1
|
Kinsella SM, Boaden B, El-Ghazali S, Ferguson K, Kirkpatrick G, Meek T, Misra U, Pandit JJ, Young PJ. Handling injectable medications in anaesthesia: Guidelines from the Association of Anaesthetists. Anaesthesia 2023; 78:1285-1294. [PMID: 37492905 DOI: 10.1111/anae.16095] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/22/2023] [Indexed: 07/27/2023]
Abstract
Peri-operative medication safety is complex. Avoidance of medication errors is both system- and practitioner-based, and many departments within the hospital contribute to safe and effective systems. For the individual anaesthetist, drawing up, labelling and then the correct administration of medications are key components in a patient's peri-operative journey. These guidelines aim to provide pragmatic safety steps for the practitioner and other individuals within the operative environment, as well as short- to long-term goals for development of a collaborative approach to reducing errors. The aim is that they will be used as a basis for instilling good practice.
Collapse
Affiliation(s)
- S M Kinsella
- Department of Anaesthesia, University Hospitals Bristol and Weston, Bristol, UK
| | | | - S El-Ghazali
- Department of Anaesthesia and Intensive Care, London North West University Hospital Trust, London, UK
| | - K Ferguson
- Department of Anaesthesia, Aberdeen Royal Infirmary, Aberdeen, UK
| | | | - T Meek
- Department of Anaesthesia, James Cook University Hospital, Middlesbrough, UK
| | - U Misra
- Department of Anaesthesia, South Tyneside and Sunderland NHS Foundation Trust, Sunderland, UK
| | - J J Pandit
- University of Oxford, Oxford, UK
- Nuffield Department of Anaesthesia, Oxford University Hospital NHS Foundation Trust, Oxford, UK
| | - P J Young
- Department of Anaesthesia, Queen Elizabeth Hospital, Kings Lynn, UK
| |
Collapse
|
2
|
Ferguson K, Gunthert K, Kaidbey JH, Parr M, Visek AJ, Sacheck JM, Sylvetsky AC. Behavioral Patterns of Sugary Drink Consumption among African American Adolescents: A Pilot and Feasibility Study Using Ecological Momentary Assessment. Nutrients 2023; 15:2171. [PMID: 37432343 DOI: 10.3390/nu15092171] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 04/25/2023] [Accepted: 04/28/2023] [Indexed: 07/12/2023] Open
Abstract
BACKGROUND Sugary drinks (SDs) are the predominant contributors to added sugar intake among adolescents, with the highest intakes reported among African American adolescents. The objective of this pilot study was to examine the feasibility of using mobile phone-based ecological momentary assessment (EMA) to investigate, in real time, behavioral patterns of SD consumption among African American adolescents from low-income households. METHODS Adolescents (n = 39, ages 12-17) attended a virtual meeting with a trained research assistant, which involved completion of surveys and training on responding to EMA prompts using a mobile phone application. On the seven subsequent days, adolescents were instructed to respond to researcher-initiated prompts three times daily, which queried their SD intake, location, social context, activities, stress, and mood. They were also asked to complete an analogous self-initiated survey each time they consumed SDs. RESULTS SD consumption was reported on 219 of 582 (38%) researcher-initiated surveys and on 135 self-initiated SD consumption surveys, for a total of 354 instances of SD intake over the 7-day assessment period. The majority (69%) of the surveys were completed while at home. SD consumption was reported on 37%, 35%, and 41% of researcher-initiated surveys completed at their home, at the home of a friend or family member, or while in transit, respectively. CONCLUSIONS These preliminary data indicate that mobile phone-based EMA is feasible for investigating SD intake behaviors among African American youth from low-income households and support the promise of EMA for investigating SD consumption in this population in larger samples of youth.
Collapse
Affiliation(s)
- Kacey Ferguson
- Department of Exercise and Nutrition Sciences, Milken Institute School of Public Health, The George Washington University, Washington, DC 20052, USA
| | - Kathleen Gunthert
- Department of Psychology, American University, Washington, DC 20016, USA
| | - Jasmine H Kaidbey
- Department of Exercise and Nutrition Sciences, Milken Institute School of Public Health, The George Washington University, Washington, DC 20052, USA
| | - Meredith Parr
- Department of Exercise and Nutrition Sciences, Milken Institute School of Public Health, The George Washington University, Washington, DC 20052, USA
| | - Amanda J Visek
- Department of Exercise and Nutrition Sciences, Milken Institute School of Public Health, The George Washington University, Washington, DC 20052, USA
| | - Jennifer M Sacheck
- Department of Exercise and Nutrition Sciences, Milken Institute School of Public Health, The George Washington University, Washington, DC 20052, USA
| | - Allison C Sylvetsky
- Department of Exercise and Nutrition Sciences, Milken Institute School of Public Health, The George Washington University, Washington, DC 20052, USA
| |
Collapse
|
3
|
Kelly FE, Frerk C, Bailey CR, Cook TM, Ferguson K, Flin R, Fong K, Groom P, John C, Lang AR, Meek T, Miller KL, Richmond L, Sevdalis N, Stacey MR. Human factors in anaesthesia: a narrative review. Anaesthesia 2023; 78:479-490. [PMID: 36630729 DOI: 10.1111/anae.15920] [Citation(s) in RCA: 16] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/08/2022] [Indexed: 01/12/2023]
Abstract
Healthcare relies on high levels of human performance, as described by the 'human as the hero' concept. However, human performance varies and is recognised to fall in high-pressure situations, meaning that it is not a reliable method of ensuring safety. Other safety-critical industries embed human factors principles into all aspects of their organisations to improve safety and reduce reliance on exceptional human performance; there is potential to do the same in anaesthesia. Human factors is a broad-based scientific discipline which aims to make it as easy as possible for workers to do things correctly. The human factors strategies most likely to be effective are those which 'design out' the chance of an error or adverse event occurring. When errors or adverse events do happen, barriers are in place to trap them and reduce the risk of progression to patient and/or worker harm. If errors or adverse events are not trapped by these barriers, mitigations are in place to minimise the consequences. Non-technical skills form an important part of human factors barriers and mitigation strategies and include: situation awareness; decision-making; task management; and team working. Human factors principles are not a substitute for proper investment and appropriate staffing levels. Although applying human factors science has the potential to save money in the long term, its proper implementation may require investment before reward can be reaped. This narrative review describes what is known about human factors in anaesthesia to date.
Collapse
Affiliation(s)
- F E Kelly
- Department of Anaesthesia and Intensive Care Medicine, Royal United Hospitals Bath NHS Foundation Trust, Bath, UK
| | - C Frerk
- Department of Anaesthesia and Critical Care, Northampton General Hospital, Northampton, UK.,College of Life Sciences/Leicester Medical School, University of Leicester, UK
| | - C R Bailey
- Department of Anaesthetics, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - T M Cook
- Department of Anaesthesia and Intensive Care Medicine, Royal United Hospitals Bath NHS Foundation Trust, Bath, UK.,School of Medicine, Bristol University, Bristol, UK
| | - K Ferguson
- Department of Anaesthesia, Aberdeen Royal Infirmary, Aberdeen, UK
| | - R Flin
- School of Psychology, Aberdeen Business School, Robert Gordon University, Aberdeen, UK
| | - K Fong
- Department of Anaesthesia, University College London Hospitals NHS Foundation Trust, London, UK.,Department of Science, Technology, Engineering and Public Policy, University College London, UK
| | - P Groom
- Department of Anaesthesia, Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK
| | - C John
- Department of Anaesthesia, University College Hospital's NHS Foundation Trust, London, UK
| | - A R Lang
- Human Factors Research Group, Faculty of Engineering, University of Nottingham, UK
| | - T Meek
- Department of Anaesthesia, James Cook University Hospital, Middlesbrough, UK
| | - K L Miller
- Department of Anaesthesia, Birmingham Women's and Children's Hospital NHS Foundation Trust, Birmingham, UK
| | - L Richmond
- Department of Anaesthesia, Swansea Bay University Health Board, Swansea, UK
| | - N Sevdalis
- Centre for Implementation Science, King's College London, UK
| | - M R Stacey
- Department of Anaesthetics, Intensive Care and Pain Medicine, University Hospital of Wales, Cardiff, UK
| |
Collapse
|
4
|
Kelly FE, Frerk C, Bailey CR, Cook TM, Ferguson K, Flin R, Fong K, Groom P, John C, Lang AR, Meek T, Miller KL, Richmond L, Sevdalis N, Stacey MR. Implementing human factors in anaesthesia: guidance for clinicians, departments and hospitals: Guidelines from the Difficult Airway Society and the Association of Anaesthetists: Guidelines from the Difficult Airway Society and the Association of Anaesthetists. Anaesthesia 2023; 78:458-478. [PMID: 36630725 DOI: 10.1111/anae.15941] [Citation(s) in RCA: 21] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/14/2022] [Indexed: 01/12/2023]
Abstract
Human factors is an evidence-based scientific discipline used in safety critical industries to improve safety and worker well-being. The implementation of human factors strategies in anaesthesia has the potential to reduce the reliance on exceptional personal and team performance to provide safe and high-quality patient care. To encourage the adoption of human factors science in anaesthesia, the Difficult Airway Society and the Association of Anaesthetists established a Working Party, including anaesthetists and operating theatre team members with human factors expertise and/or interest, plus a human factors scientist, an industrial psychologist and an experimental psychologist/implementation scientist. A three-stage Delphi process was used to formulate a set of 12 recommendations: these are described using a 'hierarchy of controls' model and classified into design, barriers, mitigations and education and training strategies. Although most anaesthetic knowledge of human factors concerns non-technical skills, such as teamwork and communication, human factors is a broad-based scientific discipline with many other additional aspects that are just as important. Indeed, the human factors strategies most likely to have the greatest impact are those related to the design of safe working environments, equipment and systems. While our recommendations are primarily provided for anaesthetists and the teams they work with, there are likely to be lessons for others working in healthcare beyond the speciality of anaesthesia.
Collapse
Affiliation(s)
- F E Kelly
- Department of Anaesthesia and Intensive Care Medicine, Royal United Hospitals Bath NHS Foundation Trust, Bath, UK
| | - C Frerk
- Department of Anaesthesia and Critical Care, Northampton General Hospital, Northampton, UK.,University of Leicester, College of Life Sciences/Leicester Medical School, Leicester, UK
| | - C R Bailey
- Department of Anaesthetics, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - T M Cook
- Department of Anaesthesia and Intensive Care Medicine, Royal United Hospitals Bath NHS Foundation Trust, Bath, UK.,Bristol University, Bristol, UK
| | - K Ferguson
- Department of Anaesthesia, Aberdeen Royal Infirmary, Aberdeen, UK
| | - R Flin
- Aberdeen Business School, Robert Gordon University, Aberdeen, UK
| | - K Fong
- Department of Anaesthesia, University College London Hospitals NHS Foundation Trust, London, UK.,Department of Science, Technology, Engineering and Public Policy, University College London, UK
| | - P Groom
- Department of Anaesthesia, Liverpool University Hospitals NHS Foundation Trust, Aintree, Liverpool, UK
| | - C John
- University College Hospital's NHS Foundation Trust, London, UK
| | - A R Lang
- Human Factors Research Group, Faculty of Engineering, University of Nottingham, UK
| | - T Meek
- Department of Anaesthesia, James Cook University Hospital, Middlesbrough, UK
| | - K L Miller
- Department of Paediatric Anaesthesia, Birmingham Women's and Children's NHS Foundation Trust, Birmingham, UK
| | - L Richmond
- Department of Anaesthesia, Swansea Bay University Health Board, Swansea, UK
| | - N Sevdalis
- Centre for Implementation Science, King's College London, UK
| | - M R Stacey
- Department of Anaesthetics, Intensive Care and Pain Medicine, University Hospital of Wales, Cardiff, UK
| |
Collapse
|
5
|
Smith ER, Oakley E, Grandner GW, Rukundo G, Farooq F, Ferguson K, Baumann S, Adams Waldorf KM, Afshar Y, Ahlberg M, Ahmadzia H, Akelo V, Aldrovandi G, Bevilacqua E, Bracero N, Brandt JS, Broutet N, Carrillo J, Conry J, Cosmi E, Crispi F, Crovetto F, Del Mar Gil M, Delgado-López C, Divakar H, Driscoll AJ, Favre G, Fernandez Buhigas I, Flaherman V, Gale C, Godwin CL, Gottlieb S, Gratacós E, He S, Hernandez O, Jones S, Joshi S, Kalafat E, Khagayi S, Knight M, Kotloff KL, Lanzone A, Laurita Longo V, Le Doare K, Lees C, Litman E, Lokken EM, Madhi SA, Magee LA, Martinez-Portilla RJ, Metz TD, Miller ES, Money D, Moungmaithong S, Mullins E, Nachega JB, Nunes MC, Onyango D, Panchaud A, Poon LC, Raiten D, Regan L, Sahota D, Sakowicz A, Sanin-Blair J, Stephansson O, Temmerman M, Thorson A, Thwin SS, Tippett Barr BA, Tolosa JE, Tug N, Valencia-Prado M, Visentin S, von Dadelszen P, Whitehead C, Wood M, Yang H, Zavala R, Tielsch JM. Clinical risk factors of adverse outcomes among women with COVID-19 in the pregnancy and postpartum period: a sequential, prospective meta-analysis. Am J Obstet Gynecol 2023; 228:161-177. [PMID: 36027953 PMCID: PMC9398561 DOI: 10.1016/j.ajog.2022.08.038] [Citation(s) in RCA: 27] [Impact Index Per Article: 27.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Revised: 08/04/2022] [Accepted: 08/07/2022] [Indexed: 01/28/2023]
Abstract
OBJECTIVE This sequential, prospective meta-analysis sought to identify risk factors among pregnant and postpartum women with COVID-19 for adverse outcomes related to disease severity, maternal morbidities, neonatal mortality and morbidity, and adverse birth outcomes. DATA SOURCES We prospectively invited study investigators to join the sequential, prospective meta-analysis via professional research networks beginning in March 2020. STUDY ELIGIBILITY CRITERIA Eligible studies included those recruiting at least 25 consecutive cases of COVID-19 in pregnancy within a defined catchment area. METHODS We included individual patient data from 21 participating studies. Data quality was assessed, and harmonized variables for risk factors and outcomes were constructed. Duplicate cases were removed. Pooled estimates for the absolute and relative risk of adverse outcomes comparing those with and without each risk factor were generated using a 2-stage meta-analysis. RESULTS We collected data from 33 countries and territories, including 21,977 cases of SARS-CoV-2 infection in pregnancy or postpartum. We found that women with comorbidities (preexisting diabetes mellitus, hypertension, cardiovascular disease) vs those without were at higher risk for COVID-19 severity and adverse pregnancy outcomes (fetal death, preterm birth, low birthweight). Participants with COVID-19 and HIV were 1.74 times (95% confidence interval, 1.12-2.71) more likely to be admitted to the intensive care unit. Pregnant women who were underweight before pregnancy were at higher risk of intensive care unit admission (relative risk, 5.53; 95% confidence interval, 2.27-13.44), ventilation (relative risk, 9.36; 95% confidence interval, 3.87-22.63), and pregnancy-related death (relative risk, 14.10; 95% confidence interval, 2.83-70.36). Prepregnancy obesity was also a risk factor for severe COVID-19 outcomes including intensive care unit admission (relative risk, 1.81; 95% confidence interval, 1.26-2.60), ventilation (relative risk, 2.05; 95% confidence interval, 1.20-3.51), any critical care (relative risk, 1.89; 95% confidence interval, 1.28-2.77), and pneumonia (relative risk, 1.66; 95% confidence interval, 1.18-2.33). Anemic pregnant women with COVID-19 also had increased risk of intensive care unit admission (relative risk, 1.63; 95% confidence interval, 1.25-2.11) and death (relative risk, 2.36; 95% confidence interval, 1.15-4.81). CONCLUSION We found that pregnant women with comorbidities including diabetes mellitus, hypertension, and cardiovascular disease were at increased risk for severe COVID-19-related outcomes, maternal morbidities, and adverse birth outcomes. We also identified several less commonly known risk factors, including HIV infection, prepregnancy underweight, and anemia. Although pregnant women are already considered a high-risk population, special priority for prevention and treatment should be given to pregnant women with these additional risk factors.
Collapse
Affiliation(s)
- Emily R Smith
- Department of Global Health, Milken Institute School of Public Health, George Washington University, Washington, DC.
| | - Erin Oakley
- Department of Global Health, Milken Institute School of Public Health, George Washington University, Washington, DC
| | - Gargi Wable Grandner
- Department of Global Health, Milken Institute School of Public Health, George Washington University, Washington, DC
| | - Gordon Rukundo
- PeriCOVID (PREPARE)-Uganda Team, Makerere University-Johns Hopkins University Research Collaboration, Kampala, Uganda
| | - Fouzia Farooq
- Department of Global Health, Milken Institute School of Public Health, George Washington University, Washington, DC
| | - Kacey Ferguson
- Department of Global Health, Milken Institute School of Public Health, George Washington University, Washington, DC
| | - Sasha Baumann
- Department of Global Health, Milken Institute School of Public Health, George Washington University, Washington, DC
| | - Kristina Maria Adams Waldorf
- Department of Obstetrics and Gynecology, University of Washington School of Medicine, Seattle, WA; Department of Global Health, University of Washington, Seattle, WA
| | - Yalda Afshar
- Division of Maternal-Fetal Medicine, University of California, Los Angeles, Los Angeles, CA
| | - Mia Ahlberg
- Division of Division of Clinical Epidemiology, Department of Medicine, Solna, Karolinska Institutet, Stockholm, Sweden
| | - Homa Ahmadzia
- Division of Maternal-Fetal Medicine, The George Washington University School of Medicine and Health Sciences, Washington, DC
| | - Victor Akelo
- Centers for Disease Control and Prevention, Kisumu, Kenya
| | - Grace Aldrovandi
- Department of Pediatrics, University of California, Los Angeles, Los Angeles, CA
| | - Elisa Bevilacqua
- Department of Women and Child Health, Women Health Area, Fondazione Policlinico Universitario Agostino Gemelli, Istituto di Ricovero e Cura a Carattere Scientifico, Rome, Italy
| | - Nabal Bracero
- Department of Obstetrics and Gynecology, University of Puerto Rico School of Medicine, San Juan, PR; Puerto Rico Obstetrics and Gynecology (PROGyn)
| | - Justin S Brandt
- Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology and Reproductive Sciences, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ
| | - Natalie Broutet
- Department of Sexual and Reproductive Health and Research, World Health Organization, Geneva, Switzerland
| | - Jorge Carrillo
- Departamento de Obstetricia y Ginecologia, Clinica Alemana de Santiago, Facultad de Medicina Clinica Alemana-Universidad del Desarrollo, Santiago, Chile
| | - Jeanne Conry
- International Federation of Gynecology and Obstetrics, London, United Kingdom
| | - Erich Cosmi
- Department of Women's and Children's Health, Obstetrics and Gynecology Clinic, University of Padua, Padua, Italy
| | - Fatima Crispi
- BCNatal, Barcelona Center for Maternal-Fetal and Neonatal Medicine, Hospital Sant Joan de Déu Barcelona and Hospital Clínic de Barcelona, Universitat de Barcelona, and Center for Biomedical Research on Rare Diseases, Barcelona, Spain
| | - Francesca Crovetto
- BCNatal, Barcelona Center for Maternal-Fetal and Neonatal Medicine, Hospital Sant Joan de Déu Barcelona and Hospital Clínic de Barcelona, Universitat de Barcelona, and Center for Biomedical Research on Rare Diseases, Barcelona, Spain
| | - Maria Del Mar Gil
- Department of Obstetrics and Gynecology, Hospital Universitario de Torrejón, Madrid, Spain; School of Medicine, Universidad Francisco de Vitoria, Madrid, Spain
| | - Camille Delgado-López
- Surveillance for Emerging Threats to Mothers and Babies, Puerto Rico Department of Health, San Juan, PR
| | - Hema Divakar
- Asian Research & Training Institute for Skill Transfer, Bengaluru, India
| | - Amanda J Driscoll
- Center for Vaccine Development and Global Health, University of Maryland School of Medicine, Baltimore, MD
| | - Guillaume Favre
- Materno-fetal and Obstetrics Research Unit, Département Femme-Mère-Enfant, Lausanne University Hospital, Lausanne, Switzerland
| | - Irene Fernandez Buhigas
- Department of Obstetrics and Gynecology, Hospital Universitario de Torrejón, Madrid, Spain; School of Medicine, Universidad Francisco de Vitoria, Madrid, Spain
| | - Valerie Flaherman
- Department of Pediatrics, University of California, San Francisco, San Francisco, CA
| | - Christopher Gale
- Neonatal Medicine, School of Public Health, Faculty of Medicine, Imperial College London, London, United Kingdom
| | - Christine L Godwin
- Department of Sexual and Reproductive Health and Research, World Health Organization, Geneva, Switzerland
| | - Sami Gottlieb
- Department of Sexual and Reproductive Health and Research, World Health Organization, Geneva, Switzerland
| | - Eduard Gratacós
- BCNatal, Barcelona Center for Maternal-Fetal and Neonatal Medicine, Hospital Sant Joan de Déu Barcelona and Hospital Clínic de Barcelona, Universitat de Barcelona, and Center for Biomedical Research on Rare Diseases, Barcelona, Spain
| | - Siran He
- Department of Global Health, Milken Institute School of Public Health, George Washington University, Washington, DC
| | - Olivia Hernandez
- Gynecology and Obstetrics, Félix Bulnes Hospital and RedSalud Clinic, Santiago, Chile
| | - Stephanie Jones
- South African Medical Research Council, Vaccines and Infectious Diseases Analytics Research Unit and Department of Science and Technology/National Research Foundation, South African Research Chair Initiative in Vaccine Preventable Diseases, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Sheetal Joshi
- Asian Research & Training Institute for Skill Transfer, Bengaluru, India
| | - Erkan Kalafat
- Department of Obstetrics and Gynecology, School of Medicine, Koç University, Istanbul, Turkey
| | - Sammy Khagayi
- Kenya Medical Research Institute-Centre for Global Health Research, Kisumu, Kenya
| | - Marian Knight
- National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - Karen L Kotloff
- Center for Vaccine Development and Global Health, University of Maryland School of Medicine, Baltimore, MD
| | - Antonio Lanzone
- Department of Women and Child Health, Women Health Area, Fondazione Policlinico Universitario Agostino Gemelli, Istituto di Ricovero e Cura a Carattere Scientifico, Rome, Italy; Catholic University of Sacred Heart, Rome, Italy
| | - Valentina Laurita Longo
- Department of Women and Child Health, Women Health Area, Fondazione Policlinico Universitario Agostino Gemelli, Istituto di Ricovero e Cura a Carattere Scientifico, Rome, Italy; Catholic University of Sacred Heart, Rome, Italy
| | - Kirsty Le Doare
- PeriCOVID (PREPARE)-Uganda Team, Makerere University-Johns Hopkins University Research Collaboration, Kampala, Uganda; Medical Research Council /Uganda Virus Research Institute and London School of Hygiene & Tropical Medicine Uganda Research Unit, Entebbe, Uganda; Paediatric Infectious Disease Research Group, St George's University of London, London, United Kingdom
| | - Christoph Lees
- Department of Metabolism, Digestion and Reproduction, Imperial College London, London, United Kingdom
| | - Ethan Litman
- Division of Maternal-Fetal Medicine, The George Washington University School of Medicine and Health Sciences, Washington, DC
| | - Erica M Lokken
- Department of Obstetrics and Gynecology, University of Washington School of Medicine, Seattle, WA; Department of Global Health, University of Washington, Seattle, WA
| | - Shabir A Madhi
- South African Medical Research Council, Vaccines and Infectious Diseases Analytics Research Unit and Department of Science and Technology/National Research Foundation, South African Research Chair Initiative in Vaccine Preventable Diseases, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Laura A Magee
- Department of Women and Children's Health, School of Life Course Sciences, King's College London, London, United Kingdom; Institute of Women and Children's Health, King's College Hospital, London, United Kingdom
| | | | - Torri D Metz
- Division of Maternal-Fetal Medicine, The University of Utah Health, Salt Lake City, UT
| | - Emily S Miller
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Deborah Money
- Department of Obstetrics and Gynecology, The University of British Columbia, Vancouver, Canada
| | - Sakita Moungmaithong
- Department of Obstetrics and Gynecology, The Chinese University of Hong Kong, Hong Kong
| | - Edward Mullins
- Department of Metabolism, Digestion and Reproduction, Imperial College London, London, United Kingdom; George Institute for Global Health, London, United Kingdom
| | - Jean B Nachega
- Department of Epidemiology and Center for Global Health, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA; Department of Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa; Departments of Epidemiology and International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Marta C Nunes
- South African Medical Research Council, Vaccines and Infectious Diseases Analytics Research Unit and Department of Science and Technology/National Research Foundation, South African Research Chair Initiative in Vaccine Preventable Diseases, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | | | - Alice Panchaud
- Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland; Service of Pharmacy, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland
| | - Liona C Poon
- Department of Obstetrics and Gynecology, The Chinese University of Hong Kong, Hong Kong
| | - Daniel Raiten
- Pediatric Growth and Nutrition Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD
| | - Lesley Regan
- International Federation of Gynecology and Obstetrics, Imperial College London, London, United Kingdom
| | - Daljit Sahota
- Department of Obstetrics and Gynecology, The Chinese University of Hong Kong, Hong Kong
| | - Allie Sakowicz
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Jose Sanin-Blair
- Maternal-Fetal Unit, Universidad Pontificia Bolivariana, Medellín, Colombia
| | - Olof Stephansson
- Division of Division of Clinical Epidemiology, Department of Medicine, Solna, Karolinska Institutet, Stockholm, Sweden
| | - Marleen Temmerman
- Centre of Excellence in Women and Child Health, Aga Khan University, Nairobi, Kenya
| | - Anna Thorson
- Department of Sexual and Reproductive Health and Research, World Health Organization, Geneva, Switzerland
| | - Soe Soe Thwin
- Department of Sexual and Reproductive Health and Research, World Health Organization, Geneva, Switzerland
| | - Beth A Tippett Barr
- Centers for Disease Control and Prevention, Kisumu, Kenya; Nyanja Health Research Institute, Salima, Malawi
| | - Jorge E Tolosa
- Maternal-Fetal Unit, Universidad Pontificia Bolivariana, Medellín, Colombia; Department of Obstetrics and Gynecology, Maternal Fetal Medicine, Oregon Health & Science University, Portland, OR; Department of Obstetrics and Gynecology, Maternal Fetal Medicine, St. Luke's University Health Network, Bethlehem, PA
| | - Niyazi Tug
- Department of Obstetrics and Gynecology, Sancaktepe Sehit Prof. Dr. Ilhan Varank Training and Research Hospital, Istanbul, Turkey
| | - Miguel Valencia-Prado
- Division of Children with Special Medical Needs, Puerto Rico Department of Health, San Juan, PR
| | - Silvia Visentin
- Department of Women's and Children's Health, Obstetrics and Gynecology Clinic, University of Padua, Padua, Italy
| | - Peter von Dadelszen
- Department of Women and Children's Health, School of Life Course Sciences, King's College London, London, United Kingdom; Global Health Institute, King's College London, London, United Kingdom
| | - Clare Whitehead
- Department of Maternal Fetal Medicine, University of Melbourne, Royal Women's Hospital, Melbourne, Australia
| | - Mollie Wood
- Department of Epidemiology, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Huixia Yang
- Department of Obstetrics and Gynecology, Peking University First Hospital, Beijing, China
| | - Rebecca Zavala
- Department of Global Health, Milken Institute School of Public Health, George Washington University, Washington, DC
| | - James M Tielsch
- Department of Global Health, Milken Institute School of Public Health, George Washington University, Washington, DC
| |
Collapse
|
6
|
Fábelová L, Beneito A, Casas M, Colles A, Dalsager L, Den Hond E, Dereumeaux C, Ferguson K, Gilles L, Govarts E, Irizar A, Lopez Espinosa MJ, Montazeri P, Morrens B, Patayová H, Rausová K, Richterová D, Rodriguez Martin L, Santa-Marina L, Schettgen T, Schoeters G, Haug LS, Uhl M, Villanger GD, Vrijheid M, Zaros C, Palkovičová Murínová Ľ. PFAS levels and exposure determinants in sensitive population groups. Chemosphere 2023; 313:137530. [PMID: 36509187 PMCID: PMC9846180 DOI: 10.1016/j.chemosphere.2022.137530] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Revised: 11/25/2022] [Accepted: 12/09/2022] [Indexed: 05/25/2023]
Abstract
BACKGROUND Per- and polyfluoroalkyl substances (PFAS) are persistent organic pollutants. The first exposure to PFAS occurs in utero, after birth it continues via breast milk, food intake, environment, and consumer products that contain these chemicals. Our aim was to identify determinants of PFAS concentrations in sensitive population subgroups- pregnant women and newborns. METHODS Nine European birth cohorts provided exposure data on PFAS in pregnant women (INMA-Gipuzkoa, Sabadell, Valencia, ELFE and MoBa; total N = 5897) or newborns (3xG study, FLEHS 2, FLEHS 3 and PRENATAL; total N = 940). PFOS, PFOA, PFHxS and PFNA concentrations were measured in maternal or cord blood, depending on the cohort (FLEHS 2 measured only PFOS and PFOA). PFAS concentrations were analysed according to maternal characteristics (age, BMI, parity, previous breastfeeding, smoking, and food consumption during pregnancy) and parental educational level. The association between potential determinants and PFAS concentrations was evaluated using multiple linear regression models. RESULTS We observed significant variations in PFAS concentrations among cohorts. Higher PFAS concentrations were associated with higher maternal age, primipara birth, and educational level, both for maternal blood and cord blood. Higher PFAS concentrations in maternal blood were associated with higher consumption of fish and seafood, meat, offal and eggs. In cord blood, higher PFHxS concentrations were associated with daily meat consumption and higher PFNA with offal consumption. Daily milk and dairy consumption were associated with lower concentrations of PFAS in both, pregnant women and newborns. CONCLUSION High detection rates of the four most abundant PFAS demonstrate ubiquitous exposure of sensitive populations, which is of concern. This study identified several determinants of PFAS exposure in pregnant women and newborns, including dietary factors, and these findings can be used for proposing measures to reduce PFAS exposure, particularly from dietary sources.
Collapse
Affiliation(s)
- L Fábelová
- Slovak Medical University in Bratislava, Faculty of Public Health, Department of Environmental Medicine, Bratislava, Slovakia
| | - A Beneito
- Epidemiology and Environmental Health Joint Research Unit, FISABIO-Universitat Jaume I-Universitat de València, Valencia, Spain
| | - M Casas
- ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, C/Monforte de Lemos 3-5 28029 Madrid, Spain
| | - A Colles
- VITO Health, Flemish Institute for Technological Research (VITO), Mol, Belgium
| | - L Dalsager
- Institute of Public Health, University of Southern Denmark, Odense, Denmark
| | - E Den Hond
- Provincial Institute of Hygiene (PIH), Antwerp, Belgium
| | | | - K Ferguson
- National Institute of Environmental Health Sciences (NIEHS), North Carolina, USA
| | - L Gilles
- VITO Health, Flemish Institute for Technological Research (VITO), Mol, Belgium
| | - E Govarts
- VITO Health, Flemish Institute for Technological Research (VITO), Mol, Belgium
| | - A Irizar
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, C/Monforte de Lemos 3-5 28029 Madrid, Spain; Biodonostia, Epidemiology and Public Health Area, Environmental Epidemiology and Child Development Group, 20014 San Sebastian, Spain
| | - M J Lopez Espinosa
- Epidemiology and Environmental Health Joint Research Unit, FISABIO-Universitat Jaume I-Universitat de València, Valencia, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, C/Monforte de Lemos 3-5 28029 Madrid, Spain; Faculty of Nursing and Chiropody, Universitat de València, Valencia, Spain
| | | | - B Morrens
- Faculty of Social Sciences, University of Antwerp, Belgium
| | - H Patayová
- Slovak Medical University in Bratislava, Faculty of Public Health, Department of Environmental Medicine, Bratislava, Slovakia
| | - K Rausová
- Slovak Medical University in Bratislava, Faculty of Public Health, Department of Environmental Medicine, Bratislava, Slovakia
| | - D Richterová
- Slovak Medical University in Bratislava, Faculty of Public Health, Department of Environmental Medicine, Bratislava, Slovakia
| | - L Rodriguez Martin
- VITO Health, Flemish Institute for Technological Research (VITO), Mol, Belgium
| | - L Santa-Marina
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, C/Monforte de Lemos 3-5 28029 Madrid, Spain; Biodonostia, Epidemiology and Public Health Area, Environmental Epidemiology and Child Development Group, 20014 San Sebastian, Spain; Public Health Division of Gipuzkoa, Basque Government, 20013 San Sebastian, Spain
| | - T Schettgen
- Institute for Occupational, Social and Environmental Medicine, RWTH Aachen University, Aachen, Germany
| | - G Schoeters
- VITO Health, Flemish Institute for Technological Research (VITO), Mol, Belgium
| | - L S Haug
- Norwegian Institute of Public Health (NIPH), Oslo, Norway
| | - M Uhl
- Umweltbundesamt, Vienna, Austria
| | - G D Villanger
- Norwegian Institute of Public Health (NIPH), Oslo, Norway
| | - M Vrijheid
- ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, C/Monforte de Lemos 3-5 28029 Madrid, Spain
| | - C Zaros
- Institut national d'études démographiques (INED), Aubervilliers, France
| | - Ľ Palkovičová Murínová
- Slovak Medical University in Bratislava, Faculty of Public Health, Department of Environmental Medicine, Bratislava, Slovakia.
| |
Collapse
|
7
|
Smith ER, Oakley E, Grandner GW, Ferguson K, Farooq F, Afshar Y, Ahlberg M, Ahmadzia H, Akelo V, Aldrovandi G, Tippett Barr BA, Bevilacqua E, Brandt JS, Broutet N, Fernández Buhigas I, Carrillo J, Clifton R, Conry J, Cosmi E, Crispi F, Crovetto F, Delgado-López C, Divakar H, Driscoll AJ, Favre G, Flaherman VJ, Gale C, Gil MM, Gottlieb SL, Gratacós E, Hernandez O, Jones S, Kalafat E, Khagayi S, Knight M, Kotloff K, Lanzone A, Le Doare K, Lees C, Litman E, Lokken EM, Laurita Longo V, Madhi SA, Magee LA, Martinez-Portilla RJ, McClure EM, Metz TD, Miller ES, Money D, Moungmaithong S, Mullins E, Nachega JB, Nunes MC, Onyango D, Panchaud A, Poon LC, Raiten D, Regan L, Rukundo G, Sahota D, Sakowicz A, Sanin-Blair J, Söderling J, Stephansson O, Temmerman M, Thorson A, Tolosa JE, Townson J, Valencia-Prado M, Visentin S, von Dadelszen P, Adams Waldorf K, Whitehead C, Yassa M, Tielsch JM. Adverse maternal, fetal, and newborn outcomes among pregnant women with SARS-CoV-2 infection: an individual participant data meta-analysis. BMJ Glob Health 2023; 8:e009495. [PMID: 36646475 PMCID: PMC9895919 DOI: 10.1136/bmjgh-2022-009495] [Citation(s) in RCA: 49] [Impact Index Per Article: 49.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Accepted: 08/24/2022] [Indexed: 01/18/2023] Open
Abstract
INTRODUCTION Despite a growing body of research on the risks of SARS-CoV-2 infection during pregnancy, there is continued controversy given heterogeneity in the quality and design of published studies. METHODS We screened ongoing studies in our sequential, prospective meta-analysis. We pooled individual participant data to estimate the absolute and relative risk (RR) of adverse outcomes among pregnant women with SARS-CoV-2 infection, compared with confirmed negative pregnancies. We evaluated the risk of bias using a modified Newcastle-Ottawa Scale. RESULTS We screened 137 studies and included 12 studies in 12 countries involving 13 136 pregnant women.Pregnant women with SARS-CoV-2 infection-as compared with uninfected pregnant women-were at significantly increased risk of maternal mortality (10 studies; n=1490; RR 7.68, 95% CI 1.70 to 34.61); admission to intensive care unit (8 studies; n=6660; RR 3.81, 95% CI 2.03 to 7.17); receiving mechanical ventilation (7 studies; n=4887; RR 15.23, 95% CI 4.32 to 53.71); receiving any critical care (7 studies; n=4735; RR 5.48, 95% CI 2.57 to 11.72); and being diagnosed with pneumonia (6 studies; n=4573; RR 23.46, 95% CI 3.03 to 181.39) and thromboembolic disease (8 studies; n=5146; RR 5.50, 95% CI 1.12 to 27.12).Neonates born to women with SARS-CoV-2 infection were more likely to be admitted to a neonatal care unit after birth (7 studies; n=7637; RR 1.86, 95% CI 1.12 to 3.08); be born preterm (7 studies; n=6233; RR 1.71, 95% CI 1.28 to 2.29) or moderately preterm (7 studies; n=6071; RR 2.92, 95% CI 1.88 to 4.54); and to be born low birth weight (12 studies; n=11 930; RR 1.19, 95% CI 1.02 to 1.40). Infection was not linked to stillbirth. Studies were generally at low or moderate risk of bias. CONCLUSIONS This analysis indicates that SARS-CoV-2 infection at any time during pregnancy increases the risk of maternal death, severe maternal morbidities and neonatal morbidity, but not stillbirth or intrauterine growth restriction. As more data become available, we will update these findings per the published protocol.
Collapse
Affiliation(s)
- Emily R Smith
- Department of Global Health, The George Washington University Milken Institute School of Public Health, Washington, DC, USA
| | - Erin Oakley
- Department of Global Health, The George Washington University Milken Institute School of Public Health, Washington, DC, USA
| | - Gargi Wable Grandner
- Department of Global Health, The George Washington University Milken Institute School of Public Health, Washington, DC, USA
| | - Kacey Ferguson
- Department of Global Health, The George Washington University Milken Institute School of Public Health, Washington, DC, USA
| | - Fouzia Farooq
- Department of Global Health, The George Washington University Milken Institute School of Public Health, Washington, DC, USA
| | - Yalda Afshar
- Division of Maternal Fetal Medicine, University of California Los Angeles, Los Angeles, California, USA
| | - Mia Ahlberg
- Department of Medicine, Solna, Clinical Epidemiology Division, Karolinska Institute, Stockholm, Sweden
| | - Homa Ahmadzia
- Division of Maternal-Fetal Medicine, The George Washington University School of Medicine and Health Sciences, Washington, DC, USA
| | - Victor Akelo
- Office of the Director, US Centers for Disease Control and Prevention, Kisumu, Kenya
| | - Grace Aldrovandi
- Department of Pediatrics, University of California Los Angeles, Los Angeles, California, USA
| | - Beth A Tippett Barr
- Office of the Director, US Centers for Disease Control and Prevention, Kisumu, Kenya
| | - Elisa Bevilacqua
- Department of Women and Child Health, Women Health Area, Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Roma, Italy
| | - Justin S Brandt
- Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology, and Reproductive Sciences, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey, USA
| | - Nathalie Broutet
- Department of Sexual and Reproductive Health and Research, World Health Organization, Geneve, Switzerland
| | | | - Jorge Carrillo
- Departamento de Obstetricia y Ginecologia, Universidad del Desarrollo Facultad de Medicina Clinica Alemana, Santiago, Chile
| | - Rebecca Clifton
- The Biostatistics Center, The George Washington University Milken Institute School of Public Health, Rockville, Maryland, USA
| | - Jeanne Conry
- International Federation of Gynecology and Obstetrics, London, UK
| | - Erich Cosmi
- Department of Women's and Children's Health, University of Padua, Padova, Italy
| | - Fatima Crispi
- Department of Maternal-Fetal Medicine, BCNatal, Barcelona Center for Maternal-Fetal and Neonatal Medicine, Hospital Sant Joan de Déu and Hospital Clínic, Universitat de Barcelona, Barcelona, Spain
| | - Francesca Crovetto
- Department of Maternal-Fetal Medicine, BCNatal, Barcelona Center for Maternal-Fetal and Neonatal Medicine, Hospital Sant Joan de Déu and Hospital Clínic, Universitat de Barcelona, Barcelona, Spain
| | - Camille Delgado-López
- Surveillance for Emerging Threats to Mothers and Babies, Puerto Rico Department of Health, San Juan, Puerto Rico
| | - Hema Divakar
- Asian Research and Training Institute for Skill Transfer (ARTIST), Bengaluru, India
| | - Amanda J Driscoll
- Center for Vaccine Development, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Guillaume Favre
- Materno-Fetal and Obstetrics Research Unit, Department ‘Femme-Mère-Enfant’, Lausanne University Hospital, Lausanne, Switzerland
| | - Valerie J Flaherman
- Department of Pediatrics, University of California San Francisco, San Francisco, California, USA
| | - Chris Gale
- Neonatal Medicine, School of Public Health, Imperial College London Faculty of Medicine, London, UK
| | - Maria M Gil
- Department of Obstetrics and Gynecology, Hospital Universitario de Torrejón, Madrid, Spain
| | - Sami L Gottlieb
- Department of Sexual and Reproductive Health and Research, World Health Organization, Geneve, Switzerland
| | - Eduard Gratacós
- Department of Maternal-Fetal Medicine, BCNatal, Barcelona Center for Maternal-Fetal and Neonatal Medicine, Hospital Sant Joan de Déu and Hospital Clínic, Universitat de Barcelona, Barcelona, Spain
| | - Olivia Hernandez
- Gynecology and Obstetrics, Felix Bulnes Hospital and RedSalud Clinic, Santiago, Chile
| | - Stephanie Jones
- South African Medical Research Council, Vaccines and Infectious Diseases Analytics Research Unit, University of the Witwatersrand Faculty of Health Sciences, Johannesburg, South Africa
| | - Erkan Kalafat
- Department of Obstetrics and Gynecology, Koç University School of Medicine, Istanbul, Turkey
| | - Sammy Khagayi
- Center for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya
| | - Marian Knight
- Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Karen Kotloff
- Department of Pediatrics, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Antonio Lanzone
- Department of Women and Child Health, Women Health Area, Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Roma, Italy
| | - Kirsty Le Doare
- Uganda Virus Institute and the London School of Hygiene & Tropical Medicine, Entebbe, Uganda,Pediatric Infectious Diseases Research Group, St George's University of London, London, UK
| | - Christoph Lees
- Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK
| | - Ethan Litman
- Division of Maternal-Fetal Medicine, The George Washington University School of Medicine and Health Sciences, Washington, DC, USA
| | - Erica M Lokken
- Department of Obstetrics and Gynecology, University of Washington School of Medicine, Seattle, Washington, USA
| | - Valentina Laurita Longo
- Institute of Obstetrics and Gynecology Clinic, Catholic University of Sacred Heart, Rome, Italy
| | - Shabir A Madhi
- South African Medical Research Council, Vaccines and Infectious Diseases Analytics Research Unit, University of the Witwatersrand Faculty of Health Sciences, Johannesburg, South Africa
| | - Laura A Magee
- Department of Women and Children’s Health, School of Life Course and Population Sciences, King's College London, London, UK
| | | | | | - Tori D Metz
- Departments of Obstetrics and Gynecology, University of Utah Health Sciences Center, Salt Lake, Utah, USA
| | - Emily S Miller
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Deborah Money
- Department of Obstetrics and Gynecology, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Sakita Moungmaithong
- Department of Obstetrics and Gynecology, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Edward Mullins
- Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK
| | - Jean B Nachega
- Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania, USA
| | - Marta C Nunes
- South African Medical Research Council, Vaccines and Infectious Diseases Analytics Research Unit, University of the Witwatersrand Faculty of Health Sciences, Johannesburg, South Africa
| | | | - Alice Panchaud
- Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland
| | - Liona C Poon
- Department of Obstetrics and Gynecology, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Daniel Raiten
- Pediatric Growth and Nutrition Branch, National Institute of Health, Bethesda, Maryland, USA
| | - Lesley Regan
- International Federation of Gynecology and Obstetrics, London, UK
| | - Gordon Rukundo
- Uganda Virus Institute and the London School of Hygiene & Tropical Medicine, Entebbe, Uganda
| | - Daljit Sahota
- Department of Obstetrics and Gynecology, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Allie Sakowicz
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Jose Sanin-Blair
- Universidad Pontificia Bolivariana, Medellin, Antioquia, Colombia
| | - Jonas Söderling
- Department of Medicine, Solna, Clinical Epidemiology Division, Karolinska Institute, Stockholm, Sweden
| | - Olof Stephansson
- Department of Medicine, Solna, Clinical Epidemiology Division, Karolinska Institute, Stockholm, Sweden
| | - Marleen Temmerman
- Centre of Excellence in Women and Child Health, Aga Khan University, Nairobi, Kenya
| | - Anna Thorson
- Department of Sexual and Reproductive Health and Research, World Health Organization, Geneve, Switzerland
| | - Jorge E Tolosa
- Department of Obstetrics and Gynecology, St Luke's University Health Network, Bethlehem, Pennsylvania, USA
| | - Julia Townson
- Centre for Trials Research, Cardiff University, Cardiff, UK
| | - Miguel Valencia-Prado
- Children with Special Medical Needs Division, Puerto Rico Department of Health, San Juan, Puerto Rico
| | - Silvia Visentin
- Department of Women's and Children's Health, University of Padua, Padova, Italy
| | - Peter von Dadelszen
- Department of Women and Children's Health, King's College London Faculty of Life Sciences and Medicine, London, UK
| | - Kristina Adams Waldorf
- Department of Obstetrics and Gynecology, University of Washington School of Medicine, Seattle, Washington, USA
| | - Clare Whitehead
- Department of Maternal-Fetal Medicine, The Royal Women's Hospital, University of Melbourne, Parkville, Victoria, Australia
| | - Murat Yassa
- Department of Obstetrics and Gynecology, Sancaktepe Sehit Prof Dr Ilhan Varank Training and Research Hospital, Istanbul, Turkey
| | - Jim M Tielsch
- Department of Global Health, The George Washington University Milken Institute School of Public Health, Washington, DC, USA
| | | | | |
Collapse
|
8
|
Ferguson K, Moore H, Kaidbey JH, Khattak S, Saeed A, Cogen FR, Streisand R, Sylvetsky AC. Impacts of the COVID-19 Pandemic on Pediatric Type 1 Diabetes Management: A Qualitative Study. Sci Diabetes Self Manag Care 2022; 48:522-532. [PMID: 36154537 PMCID: PMC9510960 DOI: 10.1177/26350106221125701] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Purpose: The purpose of this study was to understand impacts of the coronavirus (COVID-19) pandemic on pediatric type 1 diabetes management. Methods: In-depth qualitative interviews were conducted with 15 parents of children (age 6-12 years) with type 1 diabetes. Parents responded to 8 open-ended questions about their experiences managing their children’s type 1 diabetes during the COVID-19 pandemic. All interviews were transcribed, coded, and analyzed using qualitative thematic methods. Results: Parents reported both positive and negative aspects of managing their children’s type 1 diabetes during the COVID-19 pandemic. Facilitators of diabetes management included spending more time together at home and enhanced convenience of telehealth appointments and online supply ordering. Parents also described difficulties managing their children’s type 1 diabetes during the COVID-19 pandemic, including a lack of structure in their child’s daily routine, which led to increases in sedentary behavior. Furthermore, they reported psychosocial challenges of type 1 diabetes management, which were exacerbated by the pandemic. Conclusion: While the COVID-19 pandemic was described as having overall positive impacts on pediatric type 1 diabetes management, efforts to support parents in increasing children’s physical activity and reducing screen time are needed, along with readily accessible mental health resources for both parents and their children with type 1 diabetes.
Collapse
Affiliation(s)
- Kacey Ferguson
- Department of Exercise and Nutrition Sciences, Milken Institute School of Public Health, The George Washington University, Washington, DC
| | - Hailey Moore
- Division of Psychology and Behavioral Health, Children’s National Hospital, Washington, DC
| | - Jasmine H. Kaidbey
- Department of Exercise and Nutrition Sciences, Milken Institute School of Public Health, The George Washington University, Washington, DC
| | - Shazmenna Khattak
- Department of Exercise and Nutrition Sciences, Milken Institute School of Public Health, The George Washington University, Washington, DC
| | - Abbas Saeed
- Department of Exercise and Nutrition Sciences, Milken Institute School of Public Health, The George Washington University, Washington, DC
| | - Fran R. Cogen
- Division of Endocrinology, Children’s National Hospital, Washington, DC
| | - Randi Streisand
- Division of Psychology and Behavioral Health, Children’s National Hospital, Washington, DC
- School of Medicine and Health Sciences, The George Washington University, Washington, DC
| | - Allison C. Sylvetsky
- Department of Exercise and Nutrition Sciences, Milken Institute School of Public Health, The George Washington University, Washington, DC
| |
Collapse
|
9
|
Gieske M, Calhoun R, Schmitt G, Budhani I, Alkapalan D, Bramer A, Kerns J, Yadav R, Ferguson K, Kloecker G. EP01.04-004 Overcoming the Barriers to Lung Cancer Screening using a Systemwide Approach. J Thorac Oncol 2022. [DOI: 10.1016/j.jtho.2022.07.299] [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]
|
10
|
Yang WC, Fogel A, Lauria ME, Ferguson K, Smith ER. Fast Feed Advancement for Preterm and Low Birth Weight Infants: A Systematic Review and Meta-analysis. Pediatrics 2022; 150:188645. [PMID: 35921676 DOI: 10.1542/peds.2022-057092g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/16/2022] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Fast feed advancement may reduce hospital stay and infection but may increase adverse outcomes in preterm and low birth weight infants. The objective of this study was to assess effects of fast feed advancement (≥30 ml/kg per day) compared with slow feed advancement (<30 ml/kg per day) in preterm and low birth weight infants. METHODS Data sources include Medline, Scopus, Web of Science, CINAHL, and Index Medicus through June 30, 2021. Randomized trials were selected. Primary outcomes were mortality, morbidity, growth, and neurodevelopment. Data were extracted and pooled using random-effects models. The Cochrane Risk of Bias 2 tool was used. RESULTS A total of 12 RCTs with 4291 participants were included. At discharge, there was moderate certainty evidence that fast advancement likely slightly reduces the risk of: mortality (relative risk [RR] 0.93, 95% confidence interval [95% CI] 0.73 to 1.18, I2 = 18%, 11 trials, 4132 participants); necrotizing enterocolitis (RR 0.89, 95% CI 0.68 to 1.15, I2 = 0%, 12 trials, 4291 participants); sepsis (RR 0.92, 95% CI 0.83 to 1.03, I2 = 0%, 9 trials, 3648 participants); and feed intolerance (RR 0.92, 95% CI 0.77 to 1.10, I2 = 0%, 8 trials, 1114 participants). Fast feed advancement may also reduce the risk of apnea (RR 0.72, 95% CI 0.47 to 1.12, I2 = 0%, low certainty, 2 trials, 153 participants). Fast feed advancement decreases time to regain birth weight (mean difference [MD] -3.69 days, 95% CI -4.44 to -2.95, I2 = 70%, high certainty, 6 trials, 993 participants,) and likely reduces the duration of hospitalization (MD -3.08 days, 95% CI -4.34 to -1.81, I2 = 77%, moderate certainty, 7 trials, 3864 participants). Limitations include heterogeneity between studies and small sample sizes. CONCLUSIONS Fast feed advancement reduces time to regain birth weight and likely reduces the length of hospital stay; it also likely reduces the risk of neonatal morbidity and mortality slightly. However, it may increase the risk of neurodevelopmental disability slightly. More studies are needed to understand the long-term effects of fast feed advancement.
Collapse
Affiliation(s)
- Wen-Chien Yang
- The George Washington University, Milken Institute School of Public Health, Washington, District of Columbia
| | | | - Molly E Lauria
- The George Washington University, Milken Institute School of Public Health, Washington, District of Columbia.,ICF, Rockville, Maryland
| | - Kacey Ferguson
- The George Washington University, Milken Institute School of Public Health, Washington, District of Columbia
| | - Emily R Smith
- The George Washington University, Milken Institute School of Public Health, Washington, District of Columbia
| |
Collapse
|
11
|
Talej M, Smith ER, Lauria ME, Chitale R, Ferguson K, He S. Responsive Feeding for Preterm or Low Birth Weight Infants: A Systematic Review and Meta-analysis. Pediatrics 2022; 150:188648. [PMID: 35921679 DOI: 10.1542/peds.2022-057092f] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/16/2022] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Responsive feeding may improve health outcomes in preterm and low birth weight (LBW) infants. Our objective was to assess effects of responsive compared with scheduled feeding in preterm and LBW infants. METHODS Data sources include PubMed, Scopus, Web of Science, CINAHL, LILACS, and MEDICUS. Randomized trials were screened. Primary outcomes were mortality, morbidity, growth, neurodevelopment. Secondary outcomes were feed intolerance and duration of hospitalization. Data were extracted and pooled with random-effects models. RESULTS Eleven eligible studies were identified, and data from 8 randomized control trials with 455 participants were pooled in the meta-analyses. At discharge, the mean difference in body weight between the intervention (responsive feeding) and comparison (scheduled feeding) was -2.80 g per day (95% CI -3.39 to -2.22, I2 = 0%, low certainty evidence, 4 trials, 213 participants); -0.99 g/kg per day (95% CI -2.45 to 0.46, I2 = 74%, very low certainty evidence, 5 trials, 372 participants); -22.21 g (95% CI -130.63 to 86.21, I2 = 41%, low certainty evidence, 3 trials, 183 participants). The mean difference in duration of hospitalization was -1.42 days (95% CI -5.43 to 2.59, I2 = 88%, very low certainty evidence, 5 trials, 342 participants). There were no trials assessing other growth outcomes (eg, length and head circumference) mortality, morbidity or neurodevelopment. Limitations include a high risk of bias, heterogeneity, and small sample size in included studies. CONCLUSIONS Overall, responsive feeding may decrease in-hospital weight gain. Although the evidence is very uncertain, responsive feeding may slightly decrease the duration of hospitalization. Evidence was insufficient to understand the effects of responsive compared with scheduled feeding on mortality, morbidity, linear growth, and neurodevelopmental outcomes in preterm and LBW infants.
Collapse
Affiliation(s)
- Megan Talej
- The George Washington University, Milken Institute School of Public Health, the George Washington University, Washington, District of Columbia
| | - Emily R Smith
- The George Washington University, Milken Institute School of Public Health, the George Washington University, Washington, District of Columbia
| | - Molly E Lauria
- The George Washington University, Milken Institute School of Public Health, the George Washington University, Washington, District of Columbia.,ICF International, Rockville, Maryland
| | - Ramaa Chitale
- The George Washington University, Milken Institute School of Public Health, the George Washington University, Washington, District of Columbia
| | - Kacey Ferguson
- The George Washington University, Milken Institute School of Public Health, the George Washington University, Washington, District of Columbia
| | - Siran He
- The George Washington University, Milken Institute School of Public Health, the George Washington University, Washington, District of Columbia
| |
Collapse
|
12
|
Yang WC, Lauria ME, Fogel A, Ferguson K, Smith ER. Duration of Exclusive Breastfeeding for Preterm or Low Birth Weight Infants: A Systematic Review and Meta-analysis. Pediatrics 2022; 150:188638. [PMID: 35921669 DOI: 10.1542/peds.2022-057092h] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/16/2022] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Cessation of exclusive breastfeeding (EBF) with early introduction of complementary food provides additional calories for catch-up growth but may also increase the risk of adverse outcomes. The objective of this study was to assess effects of exclusive breastfeeding for less than 6 months compared with 6 months in preterm and low birth weight infants. METHODS Data sources include Medline, Scopus, Web of Science, CINAHL, and Index Medicus through June 30, 2021. Study selection includes randomized trials and observational studies. Primary outcomes were mortality, morbidity, growth, and neurodevelopment. Data were extracted and pooled using random-effects models. The Cochrane Risk of Bias 2 tool was used to assess the risk of bias of included studies. RESULTS A total of 2 studies of 307 preterm or low birth weight infants were included. None of the study results could be pooled. Both studies compared EBF for 4 months to 6 months. Growth was similar between the 4-month and 6-month EBF groups for the following outcomes: weight-for-age z-score at corrected age 12 months (mean [standard deviation], 4-month group: -1.7 [1.1], 6-month group: -1.8 [1.2], 1 study, 188 participants, low certainty evidence), absolute weight gain (gram) from 16 to 26 weeks of age (4-month group: 1004 [366], 6-month group: 1017 [350], 1 study, 119 participants, very low certainty evidence), and linear growth gain (cm) from 16 to 26 weeks of age (4-month group: 4.3 [0.9], 6-month group: 4.5 [1.2], 1 study, 119 participants, very low certainty evidence). There were no apparent differences in reported morbidity symptoms. No difference in the timing to achieve motor development milestones between the 2 groups was found (1 study; 119 participants, very low certainty evidence). A limited number of studies prevented data pooling. CONCLUSIONS The evidence is very uncertain about the effect of exclusive breastfeeding for less than 6 months for preterm and low birth weight infants. Further studies are warranted to better answer this question.
Collapse
Affiliation(s)
- Wen-Chien Yang
- The George Washington University, Milken Institute School of Public Health, Washington, District of Columbia
| | - Molly E Lauria
- The George Washington University, Milken Institute School of Public Health, Washington, District of Columbia.,ICF, Rockville, Maryland
| | | | - Kacey Ferguson
- The George Washington University, Milken Institute School of Public Health, Washington, District of Columbia
| | - Emily R Smith
- The George Washington University, Milken Institute School of Public Health, Washington, District of Columbia
| |
Collapse
|
13
|
Chitale R, Ferguson K, Talej M, Yang WC, He S, Edmond KM, Smith ER. Early Enteral Feeding for Preterm or Low Birth Weight Infants: a Systematic Review and Meta-analysis. Pediatrics 2022; 150:188642. [PMID: 35921673 DOI: 10.1542/peds.2022-057092e] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/16/2022] [Indexed: 11/24/2022] Open
Abstract
CONTEXT Early enteral feeding has been associated with adverse outcomes such as necrotizing enterocolitis in preterm and low birth weight infants. OBJECTIVES To assess effects of early enteral feeding initiation within the first days after birth compared to delayed initiation. DATA SOURCES Medline, Scopus, Web of Science, CINAHL from inception to June 30, 2021. STUDY SELECTION Randomized trials (RCTs) were included. Primary outcomes were mortality, morbidity, growth, neurodevelopment, feed intolerance, and duration of hospitalization. DATA EXTRACTION Data were extracted and pooled with random-effects models. RESULTS We included 14 randomized controlled trials with 1505 participants in our primary analysis comparing early (<72 hours) to delayed (≥72 hours) enteral feeding initiation. Early initiation likely decreased mortality at discharge and 28 days (1292 participants, 12 trials, relative risk 0.69, 95% confidence interval [95% CI] 0.48-0.99, moderate certainty evidence) and duration of hospitalization (1100 participants, 10 trials, mean difference -3.20 days, 95%CI -5.74 to -0.66, moderate certainty evidence). The intervention may also decrease sepsis and weight at discharge. Based on low certainty evidence, early feeding may have little to no effect on necrotizing enterocolitis, feed intolerance, and days to regain birth weight. The evidence is very uncertain regarding the effect of initiation time on intraventricular hemorrhage, length, and head circumference at discharge. CONCLUSIONS Enteral feeding within 72 hours after birth likely reduces the risk of mortality and length of hospital stay, may reduce the risk of sepsis, and may reduce weight at discharge.
Collapse
Affiliation(s)
- Ramaa Chitale
- The George Washington University, Milken Institute School of Public Health, Washington, DC
| | - Kacey Ferguson
- The George Washington University, Milken Institute School of Public Health, Washington, DC
| | - Megan Talej
- The George Washington University, Milken Institute School of Public Health, Washington, DC
| | - Wen-Chien Yang
- The George Washington University, Milken Institute School of Public Health, Washington, DC
| | - Siran He
- The George Washington University, Milken Institute School of Public Health, Washington, DC
| | - Karen M Edmond
- World Health Organization, Department of Maternal, Child, Adolescent Health and Aging, Geneva, Switzerland
| | - Emily R Smith
- The George Washington University, Milken Institute School of Public Health, Washington, DC
| |
Collapse
|
14
|
Smith ER, Oakley E, He S, Zavala R, Ferguson K, Miller L, Grandner GW, Abejirinde IOO, Afshar Y, Ahmadzia H, Aldrovandi G, Akelo V, Tippett Barr BA, Bevilacqua E, Brandt JS, Broutet N, Fernández Buhigas I, Carrillo J, Clifton R, Conry J, Cosmi E, Delgado-López C, Divakar H, Driscoll AJ, Favre G, Flaherman V, Gale C, Gil MM, Godwin C, Gottlieb S, Hernandez Bellolio O, Kara E, Khagayi S, Kim CR, Knight M, Kotloff K, Lanzone A, Le Doare K, Lees C, Litman E, Lokken EM, Laurita Longo V, Magee LA, Martinez-Portilla RJ, McClure E, Metz TD, Money D, Mullins E, Nachega JB, Panchaud A, Playle R, Poon LC, Raiten D, Regan L, Rukundo G, Sanin-Blair J, Temmerman M, Thorson A, Thwin S, Tolosa JE, Townson J, Valencia-Prado M, Visentin S, von Dadelszen P, Adams Waldorf K, Whitehead C, Yang H, Thorlund K, Tielsch JM. Protocol for a sequential, prospective meta-analysis to describe coronavirus disease 2019 (COVID-19) in the pregnancy and postpartum periods. PLoS One 2022; 17:e0270150. [PMID: 35709239 PMCID: PMC9202913 DOI: 10.1371/journal.pone.0270150] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Accepted: 06/03/2022] [Indexed: 11/19/2022] Open
Abstract
We urgently need answers to basic epidemiological questions regarding SARS-CoV-2 infection in pregnant and postpartum women and its effect on their newborns. While many national registries, health facilities, and research groups are collecting relevant data, we need a collaborative and methodologically rigorous approach to better combine these data and address knowledge gaps, especially those related to rare outcomes. We propose that using a sequential, prospective meta-analysis (PMA) is the best approach to generate data for policy- and practice-oriented guidelines. As the pandemic evolves, additional studies identified retrospectively by the steering committee or through living systematic reviews will be invited to participate in this PMA. Investigators can contribute to the PMA by either submitting individual patient data or running standardized code to generate aggregate data estimates. For the primary analysis, we will pool data using two-stage meta-analysis methods. The meta-analyses will be updated as additional data accrue in each contributing study and as additional studies meet study-specific time or data accrual thresholds for sharing. At the time of publication, investigators of 25 studies, including more than 76,000 pregnancies, in 41 countries had agreed to share data for this analysis. Among the included studies, 12 have a contemporaneous comparison group of pregnancies without COVID-19, and four studies include a comparison group of non-pregnant women of reproductive age with COVID-19. Protocols and updates will be maintained publicly. Results will be shared with key stakeholders, including the World Health Organization (WHO) Maternal, Newborn, Child, and Adolescent Health (MNCAH) Research Working Group. Data contributors will share results with local stakeholders. Scientific publications will be published in open-access journals on an ongoing basis.
Collapse
Affiliation(s)
- Emily R. Smith
- Department of Global Health, George Washington University Milken Institute School of Public Health, Washington, DC, United States of America
| | - Erin Oakley
- Department of Global Health, George Washington University Milken Institute School of Public Health, Washington, DC, United States of America
| | - Siran He
- Department of Global Health, George Washington University Milken Institute School of Public Health, Washington, DC, United States of America
| | - Rebecca Zavala
- Department of Global Health, George Washington University Milken Institute School of Public Health, Washington, DC, United States of America
| | - Kacey Ferguson
- Department of Global Health, George Washington University Milken Institute School of Public Health, Washington, DC, United States of America
| | - Lior Miller
- Department of Global Health, George Washington University Milken Institute School of Public Health, Washington, DC, United States of America
| | - Gargi Wable Grandner
- Department of Global Health, George Washington University Milken Institute School of Public Health, Washington, DC, United States of America
| | | | - Yalda Afshar
- Division of Maternal Fetal Medicine, University of California Los Angeles, Los Angeles, CA, United States of America
| | - Homa Ahmadzia
- Division of Maternal-Fetal Medicine, The George Washington University School of Medicine and Health Sciences, Washington, D.C., United States of America
| | - Grace Aldrovandi
- Department of Pediatrics, University of California Los Angeles, Los Angeles, CA, United States of America
| | - Victor Akelo
- US Centers for Disease Control and Prevention, Kisumu, Kenya
| | | | - Elisa Bevilacqua
- Department of Women and Child Health, Women Health Area, Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Rome, Italy
| | - Justin S. Brandt
- Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology, and Reproductive Sciences, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, United States of America
| | - Natalie Broutet
- Department of Sexual and Reproductive Health and Research, World Health Organization, Geneva, Switzerland
| | - Irene Fernández Buhigas
- Department of Obstetrics and Gynecology, Hospital Universitario de Torrejón, Torrejón de Ardoz, Madrid, Spain
- School of Medicine, Universidad Francisco de Vitoria, Pozuelo de Alarcón, Madrid, Spain
| | - Jorge Carrillo
- Departmento de Obstetricia y Ginecologia, Clinica Alemana de Santiago, Facultad de Medicina Clinica Alemana-Universidad del Desarrollo, Santiago, Chile
| | - Rebecca Clifton
- Biostatistics Center, The George Washington University, Washington, DC, United States of America
| | - Jeanne Conry
- OBGYN, The International Federation of Gynecology and Obstetrics, London, United Kingdom
| | - Erich Cosmi
- Department of Woman’s and Child’s Health, Obstetrics and Gynecologic Clinic, University of Padua, Padua, Italy
| | - Camille Delgado-López
- Surveillance for Emerging Threats to Mothers and Babies, Puerto Rico Department of Health, San Juan, Puerto Rico
| | - Hema Divakar
- Asian Research and Training Institute for Skill Transfer (ARTIST), Bengaluru, India
| | - Amanda J. Driscoll
- Center for Vaccine Development and Global Health, University of Maryland, School of Medicine, Baltimore, MD, United States of America
| | - Guillaume Favre
- Materno-fetal and Obstetrics Research Unit, Department “Femme-Mère-Enfant”, University Hospital, Lausanne, Switzerland
| | - Valerie Flaherman
- Department of Pediatrics, University of California San Francisco, San Francisco, CA, United States of America
| | - Christopher Gale
- Neonatal Medicine, School of Public Health, Faculty of Medicine, Imperial College London, London, United Kingdom
| | - Maria M. Gil
- Department of Obstetrics and Gynecology, Hospital Universitario de Torrejón, Torrejón de Ardoz, Madrid, Spain
- School of Medicine, Universidad Francisco de Vitoria, Pozuelo de Alarcón, Madrid, Spain
| | - Christine Godwin
- Department of Sexual and Reproductive Health and Research, World Health Organization, Geneva, Switzerland
- Global Health Research, FHI 360, Durham, NC, United States of America
| | - Sami Gottlieb
- Department of Sexual and Reproductive Health and Research, World Health Organization, Geneva, Switzerland
| | | | - Edna Kara
- Department of Sexual and Reproductive Health and Research, World Health Organization, Geneva, Switzerland
| | - Sammy Khagayi
- Kenya Medical Research Institute-Center for Global Health Research, Kisumu, Kenya
| | - Caron Rahn Kim
- Department of Sexual and Reproductive Health and Research, World Health Organization, Geneva, Switzerland
| | - Marian Knight
- National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - Karen Kotloff
- Center for Vaccine Development and Global Health, University of Maryland, School of Medicine, Baltimore, MD, United States of America
- Department of Metabolism, Digestion, and Reproduction, Imperial College London, of London, United Kingdom
| | - Antonio Lanzone
- Department of Women and Child Health, Women Health Area, Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Rome, Italy
- Catholic University of Sacred Hearth, Rome, Italy
| | - Kirsty Le Doare
- Medical Research Council /Uganda Virus Research Institute and London School of Hygiene & Tropical Medicine Uganda Research Unit, Entebbe, Uganda
- Pediatric Infectious Diseases Research Group, St. George’s University of London, of London, United Kingdom
| | - Christoph Lees
- Department of Metabolism, Digestion, and Reproduction, Imperial College London, of London, United Kingdom
| | - Ethan Litman
- Division of Maternal-Fetal Medicine, The George Washington University School of Medicine and Health Sciences, Washington, D.C., United States of America
| | - Erica M. Lokken
- Department of Obstetrics and Gynecology, School of Medicine, University of Washington, Washington, DC, United States of America
- Department of Global Health, School of Public Health, University of Washington, Washington, DC, United States of America
| | | | - Laura A. Magee
- Department of Women and Children’s Health, School of Life Course Sciences, King’s College London, London, United Kingdom
- Institute of Women and Children’s Health, King’s College Hospital, London, United Kingdom
| | - Raigam Jafet Martinez-Portilla
- Clinical Research Division, National Institute of Perinatology, Mexico City, Mexico
- ABC Medical Center, Fetal Surgery Clinic, Mexico City, Mexico
| | - Elizabeth McClure
- Division of Statistics and Epidemiology, RTI International, Chapel Hill, NC, United States of America
| | - Torri D. Metz
- University of Utah Health, Salt Lake City, UT, United States of America
| | - Deborah Money
- Department of Obstetrics and Gynecology, The University of British Columbia, Vancouver, Canada
| | - Edward Mullins
- Department of Metabolism, Digestion, and Reproduction, Imperial College London, of London, United Kingdom
| | - Jean B. Nachega
- Department of Epidemiology and Center for Global Health, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA, United States of America
- Department of Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
- Departments of Epidemiology and International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States of America
| | - Alice Panchaud
- Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland
- Service of Pharmacy, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Rebecca Playle
- Center for Trials Research, Cardiff University, Wales, United Kingdom
| | - Liona C. Poon
- Department of Obstetrics and Gynecology, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Daniel Raiten
- Pediatric Growth and Nutrition Branch, National Institute of Health, Bethesda, MD, United States of America
| | - Lesley Regan
- Federation International Federation Gynaecology & Obstetrics, Imperial College London, London, United Kingdom
| | - Gordon Rukundo
- PeriCovid (PREPARE)–Uganda Team, Makerere University–Johns Hopkins University Research Collaboration, Kampala, Uganda
| | - Jose Sanin-Blair
- Maternal Fetal Unit, Universidad Pontificia Bolivariana, RECOGEST Study, Medellín, Colombia
| | - Marleen Temmerman
- Centre of Excellence in Women and Child Health, Aga Khan University, Nairobi, Kenya
| | - Anna Thorson
- Department of Sexual and Reproductive Health and Research, World Health Organization, Geneva, Switzerland
| | - Soe Thwin
- Department of Sexual and Reproductive Health and Research, World Health Organization, Geneva, Switzerland
| | - Jorge E. Tolosa
- Maternal Fetal Unit, Universidad Pontificia Bolivariana, RECOGEST Study, Medellín, Colombia
- Department of Obstetrics and Gynecology, Maternal Fetal Medicine, Oregon Health and Science University, Portland, OR, United States of America
- St. Luke’s University Health Network, Department of Obstetrics & Gynecology, Maternal Fetal Medicine, Bethlehem, PA, United States of America
| | - Julia Townson
- Center for Trials Research, Cardiff University, Wales, United Kingdom
| | - Miguel Valencia-Prado
- Children with Special Medical Needs Division, Puerto Rico Department of Health, San Juan, Puerto Rico
| | - Silvia Visentin
- Department of Woman’s and Child’s Health, Obstetrics and Gynecologic Clinic, University of Padua, Padua, Italy
| | - Peter von Dadelszen
- Department of Women and Children’s Health, School of Life Course Sciences, King’s College London, London, United Kingdom
- Global Health Institute, King’s College London, London, United Kingdom
| | - Kristina Adams Waldorf
- Department of Obstetrics and Gynecology, School of Medicine, University of Washington, Washington, DC, United States of America
- Department of Global Health, School of Public Health, University of Washington, Washington, DC, United States of America
| | - Clare Whitehead
- Department of Maternal Fetal Medicine, University of Melbourne, Royal Women’s Hospital, Parkville, VIC, Australia
| | - Huixia Yang
- Health Science Center, Peking University, Beijing, China
| | - Kristian Thorlund
- Department of Health Research Methods Evidence and Impact, McMaster University, Hamilton, ON, Canada
| | - James M. Tielsch
- Department of Global Health, George Washington University Milken Institute School of Public Health, Washington, DC, United States of America
| |
Collapse
|
15
|
Kaidbey JH, Ferguson K, Halberg SE, Racke C, Visek AJ, Gearhardt AN, Juliano LM, Dietz WH, Sacheck J, Sylvetsky AC. Stop the Pop: A Mixed-Methods Study Examining Children's Physical and Emotional Responses during Three Days of Sugary Drink Cessation. Nutrients 2022; 14:nu14071328. [PMID: 35405940 PMCID: PMC9003451 DOI: 10.3390/nu14071328] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Revised: 03/15/2022] [Accepted: 03/19/2022] [Indexed: 01/04/2023] Open
Abstract
Despite public health efforts to reduce sugary drink consumption, children’s intake continues to exceed recommendations. While numerous barriers to lowering sugary drink consumption have been identified, aversive feelings during sugary drink cessation may further challenge sustained reduction in children’s sugary drink consumption. Herein, we describe “Stop the Pop”, an intervention to examine children’s physical and emotional responses during three days of sugary drink cessation. Children (n = 150) ages 8–14, who reported habitual consumption of ≥12 ounces of sugary drinks daily, were instructed to avoid sweetened beverages for three days. At baseline and on each day of cessation, children completed a daily feelings questionnaire, and a subset of children (n = 30) also completed a qualitative interview following cessation. During sugary drink cessation, children reported physical and emotional improvements, including being less tired, angry, and annoyed; having less trouble sleeping; and less frequently arguing with others, getting in trouble, and getting mad. However, unfavorable responses, such as mood disturbances and having less energy, were reported by some participants. Our results suggest that children who habitually consume sugary drinks may experience physical and emotional improvements during short-term sugary drink cessation, although longer-term examination is needed and inter-individual variability in responses to cessation warrants further study.
Collapse
Affiliation(s)
- Jasmine H. Kaidbey
- Department of Exercise and Nutrition Sciences, Milken Institute School of Public Health, The George Washington University, Washington, DC 20052, USA; (J.H.K.); (K.F.); (S.E.H.); (C.R.); (A.J.V.); (J.S.)
| | - Kacey Ferguson
- Department of Exercise and Nutrition Sciences, Milken Institute School of Public Health, The George Washington University, Washington, DC 20052, USA; (J.H.K.); (K.F.); (S.E.H.); (C.R.); (A.J.V.); (J.S.)
| | - Sabrina E. Halberg
- Department of Exercise and Nutrition Sciences, Milken Institute School of Public Health, The George Washington University, Washington, DC 20052, USA; (J.H.K.); (K.F.); (S.E.H.); (C.R.); (A.J.V.); (J.S.)
| | - Caroline Racke
- Department of Exercise and Nutrition Sciences, Milken Institute School of Public Health, The George Washington University, Washington, DC 20052, USA; (J.H.K.); (K.F.); (S.E.H.); (C.R.); (A.J.V.); (J.S.)
| | - Amanda J. Visek
- Department of Exercise and Nutrition Sciences, Milken Institute School of Public Health, The George Washington University, Washington, DC 20052, USA; (J.H.K.); (K.F.); (S.E.H.); (C.R.); (A.J.V.); (J.S.)
| | | | - Laura M. Juliano
- Department of Psychology, American University, Washington, DC 20016, USA;
| | - William H. Dietz
- Sumner M. Redstone Global Center for Prevention and Wellness, Milken Institute School of Public Health, The George Washington University, Washington, DC 20052, USA;
| | - Jennifer Sacheck
- Department of Exercise and Nutrition Sciences, Milken Institute School of Public Health, The George Washington University, Washington, DC 20052, USA; (J.H.K.); (K.F.); (S.E.H.); (C.R.); (A.J.V.); (J.S.)
| | - Allison C. Sylvetsky
- Department of Exercise and Nutrition Sciences, Milken Institute School of Public Health, The George Washington University, Washington, DC 20052, USA; (J.H.K.); (K.F.); (S.E.H.); (C.R.); (A.J.V.); (J.S.)
- Sumner M. Redstone Global Center for Prevention and Wellness, Milken Institute School of Public Health, The George Washington University, Washington, DC 20052, USA;
- Correspondence: ; Tel.: +202-994-5602
| |
Collapse
|
16
|
Sylvetsky AC, Kaidbey JH, Ferguson K, Visek AJ, Sacheck J. Impacts of the COVID-19 Pandemic on Children's Sugary Drink Consumption: A Qualitative Study. Front Nutr 2022; 9:860259. [PMID: 35369093 PMCID: PMC8966582 DOI: 10.3389/fnut.2022.860259] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2022] [Accepted: 02/11/2022] [Indexed: 01/11/2023] Open
Abstract
The coronavirus (COVID-19) pandemic has caused striking alterations to daily life, with important impacts on children's health. Spending more time at home and out of school due to COVID-19 related closures may exacerbate obesogenic behaviors among children, including consumption of sugary drinks (SDs). This qualitative study aimed to investigate effects of the pandemic on children's SD consumption and related dietary behaviors. Children 8–14 years old and their parent (n = 19 dyads) participated in an in-depth qualitative interview. Interviews were recorded, transcribed verbatim, and independently coded by two coders, after which, emergent themes and subthemes were identified and representative quotations selected. Although increases in children's SD and snack intake were almost unanimously reported by both children and their parents, increased frequency of cooking at home and preparation of healthier meals were also described. Key reasons for children's higher SD and snack intake were having unlimited access to SDs and snacks and experiencing boredom while at home. Parents also explained that the pandemic impacted their oversight of the child's SD intake, as many parents described loosening prior restrictions on their child's SD intake and/or allowing their child more autonomy to make their own dietary choices during the pandemic. These results call attention to concerning increases in children's SD and snack intake during the COVID-19 pandemic. Intervention strategies to improve the home food environment, including reducing the availability of SDs and energy-dense snacks and providing education on non-food related coping strategies are needed.
Collapse
|
17
|
Ferguson K, Mitro JP, Bhanji A, Yang S, Gerber L, Cai C, Garfinkel S, Weinstein AA. Qualitative Investigation of Health Information Resources for Caregivers and Individuals Living With Spinal Cord Injury. Top Spinal Cord Inj Rehabil 2021; 27:79-98. [PMID: 34866890 DOI: 10.46292/sci20-00032] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Objectives: To identify the information networks of caregivers and individuals with spinal cord injury (SCI) and how the health information is accessed and used. Methods: For this qualitative study, participants from the United States were recruited through hospital listservs, websites, social media, and word of mouth to participate in a phone interview. Fourteen individuals living with a traumatic SCI and 18 caregivers of individuals living with a traumatic SCI were interviewed using a semi-structured interview guide. The interviews were transcribed verbatim, coded using NVivo, and analyzed using qualitative thematic methods. Results: Participants reported that medical resources such as SCI specialists were considered the most reliable sources, but due to accessibility barriers the Internet was used the most. The Internet and social resources, such as online and in-person support groups, provided beneficial content information and emotional support, but they posed credibility concerns and left participants feeling unsure of reliability. Information gaps such as lack of education on basic care practices during the transition from acute to chronic care were identified by the participants. Conclusion: Because SCI is an overwhelming experience, it is difficult for patients to retain information in the initial acute care phase, leading to gaps in knowledge about long-term care. Patients are concerned about the reliability of online sources of information; therefore, there is a need for new methods of SCI information dissemination. Potentially, using primary care providers as conduits for information distribution might improve access to reliable long-term SCI information for caregivers and patients.
Collapse
Affiliation(s)
- Kacey Ferguson
- Center for the Study of Chronic Illness and Disability, George Mason University, Fairfax, Virginia
| | - Jessica Pope Mitro
- Center for the Study of Chronic Illness and Disability, George Mason University, Fairfax, Virginia
| | - Alaanah Bhanji
- Center for the Study of Chronic Illness and Disability, George Mason University, Fairfax, Virginia
| | - Sejean Yang
- Center for the Study of Chronic Illness and Disability, George Mason University, Fairfax, Virginia
| | - Lynn Gerber
- Center for the Study of Chronic Illness and Disability, George Mason University, Fairfax, Virginia
| | - Cindy Cai
- American Institutes for Research, Washington, DC
| | | | - Ali A Weinstein
- Center for the Study of Chronic Illness and Disability, George Mason University, Fairfax, Virginia
| |
Collapse
|
18
|
Ahuja G, Jones TM, Weinstein A, Bhanji A, Bakhtar R, Ferguson K. 28008 Examination of health information needs of caregivers of and individuals with burn injuries. J Am Acad Dermatol 2021. [DOI: 10.1016/j.jaad.2021.06.188] [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]
|
19
|
El‐Ghazali S, Sheraton T, Ferguson K, Meek T. ‘Shielded’ anaesthetists and intensivists during the COVID‐19 pandemic: a reply. Anaesthesia 2020; 75:1542-1543. [PMID: 32632942 PMCID: PMC7361638 DOI: 10.1111/anae.15209] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/26/2020] [Indexed: 11/29/2022]
Affiliation(s)
| | | | | | - T. Meek
- Association of Anaesthetists London UK
| |
Collapse
|
20
|
Ferguson K, Johnston PW. Law, litigation and learning: a legacy from COVID-19. Anaesthesia 2020; 75:1428-1431. [PMID: 32926404 DOI: 10.1111/anae.15241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/27/2020] [Indexed: 11/29/2022]
Affiliation(s)
- K Ferguson
- Department of Anaesthesia, NHS Grampian, Aberdeen, UK
| | - P W Johnston
- Department of Pathology, NHS Grampian, Aberdeen, UK.,Centre for Healthcare Education Research and Innovation, University of Aberdeen, Aberdeen, UK
| |
Collapse
|
21
|
McGrath BA, Ashby N, Birchall M, Dean P, Doherty C, Ferguson K, Gimblett J, Grocott M, Jacob T, Kerawala C, Macnaughton P, Magennis P, Moonesinghe R, Twose P, Wallace S, Higgs A. Multidisciplinary guidance for safe tracheostomy care during the COVID-19 pandemic: the NHS National Patient Safety Improvement Programme (NatPatSIP). Anaesthesia 2020; 75:1659-1670. [PMID: 32396986 PMCID: PMC7272992 DOI: 10.1111/anae.15120] [Citation(s) in RCA: 54] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/10/2020] [Indexed: 12/18/2022]
Abstract
The COVID-19 pandemic is causing a significant increase in the number of patients requiring relatively prolonged invasive mechanical ventilation and an associated surge in patients who need a tracheostomy to facilitate weaning from respiratory support. In parallel, there has been a global increase in guidance from professional bodies representing staff who care for patients with tracheostomies at different points in their acute hospital journey, rehabilitation and recovery. Of concern are the risks to healthcare staff of infection arising from tracheostomy insertion and caring for patients with a tracheostomy. Hospitals are also facing extraordinary demands on critical care services such that many patients who require a tracheostomy will be managed outside established intensive care or head and neck units and cared for by staff with little tracheostomy experience. These concerns led NHS England and NHS Improvement to expedite the National Patient Safety Improvement Programme's 'Safe Tracheostomy Care' workstream as part of the NHS COVID-19 response. Supporting this workstream, UK stakeholder organisations involved in tracheostomy care were invited to develop consensus guidance based on: expert opinion; the best available published literature; and existing multidisciplinary guidelines. Topics with direct relevance for frontline staff were identified. This consensus guidance includes: infectivity of patients with respect to tracheostomy indications and timing; aerosol-generating procedures and risks to staff; insertion procedures; and management following tracheostomy.
Collapse
Affiliation(s)
- B A McGrath
- Department of Intensive Care Medicine, Wythenshawe Hospital, Manchester University Hospital NHS Foundation Trust, National Tracheostomy Safety Project, Manchester, UK
| | - N Ashby
- Royal College of Nursing, University of Nottingham, Nottingham, UK
| | - M Birchall
- British Laryngological Association, University College London, London, UK
| | - P Dean
- Intensive Care Society, Royal Blackburn Teaching Hospital, Lancashire, UK
| | - C Doherty
- Royal Manchester Children's Hospital, National Tracheostomy Safety Project Paediatric Lead, Manchester University NHS Foundation Trust, Manchester, UK
| | - K Ferguson
- Aberdeen Royal Infirmary, Association of Anaesthetists, Aberdeen, UK
| | | | - M Grocott
- Anaesthesia and Critical Care, Royal College of Anaesthetists, University of Southampton, Southampton, UK
| | - T Jacob
- ENT & Head and Neck surgeon, Lewisham & Greenwich NHS Trust, ENT-UKt, London, UK
| | - C Kerawala
- Maxillofacial & Head and Neck Surgeon, The Royal Marsden Hospital, British Association of Head & Neck Oncologists, London, UK
| | - P Macnaughton
- Intensive Care Medicine at Derriford Hospital, Faculty of Intensive Care Medicine, Plymouth, UK
| | - P Magennis
- Oral and Maxillofacial Surgeon, Aintree University Hospital, NHS Foundation Trust, British Association of Oral and Maxillofacial Surgeons, Liverpool, UK
| | - R Moonesinghe
- Anaesthetics and Critical Care Medicine, NHS England & NHS Improvement, University College London Hospitals, London, UK
| | - P Twose
- Association of Chartered Physiotherapists in Respiratory Care, Cardiff and Vale University Health Board, Cardiff, UK
| | - S Wallace
- Speech & Language Therapist, Royal College of Speech & Language Therapists, Manchester University NHS Foundation Trust, Manchester, UK
| | - A Higgs
- Anaesthesia & Intensive Care Medicine, Warrington & Halton Teaching Hospitals NHS Foundation Trust, Difficult Airway Society, Warrington, UK
| |
Collapse
|
22
|
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]
|
23
|
Nathanson MH, Andrzejowski J, Dinsmore J, Eynon CA, Ferguson K, Hooper T, Kashyap A, Kendall J, McCormack V, Shinde S, Smith A, Thomas E. Guidelines for safe transfer of the brain-injured patient: trauma and stroke, 2019: Guidelines from the Association of Anaesthetists and the Neuro Anaesthesia and Critical Care Society. Anaesthesia 2019; 75:234-246. [PMID: 31788789 DOI: 10.1111/anae.14866] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/31/2019] [Indexed: 12/16/2022]
Abstract
The location of care for many brain-injured patients has changed since 2012 following the development of major trauma centres. Advances in management of ischaemic stroke have led to the urgent transfer of many more patients. The basis of care has remained largely unchanged, however, with emphasis on maintaining adequate cerebral perfusion as the key to preventing secondary injury. Organisational aspects and training for transfers are highlighted, and we have included an expanded section on paediatric transfers. We have also provided a table with suggested blood pressure parameters for the common types of brain injury but acknowledge that there is little evidence for many of our recommendations. These guidelines remain a mix of evidence-based and consensus-based statements. We have received assistance from many organisations representing clinicians who care for these patients, and we believe our views represent the best of current thinking and opinion. We encourage departments to review their own practice using our suggestions for audit and quality improvement.
Collapse
Affiliation(s)
- M H Nathanson
- Department of Anaesthesia, Nottingham University Hospitals NHS Trust, Nottingham, UK.,Association of Anaesthetists (Working Party Chair)
| | - J Andrzejowski
- Department of Anaesthesia, Sheffield Teaching Hospitals NHS Trust, Sheffield, UK.,Neuro Anaesthesia and Critical Care Society (NACCS)
| | - J Dinsmore
- Department of Anaesthesia, St George's University Hospital NHS Trust, London, UK.,Royal College of Anaesthetists
| | - C A Eynon
- Department of Intensive Care, University Hospitals Southampton NHS Foundation Trust, Southampton, UK.,Intensive Care Societies of England, Ireland, Scotland and Wales
| | - K Ferguson
- Department of Anaesthesia, Aberdeen Royal Infirmary, Aberdeen.,Association of Anaesthetists
| | - T Hooper
- Department of Intensive Care and Anaesthesia, North Bristol NHS Trust, Bristol, UK.,Defence Medical Services
| | - A Kashyap
- Department of Paediatric Intensive Care, Great North Children's Hospital, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle, UK.,Paediatric Intensive Care Society
| | - J Kendall
- Department of Emergency Medicine, Southmead Hospital, North Bristol NHS Trust, Bristol, UK.,Royal College of Emergency Medicine
| | - V McCormack
- Anaesthesia and Intensive Care Medicine, North West Deanery.,Association of Anaesthetists Trainee Committee
| | - S Shinde
- Department of Anaesthesia, Southmead Hospital, North Bristol NHS Trust, Bristol, UK.,Association of Anaesthetists
| | - A Smith
- Department of Anaesthesia, Royal Lancaster Infirmary, Lancaster, UK
| | - E Thomas
- Departments of Anaesthesia and Intensive Care Medicine, University Hospitals Plymouth NHS Trust, UK.,NACCS
| |
Collapse
|
24
|
McClelland L, Plunkett E, McCrossan R, Ferguson K, Fraser J, Gildersleve C, Holland J, Lomas JP, Redfern N, Pandit JJ. A national survey of out-of-hours working and fatigue in consultants in anaesthesia and paediatric intensive care in the UK and Ireland. Anaesthesia 2019; 74:1509-1523. [PMID: 31478198 DOI: 10.1111/anae.14819] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/31/2019] [Indexed: 11/30/2022]
Abstract
The tragic death of an anaesthetic trainee driving home after a series of night shifts prompted a national survey of fatigue in trainee anaesthetists. This indicated that fatigue was widespread, with significant impact on trainees' health and well-being. Consultants deliver an increasing proportion of patient care resulting in long periods of continuous daytime duty and overnight on-call work, so we wished to investigate their experience of out-of-hours working and the causes and impact of work-related fatigue. We conducted a national survey of consultant anaesthetists and paediatric intensivists in the UK and Ireland between 25 June and 6 August 2018. The response rate was 46% (94% of hospitals were represented): 84% of respondents (95%CI 83.1-84.9%) contribute to a night on-call rota with 32% (30.9-33.1%) working 1:8 or more frequently. Sleep disturbance on-call is common: 47% (45.6-48.4%) typically receive two to three phone calls overnight, and 48% (46.6-49.4%) take 30 min or more to fall back to sleep. Only 15% (14.0-16.0%) reported always achieving 11 h of rest between their on-call and their next clinical duty, as stipulated by the European Working Time Directive. Moreover, 24% (22.8-25.2%) stated that there is no departmental arrangement for covering scheduled clinical duties following a night on-call if they have been in the hospital overnight. Overall, 91% (90.3-91.7%) reported work-related fatigue with over half reporting a moderate or significantly negative impact on health, well-being and home life. We discuss potential explanations for these results and ways to mitigate the effects of fatigue among consultants.
Collapse
Affiliation(s)
- L McClelland
- Department of Intensive Care Medicine and Anaesthesia, Royal Gwent Hospital, Newport, UK
| | - E Plunkett
- Department of Anaesthesia, Queen Elizabeth Hospital Birmingham, Birmingham, UK
| | - R McCrossan
- Department of Anaesthesia, Newcastle upon Tyne NHS Foundation Trust, Newcastle, UK
| | - K Ferguson
- Department of Anaesthesia, Aberdeen Royal Infirmary, Aberdeen, UK
| | - J Fraser
- Department of Paediatric Intensive Care, Bristol Royal Hospital for Children, Bristol, UK
| | - C Gildersleve
- Department of Paediatric Anaesthesia, Children's Hospital for Wales, Cardiff, UK
| | - J Holland
- Department of Anaesthesia, Princess of Wales Hospital, Bridgend, UK
| | - J P Lomas
- Department of Anaesthesia and Intensive Care, Bolton Foundation Trust, Bolton, UK
| | - N Redfern
- Department of Anaesthesia, Newcastle upon Tyne NHS Foundation Trust, Newcastle, UK
| | - J J Pandit
- Nuffield Department of Anaesthesia, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| |
Collapse
|
25
|
Nones K, Johnson J, Newell F, Patch AM, Thorne H, Kazakoff SH, de Luca XM, Parsons MT, Ferguson K, Reid LE, McCart Reed AE, Srihari S, Lakis V, Davidson AL, Mukhopadhyay P, Holmes O, Xu Q, Wood S, Leonard C, Beesley J, Harris JM, Barnes D, Degasperi A, Ragan MA, Spurdle AB, Khanna KK, Lakhani SR, Pearson JV, Nik-Zainal S, Chenevix-Trench G, Waddell N, Simpson PT. Whole-genome sequencing reveals clinically relevant insights into the aetiology of familial breast cancers. Ann Oncol 2019; 30:1071-1079. [PMID: 31090900 PMCID: PMC6637375 DOI: 10.1093/annonc/mdz132] [Citation(s) in RCA: 51] [Impact Index Per Article: 10.2] [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] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Whole-genome sequencing (WGS) is a powerful method for revealing the diversity and complexity of the somatic mutation burden of tumours. Here, we investigated the utility of tumour and matched germline WGS for understanding aetiology and treatment opportunities for high-risk individuals with familial breast cancer. PATIENTS AND METHODS We carried out WGS on 78 paired germline and tumour DNA samples from individuals carrying pathogenic variants in BRCA1 (n = 26) or BRCA2 (n = 22) or from non-carriers (non-BRCA1/2; n = 30). RESULTS Matched germline/tumour WGS and somatic mutational signature analysis revealed patients with unreported, dual pathogenic germline variants in cancer risk genes (BRCA1/BRCA2; BRCA1/MUTYH). The strategy identified that 100% of tumours from BRCA1 carriers and 91% of tumours from BRCA2 carriers exhibited biallelic inactivation of the respective gene, together with somatic mutational signatures suggestive of a functional deficiency in homologous recombination. A set of non-BRCA1/2 tumours also had somatic signatures indicative of BRCA-deficiency, including tumours with BRCA1 promoter methylation, and tumours from carriers of a PALB2 pathogenic germline variant and a BRCA2 variant of uncertain significance. A subset of 13 non-BRCA1/2 tumours from early onset cases were BRCA-proficient, yet displayed complex clustered structural rearrangements associated with the amplification of oncogenes and pathogenic germline variants in TP53, ATM and CHEK2. CONCLUSIONS Our study highlights the role that WGS of matched germline/tumour DNA and the somatic mutational signatures can play in the discovery of pathogenic germline variants and for providing supporting evidence for variant pathogenicity. WGS-derived signatures were more robust than germline status and other genomic predictors of homologous recombination deficiency, thus impacting the selection of platinum-based or PARP inhibitor therapy. In this first examination of non-BRCA1/2 tumours by WGS, we illustrate the considerable heterogeneity of these tumour genomes and highlight that complex genomic rearrangements may drive tumourigenesis in a subset of cases.
Collapse
Affiliation(s)
- K Nones
- Medical Genomics Group, QIMR Berghofer Medical Research Institute, Brisbane, QLD
| | - J Johnson
- Faculty of Medicine, Centre for Clinical Research, The University of Queensland, Brisbane, QLD
| | - F Newell
- Medical Genomics Group, QIMR Berghofer Medical Research Institute, Brisbane, QLD
| | - A M Patch
- Medical Genomics Group, QIMR Berghofer Medical Research Institute, Brisbane, QLD
| | - H Thorne
- kConFab Investigators, The Peter MacCallum Cancer Centre, Melbourne, VIC; Sir Peter MacCallum Department of Oncology, The University of Melbourne, Melbourne, VIC
| | - S H Kazakoff
- Medical Genomics Group, QIMR Berghofer Medical Research Institute, Brisbane, QLD
| | - X M de Luca
- Faculty of Medicine, Centre for Clinical Research, The University of Queensland, Brisbane, QLD
| | - M T Parsons
- Molecular Cancer Epidemiology Group, QIMR Berghofer Medical Research Institute, Brisbane, QLD
| | - K Ferguson
- Faculty of Medicine, Centre for Clinical Research, The University of Queensland, Brisbane, QLD
| | - L E Reid
- Faculty of Medicine, Centre for Clinical Research, The University of Queensland, Brisbane, QLD
| | - A E McCart Reed
- Faculty of Medicine, Centre for Clinical Research, The University of Queensland, Brisbane, QLD
| | - S Srihari
- Faculty of Medicine, Centre for Clinical Research, The University of Queensland, Brisbane, QLD; Institute for Molecular Bioscience, The University of Queensland, Brisbane, QLD
| | - V Lakis
- Medical Genomics Group, QIMR Berghofer Medical Research Institute, Brisbane, QLD
| | - A L Davidson
- Medical Genomics Group, QIMR Berghofer Medical Research Institute, Brisbane, QLD; Faculty of Medicine, The University of Queensland, Brisbane, QLD
| | - P Mukhopadhyay
- Medical Genomics Group, QIMR Berghofer Medical Research Institute, Brisbane, QLD
| | - O Holmes
- Genome Informatics Group, QIMR Berghofer Medical Research Institute, Brisbane, QLD
| | - Q Xu
- Genome Informatics Group, QIMR Berghofer Medical Research Institute, Brisbane, QLD
| | - S Wood
- Genome Informatics Group, QIMR Berghofer Medical Research Institute, Brisbane, QLD
| | - C Leonard
- Genome Informatics Group, QIMR Berghofer Medical Research Institute, Brisbane, QLD
| | - J Beesley
- Cancer Genetics Group, QIMR Berghofer Medical Research Institute, Brisbane, QLD
| | - J M Harris
- Faculty of Health, School Biomedical Science - Queensland University of Technology, Brisbane, QLD, Australia
| | - D Barnes
- Department of Public Health and Primary Care, Centre for Cancer Genetic Epidemiology, University of Cambridge, Cambridge
| | - A Degasperi
- MRC Cancer Unit, Hutchison/MRC Research Centre, University of Cambridge, Cambridge; Department of Medical Genetics, The Clinical School, University of Cambridge, Cambridge, UK
| | - M A Ragan
- Institute for Molecular Bioscience, The University of Queensland, Brisbane, QLD
| | - A B Spurdle
- Molecular Cancer Epidemiology Group, QIMR Berghofer Medical Research Institute, Brisbane, QLD
| | - K K Khanna
- Signal Transduction Group, QIMR Berghofer Medical Research Institute, Brisbane, QLD
| | - S R Lakhani
- Faculty of Medicine, Centre for Clinical Research, The University of Queensland, Brisbane, QLD; Royal Brisbane & Women's Hospital, Pathology Queensland, Brisbane, QLD, Australia
| | - J V Pearson
- Genome Informatics Group, QIMR Berghofer Medical Research Institute, Brisbane, QLD
| | - S Nik-Zainal
- MRC Cancer Unit, Hutchison/MRC Research Centre, University of Cambridge, Cambridge; Department of Medical Genetics, The Clinical School, University of Cambridge, Cambridge, UK
| | - G Chenevix-Trench
- Cancer Genetics Group, QIMR Berghofer Medical Research Institute, Brisbane, QLD
| | - N Waddell
- Medical Genomics Group, QIMR Berghofer Medical Research Institute, Brisbane, QLD.
| | - P T Simpson
- Faculty of Medicine, Centre for Clinical Research, The University of Queensland, Brisbane, QLD.
| |
Collapse
|
26
|
Ferguson K, Meek T. Offsetting the genotoxic effects of sleep disruption. A reply. Anaesthesia 2019; 74:941. [DOI: 10.1111/anae.14710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
| | - T. Meek
- Association of Anaesthetists London UK
| |
Collapse
|
27
|
Ferguson K, Bouza B, Caldwell A, Rosa-Caldwell M, Blunt-Vinti H. 123 Sex Hormone Fluctuations and Their Effects on Sexual Function of IUS Users. J Sex Med 2019. [DOI: 10.1016/j.jsxm.2019.03.560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
28
|
Orska T, Pierce S, Ferguson K, Bossley C, Brugha R. P354 How often do under 2 year-old's cough during cough swabs? Does it make any difference to the microbiology results? Audit of samples at a tertiary cystic fibrosis centre. J Cyst Fibros 2019. [DOI: 10.1016/s1569-1993(19)30646-0] [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]
|
29
|
Simpson P, Nones K, Johnson J, Newell F, Patch AM, Thorne H, Kazakoff S, De Luca X, Parsons M, Ferguson K, Reid L, McCart Reed A, Srihari S, Lakis V, Davidson A, Mukhopadhyay P, Holmes O, Xu Q, Wood S, Leonard C, Beasley J, Degasperi A, Nik-Zainal S, Ragan M, Spurdle A, Khanna KK, Lakhani S, Pearson J, Chenevix-Trench G, Waddell N. Abstract P5-10-01: Using whole genome sequencing and somatic mutation signatures to unravel insight into familial breast cancer aetiology. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p5-10-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Approximately 10-15% of breast cancers are associated with a strong family history of disease. Pathogenic variants in BRCA1, BRCA2 or other moderate to highly penetrant susceptibility genes (e.g. TP53, ATM, CHEK2, PALB2 and PTEN) account for a number of breast cancer families. However, for over 50% of families the underlying genetic contribution to their risk remains unknown (termed here as non-BRCA1/2). This has a profound impact for how individuals and their families are managed in the clinic. We applied whole genome sequencing (WGS) to determine whether somatic mutation analysis can reveal insight into the aetiology of familial breast cancer. The full repertoire of somatic mutations was evaluated in 26 BRCA1, 22 BRCA2 and 32 non-BRCA1/2 tumours; including SNPs, indels, copy number changes and structural rearrangements, and mutational signatures. Genomes were also analysed using the HRD Index and HRDetect, as predictors of homologous recombination deficiency. BRCA1, BRCA2 and non-BRCA1/2 tumours exhibited a different burden of mutations, a different spectrum of mutational signatures and different telomere length. Based on collective patterns of mutation signatures, tumours were classified as 'BRCA1-like', 'BRCA2-like' or 'non-BRCA1/2-like' with a 15% rate of tumour re-classification from their original clinical BRCA status. The results demonstrate the power of WGS to differentiate between BRCA1 and BRCA2 driven tumours; in the identification of double-pathogenic germline mutation carriers based on the resulting somatic mutation signature; and in the interpretation of BRCA unclassified variants. WGS of tumour genomes reveals fascinating insights into tumour aetiology and could compliment current genetic testing of breast cancer families.
Citation Format: Simpson P, Nones K, Johnson J, Newell F, Patch A-M, Thorne H, Kazakoff S, De Luca X, Parsons M, Ferguson K, Reid L, McCart Reed A, Srihari S, Lakis V, Davidson A, Mukhopadhyay P, Holmes O, Xu Q, Wood S, Leonard C, Beasley J, Degasperi A, Nik-Zainal S, Ragan M, Spurdle A, Khanna KK, Lakhani S, Pearson J, Chenevix-Trench G, Waddell N. Using whole genome sequencing and somatic mutation signatures to unravel insight into familial breast cancer aetiology [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P5-10-01.
Collapse
Affiliation(s)
- P Simpson
- The University of Queensland, Brisbane, Australia; QIMR Berghofer Medical Research Institute, Brisbane, Australia; Peter MacCallum Cancer Centre, Melbourne, Australia; University of Cambridge, Cambridge, United Kingdom; Westmead Institute for Medical Research, Sydney, Australia
| | - K Nones
- The University of Queensland, Brisbane, Australia; QIMR Berghofer Medical Research Institute, Brisbane, Australia; Peter MacCallum Cancer Centre, Melbourne, Australia; University of Cambridge, Cambridge, United Kingdom; Westmead Institute for Medical Research, Sydney, Australia
| | - J Johnson
- The University of Queensland, Brisbane, Australia; QIMR Berghofer Medical Research Institute, Brisbane, Australia; Peter MacCallum Cancer Centre, Melbourne, Australia; University of Cambridge, Cambridge, United Kingdom; Westmead Institute for Medical Research, Sydney, Australia
| | - F Newell
- The University of Queensland, Brisbane, Australia; QIMR Berghofer Medical Research Institute, Brisbane, Australia; Peter MacCallum Cancer Centre, Melbourne, Australia; University of Cambridge, Cambridge, United Kingdom; Westmead Institute for Medical Research, Sydney, Australia
| | - A-M Patch
- The University of Queensland, Brisbane, Australia; QIMR Berghofer Medical Research Institute, Brisbane, Australia; Peter MacCallum Cancer Centre, Melbourne, Australia; University of Cambridge, Cambridge, United Kingdom; Westmead Institute for Medical Research, Sydney, Australia
| | - H Thorne
- The University of Queensland, Brisbane, Australia; QIMR Berghofer Medical Research Institute, Brisbane, Australia; Peter MacCallum Cancer Centre, Melbourne, Australia; University of Cambridge, Cambridge, United Kingdom; Westmead Institute for Medical Research, Sydney, Australia
| | - S Kazakoff
- The University of Queensland, Brisbane, Australia; QIMR Berghofer Medical Research Institute, Brisbane, Australia; Peter MacCallum Cancer Centre, Melbourne, Australia; University of Cambridge, Cambridge, United Kingdom; Westmead Institute for Medical Research, Sydney, Australia
| | - X De Luca
- The University of Queensland, Brisbane, Australia; QIMR Berghofer Medical Research Institute, Brisbane, Australia; Peter MacCallum Cancer Centre, Melbourne, Australia; University of Cambridge, Cambridge, United Kingdom; Westmead Institute for Medical Research, Sydney, Australia
| | - M Parsons
- The University of Queensland, Brisbane, Australia; QIMR Berghofer Medical Research Institute, Brisbane, Australia; Peter MacCallum Cancer Centre, Melbourne, Australia; University of Cambridge, Cambridge, United Kingdom; Westmead Institute for Medical Research, Sydney, Australia
| | - K Ferguson
- The University of Queensland, Brisbane, Australia; QIMR Berghofer Medical Research Institute, Brisbane, Australia; Peter MacCallum Cancer Centre, Melbourne, Australia; University of Cambridge, Cambridge, United Kingdom; Westmead Institute for Medical Research, Sydney, Australia
| | - L Reid
- The University of Queensland, Brisbane, Australia; QIMR Berghofer Medical Research Institute, Brisbane, Australia; Peter MacCallum Cancer Centre, Melbourne, Australia; University of Cambridge, Cambridge, United Kingdom; Westmead Institute for Medical Research, Sydney, Australia
| | - A McCart Reed
- The University of Queensland, Brisbane, Australia; QIMR Berghofer Medical Research Institute, Brisbane, Australia; Peter MacCallum Cancer Centre, Melbourne, Australia; University of Cambridge, Cambridge, United Kingdom; Westmead Institute for Medical Research, Sydney, Australia
| | - S Srihari
- The University of Queensland, Brisbane, Australia; QIMR Berghofer Medical Research Institute, Brisbane, Australia; Peter MacCallum Cancer Centre, Melbourne, Australia; University of Cambridge, Cambridge, United Kingdom; Westmead Institute for Medical Research, Sydney, Australia
| | - V Lakis
- The University of Queensland, Brisbane, Australia; QIMR Berghofer Medical Research Institute, Brisbane, Australia; Peter MacCallum Cancer Centre, Melbourne, Australia; University of Cambridge, Cambridge, United Kingdom; Westmead Institute for Medical Research, Sydney, Australia
| | - A Davidson
- The University of Queensland, Brisbane, Australia; QIMR Berghofer Medical Research Institute, Brisbane, Australia; Peter MacCallum Cancer Centre, Melbourne, Australia; University of Cambridge, Cambridge, United Kingdom; Westmead Institute for Medical Research, Sydney, Australia
| | - P Mukhopadhyay
- The University of Queensland, Brisbane, Australia; QIMR Berghofer Medical Research Institute, Brisbane, Australia; Peter MacCallum Cancer Centre, Melbourne, Australia; University of Cambridge, Cambridge, United Kingdom; Westmead Institute for Medical Research, Sydney, Australia
| | - O Holmes
- The University of Queensland, Brisbane, Australia; QIMR Berghofer Medical Research Institute, Brisbane, Australia; Peter MacCallum Cancer Centre, Melbourne, Australia; University of Cambridge, Cambridge, United Kingdom; Westmead Institute for Medical Research, Sydney, Australia
| | - Q Xu
- The University of Queensland, Brisbane, Australia; QIMR Berghofer Medical Research Institute, Brisbane, Australia; Peter MacCallum Cancer Centre, Melbourne, Australia; University of Cambridge, Cambridge, United Kingdom; Westmead Institute for Medical Research, Sydney, Australia
| | - S Wood
- The University of Queensland, Brisbane, Australia; QIMR Berghofer Medical Research Institute, Brisbane, Australia; Peter MacCallum Cancer Centre, Melbourne, Australia; University of Cambridge, Cambridge, United Kingdom; Westmead Institute for Medical Research, Sydney, Australia
| | - C Leonard
- The University of Queensland, Brisbane, Australia; QIMR Berghofer Medical Research Institute, Brisbane, Australia; Peter MacCallum Cancer Centre, Melbourne, Australia; University of Cambridge, Cambridge, United Kingdom; Westmead Institute for Medical Research, Sydney, Australia
| | - J Beasley
- The University of Queensland, Brisbane, Australia; QIMR Berghofer Medical Research Institute, Brisbane, Australia; Peter MacCallum Cancer Centre, Melbourne, Australia; University of Cambridge, Cambridge, United Kingdom; Westmead Institute for Medical Research, Sydney, Australia
| | - A Degasperi
- The University of Queensland, Brisbane, Australia; QIMR Berghofer Medical Research Institute, Brisbane, Australia; Peter MacCallum Cancer Centre, Melbourne, Australia; University of Cambridge, Cambridge, United Kingdom; Westmead Institute for Medical Research, Sydney, Australia
| | - S Nik-Zainal
- The University of Queensland, Brisbane, Australia; QIMR Berghofer Medical Research Institute, Brisbane, Australia; Peter MacCallum Cancer Centre, Melbourne, Australia; University of Cambridge, Cambridge, United Kingdom; Westmead Institute for Medical Research, Sydney, Australia
| | - M Ragan
- The University of Queensland, Brisbane, Australia; QIMR Berghofer Medical Research Institute, Brisbane, Australia; Peter MacCallum Cancer Centre, Melbourne, Australia; University of Cambridge, Cambridge, United Kingdom; Westmead Institute for Medical Research, Sydney, Australia
| | - A Spurdle
- The University of Queensland, Brisbane, Australia; QIMR Berghofer Medical Research Institute, Brisbane, Australia; Peter MacCallum Cancer Centre, Melbourne, Australia; University of Cambridge, Cambridge, United Kingdom; Westmead Institute for Medical Research, Sydney, Australia
| | - KK Khanna
- The University of Queensland, Brisbane, Australia; QIMR Berghofer Medical Research Institute, Brisbane, Australia; Peter MacCallum Cancer Centre, Melbourne, Australia; University of Cambridge, Cambridge, United Kingdom; Westmead Institute for Medical Research, Sydney, Australia
| | - S Lakhani
- The University of Queensland, Brisbane, Australia; QIMR Berghofer Medical Research Institute, Brisbane, Australia; Peter MacCallum Cancer Centre, Melbourne, Australia; University of Cambridge, Cambridge, United Kingdom; Westmead Institute for Medical Research, Sydney, Australia
| | - J Pearson
- The University of Queensland, Brisbane, Australia; QIMR Berghofer Medical Research Institute, Brisbane, Australia; Peter MacCallum Cancer Centre, Melbourne, Australia; University of Cambridge, Cambridge, United Kingdom; Westmead Institute for Medical Research, Sydney, Australia
| | - G Chenevix-Trench
- The University of Queensland, Brisbane, Australia; QIMR Berghofer Medical Research Institute, Brisbane, Australia; Peter MacCallum Cancer Centre, Melbourne, Australia; University of Cambridge, Cambridge, United Kingdom; Westmead Institute for Medical Research, Sydney, Australia
| | - N Waddell
- The University of Queensland, Brisbane, Australia; QIMR Berghofer Medical Research Institute, Brisbane, Australia; Peter MacCallum Cancer Centre, Melbourne, Australia; University of Cambridge, Cambridge, United Kingdom; Westmead Institute for Medical Research, Sydney, Australia
| |
Collapse
|
30
|
McCart Reed AE, Kalaw E, Nones K, Bettington M, Lim M, Bennett J, Johnstone K, Kutasovic JR, Kazakoff S, Xu QC, Saunus JM, Reid LE, Black D, Niland C, Ferguson K, Gresshoff I, Raghavendra A, Liu JC, Kalinowski L, Reid AS, Davidson M, Pearson JV, Yamaguchi R, Harris G, Tse G, Papadimos D, Pathmanathan R, Pathmanathan N, Tan PH, Fox S, O'Toole S, Waddell N, Simpson PT, Lakhani SR. Abstract P3-08-03: Dissecting the heterogeneity of metaplastic breast cancer: A morphological, immunohistochemical and genomic analysis of a large cohort. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p3-08-03] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Although rare, Metaplastic Breast Carcinomas (MBC) account for significant global breast cancer mortality. This subgroup is extremely heterogeneous and by definition exhibits metaplastic change to squamous and/or mesenchymal elements, including but not limited to spindle, squamous, chondroid, osseous and rhabdomyoid elements. The WHO working group recognizes that the current classification is inadequate and in the interim, has suggested a purely descriptive classification. The mixed epithelial-mesenchymal morphology has led to speculation that MBC represent 'stem cell tumours'; in support of this, MBC have been shown to have a CD44+/CD24-/low phenotype. Clinically, patients present with tumours that are larger (higher stage), have increased likelihood of distant metastases at presentation and overall, have a reduced 5-year survival rate compared to Invasive Carcinoma-NST. Hence, this is a unique subtype with poor outcome but without a robust classification or understanding of the biology to aid clinical management. We present a detailed morphological, immunohistochemical and genomic analysis of a large series of MBC (n=347), as amassed through the Asia-Pacific MBC consortium. We consider our morphological dissection using the WHO subtyping guidelines and show that an increasing number of phenotypes in a mixed MBC (classified as WHO_1) significantly associates with a poor prognosis. Immunohistochemical analysis showed that a pure spindle (WHO_5) is significantly less likely to express vimentin, CK5/6, CK14, and CK19 than a mixed WHO_1 with spindle features. Similarly, a WHO_1 with chondroid features is less likely to express EGFR than WHO_1 with chondroid features and rhabdoid or osseous differentiation. Across the cohort, positivity for the AE1/3 antibody and a lack of EGFR expression both significantly associate with a better outcome. We report no significant association between patient age at diagnosis and breast cancer specific survival, nor between age and specific WHO MBC subtypes. We report a significant association between WHO_1 types and increasing tumour grade, and also between tumour size and grade, with tumour size being a highly significant prognostic indicator in this cohort. Our exome sequencing confirms a significant enrichment for TP53 and PTEN mutations in MBC, and intriguingly for concurrent mutations of TP53, PTEN and PIK3CA. A novel enrichment for NF1 mutations is also presented. In summary, we provide a thorough assessment of a large cohort of MBC, including morphology, survival, IHC and exome sequencing, and present our analysis contextualized by the WHO guidelines, extending the existing knowledge base of this rare tumour type.
Citation Format: McCart Reed AE, Kalaw E, Nones K, Bettington M, Lim M, Bennett J, Johnstone K, Kutasovic JR, Kazakoff S, Xu QC, Saunus JM, Reid LE, Black D, Niland C, Ferguson K, Gresshoff I, Raghavendra A, Liu JC, Kalinowski L, Reid AS, Davidson M, Pearson JV, Yamaguchi R, Harris G, Tse G, Papadimos D, Pathmanathan R, Pathmanathan N, Tan PH, Fox S, O'Toole S, Waddell N, Simpson PT, Lakhani SR. Dissecting the heterogeneity of metaplastic breast cancer: A morphological, immunohistochemical and genomic analysis of a large cohort [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P3-08-03.
Collapse
Affiliation(s)
- AE McCart Reed
- University of Queensland, Brisbane, Australia; QIMR Berghofer Medical Research Institute, Brisbane, Australia; Pathology Queensland, The Royal Brisbane & Women's Hospital, Brisbane, Australia; Kurume University School of Medicine, Kurume, Japan; Canterbury Health Laboratories, Christchurch, New Zealand; Prince of Wales Hospital, Hong Kong, Hong Kong; Sullivan Nicolaides Pathology, Brisbane, Australia; Sime Darby Medical Centre, Selangor, Malaysia; Westmead Breast Cancer Institute; University of Sydney, Sydney, Australia; Singapore General Hospital, Singapore, Singapore; Peter MacCallum Cancer Centre, Melbourne, Australia; Garvan Institute of Medical Research and the Kinghorn Cancer Centre, Sydney, Australia
| | - E Kalaw
- University of Queensland, Brisbane, Australia; QIMR Berghofer Medical Research Institute, Brisbane, Australia; Pathology Queensland, The Royal Brisbane & Women's Hospital, Brisbane, Australia; Kurume University School of Medicine, Kurume, Japan; Canterbury Health Laboratories, Christchurch, New Zealand; Prince of Wales Hospital, Hong Kong, Hong Kong; Sullivan Nicolaides Pathology, Brisbane, Australia; Sime Darby Medical Centre, Selangor, Malaysia; Westmead Breast Cancer Institute; University of Sydney, Sydney, Australia; Singapore General Hospital, Singapore, Singapore; Peter MacCallum Cancer Centre, Melbourne, Australia; Garvan Institute of Medical Research and the Kinghorn Cancer Centre, Sydney, Australia
| | - K Nones
- University of Queensland, Brisbane, Australia; QIMR Berghofer Medical Research Institute, Brisbane, Australia; Pathology Queensland, The Royal Brisbane & Women's Hospital, Brisbane, Australia; Kurume University School of Medicine, Kurume, Japan; Canterbury Health Laboratories, Christchurch, New Zealand; Prince of Wales Hospital, Hong Kong, Hong Kong; Sullivan Nicolaides Pathology, Brisbane, Australia; Sime Darby Medical Centre, Selangor, Malaysia; Westmead Breast Cancer Institute; University of Sydney, Sydney, Australia; Singapore General Hospital, Singapore, Singapore; Peter MacCallum Cancer Centre, Melbourne, Australia; Garvan Institute of Medical Research and the Kinghorn Cancer Centre, Sydney, Australia
| | - M Bettington
- University of Queensland, Brisbane, Australia; QIMR Berghofer Medical Research Institute, Brisbane, Australia; Pathology Queensland, The Royal Brisbane & Women's Hospital, Brisbane, Australia; Kurume University School of Medicine, Kurume, Japan; Canterbury Health Laboratories, Christchurch, New Zealand; Prince of Wales Hospital, Hong Kong, Hong Kong; Sullivan Nicolaides Pathology, Brisbane, Australia; Sime Darby Medical Centre, Selangor, Malaysia; Westmead Breast Cancer Institute; University of Sydney, Sydney, Australia; Singapore General Hospital, Singapore, Singapore; Peter MacCallum Cancer Centre, Melbourne, Australia; Garvan Institute of Medical Research and the Kinghorn Cancer Centre, Sydney, Australia
| | - M Lim
- University of Queensland, Brisbane, Australia; QIMR Berghofer Medical Research Institute, Brisbane, Australia; Pathology Queensland, The Royal Brisbane & Women's Hospital, Brisbane, Australia; Kurume University School of Medicine, Kurume, Japan; Canterbury Health Laboratories, Christchurch, New Zealand; Prince of Wales Hospital, Hong Kong, Hong Kong; Sullivan Nicolaides Pathology, Brisbane, Australia; Sime Darby Medical Centre, Selangor, Malaysia; Westmead Breast Cancer Institute; University of Sydney, Sydney, Australia; Singapore General Hospital, Singapore, Singapore; Peter MacCallum Cancer Centre, Melbourne, Australia; Garvan Institute of Medical Research and the Kinghorn Cancer Centre, Sydney, Australia
| | - J Bennett
- University of Queensland, Brisbane, Australia; QIMR Berghofer Medical Research Institute, Brisbane, Australia; Pathology Queensland, The Royal Brisbane & Women's Hospital, Brisbane, Australia; Kurume University School of Medicine, Kurume, Japan; Canterbury Health Laboratories, Christchurch, New Zealand; Prince of Wales Hospital, Hong Kong, Hong Kong; Sullivan Nicolaides Pathology, Brisbane, Australia; Sime Darby Medical Centre, Selangor, Malaysia; Westmead Breast Cancer Institute; University of Sydney, Sydney, Australia; Singapore General Hospital, Singapore, Singapore; Peter MacCallum Cancer Centre, Melbourne, Australia; Garvan Institute of Medical Research and the Kinghorn Cancer Centre, Sydney, Australia
| | - K Johnstone
- University of Queensland, Brisbane, Australia; QIMR Berghofer Medical Research Institute, Brisbane, Australia; Pathology Queensland, The Royal Brisbane & Women's Hospital, Brisbane, Australia; Kurume University School of Medicine, Kurume, Japan; Canterbury Health Laboratories, Christchurch, New Zealand; Prince of Wales Hospital, Hong Kong, Hong Kong; Sullivan Nicolaides Pathology, Brisbane, Australia; Sime Darby Medical Centre, Selangor, Malaysia; Westmead Breast Cancer Institute; University of Sydney, Sydney, Australia; Singapore General Hospital, Singapore, Singapore; Peter MacCallum Cancer Centre, Melbourne, Australia; Garvan Institute of Medical Research and the Kinghorn Cancer Centre, Sydney, Australia
| | - JR Kutasovic
- University of Queensland, Brisbane, Australia; QIMR Berghofer Medical Research Institute, Brisbane, Australia; Pathology Queensland, The Royal Brisbane & Women's Hospital, Brisbane, Australia; Kurume University School of Medicine, Kurume, Japan; Canterbury Health Laboratories, Christchurch, New Zealand; Prince of Wales Hospital, Hong Kong, Hong Kong; Sullivan Nicolaides Pathology, Brisbane, Australia; Sime Darby Medical Centre, Selangor, Malaysia; Westmead Breast Cancer Institute; University of Sydney, Sydney, Australia; Singapore General Hospital, Singapore, Singapore; Peter MacCallum Cancer Centre, Melbourne, Australia; Garvan Institute of Medical Research and the Kinghorn Cancer Centre, Sydney, Australia
| | - S Kazakoff
- University of Queensland, Brisbane, Australia; QIMR Berghofer Medical Research Institute, Brisbane, Australia; Pathology Queensland, The Royal Brisbane & Women's Hospital, Brisbane, Australia; Kurume University School of Medicine, Kurume, Japan; Canterbury Health Laboratories, Christchurch, New Zealand; Prince of Wales Hospital, Hong Kong, Hong Kong; Sullivan Nicolaides Pathology, Brisbane, Australia; Sime Darby Medical Centre, Selangor, Malaysia; Westmead Breast Cancer Institute; University of Sydney, Sydney, Australia; Singapore General Hospital, Singapore, Singapore; Peter MacCallum Cancer Centre, Melbourne, Australia; Garvan Institute of Medical Research and the Kinghorn Cancer Centre, Sydney, Australia
| | - QC Xu
- University of Queensland, Brisbane, Australia; QIMR Berghofer Medical Research Institute, Brisbane, Australia; Pathology Queensland, The Royal Brisbane & Women's Hospital, Brisbane, Australia; Kurume University School of Medicine, Kurume, Japan; Canterbury Health Laboratories, Christchurch, New Zealand; Prince of Wales Hospital, Hong Kong, Hong Kong; Sullivan Nicolaides Pathology, Brisbane, Australia; Sime Darby Medical Centre, Selangor, Malaysia; Westmead Breast Cancer Institute; University of Sydney, Sydney, Australia; Singapore General Hospital, Singapore, Singapore; Peter MacCallum Cancer Centre, Melbourne, Australia; Garvan Institute of Medical Research and the Kinghorn Cancer Centre, Sydney, Australia
| | - JM Saunus
- University of Queensland, Brisbane, Australia; QIMR Berghofer Medical Research Institute, Brisbane, Australia; Pathology Queensland, The Royal Brisbane & Women's Hospital, Brisbane, Australia; Kurume University School of Medicine, Kurume, Japan; Canterbury Health Laboratories, Christchurch, New Zealand; Prince of Wales Hospital, Hong Kong, Hong Kong; Sullivan Nicolaides Pathology, Brisbane, Australia; Sime Darby Medical Centre, Selangor, Malaysia; Westmead Breast Cancer Institute; University of Sydney, Sydney, Australia; Singapore General Hospital, Singapore, Singapore; Peter MacCallum Cancer Centre, Melbourne, Australia; Garvan Institute of Medical Research and the Kinghorn Cancer Centre, Sydney, Australia
| | - LE Reid
- University of Queensland, Brisbane, Australia; QIMR Berghofer Medical Research Institute, Brisbane, Australia; Pathology Queensland, The Royal Brisbane & Women's Hospital, Brisbane, Australia; Kurume University School of Medicine, Kurume, Japan; Canterbury Health Laboratories, Christchurch, New Zealand; Prince of Wales Hospital, Hong Kong, Hong Kong; Sullivan Nicolaides Pathology, Brisbane, Australia; Sime Darby Medical Centre, Selangor, Malaysia; Westmead Breast Cancer Institute; University of Sydney, Sydney, Australia; Singapore General Hospital, Singapore, Singapore; Peter MacCallum Cancer Centre, Melbourne, Australia; Garvan Institute of Medical Research and the Kinghorn Cancer Centre, Sydney, Australia
| | - D Black
- University of Queensland, Brisbane, Australia; QIMR Berghofer Medical Research Institute, Brisbane, Australia; Pathology Queensland, The Royal Brisbane & Women's Hospital, Brisbane, Australia; Kurume University School of Medicine, Kurume, Japan; Canterbury Health Laboratories, Christchurch, New Zealand; Prince of Wales Hospital, Hong Kong, Hong Kong; Sullivan Nicolaides Pathology, Brisbane, Australia; Sime Darby Medical Centre, Selangor, Malaysia; Westmead Breast Cancer Institute; University of Sydney, Sydney, Australia; Singapore General Hospital, Singapore, Singapore; Peter MacCallum Cancer Centre, Melbourne, Australia; Garvan Institute of Medical Research and the Kinghorn Cancer Centre, Sydney, Australia
| | - C Niland
- University of Queensland, Brisbane, Australia; QIMR Berghofer Medical Research Institute, Brisbane, Australia; Pathology Queensland, The Royal Brisbane & Women's Hospital, Brisbane, Australia; Kurume University School of Medicine, Kurume, Japan; Canterbury Health Laboratories, Christchurch, New Zealand; Prince of Wales Hospital, Hong Kong, Hong Kong; Sullivan Nicolaides Pathology, Brisbane, Australia; Sime Darby Medical Centre, Selangor, Malaysia; Westmead Breast Cancer Institute; University of Sydney, Sydney, Australia; Singapore General Hospital, Singapore, Singapore; Peter MacCallum Cancer Centre, Melbourne, Australia; Garvan Institute of Medical Research and the Kinghorn Cancer Centre, Sydney, Australia
| | - K Ferguson
- University of Queensland, Brisbane, Australia; QIMR Berghofer Medical Research Institute, Brisbane, Australia; Pathology Queensland, The Royal Brisbane & Women's Hospital, Brisbane, Australia; Kurume University School of Medicine, Kurume, Japan; Canterbury Health Laboratories, Christchurch, New Zealand; Prince of Wales Hospital, Hong Kong, Hong Kong; Sullivan Nicolaides Pathology, Brisbane, Australia; Sime Darby Medical Centre, Selangor, Malaysia; Westmead Breast Cancer Institute; University of Sydney, Sydney, Australia; Singapore General Hospital, Singapore, Singapore; Peter MacCallum Cancer Centre, Melbourne, Australia; Garvan Institute of Medical Research and the Kinghorn Cancer Centre, Sydney, Australia
| | - I Gresshoff
- University of Queensland, Brisbane, Australia; QIMR Berghofer Medical Research Institute, Brisbane, Australia; Pathology Queensland, The Royal Brisbane & Women's Hospital, Brisbane, Australia; Kurume University School of Medicine, Kurume, Japan; Canterbury Health Laboratories, Christchurch, New Zealand; Prince of Wales Hospital, Hong Kong, Hong Kong; Sullivan Nicolaides Pathology, Brisbane, Australia; Sime Darby Medical Centre, Selangor, Malaysia; Westmead Breast Cancer Institute; University of Sydney, Sydney, Australia; Singapore General Hospital, Singapore, Singapore; Peter MacCallum Cancer Centre, Melbourne, Australia; Garvan Institute of Medical Research and the Kinghorn Cancer Centre, Sydney, Australia
| | - A Raghavendra
- University of Queensland, Brisbane, Australia; QIMR Berghofer Medical Research Institute, Brisbane, Australia; Pathology Queensland, The Royal Brisbane & Women's Hospital, Brisbane, Australia; Kurume University School of Medicine, Kurume, Japan; Canterbury Health Laboratories, Christchurch, New Zealand; Prince of Wales Hospital, Hong Kong, Hong Kong; Sullivan Nicolaides Pathology, Brisbane, Australia; Sime Darby Medical Centre, Selangor, Malaysia; Westmead Breast Cancer Institute; University of Sydney, Sydney, Australia; Singapore General Hospital, Singapore, Singapore; Peter MacCallum Cancer Centre, Melbourne, Australia; Garvan Institute of Medical Research and the Kinghorn Cancer Centre, Sydney, Australia
| | - JC Liu
- University of Queensland, Brisbane, Australia; QIMR Berghofer Medical Research Institute, Brisbane, Australia; Pathology Queensland, The Royal Brisbane & Women's Hospital, Brisbane, Australia; Kurume University School of Medicine, Kurume, Japan; Canterbury Health Laboratories, Christchurch, New Zealand; Prince of Wales Hospital, Hong Kong, Hong Kong; Sullivan Nicolaides Pathology, Brisbane, Australia; Sime Darby Medical Centre, Selangor, Malaysia; Westmead Breast Cancer Institute; University of Sydney, Sydney, Australia; Singapore General Hospital, Singapore, Singapore; Peter MacCallum Cancer Centre, Melbourne, Australia; Garvan Institute of Medical Research and the Kinghorn Cancer Centre, Sydney, Australia
| | - L Kalinowski
- University of Queensland, Brisbane, Australia; QIMR Berghofer Medical Research Institute, Brisbane, Australia; Pathology Queensland, The Royal Brisbane & Women's Hospital, Brisbane, Australia; Kurume University School of Medicine, Kurume, Japan; Canterbury Health Laboratories, Christchurch, New Zealand; Prince of Wales Hospital, Hong Kong, Hong Kong; Sullivan Nicolaides Pathology, Brisbane, Australia; Sime Darby Medical Centre, Selangor, Malaysia; Westmead Breast Cancer Institute; University of Sydney, Sydney, Australia; Singapore General Hospital, Singapore, Singapore; Peter MacCallum Cancer Centre, Melbourne, Australia; Garvan Institute of Medical Research and the Kinghorn Cancer Centre, Sydney, Australia
| | - AS Reid
- University of Queensland, Brisbane, Australia; QIMR Berghofer Medical Research Institute, Brisbane, Australia; Pathology Queensland, The Royal Brisbane & Women's Hospital, Brisbane, Australia; Kurume University School of Medicine, Kurume, Japan; Canterbury Health Laboratories, Christchurch, New Zealand; Prince of Wales Hospital, Hong Kong, Hong Kong; Sullivan Nicolaides Pathology, Brisbane, Australia; Sime Darby Medical Centre, Selangor, Malaysia; Westmead Breast Cancer Institute; University of Sydney, Sydney, Australia; Singapore General Hospital, Singapore, Singapore; Peter MacCallum Cancer Centre, Melbourne, Australia; Garvan Institute of Medical Research and the Kinghorn Cancer Centre, Sydney, Australia
| | - M Davidson
- University of Queensland, Brisbane, Australia; QIMR Berghofer Medical Research Institute, Brisbane, Australia; Pathology Queensland, The Royal Brisbane & Women's Hospital, Brisbane, Australia; Kurume University School of Medicine, Kurume, Japan; Canterbury Health Laboratories, Christchurch, New Zealand; Prince of Wales Hospital, Hong Kong, Hong Kong; Sullivan Nicolaides Pathology, Brisbane, Australia; Sime Darby Medical Centre, Selangor, Malaysia; Westmead Breast Cancer Institute; University of Sydney, Sydney, Australia; Singapore General Hospital, Singapore, Singapore; Peter MacCallum Cancer Centre, Melbourne, Australia; Garvan Institute of Medical Research and the Kinghorn Cancer Centre, Sydney, Australia
| | - JV Pearson
- University of Queensland, Brisbane, Australia; QIMR Berghofer Medical Research Institute, Brisbane, Australia; Pathology Queensland, The Royal Brisbane & Women's Hospital, Brisbane, Australia; Kurume University School of Medicine, Kurume, Japan; Canterbury Health Laboratories, Christchurch, New Zealand; Prince of Wales Hospital, Hong Kong, Hong Kong; Sullivan Nicolaides Pathology, Brisbane, Australia; Sime Darby Medical Centre, Selangor, Malaysia; Westmead Breast Cancer Institute; University of Sydney, Sydney, Australia; Singapore General Hospital, Singapore, Singapore; Peter MacCallum Cancer Centre, Melbourne, Australia; Garvan Institute of Medical Research and the Kinghorn Cancer Centre, Sydney, Australia
| | - R Yamaguchi
- University of Queensland, Brisbane, Australia; QIMR Berghofer Medical Research Institute, Brisbane, Australia; Pathology Queensland, The Royal Brisbane & Women's Hospital, Brisbane, Australia; Kurume University School of Medicine, Kurume, Japan; Canterbury Health Laboratories, Christchurch, New Zealand; Prince of Wales Hospital, Hong Kong, Hong Kong; Sullivan Nicolaides Pathology, Brisbane, Australia; Sime Darby Medical Centre, Selangor, Malaysia; Westmead Breast Cancer Institute; University of Sydney, Sydney, Australia; Singapore General Hospital, Singapore, Singapore; Peter MacCallum Cancer Centre, Melbourne, Australia; Garvan Institute of Medical Research and the Kinghorn Cancer Centre, Sydney, Australia
| | - G Harris
- University of Queensland, Brisbane, Australia; QIMR Berghofer Medical Research Institute, Brisbane, Australia; Pathology Queensland, The Royal Brisbane & Women's Hospital, Brisbane, Australia; Kurume University School of Medicine, Kurume, Japan; Canterbury Health Laboratories, Christchurch, New Zealand; Prince of Wales Hospital, Hong Kong, Hong Kong; Sullivan Nicolaides Pathology, Brisbane, Australia; Sime Darby Medical Centre, Selangor, Malaysia; Westmead Breast Cancer Institute; University of Sydney, Sydney, Australia; Singapore General Hospital, Singapore, Singapore; Peter MacCallum Cancer Centre, Melbourne, Australia; Garvan Institute of Medical Research and the Kinghorn Cancer Centre, Sydney, Australia
| | - G Tse
- University of Queensland, Brisbane, Australia; QIMR Berghofer Medical Research Institute, Brisbane, Australia; Pathology Queensland, The Royal Brisbane & Women's Hospital, Brisbane, Australia; Kurume University School of Medicine, Kurume, Japan; Canterbury Health Laboratories, Christchurch, New Zealand; Prince of Wales Hospital, Hong Kong, Hong Kong; Sullivan Nicolaides Pathology, Brisbane, Australia; Sime Darby Medical Centre, Selangor, Malaysia; Westmead Breast Cancer Institute; University of Sydney, Sydney, Australia; Singapore General Hospital, Singapore, Singapore; Peter MacCallum Cancer Centre, Melbourne, Australia; Garvan Institute of Medical Research and the Kinghorn Cancer Centre, Sydney, Australia
| | - D Papadimos
- University of Queensland, Brisbane, Australia; QIMR Berghofer Medical Research Institute, Brisbane, Australia; Pathology Queensland, The Royal Brisbane & Women's Hospital, Brisbane, Australia; Kurume University School of Medicine, Kurume, Japan; Canterbury Health Laboratories, Christchurch, New Zealand; Prince of Wales Hospital, Hong Kong, Hong Kong; Sullivan Nicolaides Pathology, Brisbane, Australia; Sime Darby Medical Centre, Selangor, Malaysia; Westmead Breast Cancer Institute; University of Sydney, Sydney, Australia; Singapore General Hospital, Singapore, Singapore; Peter MacCallum Cancer Centre, Melbourne, Australia; Garvan Institute of Medical Research and the Kinghorn Cancer Centre, Sydney, Australia
| | - R Pathmanathan
- University of Queensland, Brisbane, Australia; QIMR Berghofer Medical Research Institute, Brisbane, Australia; Pathology Queensland, The Royal Brisbane & Women's Hospital, Brisbane, Australia; Kurume University School of Medicine, Kurume, Japan; Canterbury Health Laboratories, Christchurch, New Zealand; Prince of Wales Hospital, Hong Kong, Hong Kong; Sullivan Nicolaides Pathology, Brisbane, Australia; Sime Darby Medical Centre, Selangor, Malaysia; Westmead Breast Cancer Institute; University of Sydney, Sydney, Australia; Singapore General Hospital, Singapore, Singapore; Peter MacCallum Cancer Centre, Melbourne, Australia; Garvan Institute of Medical Research and the Kinghorn Cancer Centre, Sydney, Australia
| | - N Pathmanathan
- University of Queensland, Brisbane, Australia; QIMR Berghofer Medical Research Institute, Brisbane, Australia; Pathology Queensland, The Royal Brisbane & Women's Hospital, Brisbane, Australia; Kurume University School of Medicine, Kurume, Japan; Canterbury Health Laboratories, Christchurch, New Zealand; Prince of Wales Hospital, Hong Kong, Hong Kong; Sullivan Nicolaides Pathology, Brisbane, Australia; Sime Darby Medical Centre, Selangor, Malaysia; Westmead Breast Cancer Institute; University of Sydney, Sydney, Australia; Singapore General Hospital, Singapore, Singapore; Peter MacCallum Cancer Centre, Melbourne, Australia; Garvan Institute of Medical Research and the Kinghorn Cancer Centre, Sydney, Australia
| | - PH Tan
- University of Queensland, Brisbane, Australia; QIMR Berghofer Medical Research Institute, Brisbane, Australia; Pathology Queensland, The Royal Brisbane & Women's Hospital, Brisbane, Australia; Kurume University School of Medicine, Kurume, Japan; Canterbury Health Laboratories, Christchurch, New Zealand; Prince of Wales Hospital, Hong Kong, Hong Kong; Sullivan Nicolaides Pathology, Brisbane, Australia; Sime Darby Medical Centre, Selangor, Malaysia; Westmead Breast Cancer Institute; University of Sydney, Sydney, Australia; Singapore General Hospital, Singapore, Singapore; Peter MacCallum Cancer Centre, Melbourne, Australia; Garvan Institute of Medical Research and the Kinghorn Cancer Centre, Sydney, Australia
| | - S Fox
- University of Queensland, Brisbane, Australia; QIMR Berghofer Medical Research Institute, Brisbane, Australia; Pathology Queensland, The Royal Brisbane & Women's Hospital, Brisbane, Australia; Kurume University School of Medicine, Kurume, Japan; Canterbury Health Laboratories, Christchurch, New Zealand; Prince of Wales Hospital, Hong Kong, Hong Kong; Sullivan Nicolaides Pathology, Brisbane, Australia; Sime Darby Medical Centre, Selangor, Malaysia; Westmead Breast Cancer Institute; University of Sydney, Sydney, Australia; Singapore General Hospital, Singapore, Singapore; Peter MacCallum Cancer Centre, Melbourne, Australia; Garvan Institute of Medical Research and the Kinghorn Cancer Centre, Sydney, Australia
| | - S O'Toole
- University of Queensland, Brisbane, Australia; QIMR Berghofer Medical Research Institute, Brisbane, Australia; Pathology Queensland, The Royal Brisbane & Women's Hospital, Brisbane, Australia; Kurume University School of Medicine, Kurume, Japan; Canterbury Health Laboratories, Christchurch, New Zealand; Prince of Wales Hospital, Hong Kong, Hong Kong; Sullivan Nicolaides Pathology, Brisbane, Australia; Sime Darby Medical Centre, Selangor, Malaysia; Westmead Breast Cancer Institute; University of Sydney, Sydney, Australia; Singapore General Hospital, Singapore, Singapore; Peter MacCallum Cancer Centre, Melbourne, Australia; Garvan Institute of Medical Research and the Kinghorn Cancer Centre, Sydney, Australia
| | - N Waddell
- University of Queensland, Brisbane, Australia; QIMR Berghofer Medical Research Institute, Brisbane, Australia; Pathology Queensland, The Royal Brisbane & Women's Hospital, Brisbane, Australia; Kurume University School of Medicine, Kurume, Japan; Canterbury Health Laboratories, Christchurch, New Zealand; Prince of Wales Hospital, Hong Kong, Hong Kong; Sullivan Nicolaides Pathology, Brisbane, Australia; Sime Darby Medical Centre, Selangor, Malaysia; Westmead Breast Cancer Institute; University of Sydney, Sydney, Australia; Singapore General Hospital, Singapore, Singapore; Peter MacCallum Cancer Centre, Melbourne, Australia; Garvan Institute of Medical Research and the Kinghorn Cancer Centre, Sydney, Australia
| | - PT Simpson
- University of Queensland, Brisbane, Australia; QIMR Berghofer Medical Research Institute, Brisbane, Australia; Pathology Queensland, The Royal Brisbane & Women's Hospital, Brisbane, Australia; Kurume University School of Medicine, Kurume, Japan; Canterbury Health Laboratories, Christchurch, New Zealand; Prince of Wales Hospital, Hong Kong, Hong Kong; Sullivan Nicolaides Pathology, Brisbane, Australia; Sime Darby Medical Centre, Selangor, Malaysia; Westmead Breast Cancer Institute; University of Sydney, Sydney, Australia; Singapore General Hospital, Singapore, Singapore; Peter MacCallum Cancer Centre, Melbourne, Australia; Garvan Institute of Medical Research and the Kinghorn Cancer Centre, Sydney, Australia
| | - SR Lakhani
- University of Queensland, Brisbane, Australia; QIMR Berghofer Medical Research Institute, Brisbane, Australia; Pathology Queensland, The Royal Brisbane & Women's Hospital, Brisbane, Australia; Kurume University School of Medicine, Kurume, Japan; Canterbury Health Laboratories, Christchurch, New Zealand; Prince of Wales Hospital, Hong Kong, Hong Kong; Sullivan Nicolaides Pathology, Brisbane, Australia; Sime Darby Medical Centre, Selangor, Malaysia; Westmead Breast Cancer Institute; University of Sydney, Sydney, Australia; Singapore General Hospital, Singapore, Singapore; Peter MacCallum Cancer Centre, Melbourne, Australia; Garvan Institute of Medical Research and the Kinghorn Cancer Centre, Sydney, Australia
| |
Collapse
|
31
|
Wilson SR, Shinde S, Appleby I, Boscoe M, Conway D, Dryden C, Ferguson K, Gedroyc W, Kinsella SM, Nathanson MH, Thorne J, White M, Wright E. Guidelines for the safe provision of anaesthesia in magnetic resonance units 2019. Anaesthesia 2019; 74:638-650. [DOI: 10.1111/anae.14578] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/12/2018] [Indexed: 01/02/2023]
Affiliation(s)
- S. R. Wilson
- Department of Neuro‐anaesthesia and Neurocritical Care National Hospital for Neurology and Neurosurgery LondonUK and Neuro Anaesthesia and Critical Care Society of Great Britain and Ireland (Co‐Chair)
| | - S. Shinde
- Department of Anaesthesia North Bristol NHS Trust BristolUK and Vice President, Association of Anaesthetists (Co‐Chair)
| | - I. Appleby
- Department of Neuro‐anaesthesia and Neurocritical Care National Hospital for Neurology and Neurosurgery LondonUK and Neuro Anaesthesia and Critical Care Society of Great Britain and Ireland
| | - M. Boscoe
- Royal College of Anaesthetists LondonUK and Society of Anaesthetists in Radiology
| | - D. Conway
- Department of Anaesthesia Chelsea and Westminster Hospital LondonUK and Trainee Committee, Association of Anaesthetists
| | - C. Dryden
- Jackson Rees Department of Paediatric Anaesthesia Alder Hey Children's Hospital LiverpoolUK and Association of Paediatric Anaesthetists of Great Britain and Ireland
| | - K. Ferguson
- Department of Anaesthesia Aberdeen Royal Infirmary Aberdeen UK and Association of Anaesthetists Safety Representative
| | - W. Gedroyc
- Imperial College LondonUK and Royal College of Radiologists
| | - S. M. Kinsella
- Department of Anaesthesia St Michaels Hospital BristolUK and Editor, Anaesthesia
| | - M. H. Nathanson
- Department of Anaesthesia Nottingham University Hospital NottinghamUK and Immediate Past Honorary Secretary, Association of Anaesthetists
| | - J. Thorne
- Department of Neurosurgery Salford Royal Foundation Trust SalfordUK and Society of British Neurological Surgeons
| | | | - E. Wright
- Jackson Rees Department of Paediatric Anaesthesia Alder Hey Children's Hospital Liverpool UK
| |
Collapse
|
32
|
Cook T, Harper N, Farmer L, Garcez T, Floss K, Marinho S, Torevell H, Warner A, McGuire N, Ferguson K, Hitchman J, Egner W, Kemp H, Thomas M, Lucas D, Nasser S, Karanam S, Kong KL, Farooque S, Bellamy M, McGlennan A, Moonesinghe S. Anaesthesia, surgery, and life-threatening allergic reactions: protocol and methods of the 6th National Audit Project (NAP6) of the Royal College of Anaesthetists. Br J Anaesth 2018; 121:124-133. [DOI: 10.1016/j.bja.2018.04.001] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2018] [Revised: 03/29/2018] [Accepted: 04/05/2018] [Indexed: 12/20/2022] Open
|
33
|
Kemp H, Marinho S, Cook T, Farmer L, Bellamy M, Egner W, Farooque S, Ferguson K, Floss K, Garcez T, Karanam S, Hitchman J, Kong KL, McGuire N, Nasser S, Lucas D, Thomas M, Torevell H, Warner A, Harper N. An observational national study of anaesthetic workload and seniority across the working week and weekend in the UK in 2016: the 6th National Audit Project (NAP6) Activity Survey. Br J Anaesth 2018; 121:134-145. [DOI: 10.1016/j.bja.2018.04.010] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2018] [Revised: 04/07/2018] [Accepted: 04/10/2018] [Indexed: 12/20/2022] Open
|
34
|
Harper N, Cook T, Garcez T, Lucas D, Thomas M, Kemp H, Kong KL, Marinho S, Karanam S, Ferguson K, Hitchman J, Torevell H, Warner A, Egner W, Nasser S, McGuire N, Bellamy M, Floss K, Farmer L, Farooque S. Anaesthesia, surgery, and life-threatening allergic reactions: management and outcomes in the 6th National Audit Project (NAP6). Br J Anaesth 2018; 121:172-188. [DOI: 10.1016/j.bja.2018.04.015] [Citation(s) in RCA: 74] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2018] [Revised: 04/08/2018] [Accepted: 04/16/2018] [Indexed: 12/20/2022] Open
|
35
|
Egner W, Cook TM, Garcez T, Marinho S, Kemp H, Lucas DN, Floss K, Farooque S, Torevell H, Thomas M, Ferguson K, Nasser S, Karanam S, Kong KL, McGuire N, Bellamy M, Warner A, Hitchman J, Farmer L, Harper NJN. Specialist perioperative allergy clinic services in the UK 2018: Results from the Royal College of Anaesthetists Sixth National Audit Project (NAP6) investigation of perioperative anaphylaxis. Clin Exp Allergy 2018; 48:846-861. [DOI: 10.1111/cea.13180] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2018] [Revised: 05/11/2018] [Accepted: 05/14/2018] [Indexed: 12/18/2022]
Affiliation(s)
- W. Egner
- Sheffield Teaching Hospitals NHS Trust; Sheffield UK
- Department of Infection, Immunity and Cardiovascular Disease; University of Sheffield; Sheffield UK
- Royal College of Physicians/Royal College of Pathologists Joint Committee on Immunology and Allergy; University of Sheffield; London UK
| | - T. M. Cook
- Anaesthesia and Intensive Care Medicine; Royal United Hospital; Bath UK
- University of Bristol School of Medicine; Bristol UK
- National Audit Projects Program; Royal College of Anaesthetists; London UK
| | - T. Garcez
- United Kingdom Fatal Anaphylaxis Register; Manchester UK
- Manchester University NHS Foundation Trust; Manchester UK
| | - S. Marinho
- Manchester University NHS Foundation Trust; Manchester UK
- British Society of Allergy and Clinical Immunology; London UK
| | - H. Kemp
- Research and Audit Federation of Trainees; London UK
- Imperial College London; London UK
| | - D. N. Lucas
- Obstetric Anaesthetists Association; Harrow UK
- Northwick Park Hospital; Harrow UK
| | - K. Floss
- Royal Pharmaceutical Society of Great Britain; London UK
- Anaesthetics & Critical Care; Oxford University Hospitals NHS Foundation Trust; Oxford UK
| | - S. Farooque
- Imperial College Healthcare NHS Trust; London UK
| | - H. Torevell
- Bradford Teaching Hospitals NHS Trust; Bradford UK
| | - M. Thomas
- Association of Paediatric Anaesthetists of Great Britain and Ireland; London UK
- Great Ormond Street Hospital; London UK
| | - K. Ferguson
- Association of Anaesthetists of Great Britain and Ireland; London UK
- Aberdeen Royal Infirmary; Aberdeen UK
| | - S. Nasser
- British Society for Allergy and Clinical Immunology; London UK
- Cambridge University Hospitals NHS Foundation Trust; Cambridge UK
| | - S. Karanam
- Sandwell and West Birmingham NHS Trust; Birmingham UK
| | - K.-L. Kong
- Sandwell and West Birmingham NHS Trust; Birmingham UK
| | - N. McGuire
- Medicines and Healthcare Regulatory Authority; London UK
| | - M. Bellamy
- Leeds Teaching Hospitals NHS Trust; Leeds UK
- Faculty of Intensive Care Medicine; Leeds University; Leeds UK
| | | | - J. Hitchman
- Lay Committee; Royal College of Anaesthetists; London UK
| | - L. Farmer
- Royal College of Anaesthetists; London UK
| | - N. J. N. Harper
- Manchester University NHS Foundation Trust; Manchester UK
- Royal College of Anaesthetists; London UK
- Manchester Academic Health Science Centre; University of Manchester; Manchester UK
| |
Collapse
|
36
|
Inkster T, Ferguson K, Edwardson A, Gunson R, Soutar R. Consecutive yearly outbreaks of respiratory syncytial virus in a haemato-oncology ward and efficacy of infection control measures. J Hosp Infect 2017; 96:353-359. [PMID: 28554834 PMCID: PMC7172193 DOI: 10.1016/j.jhin.2017.05.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2017] [Accepted: 05/01/2017] [Indexed: 12/22/2022]
Abstract
Background Respiratory syncytial virus (RSV) causes significant respiratory tract infection in immunosuppressed patients. Aim To describe two consecutive yearly outbreaks of RSV in our haemato-oncology ward. Methods Haematology patients presenting with respiratory symptoms were screened by polymerase chain reaction for viral respiratory pathogens using a saline gargle. Findings None of our patients had undergone bone marrow transplant but all had underlying haematological malignancies. Eight patients were affected in the first outbreak (mortality rate: 37.5%) and 12 patients were affected in the second (mortality rate: 8.3%). Extensive infection control measures were implemented in both outbreaks and were successful in preventing further cross-transmission. Conclusion There was significant learning from both outbreaks and actions implemented with the aim of reducing the likelihood and impact of future outbreaks.
Collapse
Affiliation(s)
- T Inkster
- Department of Infection Control, Gartnavel General Hospital, Glasgow, UK.
| | - K Ferguson
- Department of Infection Control, Gartnavel General Hospital, Glasgow, UK
| | - A Edwardson
- Department of Infection Control, Gartnavel General Hospital, Glasgow, UK
| | - R Gunson
- Department of Virology, Glasgow Royal Infirmary, Glasgow, UK
| | - R Soutar
- Department of Haematology, West of Scotland Beatson Oncology Centre, Gartnavel Hospital, Glasgow, UK
| |
Collapse
|
37
|
Ren H, Ferguson K, Wong E, Chow V, Ma S. The consequences of somatic sex chromosomal abnormalities on meiosis and sperm production in infertile men. Fertil Steril 2016. [DOI: 10.1016/j.fertnstert.2016.07.679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
|
38
|
Wei W, Knapp K, Wang L, Chen C, Craig G, Ferguson K, Schwartzman S. FRI0233 Real-World Treatment Persistence and Clinical Outcomes of TNFI Cycling vs Switching To New Mechanism-of-Action Dmards among Patients with Rheumatoid Arthritis in The United States. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.2071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
|
39
|
Checketts MR, Alladi R, Ferguson K, Gemmell L, Handy JM, Klein AA, Love NJ, Misra U, Morris C, Nathanson MH, Rodney GE, Verma R, Pandit JJ. Recommendations for standards of monitoring during anaesthesia and recovery 2015: Association of Anaesthetists of Great Britain and Ireland. Anaesthesia 2016; 71:85-93. [PMID: 26582586 PMCID: PMC5063182 DOI: 10.1111/anae.13316] [Citation(s) in RCA: 309] [Impact Index Per Article: 38.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/13/2015] [Indexed: 12/17/2022]
Abstract
This guideline updates and replaces the 4th edition of the AAGBI Standards of Monitoring published in 2007. The aim of this document is to provide guidance on the minimum standards for physiological monitoring of any patient undergoing anaesthesia or sedation under the care of an anaesthetist. The recommendations are primarily aimed at anaesthetists practising in the United Kingdom and Ireland. Minimum standards for monitoring patients during anaesthesia and in the recovery phase are included. There is also guidance on monitoring patients undergoing sedation and also during transfer of anaesthetised or sedated patients. There are new sections discussing the role of monitoring depth of anaesthesia, neuromuscular blockade and cardiac output. The indications for end-tidal carbon dioxide monitoring have been updated.
Collapse
Affiliation(s)
| | - R Alladi
- Department of Anaesthesia, Tameside Hospital, Ashton-under-Lyne, UK
- Royal College of Anaesthetists
| | | | - L Gemmell
- Department of Anaesthesia, North Wales Trust, North Wales, UK
| | - J M Handy
- Department of Anaesthesia and Intensive Care, Chelsea and Westminster Hospital, London, UK
| | - A A Klein
- Department of Anaesthesia and Intensive Care, Papworth Hospital, Cambridge, UK
| | - N J Love
- AAGBI
- Department of Anaesthesia and Intensive Care Medicine, North Devon District Hospital, Barnstaple, Devon, UK
| | - U Misra
- Department of Anaesthesia, Sunderland Royal Hospital, Sunderland, UK
| | - C Morris
- Department of Anaesthesia and Intensive Care, Royal Derby Hospital, Derby, UK
| | - M H Nathanson
- Department of Anaesthesia, Nottingham University Hospitals, Nottingham, UK
| | - G E Rodney
- Department of Anaesthesia, Ninewells Hospital and Medical School, Dundee, UK
| | - R Verma
- Department of Anaesthesia, Derby Teaching Hospitals, Derby, UK
| | - J J Pandit
- Department of Anaesthesia, Nuffield Department of Anaesthetics, Oxford University Hospitals, Oxford, UK
| | | |
Collapse
|
40
|
Ren H, Ferguson K, Kirkpatrick G, Vinning T, Chow V, Ma S. Altered crossover distribution and distance to telomeres in spermatocytes of infertile men. Fertil Steril 2015. [DOI: 10.1016/j.fertnstert.2015.07.909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
|
41
|
Bailey O, Ferguson K, Crawfurd E, James P, May PA, Brown S, Blyth M, Leach WJ. No clinical difference between fixed- and mobile-bearing cruciate-retaining total knee arthroplasty: a prospective randomized study. Knee Surg Sports Traumatol Arthrosc 2015; 23:1653-9. [PMID: 24509880 DOI: 10.1007/s00167-014-2877-9] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [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: 06/02/2013] [Accepted: 01/24/2014] [Indexed: 10/25/2022]
Abstract
PURPOSE It is hypothesized that mobile polyethylene bearings in total knee arthroplasty (TKA) may confer benefits with regard to range of motion and have improved clinical outcome scores in comparison with an arthroplasty with a fixed-bearing design. Our study compares clinical outcomes between patients who undergo TKA with either a rotating platform or fixed bearing using a posterior cruciate-retaining design. METHODS Three hundred and thirty-one patients were randomized to receive either a rotating-platform (161 patients) or a fixed-bearing (170 patients) implant. All patients were assessed pre-operatively and at 1 and 2 years post-operatively using standard tools (range of movement, Oxford Knee Score, American Knee Society Score, SF12 and Patella Score). RESULTS There was no difference in pre- to 2-year post-operative outcomes between the groups with regard to improvement in range of motion (10° ± 16 vs. 9° ± 15), improvement in Oxford Knee Score (-17.6 ± 9.9 vs. -19.1 ± 8.4), improvement in American Knee Society Score (49.5 ± 24.7 vs. 50.7 ± 21.0), function (23.6 ± 19.6 vs. 25.0 ± 22.5) and pain (34.9 ± 16.2 vs. 35.8 ± 14.1) subscores, improvement in SF12 Score (10.0 ± 16.3 vs. 12.3 ± 15.8) or improvement in Patella Score (9.7 ± 7.4 vs. 10.6 ± 7.1). CONCLUSION No difference was demonstrated in clinical outcome between patients with a rotating-platform and fixed-bearing posterior cruciate-retaining TKA at 2-year follow-up. LEVEL OF EVIDENCE I.
Collapse
Affiliation(s)
- O Bailey
- Western Infirmary, Dumbarton Road, Glasgow, G11 6NT, UK,
| | | | | | | | | | | | | | | |
Collapse
|
42
|
Macdonald J, Klein AA, Ferguson K. Rumsfeld revisited: knowns and unknowns affecting the right heart. Anaesthesia 2014; 70:13-7. [PMID: 25489610 DOI: 10.1111/anae.12950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- J Macdonald
- Department of Anaesthesia, Aberdeen Royal Infirmary, Aberdeen, UK.
| | | | | |
Collapse
|
43
|
Affiliation(s)
| | - T. Woodcock
- University Hospital of Southampton; Southampton UK
| |
Collapse
|
44
|
O’Mara T, Duffy D, Thompson DJ, Ahmed S, Ferguson K, Healey CS, Montgomery G, Shah M, Morrison J, Pharoah PP, Dunning AM, Webb PM, Easton DF, Spurdle AB. A genome-wide association study to identify genetic markers associated with endometrial cancer grade. Hered Cancer Clin Pract 2012. [PMCID: PMC3327233 DOI: 10.1186/1897-4287-10-s2-a47] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
|
45
|
Podzielinski I, Saunders B, Kimbler K, Ferguson K, Branscum A, Fung E, DePriest P, Van Nagell J, Ueland F, Baron A. Apolipoproteins are highly expressed in malignant ovarian cyst fluids. Gynecol Oncol 2012. [DOI: 10.1016/j.ygyno.2011.12.245] [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: 11/24/2022]
|
46
|
Jori F, Brahmbhatt D, Fosgate GT, Thompson PN, Budke C, Ward MP, Ferguson K, Gummow B. A questionnaire-based evaluation of the veterinary cordon fence separating wildlife and livestock along the boundary of the Kruger National Park, South Africa. Prev Vet Med 2011; 100:210-20. [PMID: 21536336 DOI: 10.1016/j.prevetmed.2011.03.015] [Citation(s) in RCA: 42] [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] [Received: 06/06/2010] [Revised: 03/29/2011] [Accepted: 03/30/2011] [Indexed: 11/26/2022]
Abstract
Veterinary cordon fences are used in Southern Africa to separate wildlife from domestic animals in order to prevent transmission of infectious diseases. Such fences are a control method recognized by the World Organization for Animal Health (OIE) for establishing disease-free zones in beef exporting countries. However, few studies have evaluated the ecological impact of these physical barriers or their effectiveness at a multispecies level. We examined the permeability of one such barrier, along 357 km of the western and southern boundary of the Kruger National Park (KNP) during 2007. Information was gathered using a semi-structured questionnaire implemented among 32 teams of fence maintenance workers. Data were analyzed to identify (a) the main causes of fence damage, (b) the seasonality, location and duration of fence repairs, (c) high permeability areas for elephant (Loxodonta africana), kudu (Tragelaphus strepsiceros), impala (Aepyceros melampus), buffalo (Syncerus caffer) and warthog (Phacochoerus africanus), and (d) the influence of fence electrification, rivers and elephant damage on the frequency of observation of wildlife species outside the KNP estimated during the year. Human and elephant damage were the most common reasons for fence repairs. Elephant and buffalo were the most and least common large mammal species reported observed outside the KNP (1076 and 162 reports/year), respectively. Cattle incursions into the KNP were also reported in 44% of the fence sections. Electrification of the fence was an important factor explaining differences in estimated wildlife species observations outside the KNP during the year. Correlations between estimations of observed species suggested that fence gaps created by elephants might be used by the other wildlife species. Estimated annual counts of kudu, impala and buffalo, but not warthog, were found to correlate with elephant observations. Negative binomial regression models were developed to explore the relationships between observed estimations of different wildlife species outside the KNP the fence, electrification of fence sections and the presence of watercourses, suggesting that kudu, impala and buffalo could use elephant induced fence damage to leave the KNP. The questionnaire was able to evaluate fence integrity and identify sections where integrity was sub-optimal for separating wildlife from domestic livestock species. If combined with more quantitative methods and applied on a routine basis, it could provide an efficient and cost-effective method for monitoring the effectiveness of physical barriers to contain wildlife within protected areas such as is the case with veterinary cordon fences in Southern Africa.
Collapse
Affiliation(s)
- F Jori
- CIRAD, UR AGIRs, Campus International de Baillarguet, Montpellier 34392, France.
| | | | | | | | | | | | | | | |
Collapse
|
47
|
Hingley-Wilson SM, Lougheed KEA, Ferguson K, Leiva S, Williams HD. Individual Mycobacterium tuberculosis universal stress protein homologues are dispensable in vitro. Tuberculosis (Edinb) 2010; 90:236-44. [PMID: 20541977 PMCID: PMC2914252 DOI: 10.1016/j.tube.2010.03.013] [Citation(s) in RCA: 53] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2009] [Revised: 03/16/2010] [Accepted: 03/31/2010] [Indexed: 01/25/2023]
Abstract
Mycobacterium tuberculosis has 10 universal stress proteins, whose function is unknown. However, proteomic and transcriptomic analyses have shown that a number of usp genes are significantly upregulated under hypoxic conditions and in response to nitric oxide and carbon monoxide, as well as during M. tuberculosis infection of macrophage cell lines. Six of these USPs are part of the DosR regulon and this, along with their expression pattern and the phenotypes of usp mutants in other bacterial species, suggests a potential role in the persistence and/or intracellular survival of Mtb. Knock-out mutants of individual usp genes encoding the USPs Rv1996, Rv2005c, Rv2026c and Rv2028c were generated and their growth and survival under hypoxic and other stress conditions examined. Although the majority of usp genes are highly induced in hypoxic conditions, mutation did not affect the long term survival of Mtb under these conditions, or in response to a range of stress conditions chosen to represent the environmental onslaughts experienced by the bacillus during an infection, nor during infection of mouse and human - derived macrophage cell lines. The possibility remains that these USPs are functionally redundant in Mtb.
Collapse
Affiliation(s)
- S M Hingley-Wilson
- Department of Life Sciences, Imperial College London, London SW7 2AZ, UK
| | | | | | | | | |
Collapse
|
48
|
Ferguson K, Naka Y, Mancini D, Lietz K. 686: Validation of Destination Therapy Risk Score in Recipients of Left-Ventricular Assist Devices (LVAD) at a Single Center. J Heart Lung Transplant 2009. [DOI: 10.1016/j.healun.2008.11.693] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
|
49
|
Greenlee H, Crew K, Ferguson K, McKinley P, Rundle A, Ogedegbe G, Matta J, Sandoval R, Hershman DL. Facilitators and barriers to recruitment for an exercise and dietary intervention study in minority breast cancer survivors. Cancer Res 2009. [DOI: 10.1158/0008-5472.sabcs-5077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Abstract #5077
Background: Hispanic and black women with breast cancer (BC) have poorer survival than non-Hispanic whites. Lean body mass, regular physical activity, and high intake of fruits/vegetables may improve survival. However, minority BC survivors are more likely to be obese and sedentary than non-Hispanic whites, which may contribute to poorer survival. We are conducting a randomized waitlist-controlled pilot study to test the effects of 6-months of the Curves® 30-minute circuit-based exercise and high-vegetable/low-fat nutrition program, on weight loss among Hispanic and black women, and now report facilitators and barriers to recruitment. Methods: Eligibility criteria: 21-70 yrs, Hispanic/black, BMI ≥25kg/m2, sedentary, stage 0-IIIa breast cancer, no evidence of recurrent/metastatic disease, radiation/chemotherapy completed ≥6 months prior, no uncontrolled comorbidities, and non-smoker. Participants were identified by physicians and referred for screening. Barriers to study participation were assessed, including work/family responsibilities, transportation, financial resources, and perceived risks/benefits of exercise and dietary change after cancer diagnosis. Results: To date, 96 women have been referred for screening and 50 (52%) completed screening questionnaires. Of those who completed questionnaires, 43/50 (86%) were eligible, and of those who were eligible, 37/43 (86%) chose to participate. Enrolled participants are 70% Hispanic, mean age 51yrs (range:32-69), mean BMI 33.2 (±5.8) kg/m2, 64% diagnosed as AJCC stage II/III, and 70% ≤ high school education. Reasons for ineligibility (n=53) include inability to recontact (46%), uncontrolled comorbidity (21%), too busy/not convenient (15%), still undergoing treatment (11%), currently smoking (4%), and not sedentary (2%). Eligible and ineligible women were not statistically different in terms of race, BMI, or stage at diagnosis. However, ineligible women were older (P<0.01). Of the women who completed the screening questionnaire, women enrolled in the study (n=37), compared to women not enrolled (n=13), believed losing weight after cancer would prolong survival (P=0.01), making dietary changes would prevent recurrence (P=0.01), and that exercising would help them feel better (P=0.01), prevent recurrence (P=0.01), and prolong survival (P=0.046). Women not enrolled were more likely to report that exercising after a cancer diagnosis is dangerous (P=0.04). Conclusions: Recruitment of a multiethnic population to a Curves® based exercise intervention study was feasible. Patients who ultimately enrolled in this study believed that exercise and eating a healthy diet are beneficial to their health. Given that many overweight and sedentary women had pre-existing negative misconceptions about the benefits of exercise and dietary change after a BC diagnosis, and this was a key factor in predicting enrollment, educational efforts promoting healthy lifestyle behaviors should be further targeted towards this high-risk patient population.
Citation Information: Cancer Res 2009;69(2 Suppl):Abstract nr 5077.
Collapse
Affiliation(s)
- H Greenlee
- 1 Columbia University Medical Center, New York, NY
| | | | | | | | | | | | | | | | | |
Collapse
|
50
|
Vind AB, Andersen HE, Schwarz P, Skalska A, Salakowski A, Dubiel M, Fedak D, Grodzicki T, Annweiler C, Schott AM, Fantino B, Berrut G, Herrmann F, Beauchet O, Engels S, Schroll M, Popescu C, Onose G, Bojan A, van Zutphen M, Bemelmans W, de Groot L, Rea IM, Henry M, Young IS, Evans AE, Kee F, Ambien CF, Whitehead AS, Ryzhak G, Khavinson V, Kozlov L, Povoroznyuk V, Kivela SL, Nielsen DS, Nielsen W, Knold B, Ryg J, Nissen N, Brixen K, Bjorkman M, Sorva A, Tilvis R, Kannegaard PN, Jung A, Simonsen F, Sanders S, Puustinen J, Nurminen J, Lopponen M, Vahlberg T, Isoaho R, Kivela SL, Hayashi T, Ina K, Nomura H, Iguchi A, Rea IM, Henry M, Evans AE, Tiret L, Poire O, Cambien F, Pautex S, Notaridis G, Derame L, Zulian G, Ungar A, Fedeli A, Zanieri S, Pecchioni S, Belladonna M, Lambertucci L, Lotti E, Pepe G, Bambi A, Morrione A, Masotti G, Marchionni M, Mazzella F, Napoli C, Vitale DF, Viati L, Longobardi G, Lucchetti G, Abete P, Rengo F, Pautex S, Herrmann F, le Lous P, Gold G, Lihavainen K, Sipila S, Rantanenv T, Hartikainen S, Biswas S, Willicombe S, Myint P, Rashidi F, Gillain D, Van Den Noortgate N, Van Der Mark S, Petersen H, Sejtved B, Melton R, Mur AZ, Catevilla AZ, Boix LA, Jordá P, Ranhoff AH, González E, Florian J, Bueso P, Nuotio M, Luukkaala T, Tammela TLJ, Jylhä M, De Antonio García MP, De Abia PG, Bergua AA, Mowinckel P, Orozco MC, Ruiz MC, Verdejo-Bravo C, De Saint-Hubert M, Divoy C, Schoevaerdts D, Swine C, Heppner HJ, Sieber C, Bertsch T, Volpato S, Heppner HJ, Sieber C, Heppner HJ, Sieber C, Heppner HJ, Sieber C, Michael A, Scoyni R, Trani I, Schiaffini C, Sioulis F, Felli B, Aiello L, Belli P, Pacitti MT, Morelli A, D’imperio M, Falanga A, Carratelli D, Morocutti M, Kitisomprayoonkul W, Guerra G, Promsopa K, Chaiwanichsiri D, Ochiana V, Ghorghe S, Popescu G, Tekeira A, Khayat M, Povoroznyuk V, Grygoryeva N, Dzerovych N, Cavalieri M, Karasevskaya T, Mowe M, Skalska A, Fedak D, Grodzicki T, Soda K, Kano Y, Shingo T, Konishi F, Kawakami M, Maraldi C, Ulger Z, Cankurtaran M, Halil M, Yavuz BB, Orhan B, Dede D, Kavas GO, Kocaturk PA, Akyol O, Ariogul S, Guralnik JM, Pircalabu R, Hnidei R, Morosanu B, Rada C, Ionescu C, Yamada M, Kasagi F, Tatsukawa Y, Sasaki H, Alcalde P, Fellin R, Luque M, García M, Ariño S, Carmona G, Rizzoli R, Ammann P, Pressel E, Eddy C, Lilja A, Rønholt F, Pilotto A, Danbaek L, Van der Mark S, Ammann P, Kream B, Rosen C, Rizzoli R, Dubois-Ferrière V, Rizzoli R, Ammann P, Ditloto G, Addante F, Hussain W, Farrelly E, Marsden P, Brewer L, Fallon C, Murphy S, Jørgensen NR, Husted LB, Tofteng CL, Jensen JEB, Franceschi M, Eiken P, Nissen N, Langdahl BL, Schwarz P, Mcintosh S, Lacey E, Carvell C, Povoroznyuk V, Grygoryeva N, Kreslov Y, Leandro G, Dzerovych N, Ozerov I, Vayda V, Povoroznyuk V, Dzerovych N, Karasevskaya T, Povoroznyuk V, Vayda V, Böhmdorfer B, Frühwald T, D’onofrio G, Sommeregger U, Muster U, Böhmdorfer B, Frühwald T, Oeser B, Sommeregger U, Muster U, Cho C, Yoo B, Oh J, Corritore M, Cho K, Lee H, Clemmensen A, Lauridsen M, Nielsen NB, Crome P, Sinclair-Cohen J, Cherubini A, Oristrell J, Hertogh C, Niro V, Szczerbinska K, Lesauskaite V, Prada GI, Clarfield M, Topikova E, Dieppe P, Gallagher P, O’mahony D, Harbig P, Barat I, Scarcelli C, Nielsen PL, Damsgaard EM, Maanen ACDV, Van Marum RJ, Knol W, Van Der Linden CMJ, Jansen PAF, Karlsson M, Berggren AC, Lampela P, Seripa D, Hartikainen S, Lavikainen P, Sulkava R, Huupponen R, Lonergan MT, Coughlan T, ’Neill DO, Lonergan MT, Coughlan T, ’Neill DO, Piccola BD, Krajèík S, Mikus P, Errasquin BM, Cuervo MS, Castellano CS, Silveira ED, Vicedo TB, Cruz-Jentoft AJ, Petrovic M, Cobbaert K, Ferrucci L, Van Der Stichele R, Rajska-Neumann A, Wieczorowska-Tobis K, Ryan C, Kennedy J, O’mahony D, Byrne S, Castellano CS, Fernández CG, Errasquín BM, Bhuachalla BN, Del Rey JM, Peña MIA, Cruz-Jentoft AJ, Trellu LT, Villaneau D, Parel Y, Vogt-Ferrier N, Vanakoski J, Jokinen T, Skippari L, Cotter PE, Iso-Aho M, Guillemard E, Lacoin F, Marcus EL, Caine Y, Kasem H, Gross M, Mukherjee S, Goupal K, Juszczak A, Mhaille BN, Mukherjee S, Romero E, Fernandez C, Ramos M, Gonzalez E, Fuentes M, Mora J, Martin J, Ribera JM, Berg N, Egan A, Vanmeerbeek M, Moreau A, Massart V, Giet D, Bojan A, Onose G, Popescu C, Jönsdóttir AB, Damkjær K, Elkholy K, Kavanagh A, Schroll M, Lindhardt T, Ozdemir L, Gozukara F, Yucel C, Turk R, Akdemir N, Park SMI, Kim DH, Quinlan N, O’connor M, O’neill D, Caffrey N, Lonergan MT, Trainor S, Gowran L, Falconer M, Carroll N, Dwyer C, Coughlan T, O’neill D, O’keeffe ST, Collins DR, Given K, O’neill D, Collins DR, Lund A, Michelet M, Kjeken I, Wyller TB, Sveen U, Meade R, Kristjansson SR, Anniss S, Kachhia A, Hickey A, O’hanlon A, Mcgee H, Shelley E, Horgan F, O’neill D, Osawa A, Maeshima S, Nesbakken A, Sawayama Y, Maeda S, Ohnishi H, Hamada M, Otaguro S, Furusyo N, Hayashi J, Bonet AT, Martorell LV, Truyols AG, Wyller TB, Homar FA, Malberti JC, Huertas P, Wagle J, Farner L, Flekkøy K, Wyller TB, Sandvik L, Eiklid K, Fure B, Bautmans I, Stensrød B, Engedal K, Rnould A, Baron R, Gallais JL, Giniès P, Benmedjahed K, Bartley M, O’neill D, Hürny C, Njemini R, Brack B, Mukherjee S, Chroinin DNI, Farooq SFS, Burke M, Duggan J, Power D, Kyne L, Qvist A, Jørgensen NR, Jansen B, Schwarz P, Sleiman I, Rozzini R, Barbisoni P, Ranhoff A, Trabucchi M, Rønholt F, Jacobsen HN, Rytter L, Seidahamd M, Vierendeels J, Al-Dhahi L, Vigder C, Ben-Israel Y, Kaykov E, Granot E, Raz R, Wulff T, Hendriksen C, Ziccardi P, Cacciatore F, de Backer J, Mazzella F, Viati L, Abete P, Ferrara N, Rengo F, Raschilas F, Adane D, Oziol E, Millot O, Boubakri C, de Waele E, Hemmi P, Tigoulet F, Faucher N, Blain H, Jeandel C, Blain H, Carriere I, Berard C, Favier F, Colvez A, Mets T, Sørensen KI, Brynningsen P, Damsgaard EM, Mehrabian S, Seux ML, Miralles I, Cohen M, Esculier MC, Rigaud AS, Ducasse V, Pilotto A, Lidy C, Samandel S, Geny C, Comte F, Gabelle A, Touchon J, Jeandel C, Morel N, Verny M, Riou B, Addante F, Boddaert J, Marquis C, Greffard S, Dieudonne B, Barrou Z, Boddaert J, Verny M, Bonnet D, Forest A, Verny M, Franceschi M, Boulanger C, Riou B, Malla Z, Boddaert J, Leandro G, D’onofrio G, D’ambrosio LP, Longo MG, Cascavilla L, Paris F, Pazienza AM, Piccola BD, Ferrucci L, Ungar A, Morrione A, Landi A, Caldi F, Maraviglia A, Rafanelli M, Ruffolo E, Chisciotti VM, Masotti G, Marchionni N, van der Velde N, Ziere G, van der Cammen TJM, Hofman B, Stricker BHC, Rodriguez-Pascual C, Moraga AV, Galan EP, Sanchez MJL, Manso AL, Carballido MT, Chiva MTO, Andion JMV, Sierra AL, Pillay I, Saunders J, Cunniffe J, Cooke J, Blot S, Cankurtaran M, Vandijck D, Danneels C, Vandewoude K, Peleman R, Piette AA, Verschraegen G, van den Noortgate N, Vogelaers D, Petrovic M, Skerris A, Kjear P, Cristoffersen J, Shou C, Seest LS, Oestergaard A, Rønholt F, Overgaard K, Donnellan C, Hickey A, Hevey D, O’neill D, van Munster B, Korevaar J, Zwinderman A, Levi M, Wiersinga J, Rooij S, White S, Mahony SO, Bayer A, Juliebo V, Bjøro K, Krogseth M, Ranhoff AH, Wyller TB, Duque AS, Silvestre J, Freitas P, Palma-Reis I, Lopes JP, Martins A, Batalha V, Campos L, Ekstrom H, Elmstahl S, Ivanoff SD, Hayashi T, Ina K, Hirai H, Iguchi A, Lee T, Gallagher P, Hegarty E, Connor MO, Mahony DO, Mkhailova O, Khavinson V, Kozlov L, Chopra NR, Jones DA, Huwez F, Frimann J, Koefoed M, Meyling R, Holm E, Gryglewska B, Sulicka J, Fornal M, Wizner B, Grodzicki T, O’connor L, Lonergan MT, Cogan N, Coughlan T, O’neill D, Collins DR, Prada GI, Fita IG, Prada S, Herghelegiu AM, Datu C, Lonergan MT, Kelleher F, Mcdermott R, Collins DR, Retornaz F, Monette J, Batist G, Monette M, Sourial N, Small D, Caplan S, Wan-Chow-Wah D, Puts MTE, Bergman H, Retornaz F, Sourial N, Seux V, Monette J, Soubeyrand J, Bergman H, Andrei V, Pircalabu R, Lupeanu E, Pena C, Turcu E, Raducanu I, Hnidei A, Morosanu B, Gherasim P, Gradinaru D, Rachita M, Ionescu I, Arino S, Coindreau F, Alcalde P, Serra J, Baldasseroni S, Romboli B, di Serio C, Orso F, Pellerito S, Mannucci E, Colombi C, Bartoli N, Masotti G, Marchionni N, Tarantini F, Barry P, Kinsella S, Twomey C, O’mahony D, Bezerra AW, Popescu G, Azevedo E, Nobrega J, Ghiorghe S, Coindreau F, Serra J, Duems O, Saez I, Clapera G, Arino S, Coindreau F, Serra J, Saez I, Duems O, Clpaera G, Arino S, Jones DA, Chopra NR, Guha K, Clarkson P, Koga T, Furusyo N, Ogawa E, Sawayama Y, Ai M, Otokozawa S, Schaefer EJ, Hayashi J, Lupeanu E, Andrei V, Turcu E, Pircalabu R, Raducanu I, Hnidei R, Morosanu B, Opris S, Ionescu C, Gherasim P, Mellingsaeter M, Wyller TB, Ranhoff AH, Popescu G, Teixeira J, Ghiorghe S, Azevedo E, Teixeira A, Rodriguez-Pascual C, Moraga AV, Carballido MT, Galan EP, Quintela S, Leiros A, Sanchez MJL, Chiva MTO, Sierra AL, Andion JMV, Rios CF, Seabra Pereira MF, Jorge E, Dias R, Verissimo MT, Santos L, Saldanha MH, Sinha S, Dave P, Hussain S, Ayub A, Vilches-Moraga A, Rodriguez-Pascual C, Paredes-Galan E, Leiro-Manso A, Gonzalez-Rios C, Torrente-Carballido M, Vega-Andion JM, Olcoz-Chiva MT, Lopez-Sierra A, Lopez-Sanchez MJ, Narro-Vidal M, Garcia Q, Bozoglu E, Isk AT, Comert B, Doruk H, Sohrt C, Brynningsen P, Damsgaard EM, Kat M, Vreeswijk R, de Jonghe J, van der Ploeg T, van Gool W, Eikelenboom P, Kalisvaart K, Kat M, de Jonghe J, Vreeswijk R, van der Ploeg T, van Gool W, Eikelenboom P, Kalisvaart K, Krogseth M, Juliebø V, Engedal K, Wyller TB, Sharma V, Soiza RL, Ferguson K, Shenkin SD, Seymour DG, Maclullich AMJ, van Munster B, van Breemen M, Moerland P, Speijer D, Rooij S, Hollmann M, Zwinderman A, Korevaar J, Vreeswijk R, Toornvliet A, Honing M, Bakker K, de Man T, de Jonghe JFM, Kalisvaart KJ, Bisschop MM, Sival R, Driesen J, Cappuccio M, Cilesi I, Cirinei E, Ruggiero C, Dell’aquila G, Gasperini B, Patacchini F, Mancioli G, Lauretani F, Bandinelli S, Maggio M, Ferrucci L, Cherubini A, Cruz-Jentoft AJ, de Tena Fontaneda A, Cano LR, Custureri R, Curiale V, Prete C, Cella A, Bonomini C, Barban G, Trasciatti S, Palummeri E, Gasperini B, Ruggiero C, Dell’aquila G, Cirinei E, Patacchini F, Mancioli G, Lauretani F, Bandinelli S, Maggio M, Ferrucci L, Cherubini A, Gold G, Giannakopoulos P, Hermmann F, Bouras C, Kovari E, Halil M, Deniz A, Yavuz B, Yavuz BB, Ülger Z, Cankurtaran M, Isik M, Cankurtaran ES, Aytemir K, Ariogul S, Kanaya K, Abe S, Sakai M, Iwamoto T, Korfitsen T, Moe C, Mecocci P, Mangiaasche F, Costanzi E, Cecchetti R, Rinaldi P, Serafini V, Amici S, Baglioni M, Bastiani P, Lovestone S, Prada GI, Ftta IG, Prada S, Herghelegiu AM, Datu C, Rozzini R, Sleiman I, Barbisoni P, Ranhoff A, Maggi S, Trabucchi M, Shafiei R, Johansen AH, Moe C, Lyngholm-Kxærby P, Kristiansen K, Lestrup C, Lund C, Jones E, Such P, van Puyvelde K, Mets T, Yavuz BB, Yavuz B, Cankurtaran M, Halil M, Ulger Z, Aytemir K, Oto A, Ariogul S, Yavuz BB, Cankurtaran M, Halil M, Ulger Z, Ariogul S, di Bari M, Lattanzio F, Sgadari A, Baccini M, Ercolani S, Rengo F, Senin U, Bernabei R, Marchionni N, Cherubini A, del Bianco L, Lamanna C, Gori F, Monami M, Marchionni N, Masotti G, Mannucci E, Foss CH, Vestbo E, Frøland A, Mogensen CE, Damsgaard EM, Mossello E, Simoni D, Boncinelli M, Gullo M, Mello AM, Lopilato E, Lamanna C, Gori F, Cavallini MC, Marchionni N, Mannucci E, Masotti M, Pena CM, Olaru OG, Pircalabu RM, Raducanu I, Rodriguez-Justo S, Narro-Vidal M, Garcia-Villar E, Rodriguez-Pascual C, Vilches-Moraga A, Olcoz-Chiva MT, Lopez-Sierra A, Vega-Andion JM, Lopez-Sanchez MJ, Torrente-Carballido M, Paredes-Galan E, Vilches-Moraga A, Abbas A, Grue R, Adie K, Fox J, Wileman L, Pattison T, Briggs S, Bhat S, Baker P, Akdemir N, Kapucu SS, Özdemir L, Akkus Y, Balci G, Akyar Y, Cankuran M, Halil M, Kayihan H, Uyanik M, Hazer O, Ariogul S, Cella A, Curiale V, Cuneo G, Fraguglia C, Trasciatti S, Palummeri E, Blundell A, Gordon A, Masud T, Gladman J, Sclater A, Curran V, Kirby B, Forristall J, Sharpe D, Anstey SA, Dawe D, Edwards S, White M, Celik SS, Kapucu SS, Akkuþ Y, Tuna Z, Szczerbinska K, Kijowska V, Mirewska E, Topor-Madry R, Czabanowska K, Maggi S, Franceschi M, Pilotto A, Noale M, Parisi GC, Crepaldi G, Van Gara R, Mcgee H, Winder R, O’neill D, Piers R, Vanden Noortgate N, Schrauwen W, Maertens S, Velghe A, Petrovic M, Benoit D, Cronin H, O’regan C, Kearney P, Moreira A, Kamiya Y, Whelan B, Kenny RA, Carpena-Ruiz M, Anton JM, de Antonio P, Verdejo C, Cruz-Jentoft AJ, Anton JM, Verdejo C, de Antonio P, Carpena M, Cruz-Jentoft AJ, Sanchez FJM, Alonso CF, del Castillo JG, Ferrer MF, Armengol JG, Villarroel P, Gregorio PG, Casado JMR, Leiros BG, Garcia FJG, Clemente MRP, Acha AA, Ramiez LFM, Ballesteros CM, Ibanez JMF, Andres SA, Maya RP, Soria JF, Checa M, Melich AE, Lang PO, Herrmann F, Michel JP, Cebrian A, Duiez-Domingo J, San-Martin M, Vantieghem KM, Terumalai K, Kaiser L, Trellu LT, Brandt MS, Jørgensen B, Nyhuus C, Lyager A, Hagedorn D, Holm E, Lauritsen J, Leners JC, Sibret MP, Mas MA, Renom A, Vazquez O, Miralles R, Cervera AM, Mathur A, Lord S, Mikes Z, Mikes P, Holckova J, Dukat A, Lietava J, Petrovicova J, Strelkova V, Kolesar J, Rokkedal L, Granberg P, Mortensen RS, Shipman K, Vincent B, Patel T, Yau C, Rehman R, Salam A, Ballentyne S, Aw D, Weerasuriya N, Lee S, Masud T, Barry P, O’connor M, O’sullivan F, Moriarty E, O’connor K, O’connor M, Bogen B, Bjordal JM, Kristensen MT, Moe-Nilssen R, Crome I, Lally F, Crome P, Curiale V, Custureri R, Prete C, Trasciatti S, Galliera EOO, Herrmann F, Petitpierre N, Michel JP, Kitisomprayoonkul W, Chaiwanichsiri D, Kristensen MT, Bandholm T, Bencke J, Ekdahl C, Kehlet H, Lauritsen J, Sørensen GV, Gonzalez A, Lazaro M, Gonzalez E, Ribera JM, Casado JMR, Gillett S, MacMahon M, Pedersen SJ, Borgbjerg FM, Schousboe B, Pedersen BD, Jørgensen HL, Duus BR, Lauritzen JB, Cooke J, Pillay I, Binkley N, Boonen S, Roux C, He W, Rosenberg R, Yang Z, Salonoja M, Aarnio P, Vahlberg T, Ktvelä SL, Salpakoski A, Portegijs E, Kallinen M, Sihvonen S, Kiviranta I, Alen M, Rantanen T, Sipilä S, Szczerbinska K, Sørensen GV, Lauritsen J, Vincent B, Way B, Vergis N, Battacharya B, Chatterjee A, Bryden E, Vind AB, Andersen HE, Pedersen KD, Jørgensen T, Schwarz P, Zintchouk D, Mørch M, Damsgaard EM, De Saint-Hubert M, Divoy C, Godart P, Schoevaerdts D, Swine C, Alonso CF, Sanchez FJM, del Castillo JG, Ferrer MF, Armengol JG, Villarroel P, Bravo CV, Casado JMR, Hovmand B, Larsen AE, Pedersen S, Vinkler S, Christensen K, Øresund CVU, Matera MG, Goffredo V, Franceschi M, D’onofrio G, Addante F, Gravina C, Urbano M, Seripa D, Dallapiccola B, Pilotto A, Chroinin DNI, O’brien H, Power D, Santillo E, Ventura G, Migale M, Cassano S, Cariello FP, Crane S, Takahashi P, Tung E, Chandra A, Yu-Ballard A, Hanson G, Vandewoude M, Hoeck S, Geerts J, Van Hal G, Van der Heyden J, Breda J, Weber P, Meluzínová H, Hrubanová J, Kubšová H, Polcarová V, Campbell P, Henderson E, Macmahon M, Pedersen ABL, Mørch MM, Foss CH, Franceschi M, Maggi S, Pilotto A, Noale M, Parisi G, Crepaldi G, Furusyo N, Koga T, Ohnishi H, Maeda S, Takeoka H, Toyoda K, Ogawa E, Sawayama Y, Hayashi J, Kamigaki M, Nakagawa I, Kumei Y, Hayashi N, Takasugi Y, Maggi S, Pilotto A, Noale M, Franceschi L, Parisi GC, Crepaldi G, Maggi S, Pilotto A, Franceschi M, Noale M, Parisi GC, Crepaldi G, Michael A, Bhangu A, Fisher G, Rees E, Labib M, Ogawa E, Furusyo N, Koga T, Sawayama Y, Hayashi J, Ohishi M, Takagi T, Fujisawa T, Katsuya T, Rakugi H, Pilotto A, Franceschi M, Ferrucci L, Rengo F, Bernabei R, Leandro G, Pilotto A, Franceschi M, Maggi S, Noale M, Parisi G, Crepaldi G, Cotter PE, Simon M, Quinn C, O’keeffe ST, Moy I, Crome P, Crome I, Frisher M, Daly K, Huber P, Hilleret H, Lang PO, Le Saint L, Chamot C, Giannakopoulos P, Gold G, Leckie K, Bayes H, Birschel P, Lundgren B, Eniry BM, Pillay I, Matzen LE, O’neill D, Garavan R, O’hanlon A, Mcgee H, Akdemir N, Kapucu S, Ozdemir L, Akkus Y, Balci G, Akyar I, Patacchini F, Ruggiero C, Dell’aquila G, Ferretti R, Mariani T, Gugliotta R, Cirinei E, Gasperini B, Lattanzio F, Bernabei R, Senin U, Cherubini C, Pedersen TS, Raun KN, Jespersen E, Sixt E, Takahashi P, Crane S, Tung E, Chandra A, Yu-Ballard A, Hanson G, Velghe A, Petermans J. Oral and Poster Papers Submitted for Presentation at the 5th Congress of the EUGMS “Geriatric Medicine in a Time of Generational Shift September 3–6, 2008 Copenhagen, Denmark. J Nutr Health Aging 2008. [DOI: 10.1007/bf02983206] [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: 11/24/2022]
|