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Maeyouf K, Sakpakdeejaroen I, Somani S, Meewan J, Ali-Jerman H, Laskar P, Mullin M, MacKenzie G, Tate RJ, Dufès C. Transferrin-Bearing, Zein-Based Hybrid Lipid Nanoparticles for Drug and Gene Delivery to Prostate Cancer Cells. Pharmaceutics 2023; 15:2643. [PMID: 38004621 PMCID: PMC10675605 DOI: 10.3390/pharmaceutics15112643] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2023] [Revised: 10/31/2023] [Accepted: 11/08/2023] [Indexed: 11/26/2023] Open
Abstract
Gene therapy holds great promise for treating prostate cancer unresponsive to conventional therapies. However, the lack of delivery systems that can transport therapeutic DNA and drugs while targeting tumors without harming healthy tissues presents a significant challenge. This study aimed to explore the potential of novel hybrid lipid nanoparticles, composed of biocompatible zein and conjugated to the cancer-targeting ligand transferrin. These nanoparticles were designed to entrap the anti-cancer drug docetaxel and carry plasmid DNA, with the objective of improving the delivery of therapeutic payloads to prostate cancer cells, thereby enhancing their anti-proliferative efficacy and gene expression levels. These transferrin-bearing, zein-based hybrid lipid nanoparticles efficiently entrapped docetaxel, leading to increased uptake by PC-3 and LNCaP cancer cells and significantly enhancing anti-proliferative efficacy at docetaxel concentrations exceeding 1 µg/mL. Furthermore, they demonstrated proficient DNA condensation, exceeding 80% at polymer-DNA weight ratios of 1500:1 and 2000:1. This resulted in increased gene expression across all tested cell lines, with the highest transfection levels up to 11-fold higher than those observed with controls, in LNCaP cells. These novel transferrin-bearing, zein-based hybrid lipid nanoparticles therefore exhibit promising potential as drug and gene delivery systems for prostate cancer therapy.
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Affiliation(s)
- Khadeejah Maeyouf
- Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, Glasgow G4 0RE, UK; (K.M.); (I.S.); (S.S.); (J.M.); (H.A.-J.); (P.L.); (G.M.); (R.J.T.)
| | - Intouch Sakpakdeejaroen
- Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, Glasgow G4 0RE, UK; (K.M.); (I.S.); (S.S.); (J.M.); (H.A.-J.); (P.L.); (G.M.); (R.J.T.)
- Faculty of Medicine, Thammasat University, Klong Nueng, Klong Luang, Pathumthani 12121, Thailand
| | - Sukrut Somani
- Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, Glasgow G4 0RE, UK; (K.M.); (I.S.); (S.S.); (J.M.); (H.A.-J.); (P.L.); (G.M.); (R.J.T.)
| | - Jitkasem Meewan
- Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, Glasgow G4 0RE, UK; (K.M.); (I.S.); (S.S.); (J.M.); (H.A.-J.); (P.L.); (G.M.); (R.J.T.)
| | - Hawraa Ali-Jerman
- Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, Glasgow G4 0RE, UK; (K.M.); (I.S.); (S.S.); (J.M.); (H.A.-J.); (P.L.); (G.M.); (R.J.T.)
| | - Partha Laskar
- Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, Glasgow G4 0RE, UK; (K.M.); (I.S.); (S.S.); (J.M.); (H.A.-J.); (P.L.); (G.M.); (R.J.T.)
- Department of Chemistry, School of Science, Gandhi Institute of Technology and Management, Visakhapatnam 530045, Andhra Pradesh, India
| | - Margaret Mullin
- Glasgow Imaging Facility, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow G12 8QQ, UK;
| | - Graeme MacKenzie
- Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, Glasgow G4 0RE, UK; (K.M.); (I.S.); (S.S.); (J.M.); (H.A.-J.); (P.L.); (G.M.); (R.J.T.)
| | - Rothwelle J. Tate
- Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, Glasgow G4 0RE, UK; (K.M.); (I.S.); (S.S.); (J.M.); (H.A.-J.); (P.L.); (G.M.); (R.J.T.)
| | - Christine Dufès
- Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, Glasgow G4 0RE, UK; (K.M.); (I.S.); (S.S.); (J.M.); (H.A.-J.); (P.L.); (G.M.); (R.J.T.)
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Meewan J, Somani S, Almowalad J, Laskar P, Mullin M, MacKenzie G, Khadke S, Perrie Y, Dufès C. Preparation of Zein-Based Nanoparticles: Nanoprecipitation versus Microfluidic-Assisted Manufacture, Effects of PEGylation on Nanoparticle Characteristics and Cellular Uptake by Melanoma Cells. Int J Nanomedicine 2022; 17:2809-2822. [PMID: 35791309 PMCID: PMC9250780 DOI: 10.2147/ijn.s366138] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Accepted: 06/15/2022] [Indexed: 12/02/2022] Open
Abstract
Background The manufacture of nanoparticles using manual methods is hampered by its challenging scale-up and poor reproducibility. To overcome this issue, the production of zein nanoparticles entrapping a lipophilic drug model, coumarin-6, by using a microfluidic system was assessed in this study. The influence of PEG density and chain length on zein nanoparticle characteristics, as well as their uptake efficacy in melanoma cancer cells, was also evaluated. Methods Zein nanoparticles were prepared by both manual and microfluidic approaches to allow comparison between the two processes. PEGylated zein nanoparticles with various PEG densities and chain lengths were produced by nanoprecipitation and characterized. Their cellular uptake was evaluated on B16F10 melanoma cancer cells in vitro. Results Zein nanoparticles have successfully been produced by both manual and microfluidic approaches. Parameters such as total flow rate and flow rate ratio of the aqueous and organic phases in microfluidic process, as well as the method preparation and aqueous to organic phase volume ratio during nanoprecipitation, have been shown to strongly influence the characteristics of the resulting nanoparticles. Continuous microfluidics led to the production of nanoparticles with low yield and drug entrapment, unlike nanoprecipitation, which resulted in zein nanoparticles with an appropriate size and an optimal drug entrapment efficiency of 64%. The surface modification of the nanoparticles produced by nanoprecipitation, with lower PEG density and shorter PEG chain length made mPEG5K-zein (0.5:1) the most favorable formulation in our study, resulting in enhanced stability and higher coumarin-6 uptake by melanoma cancer cells. Conclusion mPEG5K-zein (0.5:1) nanoparticles prepared by nanoprecipitation were the most promising formulation in our study, exhibiting increased stability and enhancing coumarin-6 uptake by melanoma cancer cells.
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Affiliation(s)
- Jitkasem Meewan
- Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, Glasgow, G4 0RE, UK
| | - Sukrut Somani
- Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, Glasgow, G4 0RE, UK
| | - Jamal Almowalad
- Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, Glasgow, G4 0RE, UK
| | - Partha Laskar
- Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, Glasgow, G4 0RE, UK
| | - Margaret Mullin
- Glasgow Imaging Facility, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, G12 8QQ, UK
| | - Graeme MacKenzie
- Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, Glasgow, G4 0RE, UK
| | - Swapnil Khadke
- Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, Glasgow, G4 0RE, UK
| | - Yvonne Perrie
- Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, Glasgow, G4 0RE, UK
| | - Christine Dufès
- Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, Glasgow, G4 0RE, UK
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Piyasena P, Olvera-Herrera VO, Chan VF, Clarke M, Wright DM, MacKenzie G, Virgili G, Congdon N. Vision impairment and traffic safety outcomes in low-income and middle-income countries: a systematic review and meta-analysis. Lancet Glob Health 2021; 9:e1411-e1422. [PMID: 34411516 DOI: 10.1016/s2214-109x(21)00303-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Revised: 06/01/2021] [Accepted: 06/21/2021] [Indexed: 12/18/2022]
Abstract
BACKGROUND Road traffic injuries are a major public health concern and their prevention requires concerted efforts. We aimed to systematically analyse the current evidence to establish whether any aspects of vision, and particularly interventions to improve vision function, are associated with traffic safety outcomes in low-income and middle-income countries (LMICs). METHODS We did a systematic review and meta-analysis to assess the association between poor vision and traffic safety outcomes. We searched MEDLINE, Embase, PsycINFO, CINAHL, Web of Science, Cochrane Database of Systematic Reviews, and the Cochrane Central Register of Controlled Trials in the Cochrane Library from database inception to April 2, 2020. We included any interventional or observational studies assessing whether vision is associated with traffic safety outcomes, studies describing prevalence of poor vision among drivers, and adherence to licensure regulations. We excluded studies done in high-income countries. We did a meta-analysis to explore the associations between vision function and traffic safety outcomes and a narrative synthesis to describe the prevalence of vision disorders and adherence to licensure requirements. We used random-effects models with residual maximum likelihood method. The systematic review protocol was registered on PROSPERO, CRD-42020180505. FINDINGS We identified 49 (1·8%) eligible articles of 2653 assessed and included 29 (59·2%) in the various data syntheses. 15 394 participants (mean sample size n=530 [SD 824]; mean age of 39·3 years [SD 9·65]; 1167 [7·6%] of 15 279 female) were included. The prevalence of vision impairment among road users ranged from 1·2% to 26·4% (26 studies), colour vision defects from 0·5% to 17·1% (15 studies), and visual field defects from 2·0% to 37·3% (ten studies). A substantial proportion (range 10·6-85·4%) received licences without undergoing mandatory vision testing. The meta-analysis revealed a 46% greater risk of having a road traffic crash among those with central acuity visual impairment (risk ratio [RR] 1·46 [95% CI 1·20-1·78]; p=0·0002, 13 studies) and a greater risk among those with defects in colour vision (RR 1·36 [1·01-1·82]; p=0·041, seven studies) or the visual field (RR 1·36 [1·25-1·48]; p<0·0001, seven studies). The I2 value for overall statistical heterogeneity was 63·4%. INTERPRETATION This systematic review shows a positive association between vision impairment and traffic crashes in LMICs. Our findings provide support for mandatory vision function assessment before issuing a driving licence. FUNDING None.
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Affiliation(s)
- Prabhath Piyasena
- School of Medicine, Dentistry and Biomedical Sciences, Institute of Clinical Science, Centre for Public Health, Royal Victoria Hospital, Queen's University, Belfast, UK
| | - Victoria Odette Olvera-Herrera
- School of Medicine, Dentistry and Biomedical Sciences, Institute of Clinical Science, Centre for Public Health, Royal Victoria Hospital, Queen's University, Belfast, UK
| | - Ving Fai Chan
- School of Medicine, Dentistry and Biomedical Sciences, Institute of Clinical Science, Centre for Public Health, Royal Victoria Hospital, Queen's University, Belfast, UK; School of Optometry, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
| | - Mike Clarke
- School of Medicine, Dentistry and Biomedical Sciences, Institute of Clinical Science, Centre for Public Health, Royal Victoria Hospital, Queen's University, Belfast, UK
| | - David M Wright
- School of Medicine, Dentistry and Biomedical Sciences, Institute of Clinical Science, Centre for Public Health, Royal Victoria Hospital, Queen's University, Belfast, UK
| | | | - Gianni Virgili
- School of Medicine, Dentistry and Biomedical Sciences, Institute of Clinical Science, Centre for Public Health, Royal Victoria Hospital, Queen's University, Belfast, UK
| | - Nathan Congdon
- School of Medicine, Dentistry and Biomedical Sciences, Institute of Clinical Science, Centre for Public Health, Royal Victoria Hospital, Queen's University, Belfast, UK; Department of Preventive Ophthalmology, Zhongshan Ophthalmic Centre, Sun Yat-sen University, Guangzhou, China; Orbis International, New York, NY, USA.
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Wang H, Barket B, Du S, Friesen D, Kohrman E, Tok E, Xiao B, Huang W, Chan VF, MacKenzie G, Congdon N. The prevalence and correlates of vision impairment and glasses ownership among ethnic minority and Han schoolchildren in rural China. PLoS One 2021; 16:e0256565. [PMID: 34460851 PMCID: PMC8405009 DOI: 10.1371/journal.pone.0256565] [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] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Accepted: 08/09/2021] [Indexed: 11/19/2022] Open
Abstract
PURPOSE To determine the prevalence of visual impairment and glasses ownership among Han Chinese and Hui minority junior high school children in Ningxia Hui Autonomous Region, China. DESIGN Population-based cross-sectional study. METHODS Vision screening was conducted on 20,376 children (age 12-15 years) in all 124 rural junior high schools in Ningxia. Personal and family characteristics, glasses ownership, and academic performance were assessed through a survey questionnaire and standardized mathematics test, respectively. RESULTS The prevalence of visual acuity (VA) ≤6/12 in either eye was significantly higher among Han (54.5%) than Hui (45.2%) children (P<0.001), and was significantly positively associated with age, female sex, Han ethnicity, parental outmigration for work, shorter time spent outside during recess, shorter time spent watching television and higher time spent studying. Among children with VA≤6/12 in both eyes, only 56.8% of Han and 41.5% of Hui children had glasses (P<0.001). Glasses ownership was significantly associated with worse vision, greater family wealth, female sex, higher test scores, age, parental outmigration for work, understanding of myopia and glasses, higher time spent studying and Han ethnicity. CONCLUSION One of the first of its kind, this report on Han and Hui ethnic schoolchildren confirms a high prevalence of visual impairment among both populations, but slightly higher among the Han. Both groups, especially the Hui, have low rates of glasses ownership. Future interventions and policies designed to improve glasses usage should focus on populations with lower incomes and seek to correct erroneous beliefs about the safety of glasses and efficacy of traditional eye exercises.
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Affiliation(s)
- Huan Wang
- Stanford Center on China’s Economy and Institutions, Stanford University, California, Stanford, United States of America
| | - Brandon Barket
- Stanford Center on China’s Economy and Institutions, Stanford University, California, Stanford, United States of America
| | - Sharon Du
- Stanford Center on China’s Economy and Institutions, Stanford University, California, Stanford, United States of America
| | - Dimitris Friesen
- Stanford Center on China’s Economy and Institutions, Stanford University, California, Stanford, United States of America
| | - Ezra Kohrman
- Stanford Center on China’s Economy and Institutions, Stanford University, California, Stanford, United States of America
| | - Esther Tok
- Stanford Center on China’s Economy and Institutions, Stanford University, California, Stanford, United States of America
| | - Baixiang Xiao
- Affiliated Eye Hospital of Nanchang University, Nanchang, China
- State Key Laboratory of Ophthalmology and Division of Preventive Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Wenyong Huang
- Affiliated Eye Hospital of Nanchang University, Nanchang, China
- State Key Laboratory of Ophthalmology and Division of Preventive Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Ving Fai Chan
- School of Medicine, Dentistry and Biomedical Sciences, Queen’s University Belfast, Belfast, Northern Ireland, United Kingdom
| | | | - Nathan Congdon
- State Key Laboratory of Ophthalmology and Division of Preventive Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
- School of Medicine, Dentistry and Biomedical Sciences, Queen’s University Belfast, Belfast, Northern Ireland, United Kingdom
- Orbis International, New York, NY, United States of America
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Cullen C, MacKenzie G, Adgey AAJ, Anderson JM, Dempsey GJ, Wright GTH, Crawley M, McAdams ET, McLaughlin J. Portable Cardiac Mapping Assessment of Acute Ischaemic Injury. Methods Inf Med 2018. [DOI: 10.1055/s-0038-1634985] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Abstract:A portable cardiac mapping system is used to improve the accuracy of diagnosis of acute ischaemic injury outside hospital. Patients presenting chest pain suggestive of myocardial infarction (Ml) were mapped by attendant medical personnel operating from a mobile coronary unit. These first Ml maps were compared against average normal maps using QRS and ST-T isointegral values. Discriminant function analysis performed on the parameters achieved a sensitivity of 90% and a specificity of 96%.
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Burke K, MacKenzie G. Multi-parameter regression survival modeling: An alternative to proportional hazards. Biometrics 2016; 73:678-686. [DOI: 10.1111/biom.12625] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2016] [Revised: 10/01/2016] [Accepted: 10/01/2016] [Indexed: 11/27/2022]
Affiliation(s)
- K. Burke
- Department of Mathematics and Statistics; University of Limerick; Limerick Ireland
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Abstract
Acute myeloid leukaemia is a disease of increasing frequency in the elderly. The aim of this study was to describe the survival and the factors influencing survival in a cohort older than 55 years in Northern Ireland, which has a relatively stable population. The median survival of the 92 cases identified in a 6-year period was 18 weeks with an actuarial survival overall at one year of 24%. Independent risk factors for survival were administration of chemotherapy with the intention to induce remission, social class 1 and 2, hepatomegaly, absence of splenomegaly, lower LDH, lower PB blast count, higher haemoglobin, female sex and WHO performance status 0-2. The results of this study suggest that survival from acute leukaemia in the elderly is very poor when an unselected patient cohort is considered.
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Affiliation(s)
- M F McMullin
- a Department of Haematology , The Queen's University of Belfast, The Institute of Clinical Science, Royal Victoria Hospital , Grosvenor Road, Belfast BT12 6BA , N. Ireland , UK
| | - G MacKenzie
- b Centre for Medical Statistics , Keele University , Keele , Staffordshire ST5 5BG , UK
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Edwards H, Battrum G, Watts S, MacKenzie G, Le Ball K. 19 * THE INTRODUCTION OF GENERAL PRACTITIONERS (GP), CARE HOME SUPPORT TEAM (CHST) AND ANTICIPATORY MANAGEMENT PLANS (AMP) IN AN ATTEMPT TO REDUCE HOSPITAL ATTENDANCES AND ADMISSIONS FROM CARE HOMES. Age Ageing 2015. [DOI: 10.1093/ageing/afv029.19] [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
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Kiri V, MacKenzie G. Assessing the Effectiveness of Counter Matching for Improving the Efficiency of the Nested Case-Control Design in Observational Studies. Value Health 2014; 17:A581. [PMID: 27201960 DOI: 10.1016/j.jval.2014.08.1966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Affiliation(s)
- V Kiri
- FV & JK Consulting Ltd, Guildford, UK
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Phillips C, Stevenson J, MacKenzie G. P1-288 Patterns of social inequality among cases of meningococcal infection in Scotland from 2005 to 2008. Br J Soc Med 2011. [DOI: 10.1136/jech.2011.142976e.80] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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He M, Congdon N, MacKenzie G, Zeng Y, Silver JD, Ellwein L. The child self-refraction study results from urban Chinese children in Guangzhou. Ophthalmology 2011; 118:1162-9. [PMID: 21232802 DOI: 10.1016/j.ophtha.2010.10.003] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2010] [Revised: 10/04/2010] [Accepted: 10/04/2010] [Indexed: 10/18/2022] Open
Abstract
OBJECTIVE To compare visual and refractive outcomes between self-refracting spectacles (Adaptive Eyecare, Ltd, Oxford, UK), noncycloplegic autorefraction, and cycloplegic subjective refraction. DESIGN Cross-sectional study. PARTICIPANTS Chinese school-children aged 12 to 17 years. METHODS Children with uncorrected visual acuity ≤ 6/12 in either eye underwent measurement of the logarithm of the minimum angle of resolution visual acuity, habitual correction, self-refraction without cycloplegia, autorefraction with and without cycloplegia, and subjective refraction with cycloplegia. MAIN OUTCOME MEASURES Proportion of children achieving corrected visual acuity ≥ 6/7.5 with each modality; difference in spherical equivalent refractive error between each of the modalities and cycloplegic subjective refractive error. RESULTS Among 556 eligible children of consenting parents, 554 (99.6%) completed self-refraction (mean age, 13.8 years; 59.7% girls; 54.0% currently wearing glasses). The proportion of children with visual acuity ≥ 6/7.5 in the better eye with habitual correction, self-refraction, noncycloplegic autorefraction, and cycloplegic subjective refraction were 34.8%, 92.4%, 99.5% and 99.8%, respectively (self-refraction versus cycloplegic subjective refraction, P<0.001). The mean difference between cycloplegic subjective refraction and noncycloplegic autorefraction (which was more myopic) was significant (-0.328 diopter [D]; Wilcoxon signed-rank test P<0.001), whereas cycloplegic subjective refraction and self-refraction did not differ significantly (-0.009 D; Wilcoxon signed-rank test P = 0.33). Spherical equivalent differed by ≥ 1.0 D in either direction from cycloplegic subjective refraction more frequently among right eyes for self-refraction (11.2%) than noncycloplegic autorefraction (6.0%; P = 0.002). Self-refraction power that differed by ≥ 1.0 D from cycloplegic subjective refractive error (11.2%) was significantly associated with presenting without spectacles (P = 0.011) and with greater absolute power of both spherical (P = 0.025) and cylindrical (P = 0.022) refractive error. CONCLUSIONS Self-refraction seems to be less prone to accommodative inaccuracy than noncycloplegic autorefraction, another modality appropriate for use in areas where access to eye care providers is limited. Visual results seem to be comparable. Greater cylindrical power is associated with less accurate results; the adjustable glasses used in this study cannot correct astigmatism. Further studies of the practical applications of this modality are warranted. FINANCIAL DISCLOSURE(S) Proprietary or commercial disclosure may be found after the references.
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Affiliation(s)
- Mingguang He
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat Sen University, Guangzhou, PRC.
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Abstract
AIMS To examine the long-term effectiveness of atypical antipsychotics in a naturalistic setting for patients with schizophrenia. METHOD A retrospective analysis of atypical antipsychotic prescribing in one Health District between 1994 and 2001. Time to discontinuation of the first atypical antipsychotic prescribed was calculated using survival analysis. RESULTS 253 patients were identified. Clozapine had a significantly lower discontinuation rate compared with olanzapine and risperidone (p = 0.018). Patients taking risperidone were 1.3 times more likely to discontinue than those taking olanzapine (p = 0.23). Older age (p = 0.0001), male sex (p = 0.016) and exposure to antidepressants (p = 0.014) significantly predicted compliance. CONCLUSIONS Clozapine is an effective long-term schizophrenia treatment. The trend to superior effectiveness of olanzapine over risperidone in the long-term has not been reported before and warrants further investigation.
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Affiliation(s)
- Richard Hodgson
- Lyme Brook Mental Health Centre, Bradwell Hospital site, Talke Road, Stoke on Trent ST5 7TL, UK.
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Wood AM, MacKenzie G, McGiliveray NC, Brown L, Devriese LA, Baele M. Isolation of Enterococcus cecorum from bone lesions in broiler chickens. Vet Rec 2002; 150:27. [PMID: 11822370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/23/2023]
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MacKenzie G, Draper H, Barnett G, Wakeel BA. An unconscious man with transient exposure of an accessory pathway. Eur J Emerg Med 2000; 7:295-6. [PMID: 11764139 DOI: 10.1097/00063110-200012000-00008] [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: 11/26/2022]
Affiliation(s)
- G MacKenzie
- Department of Diabetes and Endocrinology, Kingston Hospital, UK
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Betarbet R, Sherer TB, MacKenzie G, Garcia-Osuna M, Panov AV, Greenamyre JT. Chronic systemic pesticide exposure reproduces features of Parkinson's disease. Nat Neurosci 2000; 3:1301-6. [PMID: 11100151 DOI: 10.1038/81834] [Citation(s) in RCA: 2486] [Impact Index Per Article: 103.6] [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] [Indexed: 01/19/2023]
Abstract
The cause of Parkinson's disease (PD) is unknown, but epidemiological studies suggest an association with pesticides and other environmental toxins, and biochemical studies implicate a systemic defect in mitochondrial complex I. We report that chronic, systemic inhibition of complex I by the lipophilic pesticide, rotenone, causes highly selective nigrostriatal dopaminergic degeneration that is associated behaviorally with hypokinesia and rigidity. Nigral neurons in rotenone-treated rats accumulate fibrillar cytoplasmic inclusions that contain ubiquitin and alpha-synuclein. These results indicate that chronic exposure to a common pesticide can reproduce the anatomical, neurochemical, behavioral and neuropathological features of PD.
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Affiliation(s)
- R Betarbet
- Department of Neurology, Emory University, 1639 Pierce Drive, WMB 6000, Atlanta, Georgia 30322, USA
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Abstract
The cause of Parkinson's disease (PD) is unknown, but reduced activity of complex I of the electron-transport chain has been implicated in the pathogenesis of both mitochondrial permeability transition pore-induced Parkinsonism and idiopathic PD. We developed a novel model of PD in which chronic, systemic infusion of rotenone, a complex-I inhibitor, selectively kills dopaminergic nerve terminals and causes retrograde degeneration of substantia nigra neurons over a period of months. The distribution of dopaminergic pathology replicates that seen in PD, and the slow time course of neurodegeneration mimics PD more accurately than current models. Our model should enhance our understanding of neurodegeneration in PD. Metabolic impairment depletes ATP, depresses Na+/K(+)-ATPase activity, and causes graded neuronal depolarization. This relieves the voltage-dependent Mg2+ block of the N-methyl-D-aspartate (NMDA) subtype of the glutamate receptor, which is highly permeable to Ca2+. Consequently, innocuous levels of glutamate become lethal via secondary excitotoxicity. Mitochondrial impairment also disrupts cellular Ca2+ homoeostasis. Moreover, the facilitation of NMDA-receptor function leads to further mitochondrial dysfunction. To a large part, this occurs because Ca2+ entering neurons through NMDA receptors has 'privileged' access to mitochondria, where it causes free-radical production and mitochondrial depolarization. Thus there may be a feed-forward cycle wherein mitochondrial dysfunction causes NMDA-receptor activation, which leads to further mitochondrial impairment. In this scenario, NMDA-receptor antagonists may be neuroprotective.
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Affiliation(s)
- J T Greenamyre
- Department of Neurology, Emory University, Atlanta, GA 30322, USA
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Templeton J, Oakley PA, MacKenzie G, Cook AL, Brand D, Mullins RJ, Trunkey DD. A comparison of patient characteristics and survival in two trauma centres located in different countries. Injury 2000; 31:493-501. [PMID: 10908742 DOI: 10.1016/s0020-1383(00)00029-2] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
INTRODUCTION The aim of the study was to compare patient characteristics and mortality in severely injured patients in two trauma centres located in different countries, allowing for differences in case-mix. It represents a direct bench-marking exercise between the trauma centres at the North Staffordshire Hospital (NSH), Stoke-on-Trent, UK and the Oregon Health Sciences University (OHSU) Hospital, Portland, Oregon, USA. METHODS Patients of all ages admitted to the two hospitals during 1995 and 1996 with an Injury Severity Score >15 were included, except for those who died in the emergency departments. Twenty-three factors were studied, including the Injury Severity Score, Glasgow Coma Score, mechanism of injury and anatomical site of injury. Outcome analysis was based on mortality at discharge. RESULTS The pattern of trauma differed significantly between Stoke and Portland. Patients from Stoke tended to be older, presented with a lower conscious level and a lower systolic blood pressure and were intubated less frequently before arriving at hospital. Mortality depended on similar factors in both centres, especially age, highest AIS score, systolic blood pressure and Glasgow Coma Score.The crude analysis of mortality showed a highly significant odds-ratio of 1.64 in Stoke compared with Portland. Single-factor adjustments were made for the above four factors, which had a similar influence on mortality in both centres. Adjusting for the first three factors individually did not alter the odds-ratio, which stayed in the range 1.53-1.59 and remained highly significant. Adjusting for the Glasgow Coma Score reduced the odds-ratio to 0.82 and rendered it non-significant. In a multi-factor logistic regression model incorporating all of the factors shown to influence mortality in either centre, the odds-ratio was 1.7 but was not significant. CONCLUSION The analysis illustrates the limitations and pitfalls of making crude outcome comparisons between centres. Highly significant differences in crude mortality were rendered non-significant by case-mix adjustments, supporting the null hypothesis that the two centres were equally effective in terms of this short-term indicator of outcome. To achieve a meaningful comparison between centres, adjustments must be made for the factors which affect mortality.
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Affiliation(s)
- J Templeton
- Department of Trauma Research, North Staffordshire Hospital NHS Trust, Princes Road, Hartshill, Stoke-on-Trent ST4 7LN, UK
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19
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Abstract
Between 1995 and 1997 a neurological condition in pheasant poults from 24 sites in England and Scotland was investigated. Affected birds showed varying degrees of ataxia and incoordinated movements and, in severe cases, recumbency, but generally remained alert with their heads held upright. The condition characteristically affected poults from seven weeks of age and the incidence on any one site was low. No significant bacteria were isolated consistently from brain tissue. The condition was characterised histologically by a non-suppurative meningoencephalitis, in which lesions were found predominantly in the cerebellum in 61 of 81 samples examined (75.3 per cent). A non-suppurative myelitis was recorded in 16 of 20 spinal cords examined. No lesions were recorded in peripheral neural tissue and lesions were rare in other tissues. The condition appeared not to have been recorded previously in pheasants. A viral aetiology was suspected but Newcastle disease virus was not involved.
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Abstract
In recent years external beam radiotherapy (EBRT) has been proposed as a treatment for the wet form of age-related macular degeneration (AMD) where choroidal neovascularization (CNV) is the hallmark. While the majority of pilot (Phase I) studies have reported encouraging results, a few have found no benefit, i.e. EBRT was not found to result in either improvement or stabilization of visual acuity of the treated eye. The natural history of visual loss in untreated CNV of AMD is highly variable. Loss of vision is influenced mainly by the presenting acuity, and size and composition of the lesion, and to a lesser extent by a variety of other factors. Thus the variable outcome reported by the small Phase I studies of EBRT published to date may simply reflect the variation in baseline factors. We therefore obtained information on 409 patients treated with EBRT from eight independent centres, which included details of visual acuity at baseline and at subsequent follow-up visits. Analysis of the data showed that 22.5% and 14.9% of EBRT-treated eyes developed moderate and severe loss of vision, respectively, during an average follow-up of 13 months. Initial visual acuity, which explained 20.5% of the variation in visual loss, was the most important baseline factor studied. Statistically significant differences in loss of vision were observed between centres, after considering the effects of case mix factors. Comparisons with historical data suggested that while moderate visual loss was similar to that of the natural history of the disease, the likelihood of suffering severe visual loss was halved. However, the benefit in terms of maintained/improved vision in the treated eye was modest.
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Abstract
The standard 12-lead ECG is only 50% sensitive for the detection of acute myocardial infarction (AMI). The majority of leads for optimal classification of AMI probably lie outside the area covered by the 6 precordial leads. Thus, body-surface mapping (BSM) may be more helpful, as a larger thoracic area is sampled. We recorded 64-lead anterior BSMs in 635 patients with chest pain suggestive of AMI and abnormal electrocardiograms (ECGs), and 125 controls without chest pain. Of the 635 patients, 325 had AMI according to World Health Organization (WHO) criteria (203 presenting with ST segment elevation, and 122 with nondiagnostic ECG), and 310 had an "abnormal ECG but not AMI." QRS and ST-T isointegrals and variables describing map shape were derived. Subjects were randomly allocated to a training set (63 controls, 321 patients) and a validation set (62 controls, 314 patients). Multiple logistic regression was used in the training set to identify which variables gave best discrimination between groups. A model with these variables was then tested prospectively in the validation set. In stage 1 (all subjects), controls were compared with patients. In the training set, a model containing 21 variables classified 58/63 controls (specificity 92%) and 316/321 patients (sensitivity 98%). In the validation set, the model classified 48/62 controls (specificity 77.4%) and 302/314 patients (sensitivity 96%). In stage 2 (studying patients only), patients with AMI were compared with patients who had an abnormal ECG-not AMI. In the training set, a model containing 28 variables classified 132/165 patients (sensitivity 80%) with AMI and 134/156 patients (specificity 86%) with an abnormal ECG-not AMI. In the validation set, the model classified 123/160 patients (sensitivity 77%) with AMI and 131/154 patients (specificity 85%) with an abnormal ECG-not AMI. Combining results of both stages in a two-step algorithm gave an overall classification in the training set of controls 92%, abnormal ECG-not AMI 84%, AMI 80%, and in the validation set of controls 77%, abnormal ECG-not AMI 82%, AMI 74%. Thus, in conclusion, when compared with the 12-lead ECG, BSM models results in higher sensitivity and specificity for detection of AMI, particularly in patients presenting with chest pain and nondiagnostic ECG changes. The use of BSM models in such patients, may lead to the earlier detection of AMI and appropriate administration of fibrinolytic therapy and/or anti-platelet agents.
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Affiliation(s)
- I B Menown
- Regional Medical Cardiology Centre, Royal Victoria Hospital, Belfast, Northern Ireland
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Monown I, MacKenzie G, Patterson R, Adgey A. Limits to the 12-lead electrocardiographic diagnosis of acute myocardial infarction: can we improve on ST elevation? J Am Coll Cardiol 1998. [DOI: 10.1016/s0735-1097(98)80289-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Seifer C, McNeill B, O’Donnell M, Daly K, Kellett J, McGee HM, Montogomery AJ, O’Callaghan D, Horgan JH, Mahon NG, Codd M, Brennan J, Egan B, McCann HA, Sugrue DD, Menown IBA, Patterson RSHW, McMechan SR, Hameed S, Adgey AAJ, Baird SH, McBride SJ, Trouton TG, Wilson C, McRedmond JP, Fitzgerald DJ, Crowley JJ, Tanguay JF, Santos RM, Stack RS, Mahon NG, Keelan P, McCann HA, Sugrue DD, McKenna CJ, AuBuchon R, Camrud AR, Holmes DR, Schwartz RS, McKenna CJ, Camrud AR, Wolff R, Edwards WD, Holmes DR, Schwartz RS, Hanratty C, McAuley D, Young I, Murtagh G, O’Keeffe B, Richardson G, Scott M, Chew EW, Bailie NA, Graham AMJ, O’Kane H, McKenna CJ, Kwon HM, Ellis L, Holmes DR, Virmani R, Schwartz RS, Noelke L, Wood AE, Javadpour H, Veerasingham D, Wood AE, O’Kane D, Allen JD, Adgey AAJ, Hennessy T, Johnson P, Hildick-Smith D, Winter E, Shapiro L, McKenna CJ, Edwards WD, Lerman A, Holmes DR, Schwartz RS, McGrath LT, Passmore P, Silke B, McAuley D, Nugent AG, McGurk C, Hanratty C, Maguire S, Johnston GD, McAuley D, Nugent AG, McGurk C, Hanratty C, Maguire S, Johnston GD, Lovell SL, McDowell G, McEneany D, Riley MS, Nicholls DP, Gilligan D, Sargent D, Dan D, Gilligan D, Elam G, Rhee B, Keane D, Zhou L, McGovern B, Garan H, Ruskin J, O’Shea JC, Tan HC, Zidar JP, Stack RS, Crowley JJ, O’Keeffe DB, Graffin S, Fitzsimmons D, Brown S, Duff D, Denham B, Woods F, Neligan M, Oslizlok P, Connolly CK, Danton MHD, O’Kane H, Danton M, Gladstone DJ, Craig B, Mulholland HC, Casey F, Chaudhuri S, Hinchion J, Wood AE, Hinchion J, Wood AE, Menown IBA, Patterson RHSW, MacKenzie G, Adgey AAJ, Harbinson MT, Burgess LM, Moohan V, McEneaney DJ, Adgey AAJ, Menown IBA, MacKenzie G, Patterson RSHW, Adgey AAJ, Finnegan OC, Doherty L, Silke B, Riddell JG, Meleady R, Daly L, Graham I, Quinn M, Foley B, Lee J, Mulvihill N, Crean P, Walsh M, O’Morain C, Quinn M, Crean P, Foley B, Walsh M, Hynes C, King SM, David S, Newton H, Maguire M, Rafferty F, Horgan JH, Sullivan PA, Murphy D, Gallagher S, Menown IBA, Allen J, Anderson JM, Adgey AAJ, Dan D, Hoag J, Eckberg D, Gilligan D, Galvin J, Garan H, McGovern B, Ruskin J, Mahon NG, Diamond P, Neilan T, Keelan E, H. A., McCarthy C, Sugrue DD, Harbinson MT, Moohan VP, McEneaney DJ, Burgess LM, Anderson JM, Ayers GM, Adgey AAJ, Roberts M, Burgess L, Anderson C, Wilson C, Khan M, Clements IP, Miller WL, Seifer C, O’Donnell M, McNeill B, Daly K, Turtle F, McDowell G, Long H, McNair W, Campbell NPS, Mathew TP, Turtle F, Smye M, Nesbitt GS, Young IS, Adgey AAJ, Meleady R, Mulcahy D, Graham IM, Moore D, Menown IBA, McMechan SR, MacKenzie G, Adgey AAJ, Diamond P, Sugrue D, Codd MB, Galvin J, Zimmerman P, Winget J, Capeless M, Galvin J, Garan H, McGovern B, Ruskin J, McKelvey TA, Danton MHD, Sarsam MIA, McEneaney D, Roberts M, Burgess L, Anderson C, Wilson C, Khan M. Irish cardiac society. Ir J Med Sci 1998. [DOI: 10.1007/bf02937898] [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]
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Wood AM, MacKenzie G, Dagless MD, Pearson DB, Delissen G. Re-emergence of a stunting syndrome in broiler chickens. Vet Rec 1997; 140:463. [PMID: 9153749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
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Affiliation(s)
- J C Gibbens
- Veterinary Investigation Centre, Itchen Abbas, Winchester, Hampshire
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Hart PM, Chakravarthy U, MacKenzie G, Archer DB, Houston RF. Teletherapy for subfoveal choroidal neovascularisation of age-related macular degeneration: results of follow up in a non-randomised study. Br J Ophthalmol 1996; 80:1046-50. [PMID: 9059267 PMCID: PMC505700 DOI: 10.1136/bjo.80.12.1046] [Citation(s) in RCA: 65] [Impact Index Per Article: 2.3] [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] [Indexed: 02/03/2023]
Abstract
AIM A preliminary report indicated stable or improved vision in 12 of 19 patients with subfoveal choroidal neovascularisation treated with 12 or 15 Gy of 6 MV photons to the affected macula after an average follow up of 18 months. Here the prolonged follow up findings in this group of treated patients is reported which was further increased to 41. METHODS Forty one patients with subfoveal choroidal neovascularisation were treated with 10, 12, or 15 Gy of 6 MV photons to the macula of the affected eye. Thirteen eyes of 12 patients were also observed as a non-randomised comparison group. RESULTS At 12, 18, and 24 months of follow up the mean change in visual acuity in eyes treated with radiotherapy was less than 1 Bailey-Lovie line from that measured at presentation. By contrast, the eyes in the comparison group lost 3.7 lines of acuity at 12 months which increased to 4.5 at 24 months. These differences were highly significant at each of the time points. When initial visual acuity was taken into account, treated eyes lost on average 12% of baseline acuity throughout follow up, whereas eyes belonging to the untreated group lost 50% of baseline acuity at 1 year, and 75% at 2 years. There was no significant difference in visual outcome between the three dose regimens used, which may simply be a reflection of the small sample size in each group. There was no evidence of radiation induced retinopathy or optic neuropathy in any treated patients. CONCLUSIONS Teletherapy appeared to have a treatment effect in eyes with subfoveal choroidal neovascularisation resulting in maintained visual function without significant radiation induced morbidity.
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Affiliation(s)
- P M Hart
- Department of Ophthalmology, Queen's University of Belfast, Royal Victoria Hospital, Belfast
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Gough RE, Cox WJ, Gutierrez E, MacKenzie G, Wood AM, Dagless MD. Isolation of 'variant' strains of infectious bronchitis virus from vaccinated chickens in Great Britain. Vet Rec 1996; 139:552. [PMID: 8961529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
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Affiliation(s)
- V R Simpson
- Lasswade Veterinary Laboratory, Penicuik, Midlothian
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McMechan SR, MacKenzie G, Allen J, Wright GT, Dempsey GJ, Crawley M, Anderson J, Adgey AA. Body surface ECG potential maps in acute myocardial infarction. J Electrocardiol 1995; 28 Suppl:184-90. [PMID: 8656109 DOI: 10.1016/s0022-0736(95)80054-9] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
An algorithm for the early detection of acute myocardial infarction (MI) using body surface electrocardiographic potential mapping has been developed. The mapping system consists of a 64-hydrogel electrode harness applied rapidly to the anterior chest, from which electrocardiographic signals are stored on a memory card and processed by computer. At each of the 64 points, QRS and ST-T isointegrals and 10 other features of the QRST segment are measured. Using these measurements, new variables are derived that express the shape of the three-dimensional geometric surface of the map. The isointegrals, features, and shape variables are used in a variety of techniques to discriminate between MI and control subjects. Maps were recorded from 69 patients at initial presentation of chest pain suggestive of acute MI and from 80 healthy control subjects. Using a multiple logistic regression technique, 14 variables were identified that correctly classified 79 of the 80 control subjects (specificity, 98.8%) and 65 of the 69 MI patients (sensitivity, 94.2%). The algorithm based on these 14 variables was applied prospectively to maps recorded on a further 48 control subjects and 59 patients with acute MI. Of the MI patients, 31 had inferior, 13 inferoposterior, 10 anterior, 2 posterior, 1 lateral, 1 inferior with right bundle branch block, and 1 anterior non Q wave MI. The algorithm correctly classified all 48 control subjects (specificity, 100%) and 57 of the 59 MI patients (sensitivity, 96.6%). Marked differences in the three-dimensional geometric map surfaces between the control subjects and MI patients were demonstrated. Variables derived from these surfaces form the basis of an algorithm with a high sensitivity and specificity for the automated detection of acute MI. The design of adaptive algorithms and their application to patients with chest pain and atypical electrocardiographic changes, particularly ST depression, may lead to the earlier detection of MI and greater numbers of patients receiving thrombolytic therapy.
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Affiliation(s)
- S R McMechan
- Regional Medical Cardiology Centre, Royal Victoria Hospital, Belfast, UK
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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]
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O’Callaghan D, Horgan JH, Kellett J, Graham J, Deb B, Caldwell MTP, O'Callaghan P, Byrne PJ, Hennessy TPJ, Crean P, Walsh M, Gearty G, Boyle DM, Higginson JDS, Salathia K, Chandler R, Shah P, Lavin F, Daly K, Steele IC, Nugent AM, Vallely SR, Campbell NPS, Nicholls DP, Coghlan JG, Flitter WD, Daly R, Wright GD, Ilsley CD, Slate T, Foley DP, Melkert R, Keane D, Serruys PW, Foley JB, Sridhar K, Brown RIG, Penn IM, Umans VA, de Jaegere P, Galvin J, Codd M, Hennessy A, Leavey S, Keelan E, McCarthy C, Sugrue D, Craig BG, Mulholland HC, Kearney P, Erbel R, Koch L, Ge J, Görge G, Meyer J, Anderson D, Marrinan M, Sulke N, Cooke R, Jackson G, Sowton E, McEneaney DJ, Anderson J, Adgey AAJ, Marks P, Walsh TN, Leavey, Crowley JJ, Kenny A, Dardas P, Shapiro LM, Delanty N, Moran N, Catella F, FitzGerald GA, Fitzgerald DJ, Umans V, Moore D, Weston A, Hughes M, Maurer B, Cleland J, McGee HM, Graham I, Cullen C, Dempsey G, Wright G, Martin L, MacKenzie G, Adgey J, Lawson JA, Herity NA, Allen JD, Silke B, Northridge DB, Jackson NC, Metcalfe MJ, Dargie HJ, Gates ARC, Huang CLH, Gresham A, Carpenter TA, Hall LD, Johnston PW, Jossinet J, Imam Z, Sheahan R, Newman D, Dorian P, Meleady R, Tan KS, O’Brien C, Graham IH, Maderna P, Fitzgerald D, O'Callaghan DM, Rafferty SM, Canton MC, Connolly BF, Buchalter MB, Shandall A, Rees A, Rajan L, Sheehan R, Ghaisas N, Geraty G. Irish Cardiac Society. Ir J Med Sci 1994. [DOI: 10.1007/bf02942835] [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]
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Roberts MJ, McNeill AJ, MacKenzie G, Adgey AA. Time delays to lytic therapy and outcome in 100 consecutive patients with a history suggestive of acute myocardial infarction in an area with access to a mobile coronary care unit. Eur Heart J 1994; 15:594-601. [PMID: 8055997 DOI: 10.1093/oxfordjournals.eurheartj.a060554] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
Time delays to fibrinolytic treatment and outcome were assessed in 100 consecutive patients, with suggestive symptoms and electrocardiographic changes of acute myocardial infarction, admitted to the coronary care unit of this hospital. All patients admitted from out-of-hospital had access to a mobile coronary care unit. Initially, 40 patients called a general practitioner, 30 called the '999' operator, 12 called the mobile coronary care unit, 10 reported directly to the Accident and Emergency Department, seven were in-hospital and one spoke to the general practitioner's receptionist. Subsequently, 59 patients were attended by the mobile coronary care unit, 34 were admitted via the Accident and Emergency Department and seven had symptoms in-hospital. Thrombolytic therapy was initiated in 45/59 (76%) patients by the mobile coronary care unit staff and in 29/34 (85%) patients in the Accident and Emergency Department by cardiac staff. The remaining 26 patients received thrombolytic treatment in the hospital coronary care unit or cardiac department. The mean (+/- SEM) time from symptom onset to the initiation of thrombolytic therapy was 127 (+/- 11 min) for those patients treated by the mobile coronary care unit staff and for those treated in the Accident and Emergency Department was 187 (+/- 13 min) (P = 0.005). Multiple regression analysis showed significant reductions in total time delay if patients received thrombolytic therapy by the mobile coronary care unit staff out-of-hospital, when chest pain began in-hospital, or if patients had a previous myocardial infarction.(ABSTRACT TRUNCATED AT 250 WORDS)
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Affiliation(s)
- M J Roberts
- Regional Medical Cardiology Centre, Royal Victoria Hospital, Belfast, Northern Ireland
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Anderson JM, Dempsey GJ, Wright GT, Cullen C, Crawley M, McAdams ET, McLaughlin J, MacKenzie G, Adgey AA. Portable cardiac mapping assessment of acute ischaemic injury. Methods Inf Med 1994; 33:72-5. [PMID: 8177084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
A portable cardiac mapping system is used to improve the accuracy of diagnosis of acute ischaemic injury outside hospital. Patients presenting chest pain suggestive of myocardial infarction (MI) were mapped by attendant medical personnel operating from a mobile coronary unit. These first MI maps were compared against average normal maps using QRS and ST-T isointegral values. Discriminant function analysis performed on the parameters achieved a sensitivity of 90% and a specificity of 96%.
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Affiliation(s)
- J M Anderson
- N. Ireland Bio-Engineering Centre, University of Ulster
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McMechan SR, Cullen CM, MacKenzie G, Dempsey GJ, Wright GT, Crawley M, Anderson J, Adgey AA. Discriminant function analysis of body surface potential maps in acute myocardial infarction. J Electrocardiol 1994; 27 Suppl:117-20. [PMID: 7884345 DOI: 10.1016/s0022-0736(94)80068-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Using a newly developed 64-electrode portable mapping device, QRS and ST-T isointegral maps were compared in 194 control subjects and 101 patients. One hundred ninety-four control subjects (mean age, 48 years; 120 men) with no history of cardiac disease were selected randomly and mapped. One hundred one patients (mean age, 62 years; 77 men) were mapped at presentation of chest pain suggestive of first myocardial infarction (MI); all patients had classic 12-lead electrocardiographic findings--46 with anterior and 55 with inferior MI. The diagnosis was confirmed in all cases by a significant rise in serial cardiac enzymes. The mean delay between onset of chest pain to map recording was 163 minutes. Of the 101 patients, 78 were first mapped outside the hospital. Applying discriminant function analysis to the isointegral measurements made on the control subjects and on the first map of MI patients achieved a correct classification of 97% of the control subjects (189 of 194) and 72% of the anterior (33 of 46) and 76% of the inferior (42 of 55) MI groups. This preliminary study suggests that discriminant function analysis, based on isointegral maps, not only provides a method of separating control subjects from MI patients but that it can also differentiate between types of infarct. Further studies are required to improve the predictive values of discriminant function and to extend the methodology to assess both the site and size of MI.
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Affiliation(s)
- S R McMechan
- Regional Medical Cardiology Centre, Royal Victoria Hospital, Belfast, Northern Ireland
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Cullen C, MacKenzie G, Adgey J, Lavin F, Keane M, Forde A, Shah P, Gannon F, Daly K, McClements BM, McNeil AJ, Wilson CM, Webb SW, Campbell NPS, Khan MM, O’Murchu B, Gersh BJ, Bailey KR, Holmes DR, Foley DP, Hermans WR, Rensing BJ, Vos J, Herman JP, Serruys PW, Mannion A, Finn J, Grimes H, Lonergan M, O’Donnell, Daly L, McGovern E, Graham I, Joseph PA, Robinson K, Kinsella T, Crean P, Gearty G, Walsh M, Ryan M, Clarke R, Refsum R, Ueland P, Coehrane DJ, Stewart AJ, McEneaney DJ, Allen JD, Anderson J, Dempsey G, Adgey AAJ, Casey FA, Mulholland HC, Craig BG, Power R, Rooney N, O’Keeffe DB, McComb J, Wilson C, Tan KS, Pye C, McCabe N, Hickey N, McEneaney D, Cochrane D, Oslizlok PC, Case CL, Gillette PC, Knick BJ, Henry LPN, Blair L, Gumbrielle T, Bourke JP, Hilton CJ, Campbell RWF, Kearney PP, Fennell F, McKiernan S, Fennell W, Escaned J, Hermans WR, Umans VA, de Jaegere PP, de Feyter PJ, Galvin J, Leavey S, Sugrue D, Vallely SR, Campbell NPS, Laird JD, Ferguson R, Duff S, Bridges AB, Pringle TH, McNeill GP, McLaren M, Belch JJF, O’Sullivan L, Bain H, Hunter S, Wren C, Hennesy A, Codd M, Daly C, McCarthy C, Carroll K, Coakley F, O’Mahony S, Sullivan PA, Kearney P, Higgins T, Crowey JJ, Donnelly SM, Tobin M, FitzGerald O, Bresnihan B, Maurer BJ, Quigley PJ, Shelley E, Collins C, Hickey N, ulcahy R, Johnston PW, Gibson J, Crowe P, King G, Freyne PJ, Geary G, McAdam B, Sheahan R, Gaylani NE, Simpson A, Temperley I, Mulcahy F, McGee HM, Graham T, Crowe B, Horgan JH, McGinley J, Hurley J, Neligan M, Austin C, Cleland J, Gladstone D, O’Kane H, O’Sullivan J, Hasan A, Hamilton JRL, Hunter S, Dark JH, McDaid CM, Phillips AS, Lewis SA, McMurray TJ, Walsh KP, Abrams SE, Diamond M, Clarkson MJ, Rutsch W, Emanuelsson H, Danchin N, Wijns W, Chappuis F. Irish cardiac society. Ir J Med Sci 1993. [DOI: 10.1007/bf02945184] [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: 11/24/2022]
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Abstract
This is part of a major epidemiological survey of the reported incidence (new cases) of child sexual abuse in Northern Ireland. Based on multi-source methodology, the study used computer-based record linkage techniques to find the number of incident cases occurring in the Province in 1987. Reporters involved with the incident cases were interviewed by OEV who recorded details of the child, the abuse, and the abuser using a specially designed questionnaire. Age-sex specific incidence rates adjusted for potential misclassification were computed and allowance made for under-ascertainment. Overall, 408 Established cases were reported during 1987. The corresponding incidence rate for Northern Ireland was 0.9 cases per 1000 children. When Suspected and Alleged cases were compared with Established cases, a further 119 cases were allocated by discriminant function analysis to the Established group, and the rate rose to 1.16 per thousand. Selected reporters were interviewed about ascertainment which was estimated to lie between 62% and 74%. If the lowest level of ascertainment applied the corresponding incidence rate for Northern Ireland would increase to 1.87. These figures are higher than those currently reported elsewhere in the UK, but methodological differences in study design hamper interregional comparisons. A number of relevant methodological problems are discussed.
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Affiliation(s)
- G MacKenzie
- Department of Epidemiology and Public Health, Queen's University of Belfast, Northern Ireland, UK
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Tohani VK, Kennedy FD, McCann R, Kerr S, Little J, Love AHG, Corrigan D, Malcolm S, Smyth B, McCaugherty C, Connolly JH, Coyle PV, Fogarty J, Nolan G, Howell F, Buttenshaw C, Devlin J, O’Mahony M, O’Reilly O, Smith GD, Shipley MJ, Marmot MG, Barry J, Gavin AT, Ben-Sholmo Y, Smith GD, Johnson Z, Lyons R, Kelleher C, Wilkes HC, Meade TW, Lonergan M, Daly L, Graham I, Fogarty J, Jennings S, Johnson H, Doorley P, Donoghue F, Hynes M, Hurley M, Peyton M, O’Herlihy B, Darragh PM, Sykes DH, Evans AE, Haertel U, Quinlivan CM, Hurson B, Allwright S, Robinson K, Clarke R, Naughton E, Graham I, Evans AE, Byrne J, Fears TR, Gail MH, Shelley E, MacKenzie G, Molloy B, Howell F. All Ireland Social Medicine Meeting Proceedings of the 12th All Ireland Social Medicine Meeting held in Ballyconnell, Co. Cavan, in March 1991. Ir J Med Sci 1991. [DOI: 10.1007/bf02957802] [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]
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Dickey W, MacKenzie G, Adgey AA. Long-term survival after resuscitation from ventricular fibrillation occurring before hospital admission. Q J Med 1991; 80:729-37. [PMID: 1754673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Factors related to long-term (post-discharge) outcome following successful resuscitation from pre-hospital ventricular fibrillation by a physician-manned mobile coronary care unit were studied. Between 1 January 1966 and 31 December 1987, 190 patients were resuscitated from pre-hospital ventricular fibrillation (158 male; mean age 56 years). The aetiology of ventricular fibrillation was acute myocardial infarction in 131 patients (69 per cent), ischaemic heart disease without infarction in 48 (25 per cent) and other or unknown in 11 (6 per cent). Predicted actuarial survival rates at 1, 2, 5, 10 and 20 years were 76 per cent, 66 per cent, 41 per cent, 27 per cent and 12 per cent respectively. Of 128 recorded deaths over 20 years, 85 per cent were cardiac and 48 per cent were defined as sudden death outside hospital. Factors significantly associated with increased long-term mortality (p less than 0.05), based on analysis of 10 year actuarial life tables using the Lee-Desu statistic were ventricular fibrillation due to ischaemic heart disease without infarction rather than acute myocardial infarction, a history of previous myocardial infarction, a history of hypertension, digoxin and diuretic therapy before ventricular fibrillation and digoxin as discharge medication, and failure to stop smoking after discharge from hospital by patients who had been smoking prior to ventricular fibrillation. In addition, Cox's regression analysis showed that patient age greater than or equal to 60 years was significantly associated with increased long-term mortality. On multivariate analysis, factors independently associated with increased long-term mortality were ventricular fibrillation occurring before 1977, previous myocardial infarction or hypertension and digoxin as discharge medication.(ABSTRACT TRUNCATED AT 250 WORDS)
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Affiliation(s)
- W Dickey
- Regional Medical Cardiology Centre, Royal Victoria Hospital, Belfast, N. Ireland
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MacKenzie G, Lucia D. Materials managers must lay the foundation for a new facility's supply distribution system. Hosp Mater Manage 1990; 15:18-9. [PMID: 10113247] [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: 02/11/2023]
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Cederna J, Bandlien K, Toledo-Pereyra LH, Bergren C, MacKenzie G, Guttierez-Vega R. Effect of allopurinol and/or catalase on hemorrhagic shock and their potential application to multiple organ harvesting. Transplant Proc 1990; 22:444-5. [PMID: 1691539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Affiliation(s)
- J Cederna
- Borgess Medical Center, Kalamazoo, MI 49001
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Affiliation(s)
- S R Duff
- Agricultural and Food Research Council, Institute for Grassland and Animal Production, Poultry Department, Roslin, Midlothian
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Abstract
Sixty six patients with angina at rest were investigated by exercise electrocardiography, thallium scintigraphy, and coronary arteriography. A positive exercise electrocardiogram was highly predictive (93%) but poorly sensitive (52%) of coronary artery disease (greater than or equal to 50% stenosis). Thallium scintigraphy was as predictive of the presence of coronary artery disease (91%) but was also highly sensitive (91%). The diagnostic contribution of the thallium scan was greatest in those patients with an inconclusive exercise electrocardiogram without Q waves.
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Affiliation(s)
- R J Lee
- Regional Medical Cardiology Centre, Belfast
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Walker LJ, MacKenzie G, Adgey AA. Effect of nifedipine on arrhythmias in the acute phase of myocardial infarction. Eur Heart J 1988; 9:471-8. [PMID: 3042398 DOI: 10.1093/oxfordjournals.eurheartj.a062531] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
In a double-blind placebo-controlled trial to study the effect of nifedipine on ventricular arrhythmias among patients with acute myocardial infarction, 434 patients with suspected myocardial infarction were randomized within 6 h from the onset of chest pain to treatment with nifedipine (p = 217) or placebo (p = 217). During the 48-h treatment period, a 10-mg capsule containing active drug or placebo was administered sublingually every 4 h for 24 h, then orally every 4 h for the next 24 h. Acute myocardial infarction was confirmed in 295 patients (146 in the nifedipine group and 149 in the placebo group). Twenty-four hour ECG tape analysis during 1-5 h from onset of chest pain showed that there was no significant difference in the number of patients with ventricular ectopics, ventricular couplets, ventricular tachycardia (3-9 beats), self terminating or sustained ventricular tachycardia between the two treatment groups. Also during the greater than 5-24 h from onset of chest pain, the numbers of patients with ventricular ectopics, multifocal, bigeminal or couplets, self-terminating ventricular tachycardia or sustained ventricular tachycardia did not differ significantly. However, there was a significant reduction in the number of patients with short runs of ventricular tachycardia (3-9 beats) in the nifedipine-treated group. There was no significant difference among patients with ventricular fibrillation between the two treatment groups.
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Affiliation(s)
- L J Walker
- Regional Medical Cardiology Centre, Royal Victoria Hospital, Belfast, U.K
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McIlwaine WJ, Chivers AT, Donnelly MD, Evans AE, MacKenzie G. Fatal ischaemic heart disease in Belfast: a comparison of two community surveys. Ulster Med J 1988; 57:70-5. [PMID: 3420724 PMCID: PMC2448468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Data from two community surveys in Belfast were used to compare all deaths attributed to ischaemic heart disease during two one-year periods (1965/66 and 1981/82). There was an increase in mortality in men of all ages from 3.3 to 4.4 per 1,000 population (33%) and in women from 1.6 to 3.1 per 1,000 population (94%). Only in men aged less than 70 years was the mortality rate unchanged (2.2 per 1,000 population). The proportion of deaths in persons whose fatal attack began outside the hospital was virtually unchanged (65% in 1965/66 compared with 69% in 1981/82). Survival time was markedly decreased in the later survey, as were delay times in initiating medical care. The increase in mortality probably is due to an increase in the incidence of acute myocardial infarction. The introduction of mobile coronary care in Belfast in 1965 seems to have had equal effects in reducing mortality inside and outside hospital.
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Abstract
In a double blind placebo controlled trial, 434 patients with suspected myocardial infarction were randomised to treatment with nifedipine (n = 217) or placebo (n = 217) within six hours from the onset of chest pain. During the treatment period of 48 hours, a 10 mg capsule containing nifedipine or placebo was given sublingually every four hours for 24 hours, then orally every four hours for the next 24 hours. Acute myocardial infarction was confirmed in 295 patients (146 in the nifedipine group and 149 in the placebo group). The median delay time to intervention with nifedipine in patients with acute myocardial infarction was 111 minutes. Infarct size was assessed by the estimation of release of creatine kinase isoenzyme MB and creatine kinase from blood samples taken every four hours for 48 hours. The total mean (SEM) creatine kinase MB released was 406.4 (27.2) IU/l in the nifedipine group and 345.7 (20.5) IU/l in the placebo group. Total mean (SEM) creatine kinase released was 2749.6 (165.1) IU/l in the nifedipine group and 2698.4 (145.9) IU/l in the placebo group. In hospital mortality was similar for both the nifedipine and placebo groups (6.6% and 5.8% respectively). Treatment with nifedipine in the early phase of acute myocardial infarction seems to have no effect on enzymatically measured infarct size.
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Affiliation(s)
- L J Walker
- Regional Medical Cardiology Centre, Royal Victoria Hospital, Belfast
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Graham IM, Hickey N, Daly L, Mulcahy R, Doyle Y, Conroy R, Mulcahy R, Donnelly MDI, Toner P, Nugent T, Anderson D, Chadwick E, Turkington E, Varma MPS, Graham I, Comerford D, Shelley E, Daly L, Gibney M, Hickey N, Kilcoyne D, O’Dwyer T, Radic A, Conroy R, Herity B, Fennelly J, Hilliard N, Moriarty M, Gavin AT, Telford AM, Lowry G, MacKenzie G, Bridges J, Nevin N, Blaney R, McDonnell M, Corridan JP, Doyle CT, Allwright S, Sadek F, Kirke PN, Molloy AM, Weir DG, Scott JM, Hillary I, Evans AE, Condren L, Sinclair H, Tohani VK, Dean G, Elian M. All-Ireland social medicine meeting. Ir J Med Sci 1987. [DOI: 10.1007/bf02954638] [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]
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Amiel J, Toledo-Pereyra LH, Bandlien K, Gordon D, MacKenzie G. Effect of skin grafts on pancreatic islet cell allografts in the renal subcapsular space. Transplant Proc 1987; 19:2368-71. [PMID: 3103295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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MacKenzie G. Calculation of pneumothorax size. Ann Emerg Med 1986; 15:1377. [PMID: 3777603 DOI: 10.1016/s0196-0644(86)80651-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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50
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Bergren CT, Toledo-Pereyra LH, MacKenzie G. Preservation methods for liver transplantation. Bol Asoc Med P R 1986; 78:434-6. [PMID: 3539137] [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: 01/06/2023]
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