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Mattè A, Federti E, Recchiuti A, Hamza M, Ferri G, Riccardi V, Ceolan J, Passarini A, Mazzi F, Siciliano A, Bhatt DL, Coughlan D, Climax J, Gremese E, Brugnara C, De Franceschi L. Epeleuton, a novel synthetic ω-3 fatty acid, reduces the hypoxia/reperfusion stress in a mouse model of sickle cell disease. Haematologica 2023:0-0. [PMID: 38105727 DOI: 10.3324/haematol.2023.284028] [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: 08/11/2023] [Indexed: 12/19/2023] Open
Abstract
Inflammatory vasculopathy is critical in sickle cell disease (SCD)-associated organ damage. An imbalance between pro-inflammatory and pro-resolving mechanisms in response to different triggers such as hypoxia/reoxygenation or infections has been proposed to contribute to SCD disease progression. Administration of specialized pro-resolving lipid mediators may provide an effective therapeutic strategy to target inflammatory vasculopathy and to modulate inflammatory response. Epeleuton (15 hydroxy eicosapentaenoic acid ethyl ester) is a novel orally administered second-generation ω-3 fatty acid with a favorable clinical safety profile. In this study we show that epeleuton re-programs the lipidomic pattern of target organs for SCD towards a pro-resolving pattern. This protects against systemic and local inflammatory response and improves red cell features, resulting in reduced hemolysis and sickling compared with vehicle treated SCD mice. In addition, epeleuton prevents the hypoxia/reoxygenation induced activation of NF-kB with downregulation of NLRP3 inflammasome in lung, kidney, and liver. This was associated with down-regulation of vascular activation markers in epeleuton treated SCD mice when compared to vehicle treated animals. Collectively our data support the potential therapeutic utility of epeleuton and provide the rationale for the design of clinical trials to evaluate the efficacy of epeleuton in patients with SCD.
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Affiliation(s)
- Alessandro Mattè
- Department of Medicine, University of Verona and AOUI Verona, Verona
| | - Enrica Federti
- Department of Medicine, University of Verona and AOUI Verona, Verona
| | - Antonio Recchiuti
- Department of Medical, Oral, and Biotechnology Science, "G. d'Annunzio"University Chieti - Pescara
| | | | - Giulia Ferri
- Department of Medical, Oral, and Biotechnology Science, "G. d'Annunzio"University Chieti - Pescara
| | - Veronica Riccardi
- Department of Medicine, University of Verona and AOUI Verona, Verona
| | - Jacopo Ceolan
- Department of Medicine, University of Verona and AOUI Verona, Verona
| | - Alice Passarini
- Department of Medicine, University of Verona and AOUI Verona, Verona
| | - Filippo Mazzi
- Department of Medicine, University of Verona and AOUI Verona, Verona
| | - Angela Siciliano
- Department of Medicine, University of Verona and AOUI Verona, Verona
| | - Deepak L Bhatt
- Mount Sinai Heart, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | | | | | - Elisa Gremese
- Division of Clinical Immunology, Fondazione Policlinico Universitario A. Gemelli-IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy; Immunology Core Facility, Fondazione Policlinico Universitario A. Gemelli-IRCCS, Rome
| | - Carlo Brugnara
- Department of Laboratory Medicine, Boston Children's Hospital, Department of Pathology, Harvard Medical School, Boston, MA, USA.
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Watson M, Coughlan D, Clement ND, Murray IR, Murray AD, Miller SC. Biomechanical parameters of the golf swing associated with lower back pain: A systematic review. J Sports Sci 2023; 41:2236-2250. [PMID: 38446499 DOI: 10.1080/02640414.2024.2319443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Accepted: 02/08/2024] [Indexed: 03/07/2024]
Abstract
Low back pain (LBP) is the most common injury in golfers of all abilities. The primary aim of this review was to improve understanding of human golf swing biomechanics associated with LBP. A systematic review using the PRISMA guidelines was performed. Nine studies satisfying inclusion criteria and dually reporting golf swing biomechanics and LBP were identified. Human golf swing biomechanics potentially associated with LBP include: reduced lumbar flexion velocity; reduced transition phase length; reduced lumbar torsional load; earlier onset of erector spinae contraction; increased lumbar lateral flexion velocity; reduced or greater erector spinae activity; and earlier onset of external oblique contraction. These potential associations were undermined by a very limited and conflicting quality of evidence, study designs which introduced a severe potential for bias and a lack of prospective study design. There is no conclusive evidence to support the commonly held belief that LBP is associated with "poor" golf swing technique. The potential associations identified should be further investigated by prospective studies of robust design, recruiting participants of both sexes and dexterities. Once firm associations have been identified, further research is required to establish how this knowledge can be best integrated into injury prevention and rehabilitation.
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Affiliation(s)
- M Watson
- European Tour Health and Performance Institute, European Tour Group, Virginia Water, UK
- Medical and Scientific Department, The R&A, St Andrews, UK
| | - D Coughlan
- European Tour Health and Performance Institute, European Tour Group, Virginia Water, UK
- Medical and Scientific Department, The R&A, St Andrews, UK
- London Sport Institute, Middlesex University, London, UK
| | - N D Clement
- European Tour Health and Performance Institute, European Tour Group, Virginia Water, UK
- Edinburgh Orthopaedics, Royal Infirmary of Edinburgh, Edinburgh, UK
- Department of Orthopaedics, University of Edinburgh, Edinburgh, UK
| | - I R Murray
- European Tour Health and Performance Institute, European Tour Group, Virginia Water, UK
- Edinburgh Orthopaedics, Royal Infirmary of Edinburgh, Edinburgh, UK
- Department of Orthopaedics, University of Edinburgh, Edinburgh, UK
| | - A D Murray
- European Tour Health and Performance Institute, European Tour Group, Virginia Water, UK
- Medical and Scientific Department, The R&A, St Andrews, UK
- Department of Sports and Exercise/Physical Activity for Health, University of Edinburgh, Edinburgh, UK
| | - S C Miller
- Department of Sports and Exercise Medicine, Queen Mary University of London, London, UK
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Federti E, Matte’ A, Hamza M, Lafferty A, Coughlan D, Weissbach M, Bhatt DL, Riccardi V, Perissinotto R, Siciliano A, Climax J, Brugnara C, De Franceschi L. P1483: EPELEUTON, A NOVEL SYNTHETIC SECOND GENERATION W-3 FATTY ACID, PROTECTS HUMANIZED SICKLE CELL MICE AGAINST HYPOXIA/REOXYGENATION ORGAN DAMAGE. Hemasphere 2022. [PMCID: PMC9429060 DOI: 10.1097/01.hs9.0000848788.30039.63] [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: 11/29/2022] Open
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Sin J, Henderson C, Elkes J, Cornelius V, Woodham LA, Batchelor R, Chen T, Corredor AM, Coughlan D, Dhital R, Evans S, Haider B, Heathcote J, Mansfield S, O'Brien A, Qassim M, Sserunkuma J, Travis CH, Williams E, Gillard S. Effect of digital psychoeducation and peer support on the mental health of family carers supporting individuals with psychosis in England (COPe-support): a randomised clinical trial. Lancet Digit Health 2022; 4:e320-e329. [PMID: 35379593 PMCID: PMC9021027 DOI: 10.1016/s2589-7500(22)00031-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 12/21/2021] [Accepted: 02/04/2022] [Indexed: 11/26/2022]
Abstract
Background Psychoeducation delivered face-to-face is effective in alleviating mental health morbidities in family carers of individuals with psychosis. However, research in such interventions delivered online is scarce. We evaluated the effectiveness of a digital multicomponent intervention—COPe-support—in improving carers' mental wellbeing and caregiving-related outcomes. Methods In this two-arm, individually randomised, superiority trial, people aged 18 years or older who provided at least weekly support in any format for a relative or close friend affected by psychosis across England were randomly assigned (1:1) to either COPe-support or a passive online information resource using an independent online system. Participants were recruited through 30 mental health UK National Health Service trusts. The study team were masked to allocation and assessment of outcomes as all data collection took place online. Participants had access to either condition for 40 weeks and were advised to spend at least half an hour per week over the initial 20 weeks to go through materials at their own pace and to allow time to integrate knowledge and skills learned into practice. It was not feasible to mask participants or the online facilitator to intervention allocation. COPe-support provided psychoeducation on psychosis-related caregiving strategies and forums with professionals and other carers, and the control intervention comprised a passive online information resource. The primary outcome at 20 weeks was mental wellbeing measured by the Warwick-Edinburgh Mental Wellbeing Scale (WEMWBS; minimally clinically important difference [MCID] 3). This trial is registered with ISRCTN, 89563420. Findings Between March 1, 2018, and Feb 14, 2020, 407 participants were randomly assigned, with 204 allocated to COPe-support and 203 allocated to control. The participants (mean age 53·1 years, SD 13·2) were mostly female (330 [81%] of 407 participants) and White (359 [88%] of 407 participants). 346 (85%) of 407 participants provided primary endpoint data, 174 (85%) of 204 participants in the COPe-support group and 172 (85%) of 203 participants in the control group. The mean WEMWBS score at 20 weeks was 44·5 (SD 8·31) for the COPe-support group and 43·3 (9·19) for the control group. We found no evidence of a difference in wellbeing between the two groups (adjusted mean difference 0·37, 95% CI –1·14 to 1·88; p=0·63). In the COPe-support group, 106 (52%) of 204 participants met the complier definition of a minimum of two logins in separate weeks. The complier average causal effect analysis increased the difference in WEMWBS scores (adjusted difference 0·83, 95% CI –1·45 to 3·11; p=0·47), but this was lower than the MCID. There were no adverse events. Interpretation Our findings did not support the use of COPe-support over a passive online information resource. However, further research to optimise digital interventions adjunctive to face-to-face support for carers remains important. Funding National Institute for Health Research.
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Climax J, Newsome PN, Hamza M, Weissbach M, Coughlan D, Sattar N, McGuire DK, Bhatt DL. Effects of Epeleuton, a Novel Synthetic Second-Generation n-3 Fatty Acid, on Non-Alcoholic Fatty Liver Disease, Triglycerides, Glycemic Control, and Cardiometabolic and Inflammatory Markers. J Am Heart Assoc 2020; 9:e016334. [PMID: 32779505 PMCID: PMC7660824 DOI: 10.1161/jaha.119.016334] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Background Epeleuton is 15‐hydroxy eicosapentaenoic acid ethyl ester, a second‐generation synthetic n‐3 fatty acid derivative of eicosapentaenoic acid. The primary objective was to assess the effect of epeleuton on markers of nonalcoholic fatty liver disease (NAFLD) with post hoc analyses of cardiometabolic markers. Methods and Results In a multicenter, randomized, double‐blind, placebo‐controlled trial, 96 adults with nonalcoholic fatty liver disease and body mass index 25 to 40 were randomized in a 1:1:1 ratio to receive epeleuton 2 g/day, epeleuton 1 g/day, or placebo for 16 weeks. A total of 27% of patients had diabetes mellitus. Primary end points of changes in alanine aminotransferase and liver stiffness did not improve at week 16. Secondary and post hoc analyses investigated changes in cardiometabolic markers. Epeleuton 2 g/day significantly decreased triglycerides, very‐low‐density lipoprotein cholesterol, and total cholesterol without increasing low‐density lipoprotein cholesterol. Despite a low mean baseline hemoglobin A1C (HbA1C; 6.3±1.3%), epeleuton 2 g/day significantly decreased HbA1c (−0.4%; P=0.026). Among patients with baseline HbA1c >6.5%, epeleuton 2 g/day decreased HbA1c by 1.1% (P=0.047; n=26). Consistent dose‐dependent reductions were observed for fasting plasma glucose, insulin, and insulin resistance indices. Epeleuton 2 g/day decreased circulating markers of cardiovascular risk and endothelial dysfunction. Epeleuton was well tolerated, with a safety profile not different from placebo. Conclusions While epeleuton did not meet its primary end points on alanine aminotransferase or liver stiffness, it significantly decreased triglycerides, HbA1C, plasma glucose, and inflammatory markers. These data suggest epeleuton may have potential for cardiovascular risk reduction and nonalcoholic fatty liver disease by simultaneously targeting hypertriglyceridemia, hyperglycemia, and systemic inflammation. Further trials are planned. Registration URL: https://www.clinicaltrials.gov; Unique identifier: NCT02941549.
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Affiliation(s)
| | - Philip N Newsome
- National Institute for Health Research Biomedical Research Centre at University Hospitals Birmingham NHS Foundation Trust and the University of Birmingham United Kingdom.,Centre for Liver and Gastrointestinal Research Institute of Immunology and Immunotherapy University of Birmingham United Kingdom.,Liver Unit University Hospitals Birmingham NHS Foundation Trust Birmingham United Kingdom
| | | | | | | | - Naveed Sattar
- Institute of Cardiovascular and Medical Sciences University of Glasgow United Kingdom
| | | | - Deepak L Bhatt
- Brigham and Women's Hospital Heart & Vascular Center Harvard Medical School Boston MA
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Reynolds A, O'Driscoll J, Quinn S, Coughlan D. Cows Milk Allergy: A Cohort of Patients from a University Hospital. Ir Med J 2016; 109:390. [PMID: 27685484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
The study illustrates advantages of Fiberoptic Bronchoscopy, a new service started at St. Lukes General Hospital in patient care since April 2014. Retrospective review of Bronchoscopies and referrals to Tertiary care unit for Bronchoscopy, prior and after initiation of service at St. Lukes Hospital were studied. Total 106 procedures were performed out of which 103(98%) were for diagnostic purpose. Common Indications for bronchoscopy were functional airway assessment in 38 cases (35%) of chronic cough, 26 cases (24.8%) of suspected Malignancy. The average time taken for procedure was 15 + 1 minute with overall rate of complication recorded in 1 case (0.95%). 32(30%) inpatients were referred before Bronchoscopy services were started locally.15(14%) patients were referred for Endobronchial ultrasound (EBUS) after diagnostic procedure performed at St. Lukes Hospital. To conclude, Bronchoscopy is a safe procedure used for diagnosis of various Lung conditions. The services offered locally reduced the time and cost involved in referrals. The diagnostic Bronchoscopies performed for Malignancy at St. Lukes Hospital have rightly increased references for EBUS at Tertiary care Unit.
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Affiliation(s)
- A Reynolds
- Department of Paediatrics, AMNCH, Tallaght, Dublin 24
| | - J O'Driscoll
- Department of Nutrition and Dietetics, AMNCH, Tallaght, Dublin 24
| | - S Quinn
- Department of Paediatrics, AMNCH, Tallaght, Dublin 24
| | - D Coughlan
- Department of Paediatrics, AMNCH, Tallaght, Dublin 24
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Coughlan D, Doherty E, Frick K, Ward P, O'Neill C. Healthcare utilisation among cancer survivors over 50 years of age. Ir Med J 2016; 109:359. [PMID: 27685692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
There are now over 104,000 people living in Ireland with a cancer diagnosis. Using The Irish Longitudinal Study on Ageing (TILDA), healthcare utilisation of cancer survivors (aged 50 +) was compared with those without a history of cancer across service providers. Our cancer variable was stratified by time since diagnosis (2-5, 6-10, 11+ years) and type (breast, prostate, colorectal and a miscellaneous group of other cancers). While the probability of cancer survivors accessing GP services was not significant different to respondents without a history of cancer, the probability of an outpatient specialist office visit was 19.5, 11.8 and 14.0 percentage points higher, respectively for those 2-5years, 6-10 years and 11 years or more after their cancer diagnosis and was statistically significant. In Ireland, the pattern of GP and specialist use appears less well defined compared to other European countries. This suggests an overarching policy response is required for cancer survivorship care.
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Affiliation(s)
- D Coughlan
- JE Cairns School of Business and Economics, NUI, Galway
| | - E Doherty
- JE Cairns School of Business and Economics, NUI, Galway
| | - K Frick
- Johns Hopkins Carey School of Business, Baltimore, USA
| | - P Ward
- JE Cairns School of Business and Economics, NUI, Galway
| | - C O'Neill
- JE Cairns School of Business and Economics, NUI, Galway
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O'Mahony J, Coughlan D. The Irish Cost-Effectiveness Threshold: Does It Support Rational Rationing or Might It Lead To Systematic Damage Of Ireland's Health System? Value Health 2014; 17:A451. [PMID: 27201239 DOI: 10.1016/j.jval.2014.08.1220] [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] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Affiliation(s)
| | - D Coughlan
- Newcastle University, Newcastle upon Tyne, UK
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Coughlan D, Keogh I, Connor TO. The Jade Goody legacy has undoubtedly saved lives, but what will be the Michael Douglas effect? Ir Med J 2013; 106:197-198. [PMID: 24218743] [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: 06/02/2023]
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Eustace S, Hanratty B, Coughlan D, Graham D, Otridge B. Myelomatous infiltration of the soft tissues following internal fixation of a pathological fracture. Skeletal Radiol 1995; 24:67-8. [PMID: 7709259 DOI: 10.1007/bf02425955] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Affiliation(s)
- S Eustace
- Department of Radiological Sciences, Deaconess Hospital, Boston, Massachusetts 02215, USA
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