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van der Sluis LG, McGrath K, Thil F, Cersoy S, Pétillon JM, Zazzo A. Identification and tentative removal of collagen glue in Palaeolithic worked bone objects: implications for ZooMS and radiocarbon dating. Sci Rep 2023; 13:22119. [PMID: 38092830 PMCID: PMC10719399 DOI: 10.1038/s41598-023-49242-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Accepted: 12/06/2023] [Indexed: 12/17/2023] Open
Abstract
Collagen glue has been used for nearly two centuries to consolidate bone material, although its prevalence in museum collections is only now becoming visible. Identifying and removing collagen glue is crucial before the execution of any geochemical or molecular analyses. Palaeolithic bone objects from old excavations intended for radiocarbon dating were first analysed using ZooMS (Zooarchaeology by Mass Spectrometry) to identify the animal species, however peaks characteristic of both cattle and whale were discovered. Two extraction methods for ZooMS were tested to identify the authentic animal species of these objects, which revealed that these were originally whale bone objects that had been consolidated with cattle collagen glue. This is the first time animal collagen glue has been identified in archaeological remains with ZooMS, illustrating again the incredible versatility of this technique. Another technique, Fourier Transform Infrared Spectroscopy in Attenuated Total Reflectance mode (FTIR-ATR), was also tested if it could rapidly identify the presence of collagen glue in archaeological bone material, which was not the case. Two other cleaning methods were tested to remove bone glue contamination prior to radiocarbon dating, along with two modified collagen extraction methods for ZooMS. These methods were applied to bone blank samples (FmC = 0.0031 ± 0.0002, (n = 219), 47 336 ± 277 yr BP) that were experimentally consolidated with collagen glue and to the Palaeolithic bone material (ca. 15 000 and 12 000 yr BP). The experimental bone blanks produced excellent 14C ages, suggesting the cleaning methods were successful, however the 14C ages for some of the Palaeolithic material remained too young considering their contextual age, suggesting that the collagen glue contamination had most likely cross-linked to the authentic collagen molecule. More research is needed in order to gain a deeper understanding of the occurrence and elimination of cross-linked collagen-based glues in material from museum collections.
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Affiliation(s)
- L G van der Sluis
- UMR 7209, Archéozoologie, Archéobotanique: Sociétés, Pratiques et Environnements (AASPE), CNRS, Muséum national d'Histoire naturelle, Paris, France.
- Department of Evolutionary Anthropology, University of Vienna, Djerassiplatz 1, 1030, Vienna, Austria.
- Human Evolution and Archaeological Sciences (HEAS), University of Vienna, 1030, Vienna, Austria.
| | - K McGrath
- Department of Prehistory and Institute of Environmental Science and Technology (ICTA-UAB), Universitat Autònoma de Barcelona, 08193, Cerdanyola del Vallès, Barcelona, Spain
| | - F Thil
- Laboratoire des Sciences du Climat et de l'Environnement, LSCE/IPSL UMR 8212, CEA-CNRS-UVSQ, Université Paris Saclay, 91198, Gif-sur-Yvette, France
| | - S Cersoy
- Centre de Recherche sur la Conservation (CRC), UAR 3224, CNRS, Muséum national d'Histoire naturelle, Paris, France
| | - J-M Pétillon
- Travaux et Recherches Archéologiques sur les Cultures, les Espaces et les Sociétés (TRACES) UMR 5608, CNRS, Université Toulouse Jean Jaurès, Toulouse, France
| | - A Zazzo
- UMR 7209, Archéozoologie, Archéobotanique: Sociétés, Pratiques et Environnements (AASPE), CNRS, Muséum national d'Histoire naturelle, Paris, France
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Siegel J, McGrath K, Muniz E, Siasoco V, Chandan P, Noonan E, Bonuck K. Infusing intellectual and Developmental disability training into Medical School curriculum: a Pilot intervention. Med Educ Online 2023; 28:2271224. [PMID: 37859424 PMCID: PMC10591531 DOI: 10.1080/10872981.2023.2271224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Accepted: 10/11/2023] [Indexed: 10/21/2023]
Abstract
PURPOSE Despite the rising prevalence of developmental disabilities (DD) in the US, there remains insufficient training for healthcare professionals to care for this medically underserved population - particularly adults. The National Inclusive Curriculum for Health Education (NICHE) aims to improve attitudes and knowledge towards people with intellectual and developmental disabilities (PWIDD); herein we describe one such intervention. METHOD The intervention integrated didactic, panel presentation and clinical skills components into a 2nd year medical school curriculum. The didactic session, covering health and assessment of PWIDDs, history of IDD, stigma, etc., was co-taught by a developmental pediatrician, family medicine physician and social worker. A panel of 3 adult self-advocates (SAs) with DD and a parent of a child with DD spoke about their lived experiences. One week later, students practiced taking clinical histories of SAs within small group settings with adult PWIDDs, facilitated by medical school faculty. Students completed the NICHE Knowledge(49 items) and Attitudes (60 items) surveys. The evaluation analyzed pre/post intervention differences in a) knowledge and attitude scores overall and b) by student age, gender, intended medical specialty, and prior experiences with PWIDDs. Open-ended comments were analyzed with content analysis. RESULTS Overall Knowledge scores increased from pre-to posttest (n = 85; 65[19] vs. 73[17], p = 0.00), while Attitudes score improved (i.e., decreased) (n = 88; 0.55 [.06] vs. 0.53 [0.06]); p = 0.00). Higher pretest knowledge was found among female identified students (vs. others; p = 0.01) and those knowing > = 5 PWIDD (vs < 5; p = 0.02). Students characterize their IDD training and experience prior to intervention as 'lacking' and described the sessions as effective. CONCLUSIONS A brief (4 hours total) intervention was associated with modest but significant improved knowledge and attitudes towards PWIDDs. Replication and sustainability of this and other NICHE interventions are needed to fill gaps in PWIDDs' health care.
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Affiliation(s)
- Joanne Siegel
- Department of Pediatrics, Co-director, Rose F. Kennedy Univeristy Center of Excellence (UCEDD) at Chidlren’s Evaluation and Rehabilitation Center (CERC), Albert Einstein College of Medicine-Montefiore Medical Center, Bronx, NY, USA
| | - Kathleen McGrath
- Department of Pediatrics, CERC/Rose F. Kennedy Center, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Elisa Muniz
- Developmental-Behavioral Pediatrics Fellowship Program, Department of Pediatrics (Developmental Medicine), CERC/Rose F. Kennedy Center, Albert Einstein College of Medicine-Montefiore Medical Center, Bronx, NY, USA
| | - Vincent Siasoco
- Department of Pediatrics (Developmental Medicine), Department of Family & Social Medicine, CERC/Rose F. KennedyCenter, Albert Einstein College of Medicine-Montefiore Medical Center, Bronx, NY, USA
| | - Priya Chandan
- Healthcare Quality and Analytics, Kramer DavisHealth, Clinical Associate, Professor, Division of Physical Medicine & Rehabilitation, University of Louisville School of Medicine, Louisville, KY, USA
| | - Emily Noonan
- Department of Undergraduate Medical Education, University of Louisville School of Medicine, Louisville, KY, USA
| | - Karen Bonuck
- Department of Pediatrics, Co-director, Rose F. Kennedy Univeristy Center of Excellence (UCEDD) at Chidlren’s Evaluation and Rehabilitation Center (CERC), Albert Einstein College of Medicine-Montefiore Medical Center, Bronx, NY, USA
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Newell P, Kudlaty E, Patel G, McGrath K. A RARE CASE OF PROTRACTED ANAPHYLAXIS CAUSED BY ACETAMINOPHEN. Ann Allergy Asthma Immunol 2022. [DOI: 10.1016/j.anai.2022.08.791] [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: 11/11/2022]
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Phalen P, Grossmann J, Bruder T, Jeong JY, Calmes C, McGrath K, Malouf E, James A, Romero E, Bennett M. Description of a Dialectical Behavior Therapy program in a Veterans Affairs Health Care System. Eval Program Plann 2022; 92:102098. [PMID: 35525095 DOI: 10.1016/j.evalprogplan.2022.102098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Revised: 09/30/2021] [Accepted: 04/17/2022] [Indexed: 06/14/2023]
Abstract
A comprehensive Dialectical Behavior Therapy (DBT) program was created within a VA Health Care System for patients with recent psychiatric hospitalization, suicidality and/or significant emotion dysregulation. The program was notable for being one of a relatively small number of comprehensive DBT programs in the VA system, and for including patients with psychosis and psychotic disorder, with a majority of patients (58%) having a documented history of psychosis or endorsing psychotic symptoms in assessments. We describe the process of creating this program at a VA medical center and present preliminary program evaluation data. All patients completed assessments of suicidality (C-SSRS), emotion dysregulation (DERS), skills use and dysfunctional coping (DBT-WCCL), borderline symptomatology (BSL-23), and depression (PHQ-9) at program entry and subsequently every 6-8 weeks through program completion. Suicide attempts and hospitalizations were also tracked. Twelve patients completed multiple (up to six) assessment timepoints, allowing for evaluation of change during treatment. Patients demonstrated improvements on most measures and no hospitalizations or suicide attempts during active treatment, and the subsample with psychosis showed average improvements on every outcome measure. Eleven of 12 patients completed a full six-month rotation.
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Affiliation(s)
- Peter Phalen
- VA Maryland Health Care System, United States; University of Maryland School of Medicine, United States.
| | | | | | - Jae Yeon Jeong
- VA Maryland Health Care System, United States; University of Maryland School of Medicine, United States
| | | | | | | | | | - Erin Romero
- VA Maryland Health Care System, United States; University of Maryland School of Medicine, United States
| | - Melanie Bennett
- VA Maryland Health Care System, United States; University of Maryland School of Medicine, United States
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Dagra A, Barpujari A, Bauer SZ, Olowofela BO, Mohamed S, McGrath K, Robinson C, Robicsek S, Snyder A, Lucke-Wold B. Epigenetics of Neurotrauma. Neurology (Chic) 2022; 2:42-47. [PMID: 36507115 PMCID: PMC9732507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Epigenetic changes have been linked to a host of disease states. Besides the physiological function of epigenetic changes in regulating cellular function, recent data indicates that key changes in epigenetic activity also play an important pathophysiologic role following neurotrauma specifically. Such manifestations occur through the activation or silencing of different genes. Histone methylation has emerged as a critical component of this process and can be selectively modulated after injury. Pre-clinical studies have resulted in key discoveries regarding specific methylation sites of interest. This focused review highlights some of these early findings and their relationship to clinical outcomes. These findings suggest areas of future investigation and discovery in the quest to develop ideal biomarkers and methods to utilize them in developing therapeutic interventions.
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Affiliation(s)
- A Dagra
- College of Medicine, University of Florida, USA
| | - A Barpujari
- College of Liberal Arts and Sciences, University of Florida, USA
| | - SZ Bauer
- College of Medicine, University of Nevada, USA
| | | | - S Mohamed
- College of Medicine, University of Florida, USA
| | - K McGrath
- College of Medicine, University of Florida, USA
| | - C Robinson
- Departments of Neurology and Neuroscience, McKnight Brain Institute, University of Florida, USA
- Department of Neuroscience, Center for Translational Research in Neurodegenerative Disease, and Brain Injury Rehabilitation and Neuroresilience Center, University of Florida, USA
| | - S Robicsek
- Department of Anesthesiology, University of Florida, USA
| | - A Snyder
- Department of Neuropsychology, University of Florida, USA
| | - B Lucke-Wold
- Department of Neurosurgery, University of Florida, USA
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Bonuck K, Shafer V, Battino R, Valicenti-McDermott RM, Sussman ES, McGrath K. Language Disorders Research on Bilingualism, School-Age, and Related Difficulties: A Scoping Review of Descriptive Studies. Acad Pediatr 2022; 22:518-525. [PMID: 34896271 PMCID: PMC9252163 DOI: 10.1016/j.acap.2021.12.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 11/08/2021] [Accepted: 12/02/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND Developmental language disorder (DLD) often remains undetected until children shift from 'learning to read' to 'reading to learn,' around 9 years of age. Mono- and bilingual children with DLD frequently have co-occurring reading, attention, and related difficulties, compared to children with typical language development (TLD). Data for mono- and bilingual children with DLD and TLD would aid differentiation of language differences versus disorders in bilingual children. OBJECTIVE We conducted a scoping review of descriptive research on mono-and bilingual children < and >= 9 years old with DLD versus TLD, and related skills (auditory processing, attention, cognition, executive function, and reading). DATA SOURCES We searched PubMed for the terms "bilingual" and "language disorders" or "impairment" and "child[ren]" from August 1, 1979 through October 1, 2018. CHARTING METHODS Two abstracters charted all search results. Main exclusions were: secondary data/reviews, special populations, intervention studies, and case studies/series. Abstracted data included age, related skills measures', and four language groups of participants: monolingual DLD, monolingual TLD, bilingual DLD, and bilingual TLD. RESULTS Of 366 articles, 159 (43%) met inclusion criteria. Relatively few (14%, n = 22) included all 4 language groups, co-occurring difficulties other than nonverbal intelligence (n = 49, 31%) or reading (n = 51, 32%) or any 9-18 year-olds (31%, n = 48). Just 5 (3%) included only 9-18 year-olds. Among studies with any 9 to 18 year olds, just 4 (8%, 4/48) included 4 language groups. CONCLUSIONS Future research should include mono- and bilingual children with both DLD and TLD, beyond 8 years of age, along with data about their related skills.
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Affiliation(s)
| | | | | | | | | | - Kathleen McGrath
- Rose F. Kennedy CERC at Montefiore Medical Center, The University Hospital for Albert Einstein College of Medicine (R Battino, K McGrath), Bronx, NY.
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Rumore S, McGrath K, Scott A, Sexton E, Wong T. Fat soluble vitamin status in children on home parenteral nutrition in a tertiary paediatric intestinal rehabilitation unit. Clin Nutr ESPEN 2021; 46:240-245. [PMID: 34857203 DOI: 10.1016/j.clnesp.2021.10.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2021] [Revised: 09/20/2021] [Accepted: 10/04/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUNDS & AIMS Children with intestinal failure on home parenteral nutrition are at risk of fat malabsorption and fat soluble vitamin deficiency. Fish oil containing mixed lipid emulsions (SMOFlipid®) with higher vitamin E content, have a theoretical risk of exceeding current recommendations for vitamin E dosing and, may influence other fat soluble vitamin status in these children. The aim of this study was to assess for fat soluble vitamin status in children on long-term home parental nutrition receiving a mixed lipid emulsion (SMOFlipid®) compared with those receiving traditional soy or soy/olive oil based (non- SMOFlipid®) lipid emulsions and whether this is influenced by the underlying cause of intestinal failure. METHODS Retrospective longitudinal study in a tertiary referral paediatric hospital of children on home parental nutrition during the period January 2000 to June 2019. Data was retrieved using medical and pharmacy records, laboratory database, and summarised using inferential statistics. RESULTS 111 patients (n = 58 female) received home parental nutrition in 121 discrete episodes (range 45-5329 days). N = 61 (55%) were diagnosed with anatomical short bowel syndrome, of which necrotising enterocolitis was the most common cause (n = 14). SMOFlipid® was used exclusively in n = 79 patients, non-SMOFlipid® exclusively in n = 19, and n = 13 changed from non-SMOFlipid® to SMOFlipid® during the study period. The median vitamin E level and vitamin E:lipid ratio were significantly higher for patients on SMOFlipid® compared to non-SMOFlipid® (27.9 vs 18.3 μmol/L respectively, p < 0.001; 7.10 vs 4.00 μmol/mmol; p < 0.001). Median vitamin A level was comparable (1.19 vs 1.12 μmol/L, p = 0.241), while median vitamin D level was significantly lower in the non-SMOFlipid® group consistent with mild deficiency (63.7 vs 43.0 nmol/L, p < 0.001). CONCLUSION The use of SMOFlipid® correlated with higher Vitamin E level in paediatric home parental nutrition patients. Lower vitamin D level appears to correlate with the use of non-SMOFlipid®. A larger prospective cohort is required to delineate any clinical significance from these findings.
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Affiliation(s)
- Sarah Rumore
- Department of Gastroenterology and Nutrition, Nutritional Support and Intestinal Failure Team, Birmingham Women's and Children's Hospital, Steelhouse Lane, Birmingham, B4 6NH, UK.
| | - Kathleen McGrath
- Department of Gastroenterology and Nutrition, Nutritional Support and Intestinal Failure Team, Birmingham Women's and Children's Hospital, Steelhouse Lane, Birmingham, B4 6NH, UK
| | - Amanda Scott
- Nutritional Support and Intestinal Failure Team, Birmingham Women's and Children's Hospital, Steelhouse Lane, Birmingham, B4 6NH, UK
| | - Elaine Sexton
- Birmingham Women's and Children's Hospital, Steelhouse Lane, Birmingham, B4 6NH, UK
| | - Theodoric Wong
- Department of Gastroenterology and Nutrition, Nutritional Support and Intestinal Failure Team, Birmingham Women's and Children's Hospital, Steelhouse Lane, Birmingham, B4 6NH, UK
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Crowley P, Saramago I, Cannon R, McGrath K. 32 SIMULATION-BASED EDUCATION FOR ACUTE STROKE. Age Ageing 2021. [DOI: 10.1093/ageing/afab216.32] [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: 02/25/2023] Open
Abstract
Abstract
Background
Acute stroke requires efficient multi-disciplinary collaboration to deliver time-sensitive treatment in a prompt and effective manner. The European Stroke Organization (ESO) recommends simulation-based education (SBE) for stroke care. Studies have shown SBE improves door-to-needle times, which predict better patient outcomes.
SimStars was a competition, run by the National Doctors Training and Planning leads for the South-SouthWest Hospitals Group, to develop in-situ SBE scenarios.
We developed a SBE program for acute stroke in an Irish teaching hospital.
Methods
Medical doctors and nursing staff are included in the SBE scenario as candidates/target learners. Patients are played by role-players. Anonymised data and neuroimaging from real patients is utilized to maximize fidelity to real life. Other participants, such as paramedics, can be included to facilitate scenarios as required.
Candidates are briefed before each scenario. Clear learning objectives are set. All participants are provided with a script outlining their roles. Candidates are appraised using standard evaluation forms. A de-brief is undertaken to reinforce learning objectives.
Results
We qualified for the final of SimStars by establishing a SBE program for acute stroke, including a video of a simulated scenario that can be utilized for demonstration purposes. 100% of candidates who have participated in the SBE program so far have stated that it made a valuable contribution to their learning in the field of stroke care.
Conclusion
Stroke has been described as an exemplar of how SBE may benefit training along an entire clinical pathway. Scenarios can be adapted to cover an endless variety of stroke-related situations. SBE has been shown to improve hyper-acute clinical pathway performance and outcomes.
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Affiliation(s)
- P Crowley
- Mercy University Hospital , Cork, Ireland
| | - I Saramago
- Mercy University Hospital , Cork, Ireland
| | - R Cannon
- Mercy University Hospital , Cork, Ireland
| | - K McGrath
- Mercy University Hospital , Cork, Ireland
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McGrath K, Gibson J, Mardell A, Sumner G, Clarke B, Miller R. AMBULATORY PULMONARY ARTERY PRESSURE MONITORING REDUCES COSTS AND IMPROVES OUTCOMES IN SYMPTOMATIC HEART FAILURE: A SINGLE-CENTER CANADIAN EXPERIENCE. Can J Cardiol 2021. [DOI: 10.1016/j.cjca.2021.07.138] [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: 10/20/2022] Open
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Iadarola S, Siegel JF, Gao Q, McGrath K, Bonuck KA. COVID-19 vaccine perceptions in New York State's intellectual and developmental disabilities community. Disabil Health J 2021; 15:101178. [PMID: 34362712 PMCID: PMC8325377 DOI: 10.1016/j.dhjo.2021.101178] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Revised: 07/27/2021] [Accepted: 07/28/2021] [Indexed: 11/30/2022]
Abstract
Background People with intellectual and developmental disabilities (IDD) are at disproportionate risk for severe COVID-19 outcomes, particularly those living in congregate care settings. Yet, there is limited data on vaccine perceptions in the disability community. Objective To explore COVID-19 vaccine perceptions in individuals with IDD, their family members, and those who work with them, to inform a statewide vaccine information and messaging project. Methods A national survey, adapted in five languages for the IDD community, was distributed to a convenience sample of IDD organizations throughout New York State. Constructs included vaccine intention, reasons for vaccine hesitancy, and trusted sources of vaccine information. Zip code data were used to map respondent location and vaccine preferences. Results Of n = 825 respondents, approximately 75% intended to or had received the vaccine across roles (i.e., people with developmental disabilities, family members, direct care workers) and racial/ethnic groups. Greater vaccine hesitancy was reported in younger individuals and those making decisions on behalf of a person with IDD. Concerns included side effects and the swiftness of vaccine development. Black and Hispanic participants had heightened concerns about being an “experiment” for the vaccine. Trusted sources of information included healthcare providers and family members. Respondents who intended to/received the vaccine were dispersed throughout the state. Conclusions Vaccine preferences in this New York State disability community sample align with national data. Identified concerns suggest the need for community education that addresses misperceptions. Age and race differences in perspectives highlight the need for tailored education, delivered by trusted messengers.
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Affiliation(s)
- Suzannah Iadarola
- Strong Center for Developmental Disabilities, University of Rochester Medical Center, 601 Elmwood Ave, Box 671, Rochester, NY, 14642, United States.
| | - Joanne F Siegel
- Department of Pediatrics, Co-Director University Center of Excellence in Developmental Disabilities, Einstein College of Medicine-Montefiore Medical Center, 1300 Morris Park Ave., Bronx, NY, 10461, United States.
| | - Qi Gao
- Department of Epidemiology and Population Health, Einstein College of Medicine-Montefiore Medical Center, 1300 Morris Park Ave., Bronx, NY, 10461, United States.
| | - Kathleen McGrath
- Hunter College, Senior Research Coordinator, Einstein College of Medicine-Montefiore Medical Center, 1300 Morris Park Ave., Bronx, NY, 10461, United States.
| | - Karen A Bonuck
- Department of Family and Social Medicine/Department of Pediatrics, Co-Director, University Center of Excellence in Developmental Disabilities, Einstein College of Medicine-Montefiore Medical Center, 1300 Morris Park Ave., Bronx, NY, 10461, United States.
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McGrath K, Cox D. EPS2.03 Lumacaftor-ivacaftor therapy and its impact on glucose tolerance in children with cystic fibrosis. J Cyst Fibros 2021. [DOI: 10.1016/s1569-1993(21)01010-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Affiliation(s)
- R O'Caoimh
- Rónán O'Caoimh, Department of Geriatric Medicine, Mercy University Hospital, Grenville Place, Cork City, T12 WE28, Ireland, or , Orcid ID: 0000-0002-1499-673X, Tel: 00353 21 420 5976
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McGrath K, Bonuck K, Mann M. Exploratory spatial analysis of autism rates in New York school districts: role of sociodemographic and language differences. J Neurodev Disord 2020; 12:35. [PMID: 33327937 PMCID: PMC7745507 DOI: 10.1186/s11689-020-09338-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Accepted: 11/13/2020] [Indexed: 11/13/2022] Open
Abstract
Background Literature on autism spectrum disorder (ASD) suggests lower ASD prevalence and higher age of diagnosis among children of color, from lower socioeconomic backgrounds, and from families with lower educational levels. These disparities have been attributed to factors such as limited access to diagnostic and treatment services, less opportunity for upward mobility to locales with ample resources, and linguistic barriers. However, few studies describe prevalence and geographic differences of ASD diagnoses by English Language Learner (ELL) status. Objectives The primary objectives of this study are to (1) spatially explore the prevalence of ASD among New York State school districts and (2) examine differences of ASD prevalence rates between ELLs and native English-speaking peers. Methods Using the 2016–2017 district-level data on public and non-public school age students (3–21 years old) receiving special education services in New York, we analyzed sociodemographic trends among school districts with varying percentages (low, medium, and high ranges) of students with ASD and ELLs. To do this, we conducted exploratory spatial analyses using GIS software, analysis of school district level demographic data, and multivariate linear regression. Results In contrast to prior research on ASD prevalence among minority groups, we found disproportionately higher rates of ASD among school districts with higher proportions of Black and Hispanic students. Geographic analysis revealed statistically significant clustering of school districts with high ASD rates in New York City and Albany. Higher proportions of ELLs tended to be concentrated in densely populated, urban, and geographically smaller school districts and had higher proportions of Black, Hispanic, and Asian students. Conclusions Schools with higher rates of ASD and ELL students tend to be concentrated in urban regions throughout New York and have higher representation of Black and Hispanic/Latino students, as well as higher rates of learning disabilities in general. Further research is warranted to explore possible reasons for this phenomenon.
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Affiliation(s)
- Kathleen McGrath
- Albert Einstein College of Medicine, New York City, USA. .,CUNY Graduate Center, New York City, USA.
| | - Karen Bonuck
- Albert Einstein College of Medicine, New York City, USA
| | - Mana Mann
- Albert Einstein College of Medicine, New York City, USA
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Kim M, Perez M, Chen M, McGrath K. M168 RECURRENT OROLINGUAL ANGIOEDEMA (OAE) IN THE SETTING OF STROKE. Ann Allergy Asthma Immunol 2020. [DOI: 10.1016/j.anai.2020.08.240] [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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Bonuck K, McGrath K, Gao Q. National Parent Survey 2017: Worries, hopes, and child well-being. J Community Psychol 2020; 48:2532-2551. [PMID: 32840885 DOI: 10.1002/jcop.22434] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/03/2020] [Revised: 08/05/2020] [Accepted: 08/06/2020] [Indexed: 06/11/2023]
Abstract
Sociopolitical events impact population health; parents' perspective of such events crosses demographics, geography, and generations. We elicited changes in U.S. parents' hopes and worries for their children 1 year after the 2016 election via an online survey of school climate, discrimination against child, family health care and security, and macrolevel/future concerns (e.g., environment, postsecondary options). Among n = 1189 respondents, national security (39%), the environment (30.5%), and "continued place in America" (25.7%) were most worrisome. In general linear mixed models, employment buffered against social and material stressors such as discrimination (odds ratio [OR] = 0.67; 95% confidence interval [CI] = 0.49-0.92), and family health care/security (OR = 0.62; 95% CI = 0.45-0.86) while being of a dominant religion and ethnicity buffered future macrolevel (Christianity, OR = 70; 95% CI = 0.54-0.92/non-Hispanic, OR = 59; 95% CI = 0.39-0.90) and existential "continued place in America" (Christianity, OR = 69; 95% CI = 0.51-0.94/non-Hispanic, OR = 56; 95% CI = 0.36-0.88) worries. Qualitative comments underscored macrolevel worries. Parents represent a unique vantage for gauging how sociopolitical events impact health and well-being.
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Affiliation(s)
- Karen Bonuck
- Department of Family and Social Medicine, Einstein College of Medicine-Montefiore Medical Center, New York, USA
| | - Kathleen McGrath
- Department of Epidemiology and Population Health, Einstein College of Medicine-Montefiore Medical Center, New York, USA
| | - Qi Gao
- Department of Pediatrics, Einstein College of Medicine-Montefiore Medical Center, New York, USA
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Aleksova N, McGuinty C, Amadio J, McGrath K, Anderson K, Davey R, Clarke B, Chih S, Ross H, McDonald M. CANADIAN REPORT ON HEART TRANSPLANT OUTCOMES IN PATIENTS WITH URGENT LISTING PRIORITY. Can J Cardiol 2020. [DOI: 10.1016/j.cjca.2020.07.125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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McGrath K, Casserly M, O'mara F, Mulsow J, Shields C, Staunton O, Teeling SP, Ward M. Zap it track it: the application of Lean Six Sigma methods to improve the screening system of low-grade mucinous neoplasms of the appendix in an acute hospital setting. Int J Qual Health Care 2020; 31:35-44. [PMID: 31665301 DOI: 10.1093/intqhc/mzz075] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Revised: 05/20/2019] [Accepted: 07/03/2019] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVE To improve the number of patients receiving annual computed tomography (CT) scan and tumour markers, who are diagnosed with low-grade mucinous neoplasms (LAMN). DESIGN A pre-/post-intervention design was employed using Lean Six Sigma methods to identify gaps in the screening system and to develop and implement solutions for a more robust, auditable screening programme. SETTING The patients diagnosed with LAMN of the appendix referred to the acute hospital and are enrolled in the screening service. PARTICIPANTS Consultant colorectal surgeons, cancer nurse specialist, colorectal medical team and quality improvement staff. INTERVENTIONS Diagnostic tools identified gaps in the current process. A set of improvements were implemented to standardize the pathway for referral and surveillance of patients, provide information on the condition and treatment and standardize and track information received by patients and their referring hospital. MAIN OUTCOME MEASURE(S) Pre and post-intervention outcome measures were taken for the number of patients who receive an annual CT of thoracic, abdomen and peritoneum and tumour markers and number of patients who receive information and contact details. RESULTS At baseline, of the 28 patients that met the inclusion criteria only 61% had a correct follow-up. Following the implementation of improvements, 78% of patients had correct follow-up and 90% had received information. CONCLUSIONS Gaps in the current cancer screening system were identified and improvements implemented a reduced number of patients having an incorrect follow-up. Findings are applicable across all precancerous screening systems irrespective of the type of malignancy. The methods used empowered patients and fostered an interdisciplinary team approach to care.
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Affiliation(s)
- Kathleen McGrath
- Cancer Services, Mater Misericordiae University Hospital, Eccles St, Dublin 7, Republic of Ireland
| | - Mairéad Casserly
- Pharmacy Department, Mater Misericordiae University Hospital, Eccles St, Dublin 7, Republic of Ireland
| | - Freda O'mara
- Group Management, Ireland East Hospital Group, Mater Misericordiae University Hospital, Eccles St, Dublin 7, Republic of Ireland
| | - Jurgen Mulsow
- Peritoneal Malignancy Institute and Colorectal Surgery, Mater Misericordiae University Hospital, Eccles St, Dublin 7, Republic of Ireland
| | - Conor Shields
- Peritoneal Malignancy Institute and Colorectal Surgery, Mater Misericordiae University Hospital, Eccles St, Dublin 7, Republic of Ireland
| | - Oonagh Staunton
- Peritoneal Malignancy Institute and Colorectal Surgery, Mater Misericordiae University Hospital, Eccles St, Dublin 7, Republic of Ireland
| | - Seán Paul Teeling
- Lean Academy, Mater Misericordiae University Hospital, Eccles St, Dublin 7, Republic of Ireland and School of Nursing, Midwifery and Health Systems, C145, UCD Health Sciences Centre, University College Dublin, Belfield, Dublin 4, Ireland
| | - Marie Ward
- Centre for Innovative Human Systems, School of Psychology, Trinity College Dublin, the University of Dublin, Dublin 2, Ireland
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Suvakov S, Richards C, Nikolic V, Simic T, McGrath K, Krasnodembskaya A, McClements L. Emerging Therapeutic Potential of Mesenchymal Stem/Stromal Cells in Preeclampsia. Curr Hypertens Rep 2020; 22:37. [PMID: 32291521 DOI: 10.1007/s11906-020-1034-8] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
PURPOSE OF REVIEW Preeclampsia is a dangerous pregnancy condition affecting both the mother and offspring. It is a multifactorial disease with poorly understood pathogenesis, lacking effective treatments. Maternal immune response, inflammation and oxidative stress leading to endothelial dysfunction are the most prominent pathogenic processes implicated in preeclampsia development. Here, we give a detailed overview of the therapeutic applications and mechanisms of mesenchymal stem/stromal cells (MSCs) as a potential new treatment for preeclampsia. RECENT FINDINGS MSCs have gained growing attention due to low immunogenicity, easy cultivation and expansion in vitro. Accumulating evidence now suggests that MSCs act primarily through their secretomes facilitating paracrine signalling that leads to potent immunomodulatory, pro-angiogenic and regenerative therapeutic effects. MSCs have been studied in different animal models of preeclampsia demonstrating promising result, which support further investigations into the therapeutic effects and mechanisms of MSC-based therapies in preeclampsia, steering these therapies into clinical trials.
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Affiliation(s)
- S Suvakov
- Department of Nephrology and Hypertension, Mayo Clinic, Rochester, MN, USA.,Institute of Medical and Clinical Biochemistry, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - C Richards
- School of Life Sciences, Faculty of Science, University of Technology Sydney, Ultimo, NSW, Australia
| | - V Nikolic
- Department of Pharmacology and Toxicology, Medical Faculty, University of Nis, Nis, Serbia
| | - T Simic
- Institute of Medical and Clinical Biochemistry, Faculty of Medicine, University of Belgrade, Belgrade, Serbia.,Serbian Academy of Sciences and Arts, Belgrade, Serbia
| | - K McGrath
- School of Life Sciences, Faculty of Science, University of Technology Sydney, Ultimo, NSW, Australia
| | - A Krasnodembskaya
- The Wellcome-Wolfson Institute for Experimental Medicine, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, Northern Ireland, UK
| | - L McClements
- School of Life Sciences, Faculty of Science, University of Technology Sydney, Ultimo, NSW, Australia.
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Chen H, McGrath K, Rayner B, McClements L. 054 Potential New Treatment Based on FKBPL for Hypertension-Induced Cardiac Hypertrophy. Heart Lung Circ 2020. [DOI: 10.1016/j.hlc.2020.09.061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Sturgeon C, Dege C, Fegan K, Creamer JP, Berrien-Elliot M, Luff S, Kim D, Wagner J, Kingsley P, Fehniger T, McGrath K, Palis J, Sturgeon C. ONTOGENY IS A CRITICAL DETERMINANT OF NATURAL KILLER CELL POTENTIAL AND FUNCTION. Exp Hematol 2019. [DOI: 10.1016/j.exphem.2019.06.440] [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: 10/26/2022]
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Palis J, McGrath K, Frisch B, Li A, Ayoub E, Zhang YS, Becker M, Perkins A, Calvi L, Steiner L. Modeling Defective Erythropoiesis in Myelodysplastic Syndrome (MDS). Exp Hematol 2018. [DOI: 10.1016/j.exphem.2018.06.114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Sturgeon C, Dege C, McGrath K, Berrien-Elliot M, Fegan K, Fehniger T, Palis J. Ontogeny as a Critical Determinant of Natural Killer Cell Potential and Function. Exp Hematol 2018. [DOI: 10.1016/j.exphem.2018.06.158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Heinicke MP, Lemmon AR, Lemmon EM, McGrath K, Hedges SB. Phylogenomic support for evolutionary relationships of New World direct-developing frogs (Anura: Terraranae). Mol Phylogenet Evol 2018; 118:145-155. [DOI: 10.1016/j.ympev.2017.09.021] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2017] [Revised: 09/15/2017] [Accepted: 09/25/2017] [Indexed: 10/18/2022]
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Guo C, Cuervo-Pardo L, McGrath K. P478 Successful treatment of refractory itch with aprepitant. Ann Allergy Asthma Immunol 2017. [DOI: 10.1016/j.anai.2017.09.045] [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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Palis J, Frame J, Azzoni E, Koniski A, Lillis J, de Bruijn M, McGrath K. Emergence of definitive hematopoiesis in Myb-null mouse embryos. Exp Hematol 2017. [DOI: 10.1016/j.exphem.2017.06.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Palis J, Frame J, Azzoni E, Koniski A, Lillis J, de Bruijn M, McGrath K. Definitive erythro-myeloid progenitors (EMP) with macrophage-restricted lineage potential emerge in Myb-null murine embryos. Exp Hematol 2016. [DOI: 10.1016/j.exphem.2016.06.197] [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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Azzoni E, Harman J, Carrelha J, McGrath K, Nerlov C, Palis J, Jacobsen SE, De Bruijn M. Embryonic hematopoietic progenitors depend on kit ligand for in vivo expansion and differentiation. Exp Hematol 2016. [DOI: 10.1016/j.exphem.2016.06.048] [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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Wang J, Gibbons JF, McGrath K, Bai L, Li F, Leonard FC, Stephan R, Fanning S. Molecular characterization ofblaESBL-producingEscherichia colicultured from pig farms in Ireland. J Antimicrob Chemother 2016; 71:3062-3065. [DOI: 10.1093/jac/dkw278] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2016] [Revised: 05/17/2016] [Accepted: 06/09/2016] [Indexed: 11/13/2022] Open
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Thompson P, Conn H, Baxendale S, Donnachie E, McGrath K, Geraldi C, Duncan J. Optimizing memory function in temporal lobe epilepsy. Seizure 2016; 38:68-74. [DOI: 10.1016/j.seizure.2016.04.008] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2015] [Revised: 04/06/2016] [Accepted: 04/19/2016] [Indexed: 11/30/2022] Open
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Mulvey KL, Buchheister K, McGrath K. Evaluations of intergroup resource allocations: The role of theory of mind. J Exp Child Psychol 2016; 142:203-11. [DOI: 10.1016/j.jecp.2015.10.002] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2015] [Revised: 10/01/2015] [Accepted: 10/02/2015] [Indexed: 10/22/2022]
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McGrath K, Kingsley P, Bowen J, Fegan K, Palis J. Megakaryopoiesis in the mammalian embryo is associated with rapid lineage maturation and synthesis of platelets with altered activation. Exp Hematol 2013. [DOI: 10.1016/j.exphem.2013.05.043] [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: 10/26/2022]
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McGrath K. Effective nurse-patient communication in diabetes. Br J Nurs 2012; 21:458. [PMID: 22585072 DOI: 10.12968/bjon.2012.21.8.458] [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] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
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Greenberger P, Avila P, Ditto A, Grammer L, McGrath K, Peters A, Saltoun C. Skin Testing and Graded Challenges for Meropenem Hypersensitivity in Penicillin Allergic Subjects. J Allergy Clin Immunol 2012. [DOI: 10.1016/j.jaci.2011.12.504] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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Arya SK, Krishnan S, McGrath K, Rinaldi F, Bhansali S. Palladium Nanoparticles Film Based Concentration Specific Hydrogen Sensor. ACTA ACUST UNITED AC 2012. [DOI: 10.1166/sl.2012.2315] [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: 11/23/2022]
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Echeverri GJ, McGrath K, Bottino R, Hara H, Dons EM, van der Windt DJ, Ekser B, Casu A, Houser S, Ezzelarab M, Wagner R, Trucco M, Lakkis FG, Cooper DKC. Endoscopic gastric submucosal transplantation of islets (ENDO-STI): technique and initial results in diabetic pigs. Am J Transplant 2009; 9:2485-96. [PMID: 19775318 DOI: 10.1111/j.1600-6143.2009.02815.x] [Citation(s) in RCA: 66] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
The results of transplantation of human donor islets into the portal vein (PV) in patients with diabetes are encouraging. However, there are complications, for example, hemorrhage, thrombosis and an immediate loss of islets through the 'instant blood-mediated inflammatory reaction' (IBMIR). The gastric submucosal space (GSMS) offers potential advantages. Islets were isolated from adult pigs. Recipient pigs were made diabetic by streptozotocin. Donor islets were injected into the GSMS through a laparotomy (Group 1A, n = 4) or endoscopically (Group 1B, n = 8) or into the PV through a laparotomy (Group 2, n = 3). The pigs were followed for a maximum of 28 days. Monitoring of C-peptide in Group 1 indicated that there was minimal immediate loss of islets whereas in Group 2 there was considerable loss from IBMIR. In Group 1, there were significant reductions in mean blood glucose and mean exogenous insulin requirement between pretransplantation and 20 days posttransplantation. In Group 2, there was no significant reduction in either parameter. Insulin-positive cells were seen in the GSMS in Group 1, but not in the liver in Group 2. Endoscopic gastric submucosal transplantation of islets (ENDO-STI) offers a minimally invasive and quick approach to islet transplantation, avoids IBMIR and warrants further exploration.
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Affiliation(s)
- G J Echeverri
- Thomas E. Starzl Transplantation Institute, Department of Surgery, University of Pittsburgh, Pittsburgh, PA, USA
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Abstract
Red cells are required not only for adult well-being but also for survival and growth of the mammalian embryo beyond early postimplantation stages of development. The embryo's first "primitive" erythroid cells, derived from a transient wave of committed progenitors, emerge from the yolk sac as immature precursors and differentiate as a semisynchronous cohort in the bloodstream. Surprisingly, this maturational process in the mammalian embryo is characterized by globin gene switching and ultimately by enucleation. The yolk sac also synthesizes a second transient wave of "definitive" erythroid progenitors that enter the bloodstream and seed the liver of the fetus. At the same time, hematopoietic stem cells within the embryo also seed the liver and are the presumed source of long-term erythroid potential. Fetal definitive erythroid precursors mature in macrophage islands within the liver, enucleate, and enter the bloodstream as erythrocytes. Toward the end of gestation, definitive erythropoiesis shifts to its final location, the bone marrow. It has recently been recognized that the yolk sac-derived primitive and fetal definitive erythroid lineages, like their adult definitive erythroid counterpart, are each hierarchically associated with the megakaryocyte lineage. Continued comparative studies of primitive and definitive erythropoiesis in mammalian and nonmammalian embryos will lead to an improved understanding of terminal erythroid maturation and globin gene regulation.
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Affiliation(s)
- Kathleen McGrath
- Department of Pediatrics, Center for Pediatric Biomedical Research, University of Rochester, Rochester, New York 14642, USA
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Jani N, Dewitt J, Eloubeidi M, Varadarajulu S, Appalaneni V, Hoffman B, Brugge W, Lee K, Khalid A, McGrath K. Endoscopic ultrasound-guided fine-needle aspiration for diagnosis of solid pseudopapillary tumors of the pancreas: a multicenter experience. Endoscopy 2008; 40:200-3. [PMID: 18067066 DOI: 10.1055/s-2007-995364] [Citation(s) in RCA: 81] [Impact Index Per Article: 5.1] [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: 02/06/2023]
Abstract
BACKGROUND AND STUDY AIMS Solid pseudopapillary tumors of the pancreas are rare, low-grade, epithelial neoplasms that are usually discovered incidentally in young women. Distinguishing solid pseudopapillary tumors from other pancreatic tumors, especially pancreatic endocrine tumors, can be challenging. The role of endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) in this context remains unclear. The purpose of this study was to describe the endoscopic ultrasound features of solid pseudopapillary tumors and the role of EUS-FNA in the preoperative diagnosis of these tumors. PATIENTS AND METHODS Patients from five tertiary referral centers with surgically confirmed solid pseudopapillary tumors who had undergone preoperative EUS-FNA were included. The endoscopic ultrasound findings, cytologic descriptions, immunostaining results, operative records, surgical pathology, and results of the most recent clinical follow-up were reviewed. RESULTS A total of 28 patients were identified (four men [14 %], 24 women [86 %], mean age +/- standard deviation [SD] 35 +/- 10 years). Solid pseudopapillary tumors had been found as incidental findings on cross-sectional imaging in 50 % of cases. The mean tumor size +/- SD was 42 +/- 19.5 mm and the majority were located in the pancreatic body and tail. The endoscopic ultrasound report described a well-defined, echo-poor mass in 86 %; the tumors were solid in 14 patients (50 %), mixed solid and cystic in 11 patients (39 %), and cystic in three patients (11 %). A preoperative diagnosis of solid pseudopapillary tumor was made in 21 patients (75 %) on the basis of EUS-FNA cytology. Surgical resection was performed in all cases. Laparoscopic resection was performed in eight of these patients (29 %). CONCLUSIONS A solid pseudopapillary tumor should be included in the differential diagnosis of any well-demarcated, echo-poor, solid or mixed solid/cystic pancreatic lesion seen during endoscopic ultrasound, particularly in young women. The diagnostic accuracy of EUS-FNA for solid pseudopapillary tumors was 75 % in this study. A definitive preoperative diagnosis can guide the surgical approach in selected cases.
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Affiliation(s)
- N Jani
- University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
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Byrne MF, Gerke H, Mitchell RM, Stiffler HL, McGrath K, Branch MS, Baillie J, Jowell PS. Yield of endoscopic ultrasound-guided fine-needle aspiration of bile duct lesions. Endoscopy 2004; 36:715-9. [PMID: 15280978 DOI: 10.1055/s-2004-825657] [Citation(s) in RCA: 90] [Impact Index Per Article: 4.5] [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: 12/18/2022]
Abstract
BACKGROUND AND STUDY AIMS It is still difficult to differentiate reliably between benign and malignant biliary tract lesions. Endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) has added to the diagnostic power of EUS for other gastrointestinal tumors. A retrospective analysis of experience with FNA sampling of bile duct lesions was therefore carried out. PATIENTS AND METHODS All EUS-FNA procedures for bile duct masses or strictures were analyzed at our tertiary referral center from May 2000 through October 2002. Data for EUS findings, the results of EUS-FNA, and tissue sampling at surgery were included. EUS-FNA procedures were carried out using a 22-gauge needle. An experienced cytopathologist was present during FNA in all but three cases. Clinical follow-up details were recorded when available for patients in whom a suitable diagnostic gold standard was not available for comparison. RESULTS A total of 35 patients underwent EUS-FNA of bile duct lesions during the study period. There were no complications. Data for EUS-FNA of bile duct masses or strictures and tissue obtained at surgery were available for 23 patients. If positive cytology at surgical pathology is taken as the gold standard, EUS-FNA has a diagnostic yield for cancer of 100 % (if atypia/inconclusive findings in the FNA sample are regarded as benign). Eleven patients had a definite malignancy on surgical pathology. Of these 11 patients, five had a finding of malignancy on EUS-FNA, giving a sensitivity of 45 % (if FNA cytology reported as atypia/inconclusive is regarded as benign). Twelve patients had findings of no malignancy from tissue obtained at surgery. Of these 12 patients, nine had benign pathology and three had atypia/inconclusive findings in the EUS-FNA sample (specificity of 100 % if atypia/inconclusive findings are considered benign). A further 12 patients did not have surgical specimens for comparison with EUS-FNA results. Four patients had definite findings of malignancy on EUS-FNA alone, and one patient had FNA findings suspicious for malignancy. Seven patients had negative or equivocal EUS-FNA results. These 12 patients are described but excluded from further analysis, as a gold standard was not available for comparison. However, clinical follow-up data were available for eight of these 12 patients, and in each case the follow-up findings were compatible with previous benign or malignant EUS-FNA findings. CONCLUSIONS The practice of EUS-FNA has improved the diagnostic yield of EUS. These results suggest that it is a safe and useful procedure for investigating biliary masses or strictures that have hitherto caused considerable diagnostic confusion, especially in patients with negative brush cytology findings. The possibility of false-negative findings remains, but core biopsy needles may improve the situation. The results of further studies are awaited.
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Affiliation(s)
- M F Byrne
- Division of Gastroenterology, Duke University Medical Center, Durham, North Carolina, USA.
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Kim OK, Choi LS, Long T, McGrath K, Armistead JP, Yoon TH. Unusual complexation behavior of poly(acrylic acid) induced by shear. Macromolecules 2002. [DOI: 10.1021/ma00054a018] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.7] [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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Onaitis MW, Noone RB, Fields R, Hurwitz H, Morse M, Jowell P, McGrath K, Lee C, Anscher MS, Clary B, Mantyh C, Pappas TN, Ludwig K, Seigler HF, Tyler DS. Complete response to neoadjuvant chemoradiation for rectal cancer does not influence survival. Ann Surg Oncol 2001; 8:801-6. [PMID: 11776494 DOI: 10.1007/s10434-001-0801-2] [Citation(s) in RCA: 103] [Impact Index Per Article: 4.5] [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: 10/25/2022]
Abstract
BACKGROUND Up to 30% of patients with locally advanced rectal cancer have a complete clinical or pathologic response to neoadjuvant chemoradiation. This study analyzes complete clinical and pathologic responders among a large group of rectal cancer patients treated with neoadjuvant chemoradiation. METHODS From 1987 to 2000, 141 consecutive patients with biopsy-proven, locally advanced rectal cancer were treated with preoperative 5-fluorouracil-based chemotherapy and radiation. Clinical restaging after treatment consisted of proctoscopic examination and often computed tomography scan. One hundred forty patients then underwent operative resection, with results tracked in a database. Standard statistical methods were used to examine the outcomes of those patients with complete clinical or pathologic responses. RESULTS No demographic differences were detected between either clinical complete and clinical partial responders or pathologic complete and pathologic partial responders. The positive predictive value of clinical restaging was 60%, and accuracy was 82%. By use of the Kaplan-Meier life table analysis, clinical complete responders had no advantage in local recurrence, disease-free survival, or overall survival rates when compared with clinical partial responders. Pathologic complete responders also had no recurrence or survival advantage when compared with pathologic partial responders. Of the 34 pathologic T0 tumors, 4 (13%) had lymph node metastases. CONCLUSIONS Clinical assessment of complete response to neoadjuvant chemoradiation is unreliable. Micrometastatic disease persists in a proportion of patients despite pathologic complete response. Observation or local excision for patients thought to be complete responders should be undertaken with caution.
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Affiliation(s)
- M W Onaitis
- Department of Surgery, Duke University Medical Center, Durham, North Carolina 27710, USA
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Affiliation(s)
- M Golioto
- Division of Gastroenterology, Duke University Medical Center, Durham, North Carolina 27710, USA
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Onaitis MW, Noone RB, Hartwig M, Hurwitz H, Morse M, Jowell P, McGrath K, Lee C, Anscher MS, Clary B, Mantyh C, Pappas TN, Ludwig K, Seigler HF, Tyler DS. Neoadjuvant chemoradiation for rectal cancer: analysis of clinical outcomes from a 13-year institutional experience. Ann Surg 2001; 233:778-85. [PMID: 11371736 PMCID: PMC1421320 DOI: 10.1097/00000658-200106000-00007] [Citation(s) in RCA: 117] [Impact Index Per Article: 5.1] [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: 12/16/2022]
Abstract
OBJECTIVE To examine clinical outcomes in patients receiving neoadjuvant chemoradiation for locally advanced rectal adenocarcinoma. SUMMARY BACKGROUND DATA Preoperative radiation therapy, either alone or in combination with 5-fluorouracil-based chemotherapy, has proven both safe and effective in the treatment of rectal cancer. However, data are lacking regarding which subgroups of patients benefit from the therapy in terms of decreased local recurrence and increased survival rates. METHODS A retrospective chart review was performed on 141 consecutive patients who received neoadjuvant chemoradiation (5-fluorouracil +/- cisplatin and 4,500-5,040 cGy) for biopsy-proven locally advanced adenocarcinoma of the rectum. Surgery was performed 4 to 8 weeks after completion of chemoradiation. Standard statistical methods were used to analyze recurrence and survival. RESULTS Median follow-up was 27 months, and mean age was 59 years (range 28-81). Mean tumor distance from the anal verge was 6 cm (range 1-15). Of those staged before surgery with endorectal ultrasound or magnetic resonance imaging, 57% of stage II patients and 82% of stage III patients were downstaged. The chemotherapeutic regimens were well tolerated, and resections were performed on 140 patients. The percentage of sphincter-sparing procedures increased from 20% before 1996 to 76% after 1996. On pathologic analysis, 24% of specimens were T0. However, postoperative pathologic T stage had no effect on either recurrence or survival. Positive lymph node status predicted increased local recurrence and decreased survival. CONCLUSIONS Neoadjuvant chemoradiation is safe, effective, and well tolerated. Postoperative lymph node status is the only independent predictor of recurrence and survival.
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Affiliation(s)
- M W Onaitis
- Department of Surgery, Duke University Medical Center, Durham, North Carolina 27710, USA
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Golioto M, McGrath K. Primary lymphoma of the esophagus in a chronically immunosuppressed patient with hepatitis C infection: case report and review of the literature. Am J Med Sci 2001; 321:203-5. [PMID: 11269799 DOI: 10.1097/00000441-200103000-00010] [Citation(s) in RCA: 21] [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: 11/26/2022]
Abstract
Adenocarcinoma and squamous cell carcinoma account for the vast majority of esophageal malignancies. Other malignancies that can involve the esophagus include melanoma, sarcoma, and lymphoma. Gastrointestinal involvement with lymphoma has a variable incidence, as reported in the literature. However, primary involvement, as defined by Dawson, is extremely rare. Lymphoma has been linked to immunosuppressive conditions (such as AIDS), medications, and transplantation. We present what we believe to be the first case of primary esophageal lymphoma in a patient on long-term immunosuppression with azathioprine who was also infected with the hepatitis C virus (HCV). HCV has been postulated to have a relationship with B cell lymphomas.
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Affiliation(s)
- M Golioto
- Division of Gastroenterology, Duke University Medical Center, Durham, North Carolina, USA.
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McGrath K, Brazer S. Photodynamic therapy. A shining light. N C Med J 1999; 60:237-9. [PMID: 10424122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/13/2023]
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Abstract
This paper details the benchmarking process and its application to the activities of pathology laboratories participating in a benchmark pilot study [the Royal College of Pathologists of Australasian (RCPA) Benchmarking Project]. The discussion highlights the primary issues confronted in collecting, processing, analysing and comparing benchmark data. The paper outlines the benefits of engaging in a benchmarking exercise and provides a framework which can be applied across a range of public health settings. This information is then applied to a review of the development of the RCPA Benchmarking Project. Consideration is also given to the nature of the preliminary results of the project and the implications of these results to the on-going conduct of the study.
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Affiliation(s)
- M Gordon
- Centre for Clinical Epidemiology and BioStatistics, University of Newcastle, New South Wales, Australia
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Abstract
Two cases of endoscopic band ligation as lone therapy for Dieulafoy's lesions are presented. Neither patient has experienced further gastrointestinal bleeding; one patient has been followed for 27 months. Endoscopic band ligation is an alternative and attractive treatment modality for Dieulafoy's lesions.
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Affiliation(s)
- K McGrath
- Department of Medicine, Duke University Medical Center, Durham, North Carolina 27710, USA
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Q’Reilly G, Sheridan A, Carr A, Cherry J, Donohoe E, McGrath K, Phelan S, Tallon M, O’Reilly K. A descriptive study of adolescent sexual offenders in an Irish community based treatment programme. ACTA ACUST UNITED AC 1998. [DOI: 10.1080/03033910.1998.10558177] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Brouard M, Burak I, Markillie G, McGrath K, Vallance C. The H + H2O → OH + H2 reaction: OH state-resolved differential cross-sections and H2 internal energy disposals. Chem Phys Lett 1997. [DOI: 10.1016/s0009-2614(97)01158-5] [Citation(s) in RCA: 23] [Impact Index Per Article: 0.9] [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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Abstract
Idiopathic anaphylaxis in the pediatric population is being increasingly recognized, with symptoms (and therefore classifications) the same as those described in adults. We present a series of 22 patients with special attention to considerations relatively unique to the pediatric population. Prednisone, hydroxyzine, and albuterol were used to control symptoms and induce remission. No deaths occurred during treatment. One adolescent who presented with corticosteroid-dependent idiopathic anaphylaxis was diagnosed with undifferentiated somatoform-idiopathic anaphylaxis. Local physician reluctance to participate in management complicated care for some patients.
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Affiliation(s)
- A M Ditto
- Department of Medicine and the Ernest S. Bazley Asthma and Allergic Diseases Center of Northwestern Memorial Hospital and Northwestern University Medical School, Chicago, IL 60611, USA
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