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Gowda V, Atherton M, Murugan A, Servais L, Sheehan J, Standing E, Manzur A, Scoto M, Baranello G, Munot P, McCullagh G, Willis T, Tirupathi S, Horrocks I, Dhawan A, Eyre M, Vanegas M, Fernandez-Garcia MA, Wolfe A, Pinches L, Illingworth M, Main M, Abbott L, Smith H, Milton E, D’Urso S, Vijayakumar K, Marco SS, Warner S, Reading E, Douglas I, Muntoni F, Ong M, Majumdar A, Hughes I, Jungbluth H, Wraige E. Efficacy and safety of onasemnogene abeparvovec in children with spinal muscular atrophy type 1: real-world evidence from 6 infusion centres in the United Kingdom. Lancet Reg Health Eur 2024; 37:100817. [PMID: 38169987 PMCID: PMC10758961 DOI: 10.1016/j.lanepe.2023.100817] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 11/17/2023] [Accepted: 11/29/2023] [Indexed: 01/05/2024]
Abstract
Background Real-world data on the efficacy and safety of onasemnogene abeparvovec (OA) in spinal muscular atrophy (SMA) are needed, especially to overcome uncertainties around its use in older and heavier children. This study evaluated the efficacy and safety of OA in patients with SMA type 1 in the UK, including patients ≥2 years old and weighing ≥13.5 kg. Methods This observational cohort study used data from patients with genetically confirmed SMA type 1 treated with OA between May 2021 and January 2023, at 6 infusion centres in the United Kingdom. Functional outcomes were assessed using age-appropriate functional scales. Safety analyses included review of liver function, platelet count, cardiac assessments, and steroid requirements. Findings Ninety-nine patients (45 SMA therapy-naïve) were treated with OA (median age at infusion: 10 [range, 0.6-89] months; median weight: 7.86 [range, 3.2-20.2] kg; duration of follow-up: 3-22 months). After OA infusion, mean ± SD change in CHOP-INTEND score was 11.0 ± 10.3 with increased score in 66/78 patients (84.6%); patients aged <6 months had a 13.9 points higher gain in CHOP-INTEND score than patients ≥2 years (95% CI, 6.8-21.0; P < 0.001). Asymptomatic thrombocytopenia (71/99 patients; 71.7%), asymptomatic troponin-I elevation (30/89 patients; 33.7%) and transaminitis (87/99 patients; 87.9%) were reported. No thrombotic microangiopathy was observed. Median steroid treatment duration was 97 (range, 28-548) days with dose doubled in 35/99 patients (35.4%). There were 22.5-fold increased odds of having a transaminase peak >100 U/L (95% CI, 2.3-223.7; P = 0.008) and 21.2-fold increased odds of steroid doubling, as per treatment protocol (95% CI, 2.2-209.2; P = 0.009) in patients weighing ≥13.5 kg versus <8.5 kg. Weight at infusion was positively correlated with steroid treatment duration (r = 0.43; P < 0.001). Worsening transaminitis, despite doubling of oral prednisolone, led to treatment with intravenous methylprednisolone in 5 children. Steroid-sparing immunosuppressants were used in 5 children to enable steroid weaning. Two deaths apparently unrelated to OA were reported. Interpretation OA led to functional improvements and was well tolerated with no persistent clinical complications, including in older and heavier patients. Funding Novartis Innovative Therapies AG provided a grant for independent medical writing services.
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Affiliation(s)
- Vasantha Gowda
- Children’s Neurosciences, Evelina London Children’s Hospital, Guy’s and St Thomas’ NHS Foundation Trust, London, United Kingdom
| | - Mark Atherton
- Sheffield Children’s NHS Foundation Trust, Sheffield, United Kingdom
| | - Archana Murugan
- Department of Paediatric Neurology, University Hospital Bristol, Bristol, United Kingdom
| | - Laurent Servais
- MDUK Oxford Neuromuscular Centre and NIHR Oxford Biomedical Research Centre, University of Oxford, Oxford, United Kingdom
- Division of Child Neurology, Centre de Référence des Maladies Neuromusculaires, Department of Pediatrics, University Hospital Liège and University of Liège, Avenue de l’Hôpital 1 4000 Liège, Belgium
| | - Jennie Sheehan
- Children’s Neurosciences, Evelina London Children’s Hospital, Guy’s and St Thomas’ NHS Foundation Trust, London, United Kingdom
| | - Emma Standing
- Children’s Neurosciences, Evelina London Children’s Hospital, Guy’s and St Thomas’ NHS Foundation Trust, London, United Kingdom
| | - Adnan Manzur
- Dubowitz Neuromuscular Centre, Great Ormond Street Hospital, London, United Kingdom
| | - Mariacristina Scoto
- Dubowitz Neuromuscular Centre, Great Ormond Street Hospital, London, United Kingdom
| | - Giovanni Baranello
- Dubowitz Neuromuscular Centre, Great Ormond Street Hospital, London, United Kingdom
- NIHR Great Ormond Street Hospital Biomedical Research Centre and Great Ormond Street Hospital NHS Foundation Trust, London, United Kingdom
| | - Pinki Munot
- Dubowitz Neuromuscular Centre, Great Ormond Street Hospital, London, United Kingdom
| | - Gary McCullagh
- Royal Manchester Children’s Hospital, Manchester, United Kingdom
| | - Tracey Willis
- Robert Jones and Agnes Hunt Orthopaedic Hospital NHS Foundation Trust, Oswestry, United Kingdom
| | - Sandya Tirupathi
- Royal Belfast Hospital for Sick Children, Belfast, United Kingdom
| | - Iain Horrocks
- Royal Hospital for Children, Glasgow, United Kingdom
| | - Anil Dhawan
- Paediatric Liver, GI and Nutrition Centre and MowatLabs, King’s College Hospital, London, United Kingdom
| | - Michael Eyre
- School of Biomedical Engineering and Imaging Sciences, King’s College London, London, United Kingdom
| | - Maria Vanegas
- Children’s Neurosciences, Evelina London Children’s Hospital, Guy’s and St Thomas’ NHS Foundation Trust, London, United Kingdom
| | - Miguel A. Fernandez-Garcia
- Children’s Neurosciences, Evelina London Children’s Hospital, Guy’s and St Thomas’ NHS Foundation Trust, London, United Kingdom
| | - Amy Wolfe
- Children’s Neurosciences, Evelina London Children’s Hospital, Guy’s and St Thomas’ NHS Foundation Trust, London, United Kingdom
| | - Laura Pinches
- Children’s Neurosciences, Evelina London Children’s Hospital, Guy’s and St Thomas’ NHS Foundation Trust, London, United Kingdom
| | - Marjorie Illingworth
- University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom
| | - Marion Main
- Dubowitz Neuromuscular Centre, Great Ormond Street Hospital, London, United Kingdom
| | - Lianne Abbott
- Dubowitz Neuromuscular Centre, Great Ormond Street Hospital, London, United Kingdom
| | - Hayley Smith
- Department of Paediatric Neurology, University Hospital Bristol, Bristol, United Kingdom
| | - Emily Milton
- Department of Paediatric Neurology, University Hospital Bristol, Bristol, United Kingdom
| | - Sarah D’Urso
- Sheffield Children’s NHS Foundation Trust, Sheffield, United Kingdom
| | | | - Silvia Sanchez Marco
- Paediatric Neurology Department, University Hospital of Wales, Cardiff, United Kingdom
| | - Sinead Warner
- Royal Manchester Children’s Hospital, Manchester, United Kingdom
| | - Emily Reading
- Royal Manchester Children’s Hospital, Manchester, United Kingdom
| | - Isobel Douglas
- Royal Belfast Hospital for Sick Children, Belfast, United Kingdom
| | - Francesco Muntoni
- Dubowitz Neuromuscular Centre, Great Ormond Street Hospital, London, United Kingdom
- NIHR Great Ormond Street Hospital Biomedical Research Centre and Great Ormond Street Hospital NHS Foundation Trust, London, United Kingdom
| | - Min Ong
- Sheffield Children’s NHS Foundation Trust, Sheffield, United Kingdom
| | - Anirban Majumdar
- Department of Paediatric Neurology, University Hospital Bristol, Bristol, United Kingdom
| | - Imelda Hughes
- Royal Manchester Children’s Hospital, Manchester, United Kingdom
| | - Heinz Jungbluth
- Children’s Neurosciences, Evelina London Children’s Hospital, Guy’s and St Thomas’ NHS Foundation Trust, London, United Kingdom
- Randall Centre for Cell and Molecular Biophysics, Faculty of Life Sciences and Medicine (FoLSM), London, King’s College London, London, United Kingdom
- King’s College London, London, United Kingdom
| | - Elizabeth Wraige
- Children’s Neurosciences, Evelina London Children’s Hospital, Guy’s and St Thomas’ NHS Foundation Trust, London, United Kingdom
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McCluskey G, Lamb S, Mason S, NicFhirleinn G, Douglas I, Tirupathi S, Morrison KE, McConville J. Risdiplam for the treatment of adults with spinal muscular atrophy: Experience of the Northern Ireland neuromuscular service. Muscle Nerve 2023; 67:157-161. [PMID: 36382958 DOI: 10.1002/mus.27755] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2022] [Revised: 11/11/2022] [Accepted: 11/13/2022] [Indexed: 11/18/2022]
Abstract
INTRODUCTION/AIMS Risdiplam is the newest available treatment for patients with spinal muscular atrophy (SMA). There is little information on its use in adults. We present the clinical experience of adults with SMA treated with risdiplam through the Early Access to Medicines Scheme (EAMS) in Northern Ireland. METHODS All adults with Type 2 SMA attending the regional neuromuscular clinic were offered risdiplam treatment. Patients had assessments of respiratory function, the Epworth Sleepiness Scale (ESS), Quality of Life Measure for People with Slowly Progressive and Genetic Neuromuscular Disease (QOLM), and Egen Klassifikation 2 (EK2) every 3 mo and the Revised Upper Limb Module for SMA (RULM) at baseline and 6 mo. All assessments other than the RULM were carried out virtually. RESULTS Six of seven patients who were offered risdiplam consented to treatment through the EAMS (five female, one male, mean age 33.7 y). It was generally well tolerated other than skin photosensitivity in all patients. All patients remained on therapy at 9 mo. All reported meaningful improvements in overall strength, sense of wellbeing, and speech quality. There was no change in respiratory function, daytime hypersomnolence, or upper limb function (all p > .05). There was improvement in the QOLM (p = .027) and EK2 (p = .009). DISCUSSION Our study raises hopes that risdiplam may be efficacious in adults; however, more systematic studies in larger cohorts are needed before drawing any definitive conclusions. This study also demonstrated the feasibility of virtual assessments.
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Affiliation(s)
- Gavin McCluskey
- Department of Neurology, Belfast City Hospital, Belfast, UK.,Northern Ireland Centre for Stratified Medicine, Altnagelvin Hospital Campus, Ulster University, Derry, UK
| | - Siobhan Lamb
- Department of Neurology, Belfast City Hospital, Belfast, UK
| | - Sarah Mason
- Department of Neurology, Belfast City Hospital, Belfast, UK
| | - Grainne NicFhirleinn
- Department of Paediatric Neurology, Royal Belfast Hospital for Sick Children, Belfast, UK
| | - Isobel Douglas
- Department of Paediatric Neurology, Royal Belfast Hospital for Sick Children, Belfast, UK
| | - Sandya Tirupathi
- Department of Paediatric Neurology, Royal Belfast Hospital for Sick Children, Belfast, UK
| | - Karen E Morrison
- Department of Neurology, Belfast City Hospital, Belfast, UK.,Faculty of Medicine, Health and Life Sciences, Queen's University Belfast, Belfast, UK
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Österdahl MF, Wong A, Douglas I, Sinnott SJ, Smeeth L, Williamson E, Tomlinson L. 11 Frailty and the Rate of Fractures in Patients Initiated on Antihypertensive Medication. Age Ageing 2021. [DOI: 10.1093/ageing/afab028.11] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Introduction
There is concern regarding adverse effects of antihypertensive treatment, including falls and subsequent fractures, especially hip fractures. As frailty is increasingly recognised as an important risk factor for adverse outcomes, we examined its relationship to fracture rates in older patients after starting antihypertensives.
Methods
Using the Clinical Practice Research Datalink (CPRD), we identified participants over 65-years old starting a first-line antihypertensive medication. Using deficits identified in CPRD we classified patient-level frailty as “Fit”, “Mild”, “Moderate” or “Severe” using the Electronic Frailty Index. We calculated the rate of fractures by frailty level and fracture site, and determined the rate ratio (RR) of first fracture by frailty level, adjusting for confounding, using multivariable poisson regression. We conducted sensitivity analyses to additionally adjust for ethnicity, deprivation, and bisphosphonate use.
Results
44% of participants were classified as mildly frail or greater, but frail participants experienced 58% of all fractures, and 63% of hip fractures. The whole cohort showed a crude rate of 14.1 fractures/1000 person-years, with 4.5 hip fractures/1000 person-years. In severe frailty, this rises to 51.0 fractures/1000 person-years, and 17.7 hip fractures/1000 person-years. After adjustment for confounding, increasing frailty was associated with greater rate of any fracture, reaching RR 2.85 (95% confidence interval 2.43–3.33) for severe frailty versus fit. Results were unchanged in sensitivity analyses.
Conclusions
Frailty and fracture are both common in older participants who start antihypertensive medications. Increasing frailty was positively associated with increased rates of fracture. Clinicians need awareness of this relationship to consider fracture risk assessment and prevention in these patients.
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Affiliation(s)
- M F Österdahl
- London School of Hygiene & Tropical Medicine, Keppel St, London, UK
- Guy’s and St Thomas’ NHS Foundation Trust, Westminster Bridge Rd, London, UK
| | - A Wong
- London School of Hygiene & Tropical Medicine, Keppel St, London, UK
| | - I Douglas
- London School of Hygiene & Tropical Medicine, Keppel St, London, UK
| | - S J Sinnott
- London School of Hygiene & Tropical Medicine, Keppel St, London, UK
| | - L Smeeth
- London School of Hygiene & Tropical Medicine, Keppel St, London, UK
| | - E Williamson
- London School of Hygiene & Tropical Medicine, Keppel St, London, UK
| | - L Tomlinson
- London School of Hygiene & Tropical Medicine, Keppel St, London, UK
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Leasia K, Douglas I, Lawless R, Burlew CC, Platnick KB, Moore EE, Pieracci FM. Validation of current procedural terminology codes for surgical stabilization of rib fractures. Injury 2020; 51:2500-2506. [PMID: 32962828 DOI: 10.1016/j.injury.2020.09.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Revised: 09/02/2020] [Accepted: 09/04/2020] [Indexed: 02/02/2023]
Abstract
INTRODUCTION Current procedural terminology (CPT) codes for surgical stabilization of rib fractures (SSRF) are based solely on the number of ribs fixed, tricotomized at 1-3, 4-6, and ≥ 7. Our objective was to validate CPT codes against operative time at our institution, as well as further stratify complexity by rib fracture location and surgical approach. The purpose of this study is to validate the current CPT coding schema for SSRF, and to identify potential modifiers that are associated with increased case complexity. We hypothesized that operative time is associated with CPT code, number of fractures repaired, exposure technique, and fracture location. METHODS Retrospective review of SSRF cases from October 2010 to March 2020. The primary outcome was the length of the operation (minutes). Predictor variables were CPT code, number of fractures repaired (grouped similarly to CPT codes), fractures repaired:ribs repaired ratio > 1, fracture location (sub-scapular vs. other), and positioning/exposure (supine, lateral, prone, and multiple). Kaplan-Meier time-to-event analyses were used to assess relationship with operative time. RESULTS 188 patients underwent repair of 904 fractures. Operative time was significantly associated with both number of ribs repaired and number of fractures repaired (p<0.01). Although operative time varied significantly by CPT group (p<0.01), there was no significant difference between the 4-6 rib and the ≥ 7 rib groups (p = 0.33). By contrast, each group was significantly different from the others when organized by number of fractures repaired (p = 0.04). Operative time was significantly longer when the fractures repaired:ribs repaired ratio was > 1 (p<0.01), even after stratifying by number of ribs repaired. Both multiple positions/exposures (p<0.01), and repair of ≥ 1 sub-scapular fracture (p<0.01) were significantly associated with operative time. CONCLUSION Number of fractures repaired provided a more accurate estimation of operative time as compared to number of ribs repaired. Based on these data, we recommend altering the CPT schema for SSRF to involve number of fractures repaired, with modifiers for both multiple positions/exposures and repair of sub-scapular fractures.
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Affiliation(s)
- K Leasia
- Denver Health & Hospital Authority, 777 Bannock st. MC 0206 Denver CO 80204 USA.
| | - I Douglas
- Denver Health & Hospital Authority, 777 Bannock st. MC 0206 Denver CO 80204 USA
| | - R Lawless
- Denver Health & Hospital Authority, 777 Bannock st. MC 0206 Denver CO 80204 USA
| | - C C Burlew
- Denver Health & Hospital Authority, 777 Bannock st. MC 0206 Denver CO 80204 USA
| | - K B Platnick
- Denver Health & Hospital Authority, 777 Bannock st. MC 0206 Denver CO 80204 USA
| | - E E Moore
- Denver Health & Hospital Authority, 777 Bannock st. MC 0206 Denver CO 80204 USA
| | - F M Pieracci
- Denver Health & Hospital Authority, 777 Bannock st. MC 0206 Denver CO 80204 USA
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Gregson J, Qizilbash N, Iwagami M, Douglas I, Johnson M, Pearce N, Pocock S. Blood pressure and risk of dementia and its subtypes: a historical cohort study with long‐term follow‐up in 2.6 million people. Eur J Neurol 2019; 26:1479-1486. [DOI: 10.1111/ene.14030] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2018] [Accepted: 06/18/2019] [Indexed: 11/26/2022]
Affiliation(s)
- J. Gregson
- London School of Hygiene and Tropical Medicine LondonUK
| | - N. Qizilbash
- London School of Hygiene and Tropical Medicine LondonUK
- OXON Epidemiology London UK
| | - M. Iwagami
- London School of Hygiene and Tropical Medicine LondonUK
- Department of Health Services Research University of Tsukuba Tsukuba Japan
| | - I. Douglas
- London School of Hygiene and Tropical Medicine LondonUK
| | | | - N. Pearce
- London School of Hygiene and Tropical Medicine LondonUK
| | - S. Pocock
- London School of Hygiene and Tropical Medicine LondonUK
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Parke HG, Groves H, Broadbent L, Touzelet O, Douglas I, Campos GL, Canning P, Lyons JD, Coyle P, Heaney L, Shields MD, Power UF. Identification of novel factors associated with severe respiratory syncytial virus disease in infants. Access Microbiol 2019. [DOI: 10.1099/acmi.ac2019.po0539] [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: 11/18/2022] Open
Affiliation(s)
- Hong Guo Parke
- 1Wellcome Wolfson Institute for Experimental Medicine, Queen’s University Belfast, Belfast, United Kingdom
| | - Helen Groves
- 1Wellcome Wolfson Institute for Experimental Medicine, Queen’s University Belfast, Belfast, United Kingdom
| | - Lindsay Broadbent
- 1Wellcome Wolfson Institute for Experimental Medicine, Queen’s University Belfast, Belfast, United Kingdom
| | - Olivier Touzelet
- 1Wellcome Wolfson Institute for Experimental Medicine, Queen’s University Belfast, Belfast, United Kingdom
| | - Isobel Douglas
- 2The Royal Belfast Hospital for Sick Children, Belfast, United Kingdom
| | - Guillermo Lopez Campos
- 1Wellcome Wolfson Institute for Experimental Medicine, Queen’s University Belfast, Belfast, United Kingdom
| | - Paul Canning
- 1Wellcome Wolfson Institute for Experimental Medicine, Queen’s University Belfast, Belfast, United Kingdom
| | - Jeremy D. Lyons
- 2The Royal Belfast Hospital for Sick Children, Belfast, United Kingdom
| | - Peter Coyle
- 3The Regional Virus Laboratory, Belfast Trust, Belfast, United Kingdom
| | - Liam Heaney
- 1Wellcome Wolfson Institute for Experimental Medicine, Queen’s University Belfast, Belfast, United Kingdom
| | - Michael D. Shields
- 1Wellcome Wolfson Institute for Experimental Medicine, Queen’s University Belfast, Belfast, United Kingdom
| | - Ultan F. Power
- 1Wellcome Wolfson Institute for Experimental Medicine, Queen’s University Belfast, Belfast, United Kingdom
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7
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Hamill L, Ferris K, Kapande K, McConaghy L, Douglas I, McGovern V, Shields MD. Exhaled breath temperature measurement and asthma control in children prescribed inhaled corticosteroids: A cross sectional study. Pediatr Pulmonol 2016; 51:13-21. [PMID: 25917297 DOI: 10.1002/ppul.23204] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [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] [Received: 06/01/2014] [Revised: 01/06/2015] [Accepted: 01/15/2015] [Indexed: 01/19/2023]
Abstract
BACKGROUND Exhaled breath temperature (EBT) reflects airways (both eosinophilic and neutrophilic) inflammation in asthma and thus may aid the management of children with asthma that are treated with anti-inflammatory drugs. A new EBT monitor has become available that is cheap and easy to use and may be a suitable monitoring device for airways inflammation. Little is known about how EBT relates to asthma treatment decisions, disease control, lung function, or other non-invasive measures of airways inflammation, such as exhaled nitric oxide (ENO). OBJECTIVE To determine the relationships between EBT and asthma treatment decision, current control, pulmonary function, and ENO. METHODS Cross-sectional prospective study on 159 children aged 5-16 years attending a pediatric respiratory clinic. EBT was compared with the clinician's decision regarding treatment (decrease, no change, increase), asthma control assessment (controlled, partial, uncontrolled), level of current treatment (according to British Thoracic Society guideline, BTS step), ENO, and spirometry. RESULTS EBT measurement was feasible in the majority of children (25 of 159 could not perform the test) and correlated weakly with age (R = 0.33, P = <0.01). EBT did not differ significantly between the three clinician decision groups (P = 0.42), the three asthma control assessment groups (P = 0.9), or the current asthma treatment BTS step (P = 0.57). CONCLUSIONS & CLINICAL IMPLICATIONS EBT measurement was not related to measures of asthma control determined at the clinic. The routine intermittent monitoring of EBT in children prescribed inhaled corticosteroids who attend asthma clinics cannot be recommended for adjusting anti-inflammatory asthma therapy.
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Affiliation(s)
- Laura Hamill
- Centre of Infection & Immunity, Queen's University Belfast, Northern Ireland, UK
| | - Kathryn Ferris
- Centre of Infection & Immunity, Queen's University Belfast, Northern Ireland, UK
| | - Kirsty Kapande
- Centre of Infection & Immunity, Queen's University Belfast, Northern Ireland, UK
| | - Laura McConaghy
- Centre of Infection & Immunity, Queen's University Belfast, Northern Ireland, UK
| | - Isobel Douglas
- Royal Belfast Hospital for Sick Children, Belfast Health Social Care Trust, Belfast, Northern Ireland, UK
| | - Vincent McGovern
- Royal Belfast Hospital for Sick Children, Belfast Health Social Care Trust, Belfast, Northern Ireland, UK
| | - Michael D Shields
- Centre of Infection & Immunity, Queen's University Belfast, Northern Ireland, UK.,Royal Belfast Hospital for Sick Children, Belfast Health Social Care Trust, Belfast, Northern Ireland, UK
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Hamill L, Ferris K, Kapande K, McConaghy L, Douglas I, McGovern V, Shields MD. Response to letter by Popov, Todor regarding our paper: Exhaled breath temperature measurement and asthma control in children prescribed inhaled corticosteroids: A cross sectional study. Pediatr Pulmonol 2016; 51:93. [PMID: 26524608 DOI: 10.1002/ppul.23300] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2015] [Accepted: 07/11/2015] [Indexed: 11/10/2022]
Affiliation(s)
- Laura Hamill
- Queen's University Belfast, Centre for Infection and Immunity, Belfast, United Kingdom
| | - Kathryn Ferris
- Queen's University Belfast, Centre for Infection and Immunity, Belfast, United Kingdom
| | - Kirsty Kapande
- Queen's University Belfast, Centre for Infection and Immunity, Belfast, United Kingdom
| | - Laura McConaghy
- Queen's University Belfast, Centre for Infection and Immunity, Belfast, United Kingdom
| | - Isobel Douglas
- Royal Belfast Hospital for Sick Children, Royal Hospitals Group, Belfast, United Kingdom
| | - Vincent McGovern
- Royal Belfast Hospital for Sick Children, Royal Hospitals Group, Belfast, United Kingdom
| | - Michael D Shields
- Queen's University Belfast, Centre for Infection and Immunity, Belfast, United Kingdom.,Royal Belfast Hospital for Sick Children, Royal Hospitals Group, Belfast, United Kingdom
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Villenave R, Broadbent L, Douglas I, Lyons JD, Coyle PV, Teng MN, Tripp RA, Heaney LG, Shields MD, Power UF. Induction and Antagonism of Antiviral Responses in Respiratory Syncytial Virus-Infected Pediatric Airway Epithelium. J Virol 2015; 89:12309-18. [PMID: 26423940 PMCID: PMC4665230 DOI: 10.1128/jvi.02119-15] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2015] [Accepted: 09/21/2015] [Indexed: 01/08/2023] Open
Abstract
UNLABELLED Airway epithelium is the primary target of many respiratory viruses. However, virus induction and antagonism of host responses by human airway epithelium remains poorly understood. To address this, we developed a model of respiratory syncytial virus (RSV) infection based on well-differentiated pediatric primary bronchial epithelial cell cultures (WD-PBECs) that mimics hallmarks of RSV disease in infants. RSV is the most important respiratory viral pathogen in young infants worldwide. We found that RSV induces a potent antiviral state in WD-PBECs that was mediated in part by secreted factors, including interferon lambda 1 (IFN-λ1)/interleukin-29 (IL-29). In contrast, type I IFNs were not detected following RSV infection of WD-PBECs. IFN responses in RSV-infected WD-PBECs reflected those in lower airway samples from RSV-hospitalized infants. In view of the prominence of IL-29, we determined whether recombinant IL-29 treatment of WD-PBECs before or after infection abrogated RSV replication. Interestingly, IL-29 demonstrated prophylactic, but not therapeutic, potential against RSV. The absence of therapeutic potential reflected effective RSV antagonism of IFN-mediated antiviral responses in infected cells. Our data are consistent with RSV nonstructural proteins 1 and/or 2 perturbing the Jak-STAT signaling pathway, with concomitant reduced expression of antiviral effector molecules, such as MxA/B. Antagonism of Jak-STAT signaling was restricted to RSV-infected cells in WD-PBEC cultures. Importantly, our study provides the rationale to further explore IL-29 as a novel RSV prophylactic. IMPORTANCE Most respiratory viruses target airway epithelium for infection and replication, which is central to causing disease. However, for most human viruses we have a poor understanding of their interactions with human airway epithelium. Respiratory syncytial virus (RSV) is the most important viral pathogen of young infants. To help understand RSV interactions with pediatric airway epithelium, we previously developed three-dimensional primary cell cultures from infant bronchial epithelium that reproduce several hallmarks of RSV infection in infants, indicating that they represent authentic surrogates of RSV infection in infants. We found that RSV induced a potent antiviral state in these cultures and that a type III interferon, interleukin IL-29 (IL-29), was involved. Indeed, our data suggest that IL-29 has potential to prevent RSV disease. However, we also demonstrated that RSV efficiently circumvents this antiviral immune response and identified mechanisms by which this may occur. Our study provides new insights into RSV interaction with pediatric airway epithelium.
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Affiliation(s)
- Rémi Villenave
- Centre for Infection and Immunity, School of Medicine, Dentistry, and Biomedical Sciences, Queens University Belfast, Belfast, Northern Ireland
| | - Lindsay Broadbent
- Centre for Infection and Immunity, School of Medicine, Dentistry, and Biomedical Sciences, Queens University Belfast, Belfast, Northern Ireland
| | - Isobel Douglas
- The Royal Belfast Hospital for Sick Children, Belfast, Northern Ireland
| | - Jeremy D Lyons
- The Royal Belfast Hospital for Sick Children, Belfast, Northern Ireland
| | - Peter V Coyle
- The Regional Virus Laboratory, Belfast Trust, Belfast, Northern Ireland
| | - Michael N Teng
- Joy McCann Culverhouse Airway Disease Research Center, Department of Internal Medicine, University of South Florida Morsani College of Medicine, Tampa, Florida, USA
| | - Ralph A Tripp
- Department of Infectious Diseases, University of Georgia, Athens, Georgia, USA
| | - Liam G Heaney
- Centre for Infection and Immunity, School of Medicine, Dentistry, and Biomedical Sciences, Queens University Belfast, Belfast, Northern Ireland
| | - Michael D Shields
- Centre for Infection and Immunity, School of Medicine, Dentistry, and Biomedical Sciences, Queens University Belfast, Belfast, Northern Ireland The Royal Belfast Hospital for Sick Children, Belfast, Northern Ireland
| | - Ultan F Power
- Centre for Infection and Immunity, School of Medicine, Dentistry, and Biomedical Sciences, Queens University Belfast, Belfast, Northern Ireland
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Delatolla R, Séguin C, Springthorpe S, Gorman E, Campbell A, Douglas I. Disinfection byproduct formation during biofiltration cycle: Implications for drinking water production. Chemosphere 2015; 136:190-197. [PMID: 26002158 DOI: 10.1016/j.chemosphere.2015.05.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/25/2014] [Revised: 03/15/2015] [Accepted: 05/02/2015] [Indexed: 06/04/2023]
Abstract
The goal of this study was to investigate the potential of biofiltration to reduce the formation potential of disinfection byproducts (DBPs). Particularly, the work investigates the effect of the duration of the filter cycle on the formation potential of total trihalomethanes (TTHM) and five species of haloacetic acids (HAA5), dissolved oxygen (DO), organic carbon, nitrogen and total phosphorous concentrations along with biofilm coverage of the filter media and biomass viability of the attached cells. The study was conducted on a full-scale biologically active filter, with anthracite and sand media, at the Britannia water treatment plant (WTP), located in Ottawa, Ontario, Canada. The formation potential of both TTHMs and HAA5s decreased due to biofiltration. However the lowest formation potentials for both groups of DBPs and or their precursors were observed immediately following a backwash event. Hence, the highest percent removal of DBPs was observed during the early stages of the biofiltration cycle, which suggests that a higher frequency of backwashing will reduce the formation of DBPs. Variable pressure scanning electron microscopy (VPSEM) analysis shows that biofilm coverage of anthracite and sand media increases as the filtration cycle progressed, while biomass viability analysis demonstrates that the percentage of cells attached to the anthracite and sand media also increases as the filtration cycle progresses. These results suggest that the development and growth of biofilm on the filters increases the DPB formation potential.
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Affiliation(s)
- R Delatolla
- Department of Civil Engineering, University of Ottawa, Ottawa, Ontario K1N 6N5, Canada.
| | - C Séguin
- Department of Civil Engineering, University of Ottawa, Ottawa, Ontario K1N 6N5, Canada
| | - S Springthorpe
- Center for Research on Environmental Microbiology, University of Ottawa, Ottawa, Ontario K1H 8M5, Canada
| | - E Gorman
- City of Ottawa, Ottawa, Ontario K1P 1J1, Canada
| | - A Campbell
- City of Ottawa, Ottawa, Ontario K1P 1J1, Canada
| | - I Douglas
- City of Ottawa, Ottawa, Ontario K1P 1J1, Canada
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Hayes JF, Bhaskaran K, Batterham R, Smeeth L, Douglas I. The effect of sibutramine prescribing in routine clinical practice on cardiovascular outcomes: a cohort study in the United Kingdom. Int J Obes (Lond) 2015; 39:1359-64. [PMID: 25971925 PMCID: PMC4551415 DOI: 10.1038/ijo.2015.86] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2015] [Revised: 04/24/2015] [Accepted: 05/06/2015] [Indexed: 02/02/2023]
Abstract
BACKGROUND/OBJECTIVES The marketing authorization for the weight loss drug sibutramine was suspended in 2010 following a major trial that showed increased rates of non-fatal myocardial infarction and cerebrovascular events in patients with pre-existing cardiovascular disease. In routine clinical practice, sibutramine was already contraindicated in patients with cardiovascular disease and so the relevance of these influential clinical trial findings to the 'real World' population of patients receiving or eligible for the drug is questionable. We assessed rates of myocardial infarction and cerebrovascular events in a cohort of patients prescribed sibutramine or orlistat in the United Kingdom. SUBJECTS/METHODS A cohort of patients prescribed weight loss medication was identified within the Clinical Practice Research Datalink. Rates of myocardial infarction or cerebrovascular event, and all-cause mortality were compared between patients prescribed sibutramine and similar patients prescribed orlistat, using both a multivariable Cox proportional hazard model, and propensity score-adjusted model. Possible effect modification by pre-existing cardiovascular disease and cardiovascular risk factors was assessed. RESULTS Patients prescribed sibutramine (N=23,927) appeared to have an elevated rate of myocardial infarction or cerebrovascular events compared with those taking orlistat (N=77,047; hazard ratio 1.69, 95% confidence interval 1.12-2.56). However, subgroup analysis showed the elevated rate was larger in those with pre-existing cardiovascular disease (hazard ratio 4.37, 95% confidence interval 2.21-8.64), compared with those with no cardiovascular disease (hazard ratio 1.52, 95% confidence interval 0.92-2.48, P-interaction=0.0076). All-cause mortality was not increased in those prescribed sibutramine (hazard ratio 0.67, 95% confidence interval 0.34-1.32). CONCLUSIONS Sibutramine was associated with increased rates of acute cardiovascular events in people with pre-existing cardiovascular disease, but there was a low absolute risk in those without. Sibutramine's marketing authorization may have, therefore, been inappropriately withdrawn for people without cardiovascular disease.
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Affiliation(s)
- J F Hayes
- Division of Psychiatry, University College London, London, UK
| | - K Bhaskaran
- Department of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
| | - R Batterham
- Department of Medicine, University College London, London, UK
| | - L Smeeth
- Department of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
| | - I Douglas
- Department of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
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Parker JC, Douglas I, Bell J, Comer D, Bailie K, Skibinski G, Heaney LG, Shields MD. Epidermal Growth Factor Removal or Tyrphostin AG1478 Treatment Reduces Goblet Cells & Mucus Secretion of Epithelial Cells from Asthmatic Children Using the Air-Liquid Interface Model. PLoS One 2015; 10:e0129546. [PMID: 26057128 PMCID: PMC4461195 DOI: 10.1371/journal.pone.0129546] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2014] [Accepted: 05/11/2015] [Indexed: 11/30/2022] Open
Abstract
Rationale Epithelial remodelling in asthma is characterised by goblet cell hyperplasia and mucus hypersecretion for which no therapies exist. Differentiated bronchial air-liquid interface cultures from asthmatic children display high goblet cell numbers. Epidermal growth factor and its receptor have been implicated in goblet cell hyperplasia. Objectives We hypothesised that EGF removal or tyrphostin AG1478 treatment of differentiating air-liquid interface cultures from asthmatic children would result in a reduction of epithelial goblet cells and mucus secretion. Methods In Aim 1 primary bronchial epithelial cells from non-asthmatic (n = 5) and asthmatic (n = 5) children were differentiated under EGF-positive (10ng/ml EGF) and EGF-negative culture conditions for 28 days. In Aim 2, cultures from a further group of asthmatic children (n = 5) were grown under tyrphostin AG1478, a tyrosine kinase inhibitor, conditions. All cultures were analysed for epithelial resistance, markers of differentiation using immunocytochemistry, ELISA for MUC5AC mucin secretion and qPCR for MUC5AC mRNA. Results In cultures from asthmatic children the goblet cell number was reduced in the EGF negative group (p = 0.01). Tyrphostin AG1478 treatment of cultures from asthmatic children had significant reductions in goblet cells at 0.2μg/ml (p = 0.03) and 2μg/ml (p = 0.003) as well as mucus secretion at 2μg/ml (p = 0.04). Conclusions We have shown in this preliminary study that through EGF removal and tyrphostin AG1478 treatment the goblet cell number and mucus hypersecretion in differentiating air-liquid interface cultures from asthmatic children is significantly reduced. This further highlights the epidermal growth factor receptor as a potential therapeutic target to inhibit goblet cell hyperplasia and mucus hypersecretion in asthma.
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Affiliation(s)
- Jeremy C. Parker
- Centre for Infection and Immunity, Health Sciences Building, Queen’s University Belfast, Belfast, Northern Ireland
| | - Isobel Douglas
- Royal Belfast Hospital for Sick Children, Belfast, Northern Ireland
| | - Jennifer Bell
- Centre for Infection and Immunity, Health Sciences Building, Queen’s University Belfast, Belfast, Northern Ireland
| | - David Comer
- Centre for Infection and Immunity, Health Sciences Building, Queen’s University Belfast, Belfast, Northern Ireland
| | - Keith Bailie
- Royal Belfast Hospital for Sick Children, Belfast, Northern Ireland
| | - Grzegorz Skibinski
- Centre for Infection and Immunity, Health Sciences Building, Queen’s University Belfast, Belfast, Northern Ireland
| | - Liam G. Heaney
- Centre for Infection and Immunity, Health Sciences Building, Queen’s University Belfast, Belfast, Northern Ireland
- * E-mail:
| | - Michael D. Shields
- Centre for Infection and Immunity, Health Sciences Building, Queen’s University Belfast, Belfast, Northern Ireland
- Royal Belfast Hospital for Sick Children, Belfast, Northern Ireland
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Guo-Parke H, Canning P, Douglas I, Villenave R, Heaney LG, Coyle PV, Lyons JD, Shields MD, Power UF. Relative respiratory syncytial virus cytopathogenesis in upper and lower respiratory tract epithelium. Am J Respir Crit Care Med 2013; 188:842-51. [PMID: 23952745 DOI: 10.1164/rccm.201304-0750oc] [Citation(s) in RCA: 62] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
RATIONALE Respiratory syncytial virus (RSV) is a major pathogen that primarily infects airway epithelium. Most infants suffer mild upper respiratory tract (URT) symptoms, whereas approximately one-third progress to lower respiratory tract (LRT) involvement. Despite the ubiquity of URT infection, little is known about the relative cytopathogenesis of RSV infection in infant URT and LRT. OBJECTIVES This study aimed to compare RSV cytopathogenesis in nasal- and bronchial-derived epithelium from the same individuals using novel models derived from well-differentiated primary pediatric nasal (WD-PNECs) and bronchial epithelial cells (WD-PBECs). METHODS WD-PNECs and WD-PBECs were generated from nasal and bronchial brushes, respectively, and mock-infected or infected with RSV BT2a. RSV tropism, infectivity, cytopathology, growth kinetics, cell sloughing, apoptosis, and cytokine and chemokine responses were determined. MEASUREMENTS AND MAIN RESULTS RSV infection in both cultures was restricted to apical ciliated cells and occasional nonciliated cells but not goblet cells. It did not cause gross cytopathology. Infection resulted in apical release of progeny virus, increased apical cell sloughing, apoptosis, and occasional syncytia. RSV growth kinetics and peak titers were higher in WD-PBECs, coincident with higher ciliated cell contents, cell sloughing, and slightly compromised tight junctions. However, proinflammatory chemokine responses were similar for both cultures. Also, lambda IFNs, especially IL-29, were induced by RSV infection. CONCLUSIONS RSV induced remarkably similar, albeit quantitatively lower, cytopathogenesis and proinflammatory responses in WD-PNECs compared with WD-PBECs that reproduce many hallmarks of RSV pathogenesis in infants. WD-PNECs may provide an authentic surrogate model with which to study RSV cytopathogenesis in infant airway epithelium.
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Affiliation(s)
- Hong Guo-Parke
- 1 Centre for Infection and Immunity, School of Medicine, Dentistry and Biomedical Sciences, Queens University Belfast, Belfast, Northern Ireland, United Kingdom
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Langham J, Smeeth L, Brauer R, Bhaskaran K, Douglas I. OP93 Orlistat and the Risk of Acute Liver Injury: A Self-Controlled Case-Series Study in United Kingdom General Practice Research Database. Br J Soc Med 2012. [DOI: 10.1136/jech-2012-201753.093] [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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15
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Walsh RPD, Bidin K, Blake WH, Chappell NA, Clarke MA, Douglas I, Ghazali R, Sayer AM, Suhaimi J, Tych W, Annammala KV. Long-term responses of rainforest erosional systems at different spatial scales to selective logging and climatic change. Philos Trans R Soc Lond B Biol Sci 2012; 366:3340-53. [PMID: 22006973 DOI: 10.1098/rstb.2011.0054] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Long-term (21-30 years) erosional responses of rainforest terrain in the Upper Segama catchment, Sabah, to selective logging are assessed at slope, small and large catchment scales. In the 0.44 km(2) Baru catchment, slope erosion measurements over 1990-2010 and sediment fingerprinting indicate that sediment sources 21 years after logging in 1989 are mainly road-linked, including fresh landslips and gullying of scars and toe deposits of 1994-1996 landslides. Analysis and modelling of 5-15 min stream-suspended sediment and discharge data demonstrate a reduction in storm-sediment response between 1996 and 2009, but not yet to pre-logging levels. An unmixing model using bed-sediment geochemical data indicates that 49 per cent of the 216 t km(-2) a(-1) 2009 sediment yield comes from 10 per cent of its area affected by road-linked landslides. Fallout (210)Pb and (137)Cs values from a lateral bench core indicate that sedimentation rates in the 721 km(2) Upper Segama catchment less than doubled with initially highly selective, low-slope logging in the 1980s, but rose 7-13 times when steep terrain was logged in 1992-1993 and 1999-2000. The need to keep steeplands under forest is emphasized if landsliding associated with current and predicted rises in extreme rainstorm magnitude-frequency is to be reduced in scale.
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Affiliation(s)
- R P D Walsh
- Department of Geography, College of Science, Swansea University, Singleton Park, Swansea SA2 8PP, UK.
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Lamontagne F, Adhikari N, Cook D, Koo KK, Lauzier F, Burns KE, Douglas I, Turgeon AF, Quiroz H, Poulin Y, Choong K, Ferguson N, Kho ME, Duffett M, Chant C, Lesur O, Meade MO. Corticosteroids for critically ill patients: an international survey of intensivists. Crit Care 2012. [PMCID: PMC3363519 DOI: 10.1186/cc10708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Affiliation(s)
- P Costello
- Ardenlea Marie Curie Centre, Ilkley, UK.
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18
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19
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Chappell NA, McKenna P, Bidin K, Douglas I, Walsh RP. Parsimonious modelling of water and suspended sediment flux from nested catchments affected by selective tropical forestry. Philos Trans R Soc Lond B Biol Sci 1999; 354:1831-46. [PMID: 11605626 PMCID: PMC1692696 DOI: 10.1098/rstb.1999.0525] [Citation(s) in RCA: 48] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
The ability to model the suspended sediment flux (SSflux) and associated water flow from terrain affected by selective logging is important to the establishment of credible measures to improve the ecological sustainability of forestry practices. Recent appreciation of the impact of parameter uncertainty on the statistical credibility of complex models with little internal state validation supports the use of more parsimonious approaches such as data-based mechanistic (DBM) modelling. The DBM approach combines physically based understanding with model structure identification based on transfer functions and objective statistical inference. Within this study, these approaches have been newly applied to rainfall-SSflux response. The dynamics of the sediment system, together with the rainfall-river flow system, were monitored at five nested contributory areas within a 44 ha headwater region in Malaysian Borneo. The data series analysed covered a whole year at a 5 min resolution, and were collected during a period some five to six years after selective timber harvesting had ceased. Physically based and statistical interpretation of these data was possible given the wealth of contemporary and past hydrogeomorphic data collected within the same region. The results indicated that parsimonious, three-parameter models of rainfall-river flow and rainfall-SSflux for the whole catchment describe 80 and 90% of the variance, respectively, and that parameter changes between scales could be explained in physically meaningful terms. Indeed, the modelling indicated some new conceptual descriptions of the river flow and sediment-generation systems. An extreme rainstorm having a 10-20 year return period was present within the data series and was shown to generate new mass movements along the forestry roads that had a differential impact on the monitored contributory areas. Critically, this spatially discrete behaviour was captured by the modelling and may indicate the potential use of DBM approaches for (i) predicting the differential effect of alternative forestry practices, (ii) estimating uncertainty in the behaviour of ungauged areas and (iii) forecasting river flow and SSflux in terrain with temporal changes in rainfall regime and forestry impacts.
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Affiliation(s)
- N A Chappell
- Centre for Research on Environmental Systems and Statistic, Institute of Environmental and Natural Sciences, University of Lancaster, UK.
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20
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Douglas I, Bidin K, Balamurugan G, Chappell NA, Walsh RP, Greer T, Sinun W. The role of extreme events in the impacts of selective tropical forestry on erosion during harvesting and recovery phases at Danum Valley, Sabah. Philos Trans R Soc Lond B Biol Sci 1999; 354:1749-61. [PMID: 11605619 PMCID: PMC1692689 DOI: 10.1098/rstb.1999.0518] [Citation(s) in RCA: 86] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Ten years' hydrological investigations at Danum have provided strong evidence of the effects of extremes of drought, as in the April 1992 El Niño southern oscillation event, and flood, as in January 1996. The 1.5 km2 undisturbed forest control catchment experienced a complete drying out of the stream for the whole 1.5 km of defined channel above the gauging station in 1992, but concentrated surface flow along every declivity from within a few metres of the catchment divide after the exceptional rains of 19 January 1996. Under these natural conditions, erosion is episodic. Sediment is discharged in pulses caused by storm events, collapse of debris dams and occasional landslips. Disturbance by logging accentuates this irregular regime. In the first few months following disturbance, a wave of sediment is moved by each storm, but over subsequent years, rare events scour sediment from bare areas, gullies and channel deposits. The spatial distribution of sediment sources changes with time after logging, as bare areas on slopes are revegetated and small gullies are filled with debris. Extreme storm events, as in January 1996, cause logging roads to collapse, with landslides leading to surges of sediment into channels, reactivating the pulsed sediment delivery by every storm that happened immediately after logging. These effects are not dampened out with increasing catchment scale. Even the 721 km2 Sungai Segama has a sediment yield regime dominated by extreme events, the sediment yield in that single day on 19 January 1996 exceeding the annual sediment load in several previous years. In a large disturbed catchment, such road failures and logging-activity-induced mass movements increase the mud and silt in floodwaters affecting settlements downstream. Management systems require long-term sediment reduction strategies. This implies careful road design and good water movement regulation and erosion control throughout the logging process.
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Affiliation(s)
- I Douglas
- School of Geography, University of Manchester, UK
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21
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Abstract
Investigations of land management impacts on hydrology are well developed in South-East Asia, having been greatly extended by national organizations in the last two decades. Regional collaborative efforts, such as the ASEAN-US watershed programme, have helped develop skills and long-running monitoring programmes. Work in different countries is significant for particular aspects: the powerful effects of both cyclones and landsliding in Taiwan, the significance of lahars in Java, of small-scale agriculture in Thailand and plantation establishment in Malaysia. Different aid programmes have contributed specialist knowledge such as British work on reservoir sedimentation, Dutch, Swedish and British work on softwood plantations and US work in hill-tribe agriculture. Much has been achieved through individual university research projects, including PhD and MSc theses. The net result is that for most countries there is now good information on changes in the rainfall-run-off relationship due to forest disturbance or conversion, some information on the impacts on sediment delivery and erosion of hillslopes, but relatively little about the dynamics and magnitude of nutrient losses. Improvements have been made in the ability to model the consequences of forest conversion and of selective logging and exciting prospects exist for the development of better predictions of transfer of water from the hillslopes to the stream channels using techniques such as multilevel modelling. Understanding of the processes involved has advanced through the detailed monitoring made possible at permanent field stations such as that at Danum Valley, Sabah.
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Affiliation(s)
- I Douglas
- School of Geography, University of Manchester, UK
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22
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Kopp E, Medzhitov R, Carothers J, Xiao C, Douglas I, Janeway CA, Ghosh S. ECSIT is an evolutionarily conserved intermediate in the Toll/IL-1 signal transduction pathway. Genes Dev 1999; 13:2059-71. [PMID: 10465784 PMCID: PMC316957 DOI: 10.1101/gad.13.16.2059] [Citation(s) in RCA: 243] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Activation of NF-kappaB as a consequence of signaling through the Toll and IL-1 receptors is a major element of innate immune responses. We report the identification and characterization of a novel intermediate in these signaling pathways that bridges TRAF6 to MEKK-1. This adapter protein, which we have named ECSIT (evolutionarily conserved signaling intermediate in Toll pathways), is specific for the Toll/IL-1 pathways and is a regulator of MEKK-1 processing. Expression of wild-type ECSIT accelerates processing of MEKK-1, whereas a dominant-negative fragment of ECSIT blocks MEKK-1 processing and activation of NF-kappaB. These results indicate an important role for ECSIT in signaling to NF-kappaB and suggest that processing of MEKK-1 is required for its function in the Toll/IL-1 pathway.
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Affiliation(s)
- E Kopp
- Section of Immunobiology and Department of Molecular Biophysics and Biochemistry, Howard Hughes Medical Institute (HHMI), Yale University School of Medicine, New Haven, Connecticut 06520 USA
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23
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McCall B, Looke D, Crome M, Nimmo G, O'Kane G, Harper J, Jones A, Wright J, Douglas I, Whitby M. Sporadic human anthrax in urban Brisbane. Commun Dis Intell (2018) 1998; 22:189-90. [PMID: 9775523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Affiliation(s)
- B McCall
- Brisbane Southside Public Health Unit, Upper Mt Gravatt, Queensland
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24
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Packham G, Lahti JM, Fee BE, Gawn JM, Coustan-Smith E, Campana D, Douglas I, Kidd VJ, Ghosh S, Cleveland JL. Fas activates NF-κB and induces apoptosis in T-cell lines by signaling pathways distinct from those induced by TNF-α. Cell Death Differ 1997; 4:130-9. [PMID: 16465219 DOI: 10.1038/sj.cdd.4400217] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/1999] [Revised: 09/12/1999] [Accepted: 09/13/1999] [Indexed: 11/08/2022] Open
Abstract
The p55 tumor necrosis factor (TNF) receptor and the Fas (CD95/APO-1) receptor share an intracellular domain necessary to induce apoptosis, suggesting they utilize common signaling pathways. To define pathways triggered by Fas and TNF-alpha we utilized human CEM-C7 T-cells. As expected, stimulation of either receptor induced apoptosis and TNF-alpha-induced signaling included the activation of NF-kappaB. Surprisingly, Fas-induced signaling also triggered the activation of NF-kappaB in T cells, yet the kinetics of NF-kappaB induction by Fas was markedly delayed. NF-kappaB activation by both pathways was persistent and due to the sequential degradation of IkappaB-alpha and IkappaB-beta. However, the kinetics of IkappaB degradation were different and there were differential effects of protease inhibitors and antioxidants on NF-kappaB activation. Signaling pathways leading to activation of apoptosis were similarly separable and were also independent of NF-kappaB activation. Thus, the Fas and TNF receptors utilize distinct signal transduction pathways in T-cells to induce NF-kappaB and apoptosis.
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Affiliation(s)
- G Packham
- Department of Biochemistry, St. Jude Children's Research Hospital, Memphis, TN 38105, USA
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25
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Muñoz NM, Douglas I, Mayer D, Herrnreiter A, Zhu X, Leff AR. Eosinophil chemotaxis inhibited by 5-lipoxygenase blockade and leukotriene receptor antagonism. Am J Respir Crit Care Med 1997; 155:1398-403. [PMID: 9105085 DOI: 10.1164/ajrccm.155.4.9105085] [Citation(s) in RCA: 63] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
We studied the effects of the 5-lipoxygenase inhibition and sulfidopeptidyl leukotriene receptor antagonism on lumenal chemotaxis of eosinophils in 124 guinea pig tracheal explant preparations from 62 animals. Cell migration was assessed histologically and by differential cell count, and airway narrowing was measured by calibrated micrometry. Intralumenal instillation of the chemotaxin, formyl-met-leu-phe (FMLP) caused migration of 163,509 +/- 18,103 eosinophils/cm segment (eos/cm) versus 15,443 +/- 3,557 eos/cm for segments receiving vehicle only (p < 0.001). Coincubation of FMLP with zileuton, a selective inhibitor of 5-lipoxygenase, caused a concentration-related inhibition of eosinophil migration. At 10(-10) M zileuton, cell migration caused by FMLP was decreased by 57% and nearly complete reduction to 17,200 +/- 3,620 eos/cm resulted after 10(-6) M zileuton (p < 0.001 versus FMLP). Lumenal narrowing caused by FMLP (15.3 +/- 3.4%) was attenuated maximally to 1.15 +/- 2.51% after 10(-8) M zileuton (p < 0.02). In 36 preparations, concentration of leukotriene B4 (LTB4) was measured in treated tracheal perfusate. LTB4 secretion caused by FMLP was 6.4 +/- 0.48 pg/ml versus 3.32 +/- 0.89 pg/ml for buffer control at 5 min (p < 0.02) and was undetectable 120 min after activation with FMLP. Blockade of LTB4-receptor with the selective antagonist, LTB4 dimethyl amide, caused > 90% inhibition of eosinophil migration (p < 0.001). Comparable results were obtained with zafirlukast, an LTD4-receptor antagonist. Our data demonstrate that both LTB4 and LTD4 facilitate eosinophil migration from lamina propria to lumen caused by the chemotaxin, FMLP, and that LTB4-induced eosinophil migration is accompanied by initial lumenal secretion of LTB4.
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Affiliation(s)
- N M Muñoz
- Department of Medicine, University of Chicago, Illinois 60637, USA
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26
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Sathananthan H, Selwood L, Douglas I, Nanayakkara K. Early cleavage to formation of the unilaminar blastocyst in the marsupial Antechinus stuartii: ultrastructure. Reprod Fertil Dev 1997; 9:201-12. [PMID: 9208430 DOI: 10.1071/r96049] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
The development of Antechinus stuartii from the 2-cell stage to the blastocyst stage in vivo was examined by routine transmission electron microscopy. The 2-8-cell stages had a similar organization of organelles, whereas the 16- to 32-cell stages had pluriblast cells and trophoblast cells forming an epithelium closely apposed to the zona pellucida. Specialized cell-zona plugs were formed at the 8-cell stage, and primitive cell junctions appeared in later conceptuses. The cytoplasmic organelles included mitochondria, lysosomes, aggregates of smooth endoplasmic reticulum, lipid and protein yolk bodies and fibrillar arrays, possibly contractile in function. Nuclei had uniformly-dispersed dense chromatin. Nucleoli of 2-4-cell conceptuses were dense, compact and fibrillar, and those of 8-cell conceptuses and later conceptuses were finely granular and became progressively reticulated. The embryonic genome is probably not switched on before the 8-cell stage. Sperm tails were detected in cells in several early conceptuses. The yolk mass had the same organelles as cells. Centrioles were discovered for the first time in marsupial conceptuses. These were prominently situated at a spindle pole in a 32-cell blastomere and were associated with a nucleus and sperm tail at the 4-cell stage. It is very likely that the paternal centrosome is inherited at fertilization and perpetuated in Antechinus embryos during cleavage.
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Affiliation(s)
- H Sathananthan
- School of Human Biosciences, La Trobe University, Carlton, Vic, Australia
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Zhu X, Muñoz NM, Rubio N, Herrnreiter A, Mayer D, Douglas I, Leff AR. Quantitation of the cytosolic phospholipase A2 (type IV) in isolated human peripheral blood eosinophils by sandwich-ELISA. J Immunol Methods 1996; 199:119-26. [PMID: 8982353 DOI: 10.1016/s0022-1759(96)00166-4] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Sandwich enzyme-linked immunosorbent assay (sELISA) was developed for precise quantitation of cytosolic phospholipase A2 (cPLA2 type IV) concentration in isolated human peripheral blood eosinophils as an alternative to semiquantitative chemiluminescent assay employing immunoprecipitation/Western blot analysis. In this assay, monoclonal mouse anti-human cPLA2 antiserum was used as the capture antibody, polyclonal rabbit anti-human cPLA2 antiserum as the secondary antibody, and alkaline phosphatase-conjugated goat anti-rabbit IgG as the tertiary, reporter antibody. Purified human cPLA2 (0-1000 ng/ml) dissolved in Tris-HCl buffered saline was used as the standard protein. The detection limit for cPLA2 in 10(6) eosinophils was 0.109 ng/ml, and coefficients of inter- and intra-assay variation were 4.23% and 7.07%, respectively. There was no cross-reactivity with other (secretory) isoforms of PLA2 (sPLA2 types I-III) either from porcine pancreas, human synovial fluid, or bee venom. In separate studies, the recovery of cPLA2 was > 83% when eosinophil lysate was supplemented exogenously with two different concentrations of cPLA2. From a total protein content of 22.3 +/- 1.7 micrograms/10(6) cells, the baseline concentration of cPLA2 was 0.38 +/- 0.18 ng/10(6) cells in eosinophils obtained from mildly atopic donors. Immunoblotting studies confirmed the complete specificity for the type IV isoform as detected by sELISA. This sELISA method permits the precise quantitative assessment of cPLA2 in nanogram quantities per million cells, which has not previously been possible by immunoblotting analysis.
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Affiliation(s)
- X Zhu
- Department of Medicine, University of Chicago, IL 60637, USA
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28
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Abstract
Stimulation with inducers that cause persistent activation of NF-kappa B results in the degradation of the NF-kappa B inhibitors, I kappa B alpha and I kappa B beta. Despite the rapid resynthesis and accumulation of I kappa B alpha, NF-kappa B remains induced under these conditions. We now report that I kappa B beta is also resynthesized in stimulated cells and appears as an unphosphorylated protein. The unphosphorylated I kappa B beta forms a stable complex with NF-kappa B in the cytosol; however, this binding fails to mask the nuclear localization signal and DNA binding domain on NF-kappa B, and the I kappa B beta-NF-kappa B complex enters the nucleus. It appears therefore that during prolonged stimulation, I kappa B beta functions as a chaperone for NF-kappa B by protecting it from I kappa B alpha and allowing it to be transported to the nucleus.
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Affiliation(s)
- H Suyang
- Section of Immunobiology, Howard Hughes Medical Institute, Yale University School of Medicine, New Haven, Connecticut, USA
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29
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Johnson DR, Douglas I, Jahnke A, Ghosh S, Pober JS. A sustained reduction in IkappaB-beta may contribute to persistent NF-kappaB activation in human endothelial cells. J Biol Chem 1996; 271:16317-22. [PMID: 8663191 DOI: 10.1074/jbc.271.27.16317] [Citation(s) in RCA: 92] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
The responses of vascular endothelial cells (EC) to tumor necrosis factor-alpha (TNF), interleukin-1alpha (IL-1), and phorbol myristate acetate (PMA) were compared with respect to the kinetics of (i) NF-kappaB activation, (ii) IkappaB-alpha and IkappaB-beta degradation, and (iii) NF-kappaB-dependent cell surface molecule expression. TNF rapidly (</=20 min) and persistently (>20 h) activates NF-kappaB; IL-1 rapidly activates NF-kappaB, but activity declines by 3 h and further by 20 h; PMA slowly and transiently activates NF-kappaB. Untreated EC contain the inhibitory proteins IkappaB-alpha and IkappaB-beta. The onset of NF-kappaB activation correlates with degradation of IkappaB-alpha, but IkappaB-alpha reappears by 4 h without resequestration of NF-kappaB. TNF causes a rapid but partial (50%) reduction in IkappaB-beta, which does not recover by 22 h; IL-1 and PMA cause slower and less sustained reductions in IkappaB-beta. All three agonists induce de novo expression of E-selectin (CD62E) and vascular cell adhesion molecule-1 (CD106) and increase expression of intercellular adhesion molecule-1 (CD54) at 4 h. TNF induces sustained increases in vascular cell adhesion molecule-1 and intercellular adhesion molecule-1 and increases human leukocyte antigen class I molecules at 24 h. We conclude that TNF causes persistent activation of NF-kappaB in human EC and that this may result from sustained reductions in IkappaB-beta levels.
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Affiliation(s)
- D R Johnson
- Department of Pathology, Boyer Center for Molecular Medicine, Howard Hughes Medical Institute, Yale University School of Medicine, New Haven, Connecticut 06511, USA
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30
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Douglas I. Focus on board effectiveness. Leadersh Health Serv 1993; 2:34-5. [PMID: 10124281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
Abstract
In its ongoing effort to promote and ensure the highest quality of health care throughout Canada, The Canadian Hospital Association has entered into a partnership with The Centre for Quality in Governance, a Toronto-based non-profit organization formed in 1992. The Centre's mandate is to improve the effectiveness of organizations by researching and evaluating various aspects of governance.
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Affiliation(s)
- I Douglas
- Centre for Quality in Governance, Toronto, Ont
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31
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Affiliation(s)
- G Brown
- Intensive Care Unit, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
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32
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Rush J, Lin TC, Quinones M, Spicer EK, Douglas I, Williams KR, Konigsberg WH. The 44P subunit of the T4 DNA polymerase accessory protein complex catalyzes ATP hydrolysis. J Biol Chem 1989; 264:10943-53. [PMID: 2786875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
The genes encoding all three T4 DNA polymerase accessory proteins have been cloned into overexpression plasmids. Induction of cells harboring these plasmids results in the synthesis of each accessory protein at levels that approach 10% of the total cellular protein. The solubility of the accessory proteins after induction at 42 degrees C ranges from about 60% to greater than 95%. A plasmid that allows overexpression of the 44P/62P complex has been manipulated further to overexpress selectively the 44P subunit without 62P, permitting us to assess how each subunit contributes to the properties of the 44P/62P complex. A comparison of 44P and 44P/62P by conventional hydrodynamic techniques shows that 44P forms a subcomplex nearly as large as the 44P/62P complex. In addition, 44P catalyzes DNA-dependent ATP hydrolysis with a specific activity similar to that of the 44P/62P ATPase. However, unlike the 44P/62P complex, the ATPase activity of 44P alone is only slightly stimulated by 45P. This suggests that one role of the 62P subunit is to facilitate a productive interaction of 44P and 45P.
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Affiliation(s)
- J Rush
- Department of Molecular Biophysics and Biochemistry, Yale School of Medicine, New Haven, Connecticut 06510
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33
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Rush J, Lin TC, Quinones M, Spicer EK, Douglas I, Williams KR, Konigsberg WH. The 44P Subunit of the T4 DNA Polymerase Accessory Protein Complex Catalyzes ATP Hydrolysis. J Biol Chem 1989. [DOI: 10.1016/s0021-9258(18)60410-7] [Citation(s) in RCA: 52] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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34
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Burton NK, Barnett MJ, Aherne GW, Evans J, Douglas I, Lister TA. The effect of food on the oral administration of 6-mercaptopurine. Cancer Chemother Pharmacol 1986; 18:90-1. [PMID: 3757164 DOI: 10.1007/bf00253074] [Citation(s) in RCA: 24] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
The effect of food on the bioavailability of 6-mercaptopurine (6-MP) has been investigated. Seven patients were studied on two separate occasions. On the first occasion 6-MP was administered p.o. after an overnight fast and on the second, 15 min after a standard breakfast. 6-MP concentrations were determined by high-performance liquid chromatography. Variable plasma drug levels were observed between individual subjects in the fasting state. The peak levels of 6-MP were lower and took longer to be achieved following administration after a standard breakfast than after an overnight fast. In two subjects levels were undetectable (less than 20 ng/ml). In view of these observations it is suggested that 6-MP should be administered before food if maximum blood levels are to be achieved.
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35
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Andoseh IN, Douglas I, Egharevba GO, M�gnamisi-B�lomb� M. Superexchange in copper(II) Dimers. 3. Synthesis and characterization of binuclear adducts of copper(II) halides with some ?,?-dione dioximes. Z Anorg Allg Chem 1982. [DOI: 10.1002/zaac.19824840119] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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36
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Lewis-Hughes JH, Douglas I. Letters to the editor. Disasters 1981; 5:166-168. [PMID: 20958494 DOI: 10.1111/j.1467-7717.1981.tb01101.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Affiliation(s)
- J H Lewis-Hughes
- Deputy Director, New South Wales State Emergency Services, 73-77 Bathurst Street, Sydney, NSW, Australia School of Geography, University of Manchester, Manchester M13 9PL, U.K
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37
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Douglas I. Difficult Dental Prosthesis. Dent Regist 1892; 46:591-595. [PMID: 33700491 PMCID: PMC6967825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
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