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Favors L, Harrell K, Miles V, Hicks RC, Rippy M, Parmer H, Edwards A, Brown C, Stewart K, Day L, Wilson A, Maxwell R. Analysis of fibrinolytic shutdown in trauma patients with traumatic brain injury. Am J Surg 2024; 227:72-76. [PMID: 37802703 DOI: 10.1016/j.amjsurg.2023.09.034] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 09/01/2023] [Accepted: 09/25/2023] [Indexed: 10/08/2023]
Abstract
BACKGROUND Coagulation profiles following major trauma vary depending on injury pattern and degree of shock. The physiologic mechanisms involved in coagulation function at any given time are varied and remain poorly understood. Thromboelastography (TEG) has been used evaluate coagulation profiles in the trauma population with some reports demonstrating a spectrum of fibrinolysis to fibrinolytic shutdown on initial presentation. The objective of this study was to evaluate the fibrinolytic profile of patients with TBI using thromboelastography (TEG). We hypothesized that patients with TBI would demonstrate low fibrinolytic activity. METHODS All trauma activations at an ACS-verified level 1 trauma center received a TEG analysis upon arrival from December 2019 to June 2021. A retrospective review of the results and outcomes was conducted, and TBI patients were compared to patients without TBI. Linear regression was used to evaluate the effect of patient and injury factors on fibrinolysis. Hyperfibrinolysis was defined as LY30 > 7.7%, physiologic fibrinolysis as LY30 0.6-7.7%, and fibrinolytic shutdown as LY30 < 0.6%. RESULTS A total of 1369 patients received an admission TEG analysis. Patients with TBI had a significantly higher median ISS (16 vs. 8, p < 0.001), lower median admission Glasgow Coma Scale (14 vs. 15, p < 0.001), longer intensive care unit length of stay (3 vs. 2 days, p < 0.0001), increased ventilator days (216 vs. 183, p < 0.001), higher mortality (14.6% vs. 5.1%, p < 0.001), but lower shock index (0.6 vs. 0.7, p < 0.0001) compared to those without TBI. Median LY30 was found to be decreased in the TBI group (0.1 vs. 0.2, p = 0.0006). Patients with TBI were found to have a higher rate of fibrinolytic shutdown compared those without TBI (68.7% vs. 63.5%, p = 0.054). ISS, sex, and shock index were found to be predictive of LY30 on linear regression, but TBI was not (Β: 0.09, SE: 0.277, p = 0.745). The rate of DVT/PE did not appear to be elevated in patients with TBI (0.8%) and without TBI (1.2%). CONCLUSIONS Trauma patients with and without TBI were found to have high rates of fibrinolytic shutdown. Although there was a high incidence of fibrinolytic shutdown, it did not appear to have an impact on the rate of thrombotic complications. The clinical significance of these results is unclear and differs significantly from recent reports which demonstrated that TBI is associated with a 25% rate of fibrinolytic shutdown. Further investigation is needed to better define the fibrinolytic pathway in patients with trauma and TBI to develop optimal treatment algorithms.
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Affiliation(s)
- L Favors
- Department of Surgery, University of Tennessee College of Medicine Chattanooga, 979 East Third Street, Suite B-401, Chattanooga, TN, 37403, USA.
| | - K Harrell
- Department of Surgery, University of Tennessee College of Medicine Chattanooga, 979 East Third Street, Suite B-401, Chattanooga, TN, 37403, USA.
| | - V Miles
- Department of Surgery, University of Tennessee College of Medicine Chattanooga, 979 East Third Street, Suite B-401, Chattanooga, TN, 37403, USA.
| | - R C Hicks
- Department of Surgery, University of Tennessee College of Medicine Chattanooga, 979 East Third Street, Suite B-401, Chattanooga, TN, 37403, USA
| | - M Rippy
- Department of Surgery, University of Tennessee College of Medicine Chattanooga, 979 East Third Street, Suite B-401, Chattanooga, TN, 37403, USA
| | - H Parmer
- Department of Surgery, University of Tennessee College of Medicine Chattanooga, 979 East Third Street, Suite B-401, Chattanooga, TN, 37403, USA
| | - A Edwards
- Department of Surgery, University of Tennessee College of Medicine Chattanooga, 979 East Third Street, Suite B-401, Chattanooga, TN, 37403, USA
| | - C Brown
- Department of Surgery, University of Tennessee College of Medicine Chattanooga, 979 East Third Street, Suite B-401, Chattanooga, TN, 37403, USA
| | - K Stewart
- Department of Surgery, University of Tennessee College of Medicine Chattanooga, 979 East Third Street, Suite B-401, Chattanooga, TN, 37403, USA
| | - L Day
- Department of Surgery, University of Tennessee College of Medicine Chattanooga, 979 East Third Street, Suite B-401, Chattanooga, TN, 37403, USA
| | - A Wilson
- Department of Surgery, University of Tennessee College of Medicine Chattanooga, 979 East Third Street, Suite B-401, Chattanooga, TN, 37403, USA
| | - R Maxwell
- Department of Surgery, University of Tennessee College of Medicine Chattanooga, 979 East Third Street, Suite B-401, Chattanooga, TN, 37403, USA.
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Russell ER, Spencer SJ, Atherton CM, Lyall DM, Mackay DF, Stewart K, MacLean JA, Pell JP, Stewart W. Increased risk of lower limb osteoarthritis among former professional soccer (football) players. Occup Med (Lond) 2023; 73:547-553. [PMID: 38070190 PMCID: PMC10824258 DOI: 10.1093/occmed/kqad132] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2024] Open
Abstract
BACKGROUND Soccer is a high-speed contact sport with risk of injury. Despite long-standing concern, evidence to date remains inconsistent as to the association between playing professional-level soccer and lifelong musculoskeletal consequences. AIMS The objectives were to assess risk of osteoarthritis in former professional soccer players compared to matched general population controls, and subsequently assess associated musculoskeletal disorders which may contribute to, or result from, osteoarthritis-specifically meniscal injury and joint replacement. METHODS We conducted a retrospective cohort study using national electronic health records (EHRs) on a cohort of 7676 former professional soccer players aged 40 or over at recruitment, matched on year of birth, sex (all male) and socio-economic status with 23 028 general population controls. Outcomes of interest were obtained by utilizing individual-level record linkage to EHRs from general hospital inpatient and day-case admissions. RESULTS Compared to controls, former soccer players showed a greater risk of hospital admission for osteoarthritis (hazard ratio [HR] 3.01; 95% confidence interval [CI] 2.80-3.25; P < 0.001). This increased risk appeared age dependant, normalizing over age 80 years and reflective of increased risk of lower limb osteoarthritis. Further, risk of hospital admissions for meniscal injury (HR 2.73; 95% CI 2.42-3.08; P < 0.001) and joint replacement (HR 2.82; 95% CI 2.23-3.57; P < 0.001) were greater among former soccer players. CONCLUSIONS We report an increased risk of lower limb osteoarthritis in former soccer players when compared with matched population controls. The results of this research add data in support of lower limb osteoarthritis among former soccer players representing a potential industrial injury.
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Affiliation(s)
- E R Russell
- School of Psychology and Neuroscience, University of Glasgow, Glasgow G12 8QQ, UK
| | - S J Spencer
- Department of Orthopaedic Surgery, Queen Elizabeth University Hospital, Glasgow, G51 4TF, UK
| | - C M Atherton
- Department of Trauma and Orthopaedics, Queen Elizabeth University Hospital, Glasgow, G51 4TF, UK
| | - D M Lyall
- School of Health and Wellbeing, University of Glasgow, Glasgow G12 8TB, UK
| | - D F Mackay
- School of Health and Wellbeing, University of Glasgow, Glasgow G12 8TB, UK
| | - K Stewart
- School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow G12 8TA, UK
- Hampden Sports Clinic, Hampden Stadium, Glasgow G42 9ED, UK
| | - J A MacLean
- School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow G12 8TA, UK
- Hampden Sports Clinic, Hampden Stadium, Glasgow G42 9ED, UK
| | - J P Pell
- School of Health and Wellbeing, University of Glasgow, Glasgow G12 8TB, UK
| | - W Stewart
- School of Psychology and Neuroscience, University of Glasgow, Glasgow G12 8QQ, UK
- Department of Neuropathology, Queen Elizabeth University Hospital, Glasgow G51 4TF, UK
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Yeo JJY, Stewart K, Maniam P, Arman S, Srinivasan D, Wall L, MacNeill M, Strachan M, Nixon I. Neoadjuvant tyrosine kinase inhibitor therapy in locally advanced differentiated thyroid cancer: a single centre case series. J Laryngol Otol 2023; 137:1237-1243. [PMID: 36946096 DOI: 10.1017/s0022215123000506] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/23/2023]
Abstract
OBJECTIVE Primary surgical resection remains the mainstay of management in locally advanced differentiated thyroid cancer. Tyrosine kinase inhibitors have recently shown promising results in patients with recurrent locally advanced differentiated thyroid cancer. This study discussed four patients with locally advanced differentiated thyroid cancer managed with tyrosine kinase inhibitors used prior to surgery in the 'neoadjuvant' setting. METHOD Prospective data collection through a local thyroid database from February 2016 identified four patients with locally advanced differentiated thyroid cancer unsuitable for primary surgical resection commenced on neoadjuvant tyrosine kinase inhibitor therapy. RESULTS All cases had T4a disease at presentation. Three cases tolerated tyrosine kinase inhibitor therapy for more than 14 months while the last case failed to tolerate treatment at 1 month. All patients subsequently underwent total thyroidectomy to facilitate adjuvant radioactive iodine treatment. Disease-specific survival remains at 100 per cent currently (range, 29-75 months). CONCLUSION Neoadjuvant tyrosine kinase inhibitors in locally advanced differentiated thyroid cancer can be effective in reducing primary tumour extent to potentially facilitate a more limited surgical resection for local disease control.
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Affiliation(s)
- J J Y Yeo
- Department of Head and Neck Surgery, St John's Hospital at Howden, Livingston, UK
| | - K Stewart
- Department of Head and Neck Surgery, St John's Hospital at Howden, Livingston, UK
| | - P Maniam
- Department of Head and Neck Surgery, St John's Hospital at Howden, Livingston, UK
| | - S Arman
- Department of Head and Neck Surgery, St John's Hospital at Howden, Livingston, UK
| | - D Srinivasan
- Department of Oncology, Western General Hospital, Edinburgh, UK
| | - L Wall
- Department of Oncology, Western General Hospital, Edinburgh, UK
| | - M MacNeill
- Department of Pathology, Royal Infirmary of Edinburgh, Edinburgh, UK
| | - M Strachan
- Metabolic Unit, Western General Hospital, Edinburgh, UK
| | - I Nixon
- Department of Head and Neck Surgery, St John's Hospital at Howden, Livingston, UK
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Smitherman EA, Chahine RA, Beukelman T, Lewandowski LB, Rahman AKMF, Wenderfer SE, Curtis JR, Hersh AO, Abulaban K, Adams A, Adams M, Agbayani R, Aiello J, Akoghlanian S, Alejandro C, Allenspach E, Alperin R, Alpizar M, Amarilyo G, Ambler W, Anderson E, Ardoin S, Armendariz S, Baker E, Balboni I, Balevic S, Ballenger L, Ballinger S, Balmuri N, Barbar‐Smiley F, Barillas‐Arias L, Basiaga M, Baszis K, Becker M, Bell‐Brunson H, Beltz E, Benham H, Benseler S, Bernal W, Beukelman T, Bigley T, Binstadt B, Black C, Blakley M, Bohnsack J, Boland J, Boneparth A, Bowman S, Bracaglia C, Brooks E, Brothers M, Brown A, Brunner H, Buckley M, Buckley M, Bukulmez H, Bullock D, Cameron B, Canna S, Cannon L, Carper P, Cartwright V, Cassidy E, Cerracchio L, Chalom E, Chang J, Chang‐Hoftman A, Chauhan V, Chira P, Chinn T, Chundru K, Clairman H, Co D, Confair A, Conlon H, Connor R, Cooper A, Cooper J, Cooper S, Correll C, Corvalan R, Costanzo D, Cron R, Curiel‐Duran L, Curington T, Curry M, Dalrymple A, Davis A, Davis C, Davis C, Davis T, De Benedetti F, De Ranieri D, Dean J, Dedeoglu F, DeGuzman M, Delnay N, Dempsey V, DeSantis E, Dickson T, Dingle J, Donaldson B, Dorsey E, Dover S, Dowling J, Drew J, Driest K, Du Q, Duarte K, Durkee D, Duverger E, Dvergsten J, Eberhard A, Eckert M, Ede K, Edelheit B, Edens C, Edens C, Edgerly Y, Elder M, Ervin B, Fadrhonc S, Failing C, Fair D, Falcon M, Favier L, Federici S, Feldman B, Fennell J, Ferguson I, Ferguson P, Ferreira B, Ferrucho R, Fields K, Finkel T, Fitzgerald M, Fleming C, Flynn O, Fogel L, Fox E, Fox M, Franco L, Freeman M, Fritz K, Froese S, Fuhlbrigge R, Fuller J, George N, Gerhold K, Gerstbacher D, Gilbert M, Gillispie‐Taylor M, Giverc E, Godiwala C, Goh I, Goheer H, Goldsmith D, Gotschlich E, Gotte A, Gottlieb B, Gracia C, Graham T, Grevich S, Griffin T, Griswold J, Grom A, Guevara M, Guittar P, Guzman M, Hager M, Hahn T, Halyabar O, Hammelev E, Hance M, Hanson A, Harel L, Haro S, Harris J, Harry O, Hartigan E, Hausmann J, Hay A, Hayward K, Heiart J, Hekl K, Henderson L, Henrickson M, Hersh A, Hickey K, Hill P, Hillyer S, Hiraki L, Hiskey M, Hobday P, Hoffart C, Holland M, Hollander M, Hong S, Horwitz M, Hsu J, Huber A, Huggins J, Hui‐Yuen J, Hung C, Huntington J, Huttenlocher A, Ibarra M, Imundo L, Inman C, Insalaco A, Jackson A, Jackson S, James K, Janow G, Jaquith J, Jared S, Johnson N, Jones J, Jones J, Jones J, Jones K, Jones S, Joshi S, Jung L, Justice C, Justiniano A, Karan N, Kaufman K, Kemp A, Kessler E, Khalsa U, Kienzle B, Kim S, Kimura Y, Kingsbury D, Kitcharoensakkul M, Klausmeier T, Klein K, Klein‐Gitelman M, Kompelien B, Kosikowski A, Kovalick L, Kracker J, Kramer S, Kremer C, Lai J, Lam J, Lang B, Lapidus S, Lapin B, Lasky A, Latham D, Lawson E, Laxer R, Lee P, Lee P, Lee T, Lentini L, Lerman M, Levy D, Li S, Lieberman S, Lim L, Lin C, Ling N, Lingis M, Lo M, Lovell D, Lowman D, Luca N, Lvovich S, Madison C, Madison J, Manzoni SM, Malla B, Maller J, Malloy M, Mannion M, Manos C, Marques L, Martyniuk A, Mason T, Mathus S, McAllister L, McCarthy K, McConnell K, McCormick E, McCurdy D, Stokes PM, McGuire S, McHale I, McMonagle A, McMullen‐Jackson C, Meidan E, Mellins E, Mendoza E, Mercado R, Merritt A, Michalowski L, Miettunen P, Miller M, Milojevic D, Mirizio E, Misajon E, Mitchell M, Modica R, Mohan S, Moore K, Moorthy L, Morgan S, Dewitt EM, Moss C, Moussa T, Mruk V, Murphy A, Muscal E, Nadler R, Nahal B, Nanda K, Nasah N, Nassi L, Nativ S, Natter M, Neely J, Nelson B, Newhall L, Ng L, Nicholas J, Nicolai R, Nigrovic P, Nocton J, Nolan B, Oberle E, Obispo B, O'Brien B, O'Brien T, Okeke O, Oliver M, Olson J, O'Neil K, Onel K, Orandi A, Orlando M, Osei‐Onomah S, Oz R, Pagano E, Paller A, Pan N, Panupattanapong S, Pardeo M, Paredes J, Parsons A, Patel J, Pentakota K, Pepmueller P, Pfeiffer T, Phillippi K, Marafon DP, Phillippi K, Ponder L, Pooni R, Prahalad S, Pratt S, Protopapas S, Puplava B, Quach J, Quinlan‐Waters M, Rabinovich C, Radhakrishna S, Rafko J, Raisian J, Rakestraw A, Ramirez C, Ramsay E, Ramsey S, Randell R, Reed A, Reed A, Reed A, Reid H, Remmel K, Repp A, Reyes A, Richmond A, Riebschleger M, Ringold S, Riordan M, Riskalla M, Ritter M, Rivas‐Chacon R, Robinson A, Rodela E, Rodriquez M, Rojas K, Ronis T, Rosenkranz M, Rosolowski B, Rothermel H, Rothman D, Roth‐Wojcicki E, Rouster – Stevens K, Rubinstein T, Ruth N, Saad N, Sabbagh S, Sacco E, Sadun R, Sandborg C, Sanni A, Santiago L, Sarkissian A, Savani S, Scalzi L, Schanberg L, Scharnhorst S, Schikler K, Schlefman A, Schmeling H, Schmidt K, Schmitt E, Schneider R, Schollaert‐Fitch K, Schulert G, Seay T, Seper C, Shalen J, Sheets R, Shelly A, Shenoi S, Shergill K, Shirley J, Shishov M, Shivers C, Silverman E, Singer N, Sivaraman V, Sletten J, Smith A, Smith C, Smith J, Smith J, Smitherman E, Soep J, Son M, Spence S, Spiegel L, Spitznagle J, Sran R, Srinivasalu H, Stapp H, Steigerwald K, Rakovchik YS, Stern S, Stevens A, Stevens B, Stevenson R, Stewart K, Stingl C, Stokes J, Stoll M, Stringer E, Sule S, Sumner J, Sundel R, Sutter M, Syed R, Syverson G, Szymanski A, Taber S, Tal R, Tambralli A, Taneja A, Tanner T, Tapani S, Tarshish G, Tarvin S, Tate L, Taxter A, Taylor J, Terry M, Tesher M, Thatayatikom A, Thomas B, Tiffany K, Ting T, Tipp A, Toib D, Torok K, Toruner C, Tory H, Toth M, Tse S, Tubwell V, Twilt M, Uriguen S, Valcarcel T, Van Mater H, Vannoy L, Varghese C, Vasquez N, Vazzana K, Vehe R, Veiga K, Velez J, Verbsky J, Vilar G, Volpe N, von Scheven E, Vora S, Wagner J, Wagner‐Weiner L, Wahezi D, Waite H, Walker J, Walters H, Muskardin TW, Waqar L, Waterfield M, Watson M, Watts A, Weiser P, Weiss J, Weiss P, Wershba E, White A, Williams C, Wise A, Woo J, Woolnough L, Wright T, Wu E, Yalcindag A, Yee M, Yen E, Yeung R, Yomogida K, Yu Q, Zapata R, Zartoshti A, Zeft A, Zeft R, Zhang Y, Zhao Y, Zhu A, Zic C. Childhood-Onset Lupus Nephritis in the Childhood Arthritis and Rheumatology Research Alliance Registry: Short-Term Kidney Status and Variation in Care. Arthritis Care Res (Hoboken) 2023; 75:1553-1562. [PMID: 36775844 PMCID: PMC10500561 DOI: 10.1002/acr.25002] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 07/14/2022] [Accepted: 08/16/2022] [Indexed: 11/10/2022]
Abstract
OBJECTIVE The goal was to characterize short-term kidney status and describe variation in early care utilization in a multicenter cohort of patients with childhood-onset systemic lupus erythematosus (cSLE) and nephritis. METHODS We analyzed previously collected prospective data from North American patients with cSLE with kidney biopsy-proven nephritis enrolled in the Childhood Arthritis and Rheumatology Research Alliance (CARRA) Registry from March 2017 through December 2019. We determined the proportion of patients with abnormal kidney status at the most recent registry visit and applied generalized linear mixed models to identify associated factors. We also calculated frequency of medication use, both during induction and ever recorded. RESULTS We identified 222 patients with kidney biopsy-proven nephritis, with 64% class III/IV nephritis on initial biopsy. At the most recent registry visit at median (interquartile range) of 17 (8-29) months from initial kidney biopsy, 58 of 106 patients (55%) with available data had abnormal kidney status. This finding was associated with male sex (odds ratio [OR] 3.88, 95% confidence interval [95% CI] 1.21-12.46) and age at cSLE diagnosis (OR 1.23, 95% CI 1.01-1.49). Patients with class IV nephritis were more likely than class III to receive cyclophosphamide and rituximab during induction. There was substantial variation in mycophenolate, cyclophosphamide, and rituximab ever use patterns across rheumatology centers. CONCLUSION In this cohort with predominately class III/IV nephritis, male sex and older age at cSLE diagnosis were associated with abnormal short-term kidney status. We also observed substantial variation in contemporary medication use for pediatric lupus nephritis between pediatric rheumatology centers. Additional studies are needed to better understand the impact of this variation on long-term kidney outcomes.
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Stewart K, Ellsworth K, Degraffenreid C, Kilic S. Lumbosacral osteomyelitis after robotic sacrocolpopexy. Am J Obstet Gynecol 2023. [DOI: 10.1016/j.ajog.2022.12.270] [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: 03/10/2023]
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Hahn T, Daymont C, Beukelman T, Groh B, Hays K, Bingham CA, Scalzi L, Abel N, Abulaban K, Adams A, Adams M, Agbayani R, Aiello J, Akoghlanian S, Alejandro C, Allenspach E, Alperin R, Alpizar M, Amarilyo G, Ambler W, Anderson E, Ardoin S, Armendariz S, Baker E, Balboni I, Balevic S, Ballenger L, Ballinger S, Balmuri N, Barbar-Smiley F, Barillas-Arias L, Basiaga M, Baszis K, Becker M, Bell-Brunson H, Beltz E, Benham H, Benseler S, Bernal W, Beukelman T, Bigley T, Binstadt B, Black C, Blakley M, Bohnsack J, Boland J, Boneparth A, Bowman S, Bracaglia C, Brooks E, Brothers M, Brown A, Brunner H, Buckley M, Buckley M, Bukulmez H, Bullock D, Cameron B, Canna S, Cannon L, Carper P, Cartwright V, Cassidy E, Cerracchio L, Chalom E, Chang J, Chang-Hoftman A, Chauhan V, Chira P, Chinn T, Chundru K, Clairman H, Co D, Confair A, Conlon H, Connor R, Cooper A, Cooper J, Cooper S, Correll C, Corvalan R, Costanzo D, Cron R, Curiel-Duran L, Curington T, Curry M, Dalrymple A, Davis A, Davis C, Davis C, Davis T, De Benedetti F, De Ranieri D, Dean J, Dedeoglu F, DeGuzman M, Delnay N, Dempsey V, DeSantis E, Dickson T, Dingle J, Donaldson B, Dorsey E, Dover S, Dowling J, Drew J, Driest K, Du Q, Duarte K, Durkee D, Duverger E, Dvergsten J, Eberhard A, Eckert M, Ede K, Edelheit B, Edens C, Edens C, Edgerly Y, Elder M, Ervin B, Fadrhonc S, Failing C, Fair D, Falcon M, Favier L, Federici S, Feldman B, Fennell J, Ferguson I, Ferguson P, Ferreira B, Ferrucho R, Fields K, Finkel T, Fitzgerald M, Fleming C, Flynn O, Fogel L, Fox E, Fox M, Franco L, Freeman M, Fritz K, Froese S, Fuhlbrigge R, Fuller J, George N, Gerhold K, Gerstbacher D, Gilbert M, Gillispie-Taylor M, Giverc E, Godiwala C, Goh I, Goheer H, Goldsmith D, Gotschlich E, Gotte A, Gottlieb B, Gracia C, Graham T, Grevich S, Griffin T, Griswold J, Grom A, Guevara M, Guittar P, Guzman M, Hager M, Hahn T, Halyabar O, Hammelev E, Hance M, Hanson A, Harel L, Haro S, Harris J, Harry O, Hartigan E, Hausmann J, Hay A, Hayward K, Heiart J, Hekl K, Henderson L, Henrickson M, Hersh A, Hickey K, Hill P, Hillyer S, Hiraki L, Hiskey M, Hobday P, Hoffart C, Holland M, Hollander M, Hong S, Horwitz M, Hsu J, Huber A, Huggins J, Hui-Yuen J, Hung C, Huntington J, Huttenlocher A, Ibarra M, Imundo L, Inman C, Insalaco A, Jackson A, Jackson S, James K, Janow G, Jaquith J, Jared S, Johnson N, Jones J, Jones J, Jones J, Jones K, Jones S, Joshi S, Jung L, Justice C, Justiniano A, Karan N, Kaufman K, Kemp A, Kessler E, Khalsa U, Kienzle B, Kim S, Kimura Y, Kingsbury D, Kitcharoensakkul M, Klausmeier T, Klein K, Klein-Gitelman M, Kompelien B, Kosikowski A, Kovalick L, Kracker J, Kramer S, Kremer C, Lai J, Lam J, Lang B, Lapidus S, Lapin B, Lasky A, Latham D, Lawson E, Laxer R, Lee P, Lee P, Lee T, Lentini L, Lerman M, Levy D, Li S, Lieberman S, Lim L, Lin C, Ling N, Lingis M, Lo M, Lovell D, Lowman D, Luca N, Lvovich S, Madison C, Madison J, Manzoni SM, Malla B, Maller J, Malloy M, Mannion M, Manos C, Marques L, Martyniuk A, Mason T, Mathus S, McAllister L, McCarthy K, McConnell K, McCormick E, McCurdy D, Stokes PMC, McGuire S, McHale I, McMonagle A, McMullen-Jackson C, Meidan E, Mellins E, Mendoza E, Mercado R, Merritt A, Michalowski L, Miettunen P, Miller M, Milojevic D, Mirizio E, Misajon E, Mitchell M, Modica R, Mohan S, Moore K, Moorthy L, Morgan S, Dewitt EM, Moss C, Moussa T, Mruk V, Murphy A, Muscal E, Nadler R, Nahal B, Nanda K, Nasah N, Nassi L, Nativ S, Natter M, Neely J, Nelson B, Newhall L, Ng L, Nicholas J, Nicolai R, Nigrovic P, Nocton J, Nolan B, Oberle E, Obispo B, O’Brien B, O’Brien T, Okeke O, Oliver M, Olson J, O’Neil K, Onel K, Orandi A, Orlando M, Osei-Onomah S, Oz R, Pagano E, Paller A, Pan N, Panupattanapong S, Pardeo M, Paredes J, Parsons A, Patel J, Pentakota K, Pepmueller P, Pfeiffer T, Phillippi K, Marafon DP, Phillippi K, Ponder L, Pooni R, Prahalad S, Pratt S, Protopapas S, Puplava B, Quach J, Quinlan-Waters M, Rabinovich C, Radhakrishna S, Rafko J, Raisian J, Rakestraw A, Ramirez C, Ramsay E, Ramsey S, Randell R, Reed A, Reed A, Reed A, Reid H, Remmel K, Repp A, Reyes A, Richmond A, Riebschleger M, Ringold S, Riordan M, Riskalla M, Ritter M, Rivas-Chacon R, Robinson A, Rodela E, Rodriquez M, Rojas K, Ronis T, Rosenkranz M, Rosolowski B, Rothermel H, Rothman D, Roth-Wojcicki E, Rouster-Stevens K, Rubinstein T, Ruth N, Saad N, Sabbagh S, Sacco E, Sadun R, Sandborg C, Sanni A, Santiago L, Sarkissian A, Savani S, Scalzi L, Schanberg L, Scharnhorst S, Schikler K, Schlefman A, Schmeling H, Schmidt K, Schmitt E, Schneider R, Schollaert-Fitch K, Schulert G, Seay T, Seper C, Shalen J, Sheets R, Shelly A, Shenoi S, Shergill K, Shirley J, Shishov M, Shivers C, Silverman E, Singer N, Sivaraman V, Sletten J, Smith A, Smith C, Smith J, Smith J, Smitherman E, Soep J, Son M, Spence S, Spiegel L, Spitznagle J, Sran R, Srinivasalu H, Stapp H, Steigerwald K, Rakovchik YS, Stern S, Stevens A, Stevens B, Stevenson R, Stewart K, Stingl C, Stokes J, Stoll M, Stringer E, Sule S, Sumner J, Sundel R, Sutter M, Syed R, Syverson G, Szymanski A, Taber S, Tal R, Tambralli A, Taneja A, Tanner T, Tapani S, Tarshish G, Tarvin S, Tate L, Taxter A, Taylor J, Terry M, Tesher M, Thatayatikom A, Thomas B, Tiffany K, Ting T, Tipp A, Toib D, Torok K, Toruner C, Tory H, Toth M, Tse S, Tubwell V, Twilt M, Uriguen S, Valcarcel T, Van Mater H, Vannoy L, Varghese C, Vasquez N, Vazzana K, Vehe R, Veiga K, Velez J, Verbsky J, Vilar G, Volpe N, von Scheven E, Vora S, Wagner J, Wagner-Weiner L, Wahezi D, Waite H, Walker J, Walters H, Muskardin TW, Waqar L, Waterfield M, Watson M, Watts A, Weiser P, Weiss J, Weiss P, Wershba E, White A, Williams C, Wise A, Woo J, Woolnough L, Wright T, Wu E, Yalcindag A, Yee M, Yen E, Yeung R, Yomogida K, Yu Q, Zapata R, Zartoshti A, Zeft A, Zeft R, Zhang Y, Zhao Y, Zhu A, Zic C. Intraarticular steroids as DMARD-sparing agents for juvenile idiopathic arthritis flares: Analysis of the Childhood Arthritis and Rheumatology Research Alliance Registry. Pediatr Rheumatol Online J 2022; 20:107. [PMID: 36434731 PMCID: PMC9701017 DOI: 10.1186/s12969-022-00770-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Accepted: 11/08/2022] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Children with juvenile idiopathic arthritis (JIA) who achieve a drug free remission often experience a flare of their disease requiring either intraarticular steroids (IAS) or systemic treatment with disease modifying anti-rheumatic drugs (DMARDs). IAS offer an opportunity to recapture disease control and avoid exposure to side effects from systemic immunosuppression. We examined a cohort of patients treated with IAS after drug free remission and report the probability of restarting systemic treatment within 12 months. METHODS We analyzed a cohort of patients from the Childhood Arthritis and Rheumatology Research Alliance (CARRA) Registry who received IAS for a flare after a period of drug free remission. Historical factors and clinical characteristics and of the patients including data obtained at the time of treatment were analyzed. RESULTS We identified 46 patients who met the inclusion criteria. Of those with follow up data available 49% had restarted systemic treatment 6 months after IAS injection and 70% had restarted systemic treatment at 12 months. The proportion of patients with prior use of a biologic DMARD was the only factor that differed between patients who restarted systemic treatment those who did not, both at 6 months (79% vs 35%, p < 0.01) and 12 months (81% vs 33%, p < 0.05). CONCLUSION While IAS are an option for all patients who flare after drug free remission, it may not prevent the need to restart systemic treatment. Prior use of a biologic DMARD may predict lack of success for IAS. Those who previously received methotrexate only, on the other hand, are excellent candidates for IAS.
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Affiliation(s)
- Timothy Hahn
- Department of Pediatrics, Penn State Children's Hospital, 500 University Dr, Hershey, 90 Hope Drive, P.O. Box 855, Hershey, PA, 17033-0855, USA.
| | - Carrie Daymont
- grid.240473.60000 0004 0543 9901Department of Pediatrics, Penn State Children’s Hospital, 500 University Dr, Hershey, 90 Hope Drive, P.O. Box 855, Hershey, PA 17033-0855 USA
| | - Timothy Beukelman
- grid.265892.20000000106344187Department of Pediatrics, University of Alabama at Birmingham, CPPN G10, 1600 7th Ave South, Birmingham, AL 35233 USA
| | - Brandt Groh
- grid.240473.60000 0004 0543 9901Department of Pediatrics, Penn State Children’s Hospital, 500 University Dr, Hershey, 90 Hope Drive, P.O. Box 855, Hershey, PA 17033-0855 USA
| | | | - Catherine April Bingham
- grid.240473.60000 0004 0543 9901Department of Pediatrics, Penn State Children’s Hospital, 500 University Dr, Hershey, 90 Hope Drive, P.O. Box 855, Hershey, PA 17033-0855 USA
| | - Lisabeth Scalzi
- grid.240473.60000 0004 0543 9901Department of Pediatrics, Penn State Children’s Hospital, 500 University Dr, Hershey, 90 Hope Drive, P.O. Box 855, Hershey, PA 17033-0855 USA
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Gwilym BL, Pallmann P, Waldron CA, Thomas-Jones E, Milosevic S, Brookes-Howell L, Harris D, Massey I, Burton J, Stewart P, Samuel K, Jones S, Cox D, Clothier A, Edwards A, Twine CP, Bosanquet DC, Benson R, Birmpili P, Blair R, Bosanquet DC, Dattani N, Dovell G, Forsythe R, Gwilym BL, Hitchman L, Machin M, Nandhra S, Onida S, Preece R, Saratzis A, Shalhoub J, Singh A, Forget P, Gannon M, Celnik A, Duguid M, Campbell A, Duncan K, Renwick B, Moore J, Maresch M, Kamal D, Kabis M, Hatem M, Juszczak M, Dattani N, Travers H, Shalan A, Elsabbagh M, Rocha-Neves J, Pereira-Neves A, Teixeira J, Lyons O, Lim E, Hamdulay K, Makar R, Zaki S, Francis CT, Azer A, Ghatwary-Tantawy T, Elsayed K, Mittapalli D, Melvin R, Barakat H, Taylor J, Veal S, Hamid HKS, Baili E, Kastrisios G, Maltezos C, Maltezos K, Anastasiadou C, Pachi A, Skotsimara A, Saratzis A, Vijaynagar B, Lau S, Velineni R, Bright E, Montague-Johnstone E, Stewart K, King W, Karkos C, Mitka M, Papadimitriou C, Smith G, Chan E, Shalhoub J, Machin M, Agbeko AE, Amoako J, Vijay A, Roditis K, Papaioannou V, Antoniou A, Tsiantoula P, Bessias N, Papas T, Dovell G, Goodchild F, Nandhra S, Rammell J, Dawkins C, Lapolla P, Sapienza P, Brachini G, Mingoli A, Hussey K, Meldrum A, Dearie L, Nair M, Duncan A, Webb B, Klimach S, Hardy T, Guest F, Hopkins L, Contractor U, Clothier A, McBride O, Hallatt M, Forsythe R, Pang D, Tan LE, Altaf N, Wong J, Thurston B, Ash O, Popplewell M, Grewal A, Jones S, Wardle B, Twine C, Ambler G, Condie N, Lam K, Heigberg-Gibbons F, Saha P, Hayes T, Patel S, Black S, Musajee M, Choudhry A, Hammond E, Costanza M, Shaw P, Feghali A, Chawla A, Surowiec S, Encalada RZ, Benson R, Cadwallader C, Clayton P, Van Herzeele I, Geenens M, Vermeir L, Moreels N, Geers S, Jawien A, Arentewicz T, Kontopodis N, Lioudaki S, Tavlas E, Nyktari V, Oberhuber A, Ibrahim A, Neu J, Nierhoff T, Moulakakis K, Kakkos S, Nikolakopoulos K, Papadoulas S, D'Oria M, Lepidi S, Lowry D, Ooi S, Patterson B, Williams S, Elrefaey GH, Gaba KA, Williams GF, Rodriguez DU, Khashram M, Gormley S, Hart O, Suthers E, French S. Short-term risk prediction after major lower limb amputation: PERCEIVE study. Br J Surg 2022; 109:1300-1311. [PMID: 36065602 DOI: 10.1093/bjs/znac309] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 05/06/2022] [Accepted: 07/31/2022] [Indexed: 01/22/2023]
Abstract
BACKGROUND The accuracy with which healthcare professionals (HCPs) and risk prediction tools predict outcomes after major lower limb amputation (MLLA) is uncertain. The aim of this study was to evaluate the accuracy of predicting short-term (30 days after MLLA) mortality, morbidity, and revisional surgery. METHODS The PERCEIVE (PrEdiction of Risk and Communication of outcomE following major lower limb amputation: a collaboratIVE) study was launched on 1 October 2020. It was an international multicentre study, including adults undergoing MLLA for complications of peripheral arterial disease and/or diabetes. Preoperative predictions of 30-day mortality, morbidity, and MLLA revision by surgeons and anaesthetists were recorded. Probabilities from relevant risk prediction tools were calculated. Evaluation of accuracy included measures of discrimination, calibration, and overall performance. RESULTS Some 537 patients were included. HCPs had acceptable discrimination in predicting mortality (931 predictions; C-statistic 0.758) and MLLA revision (565 predictions; C-statistic 0.756), but were poor at predicting morbidity (980 predictions; C-statistic 0.616). They overpredicted the risk of all outcomes. All except three risk prediction tools had worse discrimination than HCPs for predicting mortality (C-statistics 0.789, 0.774, and 0.773); two of these significantly overestimated the risk compared with HCPs. SORT version 2 (the only tool incorporating HCP predictions) demonstrated better calibration and overall performance (Brier score 0.082) than HCPs. Tools predicting morbidity and MLLA revision had poor discrimination (C-statistics 0.520 and 0.679). CONCLUSION Clinicians predicted mortality and MLLA revision well, but predicted morbidity poorly. They overestimated the risk of mortality, morbidity, and MLLA revision. Most short-term risk prediction tools had poorer discrimination or calibration than HCPs. The best method of predicting mortality was a statistical tool that incorporated HCP estimation.
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Affiliation(s)
- Brenig L Gwilym
- South East Wales Vascular Network, Aneurin Bevan University Health Board, Royal Gwent Hospital, Newport, UK
| | | | | | | | | | | | - Debbie Harris
- Centre for Trials Research, Cardiff University, Cardiff, UK
| | - Ian Massey
- Artificial Limb and Appliance Centre, Rookwood Hospital, Cardiff and Vale University Health Board, Cardiff, UK
| | - Jo Burton
- Artificial Limb and Appliance Centre, Rookwood Hospital, Cardiff and Vale University Health Board, Cardiff, UK
| | - Phillippa Stewart
- Artificial Limb and Appliance Centre, Rookwood Hospital, Cardiff and Vale University Health Board, Cardiff, UK
| | - Katie Samuel
- Department of Anaesthesia, North Bristol NHS Trust, Bristol, UK
| | - Sian Jones
- c/o INVOLVE Health and Care Research Wales, Cardiff, UK
| | - David Cox
- c/o INVOLVE Health and Care Research Wales, Cardiff, UK
| | - Annie Clothier
- South East Wales Vascular Network, Aneurin Bevan University Health Board, Royal Gwent Hospital, Newport, UK
| | - Adrian Edwards
- Division of Population Medicine, Cardiff University, Cardiff, UK
| | - Christopher P Twine
- Bristol, Bath and Weston Vascular Network, North Bristol NHS Trust, Southmead Hospital, Bristol, UK
| | - David C Bosanquet
- South East Wales Vascular Network, Aneurin Bevan University Health Board, Royal Gwent Hospital, Newport, UK
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Corona K, Chavez T, Stewart K, Toledo-Corral CM, Farzan SF, Habre R, Grubbs B, Al-Marayati L, Lurvey N, Lerner D, Eckel SP, Lagomasino I, Breton CV, Bastain TM. Adverse childhood experiences and prenatal depression in the maternal and development risks from environmental and social stressors pregnancy cohort. J OBSTET GYNAECOL 2022; 42:3014-3020. [PMID: 36178435 PMCID: PMC9851371 DOI: 10.1080/01443615.2022.2125298] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
The aim of this study was to examine the association between adverse childhood experiences (ACEs) and risk for depression among 480 predominantly low-income Hispanic/Latina women in the Maternal and Development Risks from Environmental and Social Stressors pregnancy cohort. Models were fitted to evaluate associations between ACEs and prenatal probable depression measured by the Center for Epidemiologic Studies-Depression Scale adjusting for recruitment site, age, income, race/ethnicity, marital status and parity. The ACEs Questionnaire parameterised experiences as counts (0-10), categories (0, 1-3 and 4+ ACEs) and domains. Participants had a significantly higher likelihood of prenatal probable depression per unit increase in ACEs count or if they reported 4+ ACEs relative to 0 ACEs. Higher likelihood of probable depression was also associated with higher counts of each ACEs domains: abuse, neglect and household dysfunction. Findings suggest systematic screening for depressive symptoms in those with a history of childhood adversities may be important in prenatal care practice.Impact StatementWhat is already known on this subject? Experiencing depression during pregnancy has been associated with later adverse maternal mental and physical health outcomes. Emerging studies indicate that adverse childhood experiences (ACEs) may maintain or increase the predisposition to prenatal depression.What do the results of this study add? Although prenatal depressive symptoms are prevalent among racial/ethnic minority samples including Hispanic/Latinas, research determining whether the association between ACEs and prenatal depression varies by nativity is scarce. Overall, ACEs were common among Maternal and Developmental Risks from Environmental and Social Stressors (MADRES) participants and were associated with a higher likelihood of probable depression during pregnancy. These patterns did not significantly differ among the foreign-born versus U.S.-born Hispanic/Latina women, although the associations were stronger among U.S.-born Hispanic/Latina women.What are the implications of these findings for clinical practice and/or further research? Research should continue to focus on the effects of ACEs in communities that have been historically excluded in perinatal mental health services such as pregnant women from racial and ethnic minority groups. It may be important for clinicians to routinely screen for mental health during pregnancy as an adverse, psychological environment may impact both women and children. These findings suggest a need for improvement in systematic screening for depressive symptoms in those with a history of childhood adversities.
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Affiliation(s)
- Karina Corona
- Department of Population and Public Health Sciences, University of Southern California
| | - Thomas Chavez
- Department of Population and Public Health Sciences, University of Southern California
| | - Kennedy Stewart
- Department of Health Sciences, California State University, Northridge
| | - Claudia M. Toledo-Corral
- Department of Population and Public Health Sciences, University of Southern California
- Department of Health Sciences, California State University, Northridge
| | - Shohreh F. Farzan
- Department of Population and Public Health Sciences, University of Southern California
| | - Rima Habre
- Department of Population and Public Health Sciences, University of Southern California
| | - Brendan Grubbs
- Department of Obstetrics and Gynecology, University of Southern California
| | - Laila Al-Marayati
- Department of Obstetrics and Gynecology, University of Southern California
| | | | | | - Sandrah P. Eckel
- Department of Population and Public Health Sciences, University of Southern California
| | - Isabel Lagomasino
- Department of Psychiatry and Behavioral Sciences, University of Southern California
| | - Carrie V. Breton
- Department of Population and Public Health Sciences, University of Southern California
| | - Theresa M. Bastain
- Department of Population and Public Health Sciences, University of Southern California
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Karamanos A, Stewart K, Harding S, Kelly Y, Lacey R. Adverse childhood experiences and adolescent drug use in the UK: The moderating role of socioeconomic position and ethnicity. SSM Popul Health 2022; 19:101142. [PMID: 35733836 PMCID: PMC9207135 DOI: 10.1016/j.ssmph.2022.101142] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 05/10/2022] [Accepted: 06/05/2022] [Indexed: 11/29/2022] Open
Abstract
Rationale There is a paucity of prospective UK studies exploring the role of Adverse Childhood Experiences (ACEs) on adolescent teenage drug use and even less is known about the complex interplay between ACEs and adolescent social, demographic, and economic characteristics. To address these gaps, we use rich longitudinal data from the nationally representative Millennium Cohort Study. Methods Sex-stratified survey logistic regression modelling was applied using data from 9,476 adolescents and their parents to examine associations between ACEs between ages 3 and 14 years and drug use at ages 14 and 17 years. We a) explore the extent to which associations are robust to adjustment for ethnicity, family income, parental social class, and parental education, b) examine whether associations differ by these factors, and c) estimate the proportion of drug use at ages 14 and 17 years attributable to ACEs after controlling for these factors. Results Half of MCS cohort members had been exposed to at least one ACE and approximately 1 in 11 were exposed to 3+ ACEs. Multivariable analyses suggest that ACEs were associated with a higher likelihood of drug use at age 14 than age 17, especially for girls. No evidence was found that either advantaged socio-economic position or ethnicity acted as a buffer against the negative effects of ACEs in relation to adolescent drug use. Finally, we found that prevention of exposure to sexual violence, bullying and violence within the household (if causal) is more important for girls' drug use at age 14 than age 17. Conclusions ACEs are associated with adolescent drug use with potential consequences on wider aspects of young people's lives, regardless of their social, ethnic, or economic background, adding further urgency to the need to reduce the incidence of these negative experiences.
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Affiliation(s)
- A. Karamanos
- School of Life Course/ Nutritional Sciences, King's College London, UK
| | - K. Stewart
- Department of Social Policy and Centre for Analysis of Social Exclusion (CASE), London School of Economics and Political Science, UK
| | - S. Harding
- School of Life Course/ Nutritional Sciences, King's College London, UK
- Department of Population Health Sciences, School of Population Health & Environmental Sciences, Faculty of Life Sciences & Medicine, King's College London, London, UK
| | - Y. Kelly
- Department of Epidemiology & Public Health, University College London, UK
| | - R.E. Lacey
- Department of Epidemiology & Public Health, University College London, UK
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Soulsby WD, Balmuri N, Cooley V, Gerber LM, Lawson E, Goodman S, Onel K, Mehta B, Abel N, Abulaban K, Adams A, Adams M, Agbayani R, Aiello J, Akoghlanian S, Alejandro C, Allenspach E, Alperin R, Alpizar M, Amarilyo G, Ambler W, Anderson E, Ardoin S, Armendariz S, Baker E, Balboni I, Balevic S, Ballenger L, Ballinger S, Balmuri N, Barbar-Smiley F, Barillas-Arias L, Basiaga M, Baszis K, Becker M, Bell-Brunson H, Beltz E, Benham H, Benseler S, Bernal W, Beukelman T, Bigley T, Binstadt B, Black C, Blakley M, Bohnsack J, Boland J, Boneparth A, Bowman S, Bracaglia C, Brooks E, Brothers M, Brown A, Brunner H, Buckley M, Buckley M, Bukulmez H, Bullock D, Cameron B, Canna S, Cannon L, Carper P, Cartwright V, Cassidy E, Cerracchio L, Chalom E, Chang J, Chang-Hoftman A, Chauhan V, Chira P, Chinn T, Chundru K, Clairman H, Co D, Confair A, Conlon H, Connor R, Cooper A, Cooper J, Cooper S, Correll C, Corvalan R, Costanzo D, Cron R, Curiel-Duran L, Curington T, Curry M, Dalrymple A, Davis A, Davis C, Davis C, Davis T, De Benedetti F, De Ranieri D, Dean J, Dedeoglu F, DeGuzman M, Delnay N, Dempsey V, DeSantis E, Dickson T, Dingle J, Donaldson B, Dorsey E, Dover S, Dowling J, Drew J, Driest K, Du Q, Duarte K, Durkee D, Duverger E, Dvergsten J, Eberhard A, Eckert M, Ede K, Edelheit B, Edens C, Edens C, Edgerly Y, Elder M, Ervin B, Fadrhonc S, Failing C, Fair D, Falcon M, Favier L, Federici S, Feldman B, Fennell J, Ferguson I, Ferguson P, Ferreira B, Ferrucho R, Fields K, Finkel T, Fitzgerald M, Fleming C, Flynn O, Fogel L, Fox E, Fox M, Franco L, Freeman M, Fritz K, Froese S, Fuhlbrigge R, Fuller J, George N, Gerhold K, Gerstbacher D, Gilbert M, Gillispie-Taylor M, Giverc E, Godiwala C, Goh I, Goheer H, Goldsmith D, Gotschlich E, Gotte A, Gottlieb B, Gracia C, Graham T, Grevich S, Griffin T, Griswold J, Grom A, Guevara M, Guittar P, Guzman M, Hager M, Hahn T, Halyabar O, Hammelev E, Hance M, Hanson A, Harel L, Haro S, Harris J, Harry O, Hartigan E, Hausmann J, Hay A, Hayward K, Heiart J, Hekl K, Henderson L, Henrickson M, Hersh A, Hickey K, Hill P, Hillyer S, Hiraki L, Hiskey M, Hobday P, Hoffart C, Holland M, Hollander M, Hong S, Horwitz M, Hsu J, Huber A, Huggins J, Hui-Yuen J, Hung C, Huntington J, Huttenlocher A, Ibarra M, Imundo L, Inman C, Insalaco A, Jackson A, Jackson S, James K, Janow G, Jaquith J, Jared S, Johnson N, Jones J, Jones J, Jones J, Jones K, Jones S, Joshi S, Jung L, Justice C, Justiniano A, Karan N, Kaufman K, Kemp A, Kessler E, Khalsa U, Kienzle B, Kim S, Kimura Y, Kingsbury D, Kitcharoensakkul M, Klausmeier T, Klein K, Klein-Gitelman M, Kompelien B, Kosikowski A, Kovalick L, Kracker J, Kramer S, Kremer C, Lai J, Lam J, Lang B, Lapidus S, Lapin B, Lasky A, Latham D, Lawson E, Laxer R, Lee P, Lee P, Lee T, Lentini L, Lerman M, Levy D, Li S, Lieberman S, Lim L, Lin C, Ling N, Lingis M, Lo M, Lovell D, Lowman D, Luca N, Lvovich S, Madison C, Madison J, Manzoni SM, Malla B, Maller J, Malloy M, Mannion M, Manos C, Marques L, Martyniuk A, Mason T, Mathus S, McAllister L, McCarthy K, McConnell K, McCormick E, McCurdy D, Stokes PMC, McGuire S, McHale I, McMonagle A, McMullen-Jackson C, Meidan E, Mellins E, Mendoza E, Mercado R, Merritt A, Michalowski L, Miettunen P, Miller M, Milojevic D, Mirizio E, Misajon E, Mitchell M, Modica R, Mohan S, Moore K, Moorthy L, Morgan S, Dewitt EM, Moss C, Moussa T, Mruk V, Murphy A, Muscal E, Nadler R, Nahal B, Nanda K, Nasah N, Nassi L, Nativ S, Natter M, Neely J, Nelson B, Newhall L, Ng L, Nicholas J, Nicolai R, Nigrovic P, Nocton J, Nolan B, Oberle E, Obispo B, O’Brien B, O’Brien T, Okeke O, Oliver M, Olson J, O’Neil K, Onel K, Orandi A, Orlando M, Osei-Onomah S, Oz R, Pagano E, Paller A, Pan N, Panupattanapong S, Pardeo M, Paredes J, Parsons A, Patel J, Pentakota K, Pepmueller P, Pfeiffer T, Phillippi K, Marafon DP, Phillippi K, Ponder L, Pooni R, Prahalad S, Pratt S, Protopapas S, Puplava B, Quach J, Quinlan-Waters M, Rabinovich C, Radhakrishna S, Rafko J, Raisian J, Rakestraw A, Ramirez C, Ramsay E, Ramsey S, Randell R, Reed A, Reed A, Reed A, Reid H, Remmel K, Repp A, Reyes A, Richmond A, Riebschleger M, Ringold S, Riordan M, Riskalla M, Ritter M, Rivas-Chacon R, Robinson A, Rodela E, Rodriquez M, Rojas K, Ronis T, Rosenkranz M, Rosolowski B, Rothermel H, Rothman D, Roth-Wojcicki E, Rouster-Stevens K, Rubinstein T, Ruth N, Saad N, Sabbagh S, Sacco E, Sadun R, Sandborg C, Sanni A, Santiago L, Sarkissian A, Savani S, Scalzi L, Schanberg L, Scharnhorst S, Schikler K, Schlefman A, Schmeling H, Schmidt K, Schmitt E, Schneider R, Schollaert-Fitch K, Schulert G, Seay T, Seper C, Shalen J, Sheets R, Shelly A, Shenoi S, Shergill K, Shirley J, Shishov M, Shivers C, Silverman E, Singer N, Sivaraman V, Sletten J, Smith A, Smith C, Smith J, Smith J, Smitherman E, Soep J, Son M, Spence S, Spiegel L, Spitznagle J, Sran R, Srinivasalu H, Stapp H, Steigerwald K, Rakovchik YS, Stern S, Stevens A, Stevens B, Stevenson R, Stewart K, Stingl C, Stokes J, Stoll M, Stringer E, Sule S, Sumner J, Sundel R, Sutter M, Syed R, Syverson G, Szymanski A, Taber S, Tal R, Tambralli A, Taneja A, Tanner T, Tapani S, Tarshish G, Tarvin S, Tate L, Taxter A, Taylor J, Terry M, Tesher M, Thatayatikom A, Thomas B, Tiffany K, Ting T, Tipp A, Toib D, Torok K, Toruner C, Tory H, Toth M, Tse S, Tubwell V, Twilt M, Uriguen S, Valcarcel T, Van Mater H, Vannoy L, Varghese C, Vasquez N, Vazzana K, Vehe R, Veiga K, Velez J, Verbsky J, Vilar G, Volpe N, von Scheven E, Vora S, Wagner J, Wagner-Weiner L, Wahezi D, Waite H, Walker J, Walters H, Muskardin TW, Waqar L, Waterfield M, Watson M, Watts A, Weiser P, Weiss J, Weiss P, Wershba E, White A, Williams C, Wise A, Woo J, Woolnough L, Wright T, Wu E, Yalcindag A, Yee M, Yen E, Yeung R, Yomogida K, Yu Q, Zapata R, Zartoshti A, Zeft A, Zeft R, Zhang Y, Zhao Y, Zhu A, Zic C. Social determinants of health influence disease activity and functional disability in Polyarticular Juvenile Idiopathic Arthritis. Pediatr Rheumatol Online J 2022; 20:18. [PMID: 35255941 PMCID: PMC8903717 DOI: 10.1186/s12969-022-00676-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Accepted: 02/07/2022] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Social determinants of health (SDH) greatly influence outcomes during the first year of treatment in rheumatoid arthritis, a disease similar to polyarticular juvenile idiopathic arthritis (pJIA). We investigated the correlation of community poverty level and other SDH with the persistence of moderate to severe disease activity and functional disability over the first year of treatment in pJIA patients enrolled in the Childhood Arthritis and Rheumatology Research Alliance Registry. METHODS In this cohort study, unadjusted and adjusted generalized linear mixed effects models analyzed the effect of community poverty and other SDH on disease activity, using the clinical Juvenile Arthritis Disease Activity Score-10, and disability, using the Child Health Assessment Questionnaire, measured at baseline, 6, and 12 months. RESULTS One thousand six hundred eighty-four patients were identified. High community poverty (≥20% living below the federal poverty level) was associated with increased odds of functional disability (OR 1.82, 95% CI 1.28-2.60) but was not statistically significant after adjustment (aOR 1.23, 95% CI 0.81-1.86) and was not associated with increased disease activity. Non-white race/ethnicity was associated with higher disease activity (aOR 2.48, 95% CI: 1.41-4.36). Lower self-reported household income was associated with higher disease activity and persistent functional disability. Public insurance (aOR 1.56, 95% CI 1.06-2.29) and low family education (aOR 1.89, 95% CI 1.14-3.12) was associated with persistent functional disability. CONCLUSION High community poverty level was associated with persistent functional disability in unadjusted analysis but not with persistent moderate to high disease activity. Race/ethnicity and other SDH were associated with persistent disease activity and functional disability.
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Affiliation(s)
- William Daniel Soulsby
- University of California, San Francisco, 550 16th Street, 4th Floor, Box #0632, San Francisco, CA, 94158, USA.
| | - Nayimisha Balmuri
- grid.239915.50000 0001 2285 8823Hospital for Special Surgery, New York, NY USA ,grid.5386.8000000041936877XWeill Cornell Medicine, New York, NY USA
| | - Victoria Cooley
- grid.5386.8000000041936877XWeill Cornell Medicine, New York, NY USA
| | - Linda M. Gerber
- grid.5386.8000000041936877XWeill Cornell Medicine, New York, NY USA
| | - Erica Lawson
- grid.266102.10000 0001 2297 6811University of California, San Francisco, 550 16th Street, 4th Floor, Box #0632, San Francisco, CA 94158 USA
| | - Susan Goodman
- grid.239915.50000 0001 2285 8823Hospital for Special Surgery, New York, NY USA ,grid.5386.8000000041936877XWeill Cornell Medicine, New York, NY USA
| | - Karen Onel
- grid.239915.50000 0001 2285 8823Hospital for Special Surgery, New York, NY USA ,grid.5386.8000000041936877XWeill Cornell Medicine, New York, NY USA
| | - Bella Mehta
- grid.239915.50000 0001 2285 8823Hospital for Special Surgery, New York, NY USA ,grid.5386.8000000041936877XWeill Cornell Medicine, New York, NY USA
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Stewart K, Vu N, Redmon C, Nguyen C, Jackson E, Lee A, Kilic S. Knowledge of pelvic floor disorders among reproductive aged women a cross sectional study. Am J Obstet Gynecol 2022. [DOI: 10.1016/j.ajog.2021.12.060] [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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Stewart K, Kilic G, Lee A. 58 Robotic assisted high uterosacral ligament suspension. Am J Obstet Gynecol 2021. [DOI: 10.1016/j.ajog.2021.04.202] [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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Stewart K, Ly P, Kilic S, Lee T. 110 Long term follow up on barbed sutures in sacrocolpopexy. Am J Obstet Gynecol 2021. [DOI: 10.1016/j.ajog.2021.04.135] [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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Farragher J, Stewart K, Harrison T, Engel L, Seaton S, Donald M, Jassal Vanita S, Hemmelgarn B. POS-257 INTERVENTIONS TO ADDRESS COGNITIVE IMPAIRMENT IN KIDNEY DISEASE: A SCOPING REVIEW. Kidney Int Rep 2021. [DOI: 10.1016/j.ekir.2021.03.272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Ismail K, Stewart K, Ridge K, Britneff E, Freudenthal R, Stahl D, McCrone P, Gayle C, Doherty AM. A pilot study of an integrated mental health, social and medical model for diabetes care in an inner-city setting: Three Dimensions for Diabetes (3DFD). Diabet Med 2020; 37:1658-1668. [PMID: 30706535 DOI: 10.1111/dme.13918] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/29/2019] [Indexed: 12/13/2022]
Abstract
AIMS We examined the effectiveness of a service innovation, Three Dimensions for Diabetes (3DFD), that consisted of a referral to an integrated mental health, social care and diabetes treatment model, compared with usual care in improving biomedical and health economic outcomes. METHODS Using a non-randomized control design, the 3DFD model was offered in two inner-city boroughs in London, UK, where diabetes health professionals could refer adult residents with diabetes, suboptimal glycaemic control [HbA1c ≥ 75 mmol/mol (≥ 9.0%)] and mental health and/or social problems. In the usual care group, there was no referral pathway and anonymized data on individuals with HbA1c ≥ 75 mmol/mol (≥ 9.0%) were collected from primary care records. Change in HbA1c from baseline to 12 months was the primary outcome, and change in healthcare costs and biomedical variables were secondary outcomes. RESULTS 3DFD participants had worse glycaemic control and higher healthcare costs than control participants at baseline. 3DFD participants had greater improvement in glycaemic control compared with control participants [-14 mmol/mol (-1.3%) vs. -6 mmol/mol (-0.6%) respectively, P < 0.001], adjusted for confounding. Total follow-up healthcare costs remained higher in the 3DFD group compared with the control group (mean difference £1715, 95% confidence intervals 591 to 2811), adjusted for confounding. The incremental cost-effectiveness ratio was £398 per mmol/mol unit decrease in HbA1c , indicating the 3DFD intervention was more effective and costed more than usual care. CONCLUSIONS A biomedical, psychological and social criteria-based referral system for identifying and managing high-cost and high-risk individuals with poor glycaemic control can lead to improved health in all three dimensions.
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Affiliation(s)
- K Ismail
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neurosciences, King's College London, London, UK
| | - K Stewart
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neurosciences, King's College London, London, UK
| | - K Ridge
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neurosciences, King's College London, London, UK
| | - E Britneff
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neurosciences, King's College London, London, UK
| | - R Freudenthal
- Diabetes Centre, King's College Hospital NHS Foundation Trust, London, UK
| | - D Stahl
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neurosciences, King's College London, London, UK
| | - P McCrone
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neurosciences, King's College London, London, UK
| | - C Gayle
- Diabetes Centre, King's College Hospital NHS Foundation Trust, London, UK
| | - A M Doherty
- Diabetes Centre, King's College Hospital NHS Foundation Trust, London, UK
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Peterson G, Kranker K, Pu J, Magid D, Blue L, McCall N, Markovitz A, Concannon T, Stewart K, Markovich P. Impacts of the Million Hearts® Cardiovascular Disease Risk Reduction Model on Medications, Heart Attacks and Strokes, and Medicare Spending after Two Years: A Cluster‐Randomized Trial. Health Serv Res 2020. [DOI: 10.1111/1475-6773.13469] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Affiliation(s)
| | - K. Kranker
- Mathematica Policy Research Princeton NJ United States
| | - J. Pu
- Mathematica Oakland CA United States
| | - D. Magid
- Kaiser Permanente Colorado Denver CO United States
| | - L. Blue
- Mathematica Washington DC United States
| | - N. McCall
- Mathematica Washington DC United States
| | | | | | | | - P. Markovich
- CMS Innovation Center Silver Spring MD United States
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Hurst WJ, Martin RA, Bueno M, Clemente H, DeVries JW, Levi C, Li B, Popovich DJ, Sheeley R, Schumacher D, Stewart K, Taylor J, Toomey P. High Performance Liquid Chromatographic Determination of Carbohydrates in Chocolate: Collaborative Study. J AOAC Int 2020. [DOI: 10.1093/jaoac/63.3.595] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
A collaborative study determining sucrose, glucose, fructose, maltose, and lactose in chocolate products was conducted using a previously published high performance liquid chromatographic (HPLC) method. Five samples (2 milk chocolates, 1 dark chocolate, 1 powdered mix, and 1 sirup) were analyzed in duplicate by 7 collaborators. The results indicate adequate method precision. In addition, the HPLC method allows for the simultaneous determination of 5 saccharides in chocolate products in 15 min. The method has been adopted as official first action.
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Affiliation(s)
- W Jeffrey Hurst
- Hershey Foods Corp., Research Laboratories, PO Box 54, Hershey, PA 17033
| | - Robert A Martin
- Hershey Foods Corp., Research Laboratories, PO Box 54, Hershey, PA 17033
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Abstract
BACKGROUND Numerous studies of dental antibiotic prescribing show that overprescribing is a worldwide occurrence. The aim of this study was to assess prescribing practices of general dentists in Australia for antibiotics, analgesics and anxiolytics and to determine the extent to which prescribing is in accordance with current guidelines. METHODS A structured questionnaire was sent to 1468 dentists in Victoria and Queensland in July-August 2018. The questionnaire covered demographics, clinical conditions where dentists prescribe antibiotics, non-clinical factors which influence prescribing, and medicines for anxiolysis and pain relief. Responses were scored using a system based on the current Australian therapeutic guidelines. Logistic regression was used to determine the relative importance of independent variables on inappropriate prescribing. RESULTS Three hundred eighty-two responses were received. Overall, 55% of overprescribing of antibiotics was detected, with a range of 13-88% on a routine or occasional basis depending on the scenario. Between 16 and 27% of respondents inappropriately preferenced analgesics over anti-inflammatories for dental pain; 46% of those who prescribed anxiolytic medicines did so inappropriately, with varying regimens and choices outside the guidelines. Years of practice was the main demographic factor influencing prescribing, with recent graduates (0-5 years) generally scoring better than their colleagues for antibiotic prescribing (p < 0.05). CONCLUSIONS Future interventions could be directed towards the appropriate role and use of antibiotics, shortfalls in knowledge and appropriate choices of medicines for pain relief and anxiolysis. Given that the most overprescribing occurred for localised swellings (88%), this area could be focused on in continuing education as well as ensuring it is addressed in undergraduate teaching. Continuing education on the appropriate use of medicines can be targeted at more experienced dentists as well as patients, especially those who expect antibiotics instead of treatment. TRIAL REGISTRATION University of Melbourne Human Ethics Sub-Committee; ID: 1750768.1 .
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Affiliation(s)
- L Teoh
- Melbourne Dental School, The University of Melbourne, 720 Swanston Street, Carlton, VIC, 3010, Australia.
| | - R J Marino
- Melbourne Dental School, The University of Melbourne, 720 Swanston Street, Carlton, VIC, 3010, Australia
| | - K Stewart
- Centre for Medicine Use and Safety, Monash University, Parkville, VIC, Australia
| | - M J McCullough
- Melbourne Dental School, The University of Melbourne, 720 Swanston Street, Carlton, VIC, 3010, Australia
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Taylor J, Cain K, Ramirez P, Earles T, Harris M, James D, Dottino J, Hubbs C, Stewart K, McGrew L, Siebel C, Enbaya A, Iniesta-Donate M, Vachhani S, Lasala J, Best C, Thosani S, Sahai S, Schmeler K, Meyer L. Integration of a standardized diabetic management protocol into an ERAS program. Clin Nutr ESPEN 2019. [DOI: 10.1016/j.clnesp.2019.03.056] [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: 11/25/2022]
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Heinz J, Stewart K, Ghoneima A. Evaluation of two-dimensional lateral cephalogram and three-dimensional cone beam computed tomography superimpositions: a comparative study. Int J Oral Maxillofac Surg 2019; 48:519-525. [DOI: 10.1016/j.ijom.2018.10.002] [Citation(s) in RCA: 9] [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: 05/09/2018] [Revised: 07/03/2018] [Accepted: 10/05/2018] [Indexed: 11/26/2022]
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Kaliaperumal C, Gallo P, Campbell D, Stewart K, Kandasamy J, Rose M. P97 Utility of computer technology in management of non-syndromic craniosynostosis- is it cost effective? J Neurol Psychiatry 2019. [DOI: 10.1136/jnnp-2019-abn.154] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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
ObjectivesTo discuss the utility of Computer technology for non-syndromic craniosynostosis (Metopic craniosynostosis) in the form of 3D printed models that could be utilised intraoperatively to aid fronto-orbital remodelling.DesignProspective study form 2015–2017.SubjectsPaediatric non-syndromic metopic craniosynostosis cohort.MethodsWe present a series of 7 patients with non-syndromic metopic craniosynostosis operated on by the craniofacial team Edinburgh over a three year period. The Edinburgh Craniofacial service is supported by the Managed Service Network (MSN) for Neurosurgery, Scotland as a part of nationally delivered Craniofacial service. We utilised 3D printing models of the orbital bar to plan a fronto-orbital advancement technique. The models were then subsequently sterilised and used intra operatively. 3D printer utility is available to us as a part of the NHS Lothian craniomaxillofacial and plastics surgery service.ResultsNo intra-operative or post operative complications were noted in our series. All patients undergo standardised pre and post operative 3D CT and photography follow up to objectively measure the outcome.ConclusionsThe utility of Computer technology is a useful and safe adjunct for non-syndromic craniosynostosis, particularly metopic craniosynostosis. A careful pre-operative planning and 3D printed model is helpful to achieve the desired bespoke surgical outcome and to reduce operative time. Post operative 3D CT and 3D photography were utilised to objectively measure the outcome. No extra costs were incurred to our service. We believe that this could be incorporated in preoperative planning as an essential tool.
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Teoh L, Stewart K, Marino R, McCullough M. Antibiotic resistance and relevance to general dental practice in Australia. Aust Dent J 2018; 63:414-421. [DOI: 10.1111/adj.12643] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/11/2018] [Indexed: 12/20/2022]
Affiliation(s)
- L Teoh
- Melbourne Dental School; University of Melbourne; Carlton Victoria Australia
| | - K Stewart
- Centre for Medicine Use and Safety; Monash University; Parkville Victoria Australia
| | - R Marino
- Melbourne Dental School; University of Melbourne; Carlton Victoria Australia
| | - M McCullough
- Melbourne Dental School; University of Melbourne; Carlton Victoria Australia
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Champion WM, Charley PH, Klein B, Stewart K, Solomon PA, Montoya LD. Erratum to "Perception, culture, and science: A framework to identify in-home heating options to improve indoor air quality in the Navajo Nation" [Sci. Total Environ. 580(2017) 297-306]. Sci Total Environ 2018; 627:1656. [PMID: 29499922 DOI: 10.1016/j.scitotenv.2018.02.182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Affiliation(s)
- W M Champion
- University of Colorado, Boulder, Civil, Environmental & Architectural Engr. Dept., Sustainability, Energy and Environment Complex, 4001 Discovery Drive, 607 UCB, S286A, Boulder, CO 80303-0607, United States
| | - P H Charley
- Diné College- Shiprock Campus, Dine Environmental Institute, PO Box 580, Shiprock, NM 87420, United States
| | - B Klein
- Diné College- Shiprock Campus, Dine Environmental Institute, PO Box 580, Shiprock, NM 87420, United States
| | - K Stewart
- United States Environmental Protection Agency, Region 9 Air Division, Air Toxics, Radiation, and Indoor Air Office, 75 Hawthorne St, San Francisco, CA 94105, United States
| | - P A Solomon
- United States Environmental Protection Agency, Office of Research and Development, 944 E. Harmon Ave., Las Vegas, NV 89119, United States
| | - L D Montoya
- University of Colorado, Boulder, Civil, Environmental & Architectural Engr. Dept., Sustainability, Energy and Environment Complex, 4001 Discovery Drive, 607 UCB, S286A, Boulder, CO 80303-0607, United States.
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Teoh L, Stewart K, Marino RJ, McCullough MJ. Part 1. Current prescribing trends of antibiotics by dentists in Australia from 2013 to 2016. Aust Dent J 2018; 63:329-337. [PMID: 29754452 DOI: 10.1111/adj.12622] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/10/2018] [Indexed: 12/19/2022]
Abstract
BACKGROUND Literature has shown dentists tend to overprescribe antibiotics and do not always prescribe in accordance with recommended guidelines. Unnecessary prescribing is one major factor that contributes to the development of antibiotic resistance. The aim of the present study was to assess the antibacterial prescribing patterns of dentists in Australia from 2013 to 2016. METHODS Data on dental antibacterial prescriptions dispensed under the Pharmaceutical Benefits Scheme (PBS) from 2013 to 2016 was accessed and prescribing trends analysed. The prescribing rates were standardized to the dose and population. RESULTS There was a slight decrease in the dispensed use of most antibacterials from 2013 to 2016, but there was a significant increase in the dispensed use of amoxicillin/clavulanic acid of 11.2%. Amoxicillin was the most commonly dispensed antibiotic, accounting for approximately 65% of all antibacterials from 2013 to 2016, while phenoxymethylpenicillin accounted for only 1.4% of prescriptions in 2016. There were low but significant quantities of dispensed antibiotic prescriptions that do not fit with current guidelines. CONCLUSIONS The data suggest that dentists in Australia are prescribing some antibiotics inappropriately and there is a preference for moderate- to broad-spectrum agents. The current PBS dental schedule is inconsistent with prescribing guidelines and may contribute to inappropriate prescribing.
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Affiliation(s)
- L Teoh
- Melbourne Dental School, The University of Melbourne, Carlton, Victoria, Australia
| | - K Stewart
- Centre for Medicine Use and Safety, Monash University, Parkville, Victoria, Australia
| | - R J Marino
- Melbourne Dental School, The University of Melbourne, Carlton, Victoria, Australia
| | - M J McCullough
- Melbourne Dental School, The University of Melbourne, Carlton, Victoria, Australia
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Denis D, Sato E, Larson O, Kohnke EJ, Parr E, King J, Stewart K, Baran B, Keshavan M, Manoach D, Stickgold R. 0998 Sleep-dependent Memory Consolidation In Early Course Schizophrenia Patients And Familial High-risk Relatives. Sleep 2018. [DOI: 10.1093/sleep/zsy061.997] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- D Denis
- Beth Israel Deaconess Medical Center / Harvard Medical School, Boston, MA
| | - E Sato
- Beth Israel Deaconess Medical Center / Harvard Medical School, Boston, MA
| | - O Larson
- Massachusetts General Hospital / Harvard Medical School, Boston, MA
| | - E J Kohnke
- Massachusetts General Hospital / Harvard Medical School, Boston, MA
| | - E Parr
- Beth Israel Deaconess Medical Center / Harvard Medical School, Boston, MA
| | - J King
- Beth Israel Deaconess Medical Center / Harvard Medical School, Boston, MA
| | - K Stewart
- Beth Israel Deaconess Medical Center / Harvard Medical School, Boston, MA
| | - B Baran
- Massachusetts General Hospital / Harvard Medical School, Boston, MA
| | - M Keshavan
- Beth Israel Deaconess Medical Center / Harvard Medical School, Boston, MA
| | - D Manoach
- Massachusetts General Hospital / Harvard Medical School, Boston, MA
| | - R Stickgold
- Beth Israel Deaconess Medical Center / Harvard Medical School, Boston, MA
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Teoh L, Stewart K, Marino RJ, McCullough MJ. Part 2. Current prescribing trends of dental non-antibacterial medicines in Australia from 2013 to 2016. Aust Dent J 2018; 63:338-346. [PMID: 29676050 DOI: 10.1111/adj.12613] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/10/2018] [Indexed: 10/17/2022]
Abstract
BACKGROUND There is limited literature regarding dental prescribing preferences for medicines other than antibiotics. This study aimed to describe the prescribing trends of dispensed prescription medicines by dentists in Australia from 2013 and 2016 and assess adherence to current guidelines. METHODS Data were accessed from the Department of Health of all dental prescriptions dispensed under the Pharmaceutical Benefits Scheme (PBS) from 2013 to 2016 and prescribing patterns were analysed. The prescribing rates were standardized to the dose and population. RESULTS There was an overall increase in the standardized use of opioid analgesics by almost 30% over the time frame, with the combination paracetamol 500 mg plus codeine 30 mg tablet accounting for the majority of dispensed opioid prescriptions (96.2% in 2016). Dispensed benzodiazepine prescriptions increased by 14.6%. CONCLUSIONS The increase in the consumption of opioids is concerning, suggesting that continuing education is required for dentists to better understand their limited role in managing dental pain and potential for abuse. The substantial increase in the dispensed use of benzodiazepines also requires further investigation and there were some drugs prescribed inappropriately and not in accordance with guidelines. Consideration could also be given to reviewing the drugs listed on the PBS for dental prescribing.
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Affiliation(s)
- L Teoh
- Melbourne Dental School, The University of Melbourne, Melbourne, Victoria, Australia
| | - K Stewart
- Centre for Medicine Use and Safety, Monash University, Parkville, Victoria, Australia
| | - R J Marino
- Melbourne Dental School, The University of Melbourne, Melbourne, Victoria, Australia
| | - M J McCullough
- Melbourne Dental School, The University of Melbourne, Melbourne, Victoria, Australia
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Hasan S, Stewart K, Chapman CB, Kong DCM. Physicians’ perspectives of pharmacist-physician collaboration in the United Arab Emirates: Findings from an exploratory study. J Interprof Care 2018; 32:566-574. [DOI: 10.1080/13561820.2018.1452726] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- S. Hasan
- Department of Clinical Sciences, College of Pharmacy, Ajman University, Ajman, United Arab Emirates
| | - K. Stewart
- Centre for Medicine Use and Safety, Monash University, Parkville, Australia
| | - C. B. Chapman
- Centre for Medicine Use and Safety, Monash University, Parkville, Australia
| | - D. C. M. Kong
- Centre for Medicine Use and Safety, Monash University, Parkville, Australia
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Feld J, Conway B, Bruneau J, Cooper C, Cox J, Deshaies L, Fraser C, Macphail G, Powis J, Steingart C, Stewart K, Thomas R, Webster D, Drolet M, Mcgovern M, Trepanier J. A27 CHARACTERIZATION OF HCV INFECTED PWID IN THE SETTING OF CLINICAL CARE IN CANADA (CAPICA): FINAL RESULTS. J Can Assoc Gastroenterol 2018. [DOI: 10.1093/jcag/gwy008.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- J Feld
- Centre for Liver Disease, Toronto General Hospital, Toronto, ON, Canada
| | - B Conway
- Vancouver Infectious Diseases Centre, Vancouver, BC, Canada
| | - J Bruneau
- CHUM:Hopital St-Luc, Montreal, QC, Canada
| | - C Cooper
- Ottawa Hospital Research Institute, Ottawa, ON, Canada
| | - J Cox
- McGill University Health Center, Montreal, QC, Canada
| | - L Deshaies
- Clinique Médicale Lauberivière, Quebec, QC, Canada
| | - C Fraser
- Cool Aid Community Health Center, Victoria, BC, Canada
| | - G Macphail
- Calgary Urban Project Society (CUPS), Calgary, AB, Canada
| | - J Powis
- Toronto Community Hep C Program, Toronto, ON, Canada
| | | | - K Stewart
- Saskatoon Infectious Disease Care Network, Saskatoon, SK, Canada
| | - R Thomas
- Clinique Médicale l’Actuel, Montreal, QC, Canada
| | - D Webster
- Dalhousie University, Saint John, NB, Canada
| | - M Drolet
- Merck Canada, Kirkland, QC, Canada
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NematiShafaee M, Natal RA, Ramalho S, Dória MT, Conz L, Cabello V, Pavanello M, Mano MS, Linck RDM, Batista LS, Pedro EP, Bines J, de Paula BH, Zucca-Matthes G, Bondy ML, Ellis MJ, Podany E, Debord L, Makawita S, Stewart K, Cabello C. Abstract P4-10-15: Impact of delay in breast cancer diagnosis and treatment according to health insurance status in southwest Brazil and Houston, Texas. Cancer Res 2018. [DOI: 10.1158/1538-7445.sabcs17-p4-10-15] [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: Access to medical care vary across the world and is related to different health systems with an impact in recurrence.Objective: To evaluate disparities in breast cancer(BC) diagnosis and treatment between public and private services in southwest Brazil and at two public safety net hospitals in Houston, Texas.Methods: Women diagnosed with BC stages I-III between 2009 to 2011, and treated at the four hospitals in Brazil and two health centers in US were included. All statistical analyses were performed in R studio software, and p<0.05 was considered significant.Results: 1245 women were included: 967 from public health system (PHS) (20.3% from Houston, Texas) and 274 from private system(PS). Recurrence rate was higher in PHS (14.6% vs. 2.6%, p<0.001)
Table 1. Clinical and demographic characteristics of the patientsCharacteristicsPublic (%), n=967Private (%), n=274pDiscovery of BC By patient530 (54.8)92 (33.5) Routine exam87 (9)109 (39.8) Screening mammography270 (27.9)23 (8.4) Other80 (8.3)50 (18.3)<0.001Initial treatment Surgery687 (71)241 (88) Neo-adjuvant chemotherapy224 (23.2)27 (9.8) Neo-adjuvant hormone therapy23 (2.3)27 (9.8) Not available33 (3.4)3 (1.1)<0.001Clinical Stage I293 (30.3)113 (41.2) II342 (35.4)52 (19) III271 (28)15 (5.5) Unknown61 (6.3)94 (34.3)<0.001Subtype HR+/HER2 -561 (58)192 (70.1) HR-/HER2+108 (11.1)29 (10.6) HR-/HER2+76 (7.9)14 (5.1) Triple negative149 (15.4)28 (10.2) Unknown73 (7.6)11 (4)0.012Symptomatic at Diagnosis Yes591 (61.1)100 (36.5) No306 (31.6)97 (35.4) Unknown70 (7.2)77 (28.1)<0.001Recurencen=772n=146 No719 (74.4)193 (70.4) Yes142 (14.6)7 (2.6) Unknown106 (11)74 (27)<0.001
. Considering the interval in weeks: symptoms to diagnosis, diagnosis to first treatment (either surgery or neoadjuvant chemotherapy), diagnosis to first systemic treatment, diagnosis to surgical treatment and diagnosis to radiotherapy were longer in public patients (24.1 vs. 8.7; 11.1 vs. 3.5; 18.6 vs. 9.8; 16.9 vs. 5.6; 51.4 vs. 26.1; p<0.001).
Table 2. Delay disparities between public and private health system PublicPrivatepSymptoms to diagnosis Number of patients575146 Time (weeks)24.1 (0.4-104.9)8.7 (0.0-43.7)<0.001Diagnosis to first treatment Number of patients663180 Time (weeks)11.1 (2.0-31.5)3.5 (0.0-11.0)<0.001Diagnosis to first systemic treatment Number of patients526106 Time (weeks)18.6 (2.6-44.7)9.8 (1.9-29.3)<0.001Diagnosis to surgical treatment Number of patients657178 Time (weeks)16.9 (3.4-45.6)5.6 (0.0-32.9)<0.001Diagnosis to radiotherapy Number of patients465127 Time (weeks)51.4 (18.7-88.4)26.1 (5.6-66.4)<0.001
In multivariate analysis, PHS (HR 1.72; 95% CI 1.34-1.88; p adj=0.003), presence of symptoms (HR 2.29; 95% CI 1.39-3.78; p adj=0.001), clinical stage III (HR 1.62; 95% CI 1.35-1.93; p adj<0.001), and triple negativity and HER2neu positivity (1.18; 95% CI 1.03-1.35; p adj=0.021) were all associated with a higher recurrence rate.Conclusions: There were significant disparities between PHS and PS. Women in the PHS presented higher rates of recurrence, advanced clinical stages at diagnosis, symptoms and more aggressive subtypes by IHC. additionally, the interval between symptoms to diagnosis and diagnosis to treatments was longer in PHS.
Citation Format: NematiShafaee M, Natal RA, Ramalho S, Dória MT, Conz L, Cabello V, Pavanello M, Mano MS, Linck RDM, Batista LS, Pedro EP, Bines J, de Paula BH, Zucca-Matthes G, Bondy ML, Ellis MJ, Podany E, Debord L, Makawita S, Stewart K, Cabello C. Impact of delay in breast cancer diagnosis and treatment according to health insurance status in southwest Brazil and Houston, Texas [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P4-10-15.
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Affiliation(s)
- M NematiShafaee
- Baylor College of Medecine, Houston, TX; State University of Campinas, Campinas, Sao Paulo, Brazil; Sírio Libanês Hospital, São Paulo, Brazil; Brazilian National Cancer Institute, Rio de Janeiro, Brazil; Barretos Cancer Hospital, Barretos, Sao Paulo, Brazil
| | - RA Natal
- Baylor College of Medecine, Houston, TX; State University of Campinas, Campinas, Sao Paulo, Brazil; Sírio Libanês Hospital, São Paulo, Brazil; Brazilian National Cancer Institute, Rio de Janeiro, Brazil; Barretos Cancer Hospital, Barretos, Sao Paulo, Brazil
| | - S Ramalho
- Baylor College of Medecine, Houston, TX; State University of Campinas, Campinas, Sao Paulo, Brazil; Sírio Libanês Hospital, São Paulo, Brazil; Brazilian National Cancer Institute, Rio de Janeiro, Brazil; Barretos Cancer Hospital, Barretos, Sao Paulo, Brazil
| | - MT Dória
- Baylor College of Medecine, Houston, TX; State University of Campinas, Campinas, Sao Paulo, Brazil; Sírio Libanês Hospital, São Paulo, Brazil; Brazilian National Cancer Institute, Rio de Janeiro, Brazil; Barretos Cancer Hospital, Barretos, Sao Paulo, Brazil
| | - L Conz
- Baylor College of Medecine, Houston, TX; State University of Campinas, Campinas, Sao Paulo, Brazil; Sírio Libanês Hospital, São Paulo, Brazil; Brazilian National Cancer Institute, Rio de Janeiro, Brazil; Barretos Cancer Hospital, Barretos, Sao Paulo, Brazil
| | - V Cabello
- Baylor College of Medecine, Houston, TX; State University of Campinas, Campinas, Sao Paulo, Brazil; Sírio Libanês Hospital, São Paulo, Brazil; Brazilian National Cancer Institute, Rio de Janeiro, Brazil; Barretos Cancer Hospital, Barretos, Sao Paulo, Brazil
| | - M Pavanello
- Baylor College of Medecine, Houston, TX; State University of Campinas, Campinas, Sao Paulo, Brazil; Sírio Libanês Hospital, São Paulo, Brazil; Brazilian National Cancer Institute, Rio de Janeiro, Brazil; Barretos Cancer Hospital, Barretos, Sao Paulo, Brazil
| | - MS Mano
- Baylor College of Medecine, Houston, TX; State University of Campinas, Campinas, Sao Paulo, Brazil; Sírio Libanês Hospital, São Paulo, Brazil; Brazilian National Cancer Institute, Rio de Janeiro, Brazil; Barretos Cancer Hospital, Barretos, Sao Paulo, Brazil
| | - RDM Linck
- Baylor College of Medecine, Houston, TX; State University of Campinas, Campinas, Sao Paulo, Brazil; Sírio Libanês Hospital, São Paulo, Brazil; Brazilian National Cancer Institute, Rio de Janeiro, Brazil; Barretos Cancer Hospital, Barretos, Sao Paulo, Brazil
| | - LS Batista
- Baylor College of Medecine, Houston, TX; State University of Campinas, Campinas, Sao Paulo, Brazil; Sírio Libanês Hospital, São Paulo, Brazil; Brazilian National Cancer Institute, Rio de Janeiro, Brazil; Barretos Cancer Hospital, Barretos, Sao Paulo, Brazil
| | - EP Pedro
- Baylor College of Medecine, Houston, TX; State University of Campinas, Campinas, Sao Paulo, Brazil; Sírio Libanês Hospital, São Paulo, Brazil; Brazilian National Cancer Institute, Rio de Janeiro, Brazil; Barretos Cancer Hospital, Barretos, Sao Paulo, Brazil
| | - J Bines
- Baylor College of Medecine, Houston, TX; State University of Campinas, Campinas, Sao Paulo, Brazil; Sírio Libanês Hospital, São Paulo, Brazil; Brazilian National Cancer Institute, Rio de Janeiro, Brazil; Barretos Cancer Hospital, Barretos, Sao Paulo, Brazil
| | - BH de Paula
- Baylor College of Medecine, Houston, TX; State University of Campinas, Campinas, Sao Paulo, Brazil; Sírio Libanês Hospital, São Paulo, Brazil; Brazilian National Cancer Institute, Rio de Janeiro, Brazil; Barretos Cancer Hospital, Barretos, Sao Paulo, Brazil
| | - G Zucca-Matthes
- Baylor College of Medecine, Houston, TX; State University of Campinas, Campinas, Sao Paulo, Brazil; Sírio Libanês Hospital, São Paulo, Brazil; Brazilian National Cancer Institute, Rio de Janeiro, Brazil; Barretos Cancer Hospital, Barretos, Sao Paulo, Brazil
| | - ML Bondy
- Baylor College of Medecine, Houston, TX; State University of Campinas, Campinas, Sao Paulo, Brazil; Sírio Libanês Hospital, São Paulo, Brazil; Brazilian National Cancer Institute, Rio de Janeiro, Brazil; Barretos Cancer Hospital, Barretos, Sao Paulo, Brazil
| | - MJ Ellis
- Baylor College of Medecine, Houston, TX; State University of Campinas, Campinas, Sao Paulo, Brazil; Sírio Libanês Hospital, São Paulo, Brazil; Brazilian National Cancer Institute, Rio de Janeiro, Brazil; Barretos Cancer Hospital, Barretos, Sao Paulo, Brazil
| | - E Podany
- Baylor College of Medecine, Houston, TX; State University of Campinas, Campinas, Sao Paulo, Brazil; Sírio Libanês Hospital, São Paulo, Brazil; Brazilian National Cancer Institute, Rio de Janeiro, Brazil; Barretos Cancer Hospital, Barretos, Sao Paulo, Brazil
| | - L Debord
- Baylor College of Medecine, Houston, TX; State University of Campinas, Campinas, Sao Paulo, Brazil; Sírio Libanês Hospital, São Paulo, Brazil; Brazilian National Cancer Institute, Rio de Janeiro, Brazil; Barretos Cancer Hospital, Barretos, Sao Paulo, Brazil
| | - S Makawita
- Baylor College of Medecine, Houston, TX; State University of Campinas, Campinas, Sao Paulo, Brazil; Sírio Libanês Hospital, São Paulo, Brazil; Brazilian National Cancer Institute, Rio de Janeiro, Brazil; Barretos Cancer Hospital, Barretos, Sao Paulo, Brazil
| | - K Stewart
- Baylor College of Medecine, Houston, TX; State University of Campinas, Campinas, Sao Paulo, Brazil; Sírio Libanês Hospital, São Paulo, Brazil; Brazilian National Cancer Institute, Rio de Janeiro, Brazil; Barretos Cancer Hospital, Barretos, Sao Paulo, Brazil
| | - C Cabello
- Baylor College of Medecine, Houston, TX; State University of Campinas, Campinas, Sao Paulo, Brazil; Sírio Libanês Hospital, São Paulo, Brazil; Brazilian National Cancer Institute, Rio de Janeiro, Brazil; Barretos Cancer Hospital, Barretos, Sao Paulo, Brazil
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Burton KLO, Bau K, Lewis J, Aroyan KR, Botha B, Botman AGM, Stewart K, Waugh MCA, Paget SP. Using family and staff experiences of a botulinum toxin-A service to improve service quality. Child Care Health Dev 2017; 43:847-853. [PMID: 28748610 DOI: 10.1111/cch.12500] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2017] [Revised: 05/30/2017] [Accepted: 07/05/2017] [Indexed: 11/30/2022]
Abstract
BACKGROUND The decision for families to proceed with botulinum toxin-A (BoNT-A) injections for managing childhood conditions involving hypertonia can be complex. Family-centred care is a service model that facilitates supporting families in this decision-making process. Understanding families' experiences of services is critical to developing family-centred care. The aim of this project was therefore to increase understanding of the experiences of families of children attending a BoNT-A service in order to improve the service and its family-centred approach to care. METHOD Sixteen staff of a BoNT-A service participated in a patient journey mapping exercise. Nine families of the service participated in in-depth interviews. Interviews were audio-recorded and transcribed verbatim. Data from the staff session and interviews were analysed independently using grounded, hermeneutic thematic analysis. RESULTS Staff sessions revealed 5 core themes that related to impacting on the family experience. Family interviews revealed 4 core themes, with 7 subthemes and 1 latent theme. CONCLUSIONS Areas of importance identified by families relating to BoNT-A treatment included acknowledgement of individual needs, care coordination, empowerment of families and patients, consistency in service delivery, and the distressing nature of appointment and decision-making. Comparison of the data from the staff patient journey mapping and family interviews suggested that staff have a good but incomplete understanding of the factors important to families, highlighting the need for consumer engagement in establishing family-centred care. The themes identified can guide the provision of family-centred BoNT-A injection clinics.
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Affiliation(s)
- K L O Burton
- Kids Rehab, The Children's Hospital at Westmead, Sydney, NSW, Australia.,Sydney Medical School, University of Sydney, Sydney, NSW, Australia
| | - K Bau
- Kids Rehab, The Children's Hospital at Westmead, Sydney, NSW, Australia
| | - J Lewis
- Kids Rehab, The Children's Hospital at Westmead, Sydney, NSW, Australia
| | - K R Aroyan
- Kids Rehab, The Children's Hospital at Westmead, Sydney, NSW, Australia
| | - B Botha
- Kids Rehab, The Children's Hospital at Westmead, Sydney, NSW, Australia
| | - A G M Botman
- Kids Rehab, The Children's Hospital at Westmead, Sydney, NSW, Australia
| | - K Stewart
- Kids Rehab, The Children's Hospital at Westmead, Sydney, NSW, Australia.,Sydney Medical School, University of Sydney, Sydney, NSW, Australia
| | - M-C A Waugh
- Kids Rehab, The Children's Hospital at Westmead, Sydney, NSW, Australia.,Sydney Medical School, University of Sydney, Sydney, NSW, Australia
| | - S P Paget
- Kids Rehab, The Children's Hospital at Westmead, Sydney, NSW, Australia.,Sydney Medical School, University of Sydney, Sydney, NSW, Australia
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Stewart K, Evans E, Singh V. Introduction of an ENT Nurse Led Clinic: A Joint Community & Secondary Care Project. Int J Surg 2017. [DOI: 10.1016/j.ijsu.2017.08.246] [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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Stewart K, Whelan D, Banerjee A. Are Cervical Collars a Necessary Post-Procedure Restriction in Patients With Benign Paroxysmal Positional Vertigo Treated With Particle Repositioning Manoeuvres? Int J Surg 2017. [DOI: 10.1016/j.ijsu.2017.08.063] [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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Ryan G, Thoma M, Stern J, Mengeling M, O'Shea A, Syrop C, Stewart K, Torner J, Van Voorhis B. Reproductive health risk due to sexual and combat-related trauma in US veterans. Fertil Steril 2017. [DOI: 10.1016/j.fertnstert.2017.07.025] [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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Edwards B, Stewart K, Al-Rikabi A, Thomas C. Comorbidity scoring in head and neck cancer patients. Int J Oral Maxillofac Surg 2017. [DOI: 10.1016/j.ijom.2017.02.956] [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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Champion WM, Charley PH, Klein B, Stewart K, Solomon PA, Montoya LD. Perception, culture, and science: A framework to identify in-home heating options to improve indoor air quality in the Navajo Nation. Sci Total Environ 2017; 580:297-306. [PMID: 28011023 DOI: 10.1016/j.scitotenv.2016.11.053] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [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: 08/30/2016] [Revised: 11/08/2016] [Accepted: 11/08/2016] [Indexed: 06/06/2023]
Abstract
A 2010 study identified higher than average incidence of respiratory disease in Shiprock, NM, the largest city in the Navajo Nation. That study suggested that the potential cause was the combustion of solid fuels in in-home heating stoves and that respiratory disease could be greatly reduced by changing indoor heating behaviors and improving heating stove quality. Since the Navajo people are deeply embedded in culture and traditions that strongly influence their daily lives, a new framework was needed to identify feasible heating alternatives that could reduce the negative environmental and health impacts related to solid fuel use while respecting the culture of the Navajo people. The resulting Navajo framework included perception, cultural, and technical assessments to evaluate seven heating alternatives perceived viable by Navajo stakeholders. Cultural experts at the Diné Policy Institute identified potential cultural limitations and motivating factors for each alternative. A limited technical assessment of the health benefits of these options was conducted and integrated into the process. A parallel convergent mixed-methods approach was employed to integrate qualitative and quantitative results. The results and framework developed and presented here may be useful for decision makers in communities heavily reliant on solid fuels for heat, especially Native Nations, where culture plays an important role in the success of any intervention.
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Affiliation(s)
- W M Champion
- University of Colorado, Boulder, Civil, Environmental & Architectural Engr. Dept., Sustainability, Energy and Environment Complex, 4001 Discovery Drive, 607 UCB, S286A, Boulder, Colorado 80303-0607, United States.
| | - P H Charley
- Diné College- Shiprock Campus, Dine Environmental Institute, PO Box 580, Shiprock, New Mexico 87420, United States.
| | - B Klein
- Diné College- Shiprock Campus, Dine Environmental Institute, PO Box 580, Shiprock, New Mexico 87420, United States.
| | - K Stewart
- United States Environmental Protection Agency, Region 9 Air Division, Air Toxics, Radiation, and Indoor Air Office, 75 Hawthorne St, San Francisco, CA 94105, United States.
| | - P A Solomon
- United States Environmental Protection Agency, Office of Research and Development, 944 E. Harmon Ave., Las Vegas, NV 89119, United States.
| | - L D Montoya
- University of Colorado, Boulder, Civil, Environmental & Architectural Engr. Dept., Sustainability, Energy and Environment Complex, 4001 Discovery Drive, 607 UCB, S286A, Boulder, Colorado 80303-0607, United States.
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Maile LA, Busby WH, Xi G, Gollahan KP, Flowers W, Gafbacik N, Gafbacik S, Stewart K, Merricks EP, Nichols TC, Bellinger DA, Clemmons DR. An anti-αVβ3 antibody inhibits coronary artery atherosclerosis in diabetic pigs. Atherosclerosis 2017; 258:40-50. [PMID: 28189040 DOI: 10.1016/j.atherosclerosis.2017.01.030] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [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: 06/28/2016] [Revised: 01/19/2017] [Accepted: 01/25/2017] [Indexed: 12/31/2022]
Abstract
BACKGROUND AND AIMS Diabetes is a major risk factor for the development of atherosclerosis. Hyperglycemia stimulates vascular smooth muscle cells (VSMC) to secrete ligands that bind to the αVβ3 integrin, a receptor that regulates VSMC proliferation and migration. This study determined whether an antibody that had previously been shown to block αVβ3 activation and to inhibit VSMC proliferation and migration in vitro, inhibited the development of atherosclerosis in diabetic pigs. METHODS Twenty diabetic pigs were maintained on a high fat diet for 22 weeks. Ten received injections of anti-β3 F(ab)2 and ten received control F(ab)2 for 18 weeks. RESULTS The active antibody group showed reduction of atherosclerosis of 91 ± 9% in the left main, 71 ± 11%, in left anterior descending, 80 ± 10.2% in circumflex, and 76 ± 25% in right coronary artery, (p < 0.01 compared to lesions areas from corresponding control treated arteries). There were significant reductions in both cell number and extracellular matrix. Histologic analysis showed neointimal hyperplasia with macrophage infiltration, calcifications and cholesterol clefts. Antibody treatment significantly reduced number of macrophages contained within lesions, suggesting that this change contributed to the decrease in lesion cellularity. Analysis of the biochemical changes within the femoral arteries that received the active antibody showed a 46 ± 12% (p < 0.05) reduction in the tyrosine phosphorylation of the β3 subunit of αVβ3 and a 40 ± 14% (p < 0.05) reduction in MAP kinase activation. CONCLUSIONS Blocking ligand binding to the αVβ3 integrin inhibits its activation and attenuates increased VSMC proliferation that is induced by chronic hyperglycemia. These changes result in significant decreases in atherosclerotic lesion size in the coronary arteries. The results suggest that this approach may have efficacy in treating the proliferative phase of atherosclerosis in patients with diabetes.
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Affiliation(s)
- L A Maile
- Department of Medicine, UNC School of Medicine, Chapel Hill, NC, USA
| | - W H Busby
- Department of Medicine, UNC School of Medicine, Chapel Hill, NC, USA
| | - G Xi
- Department of Medicine, UNC School of Medicine, Chapel Hill, NC, USA
| | - K P Gollahan
- Department of Medicine, UNC School of Medicine, Chapel Hill, NC, USA
| | - W Flowers
- Department of Animal Science, NC State University, Raleigh, NC, USA
| | - N Gafbacik
- Department of Animal Science, NC State University, Raleigh, NC, USA
| | - S Gafbacik
- Department of Animal Science, NC State University, Raleigh, NC, USA
| | - K Stewart
- Department of Animal Science, NC State University, Raleigh, NC, USA
| | - E P Merricks
- Department of Medicine, UNC School of Medicine, Chapel Hill, NC, USA
| | - T C Nichols
- Department of Medicine, UNC School of Medicine, Chapel Hill, NC, USA
| | - D A Bellinger
- Department of Medicine, UNC School of Medicine, Chapel Hill, NC, USA
| | - D R Clemmons
- Department of Medicine, UNC School of Medicine, Chapel Hill, NC, USA.
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Ives AK, Antaki E, Stewart K, Francis S, Jay-Russell MT, Sithole F, Kearney MT, Griffin MJ, Soto E. Detection of Salmonella enterica Serovar Montevideo and Newport in Free-ranging Sea Turtles and Beach Sand in the Caribbean and Persistence in Sand and Seawater Microcosms. Zoonoses Public Health 2016; 64:450-459. [PMID: 28009107 DOI: 10.1111/zph.12324] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2016] [Indexed: 12/01/2022]
Abstract
Salmonellae are Gram-negative zoonotic bacteria that are frequently part of the normal reptilian gastrointestinal flora. The main objective of this project was to estimate the prevalence of non-typhoidal Salmonella enterica in the nesting and foraging populations of sea turtles on St. Kitts and in sand from known nesting beaches. Results suggest a higher prevalence of Salmonella in nesting leatherback sea turtles compared with foraging green and hawksbill sea turtles. Salmonella was cultured from 2/9 and identified by molecular diagnostic methods in 3/9 leatherback sea turtle samples. Salmonella DNA was detected in one hawksbill turtle, but viable isolates were not recovered from any hawksbill sea turtles. No Salmonella was detected in green sea turtles. In samples collected from nesting beaches, Salmonella was only recovered from a single dry sand sample. All recovered isolates were positive for the wzx gene, consistent with the O:7 serogroup. Further serotyping characterized serovars Montevideo and Newport present in cloacal and sand samples. Repetitive-element palindromic PCR (rep-PCR) fingerprint analysis and pulsed-field gel electrophoresis of the 2014 isolates from turtles and sand as well as archived Salmonella isolates recovered from leatherback sea turtles in 2012 and 2013, identified two distinct genotypes and four different pulsotypes, respectively. The genotyping and serotyping were directly correlated. To determine the persistence of representative strains of each serotype/genotype in these environments, laboratory-controlled microcosm studies were performed in water and sand (dry and wet) incubated at 25 or 35°C. Isolates persisted for at least 32 days in most microcosms, although there were significant decreases in culturable bacteria in several microcosms, with the greatest reduction in dry sand incubated at 35°C. This information provides a better understanding of the epizootiology of Salmonella in free-ranging marine reptiles and the potential public health risks associated with human interactions with these animals in the Caribbean.
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Affiliation(s)
- A-K Ives
- Department of Biomedical Sciences, Ross University School of Veterinary Medicine, Basseterre, St. Kitts
| | - E Antaki
- Western Center for Food Safety, University of California, Davis, CA, USA
| | - K Stewart
- Department of Biomedical Sciences, Ross University School of Veterinary Medicine, Basseterre, St. Kitts
- St. Kitts Sea Turtle Monitoring Network, Basseterre, St Kitts
| | - S Francis
- Department of Biomedical Sciences, Ross University School of Veterinary Medicine, Basseterre, St. Kitts
| | - M T Jay-Russell
- Western Center for Food Safety, University of California, Davis, CA, USA
| | - F Sithole
- Department of Biomedical Sciences, Ross University School of Veterinary Medicine, Basseterre, St. Kitts
| | - M T Kearney
- Department of Pathobiological Sciences, School of Veterinary Medicine, Louisiana State University, Baton Rouge, LA, USA
| | - M J Griffin
- Department of Pathobiology and Population Medicine, College of Veterinary Medicine, Mississippi State University, Stoneville, MS, USA
| | - E Soto
- Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California-Davis, Davis, CA, USA
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Orchard GE, Shams M, Nwokie T, Fernando P, Bulut C, Quaye CJ, Gabriel J, Ramji Z, Georgaki A, Watt M, Cole Z, Stewart K, McTaggart V, Padayachy S, Long AM, Ogden A, Andrews C, Birchall A, Shams F, Neesam H, Haine N. A multicentre study of the precision and accuracy of the TruSlice and TruSlice Digital histological dissection devices. Br J Biomed Sci 2016; 73:163-167. [PMID: 27922431 DOI: 10.1080/09674845.2016.1233791] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND Five key factors enabling a good surgical grossing technique include a flat uniformly perpendicular specimen cutting face, appropriate immobilisation of the tissue specimen during grossing, good visualisation of the cutting tissue face, sharp cutting knives and the grossing knife action. TruSlice and TruSlice Digital are new innovative tools based on a guillotine configuration. The TruSlice has plastic inserts whilst the TruSlice Digital has an electronic micrometre attached: both features enable these dissection factors to be controlled. The devices were assessed in five hospitals in the UK. MATERIAL AND METHODS A total of 267 fixed tissue samples from 23 tissue types were analysed, principally the breast (n = 32) skin (30), rectum (28), colon (27) and cervix (17). Precision and accuracy were evaluated by measuring the defined thickness, and the consistency of achieving the defined thickness of tissue samples taken respectively. Both parameters were expressed as a total percentage of compliance for the cohort of samples accessed. RESULTS Overall, the mean (standard deviation) score for precision was 81 (11) % whilst the accuracy score was 82 (11) % (both p < 0.05, chi-squared test), although this varied with type of tissue. Accuracy and precision were strongly correlated (rp = 0.83, p < 0.001). CONCLUSION The TruSlice Digital devices offer an assured precision and accuracy performance which is reproducible across an assortment of tissue types. The use of a micrometre to set tissue slice thickness is innovative and should comply with laboratory accreditation requirements, alleviating concerns of how to tackle issues such as the 'measurement of uncertainty' at the grossing bench.
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Affiliation(s)
- G E Orchard
- a Viapath, St John's Institute of Dermatology , St. Thomas' Hospital , London , UK
| | - M Shams
- a Viapath, St John's Institute of Dermatology , St. Thomas' Hospital , London , UK
| | - T Nwokie
- a Viapath, St John's Institute of Dermatology , St. Thomas' Hospital , London , UK
| | - P Fernando
- a Viapath, St John's Institute of Dermatology , St. Thomas' Hospital , London , UK
| | - C Bulut
- a Viapath, St John's Institute of Dermatology , St. Thomas' Hospital , London , UK
| | - C J Quaye
- a Viapath, St John's Institute of Dermatology , St. Thomas' Hospital , London , UK
| | - J Gabriel
- a Viapath, St John's Institute of Dermatology , St. Thomas' Hospital , London , UK
| | - Z Ramji
- a Viapath, St John's Institute of Dermatology , St. Thomas' Hospital , London , UK
| | - A Georgaki
- a Viapath, St John's Institute of Dermatology , St. Thomas' Hospital , London , UK
| | - M Watt
- b Crosshouse Hospital , Kilmarnock , UK
| | - Z Cole
- b Crosshouse Hospital , Kilmarnock , UK
| | - K Stewart
- b Crosshouse Hospital , Kilmarnock , UK
| | | | - S Padayachy
- c Southampton General Hospital , Southampton , UK
| | - A M Long
- c Southampton General Hospital , Southampton , UK
| | - A Ogden
- c Southampton General Hospital , Southampton , UK
| | - C Andrews
- d Heartlands Hospital , Birmingham , UK
| | - A Birchall
- e Wythenshawe Hospital , Manchester , UK
| | - F Shams
- f Barts and the London School of Medicine, Queen Mary University of London , London , UK
| | | | - N Haine
- g CellPath Ltd. , Powys , UK
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Burleigh DW, Stewart K, Grindle KM, Kay HH, Golos TG. Influence of Maternal Diabetes on Placental Fibroblast Growth Factor-2 Expression, Proliferation, and Apoptosis. ACTA ACUST UNITED AC 2016; 11:36-41. [PMID: 14706681 DOI: 10.1016/j.jsgi.2003.06.001] [Citation(s) in RCA: 26] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVE Type I diabetes mellitus during pregnancy is associated with dysregulation of the oxygen and glucose metabolic pathways, both of which affect placental villous growth and function. Alteration of placental development in women with diabetes may contribute to the increased risk of preeclampsia, macrosomia, or fetal growth restriction. METHODS To evaluate placental growth in the setting of maternal diabetes, immunohistochemical techniques were used to examine fibroblast growth factor-2 (FGF-2) expression, cell proliferation (Ki67), and apoptosis (Apo-Tag) in placentas from diabetic and nondiabetic patients. RESULTS Immunostaining for FGF-2 in placentas from diabetic women demonstrated an increase in intensity within the villous stroma and syncytiotrophoblast (P<.05). Associated with these changes in FGF-2 expression, placentas from diabetic women showed no change in villous mitotic activity but did show decreased stromal compartment apoptosis. When expressed as a ratio of Ki67-positive:Apo-Tag-positive nuclei as an index of relative cell turnover, the stromal compartment showed a significant trend towards decreased nuclei turnover (P<.05), suggesting relative tissue growth in diabetic patients. CONCLUSION Increased FGF-2 expression and decreased stromal cell compartment turnover in the diabetic placenta might be a compensatory mechanism in response to the altered physiologic milieu of maternal diabetes on placental function.
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Affiliation(s)
- D W Burleigh
- Wisconsin National Primate Research Center, University of Wisconsin, Madison, Wisconsin, USA
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Horrocks JA, Stapleton S, Guada H, Lloyd C, Harris E, Fastigi M, Berkel J, Stewart K, Gumbs J, Eckert KL. International movements of adult female leatherback turtles in the Caribbean: results from tag recovery data (2002-2013). ENDANGER SPECIES RES 2016. [DOI: 10.3354/esr00718] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Christophersen AS, Mørland J, Stewart K, Gjerde H. International trends in alcohol and drug use among vehicle drivers. Forensic Sci Rev 2016; 28:37-66. [PMID: 26841722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Trends in the use of alcohol and drugs among motor vehicle drivers in Australia, Brazil, Norway, Spain, and the United States have been reviewed. Laws, regulations, enforcement, and studies on alcohol and drugs in biological samples from motor vehicle drivers in general road traffic and fatal road traffic crashes (RTCs) are discussed. Roadside surveys showed a reduction of drunk driving over time in the studied countries; however, the pattern varied within and between different countries. The reduction of alcohol use may be related to changes in road traffic laws, public information campaigns, and enforcement, including implementation of random breath testing or sobriety checkpoints. For non-alcohol drugs, the trend in general road traffic is an increase in use. However, drugs were not included in older studies; it is therefore impossible to assess the trends over longer time periods. Data from the studied countries, except Brazil, have shown a significant decrease in fatal RTCs per 100,000 inhabitants over the last decades; from 18.6 to 4.9 in Australia, 14.5 to 2.9 in Norway, 11.1 to 3.6 in Spain, and 19.3 to 10.3 in the United States. The number of alcohol-related fatal RTCs also decreased during the same time period. The proportion of fatal RTCs related to non-alcohol drugs increased, particularly for cannabis and stimulants. A general challenge when comparing alcohol and drug findings in biological samples from several countries is connected to differences in study design, particularly the time period for performing roadside surveys, biological matrix types, drugs included in the analytical program, and the cutoff limits used for evaluation of results. For RTC fatalities, the cases included are based on the police requests for legal autopsy or drug testing, which may introduce a significant selection bias. General comparisons between high-income countries and low- and middle-income countries as well as a discussion of possible future trends are included.
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Affiliation(s)
- A S Christophersen
- Division of Forensic Sciences, Norwegian Institute of Public Health, Oslo, Norway
- Department of International Public Health, Norwegian Institute of Public Health, Oslo, Norway
| | - J Mørland
- Division of Forensic Sciences, Norwegian Institute of Public Health, Oslo, Norway
| | - K Stewart
- Prevention Research Center, Safety and Policy Analysis International, Oakland, CA, USA
| | - H Gjerde
- Division of Forensic Sciences, Norwegian Institute of Public Health, Oslo, Norway
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Stewart K, Vijayaraman A, Alley M, Bradley J, Dresner S. A retrospective audit of patient selection for bariatric surgery. Int J Surg 2015. [DOI: 10.1016/j.ijsu.2015.07.566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Stewart K, Vijayaraman A, Alley M, Bradley J, Dresner S. Bariatric surgery in patients with type 2 diabetes. Int J Surg 2015. [DOI: 10.1016/j.ijsu.2015.07.565] [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: 10/22/2022]
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Tewani K, Mulholland H, Gambles M, Lowe D, Husk J, Stewart K, Ellershaw J. THE USE OF MEDICATIONS IN THE LAST 24 HOURS OF LIFE IN THE ACUTE HOSPITAL SETTING—A DESCRIPTIVE COMPARISON OF CANCER AND NON CANCER PATIENTS USING DATA FROM THE NATIONAL CARE OF THE DYING AUDIT HOSPITALS—ENGLAND (NCDAH) 2013/14. BMJ Support Palliat Care 2015. [DOI: 10.1136/bmjspcare-2014-000838.5] [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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Duncan G, Swinburne G, Hussainy S, Mc Namara K, Stewart K, Emmerton L. An Evaluation of the Impact of a Health Literacy Educational Package for Community Pharmacists and Pharmacy Staff in Australia. Res Social Adm Pharm 2014. [DOI: 10.1016/j.sapharm.2014.07.025] [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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Hasan S, Kong D, Stewart K. Physicians’ Opinions on Collaboration with Pharmacists in the United Arab Emirates. Res Social Adm Pharm 2014. [DOI: 10.1016/j.sapharm.2014.07.115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Summers K, Stewart K, Gharani P, Ryan G, Van Voorhis B. Geospatial modeling of in-vitro fertilization (IVF) accessibility in a rural midwestern state. Fertil Steril 2014. [DOI: 10.1016/j.fertnstert.2014.07.939] [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: 11/28/2022]
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Bohm C, Stewart K, Onyskie-Marcus J, Esliger D, Kriellaars D, Rigatto C. Effects of intradialytic cycling compared with pedometry on physical function in chronic outpatient hemodialysis: a prospective randomized trial. Nephrol Dial Transplant 2014; 29:1947-55. [DOI: 10.1093/ndt/gfu248] [Citation(s) in RCA: 59] [Impact Index Per Article: 5.9] [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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Stewart K, George J, Mc Namara KP, Jackson SL, Peterson GM, Bereznicki LR, Gee PR, Hughes JD, Bailey MJ, Hsueh YSA, McDowell JM, Bortoletto DA, Lau R. A multifaceted pharmacist intervention to improve antihypertensive adherence: a cluster-randomized, controlled trial (HAPPy trial). J Clin Pharm Ther 2014; 39:527-34. [DOI: 10.1111/jcpt.12185] [Citation(s) in RCA: 65] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2014] [Accepted: 05/19/2014] [Indexed: 12/26/2022]
Affiliation(s)
- K. Stewart
- Centre for Medicine Use and Safety; Monash University; Melbourne Vic. Australia
| | - J. George
- Centre for Medicine Use and Safety; Monash University; Melbourne Vic. Australia
| | - K. P. Mc Namara
- Centre for Medicine Use and Safety; Monash University; Melbourne Vic. Australia
- Greater Green Triangle University Department of Rural Health; Flinders University and Deakin University; Warrnambool Vic. Australia
| | - S. L. Jackson
- Unit for Medication Outcomes Research and Education, Pharmacy; University of Tasmania; Hobart Tas. Australia
| | - G. M. Peterson
- Unit for Medication Outcomes Research and Education, Pharmacy; University of Tasmania; Hobart Tas. Australia
| | - L. R. Bereznicki
- Unit for Medication Outcomes Research and Education, Pharmacy; University of Tasmania; Hobart Tas. Australia
| | - P. R. Gee
- Unit for Medication Outcomes Research and Education, Pharmacy; University of Tasmania; Hobart Tas. Australia
| | - J. D. Hughes
- School of Pharmacy; Curtin University; Perth WA Australia
| | - M. J. Bailey
- Department of Epidemiology & Preventive Medicine; Monash University; Melbourne Vic. Australia
| | - YS. A. Hsueh
- Centre for Health Policy; Melbourne School of Population and Global Health; The University of Melbourne; Melbourne Vic. Australia
| | - J. M. McDowell
- Centre for Medicine Use and Safety; Monash University; Melbourne Vic. Australia
| | | | - R. Lau
- School of Nursing and Midwifery; Monash University; Melbourne Vic. Australia
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Voss J, Graff C, Schwartz A, Hyland D, Argiriadi M, Camp H, Dowding L, Friedman M, Frank K, George J, Goedken E, Lo Schiavo G, Morytko M, O'Brien R, Padley R, Rozema M, Rosebraugh M, Stewart K, Wallace G, Wishart N, Murtaza A, Olson L. THU0127 Pharmacodynamics of A Novel JAK1 Selective Inhibitor in Rat Arthritis and Anemia Models and in Healthy Human Subjects. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.3823] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [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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