1
|
Ralston K, Degnan A, Groom C, Leonard C, Munang L, Japp A, Rimer J. 1234 IMPROVING HEART FAILURE MANAGEMENT WITHIN HOSPITAL AT HOME. Age Ageing 2023. [DOI: 10.1093/ageing/afac322.070] [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: 01/18/2023] Open
Abstract
Abstract
Introduction
Heart failure (HF) is a common problem managed in our West Lothian multi-disciplinary hospital at home (HaH) service, however significant variation in practice was noted with considerable resource implications. We aimed to standardise and improve this by developing a dedicated protocol.
Methods
We developed a protocol to guide the assessment and management of HF within HaH. We collected baseline (n=25) and follow-up data (n=10) after protocol introduction from patients referred to HaH with heart failure. Outcomes reviewed included anticipatory care planning (ACP) decisions, length of stay (LOS) and treatment strategy. We held staff education sessions and surveyed staff confidence regarding HF management.
Results
ACP discussion rates improved after protocol introduction, with decision rates improving for both escalation of care (28% to 80%) and resuscitation (44% to 60%). LOS reduced after protocol introduction (mean 6.3 days to 5.9 days). Titration of oral diuretics alone (71%) was associated with a shorter LOS (mean 5.4 days) compared to IV (29%, mean 8.1 days), with no difference in 28 day outcome. In those with HF with reduced ejection fraction, the rates of beta-blocker prescription increased (57% to 80%) however ACE-inhibitor prescription decreased (29% to 20%). Use of add-on therapy (e.g. thiazide diuretics) increased (12% to 30%) with a decrease in complication rates (12% to 0%). All staff found the protocol helpful with an improvement in confidence levels.
Conclusions
Through introducing a standardised protocol, we observed an improvement in anticipatory care discussion rates and a trend towards shorter LOS. Oral diuretic titration was less resource intensive without an adverse impact on outcome. Future plans include ongoing education and data collection, trialling a joint multi-disciplinary meeting with cardiology for discussion of complex patients and embedding a treatment strategy of oral diuretic titration with a ‘discharge with planned review' approach in appropriate patients.
Collapse
Affiliation(s)
- K Ralston
- REACT Hospital at Home, Medicine of the Elderly, St John’s Hospital , Livingston, UK
| | - A Degnan
- REACT Hospital at Home, Medicine of the Elderly, St John’s Hospital , Livingston, UK
| | - C Groom
- REACT Hospital at Home, Medicine of the Elderly, St John’s Hospital , Livingston, UK
| | - C Leonard
- REACT Hospital at Home, Medicine of the Elderly, St John’s Hospital , Livingston, UK
| | - L Munang
- REACT Hospital at Home, Medicine of the Elderly, St John’s Hospital , Livingston, UK
| | - A Japp
- St John’s Hospital Department of Cardiology, , Livingston, UK
| | - J Rimer
- REACT Hospital at Home, Medicine of the Elderly, St John’s Hospital , Livingston, UK
| |
Collapse
|
2
|
Kodate N, Kohli P, McGinn C, Scott R, Ross E, Treusch P, Maeda Y, Donnelly S, Leonard C, Cogan L, Mannan H, O’Shea D, Obayashi K, Masuyama S. 43 EXPLORING STAFF PERCEPTIONS AND ATTITUDES TO CARE AND CAREBOTS: THE CASE OF AN ORIGINAL AIR-DISINFECTION ROBOT IN IRELAND. Age Ageing 2022. [DOI: 10.1093/ageing/afac218.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
The pandemic heightened the sense of security and safety in care settings, with cleanliness and infection control becoming an even more important aspect of care delivery. Although the impact of new welfare technology on health and social care has been discussed in recent years, few studies have reported the implementation processes or human-robot interactions in care facilities in different cultural settings. The aims of this interdisciplinary research therefore were to understand needs and aspects that have to be considered for implementing an assistive robot, and to explore user perceptions, and the process by which the robots are adopted in Ireland and Japan.
Methods
An original air-disinfection robot (V-Air) was developed by Akara Robotics, as part of research project “Harmonisation towards the establishment of Person-centred, Robotics-aided Care System” (Toyota Foundation, D18-ST-0005). Prior to its instalment in a rehabilitation centre in Dublin, semi-structured interviews were conducted, and observations carried out with seven care professionals, as they interacted with V-Air. The robot was then trialled for eight weeks (March-May 2022) in selected areas of the facility. After four weeks, the users filled out the System Usability Score and were asked questions at the end of the trial. Their scores and answers to the questions revealed staff perceptions and attitudes to care robots.
Results
Overall, the users had positive perceptions of V-Air and its usability. Initial differences existed in staff’s confidence levels, depending on prior experiences with technologies. Collective sensemaking was observed, particularly, around care delivery processes and robot functionalities. The adoption process was facilitated by several factors such as the timing of introduction, user-centred design, concept of care and organisational support.
Conclusion
The findings suggest that the introduction of care robots in care settings can offer an additional layer of organisational safety, while highlighting the significance of the iterative process in adopting assistive technologies.
Collapse
Affiliation(s)
- N Kodate
- University College Dublin School of Social Policy, Social Work and Social Justice, , Dublin, Ireland
- Universal Accessibility & Ageing Research Centre , Nishitokyo, Japan
- Hokkaido University Public Policy Research Center, , Sapporo, Japan
- L’École des Hautes Etudes En Sciences Sociales, Fondation France Japon , Paris, France
- University of Tokyo Institute for Future Initiatives, , Tokyo, Japan
| | - P Kohli
- Maynooth University Department of Sociology, , Maynooth, Ireland
| | - C McGinn
- Trinity College Dublin Department of Mechanical, Manufacturing & Biomedical Engineering, , Dublin, Ireland
- Akara Robotics , Dublin, Ireland
| | - R Scott
- Akara Robotics , Dublin, Ireland
| | - E Ross
- Royal Hospital Donnybrook , Dublin, Ireland
| | - P Treusch
- Trinity College Dublin Trinity Long Room Hub, , Dublin, Ireland
| | - Y Maeda
- Technological University Dublin , Dublin, Ireland
| | - S Donnelly
- University College Dublin School of Social Policy, Social Work and Social Justice, , Dublin, Ireland
| | - C Leonard
- Royal Hospital Donnybrook , Dublin, Ireland
| | - L Cogan
- Royal Hospital Donnybrook , Dublin, Ireland
| | - H Mannan
- University College Dublin School of Nursing, Midwifery and Health System, , Dublin, Ireland
| | - D O’Shea
- St. Vincent’s University Hospital , Dublin, Ireland
| | - K Obayashi
- Nihon Fukushi University Faculty of Healthcare Management, , Mihama, Japan
- Social Welfare Corporation Tokyo Seishin-kai , Nishitokyo, Japan
| | | |
Collapse
|
3
|
Ramarao-Milne P, Kondrashova O, Patch AM, Nones K, Koufariotis LT, Newell F, Addala V, Lakis V, Holmes O, Leonard C, Wood S, Xu Q, Mukhopadhyay P, Naeini MM, Steinfort D, Williamson JP, Bint M, Pahoff C, Nguyen PT, Twaddell S, Arnold D, Grainge C, Basirzadeh F, Fielding D, Dalley AJ, Chittoory H, Simpson PT, Aoude LG, Bonazzi VF, Patel K, Barbour AP, Fennell DA, Robinson BW, Creaney J, Hollway G, Pearson JV, Waddell N. Comparison of actionable events detected in cancer genomes by whole-genome sequencing, in silico whole-exome and mutation panels. ESMO Open 2022; 7:100540. [PMID: 35849877 PMCID: PMC9463385 DOI: 10.1016/j.esmoop.2022.100540] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 06/07/2022] [Accepted: 06/19/2022] [Indexed: 12/14/2022] Open
Abstract
Background Next-generation sequencing is used in cancer research to identify somatic and germline mutations, which can predict sensitivity or resistance to therapies, and may be a useful tool to reveal drug repurposing opportunities between tumour types. Multigene panels are used in clinical practice for detecting targetable mutations. However, the value of clinical whole-exome sequencing (WES) and whole-genome sequencing (WGS) for cancer care is less defined, specifically as the majority of variants found using these technologies are of uncertain significance. Patients and methods We used the Cancer Genome Interpreter and WGS in 726 tumours spanning 10 cancer types to identify drug repurposing opportunities. We compare the ability of WGS to detect actionable variants, tumour mutation burden (TMB) and microsatellite instability (MSI) by using in silico down-sampled data to mimic WES, a comprehensive sequencing panel and a hotspot mutation panel. Results We reveal drug repurposing opportunities as numerous biomarkers are shared across many solid tumour types. Comprehensive panels identify the majority of approved actionable mutations, with WGS detecting more candidate actionable mutations for biomarkers currently in clinical trials. Moreover, estimated values for TMB and MSI vary when calculated from WGS, WES and panel data, and are dependent on whether all mutations or only non-synonymous mutations were used. Our results suggest that TMB and MSI thresholds should not only be tumour-dependent, but also be sequencing platform-dependent. Conclusions There is a large opportunity to repurpose cancer drugs, and these data suggest that comprehensive sequencing is an invaluable source of information to guide clinical decisions by facilitating precision medicine and may provide a wealth of information for future studies. Furthermore, the sequencing and analysis approach used to estimate TMB may have clinical implications if a hard threshold is used to indicate which patients may respond to immunotherapy. Genome analysis revealed that treatment biomarkers are shared across solid tumours, highlighting repurposing opportunities. Comprehensive panels detect most known biomarkers; however, WGS detects more biomarkers for treatments in clinical trials. TMB is well correlated between sequencing methods, but absolute values vary and are dependent on mutation types considered.
Collapse
Affiliation(s)
- P Ramarao-Milne
- Cancer Program, QIMR Berghofer Medical Research Institute, Brisbane, Australia; Australian e-Health Research Centre, Commonwealth Scientific and Industrial Research Organisation, Brisbane, Australia
| | - O Kondrashova
- Cancer Program, QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - A-M Patch
- Cancer Program, QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - K Nones
- Cancer Program, QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - L T Koufariotis
- Cancer Program, QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - F Newell
- Cancer Program, QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - V Addala
- Cancer Program, QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - V Lakis
- Cancer Program, QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - O Holmes
- Cancer Program, QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - C Leonard
- Cancer Program, QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - S Wood
- Cancer Program, QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - Q Xu
- Cancer Program, QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - P Mukhopadhyay
- Cancer Program, QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - M M Naeini
- Cancer Program, QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - D Steinfort
- Department of Thoracic Medicine, Royal Melbourne Hospital, Melbourne, Australia
| | - J P Williamson
- Department of Thoracic Medicine, Liverpool Hospital Sydney, Sydney, Australia
| | - M Bint
- Department of Thoracic Medicine, Sunshine Coast University Hospital, Birtinya, Australia
| | - C Pahoff
- Department of Respiratory Medicine, Gold Coast University Hospital, Southport, Australia
| | - P T Nguyen
- Department of Thoracic Medicine, Royal Adelaide Hospital, Adelaide, Australia
| | - S Twaddell
- Department of Respiratory and Sleep Medicine, John Hunter Hospital, Newcastle, Australia
| | - D Arnold
- Department of Respiratory and Sleep Medicine, John Hunter Hospital, Newcastle, Australia
| | - C Grainge
- Department of Respiratory and Sleep Medicine, John Hunter Hospital, Newcastle, Australia
| | - F Basirzadeh
- Department of Thoracic Medicine, Royal Brisbane and Women's Hospital, Brisbane, Australia
| | - D Fielding
- Department of Thoracic Medicine, Royal Brisbane and Women's Hospital, Brisbane, Australia
| | - A J Dalley
- UQ Centre for Clinical Research, Faculty of Medicine, University of Queensland, Brisbane, Australia
| | - H Chittoory
- UQ Centre for Clinical Research, Faculty of Medicine, University of Queensland, Brisbane, Australia
| | - P T Simpson
- UQ Centre for Clinical Research, Faculty of Medicine, University of Queensland, Brisbane, Australia
| | - L G Aoude
- The University of Queensland Diamantina Institute, Faculty of Medicine, University of Queensland, Brisbane, Australia
| | - V F Bonazzi
- The University of Queensland Diamantina Institute, Faculty of Medicine, University of Queensland, Brisbane, Australia
| | - K Patel
- The University of Queensland Diamantina Institute, Faculty of Medicine, University of Queensland, Brisbane, Australia
| | - A P Barbour
- The University of Queensland Diamantina Institute, Faculty of Medicine, University of Queensland, Brisbane, Australia; Upper Gastro-intestinal Surgical Unit, Department of Surgery, Princess Alexandra Hospital, Brisbane, Australia
| | - D A Fennell
- Cancer Research UK Centre Leicester, University of Leicester & University Hospitals of Leicester NHS Trust, Leicester, UK
| | - B W Robinson
- National Centre for Asbestos Related Disease, Institute of Respiratory Health, University of Western Australia, Nedlands, Australia; Department of Respiratory Medicine, Sir Charles Gairdner Hospital, Nedlands, Australia
| | - J Creaney
- National Centre for Asbestos Related Disease, Institute of Respiratory Health, University of Western Australia, Nedlands, Australia; Department of Respiratory Medicine, Sir Charles Gairdner Hospital, Nedlands, Australia
| | - G Hollway
- Cancer Program, QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - J V Pearson
- Cancer Program, QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - N Waddell
- Cancer Program, QIMR Berghofer Medical Research Institute, Brisbane, Australia.
| |
Collapse
|
4
|
Abbas Y, Abdelkader M, Adams M, Addison A, Advani R, Ahmed T, Alexander V, Alexander V, Alli B, Alvi S, Amiraraghi N, Ashman A, Balakumar R, Bewick J, Bhasker D, Bola S, Bowles P, Campbell N, Can Guru Naidu N, Caton N, Chapman J, Chawdhary G, Cherko M, Coates M, Conroy K, Coyle P, Cozar O, Cresswell M, Dalton L, Danino J, Daultrey C, Davies K, Carrie S, Dick D, Dimitriadis PA, Doddi N, Dowling M, Easto R, Edmiston R, Ellul D, Erskine S, Evans A, Farboud A, Forde C, Fussey J, Gaunt A, Gilchrist J, Gohil R, Gosnell E, Grech Marguerat D, Green R, Grounds R, Hall A, Hardman J, Harris A, Harrison L, Hone R, Hoskison E, Howard J, Ioannidis D, Iqbal I, Janjua N, Jolly K, Kamal S, Kanzara T, Keates N, Kelly A, Khan H, Korampalli T, Kuet M, Kul‐loo P, Lakhani R, Lambert A, Lancer H, Leonard C, Lloyd G, Lowe E, Mair J, Maughan E, Gao C, Mayberry T, McCadden L, McClenaghan F, McKenzie G, Mcleod R, Meghji S, Mian M, Millington A, Mirza O, Mistry S, Molena E, Morris J, Myuran T, Navaratnam A, Noon E, Okonkwo O, Oremule B, Pabla L, Papesch E, Puranik V, Roplekar R, Ross E, Rudd J, Schechter E, Senior A, Sethi N, Sharma S, Sharma R, Shelton F, Sherazi Z, Tahir A, Tikka T, Tkachuk Hlinicanova O, To K, Tse A, Toll E, Ubayasiri K, Unadkat S, Upile N, Vijendren A, Walijee H, Wilkie M, Williams R, Williams M, Wilson G, Wong W, Wong G, Xie C, Yao A, Zhang H, Ellis M, Mehta N, Milinis K, Tikka T, Slovick A, Swords C, Hutson K, Smith ME, Hopkins C, Ng Kee Kwong F. Nasal Packs for Epistaxis: Predictors of Success. Clin Otolaryngol 2020; 45:659-666. [DOI: 10.1111/coa.13555] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2019] [Revised: 03/08/2020] [Accepted: 04/13/2020] [Indexed: 11/30/2022]
|
5
|
Batchelor G, McNaughten B, Bourke T, Dick J, Leonard C, Thompson A. How to use the videofluoroscopy swallow study in paediatric practice. Arch Dis Child Educ Pract Ed 2019; 104:313-320. [PMID: 30322859 DOI: 10.1136/archdischild-2017-313787] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [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] [Accepted: 09/02/2018] [Indexed: 11/03/2022]
Abstract
In paediatric practice feeding, eating, drinking and swallowing difficulties are present in up to 1% of children. Dysphagia is any disruption to the swallow sequence that results in compromise to the safety, efficiency or adequacy of nutritional intake. Swallowing difficulties may lead to pharyngeal aspiration, respiratory compromise or poor nutritional intake. It causes sensory and motor dysfunction impacting on a child's ability to experience normal feeding. Incoordination can result in oral pharyngeal aspiration where fluid or food is misdirected and enters the airway, or choking where food physically blocks the airway The incidence is much higher in some clinical populations, including children with neuromuscular disease, traumatic brain injury and airway malformations. The prevalence of dysphagia and aspiration-related disease is increasing secondary to the better survival of children with highly complex medical and surgical needs. This article aims to outline the indications for performing videofluoroscopy swallow (VFS). This includes the technical aspects of the study, how to interrupt a VFS report and some of the limitations to the study.
Collapse
Affiliation(s)
| | | | - Thomas Bourke
- Royal Belfast Hospital for Sick Children, Belfast, UK.,Centre for Medical Education, Queen's University Belfast, Belfast, UK
| | - Julie Dick
- Royal Belfast Hospital for Sick Children, Belfast, UK
| | | | | |
Collapse
|
6
|
Ramarao-Milne K, Patch AM, Nones K, Koufariotis R, Newell F, Addala V, Kondrashova O, Mukhopadhyay P, Kazakoff S, Lakis V, Holmes O, Leonard C, Wood S, Xu C, Pearson J, Hollway G, Waddell N. Detection of actionable variants in various cancer types reveals value of whole-genome sequencing over in-silico whole-exome and hotspot panel sequencing. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz413.119] [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
|
7
|
Nones K, Johnson J, Newell F, Patch AM, Thorne H, Kazakoff SH, de Luca XM, Parsons MT, Ferguson K, Reid LE, McCart Reed AE, Srihari S, Lakis V, Davidson AL, Mukhopadhyay P, Holmes O, Xu Q, Wood S, Leonard C, Beesley J, Harris JM, Barnes D, Degasperi A, Ragan MA, Spurdle AB, Khanna KK, Lakhani SR, Pearson JV, Nik-Zainal S, Chenevix-Trench G, Waddell N, Simpson PT. Whole-genome sequencing reveals clinically relevant insights into the aetiology of familial breast cancers. Ann Oncol 2019; 30:1071-1079. [PMID: 31090900 PMCID: PMC6637375 DOI: 10.1093/annonc/mdz132] [Citation(s) in RCA: 51] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Whole-genome sequencing (WGS) is a powerful method for revealing the diversity and complexity of the somatic mutation burden of tumours. Here, we investigated the utility of tumour and matched germline WGS for understanding aetiology and treatment opportunities for high-risk individuals with familial breast cancer. PATIENTS AND METHODS We carried out WGS on 78 paired germline and tumour DNA samples from individuals carrying pathogenic variants in BRCA1 (n = 26) or BRCA2 (n = 22) or from non-carriers (non-BRCA1/2; n = 30). RESULTS Matched germline/tumour WGS and somatic mutational signature analysis revealed patients with unreported, dual pathogenic germline variants in cancer risk genes (BRCA1/BRCA2; BRCA1/MUTYH). The strategy identified that 100% of tumours from BRCA1 carriers and 91% of tumours from BRCA2 carriers exhibited biallelic inactivation of the respective gene, together with somatic mutational signatures suggestive of a functional deficiency in homologous recombination. A set of non-BRCA1/2 tumours also had somatic signatures indicative of BRCA-deficiency, including tumours with BRCA1 promoter methylation, and tumours from carriers of a PALB2 pathogenic germline variant and a BRCA2 variant of uncertain significance. A subset of 13 non-BRCA1/2 tumours from early onset cases were BRCA-proficient, yet displayed complex clustered structural rearrangements associated with the amplification of oncogenes and pathogenic germline variants in TP53, ATM and CHEK2. CONCLUSIONS Our study highlights the role that WGS of matched germline/tumour DNA and the somatic mutational signatures can play in the discovery of pathogenic germline variants and for providing supporting evidence for variant pathogenicity. WGS-derived signatures were more robust than germline status and other genomic predictors of homologous recombination deficiency, thus impacting the selection of platinum-based or PARP inhibitor therapy. In this first examination of non-BRCA1/2 tumours by WGS, we illustrate the considerable heterogeneity of these tumour genomes and highlight that complex genomic rearrangements may drive tumourigenesis in a subset of cases.
Collapse
Affiliation(s)
- K Nones
- Medical Genomics Group, QIMR Berghofer Medical Research Institute, Brisbane, QLD
| | - J Johnson
- Faculty of Medicine, Centre for Clinical Research, The University of Queensland, Brisbane, QLD
| | - F Newell
- Medical Genomics Group, QIMR Berghofer Medical Research Institute, Brisbane, QLD
| | - A M Patch
- Medical Genomics Group, QIMR Berghofer Medical Research Institute, Brisbane, QLD
| | - H Thorne
- kConFab Investigators, The Peter MacCallum Cancer Centre, Melbourne, VIC; Sir Peter MacCallum Department of Oncology, The University of Melbourne, Melbourne, VIC
| | - S H Kazakoff
- Medical Genomics Group, QIMR Berghofer Medical Research Institute, Brisbane, QLD
| | - X M de Luca
- Faculty of Medicine, Centre for Clinical Research, The University of Queensland, Brisbane, QLD
| | - M T Parsons
- Molecular Cancer Epidemiology Group, QIMR Berghofer Medical Research Institute, Brisbane, QLD
| | - K Ferguson
- Faculty of Medicine, Centre for Clinical Research, The University of Queensland, Brisbane, QLD
| | - L E Reid
- Faculty of Medicine, Centre for Clinical Research, The University of Queensland, Brisbane, QLD
| | - A E McCart Reed
- Faculty of Medicine, Centre for Clinical Research, The University of Queensland, Brisbane, QLD
| | - S Srihari
- Faculty of Medicine, Centre for Clinical Research, The University of Queensland, Brisbane, QLD; Institute for Molecular Bioscience, The University of Queensland, Brisbane, QLD
| | - V Lakis
- Medical Genomics Group, QIMR Berghofer Medical Research Institute, Brisbane, QLD
| | - A L Davidson
- Medical Genomics Group, QIMR Berghofer Medical Research Institute, Brisbane, QLD; Faculty of Medicine, The University of Queensland, Brisbane, QLD
| | - P Mukhopadhyay
- Medical Genomics Group, QIMR Berghofer Medical Research Institute, Brisbane, QLD
| | - O Holmes
- Genome Informatics Group, QIMR Berghofer Medical Research Institute, Brisbane, QLD
| | - Q Xu
- Genome Informatics Group, QIMR Berghofer Medical Research Institute, Brisbane, QLD
| | - S Wood
- Genome Informatics Group, QIMR Berghofer Medical Research Institute, Brisbane, QLD
| | - C Leonard
- Genome Informatics Group, QIMR Berghofer Medical Research Institute, Brisbane, QLD
| | - J Beesley
- Cancer Genetics Group, QIMR Berghofer Medical Research Institute, Brisbane, QLD
| | - J M Harris
- Faculty of Health, School Biomedical Science - Queensland University of Technology, Brisbane, QLD, Australia
| | - D Barnes
- Department of Public Health and Primary Care, Centre for Cancer Genetic Epidemiology, University of Cambridge, Cambridge
| | - A Degasperi
- MRC Cancer Unit, Hutchison/MRC Research Centre, University of Cambridge, Cambridge; Department of Medical Genetics, The Clinical School, University of Cambridge, Cambridge, UK
| | - M A Ragan
- Institute for Molecular Bioscience, The University of Queensland, Brisbane, QLD
| | - A B Spurdle
- Molecular Cancer Epidemiology Group, QIMR Berghofer Medical Research Institute, Brisbane, QLD
| | - K K Khanna
- Signal Transduction Group, QIMR Berghofer Medical Research Institute, Brisbane, QLD
| | - S R Lakhani
- Faculty of Medicine, Centre for Clinical Research, The University of Queensland, Brisbane, QLD; Royal Brisbane & Women's Hospital, Pathology Queensland, Brisbane, QLD, Australia
| | - J V Pearson
- Genome Informatics Group, QIMR Berghofer Medical Research Institute, Brisbane, QLD
| | - S Nik-Zainal
- MRC Cancer Unit, Hutchison/MRC Research Centre, University of Cambridge, Cambridge; Department of Medical Genetics, The Clinical School, University of Cambridge, Cambridge, UK
| | - G Chenevix-Trench
- Cancer Genetics Group, QIMR Berghofer Medical Research Institute, Brisbane, QLD
| | - N Waddell
- Medical Genomics Group, QIMR Berghofer Medical Research Institute, Brisbane, QLD.
| | - P T Simpson
- Faculty of Medicine, Centre for Clinical Research, The University of Queensland, Brisbane, QLD.
| |
Collapse
|
8
|
Kharsany K, Viljoen A, Leonard C, van Vuuren S. The new buzz: Investigating the antimicrobial interactions between bioactive compounds found in South African propolis. J Ethnopharmacol 2019; 238:111867. [PMID: 30978456 DOI: 10.1016/j.jep.2019.111867] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [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: 02/14/2019] [Revised: 04/04/2019] [Accepted: 04/04/2019] [Indexed: 06/09/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Propolis, a resinous substance produced by the Apis mellifera bee, contains a number of flavonoids sourced from plants found in the surrounding region. Whilst bees use this substance to seal off and protect the beehive, humans have used propolis therapeutically for centuries, making use of its antibacterial, antiseptic, antipyretic and wound healing properties, among others. South African propolis is rich in the flavonoids pinocembrin, galangin, and chrysin and very little previous research has been conducted on the antimicrobial effects of these compounds. AIM OF THE STUDY To obtain an understanding of the antimicrobial activity of the compounds pinocembrin, galangin, and chrysin, both independently and in combination. MATERIALS AND METHODS The compounds pinocembrin, galangin and chrysin were investigated for interactive antimicrobial activity by determining the minimum inhibitory concentrations (MIC), minimum bactericidal concentrations (MBC), anti-quorum sensing activity, biofilm studies, and toxicity studies (brine shrimp lethality assay). RESULTS Minimum inhibitory concentration results demonstrated that combinations of compounds showed better inhibitory activity than single compounds. When the flavonoids were tested in combination using the MIC assay, synergy was noted for 22% of the 1:1 ratio combinations and for 66% of the triple 1:1:1 ratio combinations. Similarly, MBC results showed bactericidal activity from selected combinations, while the compounds on their own demonstrated no cidal activity. Quorum sensing studies showed that compound combinations are more effective at inhibiting bacterial communication than the individual compounds. Biofilm assays showed that the highest percentage inhibition was observed for the triple combination against E. coli at 24 h. Finally, brine shrimp lethality studies revealed that combinations of the three compounds had reduced cytotoxicity when compared to the individual compounds. CONCLUSION The results obtained in this study demonstrate that the compounds found in South African propolis work synergistically to achieve an optimal antimicrobial effect, whilst simultaneously minimizing cytotoxicity.
Collapse
Affiliation(s)
- K Kharsany
- Department of Pharmacy and Pharmacology, Faculty of Health Science, University of the Witwatersrand, 7 York Road, Parktown, 2193, South Africa
| | - A Viljoen
- Department of Pharmaceutical Sciences, Tshwane University of Technology, Private Bag X680, Pretoria, 0001, South Africa; SAMRC Herbal Drugs Research Unit, Department of Pharmaceutical Sciences, Tshwane University of Technology, Pretoria, South Africa
| | - C Leonard
- Department of Pharmaceutical Sciences, Tshwane University of Technology, Private Bag X680, Pretoria, 0001, South Africa
| | - S van Vuuren
- Department of Pharmacy and Pharmacology, Faculty of Health Science, University of the Witwatersrand, 7 York Road, Parktown, 2193, South Africa.
| |
Collapse
|
9
|
Combaluzier S, Boismenu L, Boulamery A, Becas D, Salomon M, Constans C, Leonard C, Descoeur J, Reynoard J, Simon N, Baccino E, Mathieu O. A bad salad seasoning: When aconite confused with Couscouil. Toxicologie Analytique et Clinique 2019. [DOI: 10.1016/j.toxac.2019.03.045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
|
10
|
Artz CE, Ward Jr MA, Miles MP, Alexander K, Blanche AL, Lintner A, Leonard C, Bright A, Kahn SA. 239 Intraoperative Liposomal Bupivacaine for Skin Graft Donor Site Analgesia. J Burn Care Res 2019. [DOI: 10.1093/jbcr/irz013.165] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- C E Artz
- University of South Alabama, Mobile, AL; University of South Alabama Medical Center, Mobile, AL; University of South Alabama College of Medicine, Mobile, AL
| | - M A Ward Jr
- University of South Alabama, Mobile, AL; University of South Alabama Medical Center, Mobile, AL; University of South Alabama College of Medicine, Mobile, AL
| | - M P Miles
- University of South Alabama, Mobile, AL; University of South Alabama Medical Center, Mobile, AL; University of South Alabama College of Medicine, Mobile, AL
| | - K Alexander
- University of South Alabama, Mobile, AL; University of South Alabama Medical Center, Mobile, AL; University of South Alabama College of Medicine, Mobile, AL
| | - A L Blanche
- University of South Alabama, Mobile, AL; University of South Alabama Medical Center, Mobile, AL; University of South Alabama College of Medicine, Mobile, AL
| | - A Lintner
- University of South Alabama, Mobile, AL; University of South Alabama Medical Center, Mobile, AL; University of South Alabama College of Medicine, Mobile, AL
| | - C Leonard
- University of South Alabama, Mobile, AL; University of South Alabama Medical Center, Mobile, AL; University of South Alabama College of Medicine, Mobile, AL
| | - A Bright
- University of South Alabama, Mobile, AL; University of South Alabama Medical Center, Mobile, AL; University of South Alabama College of Medicine, Mobile, AL
| | - S A Kahn
- University of South Alabama, Mobile, AL; University of South Alabama Medical Center, Mobile, AL; University of South Alabama College of Medicine, Mobile, AL
| |
Collapse
|
11
|
Simpson P, Nones K, Johnson J, Newell F, Patch AM, Thorne H, Kazakoff S, De Luca X, Parsons M, Ferguson K, Reid L, McCart Reed A, Srihari S, Lakis V, Davidson A, Mukhopadhyay P, Holmes O, Xu Q, Wood S, Leonard C, Beasley J, Degasperi A, Nik-Zainal S, Ragan M, Spurdle A, Khanna KK, Lakhani S, Pearson J, Chenevix-Trench G, Waddell N. Abstract P5-10-01: Using whole genome sequencing and somatic mutation signatures to unravel insight into familial breast cancer aetiology. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p5-10-01] [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: 11/16/2022]
Abstract
Abstract
Approximately 10-15% of breast cancers are associated with a strong family history of disease. Pathogenic variants in BRCA1, BRCA2 or other moderate to highly penetrant susceptibility genes (e.g. TP53, ATM, CHEK2, PALB2 and PTEN) account for a number of breast cancer families. However, for over 50% of families the underlying genetic contribution to their risk remains unknown (termed here as non-BRCA1/2). This has a profound impact for how individuals and their families are managed in the clinic. We applied whole genome sequencing (WGS) to determine whether somatic mutation analysis can reveal insight into the aetiology of familial breast cancer. The full repertoire of somatic mutations was evaluated in 26 BRCA1, 22 BRCA2 and 32 non-BRCA1/2 tumours; including SNPs, indels, copy number changes and structural rearrangements, and mutational signatures. Genomes were also analysed using the HRD Index and HRDetect, as predictors of homologous recombination deficiency. BRCA1, BRCA2 and non-BRCA1/2 tumours exhibited a different burden of mutations, a different spectrum of mutational signatures and different telomere length. Based on collective patterns of mutation signatures, tumours were classified as 'BRCA1-like', 'BRCA2-like' or 'non-BRCA1/2-like' with a 15% rate of tumour re-classification from their original clinical BRCA status. The results demonstrate the power of WGS to differentiate between BRCA1 and BRCA2 driven tumours; in the identification of double-pathogenic germline mutation carriers based on the resulting somatic mutation signature; and in the interpretation of BRCA unclassified variants. WGS of tumour genomes reveals fascinating insights into tumour aetiology and could compliment current genetic testing of breast cancer families.
Citation Format: Simpson P, Nones K, Johnson J, Newell F, Patch A-M, Thorne H, Kazakoff S, De Luca X, Parsons M, Ferguson K, Reid L, McCart Reed A, Srihari S, Lakis V, Davidson A, Mukhopadhyay P, Holmes O, Xu Q, Wood S, Leonard C, Beasley J, Degasperi A, Nik-Zainal S, Ragan M, Spurdle A, Khanna KK, Lakhani S, Pearson J, Chenevix-Trench G, Waddell N. Using whole genome sequencing and somatic mutation signatures to unravel insight into familial breast cancer aetiology [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P5-10-01.
Collapse
Affiliation(s)
- P Simpson
- The University of Queensland, Brisbane, Australia; QIMR Berghofer Medical Research Institute, Brisbane, Australia; Peter MacCallum Cancer Centre, Melbourne, Australia; University of Cambridge, Cambridge, United Kingdom; Westmead Institute for Medical Research, Sydney, Australia
| | - K Nones
- The University of Queensland, Brisbane, Australia; QIMR Berghofer Medical Research Institute, Brisbane, Australia; Peter MacCallum Cancer Centre, Melbourne, Australia; University of Cambridge, Cambridge, United Kingdom; Westmead Institute for Medical Research, Sydney, Australia
| | - J Johnson
- The University of Queensland, Brisbane, Australia; QIMR Berghofer Medical Research Institute, Brisbane, Australia; Peter MacCallum Cancer Centre, Melbourne, Australia; University of Cambridge, Cambridge, United Kingdom; Westmead Institute for Medical Research, Sydney, Australia
| | - F Newell
- The University of Queensland, Brisbane, Australia; QIMR Berghofer Medical Research Institute, Brisbane, Australia; Peter MacCallum Cancer Centre, Melbourne, Australia; University of Cambridge, Cambridge, United Kingdom; Westmead Institute for Medical Research, Sydney, Australia
| | - A-M Patch
- The University of Queensland, Brisbane, Australia; QIMR Berghofer Medical Research Institute, Brisbane, Australia; Peter MacCallum Cancer Centre, Melbourne, Australia; University of Cambridge, Cambridge, United Kingdom; Westmead Institute for Medical Research, Sydney, Australia
| | - H Thorne
- The University of Queensland, Brisbane, Australia; QIMR Berghofer Medical Research Institute, Brisbane, Australia; Peter MacCallum Cancer Centre, Melbourne, Australia; University of Cambridge, Cambridge, United Kingdom; Westmead Institute for Medical Research, Sydney, Australia
| | - S Kazakoff
- The University of Queensland, Brisbane, Australia; QIMR Berghofer Medical Research Institute, Brisbane, Australia; Peter MacCallum Cancer Centre, Melbourne, Australia; University of Cambridge, Cambridge, United Kingdom; Westmead Institute for Medical Research, Sydney, Australia
| | - X De Luca
- The University of Queensland, Brisbane, Australia; QIMR Berghofer Medical Research Institute, Brisbane, Australia; Peter MacCallum Cancer Centre, Melbourne, Australia; University of Cambridge, Cambridge, United Kingdom; Westmead Institute for Medical Research, Sydney, Australia
| | - M Parsons
- The University of Queensland, Brisbane, Australia; QIMR Berghofer Medical Research Institute, Brisbane, Australia; Peter MacCallum Cancer Centre, Melbourne, Australia; University of Cambridge, Cambridge, United Kingdom; Westmead Institute for Medical Research, Sydney, Australia
| | - K Ferguson
- The University of Queensland, Brisbane, Australia; QIMR Berghofer Medical Research Institute, Brisbane, Australia; Peter MacCallum Cancer Centre, Melbourne, Australia; University of Cambridge, Cambridge, United Kingdom; Westmead Institute for Medical Research, Sydney, Australia
| | - L Reid
- The University of Queensland, Brisbane, Australia; QIMR Berghofer Medical Research Institute, Brisbane, Australia; Peter MacCallum Cancer Centre, Melbourne, Australia; University of Cambridge, Cambridge, United Kingdom; Westmead Institute for Medical Research, Sydney, Australia
| | - A McCart Reed
- The University of Queensland, Brisbane, Australia; QIMR Berghofer Medical Research Institute, Brisbane, Australia; Peter MacCallum Cancer Centre, Melbourne, Australia; University of Cambridge, Cambridge, United Kingdom; Westmead Institute for Medical Research, Sydney, Australia
| | - S Srihari
- The University of Queensland, Brisbane, Australia; QIMR Berghofer Medical Research Institute, Brisbane, Australia; Peter MacCallum Cancer Centre, Melbourne, Australia; University of Cambridge, Cambridge, United Kingdom; Westmead Institute for Medical Research, Sydney, Australia
| | - V Lakis
- The University of Queensland, Brisbane, Australia; QIMR Berghofer Medical Research Institute, Brisbane, Australia; Peter MacCallum Cancer Centre, Melbourne, Australia; University of Cambridge, Cambridge, United Kingdom; Westmead Institute for Medical Research, Sydney, Australia
| | - A Davidson
- The University of Queensland, Brisbane, Australia; QIMR Berghofer Medical Research Institute, Brisbane, Australia; Peter MacCallum Cancer Centre, Melbourne, Australia; University of Cambridge, Cambridge, United Kingdom; Westmead Institute for Medical Research, Sydney, Australia
| | - P Mukhopadhyay
- The University of Queensland, Brisbane, Australia; QIMR Berghofer Medical Research Institute, Brisbane, Australia; Peter MacCallum Cancer Centre, Melbourne, Australia; University of Cambridge, Cambridge, United Kingdom; Westmead Institute for Medical Research, Sydney, Australia
| | - O Holmes
- The University of Queensland, Brisbane, Australia; QIMR Berghofer Medical Research Institute, Brisbane, Australia; Peter MacCallum Cancer Centre, Melbourne, Australia; University of Cambridge, Cambridge, United Kingdom; Westmead Institute for Medical Research, Sydney, Australia
| | - Q Xu
- The University of Queensland, Brisbane, Australia; QIMR Berghofer Medical Research Institute, Brisbane, Australia; Peter MacCallum Cancer Centre, Melbourne, Australia; University of Cambridge, Cambridge, United Kingdom; Westmead Institute for Medical Research, Sydney, Australia
| | - S Wood
- The University of Queensland, Brisbane, Australia; QIMR Berghofer Medical Research Institute, Brisbane, Australia; Peter MacCallum Cancer Centre, Melbourne, Australia; University of Cambridge, Cambridge, United Kingdom; Westmead Institute for Medical Research, Sydney, Australia
| | - C Leonard
- The University of Queensland, Brisbane, Australia; QIMR Berghofer Medical Research Institute, Brisbane, Australia; Peter MacCallum Cancer Centre, Melbourne, Australia; University of Cambridge, Cambridge, United Kingdom; Westmead Institute for Medical Research, Sydney, Australia
| | - J Beasley
- The University of Queensland, Brisbane, Australia; QIMR Berghofer Medical Research Institute, Brisbane, Australia; Peter MacCallum Cancer Centre, Melbourne, Australia; University of Cambridge, Cambridge, United Kingdom; Westmead Institute for Medical Research, Sydney, Australia
| | - A Degasperi
- The University of Queensland, Brisbane, Australia; QIMR Berghofer Medical Research Institute, Brisbane, Australia; Peter MacCallum Cancer Centre, Melbourne, Australia; University of Cambridge, Cambridge, United Kingdom; Westmead Institute for Medical Research, Sydney, Australia
| | - S Nik-Zainal
- The University of Queensland, Brisbane, Australia; QIMR Berghofer Medical Research Institute, Brisbane, Australia; Peter MacCallum Cancer Centre, Melbourne, Australia; University of Cambridge, Cambridge, United Kingdom; Westmead Institute for Medical Research, Sydney, Australia
| | - M Ragan
- The University of Queensland, Brisbane, Australia; QIMR Berghofer Medical Research Institute, Brisbane, Australia; Peter MacCallum Cancer Centre, Melbourne, Australia; University of Cambridge, Cambridge, United Kingdom; Westmead Institute for Medical Research, Sydney, Australia
| | - A Spurdle
- The University of Queensland, Brisbane, Australia; QIMR Berghofer Medical Research Institute, Brisbane, Australia; Peter MacCallum Cancer Centre, Melbourne, Australia; University of Cambridge, Cambridge, United Kingdom; Westmead Institute for Medical Research, Sydney, Australia
| | - KK Khanna
- The University of Queensland, Brisbane, Australia; QIMR Berghofer Medical Research Institute, Brisbane, Australia; Peter MacCallum Cancer Centre, Melbourne, Australia; University of Cambridge, Cambridge, United Kingdom; Westmead Institute for Medical Research, Sydney, Australia
| | - S Lakhani
- The University of Queensland, Brisbane, Australia; QIMR Berghofer Medical Research Institute, Brisbane, Australia; Peter MacCallum Cancer Centre, Melbourne, Australia; University of Cambridge, Cambridge, United Kingdom; Westmead Institute for Medical Research, Sydney, Australia
| | - J Pearson
- The University of Queensland, Brisbane, Australia; QIMR Berghofer Medical Research Institute, Brisbane, Australia; Peter MacCallum Cancer Centre, Melbourne, Australia; University of Cambridge, Cambridge, United Kingdom; Westmead Institute for Medical Research, Sydney, Australia
| | - G Chenevix-Trench
- The University of Queensland, Brisbane, Australia; QIMR Berghofer Medical Research Institute, Brisbane, Australia; Peter MacCallum Cancer Centre, Melbourne, Australia; University of Cambridge, Cambridge, United Kingdom; Westmead Institute for Medical Research, Sydney, Australia
| | - N Waddell
- The University of Queensland, Brisbane, Australia; QIMR Berghofer Medical Research Institute, Brisbane, Australia; Peter MacCallum Cancer Centre, Melbourne, Australia; University of Cambridge, Cambridge, United Kingdom; Westmead Institute for Medical Research, Sydney, Australia
| |
Collapse
|
12
|
Ren G, Whittaker JL, Leonard C, De Rantere D, Pang DSJ, Salo P, Fritzler M, Kapoor M, de Koning APJ, Jaremko JL, Emery CA, Krawetz RJ. CCL22 is a biomarker of cartilage injury and plays a functional role in chondrocyte apoptosis. Cytokine 2019; 115:32-44. [PMID: 30623804 DOI: 10.1016/j.cyto.2018.11.030] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2018] [Revised: 11/09/2018] [Accepted: 11/25/2018] [Indexed: 12/20/2022]
Abstract
BACKGROUND Osteoarthritis (OA) is one of the leading causes of disability worldwide. Previous history of knee injury is a significant risk factor for OA. It has been established that low-level chronic inflammation plays a pivotal role in the onset and pathogenesis of OA. The primary aim of this research was to determine if a history of knee joint injury is associated with systemic inflammation. A secondary aim was to determine if systemic inflammation is related to knee pain and joint structure. METHODS Differences in serum cytokine association networks, knee joint structural changes (MRI), and self-reported pain (i.e., Knee Injury and Osteoarthritis Outcome Score Pain subscale, KOOSPAIN and Intermittent and Constant Osteoarthritis Pain score, ICOAP) between individuals who had sustained a youth (aged 15-26 years) sport-related knee injury 3-10 years previously and age- and sex-matched controls were examined. Proteins of interest were also examined in an OA rat model. RESULTS Cytokine association networks were found to differ significantly between study groups, yet no significant associations were found between networks and KOOSPAIN or MRI-defined OA. A group of cytokines (MCP1/CCL2, CCL22 and TNFα) were differentially associated with other cytokines between study groups. In a pre-clinical rat OA model, serum CCL22 levels were associated with pain (r = 0.255, p = 0.045) and structural changes to the cartilage. CCL22 expression was also observed in human OA cartilage and furthermore, CCL22 induced apoptosis of isolated human chondrocytes. DISCUSSION These results suggest that CCL22 may be an early factor in the onset/pathogenic process of cartilage degeneration and/or related to pain OA.
Collapse
Affiliation(s)
- G Ren
- McCaig Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada; Biomedical Engineering Graduate Program, University of Calgary, Calgary, Alberta, Canada
| | - J L Whittaker
- Department of Physical Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Alberta, Canada; Glen Sather Sports Medicine Clinic, University of Alberta, Edmonton, Alberta, Canada; Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
| | - C Leonard
- McCaig Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - D De Rantere
- Department of Small Animal Clinical Sciences, Western College of Veterinary Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - D S J Pang
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Université de Montréal, Montreal, Quebec, Canada
| | - P Salo
- McCaig Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - M Fritzler
- Eve Technologies, Calgary, Alberta, Canada
| | - M Kapoor
- Arthritis Program, University Health Network, Toronto, Ontario, Canada; Department of Surgery and Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada
| | - A P J de Koning
- The Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada; Department of Biochemistry and Molecular Biology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - J L Jaremko
- Department of Radiology and Diagnostic Imaging, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - C A Emery
- McCaig Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada; Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada; Department of Surgery and Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada
| | - R J Krawetz
- McCaig Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada; Biomedical Engineering Graduate Program, University of Calgary, Calgary, Alberta, Canada.
| |
Collapse
|
13
|
Balata H, Hayton C, Barber P, Duerden R, Evison M, Greaves M, Howells J, Irion K, Karunaratne D, Leonard C, Mellor S, Newton T, Sawyer R, Sharman A, Smith E, Taylor B, Walsham A, Whittaker J, Chaudhuri N, Booton R, Crosbie P. Prevalence of incidental interstitial lung disease in the Manchester lung cancer screening pilot. Lung Cancer 2019. [DOI: 10.1016/s0169-5002(19)30103-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
|
14
|
Leonard C, Ferrasse JH, Boutin O, Lefevre S, Viand A. Measurements and correlations for gas liquid surface tension at high pressure and high temperature. AIChE J 2018. [DOI: 10.1002/aic.16216] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- C. Leonard
- Aix Marseille University, CNRS, Centrale Marseille, M2P2; Marseille France
- ZAC des Eoliennes; S.A.R.L. A3i, 255 rue Gustave Eiffel; Donzere 26290 France
| | - J-H. Ferrasse
- Aix Marseille University, CNRS, Centrale Marseille, M2P2; Marseille France
| | - O. Boutin
- Aix Marseille University, CNRS, Centrale Marseille, M2P2; Marseille France
| | - S. Lefevre
- ZAC des Eoliennes; S.A.R.L. A3i, 255 rue Gustave Eiffel; Donzere 26290 France
| | - A. Viand
- ZAC des Eoliennes; S.A.R.L. A3i, 255 rue Gustave Eiffel; Donzere 26290 France
| |
Collapse
|
15
|
Purvis MV, Lindsey LJ, Leonard C, Lintner AC, Scott V, Brevard SB, Kahn SE. 3 An Adjusted Ideal Body Weight Index Formula with FFP Rescue Decreases Fluid Creep During Burn Resuscitation. J Burn Care Res 2018. [DOI: 10.1093/jbcr/iry006.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- M V Purvis
- The University of South Alabama Medical Center, Mobile, AL
| | - L J Lindsey
- The University of South Alabama Medical Center, Mobile, AL
| | - C Leonard
- The University of South Alabama Medical Center, Mobile, AL
| | - A C Lintner
- The University of South Alabama Medical Center, Mobile, AL
| | - V Scott
- The University of South Alabama Medical Center, Mobile, AL
| | - S B Brevard
- The University of South Alabama Medical Center, Mobile, AL
| | - S E Kahn
- The University of South Alabama Medical Center, Mobile, AL
| |
Collapse
|
16
|
Toellner H, Hughes G, Beswick W, Crooks MG, Donaldson C, Forrest I, Hart SP, Leonard C, Major M, Simpson AJ, Chaudhuri N. Early clinical experiences with nintedanib in three UK tertiary interstitial lung disease centres. Clin Transl Med 2017; 6:41. [PMID: 29101500 PMCID: PMC5670096 DOI: 10.1186/s40169-017-0172-3] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2017] [Accepted: 10/22/2017] [Indexed: 01/09/2023] Open
Abstract
Background Nintedanib has been shown to slow disease progression in patients with idiopathic pulmonary fibrosis (IPF). It was approved by the National Institute for Health and Care Excellence (NICE) in January 2016 for IPF patients with a forced vital capacity (FVC) of 50–80% in the United Kingdom (UK). Aim To report real world data about our early clinical experience using nintedanib in 187 patients with a multi-disciplinary (MDT) diagnosis of IPF in a manufacturer funded patient in need scheme (three UK centres) prior to NICE approval. Methods All patients with a MDT diagnosis of IPF from December 2014 to January 2016 commenced on nintedanib were included. Demographic details, adverse events (AEs) and where available lung function results were retrospectively collected from clinical letters. Results 187 patients (76% males) with a median age of 72 years (49–89) were treated with nintedanib. The average pre-treatment FVC was 81.1 ± 19.8% and diffusion capacity of the lungs for carbon monoxide was 43.9 ± 15% (n = 82). Fifty percent of patients started nintedanib because they were ineligible for pirfenidone due to an FVC > 80%. The median treatment course was 8 ± 4 months. The majority of patients experienced 1–3 AEs with nintedanib (52%, n = 97). The most frequent AEs were diarrhoea (50%), nausea (36%), reduced appetite (24%), tiredness (20%) and gastro-oesophageal reflux (18%). The majority of AEs resulted in no change in treatment (64%, n = 461). 21% (n = 150) of AEs resulted in a dose reduction and 13% (n = 94) necessitated discontinuation of treatment. 1 in 5 patients discontinued treatment either temporarily or on a permanent basis during the monitoring period. In a select cohort of patients, a statistically significant greater proportion of patients remained stable or improved and a lower proportion declined, as depicted by FVC changes of > 5% after nintedanib commencement (P < 0.05 using Chi squared test). Conclusions Nintedanib is well tolerated and has an acceptable safety profile. Only 8% of those reporting diarrhoea discontinued treatment either on a temporary or permanent basis. There were no signals with respect to increased cardiovascular morbidity or major bleeding risk. This is in keeping with the INPULSIS clinical trial findings but in a real world cohort.
Collapse
Affiliation(s)
- Hannah Toellner
- Manchester Medical School, University of Manchester, Stopford Building, Oxford Rd, Manchester, M13 9PT, UK.
| | - G Hughes
- Manchester University NHS Foundation Trust, Wythenshawe Hospital, Southmoor Rd, Wythenshawe, Manchester, M23 9LT, UK
| | - W Beswick
- Hull and East Yorkshire Hospitals NHS Trust, Castle Road, Cottingham, HU16 5JQ, UK
| | - M G Crooks
- Hull and East Yorkshire Hospitals NHS Trust, Castle Road, Cottingham, HU16 5JQ, UK
| | - C Donaldson
- Newcastle Upon Tyne Hospitals NHS Trust, Queen Victoria Rd, Newcastle upon Tyne, NE1 4LP, UK
| | - I Forrest
- Newcastle Upon Tyne Hospitals NHS Trust, Queen Victoria Rd, Newcastle upon Tyne, NE1 4LP, UK
| | - S P Hart
- Hull and East Yorkshire Hospitals NHS Trust, Castle Road, Cottingham, HU16 5JQ, UK
| | - C Leonard
- Manchester University NHS Foundation Trust, Wythenshawe Hospital, Southmoor Rd, Wythenshawe, Manchester, M23 9LT, UK
| | - M Major
- Hull and East Yorkshire Hospitals NHS Trust, Castle Road, Cottingham, HU16 5JQ, UK
| | - A J Simpson
- Newcastle Upon Tyne Hospitals NHS Trust, Queen Victoria Rd, Newcastle upon Tyne, NE1 4LP, UK
| | - N Chaudhuri
- Manchester University NHS Foundation Trust, Wythenshawe Hospital, Southmoor Rd, Wythenshawe, Manchester, M23 9LT, UK
| |
Collapse
|
17
|
Leonard C, Chen W, van Vuuren S, Viljoen A. Exploring the phytochemical variation of the “Pepper-bark” tree (Warburgia salutaris) using HPTLC and UPLC-MS. Am J Transl Res 2017. [DOI: 10.1055/s-0037-1608527] [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: 10/18/2022]
Affiliation(s)
- C Leonard
- Department of Pharmaceutical Sciences, Faculty of Science, Tshwane University of Technology, Pretoria, South Africa
| | - W Chen
- Department of Pharmaceutical Sciences, Faculty of Science, Tshwane University of Technology, Pretoria, South Africa
| | - S van Vuuren
- Department of Pharmacy and Pharmacology, University of Witwatersrand, Johannesburg, South Africa
| | - A Viljoen
- Department of Pharmaceutical Sciences, Faculty of Science, Tshwane University of Technology, Pretoria, South Africa
- SAMRC Herbal Drugs Research Unit, Faculty of Science, Tshwane University of Technology, Pretoria, South Africa
| |
Collapse
|
18
|
Leonard C, Conrard L, Guthmann M, Pollet H, Carquin M, Vermylen C, Gailly P, Van Der Smissen P, Mingeot-Leclercq MP, Tyteca D. Contribution of plasma membrane lipid domains to red blood cell (re)shaping. Sci Rep 2017; 7:4264. [PMID: 28655935 PMCID: PMC5487352 DOI: 10.1038/s41598-017-04388-z] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [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: 01/12/2017] [Accepted: 05/15/2017] [Indexed: 11/25/2022] Open
Abstract
Although lipid domains have been evidenced in several living cell plasma membranes, their roles remain largely unclear. We here investigated whether they could contribute to function-associated cell (re)shaping. To address this question, we used erythrocytes as cellular model since they (i) exhibit a specific biconcave shape, allowing for reversible deformation in blood circulation, which is lost by membrane vesiculation upon aging; and (ii) display at their outer plasma membrane leaflet two types of submicrometric domains differently enriched in cholesterol and sphingomyelin. We here reveal the specific association of cholesterol- and sphingomyelin-enriched domains with distinct curvature areas of the erythrocyte biconcave membrane. Upon erythrocyte deformation, cholesterol-enriched domains gathered in high curvature areas. In contrast, sphingomyelin-enriched domains increased in abundance upon calcium efflux during shape restoration. Upon erythrocyte storage at 4 °C (to mimick aging), lipid domains appeared as specific vesiculation sites. Altogether, our data indicate that lipid domains could contribute to erythrocyte function-associated (re)shaping.
Collapse
Affiliation(s)
- C Leonard
- FACM Unit, Louvain Drug Research Institute & Université catholique de Louvain, 1200, Brussels, Belgium.,CELL Unit, de Duve Institute & Université catholique de Louvain, 1200, Brussels, Belgium
| | - L Conrard
- CELL Unit, de Duve Institute & Université catholique de Louvain, 1200, Brussels, Belgium
| | - M Guthmann
- CELL Unit, de Duve Institute & Université catholique de Louvain, 1200, Brussels, Belgium
| | - H Pollet
- CELL Unit, de Duve Institute & Université catholique de Louvain, 1200, Brussels, Belgium
| | - M Carquin
- CELL Unit, de Duve Institute & Université catholique de Louvain, 1200, Brussels, Belgium
| | - C Vermylen
- PEDI Unit, Institut de Recherche expérimentale et clinique & Université catholique de Louvain, 1200, Brussels, Belgium
| | - P Gailly
- CEMO Unit, Institute of Neuroscience & Université catholique de Louvain, 1200, Brussels, Belgium
| | - P Van Der Smissen
- CELL Unit, de Duve Institute & Université catholique de Louvain, 1200, Brussels, Belgium
| | - M P Mingeot-Leclercq
- FACM Unit, Louvain Drug Research Institute & Université catholique de Louvain, 1200, Brussels, Belgium
| | - D Tyteca
- CELL Unit, de Duve Institute & Université catholique de Louvain, 1200, Brussels, Belgium.
| |
Collapse
|
19
|
|
20
|
Lee M, Bennett M, Leonard C, Chadhuri N. P275 Patient understanding, expectations and experiences of an interstitial lung disease specialist centre. Thorax 2016. [DOI: 10.1136/thoraxjnl-2016-209333.418] [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]
|
21
|
Nuttall J, Newton H, Culshaw C, Pate L, Leonard C, Al-Aloul M. Changes in Smoking Habits in Potential Lung Transplant (LTx) Candidates. J Heart Lung Transplant 2016. [DOI: 10.1016/j.healun.2016.01.141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
|
22
|
Iqbal SM, Leonard C, Regmi SC, De Rantere D, Tailor P, Ren G, Ishida H, Hsu C, Abubacker S, Pang DS, Salo PT, Vogel HJ, Hart DA, Waterhouse CC, Jay GD, Schmidt TA, Krawetz RJ. Lubricin/Proteoglycan 4 binds to and regulates the activity of Toll-Like Receptors In Vitro. Sci Rep 2016; 6:18910. [PMID: 26752378 PMCID: PMC4707532 DOI: 10.1038/srep18910] [Citation(s) in RCA: 100] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2015] [Accepted: 11/30/2015] [Indexed: 01/03/2023] Open
Abstract
Proteoglycan 4 (PRG4/lubricin) is secreted by cells that reside in articular cartilage and line the synovial joint. Lubricin may play a role in modulating inflammatory responses through interaction with CD44. This led us to examine if lubricin could be playing a larger role in the modulation of inflammation/immunity through interaction with Toll-like receptors (TLRs). Human Embryonic Kidney (HEK) cells overexpressing TLRs 2, 4 or 5 and surface plasmon resonance were employed to determine if full length recombinant human lubricin was able to bind to and activate TLRs. Primary human synovial fibroblasts were also examined using flow cytometry and Luminex multiplex ELISA. A rat destabilization model of osteoarthritis (OA) was used to determine if lubricin injections were able to regulate pain and/or inflammation in vivo. Lubricin can bind to and regulate the activity of TLRs, leading to downstream changes in inflammatory signalling independent of HA. We confirmed these findings in vivo through intra-articular injections of lubricin in a rat OA model where the inhibition of systemic inflammatory signaling and reduction in pain were observed. Lubricin plays an important role in regulating the inflammatory environment under both homeostatic and tissue injury states.
Collapse
Affiliation(s)
- S M Iqbal
- McCaig Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - C Leonard
- McCaig Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - S C Regmi
- Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
| | - D De Rantere
- Faculty of Veterinary Medicine, University of Calgary, Calgary, Alberta, Canada
| | - P Tailor
- McCaig Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - G Ren
- McCaig Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - H Ishida
- Faculty of Science, University of Calgary, Calgary, Alberta, Canada
| | - Cy Hsu
- McCaig Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - S Abubacker
- McCaig Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - D Sj Pang
- Faculty of Veterinary Medicine, University of Calgary, Calgary, Alberta, Canada
| | - P T Salo
- McCaig Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - H J Vogel
- Faculty of Science, University of Calgary, Calgary, Alberta, Canada
| | - D A Hart
- McCaig Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - C C Waterhouse
- Snyder Institute, Cummings School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - G D Jay
- Faculty of Medicine, Brown University, Providence, Rhode Island, United States
| | - T A Schmidt
- McCaig Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.,Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada.,Schulich School of Engineering, University of Calgary, Calgary, Alberta, Canada
| | - R J Krawetz
- McCaig Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| |
Collapse
|
23
|
Gudur S, Nuttall E, Harris C, Chaudhuri N, Leonard C, Muldoon E. P34 Sarcoidosis and co-existent Aspergillus lung disease. Thorax 2015. [DOI: 10.1136/thoraxjnl-2015-207770.171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
|
24
|
Nuttall E, Crooks M, Gudur S, Leonard C, Major C, Hart S, Chaudhuri N. P6 Early Clinical Experience With Nintedanib – a two centre review. Thorax 2015. [DOI: 10.1136/thoraxjnl-2015-207770.143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
|
25
|
Mak J, Leonard C, Foniok T, Rushforth D, Dunn JF, Krawetz R. Evaluating endogenous repair of focal cartilage defects in C57BL/6 and MRL/MpJ mice using 9.4T magnetic resonance imaging: A pilot study. Magn Reson Imaging 2015; 33:690-4. [PMID: 25597446 DOI: 10.1016/j.mri.2015.01.001] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2014] [Revised: 12/12/2014] [Accepted: 01/09/2015] [Indexed: 11/17/2022]
Abstract
The use of magnetic resonance imaging (MRI) for evaluating joint injuries is often considered superior to radiography due to the capacity of MRI for visualizing both soft and hard tissues. While longitudinal studies regarding cartilage repair have been undertaken on patients and in larger animal models, a method has yet to be developed for mouse cartilage to be repeatedly and non-invasively evaluated over time. The aim of this pilot study was to investigate if morphological changes following a focal cartilage injury in mice could be measured by 9.4T magnetic resonance imaging. Focal cartilage defects were induced in the left knee of 4-6weeks old C57BL/6 and MRL/MpJ mice. At endpoints 0, 2, and 4weeks post-injury, legs were dissected out and imaged ex vivo. The defect could be detected by MRI immediately after injury, appearing as a hyperintense focal point and with size similar to that of the surgical tool used. Defects were visible in both strains up to 4weeks post-injury, although signal intensity decreased over time. One C57BL/6 in particular, displayed extensive fibrosis in the patellar tendon at 4weeks as assessed by histology, while the MR images of the same animal displayed a clear, structural distinction between the patella and the new tissue growth. Overall, our results suggest that MRI could be used for longitudinal studies in murine cartilage injury models to evaluate certain characteristics of repair not detectable through histology.
Collapse
Affiliation(s)
- J Mak
- McCaig Institute for Bone & Joint Health, University of Calgary, Calgary, AB, Canada
| | - C Leonard
- McCaig Institute for Bone & Joint Health, University of Calgary, Calgary, AB, Canada; Department of Surgery, University of Calgary, Calgary, AB, Canada
| | - T Foniok
- Experimental Imaging Centre, University of Calgary, Calgary, AB, Canada
| | - D Rushforth
- Experimental Imaging Centre, University of Calgary, Calgary, AB, Canada
| | - J F Dunn
- Department of Radiology, University of Calgary, Calgary, AB, Canada; Experimental Imaging Centre, University of Calgary, Calgary, AB, Canada
| | - R Krawetz
- McCaig Institute for Bone & Joint Health, University of Calgary, Calgary, AB, Canada; Department of Surgery, University of Calgary, Calgary, AB, Canada; Department of Anatomy and Cell Biology, University of Calgary, Calgary, AB, Canada.
| |
Collapse
|
26
|
Chaudhuri N, Leonard C. M263 A Quarter Of Ipf Patients Not Eligible For Pirfenidone Treatment Due To The Nice Criteria Significantly Decline Over Time. Thorax 2014. [DOI: 10.1136/thoraxjnl-2014-206260.444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
|
27
|
Chaudhuri N, Leonard C. M264 Health And Economic Impact Of Prescribing Pirfenidone. Thorax 2014. [DOI: 10.1136/thoraxjnl-2014-206260.445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
|
28
|
Abstract
BACKGROUND Mobile smart phones have become increasingly integrated into the practice of doctors and allied medical professionals. Recent studies suggest them to represent reservoirs for pathogens with potential to cause nosocomial infections. This study aimed to investigate the level of contamination on phones used on surgical wards and identify strategies for their safe use within clinical areas. METHODS Fifty mobile phones were taken from members of the multidisciplinary team working in a surgical unit. Phones were swabbed by two trained investigators using a standardised technique and samples streaked out using an automated specimen inoculator onto two types of culture media (Columbia blood agar and MacConkey agar). Colonies were identified and counted by a single trained investigator in a blinded fashion. Simultaneously a questionnaire investigating usage levels of phones was given to 150 healthcare workers. RESULTS Sixty per cent of phones sampled had some form of contaminant isolated from their phone. Thirty-one (62%) of phones had only three colonies or less isolated on medium. No pathogenic or drug resistant strains of bacteria were identified. A total of 88% of individuals sampled by questionnaire used their phone within the workplace of which 55% used it for clinical purposes. Sixty-three per cent expected there to be some form of contaminant on their phone with only 37% admitting to cleaning it regularly. Seventy-five per cent of people did not view a ban on phones as a practical solution was they found to be an infection risk. CONCLUSION Touch screen smart phones may be used safely in a clinical environment, with a low risk of cross-contamination of nosocomial bacteria to patients, in the setting of effective adherence to hand hygiene policies.
Collapse
Affiliation(s)
- D Mark
- Department of General Surgery, Ulster Hospital, Belfast, UK
| | | | | | | | | | | |
Collapse
|
29
|
Leonard C, Bein KJ, Latt M, Muscatello D, Veillard AS, Dinh MM. Demand for emergency department services in the elderly: An 11 year analysis of the Greater Sydney Area. Emerg Med Australas 2014; 26:356-60. [DOI: 10.1111/1742-6723.12250] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/16/2014] [Indexed: 11/30/2022]
Affiliation(s)
- Claire Leonard
- Royal Prince Alfred Hospital; Sydney New South Wales Australia
| | - Kendall J Bein
- Royal Prince Alfred Hospital; Sydney New South Wales Australia
| | - Mark Latt
- Royal Prince Alfred Hospital; Sydney New South Wales Australia
| | | | | | - Michael M Dinh
- Discipline of Emergency Medicine, Sydney Medical School; The University of Sydney; Sydney New South Wales Australia
| |
Collapse
|
30
|
Leonard C, Vinoy S. Reflections on the International Congress of Nutrition: A positive academic partnership with industry to progress scientific knowledge for the benefit of all. NUTR BULL 2014. [DOI: 10.1111/nbu.12081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- C. Leonard
- Mondelēz International; Zurich Switzerland
| | - S. Vinoy
- Mondelēz International; Zurich Switzerland
| |
Collapse
|
31
|
Parfrey H, Leonard C, Gibbons MA, Armstrong E, Harris E, Frank R, Sharp C, Percival F. P196 Healthcare utilisation by patients with Idiopathic Pulmonary Fibrosis; observations from the UK pirfenidone Named Patient Programme. Thorax 2013. [DOI: 10.1136/thoraxjnl-2013-204457.348] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
|
32
|
Wright A, Helm J, Spencer L, Leonard C, Bishop P, Greaves M, Chaudhuri N. S12 Interstitial lung disease multidisciplinary discussion: six years of data from a tertiary service. Thorax 2013. [DOI: 10.1136/thoraxjnl-2013-204457.18] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
|
33
|
Al-Aloul M, Al-Skeklley B, Salaie J, Koduri S, Leonard C. P115 Induction Immunosuppression (IS) with Antithymocyte Globulin (ATG) Followed by Mycophenolic Acid (MPA) Significantly Reduces Risk of Acute Cellular Rejection (ACR) But May Increase the Risk of Post-Transplant Lymphoproliferative Disease (PTLD) Post Lung Transplantation (LTx). Thorax 2012. [DOI: 10.1136/thoraxjnl-2012-202678.398] [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]
|
34
|
Capps J, Amies B, Duck A, Frank R, Leonard C, Holme J. P135 Quality of Life and Adverse Effects in Patients Taking Pirfenidone For Idiopathic Pulmonary Fibrosis. Thorax 2012. [DOI: 10.1136/thoraxjnl-2012-202678.418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
|
35
|
Parfrey H, Leonard C, Gibbons MA, Harris E, Frank R, Sharp C, Dew RM, Maher TM. S98 Early Clinical Experience with Pirfenidone For Idiopathic Pulmonary Fibrosis (IPF) in the UK: Interim Results from a UK Cohort. Thorax 2012. [DOI: 10.1136/thoraxjnl-2012-202678.103] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
|
36
|
Felton TW, Roberts SA, Isalska B, Brennan S, Philips A, Whiteside S, Doran HM, Leonard C, Al-Aloul M, Yonan N, Hope WW. Isolation of Aspergillus species from the airway of lung transplant recipients is associated with excess mortality. J Infect 2012; 65:350-6. [PMID: 22863902 DOI: 10.1016/j.jinf.2012.07.008] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2012] [Revised: 07/19/2012] [Accepted: 07/30/2012] [Indexed: 10/28/2022]
Abstract
BACKGROUND Aspergillus spp. are the leading cause of invasive fungal infection in lung transplant recipients. We investigated the relationship between the isolation of Aspergillus spp. from the respiratory tract of lung transplant recipients and their risk of mortality. METHODS A retrospective, observational cohort study of all patients who received lung allografts between January 1999 and May 2011 at a single UK centre was performed. The time from transplantation to death was analysed using Cox regression models. Isolation of Aspergillus spp. from the respiratory tract was included as a covariate in the Cox regression model. RESULTS Two hundred-thirteen patients were included. The median follow-up time was 5 years during which 102 patients (47.9%) died. Aspergillus was isolated from 74 (34.7%) patients. Twenty patients (27%) had Aspergillus isolated in the first 60 days post-transplant. Forty-one patients (55.4%) in the Aspergillus group and 61 patients (43.9%) in the non-Aspergillus group died during follow-up. A hazard ratio of 2.2 (95% CI 1.5-3.3; P < 0.001) for death following a positive Aspergillus sample was observed. CONCLUSION Isolation of Aspergillus spp. from patients following lung transplantation is associated with a significant increase in mortality. Novel preventative strategies are required to minimise the impact of Aspergillus in lung transplant recipients.
Collapse
Affiliation(s)
- T W Felton
- The University of Manchester, Manchester Academic Health Science Centre, NIHR Translational Research Facility in Respiratory Medicine, University Hospital of South Manchester NHS Foundation Trust, Southmoor Road, Manchester M23 9LT, UK.
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
37
|
Ström O, Leonard C, Marsh D, Cooper C. Cost-effectiveness of balloon kyphoplasty in patients with symptomatic vertebral compression fractures in a UK setting. Osteoporos Int 2010; 21:1599-608. [PMID: 19924497 DOI: 10.1007/s00198-009-1096-6] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2009] [Accepted: 09/30/2009] [Indexed: 10/20/2022]
Abstract
SUMMARY Balloon kyphoplasty (BKP) is a procedure used to treat vertebral compression fractures (VCFs). We developed a cost-effectiveness model to evaluate BKP in United Kingsdom patients with hospitalised VCFs and estimated the cost-effectiveness of BKP compared to non-surgical management. The results indicate that BKP provides a cost-effective alternative for treating these patients. INTRODUCTION VCFs of osteoporotic patients are associated with chronic pain, a reduction in health-related quality of life (QoL) and high healthcare costs. BKP is a minimally invasive procedure that has resulted in pain relief, vertebral body height-restoration, decreased kyphosis and improved physical functioning in patients with symptomatic VCFs. BKP was shown to improve health-related QoL in a 12-month interim analysis of a randomised phase-III trial. METHODS The objectives of this study were to develop a Markov cost-effectiveness model to evaluate BKP in patients with painful hospitalised VCFs and to estimate the cost-effectiveness of BKP compared with non-surgical management in a UK setting. It was assumed that QoL-benefits found at 12 months linearly approached zero during another 2 years, and that patients receiving BKP warranted six fewer hospital bed days compared with patients given non-surgical management. RESULTS The procedure was associated with quality-adjusted life-years (QALY)-gains of 0.17 and cost/QALY-gains at 8,800 pound sterling. The results were sensitive to assumptions about avoided length of hospital-stay and persistence of kyphoplasty-related QoL-benefits. CONCLUSION In conclusion, the results indicate that BKP provides a cost-effective alternative for treating patients with hospitalised VCFs in a UK-setting.
Collapse
Affiliation(s)
- O Ström
- i3 Innovus, Stockholm, Sweden.
| | | | | | | |
Collapse
|
38
|
Cerga-Pashoja A, Lowery D, Bhattacharya R, Griffin M, Iliffe S, Lee J, Leonard C, Ricketts S, Strother L, Waters F, Ritchie CW, Warner J. Evaluation of exercise on individuals with dementia and their carers: a randomised controlled trial. Trials 2010; 11:53. [PMID: 20465799 PMCID: PMC2881915 DOI: 10.1186/1745-6215-11-53] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [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: 12/11/2009] [Accepted: 05/13/2010] [Indexed: 11/29/2022] Open
Abstract
Background Almost all of the 820,000 people in the UK with dementia will experience Behavioural and Psychological Symptoms of Dementia (BPSD). However, research has traditionally focused on treating cognitive symptoms, thus neglecting core clinical symptoms that often have a more profound impact on living with dementia. Recent evidence (Kales et al, 2007; Ballard et al, 2009) indicates that the popular approach to managing BPSD - prescription of anti-psychotic medication - can increase mortality and the risk of stroke in people with dementia as well as impair quality of life and accelerate cognitive decline. Consequently, there is a need to evaluate the impact that non-pharmacological interventions have on BPSD; we believe physical exercise is a particularly promising approach. Methods/Design We will carry out a pragmatic, randomised, single-blind controlled trial to evaluate the effectiveness of exercise (planned walking) on the behavioural and psychological symptoms of individuals with dementia. We aim to recruit 146 people with dementia and their carers to be randomized into two groups; one will be trained in a structured, tailored walking programme, while the other will continue with treatment as usual. The primary outcome (BPSD) will be assessed with the Neuropsychiatric Inventory (NPI) along with relevant secondary outcomes at baseline, 6 and 12 weeks. Discussion Designing this study has been challenging both ethically and methodologically. In particular to design an intervention that is simple, measurable, safe, non-invasive and enjoyable has been testing and has required a lot of thought. Throughout the design, we have attempted to balance methodological rigour with study feasibility. We will discuss the challenges that were faced and overcome in this paper. Trial Registration ISRCTN01423159
Collapse
Affiliation(s)
- Arlinda Cerga-Pashoja
- Central & North West London NHS Foundation Trust, Greater London House, Hampstead Rd, London, NW1 7QY, UK
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
39
|
Leonard C, Moher J, Egeth H. Finding top-down guidance in singleton search: An exploration of critical conditions. J Vis 2010. [DOI: 10.1167/8.6.776] [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: 11/24/2022] Open
|
40
|
Palomares M, Torres L, Leonard C, Egeth H. Does subitizing require attention? J Vis 2010. [DOI: 10.1167/6.6.782] [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: 11/24/2022] Open
|
41
|
|
42
|
|
43
|
Liu J, Palomares M, Leonard C, Egeth H. Subitizing capacity is decreased when visual short-term memory capacity is exceeded. J Vis 2010. [DOI: 10.1167/5.8.623] [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: 11/24/2022] Open
|
44
|
Girard P, Leonard C, Quillard J, Eydoux P, Danel P, Dommergues J, Tchernia G. Myelofibrosis, myeloproliferative syndrome and monosomy C in children. ACTA ACUST UNITED AC 2009. [DOI: 10.3109/08880018509141198] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
|
45
|
Rovero F, Rathbun GB, Perkin A, Jones T, Ribble DO, Leonard C, Mwakisoma RR, Doggart N. A new species of giant sengi or elephant-shrew (genus Rhynchocyon) highlights the exceptional biodiversity of the Udzungwa Mountains of Tanzania. J Zool (1987) 2008. [DOI: 10.1111/j.1469-7998.2007.00363.x] [Citation(s) in RCA: 53] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
46
|
Rochon E, Leonard C, Laird L, Burianova H, Soros P, Graham S, Grady C. Investigation of a phonologically based treatment for anomia: Behavioral and neural changes. Brain Cogn 2007. [DOI: 10.1016/j.bandc.2006.08.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
47
|
Evman S, Machaal A, Khasati N, Leonard C, Yonan N. 116: Lung malignancy incidence following lung transplantation. J Heart Lung Transplant 2007. [DOI: 10.1016/j.healun.2006.11.132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
|
48
|
Abstract
This work represents the first clinical data acquired with the endoscopic laser speckle imaging (eLSPI) system, a new diagnostic tool developed for real-time imaging of tissue blood flow during endoscopic surgical procedures. eLSPI was used to image tissue perfusion in the medial compartment of the knee of five patients requiring arthroscopic knee surgery. The effectiveness of eLSPI as a diagnostic tool was tested by measuring changes in tissue perfusion resultant from tourniquet application, and intra-articular epinephrine. eLSPI produced real-time perfusion video images of tissue blood flow in the knee joint. Tourniquet applications produced consistent decreases in mean perfusion index measurements (29.3% +/- 5.1% in meniscus; 39.5% +/- 8.2% in synovium with an intra patient variability of 6%-9%). A dose-dependent vasoconstrictive response to the administration of intra-articular epinephrine was measured, with maximum dose producing a mean decrease in perfusion of 31.0%-9.3% in meniscus and 41.2%-10.9% in synovium. eLSPI consistently detects decreases in articular tissue blood flow resultant from tourniquet inflation or from the administration of increasing concentrations of epinephrine. These are the first in vivo results indicating physiologic changes in articular tissue as a function of two commonly applied practices in endoscopic joint surgery.
Collapse
Affiliation(s)
- R C Bray
- McCaig Centre for Joint Injury and Arthritis Research, Department of Surgery, University of Calgary, Calgary, Alberta, Canada T2N 4N1.
| | | | | | | | | |
Collapse
|
49
|
Barnard J, Fildes J, Richardson S, Pravica V, Hutchinson I, Yonan N, Leonard C. 250. J Heart Lung Transplant 2006. [DOI: 10.1016/j.healun.2005.11.260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
|
50
|
Bhagavathula N, Kelley EA, Reddy M, Nerusu KC, Leonard C, Fay K, Chakrabarty S, Varani J. Upregulation of calcium-sensing receptor and mitogen-activated protein kinase signalling in the regulation of growth and differentiation in colon carcinoma. Br J Cancer 2006; 93:1364-71. [PMID: 16278666 PMCID: PMC2361535 DOI: 10.1038/sj.bjc.6602852] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
In the present study, we demonstrate that Ca2+-induced growth inhibition and induction of differentiation in a line of human colon carcinoma cells (CBS) is dependent on mitogen-activated protein (MAP) kinase signaling and is associated with upregulation of extracellular calcium-sensing receptor (CaSR) expression. When CBS cells were grown in Ca2+-free medium and then switched to medium supplemented with 1.4 mM Ca2+, proliferation was reduced and morphologic features of differentiation were expressed. E-cadherin, which was minimally expressed in nonsupplemented medium, was rapidly induced in response to Ca2+ stimulation. Sustained activation of the extracellular signal-regulated kinase (ERK) occured in Ca2+-supplemented medium. When an inhibitor of ERK activation (10 μM U0126) was included in the Ca2+-supplemented culture medium, ERK-activation did not occur. Concomitantly, E-cadherin was not induced, cell proliferation remained high and differentiation was not observed. The same level of Ca2+ supplementation that induced MAP kinase activation also stimulated CaSR upregulation in CBS cells. A clonal isolate of the CBS line that did not upregulate CaSR expression in response to extracellular Ca2+ was isolated from the parent cells. This isolate failed to produce E-cadherin or undergo growth inhibition/induction of differentiation when exposed to Ca2+ in the culture medium. However, ERK-activation occurred as efficiently in this isolate as in parent CBS cells or in a cloned isolate that underwent growth reduction and differentiation in response to Ca2+ stimulation. Together, these data indicate that CaSR upregulation and MAP kinase signalling are both intermediates in the control of colon carcinoma cell growth and differentiation. They appear to function, at least in part, independently of one another.
Collapse
Affiliation(s)
- N Bhagavathula
- Department of Pathology, University of Michigan Medical School, Ann Arbor, MI 48109-0602, USA
| | - E A Kelley
- Department of Pathology, University of Michigan Medical School, Ann Arbor, MI 48109-0602, USA
| | - M Reddy
- Department of Pathology, University of Michigan Medical School, Ann Arbor, MI 48109-0602, USA
| | - K C Nerusu
- Department of Pathology, University of Michigan Medical School, Ann Arbor, MI 48109-0602, USA
| | - C Leonard
- Department of Pathology, University of Michigan Medical School, Ann Arbor, MI 48109-0602, USA
| | - K Fay
- Department of Pathology, University of Michigan Medical School, Ann Arbor, MI 48109-0602, USA
| | - S Chakrabarty
- Southern Illinois University Cancer Institute, Springfield, IL 62794-9677, USA
| | - J Varani
- Department of Pathology, University of Michigan Medical School, Ann Arbor, MI 48109-0602, USA
- Department of Pathology, The University of Michigan, 1301 Catherine Road/Box 0602, Ann Arbor, MI 48109, USA; E-mail:
| |
Collapse
|