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Huynh A, Aguirre BA, English J, Guzman D, Wright AJ. Atmospheric drying and soil drying: Differential effects on grass community composition. Glob Chang Biol 2024; 30:e17106. [PMID: 38273553 DOI: 10.1111/gcb.17106] [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] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Revised: 12/01/2023] [Accepted: 12/08/2023] [Indexed: 01/27/2024]
Abstract
Global surface temperatures are projected to increase in the future; this will modify regional precipitation regimes and increase global atmospheric drying. Despite many drought studies examining the consequences of reduced precipitation, there are few experimental studies exploring plant responses to atmospheric drying via relative humidity and vapor pressure deficit (VPD). We examined eight native California perennial grass species grown in pots in a greenhouse in Los Angeles, California for 34 weeks. All pots were well-watered for 21 weeks, at which point we reduced watering to zero and recorded daily growth and dormancy for 3 weeks. We used this information to better understand the drought tolerance of our species in a larger soil drying × atmospheric drying experiment. In this larger experiment, we grew all eight species together in outdoor mesocosms and measured changes in community composition after 4 years of growth. Soil drying in our small pot experiment mirrored compositional shifts in the larger experiment. Namely, our most drought-tolerant species in our pot experiment was Poa secunda, due to a summer dormancy strategy. Similarly, the grass community shifted toward P. secunda in the driest soils as P. secunda was mostly unaffected by either soil drying or atmospheric drying. We found that some species responded strongly to soil drying (Elymus glaucus, Festuca idahoensis, and Hordeum b. californicum), while others responded strongly to atmospheric drying (Bromus carinatus and Stipa cernua). As result, community composition shifted in different and interacting ways in response to soil drying, atmospheric drying, and their combination. Further study of community responses to increasing atmospheric aridity is an essential next step to predicting the future consequences of climate change.
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Affiliation(s)
- A Huynh
- Department of Biological Sciences, California State University Los Angeles, Los Angeles, California, USA
| | - B A Aguirre
- Department of Ecology and Evolutionary Biology, Cornell University, Ithaca, New York, USA
| | - J English
- Department of Ecology and Evolutionary Biology, University of Toronto, Toronto, Ontario, Canada
| | - D Guzman
- Department of Biological Sciences, California State University Los Angeles, Los Angeles, California, USA
| | - A J Wright
- Department of Biological Sciences, California State University Los Angeles, Los Angeles, California, USA
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Yuan R, Mayo J, Myers R, Atkar-Khattra S, Yee J, English J, Chen D, Lam S. MA11.08 Value of Computer Aided Diagnosis on Radiologists’ Workflow and Recommendation for Reporting Lung Cancer Screening LDCT. J Thorac Oncol 2022. [DOI: 10.1016/j.jtho.2022.07.141] [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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Metzemaekers J, Blikkendaal M, v. Nieuwenhuizen K, Bronsgeest K, Rhemrev J, Smeets M, English J, Jansen F, Both S, Twijnstra A. Preoperative pain measurements in correlation to deep endometriosis classification with Enzian. Deep endometriosis classification in relation to pain. Facts Views Vis Obgyn 2022; 14:245-253. [DOI: 10.52054/fvvo.14.3.034] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Background: Deep Endometriosis (DE) classification studies with Enzian never compared solitary (A, B, C, F), and combinations of anatomical locations (A&B, A&C, B&C, A&B&C), in correlation to pain. Therefore, the results of these studies are challenging to translate to the clinical situation.
Objectives: We studied pain symptoms and their correlation with the solitary and combinations of anatomical locations of deep endometriosis lesion(s) classified by the Enzian score.
Materials and Methods: A prospective multi-centre study was conducted with data from university and non-university hospitals. A total of 419 surgical DE cases were collected with the web-based application called EQUSUM (www.equsum.org).
Main outcome measures: Preoperative reported numeric rating scale (NRS) were collected along with the Enzian classification. Baseline characteristics, pain scores, surgical procedure and extent of the disease were also collected.
Results: In general, more extensive involvement of DE does not lead to an increase in the numerical rating scale for pain measures. However, dysuria and bladder involvement do show a clear correlation AUC 0.62 (SE 0.04, CI 0.54-0.71, p< 0.01). Regarding the predictive value of dyschezia, we found a weak, but significant correlation with ureteric involvement; AUC 0.60 (SE 0.04, CI 0.53-0.67, p< 0.01).
Conclusions:TPain symptoms poorly correlate with anatomical locations of deep endometriosis in almost all pain scores, with the exception of bladder involvement and dysuria which did show a correlation. Also, dyschezia seems to have predictive value for DE ureteric involvement and therefore MRI or ultrasound imaging (ureter and kidney) could be recommended in the preoperative workup of these patients.
What’s new? Dyschezia might have a predictive value in detecting ureteric involvement.
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Myers R, Mayo J, Atkar-Khattra S, Yuan R, Yee J, English J, Mcguire A, Grant K, Dewar L, Tammemagi M, Lam S. MA10.01 Prospective Evaluation of the International Lung Screening Trial (ILST) Protocol for Management of First Screening LDCT. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.08.158] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Abstract
BACKGROUND Hand dermatitis is highly prevalent among nurses due to their frequent exposure to wet work. Providing cost-effective dermatological health surveillance for this occupational group presents a challenge to health service providers. AIMS To ascertain the predictive value of nurses' self-assessment of whether they had current hand dermatitis using a screening questionnaire when compared with the assessment made by a dermatologist of the nurses' hand photographs. METHODS We conducted a cross-sectional study comparing the self-report decision made by student and intensive care nurses using a single hand dermatitis screening question with the clinical assessment of their hand photographs made by dermatologists using a standardized photographic guide. RESULTS We analysed data collected at study baseline (n = 1599). The results showed that the screening question had a high negative predictive value (91%; 95% CI 89-93), but a low positive predictive value (39%; 95% CI 34-45). It demonstrated acceptable accuracy in distinguishing those with and without the disease (area under the receiver operator curve = 0.7) and had a high specificity (86%; 95% CI 84-88) but a sensitivity of only 52% (95% CI 46-59) in identifying hand dermatitis. CONCLUSIONS We found that nurses were able to accurately self-assess themselves as not having any signs of hand dermatitis. By contrast, they were less able to accurately self-assess positive cases suggesting under-recognition of early disease. We propose that a questionnaire containing a single hand dermatitis screening question should be considered as a tool for screening out clear cases as part of a workplace health surveillance programme for detecting hand dermatitis.
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Affiliation(s)
- V Parsons
- Occupational Health Service, Guy's and St Thomas' NHS Foundation Trust/Faculty of Life Sciences and Medicine, King's College London, London, UK
| | - H C Williams
- Centre of Evidence Based Dermatology, University of Nottingham, Nottingham, UK
| | - J English
- Dermatology, Circle Nottingham NHS Treatment Centre, Nottingham, UK
| | - J Llewellyn
- Centre of Evidence Based Dermatology, University of Nottingham, Nottingham, UK
| | - G Ntani
- Medical Research Council Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
| | - I Madan
- Occupational Health Service, Guy's and St Thomas' NHS Foundation Trust/Faculty of Life Sciences and Medicine, King's College London, London, UK
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Cressman S, Tammemagi M, Myers R, Yee J, English J, Mayo J, Atkar-Khattra S, Yuan R, Fernandes A, Lam S. FP09.01 Economic Impact of Screening Selection with the PLCOm2012 Risk Model Versus USPSTF-Guidelines in the International Lung Screening Trial (ILST). J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.01.118] [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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Metzemaekers J, Haazebroek P, Smeets MJGH, English J, Blikkendaal MD, Twijnstra ARH, Adamson GD, Keckstein J, Jansen FW. EQUSUM: Endometriosis QUality and grading instrument for SUrgical performance: proof of concept study for automatic digital registration and classification scoring for r-ASRM, EFI and Enzian. Hum Reprod Open 2020; 2020:hoaa053. [PMID: 33409380 PMCID: PMC7772248 DOI: 10.1093/hropen/hoaa053] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [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: 05/17/2020] [Revised: 09/22/2020] [Indexed: 12/13/2022] Open
Abstract
STUDY QUESTION Is electronic digital classification/staging of endometriosis by the EQUSUM application more accurate in calculating the scores/stages and is it easier to use compared to non-digital classification? SUMMARY ANSWER We developed the first digital visual classification system in endometriosis (EQUSUM). This merges the three currently most frequently used separate endometriosis classification/scoring systems (i.e. revised American Society for Reproductive Medicine (rASRM), Enzian and Endometriosis Fertility Index (EFI)) to allow uniform and adequate classification and registration, which is easy to use. The EQUSUM showed significant improvement in correctly classifying/scoring endometriosis and is more user-friendly compared to non-digital classification. WHAT IS KNOWN ALREADY Endometriosis classification is complex and until better classification systems are developed and validated, ideally all women with endometriosis undergoing surgery should have a correct rASRM score and stage, while women with deep endometriosis (DE) should have an Enzian classification and if there is a fertility wish, the EFI score should be calculated. STUDY DESIGN SIZE DURATION A prospective endometriosis classification proof of concept study under experts in deep endometriosis was conducted. A comparison was made between currently used non-digital classification formats for endometriosis versus a newly developed digital classification application (EQUSUM). PARTICIPANTS/MATERIALS SETTING METHODS A hypothetical operative endometriosis case was created and summarized in both non-digital and digital form. During European endometriosis expert meetings, 45 DE experts were randomly assigned to the classic group versus the digital group to provide a proper classification of this DE case. Each expert was asked to provide the rASRM score and stage, Enzian and EFI score. Twenty classic forms and 20 digital forms were analysed. Questions about the user-friendliness (system usability scale (SUS) and subjective mental effort questionnaire (SMEQ)) of both systems were collected. MAIN RESULTS AND THE ROLE OF CHANCE The rASRM stage was scored completely correctly by 10% of the experts in the classic group compared to 75% in the EQUSUM group (P < 0. 01). The rASRM numerical score was calculated correctly by none of the experts in the classic group compared with 70% in the EQUSUM group (P < 0.01). The Enzian score was correct in 60% of the classic group compared to 90% in the EQUSUM group (P = 0.03). EFI scores were calculated correctly in 25% of the classic group versus 85% in the EQUSUM group (P < 0.01). Finally, the usability measured with the SUS was significantly better in the EQUSUM group compared to the classic group: 80.8 ± 11.4 and 61.3 ± 20.5 (P < 0.01). Also the mental effort measured with the SMEQ was significant lower in the EQUSUM group compared to the classic group: 52.1 ± 18.7 and 71.0 ± 29.1 (P = 0.04). Future research should further develop and confirm these initial findings by conducting similar studies with larger study groups, to limit the possible role of chance. LIMITATIONS REASONS FOR CAUTION These first results are promising, however it is important to note that this is a preliminary result of experts in DE and needs further testing in daily practice with different types (complex and easy) of endometriosis cases and less experienced gynaecologists in endometriosis surgery. WIDER IMPLICATIONS OF THE FINDINGS This is the first time that the rASRM, Enzian and EFI are combined in one web-based application to simplify correct and automatic endometriosis classification/scoring and surgical registration through infographics. Collection of standardized data with the EQUSUM could improve endometriosis reporting and increase the uniformity of scientific output. However, this requires a broad implementation. STUDY FUNDING/COMPETING INTERESTS To launch the EQUSUM application, a one-time financial support was provided by Medtronic to cover the implementation cost. No competing interests were declared. TRIAL REGISTRATION NUMBER N/A.
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Affiliation(s)
- J Metzemaekers
- Department of Gynaecology, Leiden University Medical Center, Leiden, the Netherlands
| | - P Haazebroek
- Institute of Psychology, Leiden University, Leiden, the Netherlands
| | - M J G H Smeets
- Department of Gynaecology, Haaglanden Medisch Centrum-Bronovo, Den Haag, the Netherlands
| | - J English
- Department of Gynaecology, Haaglanden Medisch Centrum-Bronovo, Den Haag, the Netherlands
| | - M D Blikkendaal
- Department of Gynaecology, Leiden University Medical Center, Leiden, the Netherlands
| | - A R H Twijnstra
- Department of Gynaecology, Leiden University Medical Center, Leiden, the Netherlands
| | | | - J Keckstein
- Stiftung Endometrioseforschung (SEF), Westerstede,Germany
- Gynecological Clinic Drs. Keckstein, Villach, Austria
| | - F W Jansen
- Department of Gynaecology, Leiden University Medical Center, Leiden, the Netherlands
- Department of Biomechanical Engineering, Delft University of Technology, Delft, the Netherlands
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Madan I, Parsons V, Ntani G, Coggon D, Wright A, English J, McCrone P, Smedley J, Rushton L, Murphy C, Cookson B, Williams HC. A behaviour change package to prevent hand dermatitis in nurses working in the National Health Service: results of a cluster randomized controlled trial. Br J Dermatol 2020; 183:462-470. [PMID: 31989580 PMCID: PMC7497001 DOI: 10.1111/bjd.18862] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [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: 01/06/2020] [Indexed: 12/01/2022]
Abstract
BACKGROUND Occupational hand dermatitis poses a serious risk for nurses. OBJECTIVES To evaluate the clinical and cost-effectiveness of a complex intervention in reducing the prevalence of hand dermatitis in nurses METHODS: This was a cluster randomized controlled trial conducted at 35 hospital trusts, health boards or universities in the UK. Participants were (i) first-year student nurses with a history of atopic conditions or (ii) intensive care unit (ICU) nurses. Participants at intervention sites received access to a behavioural change programme plus moisturizing creams. Participants at control sites received usual care. The primary outcome was the change of prevalent dermatitis at follow-up (adjusted for baseline dermatitis) in the intervention vs. the control group. Randomization was blinded to everyone bar the trials unit to ensure allocation concealment. The trial was registered on the ISRCTN registry: ISRCTN53303171. RESULTS Fourteen sites were allocated to the intervention arm and 21 to the control arm. In total 2040 (69·5%) nurses consented to participate and were included in the intention-to-treat analysis. The baseline questionnaire was completed by 1727 (84·7%) participants. Overall, 789 (91·6%) ICU nurses and 938 (84·0%) student nurses returned completed questionnaires. Of these, 994 (57·6%) had photographs taken at baseline and follow-up (12-15 months). When adjusted for baseline prevalence of dermatitis and follow-up interval, the odds ratios (95% confidence intervals) for hand dermatitis at follow-up in the intervention group relative to the controls were 0·72 (0·33-1·55) and 0·62 (0·35-1·10) for student and ICU nurses, respectively. No harms were reported. CONCLUSIONS There was insufficient evidence to conclude whether our intervention was effective in reducing hand dermatitis in our populations. Linked Comment: Brans. Br J Dermatol 2020; 183:411-412.
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Affiliation(s)
- I Madan
- Occupational Health Service, Guy's and St Thomas' NHS Foundation Trust and King's College London, London, U.K
| | - V Parsons
- Occupational Health Service, Guy's and St Thomas' NHS Foundation Trust and King's College London, London, U.K
| | - G Ntani
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, U.K
| | - D Coggon
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, U.K
| | - A Wright
- Centre for Behaviour Change, Department of Clinical, Educational and Health Psychology, University College London, London, U.K
| | - J English
- Dermatology, Circle Nottingham NHS Treatment Centre, Nottingham, U.K
| | - P McCrone
- Centre for the Economics of Mental and Physical Health, King's College London, London, U.K
| | - J Smedley
- Occupational Health Service, University Hospital Southampton NHS Foundation Trust, Southampton, U.K
| | - L Rushton
- Epidemiology and Biostatistics, Imperial College London, London, U.K
| | - C Murphy
- King's Clinical Trial Unit, King's College London, London, U.K
| | - B Cookson
- Medical Microbiology, University College London, London, U.K
| | - H C Williams
- Centre of Evidence Based Dermatology, University of Nottingham, Nottingham, U.K
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Clarençon F, Baronnet F, Shotar E, Degos V, Rolla-Bigliani C, Bartolini B, Veznedaroglu E, Budzik R, English J, Baxter B, Liebeskind DS, Krajina A, Gupta R, Miralbes S, Lüttich A, Nogueira RG, Samson Y, Alamowitch S, Sourour NA. Should posterior cerebral artery occlusions be recanalized? Insights from the Trevo Registry. Eur J Neurol 2020; 27:787-792. [PMID: 31997505 DOI: 10.1111/ene.14154] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [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: 09/17/2019] [Accepted: 01/09/2020] [Indexed: 01/06/2023]
Abstract
BACKGROUND AND PURPOSE The purpose of this study was to evaluate the safety and effectiveness of mechanical thrombectomy (MT) in patients with acute ischaemic stroke related to isolated and primary posterior cerebral artery (PCA) occlusions amongst the patients enrolled in the multicentre post-market Trevo Registry. METHOD Amongst the 2008 patients enrolled in the Trevo Registry with acute ischaemic stroke due to large vessel occlusion treated by MT, 22 patients (1.1%) [10 females (45.5%), mean age 66.2 ± 14.3 years (range 28-91)] had a PCA occlusion [17 P1 (77.3%) and five P2 occlusions (22.7%)]. Recanalization after the first Trevo (Stryker, Fremont, CA, USA) pass and at the end of the procedure was rated using the modified Thrombolysis in Cerebral Infarction (mTICI) score. Procedure-related complications (i.e. groin puncture complication, perforation, symptomatic haemorrhage, embolus in a new territory) were also recorded. The modified Rankin Scale at 90 days was assessed. RESULTS Median National Institutes of Health Stroke Scale at admission was 14 (interquartile range 8-16). Stroke aetiology was cardio-embolic in 68.2% of cases. Half of the patients (11/22) received intravenous tissue plasminogen activator. 54.5% of the patients were treated under general anaesthesia. Reperfusion (i.e. mTICI 2b or 3) after first pass was obtained in 65% of cases. Final mTICI 2b-3 reperfusion was obtained in all cases. Only one (4.5%) procedure-related complication was recorded (puncture site) that resolved after surgery. At 90-day follow-up, modified Rankin Scale 0-2 was obtained in 59% of the patients and 9.1% died within the first 3 months after MT. CONCLUSION Mechanical thrombectomy for PCA occlusions seems to be safe (<5% procedure-related complications) and effective. Larger repository datasets are needed.
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Affiliation(s)
- F Clarençon
- Sorbonne University, Paris, France.,Department of Neuroradiology, Pitié-Salpêtrière Hospital, Paris, France
| | - F Baronnet
- Department of Vascular Neurology, Pitié-Salpêtrière Hospital, Paris, France
| | - E Shotar
- Department of Neuroradiology, Pitié-Salpêtrière Hospital, Paris, France
| | - V Degos
- Sorbonne University, Paris, France.,Department of Anesthesiology, Pitié-Salpêtrière Hospital, Paris, France
| | - C Rolla-Bigliani
- Department of Neuroradiology, Pitié-Salpêtrière Hospital, Paris, France
| | - B Bartolini
- Department of Radiology, Interventional Neuroradiology Unit, Lausanne University Hospital, Lausanne, Switzerland
| | - E Veznedaroglu
- Endovascular Neurosurgery, Drexel Neurosciences Institute, Philadelphia, PA, USA
| | - R Budzik
- Interventional Neuroradiology, Riverside Methodist Hospital/Ohio Health Research Institute, Columbus, OH, USA
| | - J English
- Interventional Neurology, California Pacific Medical Center, San Francisco, CA, USA
| | - B Baxter
- Interventional Neuroradiology, Erlanger, Chattanooga, TN, USA
| | - D S Liebeskind
- Department of Neurology and Comprehensive Stroke Center, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
| | - A Krajina
- Department of Radiology, University Hospital Hradec Kralove, Hradec Kralove, Czech Republic
| | - R Gupta
- Interventional Neurology, Wellstar Health System, Atlanta, GA, USA
| | - S Miralbes
- Hospital Universitario Son Espases, Mallorca, España
| | - A Lüttich
- Hospital de Donostia, San Sebastian, España
| | - R G Nogueira
- Department of Neurology, Marcus Stroke and Neuroscience Center/Grady Memorial Hospital/Emory University, Atlanta, GA, USA
| | - Y Samson
- Sorbonne University, Paris, France.,Department of Vascular Neurology, Pitié-Salpêtrière Hospital, Paris, France
| | - S Alamowitch
- Sorbonne University, Paris, France.,Department of Vascular Neurology, Saint Antoine University Hospital, Paris, France
| | - N-A Sourour
- Department of Neuroradiology, Pitié-Salpêtrière Hospital, Paris, France
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Myers R, Mayo J, Tammemägi M, Atkar-Khattra S, Yuan R, Yee J, English J, Grant K, Lee A, Mcguire A, Mcwilliams A, Brims F, Mo L, Lam S. MA10.09 Evaluation of the Clinical Utility of the PanCan, EU-NELSON and Lung-RADS Protocols for Management of Screen Detected Lung Nodules at Baseline. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.580] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Holtsche MM, Goletz S, van Beek N, Zillikens D, Benoit S, Harman K, Walton S, English J, Sticherling M, Chapman A, Levell NJ, Groves R, Williams HC, König IR, Schmidt E. Prospective study in bullous pemphigoid: association of high serum anti-BP180 IgG levels with increased mortality and reduced Karnofsky score. Br J Dermatol 2018; 179:918-924. [PMID: 29607480 DOI: 10.1111/bjd.16553] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/08/2018] [Indexed: 11/28/2022]
Abstract
BACKGROUND Bullous pemphigoid (BP) is a subepidermal blistering disease characterized by autoantibodies against the two hemidesmosomal proteins, BP180 (type XVII collagen) and BP230. The multicentre prospective BLISTER (Bullous Pemphigoid Steroids and Tetracyclines) trial randomized 253 patients with BP to compare the benefits and harms between initial treatment with doxycycline or prednisolone. OBJECTIVES To analyse distinct autoantibody profiles for the prediction of the disease course in a well-characterized cohort of BP sera. METHODS One hundred and forty-three patients of the BLISTER trial consented to participate in this serological study. Sera taken at baseline were analysed by (i) indirect immunofluorescence, (ii) anti-BP180 NC16A (16th noncollagenous domain) and anti-BP230 enzyme-linked immunosorbent assay and (iii) immunoblotting with various substrates. Results were then linked with clinical parameters including age, Karnofsky score, number of blisters, related adverse events and mortality. RESULTS Disease activity correlated with immunoglobulin (Ig)G anti-BP180 levels but not with levels of anti-BP230 IgG and anti-BP180 IgE. High levels of both anti-BP180 IgG and anti-BP230 IgG were associated with a low Karnofsky score. The presence of anti-BP230 IgG was more frequent in older patients. Those with higher total IgE serum levels suffered from fewer adverse events. Higher IgG anti-BP180 levels were associated with an increased 1-year mortality rate. CONCLUSIONS Analysis of the autoantibody profile is not only of diagnostic relevance but may also be helpful in predicting the course of the disease.
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Affiliation(s)
- M M Holtsche
- Department of Dermatology, University of Lübeck, Lübeck, Germany
| | - S Goletz
- Lübeck Institute of Experimental Dermatology (LIED), University of Lübeck, Lübeck, Germany
| | - N van Beek
- Department of Dermatology, University of Lübeck, Lübeck, Germany
| | - D Zillikens
- Department of Dermatology, University of Lübeck, Lübeck, Germany
| | - S Benoit
- Department of Dermatology, Venereology and Allergology, University Hospital Würzburg, Würzburg, Germany
| | - K Harman
- Department of Dermatology, University Hospitals Leicester, Leicester Royal Infirmary, Leicester, U.K
| | - S Walton
- Castle Hill Hospital, Cottingham, U.K
| | - J English
- Queen's Medical Centre, University Hospital, Nottingham, U.K
| | - M Sticherling
- Department of Dermatology, University of Erlangen, Erlangen, Germany
| | - A Chapman
- Queen Elizabeth Hospital, Greenwich, London, U.K
| | - N J Levell
- Norfolk and Norwich University Hospital, Norwich, U.K
| | - R Groves
- Department of Immunodermatology, St John's Institute of Dermatology, St Thomas' Hospital, London, U.K
| | - H C Williams
- Centre of Evidence Based Dermatology, University of Nottingham, Nottingham, U.K
| | - I R König
- Institute of Medical Biometry and Statistics, University of Lübeck, Lübeck, Germany
| | - E Schmidt
- Department of Dermatology, University of Lübeck, Lübeck, Germany
- Lübeck Institute of Experimental Dermatology (LIED), University of Lübeck, Lübeck, Germany
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Lam S, Myers R, Atkar-Khattra S, Yuan R, Yee J, English J, Grant K, Lee A, Mcguire A, McWilliams A, Brims F, Stone E, Chin V, Chantrill L, Connellan M, Plitt M, Marshall H, Yang I, Bowman R, Fong K, Mayo J. MA03.02 Prospective Evaluation of the Clinical Utility of the International Lung Screen Trial Lung Nodule Management Protocol. J Thorac Oncol 2018. [DOI: 10.1016/j.jtho.2018.08.332] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Finley R, Mayo J, Donagh C, Leo J, Grant K, Lam S, English J. P1.16-34 The Impact of Pathology, Staging and Operative Resection on Survival and CT Evidence of Recurrence of Early NSCLC. J Thorac Oncol 2018. [DOI: 10.1016/j.jtho.2018.08.1003] [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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Holtsche M, Goletz S, van Beek N, Zillikens D, Benoit S, Harman K, Walton S, English J, Sticherling M, Chapman A, Levell N, Groves R, Williams H, K€onig I, Schmidt E. BP:血清抗 BP180 IgG 水平、死亡率和卡式评分. Br J Dermatol 2018. [DOI: 10.1111/bjd.17174] [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: 11/26/2022]
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Holtsche M, Goletz S, van Beek N, Zillikens D, Benoit S, Harman K, Walton S, English J, Sticherling M, Chapman A, Levell N, Groves R, Williams H, König I, Schmidt E. BP: serum anti-BP180 IgG levels, mortality and Karnofsky score. Br J Dermatol 2018. [DOI: 10.1111/bjd.17163] [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: 12/01/2022]
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Crane M, Webb D, Watson E, Cunliffe T, English J. Hand eczema and steroid-refractory chronic hand eczema in general practice: prevalence and initial treatment. Br J Dermatol 2017; 176:955-964. [DOI: 10.1111/bjd.14974] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/11/2016] [Indexed: 11/30/2022]
Affiliation(s)
- M.M. Crane
- GlaxoSmithKline; Research Triangle Park NC U.S.A
- Consultant epidemiologist; Chapel Hill NC U.S.A
| | | | - E. Watson
- GlaxoSmithKline; Research Triangle Park NC U.S.A
- Consultant epidemiologist; Chapel Hill NC U.S.A
| | - T. Cunliffe
- South Tees Hospitals NHS Foundation Trust; Northallerton U.K
| | - J. English
- Nottingham University Hospitals NHS Trust; Nottingham U.K
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O'Connor M, Odedra R, Palakurthi S, Hughes A, Lai Z, Kirschmeier P, Zeng Q, Zhou S, Dharma S, Ivanova E, Wang A, Pierce A, Yates J, Powell S, Dougherty B, Barrett J, English J, Jewsbury P, Matulonis U, Liu J. Antitumor activity of the WEE1 inhibitor AZD1775 as a monotherapy and in combination with the PARP inhibitor olaparib in patient-derived explant (PDX) models. Eur J Cancer 2016. [DOI: 10.1016/s0959-8049(16)33023-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [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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Hines J, Wilkinson SM, John SM, Diepgen TL, English J, Rustemeyer T, Wassilew S, Kezic S, Maibach HI. Response to letter to the editor re. Hines J, Wilkinson SM, John SM, et al. The three moments of skin cream application: an evidence-based proposal for use of skin creams in the prevention of irritant contact dermatitis in the workplace. J Eur Acad Dermatol Venereol 2016; 31:e308. [PMID: 27878862 DOI: 10.1111/jdv.14039] [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: 11/28/2022]
Affiliation(s)
- J Hines
- Deb Group Ltd., Research & Development, Denby, Derbyshire, DE5 8JZ, UK
| | - S M Wilkinson
- Leeds Teaching Hospitals NHS Trust, Leeds, LS7 4SA, UK
| | - S M John
- Department of Dermatology, Environmental Medicine, Health Theory, University of Osnabrueck, Am Finkenhügel 7a, 49076, Osnabrueck, Germany
| | - T L Diepgen
- Department of Social Medicine, Occupational and Environmental Dermatology, University of Heidelberg, Grabengasse 1, 69117, Heidelberg, Germany
| | - J English
- Nottingham NHS Treatment Center, Nottingham, NG7 2FT, UK
| | - T Rustemeyer
- Department of Dermatology and Allergology, VU University Medical Center Amsterdam, 1081 HV, Amsterdam, The Netherlands
| | - S Wassilew
- Hautarztzentrum Krefeld, Moerser Landstraβe 352, 47802, Krefeld, Germany
| | - S Kezic
- Coronel Institute of Occupational Health, Academic Medical Centre, 1105 AZ, Amsterdam, The Netherlands
| | - H I Maibach
- Dermatology Department, University of California San Francisco, 94115, San Francisco, CA, USA
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Affiliation(s)
- J. English
- Department of Biochemistry, University of Surrey, Guildford, U.K
| | - J. Chakraborty
- Department of Biochemistry, University of Surrey, Guildford, U.K
| | - V. Marks
- Department of Biochemistry, University of Surrey, Guildford, U.K
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Hines J, Wilkinson SM, John SM, Diepgen TL, English J, Rustemeyer T, Wassilew S, Kezic S, Maibach HI. The three moments of skin cream application: an evidence-based proposal for use of skin creams in the prevention of irritant contact dermatitis in the workplace. J Eur Acad Dermatol Venereol 2016; 31:53-64. [PMID: 27545662 PMCID: PMC5434821 DOI: 10.1111/jdv.13851] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [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: 03/10/2016] [Accepted: 06/08/2016] [Indexed: 11/29/2022]
Abstract
Contact dermatitis is one of the most common occupational diseases, with serious impact on quality of life, lost days at work and a condition that may be chronically relapsing. Regular prophylactic skin cream application is widely acknowledged to be an effective prevention strategy against occupational contact dermatitis; however, compliance rates remain low. To present a simple programme for skin cream application in the workplace with focus on implementation to drive down the rate of occupational irritant contact dermatitis, an expert panel of eight international dermatologists combined personal experience with extensive literature review. The recommendations are based on clinical experience as supported by evidence-based data from interventional studies. The authors identified three moments for skin cream application in the work place: (i) before starting a work period; (ii) after washing hands; and (iii) after work. Affecting behaviour change requires systematic communications, monitoring and reporting, which is proposed through Kotter's principles of organizational change management. Measurement tools are provided in the appendix. Interventional data based on application of this proposal is required to demonstrate its effectiveness.
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Affiliation(s)
- J Hines
- Deb Group Ltd., Research & Development, Denby, Derbyshire, UK
| | | | - S M John
- Department of Dermatology, Environmental Medicine, Health Theory, University of Osnabrueck, Osnabrueck, Germany
| | - T L Diepgen
- Department of Social Medicine, Occupational and Environmental Dermatology, University of Heidelberg, Heidelberg, Germany
| | - J English
- Nottingham NHS Treatment Center, Nottingham, UK
| | - T Rustemeyer
- Department of Dermatology and Allergology, VU University Medical Center Amsterdam, Amsterdam, The Netherlands
| | - S Wassilew
- Hautarztzentrum Krefeld, Krefeld, Germany
| | - S Kezic
- Coronel Institute of Occupational Health, Academic Medical Centre, Amsterdam, The Netherlands
| | - H I Maibach
- Department of Dermatology, University of California San Francisco, San Francisco, CA, USA
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Turk AS, Johnston SC, Hetts S, Mocco J, English J, Murayama Y, Prestigiacomo CJ, Lopes D, Gobin YP, Carroll K, McDougall C. Geographic Differences in Endovascular Treatment and Retreatment of Cerebral Aneurysms. AJNR Am J Neuroradiol 2016; 37:2055-2059. [PMID: 27390314 DOI: 10.3174/ajnr.a4857] [Citation(s) in RCA: 6] [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: 02/02/2016] [Accepted: 05/05/2016] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Comparing outcomes between endovascular aneurysm coiling trials can be difficult because of heterogeneity in patients and end points. We sought to understand the impact of geography on aneurysm retreatment in patients enrolled in the Matrix and Platinum Science Trial. MATERIALS AND METHODS Post hoc analysis was performed on data from the Matrix and Platinum Science trial. Patients were stratified as either North American or international. Baseline patient demographics, comorbidities, aneurysm characteristics, procedural complications, and clinical and angiographic outcomes were compared. RESULTS We evaluated 407 patients from 28 North American sites and 219 patients from 15 international sites. Patient demographics differed significantly between North American and international sites. Aneurysms were well occluded postprocedure more often at international than North American sites (P < .001). Stents were used significantly more often at North American sites (32.7% [133 of 407]) compared with international sites (10.0% [22 of 219]; P < .001). At 455 days, there was no difference in the proportion of patients alive and free of disability (P = .56) or with residual aneurysm filling (P = .10). Ruptured aneurysms were significantly more likely to have been retreated at North American sites within the first year (P < .001) and at 2 years (P < .001). Among all patients for whom the treating physician believed there to be Raymond 3 aneurysm filling at follow-up, absolute rates of retreatment at international and North American sites were similar by 2-year follow-up. CONCLUSIONS Data from the Matrix and Platinum Science Trial demonstrate that aneurysm retreatment occurs with different frequency and at different times in different regions of the world. This trend has critical value when interpreting trials reporting short-term outcomes, especially when judgment-based metrics such as retreatment are primary end points that may or may not take place within the defined study follow-up period. Though these variations can be controlled for and balanced within a given randomized trial, such differences in practice patterns must be accounted for in any attempt to compare outcomes between different trials. Despite these differences, endovascular-treated intracranial aneurysms around the world have similar clinical outcomes.
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Affiliation(s)
- A S Turk
- From the Departments of Radiology (A.S.T.) .,Neurosurgery (A.S.T.), Medical University of South Carolina, Charleston, South Carolina
| | - S C Johnston
- Clinical and Translational Science Institute (S.C.J.), University of California, San Francisco, San Francisco, California.,Dell Medical School at The University of Texas at Austin (S.C.J.), Austin, Texas
| | - S Hetts
- Department of Radiology and Biomedical Imaging (S.H.), University of California, San Francisco School of Medicine, San Francisco, California
| | - J Mocco
- Department of Neurosurgery (J.M.), Icahn School of Medicine at Mount Sinai, New York, New York
| | - J English
- California Pacific Medical Center (J.E.), San Francisco, California
| | - Y Murayama
- Department of Neurosurgery (Y.M.), Jikei University Hospital, Tokyo, Japan
| | - C J Prestigiacomo
- Department of Neurological Surgery (C.J.P.), University of Medicine and Dentistry of New Jersey, Newark, New Jersey
| | - D Lopes
- Department of Neurosurgery (D.L.), Rush University Medical Center, Chicago, Illinois
| | - Y P Gobin
- Department of Neurosurgery (Y.P.G.), Weill Cornell Medical College, New York, New York
| | - K Carroll
- Stryker Corporation (K.C.), Fremont, California
| | - C McDougall
- Department of Neurosurgery (C.M.), Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona
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Castonguay A, Nogueira R, English J, Satti S, Farid H, Veznedaroglu E, Binning M, Puri A, Vora N, Budzik R, Dabus G, Linfante I, Janardhan V, Alshekhlee A, Abraham M, Edgell R, Taqi M, El Khoury R, Mokin M, Mokin M, Majjhoo A, Kabbani M, Froehler M, Finch I, Ansari S, Novakovic R, Nguyen T, Zaidat O. O-004 Analysis of M2 Occlusions within TREVO Acute Ischemic Stroke (TRACK) stent-retriever Thrombectomy Registry. J Neurointerv Surg 2016. [DOI: 10.1136/neurintsurg-2016-012589.4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Zaidat OO, Castonguay A, Haussen D, English J, Farid H, Veznedaroglu E, Binning M, Puri AS, Hou SY, Janardhan V, Vora N, Budzik RF, Alshekhlee A, Abraham MG, Edgell R, Taqi A, Lin E, Khoury R, Mokin M, Majjhoo AQ, Kabbani MR, Froehler MT, Finch I, Prabhakaran S, Novakovic R, Nguyen T, Mehta S, Quadri SA, Ramakrishnan P, Nogueira RG. Abstract WMP8: Results of Trevo Acute Ischemic Stroke Thrombectomy Registry: Predictors of Clinical Outcome. Stroke 2016. [DOI: 10.1161/str.47.suppl_1.wmp8] [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: 11/16/2022]
Abstract
Background and Purpose:
Recent randomized clinical trial (RCTs) demonstrated efficacy of mechanical thrombectomy using stent-retrievers in acute ischemic stroke (AIS) patients. The main purpose of TRevo ACute Ischemic StroKe (TRACK) stent-retriever thrombectomy multicenter registry is to demonstrate safety and efficacy in real life clinical practice.
Methods:
The investigator-initiated TRACK multicenter registry recruited 24 sites in north America to submit demographic, clinical, site-adjudicated angiographic, and outcome data on consecutive AIS patients treated with Trevo stent-retriever device as the first treatment option. Standard clinical safety (symptomatic intracranial hemorrhage (sICH), and mortality) and efficacy (revascularization and disability) outcomes and predictors of clinical outcome were analyzed.
Results:
624 patients were enrolled in the TRACK registry. Median age was 68 years (range 16-94, 118 (18.1%) >80), male gender was 51.4%, and 67.7% were white. The median National Institutes of Health Stroke Severity Scale (NIHSS) was 17 (IQR 13-22). Transfer cases were 50.6% with IV-rtPA use in 318 cases (51.3%). Median onset to groin puncture (OTG) time was 283 min (IQR 198.5-443), and groin puncture to revascularization was 66 min (IQR 37.5-103). Anterior circulation occlusion was 86.2% (MCA/M2 in 55.2% followed by ICA in 15.9% and M2 in 12.7%). Use of GA was in 389 cases (62.3%), number of passes were ≤ 3 in 92% of the cases (1: 45.2%, 2:28%, and 3:18.7%), 291 (46.7%) had BGC use. Rescue use was seen in 21.7%. Revascularization of ≥ TIMI 2 was 81.8% and ≥ TICI 2b was 70%. The primary outcome of mRS of ≥ 2 was 48.3% in the full cohort, and 50.6% in TREVO-2 like group. sICH and mortality were 7.2%, and 20.1% in the full cohort vs 6.9% and 17.5% in the TREVO-2 like group, respectively. The independent predictors of clinical outcome were lower baseline NIHSS, younger age, use of BGC, successful recanalization, and no general anesthesia (GA).
Conclusions:
The real life clinical practice Trevo registry demonstrated good clinical outcome and high rate of recanalization. Younger age, lower baseline NIHSS, use of balloon guide catheter, successful recanalization, and avoiding endotrachaeal GA independent predictors of good clinical outcome.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | - N Vora
- Riverside Radiology, Columbus, OH
| | | | | | | | | | | | - E Lin
- St Vincent Mercy Hosp, Toledo, OH
| | | | - M Mokin
- Univ of S Florida, Tampa, FL
| | | | | | | | - I Finch
- John Muir Med Cntr, Walnut Creek, CA
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Zaidat O, Castonguay A, Gupta R, Sun C, Martin C, Holloway W, Mueller-Kronast N, English J, Linfante I, Dabus G, Malisch T, Marden F, Bozorgchami H, Xavier A, Rai A, Froehler M, Badruddin A, Nguyen T, Taqi M, Abraham M, Janardhan V, Shaltoni H, Novakovic R, Yoo A, Abou-Chebl A, Chen P, Britz G, Kaushal R, Nanda A, Nogueira R. O-004 the first pass effect: a new measure for stroke thrombectomy devices. J Neurointerv Surg 2015. [DOI: 10.1136/neurintsurg-2015-011917.4] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [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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Taqi M, Quadri S, Puri A, Fitzsimmons B, Rai A, Given C, Masso J, Powers C, English J, Zaidat S. P-029 a prospective multi-center trial of transform™ occlusion balloon catheter (tobc): trial design and results. J Neurointerv Surg 2015. [DOI: 10.1136/neurintsurg-2015-011917.68] [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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Zaidat O, Castonguay A, Nogueira R, Ramakrishnan P, Haussen D, Lima A, English J, Farid H, Veznedaroglu E, Binning M, Puri A, Hou S, Janardhan V, Vora N, Budzik R, Alshekhlee A, Abraham M, Edgell R, Taqi M, Lin E, Khoury R, Mokin M, Majjhoo A, Kabbani M, Froehler M, Finch I, Prabhakaran S, Novakovic R, Nguyen T, Wesley J. O-008 final revascularization and clinical outcome results from the multicenter trevo stent-retriever acute stroke (track) post-marketing registry. J Neurointerv Surg 2015. [DOI: 10.1136/neurintsurg-2015-011917.8] [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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Gao B, Barazangi N, Tong D, Chen C, Wong C, Yee A, Morrow M, Bedenk A, Kim W, English J. P-012 stent retrievers in clinical practice: are results from recent trials reproducible in a community hospital referral network? J Neurointerv Surg 2015. [DOI: 10.1136/neurintsurg-2015-011917.51] [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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Castonguay A, Zaidat O, Nogueira R, Ramakrishnan P, Haussen D, Lima A, English J, Farid H, Veznedaroglu E, Binning M, Puri A, Hou S, Janardhan V, Vora N, Budzik R, Alshekhlee A, Abraham M, Edgell R, Taqi M, Lin E, Khoury R, Mokin M, Majjhoo A, Kabbani M, Froehler M, Finch I, Prabhakaran S, Novakovic R, Nguyen T. E-055 analysis of a mr clean-like group in the multicenter track registry. J Neurointerv Surg 2015. [DOI: 10.1136/neurintsurg-2015-011917.130] [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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Gupta R, Budzik R, Xiang B, English J, Baxter B, Ge S, Veznedaroglu E. O-005 preliminary results of the trevo retriever registry. J Neurointerv Surg 2015. [DOI: 10.1136/neurintsurg-2015-011917.5] [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: 11/04/2022]
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Abstract
BACKGROUND Health care workers (HCWs) are at increased risk of irritant contact dermatitis due to frequent hand washing and use of alcohol gel. This has increased the incidence of occupational skin diseases. AIMS To evaluate hand dermatitis in HCWs in our hospital by means of a survey which also examined trends of exposure and the utility of patch testing. METHODS HCWs diagnosed with hand dermatitis in our contact dermatitis clinic from January 2011 to July 2012 were included. Information was collected retrospectively from medical notes, computer records and the database of the British Cutaneous Allergy Society. RESULTS A total of 69 HCWs were diagnosed with hand dermatitis, with a prevalence of ~4%. The majority were female and the clinical areas in which they worked were diverse. About 98% (68) had irritant contact dermatitis, and hand washing was the commonest cause of symptoms. About 75% (51) had irritant dermatitis exclusively. Patch test was positive in 42% with the commonest reaction to nickel, followed by formaldehyde. Associated atopy was found in less than half of the cases. CONCLUSIONS Irritant hand dermatitis is prevalent in HCWs in this setting. Patch testing is useful to identify any additional allergic element in such cases.
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Affiliation(s)
- M Malik
- Derby Teaching Hospitals NHS Foundation Trust, London Road Community Hospital, London Road, Derby DE1 2QY, UK,
| | - J English
- Circle, NHS Treatment Centre, Nottingham NG7 2FT, UK
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Linfante I, Dabus G, Starosciak A, Castonguay A, Gupta R, Sun C, Martin C, Holloway W, Mueller-Kronast N, English J, Malisch T, Marden F, Bozorgchami H, Xavier A, Rai A, Froehler M, Badruddin A, Nguyen T, Taqi M, Abraham M, Janardhan V, Shaltoni H, Novakovic R, Yoo A, Zaidat O. O-032 Predictors of Poor Outcomes Despite Successful Recanalization in Patients with Acute Ischemic Stroke. J Neurointerv Surg 2014. [DOI: 10.1136/neurintsurg-2014-011343.32] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [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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Castonguay A, Zaidat O, Novakovic R, Gupta R, Sun C, Martin C, Holloway W, Mueller-Kronast N, English J, Linfante I, Dabus G, Malisch T, Marden F, Bozorgchami H, Xavier A, Rai A, Froehler M, Badruddin A, Nguyen T, Taqi M, Abraham M, Janardhan V, Shaltoni H, Yoo A, Abou-Chebl A. E-040 Analysis of the SPAN-100 Index as a Predictor of Clinical Outcome in the Post-Marketing North American SOLITAIRE Stent-Retriever Acute Stroke Registry. J Neurointerv Surg 2014. [DOI: 10.1136/neurintsurg-2014-011343.107] [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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Nogueira R, Castonguay A, Gupta R, Sun C, Martin C, Holloway W, Mueller-Kronast N, English J, Linfante I, Dabus G, Malisch T, Bozorgchami H, Xavier A, Rai A, Froehler M, Badruddin A, Nguyen T, Taqi M, Abraham M, Janardhan V, Shaltoni H, Yoo A, Abou-Chebl A, Chen P, Zaidat O. O-003 IMS3 Like Subgroup Analysis in the North American SOLITAIRE Stent-Retriever Acute Stroke Registry: Abstract O-003 Table 1. J Neurointerv Surg 2013. [DOI: 10.1136/neurintsurg-2013-010870.3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Zaidat O, Castonguay A, Gupta R, Sun C, Martin C, Mueller-Kronast N, Holloway W, English J, Linfante I, Dabus G, Malisch T, Marden F, Bozorgchami H, Xavier A, Rai A, Froehler M, Badruddin A, Nguyen T, Taqi M, Abraham M, Janardhan V, Shaltoni H, Yoo A, Abou-Chebl A, Chen P. E-039 North American Solitaire Stent-Retriever Acute Stroke Registry: Post-Marketing Revascularisation and Clinical Outcome Results As Compared to the SWIFT and TREVO-2 Clinical Trials. J Neurointerv Surg 2013. [DOI: 10.1136/neurintsurg-2013-010870.97] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Alexander MD, English J, Hetts SW. Occipital artery anastomosis to vertebral artery causing pulsatile tinnitus. Case Reports 2013; 2013:bcr-2012-010632. [DOI: 10.1136/bcr-2012-010632] [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] Open
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Zaidat OO, Lazzaro MA, Liebeskind DS, Janjua N, Wechsler L, Nogueira RG, Edgell RC, Kalia JS, Badruddin A, English J, Yavagal D, Kirmani JF, Alexandrov AV, Khatri P. Revascularization grading in endovascular acute ischemic stroke therapy. Neurology 2012; 79:S110-6. [PMID: 23008384 DOI: 10.1212/wnl.0b013e3182695916] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Recanalization and angiographic reperfusion are key elements to successful endovascular and interventional acute ischemic stroke (AIS) therapy. Intravenous recombinant tissue plasminogen activator (rt-PA), the only established revascularization therapy approved by the US Food & Drug Administration for AIS, may be less effective for large artery occlusion. Thus, there is enthusiasm for endovascular revascularization therapies, which likely provide higher recanalization rates, and trials are ongoing to determine clinical efficacy and compare various methods. It is anticipated that clinical efficacy will be well correlated with revascularization of viable tissue in a timely manner. METHOD Reporting, interpretation, and comparison of the various revascularization grading methods require agreement on measurement criteria, reproducibility, ease of use, and correlation with clinical outcome. These parameters were reviewed by performing a Medline literature search from 1965 to 2011. This review critically evaluates current revascularization grading systems. RESULTS AND CONCLUSION The most commonly used revascularization grading methods in AIS interventional therapy trials are the thrombolysis in cerebral ischemia (TICI, pronounced "tissy") and thrombolysis in myocardial ischemia (TIMI) scores. Until further technical and imaging advances can incorporate real-time reliable perfusion studies in the angio-suite to delineate regional perfusion more accurately, the TICI grading system is the best defined and most widely used scheme. Other grading systems may be used for research and correlation purposes. A new scale that combines primary site occlusion, lesion location, and perfusion should be explored in the future.
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Affiliation(s)
- O O Zaidat
- Department of Neurology, Medical College of Wisconsin/Froedtert Hospital, Milwaukee, WI, USA.
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Rakhshandeh A, Dekkers JCM, Kerr BJ, Weber TE, English J, Gabler NK. Effect of immune system stimulation and divergent selection for residual feed intake on digestive capacity of the small intestine in growing pigs1. J Anim Sci 2012; 90 Suppl 4:233-5. [DOI: 10.2527/jas.53976] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- A. Rakhshandeh
- Department of Animal Science, Iowa State University, Ames, IA50011
| | - J. C. M. Dekkers
- Department of Animal Science, Iowa State University, Ames, IA50011
| | | | | | - J. English
- Department of Animal Science, Iowa State University, Ames, IA50011
| | - N. K. Gabler
- Department of Animal Science, Iowa State University, Ames, IA50011
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Brown A, Horobin A, Blount DG, Hill PJ, English J, Rich A, Williams PM, Pritchard DI. Blow fly Lucilia sericata nuclease digests DNA associated with wound slough/eschar and with Pseudomonas aeruginosa biofilm. Med Vet Entomol 2012; 26:432-439. [PMID: 22827809 DOI: 10.1111/j.1365-2915.2012.01029.x] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
In chronic wounds, it may be clinically important to remove extracellular bacterial and patient DNA as its presence may impede wound healing and promote bacterial survival in biofilm, in which extracellular DNA forms part of the biofilm architecture. As medicinal maggots, larvae of Lucilia sericata Meigen (Diptera: Calliphoridae) have been shown to efficiently debride wounds it became of interest to investigate their excretions/secretions (ES) for the presence of a deoxyribonuclease (DNAse) activity. Excretions/secretions products were shown to contain a DNAse, with magnesium, sodium and calcium metal ion dependency, and a native molecular mass following affinity purification of approximately 45 kDa. The affinity purified DNAse degraded genomic bacterial DNA per se, DNA from the slough/eschar of a venous leg ulcer, and extracellular bacterial DNA in biofilms pre-formed from a clinical isolate of Pseudomonas aeruginosa. The latter finding highlights an important attribute of the DNAse, given the frequency of P. aeruginosa infection in non-healing wounds and the fact that P. aeruginosa virulence factors can be toxic to maggots. Maggot DNAse is thus a competent enzyme derived from a rational source, with the potential to assist in clinical wound debridement by removing extracellular DNA from tissue and biofilm, and promoting tissue viability, while liberating proteinaceous slough/eschar for debridement by the suite of proteinases secreted by L. sericata.
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Affiliation(s)
- A Brown
- School of Pharmacy, University of Nottingham, Nottingham, U.K
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English J. Is there still a role for psoralen ultraviolet A in the treatment of chronic hand eczema? Clin Exp Dermatol 2012; 37:802-3. [DOI: 10.1111/j.1365-2230.2012.04444.x] [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: 12/01/2022]
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Hetts S, Turk A, English J, Mocco J, Prestigiacomo C, Nesbit G, Ge S, Jin J, Murayama Y, Gholkar A, Barnwell S, Lopes D, Gobin Y, Johnston S, McDougall C. O-010 Stent assisted coiling versus coiling of unruptured intracranial aneurysms in the MAPS trial: safety, efficacy, and mid term outcomes. J Neurointerv Surg 2012. [DOI: 10.1136/neurintsurg-2012-010455a.10] [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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Kansagra A, English J, Sincic R, Hetts S. O-032 Current trends in endovascular management of traumatic cerebrovascular injury: Abstract O-032 Table 1. J Neurointerv Surg 2012. [DOI: 10.1136/neurintsurg-2012-010455a.32] [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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Hetts S, Kim H, Cooke D, English J, Gupta N, Stout C, Kim W, Dowd C, Halbach V, Higashida R, Lawton M, Young W. O-023 Pediatric versus adult AVM angioarchitecture: are children really just small adults? J Neurointerv Surg 2012. [DOI: 10.1136/neurintsurg-2012-010455a.23] [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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Abstract
PURPOSE To directly measure skin dose using point-dosimeters from dental cone-beam CT (CBCT) scans. To compare the results among three different dental CBCT scanners and compare the CBCT results with those from a conventional panoramic and cephalomic dental imaging system. METHODS A head anthropomorphic phantom was used with nanoDOT dosimeters attached to specified anatomic landmarks of selected radiosensitive tissues of interest. To ensure reliable measurement results, three dosimeters were used for each location. The phantom was scanned under various modes of operation and scan protocols for typical dental exams on three dental CBCT systems plus a conventional dental imaging system. The Landauer OSL nanoDOT dosimeters were calibrated under the same imaging condition as the head phantom scan protocols, and specifically for each of the imaging systems. Using nanoDOT dosimeters, skin doses at several positions on the surface of an adult head anthropomorphic phantom were measured for clinical dental imaging. RESULTS The measured skin doses ranged from 0.04 to 4.62mGy depending on dosimeter positions and imaging systems. The highest dose location was at the parotid surface for all three CBCT scanners. The surface doses to the locations of the eyes were ∼4.0mGy, well below the 500mGy threshold for possibly causing cataract development. The results depend on x-ray tube output (kVp and mAs) and also are sensitive to SFOV. Comparing to the conventional dental imaging system operated in panoramic and cephalometric modes, doses from all three CBCT systems were at least an order of magnitude higher. No image artifact was caused by presence of nanoDOT dosimeters in the head phantom images. CONCLUSIONS Direct measurements of skin dose using nanoDOT dosimeters provided accurate skin dose values without any image artifacts. The results of skin dose measurements serve as dose references in guiding future dose optimization efforts in dental CBCT imaging.
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Affiliation(s)
- S Akyalcin
- University of Texas Health Sciences Center at Houston, School of Dentistry, Houston, TX.,MD Anderson Cancer Center, Houston, TX
| | - J English
- University of Texas Health Sciences Center at Houston, School of Dentistry, Houston, TX.,MD Anderson Cancer Center, Houston, TX
| | - K Abramovitch
- University of Texas Health Sciences Center at Houston, School of Dentistry, Houston, TX.,MD Anderson Cancer Center, Houston, TX
| | - J Rong
- University of Texas Health Sciences Center at Houston, School of Dentistry, Houston, TX.,MD Anderson Cancer Center, Houston, TX
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Peiser M, Tralau T, Heidler J, Api AM, Arts JHE, Basketter DA, English J, Diepgen TL, Fuhlbrigge RC, Gaspari AA, Johansen JD, Karlberg AT, Kimber I, Lepoittevin JP, Liebsch M, Maibach HI, Martin SF, Merk HF, Platzek T, Rustemeyer T, Schnuch A, Vandebriel RJ, White IR, Luch A. Allergic contact dermatitis: epidemiology, molecular mechanisms, in vitro methods and regulatory aspects. Current knowledge assembled at an international workshop at BfR, Germany. Cell Mol Life Sci 2011; 69:763-81. [PMID: 21997384 PMCID: PMC3276771 DOI: 10.1007/s00018-011-0846-8] [Citation(s) in RCA: 221] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2011] [Revised: 08/29/2011] [Accepted: 09/20/2011] [Indexed: 12/13/2022]
Abstract
Contact allergies are complex diseases, and one of the important challenges for public health and immunology. The German ‘Federal Institute for Risk Assessment’ hosted an ‘International Workshop on Contact Dermatitis’. The scope of the workshop was to discuss new discoveries and developments in the field of contact dermatitis. This included the epidemiology and molecular biology of contact allergy, as well as the development of new in vitro methods. Furthermore, it considered regulatory aspects aiming to reduce exposure to contact sensitisers. An estimated 15–20% of the general population suffers from contact allergy. Workplace exposure, age, sex, use of consumer products and genetic predispositions were identified as the most important risk factors. Research highlights included: advances in understanding of immune responses to contact sensitisers, the importance of autoxidation or enzyme-mediated oxidation for the activation of chemicals, the mechanisms through which hapten-protein conjugates are formed and the development of novel in vitro strategies for the identification of skin-sensitising chemicals. Dendritic cell cultures and structure-activity relationships are being developed to identify potential contact allergens. However, the local lymph node assay (LLNA) presently remains the validated method of choice for hazard identification and characterisation. At the workshop the use of the LLNA for regulatory purposes and for quantitative risk assessment was also discussed.
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Affiliation(s)
- M. Peiser
- Department of Product Safety, German Federal Institute for Risk Assessment (BfR), Thielallee 88-92, 14195 Berlin, Germany
| | - T. Tralau
- Department of Product Safety, German Federal Institute for Risk Assessment (BfR), Thielallee 88-92, 14195 Berlin, Germany
| | - J. Heidler
- Department of Product Safety, German Federal Institute for Risk Assessment (BfR), Thielallee 88-92, 14195 Berlin, Germany
| | - A. M. Api
- Research Institute for Fragrance Materials, Hackensack, NJ USA
| | | | | | - J. English
- Nottingham University Hospitals, Nottingham, UK
| | - T. L. Diepgen
- Department of Social Medicine, Occupational and Environmental Dermatology, University of Heidelberg, Heidelberg, Germany
| | | | - A. A. Gaspari
- School of Medicine, University of Maryland, Baltimore, MD USA
| | - J. D. Johansen
- Department of Derma-allergology, Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark
| | - A. T. Karlberg
- Department of Chemistry, Dermatochemistry and Skin Allergy, University of Gothenburg, Gothenburg, Sweden
| | - I. Kimber
- Faculty of Life Sciences, University of Manchester, Manchester, UK
| | | | - M. Liebsch
- Department of Experimental Toxicology and ZEBET, Center for Alternatives to Animal Testing, German Federal Institute for Risk Assessment (BfR), Berlin, Germany
| | - H. I. Maibach
- Department of Dermatology, University of California San Francisco, San Francisco, CA USA
| | - S. F. Martin
- Allergy Research Group, Department of Dermatology, University Medical Center Freiburg, Freiburg, Germany
| | - H. F. Merk
- Department of Dermatology and Allergology, University Hospitals Aachen, Aachen, Germany
| | - T. Platzek
- Department of Product Safety, German Federal Institute for Risk Assessment (BfR), Thielallee 88-92, 14195 Berlin, Germany
| | - T. Rustemeyer
- VU University Medical Center, Amsterdam, The Netherlands
| | - A. Schnuch
- Department of Dermatology, University of Göttingen, Göttingen, Germany
| | - R. J. Vandebriel
- National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - I. R. White
- St. John’s Institute of Dermatology, St. Thomas’ Hospital, London, UK
| | - A. Luch
- Department of Product Safety, German Federal Institute for Risk Assessment (BfR), Thielallee 88-92, 14195 Berlin, Germany
- Department of Experimental Toxicology and ZEBET, Center for Alternatives to Animal Testing, German Federal Institute for Risk Assessment (BfR), Berlin, Germany
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Toy B, Smith W, English J, Halbach V, Hetts S. P-013 Endovascular intervention for acute cerebral ischemia: 13-year single-institution experience. J Neurointerv Surg 2011. [DOI: 10.1136/neurintsurg-2011-010097.47] [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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Hetts S, Martin A, English J, Dowd C, Halbach V, Higashida R, McDermott M, Cha S, Saloner D. P-003 Intraarterial MR perfusion imaging of meningiomas: comparison to digital subtraction angiography. J Neurointerv Surg 2011. [DOI: 10.1136/neurintsurg-2011-010097.37] [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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Hudelist G, English J, Thomas A, Tinelli A, Singer C, Keckstein J. Diagnostic accuracy of transvaginal sonography (TVS) for non-invasive diagnosis of rectosigmoidal endometriosis – a systematic review and meta-analysis. Geburtshilfe Frauenheilkd 2011. [DOI: 10.1055/s-0031-1280507] [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: 10/18/2022] Open
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Hudelist G, English J, Thomas A, Tinelli A, Singer C, Keckstein J. Diagnostic accuracy of transvaginal sonography (TVS) for non-invasive diagnosis of rectosigmoidal endometriosis – a systematic review and meta-analysis. Geburtshilfe Frauenheilkd 2011. [DOI: 10.1055/s-0031-1278538] [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: 10/18/2022] Open
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Hudelist G, Ballard K, English J, Wright J, Banerjee S, Mastoroudes H, Thomas A, Singer CF, Keckstein J. Transvaginal sonography vs. clinical examination in the preoperative diagnosis of deep infiltrating endometriosis. Ultrasound Obstet Gynecol 2011; 37:480-487. [PMID: 21433168 DOI: 10.1002/uog.8935] [Citation(s) in RCA: 125] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
OBJECTIVE The aim of this study was to compare the diagnostic performance of clinical vaginal examination with that of transvaginal sonography (TVS) in the presurgical diagnosis of deep infiltrating endometriosis. METHODS One-hundred and fifty-five women with symptoms suggestive of endometriosis were included. One-hundred and twenty-nine patients met the inclusion criteria and were prospectively and independently assessed by vaginal examination and TVS prior to a diagnostic laparoscopy and, where appropriate, radical resection and histological confirmation of endometriosis was performed. Sensitivity, specificity, positive predictive values (PPV), negative predictive values (NPV) and positive and negative likelihood ratios (LR+ and LR-) were calculated for each test method. RESULTS In total, 83 (64%) women had histological confirmation of endometriosis, 52 (40%) of whom had deep infiltrating endometriosis. The prevalence of endometriosis on the uterosacral ligaments, pouch of Douglas, vagina, bladder, rectovaginal space and rectosigmoid was 23.3%, 16.3%, 8.5%, 3.1%, 6.9% and 24%. PPV, NPV, LR+ and LR- for vaginal examination were 92%, 87%, 41.56 and 0.60 for ovarian endometriosis; 43%, 84%, 2.48 and 0.63 for uterosacral ligament disease; 64%, 95%, 9.14 and 0.26 for involvement of the pouch of Douglas; 80%, 97%, 42.91 and 0.28 for vaginal endometriosis; 78%, 98%, 46.67 and 0.23 for endometriosis of the rectovaginal space; 100%, 98%, 75.60 and 0.75 for bladder involvement; 86%, 84%, 18.97 and 0.63 for rectosigmoidal endometriosis. Values for TVS were similar with regard to vaginal and rectovaginal space endometriosis, but were clearly superior to vaginal examination in cases of ovarian (87%, 99%, 24.56 and 0.04), uterosacral ligament (91%, 90%, 31.35 and 0.37) and rectosigmoidal (97%, 97%, 88.51 and 0.1) endometriosis. CONCLUSIONS TVS is a more useful test than is vaginal examination in detecting endometriosis in the ovaries and rectosigmoid.
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Affiliation(s)
- G Hudelist
- Department of Obstetrics and Gynaecology, Endometriosis and Pelvic Pain Clinic, Wilhelminen Hospital, Vienna, Austria.
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Hudelist G, English J, Thomas AE, Tinelli A, Singer CF, Keckstein J. Diagnostic accuracy of transvaginal ultrasound for non-invasive diagnosis of bowel endometriosis: systematic review and meta-analysis. Ultrasound Obstet Gynecol 2011; 37:257-263. [PMID: 20954166 DOI: 10.1002/uog.8858] [Citation(s) in RCA: 137] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
OBJECTIVE To critically analyze the diagnostic value of transvaginal sonography (TVS) for non-invasive, presurgical detection of bowel endometriosis. METHODS MEDLINE (1966-2010) and EMBASE (1980-2010) databases were searched for relevant studies investigating the diagnostic accuracy of TVS for diagnosing deep infiltrating endometriosis involving the bowel. Diagnosis was established by laparoscopy and/or histopathological analysis. Likelihood ratios (LRs) were recalculated in addition to traditional measures of effectiveness. RESULTS Out of 188 papers, a total of 10 studies fulfilled predefined inclusion criteria involving 1106 patients with suspected endometriosis. The prevalence of bowel endometriosis varied from 24 to 73.3%. LR+ ranged from 4.8 to 48.56 and LR- ranged from 0.02 to 0.36, with wide confidence intervals. Pooled estimates of sensitivities and specificities were 91 and 98%; LR+ and LR- were 30.36 and 0.09; and positive and negative predictive values were 98 and 95%, respectively. Three of the studies used bowel preparations to enhance the visibility of the rectal wall; one study directly compared the use of water contrast vs. no prior bowel enema, for which the LR- was 0.04 and 0.47, respectively. CONCLUSIONS TVS with or without the use of prior bowel preparation is an accurate test for non-invasive, presurgical detection of deep infiltrating endometriosis of the rectosigmoid.
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Affiliation(s)
- G Hudelist
- Department of Obstetrics and Gynaecology, Endometriosis and Pelvic Pain Clinic, Wilhelminen Hospital, Vienna, Austria.
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