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Ryan E, Hannigan A, Grol-Prokopczyk H, May P, Purtill H. Sociodemographic disparities and potential biases in persistent pain estimates: Findings from 5 waves of the Irish Longitudinal Study on Ageing (TILDA). Eur J Pain 2024; 28:754-768. [PMID: 38059524 PMCID: PMC11023795 DOI: 10.1002/ejp.2215] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Revised: 11/03/2023] [Accepted: 11/20/2023] [Indexed: 12/08/2023]
Abstract
BACKGROUND Pain is a prevalent, debilitating condition among older adults. Much evidence on this topic comes from cohort studies, which may be affected by attrition and measurement bias. Little is known about the impact of these biases on pain estimates for European older adults. Additionally, there is a lack of longitudinal research on pain and sociodemographic disparities in Irish older adults. METHODS We analysed data from 8171 participants (aged ≥50 at baseline) across five waves of the Irish Longitudinal Study on Ageing. Longitudinal pain severity and sociodemographic disparities in pain were explored visually and using a latent growth curve model. Using multivariate logistic regression, we examined bias due to attrition at later waves associated with reported pain at Wave 1. Measurement biases due to reporting heterogeneity were assessed by investigating associations between sociodemographic factors and pain-related disability for given pain levels. RESULTS Wave 1 severe pain was associated with increased odds of attrition due to death by Wave 5 (AOR: 1.63, 95% CI: 1.20, 2.19). Not having private health insurance was associated with increased odds of pain-related disability at Wave 1, controlling for pain severity (AOR: 1.37, 95% CI: 1.15, 1.64). These results suggested mortality bias and reporting heterogeneity measurement bias, respectively. Sex, education level, and private health insurance status disparities in pain were observed longitudinally. CONCLUSIONS Mortality bias and reporting heterogeneity measurement bias must be accounted for to improve older adult pain estimates. There is a need for policymakers to address sociodemographic disparities in older adult pain levels. SIGNIFICANCE This study highlights a need to address bias in the estimation of pain in observational studies of older adults. Understanding the sources and extent of these biases is important so that health practices and policies to address pain disparities can be guided by accurate estimates. Women, those with lower educational attainment, and those without private health insurance were found to have the highest pain burden longitudinally, suggesting a need for targeted interventions for these groups in Ireland and internationally.
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Affiliation(s)
- E Ryan
- Department of Mathematics and Statistics, University of Limerick, Limerick, Ireland
| | - A Hannigan
- School of Medicine, University of Limerick, Limerick, Ireland
- Health Research Institute, University of Limerick, Limerick, Ireland
| | - H Grol-Prokopczyk
- Department of Sociology, University at Buffalo, State University of New York, Buffalo, New York, USA
| | - P May
- Centre for Health Policy and Management, School of Medicine, Trinity College Dublin, Dublin, Ireland
- The Irish Longitudinal Study on Ageing, School of Medicine, Trinity College Dublin, Dublin, Ireland
- Cicely Saunders Institute of Palliative Care, Policy & Rehabilitation, King's College London, London, UK
| | - H Purtill
- Department of Mathematics and Statistics, University of Limerick, Limerick, Ireland
- Health Research Institute, University of Limerick, Limerick, Ireland
- Ageing Research Centre, University of Limerick, Limerick, Ireland
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Duff C, Kennedy L, Ryan E, James J, Binchy A, O'Donovan D. Introducing LISA: Less Invasive Surfactant Administration. Ir Med J 2023; 116:854. [PMID: 37874313] [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: 10/25/2023]
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Leonard F, O'Reilly H, Blackburn C, Melody L, Hall D, Ryan E, Bruton K, Doyle P, Conway B, Barrett M. Learnings From a National Cyberattack Digital Disaster During the SARS-CoV-2 Pandemic in a Pediatric Emergency Medicine Department. Disaster Med Public Health Prep 2023; 17:e419. [PMID: 37357951 DOI: 10.1017/dmp.2023.86] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/27/2023]
Abstract
OBJECTIVE The primary objective was to analyze the impact of the national cyberattack in May 2021 on patient flow and data quality in the Paediatric Emergency Department (ED), amid the SARS-CoV-2 (COVID-19) pandemic. METHODS A single site retrospective time series analysis was conducted of three 6-week periods: before, during, and after the cyberattack outage. Initial emergent workflows are described. Analysis includes diagnoses, demographic context, key performance indicators, and the gradual return of information technology capability on ED performance. Data quality was compared using 10 data quality dimensions. RESULTS Patient visits totaled 13 390. During the system outage, patient experience times decreased significantly, from a median of 188 minutes (pre-cyberattack) down to 166 minutes, most notable for the period from registration to triage, and from clinician review to discharge (excluding admitted patients). Following system restoration, most timings increased. Data quality was significantly impacted, with data imperfections noted in 19.7% of data recorded during the system outage compared to 4.7% before and 5.1% after. CONCLUSIONS There was a reduction in patient experience time, but data quality suffered greatly. A hospital's major emergency plan should include provisions for digital disasters that address essential data requirements and quality as well as maintaining patient flow.
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Affiliation(s)
- Fiona Leonard
- School of Computer Science, Technological University Dublin, Dublin, Ireland
- Data Analytics, Children's Health Ireland, Dublin, Ireland
| | - Hugh O'Reilly
- Department of Paediatric Emergency Medicine, Children's Health Ireland at Crumlin, Dublin, Ireland
| | - Carol Blackburn
- Department of Paediatric Emergency Medicine, Children's Health Ireland at Crumlin, Dublin, Ireland
| | - Laura Melody
- Department of Paediatric Emergency Medicine, Children's Health Ireland at Crumlin, Dublin, Ireland
| | - Dani Hall
- Department of Paediatric Emergency Medicine, Children's Health Ireland at Crumlin, Dublin, Ireland
- Blizzard Institute, Faculty of Medicine and Dentistry, Queen Mary University of London, UK
- Women's and Children's Health, School of Medicine, University College Dublin, Ireland
| | - Eleanor Ryan
- Department of Paediatric Emergency Medicine, Children's Health Ireland at Crumlin, Dublin, Ireland
| | - Kate Bruton
- Department of Paediatric Emergency Medicine, Children's Health Ireland at Crumlin, Dublin, Ireland
- Women's and Children's Health, School of Medicine, University College Dublin, Ireland
| | - Pamela Doyle
- Department of Paediatric Emergency Medicine, Children's Health Ireland at Crumlin, Dublin, Ireland
| | - Bridget Conway
- Department of Paediatric Emergency Medicine, Children's Health Ireland at Crumlin, Dublin, Ireland
| | - Michael Barrett
- Department of Paediatric Emergency Medicine, Children's Health Ireland at Crumlin, Dublin, Ireland
- Women's and Children's Health, School of Medicine, University College Dublin, Ireland
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Ryan E, Mulready K, Wiegerinck E, Russell J, Swinkels DW, Stewart S. NTBI levels in C282Y homozygotes after therapeutic phlebotomy. eJHaem 2022; 3:644-652. [PMID: 36051052 PMCID: PMC9422009 DOI: 10.1002/jha2.507] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 05/31/2022] [Accepted: 05/31/2022] [Indexed: 11/13/2022]
Abstract
C282Y homozygotes exposed to sustained elevated transferrin saturation (TS) may develop worsening clinical symptoms. This might be related to the appearance of non‐transferrin bound iron (NTBI) when TS≥50% and labile plasma iron (LPI) when TS levels reach 75–80%. In this study, NTBI levels were examined in 219 randomly selected untreated and treated C282Y homozygotes. Overall, 161 of 219 had TS ≥ 50%, 124 of whom had detectable NTBI (≥0.47 µM, 1.81 µM [0.92–2.46 µM]) with a median serum ferritin 320 µg/L (226–442 µg/L). Ninety of 219 homozygotes had TS ≥ 75%, and all had detectable NTBI (2.21 µM [1.53–2.59 µM] with a median ferritin 338 µg/L [230–447 µg/L]). Of 125 homozygotes who last had phlebotomy ≥12 months ago (42 months [25–74 months], 92 had TS levels ≥ 50%, and 70 of these had NTBI ≥ 0.47 µM (2.06 µM [1.23–2.61µM]). Twenty‐six of these 70 had a normal ferritin. Fifty‐five of 125 had TS ≥ 75%, and NTBI was detected in all of these (2.32 µM [1.57–2.77 µM]) with a median ferritin 344 µg/L (255–418 µg/L). Eighteen of these 55 had a normal ferritin. In summary, NTBI is frequently found in C282Y homozygotes with TS ≥ 50%. Furthermore, C282Y homozygotes in the maintenance phase often have TS ≥ 50% together with a normal ferritin. Therefore, monitoring the TS level during the maintenance phase is recommended as an accessible clinical marker of the presence of NTBI.
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Affiliation(s)
- Eleanor Ryan
- Liver Centre Mater Misericordiae University Hospital Dublin Ireland
| | - Keith Mulready
- Department of Biochemistry and Diagnostic Endocrinology Mater Misericordiae University Hospital Dublin Ireland
| | - Erwin Wiegerinck
- Laboratory of Genetic, Endocrine and Metabolic Diseases, Department of Laboratory Medicine Radboud University Medical Centre Nijmegen The Netherlands
| | - Jennifer Russell
- Liver Centre Mater Misericordiae University Hospital Dublin Ireland
| | - Dorine W. Swinkels
- Laboratory of Genetic, Endocrine and Metabolic Diseases, Department of Laboratory Medicine Radboud University Medical Centre Nijmegen The Netherlands
| | - Stephen Stewart
- Liver Centre Mater Misericordiae University Hospital Dublin Ireland
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Frawley E, Cowman M, Cella M, Cohen D, Ryan E, Hallahan B, Bowie C, McDonald C, Fowler D, Wykes T, Donohoe G. Cognitive Remediation and Social Recovery in Early Psychosis (CReSt-R): protocol for a pilot randomised controlled study. Pilot Feasibility Stud 2022; 8:109. [PMID: 35610711 PMCID: PMC9126749 DOI: 10.1186/s40814-022-01064-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Accepted: 05/06/2022] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Psychosis, even in its early stages, is associated with significant disability, causing it to be ranked ahead of paraplegia and blindness in those aged 18-35 in terms of years lived with disability. Current pharmacological and psychological interventions intervention have focused primarily on the reduction of positive symptoms (hallucinations and delusions), with little benefit to domains of psychosis such as cognitive difficulties and social and occupational functioning. METHODS/DESIGN The CReSt-R intervention trial is a single center, pilot randomised controlled study based at the National University of Ireland (NUI), Galway. The trial will recruit participants from four clinical sites with assessment and intervention completed by the primary NUI Galway team. The trial will explore the feasibility, acceptability, and effectiveness of a novel psychosocial intervention for early psychosis based on a combined cognitive remediation training and cognitive behavioural therapy approach focused on social recovery. Participants, aged 16-35 within the first 5 years of a diagnosed psychotic disorder, will be recruited from the Children and Adolescent Mental Health Service and the Adult Mental Health Services in the region. DISCUSSION Cognitive remediation training (for improving cognition) and social recovery focused cognitive behavioural therapy, have both separately demonstrated effectiveness. This trial will evaluate the feasibility, acceptability, and explore the efficacy of a treatment approach that combines both approaches as part of an integrated, multicomponent intervention. TRIAL REGISTRATION Cognitive Remediation & Social Recovery in Early Psychosis (CReSt-R): ClincialTrials.gov Identifier NCT04273685. Trial registered Feb 18th, 2020. Last updated April 14th, 2021.
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Affiliation(s)
- E Frawley
- Centre for Neuroimaging, Cognition & Genomics (NICOG), School of Psychology, National University of Ireland, Galway, Ireland
| | - M Cowman
- Centre for Neuroimaging, Cognition & Genomics (NICOG), School of Psychology, National University of Ireland, Galway, Ireland
| | - M Cella
- Institute of Psychiatry, Psychology & Neuroscience, King's College, London, England
| | - D Cohen
- South Galway Child & Adolescent Mental Health Service, Health Service Executive, Merlin Park Hospital, Galway, Ireland
- Department of Psychiatry, National University of Ireland, Galway, Ireland
| | - E Ryan
- Psychology Service, Adult Mental Health Service, University Hospital Galway, Galway, Ireland
| | - B Hallahan
- Centre for Neuroimaging, Cognition & Genomics (NICOG), School of Psychology, National University of Ireland, Galway, Ireland
| | - C Bowie
- Department of Psychology, Queen's University, Kingston, ON, Canada
| | - C McDonald
- Centre for Neuroimaging, Cognition & Genomics (NICOG), School of Psychology, National University of Ireland, Galway, Ireland
| | - D Fowler
- Department of Psychology, University of Sussex, Brighton, England
| | - T Wykes
- Institute of Psychiatry, Psychology & Neuroscience, King's College, London, England
| | - G Donohoe
- Centre for Neuroimaging, Cognition & Genomics (NICOG), School of Psychology, National University of Ireland, Galway, Ireland.
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Bohon J, Gonzalez E, Grace C, Harris CT, Jacobsen B, Kachiguine S, Kim D, MacArthur J, Martinez-McKinney F, Mazza S, Nizam M, Norvell N, Padilla R, Potter E, Prakash T, Prebys E, Ryan E, Schumm BA, Smedley J, Stuart D, Tarka M, Torrecilla IS, Wilder M, Zhu D. Use of diamond sensors for a high-flux, high-rate X-ray pass-through diagnostic. J Synchrotron Radiat 2022; 29:595-601. [PMID: 35510992 PMCID: PMC9070720 DOI: 10.1107/s1600577522003022] [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] [Figures] [Subscribe] [Scholar Register] [Received: 12/18/2021] [Accepted: 03/19/2022] [Indexed: 06/14/2023]
Abstract
X-ray free-electron lasers (XFELs) deliver pulses of coherent X-rays on the femtosecond time scale, with potentially high repetition rates. While XFELs provide high peak intensities, both the intensity and the centroid of the beam fluctuate strongly on a pulse-to-pulse basis, motivating high-rate beam diagnostics that operate over a large dynamic range. The fast drift velocity, low X-ray absorption and high radiation tolerance properties of chemical vapour deposition diamonds make these crystals a promising candidate material for developing a fast (multi-GHz) pass-through diagnostic for the next generation of XFELs. A new approach to the design of a diamond sensor signal path is presented, along with associated characterization studies performed in the XPP endstation of the LINAC Coherent Light Source (LCLS) at SLAC. Qualitative charge collection profiles (collected charge versus time) are presented and compared with those from a commercially available detector. Quantitative results on the charge collection efficiency and signal collection times are presented over a range of approximately four orders of magnitude in the generated electron-hole plasma density.
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Affiliation(s)
- J. Bohon
- Los Alamos National Laboratory, Los Alamos, NM 87545, USA
| | - E. Gonzalez
- Santa Cruz Institute for Particle Physics, University of California, Santa Cruz, CA 95064, USA
| | - C. Grace
- Lawrence Berkeley National Laboratory, Berkeley, CA 94720, USA
| | - C. T. Harris
- Sandia National Laboratories, Albuquerque, NM 87123, USA
| | - B. Jacobsen
- SLAC National Accelerator Laboratory, Menlo Park, CA 94025, USA
| | - S. Kachiguine
- Santa Cruz Institute for Particle Physics, University of California, Santa Cruz, CA 95064, USA
| | - D. Kim
- Los Alamos National Laboratory, Los Alamos, NM 87545, USA
| | - J. MacArthur
- SLAC National Accelerator Laboratory, Menlo Park, CA 94025, USA
| | - F. Martinez-McKinney
- Santa Cruz Institute for Particle Physics, University of California, Santa Cruz, CA 95064, USA
| | - S. Mazza
- Santa Cruz Institute for Particle Physics, University of California, Santa Cruz, CA 95064, USA
| | - M. Nizam
- Santa Cruz Institute for Particle Physics, University of California, Santa Cruz, CA 95064, USA
| | - N. Norvell
- Santa Cruz Institute for Particle Physics, University of California, Santa Cruz, CA 95064, USA
| | - R. Padilla
- Santa Cruz Institute for Particle Physics, University of California, Santa Cruz, CA 95064, USA
| | - E. Potter
- Santa Cruz Institute for Particle Physics, University of California, Santa Cruz, CA 95064, USA
| | - T. Prakash
- Lawrence Berkeley National Laboratory, Berkeley, CA 94720, USA
| | - E. Prebys
- University of California, Davis, CA 95616, USA
| | - E. Ryan
- Santa Cruz Institute for Particle Physics, University of California, Santa Cruz, CA 95064, USA
| | - B. A. Schumm
- Santa Cruz Institute for Particle Physics, University of California, Santa Cruz, CA 95064, USA
| | - J. Smedley
- Los Alamos National Laboratory, Los Alamos, NM 87545, USA
| | - D. Stuart
- University of California, Santa Barbara, CA 93106, USA
| | - M. Tarka
- Santa Cruz Institute for Particle Physics, University of California, Santa Cruz, CA 95064, USA
| | | | - M. Wilder
- Santa Cruz Institute for Particle Physics, University of California, Santa Cruz, CA 95064, USA
| | - D. Zhu
- SLAC National Accelerator Laboratory, Menlo Park, CA 94025, USA
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Abstract
BACKGROUND AND PURPOSE Microthrombosis could play a role in delayed cerebral ischemia after aneurysmal subarachnoid hemorrhage. Tirofiban has shown promising results in reducing delayed cerebral ischemia in retrospective studies. However, the safety of using tirofiban in aneurysmal subarachnoid hemorrhage is not rigorously established. METHODS A phase 1/2a double-blinded randomized controlled trial (2:1 randomization) to assess the safety of a 7-day intravenous infusion of tirofiban compared with placebo, in patients with aneurysmal subarachnoid hemorrhage treated with ventriculostomy placed in the operative room and coiling was conducted. The primary end point was any intracranial hemorrhage during the hospital stay. The secondary end points were: incidence of radiographic and clinical vasospasm, incidence of delayed cerebral ischemia, and incidence of cerebral ischemic changes noted on magnetic resonance imaging or computed tomography. RESULTS Eighteen patients received intravenous tirofiban and 12 received placebo. There was no difference in baseline characteristics except for higher male proportions in the tirofiban group. There was no difference in death, in development of new or change in existing intracranial hemorrhages, in thrombocytopenia, and need for shunts in the two arms. However, the tirofiban arm had a lower incidence of delayed cerebral ischemia compared with placebo (6% [1/18] versus 33% [4/12]; P=0.04), and less radiographic vasospasm as detected by catheter angiogram or computed tomography angiography (P=0.01) and computed tomography perfusion (P=0.01). CONCLUSIONS The above preliminary results support proceeding with further testing of the safety and efficacy of 7-day intravenous infusion of tirofiban in a pragmatic (placing external ventricular drain by the bedside), multicenter setting, and using a larger population. Registration: URL: https://www.clinicaltrials.gov; Unique identifier: NCT03691727.
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Affiliation(s)
- Mario Zanaty
- Department of Neurosurgery (M.Z., A.P., E.R., D.H.), University of Iowa Hospital and Clinics
| | - Lauren Allan
- Department of General Surgery, Department of Surgical and Neuroscience Intensive Care Unit (L.A.), University of Iowa Hospital and Clinics
| | - Edgar A Samaniego
- Department of Neurology, Neuro Interventional Radiology (E.A.S.), University of Iowa Hospital and Clinics
| | - Anthony Piscopo
- Department of Neurosurgery (M.Z., A.P., E.R., D.H.), University of Iowa Hospital and Clinics
| | - Eleanor Ryan
- Department of Neurosurgery (M.Z., A.P., E.R., D.H.), University of Iowa Hospital and Clinics
| | - James C Torner
- Department of Epidemiology and Public Health (J.C.T.), University of Iowa Hospital and Clinics
| | - David Hasan
- Department of Neurosurgery (M.Z., A.P., E.R., D.H.), University of Iowa Hospital and Clinics
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Lloyd A, Ryan E, Boland M, Medani S, Elwahab A, Malone C, Sweeney K, Barry K, McLaughlin R, Lowery A, Kerin M. O39: THE HISTOPATHOLOGICAL AND MOLECULAR FEATURES OF BREAST CARCINOMA WITH HIGH-GRADE TUMOUR BUDDING. Br J Surg 2021. [DOI: 10.1093/bjs/znab117.039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
Background
Tumour budding (TB) is an adverse histological feature in many cancers. It is thought to represent epithelial-to-mesenchymal transition, a key step in the metastatic process. The role of TB in breast carcinoma (BC) remains unclear.
Aim
To investigate the relationship between TB and other histological and molecular features of BC.
Method
A systematic search was performed to identify studies that compared features of BC based on the presence or absence of high-grade TB. Dichotomous variables were pooled as odds ratios (OR) using the Cochran–Mantel–Haenszel method. Quality assessment of the included studies was performed using the Newcastle-Ottawa scale (NOS).
Result
Seven studies with a total of 1040 patients (high grade TB n=519, 49.9%; low grade TB n=521, 50.1%) were included. A moderate- to high-risk of bias was noted. The median NOS was 7 (range 6-8). High-grade TB was significantly associated with lymph node involvement (OR 2.28, 95% c.i. 1.74 to 2.98, P<0.001) and lymphovascular invasion (OR 3.08, 95% c.i. 2.13 to 4.47, P<0.001). Regarding molecular subtypes, there was an increased likelihood of high-grade TB in oestrogen- (OR 1.66, 95% c.i. 1.21 to 2.29, P=0.002) and progesterone-receptor positive (OR 1.68, 95% c.i. 1.10 to 2.59, P=0.02) tumours. In contrast triple negative breast cancer had a reduced incidence of high-grade TB (OR 0.46, 95% c.i. 0.30 to 0.72, P=0.0006).
Conclusion
High-grade TB is enriched in hormone-positive BC and is associated with known adverse prognostic variables. TB may offer new insights into the metastatic processes of luminal BC.
Take-home message
High-grade TB is enriched in hormone-positive BC and is associated with known adverse prognostic variables. TB may offer new insights into the metastatic processes of luminal BC.
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Affiliation(s)
- A Lloyd
- Royal College of Surgeons Ireland
| | - E Ryan
- Galway University Hospital
| | - M Boland
- Royal College of Surgeons Ireland
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Buch S, Sharma A, Ryan E, Datz C, Griffiths WJH, Way M, Buckley TWM, Ryan JD, Stewart S, Wright C, Dongiovanni P, Fracanzani A, Zwerina J, Merle U, Weiss KH, Aigner E, Krones E, Dejaco C, Fischer J, Berg T, Valenti L, Zoller H, McQuillin A, Hampe J, Stickel F, Morgan MY. Variants in PCSK7, PNPLA3 and TM6SF2 are risk factors for the development of cirrhosis in hereditary haemochromatosis. Aliment Pharmacol Ther 2021; 53:830-843. [PMID: 33565643 DOI: 10.1111/apt.16252] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Revised: 09/02/2020] [Accepted: 12/21/2020] [Indexed: 12/09/2022]
Abstract
BACKGROUND Cirrhosis develops in <10% of individuals homozygous for the C282Y variant in the homeostatic iron regulator (HFE) gene. Carriage of PCSK7:rs236918 is associated with an increased risk of cirrhosis in this population. AIM To determine if genetic variants significantly associated with the risk of alcohol- and NAFLD-related cirrhosis also modulate the cirrhosis risk in C282Y homozygotes. METHODS Variants in PCSK7, PNPLA3, TM6SF2, MBOAT7 and HSD17B13 were genotyped in 1319 C282Y homozygotes, from six European countries, of whom 171 (13.0%) had cirrhosis. Genotypic and allelic associations with the risk for developing cirrhosis were assessed, adjusting for age and sex. Fixed effects meta-analyses of the adjusted summary data for each country were performed. Post hoc association testing was undertaken in the 131 (76.6%) cases and 299 (26.0%) controls with available liver histology. RESULTS Significant associations were observed between PCSK7:rs236918 (OR = 1.52 [95% CI 1.06-2.19]; P = 0.022; I2 = 0%); PNPLA3:rs738409 (OR = 1.60 [95% CI 1.22-2.11]; P = 7.37 × 10-4 ; I2 = 45.5%) and TM6SF2:rs58542926 (OR = 1.94 [95% CI 1.28-2.95]; P = 1.86 × 10-3 ; I2 = 0%) and the cirrhosis risk in C282Y homozygotes. These findings remained significant in the subpopulation with available liver histology. The population-attributable fractions were 5.6% for PCSK7:rs236918, 13.8% for PNPLA3:rs738409, 6.5% for TM6SF2:rs58542926 and 24.0% for carriage of all three variants combined. CONCLUSIONS The risk of cirrhosis associated with carriage of PCSK7:rs236918 was confirmed in this much larger population of C282Y homozygotes. In addition, PNPLA3:rs738409 and TM6SF2:rs58542926 were established as significant additional risk factors. More detailed genetic testing of C282Y homozygotes would allow risk stratification and help guide future management.
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Ryan E, Bolger T, Barrett MJ, Blackburn C, Okafor I, McNamara R, Molloy EJ. Paediatric Head Injury and Traumatic Brain Injury. Ir Med J 2020; 113:94. [PMID: 32816429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Aim To determine prevalence of head injury presenting to paediatric emergency departments (PEDs) and characterise by demographics, triage category, disposition neuroimaging or re-attendance. Methods Presentations in 2014 and 2015, with diagnoses of head injury, intracranial bleed, skull fracture including single or re-attendances within 28 days post head injury to all national PEDs, were analysed. Demographics, triage score, imaging rate, admission, mechanisms and representation rate were recorded. Results Head injury was diagnosed in 13,392 of 224,860 (5.9%), median (IQR) age 3.9 (1.4 - 8.3) years. Regionally 3% of children <5 years attend each year. The total admitted/transferred was 10.8% (n=1460). Neuroimaging rate was 4.3% (n= 570). Falls predominated. Sport accounted for 12.2%. Conclusion One in twenty children PED presentations are head injury, over half in preschool children. A sizeable number were symptomatic reflected by admission, transfer, imaging or re-attendance. Observational management was favoured over imaging reflected in the higher admission versus imaging rate.
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Affiliation(s)
- E Ryan
- Paediatrics, Children's Hospital Ireland (CHI) at Tallaght, Tallaght University Hospital, Dublin
- Discipline of Paediatrics, School of Medicine, Trinity College, the University of Dublin
| | - T Bolger
- Paediatrics, Children's Hospital Ireland (CHI) at Tallaght, Tallaght University Hospital, Dublin
| | - M J Barrett
- Emergency Medicine, CHI at Crumlin, Dublin
- Women's & Children's Health, School of Medicine, University College, Dublin
- National Children's Research Centre, Dublin
| | - C Blackburn
- Emergency Medicine, CHI at Crumlin, Dublin
- Women's & Children's Health, School of Medicine, University College, Dublin
| | - I Okafor
- Emergency Medicine, CHI at Temple Street
| | - R McNamara
- Emergency Medicine, CHI at Temple Street
| | - E J Molloy
- Paediatrics, Children's Hospital Ireland (CHI) at Tallaght, Tallaght University Hospital, Dublin
- Discipline of Paediatrics, School of Medicine, Trinity College, the University of Dublin
- Neonatology, CHI at Crumlin, Dublin
- National Children's Research Centre, Dublin
- Neonatology, Coombe Women and Infants' University Hospital, Dublin, Ireland
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Giudice V, Downie L, Lindsay F, Ryan E, MacKay A. Improving the communication of dysphagia recommendations in the inpatient setting. Clin Nutr ESPEN 2020. [DOI: 10.1016/j.clnesp.2019.12.078] [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: 11/28/2022]
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Arnold R, Amos D, Lowe H, Elder A, Martin S, Moss S, McMaster K, Juergens C, Ryan E, Larnach G, Adams M. 472 Development of a Rural NSW Cardiac Catheter and Coronary Intervention Service Over 14 Years: Impacts on Service and 30 Day AMI Mortality. Heart Lung Circ 2020. [DOI: 10.1016/j.hlc.2020.09.479] [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: 10/23/2022]
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13
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Johnson RL, Jechorek RP, Andrews H, Bautista P, Bird P, Blamey S, Connell E, Cooper C, Cooper WD, Crowley E, Doane C, Elton S, Falkenberg R, Fernandes-Monteiro C, Gharst T, Gonzalez E, Hawes B, Hemming B, High E, Hsu D, Iannucci C, Kora L, Lara A, Lee M, Masanz G, Mattson D, Okolo C, Parra G, Ryan E, Torontali M, Vega H. Evaluation of VIDAS® Listeria species Xpress (LSX) Immunoassay Method for the Detection of Listeria species in Foods: Collaborative Study. J AOAC Int 2019. [DOI: 10.1093/jaoac/94.1.159] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Abstract
In a multilaboratory study, the effectiveness of an alternative method for rapid screening of Listeria species compared to traditional reference methods was demonstrated in a variety of food products. A collaborative study was conducted to compare the VIDAS® Listeria species Xpress (LSX) method and the standard cultural methods for the detection of Listeria species in foods. Six food types were tested: vanilla ice cream, cheddar cheese, raw ground beef, frozen green beans, deli turkey, and cooked shrimp. Each food, inoculated with a different Listeria strain at two levels and uninoculated test portions, was analyzed by each method. A total of 15 laboratories representing government and industry participated. In this study 1134 tests were analyzed in the statistical analysis. There were 490 positives by the VIDAS LSX method using the sample boiling step, 483 positives by the VIDAS LSX method using the Heat and Go system, and 439 positives by the standard culture methods. Overall, the Chi-square result for the VIDAS LSX method with boiling for all foods was 7.25, indicating a significant statistical difference between the VIDAS method and the standard methods at the 5% confidence. For the VIDAS LSX method with the Heat and Go system, the Chi-square result for all foods was 5.37, indicating a significant statistical difference between the VIDAS LSX assay with the Heat and Go system and the standard methods at the 5% level of significance. In both cases, the VIDAS method was more sensitive than the standard methods. The LSX method detects Listeria species in foods with negative or presumptive positive results in a minimum of 30 h compared to at least 5 days for the cultural methods. Based on the results of this collaborative study, it is recommended that the VIDAS LSX method be adopted as an AOAC Official MethodSM for the detection of Listeria species in dairy products, vegetables, seafood, raw meats and poultry, and processed meats and poultry.
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Cacciottolo TM, Perikari A, van der Klaauw A, Henning E, Stadler LKJ, Keogh J, Farooqi IS, Tenin G, Keavney B, Ryan E, Budd R, Bewley M, Coelho P, Rumsey W, Sanchez Y, McCafferty J, Dockrell D, Walmsley S, Whyte M, Liu Y, Choy MK, Tenin G, Abraham S, Black G, Keavney B, Ford T, Stanley B, Good R, Rocchiccioli P, McEntegart M, Watkins S, Eteiba H, Shaukat A, Lindsay M, Robertson K, Hood S, McGeoch R, McDade R, Sidik N, McCartney P, Corcoran D, Collison D, Rush C, McConnachie A, Touyz R, Oldroyd K, Berry C, Gazdagh G, Diver L, Marshall J, McGowan R, Ahmed F, Tobias E, Curtis E, Parsons C, Maslin K, D'Angelo S, Moon R, Crozier S, Gossiel F, Bishop N, Kennedy S, Papageorghiou A, Fraser R, Gandhi S, Prentice A, Inskip H, Godfrey K, Schoenmakers I, Javaid MK, Eastell R, Cooper C, Harvey N, Watt ER, Howden A, Mirchandani A, Coelho P, Hukelmann JL, Sadiku P, Plant TM, Cantrell DA, Whyte MKB, Walmsley SR, Mordi I, Forteath C, Wong A, Mohan M, Palmer C, Doney A, Rena G, Lang C, Gray EH, Azarian S, Riva A, Edwards H, McPhail MJW, Williams R, Chokshi S, Patel VC, Edwards LA, Page D, Miossec M, Williams S, Monaghan R, Fotiou E, Santibanez-Koref M, Keavney B, Badat M, Mettananda S, Hua P, Schwessinger R, Hughes J, Higgs D, Davies J. Scientific Business Abstracts of the 113th Annual Meeting of the Association of Physicians of Great Britain and Ireland. QJM 2019; 112:724-729. [PMID: 31505685 DOI: 10.1093/qjmed/hcz175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
| | - A Perikari
- University of Cambridge Metabolic Research Laboratories
| | | | - E Henning
- University of Cambridge Metabolic Research Laboratories
| | - L K J Stadler
- University of Cambridge Metabolic Research Laboratories
| | - J Keogh
- University of Cambridge Metabolic Research Laboratories
| | - I S Farooqi
- University of Cambridge Metabolic Research Laboratories
| | - G Tenin
- From University of Manchester
| | | | - E Ryan
- Department of Respiratory Medicine, Centre for Inflammation Research, University of Edinburgh
| | - R Budd
- Department of Infection Immunity and Cardiovascular Disease, The Florey Institute for Host-Pathogen Interactions, University of Sheffield
| | - M Bewley
- Department of Infection Immunity and Cardiovascular Disease, The Florey Institute for Host-Pathogen Interactions, University of Sheffield
| | - P Coelho
- Department of Respiratory Medicine, Centre for Inflammation Research, University of Edinburgh
| | - W Rumsey
- Stress and Repair Discovery Performance Unit, Respiratory Therapy Area
| | - Y Sanchez
- Stress and Repair Discovery Performance Unit, Respiratory Therapy Area
| | - J McCafferty
- Department of Respiratory Medicine, Centre for Inflammation Research, University of Edinburgh
| | - D Dockrell
- Department of Respiratory Medicine, Centre for Inflammation Research, University of Edinburgh
| | - S Walmsley
- Department of Respiratory Medicine, Centre for Inflammation Research, University of Edinburgh
| | - M Whyte
- Department of Respiratory Medicine, Centre for Inflammation Research, University of Edinburgh
| | - Y Liu
- From the University of Manchester
| | - M-K Choy
- From the University of Manchester
| | - G Tenin
- From the University of Manchester
| | | | - G Black
- From the University of Manchester
| | | | - T Ford
- BHF Centre of Excellence in Vascular Science and Medicine, University of Glasgow
- Golden Jubilee National Hospital
| | | | - R Good
- Golden Jubilee National Hospital
| | - P Rocchiccioli
- BHF Centre of Excellence in Vascular Science and Medicine, University of Glasgow
- Golden Jubilee National Hospital
| | - M McEntegart
- BHF Centre of Excellence in Vascular Science and Medicine, University of Glasgow
- Golden Jubilee National Hospital
| | | | - H Eteiba
- Golden Jubilee National Hospital
| | | | | | | | - S Hood
- Golden Jubilee National Hospital
| | | | - R McDade
- Golden Jubilee National Hospital
| | - N Sidik
- BHF Centre of Excellence in Vascular Science and Medicine, University of Glasgow
- Golden Jubilee National Hospital
| | - P McCartney
- BHF Centre of Excellence in Vascular Science and Medicine, University of Glasgow
- Golden Jubilee National Hospital
| | - D Corcoran
- BHF Centre of Excellence in Vascular Science and Medicine, University of Glasgow
- Golden Jubilee National Hospital
| | - D Collison
- BHF Centre of Excellence in Vascular Science and Medicine, University of Glasgow
- Golden Jubilee National Hospital
| | - C Rush
- BHF Centre of Excellence in Vascular Science and Medicine, University of Glasgow
- Golden Jubilee National Hospital
| | | | - R Touyz
- BHF Centre of Excellence in Vascular Science and Medicine, University of Glasgow
| | - K Oldroyd
- BHF Centre of Excellence in Vascular Science and Medicine, University of Glasgow
- Golden Jubilee National Hospital
| | - Colin Berry
- BHF Centre of Excellence in Vascular Science and Medicine, University of Glasgow
- Golden Jubilee National Hospital
| | - G Gazdagh
- School of Medicine, Dentistry & Nursing, College of Medical, Veterinary and Life Sciences, University of Glasgow
| | - L Diver
- West of Scotland Regional Genetics Service, Laboratory Medicine Building, Queen Elizabeth University Hospital
| | - J Marshall
- Institute of Cancer Sciences, College of Medical, Veterinary and Life Sciences, University of Glasgow
| | - R McGowan
- West of Scotland Regional Genetics Service, Laboratory Medicine Building, Queen Elizabeth University Hospital
| | - F Ahmed
- Developmental Endocrinology Research Group, Royal Hospital for Children, University of Glasgow
| | - E Tobias
- Academic Unit of Medical Genetics and Clinical Pathology, Laboratory Medicine Building, Queen Elizabeth University Hospital, University of Glasgow
| | - E Curtis
- MRC Lifecourse Epidemiology Unit, University of Southampton
| | - C Parsons
- MRC Lifecourse Epidemiology Unit, University of Southampton
| | - K Maslin
- MRC Lifecourse Epidemiology Unit, University of Southampton
| | - S D'Angelo
- MRC Lifecourse Epidemiology Unit, University of Southampton
| | - R Moon
- MRC Lifecourse Epidemiology Unit, University of Southampton
| | - S Crozier
- MRC Lifecourse Epidemiology Unit, University of Southampton
| | - F Gossiel
- Academic Unit of Bone Metabolism, University of Sheffield
| | - N Bishop
- Academic Unit of Child Health, University of Sheffield
| | - S Kennedy
- Nuffield Department of Women's & Reproductive Health, John Radcliffe Hospital, University of Oxford
| | - A Papageorghiou
- Nuffield Department of Women's & Reproductive Health, John Radcliffe Hospital, University of Oxford
| | - R Fraser
- Department of Obstetrics and Gynaecology, Sheffield Hospitals NHS Trust, University of Sheffield
| | - S Gandhi
- Department of Obstetrics and Gynaecology, Sheffield Hospitals NHS Trust, University of Sheffield
| | | | - H Inskip
- MRC Lifecourse Epidemiology Unit, University of Southampton
| | - K Godfrey
- MRC Lifecourse Epidemiology Unit, University of Southampton
| | - I Schoenmakers
- Department of Medicine, Faculty of Medicine and Health Sciences, University of East Anglia
| | - M K Javaid
- NIHR Oxford Biomedical Research Centre, University of Oxford
| | - R Eastell
- Academic Unit of Bone Metabolism, University of Sheffield
| | - C Cooper
- MRC Lifecourse Epidemiology Unit, University of Southampton
| | - N Harvey
- MRC Lifecourse Epidemiology Unit, University of Southampton
| | | | - A Howden
- School of Life Sciences, University of Dundee
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - E H Gray
- Institute of Hepatology, Foundation for Liver Research
- School of Immunology and Microbial Sciences, King's College London
| | - S Azarian
- Institute of Hepatology, Foundation for Liver Research
| | - A Riva
- Institute of Hepatology, Foundation for Liver Research
- School of Immunology and Microbial Sciences, King's College London
| | - H Edwards
- Institute of Hepatology, Foundation for Liver Research
- School of Immunology and Microbial Sciences, King's College London
| | - M J W McPhail
- School of Immunology and Microbial Sciences, King's College London
- Institute of Liver Studies & Transplantation, King's College Hospital
| | - R Williams
- Institute of Hepatology, Foundation for Liver Research
- School of Immunology and Microbial Sciences, King's College London
| | - S Chokshi
- Institute of Hepatology, Foundation for Liver Research
- School of Immunology and Microbial Sciences, King's College London
| | - V C Patel
- Institute of Hepatology, Foundation for Liver Research
- School of Immunology and Microbial Sciences, King's College London
- Institute of Liver Studies & Transplantation, King's College Hospital
| | - L A Edwards
- Institute of Hepatology, Foundation for Liver Research
- School of Immunology and Microbial Sciences, King's College London
| | - D Page
- University of Manchester
- Manchester Metropolitan University
| | - M Miossec
- Manchester Metropolitan University
- University of Newcastle
| | | | | | | | | | | | - M Badat
- MRC Molecular Haematology Unit, MRC Weatherall Institute of Molecular Medicine, University of Oxford, John Radcliffe Hospital
| | - S Mettananda
- Department of Paediatrics, Faculty of Medicine, University of Kelaniya
| | - P Hua
- MRC Molecular Haematology Unit, MRC Weatherall Institute of Molecular Medicine, University of Oxford, John Radcliffe Hospital
| | - R Schwessinger
- MRC Molecular Haematology Unit, MRC Weatherall Institute of Molecular Medicine, University of Oxford, John Radcliffe Hospital
| | - J Hughes
- MRC Molecular Haematology Unit, MRC Weatherall Institute of Molecular Medicine, University of Oxford, John Radcliffe Hospital
| | - D Higgs
- MRC Molecular Haematology Unit, MRC Weatherall Institute of Molecular Medicine, University of Oxford, John Radcliffe Hospital
| | - J Davies
- MRC Molecular Haematology Unit, MRC Weatherall Institute of Molecular Medicine, University of Oxford, John Radcliffe Hospital
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Clegg TA, Doyle M, Ryan E, More SJ, Gormley E. Characteristics of Mycobacterium bovis infected herds tested with the interferon-gamma assay. Prev Vet Med 2019; 168:52-59. [PMID: 31097123 DOI: 10.1016/j.prevetmed.2019.04.004] [Citation(s) in RCA: 9] [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: 01/21/2019] [Revised: 04/12/2019] [Accepted: 04/12/2019] [Indexed: 01/09/2023]
Abstract
The IFN-γ (interferon gamma) assay is used in Ireland as an ancillary diagnostic test to the single intradermal comparative tuberculin test (SICTT) to maximise the detection of Mycobacterium bovis infected animals (bTB) in cattle herds. Understanding the relationships between herd and animal risk factors and IFN-γ test results is critical to enable the development and evaluation of policy measures on how best to use the test. In this study, we set out to characterise Irish herds with IFN-γ test positive animals in terms of herd size, number of SICTT reactors and number of IFN-γ positive tests, and to evaluate the IFN-γ test in terms of the test cut-off values. The results showed that larger herds with more SICTT reactors were likely to have more IFN-γ positives in the herd, and herds with an IFN-γ test positive animal that was also positive for bTB lesions at post-mortem had higher numbers of IFN-γ positive animals in the herd. Raising the cut-off values for the IFN-γ test only marginally decreased the combined sensitivity of the IFN-γ and the SICTT for diagnosis of bTB lesioned animals. The analysis has provided valuable information on the performance of the IFN-γ test as it is used under current bTB infection levels in Ireland.
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Affiliation(s)
- T A Clegg
- Centre for Veterinary Epidemiology and Risk Analysis, UCD School of Veterinary Medicine, University College Dublin, Belfield, Dublin 4, Ireland.
| | - M Doyle
- Tuberculosis Diagnostics and Immunology Research Laboratory, School of Veterinary Medicine, University College Dublin, UCD, Belfield, Dublin 4, Ireland.
| | - E Ryan
- Department of Agriculture, Food & the Marine, Backweston, Co. Kildare, Ireland.
| | - S J More
- Centre for Veterinary Epidemiology and Risk Analysis, UCD School of Veterinary Medicine, University College Dublin, Belfield, Dublin 4, Ireland.
| | - E Gormley
- Tuberculosis Diagnostics and Immunology Research Laboratory, School of Veterinary Medicine, University College Dublin, UCD, Belfield, Dublin 4, Ireland.
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McGovern M, Morrissey P, Ryan E. Can Early Changes in Vital signs Predict Duration of Antibiotic Therapy in Suspected Neonatal Sepsis? Ir Med J 2019; 112:909. [PMID: 31241276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Aims Suspected sepsis remains a leading causes of Neonatal Intensive Care Unit admission, with infants often receiving 48-72 hours of empirical antibiotic therapy. Early in treatment it is difficult to predict infants who will require prolonged antibiotic therapy. Our aim was to assess if vital sign measurements in the initial period of treatment can predict those neonates requiring prolonged antibiotic therapy in term and late-preterm infants. Methods Data was retrospectively collected over 1 year on neonates admitted to our institute for antibiotics. Infants were classified as standard (<48hours duration) or prolonged (>48hours duration) antibiotic therapy. Results Respiratory rate on admission and 12 hours after initiation of therapy correlated significantly with duration of antibiotic therapy and infants requiring prolonged therapy were more likely to have one or more abnormal vital signs 12 hours after initiation of treatment (p<0.05). Conclusion Respiratory rate shows a weak positive correlation with antibiotic duration. Infants requiring prolonged therapy were more likely to have abnormal vital signs 12 hours after initiating antibiotic therapy. Changes in vital signs maybe useful in detecting infants who will require prolonged antibiotic therapy.
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Affiliation(s)
- M McGovern
- Department of Paediatrics and Neonatology University College Hospital Galway
- Academic Department of Paediatrics, National University of Ireland, Galway
| | - P Morrissey
- Department of Paediatrics and Neonatology University College Hospital Galway
- Academic Department of Paediatrics, National University of Ireland, Galway
| | - E Ryan
- Department of Paediatrics and Neonatology University College Hospital Galway
- Academic Department of Paediatrics, National University of Ireland, Galway
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17
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Kyne S, Donohue S, Ryan E. Management of Acute Wheeze in a Paediatric Emergency Department. Ir Med J 2019; 112:923. [PMID: 31245965] [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: 06/09/2023]
Affiliation(s)
- S Kyne
- Department of Paediatrics, University Hospital Galway, Ireland
| | - S Donohue
- Department of Paediatrics, University Hospital Galway, Ireland
| | - E Ryan
- Department of Paediatrics, University Hospital Galway, Ireland
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18
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Ryan E, Poole C. EP-2211 Impact of virtual learning environment on students’ satisfaction, engagement, recall and retention. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)32631-3] [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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19
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Smith A, Ryan E, O’Keeffe D, O’Donovan D. Meconium Ileus in Two Irish Newborns: The Presenting Feature of Cystic Fibrosis. Ir Med J 2019; 112:901. [PMID: 30932447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Introduction Meconium Ileus (MI) is the presenting feature of CF in approximately 10-15% of cases. This report outlines the clinical presentation, imaging and management of two neonates with MI and subsequent diagnosis of Cystic Fibrosis (CF). Methods A retrospective chart review was performed to evaluate the clinical course of two neonates with MI. Results Case 1 and 2 presented clinically with signs of abdominal obstruction. Subsequent laparotomies confirmed MI. MI is strongly associated with CF and CF is the most common genetically inherited disease in Ireland. Genetic testing was positive for a homozygous ∆ F508 mutation in both case 1 and 2, securing a diagnosis of MI secondary to CF. Conclusion Our cases highlight that all infants born in Ireland with MI should be considered as CF positive until proven otherwise.
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Affiliation(s)
- A Smith
- Department of Neonatology, University Hospital, Galway
| | - E Ryan
- Department of Neonatology, University Hospital, Galway
| | - D O’Keeffe
- Department of Radiology, University Hospital Galway
| | - D O’Donovan
- Department of Neonatology, University Hospital, Galway
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20
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Ring SC, Purfield DC, Good M, Breslin P, Ryan E, Blom A, Evans RD, Doherty ML, Bradley DG, Berry DP. Variance components for bovine tuberculosis infection and multi-breed genome-wide association analysis using imputed whole genome sequence data. PLoS One 2019; 14:e0212067. [PMID: 30763354 PMCID: PMC6375599 DOI: 10.1371/journal.pone.0212067] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2018] [Accepted: 01/25/2019] [Indexed: 11/18/2022] Open
Abstract
Bovine tuberculosis (bTB) is an infectious disease of cattle generally caused by Mycobacterium bovis, a bacterium that can elicit disease humans. Since the 1950s, the objective of the national bTB eradication program in Republic of Ireland was the biological extinction of bTB; that purpose has yet to be achieved. Objectives of the present study were to develop the statistical methodology and variance components to undertake routine genetic evaluations for resistance to bTB; also of interest was the detection of regions of the bovine genome putatively associated with bTB infection in dairy and beef breeds. The novelty of the present study, in terms of research on bTB infection, was the use of beef breeds in the genome-wide association and the utilization of imputed whole genome sequence data. Phenotypic bTB data on 781,270 animals together with imputed whole genome sequence data on 7,346 of these animals' sires were available. Linear mixed models were used to quantify variance components for bTB and EBVs were validated. Within-breed and multi-breed genome-wide associations were undertaken using a single-SNP regression approach. The estimated genetic standard deviation (0.09), heritability (0.12), and repeatability (0.30) substantiate that genetic selection help to eradicate bTB. The multi-breed genome-wide association analysis identified 38 SNPs and 64 QTL regions associated with bTB infection; two QTL regions (both on BTA23) identified in the multi-breed analysis overlapped with the within-breed analyses of Charolais, Limousin, and Holstein-Friesian. Results from the association analysis, coupled with previous studies, suggest bTB is controlled by an infinitely large number of loci, each having a small effect. The methodology and results from the present study will be used to develop national genetic evaluations for bTB in the Republic of Ireland. In addition, results can also be used to help uncover the biological architecture underlying resistance to bTB infection in cattle.
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Affiliation(s)
- S. C. Ring
- Teagasc, Animal and Grassland Research and Innovation Centre, Moorepark, Fermoy, Co. Cork, Ireland
- School of Veterinary Medicine, University College Dublin, Belfield, Dublin 4, Ireland
| | - D. C. Purfield
- Teagasc, Animal and Grassland Research and Innovation Centre, Moorepark, Fermoy, Co. Cork, Ireland
| | - M. Good
- Department of Agriculture, Food and the Marine, Dublin 2, Ireland
| | - P. Breslin
- Department of Agriculture, Food and the Marine, Dublin 2, Ireland
| | - E. Ryan
- Department of Agriculture, Food and the Marine, Dublin 2, Ireland
| | - A. Blom
- Irish Cattle Breeding Federation, Highfield House, Bandon, Co. Cork, Ireland
| | - R. D. Evans
- Irish Cattle Breeding Federation, Highfield House, Bandon, Co. Cork, Ireland
| | - M. L. Doherty
- School of Veterinary Medicine, University College Dublin, Belfield, Dublin 4, Ireland
| | - D. G. Bradley
- Smurfit Institute of Genetics, University of Dublin, Trinity College, Dublin, Ireland
| | - D. P. Berry
- Teagasc, Animal and Grassland Research and Innovation Centre, Moorepark, Fermoy, Co. Cork, Ireland
- * E-mail:
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Feehan S, Fox E, Greene J, Ryan E. Determine whether having a specified weigh day improves compliance with patient weighing and MUST screening guidelines on admission and one week post-admission in an acute hospital? Clin Nutr ESPEN 2019. [DOI: 10.1016/j.clnesp.2018.12.077] [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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22
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Allen WL, Dunne PD, McDade S, Scanlon E, Loughrey M, Coleman H, McCann C, McLaughlin K, Nemeth Z, Syed N, Jithesh P, Arthur K, Wilson R, Coyle V, McArt D, Murray GI, Samuel L, Nuciforo P, Jimenez J, Argiles G, Dienstmann R, Tabernero J, Messerini L, Nobili S, Mini E, Sheahan K, Ryan E, Johnston PG, Van Schaeybroeck S, Lawler M, Longley DB. Transcriptional subtyping and CD8 immunohistochemistry identifies poor prognosis stage II/III colorectal cancer patients who benefit from adjuvant chemotherapy. JCO Precis Oncol 2018; 2018. [PMID: 30088816 PMCID: PMC6040635 DOI: 10.1200/po.17.00241] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [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] [Indexed: 01/15/2023] Open
Abstract
Purpose Transcriptomic profiling of colorectal cancer (CRC) has led to the identification of four consensus molecular subtypes (CMS1 to 4) that have prognostic value in stage II and III disease. More recently, the Colorectal Cancer Intrinsic Subtypes (CRIS) classification system has helped to define the biology specific to the epithelial component of colorectal tumors; however, the clinical value of these classification systems in the prediction of response to standard-of-care adjuvant chemotherapy remains unknown. Patients and Methods Using samples from four European sites, we assembled a novel cohort of patients with stage II and III CRC (n = 156 samples) and performed transcriptomic profiling and targeted sequencing and generated a tissue microarray to enable integrated multiomics analyses. We also accessed data from two published cohorts of patients with stage II and III CRC: GSE39582 and GSE14333 (n = 479 and n = 185 samples, respectively). Results The epithelial-rich CMS2 subtype of CRC benefitted significantly from treatment with adjuvant chemotherapy in both stage II and III disease (P = .02 and P < .001, respectively), whereas the CMS3 subtype significantly benefitted in stage III only (P = .001). After CRIS substratification of CMS2, we observed that only the CRIS-C subtype significantly benefitted from treatment with adjuvant chemotherapy in stage II and III disease (P = .0081 and P < .001, respectively), whereas the CRIS-D subtype significantly benefitted in stage III only (P = .0034). We also observed that CRIS-C patients with low levels of CD8+ tumor-infiltrating lymphocytes were most at risk for relapse in both stage II and III disease (log-rank P = .0031; hazard ratio, 12.18 [95% CI, 1.51 to 98.58]). Conclusion Patient stratification using a combination of transcriptional subtyping and CD8 immunohistochemistry analyses is capable of identifying patients with poor prognostic stage II and III disease who benefit from adjuvant standard-of-care chemotherapy. These findings are particularly relevant for patients with stage II disease, where the overall benefit of adjuvant chemotherapy is marginal.
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Affiliation(s)
- W L Allen
- Centre for Cancer Research and Cell Biology, Queen's University Belfast, UK
| | - P D Dunne
- Centre for Cancer Research and Cell Biology, Queen's University Belfast, UK
| | - S McDade
- Centre for Cancer Research and Cell Biology, Queen's University Belfast, UK
| | - E Scanlon
- Centre for Cancer Research and Cell Biology, Queen's University Belfast, UK
| | - M Loughrey
- Centre for Cancer Research and Cell Biology, Queen's University Belfast, UK
| | - H Coleman
- Centre for Cancer Research and Cell Biology, Queen's University Belfast, UK
| | - C McCann
- Centre for Cancer Research and Cell Biology, Queen's University Belfast, UK
| | - K McLaughlin
- Centre for Cancer Research and Cell Biology, Queen's University Belfast, UK
| | - Z Nemeth
- Centre for Cancer Research and Cell Biology, Queen's University Belfast, UK
| | - N Syed
- Sidra Medical and Research Center, Qatar
| | - P Jithesh
- Sidra Medical and Research Center, Qatar
| | - K Arthur
- Centre for Cancer Research and Cell Biology, Queen's University Belfast, UK
| | - R Wilson
- Centre for Cancer Research and Cell Biology, Queen's University Belfast, UK
| | - V Coyle
- Centre for Cancer Research and Cell Biology, Queen's University Belfast, UK
| | - D McArt
- Centre for Cancer Research and Cell Biology, Queen's University Belfast, UK
| | | | | | - P Nuciforo
- University Hospital Vall d'Hebron, Barcelona, Spain
| | - J Jimenez
- University Hospital Vall d'Hebron, Barcelona, Spain
| | - G Argiles
- University Hospital Vall d'Hebron, Barcelona, Spain
| | - R Dienstmann
- University Hospital Vall d'Hebron, Barcelona, Spain
| | - J Tabernero
- University Hospital Vall d'Hebron, Barcelona, Spain
| | | | | | - E Mini
- University of Florence, Italy
| | - K Sheahan
- School of Medicine and Medical Science, University College Dublin
| | - E Ryan
- School of Medicine and Medical Science, University College Dublin
| | - P G Johnston
- Centre for Cancer Research and Cell Biology, Queen's University Belfast, UK
| | - S Van Schaeybroeck
- Centre for Cancer Research and Cell Biology, Queen's University Belfast, UK
| | - M Lawler
- Centre for Cancer Research and Cell Biology, Queen's University Belfast, UK
| | - D B Longley
- Centre for Cancer Research and Cell Biology, Queen's University Belfast, UK
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Verrilli L, Vaughn S, Ryan E, Lathi R. Subclinical chronic endometritis and test of cure rates in a recurrent pregnancy loss cohort. Fertil Steril 2018. [DOI: 10.1016/j.fertnstert.2018.07.733] [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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24
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Walsh G, Curley S, Costello A, Elliott L, Ryan E, Blanco A, Kolch W, Eissner G. PO-311 Characterisation of colorectal tumour endothelial cells. ESMO Open 2018. [DOI: 10.1136/esmoopen-2018-eacr25.824] [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] Open
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25
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Jones TP, Brennan PC, Ryan E. THE IMPACT OF DIGITAL TECHNOLOGY ON DOSE REDUCTION IN PAEDIATRIC CARDIAC CATHETERISATION WITHIN A LARGE METROPOLITAN CHILDREN'S HOSPITAL. Radiat Prot Dosimetry 2018; 179:358-363. [PMID: 29309695 DOI: 10.1093/rpd/ncx294] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/03/2017] [Accepted: 12/06/2017] [Indexed: 06/07/2023]
Abstract
This study examines the kerma-area product (PKA) levels from paediatric cardiac catheterisations at a major Children's Hospital over three different time periods in order to gain an understanding of the causation of dose variations over time and to present a model for dose reduction. A retrospective review of 1245 paediatric procedural records was undertaken. This cohort consisted of patients that were catheterised over a period from November 2007 to July 2009, October 2009 to November 2011 and January 2016 to December 2016. The age distribution was from newborn to 18 years. Archived (PKA) readings were retrieved and analysed. The 75th percentile PKA values for the specific age categories over time periods (1, 2, 3) were 0-30 days-(5.47, 1.37, 1.37) Gy cm2; 1-12 months-(6.42, 2.03, 1.06) Gy cm2; 1-3 years-(11.25, 3.20, 1.25) Gy cm2; 3-5 years-(12.65, 3.72, 2.88) Gy cm2; 5-10 years-(12.80, 8.53, 3.52) Gy cm2; 10-15 years-(27.92, 10.85, 2.97) Gy cm2; >15 years-(29.09, 27.81, 11.65) Gy cm2. Using newer imaging technologies, optimising dose reduction strategies and regular dose auditing can transform radiation dose delivery for paediatric x-ray examinations. Our centre provides a template for dose reduction success worldwide.
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Affiliation(s)
- T P Jones
- Medical Imaging Optimisation and Perception Group (MIOPeG), Discipline of Medical Radiation Sciences, Faculty of Health Science, University of Sydney, 75 East Street, Lidcombe NSW 2141, Australia
| | - P C Brennan
- Medical Imaging Optimisation and Perception Group (MIOPeG), Discipline of Medical Radiation Sciences, Faculty of Health Science, University of Sydney, 75 East Street, Lidcombe NSW 2141, Australia
| | - E Ryan
- Medical Imaging Optimisation and Perception Group (MIOPeG), Discipline of Medical Radiation Sciences, Faculty of Health Science, University of Sydney, 75 East Street, Lidcombe NSW 2141, Australia
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Chaudhari N, Toshniwal P, Clemons T, Stevenson A, Ryan E, Jarolimek W, Wood F, Fear M. 527 Targeting Lysyl Oxidase (LOX) Activity to Improve Scar Appearance. J Burn Care Res 2018. [DOI: 10.1093/jbcr/iry006.450] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- N Chaudhari
- University of Western Australia, Crawley, Australia; Pharmaxis Ltd, Sydney, Australia; burns service Western Australia, Murdoch, Australia
| | - P Toshniwal
- University of Western Australia, Crawley, Australia; Pharmaxis Ltd, Sydney, Australia; burns service Western Australia, Murdoch, Australia
| | - T Clemons
- University of Western Australia, Crawley, Australia; Pharmaxis Ltd, Sydney, Australia; burns service Western Australia, Murdoch, Australia
| | - A Stevenson
- University of Western Australia, Crawley, Australia; Pharmaxis Ltd, Sydney, Australia; burns service Western Australia, Murdoch, Australia
| | - E Ryan
- University of Western Australia, Crawley, Australia; Pharmaxis Ltd, Sydney, Australia; burns service Western Australia, Murdoch, Australia
| | - W Jarolimek
- University of Western Australia, Crawley, Australia; Pharmaxis Ltd, Sydney, Australia; burns service Western Australia, Murdoch, Australia
| | - F Wood
- University of Western Australia, Crawley, Australia; Pharmaxis Ltd, Sydney, Australia; burns service Western Australia, Murdoch, Australia
| | - M Fear
- University of Western Australia, Crawley, Australia; Pharmaxis Ltd, Sydney, Australia; burns service Western Australia, Murdoch, Australia
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27
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Ramsay C, McRae C, Ryan E, McCallum A, Wellington L, Lauder L, Millar R, Haunch S, Othieno R. Carbon dioxide ingress into residential houses at Gorebridge in Midlothian, Scotland, United Kingdom. Eur J Public Health 2017. [DOI: 10.1093/eurpub/ckx187.278] [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] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- C Ramsay
- Health Protection Scotland, National Health Service, National Services Scotland, Glasgow, UK
| | - C McRae
- Health Protection Scotland, National Health Service, National Services Scotland, Glasgow, UK
| | - E Ryan
- Environmental Health Services, Midlothian Council, Dalkeith, UK
| | - A McCallum
- Directorate of Public Health and Health Policy, NHS Lothian, Edinburgh, UK
| | - L Wellington
- Directorate of Public Health and Health Policy, NHS Lothian, Edinburgh, UK
| | - L Lauder
- Environmental Health Services, Midlothian Council, Dalkeith, UK
| | - R Millar
- Public Health Department, NHS Tayside, Dundee, UK
| | - S Haunch
- Scottish Environment Protection Agency (SEPA), Edinburgh, UK
| | - R Othieno
- Directorate of Public Health and Health Policy, NHS Lothian, Edinburgh, UK
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28
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Jones TP, Brennan PC, Ryan E. Cumulative Effective and Individual Organ Dose Levels in Paediatric Patients Undergoing Multiple Catheterisations for Congenital Heart Disease. Radiat Prot Dosimetry 2017; 176:252-257. [PMID: 28115657 DOI: 10.1093/rpd/ncx003] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/15/2016] [Accepted: 01/06/2017] [Indexed: 06/06/2023]
Abstract
This study examines the cumulative radiation dose levels received by a group of children who underwent multiple cardiac catheterisation procedures during the investigation and management of congenital heart disease (CHD). The purpose is to calculate cumulative doses, identify higher dose individuals, outline the inconsistencies with risk assessment and encourage the establishment of dose databases in order to facilitate the longitudinal research necessary to better understand health risks. A retrospective review of patient records for 117 paediatric patients who have undergone two or more cardiac catheterisations for the investigation of CHD was undertaken. This cohort consisted of patients who were catheterised over a period from September 2002 to August 2014. The age distribution was from newborn to 17 y. Archived kerma-area product (PKA) and fluoroscopy time (T) readings were retrieved and analysed. Cumulative effective and individual organ doses were determined. The cumulative PKA levels ranged from 1.8 to 651.2 Gycm2, whilst cumulative effective dose levels varied from 2 to 259 mSv. The cumulative fluoroscopy time was shown to vary from 8.1 to 193.5 min. Median cumulative organ doses ranged from 3 to 94 mGy. Cumulative effective dose levels are highly variable but may exceed 250 mSv. Individual organ and effective dose measurements remain useful for comparison purposes between institutions although current methodologies used for determining lifetime risks are inadequate.
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Affiliation(s)
- T P Jones
- Medical Imaging Optimisation and Perception Group (MIOPeG), Discipline of Medical Radiation Sciences, Faculty of Health Science, University of Sydney, 75 East Street, Lidcombe, NSW2141, Australia
| | - P C Brennan
- Medical Imaging Optimisation and Perception Group (MIOPeG), Discipline of Medical Radiation Sciences, Faculty of Health Science, University of Sydney, 75 East Street, Lidcombe, NSW2141, Australia
| | - E Ryan
- Medical Imaging Optimisation and Perception Group (MIOPeG), Discipline of Medical Radiation Sciences, Faculty of Health Science, University of Sydney, 75 East Street, Lidcombe, NSW2141, Australia
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Creavin B, Kelly ME, Ryan E, Winter DC. Meta-analysis of the impact of surgical approach on the grade of mesorectal excision in rectal cancer. Br J Surg 2017; 104:1609-1619. [PMID: 29044484 DOI: 10.1002/bjs.10664] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2017] [Revised: 05/17/2017] [Accepted: 07/07/2017] [Indexed: 12/20/2022]
Abstract
BACKGROUND The subspecialization of colorectal surgeons, and improvements in the quality of mesorectal excision have revolutionized rectal cancer surgery. With the increasing use of minimally invasive techniques, the completeness of the mesorectal excision has been questioned. This study aimed to assess the pathological outcomes of open versus laparoscopic rectal resection. METHODS A meta-analysis of RCTs was undertaken. The primary endpoint was the adequacy of the mesorectal excision. Secondary endpoints included circumferential resection margin and distance to resection margins. RESULTS Four studies were included, reporting on 2319 patients; 972 (41·9 per cent) had open and 1347 (58·1 per cent) had laparoscopic resections. Meta-analysis of adequacy of the mesorectal excision showed a small difference in achieving an intact mesorectum in favour of open surgery (risk ratio (RR) 1·06, 95 per cent c.i. 1·02 to 1·10; P = 0·001). Superficial defects were more common in laparoscopic surgery (RR 0·70, 0·54 to 0·89; P = 0·004). Deep mesorectal defects (RR 0·78, 0·51 to 1·20; P = 0·256), circumferential margin (CRM) positivity (RR 0·85, 0·62 to 1·16; P = 0·310), and distance to radial (mean difference (MD) -0·06, 95 per cent c.i. -0·10 to 0·23; P = 0·443) and distal (MD 0·03, -0·06 to 0·12; P = 0·497) margins were all similar. A complete resection (intact mesorectum, negative CRM and distal margin) was achieved in 350 of 478 patients (73·2 per cent) in the laparoscopic group and 372 of 457 (81·4 per cent) in the open group (risk difference (RD) 8 (95 per cent c.i. 3 to 13) per cent; P = 0·003). However, an acceptable mesorectum (intact or superficial defects only) was present in 1254 of 1308 (95·9 per cent) and 916 of 949 (96·5 per cent) in the laparoscopic and open groups respectively (RD 1 (-1 to 3) per cent; P = 0·263). CONCLUSION Small differences in mesorectal quality were evident between open and laparoscopic rectal resections. This may be attributable to use of laparoscopic instruments; however, to date minor defects have not affected oncological outcomes.
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Affiliation(s)
- B Creavin
- Centre for Colorectal Disease, St Vincent's University Hospital, Elm Park, Dublin 4, Ireland
| | - M E Kelly
- Centre for Colorectal Disease, St Vincent's University Hospital, Elm Park, Dublin 4, Ireland
| | - E Ryan
- Centre for Colorectal Disease, St Vincent's University Hospital, Elm Park, Dublin 4, Ireland
| | - D C Winter
- Centre for Colorectal Disease, St Vincent's University Hospital, Elm Park, Dublin 4, Ireland
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Patel P, Rebollo-Mesa I, Ryan E, Sinha MD, Marks SD, Banga N, Macdougall IC, Webb MC, Koffman G, Olsburgh J. Prophylactic Ureteric Stents in Renal Transplant Recipients: A Multicenter Randomized Controlled Trial of Early Versus Late Removal. Am J Transplant 2017; 17:2129-2138. [PMID: 28188678 DOI: 10.1111/ajt.14223] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [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: 11/20/2016] [Revised: 01/19/2017] [Accepted: 01/31/2017] [Indexed: 01/25/2023]
Abstract
Prophylactic ureteric stenting in renal transplantation reduces major urological complications; however, morbidity is related to the indwelling duration of a stent. We aimed to determine the optimal duration for stents in this clinical setting. Patients (aged 2-75 years) from six UK hospitals who were undergoing renal transplantation were recruited and randomly assigned to either early stent removal at 5 days (without cystoscopy) or late removal at 6 weeks after transplantation (with cystoscopy). The primary outcome was a composite of stent-related complications defined as pain, visible hematuria, migration, fragmentation, and urinary tract infections (UTIs) within 3 mo of transplantation. Between May 2010 and Nov 2013, we randomly assigned 227 participants, with 205 included in the final analysis of the primary outcome. Stent-related complications were significantly higher in the late versus early stent removal groups (36 of 126 [28.6%] vs. 6 of 79 [7.6%]; p < 0.001). The majority of stent complications consisted of UTIs, with an incidence of 31 of 126 (24.6%) in the late group compared with 6 of 79 (7.6%) in the early group (p = 0.004). We found early stent removal on day 5 significantly reduced stent-related complications and improved quality of life in the first 3 mo after transplantation (ISRCTN09184595).
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Affiliation(s)
- P Patel
- Department of Nephrology, Transplantation and Urology, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - I Rebollo-Mesa
- MRC Centre for Transplantation, King's College Hospital; Global Exploratory Development, UCB Biopharma, London, UK
| | - E Ryan
- Biostatistics Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - M D Sinha
- Department of Paediatric Nephrology, Evelina London Children's Hospital, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - S D Marks
- Department of Paediatric Nephrology, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - N Banga
- Department of Renal Transplantation, Royal Free London NHS Foundation Trust, London, UK
| | - I C Macdougall
- Department of Renal Medicine, King's College Hospital, London, UK
| | - M C Webb
- Department of Renal Medicine, East Kent Hospitals University NHS Foundation Trust, Canterbury, UK
| | - G Koffman
- Department of Nephrology, Transplantation and Urology, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - J Olsburgh
- Department of Nephrology, Transplantation and Urology, Guy's and St Thomas' NHS Foundation Trust, London, UK
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31
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Maher B, Ryan E, Little M, Boardman P, Stedman B. The management of colorectal liver metastases. Clin Radiol 2017; 72:617-625. [DOI: 10.1016/j.crad.2017.05.016] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2017] [Accepted: 05/30/2017] [Indexed: 02/07/2023]
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Abstract
OBJECTIVE A clinical audit was performed to evaluate whether Acapsil micropore particle technology (MPPT) powder could improve the management of acute wounds to heal by secondary intention. METHOD Wounds, which could be characterised as sloughy, wet and probably infected, normally managed by debridement followed by negative pressure wound therapy (NPWT), were included in the evaluation. The MPPT powder was applied topically to the wound surface either once daily or on alternate days, with each wound receiving a total of two to five applications. Most patients had NPWT after the MPPT powder treatment had finished to assist healing. RESULTS The study included nine patients with dehisced surgical wounds and one with a category IV pressure ulcer (PU). The wounds were generally covered in slough, exudate and showing signs of local infection. The topical MPPT powder rapidly desloughed the wounds, controlled exudate levels, promoted granulation and was well tolerated. All wounds proceeded towards closure. CONCLUSION Comparison of the present data with MPPT powder to standard treatment suggests that the speed of healing using MPPT was improved. Further examination is required to determine if this reduces dressing changes, nursing time, and financial cost.
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Affiliation(s)
- E Ryan
- Acting Tissue Viability Lead, Bristol University Hospital, Bristol Royal Infirmary, Upper Maudlin St., Bristol, UK
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33
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Micci L, Harper J, Paganini S, King C, Ryan E, Lifson J, Paiardini M. OA4-1 Combined IL-21 and IFNα treatment limits residual inflammation, viral persistence and delays viral rebound in SIV-infected rhesus macaques. J Virus Erad 2017. [DOI: 10.1016/s2055-6640(20)30841-4] [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: 10/23/2022] Open
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Ryan E, Tartarini W, Palastro M, Lukas S. 0472 OBSTRUCTIVE SLEEP APNEA IN A PSYCHIATRIC POPULATION: HIGH PREVALENCE AND LACK OF RISK FACTORS. Sleep 2017. [DOI: 10.1093/sleepj/zsx050.471] [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: 11/15/2022] Open
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35
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Jones T, Brennan PC, Mello-Thoms C, Ryan E. CONTEMPORARY AUSTRALIAN DOSE AREA PRODUCT LEVELS IN THE FLUOROSCOPIC INVESTIGATION OF PAEDIATRIC CONGENITAL HEART DISEASE. Radiat Prot Dosimetry 2017; 173:374-379. [PMID: 26908924 DOI: 10.1093/rpd/ncw012] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/21/2015] [Accepted: 01/06/2016] [Indexed: 06/05/2023]
Abstract
This study examines radiation dose levels delivered to children from birth to 15 y of age in the investigation of congenital heart disease (CHD) at a major Sydney children's hospital. The aims are to compare values with those derived from similar studies, to provide a template for more consistent dose reporting, to establish local and national diagnostic reference levels and to contribute to the worldwide paediatric dosimetry database. A retrospective review of 1007 paediatric procedural records was undertaken. The cohort consisted of 795 patients over a period from January 2007 to December 2012 who have undergone cardiac catheterisation for the investigation of CHD. The age range included was from the day of birth to 15 y. Archived dose area product (DAP) and fluoroscopy time (FT) readings were retrieved and analysed. The mean, median, 25th and 75th percentile DAP levels were calculated for six specific age groupings. The 75th percentile DAP values for the specific age categories were as follows: 0-30 d-1.9 Gy cm2, 1-12 months-2.9 Gy cm2, 1-3 y-5.3 Gy cm2, 3-5 y-6.2 Gy cm2, 5-10 y-7.5 Gy cm2 and 10-15 y-17.3 Gy cm2. These levels were found to be lower than the values reported in comparable overseas studies. Individual year-specific levels were determined, and it is proposed that these are more useful than the common grouping method. The age-specific 75th percentile DAP levels outlined in this study can be used as baseline local diagnostic reference levels. The needs for the standardisation of DAP reporting and for a greater range of age-specific diagnostic reference levels have been highlighted. For the first time, Australian dose values for paediatric cardiac catheterisation are presented.
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Affiliation(s)
- T Jones
- Medical Imaging Optimisation and Perception Group (MIOPeG), Discipline of Medical Radiation Sciences, Faculty of Health Science, University of Sydney, 75 East Street, Room M208, Lidcombe, NSW 2141, Australia
| | - P C Brennan
- Medical Imaging Optimisation and Perception Group (MIOPeG), Discipline of Medical Radiation Sciences, Faculty of Health Science, University of Sydney, 75 East Street, Room M208, Lidcombe, NSW 2141, Australia
| | - C Mello-Thoms
- Medical Imaging Optimisation and Perception Group (MIOPeG), Discipline of Medical Radiation Sciences, Faculty of Health Science, University of Sydney, 75 East Street, Room M208, Lidcombe, NSW 2141, Australia
| | - E Ryan
- Medical Imaging Optimisation and Perception Group (MIOPeG), Discipline of Medical Radiation Sciences, Faculty of Health Science, University of Sydney, 75 East Street, Room M208, Lidcombe, NSW 2141, Australia
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Hayden J, Crealey M, O'Connor B, Mortell A, Ryan E. A Turn for the Worse. Ir Med J 2017; 110:556. [PMID: 28665095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Affiliation(s)
- J Hayden
- Department of Paediatrics, Galway University Hospital, Galway, Ireland
| | - M Crealey
- Department of Paediatrics, Galway University Hospital, Galway, Ireland
| | - B O'Connor
- Department of Paediatric Surgery, Children's University Hospital, Temple St, Dublin 1, Ireland
| | - A Mortell
- Department of Paediatric Surgery, Children's University Hospital, Temple St, Dublin 1, Ireland
- Department of Paediatric Surgery, Our Lady's Children's Hospital, Crumlin, Dublin, Ireland
| | - E Ryan
- Department of Paediatrics, Galway University Hospital, Galway, Ireland
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Thompson A, Dickinson R, Murphy F, Thomson JP, Marriott H, Tavares A, Willson J, Williams L, Lewis A, Mirchandani A, Dos Santos Coelho P, Doherty C, Ryan E, Watts E, Morton NM, Forbes S, Stimson RH, Hameed AG, Arnold N, Preston J, Lawrie A, Finisguerra V, Mazzone M, Sadiku P, Goveia J, Taverna F, Carmeliet P, Foster S, Chilvers E, Cowburn A, Dockrell D, Johnson R, Meehan RR, Whyte M, Walmsley S. Hypoxia determines survival outcomes of bacterial infection through HIF-1alpha dependent re-programming of leukocyte metabolism. Sci Immunol 2017; 2:eaal2861. [PMID: 28386604 PMCID: PMC5380213 DOI: 10.1126/sciimmunol.aal2861] [Citation(s) in RCA: 51] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Hypoxia and bacterial infection frequently co-exist, in both acute and chronic clinical settings, and typically result in adverse clinical outcomes. To ameliorate this morbidity, we investigated the interaction between hypoxia and the host response. In the context of acute hypoxia, both S. aureus and S. pneumoniae infections rapidly induced progressive neutrophil mediated morbidity and mortality, with associated hypothermia and cardiovascular compromise. Preconditioning animals through longer exposures to hypoxia, prior to infection, prevented these pathophysiological responses and profoundly dampened the transcriptome of circulating leukocytes. Specifically, perturbation of HIF pathway and glycolysis genes by hypoxic preconditioning was associated with reduced leukocyte glucose utilisation, resulting in systemic rescue from a global negative energy state and myocardial protection. Thus we demonstrate that hypoxia preconditions the innate immune response and determines survival outcomes following bacterial infection through suppression of HIF-1α and neutrophil metabolism. The therapeutic implications of this work are that in the context of systemic or tissue hypoxia therapies that target the host response could improve infection associated morbidity and mortality.
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Affiliation(s)
- A.A.R. Thompson
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, UK
| | - R.S. Dickinson
- MRC/University of Edinburgh Centre for Inflammation Research, Queen’s Medical Research Institute, University of Edinburgh, Edinburgh, UK
| | - F. Murphy
- MRC/University of Edinburgh Centre for Inflammation Research, Queen’s Medical Research Institute, University of Edinburgh, Edinburgh, UK
| | - J. P. Thomson
- MRC Human Genetics Unit at the Institute of Genetics and Molecular Medicine at the University of Edinburgh, Edinburgh, UK
| | - H.M. Marriott
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, UK
| | - A. Tavares
- University of Edinburgh/BHF Centre for Cardiovascular Science, Queen’s Medical Research Institute, University of Edinburgh, Edinburgh, UK
| | - J. Willson
- MRC/University of Edinburgh Centre for Inflammation Research, Queen’s Medical Research Institute, University of Edinburgh, Edinburgh, UK
| | - L. Williams
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, UK
| | - A. Lewis
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, UK
| | - A. Mirchandani
- MRC/University of Edinburgh Centre for Inflammation Research, Queen’s Medical Research Institute, University of Edinburgh, Edinburgh, UK
| | - P. Dos Santos Coelho
- MRC/University of Edinburgh Centre for Inflammation Research, Queen’s Medical Research Institute, University of Edinburgh, Edinburgh, UK
| | - C. Doherty
- MRC/University of Edinburgh Centre for Inflammation Research, Queen’s Medical Research Institute, University of Edinburgh, Edinburgh, UK
| | - E. Ryan
- MRC/University of Edinburgh Centre for Inflammation Research, Queen’s Medical Research Institute, University of Edinburgh, Edinburgh, UK
| | - E. Watts
- MRC/University of Edinburgh Centre for Inflammation Research, Queen’s Medical Research Institute, University of Edinburgh, Edinburgh, UK
| | - N. M. Morton
- University of Edinburgh/BHF Centre for Cardiovascular Science, Queen’s Medical Research Institute, University of Edinburgh, Edinburgh, UK
| | - S. Forbes
- University of Edinburgh/BHF Centre for Cardiovascular Science, Queen’s Medical Research Institute, University of Edinburgh, Edinburgh, UK
| | - R. H. Stimson
- University of Edinburgh/BHF Centre for Cardiovascular Science, Queen’s Medical Research Institute, University of Edinburgh, Edinburgh, UK
| | - A. G. Hameed
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, UK
| | - N. Arnold
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, UK
| | - J.A. Preston
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, UK
| | - A. Lawrie
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, UK
| | - V. Finisguerra
- Laboratory of Molecular Oncology and Angiogenesis, Vesalius Research Center, VIB, Leuven, B3000, Belgium
- Laboratory of Molecular Oncology and Angiogenesis, Vesalius Research Center, Department of Oncology, KU Leuven, Leuven, B3000, Belgium
| | - M. Mazzone
- Laboratory of Molecular Oncology and Angiogenesis, Vesalius Research Center, VIB, Leuven, B3000, Belgium
- Laboratory of Molecular Oncology and Angiogenesis, Vesalius Research Center, Department of Oncology, KU Leuven, Leuven, B3000, Belgium
| | - P. Sadiku
- MRC/University of Edinburgh Centre for Inflammation Research, Queen’s Medical Research Institute, University of Edinburgh, Edinburgh, UK
| | - J. Goveia
- Laboratory of Angiogenesis and Vascular Metabolism, Vesalius Research Centre, VIB, Leuven, B3000, Belgium
- Laboratory of Angiogenesis and Vascular Metabolism, Vesalius Research Centre, K.U. Leuven, B3000, Belgium
| | - F. Taverna
- Laboratory of Angiogenesis and Vascular Metabolism, Vesalius Research Centre, VIB, Leuven, B3000, Belgium
- Laboratory of Angiogenesis and Vascular Metabolism, Vesalius Research Centre, K.U. Leuven, B3000, Belgium
| | - P. Carmeliet
- Laboratory of Angiogenesis and Vascular Metabolism, Vesalius Research Centre, VIB, Leuven, B3000, Belgium
- Laboratory of Angiogenesis and Vascular Metabolism, Vesalius Research Centre, K.U. Leuven, B3000, Belgium
| | - S.J. Foster
- Department of Molecular Biology and Biotechnology, University of Sheffield, Sheffield, UK
| | - E.R. Chilvers
- Department of Medicine, University of Cambridge, Cambridge, UK
| | - A.S. Cowburn
- Department of Medicine, University of Cambridge, Cambridge, UK
- Department of Physiology, Development and Neuroscience, University of Cambridge, UK
| | - D.H. Dockrell
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, UK
| | - R.S. Johnson
- Department of Physiology, Development and Neuroscience, University of Cambridge, UK
| | - R. R. Meehan
- MRC Human Genetics Unit at the Institute of Genetics and Molecular Medicine at the University of Edinburgh, Edinburgh, UK
| | - M.K.B. Whyte
- MRC/University of Edinburgh Centre for Inflammation Research, Queen’s Medical Research Institute, University of Edinburgh, Edinburgh, UK
| | - S.R. Walmsley
- MRC/University of Edinburgh Centre for Inflammation Research, Queen’s Medical Research Institute, University of Edinburgh, Edinburgh, UK
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Elliott L, Sheahan K, Doherty G, Fennelly D, Ryan E. The colorectal cancer (CRC) tumour microenvironment recruits and polarises two distinct populations of myeloid cells with unique regulatory profiles. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw393.13] [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: 11/14/2022] Open
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Abstract
Venous thromboembolism is a common condition with widely varied outcomes. Pulmonary embolism is associated with a case-fatality rate of up to 8%, increasing up to 18-fold in massive PE. Pharmacological treatment of VTE with anticoagulant medication (AC) is the first line therapy of choice. Retrievable inferior vena cava filters (IVCF) are indicated as a short-term replacement for AC in certain circumstances. Most of the evidence concerning IVCF pertains to permanent filters and older filter models. Limited evidence for retrievable IVCF results in poor consensus regarding indications, follow-up and retrieval. Complications increase with dwell-time and retrieval success rates decline. Professional bodies advocate strict guideline adherence and robust strategies for filter monitoring to maximise retrieval rate.
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Affiliation(s)
- E Ryan
- Department of Imaging and Interventional Radiology, Royal College of Surgeons and Beaumont Hospital, Ireland
| | - H K Kok
- Department of Imaging and Interventional Radiology, Royal College of Surgeons and Beaumont Hospital, Ireland
| | - M J Lee
- Department of Imaging and Interventional Radiology, Royal College of Surgeons and Beaumont Hospital, Ireland.
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Ryan E, Colleran N, Cullinane P, Fitzsimons M, Flynn F, Delanty N, Hennessy M. Perampanel: An audit of clinical experience using the epilepsy electronic patient record. Ir Med J 2016; 109:437. [PMID: 27834088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Perampanel is a non-competitive antagonist of AMPA glutamate receptors on post synaptic neurons. The aim of this study was to conduct an audit of the experience of perampanel treatment in Ireland based on the interrogation of the national epilepsy electronic patient record (EPR). A retrospective audit was compiled which reviewed the progress of patients who had been treated across two regional epilepsy centres. The EPR was used to identify patients and collect information relevant to their perampanel therapy. Collected data was entered into a statistical package for social sciences for analysis using descriptive statistics. Seventy patients were identified for inclusion in this audit. Partial onset epilepsy was the predominant epilepsy syndrome treated with perampanel. Eight milligrams daily was the maximum dose achieved in 31.45% (n=22). Complex partial seizures demonstrated the best seizure response to perampanel, which was optimal at doses of 4mgs to 8mgs once daily. Treatment was discontinued primarily due to side effect profile (28.5%; n=20). The common side effects reported were behavioural alteration, sedation and dizziness. Abnormal thoughts were identified in 4.2% (n=3). Overall perampanel has been shown to be an effective adjunct. The EPR was demonstrated as an effective tool for audit and research.
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Affiliation(s)
- E Ryan
- Department of Neurology, Galway University Hospital, Ireland
| | - N Colleran
- Department of Neurology, Galway University Hospital, Ireland
| | - P Cullinane
- Department of Neurology, Galway University Hospital, Ireland
| | - M Fitzsimons
- Department of Medical Physics, Beaumont Hospital, Dublin, Ireland
| | - F Flynn
- Department of Neurology, Beaumont Hospital, Dublin, Ireland
| | - N Delanty
- Department of Neurology, Beaumont Hospital, Dublin, Ireland
| | - M Hennessy
- Department of Neurology, Beaumont Hospital, Dublin, Ireland
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Elder A, Dunkerton S, Arnold R, Amos D, French A, Ryan E, Faddy S, McMullen M. Delays in Treatment of Rural STEMI: Stoic Patients or System Delays? Heart Lung Circ 2016. [DOI: 10.1016/j.hlc.2016.06.753] [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: 11/25/2022]
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Elder A, Dunkerton S, Arnold R, French A, Amos D, Ryan E, Faddy S, McMullen M. Early Cardiologist Input via LIFENET ECG Transmission and Pre-Hospital Thrombolysis Achieves Improved Lysis Times for STEMI in a Rural Setting. Heart Lung Circ 2016. [DOI: 10.1016/j.hlc.2016.06.627] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Mohan HM, Ryan E, Balasubramanian I, Kennelly R, Geraghty R, Sclafani F, Fennelly D, McDermott R, Ryan EJ, O'Donoghue D, Hyland JMP, Martin ST, O'Connell PR, Gibbons D, Winter D, Sheahan K. Microsatellite instability is associated with reduced disease specific survival in stage III colon cancer. Eur J Surg Oncol 2016; 42:1680-1686. [PMID: 27370895 DOI: 10.1016/j.ejso.2016.05.013] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [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: 11/30/2015] [Revised: 04/19/2016] [Accepted: 05/19/2016] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND Up to 15% of colorectal cancers exhibit microsatellite instability (MSI), where errors in replication go unchecked due to defects in the mismatch repair system. This study aimed to determine survival in a large single-centre series of 1250 consecutive colorectal cancers subjected to universal MSI testing. METHODS Clinical and pathological features of patients with colorectal cancer identified on prospectively maintained colorectal and pathology databases at St. Vincent's University Hospital from 2004 to May 2012 were examined. Mismatch repair (MMR) status was determined by immunohistochemistry. Kaplan-Meier curves, the log-rank test and Cox regression were used to associate survival with clinical and pathological characteristics. RESULTS Of the 1250 colorectal cancers in the study period, 11% exhibited MSI (n = 138). Patients with MSI tumours had significantly lower rates of lymph node and distant metastases (MSI N+ rate: 24.8% compared with MSS N+ rate: 46.2%, p < 0.001). For Stage I and II disease MSI was associated with improved disease free survival (DSS) compared with MSS colon cancer. However, patients with Stage III MSI colon cancers had a worse DSS than those with MSS tumours. Stage III MSI tumours exhibited higher rates of lymphovascular invasion and perineural invasion than Stage I/II MSI tumours. CONCLUSION MSI is associated with a reduced risk of nodal and distant metastases, with an improved DSS in Stage I/II colon cancer. However, when MSI tumours progress to Stage III these patients had worse outcomes and pathological features. New strategies for this cohort of patients may be required to improve outcomes.
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Affiliation(s)
- H M Mohan
- Centre for Colorectal Disease, St. Vincent's University Hospital, Elm Park, Dublin 4, Ireland; School of Medicine and Medical Sciences, University College Dublin, Belfield, Dublin 4, Ireland
| | - E Ryan
- Centre for Colorectal Disease, St. Vincent's University Hospital, Elm Park, Dublin 4, Ireland; School of Medicine and Medical Sciences, University College Dublin, Belfield, Dublin 4, Ireland
| | - I Balasubramanian
- Centre for Colorectal Disease, St. Vincent's University Hospital, Elm Park, Dublin 4, Ireland
| | - R Kennelly
- Centre for Colorectal Disease, St. Vincent's University Hospital, Elm Park, Dublin 4, Ireland
| | - R Geraghty
- Centre for Colorectal Disease, St. Vincent's University Hospital, Elm Park, Dublin 4, Ireland
| | - F Sclafani
- Centre for Colorectal Disease, St. Vincent's University Hospital, Elm Park, Dublin 4, Ireland
| | - D Fennelly
- Centre for Colorectal Disease, St. Vincent's University Hospital, Elm Park, Dublin 4, Ireland
| | - R McDermott
- Centre for Colorectal Disease, St. Vincent's University Hospital, Elm Park, Dublin 4, Ireland
| | - E J Ryan
- Centre for Colorectal Disease, St. Vincent's University Hospital, Elm Park, Dublin 4, Ireland; School of Medicine and Medical Sciences, University College Dublin, Belfield, Dublin 4, Ireland
| | - D O'Donoghue
- Centre for Colorectal Disease, St. Vincent's University Hospital, Elm Park, Dublin 4, Ireland
| | - J M P Hyland
- Centre for Colorectal Disease, St. Vincent's University Hospital, Elm Park, Dublin 4, Ireland
| | - S T Martin
- Centre for Colorectal Disease, St. Vincent's University Hospital, Elm Park, Dublin 4, Ireland
| | - P R O'Connell
- Centre for Colorectal Disease, St. Vincent's University Hospital, Elm Park, Dublin 4, Ireland; School of Medicine and Medical Sciences, University College Dublin, Belfield, Dublin 4, Ireland
| | - D Gibbons
- Centre for Colorectal Disease, St. Vincent's University Hospital, Elm Park, Dublin 4, Ireland
| | - Des Winter
- Centre for Colorectal Disease, St. Vincent's University Hospital, Elm Park, Dublin 4, Ireland; School of Medicine and Medical Sciences, University College Dublin, Belfield, Dublin 4, Ireland
| | - K Sheahan
- Centre for Colorectal Disease, St. Vincent's University Hospital, Elm Park, Dublin 4, Ireland; School of Medicine and Medical Sciences, University College Dublin, Belfield, Dublin 4, Ireland.
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Affiliation(s)
- Eleanor Ryan
- Liver Centre, Mater Misericordiae University Hospital, Dublin, Ireland
| | - Jennifer Russell
- Liver Centre, Mater Misericordiae University Hospital, Dublin, Ireland
| | - John D Ryan
- Translational Gastroenterology Unit, Nuffield Department of Experimental Medicine, University of Oxford, Oxford, UK
| | - John Crowe
- Liver Centre, Mater Misericordiae University Hospital, Dublin, Ireland
| | - Stephen Stewart
- Liver Centre, Mater Misericordiae University Hospital, Dublin, Ireland
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Paiardini M, Micci L, Ryan E, Fromentin R, Chomont N, Sekaly R, Lifson J. Virologic and immunologic correlates of viral control after ART-interruption in SIV-infected rhesus macaques. J Virus Erad 2015. [DOI: 10.1016/s2055-6640(20)31396-0] [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: 10/23/2022] Open
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Boss R, Cosandey A, Luini M, Artursson K, Bardiau M, Breitenwieser F, Hehenberger E, Lam T, Mansfeld M, Michel A, Mösslacher G, Naskova J, Nelson S, Podpečan O, Raemy A, Ryan E, Salat O, Zangerl P, Steiner A, Graber HU. Bovine Staphylococcus aureus: Subtyping, evolution, and zoonotic transfer. J Dairy Sci 2015; 99:515-28. [PMID: 26601578 DOI: 10.3168/jds.2015-9589] [Citation(s) in RCA: 65] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2015] [Accepted: 08/27/2015] [Indexed: 11/19/2022]
Abstract
Staphylococcus aureus is globally one of the most important pathogens causing contagious mastitis in cattle. Previous studies using ribosomal spacer (RS)-PCR, however, demonstrated in Swiss cows that Staph. aureus isolated from bovine intramammary infections are genetically heterogeneous, with Staph. aureus genotype B (GTB) and GTC being the most prominent genotypes. Furthermore, Staph. aureus GTB was found to be contagious, whereas Staph. aureus GTC and all the remaining genotypes were involved in individual cow disease. In addition to RS-PCR, other methods for subtyping Staph. aureus are known, including spa typing and multilocus sequence typing (MLST). They are based on sequencing the spa and various housekeeping genes, respectively. The aim of the present study was to compare the 3 analytic methods using 456 strains of Staph. aureus isolated from milk of bovine intramammary infections and bulk tanks obtained from 12 European countries. Furthermore, the phylogeny of animal Staph. aureus was inferred and the zoonotic transfer of Staph. aureus between cattle and humans was studied. The analyzed strains could be grouped into 6 genotypic clusters, with CLB, CLC, and CLR being the most prominent ones. Comparing the 3 subtyping methods, RS-PCR showed the highest resolution, followed by spa typing and MLST. We found associations among the methods but in many cases they were unsatisfactory except for CLB and CLC. Cluster CLB was positive for clonal complex (CC)8 in 99% of the cases and typically positive for t2953; it is the cattle-adapted form of CC8. Cluster CLC was always positive for tbl 2645 and typically positive for CC705. For CLR and the remaining subtypes, links among the 3 methods were generally poor. Bovine Staph. aureus is highly clonal and a few clones predominate. Animal Staph. aureus always evolve from human strains, such that every human strain may be the ancestor of a novel animal-adapted strain. The zoonotic transfer of IMI- and milk-associated strains of Staph. aureus between cattle and humans seems to be very limited and different hosts are not considered as a source for mutual, spontaneous infections. Spillover events, however, may happen.
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Affiliation(s)
- R Boss
- Agroscope, Institute for Food Sciences (IFS), Schwarzenburgstrasse 161, 3003 Berne, Switzerland
| | - A Cosandey
- Agroscope, Institute for Food Sciences (IFS), Schwarzenburgstrasse 161, 3003 Berne, Switzerland; Clinic for Ruminants, Department of Clinical Veterinary Medicine, Vetsuisse-Faculty, University of Berne, Bremgartenstrasse 109a, P.O. Box 8466, 3001 Berne, Switzerland
| | - M Luini
- Istituto Zooprofilattico Sperimentale della Lombardia e dell'Emilia Romagna, Via Einstein, 26900 Lodi, Italy
| | - K Artursson
- Department of Bacteriology, National Veterinary Institute, SE-751 89 Uppsala, Sweden
| | - M Bardiau
- Bacteriology, Department of Infectious Diseases, Faculty of Veterinary Medicine, University of Liège, Avenue de Cureghem 6, 4000 Liège, Belgium
| | - F Breitenwieser
- Milchprüfring Baden-Württemberg e. V., Marie-Curie-Strasse 19, 73230 Kirchheim/Teck, Germany
| | - E Hehenberger
- Clinic for Ruminants, Department of Clinical Veterinary Medicine, Vetsuisse-Faculty, University of Berne, Bremgartenstrasse 109a, P.O. Box 8466, 3001 Berne, Switzerland
| | - Th Lam
- GD Animal Health, Arnsbergstraat 7, PO Box 9, 7400 AA Deventer, the Netherlands
| | - M Mansfeld
- Carinthian Institute for Veterinary Disease Control, Kirchengasse 43, 9020 Klagenfurt, Austria
| | - A Michel
- Clinic for Ruminants, Department of Clinical Veterinary Medicine, Vetsuisse-Faculty, University of Berne, Bremgartenstrasse 109a, P.O. Box 8466, 3001 Berne, Switzerland
| | - G Mösslacher
- Animal Health Organisation Upper Austria, Bahnhofplatz 1, 4021 Linz, Austria
| | - J Naskova
- Agroscope, Institute for Food Sciences (IFS), Schwarzenburgstrasse 161, 3003 Berne, Switzerland
| | - S Nelson
- Department of Production Animal Clinical Sciences, Norwegian School of Veterinary Science, Ullevalsvn 72, PO Box 8146 Dep, N-0033 Oslo, Norway
| | - O Podpečan
- Ambulatory Clinic for Large Animals, University of Ljubljana, Veterinary Faculty, Gerbičeva ul. 60, 1000 Ljubljana, Slovenia
| | - A Raemy
- Clinic for Ruminants, Department of Clinical Veterinary Medicine, Vetsuisse-Faculty, University of Berne, Bremgartenstrasse 109a, P.O. Box 8466, 3001 Berne, Switzerland
| | - E Ryan
- School of Veterinary Medicine, University College Dublin, Belfield, Dublin 4, Ireland
| | - O Salat
- Veterinary Clinic of Haute Auvergne, Allauzier, 15100 Saint Flour, France
| | - P Zangerl
- Federal Institute for Alpine Dairying BAM, 6200 Jenbach, Austria
| | - A Steiner
- Clinic for Ruminants, Department of Clinical Veterinary Medicine, Vetsuisse-Faculty, University of Berne, Bremgartenstrasse 109a, P.O. Box 8466, 3001 Berne, Switzerland
| | - H U Graber
- Agroscope, Institute for Food Sciences (IFS), Schwarzenburgstrasse 161, 3003 Berne, Switzerland.
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Cosandey A, Boss R, Luini M, Artursson K, Bardiau M, Breitenwieser F, Hehenberger E, Lam T, Mansfeld M, Michel A, Mösslacher G, Naskova J, Nelson S, Podpečan O, Raemy A, Ryan E, Salat O, Zangerl P, Steiner A, Graber HU. Staphylococcus aureus genotype B and other genotypes isolated from cow milk in European countries. J Dairy Sci 2015; 99:529-40. [PMID: 26585469 DOI: 10.3168/jds.2015-9587] [Citation(s) in RCA: 41] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2015] [Accepted: 09/14/2015] [Indexed: 11/19/2022]
Abstract
Staphylococcus aureus is globally one of the most important pathogens causing contagious mastitis in cattle. Previous studies, however, have demonstrated in Swiss cows that Staph. aureus isolated from bovine intramammary infection is genetically heterogeneous, with Staph. aureus genotype B (GTB) and GTC being the most prominent genotypes. In addition, Staph. aureus GTB was found to be contagious, whereas Staph. aureus GTC and all the remaining genotypes were involved in individual cow disease. The aim of this study was to subtype strains of Staph. aureus isolated from bovine mastitic milk and bulk tank milk to obtain a unified view of the presence of bovine staphylococcal subtypes in 12 European countries. A total of 456 strains of Staph. aureus were subjected to different typing methods: ribosomal spacer PCR, detection of enterotoxin genes, and detection of gene polymorphisms (lukE, coa). Major genotypes with their variants were combined into genotypic clusters (CL). This study revealed 5 major CL representing 76% of all strains and comprised CLB, CLC, CLF, CLI, and CLR. The clusters were characterized by the same genetic properties as the Swiss isolates, demonstrating high clonality of bovine Staph. aureus. Interestingly, CLB was situated in central Europe whereas the other CL were widely disseminated. The remaining 24% of the strains comprised 41 genotypes and variants, some of which (GTAM, GTBG) were restricted to certain countries; many others, however, were observed only once.
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Affiliation(s)
- A Cosandey
- Agroscope, Institute for Food Sciences (IFS), Schwarzenburgstrasse 161, 3003 Berne, Switzerland; Clinic for Ruminants, Department of Clinical Veterinary Medicine, Vetsuisse-Faculty, University of Berne, Bremgartenstrasse 109a, PO Box 8466, 3001 Berne, Switzerland
| | - R Boss
- Agroscope, Institute for Food Sciences (IFS), Schwarzenburgstrasse 161, 3003 Berne, Switzerland
| | - M Luini
- Istituto Zooprofilattico Sperimentale della Lombardia e dell'Emilia Romagna, Via Einstein, 26900 Lodi, Italy
| | - K Artursson
- Department of Bacteriology, National Veterinary Institute, SE-751 89 Uppsala, Sweden
| | - M Bardiau
- Bacteriology, Department of Infectious Diseases, Faculty of Veterinary Medicine, University of Liège, Avenue de Cureghem 6, 4000 Liège, Belgium
| | - F Breitenwieser
- Milchprüfring Baden-Württemberg e. V., Marie-Curie-Strasse 19, 73230 Kirchheim/Teck, Germany
| | - E Hehenberger
- Clinic for Ruminants, Department of Clinical Veterinary Medicine, Vetsuisse-Faculty, University of Berne, Bremgartenstrasse 109a, PO Box 8466, 3001 Berne, Switzerland
| | - Th Lam
- GD Animal Health, Arnsbergstraat 7, PO Box 9, 7400 AA Deventer, the Netherlands
| | - M Mansfeld
- Carinthian Institute for Veterinary Disease Control, Kirchengasse 43, 9020 Klagenfurt, Austria
| | - A Michel
- Clinic for Ruminants, Department of Clinical Veterinary Medicine, Vetsuisse-Faculty, University of Berne, Bremgartenstrasse 109a, PO Box 8466, 3001 Berne, Switzerland
| | - G Mösslacher
- Animal Health Organisation Upper Austria, Bahnhofplatz 1, 4021 Linz, Austria
| | - J Naskova
- Agroscope, Institute for Food Sciences (IFS), Schwarzenburgstrasse 161, 3003 Berne, Switzerland
| | - S Nelson
- Department of Production Animal Clinical Sciences, Norwegian School of Veterinary Science, Ullevalsvn 72, PO Box 8146 Dep, N-0033 Oslo, Norway
| | - O Podpečan
- Ambulatory Clinic for Large Animals, University of Ljubljana, Veterinary Faculty, Gerbičeva ul. 60, 1000 Ljubljana, Slovenia
| | - A Raemy
- Clinic for Ruminants, Department of Clinical Veterinary Medicine, Vetsuisse-Faculty, University of Berne, Bremgartenstrasse 109a, PO Box 8466, 3001 Berne, Switzerland
| | - E Ryan
- School of Veterinary Medicine, University College Dublin, Belfield, Dublin 4, Ireland
| | - O Salat
- Veterinary Clinic of Haute Auvergne, Allauzier, 15100 Saint Flour, France
| | - P Zangerl
- Federal Institute for Alpine Dairying BAM, 6200 Jenbach, Austria
| | - A Steiner
- Clinic for Ruminants, Department of Clinical Veterinary Medicine, Vetsuisse-Faculty, University of Berne, Bremgartenstrasse 109a, PO Box 8466, 3001 Berne, Switzerland
| | - H U Graber
- Agroscope, Institute for Food Sciences (IFS), Schwarzenburgstrasse 161, 3003 Berne, Switzerland.
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Gleeson LE, Varghese C, Ryan E, Kane M, McDonald C, Gleeson N, McLaughlin AM, Butler K, Gavin P, Keane J. Untreated chronic tuberculous salpingitis followed by successful in vitro fertilization conception and congenital tuberculosis. QJM 2015; 108:899-901. [PMID: 25638787 DOI: 10.1093/qjmed/hcv019] [Citation(s) in RCA: 7] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- L E Gleeson
- From the Department of Respiratory Medicine, St James's Hospital, James's Street, Dublin 8, Department of Clinical Medicine, Trinity College Dublin, St James's Hospital, James's Street, Dublin 8
| | - C Varghese
- From the Department of Respiratory Medicine, St James's Hospital, James's Street, Dublin 8
| | - E Ryan
- Department of Infectious Diseases, Our Lady Children's Hospital, Crumlin, Dublin 12 and
| | - M Kane
- From the Department of Respiratory Medicine, St James's Hospital, James's Street, Dublin 8
| | - C McDonald
- From the Department of Respiratory Medicine, St James's Hospital, James's Street, Dublin 8
| | - N Gleeson
- Department of Gynaecology, St James's Hospital, James's Street, Dublin 8, Ireland
| | - A-M McLaughlin
- From the Department of Respiratory Medicine, St James's Hospital, James's Street, Dublin 8
| | - K Butler
- Department of Infectious Diseases, Our Lady Children's Hospital, Crumlin, Dublin 12 and
| | - P Gavin
- Department of Infectious Diseases, Our Lady Children's Hospital, Crumlin, Dublin 12 and
| | - J Keane
- From the Department of Respiratory Medicine, St James's Hospital, James's Street, Dublin 8, Department of Clinical Medicine, Trinity College Dublin, St James's Hospital, James's Street, Dublin 8,
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Caiazza F, Power R, Elliott L, Tosetto M, Nolan B, Doherty G, Ryan E. 2020 Modulation of colorectal cancer tumorigenesis by KHSRP through the tumor microenvironment. Eur J Cancer 2015. [DOI: 10.1016/s0959-8049(16)30943-1] [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: 11/30/2022]
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Ryan E, Ryan JD, Russell J, Coughlan B, Tjalsma H, Swinkels DW, Stewart S, Crowe JP. Correlates of hepcidin and NTBI according to HFE status in patients referred to a liver centre. Acta Haematol 2014; 133:155-61. [PMID: 25277871 DOI: 10.1159/000363490] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2014] [Accepted: 05/08/2014] [Indexed: 12/21/2022]
Abstract
BACKGROUND/AIMS Innately low hepcidin levels lead to iron overload in HFE-associated hereditary haemochromatosis. METHODS This study compared hepcidin and non-transferrin bound iron (NTBI) levels in untreated iron-loaded and non-iron-loaded C282Y homozygotes to levels in C282Y/H63D compound heterozygotes and individuals with other HFE genotypes associated with less risk of iron overload. RESULTS As the genotypic risk for iron overload increased, transferrin saturation and serum NTBI levels increased while serum hepcidin levels decreased. Overweight and obese male C282Y homozygotes had significantly higher hepcidin levels than male C282Y homozygotes with a normal BMI. Pearson product-moment analysis showed that serum hepcidin levels significantly correlated with HFE status, serum ferritin, age, NTBI, transferrin saturation, gender and BMI. Subsequent multiple regression analysis showed that HFE status and serum ferritin were significant independent correlates of serum hepcidin levels. CONCLUSIONS In summary, this study has shown that while serum ferritin and HFE status are the most important determinants of hepcidin levels, factors such age, gender, BMI, transferrin saturation and NTBI all interact closely in the matrix of homeostatic iron balance.
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Affiliation(s)
- Eleanor Ryan
- Liver Centre, Mater Misericordiae University Hospital, Dublin, Ireland
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