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Charlucien-Koech R, Brady J, Fryer A, Diaz-Gonzalez de Ferris ME. School Nurses Practices Promoting Self-Management and Healthcare Transition Skills for Adolescents with Chronic Conditions in Urban Public Schools: A Mixed Methods Study. J Sch Nurs 2024; 40:174-188. [PMID: 34928723 DOI: 10.1177/10598405211053266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background: Adolescents and young adults (AYA) with chronic conditions should acquire self-management skills as part of their healthcare transition (HCT) from pediatric to adult-focused care. HCT/self-management skills have the potential to help mitigate health disparities among minority AYA with chronic conditions. This study investigated school nurses' practices promoting HCT/self-management skills in urban public schools. Methods: Seventy-nine nurses from three urban school districts in Massachusetts completed a survey of 32 Likert-type questions on HCT/self-management skills, eight demographic questions, and five open-ended practice questions assessing how often they have asked students with chronic conditions about HCT/self-management skills, based on the UNC TRxANSITION IndexTM. Results: Among the 79 school nurses who participated (response rate 76%), 67% never or rarely assessed students' knowledge of HCT/self-management, and 90% would use a tool that promotes/measures HCT/self-management skills. Conclusion: In our study sample, most school nurses acknowledged the importance of assessing HCT/self-management skills. The majority favored using a tool to promote these skills.
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Affiliation(s)
- Roselaine Charlucien-Koech
- Department of Health Services, Boston Public Schools, Boston, Massachusetts
- Department of Nursing and Health Sciences, Regis College, Weston, Massachusetts
| | - Jacqueline Brady
- Department of Health Services, Boston Public Schools, Boston, Massachusetts
| | - Anne Fryer
- Department of Nursing and Health Sciences, Regis College, Weston, Massachusetts
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2
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Evers J, Sridhar K, Liegey J, Brady J, Jahns H, Lowery M. Stimulation-induced changes at the electrode-tissue interface and their influence on deep brain stimulation. J Neural Eng 2022; 19. [PMID: 35728575 DOI: 10.1088/1741-2552/ac7ad6] [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] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Accepted: 06/21/2022] [Indexed: 11/12/2022]
Abstract
OBJECTIVE During deep brain stimulation (DBS) the electrode-tissue interface forms a critical path between device and brain tissue. Although changes in the electrical double layer and glial scar can impact stimulation efficacy, the effects of chronic DBS on the electrode-tissue interface have not yet been established. APPROACH In this study, we characterised the electrode-tissue interface surrounding chronically implanted DBS electrodes in rats and compared the impedance and histological properties at the electrode interface in animals that received daily stimulation and in those where no stimulation was applied, up to eight weeks post-surgery. A computational model was developed based on the experimental data, which allowed the dispersive electrical properties of the surrounding encapsulation tissue to be estimated. The model was then used to study the effect of stimulation-induced changes in the electrode-tissue interface on the electric field and neural activation during voltage- and current-controlled stimulation. MAIN RESULTS Incorporating the observed changes in simulations in silico, we estimated the frequency-dependent dielectric properties of the electrical double layer and surrounding encapsulation tissue. Through simulations we show how stimulation-induced changes in the properties of the electrode-tissue interface influence the electric field and alter neural activation during voltage-controlled stimulation. A substantial increase in the number of stimulated collaterals, and their distance from the electrode, was observed during voltage-controlled stimulation with stimulated ETI properties. In vitro examination of stimulated electrodes confirmed that high frequency stimulation leads to desorption of proteins at the electrode interface, with a concomitant reduction in impedance. SIGNIFICANCE The demonstration of stimulation-induced changes in the electrode-tissue interface has important implications for future DBS systems including closed-loop systems where the applied stimulation may change over time. Understanding these changes is particularly important for systems incorporating simultaneous stimulation and sensing, which interact dynamically with brain networks.
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Affiliation(s)
- J Evers
- School of Electrical and Electronic Engineering, University College Dublin, Engineering Building, UCD Belfield, Dublin, Dublin, 4, IRELAND
| | - K Sridhar
- School of Electrical and Electronic Engineering, University College Dublin, Engineering Building, UCD Belfield, Dublin, Dublin, 4, IRELAND
| | - J Liegey
- School of Electrical and Electronic Engineering, University College Dublin, Engineering Building, UCD Belfield, Dublin, Dublin, 4, IRELAND
| | - J Brady
- School of Veterinary Medicine, University College Dublin, Veterinary Science Center, Dublin, 4, IRELAND
| | - H Jahns
- School of Veterinary Medicine, University College Dublin, Veterinary Science Center, Dublin, 4, IRELAND
| | - M Lowery
- School of Electrical, Electronic & Mechancial Engineering, University College Dublin, Engineering & Materials Science Centre, Belfield, Dublin 4, Dublin, 4, IRELAND
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3
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Goffe K, Wilson J, Gluck T, Brady J, Burns A, Bergbaum C, Petra H, Stewart M, Wilson E. 779 IMPROVING USE OF COORDINATE MY CARE USING A QUALITY IMPROVEMENT APPROACH FOR MEDICAL PATIENTS ADMITTED TO BARNET HOSPITAL. Age Ageing 2022. [DOI: 10.1093/ageing/afac034.779] [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: 11/14/2022] Open
Abstract
Abstract
Introduction
Coordinate My Care (CMC) is a digital care plan for communicating person-centred urgent and advance care planning. We recognised that it was not being consistently accessed on admission, nor updated on discharge, leading to a risk of ignoring patient wishes and previously clinician-agreed care plans. We used a quality improvement approach to increase use of CMC.
Method
We gathered baseline data on the number of users utilising their account, and explored current practice and barriers. A driver diagram was developed, a Steering Group met regularly, and interventions were tested using Plan, Do, Study, Act. Interventions began in January 2021, including electronic circulation of a guide to gain access to CMC, posters about CMC, departmental teaching, and drop-in training. A Core Group of clinicians repeatedly surveyed 12 medical ward areas and offered on-the-spot troubleshooting. To mitigate effects of staff turnover, we developed e-classroom training for new starters.
Results
53 people attended departmental teaching and drop-ins. The number of users utilising their account each month showed a steady increase, rising from 25 to 42 users. Monthly views of CMC records are increasing, with 167 in May 2021 compared to an average of 105 in the 5 months prior to the project. We have still to examine patient feedback.
Conclusion
Use of CMC is becoming more established. Future actions will concentrate on training (including in the emergency department and during junior doctor changeover), helping clinicians hold conversations, and establishing mentoring. Recording Advance Care Planning on CMC is a final step in a complex process of identifying that a patient may be in the last year of their life, starting conversations and taking actions. It follows that varied and sustained actions are needed to improve this, in order to realise the benefits of person-centred planning for our patients and those caring for them.
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Affiliation(s)
- K Goffe
- Barnet Hospital, Royal Free London NHS Trust
| | - J Wilson
- Barnet Hospital, Royal Free London NHS Trust
| | - T Gluck
- Barnet Hospital, Royal Free London NHS Trust
| | - J Brady
- Barnet Hospital, Royal Free London NHS Trust
| | - A Burns
- Barnet Hospital, Royal Free London NHS Trust
| | - C Bergbaum
- Barnet Hospital, Royal Free London NHS Trust
| | - H Petra
- Barnet Hospital, Royal Free London NHS Trust
| | - M Stewart
- Barnet Hospital, Royal Free London NHS Trust
| | - E Wilson
- Barnet Hospital, Royal Free London NHS Trust
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Brady J, Vasiliadou I, Potter V, Benjamin R, Patten P, Cuadrado M, Evans O, Alexander E, Gillham C, Summers J, Ajithkumar T, Bates A, Sanderson R, Kuhnl A, Mikhaeel N. PH-0329 Feasibility and outcome of bridging RT pre CAR-T in DLBCL in one centre with a wide referral network. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)07302-3] [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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5
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Jones K, Webster A, Ntentas G, Brady J, Mikhaeel N. PO-1972 DIBH for mediastinal lymphoma: Implementation and evaluation of a 5-year service. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)08423-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Hafez O, Brady J, Attallah H, Mikhaeel N. OC-0458: Local tumour control after mediastinal radiotherapy with DIBH and small CTV-PTV margin. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)00480-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Shelley C, Brady J, Rahman F, Mikhaeel G. PO-0919: Low vs intermediate dose radiotherapy in head & neck MALT lymphoma with and without Sjogren syndrome. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)00936-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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8
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Maurouard T, Shivakumar R, Brady J. Advancing cellular therapies using clinically scalable engineering of T Cells and NK cells. Cytotherapy 2020. [DOI: 10.1016/j.jcyt.2020.03.390] [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: 10/24/2022]
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9
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Motov S, Butt M, Masoudi A, Hossain R, Drapkin J, Likourezos A, Fassassi C, Brady J, Rothberger N, Flom P, Marshall J. 257 Comparison of Analgesic Efficacy of Morphine Sulfate Immediate Release/Acetaminophen vs. Oxycodone/Acetaminophen (Percocet) for Acute Pain in Emergency Department Patients. Ann Emerg Med 2019. [DOI: 10.1016/j.annemergmed.2019.08.215] [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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10
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Owen L, Pleming J, Lisk C, Brady J, Benafif A, Lewis A, Bertfield D, Mani S. 22‘THE FRAILTY JOURNEY – FROM EARLY RECOGNITION TO END OF LIFE’: AN INNOVATIVE MULTIDISCIPLINARY LEARNING EVENT. Age Ageing 2019. [DOI: 10.1093/ageing/afz055.22] [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: 11/13/2022] Open
Affiliation(s)
- L Owen
- Geriatrics Department, Barnet Hospital
| | - J Pleming
- Geriatrics Department, Barnet Hospital
| | - C Lisk
- Geriatrics Department, Barnet Hospital
| | - J Brady
- Geriatrics Department, Barnet Hospital
| | - A Benafif
- Geriatrics Department, Barnet Hospital
| | - A Lewis
- Geriatrics Department, Barnet Hospital
| | | | - S Mani
- Geriatrics Department, Barnet Hospital
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11
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Noble M, Brady J. Response Rates to Newly Implemented Neoadjuvant TCHP Chemotherapy in the Dorset Cancer Network. Clin Oncol (R Coll Radiol) 2019. [DOI: 10.1016/j.clon.2019.03.030] [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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12
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Erickson BJ, Nguyen J, Gasik K, Gruber S, Brady J, Shubin Stein BE. Isolated Medial Patellofemoral Ligament Reconstruction for Patellar Instability Regardless of Tibial Tubercle-Trochlear Groove Distance and Patellar Height: Outcomes at 1 and 2 Years. Am J Sports Med 2019; 47:1331-1337. [PMID: 30986090 DOI: 10.1177/0363546519835800] [Citation(s) in RCA: 79] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND It is unclear which patients with recurrent patellar instability require a bony procedure in addition to medial patellofemoral ligament (MPFL) reconstruction. PURPOSE To report 1- and 2-year outcomes of patients after isolated MPFL reconstruction performed for patellar instability regardless of patellar height, tibial tubercle-trochlear groove (TT-TG) distance, or trochlear dysplasia. STUDY DESIGN Case series; Level of evidence, 4. METHODS All patients with recurrent patellar instability and without significant unloadable chondral defects (Outerbridge grade IV), cartilage defects (especially inferior/lateral patella), previous failed surgery, or pain >50% as their chief complaint were prospectively enrolled beginning March 2014. All patients underwent primary, unilateral, isolated MPFL reconstruction regardless of concomitant bony pathology for treatment of recurrent patellar instability. Information on recurrent subjective instability, dislocations, ability to return to sport (RTS), and outcome scores was recorded at 1 and 2 years. TT-TG distance, patellar height (with the Caton-Deschamps index), and trochlear depth were measured. RESULTS Ninety patients (77% female; mean ± SD age, 19.4 ± 5.6 years) underwent MPFL reconstruction between March 2014 and August 2017: 72 (80%) reached 1-year follow-up, and 47 (52.2%) reached 2-year follow-up (mean follow-up, 2.2 years). Mean TT-TG distance was 14.7 ± 5.4 mm (range, -2.2 to 26.8 mm); mean patellar height, 1.2 ± 0.11 mm (range, 0.89-1.45 mm); and mean trochlear depth, 1.8 ± 1.4 mm (range, 0.05-6.85 mm). Ninety-six percent of patients at 1 year and 100% at 2 years had no self-reported patellofemoral instability; 1 patient experienced a redislocation at 3.5 years. RTS rates at 1 and 2 years were 90% and 88%, respectively. Mean time to RTS was 8.8 months. All patients had clinically and statistically significant improvement in mean Knee injury and Osteoarthritis Outcome Score-Quality of Life (32.7 to 72.0, P < .001), mean International Knee Documentation Committee subjective form (51.4 to 82.6, P < .001), and mean Kujala score (62.2 to 89.5, P < .001). No difference existed between 1- and 2-year outcome scores (all P > .05). CONCLUSION At early follow-up of 1 and 2 years, isolated MPFL reconstruction is an effective treatment for patellar instability and provides significant improvements in outcome scores with a low redislocation/instability rate regardless of bony pathologies, including TT-TG distance, Caton-Deschamps index, and trochlear dysplasia. Future data from this cohort will be used to assess long-term outcomes.
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Affiliation(s)
| | - Joseph Nguyen
- Division of Sports and Shoulder, Hospital for Special Surgery, New York, New York, USA
| | - Katelyn Gasik
- Division of Sports and Shoulder, Hospital for Special Surgery, New York, New York, USA
| | - Simone Gruber
- Division of Sports and Shoulder, Hospital for Special Surgery, New York, New York, USA
| | - Jacqueline Brady
- Division of Orthopaedic Surgery, Oregon Health and Science University, Portland, Oregon, USA
| | - Beth E Shubin Stein
- Division of Sports and Shoulder, Hospital for Special Surgery, New York, New York, USA
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13
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Ronald J, Nixon A, Hatch A, Brady J, Campa M, Devos N, Corcoran D, Hurwitz H, Martin J, Kim C. 04:03 PM Abstract No. 323 Transcatheter arterial embolization increases circulating cell-free DNA in patients with hepatocellular carcinoma. J Vasc Interv Radiol 2019. [DOI: 10.1016/j.jvir.2018.12.391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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14
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Brady J, Stewart W, Whitney T, Scholljegerdes E, Yeoman C, Waldron D, Musser J, Adams R, Walker J. PSXI-10 Rumen microbial characteristics of goats selectively bred to have greater consumption of Juniperus pinchotii forage. J Anim Sci 2018. [DOI: 10.1093/jas/sky404.789] [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: 11/13/2022] Open
Affiliation(s)
- J Brady
- Texas A&M AgriLife Research,Stephenville, TX, United States
| | - W Stewart
- Univ. of WY, Dept. of Anim. Sci.,Laramie, United States
| | - T Whitney
- Texas A&M AgriLife Research, San Angelo, TX, United States
| | - E Scholljegerdes
- NM State Univ., Dept. Animal and Range Sci., Las Cruces, NM, United States
| | - C Yeoman
- MT State Univ., Dept Anim. and Range Sci.,Bozeman, MT, United States
| | - D Waldron
- Texas A&M AgriLife Research, San Angelo, TX, United States
| | - J Musser
- Texas A&M University, College of Vet. Medicine and Biomedical Sci.,College Station, TX, United States
| | - R Adams
- Baylor Univ.,Hurricane, UT, United States
| | - J Walker
- Texas A&M AgriLife Research, San Angelo, TX, United States
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15
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Drapkin J, Motov S, Likourezos A, Monfort R, Butt M, Hossain R, Gulati V, Brady J, Mann S, Rothberger N, Marshall J. 1 A Randomized Trial Comparing the Combination of Intravenous Lidocaine and Ketorolac to Either Analgesics Alone for Emergency Department Patients With Acute Renal Colic. Ann Emerg Med 2018. [DOI: 10.1016/j.annemergmed.2018.08.006] [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: 11/15/2022]
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Abstract
Aims Little is known about the effect of haemorrhagic shock and resuscitation
on fracture healing. This study used a rabbit model with a femoral
osteotomy and fixation to examine this relationship. Materials and Methods A total of 18 male New Zealand white rabbits underwent femoral
osteotomy with intramedullary fixation with ‘shock’ (n = 9) and
control (n = 9) groups. Shock was induced in the study group by
removal of 35% of the total blood volume 45 minutes before resuscitation
with blood and crystalloid. Fracture healing was monitored for eight weeks
using serum markers of healing and radiographs. Results Four animals were excluded due to postoperative complications.
The serum concentration of osteocalcin was significantly elevated
in the shock group postoperatively (p < 0.0001). There were otherwise
no differences with regard to serum markers of bone healing. The
callus index was consistently increased in the shock group on anteroposterior
(p = 0.0069) and lateral (p = 0.0165) radiographs from three weeks
postoperatively. The control group showed an earlier decrease of
callus index. Radiographic scores were significantly greater in
the control group (p = 0.0025). Conclusion In a rabbit femoral osteotomy model with intramedullary fixation,
haemorrhagic shock and resuscitation produced larger callus but
with evidence of delayed remodelling. Cite this article: Bone Joint J 2018;100-B:1234–40.
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Affiliation(s)
- J Brady
- Lismore Base Hospital, Lismore, Australia
| | - B M Hardy
- John Hunter Hospital, New Lambton Heights, Australia
| | - O Yoshino
- Austin Hospital, Melbourne, Australia
| | - A Buxton
- University of Newcastle, Newcastle, Australia
| | - A Quail
- School of Medicine and Public Health, University of Newcastle, Australia
| | - Z J Balogh
- University of Newcastle, Newcastle, Australia and Orthopaedic Surgeon, John Hunter Hospital, New Lambton Heights, Australia
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Stotz MK, Smith BW, Herrygers K, Bidwell C, Brady J, Waddell J. 147 Calpastatin Isoforms Related to Meat Tenderness in Beef Cattle. J Anim Sci 2018. [DOI: 10.1093/jas/sky027.147] [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: 11/12/2022] Open
Affiliation(s)
- M K Stotz
- Tarleton State University, Stephneville, TX
| | - B W Smith
- Tarleton State University, Stephenville, TX
| | | | | | - J Brady
- Texas A&M University, College Station, TX
| | - J Waddell
- Tarleton State University, Stephenville, TX
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Yoshino O, Brady J, Young K, Hardy B, Matthys R, Buxton T, Appleyard R, Tomka J, Dabirrahmani D, Woodford P, Fadia M, Steck R, Quail A, Richards RG, Balogh ZJ. Reamed locked intramedullary nailing for studying femur fracture and its complications. Eur Cell Mater 2017; 34:99-107. [PMID: 28891043 DOI: 10.22203/ecm.v034a07] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [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: 01/31/2023] Open
Abstract
Morbidity associated with femur fractures in polytrauma patients is known to be high. The many unsolved clinical questions include the immunological effect of the fracture and its fixation, timing of fracture fixation, management of fracture non-union, effect of infection and critical size of bone defects. The aim of this study was to establish a clinically-relevant and reproducible animal model with regards to histological, biomechanical and radiological changes during bone healing. A custom-designed intramedullary nail with interlocking system (RabbitNail, RISystem AG, Davos Platz, Switzerland) was used for fixation, following femur fracture. New Zealand White rabbits were assigned to two groups: 1. closed fracture model (CF; non-survival model: n = 6, survival model: n = 3) with unilateral mid-shaft femur fracture created by blunt force; 2. osteotomy model (OT; survival model: n = 14) with unilateral transverse osteotomy creating femur fracture. There were no intraoperative complications and full-weight bearing was achieved in all survival rabbits. Significant periosteal reaction and callus formation were confirmed from 2 weeks postoperatively, with a significant volume formation (739.59 ± 62.14 mm3) at 8 weeks confirmed by micro-computed tomography (µ-CT). 2 months after fixation, there was no difference between the osteotomised and contralateral control femora in respect to the maximum torque (3.47 ± 0.35 N m vs. 3.26 ± 0.37 N m) and total energy (21.11 ± 3.09 N m × degree vs. 20.89 ± 2.63 N m × degree) required to break the femur. The data confirmed that a standardised internal fixation technique with an intramedullary nail for closed fracture or osteotomy produced satisfactory bone healing. It was concluded that important clinically-relevant studies can be conducted using this rabbit model.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | | | - Z J Balogh
- Department of Traumatology, University of Newcastle and John Hunter Hospital, 2310 Newcastle, NSW,
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Herzberg SD, Motu'apuaka ML, Lambert W, Fu R, Brady J, Guise JM. The Effect of Menstrual Cycle and Contraceptives on ACL Injuries and Laxity: A Systematic Review and Meta-analysis. Orthop J Sports Med 2017; 5:2325967117718781. [PMID: 28795075 PMCID: PMC5524267 DOI: 10.1177/2325967117718781] [Citation(s) in RCA: 87] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Women are at substantially greater risk for anterior cruciate ligament (ACL) injuries than are men. PURPOSE To conduct a systematic review and meta-analysis of the literature to clarify the effect of the menstrual cycle and contraceptives on the laxity of and noncontact injuries to the ACL. STUDY DESIGN Systematic review; Level of evidence, 4. METHODS Searches were conducted using MEDLINE (1946-August 2016), the Cochrane Library Database, clinical trial registries, and related reference lists. Search terms included athletic injuries, knee injuries, ligaments, joint instability, menstrual cycle, ovulation, hormones, and contraceptives. Investigators independently dually abstracted and reviewed study details and quality using predefined criteria and evaluated overall strength of evidence using the GRADE (Grading of Recommendations Assessment, Development and Evaluation) criteria. RESULTS Twenty-one studies totaling 68,758 participants were included: 5 on the menstrual cycle and ACL injury, 7 on hormonal contraceptives and ACL injury, as well as 13 on menstrual cycle and ligament laxity. Four of 5 studies of women not using hormonal contraception indicated that the luteal phase was the least associated with ACL injuries. The 2 largest and highest quality studies on hormonal contraceptives suggested that hormonal contraceptives may be protective against ACL injury. Six of 12 studies on ACL laxity provided quantitative data for meta-analysis, finding significantly increased laxity during the ovulatory phase compared with the follicular phase. CONCLUSION The literature suggests an association between hormonal fluctuations and ACL injury. Recent studies have suggested that oral contraceptives may offer up to a 20% reduction in risk of injury. The literature on ACL injuries and the menstrual cycle has more than doubled over the past decade, permitting quantitative analysis for the first time. However, the overall strength of this evidence is low. Promising potential directions for future research include long-term observational studies with ongoing hormonal assays and large interventional trials of follicular suppression, including newer hormonal methods.
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Affiliation(s)
- Simone D Herzberg
- Seattle Pacific University, Seattle, Washington, USA.,Department of Obstetrics & Gynecology, Oregon Health & Science University, Portland, Oregon, USA
| | - Makalapua L Motu'apuaka
- School of Public Health, Oregon Health & Science University, Portland, Oregon, USA.,Scientific Resource Center for the Evidence-Based Practice Center (EPC) Program, Portland VA Research Foundation, Portland, Oregon, USA
| | - William Lambert
- School of Public Health, Oregon Health & Science University, Portland, Oregon, USA
| | - Rongwei Fu
- School of Public Health, Oregon Health & Science University, Portland, Oregon, USA.,Department of Medical Informatics & Clinical Epidemiology, Oregon Health & Science University, Portland, Oregon, USA
| | - Jacqueline Brady
- Department of Orthopaedics and Rehabilitation, Oregon Health & Science University, Portland, Oregon, USA
| | - Jeanne-Marie Guise
- Department of Obstetrics & Gynecology, Oregon Health & Science University, Portland, Oregon, USA.,School of Public Health, Oregon Health & Science University, Portland, Oregon, USA.,Scientific Resource Center for the Evidence-Based Practice Center (EPC) Program, Portland VA Research Foundation, Portland, Oregon, USA.,Department of Medical Informatics & Clinical Epidemiology, Oregon Health & Science University, Portland, Oregon, USA.,Department of Emergency Medicine, Oregon Health & Science University, Portland, Oregon, USA
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Brady J, O’Loughlin K. AUSTRALIAN LIVES ALTERED BY PARKINSON’S DISEASE: WORK, RETIREMENT, AND CARE. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.1171] [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: 11/14/2022] Open
Affiliation(s)
- J. Brady
- Faculty of Health Sciences, University of Sydney, Cremorne, New South Wales, Australia
| | - K. O’Loughlin
- Faculty of Health Sciences, University of Sydney, Cremorne, New South Wales, Australia
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Craig J, Broghammer J, Kaufman M, Milam D, Cleves M, McClung C, Brady J, Jones L, Gross M, Henry G, Brant W. 011 Outcomes after AUS Replacement due to Cuff Erosion: Results from a Multicenter Retrospective Analysis. J Sex Med 2017. [DOI: 10.1016/j.jsxm.2016.12.024] [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: 11/28/2022]
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Nikolic MZ, Johnson JA, Sun D, Caritg O, Laresgoiti U, Brady J, Allen G, Giangreco A, Rawlins EL. T5 Towards human lung regeneration in end-stage respiratory failure: genetically-modifiable 3d organoid culture of human embryonic lung stem cells enables for the first time the study of human lung development in vitro. Thorax 2016. [DOI: 10.1136/thoraxjnl-2016-209333.5] [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: 11/03/2022]
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Brady J, Costantini C, Sagnon N, Gibson G, Coluzzi M. The role of body odours in the relative attractiveness of different men to malarial vectors in Burkina Faso. Annals of Tropical Medicine & Parasitology 2016. [DOI: 10.1080/00034983.1997.11813252] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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Rahman F, Brady J, Galli S, Mikhaeel N. PO-0668: Outcome of low and intermediate dose radiotherapy in head and neck MALT lymphoma. Radiother Oncol 2016. [DOI: 10.1016/s0167-8140(16)31918-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Meeske AJ, Rodrigues CDA, Brady J, Lim HC, Bernhardt TG, Rudner DZ. High-Throughput Genetic Screens Identify a Large and Diverse Collection of New Sporulation Genes in Bacillus subtilis. PLoS Biol 2016; 14:e1002341. [PMID: 26735940 PMCID: PMC4703394 DOI: 10.1371/journal.pbio.1002341] [Citation(s) in RCA: 69] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2015] [Accepted: 11/25/2015] [Indexed: 01/09/2023] Open
Abstract
The differentiation of the bacterium Bacillus subtilis into a dormant spore is among the most well-characterized developmental pathways in biology. Classical genetic screens performed over the past half century identified scores of factors involved in every step of this morphological process. More recently, transcriptional profiling uncovered additional sporulation-induced genes required for successful spore development. Here, we used transposon-sequencing (Tn-seq) to assess whether there were any sporulation genes left to be discovered. Our screen identified 133 out of the 148 genes with known sporulation defects. Surprisingly, we discovered 24 additional genes that had not been previously implicated in spore formation. To investigate their functions, we used fluorescence microscopy to survey early, middle, and late stages of differentiation of null mutants from the B. subtilis ordered knockout collection. This analysis identified mutants that are delayed in the initiation of sporulation, defective in membrane remodeling, and impaired in spore maturation. Several mutants had novel sporulation phenotypes. We performed in-depth characterization of two new factors that participate in cell–cell signaling pathways during sporulation. One (SpoIIT) functions in the activation of σE in the mother cell; the other (SpoIIIL) is required for σG activity in the forespore. Our analysis also revealed that as many as 36 sporulation-induced genes with no previously reported mutant phenotypes are required for timely spore maturation. Finally, we discovered a large set of transposon insertions that trigger premature initiation of sporulation. Our results highlight the power of Tn-seq for the discovery of new genes and novel pathways in sporulation and, combined with the recently completed null mutant collection, open the door for similar screens in other, less well-characterized processes. Transposon sequencing enables the recovery of virtually all previously characterized genes required for the differentiation of the bacterium Bacillus subtilis into a dormant spore and identifies 24 new ones. When starved of nutrients, the bacterium Bacillus subtilis differentiates into a dormant spore that is impervious to environmental insults. Decades of research have uncovered over 100 genes required for spore formation. Molecular dissection of these genes has revealed factors that act at every stage of this developmental process. In this study, we used a high-throughput genetic screening method called transposon sequencing to assess whether there were any sporulation genes left to be discovered. This approach identified virtually all of the known sporulation genes, as well as 24 new ones. Furthermore, transposon sequencing enabled the discovery of two new sets of mutants in which the sporulation process was either delayed or accelerated. Using fluorescence microscopy, we determined the developmental stage at which each mutant was impaired and discovered mutants that are delayed in initiation of sporulation, or defective in morphogenesis, cell–cell signaling, or spore maturation. Our findings exemplify the utility of transposon sequencing to uncover new biology in well-studied processes, suggesting that it could similarly be used to identify novel genes required for other aspects of bacterial physiology, such as natural competence, stationary phase survival, or the responses to cell envelope stress and DNA damage.
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Affiliation(s)
- Alexander J. Meeske
- Department of Microbiology and Immunobiology, Harvard Medical School, Boston, Massachusetts, United States of America
| | - Christopher D. A. Rodrigues
- Department of Microbiology and Immunobiology, Harvard Medical School, Boston, Massachusetts, United States of America
| | - Jacqueline Brady
- Department of Microbiology and Immunobiology, Harvard Medical School, Boston, Massachusetts, United States of America
| | - Hoong Chuin Lim
- Department of Microbiology and Immunobiology, Harvard Medical School, Boston, Massachusetts, United States of America
| | - Thomas G. Bernhardt
- Department of Microbiology and Immunobiology, Harvard Medical School, Boston, Massachusetts, United States of America
| | - David Z. Rudner
- Department of Microbiology and Immunobiology, Harvard Medical School, Boston, Massachusetts, United States of America
- * E-mail:
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French J, Purificacion S, Brown E, MacDonald R, Wilson L, Kumar E, Bird L, Brady J, Milosevic M, Mitera G. Each Cancer Journey Begins With One Shared Step: Patient Engagement and Radiation Therapy. Int J Radiat Oncol Biol Phys 2015. [DOI: 10.1016/j.ijrobp.2015.07.1831] [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: 10/22/2022]
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Hawthorne W, Hawkes J, Salvaris E, Liuwantara D, Barlow H, Phillips P, Robson S, Brady J, Lew A, Mark N, OʼConnell P, Cowan P. Survival of Genetically Modified Porcine Neonatal Islet Xenografts in Baboons. Transplantation 2014. [DOI: 10.1097/00007890-201407151-01368] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Holzinger D, Lohse P, Faßl S, Austermann J, Vogl T, de Jager W, Holland S, Gattorno M, Rodriguez-Gallego C, Arostegui J, Fessatou S, Isidor B, Ito K, Epple HJ, Bernstein J, Jeng M, Lionetti G, Ong P, Hinze C, Sampson B, Sunderkoetter C, Foell D, Chae J, Ombrello A, Brady J, Aksentijevich I, Roth J. PW02-018 - Impact of PSTPIP1 mutaions on clinical phenotype. Pediatr Rheumatol Online J 2013. [PMCID: PMC3953041 DOI: 10.1186/1546-0096-11-s1-a158] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
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Chen Y, Tascón I, Neunuebel MR, Pallara C, Brady J, Kinch LN, Fernández-Recio J, Rojas AL, Machner MP, Hierro A. Structural basis for Rab1 de-AMPylation by the Legionella pneumophila effector SidD. PLoS Pathog 2013; 9:e1003382. [PMID: 23696742 DOI: 10.1371/journal.ppat.1003382] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [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] [Received: 01/02/2013] [Accepted: 04/08/2013] [Indexed: 12/31/2022] Open
Abstract
The covalent attachment of adenosine monophosphate (AMP) to proteins, a process called AMPylation (adenylylation), has recently emerged as a novel theme in microbial pathogenesis. Although several AMPylating enzymes have been characterized, the only known virulence protein with de-AMPylation activity is SidD from the human pathogen Legionella pneumophila. SidD de-AMPylates mammalian Rab1, a small GTPase involved in secretory vesicle transport, thereby targeting the host protein for inactivation. The molecular mechanisms underlying Rab1 recognition and de-AMPylation by SidD are unclear. Here, we report the crystal structure of the catalytic region of SidD at 1.6 Å resolution. The structure reveals a phosphatase-like fold with additional structural elements not present in generic PP2C-type phosphatases. The catalytic pocket contains a binuclear metal-binding site characteristic of hydrolytic metalloenzymes, with strong dependency on magnesium ions. Subsequent docking and molecular dynamics simulations between SidD and Rab1 revealed the interface contacts and the energetic contribution of key residues to the interaction. In conjunction with an extensive structure-based mutational analysis, we provide in vivo and in vitro evidence for a remarkable adaptation of SidD to its host cell target Rab1 which explains how this effector confers specificity to the reaction it catalyses.
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Affiliation(s)
- Yang Chen
- Cell Biology and Metabolism Program, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland, United States of America
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Abstract
Inborn errors of metabolism (IEMs) that manifest primarily as psychiatric and behavioural symptoms in childhood are often mistaken for idiopathic primary psychiatric disorders. The pathophysiological basis of these symptoms may be overlooked until later in the disease course when neurological deficits become dominant; this results in a significant delay in establishing a proper diagnosis. To illustrate this, we describe two siblings who presented with behavioural issues and mild learning disabilities in childhood, and were consequently given multiple psychiatric diagnoses. In early adulthood, however, they manifested a rapid cognitive decline. Subsequent cranial MRI imaging revealed progressive brain iron accumulation in deep brain nuclei. Whole exome sequencing and biochemical investigation confirmed the diagnosis of mucopolysaccharidosis type IIIB. Their long diagnostic odyssey illustrates the importance of considering IEMs when assessing individuals with behavioural abnormalities and cognitive impairment.
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Affiliation(s)
- Jacqueline Brady
- Office of the Clinical Director, NHGRI/NIH, Bethesda, Maryland, USA
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Kieran M, O’Sullivan D, Brady J, McQuaid S, Meegan C. DGI-025 Development of a Protocol For the Treatment of Vitamin D Deficiency/Insufficiency in Adults. Eur J Hosp Pharm 2013. [DOI: 10.1136/ejhpharm-2013-000276.291] [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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Kieran M, Gavin C, O’Shea L, Brady J, Meegan C. DGI-002 Adrenal Insufficiency Induced by a Chinese Herbal Medicine. Eur J Hosp Pharm 2013. [DOI: 10.1136/ejhpharm-2013-000276.268] [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] Open
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Murphy TM, Mullins N, Ryan M, Foster T, Kelly C, McClelland R, O'Grady J, Corcoran E, Brady J, Reilly M, Jeffers A, Brown K, Maher A, Bannan N, Casement A, Lynch D, Bolger S, Buckley A, Quinlivan L, Daly L, Kelleher C, Malone KM. Genetic variation in DNMT3B and increased global DNA methylation is associated with suicide attempts in psychiatric patients. Genes Brain Behav 2013; 12:125-32. [PMID: 23025623 DOI: 10.1111/j.1601-183x.2012.00865.x] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/05/2012] [Revised: 08/17/2012] [Accepted: 09/27/2012] [Indexed: 11/28/2022]
Abstract
Recently, a significant epigenetic component in the pathology of suicide has been realized. Here we investigate candidate functional SNPs in epigenetic-regulatory genes, DNMT1 and DNMT3B, for association with suicide attempt (SA) among patients with co-existing psychiatric illness. In addition, global DNA methylation levels [5-methyl cytosine (5-mC%)] between SA and psychiatric controls were quantified using the Methylflash Methylated DNA Quantification Kit. DNA was obtained from blood of 79 suicide attempters and 80 non-attempters, assessed for DSM-IV Axis I disorders. Functional SNPs were selected for each gene (DNMT1; n = 7, DNMT3B; n = 10), and genotyped. A SNP (rs2424932) residing in the 3' UTR of the DNMT3B gene was associated with SA compared with a non-attempter control group (P = 0.001; Chi-squared test, Bonferroni adjusted P value = 0.02). Moreover, haplotype analysis identified a DNMT3B haplotype which differed between cases and controls, however this association did not hold after Bonferroni correction (P = 0.01, Bonferroni adjusted P value = 0.56). Global methylation analysis showed that psychiatric patients with a history of SA had significantly higher levels of global DNA methylation compared with controls (P = 0.018, Student's t-test). In conclusion, this is the first report investigating polymorphisms in DNMT genes and global DNA methylation quantification in SA risk. Preliminary findings suggest that allelic variability in DNMT3B may be relevant to the underlying diathesis for suicidal acts and our findings support the hypothesis that aberrant DNA methylation profiles may contribute to the biology of suicidal acts. Thus, analysis of global DNA hypermethylation in blood may represent a biomarker for increased SA risk in psychiatric patients.
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Affiliation(s)
- T M Murphy
- Department of Psychiatry and Mental Health Research & Education and Research Centre, St Vincent's University Hospital, and School of Medicine & Medical Science, University College Dublin, Dublin 4, Ireland
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Rodríguez-Lecompte JC, Yitbarek A, Brady J, Sharif S, Cavanagh MD, Crow G, Guenter W, House JD, Camelo-Jaimes G. The effect of microbial-nutrient interaction on the immune system of young chicks after early probiotic and organic acid administration1. J Anim Sci 2012; 90:2246-54. [DOI: 10.2527/jas.2011-4184] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.3] [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. Yitbarek
- Department of Animal Science, University of Manitoba, Winnipeg R3T 2N2, Canada
| | - J. Brady
- Department of Animal Science, University of Manitoba, Winnipeg R3T 2N2, Canada
| | - S. Sharif
- Department of Pathobiology, University of Guelph, Guelph, Ontario N1G 2W1, Canada
| | - M. D. Cavanagh
- Department of Animal Science, University of Manitoba, Winnipeg R3T 2N2, Canada
| | - G. Crow
- Department of Animal Science, University of Manitoba, Winnipeg R3T 2N2, Canada
| | - W. Guenter
- Department of Animal Science, University of Manitoba, Winnipeg R3T 2N2, Canada
| | - J. D. House
- Department of Human Nutritional Science, University of Manitoba, Winnipeg R3T 2N2, Canada
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Yitbarek A, Echeverry H, Brady J, Hernandez-Doria J, Camelo-Jaimes G, Sharif S, Guenter W, House J, Rodriguez-Lecompte J. Innate immune response to yeast-derived carbohydrates in broiler chickens fed organic diets and challenged with Clostridium perfringens. Poult Sci 2012; 91:1105-12. [DOI: 10.3382/ps.2011-02109] [Citation(s) in RCA: 55] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Ratkevicius A, Joyson A, Selmer I, Dhanani T, Grierson C, Tommasi AM, DeVries A, Rauchhaus P, Crowther D, Alesci S, Yaworsky P, Gilbert F, Redpath TW, Brady J, Fearon KCH, Reid DM, Greig CA, Wackerhage H. Serum Concentrations of Myostatin and Myostatin-Interacting Proteins Do Not Differ Between Young and Sarcopenic Elderly Men. J Gerontol A Biol Sci Med Sci 2011; 66:620-6. [DOI: 10.1093/gerona/glr025] [Citation(s) in RCA: 70] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
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Lonergan R, Kinsella K, Fitzpatrick P, Brady J, Murray B, Dunne C, Hagan R, Duggan M, Jordan S, McKenna M, Hutchinson M, Tubridy N. Multiple sclerosis prevalence in Ireland: relationship to vitamin D status and HLA genotype. J Neurol Neurosurg Psychiatry 2011; 82:317-22. [PMID: 21248317 DOI: 10.1136/jnnp.2010.220988] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.8] [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: 11/03/2022]
Abstract
BACKGROUND The relationship between prevalence of multiple sclerosis (MS) and latitude may be due to both genetic and environmental factors. The hypothesis that, in Ireland, MS prevalence is increasing and that north-south differences relate to variation in serum 25-hydroxyvitamin D (25(OH)D) levels was tested in this study. PATIENTS AND METHODS Patients and matched control subjects were identified in counties Donegal, Wexford and South Dublin through multiple sources. Prevalence was determined. Blood samples were taken for serum 25(OH)D and serum intact parathyroid hormone measurement, and DNA was extracted. RESULTS Prevalence in 2007 was significantly greater in Donegal (northwest) (290.3/105, 95% CI 262.3 to 321.7) compared with 2001 (184.6/105; 162 to 209.5). In Wexford (southeast), there was a non-significant increase in prevalence in 2007 compared with 2001. Prevalence was significantly higher in Donegal than in Wexford (144.8/105; 126.7 to 167.8, p<0.0001) and South Dublin (127.8/105; 111.3 to 148.2, p<0.0001). Overall, mean 25(OH)D levels were low and did not differ between patients (38.6 nmol/l) and controls (36.4 nmol/l) However, significantly more patients than controls had 25(OH)D levels <25 nmol/l (deficiency) (p=0.004). Levels of 25(OH)D (mean 50.74 nmol/l) were significantly higher in South Dublin (area with lowest prevalence) (p<0.0001) than in Donegal or Wexford. HLA DRB1*15 occurred most frequently in Donegal (greatest MS prevalence) and least frequently in South Dublin. CONCLUSION Vitamin D deficiency is common in Ireland. Latitudinal variation in MS probably relates to an interaction between genetic factors and environment (25(OH)D levels), and MS risk may be modified by vitamin D in genetically susceptible individuals.
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Affiliation(s)
- R Lonergan
- Department of Neurology, St Vincent's University Hospital, Elm Park, Dublin 4, Ireland.
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Grierson C, Miller D, LaPan P, Brady J. Utility of combining MMP-9 enzyme-linked immunosorbent assay and MMP-9 activity assay data to monitor plasma enzyme specific activity. Anal Biochem 2010; 404:232-4. [DOI: 10.1016/j.ab.2010.05.020] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2010] [Revised: 05/17/2010] [Accepted: 05/20/2010] [Indexed: 11/29/2022]
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Cawood TJ, Bashir M, Brady J, Murray B, Murray PT, O'Shea D. Urinary collagen IV and πGST: potential biomarkers for detecting localized kidney injury in diabetes--a pilot study. Am J Nephrol 2010; 32:219-225. [PMID: 20664197 DOI: 10.1159/000317531] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2010] [Accepted: 06/19/2010] [Indexed: 11/19/2022]
Abstract
BACKGROUND/AIMS Urinary biomarkers can identify damage to specific parts of the nephron. We performed a cross-sectional study to characterise the pattern of diabetic nephropathy using urinary biomarkers of glomerular fibrosis (collagen IV), proximal tubular damage (α-glutathione-S-transferase, GST) and distal tubular damage (πGST). METHODS Clinical data from 457 unselected patients attending a hospital diabetes clinic were collected. Spot urine samples were analysed for albumin and creatinine. Biomarkers were measured by enzyme-linked immunosorbent assay, and corrected to urinary creatinine. RESULTS All 3 biomarkers correlated weakly with albumin/creatinine ratios (Pearson correlation <0.2, p values <0.001). The most common abnormality was elevated urinary collagen IV (glomerular, 35%) compared to αGST (proximal tubule, 18%) or πGST (distal tubule, 15%). The proportion of patients with abnormal biomarker results increased across the normo-, micro- and macroalbuminuria groups, with collagen IV (26, 58, 65%) and πGST (11, 25, 35%) but not αGST. CONCLUSION In patients with diabetes, these urinary biomarkers appear to identify renal damage that is related to, but distinct from, urine albumin/creatinine ratios. The markers of glomerular fibrosis and distal tubular damage related most closely to the degree of albuminuria. Longitudinal studies are now required to assess whether these biomarkers can detect early renal disease with greater specificity and sensitivity than the albumin/creatinine ratio.
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Sabharwal A, Corrie PG, Midgley RS, Palmer C, Brady J, Mortimer P, Watson AJ, Margison GP, Middleton MR. A phase I trial of lomeguatrib and irinotecan in metastatic colorectal cancer. Cancer Chemother Pharmacol 2009; 66:829-35. [DOI: 10.1007/s00280-009-1225-0] [Citation(s) in RCA: 9] [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] [Received: 11/01/2009] [Accepted: 12/13/2009] [Indexed: 11/24/2022]
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Patel C, Ullal A, Roberts M, Brady J, Birch P, Bulmer JN, Wadehra V. Endometrial carcinoma detected with SurePath liquid-based cervical cytology: comparison with conventional cytology. Cytopathology 2009; 20:380-7. [DOI: 10.1111/j.1365-2303.2008.00621.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Brady J, Middleton M, Midgley RS, Mallath MK, Corrie P, Sirohi B, Chau I, Digumarti R, Botbyl J, Lager JJ. A phase I study of pazopanib in combination with FOLFOX 6 or capeOx in subjects with colorectal cancer. J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.4133] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
4133 Background: Pazopanib (paz) is a tyrosine kinase inhibitor of VEGFR-1, -2, -3, PDGF-α, -β, and c-kit. Inhibition of angiogenic pathways in combination with chemotherapy has been shown to benefit patients (pts) with colorectal cancer (CRC). Methods: Pts with previously untreated advanced or metastatic CRC and adequate organ function were assigned to paz with FOLFOX6 (FO) or capeOx (CO) by their physician. Doses of paz were escalated with full strength chemotherapy, starting at 400mg daily. The optimally tolerated regimen (OTR) was the combination dose at which <1/6 pts experienced dose-limiting toxicity (DLT). Results: Fifty pts were enrolled in FO (paz 400 mg, n=6; 800, 15), CO (400, 12; 800, 9) and reduced capecitabine (rc) CO (800, 8) cohorts: median age = 55.5, M/F = 37/13. Pts have remained on therapy for a median of 3 (range 0–17) months. Three pts remain on study. Safety data is available on 41. The most common AEs are summarized in the table below. The OTR was exceeded with CO in combination with 800 mg and 400 mg of pazopanib, but was not exceeded with 800 mg pazopanib when capecitabine was reduced to 850 mg/m2 twice daily or with FO with 800 mg pazopanib. Efficacy and pharmacokinetic analyses are ongoing. Conclusions: The OTRs were achieved at 800 mg paz with full-dose FO, and at 800mg paz with rcCO. [Table: see text] [Table: see text]
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Affiliation(s)
- J. Brady
- Churchill Hospital, Oxford, United Kingdom; Tata Memorial Hospital, Mumbai, India; Addenbrooke's Hospital, Cambridge, United Kingdom; Royal Marsden Hospital, London, United Kingdom; Nizam's Insitute of Medical Sciences, Hyderabad, India; GlaxoSmithKline, Research Triangle Park, NC
| | - M. Middleton
- Churchill Hospital, Oxford, United Kingdom; Tata Memorial Hospital, Mumbai, India; Addenbrooke's Hospital, Cambridge, United Kingdom; Royal Marsden Hospital, London, United Kingdom; Nizam's Insitute of Medical Sciences, Hyderabad, India; GlaxoSmithKline, Research Triangle Park, NC
| | - R. S. Midgley
- Churchill Hospital, Oxford, United Kingdom; Tata Memorial Hospital, Mumbai, India; Addenbrooke's Hospital, Cambridge, United Kingdom; Royal Marsden Hospital, London, United Kingdom; Nizam's Insitute of Medical Sciences, Hyderabad, India; GlaxoSmithKline, Research Triangle Park, NC
| | - M. K. Mallath
- Churchill Hospital, Oxford, United Kingdom; Tata Memorial Hospital, Mumbai, India; Addenbrooke's Hospital, Cambridge, United Kingdom; Royal Marsden Hospital, London, United Kingdom; Nizam's Insitute of Medical Sciences, Hyderabad, India; GlaxoSmithKline, Research Triangle Park, NC
| | - P. Corrie
- Churchill Hospital, Oxford, United Kingdom; Tata Memorial Hospital, Mumbai, India; Addenbrooke's Hospital, Cambridge, United Kingdom; Royal Marsden Hospital, London, United Kingdom; Nizam's Insitute of Medical Sciences, Hyderabad, India; GlaxoSmithKline, Research Triangle Park, NC
| | - B. Sirohi
- Churchill Hospital, Oxford, United Kingdom; Tata Memorial Hospital, Mumbai, India; Addenbrooke's Hospital, Cambridge, United Kingdom; Royal Marsden Hospital, London, United Kingdom; Nizam's Insitute of Medical Sciences, Hyderabad, India; GlaxoSmithKline, Research Triangle Park, NC
| | - I. Chau
- Churchill Hospital, Oxford, United Kingdom; Tata Memorial Hospital, Mumbai, India; Addenbrooke's Hospital, Cambridge, United Kingdom; Royal Marsden Hospital, London, United Kingdom; Nizam's Insitute of Medical Sciences, Hyderabad, India; GlaxoSmithKline, Research Triangle Park, NC
| | - R. Digumarti
- Churchill Hospital, Oxford, United Kingdom; Tata Memorial Hospital, Mumbai, India; Addenbrooke's Hospital, Cambridge, United Kingdom; Royal Marsden Hospital, London, United Kingdom; Nizam's Insitute of Medical Sciences, Hyderabad, India; GlaxoSmithKline, Research Triangle Park, NC
| | - J. Botbyl
- Churchill Hospital, Oxford, United Kingdom; Tata Memorial Hospital, Mumbai, India; Addenbrooke's Hospital, Cambridge, United Kingdom; Royal Marsden Hospital, London, United Kingdom; Nizam's Insitute of Medical Sciences, Hyderabad, India; GlaxoSmithKline, Research Triangle Park, NC
| | - J. J. Lager
- Churchill Hospital, Oxford, United Kingdom; Tata Memorial Hospital, Mumbai, India; Addenbrooke's Hospital, Cambridge, United Kingdom; Royal Marsden Hospital, London, United Kingdom; Nizam's Insitute of Medical Sciences, Hyderabad, India; GlaxoSmithKline, Research Triangle Park, NC
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Amato RJ, Jac J, Harris P, Dalton M, Saxena S, Monzon F, Zhai J, Brady J, Willis JP. A phase II trial of intra-patient dose escalated-sorafenib in patients (pts) with metastatic renal cell cancer (MRCC). J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.5122] [Citation(s) in RCA: 8] [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: 11/20/2022] Open
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Bonome T, Samimi G, Randonovich M, Brady J, Ghosh S, Ng S, Mok SC, Birrer MJ. A stromal-associated gene expression signature predicting for survival in a series of patients with advanced high-grade serous ovarian cancer. J Clin Oncol 2007. [DOI: 10.1200/jco.2007.25.18_suppl.5552] [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: 11/20/2022] Open
Abstract
5552 Background: Prognostic gene expression signatures have been derived for undissected serous ovarian epithelial tumors, yet the specific contribution of stromal cells to patient survival has not been addressed. The aim of this study is to identify stromal genes impacting patient survival in the context of serous ovarian cancer. Methods: Expression profiling utilizing Affymetrix U133 Plus 2.0 oligonucleotide arrays was completed for 50 microdissected stromal samples derived from high-grade, late-stage serous tumors displaying a broad spectrum of survival endpoints. A semi-supervised dimension reduction method employing multivariate Cox regression and principal components analysis was applied to the expression data to identify genes associated with patient survival and establish a predictive model. qRT-PCR was employed to validate the microarray expression data. Results: Cox regression analysis identified 267 significant genes. The first 6 principal components of these genes, representing >65% of total variance, entered a multivariate Cox model through which the relative hazard of future patients can be predicted. To confirm our finding, the microarray data underwent leave-one-out validation. The patients were equally divided into low- and high-risk groups and non-parametric Kaplan-Meier analysis and log rank test demonstrated the two groups were significantly different in survival (p = 0.0115). Genes associated with cell survival and migration were identified in the prognostic signature. For validation, qRT-PCR data for all 50 specimens was correlated with microarray expression values for a series of select prognostic genes. Conculsions: In this study, we characterized and validated a stromal dervied prognostic signature associated with poor patient survival. Contained in this novel predictor may be stromal targets suitable for the design of new therapeutic interventions, or use as independent diagnostic markers. No significant financial relationships to disclose.
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Affiliation(s)
- T. Bonome
- National Cancer Institute, Bethesda, MD; Brigham and Women’s Hospital, Boston, MA
| | - G. Samimi
- National Cancer Institute, Bethesda, MD; Brigham and Women’s Hospital, Boston, MA
| | - M. Randonovich
- National Cancer Institute, Bethesda, MD; Brigham and Women’s Hospital, Boston, MA
| | - J. Brady
- National Cancer Institute, Bethesda, MD; Brigham and Women’s Hospital, Boston, MA
| | - S. Ghosh
- National Cancer Institute, Bethesda, MD; Brigham and Women’s Hospital, Boston, MA
| | - S. Ng
- National Cancer Institute, Bethesda, MD; Brigham and Women’s Hospital, Boston, MA
| | - S. C. Mok
- National Cancer Institute, Bethesda, MD; Brigham and Women’s Hospital, Boston, MA
| | - M. J. Birrer
- National Cancer Institute, Bethesda, MD; Brigham and Women’s Hospital, Boston, MA
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Ozbun L, Bonome T, Radonovich M, Pise-Masison C, Brady J, Caplen N, Johnson M, Mok SC, Birrer MJ. Use of predictive gene expression signature from advanced-stage serous papillary ovarian cancer to identify biologically relevant molecular targets for chemoresponse. J Clin Oncol 2007. [DOI: 10.1200/jco.2007.25.18_suppl.5500] [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: 11/20/2022] Open
Abstract
5500 Background: The aim of our study was to develop and validate a gene expression signature predictive for chemoresponse in advanced stage serous papillary ovarian cancer. Methods: Gene expression profiling was performed on 52 chemonaive, microdissected advanced stage, high-grade papillary serous ovarian cancers using Affymetrix whole-genome microarrays. Patient samples were grouped based on chemoresponse. 19 nonresponders were refractory to chemotherapy, 14 responders relapsing 6 months were considered chemosensitive. Each group was divided into training/validation sets. To generate a predictive gene signature, class prediction algorithms were applied to genes differentially expressed between chemosensitive/resistant or chemosensitive/refractory tumors (p<0.001) using leave-one-out cross-validation. Array validation was performed by qRT-PCR. Select genes underwent biological validation in a series of ovarian cancer cell lines. Results: 31 genes predictive for resistance and 105 genes predictive for refractory to chemotherapy were identified. Percentages of arrays accurately predicted in independent validation sets were 90% (9/10) for resistant and 92% (12/13) for refractory gene signatures. Correlations between microarray/qRT-PCR data were robust for both resistant (17/23 genes) and refractory gene signatures (25/34 genes). Data mining of the predictive signatures using PathwayStudio software identified several biological processes (collagen regulation, apoptosis, cell survival, and DNA repair) implicated in conferring resistance to chemotherapy. We transiently transfected RNAi molecules to silence several signature genes and determine their contribution to taxol/cisplatin sensitivity in a series ofl ovarian cancer cell lines. Preliminary data showed DUSP1 gene expression knockdown potentiated cisplatin sensitivity in SKOV3/OVCA429 cell lines, while POLH knockdown potentiated cisplatin sensitivity in OVCA429/OVCA420 cell lines. Conclusions: A gene expression signature predicts for chemoresponse in ovarian cancers, and has identified novel targets of biological/therapeutic interest. No significant financial relationships to disclose.
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Affiliation(s)
- L. Ozbun
- NIH/NCI, Bethesda, MD; Brigham and Women’s Hospital, Boston, MA
| | - T. Bonome
- NIH/NCI, Bethesda, MD; Brigham and Women’s Hospital, Boston, MA
| | - M. Radonovich
- NIH/NCI, Bethesda, MD; Brigham and Women’s Hospital, Boston, MA
| | - C. Pise-Masison
- NIH/NCI, Bethesda, MD; Brigham and Women’s Hospital, Boston, MA
| | - J. Brady
- NIH/NCI, Bethesda, MD; Brigham and Women’s Hospital, Boston, MA
| | - N. Caplen
- NIH/NCI, Bethesda, MD; Brigham and Women’s Hospital, Boston, MA
| | - M. Johnson
- NIH/NCI, Bethesda, MD; Brigham and Women’s Hospital, Boston, MA
| | - S. C. Mok
- NIH/NCI, Bethesda, MD; Brigham and Women’s Hospital, Boston, MA
| | - M. J. Birrer
- NIH/NCI, Bethesda, MD; Brigham and Women’s Hospital, Boston, MA
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Patel CJ, Ullal A, Roberts M, Brady J, Bulmer JN, Wadehra V. O-13 ENDOMETRIAL CARCINOMA DETECTED WITH SUREPATH LIQUID BASED CERVICAL CYTOLOGY: COMPARISON WITH CONVENTIONAL CERVICAL CYTOLOGY. Cytopathology 2006. [DOI: 10.1111/j.1365-2303.2006.00392_12_4.x] [Citation(s) in RCA: 2] [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: 11/28/2022]
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Ozbun L, Bonome T, Johnson ME, Radonovich M, Pise-Masison C, Brady J, Mok S, Birrer ME. Gene expression signature predicts chemoresponse of microdissected papillary serous ovarian tumors. J Clin Oncol 2006. [DOI: 10.1200/jco.2006.24.18_suppl.5064] [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: 11/20/2022] Open
Abstract
5064 Background: The purpose of this study was to identify a predictive gene signature for chemoresponse in patients with advanced stage papillary serous ovarian cancer. Methods: Expression profiling was performed on 50 chemonaive, microdissected advanced stage papillary serous ovarian cancers using Affymetrix Human Genome U133 Plus 2.0 microarrays. Chemoresistance was defined as disease progression while the patients remained on primary chemotherapy. Nine normal human ovarian surface epithelial (HOSE) brushings were also assessed to quantify normal gene expression levels. Validation was performed by quantitative real time PCR using the HOSE isolates and microdissected ovarian tumor samples. Results: A supervised learning algorithm applied to genes differentially expressed between chemosensitive/resistance tumors (p < 0.001) using leave-one-out cross-validation (LOOCV), identified over 2000 genes associated with tumor chemosensitivity. The chemoresponsive gene list was further refined to 576 genes by including only genes used for all LOOCV iterations. An independent gene list was generated comparing expression profiles of chemoresistant tumors to HOSE. The two lists were compared to identify common genes, generating final classifier list of 75 genes that included genes involved in apoptosis, RNA processing, protein ubiquitination, transcription regulation, and other novel genes. We hypothesized genes identified in both data sets would be predictive and biologically relevant. Of these 75 genes, 20 were validated by real-time PCR. Validated genes were ranked by a univariate t-stat value to further resolve the predictor. 4 multivariate predictor algorithms demonstrated the 10 top ranked validated genes maximixed prediction accuracy (compound covariate, 91%; diagonal linear discriminant analysis, 91%; 3-nearest neighbor, 86%; nearest centroid, 95%). The predictive value of these genes will be evaluated on an independent sample set. Conclusions: Gene expression profiling can distinguish between chemosensitive and chemoresistant ovarian cancers. This signature can predict response to therapy and has identified novel biologically and clinically relevant targets. No significant financial relationships to disclose.
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Affiliation(s)
- L. Ozbun
- National Institute of Health/National Cancer Institute, Bethesda, MD; Brigham and Women’s Hospital, Boston, MA
| | - T. Bonome
- National Institute of Health/National Cancer Institute, Bethesda, MD; Brigham and Women’s Hospital, Boston, MA
| | - M. E. Johnson
- National Institute of Health/National Cancer Institute, Bethesda, MD; Brigham and Women’s Hospital, Boston, MA
| | - M. Radonovich
- National Institute of Health/National Cancer Institute, Bethesda, MD; Brigham and Women’s Hospital, Boston, MA
| | - C. Pise-Masison
- National Institute of Health/National Cancer Institute, Bethesda, MD; Brigham and Women’s Hospital, Boston, MA
| | - J. Brady
- National Institute of Health/National Cancer Institute, Bethesda, MD; Brigham and Women’s Hospital, Boston, MA
| | - S. Mok
- National Institute of Health/National Cancer Institute, Bethesda, MD; Brigham and Women’s Hospital, Boston, MA
| | - M. E. Birrer
- National Institute of Health/National Cancer Institute, Bethesda, MD; Brigham and Women’s Hospital, Boston, MA
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Zachariadis O, Cassidy JP, Brady J, Mahon BP. gammadelta T cells regulate the early inflammatory response to bordetella pertussis infection in the murine respiratory tract. Infect Immun 2006; 74:1837-45. [PMID: 16495558 PMCID: PMC1418642 DOI: 10.1128/iai.74.3.1837-1845.2006] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
The role of gammadelta T cells in the regulation of pulmonary inflammation following Bordetella pertussis infection was investigated. Using a well-characterized murine aerosol challenge model, inflammatory events in mice with targeted disruption of the T-cell receptor delta-chain gene (gammadelta TCR-/- mice) were compared with those in wild-type animals. Early following challenge with B. pertussis, gammadelta TCR-/- mice exhibited greater pulmonary inflammation, as measured by intra-alveolar albumin leakage and lesion histomorphometry, yet had lower contemporaneous bacterial lung loads. The larger numbers of neutrophils and macrophages and the greater concentration of the neutrophil marker myeloperoxidase in bronchoalveolar lavage fluid from gammadelta TCR-/- mice at this time suggested that differences in lung injury were mediated through increased leukocyte trafficking into infected alveoli. Furthermore, flow cytometric analysis found the pattern of recruitment of natural killer (NK) and NK receptor+ T cells into airspaces differed between the two mouse types over the same time period. Taken together, these findings suggest a regulatory influence for gammadelta T cells over the early pulmonary inflammatory response to bacterial infection. The absence of gammadelta T cells also influenced the subsequent adaptive immune response to specific bacterial components, as evidenced by a shift from a Th1 to a Th2 type response against the B. pertussis virulence factor filamentous hemagglutinin in gammadelta TCR-/- mice. The findings are relevant to the study of conditions such as neonatal B. pertussis infection and acute respiratory distress syndrome where gammadelta T cell dysfunction has been implicated in the inflammatory process.
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Affiliation(s)
- O Zachariadis
- Department of Veterinary Pathology, Faculty of Veterinary Medicine, University College Dublin, Belfield, Dublin 4, Ireland
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Mandall NA, O'Brien KD, Brady J, Worthington HV, Harvey L. Teledentistry for screening new patient orthodontic referrals. Part 1: A randomised controlled trial. Br Dent J 2005; 199:659-62, discussion 653. [PMID: 16311569 DOI: 10.1038/sj.bdj.4812930] [Citation(s) in RCA: 67] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/21/2004] [Indexed: 11/09/2022]
Abstract
OBJECTIVE The primary aim was to evaluate the validity of a teledentistry system for screening new patient orthodontic referrals. The secondary aims were to evaluate whether the teledentistry system affected i) referral rates ii) inappropriate referral rates iii) number of failed appointments. STUDY DESIGN Randomised controlled trial. SAMPLE Fifteen dental practices in Greater Manchester, UK, were randomly allocated to either a teledentistry test group (n = 8) or a control group (n = 7). They referred 327 patients over a 15 month period. METHOD Practitioners in the test group referred patients to one of two consultant orthodontists via a 'store and forward' teledentistry system consisting of photographs sent as email attachments. The decision to accept or not accept a referral on this basis was compared with the same decision choice when the same patient was subsequently seen on a new patient clinic. This measured the validity of the system with the clinic's decision used as the gold standard. Patients in the control group were referred using the usual letter system. Referral rates, inappropriate referrals and number of failed appointments were then compared between the teledentistry and control groups. RESULTS The sensitivity (true positive value) of the teledentistry system was high at 0.80 with a positive predictive value of 0.92. The specificity (true negative value) was slightly lower at 0.73 with a negative predictive value of 0.50. The inappropriate referral rate for the teledentistry group was 8.2% and for the controls 26.2% (p = 0.037). There was no statistically significant difference in clinic attendance between teledentistry and control groups (p = 0.36). CONCLUSIONS Teledentistry is a valid system for positively identifying appropriate new patient orthodontic referrals. However, there is a risk that a patient is not accepted on the teledentistry system who would benefit from a full clinical examination. Teledentistry could be a significant factor in reducing the inappropriate referral rate. Patient participation in a teledentistry system does not appear to mean they are any more likely to attend their hospital appointment.
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Affiliation(s)
- N A Mandall
- Orthodontic Department, University Dental Hospital of Manchester.
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Bonome T, Park DC, Hao K, Donninger H, Radonovich M, Brady J, Barrett JC, Wong WH, Welch WR, Mok SC, Birrer MJ. Identification of a gene signature that can predict lone-term survival in patients with high-grade late stage serous ovarian cancer. J Clin Oncol 2005. [DOI: 10.1200/jco.2005.23.16_suppl.5032] [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: 11/20/2022] Open
Affiliation(s)
- T. Bonome
- National Cancer Institute, Rockville, MD; Brigham & Women’s Hosp, Boston, MA; Harvard Sch of Public Health, Boston, MA
| | - D.-C. Park
- National Cancer Institute, Rockville, MD; Brigham & Women’s Hosp, Boston, MA; Harvard Sch of Public Health, Boston, MA
| | - K. Hao
- National Cancer Institute, Rockville, MD; Brigham & Women’s Hosp, Boston, MA; Harvard Sch of Public Health, Boston, MA
| | - H. Donninger
- National Cancer Institute, Rockville, MD; Brigham & Women’s Hosp, Boston, MA; Harvard Sch of Public Health, Boston, MA
| | - M. Radonovich
- National Cancer Institute, Rockville, MD; Brigham & Women’s Hosp, Boston, MA; Harvard Sch of Public Health, Boston, MA
| | - J. Brady
- National Cancer Institute, Rockville, MD; Brigham & Women’s Hosp, Boston, MA; Harvard Sch of Public Health, Boston, MA
| | - J. C. Barrett
- National Cancer Institute, Rockville, MD; Brigham & Women’s Hosp, Boston, MA; Harvard Sch of Public Health, Boston, MA
| | - W. H. Wong
- National Cancer Institute, Rockville, MD; Brigham & Women’s Hosp, Boston, MA; Harvard Sch of Public Health, Boston, MA
| | - W. R. Welch
- National Cancer Institute, Rockville, MD; Brigham & Women’s Hosp, Boston, MA; Harvard Sch of Public Health, Boston, MA
| | - S. C. Mok
- National Cancer Institute, Rockville, MD; Brigham & Women’s Hosp, Boston, MA; Harvard Sch of Public Health, Boston, MA
| | - M. J. Birrer
- National Cancer Institute, Rockville, MD; Brigham & Women’s Hosp, Boston, MA; Harvard Sch of Public Health, Boston, MA
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