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O'Keefe D, Jacka D, Douglass C, Gunn J, Stoove M, Crawford S, Bryant M, Higgs P, Dietze P, Hellard M. Distribution of rapid HCV antibody self-test kits via needle/syringe dispensing machines: Implementation and evaluation of the Vend-C pilot study in Melbourne, Australia. J Viral Hepat 2024; 31:151-155. [PMID: 38158743 DOI: 10.1111/jvh.13909] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Revised: 10/14/2023] [Accepted: 12/13/2023] [Indexed: 01/03/2024]
Abstract
Recent guidance from the World Health Organization strongly recommended hepatitis C virus (HCV) self-testing. We implemented the Vend-C pilot study to explore the effectiveness and feasibility of distributing rapid HCV antibody self-test kits to people who inject drugs via needle/syringe dispensing machines (SDMs). Over a 51-day study period between August and September 2022, we distributed HCV antibody self-test kits via two SDMs. During the study period, 63 self-test kits were dispensed, averaging 1.2 self-test kits per day. Our access methods for evaluation questionnaires failed to attract participants (n = 4). We implemented the Vend-C pilot study in direct response to recent WHO recommendations. While self-test kits were effectively distributed from the two SDMs, our evaluation methodology failed. Consequently, we cannot determine the success of linkage to care. Even so, with HCV treatment numbers dropping in Australia, innovative engagement solutions are needed, and considering the number of self-test kits provided in our pilot, the model could have an important future place in HCV elimination efforts.
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Affiliation(s)
| | - David Jacka
- Monash Health, Dandenong, Victoria, Australia
| | | | - Jack Gunn
- Burnet Institute, Melbourne, Victoria, Australia
| | - Mark Stoove
- Burnet Institute, Melbourne, Victoria, Australia
| | | | | | - Peter Higgs
- Burnet Institute, Melbourne, Victoria, Australia
| | - Paul Dietze
- Burnet Institute, Melbourne, Victoria, Australia
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2
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Dawe J, Cassano D, Keane R, Ruth S, Wilkinson AL, Elsum I, Gunn J, Brown G, West M, Hoy J, Power J, Stoové M. Quality of life among people living with HIV aged 50 years and over in Australia: Identifying opportunities to support better ageing. HIV Med 2023; 24:1253-1267. [PMID: 37990812 DOI: 10.1111/hiv.13592] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Accepted: 11/14/2023] [Indexed: 11/23/2023]
Abstract
OBJECTIVES Improved life expectancy has led to an ageing population of people living with HIV in most countries. Research on ageing among people living with HIV has predominantly focused on physical and health-related quality of life rather than multidimensional quality of life. We measured quality of life among older people living with HIV in Australia and identified opportunities to guide the development and implementation of appropriate interventions. METHODS In a national health and wellbeing survey of Australian people living with HIV, participants aged ≥50 years completed additional questions relevant to ageing. Quality of life was measured using PozQoL, a validated multidimensional instrument assessing quality of life among people living with HIV (range 1-5). Exploratory bivariate analyses aimed to identify sociodemographic characteristics associated with quality of life. Adjusted linear regressions aimed to assess changes in PozQoL score associated with recent experiences (last 12 months) of four exposures: food insecurity, HIV-related stigma, isolation from the HIV community, and difficulties accessing non-HIV health services. RESULTS Among 319 older people living with HIV, the mean PozQol score was 3.30 (95% confidence interval [CI] 3.20-3.39). In bivariate analyses, PozQol scores were significantly higher among participants who were older (p = 0.006), had higher educational attainment (p = 0.009), were in a relationship (p = 0.005), were employed (p = 0.005), and had a higher income (p = 0.001). In adjusted regression models, PozQoL scores were lower among participants who reported recent experiences of food insecurity (β -0.49; 95% CI -0.74 to -0.24), stigma (β -0.53; 95% CI -0.73 to -0.33), isolation from the HIV community (β -0.49; 95% CI -0.70 to -0.29), and difficulties accessing non-HIV health services (β -0.50; 95% CI -0.71 to -0.30). CONCLUSIONS Overall, older people living with HIV in this study had a moderate quality of life. Our findings suggest that HIV services should integrate programmes to support economic security and foster connections within the HIV community and across health services.
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Affiliation(s)
- Joshua Dawe
- Burnet Institute, Public Health Discipline, Melbourne, Victoria, Australia
| | - Dean Cassano
- Burnet Institute, Public Health Discipline, Melbourne, Victoria, Australia
| | - Richard Keane
- Living Positive Victoria, Melbourne, Victoria, Australia
| | - Simon Ruth
- Thorne Harbour Health, Melbourne, Victoria, Australia
| | - Anna Lee Wilkinson
- Burnet Institute, Public Health Discipline, Melbourne, Victoria, Australia
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
- University of Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Imogen Elsum
- Burnet Institute, Public Health Discipline, Melbourne, Victoria, Australia
| | - Jack Gunn
- Burnet Institute, Public Health Discipline, Melbourne, Victoria, Australia
| | - Graham Brown
- Australian Research Centre in Sex, Health and Society, La Trobe University, Melbourne, Victoria, Australia
| | - Michael West
- Department of Health, Melbourne, Victoria, Australia
| | - Jennifer Hoy
- Department of Infectious Diseases, The Alfred Hospital and Monash University, Melbourne, Victoria, Australia
| | - Jennifer Power
- Australian Research Centre in Sex, Health and Society, La Trobe University, Melbourne, Victoria, Australia
| | - Mark Stoové
- Burnet Institute, Public Health Discipline, Melbourne, Victoria, Australia
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
- Australian Research Centre in Sex, Health and Society, La Trobe University, Melbourne, Victoria, Australia
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3
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Missirlian M, Firdaouss M, Richou M, Hernandez C, Gargiulo L, Bucalossi J, Brun C, Corre Y, Delmas E, Greuner H, Guillermin B, Gunn J, Hatchressian J, Jalageas R, Li Q, Lipa M, Lozano M, Luo G, Pocheau C, Roche H, Tsitrone E, Vignal N, Wang W, Saille A, Zago B. Manufacturing, testing and installation of the full tungsten actively cooled ITER-like divertor in the WEST tokamak. Fusion Engineering and Design 2023. [DOI: 10.1016/j.fusengdes.2023.113683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/29/2023]
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4
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Gunn J, O'Keefe D, Draper BL, Djordjevic F, Ryan K, Kerr P, Elsum I, Gold J, Layton C, Chan K, Dietze P, Higgs P, Doyle J, Stoové MA, Hellard M, Pedrana A. The eliminate hepatitis C (EC) experience study: baseline characteristics of a cohort of people who inject drugs in Melbourne, Australia. BMJ Open 2023; 13:e071665. [PMID: 37400235 DOI: 10.1136/bmjopen-2023-071665] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/05/2023] Open
Abstract
OBJECTIVES Direct-acting antivirals provide an opportunity to eliminate hepatitis C virus (HCV) as a public health threat in Australia, yet barriers to care remain. In this study, we use baseline data from a longitudinal cohort of people who inject drugs to understand differences in participant characteristics and explore experiences of stigma, health service utilisation and health literacy between three care cascade groups. DESIGN Cross-sectional. SETTING Community and private primary healthcare services in Melbourne, Australia. PARTICIPANTS Participants completed baseline surveys between 19 September 2018 and 15 December 2020. We recruited 288 participants; the median age was 42 years (IQR: 37-49 years) and 198 (69%) were male. At baseline, 103 (36%) self-reported being 'not engaged in testing', 127 (44%) had HCV RNA positivity but were 'not engaged in treatment' and 58 (20%) were 'engaged in HCV treatment'. OUTCOME MEASURES Descriptive statistics were used to present the baseline demographics, health service utilisation and experiences of stigma data. We explored differences in these scales between participant demographics using χ2 test or fisher's exact tests, and differences between health literacy scores using one-way analysis of variance tests. RESULTS A majority were in regular contact with multiple health services, and most had previously been identified as at-risk of HCV. In the 12 months preceding baseline, 70% reported any experiences of stigma related to injecting drug use. Assessment of health literacy data identified gaps for those 'not engaged in testing' and 'not engaged in treatment' across two relevant domains: 'ability to appraise health information' and 'ability to actively engage with healthcare providers'. CONCLUSION In eliminate hepatitis C experience, lower HCV testing and treatment may be explained by experiences of stigmatisation or gaps in health literacy. Enhanced interventions targeting people who inject drugs to promote HCV care are needed.
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Affiliation(s)
- Jack Gunn
- Disease Elimination Program, Burnet Institute, Melbourne, Victoria, Australia
| | - Daniel O'Keefe
- Disease Elimination Program, Burnet Institute, Melbourne, Victoria, Australia
- School of Public Health and Preventive Medicine, Monash University, Clayton, Victoria, Australia
| | - Bridget Louise Draper
- Disease Elimination Program, Burnet Institute, Melbourne, Victoria, Australia
- School of Public Health and Preventive Medicine, Monash University, Clayton, Victoria, Australia
| | - Filip Djordjevic
- Disease Elimination Program, Burnet Institute, Melbourne, Victoria, Australia
| | - Kathleen Ryan
- Disease Elimination Program, Burnet Institute, Melbourne, Victoria, Australia
| | - Phoebe Kerr
- Disease Elimination Program, Burnet Institute, Melbourne, Victoria, Australia
| | - Imogen Elsum
- Disease Elimination Program, Burnet Institute, Melbourne, Victoria, Australia
| | - Judy Gold
- Disease Elimination Program, Burnet Institute, Melbourne, Victoria, Australia
- School of Public Health and Preventive Medicine, Monash University, Clayton, Victoria, Australia
| | - Chloe Layton
- Disease Elimination Program, Burnet Institute, Melbourne, Victoria, Australia
| | - Kico Chan
- Disease Elimination Program, Burnet Institute, Melbourne, Victoria, Australia
| | - Paul Dietze
- School of Public Health and Preventive Medicine, Monash University, Clayton, Victoria, Australia
- National Drug Research Institute, Curtin University, Perth, Western Australia, Australia
- Behaviours and Health Risks Program, Burnet Institute, Melbourne, Victoria, Australia
| | - Peter Higgs
- Behaviours and Health Risks Program, Burnet Institute, Melbourne, Victoria, Australia
- Department of Public Health, La Trobe University, Bundoora, Victoria, Australia
| | - Joseph Doyle
- Disease Elimination Program, Burnet Institute, Melbourne, Victoria, Australia
- School of Public Health and Preventive Medicine, Monash University, Clayton, Victoria, Australia
| | - Mark A Stoové
- Disease Elimination Program, Burnet Institute, Melbourne, Victoria, Australia
- School of Public Health and Preventive Medicine, Monash University, Clayton, Victoria, Australia
| | - Margaret Hellard
- Disease Elimination Program, Burnet Institute, Melbourne, Victoria, Australia
- School of Public Health and Preventive Medicine, Monash University, Clayton, Victoria, Australia
- Department of Infectious Diseases, The Alfred and Monash University, Melbourne, Victoria, Australia
- Doherty Institute and Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Alisa Pedrana
- Disease Elimination Program, Burnet Institute, Melbourne, Victoria, Australia
- School of Public Health and Preventive Medicine, Monash University, Clayton, Victoria, Australia
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5
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Maeker J, Nichols J, Donovan D, Grosjean A, Gunn J, Fedorczak N, Guillemaut C, Klepper C, Unterberg E, Easley D, Team WEST. OEDGE modeling of far-SOL tungsten impurity sources and screening in WEST. Nuclear Materials and Energy 2022. [DOI: 10.1016/j.nme.2022.101309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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6
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Kirwan A, Winter R, Gunn J, Djordjevic F, Curtis M, Gough C, Dietze PM. The feasibility of a drug consumption room in the Australian Capital Territory. Drug Alcohol Rev 2022; 41:1440-1443. [PMID: 35038373 DOI: 10.1111/dar.13427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2021] [Revised: 12/10/2021] [Accepted: 12/10/2021] [Indexed: 11/29/2022]
Affiliation(s)
| | - Rebecca Winter
- Burnet Institute, Melbourne, Australia.,Department of Gastroenterology, St Vincent's Hospital Melbourne, Melbourne, Australia.,School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Jack Gunn
- Burnet Institute, Melbourne, Australia
| | - Filip Djordjevic
- Burnet Institute, Melbourne, Australia.,Centre for Alcohol Policy Research, La Trobe University, Melbourne, Australia
| | - Michael Curtis
- Burnet Institute, Melbourne, Australia.,School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.,Monash Addiction Research Centre, Monash University, Melbourne, Australia
| | - Chris Gough
- Canberra Alliance for Harm Minimisation and Advocacy, Canberra, Australia
| | - Paul M Dietze
- Burnet Institute, Melbourne, Australia.,National Drug Research Institute and enAble Institute, Faculty of Health Sciences, Curtin University, Melbourne, Australia
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7
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O'Keefe D, Gunn J, Ryan K, Djordjevic F, Kerr P, Gold J, Elsum I, Layton C, Chan K, Dietze P, Higgs P, Doyle J, Stoové MA, Hellard M, Pedrana AE. Exploring hepatitis C virus testing and treatment engagement over time in Melbourne, Australia: a study protocol for a longitudinal cohort study (EC-Experience Cohort study). BMJ Open 2022; 12:e057618. [PMID: 34983773 PMCID: PMC8728403 DOI: 10.1136/bmjopen-2021-057618] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Accepted: 12/16/2021] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION The advent of direct acting antiviral therapy for hepatitis C virus (HCV) means the elimination of HCV is possible but requires sustained effort to achieve. Between 2016 and 2019, 44% of those living with HCV were treated in Australia. However, treatment uptake has declined significantly. In Australia, people who inject drugs (PWID) are the population most at risk of HCV acquisition. Eliminating HCV in Australia will require nuanced understanding of the barriers to HCV treatment experienced by PWID and tailored interventions to address these barriers. The EC-Experience Cohort study aims to explore the barriers and enablers reported by PWID to engagement in HCV care. METHODS AND ANALYSIS The EC-Experience Cohort study is a prospective cohort of PWID, established in Melbourne, Australia in 2018. Participants are assigned into three study groups: (1) those not currently engaged in HCV testing; (2) those diagnosed with HCV but not currently engaged in treatment and (3) those completed treatment. Participants complete a total of four interviews every 6 months across an 18-month study period. Predictors of experience of key outcome events along the HCV care cascade will be explored over time. ETHICS AND DISSEMINATION Ethical approval for the EC-Experience Cohort study was obtained by the Alfred Hospital Ethics Committee in Melbourne, Australia (Project Number: HREC/16/Alfred/164). All eligible participants are assessed for capacity to consent and partake in a thorough informed consent process. Results from the EC-Experience Cohort study will be disseminated via national and international scientific and public health conferences and peer-reviewed journal publications. Data from the EC-Experience Cohort study will improve the current understanding of the barriers to HCV care for PWID and guide the tailoring of service provision for specific subgroups. Understanding the barriers and how to increase engagement in care of PWID is critical to achieve HCV elimination goals.
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Affiliation(s)
- Daniel O'Keefe
- Disease Elimination Program, Burnet Institute, Melbourne, Victoria, Australia
- School of Public Health and Preventive Medicine, Monash University, Clayton, Victoria, Australia
| | - J Gunn
- Disease Elimination Program, Burnet Institute, Melbourne, Victoria, Australia
| | - Kathleen Ryan
- Disease Elimination Program, Burnet Institute, Melbourne, Victoria, Australia
| | - Filip Djordjevic
- Disease Elimination Program, Burnet Institute, Melbourne, Victoria, Australia
| | - Phoebe Kerr
- Disease Elimination Program, Burnet Institute, Melbourne, Victoria, Australia
| | - Judy Gold
- Disease Elimination Program, Burnet Institute, Melbourne, Victoria, Australia
- School of Public Health and Preventive Medicine, Monash University, Clayton, Victoria, Australia
| | - Imogen Elsum
- Disease Elimination Program, Burnet Institute, Melbourne, Victoria, Australia
| | - Chloe Layton
- Disease Elimination Program, Burnet Institute, Melbourne, Victoria, Australia
- Department of Infectious Diseases, The Alfred Hospital, Melbourne, Victoria, Australia
| | - Kico Chan
- Disease Elimination Program, Burnet Institute, Melbourne, Victoria, Australia
| | - Paul Dietze
- Disease Elimination Program, Burnet Institute, Melbourne, Victoria, Australia
- School of Public Health and Preventive Medicine, Monash University, Clayton, Victoria, Australia
- National Drug Research Institute, Curtin University, Perth, Western Australia, Australia
| | - Peter Higgs
- Disease Elimination Program, Burnet Institute, Melbourne, Victoria, Australia
- National Drug Research Institute, Curtin University, Perth, Western Australia, Australia
- Department of Public Health, La Trobe University, Bundoora, Victoria, Australia
| | - Joseph Doyle
- Disease Elimination Program, Burnet Institute, Melbourne, Victoria, Australia
- Department of Infectious Diseases, The Alfred Hospital, Melbourne, Victoria, Australia
| | - Mark A Stoové
- Disease Elimination Program, Burnet Institute, Melbourne, Victoria, Australia
- School of Public Health and Preventive Medicine, Monash University, Clayton, Victoria, Australia
| | - Margaret Hellard
- Disease Elimination Program, Burnet Institute, Melbourne, Victoria, Australia
- Department of Infectious Diseases, The Alfred Hospital, Melbourne, Victoria, Australia
- Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia
- School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
| | - A E Pedrana
- Disease Elimination Program, Burnet Institute, Melbourne, Victoria, Australia
- Centre for Social Research in Health, University of New South Wales, Sydney, New South Wales, Australia
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8
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Djordjevic F, Ryan K, Gunn J, Brener L, O'Keefe D, Draper B, Schroeder S, Gold J, Treloar C, Broady T, Dietze P, Hellard M, Pedrana A. Health service utilization and experiences of stigma amongst people who inject drugs in Melbourne, Australia. J Viral Hepat 2021; 28:1738-1743. [PMID: 34510655 DOI: 10.1111/jvh.13612] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [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: 05/19/2021] [Revised: 08/24/2021] [Accepted: 08/30/2021] [Indexed: 12/09/2022]
Abstract
Whilst the testing and treatment of people who inject drugs (PWID) in Australia is a priority for local hepatitis C (HCV) elimination efforts, perceived stigma related to injecting drug use (IDU) has been identified as a major barrier for PWID engaging in health services. We used data from the EC Experience cohort study to explore associations between IDU-related perceived stigma and the number of different health services accessed by PWID in Melbourne, Australia. Data from the baseline questionnaire were used. Primary outcome was self-reported experience of stigma due to IDU (never, rarely, sometimes, often, always) in the previous 12 months. An ordinal logistic regression model assessed the association between stigma experienced and the number of different health services used (1-2, 3-4, 5-6, 7-10 different services) adjusted for recent IDU and key socio-demographics. Between September 2018 and February 2020, 281 participants were recruited from four health services. Sixty-nine per cent were male, median age was 42, 83% reported past-month IDU, 34% had never tested/tested >12 months, 8% tested negative <12 months, 43% were HCV-positive but not treated and 16% had been treated. Those accessing 5-6 services had 2.2 times greater odds of experiencing stigma (95% CI 0.86-6.65) compared with those using <5 services and those reporting 7-10 services had 2.43 times greater odds of experiencing stigma (95% CI 0.85-6.92) compared with those accessing <7 services. In conclusion, experiences of stigma may not necessarily be a barrier for PWID to access health services, but high rates of health service use may further expose, exacerbate or exaggerate stigma amongst PWID. Further examination of how stigma may be in/directly impact on hepatitis C treatment uptake is important and place-based interventions aimed at reducing stigma experienced by PWID may be needed.
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Affiliation(s)
- Filip Djordjevic
- Disease Elimination Program, Burnet Institute, Melbourne, Vic., Australia.,Behaviours and Health Risks Program, Burnet Institute, Melbourne, Vic., Australia
| | - Kathleen Ryan
- Disease Elimination Program, Burnet Institute, Melbourne, Vic., Australia.,Department of Infectious Diseases, The Alfred and Monash University, Melbourne, Vic., Australia
| | - Jack Gunn
- Disease Elimination Program, Burnet Institute, Melbourne, Vic., Australia
| | - Loren Brener
- Centre for Social Research in Health, The University of New South Wales, Sydney, NSW, Australia
| | - Daniel O'Keefe
- Disease Elimination Program, Burnet Institute, Melbourne, Vic., Australia.,Behaviours and Health Risks Program, Burnet Institute, Melbourne, Vic., Australia
| | - Bridget Draper
- Disease Elimination Program, Burnet Institute, Melbourne, Vic., Australia.,Centre for Social Research in Health, The University of New South Wales, Sydney, NSW, Australia
| | - Sophia Schroeder
- Disease Elimination Program, Burnet Institute, Melbourne, Vic., Australia.,School of Public Health and Preventive Medicine, Monash University, Melbourne, Vic., Australia
| | - Judy Gold
- Disease Elimination Program, Burnet Institute, Melbourne, Vic., Australia.,School of Public Health and Preventive Medicine, Monash University, Melbourne, Vic., Australia
| | - Carla Treloar
- Centre for Social Research in Health, The University of New South Wales, Sydney, NSW, Australia
| | - Tim Broady
- Centre for Social Research in Health, The University of New South Wales, Sydney, NSW, Australia
| | - Paul Dietze
- Behaviours and Health Risks Program, Burnet Institute, Melbourne, Vic., Australia
| | - Margaret Hellard
- Disease Elimination Program, Burnet Institute, Melbourne, Vic., Australia.,Department of Infectious Diseases, The Alfred and Monash University, Melbourne, Vic., Australia.,Centre for Social Research in Health, The University of New South Wales, Sydney, NSW, Australia.,Peter Doherty Institute for Infection and Immunity, Melbourne, Vic., Australia.,School of Population and Global Health, University of Melbourne, Carlton, Vic., Australia
| | - Alisa Pedrana
- Disease Elimination Program, Burnet Institute, Melbourne, Vic., Australia.,Centre for Social Research in Health, The University of New South Wales, Sydney, NSW, Australia
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9
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Schmauch E, Linna-Kuosmanen S, Galani K, Kang K, Adsera C, Park Y, Hollmen M, Gunn J, Kiviniemi T, Garcia-Cardena G, Kellis M. Single-cell transcriptional and epigenomic dissection of human heart in health and coronary artery disease reveals cell-type-specific driver genes and pathways. Atherosclerosis 2021. [DOI: 10.1016/j.atherosclerosis.2021.06.156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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10
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Gunn J, McNally S, Ryan J, Layton C, Bryant M, Walker S, O'Mahony C, Pedrana A. Barriers to hepatitis C treatment among secondary needle and syringe program clients and opportunities to intervene. Int J Drug Policy 2021; 96:103387. [PMID: 34330571 DOI: 10.1016/j.drugpo.2021.103387] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Revised: 07/02/2021] [Accepted: 07/08/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND At least 160,000 Australians are living with hepatitis C (HCV), many of whom are people who inject drugs and access needle and syringe programs (NSP). Secondary NSPs provide injecting equipment via health services that are not dedicated to the provision of services to people who inject drugs; these sites could be a suitable space to increase engagement of people who inject drugs in HCV treatment. Drawing on data from a pilot study exploring the potential of upscaling linkage to HCV care in secondary NSPs, the aim of this research was to explore barriers and enablers to HCV treatment for clients who use these services. METHODS We interviewed 34 people who inject drugs (who self-reported HCV positivity) from six secondary NSPs in urban and regional Victoria, Australia in 2018. Fifty per cent were male, with ages ranging from 33 to 58. Twenty-two (65%) had never received HCV treatment and none had experience with direct-acting antiviral (DAA) treatment. Interviews were transcribed and analysed thematically. Field notes from a program evaluation with feedback from secondary NSP staff was also used as a secondary data source. RESULTS Five themes encompassing a set of contrasting barriers and enablers to accessing HCV care through secondary NSPs were uncovered. Themes included 'misinformation' vs. 'multiple trusted information sources; 'lack of symptoms and motivation' vs. 'benefits of cure'; 'competing priorities' vs. 'willingness and readiness to be cured'; 'unsupportive relationships with staff' vs. 'supportive relationships with staff'; and 'inaccessibility and stigma in health services' vs. 'enhanced support'. Secondary program evaluation data also highlighted that secondary NSP staff were under-resourced and had limited capacity to implement HCV care linkage and information. CONCLUSION We identified contrasting barriers and opportunities for accessing DAAs among a sample of secondary NSP clients and staff. Interventions that consider individual, provider and health system level factors are needed if secondary NSP services are to become a suitable setting to initiate conversations with clients around HCV treatment and provide linkages to care.
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Affiliation(s)
- Jack Gunn
- Disease Elimination Program, Burnet Institute, Melbourne, Melbourne, Australia.
| | | | - John Ryan
- Penington Institute, Melbourne, Victoria, Australia
| | - Chloe Layton
- Disease Elimination Program, Burnet Institute, Melbourne, Melbourne, Australia
| | - Mellissa Bryant
- Disease Elimination Program, Burnet Institute, Melbourne, Melbourne, Australia
| | - Shelley Walker
- Disease Elimination Program, Burnet Institute, Melbourne, Melbourne, Australia
| | | | - Alisa Pedrana
- Disease Elimination Program, Burnet Institute, Melbourne, Melbourne, Australia; Department of Epidemiology and Preventative Medicine, Monash University, Melbourne, Victoria, Australia
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11
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Bisson R, Hodille E, Gaspar J, Douai D, Wauters T, Gallo A, Gunn J, Hakola A, Loarer T, Nouailletas R, Morales J, Pégourié B, Reux C, Sabot R, Tsitrone E, Vartanian S, Wang E, Fedorczak N, Brezinsek S. Deuterium and helium outgassing following plasma discharges in WEST: Delayed D outgassing during D-to-He changeover experiments studied with threshold ionization mass spectrometry. Nuclear Materials and Energy 2021. [DOI: 10.1016/j.nme.2020.100885] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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12
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Urbanczyk G, Fedorczak N, Gunn J, Colas L, Li J, Wang K. Perspective of analogy between heat loads and impurity production in L-mode discharges with ICRH in WEST. Nuclear Materials and Energy 2021. [DOI: 10.1016/j.nme.2021.100925] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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13
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Chan K, Elsum I, Gold J, Layton C, Accadia L, Bryant M, Gunn J, Djordjevic F, Purcell I, Dicka J, Forrest M, Crawford S, Hellard M, Pedrana A. Increasing hepatitis C testing and linkage to care: Results of a testing campaign with incentives at primary care clinics in Melbourne, Australia. J Viral Hepat 2021; 28:569-572. [PMID: 33259117 DOI: 10.1111/jvh.13447] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Revised: 09/16/2020] [Accepted: 11/02/2020] [Indexed: 12/09/2022]
Affiliation(s)
- Kico Chan
- Disease Elimination, Burnet Institute, Melbourne, Vic., Australia
| | - Imogen Elsum
- Disease Elimination, Burnet Institute, Melbourne, Vic., Australia
| | - Judy Gold
- Disease Elimination, Burnet Institute, Melbourne, Vic., Australia.,Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Vic., Australia
| | - Chloe Layton
- Disease Elimination, Burnet Institute, Melbourne, Vic., Australia.,Department of Infectious Diseases, The Alfred and Monash University, Melbourne, Vic., Australia
| | - Lisa Accadia
- Disease Elimination, Burnet Institute, Melbourne, Vic., Australia.,Department of Infectious Diseases, The Alfred and Monash University, Melbourne, Vic., Australia
| | - Mellissa Bryant
- Disease Elimination, Burnet Institute, Melbourne, Vic., Australia.,Department of Infectious Diseases, The Alfred and Monash University, Melbourne, Vic., Australia
| | - Jack Gunn
- Disease Elimination, Burnet Institute, Melbourne, Vic., Australia
| | - Filip Djordjevic
- Disease Elimination, Burnet Institute, Melbourne, Vic., Australia.,Behaviours and Health Risks, Burnet Institute, Melbourne, Vic., Australia
| | | | - Jane Dicka
- Harm Reduction Victoria, Melbourne, Vic., Australia
| | - Martin Forrest
- Hepatitis Victoria/LiverWELL, Melbourne, Vic., Australia
| | | | - Margaret Hellard
- Disease Elimination, Burnet Institute, Melbourne, Vic., Australia.,Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Vic., Australia.,Department of Infectious Diseases, The Alfred and Monash University, Melbourne, Vic., Australia.,Doherty Institute and School of Population and Global Health, University of Melbourne, Melbourne, Vic., Australia
| | - Alisa Pedrana
- Disease Elimination, Burnet Institute, Melbourne, Vic., Australia.,Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Vic., Australia
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Maaniitty E, Sinisilta S, Jalkanen J, Hollmen M, Biancari F, Gunn J, Jalkanen S, Airaksinen K, Kiviniemi T. Distinct circulating cytokine levels in patients with angiography-proven coronary artery disease compared to disease-free controls. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.1294] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Systemic inflammation has a critical role in the development of coronary artery disease (CAD). Identification of inflammatory pathways may provide a platform for novel therapeutic approaches.
Purpose
We sought to determine whether there are differences in circulating cytokine profiles between patients with CAD and disease-free controls.
Methods
Study population consisted of 458 patients who underwent diagnostic invasive coronary angiography for clinical indications. Altogether 312 patients had angiographically significant CAD whereas 146 had no angiographically-detected coronary atherosclerosis. We measured the serum concentrations of 48 circulating cytokines.
Results
Patients with CAD had increased levels of interleukin-1 receptor antagonist (IL-1-RA), interleukin-2 receptor alpha (IL-2Rα), IL-3, IL-4, IL-6, IL-9, IL-10, IL-16, IL-17, IL-18, granulocyte-macrophage colony-stimulating factor (GM-CSF), platelet-derived growth factor-BB (PDGF-BB), macrophage inflammatory protein-1-beta (MIP-1-β), tumor necrosis factor-alpha (TNF-α), TNF-β, cutaneous T-cell-attracting chemokine (CTACK), growth regulated oncogene alpha (GRO-α), hepatocyte growth factor (HGF), interferon alpha-2 (IFNα-2), leukemia inhibitory factor (LIF), macrophage colony-stimulating factor (M-CSF), macrophage migration inhibitory factor (MIF), monokine induced by gamma interferon (MIG), beta-nerve growth factor (β-NGF), stem cell factor (SCF) and stromal cell-derived factor 1 alfa (SDF1α). On a logistic multivariate regression model adjusted with age, sex, hypertension and treatment for diabetes, increased levels of IL-4 (p=0.027, OR 1.090), IL-9 (p=0.000, OR 1.013), IL-17 (p=0.011, OR 1.005), CTACK (p=0.008, OR 1.001), MIP-1-β (p=0.004, OR 1.006), GRO-α (p=0.008, OR 1.004), TNF-α (p=0.019, OR 1.011) were independently associated with atherosclerosis.
Conclusions
Patients with CAD have distinct circulating cytokine profiles compared to disease-free controls. Based on these findings, certain cytokines may have a pivotal role in the development of atherosclerotic cardiovascular disease and cytokine-mediated pathway appear as a promising target for cardiovascular drug development.
Funding Acknowledgement
Type of funding source: Foundation. Main funding source(s): The Finnish Medical Foundation, Helsinki, Finland; The Finnish Foundation for Cardiovascular Research, Helsinki, Finland
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Affiliation(s)
| | | | - J Jalkanen
- Turku University Hospital, Turku, Finland
| | | | | | - J Gunn
- Turku University Hospital, Turku, Finland
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15
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Kyto V, Sipila J, Pikkarainen E, Rautava P, Gunn J. 2227Limited impact of concomitant coronary artery by-pass grafting on long-term outcomes after surgical aortic valve replacement: a nationwide propensity matched study. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.0123] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Objective
Coronary artery disease is a common comorbidity of aortic stenosis. Addition of coronary artery by-pass grafting (CABG) to surgical aortic valve replacement (SAVR) is viable solution for treating both. Modern era impact of concomitant CABG to long-term outcomes is however inadequately known. We set out to study long-term outcomes of patients with or without CABG added to SAVR.
Methods
Patients (excluding infective endocarditis) aged ≥50 years with isolated first-time SAVR with or without CABG in Finland between 2004–2014 (n=7060) were retrospectively studied using nationwide registries. Propensity score matching (1:1) was used to identify patients with comparable baseline features (n=2188 with and n=2188 without concomitant CABG). Outcomes were 10-year all-cause mortality, stroke, major bleeding and myocardial infarction. Median follow-up was 6.1 years.
Results
In matched population mortality after SAVR was comparable with or without CABG (31.0% vs. 32.7%; HR 1.05; CI 0.93–1.20; p=0.428). However, if CABG was performed solely with venous grafts mortality was higher (35.9%; HR 1.21; CI 1.02–1.43; p=0.030 vs. no-CABG). Myocardial infarction was more common in patients with CABG (13.4% vs. 6.9%; HR 1.62; CI 1.22–2.17; p=0.0008). Occurrence of stroke was comparable with or without CABG (15.1% vs. 13.5%; p=0.933). Rate on any major bleeding was also comparable (20.0% with vs. 21.9% without CABG; p=0.496). Gastrointestinal (8.1% vs. 10.3%; p=0.978) and intracranial bleeds (6.0% vs. 5.5%; p=0.383) were also comparable between study groups.
Conclusions
Matched patients with or without concomitant CABG had comparable long-term mortality, stroke and major bleeding rates after SAVR. Our results suggest that successful concomitant CABG has limited impact on long-term outcomes after SAVR.
Acknowledgement/Funding
Finnish Cardiac Society, Finnish Cultural Foundation, Governmental VTR-funding
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Affiliation(s)
- V Kyto
- Turku University Hospital, Turku, Finland
| | - J Sipila
- North Karelia Central Hospital, Joensuu, Finland
| | | | | | - J Gunn
- Turku University Hospital, Turku, Finland
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16
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Zun PS, Narracott AJ, Chiastra C, Gunn J, Hoekstra AG. Location-Specific Comparison Between a 3D In-Stent Restenosis Model and Micro-CT and Histology Data from Porcine In Vivo Experiments. Cardiovasc Eng Technol 2019; 10:568-582. [PMID: 31531821 PMCID: PMC6863796 DOI: 10.1007/s13239-019-00431-4] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Accepted: 09/07/2019] [Indexed: 11/25/2022]
Abstract
Background Coronary artery restenosis is an important side effect of percutaneous coronary intervention. Computational models can be used to better understand this process. We report on an approach for validation of an in silico 3D model of in-stent restenosis in porcine coronary arteries and illustrate this approach by comparing the modelling results to in vivo data for 14 and 28 days post-stenting. Methods This multiscale model includes single-scale models for stent deployment, blood flow and tissue growth in the stented vessel, including smooth muscle cell (SMC) proliferation and extracellular matrix (ECM) production. The validation procedure uses data from porcine in vivo experiments, by simulating stent deployment using stent geometry obtained from micro computed tomography (micro-CT) of the stented vessel and directly comparing the simulation results of neointimal growth to histological sections taken at the same locations. Results Metrics for comparison are per-strut neointimal thickness and per-section neointimal area. The neointimal area predicted by the model demonstrates a good agreement with the detailed experimental data. For 14 days post-stenting the relative neointimal area, averaged over all vessel sections considered, was 20 ± 3% in vivo and 22 ± 4% in silico. For 28 days, the area was 42 ± 3% in vivo and 41 ± 3% in silico. Conclusions The approach presented here provides a very detailed, location-specific, validation methodology for in silico restenosis models. The model was able to closely match both histology datasets with a single set of parameters. Good agreement was obtained for both the overall amount of neointima produced and the local distribution. It should be noted that including vessel curvature and ECM production in the model was paramount to obtain a good agreement with the experimental data. Electronic supplementary material The online version of this article (10.1007/s13239-019-00431-4) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- P S Zun
- Institute for Informatics, Faculty of Science, University of Amsterdam, Amsterdam, The Netherlands.
- Biomechanics Laboratory, Department of Biomedical Engineering, Erasmus Medical Center, Rotterdam, The Netherlands.
- National Center for Cognitive Technologies, ITMO University, Saint Petersburg, Russia.
| | - A J Narracott
- Department of Infection, Immunity & Cardiovascular Disease, University of Sheffield, Sheffield, UK
- Insigneo Institute for In Silico Medicine, University of Sheffield, Sheffield, UK
| | - C Chiastra
- Laboratory of Biological Structure Mechanics (LaBS), Department of Chemistry, Materials and Chemical Engineering "Giulio Natta", Politecnico di Milano, Milan, Italy
- PoliToBIOMed Lab, Department of Mechanical and Aerospace Engineering, Politecnico di Torino, Turin, Italy
| | - J Gunn
- Department of Infection, Immunity & Cardiovascular Disease, University of Sheffield, Sheffield, UK
- Insigneo Institute for In Silico Medicine, University of Sheffield, Sheffield, UK
| | - A G Hoekstra
- Institute for Informatics, Faculty of Science, University of Amsterdam, Amsterdam, The Netherlands
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Helminen O, Kytö V, Kauppila JH, Gunn J, Lagergren J, Sihvo E. Population-based study of anastomotic stricture rates after minimally invasive and open oesophagectomy for cancer. BJS Open 2019; 3:634-640. [PMID: 31592081 PMCID: PMC6773660 DOI: 10.1002/bjs5.50176] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2018] [Revised: 01/16/2019] [Accepted: 04/01/2019] [Indexed: 12/19/2022] Open
Abstract
Background The population‐based incidence of anastomotic stricture after minimally invasive oesophagectomy (MIO) and open oesophagectomy (OO) is not known. The aim of this study was to compare rates of anastomotic stricture requiring dilatation after the two approaches in an unselected cohort using nationwide data from Finland and Sweden. Methods All patients who had MIO or OO for oesophageal cancer between 2007 and 2014 were identified from nationwide registries in Finland and Sweden. Outcomes were the overall rate of anastomotic stricture and need for single or repeated (3 or more) dilatations for stricture within the first year after surgery. Multivariable Cox regression provided hazard ratios (HRs) with 95 per cent confidence intervals, adjusted for age, sex, co‐morbidity, histology, stage, year, country, hospital volume, length of hospital stay and readmissions. Results Some 239 patients underwent MIO and 1430 had an open procedure. The incidence of strictures requiring one dilatation was 16·7 per cent, and that for strictures requiring three or more dilatations was 6·6 per cent. The HR for strictures requiring one dilatation was not increased after MIO compared with that after OO (HR 1·19, 95 per cent c.i. 0·66 to 2·12), but was threefold higher for repeated dilatations (HR 3·25, 1·43 to 7·36). Of 18 strictures following MIO, 14 (78 per cent) occurred during the first 2 years after initiating this approach. Conclusion The need for endoscopic anastomotic dilatation after oesophagectomy was common, and the need for repeated dilatation was higher after MIO than following OO. The increased risk after MIO may reflect a learning curve.
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Affiliation(s)
- O Helminen
- Department of Surgery Central Finland Central Hospital Jyväskylä Finland.,Cancer and Translational Medicine Research Unit, Medical Research Centre Oulu University of Oulu Oulu Finland.,Department of Surgery Oulu University Hospital Oulu Finland
| | - V Kytö
- Heart Centre Turku University Hospital Turku Finland.,Research Centre of Applied and Preventive Cardiovascular Medicine University of Turku Turku Finland
| | - J H Kauppila
- Cancer and Translational Medicine Research Unit, Medical Research Centre Oulu University of Oulu Oulu Finland.,Department of Surgery Oulu University Hospital Oulu Finland.,Upper Gastrointestinal Surgery, Department of Molecular Medicine and Surgery, Karolinska Institutet Karolinska University Hospital Stockholm Sweden
| | - J Gunn
- Heart Centre Turku University Hospital Turku Finland.,Department of Surgery, Faculty of Medicine University of Turku Turku Finland
| | - J Lagergren
- Upper Gastrointestinal Surgery, Department of Molecular Medicine and Surgery, Karolinska Institutet Karolinska University Hospital Stockholm Sweden.,School of Cancer and Pharmaceutical Sciences King's College London London UK.,Guy's and St Thomas' NHS Foundation Trust London UK
| | - E Sihvo
- Department of Surgery Central Finland Central Hospital Jyväskylä Finland
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18
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Gunn J, Higgs P. Directly observed hepatitis C treatment with opioid substitution therapy in community pharmacies: A qualitative study. Res Social Adm Pharm 2019; 16:1298-1301. [PMID: 31003763 DOI: 10.1016/j.sapharm.2019.04.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Revised: 03/22/2019] [Accepted: 04/07/2019] [Indexed: 12/25/2022]
Abstract
BACKGROUND The hepatitis C virus (HCV) will only be eliminated through successful engagement with people who inject drugs (PWID), however some of this population experience socioeconomic and individual issues that can lead to poor HCV treatment adherence. A key sub-group of (PWID) are those who receive opioid substitution therapy (OST). In Australia, OST is most often delivered under direct supervision by a community pharmacist every day or multiple times a week. This regular interaction could be an ideal opportunity to enhance direct-acting antiviral (DAA) treatment adherence under directly observed therapy (DOT) by the pharmacist. AIM The aim of this study was to explore the perspectives of OST patients with a lived experience of HCV to understand whether or not dispensing DAAs in the same way as, or simultaneously with OST would benefit HCV treatment. METHODS Data collection occurred from June to August 2017. Semi-structured interviews were conducted with a sample of PWID living with HCV and on OST programs (n = 12) in Melbourne, Australia. Interviews were voice recorded and transcribed in verbatim. Interpretive phenomenology guided analysis of the data. RESULTS Themes reported by participants that provide insight into the suitability of DOT of DAAs include: Adherence and non-adherence to DAA treatment; Mixed views towards DOT of DAAs; Experiences and perceptions of OST providers; and Perceived stigma in the pharmacy. CONCLUSIONS Community pharmacies offering OST may be an effective place for DOT of HCV treatment, but is likely only to benefit people who face significant challenges to adherence. We suggest that a positive pharmacist-patient relationship, high OST adherence, and commitment to reducing stigma in the pharmacy would be necessary for the intervention to be effective. Further research is needed to evaluate the expanded-role of community pharmacies in improving DAA adherence and eliminating HCV.
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Affiliation(s)
- Jack Gunn
- Disease Elimination, Burnet Institute, Melbourne, VIC, Australia.
| | - Peter Higgs
- Disease Elimination, Burnet Institute, Melbourne, VIC, Australia; Department of Public Health, La Trobe University, Melbourne, VIC, Australia
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Gunn J, Higgs P. Pharmacy-led hepatitis C treatment pathways to help ensure elimination. Lancet Gastroenterol Hepatol 2019; 4:12-13. [DOI: 10.1016/s2468-1253(18)30380-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2018] [Accepted: 10/26/2018] [Indexed: 10/27/2022]
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20
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Gaspar J, Coenen J, Corre Y, Dejarnac R, Firdaouss M, Clairet F, Gunn J, Iglesias D, Komm M, Krieger K, Matthews G, Pitts R, Silburn S. Heat flux analysis of Type-I ELM impact on a sloped, protruding surface in the JET bulk tungsten divertor. Nuclear Materials and Energy 2018. [DOI: 10.1016/j.nme.2018.10.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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21
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Parker W, Gosling R, Churton A, Parviz Y, Iqbal J, Heppenstall J, Teare D, Gunn J. P28 DOES MILD CORONARY ARTERY ATHEROSCLEROSIS PROGRESS AT SERIAL ANGIOGRAPHY? Cardiovasc Res 2018. [DOI: 10.1093/cvr/cvy216.031] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- W Parker
- Department of Infection, Immunity & Cardiovascular Disease, University of Sheffield Medical School, Sheffield, UK
- Department of Cardiology, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
| | - R Gosling
- Department of Infection, Immunity & Cardiovascular Disease, University of Sheffield Medical School, Sheffield, UK
- Department of Cardiology, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
| | - A Churton
- University of Birmingham Medical School, Birmingham, UK
| | - Y Parviz
- Department of Cardiology, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
| | - J Iqbal
- Department of Cardiology, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
| | - J Heppenstall
- Department of Cardiology, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
| | - D Teare
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - J Gunn
- Department of Infection, Immunity & Cardiovascular Disease, University of Sheffield Medical School, Sheffield, UK
- Department of Cardiology, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
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22
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Sinisilta S, Hollmen M, Gunn J, Ruohonen I, Jalkanen J, Airaksinen J, Jalkanen S, Kiviniemi T. P1656Circulating cytokines predict atrial fibrillation in patients undergoing open-heart coronary bypass. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.p1656] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- S Sinisilta
- Turku University Hospital, Heart Center, Turku, Finland
| | - M Hollmen
- University of Turku, MediCity Research Laboratory, Turku, Finland
| | - J Gunn
- Turku University Hospital, Heart Center, Turku, Finland
| | - I Ruohonen
- Turku University Hospital, Heart Center, Turku, Finland
| | - J Jalkanen
- University of Turku, MediCity Research Laboratory, Turku, Finland
| | - J Airaksinen
- Turku University Hospital, Heart Center, Turku, Finland
| | - S Jalkanen
- University of Turku, MediCity Research Laboratory, Turku, Finland
| | - T Kiviniemi
- Turku University Hospital, Heart Center, Turku, Finland
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23
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Lehto J, Kiviniemi T, Gunn J, Airaksinen J, Kyto V. P5338The occurrence of postpericardiotomy syndrome: association with operation type and post-operative mortality after open-heart operations. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy566.p5338] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- J Lehto
- Turku University Hospital and University of Turku, Heart Centre, Turku, Finland
| | - T Kiviniemi
- Turku University Hospital and University of Turku, Heart Centre, Turku, Finland
| | - J Gunn
- Turku University Hospital and University of Turku, Heart Centre, Turku, Finland
| | - J Airaksinen
- Turku University Hospital and University of Turku, Heart Centre, Turku, Finland
| | - V Kyto
- Turku University Hospital and University of Turku, Heart Centre and Research Centre of Applied and Preventive Cardiovascular Medicine, Turku, Finland
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24
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Viikinkoski E, Hollmen M, Jalkanen J, Gunn J, Airaksinen J, Jalkanen S, Kiviniemi T. P1655Preoperative predictors for systemic inflammatory response in open-heart surgery. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.p1655] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- E Viikinkoski
- Heart Centre, Turku University Hospital and University of Turku, Finland, Turku, Finland
| | - M Hollmen
- Medicity Research Laboratory, Department of Microbiology and Immunology, University of Turku, Turku, Turku, Finland
| | - J Jalkanen
- Department of Vascular Surgery, Turku University and Turku University Hospital, Turku, Finland, Turku, Finland
| | - J Gunn
- Heart Centre, Turku University Hospital and University of Turku, Finland, Turku, Finland
| | - J Airaksinen
- Heart Centre, Turku University Hospital and University of Turku, Finland, Turku, Finland
| | - S Jalkanen
- Medicity Research Laboratory, Department of Microbiology and Immunology, University of Turku, Turku, Turku, Finland
| | - T Kiviniemi
- Heart Centre, Turku University Hospital and University of Turku, Finland, Turku, Finland
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25
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Anand A, Cudmore S, Robertson S, Stephen J, Haga K, Weir CJ, Murray SA, Boyd K, Gunn J, Iqbal J, MacLullich A, Shenkin S, Fox KAA, Mills NL, Denvir MA. P4616Frailty assessment and risk prediction by GRACE score in older patients with acute myocardial infarction. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy563.p4616] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- A Anand
- University of Edinburgh, Centre for Cardiovascular Science, Edinburgh, United Kingdom
| | - S Cudmore
- Royal Infirmary of Edinburgh, Edinburgh, United Kingdom
| | - S Robertson
- Royal Infirmary of Edinburgh, Edinburgh, United Kingdom
| | - J Stephen
- Royal Infirmary of Edinburgh, Edinburgh, United Kingdom
| | - K Haga
- Royal Infirmary of Edinburgh, Edinburgh, United Kingdom
| | - C J Weir
- University of Edinburgh, Edinburgh, United Kingdom
| | - S A Murray
- University of Edinburgh, Edinburgh, United Kingdom
| | - K Boyd
- University of Edinburgh, Edinburgh, United Kingdom
| | - J Gunn
- University of Sheffield, Sheffield, United Kingdom
| | - J Iqbal
- University of Sheffield, Sheffield, United Kingdom
| | - A MacLullich
- University of Edinburgh, Edinburgh, United Kingdom
| | - S Shenkin
- University of Edinburgh, Edinburgh, United Kingdom
| | - K A A Fox
- University of Edinburgh, Edinburgh, United Kingdom
| | - N L Mills
- University of Edinburgh, Centre for Cardiovascular Science, Edinburgh, United Kingdom
| | - M A Denvir
- University of Edinburgh, Centre for Cardiovascular Science, Edinburgh, United Kingdom
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26
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Son S, Gosling R, Morris P, Gunn J. What will be the Impact of Virtual Coronary Physiology upon the Practice of Coronary Artery Bypass Grafting Surgery for Patients with Coronary Artery Disease? Int J Surg 2018. [DOI: 10.1016/j.ijsu.2018.05.712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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27
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Gunn J, Higgs P. Pharmacies dispensing opioid substitution therapy also play a role in hepatitis C virus elimination. J Am Pharm Assoc (2003) 2018; 58:245. [DOI: 10.1016/j.japh.2018.01.008] [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] [Received: 12/19/2017] [Revised: 01/06/2018] [Accepted: 01/27/2018] [Indexed: 01/26/2023]
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28
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Moreau P, Bucalossi J, Missirlian M, Samaille F, Courtois X, Gil C, Lotte P, Meyer O, Nardon E, Nouailletas R, Ravenel N, Travere J, Alarcon T, Antusch S, Aumeunier M, Barjat P, Belsare S, Bernard J, Bhandarkar M, Bottereau C, Bourdelle C, Brémond S, Camenen Y, Chaudhari V, Chavda C, Chernyshova M, Clairet F, Colnel J, Czarski T, Choi M, Colledani G, Corre Y, Daniel R, Davis D, Dejarnac R, Devynck P, Dhongde J, Douai D, Elbeze D, Escarguel A, Fenzi C, Figacz W, Guangwu Z, Giacalone J, Guirlet R, Gunn J, Hacquin S, Hao X, Harris J, Hoang G, Houry M, Imbeaux F, Jablonski S, Jardin A, Joshi H, Kasprowicz G, Klepper C, Kowalska-Strzeciwilk E, Kubkowska M, Kumar A, Kumar V, Kumari P, Laqua H, Le-Luyer A, Lee W, Lewerentz M, Lyu B, Malard P, Manenc L, Mansuri I, Marandet Y, Masand H, Mazon D, Molina D, Moureau G, Nam Y, Park H, Pascal J, Patel K, Patel M, Pozniak K, Radloff D, Ranjan S, Rapson C, Raupp G, Rieth M, Sabot R, Santraine B, Sestac D, Sharma M, Shen J, Signoret J, Soni J, Spring A, Spuig P, Sugandhi R, Treuterrer W, Tsitrone E, Varshney S, Vartanian S, Volpe D, Wang F, Werner A, Yun G, Zabolotny W, Zhao W. Measurements and controls implementation for WEST. Fusion Engineering and Design 2017. [DOI: 10.1016/j.fusengdes.2017.01.046] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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29
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Rothman A, Arnold N, Abou Hanna J, Rowland H, Poff B, Macdonald K, Nagy M, Panian T, Sundaram B, Pham P, Forouzan O, Gunn J, Lawrie A, Chronos N. P612Feasibility and safety of a wireless pulmonary artery pressure monitoring system in chronic porcine models of pulmonary hypertension. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx501.p612] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Killeen S, Gunn J, Hartley J. Surgical management of complicated and medically refractory inflammatory bowel disease during pregnancy. Colorectal Dis 2017; 19:123-138. [PMID: 27317641 DOI: 10.1111/codi.13413] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [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: 11/17/2015] [Accepted: 04/28/2016] [Indexed: 02/08/2023]
Abstract
AIM The medical management of inflammatory bowel disease (IBD) in pregnancy and the puerperium is well defined. Data on surgical management of complicated IBD in this setting are lacking. This study aimed to determine the optimal surgical strategy for medically refractory IBD during pregnancy and the puerperium. METHOD Three databases were systematically reviewed to identify all published series or case reports of women undergoing surgery for Crohn's disease (CD) or ulcerative colitis (UC) while pregnant or during the puerperium. RESULTS Thirty-two papers were identified, including 86 patients. Nearly one-fifth (18%) of cases were de novo presentations and intervention was required at all stages of pregnancy. UC refractory to medical treatment and perforated small bowel CD were the commonest indications for surgery. Operations used included colectomy, colectomy with mucous fistula and Turnbull-blowhole colostomy for complicated UC and open or laparoscopic small bowel resection with stoma formation for CD. Surgical intervention during the third trimester universally resulted in the onset of labour. Endoscopic and radiological interventions were rarely employed. In studies after 1980 there was no maternal or foetal mortality but there was an almost 50% preterm delivery rate. CONCLUSION Surgical management of complicated IBD during pregnancy and the puerperium needs to be tailored to disease severity, the type of complications and foetal status. It should involve gastroenterologists, colorectal surgeons, obstetricians and neonatal specialists in a multidisciplinary manner within a single unit.
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Affiliation(s)
- S Killeen
- Department of Colorectal Surgery, Castlehill Hospital, Cottingham, UK
| | - J Gunn
- Department of Colorectal Surgery, Castlehill Hospital, Cottingham, UK
| | - J Hartley
- Department of Colorectal Surgery, Castlehill Hospital, Cottingham, UK
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Gibson S, Center K, Gunn J, Craig C, Cragun J, Chase D, Barnes D. Using Quality of Life Data to Redesign Interventions and Allocate Resources toward Treatment and Survivorship in a Gynecologic Oncology Program. Gynecol Oncol 2016. [DOI: 10.1016/j.ygyno.2016.08.253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Ponte C, Floris A, Vaggers S, Goodfellow N, Sznajd J, O'Neill L, Piper J, Gunn J, Mankia K, Luqmani R. FRI0368 The Use of Ultrasound in The Diagnosis and Management of Patients with Giant Cell Arteritis: Experience of A Single Centre. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.3624] [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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Yeung A, Hocking J, Vaisey A, Lorch R, Guy R, Fairley CK, Smith K, Imrie J, Donovan B, Gunn J, Temple-Smith M. P04.16 “It opened my eyes” – examining the impact of the australian chlamydia control effectiveness pilot (accept) on chlamydia testing practices of general practitioners. Br J Vener Dis 2015. [DOI: 10.1136/sextrans-2015-052270.270] [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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Zhang R, Dsouza A, Gunn J, Esipova T, Vinogradov S, Glaser A, Jarvis L, Gladstone D, Pogue B. TH-AB-204-01: Cherenkov- Excited Luminescence Scanned Imaging (CELSI) for High-Resolution, Deep-Tissue, in Vivo Optical Molecular Imaging with Limited Radiation Dose. Med Phys 2015. [DOI: 10.1118/1.4926168] [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: 11/07/2022] Open
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Inkinen J, Kirjasuo K, Gunn J, Kuttila K. Penetrating trauma; experience from Southwest Finland between 1997 and 2011, a retrospective descriptive study. Eur J Trauma Emerg Surg 2014; 41:429-33. [DOI: 10.1007/s00068-014-0445-0] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2014] [Accepted: 09/01/2014] [Indexed: 11/30/2022]
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Bucalossi J, Missirlian M, Moreau P, Samaille F, Tsitrone E, van Houtte D, Batal T, Bourdelle C, Chantant M, Corre Y, Courtois X, Delpech L, Doceul L, Douai D, Dougnac H, Faïsse F, Fenzi C, Ferlay F, Firdaouss M, Gargiulo L, Garin P, Gil C, Grosman A, Guilhem D, Gunn J, Hernandez C, Keller D, Larroque S, Leroux F, Lipa M, Lotte P, Martinez A, Meyer O, Micolon F, Mollard P, Nardon E, Nouailletas R, Pilia A, Richou M, Salasca S, Travère JM. The WEST project: Testing ITER divertor high heat flux component technology in a steady state tokamak environment. Fusion Engineering and Design 2014. [DOI: 10.1016/j.fusengdes.2014.01.062] [Citation(s) in RCA: 96] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Missirlian M, Bucalossi J, Corre Y, Ferlay F, Firdaouss M, Garin P, Grosman A, Guilhem D, Gunn J, Languille P, Lipa M, Richou M, Tsitrone E. The WEST project: Current status of the ITER-like tungsten divertor. Fusion Engineering and Design 2014. [DOI: 10.1016/j.fusengdes.2014.01.050] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Hsiao S, Tovar-Lopez FJ, Gunn J, Spencer T, Halliday I, Perrault C, Evans PC. 292Endothelial cell forward migration in a disturbed wall shear stress environment is promoted by ROCK inhibition. Cardiovasc Res 2014. [DOI: 10.1093/cvr/cvu087.6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Killeen S, Souroullas P, Ho Tin H, Hunter IA, O'Grady H, Gunn J, Hartley JE. Outcomes of asymptomatic anastomotic leaks found on routine postoperative water-soluble enema following anterior resection for cancer. World J Surg 2014; 37:2700-4. [PMID: 23982778 DOI: 10.1007/s00268-013-2193-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
BACKGROUND The incidence and consequence of an anastomotic leak associated with low anterior resection for cancer mandates covering stoma in most cases. A water-soluble enema is often performed to assess anastomotic integrity prior to stoma reversal. The functional outcome following reversal in patients with occult radiologically detected leaks is poorly defined. The goal of the present study was to determine the functional outcome in patients with a radiologically detected anastomotic leak who subsequently underwent stoma reversal. METHODS This case control study used patients with and without radiologically detected occult anastomotic leak having undergone reversal of covering stomata. The study group was matched with controls for age, gender, procedure, tumor stage, and adjuvant/neoadjuvant therapy. Validated fecal incontinence quality of life (FIQL), Cleveland Clinic Fecal Incontinence Score (CCFIS), and the Memorial Sloan-Kettering Cancer Center (MSKCC) Bowel Function Index (BFI) were used. Patient satisfaction, medication use, and ancillary procedures prior to closure were also recorded. RESULTS Thirteen patients with radiologically detected occult anastomotic leaks and 13 matched controls were identified from a prospectively maintained database. The FIQL, CCFIS, and MSKCC BFI scores were significantly reduced in those with occult leaks. The mean number of radiological and surgical interventions was significantly greater in the patients with occult leaks. Antidiarrheal and bulking agent use, as well as patient satisfaction, were the same for both groups. Only one patient in the occult leak group would not undergo stoma reversal again. CONCLUSIONS Reversal of a defunctioning ileostomy in the presence of an occult radiological leak can be associated with poorer functional outcomes, but patient satisfaction is undiminished.
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Affiliation(s)
- S Killeen
- Academic Surgical Unit, Castle Hill Hospital, University of Hull, Cottingham, HU16 5JQ, UK,
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Caputo M, Chiastra C, Cianciolo C, Cutrì E, Dubini G, Gunn J, Keller B, Migliavacca F, Zunino P. Simulation of oxygen transfer in stented arteries and correlation with in-stent restenosis. Int J Numer Method Biomed Eng 2013; 29:1373-1387. [PMID: 23996860 DOI: 10.1002/cnm.2588] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [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: 12/19/2012] [Revised: 07/10/2013] [Accepted: 07/20/2013] [Indexed: 06/02/2023]
Abstract
Computational models are used to study the combined effect of biomechanical and biochemical factors on coronary in-stent restenosis, which is a postoperative remodeling and regrowth pathology of the stented arteries. More precisely, we address numerical simulations, on the basis of Navier-Stokes and mass transport equations, to study the role of perturbed wall shear stresses and reduced oxygen concentration in a geometrical model reconstructed from a real porcine artery treated with a stent. Joining in vivo and in silico tools of investigation has multiple benefits in this case. On one hand, the geometry of the arterial wall and of the stent closely correspond to a real implanted configuration. On the other hand, the inspection of histological tissue samples informs us on the location and intensity of in-stent restenosis. As a result, we are able to correlate geometrical factors, such as the axial variation of the artery diameter and its curvature; the numerical quantification of biochemical stimuli, such as wall shear stresses; and the availability of oxygen to the inner layers of the artery, with the appearance of in-stent restenosis. This study shows that the perturbation of the vessel curvature could induce hemodynamic conditions that stimulate undesired arterial remodeling.
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Affiliation(s)
- M Caputo
- LaBS, Department of Chemistry, Materials and Chemical Engineering 'Giulio Natta', Politecnico di Milano, Italy
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Moretti C, Fenning S, Parviz Y, Gunn J, D'Ascenzo F, Giusto F, Gaita F, Lane N, Iqbal J, Denvir M. Frailty assessment as a prognostic tool in elderly acute coronary syndrome patients to identify those approaching end-of-life: results from prospective multicenter fate-acs study. Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht309.p3083] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Roth AM, Hensel DJ, Gunn J, Fortenberry JD, Garfein R, Arno JN, Wiehe SE. P4.037 Use of Cell Phone Diaries to Understand Risk Contexts of Sexual Events Among Female Sex Workers. Br J Vener Dis 2013. [DOI: 10.1136/sextrans-2013-051184.0935] [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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Hocking J, Temple-Smith M, Guy R, Kong F, Low N, Donovan B, Law M, Kaldor J, Gunn J, Fairley C. P5.017 The Australian Chlamydia Control Effectiveness Pilot (ACCEPt): Early Results from a Randomised Trial of Annual Chlamydia Screening in General Practise. Br J Vener Dis 2013. [DOI: 10.1136/sextrans-2013-051184.1062] [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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Kidambi A, Mather AN, Uddin A, Motwani M, Ripley DP, Herzog B, Gunn J, Plein S, Greenwood JP. 093 RECIPROCAL ECG CHANGE IN ST-ELEVATION MYOCARDIAL INFARCTION IS ASSOCIATED WITH AREA AT RISK AND MYOCARDIAL SALVAGE FOLLOWING REVASCULARIZATION. Heart 2013. [DOI: 10.1136/heartjnl-2013-304019.93] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Gillespie C, Maalouf J, Yuan K, Cogswell ME, Gunn J, Levings J, Moshfegh A, Merritt R. Sodium content in US packaged foods, 2009. FASEB J 2013. [DOI: 10.1096/fasebj.27.1_supplement.354.3] [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: 11/11/2022]
Affiliation(s)
| | - J. Maalouf
- Epidemiology & SurveillanceCDCChambleeGA
| | - K. Yuan
- Epidemiology & SurveillanceCDCChambleeGA
| | | | - J. Gunn
- Epidemiology & SurveillanceCDCChambleeGA
| | - J. Levings
- Epidemiology & SurveillanceCDCChambleeGA
| | | | - R. Merritt
- Epidemiology & SurveillanceCDCChambleeGA
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Jakubowski L, Sadowski MJ, Zebrowski J, Rabinski M, Jakubowski MJ, Malinowski K, Mirowski R, Lotte P, Goniche M, Gunn J, Colledani G, Pascal JY, Basiuk V. Note: Measurements of fast electrons in the TORE-SUPRA tokamak by means of modified Cherenkov-type diamond detector. Rev Sci Instrum 2013; 84:016107. [PMID: 23387713 DOI: 10.1063/1.4776190] [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] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
The Note reports on experimental studies of ripple born fast electrons within the TORE-SUPRA facility, which were performed by means of a modified measuring head equipped with diamond detectors designed especially for recording the electron-induced Cherenkov radiation. There are presented signals produced by fast electrons in the TORE-SUPRA machine, which were recorded during two experimental campaigns performed in 2010. Shapes of these electron-induced signals are considerably different from those observed during the first measurements carried out by the prototype Cherenkov probe in 2008. An explanation of the observed differences is given.
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Affiliation(s)
- L Jakubowski
- National Centre for Nuclear Research, 7 Andrzeja Soltana Str., 05-400 Otwock, Poland.
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Hocking JS, Spark S, Guy R, Temple-Smith M, Fairley CK, Kaldor J, Donovan B, Law M, Gunn J, Low N. O8 The Australian chlamydia control effectiveness pilot (ACCEPt): first results from a randomised trial of annual chlamydia screening in general practice. Sex Transm Infect 2012. [DOI: 10.1136/sextrans-2012-050601a.8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Malkin CJ, Ghobrial MSA, Raina T, Siotia A, Morton AC, Gunn J. 046 Impact of incomplete revascularisation in patients undergoing PCI for unprotected left main stem stenosis: Abstract 046 Figure 1. Heart 2012. [DOI: 10.1136/heartjnl-2012-301877b.46] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Morris PD, Ryan DR, Lycett R, Morton AC, Lawford PV, Hose DR, Gunn J. 021 Computer modelled coronary physiology and “virtual” fractional flow reserve from rotational angiography: Abstract 021 Figure 1. Heart 2012. [DOI: 10.1136/heartjnl-2012-301877b.21] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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