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Danda V, Jain N, Abboud R, Charles D, Mihalic A, Cardella J. Abstract No. 282 Impact of the COVID-19 pandemic on the 2021 integrated interventional radiology residency match: analysis of the Texas STAR database. J Vasc Interv Radiol 2022. [PMCID: PMC9136280 DOI: 10.1016/j.jvir.2022.03.363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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Charles D, Abboud R, Mihalic A, Fischman A. Abstract No. 201 Predictors of interview invitation of applicants to integrated interventional radiology residency: a cohort study. J Vasc Interv Radiol 2021. [DOI: 10.1016/j.jvir.2021.03.207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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Tsay T, Tsay T, Shugrue N, Charles D, Migneault D, McManus R, Gruman C, Robison J. Type of HCBS Support Provided Predictive of Frailty Status Change Among Older Participants. J Am Med Dir Assoc 2021; 22:B24. [PMID: 34287174 DOI: 10.1016/j.jamda.2021.01.091] [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: 11/27/2022]
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Harper K, Davis T, Phibbs F, Charles D. Inspiring neurology residents to specialize in movement disorders. Parkinsonism Relat Disord 2020. [DOI: 10.1016/j.parkreldis.2020.06.436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Anger HA, Dabash R, Durocher J, Hassanein N, Ononge S, Frye LJ, Diop A, Beye SB, Burkhardt G, Darwish E, Ramadan MC, Kayaga J, Charles D, Gaye A, Eckardt M, Winikoff B. The effectiveness and safety of introducing condom-catheter uterine balloon tamponade for postpartum haemorrhage at secondary level hospitals in Uganda, Egypt and Senegal: a stepped wedge, cluster-randomised trial. BJOG 2019; 126:1612-1621. [PMID: 31410966 PMCID: PMC6899652 DOI: 10.1111/1471-0528.15903] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/02/2019] [Indexed: 01/20/2023]
Abstract
OBJECTIVE To assess the effectiveness of introducing condom-catheter uterine balloon tamponade (UBT) for postpartum haemorrhage (PPH) management in low- and middle-income settings. DESIGN Stepped wedge, cluster-randomised trial. SETTING Eighteen secondary-level hospitals in Uganda, Egypt and Senegal. POPULATION Women with vaginal delivery from October 2016 to March 2018. METHODS Use of condom-catheter UBT for PPH management was introduced using a half-day training and provision of pre-packaged UBT kits. Hospitals were randomised to when UBT was introduced. The incident rate (IR) of study outcomes was compared in the control (i.e. before UBT) and intervention (i.e. after UBT) periods. Mixed effects regression models accounted for clustering (random effect) and time period (fixed effect). MAIN OUTCOME MEASURES Combined IR of PPH-related invasive surgery and/or maternal death. RESULTS There were 28 183 and 31 928 deliveries in the control and intervention periods, respectively. UBT was used for 9/1357 and 55/1037 women diagnosed with PPH in control and intervention periods, respectively. PPH-related surgery or maternal death occurred in 19 women in the control period (IR = 6.7/10 000 deliveries) and 37 in the intervention period (IR = 11.6/10 000 deliveries). The adjusted IR ratio was 4.08 (95% confidence interval 1.07-15.58). Secondary outcomes, including rates of transfer and blood transfusion, were similar in the trial periods. CONCLUSIONS Introduction of condom-catheter UBT in these settings did not improve maternal outcomes and was associated with an increase in the combined incidence of PPH-related surgery and maternal death. The lack of demonstrated benefit of UBT introduction with respect to severe outcomes warrants reflection on its role. TWEETABLE ABSTRACT Stepped wedge trial shows UBT introduction does not reduce the combined incidence of PPH-related surgery or death.
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Affiliation(s)
- H A Anger
- Gynuity Health Projects, New York, NY, USA
| | - R Dabash
- Gynuity Health Projects, New York, NY, USA
| | - J Durocher
- Gynuity Health Projects, New York, NY, USA
| | - N Hassanein
- Obstetrician/Gynaecologist consultant, Alexandria, Egypt
| | - S Ononge
- Makerere University School of Health Sciences, Kampala, Uganda
| | - L J Frye
- Gynuity Health Projects, New York, NY, USA
| | - A Diop
- Gynuity Health Projects, New York, NY, USA
| | - S B Beye
- Centre De Santé Philippe Senghor, Dakar, Senegal
| | | | - E Darwish
- Alexandria Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - M C Ramadan
- El Galaa Maternity Teaching Hospital, Cairo, Egypt
| | - J Kayaga
- Global Health Uganda, Kampala, Uganda
| | - D Charles
- Gynuity Health Projects, New York, NY, USA
| | - A Gaye
- Obstetrician/Gynaecologist, Dakar, Senegal
| | - M Eckardt
- Division of Global Health Innovation, Massachusetts General Hospital, Boston, MA, USA
| | - B Winikoff
- Gynuity Health Projects, New York, NY, USA
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Marinelli B, Pasik S, Charles D, Ranade M, Bishay V, Nowakowski F, Fischman A, Patel R, Lookstein R, Kim E. 04:12 PM Abstract No. 324 Concurrent nivolumab and local regional therapy for advanced hepatocellular carcinoma. J Vasc Interv Radiol 2019. [DOI: 10.1016/j.jvir.2018.12.392] [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] Open
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Howes S, Charles D, Holmes D, Pedlow K, Wilson I, McDonough S. Older adults’ experience of falls prevention exercise delivered using active gaming and virtual reality. Physiotherapy 2017. [DOI: 10.1016/j.physio.2017.11.155] [Citation(s) in RCA: 3] [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: 11/26/2022]
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Heal CF, Charles D, Hardy A, Delpachitra M, Banks J, Wohlfahrt M, Saednia S, Buettner P. Protocol for a randomised controlled trial comparing aqueous with alcoholic chlorhexidine antisepsis for the prevention of superficial surgical site infection after minor surgery in general practice: the AVALANCHE trial. BMJ Open 2016; 6:e011604. [PMID: 27388361 PMCID: PMC4947720 DOI: 10.1136/bmjopen-2016-011604] [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] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
INTRODUCTION Surgical site infection (SSI) after minor skin excisions has a significant impact on patient morbidity and healthcare resources. Skin antisepsis prior to surgical incision is used to prevent SSI, and is performed routinely worldwide. However, in spite of the routine use of skin antisepsis, there is no consensus regarding which antiseptic agents are most effective. The AVALANCHE trial will compare Aqueous Versus Alcoholic Antisepsis with Chlorhexidine for Skin Excisions. METHODS AND ANALYSIS The study design is a prospective, randomised controlled trial (RCT) with the aim of investigating the impact of two different antiseptic preparations on the incidence of superficial SSI in patients undergoing minor skin excisions. The intervention of 0.5% chlorhexidine gluconate (CHG) in 70% alcohol will be compared with that of 0.5% CHG in aqueous solution. The trial will be conducted in four Australian general practices over a 9-month period, with 920 participants to be recruited. Consecutive patients presenting for minor skin excisions will be eligible to participate. Randomisation will be on the level of the patient. The primary outcome is superficial SSI in the first 30 days following the excision. Secondary outcomes will be adverse effects, including anaphylaxis, skin irritation, contact dermatitis and rash and patterns of antibiotic resistance. ETHICS AND DISSEMINATION The study has been approved by the James Cook University Human Research Ethics Committee (HREC). Findings will be disseminated in conference presentations and journals and through online electronic media. DISCUSSION RCTs conducted in general practice differ from hospital-based projects in terms of feasibility, pragmatism and funding. The success of this trial will be cemented in the fact that the research question was established by a group of general practitioners who identified an interesting question which is relevant to their clinical practice and not answered by current evidence. TRIAL REGISTRATION NUMBER ACTRN12615001045505; Pre-results.
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Affiliation(s)
- C F Heal
- Discipline of General Practice and Rural Medicine, Mackay Clinical School, College of Medicine and Dentistry, James Cook University, Townsville, Queensland, Australia Anton Breinl Research Centre for Health Systems Strengthening, Australian Institute of Tropical Health and Medicine, Townsville, Queensland, Australia
| | - D Charles
- Discipline of General Practice and Rural Medicine, Mackay Clinical School, College of Medicine and Dentistry, James Cook University, Townsville, Queensland, Australia
| | - A Hardy
- Discipline of General Practice and Rural Medicine, Mackay Clinical School, College of Medicine and Dentistry, James Cook University, Townsville, Queensland, Australia
| | - M Delpachitra
- Discipline of General Practice and Rural Medicine, Mackay Clinical School, College of Medicine and Dentistry, James Cook University, Townsville, Queensland, Australia
| | | | - M Wohlfahrt
- Discipline of General Practice and Rural Medicine, Mackay Clinical School, College of Medicine and Dentistry, James Cook University, Townsville, Queensland, Australia
| | - Sabine Saednia
- Discipline of General Practice and Rural Medicine, Mackay Clinical School, College of Medicine and Dentistry, James Cook University, Townsville, Queensland, Australia
| | - P Buettner
- Discipline of General Practice and Rural Medicine, Mackay Clinical School, College of Medicine and Dentistry, James Cook University, Townsville, Queensland, Australia Tropical Health Solutions, Townsville, Queensland, Australia Queensland Centre for Chronic Disease Prevention, James Cook University, Cairns, Queensland, Australia
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Vinod KV, Charles D, Hitha B, Radhakrishna P, Dutta TK. Severe cutaneous vasculitis: an unusual complication of equine antithymocyte globulin treatment. QJM 2016; 109:411-2. [PMID: 26559082 DOI: 10.1093/qjmed/hcv209] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- K V Vinod
- From the Department of General Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research [JIPMER], Dhanvantri Nagar, Pondicherry, India
| | - D Charles
- Department of Clinical Haematology, Jawaharlal Institute of Postgraduate Medical Education and Research [JIPMER], Dhanvantri Nagar, Pondicherry, India
| | - B Hitha
- Department of Clinical Haematology, Jawaharlal Institute of Postgraduate Medical Education and Research [JIPMER], Dhanvantri Nagar, Pondicherry, India
| | - P Radhakrishna
- From the Department of General Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research [JIPMER], Dhanvantri Nagar, Pondicherry, India
| | - T K Dutta
- Department of Clinical Haematology, Jawaharlal Institute of Postgraduate Medical Education and Research [JIPMER], Dhanvantri Nagar, Pondicherry, India
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Garcia-Larsen V, Del Giacco SR, Moreira A, Bonini M, Charles D, Reeves T, Carlsen KH, Haahtela T, Bonini S, Fonseca J, Agache I, Papadopoulos NG, Delgado L. Asthma and dietary intake: an overview of systematic reviews. Allergy 2016; 71:433-42. [PMID: 26505989 DOI: 10.1111/all.12800] [Citation(s) in RCA: 87] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/21/2015] [Indexed: 12/20/2022]
Abstract
Epidemiological research on the relationship between diet and asthma has increased in the last decade. Several components found in foods have been proposed to have a series of antioxidant, anti-allergic and anti-inflammatory properties, which can have a protective effect against asthma risk. Several literature reviews and critical appraisals have been published to summarize the existing evidence in this field. In the context of this EAACI Lifestyle and asthma Task Force, we summarize the evidence from existing systematic reviews on dietary intake and asthma, using the PRISMA guidelines. We therefore report the quality of eligible systematic reviews and summarize the results of those with an AMSTAR score ≥32. The GRADE approach is used to assess the overall quality of the existing evidence. This overview is centred on systematic reviews of nutritional components provided in the diet only, as a way to establish what type of advice can be given in clinical practice and to the general population on dietary habits and asthma.
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Affiliation(s)
- V. Garcia-Larsen
- Respiratory Epidemiology, Occupational Medicine, and Public Health Group; National Heart and Lung Institute; Imperial College London; London UK
| | - S. R. Del Giacco
- Department of Medical Sciences ‘M Aresu’; University of Cagliari; Cagliari Italy
| | - A. Moreira
- Faculty of Medicine; University of Porto and Hospital São João; Porto Portugal
- CINTESIS - Center for Health Technology and Services Research; Faculty of Medicine; University of Porto; Porto Portugal
| | - M. Bonini
- Department of Internal Medicine; Lung Function Unit; Sapienza University of Rome; Rome Italy
| | - D. Charles
- Respiratory Epidemiology, Occupational Medicine, and Public Health Group; National Heart and Lung Institute; Imperial College London; London UK
| | - T. Reeves
- Central Library; Imperial College London; London UK
| | - K.-H. Carlsen
- Department of Medicine and Allergology; University of Oslo; Oslo Norway
| | - T. Haahtela
- Skin and Allergy Hospital; Helsinki University Central Hospital; Helsinki Finland
| | - S. Bonini
- Second University of Naples and IFT-CNR; Rome Italy
| | - J. Fonseca
- CINTESIS - Center for Health Technology and Services Research; Faculty of Medicine; University of Porto; Porto Portugal
| | - I. Agache
- Transylvania University Brasov; Brasov Romania
| | - N. G. Papadopoulos
- Centre for Paediatrics and Child Health; Institute of Human Development; The University of Manchester; Manchester UK
| | - L. Delgado
- Faculty of Medicine; University of Porto and Hospital São João; Porto Portugal
- CINTESIS - Center for Health Technology and Services Research; Faculty of Medicine; University of Porto; Porto Portugal
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Verma SP, Dutta TK, Mahadevan S, Nalini P, Basu D, Biswal N, Ramesh A, Charles D, Vinod KV, Harichandra Kumar KT. A randomized study of very low-dose factor VIII prophylaxis in severe haemophilia - A success story from a resource limited country. Haemophilia 2016; 22:342-8. [PMID: 26987935 DOI: 10.1111/hae.12838] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/18/2015] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Current factor prophylaxis strategy practised in developed countries is not feasible in resource constraint developing countries like India. AIM The aim of this study was to investigate the efficacy and safety of very low-dose factor prophylaxis in India. METHODS Children of 1-10 years of age with severe haemophilia were randomized to Prophylaxis group and Episodic (On demand) group. Children in prophylaxis group received very low-dose factor VIII (FVIII) concentrate, i.e. 10 units kg(-1) body weights on 2 days a week. Episodic group received factor concentrate in standard recommended doses. The study period was 11.5 months. RESULTS In total 21 children were enrolled in this study, 11 assigned to prophylaxis and 10 to episodic group. Children on prophylaxis had 11 joint bleeds in comparison to 57 joint bleeds in episodic group. Mean number of haemarthrosis per patient per month were 0.08 (0.08 ± 0.13) in prophylaxis group compared to 0.48 (0.48 ± 0.34) in episodic group (P < 0.05). Total FVIII consumption was 87.51 and 56.32 units kg(-1) month(-1) in prophylaxis and episodic group respectively (P = ns). Overall median hospital emergency visits were 1 day in prophylaxis group and 9 days in episodic group (P ≤ 0.05). Median days of absenteeism from school were 25 days in episodic group and 3 days in prophylaxis group (P < 0.05). No significant complications were noted in prophylaxis group and compliance was 98%. CONCLUSION To conclude, low-dose FVIII prophylaxis is cost effective, efficacious and a safe method of preventing joint bleeds and consequent joint damages.
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Affiliation(s)
- S P Verma
- Clinical Haematology, Jawaharlal Institute of Post Graduate Medical Education and Research (JIPMER), Puducherry, India
| | - T K Dutta
- Medicine, Division of Clinical Haematology, Jawaharlal Institute of Post Graduate Medical Education and Research (JIPMER), Puducherry, India
| | - S Mahadevan
- Pediatrics, Jawaharlal Institute of Post Graduate Medical Education and Research (JIPMER), Puducherry, India
| | - P Nalini
- Pediatrics, Jawaharlal Institute of Post Graduate Medical Education and Research (JIPMER), Puducherry, India
| | - D Basu
- Pathology, Jawaharlal Institute of Post Graduate Medical Education and Research (JIPMER), Puducherry, India
| | - N Biswal
- Pediatrics, Jawaharlal Institute of Post Graduate Medical Education and Research (JIPMER), Puducherry, India
| | - A Ramesh
- Radiology, Jawaharlal Institute of Post Graduate Medical Education and Research (JIPMER), Puducherry, India
| | - D Charles
- Clinical Haematology, Jawaharlal Institute of Post Graduate Medical Education and Research (JIPMER), Puducherry, India
| | - K V Vinod
- Medicine, Jawaharlal Institute of Post Graduate Medical Education and Research (JIPMER), Puducherry, India
| | - K T Harichandra Kumar
- Biometrics, Jawaharlal Institute of Post Graduate Medical Education and Research (JIPMER), Puducherry, India
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Charles D. L’interne en psychiatrie face au risque juridique : quels aspects pratiques ? Eur Psychiatry 2014. [DOI: 10.1016/j.eurpsy.2014.09.146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Plus ou moins médiatisées, les mises en cause de la responsabilité des médecins en psychiatrie connaissent une grande stabilité en nombre depuis près de 15 ans. Or le suivi psychiatrique est assuré, aux côtés des médecins thésés et des personnels soignants, par des internes, relevant à la fois de l’étudiant par son statut, du personnel soignant maîtrisant de mieux en mieux la notion diagnostic dans sa pratique… et du futur praticien autonome dans son objectif final. Le code de la santé publique a ainsi qualifié l’interne en son article R. 6153-2 de « Praticien en formation spécialisée » en précisant à l’article suivant : « L’interne en médecine exerce des fonctions de prévention, de diagnostic et de soins, par délégation et sous la responsabilité du praticien dont il relève ». La problématique de la responsabilité de l’interne va donc reposer sur la prééminence alternative entre la notion de délégation qui suppose une réelle autonomie et la notion de responsabilité du praticien qui rappelle que les actes des internes sont présumés recevoir la validation d’un praticien non seulement sur le plan de la traçabilité mais surtout du fait de l’existence d’échanges en temps réel sur les cas présentés. Au surplus, la particularité de la psychiatrie consiste à donner un sens somatique ou purement imaginaire à tout ou partie de l’expression plaignante du patient. Autrement dit, hors la psychiatrie, l’interrogatoire du patient a pour but d’orienter la clinique et les moyens complémentaires vers un type d’affection. Or la reconnaissance de la nécessité de soins psychiatriques constitue un redoutable filtre de lecture qui risque de conduire l’interne à négliger une réalité somatique au profit de la simple expression d’un tableau psychiatrique documenté.
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Charles D, Jankovic J, Schwartz M, Brin M. Cervical dystonia patient registry for observation of onabotulinum /INS;toxin /INS;A efficacy (CD Probe): Pain at baseline. J Neurol Sci 2013. [DOI: 10.1016/j.jns.2013.07.395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Meldrum RJ, Garside J, Mannion P, Charles D, Ellis P. Variation in the annual unsatisfactory rates of selected pathogens and indicators in ready-to-eat food sampled from the point of sale or service in Wales, United Kingdom. J Food Prot 2012; 75:2238-40. [PMID: 23212024 DOI: 10.4315/0362-028x.jfp-12-244] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The Welsh Food Microbiological Forum "shopping basket" survey is a long running, structured surveillance program examining ready-to-eat food randomly sampled from the point of sale or service in Wales, United Kingdom. The annual unsatisfactory rates for selected indicators and pathogens for 1998 through 2008 were examined. All the annual unsatisfactory rates for the selected pathogens were <0.5%, and no pattern with the annual rate was observed. There was also no discernible trend observed for the annual rates of Listeria spp. (not moncytogenes), with all rates <0.5%. However, there was a trend observed for Esherichia coli, with a decrease in rate between 1998 and 2003, rapid in the first few years, and then a gradual increase in rate up to 2008. It was concluded that there was no discernible pattern to the annual unsatisfactory rates for Listeria spp. (not monocytogenes), L. monocytogenes, Staphylococcus aureus, and Bacillus cereus, but that a definite trend had been observed for E. coli.
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Affiliation(s)
- R J Meldrum
- School of Occupational and Public Health, Ryerson University, 350 Victoria Street, Toronto, Ontario, Canada M5B 2K3.
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Chukudebelu O, Leonard DS, Healy A, McCoy D, Charles D, Hone S, Rafferty M. The effect of gastric decompression on postoperative nausea and emesis in pediatric, tonsillectomy patients. Int J Pediatr Otorhinolaryngol 2010; 74:674-6. [PMID: 20381174 DOI: 10.1016/j.ijporl.2010.03.021] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2009] [Revised: 03/04/2010] [Accepted: 03/08/2010] [Indexed: 10/19/2022]
Affiliation(s)
- O Chukudebelu
- Department of Otolaryngology, Royal Victoria Eye and Ear Hospital, Adelaide Road, Dublin 2, Ireland.
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Gill C, Kahn E, Bowman A, Davis T, Wang L, Charles D. P2.131 Rate of antiparkinsonian medication increase after bilateral deep brain stimulation of the subthalamic nucleus. Parkinsonism Relat Disord 2009. [DOI: 10.1016/s1353-8020(09)70482-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Ryan S, Thornton MA, Kieran S, Charles D. A comparison of CO2 laser versus traditional stapedectomy outcomes. Ir Med J 2009; 102:218-220. [PMID: 19772003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
The aim of this study was to audit the introduction of the use of the CO2 laser into our department and to compare hearing outcomes and complication rates in patients who underwent either laser or mechanical stapedectomy. We found that the use of laser is at least as safe as the traditional approach with regards the rate of post-operative complications. One patient in the laser group suffered prolonged post-operative tinnitus, whilst one patient in the traditional group suffered prolonged post-operative vertigo. There was no evidence, however, of improved Air-Bone Gap closure compared to the traditional approach (Pre- and Post-Op Air Bone Gaps of 34 +/- 3 and 9 +/- 2 for laser stapedectomy versus 35 +/- 4 and 13 +/- 2 for traditional stapedectomy (mean +/- SEM)). In summary, therefore, CO2 laser surgery for otosclerosis is a safe surgical procedure resulting in similar hearing outcomes to that obtained following mechanical stapes surgery.
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Affiliation(s)
- S Ryan
- Royal Victoria Eye and Ear Hospital, Dublin.
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Hariharan S, Chen D, Merritt-Charles L, Bobb N, De Freitas L, Esdelle-Thomas A, Mohamed J, Charles D, Colley K, Renaud E. An evaluation of the intensive care unit resources and utilization in Trinidad. W INDIAN MED J 2007; 56:144-51. [PMID: 17910145 DOI: 10.1590/s0043-31442007000200008] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJECTIVES To evaluate resources and utilization of Intensive Care Units in Trinidad and Tobago. DESIGN AND METHODS This was a prospective observational study to evaluate Intensive Care Units (ICU) of three public and two private hospitals in Trinidad with respect to their infrastructure, process of care and patient outcome. Structure of ICUs was assessed by interviews and personal observations. A Cost Block Model was used to determine the expenditure for ICUs. The process of ICU was assessed by Therapeutic Intervention Scoring System (TISS-28). For outcome evaluation, two prognostic scoring systems namely Simplified Acute Physiology Score (SAPS II) and Paediatric Index of Mortality-2 (PIM-2) were used RESULTS The total number of ICU beds was 27. The overall bed occupancy was 66.2%. One hundred and eighteen patients consecutively admitted to ICU during a two-month period were enrolled for process and outcome evaluation. The overall median age of patients was 44 years [Interquartile range (IQR) 25, 59]. The mean cost per patient in the public hospitals was TT $64,746 compared to $77,000 in a private hospital. The average total daily TISS per patient was 27.01 +/- 5.4 (SD). The median length of stay was five days (IQR 2, 9). The overall predicted mortality was 32.9%, the observed mortality was 29.7% and thus the standardized mortality ratio (SMR) was 0.9. CONCLUSIONS The overall bed availability in ICUs with respect to Trinidad and Tobago's population and case-mix is low compared to developed countries, although the process of ICU care is comparable. Outcome of patients was good in terms of risk-adjusted mortality. The study highlights the need to further increase bed-strength and optimize the resource utilization of ICUs in Trinidad and Tobago.
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Affiliation(s)
- S Hariharan
- Anaesthesia and Intensive Care Unit, Faculty of Medical Sciences, The University of the West Indies, Eric Williams Medical Sciences Complex, Mount Hope, Trinidad and Tobago, West Indies.
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Dauty M, Dominique H, Héléna A, Charles D. Évolution de la force isocinétique des rotateurs d'épaule avant et à trois mois d'une stabilisation de l'épaule par technique chirurgicale de Latarjet. ACTA ACUST UNITED AC 2007; 50:201-8. [PMID: 17320998 DOI: 10.1016/j.annrmp.2007.01.009] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2006] [Accepted: 01/15/2007] [Indexed: 11/21/2022]
Abstract
OBJECTIVE To compare prospectively isokinetic shoulder strength before and 3 months after shoulder stabilization by the Latarjet procedure indicated for the treatment of recurrent dislocation. METHOD Twenty-five subjects, 23+/-6 years old, with anterior unidirectional recurrent shoulder dislocation, underwent isokinetic concentric (con) and eccentric (ecc) measurement of lateral rotators (LR) and medial rotators (MR) of both shoulders at the angular speed of 60 and 120 degrees par second. Evaluation was carried out in the scapular plane with the patient in a sitting position one month before and 3 months after shoulder stabilization by the Latarjet technique. We calculated the concentric ratio LR/MR and mixed ratios LR(ecc)/MR(con) and LR(con)/MR(ecc). RESULTS Before surgery, the rotator peak torque for the operated shoulder side was similar to that of the healthy shoulder side. The concentric ratio for the healthy shoulder side was higher because the lateral rotators were slightly weaker on the recurrent-dislocated shoulder side. Three months after shoulder stabilization by the Latarjet technique, for the operated shoulder side, the isokinetic concentric torque of rotators was similar to that before surgery. For the operated shoulder side, only the eccentric torque of medial rotators was significantly lower after surgery than before surgery and lower than that for the healthy shoulder side (9 to 15%). Ratios did not differ before and after surgery. CONCLUSION Three months after surgery with Latarjet technique for recurrent dislocated shoulder, operated shoulders showed a slight strength deficit as compared with healthy shoulders. The concentric deficit after surgery was not significantly different from that before surgery. This result could be explained by strengthening exercises performed during the shoulder rehabilitation program. However, the eccentric strength deficit of medial rotators of the operated shoulder is certainly associated with the opening and stitching of the sub-scapular muscle necessary for the shoulder stabilization.
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Affiliation(s)
- M Dauty
- Pôle de médecine physique et réadaptation, hôpital Saint-Jacques, CHU de Nantes, 44035 Nantes cedex 01, France.
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Calvez T, Charles D, Charles-Coquard A, Creux S, Paysant A, Targhetta JL, Verrier A, Viard D. Résumés des posters. ARCH MAL PROF ENVIRO 2007. [DOI: 10.1016/s1775-8785(07)88894-1] [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: 11/17/2022]
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22
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Charles D, Lantuejoil H, Mazot P, Andre LJ. [Drug interference with contraceptive effectiveness]. Med Armees 2002; 5:35-6. [PMID: 12335618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/26/2023]
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23
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Charles D. Genetic resources. Seed treaty signed; U.S., Japan abstain. Science 2001; 294:1263-4. [PMID: 11701904 DOI: 10.1126/science.294.5545.1263b] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
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Berge J, Maugey B, Charles D, Jimenez M, Mangione R. Correlation of prenatal MRI and autopsy findings in the diagnosis of vein of galen arteriovenous malformation. Interv Neuroradiol 2001; 7:135-40. [PMID: 20663340 DOI: 10.1177/159101990100700208] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2001] [Accepted: 03/25/2001] [Indexed: 11/15/2022] Open
Abstract
SUMMARY We report the case of an arteriovenous malformation (AVM) of the vein of Galen diagnosed in utero at the 34th week of gestation by ultrasound and MRI. Following interdisciplinary advice, the family decided to terminate the pregnancy. This was carried out in the 36th week of gestation. Mascroscopic study of the fetus confirmed the in utero diagnosis: considerable dilatation of the cerebral arteries, the Galen vein and the anteroinferior sinuses. Based on the correlation of pre and post natal examinations, this study highlights the accuracy of in utero MRI, coupled with ultrasound scanning in the diagnosis of an AVM of the Galen vein. It provides specific information on the degree of cerebral impairment. MRI in utero helps in decision-making for pregnancy termination.
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Affiliation(s)
- J Berge
- Neuroradiology Department, Hôpital Pellegrin; Bordeaux, France
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27
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Charles D. Missile defense. SDI redux has one element critics like. Science 2001; 292:1035. [PMID: 11352034 DOI: 10.1126/science.292.5519.1035] [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: 11/02/2022]
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Shanks DR, Darby RJ, Charles D. Resistance to interference in human associative learning: evidence of configural processing. J Exp Psychol Anim Behav Process 1998. [PMID: 9556907 DOI: 10.1037//0097-7403.24.2.136] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
In 4 experiments the authors used 2-stage designs to study susceptibility to interference in human discrimination learning. The experiments used a food allergy task. In Experiment 1, participants were presented with a discrimination in Stage 1 in which Food A predicted an allergy outcome (A-->O). In Stage 2, when combined with Food B, Food A predicted the absence of the allergy (B-->O, AB-->no O). In the test phase, Food A was found to have retained its Stage 1 association with the allergy despite the potentially interfering Stage 2 trials. In Experiment 2, a discrimination between 2 compounds (AB-->O, CD-->no O) remained intact despite subsequent complete reevaluation of the elements, (A-->no O, B-->no O, C-->O, D-->O); in Experiments 3 and 4, a discrimination between 2 pairs of elements (A-->O, B-->O, C-->no O, D-->no O) remained intact despite subsequent complete reevaluation of the AB and CD compounds, (AB-->no O, CD-->O). These experiments yielded evidence of remarkable resistance to interference in human discrimination learning. The results are at variance with the predictions of J. M. Pearce's (1987, 1994a) configural theory of associative learning.
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Affiliation(s)
- D R Shanks
- Department of Psychology, University College London, England
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29
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Charles D, Fyfe C. Modelling multiple-cause structure using rectification constraints. Network 1998; 9:167-182. [PMID: 9861984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
We present an artificial neural network which self-organizes in an unsupervised manner to form a sparse distributed representation of the underlying causes in data sets. This coding is achieved by introducing several rectification constraints to a PCA network, based on our prior beliefs about the data. Through experimentation we investigate the relative performance of these rectifications on the weights and/or outputs of the network. We find that use of an exponential function on the output to the network is most reliable in discovering all the causes in data sets even when the input data are strongly corrupted by random noise. Preprocessing our inputs to achieve unit variance on each is very effective in helping us to discover all underlying causes when the power on each cause is variable. Our resulting network methodologies are straightforward yet extremely robust over many trials.
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Affiliation(s)
- D Charles
- Department of Computing and Information Systems, University of Paisley, UK.
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Shanks DR, Darby RJ, Charles D. Resistance to interference in human associative learning: evidence of configural processing. J Exp Psychol Anim Behav Process 1998; 24:136-50. [PMID: 9556907 DOI: 10.1037/0097-7403.24.2.136] [Citation(s) in RCA: 22] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
In 4 experiments the authors used 2-stage designs to study susceptibility to interference in human discrimination learning. The experiments used a food allergy task. In Experiment 1, participants were presented with a discrimination in Stage 1 in which Food A predicted an allergy outcome (A-->O). In Stage 2, when combined with Food B, Food A predicted the absence of the allergy (B-->O, AB-->no O). In the test phase, Food A was found to have retained its Stage 1 association with the allergy despite the potentially interfering Stage 2 trials. In Experiment 2, a discrimination between 2 compounds (AB-->O, CD-->no O) remained intact despite subsequent complete reevaluation of the elements, (A-->no O, B-->no O, C-->O, D-->O); in Experiments 3 and 4, a discrimination between 2 pairs of elements (A-->O, B-->O, C-->no O, D-->no O) remained intact despite subsequent complete reevaluation of the AB and CD compounds, (AB-->no O, CD-->O). These experiments yielded evidence of remarkable resistance to interference in human discrimination learning. The results are at variance with the predictions of J. M. Pearce's (1987, 1994a) configural theory of associative learning.
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Affiliation(s)
- D R Shanks
- Department of Psychology, University College London, England
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Cloatre G, Gueye PM, Niang B, Haudrechy D, Wade B, Sane M, Thiam M, Charles D, Klotz F. [Etiopathogenic, ultrasonographic and prognostic features of postpartum cardiomyopathy]. Med Trop (Mars) 1996; 56:376-80. [PMID: 9139197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Peripartum cardiomyopathy is a classic but uncommon entity in African women about which there is little etiologic understanding. From January 1990 to March 1996 a series of 30 cases of peripartum cardiomyopathy was collected at the Principal Hospital in Dakar, Senegal. Peripartum cardiomyopathy was defined as the occurrence of cardiac insufficiency in a woman with no previous history of heart disease, during the period between the second and twentieth weeks after delivery confirmed by ultrasound evidence of dilated cardiomyopathy. The overall incidence of peripartum cardiomyopathy during the study period was 30 out of 1200 deliveries. The mean age of the women in the study was 34 years and mean parity was 5.2. In 13.3% of cases births involved twins. There were no predisposing socio-economic or climatic factors. The clinical picture was severe cardiac failure in 80.3% of cases and left ventricular insufficiency in 16.6%. In all cases ultrasound findings were typical of dilated cardiomyopathy. Serum selenium and vitamin B1 levels were normal. Measurements of T CD4 and CD8 in eight patients were normal. Conversion enzyme inhibitors were administered to twenty patients. Complete remission was achieved in 14 patients, three patients died, and thirteen patients presented ultrasonic evidence of persistent dilated cardiomyopathy. One patient relapsed after a subsequent delivery. These findings are in agreement with previous reports concerning the clinical and prognostic features of peripartum cardiomyopathy in Africa.
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Affiliation(s)
- G Cloatre
- Service Médicaux, Hôpital Principal, Dakar, Sénégal
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32
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Charles D. Children with AIDS need equal rights. J Int Assoc Physicians AIDS Care 1995; 1:41. [PMID: 11363095] [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: 04/16/2023]
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Crofts SL, Alzeer A, McGuire GP, Wong DT, Charles D. A comparison of percutaneous and operative tracheostomies in intensive care patients. Can J Anaesth 1995; 42:775-9. [PMID: 7497556 DOI: 10.1007/bf03011175] [Citation(s) in RCA: 88] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
The aim of our study was to compare the complication rate of convenional surgical and percutaneous dilational tracheostomies performed under general anaesthesia in critically ill patients. Fifty-three consecutive patients whose lungs were mechanically ventilated and who required tracheostomy were randomised to undergo either conventional surgical tracheostomy (n = 28) in the operating room or percutaneous dilational tracheostomy (n = 25) in the intensive care unit under general anaesthesia. All of the procedures were successfully completed. No deaths were related to the performance of either tracheostomy technique. Three patients in each group required a dressing change for minor bleeding at the tracheostomy site. There was no major bleeding requiring blood transfusion. One patient in each group developed atelectasis detected on chest x-ray post-operatively. In the surgical tracheostomy group, there were two patients with cuff leaks, one with a stomal infection and one with a pneumothorax. None of these complications occurred after percutaneous, dilational tracheostomy. We conclude that the low incidence of complications in both groups indicates that percutaneous dilational tracheostomy can be performed as safely in the intensive care unit with general anaesthesia as surgical tracheostomy can be performed in the operating room.
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Affiliation(s)
- S L Crofts
- Department of Anaesthesia, Toronto Hospital, Ontario
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Elden L, Montanera W, Terbrugge K, Willinsky R, Lasjaunias P, Charles D. Angiographic embolization for the treatment of epistaxis: a review of 108 cases. Otolaryngol Head Neck Surg 1994; 111:44-50. [PMID: 8028941 DOI: 10.1177/019459989411100110] [Citation(s) in RCA: 124] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Ninety-seven patients were referred to the Toronto Hospital (Western Division) between January 1984 and January 1992 for selective angiographic embolization (108 embolizations, including repeat procedures) to control intractable or recurrent severe epistaxis. Eighty-one patients (comprising 94 embolizations) were referred on an emergent basis because of failure of conventional conservative therapy, consisting of anterior and posterior packing. The remaining 16 patients (14 embolizations) were referred electively for recurrent epistaxis. A retrospective review of these cases was performed, with long-term telephone follow-up achieved in over 95% of cases. Embolization safely controlled active hemorrhage in 88% of the emergent cases. The success rate increased to 90% when two cases in which the source of epistaxis was found to be from the internal carotid artery were excluded (because these vessels could not be safely embolized). Of the patients whose epistaxis was initially controlled by embolization, 82% had no further nosebleeds (follow-up time ranged from 2 to 82 months; average, 26.8 months). More than half of the long-term failures were seen in patients with Osler-Weber-Rendu disease. Overall, the mortality rate was 0% and the long-term morbidity rate was 2% (one cerebral vascular accident and one case of skin slough in the territory of the superficial temporal artery.
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Affiliation(s)
- L Elden
- Ear, Nose, and Throat Department, University of Toronto, Ontario, Canada
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35
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Philpot CM, Charles D. Determination of sensitivity to antifungal drugs: evaluation of an API kit. Br J Biomed Sci 1993; 50:27-30. [PMID: 8032291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Evaluation of a commercial kit method for testing sensitivity of yeasts to antifungal drugs was performed employing agar gel dilution as the reference method. For the cidal drugs amphotericin B and flucytosine, results were closely comparable. For the three azole drugs tested, miconazole, econazole and ketoconazole, the discrepant results obtained probably relate to a number of factors affecting the end-point when testing these agents. Although easy to perform, the kit method is relatively expensive and the newer antifungal agents (e.g. fluconazole and itraconazole) are not included. Though showing promise, the kit method has limitations in its present format.
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Affiliation(s)
- C M Philpot
- Department of Medical Microbiology, University Hospital of Wales, Cardiff, Wales, UK
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Malaterre HR, Ferracci A, Ebagosti A, Faugier JP, Charles D, Levy S. [Slow ventricular tachycardia caused by naftidrofuryl overdose (naftidrofuryl and ventricular tachycardia)]. Ann Cardiol Angeiol (Paris) 1992; 41:379-81. [PMID: 1285624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Treatment with intravenous naftidrofuryl may be complicated by ventricular arrhythmias. A case of slow ventricular tachycardia occurring in a 65-year-old man with a dilated cardiomyopathy following an accidental overdose of naftidrofuryl (2 x 200 mg ampules in 250 ml of 5% glucose solution in 2 hours) prescribed for complicated arterial disease of the lower limbs is reported. This sustained ventricular tachycardia converted spontaneously after several hours. This case emphasises the risk of arrhythmogenic effects of this drug and indicates the need for careful monitoring when it is used intravenously in patients with underlying heart disease.
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Charles D. Abandoned fraud case too baffling for jury. New Sci 1992; 135:4. [PMID: 16044593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
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Srinivasagam D, Seshadri MS, Peter JV, Cherian AM, Charles D, Kanagasabapathy AS. Prevalence & pathogenesis of hypophosphatemia in ventilated patients. Indian J Med Res 1992; 96:87-90. [PMID: 1428070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Hypophosphatemia was found in 12 (43%) patients within 24-36 h of mechanical ventilation in a group of 28 patients in an intensive care unit. The hypophosphatemic patients had a significant lowering of renal phosphorus threshold (P = 0.005) and inappropriate phosphaturia. These abnormalities resolved once ventilation was discontinued. Serum parathyroid hormone (PTH) levels were unaltered in this group of patients suggesting that some factor other than PTH was responsible for hypophosphatemia. This study has demonstrated that abnormalities of renal phosphate handling can cause hypophosphatemia in ventilated patients.
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Affiliation(s)
- D Srinivasagam
- Department of Medicine, Christian Medical College & Hospital, Vellore
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Charles D, Coghlan A. Ministers move to limit genome patents. New Sci 1992; 133:9. [PMID: 16044589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
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Abstract
Biomechanical studies of wound strength are important because of new investigations in growth factors, cytokines, and fetal wounds. We compared two traditional methods of wound disruption measurement with a novel computerized model designed for in vivo experiments. An Instron tensiometer (INSTS) and an air insufflated positive pressure device (AIPPD) were compared with a vacuum-controlled wound chamber device (VCWCD). The VCWCD produced vacuum at the wound site and wound disruption was monitored with two video camera/recorders. Rats were marked with a template guide for a 2.5 cm, full-thickness, abdominal incisional wound. Rats were divided into three groups and studied at 2, 7, or 14 days after wounding. The recorded images were computer digitalized to generate wound strength curves from a three-dimensional model. A comparison of the wound disruption curves demonstrated that the VCWCD was comparable to the INST or AIPPD in normal wound healing (P greater than .40). The VCWCD provided data with less standard error at 2 days after wounding (P less than 05). In separate series of experiments, VCWCD was tested in the early phases of healing and was found to be sensitive to change at intervals of 48 hr after wounding (P less than .005). The INST or AIPPD methods could not perform this task because of an unacceptable level of random error after tissue manipulation. The VCWCD system was considered superior for evaluating early wound healing because it was an in vivo method which required minimal wound manipulation.
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Affiliation(s)
- D Charles
- Vanderbilt University School of Medicine, Nashville, Tennessee
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41
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Charles D, Bluestone MD. [Epidemiology, bacteriology and clinical experience with cefixime in the treatment of acute infantile otitis media]. An Esp Pediatr 1991; 35 Suppl 46:101-4. [PMID: 1821523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Affiliation(s)
- D Charles
- Universidad de Pittsburg, Facultad de Medicina
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Vega ME, Ley Pozo J, Charles D, Cardona M, Alvarez JA, Fernández A, Gutiérrez O. [The maximum flow-venous capacitance relationship in the detection of deep venous thromboses]. Angiologia 1991; 43:231-4. [PMID: 1799231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Affiliation(s)
- M E Vega
- Instituto Nacional de Angiología y Cirugía Vascular, La Habana, Cuba
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Griffet P, Charles D, Morcillo R, Hugard L, Wade B, Gueye PM, Diallo A. [From suspicion to diagnosis. Clinical, epidemiological, radiological and endoscopic aspects of bronchopulmonary cancer in Senegal. Apropos of 700 endoscopies performed at the Principle Hospital of Dakar from 1987 to 1990]. Med Trop (Mars) 1991; 51:347-53. [PMID: 1943647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
700 bronchial endoscopies were performed over a period of three years at the Dakar "Hôpital Principal". 40 bronchopulmonary cancers were identified (34 epidermoid, 4 adenocarcinoma, 2 with "small cells") out of 80 suspect cases. When we examine the clinical, radiological, endoscopic features, we are able to classify the following as the most established facts: 1. Higher radiological frequency of the pulmonary retractile condensation syndrome (40 cases). 2. Main frequency of proximal granulated tumors (45) in comparison with endoscopic bronchial stenosis (22). 3. Identification almost exclusive of bronchial epidermoid cancer in that series (34). 4. Male sex and smoking are two unequivocal elements of that pathology. Bronchial endoscopy, absolutely necessary test easy to perform and to get, enables to visualize a lesion and to bring forward the indisputable histological evidence through the biopsy either alone or associated with endoscopic brushing and alveolar washing.
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Affiliation(s)
- P Griffet
- Médecin des Hôpitaux des Armées, Médecine Interne Hôpital Principal de Dakar, Sénégal
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Shields PP, Gonzales TA, Charles D, Gilligan JP, Stern W. Accumulation of pepstatin in cultured endothelial cells and its effect on endothelial processing. Biochem Biophys Res Commun 1991; 177:1006-12. [PMID: 2059194 DOI: 10.1016/0006-291x(91)90638-n] [Citation(s) in RCA: 28] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Aspartic acid proteases have been implicated in the processing of ET-1(1-39) to ET-1(1-21). To further understand the role of this class of enzymes in ET-1 synthesis, cultured vascular endothelial cells were incubated with pepstatin, and the accumulation of the inhibitor and its effect on the processing of ET-1(1-39) was examined. Pepstatin accumulated in the cells in a time-dependent manner, to a concentration (greater than 10(-7) M) sufficient to inhibit aspartic acid proteases. Pepstatin did not alter the ratio of ET-1(1-21) to ET-1(1-39), nor did it affect the rate of secretion of either peptide. When endothelial cells were incubated with phosphoramidon under identical conditions, the secretion of ET-1(1-21) was significantly reduced with a concomitant increase in the secretion of ET-1(1-39). These results suggest that the processing of ET-1(1-39) does not involve a pepstatin-sensitive aspartic acid protease, and that the enzyme responsible for generating ET-1(1-21) is sensitive to phosphoramidon.
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Affiliation(s)
- P P Shields
- Protein Chemistry Group, Unigene Laboratories, Inc., Fairfield, NJ 07004
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Charles D, Rotsaert H. Dental implants. A cosmetic solution for the severely atrophied edentulous jaw. Ont Dent 1991; 68:19-21, 24. [PMID: 1923282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
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Walker T, Jelly R, Heaton-Renshaw J, Charles D, Winterton A, Booth P, Howell M, Jones N. General practitioner maternity units. West J Med 1990. [DOI: 10.1136/bmj.301.6753.666-c] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Affiliation(s)
| | - J. Mustafa
- ; Section of Oils and Fats, Department of Chemistry; Aligarth Muslim University; Aligarh 202 002 India
| | - S. M. Osman
- ; Section of Oils and Fats, Department of Chemistry; Aligarth Muslim University; Aligarh 202 002 India
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Tator CH, Duncan EG, Charles D. Comparisons of the clinical and radiological features and surgical management of posterior fossa meningiomas and acoustic neuromas. Neurol Sci 1990; 17:170-6. [PMID: 2357653 DOI: 10.1017/s0317167100030407] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Next to acoustic neuromas, meningiomas are the most common benign tumour of the posterior fossa. This paper reviews the personal experience of one of the authors with the management of 26 posterior fossa meningiomas and 212 acoustic neuromas. The aim was to compare the clinical and radiological features of these two types of posterior fossa tumours to determine whether they can be differentiated preoperatively. The study also aimed at analysing the surgical treatment of posterior fossa meningiomas. The results showed that posterior fossa meningiomas can usually be differentiated from acoustic neuromas on the basis of clinical and radiological features. Preoperative differentiation aids surgical management, especially for selection of surgical approach. In most instances, posterior fossa meningiomas can be totally resected with minimal morbidity and mortality.
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Affiliation(s)
- C H Tator
- Division of Neurosurgery, Toronto Hospital, University of Toronto, Ontario, Canada
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Charles D. East German Environment Comes into the Light: Environmental issues--particularly air pollution--are finally getting attention after years of political repression and neglect; an industrial complex near Leipzig indicates the extent of the change. Science 1990; 247:274-6. [PMID: 17735829 DOI: 10.1126/science.247.4940.274] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
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Tamburini PP, Koehn JA, Gilligan JP, Charles D, Palmesino RA, Sharif R, McMartin C, Erion MD, Miller MJ. Rat vascular tissue contains a neutral endopeptidase capable of degrading atrial natriuretic peptide. J Pharmacol Exp Ther 1989; 251:956-61. [PMID: 2532252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Neutral endopeptidase (NEP, EC 3.4.24.11), purified from renal brush border, cleaves the Cys7-Phe8 amide bond of rat atrial natriuretic peptide (ANP), to generate the inactive metabolite (ANP cleaved at the Cys7-Phe8 bond; x-ANP). To determine if NEP contributes to the inactivation of circulating ANP, we investigated the degradation of rat ANP (rANP, 1-28) in the vasculature. Formation of x-ANP from exogenous ANP was studied in a mesenteric arterial preparation by perfusion in a single pass system in the presence and absence of the NEP inhibitors, thiorphan or phosphoramidon. In addition, a purified membrane fraction was prepared from mesenteric arterial homogenate and compared with an equivalent renal membrane fraction. Formation of x-ANP was quantified by a specific immunoassay (ELISA). Renal and vascular membranes shared the same pH optima for x-ANP formation (pH 7.5), although x-ANP generation was considerably greater in renal vs. vascular membranes (31.6 and 0.4 nmol min-1 mg-1 of protein, respectively). Both preparations were inhibited in a similar, dose-dependent manner by phosphoramidon, thiorphan or a polyclonal antibody to NEP. In perfused mesenteric arteries, 1.6 +/- 0.8 pmol of x-ANP were generated from 1 microgram of ANP; this formation was inhibited 51% by 10 microM phosphoramidon or thiorphan. Plasma levels of x-ANP after bolus i.v. administration of rANP in rats, were inhibited (70-80%) by thiorphan at comparable doses to those used in perfused mesenteric arteries. These studies indicate that ANP is degraded in the vasculature by NEP or an "NEP-like" enzyme(s).
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