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Parker R, Allison M, Anderson S, Aspinall R, Bardell S, Bains V, Buchanan R, Corless L, Davidson I, Dundas P, Fernandez J, Forrest E, Forster E, Freshwater D, Gailer R, Goldin R, Hebditch V, Hood S, Jones A, Lavers V, Lindsay D, Maurice J, McDonagh J, Morgan S, Nurun T, Oldroyd C, Oxley E, Pannifex S, Parsons G, Phillips T, Rainford N, Rajoriya N, Richardson P, Ryan J, Sayer J, Smith M, Srivastava A, Stennett E, Towey J, Vaziri R, Webzell I, Wellstead A, Dhanda A, Masson S. Quality standards for the management of alcohol-related liver disease: consensus recommendations from the British Association for the Study of the Liver and British Society of Gastroenterology ARLD special interest group. BMJ Open Gastroenterol 2023; 10:e001221. [PMID: 37797967 PMCID: PMC10551993 DOI: 10.1136/bmjgast-2023-001221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Accepted: 08/29/2023] [Indexed: 10/07/2023] Open
Abstract
OBJECTIVE Alcohol-related liver disease (ALD) is the most common cause of liver-related ill health and liver-related deaths in the UK, and deaths from ALD have doubled in the last decade. The management of ALD requires treatment of both liver disease and alcohol use; this necessitates effective and constructive multidisciplinary working. To support this, we have developed quality standard recommendations for the management of ALD, based on evidence and consensus expert opinion, with the aim of improving patient care. DESIGN A multidisciplinary group of experts from the British Association for the Study of the Liver and British Society of Gastroenterology ALD Special Interest Group developed the quality standards, with input from the British Liver Trust and patient representatives. RESULTS The standards cover three broad themes: the recognition and diagnosis of people with ALD in primary care and the liver outpatient clinic; the management of acutely decompensated ALD including acute alcohol-related hepatitis and the posthospital care of people with advanced liver disease due to ALD. Draft quality standards were initially developed by smaller working groups and then an anonymous modified Delphi voting process was conducted by the entire group to assess the level of agreement with each statement. Statements were included when agreement was 85% or greater. Twenty-four quality standards were produced from this process which support best practice. From the final list of statements, a smaller number of auditable key performance indicators were selected to allow services to benchmark their practice and an audit tool provided. CONCLUSION It is hoped that services will review their practice against these recommendations and key performance indicators and institute service development where needed to improve the care of patients with ALD.
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Affiliation(s)
- Richard Parker
- Leeds Liver Unit, Leeds Teaching Hospitals NHS Trust, Leeds, UK
- Leeds Institute of Medical Research at St James's University Hospital, University of Leeds, Leeds, UK
| | | | - Seonaid Anderson
- Angus Integrated Drug and Alcohol Recovery Service (AIDARS), Ninewells Hospital and Medical School, Dundee, UK
| | - Richard Aspinall
- Gastroenterology & Hepatology, Portsmouth Hospitals NHS Trust, Portsmouth, UK
| | - Sara Bardell
- Birmingham Liver Services Unit, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Vikram Bains
- Liver Transplant Unit, King's College Hospital NHS Foundation Trust, London, UK
| | - Ryan Buchanan
- Faculty of Medicine, University of Southampton, Southampton, UK
| | - Lynsey Corless
- Department of Gastroenterology, Hepatology and Endoscopy, Hull University Teaching Hospitals NHS Trust, Hull, UK
| | - Ian Davidson
- NHS Fife Addiction Services, NHS Fife, Kirkcaldy, UK
| | - Pauline Dundas
- Peter Brunt Centre, Aberdeen Royal Infirmary, NHS Grampian, Aberdeen, UK
| | - Jeff Fernandez
- Alcohol and Drug Liaison, Royal Free London NHS Foundation Trust, London, UK
| | - Ewan Forrest
- Dept of Gastroenterology, Glasgow Royal Infirmary, Glasgow, UK
| | - Erica Forster
- Leeds Liver Unit, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - Dennis Freshwater
- Birmingham Liver Services Unit, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Ruth Gailer
- Islington Primary Care Federation, London, UK
| | - Robert Goldin
- Department of Digestive Diseases, Department of Medicine, Imperial College London, London, UK
| | | | - Steve Hood
- Digestive Diseases Unit, Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK
| | - Arron Jones
- Pharmacy, Barts and The London NHS Trust, London, UK
| | | | - Deborah Lindsay
- Alcohol Care Team, East Lancashire Hospitals NHS Trust, Blackburn, UK
| | - James Maurice
- Gastroenterology and hepatology, North Bristol NHS Trust, Westbury on Trym, UK
| | - Joanne McDonagh
- Birmingham Liver Services Unit, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | | | - Tania Nurun
- Department of Gastroenterology, Hepatology and Endoscopy, Hull University Teaching Hospitals NHS Trust, Hull, UK
| | | | | | - Sally Pannifex
- Hepatology, St George's Healthcare NHS Trust, London, UK
| | | | | | - Nicole Rainford
- Liver Transplant Unit, King's College Hospital NHS Foundation Trust, London, UK
| | - Neil Rajoriya
- Birmingham Liver Services Unit, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Paul Richardson
- Gastroenterology and Hepatology, Royal Liverpool and Broadgreen University Hospitals NHS Trust, Liverpool, UK
| | - J Ryan
- Sheila Sherlock Liver Centre, Royal Free London NHS Foundation Trust, London, UK
| | - Joanne Sayer
- Gastroenterology, Doncaster and Bassetlaw Hospitals NHS Foundation Trust, Doncaster, UK
| | - Mandy Smith
- Alcohol care team, Southport and Ormskirk Hospital NHS Trust, Southport, UK
| | - Ankur Srivastava
- Gastroenterology and hepatology, North Bristol NHS Trust, Westbury on Trym, UK
| | - Emma Stennett
- Gastroenterology, Guy's and St Thomas' Hospitals NHS Trust, London, UK
| | - Jennifer Towey
- Birmingham Liver Services Unit, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | | | - Ian Webzell
- Liver Transplant Unit, King's College Hospital NHS Foundation Trust, London, UK
| | - Andrew Wellstead
- Gastroenterology, University Hospitals Dorset NHS Foundation Trust, Poole, UK
| | - Ashwin Dhanda
- Faculty of health, University of Plymouth, Plymouth, UK
| | - Steven Masson
- Liver unit, The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle, UK
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Taniere P, Nicholson AG, Gosney JR, Montero Fernandez MA, Bury D, Moore DA, Verghese E, Soomro I, Joseph L, Bhatt N, Viola P, Bains R, Lanctot AG, Ryan J. Landscape of cancer biomarker testing in England following genomic services reconfiguration: insights from a nationwide pathologist survey. J Clin Pathol 2023:jcp-2023-208890. [PMID: 37258251 DOI: 10.1136/jcp-2023-208890] [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: 03/16/2023] [Accepted: 03/29/2023] [Indexed: 06/02/2023]
Abstract
AIMS Cancer diagnostics have been evolving rapidly. In England, the new National Health Service Genomic Medicine Service (GMS) provides centralised access to genomic testing via seven regional Genomic Laboratory Hubs. The PATHways survey aimed to capture pathologists' experience with current diagnostic pathways and opportunities for optimisation to ensure equitable and timely access to biomarker testing. METHODS A nationwide survey was conducted with consultant pathologists from regional laboratories, via direct interviews based on a structured questionnaire. Descriptive analysis of responses was undertaken using quantitative and qualitative methods. RESULTS Fifteen regional centres completed the survey covering a median population size of 2.5 (1.9-3.6) million (each for n=12). The median estimated turnaround time (calendar days) for standard molecular markers in melanoma, breast and lung cancers ranged from 2 to 3 days by immunohistochemistry (excluding NTRKfus in breast and lung cancers, and PD-L1 in melanoma) and 6-15 days by real-time-PCR (excluding KIT for melanoma), to 17.5-24.5 days by next-generation sequencing (excluding PIK3CA for breast cancer). Tests were mainly initiated by pathologists and oncologists. All respondents discussed the results at multidisciplinary team (MDT) meetings. The GMS roll-out was perceived to have high impact on services by 53% of respondents, citing logistical and technical issues. Enhanced education on new pathways, tissue requirements, report interpretation, providing patient information and best practice sharing was suggested for pathologists and other MDT members. CONCLUSION Our survey highlighted the role of regional pathology within the evolving diagnostic landscape in England. Notable recommendations included improved communication and education, active stakeholder engagement, and tackling informatics barriers.
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Affiliation(s)
- Phillipe Taniere
- Histopathology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Andrew G Nicholson
- Respiratory Pathology, National Heart and Lung Institute, Imperial College London, London, UK
- Histopathology, Royal Brompton and Harefield Hospitals, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - John R Gosney
- Cellular Pathology, Royal Liverpool University Hospital, Liverpool, UK
| | | | - Danielle Bury
- Histopathology, Blackpool Teaching Hospitals NHS Foundation Trust, Blackpool, UK
| | - David Allan Moore
- Cellular Pathology, University College London Cancer Institute, London, UK
| | - Eldo Verghese
- Histopathology, St James's University Hospital, Leeds, UK
| | - Irshad Soomro
- Histopathology, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Leena Joseph
- Histopathology, Manchester University NHS Foundation Trust, Manchester, UK
| | - Nidhi Bhatt
- Cellular Pathology, North Bristol NHS Trust, Westbury on Trym, UK
| | - Patrizia Viola
- Cellular Pathology, Imperial College Healthcare NHS Trust, London, UK
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Gutteridge DS, Segal A, McNeil JJ, Beilin L, Brodtmann A, Chowdhury EK, Egan GF, Ernst ME, Hussain SM, Reid CM, Robb CE, Ryan J, Woods RL, Keage HA, Jamadar S. The relationship between long-term blood pressure variability and cortical thickness in older adults. Neurobiol Aging 2023; 129:157-167. [PMID: 37331246 DOI: 10.1016/j.neurobiolaging.2023.05.011] [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: 01/17/2023] [Revised: 05/02/2023] [Accepted: 05/17/2023] [Indexed: 06/20/2023]
Abstract
High blood pressure variability (BPV) is a risk factor for cognitive decline and dementia, but its association with cortical thickness is not well understood. Here we use a topographical approach, to assess links between long-term BPV and cortical thickness in 478 (54% men at baseline) community dwelling older adults (70-88 years) from the ASPirin in Reducing Events in the Elderly NEURO sub-study. BPV was measured as average real variability, based on annual visits across three years. Higher diastolic BPV was significantly associated with reduced cortical thickness in multiple areas, including temporal (banks of the superior temporal sulcus), parietal (supramarginal gyrus, post-central gyrus), and posterior frontal areas (pre-central gyrus, caudal middle frontal gyrus), while controlling for mean BP. Higher diastolic BPV was associated with faster progression of cortical thinning across the three years. Diastolic BPV is an important predictor of cortical thickness, and trajectory of cortical thickness, independent of mean blood pressure. This finding suggests an important biological link in the relationship between BPV and cognitive decline in older age.
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Affiliation(s)
- D S Gutteridge
- Cognitive Ageing and Impairment Neuroscience Laboratory (CAIN), University of South Australia, Adelaide, South Australia, Australia.
| | - A Segal
- Turner Institute for Brain & Mental Health, Monash University, Melbourne, Victoria, Australia
| | - J J McNeil
- School of Public Health & Preventative Medicine, Monash University, Melbourne, Victoria, Australia
| | - L Beilin
- School of Medicine, Royal Perth Hospital Unit, University of Western Australia, Perth, Western Australia, Australia
| | - A Brodtmann
- Cognitive Health Initiative, Central Clinical School, Monash University, Melbourne, Victoria, Australia
| | - E K Chowdhury
- School of Population Health, Curtin University, Perth, Western Australia, Australia
| | - G F Egan
- Turner Institute for Brain & Mental Health, Monash University, Melbourne, Victoria, Australia; Monash Biomedical Imaging, Monash University, Melbourne, Victoria, Australia
| | - M E Ernst
- Department of Family Medicine, Carver College of Medicine. The University of Iowa, Iowa City, IA, USA; Department of Pharmacy Practice and Science, College of Pharmacy, Carver College of Medicine. The University of Iowa, Iowa City, IA, USA
| | - S M Hussain
- School of Public Health & Preventative Medicine, Monash University, Melbourne, Victoria, Australia; Department of Medical Education, Melbourne Medical School, University of Melbourne, Melbourne, Victoria, Australia
| | - C M Reid
- School of Public Health & Preventative Medicine, Monash University, Melbourne, Victoria, Australia; School of Population Health, Curtin University, Perth, Western Australia, Australia
| | - C E Robb
- School of Public Health & Preventative Medicine, Monash University, Melbourne, Victoria, Australia
| | - J Ryan
- School of Public Health & Preventative Medicine, Monash University, Melbourne, Victoria, Australia
| | - R L Woods
- School of Public Health & Preventative Medicine, Monash University, Melbourne, Victoria, Australia
| | - H A Keage
- Cognitive Ageing and Impairment Neuroscience Laboratory (CAIN), University of South Australia, Adelaide, South Australia, Australia
| | - S Jamadar
- Turner Institute for Brain & Mental Health, Monash University, Melbourne, Victoria, Australia; Monash Biomedical Imaging, Monash University, Melbourne, Victoria, Australia
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DesJardin J, Kolaitis N, Kime N, Kronmal R, Lammi M, Mathai S, Ryan J, Ventetuolo C, De Marco T. Female Sex is Associated with Worse Functional Impairment and Health-Related Quality of Life In Pulmonary Arterial Hypertension: Baseline Results from the Pulmonary Hypertension Association Registry (PHAR). J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.131] [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: 04/05/2023] Open
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Connolly E, Thomson K, King D, Schilling K, Ryan J, Grimison P, Zhou D, Zhang B, Strach M, Baker A, Sibbald T, Bhadri V. 115TiP MYTH Study: Methotrexate for AYA in the home: A study of safety, feasibility, patient acceptability and cost effectiveness of an ambulatory model for AYA osteosarcoma patients. ESMO Open 2023. [DOI: 10.1016/j.esmoop.2023.101152] [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: 04/05/2023] Open
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Prendergast C, Ryan J. Irish Specialist Registrars Infected with SARS-CoV-2. Ir Med J 2023; 116:737. [PMID: 37555805] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 08/10/2023]
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Berger J, Abdou W, Roberts J, Ryan J, Attaluri S, Sur R, Finneran Iv J, Bechis S. Erector spinae plane blocks for analgesia after percutaneous nephrolithotomy: A pathway to reduce opiates. Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)00986-7] [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: 02/12/2023]
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Saifuddin Ekram ARM, Espinoza SE, Ernst ME, Ryan J, Beilin L, Stocks NP, Ward SA, McNeil JJ, Shah RC, Woods RL. The Association between Metabolic Syndrome, Frailty and Disability-Free Survival in Healthy Community-dwelling Older Adults. J Nutr Health Aging 2023; 27:1-9. [PMID: 36651481 PMCID: PMC10061371 DOI: 10.1007/s12603-022-1860-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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: 05/20/2022] [Accepted: 09/16/2022] [Indexed: 11/16/2022]
Abstract
OBJECTIVES To examine the association between metabolic syndrome (MetS) and frailty, and determine whether co-existent MetS and frailty affect disability-free survival (DFS), assessed through a composite of death, dementia or physical disability. DESIGN Longitudinal study. SETTING AND PARTICIPANTS Community-dwelling older adults from Australia and the United States (n=18,264) from "ASPirin in Reducing Events in the Elderly" (ASPREE) study. MEASUREMENTS MetS was defined according to American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines (2018). A modified Fried phenotype and a deficit accumulation Frailty Index (FI) were used to assess frailty. Association between MetS and frailty was examined using multinomial logistic regression. Cox regression was used to analyze the association between MetS, frailty and DFS over a median follow-up of 4.7 years. RESULTS Among 18,264 participants, 49.9% met the criteria for MetS at baseline. Participants with Mets were more likely to be pre-frail [Relative Risk Ratio (RRR): 1.22; 95%Confidence Interval (CI): 1.14, 1.30)] or frail (RRR: 1.66; 95%CI: 1.32, 2.08) than those without MetS. MetS alone did not shorten DFS while pre-frailty or frailty alone did [Hazard Ratio (HR): 1.68; 95%CI: 1.45, 1.94; HR: 2.65; 95%CI:1.92, 3.66, respectively]. Co-existent MetS with pre-frailty/frailty did not change the risk of shortened DFS. CONCLUSIONS MetS was associated with pre-frailty or frailty in community-dwelling older individuals. Pre-frailty or frailty increased the risk of reduced DFS but presence of MetS did not change this risk. Assessment of frailty may be more important than MetS in predicting survival free of dementia or physical disability.
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Affiliation(s)
- A R M Saifuddin Ekram
- Dr. A R M Saifuddin Ekram, Senior Clinical Research Consultant (ASPREE), SPHPM, Monash University, 553 St Kilda Road, Melbourne, Victoria 3004, Australia. Mobile phone: +61449031659, E-mail:
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Alharbi TA, Ryan J, Freak-Poli R, Gasevic D, McNeil J, Woods RL, Britt C, Nelson MR, Owen AJ. Self-Reported Early and Later Life Weight and the Risk of All-Cause Mortality in Older Adults. J Nutr Health Aging 2023; 27:301-308. [PMID: 37170438 PMCID: PMC10353754 DOI: 10.1007/s12603-023-1907-1] [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: 07/12/2022] [Accepted: 01/25/2023] [Indexed: 05/13/2023]
Abstract
OBJECTIVES The extent to which body weight in early adulthood is associated with late-life mortality risk is unclear. This study aimed to determine the association between body mass index (BMI) in early adulthood (at 18 years of age) and older age (70 years and over), and the risk of mortality in later life. DESIGN Secondary analysis of the ASPREE Longitudinal Study of Older Persons (ALSOP). SETTING, PARTICIPANTS Data were from 14,853 relatively healthy community-dwelling Australians aged ≥ 70 years when enrolled in the study. MEASUREMENTS Self-reported weight at age ≥ 70 years and recalled weight at age 18 years were collected at ALSOP study baseline. Height was measured with a stadiometer and was used for calculation of BMI at both timepoints. BMI at each timepoint was defined as: underweight, normal weight, overweight and obese. Individuals were categorised into one of five 'lifetime' BMI groups: normal weight (BMI between 18.5 and 24.9 at both times), overweight (25.0-29.9 at either or both times), obesity to non-obese (≥30.0 at age 18 and <30.0 ≥ 70 years), non-obese to obesity (<30.0 at age 18 and ≥30.0 at age ≥ 70 years), and early and later life obesity (≥30.0 at both times). RESULTS During a median 4.7 years follow-up, 715 deaths occurred. Obesity at 18 years, but not in older age (p=0.44), was significantly associated with the risk of mortality in later life, even after accounting for current health status (HR: 2.35, 95% CI: 1.53-3.58, p<0.001). Compared with participants with normal BMI at both time points, being obese at both time points was associated with increased mortality risk (HR=1.99, 95% CI: 1.04-3.81, p=0.03), and the risk was even greater for individuals who were obese at 18 years but were no longer obese in older age (HR=2.92, 95% CI: 1.65-5.16, p<0.001), in fully adjusted models. Participants who were normal weight at 18 years and were obese in later life, did not have an increased mortality risk (p=0.78). CONCLUSIONS Obesity in early adulthood, and obesity in both early and later life, were associated with increased mortality risk in later life. This highlights the importance of preventing obesity in early adulthood and maintaining a normal weight over an adult lifespan.
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Affiliation(s)
- T A Alharbi
- Dr Alice J. Owen, Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, 553 St. Kilda Rd., Level 4, Melbourne VIC 3004, Australia, Tel: +61 3 9903 0416,
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10
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Wild H, Gasevic D, Woods RL, Ryan J, Berk M, Wolfe R, McNeil J, Owen AJ. Correlates of Meal Skipping in Community Dwelling Older Adults: A Cross-Sectional Study. J Nutr Health Aging 2023; 27:159-165. [PMID: 36806870 PMCID: PMC10035663 DOI: 10.1007/s12603-023-1884-2] [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: 07/07/2022] [Accepted: 11/24/2022] [Indexed: 02/05/2023]
Abstract
In this cross-sectional analysis of 10,071 community dwelling adults aged ≥70 years, we examined factors associated with meal skipping (self-reported) using multivariable logistic regression. Prevalence of meal skipping in this study was 19.5%. The adjusted odds (aOR [95%CI]) of meal skipping were lower in those 85+ years (vs. 70-74.9 years, 0.56 [0.45-0.70]), and in those in regional areas (vs. urban area, 0.81 [0.72-0.92]). Higher odds of meal skipping were observed for those living alone (vs. living with someone, 1.84 [1.64-2.05]), current smokers (vs. non-smokers, 2.07 [1.54-2.80]), consumers of high amounts of alcohol (vs. abstainers 1.93 [1.35-2.75]), those with poor oral health (vs. excellent oral health, 1.71 [1.07 -2.73]) diabetes (vs. not 1.26 [1.06-1.50]), or frailty (vs. not, 1.63 [1.09-2.43]). This study identified socio-demographic, social, behavioural and biomedical correlates of meal skipping in later life, which may assist in targeting interventions to address meal skipping.
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Affiliation(s)
- H Wild
- Dr Alice J Owen, School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Melbourne 3004, VIC, Australia, T: +61 3 9903 0416
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Agrawal R, Vieira J, Ryan J, Negi H, Rajput T, Corbin R, Viana R. A Systematic Literature Review of the Economic Evaluations of Treatments for Patients with Chronic Myeloid Leukemia. Pharmacoeconomics 2022; 40:1159-1186. [PMID: 36175789 DOI: 10.1007/s40273-022-01189-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 09/04/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND AND OBJECTIVES The management of chronic myeloid leukemia is associated with an extensive economic burden, and as novel interventions are being tested in this disease, understanding the comparative effectiveness is of interest. Findings and conclusions of this important issue continue to evolve with improvements in clinical research and economic understanding. This systematic literature review aims to conduct a comprehensive assessment of economic evaluations in chronic phase chronic myeloid leukemia. METHODS Embase®, MEDLINE®, and the National Health Service Economic Evaluation Database were searched on 4 July, 2022 to identify economic evaluations of chronic myeloid leukemia. Health technology assessment websites and key conference proceedings were also searched. Economic evaluations comparing treatment options in adult patients with chronic phase chronic myeloid leukemia were included. The quality of the studies were assessed using Drummond's checklists. RESULTS The search retrieved 47 studies and 16 health technology assessments that fulfilled the eligibility criteria. Most were cost-utility analyses (23 studies and 11 health technology assessments) and were from the USA (n = 15) and China (n = 7). Twenty-seven studies and six health technology assessments included only patients with chronic phase chronic myeloid leukemia. Most models had a Markov structure, a 1 year to lifetime time horizon, and a 1-month cycle length. Commonly assessed treatments were various tyrosine kinase inhibitors (imatinib, nilotinib, dasatinib, bosutinib, and ponatinib) and other interventions such as interferon-α, hydroxyurea, and allogeneic stem cell transplant. CONCLUSIONS In patients with newly diagnosed chronic myeloid leukemia, imatinib regimens were cost effective, mostly owing to the availability of generics. Nilotinib and dasatinib were generally cost effective as second-line agents for patients who were resistant or intolerant to imatinib. Though progress has been made to better characterize the cost effectiveness of first-line and second-line chronic myeloid leukemia therapies, the paucity of published cost-effectiveness studies of third-line treatments increases the uncertainty associated with economic evaluations of later lines of therapy.
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Affiliation(s)
| | - Joao Vieira
- Novartis Pharmaceuticals UK Ltd., London, UK
| | | | - Harish Negi
- Novartis Healthcare Pvt. Ltd., Hyderabad, India
| | | | - Regina Corbin
- Novartis Pharmaceuticals Corp., East Hanover, NJ, USA
| | - Ricardo Viana
- Novartis Pharma AG, Basel, Switzerland.
- Worldwide Access Disease Lead, Hematology, Global Value & Access, Oncology, WSJ- Fabrikstrasse 18-3.330, 4056, Basel, Switzerland.
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Edwards P, Tan J, Wilson J, Lake J, Ryan J, Ebert J, D'Alessandro P. Upper limb performance and neuromuscular asymmetries in Australian Rules Footballers following shoulder stabilisation surgery. J Sci Med Sport 2022. [DOI: 10.1016/j.jsams.2022.09.068] [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: 11/17/2022]
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13
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Taniere P, Nicholson A, Gosney J, Joseph L, Shaw E, Lanctot A, Bains R, Ryan J. PATHways UK survey: Pathology perceptions on current biomarker testing and pathways for breast cancer in England. Eur J Cancer 2022. [DOI: 10.1016/s0959-8049(22)01595-7] [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: 11/19/2022]
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Healy O, McStay M, Mannion H, Reynolds IS, Ryan J, Winter DC. Optimising the Use of Procedural Beds: Time for an Intervention. Ir Med J 2022; 115:675. [PMID: 36920414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Subscribe] [Scholar Register] [Indexed: 03/16/2023]
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15
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Croghan S, O’Connor E, Baird O, Fallon J, Loughman P, Esoof J, Keenan R, Ryan J, Manecksha R, D’Arcy F, Vaidyanathan S, Varma R, Thursby H, Matkowski A, El Hadi S, Mahmalji W, Giri S. Use of the Transurethral Catheterisation Safety Valve (TUCSV) for the Prevention of Catheter Balloon Inflation Injury of the Urethra: A Prospective Multi-Institutional Study. EUR UROL SUPPL 2022. [DOI: 10.1016/s2666-1683(22)00948-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Phyo AZZ, Ryan J, Gonzalez-Chica D, Stocks N, Woods R, Murray A, Reid C, Nelson M, Tonkin A, Storey E, Gasevic D, Orchard, Shah R, Freak-Poli R. 1005 HEALTH-RELATED QUALITY OF LIFE AND FUTURE RISK OF HEALTH OUTCOMES AMONG OLDER ADULTS LIVING IN AUSTRALIA AND THE UNITED STATES. Age Ageing 2022. [DOI: 10.1093/ageing/afac124.009] [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
Poor health-related quality of life (HRQoL) is associated with higher morbidity and mortality in patient populations. However, whether HRQoL is associated with health outcomes among community-dwelling older people requires further investigation. This study aimed to examine whether HRQoL predicts cognitive decline, dementia, cardiovascular disease (CVD), and mortality in community-dwelling older people living in Australia and the United States.
Method
A cohort of 19,106 individuals from the ASPirin in Reducing Events in the Elderly (ASPREE) study, aged 65–98 years, initially free of dementia or CVD, and who completed the HRQoL 12-item short form (SF-12, version-2) at baseline (2010–2014), were followed until June 2017. The physical (PCS) and mental component scores (MCS) of SF-12 were generated using standardized norm-based method.
Results
Over a median of 4.7 years, there were 2,412 cognitive declines, 574 dementia, 922 incident CVD events, and 1,052 deaths. Using Cox proportional-hazard regression adjusted for a range of covariates, every 10-unit increase in PCS was associated with a 6% lower risk of cognitive decline, a 14% lower risk of incident CVD, and 17% lower risk of all-cause mortality, but was not associated with incident dementia. In contrast, higher MCS was only associated with a 12% and 15% lower risk of cognitive decline and dementia, respectively. Findings did not differ by sex.
Conclusion
Our study provides some of the first evidence that HRQoL can be used in combination with clinical data to identify the future risks of health outcomes among older individuals living in the community. Our findings support the decision of the Australian Commission on Safety and Quality in Health Care to incorporate the SF-12 into the annual Patient-Reported Outcome Measures (PROMs assessment.
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Affiliation(s)
| | - J Ryan
- Monash University , Australia
| | | | - N Stocks
- The University of Adelaide , Australia
| | - R Woods
- Monash University , Australia
| | - A Murray
- Berman Center for Outcomes and Clinical Research , Minneapolis, Minnesota, USA
| | - C Reid
- Monash University , Australia
- Curtin University , Australia
| | - M Nelson
- Monash University , Australia
- University of Tasmania , Australia
| | | | | | - D Gasevic
- Monash University , Australia
- University of Edinburgh , UK
| | - Orchard
- Monash University , Australia
| | - R Shah
- Rush University Medical Center , Chicago, Illinois, USA
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Ashraf S, Chan E, Pan G, Furukawa M, Coster J, Ryan J, Kilaru S, Sanchez P. Clinical Predictors of Lung Transplant Outcomes in Patients with Scleroderma Compared with Pulmonary Fibrosis. J Heart Lung Transplant 2022. [DOI: 10.1016/j.healun.2022.01.638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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18
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Jochimsen K, Brown-Taylor L, Perry J, Glaws K, Lewis C, Ryan J, Di Stasi S. Biomechanical measures of clinician-defined unsteadiness during a forward stepdown task in individuals post-arthroscopy for femoroacetabular impingement syndrome. Clin Biomech (Bristol, Avon) 2022; 93:105586. [PMID: 35219043 PMCID: PMC9520757 DOI: 10.1016/j.clinbiomech.2022.105586] [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] [Received: 04/12/2021] [Revised: 01/20/2022] [Accepted: 01/25/2022] [Indexed: 02/07/2023]
Abstract
BACKGROUND Patients with femoroacetabular impingement syndrome can present with aberrant movement patterns including unsteady balance. Balance training is included in rehabilitation after hip arthroscopy and may improve quality of movement; however, specific biomechanical measures associated with clinician-defined balance impairments are unknown. We aimed to understand these associations as they may inform targeted rehabilitative interventions. METHODS The forward stepdown is a clinical test used to evaluate movement quality, including balance. 23 individuals at least one-year post-arthroscopy for femoroacetabular impingement syndrome and 15 healthy comparisons performed the forward stepdown, recorded by 3-dimensional motion capture and 2-dimensional video. Three physical therapists graded the 2-dimensional video for steadiness. Two-way analyses of variance were used to evaluate the interaction of group (post-arthroscopy/healthy comparison) by steadiness (steady/unsteady), for center of pressure medial-lateral excursion, center of pressure path length, and lateral trunk, pelvis, and lower extremity joint excursions. FINDINGS Six (26.1%) participants post-arthroscopy and five (33.3%) healthy comparisons were categorized as unsteady. The odds of being categorized as unsteady were not greater for participants post-arthroscopy (P = 0.72). There were no significant interactions; however, participants with clinician-defined unsteady balance, regardless of group, had significantly greater frontal plane trunk excursion, greater hip excursion, and greater center of pressure path length than those with steady balance (P ≤ 0.006). INTERPRETATION The odds of being categorized as unsteady were not greater for individuals post-arthroscopy for femoroacetabular impingement syndrome. Clinician-defined unsteadiness was associated with greater frontal plane trunk and hip motion which may be rehabilitation targets to improve balance during a dynamic single-leg task.
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Affiliation(s)
- K.N. Jochimsen
- Sports Medicine Research Institute, The Ohio State University Wexner Medical Center, 2835 Fred Taylor Drive, Columbus, OH 43202, United States,Division of Physical Therapy, School of Health and Rehabilitation Sciences, The Ohio State University, 453 W. 10th Avenue, Columbus, OH 43210, United States,Corresponding author at: Division of Athletic Training, School of Medicine, West Virginia University, 1 Medical Center Drive, 8501B Health Sciences Center South, Morgantown, WV 26506-9225, United States. (K.N. Jochimsen)
| | - L. Brown-Taylor
- Sports Medicine Research Institute, The Ohio State University Wexner Medical Center, 2835 Fred Taylor Drive, Columbus, OH 43202, United States,Division of Physical Therapy, School of Health and Rehabilitation Sciences, The Ohio State University, 453 W. 10th Avenue, Columbus, OH 43210, United States,Health and Rehabilitation Sciences Doctoral Program, School of Health and Rehabilitation Sciences, The Ohio State University, 453 W. 10th Avenue, Columbus, OH 43210, United States
| | - J. Perry
- Sports Medicine Research Institute, The Ohio State University Wexner Medical Center, 2835 Fred Taylor Drive, Columbus, OH 43202, United States
| | - K. Glaws
- Sports Medicine Research Institute, The Ohio State University Wexner Medical Center, 2835 Fred Taylor Drive, Columbus, OH 43202, United States
| | - C.L. Lewis
- Department of Physical Therapy and Athletic Training, Boston University, 635 Commonwealth Avenue, Boston, MA 02215, United States
| | - J. Ryan
- Sports Medicine Research Institute, The Ohio State University Wexner Medical Center, 2835 Fred Taylor Drive, Columbus, OH 43202, United States,Department of Orthopaedics, The Ohio State University Wexner Medical Center, 370 W. 9th Avenue, Columbus, OH 43210, United States
| | - S. Di Stasi
- Sports Medicine Research Institute, The Ohio State University Wexner Medical Center, 2835 Fred Taylor Drive, Columbus, OH 43202, United States,Division of Physical Therapy, School of Health and Rehabilitation Sciences, The Ohio State University, 453 W. 10th Avenue, Columbus, OH 43210, United States
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19
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Allen K, McKenna R, Ryan J, Quirke M. The Impact of COVID-19 on Alcohol Consumption. Ir Med J 2022; 115:550. [PMID: 35420012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Affiliation(s)
- K Allen
- Department of Gastroenterology, Beaumont Hospital, Dublin
| | - R McKenna
- Department of Emergency Medicine, Beaumont Hospital, Dublin
| | - J Ryan
- Department of Gastroenterology, Beaumont Hospital, Dublin
| | - M Quirke
- Department of Emergency Medicine, Beaumont Hospital, Dublin
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20
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Cassidy C, Moore L, Ryan J, Brennan S. Audit on Oral Health Examinations in an Approved Psychiatric Centre. Ir Med J 2022; 115:527. [PMID: 35279061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Affiliation(s)
- C Cassidy
- Department of Psychiatry, South Tipperary Hospital, Clonmel, Tipperary
| | - L Moore
- Department of Psychiatry, South Tipperary Hospital, Clonmel, Tipperary
| | - J Ryan
- Suirside Medical Practice, Clonmel, Tipperary
| | - S Brennan
- Department of Psychiatry, South Tipperary Hospital, Clonmel, Tipperary
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21
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Gananandan K, Thomas R, Burke N, Jameie-Oskooei S, Singh A, Westbrook R, Ryan J. Adult-onset Still's disease with secondary haemophagocytic lymphohistiocytosis induced acute liver failure: A case series. Journal of Liver Transplantation 2022. [DOI: 10.1016/j.liver.2021.100059] [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: 10/19/2022] Open
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22
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Ekram ARMS, Woods RL, Britt C, Espinoza S, Ernst ME, Ryan J. Erratum: The Association Between Frailty and All-Cause Mortality in Community-Dwelling Older Individuals: An Umbrella Review. J Frailty Aging 2022; 11:247. [PMID: 35441207 PMCID: PMC10433462 DOI: 10.14283/jfa.2021.24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/19/2023]
Abstract
The original version of this article unfortunately contained a mistake. Appendix II was published twice in the supporting information. The original publication has been updated. Appendix I and Appendix II are now both available in the online publication.
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Affiliation(s)
- A R M S Ekram
- ARM Saifuddin Ekram, School of Public Health and Preventive Medicine, Monash University, Alfred Campus, Melbourne, Victoria-3004, Australia; E-mail:
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23
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Wayland S, Cook O, Cartwright A, Ryan J, Brondolo E, Bassed R, Bugeja L. The nature and impact of occupational trauma exposure among staff working in a forensic medical and scientific service: a qualitative interview study. AUST J FORENSIC SCI 2021. [DOI: 10.1080/00450618.2021.2002409] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- S. Wayland
- Faculty of Medicine and Health, University of New England, Armidale, Australia
| | - O. Cook
- Monash Nursing & Midwifery, Monash University, Clayton, Victoria, Australia
| | - A. Cartwright
- Monash Nursing & Midwifery, Monash University, Clayton, Victoria, Australia
| | - J. Ryan
- Victorian Institute of Forensic Medicine Department of Forensic Medicine, Monash University, Melbourne, Australia
| | - E. Brondolo
- Collaborative Health Integration Research Program (CHIRP), Department of Psychology, St. John’s University Jamaica, Victoria, Australia
| | - R. Bassed
- Academic Programs Victorian Institute of Forensic Medicine. Department of Forensic Medicine, Monash University, Melbourne Australia
| | - L. Bugeja
- Department of Forensic Medicine. Research Lead - Violence Investigation, Research and Training Unit, Monash University Clayton, Victoria, Australia
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24
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O'Connor C, Kiely L, Heffron C, Ryan J, Bennett M. PAPA-like syndrome with heterozygous mutation in the MEFV gene. Clin Exp Dermatol 2021; 47:642-645. [PMID: 34882829 DOI: 10.1111/ced.15027] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 11/09/2021] [Accepted: 11/16/2021] [Indexed: 11/30/2022]
Abstract
A patient presented with a history of recurrent pyoderma gangrenosum, arthritis and extensive acne, prompting a genetic workup for PAPA syndrome. An MEFV mutation was identified and a change in therapeutic strategy from anakinra to colchicine was successful.
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Affiliation(s)
- C O'Connor
- Department of Dermatology, South Infirmary Victoria University Hospital, Cork, Ireland.,Department of Paediatrics and Child Health, University College Cork, Cork, Ireland
| | - L Kiely
- Department of Dermatology, South Infirmary Victoria University Hospital, Cork, Ireland
| | - C Heffron
- Pathology, Cork University Hospital, Cork, Ireland
| | - J Ryan
- Rheumatology, Cork University Hospital, Cork, Ireland
| | - M Bennett
- Department of Dermatology, South Infirmary Victoria University Hospital, Cork, Ireland
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25
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Ryan J, McCallion P, McCarron M, Luus R, Burke EA. Overweight/obesity and chronic health conditions in older people with intellectual disability in Ireland. J Intellect Disabil Res 2021; 65:1097-1109. [PMID: 34750916 DOI: 10.1111/jir.12900] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [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: 03/19/2021] [Revised: 10/11/2021] [Accepted: 10/12/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND This study examines overweight/obesity and chronic health conditions (CHCs) in older people with intellectual disability (ID). METHODS Data for this cross-sectional observational study emanated from Wave 2 of the Intellectual Disability Supplement to the Irish Longitudinal Study on Ageing, a longitudinal study assessing the health and well-being of older Irish adults with ID aged ≥40 years across all levels of ID. Participation involves an interview process and collation of objective health measures. In this study, body mass index (BMI) (n = 572), used as a measure of weight status, was examined with clustered doctor's diagnosed CHCs. Descriptive analysis was conducted where counts (n) and proportions (%) were used to summarise the variables univariately, while cross-tabulations were used for bivariate summary into counts and proportions. With overweight/obesity prevalence established and patterns described using logistical regression, Pearson's chi-squared test was used to test for significant associations. RESULTS Overweight/obesity identified in 69% of participants occurred with greater frequency in women (72%). A higher percentage of participants aged <50 years (72.5%) were overweight/obese than those aged 50-64 (70%) and 65+ (61.4%). Level of ID and residence type were significantly associated with weight status (P < 0.001), with overweight/obesity more prevalent in mild (85.7%) than moderate (72%) or severe/profound ID (51.4%). Of those who lived independently/with family, 78.4% were overweight/obese, as were 74% living in a community group home (P < 0.001). Almost all overweight/obese participants' waist measurements were in the substantially increased risk of metabolic disease waist measurement category (92%, P < 0.001). Logistical regression used to model CHCs on BMI showed significant association between BMI and gastrointestinal tract [odds ratio (OR) = 0.57, P < 0.008, 95% confidence interval (CI) = (0.37; 0.86)], respiratory condition [OR = 8.95, P < 0.004, 95% CI = (2.57; 56.72)] and musculoskeletal disorders [OR = 0.40, P < 0.001, 95% CI = (0.25; 0.63)]. CONCLUSIONS The findings illustrate the strong cross-sectional association between overweight/obesity and CHCs. These findings suggest a need to prioritise weight status as a health risk to people with ID as they age.
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Affiliation(s)
- J Ryan
- Trinity Center for Ageing and Intellectual Disability, School of Nursing and Midwifery, Trinity College Dublin, The University of Dublin, Dublin 2, Ireland
| | - P McCallion
- Temple School of Social Work, Temple University College of Public Health, Philadelphia, PA, USA
| | - M McCarron
- Trinity Center for Ageing and Intellectual Disability, School of Nursing and Midwifery, Trinity College Dublin, The University of Dublin, Dublin 2, Ireland
| | - R Luus
- Department of Statistics and Population Studies, University of the Western Cape, Cape Town, South Africa
| | - E A Burke
- Trinity Center for Ageing and Intellectual Disability, School of Nursing and Midwifery, Trinity College Dublin, The University of Dublin, Dublin 2, Ireland
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26
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Lukovic J, Moore A, Lee M, Willis D, Ahmed S, Akra M, Hortobagyi E, Joon D, Kron T, Liu Z, Ryan J, Thomas M, Wall K, Ward I, Wiltshire K, O'Callaghan C, Wong R, Ringash J, Haustermans K, Leong T. The Feasibility of Quality Assurance in the TOPGEAR International Phase III Clinical Trial of Neoadjuvant Chemoradiotherapy for Gastric Cancer (An Intergroup Trial of the AGITG/TROG/EORTC/CCTG). Int J Radiat Oncol Biol Phys 2021. [DOI: 10.1016/j.ijrobp.2021.07.111] [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: 11/12/2022]
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27
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Ekram ARMS, Woods RL, Britt C, Espinoza S, Ernst ME, Ryan J. The Association between Frailty and All-Cause Mortality in Community-Dwelling Older Individuals: An Umbrella Review. J Frailty Aging 2021; 10:320-326. [PMID: 34549245 PMCID: PMC10376924 DOI: 10.14283/jfa.2021.20] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Frailty is associated with multiple adverse health outcomes, including mortality. Several methods have been used to characterize frailty, each based on different frailty scales. These include scales based on phenotype, multidomain, and deficit accumulations. Several systematic reviews have examined the association between frailty and mortality; however, it is unclear whether these different frailty scales similarly predict mortality. This umbrella review aims to examine the association between frailty assessed by different frailty scales and all-cause mortality among community-dwelling older adults. A protocol was registered at PROSPERO, and it was conducted following the PRISMA statement. MEDLINE, Embase, PubMed, Cochrane Database of Systematic Reviews, Joanna Briggs Institute (JBI) EBP database, and Web of Science database was searched. Methodological quality was assessed using the JBI critical appraisal checklist and online AMSTAR-2 critical appraisal checklist. For eligible studies, essential information was extracted and synthesized qualitatively. Five systematic reviews were included, with a total of 434,115 participants. Three systematic reviews focused on single frailty scales; one evaluated Fried's physical frailty phenotype and its modifications; another focused on the deficit accumulation frailty index. The third evaluated the FRAIL (Fatigue, Resistance, Ambulation, Illness, and Loss of weight) scale. The two other systematic reviews determined the association between frailty and mortality using different frailty scales. All of the systematic reviews found that frailty was significantly associated with all-cause mortality. This umbrella review demonstrates that frailty is a significant predictor of all-cause mortality, irrespective of the specific frailty scale.
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Affiliation(s)
- A R M S Ekram
- ARM Saifuddin Ekram, School of Public Health and Preventive Medicine, Monash University, Alfred Campus, Melbourne, Victoria-3004, Australia; E-mail:
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28
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Fransquet PD, Lacaze P, Saffery R, Shah RC, Vryer R, Murray A, Woods RL, Ryan J. Accelerated Epigenetic Aging in Peripheral Blood does not Predict Dementia Risk. Curr Alzheimer Res 2021; 18:443-451. [PMID: 34429046 DOI: 10.2174/1567205018666210823100721] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [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: 08/17/2020] [Revised: 04/08/2021] [Accepted: 06/15/2021] [Indexed: 11/22/2022]
Abstract
BACKGROUND There is strong evidence that epigenetic age acceleration is associated with increased risk of later-life diseases and all-cause mortality. However, there is currently limited evidence that suggests accelerated epigenetic age is associated with dementia risk. OBJECTIVE This study aims to clarify whether epigenetic biomarkers of accelerated aging can predict dementia risk, which is an important consideration as aging is the greatest risk factor for the disease. METHODS DNA methylation was measured in peripheral blood samples provided by 160 participants from the ASPirin in Reducing Events in the Elderly study, including 73 pre-symptomatic dementia cases and 87 controls matched for age, sex, and smoking and education status. Epigenetic age was calculated using Horvath, Hannum, GrimAge and PhenoAge DNA methylation clocks, and age acceleration (the disparity between chronological age and epigenetic age) was determined. RESULTS There was no difference in age acceleration between dementia cases and controls. In males, only Hannum's intrinsic epigenetic age acceleration was increased in pre-symptomatic dementia cases compared to controls (Δ +1.8 years, p = 0.03). CONCLUSION These findings provide no strong evidence that accelerated epigenetic aging measured in peripheral blood can predict dementia risk.
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Affiliation(s)
- P D Fransquet
- School of Public Health and Preventive Medicine, Monash University, Melbourne, 3004, Victoria, Australia
| | - P Lacaze
- School of Public Health and Preventive Medicine, Monash University, Melbourne, 3004, Victoria, Australia
| | - R Saffery
- Murdoch Children's Research Institute, Department of Paediatrics, The University of Melbourne, Parkville, 3052 Victoria, Australia
| | - R C Shah
- Department of Family Medicine and Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL 60612, United States
| | - R Vryer
- Murdoch Children's Research Institute, Department of Paediatrics, The University of Melbourne, Parkville, 3052 Victoria, Australia
| | - A Murray
- Berman Center for Outcomes and Clinical Research, Hennepin Healthcare Research Institute, Hennepin Healthcare, Division of Geriatrics, Department of Medicine, University of Minnesota, Minneapolis, MN 55455, United States
| | - R L Woods
- School of Public Health and Preventive Medicine, Monash University, Melbourne, 3004, Victoria, Australia
| | - J Ryan
- School of Public Health and Preventive Medicine, Monash University, Melbourne, 3004, Victoria, Australia
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Dorlis C, Garcia-Pertierra S, Richardson J, Koterwas B, Keeble E, Eatwell K, Ryan J, Clements DN. Femoral condylar fractures in four continental giant breed rabbits. J Small Anim Pract 2021; 63:325-330. [PMID: 34418096 DOI: 10.1111/jsap.13417] [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] [Received: 11/07/2020] [Revised: 05/24/2021] [Accepted: 08/06/2021] [Indexed: 11/30/2022]
Abstract
Four male neutered continental giant rabbits aged between 10 and 30 months were presented with femoral condylar fractures, which developed without an observed traumatic injury. Stabilisation of the condylar fracture was achieved with screw fixation in all cases, which was supplemented with additional fixation in three cases. Complications consequent to the surgical intervention occurred in two cases: a femoral fracture and loss of fixation. Three rabbits were reported to have recovered normal limb function, and the rabbit that developed a femoral fracture as a consequence of its surgical intervention was treated with amputation.
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Affiliation(s)
- C Dorlis
- Hospital for Small Animals, Royal (Dick) School of Veterinary Studies and The Roslin Institute, Midlothian, EH25 9RG, UK
| | - S Garcia-Pertierra
- Hospital for Small Animals, Royal (Dick) School of Veterinary Studies and The Roslin Institute, Midlothian, EH25 9RG, UK
| | - J Richardson
- Hospital for Small Animals, Royal (Dick) School of Veterinary Studies and The Roslin Institute, Midlothian, EH25 9RG, UK
| | - B Koterwas
- Hospital for Small Animals, Royal (Dick) School of Veterinary Studies and The Roslin Institute, Midlothian, EH25 9RG, UK
| | - E Keeble
- Hospital for Small Animals, Royal (Dick) School of Veterinary Studies and The Roslin Institute, Midlothian, EH25 9RG, UK
| | - K Eatwell
- Hospital for Small Animals, Royal (Dick) School of Veterinary Studies and The Roslin Institute, Midlothian, EH25 9RG, UK
| | - J Ryan
- Hospital for Small Animals, Royal (Dick) School of Veterinary Studies and The Roslin Institute, Midlothian, EH25 9RG, UK
| | - D N Clements
- Hospital for Small Animals, Royal (Dick) School of Veterinary Studies and The Roslin Institute, Midlothian, EH25 9RG, UK
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Foley J, Robinson M, Ryan J, Cronin J. Impact of a National Lockdown on Cycling Injuries. Ir Med J 2021; 114:412. [PMID: 34520647] [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] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Introduction The Sars-CoV-2 pandemic led to a national lockdown in Ireland from March 12th to June 7th, 2020. The present study aimed to assess the change in the pattern of cycling attendances to an Irish ED during a pandemic. Methods This is a retrospective before-and-after study carried out at a university hospital ED. We compared cycling attendances during Lockdown (LD) (13th March-7th June 2020) with Pre-Lockdown (PLD) (January 1st-March 12th, 2020). Furthermore, we also compared lockdown to an historical control period during the equivalent dates in 2019 (i.e. March 13th-June 7th, 2019) Results There were 151 cycling attendances during LD, 122 in PLD and 164 during the control period. The number of cyclists presenting during "rush hour traffic" in the LD period was 30 (19.9%) versus 42 (34.4%) during PLD (p<0.05) and 51 (31.1%) during the control period (p<0.05). During LD, 8 (5.3%) collisions involved a motor vehicle compared to 26 (21.3%) in PLD (p<0.05) and 43 (26.2%) during the control period (p<0.05). Conclusion Lockdown did not result in increased cycling attendances to this ED. The patients who did sustain a cycling-related injury during lockdown were less likely to have collided with a motor vehicle compared to the control period. The reduction in motor vehicle collisions could be attributed to less traffic congestion and highlights the potential benefits of road-user segregation.
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Affiliation(s)
- J Foley
- Department of Emergency Medicine, St. Vincent's University Hospital, Dublin 4
| | - M Robinson
- Department of Emergency Medicine, St. Vincent's University Hospital, Dublin 4
| | - J Ryan
- Department of Emergency Medicine, St. Vincent's University Hospital, Dublin 4
| | - J Cronin
- Department of Emergency Medicine, St. Vincent's University Hospital, Dublin 4
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31
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Bhandary L, Mohd Asri NA, Taylor A, Muslim A, Hickey P, Lenihan B, Condon F, Ryan J. 411 EFFICACY OF CDSS IN IMPROVING ANTI-RESORPTIVE BONE PROTECTIVE THERAPY AMONGST ORTHOGERIATRIC INPATIENTS: A COMPARISON STUDY. Age Ageing 2021. [DOI: 10.1093/ageing/afab116.01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Hip fractures have a mortality rate of 20% in the year following the fracture. Therefore, patients presenting with hip fractures should be assessed and prescribed anti-resorptive bone protective therapy (ABPT) to reduce the risk of further fractures. In our institution, this decision is undertaken by a specialist only. Purpose: The objective of this study is to compare the proportion of patients commenced on ABPT by surgical interns following the introduction of a Clinical Decision Support System (CDSS) in January 2020 to support appropriate ABPT prescribing amongst non-specialists.
Methods
The study compares the orthogeriatric patient cohort before and after CDSS introduction within the same time period (Jan 1st to June 30th) in 2019 and 2020. Data were extracted from the Irish Hip Fracture Database and statistically analyzed using SPSS. The Mann–Whitney two-tailed test was employed to calculate statistical significance.
Results
In 2019, 31% (55/178) of patients admitted during the study period (n = 178) did not receive orthogeriatric specialist input and only 27% (15/55) of these had ABPT prescribed during their admission. In 2020, 17% (32/185) of patients admitted during the study period (n = 185) did not receive specialist input; however, 44% (14/32) of these were commenced on ABPT. Overall, more patients were prescribed ABPT in 2020 (78%;146/185), as compared to 55% (98/178) in 2019 (z-score 6.57069; p-value <0.01). The number of patients awaiting specialist outpatient appointments before being prescribed ABPT also dropped from 40% (71/178) in 2019 to 13% (24/185) in 2020 (p-value <0.01).
Conclusion
This study highlighted the significance of a CDSS to improve inpatient ABPT prescribing by non-specialists and to reduce outpatient specialist appointments. This could have a major impact on the long-term reduction of mortality rates amongst orthogeriatric patients and the reduction of future healthcare costs.
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Affiliation(s)
| | | | - A Taylor
- The University Hospital Limerick
| | - A Muslim
- The University Hospital Limerick
| | - P Hickey
- The University Hospital Limerick
| | | | - F Condon
- The University Hospital Limerick
| | - J Ryan
- The University Hospital Limerick
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Conway R, Nikiphorou E, Demetriou C, Low C, Leamy K, Ryan J, Kavanagh R, Fraser A, Carey J, O’connell P, Flood R, Mullan R, Kane D, Robinson P, Liew J, Grainger R, Mccarthy G. POS1162 PREDICTORS OF HOSPITALISATION IN PATIENTS WITH RHEUMATIC DISEASE AND COVID-19 IN IRELAND: DATA FROM THE COVID-19 GLOBAL RHEUMATOLOGY ALLIANCE PHYSICIAN-REPORTED REGISTRY. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.420] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:There is limited data regarding the risk of hospitalisation in patients with rheumatic disease and COVID-19 in Ireland.Objectives:We used the COVID-19 Global Rheumatology Alliance (GRA) registry data to study outcomes and their predictors.Methods:We examined data on patients and their disease-related characteristics entered into the COVID-19 GRA provider registry from Ireland (24th March 2020 to 31st August 2020). Multivariable logistic regression was used to assess the association of demographic and clinical characteristics with hospitalisation.Results:Of 105 patients, 47 (45.6%) were hospitalised and 10 (9.5%) died. Multivariable logistic regression analysis showed age (OR=1.06, 95%CI 1.01 to 1.10), number of comorbidities (OR=1.93, 95%CI 1.11 to 3.35), and glucocorticoid use (OR=15.01, 95%CI 1.77 to 127.16) were significantly associated with hospitalisation. A diagnosis of inflammatory arthritis was associated with a lower odds of hospitalisation (OR=0.09, 95%CI 0.02 to 0.32).All significant variable modelMost parsimonious modelUnadjusted OR (95% CI)Adjusted OR (95%CI)*Adjusted p-value*Adjusted OR (95%CI)&Adjusted p-value&Female0.45 (0.20-1.02)0.33 (0.05-2.23)0.34 (0.09-1.36)0.128Age (years)1.08 (1.05-1.11)1.04 (0.97-1.10)0.2241.06 (1.01-1.10)0.010Inflammatory arthritis0.11 (0.05-0.28)0.14 (0.02-0.95)0.0440.09 (0.02-0.32)<0.001Connective Tissue Disease and Other1.56 (0.62 - 3.92)No comorbidities0.11 (0.04-0.30)0.76 (0.09-6.58)0.802Most common comorbiditiesCOPD / asthma4.77 (1.23-18.54)3.09 (0.16-60.07)0.456CVD3.40 (1.31-8.85)0.11 (0.01-1.88)0.129Hypertension3.71 (1.52-9.08)0.56 (0.04-7.94)0.668Obesity0.58 (0.10-3.30)Number of comorbidities (Median, IQR)3.01 (1.92-4.72)2.99 (0.59-15.02)0.1841.93 (1.11-3.35)0.020Never Smokerref.0.889Ever Smoker3.17 (1.18-8.89)1.19 (0.10-13.68)Medication prior to COVID-19 diagnosisGlucocorticoids9.26 (1.95-43.89)18.14 (1.13-290.81)0.04115.01 (1.77-127.16)0.013csDMARD monotherapy0.42 (0.17-1.00)b/tsDMARD (monotherapy or in combination with csDMARD)0.24 (0.10-0.58)1.36 (0.19-9.72)0.557Conclusion:Increasing age, comorbidity burden, and glucocorticoid use were associated with hospitalisation, while a diagnosis of inflammatory arthritis was associated with lower odds of hospitalization.Disclosure of Interests:Richard Conway Speakers bureau: Janssen, Roche, Sanofi, Abbvie, Elena Nikiphorou Speakers bureau: AbbVie, Eli-Lilly, Gilead, Celltrion, Pfizer, Sanofi, Christiana Demetriou: None declared, Candice Low: None declared, Kelly Leamy: None declared, John Ryan: None declared, Ronan Kavanagh: None declared, Alexander Fraser: None declared, John Carey: None declared, Paul O’Connell: None declared, Rachael Flood: None declared, Ronan Mullan: None declared, David Kane: None declared, Philip Robinson Speakers bureau: UCB, Roche, Pfizer, Gilead, Janssen, Novartis, Eli Lilly, Abbvie, Grant/research support from: Abbvie, UCB, Novartis, Janssen, Pfizer, Jean Liew Grant/research support from: Pfizer, Rebecca Grainger Speakers bureau: Pfizer, Cornerstones, Janssen, Novartis, Abbvie, Geraldine McCarthy: None declared.
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Ryan J, Elsmore MT, Binner ER, De Focatiis DSA, Irvine DJ, Robinson JP. Solvent-free manufacture of methacrylate polymers from biomass pyrolysis products. REACT CHEM ENG 2021. [DOI: 10.1039/d0re00419g] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Biomass pyrolysis liquid is functionalised into a potential replacement for petrochemical derived methacrylates used in resins, adhesives and binders.
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Affiliation(s)
- J. Ryan
- Coates Building
- Faculty of Engineering
- University of Nottingham
- UK
| | - M. T. Elsmore
- Coates Building
- Faculty of Engineering
- University of Nottingham
- UK
| | - E. R. Binner
- Coates Building
- Faculty of Engineering
- University of Nottingham
- UK
| | | | - D. J. Irvine
- Coates Building
- Faculty of Engineering
- University of Nottingham
- UK
| | - J. P. Robinson
- Coates Building
- Faculty of Engineering
- University of Nottingham
- UK
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Singh J, Ly M, Wolfers D, Awad J, Ryan J, Akhunji Z, Wolfenden H, Grant P. R27 A Single Centre Five Year Retrospective Case Study Analysing Risk Factors and Surgical Outcomes of Secondary Tricuspid Regurgitation Progression. Heart Lung Circ 2021. [DOI: 10.1016/j.hlc.2021.03.185] [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: 11/16/2022]
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Milojkovic D, Cross NCP, Ali S, Byrne J, Campbell G, Dignan FL, Drummond M, Huntly B, Marshall S, McMullin MF, Neelakantan P, Raghavan M, Sivakumaran M, Tighe J, Wandroo F, Willis F, Glen F, Fildes L, Collington SJ, Ryan J, Clark RE, Mead AJ. Real-world tyrosine kinase inhibitor treatment pathways, monitoring patterns and responses in patients with chronic myeloid leukaemia in the United Kingdom: the UK TARGET CML study. Br J Haematol 2021; 192:62-74. [PMID: 32449159 DOI: 10.1111/bjh.16733] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [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: 02/06/2020] [Accepted: 04/18/2020] [Indexed: 10/24/2022]
Abstract
Management of chronic myeloid leukaemia (CML) has recently undergone dramatic changes, prompting the European LeukemiaNet (ELN) to issue recommendations in 2013; however, it remains unclear whether real-world CML management is consistent with these goals. We report results of UK TARGET CML, a retrospective observational study of 257 patients with chronic-phase CML who had been prescribed a first-line TKI between 2013 and 2017, most of whom received first-line imatinib (n = 203). Although 44% of patients required ≥1 change of TKI, these real-world data revealed that molecular assessments were frequently missed, 23% of patients with ELN-defined treatment failure did not switch TKI, and kinase domain mutation analysis was performed in only 49% of patients who switched TKI for resistance. Major molecular response (MMR; BCR-ABL1IS ≤0·1%) and deep molecular response (DMR; BCR-ABL1IS ≤0·01%) were observed in 50% and 29%, respectively, of patients treated with first-line imatinib, and 63% and 54%, respectively, receiving a second-generation TKI first line. MMR and DMR were also observed in 77% and 44% of evaluable patients with ≥13 months follow-up, receiving a second-generation TKI second line. We found little evidence that cardiovascular risk factors were considered during TKI management. These findings highlight key areas for improvement in providing optimal care to patients with CML.
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Affiliation(s)
| | | | - Sahra Ali
- Castle Hill Hospital, Hull and East Yorkshire Hospitals NHS Trust, Cottingham, UK
| | - Jenny Byrne
- Nottingham City Hospital, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Gavin Campbell
- Colchester Hospital University NHS Foundation Trust, Colchester, UK
| | - Fiona L Dignan
- Manchester Royal Infirmary, Manchester University Hospitals Foundation Trust, Manchester, UK
| | | | - Brian Huntly
- Addenbrookes, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Scott Marshall
- Sunderland Royal Hospital, City Hospitals Sunderland NHS Foundation Trust, Sunderland, UK
| | | | | | - Manoj Raghavan
- Queen Elizabeth Hospital Birmingham, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | | | - Jane Tighe
- Aberdeen Royal Infirmary, NHS Grampian, Aberdeen, UK
| | - Farooq Wandroo
- Sandwells District General Hospital, Sandwells and West Birmingham Hospitals NHS Trust, West Bromwich, UK
| | - Fenella Willis
- St George's University Hospitals NHS Foundation Trust, London, UK
| | | | | | | | | | | | - Adam J Mead
- NIHR Oxford Biomedical Research Centre, John Radcliffe Hospital, Oxford, UK
- MRC Molecular Haematology Unit, MRC Weatherall Institute of Molecular Medicine, John Radcliffe Hospital, Oxford, UK
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Perni S, Bitterman D, Ryan J, Silver J, Mitchell E, Christensen S, Bloom M, Hochberg E, Ryan D, Haas-Kogan D, Tarbell N, Parikh A, Wo J. Gender Disparities in Philanthropic Fundraising by Academic Oncologists. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.07.2541] [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: 11/16/2022]
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Broe M, Ryan J, Lynch O, Ryan P, Hegazy M, Mulvin D, McGuire B. More Than Just a UPJ Problem: Robotic-Assisted Pyeloplasty with Description of Technique for Reconstruction of Large Renal Pelvis. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)35293-9] [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: 11/16/2022] Open
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Ryan P, Broe M, Hegazy M, Ryan J, Lynch O, Haroon U, McGuire B. Robot-assisted Ureteric Reconstruction using a Buccal Mucosal Graft. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)35282-4] [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: 11/16/2022] Open
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von Doetinchem P, Perez K, Aramaki T, Baker S, Barwick S, Bird R, Boezio M, Boggs S, Cui M, Datta A, Donato F, Evoli C, Fabris L, Fabbietti L, Ferronato Bueno E, Fornengo N, Fuke H, Gerrity C, Gomez Coral D, Hailey C, Hooper D, Kachelriess M, Korsmeier M, Kozai M, Lea R, Li N, Lowell A, Manghisoni M, Moskalenko I, Munini R, Naskret M, Nelson T, Ng K, Nozzoli F, Oliva A, Ong R, Osteria G, Pierog T, Poulin V, Profumo S, Pöschl T, Quinn S, Re V, Rogers F, Ryan J, Saffold N, Sakai K, Salati P, Schael S, Serksnyte L, Shukla A, Stoessl A, Tjemsland J, Vannuccini E, Vecchi M, Winkler M, Wright D, Xiao M, Xu W, Yoshida T, Zampa G, Zuccon P. Cosmic-ray antinuclei as messengers of new physics: status and outlook for the new decade. J Cosmol Astropart Phys 2020; 2020:035. [PMID: 34712102 PMCID: PMC8549764 DOI: 10.1088/1475-7516/2020/08/035] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
The precise measurement of cosmic-ray antinuclei serves as an important means for identifying the nature of dark matter and other new astrophysical phenomena, and could be used with other cosmic-ray species to understand cosmic-ray production and propagation in the Galaxy. For instance, low-energy antideuterons would provide a "smoking gun" signature of dark matter annihilation or decay, essentially free of astrophysical background. Studies in recent years have emphasized that models for cosmic-ray antideuterons must be considered together with the abundant cosmic antiprotons and any potential observation of antihelium. Therefore, a second dedicated Antideuteron Workshop was organized at UCLA in March 2019, bringing together a community of theorists and experimentalists to review the status of current observations of cosmic-ray antinuclei, the theoretical work towards understanding these signatures, and the potential of upcoming measurements to illuminate ongoing controversies. This review aims to synthesize this recent work and present implications for the upcoming decade of antinuclei observations and searches. This includes discussion of a possible dark matter signature in the AMS-02 antiproton spectrum, the most recent limits from BESS Polar-II on the cosmic antideuteron flux, and reports of candidate antihelium events by AMS-02; recent collider and cosmic-ray measurements relevant for antinuclei production models; the state of cosmic-ray transport models in light of AMS-02 and Voyager data; and the prospects for upcoming experiments, such as GAPS. This provides a roadmap for progress on cosmic antinuclei signatures of dark matter in the coming years.
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Affiliation(s)
- P. von Doetinchem
- Department of Physics and Astronomy, University of Hawaii at Manoa, 2505 Correa Rd, Honolulu, HI 96822 U.S.A
| | - K. Perez
- Department of Physics, Massachusetts Institute of Technology, 77 Massachusetts Ave, Cambridge, MA 02139 U.S.A
| | - T. Aramaki
- Stanford Linear Accelerator Center, 2575 Sand Hill Rd, Menlo Park, CA 94025 U.S.A
| | - S. Baker
- Imperial College London, London, SW7 2AZ, U.K
| | - S. Barwick
- Department of Physics & Astronomy, University of California at Irvine, 4129 Frederick Reines Hall, Irvine, CA 92697, U.S.A
| | - R. Bird
- Department of Physics and Astronomy, University of California at Los Angeles, 475 Portola Plaza, Los Angeles, CA 90095, U.S.A
| | - M. Boezio
- INFN, Sezione di Trieste, Padriciano 99, 34149 Trieste, Italy
| | - S.E. Boggs
- Department of Physics, University of California at San Diego, 9500 Gilman Dr., La Jolla, CA 90037, U.S.A
| | - M. Cui
- Purple Mountain Observatory, Yuanhua Road, Qixia District, Nanjing 210033, China
| | - A. Datta
- Department of Physics and Astronomy, University of Hawaii at Manoa, 2505 Correa Rd, Honolulu, HI 96822 U.S.A
| | - F. Donato
- Department of Physics, University of Turin, Via Pietro Giuria, 1, 10125 Torino, Italy
- INFN, Sezione di Torino, Via Pietro Giuria, 1, 10125 Torino, Italy
| | - C. Evoli
- Gran Sasso Science Institute, Viale Francesco Crispi 7, 67100 L’Aquila, Italy
- INFN, Laboratori Nazionali del Gran Sasso, Via G. Acitelli, 22, 67100 Assergi, L’Aquila, Italy
| | - L. Fabris
- Isotope and Fuel Cycle and Technology Division, Oak Ridge National Laboratory, PO BOX 2008, Oak Ridge, TN 37831, U.S.A
| | - L. Fabbietti
- Department of Physics, Technical University of Munich, James-Franck Str. 1, 85748 Garching, Germany
| | - E. Ferronato Bueno
- Kapteyn Astronomical Institute, Rijksuniversiteit Groningen, Landleven 12, 9717 AD Groningen, The Netherlands
| | - N. Fornengo
- Department of Physics, University of Turin, Via Pietro Giuria, 1, 10125 Torino, Italy
- INFN, Sezione di Torino, Via Pietro Giuria, 1, 10125 Torino, Italy
| | - H. Fuke
- Institute of Space and Astronautical Science, Japan Aerospace Exploration Agency (ISAS/JAXA), Sagamihara, Kanagawa 252-5210, Japan
| | - C. Gerrity
- Department of Physics and Astronomy, University of Hawaii at Manoa, 2505 Correa Rd, Honolulu, HI 96822 U.S.A
| | - D. Gomez Coral
- Department of Physics and Astronomy, University of Hawaii at Manoa, 2505 Correa Rd, Honolulu, HI 96822 U.S.A
- Institute of Physics, National Autonomous University of Mexico, Circuito de la investigación científica, C.U. 04510, Ciudad de México, Mexico
| | - C. Hailey
- Department of Physics, Columbia University, 500 W 120th St, New York, NY 10027, U.S.A
| | - D. Hooper
- Theoretical Astrophysics, Fermi National Accelerator Laboratory, Wilson and Kirk Rds, Batavia, IL 60510, U.S.A
- Department of Astronomy and Astrophysics, University of Chicago, 5640 S. Ellis Ave, Chicago, IL 60637, U.S.A
- Kavli Institute for Cosmological Physics, University of Chicago, 5640 S. Ellis Ave, Chicago, IL 60637, U.S.A
| | - M. Kachelriess
- Department of Physics, Norwegian University of Science and Technology, 7491 Trondheim, Norway
| | - M. Korsmeier
- Department of Physics, University of Turin, Via Pietro Giuria, 1, 10125 Torino, Italy
- INFN, Sezione di Torino, Via Pietro Giuria, 1, 10125 Torino, Italy
- Institute for Theoretical Particle Physics and Cosmology, RWTH Aachen University, 52056 Aachen, Germany
| | - M. Kozai
- Institute of Space and Astronautical Science, Japan Aerospace Exploration Agency (ISAS/JAXA), Sagamihara, Kanagawa 252-5210, Japan
| | - R. Lea
- INFN, Sezione di Trieste, Padriciano 99, 34149 Trieste, Italy
- Dipartimento di Fisica dell’Universitá Trieste, Via Valerio 2, 34127 Trieste, Italy
| | - N. Li
- CAS Key Laboratory of Theoretical Physics, Institute of Theoretical Physics, Chinese Academy of Sciences, Beijing 100190, China
- University of Chinese Academy of Sciences, No.19A Yuquan Road, Shijingshan District, Beijing 100049, China
| | - A. Lowell
- Department of Physics, University of California at San Diego, 9500 Gilman Dr., La Jolla, CA 90037, U.S.A
| | - M. Manghisoni
- INFN, Sezione di Pavia, Via Agostino Bassi 6, 27100 Pavia, Italy
- Dipartimento di Ingegneria Industriale, Università di Bergamo, Viale Marconi 5, 24044 Dalmine, Italy
| | - I.V. Moskalenko
- Hansen Experimental Physics Laboratory, Stanford University, 452 Lomita Mall, Stanford, CA 94305, U.S.A
- Kavli Institute for Particle Astrophysics and Cosmology, Stanford University, CA 94305, U.S.A
| | - R. Munini
- INFN, Sezione di Trieste, Padriciano 99, 34149 Trieste, Italy
| | - M. Naskret
- Department of Physics and Astronomy, University of Hawaii at Manoa, 2505 Correa Rd, Honolulu, HI 96822 U.S.A
- Institute of Theoretical Physics, University of Wroclaw, pl. M. Borna 9, 50-204 Wroclaw, Poland
| | - T. Nelson
- Department of Physics and Astronomy, University of Hawaii at Manoa, 2505 Correa Rd, Honolulu, HI 96822 U.S.A
| | - K.C.Y. Ng
- Department of Particle Physics and Astrophysics, Weizmann Institute of Science, Rehovot 76100, Israel
| | - F. Nozzoli
- INFN, Trento Institute for Fundamental Physics and Applications, Via Sommarive, 14, 38123 Povo, Italy
| | - A. Oliva
- INFN, Sezione di Bologna, Via Irnerio 46, Bologna 40126, Italy
| | - R.A. Ong
- Department of Physics and Astronomy, University of California at Los Angeles, 475 Portola Plaza, Los Angeles, CA 90095, U.S.A
| | - G. Osteria
- INFN, Sezione di Napoli, Strada Comunale Cinthia, 80126 Naples, Italy
| | - T. Pierog
- Institute for Nuclear Physics, Karlsruhe Institute of Technology, Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
| | - V. Poulin
- Laboratoire Univers & Particules de Montpellier, CNRS, Université de Montpellier, Place Eugène Bataillon, 34095 Montpellier Cedex 05, France
| | - S. Profumo
- Department of Physics and Santa Cruz Institute for Particle Physics, University of California, Santa Cruz, CA 95064, U.S.A
| | - T. Pöschl
- Department of Physics, Technical University of Munich, James-Franck Str. 1, 85748 Garching, Germany
| | - S. Quinn
- Department of Physics and Astronomy, University of California at Los Angeles, 475 Portola Plaza, Los Angeles, CA 90095, U.S.A
| | - V. Re
- INFN, Sezione di Pavia, Via Agostino Bassi 6, 27100 Pavia, Italy
- Dipartimento di Ingegneria Industriale, Università di Bergamo, Viale Marconi 5, 24044 Dalmine, Italy
| | - F. Rogers
- Department of Physics, Massachusetts Institute of Technology, 77 Massachusetts Ave, Cambridge, MA 02139 U.S.A
| | - J. Ryan
- Department of Physics and Astronomy, University of California at Los Angeles, 475 Portola Plaza, Los Angeles, CA 90095, U.S.A
| | - N. Saffold
- Department of Physics, Columbia University, 500 W 120th St, New York, NY 10027, U.S.A
| | - K. Sakai
- NASA-Goddard Space Flight Center), 8800 Greenbelt Rd, Greenbelt, MD 20771, U.S.A
- CRESST, University of Maryland, Baltimore County, MD 21250, U.S.A
| | - P. Salati
- Laboratoire d’Annecy-le-Vieux de Physique Théorique, 9 Chemin de Bellevue, 74940 Annecy, France
| | - S. Schael
- I. Physikalisches Institut, RWTH Aachen University, Sommerfeldstr. 14, 52074 Aachen, Germany
| | - L. Serksnyte
- Department of Physics, Technical University of Munich, James-Franck Str. 1, 85748 Garching, Germany
| | - A. Shukla
- Department of Physics and Astronomy, University of Hawaii at Manoa, 2505 Correa Rd, Honolulu, HI 96822 U.S.A
| | - A. Stoessl
- Department of Physics and Astronomy, University of Hawaii at Manoa, 2505 Correa Rd, Honolulu, HI 96822 U.S.A
| | - J. Tjemsland
- Department of Physics, Norwegian University of Science and Technology, 7491 Trondheim, Norway
| | - E. Vannuccini
- INFN, Sezione di Firenze, 50019 Sesto Fiorentino, Florence, Italy
| | - M. Vecchi
- Kapteyn Astronomical Institute, Rijksuniversiteit Groningen, Landleven 12, 9717 AD Groningen, The Netherlands
| | - M.W. Winkler
- The Oskar Klein Centre for Cosmoparticle Physics, Department of Physics, Stockholm University, Alba Nova, 10691 Stockholm, Sweden
| | - D. Wright
- Stanford Linear Accelerator Center, 2575 Sand Hill Rd, Menlo Park, CA 94025 U.S.A
| | - M. Xiao
- Department of Physics, Massachusetts Institute of Technology, 77 Massachusetts Ave, Cambridge, MA 02139 U.S.A
| | - W. Xu
- Department of Physics, Harvard University, 17 Oxford St, Cambridge, MA, 95129, U.S.A
| | - T. Yoshida
- Institute of Space and Astronautical Science, Japan Aerospace Exploration Agency (ISAS/JAXA), Sagamihara, Kanagawa 252-5210, Japan
| | - G. Zampa
- INFN, Sezione di Trieste, Padriciano 99, 34149 Trieste, Italy
| | - P. Zuccon
- INFN, Trento Institute for Fundamental Physics and Applications, Via Sommarive, 14, 38123 Povo, Italy
- Department of Physics, University of Trento, Via Sommarive 14, 38123 Povo, Italy
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Kilbride C, Scott D, Butcher T, Warland A, Ryan J, Norris M, Baker K, Anoyke N, Buxarrais GS, Athanasiou D, Nowicky A. Rehabilitation via home based gaming exercise for the upper-limb post stroke (RHOMBUS): results of an intervention feasibility trial. Physiotherapy 2020. [DOI: 10.1016/j.physio.2020.03.036] [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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Affiliation(s)
- J. P. Shroyer
- Dep. of Agronomy; 219 Throckmorton, Kansas State Univ.; Manhattan KS 66506
| | - J. Ryan
- MIAC/INRA Aridoculture Ctr.; B.P. 290 Settat Morocco
| | | | - M. El Mourid
- MIAC/INRA Aridoculture Ctr.; B.P. 290 Settat Morocco
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Affiliation(s)
- J. Ryan
- MIAC/INRA Aridoculture CenterB.P. 290SettatMorocco
| | | | - J. P. Shroyer
- Dep. of Agronomy, 219 Throckmorton HallKansas State Univ.ManhattanKS66506-5504
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Garcia-Pertierra S, Ryan J, Richardson J, Koterwas B, Keeble E, Eatwell K, Clements DN. Presentation, treatment and outcome of long-bone fractures in pet rabbits (Oryctolagus cuniculus). J Small Anim Pract 2019; 61:46-50. [PMID: 31782172 DOI: 10.1111/jsap.13087] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Revised: 10/07/2019] [Accepted: 10/10/2019] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To describe the incidence, aetiology, characteristics, assessment, management and outcome of long-bone fractures in rabbits presenting to a single institution. MATERIALS AND METHODS Medical records of pet rabbits diagnosed with long-bone fractures over a 12-year period were analysed. Patient signalment, fracture aetiology, fracture location, fracture description, time from fracture occurrence to veterinary presentation, fixation method, postoperative complications, clinical outcome and follow-up were recorded. RESULTS Twenty-eight pet rabbits that sustained 30 fractures were included in the study [femoral (n=12), tibial (n=6), metacarpal/metatarsal/phalangeal (n=5), radial and ulnar (n=4) and tarsal (n=3)]. Twenty-one (75%) of the rabbits were less than 2 years of age, including seven (25%) under 6 months of age. Twenty-five fractures had no identifiable cause and five were traumatic. Only one fracture was open. Surgical stabilisation was performed in 22 fractures, four were non-surgically managed, two had the affected limb amputated, one underwent digital amputation and one was euthanased. Postoperative complications occurred in nine fractures [major (n=6), minor (n=3)]. The frequency of complications or attainment of a functional recovery was not notably different between the different methods of fixation. Overall, 24 rabbits recovered, two were euthanased and four underwent limb amputation. CLINICAL SIGNIFICANCE Fractures in rabbits typically occur in young animals and they usually lack an obvious aetiology. The majority of the rabbits treated achieved a functional recovery, although the postoperative complication rate was high in fractures treated surgically (41%).
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Affiliation(s)
- S Garcia-Pertierra
- Hospital for Small Animals, Royal (Dick) School of Veterinary Studies and Roslin Institute, Midlothian, EH25 9RG, Scotland
| | - J Ryan
- Hospital for Small Animals, Royal (Dick) School of Veterinary Studies and Roslin Institute, Midlothian, EH25 9RG, Scotland
| | - J Richardson
- Hospital for Small Animals, Royal (Dick) School of Veterinary Studies and Roslin Institute, Midlothian, EH25 9RG, Scotland
| | - B Koterwas
- Hospital for Small Animals, Royal (Dick) School of Veterinary Studies and Roslin Institute, Midlothian, EH25 9RG, Scotland
| | - E Keeble
- Hospital for Small Animals, Royal (Dick) School of Veterinary Studies and Roslin Institute, Midlothian, EH25 9RG, Scotland
| | - K Eatwell
- Hospital for Small Animals, Royal (Dick) School of Veterinary Studies and Roslin Institute, Midlothian, EH25 9RG, Scotland
| | - D N Clements
- Hospital for Small Animals, Royal (Dick) School of Veterinary Studies and Roslin Institute, Midlothian, EH25 9RG, Scotland
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Gilmartin S, Ryan J. A Temporal Comparative Study of Women’s Rugby Injuries Presenting to an Emergency Department. Ir Med J 2019; 112:1004. [PMID: 31651133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Aim We aimed to examine the change in injury patterns, diagnostics and treatments provided to female rugby players in an emergency department between two separate seasons ten years apart. Methods A search was carried out on attendances from 01/07/2007 to 30/06/2008 and from 01/07/2017 to 30/06/2018. The records of females presenting following rugby injuries were studied to establish demographics, investigations used, injury suffered and definitive care. Results There was a 242.9% increase in attendances with women’s rugby injuries. There were increases in high impact injuries: dislocations (0% vs 2.8%), wounds (4.8% vs 6.3%) and concussions (2.4% vs 10.4%). Ct scans are utilised more (2.4% vs 6.9%). Follow up has changed with increased specialist opinion with team physicians (0% vs 7.7%), hand clinics (4.8% vs 9.0%) and concussion clinics (0.0% vs 6.9%). Discussion Women’s rugby injury presentations are increasing. We have seen a rise in significant injuries. Patients now require first level diagnostics and specialist follow up care.
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Affiliation(s)
- S Gilmartin
- Emergency Department, St Vincent’s University Hospital, Elm Park, Dublin 4
| | - J Ryan
- Emergency Department, St Vincent’s University Hospital, Elm Park, Dublin 4
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Qian P, Barry MA, Lu J, Mina A, Ryan J, Bandodkar S, Alvarez S, James V, Ronquillo J, Varikatt W, Kovoor P, Pouliopoulos J, McEwan A, Thiagalingam A, Thomas S. 1197The development and validation of a novel transcatheter microwave renal denervation system. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.0027] [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: 11/12/2022] Open
Abstract
Abstract
Background
Clinical studies of transcatheter radiofrequency renal denervation for treating hypertension have been hampered by the lack of consistent denervation efficacy. Microwave energy is well suited to renal denervation due to its capacity to spare vascular structures due to cooling from adjacent blood flow while enabling deep perivascular heating.
Purpose
We aimed to: 1) develop a transcatheter microwave system capable of safely delivering deep and circumferential perivascular renal nerve ablation, and 2) demonstrate the feasibility, short-term efficacy and safety of transcatheter microwave renal denervation.
Method
A novel 7F transcatheter microwave denervation system was designed, built, and iteratively prototyped in vitro and in 15 sheep. A histological grading system for microwave induced renal arterial and renal nerve injury was devised. The microwave denervation system was validated in an additional 9 sheep, which underwent unilateral renal denervation. Up to 2 microwave ablations were delivered to each artery with maximum power at 100–110W for 480s. Sheep were euthanised at 2–3 weeks post procedure. Gross microscopic histological examination as well as renal tissue norepinephrine content was analysed.
Results
Catheter deployment and ablation was successful in all 19 targeted vessel segments and ablation produced substantial circumferential perivascular injury; median ablation lesion area >395 (IQR 251–437) mm2, depth 17.1 (IQR 15.8–18.4) mm, length 16 (IQR 12–20) mm, without collateral visceral injury. Limiting power to 100W minimised arterial injury, while maintaining a deep circumferential perivascular ablation. At microwave ablation sites, a total of 292 nerve fascicles were identified, median distance from the renal artery of 4.2mm (IQR 2.1–8.8mm), of which 249 (85%) had sustained thermal injury with 128/249 (51%) showing grade 3–4 (moderate to severe) injury. Microwave denervation reduced median functional sympathetic nerve surface area at the renal hilum on anti-tyrosine hydroxylase staining by 100% (IQR 87%-100%), p=0.0039, and median renal cortical norepinephrine content by 83% (IQR 76%–92%), p=0.0078, compared to the paired control kidney.
Conclusion
Transcatheter microwave ablation can produce deep circumferential perivascular ablations over a long segment of the renal artery without significant arterial or collateral visceral injury to provide effective renal denervation. Clinical translation may enable more consistent and complete transcatheter renal denervation and antihypertensive efficacy.
Acknowledgement/Funding
University of Sydney; Western Sydney Local health District; National Health and Medical Research Council of Australia; National Heart Foundation (Au)
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Affiliation(s)
- P Qian
- Westmead Hospital, Sydney, Australia
| | - M A Barry
- Westmead Hospital, Cardiology, Sydney, Australia
| | - J Lu
- Westmead Hospital, Cardiology, Sydney, Australia
| | - A Mina
- Westmead Hospital, Institute of Clinical Pathology and Medical Research, Sydney, Australia
| | - J Ryan
- Westmead Hospital, Institute of Clinical Pathology and Medical Research, Sydney, Australia
| | - S Bandodkar
- The Children's Hospital at Westmead, Biochemistry, Sydney, Australia
| | - S Alvarez
- The Children's Hospital at Westmead, Biochemistry, Sydney, Australia
| | - V James
- Westmead Institute for Medical Research, Histology, Sydney, Australia
| | - J Ronquillo
- Westmead Hospital, Institute of Clinical Pathology and Medical Research, Sydney, Australia
| | - W Varikatt
- Westmead Hospital, Institute of Clinical Pathology and Medical Research, Sydney, Australia
| | - P Kovoor
- Westmead Hospital, Cardiology, Sydney, Australia
| | | | - A McEwan
- Westmead Hospital, Sydney, Australia
| | | | - S Thomas
- Westmead Hospital, Sydney, Australia
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Pentland A, Pentland B, Ryan J. 171 Visualizing clinic routines from multiple points of view. J Invest Dermatol 2019. [DOI: 10.1016/j.jid.2019.07.175] [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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JAYASINGHE K, Zortnitza S, Kerr P, Andrew T, John W, Lilian J, Ryan J, Elly L, Mallett A, Quinlan C. SAT-195 DIAGNOSTIC UTILITY OF WHOLE-EXOME SEQUENCING IN A CHRONIC KIDNEY DISEASE COHORT. Kidney Int Rep 2019. [DOI: 10.1016/j.ekir.2019.05.229] [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] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
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Ouwens M, Darilay A, Zhang Y, Mukhopadhyay P, Mann H, Ryan J, Dennis P. Impact of subsequent post-discontinuation immunotherapy on overall survival in patients with unresectable, stage III NSCLC from PACIFIC. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz067] [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] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Howell S, Hoeks S, West R, Wheatcroft S, Hoeft A, Leva B, Plichon B, Damster S, Momeni M, Watremez C, Kahn D, Dincq AS, Danila A, Wittmann M, Struck R, Rüddel T, Kessler F, Rasche S, Matsota P, Hasani A, Gudaityte J, Karbonskiene A, Ferreira R, Carvalho S, Tomescu D, Martac C, Grintescu I, Mirea L, Serrano L, Serrano L, Sierra P, Sabaté S, Hernando D, Matute P, Trashorras M, Suñé M, Sarmiento L, Hervias A, González O, Hermina A, González O, Hermina A, Navarro Perez R, Orts M, Fernandez-Garcia R, Sanchez Pérez D, Sepulveda Gil I, Monedero P, Hidalgo F, Mbongo C, Pont A, Reyes H, Bartolo C, Galera S, Valentijn T, Stolker R, Tugrul M, Emre Demirel E, Hough M, Griffiths K, Birch S, Beardow Z, Elliot S, Thompson J, Bowrey S, Northey M, Melson H, Telford R, Nadolski M, Potter A, Fuller D, Rose A, Varma S, Simeson K, Pettit J, Smith N, Martinson V, Sleight L, Naylor C, Watt P, Raymode P, Dunk N, Twohey L, Hollos L, Davies S, Gibson A, Coleman Z, Tamm T, Joscak J, Zsisku L, Zuleika M, Carvalho P, Collyer T, Ryan J, Colling K, Dharmarajah S, Krishnan A, Paddle J, Fouracres A, Arnell K, Muhammad K. Prospective observational cohort study of the association between antiplatelet therapy, bleeding and thrombosis in patients with coronary stents undergoing noncardiac surgery. Br J Anaesth 2019; 122:170-179. [DOI: 10.1016/j.bja.2018.09.029] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2017] [Revised: 09/16/2018] [Accepted: 09/24/2018] [Indexed: 01/19/2023] Open
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Ryan J. Zero Suicide Implementation. Perm J 2019. [DOI: 10.7812/tpp/19-039-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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