1
|
Garcia L, Pearce M, Abbas A, Mok A, Strain T, Ali S, Crippa A, Dempsey PC, Golubic R, Kelly P, Laird Y, McNamara E, Moore S, de Sa TH, Smith AD, Wijndaele K, Woodcock J, Brage S. Non-occupational physical activity and risk of cardiovascular disease, cancer and mortality outcomes: a dose-response meta-analysis of large prospective studies. Br J Sports Med 2023; 57:979-989. [PMID: 36854652 PMCID: PMC10423495 DOI: 10.1136/bjsports-2022-105669] [Citation(s) in RCA: 18] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/15/2022] [Indexed: 03/02/2023]
Abstract
OBJECTIVE To estimate the dose-response associations between non-occupational physical activity and several chronic disease and mortality outcomes in the general adult population. DESIGN Systematic review and cohort-level dose-response meta-analysis. DATA SOURCES PubMed, Scopus, Web of Science and reference lists of published studies. ELIGIBILITY CRITERIA Prospective cohort studies with (1) general population samples >10 000 adults, (2) ≥3 physical activity categories, and (3) risk measures and CIs for all-cause mortality or incident total cardiovascular disease, coronary heart disease, stroke, heart failure, total cancer and site-specific cancers (head and neck, myeloid leukaemia, myeloma, gastric cardia, lung, liver, endometrium, colon, breast, bladder, rectum, oesophagus, prostate, kidney). RESULTS 196 articles were included, covering 94 cohorts with >30 million participants. The evidence base was largest for all-cause mortality (50 separate results; 163 415 543 person-years, 811 616 events), and incidence of cardiovascular disease (37 results; 28 884 209 person-years, 74 757 events) and cancer (31 results; 35 500 867 person-years, 185 870 events). In general, higher activity levels were associated with lower risk of all outcomes. Differences in risk were greater between 0 and 8.75 marginal metabolic equivalent of task-hours per week (mMET-hours/week) (equivalent to the recommended 150 min/week of moderate-to-vigorous aerobic physical activity), with smaller marginal differences in risk above this level to 17.5 mMET-hours/week, beyond which additional differences were small and uncertain. Associations were stronger for all-cause (relative risk (RR) at 8.75 mMET-hours/week: 0.69, 95% CI 0.65 to 0.73) and cardiovascular disease (RR at 8.75 mMET-hours/week: 0.71, 95% CI 0.66 to 0.77) mortality than for cancer mortality (RR at 8.75 mMET-hours/week: 0.85, 95% CI 0.81 to 0.89). If all insufficiently active individuals had achieved 8.75 mMET-hours/week, 15.7% (95% CI 13.1 to 18.2) of all premature deaths would have been averted. CONCLUSIONS Inverse non-linear dose-response associations suggest substantial protection against a range of chronic disease outcomes from small increases in non-occupational physical activity in inactive adults. PROSPERO registration number CRD42018095481.
Collapse
Affiliation(s)
- Leandro Garcia
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, UK
- Centre for Public Health, Queen's University Belfast, Belfast, UK
| | - Matthew Pearce
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, UK
| | - Ali Abbas
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, UK
| | - Alexander Mok
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, UK
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore
| | - Tessa Strain
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, UK
| | - Sara Ali
- University of Cambridge School of Clinical Medicine, Cambridge, UK
| | - Alessio Crippa
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Paddy C Dempsey
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, UK
- Diabetes Research Centre, University of Leicester, Leicester, UK
| | - Rajna Golubic
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, UK
- Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Paul Kelly
- Physical Activity for Health Research Centre, University of Edinburgh Institute for Sport, Physical Education and Health Sciences, Edinburgh, UK
| | - Yvonne Laird
- Sydney School of Public Health, Prevention Research Collaboration, The University of Sydney, Sydney, New South Wales, Australia
- Charles Perkins Centre, The University of Sydney, Sydney, New South Wales, Australia
| | - Eoin McNamara
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, UK
- Economic and Social Research Institute, Dublin, Ireland
| | - Samuel Moore
- University of Cambridge School of Clinical Medicine, Cambridge, UK
| | - Thiago Herick de Sa
- Center for Epidemiological Research in Nutrition and Health, University of Sao Paulo, Sao Paulo, Brazil
| | - Andrea D Smith
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, UK
- Department of Behavioural Science and Health, University College London, London, UK
| | - Katrien Wijndaele
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, UK
| | - James Woodcock
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, UK
| | - Soren Brage
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, UK
| |
Collapse
|
2
|
Creedon M, O'Gorman C, McDonnell C, McNamara E, Boyle B. Fournier's Gangrene Associated with SGLT-2 Inhibitor Use. Ir Med J 2022; 115:701. [PMID: 36920488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Subscribe] [Scholar Register] [Indexed: 03/16/2023]
|
3
|
Kelly L, Murray A, Quail A, McNamara E. Adaptations to a cohort study in response to the COVID-19 pandemic: insights from Growing Up in Ireland. Longit Life Course Stud 2022; 14:294-307. [PMID: 37022314 DOI: 10.1332/175795921x16605676242991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 08/15/2022] [Indexed: 06/19/2023]
Abstract
Growing Up in Ireland (GUI) is the national longitudinal study of children and young people in the Republic of Ireland and has followed two cohorts for over ten years to date: Cohort '98 who were recruited into the study at age nine years and Cohort '08, recruited at age nine months. The study aims to describe the lives of Irish children and young people in terms of their development, with a view to positively affecting policies and services available for them. Traditionally, data collection involved in-home visits from an interviewer who conducted face-to-face interviews, recorded physical measurements of study participants and administered cognitive assessments. However, with the onset of the COVID-19 pandemic and the associated restrictions, significant adaptations were required to these methods to ensure data collection for the pilot and main fieldwork for Cohort '08 at age 13 could continue to the expected timeline. Face-to-face interviews with participants were replaced with telephone and web-based modes, interviewer training was conducted online, online resources were made available for interviewers and participants and COVID-19 related items were added to questionnaires. In addition to the scheduled data collection, a special COVID-19 survey was also conducted on both GUI cohorts in December 2020 to explore the impact of the pandemic on participants' lives. This paper outlines the adaptations made to traditional data collection methods in GUI, highlighting the challenges that were met, but also the benefits of some changes that may be worth incorporating into future waves of GUI.
Collapse
Affiliation(s)
- Lisa Kelly
- Economic and Social Research Institute, Ireland
| | | | | | | |
Collapse
|
4
|
Harris J, Fleming CA, Ullah MF, McNamara E, Murphy S, Shelly M, Waldron D, Condon E, Coffey JC, Peirce CB. P10: LYMPH NODE YIELD IS NOT A RELIABLE PROGNOSTIC MARKER IN ANTERIOR RESECTION AND ABDOMINOPERINEAL RESECTION FOLLOWING NEOADJUVANT THERAPY FOR RECTAL CANCER. Br J Surg 2021. [DOI: 10.1093/bjs/znab117.095] [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: 11/12/2022]
Abstract
Abstract
Introduction
International guidelines recommend a minimum lymph node yield (LNY) of ≥12 for oncological resection in colorectal cancer (CRC). Neoadjuvant chemoradiotherapy (NACRT) decreases LNY, which questions its ability to provide accurate prognostic information. The consensus of this significance remains undetermined. This study aimed to investigate the significance of LNY on recurrence and survival following anterior resection and abdominoperineal resection with or without NACRT for rectal cancer.
Method
Prospectively collected data on patients diagnosed with rectal cancer in a tertiary referral centre was interrogated retrospectively. Patients were divided into primary surgery and NACRT groups. Univariable analysis was performed using Fisher's exact test, t-test, and x2 test, while multivariable analysis utilised a multiple regression model. Disease recurrence and survival was analysed with logrank test for Kaplan-Meier curves.
Result
148 patients were included [56.1% (n=83) receiving NACRT]. The median LNY of the primary surgery group was 14 [interquartile range (IQR) 11-19] and for the NACRT group was 12 (IQR 8-14) (p <0.001). Disease recurrence was similar in both primary surgery and NACRT groups. There was a significant decrease in overall mortality in NACRT patients (p = 0.03), but there was no significant difference observed in recurrence or mortality amongst LNYs of <8, 8-11, and ≥12.
Conclusion
LNY less than 12 was not a negative prognostic indicator following NACRT and surgery for rectal cancer.
Take-home message
A lymph node yield of less than 12 is not a negative prognostic indicator in rectal cancer patients who receive neoadjuvant chemotherapy.
Collapse
Affiliation(s)
- J Harris
- Graduate Entry Medical School, University of Limerick
| | - CA Fleming
- Department of Colorectal Surgery, University of Limerick Hospital Group
| | - MF Ullah
- Department of Colorectal Surgery, University of Limerick Hospital Group
| | - E McNamara
- Department of Colorectal Surgery, University of Limerick Hospital Group
| | - S Murphy
- Department of Radiology, University of Limerick Hospital Group
| | - M Shelly
- Department of Radiology, University of Limerick Hospital Group
| | - D Waldron
- Department of Colorectal Surgery, University of Limerick Hospital Group
| | - E Condon
- Department of Colorectal Surgery, University of Limerick Hospital Group
| | - JC Coffey
- Graduate Entry Medical School, University of Limerick
- Department of Colorectal Surgery, University of Limerick Hospital Group
| | - CB Peirce
- Graduate Entry Medical School, University of Limerick
- Department of Colorectal Surgery, University of Limerick Hospital Group
| |
Collapse
|
5
|
Patterson R, McNamara E, Tainio M, de Sá TH, Smith AD, Sharp SJ, Edwards P, Woodcock J, Brage S, Wijndaele K. Sedentary behaviour and risk of all-cause, cardiovascular and cancer mortality, and incident type 2 diabetes: a systematic review and dose response meta-analysis. Eur J Epidemiol 2018; 33:811-829. [PMID: 29589226 PMCID: PMC6133005 DOI: 10.1007/s10654-018-0380-1] [Citation(s) in RCA: 649] [Impact Index Per Article: 108.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2017] [Accepted: 03/12/2018] [Indexed: 12/12/2022]
Abstract
PURPOSE To estimate the strength and shape of the dose-response relationship between sedentary behaviour and all-cause, cardiovascular disease (CVD) and cancer mortality, and incident type 2 diabetes (T2D), adjusted for physical activity (PA). Data Sources: Pubmed, Web of Knowledge, Medline, Embase, Cochrane Library and Google Scholar (through September-2016); reference lists. Study Selection: Prospective studies reporting associations between total daily sedentary time or TV viewing time, and ≥ one outcome of interest. Data Extraction: Two independent reviewers extracted data, study quality was assessed; corresponding authors were approached where needed. Data Synthesis: Thirty-four studies (1,331,468 unique participants; good study quality) covering 8 exposure-outcome combinations were included. For total sedentary behaviour, the PA-adjusted relationship was non-linear for all-cause mortality (RR per 1 h/day: were 1.01 (1.00-1.01) ≤ 8 h/day; 1.04 (1.03-1.05) > 8 h/day of exposure), and for CVD mortality (1.01 (0.99-1.02) ≤ 6 h/day; 1.04 (1.03-1.04) > 6 h/day). The association was linear (1.01 (1.00-1.01)) with T2D and non-significant with cancer mortality. Stronger PA-adjusted associations were found for TV viewing (h/day); non-linear for all-cause mortality (1.03 (1.01-1.04) ≤ 3.5 h/day; 1.06 (1.05-1.08) > 3.5 h/day) and for CVD mortality (1.02 (0.99-1.04) ≤ 4 h/day; 1.08 (1.05-1.12) > 4 h/day). Associations with cancer mortality (1.03 (1.02-1.04)) and T2D were linear (1.09 (1.07-1.12)). CONCLUSIONS Independent of PA, total sitting and TV viewing time are associated with greater risk for several major chronic disease outcomes. For all-cause and CVD mortality, a threshold of 6-8 h/day of total sitting and 3-4 h/day of TV viewing was identified, above which the risk is increased.
Collapse
Affiliation(s)
- Richard Patterson
- Public Health Policy Evaluation Unit, School of Public Health, Imperial College London, London, W6 8RP, UK.
| | - Eoin McNamara
- MRC Epidemiology Unit, School of Clinical Medicine, University of Cambridge, Cambridge, CB2 0QQ, UK
| | - Marko Tainio
- MRC Epidemiology Unit, School of Clinical Medicine, University of Cambridge, Cambridge, CB2 0QQ, UK
| | - Thiago Hérick de Sá
- Centre for Epidemiological Research in Nutrition and Health, University of São Paulo, São Paulo, Brazil
| | - Andrea D Smith
- Research Department of Behavioural Science and Health, University College London, London, WC1E 6BT, UK
| | - Stephen J Sharp
- MRC Epidemiology Unit, School of Clinical Medicine, University of Cambridge, Cambridge, CB2 0QQ, UK
| | - Phil Edwards
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, WC1E 7HT, UK
| | - James Woodcock
- MRC Epidemiology Unit, School of Clinical Medicine, University of Cambridge, Cambridge, CB2 0QQ, UK
| | - Søren Brage
- MRC Epidemiology Unit, School of Clinical Medicine, University of Cambridge, Cambridge, CB2 0QQ, UK
| | - Katrien Wijndaele
- MRC Epidemiology Unit, School of Clinical Medicine, University of Cambridge, Cambridge, CB2 0QQ, UK
| |
Collapse
|
6
|
Jinno C, Morash D, McNamara E, King A, Liu Y. 116 Chemical composition of enzymatically digested food waste byproducts. J Anim Sci 2017. [DOI: 10.2527/asasann.2017.116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
7
|
Donkervoort S, Papadaki M, de Winter JM, Neu MB, Kirschner J, Bolduc V, Yang ML, Gibbons MA, Hu Y, Dastgir J, Leach ME, Rutkowski A, Foley AR, Krüger M, Wartchow EP, McNamara E, Ong R, Nowak KJ, Laing NG, Clarke NF, Ottenheijm C, Marston SB, Bönnemann CG. TPM3 deletions cause a hypercontractile congenital muscle stiffness phenotype. Ann Neurol 2015; 78:982-994. [PMID: 26418456 DOI: 10.1002/ana.24535] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2015] [Revised: 09/02/2015] [Accepted: 09/05/2015] [Indexed: 12/21/2022]
Abstract
OBJECTIVE Mutations in TPM3, encoding Tpm3.12, cause a clinically and histopathologically diverse group of myopathies characterized by muscle weakness. We report two patients with novel de novo Tpm3.12 single glutamic acid deletions at positions ΔE218 and ΔE224, resulting in a significant hypercontractile phenotype with congenital muscle stiffness, rather than weakness, and respiratory failure in one patient. METHODS The effect of the Tpm3.12 deletions on the contractile properties in dissected patient myofibers was measured. We used quantitative in vitro motility assay to measure Ca(2+) sensitivity of thin filaments reconstituted with recombinant Tpm3.12 ΔE218 and ΔE224. RESULTS Contractility studies on permeabilized myofibers demonstrated reduced maximal active tension from both patients with increased Ca(2+) sensitivity and altered cross-bridge cycling kinetics in ΔE224 fibers. In vitro motility studies showed a two-fold increase in Ca(2+) sensitivity of the fraction of filaments motile and the filament sliding velocity concentrations for both mutations. INTERPRETATION These data indicate that Tpm3.12 deletions ΔE218 and ΔE224 result in increased Ca(2+) sensitivity of the troponin-tropomyosin complex, resulting in abnormally active interaction of the actin and myosin complex. Both mutations are located in the charged motifs of the actin-binding residues of tropomyosin 3, thus disrupting the electrostatic interactions that facilitate accurate tropomyosin binding with actin necessary to prevent the on-state. The mutations destabilize the off-state and result in excessively sensitized excitation-contraction coupling of the contractile apparatus. This work expands the phenotypic spectrum of TPM3-related disease and provides insights into the pathophysiological mechanisms of the actin-tropomyosin complex.
Collapse
Affiliation(s)
- S Donkervoort
- National Institutes of Health, Neuromuscular and Neurogenetic Disorders of Childhood Section, Bethesda, MD, USA
| | - M Papadaki
- National Heart and Lung Institute, Imperial College London, London, UK
| | - J M de Winter
- Department of Physiology, VU University Medical Center, Amsterdam, The Netherlands
| | - M B Neu
- National Institutes of Health, Neuromuscular and Neurogenetic Disorders of Childhood Section, Bethesda, MD, USA
| | - J Kirschner
- Department of Neuropediatrics and Muscle Disorders, University Medical Center Freiburg, Freiburg, Germany
| | - V Bolduc
- National Institutes of Health, Neuromuscular and Neurogenetic Disorders of Childhood Section, Bethesda, MD, USA
| | - M L Yang
- University of Colorado School of Medicine, Department of Pediatrics and Neurology, Section of Child Neurology, Aurora, CO, USA
| | - M A Gibbons
- University of Colorado Denver School of Medicine, Aurora, CO, USA
| | - Y Hu
- National Institutes of Health, Neuromuscular and Neurogenetic Disorders of Childhood Section, Bethesda, MD, USA
| | - J Dastgir
- National Institutes of Health, Neuromuscular and Neurogenetic Disorders of Childhood Section, Bethesda, MD, USA
| | - M E Leach
- National Institutes of Health, Neuromuscular and Neurogenetic Disorders of Childhood Section, Bethesda, MD, USA.,Children's National Health System, Washington DC, USA
| | - A Rutkowski
- Kaiser SCPMG, Cure CMD, P.O. Box 701, Olathe, KS 66051, USA
| | - A R Foley
- National Institutes of Health, Neuromuscular and Neurogenetic Disorders of Childhood Section, Bethesda, MD, USA
| | - M Krüger
- Department of General Pediatrics, Adolescent Medicine and Neonatology, University Medical Center Freiburg, Freiburg, Germany
| | - E P Wartchow
- Department of Pathology, Children's Hospital Colorado, Aurora, Colorado, USA
| | - E McNamara
- Neuromuscular Diseases Laboratory, Centre for Medical Research, Faculty of Medicine, Dentistry and Health Sciences, The University of Western Australia Crawley, WA, Australia
| | - R Ong
- Neuromuscular Diseases Laboratory, Centre for Medical Research, Faculty of Medicine, Dentistry and Health Sciences, The University of Western Australia Crawley, WA, Australia
| | - K J Nowak
- National Institutes of Health, Neuromuscular and Neurogenetic Disorders of Childhood Section, Bethesda, MD, USA
| | - N G Laing
- Centre for Medical Research, University of Western Australia, Harry Perkins Institute of Medical Research, QEII Medical Centre, Perth, Western Australia, Australia
| | - N F Clarke
- Institute for Neuroscience and Muscle Research, The Children's Hospital at Westmead, University of Sydney, Sydney, Australia
| | - Cac Ottenheijm
- Department of Physiology, VU University Medical Center, Amsterdam, The Netherlands
| | - S B Marston
- National Heart and Lung Institute, Imperial College London, London, UK
| | - C G Bönnemann
- National Institutes of Health, Neuromuscular and Neurogenetic Disorders of Childhood Section, Bethesda, MD, USA
| |
Collapse
|
8
|
Papadaki M, Marston S, Memo M, Messer A, Donkervoort S, Bönnemann C, Nowak K, Ong R, McNamara E. Molecular basis of stiff patient syndrome caused by mutations in ACTA1 and TPM3. Neuromuscul Disord 2015. [DOI: 10.1016/j.nmd.2015.06.359] [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]
|
9
|
Donkervoort S, Neu M, Kirschner J, Yang M, Marston S, Gibbons M, Hu Y, de Winter J, Ottenheijm C, Rutkowski A, Krüger M, McNamara E, Ong R, Nowak K, Clarke N, Bönnemann C. G.P.272. Neuromuscul Disord 2014. [DOI: 10.1016/j.nmd.2014.06.348] [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]
|
10
|
Boutilier J, Ma J, Ram R, McNamara E, Laing N, Morahan G, Nowak K. P.10.22 Powerful mouse resource for determining modifier genes for neuromuscular diseases. Neuromuscul Disord 2013. [DOI: 10.1016/j.nmd.2013.06.552] [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]
|
11
|
Kim SB, Shultz C, Stuart M, McNamara E, Festarini A, Bureau DP. Organically bound tritium (OBT) formation in rainbow trout (Oncorhynchus mykiss): HTO and OBT-spiked food exposure experiments. Appl Radiat Isot 2012. [PMID: 23208241 DOI: 10.1016/j.apradiso.2012.10.001] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
In order to determine the rate of organically bound tritium (OBT) formation, rainbow trout (Oncorhynchus mykiss) were exposed to tritiated water (HTO) or OBT-spiked food. The HTO (in water) exposure study was conducted using a tritium activity concentration of approximately 7000 Bq/L and the OBT (in food) exposure study was conducted using a tritium activity concentration of approximately 30,000 Bq/L. Fish in both studies were expected to be exposed to similar tritium levels assuming 25% incorporation of the tritiated amino acids found in the food. Four different sampling campaigns of HTO exposure (Day 10, 30, 70, 140) and five different sampling campaigns of OBT-spiked food exposure (Day 9, 30, 70, 100, 140) were conducted to measure HTO and OBT activity concentrations in fish tissues. OBT depuration was also evaluated over a period of 30 days following the 140 d exposure studies. The results suggested that the OBT formation rate was slower when the fish were exposed to HTO compared to when the fish were ingesting OBT. In addition, the results indicated that OBT can bioaccumulate in fish tissues following OBT-spiked food exposure.
Collapse
Affiliation(s)
- S B Kim
- Environmental Technologies Branch, Chalk River Laboratories, AECL, Chalk River, Ontario, K0J 1J0 Canada.
| | | | | | | | | | | |
Collapse
|
12
|
Mokbel N, Ilkovski B, Memo M, Marttila M, Kreissl M, Wallgren-Pettersson C, Menard D, Marcorelles P, Echaniz-Laguna A, Reimann J, Vainzof M, Monnier N, Nowak K, McNamara E, Laing N, Trewhella J, Jeffries C, Ottenheijm C, North K, Clarke N. C.P.15 K7del is a recurrent TPM2 nemaline myopathy mutation associated with joint contractures and increased calcium sensitivity. Neuromuscul Disord 2012. [DOI: 10.1016/j.nmd.2012.06.143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
13
|
Ravenscroft G, McNamara E, Griffiths L, Papadimitriou J, Hardeman E, Bakker A, Laing N, Nowak K. C.O.3 Efficacy of cardiac actin over-expression therapy for ACTA1 disease seems mutation specific. Neuromuscul Disord 2012. [DOI: 10.1016/j.nmd.2012.06.125] [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: 11/16/2022]
|
14
|
Boutilier J, McNamara E, Laing N, Morahan G, Nowak K. D.P.14 Mining modifier genes for skeletal muscle actin diseases. Neuromuscul Disord 2012. [DOI: 10.1016/j.nmd.2012.06.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
15
|
Zheng Y, Hamilton E, McNamara E, Smith P, Darlington C. The effects of chronic tinnitus caused by acoustic trauma on social behaviour and anxiety in rats. Neuroscience 2011; 193:143-53. [DOI: 10.1016/j.neuroscience.2011.07.026] [Citation(s) in RCA: 30] [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: 05/18/2011] [Revised: 07/06/2011] [Accepted: 07/08/2011] [Indexed: 01/14/2023]
|
16
|
Zheng Y, Hamilton E, Stiles L, McNamara E, de Waele C, Smith PF, Darlington CL. Acoustic trauma that can cause tinnitus impairs impulsive control but not performance accuracy in the 5-choice serial reaction time task in rats. Neuroscience 2011; 180:75-84. [PMID: 21352899 DOI: 10.1016/j.neuroscience.2011.02.040] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2010] [Revised: 02/16/2011] [Accepted: 02/17/2011] [Indexed: 10/18/2022]
Abstract
Although tinnitus is an auditory disorder, it is often associated with attentional and emotional problems. Functional neuroimaging studies in humans have revealed that the hippocampus, amygdala and anterior cingulate, areas of the brain involved in emotion, attention and spatial processing, are also involved in auditory memory and tinnitus perception. However, few studies of tinnitus-evoked emotional and cognitive changes have been reported using animal models of tinnitus. In the present study, we investigated whether acoustic trauma that could cause tinnitus would affect attention and impulsivity in rats. Eight male Wistar rats were exposed to unilateral acoustic trauma (110 dB, 16 kHz for 1 h under anaesthesia) and eight rats underwent the same anaesthesia without acoustic trauma. Tinnitus was tested in noise-exposed rats using a frequency-specific shift in a discrimination function with a conditioned lick suppression paradigm. At 4 months after the noise exposure, the rats were tested in a 5-choice serial reaction time task. The behavioural procedure involved training the rats to discriminate a brief visual stimulus presented randomly in one of the five spatial locations and responding by poking its nose through the illuminated hole and collecting a food pellet from the magazine. While all of the animals performed equally well in making correct responses, the animals exposed to acoustic trauma made significantly more premature responses. The results suggest that rats exposed to acoustic trauma and some of which have chronic tinnitus are impaired in impulsive control, but not performance accuracy.
Collapse
Affiliation(s)
- Y Zheng
- Department of Pharmacology and Toxicology, School of Medical Sciences, University of Otago Medical School, P.O. Box 913, Dunedin, New Zealand.
| | | | | | | | | | | | | |
Collapse
|
17
|
Kennedy C, Lenahan M, Ryan M, Fanning S, Sheridan J, McNamara E, Carroll A, Sweeney T. Shiga toxin-producing Escherichia coli isolated from human and pig origin induce different gene expression profiles in human Caco-2 epithelial cells. Livest Sci 2010. [DOI: 10.1016/j.livsci.2010.06.061] [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: 11/17/2022]
|
18
|
Abstract
The valid measurement of physical activity has the potential to be a very useful tool in countering the obesity epidemic. Previously, reviews have been carried out to investigate the validity of pedometers among adults. This paper aimed to carry out a similar review among children. A literature search was performed in PubMed, Web of Science, PsycINFO, CINAHL and SportDISCUS. Here, 25 papers investigating the validity, reliability and feasibility of pedometers for children were included in the study. Pedometers correlated highly in terms of both criterion (direct observation) and convergent validity (heart-rate monitor, accelerometer). Intra- and inter-unit reliability was also consistently high. Few studies report on feasibility issues of pedometer use in children, particularly compliance, reactivity and dealing with missing data. Given that they are both cheap and easy to use, pedometers can be effectively utilized as a valid determinant of physical activity levels among children and adolescents, particularly in large-scale epidemiological studies. There remains a need for accepted outliers and proper protocol regarding missing data.
Collapse
Affiliation(s)
- Eoin McNamara
- Centre for Sports and Exercise Medicine, Mile End Hospital, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK.
| | | | | |
Collapse
|
19
|
McGill K, Kelly L, Madden R, Moran L, Carroll C, O'Leary A, Moore J, McNamara E, O'Mahony M, Fanning S, Whyte P. Comparison of disc diffusion and epsilometer (E-test) testing techniques to determine antimicrobial susceptibiliy of Campylobacter isolates of food and human clinical origin. J Microbiol Methods 2009; 79:238-41. [DOI: 10.1016/j.mimet.2009.09.020] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2009] [Revised: 09/21/2009] [Accepted: 09/22/2009] [Indexed: 10/20/2022]
|
20
|
O'Sullivan MB, Garvey P, O'Riordan M, Coughlan H, McKeown P, Brennan A, McNamara E. Increase in VTEC cases in the south of Ireland: link to private wells? Euro Surveill 2008; 13:18991. [PMID: 18822242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023] Open
|
21
|
O’Sullivan MB, Garvey P, O’Riordan M, Coughlan H, McKeown P, Brennan A, McNamara E. Increase in VTEC cases in the south of Ireland: link to private wells? Euro Surveill 2008. [DOI: 10.2807/ese.13.39.18991-en] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
High levels of verotoxigenic Escherichia coli (VTEC) have been recorded to date in 2008 in the Republic of Ireland. One hundred and forty-eight VTEC cases were notified up to the end of August 2008 (Figure 1), compared to 70-90 confirmed cases reported in the equivalent time period in 2006 and 2007. Thirty three percent of cases notified in Ireland in 2008 indicated that their usual drinking water supply was a private well.
Collapse
Affiliation(s)
- M B O’Sullivan
- Department of Public Health, Health Service Executive - South, Cork, Ireland
| | - P Garvey
- Health Protection Surveillance Centre, Dublin, Ireland
| | - M O’Riordan
- Department of Public Health, Health Service Executive - South, Cork, Ireland
| | - H Coughlan
- Department of Public Health, Health Service Executive - South, Cork, Ireland
| | - P McKeown
- Health Protection Surveillance Centre, Dublin, Ireland
| | - A Brennan
- Department of Public Health, Health Service Executive - South, Cork, Ireland
| | - E McNamara
- Public Health Laboratory, HSE Dublin Mid-Leinster, Cherry Orchard Hospital, Dublin, Ireland
| |
Collapse
|
22
|
Mannix M, Whyte D, McNamara E, O’Connell N, FitzGerald R, Mahony M, Prendiville T, Norris T, Curtin A, Carroll A, Whelan E, Buckley J, McCarthy J, Murphy M, Greally T. Large outbreak of E. coli O157 in 2005, Ireland. Euro Surveill 2007. [DOI: 10.2807/esm.12.02.00683-en] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
In October/November 2005, the largest outbreak of verotoxin-producing Escherichia coli (VTEC) ever recorded in Ireland occurred. Eighteen E. coli O157 culture-positive cases, phage type 32, verotoxin 2 positive, were identified in a small rural area of mid-west Ireland. Half of these patients were asymptomatic. Two children were admitted to hospital with haemolytic uraemic syndrome, one of whom required peritoneal dialysis, and both recovered. All 18 culture-positive patients had indistinguishable or closely related pulsed field gel electrophoresis (PFGE) patterns. Nine of the VTEC O157 culture-positive individuals were in preschool children attending two local crèches. Several culture-positive individuals apparently had exposure to a vulnerable private group water scheme (GWS) in an agricultural area. No microbiological evidence of VTEC was found in food or water. One veterinary sample (an animal rectal swab) was positive for E. coli O157 and the PFGE strain was indistinguishable from the outbreak strain. A case control study showed analytical epidemiological evidence of risk related to potential exposure to the GWS but not related to reported consumption of that water. Selection of cases and controls proved challenging. Transmission occurred primarily in childcare and family settings, with significant person-to-person spread. Control measures included voluntary closure of the crèches, exclusion of culture-positive individuals in risk groups until microbiological clearance was achieved and the issuing of a ‘boil water’ advisory for drinking water pending upgrading of disinfection facilities.
Collapse
Affiliation(s)
- M Mannix
- Department of Public Health, HSE West, Limerick, Ireland
| | - D Whyte
- Department of Public Health, HSE West, Limerick, Ireland
| | - E McNamara
- Public Health Laboratory, HSE Dublin Mid-Leinster, Ireland
| | - N O’Connell
- Department of Medical Microbiology, Mid-Western Regional Hospital, Limerick, Ireland
| | - R FitzGerald
- Department of Public Health, HSE West, Limerick, Ireland
| | - M Mahony
- Paediatric Department, Mid-Western Regional Hospital, Limerick, Ireland
| | - T Prendiville
- Paediatric Department, Mid-Western Regional Hospital, Limerick, Ireland
| | - T Norris
- Department of Public Health, HSE West, Limerick, Ireland
| | - A Curtin
- Environmental Health Services, HSE West, Limerick, Ireland
| | - A Carroll
- Public Health Laboratory, HSE Dublin Mid-Leinster, Ireland
| | - E Whelan
- Department of Medical Microbiology, Mid-Western Regional Hospital, Limerick, Ireland
| | - J Buckley
- Veterinary Section, Cork County Council, Ireland
| | - J McCarthy
- Veterinary Section, Limerick County Council, Ireland
| | - M Murphy
- Veterinary Section, Cork County Council, Ireland
| | - T Greally
- Department of Public Health, HSE West, Limerick, Ireland
| |
Collapse
|
23
|
Sayers G, McCarthy T, O'Connell M, O'Leary M, O'Brien D, Cafferkey M, McNamara E. Haemolytic uraemic syndrome associated with interfamilial spread of E. coli O26:H11. Epidemiol Infect 2006; 134:724-8. [PMID: 16371176 PMCID: PMC2870445 DOI: 10.1017/s0950268805005455] [Citation(s) in RCA: 8] [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] [Accepted: 09/09/2005] [Indexed: 11/06/2022] Open
Abstract
In September 2000, haemolytic uraemic syndrome (HUS) was diagnosed in a 10-month-old child with a prodromal history of vomiting and diarrhoea (non-bloody). Investigation revealed that a self-limiting gastrointestinal illness (mean duration 48 h) had occurred among immediate and extended family in the 2 weeks prior to the child's admission. The epidemiology of the illness suggested person-to-person spread. Five children (close family contacts) had E. coli O26 verocytotoxin (VT1 and VT2) isolated from stools. Stool culture and serology from the index case were negative for shiga toxin-producing E. coli (STEC) organisms. Control measures in accordance with the Public Health Laboratory Service (PHLS), verocytotoxogenic organisms (VTEC) guidelines were applied to prevent further spread among the extended family and contacts. Despite detailed food and environmental exposure histories, the source of the illness was not identified. This incident highlights the importance of investigation of cases of post-diarrhoeal HUS, for potential shiga toxin E. coli aetiology.
Collapse
Affiliation(s)
- G Sayers
- Department of Public Health, Health Service Executive Eastern Region, Dublin.
| | | | | | | | | | | | | |
Collapse
|
24
|
McGill K, Cowley D, Moran L, Scates P, O'Leary A, Madden RH, Carroll C, McNamara E, Moore JE, Fanning S, Collins JD, Whyte P. Antibiotic resistance of retail food and human Campylobacter isolates on the island of Ireland from 2001-2002. Epidemiol Infect 2006; 134:1282-91. [PMID: 16623987 PMCID: PMC2870507 DOI: 10.1017/s0950268806006200] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/23/2006] [Indexed: 11/05/2022] Open
Abstract
The antimicrobial resistance profiles of Campylobacter isolates recovered from a range of retail food samples (n=374) and humans (n=314) to eight antimicrobial compounds were investigated. High levels of resistance in food C. jejuni isolates were observed for ceftiofur (58%), ampicillin (25%) and nalidixic acid (17%) with lower levels observed for streptomycin (7.9%) and chloramphenicol (8.3%). A total of 80% of human C. jejuni isolates were resistant to ceftiofur, while 17% showed resistance to ampicillin and nalidixic acid, 8.6% to streptomycin and 4.1% to chloramphenicol. Resistance to clinically relevant antimicrobials such as erythromycin, ciprofloxacin and tetracycline was 6.7, 12, and 15% respectively for all food isolates and was similar to corresponding resistance prevalences observed for human isolates, where 6.4, 12 and 13% respectively were found to be resistant. Comparisons of C. jejuni isolates in each location showed a high degree of similarity although some regional variations did exist. Comparison of total C. jejuni and C. coli populations showed minor differences, with C. jejuni isolates more resistant to ampicillin and ceftiofur. Multidrug resistance patterns showed some profiles common to human and clinical isolates.
Collapse
Affiliation(s)
- K McGill
- Veterinary Public Health and Food Safety Research Laboratory, School of Agriculture, Food Science and Veterinary Medicine, University College Dublin, Belfield, Dublin, Ireland.
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
25
|
Whyte P, McGill K, Cowley D, Madden RH, Moran L, Scates P, Carroll C, O'Leary A, Fanning S, Collins JD, McNamara E, Moore JE, Cormican M. Occurrence of Campylobacter in retail foods in Ireland. Int J Food Microbiol 2004; 95:111-8. [PMID: 15282123 DOI: 10.1016/j.ijfoodmicro.2003.10.018] [Citation(s) in RCA: 110] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2003] [Revised: 10/01/2003] [Accepted: 10/31/2003] [Indexed: 11/24/2022]
Abstract
A surveillance study was carried out to determine the prevalence of Campylobacter in a range of retail foods purchased in three Irish cities over a 20-month period between March 2001 and October 2002. In total 2391 food samples were analysed during this period. Campylobacter was isolated from 444 raw chicken (49.9%), 33 turkey (37.5%) and 11 duck samples (45.8%). Lower isolation rates of 7/221 (3.2%), 10/197 (5.1%) and 31/262 (11.8%) were observed for raw beef, pork and lamb, respectively. One sample of pork paté from 120 samples analysed (0.8%) was Campylobacter-positive. A total of three shellfish samples (oysters) from 129 raw specimens examined (2.3%) were found to contain Campylobacter. Low prevalences of the organism (0.9%) were also isolated from fresh mushrooms. Of 62 raw bulk tank milk samples analysed, Campylobacter was recovered in a single sample (1.6%). Campylobacter was not detected in any of the comminuted pork puddings, prepared vegetables and salads, retail sandwiches or cheeses made from unpasteurised milk. In total, 543 Campylobacter were isolated from all of the food samples analysed, of which 453 (83.4%) were confirmed as Campylobacter jejuni and the remaining 90 (16.6%) as Campylobacter coli.
Collapse
Affiliation(s)
- P Whyte
- Veterinary Public Health and Food Safety Research Laboratory, Faculty of Veterinary Medicine, University College Dublin, Ballsbridge, Belfield, Dublin 4, Ireland.
| | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
26
|
Loane D, Flanagan G, Siún A, McNamara E, Kenny S. Nutrition in the community - an exploratory study of oral nutritional supplements in a health board area in Ireland. J Hum Nutr Diet 2004; 17:257-66. [PMID: 15139898 DOI: 10.1111/j.1365-277x.2004.00527.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
BACKGROUND A review of the General Medical (Payments) Scheme data in the Midland Health Board (MHB) Ireland identified a spend of just over euro 0.5 million on enteral nutritional supplements (oral and tube feeds) in an 11-month period in 1998 [General Medical Services (Payments) Board, 1998, MHB Clinical Nutritional Products: January-December 1998, Dublin]. In 2000, a figure of euro5 million was reported as the annual spend (oral and tube feeds) [General Medical Services (Payments) Board, 2000, MHB Clinical Nutritional Products: January-December 2000, Dublin]. Research has shown that a high proportion of Oral Nutritional Supplements (ONS) are inappropriately prescribed by primary care practitioners (Gall et al., 2001). The role of General Practitioners (GPs) and Public Health Nurses (PHNs) in prescribing ONS to patients aged 65 years and older was examined, as they are directly involved in the delivery of primary health care. AIM (i) Assess current trends, decision-making processes and monitoring procedures in the use of ONS for older patients in the community. (ii) Identify whether nutritional assessments and appropriate nutritional criteria are standard practice in determining selection of ONS. METHODS A study was conducted among 99 GPs and 120 PHNs in the MHB. All GPs were selected to participate and 50% (60) of PHNs were randomly selected. A telephone questionnaire was administered to each subject over a 2-week period. RESULTS Both GPs (78%) and PHNs (47%) reported that their prescription of/recommendations for ONS had increased in the last 4 years. None conducted a full nutritional assessment, but 25% of PHNs used a Nutrition Screening Tool when trying to ascertain whether a patient requires an ONS. Only 19.6% of GPs and 6.8% of PHNs surveyed were aware of the calorie content of a standard 200 mL ONS (sip-feed). In addition, a very significant proportion of both GPs and PHNs do not appear to give appropriate dietary advice to patients who may be at risk of malnutrition. Only 55% of GPs stated that they would specifically review a patient's ONS prescription. All GPs said that they would not conduct a full nutritional assessment at the review appointment. CONCLUSION The results of this study raise concerns as to the appropriateness of current ONS prescription and monitoring in the community. They also highlight the need for further intervention in the primary care setting in order to ensure that elderly malnourished patients are detected, treated and monitored in an appropriate and cost-effective manner.
Collapse
Affiliation(s)
- D Loane
- School of Biological Sciences, Dublin Institute of Technology, Dublin, Ireland
| | | | | | | | | |
Collapse
|
27
|
Flanagan G, Loane D, Kenny S, McNamara E. Oral nutrition supplements use in an Irish community. Clin Nutr 2003. [DOI: 10.1016/s0261-5614(03)80368-0] [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: 10/26/2022]
|
28
|
Roche M, Humphreys H, Smyth E, Phillips J, Cunney R, McNamara E, O'Brien D, McArdle O. A twelve-year review of central nervous system bacterial abscesses; presentation and aetiology. Clin Microbiol Infect 2003; 9:803-9. [PMID: 14616700 DOI: 10.1046/j.1469-0691.2003.00651.x] [Citation(s) in RCA: 81] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVES To review and document the changing patterns in diagnosis, causes and treatment of bacterial infections of the central nervous system (CNS) in a national neurosurgical unit only in patients from whom a specimen was obtained for culture. METHODS The case notes, radiological results and laboratory records of all 163 patients in our institution who underwent a neurosurgical procedure between 1988 and 2000 for a CNS abscess in a national center were reviewed retrospectively. Those patients from whom there were no operative specimens (i.e. neurosurgical intervention was not performed) and who were treated empirically were excluded, as were patients with mycobacterial infection. RESULTS The mean age of the 163 patients was 35.2 years. Headache, pyrexia and an altered mental state were the commonest presentations. The frontal lobe was the commonest anatomical site (62 patients, 38%) and the majority of abscesses occurred following community infections such as sinusitis and mastoiditis; no primary source could be identified in 32 (20%) patients. Bacteria were isolated from 73% of patients and polymicrobial infections occurred in 29 (17.7%) patients. Anaerobes accounted for only 13.6% of isolates and methicillin-resistant Staphylococcus aureus (MRSA) was isolated on five occasions, all in the last five years of this review. Sixteen (9.8%) patients died prior to discharge or transfer back to the original referring hospital and 18 (11%) patients developed epilepsy. CONCLUSION There was a relatively high incidence of polymicrobial infection but the number of specimens with anaerobes was small, which may be because of the use of empiric metronidazole before surgical intervention. Most infections were community-acquired and responded well to a combination of surgical drainage and antibiotic therapy. The emergence of MRSA in this group of patients is, however, worrying.
Collapse
Affiliation(s)
- M Roche
- Department of Microbiology, Beaumont Hospital, Dublin, Ireland
| | | | | | | | | | | | | | | |
Collapse
|
29
|
Power RE, Little DM, Smyth E, McNamara E, Hickey DP. Successful replacement of systemic immunosuppression by local graft irradiation in the management of listeria meningitis. Transplant Proc 2003; 35:1322-3. [PMID: 12826148 DOI: 10.1016/s0041-1345(03)00436-6] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- R E Power
- Department of Transplantation, Beaumont Hospital, Dublin, Ireland.
| | | | | | | | | |
Collapse
|
30
|
Abstract
The use of tube feeding in some patients can be controversial, however, few studies have investigated dietitians' opinions on this subject. A cross-sectional survey of 345 members the Irish Nutrition and Dietetic Institute was conducted using a self-administered, anonymous, postal questionnaire. A 44% response rate was achieved. Mean number of years qualified was 9.3 (8.4). Eighty-one per cent of responders were involved in initiating tube feeding in stroke patients, and 8.5% in discontinuing tube feeding in a patient in a persistent vegetative state (PVS). Nine per cent felt that their input had no influence on the care plan of the patient with dementia and 67% felt that the information given to families (or other decision makers) concerning tube feeding was inadequate. The majority of respondents favoured tube feeding fictitious stroke and cancer patients, but less than half favoured tube feeding a fictitious patient in a PVS or a patient with dementia. When given similar scenarios involving themselves, fewer dietitians wanted to be tube fed.
Collapse
Affiliation(s)
- S Healy
- School of Biological Sciences, Dublin Institute of Technology, Kevin Street, Dublin 7, Republic of Ireland
| | | |
Collapse
|
31
|
Murphy TM, McNamara E, Hill M, Rooney N, Barry J, Egan J, O'Connell A, O'Loughlin J, McFaddyen S. Epidemiological studies of human and animal Salmonella typhimurium DT104 and DT104b isolates in Ireland. Epidemiol Infect 2001; 126:3-9. [PMID: 11293679 PMCID: PMC2869670 DOI: 10.1017/s0950268801005143] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
A total of 122 human and animal Salmonella Typhimurium DT104 isolates and 6 epidemiologically related DT104b isolates from human and animal products were analysed by pulsed-field gel electrophoresis (PFGE). Genomic DNA was subjected to macrorestriction with three enzymes, SpeI, SfiI and XbaI. A total of 14 restriction fragment length polymorphism (RFLP) profiles were identified when the PFGE patterns from the three enzymes were combined. The majority of isolates (81.2%) exhibited the same RFLP profile. Six animal DT104 isolates, susceptible to enrofloxacin and resistant to naladixic acid, were identified from the antibiotic susceptibility test. Four of these isolates had a different PFGE profile from the common RFLP. In addition, 4 of the 6 isolates were geographically clustered in one region. It was concluded that there was one predominant strain of S. Typhimurium DT104 in Ireland and that the potential and selection pressures for emergence of fluoroquinolone-resistant isolates were present.
Collapse
Affiliation(s)
- T M Murphy
- Department of Agriculture, Central Veterinary Laboratory, Castleknock, Dublin, Ireland
| | | | | | | | | | | | | | | | | |
Collapse
|
32
|
Uboh CE, Soma LR, Luo Y, McNamara E, Fennell MA, May L, Teleis DC, Rudy JA, Watson AO. Pharmacokinetics of penicillin G procaine versus penicillin G potassium and procaine hydrochloride in horses. Am J Vet Res 2000; 61:811-5. [PMID: 10895905 DOI: 10.2460/ajvr.2000.61.811] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To compare the pharmacokinetics of penicillin G and procaine in racehorses following i.m. administration of penicillin G procaine (PGP) with pharmacokinetics following i.m. administration of penicillin G potassium and procaine hydrochloride (PH). ANIMALS 6 healthy adult mares. PROCEDURE Horses were treated with PGP (22,000 units of penicillin G/kg of body weight, i.m.) and with penicillin G potassium (22,000 U/kg, i.m.) and PH (1.55 mg/kg, i.m.). A minimum of 3 weeks was allowed to elapse between drug treatments. Plasma and urine penicillin G and procaine concentrations were measured by use of high-pressure liquid chromatography. RESULTS Median elimination phase half-lives of penicillin G were 24.7 and 12.9 hours, respectively, after administration of PGP and penicillin G potassium. Plasma penicillin G concentration 24 hours after administration of penicillin G potassium and PH was not significantly different from concentration 24 hours after administration of PGP. Median elimination phase half-life of procaine following administration of PGP (15.6 hours) was significantly longer than value obtained after administration of penicillin G potassium and PH (1 hour). CONCLUSIONS AND CLINICAL RELEVANCE Results suggest that i.m. administration of penicillin G potassium will result in plasma penicillin G concentrations for 24 hours after drug administration comparable to those obtained with administration of PGP Clearance of procaine from plasma following administration of penicillin G potassium and PH was rapid, compared with clearance following administration of PGP.
Collapse
Affiliation(s)
- C E Uboh
- West Chester University, Department of Chemistry, PA 19382, USA
| | | | | | | | | | | | | | | | | |
Collapse
|
33
|
Cunney R, Aziz HA, Schubert D, McNamara E, Smyth E. Interpretative reporting and selective antimicrobial susceptibility release in non-critical microbiology results. J Antimicrob Chemother 2000; 45:705-8. [PMID: 10797098 DOI: 10.1093/jac/45.5.705] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
The action taken in response to 169 positive sputum, urine and wound culture reports was examined. All reports included interpretative comments. Antimicrobial susceptibilities were released in 29 (17%). Therapy was significantly more likely to be started or altered in response to reports where susceptibilities were released (13 of 29, 45%) versus those without susceptibility release (31 of 140, 22%). Susceptibility release did not influence the appropriateness of antibiotic therapy. The clinical microbiology team was contacted for therapeutic advice in response to 32 (19%) reports. Of the remaining 137 reports, therapy was started or altered in response to 30 (22%) reports, but was considered appropriate in only seven (22%) of these.
Collapse
Affiliation(s)
- R Cunney
- Beaumont Hospital and Royal College of Surgeons in Ireland, Dublin 9, Ireland.
| | | | | | | | | |
Collapse
|
34
|
Affiliation(s)
- E McNamara
- Department of Clinical Medicine, Trinity Centre for Health Sciences, St. James's Hospital, Dublin
| | | | | |
Collapse
|
35
|
Abstract
BACKGROUND Clostridium difficile-associated diarrhoea (CDAD) is a potentially life-threatening illness which has been shown to be more common and more severe in patients with chronic renal failure (CRF) than in other groups. A review of CDAD in our nephrology unit was carried out. METHODS A review of microbiology and histology records identified 32 cases of CDAD in the nephrology unit over a 24-month period. Patient notes were reviewed to identify risk factors, clinical features and outcome. Available isolates of C. difficile underwent 16S ribosomal RNA typing. RESULTS The incidence of CDAD in the nephrology unit was 10.7 per 1000 admissions, compared to 2.7 per 1000 in other areas of the hospital (P<0.0001). CDAD was considered the sole or principal cause of death in six (19%) and was considered a contributing factor in a further seven (22%). Mortality was significantly higher among patients with established CRF (P=0.04). Seven cases occurred as a cluster, over a 1-month period. Isolates from this cluster, along with comparative strains from other areas of the hospital, were found to be PCR type 1. Diarrhoea occurred in 28 (89%) of cases, pyrexia in 17 (53%) and ileus or abdominal pain in 14 (44%). Six patients responded to discontinuation of antibiotics alone and 22 required metronidazole and/or vancomycin. Three patients had colectomy and one caecostomy because of toxic megacolon. Four patients died before specific therapy could be given and in two of these cases the diagnosis was made at autopsy. Twenty-six patients had a record of recent antibiotic therapy. Of these, 15 had at least one agent considered to be inappropriate (excessively broad spectrum agent in 11, excessive duration of therapy in four). Nine patients had only received antibiotics prior to admission. CONCLUSIONS CDAD carries a high mortality in nephrology patients, especially those with established CRF. The diagnosis may be missed if a careful antibiotic history is not taken, including agents received prior to admission. Rational antibiotic prescribing and adherence to infection control measures are vital to reduce the incidence of this serious condition.
Collapse
Affiliation(s)
- R J Cunney
- Department of Clinical Microbiology, Beaumont Hospital, Dublin, Ireland
| | | | | | | | | |
Collapse
|
36
|
Willison HJ, Lastovica AJ, Prendergast MM, Moran AP, Walsh C, Flitcroft I, Eustace P, McMahon C, Smith J, Smith OP, Lakshmandass G, Taylor MRH, Holland CV, Cox D, Good B, Kearns GM, Gaffney P, Shark K, Frauenshuh M, Ortmann W, Messner R, King R, Rich S, Behrens T, Mahmud N, Molloy A, McPartlin J, Scott JM, Weir DG, Walsh KM, Thorburn D, Mills P, Morris AJ, Good T, Cameron S, McCruden EAB, Bennett MW, O’Connell J, Brady C, Roche D, Collins JK, Shanahan F, O’Sullivant GC, Henry M, Koston S, McMahon K, MacNee W, FitzGerald MX, O’Connor CM, McGonagle D, Gibbon W, O’Connor P, Emery P, Murphy M, Watson R, Casey E, Naidu E, Murphy M, Watson R, Barnes L, McCann S, Murphy M, Watson R, Barnes L, Sweeney E, Barrett EJ, Graham H, Cunningham RT, Johnston CF, Curry WJ, Buchanan KD, Courtney CH, McAllister AS, McCance DR, Hadden DR, Bell PM, Leslie H, Sheridan B, Atkinson AB, Kilbane MT, Smith DF, Murray MJ, Shering SG, McDermott EWM, O’Higgins NJ, Smyth PPA, McEneny J, Trimble ER, Young IS, Sharpe P, Mercer C, McMaster D, Young IS, Evans AE, Young IS, Cundick J, Hasselwander O, McMaster D, McGeough J, Savage D, Maxwell AP, Evans AE, Kee F, Larkin CJ, Watson RGP, Johnston C, Ardill JES, Buchanan KD, McNamara DA, Walsh TN, Bouchier-Hayes DJ, Madden C, Timon C, Gardiner N, Lawler M, O’Riordan J, Duggan C, McCann SR, Gowing H, Braakman E, Lawler M, Byrne C, Martens ACM, Hagenbeek A, McCann SR, Kinsella N, Cusack S, Lawler M, Baker H, White B, Smith OP, Lawler M, Gardiner N, Molloy K, Gowing H, Wogan A, McCann SR, McElwaine S, Lawler M, Hollywood D, McCann SR, Mcmahon C, Merry C, Ryan M, Smith O, Mulcahy FM, Murphy C, Briones J, Gardiner N, McCann SR, Lawler M, White B, Lawler M, Cusack S, Kinsella N, Smith OP, Lavin P, McCaffrey M, Gillen P, White B, Smith OP, Thompson L, Lalloz M, Layton M, Barnes L, Corish C, Kennedy NP, Flood P, Mulligan S, McNamara E, Kennedy NP, Flood P, Mathias PM, Ball E, Duiculescu D, Calistru P, O’Gorman N, Kennedy NP, Abuzakouk M, Feighery C, Brannigan M, Pender S, Keeling F, Varghese J, Lee M, Colreavy M, Gaffney R, Hone S, Herzig M, Walsh M, Dolan C, Wogan A, Lawler M, McCann SR, Hollywood D, Donovan D, Harmey J, Bouchier-Hayes DJ, Haverty A, Wang JH, Harmey JH, Redmond HP, Bouchier-Hayes DJ, McGreal G, Shering SG, Moriarty MJ, Shortt A, Kilbane MT, Smith DF, McDermott EWM, O’Higgins NJ, Smyth PPA, McNamara DA, Harmey J, Wang JH, Donovan D, Walsh TN, Bouchier-Hayes DJ, Kay E, Pidgeon G, Harmey J, McNamara DA, Bouchier-Hayes DJ, Dunne P, Lambkin H, Russell JM, O’Neill AJ, Dunne BM, O’Donovan M, Lawler M, Gaffney EF, Gillan JE, Cotter TG, Horan J, Jones D, Biswas SK, Mulkerrin EC, Brady H, O’Donnell J, Neary J, Healy E, Watson A, Keogh B, Ryan M, Cassidy C, Ward S, Stokes E, Keoghan F, Barrett A, O’Connell P, Ryall N, O’Connell PA, Jenkinson A, O’Brien T, O’Connell PG, Harrison R, Barrett T, Bailey DMD, Butler A, Barton DE, Byrne C, McElwaine S, McCann SR, Lawler M, Cusack S, Lawler M, White B, Smith OP, Daly G, Gill M, Heron S, Hawi Z, Fitzgerald M, Hawi Z, Mynett-Johnson L, Shiels D, Kendler K, McKeon P, Gill M, Straub R, Walsh D, Ryan F, Barton DE, McCabe D, Murphy R, Segurado R, Mulcahy T, Larson B, Comerford C, O’Connell R, O’Mahony E, Gill M, Donnelly J, Minahan F, O’Neill D, Farrell Z, O’Neill D, Jones D, Horan J, Glynn C, Biswas SK, Mulkerrin E, Brady H, Lennox SE, Murphy A, Rea IM, McNulty H, McMeel C, O’Neill D, McEvoy H, Freaney R, McKenna MJ, Crowe M, Keating D, Colreavy M, Hone S, Norman G, Widda S, Viani L, Galvin, Nolan CM, Hardiman O, Hardiman O, Brett F, Droogan O, Gallagher P, Harmey M, King M, Murphy J, Perryrnan R, Sukumaran S, Walsh J, Farrell MA, Hughes G, Cunningham C, Walsh JB, Coakley D, O’Neill D, Hurson M, Flood P, McMonagle P, Hardiman O, Ryan F, O’Sullivan S, Merry C, Dodd P, Redmond J, Mulcahy FM, Browne R, Keating S, O’Connor J, Cassidy BP, Smyth R, Sheppard NP, Cullivan R, Crown J, Walsh N, Denihan A, Bruce I, Radic A, Coakley D, Lawlor BA, Bridges PK, O’Doherty M, Farrington A, O’Doherty M, Farragher B, Fahy S, Kelly R, Carey T, Owens J, Gallagher O, Sloan D, McDonough C, Casey P, Horgan A, Elneihum A, O’Neill C, McMonagle T, Quinn J, Meagher D, Murphy P, Kinsella A, Mullaney J, Waddington JL, Rooney S, Rooney S, Bamford L, Sloan D, O’Connor JJ, Franklin R, O’Brien K, Fitzpatrick G, Laffey JG, Boylan JF, Laffey J, Coleman M, Boylan J, Laffey JG, McShane AJ, Boylan JF, Loughrey JPR, Gardiner J, McGinley J, Leonard I, Carey M, Neligan P, O’Rourke J, Cunningham A, Fennessy F, Kelly C, Bouchier-Hayes D, Fennessy F, Wang JH, Kelly C, Bouchier-Hayes D, Fennessy F, Wang JH, Kelly C, Bouchier-Hayes DJ, Kellett J, Laffey J, Murphy D, Regan J, O’Keeffe D, Mahmud A, Hemeryck L, Feely J, Mahmud A, Hemeryck L, Hall M, Feely J, Menown IBA, Mathew TP, Nesbitt GS, Syme M, Young IS, Adgey AAJ, Menown IBA, Turtle F, Allen J, Anderson J, Adgey AAJ, O’Hanlon R, Codd MB, Walkin S, McCann HA, Sugrue DD, Rasheed AM, Chen G, Kelly C, Bouchier-Hayes DJ, Leahy A, Rasheed AM, Kay E, Jina S, Bouchier-Hayes DJ, Leahy A, McDowell I, Rasheed AM, Wang JH, Wo Q, Kelly C, Bouchier-Hayes DJ, Leahy A, Shuhaibar MN, McGovern E, Turtle F, Menown IBA, Manoharan G, Kirkpatrick R, Campbell NPS, Walkin S, Codd MB, O’Hanlon R, McCarthy C, McCann HA, Sugrue DD, Wen Y, Killalea S, Hall M, Hemeryck L, Feely J, Fahy CJ, Griffith A, McGinley J, McCabe D, Fraser A, Casey E, Ryan T, Murphy R, Browne M, Fenton J, Hughes J, Timon CI, Fenton J, Curran A, Smyth D, Viani L, Walsh M, Hughes JP, Fenton J, Lee P, Kelly A, Timon CI, Hughes JP, Fenton J, Shine N, Blayney A, McShane DP, Timon CI, Hussey J, Howlett M, Langton A, McEvoy A, Slevin J, Fitzpatrick C, Turner MJ, Enright F, Goggin N, Costigan C, Duff D, Osizlok P, Wood F, Watson R, Fitzsimons RB, Flanagan N, Enright F, Barnes L, Watson R, Molloy E, Griffin E, Deasy PF, Sheridan M, White MJ, Moore R, Gray A, Hill J, Glasgow JFT, Middleton B, Slattery D, Donoghue V, McMahon A, Murphy J, Slattery D, McCarthy A, Oslislok P, Duff D, Colreavy M, Keogh I, Hone S, Walsh M, Henry M, Koston S, McMahon K, MacNee W, FitzGerald MX, O’Connor CM, Russell KJ, Henry M, Fitzgerald MX, O’Connor CM, Kavanagh PV, McNamara SM, Feely J, Barry M, O’Brien JE, McCormick P, Molony C, Doyle RM, Walsh JB, Coakley D, Codd MB, O’Connell PR, Dowey LC, McGlynn H, Thurnham DI, Elborn SJ, Flynn L, Carton J, Byrne B, O’Farrelly C, Kelehan P, O’Herlihy C, O’Hara AM, Moran AP, Orren A, Fernie BA, Merry C, Clarke S, Courtney G, de Gascun C, Mulcahy FM, Merry C, Ryan M, Barry M, Mulcahy FM, Merry C, Ryan M, Barry M, Mulcahy FM, Byrne M, Moylett E, Murphy H, Butler K, Nourse C, Thaker H, Barry C, Russell J, Sheehan G, Boyle B, Hone R, Conboy B, Butler C, Moris D, Cormican M, Flynn J, McCormack O, Corbally N, Murray A, Kirrane S, O’Keane C, Hone R, Lynch SM, Cryan B, Whyte D, Morris D, Butler C, Cormican M, Flynn J, Corbett-Feeney G, Murray A, Corbally N, Hone R, Mackle T, Colreavy M, Perkins J, Saidlear C, Young A, Eustace P, Wrigley M, Clifford J, Waddington JL, Tighe O, Croke DT, Drago J, Sibley DR, Feely J, Kelly A, Carvalho M, Hennessy M, Kelly M, Feely J, Hughes C, Hanlon M, Feely J, Sabra K, Keane T, Egan D, Ryan M, Maerry C, Ryan M, Barry M, Mulcahy FM, Maerry C, Ryan M, Barry M, Mulcahy FM, Sharma SC, Williams D, Kelly A, Carvalho M, Feely J, Williams D, Kelly A, Carvalho M, Feely J, Codd MB, Mahon NG, McCann HA, Sugrue DD, Sayers GM, Johnson Z, McNamara SM, Kavanagh PV, Feely J. National scientific medical meeting 1997 abstracts. Ir J Med Sci 1998. [DOI: 10.1007/bf02937234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
|
37
|
Cunney RJ, McNamara E, al Ansari N, O'Neill G, O'Neill S, Smyth EC. Failure of teicoplanin therapy in Staphylococcus aureus septicaemia. J Hosp Infect 1994; 28:325-7. [PMID: 7897196 DOI: 10.1016/0195-6701(94)90098-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
|
38
|
Carson KD, Grimes SB, McGinley JM, Thornton MT, Mulhall J, Bourke AM, McCrory C, Marsh B, Hone R, Phelan D, White M, Fabry J, Hughes D, Carson K, Donnelly M, Shanahan E, Fitzpatrick GJ, Bourke M, Warde D, Buggy D, Hughes N, Taylor A, Dowd N, Markham T, Blunnie W, Nicholson G, O’Leary E, Cunningham AJ, Dwyer R, McMechan S, Cullen C, Dempsey G, Wright G, MacKenzie G, Anderson J, Adgey J, Walsh M, O’Callaghan P, Graham I, O’Hare JA, Geoghegan M, Iman N, Shah P, Chander R, Lavin F, Daly K, Johnston PW, Imam Z, Adgey AAJ, Rusk RA, Richardson SG, Hale A, Kinsella BM, FitzGerald GA, King G, Crean P, Gearty G, Cawley T, Docherty JR, Geraghty J, Osborne H, Upton J, D’Arcy G, Stinson J, Cooke T, Colgan MP, Hall M, Tyrrell J, Gaffney K, Grouden M, Moore DJ, Shanik G, Feely J, Delanty N, Reilly M, Lawson JA, Fitzgerald DJ, Reilly MP, McAdam BF, Bergin C, Walshe MJ, Herity NA, Allen JD, Silke B, Singh HP, O’Neill S, Hargrove M, Coleman E, Shorten E, Aherne T, Kelly BE, Hill DH, McIlrath E, Morrow BC, Lavery GG, Blackwood B, Fee JPH, Kevin L, Doran M, Tansey D, Boylan I, McShane AJ, O’Reilly G, Tuohy B, Grainger P, Larkin T, Mahady J, Malone J, Condon C, Donoghue T, O’Leary J, Lyons JF, Tay YK, Tham SN, Khoo Tan HS, Gibson G, O’Grady A, Leader M, Walshe J, Carmody M, Donohoe J, Murphy GM, O’Connor W, Barnes L, Watson R, Darby C, O’Moore R, Mulcahy F, O’Toole E, O’Briain DS, Young MM, Buckley D, Healy E, Rogers S, Ni Scannlain N, McKenna MJ, McBrinn Y, Murray B, Freaney R, Barrett E, Razza Q, Abuaisha F, Powell D, Murray TM, Powell AM, O’Mongain E, O’Neill J, Kernan RP, O’Connor P, Clarke D, Fearon U, Cunningham SK, McKenna TJ, Hayes F, Heffernan A, Sheahan K, Harper R, Johnston GD, Atkinson AB, Sheridan B, Bell PM, Heaney AP, Loughrey G, McCance DR, Hadden DR, Kennedy AL, McNamara P, O’Shaughnessy C, Loughrey HC, Reid I, Teahan S, Caldwell M, Walsh TN, McSweeney J, Hennessy TP, Caldwell MTP, Byrne PJ, Hennessy TPJ, El-Magbri AA, Stevens FM, O’Sullivan R, McCarthy CF, Laundon J, Heneghan MA, Kearns M, Goulding J, Egan EL, McMahon BP, Hegarty F, Malone JF, Merriman R, MacMathuna P, Crowe J, Lennon J, White P, Clarke E, Prabhakar MC, Ryan E, Graham D, Yeoh PL, Kelly P, McKeogh D, O’Keane C, Kitching A, Mulligan E, Gorey TF, Mahmud N, O’Connell M, Goggins M, Keeling PWN, Weir DG, Kelleher D, McDonald GSA, Maguire D, O’Sullivan G, Harvey B, Cherukuri A, McGrath JP, Timon C, Lawlor P, O’Shea J, Buckley M, English L, Walsh T, O’Morain C, Lavelle SM, Kanagaratnam B, Harding B, Murphy B, Kavanagh J, Kerr D, Lavelle E, O’Gorman T, Liston S, Fitzpatrick C, Fitzpatrick P, Turner M, Murphy AW, Cafferty D, Dowling J, Bury G, Kaf Al-Ghazal S, Zimmermann E, O’Donoghue J, McCann J, Sheehan C, Boissel L, Lynch M, Cryan B, Fanning S, O’Meara D, Fennell J, Byrne PM, Lyons D, Mulcahy R, Pooransingh A, Walsh JB, Coakley D, O’Neill D, Ryall N, Connolly P, Namushi R, Lawler M, Locasciulli A, Bacigalupo A, Humphries P, McCann SR, Pamphilon D, Reidy M, Madden M, Finch T, Borton M, Barnes CA, Lawlor SE, Gardiner N, Egan LJ, Orren A, Doherty J, Curran C, O’Hanlon D, Kent P, Kerin M, Maher D, Given HF, Lynch S, McManus R, O’Farrelly C, Madrigal L, Feighery C, O’Donoghue D, Whelan CA, Rea IM, Stewart M, Campbell P, Alexander HD, Crockard AD, Morris TCM, Maguire H, Davidson F, Kaminski GZ, Butler K, Hillary IB, Parfrey NA, Crowley B, McCreary C, Keane C, O’Reilly M, Goh J, Kennedy M, Fitzgerald M, Scott T, Murphy S, Hildebrand J, Holliman R, Smith C, Kengasu K, Riain UN, Cormican M, Flynn J, Glennon M, Smith T, Whyte D, Keane CT, Barry T, Noone D, Maher M, Dawson M, Gilmartin JJ, Gannon F, Eljamel MS, Allcut D, Pidgeon CN, Phillips J, Rawluk D, Young S, Toland J, Deveney AM, Waddington JL, O’Brien DP, Hickey A, Maguire E, Phillips JP, Al-Ansari N, Cunney R, Smyth E, Sharif S, Eljamel M, Pidgeon C, Maguire EA, Burke ET, Staunton H, O’Riordan JI, Hutchinson M, Norton M, McGeeney B, O’Connor M, Redmond JMT, Feely S, Boyle G, McAuliffe F, Foley M, Kelehan P, Murphy J, Greene RA, Higgins J, Darling M, Byrne P, Kondaveeti U, Gordon AC, Hennelly B, Woods T, Harrison RF, Geary M, Sutherst JR, Turner MJ, DeLancey JOL, Donnelly VS, O’Connell PR, O’Herlihy C, Barry-Kinsella C, Sharma SC, Drury L, Lewis S, Stratton J, Ni Scanaill S, Stuart B, Hickey K, Coulter-Smith S, Moloney A, Robson MS, Murphy M, Keane D, Stronge J, Boylan P, Gonsalves R, Blankson S, McGuinness E, Sheppard B, Bonnar J, MacDonagh-White CM, Kelleher CC, Newell J, White O, Young Y, Hallahan C, Carroll K, Tipton K, McDermott EW, Reynolds JV, Nolan N, McCann A, Rafferty R, Sweeney P, Carney D, O’Higgins NJ, Duffy MJ, Grimes H, Gallagher S, O’Hanlon DM, Strattan J, Lenehan P, Robson M, Cusack YA, O’Riordain D, Mercer PM, Smyth PPA, Gallagher HJ, Moule B, Cooke TG, McArdle CS, Burke C, Vance A, Saidtéar C, Early A, Eustace P, Maguire L, Cullinane ABP, Prosser ES, Coca-Prados M, Harvey BJ, Saidléar C, Orwa S, Fitzsimons RB, Bradley O, Hogan M, Zimmerman L, Wang J, Kuliszewski M, Liu J, Post M, Premkumar, Conran MJ, Nolan G, Duff D, Oslizlok P, Denham B, O’Connell PA, Birthistle K, Hitchcock R, Carrington D, Calvert S, Holmes K, Smith DF, Hetherton AM, Mott MG, Oakhill A, Foreman N, Foot A, Dixon J, Walsh S, Mortimer G, O’Sullivan C, Kilgallen CM, Sweeney EC, Brayden DJ, Kelly JG, McCormack PME, Hayes C, Johnson Z, Dack P, Hosseini J, O’Connell T, Hemeryck L, Condren L, McCormack P, McAdam B, Lawson J, Keimowitz R, O’Leary A, Pilkington R, Adebayo GI, Gaffney P, McGettigan P, McManus J, O’Shea B, Wen Y, Killalea S, Golden J, Swanwick G, Clare AW, Mulvany F, Byrne M, O’Callaghan E, Byrne H, Cannon N, Kinsella T, Cassidy B, Shepard N, Horgan R, Larkin C, Cotter D, Coffey VP, Sham PC, Murray LH, Lane A, Kinsella A, Murphy P, Colgan K, Sloan D, Gilligan P, McEnri J, Ennis JT, Stack J, Corcoran E, Walsh D, Thornton L, Temperley I, Lawlor E, Tobin A, Hillary I, Nelson HG, Martin M, Ryan FM, Christie MA, Murray D, Keane E, Holmes E, Hollyer J, Strangeways J, Foster P, Stanwell-Smith R, Griffin E, Conlon T, Hayes E, Clarke T, Fogarty J, Moloney AC, Killeen P, Farrell S, Clancy L, Hynes M, Conlon C, Foley-Nolan C, Shelley E, Collins C, McNamara E, Hayes B, Creamer E, LaFoy M, Costigan P, Al fnAnsari N, Cunney RJ, Smyth EG, Johnson H, McQuoid G, Gilmer B, Browne G, Keogh JAB, Jefferson A, Smith M, Hennessy S, Burke CM, Sreenan S, Power CK, Pathmakanthan S, Poulter LW, Chan A, Sheehan M, Maguire M, O’Connor CM, FitzGerald MX, Southey A, Costello CM, McQuaid K, Urbach V, Thomas S, Horwitz ER, Mulherin D, FitzGerald O, Bresnihan B, Kirk G, Veale DJ, Belch JJF, Mofidi A, Mofidi R, Quigley C, McLaren M, Veale D, D’Arrigo C, Couto JC, Woof J, Greer M, Cree I, Belch J, Hone S, Fenton J, Hamilton S, McShane D. National Scientific Medical Meeting 1994 Abstracts. Ir J Med Sci 1994. [DOI: 10.1007/bf02943102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
|
39
|
Affiliation(s)
- M Mirochnick
- Department of Pediatrics, Boston City Hospital, MA 02118
| | | | | | | | | |
Collapse
|
40
|
Williamson AD, Woods JD, Conley JM, O'Barr WM, Losey MR, Colbert C, Wofford J, McNamara E. Is this the right time to come out? Case study. Harv Bus Rev 1993; 71:18-20, 22, 24 passim. [PMID: 10127038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
In this fictional case study, Adam Lawson is a promising young associate at Kirkham McDowell Securities, a St. Louis underwriting and financial advisory firm. Recently, Adam helped to bring in an extremely lucrative deal, and soon he and a few other associates will be honored for their efforts at the firm's silver anniversary dinner. George Campbell, vice president in mergers and acquisitions, is caught unprepared when Adam tells him that, after serious reflection, he has decided to bring his partner, Robert Collins, to the banquet. George is one of Adam's biggest supporters at the firm, and he personally has no problem with Adam being gay. But it is one thing for Adam to come out of the closet at the office. It is quite another to do so at a public company-client event. After all, Kirkham McDowell's client roster includes some very conservative companies--one of the country's largest defense contractors, for example. George is concerned with how Adam's openness about his sexual orientation will play with their clients and, as a result, how senior management will react. Adam has not come to George for permission to bring Robert to the dinner. But clearly Adam wants some sort of response. George has never faced sexual diversity issues in the workplace before, and there is no company policy to guide him. Just how negative an effect could Robert have on Adam's career with the firm and the firm's relationship with its clients? Isn't it possible that even the firm's most conservative clients will simply decide that Adam's choice of guest is a personal matter--not a business one?(ABSTRACT TRUNCATED AT 250 WORDS)
Collapse
|
41
|
Devany DM, Corbally N, Carney DN, Dervan PA, Sullivan RP, Mortimer G, McNamara E, Landers RJ, Sheehan M, O’Briain DS, Cormican MG, McDermott M, Gillen J. Royal academy of medicine in Ireland section of pathology. Ir J Med Sci 1992. [DOI: 10.1007/bf02942093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
|
42
|
Abstract
During a six-month period in a hospital in Ireland, four patients were infected (isolation from blood cultures) and two were colonized (isolation from rectal swabs) with strains of Enterococcus faecium highly resistant to gentamicin. MICs of gentamicin were greater than 1000 mg/L for all six strains, and each possessed a plasmid of approximately 50 MDa. Resistance to gentamicin was transferable by conjugation from two of the six strains, and was associated with transfer of the 50 MDa plasmid. This plasmid hybridized with a DNA probe specific for the bifunctional AAC(6')-APH(2") aminoglycoside-modifying enzyme. The mechanism of high-level gentamicin resistance in these strains appeared therefore, to be identical to that encountered in Enterococcus faecalis strains worldwide and reported in E. faecium strains in the USA.
Collapse
Affiliation(s)
- N Woodford
- Antibiotic Reference Laboratory, Central Public Health Laboratory, London, UK
| | | | | | | |
Collapse
|
43
|
Abstract
Coumarin, a potent immune stimulant and macrophage activator, has been used to treat brucellosis and as an immune suppressor. The effect of Coumarin and systemic antibiotics on septicaemia, survival and peritoneal contamination in experimental peritonitis was assessed. Four groups of male Sprague-Dawley rats were inoculated with Clostridium perfringens, Escherichia coli and Bacteroides fragilis. Group A received saline alone, Group B received Coumarin alone, Group C received antibiotics (Clindamycin and Cephradine) alone and Group D received both Coumarin and antibiotics. Septicaemia, confirmed by blood culture, occurred in all animals. Coumarin did not improve survival whether given alone or in combination with antibiotics. Animals given Coumarin (Groups B and D) had significantly less peritoneal soiling (54%, 0%) (P less than 0.02, P less than 0.001) than their controls (Groups A and C: 92%; 29%). While Coumarin did not improve resistance to septicaemia it did exert a local beneficial effect.
Collapse
Affiliation(s)
- T A Creagh
- Department of Surgery, Beaumont Hospital, Dublin
| | | | | | | |
Collapse
|
44
|
|
45
|
|
46
|
|
47
|
McNamara E. Discharge planning for continuity of care. Patient and family involvement. NLN Publ 1985:29-34. [PMID: 3849707] [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: 01/07/2023]
|
48
|
Liang MH, Larson M, Thompson M, Eaton H, McNamara E, Katz R, Taylor J. Costs and outcomes in rheumatoid arthritis and osteoarthritis. Arthritis Rheum 1984; 27:522-9. [PMID: 6721884 DOI: 10.1002/art.1780270507] [Citation(s) in RCA: 98] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
A prospective descriptive study was done on the direct and indirect costs to ambulatory patients with rheumatoid arthritis and osteoarthritis, stratified at study entry by level of function. Measures of health status over a 1-year period were taken. On a yearly basis, in 1979 dollars, patients spent an average of $147 for arthritis medications, aids, and devices, and $207 for outpatient visits. A small number were hospitalized and incurred an average charge of $245, and an additional $84 for physician fees. In addition to direct monetary costs, patients averaged 6.8 days of restricted activity costs, patients averaged 6.8 days of restricted activity per month, in some cases so severe as to confine patients to bed for an average of 1.3 days per month. Among students and working patients, 2.5 work-days per month were lost due to arthritis, and 30% reported that they were unemployed or retired because of impaired health. Functional capacity and specific diagnosis on entry to the study were the most important determinants of arthritis-related expenditures. Both direct and indirect costs varied considerably from the observed average. Twenty percent of patients incurred no costs for arthritis-related purchases, 42+ had no costs for outpatient visits, and 93% had no inpatient costs. Yet for some patients, the financial burden was very high.
Collapse
|
49
|
Abstract
In this study the sleep of borderline patients and patients with primary nondelusional depression showed sleep continuity disturbance and greater REM activity and density (particularly during the first REM period) than that of normal control subjects. First-night REM latencies were more variable in the borderline than in the depressed group, but by the second night both groups showed shorter REM latencies than the controls. The similarities in EEG sleep suggest a relationship between borderline disorder and the affective spectrum and cast doubt on the definition of the borderline disorder as a pure character type.
Collapse
|
50
|
McNamara E. Home care: hospitals rediscover comprehensive home care. Hospitals 1982; 56:60-6. [PMID: 6749644] [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: 01/21/2023]
|