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Lee ME, Ghosh G, Rooney K, Soumekh A, Schnoll-Sussman F, Katz P. Prolonged acid reflux monitoring using acid exposure time and DeMeester score: two days are not enough. Surg Endosc 2024:10.1007/s00464-024-10733-x. [PMID: 38467859 DOI: 10.1007/s00464-024-10733-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Accepted: 01/28/2024] [Indexed: 03/13/2024]
Abstract
BACKGROUND Wireless pH monitoring allows for a definitive GERD diagnosis, which is essential for optimal medical or surgical management of the patient. However, there is no guideline recommendation on whether prolonged pH testing (72 or 96 h) provides additional benefit when compared to the standard 48-h testing. We aimed to assess whether prolonged pH monitoring diagnoses more patients with GERD, as well as compare the DeMeester score to acid exposure time as diagnostic criteria for GERD. METHODS This was a retrospective analysis of consecutive adult patients who underwent wireless esophageal pH monitoring between August 2018 and July 2021. The primary outcome was the additional diagnoses of GERD (predominant acid exposure pattern) in patients who underwent 48-h versus 96-h pH monitoring. Secondary outcomes included comparison of the DeMeester score to acid exposure time and internal agreement between the first and second 48-h blocks of a prolonged 96-h pH study. RESULTS When comparing 48-h versus 96-h pH testing, the prolonged monitoring group was more likely to have a predominant reflux pattern and thus be diagnosed with definitive GERD by elevated DeMeester score (58.8% vs. 40.8%, p = 0.003) or acid exposure time > 6% (44.7% vs. 32.4%, p = 0.039). For patients who underwent prolonged testing, the results of monitoring beyond 48 h led to a clinically meaningful change in study interpretation in 24.8% of patients. The study data from Days 3 to 4 yielded only a 56.6% agreement with the first 2 days. CONCLUSIONS In patients undergoing extended pH monitoring, almost half were found to have an abnormal pH study after a normal study on Day 1. An additional 25% of patients had a change in study interpretation by extending the study beyond 48 h. Our findings suggest only 48 h of pH monitoring will miss a diagnosis of GERD in a clinically important number of patients.
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Affiliation(s)
- Michelle E Lee
- Division of Gastroenterology and Hepatology, New York-Presbyterian Hospital/Weill Cornell Medicine, New York, NY, USA.
- Department of Medicine, New York-Presbyterian Hospital/Weill Cornell Medicine, New York, NY, USA.
| | - Gaurav Ghosh
- Division of Gastroenterology and Hepatology, New York-Presbyterian Hospital/Weill Cornell Medicine, New York, NY, USA
| | - Katharine Rooney
- Division of Gastroenterology and Hepatology, New York-Presbyterian Hospital/Weill Cornell Medicine, New York, NY, USA
| | - Amir Soumekh
- Division of Gastroenterology and Hepatology, New York-Presbyterian Hospital/Weill Cornell Medicine, New York, NY, USA
| | - Felice Schnoll-Sussman
- Division of Gastroenterology and Hepatology, New York-Presbyterian Hospital/Weill Cornell Medicine, New York, NY, USA
| | - Philip Katz
- Division of Gastroenterology and Hepatology, New York-Presbyterian Hospital/Weill Cornell Medicine, New York, NY, USA
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Sundaram R, Rooney K, Koteeswaran SK. The use of cerebral CT angiography as an ancillary investigation to support a clinical diagnosis of death using neurological criteria. Anaesthesia 2024; 79:321. [PMID: 37720964 DOI: 10.1111/anae.16132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/01/2023] [Indexed: 09/19/2023]
Affiliation(s)
| | - K Rooney
- Royal Alexandra Hospital, Paisley, UK
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Jansen MB, Lund DW, Baume K, Lillyman S, Rooney K, Nielsen DS. International clinical placement - Experiences of nursing students' cultural, personal and professional development; a qualitative study. Nurse Educ Pract 2021; 51:102987. [PMID: 33610023 DOI: 10.1016/j.nepr.2021.102987] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Revised: 01/17/2021] [Accepted: 01/19/2021] [Indexed: 11/25/2022]
Abstract
The purpose was to capture the experiences of cultural, personal and professional development during International Clinical Placement (ICP) among nursing students from three European countries. The paper presents findings based on the analysis of 23 reflections written by students immediately after returning from their ICP. The design builds on a qualitative study using a phenomenological approach and meaning condensation inspired by Kirsti Malterud. The analysis revealed four themes: Communication and barriers to be overcome, Culture as a serious business, Personal and professional achievements and Challenges and the importance of preceptorship. The ICP impacted on the participants' personal as well as professional way of understanding themselves as students and future nurses. A profound difference was seen between the achieved learning outcomes of participants completing an ICP in a high- or low-income country, respectively. Language barriers, the local culture and different nursing cultures were often challenging and pushed participants out of their comfort zone. All participants developed their cultural understanding in accordance with the Papadopoulos, Tilki and Taylor Model for Developing Cultural Competence. Findings indicate that educational institutions should establish well-planned exchange opportunities that adopt a two-way reciprocal (Erasmus) exchange programmes and be aware of the value of an appointed preceptor in the host country.
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Affiliation(s)
- M B Jansen
- UCL University College, Department of Nursing, Odense, Niels Bohrs Allé 1, 5230, Odense, Denmark.
| | - D W Lund
- UCL University College, Department of Nursing, Odense, Niels Bohrs Allé 1, 5230, Odense, Denmark.
| | - K Baume
- Department of Nursing, Three Counties School of Nursing & Midwifery, St John's Campus, University of Worcester, Henwick Grove, Worcester, WR2 6AJ, Great Britain, UK.
| | - S Lillyman
- Department of Nursing, Three Counties School of Nursing & Midwifery, St John's Campus, University of Worcester, Henwick Grove, Worcester, WR2 6AJ, Great Britain, UK.
| | - K Rooney
- Department of Nursing, Midwifery & Health Studies, Dundalk Institute of Technology, Dundalk, Co. Louth, A91 K584, Ireland.
| | - D S Nielsen
- UCL University College, Department of Nursing, Odense, Niels Bohrs Allé 1, 5230, Odense, Denmark; University of Southern Denmark Centre for Global Health, University of Southern Denmark, Campusvej 55, 5230, Odense, Denmark; Migrant Health Clinic, Odense University Hospital, Soenderboulevard, 5000, Odense, Denmark.
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Schenkel LC, Aref-Eshghi E, Rooney K, Kerkhof J, Levy MA, McConkey H, Rogers RC, Phelan K, Sarasua SM, Jain L, Pauly R, Boccuto L, DuPont B, Cappuccio G, Brunetti-Pierri N, Schwartz CE, Sadikovic B. DNA methylation epi-signature is associated with two molecularly and phenotypically distinct clinical subtypes of Phelan-McDermid syndrome. Clin Epigenetics 2021; 13:2. [PMID: 33407854 PMCID: PMC7789817 DOI: 10.1186/s13148-020-00990-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [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: 07/17/2020] [Accepted: 12/09/2020] [Indexed: 12/31/2022] Open
Abstract
Background Phelan-McDermid syndrome is characterized by a range of neurodevelopmental phenotypes with incomplete penetrance and variable expressivity. It is caused by a variable size and breakpoint microdeletions in the distal long arm of chromosome 22, referred to as 22q13.3 deletion syndrome, including the SHANK3 gene. Genetic defects in a growing number of neurodevelopmental genes have been shown to cause genome-wide disruptions in epigenomic profiles referred to as epi-signatures in affected individuals. Results In this study we assessed genome-wide DNA methylation profiles in a cohort of 22 individuals with Phelan-McDermid syndrome, including 11 individuals with large (2 to 5.8 Mb) 22q13.3 deletions, 10 with small deletions (< 1 Mb) or intragenic variants in SHANK3 and one mosaic case. We describe a novel genome-wide DNA methylation epi-signature in a subset of individuals with Phelan-McDermid syndrome. Conclusion We identified the critical region including the BRD1 gene as responsible for the Phelan-McDermid syndrome epi-signature. Metabolomic profiles of individuals with the DNA methylation epi-signature showed significantly different metabolomic profiles indicating evidence of two molecularly and phenotypically distinct clinical subtypes of Phelan-McDermid syndrome.
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Affiliation(s)
- L C Schenkel
- Molecular Genetics Laboratory, Molecular Diagnostics Division, London Health Sciences Centre, London, ON, N6A5W9, Canada.,Department of Pathology and Laboratory Medicine, Western University, London, ON, N6A3K7, Canada
| | - E Aref-Eshghi
- Molecular Genetics Laboratory, Molecular Diagnostics Division, London Health Sciences Centre, London, ON, N6A5W9, Canada
| | - K Rooney
- Molecular Genetics Laboratory, Molecular Diagnostics Division, London Health Sciences Centre, London, ON, N6A5W9, Canada
| | - J Kerkhof
- Molecular Genetics Laboratory, Molecular Diagnostics Division, London Health Sciences Centre, London, ON, N6A5W9, Canada
| | - M A Levy
- Molecular Genetics Laboratory, Molecular Diagnostics Division, London Health Sciences Centre, London, ON, N6A5W9, Canada
| | - H McConkey
- Molecular Genetics Laboratory, Molecular Diagnostics Division, London Health Sciences Centre, London, ON, N6A5W9, Canada
| | - R C Rogers
- Greenville Office, Greenwood Genetic Center, Greenville, SC, 29605, USA
| | - K Phelan
- Genetics Laboratory, Florida Cancer Specialists and Research Institute, Fort Myers, FL, 33816, USA
| | | | - L Jain
- Greenwood Genetic Center, Greenwood, SC, 29646, USA.,Clemson University, Clemson, SC, 29634, USA
| | - R Pauly
- Greenwood Genetic Center, Greenwood, SC, 29646, USA
| | - L Boccuto
- Greenwood Genetic Center, Greenwood, SC, 29646, USA.,Clemson University, Clemson, SC, 29634, USA
| | - B DuPont
- Greenwood Genetic Center, Greenwood, SC, 29646, USA
| | - G Cappuccio
- Department of Translational Medicine, University Federico II, 80131, Naples, NA, Italy.,Telethon Institute of Genetics and Medicine, Pozzuoli, NA, Italy
| | - N Brunetti-Pierri
- Department of Translational Medicine, University Federico II, 80131, Naples, NA, Italy.,Telethon Institute of Genetics and Medicine, Pozzuoli, NA, Italy
| | - C E Schwartz
- Greenwood Genetic Center, Greenwood, SC, 29646, USA.
| | - B Sadikovic
- Molecular Genetics Laboratory, Molecular Diagnostics Division, London Health Sciences Centre, London, ON, N6A5W9, Canada. .,Department of Pathology and Laboratory Medicine, Western University, London, ON, N6A3K7, Canada.
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Howse E, Freeman B, Wu J, Rooney K. Perceptions and attitudes about the sale and promotion of sugar-sweetened beverages in a university. Eur J Public Health 2017. [DOI: 10.1093/eurpub/ckx187.353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- E Howse
- The University of Sydney, Sydney, Australia
| | - B Freeman
- The University of Sydney, Sydney, Australia
| | - J Wu
- The George Institute for Global Health, Sydney, Australia
| | - K Rooney
- The University of Sydney, Sydney, Australia
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McCauley S, McCloskey P, Lyons C, Brown K, Rooney K, Houghton F. Should all oropharyngeal squamous cell carcinomas be stratified by HPV p16 status? Clin Oncol (R Coll Radiol) 2017. [DOI: 10.1016/j.clon.2017.04.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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McCauley S, McCloskey P, Lyons C, Brown K, Rooney K, Houghton F. PO-105: Is there justification for age bias in HPV p16 testing for Oropharyngeal Squamous Cell Carcinoma? Radiother Oncol 2017. [DOI: 10.1016/s0167-8140(17)30239-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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8
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Maplethorpe N, Rooney K, Nicholson S. Sodium intake in England and Scotland: Assessment of dietary sodium. Eur J Public Health 2016. [DOI: 10.1093/eurpub/ckw169.023] [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: 11/14/2022] Open
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Alper M, Matin M, French B, Widra E, Copperman A, Levy M, Lee J, Granger S, Rooney K, Sakkas D. Blind validation of estrogen monitoring in controlled ovarian stimulation IVF cycles using a “patient-friendly” saliva-based estradiol assay. Fertil Steril 2016. [DOI: 10.1016/j.fertnstert.2016.07.566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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11
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Barr J, Ogden K, Rooney K. Building the community of patient-centred care practice across all sectors of health care and health professional education. Intern Med J 2016; 46:122-3. [PMID: 26813909 DOI: 10.1111/imj.12932] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2015] [Accepted: 08/18/2015] [Indexed: 12/01/2022]
Affiliation(s)
- J Barr
- School of Medicine, University of Tasmania, Launceston, Tasmania, Australia.
| | - K Ogden
- School of Medicine, University of Tasmania, Launceston, Tasmania, Australia
| | - K Rooney
- School of Medicine, University of Tasmania, Launceston, Tasmania, Australia
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Lexmond WS, Hu L, Pardo M, Heinz N, Rooney K, LaRosa J, Dehlink E, Fiebiger E, Nurko S. Accuracy of digital mRNA profiling of oesophageal biopsies as a novel diagnostic approach to eosinophilic oesophagitis. Clin Exp Allergy 2016; 45:1317-1327. [PMID: 25728460 DOI: 10.1111/cea.12523] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2014] [Revised: 01/14/2015] [Accepted: 02/15/2015] [Indexed: 01/07/2023]
Abstract
BACKGROUND Quantification of tissue eosinophils remains the golden standard in diagnosing eosinophilic oesophagitis (EoE), but this approach suffers from poor specificity. It has been recognized that histopathological changes that occur in patients with EoE are associated with a disease-specific tissue transcriptome. OBJECTIVE We hypothesized that digital mRNA profiling targeted at a set of EoE-specific and Th2 inflammatory genes in oesophageal biopsies could help differentiate patients with EoE from those with reflux oesophagitis (RE) or normal tissue histology (NH). METHODS The mRNA expression levels of 79 target genes were defined in both proximal and distal biopsies of 196 patients with nCounter® (Nanostring) technology. According to clinicopathological diagnosis, these patients were grouped in a training set (35 EoE, 30 RE, 30 NH) for building of a three-class prediction model using the random forest method, and a blinded predictive set (n = 47) for model validation. RESULTS A diagnostic model built on ten differentially expressed genes was able to differentiate with 100% sensitivity and specificity between conditions in the training set. In a blinded predictive set, this model was able to correctly predict EoE in 14 of 18 patients in distal (sensitivity 78%, 95% CI 52-93%) and 16 of 18 patients in proximal biopsies (sensitivity 89%, 95% CI 64-98%), without false-positive diagnosis of EoE in RE or NH patients (specificity 100%, 95% CI 85-100%). Sensitivity was increased to 94% (95% CI 71-100%) when either the best predictive distal or proximal biopsy was used. CONCLUSION AND CLINICAL RELEVANCE We conclude that mRNA profiling of oesophageal tissue is an accurate diagnostic strategy in detecting EoE.
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Affiliation(s)
- Willem S Lexmond
- Division of Gastroenterology and Nutrition, Center for Motility and Functional Gastrointestinal Disorders, and Eosinophilic Gastrointestinal Disease Center Boston Children's Hospital and Harvard Medical School; Boston, Massachusetts
| | - Lan Hu
- Center for Cancer Computational Biology, Department of Biostatistics and Computational Biology, Dana-Farber Cancer Institute; Boston, Massachusetts
| | - Michael Pardo
- Division of Gastroenterology and Nutrition, Center for Motility and Functional Gastrointestinal Disorders, and Eosinophilic Gastrointestinal Disease Center Boston Children's Hospital and Harvard Medical School; Boston, Massachusetts
| | - Nicole Heinz
- Division of Gastroenterology and Nutrition, Center for Motility and Functional Gastrointestinal Disorders, and Eosinophilic Gastrointestinal Disease Center Boston Children's Hospital and Harvard Medical School; Boston, Massachusetts
| | - Katharine Rooney
- Division of Gastroenterology and Nutrition, Center for Motility and Functional Gastrointestinal Disorders, and Eosinophilic Gastrointestinal Disease Center Boston Children's Hospital and Harvard Medical School; Boston, Massachusetts
| | - Jessica LaRosa
- Division of Gastroenterology and Nutrition, Center for Motility and Functional Gastrointestinal Disorders, and Eosinophilic Gastrointestinal Disease Center Boston Children's Hospital and Harvard Medical School; Boston, Massachusetts
| | - Eleonora Dehlink
- Division of Gastroenterology and Nutrition, Center for Motility and Functional Gastrointestinal Disorders, and Eosinophilic Gastrointestinal Disease Center Boston Children's Hospital and Harvard Medical School; Boston, Massachusetts
| | - Edda Fiebiger
- Division of Gastroenterology and Nutrition, Center for Motility and Functional Gastrointestinal Disorders, and Eosinophilic Gastrointestinal Disease Center Boston Children's Hospital and Harvard Medical School; Boston, Massachusetts
| | - Samuel Nurko
- Division of Gastroenterology and Nutrition, Center for Motility and Functional Gastrointestinal Disorders, and Eosinophilic Gastrointestinal Disease Center Boston Children's Hospital and Harvard Medical School; Boston, Massachusetts
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Tyler J, Bernstein D, Rooney K, Nutting C. PO-0858: Development of dysphagia optimised IMRT for head and neck cancer treatment in the DARS trial. Radiother Oncol 2016. [DOI: 10.1016/s0167-8140(16)32108-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Lexmond WS, Pardo M, Rooney K, Goettel JA, Snapper SB, Yen EH, Dehlink E, Nurko S, Fiebiger E. Elevated levels of leukotriene C4 synthase mRNA distinguish a subpopulation of eosinophilic oesophagitis patients. Clin Exp Allergy 2014; 43:902-13. [PMID: 23889244 DOI: 10.1111/cea.12146] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2013] [Revised: 03/23/2013] [Accepted: 05/03/2013] [Indexed: 12/18/2022]
Abstract
BACKGROUND Cysteinyl leukotrienes contribute to Th2-type inflammatory immune responses. Their levels in oesophageal tissue, however, do not distinguish patients with eosinophilic oesophagitis (EoE) from controls. OBJECTIVE We asked whether mRNA levels of leukotriene C4 synthase (LTC4 S), a key regulator of leukotriene production, could serve as a marker for EoE. METHODS Digital mRNA expression profiling (nCounter(®) Technology) was performed on proximal and distal oesophageal biopsies of 30 paediatric EoE patients and 40 non-EoE controls. Expression data were confirmed with RT-qPCR. LTC4 S mRNA levels were quantified in whole blood samples. Leukotriene E4 was measured in urine. RESULTS LTC4 S mRNA levels were elevated in proximal (2.6-fold, P < 0.001) and distal (2.9-fold, P < 0.001) oesophageal biopsies from EoE patients. Importantly, increased LTC4 S mRNA transcripts identified a subpopulation of EoE patients (28%). This patient subgroup had higher serum IgE levels (669 U/mL vs. 106 U/mL, P = 0.01), higher mRNA transcript numbers of thymic stromal lymphopoietin (TSLP) (1.6-fold, P = 0.009) and CD4 (1.4-fold, P = 0.04) but lower IL-23 mRNA levels (0.5-fold, P = 0.04). In contrast, elevated levels of IL-23 mRNA were found in oesophageal biopsies of patients with reflux oesophagitis. LTC4 S mRNA transcripts in whole blood and urinary excretion of leukotriene E4 were similar in EoE patient subgroups and non-EoE patients. CONCLUSION & CLINICAL RELEVANCE Elevated oesophageal expression of LTC4 S mRNA is found in a subgroup of EoE patients, concomitant with higher serum IgE levels and an oesophageal transcriptome indicative of a more-pronounced allergic phenotype. Together with TSLP and IL-23 mRNA levels, oesophageal LTC4 S mRNA may facilitate diagnosis of an EoE subpopulation for personalized therapy.
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Affiliation(s)
- W S Lexmond
- Division of Gastroenterology and Nutrition, Boston Children's Hospital and Harvard Medical School, Boston, MA, USA
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Jayewardene A, Gwinn T, Hancock D, Rooney K. The effects of a polymorphism in the CD36 gene on metabolic response to a short-term endurance training program: A pilot study. J Sci Med Sport 2013. [DOI: 10.1016/j.jsams.2013.10.086] [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: 10/25/2022]
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Abstract
The Knowledge Network (www.knowledge.scot.nhs.uk) is Scotland's online knowledge service for health and social care. It is designed to support practitioners to apply knowledge in frontline delivery of care, helping to translate knowledge into better health-care outcomes through safe, effective, person-centred care. The Knowledge Network helps to combine the worlds of evidence-based practice and quality improvement by providing access to knowledge about the effectiveness of clinical interventions ('know-what') and knowledge about how to implement this knowledge to support individual patients in working health-care environments ('know-how'). An 'evidence and guidance' search enables clinicians to quickly access quality-assured evidence and best practice, while point of care and mobile solutions provide knowledge in actionable formats to embed in clinical workflow. This research-based knowledge is complemented by social networking services and improvement tools which support the capture and exchange of knowledge from experience, facilitating practice change and systems improvement. In these cases, the Knowledge Network supports key components of the knowledge-to-action cycle--acquiring, creating, sharing and disseminating knowledge to improve performance and innovate. It provides a vehicle for implementing the recommendations of the national Knowledge into Action review, which outlines a new national approach to embedding knowledge in frontline practice and systems improvement.
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Affiliation(s)
- A Wales
- NHS Education for Scotland, Glasgow, Scotland, UK.
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Abstract
A growing number of studies suggest a potential link between obesity and altered iron metabolism. The purpose of this systematic review was to examine existing literature on iron status in obese populations. A comprehensive literature search was conducted. Included studies recruited participants ≥ 18 years with a body mass index ≥ 30 kg m(-2) and provided descriptive statistics for haemoglobin or ferritin at a minimum. There were 25 studies meeting all eligibility criteria, of these 10 examined iron status in free-living obese individuals and 15 reported baseline iron biomarkers from bariatric surgery candidates. Non-obese comparison groups were used by 10 (40%) articles. In these, seven obese groups reported higher mean haemoglobin concentration; six reported significantly higher ferritin concentration; and four significantly lower transferrin saturation. Due to insufficient data, it was not possible to make conclusions regarding mean differences for soluble transferrin receptor (sTfR), hepcidin or C-reactive protein. Existing evidence suggests a tendency for higher haemoglobin and ferritin concentration and lower transferrin saturation in obesity. Alternation of iron biomarkers in obese populations may be a result of obesity-related inflammation and/or related comorbidities. Further research incorporating measurement of inflammatory cytokines, sTfR and hepcidin is required to confirm the impact of obesity on iron status.
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Affiliation(s)
- H L Cheng
- Discipline of Exercise and Sport Science, Faculty of Health Sciences, The University of Sydney, Sydney, New South Wales, Australia.
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Rooney K, Vengalil S, Hanna G, Harney J, Eakin R, Young L, McAleese J. 176 Concurrent chemoradiation for lung cancer in routine practice. Lung Cancer 2012. [DOI: 10.1016/s0169-5002(12)70177-0] [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: 11/26/2022]
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Keating S, Machan E, Rooney K, O’Connor H, Caterson I, Johnson N. A novel exercise regime to reduce cardiometabolic risk in overweight sedentary individuals. J Sci Med Sport 2011. [DOI: 10.1016/j.jsams.2011.11.226] [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: 10/28/2022]
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Rooney K, Cummins P. A service review of dietetic input for chronic obstructive pulmonary disease patients on long-term oral nutritional support. J Hum Nutr Diet 2011. [DOI: 10.1111/j.1365-277x.2011.01175_33.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Ainge H, Thompson C, Ozanne S, Rooney K. A systematic review on animal models of maternal high fat feeding and offspring glycaemic control and adiposity. Obes Res Clin Pract 2010. [DOI: 10.1016/j.orcp.2010.09.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Norquay M, Walters M, Rooney K, Gillett D. Patterns of facial growth in Western Australian children and adolescents. HOMO 2010. [DOI: 10.1016/j.jchb.2010.01.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Affiliation(s)
- J S Michael
- University of Sydney, Exercise Health and Performance Research Group, Lidcombe, Australia.
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Khalafallah A, Vos LJ, Beamish M, Rooney K. Successful rituximab therapy in the treatment of refractory cold haemagglutinin disease with long-term disease control. Intern Med J 2010; 40:387-9. [DOI: 10.1111/j.1445-5994.2010.02173.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Affiliation(s)
- S M Murphy
- Department of Plastic and Reconstructive Surgery, Our Lady's Hospital for Sick Children, Crumlin, Dublin 12, Ireland
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Rooney K, Bertram J, Austen C, Connelley G, Rose M, Williams O, Carter C. The effective use of automated apheresis of autologous red cells in elective orthopaedic and major urological surgery – a rural hospital experience. Transfus Apher Sci 2001. [DOI: 10.1016/s1473-0502(01)00013-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Denney R, Feaster T, Hughes M, Estees S, McKay D, Mockenhaupt S, Rooney K, Whisman K. Recognition items on the WMS-III as a forced choice test of negative response bias. Arch Clin Neuropsychol 1999. [DOI: 10.1093/arclin/14.1.97] [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: 11/14/2022] Open
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Morton J, Taylor K, Bunce I, Eliadis P, Rentoul A, Moore D, Kelly C, Wright S, Bashford J, Rodwell R, Rooney K, Mulligan S, Firkin F, Dodds A, Parkin J, Lowenthal R, Kimber R, Frost T, Grigg A, Goldstein D, Stone J, Lee N. High response rates with short infusional 2-chlorodeoxyadenosine in de novo and relapsed low-grade lymphoma. Australian and New Zealand Lymphoma Study Group. Br J Haematol 1996; 95:110-5. [PMID: 8857946 DOI: 10.1046/j.1365-2141.1996.d01-1868.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Thirty-five patients (eight de novo, 27 relapsed disease) with low-grade non-Hodgkin's lymphoma (diffuse small lymphocytic, follicular small cleaved cell, follicular mixed cell, and lymphoplasmacytoid) were treated with 2-chlorodeoxyadenosine (2CdA) at a daily dose of 0.14 mg/kg for 5d (2 h infusion) for an average of three cycles. Minor treatment delays, generally due to haematological toxicities, occurred in nine of 105 cycles. Major toxicities were lymphopenia, neutropenia and thrombocytopenia. Opportunistic infections occurred in seven patients. Overall response rate was 69% (five complete, 19 partial) reaching 88% for de novo patients (two complete, five partial). Elevated beta 2-microglobulin level was negatively predictive of response (P = 0.0014). Eight of 24 responders relapsed, with a median follow-up of 13 months. 2CdA administered as an intermittent infusion shows considerable single-agent activity in low-grade lymphomas achieving high response rates of prolonged duration. Consideration of schedules where 2CdA is alternatively administered with combination chemotherapy appears warranted.
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Affiliation(s)
- J Morton
- Mater Misericordiae Hospitals, South Brisbane, Australia
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Vander Salm TJ, Ansell JE, Okike ON, Marsicano TH, Lew R, Stephenson WP, Rooney K. The role of epsilon-aminocaproic acid in reducing bleeding after cardiac operation: a double-blind randomized study. J Thorac Cardiovasc Surg 1988; 95:538-40. [PMID: 3278170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Sixty patients scheduled for elective coronary artery bypass graft operations were randomly assigned to receive epsilon-aminocaproic acid or placebo to test whether antifibrinolytic therapy would decrease postoperative bleeding. A small but significant decrease in bleeding was observed in the treated group without complications resulting from treatment with epsilon-aminocaproic acid.
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Affiliation(s)
- T J Vander Salm
- Department of Surgery, University of Massachusetts Medical Center, Worcester 01655
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Durham J, MacNeish A, Rooney PJ, Rooney K, Hart LE, Norman G. The M.D.R. index of function in rheumatoid arthritis. Clin Exp Rheumatol 1985; 3:297-302. [PMID: 4085160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
The M.D.R. index is a new instrument which has been designed to give a measurement of physical function in inflammatory joint disease. It is very easy to apply and is not time-consuming. In preliminary assessment, the index has proven to be highly reliable. It has also been sufficiently sensitive to detect short-term changes in functional capacity which were unrelated to changes in the severity of joint inflammation. The application of the index is inexpensive and does not require extensive training of personnel for its accurate use. It is expected that the M.D.R. index will prove to be suitable for widespread use as a clinical assessment of physical function.
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