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Mazzio E, Barnes A, Badisa R, Fierros-Romero G, Williams H, Council S, Soliman K. Functional immune boosters; the herb or its dead microbiome? Antigenic TLR4 agonist MAMPs found in 65 medicinal roots and algae's. J Funct Foods 2023; 107:105687. [PMID: 37654434 PMCID: PMC10469438 DOI: 10.1016/j.jff.2023.105687] [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] [Indexed: 09/02/2023] Open
Abstract
Background Humans have been consuming medicinal plants (as herbs/ spices) to combat illness for centuries while ascribing beneficial effects predominantly to the plant/phytochemical constituents, without recognizing the power of obligatory resident microorganism' communities (MOCs) (live/dead bacteria, fungus, yeast, molds etc.) which remain after industrial microbial reduction methods. Very little is known about the taxonomic identity of residual antigenic microbial associated molecular patterns (MAMPs) debris in our botanical over the counter (OTC) products, which if present would be recognized as foreign (non-self) antigenic matter by host pattern recognition receptors (PRRs) provoking a host immune response; this the basis of vaccine adjuvants. As of today, only few research groups have removed the herbal MAMP biomass from herbs, all suggesting that immune activation may not be from the plant but rather its microbial biomass; a hypothesis we corroborate. Purpose The purpose of this work was to conduct a high through put screening (HTPS) of over 2500 natural plants, OTC botanical supplements and phytochemicals to elucidate those with pro-inflammatory; toll like receptor 4 (TLR4) activating properties in macrophages. Study Design The HTPS was conducted on RAW 264.7 cells vs. lipopolysaccharide (LPS) E. coli 0111:B4, testing iNOS / nitric oxide production ( NO 2 - ) as a perimeter endpoint. The data show not a single drug/chemical/ phytochemical and approximately 98 % of botanicals to be immune idle (not effective) with only 65 pro-inflammatory (hits) in a potency range of LPS. Method validation studies eliminated the possibility of false artifact or contamination, and results were cross verified through multiple vendors/ manufacturers/lot numbers by botanical species. Lead botanicals were evaluated for plant concentration of LPS, 1,3:1,6-β-glucan, 1,3:1,4-β-D-glucan and α-glucans; where the former paralleled strength in vitro. LPS was then removed from plants using high-capacity endotoxin poly lysine columns, where bioactivity of LPS null "plant" extracts were lost. The stability of E.Coli 0111:B4 in an acid stomach mimetic model was confirmed. Last, we conducted a reverse culture on aerobic plate counts (APCs) from select hits, with subsequent isolation of gram-negative bacteria (MacConkey agar). Cultures were 1) heat destroyed (retested/ confirming bioactivity) and 2) subject to taxonomical identification by genetic sequencing 18S, ITS1, 5.8 s, ITS2 28S, and 16S. Conclusion The data show significant gram negative MAMP biomass dominance in A) roots (e.g. echinacea, yucca, burdock, stinging nettle, sarsaparilla, hydrangea, poke, madder, calamus, rhaponticum, pleurisy, aconite etc.) and B) oceanic plants / algae's (e.g. bladderwrack, chlorella, spirulina, kelp, and "OTC Seamoss-blends" (irish moss, bladderwrack, burdock root etc), as well as other random herbs (eg. corn silk, cleavers, watercress, cardamom seed, tribulus, duckweed, puffball, hordeum and pollen). The results show a dominance of gram negative microbes (e.g. Klebsilla aerogenes, Pantoae agglomerans, Cronobacter sakazakii), fungus (Glomeracaea, Ascomycota, Irpex lacteus, Aureobasidium pullulans, Fibroporia albicans, Chlorociboria clavula, Aspergillus_sp JUC-2), with black walnut hull, echinacea and burdock root also containing gram positive microbial strains (Fontibacillus, Paenibacillus, Enterococcus gallinarum, Bromate-reducing bacterium B6 and various strains of Clostridium). Conclusion This work brings attention to the existence of a functional immune bioactive herbal microbiome, independent from the plant. There is need to further this avenue of research, which should be carried out with consideration as to both positive or negative consequences arising from daily consumption of botanicals highly laden with bioactive MAMPS.
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Affiliation(s)
- E. Mazzio
- Florida Agricultural and Mechanical University, College of Pharmacy and Pharmaceutical Sciences, Tallahassee, FL 32307, United States
| | - A. Barnes
- Florida Agricultural and Mechanical University, College of Pharmacy and Pharmaceutical Sciences, Tallahassee, FL 32307, United States
| | - R. Badisa
- Florida Agricultural and Mechanical University, College of Pharmacy and Pharmaceutical Sciences, Tallahassee, FL 32307, United States
| | - G. Fierros-Romero
- Florida Agricultural and Mechanical University, School of Environment, Tallahassee, FL 32307, United States
| | - H. Williams
- Florida Agricultural and Mechanical University, School of Environment, Tallahassee, FL 32307, United States
| | - S. Council
- John Gnabre Science Research Institute, Baltimore, MD 21224, United States
| | - K.F.A. Soliman
- Florida Agricultural and Mechanical University, College of Pharmacy and Pharmaceutical Sciences, Tallahassee, FL 32307, United States
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Langan SM, Mulick AR, Rutter CE, Silverwood R, Asher I, García‐Marcos L, Ellwood E, Bissell K, Chiang C, Sony AE, Ellwood P, Marks G, Mortimer K, Martínez‐Torres AE, Morales E, Perez‐Fernandez V, Robertson S, Williams H, Strachan DP, Pearce N, Bissell K, Chiang CY, Marks , Mortimer K, Masekela R, Perez‐Fernández V, Martinez‐Torres AE, Robertson S, Rutter CE, Silverwood RJ, Mallol J, Soto‐Martinez ME, Cabrera Aguilar A, Douros K, Mohammed S, Singh M, Singh V, Sukumaran TU, Awasthi S, Kabra SK, Salvi S, Mérida‐Palacio JV, González‐Díaz SN, Navarrete‐Rodriguez EM, Sánchez JF, Falade AG, Zar HJ, López‐Silvarrey Varela A, González Díaz C, Nour M, Dib G, Mohammad Y, Huang J, Chinratanapisit S, Soto‐Quirós ME, El‐Sony A, Vichyanond P, Aguilar P, Barba S, Kumar L, Sharma SK, Hanumante NM, García‐Almaráz R, Merida‐Palacio JV, Del‐Río‐Navarro BE, Linares‐Zapién FJ, Onadeko BO, Musa OAA, Aguirre V, Baeza‐Bacab M, Mohammad S, Cortéz E, Gratziou CH, Chopra K, Nelson H, Rubio AD, Hsieh K, Shah J. Trends in eczema prevalence in children and adolescents: A Global Asthma Network Phase I Study. Clin Exp Allergy 2023. [DOI: 10.1111/cea.14276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/10/2023]
Affiliation(s)
| | - Amy R. Mulick
- London School of Hygiene & Tropical Medicine London UK
| | | | - Richard J. Silverwood
- London School of Hygiene & Tropical Medicine London UK
- Centre for Longitudinal Studies, UCL Social Research Institute University College London London UK
| | - Innes Asher
- Department of Paediatrics: Child and Youth Health, Faculty of Medical and Health Sciences University of Auckland Auckland New Zealand
| | - Luis García‐Marcos
- Paediatric Allergy and Pulmonology Units, Virgen de la Arrixaca University Children's Hospital University of Murcia Murcia Spain
- IMIB Bio‐health Research Institute Murcia Spain
- ARADyAL Allergy Network Murcia Spain
| | - Eamon Ellwood
- Department of Paediatrics: Child and Youth Health, Faculty of Medical and Health Sciences University of Auckland Auckland New Zealand
| | - Karen Bissell
- School of Population Health, Faculty of Medical and Health Sciences University of Auckland Auckland New Zealand
| | - Chen‐Yuan Chiang
- International Union Against Tuberculosis and Lung Disease Paris France
- Division of Pulmonary Medicine, Department of Internal Medicine, Wan Fang Hospital Taipei Medical University Taipei Taiwan
- Division of Pulmonary Medicine, Department of Internal Medicine, School of Medicine, College of Medicine Taipei Medical University Taipei Taiwan
| | - Asma El Sony
- Epidemiological Laboratory (Epi‐Lab) for Public Health, Research and Development Khartoum Sudan
| | - Philippa Ellwood
- Department of Paediatrics: Child and Youth Health, Faculty of Medical and Health Sciences University of Auckland Auckland New Zealand
| | - Guy B. Marks
- Respiratory & Environmental Epidemiology University of New South Wales Sydney New South Wales Australia
| | - Kevin Mortimer
- Department of Medicine University of Cambridge Cambridge UK
- Department of Respiratory Medicine Liverpool University Hospitals NHS Foundation Trust Liverpool UK
- Department of Paediatrics and Child Health, College of Health Sciences, School of Clinical Medicine University of KwaZulu‐Natal Durban South Africa
| | - A. Elena Martínez‐Torres
- Paediatric Allergy and Pulmonology Units and Nurse Research Group Virgen de la Arrixaca University Children's Hospital Murcia Spain
- IMIB Bio‐health Research Institute, Edificio Departamental‐Laib Murcia Spain
| | - Eva Morales
- IMIB Bio‐health Research Institute, Edificio Departamental‐Laib Murcia Spain
- Department of Public Health Sciences University of Murcia Murcia Spain
| | - Virginia Perez‐Fernandez
- IMIB Bio‐health Research Institute, Edificio Departamental‐Laib Murcia Spain
- Department of Biostatistics University of Murcia Murcia Spain
| | - Steven Robertson
- Centre for Longitudinal Studies, UCL Social Research Institute University College London London UK
| | - Hywel C. Williams
- Centre for Evidence‐Based Dermatology University of Nottingham Nottingam UK
| | - David P. Strachan
- Population Health Research Institute St George's, University of London London UK
| | - Neil Pearce
- London School of Hygiene & Tropical Medicine London UK
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Kouli O, Murray V, Bhatia S, Cambridge WA, Kawka M, Shafi S, Knight SR, Kamarajah SK, McLean KA, Glasbey JC, Khaw RA, Ahmed W, Akhbari M, Baker D, Borakati A, Mills E, Thavayogan R, Yasin I, Raubenheimer K, Ridley W, Sarrami M, Zhang G, Egoroff N, Pockney P, Richards T, Bhangu A, Creagh-Brown B, Edwards M, Harrison EM, Lee M, Nepogodiev D, Pinkney T, Pearse R, Smart N, Vohra R, Sohrabi C, Jamieson A, Nguyen M, Rahman A, English C, Tincknell L, Kakodkar P, Kwek I, Punjabi N, Burns J, Varghese S, Erotocritou M, McGuckin S, Vayalapra S, Dominguez E, Moneim J, Salehi M, Tan HL, Yoong A, Zhu L, Seale B, Nowinka Z, Patel N, Chrisp B, Harris J, Maleyko I, Muneeb F, Gough M, James CE, Skan O, Chowdhury A, Rebuffa N, Khan H, Down B, Fatimah Hussain Q, Adams M, Bailey A, Cullen G, Fu YXJ, McClement B, Taylor A, Aitken S, Bachelet B, Brousse de Gersigny J, Chang C, Khehra B, Lahoud N, Lee Solano M, Louca M, Rozenbroek P, Rozitis E, Agbinya N, Anderson E, Arwi G, Barry I, Batchelor C, Chong T, Choo LY, Clark L, Daniels M, Goh J, Handa A, Hanna J, Huynh L, Jeon A, Kanbour A, Lee A, Lee J, Lee T, Leigh J, Ly D, McGregor F, Moss J, Nejatian M, O'Loughlin E, Ramos I, Sanchez B, Shrivathsa A, Sincari A, Sobhi S, Swart R, Trimboli J, Wignall P, Bourke E, Chong A, Clayton S, Dawson A, Hardy E, Iqbal R, Le L, Mao S, Marinelli I, Metcalfe H, Panicker D, R HH, Ridgway S, Tan HH, Thong S, Van M, Woon S, Woon-Shoo-Tong XS, Yu S, Ali K, Chee J, Chiu C, Chow YW, Duller A, Nagappan P, Ng S, Selvanathan M, Sheridan C, Temple M, Do JE, Dudi-Venkata NN, Humphries E, Li L, Mansour LT, Massy-Westropp C, Fang B, Farbood K, Hong H, Huang Y, Joan M, Koh C, Liu YHA, Mahajan T, Muller E, Park R, Tanudisastro M, Wu JJG, Chopra P, Giang S, Radcliffe S, Thach P, Wallace D, Wilkes A, Chinta SH, Li J, Phan J, Rahman F, Segaran A, Shannon J, Zhang M, Adams N, Bonte A, Choudhry A, Colterjohn N, Croyle JA, Donohue J, Feighery A, Keane A, McNamara D, Munir K, Roche D, Sabnani R, Seligman D, Sharma S, Stickney Z, Suchy H, Tan R, Yordi S, Ahmed I, Aranha M, El Sabawy D, Garwood P, Harnett M, Holohan R, Howard R, Kayyal Y, Krakoski N, Lupo M, McGilberry W, Nepon H, Scoleri Y, Urbina C, Ahmad Fuad MF, Ahmed O, Jaswantlal D, Kelly E, Khan MHT, Naidu D, Neo WX, O'Neill R, Sugrue M, Abbas JD, Abdul-Fattah S, Azlan A, Barry K, Idris NS, Kaka N, Mc Dermott D, Mohammad Nasir MN, Mozo M, Rehal A, Shaikh Yousef M, Wong RH, Curran E, Gardner M, Hogan A, Julka R, Lasser G, Ní Chorráin N, Ting J, Browne R, George S, Janjua Z, Leung Shing V, Megally M, Murphy S, Ravenscroft L, Vedadi A, Vyas V, Bryan A, Sheikh A, Ubhi J, Vannelli K, Vawda A, Adeusi L, Doherty C, Fitzgerald C, Gallagher H, Gill P, Hamza H, Hogan M, Kelly S, Larry J, Lynch P, Mazeni NA, O'Connell R, O'Loghlin R, Singh K, Abbas Syed R, Ali A, Alkandari B, Arnold A, Arora E, Azam R, Breathnach C, Cheema J, Compton M, Curran S, Elliott JA, Jayasamraj O, Mohammed N, Noone A, Pal A, Pandey S, Quinn P, Sheridan R, Siew L, Tan EP, Tio SW, Toh VTR, Walsh M, Yap C, Yassa J, Young T, Agarwal N, Almoosawy SA, Bowen K, Bruce D, Connachan R, Cook A, Daniell A, Elliott M, Fung HKF, Irving A, Laurie S, Lee YJ, Lim ZX, Maddineni S, McClenaghan RE, Muthuganesan V, Ravichandran P, Roberts N, Shaji S, Solt S, Toshney E, Arnold C, Baker O, Belais F, Bojanic C, Byrne M, Chau CYC, De Soysa S, Eldridge M, Fairey M, Fearnhead N, Guéroult A, Ho JSY, Joshi K, Kadiyala N, Khalid S, Khan F, Kumar K, Lewis E, Magee J, Manetta-Jones D, Mann S, McKeown L, Mitrofan C, Mohamed T, Monnickendam A, Ng AYKC, Ortu A, Patel M, Pope T, Pressling S, Purohit K, Saji S, Shah Foridi J, Shah R, Siddiqui SS, Surman K, Utukuri M, Varghese A, Williams CYK, Yang JJ, Billson E, Cheah E, Holmes P, Hussain S, Murdock D, Nicholls A, Patel P, Ramana G, Saleki M, Spence H, Thomas D, Yu C, Abousamra M, Brown C, Conti I, Donnelly A, Durand M, French N, Goan R, O'Kane E, Rubinchik P, Gardiner H, Kempf B, Lai YL, Matthews H, Minford E, Rafferty C, Reid C, Sheridan N, Al Bahri T, Bhoombla N, Rao BM, Titu L, Chatha S, Field C, Gandhi T, Gulati R, Jha R, Jones Sam MT, Karim S, Patel R, Saunders M, Sharma K, Abid S, Heath E, Kurup D, Patel A, Ali M, Cresswell B, Felstead D, Jennings K, Kaluarachchi T, Lazzereschi L, Mayson H, Miah JE, Reinders B, Rosser A, Thomas C, Williams H, Al-Hamid Z, Alsadoun L, Chlubek M, Fernando P, Gaunt E, Gercek Y, Maniar R, Ma R, Matson M, Moore S, Morris A, Nagappan PG, Ratnayake M, Rockall L, Shallcross O, Sinha A, Tan KE, Virdee S, Wenlock R, Donnelly HA, Ghazal R, Hughes I, Liu X, McFadden M, Misbert E, Mogey P, O'Hara A, Peace C, Rainey C, Raja P, Salem M, Salmon J, Tan CH, Alves D, Bahl S, Baker C, Coulthurst J, Koysombat K, Linn T, Rai P, Sharma A, Shergill A, Ahmed M, Ahmed S, Belk LH, Choudhry H, Cummings D, Dixon Y, Dobinson C, Edwards J, Flint J, Franco Da Silva C, Gallie R, Gardener M, Glover T, Greasley M, Hatab A, Howells R, Hussey T, Khan A, Mann A, Morrison H, Ng A, Osmond R, Padmakumar N, Pervaiz F, Prince R, Qureshi A, Sawhney R, Sigurdson B, Stephenson L, Vora K, Zacken A, Cope P, Di Traglia R, Ferarrio I, Hackett N, Healicon R, Horseman L, Lam LI, Meerdink M, Menham D, Murphy R, Nimmo I, Ramaesh A, Rees J, Soame R, Dilaver N, Adebambo D, Brown E, Burt J, Foster K, Kaliyappan L, Knight P, Politis A, Richardson E, Townsend J, Abdi M, Ball M, Easby S, Gill N, Ho E, Iqbal H, Matthews M, Nubi S, Nwokocha JO, Okafor I, Perry G, Sinartio B, Vanukuru N, Walkley D, Welch T, Yates J, Yeshitila N, Bryans K, Campbell B, Gray C, Keys R, Macartney M, Chamberlain G, Khatri A, Kucheria A, Lee STP, Reese G, Roy choudhury J, Tan WYR, Teh JJ, Ting A, Kazi S, Kontovounisios C, Vutipongsatorn K, Amarnath T, Balasubramanian N, Bassett E, Gurung P, Lim J, Panjikkaran A, Sanalla A, Alkoot M, Bacigalupo V, Eardley N, Horton M, Hurry A, Isti C, Maskell P, Nursiah K, Punn G, Salih H, Epanomeritakis E, Foulkes A, Henderson R, Johnston E, McCullough H, McLarnon M, Morrison E, Cheung A, Cho SH, Eriksson F, Hedges J, 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Upcott M, Vijayasingam D, Anarfi S, Dauncey J, Devindaran A, Havalda P, Komninos G, Mwendwa E, Norman C, Richards J, Urquhart A, Allan J, Cahya E, Hunt H, McWhirter C, Norton R, Roxburgh C, Tan JY, Ali Butt S, Hansdot S, Haq I, Mootien A, Sanchez I, Vainas T, Deliyannis E, Tan M, Vipond M, Chittoor Satish NN, Dattani A, De Carvalho L, Gaston-Grubb M, Karunanithy L, Lowe B, Pace C, Raju K, Roope J, Taylor C, Youssef H, Munro T, Thorn C, Wong KHF, Yunus A, Chawla S, Datta A, Dinesh AA, Field D, Georgi T, Gwozdz A, Hamstead E, Howard N, Isleyen N, Jackson N, Kingdon J, Sagoo KS, Schizas A, Yin L, Aung E, Aung YY, Franklin S, Han SM, Kim WC, Martin Segura A, Rossi M, Ross T, Tirimanna R, Wang B, Zakieh O, Ben-Arzi H, Flach A, Jackson E, Magers S, Olu abara C, Rogers E, Sugden K, Tan H, Veliah S, Walton U, Asif A, Bharwada Y, Bowley D, Broekhuizen A, Cooper L, Evans N, Girdlestone H, Ling C, Mann H, Mehmood N, Mulvenna CL, Rainer N, Trout I, Gujjuri R, Jeyaraman D, Leong E, Singh D, Smith 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McEneaney L, N D G, Pranoy S, Ting M, Abada S, Alawattegama LH, Ashok A, Carey C, Gogna A, Haglund C, Hurley P, Leelo N, Liu B, Mannan F, Paramjothy K, Ramlogan K, Raymond-Hayling O, Shanmugarajah A, Solichan D, Wilkinson B, Ahmad NA, Allan D, Amin A, Bakina C, Burns F, Cameron F, Campbell A, Cavanagh S, Chan SMZ, Chapman S, Chong V, Edelsten E, Ekpete O, El Sheikh M, Ghose R, Hassane A, Henderson C, Hilton-Christie S, Husain M, Hussain H, Javid Z, Johnson-Ogbuneke J, Johnston A, Khalil M, Leung TCC, Makin I, Muralidharan V, Naeem M, Patil P, Ravichandran S, Saraeva D, Shankey-Smith W, Sharma N, Swan R, Waudby-West R, Wilkinson A, Wright K, Balasubramanian A, Bhatti S, Chalkley M, Chou WK, Dixon M, Evans L, Fisher K, Gandhi P, Ho S, Lau YB, Lowe S, Meechan C, Murali N, Musonda C, Njoku P, Ochieng L, Pervez MU, Seebah K, Shaikh I, Sikder MA, Vanker R, Alom J, Bajaj V, Coleman O, Finch G, Goss J, Jenkins C, Kontothanassis A, Liew MS, Ng K, Outram M, Shakeel MM, Tawn J, Zuhairy S, Chapple K, Cinnamond A, Coleman S, George HA, Goulder L, Hare N, Hawksley J, Kret A, Luesley A, Mecia L, Porter H, Puddy E, Richardson G, Sohail B, Srikaran V, Tadross D, Tobin J, Tokidis E, Young L, Ashdown T, Bratsos S, Koomson A, Kufuor A, Lim MQ, Shah S, Thorne EPC, Warusavitarne J, Xu S, Abigail S, Ahmed A, Ahmed J, Akmal A, Al-Khafaji M, Amini B, Arshad M, Bogie E, Brazkiewicz M, Carroll M, Chandegra A, Cirelli C, Deng A, Fairclough S, Fung YJ, Gornell C, Green RL, Green SV, Gulamhussein AHM, Isaac AG, Jan R, Jegatheeswaran L, Knee M, Kotecha J, Kotecha S, Maxwell-Armstrong C, McIntyre C, Mendis N, Naing TKP, Oberman J, Ong ZX, Ramalingam A, Saeed Adam A, Tan LL, Towell S, Yadav J, Anandampillai R, Chung S, Hounat A, Ibrahim B, Jeyakumar G, Khalil A, Khan UA, Nair G, Owusu-Ayim M, Wilson M, Kanani A, Kilkelly B, Ogunmwonyi I, Ong L, Samra B, Schomerus L, Shea J, Turner O, Yang Y, Amin M, Blott N, Clark A, Feather A, Forrest M, Hague S, Hamilton K, Higginbotham G, Hope E, Karimian S, Loveday K, Malik H, McKenna O, Noor A, Onsiong C, Patel B, Radcliffe N, Shah P, Tye L, Verma K, Walford R, Yusufi U, Zachariah M, Casey A, Doré C, Fludder V, Fortescue L, Kalapu SS, Karel E, Khera G, Smith C, Appleton B, Ashaye A, Boggon E, Evans A, Faris Mahmood H, Hinchcliffe Z, Marei O, Silva I, Spooner C, Thomas G, Timlin M, Wellington J, Yao SL, Abdelrazek M, Abdelrazik Y, Bee F, Joseph A, Mounce A, Parry G, Vignarajah N, Biddles D, Creissen A, Kolhe S, K T, Lea A, Ledda V, O'Loughlin P, Scanlon J, Shetty N, Weller C, Abdalla M, Adeoye A, Bhatti M, Chadda KR, Chu J, Elhakim H, Foster-Davies H, Rabie M, Tailor B, Webb S, Abdelrahim ASA, Choo SY, Jiwa A, Mangam S, Murray S, Shandramohan A, Aghanenu O, Budd W, Hayre J, Khanom S, Liew ZY, McKinney R, Moody N, Muhammad-Kamal H, Odogwu J, Patel D, Roy C, Sattar Z, Shahrokhi N, Sinha I, Thomson E, Wonga L, Bain J, Khan J, Ricardo D, Bevis R, Cherry C, Darkwa S, Drew W, Griffiths E, Konda N, Madani D, Mak JKC, Meda B, Odunukwe U, Preest G, Raheel F, Rajaseharan A, Ramgopal A, Risbrooke C, Selvaratnam K, Sethunath G, Tabassum R, Taylor J, Thakker A, Wijesingha N, Wybrew R, Yasin T, Ahmed Osman A, Alfadhel S, Carberry E, Chen JY, Drake I, Glen P, Jayasuriya N, Kawar L, Myatt R, Sinan LOH, Siu SSY, Tjen V, Adeboyejo O, Bacon H, Barnes R, Birnie C, D'Cunha Kamath A, Hughes E, Middleton S, Owen R, Schofield E, Short C, Smith R, Wang H, Willett M, Zimmerman M, Balfour J, Chadwick T, Coombe-Jones M, Do Le HP, Faulkner G, Hobson K, Shehata Z, Beattie M, Chmielewski G, Chong C, Donnelly B, Drusch B, Ellis J, Farrelly C, Feyi-Waboso J, Hibell I, Hoade L, Ho C, Jones H, Kodiatt B, Lidder P, Ni Cheallaigh L, Norman R, Patabendi I, Penfold H, Playfair M, Pomeroy S, Ralph C, Rottenburg H, Sebastian J, Sheehan M, Stanley V, Welchman J, Ajdarpasic D, Antypas A, Azouaghe O, Basi S, Bettoli G, Bhattarai S, Bommireddy L, Bourne K, Budding J, Cookey-Bresi R, Cummins T, Davies G, Fabelurin C, Gwilliam R, Hanley J, Hird A, Kruczynska A, Langhorne B, Lund J, Lutchman I, McGuinness R, Neary M, Pampapathi S, Pang E, Podbicanin S, Rai N, Redhouse White G, Sujith J, Thomas P, Walker I, Winterton R, Anderson P, Barrington M, Bhadra K, Clark G, Fowler G, Gibson C, Hudson S, Kaminskaite V, Lawday S, Longshaw A, MacKrill E, McLachlan F, Murdeshwar A, Nieuwoudt R, Parker P, Randall R, Rawlins E, Reeves SA, Rye D, Sirkis T, Sykes B, Ventress N, Wosinska N, Akram B, Burton L, Coombs A, Long R, Magowan D, Ong C, Sethi M, Williams G, Chan C, Chan LH, Fernando D, Gaba F, Khor Z, Les JW, Mak R, Moin S, Ng Kee Kwong KC, Paterson-Brown S, Tew YY, Bardon A, Burrell K, Coldwell C, Costa I, Dexter E, Hardy A, Khojani M, Mazurek J, Raymond T, Reddy V, Reynolds J, Soma A, Agiotakis S, Alsusa H, Desai N, Peristerakis I, Adcock A, Ayub H, Bennett T, Bibi F, Brenac S, Chapman T, Clarke G, Clark F, Galvin C, Gwyn-Jones A, Henry-Blake C, Kerner S, Kiandee M, Lovett A, Pilecka A, Ravindran R, Siddique H, Sikand T, Treadwell K, Akmal K, Apata A, Barton O, Broad G, Darling H, Dhuga Y, Emms L, Habib S, Jain R, Jeater J, Kan CYP, Kathiravelupillai A, Khatkar H, Kirmani S, Kulasabanathan K, Lacey H, Lal K, Manafa C, Mansoor M, McDonald S, Mittal A, Mustoe S, Nottrodt L, Oliver P, Papapetrou I, Pattinson F, Raja M, Reyhani H, Shahmiri A, Small O, Soni U, Aguirrezabala Armbruster B, Bunni J, Hakim MA, Hawkins-Hooker L, Howell KA, Hullait R, Jaskowska A, Ottewell L, Thomas-Jones I, Vasudev A, Clements B, Fenton J, Gill M, Haider S, Lim AJM, Maguire H, McMullan J, Nicoletti J, Samuel S, Unais MA, White N, Yao PC, Yow L, Boyle C, Brady R, Cheekoty P, Cheong J, Chew SJHL, Chow R, Ganewatta Kankanamge D, Mamer L, Mohammed B, Ng Chieng Hin J, Renji Chungath R, Royston A, Sharrad E, Sinclair R, Tingle S, Treherne K, Wyatt F, Maniarasu VS, Moug S, Appanna T, Bucknall T, Hussain F, Owen A, Parry M, Parry R, Sagua N, Spofforth K, Yuen ECT, Bosley N, Hardie W, Moore T, Regas C, Abdel-Khaleq S, Ali N, Bashiti H, Buxton-Hopley R, Constantinides M, D'Afflitto M, Deshpande A, Duque Golding J, Frisira E, Germani Batacchi M, Gomaa A, Hay D, Hutchison R, Iakovou A, Iakovou D, Ismail E, Jefferson S, Jones L, Khouli Y, Knowles C, Mason J, McCaughan R, Moffatt J, Morawala A, Nadir H, Neyroud F, Nikookam Y, Parmar A, Pinto L, Ramamoorthy R, Richards E, Thomson S, Trainer C, Valetopoulou A, Vassiliou A, Wantman A, Wilde S, Dickinson M, Rockall T, Senn D, Wcislo K, Zalmay P, Adelekan K, Allen K, Bajaj M, Gatumbu P, Hang S, Hashmi Y, Kaur T, Kawesha A, Kisiel A, Woodmass M, Adelowo T, Ahari D, Alhwaishel K, Atherton R, Clayton B, Cockroft A, Curtis Lopez C, Hilton M, Ismail N, Kouadria M, Lee L, MacConnachie A, Monks F, Mungroo S, Nikoletopoulou C, Pearce L, Sara X, Shahid A, Suresh G, Wilcha R, Atiyah A, Davies E, Dermanis A, Gibbons H, Hyde A, Lawson A, Lee C, Leung-Tack M, Li Saw Hee J, Mostafa O, Nair D, Pattani N, Plumbley-Jones J, Pufal K, Ramesh P, Sanghera J, Saram S, Scadding S, See S, Stringer H, Torrance A, Vardon H, Wyn-Griffiths F, Brew A, Kaur G, Soni D, Tickle A, Akbar Z, Appleyard T, Figg K, Jayawardena P, Johnson A, Kamran Siddiqui Z, Lacy-Colson J, Oatham R, Rowlands B, Sludden E, Turnbull C, Allin D, Ansar Z, Azeez Z, Dale VH, Garg J, Horner A, Jones S, Knight S, McGregor C, McKenna J, McLelland T, Packham-Smith A, Rowsell K, Spector-Hill I, Adeniken E, Baker J, Bartlett M, Chikomba L, Connell B, Deekonda P, Dhar M, Elmansouri A, Gamage K, Goodhew R, Hanna P, Knight J, Luca A, Maasoumi N, Mahamoud F, Manji S, Marwaha PK, Mason F, Oluboyede A, Pigott L, Razaq AM, Richardson M, Saddaoui I, Wijeyendram P, Yau S, Atkins W, Liang K, Miles N, Praveen B, Ashai S, Braganza J, Common J, Cundy A, Davies R, Guthrie J, Handa I, Iqbal M, Ismail R, Jones C, Jones I, Lee KS, Levene A, Okocha M, Olivier J, Smith A, Subramaniam E, Tandle S, Wang A, Watson A, Wilson C, Chan XHF, Khoo E, Montgomery C, Norris M, Pugalenthi PP, Common T, Cook E, Mistry H, Shinmar HS, Agarwal G, Bandyopadhyay S, Brazier B, Carroll L, Goede A, Harbourne A, Lakhani A, Lami M, Larwood J, Martin J, Merchant J, Pattenden S, Pradhan A, Raafat N, Rothwell E, Shammoon Y, Sudarshan R, Vickers E, Wingfield L, Ashworth I, Azizi S, Bhate R, Chowdhury T, Christou A, Davies L, Dwaraknath M, Farah Y, Garner J, Gureviciute E, Hart E, Jain A, Javid S, Kankam HK, Kaur Toor P, Kaz R, Kermali M, Khan I, Mattson A, McManus A, Murphy M, Nair K, Ngemoh D, Norton E, Olabiran A, Parry L, Payne T, Pillai K, Price S, Punjabi K, Raghunathan A, Ramwell A, Raza M, Ritehnia J, Simpson G, Smith W, Sodeinde S, Studd L, Subramaniam M, Thomas J, Towey S, Tsang E, Tuteja D, Vasani J, Vio M, Badran A, Adams J, Anthony Wilkinson J, Asvandi S, Austin T, Bald A, Bix E, Carrick M, Chander B, Chowdhury S, Cooper Drake B, Crosbie S, D Portela S, Francis D, Gallagher C, Gillespie R, Gravett H, Gupta P, Ilyas C, James G, Johny J, Jones A, Kinder F, MacLeod C, Macrow C, Maqsood-Shah A, Mather J, McCann L, McMahon R, Mitham E, Mohamed M, Munton E, Nightingale K, O'Neill K, Onyemuchara I, Senior R, Shanahan A, Sherlock J, Spyridoulias A, Stavrou C, Stokes D, Tamang R, Taylor E, Trafford C, Uden C, Waddington C, Yassin D, Zaman M, Bangi S, Cheng T, Chew D, Hussain N, Imani-Masouleh S, Mahasivam G, McKnight G, Ng HL, Ota HC, Pasha T, Ravindran W, Shah K, Vishnu K S, Zaman S, Carr W, Cope S, Eagles EJ, Howarth-Maddison M, Li CY, Reed J, Ridge A, Stubbs T, Teasdaled D, Umar R, Worthington J, Dhebri A, Kalenderov R, Alattas A, Arain Z, Bhudia R, Chia D, Daniel S, Dar T, Garland H, Girish M, Hampson A, Kyriacou H, Lehovsky K, Mullins W, Omorphos N, Vasdev N, Venkatesh A, Waldock W, Bhandari A, Brown G, Choa G, Eichenauer CE, Ezennia K, Kidwai Z, Lloyd-Thomas A, Macaskill Stewart A, Massardi C, Sinclair E, Skajaa N, Smith M, Tan I, Afsheen N, Anuar A, Azam Z, Bhatia P, Davies-kelly N, Dickinson S, Elkawafi M, Ganapathy M, Gupta S, Khoury EG, Licudi D, Mehta V, Neequaye S, Nita G, Tay VL, Zhao S, Botsa E, Cuthbert H, Elliott J, Furlepa M, Lehmann J, Mangtani A, Narayan A, Nazarian S, Parmar C, Shah D, Shaw C, Zhao Z, Beck C, Caldwell S, Clements JM, French B, Kenny R, Kirk S, Lindsay J, McClung A, McLaughlin N, Watson S, Whiteside E, Alyacoubi S, Arumugam V, Beg R, Dawas K, Garg S, Lloyd ER, Mahfouz Y, Manobharath N, Moonesinghe R, Morka N, Patel K, Prashar J, Yip S, Adeeko ES, Ajekigbe F, Bhat A, Evans C, Farrugia A, Gurung C, Long T, Malik B, Manirajan S, Newport D, Rayer J, Ridha A, Ross E, Saran T, Sinker A, Waruingi D, Allen R, Al Sadek Y, Alves do Canto Brum H, Asharaf H, Ashman M, Balakumar V, Barrington J, Baskaran R, Berry A, Bhachoo H, Bilal A, Boaden L, Chia WL, Covell G, Crook D, Dadnam F, Davis L, De Berker H, Doyle C, Fox C, Gruffydd-Davies M, Hafouda Y, Hill A, Hubbard E, Hunter A, Inpadhas V, Jamshaid M, Jandu G, Jeyanthi M, Jones T, Kantor C, Kwak SY, Malik N, Matt R, McNulty P, Miles C, Mohomed A, Myat P, Niharika J, Nixon A, O'Reilly D, Parmar K, Pengelly S, Price L, Ramsden M, Turnor R, Wales E, Waring H, Wu M, Yang T, Ye TTS, Zander A, Zeicu C, Bellam S, Francombe J, Kawamoto N, Rahman MR, Sathyanarayana A, Tang HT, Cheung J, Hollingshead J, Page V, Sugarman J, Wong E, Chiong J, Fung E, Kan SY, Kiang J, Kok J, Krahelski O, Liew MY, Lyell B, Sharif Z, Speake D, Alim L, Amakye NY, Chandrasekaran J, Chandratreya N, Drake J, Owoso T, Thu YM, Abou El Ela Bourquin B, Alberts J, Chapman D, Rehnnuma N, Ainsworth K, Carpenter H, Emmanuel T, Fisher T, Gabrel M, Guan Z, Hollows S, Hotouras A, Ip Fung Chun N, Jaffer S, Kallikas G, Kennedy N, Lewinsohn B, Liu FY, Mohammed S, Rutherfurd A, Situ T, Stammer A, Taylor F, Thin N, Urgesi E, Zhang N, Ahmad MA, Bishop A, Bowes A, Dixit A, Glasson R, Hatta S, Hatt K, Larcombe S, Preece J, Riordan E, Fegredo D, Haq MZ, Li C, McCann G, Stewart D, Baraza W, Bhullar D, Burt G, Coyle J, Deans J, Devine A, Hird R, Ikotun O, Manchip G, Ross C, Storey L, Tan WWL, Tse C, Warner C, Whitehead M, Wu F, Court EL, Crisp E, Huttman M, Mayes F, Robertson H, Rosen H, Sandberg C, Smith H, Al Bakry M, Ashwell W, Bajaj S, Bandyopadhyay D, Browlee O, Burway S, Chand CP, Elsayeh K, Elsharkawi A, Evans E, Ferrin S, Fort-Schaale A, Iacob M, I K, Impelliziere Licastro G, Mankoo AS, Olaniyan T, Otun J, Pereira R, Reddy R, Saeed D, Simmonds O, Singhal G, Tron K, Wickstone C, Williams R, Bradshaw E, De Kock Jewell V, Houlden C, Knight C, Metezai H, Mirza-Davies A, Seymour Z, Spink D, Wischhusen S. Evaluation of prognostic risk models for postoperative pulmonary complications in adult patients undergoing major abdominal surgery: a systematic review and international external validation cohort study. Lancet Digit Health 2022; 4:e520-e531. [PMID: 35750401 DOI: 10.1016/s2589-7500(22)00069-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2021] [Revised: 01/07/2022] [Accepted: 04/06/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Stratifying risk of postoperative pulmonary complications after major abdominal surgery allows clinicians to modify risk through targeted interventions and enhanced monitoring. In this study, we aimed to identify and validate prognostic models against a new consensus definition of postoperative pulmonary complications. METHODS We did a systematic review and international external validation cohort study. The systematic review was done in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We searched MEDLINE and Embase on March 1, 2020, for articles published in English that reported on risk prediction models for postoperative pulmonary complications following abdominal surgery. External validation of existing models was done within a prospective international cohort study of adult patients (≥18 years) undergoing major abdominal surgery. Data were collected between Jan 1, 2019, and April 30, 2019, in the UK, Ireland, and Australia. Discriminative ability and prognostic accuracy summary statistics were compared between models for the 30-day postoperative pulmonary complication rate as defined by the Standardised Endpoints in Perioperative Medicine Core Outcome Measures in Perioperative and Anaesthetic Care (StEP-COMPAC). Model performance was compared using the area under the receiver operating characteristic curve (AUROCC). FINDINGS In total, we identified 2903 records from our literature search; of which, 2514 (86·6%) unique records were screened, 121 (4·8%) of 2514 full texts were assessed for eligibility, and 29 unique prognostic models were identified. Nine (31·0%) of 29 models had score development reported only, 19 (65·5%) had undergone internal validation, and only four (13·8%) had been externally validated. Data to validate six eligible models were collected in the international external validation cohort study. Data from 11 591 patients were available, with an overall postoperative pulmonary complication rate of 7·8% (n=903). None of the six models showed good discrimination (defined as AUROCC ≥0·70) for identifying postoperative pulmonary complications, with the Assess Respiratory Risk in Surgical Patients in Catalonia score showing the best discrimination (AUROCC 0·700 [95% CI 0·683-0·717]). INTERPRETATION In the pre-COVID-19 pandemic data, variability in the risk of pulmonary complications (StEP-COMPAC definition) following major abdominal surgery was poorly described by existing prognostication tools. To improve surgical safety during the COVID-19 pandemic recovery and beyond, novel risk stratification tools are required. FUNDING British Journal of Surgery Society.
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Sarfraz F, Barrington C, Williams H, Lang E. Standardising Clinic Letters to Aid Care Beyond the Cancer Centre. Clin Oncol (R Coll Radiol) 2022. [DOI: 10.1016/j.clon.2022.01.014] [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: 11/03/2022]
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Drummond C, Drummond M, Fennell M, Hart J, Kamaludin M, Keith C, Lange B, Paparella L, Ramos J, Wallen M, Williams H. The relationship between cardiorespiratory fitness and chronic pelvic pain in women with endometriosis: a preliminary cross-sectional analysis. J Sci Med Sport 2021. [DOI: 10.1016/j.jsams.2021.09.097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Motter D, Williams H. 1184 Operation Note – Are We Documenting Accessibility to The Larynx. Br J Surg 2021. [DOI: 10.1093/bjs/znab259.560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
Introduction
Diagnostic laryngeal procedures are often done under general anaesthesia to aid in assessment and management of laryngeal lesions. Obtaining tissue samples for histology is an extremely important tool used to aid in further surgical planning. Documentation of accessibility to the larynx is paramount to patient care and future surgical planning. We aimed to highlight operative notes for those undergoing diagnostic procedures and assess whether sufficient detail is documented. The Royal College of Surgeons recommends that all operative notes must be comprehensive and “all problems/complications” must be documented for good practice.
Method
We carried out a 3-month retrospective data collection on patients who have undergone diagnostic laryngeal procedures at the Royal Glamorgan Hospital. We included microlaryngoscopies, panendoscopies and laser-specific procedures. We accessed the theatre booking system and retrieved the operation notes.
Results
During the 3-month period, 33 procedures were undertaken. 52% of the operative notes did not document level of accessibility. 48% of the operative notes included the level of accessibility, highlighting keywords such as “good access”, “difficult access” and “difficult access but possible for laser therapy”.
Conclusions
Documentation of intra-operative findings can aid further surgical management and help prepare the surgeon and theatre staff. It is especially important in patients who have vocal cord lesions that might benefit from laser therapy. We recommend documenting the intubation grade (Malampati Score) and accessibility to the larynx.
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Affiliation(s)
- D Motter
- Royal Glamorgan Hospital, Wales, United Kingdom
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- Royal Glamorgan Hospital, Wales, United Kingdom
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Gibson R, Macleod N, Donaldson L, Williams H, Sheikh A, Carson-Stevens A. A mixed-methods analysis of patient safety incidents involving opioid substitution treatment with methadone or buprenorphine in community-based care in England and Wales. Eur Psychiatry 2021. [PMCID: PMC9475774 DOI: 10.1192/j.eurpsy.2021.1488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
IntroductionThere is a paucity of knowledge and understanding of medical error in opioid substitution treatment programmes.ObjectivesTo characterise patient safety incidents involving opioid-substitution treatment with methadone or buprenorphine in community-based care to identify the sources and nature of harm, describe and interpret themes and use this qualitative analysis to identify priorities to focus future improvement work.MethodsWe undertook a mixed-methods study examining incidents involving opioid substitution treatment with methadone or buprenorphine in community-based care submitted between 2005 and 2015 from the National Reporting and Learning System, a repository of incident reports from England and Wales. We analysed each report using four frameworks to identify incident type, contributory factors, incident outcome and severity of harm. Analysis involved detailed data coding and iterative generation of data summaries using descriptive statistical and thematic analysis.Results2,284 reports were identified. We found that most risks of harm came from failure in one of four processes of care delivery: prescribing opiate-substitution (n=151); supervised dispensing errors (n=248); non-supervised dispensing errors (n=318); and monitoring and communication activities (n=1544). Most incidents resulting in harm involved supervised or non-supervised dispensing (n=91/127, 72%). Staff- (e.g. mistakes, not following protocols) and organisation-related (e.g. poor working conditions or poor continuity of care between services) contributory factors were present for over half of incidents.ConclusionsWe have identified four processes of care delivery and associated contributory factors, which represent potential target areas for healthcare systems worldwide to develop interventions to improve the safe delivery of opioid substitution treatment.
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Bradley R, Williams H, Takats Z. EPS3.02 Using rapid evaporative ionisation mass spectrometry (REIMS) for biomarker discovery and mechanistic studies of Pseudomonas aeruginosa stress responses. J Cyst Fibros 2021. [DOI: 10.1016/s1569-1993(21)01019-5] [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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McLean KA, Ahmed WUR, Akhbari M, Claireaux HA, English C, Frost J, Henshall DE, Khan M, Kwek I, Nicola M, Rehman S, Varghese S, Drake TM, Bell S, Nepogodiev D, McLean KA, Drake TM, Glasbey JC, Borakati A, Drake TM, Kamarajah S, McLean KA, Bath MF, Claireaux HA, Gundogan B, Mohan M, Deekonda P, Kong C, Joyce H, Mcnamee L, Woin E, Burke J, Khatri C, Fitzgerald JE, Harrison EM, Bhangu A, Nepogodiev D, Arulkumaran N, Bell S, Duthie F, Hughes J, Pinkney TD, Prowle J, Richards T, Thomas M, Dynes K, Patel M, Patel P, Wigley C, Suresh R, Shaw A, Klimach S, Jull P, Evans D, Preece R, Ibrahim I, Manikavasagar V, Smith R, Brown FS, Deekonda P, Teo R, Sim DPY, Borakati A, Logan AE, Barai I, Amin H, Suresh S, Sethi R, Bolton W, Corbridge O, Horne L, Attalla M, Morley R, Robinson C, Hoskins T, McAllister R, Lee S, Dennis Y, Nixon G, Heywood E, Wilson H, Ng L, Samaraweera S, Mills A, Doherty C, Woin E, Belchos J, Phan V, Chouari T, Gardner T, Goergen N, Hayes JDB, MacLeod CS, McCormack R, McKinley A, McKinstry S, Milligan W, Ooi L, Rafiq NM, Sammut T, Sinclair E, Smith M, Baker C, Boulton APR, Collins J, Copley HC, Fearnhead N, Fox H, Mah T, McKenna J, Naruka V, Nigam N, Nourallah B, Perera S, Qureshi A, Saggar S, Sun L, Wang X, Yang DD, Caroll P, Doyle C, Elangovan S, Falamarzi A, Perai KG, Greenan E, Jain D, Lang-Orsini M, Lim S, O'Byrne L, Ridgway P, Van der Laan S, Wong J, Arthur J, Barclay J, Bradley P, Edwin C, Finch E, Hayashi E, Hopkins M, Kelly D, Kelly M, McCartan N, Ormrod A, Pakenham A, Hayward J, Hitchen C, Kishore A, Martins T, Philomen J, Rao R, Rickards C, Burns N, Copeland M, Durand C, Dyal A, Ghaffar A, Gidwani A, Grant M, Gribbon C, Gruhn A, Leer M, Ahmad K, Beattie G, Beatty M, Campbell G, Donaldson G, Graham S, Holmes D, Kanabar S, Liu H, McCann C, Stewart R, Vara S, Ajibola-Taylor O, Andah EJE, Ani C, Cabdi NMO, Ito G, Jones M, Komoriyama A, Patel P, Titu L, Basra M, Gallogly P, Harinath G, Leong SH, Pradhan A, Siddiqui I, Zaat S, Ali A, Galea M, Looi WL, Ng 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M, Popat K, Rimmer L, Riyat H, Smith H, Anandarajah C, Cipparrone M, Desai K, Gao C, Goh ET, Howlader M, Jeffreys N, Karmarkar A, Mathew G, Mukhtar H, Ozcan E, Renukanthan A, Sarens N, Sinha C, Woolley A, Bogle R, Komolafe O, Loo F, Waugh D, Zeng R, Crewe A, Mathias J, Mills A, Owen A, Prior A, Saunders I, Baker A, Crilly L, McKeon J, Ubhi HK, Adeogun A, Carr R, Davison C, Devalia S, Hayat A, Karsan RB, Osborne C, Scott K, Weegenaar C, Wijeyaratne M, Babatunde F, Barnor-Ahiaku E, Beattie G, Chitsabesan P, Dixon O, Hall N, Ilenkovan N, Mackrell T, Nithianandasivam N, Orr J, Palazzo F, Saad M, Sandland-Taylor L, Sherlock J, Ashdown T, Chandler S, Garsaa T, Lloyd J, Loh SY, Ng S, Perkins C, Powell-Chandler A, Smith F, Underhill R. Perioperative intravenous contrast administration and the incidence of acute kidney injury after major gastrointestinal surgery: prospective, multicentre cohort study. Br J Surg 2020; 107:1023-1032. [PMID: 32026470 DOI: 10.1002/bjs.11453] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Revised: 09/21/2019] [Accepted: 11/08/2019] [Indexed: 01/14/2023]
Abstract
BACKGROUND This study aimed to determine the impact of preoperative exposure to intravenous contrast for CT and the risk of developing postoperative acute kidney injury (AKI) in patients undergoing major gastrointestinal surgery. METHODS This prospective, multicentre cohort study included adults undergoing gastrointestinal resection, stoma reversal or liver resection. Both elective and emergency procedures were included. Preoperative exposure to intravenous contrast was defined as exposure to contrast administered for the purposes of CT up to 7 days before surgery. The primary endpoint was the rate of AKI within 7 days. Propensity score-matched models were adjusted for patient, disease and operative variables. In a sensitivity analysis, a propensity score-matched model explored the association between preoperative exposure to contrast and AKI in the first 48 h after surgery. RESULTS A total of 5378 patients were included across 173 centres. Overall, 1249 patients (23·2 per cent) received intravenous contrast. The overall rate of AKI within 7 days of surgery was 13·4 per cent (718 of 5378). In the propensity score-matched model, preoperative exposure to contrast was not associated with AKI within 7 days (odds ratio (OR) 0·95, 95 per cent c.i. 0·73 to 1·21; P = 0·669). The sensitivity analysis showed no association between preoperative contrast administration and AKI within 48 h after operation (OR 1·09, 0·84 to 1·41; P = 0·498). CONCLUSION There was no association between preoperative intravenous contrast administered for CT up to 7 days before surgery and postoperative AKI. Risk of contrast-induced nephropathy should not be used as a reason to avoid contrast-enhanced CT.
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Williams H, Calvo I, Gaines A, Kalff S, Sajik D, Kulendra NJ, Meeson RL, Parsons K, Farrell M, Kulendra ER. Multi-centre retrospective study of the long-term outcome following suspected traumatic elbow luxation in 32 cats. J Small Anim Pract 2020; 61:354-362. [PMID: 32346883 DOI: 10.1111/jsap.13143] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Revised: 03/18/2020] [Accepted: 03/19/2020] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To describe reduction techniques and clinical outcome in a series of traumatic elbow luxations in cats. MATERIALS AND METHODS Retrospective review of unilateral elbow luxations treated at five specialist referral centres. Data included signalment, aetiology, concurrent injuries, luxation direction, time to reduction, primary reduction technique, surgical procedure and complications. Cases were excluded if reduction technique was unknown. Telephone owner questionnaire follow-up was completed using a Feline Musculoskeletal Pain Index. RESULTS Thirty-two cats were included. Lateral luxations were most common (n = 21). Time (hours) until attempted initial closed reduction was <24 (n = 12), 24-48 (n = 13), >48 (n = 3) or unrecorded (n = 4). Luxation was treated by closed reduction alone (n = 7) or by surgery (n = 25); 14 of 25 cases underwent primary surgical reduction and 11 of 25 were secondary procedures following failure of closed reduction. Transcondylar bone tunnels and circumferential suture (n = 19) was the most commonly used surgical technique. Catastrophic (n = 1), major (n = 11) and minor complications (n = 5) were recorded; reluxation occurred more frequently after closed reduction (n = 8) than after open reduction with fixation (n = 0). Feline Musculoskeletal Pain Index data were available for 12 cats; outcome was good-excellent in all 12, with a median function score of 64.5/68 (range: 55-68) and a median pain score of 0/15 (range: 0-5). Outcome was not associated with reduction technique. CLINICAL SIGNIFICANCE Elbow reluxation occurred in 61% of cats following primary closed reduction but did not occur in any open reduction cases. Reluxation rate increased with duration from injury. Most cats had good-excellent owner-assessed outcome, regardless of reduction technique.
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Affiliation(s)
- H Williams
- Queen Mother Hospital for Animals, RVC, North Mymms, Hertfordshire, AL97TA, UK
| | - I Calvo
- Queen Mother Hospital for Animals, RVC, North Mymms, Hertfordshire, AL97TA, UK.,VETSIA Hospital Veterinario, Madrid, 28914, Spain
| | - A Gaines
- Animal Trust not for Profit Veterinary Surgeons, M359AA, UK
| | - S Kalff
- Fitzpatrick Referrals, Surrey, GU72QQ, UK
| | - D Sajik
- Queen Mother Hospital for Animals, RVC, North Mymms, Hertfordshire, AL97TA, UK
| | - N J Kulendra
- North Downs Specialist Referrals, Bletchingley, Surrey, RH14QP, UK
| | - R L Meeson
- Queen Mother Hospital for Animals, RVC, North Mymms, Hertfordshire, AL97TA, UK
| | - K Parsons
- Langford Veterinary Services, University of Bristol, Langford House, Langford, Bristol, BS405DU, UK
| | - M Farrell
- Davies Veterinary Specialists, Higham Gobion, Hitchin, SG53HR, UK
| | - E R Kulendra
- North Downs Specialist Referrals, Bletchingley, Surrey, RH14QP, UK
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Williams H, Boyce S, Lim J, Patel M, Jacobs C, Muirhead R. Rectal Squamous Cell Carcinomas - Are They Really Rectal? Clin Oncol (R Coll Radiol) 2020; 32:343-344. [PMID: 31992487 DOI: 10.1016/j.clon.2020.01.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Revised: 12/24/2019] [Accepted: 01/09/2020] [Indexed: 11/16/2022]
Affiliation(s)
- H Williams
- Department of Medicine, Oxford University Hospitals NHS Trust, Oxford, UK
| | - S Boyce
- Department of Surgery, Oxford University Hospitals NHS Trust, Oxford, UK
| | - J Lim
- Department of Surgery, Great Western Hospitals NHS Foundation Trust, Swindon, UK
| | - M Patel
- Department of Surgery, Oxford University Hospitals NHS Trust, Oxford, UK
| | - C Jacobs
- Department of Oncology, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - R Muirhead
- Department of Oncology, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
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12
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Curiale MS, Gangar V, D’onorio A, Gambrel-Lenarz S, Mcallister JS, Bailey B, Bednar AM, Bowen B, Brown D, Bulthaus M, Cash J, Cirigliano M, Cox M, D’onorio A, David OE, Fraser J, Frye K, Gangar V, Gambrel-Lenarz S, Hanlin J, Helbig T, Johnson J, Jost-Keating K, Kora L, Koeritzer R, Kozlowski S, Kraemer M, Lally S, Lambeth B, Lawlor K, Lewandowski V, Lopez S, McDonald S, Mclntyre S, Naq M, Pierson M, Reinhard J, Richter D, Saunders L, Simpson P, Smoot L, Tong MS, Warburton D, Williams H, Wilson-Perry A, Yuan J. High-Sensitivity Dry Rehydratable Film Method for Enumeration of Coliforms in Dairy Products: Collaborative Study. J AOAC Int 2020. [DOI: 10.1093/jaoac/80.3.505] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
A dry-film coliform count plate that is inoculated with 5 mL sample was compared with the Violet Red Bile Agar plate method in a collaborative study by 18 laboratories. Products analyzed were 2% milk, chocolate milk, cream, vanilla ice cream, cottage cheese, and cheese. Collaborators tested blind duplicate uninoculated samples and samples inoculated at low, medium, and high level. Significantly (P< 0.05) higher numbers of coliforms were recovered by the dry-film method from 2% milk samples at the 3 inoculum levels, the chocolate milk at the low- and high-inoculum levels, and the cream at the high-inoculum level. Significantly higher counts were obtained by the agar method for cottage cheese samples at the low-inoculum level. The repeatability standard deviation for the dry-film method was significantly higher for the high-inoculum level chocolate milk sample and the medium-inoculum level cottage cheese. The same statistic was significantly higher for the agar method at all 3 inoculum levels in the 2% milk and the medium-inoculum level cream. The high-sensitivity dry rehydratable film method for enumeration of coliforms in dairy products has been adopted first action by AOAC INTERNATIONAL.
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Affiliation(s)
- Michael S Curiale
- Silliker Laboratories Group, Inc., Corporate Research Center, 160 Armory Dr, South Holland, IL 60473
| | - Vidhya Gangar
- Silliker Laboratories Group, Inc., Corporate Research Center, 160 Armory Dr, South Holland, IL 60473
| | - Armando D’onorio
- Silliker Laboratories Group, Inc., Corporate Research Center, 160 Armory Dr, South Holland, IL 60473
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13
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Smires S, Afach S, Mazaud C, Phan C, Garcia Doval I, Boyle R, Dellavalle R, Williams H, Grindlay D, Sbidian E, Le Cleach L. Méthodologie et description des revues systématiques et méta-analyses en dermatologie. Ann Dermatol Venereol 2019. [DOI: 10.1016/j.annder.2019.09.374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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14
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Nieto-Orellana A, Li H, Rosiere R, Wauthoz N, Williams H, Monteiro CJ, Bosquillon C, Childerhouse N, Keegan G, Coghlan D, Mantovani G, Stolnik S. Targeted PEG-poly(glutamic acid) complexes for inhalation protein delivery to the lung. J Control Release 2019; 316:250-262. [PMID: 31678655 DOI: 10.1016/j.jconrel.2019.10.012] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Revised: 09/02/2019] [Accepted: 10/06/2019] [Indexed: 12/18/2022]
Abstract
Pulmonary delivery is increasingly seen as an attractive, non-invasive route for the delivery of forthcoming protein therapeutics. In this context, here we describe protein complexes with a new 'complexing excipient' - vitamin B12-targeted poly(ethylene glycol)-block-poly(glutamic acid) copolymers. These form complexes in sub-200nm size with a model protein, suitable for cellular targeting and intracellular delivery. Initially we confirmed expression of vitamin B12-internalization receptor (CD320) by Calu-3 cells of the in vitro lung epithelial model used, and demonstrated enhanced B12 receptor-mediated cellular internalization of B12-targeted complexes, relative to non-targeted counterparts or protein alone. To develop an inhalation formulation, the protein complexes were spray dried adopting a standard protocol into powders with aerodynamic diameter within the suitable range for lower airway deposition. The cellular internalization of targeted complexes from dry powders applied directly to Calu-3 model was found to be 2-3 fold higher compared to non-targeted complexes. The copolymer complexes show no complement activation, and in vivo lung tolerance studies demonstrated that repeated administration of formulated dry powders over a 3 week period in healthy BALB/c mice induced no significant toxicity or indications of lung inflammation, as assessed by cell population count and quantification of IL-1β, IL-6, and TNF-α pro-inflammatory markers. Importantly, the in vivo data appear to suggest that B12-targeted polymer complexes administered as dry powder enhance lung retention of their protein payload, relative to protein alone and non-targeted counterparts. Taken together, our data illustrate the potential developability of novel B12-targeted poly(ethylene glycol)-poly(glutamic acid) copolymers as excipients suitable to be formulated into a dry powder product for the inhalation delivery of proteins, with no significant lung toxicity, and with enhanced protein retention at their in vivo target tissue.
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Affiliation(s)
- A Nieto-Orellana
- Molecular Therapeutics and Formulation Division, School of Pharmacy, University of Nottingham, Nottingham, UK
| | - H Li
- Molecular Therapeutics and Formulation Division, School of Pharmacy, University of Nottingham, Nottingham, UK
| | - R Rosiere
- Laboratory of Pharmaceutics and Biopharmaceutics (ULBGAL), Université Libre de Bruxelles, Bruxelles, BE, Belgium
| | - N Wauthoz
- Laboratory of Pharmaceutics and Biopharmaceutics (ULBGAL), Université Libre de Bruxelles, Bruxelles, BE, Belgium
| | - H Williams
- Centre for Biomolecular Sciences, University of Nottingham, Nottingham, UK
| | - C J Monteiro
- Molecular Therapeutics and Formulation Division, School of Pharmacy, University of Nottingham, Nottingham, UK
| | - C Bosquillon
- Molecular Therapeutics and Formulation Division, School of Pharmacy, University of Nottingham, Nottingham, UK
| | | | - G Keegan
- Vectura Group plc, Chippenhafm, UK
| | | | - G Mantovani
- Molecular Therapeutics and Formulation Division, School of Pharmacy, University of Nottingham, Nottingham, UK.
| | - S Stolnik
- Molecular Therapeutics and Formulation Division, School of Pharmacy, University of Nottingham, Nottingham, UK.
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Turner-Stokes L, Rose H, Lakra C, Williams H, Ashford SA, Siegert RJ. Goal-setting and attainment in prolonged disorders of consciousness – development of a structured approach. Brain Inj 2019; 34:78-88. [PMID: 31661982 DOI: 10.1080/02699052.2019.1682190] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- L. Turner-Stokes
- King’s College London, Faulty of Nursing, Midwifery and Palliative care, Department of Palliative Care, Policy and Rehabilitation, Cicely Saunders Institute, London, UK
- Regional Hyper-acute Rehabilitation Unit, Northwick Park Hospital, London North West University Healthcare NHS Trust, London, UK
| | - H. Rose
- Regional Hyper-acute Rehabilitation Unit, Northwick Park Hospital, London North West University Healthcare NHS Trust, London, UK
| | - C. Lakra
- Regional Hyper-acute Rehabilitation Unit, Northwick Park Hospital, London North West University Healthcare NHS Trust, London, UK
| | - H. Williams
- Regional Hyper-acute Rehabilitation Unit, Northwick Park Hospital, London North West University Healthcare NHS Trust, London, UK
| | - S. A. Ashford
- King’s College London, Faulty of Nursing, Midwifery and Palliative care, Department of Palliative Care, Policy and Rehabilitation, Cicely Saunders Institute, London, UK
- Regional Hyper-acute Rehabilitation Unit, Northwick Park Hospital, London North West University Healthcare NHS Trust, London, UK
| | - R. J. Siegert
- School of Public Health & Psychosocial Studies and School of Clinical Sciences, Auckland University of Technology, Auckland, New Zealand
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16
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Abstract
Abstract
Background
Myocardial infarction (MI) and hypertension lead to myocardial injury, which induces negative remodelling and cardiac fibrosis. Cardiac fibrosis, which involves inflammatory cell infiltration and myofibroblast activation, causes worldwide mortality and morbidity. In response to MI or hypertension induced by prolonged angiotensin II (AngII) exposure, activated myofibroblasts produce extracellular matrix proteins. However, if unchecked, excessive collagen deposition occurs leading to myocardial stiffening, heart failure and arrhythmias.
Purpose
The underlying mechanisms leading to pathological collagen deposition are not fully elucidated. There is debate regarding the involvement of the Wnt signalling pathway and its product Wnt Inducible Signalling pathway protein-1 (WISP-1) in cardiac fibrosis. Therefore, this project aimed to investigate the interaction of AngII and the Wnt/β-catenin signalling pathway in cardiac fibrosis.
Methods
The effect of AngII (100nM) on collagen levels in human cardiac fibroblasts was investigated in vitro (data expressed as fold change from control ± SEM). In vivo experiments (n=6–8) determined the involvement of the Wnt/b-catenin pathway, specifically WISP-1, in response to AngII infusion (500ng/kg/min) for 4 weeks (Apolipoprotein E−/−/WISP-1+/+ vs. ApolipoproteinE−/−/WISP-1−/− mice on a high-fat diet, data expressed as mean positive pixel % ± SEM).
Results
AngII significantly increased collagen type 1 protein levels produced by human cardiac fibroblasts (2.94±0.75 vs 1±0, p<0.05). Inhibition of Wnt/b-catenin signalling with 25nM iCRT14 significantly suppressed AngII-induced collagen levels (0.46±0.07 vs. 1±0, p<0.05). As expected, AngII infusion significantly induced hypertension in all mice. Immunohistochemistry demonstrated type 1 collagen was markedly higher in AngII mice than control mice (1.07±0.27 vs. 0.29±0.06, p<0.05). However, in the absence of WISP-1, AngII did not enhance collagen type 1 levels. Further immunohistochemical analysis of murine hearts demonstrated that AngII infusion caused significant alterations in the Wnt/β-catenin signalling markers AXIN-2 (35±3.9 vs. 10.7±2.6 p<0.05) and PPAR-d (92±1.4 vs. 17.3±4.3 p<0.05). This effect was reduced by WISP-1 deletion. Furthermore, AngII-infusion disrupted N-cadherin junctions (0.55±0.08 vs. 0.29±0.02 p<0.05) suggesting modulation of cell-to-cell contacts and enhanced β-catenin signalling.
Conclusion
This study indicates that AngII enhances cardiac fibrosis via modulation of the Wnt signalling pathway, in part via WISP-1. Further delineation of this interaction may lead to the use of Wnt/β-catenin or WISP-1 inhibitors to suppress myocardial injury induced cardiac fibrosis in post-MI or hypertensive patients.
Acknowledgement/Funding
Elizabeth Blackwell Institute, British Heart Foundation
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Affiliation(s)
| | - Z Li
- University of Bristol, Bristol, United Kingdom
| | - M Young
- University of Bristol, Bristol, United Kingdom
| | - B A Brown
- University of Bristol, Bristol, United Kingdom
| | - J L Johnson
- University of Bristol, Bristol, United Kingdom
| | - H Williams
- University of Bristol, Bristol, United Kingdom
| | - S J George
- University of Bristol, Bristol, United Kingdom
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17
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Williams H, Hamiko M, Schiller W, Mellert F, Fimmers R, Probst C. Retrograde Autologous Priming in Surgery of Thoracic Aortic Aneurysm. Thorac Cardiovasc Surg 2019. [DOI: 10.1055/s-0039-1678860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- H. Williams
- Rheinische Friedrich-Wilhelms-Universität Bonn, Klinik und Poliklinik für Herzchirurgie, Bonn, Germany
| | - M. Hamiko
- Rheinische Friedrich-Wilhelms-Universität Bonn, Klinik und Poliklinik für Herzchirurgie, Bonn, Germany
| | - W. Schiller
- Rheinische Friedrich-Wilhelms-Universität Bonn, Klinik und Poliklinik für Herzchirurgie, Bonn, Germany
| | - F. Mellert
- Rheinische Friedrich-Wilhelms-Universität Bonn, Klinik und Poliklinik für Herzchirurgie, Bonn, Germany
| | - R. Fimmers
- Institut für Medizinische Biometrie, Informatik und Epidemiologie Bonn, Bonn, Germany
| | - C. Probst
- Rheinische Friedrich-Wilhelms-Universität Bonn, Klinik und Poliklinik für Herzchirurgie, Bonn, Germany
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18
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Brown BA, Williams H, Bond AR, Angelini GD, Johnson JL, George SJ. Carotid artery ligation induced intimal thickening and proliferation is unaffected by ageing. J Cell Commun Signal 2018; 12:529-537. [PMID: 29185213 PMCID: PMC6039339 DOI: 10.1007/s12079-017-0431-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2017] [Accepted: 10/27/2017] [Indexed: 01/20/2023] Open
Abstract
Following interventions to treat atherosclerosis, such as coronary artery bypass graft surgery, restenosis occurs in approximately 40% of patients. Identification of proteins regulating intimal thickening could represent targets to prevent restenosis. Our group previously demonstrated that in a murine model of vascular occlusion, Wnt4 protein expression and β-catenin signalling was upregulated which promoted vascular smooth muscle cell (VSMC) proliferation and intimal thickening. In this study, the effect of age on VSMC proliferation, intimal hyperplasia and Wnt4 expression was investigated. In vitro proliferation of VSMCs isolated from young (2 month) or old (18-20 month) C57BL6/J mice was assessed by immunocytochemistry for EdU incorporation. As previously reported, 400 ng/mL recombinant Wnt4 protein increased proliferation of VSMCs from young mice. However, this response was absent in VSMCs from old mice. As our group previously reported reduced intimal hyperplasia in Wnt4+/- mice compared to wildtype controls, we hypothesised that impaired Wnt4 signalling with age may result in reduced neointimal formation. To investigate this, carotid artery ligation was performed in young and old mice and neointimal area was assessed 21 days later. Surprisingly, neointimal area and percentage lumen occlusion were not significantly affected by age. Furthermore, neointimal cell density and proliferation were also unchanged. These data suggest that although Wnt4-mediated proliferation was impaired with age in primary VSMCs, carotid artery ligation induced neointimal formation and proliferation were unchanged in old mice. These results imply that Wnt4-mediated proliferation is unaffected by age in vivo, suggesting that therapeutic Wnt4 inhibition could inhibit restenosis in patients of all ages.
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Affiliation(s)
- B A Brown
- Bristol Medical School, , University of Bristol, Research Floor Level Seven, Bristol Royal Infirmary, Upper Maudlin Street, Bristol, BS2 8HW, UK
| | - H Williams
- Bristol Medical School, , University of Bristol, Research Floor Level Seven, Bristol Royal Infirmary, Upper Maudlin Street, Bristol, BS2 8HW, UK
| | - A R Bond
- Bristol Medical School, , University of Bristol, Research Floor Level Seven, Bristol Royal Infirmary, Upper Maudlin Street, Bristol, BS2 8HW, UK
| | - G D Angelini
- Bristol Medical School, , University of Bristol, Research Floor Level Seven, Bristol Royal Infirmary, Upper Maudlin Street, Bristol, BS2 8HW, UK
| | - J L Johnson
- Bristol Medical School, , University of Bristol, Research Floor Level Seven, Bristol Royal Infirmary, Upper Maudlin Street, Bristol, BS2 8HW, UK
| | - S J George
- Bristol Medical School, , University of Bristol, Research Floor Level Seven, Bristol Royal Infirmary, Upper Maudlin Street, Bristol, BS2 8HW, UK.
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Andolino C, Hess C, Prince T, Williams H, Chernin M. Drug-induced keratin 9 interaction with Hsp70 in bladder cancer cells. Cell Stress Chaperones 2018; 23:1137-1142. [PMID: 29802537 PMCID: PMC6111075 DOI: 10.1007/s12192-018-0913-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2017] [Revised: 04/05/2018] [Accepted: 05/08/2018] [Indexed: 12/18/2022] Open
Abstract
A pull-down experiment (co-immunoprecipitation) was performed on a T24 human bladder cancer cell lysate treated with the Hsp inhibitor VER155008 using an Hsp70 antibody attached to Dynabeads. Keratin 9, a cytoskeleton intermediate filament protein, was identified by LC MS/MS analysis. This novel finding was confirmed by Western blotting, RT-PCR, and immunocytochemistry. Other members of the keratin family of proteins have been shown to be involved in cancer progression, most recently identified to be associated with cell invasion and metastasis. The specific role of keratin 9 expression in these cells is yet to be determined.
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Affiliation(s)
- C Andolino
- Biology Department, Bucknell University, 1 Dent Drive, Lewisburg, PA, 17837, USA
| | - C Hess
- Biology Department, Bucknell University, 1 Dent Drive, Lewisburg, PA, 17837, USA
| | - T Prince
- Department of Urology, Geisinger Clinic, Danville, PA, USA
| | - H Williams
- Department of Urology, Geisinger Clinic, Danville, PA, USA
| | - M Chernin
- Biology Department, Bucknell University, 1 Dent Drive, Lewisburg, PA, 17837, USA.
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20
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Williams H, Johnson J, George S. WISP-1/CCN4 protects against athrosclerosis in atheroprone mice. Atherosclerosis 2018. [DOI: 10.1016/j.atherosclerosis.2018.06.900] [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: 11/30/2022]
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21
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Schaiberger G, Pucar D, Patel V, Bateson B, Williams H, Bates W. Para-atrial non-acute mediastinal hematoma after left atrial maze procedure mimicking tumor in a patient with treated melanoma. J Nucl Cardiol 2018; 25:1430-1432. [PMID: 28432672 DOI: 10.1007/s12350-017-0881-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2017] [Accepted: 03/14/2017] [Indexed: 11/30/2022]
Abstract
INTRODUCTION The Cox Maze III procedure is considered the gold standard open surgical procedure for management of atrial fibrillation. This article outlines a unique case of a para-atrial mediastinal hematoma following a bilateral thoracoscopic left atrial Maze procedure mimicking malignancy. REPORT A 60-year-old male, with past history of melanoma, underwent bilateral thoracoscopic left atrial mini maze procedure with radiofrequency energy and exclusion of the left atrial appendage. Seven months later, a chest computed tomography (CT) scan was performed to evaluate for pulmonary embolism. The CT scan unexpectedly showed an ill-defined, heterogeneous para-atrial mass immediately superior to the left atrium concerning for tumor and mediastinal adenopathy. The mass was moderately hypermetabolic on subsequent 2-[fluorine-18]fluoro-2-deoxy-D-glucose (FDG) positron emission tomography (PET) scan. A follow-up PET/CT three months later demonstrated near-complete resolution of the para-atrial mass with minimal residual hematoma. CONCLUSION Non-acute mediastinal hematoma following a maze procedure can potentially be confused with a tumor mass and/or lymphadenopathy on CT and FDG PET/CT. With knowledge of the potential for false-positive FDG uptake in a hematoma, the lesion was monitored, and unnecessary biopsy was avoided.
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Affiliation(s)
- G Schaiberger
- Department of Radiology, Augusta University Medical Center, 1120 15th St, Augusta, GA, 30912, USA
| | - D Pucar
- Department of Radiology, Augusta University Medical Center, 1120 15th St, Augusta, GA, 30912, USA
| | - V Patel
- Department of Cardiothoracic Surgery, Augusta University Medical Center, 1120 15th St, Augusta, GA, 30912, USA
| | - B Bateson
- Department of Cardiothoracic Surgery, Augusta University Medical Center, 1120 15th St, Augusta, GA, 30912, USA.
| | - H Williams
- Department of Radiology, Augusta University Medical Center, 1120 15th St, Augusta, GA, 30912, USA
| | - W Bates
- Department of Radiology, Augusta University Medical Center, 1120 15th St, Augusta, GA, 30912, USA
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Abstract
We describe our training experience as members of a drug and alcohol liaison service within a major general teaching hospital. This type of liaison work offers valuable experience in the joint management of patients with well established substance misuse problems and also provides the opportunity for early recognition and preventative interventions.
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Campbell M, Macaulay C, Eagleson K, Hooke B, Williams H, Justo R, Webb K. Improving Paediatric Health Service Translation Through Consumer Co-Design. Heart Lung Circ 2018. [DOI: 10.1016/j.hlc.2018.06.796] [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: 10/28/2022]
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24
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Alexander L, Cooper K, Mitchell D, Williams H. Evaluation of a musculoskeletal physiotherapy service and associated cost benefits. Physiotherapy 2017. [DOI: 10.1016/j.physio.2017.11.173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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25
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Hamedi N, Antoniou S, Edwards F, Edwards F, Spratling L, Long G, Butt J, Anandan A, Cross J, Stebbings A, Cutting H, Lobban TCA, Williams H. 92Pan London ‘know your pulse’ awareness campaign during world heart rhythm week 2017. Europace 2017. [DOI: 10.1093/europace/eux283.087] [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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26
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Tan J, Linos E, Sendelweck MA, van Zuuren EJ, Ersser S, Dellavalle RP, Williams H. Shared decision making and patient decision aids in dermatology. Br J Dermatol 2017; 175:1045-1048. [PMID: 27790692 DOI: 10.1111/bjd.14803] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/10/2016] [Indexed: 11/30/2022]
Abstract
Shared decision making combines individual patient interests and values with clinical best evidence under the guiding principle of patient autonomy. Patient decision aids can support shared decision making and facilitate decisions that have multiple options with varying outcomes for which patients may attribute different values. Given the variable psychosocial impact of skin disease on individuals and relative uncertainty regarding best treatments and their adherence in many dermatological conditions, informed shared decision making, supported by patient decision aids, should constitute a central component of dermatological care.
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Affiliation(s)
- J Tan
- Western University, London, ON, Canada.
| | - E Linos
- Department of Dermatology, University of California, San Francisco School of Medicine, San Francisco, CA, U.S.A
| | | | - E J van Zuuren
- Department of Dermatology, Leiden University Medical Centre, Leiden, the Netherlands
| | - S Ersser
- School of Healthcare, University of Leeds, Leeds, U.K
| | - R P Dellavalle
- Denver Veterans Affairs Medical Center, Denver, CO, U.S.A
| | - H Williams
- Centre of Evidence Based Dermatology, University of Nottingham, Nottingham, U.K
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Youkhana K, Tutaeva V, Williams H, Corbali O, Krishnamurthy S, Metpally R, Kip N. Assessing cancer risk in patients with HFE gene variants and type 1 hereditary hemochromatosis. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx369.094] [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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Swinbourne F, Jeffery N, Tivers M, Artingstall R, Bird F, Charlesworth T, Doran I, Freeman A, Hall J, Hattersley R, Henken J, Hughes J, de la Puerta B, Rutherford L, Ryan T, Williams H, Woods S, Nicholson I. The incidence of surgical site dehiscence following full-thickness gastrointestinal biopsy in dogs and cats and associated risk factors. J Small Anim Pract 2017; 58:495-503. [DOI: 10.1111/jsap.12696] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2016] [Revised: 05/01/2017] [Accepted: 05/01/2017] [Indexed: 11/28/2022]
Affiliation(s)
- F. Swinbourne
- Willows Referral Service; Shirley Solihull B90 4NH UK
| | - N. Jeffery
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences; Texas A&M University; College Station Texas 77843 USA
| | - M.S. Tivers
- School of Veterinary Sciences; University of Bristol; Langford Bristol BS40 5DU UK
| | - R. Artingstall
- Vale Referrals; The Animal Hospital; Stinchcombe Dursley GL11 6AJ UK
| | - F. Bird
- Pride Veterinary Hospital; Derby DE24 8HY UK
| | | | - I. Doran
- School of Veterinary Sciences; University of Bristol; Langford Bristol BS40 5DU UK
| | - A. Freeman
- Small Animal Teaching Hospital, Institute of Veterinary Science; University of Liverpool; Neston Wirral CH64 7TE UK
| | - J. Hall
- Northwest Surgeons; Sutton Weaver Cheshire WA7 3FW UK
| | | | - J. Henken
- Village Vet Highgate; London NW51BX UK
| | - J. Hughes
- North Downs Specialist Referrals; Bletchingley Surrey RH1 4QP UK
| | - B. de la Puerta
- Department of Clinical Services, Royal Veterinary College; Queen Mother Hospital for Animals; North Mymms Hatfield AL9 7TA UK
| | - L. Rutherford
- Southern Counties Veterinary Specialists; Ringwood Hampshire BH24 3JW UK
| | - T. Ryan
- Easter Bush Veterinary Centre, Royal (Dick) School of Veterinary Studies; University of Edinburgh; Roslin Midlothian EH25 9RG UK
| | - H. Williams
- School of Veterinary Sciences; University of Bristol; Langford Bristol BS40 5DU UK
| | - S. Woods
- Northwest Surgeons; Sutton Weaver Cheshire WA7 3FW UK
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Antoniou S, Papastergiou J, De Rango F, Griffiths D, Hamedi N, Williams H, Dolores Murillo M, Tous S, Lobban T, Alves Da Costa F. P4608Benefits of active involvement of community pharmacists in know your pulse awareness campaign. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx504.p4608] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- S. Antoniou
- Barts Health NHS Trust, London, United Kingdom
| | - J. Papastergiou
- University of Toronto, Center for Practice Excellence, Toronto, Canada
| | - F. De Rango
- Shoppers Drug Mart, Pharmacy, Toronto, Canada
| | | | - N. Hamedi
- Southwark Clinical Commissioning Group, London, United Kingdom
| | - H. Williams
- Southwark Clinical Commissioning Group, London, United Kingdom
| | - M. Dolores Murillo
- Sociedad Española de Farmacia Familiar y Comunitaria SEFAC, Madrid, Spain
| | - S. Tous
- Sociedad Española de Farmacia Familiar y Comunitaria SEFAC, Madrid, Spain
| | - T. Lobban
- Atrial Fibrillation Association, Warwickshire, United Kingdom
| | - F. Alves Da Costa
- Centre for Interdisciplinary Research Egas Moniz (CiiEM, ISCSEM), Lisbon, Portugal
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Williams H, Hodgkinson A, Brown A, Byrne R, Burgess V, Hamedi N, Balazs J. P3617Improving the uptake of anticoagulation for prevention of atrial fibrillation related stroke. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx504.p3617] [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: 11/14/2022] Open
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Quraishi M, Segal J, Mullish B, McCune V, Hawkey P, Colville A, Williams H, Hart A, Iqbal T. National survey of practice of faecal microbiota transplantation for Clostridium difficile infection in the UK. J Hosp Infect 2017; 95:444-445. [DOI: 10.1016/j.jhin.2016.10.023] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2016] [Accepted: 10/25/2016] [Indexed: 10/20/2022]
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Williams H, Gnade C, Ryken K, Racek A, Salinas E, Ginader T, Goodheart M. Factors Influencing BRCA Positive Women to Undergo Risk Reducing Surgery. Gynecol Oncol 2016. [DOI: 10.1016/j.ygyno.2016.08.299] [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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Racek A, Joglekar S, Goad L, Hoff T, Williams H, Ginader T, Goodheart M. Timing and duration of primary debulking surgery on degree of cytoreduction. Gynecol Oncol 2016. [DOI: 10.1016/j.ygyno.2016.08.315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Abstract
PURPOSE To review the outcome of total elbow replacement (TER) in 21 patients after a mean of 64 months. METHODS Records of 12 women and 9 men aged 32 to 78 (mean, 59.1) years who underwent 22 TERs for rheumatoid arthritis by a single surgeon were reviewed. Functional outcome was assessed using the disability of the arm, shoulder and hand (DASH) questionnaire. The range of movement and Kaplan- Meier survival curve was determined. Adequacy of cementation was assessed on immediate postoperative radiographs. Aseptic loosening was assessed on radiographs using the Mayo clinic scoring system. RESULTS After a mean follow-up of 64 (range, 10-145) months, the mean DASH score improved from 72.3 to 46.8, mean flexion improved from 96.9º to 128.1º, and mean extension lag from 37.3º to 24.0º. The 5-year survival rate with symptomatic aseptic loosening as the end point was 100%, and the revision rate for all reasons was 69%. Cement mantle was adequate in 17, marginal in 4 (most lacked cement around the prosthesis tip), and inadequate in one who was clinically asymptomatic. At the latest follow-up, 4 patients had a type-1 radiolucent line and one had a type-2 radiolucent line of both components; all remained clinically asymptomatic. Two patients developed transient radial nerve neuropraxia. One patient underwent revision for peri-operative fracture. One patient underwent a 2-stage revision for deep infection. One patient underwent revision for bilateral periprosthetic fracture. One patient underwent revision for symptomatic aseptic loosening. No patient had elbow dislocation. CONCLUSION TER is a viable option for pain relief and functional improvement in patients with rheumatoid arthritis.
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Affiliation(s)
- H Williams
- Glan Clwyd Hospital, Rhyl, United Kingdom
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Brown DM, Williams H, Ryan KJP, Wilson TL, Daniel ZCTR, Mareko MHD, Emes RD, Harris DW, Jones S, Wattis JAD, Dryden IL, Hodgman TC, Brameld JM, Parr T. Mitochondrial phosphoenolpyruvate carboxykinase (PEPCK-M) and serine biosynthetic pathway genes are co-ordinately increased during anabolic agent-induced skeletal muscle growth. Sci Rep 2016; 6:28693. [PMID: 27350173 PMCID: PMC4923900 DOI: 10.1038/srep28693] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2016] [Accepted: 06/08/2016] [Indexed: 02/04/2023] Open
Abstract
We aimed to identify novel molecular mechanisms for muscle growth during administration of anabolic agents. Growing pigs (Duroc/(Landrace/Large-White)) were administered Ractopamine (a beta-adrenergic agonist; BA; 20 ppm in feed) or Reporcin (recombinant growth hormone; GH; 10 mg/48 hours injected) and compared to a control cohort (feed only; no injections) over a 27-day time course (1, 3, 7, 13 or 27-days). Longissimus Dorsi muscle gene expression was analyzed using Agilent porcine transcriptome microarrays and clusters of genes displaying similar expression profiles were identified using a modified maSigPro clustering algorithm. Anabolic agents increased carcass (p = 0.002) and muscle weights (Vastus Lateralis: p < 0.001; Semitendinosus: p = 0.075). Skeletal muscle mRNA expression of serine/one-carbon/glycine biosynthesis pathway genes (Phgdh, Psat1 and Psph) and the gluconeogenic enzyme, phosphoenolpyruvate carboxykinase-M (Pck2/PEPCK-M), increased during treatment with BA, and to a lesser extent GH (p < 0.001, treatment x time interaction). Treatment with BA, but not GH, caused a 2-fold increase in phosphoglycerate dehydrogenase (PHGDH) protein expression at days 3 (p < 0.05) and 7 (p < 0.01), and a 2-fold increase in PEPCK-M protein expression at day 7 (p < 0.01). BA treated pigs exhibit a profound increase in expression of PHGDH and PEPCK-M in skeletal muscle, implicating a role for biosynthetic metabolic pathways in muscle growth.
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Affiliation(s)
- D M Brown
- School of Biosciences, University of Nottingham, Sutton Bonington Campus, Loughborough, LE12 5RD, UK
| | - H Williams
- School of Biosciences, University of Nottingham, Sutton Bonington Campus, Loughborough, LE12 5RD, UK.,School of Mathematical Sciences, University of Nottingham, University Park, Nottingham NG7 2RD, UK
| | - K J P Ryan
- School of Biosciences, University of Nottingham, Sutton Bonington Campus, Loughborough, LE12 5RD, UK
| | - T L Wilson
- VMRD Global Therapeutics Research, Zoetis, Kalamazoo, MI, 49007, USA
| | - Z C T R Daniel
- School of Biosciences, University of Nottingham, Sutton Bonington Campus, Loughborough, LE12 5RD, UK
| | - M H D Mareko
- School of Biosciences, University of Nottingham, Sutton Bonington Campus, Loughborough, LE12 5RD, UK
| | - R D Emes
- School of Veterinary Medicine and Science, University of Nottingham, Sutton Bonington Campus, Loughborough, LE12 5RD, UK
| | - D W Harris
- VMRD Global Therapeutics Research, Zoetis, Kalamazoo, MI, 49007, USA
| | - S Jones
- School of Biosciences, University of Nottingham, Sutton Bonington Campus, Loughborough, LE12 5RD, UK
| | - J A D Wattis
- School of Mathematical Sciences, University of Nottingham, University Park, Nottingham NG7 2RD, UK
| | - I L Dryden
- School of Mathematical Sciences, University of Nottingham, University Park, Nottingham NG7 2RD, UK
| | - T C Hodgman
- School of Biosciences, University of Nottingham, Sutton Bonington Campus, Loughborough, LE12 5RD, UK
| | - J M Brameld
- School of Biosciences, University of Nottingham, Sutton Bonington Campus, Loughborough, LE12 5RD, UK
| | - T Parr
- School of Biosciences, University of Nottingham, Sutton Bonington Campus, Loughborough, LE12 5RD, UK
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Papanikolaou NE, Williams H, Demiris N, Preston SP, Milonas PG, Kypraios T. Bayesian inference and model choice for Holling’s disc equation: a case study on an insect predator-prey system. COMMUNITY ECOL 2016. [DOI: 10.1556/168.2016.17.1.9] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Williams H, Paringe V, Shenoy S, Michaels P, Ramesh B. Standard preoperative analgesia with or without fascia iliaca compartment block for femoral neck fractures. J Orthop Surg (Hong Kong) 2016; 24:31-5. [PMID: 27122509 DOI: 10.1177/230949901602400109] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
PURPOSE To compare the visual analogue score (VAS) for pain in patients with femoral neck fracture who received standard preoperative analgesia with or without fascia iliaca compartment block (FICB). METHODS In patients with femoral neck fracture, 69 patients who received standard preoperative analgesia (regular paracetamol 1g 4 times a day, codeine 60 mg 4 times a day, and opioid 10 mg 2 hourly as required) were compared with 50 patients who received standard preoperative analgesia plus FICB. VAS for pain at rest and on movement (hip flexion) was assessed before FICB and 15 minutes, 2 and 8 hours after FICB. The amount of additional opioid required and the incidence of opioid overdose (necessitating administration of naloxone) were determined. RESULTS VAS for pain was significantly lower after standard analgesia plus FICB than standard analgesia alone (p=0.001). The analgesic effect (pre-score minus post-score) of standard analgesia plus FICB did not differ between genders (p=0.57) or fracture patterns (p=0.79). 19 (38%) patients with standard analgesia plus FICB required no additional opioid analgesia. Compared with standard analgesia alone, addition of FICB reduced the mean dose of opioid from 6.2 to 2.0 (p=0.001) and the number of opioid overdose from 7.2% to 0% (p=0.001). No patient had any complication following FICB. CONCLUSION In patients with femoral neck fracture, FICB reduced the need for additional opioid analgesia and avoided the risk of opioid overdose and respiratory depression.
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Affiliation(s)
- H Williams
- Glan Clwyd Hospital, Rhyl, United Kingdom
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Taylor-Robinson DC, Williams H, Pearce A, Law C, Hope S. Do early-life exposures explain why more advantaged children get eczema? Findings from the U.K. Millennium Cohort Study. Br J Dermatol 2016; 174:569-78. [PMID: 26595368 PMCID: PMC4949701 DOI: 10.1111/bjd.14310] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/16/2015] [Indexed: 11/28/2022]
Abstract
Background Atopic dermatitis (eczema) in childhood is socially patterned, with higher incidence in more advantaged populations. However, it is unclear what factors explain the social differences. Objectives To identify early‐life risk factors for eczema, and to explore how early‐life risk factors explain any differences in eczema. Methods We estimated odds ratios (ORs) for ever having had eczema by age 5 years in 14 499 children from the U.K. Millennium Cohort Study (MCS), with a focus on maternal, antenatal and early‐life risk factors and socioeconomic circumstances (SECs). Risk factors were explored to assess whether they attenuated associations between SECs and eczema. Results Overall 35·1% of children had ever had eczema by age 5 years. Children of mothers with degree‐level qualifications vs. no educational qualifications were more likely to have eczema (OR 1·52, 95% confidence interval 1·31–1·76), and there was a gradient across the socioeconomic spectrum. Maternal atopy, breastfeeding (1–6 weeks and ≥ 6 months), introduction of solids under 4 months or cow's milk under 9 months, antibiotic exposure in the first year of life and grime exposure were associated with an increased odds of having eczema. Female sex, Pakistani and Bangladeshi ethnicity, smoking during pregnancy, exposure to environmental tobacco smoke and having more siblings were associated with reduced odds for eczema. Controlling for maternal, antenatal and early‐life characteristics (particularly maternal smoking during pregnancy, breastfeeding and number of siblings) reduced the OR for eczema to 1·26 (95% confidence interval 1·03–1·50) in the group with the highest educational qualifications compared with the least. Conclusions In a representative U.K. child cohort, eczema was more common in more advantaged children. This was explained partially by early‐life factors including not smoking during pregnancy, breastfeeding and having fewer siblings. What's already known about this topic? Previous studies have suggested that atopic dermatitis (eczema) in childhood is socially patterned, with higher incidence in more advantaged populations. It is unclear what explains these differences.
What does this study add? This large longitudinal study confirmed a significant excess of atopic dermatitis in more advantaged children born in 2000. This could be explained partially by maternal and early‐life factors including less maternal smoking in pregnancy, prolonged breastfeeding and fewer siblings.
Plain language summary available online
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Affiliation(s)
- D C Taylor-Robinson
- Department of Public Health and Policy, Whelan Building, University of Liverpool, Liverpool, L69 3GB, U.K.,UCL Institute of Child Health, 30 Guilford Street, London, WC1N 1EH, U.K
| | - H Williams
- Centre of Evidence Based Dermatology, University of Nottingham, Nottingham, U.K
| | - A Pearce
- UCL Institute of Child Health, 30 Guilford Street, London, WC1N 1EH, U.K
| | - C Law
- UCL Institute of Child Health, 30 Guilford Street, London, WC1N 1EH, U.K
| | - S Hope
- UCL Institute of Child Health, 30 Guilford Street, London, WC1N 1EH, U.K
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Thomas R, Williams H, Stern M. P137 ‘I really live for coming here’. The effect of a long-term singing group on control of breathlessness, social empowerment and psychological wellbeing of patients with respiratory disease: a qualitative study. Thorax 2015. [DOI: 10.1136/thoraxjnl-2015-207770.274] [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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Williams H, Grounds R, Smith R. Power assisted endoscopic adenoidectomy using a 120° degree reverse viewing telescope and microdebrider. Int J Surg 2015. [DOI: 10.1016/j.ijsu.2015.07.238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Affiliation(s)
| | | | - B Smith
- Royal Glamorgan Hospital, Wales , UK
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Fliesser M, Williams H, Zemp R, SLorenzetti S, Taylor W, Wippert PM. Does the correlation between SES and back pain vary depending on operationalization and country? Eur J Public Health 2015. [DOI: 10.1093/eurpub/ckv176.144] [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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Taylor-Robinson DC, Williams H, Pearce A, Law C, Hope S. OP56 Do early life exposures explain why more advantaged children get eczema? findings from the UK millennium cohort study. Br J Soc Med 2015. [DOI: 10.1136/jech-2015-206256.55] [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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Lyon C, Williams H, Smith F, Johnson J, George S. N-cadherin and MMP7 modulate abdominal aortic aneurysm severity. Atherosclerosis 2015. [DOI: 10.1016/j.atherosclerosis.2015.04.126] [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: 10/23/2022]
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Catling ER, Finlay S, Williams H, Mikhail A. SP435NUTRITION SCREEENING IN NEPHROLOGY INPATIENTS-A NATIONAL AUDIT. Nephrol Dial Transplant 2015. [DOI: 10.1093/ndt/gfv193.43] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Rees P, Edwards A, Powell C, Panesar S, Evans H, Carter B, Williams H, Hibbert P, Luff D, Parry G, Carson-Stevens A. Identifying drivers for improvement using a mixed methods analysis of
pediatric vaccine-related safety incidents from England and Wales
(2003-2013). Ann Glob Health 2015. [DOI: 10.1016/j.aogh.2015.02.955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Williams H, Gwyn R, Smith A, Dramis A, Lewis J. Variable life-adjusted display (VLAD) for hip fracture patients: a prospective trial. Eur J Orthop Surg Traumatol 2015; 25:1047-50. [PMID: 25753086 DOI: 10.1007/s00590-015-1620-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/29/2014] [Accepted: 02/05/2015] [Indexed: 11/28/2022]
Abstract
PURPOSE With restructuring within the NHS, there is increased public and media interest in surgical outcomes. The Nottingham Hip Fracture Score (NHFS) is a well-validated tool in predicting 30-day mortality in hip fractures. VLAD provides a visual plot in real time of the difference between the cumulative expected mortality and the actual death occurring. Survivors are incorporated as a positive value equal to 1 minus the probability of survival and deaths as a negative value equal to the probability of survival. Downward deflections indicate mortality and potentially suboptimal care. METHODS We prospectively included every hip fracture admitted to UHW that underwent surgery from January-August 2014. NHFS was then calculated and predicted survival identified. A VLAD plot was then produced comparing the predicted with the actual 30-day mortality. RESULTS Two hundred and seventy-seven patients have completed the 30-day follow-up, and initial results showed that the actual 30-day mortality (7.2 %) was much lower than that predicted by the NHFS (8.0 %). This was reflected by a positive trend on the VLAD plot. CONCLUSION Variable life-adjusted display provides an easy-to-use graphical representation of risk-adjusted survival over time and can act as an "early warning" system to identify trends in mortality for hip fractures.
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Affiliation(s)
- H Williams
- Trauma and Orthopaedic Department, University Hospital of Wales, 2 Canada Road, Cardiff, CF14 3BW, UK,
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Merriel A, Harb HM, Williams H, Lilford R, Coomarasamy A. Global women's health: current clinical trials in low- and middle-income countries. BJOG 2015; 122:190-8. [PMID: 25546040 DOI: 10.1111/1471-0528.13183] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/01/2014] [Indexed: 11/29/2022]
Abstract
BACKGROUND Clinical trials in low- and middle-income countries (LMICs) are necessary to develop evidence-based approaches to improve women's health. Understanding what research is currently being conducted will allow the identification of research gaps, avoidance of duplication, planning of future studies, collaboration amongst research groups, and geographical targeting for research investments. OBJECTIVES To provide an overview of active women's health trials in LMICs. SEARCH STRATEGY The World Health Organization's International Clinical Trials Registry Platform was searched for trials registered between 1 April 2012 and 31 March 2014. SELECTION CRITERIA Selected trials were randomised, conducted in LMICs, active, and with a women's health intervention or a significant outcome for the woman. DATA COLLECTION AND ANALYSIS Two reviewers extracted data. Analysis included geographical spread, speciality areas, pre-enrolment registration, study size, and funders. MAIN RESULTS Of the 8966 records, 509 were eligible for inclusion. Gynaecology trials made up 57% of the research, whereas the remaining 43% of trials were in obstetrics. Research activity focused on fertility (17%), the antenatal period (15%), benign gynaecology (14%), intrapartum care (9%), and pre-invasive disease and cancers (8%). The majority of trials (84%) took place in middle-income countries (MICs). In low-income countries (LICs) 83% of research investigated obstetrics, and in MICs 60% of research investigated gynaecology. Most trials (80%) had a sample size of 500 or fewer participants. The median size of trials in LICs was 815 compared with 128 in MICs. Pre-enrolment registration occurred in 54% of trials. The majority (62%) of trials were funded locally. AUTHORS' CONCLUSIONS Many LMICs are active in women's health research. The majority of registered trials are located in MICs; however, the trials in LICs are often larger. The focus of research in MICs may be driven by local priorities and funding, with fertility being highly researched. In LICs, pregnancy is the focus, perhaps reflecting the international prioritisation of maternal health.
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Affiliation(s)
- A Merriel
- School of Clinical and Experimental Medicine, University of Birmingham, Birmingham, UK
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