1
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Steyn M, Gerbens LAA, Spuls PI, Mashayekhi S, Deleuran M, Barbarot S, Wollenberg A, Ferguson J, Ibbotson S, Flohr C. Phototherapy for atopic dermatitis: A survey of European practice. J Eur Acad Dermatol Venereol 2024; 38:521-529. [PMID: 38011002 DOI: 10.1111/jdv.19638] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Accepted: 10/26/2023] [Indexed: 11/29/2023]
Abstract
BACKGROUND Phototherapy is used to treat atopic dermatitis (AD). Evidence for its efficacy, impact on quality of life, cost-effectiveness and short- and long-term safety with real-life usage is weak. OBJECTIVES We established a taskforce to examine how phototherapy is currently being used as a treatment for AD across the United Kingdom and Europe to inform our understanding and guide future research into management of patients with AD using UV-based phototherapies. METHODS An anonymous electronic multiple-response survey exploring phototherapy prescribing practices and experience of phototherapy modalities was developed by the study authors and sent to members of phototherapy networks from the United Kingdom and Europe. Responses were received between February and July 2021. RESULTS About 144 respondents from 27 European countries completed the survey. NBUVB was the most widely used [n = 138 (96%)]. Home-based NBUVB was available in 8/27 countries (25/144 respondents, 17%). Oral psoralen-UVA (PUVA) was more widely available than bath PUVA (n = 106, 74% vs. n = 60, 42%) and used mainly in adult patients. 49/144 (34%) of respondents had access to UVA1. Phototherapy would be considered instead of systemic treatment in 96% of adults and 82% of children for NBUVB, versus 40% of adults and 3% of children for PUVA. Starting doses, standard dosing increments, length of treatment courses, lifetime limits for treatments and thresholds for performing annual skin assessments varied between responders. CONCLUSIONS NBUVB was the most widely used phototherapy for AD in adult and paediatric patients, while PUVA and UVA1 were less used. Prescribing practices varied considerably, highlighting the lack of consensus practice in many different aspects of phototherapy for the treatment of AD in children and adults. This indicates that further studies are required to determine optimal phototherapeutic regimens for AD and informs our understanding of parameters that should be included in future high-quality randomized controlled trials (RCT) of phototherapy.
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Affiliation(s)
- M Steyn
- St John's Institute for Dermatology, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - L A A Gerbens
- Department of Dermatology, Amsterdam UMC, Academic Medical Center, Amsterdam Public Health, Infection and Immunity, University of Amsterdam, Amsterdam, The Netherlands
| | - P I Spuls
- Department of Dermatology, Amsterdam UMC, Academic Medical Center, Amsterdam Public Health, Infection and Immunity, University of Amsterdam, Amsterdam, The Netherlands
| | - S Mashayekhi
- St John's Institute for Dermatology, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - M Deleuran
- Department of Dermatology, Aarhus University Hospital and Aarhus University, Aarhus, Denmark
| | - S Barbarot
- Department of Dermatology, CHU Nantes, Nantes Université, UMR 1280 PhAN, INRA, Nantes, France
| | - A Wollenberg
- Department of Dermatology and Allergy, Augsburg University Hospital, Augsburg, Germany
- Department of Dermatology and Allergy, Ludwig-Maximilian University, Munich, Germany
| | - J Ferguson
- St John's Institute for Dermatology, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - S Ibbotson
- Photobiology Unit, Ninewells Hospital & Medical School, University of Dundee, Dundee, Scotland
| | - C Flohr
- Unit for Paediatric and Population-Based Dermatology Research, St John's Institute of Dermatology, Guy's and St Thomas' NHS Foundation Trust and King's College London, London, UK
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2
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Tavabie OD, Fassihi H, Fityan A, Arujuna N, Naik H, Ferguson J, Aluvihare VR, Sarkany R. Fibrosis assessment using transient elastography identifies obesity as a risk factor for hepatic fibrosis in erythropoietic protoporphyria. Photoderm Photoimm Photomed 2022. [PMID: 36346074 DOI: 10.1111/phpp.12843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/20/2022] [Revised: 10/16/2022] [Accepted: 10/28/2022] [Indexed: 11/10/2022]
Affiliation(s)
- O. D. Tavabie
- Institute of Liver Studies King's College Hospital, London SE5 9RS U.K
| | - H. Fassihi
- St John's Institute of Dermatology, Guy's Hospital SE1 9RT London U.K
| | - A. Fityan
- St John's Institute of Dermatology, Guy's Hospital SE1 9RT London U.K
| | - N. Arujuna
- St John's Institute of Dermatology, Guy's Hospital SE1 9RT London U.K
| | - H. Naik
- St John's Institute of Dermatology, Guy's Hospital SE1 9RT London U.K
| | - J. Ferguson
- St John's Institute of Dermatology, Guy's Hospital SE1 9RT London U.K
| | - V. R. Aluvihare
- Institute of Liver Studies King's College Hospital, London SE5 9RS U.K
| | - R. Sarkany
- St John's Institute of Dermatology, Guy's Hospital SE1 9RT London U.K
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3
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Ibbotson SH, Ferguson J, Moseley H, Samuel IDW, Lesar A, Dawe RS. A Randomised Assessor Blinded Comparison of Low Irradiance and Conventional Irradiance Photodynamic Therapy for Superficial Basal Cell Carcinoma and Bowen's Disease. Br J Dermatol 2021; 186:577-579. [PMID: 34545565 DOI: 10.1111/bjd.20762] [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: 06/07/2021] [Revised: 09/14/2021] [Accepted: 09/14/2021] [Indexed: 11/26/2022]
Abstract
The inconvenience and pain of hospital-based photodynamic therapy (PDT) is sometimes limiting.1 We developed very low irradiance LEDs for ambulatory PDT. Preliminary studies showed this to be convenient and relatively painless.1-4 Here we evaluate the Ambulight® device (Ambicare Health Ltd) in a randomised controlled assessor-blinded study comparing low irradiance ambulatory PDT (APDT) with conventional PDT (CPDT) for superficial basal cell carcinoma (SBCC) and Bowen's disease (BD) (lesions ≤2cm).
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Affiliation(s)
- S H Ibbotson
- Photobiology Unit, Dermatology Department, University of Dundee, Ninewells Hospital & Medical School, Dundee, UK
| | - J Ferguson
- Photobiology Unit, Dermatology Department, University of Dundee, Ninewells Hospital & Medical School, Dundee, UK
| | - H Moseley
- Photobiology Unit, Dermatology Department, University of Dundee, Ninewells Hospital & Medical School, Dundee, UK
| | - I D W Samuel
- School of Physics and Astronomy, SUPA, University of St Andrews, St Andrews, Fife, UK
| | - A Lesar
- Photobiology Unit, Dermatology Department, University of Dundee, Ninewells Hospital & Medical School, Dundee, UK
| | - R S Dawe
- Photobiology Unit, Dermatology Department, University of Dundee, Ninewells Hospital & Medical School, Dundee, UK
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4
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Ibbotson SH, Allan D, Dawe RS, Eadie E, Farr PM, Fassihi H, Fedele F, Ferguson J, Fityan A, Freeman P, Fullerton L, Goulden V, Haque S, Ling TC, Mackay A, McKenna K, Ralph N, Rhodes LE, Sarkany R, Turner D, Ungureanu S, Weatherhead S. Photodiagnostic services in the UK and Republic of Ireland: a British Photodermatology Group Workshop Report. J Eur Acad Dermatol Venereol 2021; 35:2448-2455. [PMID: 34459043 DOI: 10.1111/jdv.17632] [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: 05/24/2021] [Accepted: 08/10/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Photodiagnostic investigations are essential for the accurate diagnosis of abnormal cutaneous photosensitivity and provide important information for the management of patients with photodermatoses (cutaneous photosensitivity disorders). Although photodiagnosis has been undertaken since the early 1970s, specialist services in the United Kingdom (UK) and Republic of Ireland are limited and there is no formal guidance on diagnostic approach. Indeed, there is a limited literature in this area of methodology and diagnostic practice. OBJECTIVES The primary objective was to undertake a British Photodermatology Group Workshop to review the role and activities of specialist centres in the UK and Republic of Ireland in order to ascertain whether there were consensus practices. Secondary objectives were to identify key priorities for service, training and research. METHODS An initial detailed survey review of current activities was undertaken prior to the Workshop and data from this survey were used to inform discussion at the Workshop, which was attended by key photodermatology experts from the UK and Republic of Ireland. RESULTS/CONCLUSIONS We have undertaken a detailed review of current Photodiagnostic Services in the UK and Republic of Ireland and report on our findings from the 12 centres and we have identified key areas of consensus practice. This is an important step in the process of standardising and optimising procedures and protocols and defining minimum clinical standards for photodiagnostic investigations, which are of such diagnostic importance in Dermatology.
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Affiliation(s)
- S H Ibbotson
- Photobiology Unit, NHS Tayside, Ninewells Hospital & Medical School, Dundee, UK.,Photobiology Unit, University of Dundee School of Medicine, Ninewells Hospital & Medical School, Dundee, UK
| | - D Allan
- Medical Physics Department, Salford Royal NHS Foundation Trust, University of Manchester, Manchester Academic Health Science Centre, Salford, UK
| | - R S Dawe
- Photobiology Unit, NHS Tayside, Ninewells Hospital & Medical School, Dundee, UK
| | - E Eadie
- Photobiology Unit, NHS Tayside, Ninewells Hospital & Medical School, Dundee, UK
| | - P M Farr
- Department of Dermatology, Royal Victoria Infirmary, Newcastle-upon-Tyne, UK
| | - H Fassihi
- Photodermatology Unit, St John's Institute of Dermatology, Guy's Hospital, London, UK
| | - F Fedele
- Photodermatology Unit, St John's Institute of Dermatology, Guy's Hospital, London, UK
| | - J Ferguson
- Photodermatology Unit, St John's Institute of Dermatology, Guy's Hospital, London, UK
| | - A Fityan
- Department of Dermatology, University Hospital Southampton NHS Foundation Trust, Hampshire, UK
| | - P Freeman
- Department of Medical Physics, St Thomas' Hospital, London, UK
| | - L Fullerton
- Photobiology Unit, NHS Tayside, Ninewells Hospital & Medical School, Dundee, UK
| | - V Goulden
- Department of Dermatology, Leeds Teaching Hospitals NHS Trust, Chapel Allerton Hospital, Leeds, UK
| | - S Haque
- Department of Dermatology, Cambridge University Hospital, Cambridge, UK
| | - T C Ling
- Photobiology Unit, Dermatology Centre, Salford Royal NHS Foundation Trust, Manchester, UK
| | - A Mackay
- Photobiology Unit, Dermatology Centre, Salford Royal NHS Foundation Trust, Manchester, UK
| | - K McKenna
- Department of Dermatology, Belfast City Hospital, Belfast, UK
| | - N Ralph
- Department of Dermatology, Mater Misericordiae University Hospital, Dublin, Ireland
| | - L E Rhodes
- Photobiology Unit, Dermatology Centre, Salford Royal NHS Foundation Trust, Manchester, UK
| | - R Sarkany
- Photodermatology Unit, St John's Institute of Dermatology, Guy's Hospital, London, UK
| | - D Turner
- Photodermatology Unit, Leeds Teaching Hospitals NHS Trust, Chapel Allerton Hospital, Leeds, UK
| | - S Ungureanu
- Department of Dermatology, Solihull Hospital, Solihull, Birmingham, UK
| | - S Weatherhead
- Department of Dermatology, Royal Victoria Infirmary, Newcastle-upon-Tyne, UK
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5
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Groves K, Ashcroft AE, Cryar A, Sula A, Wallace BA, Stocks BB, Burns C, Cooper-Shepherd D, De Lorenzi E, Rodriguez E, Zhang H, Ault JR, Ferguson J, Phillips JJ, Pacholarz K, Thalassinos K, Luckau L, Ashton L, Durrant O, Barran P, Dalby P, Vicedo P, Colombo R, Davis R, Parakra R, Upton R, Hill S, Wood V, Soloviev Z, Quaglia M. Reference Protocol to Assess Analytical Performance of Higher Order Structural Analysis Measurements: Results from an Interlaboratory Comparison. Anal Chem 2021; 93:9041-9048. [PMID: 34165299 DOI: 10.1021/acs.analchem.0c04625] [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: 11/30/2022]
Abstract
Measurements of protein higher order structure (HOS) provide important information on stability, potency, efficacy, immunogenicity, and biosimilarity of biopharmaceuticals, with a significant number of techniques and methods available to perform these measurements. The comparison of the analytical performance of HOS methods and the standardization of the results is, however, not a trivial task, due to the lack of reference protocols and reference measurement procedures. Here, we developed a protocol to structurally alter and compare samples of somatropin, a recombinant biotherapeutic, and describe the results obtained by using a number of techniques, methods and in different laboratories. This, with the final aim to provide tools and generate a pool of data to compare and benchmark analytical platforms and define method sensitivity to structural changes. Changes in somatropin HOS, induced by the presence of zinc at increasing concentrations, were observed, both globally and at more localized resolution, across many of the methods utilized in this study and with different sensitivities, suggesting the suitability of the protocol to improve understanding of inter- and cross-platform measurement comparability and assess analytical performance as appropriate.
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Affiliation(s)
- K Groves
- National Measurement Laboratory, LGC Ltd. Queens Road, Teddington, Middlesex TW11 0LY, U.K
| | - A E Ashcroft
- Astbury Centre for Structural Molecular Biology & School of Molecular and Cellular Biology, University of Leeds, Leeds LS2 9JT, U.K
| | - A Cryar
- National Measurement Laboratory, LGC Ltd. Queens Road, Teddington, Middlesex TW11 0LY, U.K
| | - A Sula
- Institute of Structural and Molecular Biology, Birkbeck College, University of London, London WC1E 7HX, U.K
| | - B A Wallace
- Institute of Structural and Molecular Biology, Birkbeck College, University of London, London WC1E 7HX, U.K
| | - B B Stocks
- National Research Council Canada, 1200 Montreal Road, Ottawa K1A 0R6, Canada
| | - C Burns
- Biotherapeutics Division, National Institute for Biological Standards and Control, Blanche Lane South Mimms, Potters Bar, Hertfordshire EN6 3QG, U.K
| | - D Cooper-Shepherd
- National Measurement Laboratory, LGC Ltd. Queens Road, Teddington, Middlesex TW11 0LY, U.K
| | - E De Lorenzi
- Department of Drug Sciences, University of Pavia, Viale Taramelli 12, 27100 Pavia, Italy
| | - E Rodriguez
- UCB Celltech, 216 Bath Road, Slough, Berkshire SL1 3WE, U.K
| | - H Zhang
- Department of Biochemical Engineering, University College London, London WC1E 6BT, U.K
| | - J R Ault
- Astbury Centre for Structural Molecular Biology & School of Molecular and Cellular Biology, University of Leeds, Leeds LS2 9JT, U.K
| | - J Ferguson
- Biotherapeutics Division, National Institute for Biological Standards and Control, Blanche Lane South Mimms, Potters Bar, Hertfordshire EN6 3QG, U.K
| | - J J Phillips
- Living Systems Institute, Department of Biosciences, University of Exeter, Exeter EX4 4QD, , U.K
| | - K Pacholarz
- Manchester Institute of Biotechnology, The University of Manchester, 131 Princess Street, Manchester M1 7DN, U.K
| | - K Thalassinos
- Institute of Structural and Molecular Biology, Division of Biosciences, University College London, London WC1E 6AR, U.K
| | - L Luckau
- National Measurement Laboratory, LGC Ltd. Queens Road, Teddington, Middlesex TW11 0LY, U.K
| | - L Ashton
- Department of Chemistry, Lancaster University, Lancaster LA1 4YB, U.K
| | - O Durrant
- UCB Celltech, 216 Bath Road, Slough, Berkshire SL1 3WE, U.K
| | - P Barran
- Manchester Institute of Biotechnology, The University of Manchester, 131 Princess Street, Manchester M1 7DN, U.K
| | - P Dalby
- Department of Biochemical Engineering, University College London, London WC1E 6BT, U.K
| | - P Vicedo
- Manchester Institute of Biotechnology, The University of Manchester, 131 Princess Street, Manchester M1 7DN, U.K
| | - R Colombo
- Department of Drug Sciences, University of Pavia, Viale Taramelli 12, 27100 Pavia, Italy
| | - R Davis
- UCB Celltech, 216 Bath Road, Slough, Berkshire SL1 3WE, U.K
| | - R Parakra
- Living Systems Institute, Department of Biosciences, University of Exeter, Exeter EX4 4QD, , U.K
| | - R Upton
- Manchester Institute of Biotechnology, The University of Manchester, 131 Princess Street, Manchester M1 7DN, U.K
| | - S Hill
- National Measurement Laboratory, LGC Ltd. Queens Road, Teddington, Middlesex TW11 0LY, U.K
| | - V Wood
- Department of Biochemical Engineering, University College London, London WC1E 6BT, U.K
| | - Z Soloviev
- Institute of Structural and Molecular Biology, Division of Biosciences, University College London, London WC1E 6AR, U.K
| | - M Quaglia
- National Measurement Laboratory, LGC Ltd. Queens Road, Teddington, Middlesex TW11 0LY, U.K
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6
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Thulabandu V, Nehila T, Ferguson J, Atit R. 582 Dermal EZH2 orchestrates dermal differentiation and epidermal proliferation during murine skin development. J Invest Dermatol 2021. [DOI: 10.1016/j.jid.2021.02.610] [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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7
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Davidson JM, Ferguson J, Ivey E, Philip R, Weems MF, Talati AJ. A randomized trial of intravenous acetaminophen versus indomethacin for treatment of hemodynamically significant PDAs in VLBW infants. J Perinatol 2021; 41:93-99. [PMID: 32439957 DOI: 10.1038/s41372-020-0694-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [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] [Received: 01/06/2020] [Revised: 04/20/2020] [Accepted: 05/11/2020] [Indexed: 11/09/2022]
Abstract
Objective was to compare the rate of successful treatment of hsPDA based on echocardiogram criteria after use of IV acetaminophen or IV indomethacin in very low-birthweight infants. The study was a multi-center, randomized controlled trial. Infants born prior to 32 weeks with birthweight ≤ 1500 g were included if PDA treatment was indicated within the 21 days after birth. hsPDA was defined by strict echocardiogram criteria. Eligible infants were randomized to treatment with either IV acetaminophen or IV indomethacin. Of 86 eligible infants, 17 infants were randomized to acetaminophen and 20 to indomethacin. One (5.9%) hsPDA in the acetaminophen group had successful treatment compared to 11 (55%) in the indomethacin group (p = 0.002). Eight (47%) in the acetaminophen group and 3 (15%) in the indomethacin group received transcatheter PDA closure (p = 0.07). IV indomethacin was more effective than IV acetaminophen for treatment of hsPDAs. More infants in the acetaminophen group received transcatheter closure.
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Affiliation(s)
- J M Davidson
- University of Tennessee Health Science Center, Memphis, TN, USA. .,Regional One Health, Memphis, TN, USA. .,Lebonheur Children's Hospital, Memphis, TN, USA.
| | - J Ferguson
- University of Tennessee Health Science Center, Memphis, TN, USA.,Lebonheur Children's Hospital, Memphis, TN, USA
| | - E Ivey
- Mednax/Germantown Hospital, Germantown, TN, USA
| | - R Philip
- University of Tennessee Health Science Center, Memphis, TN, USA.,Lebonheur Children's Hospital, Memphis, TN, USA
| | - M F Weems
- University of Tennessee Health Science Center, Memphis, TN, USA.,Regional One Health, Memphis, TN, USA.,Lebonheur Children's Hospital, Memphis, TN, USA
| | - A J Talati
- University of Tennessee Health Science Center, Memphis, TN, USA.,Regional One Health, Memphis, TN, USA.,Lebonheur Children's Hospital, Memphis, TN, USA
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8
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Cotter C, Ferguson J. 'Ruxolitinib cream for the treatment of vitiligo: a randomised, controlled, phase 2 trial': a critical appraisal. Br J Dermatol 2020; 184:826-827. [PMID: 33179290 DOI: 10.1111/bjd.19674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Revised: 11/09/2020] [Accepted: 11/10/2020] [Indexed: 11/27/2022]
Affiliation(s)
- C Cotter
- St John's Institute of Dermatology, King's College London, London, UK
| | - J Ferguson
- St John's Institute of Dermatology, King's College London, London, UK
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9
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Chupp G, Kline J, Khatri S, McEvoy C, Shifren A, Bansal S, McClelland M, Dransfield M, Olivenstein R, Lawson E, Simoff M, Wahidi M, Lamb C, Ferguson J, Haas A, Hogarth D, Tejedor R, Laviolette M. LONG-TERM EFFICACY AND SAFETY OF BRONCHIAL THERMOPLASTY: 5-YEAR FOLLOW-UP RESULTS FROM A LARGE-SCALE PROSPECTIVE STUDY. Chest 2020. [DOI: 10.1016/j.chest.2020.08.059] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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10
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Hannaway N, Jiang X, Aspray T, Burns A, Ferguson J, Pedley I, Frew J, Azzabi A, Pearson R, Chandler R, Hughes A, Showler H, Bennett A, McMenemin R. 673P Assessing bone health and osteoporotic risk in patients requiring anti androgen therapy for prostate cancer. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.932] [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: 10/23/2022] Open
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11
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Bedair K, Elhadad A, Hamad S, Ferguson J, Donnan P, Dawe RS. No association between whole-body ultraviolet A1 phototherapy and skin cancers in humans: a cancer registry linkage study. Br J Dermatol 2020; 183:586-587. [PMID: 32198750 DOI: 10.1111/bjd.19041] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- K Bedair
- Photobiology Unit, Dermatology Department, University of Dundee, Dundee, DD1 9SY, UK.,Department of Statistics and Mathematics, Faculty of Commerce, Tanta University, Tanta, 31521, Egypt
| | - A Elhadad
- Department of Mathematics and Computer Science, Faculty of Science, South Valley University, Qena, 83523, Egypt
| | - S Hamad
- Department of Scientific Computing, Faculty of Computer and Information Sciences, Ain Shams University, Cairo, 11566, Egypt
| | - J Ferguson
- Photobiology Unit, Dermatology Department, University of Dundee, Dundee, DD1 9SY, UK
| | - P Donnan
- Department of Population Health Sciences and Medical Research Unit, School of Medicine, University of Dundee, Dundee, DD1 9SY, UK
| | - R S Dawe
- Photobiology Unit, Dermatology Department, University of Dundee, Dundee, DD1 9SY, UK
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12
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Bowe F, Paul I, Ferguson J, Dunning J, Harrison S. High intensity inspiratory muscle training (HI-IMT) in individuals referred for lung resection surgery. Physiotherapy 2020. [DOI: 10.1016/j.physio.2020.03.047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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13
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Ferguson J, Alexander L, Kelly C, Chalmers A, Rahman N, Holme J, Grundy S, Ahmed L, Maskell N, Cowell G, Dick C, Tsim S, Hopkins T, Woodward R, Blyth K. Staging by Thoracoscopy in Potentially Radically Treatable Non-Small Cell Lung Cancer Associated with Minimal Pleural Effusion (STRATIFY) study: a prospective multicentre study. Lung Cancer 2020. [DOI: 10.1016/s0169-5002(20)30245-2] [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: 11/17/2022]
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14
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Ferguson K, Blyth K, Tsim S, Ferguson J, Mercer R, Rahman N, Maskell N, Evison M. An update regarding the Meso-ORIGINS feasibility study and the PREDICT-Meso Accelerator Network. Lung Cancer 2020. [DOI: 10.1016/s0169-5002(20)30193-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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15
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Bravata DM, Myers LJ, Homoya B, Miech EJ, Rattray NA, Perkins AJ, Zhang Y, Ferguson J, Myers J, Cheatham AJ, Murphy L, Giacherio B, Kumar M, Cheng E, Levine DA, Sico JJ, Ward MJ, Damush TM. The protocol-guided rapid evaluation of veterans experiencing new transient neurological symptoms (PREVENT) quality improvement program: rationale and methods. BMC Neurol 2019; 19:294. [PMID: 31747879 PMCID: PMC6865042 DOI: 10.1186/s12883-019-1517-x] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2019] [Accepted: 10/28/2019] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Transient ischemic attack (TIA) patients are at high risk of recurrent vascular events; timely management can reduce that risk by 70%. The Protocol-guided Rapid Evaluation of Veterans Experiencing New Transient Neurological Symptoms (PREVENT) developed, implemented, and evaluated a TIA quality improvement (QI) intervention aligned with Learning Healthcare System principles. METHODS This stepped-wedge trial developed, implemented and evaluated a provider-facing, multi-component intervention to improve TIA care at six facilities. The unit of analysis was the medical center. The intervention was developed based on benchmarking data, staff interviews, literature, and electronic quality measures and included: performance data, clinical protocols, professional education, electronic health record tools, and QI support. The effectiveness outcome was the without-fail rate: the proportion of patients who receive all processes of care for which they are eligible among seven processes. The implementation outcomes were the number of implementation activities completed and final team organization level. The intervention effects on the without-fail rate were analyzed using generalized mixed-effects models with multilevel hierarchical random effects. Mixed methods were used to assess implementation, user satisfaction, and sustainability. DISCUSSION PREVENT advanced three aspects of a Learning Healthcare System. Learning from Data: teams examined and interacted with their performance data to explore hypotheses, plan QI activities, and evaluate change over time. Learning from Each Other: Teams participated in monthly virtual collaborative calls. Sharing Best Practices: Teams shared tools and best practices. The approach used to design and implement PREVENT may be generalizable to other clinical conditions where time-sensitive care spans clinical settings and medical disciplines. TRIAL REGISTRATION clinicaltrials.gov: NCT02769338 [May 11, 2016].
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Affiliation(s)
- D M Bravata
- Department of Veterans Affairs (VA) Health Services Research and Development (HSR&D), Precision Monitoring to Transform Care (PRISM) Quality Enhancement Research Initiative (QUERI), Indianapolis, USA.
- VA HSR&D Center for Health Information and Communication (CHIC), Richard L. Roudebush VA Medical Center, HSR&D Mail Code 11H, 1481 West 10th Street, Indianapolis, IN, 46202, USA.
- Department of Internal Medicine, Indiana University School of Medicine, Indianapolis, IN, USA.
- Department of Neurology, Indiana University School of Medicine, Indianapolis, IN, USA.
- Regenstrief Institute, Indianapolis, IN, USA.
| | - L J Myers
- Department of Veterans Affairs (VA) Health Services Research and Development (HSR&D), Precision Monitoring to Transform Care (PRISM) Quality Enhancement Research Initiative (QUERI), Indianapolis, USA
- VA HSR&D Center for Health Information and Communication (CHIC), Richard L. Roudebush VA Medical Center, HSR&D Mail Code 11H, 1481 West 10th Street, Indianapolis, IN, 46202, USA
- Department of Internal Medicine, Indiana University School of Medicine, Indianapolis, IN, USA
- Regenstrief Institute, Indianapolis, IN, USA
| | - B Homoya
- Department of Veterans Affairs (VA) Health Services Research and Development (HSR&D), Precision Monitoring to Transform Care (PRISM) Quality Enhancement Research Initiative (QUERI), Indianapolis, USA
- VA HSR&D Center for Health Information and Communication (CHIC), Richard L. Roudebush VA Medical Center, HSR&D Mail Code 11H, 1481 West 10th Street, Indianapolis, IN, 46202, USA
| | - E J Miech
- Department of Veterans Affairs (VA) Health Services Research and Development (HSR&D), Precision Monitoring to Transform Care (PRISM) Quality Enhancement Research Initiative (QUERI), Indianapolis, USA
- VA HSR&D Center for Health Information and Communication (CHIC), Richard L. Roudebush VA Medical Center, HSR&D Mail Code 11H, 1481 West 10th Street, Indianapolis, IN, 46202, USA
- Department of Internal Medicine, Indiana University School of Medicine, Indianapolis, IN, USA
- Regenstrief Institute, Indianapolis, IN, USA
| | - N A Rattray
- Department of Veterans Affairs (VA) Health Services Research and Development (HSR&D), Precision Monitoring to Transform Care (PRISM) Quality Enhancement Research Initiative (QUERI), Indianapolis, USA
- VA HSR&D Center for Health Information and Communication (CHIC), Richard L. Roudebush VA Medical Center, HSR&D Mail Code 11H, 1481 West 10th Street, Indianapolis, IN, 46202, USA
- Regenstrief Institute, Indianapolis, IN, USA
| | - A J Perkins
- Department of Veterans Affairs (VA) Health Services Research and Development (HSR&D), Precision Monitoring to Transform Care (PRISM) Quality Enhancement Research Initiative (QUERI), Indianapolis, USA
- Department of Biostatistics, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Y Zhang
- Department of Veterans Affairs (VA) Health Services Research and Development (HSR&D), Precision Monitoring to Transform Care (PRISM) Quality Enhancement Research Initiative (QUERI), Indianapolis, USA
- Department of Biostatistics, University of Nebraska Medical Center, Omaha, NE, USA
| | - J Ferguson
- Department of Veterans Affairs (VA) Health Services Research and Development (HSR&D), Precision Monitoring to Transform Care (PRISM) Quality Enhancement Research Initiative (QUERI), Indianapolis, USA
- VA HSR&D Center for Health Information and Communication (CHIC), Richard L. Roudebush VA Medical Center, HSR&D Mail Code 11H, 1481 West 10th Street, Indianapolis, IN, 46202, USA
| | - J Myers
- Department of Veterans Affairs (VA) Health Services Research and Development (HSR&D), Precision Monitoring to Transform Care (PRISM) Quality Enhancement Research Initiative (QUERI), Indianapolis, USA
- VA HSR&D Center for Health Information and Communication (CHIC), Richard L. Roudebush VA Medical Center, HSR&D Mail Code 11H, 1481 West 10th Street, Indianapolis, IN, 46202, USA
| | - A J Cheatham
- Department of Veterans Affairs (VA) Health Services Research and Development (HSR&D), Precision Monitoring to Transform Care (PRISM) Quality Enhancement Research Initiative (QUERI), Indianapolis, USA
- VA HSR&D Center for Health Information and Communication (CHIC), Richard L. Roudebush VA Medical Center, HSR&D Mail Code 11H, 1481 West 10th Street, Indianapolis, IN, 46202, USA
| | - L Murphy
- Department of Veterans Affairs (VA) Health Services Research and Development (HSR&D), Precision Monitoring to Transform Care (PRISM) Quality Enhancement Research Initiative (QUERI), Indianapolis, USA
- VA HSR&D Center for Health Information and Communication (CHIC), Richard L. Roudebush VA Medical Center, HSR&D Mail Code 11H, 1481 West 10th Street, Indianapolis, IN, 46202, USA
| | - B Giacherio
- Office of Healthcare Transformation (OHT), Veterans Health Administration (VHA), Washington, DC, USA
| | - M Kumar
- Office of Healthcare Transformation (OHT), Veterans Health Administration (VHA), Washington, DC, USA
| | - E Cheng
- Department of Neurology, VA Greater Los Angeles Healthcare System, California, Los Angeles, USA
- Department of Neurology, David Geffen School of Medicine, University of California at Los Angeles, California, Los Angeles, USA
| | - D A Levine
- Department of Internal Medicine and Neurology and Institute for Health Policy and Innovation, University of Michigan School of Medicine, Ann Arbor, MI, USA
| | - J J Sico
- Clinical Epidemiology Research Center and Neurology Service, VA Connecticut Healthcare System, West Haven, CT, USA
- Departments of Internal Medicine and Neurology and Center for Neuroepidemiology and Clinical Neurological Research, Yale School of Medicine, New Haven, CT, USA
| | - M J Ward
- VA Tennessee Valley Healthcare System, Nashville, TN, USA
- Department of Emergency Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | - T M Damush
- Department of Veterans Affairs (VA) Health Services Research and Development (HSR&D), Precision Monitoring to Transform Care (PRISM) Quality Enhancement Research Initiative (QUERI), Indianapolis, USA
- VA HSR&D Center for Health Information and Communication (CHIC), Richard L. Roudebush VA Medical Center, HSR&D Mail Code 11H, 1481 West 10th Street, Indianapolis, IN, 46202, USA
- Department of Internal Medicine, Indiana University School of Medicine, Indianapolis, IN, USA
- Regenstrief Institute, Indianapolis, IN, USA
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Quadros K, Baykaner T, Thosani A, Mitra R, Ferguson J, Brodt C, Zei P. SAFETY AND EFFICACY OF MINIMAL FLUOROSCOPY APPROACH FOR CATHETER ABLATION IN ATRIAL FIBRILLATION: A MULTI CENTER, PROSPECTIVE REGISTRY. Can J Cardiol 2019. [DOI: 10.1016/j.cjca.2019.07.575] [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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17
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Moody WE, Holloway B, Gill S, Boivin C, Wahid Y, Ferguson J, Steeds RP. 248Prognostic value of single photon emission computed tomography among liver transplantation candidates. Eur Heart J Cardiovasc Imaging 2019. [DOI: 10.1093/ehjci/jez150.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- W E Moody
- Royal Brompton Hospital, London, United Kingdom of Great Britain & Northern Ireland
| | - B Holloway
- University of Birmingham, Queen Elizabeth Hospital, Birmingham, United Kingdom of Great Britain & Northern Ireland
| | - S Gill
- University of Birmingham, Queen Elizabeth Hospital, Birmingham, United Kingdom of Great Britain & Northern Ireland
| | - C Boivin
- University of Birmingham, Queen Elizabeth Hospital, Birmingham, United Kingdom of Great Britain & Northern Ireland
| | - Y Wahid
- University of Birmingham, Queen Elizabeth Hospital, Birmingham, United Kingdom of Great Britain & Northern Ireland
| | - J Ferguson
- University of Birmingham, Queen Elizabeth Hospital, Birmingham, United Kingdom of Great Britain & Northern Ireland
| | - R P Steeds
- University of Birmingham, Queen Elizabeth Hospital, Birmingham, United Kingdom of Great Britain & Northern Ireland
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18
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Ferguson J, Burns CJ, Regourd E, Costanzo A. Collaborative study for the establishment of erythropoietin BRP batch 5. Pharmeur Bio Sci Notes 2019; 2019:27-33. [PMID: 30880683] [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: 06/09/2023]
Abstract
The European Pharmacopoeia (Ph. Eur.) Biological Reference Preparation (BRP) for erythropoietin (EPO) is used as a working standard for potency determination of EPO preparations by in vivo bioassay as prescribed in Ph. Eur. monograph 1316 'Erythropoietin concentrated solution'. BRP batch 4 (BRP4) was calibrated in 2014 and its stocks are depleted. The European Directorate for the Quality of Medicines and HealthCare (EDQM) thus endorsed a project (BSP147) to calibrate a replacement batch in International Units against the 3rd WHO International Standard (IS) for erythropoietin, recombinant, for bioassay (11/170). The amount of material contained in the vial of BRP4 greatly exceeded the amount needed for one bioassay, sometimes leading to considerable waste. It was thus decided to prepare a candidate material with a lower EPO content. The collaborative study involved eight laboratories in Europe, the USA and Australia. Based on the outcome of the study, the Ph. Eur. Commission adopted the proposed standard as Erythropoietin BRP batch 5 in June 2018 for use as a reference preparation solely for the polycythaemic and normocythaemic mouse bioassays, with an assigned potency of 2000 IU/ampoule. Furthermore, the potency of BRP batch 4 was confirmed during the study thus warranting a good continuity of the International Unit.
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Affiliation(s)
- J Ferguson
- National Institute for Biological Standards and Control (NIBSC), Blanche Lane, South Mimms, Potters Bar, EN6 3QG, United Kingdom
| | - C J Burns
- National Institute for Biological Standards and Control (NIBSC), Blanche Lane, South Mimms, Potters Bar, EN6 3QG, United Kingdom
| | - E Regourd
- European Directorate for the Quality of Medicines & Healthcare (EDQM), Department of Biological Standardisation, OMCL Network & HealthCare (DBO), Council of Europe, Strasbourg, France
| | - A Costanzo
- European Directorate for the Quality of Medicines & Healthcare (EDQM), Department of Biological Standardisation, OMCL Network & HealthCare (DBO), Council of Europe, Strasbourg, France. E-mail:
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19
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Franks K, Mcparland L, Webster J, Baldwin D, Sebag-Montefiore D, Evison M, Booton R, Faivre-Finn C, Naidu B, Ferguson J, Peedell C, Callister M, Kennedy M, Gregory W, Hewison J, Bestall J, Bell S, Hall P, Snee M. P2.16-16 SABRTOOTH: A Fasibility Study of SABR Versus Surgery in Patients with Peripheral Stage I NSCLC Considered to be at Higher Risk for Surgery. J Thorac Oncol 2018. [DOI: 10.1016/j.jtho.2018.08.1491] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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20
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Trivedi PJ, Reece J, Laing RW, Slaney E, Cooney R, Gunson BK, Kamarajah SK, Pinkney T, Thompson F, Muiesan P, Schlegel A, Hirschfield GM, Iqbal T, Ferguson J. The impact of ileal pouch-anal anastomosis on graft survival following liver transplantation for primary sclerosing cholangitis. Aliment Pharmacol Ther 2018; 48:322-332. [PMID: 29882252 DOI: 10.1111/apt.14828] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2018] [Revised: 03/25/2018] [Accepted: 05/08/2018] [Indexed: 12/12/2022]
Abstract
BACKGROUND Liver transplantation is the only life-extending intervention for primary sclerosing cholangitis (PSC). Given the co-existence with colitis, patients may also require colectomy; a factor potentially conferring improved post-transplant outcomes. AIM To determine the impact of restorative surgery via ileal pouch-anal anastomosis (IPAA) vs retaining an end ileostomy on liver-related outcomes post-transplantation. METHODS Graft survival was evaluated across a prospectively accrued transplant database, stratified according to colectomy status and type. RESULTS Between 1990 and 2016, 240 individuals with PSC/colitis underwent transplantation (cumulative 1870 patient-years until first graft loss or last follow-up date), of whom 75 also required colectomy. A heightened incidence of graft loss was observed for the IPAA group vs those retaining an end ileostomy (2.8 vs 0.4 per 100 patient-years, log-rank P = 0.005), whereas rates between IPAA vs no colectomy groups were not significantly different (2.8 vs 1.7, P = 0.1). In addition, the ileostomy group experienced significantly lower graft loss rates vs. patients retaining an intact colon (P = 0.044). The risks conferred by IPAA persisted when taking into account timing of colectomy as related to liver transplantation via time-dependent Cox regression analysis. Hepatic artery thrombosis and biliary strictures were the principal aetiologies of graft loss overall. Incidence rates for both were not significantly different between IPAA and no colectomy groups (P = 0.092 and P = 0.358); however, end ileostomy appeared protective (P = 0.007 and 0.031, respectively). CONCLUSION In PSC, liver transplantation, colectomy + IPAA is associated with similar incidence rates of hepatic artery thrombosis, recurrent biliary strictures and re-transplantation compared with no colectomy. Colectomy + end ileostomy confers more favourable graft outcomes.
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Affiliation(s)
- P J Trivedi
- National Institute for Health Research (NIHR) Birmingham Biomedical Research Centre (BRC), Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham, UK.,Liver Unit, University Hospitals Birmingham NHS Foundation Trust, Queen Elizabeth Hospital, Birmingham, UK.,Department of Gastroenterology, University Hospitals Birmingham NHS Foundation Trust, Queen Elizabeth Hospital, Birmingham, UK.,Centre for Rare Diseases, Institute of Translational Medicine, University of Birmingham, Birmingham, UK
| | - J Reece
- Department of Gastroenterology, University Hospitals Birmingham NHS Foundation Trust, Queen Elizabeth Hospital, Birmingham, UK
| | - R W Laing
- National Institute for Health Research (NIHR) Birmingham Biomedical Research Centre (BRC), Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham, UK.,Liver Unit, University Hospitals Birmingham NHS Foundation Trust, Queen Elizabeth Hospital, Birmingham, UK
| | - E Slaney
- Liver Unit, University Hospitals Birmingham NHS Foundation Trust, Queen Elizabeth Hospital, Birmingham, UK
| | - R Cooney
- Department of Gastroenterology, University Hospitals Birmingham NHS Foundation Trust, Queen Elizabeth Hospital, Birmingham, UK
| | - B K Gunson
- National Institute for Health Research (NIHR) Birmingham Biomedical Research Centre (BRC), Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham, UK.,Liver Unit, University Hospitals Birmingham NHS Foundation Trust, Queen Elizabeth Hospital, Birmingham, UK
| | - S K Kamarajah
- National Institute for Health Research (NIHR) Birmingham Biomedical Research Centre (BRC), Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham, UK
| | - T Pinkney
- Department of Colorectal Surgery, University Hospitals Birmingham NHS Foundation Trust, Queen Elizabeth Hospital, Birmingham, UK
| | - F Thompson
- Liver Unit, University Hospitals Birmingham NHS Foundation Trust, Queen Elizabeth Hospital, Birmingham, UK.,Centre for Rare Diseases, Institute of Translational Medicine, University of Birmingham, Birmingham, UK
| | - P Muiesan
- Liver Unit, University Hospitals Birmingham NHS Foundation Trust, Queen Elizabeth Hospital, Birmingham, UK
| | - A Schlegel
- Liver Unit, University Hospitals Birmingham NHS Foundation Trust, Queen Elizabeth Hospital, Birmingham, UK.,Swiss HPB and Transplantation Center, University Hospital Zurich, Zurich, Switzerland
| | - G M Hirschfield
- National Institute for Health Research (NIHR) Birmingham Biomedical Research Centre (BRC), Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham, UK.,Liver Unit, University Hospitals Birmingham NHS Foundation Trust, Queen Elizabeth Hospital, Birmingham, UK.,Centre for Rare Diseases, Institute of Translational Medicine, University of Birmingham, Birmingham, UK
| | - T Iqbal
- Department of Gastroenterology, University Hospitals Birmingham NHS Foundation Trust, Queen Elizabeth Hospital, Birmingham, UK
| | - J Ferguson
- Liver Unit, University Hospitals Birmingham NHS Foundation Trust, Queen Elizabeth Hospital, Birmingham, UK.,Centre for Rare Diseases, Institute of Translational Medicine, University of Birmingham, Birmingham, UK
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21
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Dawe RS, Ferguson J, Ibbotson S, Lawrence L, Paulson S, Duffy E, Cammarata S. Lack of phototoxicity potential with delafloxacin in healthy male and female subjects: comparison to lomefloxacin. Photochem Photobiol Sci 2018; 17:773-780. [PMID: 29721574 DOI: 10.1039/c8pp00019k] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [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
AIMS Delafloxacin is a fluoroquinolone antibiotic recently approved by the FDA for treatment of acute bacterial skin and skin structure infections (ABSSSI). Delafloxacin was assessed for phototoxicity potential compared with a known phototoxic fluoroquinolone. METHODS A Phase 1, investigator-blind, placebo/active-controlled, randomized, parallel-group study was conducted in 52 healthy male and female volunteers who received 200 or 400 mg of oral delafloxacin, 400 mg oral lomefloxacin or placebo once daily for 6 days. This study evaluated the photosensitizing potential and possible wavelength dependency of delafloxacin by comparing the response of the skin to ultraviolet A (UVA), ultraviolet B (UVB) and visible radiation prior to and during administration of delafloxacin, lomefloxacin as a positive control, or placebo. Adverse events were monitored throughout the study. RESULTS Forty-seven subjects completed six days of dosing, and no evidence of phototoxicity was seen with delafloxacin. Delafloxacin at 200 and 400 mg day-1 and placebo did not demonstrate differences in percent change from baseline in minimal erythema dose at all tested wavelengths (295-430 nm) by monochromator and solar simulator. Lomefloxacin, the positive control, had statistically significant differences (p < 0.05) at UVA wavelengths of 335 and 365 ± 30 nm 24 hours after radiation exposure (maximum response). The phototoxic index results were significantly higher for lomefloxacin at 335 nm and 365 nm compared to placebo and delafloxacin. CONCLUSIONS 200 and 400 mg of delafloxacin administered for 6 days were well tolerated in healthy adult volunteers. Delafloxacin and placebo failed to demonstrate a phototoxic effect but lomefloxacin, the positive control, demonstrated moderate phototoxicity.
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Affiliation(s)
- R S Dawe
- Photobiology Unit, Ninewells Hospital and Medical School, Dundee DD1 9SY, Scotland, UK
| | - J Ferguson
- Photobiology Unit, Ninewells Hospital and Medical School, Dundee DD1 9SY, Scotland, UK
| | - S Ibbotson
- Photobiology Unit, Ninewells Hospital and Medical School, Dundee DD1 9SY, Scotland, UK
| | - L Lawrence
- Melinta Therapeutics, Inc., Lincolnshire, IL 60069, USA.
| | - S Paulson
- Firma Clinical, Northbrook, IL 60062, USA
| | - E Duffy
- Melinta Therapeutics, Inc., New Haven, CT 06515, USA
| | - S Cammarata
- Melinta Therapeutics, Inc., Lincolnshire, IL 60069, USA.
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Allyn PR, O'Malley SM, Ferguson J, Tseng CH, Chew KW, Bhattacharya D. Attitudes and potential barriers towards hepatitis C treatment in patients with and without HIV coinfection. Int J STD AIDS 2018; 29:334-340. [PMID: 28820346 PMCID: PMC5670019 DOI: 10.1177/0956462417725462] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
This study aimed to assess attitudes and potential barriers towards treatment in patients with hepatitis C virus (HCV) infection, comparing those with and without HIV coinfection. A cross-sectional survey of 82 HCV-infected adults with and without HIV was conducted in greater Los Angeles between November 2013 and July 2015. Overall, there were 53 (64.6%) with HIV coinfection, 20 (25.0%) with self-reported cirrhosis, and 22 (26.8%) with a history of prior HCV treatment. Of all, 93.2% wanted HCV treatment, but 45.9% were unwilling/unable to spend anything out of pocket, 29.4% were waiting for new therapies, and 23.5% were recommended to defer HCV treatment. HIV/HCV-coinfected patients were more likely to want treatment within one year (90.2% versus 68.2%, p = 0.02), more willing to join a clinical trial (74.5% versus 8.0%, p < 0.01), more willing to take medications twice daily (86.3% versus 61.5%, p = 0.01), and more likely to prefer hepatitis C treatment by an infectious diseases/HIV physician (36.7% versus 4.0%, p < 0.01). Of all, 77.1% of coinfected patients were willing to change antiretroviral therapy if necessary to treat HCV, but only 48.0% of patients were willing to take a medication if it had not been studied in HIV-positive patients. Treatment preferences differ between HIV/HCV-coinfected and HCV-monoinfected patients. Despite a strong willingness among the study cohort to start HCV treatment, other factors such as cost, access to medications, and provider reluctance may be delaying treatment initiation.
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Affiliation(s)
- P R Allyn
- 1 Division of Infectious Diseases, Department of Medicine, 12222 University of California Los Angeles , Los Angeles, CA, USA
| | - S M O'Malley
- 2 UCLA Center for Clinical AIDS Research and Education (CARE), Los Angeles, CA, USA
| | - J Ferguson
- 3 Department of Medicine, Stanford University Medical Center, Palo Alto, CA, USA
| | - C H Tseng
- 4 Department of Medicine Statistics Core, 12222 University of California Los Angeles , Los Angeles, CA, USA
| | - K W Chew
- 1 Division of Infectious Diseases, Department of Medicine, 12222 University of California Los Angeles , Los Angeles, CA, USA
- 2 UCLA Center for Clinical AIDS Research and Education (CARE), Los Angeles, CA, USA
| | - D Bhattacharya
- 1 Division of Infectious Diseases, Department of Medicine, 12222 University of California Los Angeles , Los Angeles, CA, USA
- 2 UCLA Center for Clinical AIDS Research and Education (CARE), Los Angeles, CA, USA
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Möbius G, Ferguson J, Edinger J. Comparison of tenoscopic and ultrasonographic methods of examination of the digital flexor tendon sheath in horses. Vet Comp Orthop Traumatol 2018. [DOI: 10.1055/s-0038-1632957] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
SummaryThe purpose of this study was to compare sonographic and tenoscopic findings with the purpose of establishing the accuracy and limitations of ultrasonography as a non-invasive diagnostic modality in evaluating the DFTS and its enclosed tendons. The medical records from 22 horses which underwent tenoscopic desmotomy of the palmar/plantar annular ligament were evaluated in a retrospective study. The qualitative assessment of sonographic and tenoscopic findings were documented for the digital flexor tendon sheath (DFTS), the palmar/plantar annular ligament (PAL), the superficial digital flexor tendon (SDFT) and the deep digital flexor tendon (DDFT). The abnormalities diagnosed sonographically within the DFTS were verifiable tenoscopically with a sensitivity of 90.9% and a specificity of 53.8%. The positive predictive value of sonographic examination at the DFTS was 62.5%. The sensitivity of the sonographic examination at the PAL was 68.8%, the specificity was 50% and the positive predictive value 73.3%. Sonographic examination of the SDF tendons revealed abnormal findings in 12 tendons. The tenoscopic examination confirmed these findings on six tendons when they had a pronounced fibrillated or rough tendon surface or tear on the border. Six superficial flexor tendons and seven deep digital flexor tendons had abnormalities seen tenoscopically which were not visible on sonographic examination. Sonographic examination located lesions of the DDFT in four limbs. On tenoscopic examination the lesions could be detected in seven other DDF tendons, including signs of inflammation at the tendon surface that were not seen ultrasonographically (sensitivity 36.4%). Recognition of the limitations of sonographic results should be kept in mind so as not to misinterpret findings, especially if echogenic materials are observed.
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Vachani A, Atalay M, Bremner R, Broussard B, Copeland K, Egressy K, Ferguson J, Friedman L, Harris R, Leach J, McQuary P, O'Brien T, Sarkar S, Sheibani N, Shuff J, Siler T, Southwell C, Hesterberg L. A Blood-Based Multi-Gene Expression Classifier to Distinguish Benign From Malignant Pulmonary Nodules. Chest 2017. [DOI: 10.1016/j.chest.2017.08.661] [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: 11/27/2022] Open
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25
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Zei P, Thosani A, Mitra R, Ferguson J, Brodt C, Sakarovitch C, O'riordan G. P1405Minimal fluoroscopy atrial fibrillation catheter ablation: a prospective multicenter registry. Europace 2017. [DOI: 10.1093/ehjci/eux158.033] [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: 11/12/2022] Open
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26
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Lenet AS, Stahl SM, Guenther D, Ferguson J, Lightner N, Aichinger J, Miech EJ, Bravata DM. 0524 THE INDIANA TELEMONITORING TO OPTIMIZE USE OF CPAP AT HOME PROGRAM. Sleep 2017. [DOI: 10.1093/sleepj/zsx050.523] [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: 11/13/2022] Open
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27
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Wigham S, Bauer A, Robalino S, Ferguson J, Burke A, Newbury-Birch D. A systematic review of the effectiveness of alcohol brief interventions for the UK military personnel moving back to civilian life. J ROY ARMY MED CORPS 2017; 163:242-250. [DOI: 10.1136/jramc-2016-000712] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2016] [Revised: 12/12/2016] [Accepted: 12/19/2016] [Indexed: 11/04/2022]
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Ferguson J, Kot E, Thiel L, Karreman E, Rattray D, Thiel J. Morphologic and Histologic Changes in Hysterectomies After NovaSure Ablation: A Retrospective Chart Review. J Minim Invasive Gynecol 2016; 22:S187-S188. [PMID: 27678989 DOI: 10.1016/j.jmig.2015.08.685] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- J Ferguson
- Department of Obstetrics and Gynecology, University of Saskatchewan, Regina, Saskatchewan, Canada
| | - E Kot
- Department of Obstetrics and Gynecology, University of Saskatchewan, Regina, Saskatchewan, Canada
| | - L Thiel
- College of Medicine, University of Saskatchewan, Regina, Saskatchewan, Canada
| | - E Karreman
- Research and Health Information Services, Regina Qu'Appelle Health Region, Regina, Saskatchewan, Canada
| | - D Rattray
- Department of Obstetrics and Gynecology, University of Saskatchewan, Regina, Saskatchewan, Canada
| | - J Thiel
- Department of Obstetrics and Gynecology, University of Saskatchewan, Regina, Saskatchewan, Canada
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Stravinskas M, Horstmann P, Ferguson J, Hettwer W, Nilsson M, Tarasevicius S, Petersen MM, McNally MA, Lidgren L. Pharmacokinetics of gentamicin eluted from a regenerating bone graft substitute: In vitro and clinical release studies. Bone Joint Res 2016; 5:427-35. [PMID: 27678329 PMCID: PMC5047051 DOI: 10.1302/2046-3758.59.bjr-2016-0108.r1] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2016] [Accepted: 08/02/2016] [Indexed: 12/18/2022] Open
Abstract
Objectives Deep bone and joint infections (DBJI) are directly intertwined with health, demographic change towards an elderly population, and wellbeing. The elderly human population is more prone to acquire infections, and the consequences such as pain, reduced quality of life, morbidity, absence from work and premature retirement due to disability place significant burdens on already strained healthcare systems and societal budgets. DBJIs are less responsive to systemic antibiotics because of poor vascular perfusion in necrotic bone, large bone defects and persistent biofilm-based infection. Emerging bacterial resistance poses a major threat and new innovative treatment modalities are urgently needed to curb its current trajectory. Materials and Methods We present a new biphasic ceramic bone substitute consisting of hydroxyapatite and calcium sulphate for local antibiotic delivery in combination with bone regeneration. Gentamicin release was measured in four setups: 1) in vitro elution in Ringer’s solution; 2) local elution in patients treated for trochanteric hip fractures or uncemented hip revisions; 3) local elution in patients treated with a bone tumour resection; and 4) local elution in patients treated surgically for chronic corticomedullary osteomyelitis. Results The release pattern in vitro was comparable with the obtained release in the patient studies. No recurrence was detected in the osteomyelitis group at latest follow-up (minimum 1.5 years). Conclusions This new biphasic bone substitute containing antibiotics provides safe prevention of bone infections in a range of clinical situations. The in vitro test method predicts the in vivo performance and makes it a reliable tool in the development of future antibiotic-eluting bone-regenerating materials. Cite this article: M. Stravinskas, P. Horstmann, J. Ferguson, W. Hettwer, M. Nilsson, S. Tarasevicius, M. M. Petersen, M. A. McNally, L. Lidgren. Pharmacokinetics of gentamicin eluted from a regenerating bone graft substitute: In vitro and clinical release studies. Bone Joint Res 2016;5:427–435. DOI: 10.1302/2046-3758.59.BJR-2016-0108.R1.
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Affiliation(s)
- M Stravinskas
- Orthopaedic Surgeon, Lithuanian University of Health, Eivenių str. 2, LT-50009 Kaunas, Lithuania
| | - P Horstmann
- Musculoskeletal Tumor Section, Department of Orthopedic Surgery, Rigshospitalet, University of Copenhagen, 2100 Copenhagen, Denmark
| | - J Ferguson
- The Bone Infection Unit, Nuffield Orthopedic Centre, Oxford University Hospitals, Windmill Road, Headington, Oxford OX3 7HE, UK
| | - W Hettwer
- Musculoskeletal Tumor Section, Department of Orthopedic Surgery, Rigshospitalet, University of Copenhagen, 2100 Copenhagen, Denmark
| | - M Nilsson
- Department of Orthopedics, Lund University Hospital, SE-221 85 Lund, Sweden
| | - S Tarasevicius
- Orthopaedic Surgeon, Lithuanian University of Health, Eivenių str. 2, LT-50009 Kaunas, Lithuania
| | - M M Petersen
- Musculoskeletal Tumor Section, Department of Orthopedic Surgery, Rigshospitalet, University of Copenhagen, 2100 Copenhagen, Denmark
| | - M A McNally
- The Bone Infection Unit, Nuffield Orthopedic Centre, Oxford University Hospitals, Windmill Road, Headington, Oxford OX3 7HE, UK
| | - L Lidgren
- Department of Orthopedics, Lund University Hospital, SE-221 85 Lund, Sweden
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Brebner EM, Brebner JA, Ruddick-Bracken H, Wootton R, Ferguson J, Palombo A, Pedley D, Rowlands A, Fraser S. Evaluation of an accident and emergency teleconsultation service for north-east Scotland. J Telemed Telecare 2016; 10:16-20. [PMID: 15006210 DOI: 10.1258/135763304322764130] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
We evaluated an accident and emergency teleconsultation service provided to 14 community hospitals in north-east Scotland. Each community hospital was equipped with a videoconferencing system and a document camera to allow transmission of radiographs. The network used 384 kbit/s ISDN connections. A total of 1392 teleconsultations were recorded during a 12-month study period. Seventy-seven per cent of patients ( n = 1072) were managed locally and 23% ( n = 320) were transferred to Aberdeen. The majority (95%) of teleconsultations were conducted on weekdays, and 90% of these occurred between the hours of 09:00 and 16:00. The mean delay in contacting a doctor was 9 min and the mean consultation time was 10 min. The majority of patients were suffering from fractures or suspected fractures of the limbs. Radiograph transmission was used in 75% of all teleconsultations. A high degree of satisfaction was recorded by all users of the service.
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Affiliation(s)
- E M Brebner
- Telemedicine Laboratory, Remote Health Care Unit, Department of General Practice and Primary Care, University of Aberdeen, Aberdeen, UK.
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Keskinen H, Helenius I, Nnadi C, Cheung K, Ferguson J, Mundis G, Pawelek J, Akbarnia BA. Preliminary comparison of primary and conversion surgery with magnetically controlled growing rods in children with early onset scoliosis. Eur Spine J 2016; 25:3294-3300. [PMID: 27160822 DOI: 10.1007/s00586-016-4597-y] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2015] [Accepted: 04/29/2016] [Indexed: 12/19/2022]
Abstract
PURPOSE Non-invasive distraction of magnetically controlled growing rods (MCGR) avoids repeated surgical lengthening in patients with early onset scoliosis, but it is not known how effective this technique is in previously operated children. METHODS In a retrospective, multicentre study, the data were obtained for 27 primary (P) patients [mean age 7.0 (2.4-10.7) years at surgery] and 23 conversion (C) patients [mean age 7.7 (3.6-11.0) years at conversion from standard growing rods] with 1-year follow-up. RESULTS The mean major curve was 63.9° in the P group and 46.5° in the C group at baseline (preoperatively, p = 0.0009) and 39.5° and 39.6°, respectively, at 1-year follow-up (p = 0.99). The mean percentage change of spinal growth from baseline to 1-year follow-up was 18.3 % in the P group and 6.5 % in the C group (p = 0.007). Comparing the spinal growth from postoperative to 1-year follow-up no statistical difference was observed between the study groups (1.8 % P vs -2.2 % C, p = 0.09). CONCLUSIONS Scoliosis can be equally controlled after conversion from traditional growing rods into MCGR, but spinal growth from baseline is less in the conversion patients as compared with the primary group. LEVEL OF EVIDENCE III.
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Affiliation(s)
- Heli Keskinen
- Department of Paediatric Orthopaedic Surgery, University of Turku and Turku University Hospital, Kiinamyllynkatu 4-8, 20521, Turku, Finland
| | - Ilkka Helenius
- Department of Paediatric Orthopaedic Surgery, University of Turku and Turku University Hospital, Kiinamyllynkatu 4-8, 20521, Turku, Finland.
| | - Colin Nnadi
- Spine Unit, Oxford University Hospital, Oxford, UK
| | - Kenneth Cheung
- Department of Orthopaedic Surgery, The University of Hong Kong, Pokfulam, Hong Kong
| | - J Ferguson
- Starship Children's Hospital, 2 Park Rod, Grafton, Auckland, New Zealand
| | - Gregory Mundis
- San Diego Center for Spinal Disorders, La Jolla, CA, USA
| | - Jeff Pawelek
- San Diego Center for Spinal Disorders, La Jolla, CA, USA
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Caccese V, Ferguson J, Lloyd J, Edgecomb M, Seidi M, Hajiaghamemar M. Response of an Impact Test Apparatus for Fall Protective Headgear Testing Using a Hybrid-III Head/Neck Assembly. Exp Tech 2016; 40:413-427. [PMID: 28216804 PMCID: PMC5309928 DOI: 10.1111/ext.12079] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
A test method based upon a Hybrid-III head and neck assembly that includes measurement of both linear and angular acceleration is investigated for potential use in impact testing of protective headgear. The test apparatus is based upon a twin wire drop test system modified with the head/neck assembly and associated flyarm components. This study represents a preliminary assessment of the test apparatus for use in the development of protective headgear designed to prevent injury due to falls. By including angular acceleration in the test protocol it becomes possible to assess and intentionally reduce this component of acceleration. Comparisons of standard and reduced durometer necks, various anvils, front, rear, and side drop orientations, and response data on performance of the apparatus are provided. Injury measures summarized for an unprotected drop include maximum linear and angular acceleration, head injury criteria (HIC), rotational injury criteria (RIC), and power rotational head injury criteria (PRHIC). Coefficient of variation for multiple drops ranged from 0.4 to 6.7% for linear acceleration. Angular acceleration recorded in a side drop orientation resulted in highest coefficient of variation of 16.3%. The drop test apparatus results in a reasonably repeatable test method that has potential to be used in studies of headgear designed to reduce head impact injury.
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Affiliation(s)
- V. Caccese
- Department of Mechanical Engineering, University of Maine, Orono, ME
| | - J. Ferguson
- Department of Corporate Operations, Alba-Technic LLC, Winthrop, ME
| | - J. Lloyd
- Department of Research, James A. Haley VA Hospital, Tampa, FL
| | - M. Edgecomb
- Department of Mechanical Engineering, University of Maine, Orono, ME
| | - M. Seidi
- Department of Mechanical Engineering, University of Maine, Orono, ME
| | - M. Hajiaghamemar
- Department of Mechanical Engineering, University of Maine, Orono, ME
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Healy DA, Boyle E, McCartan D, Bourke M, Medani M, Ferguson J, Yagoub H, Bashar K, O’Donnell M, Newell J, Canning C, McMonagle M, Dowdall J, Cross S, O'Daly S, Manning B, Fulton G, Kavanagh EG, Burke P, Grace PA, Moloney MC, Walsh SR. A MultiCenter Pilot Randomized Controlled Trial of Remote Ischemic Preconditioning in Major Vascular Surgery. Vasc Endovascular Surg 2015; 49:220-7. [DOI: 10.1177/1538574415614404] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
A pilot randomized controlled trial that evaluated the effect of remote ischemic preconditioning (RIPC) on clinical outcomes following major vascular surgery was performed. Eligible patients were those scheduled to undergo open abdominal aortic aneurysm repair, endovascular aortic aneurysm repair, carotid endarterectomy, and lower limb revascularization procedures. Patients were randomized to RIPC or to control groups. The primary outcome was a composite clinical end point comprising any of cardiovascular death, myocardial infarction, new-onset arrhythmia, cardiac arrest, congestive cardiac failure, cerebrovascular accident, renal failure requiring renal replacement therapy, mesenteric ischemia, and urgent cardiac revascularization. Secondary outcomes were components of the primary outcome and myocardial injury as assessed by serum troponin values. The primary outcome occurred in 19 (19.2%) of 99 controls and 14 (14.1%) of 99 RIPC group patients ( P = .446). There were no significant differences in secondary outcomes. Our trial generated data that will guide future trials. Further trials are urgently needed.
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Affiliation(s)
- D. A. Healy
- Department of Vascular Surgery, University Hospital Limerick, Limerick, Ireland
| | - E. Boyle
- Department of Surgery Cork, University Hospital, Cork, Ireland
| | - D. McCartan
- Department of Surgery, University Hospital Waterford, Waterford, Ireland
| | - M. Bourke
- Department of Surgery, University Hospital Waterford, Waterford, Ireland
| | - M. Medani
- Department of Surgery, University Hospital Waterford, Waterford, Ireland
| | - J. Ferguson
- Department of Medicine, Graduate Entry Medical School, University of Limerick, Limerick, Ireland
| | - H. Yagoub
- Department of Medicine, Graduate Entry Medical School, University of Limerick, Limerick, Ireland
| | - K. Bashar
- Department of Vascular Surgery, University Hospital Limerick, Limerick, Ireland
| | - M. O’Donnell
- Clinical Research Facility, National University of Ireland Galway, Galway, Ireland
| | - J. Newell
- Clinical Research Facility, National University of Ireland Galway, Galway, Ireland
| | - C. Canning
- Department of Vascular Surgery, University Hospital Limerick, Limerick, Ireland
| | - M. McMonagle
- Department of Surgery, University Hospital Waterford, Waterford, Ireland
| | - J. Dowdall
- Department of Surgery, University Hospital Waterford, Waterford, Ireland
| | - S. Cross
- Department of Surgery, University Hospital Waterford, Waterford, Ireland
| | - S. O'Daly
- Clinical Research Facility, National University of Ireland Galway, Galway, Ireland
| | - B. Manning
- Department of Surgery Cork, University Hospital, Cork, Ireland
| | - G. Fulton
- Department of Surgery Cork, University Hospital, Cork, Ireland
| | - E. G. Kavanagh
- Department of Vascular Surgery, University Hospital Limerick, Limerick, Ireland
| | - P. Burke
- Department of Vascular Surgery, University Hospital Limerick, Limerick, Ireland
| | - P. A. Grace
- Department of Vascular Surgery, University Hospital Limerick, Limerick, Ireland
| | - M. Clarke Moloney
- Health Research Institute, University of Limerick, Limerick, Ireland
| | - S. R. Walsh
- Department of Surgery, National University of Ireland Galway, Galway, Ireland
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Vachani A, Silvestri G, Whitney D, Ferguson J, Porta K, Parsons E, Brody J, Lenburg M, Spira A. Prospective Validation of a Bronchial Genomic Classifier for Lung Cancer in Patients Undergoing Diagnostic Bronchoscopy: The AEGIS Trials. Chest 2015. [DOI: 10.1378/chest.2280365] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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Vachani A, Parsons E, Ferguson J, Whitney D, Porta K, Rosenbluth M, Silvestri G, Spira A. Clinical Utility of a Bronchial Genomic Classifier: An Analysis of Invasive Procedure Utilization in the AEGIS Trials. Chest 2015. [DOI: 10.1378/chest.2270755] [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: 11/01/2022] Open
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Oye KA, Jain G, Amador M, Arnaout R, Brown JS, Crown W, Ferguson J, Pezalla E, Rassen JA, Selker HP, Trusheim M, Hirsch G. The next frontier: Fostering innovation by improving health data access and utilization. Clin Pharmacol Ther 2015; 98:514-21. [PMID: 26234275 PMCID: PMC5052021 DOI: 10.1002/cpt.191] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2015] [Revised: 07/24/2015] [Accepted: 07/26/2015] [Indexed: 12/24/2022]
Affiliation(s)
- K A Oye
- Massachusetts Institute of Technology (MIT) Department of Political Science and Engineering Systems Division, Cambridge, Massachusetts, USA
| | - G Jain
- Center for Biomedical Innovation, MIT, Cambridge, Massachusetts, USA
| | - M Amador
- MIT Portugal Program, International Risk Governance Council Portugal, Portugal
| | - R Arnaout
- Department of Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA.,Department of Pathology, Harvard Medical School (HMS), Boston, Massachusetts, USA
| | - J S Brown
- Department of Population Medicine, Harvard Pilgrim Health Care Institute and HMS, Boston, Massachusetts, USA
| | - W Crown
- Optum Labs, Boston, Massachusetts, USA
| | | | - E Pezalla
- Aetna, Inc., Hartford, Connecticut, USA
| | | | - H P Selker
- Tufts Clinical and Translational Science Institute, Tufts University, and Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, Massachusetts, USA
| | - M Trusheim
- Sloan School of Management, MIT, Cambridge, Massachusetts, USA
| | - G Hirsch
- Center for Biomedical Innovation, MIT, Cambridge, Massachusetts, USA
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Moseley H, Allan D, Amatiello H, Coleman A, du Peloux Menagé H, Edwards C, Exton L, Ferguson J, Garibaldinos T, Martin C, Mohd Mustapa M, McHenry P, Griffiths M, Buckley D, Nasr I, Swale V, Duarte Williamson C, Leslie T, Mallon E, Towers K, Saunders C, Brain A. Guidelines on the measurement of ultraviolet radiation levels in ultraviolet phototherapy: report issued by the British Association of Dermatologists and British Photodermatology Group 2015. Br J Dermatol 2015; 173:333-50. [DOI: 10.1111/bjd.13937] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/17/2015] [Indexed: 11/26/2022]
Affiliation(s)
- H. Moseley
- The Photobiology Unit Ninewells Hospital and Medical School Dundee DD1 9SY U.K
| | - D. Allan
- The Christie NHS Foundation Trust and University of Manchester Manchester Academic Health Science Centre Wilmslow Road Manchester M20 4BX U.K
| | - H. Amatiello
- Radiation Physics and Protection Group Churchill Hospital Old Road Headington Oxford OX3 7LJ U.K
| | - A. Coleman
- Guy's and St Thomas' NHS Foundation Trust St Thomas' Hospital Westminster Bridge Road London SE1 7EH U.K
| | - H. du Peloux Menagé
- Guy's and St Thomas' NHS Foundation Trust St Thomas' Hospital Westminster Bridge Road London SE1 7EH U.K
- Lewisham and Greenwich NHS Trust High Street London SE13 6LH U.K
| | - C. Edwards
- Royal Gwent Hospital Cardiff Road Newport NP20 2UB U.K
| | - L.S. Exton
- British Association of Dermatologists Willan House, 4 Fitzroy Square London W1T 5HQ U.K
| | - J. Ferguson
- The Photobiology Unit Ninewells Hospital and Medical School Dundee DD1 9SY U.K
| | - T. Garibaldinos
- Guy's and St Thomas' NHS Foundation Trust St Thomas' Hospital Westminster Bridge Road London SE1 7EH U.K
| | - C. Martin
- Department of Clinical Physics and Bio‐Engineering University of Glasgow Glasgow G12 8QQ U.K
| | - M.F. Mohd Mustapa
- British Association of Dermatologists Willan House, 4 Fitzroy Square London W1T 5HQ U.K
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Samuel I, Kulyk O, McNeill A, Moseley H, Ferguson J, Ibbotson S. Ambulatory photodynamic therapy of skin cancer. Photodiagnosis Photodyn Ther 2015. [DOI: 10.1016/j.pdpdt.2015.07.029] [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: 10/23/2022]
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Woods JA, Ferguson JS, Kalra S, Degabriele A, Gardner J, Logan P, Ferguson J. The phototoxicity of vemurafenib: An investigation of clinical monochromator phototesting and in vitro phototoxicity testing. J Photochem Photobiol B 2015; 151:233-8. [PMID: 26318280 DOI: 10.1016/j.jphotobiol.2015.08.004] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/09/2015] [Revised: 06/26/2015] [Accepted: 08/11/2015] [Indexed: 12/31/2022]
Abstract
BACKGROUND Vemurafenib is a targeted therapy approved for the treatment of patients with metastatic melanoma harbouring the BRAF V600E mutation. Photosensitivity has been reported in over 50% of patients and has been demonstrated to involve at least the broadband UVA spectrum in most patients. Erythrocyte protoporphyrin levels have also been reported as elevated in some patients. OBJECTIVES We report the results of monochromator phototesting in one patient recorded before and while taking vemurafenib. Analysis of porphyrin levels was also conducted. RESULTS After one month of vemurafenib therapy the patient demonstrated markedly increased light sensitivity in the UVA spectrum between 335 ± 27 nm, 365 ± 27 nm and 400 ± 27 nm. However responses in the UVB (305 ± 5 nm) and blue light (430 ± 27 nm) regions were normal. There was no abnormal immediate erythemal response. Pre-vemurafenib baseline phototesting was normal, as was repeat testing two months later when the patient was taking high doses of systemic steroid. No abnormal porphyrins were detected and the antinuclear antibody test was normal. In parallel studies, HaCaT keratinocytes incubated with vemurafenib were killed by UVA but not by visible (blue) light and did not show evidence of detectable intracellular porphyrin in the presence of the drug. CONCLUSION These data confirm vemurafenib induced UVA photosensitivity with a probable phototoxic mechanism not mediated via enhanced porphyrin.
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Affiliation(s)
- J A Woods
- Photobiology Unit, University of Dundee, Ninewells Hospital & Medical School, Dundee, Scotland, United Kingdom.
| | - J S Ferguson
- Photobiology Unit, University of Dundee, Ninewells Hospital & Medical School, Dundee, Scotland, United Kingdom; St George's Hospital, Department of Dermatology, Blackshaw Rd, Tooting, London, United Kingdom
| | - S Kalra
- Photobiology Unit, University of Dundee, Ninewells Hospital & Medical School, Dundee, Scotland, United Kingdom
| | - A Degabriele
- Photobiology Unit, University of Dundee, Ninewells Hospital & Medical School, Dundee, Scotland, United Kingdom
| | - J Gardner
- Photobiology Unit, University of Dundee, Ninewells Hospital & Medical School, Dundee, Scotland, United Kingdom
| | - P Logan
- Photobiology Unit, University of Dundee, Ninewells Hospital & Medical School, Dundee, Scotland, United Kingdom
| | - J Ferguson
- Photobiology Unit, University of Dundee, Ninewells Hospital & Medical School, Dundee, Scotland, United Kingdom
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Ferguson J, Alzahrani N, Zhao J, Glenn D, Power M, Liauw W, Morris D. Long term results of RFA to lung metastases from colorectal cancer in 157 patients. Eur J Surg Oncol 2015; 41:690-5. [DOI: 10.1016/j.ejso.2015.01.024] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2014] [Revised: 01/07/2015] [Accepted: 01/15/2015] [Indexed: 12/27/2022] Open
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Davis M, Morris D, Bilker W, Tolomeo P, Julian K, Baron P, Brazil A, Ferguson J, Iverson S, Hu B, Rankin S, Nachamkin I, Lautenbach E. Companion animals and home surface contamination in community-associated
methicillin-resistant Staphylococcus aureus colonization of people. Ann Glob Health 2015. [DOI: 10.1016/j.aogh.2015.02.790] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Watson MC, Ferguson J, Barton GR, Maskrey V, Blyth A, Paudyal V, Bond CM, Holland R, Porteous T, Sach TH, Wright D, Fielding S. A cohort study of influences, health outcomes and costs of patients' health-seeking behaviour for minor ailments from primary and emergency care settings. BMJ Open 2015; 5:e006261. [PMID: 25694456 PMCID: PMC4336457 DOI: 10.1136/bmjopen-2014-006261] [Citation(s) in RCA: 67] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES To compare health-related and cost-related outcomes of consultations for symptoms suggestive of minor ailments in emergency departments (EDs), general practices and community pharmacies. DESIGN Observational study; prospective cohort design. SETTING EDs (n=2), general practices (n=6) and community pharmacies (n=10) in a mix of rural/urban and deprived/affluent areas across North East Scotland and East Anglia. Participants Adults (≥18 years) presenting between 09:00 and 18:00 (Monday-Friday) in general practices and 09:00-18:00 (Monday-Saturday) in pharmacies and EDs with ≥1 of the following: musculoskeletal pain; eye discomfort; gastrointestinal disturbance; or upper respiratory tract-related symptoms. INTERVENTIONS Participants completed three questionnaires: baseline (prior to index consultation); satisfaction with index consultation and follow-up (2 weeks after index consultation). MAIN OUTCOME MEASURES Symptom resolution, quality of life, costs, satisfaction and influences on care-seeking behaviour. RESULTS 377 patients participated, recruited from EDs (81), general practices (162) and community pharmacies (134). The 2-week response rate was 70% (264/377). Symptom resolution was similar across all three settings: ED (37.3%), general practice (35.7%) and pharmacy (44.3%). Mean overall costs per consultation were significantly lower for pharmacy (£29.30 (95% CI £21.60 to £37.00)) compared with general practice (£82.34 (95% CI £63.10 to £101.58)) and ED (£147.09 (95% CI £125.32 to £168.85)). Satisfaction varied across settings and by measure used. Compared with pharmacy and general practice use, ED use was significantly (p<0.001) associated with first episode and short duration of symptom(s), as well as higher levels of perceived seriousness and urgency for seeking care. Convenience of location was the most common reason for choice of consultation setting. CONCLUSIONS These results suggest similar health-related outcomes and substantially lower costs with pharmacy consultations for minor ailments. Effective strategies are now needed to shift demand for minor ailment management away from EDs and general practices to the community pharmacy setting.
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Affiliation(s)
- M C Watson
- Division of Applied Health Sciences, Centre of Academic Primary Care, University of Aberdeen, Aberdeen, UK
| | - J Ferguson
- Emergency Department, Aberdeen Royal Infirmary, Aberdeen, UK
| | - G R Barton
- Health Economics Group, Norwich Medical School, Norwich, UK
| | - V Maskrey
- Norwich Medical School, University of East Anglia, Norwich, UK
| | - A Blyth
- Norwich Medical School, University of East Anglia, Norwich, UK
| | - V Paudyal
- Division of Applied Health Sciences, Centre of Academic Primary Care, University of Aberdeen, Aberdeen, UK
| | - C M Bond
- Division of Applied Health Sciences, Centre of Academic Primary Care, University of Aberdeen, Aberdeen, UK
| | - R Holland
- Norwich Medical School, University of East Anglia, Norwich, UK
| | - T Porteous
- Division of Applied Health Sciences, Centre of Academic Primary Care, University of Aberdeen, Aberdeen, UK
| | - T H Sach
- Health Economics Group, Norwich Medical School, Norwich, UK
| | - D Wright
- School of Pharmacy, University of East Anglia, Norwich, UK
| | - S Fielding
- Division of Applied Health Sciences, Centre of Academic Primary Care, University of Aberdeen, Aberdeen, UK
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Eichler HG, Baird LG, Barker R, Bloechl-Daum B, Børlum-Kristensen F, Brown J, Chua R, Del Signore S, Dugan U, Ferguson J, Garner S, Goettsch W, Haigh J, Honig P, Hoos A, Huckle P, Kondo T, Le Cam Y, Leufkens H, Lim R, Longson C, Lumpkin M, Maraganore J, O'Rourke B, Oye K, Pezalla E, Pignatti F, Raine J, Rasi G, Salmonson T, Samaha D, Schneeweiss S, Siviero PD, Skinner M, Teagarden JR, Tominaga T, Trusheim MR, Tunis S, Unger TF, Vamvakas S, Hirsch G. From adaptive licensing to adaptive pathways: delivering a flexible life-span approach to bring new drugs to patients. Clin Pharmacol Ther 2015; 97:234-46. [PMID: 25669457 PMCID: PMC6706805 DOI: 10.1002/cpt.59] [Citation(s) in RCA: 127] [Impact Index Per Article: 14.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2014] [Accepted: 12/04/2014] [Indexed: 12/15/2022]
Abstract
The concept of adaptive licensing (AL) has met with considerable interest. Yet some remain skeptical about its feasibility. Others argue that the focus and name of AL should be broadened. Against this background of ongoing debate, we examine the environmental changes that will likely make adaptive pathways the preferred approach in the future. The key drivers include: growing patient demand for timely access to promising therapies, emerging science leading to fragmentation of treatment populations, rising payer influence on product accessibility, and pressure on pharma/investors to ensure sustainability of drug development. We also discuss a number of environmental changes that will enable an adaptive paradigm. A life‐span approach to bringing innovation to patients is expected to help address the perceived access vs. evidence trade‐off, help de‐risk drug development, and lead to better outcomes for patients.
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Abstract
Patients can acutely deteriorate unexpectedly. Junior medical officers (JMOs) are often first to review patients who become unwell. Opportunities to escalate care to a senior colleague may exist prior to the need for a rapid response team review. Little is known about the factors that influence JMO decisions to escalate care. In this study, our objective was to investigate the self-reported factors that influence escalation of care by JMOs in a university-affiliated, tertiary level hospital. We designed a face-to-face questionnaire of JMOs using standardised introduction to minimise interviewer bias. Fifty JMOs participated in the study (a 100% response rate). Most (63.3%) felt that they would be able to identify a clinically deteriorating patient. They would be more likely to escalate care if they were not familiar with the patient's clinical problem. If handover plans were seen to be adequate, JMOs felt it was less necessary to escalate care. Few JMOs (12%) agreed that they limited escalation due to fear of criticism or fear of conflict with senior medical staff. Although 36% agreed that they were concerned about waking seniors overnight, only 6% feared that escalating care overnight would affect their future career prospects. Escalation of care appears to be mostly influenced by the confidence and familiarity of the JMO with the cause of deterioration. JMOs identified clear handover with documented goals of treatment and suggested actions in event of clinical deterioration as the best means by which to improve the process of escalation of care for clinically deteriorating patients.
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Affiliation(s)
- J A Rotella
- Emergency Medicine, Austin Health, Heidelberg, Victoria
| | - W Yu
- Intensive Care, Austin Health, Heidelberg, Victoria
| | | | - D Jones
- Intensive Care, Austin Health, Heidelberg, Victoria
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Watson M, Holland R, Ferguson J, Porteous T, Sach T, Cleland J, Bond C, Wright D. Managing minor ailments: Patients’ health-seeking behaviour and the role of community pharmacy. Res Social Adm Pharm 2014. [DOI: 10.1016/j.sapharm.2014.07.082] [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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Abstract
BACKGROUND The transferrin saturation (TSAT) ratio is a commonly used indicator of iron deficiency and iron overload in clinical practice but precise relationships with total and cardiovascular mortality are unclear. PURPOSE To better understand this relationship, we explored the association of TSAT ratio (serum iron/total iron binding capacity) with mortality in the general population. METHODS The relationships of TSAT ratio with total and cardiovascular mortality were explored in 15 823 subjects age 20 and older from the Third National Health and Nutrition Examination Survey (1988-94). All subjects had vital status assessed through to 2006. RESULTS During follow-up, 9.7% died of which 4.4% were from cardiovascular disease. In unadjusted analysis, increasing TSAT ratio was inversely associated with mortality. With adjustment for baseline demographic and clinical characteristics, the TSAT-mortality relationship followed a j-shaped pattern. Compared with the referent group [ratio 23.7-31.3%: hazard ratio (HR) =1.00], subjects in the lowest two quartiles, <17.5 % and 17.5-23.7 %, experienced significantly higher mortality risks of 1.45 (1.19-1.77) and 1.27 (1.06-1.53), respectively, whereas subjects in the highest quartile, >31.3 %, experienced significantly higher mortality risks of 1.23 (1.01-1.49). The pattern of association was more pronounced for cardiovascular mortality with significantly higher mortality risks for the lowest two quartiles [HR = 2.09 (1.43-3.05) and 1.90 (1.33-2.72), respectively] and highest quartile HR = 1.59 (1.05-2.40). CONCLUSIONS Both low and high TSAT ratios are significantly and independently associated with increased total and cardiovascular mortality. The optimal TSAT ratio associated with the greatest survival is between 24% and 40%.
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Affiliation(s)
- A G Stack
- From the Departments of Nephrology and Internal Medicine, University Hospital Limerick, Limerick, Department of Nephrology, Letterkenny General Hospital, Letterkenny, Donegal and Graduate Entry Medical School, University of Limerick, Limerick, IrelandFrom the Departments of Nephrology and Internal Medicine, University Hospital Limerick, Limerick, Department of Nephrology, Letterkenny General Hospital, Letterkenny, Donegal and Graduate Entry Medical School, University of Limerick, Limerick, IrelandFrom the Departments of Nephrology and Internal Medicine, University Hospital Limerick, Limerick, Department of Nephrology, Letterkenny General Hospital, Letterkenny, Donegal and Graduate Entry Medical School, University of Limerick, Limerick, Ireland
| | - A I Mutwali
- From the Departments of Nephrology and Internal Medicine, University Hospital Limerick, Limerick, Department of Nephrology, Letterkenny General Hospital, Letterkenny, Donegal and Graduate Entry Medical School, University of Limerick, Limerick, Ireland
| | - H T Nguyen
- From the Departments of Nephrology and Internal Medicine, University Hospital Limerick, Limerick, Department of Nephrology, Letterkenny General Hospital, Letterkenny, Donegal and Graduate Entry Medical School, University of Limerick, Limerick, IrelandFrom the Departments of Nephrology and Internal Medicine, University Hospital Limerick, Limerick, Department of Nephrology, Letterkenny General Hospital, Letterkenny, Donegal and Graduate Entry Medical School, University of Limerick, Limerick, Ireland
| | - C J Cronin
- From the Departments of Nephrology and Internal Medicine, University Hospital Limerick, Limerick, Department of Nephrology, Letterkenny General Hospital, Letterkenny, Donegal and Graduate Entry Medical School, University of Limerick, Limerick, IrelandFrom the Departments of Nephrology and Internal Medicine, University Hospital Limerick, Limerick, Department of Nephrology, Letterkenny General Hospital, Letterkenny, Donegal and Graduate Entry Medical School, University of Limerick, Limerick, Ireland
| | - L F Casserly
- From the Departments of Nephrology and Internal Medicine, University Hospital Limerick, Limerick, Department of Nephrology, Letterkenny General Hospital, Letterkenny, Donegal and Graduate Entry Medical School, University of Limerick, Limerick, IrelandFrom the Departments of Nephrology and Internal Medicine, University Hospital Limerick, Limerick, Department of Nephrology, Letterkenny General Hospital, Letterkenny, Donegal and Graduate Entry Medical School, University of Limerick, Limerick, Ireland
| | - J Ferguson
- From the Departments of Nephrology and Internal Medicine, University Hospital Limerick, Limerick, Department of Nephrology, Letterkenny General Hospital, Letterkenny, Donegal and Graduate Entry Medical School, University of Limerick, Limerick, Ireland
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Ibbotson SH, Moseley H, Brancaleon L, Padgett M, O'Dwyer M, Woods JA, Lesar A, Goodman C, Ferguson J. Photodynamic therapy in dermatology: Dundee clinical and research experience. Photodiagnosis Photodyn Ther 2014; 1:211-23. [PMID: 25048335 DOI: 10.1016/s1572-1000(04)00045-6] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Topical photodynamic therapy (PDT) is increasingly accepted and used as a highly effective treatment for superficial non-melanoma skin cancer and dysplasia. We describe the developments in topical PDT for the treatment of skin diseases in our own PDT Centre in Dundee, both clinically and from a research base. Improvements in PDT could be achieved by optimisation of photosensitiser and light delivery, and these goals underpin the aims of our centre. We hope to facilitate the dissemination of use of PDT in dermatology throughout Scotland and outline some of the progress in these areas.
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Affiliation(s)
- S H Ibbotson
- Photobiology Unit, Barbara Stewart Cancer Trust, Scottish PDT Centre, Ninewells Hospital and Medical School, University of Dundee, Dundee DD19SY, UK
| | - H Moseley
- Photobiology Unit, Barbara Stewart Cancer Trust, Scottish PDT Centre, Ninewells Hospital and Medical School, University of Dundee, Dundee DD19SY, UK
| | - L Brancaleon
- Photobiology Unit, Barbara Stewart Cancer Trust, Scottish PDT Centre, Ninewells Hospital and Medical School, University of Dundee, Dundee DD19SY, UK
| | - M Padgett
- Optics Group, Department of Physics and Astronomy, University of Glasgow, Glasgow, UK
| | - M O'Dwyer
- Optics Group, Department of Physics and Astronomy, University of Glasgow, Glasgow, UK
| | - J A Woods
- Photobiology Unit, Barbara Stewart Cancer Trust, Scottish PDT Centre, Ninewells Hospital and Medical School, University of Dundee, Dundee DD19SY, UK
| | - A Lesar
- Photobiology Unit, Barbara Stewart Cancer Trust, Scottish PDT Centre, Ninewells Hospital and Medical School, University of Dundee, Dundee DD19SY, UK
| | - C Goodman
- Photobiology Unit, Barbara Stewart Cancer Trust, Scottish PDT Centre, Ninewells Hospital and Medical School, University of Dundee, Dundee DD19SY, UK
| | - J Ferguson
- Photobiology Unit, Barbara Stewart Cancer Trust, Scottish PDT Centre, Ninewells Hospital and Medical School, University of Dundee, Dundee DD19SY, UK
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Parker R, Ferguson J. Commentary: scoring models for short-term mortality in alcoholic hepatitis. Aliment Pharmacol Ther 2014; 39:1235. [PMID: 24735136 DOI: 10.1111/apt.12710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2014] [Accepted: 02/25/2014] [Indexed: 12/08/2022]
Affiliation(s)
- R Parker
- Center for Liver Research, University of Birmingham, Birmingham, UK.
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Cameron H, Yule S, Dawe RS, Ibbotson SH, Moseley H, Ferguson J. Review of an established UK home phototherapy service 1998-2011: improving access to a cost-effective treatment for chronic skin disease. Public Health 2014; 128:317-24. [PMID: 24726005 DOI: 10.1016/j.puhe.2014.01.011] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [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: 07/29/2013] [Revised: 01/14/2014] [Accepted: 01/16/2014] [Indexed: 10/25/2022]
Abstract
OBJECTIVES To review the Tayside home phototherapy service, including numbers of patients treated, diagnoses and outcomes, side-effects and safety, cost-effectiveness and absolute costs. To consider why home or outpatient phototherapy is not available to all patients who might benefit and how this could be addressed. STUDY DESIGN Observational and cost analysis. METHODS Analysis of the Tayside home phototherapy database 1998 and 2011, home phototherapy patient questionnaires, outcome data, costs and a comparison with outpatient phototherapy. Review of literature and current national guidelines for phototherapy, traditional systemic and biologic therapies for psoriasis. RESULTS 298 courses of home narrowband UVB (NB-UVB) phototherapy were undertaken by 212 patients between 1998 and 2011, five courses in 1998 increasing to 36 in 2011. The main diagnoses treated were psoriasis (72%), atopic dermatitis (8%), and desensitization of photodermatosis (7%). For psoriasis, 74.5% achieved clearance or minimal residual activity in a median of 30 exposures (range 10-60). The estimated costs to the hospital ranged from £229 to £314 per course (£307 to £422 per effective course for psoriasis), compared with £114 for out-patient therapy (£149 per effective course for psoriasis). The total cost to society (hospital and patient costs) is around £410 per course, compared to an estimated £550 for outpatient therapy for this group of patients. Treatment was well tolerated, erythema rates were similar to outpatient therapy, there were no complaints and the vast majority would choose home over outpatient phototherapy if required in the future. CONCLUSIONS Hospital supervised home phototherapy appears as safe and effective as outpatient therapy and provides equality of access for patients who cannot attend for outpatient therapy. These patients may otherwise be inadequately treated or given more costly and higher risk systemic therapies, particularly for psoriasis. Commissioners and clinicians involved in dermatology services should provide accessible phototherapy for all patients who might benefit, utilizing home phototherapy where outpatient access is not possible.
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Affiliation(s)
- H Cameron
- Photobiology Unit, The Department of Dermatology, Level 8, Ninewells Hospital and Medical School, Dundee DD1 9SY, UK.
| | - S Yule
- Photobiology Unit, The Department of Dermatology, Level 8, Ninewells Hospital and Medical School, Dundee DD1 9SY, UK
| | - R S Dawe
- Photobiology Unit, The Department of Dermatology, Level 8, Ninewells Hospital and Medical School, Dundee DD1 9SY, UK
| | - S H Ibbotson
- Photobiology Unit, The Department of Dermatology, Level 8, Ninewells Hospital and Medical School, Dundee DD1 9SY, UK
| | - H Moseley
- Photobiology Unit, The Department of Dermatology, Level 8, Ninewells Hospital and Medical School, Dundee DD1 9SY, UK
| | - J Ferguson
- Photobiology Unit, The Department of Dermatology, Level 8, Ninewells Hospital and Medical School, Dundee DD1 9SY, UK
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Dinsdale G, Murray A, Moore T, Ferguson J, Wilkinson J, Richards H, Griffiths CEM, Herrick AL. A comparison of intense pulsed light and laser treatment of telangiectases in patients with systemic sclerosis: a within-subject randomized trial. Rheumatology (Oxford) 2014; 53:1422-30. [DOI: 10.1093/rheumatology/keu006] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [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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