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Foster K, Caswell A, James L, Jessani H, Polanco A, Viggiano M, Jennings C, Yeung HM. The risk factors, consequences, and interventions of discharge against medical advice - A narrative review. Am J Med Sci 2023; 366:16-21. [PMID: 37080431 DOI: 10.1016/j.amjms.2023.04.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Revised: 01/17/2023] [Accepted: 04/11/2023] [Indexed: 04/22/2023]
Abstract
Discharge against medical advice (DAMA) represents an increasingly burdensome public health issue that leads to worse outcomes for patients and high costs to society. While the rate of patients who DAMA is higher within certain institutions and geographic locations, the problem is present across all healthcare systems. DAMAs are often challenging as they occur suddenly and can be unsatisfactory. An opportunity exists to better meet the needs of this patient population; however, many providers are unsure of how they can prevent a DAMA. In this review, we discuss the broader impact, associated factors, the most common reasons, the consequences, and the prevention strategies for DAMA. Further research is needed to create tools for stratifying patients most likely to DAMA. Early identification and appropriate interventions for these patients will allow for safe discharges.
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Affiliation(s)
- Kaleb Foster
- Department of Medicine, Lewis Katz School of Medicine at Temple University, Philadelphia, PA United States of America
| | - Anne Caswell
- Department of Medicine, Lewis Katz School of Medicine at Temple University, Philadelphia, PA United States of America
| | - Liz James
- Department of Medicine, Lewis Katz School of Medicine at Temple University, Philadelphia, PA United States of America
| | - Hussain Jessani
- Department of Medicine, Lewis Katz School of Medicine at Temple University, Philadelphia, PA United States of America
| | - Angie Polanco
- Department of Medicine, Lewis Katz School of Medicine at Temple University, Philadelphia, PA United States of America
| | - Matthew Viggiano
- Department of Medicine, Lewis Katz School of Medicine at Temple University, Philadelphia, PA United States of America
| | - Chase Jennings
- Department of Medicine, Lewis Katz School of Medicine at Temple University, Philadelphia, PA United States of America
| | - Ho-Man Yeung
- Department of Medicine, Lewis Katz School of Medicine at Temple University, Philadelphia, PA United States of America.
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Mughal Z, Patel S, Gupta KK, Metcalfe C, Beech T, Jennings C. Evaluating the perceptions of workplace-based assessments in surgical training: a systematic review. Ann R Coll Surg Engl 2023; 105:507-512. [PMID: 36374289 PMCID: PMC10313445 DOI: 10.1308/rcsann.2022.0113] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/01/2022] [Indexed: 11/24/2023] Open
Abstract
INTRODUCTION Workplace-based assessments (WBAs) are intended to maximise learning opportunities in surgical training. There is speculation as to whether mandatory assessments in this form contribute to a tick-box culture. The objective of this review was to investigate surgical trainees' attitudes towards WBAs. METHODS This systematic review of qualitative studies was performed in accordance with the PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) statement. The literature was searched on the Medline®, Embase™, PubMed and Web of Science™ databases on 22 March 2022. RESULTS Sixteen studies were included in the review, mostly carried out on users of the Intercollegiate Surgical Curriculum Programme portfolio in the UK. Trainees felt that WBAs were educationally useful, providing opportunity for feedback, but this was overshadowed by a pressure to reach a set annual quota for WBAs and achieve high scores. Other themes included inaccurate recording of WBAs, the role of WBAs as formative or summative assessments, engagement and accessibility of trainers, and lack of time to complete WBAs. CONCLUSIONS Negative perceptions about WBAs were widespread among surgical trainees despite a recognition of their capacity to facilitate learning. This review supports the recent removal of the annual quota for WBAs in UK surgical training programmes.
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Affiliation(s)
- Z Mughal
- University Hospitals Birmingham NHS Foundation Trust, UK
| | - S Patel
- Shrewsbury and Telford Hospital NHS Foundation Trust, UK
| | - K Kumar Gupta
- University Hospitals Birmingham NHS Foundation Trust, UK
| | - C Metcalfe
- University Hospitals Birmingham NHS Foundation Trust, UK
| | - T Beech
- University Hospitals Birmingham NHS Foundation Trust, UK
| | - C Jennings
- University Hospitals Birmingham NHS Foundation Trust, UK
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3
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Jennings C, Slee A, Weekes CE. 989 IS DIET QUALITY AS IMPORTANT AS DIET QUANTITY IN THE OLDER ADULT? MICRONUTRIENT DEFICIENCY, FRAILTY AND SARCOPENIA. Age Ageing 2022. [DOI: 10.1093/ageing/afac125.003] [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: 11/14/2022] Open
Abstract
Abstract
Introduction
Dietary research in older adults has focused on energy content, macronutrient composition and diet quantity. Dietary antioxidants can theoretically ameliorate oxidative stress, which is widely implicated in age-related degeneration. Additional vital micronutrients are magnesium, being a co-factor for antioxidant enzyme function, and potassium, given its role in nerve and muscle function, and fluid balance. This study sought to investigate diet quality, specifically micronutrient content, and independent nutritional risk factors for frailty and sarcopenia.
Method
Secondary analysis of NUTRICOM 2015–2018 study participants (NIHR 19045)—exploring the impact of malnutrition on community-dwelling older adults—was conducted. Dietary intake was assessed using multiple-pass 24-hour dietary recall, nutrition risk status (NRS) using Guy’s and St Thomas’ NRS Tool, frailty using the 7-point Clinical Frailty Scale (CFS) and sarcopenia using EWGSOP2 handgrip strength cut-offs. Mann–Whitney U-Test assessed differences in dietary intake between malnutrition risk groups. Multivariable regression models, adjusting for age, gender, deprivation and comorbidities, established nutritional correlates of frailty and sarcopenia.
Results
142 participants; mean age 77.4(SD 8.4) years, 83(59%) female, mean BMI 26.05(SD 5.35). 79%–91% of older adults showed dietary deficiency in zinc, selenium, copper, magnesium and potassium. CFS increase was independently associated with NRS, and deficiency of potassium, copper and cumulative micronutrients, by 1.52, 1.19, 0.82 and 0.28 respectively (p < 0.05). Individuals with dietary zinc deficiency were 3.25 times more likely to have sarcopenia than individuals with sufficient zinc intake (95%CI: 1.04–10.16, p = 0.042).
Conclusion
Routine nutrition risk screening (accounting for macronutrient intake) finds only about 5% of older adults to be at-risk of malnutrition, whilst assessment of dietary intake in this study suggests dietary micronutrient deficiency is very common and is associated with increased frailty. 24-hour recall only provides a snapshot of dietary intake; further studies should be conducted using method that measure habitual dietary intake e.g. 7-day dietary diary.
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Affiliation(s)
| | - A Slee
- University College London
| | - C E Weekes
- Guy’s and St Thomas’ NHS Foundation Trust , London
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4
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Swan D, Enright H, Desmond R, Le G, El Hassadi E, Hennessy B, Lynott F, O'Keeffe D, Crowley M, Smyth L, Perera K, Jennings C, Ni Ainle F, Coll J, Ryan K, O'Donnell J, Lavin M, O'Connell N. Vaccine-induced thrombosis and thrombocytopenia (VITT) in Ireland: A review of cases and current practices. Thromb Update 2021; 5:100086. [PMID: 38620810 PMCID: PMC8578028 DOI: 10.1016/j.tru.2021.100086] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 10/26/2021] [Accepted: 10/27/2021] [Indexed: 11/20/2022] Open
Abstract
Since the beginning of the Severe Acute Respiratory Syndrome Coronavirus-2 (SARS CoV-2) virus pandemic, several highly effective and safe vaccines have been produced at remarkable speed. Following global implementation of vaccination programmes, cases of thrombosis with thrombocytopenia following administration of adenoviral vector-based vaccines started being reported. In this review we discuss the known pathogenesis and epidemiology of so-called vaccine induced thrombocytopenia and thrombosis (VITT). We consider the available guidelines, diagnostic laboratory tests and management options for these patients. Finally, we discuss important unanswered questions and areas for future research in this novel pathoclinical entity.
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Affiliation(s)
- D Swan
- National Coagulation Centre, St James' Hospital, Dublin, Ireland
| | - H Enright
- Tallaght University Hospital, Dublin, Ireland
| | - R Desmond
- Tallaght University Hospital, Dublin, Ireland
| | - G Le
- Tallaght University Hospital, Dublin, Ireland
| | - E El Hassadi
- Waterford University Hospital, Waterford, Ireland
| | - B Hennessy
- Waterford University Hospital, Waterford, Ireland
| | - F Lynott
- Waterford University Hospital, Waterford, Ireland
| | - D O'Keeffe
- University Hospital Limerick, Limerick, Ireland
| | - M Crowley
- Cork University Hospital, Cork, Ireland
| | - L Smyth
- St Vincent's University Hospital, Dublin, Ireland
| | - K Perera
- Midland Regional Hospital Tullamore, Tullamore, Ireland
| | - C Jennings
- Midland Regional Hospital Tullamore, Tullamore, Ireland
| | - F Ni Ainle
- Mater Misericordiae University Hospital, Dublin, Ireland
| | - J Coll
- Mater Misericordiae University Hospital, Dublin, Ireland
| | - K Ryan
- National Coagulation Centre, St James' Hospital, Dublin, Ireland
| | - J O'Donnell
- National Coagulation Centre, St James' Hospital, Dublin, Ireland
| | - M Lavin
- National Coagulation Centre, St James' Hospital, Dublin, Ireland
| | - N O'Connell
- National Coagulation Centre, St James' Hospital, Dublin, Ireland
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5
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Connolly SB, Jones JL, Jennings C, Neubeck L, Wood DA. Early results on the efficacy and acceptability of a cardiac rehabilitation programme that transitioned to a fully virtual platform with adoption of wearable technology for covid era. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.2688] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background/Introduction
Cardiaovascular prevention/rehabilitation programmes continue to reduce cardiovascular mortality even with contemporary treatment. During covid the majority of face-to-face programmes were suspended but these services have never been more crucial as control of cardiovascular risk factors can mitigate the morbidity/mortality risk from covid. Programmes must now however be delivered in a way that reduces patient exposure. Here we describe how we rapidly transitioned our previously fully face to face cardiovascular prevention/programme to a completely virtual platform adopting Fitbit as wearable technology.
Methods
The previously face-to-face initial assessment (IA) conducted by the multidisciplinary team (MDT) – nurse, dietician and physiotherapist is now delivered via video/phone as per patient preference. Patients are provided with equipment kits (tape measures, blood pressure monitors (BP), Fitbit smartwatches and Fibricheck app as required.
The virtual IA includes assessment of: Smoking habit, blood pressure (BP), heart rate, lipid profile and HbA1c (taken in community phlebotomy hub), cardioprotective medications, weight, BMI, waist circumference, Mediterranean Diet Score, functional capacity via the Duke Activity Status Index, habitual activity levels, risk stratification for exercise, hospital anxiety and depression scores (HADS) and quality of life (QOL). Patients receive education and tailored advice with SMART goals as well as a written care plan.
The subsequent 12 programme is comprised of
Results
Between April and November 2020 n=262 had a virtual IA (94% of those offered and n=114 (95% of those offered) attended an end of programme assessment. 64% were male and the mean age was 64.1 years. Acceptance of the Fitbit device was 72% of those offered. Table 1 below shows the main clinical and patient-reported outcomes in those attending both an IA and EOP with the data for the same 6 months the year prior (face to face programme) also for comparison. Programme satisfaction ratings were high with 85% rating the programme as excellent or very good.
Conclusions
Transitioning a previously fully face to face cardiac rehabilitation programme to a wholly virtual platform was feasible and acceptable to patients. Early data analysis would suggest that the virtual programme achieves similar clinical and patient reported outcomes.
Funding Acknowledgement
Type of funding sources: Public hospital(s). Main funding source(s): Funded under Transformation Funding Programme, Department of Health, Northern Ireland Table 1
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Affiliation(s)
| | - J L Jones
- Brunel University, London, United Kingdom
| | - C Jennings
- National University of Ireland Galway, Galway, Ireland
| | - L Neubeck
- Edinburgh Napier University, Edinburgh, United Kingdom
| | - D A Wood
- National University of Ireland Galway, Galway, Ireland
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6
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Kotseva K, De Backer G, De Bacquer D, Grobbee D, Hoes A, Jennings C, Maggioni A, Marques-Vidal P, Ryden L, Wood D. Poor attainment of blood pressure, lipids and diabetes targets in people at high cardiovascular risk in Europe: a report from the ESC-EORP EUROASPIRE V Survey in 16 European countries. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.2821] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
The EUROASPIRE V survey in primary care was carried out by the European Society of Cardiology, EURObservational Research Programme in 2017–2018 and investigated the risk factor management in patients at high cardiovascular (CVD) risk in16 European countries.
Purpose
To provide an audit the implementation of the 2016 Joint European Societies' guidelines on CVD prevention in people at high risk of developing CVD in primary care and to see whether the practice of preventive cardiology had improved by comparison with the previous EUROASPIRE IV survey in 2014–2015.
Methods
All patients were free of coronary or other atherosclerotic diseasebut considered at high CVD risk since they had been started on blood pressure and/or lipid and/or glucose lowering treatments. They were interviewed and examined by means of standardized methods ≥6 months after the start of therapy.
Results
2,759high CVD risk individuals (58% females), mean age 59 (SD 12) years, were interviewed and examined (participation rate 70%). The risk factor control was very poor, with less than half (47%) of patients on blood pressurelowering medication reaching the target of <140/90 mmHg (<140/85 mmHg in people with self-reported diabetes). Among treated dyslipidaemic patients only 47% attained LDL-cholesterol target of <2.6 mmol/L. Among treated type 2 diabetic patients, 65% achieved the HbA1c target of <7.0mmol/L. However, many patients on no antihypertensive or lipid-lowering medications had elevated blood pressure (43%) and elevated LDL-cholesterol (81%), respectively. The use of blood pressure lowering medication in people with hypertension was: ACE inhibitors/ARBs 79%, beta-blockers 37%, diuretics 36% and calcium channel blockers 32%; with 42% on one, 34% on two, 18% on three and 6% on ≥4 blood pressure lowering drugs. Among people on lipid-lowering medication, statins were prescribed in 97% and fibrates in 3%. Less than two-thirds of patients reported complete adherence with the intake of their blood pressure and lipid-lowering medications. The comparison with EUROASPIRE IV in the same centres that took part in both surveys showed no change in the BP management. There was a slight improvement in the control of LDL-cholesterol and glucose in patients with diabetes.
Conclusions
The results of EUROASPIRE V clearly demonstrate that the control of blood pressure, LDL-cholesterol and diabetes in patients at high CVD risk remains poor with large proportions not achieving the targets defined in the prevention guidelines. There is a considerable potential to raise the standards of preventive cardiology and to improve the management of patients at high CVD risk in Europe.
Funding Acknowledgement
Type of funding source: Other. Main funding source(s): European Society of Cardiology
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Affiliation(s)
- K Kotseva
- National Institute of Preventive Cardiology, Galway, Ireland
| | | | | | - D Grobbee
- University Medical Center Utrecht, Utrecht, Netherlands (The)
| | - A Hoes
- University Medical Center Utrecht, Utrecht, Netherlands (The)
| | - C Jennings
- National Institute of Preventive Cardiology, Galway, Ireland
| | - A Maggioni
- ANMCO Foundation For Your Heart, Florence, Italy
| | - P Marques-Vidal
- University Hospital Centre Vaudois (CHUV), Lausanne, Switzerland
| | - L Ryden
- Karolinska Institute, Department of Medicine, Cardiology Unit, Stockholm, Sweden
| | - D Wood
- National Institute of Preventive Cardiology, Galway, Ireland
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McGuire HD, Jennings C, Melvin M, Duggan M. Extraconal orbital emphysema secondary to barotrauma in a ventilated patient with COVID-19. Anaesth Rep 2020; 8:111-112. [PMID: 32904584 DOI: 10.1002/anr3.12061] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/01/2020] [Indexed: 01/19/2023] Open
Affiliation(s)
- H D McGuire
- Department of Anaesthesia Mayo University Hospital Saolta Group Mayo Ireland
| | - C Jennings
- Department of Anaesthesia Mayo University Hospital Saolta Group Mayo Ireland
| | - M Melvin
- Department of Anaesthesia Mayo University Hospital Saolta Group Mayo Ireland
| | - M Duggan
- Department of Anaesthesia Mayo University Hospital Saolta Group Mayo Ireland
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Elisofon SA, Magee JC, Ng VL, Horslen SP, Fioravanti V, Economides J, Erinjeri J, Anand R, Mazariegos GV, Martin A, Mannino D, Flynn L, Mohammad S, Alonso E, Superina R, Brandt K, Riordan M, Lokar J, Ito J, Elisofon S, Zapata L, Jain A, Foristal E, Gupta N, Whitlow C, Naik K, Espinosa H, Miethke A, Hawkins A, Hardy J, Engels E, Schreibeis A, Ovchinsky N, Kogan‐Liberman D, Cunningham R, Malik P, Sundaram S, Feldman A, Garcia B, Yanni G, Kohli R, Emamaullee J, Secules C, Magee J, Lopez J, Bilhartz J, Hollenbeck J, Shaw B, Bartow C, Forest S, Rand E, Byrne A, Linguiti I, Wann L, Seidman C, Mazariegos G, Soltys K, Squires J, Kepler A, Vitola B, Telega G, Lerret S, Desai D, Moghe J, Cutright L, Daniel J, Andrews W, Fioravanti V, Slowik V, Cisneros R, Faseler M, Hufferd M, Kelly B, Sudan D, Mavis A, Moats L, Swan‐Nesbit S, Yazigi N, Buranych A, Hobby A, Rao G, Maccaby B, Gopalareddy V, Boulware M, Ibrahim S, El Youssef M, Furuya K, Schatz A, Weckwerth J, Lovejoy C, Kasi N, Nadig S, Law M, Arnon R, Chu J, Bucuvalas J, Czurda M, Secheli B, Almy C, Haydel B, Lobritto S, Emand J, Biney‐Amissah E, Gamino D, Gomez A, Himes R, Seal J, Stewart S, Bergeron J, Truxillo A, Lebel S, Davidson H, Book L, Ramstack D, Riley A, Jennings C, Horslen S, Hsu E, Wallace K, Turmelle Y, Nadler M, Postma S, Miloh T, Economides J, Timmons K, Ng V, Subramonian A, Dharmaraj B, McDiarmid S, Feist S, Rhee S, Perito E, Gallagher L, Smith K, Ebel N, Zerofsky M, Nogueira J, Greer R, Gilmour S, Robert C, Cars C, Azzam R, Boone P, Garbarino N, Lalonde M, Kerkar N, Dokus K, Helbig K, Grizzanti M, Tomiyama K, Cocking J, Alexopoulos S, Bhave C, Schillo R, Bailey A, Dulek D, Ramsey L, Ekong U, Valentino P, Hettiarachchi D, Tomlin R. Society of pediatric liver transplantation: Current registry status 2011-2018. Pediatr Transplant 2020; 24:e13605. [PMID: 31680409 DOI: 10.1111/petr.13605] [Citation(s) in RCA: 62] [Impact Index Per Article: 15.5] [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: 05/31/2019] [Revised: 08/08/2019] [Accepted: 09/27/2019] [Indexed: 11/29/2022]
Abstract
BACKGROUND SPLIT was founded in 1995 in order to collect comprehensive prospective data on pediatric liver transplantation, including waiting list data, transplant, and early and late outcomes. Since 2011, data collection of the current registry has been refined to focus on prospective data and outcomes only after transplant to serve as a foundation for the future development of targeted clinical studies. OBJECTIVE To report the outcomes of the SPLIT registry from 2011 to 2018. METHODS This is a multicenter, cross-sectional analysis characterizing patients transplanted and enrolled in the SPLIT registry between 2011 and 2018. All patients, <18 years of age, received a first liver-only, a combined liver-kidney, or a combined liver-pancreas transplant during this study period. RESULTS A total of 1911 recipients from 39 participating centers in North America were registered. Indications included biliary atresia (38.5%), metabolic disease (19.1%), tumors (11.7%), and fulminant liver failure (11.5%). Greater than 50% of recipients were transplanted as either Status 1A/1B or with a MELD/PELD exception score. Incompatible transplants were performed in 4.1%. Kaplan-Meier estimates of 1-year patient and graft survival were 97.3% and 96.6%. First 30 days of surgical complications included reoperation (31.7%), hepatic artery thrombosis (6.3%), and portal vein thrombosis (3.2%). In the first 90 days, biliary tract complications were reported in 13.6%. Acute cellular rejection during first year was 34.7%. At 1 and 2 years of follow-up, 39.2% and 50.6% had normal liver tests on monotherapy (tacrolimus or sirolimus). Further surgical, survival, allograft function, and complications are detailed.
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Affiliation(s)
- Scott A Elisofon
- Division of Gastroenterology, Hepatology and Nutrition, Boston Children's Hospital, Boston, Massachusetts
| | - John C Magee
- Division of Surgery, University of Michigan Transplant Center, Ann Arbor, Michigan
| | - Vicky L Ng
- Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Transplant and Regenerative Medicine Center, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
| | - Simon P Horslen
- Department of Pediatrics, Seattle Children's Hospital, University of Washington School of Medicine, Seattle, Washington
| | - Vicki Fioravanti
- Section of Hepatology and Liver Transplantation, Children's Mercy Hospital, Kansas City, Missouri
| | | | | | | | - George V Mazariegos
- Division of Pediatric Transplant Surgery, Hillman Center for Pediatric Transplantation, UPMC Children's Hospital of Pittsburgh, Pittsburgh, PA, USA
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Kotseva K, De Backer G, De Bacquer D, Grobbee D, Hoes A, Jennings C, Maggioni A, Marques-Vidal P, Ryden L, Wood D. P3424Gender differences in the implementation of CVD prevention In patients with coronary disease: Results from the EUROASPIRE V Survey. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0298] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
EUROASPIRE V was a cross-sectional survey carried out by the European Society of Cardiology, EURObservational Research Programme in 2016–2017 in 27 European countries
Purpose
To describe gender differences in lifestyle and risk factor management, and the use of cardioprotective drug therapies in patients with coronary heart disease in Europe.
Methods
Patients <80 years with coronary disease (CABG, PCI or an acute coronary syndrome) were identified from the hospital medical records and interviewed and examined by trained staff ≥6 months and ≤2 years later using standardized methods including central laboratory measurements.
Results
A total of 8,261 (25.8% females), mean age 63.6 (SD 9.6) were interviewed, with a median time between the index event and interview 1.12 years (IR 0.82–1.56). Women were older (mean age 65.4 years [SD 9.2] vs 63.0 [9.7] and had a lower level of education than men.Comparing women with men, the prevalence of the risk factors were as follows: current smoking 12.8% vs 20.7%,obesity (BMI ≥30 kg/m2) 45.7% vs 34.9%, central obesity (waist circumference ≥102 cm in men or ≥88 cm in women) 78.0% vs 51.8%, raised blood pressure (BP ≥140/90 mmHg, ≥140/80 mmHg in patients with diabetes) 47.1% vs 46.0%, elevated LDL-cholesterol (≥1.8 mmol/l) 77.9% vs 68.5% and self reported diabetes 33.1% vs 28.0%. Reported use of prophylactic drug therapies for the same comparison was: antiplatelets 91.8% vs. 92.8%; beta-blockers 81.8% vs. 80.8%; ACE inhibitors/ARBs 75.0% vs. 75.3%; and statins 76.8% vs. 82.2%. The therapeutic control of blood pressure, LDL-cholesterol and diabetes (HbA1c <7 mmol/L) was: 48.2% vs 49.9%; 25.7% vs 34.1% and 48.5% vs 56.7%, respectively.
Conclusions
The results show that women with coronary disease have higher prevalence of obesity, central obesity, elevated LDL-cholesterol and self-reported diabetes than men. There were no differences in terms of blood pressure management. All coronary patients require professional support to make lifestyle changes and manage risk factors more effectivelyin order to reduce their risk of recurrent cardiovascular events.
Acknowledgement/Funding
ESC-EORP supported by Amgen, Eli Lilly, Pfizer, Sanofi, Ferrer and Novo Nordisk
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Affiliation(s)
- K Kotseva
- Imperial College London, UK, London, United Kingdom
| | | | | | - D Grobbee
- University Medical Center Utrecht, Utrecht, Netherlands (The)
| | - A Hoes
- University Medical Center Utrecht, Utrecht, Netherlands (The)
| | - C Jennings
- Imperial College London, UK, London, United Kingdom
| | - A Maggioni
- ANMCO Foundation For Your Heart, Florence, Italy
| | - P Marques-Vidal
- University Hospital Centre Vaudois (CHUV), Lausanne, Switzerland
| | - L Ryden
- Karolinska Institute, Department of Medicine, Cardiology Unit, Stockholm, Sweden
| | - D Wood
- National Institute of Preventive Cardiology, Galway, Ireland
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10
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Patterson E, Jennings C, Mazzacano A, Naidoo S. Barriers and facilitators to integrating a lifestyle intervention into primary health care settings in Country SA. J Sci Med Sport 2019. [DOI: 10.1016/j.jsams.2019.08.130] [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]
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Koh C, Melling CV, Jennings C, Lewis M, Goyal A. Efficacy of electromotive drug administration in delivering botulinum toxin a in children with neuropathic detrusor overactivity-outcomes of a pilot study. J Pediatr Urol 2019; 15:552.e1-552.e8. [PMID: 31326328 DOI: 10.1016/j.jpurol.2019.05.028] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2019] [Accepted: 05/29/2019] [Indexed: 10/26/2022]
Abstract
BACKGROUND Intravesical botulinum toxin A (BtA) injection is well established in managing paediatric neuropathic detrusor overactivity (NDO). Electromotive drug administration (EMDA) is a less invasive method, which can be performed in the clinic, using pulsed electrical current for drug delivery via a urethral catheter. Few small studies report good outcomes following BtA via EMDA (BtA/EMDA) into bladders of children with NDO. OBJECTIVE The objective of this study is to assess the efficacy of BtA/EMDA in children with NDO, reduced bladder capacity and compliance. METHODS Twelve children with NDO on baseline urodynamic study were prospectively included. Pre-BtA/EMDA and post-BtA/EMDA results compared the following four parameters: maximal cystometric capacity, bladder compliance, maximal detrusor pressure (pDetmax) during detrusor overactivity and pDetmax at capacity. The Wilcoxon matched-pairs signed-rank test using Graphpad Prism 8 was used for analysis. Secondary outcomes include adverse effects and symptomatic improvement. RESULTS Fourteen episodes of BtA/EMDA were performed. Five patients received 3.3 IU/kg of Botox®, and five received 10 IU/kg (maximum 300 IU). Four patients received 10 IU/kg of Dysport®. Two patients in the Dysport®/EMDA group also received Botox®/EMDA more than six months previously. Thirteen of 14 post-EMDA results were completed and included in the paired analysis. No statistically significant improvements in any cystometric parameters were demonstrated. Eight patients subsequently had intravesical BtA injections with significant improvements in both cystometric parameters and symptoms. Two patients subsequently transitioned to adult services; one was commenced on mirabegron, and one has undergone ileocystoplasty with Mitrofanoff appendicovesicostomy. DISCUSSION Despite some evidence to support BtA/EMDA in children with NDO, the authors were unable to replicate previously published positive cystometric and symptomatic outcomes. In addition, BtA/EMDA performed poorly when compared with conventional intravesical BtA injections. This implies failure of EMDA to deliver BtA correctly to the target tissue. The large size of the BtA molecule or the abnormal bladder wall in NDO could account for the negative results. Thorough preparation and consultation was undertaken before this study with BtA/EMDA, and it is discouraging that the authors were unable to reproduce the positive results of other groups. CONCLUSIONS Although safe and acceptable to most patients, the authors cannot recommend the use of BtA/EMDA for NDO in children at present.
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Affiliation(s)
- C Koh
- Department of Paediatric Urology, Royal Manchester Children's Hospital, Manchester, M13 9WL, UK.
| | - C V Melling
- Department of Paediatric Urology, Royal Manchester Children's Hospital, Manchester, M13 9WL, UK
| | - C Jennings
- Department of Paediatric Urology, Royal Manchester Children's Hospital, Manchester, M13 9WL, UK
| | - M Lewis
- Department of Paediatric Nephrology, Royal Manchester Children's Hospital, Manchester, M13 9WL, UK
| | - A Goyal
- Department of Paediatric Urology, Royal Manchester Children's Hospital, Manchester, M13 9WL, UK
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Jennings C, Patterson E, Mazzacano A, Naidoo S. Multi-site implementation and initial uptake of a physical activity and nutrition program in Country SA. J Sci Med Sport 2019. [DOI: 10.1016/j.jsams.2019.08.202] [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]
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De Backer G, Jankowski P, Kotseva K, Mirrakhimov E, Reiner Ž, Rydén L, Tokgözoğlu L, Wood D, De Bacquer D, De Backer G, Jankowski P, Kotseva K, Mirrakhimov E, Reiner Z, Rydén L, Tokgözoğlu L, Wood D, De Bacquer D, Kotseva K, De Backer G, Abreu A, Aguiar C, Badariene J, Bruthans J, Castro Conde A, Cifkova R, Crowley J, Davletov K, Bacquer DD, De Smedt D, De Sutter J, Deckers J, Dilic M, Dolzhenko M, Druais H, Dzerve V, Erglis A, Fras Z, Gaita D, Gotcheva N, Grobbee D, Gyberg V, Hasan Ali H, Heuschmann P, Hoes A, Jankowski P, Lalic N, Lehto S, Lovic D, Maggioni A, Mancas S, Marques-Vidal P, Mellbin L, Miličić D, Mirrakhimov E, Oganov R, Pogosova N, Reiner Ž, Rydén L, Stagmo M, Störk S, Sundvall J, Tokgözoğlu L, Tsioufis K, Vulic D, Wood D, Wood D, Kotseva K, Jennings C, Adamska A, Adamska S, Rydén L, Mellbin L, Tuomilehto J, Schnell O, Druais H, Fiorucci E, Glemot M, Larras F, Missiamenou V, Maggioni A, Taylor C, Ferreira T, Lemaitre K, Bacquer DD, De Backer G, Raman L, Sundvall J, DeSmedt D, De Sutter J, Willems A, De Pauw M, Vervaet P, Bollen J, Dekimpe E, Mommen N, Van Genechten G, Dendale P, Bouvier C, Chenu P, Huyberechts D, Persu A, Dilic M, Begic A, Durak Nalbantic A, Dzubur A, Hadzibegic N, Iglica A, Kapidjic S, Osmanagic Bico A, Resic N, Sabanovic Bajramovic N, Zvizdic F, Vulic D, Kovacevic-Preradovic T, Popovic-Pejicic S, Djekic D, Gnjatic T, Knezevic T, Kovacevic-Preradovic T, Kos L, Popovic-Pejicic S, Stanetic B, Topic G, Gotcheva N, Georgiev B, Terziev A, Vladimirov G, Angelov A, Kanazirev B, Nikolaeva S, Tonkova D, Vetkova M, Milicic D, Reiner Ž, Bosnic A, Dubravcic M, Glavina M, Mance M, Pavasovic S, Samardzic J, Batinic T, Crljenko K, Delic-Brkljacic D, Dula K, Golubic K, Klobucar I, Kordic K, Kos N, Nedic M, Olujic D, Sedinic V, Blazevic T, Pasalic A, Percic M, Sikic J, Bruthans J, Cífková R, Hašplová K, Šulc P, Wohlfahrt P, Mayer O, Cvíčela M, Filipovský J, Gelžinský J, Hronová M, Hasan-Ali H, Bakery S, Mosad E, Hamed H, Ibrahim A, Elsharef M, Kholef E, Shehata A, Youssef M, Elhefny E, Farid H, Moustafa T, Sobieh M, Kabil H, Abdelmordy A, Lehto S, Kiljander E, Kiljander P, Koukkunen H, Mustonen J, Cremer C, Frantz S, Haupt A, Hofmann U, Ludwig K, Melnyk H, Noutsias M, Karmann W, Prondzinsky R, Herdeg C, Hövelborn T, Daaboul A, Geisler T, Keller T, Sauerbrunn D, Walz-Ayed M, Ertl G, Leyh R, Störk S, Heuschmann P, Ehlert T, Klocke B, Krapp J, Ludwig T, Käs J, Starke C, Ungethüm K, Wagner M, Wiedmann S, Tsioufis K, Tolis P, Vogiatzi G, Sanidas E, Tsakalis K, Kanakakis J, Koutsoukis A, Vasileiadis K, Zarifis J, Karvounis C, Crowley J, Gibson I, Houlihan A, Kelly C, O'Donnell M, Bennati M, Cosmi F, Mariottoni B, Morganti M, Cherubini A, Di Lenarda A, Radini D, Ramani F, Francese M, Gulizia M, Pericone D, Davletov K, Aigerim K, Zholdin B, Amirov B, Assembekov B, Chernokurova E, Ibragimova F, Kodasbayev A, Markova A, Mirrakhimov E, Asanbaev A, Toktomamatov U, Tursunbaev M, Zakirov U, Abilova S, Arapova R, Bektasheva E, Esenbekova J, Neronova K, Asanbaev A, Baigaziev K, Toktomamatov U, Zakirov U, Baitova G, Zheenbekov T, Erglis A, Andrejeva T, Bajare I, Kucika G, Labuce A, Putane L, Stabulniece M, Dzerve V, Klavins E, Sime I, Badariene J, Gedvilaite L, Pečiuraite D, Sileikienė V, Skiauteryte E, Solovjova S, Sidabraite R, Briedis K, Ceponiene I, Jurenas M, Kersulis J, Martinkute G, Vaitiekiene A, Vasiljevaite K, Veisaite R, Plisienė J, Šiurkaitė V, Vaičiulis Ž, Jankowski P, Czarnecka D, Kozieł P, Podolec P, Nessler J, Gomuła P, Mirek-Bryniarska E, Bogacki P, Wiśniewski A, Pająk A, Wolfshaut-Wolak R, Bućko J, Kamiński K, Łapińska M, Paniczko M, Raczkowski A, Sawicka E, Stachurska Z, Szpakowicz M, Musiał W, Dobrzycki S, Bychowski J, Kosior D, Krzykwa A, Setny M, Kosior D, Rak A, Gąsior Z, Haberka M, Gąsior Z, Haberka M, Szostak-Janiak K, Finik M, Liszka J, Botelho A, Cachulo M, Sousa J, Pais A, Aguiar C, Durazzo A, Matos D, Gouveia R, Rodrigues G, Strong C, Guerreiro R, Aguiar J, Abreu A, Cruz M, Daniel P, Morais L, Moreira R, Rosa S, Rodrigues I, Selas M, Gaita D, Mancas S, Apostu A, Cosor O, Gaita L, Giurgiu L, Hudrea C, Maximov D, Moldovan B, Mosteoru S, Pleava R, Ionescu M, Parepa I, Pogosova N, Arutyunov A, Ausheva A, Isakova S, Karpova A, Salbieva A, Sokolova O, Vasilevsky A, Pozdnyakov Y, Antropova O, Borisova L, Osipova I, Lovic D, Aleksic M, Crnokrak B, Djokic J, Hinic S, Vukasin T, Zdravkovic M, Lalic N, Jotic A, Lalic K, Lukic L, Milicic T, Macesic M, Stanarcic Gajovic J, Stoiljkovic M, Djordjevic D, Kostic S, Tasic I, Vukovic A, Fras Z, Jug B, Juhant A, Krt A, Kugonjič U, Chipayo Gonzales D, Gómez Barrado J, Kounka Z, Marcos Gómez G, Mogollón Jiménez M, Ortiz Cortés C, Perez Espejo P, Porras Ramos Y, Colman R, Delgado J, Otero E, Pérez A, Fernández-Olmo M, Torres-LLergo J, Vasco C, Barreñada E, Botas J, Campuzano R, González Y, Rodrigo M, de Pablo C, Velasco E, Hernández S, Lozano C, González P, Castro A, Dalmau R, Hernández D, Irazusta F, Vélez A, Vindel C, Gómez-Doblas J, García Ruíz V, Gómez L, Gómez García M, Jiménez-Navarro M, Molina Ramos A, Marzal D, Martínez G, Lavado R, Vidal A, Rydén L, Boström-Nilsson V, Kjellström B, Shahim B, Smetana S, Hansen O, Stensgaard-Nake E, Deckers J, Klijn A, Mangus T, Peters R, Scholte op Reimer W, Snaterse M, Aydoğdu S, Ç Erol, Otürk S, Tulunay Kaya C, Ahmetoğlu Y, Ergene O, Akdeniz B, Çırgamış D, Akkoyun H Kültürsay S, Kayıkçıoğlu M, Çatakoğlu A, Çengel A, Koçak A, Ağırbaşlı M, Açıksarı G, Çekin M, Tokgözoğlu L, Kaya E, Koçyiğit D, Öngen Z, Özmen E, Sansoy V, Kaya A, Oktay V, Temizhan A, Ünal S, İ Yakut, Kalkan A, Bozkurt E, Kasapkara H, Dolzhenko M, Faradzh C, Hrubyak L, Konoplianyk L, Kozhuharyova N, Lobach L, Nesukai V, Nudchenko O, Simagina T, Yakovenko L, Azarenko V, Potabashny V, Bazylevych A, Bazylevych M, Kaminska K, Panchenko L, Shershnyova O, Ovrakh T, Serik S, Kolesnik T, Kosova H, Wood D, Adamska A, Adamska S, Jennings C, Kotseva K, Hoye P Atkin A, Fellowes D, Lindsay S, Atkinson C, Kranilla C, Vinod M, Beerachee Y, Bennett C, Broome M, Bwalya A, Caygill L, Dinning L, Gillespie A, Goodfellow R, Guy J, Idress T, Mills C, Morgan C, Oustance N, Singh N, Yare M, Jagoda J, Bowyer H, Christenssen V, Groves A, Jan A, Riaz A, Gill M, Sewell T, Gorog D, Baker M, De Sousa P, Mazenenga T, Porter J, Haines F, Peachey T, Taaffe J, Wells K, Ripley D, Forward H, McKie H, Pick S, Thomas H, Batin P, Exley D, Rank T, Wright J, Kardos A, Sutherland SB, Wren L, Leeson P, Barker D, Moreby B, Sawyer J, Stirrup J, Brunton M, Brodison A, Craig J, Peters S, Kaprielian R, Bucaj A, Mahay K, Oblak M, Gale C, Pye M, McGill Y, Redfearn H, Fearnley M. Management of dyslipidaemia in patients with coronary heart disease: Results from the ESC-EORP EUROASPIRE V survey in 27 countries. Atherosclerosis 2019; 285:135-146. [DOI: 10.1016/j.atherosclerosis.2019.03.014] [Citation(s) in RCA: 101] [Impact Index Per Article: 20.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2019] [Revised: 02/22/2019] [Accepted: 03/19/2019] [Indexed: 12/16/2022]
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Kotseva K, De Backer G, De Bacquer D, Grobbee D, Hoes A, Jennings C, Maggioni A, Marques-Vidal P, Rydén L, Wood D. PO469 Blood Pressure, Lipids and Diabetes Management In Patients With Coronary Heart Disease Across Europe: Results of Euroaspire V Survey. Glob Heart 2018. [DOI: 10.1016/j.gheart.2018.09.358] [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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Sreedevi A, Mazumdar A, Olando Y, Sun MC, Jennings C, Gray H, Tibazarwa K, Zatonska K, PK R, Kithinji J, Mbuthia J. PO395 Patients’ Perspectives on Tobacco Cessation Services in India: A Qualitative Study. Glob Heart 2018. [DOI: 10.1016/j.gheart.2018.09.305] [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: 10/28/2022] Open
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Olando Y, Majumdar A, Sreedevi A, Chan Sun M, Jennings C, Gray H, Zatonska K, Tibazarwa K, PK R, Kithinji J, Mbuthia J. PO563 Patients Experiences In Kenya In Quitting Tobacco Use. Glob Heart 2018. [DOI: 10.1016/j.gheart.2018.09.432] [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: 10/28/2022] Open
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Snaterse M, Deckers JW, Lenzen MJ, Jorstad HT, De Bacquer D, Peters RJG, Jennings C, Kotseva K, Scholte Op Reimer WJM. Smoking cessation in European patients with coronary heart disease. Results from the EUROASPIRE IV survey: A registry from the European Society of Cardiology. Int J Cardiol 2018; 258:1-6. [PMID: 29544918 DOI: 10.1016/j.ijcard.2018.01.064] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [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: 10/10/2017] [Revised: 01/08/2018] [Accepted: 01/15/2018] [Indexed: 01/17/2023]
Abstract
OBJECTIVE We investigated smoking cessation rates in coronary heart disease (CHD) patients throughout Europe; current and as compared to earlier EUROASPIRE surveys, and we studied characteristics of successful quitters. METHODS Analyses were done on 7998 patients from the EUROASPIRE-IV survey admitted for myocardial infarction, unstable angina and coronary revascularisation. Self-reported smoking status was validated by measuring carbon monoxide in exhaled air. RESULTS Thirty-one percent of the patients reported being a smoker in the month preceding hospital admission for the recruiting event, varying from 15% in centres from Finland to 57% from centres in Cyprus. Smoking rates at the interview were also highly variable, ranging from 7% to 28%. The proportion of successful quitters was relatively low in centres with a low number of pre- event smokers. Overall, successful smoking cessation was associated with increasing age (OR 1.50; 95% CI 1.09-2.06) and higher levels of education (OR 1.38; 95% CI 1.08-1.75). Successful quitters more frequently reported that they had been advised (56% vs. 47%, p < .001) and to attend (81% vs. 75%, p < .01) a cardiac rehabilitation programme. CONCLUSION Our study shows wide variation in cessation rates in a large contemporary European survey of CHD patients. Therefore, smoking cessation rates in patients with a CHD event should be interpreted in the light of pre-event smoking prevalence, and caution is needed when comparing cessation rates across Europe. Furthermore, we found that successful quitters reported more actions to make healthy lifestyle changes, including participating in a cardiac rehabilitation programme, as compared with persistent smokers.
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Affiliation(s)
- M Snaterse
- ACHIEVE Centre of Applied Research, Faculty of Health, Amsterdam University of Applied Sciences, Amsterdam, the Netherlands.
| | - J W Deckers
- Department of Cardiology, Thoraxcenter, Erasmus Medical Centre, Rotterdam, the Netherlands
| | - M J Lenzen
- Department of Cardiology, Thoraxcenter, Erasmus Medical Centre, Rotterdam, the Netherlands
| | - H T Jorstad
- Department of Cardiology, Academic Medical Centre, Amsterdam, the Netherlands
| | - D De Bacquer
- Department of Public Health, Ghent University, Belgium
| | - R J G Peters
- Department of Cardiology, Academic Medical Centre, Amsterdam, the Netherlands
| | - C Jennings
- National Heart and Lung Institute, Imperial College, London, UK
| | - K Kotseva
- Department of Public Health, Ghent University, Belgium; National Heart and Lung Institute, Imperial College, London, UK
| | - W J M Scholte Op Reimer
- ACHIEVE Centre of Applied Research, Faculty of Health, Amsterdam University of Applied Sciences, Amsterdam, the Netherlands; Department of Cardiology, Academic Medical Centre, Amsterdam, the Netherlands
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Keating S, Stone M, Deng X, Mellors J, Bakkour S, Richman D, Gorelick R, Lifson J, Jennings C, Stengelin M, Wu G, Howell B, Bacchetti P, Busch M. Blinded evaluation of ultrasensitive assays of HIV in plasma. J Virus Erad 2017. [DOI: 10.1016/s2055-6640(20)30625-7] [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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Connolly SB, Kotseva K, Jennings C, Atrey A, Jones J, Brown A, Bassett P, Wood DA. Outcomes of an integrated community-based nurse-led cardiovascular disease prevention programme. Heart 2017; 103:840-847. [PMID: 28255098 PMCID: PMC5566096 DOI: 10.1136/heartjnl-2016-310477] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2016] [Revised: 12/15/2016] [Accepted: 12/15/2016] [Indexed: 11/05/2022] Open
Abstract
Background National guidance for England recommends that cardiovascular disease (CVD) should be managed as a family of diseases in the community. Here, we describe the results of such an approach. Methods Patients with established CVD or who were at high multifactorial risk (HRI) underwent a 12-week community-based nurse-led prevention programme (MyAction) that included lifestyle and risk factor management, prescription of medication and weekly exercise and education sessions. Results Over a 6-year period, 3232 patients attended an initial assessment; 63% were male, and 48% belonged to black and minority ethnic groups. 56% attended an end-of-programme assessment, and 33% attended a one year assessment. By the end of the programme, there was a significant reduction in smoking prevalence but only in HRI (−3.7%, p<0.001). Mediterranean diet score increased in both CVD (+1.2, p<0.001) and HRI (+1.5; p<0.001), as did fitness levels (CVD +0.8 estimated Mets maximum, p<0.001, HRI +0.9 estimated Mets maximum, p<0.001) and the proportions achieving their physical activity targets (CVD +40%, p<0.001, HRI +37%, p<0.001). There were significant increases in proportions achieving their blood pressure (CVD +15.4%, p<0.001, HRI +25%, p<0.001 and low-density lipoprotein cholesterol targets (CVD +6%, p=0.004, HRI +23%, p<0.001). Statins and antihypertensive medications significantly increased in HRI. Significant improvements in depression scores and quality-of-life measures were also seen. The majority of improvements were maintained at 1 year. Conclusion These results demonstrate that an integrated vascular prevention programme is feasible in practice and reduces cardiovascular risk in patients with established CVD and in those at high multifactorial risk.
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Affiliation(s)
- S B Connolly
- Department of Cardiovascular Medicine, National Heart and Lung Institute, Imperial College London, London, UK
| | - K Kotseva
- Department of Cardiovascular Medicine, National Heart and Lung Institute, Imperial College London, London, UK
| | - C Jennings
- Department of Cardiovascular Medicine, National Heart and Lung Institute, Imperial College London, London, UK
| | - A Atrey
- Department of Cardiovascular Medicine, National Heart and Lung Institute, Imperial College London, London, UK
| | - J Jones
- Department of Cardiovascular Medicine, National Heart and Lung Institute, Imperial College London, London, UK.,College of Health and Life Sciences, Brunel University, London, UK
| | - A Brown
- Public Health England, Fleetbank House, London, UK
| | - P Bassett
- Department of Cardiovascular Medicine, National Heart and Lung Institute, Imperial College London, London, UK
| | - D A Wood
- Department of Cardiovascular Medicine, National Heart and Lung Institute, Imperial College London, London, UK
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Kotseva K, Jennings C, De Bacquer D, De Backer G, Gyberg V, Ryden L, Wood D. PT203 Blood Pressure, Lipids and Diabetes Management in People at High Cardiovascular Risk Across Europe: Results of EUROASPIRE IV Survey. Glob Heart 2016. [DOI: 10.1016/j.gheart.2016.03.555] [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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Alley S, Jennings C, Plotnikoff R, Vandelanotte C. An evaluation of web- and print-based methods to attract people to a physical activity intervention. J Sci Med Sport 2015. [DOI: 10.1016/j.jsams.2015.12.196] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [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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Alley S, Jennings C, Duncan M, Schoeppe S, Gurtler D, Vandelanotte C. Attitudes, intentions and preferences for using physical activity tracking devices. J Sci Med Sport 2015. [DOI: 10.1016/j.jsams.2015.12.482] [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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Pfau T, Jennings C, Mitchell H, Olsen E, Walker A, Egenvall A, Tröster S, Weller R, Rhodin M. Lungeing on hard and soft surfaces: Movement symmetry of trotting horses considered sound by their owners. Equine Vet J 2014; 48:83-9. [PMID: 25297461 DOI: 10.1111/evj.12374] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2014] [Accepted: 09/30/2014] [Indexed: 11/30/2022]
Abstract
REASONS FOR PERFORMING STUDY Lungeing is often part of the clinical lameness examination. The difference in movement symmetry, which is a commonly employed lameness measure, has not been quantified between surfaces. OBJECTIVES To compare head and pelvic movement symmetry between surfaces and reins during lungeing. STUDY DESIGN Quantitative gait analysis in 23 horses considered sound by their owners. METHODS Twenty-three horses were assessed in-hand and on the lunge on both reins on hard and soft surfaces with inertial sensors. Seven movement symmetry parameters were quantified and used to establish 2 groups, namely symmetrical (n = 9) and forelimb-lame horses (n = 14), based on values from straight-line assessment. Movement symmetry values for left rein measurements were side corrected to allow comparison of the amount of movement symmetry between reins. A mixed model (P<0.05) was used to study effects on movement symmetry of surface (hard/soft) and rein (inside/outside with respect to movement symmetry on the straight). RESULTS In forelimb-lame horses, surface and rein were identified as significantly affecting all head movement symmetry measures (rein, all P<0.0001; surface, all P<0.042). In the symmetrical group, no significant influence of surface or rein was identified for head movement symmetry (rein, all P>0.245; surface, all P>0.073). No significant influence of surface or rein was identified for any of the pelvic movement symmetry measures in either group. CONCLUSIONS While more symmetrical horses showed a consistent amount of movement symmetry across surfaces/reins, horses objectively quantified as lame on the straight showed decreased movement symmetry during lungeing, in particular with the lame limb on the inside of a hard circle. The variation within group questions straight-line movement symmetry as a sole measure of lameness without quantification of movement symmetry on the lunge, ideally on hard and soft surfaces to evaluate differences between reins and surfaces. In future, thresholds for lungeing need to be determined using simultaneous visual and objective assessment.
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Affiliation(s)
- T Pfau
- Department of Clinical Science and Services, The Royal Veterinary College, University of London, Hatfield, UK
| | - C Jennings
- Department of Clinical Science and Services, The Royal Veterinary College, University of London, Hatfield, UK
| | - H Mitchell
- Department of Clinical Science and Services, The Royal Veterinary College, University of London, Hatfield, UK
| | - E Olsen
- Department of Clinical Science and Services, The Royal Veterinary College, University of London, Hatfield, UK.,Department of Large Animal Sciences, Faculty of Health and Medical Science, University of Copenhagen, Taastrup, Denmark
| | - A Walker
- Equine Studies, Moulton College, Moulton, UK
| | - A Egenvall
- Department of Clinical Sciences, Swedish University of Agricultural Sciences, Uppsala, Sweden
| | - S Tröster
- Department of Clinical Science and Services, The Royal Veterinary College, University of London, Hatfield, UK
| | - R Weller
- Department of Clinical Science and Services, The Royal Veterinary College, University of London, Hatfield, UK
| | - M Rhodin
- Department of Clinical Sciences, Swedish University of Agricultural Sciences, Uppsala, Sweden
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O'Hara J, Simo R, McQueen A, Andi K, Lester S, Giddings C, Repanos C, Moor J, Kelly C, Jennings C, Wilson J, Paleri V. Management of metastatic neck disease--summary of the 11th Evidence Based Management Day. Clin Otolaryngol 2014; 39:3-5. [PMID: 24575924 DOI: 10.1111/coa.12218] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/14/2014] [Indexed: 02/05/2023]
Affiliation(s)
- J O'Hara
- Sunderland Royal Hospital, Sunderland and Newcastle University, Newcastle-upon-Tyne, UK
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MacLeod D, Eastwood K, Struthers C, Jennings C, Rodger N. USING THE TEACH-BACK METHOD TO EVALUATE HF PATIENT EDUCATION: DOES IT WORK? Can J Cardiol 2014. [DOI: 10.1016/j.cjca.2014.07.723] [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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Parmar S, Al Asaadi Z, Martin T, Jennings C, Pracy P. The anterolateral fasciocutaneous thigh flap for circumferential pharyngeal defects--can it really replace the jejunum? Br J Oral Maxillofac Surg 2014; 52:247-50. [PMID: 24462124 DOI: 10.1016/j.bjoms.2013.12.008] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [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: 01/09/2013] [Accepted: 12/10/2013] [Indexed: 11/27/2022]
Abstract
Free jejunal transfer has been used in pharyngeal reconstruction for many years, but many have criticised it as being unreliable, poorly tolerant of radiotherapy, and susceptible to stenosis and dysphagia. Recently, the trend has been to use the anterolateral thigh (ALT) flap to overcome these problems, and many authors have reported good results. At the University of Birmingham we used the jejunal free flap for pharyngeal reconstruction for many years, but in view of recent reports we changed to the ALT flap. We retrospectively analysed all patients who had pharyngeal reconstruction with an ALT flap in our unit since changing from the jejunal flap. Only circumferential defects were included. Six patients had pharyngeal resection and required reconstruction of a circumferential defect between 2007 and 2010. All the defects were reconstructed with a tubed ALT flap. No flaps failed and there was no partial necrosis. However, stricturing still occurred and the diet of many patients was restricted. Three patients required the flap to be replaced with a jejunal free flap. Although no flaps failed, we have not been able to replicate the results of other surgeons and have therefore abandoned use of the ALT flap and returned to use of the jejunal free flap for the reconstruction of circumferential pharyngeal defects.
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Affiliation(s)
- S Parmar
- Queen Elizabeth Hospital Birmingham, United Kingdom.
| | - Z Al Asaadi
- Department of Oral & Maxillofacial Surgery, Queen Elizabeth Hospital Birmingham, United Kingdom
| | - T Martin
- Queen Elizabeth Hospital Birmingham, United Kingdom
| | - C Jennings
- Queen Elizabeth Hospital Birmingham, Edgbaston, United Kingdom
| | - P Pracy
- Queen Elizabeth Hospital Birmingham, Edgbaston, United Kingdom
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Jennings C, Ramtohul M. EP-1600: Improvement in stereotactic radiosurgery planning and delivery using Monaco SSO and Apex Micro MLC. Radiother Oncol 2014. [DOI: 10.1016/s0167-8140(15)31718-7] [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]
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Mitchell H, Jennings C, Olsen E, Walker A, Weller R, Pfau T. Lunging on soft and hard ground: differences between sound and mildly lame horses. J Equine Vet Sci 2013. [DOI: 10.1016/j.jevs.2013.08.068] [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: 10/26/2022]
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Mitchell H, Jennings C, Olsen E, Walker A, Weller R, Pfau T. Movement Symmetry Patterns During Lungeing in Trot on Hard and Soft Surface Differ Between Sound and Mildly Forelimb Lame Horses. Equine Vet J 2013. [DOI: 10.1111/evj.12145_11] [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)
- H. Mitchell
- Royal Veterinary College; North Mymms; Hertfordshire; UK
| | - C. Jennings
- Royal Veterinary College; North Mymms; Hertfordshire; UK
| | - E. Olsen
- Royal Veterinary College; North Mymms; Hertfordshire; UK
| | - A. Walker
- Royal Veterinary College; North Mymms; Hertfordshire; UK
| | - R. Weller
- Royal Veterinary College; North Mymms; Hertfordshire; UK
| | - T. Pfau
- Royal Veterinary College; North Mymms; Hertfordshire; UK
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Maron Y, Starobinets A, Fisher VI, Kroupp E, Osin D, Fisher A, Deeney C, Coverdale CA, Lepell PD, Yu EP, Jennings C, Cuneo ME, Herrmann MC, Porter JL, Mehlhorn TA, Apruzese JP. Pressure and energy balance of stagnating plasmas in z-pinch experiments: implications to current flow at stagnation. Phys Rev Lett 2013; 111:035001. [PMID: 23909333 DOI: 10.1103/physrevlett.111.035001] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/31/2011] [Indexed: 06/02/2023]
Abstract
Detailed spectroscopic diagnostics of the stagnating plasma in two disparate z pinches allow, for the first time, the examination of the plasma properties within a 1D shock wave picture, demonstrating a good agreement with this picture. The conclusion is that for a wide range of imploding-plasma masses and current amplitudes, in experiments optimizing non-Planckian hard radiation yields, contrary to previous descriptions the stagnating plasma pressure is balanced by the implosion pressure, and the radiation energy is provided by the imploding-plasma kinetic energy, rather than by the magnetic-field pressure and magnetic-field-energy dissipation, respectively.
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Affiliation(s)
- Y Maron
- Weizmann Institute of Science (WIS), Rehovot 76100, Israel
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Eastwood K, Struthers C, Jennings C. N056 Medication Reconciliation in Real Life! The Impact of Nursing Care at Transitions Points to Decrease Adverse Events in Heart Failure Patients. Can J Cardiol 2012. [DOI: 10.1016/j.cjca.2012.07.802] [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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Coleman PL, Lamppa DC, Madden RE, Wilson-Elliott K, Jones B, Ampleford DJ, Bliss DE, Jennings C, Bixler A, Krishnan M. Development and use of a two-dimensional interferometer to measure mass flow from a multi-shell Z-pinch gas puff. Rev Sci Instrum 2012; 83:083116. [PMID: 22938283 DOI: 10.1063/1.4746269] [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] [Indexed: 06/01/2023]
Abstract
For gas puff Z-pinches, the K-shell x-ray yield is maximized with the use of a multi-shell nozzle. Optimization of the yield, verification of hydrodynamic models of the nozzle flows, and plausible MHD code modeling of the implosions require data on the radial and axial (R,Z) distribution of mass in the nozzle's flow field. Interferometry is a well-established technique for acquiring such data. We describe the development and use of a two-dimensional interferometer with emphasis on the required data reduction methods. We also show that the instrument can derive the flow from each individual nozzle in a multi-shell system.
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Affiliation(s)
- P L Coleman
- Evergreen Hill Sciences, Philomath, Oregon 97370, USA
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Kotseva K, Jennings C, De Bacquer D, Hoes A, De Velasco J, Brusaferro S, Jones J, Mead A, Tonstad S, Wood D. 145 EUROACTION PLUS: a randomised controlled trial on preventive cardiology programme plus intensive smoking cessation with Varenicline for vascular and high CVD risk smokers and their partners—principal results. Heart 2012. [DOI: 10.1136/heartjnl-2012-301877b.145] [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] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Oakey J, Harris E, Pease B, Jennings C, McCubbin K. Differentiation of Solenopsis invicta social forms using high resolution melt PCR. Bull Entomol Res 2011; 101:581-589. [PMID: 21729397 DOI: 10.1017/s0007485311000204] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Solenopsis invicta Buren (red imported fire ant) are invasive pests that have the capability of major destructive impacts on lifestyle, ecology and economy. Control of this species is dependent, in part, upon ability to estimate the potential spread from newly discovered nests. The potential for spread and the spread characteristics differ between monogyne and polygyne social forms. Prior to this study, differentiation of the two social forms in laboratory test samples commonly used a method involving restriction endonuclease digestion of an amplified Gp-9 fragment. Success of this assay is limited by the quality of DNA, which in the field-collected insects may be affected by temporary storage in unfavourable conditions. Here, we describe an alternative and highly objective assay based upon a high resolution melt technique following preamplification of a significantly shorter Gp-9 fragment than that required for restriction endonuclease digestion. We demonstrate the application of this assay to a S. invicta incursion in Queensland, Australia, using field samples from which DNA may be partially degraded. The reductions in hands-on requirements and overall duration of the assay underpin its suitability for high-throughput testing.
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Affiliation(s)
- J Oakey
- Biosecurity Sciences Laboratory, Biosecurity Queensland, Health & Food Science Precinct, PO Box 156, Archerfield BC, QLD 4108, Australia.
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Roth WK, Busch MP, Schuller A, Ismay S, Cheng A, Seed CR, Jungbauer C, Minsk PM, Sondag-Thull D, Wendel S, Levi JE, Fearon M, Delage G, Xie Y, Jukic I, Turek P, Ullum H, Tefanova V, Tilk M, Reimal R, Castren J, Naukkarinen M, Assal A, Jork C, Hourfar MK, Michel P, Offergeld R, Pichl L, Schmidt M, Schottstedt V, Seifried E, Wagner F, Weber-Schehl M, Politis C, Lin CK, Tsoi WC, O'Riordan J, Gottreich A, Shinar E, Yahalom V, Velati C, Satake M, Sanad N, Sisene I, Bon AH, Koppelmann M, Flanagan P, Flesland O, Brojer E, Lętowska M, Nascimento F, Zhiburt E, Chua SS, Teo D, Stezinar SL, Vermeulen M, Reddy R, Park Q, Castro E, Eiras A, Gonzales Fraile I, Torres P, Ekermo B, Niederhauser C, Chen H, Oota S, Brant LJ, Eglin R, Jarvis L, Mohabir L, Brodsky J, Foster G, Jennings C, Notari E, Stramer S, Kessler D, Hillyer C, Kamel H, Katz L, Taylor C, Panzer S, Reesink HW. International survey on NAT testing of blood donations: expanding implementation and yield from 1999 to 2009. Vox Sang 2011; 102:82-90. [PMID: 21933190 DOI: 10.1111/j.1423-0410.2011.01506.x] [Citation(s) in RCA: 146] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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Al Asaadi Z, Parmar S, Martin T, Jennings C, Pracy P. Pharyngeal reconstruction—is the antero-lateral thigh flap the solution to all potential problems? Br J Oral Maxillofac Surg 2011. [DOI: 10.1016/j.bjoms.2011.04.036] [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]
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Beech T, Coulson C, Najran P, Olliff J, Jennings C. How good is a chest CT scan at predicting the risk of pulmonary metastatic disease in patients with head and neck cancer? A retrospective observational study. Clin Otolaryngol 2010; 35:474-8. [DOI: 10.1111/j.1749-4486.2010.02198.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
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Kotseva K, Bowker T, Jennings C, Turner E, Amber V, Wood D. 116 Prevalence of persistent lipid abnormalities in high-risk patients treated with statins: results of the dyslipidemia international study in the UK. Heart 2010. [DOI: 10.1136/hrt.2010.196089.11] [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: 11/03/2022]
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Kotseva K, Jennings C, Turner E, Wood D. 115 ASPIRE-2-PREVENT: a British cardiovascular society survey on the lifestyle and risk factor management and use of cardioprotective medication in coronary patients in the UK. Heart 2010. [DOI: 10.1136/hrt.2010.196089.10] [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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Kotseva K, Jennings C, Turner E, Wood D. 118 ASPIRE-2-PREVENT: lifestyle and risk factor management in people at high risk of developing cardiovascular disease in the UK. Heart 2010. [DOI: 10.1136/hrt.2010.196089.13] [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: 11/03/2022]
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Woolley ML, Waters KA, Gartlon JE, Lacroix LP, Jennings C, Shaughnessy F, Ong A, Pemberton DJ, Harries MH, Southam E, Jones DNC, Dawson LA. Evaluation of the pro-cognitive effects of the AMPA receptor positive modulator, 5-(1-piperidinylcarbonyl)-2,1,3-benzoxadiazole (CX691), in the rat. Psychopharmacology (Berl) 2009; 202:343-54. [PMID: 18795266 DOI: 10.1007/s00213-008-1325-2] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.3] [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: 04/22/2008] [Accepted: 08/31/2008] [Indexed: 02/03/2023]
Abstract
RATIONALE Positive allosteric modulators of the glutamatergic alpha-amino-3-hydroxy-5-methyl-4-isoazolepropionic acid (AMPA) receptor do not stimulate AMPA receptors directly but delay deactivation of the receptor and/or slow its desensitisation. This results in increased synaptic responses and enhanced long-term potentiation. Thus, it has been suggested that such compounds may have utility for the treatment of cognitive impairment. OBJECTIVES The objective of the study was to investigate the effect of an AMPA positive modulator, CX691, (1) in three rodent models of learning and memory, (2) on neurochemistry in the dorsal hippocampus and medial prefrontal cortex following acute administration, and (3) on brain-derived neurotrophic factor (BDNF) messenger RNA (mRNA) expression in the rat hippocampus following acute and sub-chronic administration. RESULTS CX691 attenuated a scopolamine-induced impairment of cued fear conditioning following acute administration (0.1 mg/kg p.o.) and a temporally induced deficit in novel object recognition following both acute (0.1 and 1.0 mg/kg p.o.) and sub-chronic (bi-daily for 7 days) administration (0.01, 0.03, 0.1 mg/kg p.o.). It also improved attentional set-shifting following sub-chronic administration (0.3 mg/kg p.o.). Acute CX691 (0.1, 0.3 and 1.0 mg/kg, p.o.) increased extracellular levels of acetylcholine in the dorsal hippocampus and medial prefrontal cortex and dopamine in the medial prefrontal cortex. Sub-chronic administration of CX691 (0.1 mg/kg, p.o.) elevated BDNF mRNA expression in both the whole and CA(1) sub-region of the hippocampus (P < 0.05). CONCLUSIONS Collectively, these data support the pro-cognitive activity reported for AMPA receptor positive modulators and suggest that these compounds may be of benefit in treating disorders characterised by cognitive deficits such as Alzheimer's disease and schizophrenia.
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Affiliation(s)
- M L Woolley
- Neurosciences Centre of Excellence for Drug Discovery, GlaxoSmithKline plc, New Frontiers Science Park, Third Avenue, Harlow, Essex CM195AW, UK.
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Wood DA, Kotseva K, Connolly S, Jennings C, Mead A, Jones J, Holden A, De Bacquer D, Collier T, De Backer G, Faergeman O. Nurse-coordinated multidisciplinary, family-based cardiovascular disease prevention programme (EUROACTION) for patients with coronary heart disease and asymptomatic individuals at high risk of cardiovascular disease: a paired, cluster-randomised controlled trial. Lancet 2008; 371:1999-2012. [PMID: 18555911 DOI: 10.1016/s0140-6736(08)60868-5] [Citation(s) in RCA: 465] [Impact Index Per Article: 29.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND Our aim was to investigate whether a nurse-coordinated multidisciplinary, family-based preventive cardiology programme could improve standards of preventive care in routine clinical practice. METHODS In a matched, cluster-randomised, controlled trial in eight European countries, six pairs of hospitals and six pairs of general practices were assigned to an intervention programme (INT) or usual care (UC) for patients with coronary heart disease or those at high risk of developing cardiovascular disease. The primary endpoints-measured at 1 year-were family-based lifestyle change; management of blood pressure, lipids, and blood glucose to target concentrations; and prescription of cardioprotective drugs. Analysis was by intention to treat. The trial is registered as ISRCTN 71715857. FINDINGS 1589 and 1499 patients with coronary heart disease in hospitals and 1189 and 1128 at high risk were assigned to INT and UC, respectively. In patients with coronary heart disease who smoked in the month before the event, 136 (58%) in the INT and 154 (47%) in the UC groups did not smoke 1 year afterwards (difference in change 10.4%, 95% CI -0.3 to 21.2, p=0.06). Reduced consumption of saturated fat (196 [55%] vs 168 [40%]; 17.3%, 6.4 to 28.2, p=0.009), and increased consumption of fruit and vegetables (680 [72%] vs 349 [35%]; 37.3%, 18.1 to 56.5, p=0.004), and oily fish (156 [17%] vs 81 [8%]; 8.9%, 0.3 to 17.5, p=0.04) at 1 year were greatest in the INT group. High-risk individuals and partners showed changes only for fruit and vegetables (p=0.005). Blood-pressure target of less than 140/90 mm Hg was attained by both coronary (615 [65%] vs 547 [55%]; 10.4%, 0.6 to 20.2, p=0.04) and high-risk (586 [58%] vs 407 [41%]; 16.9%, 2.0 to 31.8, p=0.03) patients in the INT groups. Achievement of total cholesterol of less than 5 mmol/L did not differ between groups, but in high-risk patients the difference in change from baseline to 1 year was 12.7% (2.4 to 23.0, p=0.02) in favour of INT. In the hospital group, prescriptions for statins were higher in the INT group (810 [86%] vs 794 [80%]; 6.0%, -0.5 to 11.5, p=0.04). In general practices in the intervention groups, angiotensin-converting enzyme inhibitors (297 [29%] INT vs 196 [20%] UC; 8.5%, 1.8 to 15.2, p=0.02) and statins (381 [37%] INT vs 232 [22%] UC; 14.6%, 2.5 to 26.7, p=0.03) were more frequently prescribed. INTERPRETATION To achieve the potential for cardiovascular prevention, we need local preventive cardiology programmes adapted to individual countries, which are accessible by all hospitals and general practices caring for coronary and high-risk patients.
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Affiliation(s)
- D A Wood
- Department of Cardiovascular Medicine, National Heart and Lung Institute at Charing Cross Campus, Imperial College, London, UK.
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Kotseva K, Keil U, Jennings C, DeBacquer D, De Backer G, Wood D. EUROASPIRE III: LIFESTYLE AND RISK FACTOR MANAGEMENT AND USE OF DRUG THERAPIES IN CORONARY PATIENTS FROM 22 COUNTRIES IN EUROPE. ATHEROSCLEROSIS SUPP 2008. [DOI: 10.1016/s1567-5688(08)70494-x] [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: 11/24/2022]
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Kotseva K, Jennings C, Bacquer DD, Backer GD, Keil U, Wooda D. 1349 EUROASPIRE III: Lifestyle and risk factor management and use of drug therapies in coronary patients from 22 countries in Europe. Eur J Cardiovasc Nurs 2008. [DOI: 10.1016/j.ejcnurse.2008.01.049] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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: 11/28/2022]
Affiliation(s)
- K. Kotseva
- Cardiovascular Medicine, NHLI, Imperial College London, UK
| | - C. Jennings
- Cardiovascular Medicine, NHLI, Imperial College London, UK
| | - D. De Bacquer
- Department of Public Health, University of Ghent, Belgium
| | - G. De Backer
- Department of Public Health, University of Ghent, Belgium
| | - U. Keil
- Institut of Epidemiology and Social Medicine
| | - D. Wooda
- Cardiovascular Medicine, NHLI, Imperial College London, UK
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Meada A, Jones J, Jennings C, Holden A, Connolly S, Kotseva K, Collier T, Bacquer DD, Backer GD, Wooda D. 1351 Changes in lifestyle habits and cardiovascular risk factors over one-year in a family based preventive cardiology programme in hospital and general practice: Results from EUROACTION. Eur J Cardiovasc Nurs 2008. [DOI: 10.1016/j.ejcnurse.2008.01.051] [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: 11/29/2022]
Affiliation(s)
- A. Meada
- Department of Cardiovascular Medicine, Imperial College, London, UK
| | - J. Jones
- Department of Cardiovascular Medicine, Imperial College, London, UK
- School of Health Sciences and Social Care, Brunel University, London, UK
| | - C. Jennings
- Department of Cardiovascular Medicine, Imperial College, London, UK
| | - A. Holden
- Department of Cardiovascular Medicine, Imperial College, London, UK
| | - S. Connolly
- Department of Cardiovascular Medicine, Imperial College, London, UK
| | - K. Kotseva
- Department of Cardiovascular Medicine, Imperial College, London, UK
| | - T. Collier
- Department of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - D. De Bacquer
- Department of Public Health, University of Ghent, Belgium
| | - G. De Backer
- Department of Public Health, University of Ghent, Belgium
| | - D. Wooda
- Department of Cardiovascular Medicine, Imperial College, London, UK
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Hall GN, Chittenden JP, Bland SN, Lebedev SV, Bott SC, Jennings C, Palmer JBA, Suzuki-Vidal F. Modifying wire-array Z-pinch ablation structure using coiled arrays. Phys Rev Lett 2008; 100:065003. [PMID: 18352483 DOI: 10.1103/physrevlett.100.065003] [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: 09/13/2006] [Revised: 10/09/2007] [Indexed: 05/26/2023]
Abstract
A new wire-array configuration has been used to control the modulation of ablated plasma flow for the first time. Cylindrical aluminum coiled arrays, in which each straight wire is replaced with a single helix, were driven by a 1 MA, 240 ns current pulse. Ablated plasma is directed away from the coiled wire cores in a manner that can be understood in terms of Lorentz forces that arise from a complex current path modeled by 3D magnetohydrodynamic simulations. Outside the diameter of the helix, the flow of ablated plasma is axially modulated at the wavelength of the coil.
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Affiliation(s)
- G N Hall
- Blackett Laboratory, Imperial College, London SW7 2BW, United Kingdom
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Kotseva K, Connolly S, Jennings C, Mead A, Jones J, Holden A, Collier T, De Bacquer D, De Backer G, Wood D. EUROACTION: An ESC project in preventive cardiology programme in coronary and high risk patients and their partners. Atherosclerosis 2007. [DOI: 10.1016/j.atherosclerosis.2007.04.042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Wood D, Kotseva K, Connolly S, Jennings C, Mead A, Jones J, Holden A, De Bacquer D, De Backer G. LB-OR-1 EUROACTION: A EUROPEAN SOCIETY OF CARDIOLOGY DEMONSTRATION PROJECT IN PREVENTIVE CARDIOLOGY PROGRAMME IN ASYMPTOMATIC HIGH RISK PATIENTS AND THEIR PARTNERS. ATHEROSCLEROSIS SUPP 2007. [DOI: 10.1016/s1567-5688(07)71863-9] [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: 10/23/2022]
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Kotseva K, Connolly S, Jennings C, Mead A, Jones J, Holden A, DeBacquer D, De Backer G, Wood D. PO13-331 EUROACTION: A EUROPEAN SOCIETY OF CARDIOLOGY DEMONSTRATION PROJECT IN PREVENTIVE CARDIOLOGY PROGRAMME IN CORONARY PATIENTS AND THEIR PARTNERS. ATHEROSCLEROSIS SUPP 2007. [DOI: 10.1016/s1567-5688(07)71341-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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