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Lawrence PJ, Harvey K, Williams C, Creswell C. Barriers and facilitators to targeted anxiety prevention programmes in families at risk: a qualitative interview study. Eur Child Adolesc Psychiatry 2022; 31:565-575. [PMID: 33346882 PMCID: PMC9034995 DOI: 10.1007/s00787-020-01703-4] [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] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2020] [Accepted: 12/07/2020] [Indexed: 12/24/2022]
Abstract
Anxiety disorders are the most common psychiatric disorder in children and young people. They can be prevented in those at risk, but families do not always take up opportunities to participate in prevention programmes. This qualitative study aimed to understand what families with children who were at prospective risk of anxiety disorders perceived to be the barriers to access to targeted anxiety prevention programmes, and to explore what would help facilitate access. We used Information Power to determine our sample size, and individually interviewed seven young people (14-17 years) who had anxiety disorders and their mothers, each of whom had pre-natal anxiety disorders. We transcribed all interviews and thematically analyzed them to identify perceived barriers and facilitators to targeted anxiety prevention programmes. Perceived potential barriers to access included possible negative consequences of anxiety prevention, difficulties in identifying anxiety as a problem and concerns about how professions would respond to raising concerns about anxiety. Possible facilitators included promoting awareness of anxiety prevention programmes and involvement of schools in promotion and delivery of prevention. Our findings illustrate that implementation of targeted anxiety prevention could be improved through (i) the provision of tools for parents to recognize anxiety in their children as a problem, (ii) promotion of awareness, as well as delivery, of anxiety prevention via schools and (iii) the involvement of parents and possibly adolescents in the intervention programme, but not younger children.
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Affiliation(s)
- P J Lawrence
- School of Psychology, University of Southampton, Southampton, UK.
| | - K Harvey
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, UK
| | - C Williams
- Department of Experimental Psychology , University of Oxford, Oxford, UK
- Department of Psychiatry, University of Oxford, Oxford, UK
| | - C Creswell
- Department of Experimental Psychology , University of Oxford, Oxford, UK
- Department of Psychiatry, University of Oxford, Oxford, UK
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Rand MD, Conrad K, Marvin E, Harvey K, Henderson D, Tawil R, Sobolewski M, Cory-Slechta DA. Developmental exposure to methylmercury and resultant muscle mercury accumulation and adult motor deficits in mice. Neurotoxicology 2020; 81:1-10. [PMID: 32735808 PMCID: PMC7708410 DOI: 10.1016/j.neuro.2020.07.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Revised: 07/06/2020] [Accepted: 07/17/2020] [Indexed: 11/20/2022]
Abstract
Developmental methylmercury (MeHg) exposure can have lasting consequences on neural development and motor function across the lifespan. Recent evidence for MeHg targeting of myogenic pathways has drawn attention to the possibility that developing skeletal muscle plays a role in the motor deficits stemming from early life MeHg exposure. In this study we examined a potential role for muscle in influencing MeHg developmental toxicity in offspring of female mice exposed to MeHg via drinking water. Dams had access to 0, 0.5 or 5.0 ppm MeHg chloride in drinking water from two weeks prior to mating through weaning. Blood, brain and muscle tissue was harvested from dams at weaning and pups at postnatal days (PND) 6, 21 and 60 for analysis of total Hg. Muscle tissue sections were examined with histological stains. Behavioral testing of offspring was conducted at PND 60 and included locomotor activity, inverted screen, grip strength and rotarod tests to assess motor function. Total Hg (tHg) levels in dam muscles at weaning were 1.7-3-fold higher than Hg levels in blood or brain. In PND6 male and female pups, muscle and brain tHg levels were 2 to 4-fold higher than blood tHg. Brain tHg levels decreased more rapidly than muscle tHg levels between PND 6 and 21. Premised on modeling of growth dilution, brain tissue demonstrated an elimination of tHg while muscle tissue exhibited a net uptake of tHg between PND 6 and 21. Despite overall elevated Hg levels in developing muscle, no gross morphological or cytological phenotypes were observed in muscle at PND 60. At the higher MeHg dose, grip strength was reduced in both females and males at PND 60, whereas only male specific deficits were observed in locomotor activity and inverted screen tests with marginally significant deficits on rotarod. These findings highlight a potential role for developing skeletal muscle in mediating the neuromuscular insult of early life MeHg exposure.
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Affiliation(s)
| | | | - Elena Marvin
- Department of Environmental Medicine, United States
| | | | - Don Henderson
- Department of Neurology, University of Rochester School of Medicine and Dentistry, Rochester, NY, United States
| | - Rabi Tawil
- Department of Neurology, University of Rochester School of Medicine and Dentistry, Rochester, NY, United States
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Pang JM, Castles B, Byrne D, Button P, Lakhani S, Sivasubramaniam V, Cooper W, Armes J, Millar E, Raymond W, Roberts-Thomson S, Kumar B, Burr M, Selinger C, Harvey K, Chan C, Beith J, O'Toole S, Fox S. 297P SP142 immunohistochemistry (IHC) PD-L1 inter- and intra-pathologist agreement in triple negative breast carcinoma (TNBC). Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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4
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D'Anna L, Filippidis FT, Antony S, Brown Z, Wyatt H, Malik A, Sivakumaran P, Harvey K, Marinescu M, Bentley P, Korompoki E, Veltkamp R. Early initiation of direct anticoagulation after stroke in patients with atrial fibrillation. Eur J Neurol 2020; 27:2168-2175. [PMID: 32542878 DOI: 10.1111/ene.14396] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Accepted: 06/04/2020] [Indexed: 11/27/2022]
Abstract
BACKGROUND AND PURPOSE The safety of early initiation of anticoagulant therapy in patients with ischaemic stroke related to atrial fibrillation (AF) is unknown. We investigated the safety of early initiation of direct oral anticoagulants (DOACs), vitamin K antagonists (VKAs) or no anticoagulation. METHODS This observational, retrospective, single-centre study included consecutive patients with recent (<4 weeks) ischaemic stroke and AF. The primary outcome was the rate of major (intracranial and extracranial) bleeding in patients on different treatment schemes, i.e. DOACs, VKAs and not anticoagulated. We also investigated the rate of ischaemic cerebrovascular events and mortality. RESULTS We included 959 consecutive patients with AF and ischaemic stroke followed up for an average of 16.1 days after the index event. A total of 559 out of 959 patients (58.3%) were anticoagulated with either VKAs (n = 259) or DOACs (n = 300). Anticoagulation was started after a mean of 7 ± 9.4 days in the DOAC group and 11.9 ± 19.7 days in the VKA group. Early initiation of any anticoagulant was not associated with an increased risk of any major bleeding [odds ratio (OR), 0.49; 95% confidence intervals (CI), 0.21-1.16] and in particular of intracranial bleeding (OR, 0.47; 95% CI, 0.17-1.29; P = 0.143) compared with no anticoagulation. In contrast to VKAs (OR, 0.78; 95% CI, 0.28-2.13), treatment with DOACs (OR, 0.32; 95% CI, 0.10-0.96) reduced the rate of major bleeding compared with no anticoagulation. Early recurrences of ischaemic stroke did not differ significantly among the three groups. CONCLUSIONS Starting DOACs within a mean of 7 days after stroke appeared to be safe. Randomized controlled studies are needed to establish the added efficacy of starting anticoagulation early after stroke.
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Affiliation(s)
- L D'Anna
- Department of Brain Sciences, Imperial College London, London.,Department of Stroke and Neuroscience, Charing Cross Hospital, Imperial College Healthcare NHS Trust, London
| | - F T Filippidis
- Department of Primary Care and Public Health, School of Public Health, Imperial College London, London, UK
| | - S Antony
- Department of Stroke and Neuroscience, Charing Cross Hospital, Imperial College Healthcare NHS Trust, London
| | - Z Brown
- Department of Stroke and Neuroscience, Charing Cross Hospital, Imperial College Healthcare NHS Trust, London
| | - H Wyatt
- Department of Stroke and Neuroscience, Charing Cross Hospital, Imperial College Healthcare NHS Trust, London
| | - A Malik
- Department of Stroke and Neuroscience, Charing Cross Hospital, Imperial College Healthcare NHS Trust, London
| | - P Sivakumaran
- Department of Stroke and Neuroscience, Charing Cross Hospital, Imperial College Healthcare NHS Trust, London
| | - K Harvey
- Department of Brain Sciences, Imperial College London, London
| | - M Marinescu
- Department of Brain Sciences, Imperial College London, London
| | - P Bentley
- Department of Brain Sciences, Imperial College London, London.,Department of Stroke and Neuroscience, Charing Cross Hospital, Imperial College Healthcare NHS Trust, London
| | - E Korompoki
- Department of Brain Sciences, Imperial College London, London
| | - R Veltkamp
- Department of Brain Sciences, Imperial College London, London.,Department of Neurology, Alfried-Krupp Krankenhaus, Essen.,Department of Neurology, University Hospital Heidelberg, Heidelberg, Germany
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Furie R, Parikh S, Maiquez A, Khan A, Moreno O, Soneira M, Kirk C, Bomba D, Harvey K, Farmer MK. AB0373 TREATMENT OF SLE WITH THE IMMUNOPROTEASOME INHIBITOR KZR-616: RESULTS FROM THE FIRST 4 COHORTS OF THE MISSION STUDY, AN OPEN-LABEL PHASE 1B DOSE ESCALATION TRIAL. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.2700] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:Non-specific proteasome inhibitors, such as bortezomib (BTZ), target the constitutive proteasome and immunoproteasome and are approved treatments for multiple myeloma1. BTZ has also been used to treat systemic lupus erythematosus (SLE) and lupus nephritis (LN); however, treatment emergent adverse events (TEAEs), such as gastrointestinal (GI) effects, hematologic abnormalities, asthenia and peripheral neuropathy, limit its use as a long-term treatment option for chronic autoimmune disease2. KZR-616 is a first-in-class selective immunoproteasome inhibitor and is highly active in murine SLE3. Subcutaneous (SC) administration of KZR-616 (30 and 45 mg weekly [QW]) was demonstrated as safe and well-tolerated, and successfully achieved target levels of immunoproteasome inhibition in healthy volunteers4, 5.Objectives:We report the preliminary safety and efficacy of KZR-616 in the first 4 cohorts of the Phase 1b portion of Study KZR-616-002 in patients with active SLE (NCT03393013).Methods:SLE patients (per SLICC Classification Criteria) with SLEDAI ≥4 despite stable background immunosuppressant, anti-malarial, and/or corticosteroid (≤20 mg prednisone equivalent) therapy in this open-label multicentric dose-escalation trial received KZR-616 at doses of 45mg (Cohort 1), 60mg (Cohort 2), or 30mg with escalation to 60mg (Cohorts 2a and 2b) SC weekly through Week 13 (W13) with 12 weeks of follow-up. Efficacy measures included SLEDAI, Cutaneous Lupus Erythematous Disease Area and Severity Index, 28 tender and swollen joint counts, Physicians Global Assessment, Patient Global Assessment, and Patient Assessment of Pain, in evaluable patients (those who received ≥1 month of KZR-616).Results:As of 16 January 2020, 33 patients had enrolled and received at least 1 dose of KZR-616. The majority of TEAEs have been mild or moderate with no reported peripheral neuropathy, prolonged GI-related AEs, and no clinically significant laboratory AEs. There were 3 treatment emergent SAEs, one each of thrombotic microangiopathy (Cohort 2), localized herpes zoster (Cohort 2a), and systemic inflammatory response syndrome (Cohort 2a) with the latter 2 patients completing the full 13 weeks of treatment after resolution. When compared to baseline, improvement in all measures of disease activity were seen at W13 and maintained or improved during the follow-up period, and 94% of evaluable patients had improvements on at least 2 measures/assessments of disease activity. A single patient with active class IV/V nephritis was enrolled on prednisone 10 mg, leflunomide 10 mg, and hydroxychloroquine 200mg/day; nephrotic-range proteinuria at baseline (3.85 g/day) decreased to 0.6 g/day 4 weeks after the last dose of KZR-616.Conclusion:Weekly subcutaneous administration of KZR-616 at 45 and 60 mg was safe and well-tolerated. Evidence of disease suppression at W13 in active SLE patients on stable background therapy was observed. In addition, one study participant with active proliferative nephritis was enrolled with significant reduction in proteinuria. The Phase 2 portion of this study in active proliferative LN is open for enrollment.References:[1]Scott K.et al.Cochrane Database Syst Rev 2016;4:CD010816[2]Alexander Tet al.Ann Rheum Dis 2015;74: 1474–8[3]Muchamuel T.et al.Ann Rheum Dis 2018;77: A685[4]Lickliter J.et al.Ann Rheum Dis 2018;77: A1413[5]Furie Ret al.Ann Rheum Dis 2019;78: A776Disclosure of Interests:Richard Furie Grant/research support from: AstraZeneca, Biogen, Consultant of: AstraZeneca, Biogen, SV Parikh Grant/research support from: Aurinia Pharmaceuticals, EMD-Serono, Consultant of: Aurinia, BMS, GSK, Adonis Maiquez: None declared, Amber Khan: None declared, Orlando Moreno: None declared, Miguel Soneira: None declared, Christopher Kirk Shareholder of: Kezar Life Sciences, LLC, Employee of: Kezar Life Sciences, LLC, Darrin Bomba Shareholder of: Kezar Life Sciences, LLC, Employee of: Kezar Life Sciences, LLC, Ken Harvey Shareholder of: Kezar Life Sciences, LLC, Employee of: Kezar Life Sciences, LLC, Mary Katherine Farmer Shareholder of: Kezar Life Sciences, Employee of: Kezar Life Sciences
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Dulay KM, Masento NA, Harvey K, Messer DJ, Houston‐Price C. Me and my veggies: The use of interactive, personalised picture books in healthy eating interventions. NUTR BULL 2020. [DOI: 10.1111/nbu.12415] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- K. M. Dulay
- School of Psychology and Clinical Language Sciences University of Reading Reading UK
| | - N. A. Masento
- School of Psychology and Clinical Language Sciences University of Reading Reading UK
| | - K. Harvey
- School of Psychology and Clinical Language Sciences University of Reading Reading UK
| | - D. J. Messer
- Centre for Research in Education and Educational Technology The Open University Milton Keynes UK
| | - C. Houston‐Price
- School of Psychology and Clinical Language Sciences University of Reading Reading UK
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Sobolewski M, Abston K, Conrad K, Marvin E, Harvey K, Susiarjo M, Cory-Slechta DA. Lineage- and Sex-Dependent Behavioral and Biochemical Transgenerational Consequences of Developmental Exposure to Lead, Prenatal Stress, and Combined Lead and Prenatal Stress in Mice. Environ Health Perspect 2020; 128:27001. [PMID: 32073883 PMCID: PMC7064322 DOI: 10.1289/ehp4977] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/03/2019] [Revised: 01/02/2020] [Accepted: 01/06/2020] [Indexed: 05/04/2023]
Abstract
BACKGROUND Lead (Pb) exposure and prenatal stress (PS) during development are co-occurring risk factors with shared biological substrates. PS has been associated with transgenerational passage of altered behavioral phenotypes, whereas the transgenerational behavioral or biochemical consequences of Pb exposure, and modification of any such effects by PS, is unknown. OBJECTIVES The present study sought to determine whether Pb, PS, or combined Pb and PS exposures produced adverse transgenerational consequences on brain and behavior. METHODS Maternal Pb and PS exposures were carried out in F0 mice. Outside breeders were used at each subsequent breeding, producing four F1-F2 lineages: [F1 female-F2 female (FF), FM (male), MF, and MM]. F3 offspring were generated from each of these lineages and examined for outcomes previously found to be altered by Pb, PS, or combined Pb and PS in F1 offspring: behavioral performance [fixed-interval (FI) schedule of food reward, locomotor activity, and anxiety-like behavior], dopamine function [striatal expression of tyrosine hydroxylase (Th)], glucocorticoid receptor (GR) and plasma corticosterone, as well as brain-derived neurotrophic factor (BDNF) and total percent DNA methylation of Th and Bdnf genes in the frontal cortex and hippocampus. RESULTS Maternal F0 Pb exposure produced runting in F3 offspring. Considered across lineages, F3 females exhibited Pb-related alterations in behavior, striatal BDNF levels, frontal cortical Th total percentage DNA methylation levels and serum corticosterone levels, whereas F3 males showed Pb- and PS-related alterations in behavior and total percent DNA methylation of hippocampal Bdnf. However, numerous lineage-specific effects were observed, most of greater magnitude than those observed across lineages, with outcomes differing by F3 sex. DISCUSSION These findings support the possibility that exposures of previous generations to Pb or PS may influence the brain and behavior of future generations. Observed changes were sex-dependent, with F3 females showing multiple changes through Pb-exposed lineages. Lineage effects may occur through maternal responses to pregnancy, altered maternal behavior, epigenetic modifications, or a combination of mechanisms, but they have significant public health ramifications regardless of mechanism. https://doi.org/10.1289/EHP4977.
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Affiliation(s)
- Marissa Sobolewski
- Department of Environmental Medicine, University of Rochester School of Medicine, Rochester, New York, USA
| | - Kadijah Abston
- Department of Environmental Medicine, University of Rochester School of Medicine, Rochester, New York, USA
| | - Katherine Conrad
- Department of Environmental Medicine, University of Rochester School of Medicine, Rochester, New York, USA
| | - Elena Marvin
- Department of Environmental Medicine, University of Rochester School of Medicine, Rochester, New York, USA
| | - Katherine Harvey
- Department of Environmental Medicine, University of Rochester School of Medicine, Rochester, New York, USA
| | - Martha Susiarjo
- Department of Environmental Medicine, University of Rochester School of Medicine, Rochester, New York, USA
| | - Deborah A Cory-Slechta
- Department of Environmental Medicine, University of Rochester School of Medicine, Rochester, New York, USA
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Yang Y, Cooper C, Robbins E, Swarbrick A, Harvey K, Lim E, Mak C, Carmalt H, Warrier S, Chan B, Beith J, Hui M, Gluch L, O’Toole S, Cooper W. 9. Factors influencing the success rate of patient derived xenograft formation from breast cancer specimens. Pathology 2020. [DOI: 10.1016/j.pathol.2020.01.010] [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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Morris-Schaffer K, Merrill A, Jew K, Wong C, Conrad K, Harvey K, Marvin E, Sobolewski M, Oberdörster G, Elder A, Cory-Slechta DA. Effects of neonatal inhalation exposure to ultrafine carbon particles on pathology and behavioral outcomes in C57BL/6J mice. Part Fibre Toxicol 2019; 16:10. [PMID: 30777081 PMCID: PMC6379948 DOI: 10.1186/s12989-019-0293-5] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2018] [Accepted: 02/01/2019] [Indexed: 01/01/2023] Open
Abstract
Background Recent epidemiological studies indicate early-life exposure to air pollution is associated with adverse neurodevelopmental outcomes. Previous studies investigating neonatal exposure to ambient fine and ultrafine particles have shown sex specific inflammation-linked pathological changes and protracted learning deficits. A potential contributor to the adverse phenotypes from developmental exposure to particulate matter observed in previous studies may be elemental carbon, a well-known contributor to pollution particulate. The present study is an evaluation of pathological and protracted behavioral alterations in adulthood following subacute neonatal exposure to ultrafine elemental carbon. C57BL/6J mice were exposed to ultrafine elemental carbon at 50 μg/m3 from postnatal days 4–7 and 10–13 for 4 h/day. Behavioral outcomes measured were locomotor activity, novel object recognition (short-term memory), elevated plus maze (anxiety-like behavior), fixed interval (FI) schedule of food reward (learning, timing) and differential reinforcement of low rate (DRL) schedule of food reward (impulsivity, inability to inhibit responding). Neuropathology was assessed by measures of inflammation (glial fibrillary-acidic protein), myelin basic protein expression in the corpus callosum, and lateral ventricle area. Results Twenty-four hours following the final exposure day, no significant differences in anogenital distance, body weight or central nervous system pathological markers were observed in offspring of either sex. Nor were significant changes observed in novel object recognition, elevated plus maze performance, FI, or DRL schedule-controlled behavior in either females or males. Conclusion The limited effect of neonatal exposure to ultrafine elemental carbon suggests this component of air pollution is not a substantial contributor to the behavioral alterations and neuropathology previously observed in response to ambient pollution particulate exposures. Rather, other more reactive constituent species, organic and/or inorganic, gas-phase components, or combinations of constituents may be involved. Defining these neurotoxic components is critical to the formulation of better animal models, more focused mechanistic assessments, and potential regulatory policies for air pollution. Electronic supplementary material The online version of this article (10.1186/s12989-019-0293-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Keith Morris-Schaffer
- Department of Environmental Medicine, Box EHSC, University of Rochester Medical Center, Rochester, NY, 14642, USA.
| | - Alyssa Merrill
- Department of Environmental Medicine, Box EHSC, University of Rochester Medical Center, Rochester, NY, 14642, USA
| | - Katrina Jew
- Department of Environmental Medicine, Box EHSC, University of Rochester Medical Center, Rochester, NY, 14642, USA
| | - Candace Wong
- Department of Environmental Medicine, Box EHSC, University of Rochester Medical Center, Rochester, NY, 14642, USA
| | - Katherine Conrad
- Department of Environmental Medicine, Box EHSC, University of Rochester Medical Center, Rochester, NY, 14642, USA
| | - Katherine Harvey
- Department of Environmental Medicine, Box EHSC, University of Rochester Medical Center, Rochester, NY, 14642, USA
| | - Elena Marvin
- Department of Environmental Medicine, Box EHSC, University of Rochester Medical Center, Rochester, NY, 14642, USA
| | - Marissa Sobolewski
- Department of Environmental Medicine, Box EHSC, University of Rochester Medical Center, Rochester, NY, 14642, USA
| | - Günter Oberdörster
- Department of Environmental Medicine, Box EHSC, University of Rochester Medical Center, Rochester, NY, 14642, USA
| | - Alison Elder
- Department of Environmental Medicine, Box EHSC, University of Rochester Medical Center, Rochester, NY, 14642, USA
| | - Deborah A Cory-Slechta
- Department of Environmental Medicine, Box EHSC, University of Rochester Medical Center, Rochester, NY, 14642, USA
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Sullivan J, Adjognon O, Shay K, Harvey K, Yaksic E, Intrator O, Moye J, Solimeo S. GERIATRIC PATIENT-ALIGNED CARE TEAMS IN THE VETERANS HEALTH ADMINISTRATION: HOW ARE THEY STRUCTURED? Innov Aging 2018. [DOI: 10.1093/geroni/igy023.2974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- J Sullivan
- VA Boston Healthcare System & Boston University, Boston, Massachusetts, United States
| | - O Adjognon
- Center for Healthcare Organization and Implementation Research, VA Boston Healthcare System
| | - K Shay
- US Department of Veterans Affairs, Geriatrics and Extended Care Services (10P4G)
| | - K Harvey
- Center for Healthcare Organization and Implementation Research, VA Boston Healthcare System
| | | | - O Intrator
- GEC DAC, Canandaigua VA Medical Center,Canandaigua NY
| | | | - S Solimeo
- Center for Comprehensive Access & Delivery Research & Evaluation Center, Iowa City VA Health Care System, Iowa City, IA; Department of General Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, IA
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Harvey K, Potter S, Mills N, Holcombe C. #11 The Pre-Bra Study (oral presentation). Int J Surg 2018. [DOI: 10.1016/j.ijsu.2018.10.012] [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: 10/27/2022]
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Kulkarni A, Vissers J, Harvey K. PO-100 Targeting YAP and TAZ to treat hippo pathway mutant malignant mesotheliomas. ESMO Open 2018. [DOI: 10.1136/esmoopen-2018-eacr25.141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Snuggs S, Harvey K, Houston-Price C. Development of a measure to assess parents’ feeding goals: Mealtime Goal Questionnaire. Appetite 2018. [DOI: 10.1016/j.appet.2017.11.014] [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] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Mohd Nor N, Houston-Price C, Harvey K, Methven L. The effect of repeated taste exposure of bitter tasting vegetable in children varying in bitter taste sensitivity. Appetite 2018. [DOI: 10.1016/j.appet.2017.11.017] [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: 10/18/2022]
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O'Toole S, Pidsley R, Harvey K, Karim R, Lee C, Chan B, Stirzaker C. Using the epigenome to understand and better classify phyllodes tumours. Pathology 2018. [DOI: 10.1016/j.pathol.2017.12.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Cobley J, Broadley G, Khan F, Harvey K, Parry C, Rajjayabun P. Tyrosine Kinase Inhibitors for Metastatic Renal Cell Carcinoma - What Should We Tell Our Patients? Int J Surg 2017. [DOI: 10.1016/j.ijsu.2017.08.062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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O'Callaghan J, Holton P, Gammeri E, Flach S, Jones K, Findlay J, Harvey K, Isherwood J, Van Boxel G. Oxford Surgical Collaborative for Audit and Research (OxSCAR): The UK’s Youngest Trainee-Led Collaborative. Int J Surg 2017. [DOI: 10.1016/j.ijsu.2017.08.390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Harvey K. Episcopal Virginity in Medieval England. J Hist Sex 2017; 26:273-293. [PMID: 28458500 PMCID: PMC5405854 DOI: 10.7560/jhs26205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Affiliation(s)
- Katherine Harvey
- Dept of History, Classics and Archaeology, Birkbeck, University of London
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Denekamp S, Crozier I, Melton I, Daly M, Inglis J, Greenslade J, Harvey K. Long-Term Quality of Life (QOL) Results After Insertion of Implantable Cardiac Defibrillators at Christchurch Hospital. Heart Lung Circ 2016. [DOI: 10.1016/j.hlc.2016.06.353] [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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van Geldermalsen M, Wang Q, Nagarajah R, Marshall AD, Thoeng A, Gao D, Ritchie W, Feng Y, Bailey CG, Deng N, Harvey K, Beith JM, Selinger CI, O'Toole SA, Rasko JEJ, Holst J. ASCT2/SLC1A5 controls glutamine uptake and tumour growth in triple-negative basal-like breast cancer. Oncogene 2016; 35:3201-8. [PMID: 26455325 PMCID: PMC4914826 DOI: 10.1038/onc.2015.381] [Citation(s) in RCA: 373] [Impact Index Per Article: 46.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2015] [Revised: 09/01/2015] [Accepted: 09/04/2015] [Indexed: 12/31/2022]
Abstract
Alanine, serine, cysteine-preferring transporter 2 (ASCT2; SLC1A5) mediates uptake of glutamine, a conditionally essential amino acid in rapidly proliferating tumour cells. Uptake of glutamine and subsequent glutaminolysis is critical for activation of the mTORC1 nutrient-sensing pathway, which regulates cell growth and protein translation in cancer cells. This is of particular interest in breast cancer, as glutamine dependence is increased in high-risk breast cancer subtypes. Pharmacological inhibitors of ASCT2-mediated transport significantly reduced glutamine uptake in human breast cancer cell lines, leading to the suppression of mTORC1 signalling, cell growth and cell cycle progression. Notably, these effects were subtype-dependent, with ASCT2 transport critical only for triple-negative (TN) basal-like breast cancer cell growth compared with minimal effects in luminal breast cancer cells. Both stable and inducible shRNA-mediated ASCT2 knockdown confirmed that inhibiting ASCT2 function was sufficient to prevent cellular proliferation and induce rapid cell death in TN basal-like breast cancer cells, but not in luminal cells. Using a bioluminescent orthotopic xenograft mouse model, ASCT2 expression was then shown to be necessary for both successful engraftment and growth of HCC1806 TN breast cancer cells in vivo. Lower tumoral expression of ASCT2 conferred a significant survival advantage in xenografted mice. These responses remained intact in primary breast cancers, where gene expression analysis showed high expression of ASCT2 and glutamine metabolism-related genes, including GLUL and GLS, in a cohort of 90 TN breast cancer patients, as well as correlations with the transcriptional regulators, MYC and ATF4. This study provides preclinical evidence for the feasibility of novel therapies exploiting ASCT2 transporter activity in breast cancer, particularly in the high-risk basal-like subgroup of TN breast cancer where there is not only high expression of ASCT2, but also a marked reliance on its activity for sustained cellular proliferation.
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Affiliation(s)
- M van Geldermalsen
- Origins of Cancer Program, Centenary Institute, Camperdown, New South Wales, Australia
- Gene and Stem Cell Therapy Program, Centenary Institute, Camperdown, New South Wales, Australia
- Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia
| | - Q Wang
- Origins of Cancer Program, Centenary Institute, Camperdown, New South Wales, Australia
- Gene and Stem Cell Therapy Program, Centenary Institute, Camperdown, New South Wales, Australia
- Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia
| | - R Nagarajah
- Origins of Cancer Program, Centenary Institute, Camperdown, New South Wales, Australia
- Gene and Stem Cell Therapy Program, Centenary Institute, Camperdown, New South Wales, Australia
- Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia
| | - A D Marshall
- Gene and Stem Cell Therapy Program, Centenary Institute, Camperdown, New South Wales, Australia
- Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia
| | - A Thoeng
- Gene and Stem Cell Therapy Program, Centenary Institute, Camperdown, New South Wales, Australia
- Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia
| | - D Gao
- Gene and Stem Cell Therapy Program, Centenary Institute, Camperdown, New South Wales, Australia
- Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia
- Bioinformatics Laboratory, Centenary Institute, Camperdown, New South Wales, Australia
| | - W Ritchie
- Gene and Stem Cell Therapy Program, Centenary Institute, Camperdown, New South Wales, Australia
- Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia
- Bioinformatics Laboratory, Centenary Institute, Camperdown, New South Wales, Australia
| | - Y Feng
- Gene and Stem Cell Therapy Program, Centenary Institute, Camperdown, New South Wales, Australia
- Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia
| | - C G Bailey
- Gene and Stem Cell Therapy Program, Centenary Institute, Camperdown, New South Wales, Australia
- Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia
| | - N Deng
- The Kinghorn Cancer Centre and Cancer Research Program, Garvan Institute of Medical Research, Darlinghurst, New South Wales, Australia
- St Vincent's Clinical School, Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia
| | - K Harvey
- The Kinghorn Cancer Centre and Cancer Research Program, Garvan Institute of Medical Research, Darlinghurst, New South Wales, Australia
- Department of Tissue Pathology and Diagnostic Oncology, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia
| | - J M Beith
- Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia
- Department of Medical Oncology, Chris O'Brien Lifehouse, Camperdown, New South Wales, Australia
| | - C I Selinger
- Department of Tissue Pathology and Diagnostic Oncology, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia
| | - S A O'Toole
- Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia
- The Kinghorn Cancer Centre and Cancer Research Program, Garvan Institute of Medical Research, Darlinghurst, New South Wales, Australia
- Department of Tissue Pathology and Diagnostic Oncology, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia
| | - J E J Rasko
- Gene and Stem Cell Therapy Program, Centenary Institute, Camperdown, New South Wales, Australia
- Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia
- Cell and Molecular Therapies, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
| | - J Holst
- Origins of Cancer Program, Centenary Institute, Camperdown, New South Wales, Australia
- Gene and Stem Cell Therapy Program, Centenary Institute, Camperdown, New South Wales, Australia
- Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia
- Associate, Origins of Cancer Program, Centenary Institute, Locked Bag 6, Newtown, New South Wales 2042, Australia. E-mail:
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Cook J, Hardie R, Bailey K, Tapper M, Vickers I, Calder D, Harvey K, Lindo JF. Seroprevalence of human toxocariasis, Jamaica. Trop Biomed 2016; 33:88-94. [PMID: 33579145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Seroprevalence of human toxocariasis was studied, based on 1544 samples selected from a total of 3524 submitted to the University of the West Indies in Kingston, Jamaica for diagnosis of dengue during an epidemic in 2010. The prevalence of anti-Toxocara IgG using the CELISA® (Cellabs) ELISA was 21.2% and males (24.4%) were significantly more likely to be exposed than females (17.5%) [χ2 =10.4; p=0.001]. No association was foundbetween exposure to Toxocara and area of residence (rural vs. urban) [χ2 =0.835; p = 0.409]. Prevalence of infection peaked in adolescents (10-19 years-old) and declined thereafter although a rise in prevalence was seen in older age classes. There was a high prevalence of toxocariasis in Jamaica with significant exposure among school age children with no predilection to either sex. The study will inform future work on elucidating the public health and clinical significance of toxocariasis in Jamaica.
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Affiliation(s)
- J Cook
- Department of Microbiology, University of the West Indies, Mona, Kingston, Jamaica
| | - R Hardie
- Department of Microbiology, University of the West Indies, Mona, Kingston, Jamaica
| | - K Bailey
- Department of Child and Adolescent Health, University of the West Indies, Mona, Kingston, Jamaica
| | - M Tapper
- Department of Microbiology, University of the West Indies, Mona, Kingston, Jamaica
| | - I Vickers
- Department of Microbiology, University of the West Indies, Mona, Kingston, Jamaica
| | - D Calder
- Department of Surgery, Radiology, Anaesthetics and Intensive Care, University of the West Indies, Mona, Kingston, Jamaica
| | - K Harvey
- Ministry of Health, Jamaica, Kingston, Jamaica
| | - J F Lindo
- Department of Microbiology, University of the West Indies, Mona, Kingston, Jamaica
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Broomfield A, Fletcher J, Davison J, Finnegan N, Fenton M, Chikermane A, Beesley C, Harvey K, Cullen E, Stewart C, Santra S, Vijay S, Champion M, Abulhoul L, Grunewald S, Chakrapani A, Cleary MA, Jones SA, Vellodi A. Response of 33 UK patients with infantile-onset Pompe disease to enzyme replacement therapy. J Inherit Metab Dis 2016; 39:261-71. [PMID: 26497565 DOI: 10.1007/s10545-015-9898-5] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2015] [Revised: 09/29/2015] [Accepted: 09/30/2015] [Indexed: 10/22/2022]
Abstract
BACKGROUND Enzyme replacement therapy (ERT) for infantile-onset Pompe disease has been commercially available for almost 10 years. We report the experience of its use in a cohort treated at three specialist lysosomal treatment centres in the UK. METHODS A retrospective case-note review was performed, with additional data being gathered from two national audits on all such patients treated with ERT. The impact on the outcome of various characteristics, measured just prior to the initiation of ERT (baseline), was evaluated using logistic regression. RESULTS Thirty-three patients were identified; 13/29 (45%) were cross-reactive immunological material (CRIM) negative, and nine were immunomodulated. At baseline assessment, 79% were in heart failure, 66% had failure to thrive and 70% had radiological signs of focal pulmonary collapse. The overall survival rate was 60%, ventilation-free survival was 40% and 30% of patients were ambulatory. Median follow-up of survivors was 4 years, 1.5 months (range 6 months to 13.5 years). As with previous studies, the CRIM status impacted on all outcome measures. However, in this cohort, baseline failure to thrive was related to death and lack of ambulation, and left ventricular dilatation was a risk factor for non-ventilator-free survival. CONCLUSION The outcome of treated patients remains heterogeneous despite attempts at immunomodulation. Failure to thrive at baseline and left ventricular dilation appear to be associated with poorer outcomes.
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Affiliation(s)
- A Broomfield
- Manchester Centre for Genomic Medicine, St Mary's Hospital, Central Manchester University Hospital Foundation Trust, Oxford Road, Manchester, UK.
| | - J Fletcher
- Manchester Centre for Genomic Medicine, St Mary's Hospital, Central Manchester University Hospital Foundation Trust, Oxford Road, Manchester, UK
| | - J Davison
- Metabolic Medicine Unit, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - N Finnegan
- Metabolic Medicine Unit, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - M Fenton
- Cardiology Department, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - A Chikermane
- Department of Paediatric Cardiology, Birmingham Children's Hospital, Steelhouse Lane, Birmingham, UK
| | - C Beesley
- Regional Genetics Laboratories, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - K Harvey
- Enzyme Unit, Chemical Pathology, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - E Cullen
- Enzyme Unit, Chemical Pathology, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - C Stewart
- Department of Inherited Metabolic Disorders, Birmingham Children's Hospital, Steelhouse Lane, Birmingham, UK
| | - S Santra
- Department of Inherited Metabolic Disorders, Birmingham Children's Hospital, Steelhouse Lane, Birmingham, UK
| | - S Vijay
- Department of Inherited Metabolic Disorders, Birmingham Children's Hospital, Steelhouse Lane, Birmingham, UK
| | - M Champion
- Department of Inherited Metabolic Disease, Guy's and St Thomas' NHS Foundation Trusts, Evelina London Children's Hospital, Westminster Bridge Road, London, UK
| | - L Abulhoul
- Metabolic Medicine Unit, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - S Grunewald
- Metabolic Medicine Unit, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - A Chakrapani
- Metabolic Medicine Unit, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - M A Cleary
- Metabolic Medicine Unit, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - S A Jones
- Manchester Centre for Genomic Medicine, St Mary's Hospital, Central Manchester University Hospital Foundation Trust, Oxford Road, Manchester, UK
| | - A Vellodi
- Metabolic Medicine Unit, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
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Helme S, Harvey K, Agrawal A. Breast-conserving surgery in patients with Paget's disease. Br J Surg 2015; 102:1167-74. [DOI: 10.1002/bjs.9863] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2014] [Revised: 12/06/2014] [Accepted: 04/20/2015] [Indexed: 11/10/2022]
Abstract
Abstract
Background
Paget's disease of the breast is a rare condition that is associated with underlying breast cancer in the majority of patients. The conventional treatment for Paget's disease has been mastectomy, but there is an increasing trend to consider breast-conserving surgery (BCS) in selected patients. Owing to the uncommon nature of the disease, research studies tend to be small and retrospective. This systematic review presents the published evidence regarding BCS for patients with Paget's disease with a focus on patient selection and oncological safety.
Methods
A search of Ovid and PubMed databases was conducted to identify all papers published regarding BCS for Paget's disease.
Results
The search identified 172 papers of which 43 were clinically relevant. BCS is a safe alternative to mastectomy, provided a clear surgical margin is achieved and adjuvant radiotherapy used. However, patients with Paget's disease should be assumed to have underlying breast cancer, and these cancers tend to have poor biological profiles. When BCS is considered, careful preoperative investigation should be undertaken to identify the presence and extent of an underlying cancer. These cancers can be mammographically occult, multifocal or multicentric. Although the evidence is limited, there may be a role for MRI in selecting patients with Paget's disease for BCS.
Conclusion
Patients with Paget's disease are candidates for breast conservation with appropriate preoperative investigations. Oncological outcomes are equivalent to those of mastectomy if surgical margins are achieved and adjuvant radiotherapy is given.
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Affiliation(s)
- S Helme
- Breast Department, Queen Alexandra Hospital, Portsmouth, UK
| | - K Harvey
- Breast Department, Queen Alexandra Hospital, Portsmouth, UK
| | - A Agrawal
- Breast Department, Queen Alexandra Hospital, Portsmouth, UK
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Harvey K, Marchetti B. Regulating Wnt signaling: a strategy to prevent neurodegeneration and induce regeneration. J Mol Cell Biol 2014; 6:1-2. [DOI: 10.1093/jmcb/mju002] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Wasserman E, Orth H, Senekal M, Harvey K. High prevalence of mupirocin resistance associated with resistance to other antimicrobial agents in Staphylococcus aureusisolated from patients in private health care, Western Cape. S Afr J Infect Dis 2014. [DOI: 10.1080/23120053.2014.11441586] [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] Open
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Harvey K, Muniz G, Kuh D, Stafford M. OP07 The Association between Socioeconomic Position and Longitudinal Adult Social Integration in a British Birth Cohort. Br J Soc Med 2013. [DOI: 10.1136/jech-2013-203126.7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Matthewson S, Crozier I, Greenslade J, Harvey K, Inglis J, Melton I. Quality of Life Results after Insertion of Implantable Cardiac Defibrillators at Christchurch Hospital. Heart Lung Circ 2012. [DOI: 10.1016/j.hlc.2012.03.062] [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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Harvey K, Chedgy E, Adamson A. UP-01.008 Application of the SHEFFPAT Questionnaire to Assess Patient Feedback in a One-Stop Hematuria Clinic. Urology 2011. [DOI: 10.1016/j.urology.2011.07.560] [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: 11/16/2022]
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Willaert W, Aggarwal R, Harvey K, Cochennec F, Nestel D, Darzi A, Vermassen F, Cheshire N. Efficient Implementation of Patient-specific Simulated Rehearsal for the Carotid Artery Stenting Procedure: Part-task Rehearsal. Eur J Vasc Endovasc Surg 2011; 42:158-66. [DOI: 10.1016/j.ejvs.2011.03.032] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2011] [Accepted: 03/31/2011] [Indexed: 11/27/2022]
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Switzer BA, Harvey K, Grossman SR, Phillips DA, Shah SA, Bozorgzadeh A, Piperdi B. Single-institution experience using transarterial chemoembolization (TACE) with carboplatinum (carbo) and doxorubicin in patients (pts) with hepatocellular carcimona (HCC) awaiting liver transplantation (LTx). J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.4_suppl.336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
336 Background: LTx is the best treatment option for multinodular HCC and those with advanced liver dysfunction. Tumor progression occurs in 20-50% of pts on liver transplant list. TACE is increasingly used as locoregional therapy and as a bridge to LTx. We report here our single institutional experience with TACE using carbo and doxorubicin in pts with HCC awaiting LTx. Methods: Retrospective chart review was performed in all pts who had TACE between 2008 and June 2010. Our institutional protocol uses a fixed dose of carbo 300mg, doxorubicin 50mg, in 10ml of lipoidol solution. We analyzed pt demographics, etiologies of liver disease, Child-Pugh status, CLIP scores, size of tumor, alpha-fetoprotein (AFP), toxicity, length of stay, and transplantation statistics. Results: 32 pts (28 men) were treated with 39 TACE procedures. The median age was 57 (32-83). 28 of 32 had cirrhosis with Child's A/B/C 36/51/18% respectively. The major etiologies of cirrhosis were hepatitis C (HCV) 8, alcohol and HCV 19, alcohol 7; portal vein thrombosis in 8 pts. The median tumor size was 6.2 cm (range 2-12 cm) and 81% were multifocal CLIP score 0,1/2,>3 were 5/62/38%. There were no mortality within 30 days of TACE procedure. The majority of the pts were discharged after 24 hr observation; 6 pts require readmissions within 30days. There was no systemic hematologic toxicity. 11 pts had elevated AFP at baseline and 6/11 (54%) had >50 % reduction in AFP value. 11pts (34%) received Ltx; 3 pts came off the LTx list due to disease progression, 2 pts are still on transplant list, and 16pts not able to be listed. 42% of pts received sorafenib in addition to TACE. The median time from last TACE to LTx was 55 days and 4 pts received transplantation within 30days. Very good pathological treatment effect was observed in 8/11 explanted liver. Conclusions: Our regimen of TACE with carbo/doxorubicin appears to be a safe and tolerable approach for localized treatment as a bridge to liver transplantation. It has acceptable toxicity and is associated with good AFP and pathological responses. We plan to evaluate different baseline parameters for better pt selection. No significant financial relationships to disclose.
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Affiliation(s)
- B. A. Switzer
- University of Massachusetts Medical Center, Worcester, MA; Department of Cancer Biology, University of Massachusetts Medical School, Worcester, MA; Surgical Outcomes Analysis & Research, University of Massachusetts Medical School, Worcester, MA
| | - K. Harvey
- University of Massachusetts Medical Center, Worcester, MA; Department of Cancer Biology, University of Massachusetts Medical School, Worcester, MA; Surgical Outcomes Analysis & Research, University of Massachusetts Medical School, Worcester, MA
| | - S. R. Grossman
- University of Massachusetts Medical Center, Worcester, MA; Department of Cancer Biology, University of Massachusetts Medical School, Worcester, MA; Surgical Outcomes Analysis & Research, University of Massachusetts Medical School, Worcester, MA
| | - D. A. Phillips
- University of Massachusetts Medical Center, Worcester, MA; Department of Cancer Biology, University of Massachusetts Medical School, Worcester, MA; Surgical Outcomes Analysis & Research, University of Massachusetts Medical School, Worcester, MA
| | - S. A. Shah
- University of Massachusetts Medical Center, Worcester, MA; Department of Cancer Biology, University of Massachusetts Medical School, Worcester, MA; Surgical Outcomes Analysis & Research, University of Massachusetts Medical School, Worcester, MA
| | - A. Bozorgzadeh
- University of Massachusetts Medical Center, Worcester, MA; Department of Cancer Biology, University of Massachusetts Medical School, Worcester, MA; Surgical Outcomes Analysis & Research, University of Massachusetts Medical School, Worcester, MA
| | - B. Piperdi
- University of Massachusetts Medical Center, Worcester, MA; Department of Cancer Biology, University of Massachusetts Medical School, Worcester, MA; Surgical Outcomes Analysis & Research, University of Massachusetts Medical School, Worcester, MA
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Klemp JR, Aversman S, Befort C, Harvey K, Khan QJ, Sharma P, Kimler B, Phillips T, Fabian CJ. Abstract B4: Impact of obesity on the effectiveness of aromatase inhibitors (AIs): Can breast cancer survivors on AIs lose weight compared to non-AI users? Cancer Prev Res (Phila) 2010. [DOI: 10.1158/1940-6207.prev-10-b4] [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
Background and Objectives: Weight at diagnosis and weight gain after diagnosis are associated with increased risk of breast cancer (BrCa) recurrence and mortality. In addition, post-menopausal obese breast cancer survivors on anti-hormonal therapy were 40% more likely to develop a local recurrence and 46% more likely to develop a distant recurrence compared to their normal weight counterparts. This evaluation was conducted to examine if a diet/exercise/behavioral weight loss intervention for overweight breast cancer survivors: 1) would impact BrCa risk biomarkers and 2) would the response differ by aromatase inhibitor (AI) status.
Methods: 84 BrCa survivors with a BMI 25-45 kg/m,2 ≥3 months from chemotherapy were recruited, and 52 agreed to participate. 6 (11%) participants did not complete the intervention. The 6-month intervention included: 225 minutes/week of aerobic exercise, resistance training, 1200-1500 calorie/day diet, and weekly group behavioral meetings. Pre and postintervention assessments included: anthropometrics (weight, BMI), body composition (DEXA % body fat), and serum biomarkers (estradiol, testosterone, SHBG, IGF-1/IGFBP3, insulin, leptin, adiponectin, glucose, CRP, cholesterol). Results are shown for 52 women (median age 52 ± 8 years) who initiated the program and 45 (87%) who completed the 6-month intervention.
Results: Women were approximately 4.25 years from diagnosis, their median weight at diagnosis was 84.1 kg (±15.8), and BMI was 31.3 kg/m2 (±5.6). Median pre-intervention weight was 91.8 kg (±13.4) and participants lost an average of 10.6 kg (±6.0)* or 13.3% (±28.8)* of their starting weight after the 6-month intervention. BMI decreased from 32.6 kg/m2 (±4.7) to 28.2 kg/m2 (±4.7)* and total percent body fat decreased by 5.6% (±4.5)*. Favorable changes in serum biomarkers of BrCa risk were observed for insulin*, leptin*, adiponectin*, and estradiol*. When comparing AI users to nonusers the significant favorable change in estradiol was not seen for those on AI's. There was a significant difference in decrease in % body fat* between AI users and nonusers. No other differences were significant. (*p-values <0.05)
Conclusions: Overall, results suggest a 6-month diet/exercise/behavioral weight loss intervention in overweight post-menopausal BrCa survivors results in a significant decrease in weight and change in serum biomarkers of BrCa risk in both current AI users and nonusers, however, due to the small sample size significant between group difference were not seen. Larger studies evaluating the effects of weight and weight loss based on exposure to antihormonal therapy are needed.
Citation Information: Cancer Prev Res 2010;3(12 Suppl):B4.
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Affiliation(s)
| | | | | | | | | | | | - Bruce Kimler
- 1University of Kansas Medical Center, Westwood, KS
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Barrow G, Clarke TR, Carrington D, Harvey K, Barton EN. An analysis of three opportunistic infections in an outpatient HIV clinic in Jamaica. W INDIAN MED J 2010; 59:393-399. [PMID: 21355514] [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] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
OBJECTIVES To determine the occurrence of opportunistic infection (OI) in HIV-positive patients and to identify any risk factors which may be associated with such. METHODS A cross-sectional study of all patients attending the HIV out-patient clinic was conducted. Their hospital notes were examined between January 1 and December 31, 2007 inclusive, to identify any occurrence of opportunistic infection. In addition, the patient list was also cross-referenced with all patients hospitalized on the medical wards during the same time period. Clinical and demographic data were collected for all participants. The occurrence of opportunistic infections and the variables of age, gender CD4 counts and viral loads: (first ever last in 2007 and at diagnosis of OI [or within six months]), the use of primary and secondary prophylaxis, the discontinuation of prophylactic regimens and the HAART regime at diagnosis of an OI and the diagnostic and treatment protocols of these infections were calculated. RESULTS Six hundred and three patients participated in the study and 4.7% (n = 28) were found to have experienced at least one opportunistic infection in 2007. Significant associations were found between first and last CD4 cell count, viral load in 2007, year of entry into the clinic and death (p < 0.05). CONCLUSIONS Opportunistic infections continue to cause significant morbidity and mortality in the HIV-patient population in this study. Earlier entry to treatment facilities and the use of HAART and appropriate prophylaxis can reduce this impact and lead to improved quality of life for HIV-positive individuals.
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Affiliation(s)
- G Barrow
- Centre for HIV/AIDS Research, Education and Services, University Hospital of the West Indies, Kingston 7, Jamaica
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Soobrah R, Cameron L, Harvey K, Pitkin J, Reichert R. To improve or not to improve: assessing the quality of breast cancer information for patients on the internet. Eur J Surg Oncol 2009. [DOI: 10.1016/j.ejso.2009.07.107] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Cunningham B, Devine D, Harvey K. Time is money!: Cost Analysis of Nursing Salary Expenditure and Time Savings by Utilizing the Biopatch Dressing for Central Venous Catheters on an Inpatient Bone Marrow Transplant Unit. Biol Blood Marrow Transplant 2009. [DOI: 10.1016/j.bbmt.2008.12.101] [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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Figueroa JP, Duncan J, Byfield L, Harvey K, Gebre Y, Hylton-Kong T, Hamer F, Williams E, Carrington D, Brathwaite AR. A comprehensive response to the HIV/AIDS epidemic in Jamaica: a review of the past 20 years. W INDIAN MED J 2008; 57:562-576. [PMID: 19580238] [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] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
Jamaica has a well-established, comprehensive National Human Immunodeficiency Virus (HIV) programme that has slowed the HIV epidemic and mitigated its impact. Adult HIV prevalence has been stable at approximately 1.5% since 1996. HIV rates are high among those most at risk such as sex-workers (9%) and men who have sex with men [MSM] (31.8%). Risk behaviour among adults with AIDS includes multiple sexual partners (80%), a history of a sexually transmitted infection [STI] (51.1%), commercial sex (23.9%) and crack/cocaine (8.0%). Approximately 20% of all reported AIDS cases, mainly women, give no history of any of the usual risk factors for HIV infection. The national programme is based in the Ministry of Health. Since 1988, Jamaica has had a national plan to guide its HIV response. A National AIDS Committee was established in 1988 to lead the multi-sectoral response. Prevention approaches have included information, education and communication campaigns, condom promotion, sexually transmitted infections (STI) control, targeted interventions, cultural approaches, outreach and peer education, workplace programmes and HIV counselling and testing. Concerted efforts have been made to reduce HIV stigma and discrimination. Antiretroviral therapy (ARV) was introduced for prevention of mother-to-child transmission in 2001 and a public access treatment programme introduced in 2004. A national HIV/AIDS Policy was adopted unanimously in parliament in 2005. The National Strategic plan 2007-2012 commits Jamaica to achieving universal access to HIVprevention, treatment and care. Awareness of HIV and how to prevent it is near universal though belief in myths remains strong. The condom market has increased from approximately 2.5 million in 1985 to 12 million in 2006 while condom use has grown significantly with nearly 75% of men and 65% of women reporting condom use at last sex with a non-regular partner The proportion of women 15-24 years reporting ever having a HIV test increased from 29.8% in 2004 to 48.9% in 2008. HIV transmission from mother-to-child has declined from 25% prior to 2000 to less than 8% in 2007. As of September 2008, 4450 persons or an estimated 68.5% of persons with advanced HIV and AIDS have been placed on ARV treatment resulting in a significant decline in mortality and morbidity due to HIV
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Affiliation(s)
- J P Figueroa
- Department of Community Health and Psychiatry, The University of the West Indies, Kingston 7, Jamaica, West Indies.
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Christie CDC, Steel-Duncan J, Palmer P, Pierre R, Harvey K, Johnson N, Samuels LA, Dunkley-Thompson J, Singh-Minott I, Anderson M, Billings C, Evans-Gilbert T, Rodriquez B, McDonald C, Moore J, Taylor F, Smikle MF, Williams E, Whorms S, Davis D, Mullings A, Morgan O, McDonald D, Alexander G, Onyonyor A, Hylton-Kong T, Weller P, Harris M, Woodham A, Haughton D, Carrington D, Figueroa JP. Paediatric and perinatal HIV/AIDS in Jamaica an international leadership initiative, 2002-2007. W INDIAN MED J 2008; 57:204-215. [PMID: 19583118] [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] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
BACKGROUND Paediatric and Perinatal HIV/AIDS remain significant health challenges in the Caribbean where the HIV seroprevalence is second only to Sub-Saharan Africa. METHOD We describe a collaborative approach to the prevention, treatment and care ofHIVin pregnant women, infants and children in Jamaica. A team of academic and government healthcare personnel collaborated to address the paediatric and perinatal HIV epidemic in Greater Kingston as a model for Jamaica (population 2.6 million, HIV seroprevalence 1.5%). A five-point plan was utilized and included leadership and training, preventing mother-to-child transmission (pMTCT), treatment and care of women, infants and children, outcomes-based research and local, regional and international outreach. RESULTS A core group of paediatric/perinatal HIV professionals were trained, including paediatricians, obstetricians, public health practitioners, nurses, microbiologists, data managers, information technology personnel and students to serve Greater Kingston (birth cohort 20,000). During September 2002 to August 2007, over 69 793 pregnant women presented for antenatal care. During these five years, significant improvements occurred in uptake of voluntary counselling (40% to 91%) and HIV-testing (53% to 102%). Eight hundred and eighty-three women tested HIV-positive with seroprevalence rates of 1-2% each year The use of modified short course zidovudine or nevirapine in the first three years significantly reduced mother-to-child transmission (MTCT) of HIV from 29% to 6% (RR 0.27; 95%0 CI--0.10, 0.68). During 2005 to 2007 using maternal highly active antiretroviral therapy (HAART) with zidovudine and lamivudine with either nevirapine, nelfinavir or lopinavir/ritonavir and infant zidovudine and nevirapine, MTCT was further reduced to an estimated 1.6% in Greater Kingston and 4.75% islandwide. In five years, we evaluated 1570 children in four-weekly paediatric infectious diseases clinics in Kingston, St Andrew and St Catherine and in six rural outreach sites throughout Jamaica; 24% (377) had HIV/AIDS and 76% (1193) were HIV-exposed. Among the infected children, 79% (299 of 377) initiated HAART resulting in reduced HIV-attributable childhood morbidity and mortality islandwide. An outcomes-based research programme was successfully implemented. CONCLUSION Working collaboratively, our mission of pMTCT of HIV and improving the quality of life for families living and affected by HIV/AIDS in Jamaica is being achieved.
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Harvey K, Catty J, Langman A, Winfield H, Clement S, Burns E, White S, Burns T. A review of instruments developed to measure outcomes for carers of people with mental health problems. Acta Psychiatr Scand 2008; 117:164-76. [PMID: 18241311 DOI: 10.1111/j.1600-0447.2007.01148.x] [Citation(s) in RCA: 53] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
OBJECTIVE Community-based care for mental disorders places considerable burden on families and carers. Measuring their experiences has become a priority, but there is no consensus on appropriate instruments. We aimed to review instruments carers consider relevant to their needs and assess evidence for their use. METHOD A literature search was conducted for outcome measures used with mental health carers. Identified instruments were assessed for their relevance to the outcomes identified by carers and their psychometric properties. RESULTS Three hundred and ninety two published articles referring to 241 outcome measures were identified, 64 of which were eligible for review (used in three or more studies). Twenty-six instruments had good psychometric properties; they measured (i) carers' well-being, (ii) the experience of caregiving and (iii) carers' needs for professional support. CONCLUSION Measures exist which have been used to assess the most salient aspects of carers outcome in mental health. All require further work to establish their psychometric properties fully.
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Affiliation(s)
- K Harvey
- Department of Psychology and Clinical Language Sciences, Reading University, School of Psychology, Reading, UK.
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Harvey K, Davies R, Evans A, Latto IP, Hall JE. A comparison of the use of Trachlight and Eschmann multiple-use introducer in simulated difficult intubation. Eur J Anaesthesiol 2006; 24:76-81. [PMID: 16938152 DOI: 10.1017/s0265021506001177] [Citation(s) in RCA: 8] [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] [Accepted: 06/18/2006] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND OBJECTIVE The Eschmann multiple-use introducer is widely used in the management of difficult intubations. Transillumination of the neck is less commonly used. We conducted a randomized crossover study comparing the Trachlight lightwand and Eschmann multiple-use introducer in simulated difficult intubation. METHODS Sixty-four healthy patients were studied using a standard anaesthetic and full muscle relaxation assessed by train of four. A Macintosh laryngoscope was then inserted and then lowered to simulate a Grade 3 view. Tracheal placement was attempted with both Trachlight lightwand and Eschmann multiple-use introducer in a randomized order. Anaesthetists placing the devices had extensive experience with the Eschmann multiple-use introducer, but only 15 previous uses of the Trachlight. Success rates and time for tracheal placement were recorded. RESULTS The Eschmann multiple-use introducer and Trachlight were successfully placed in 96.8% and 93.7%, respectively (n.s.). Mean (SD) time to intubation for Eschmann multiple-use introducer and Trachlight were 15(6) and *21(13), respectively (*P < 0.001). CONCLUSION The Trachlight is a potentially useful alternative to the Eschmann multiple-use introducer in difficult intubation.
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Affiliation(s)
- K Harvey
- University Hospital of Wales, Cardiff University, Cardiff, UK
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Cann C, Harmer M, Harvey K, Rosen M. Evaluation of a needle-free system for delivery of skin anaesthesia. Anaesthesia 2005; 60:720. [PMID: 15960732 DOI: 10.1111/j.1365-2044.2005.04269.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Gohel MS, Barwell JR, Wakely C, Minor J, Harvey K, Earnshaw JJ, Heather BP, Whyman MR, Poskitt KR. The influence of superficial venous surgery and compression on incompetent calf perforators in chronic venous leg ulceration. Eur J Vasc Endovasc Surg 2005; 29:78-82. [PMID: 15570276 DOI: 10.1016/j.ejvs.2004.09.016] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
OBJECTIVES Previous studies have suggested that perforating vein incompetence is reduced by surgery to superficial veins. This study analysed the effect in a randomised clinical trial. DESIGN Retrospective analysis of duplex data. METHODS Patients in this study were part of the ESCHAR randomised controlled trial. All patients had chronic venous leg ulceration with superficial venous reflux. Patients were treated with compression bandaging alone or compression plus superficial venous surgery. Legs were assessed using colour venous duplex prior to treatment and at 3 and 12 months. RESULTS Of 500 patients recruited to the ESCHAR trial, 261 were included in this study. One hundred and forty six of 261 legs were treated with compression alone and 115/261 underwent compression and superficial venous surgery. In the compression group, more legs had incompetent perforators at 12 months (77/131) compared to baseline (61/146, p =0.010, Wilcoxon Signed Ranks test for paired data in 131 legs). Following surgery, significantly fewer legs had incompetent calf perforators (59/115 vs 44/104 at 12 months, p =0.001, Wilcoxon Signed Ranks test for paired data in 104 legs). In addition, significantly fewer legs in the compression and surgery group developed new perforator incompetence in comparison to the group treated with compression alone (12/104 vs 36/131, p =0.003, Chi-Squared test). CONCLUSION Surgical correction of superficial reflux may abolish incompetence in some calf perforators and offer protection against developing new perforator incompetence.
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Affiliation(s)
- M S Gohel
- Department of Vascular Surgery, Cheltenham General Hospital, GL53 7AN Gloucestershire, UK
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Abstract
We previously demonstrated that phosphatidic acid (PA) induces chemotactic migration of highly metastatic breast cancer cells MDA-MB-231. The widely used anticancer drug doxorubicin was reported to induce apoptosis of cancer cells. Growth factors such as epidermal growth factor (EGF) and bioactive lipids such as lysophosphatidic acid (LPA) and sphingosine 1-phosphate (SPP) have been shown to enhance viability and to protect cancer cells against apoptosis. In this study, we investigated the effect of PA on MDA-MB-231 cells exposed to the anticancer drug doxorubicin. Cell migration toward PA was partially inhibited by doxorubicin treatment, and PA moderately diminished cell cycle arrest of cells exposed to doxorubicin. Although PA itself was not able to induce apoptosis of MDA-MB-231 cells, apoptosis of cells exposed to doxorubicin was markedly enhanced by PA treatment. Thus, PA is able to increase the apoptotic potential of doxorubicin, and may regulate the effects of doxorubicin used for chemotherapy.
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Affiliation(s)
- D Sliva
- Methodist Research Institute, Clarian Health Partners Inc., Indianapolis, Indiana 46202, USA.
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Barwell J, Wakely C, Harvey K, Sassano A, Minor J, Earnshaw JJ, Heather B, Mitchell D, Whyman M, Poskitt K. Vascular 06. Br J Surg 2002. [DOI: 10.1046/j.1365-2168.89.s.1.10_6.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: 11/20/2022]
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Walsh E, Gilvarry C, Samele C, Harvey K, Manley C, Tyrer P, Creed F, Murray R, Fahy T. Reducing violence in severe mental illness: randomised controlled trial of intensive case management compared with standard care. BMJ 2001; 323:1093-6. [PMID: 11701572 PMCID: PMC59682 DOI: 10.1136/bmj.323.7321.1093] [Citation(s) in RCA: 98] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 07/23/2001] [Indexed: 11/03/2022]
Abstract
OBJECTIVES To establish whether intensive case management reduces violence in patients with psychosis in comparison with standard case management. DESIGN Randomised controlled trial with two year follow up. SETTING Four inner city community mental health services. PARTICIPANTS 708 patients with established psychotic illness allocated at random to intervention (353) or control (355) group. INTERVENTION Intensive case management (caseload 10-15 per case manager) for two years compared with standard case management (30-35 per case manager). MAIN OUTCOME MEASURE Physical assault over two years measured by interviews with patients and case managers and examination of case notes. RESULTS No significant reduction in violence was found in the intensive case management group compared with the control group (22.7% v 21.9%, P=0.86). CONCLUSIONS Intensive case management does not reduce the prevalence of violence in psychotic patients in comparison with standard care.
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Affiliation(s)
- E Walsh
- Section of Forensic Mental Health, Guy's King's and St. Thomas's School of Medicine, Institute of Psychiatry, London, UK
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Harvey K, Burns T, Fahy T, Manley C, Tattan T. Relatives of patients with severe psychotic illness: factors that influence appraisal of caregiving and psychological distress. Soc Psychiatry Psychiatr Epidemiol 2001; 36:456-61. [PMID: 11766978 DOI: 10.1007/s001270170024] [Citation(s) in RCA: 48] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
BACKGROUND Research shows considerable variability in the effect on relatives of patients' mental illness but the determinants of relatives' experience remain unclear. We investigated the influence of demographic, social and clinical characteristics on relatives' experience when conceptualised using a stress-appraisal-coping paradigm. METHODS Our sample was drawn from relatives of patients recruited to the UK700 case management study (n = 154). Demographic, social and clinical data were collected from patients, and relatives completed the Experience of Caregiving Inventory and the General Health Questionnaire. We predicted that patients' symptomatology in particular would influence relatives' experience, and that relatives who appraised caregiving more negatively and less positively would experience greater psychological distress. RESULTS Linear regression analyses revealed that relatives' appraisal was not predicted by patients' symptomatology. Instead, relatives appraised caregiving more negatively if the patient was unemployed or younger, and less positively if the patient had been ill for longer or had poorer social functioning. Little of the variance in appraisal was explained by these variables, however. Consistent with the stress-coping model, relatives' negative appraisal was a strong predictor of psychological distress and accounted for a substantial proportion of its variance. Positive appraisal did not predict psychological distress, however. None of the demographic, social or clinical characteristics tested had any significant effect on relatives' psychological distress once appraisal was adjusted for. There was an unexpected positive correlation between the two appraisal scales, with relatives who appraised caregiving more negatively also appraising it more positively. CONCLUSIONS Our results support a stress-coping model of caregiving but further research is required to determine more influential predictors of relatives' appraisal. Our findings indicate that interventions aimed at patients' social functioning and relatives' negative appraisal of caregiving may assist in reducing relatives' psychological distress.
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Affiliation(s)
- K Harvey
- Department of General Practice and Primary Care, Guy's King's and St Thomas' School of Medicine, London, UK.
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Hill J, Pickles A, Burnside E, Byatt M, Rollinson L, Davis R, Harvey K. Child sexual abuse, poor parental care and adult depression: evidence for different mechanisms. Br J Psychiatry 2001; 179:104-9. [PMID: 11483470 DOI: 10.1192/bjp.179.2.104] [Citation(s) in RCA: 75] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND Child sexual abuse (CSA) and poor parental care (neglect and institutional care) are associated with depression in adult life. Little is known about possible mechanisms underlying these associations. AIMS To examine the role of adult intimate-love relationships as differential mediators or moderators of the associations between CSA, poor parental care and adult depression. METHOD Sampling was carried out in two phases. In the first, questionnaires were sent to women aged 25-36 years in five primary care practices. Second-phase subjects for interview (n=198) were drawn from three strata defined on the basis of childhood adversities. Recalled childhood experiences and recent adult relationships and depression were assessed and rated independently. Frequencies of predictor and response variables, effect estimates and their confidence intervals were weighted back to the general population questionnaire sample. RESULTS The risk for depression associated with CSA was unaffected by quality of adult relationships, while the risk associated with poor parental care was substantially altered. CONCLUSIONS There may be different pathways linking CSA and poor parental care to adult depression.
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Affiliation(s)
- J Hill
- Department of Psychiatry, University of Liverpool, UK.
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Harvey K, Burns T, Sedgwick P, Higgitt A, Creed F, Fahy T. Relatives of patients with severe psychotic disorders: factors that influence contact frequency. Report from the UK700 trial. Br J Psychiatry 2001; 178:248-54. [PMID: 11230036 DOI: 10.1192/bjp.178.3.248] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND The isolation experienced by many patients with severe psychotic disorders is generally assumed to be due to their social withdrawal. An alternative possibility is that relatives avoid frequent contact with patients because they find the situation distressing. AIMS To examine the predictors of frequent patient-relative contact, in particular the role of relatives' experience. METHOD UK700 trial data were used to determine baseline predictors of frequent contact and establish whether relatives' experience at baseline predicted continued frequent contact 2 years later. RESULTS Neither characteristics associated in the literature with relatives' 'burden' nor relatives' experience predicted patient-relative contact frequency. Instead, the predictors were mainly demographic. CONCLUSIONS Many relatives experience considerable distress, but the evidence does not suggest that they avoid frequent contact with the patient as a consequence.
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Affiliation(s)
- K Harvey
- Community Psychiatry, St George's Hospital Medical School, London
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Walsh E, Harvey K, White I, Higgitt A, Fraser J. Suicidal behaviour in psychosis: prevalence and predictors from a randomised controlled trial of case management: report from the UK700 trial. Br J Psychiatry 2001; 178:255-60. [PMID: 11230037 DOI: 10.1192/bjp.178.3.255] [Citation(s) in RCA: 39] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND It is unclear whether intensive case management influences the prevalence of suicidal behaviour in patients with psychosis. AIMS To compare the effect of intensive case management and standard care on prevalence of suicidal behaviour in patients with chronic psychosis. METHOD Patients with established psychosis (n = 708) were randomised either to intensive case management or to standard care. The prevalence of suicidal behaviour was estimated at 2-year follow-up and compared between treatment groups. Suicide attempters and non-attempters were compared on multiple socio-demographic and clinical variables to identify predictors of suicidal behaviour. RESULTS There was no significant difference in prevalence of suicidal behaviour between treatment groups. Recent attempts at suicide and multiple recent hospital admissions best predicted future attempts. CONCLUSIONS Intensive case management does not appear to influence the prevalence of suicidal behaviour in chronic psychosis. Predictors identified in this study confirm some previous findings.
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Affiliation(s)
- E Walsh
- Institute of Psychiatry, London
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Hassiotis A, Ukoumunne OC, Byford S, Tyrer P, Harvey K, Piachaud J, Gilvarry K, Fraser J. Intellectual functioning and outcome of patients with severe psychotic illness randomised to intensive case management. Report from the UK700 trial. Br J Psychiatry 2001; 178:166-71. [PMID: 11157431 DOI: 10.1192/bjp.178.2.166] [Citation(s) in RCA: 59] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND Little research has been carried out on the benefits of intensive case management (ICM) for people with borderline IQ and severe mental illness. AIMS To compare outcome and costs of care of patients with severe psychotic illness with borderline IQ to patients of normal IQ and to assess whether ICM is more beneficial for the former than for the latter. METHOD The study utilises data from the UK700 multi-centre randomised controlled trial of case management. The main outcome measure was the number of days spent in hospital for psychiatric reasons. Secondary outcomes were costs of care and clinical outcome. RESULTS ICM was significantly more beneficial for borderline-IQ patients than those of normal IQ in terms of reductions in days spent in hospital, hospital admissions, total costs and needs and increased satisfaction. CONCLUSIONS ICM appears to be a cost-effective strategy for a subgroup of patients with severe psychosis with cognitive deficits.
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Affiliation(s)
- A Hassiotis
- Department of Psychiatry and Behavioural Sciences, RF & UCMS, Wolfson Building, 48 Riding House Street, London W1N AA, UK.
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Siddiqui RA, Jenski LJ, Neff K, Harvey K, Kovacs RJ, Stillwell W. Docosahexaenoic acid induces apoptosis in Jurkat cells by a protein phosphatase-mediated process. Biochim Biophys Acta 2001; 1499:265-75. [PMID: 11341974 DOI: 10.1016/s0167-4889(00)00128-2] [Citation(s) in RCA: 76] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Docosahexaenoic acid (DHA) is an omega-3 fatty acid under intense investigation for its ability to modulate cancer cell growth and survival. This research was performed to study the cellular and molecular effects of DHA. Our experiments indicated that the treatment of Jurkat cells with DHA inhibited their survival, whereas similar concentrations (60 and 90 microM) of arachidonic acid and oleic acid had little effect. To explore the mechanism of inhibition, we used several measures of apoptosis to determine whether this process was involved in DHA-induced cell death in Jurkat cells. Caspase-3, an important cytosolic downstream regulator of apoptosis, is activated by death signals through proteolytic cleavage. Incubation of Jurkat cells with 60 and 90 microM DHA caused proteolysis of caspase-3 within 48 and 24 h, respectively. DHA treatment also caused the degradation of poly-ADP-ribose polymerase and DNA fragmentation as assayed by flow cytometric TUNEL (terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling) assay. These results indicate that DHA induces apoptosis in Jurkat leukemic cells. DHA-induced apoptosis was effectively inhibited by tautomycin and cypermethrin at concentrations that affect protein phosphatase 1 (PP1) and protein phosphatase 2B (PP2B) activities, respectively, implying a role for these phosphatases in the apoptotic pathway. Okadaic acid, an inhibitor of protein phosphatase 2A, had no effect on DHA-induced apoptosis. These results suggest that one mechanism through which DHA may control cancer cell growth is through apoptosis involving PP1/PP2B protein phosphatase activities.
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Affiliation(s)
- R A Siddiqui
- Cellular Biochemistry Laboratory, Methodist Research Institute at Clarian Health, Indianapolis, IN 46202, USA.
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Sonza S, Mutimer HP, Oelrichs R, Jardine D, Harvey K, Dunne A, Purcell DF, Birch C, Crowe SM. Monocytes harbour replication-competent, non-latent HIV-1 in patients on highly active antiretroviral therapy. AIDS 2001; 15:17-22. [PMID: 11192864 DOI: 10.1097/00002030-200101050-00005] [Citation(s) in RCA: 174] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To determine whether HIV-1 can be recovered from blood monocytes as well as resting, memory CD4 T lymphocytes of patients on highly active antiretroviral therapy (HAART) with undetectable plasma viraemia and whether infection is active or latent. DESIGN Five patients with plasma HIV-1-RNA levels of less than 500 copies/ml for at least 3 months and less than 50 copies/ml at the time of sampling were initially selected, followed by an additional five patients with viral loads of less than 50 copies/ml for 3 months or more. METHODS Monocytes were isolated from blood by plastic adherence, then further purified by a second adherence step or CD3 depletion before co-culture with CD8-depleted donor peripheral blood mononuclear cells. Virus isolates were examined for mutations conferring resistance to reverse transcriptase or protease inhibitors and for genotype. The highly purified monocytes were also analysed for the presence of proviral and unintegrated viral DNA and multiply spliced (MS) viral mRNA by polymerase chain reaction. RESULTS Virus was recovered from monocytes of five patients. Sequencing of the recovered viruses did not reveal multiple drug resistance, and was consistent with a non-syncytium-inducing/CCR5 phenotype. Proviral DNA was detectable in monocytes from all subjects, and unintegrated HIV-1 DNA and MS RNA was found in four out of five populations examined. CONCLUSION Recovery of replication-competent virus from some HAART patients indicates that monocytes can also harbour HIV-1. Detection of circular, viral DNA and spliced RNA, albeit at very low levels, in these cells suggests that their infection is recent and transcriptionally active rather than latent.
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Affiliation(s)
- S Sonza
- AIDS Pathogenesis Research, Macfarlane Burnet Centre for Medical Research, Melbourne, Australia.
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