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Chan TM, Bodnariuc N, Nandeesha N, Kodis J, O'Connor C, Mondoux S, Pardhan A, Chen R. GridlockED as an Intervention for Nurses (GAAIN) Study. J Contin Educ Nurs 2024; 55:231-238. [PMID: 38108813 DOI: 10.3928/00220124-20231211-03] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2023]
Abstract
BACKGROUND GridlockED (The Game Crafter, LLC) is a serious game that was developed to teach challenges that face nursing and medical professionals in the emergency department (ED). However, few studies have explored nurses' perceptions of the utility, fidelity, acceptability, and applicability of the serious game modality. This study examined how ED nurses view GridlockED as a continuing education platform. METHOD This single-center observational study explored how nurses engage with and respond to Grid-lockED. The convenience sample included participants recruited from a local continuing nursing education day. Participants completed a presurvey, engaged in a full game play session with the GridlockED game for approximately 45 minutes, and immediately completed a post-game play survey. RESULTS Of the 48 participants (11 male, 37 female; 44 of 48 were RNs), most (91%) agreed that the workflow reflected in the game was equivalent to the flow in a typical ED. Almost all (96%) found the cases in the game reflective of real ED patients, and most (92%) found the game a useful educational tool to prepare new nurses to transition into the ED environment. CONCLUSION The GridlockED game shows potential as a serious game to support nursing education, particularly for new ED nurse orientation and transition to ED practice. [J Contin Educ Nurs. 2024;55(5):231-238.].
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Halai P, Kiss O, Wang R, Chien AL, Kang S, O'Connor C, Bell M, Griffiths CEM, Watson REB, Langton AK. Retinoids in the treatment of photoageing: A histological study of topical retinoid efficacy in black skin. J Eur Acad Dermatol Venereol 2024. [PMID: 38682699 DOI: 10.1111/jdv.20043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Accepted: 03/15/2024] [Indexed: 05/01/2024]
Abstract
BACKGROUND Photoageing describes complex cutaneous changes that occur due to chronic exposure to solar ultraviolet radiation (UVR). The 'gold standard' for the treatment of photoaged white skin is all-trans retinoic acid (ATRA); however, cosmetic retinol (ROL) has also proven efficacious. Recent work has identified that black skin is susceptible to photoageing, characterized by disintegration of fibrillin-rich microfibrils (FRMs) at the dermal-epidermal junction (DEJ). However, the impact of topical retinoids for repair of black skin has not been well investigated. OBJECTIVES To determine the potential of retinoids to repair photoaged black skin. METHODS An exploratory intervention study was performed using an in vivo, short-term patch test protocol. Healthy but photoaged black volunteers (>45 years) were recruited to the study, and participant extensor forearms were occluded with either 0.025% ATRA (n = 6; 4-day application due to irritancy) or ROL (12-day treatment protocol for a cosmetic) at concentrations of 0.3% (n = 6) or 1% (n = 6). Punch biopsies from occluded but untreated control sites and retinoid-treated sites were processed for histological analyses of epidermal characteristics, melanin distribution and dermal remodelling. RESULTS Treatment with ATRA and ROL induced significant acanthosis (all p < 0.001) accompanied by a significant increase in keratinocyte proliferation (Ki67; all p < 0.01), dispersal of epidermal melanin and restoration of the FRMs at the DEJ (all p < 0.01), compared to untreated control. CONCLUSIONS This study confirms that topical ATRA has utility for the repair of photoaged black skin and that ROL induces comparable effects on epidermal and dermal remodelling, albeit over a longer timeframe. The effects of topical retinoids on black photoaged skin are similar to those reported for white photoaged skin and suggest conserved biology in relation to repair of UVR-induced damage. Further investigation of topical retinoid efficacy in daily use is warranted for black skin.
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Affiliation(s)
- P Halai
- Centre for Dermatology Research, The University of Manchester & Salford Royal NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
| | - O Kiss
- Centre for Dermatology Research, The University of Manchester & Salford Royal NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
| | - R Wang
- Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - A L Chien
- Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - S Kang
- Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - C O'Connor
- No7 Beauty Company, Walgreens Boots Alliance, Nottingham, UK
| | - M Bell
- No7 Beauty Company, Walgreens Boots Alliance, Nottingham, UK
| | - C E M Griffiths
- Centre for Dermatology Research, The University of Manchester & Salford Royal NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
- Department of Dermatology, King's College Hospital, King's College London, London, UK
| | - R E B Watson
- Centre for Dermatology Research, The University of Manchester & Salford Royal NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
- A*STAR Skin Research Laboratory (A*SRL), Agency for Science, Technology and Research (A*STAR), Singapore, Singapore
| | - A K Langton
- Centre for Dermatology Research, The University of Manchester & Salford Royal NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
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O'Keeffe R, Mulligan K, McParland P, McAuliffe FM, Mahony R, Corcoran S, O'Connor C, Carroll S, Walsh J. Estimating fetal weight in gastroschisis: A 10 year audit of outcomes at the National Maternity Hospital. Int J Gynaecol Obstet 2024. [PMID: 38572954 DOI: 10.1002/ijgo.15525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Revised: 03/14/2024] [Accepted: 03/24/2024] [Indexed: 04/05/2024]
Abstract
OBJECTIVE To identify whether conventional methods of estimating fetal growth (Hadlock's formula), which relies heavily on abdominal circumference measurements, are accurate in fetuses with gastroschisis. METHODS A retrospective cohort study was performed between the period January 1, 2011 and December 31, 2021 in a tertiary referral maternity hospital identifying all pregnancies with a diagnosis of gastroschisis. Projected fetal weight was obtained using the formula (EFW [Hadlock's formula] + 185 g × [X/7]) where X was the number of days to delivery. RESULTS During the study period 41 cases were identified. The median maternal age was 25. The median BMI was 25 and 63% were primiparous women (n = 26). Median gestation at diagnosis was 21 weeks. Median gestation at delivery was 36 weeks. A total of 4.8% of mothers had a history of drug use (n = 2). The rate of maternal tobacco use was 21.9% (n = 9). A total of 4.8% of fetuses had additional congenital anomalies including amniotic band syndrome and myelomeningocele (n = 2). Estimated fetal weight (EFW) and birth weight data were available for 34 cases. A Wilcoxon signed-rank test showed projected EFW using Hadlock's formula did not result in a statistically significant different birth weight (Z = -1.3, P = 0.169). Median projected weight and actual birth weight were 2241.35 and 2415 g respectively. Median difference was 0.64 g (95% CI: -148 to -28.5). CONCLUSION Our data showed accuracy using standard formulae for EFW in fetuses with gastroschisis.
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Affiliation(s)
- Rachel O'Keeffe
- UCD School of Medicine and Medical Science, National Maternity Hospital, Dublin, Ireland
| | - Karen Mulligan
- UCD School of Medicine and Medical Science, National Maternity Hospital, Dublin, Ireland
| | - Peter McParland
- UCD School of Medicine and Medical Science, National Maternity Hospital, Dublin, Ireland
- UCD Perinatal Research Centre, School of Medicine, University College Dublin, National Maternity Hospital, Dublin, Ireland
| | - Fionnuala M McAuliffe
- UCD School of Medicine and Medical Science, National Maternity Hospital, Dublin, Ireland
- UCD Perinatal Research Centre, School of Medicine, University College Dublin, National Maternity Hospital, Dublin, Ireland
| | - Rhona Mahony
- UCD School of Medicine and Medical Science, National Maternity Hospital, Dublin, Ireland
- UCD Perinatal Research Centre, School of Medicine, University College Dublin, National Maternity Hospital, Dublin, Ireland
| | - Siobhan Corcoran
- UCD School of Medicine and Medical Science, National Maternity Hospital, Dublin, Ireland
- UCD Perinatal Research Centre, School of Medicine, University College Dublin, National Maternity Hospital, Dublin, Ireland
| | - Clare O'Connor
- UCD School of Medicine and Medical Science, National Maternity Hospital, Dublin, Ireland
- UCD Perinatal Research Centre, School of Medicine, University College Dublin, National Maternity Hospital, Dublin, Ireland
| | - Stephen Carroll
- UCD School of Medicine and Medical Science, National Maternity Hospital, Dublin, Ireland
| | - Jennifer Walsh
- UCD School of Medicine and Medical Science, National Maternity Hospital, Dublin, Ireland
- UCD Perinatal Research Centre, School of Medicine, University College Dublin, National Maternity Hospital, Dublin, Ireland
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O'Leary AM, O'Connor C, Gibson L, Murphy M. Pouring cold water on fake news - a qualitative review of misinformation related to burns first aid. J Burn Care Res 2023:irad188. [PMID: 38000913 DOI: 10.1093/jbcr/irad188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Indexed: 11/26/2023]
Abstract
Health misinformation is pervasive on the internet and social media, and can have wide-ranging and devastating repercussions. Burn injuries are highly prevalent, especially in resource-poor countries with less rigorous health and safety regulations and reduced access to quality healthcare, and especially among the pediatric population who rely on caregivers to tend to their injuries. Correct first aid is crucial to improving burn outcomes and avoiding further complications. The aim of this study was to qualitatively assess the content of misinformation related to burns online. A literature search was conducted on PubMed using search terms 'burns' OR 'burn injury' OR 'burns trauma' OR 'major burns' AND 'first aid' AND 'conspiracy' OR 'disinformation' OR 'misinformation' OR 'fake news'. Combinations of these terms were searched via Google, YouTube, Facebook, Instagram, TikTok and PubMed. Key areas of misinformation included unfounded use of 'natural' remedies, injudicious use of antibiotics, omission of key steps of first aid, and errors in specific details of first aid. Clinicians should be aware of misinformation available online related to first aid for burns, be aware that patients presenting with burns may have caused further injury with insufficient first aid or inappropriate home remedies, and lead public health campaigns to educate on the initial emergency management of burns.
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Affiliation(s)
| | - C O'Connor
- Medicine, University College Cork, Ireland
- Dermatology, South Infirmary Victoria University Hospital, Cork, Ireland
- Paediatrics, Cork University Hospital, Cork, Ireland
| | - L Gibson
- Medicine, University College Cork, Ireland
- Paediatrics, Cork University Hospital, Cork, Ireland
| | - M Murphy
- Medicine, University College Cork, Ireland
- Dermatology, South Infirmary Victoria University Hospital, Cork, Ireland
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5
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Gupta AC, Cazoulat G, Zha Y, Al Tae M, Yedururi S, Castelo A, Wood J, He Y, McCulloch MM, Paolucci I, O'Connor C, Koay EJ, Brock KK. Statistical Analysis to Determine the Predictors of Liver Segmental Hypertrophy Observed Post-Radiotherapy. Int J Radiat Oncol Biol Phys 2023; 117:e667. [PMID: 37785970 DOI: 10.1016/j.ijrobp.2023.06.2109] [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: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Prediction of liver segment hypertrophy based on radiotherapy (RT) dose is crucial for maximizing functional liver volume and avoiding hepatic failure after RT. We determined predictors associated with liver hypertrophy with stratification based on induction chemo (IC) and tumor location. MATERIALS/METHODS RT planning, CT images, and 3-month-followup CTs were analyzed from 148 patients who underwent RT for primary or metastatic liver cancers. A nnUNet based model was trained (train/test = 160/40 CTs) to contour the liver segments (1, 2, 3, 4, 5-8) with accuracy assessed using Dice Similarity Coefficients (DSC). 52 features corresponding to segments 1, 2, 3, 2+3, 4, 5-8, were collected including equivalent dose to 2Gy fractions metrics-mean dose (Dmean), dose received by 95% of the volume (D95), volume spared from x gy (Vx), cancer type, tumor location, and IC status. Descriptive statistics were reported as percentage of segments showing hypertrophy under all stratification. Predictors were compared with 6 response variables using Chi-squared/Fisher-Exact test (CST/FET) and logistic regression (LR) for categorical and numerical predictors. RESULTS The nnUNet model had an average DSC of 0.91 across all segments. Overall, segments 1, 4, and 5-8 showed hypertrophy in 35% of cases, and segments 2, 3 and 2+3 showed hypertrophy in 45-49% of patients. Stratification based on tumor location resulted in segment 2+3 hypertrophy in 66% of patients when the tumor was in segments 5-8. For bilobed tumors, segment 2+3 hypertrophy was observed in 34% of patients. CST/FET showed that tumor location, IC, and tumor type were significant predictors of segment 5-8 hypertrophy. Tumor location was also a significant predictor of segments 3 and 2+3 hypertrophy. In LR analysis, all segment-based dose metrics were significant predictors of segment hypertrophy except Dmean in segment 4, and D95 in segment 2 and 4. Overall, the strongest association was obtained for V35 significantly predicting for each segment hypertrophy. The mean dose for segments with hypertrophy was significantly lower (range: 15-30 Gy) than segments with atrophy (p<0.01), except for segment 4 where the mean dose was 10Gy lower but did not reach significance. IC impacts the threshold mean dose that leads to hypertrophy, with more toxic drugs reducing the mean dose threshold. CONCLUSION Tumor location and IC significantly impact the response of segments to RT. Dose volume metrics are strong predictors of volumetric response with segment volume spared from 35 Gy being the strongest predictor.
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Affiliation(s)
- A C Gupta
- UT MD Anderson Cancer Center, Houston, TX
| | - G Cazoulat
- The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Y Zha
- UT MD Anderson Cancer Center, Houston, TX
| | - M Al Tae
- UT MD Anderson Cancer Center, Houston, TX
| | - S Yedururi
- UT MD Anderson Cancer Center, Houston, TX
| | - A Castelo
- UT MD Anderson Cancer Center, Houston, TX
| | - J Wood
- UT MD Anderson Cancer Center, Houston, TX
| | - Y He
- The University of Texas MD Anderson Cancer Center, Houston, TX
| | - M M McCulloch
- The University of Texas MD Anderson Cancer Center, Houston, TX
| | - I Paolucci
- UT MD Anderson Cancer Center, Houston, TX
| | - C O'Connor
- UT MD Anderson Cancer Center, Houston, TX
| | - E J Koay
- The University of Texas MD Anderson Cancer Center, Houston, TX
| | - K K Brock
- The University of Texas MD Anderson Cancer Center, Houston, TX
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6
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Cusack RW, Hennessy TP, Soh B, McDermott B, Ahern C, O'Connor C, Hennessy TG, Ullah I, Abbas S, Arnous S, Kiernan TJ. Management and outcomes of nonculprit coronary disease in STEMI patients. Ir Med J 2023; 116:814. [PMID: 37606262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 08/23/2023]
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7
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Bartels HC, Walsh JM, O'Connor C, McParland P, Carroll S, Higgins S, Mulligan KM, Downey P, Brophy D, Colleran G, Thompson C, Walsh T, O'Brien DJ, Brennan DJ, McVey R, McAuliffe FM, Donnelly J, Corcoran SM. Placenta accreta spectrum ultrasound stage and fetal growth. Int J Gynaecol Obstet 2023; 160:955-961. [PMID: 35964250 PMCID: PMC10087882 DOI: 10.1002/ijgo.14399] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2022] [Revised: 07/27/2022] [Accepted: 08/05/2022] [Indexed: 11/06/2022]
Abstract
OBJECTIVE to evaluate fetal growth in pregnancies complicated by placenta accreta spectrum (PAS) and to compare fetal growth between cases stratified by ultrasound stage of PAS. METHODS This was a prospective multicenter cohort study of women diagnosed with PAS between January 2018 and December 2021. We grouped participants into cases by ultrasound stage (PAS stage 1-3) and controls (PAS0). Fetal growth centiles at three timepoints with median gestational ages of 21 ± 1 weeks (interquartile range [IQR], 20 ± 1-22 ± 0 weeks), 28 ± 0 weeks (IQR, 27 ± 0-28 ± 5 weeks), and 33 ± 0 weeks (IQR, 32 ± 1-34 ± 0 weeks) and birth weight centiles were compared between cases and controls and between those with PAS stratified by ultrasound stage. RESULTS A total of 53 women met inclusion criteria, with a mean age of 37 years (standard deviation, ±4.0 years) and body mass index of 27 kg/m2 (standard deviation, ±5.8 kg/m2 ). Median (IQR) fetal weight centiles were around the 50th centile at each timepoint, with no difference between groups. The incidence of small for gestational age (birth weight ≤ 10th percentile) and large for gestational age (birth weight ≥ 90th percentile) was 11.3% (n = 6) and 15.1% (n = 8), respectively, with no differences by ultrasound stage. The median birth weight centile was 64 (IQR, 26-85), with no differences between cases and controls or by ultrasound stage. CONCLUSIONS In our cohort, a diagnosis of PAS was not associated with fetal growth restriction.
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Affiliation(s)
| | - Jennifer M Walsh
- National Maternity Hospital, Dublin 2, Ireland.,University College Dublin Gynaecological Oncology Group (UCD-GOG), Mater Misericordiae University Hospital and St Vincent's University Hospital, Dublin, Ireland
| | | | - Peter McParland
- National Maternity Hospital, Dublin 2, Ireland.,University College Dublin Gynaecological Oncology Group (UCD-GOG), Mater Misericordiae University Hospital and St Vincent's University Hospital, Dublin, Ireland
| | | | - Shane Higgins
- National Maternity Hospital, Dublin 2, Ireland.,University College Dublin Gynaecological Oncology Group (UCD-GOG), Mater Misericordiae University Hospital and St Vincent's University Hospital, Dublin, Ireland
| | | | - Paul Downey
- National Maternity Hospital, Dublin 2, Ireland
| | | | | | | | - Tom Walsh
- Rotunda Hospital, Parnell Square, Dublin 1, Ireland
| | - Donal J O'Brien
- National Maternity Hospital, Dublin 2, Ireland.,Rotunda Hospital, Parnell Square, Dublin 1, Ireland
| | - Donal J Brennan
- University College Dublin Gynaecological Oncology Group (UCD-GOG), Mater Misericordiae University Hospital and St Vincent's University Hospital, Dublin, Ireland.,Rotunda Hospital, Parnell Square, Dublin 1, Ireland
| | - Ruaidhri McVey
- National Maternity Hospital, Dublin 2, Ireland.,Rotunda Hospital, Parnell Square, Dublin 1, Ireland
| | - Fionnuala M McAuliffe
- National Maternity Hospital, Dublin 2, Ireland.,University College Dublin Gynaecological Oncology Group (UCD-GOG), Mater Misericordiae University Hospital and St Vincent's University Hospital, Dublin, Ireland
| | - Jennifer Donnelly
- Department of UCD Obstetrics and Gynaecology, School of Medicine, University College Dublin, National Maternity Hospital, Dublin 2, Ireland
| | - Siobhan M Corcoran
- National Maternity Hospital, Dublin 2, Ireland.,University College Dublin Gynaecological Oncology Group (UCD-GOG), Mater Misericordiae University Hospital and St Vincent's University Hospital, Dublin, Ireland
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8
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Hogan D, Yap L, Patterson K, Mc Guinness G, O'Connor C, Sharfi A, Hennessey D. Intrarenal pressures during percutaneous nephrolithotomy and flexible ureteroscopy: A porcine kidney model. Eur Urol 2022. [DOI: 10.1016/s0302-2838(22)01265-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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9
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O'Connor C, Kiely L, Heffron C, Ryan J, Bennett M. PAPA-like syndrome with heterozygous mutation in the MEFV gene. Clin Exp Dermatol 2021; 47:642-645. [PMID: 34882829 DOI: 10.1111/ced.15027] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 11/09/2021] [Accepted: 11/16/2021] [Indexed: 11/30/2022]
Abstract
A patient presented with a history of recurrent pyoderma gangrenosum, arthritis and extensive acne, prompting a genetic workup for PAPA syndrome. An MEFV mutation was identified and a change in therapeutic strategy from anakinra to colchicine was successful.
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Affiliation(s)
- C O'Connor
- Department of Dermatology, South Infirmary Victoria University Hospital, Cork, Ireland.,Department of Paediatrics and Child Health, University College Cork, Cork, Ireland
| | - L Kiely
- Department of Dermatology, South Infirmary Victoria University Hospital, Cork, Ireland
| | - C Heffron
- Pathology, Cork University Hospital, Cork, Ireland
| | - J Ryan
- Rheumatology, Cork University Hospital, Cork, Ireland
| | - M Bennett
- Department of Dermatology, South Infirmary Victoria University Hospital, Cork, Ireland
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10
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Roche D, Murphy M, O'Connor C. A qualitative analysis of online misinformation and conspiracy theories in psoriasis. Clin Exp Dermatol 2021; 47:949-952. [PMID: 34856001 DOI: 10.1111/ced.15041] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Revised: 11/08/2021] [Accepted: 12/01/2021] [Indexed: 12/21/2022]
Abstract
Psoriasis is a chronic, hereditary disease with a complex immunopathogenesis, rendering it susceptible to misinformation. Misinformation related to psoriasis can have negative effects both on the public perception of psoriasis and on patients' knowledge of psoriasis. To characterize misinformation related to psoriasis available online, we performed a formal literature review via PubMed and a thematic review via Google. Key themes of misinformation included 'victim-blaming' (hygiene), 'vector' (contagion), 'vaccination', 'vilification' of conventional therapy, 'validation' of natural treatment and diet, 'veneration' of cures and 'vocalization' from celebrities. Misinformation related to psoriasis is pervasive on social media and other websites. Dermatologists, as patient advocates, should be aware of the content of misinformation available online and combat misleading health information to optimize health outcomes for patients with psoriasis.
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Affiliation(s)
- D Roche
- Department of Dermatology, South Infirmary Victoria University Hospital, Cork, Ireland
| | - M Murphy
- Department of Dermatology, South Infirmary Victoria University Hospital, Cork, Ireland.,Department of Medicine, University College Cork, Cork, Ireland
| | - C O'Connor
- Department of Dermatology, South Infirmary Victoria University Hospital, Cork, Ireland.,Department of Medicine, University College Cork, Cork, Ireland
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11
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Lynch L, O'Connor C, Bennett M, Murphy M. The virtual Men's Shed: a pilot of online access to skin cancer education for a high-risk population during the COVID-19 pandemic. Clin Exp Dermatol 2021; 47:595-596. [PMID: 34674292 PMCID: PMC8652743 DOI: 10.1111/ced.14992] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Accepted: 10/20/2021] [Indexed: 11/29/2022]
Affiliation(s)
- L Lynch
- Department of Dermatology, South Infirmary Victoria University Hospital, Cork, Ireland
| | - C O'Connor
- Department of Dermatology, South Infirmary Victoria University Hospital, Cork, Ireland.,Department of Medicine, University College Cork, Cork, Ireland
| | - M Bennett
- Department of Dermatology, South Infirmary Victoria University Hospital, Cork, Ireland
| | - M Murphy
- Department of Dermatology, South Infirmary Victoria University Hospital, Cork, Ireland.,Department of Medicine, University College Cork, Cork, Ireland
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12
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O'Connor C, Moore R, McParland P, Hughes H, Cathcart B, Higgins S, Mahony R, Carroll S, Walsh J, McAuliffe F. The Natural History of Trisomy 21: Outcome Data from a Large Tertiary Referral Centre. Fetal Diagn Ther 2021; 48:575-581. [PMID: 34583352 DOI: 10.1159/000517729] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2021] [Accepted: 05/24/2021] [Indexed: 11/19/2022]
Abstract
OBJECTIVE The aim of the study was to prospectively gather data on pregnancy outcomes of prenatally diagnosed trisomy 21 (T21) in a large tertiary referral centre. METHODS Data were gathered prospectively in a large tertiary referral centre over 5 years from 2013 to 2017 inclusively. Baseline demographic and pregnancy outcome data were recorded on an anonymized computerized database. RESULTS There were 1,836 congenital anomalies diagnosed in the study period including 8.9% (n = 165) cases of T21. 79% (n = 131) were age 35 or older at diagnosis. 79/113 (69.9%) women chose a termination of pregnancy (TOP) following a diagnosis of T21. Amongst pregnancies that continued, there were 4 second-trimester miscarriages (4/34, 11.7%), 9 stillbirths (9/34, 26.4%), and 1 neonatal death, giving an overall pregnancy and neonatal loss rate of 14/34 (41.1%). CONCLUSION The risk of foetal loss in prenatally diagnosed T21 is high at 38% with an overall pregnancy loss rate of 41.1%. This information may be of benefit when counselling couples who are faced with a diagnosis of T21 particularly in the context of limited access to TOP.
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Affiliation(s)
- Clare O'Connor
- Fetal Medicine, National Maternity Hospital, Dublin, Ireland
| | - Rebecca Moore
- Fetal Medicine, National Maternity Hospital, Dublin, Ireland.,UCD Perinatal Research Centre, University College Dublin, National Maternity Hospital, Dublin, Ireland
| | - Peter McParland
- Fetal Medicine, National Maternity Hospital, Dublin, Ireland
| | - Heather Hughes
- Fetal Medicine, National Maternity Hospital, Dublin, Ireland
| | | | - Shane Higgins
- Fetal Medicine, National Maternity Hospital, Dublin, Ireland
| | - Rhona Mahony
- Fetal Medicine, National Maternity Hospital, Dublin, Ireland
| | - Steve Carroll
- Fetal Medicine, National Maternity Hospital, Dublin, Ireland
| | - Jennifer Walsh
- Fetal Medicine, National Maternity Hospital, Dublin, Ireland
| | - Fionnuala McAuliffe
- Fetal Medicine, National Maternity Hospital, Dublin, Ireland.,UCD Perinatal Research Centre, University College Dublin, National Maternity Hospital, Dublin, Ireland
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13
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Eckersley A, Ozols M, O'Connor C, Bell M, Sherratt MJ. Predicting and characterising protein damage in the extracellular matrix. Journal of Photochemistry and Photobiology 2021. [DOI: 10.1016/j.jpap.2021.100055] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
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14
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O'Connor C, Gallagher C, Bourke J, Murphy M. Confidence of Irish dermatologists in caring for patients with skin of colour. Clin Exp Dermatol 2021; 47:169-171. [PMID: 34398995 DOI: 10.1111/ced.14897] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/28/2021] [Indexed: 11/27/2022]
Abstract
To assess Irish dermatologists' confidence with dermatology in patients with skin of colour (SOC), an online survey was distributed to all members of the Irish Association of Dermatology (IAD) by email. Half (50%) of respondents were 'not confident' or 'not at all confident' in diagnosing skin conditions and one-third (33.9%) were 'not confident' or 'not at all confident' in managing skin conditions in patients with SOC. Irish dermatologists have low confidence with skin pathology in SOC, and specific training could reduce this disparity.
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Affiliation(s)
- C O'Connor
- Department of Dermatology, South Infirmary Victoria University Hospital, Cork, Ireland.,Department of Medicine, University College Cork, Cork, Ireland
| | - C Gallagher
- Department of Dermatology, South Infirmary Victoria University Hospital, Cork, Ireland
| | - J Bourke
- Department of Dermatology, South Infirmary Victoria University Hospital, Cork, Ireland.,Department of Medicine, University College Cork, Cork, Ireland
| | - M Murphy
- Department of Dermatology, South Infirmary Victoria University Hospital, Cork, Ireland.,Department of Medicine, University College Cork, Cork, Ireland
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15
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Sirotich E, Guyatt G, Gabe C, Ye Z, Beck CE, Breakey V, Cooper N, Cuker A, Charness J, de Wit K, DiRaimo J, Fein SG, Grace RF, Hassan Z, Jamula E, Kang M, Manski CF, O'Connor C, Pai M, Paynter D, Porter SC, Pruitt B, Strachan G, Webert KE, Yan JW, Kelton JG, Bakchoul T, Arnold DM. Definition of a critical bleed in patients with immune thrombocytopenia: Communication from the ISTH SSC Subcommittee on Platelet Immunology. J Thromb Haemost 2021; 19:2082-2088. [PMID: 34327824 DOI: 10.1111/jth.15368] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [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: 02/12/2021] [Revised: 04/12/2021] [Accepted: 04/28/2021] [Indexed: 01/19/2023]
Abstract
BACKGROUND Immune thrombocytopenia (ITP) is an autoimmune disease characterized by low platelet counts and increased risk of bleeding. In preparation for an upcoming guideline, the ITP Emergency Management Guideline Panel, including clinical experts in hematology, emergency medicine, research methodology, and patient representatives, identified the need for a standardized definition of a critical ITP bleed. The goal of the definition was to distinguish critical bleeds from bleeds that may not require urgent treatment, typically in the context of severe thrombocytopenia. METHODS The panel met in person and virtually to achieve consensus on the criteria for critical bleeding events among patients with ITP. Existing ITP bleeding scores and published definitions of major bleeds in patients receiving anticoagulation informed the definition of a critical ITP bleed. The Platelet Immunology Scientific Standardization Committee (SSC) of the International Society on Thrombosis and Haemostasis endorsed the definition. RESULTS A critical ITP bleed was defined as: (a) a bleed in a critical anatomical site including intracranial, intraspinal, intraocular, retroperitoneal, pericardial, or intramuscular with compartment syndrome; or (2) an ongoing bleed that results in hemodynamic instability or respiratory compromise. CONCLUSION The definition of a critical ITP bleed was developed by the ITP Emergency Management Guideline Panel and endorsed by the Platelet Immunology SSC. It incorporates both anatomic and physiologic risk and pertains to patients with confirmed or suspected ITP who typically have severe thrombocytopenia (platelet count below 20 × 109 /L).
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Affiliation(s)
- Emily Sirotich
- Department of Medicine, McMaster Centre for Transfusion Research, McMaster University, Hamilton, ON, Canada
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada
| | - Gordon Guyatt
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada
| | - Caroline Gabe
- Department of Medicine, McMaster Centre for Transfusion Research, McMaster University, Hamilton, ON, Canada
| | - Zhikang Ye
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada
| | - Carolyn E Beck
- Division of Paediatric Medicine, Department of Paediatrics, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
| | - Vicky Breakey
- Division of Pediatric Hemaology/Oncology, Department of Pediatrics, McMaster University, Hamilton, ON, Canada
| | - Nichola Cooper
- Department of Immunology and Inflammation, Department of Medicine, Imperial college, London, UK
| | - Adam Cuker
- Department of Medicine and Department of Pathology & Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | | | - Kerstin de Wit
- Department of Emergency Medicine, Queen's University, Kingston, ON, Canada
- Department of Medicine, McMaster University, Hamilton, ON, Canada
| | | | | | - Rachael F Grace
- Department of Pediatric Hematology/Oncology, Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Harvard Medical School, Boston, MA, USA
| | - Ziauddin Hassan
- Department of Emergency Medicine, Dr FH Wigmore Regional Hosiptal, Saskatchewan Health Authority, Saskatoon, SK, Canada
| | - Erin Jamula
- Department of Medicine, McMaster Centre for Transfusion Research, McMaster University, Hamilton, ON, Canada
| | - Matthew Kang
- Department of Medicine, McMaster University, Hamilton, ON, Canada
- Department of Medicine, Joseph Brant Hospital, Burlington, ON, Canada
| | - Charles F Manski
- Department of Economics and Institute for Policy Research, Northwestern University, Evanston, IL, USA
| | - Clare O'Connor
- Hamilton Health Sciences and McMaster School of Nursing, Hamilton, ON, Canada
| | - Menaka Pai
- Department of Medicine, McMaster Centre for Transfusion Research, McMaster University, Hamilton, ON, Canada
- Hamilton Health Sciences, Hamilton, ON, Canada
- Hamilton Regional Laboratory Medicine Program, Hamilton, ON, Canada
| | - Dale Paynter
- Platelet Disorder Support Association (PDSA), Cleveland, OH, USA
| | - Stephen C Porter
- Division of Emergency Medicine, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Barbara Pruitt
- Platelet Disorder Support Association, Cincinnati, OH, USA
| | - Gail Strachan
- Platelet Disorder Support Association, Cincinnati, OH, USA
| | - Kathryn E Webert
- Canadian Blood Services, Hamilton, ON, Canada
- Department of Pathology and Molecular Medicine, McMaster University, Hamilton, ON, Canada
| | - Justin W Yan
- Division of Emergency Medicine, Department of Medicine, Lawson Health Research Institute, London Health Sciences Centre, London, ON, Canada
- Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
| | - John G Kelton
- Department of Medicine, Michael G. DeGroote School of Medicine, McMaster University, Hamilton, ON, Canada
| | - Tamam Bakchoul
- Institute for Clinical and Experimental Transfusion Medicine, University Hospital Tübingen, Tübingen, Germany
| | - Donald M Arnold
- Department of Medicine, McMaster Centre for Transfusion Research, McMaster University, Hamilton, ON, Canada
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16
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O'Connor C, Gallagher C, Hollywood A, Paul L, O'Connell M. Anakinra for recalcitrant pyoderma gangrenosum. Clin Exp Dermatol 2021; 46:1558-1560. [PMID: 34137070 DOI: 10.1111/ced.14809] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/15/2021] [Indexed: 11/30/2022]
Abstract
Pyoderma gangrenosum (PG) is an autoinflammatory neutrophilic dermatosis characterized by rapidly enlarging, painful ulcers. Anakinra is a recombinant interleukin (IL)-1 receptor antagonist that blocks the activity of IL-1α and IL-1β by competitively inhibiting IL-1 binding to the IL-1 type 1 receptor. We present a series of two patients with recalcitrant PG, who had limited therapeutic options and multiple comorbidities and multiple previous treatment failures, who obtained 100% healing with anakinra. Compared with conventional first-line therapies for PG, the safety profile of anakinra may be preferable for patients with multiple comorbidities. Further research is needed to assess the safety and efficacy of anakinra for PG.
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Affiliation(s)
- C O'Connor
- Department of Dermatology, University Hospital Waterford, Waterford, Ireland.,Department of Medicine, University College Cork, Cork, Ireland
| | - C Gallagher
- Department of Dermatology, University Hospital Waterford, Waterford, Ireland
| | - A Hollywood
- Department of Dermatology, University Hospital Waterford, Waterford, Ireland
| | - L Paul
- Department of Dermatology, University Hospital Waterford, Waterford, Ireland
| | - M O'Connell
- Department of Dermatology, University Hospital Waterford, Waterford, Ireland
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17
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O'Connell G, O'Connor C, Murphy M. Every cloud has a silver lining: the environmental benefit of teledermatology during the COVID-19 pandemic. Clin Exp Dermatol 2021; 46:1589-1590. [PMID: 34114678 PMCID: PMC9213979 DOI: 10.1111/ced.14795] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Accepted: 06/08/2021] [Indexed: 01/24/2023]
Affiliation(s)
- G O'Connell
- Department of Dermatology, South Infirmary Victoria University Hospital, Cork, Ireland
| | - C O'Connor
- Department of Dermatology, South Infirmary Victoria University Hospital, Cork, Ireland.,Department of Medicine, University College Cork, Cork, Ireland
| | - M Murphy
- Department of Dermatology, South Infirmary Victoria University Hospital, Cork, Ireland.,Department of Medicine, University College Cork, Cork, Ireland
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18
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Moreiras H, O'Connor C, Bell M, Tobin DJ. Visible light and human skin pigmentation: The importance of skin phototype. Exp Dermatol 2021; 30:1324-1331. [PMID: 34081365 DOI: 10.1111/exd.14400] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2021] [Revised: 04/27/2021] [Accepted: 05/13/2021] [Indexed: 12/22/2022]
Abstract
Melanin is synthesised within melanocytes and transferred to keratinocytes in human skin, thereby regulating skin colour and protecting skin cells against UVR-induced damage. We commonly divide human skin into six phototypes (SPT)-I to -VI (Fitzpatrick scale) according to the skin's tanning response to UVR. In this pilot study, we investigated the impact of UVR (maximum 311nm), blue (peak 450nm) and green visible light (peak 530nm) on melanin production and type in healthy human skin histocultures (SPT-I, -II and -III). UVR, blue and green light stimulated a surface tanning response in SPT-II and -III, but not SPT-I. Using the Warthin-Starry stain for sensitive melanin detection, all three light treatments induced melanogenesis in SPT-II and -III skin. Surprisingly, blue and green light (but not UVR) stimulated melanin synthesis in SPT-I skin. Moreover, melanin synthesis induced by blue and green visible light in SPT-I, SPT-II, and SPT-III skin was not associated with a detectable increase in DNA damage or cell apoptosis. By contrast, both responses were detected after UVR. These data suggest that blue and green visible light can stimulate melanin production in fair-skinned individuals without, at least some of, the harmful consequences of UVR-induced pigmentation. We are currently examining the molecular basis of UVR-independent melanogenesis in fair skin.
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Affiliation(s)
- Hugo Moreiras
- The Charles Institute of Dermatology, School of Medicine, University College Dublin, Dublin, Ireland
| | | | - Mike Bell
- Walgreens Boots Alliance, Nottingham, UK
| | - Desmond J Tobin
- The Charles Institute of Dermatology, School of Medicine, University College Dublin, Dublin, Ireland.,The Conway Institute of Biomolecular and Biomedical Research, University College Dublin, Dublin, Ireland
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19
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Bowe S, O'Connor C, Kenosi M, Murphy LA. Aplasia cutis congenita in dizygotic twin infants. Clin Exp Dermatol 2021; 46:1574-1576. [PMID: 34048064 DOI: 10.1111/ced.14763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Accepted: 05/25/2021] [Indexed: 10/21/2022]
Affiliation(s)
- S Bowe
- Department of Dermatology, South Infirmary Victoria University Hospital, Cork, Ireland
| | - C O'Connor
- Department of Dermatology, South Infirmary Victoria University Hospital, Cork, Ireland.,Department of Paediatrics and Child Health, University College Cork, Cork, Ireland
| | - M Kenosi
- Department of Neonatology, Cork University Maternity Hospital, Cork, Ireland
| | - L A Murphy
- Department of Dermatology, South Infirmary Victoria University Hospital, Cork, Ireland
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20
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Roche D, O'Connor C, Murphy M. Ivermectin in dermatology: why it 'mite' be useless against COVID-19. Clin Exp Dermatol 2021; 46:1327-1328. [PMID: 33896010 PMCID: PMC8251261 DOI: 10.1111/ced.14704] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2021] [Accepted: 04/20/2021] [Indexed: 01/08/2023]
Affiliation(s)
- D Roche
- Department of Dermatology, South Infirmary Victoria University Hospital, Cork, Ireland
| | - C O'Connor
- Department of Dermatology, South Infirmary Victoria University Hospital, Cork, Ireland.,Department of Medicine, University College Cork, Cork, Ireland
| | - M Murphy
- Department of Dermatology, South Infirmary Victoria University Hospital, Cork, Ireland.,Department of Medicine, University College Cork, Cork, Ireland
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21
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Bernauer JC, Schmidt A, Henderson BS, Ice LD, Khaneft D, O'Connor C, Russell R, Akopov N, Alarcon R, Ates O, Avetisyan A, Beck R, Belostotski S, Bessuille J, Brinker F, Calarco JR, Carassiti V, Cisbani E, Ciullo G, Contalbrigo M, De Leo R, Diefenbach J, Donnelly TW, Dow K, Elbakian G, Eversheim PD, Frullani S, Funke C, Gavrilov G, Gläser B, Görrissen N, Hasell DK, Hauschildt J, Hoffmeister P, Holler Y, Ihloff E, Izotov A, Kaiser R, Karyan G, Kelsey J, Kiselev A, Klassen P, Krivshich A, Kohl M, Lehmann I, Lenisa P, Lenz D, Lumsden S, Ma Y, Maas F, Marukyan H, Miklukho O, Milner RG, Movsisyan A, Murray M, Naryshkin Y, Perez Benito R, Perrino R, Redwine RP, Rodríguez Piñeiro D, Rosner G, Schneekloth U, Seitz B, Statera M, Thiel A, Vardanyan H, Veretennikov D, Vidal C, Winnebeck A, Yeganov V. Measurement of the Charge-Averaged Elastic Lepton-Proton Scattering Cross Section by the OLYMPUS Experiment. Phys Rev Lett 2021; 126:162501. [PMID: 33961478 DOI: 10.1103/physrevlett.126.162501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Revised: 03/17/2021] [Accepted: 03/23/2021] [Indexed: 06/12/2023]
Abstract
We report the first measurement of the average of the electron-proton and positron-proton elastic scattering cross sections. This lepton charge-averaged cross section is insensitive to the leading effects of hard two-photon exchange, giving more robust access to the proton's electromagnetic form factors. The cross section was extracted from data taken by the OLYMPUS experiment at DESY, in which alternating stored electron and positron beams were scattered from a windowless gaseous hydrogen target. Elastic scattering events were identified from the coincident detection of the scattered lepton and recoil proton in a large-acceptance toroidal spectrometer. The luminosity was determined from the rates of Møller, Bhabha, and elastic scattering in forward electromagnetic calorimeters. The data provide some selectivity between existing form factor global fits and will provide valuable constraints to future fits.
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Affiliation(s)
- J C Bernauer
- Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, USA
| | - A Schmidt
- Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, USA
| | - B S Henderson
- Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, USA
| | - L D Ice
- Arizona State University, Tempe, Arizona 85287, USA
| | - D Khaneft
- Johannes Gutenberg-Universität, Mainz, Germany
| | - C O'Connor
- Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, USA
| | - R Russell
- Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, USA
| | - N Akopov
- Alikhanyan National Science Laboratory (Yerevan Physics Institute), Yerevan, Armenia
| | - R Alarcon
- Arizona State University, Tempe, Arizona 85287, USA
| | - O Ates
- Hampton University, Hampton, Virginia 23668, USA
| | - A Avetisyan
- Alikhanyan National Science Laboratory (Yerevan Physics Institute), Yerevan, Armenia
| | - R Beck
- Rheinische Friedrich-Wilhelms-Universität, Bonn, Germany
| | - S Belostotski
- Petersburg Nuclear Physics Institute, Gatchina, Russia
| | - J Bessuille
- Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, USA
| | - F Brinker
- Deutsches Elektronen-Synchrotron, Hamburg, Germany
| | - J R Calarco
- University of New Hampshire, Durham, New Hampshire 03824, USA
| | - V Carassiti
- Università degli Studi di Ferrara and Istituto Nazionale di Fisica Nucleare sezione di Ferrara, Ferrara, Italy
| | - E Cisbani
- Istituto Nazionale di Fisica Nucleare sezione di Roma and Istituto Superiore di Sanità, Rome, Italy
| | - G Ciullo
- Università degli Studi di Ferrara and Istituto Nazionale di Fisica Nucleare sezione di Ferrara, Ferrara, Italy
| | - M Contalbrigo
- Università degli Studi di Ferrara and Istituto Nazionale di Fisica Nucleare sezione di Ferrara, Ferrara, Italy
| | - R De Leo
- Istituto Nazionale di Fisica Nucleare sezione di Bari, Bari, Italy
| | - J Diefenbach
- Hampton University, Hampton, Virginia 23668, USA
| | - T W Donnelly
- Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, USA
| | - K Dow
- Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, USA
| | - G Elbakian
- Alikhanyan National Science Laboratory (Yerevan Physics Institute), Yerevan, Armenia
| | - P D Eversheim
- Rheinische Friedrich-Wilhelms-Universität, Bonn, Germany
| | - S Frullani
- Istituto Nazionale di Fisica Nucleare sezione di Roma and Istituto Superiore di Sanità, Rome, Italy
| | - Ch Funke
- Rheinische Friedrich-Wilhelms-Universität, Bonn, Germany
| | - G Gavrilov
- Petersburg Nuclear Physics Institute, Gatchina, Russia
| | - B Gläser
- Johannes Gutenberg-Universität, Mainz, Germany
| | - N Görrissen
- Deutsches Elektronen-Synchrotron, Hamburg, Germany
| | - D K Hasell
- Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, USA
| | - J Hauschildt
- Deutsches Elektronen-Synchrotron, Hamburg, Germany
| | - Ph Hoffmeister
- Rheinische Friedrich-Wilhelms-Universität, Bonn, Germany
| | - Y Holler
- Deutsches Elektronen-Synchrotron, Hamburg, Germany
| | - E Ihloff
- Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, USA
| | - A Izotov
- Petersburg Nuclear Physics Institute, Gatchina, Russia
| | - R Kaiser
- University of Glasgow, Glasgow, United Kingdom
| | - G Karyan
- Alikhanyan National Science Laboratory (Yerevan Physics Institute), Yerevan, Armenia
| | - J Kelsey
- Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, USA
| | - A Kiselev
- Petersburg Nuclear Physics Institute, Gatchina, Russia
| | - P Klassen
- Rheinische Friedrich-Wilhelms-Universität, Bonn, Germany
| | - A Krivshich
- Petersburg Nuclear Physics Institute, Gatchina, Russia
| | - M Kohl
- Hampton University, Hampton, Virginia 23668, USA
| | - I Lehmann
- University of Glasgow, Glasgow, United Kingdom
| | - P Lenisa
- Università degli Studi di Ferrara and Istituto Nazionale di Fisica Nucleare sezione di Ferrara, Ferrara, Italy
| | - D Lenz
- Deutsches Elektronen-Synchrotron, Hamburg, Germany
| | - S Lumsden
- University of Glasgow, Glasgow, United Kingdom
| | - Y Ma
- Johannes Gutenberg-Universität, Mainz, Germany
| | - F Maas
- Johannes Gutenberg-Universität, Mainz, Germany
| | - H Marukyan
- Alikhanyan National Science Laboratory (Yerevan Physics Institute), Yerevan, Armenia
| | - O Miklukho
- Petersburg Nuclear Physics Institute, Gatchina, Russia
| | - R G Milner
- Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, USA
| | - A Movsisyan
- Alikhanyan National Science Laboratory (Yerevan Physics Institute), Yerevan, Armenia
- Università degli Studi di Ferrara and Istituto Nazionale di Fisica Nucleare sezione di Ferrara, Ferrara, Italy
| | - M Murray
- University of Glasgow, Glasgow, United Kingdom
| | - Y Naryshkin
- Petersburg Nuclear Physics Institute, Gatchina, Russia
| | | | - R Perrino
- Istituto Nazionale di Fisica Nucleare sezione di Bari, Bari, Italy
| | - R P Redwine
- Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, USA
| | | | - G Rosner
- University of Glasgow, Glasgow, United Kingdom
| | | | - B Seitz
- University of Glasgow, Glasgow, United Kingdom
| | - M Statera
- Università degli Studi di Ferrara and Istituto Nazionale di Fisica Nucleare sezione di Ferrara, Ferrara, Italy
| | - A Thiel
- Rheinische Friedrich-Wilhelms-Universität, Bonn, Germany
| | - H Vardanyan
- Alikhanyan National Science Laboratory (Yerevan Physics Institute), Yerevan, Armenia
| | | | - C Vidal
- Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, USA
| | - A Winnebeck
- Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, USA
| | - V Yeganov
- Alikhanyan National Science Laboratory (Yerevan Physics Institute), Yerevan, Armenia
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22
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O'Connor C, Murphy M. Scratching the surface: a review of online misinformation and conspiracy theories in atopic dermatitis. Clin Exp Dermatol 2021; 46:1545-1547. [PMID: 33864398 DOI: 10.1111/ced.14679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Revised: 03/18/2021] [Accepted: 04/12/2021] [Indexed: 11/26/2022]
Abstract
Misinformation is one of the greatest threats to global health. Atopic dermatitis (AD) is a common skin disorder with a complex multifactorial aetiology, rendering it susceptible to misinformation. Little is known about the content of misinformation regarding AD online. We performed a review of AD-related misinformation available online, via PubMed for scientific papers and Google for nonscientific websites. Key areas of misinformation were identified, including 'simple cures' for AD, diet, chemicals, dust, vaccines, red skin syndrome and alternative therapies. Patients with AD and their families are vulnerable to misinformation given the severe impact of AD on quality of life. Dermatologists must be aware of the false AD-related content being shared online, and be prepared to refute and rebut misinformation by providing appropriate evidence.
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Affiliation(s)
- C O'Connor
- Department of Dermatology, South Infirmary Victoria University Hospital, Cork, Ireland.,Department of Medicine, University College Cork, Cork, Ireland
| | - M Murphy
- Department of Dermatology, South Infirmary Victoria University Hospital, Cork, Ireland.,Department of Medicine, University College Cork, Cork, Ireland
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23
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O'Connor C, Gallagher C, O'Connell M, Bourke J, Murphy M, Bennett M. Bare necessities? The utility of full skin examination in the COVID-19 era. Clin Exp Dermatol 2021; 46:720-722. [PMID: 33639003 PMCID: PMC8013915 DOI: 10.1111/ced.14620] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Revised: 01/18/2021] [Accepted: 02/22/2021] [Indexed: 12/24/2022]
Abstract
Full skin examination (FSE) may improve the detection of malignant melanoma (MM). The objective of this study was to assess the safety of targeted lesion examination (TLE) compared with FSE in our Pigmented Lesion Clinic (PLC). Patients attending the PLC were randomized in a 2 : 1 ratio to FSE (intervention) or TLE (standard care). Demographic details and risk factors were documented, and the time taken to perform FSE and TLE was noted. Of 763 participants, 520 were assigned to FSE and 243 were assigned to TLE. On average, FSE took 4.02 min and TLE took 30 s to perform. Of the 520 participants assigned to FSE, 37 (7.1%) had incidental findings, of whom 12 patients (2.3%) had additional lesions biopsied. No additional melanomas were detected that would have been missed by use of the standard protocol. This study suggests that in low-risk patients referred to a PLC with a lesion of concern, the possibility of missing incidental cutaneous malignancies using lesion-directed examination is low.
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Affiliation(s)
- C O'Connor
- Department of Dermatology, South Infirmary Victoria University Hospital, Cork, Ireland.,Department of Medicine, University College Cork, Cork, Ireland
| | - C Gallagher
- Department of Dermatology, South Infirmary Victoria University Hospital, Cork, Ireland
| | - M O'Connell
- Department of Dermatology, South Infirmary Victoria University Hospital, Cork, Ireland
| | - J Bourke
- Department of Dermatology, South Infirmary Victoria University Hospital, Cork, Ireland.,Department of Medicine, University College Cork, Cork, Ireland
| | - M Murphy
- Department of Dermatology, South Infirmary Victoria University Hospital, Cork, Ireland.,Department of Medicine, University College Cork, Cork, Ireland
| | - M Bennett
- Department of Dermatology, South Infirmary Victoria University Hospital, Cork, Ireland
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24
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Moriarty D, O'Connor C, Bourke J, Murphy M, Horgan M, Cremin S. An Irish Department of Genito-Urinary Medicine in the COVID-19 Era. J Eur Acad Dermatol Venereol 2021; 35:e353-e354. [PMID: 33587768 PMCID: PMC8014710 DOI: 10.1111/jdv.17169] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- D Moriarty
- Department of Genito-urinary Medicine, South Infirmary Victoria University Hospital, Cork, Ireland
| | - C O'Connor
- Department of Dermatology, South Infirmary Victoria University Hospital, Cork, Ireland.,University College Cork, Cork, Ireland
| | - J Bourke
- Department of Dermatology, South Infirmary Victoria University Hospital, Cork, Ireland.,University College Cork, Cork, Ireland
| | - M Murphy
- Department of Dermatology, South Infirmary Victoria University Hospital, Cork, Ireland.,University College Cork, Cork, Ireland
| | - M Horgan
- Department of Genito-urinary Medicine, South Infirmary Victoria University Hospital, Cork, Ireland.,University College Cork, Cork, Ireland
| | - S Cremin
- Department of Genito-urinary Medicine, South Infirmary Victoria University Hospital, Cork, Ireland
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25
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Nic Dhonncha E, O'Connor C, O'Connell G, Quinlan C, Roche L, Murphy M. Adherence to treatment with prescribed topical corticosteroid therapy and potential barriers to adherence among women with vulvar lichen sclerosus: a prospective cross-sectional study. Clin Exp Dermatol 2021; 46:734-735. [PMID: 33247952 DOI: 10.1111/ced.14527] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 11/07/2020] [Accepted: 11/24/2020] [Indexed: 12/22/2022]
Affiliation(s)
- E Nic Dhonncha
- Department of Dermatology, South Infirmary Victoria University Hospital, Cork, Ireland
| | - C O'Connor
- Department of Dermatology, South Infirmary Victoria University Hospital, Cork, Ireland
| | - G O'Connell
- Department of Dermatology, South Infirmary Victoria University Hospital, Cork, Ireland
| | - C Quinlan
- Department of Dermatology, South Infirmary Victoria University Hospital, Cork, Ireland
| | - L Roche
- Department of Dermatology, South Infirmary Victoria University Hospital, Cork, Ireland
| | - M Murphy
- Department of Dermatology, South Infirmary Victoria University Hospital, Cork, Ireland
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O'Connor C, O'Connell G, Nic Dhonncha E, Roche L, Quinlan C, Murphy LA, Gleeson C, Bennett M, Bourke J, Murphy M. Sense and sensibility: an Irish dermatology department in the era of COVID-19. Clin Exp Dermatol 2021; 46:375-377. [PMID: 33249595 PMCID: PMC7753692 DOI: 10.1111/ced.14526] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Revised: 11/04/2020] [Accepted: 11/24/2020] [Indexed: 12/05/2022]
Affiliation(s)
- C O'Connor
- Department of Dermatology, South Infirmary Victoria University Hospital, Cork, Ireland.,Department of Medicine, University College Cork, Cork, Ireland
| | - G O'Connell
- Department of Dermatology, South Infirmary Victoria University Hospital, Cork, Ireland
| | - E Nic Dhonncha
- Department of Dermatology, South Infirmary Victoria University Hospital, Cork, Ireland
| | - L Roche
- Department of Dermatology, South Infirmary Victoria University Hospital, Cork, Ireland
| | - C Quinlan
- Department of Dermatology, South Infirmary Victoria University Hospital, Cork, Ireland
| | - L A Murphy
- Department of Dermatology, South Infirmary Victoria University Hospital, Cork, Ireland
| | - C Gleeson
- Department of Dermatology, South Infirmary Victoria University Hospital, Cork, Ireland
| | - M Bennett
- Department of Dermatology, South Infirmary Victoria University Hospital, Cork, Ireland
| | - J Bourke
- Department of Dermatology, South Infirmary Victoria University Hospital, Cork, Ireland.,Department of Medicine, University College Cork, Cork, Ireland
| | - M Murphy
- Department of Dermatology, South Infirmary Victoria University Hospital, Cork, Ireland.,Department of Medicine, University College Cork, Cork, Ireland
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Kells NJ, Beausoleil NJ, Johnson CB, Chambers JP, O'Connor C, Webster J, Laven R, Cogger N. Indicators of dehydration in healthy 4- to 5-day-old dairy calves deprived of feed and water for 24 hours. J Dairy Sci 2020; 103:11820-11832. [PMID: 33222862 DOI: 10.3168/jds.2020-18743] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2020] [Accepted: 08/09/2020] [Indexed: 11/19/2022]
Abstract
Our objective was to identify practical indicators of calf dehydration that could be used in an industry context. Eleven healthy 4-d-old commercial dairy calves were fed 2 L of mixed colostrum, then deprived of food and water for 24 h. Total body water was determined in the fed state using the deuterium dilution method. Body weight, along with a range of behavioral and physiological variables, was recorded 1 h after feeding, then at 90-min intervals through to 24 h. Blood samples were collected at every second sampling to assess changes in plasma hemoglobin, hematocrit, and osmolality. Linear mixed-effects models were used to explore associations between hydration status (% body water) and outcome variables. All calves remained bright and alert with good suckling reflexes throughout the 24-h period. After 24 h, total body water had decreased by an average of 8.4% (standard error 1.18), consistent with mild to moderate dehydration. Skin tent return time, capillary refill time, and detectable enophthalmos were associated with hydration status. Calves with skin tent return times of 3 s or longer were 4.4 percentage points less hydrated than those with return times of less than 3 s. Similarly, a capillary refill time of 3 s or longer was associated with a 4.3 percentage point reduction in hydration compared with refill times of less than 3 s. Calves with detectable enophthalmos (≥1 mm) were 3.5 percentage points less hydrated than those without enophthalmos. The skin tent, capillary refill, and enophthalmos tests are all relatively simple to perform and, although requiring the calf to be briefly restrained, can easily be performed by a single operator. The outcome of these tests was relatively consistent, in that calves above the threshold in any test were 3.5 to 4.5% less hydrated than calves below the threshold. As such, these tests may be of practical utility to identify calves with mild to moderate dehydration in an industry setting.
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Affiliation(s)
- N J Kells
- School of Veterinary Science, Massey University, Private Bag 11-222, Palmerston North 4442, New Zealand.
| | - N J Beausoleil
- School of Veterinary Science, Massey University, Private Bag 11-222, Palmerston North 4442, New Zealand
| | - C B Johnson
- School of Veterinary Science, Massey University, Private Bag 11-222, Palmerston North 4442, New Zealand
| | - J P Chambers
- School of Veterinary Science, Massey University, Private Bag 11-222, Palmerston North 4442, New Zealand
| | - C O'Connor
- AgResearch, Ruakura Research Centre, Private Bag 3123, Hamilton, New Zealand
| | - J Webster
- AgResearch, Ruakura Research Centre, Private Bag 3123, Hamilton, New Zealand
| | - R Laven
- School of Veterinary Science, Massey University, Private Bag 11-222, Palmerston North 4442, New Zealand
| | - N Cogger
- School of Veterinary Science, Massey University, Private Bag 11-222, Palmerston North 4442, New Zealand
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O'Connor C, Courtney C, Murphy M. Shedding light on the myths of ultraviolet radiation in the COVID-19 pandemic. Clin Exp Dermatol 2020; 46:187-188. [PMID: 32974949 PMCID: PMC7536907 DOI: 10.1111/ced.14456] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Accepted: 09/12/2020] [Indexed: 11/29/2022]
Affiliation(s)
- C O'Connor
- Department of Dermatology, South Infirmary Victoria University Hospital, Cork, Ireland.,University College Cork, Cork, Ireland
| | - C Courtney
- Department of Dermatology, South Infirmary Victoria University Hospital, Cork, Ireland
| | - M Murphy
- Department of Dermatology, South Infirmary Victoria University Hospital, Cork, Ireland.,University College Cork, Cork, Ireland
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Rubinsak L, Wallace-Povirk A, Hou Z, O'Connor C, Gangjee A, Morris R, Matherly L. Targeting one-carbon metabolism in syngeneic mouse model of BRCA-mutated high-grade serous ovarian cancer. Gynecol Oncol 2020. [DOI: 10.1016/j.ygyno.2020.05.097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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O'Connor C, Murphy M. Going Viral: Doctors Must Combat Fake News in the Fight against Covid-19. Ir Med J 2020; 113:85. [PMID: 32603577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Affiliation(s)
- C O'Connor
- Department of Dermatology, South Infirmary Victoria University Hospital, Cork
- University College Cork, College Road, Cork
| | - M Murphy
- Department of Dermatology, South Infirmary Victoria University Hospital, Cork
- University College Cork, College Road, Cork
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O'Connor C, Heffron C, McGrath J, O'Shea S, Bourke J. Epidermolysis bullosa (EB) pruriginosa associated with recessive homozygous mutations in COL7A1: case report of a rare EB genotype-phenotype. J Eur Acad Dermatol Venereol 2020; 34:e501-e504. [PMID: 32250485 DOI: 10.1111/jdv.16418] [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: 11/30/2022]
Affiliation(s)
- C O'Connor
- Department of Dermatology, South Infirmary Victoria University Hospital, Cork, Ireland
| | - C Heffron
- Department of Pathology, Cork University Hospital, Cork, Ireland
| | - J McGrath
- National Diagnostic Epidermolysis Bullosa Laboratory, Guy's Hospital, London, UK
| | - S O'Shea
- Department of Dermatology, South Infirmary Victoria University Hospital, Cork, Ireland
| | - J Bourke
- Department of Dermatology, South Infirmary Victoria University Hospital, Cork, Ireland
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Mone F, O'Connor C, Hamilton S, Quinlan-Jones E, Allen S, Marton T, Williams D, Kilby MD. Evolution of a prenatal genetic clinic-A 10-year cohort study. Prenat Diagn 2020; 40:618-625. [PMID: 32037575 DOI: 10.1002/pd.5661] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Revised: 01/19/2020] [Accepted: 01/25/2020] [Indexed: 12/11/2022]
Abstract
OBJECTIVE To (a) evaluate the proportion of women where a unifying genetic diagnosis was obtained following assessment of an observed pattern of fetal anomalies and (b) assess trends in genetic testing in a joint fetal-medicine genetic clinic. METHOD Retrospective cohort study of all women attending the clinic. Outcomes included (a) indication for referral, (b) genetic test performed and (c) diagnoses obtained. RESULTS From 2008 to 2019, 256 patients were referred and reviewed, of which 23% (n = 59) were consanguineous. The main indication for referral was the observed pattern of fetal anomalies. Over 10 years, the number of patients reviewed increased from 11 to 35 per annum. A unifying genetic diagnosis was obtained in 43.2% (n = 79/183), the majority of which were diagnosed prenatally (50.6% [n = 40/79]). The main investigation(s) that was the ultimate diagnostic test was targeted gene panel sequencing 34.2% (n = 27/79), with this and exome sequencing becoming the dominant genetic test by 2019. Pregnancies reviewed due to an abnormal karyotype or microarray decreased as an indication for referral during the study period (21.6% [n = 16/74] 2008-2012 vs 16.5% [n = 30/182] in 2012-2019). CONCLUSION A prenatal genetic clinic with a structured multi-disciplinary team approach may be successful in obtaining a unifying prenatal genetic diagnosis.
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Affiliation(s)
- Fionnuala Mone
- Fetal Medicine Centre, Birmingham Women's and Children's NHS Foundation Trust, Birmingham, UK.,West Midlands Regional Genetics Laboratory and Clinical Genetics Service, Birmingham Women's and Children's NHS Foundation Trust, Birmingham, UK
| | - Clare O'Connor
- Fetal Medicine Centre, Birmingham Women's and Children's NHS Foundation Trust, Birmingham, UK
| | - Susan Hamilton
- West Midlands Regional Genetics Laboratory and Clinical Genetics Service, Birmingham Women's and Children's NHS Foundation Trust, Birmingham, UK
| | - Elizabeth Quinlan-Jones
- Fetal Medicine Centre, Birmingham Women's and Children's NHS Foundation Trust, Birmingham, UK
| | - Stephanie Allen
- West Midlands Regional Genetics Laboratory and Clinical Genetics Service, Birmingham Women's and Children's NHS Foundation Trust, Birmingham, UK
| | - Tamas Marton
- West Midlands Perinatal Pathology Service, Birmingham Women's and Children's NHS Foundation Trust, Birmingham, UK
| | - Denise Williams
- West Midlands Regional Genetics Laboratory and Clinical Genetics Service, Birmingham Women's and Children's NHS Foundation Trust, Birmingham, UK
| | - Mark D Kilby
- Fetal Medicine Centre, Birmingham Women's and Children's NHS Foundation Trust, Birmingham, UK.,Institute of Metabolism and Systems Research, College of Medical & Dental Sciences, University of Birmingham, Birmingham, UK
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O'Connor C, Moore R, Hughes H, Cathcart B, Higgins S, Mahony R, Carroll S, McParland P, Mcauliffe FM, Walsh J. 835: How accurate is the prenatal diagnosis of a fatal fetal abnormality? Am J Obstet Gynecol 2020. [DOI: 10.1016/j.ajog.2019.11.850] [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: 10/25/2022]
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O'Connor C, Mahony R, Downey P, Walsh J. 520: Can effective intervention reduce mortality in fetal hydrops? - A 15 year review of outcomes. Am J Obstet Gynecol 2020. [DOI: 10.1016/j.ajog.2019.11.536] [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: 10/25/2022]
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Young A, Narbutt J, Harrison G, Lawrence K, Bell M, O'Connor C, Olson P, Grys K, Baczynska K, Rogowski‐Tylman M, Wulf H, Lesiak A, Philipsen P. 使用最佳防晒霜可促进维生素 D 合成. Br J Dermatol 2019. [DOI: 10.1111/bjd.18504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Young A, Narbutt J, Harrison G, Lawrence K, Bell M, O'Connor C, Olson P, Grys K, Baczynska K, Rogowski‐Tylman M, Wulf H, Lesiak A, Philipsen P. Optimal sunscreen use allows vitamin D synthesis. Br J Dermatol 2019. [DOI: 10.1111/bjd.18492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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O'Connor C, Bicanic T, Dave J, Evans TJ, Moxey P, Adamu U, Shakespeare D, Cotter M. Candida auris outbreak on a vascular ward - the unexpected arrival of an anticipated pathogen. J Hosp Infect 2019; 103:106-108. [PMID: 31220481 DOI: 10.1016/j.jhin.2019.06.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2019] [Accepted: 06/07/2019] [Indexed: 11/19/2022]
Affiliation(s)
- C O'Connor
- Infection Care Group, St George's University Hospitals NHS Foundation Trust, London, UK. Ciara.O'
| | - T Bicanic
- Infection Care Group, St George's University Hospitals NHS Foundation Trust, London, UK; Institute for Infection & Immunity, St George's, University of London, London, UK
| | - J Dave
- Infection Care Group, St George's University Hospitals NHS Foundation Trust, London, UK; National Infection Service, Public Health England, Skipton House, London, UK
| | - T J Evans
- Infection Care Group, St George's University Hospitals NHS Foundation Trust, London, UK
| | - P Moxey
- St George's Vascular Institute, St George's University Hospitals NHS Foundation Trust, London, UK
| | - U Adamu
- Infection Prevention and Control Team, St George's University Hospitals NHS Foundation Trust, London, UK
| | - D Shakespeare
- Infection Prevention and Control Team, St George's University Hospitals NHS Foundation Trust, London, UK
| | - M Cotter
- Infection Care Group, St George's University Hospitals NHS Foundation Trust, London, UK
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Young AR, Narbutt J, Harrison GI, Lawrence KP, Bell M, O'Connor C, Olsen P, Grys K, Baczynska KA, Rogowski-Tylman M, Wulf HC, Lesiak A, Philipsen PA. Optimal sunscreen use, during a sun holiday with a very high ultraviolet index, allows vitamin D synthesis without sunburn. Br J Dermatol 2019; 181:1052-1062. [PMID: 31069787 PMCID: PMC6899952 DOI: 10.1111/bjd.17888] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [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] [Accepted: 03/14/2019] [Indexed: 12/17/2022]
Abstract
Background Sunlight contains ultraviolet (UV)A and UVB radiation. UVB is essential for vitamin D synthesis but is the main cause of sunburn and skin cancer. Sunscreen use is advocated to reduce the sun's adverse effects but may compromise vitamin D status. Objectives To assess the ability of two intervention sunscreens to inhibit vitamin D synthesis during a week‐long sun holiday. Methods The impact of sunscreens on vitamin D status was studied during a 1‐week sun holiday in Tenerife (28° N). Comparisons were made between two formulations, each with a sun protection factor (SPF) of 15. The UVA‐protection factor (PF) was low in one case and high in the other. Healthy Polish volunteers (n = 20 per group) were given the sunscreens and advised on the correct application. Comparisons were also made with discretionary sunscreen use (n = 22) and nonholiday groups (51·8° N, n = 17). Sunscreen use in the intervention groups was measured. Behaviour, UV radiation exposure, clothing cover and sunburn were monitored. Serum 25‐hydroxyvitamin D3 [25(OH)D3] was assessed by high‐performance liquid chromatography–tandem mass spectrometry. Results Use of intervention sunscreens was the same (P = 0·60), and both equally inhibited sunburn, which was present in the discretionary use group. There was an increase (P < 0·001) in mean ± SD 25(OH)D3 (28·0 ± 16·5 nmol L−1) in the discretionary use group. The high and low UVA‐PF sunscreen groups showed statistically significant increases (P < 0·001) of 19·0 ± 14·2 and 13·0 ± 11·4 nmol L−1 25(OH)D3, respectively with P = 0·022 for difference between the intervention sunscreens. The nonholiday group showed a fall (P = 0·08) of 2·5 ± 5·6 nmol L−1 25(OH)D3. Conclusions Sunscreens may be used to prevent sunburn yet allow vitamin D synthesis. A high UVA‐PF sunscreen enables significantly higher vitamin D synthesis than a low UVA‐PF sunscreen because the former, by default, transmits more UVB than the latter. What's already known about this topic? Action spectra (wavelength dependence) for erythema and the cutaneous formation of vitamin D overlap considerably in the ultraviolet (UV)B region. Theoretically, sunscreens that inhibit erythema should also inhibit vitamin D synthesis. To date, studies on the inhibitory effects of sunscreens on vitamin D synthesis have given conflicting results, possibly, in part, because people typically apply sunscreen suboptimally. Many studies have design flaws.
What does this study add? Sunscreens (sun protection factor, SPF 15) applied at sufficient thickness to inhibit sunburn during a week‐long holiday with a very high UV index still allow a highly significant improvement of serum 25‐hydroxyvitamin D3 concentration. An SPF 15 formulation with high UVA protection enables better vitamin D synthesis than a low UVA protection product. The former allows more UVB transmission.
Linked Editorial: https://doi.org/10.1111/bjd.18273. https://doi.org/10.1111/bjd.18492 available online https://www.bjdonline.com/article/optimal-sunscreen-use-during-a-sun-holiday-with-a-very-high-ultraviolet-index-allows-vitamin-d-synthesis-without-sunburn/
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Affiliation(s)
- A R Young
- King's College London, St John's Institute of Dermatology, London, SE1 9RT, U.K
| | - J Narbutt
- Medical University of Łódź, Department of Dermatology, Pediatric Dermatology and Dermatological Oncology, Łódź, 90-647, Poland
| | - G I Harrison
- King's College London, St John's Institute of Dermatology, London, SE1 9RT, U.K
| | - K P Lawrence
- King's College London, St John's Institute of Dermatology, London, SE1 9RT, U.K
| | - M Bell
- Walgreens Boots Alliance Inc., Nottingham, NG90 5EF, U.K
| | - C O'Connor
- Walgreens Boots Alliance Inc., Nottingham, NG90 5EF, U.K
| | - P Olsen
- Bispebjerg Hospital, Department of Dermatological Research, Copenhagen, 2400, Denmark
| | - K Grys
- King's College London, St John's Institute of Dermatology, London, SE1 9RT, U.K
| | - K A Baczynska
- Public Health England, Centre for Radiation, Chemical and Environmental Hazards, Chilton, Didcot, Oxfordshire, OX11 0RQ, U.K
| | | | - H C Wulf
- Bispebjerg Hospital, Department of Dermatological Research, Copenhagen, 2400, Denmark
| | - A Lesiak
- Medical University of Łódź, Department of Dermatology, Pediatric Dermatology and Dermatological Oncology, Łódź, 90-647, Poland
| | - P A Philipsen
- Bispebjerg Hospital, Department of Dermatological Research, Copenhagen, 2400, Denmark
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Wild R, McFadden A, O'Connor C, O'Grady K, Wada M. Prevalence of lameness in sheep transported to meat processing plants in New Zealand and associated risk factors. N Z Vet J 2019; 67:188-193. [PMID: 30971195 DOI: 10.1080/00480169.2019.1605944] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Aims: To estimate the prevalence of lameness in sheep transported to meat processing plants in New Zealand, and to identify factors associated with the prevalence of lameness. Methods: The survey was conducted over the main meat processing season, running from October 2012 to the end of May 2013, at 10 sheep processing premises (five North Island and five South Island). A sample of 50 sheep selected from approximately six sheep consignments per week from each of the processing plants were scored for lameness, using a scale from Grade 1 (mild) to 3 (severe, non-weight-bearing). For each consignment the breed, age class and mean carcass weight were recorded. A multivariable regression model was fitted to identify the risk factors for prevalence of lame sheep (Grade 1-3) within a consignment. Results: In total, 1,854/78,833 (2.4 (95% CI = 2.2-2.5)%) sheep were diagnosed with lameness. Of the 1,854 lame sheep, lameness severity was Grade 1 in 1,349 (72.8%), Grade 2 in 450 (24.3%) and Grade 3 in 55 (3.0%) sheep. Within consignments ≥1 lame sheep was observed in 600/1,682 (35.7 (95% CI = 33.4-38.0)%) consignments. In Merino lambs and ewes the prevalence of lameness was greater than that of other breeds (p < 0.001), but in rams/wethers, the prevalence of lameness was lower in Merino than other breeds (p < 0.05). In sheep originating from the North Island, increasing mean carcass weight was associated with an increase in the prevalence of lameness (p < 0.001), but in the South Island prevalence was similar for different carcass weights (p = 0.5). In the North Island increasing yarding time was associated with an increase in the lameness prevalence (p < 0.01), but not in the South Island (p = 0.7). Sheep from the South Island generally had a higher prevalence of lameness than the North Island and the prevalence of lameness was lower over summer and autumn relative to the previous spring (p < 0.01). Conclusion: The results from this survey provided a measure of the prevalence of lameness in a section of the New Zealand sheep population, namely those animals sent for slaughter; as well as identification of several risk factors associated with lameness.
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Affiliation(s)
- R Wild
- a Ministry for Primary Industries Verification Services , Christchurch , New Zealand
| | - Amj McFadden
- b Ministry for Primary Industries , Diagnostic and Surveillance Services, Upper Hutt , New Zealand
| | - C O'Connor
- c AgResearch Ltd., Ruakura Research Centre , Hamilton , New Zealand
| | - K O'Grady
- a Ministry for Primary Industries Verification Services , Christchurch , New Zealand
| | - M Wada
- d EpiCentre, School of Veterinary Science , Massey University , Palmerston North , New Zealand
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O'Connor C, Oh E, Jackson K, Finn D, Rosenman M, Molitch M, Kho A, Wallia A. OR22-4 Recurrent Hypoglycemia, Fragmentation of Care, and Mortality in Chicago. J Endocr Soc 2019. [PMCID: PMC6554850 DOI: 10.1210/js.2019-or22-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Hypoglycemia is an acute complication of diabetes management that has been linked to increased morbidity and mortality. In this study, we analyzed whether recurrent hypoglycemia is related to fragmentation of care. The Chicago HealthLNK Data Repository (HDR) consists of merged, de-duplicated and de-identified electronic health records from 6 institutions and employs a hashing and matching algorithm to create a unique ID for each patient (pt) so that pt care can be tracked across different institutions without sharing protected health information. The HDR contains pt demographic and clinical information. Hypoglycemia was identified using a validated algorithm using ICD-9 codes. Fragmentation was defined as an emergency department or inpatient hypoglycemia encounter at >1 institution over the 7-year study period 2006-2012. Of 187,644 patients (pts) with a diabetes diagnosis (250.x), 9,741 (5.2%) pts were identified as having hypoglycemia, representing 18,443 unique encounters, with a mortality rate of 27.7%. 1,035 pts (10.6% of all pts with hypoglycemia) had ≥ 4 hypoglycemic encounters and accounted for 40.3% (n=7,434) of all hypoglycemia encounters. Having any hypoglycemia was associated with race (p<0.001), younger age (p <0.001), and insurance status (p<0.001). Of the 9,741 pts with hypoglycemia, 304 (3.1%) had fragmented care. In 1,035 pts with ≥4 hypoglycemia encounters, 96 pts (9.3%) had fragmented care, and in 1822 pts with 2-3 hypoglycemia encounters, 208 (11.4%) had fragmented care (p=0.074). Hypoglycemic pts with fragmented care relative to those with non-fragmented care had a higher percentage of Medicare (57.9% vs 46% p < 0.001), Medicaid (16.8% vs 9.3% p < 0.001), and self-pay (11.5% vs 4.6% p <0.001). Pts with any hypoglycemia (N=9,741) had greater mortality (2,696 deaths, 27.7%) than those without any hypoglycemia (20,188 deaths, 11.4%, p < 0.00001). In comparing those with ≥ 4 episodes vs 2-3, those with ≥ 4 episodes had fewer complications (39.7% vs. 54.3% p < 0.001) and less mortality (16.0% vs. 30.6% p <0.001). Limitations of this study include use of EHR data and a previously validated algorithm that may misclassify diagnoses/encounters. Overall, hypoglycemia was associated with increased mortality. Pts who had ≥ 4 hypoglycemic encounters represented only 10.6% of patients with hypoglycemic encounters, but accounted for 40.3% of all hypoglycemic encounters, therefore likely contributing to higher healthcare costs. Increased frequency of hypoglycemia encounters was not associated with fragmentation of care. Our findings need to be validated in other large data sets.
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Affiliation(s)
| | - Elissa Oh
- Northwestern University, Chicago, IL, United States
| | | | - Dan Finn
- Center for Healthcare Studies, Institute for Public Health and Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| | - Marc Rosenman
- Ann & Robert H. Lurie Children's Hospital of Chicago and Institute of Public Health, Feinberg School of Medicine, Chicago, IL, United States
| | - Mark Molitch
- Div of Endo Metab and Molec Med, Northwestern University, Chicago, IL, United States
| | - Abel Kho
- Northwestern University and Institute of Public Health, Feinberg School of Medicine, Chicago, IL, United States
| | - Amisha Wallia
- Division of Endocrinology, Northwestern University and Institute of Public Health, Feinberg School of Medicine, Chicago, IL, United States
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Narbutt J, Philipsen P, Harrison G, Morgan K, Lawrence K, Baczynska K, Grys K, Rogowski‐Tylman M, Olejniczak‐Staruch I, Tewari A, Bell M, O'Connor C, Wulf H, Lesiak A, Young A. Optimal sunscreen use prevents holiday erythema. Br J Dermatol 2019. [DOI: 10.1111/bjd.17556] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Narbutt J, Philipsen P, Harrison G, Morgan K, Lawrence K, Baczynska K, Grys K, Rogowski‐Tylman M, Olejniczak‐Staruch I, Tewari A, Bell M, O'Connor C, Wulf H, Lesiak A, Young A. 优化防晒霜使用以防止假日红斑. Br J Dermatol 2019. [DOI: 10.1111/bjd.17572] [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]
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Messaraa C, Doyle L, Mansfield A, O'Connor C, Mavon A. Ageing profiles of Caucasian and Chinese cohorts - focus on hands skin. Int J Cosmet Sci 2019; 41:79-88. [PMID: 30762878 DOI: 10.1111/ics.12514] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2018] [Accepted: 01/07/2019] [Indexed: 11/27/2022]
Abstract
OBJECTIVE In spite of hand care being a dynamic segment of skin care, hands skin physiology has been receiving little attention in comparison to facial skin. In the present study, we aimed at gathering a comprehensive set of skin data from the dorsal part of the hand to study age related-changes in two ethnic groups (Caucasian and Chinese). METHODS Skin topographic, skin colour/colour heterogeneities, skin chromophores and skin biophysical measurements of 116 Caucasian and Chinese female volunteers aged 30-65 years old were collected in Ireland and in China as part of a cross-sectional study. RESULTS Topographic alterations happened at both micro and macro scales with a noticeable delay in the onset of 10 years for the Chinese cohort. Similar evolution of skin colour with ageing was observed between the two cohorts and strong dissimilarities were seen when it came to colour heterogeneities and melanin hyper concentration, with a 20-year delay in severity for the Chinese cohort. A similar sharp drop of skin hydration occurred when reaching the 60's regardless of the group and substantial differences were recorded for skin biomechanical properties of the skin. CONCLUSION These results provide additional insights about hand skin physiology in relation to ageing and ethnic differences, especially when put into perspective with what is currently known about facial ageing. This research yield additional material for hand cream product rationale and strategies for mitigating the appearance of ageing hands.
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Affiliation(s)
| | | | | | | | - A Mavon
- Oriflame Skin Research Institute, Oriflame Cosmetics AB, Stockholm, Sweden
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Bartels HC, O'Connor C, Segurado R, Mason O, Mehegan J, Geraghty AA, O'Brien E, Walsh J, McAuliffe F. Fetal growth trajectories and their association with maternal and child characteristics. J Matern Fetal Neonatal Med 2019; 33:2427-2433. [PMID: 30614328 DOI: 10.1080/14767058.2018.1554041] [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] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Background: The growth of the fetus is a complex process, influenced by genetic and environmental factors. Longitudinal patterns of fetal growth are required to fully understand this process, however to date, a paucity of data exists in this area.Objective: To identify fetal growth trajectories in-utero and to assess their association with maternal and child characteristics up to 5 years postnatal.Methods: Data from 781 mother-child pairs from the ROLO longitudinal birth cohort study were analyzed. The ROLO study was a randomized control trial of a low glycemic index diet in pregnancy to prevent recurrence of macrosomia. Fetal ultrasound measurements were recorded at 20 and 34 weeks gestation, and birth weight was recorded. Abdominal circumference (AC), weight (fetal weight, or birth weight), a standardized proxy for length (femur length or birth length, individually standardized), and AC:length ratio were examined for trajectory classes using latent class trajectory mixture models. Two-, three-, four-, and five-class models were evaluated for fit, using a linear (first order) trajectory over three time-points. ANOVA and chi-square tests were applied to test associations between trajectory membership and maternal and child characteristics up to age 5.Results: For AC, two fetal growth trajectories were identified, with 29% of participants on a "slow" trajectory and 71% on a "fast" trajectory. Those on a fast trajectory had higher rates of maternal impaired glucose tolerance (28.7 versus 16.5%, p<.001) and higher rates of mean child 5-year body mass index (BMI) centiles (64th versus 58th centile, p<.05) compared to those on the slow trajectory. For estimated fetal weight, four trajectories were identified, with 4% on a "very-slow" trajectory, 63% in a "moderate-slow" trajectory, 30% in a "moderate-fast" trajectory and 3% on a "very-fast" trajectory. Mothers with a fetus on the fastest trajectory had higher antenatal serum glucose levels (p<.05), and were more likely to deliver by cesarean section (59.1 versus 20%, p<.001). At 5 years of age, children on the fastest growth trajectory had the highest mean BMI centile (86th versus 60th centile, p<.05).Conclusions: This study shows that specific fetal growth trajectories may be associated with maternal serum glucose concentrations during pregnancy, mode of delivery and child BMI at 5 years of age. Diet and lifestyle measures that target maternal glucose levels during pregnancy may have lifelong benefits for children's BMI. Identifying those on an accelerated growth trajectory during fetal life provides a unique opportunity for antenatal and infant interventions that may have long-lasting health benefits.
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Affiliation(s)
- Helena C Bartels
- UCD Perinatal Research Centre, National Maternity Hospital, Dublin, Ireland
| | - Clare O'Connor
- UCD Perinatal Research Centre, National Maternity Hospital, Dublin, Ireland
| | - Ricardo Segurado
- Centre for Support and Training in Analysis and Research (CSTAR), School of Public Health, Physiotherapy and Population Science, University College Dublin, Dublin, Ireland
| | - Olivia Mason
- Centre for Support and Training in Analysis and Research and School of Public Health, Physiotherapy and Sports Science, University College Dublin, Ireland, Dublin, Ireland
| | - John Mehegan
- UCD Perinatal Research Centre, National Maternity Hospital, Dublin, Ireland
| | - Aisling A Geraghty
- UCD Perinatal Research Centre, National Maternity Hospital, Dublin, Ireland
| | - Eileen O'Brien
- UCD Perinatal Research Centre, National Maternity Hospital, Dublin, Ireland
| | - Jennifer Walsh
- UCD Perinatal Research Centre, National Maternity Hospital, Dublin, Ireland
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Narbutt J, Philipsen PA, Harrison GI, Morgan KA, Lawrence KP, Baczynska KA, Grys K, Rogowski-Tylman M, Olejniczak-Staruch I, Tewari A, Bell M, O'Connor C, Wulf HC, Lesiak A, Young AR. Sunscreen applied at ≥ 2 mg cm -2 during a sunny holiday prevents erythema, a biomarker of ultraviolet radiation-induced DNA damage and suppression of acquired immunity. Br J Dermatol 2018; 180:604-614. [PMID: 30307614 DOI: 10.1111/bjd.17277] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/08/2018] [Indexed: 01/15/2023]
Abstract
BACKGROUND Sun protection factor (SPF) is assessed with sunscreen applied at 2 mg cm-2 . People typically apply around 0·8 mg cm-2 and use sunscreen daily for holidays. Such use results in erythema, which is a risk factor for skin cancer. OBJECTIVES To determine (i) whether typical sunscreen use resulted in erythema, epidermal DNA damage and photoimmunosuppression during a sunny holiday, (ii) whether optimal sunscreen use inhibited erythema and (iii) whether erythema is a biomarker for photoimmunosuppression in a laboratory study. METHODS Holidaymakers (n = 22) spent a week in Tenerife (very high ultraviolet index) using their own sunscreens without instruction (typical sunscreen use). Others (n = 40) were given SPF 15 sunscreens with instructions on how to achieve the labelled SPF (sunscreen intervention). Personal ultraviolet radiation (UVR) exposure was monitored electronically as the standard erythemal dose (SED) and erythema was quantified. Epidermal cyclobutane pyrimidine dimers (CPDs) were determined by immunostaining, and immunosuppression was assessed by contact hypersensitivity (CHS) response. RESULTS There was no difference between personal UVR exposure in the typical sunscreen use and sunscreen intervention groups (P = 0·08). The former had daily erythema on five UVR-exposed body sites, increased CPDs (P < 0·001) and complete CHS suppression (20 of 22). In comparison, erythema was virtually absent (P < 0·001) when sunscreens were used at ≥ 2 mg cm-2 . A laboratory study showed that 3 SED from three very different spectra suppressed CHS by around ~50%. CONCLUSIONS Optimal sunscreen use prevents erythema during a sunny holiday. Erythema predicts suppression of CHS (implying a shared action spectrum). Given that erythema and CPDs share action spectra, the data strongly suggest that optimal sunscreen use will also reduce CPD formation and UVR-induced immunosuppression.
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Affiliation(s)
- J Narbutt
- Department of Dermatology, Pediatric Dermatology and Dermatological Oncology, Medical University of Łódź, 90-647, Łódź, Poland
| | - P A Philipsen
- University of Copenhagen, Bispebjerg Hospital, Department of Dermatological Research, Copenhagen, 2400, Denmark
| | - G I Harrison
- King's College London, St John's Institute of Dermatology, London, SE1 9RT, U.K
| | - K A Morgan
- King's College London, St John's Institute of Dermatology, London, SE1 9RT, U.K
| | - K P Lawrence
- King's College London, St John's Institute of Dermatology, London, SE1 9RT, U.K
| | - K A Baczynska
- Public Health England, Centre for Radiation, Chemical and Environmental Hazards, Chilton, Didcot, OX11 0RQ, U.K
| | - K Grys
- King's College London, St John's Institute of Dermatology, London, SE1 9RT, U.K
| | | | - I Olejniczak-Staruch
- Dermoklinika Centrum Medyczne, Łódź, 90-436, Poland.,Department of Dermatology and Venereology, Medical University of Łódź, 90-647, Łódź, Poland
| | - A Tewari
- King's College London, St John's Institute of Dermatology, London, SE1 9RT, U.K
| | - M Bell
- Walgreens Boots Alliance Inc., Nottingham, NG90 5EF, U.K
| | - C O'Connor
- Walgreens Boots Alliance Inc., Nottingham, NG90 5EF, U.K
| | - H C Wulf
- University of Copenhagen, Bispebjerg Hospital, Department of Dermatological Research, Copenhagen, 2400, Denmark
| | - A Lesiak
- Department of Dermatology, Pediatric Dermatology and Dermatological Oncology, Medical University of Łódź, 90-647, Łódź, Poland
| | - A R Young
- King's College London, St John's Institute of Dermatology, London, SE1 9RT, U.K
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Levine JA, Karam SL, O'Connor C, Kumar S, Soundarrajan M, McConnell D, Ammar AT, Gale AM, Zimmerman D, Szmuilowicz ED. CENTRAL DIABETES INSIPIDUS AND CHEMOTHERAPY: USE OF A CONTINUOUS ARGININE VASOPRESSIN INFUSION FOR FLUID AND SODIUM BALANCE. AACE Clin Case Rep 2018; 4:e487-e492. [PMID: 30984869 DOI: 10.4158/accr-2018-0165] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Objective Central diabetes insipidus can occur in the setting of primary or metastatic tumors that disrupt the hypothalamic-pituitary axis. Usual treatment consists of water intake to replace ongoing fluid losses and desmopressin administration aimed at decreasing the urine output to enable maintenance of eunatremia without polyuria. Marked derangement in plasma sodium concentration can occur when high-volume intravenous fluid administration is required during chemotherapy to prevent nephrotoxicity, particularly if obligate fluid intake exceeds the total daily fluid intake necessary to maintain eunatremia. Methods We developed a protocol for a rapidly titratable low-dose continuous intravenous arginine vasopressin infusion to maintain eunatremia in patients with central diabetes insipidus during periods of obligate fluid intake. Results We successfully maintained eunatremia in 2 patients with central nervous system lymphoma who underwent several cycles of obligate intravenous fluid administration with 5% dextrose in 0.45% sodium chloride for chemotherapy. Conclusion Obligate fluid administration can result in dangerous and severe fluctuations in plasma sodium concentration in patients with central diabetes insipidus receiving conventional desmopressin therapy. The use of a rapidly titratable low-dose continuous vasopressin infusion successfully maintained eunatremia in this setting. This protocol can be replicated to prevent the wide and potentially dangerous fluctuations in plasma sodium concentration that can occur in patients with central diabetes insipidus who require high-volume intravenous fluid administration. This protocol has not been assessed among patients with impaired renal function and, thus, may not be generalizable to this population. (AACE Clinical Case Rep. 2018;4:e487-e492).
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Affiliation(s)
- Joshua A Levine
- Northwestern University Feinberg School of Medicine, Division of Endocrinology, Metabolism, and Molecular Medicine, Chicago, Illinois
| | - Susan L Karam
- Northwestern University Feinberg School of Medicine, Division of Endocrinology, Metabolism, and Molecular Medicine, Chicago, Illinois
| | - Clare O'Connor
- Northwestern University Feinberg School of Medicine, Division of Endocrinology, Metabolism, and Molecular Medicine, Chicago, Illinois
| | - Smita Kumar
- Northwestern University Feinberg School of Medicine, Division of Endocrinology, Metabolism, and Molecular Medicine, Chicago, Illinois
| | - Malini Soundarrajan
- Northwestern University Feinberg School of Medicine, Division of Endocrinology, Metabolism, and Molecular Medicine, Chicago, Illinois
| | - Deepika McConnell
- Department of Pharmacy, Northwestern Memorial Hospital, Chicago, Illinois
| | - Abeer T Ammar
- Department of Pharmacy, Northwestern Memorial Hospital, Chicago, Illinois
| | - Ashley M Gale
- Department of Pharmacy, Northwestern Memorial Hospital, Chicago, Illinois
| | - Donald Zimmerman
- Department of Pediatric Endocrinology, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois
| | - Emily D Szmuilowicz
- Northwestern University Feinberg School of Medicine, Division of Endocrinology, Metabolism, and Molecular Medicine, Chicago, Illinois
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Diffey BL, O'Connor C, Marlow I, Bell M, O'Mahony MM. A theoretical and experimental study of the temporal reduction in UV protection provided by a facial day cream. Int J Cosmet Sci 2018; 40:401-407. [DOI: 10.1111/ics.12480] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2018] [Accepted: 07/04/2018] [Indexed: 11/29/2022]
Affiliation(s)
- B. L. Diffey
- Dermatological Sciences; Newcastle University; Newcastle Upon Tyne NE2 4HH UK
| | - C. O'Connor
- Walgreens Boots Alliance; Thane Road Nottingham NG90 1BS UK
| | - I. Marlow
- Walgreens Boots Alliance; Thane Road Nottingham NG90 1BS UK
| | - M. Bell
- Walgreens Boots Alliance; Thane Road Nottingham NG90 1BS UK
| | - M. M. O'Mahony
- Walgreens Boots Alliance; Thane Road Nottingham NG90 1BS UK
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Messaraa C, Metois A, Walsh M, Flynn J, Doyle L, Robertson N, Mansfield A, O'Connor C, Mavon A. Antera 3D capabilities for pore measurements. Skin Res Technol 2018; 24:606-613. [DOI: 10.1111/srt.12472] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/02/2018] [Indexed: 11/27/2022]
Affiliation(s)
- C. Messaraa
- Oriflame Research and Development; Bray Ireland
| | - A. Metois
- Oriflame Research and Development; Bray Ireland
| | - M. Walsh
- Oriflame Research and Development; Bray Ireland
| | - J. Flynn
- Oriflame Research and Development; Bray Ireland
| | - L. Doyle
- Oriflame Research and Development; Bray Ireland
| | | | | | - C. O'Connor
- Oriflame Research and Development; Bray Ireland
| | - A. Mavon
- Oriflame Skin Research Institute; Oriflame Cosmetics AB; Stockholm Sweden
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Tischendorf J, O'Connor C, Alvarez M, Johnson S. Mock Paging and Consult Curriculum to Prepare Fourth-Year Medical Students for Medical Internship. MedEdPORTAL 2018; 14:10708. [PMID: 30800908 PMCID: PMC6342441 DOI: 10.15766/mep_2374-8265.10708] [Citation(s) in RCA: 8] [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] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/19/2017] [Accepted: 03/13/2018] [Indexed: 06/09/2023]
Abstract
INTRODUCTION Internship preparation should include curricula to hone key skills such as acute medical management and communication with consulting and interprofessional providers. METHODS To enhance these skills, we developed an interprofessional mock paging and consult curriculum incorporating direct observation and peer, faculty, and nursing feedback for fourth-year medical students entering medical internships. Our brief mock paging and consult curriculum was designed as part of a larger 2-week internship preparation course. Our curriculum was delivered in two 2-hour sessions by physician and nurse educators. Sessions were conducted in small groups, offering the opportunity for direct observation and feedback from faculty, nurse educators, and peers. Our curriculum was expanded from a pilot for 10-15 students to 60 students after 2 years of a successful pilot. RESULTS Mock paging and consult sessions were highly rated by medical students and resulted in significantly enhanced self-assessment of preparedness in key intern skills such as returning pages, interprofessional communication, calling a consult, and managing acute issues for cross-cover patients. DISCUSSION We have demonstrated the effectiveness of a brief, interprofessional mock paging and consult curriculum incorporating faculty, nurse educator, and peer feedback. The tenets of our curriculum can be widely adopted for other learner groups.
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Affiliation(s)
| | - Clare O'Connor
- Fellow, Endocrinology, McGaw Medical Center of Northwestern University
| | - Madelyn Alvarez
- Fellow, Women's Health, William S. Middleton Memorial VA Hospital
| | - Sara Johnson
- Assistant Professor, Division of Hematology/Oncology, Department of Medicine, University of Wisconsin School of Medicine and Public Health
- Fellowship Director, Palliative Medicine Fellowship, University of Wisconsin School of Medicine and Public Health
- Course Co-Director, Fourth-Year Medical Student Internship Preparation Course, University of Wisconsin School of Medicine and Public Health
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