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Bhagar R, Le-Niculescu H, Roseberry K, Kosary K, Daly C, Ballew A, Yard M, Sandusky GE, Niculescu AB. Temporal effects on death by suicide: empirical evidence and possible molecular correlates. Discov Ment Health 2023; 3:10. [PMID: 37861857 PMCID: PMC10501025 DOI: 10.1007/s44192-023-00035-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Accepted: 03/01/2023] [Indexed: 10/21/2023]
Abstract
Popular culture and medical lore have long postulated a connection between full moon and exacerbations of psychiatric disorders. We wanted to empirically analyze the hypothesis that suicides are increased during the period around full moons. We analyzed pre-COVID suicides from the Marion County Coroner's Office (n = 776), and show that deaths by suicide are significantly increased during the week of the full moon (p = 0.037), with older individuals (age ≥ 55) showing a stronger effect (p = 0.019). We also examined in our dataset which hour of the day (3-4 pm, p = 0.035), and which month of the year (September, p = 0.09) show the most deaths by suicide. We had blood samples on a subset of the subjects (n = 45), which enabled us to look at possible molecular mechanisms. We tested a list of top blood biomarkers for suicidality (n = 154) from previous studies of ours 7, to assess which of them are predictive. The biomarkers for suicidality that are predictive of death by suicide during full moon, peak hour of day, and peak month of year, respectively, compared to outside of those periods, appear to be enriched in circadian clock genes. For full moon it is AHCYL2, ACSM3, AK2, and RBM3. For peak hour it is GSK3B, AK2, and PRKCB. For peak month it is TBL1XR1 and PRKCI. Half of these genes are modulated in expression by lithium and by valproate in opposite direction to suicidality, and all of them are modulated by depression and alcohol in the same direction as suicidality. These data suggest that there are temporal effects on suicidality, possibly mediated by biological clocks, pointing to changes in ambient light (timing and intensity) as a therapeutically addressable target to decrease suicidality, that can be coupled with psychiatric pharmacological and addiction treatment preventive interventions.
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Affiliation(s)
- R Bhagar
- Department of Psychiatry, Indiana University School of Medicine, Neuroscience Research Building 200B, 320 W. 15thStreet, Indianapolis, IN, 46202, USA
| | - H Le-Niculescu
- Department of Psychiatry, Indiana University School of Medicine, Neuroscience Research Building 200B, 320 W. 15thStreet, Indianapolis, IN, 46202, USA
| | - K Roseberry
- Department of Psychiatry, Indiana University School of Medicine, Neuroscience Research Building 200B, 320 W. 15thStreet, Indianapolis, IN, 46202, USA
| | - K Kosary
- Department of Psychiatry, Indiana University School of Medicine, Neuroscience Research Building 200B, 320 W. 15thStreet, Indianapolis, IN, 46202, USA
| | - C Daly
- Department of Psychiatry, Indiana University School of Medicine, Neuroscience Research Building 200B, 320 W. 15thStreet, Indianapolis, IN, 46202, USA
| | - A Ballew
- Marion County Coroner's Office, Indianapolis, IN, USA
| | - M Yard
- INBRAIN, Indiana University School of Medicine, Indianapolis, IN, USA
| | - G E Sandusky
- INBRAIN, Indiana University School of Medicine, Indianapolis, IN, USA
| | - A B Niculescu
- Department of Psychiatry, Indiana University School of Medicine, Neuroscience Research Building 200B, 320 W. 15thStreet, Indianapolis, IN, 46202, USA.
- INBRAIN, Indiana University School of Medicine, Indianapolis, IN, USA.
- Indianapolis VA Medical Center, Indianapolis, USA.
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2
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Still CJ, Sibley A, DePinte D, Busby PE, Harrington CA, Schulze M, Shaw DR, Woodruff D, Rupp DE, Daly C, Hammond WM, Page GFM. Causes of widespread foliar damage from the June 2021 Pacific Northwest Heat Dome: more heat than drought. Tree Physiol 2023; 43:203-209. [PMID: 36611006 DOI: 10.1093/treephys/tpac143] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Accepted: 12/11/2022] [Indexed: 06/17/2023]
Affiliation(s)
- C J Still
- Department of Forest Ecosystems and Society, Oregon State University, Corvallis, OR 97331, USA
| | - A Sibley
- Department of Forest Ecosystems and Society, Oregon State University, Corvallis, OR 97331, USA
| | - D DePinte
- US Department of Agriculture, Forest Service, Pacific Northwest Region, State & Private Forestry, Forest Health Protection, Redmond, OR 97756, USA
| | - P E Busby
- Department of Botany and Plant Pathology, Oregon State University, Corvallis, OR 97331, USA
| | - C A Harrington
- US Department of Agriculture, Forest Service, Pacific Northwest Research Station, Olympia, WA 98512, USA
| | - M Schulze
- Department of Forest Ecosystems and Society, Oregon State University, Corvallis, OR 97331, USA
| | - D R Shaw
- Department of Forest Engineering, Resources, and Management, Oregon State University, Corvallis, OR 97331, USA
| | - D Woodruff
- US Department of Agriculture, Forest Service, Pacific Northwest Research Station, Corvallis, OR 97331, USA
| | - D E Rupp
- Oregon Climate Change Research Institute, College of Earth, Ocean, and Atmospheric Sciences, Oregon State University, Corvallis, OR 97331, USA
| | - C Daly
- PRISM Climate Group, Northwest Alliance for Computational Science and Engineering, Oregon State University, Corvallis, OR 97331, USA
| | - W M Hammond
- Agronomy Department, University of Florida, Institute of Food and Agricultural Sciences, Gainesville, FL 32611, USA
| | - G F M Page
- Biodiversity and Conservation Science, Department of Biodiversity, Conservation and Attractions, Locked Bag 104, Bentley Delivery Centre, Bentley, Western Australia 6983, Australia
- CSIRO Land and Water, Private Bag 5, Wembley, Western Australia 6913, Australia
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3
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Mays H, Nasa A, Asif M, Cronin M, Daly C. Rhythm vs rate control strategy effect on direct current cardioversion outcomes for atrial fibrillation. Ir Med J 2023; 116:7. [PMID: 36916905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Subscribe] [Scholar Register] [Indexed: 03/16/2023]
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McGovern L, Gaine S, Coughlan JJ, Daly C, Murphy RT. Cardiac sarcoidosis with complete atrioventricular block. QJM 2022; 115:555-556. [PMID: 35512412 DOI: 10.1093/qjmed/hcac116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Revised: 04/27/2022] [Indexed: 11/12/2022] Open
Affiliation(s)
- L McGovern
- From the Department of Cardiology, St. James's Hospital, Dublin 8, Ireland
| | - S Gaine
- From the Department of Cardiology, St. James's Hospital, Dublin 8, Ireland
| | - J J Coughlan
- From the Department of Cardiology, St. James's Hospital, Dublin 8, Ireland
| | - C Daly
- From the Department of Cardiology, St. James's Hospital, Dublin 8, Ireland
| | - R T Murphy
- From the Department of Cardiology, St. James's Hospital, Dublin 8, Ireland
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Daly C, McKeating H, Kiernan D. Age related progression of clinical measures and gait in ambulant children and youth with bilateral cerebral palsy without a history of surgical intervention. Gait Posture 2022; 95:141-148. [PMID: 35489226 DOI: 10.1016/j.gaitpost.2022.04.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 03/26/2022] [Accepted: 04/21/2022] [Indexed: 02/02/2023]
Abstract
BACKGROUND Age related progression needs to be considered when assessing current status and treatment outcomes in cerebral palsy (CP). RESEARCH QUESTION What is the association between age, gait kinematics and clinical measures in children with bilateral CP? METHOD A retrospective database review was conducted. Subjects with bilateral CP with baseline and follow-up 3D gait analyses, but no history of intervening surgery were identified. Clinical and summary kinematic measures were examined for age related change using repeat measures correlation. Interactions with GMFCS classification and whether surgery was recommended were examined using robust linear regression. Timeseries kinematic data for baseline and most recent follow-up analyses were analysed using statistical parametric mapping. RESULTS 180 subjects were included. 75% of participants were classified as GMFCS I or II at baseline. Mean time to follow-up was 4.89 (2.8) years (range 1-15.9 years) with a mean age of 6.4 (2.4) at baseline and 11.3 (3.4) at final follow-up. 15.5% of subjects demonstrated an improvement in GMFCS classification while GDI remained stable. Age related progression was noted across many clinical measures with moderate correlations (r ≥ 0.5) noted for reduced popliteal angle, long lever hip abduction and internal hip rotation range. In gait, there was reduced hip extension in late stance (p < 0.001), increased knee flexion in mid-stance (p < 0.001), reduced peak knee flexion in swing (p < 0.001) and increased ankle dorsiflexion in stance (p < 0.001). In the coronal plane, there was reduced hip abduction in swing (p < 0.001). In the transverse plane, increased external rotation of the knee (p < 0.001) and reduced external ankle rotation were noted in early stance and through swing (p < 0.001). There were no changes in foot progression or hip rotation. SIGNIFICANCE Individuals with CP show age related progression of clinical and kinematic variables. Treatment can only be deemed successful if outcomes exceed or match these age-related changes.
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Affiliation(s)
- C Daly
- Central Remedial Clinic, Clontarf, Dublin 3, Ireland.
| | - H McKeating
- Central Remedial Clinic, Clontarf, Dublin 3, Ireland
| | - D Kiernan
- Central Remedial Clinic, Clontarf, Dublin 3, Ireland
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6
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Wheen P, O'Callaghan D, Murray P, Minelli C, Byrne L, Armstrong R, Maher V, Shiels P, Fleming S, Daly C. Persisting Symptomatic Severe Secondary Mitral Regurgitation in Heart Failure Patients. Ir Med J 2022; 115:514. [PMID: 35279048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Aims We aimed to assess the rate of persisting severe symptomatic secondary mitral regurgitation (MR) in a newly diagnosed heart failure (HF) population following optimisation of guideline directed medical therapy (GDMT), cardiac resynchronisation therapy (CRT) and revascularisation. Methods We assessed all new patients referred to our hospital group’s HF clinics. We retrospectively reviewed these patients at HF clinic enrolment, HF programme completion, as well as most recent follow up. Results Of the 242 new patients referred to our HF clinics, there were 10 patients (4.1%) who had either persisting symptomatic severe secondary MR at HF programme completion, or had undergone mitral valve surgery. There were no percutaneous mitral valve repairs at the time of these patients’ referrals. The rates of ACE/ARB/ARNI, BB and MRA use were 87.8%, 94.1%, and 49.8% in those with mid ranged, or reduced ejection fraction. The rates of ICD and CRT therapy were 15.1% and 4.4% at follow up. Patients with severe MR had higher time adjusted rates of death or hospitalization for heart failure. Conclusion In a well-treated newly diagnosed HF population, repeat assessment at HF programme completion suggests 4.1% of patients have a persisting indication for percutaneous mitral valve repair based on persisting severe symptomatic secondary MR.
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Affiliation(s)
- P Wheen
- School of Medicine, Trinity College, Dublin, Ireland
- St. James Hospital, James Street, Dublin 8, Ireland
- Tallaght University Hospital, Dublin 24, Ireland
| | | | - P Murray
- Tallaght University Hospital, Dublin 24, Ireland
| | - C Minelli
- Midlands Regional Hospital, Tullamore, Co. Offaly, Ireland
| | - L Byrne
- Midlands Regional Hospital, Portlaoise, Co. Laois, Ireland
| | - R Armstrong
- St. James Hospital, James Street, Dublin 8, Ireland
| | - V Maher
- Tallaght University Hospital, Dublin 24, Ireland
| | - P Shiels
- Midlands Regional Hospital, Tullamore, Co. Offaly, Ireland
| | - S Fleming
- Midlands Regional Hospital, Portlaoise, Co. Laois, Ireland
| | - C Daly
- St. James Hospital, James Street, Dublin 8, Ireland
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7
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Daly C, Maher G. 104 COMPARING THE OTTAWA 3DY AND 6CIT IN DETECTING COGNITIVE IMPAIRMENT IN OLDER PATIENTS SEEN BY AN EMERGENCY DEPARTMENT THERAPY TEAM. Age Ageing 2021. [DOI: 10.1093/ageing/afab219.104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2023] Open
Abstract
Abstract
Background
Recognising cognitive impairment in the Emergency Department (ED) is important in order to optimise outcomes for patients and to carry out a holistic assessment.
Currently the team screen routinely for delirium using the 4AT. Since 2016 the 03DY was used to screen for mild cognitive impairment however it was not being completed frequently in practice.
In a busy ED setting where time and resources are limited, one brief tool is preferable. The purpose of this investigation is to determine the most accurate cognitive screening tool to identify cognitive impairment in older adults in ED.
Methods
A literature review was completed comparing recent articles which examined the O3DY and 6CIT. The search criteria for journal articles were:
● Published within the last 10 years.
● Published in English.
● Full text only.
● Database: CINAHL.
Results
Our investigation identified that the O3DY offered the greatest sensitivity to rule out cognitive impairment.
The O3DY is quick to administer, requires no additional equipment or training, and can be completed at the patient’s bedside (BGS, 2020) which is particularly important within the ED. The 6CIT was shown to have poorer sensitivity for MCI diagnosis (Abdel-Aziz and Larner, 2014) and has a mathematical component which studies noted may not be appropriate for use in a busy clinical setting.
Conclusion
From this literature review, the O3DY has been identified as the most appropriate cognitive screening tool for our team to detect MCI in the ED. It is important to note that many of the articles reviewed highlighted that a single cognitive screen should not be used in isolation for the identification of cognitive impairment. It is unlikely that completing more than one cognitive screen is achievable in the ED however by implementing the most sensitive screening tool we can identify potential MCI and refer onwards.
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Affiliation(s)
- C Daly
- Beaumont Hospital , Dublin, Ireland
| | - G Maher
- Beaumont Hospital , Dublin, Ireland
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Craven P, Daly C, Sikotra N, Clay T, Gabbay E. Dilemmas in anticoagulation and use of inferior vena cava filters in venous thromboembolism; a survey of Respiratory Physicians, Haematologists and Medical Oncologists and a review of the literature. Pulm Circ 2021; 11:2045894020953841. [PMID: 33456754 PMCID: PMC7797600 DOI: 10.1177/2045894020953841] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 02/11/2020] [Accepted: 08/07/2020] [Indexed: 01/01/2023] Open
Abstract
Twenty percent of patients with Cancer Associated Thrombosis receive an inferior vena
cava filter annually. Insertion is guided by practice guidelines, which do not specify or
discuss the use of inferior vena cava filters in malignancy. Adherence to these guidelines
is known to be variable. We aimed to see if there was consistent management of venous
thromboembolism among Medical Oncologists/Haematologists and Respiratory Physicians, with
respect to inferior vena cava filter use in the setting of suspected and confirmed
malignancy. Medical Oncologists, Haematologists and Respiratory Physicians were surveyed
with four theoretical cases. Case 1 concerns a patient who develops a pulmonary embolism
following spinal surgery. Cases 2 and 4 explore the use of inferior vena cava filters in
the setting of malignancy. Case 3 covers the role of inferior vena cava filters in
recurrent thrombosis despite systemic anticoagulation. There were 56 responses, 32 (57%)
Respiratory Physicians and 24 (43%) Haematologists/Oncologists. Respiratory Physicians
were significantly more likely to insert an inferior vena cava filter in case 1
(p = 0.04) whilst Haematologists/Medical Oncologists were more likely
to insert an inferior vena cava filter in case 3 (p = 0.03). No
significant differences were found in cases 2 and 4. There were significant disparities in
terms of type and timing of anticoagulation. Consistency of recommendations with
guidelines was variable likely in part because guidelines are themselves inconsistent. The
heterogeneity in responses highlights the variations in venous thromboembolism management,
especially in Cancer Associated Thrombosis. International Societies should consider
addressing inferior vena cava filter use specifically in the setting of Cancer Associated
Thrombosis. Collaboration between interested specialities would assist in developing
consistent, evidence-based guidelines for the use of inferior vena cava filters in the
management of venous thromboembolism.
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Affiliation(s)
- Philip Craven
- Department of Respiratory Medicine, St John of God Healthcare, Subiaco, Australia.,Bendat Respiratory Research and Development Fund, St John of God Healthcare, Subiaco, Australia
| | - Ciara Daly
- Bendat Respiratory Research and Development Fund, St John of God Healthcare, Subiaco, Australia.,Department of Medical Oncology, St John of God Healthcare, Subiaco, Australia
| | - Nisha Sikotra
- Bendat Respiratory Research and Development Fund, St John of God Healthcare, Subiaco, Australia.,Research Department, St John of God Healthcare, Subiaco, Australia
| | - Tim Clay
- Bendat Respiratory Research and Development Fund, St John of God Healthcare, Subiaco, Australia.,Department of Medical Oncology, St John of God Healthcare, Subiaco, Australia.,School of Medical and Health Sciences, Edith Cowan University, Joondalup, Australia
| | - Eli Gabbay
- Department of Respiratory Medicine, St John of God Healthcare, Subiaco, Australia.,Bendat Respiratory Research and Development Fund, St John of God Healthcare, Subiaco, Australia.,Research Department, St John of God Healthcare, Subiaco, Australia.,Department of Medical Teaching, St John of God Healthcare, Subiaco, Australia
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Dulay G, Choy E, Barnes T, Chagadama D, Cole Z, Malaviya A, Robinson S, Walker D, Daly C, Savill N, Warren T, Williams N. SAT0609-HPR DELPHI CONSENSUS FOR THE OPTIMAL TREATMENT & MANAGEMENT OF COMPLEX RHEUMATOID ARTHRITIS (RA) PATIENTS. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.3256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:A significant proportion of patients with rheumatoid arthritis (RA) have additional considerations that must be taken into account for managing their disease.1These include; co-morbidities, extra-articular manifestations and poor prognostic factors.2-5Tailored management could reduce the burden on patients, the health system and wider society.The ‘complex’ RA patient group is ill-defined and no specific recommendations exist for their optimal management and treatment.Objectives:A group of UK Rheumatology experts aimed to provide a set of recommendations to support consistent and high quality management, grounded in current evidence, expert opinion and best practice.Methods:A steering group meeting identified priority topics associated with complex RA.Table 1.Topics for consensusTopicNo. of statementsDefinition of ‘complex’ RA from a medical perspective19Definition of patient factors that may contribute to ‘complex’ RA3Outcomes for RA patients with co-morbidities and/or extra articular manifestations5Prescribing options for ‘complex’ RA8Evidence vs. best practice requirements4Burden of ‘complex’ RA4TOTAL NUMBER OF STATEMENTS43For each topic, the group defined statements they all agreed with. Delphi methodology was used to ratify these statements with rheumatology peers.High levels of agreement (over 70%) were achieved in the first round, the group proceeded to formulate the recommendations.Figure 1.Responses received (n=163)Figure 2.Consensus Plot (total responses n=163)Conclusion:These recommendations are offered:Healthcare professionals (HCPs) should consider a patient’s complexity (including clinical co-morbidities, extra-articular manifestations and poor prognostic factors) prior to making treatment decisions;HCPs should take into account a patient’s psychosocial factors and health literacy prior to making treatment decisions;Patient specific outcomes for complex RA should always be proactively agreed with the individual and/or their carers;The local healthcare system should consider the overall costs of complex RA, beyond drug acquisition costs to allow flexibility of prescribing choices, as necessary in this group of patients;Local treatment pathways should reflect that treatments with particular modes of action are more suitable for individual patients with complex RA.Management of complex RA patients should extend beyond guidelines and recognise additional sources of evidence including; clinical studies, Real World Experience (RWE) and post-marketing surveillance.References:[1]Uhlig T, Moe RH, Kvien TK. The burden of disease in rheumatoid arthritis. Pharmacoeconomics 2014;32:841–51[2]Dougados M, et al. Ann Rheum Dis 2014;73:62–68.[3]Parodi M et al,Rheumatism, 2005, 57(3): 154-60.[4]Young A & Koduri G. Best Pract Res Clin Rheumatol. 2007 Oct;21(5):907-27.[5]Holroyd CR, et al. Rheumatology 2019;58:e3-e42Acknowledgments:Support for medical writing/editorial assistance, provided by Tim Warren at Triducive was funded by Roche Products Ltd. & Chugai Pharma Ltd. in accordance with Good Publication Practice (GPP3) guidelines (http://www.ismpp.org/gpp3).Disclosure of Interests:Gurdeep Dulay Grant/research support from: Educational grants to attend congress meetings/conferences from Roche, Chugai, UCB, Internis, Pfizer, Lilly, Sandoz, Consultant of: Honoraria for advisory board services from Roche, Chugai, Novartis, Speakers bureau: Speaker fees from Roche, Chugai, Novartis, Amgen, Lilly, Sandoz, Ernest Choy Grant/research support from: Amgen, Bio-Cancer, Chugai Pharma, Ferring Pharmaceuticals, Novimmune, Pfizer, Roche, UCB, Consultant of: AbbVie, Amgen, AstraZeneca, Biogen, Boehringer Ingelheim, Bristol-Myers Squibb, Celgene, Chelsea Therapeutics, Chugai Pharma, Daiichi Sankyo, Eli Lilly, Ferring Pharmaceuticals, GlaxoSmithKline, Hospita, Ionis, Janssen, Jazz Pharmaceuticals, MedImmune, Merck Sharp & Dohme, Merrimack Pharmaceutical, Napp, Novartis, Novimmune, ObsEva, Pfizer, R-Pharm, Regeneron Pharmaceuticals, Inc., Roche, SynAct Pharma, Sanofi Genzyme, Tonix, UCB, Speakers bureau: Amgen, Boehringer Ingelheim, Bristol-Myers Squibb, Chugai Pharma, Eli Lilly, Hospira, Merck Sharp & Dohme, Novartis, Pfizer, Regeneron Pharmaceuticals, Inc., Roche, Sanofi-Aventis, UCB, Theresa Barnes Consultant of: Ad boards for Roche, Actelion and Abbvie, Speakers bureau: Speaker for MSD, UCB, Pfizer, Abbvie, Actelion, Roche and BMS, Debbie Chagadama Consultant of: Roche, Chugai, BI, Speakers bureau: Roche, Chugai, BI, Zoe Cole Consultant of: Consultancy work for Roche, Lilly, Gilead, Abbvie, Pfizer, UCB, Speakers bureau: Lilly, BMS, Abbvie, Pfizer, UCB, Janssen, Anshuman Malaviya Consultant of: Roche, Chugai, MSD, Pfizer, Novartis, Lily, BMS, Speakers bureau: Roche, BMS, Pfizer, MSD, Sandra Robinson Consultant of: Eli Lilly for Education Nurse Meeting, David Walker Grant/research support from: Gilead, Consultant of: Gilead, Lilly, Pfizer, Roche, Speakers bureau: Lilly, Pfizer, Roche, Chris Daly Employee of: Roche, Nicola Savill Employee of: Roche, Tim Warren Consultant of: Roche, Employee of: AstraZeneca, Nick Williams Shareholder of: MSD, Consultant of: Roche, Employee of: MSD
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Slade E, Daly C, Mavranezouli I, Dias S, Kearney R, Hasler E, Carter P, Mahoney C, Macbeth F, Delgado Nunes V. Primary surgical management of anterior pelvic organ prolapse: a systematic review, network meta-analysis and cost-effectiveness analysis. BJOG 2019; 127:18-26. [PMID: 31538709 DOI: 10.1111/1471-0528.15959] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/09/2019] [Indexed: 11/30/2022]
Abstract
BACKGROUND Anterior compartment prolapse is the most common pelvic organ prolapse (POP) with a range of surgical treatment options available. OBJECTIVES To compare the clinical effectiveness and cost-effectiveness of surgical treatments for the repair of anterior POP. METHODS We conducted a systematic review of randomised controlled trials comparing surgical treatments for women with POP. Network meta-analysis was possible for anterior POP, same-site recurrence outcome. A Markov model was used to compare the cost-utility of surgical treatments for the primary repair of anterior POP from a UK National Health Service perspective. MAIN RESULTS We identified 27 eligible trials for the network meta-analysis involving eight surgical treatments tested on 3194 women. Synthetic mesh was the most effective in preventing recurrence at the same site. There was no evidence to suggest a difference between synthetic non-absorbable mesh, synthetic partially absorbable mesh, and biological mesh. The cost-utility analysis, which incorporated effectiveness, complications and cost data, found non-mesh repair to have the highest probability of being cost-effective. The conclusions were robust to model inputs including effectiveness, costs and utility values. CONCLUSIONS Anterior colporrhaphy augmented with mesh appeared to be cost-ineffective in women requiring primary repair of anterior POP. There is a need for further research on long-term effectiveness and the safety of mesh products to establish their relative cost-effectiveness with a greater certainty. TWEETABLE ABSTRACT New study finds mesh cost-ineffective in women with anterior pelvic organ prolapse.
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Affiliation(s)
- E Slade
- National Guideline Alliance, Royal College of Obstetricians and Gynaecologists, London, UK
| | - C Daly
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - I Mavranezouli
- National Guideline Alliance, Royal College of Obstetricians and Gynaecologists, London, UK.,Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - S Dias
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.,Centre for Reviews and Dissemination, University of York, York, UK
| | - R Kearney
- The Warrell Unit, St Mary's Hospital, Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK.,Faculty of Medical Human Sciences, University Institute of Human Development, University of Manchester, Manchester, UK
| | - E Hasler
- National Guideline Alliance, Royal College of Obstetricians and Gynaecologists, London, UK
| | - P Carter
- National Guideline Alliance, Royal College of Obstetricians and Gynaecologists, London, UK.,Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - C Mahoney
- Manchester University Hospitals NHS Foundation Trust, Manchester, UK
| | - F Macbeth
- Centre for Trials Research, Cardiff University, Cardiff, UK
| | - V Delgado Nunes
- National Guideline Alliance, Royal College of Obstetricians and Gynaecologists, London, UK
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11
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O'Connor CT, O'Rourke S, Buckley A, Murphy R, Crean P, Foley B, Maree A, Ryan R, Tolan M, Young V, O'Connell B, Daly C. Infective endocarditis: a retrospective cohort study. QJM 2019; 112:663-667. [PMID: 31147713 DOI: 10.1093/qjmed/hcz134] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2019] [Revised: 05/21/2019] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Infective endocarditis (IE) is a potentially life-threatening infection of the heart's endocardial surface. Despite advances in the diagnosis and management of IE, morbidity and mortality remain high. AIM To characterize the demographics, bacteriology and outcomes of IE cases presenting to an Irish tertiary referral centre. DESIGN Retrospective cohort study. METHODS Patients were identified using Hospital Inpatient Enquiry and Clinical Microbiology inpatient consult data, from January 2005 to January 2014. Patients were diagnosed with IE using Modified Duke Criteria. Standard Bayesian statistics were employed for analysis and cases were compared to contemporary international registries. RESULTS Two hundred and two patients were diagnosed with IE during this period. Mean age 54 years. Of these, 136 (67%) were native valve endocarditis (NVE), 50 (25%) were prosthetic valve endocarditis (PVE) and 22 (11%) were cardiovascular implantable electronic device-associated endocarditis. Culprit organism was identified in 176 (87.1%) cases and Staphylococcal species were the most common (57.5%). Fifty-nine per cent of NVE required surgery compared to 66% of PVE. Mean mortality rate was 17.3%, with NVE being the lowest (12.5%) and PVE the highest (32%). Increasing age was also associated with increased mortality. Fifty-three (26.2%) patients had embolic complications. CONCLUSIONS This Irish cohort exhibited first-world demographic patterns comparable to those published in contemporary international literature. PVE required surgery more often and was associated with higher rates of mortality than NVE. Embolic complications were relatively common and represent important sequelae, especially in the intravenous drug user population. It is also pertinent to aggressively treat older cohorts as they were associated with increased mortality.
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Affiliation(s)
- C T O'Connor
- Department of Cardiology, St. James's Hospital, James's Street, Dublin D08 FD2W
| | - S O'Rourke
- Department of Microbiology, St. James's Hospital, James's Street, Dublin D08 K0Y5
| | - A Buckley
- Department of Cardiology, St. James's Hospital, James's Street, Dublin D08 FD2W
| | - R Murphy
- Department of Cardiology, St. James's Hospital, James's Street, Dublin D08 FD2W
| | - P Crean
- Department of Cardiology, St. James's Hospital, James's Street, Dublin D08 FD2W
| | - B Foley
- Department of Cardiology, St. James's Hospital, James's Street, Dublin D08 FD2W
| | - A Maree
- Department of Cardiology, St. James's Hospital, James's Street, Dublin D08 FD2W
| | - R Ryan
- Department of Cardiothoracic Surgery, St. James's Hospital, James's Street, Dublin D08 FD2W, Ireland
| | - M Tolan
- Department of Cardiothoracic Surgery, St. James's Hospital, James's Street, Dublin D08 FD2W, Ireland
| | - V Young
- Department of Cardiothoracic Surgery, St. James's Hospital, James's Street, Dublin D08 FD2W, Ireland
| | - B O'Connell
- Department of Microbiology, St. James's Hospital, James's Street, Dublin D08 K0Y5
| | - C Daly
- Department of Cardiology, St. James's Hospital, James's Street, Dublin D08 FD2W
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12
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Merritt A, Booms P, Shaw MA, Miller DM, Daly C, Bilmen JG, Stowell KM, Allen PD, Steele DS, Hopkins PM. Assessing the pathogenicity of RYR1 variants in malignant hyperthermia. Br J Anaesth 2018; 118:533-543. [PMID: 28403410 DOI: 10.1093/bja/aex042] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/31/2017] [Indexed: 12/16/2022] Open
Abstract
Background . Missense variants in the ryanodine receptor 1 gene ( RYR1 ) are associated with malignant hyperthermia but only a minority of these have met the criteria for use in predictive DNA diagnosis. We examined the utility of a simplified method of segregation analysis and a functional assay for determining the pathogenicity of recurrent RYR1 variants associated with malignant hyperthermia. Methods . We identified previously uncharacterised RYR1 variants found in four or more malignant hyperthermia families and conducted simplified segregation analyses. An efficient cloning and mutagenesis strategy was used to express ryanodine receptor protein containing one of six RYR1 variants in HEK293 cells. Caffeine-induced calcium release, measured using a fluorescent calcium indicator, was compared in cells expressing each variant to that in cells expressing wild type ryanodine receptor protein. Results. We identified 43 malignant hyperthermia families carrying one of the six RYR1 variants. There was segregation of genotype with the malignant hyperthermia susceptibility phenotype in families carrying the p.E3104K and p.D3986E variants, but the number of informative meioses limited the statistical significance of the associations. HEK293 functional assays demonstrated an increased sensitivity of RyR1 channels containing the p.R2336H, p.R2355W, p.E3104K, p.G3990V and p.V4849I compared with wild type, but cells expressing p.D3986E had a similar caffeine sensitivity to cells expressing wild type RyR1. Conclusions . Segregation analysis is of limited value in assessing pathogenicity of RYR1 variants in malignant hyperthermia. Functional analyses in HEK293 cells provided evidence to support the use of p.R2336H, p.R2355W, p.E3104K, p.G3990V and p.V4849I for diagnostic purposes but not p.D3986E.
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Affiliation(s)
- A Merritt
- Leeds Institute of Biomedical & Clinical Sciences, University of Leeds, Leeds, UK
| | - P Booms
- Leeds Institute of Biomedical & Clinical Sciences, University of Leeds, Leeds, UK
| | - M-A Shaw
- Leeds Institute of Biomedical & Clinical Sciences, University of Leeds, Leeds, UK
| | - D M Miller
- Leeds Institute of Biomedical & Clinical Sciences, University of Leeds, Leeds, UK.,Malignant Hyperthermia Unit, St James's University Hospital, Leeds, UK
| | - C Daly
- Malignant Hyperthermia Unit, St James's University Hospital, Leeds, UK
| | - J G Bilmen
- Leeds Institute of Biomedical & Clinical Sciences, University of Leeds, Leeds, UK.,Malignant Hyperthermia Unit, St James's University Hospital, Leeds, UK
| | - K M Stowell
- Institute of Fundamental Sciences, Massey University, Palmerston North, New Zealand
| | - P D Allen
- Department of Molecular Biosciences, UC Davis, Davis, CA, USA
| | - D S Steele
- School of Biomedical Sciences, University of Leeds, Leeds, UK
| | - P M Hopkins
- Leeds Institute of Biomedical & Clinical Sciences, University of Leeds, Leeds, UK.,Malignant Hyperthermia Unit, St James's University Hospital, Leeds, UK
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13
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Prashad A, Camuso N, Argent-Katwala M, Daly C, Finley C. Improving the Quality of Outcomes of Complex Cancer Surgery Through National Standards: Lessons From Canada. J Glob Oncol 2018. [DOI: 10.1200/jgo.18.13400] [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: 11/20/2022] Open
Abstract
Background and context: Evidence shows there is wide variability in cancer care service delivery and patient outcomes. Outcomes of complex surgery can be improved by following standards that outline optimal ways to plan, organize and deliver surgical care. While some cancer surgeries are associated with a high risk of adverse outcomes, they also offer the best option for a cure. To ensure optimal patient outcomes, deliberate approaches are needed to standardize the organization of complex care surgeries. Aim: Leverage the expertise of specialty-based and multidisciplinary communities to develop pan-Canadian standards of practice as a means to elevate the delivery of oncologic surgery in Canada. Strategy/Tactics: A phased, multimodal qualitative and quantitative approach was undertaken to develop evidence-based consensus standards for best practice in complex surgery, through the analysis of administrative data to examine access and outcomes of complex, advanced-care surgery and discussion with public representatives to explore trade-offs for reorganizing cancer surgery. Results informed a literature review to identify best practices in complex surgery. Expert panels were convened with disease specific specialty surgeons to inform the development of evidence-informed consensus standards. Draft standards were finalized after targeted review and validation by a wider community of healthcare professionals. Program/Policy process: The standards were endorsed by national professional organizations. An audit was conducted with all surgical programs in Canada to assess pan-Canadian compliance with the standards. Barriers to compliance were tracked to identify areas where local, regional or national activity could support quality initiatives. Outcomes: National standards were developed and highlighted: surgeon criteria, practice settings, and quality improvement. These comprehensive standards provide actionable recommendations that can be tailored to meet local needs. The standards will help organize care in way that maximizes patient outcomes while maintaining reasonable access to care. This work reflects a Canadian approach to a global problem around appropriate delivery of cancer surgical services and facilitates international conversations to mobilize effective knowledge transfer and best practices. What was learned: • Development of national standards is an iterative process that requires upfront buy-in from surgeons, multidisciplinary communities and national associations. Lessons learned from this initiative can support development of international demonstration projects and can help model a process that others could use. • Mechanisms to enhance knowledge of the optimal organization of complex surgery services requires multifaceted and sustained attention. Thoughtful exploration of how surgical care interfaces with other treatment modalities is paramount to ensure a seamless patient journey.
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Affiliation(s)
- A. Prashad
- Canadian Partnership Against Cancer, Toronto, Canada
| | - N. Camuso
- Canadian Partnership Against Cancer, Toronto, Canada
| | | | - C. Daly
- Canadian Partnership Against Cancer, Toronto, Canada
| | - C. Finley
- Canadian Partnership Against Cancer, Toronto, Canada
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14
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Clay TD, Daly C, Craven P, Sikotra N, Cheruvu S, Gabbay E, Arellano A. Effect of pneumocystis jirovecii pneumonia (PJP) on morbidity and mortality in oncology patients: A single centre experience. J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.15_suppl.e22088] [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: 11/20/2022] Open
Affiliation(s)
| | - Ciara Daly
- St. John of God Hospital, Subiaco, Australia
| | | | | | | | - Eli Gabbay
- St John of God Hospital, Subiaco, Australia
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15
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Craven P, Daly C, Oates R, Sikotra N, Clay T, Gabbay E. Inferior vena cava filters (IVCFs): a review of uses and application to international guidelines at a single Australian center; implications of venous thromboembolism associated with malignancy. Pulm Circ 2018; 8:2045894018776505. [PMID: 29693482 PMCID: PMC5960862 DOI: 10.1177/2045894018776505] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Venous thromboembolism (VTE) is a potentially lethal event. Anticoagulation is the cornerstone of treatment. Inferior vena cava filters (IVCFs) may be used in circumstances when anticoagulation is contraindicated or as an adjunct to anticoagulation. IVCF use is not without controversy due to concerns over their safety profile, differences in guidelines from international societies, and a limited randomized control trial evidence. We retrospectively undertook a review of IVCF use over a three-year period (2014–2016) at our center, which has a large oncology service but no trauma unit. There were 44 patients with successful IVCF insertion and one patient with an unsuccessful attempt. Indications for insertion included: a contraindication to anticoagulation (n = 28); recurrent VTE on anticoagulation (n = 10); and extensive VTE (n = 7). There were 13 retrieval attempts, of which ten were successful. There were five documented IVCF complications (tilting: n = 2, IVC thrombus: n = 3) with one episode of IVCF failure and two episodes of deep vein thrombosis during the follow-up period. Of the patients, 71% had an active malignancy (of whom 71% had metastatic disease). Seventeen patients died due to progressive malignancy during the study period. There were no life-threatening VTEs or IVCF-associated mortalities. Adherence with published international guidelines was variable. Patients with malignancy were less likely to undergo IVCF retrieval and had a reduced rate of retrieval success. None of the international guidelines comment on the use of IVCFs in patients with malignancy despite being commonly used. IVCF use may be an underappreciated tool in this group.
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Affiliation(s)
- Philip Craven
- 1 Department of Respiratory Medicine, St John of God Healthcare, Subiaco, WA, Australia
| | - Ciara Daly
- 2 Department of Medical Oncology, St John of God Healthcare, Subiaco, WA, Australia
| | | | - Nisha Sikotra
- 4 Research Department, St John of God Healthcare, Subiaco, WA, Australia
| | - Tim Clay
- 2 Department of Medical Oncology, St John of God Healthcare, Subiaco, WA, Australia
| | - Eli Gabbay
- 1 Department of Respiratory Medicine, St John of God Healthcare, Subiaco, WA, Australia.,5 The University of Notre Dame , Fremantle, WA, Australia
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16
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O’Connor S, Daly C. Is Helmet and Faceguard Modification Common in Hurling and Camogie and Why Is It Done? Ir Med J 2018; 111:727. [PMID: 30465597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Aims Despite no previous research, it is anecdotally reported that hurling and camogie players modify their helmet and faceguard, which is against GAA regulations and can potentially increase injury risk. This study aimed to establish the prevalence and rationale behind modifications in hurling and camogie. Methods An online questionnaire was completed by 304 players aged over 18 (62% hurlers, 38% camogie players) which consisted of 27 questions. Results Appearance (43%) was the primary reasons for helmet brand choice, with just 1.6% citing safety as a main reason for choice. Surprisingly, 8% of helmets were already modified when purchased and 31% of participants made further modifications, primarily switching faceguards and removal of bars. Restricted vision, comfort and perceived poor quality of the helmet/faceguard were the most common reasons for modification. Players predominantly (75.8%) agreed that further education on modifications is required. Conclusion Future research on the relationship between helmet/faceguard modification and injury risk is required.
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Affiliation(s)
- S O’Connor
- School of Health and Human Performance, Dublin City University, Dublin 9
| | - C Daly
- Department of Sport and Health Sciences, Athlone Institute of Technology, Athlone, Co. Westmeath
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17
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Dean AP, Higgs D, Robins P, Stobie P, Craven P, Daly C, Carija S. Use of FDG PET scanning to evaluate 5-FU myocardial toxicity as a global metabolic effect rather than vascular spasm. J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.4_suppl.792] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
792 Background: This is the first ever case series which presents a series of PET images that conclusively demonstrate reversible abnormal myocardial glucose utilisation in 7 patients with normal coronary arteries occurring during 5-FU infusions. Fluoropyrimidine induced myocardial toxicity is estimated to occur in 9% of cases, with some instances proving fatal. Traditionally some hypothesised coronary artery spasm as the mechanism of action behind such events and an animal study suggesting dysfunction of the Krebs cycle, with depletion of high-energy phosphate compounds, was largely ignored. Having observed abnormal myocardial FDG uptake in a patient with chest pain undergoing FDG PET scanning, we prospectively evaluated a further 6 patients presenting with cardiac symptoms whilst receiving infusional 5-FU. Methods: Over an eighteen-month period, 7 patients experienced cardiac like chest pain during 5FU infusion. All were investigated for cardiac ischaemia as per institutional protocol (serial troponin, ECGs and coronary artery imaging), as well as FDG PET scanning to assess FDG uptake in the myocardium. Results: All 7 cases showed reduced FDG uptake throughout the myocardium, with the ventricular blood pool demonstrating a higher affinity for FDG than the myocardium itself. All 7 cases showed normal physiological uptake of FDG in the myocardium on previous and subsequent PET imaging. Imaging of the myocardium and coronary arteries in all cases showed no structural vascular disease. Conclusions: All cases demonstrated a global pattern of reduced FDG myocardial uptake that could not be isolated to a single coronary territory. Angiography or myocardial perfusion scanning demonstrated no significant coronary artery disease, and there were no features consistent with coronary artery spasm found on ECG. This supports the hypothesis that 5FU inhibits physiological myocardial glucose utilisation, thus acting as a direct myocardial toxin. We believe our findings warrant further investigation into the metabolic effects of 5FU on myocardial tissue.
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Affiliation(s)
| | - Dom Higgs
- St. John of God Hospital, Subiaco, Australia
| | - Peter Robins
- SKG Radiology St. John of God Hospital Subiaco, Subiaco, Australia
| | | | | | - Ciara Daly
- St. John of God Hospital, Subiaco, Australia
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18
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Eastwood KA, Daly C, Hunter A, McCance D, Young I, Holmes V. The impact of maternal obesity on completion of fetal anomaly screening. J Perinat Med 2017; 45:1061-1067. [PMID: 28145880 DOI: 10.1515/jpm-2016-0048] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2016] [Accepted: 12/28/2016] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To examine the impact of maternal obesity on completion of fetal anomaly screening. METHODS A retrospective analysis of 500 anomaly scans (19+0-21+6 weeks) was included. Women were categorised according to the World Health Organisation (WHO) body mass index (BMI) classification: normal weight (18.50-24.99 kg/m2), overweight (25.00-29.99 kg/m2), obese class I (30-34.99 kg/m2), obese class II (35.00-39.99 kg/m2) and obese class III (≥40.00 kg/m2). A fetal anomaly imaging scoring system was developed from the National Health Service (NHS) Fetal Anomaly Screening Programme standard to evaluate scans. RESULTS Image quality deteriorated as BMI increased and was significantly different across the BMI categories (P<0.001). Performance was poorest in imaging of the fetal chest and was significantly different across BMI categories (P<0.001). In obese class III, 33% of four-chamber cardiac views and 38% of outflow tract views were not obtained. In total, 119 women (23.6%) had an incomplete scan. In obese class III, 44.1% of scans were incomplete compared with 10.2% in the normal BMI category (P<0.001). Of 117 women attending for repeat scans, 78.6% were complete, 11.1% were incomplete, 6.8% were advised to re-attend and 3.4% were referred to Fetal Medicine. CONCLUSION Maternal obesity has a significant impact on completion of fetal anomaly screening.
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19
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Acuna SA, Sutradhar R, Camacho X, Daly C, Del Giudice ME, Kim SJ, Baxter NN. Uptake of Cancer Screening Tests Among Recipients of Solid Organ Transplantation. Am J Transplant 2017; 17:2434-2443. [PMID: 28485086 DOI: 10.1111/ajt.14272] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2016] [Revised: 02/23/2017] [Accepted: 03/01/2017] [Indexed: 01/25/2023]
Abstract
Population-based cancer screening recommendations are also suggested for solid organ transplant recipients (SOTR); however, recommendation adherence is unknown. In a population-based cohort of SOTR in Ontario between 1997 and 2010, we determined the uptake of breast, cervical, and colorectal cancer screening tests and identified factors associated with up-to-date screening using recurrent event analysis. We identified 4436 SOTR eligible for colorectal, 2252 for cervical, and 1551 for breast cancer screening. Of those, 3437 (77.5%), 1572 (69.8%), and 1417 (91.4%), respectively, were not up-to-date for cancer screening tests during the observation period. However, these rates are likely an overestimate due to the inability to differentiate between tests done for screening or for diagnosis. SOTR with fewer comorbidities had higher rates of becoming screen up-to-date. Assessment by a primary care provider (PCP) was associated with becoming up-to-date with cancer screening (breast relative risk [RR] = 1.40, 95% confidence interval [CI]: 1.12-1.76, cervical RR = 1.29, 95% CI: 1.06-1.57, colorectal RR = 1.30, 95% CI: 1.15-1.48). Similar results were observed for continuity of care by transplant specialist at a transplant center. In conclusion, cancer screening for most SOTR does not adhere to standard recommendations. Involvement of PCPs in posttransplant care and continuity of care at a transplant center may improve the uptake of screening.
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Affiliation(s)
- S A Acuna
- Department of Surgery, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Canada.,Institute of Health, Policy Management, and Evaluation, University of Toronto, Toronto, Canada
| | - R Sutradhar
- Institute of Health, Policy Management, and Evaluation, University of Toronto, Toronto, Canada.,Institute for Clinical Evaluative Sciences, Toronto, Ontario
| | - X Camacho
- Institute for Clinical Evaluative Sciences, Toronto, Ontario
| | - C Daly
- Department of Surgery, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Canada
| | - M E Del Giudice
- Sunnybrook Academic Family Health Team, Department of Family and Community Medicine, University of Toronto, Toronto, Canada
| | - S J Kim
- Institute of Health, Policy Management, and Evaluation, University of Toronto, Toronto, Canada.,Institute for Clinical Evaluative Sciences, Toronto, Ontario.,Division of Nephrology, University Health Network, Toronto, Canada
| | - N N Baxter
- Department of Surgery, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Canada.,Institute of Health, Policy Management, and Evaluation, University of Toronto, Toronto, Canada.,Institute for Clinical Evaluative Sciences, Toronto, Ontario.,Department of Surgery, University of Toronto, Toronto, Canada
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20
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Bajrangee A, Coughlan JJ, Teehan S, O'Connor C, Murphy RT, Foley B, Daly C, Burke D, Maree AO, Crean PA. Early and mid-term outcomes after transcatheter aortic valve implantation (TAVI) in Ireland. Int J Cardiol Heart Vasc 2017; 16:1-3. [PMID: 28785604 PMCID: PMC5502795 DOI: 10.1016/j.ijcha.2017.06.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2017] [Accepted: 06/16/2017] [Indexed: 11/15/2022]
Abstract
BACKGROUND TAVI is a percutaneous approach to aortic valve replacement in high surgical risk patients deemed inoperable. AIM To evaluate the early and mid-term outcomes for an Irish TAVI cohort over a six-year period at St James's Hospital and Blackrock Clinic, Dublin, Ireland. RESULTS In total 147 patients, 56% male with an average age of 82 underwent TAVI between December 2008 and December 2014. Thirty day, one year and two year survival was 90.5%, 83% and 71% respectively. Major vascular complications and renal failure were the biggest predictors of mortality at 30 days (p = 0.02). We observed a pacing rate of 13.5%, the majority in patients who had Medtronic Corevalve implants (p < 0.05). With increasing procedural experience there was a reduction in length of stay from 10 days to 7.5 days. CONCLUSION This review, the first of its kind in Ireland showed favorable rates of 30 day and one year and two year survival post TAVI with procedural success and complication rates similar to international registry data.
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Affiliation(s)
- A Bajrangee
- Department of Cardiology CREST, Dept. St. James's Hospital James Street Dublin, Ireland
| | - J J Coughlan
- Department of Cardiology CREST, Dept. St. James's Hospital James Street Dublin, Ireland
| | - S Teehan
- Department of Cardiology CREST, Dept. St. James's Hospital James Street Dublin, Ireland
| | - C O'Connor
- Department of Cardiology CREST, Dept. St. James's Hospital James Street Dublin, Ireland
| | - R T Murphy
- Department of Cardiology CREST, Dept. St. James's Hospital James Street Dublin, Ireland
| | - B Foley
- Department of Cardiology CREST, Dept. St. James's Hospital James Street Dublin, Ireland
| | - C Daly
- Department of Cardiology CREST, Dept. St. James's Hospital James Street Dublin, Ireland
| | - D Burke
- Department of Cardiology CREST, Dept. St. James's Hospital James Street Dublin, Ireland
| | - A O Maree
- Department of Cardiology CREST, Dept. St. James's Hospital James Street Dublin, Ireland
| | - P A Crean
- Department of Cardiology CREST, Dept. St. James's Hospital James Street Dublin, Ireland
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21
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Inkster T, Dodd S, Gunson R, Imrie L, Spalding E, Packer S, Deighan C, Daly C, Coia J, Imtiaz T, McGuffie C, Wilson R, Bal A. Investigation of outbreaks of Pneumocystis jirovecii pneumonia in two Scottish renal units. J Hosp Infect 2017; 96:151-156. [DOI: 10.1016/j.jhin.2016.11.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2016] [Accepted: 11/02/2016] [Indexed: 11/25/2022]
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22
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Dean A, Higgs D, Robins P, Stobie P, Craven P, Daly C, Carija S. FDG PET scanning suggests that 5FU myocardial toxicity is metabolic, rather than ischaemic. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx261.163] [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: 11/13/2022] Open
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23
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Dean AP, Higgs D, Robins P, Stobie P, Craven P, Daly C, Carija S. Fluoropyrimidine-associated myocardial toxicity as a global metabolic effect compared to vascular spasm and visibility on FDG PET scanning. J Clin Oncol 2017. [DOI: 10.1200/jco.2017.35.15_suppl.e14013] [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: 11/20/2022] Open
Abstract
e14013 Background: Myocardial toxicity from fluoropyrimidines is a rare but potentially serious side effect, estimated by some as occurring in up to 9%. Coronary spasm has been suggested as the underlying mechanism, despite a lack of supporting evidence and other toxicity mechanisms have been proposed. Matsubara described Krebs cycle dysfunction in the presence of 5FU with depletion of high energy phosphate compounds in rodent myocardial tissue with ECG changes. Following a chance discovery of abnormal myocardial FDG uptake on a PET scan shortly after presenting with presumed 5FU cardiac toxicity (angina, ST elevation, troponin rise; normal coronary vessels on imaging), we prospectively evaluated all instances of angina occurring during 5FU infusion with coronary artery imaging and FDG PET scan. Methods: We identified 5 patients who experienced angina during 5FU therapy. They were investigated for coronary ischaemia and also underwent PET scanning to assess myocardial FDG uptake. Data was collected from patient records, and subsequent cardiac investigations. Results: In all 5 cases, PET scan demonstrated markedly abnormal FDG uptake throughout the myocardium, with the ventricular blood pool demonstrating more FDG activity than myocardium. No significant underlying coronary artery disease was identified. All 5 patients had previous PET scans with normal myocardial FDG uptake. Conclusions: We identified a consistent pattern of abnormal FDG uptake throughout the myocardium for all scanned patients with chest pain following administration of 5FU. This was not restricted to a single arterial territory. There were no typical ECG changes of spasm. Obstructive coronary disease was excluded with angiographic imaging or myocardial perfusion scanning. The FDG PET scans suggest global myocardial metabolic change, supporting the notion of 5FU being a direct myocardial toxin inhibiting myocardial glucose utilization. The myocardium may then be dependent on fatty acid metabolism, posing additional risk to patients on low fat diets. Our data provides new insight into the mechanism of 5-FU myocardial toxicity and further prospective assessment using PET is warranted.
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Affiliation(s)
| | | | - Peter Robins
- SKG Radiology St. John of God Hospital Subiaco, Subiaco, Australia
| | | | | | - Ciara Daly
- St John of God Hospital, Subiaco, Australia
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24
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Daly C. Attention, Vigilance and Visuospatial Functioning in Hospitalised Elderly Medical Inpatients – Relationship to Delirium Syndromal Status and Motor Subtype Profile. Eur Psychiatry 2017. [DOI: 10.1016/j.eurpsy.2017.01.2243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
ObjectiveThe early and efficacious detection of neurocognitive disorders poses a key diagnostic challenge. We examined how bedside cognitive tests perform across the spectrum of delirium and motor subtypes.MethodsThe performance on a battery of bedside cognitive tests were compared in elderly medical inpatients with DSM-IV delirium, subsyndromal delirium, and no neuro cognitive disorder and in motor subtypes.ResultsOne hundred and ninety-eight patients (mean age 79.14 ± 8.26) were assessed with no delirium (n = 43), subsyndromal delirium (n = 45), and full syndromal delirium (n = 110). The ability to meaningfully engage with the tests varied from 59% for vigilance B test to 85% for Spatial Span forward test and was found to be least in the full syndromal delirium group. The no delirium group was distinguished from the delirium groups for all the tests and from the full syndromal delirium group for the vigilance B test and global visuospatial function test. The subsyndromal delirium group differed from the full syndromal delirium group in respect of global visuospatial function test, spatial span backwards and vigilance A tests. Patients with full syndromal delirium were best identified using the interlocking pentagons test and clock drawing test whereas those with subsyndromal delirium were best identified using interlocking pentagons test and months backwards test. Those with subsyndromal delirium were significantly better in their ability to engage than those with full syndromal delirium.ConclusionsSimple bedside tests of attention, vigilance, and visuospatial ability are useful to help to distinguish neurocognitive disorders namely subsyndromal delirium from other presentations.Disclosure of interestThe author haS not supplied his/her declaration of competing interest.
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Daly C. Attention, vigilance and visuospatial function in hospitalized elderly medical patients–relationship to delirium syndromal status and motor subtype profile. Eur Psychiatry 2017. [DOI: 10.1016/j.eurpsy.2017.01.595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
ObjectiveThe early and efficacious detection of neurocognitive disorders poses a key diagnostic challenge. We examined how nine bedside cognitive tests perform across the spectrum of delirium and motor subtypes.MethodsThe performance on a battery of nine bedside cognitive tests were compared in elderly medical inpatients with DSM-IV delirium, subsyndromal delirium, and no neurocognitive disorder and in different motor subtypes of patients with delirium.ResultsOne hundred and ninety-eight patients (mean age 79.14 ± 8.26) were assessed with no delirium (n = 43), subsyndromal delirium (n = 45), and full syndromal delirium (n = 110). The ability to meaningfully engage with the tests varied from 59% for vigilance B test to 85% for Spatial Span forward test and was found to be least in the full syndromal delirium group. The no delirium group was distinguished from the delirium groups for all the tests and from the full syndromal delirium group for the vigilance B test and global visuospatial function test. The subsyndromal delirium group differed from the full syndromal delirium group in respect of global visuospatial function test, spatial span backwards and vigilance A tests. Patients with full syndromal delirium were best identified using the interlocking pentagons test and clock drawing test. The ability to engage with testing was higher for those in the no subtype group.ConclusionsSimple bedside tests of attention, vigilance, and visuospatial ability are useful to help to distinguish neurocognitive disorders namely subsyndromal delirium from other presentations.Disclosure of interestThe author has not supplied his/her declaration of competing interest.
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Acuna SA, Huang JW, Scott AL, Micic S, Daly C, Brezden-Masley C, Kim SJ, Baxter NN. Cancer Screening Recommendations for Solid Organ Transplant Recipients: A Systematic Review of Clinical Practice Guidelines. Am J Transplant 2017; 17:103-114. [PMID: 27575845 DOI: 10.1111/ajt.13978] [Citation(s) in RCA: 116] [Impact Index Per Article: 16.6] [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: 05/19/2016] [Accepted: 07/13/2016] [Indexed: 01/25/2023]
Abstract
Solid organ transplant recipients (SOTRs) are at increased risk of developing and dying from cancer. However, controversies exist around cancer screening in this population owing to reduced life expectancy and competing causes of death. This systematic review assesses the availability, quality and consistency of cancer screening recommendations in clinical practice guidelines (CPGs). We systematically searched bibliographic databases and gray literature to identify CPGs and assessed their quality using AGREE II. Recommendations were extracted along with their supporting evidence. Thirteen guidelines were included in the review. CPGs for kidney recipients were the most frequent source of screening recommendations, and recommendations for skin cancer screening were most frequently presented. Some screening recommendations differed from those for the general population, based on literature demonstrating higher cancer incidence among SOTRs versus direct evidence of screening effectiveness. Relevant stakeholders such as oncology specialists, primary care providers and public health experts were not involved in the formulation of the screening recommendations. In conclusion, although several guidelines make recommendations for cancer screening in SOTRs, the availability of cancer screening recommendations varied considerably by transplanted organ. More studies are required to inform cancer screening recommendations in SOTRs, and guideline development should involve transplant patients, oncologists and cancer screening specialists.
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Affiliation(s)
- S A Acuna
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada.,Department of Surgery, Li Ki Shing Knowledge Institute, St. Michael's Hospital, Toronto, Canada
| | - J W Huang
- Department of Surgery, Li Ki Shing Knowledge Institute, St. Michael's Hospital, Toronto, Canada
| | - A L Scott
- Department of Surgery, Li Ki Shing Knowledge Institute, St. Michael's Hospital, Toronto, Canada
| | - S Micic
- Department of Surgery, Li Ki Shing Knowledge Institute, St. Michael's Hospital, Toronto, Canada
| | - C Daly
- Department of Surgery, Li Ki Shing Knowledge Institute, St. Michael's Hospital, Toronto, Canada
| | - C Brezden-Masley
- Division of Hematology/Oncology, St. Michael's Hospital, Toronto, Canada.,Department of Medicine, University of Toronto, Toronto, Canada
| | - S J Kim
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada.,Department of Medicine, University of Toronto, Toronto, Canada.,Division of Nephrology and the Kidney Transplant Program, Toronto General Hospital, University Health Network, Toronto, Canada
| | - N N Baxter
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada.,Department of Surgery, Li Ki Shing Knowledge Institute, St. Michael's Hospital, Toronto, Canada.,Division of General Surgery, Department of Surgery, University of Toronto, Toronto, Canada
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Tojino AL, Laymouna R, Monteiro A, Velcea A, Almeida Morais L, Enzan N, Wang TL, Kemaloglu Oz TUĞBA, Mursa A, Pfeiffer B, Tomaszewski M, Cuddy S, Giubertoni A, Rojo Prieto N, Ruivo C, Saito M, Dorobantu DM, Kemal HS, Sta Maria HF, Tiongco RP, Elsharkawy E, Morsy Y, Elshafei M, Elgowelly M, Almaghraby A, Branco L, Agapito A, Sousa L, Galrinho A, Pinto F, Rio P, Rosa S, Portugal G, Ferreira R, Mihaila S, Patrascu N, Adronic A, Cinteza M, Vinereanu D, Fiarresga A, Cacela D, Sousa L, Galrinho A, Branco L, Rodrigues R, Banazol N, Ferreira L, Ferreira R, Tsutsumi T, Matsumoto T, Uchida T, Yamada A, Hsiung MC, Eren MEHMET, Zarma L, Popescu BA, Ginghina C, Jurcut R, Neugebauer A, Rigopoulos A, Seggewiss H, Czekajska-Chehab E, Pietura R, Tomaszewski A, Sullivan V, Cosgrave J, Daly C, Murphy R, Zanaboni J, Gravellone M, Piccinino C, Marino PN, Lezcano Pertejo C, Hernandez Diez C, Alvarez Roy L, Martinez Paz E, Ascencio Lemus MG, Lopez Benito M, Fernandez-Vazquez F, Martin Gutierrez E, Castano Ruiz M, Guardado J, Santos L, Montenegro Sa F, Saraiva F, Correia J, Morais J, Mahara K, Ueda T, Ishii T, Hamamichi Y, Katsuragi S, Enache R, Platon P, Vladaia A, Popescu BA, Ginghina CD, Gunsel A, Cerit L, Duygu HS. Clinical Case Poster session 2P608Infective endocarditis in an adult female with bicuspid aortic valve, hypertrophic cardiomyopathy and amyopathic dermatomyositisP609Left ventricular massP610A rare case of mitral stenosis - Shones syndromeP611The added value of three-dimensional echocardiography in the late diagnosis of a pacemaker complication in a patient with severe congestive heart failureP612Percutaneous paravalvular leak closure - procedure pitfallsP613A case of late left ventricular pseudoaneurysm after aortic valve replacement for infective endocarditis.P614Pseudoaneurysm of right ventricle and acute heart failure caused by prosthetic aortic valve endocarditisP615A misclassification of pulmonary stenosis severity during pregnancyP616A problematic case of left ventricular hypertrophyP617High variability of dynamic obstruction in a patient with hypertrophic obstructive cardiomyopathy and tako-tsubo-cardiomyopathyP618Arterio-venous pulmonary fistula in patient after cerebral strokeP619Rapid myocardial calcification in acute sepsisP620Acute right heart failure after delivery in patient with new-diagnosed pulmonary arterial hypertensionP621When the right ventricle plays hide-and-seekP622Adult congenital heart disease: when what grows wrong goes wrongP623Prenatal diagnosis of mixed type total anomalous pulmonary venous connection in aspleniaP624Uncorrected single ventricle in an adult patient: do coexisting valvular abnormalities matter?P625Ventricular septal aneurysm associated with bicuspid aorta: a case report. Eur Heart J Cardiovasc Imaging 2016. [DOI: 10.1093/ehjci/jew249] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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St Louis KO, Sønsterud H, Junuzović-Žunić L, Tomaiuoli D, Del Gado F, Caparelli E, Theiling M, Flobakk C, Helmen LN, Heitmann RR, Kvenseth H, Nilsson S, Wetterling T, Lundström C, Daly C, Leahy M, Tyrrell L, Ward D, Węsierska M. Public attitudes toward stuttering in Europe: Within-country and between-country comparisons. J Commun Disord 2016; 62:115-30. [PMID: 27367742 DOI: 10.1016/j.jcomdis.2016.05.010] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/18/2015] [Revised: 05/17/2016] [Accepted: 05/24/2016] [Indexed: 05/14/2023]
Abstract
INTRODUCTION Epidemiological research methods have been shown to be useful in determining factors that might predict commonly reported negative public attitudes toward stuttering. Previous research has suggested that stuttering attitudes of respondents from North America and Europe (i.e., "The West"), though characterized by stereotypes and potential stigma, are more positive than those from several other regions of the world. This inference assumes that public attitudes within various regions characterized by "The West" are similar. PURPOSE This study aimed to determine the extent to which public stuttering attitudes are similar or different both within regions of three different European countries and between or among five different European countries or similar geographic areas. It also aimed to compare these European attitudes to attitudes from 135 samples around the world using a standard measure. MATERIAL AND METHODS Using convenience sampling, 1111 adult respondents from eight different investigations completed the Public Opinion Survey of Human Attributes-Stuttering (POSHA-S) in the dominant language of each country or area. In Study I, the authors compared attitudes within three different regions of Bosnia & Herzegovina, Italy, and Norway. In Study II, the authors compared attitudes between combined samples from Bosnia & Herzegovina, Italy, and Norway (with additional respondents from Sweden), and two other samples, one from Germany and the other from Ireland and England. RESULTS Attitudes of adults from the three samples within Bosnia & Herzegovina, Italy, and Norway were remarkably similar. By contrast, attitudes between the five different countries or area were quite dramatically different. Demographic variables on the POSHA-S did not predict the rank order of these between-country/area differences. Compared to the POSHA-S worldwide database, European attitudes ranged from less positive than average (i.e., Italians) to more positive than average (i.e., Norwegians and Swedes). CONCLUSION Factors related to national identity appear to play a significant role in differences in public attitudes in Europe and should be explored in future research.
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Affiliation(s)
- Kenneth O St Louis
- West Virginia University, Department of Communication Sciences & Disorders, 805 Allen Hall, PO Box 6122, Morgantown, WV 26506-6122, USA.
| | - Hilda Sønsterud
- Statped, Department of Speech and Language Disorders, Oslo, Norway.
| | | | | | | | | | - Mareen Theiling
- Rheinisch Westfälische Technische Hochschule Aachen (RWTH Aachen University), Germany.
| | - Cecilie Flobakk
- Aakershagan Training and Activity Centre, Stange, Hedmark, Norway.
| | | | | | | | | | - Tobias Wetterling
- Speech-Language Pathology, Helsingborg Hospital, Helsingborg, Sweden.
| | | | - Ciara Daly
- Wicklow Primary Healthcare Centre, Knockrobin, Wicklow Town, Ireland.
| | | | - Laila Tyrrell
- Berkshire Healthcare NHS Foundation Trust, Thatcham, UK.
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Reed K, Daly C, Shaw P, Ordonez L, Williams G, Quist J, Grigoriadias A, Van Es J, Clevers H, Clarke A. Functional redundancy between Apc and Apc2 regulates tissue homeostasis and prevents tumourigenesis in murine mammary epithelium. Eur J Cancer 2016. [DOI: 10.1016/s0959-8049(16)61177-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Parvathaiah H, Osman F, Daly C. An Audit to Improve Prescription Writing on Inpatient Medication Cards. Eur Psychiatry 2016. [DOI: 10.1016/j.eurpsy.2016.01.1588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
BackgroundThe most common intervention performed by physicians is the writing of a prescription. All elements in the complex process of prescribing and administering drugs are susceptible to error.AimsTo measure the extent to which information recorded on prescription cards conforms to basic standards of prescription writing.To improve prescribing, recording and staff knowledge.To identify common prescribing errors and focus on the same to improve our standard of practice.MethodsAn audit tool was designed to collect data and standard was set 100%.ResultsIn the initial audit, there was significant deficiency in prescription writing, which was presented at the internal teaching to all doctors and recommendations were made. This audit was repeated after a month, which showed improvement in prescription writing and recording.RecommendationsWrite all drugs in CAPITALS ensuring correct spelling, dose, route of administration and frequency.Complete all fields on front of the prescription card legibly.Document any change in prescription card in clinical notes.All doctors to go through their current clients medication cards and ensure any gaps filled and errors corrected.Audit report will be kept in audit folder as a reference for any rotating doctor to repeat the audit every six months in the services.ConclusionDoctors should continue to improve prescription writing and reduce any adverse events or errors.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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Abdullah AS, Hamra M, McKevitt K, Daly C, Kiernan TJ. 50 Clinical and economic outcomes of fractional flow reserve guided PCI in contemporary practice: Abstract 50 Table 1. Heart 2015. [DOI: 10.1136/heartjnl-2015-308621.50] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
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Morgan R, Daly C, Barry M. 31 Comprehensive cost analysis of inpatient and outpatient heart failure patients – a microcosting approach: Abstract 31 Table 1. Heart 2015. [DOI: 10.1136/heartjnl-2015-308621.31] [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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King G, Byrne D, Bennett K, Norris S, Daly C, Murphy RT. 9 Left atrial force as a precise haemodynamic monitor in patients with hereditary haemochromatosis pre and post venesection. Heart 2015. [DOI: 10.1136/heartjnl-2015-308621.9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Griffin E, Daly C, Corcoran P, Perry IJ, Arensman E. OP48 Aftercare following hospital-treated self-harm: patterns and trends over time. Br J Soc Med 2015. [DOI: 10.1136/jech-2015-206256.47] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Daly C, McCarthy Persson U, Twycross-Lewis R, Woledge RC, Morrissey D. The biomechanics of running in athletes with previous hamstring injury: A case-control study. Scand J Med Sci Sports 2015; 26:413-20. [DOI: 10.1111/sms.12464] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/04/2015] [Indexed: 01/13/2023]
Affiliation(s)
- C. Daly
- Centre for Sports and Exercise Medicine; William Harvey Research Institute; Bart's and the London School of Medicine and Dentistry; Mile End Hospital; Queen Mary University of London; London U.K
| | - U. McCarthy Persson
- School of Public Health, Physiotherapy & Population Science; Health Sciences Centre; University College Dublin; Dublin Ireland
| | - R. Twycross-Lewis
- Centre for Sports and Exercise Medicine; William Harvey Research Institute; Bart's and the London School of Medicine and Dentistry; Mile End Hospital; Queen Mary University of London; London U.K
| | - R. C. Woledge
- Centre for Sports and Exercise Medicine; William Harvey Research Institute; Bart's and the London School of Medicine and Dentistry; Mile End Hospital; Queen Mary University of London; London U.K
| | - D. Morrissey
- Centre for Sports and Exercise Medicine; William Harvey Research Institute; Bart's and the London School of Medicine and Dentistry; Mile End Hospital; Queen Mary University of London; London U.K
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Parvathaiah H, Daly C, Macsuibhne S, Ni chorcorain A, Guerandel A, Malone K. Development of E-learning Module On Delirium for Non-consultant Hospital Doctors Using the Delphi Method. Eur Psychiatry 2015. [DOI: 10.1016/s0924-9338(15)30782-3] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Loy A, Morgan R, O'Dea S, Daly C, Mulcahy F. Clinically significant extra-cardiac findings in asymptomatic HIV-positive men undergoing cardiac magnetic resonance imaging. Int J STD AIDS 2014; 26:346-51. [PMID: 24872375 DOI: 10.1177/0956462414538005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Increased research-based imaging has led to an increase in clinically significant extra-cardiac findings. HIV patients are at increased risk of having polypathology at a younger age; therefore, it may be hypothesised that they would have more incidental findings on imaging. We reviewed the magnetic resonance imaging results of 169 HIV-positive and 40 HIV-negative, clinically well volunteers undergoing cardiac magnetic resonance imaging scanning to assess the prevalence of subclinical cardiac pathology. This sub-study assessed the prevalence of clinically significant extra-cardiac findings. Associated risk factors were assessed and clinical follow-up and outcome were ascertained. Of the HIV-positive study group, 12/169 (7.1%) vs. 1/40 (2.5%) control patients had a clinically significant extra-cardiac finding which warranted further radiological or clinical intervention (p = 0.28). A total of three out of 169 (1.1%) were highly clinically significant findings. On logistic regression analysis, age was the only significant contributing factor (p = 0.049); no HIV-associated factors were found to be significant. The prevalence of clinically significant extra-cardiac findings of 7.1% in this HIV-positive cohort is comparable to the prevalence found in previous studies carried out on an older, sicker general population. This highlights the need for planning for unexpected outcomes and also the high rate of clinically significant findings in a seemingly well HIV-positive population.
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Affiliation(s)
- A Loy
- Genito-Urinary Infectious Disease Department, St James's Hospital, Dublin, Ireland
| | - R Morgan
- Cardiology Department, St James's Hospital, Dublin, Ireland
| | - S O'Dea
- Genito-Urinary Infectious Disease Department, St James's Hospital, Dublin, Ireland
| | - C Daly
- Cardiology Department, St James's Hospital, Dublin, Ireland
| | - F Mulcahy
- Genito-Urinary Infectious Disease Department, St James's Hospital, Dublin, Ireland
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Daly C, Callanan I, Butler M. Safety comes first: are doctors attentive enough to their initial clinical assessment notes? Ir Med J 2013; 106:316-318. [PMID: 24579415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Accurate hospital admission/initial history and physical examination [H&P] notes are vital to support patient care. We aimed to assess the quality of H&P notes and to compare medical/surgical, and inpatient/outpatient H&P notes. A cross-sectional study examined 154 initial H&P notes for the adherence to a standard protocol in a tertiary referral hospital. 134 doctors (87.1%) adhered to the correct layout in accordance with the standard. Only 77 doctors (50%) recorded the names of the patient's medications. 106 (68.8%) documented the allergy status. Six doctors (3.9%) omitted an objective record of their own identity. Surgeons were superior at recording admission type (p = 0.0001) and past surgical history (p = 0.002) only. The data in this study show that the standard o completeness of the H&P documentation among doctors is suboptimal. We recommend the introduction of a standardised H&P template to reduce errors.
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Aitken E, Dempster N, Ceresa C, Daly C, Kingsmore D. The Impact of Socioeconomic Deprivation on Outcomes Following Renal Transplantation in the West of Scotland. Transplant Proc 2013; 45:2176-83. [DOI: 10.1016/j.transproceed.2012.12.031] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2012] [Accepted: 12/30/2012] [Indexed: 01/20/2023]
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Kovalenko KE, Ciborowski JJH, Daly C, Dixon DG, Farwell AJ, Foote AL, Frederick KR, Costa JMG, Kennedy K, Liber K, Roy MC, Slama CA, Smits JEG. Food web structure in oil sands reclaimed wetlands. Ecol Appl 2013; 23:1048-1060. [PMID: 23967574 DOI: 10.1890/12-1279.1] [Citation(s) in RCA: 2] [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: 06/02/2023]
Abstract
Boreal wetlands play an important role in global carbon balance. However, their ecosystem function is threatened by direct anthropogenic disturbance and climate change. Oil sands surface mining in the boreal regions of Western Canada denudes tracts of land of organic materials, leaves large areas in need of reclamation, and generates considerable quantities of extraction process-affected materials. Knowledge and validation of reclamation techniques that lead to self-sustaining wetlands has lagged behind development of protocols for reclaiming terrestrial systems. It is important to know whether wetlands reclaimed with oil sands process materials can be restored to levels equivalent to their original ecosystem function. We approached this question by assessing carbon flows and food web structure in naturally formed and oil sands-affected wetlands constructed in 1970-2004 in the postmining landscape. We evaluated whether a prescribed reclamation strategy, involving organic matter amendment, accelerated reclaimed wetland development, leading to wetlands that were more similar to their natural marsh counterparts than wetlands that were not supplemented with organic matter. We measured compartment standing stocks for bacterioplankton, microbial biofilm, macrophytes, detritus, and zoobenthos; concentrations of dissolved organic carbon and residual naphthenic acids; and microbial production, gas fluxes, and aquatic-terrestrial exports (i.e., aquatic insect emergence). The total biomass of several biotic compartments differed significantly between oil sands and reference wetlands. Submerged macrophyte biomass, macroinvertebrate trophic diversity, and predator biomass and richness were lower in oil sands-affected wetlands than in reference wetlands. There was insufficient evidence to conclude that wetland age and wetland amendment with peat-mineral mix mitigate effects of oil sands waste materials on the fully aquatic biota. Although high variability was observed within most compartments, our data show that 20-year-old wetlands containing oil sands material have not yet reached the same level of function as their reference counterparts.
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Affiliation(s)
- K E Kovalenko
- Biological Sciences, University of Windsor, 401 Sunset Avenue, Windsor, Ontario N9B 3P4, Canada
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Moncrieff G, Cork M, Lawton S, Kokiet S, Daly C, Clark C. Use of emollients in dry-skin conditions: consensus statement. Clin Exp Dermatol 2013; 38:231-8; quiz 238. [DOI: 10.1111/ced.12104] [Citation(s) in RCA: 97] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/24/2012] [Indexed: 11/29/2022]
Affiliation(s)
| | | | - S. Lawton
- Dermatology Department; Queen's Medical Centre; Nottingham University Hospitals NHS Trust; Nottingham; UK
| | - S. Kokiet
- Bedford House Medical Centre; Ashton-under-Lyne; Greater Manchester; UK
| | - C. Daly
- Mid Norfolk Clinical Commissioning Group; North Elmham; Norfolk; UK
| | - C. Clark
- Christine Clark Ltd; Rossendale; Lancashire; UK
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Riaz A, Hieb H, Foley B, Mulvihill N, Crean P, Murphy RT, Daly C, Boyle N. Safety of therapeutic hypothermia in post VF/VT cardiac arrest patients. Ir Med J 2013; 106:55-56. [PMID: 23472389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Therapeutic hypothermia (TH) is a process of cooling a patient post ventricular tachycardia/ventricular fibrillation (VT/VF) cardiac arrest to 32-34 degrees C for 24 hours. This improves neurological outcome and is part of current guidelines. Hypothermia prolongs QT interval, which can precipitate torsades de pointes (TdP). We performed a retrospective review of all patients who received TH in our hospital over a period of 2 years to assess the effect of TH on the corrected OT interval (QTc) and any possible pro-arrhythmia. A total of 13 patients received TH. QTc prolonged in all patients with an average of 80.3 + 57.2 ms., and up to 109.8 + 80.4 ms in patients who received Amiodarone concurrently. No TdP was seen in any patient. We conclude that TH is safe, though careful monitoring of the OTc interval is advisable especially with concurrent use of QT prolonging drugs.
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Affiliation(s)
- A Riaz
- Cardiology Department, St. James's Hospital, James St, Dublin 8.
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Remany MC, Daly C, Nagaraj S, Panda AK, Jaideep K, Samraj YCT. Evidence for the presence of white spot syndrome virus (WSSV) and monodon baculovirus (MBV) in wild Penaeus monodon (Fabricius) broodstock, in the southeast coast of India. J Fish Dis 2012; 35:793-798. [PMID: 22924635 DOI: 10.1111/j.1365-2761.2012.01433.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/13/2011] [Revised: 06/22/2011] [Accepted: 06/24/2011] [Indexed: 06/01/2023]
Abstract
A survey on the presence of the viruses of two economically significant diseases, white spot syndrome virus (WSSV) and monodon baculovirus (MBV) in wild-collected Penaeus monodon broodstock, was conducted during different seasons of the year in two major coastal areas of southeast India. The broodstock were collected along the coast of Tamil Nadu and Andhra Pradesh during summer, premonsoon, monsoon and post-monsoon seasons for three consecutive years. A total of 7905 samples were collected and subjected to MBV screening, and 6709 samples that were screened as MBV negative were diagnosed for WSSV. MBV was detected using rapid malachite green staining and WSSV by nested polymerase chain reaction. Prevalence data of the viruses were analysed using the EpiCalc 2000 program at 95% confidence interval. Samples collected from the Andhra Pradesh coast displayed a slightly higher prevalence of WSSV and MBV infection than those collected from Tamil Nadu, although this difference was not statistically significant (P > 005). In addition, it was found that the prevalence of both WSSV and MBV infections fluctuated according to season. Data on prevalence of these viruses in broodstock would be useful to develop strategies for shrimp health management along the southeast coast of India.
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Affiliation(s)
- M C Remany
- Aquatic Quarantine Facility for L. vannamei, Rajiv Gandhi Centre for Aquaculture, MPEDA-Ministry of Commerce and Industry, Govt. of India, Chennai, Tamil Nadu, India.
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Bray BD, Boyd J, Daly C, Donaldson K, Doyle A, Fox JG, Innes A, Khan I, Peel RK, Severn A, Shilliday I, Simpson K, Stewart GA, Traynor J, Metcalfe W. Vascular access type and risk of mortality in a national prospective cohort of haemodialysis patients. QJM 2012; 105:1097-103. [PMID: 22908320 DOI: 10.1093/qjmed/hcs143] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.4] [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: 02/03/2023] Open
Abstract
BACKGROUND Central venous catheters (CVC) are a potential source of bacteraemia and have been associated with increased mortality in haemodialysis patients. We aimed to investigate the relationships between haemodialysis vascular access, taking into account changes in vascular access type during patients' lives, and cause specific mortality risk in a national cohort of dialysis patients. METHODS Prospective cohort study including all patients receiving haemodialysis in Scotland at annual cross sectional surveys in 2009, 2010 and 2011. Data were collected through the Scottish Renal Registry and by a structured review of case records following death. Cox proportional hazards regression and multivariable logistic regression were used to model survival and risk of death from septicaemia respectively. RESULTS Of a cohort of 2666 patients, 873 (32%) died during follow-up. After case-mix adjustment, patients using only tunnelled CVC during follow-up had a higher risk of all cause mortality across all strata of prior renal replacement therapy exposure [adjusted hazard ratio (HR): 1.83-2.08]. Case-mix adjusted risks of cardiovascular death (adjusted HR: 2.20-2.95) and infection-related death (adjusted HR: 3.10-3.63) were also higher in this group. Patients using tunnelled CVCs during follow-up and prior to death had 6.9-fold higher odds of death from septicaemia compared with those using only arteriovenous fistulae or grafts. CONCLUSION Compared with an arteriovenous fistula or graft, sustained use of tunnelled CVCs for vascular access is associated with higher risks of all-cause, cardiovascular and infection-related mortality.
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Affiliation(s)
- B D Bray
- Scottish Renal Registry, Cirrus House, Marchburn Drive, Paisley PA32SJ, UK.
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Byrne D, Daly C, Nicamhlaoibh R, Howlett A, Scanlon K, Clynes M. Use of ribozymes and antisense oligodeoxynucleotides to investigate mechanisms of drug resistance. Cytotechnology 2012; 27:113-36. [PMID: 19002787 DOI: 10.1023/a:1008052401952] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
Chemotherapy can cure a number of human cancers but resistance (either intrinsic or acquired) remains a significant problem in many patients and in many types of solid tumour. Combination chemotherapy (using drugs with different cellular targets/mechanisms) was introduced in order to kill cells which had developed resistance to a specific drug, and to allow delivery of a greater total dose of anti-cancer chemicals by combining drugs with different side-effects (Pratt et al., 1994). Nearly all anti-cancer drugs kill tumour cells by activating an endogenous bio-chemical pathway for cell suicide, known as programmed cell death or apoptosis.
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Affiliation(s)
- D Byrne
- National Cell and Tissue Culture Centre, Dublin City University, Glasnevin, Dublin 9, Ireland
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Kenny C, Adhya S, Dworakowski R, Brickham B, Maccarthy P, Monaghan M, Guzzo A, Innocenti F, Vicidomini S, Lazzeretti D, Squarciotta S, De Villa E, Donnini C, Bulletti F, Guerrini E, Pini R, Bendjelid K, Viale J, Duperret S, Piriou V, Jacques D, Shahgaldi K, Silva C, Pedro F, Deister L, Brodin LA, Sahlen A, Manouras A, Winter R, Berjeb N, Cimadevilla C, Dreyfus J, Cueff C, Malanca M, Chiampan A, Vahanian A, Messika-Zeitoun D, Muraru D, Peluso D, Dal Bianco L, Beraldo M, Solda' E, Tuveri M, Cucchini U, Al Mamary A, Badano L, Iliceto S, Almuntaser I, King G, Norris S, Daly C, Ellis E, Murphy R, Erdei T, Denes M, Kardos A, Foldesi C, Temesvari A, Lengyel M, Bouzas Mosquera A, Broullon F, Alvarez-Garcia N, Peteiro J, Barge-Caballero G, Lopez-Perez M, Lopez-Sainz A, Castro-Beiras A, Luotolahti M, Luotolahti H, Kantola I, Viikari J, Andersen M, Ersboell M, Bro-Jeppesen J, Gustafsson F, Koeber L, Hassager C, Moller J, Coisne D, Diakov C, Vallet F, Lequeux B, Blouin P, Christiaens L, Esposito R, Santoro A, Schiano Lomoriello V, Raia R, Santoro C, De Simone G, Galderisi M, Sahlen A, Abdula G, Winter R, Kosmala W, Szczepanik-Osadnik H, Przewlocka-Kosmala M, Mysiak A, O' Moore-Sullivan T, Marwick T, Tan YT, Wenzelburger F, Leyva F, Sanderson J, Pichler P, Syeda B, Hoefer P, Zuckermann A, Binder T, Fijalkowski M, Koprowski A, Galaska R, Blaut K, Sworczak K, Rynkiewicz A, Lee S, Kim W, Jung L, Yun H, Song M, Ko J, Khalifa EA, Szymanski P, Lipczynska M, Klisieiwcz A, Hoffman P, Jorge C, Silva Marques J, Robalo Martins S, Calisto C, Mieiro M, Vieira S, Correia M, Carvalho De Sousa J, Almeida A, Nunes Diogo A, Park C, March K, Tillin T, Mayet J, Chaturvedi N, Hughes A, Di Bello V, Giannini C, Delle Donne M, De Sanctis F, Spontoni P, Cucco C, Corciu A, Grigoratos C, Bogazzi F, Balbarini A, Enescu O, Suran B, Florescu M, Cinteza M, Vinereanu D, Higuchi Y, Iwakura K, Okamura A, Date M, Fujii K, Jorge C, Cortez-Dias N, Silva D, Carrilho-Ferreira P, Silva Marques J, Magalhaes A, Ribeiro S, Goncalves S, Fiuza M, Pinto F, Jorge C, Cortez-Dias N, Silva D, Silva Marques J, Carrilho-Ferreira P, Placido R, Bordalo A, Goncalves S, Fiuza M, Pinto F, Grzywocz P, Mizia-Stec K, Chudek J, Gasior Z, Maceira Gonzalez AM, Cosin Sales J, Dalli E, Igual B, Diago J, Aguilar J, Ruvira J, Cimino S, Pedrizzetti G, Tonti G, Canali E, Petronilli V, Boccalini F, Mattatelli A, Hiramoto Y, Iacoboni C, Agati L, Trifunovic D, Ostojic M, Vujisic-Tesic B, Petrovic M, Nedeljkovic I, Banovic M, Boricic-Kostic M, Draganic G, Tesic M, Petrovic M, Gavina C, Lopes R, Lourenco A, Almeida J, Rodrigues J, Pinho P, Zamorano J, Leite-Moreira A, Rocha-Goncalves F, Clavel MA, Capoulade R, Dumesnil J, Mathieu P, Despres JP, Pibarot P, Bull S, Pitcher A, Augustine D, D'arcy J, Karamitsos T, Rai A, Prendergast B, Becher H, Neubauer S, Myerson S, Magne J, Donal E, Davin L, O'connor K, Pirlet C, Rosca M, Szymanski C, Cosyns B, Pierard L, Lancellotti P, Calin A, Rosca M, Popescu B, Beladan C, Enache R, Lupascu L, Sandu C, Lancellotti P, Pierard L, Ginghina C, Kamperidis V, Hadjimiltiadis S, Sianos G, Anastasiadis K, Grosomanidis V, Efthimiadis G, Karvounis H, Parharidis G, Styliadis I, Gonzalez Canovas C, Munoz-Esparza C, Bonaque Gonzalez J, Fernandez A, Salar Alcaraz M, Saura Espin D, Pinar Bermudez E, Oliva-Sandoval M, De La Morena Valenzuela G, Valdes Chavarri M, Dreyfus J, Brochet E, Lepage L, Attias D, Cueff C, Detaint D, Himbert D, Iung B, Vahanian A, Messika-Zeitoun D, Pirat B, Little S, Chang S, Tiller L, Kumar R, Zoghbi W, Lee APW, Hsiung M, Wan S, Wong R, Luo F, Fang F, Xie J, Underwood M, Sun J, Yu C, Jansen R, Tietge W, Sijbrandij K, Cramer M, De Heer L, Kluin J, Chamuleau SAJ, Oliveras Vila T, Ferrer Sistach E, Delgado Ramis L, Lopez Ayerbe J, Vallejo Camazon N, Gual Capllonch F, Garcia Alonso C, Teis Soley A, Ruyra Baliarda X, Bayes Genis A, Negrea S, Alexandrescu C, Bourlon F, Civaia F, Dreyfus G, Paetzold S, Luha O, Hoedl R, Stoschitzky G, Pfeiffer K, Zweiker D, Pieske B, Maier R, Sevilla T, Revilla A, Lopez J, Vilacosta I, Arnold R, Gomez I, San Roman J, Nikcevic G, Djordjevic Dikic A, Djordjevic S, Raspopovic S, Jovanovic V, Kircanski B, Pavlovic S, Milasinovic G, Ruiz-Zamora I, Cabrera Bueno F, Molina M, Fernandez-Pastor J, Pena J, Linde A, Barrera A, Alzueta J, Bremont C, Bensaid A, Alonso H, Zaghden O, Nahum J, Dubois-Rande J, Gueret P, Lim P, Lee SP, Park K, Kim HR, Lee JH, Ahn HS, Kim JH, Kim HK, Kim YJ, Sohn DW, Niemann M, Herrmann S, Hu K, Liu D, Beer M, Ertl G, Wanner C, Takenaka T, Tei C, Weidemann F, Silva D, Madeira H, Mendes Pedro M, Nunes Diogo A, Brito D, Schiano Lomoriello V, Ippolito R, Santoro A, Esposito R, Raia R, De Palma D, Galderisi M, Gati S, Oxborough D, Reed M, Zaidi A, Ghani S, Sheikh N, Papadakis M, Sharma S, Chow V, Ng A, Pasqualon T, Zhao W, Hanzek D, Chung T, Yeoh T, Kritharides L, Florescu M, Magda L, Enescu O, Mihalcea D, Suran B, Jinga D, Mincu R, Cinteza M, Vinereanu D, Ferrazzi E, Segato G, Folino F, Famoso G, Senzolo M, Bellu R, Corbetti F, Iliceto S, Tona F, Azevedo O, Quelhas I, Guardado J, Fernandes M, Pereira V, Medeiros R, Lourenco A, Sousa P, Santos W, Pereira S, Marques N, Mimoso J, Marques V, Jesus I, Rustad L, Nytroen K, Gullestad L, Amundsen B, Aakhus S, Linhartova K, Sterbakova G, Necas J, Kovalova S, Cerbak R, Nelassov N, Korotkijan N, Shishkina A, Gagieva B, Nagaplev M, Eroshenko O, Morgunov M, Parmon S, Velthuis S, Van Gent M, Post M, Westermann C, Mager J, Snijder R, Koyalakonda SP, Anderson M, Burgess M, Bergenzaun L, Chew M, Ohlin H, Gjerdalen GF, Hisdal J, Solberg E, Andersen T, Radunovic Z, Steine K, Rutz T, Kuehn A, Petzuch K, Pekala M, Elmenhorst J, Fratz S, Mueller J, Hager A, Hess J, Vogt M, Van Der Linde D, Van De Laar I, Wessels M, Bekkers J, Moelker A, Tanghe H, Van Kooten F, Oldenburg R, Bertoli-Avella A, Roos-Hesselink J, Cresti A, Fontani L, Calabria P, Capati E, Severi S, Lynch M, Saraf S, Sandler B, Yoon S, Kim S, Ko C, Ryu S, Byun Y, Seo H, Ciampi Q, Rigo F, Pratali L, Gherardi S, Villari B, Picano E, Sicari R, Celutkiene J, Zakarkaite D, Skorniakov V, Zvironaite V, Grabauskiene V, Sinicyna J, Gruodyte G, Janonyte K, Laucevicius A, O'driscoll J, Schmid K, Marciniak A, Saha A, Gupta S, Smith R, Sharma R, Bouzas Mosquera A, Alvarez Garcia N, Peteiro J, Broullon F, Prada O, Rodriguez Vilela A, Barge Caballero G, Lopez Perez M, Lopez Sainz A, Castro Beiras A, Kochanowski J, Scislo P, Piatkowski R, Grabowski M, Marchel M, Roik M, Kosior D, Opolski G, Van De Heyning CM, Magne J, O'connor K, Mahjoub H, Pibarot P, Pirlet C, Pierard L, Lancellotti P, Clausen H, Basaggianis C, Newton J, Del Pasqua A, Carotti A, Di Carlo D, Cetrano E, Toscano A, Iacobelli R, Esposito C, Chinali M, Pongiglione G, Rinelli G, Larsson M, Larsson M, Bjallmark A, Winter R, Caidahl K, Brodin L, Velthuis S, Van Gent M, Mager J, Westermann C, Snijder R, Post M, Gao H, Coisne D, Lugiez M, Guivier C, Rieu R, D'hooge J, Lugiez M, Hang G, D'hooge J, Guerin C, Christiaens L, Menard M, Voigt JU, Coisne D, Dungu J, Campos G, Jaffarulla R, Gomes-Pereira S, Sutaria N, Baker C, Nihoyannopoulos P, Bellamy M, Adhya S, Harries D, Walker N, Pearson P, Reiken J, Batteson J, Kamdar R, Murgatroyd F, Monaghan M, D'andrea A, Riegler L, Scarafile R, Pezzullo E, Salerno G, Bossone E, Limongelli G, Russo M, Pacileo G, Calabro' R, Kang Y, Cui J, Chen H, Pan C, Shu X, Kiotsekoglou A, Saha S, Toole R, Govind S, Gopal A, Crispi F, Bijnens B, Sepulveda-Swatson E, Rojas-Benavente J, Dominguez J, Illa M, Eixarch E, Sitges M, Gratacos E, Prinz C, Faludi R, Walker A, Amzulescu M, Gao H, Uejima T, Fraser A, Voigt J, Esmaeilzadeh M, Maleki M, Amin A, Vakilian F, Noohi F, Ojaghi Haghighi Z, Nakhostin Davari P, Bakhshandeh Abkenar H, Rimbas R, Dulgheru R, Margulescu A, Florescu M, Vinereanu D, Toscano A, Chinali M, D' Asaro M, Iacobelli R, Del Pasqua A, Esposito C, Mizzon C, Parisi F, Pongiglione G, Rinelli G, Jung BC, Lee BY, Kang HJ, Kim S, Kim M, Kim Y, Cho D, Park S, Hong S, Lim D, Shim W, Bellsham-Revell H, Tibby S, Bell AJ, Miller OI, Greil G, Simpson JM, Providencia RA, Trigo J, Botelho A, Gomes P, Seca L, Barra S, Faustino A, Costa G, Quintal N, Leitao-Marques A, Nestaas E, Stoylen A, Fugelseth D, Mornos C, Ionac A, Petrescu L, Cozma D, Dragulescu D, Mornos A, Pescariu S, Fontana A, Abbate M, Cazzaniga M, Giannattasio C, Trocino G, Laser K, Faber L, Fischer M, Koerperich H, Kececioglu D, Elnoamany MF, Dawood A, Elhabashy M, Khalil Y, Fontana A, Abbate M, Cazzaniga M, Giannattasio C, Trocino G, Piriou N, Warin-Fresse K, Caza M, Fau G, Crochet D, Xhabija N, Allajbeu I, Petrela E, Heba M, Barreiro Perez M, Martin Fernandez M, Renilla Gonzalez A, Florez Munoz J, Fernandez Cimadevilla O, Alvarez Pichel I, Velasco Alonso E, Leon Duran D, Benito Martin E, Secades Gonzalez S, Gargani L, Pang P, Davis E, Schumacher A, Sicari R, Picano E, Silva Ferreira A, Bettencourt N, Matos P, Oliveira L, Almeida A, Maceira Gonzalez AM, Cosin-Sales J, Igual B, Lopez Lereu M, Monmeneu J, Estornell J, Tsverava M, Tsverava D, Varela A, Salagianni M, Galani I, Andreakos E, Davos C, Ikonomidis I, Lekakis J, Tritakis V, Kadoglou N, Papadakis J, Trivilou P, Tzortzis S, Koukoulis C, Paraskevaidis I, Anastasiou-Nana M, Kim G, Youn H, Park C, Ibrahimi P, Bajraktari G, Jashari F, Ahmeti A, Poniku A, Haliti E, Henein M, Pezo Nikolic B, Jurin H, Lovric D, Baricevic Z, Ivanac Vranesic I, Lovric Bencic M, Ernst A, Separovic Hanzevacki J. Poster Session 3: Friday 9 December 2011, 08:30-12:30 * Location: Poster Area. European Journal of Echocardiography 2011. [DOI: 10.1093/ejechocard/jer214] [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: 11/13/2022]
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Pepin NC, Daly C, Lundquist J. The influence of surface versus free-air decoupling on temperature trend patterns in the western United States. ACTA ACUST UNITED AC 2011. [DOI: 10.1029/2010jd014769] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Papadopoulos KP, Chau NG, Patnaik A, Adriaens L, Lalani AS, Daly C, Siu LL. A phase I first-in-human study of REGN910, a fully human and selective angiopoietin-2 monoclonal antibody, in patients with advanced solid tumor malignancies. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.tps159] [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: 11/20/2022] Open
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Pabari PA, Kyriacou A, Moraldo M, Unsworth B, Baruah R, Sutaria N, Hughes A, Mayet J, Francis DP, Uejima T, Loboz K, Antonini-Canterin F, Polombo C, Carerj S, Hughes A, Vinereanu D, Evangelista A, Leftheriotis G, Fraser AG, Kiotsekoglou A, Govindan M, Govind SC, Saha SK, Camm AJ, Azcarate PM, Castano S, Rodriguez-Manero M, Arraiza M, Levy B, Barba J, Rabago G, Bastarrika G, Nemes A, Takacs R, Varkonyi T, Gavaller H, Baczko I, Forster T, Wittmann T, Papp JG, Lengyel C, Varro A, Tumasyan LR, Adamyan KG, Savu O, Mieghem T, Dekoninck P, Gucciardo L, Jurcut R, Giusca S, Popescu BA, Ginghina C, Deprest J, Voigt JU, Versiero M, Galderisi M, Esposito R, Rapacciuolo A, Esposito G, Raia R, Morgillo T, Piscione F, De Simone G, Oraby MA, Maklady FA, Mohamed EM, Eraki AZ, Zaliaduonyte-Peksiene D, Tamuleviciute E, Janenaite J, Marcinkeviciene J, Mizariene V, Bucyte S, Vaskelyte J, Trifunovic D, Nedeljkovic I, Popovic D, Ostojic M, Vujisic-Tesic B, Petrovic M, Stankovic S, Sobic-Saranovic D, Banovic M, Dikic-Djordjevic A, Savino K, Lilli A, Grikstaite E, Giglio V, Bordoni E, Maragoni G, Cavallini C, Ambrosio G, Nedeljkovic I, Ostojic M, Vujisic-Tesic B, Jakovljevic B, Petrovic M, Trifunovic D, Beleslin B, Nedeljkovic M, Banovic M, Petrovic O, Moral S, Rodriguez-Palomares J, Descalzo M, Marti G, Pineda V, Mahia P, Gutierrez L, Gonzalez-Alujas T, Evangelista A, Garcia-Dorado D, Schnell F, Donal E, Thebault C, Bernard A, Corbineau H, Le Breton H, Kochanowski J, Scislo P, Piatkowski R, Roik M, Marchel M, Kosior D, Opolski G, Lesniak-Sobelga AM, Wicher-Muniak E, Kostkiewicz M, Olszowska M, Suchon E, Klimeczek P, Banys P, Pasowicz M, Tracz W, Podolec P, Moral S, Rodriguez-Palomares J, Descalzo M, Pineda V, Mahia P, Gutierrez L, Gonzalez-Alujas T, Laynez A, Evangelista A, Garcia-Dorado D, Hoefsten DE, Loegstrup BB, Norager B, Moller JE, Flyvbjerg A, Egstrup K, Streb W, Szulik M, Nowak J, Markowicz-Pawlus E, Duszanska A, Sedkowska A, Kalarus Z, Kukulski T, Spinelli L, Morisco C, Assante Di Panzillo E, Buono F, Crispo S, Trimarco B, Oraby MA, Hawary AA, Nasr GM, Fawzy MM, Faber L, Scholtz W, Boergermann J, Wiemer M, Kleikamp G, Bogunovic N, Dimitriadis Z, Gummert J, Hering D, Horstkotte D, Luca' F, Gelsomino S, Lorusso R, Caciolli S, Carella R, Bille' G, De Cicco G, Pazzagli V, Gensini GF, Borowiec A, Dabrowski R, Janas J, Kraska A, Firek B, Kowalik I, Szwed H, Marcus KA, De Korte CL, Feuth T, Thijssen JM, Kapusta L, Dahl J, Videbaek L, Poulsen MK, Pellikka PA, Veien K, Andersen LI, Haghfelt T, Moller JE, Haberka M, Mizia - Stec K, Adamczyk T, Mizia M, Chmiel A, Pysz P, Sosnowski M, Gasior Z, Trusz - Gluza M, Tendera M, Niklewski T, Wilczek K, Chodor P, Podolecki T, Frycz-Kurek A, Kukulski T, Kalarus Z, Zembala M, Yurdakul S, Yildirimturk O, Tayyareci Y, Memic K, Demiroglu ICC, Aytekin S, Garcia Alonso CJ, Ferrer Sistach E, Delgado L, Lopez Ayerbe J, Vallejo Camazon N, Gual Capllonch F, Espriu Simon M, Ruyra X, Caballero Parrilla A, Bayes Genis A, Lecuyer L, Berrebi A, Florens E, Noghin M, Huerre C, Achouh P, Zegdi R, Fabiani JN, De Chiara B, Moreo A, Musca F, De Marco F, Lobiati E, Belli O, Mauri F, Klugmann S, Caballero A, Vallejo N, Gonzalez Guardia A, Nunez Aragon R, Bosch C, Lopez Ayerbe J, Ferrer E, Pedro Botet ML, Gual F, Bayes Genis A, Cusma-Piccione M, Zito C, Oreto G, Giuffre R, Todaro MC, Barbaro CM, Lanteri S, Longordo C, Salvia J, Carerj S, Bensaid A, Gallet R, Fougeres E, Lim P, Nahum J, Deux JF, Gueret P, Teiger E, Dubois-Rande JL, Monin JL, Yurdakul S, Tayyareci Y, Yildirimturk O, Behramoglu F, Colakoglu Z, Aytekin V, Demiroglu C, Aytekin S, Gargani L, Poggianti E, Bucalo R, Rizzo M, Agrusta F, Landi P, Sicari R, Picano E, Sutandar A, Siswanto BB, Irmalita I, Harimurti G, Hayashi SY, Nascimento MM, Lindholm B, Lind B, Seeberger A, Nowak J, Pachaly MA, Riella MC, Bjallmark A, Brodin LA, Poanta L, Porojan M, Dumitrascu DL, Ikonomidis I, Tzortzis S, Lekakis J, Kremastinos DT, Paraskevaidis I, Andreadou I, Nikolaou M, Katsibri P, Anastasiou-Nana M, Maceira Gonzalez AM, Ripoll C, Cosin-Sales J, Igual B, Salazar J, Belloch V, Cosin-Aguilar J, Pennell DJ, Masaki M, Pulido JN, Yuasa T, Gillespie S, Afessa B, Brown DR, Mankad SV, Oh JK, Gurghean AL, Mihailescu AM, Tudor I, Homentcovschi C, Muraru M, Bruckner IV, Correia CE, Rodrigues B, Moreira D, Santos LF, Gama P, Dionisio O, Cabral C, Santos O, Bombardini T, Gherardi S, Arpesella G, Valente S, Calamai I, Pasanisi E, Sansoni S, Picano E, Szymanski P, Dobrowolski P, Lipczynska M, Klisiewicz A, Hoffman P, Stepowski D, Kurtz B, Grezis-Soulie G, Savoure A, Anselme F, Bauer F, Castillo J, Herszkowicz N, Ferreira C, Goscinska A, Mizia-Stec K, Gasior Z, Mizia M, Haberka M, Chmiel A, Poborski W, Azevedo O, Quelhas I, Guardado J, Fernandes M, Miranda CS, Gaspar P, Lourenco A, Medeiros R, Almeida J, L Bennani S, Algalarrondo V, Dinanian S, Guiader J, Juin C, Adams D, Slama MS, Onaindia JJ, Quintana O, Velasco S, Astigarraga E, Cacicedo A, Gonzalez J, Rodriguez I, Sadaba M, Eneriz M, Laraudogoitia Zaldumbide E, Nunez-Gil I, Luaces M, Zamorano J, Garcia Rubira JC, Vivas D, Ibanez B, Marcos Alberca P, Fernandez Golfin C, Alonso J, Macaya C, Silva Marques J, Almeida AG, Carvalho V, Jorge C, Silva D, Gato Varela M, Martins S, Brito D, Lopes MG, Tripodi E, Miserrafiti B, Montemurro V, Scali R, Tripodi P, Marchel M, Kochanowski J, Piatkowski R, Scislo P, Winkler A, Madej A, Hausmanowa-Petrusewicz I, Opolski G, Fijalkowski M, Koprowski A, Jaguszewski M, Galaska R, Taszner M, Rynkiewicz A, Citro R, Rigo F, Provenza G, Ciampi Q, Patella MM, D'andrea A, Antonini-Canterin F, Vriz O, Astarita C, Bossone E, Heggemann F, Walter TH, Kaelsch TH, Sueselbeck T, Papavassiliu TH, Borggrefe M, Haghi D, Monk-Hansen T, Have Dall C, Bisgaard Christensen S, Snoer M, Gustafsson F, Rasmusen H, Prescott E, Finocchiaro G, Pinamonti B, Merlo M, Barbati G, Di Lenarda A, Bussani R, Sinagra G, Butz T, Faber L, Lang CN, Meissner A, Plehn G, Yeni H, Langer C, Horstkotte D, Trappe HJ, Gu X, Gu XY, He YH, Li ZA, Han JC, Chen J, Gaudron P, Niemann M, Herrmann S, Hu K, Bijnens B, Hillenbrand H, Beer M, Ertl G, Weidemann F, Mazzone A, Mariani M, Foffa I, Vianello A, Del Ry S, Bevilacqua S, Andreassi MG, Glauber M, Berti S, Kochanowski J, Scislo P, Piatkowski R, Grabowski M, Roik M, Postula M, Marchel M, Kosior D, Opolski G, Dragulescu A, Van Arsdell G, Al-Radi O, Caldarone C, Mertens L, Lee KJ, Unsworth B, Casula RP, Yadav H, Baruah R, Cherian A, Sutaria N, Hughes AD, Mayet J, Francis DP, Vitarelli A, D'orazio S, Nguyen BL, Iorio G, Battaglia D, Caranci F, Padella V, Capotosto L, Alessandroni L, Barilla F, Cardin C, Hascoet S, Saudron M, Caudron G, Arnaudis B, Acar P, Sun MM, Shu XH, Pan CZ, Fang XY, Kong DH, Fang F, Zhang Q, Chan YS, Xie JM, Yip WK, Lam YY, Sanderson JE, Yu CM, Rosca M, O' Connor K, Romano G, Magne J, Calin A, Popescu BA, Muraru D, Pierard L, Ginghina C, Lancellotti P, Roushdy A, Elfiky I, El Shahid G, Elfiky A, El Sayed M, Wierzbowska-Drabik K, Chrzanowski L, Kapusta A, Plonska-Goscinak E, Krzeminska-Pakula M, Kurpesa M, Rechcinski T, Trzos E, Kasprzak JD, Ersboll MK, Valeur N, Mogensen UM, Andersen M, Moller JE, Hassager C, Sogaard P, Kober LV, Kloeckner M, Hayat D, Nahum J, Dussault C, Lellouche N, Elbaz N, Dubois-Rande JL, Gueret P, Lim P, Demopoulos A, Hatzigeorgiou G, Leontiades E, Motsi A, Karatasakis G, Athanassopoulos G, Zycinski P, Chrzanowski L, Wierzbowska-Drabik K, Kasprzak J, Vazquez Alvarez MC, Medrano Lopez C, Camino Lopez M, Granja S, Zunzunegui Martinez JL, Maroto Alvaro E, Tsai WC, Chen JY, Liu YW, Lin CC, Tsai LM, Silva Marques J, Gomes DC, Robalo Martins S, Gois MR, Ribeiro S, Nunes Diogo A, Almeida AG, Lopes MG, Zito C, Sengupta P, Di Bella G, Cusma-Piccione M, Oreto G, Caracciolo G, Longordo C, Lentini S, Carerj S, Kinova E, Zlatareva N, Goudev A, Papagiannis N, Mpouki M, Papagianni A, Vorria M, Mpenetos G, Lytra D, Papadopoulou E, Sgourakis P, Malakos J, Kyriazis J, Saha SK, Kodali V, Toole R, Govind SC, 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O, Polombo C, Carerj S, Hughes A, Vinereanu D, Gutierrez FR, Lefhtheriotis G, Fraser AG, Hurst RT, Nelson MR, Mookadam F, Thota V, Emani U, Al Harthi M, Stepanek J, Cha S, Lester SJ, Ho EMM, Hemeryck L, Hall M, Scott K, Bennett K, Mahmud A, Daly C, King G, Murphy RT, Brown AS, Teske AJ, D'Hooge J, Claus P, Rademakers F, Voigt JU, Santos L, Cortez-Dias N, Silva D, Silva Marques J, Ribeiro S, Goncalves S, Almeida Ribeiro M, Robalo Martins S, Bordalo E Sa A, Lopes MG, Teske AJ, D'Hooge J, Claus P, Rademakers F, Voigt JU, Magnino C, Marcos-Alberca P, Milan A, Nunez-Gil I, Almeria C, Caniadas V, Rodrigo JL, Perez De Isla L, Macaya C, Zamorano JL, Gustafsson U, Larsson M, Bjallmark A, Lindqvist P, Brodin L, Waldenstrom A, Roosens B, Hernot S, Droogmans S, Van Camp G, Lahoutte T, Lancellotti P, Cosyns B, Ho EMM, Scott K, Hemeryck L, Hall M, Bennett K, Mahmud A, Daly C, King G, Murphy RT, Brown AS, Rao CM, Aguglia D, Casciola G, Imbesi C, Marvelli A, Sgro M, Benedetto D, Tripepi R, Zoccali C, Benedetto FA, Muraru D, Badano LP, Cardillo M, Del Mestre L, Gianfagna P, Proclemer A, Tschernich HD, Mora B, Base E, Weber U, Dumfarth J, Mukherjee C, Skaltsiotis HS, Kaladaridis AK, Bramos DB, Kottis GK, Antoniou AA, Agrios IA, Takos DT, Vasiladiotis NV, Pamboucas KP, Toumanidis STT, Shim A, Kasprzak JD, Lipec P, Michalski B, Wozniakowski B, Stefanczyk L, Rotkiewicz A, Cameli M, Lisi M, Padeletti M, Bigio E, Bernazzali S, Tsoulpas C, Maccherini M, Henein M, Mondillo S, Garcia Lunar I, Mingo Santos S, Monivas Palomero V, Mitroi C, Beltran Correas P, Ruiz Bautista L, Muniz Lozano A, Gonzalez Gonzalez M, Pabari PA, Stegemann B, Willson K, Kyriacou A, Moraldo M, Mayet J, Hughes A, Francis DP, Zeppellini R, Iavernaro A, Zadro M, Carasi M, De Domenico R, Rigo T, Artuso E, Erente G, Ramondo A, Le TT, Huang FQ, Gu Y, Tan RS. Poster session II * Thursday 9 December 2010, 14:00-18:00. European Journal of Echocardiography 2010. [DOI: 10.1093/ejechocard/jeq138] [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: 11/12/2022]
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Murphy MC, Steele JL, Daly C, McKay LL. Concomitant conjugal transfer of reduced-bacteriophage-sensitivity mechanisms with lactose- and sucrose-fermenting ability in lactic streptococci. Appl Environ Microbiol 2010; 54:1951-6. [PMID: 16347707 PMCID: PMC202785 DOI: 10.1128/aem.54.8.1951-1956.1988] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Ten previously reported lactose-positive (Lac) transconjugants from Streptococcus lactis, S. cremoris, and S. lactis subsp. diacetylactis and one sucrose-positive (Suc) transconjugant from S. lactis were examined for their sensitivity to prolate- and small isometric-headed bacteriophages. Four of the Lac transconjugants showed a 10- to 100-fold reduction in the efficiency of plating (EOP) as well as a reduced plaque size for the prolate phage c2 and were insensitive to the small isometric phage 712. A fifth Lac transconjugant demonstrated a similar reduced sensitivity to phage c2; however, this transconjugant was able to plaque phage 712, but with a reduced plaque size and EOP. The other five Lac transconjugants were sensitive to both c2 and 712 phages. The Suc transconjugant plaqued phage 712 with a reduced plaque size and EOP, but no reduction in plaque size or EOP was observed for phage c2. The Lac and reduced bacteriophage sensitivity (Rbs) phenotypes were correlated with specific plasmids in the Lac transconjugants. As four of the Lac transconjugants exhibited a phenotypically indistinguishable Rbs, one (AB001) was selected for further study. The Rbs in AB001 for both small isometric- and prolate-headed phages was not related to adsorption, and the reduced EOP for phage c2 was not related to the presence of a restriction and modification system. The latent period for phage c2 was unchanged, but the burst size was reduced 80%. The presence of the plasmid coding for Rbs retarded the lysis of a mitomycin C-induced prophage-containing strain. The Rbs mechanism appears to be abortive phage infection. This study supports previous observations that Rbs and conjugal transfer ability are physically linked among some group N streptococci. The results presented have implications in the identification of plasmids coding for Rbs and may also aid in explaining the dissemination of Rbs genes among lactic streptococci.
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Affiliation(s)
- M C Murphy
- Department of Food Science and Nutrition, University of Minnesota, 1334 Eckles Avenue, St. Paul, Minnesota 55108, and Department of Dairy and Food Microbiology, University College, Cork, Ireland
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