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Kavanagh K, Coleman J, O'Connell SM, Fhoghlú CN, Moore DP, Brenner C, Lynch SA. A further case of chondrodysplasia with growth failure occurring after hematopoietic stem cell transplantation (HSCT). Am J Med Genet A 2024:e63603. [PMID: 38511620 DOI: 10.1002/ajmg.a.63603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 02/22/2024] [Accepted: 03/08/2024] [Indexed: 03/22/2024]
Abstract
There is an emerging body of evidence showing that young patients, post haematopoietic stem cell transplantation (HSCT), can develop skeletal changes that mimic an osteochondrodysplasia process. The key discriminator is that these children have had otherwise normal growth and skeletal development before the therapeutic intervention (HSCT), typically for a haematological malignancy. Herein we present that case of a boy who underwent HSCT for Haemophagocytic Lymphohistiocytosis (HLH) aged 2 years. Following Intervention with HSCT this boy's growth has severely decelerated (stature less than 1st centile matched for age) and he has developed a spondyloepiphyseal dysplasia.
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Affiliation(s)
- K Kavanagh
- Children's Health Ireland at Crumlin, Dublin, Ireland
| | - J Coleman
- Children's Health Ireland at Crumlin, Dublin, Ireland
| | - S M O'Connell
- Children's Health Ireland at Crumlin, Dublin, Ireland
| | - C Ní Fhoghlú
- Children's Health Ireland at Crumlin, Dublin, Ireland
| | - D P Moore
- Children's Health Ireland at Crumlin, Dublin, Ireland
| | - C Brenner
- Children's Health Ireland at Crumlin, Dublin, Ireland
| | - S A Lynch
- Children's Health Ireland at Crumlin, Dublin, Ireland
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2
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Tosh C, Kavanagh K, Flynn AC, Stephenson J, White SL, Catalao R, Wilson CA. The physical-mental health interface in the preconception period: Analysis of 131,182 women planning pregnancy in the UK. BJOG 2023. [PMID: 36883460 DOI: 10.1111/1471-0528.17447] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Revised: 02/09/2023] [Accepted: 02/28/2023] [Indexed: 03/09/2023]
Abstract
OBJECTIVE physical and mental health of women prior to conception can have a significant impact on pregnancy and child outcomes. Given the rising burden of non-communicable diseases, the aim was to explore the relationship between mental health, physical health and health behaviour in women planning a pregnancy. METHODS cross-sectional analysis of responses from 131,182 women to a preconception health digital education tool, providing data on physical and mental health and health behaviour. Logistic regression was used to explore associations between mental health and physical health variables. RESULTS physical health conditions were reported by 13.1% and mental health conditions by 17.8%. There was evidence for an association between self-reported physical and mental health conditions (OR 2.22; 95% CI 2.14 to 2.3). Those with a mental health condition were less likely to engage with healthy behaviour at preconception such as folate supplementation (OR 0.89; 95% CI 0.86 to 0.92) and consumption of the recommended amount of fruit and vegetables (OR 0.77; 95% CI 0.74 to 0.79). They were more likely to be physically inactive (OR 1.14; 95% CI 1.11 to 1.18), smoke tobacco (OR 1.72; 95% CI 1.66 to 1.78) and use illicit substances (OR 2.4; 95% CI 2.25 to 2.55). CONCLUSIONS greater recognition of mental and physical co-morbidities is needed and closer integration of physical and mental healthcare in the preconception period, which could support people to optimise their health during this time and improve long term outcomes.
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Affiliation(s)
- C Tosh
- Department of Mathematics and Statistics, University of Strathclyde, Glasgow, UK
| | - K Kavanagh
- Department of Mathematics and Statistics, University of Strathclyde, Glasgow, UK
| | - A C Flynn
- Department of Women and Children's Health, King's College London, 10th floor North Wing, St Thomas' Hospital, London, UK
| | - J Stephenson
- Institute for Women's Health, University College London, 1st floor Maple House, 149 Tottenham Court Road, London, UK
| | - S L White
- Department of Women and Children's Health, King's College London, 10th floor North Wing, St Thomas' Hospital, London, UK
| | - R Catalao
- Section of Women's Mental Health, PO31 King's College London, SE5 8AF and South London and Maudsley NHS Foundation Trust, UK
| | - C A Wilson
- NIHR Academic Clinical Lecturer, Section of Women's Mental Health, PO31 King's College London, SE5 8AF and South London and Maudsley NHS Foundation Trust, UK
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Tosh C, Kavanagh K, Flynn A, White S, Catalao R, Wilson C. The physical-mental health interface during pregnancy planning. Eur Psychiatry 2022. [PMCID: PMC9566705 DOI: 10.1192/j.eurpsy.2022.296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introduction
The physical and mental health of women prior to conception can have a significant impact on pregnancy and child outcomes. Given the rising burden of non-communicable diseases, the aim of this analysis was to explore the relationship between mental health, physical health and health behaviour in women planning a pregnancy.
Objectives
To investigate the association between indices of physical and mental health in a large population of women in the UK planning a pregnancy.
Methods
Responses to a preconception health digital education tool provided data on the physical and mental health and health behaviour of 131,182 women planning pregnancy. Logistic regression was used to explore associations between mental health and physical health variables. Multiple imputation by chained equations was implemented to handle missing data.
Results
There was evidence for an association between physical and mental health conditions (OR 2.22; 95% CI 2.14, 2.3). There was also an association between having a mental disorder and physical inactivity (OR 1.14; 95% CI 1.11, 1.18), substance misuse (OR 2.4; 95% CI 2.25, 2.55) and less folic acid use (OR 0.89; 95% CI 0.86,0.92).
Conclusions
There is a need for greater integration of physical and mental healthcare for women in the preconception period, which could support women, including those who wish to conceive, to optimise their health during this time.
Disclosure
No significant relationships.
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Worms IAM, Kavanagh K, Moulin E, Regier N, Slaveykova VI. Asymmetrical Flow Field-Flow Fractionation Methods for Quantitative Determination and Size Characterization of Thiols and for Mercury Size Speciation Analysis in Organic Matter-Rich Natural Waters. Front Chem 2022; 10:800696. [PMID: 35252112 PMCID: PMC8888841 DOI: 10.3389/fchem.2022.800696] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2021] [Accepted: 01/05/2022] [Indexed: 12/13/2022] Open
Abstract
Asymmetrical flow field-flow fractionation (AF4) efficiently separates various macromolecules and nano-components of natural waters according to their hydrodynamic sizes. The online coupling of AF4 with fluorescence (Fluo) and UV absorbance (UV) detectors (FluoD and UVD, respectively) and inductively coupled plasma–mass spectrometry (ICP-MS) provides multidimensional information. This makes it a powerful tool to characterize and quantify the size distributions of organic and inorganic nano-sized components and their interaction with trace metals. In this study, we developed a method combining thiol labeling by monobromo(trimethylammonio)bimane bromide (qBBr) with AF4–FluoD to determine the size distribution and the quantities of thiols in the macromolecular dissolved organic matter (DOM) present in highly colored DOM-rich water sampled from Shuya River and Lake Onego, Russia. We found that the qBBr-labeled components of DOM (qB-DOM) were of humic type, characterized by a low hydrodynamic size (dh < 2 nm), and have concentrations <0.3 μM. After enrichment with mercury, the complexes formed between the nano-sized components and Hg were analyzed using AF4–ICP-MS. The elution profile of Hg followed the distribution of the UV-absorbing components of DOM, characterized by slightly higher sizes than qB-DOM. Only a small proportion of Hg was associated with the larger-sized components containing Fe and Mn, probably inorganic oxides that were identified in most of the samples from river to lake. The size distribution of the Hg–DOM complexes was enlarged when the concentration of added Hg increased (from 10 to 100 nM). This was explained by the presence of small iron oxides, overlapping the size distribution of Hg–DOM, on which Hg bound to a small proportion. In addition, to provide information on the dispersion of macromolecular thiols in colored DOM-rich natural water, our study also illustrated the potential of AF4–FluoD–UVD–ICP-MS to trace or quantify dynamic changes while Hg binds to the natural nano-colloidal components of surface water.
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Cossart T, Garcia-Calleja J, Worms IAM, Tessier E, Kavanagh K, Pedrero Z, Amouroux D, Slaveykova VI. Species-specific isotope tracking of mercury uptake and transformations by pico-nanoplankton in an eutrophic lake. Environ Pollut 2021; 288:117771. [PMID: 34271517 DOI: 10.1016/j.envpol.2021.117771] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 03/04/2021] [Revised: 07/06/2021] [Accepted: 07/08/2021] [Indexed: 06/13/2023]
Abstract
The present study aims to explore the bioaccumulation and biotic transformations of inorganic (iHg) and monomethyl mercury (MMHg) by natural pico-nanoplankton community from eutrophic lake Soppen, Switzerland. Pico-nanoplankton encompass mainly bacterioplankton, mycoplankton and phytoplankton groups with size between 0.2 and 20 μm. Species-specific enriched isotope mixture of 199iHg and 201MMHg was used to explore the accumulation, the subcellular distribution and transformations occurring in natural pico-nanoplankton sampled at 2 different depths (6.6 m and 8.3 m). Cyanobacteria, diatoms, cryptophyta, green algae and heterotrophic microorganisms were identified as the major groups of pico-nanoplankton with diatoms prevailing at deeper samples. Results showed that pico-nanoplankton accumulated both iHg and MMHg preferentially in the cell membrane/organelles, despite observed losses. The ratios between the iHg and MMHg concentrations measured in the membrane/organelles and cytosol were comparable for iHg and MMHg. Pico-nanoplankton demethylate added 201MMHg (~4 and 12% per day depending on cellular compartment), although the involved pathways are to further explore. Comparison of the concentrations of 201iHg formed from 201MMHg demethylation in whole system, medium and whole cells showed that 82% of the demethylation was biologically mediated by pico-nanoplankton. No significant methylation of iHg by pico-nanoplankton was observed. The accumulation of iHg and MMHg and the percentage of demethylated MMHg correlated positively with the relative abundance of diatoms and heterotrophic microorganisms in the pico-nanoplankton, the concentrations of TN, Mg2+, NO3-, NO2-, NH4+ and negatively with the concentrations of DOC, K+, Na+, Ca2+, SO42-. Taken together the results of the present field study confirm the role of pico-nanoplankton in Hg bioaccumulation and demethylation, however further research is needed to better understand the underlying mechanisms and interconnection between heterotrophic and autotrophic microorganisms.
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Affiliation(s)
- Thibaut Cossart
- Environmental Biogeochemistry and Ecotoxicology, Department F.-A. Forel for Environmental and Aquatic Sciences, Earth and Environmental Sciences, Faculty of Sciences, University of Geneva, Uni Carl Vogt, Bvd Carl-Vogt 66, CH-1211, Geneva 4, Switzerland
| | - Javier Garcia-Calleja
- Université de Pau et des Pays de l'Adour, E2S UPPA, CNRS, IPREM, Institut des Sciences Analytiques et de Physico-chimie pour l'Environnement et les matériaux, Pau, France
| | - Isabelle A M Worms
- Environmental Biogeochemistry and Ecotoxicology, Department F.-A. Forel for Environmental and Aquatic Sciences, Earth and Environmental Sciences, Faculty of Sciences, University of Geneva, Uni Carl Vogt, Bvd Carl-Vogt 66, CH-1211, Geneva 4, Switzerland
| | - Emmanuel Tessier
- Université de Pau et des Pays de l'Adour, E2S UPPA, CNRS, IPREM, Institut des Sciences Analytiques et de Physico-chimie pour l'Environnement et les matériaux, Pau, France
| | - Killian Kavanagh
- Environmental Biogeochemistry and Ecotoxicology, Department F.-A. Forel for Environmental and Aquatic Sciences, Earth and Environmental Sciences, Faculty of Sciences, University of Geneva, Uni Carl Vogt, Bvd Carl-Vogt 66, CH-1211, Geneva 4, Switzerland
| | - Zoyne Pedrero
- Université de Pau et des Pays de l'Adour, E2S UPPA, CNRS, IPREM, Institut des Sciences Analytiques et de Physico-chimie pour l'Environnement et les matériaux, Pau, France
| | - David Amouroux
- Université de Pau et des Pays de l'Adour, E2S UPPA, CNRS, IPREM, Institut des Sciences Analytiques et de Physico-chimie pour l'Environnement et les matériaux, Pau, France
| | - Vera I Slaveykova
- Environmental Biogeochemistry and Ecotoxicology, Department F.-A. Forel for Environmental and Aquatic Sciences, Earth and Environmental Sciences, Faculty of Sciences, University of Geneva, Uni Carl Vogt, Bvd Carl-Vogt 66, CH-1211, Geneva 4, Switzerland.
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Barker M, Mehran R, Wong G, Nair P, Chou A, Butler C, Chen-Tournoux A, Coverett K, Essadiqi B, Froeschl M, Hazra S, Huitema A, Kavanagh K, Khoo C, Korley V, Ly H, Moeller A, Morin J, Teefy P, Sibbald M, Gin K, Sathananthan J. THE CURRENT LANDSCAPE OF CARDIAC CATHETERIZATION TRAINING IN CANADA: A NATIONWIDE SURVEY OF CORE CARDIOLOGY TRAINEES. Can J Cardiol 2021. [DOI: 10.1016/j.cjca.2021.07.079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Stewart S, Robertson C, Pan J, Kennedy S, Haahr L, Manoukian S, Mason H, Kavanagh K, Graves N, Dancer SJ, Cook B, Reilly J. Impact of healthcare-associated infection on length of stay. J Hosp Infect 2021; 114:23-31. [PMID: 34301393 DOI: 10.1016/j.jhin.2021.02.026] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Revised: 02/23/2021] [Accepted: 02/23/2021] [Indexed: 02/06/2023]
Abstract
BACKGROUND Increased length of stay (LOS) for patients is an important measure of the burden of healthcare-associated infection (HAI). AIM To estimate the excess LOS attributable to HAI. METHODS This was a one-year prospective incidence study of HAI observed in one teaching hospital and one general hospital in NHS Scotland as part of the Evaluation of Cost of Nosocomial Infection (ECONI) study. All adult inpatients with an overnight stay were included. HAI was diagnosed using European Centres for Disease Prevention and Control definitions. A multi-state model was used to account for the time-varying nature of HAI and the competing risks of death and discharge. FINDINGS The excess LOS attributable to HAI was 7.8 days (95% confidence interval (CI): 5.7-9.9). Median LOS for HAI patients was 30 days and for non-HAI patients was 3 days. Using a simple comparison of duration of hospital stay for HAI cases and non-cases would overestimate the excess LOS by 3.5 times (27 days compared with 7.8 days). The greatest impact on LOS was due to pneumonia (16.3 days; 95% CI: 7.5-25.2), bloodstream infections (11.4 days; 5.8-17.0) and surgical site infection (SSI) (9.8 days; 4.5-15.0). It is estimated that 58,000 bed-days are occupied due to HAI annually. CONCLUSION A reduction of 10% in HAI incidence could make 5800 bed-days available. These could be used to treat 1706 elective patients in Scotland annually and help reduce the number of patients awaiting planned treatment. This study has important implications for investment decisions in infection prevention and control interventions locally, nationally, and internationally.
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Affiliation(s)
- S Stewart
- Safeguarding Health through Infection Prevention Research Group, Research Centre for Health (ReaCH), Glasgow Caledonian University, Glasgow, UK.
| | - C Robertson
- Department of Mathematics and Statistics, University of Strathclyde, Glasgow, UK
| | - J Pan
- Department of Mathematics and Statistics, University of Strathclyde, Glasgow, UK
| | - S Kennedy
- HPS Stats Support, Public Health Scotland, Glasgow, UK
| | - L Haahr
- Safeguarding Health through Infection Prevention Research Group, Research Centre for Health (ReaCH), Glasgow Caledonian University, Glasgow, UK
| | - S Manoukian
- Yunus Centre for Social Business and Health, Glasgow Caledonian University, Glasgow, UK
| | - H Mason
- Yunus Centre for Social Business and Health, Glasgow Caledonian University, Glasgow, UK
| | - K Kavanagh
- Department of Mathematics and Statistics, University of Strathclyde, Glasgow, UK
| | - N Graves
- Duke-NUS Medical School, Singapore
| | - S J Dancer
- Department of Microbiology, Hairmyres Hospital, NHS Lanarkshire, UK; School of Applied Science, Edinburgh Napier University, Edinburgh, UK
| | - B Cook
- Departments of Anaesthesia and Critical Care, Royal Infirmary of Edinburgh, Edinburgh, UK
| | - J Reilly
- Safeguarding Health through Infection Prevention Research Group, Research Centre for Health (ReaCH), Glasgow Caledonian University, Glasgow, UK; National Services Scotland (NSS), UK
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Manoukian S, Stewart S, Graves N, Mason H, Robertson C, Kennedy S, Pan J, Kavanagh K, Haahr L, Adil M, Dancer SJ, Cook B, Reilly J. Bed-days and costs associated with the inpatient burden of healthcare-associated infection in the UK. J Hosp Infect 2021; 114:43-50. [PMID: 34301395 DOI: 10.1016/j.jhin.2020.12.027] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Revised: 12/21/2020] [Accepted: 12/23/2020] [Indexed: 01/28/2023]
Abstract
BACKGROUND Healthcare-associated infection (HAI) is associated with increased morbidity and mortality resulting in excess costs. AIM To investigate the impact of all types of HAI on the inpatient cost of HAI using different approaches. METHODS The incidence, types of HAI, and excess length of stay were estimated using data collected as part of the Evaluation of Cost of Nosocomial Infection (ECONI) study. Scottish NHS reference costs were used to estimate unit costs for bed-days. Variable (cash) costs associated with infection prevention and control (IPC) measures and treatment were calculated for each HAI type and overall. The inpatient cost of HAI is presented in terms of bed-days lost, bed-day costs, and cash costs. FINDINGS In Scotland 58,010 (95% confidence interval: 41,730-74,840) bed-days were estimated to be lost to HAI during 2018/19, costing £46.4 million (19m-129m). The total annual cost in the UK is estimated to be £774 million (328m-2,192m). Bloodstream infection and pneumonia were the most costly HAI types per case. Cash costs are a small proportion of the total cost of HAI, contributing 2.4% of total costs. CONCLUSION Reliable estimates of the cost burden of HAI management are important for assessing the cost-effectiveness of IPC programmes. This unique study presents robust economic data, demonstrating that HAI remains a burden to the UK NHS and bed-days capture the majority of inpatient costs. These findings can be used to inform the economic evaluation and decision analytic modelling of competing IPC programmes at local and national level.
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Affiliation(s)
- S Manoukian
- Yunus Centre for Social Business and Health, Glasgow Caledonian University, Glasgow, UK
| | - S Stewart
- Safeguarding Health through Infection Prevention Research Group, Research Centre for Health (ReaCH), Glasgow Caledonian University, Glasgow, UK.
| | - N Graves
- Duke-NUS Medical School, Singapore
| | - H Mason
- Yunus Centre for Social Business and Health, Glasgow Caledonian University, Glasgow, UK
| | - C Robertson
- Department of Mathematics and Statistics, University of Strathclyde, Glasgow, UK
| | - S Kennedy
- HPS Stats Support, Public Health Scotland, Glasgow, UK
| | - J Pan
- Department of Mathematics and Statistics, University of Strathclyde, Glasgow, UK
| | - K Kavanagh
- Department of Mathematics and Statistics, University of Strathclyde, Glasgow, UK
| | - L Haahr
- Safeguarding Health through Infection Prevention Research Group, Research Centre for Health (ReaCH), Glasgow Caledonian University, Glasgow, UK
| | - M Adil
- Public Health Scotland, Edinburgh, UK
| | - S J Dancer
- Department of Microbiology, Hairmyres Hospital, NHS Lanarkshire, UK; School of Applied Science, Edinburgh Napier University, Edinburgh, UK
| | - B Cook
- Departments of Anaesthesia and Critical Care, Royal Infirmary of Edinburgh, Edinburgh, UK
| | - J Reilly
- Safeguarding Health through Infection Prevention Research Group, Research Centre for Health (ReaCH), Glasgow Caledonian University, Glasgow, UK; National Services Scotland (NSS), UK
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Stewart S, Robertson C, Pan J, Kennedy S, Dancer S, Haahr L, Manoukian S, Mason H, Kavanagh K, Cook B, Reilly J. Epidemiology of healthcare-associated infection reported from a hospital-wide incidence study: considerations for infection prevention and control planning. J Hosp Infect 2021; 114:10-22. [PMID: 34301392 DOI: 10.1016/j.jhin.2021.03.031] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 02/22/2021] [Accepted: 03/04/2021] [Indexed: 01/22/2023]
Abstract
BACKGROUND The measure of disease frequency most widely used to report healthcare-associated infection (HAI) is the point-prevalence survey. Incidence studies are rarely performed due to time and cost constraints; they show which patients are affected by HAI, when and where, and inform planning and design of infection prevention and control (IPC) measures. AIM To determine the epidemiology of HAI within a general and a teaching hospital in Scotland. METHODS A prospective observational incidence study was undertaken for one year from April 2018 using data collected as part of the Evaluation of Cost of Nosocomial Infection (ECONI) study. A novel, robust approach was undertaken, using record linkage to national administrative data to provide full admission and discharge information. Cases were recorded if they met international HAI definitions. FINDINGS Incidence of HAI for the combined hospitals was 250 HAI cases per 100,000 acute occupied bed-days (AOBD). Highest frequency was in urinary tract (51.2 per 100,000 AOBD), bloodstream (44.7), and lower respiratory tract infection (42.2). The most frequently reported organisms were Escherichia coli, Staphylococcus aureus, and norovirus. Incidence of HAI was higher in older people and emergency cases. There was an increase in the rate of HAI in summer months (pneumonia, respiratory, surgical, and gastrointestinal infection) and in winter months norovirus gastrointestinal infection (P < 0.0001). The highest incidence specialties were intensive care, renal medicine, and cardiothoracic surgery. HAI occurred at a median of 9 days (interquartile range: 4-19) after admission. Incidence data were extrapolated to provide an annual national estimate of HAI in NHS Scotland of 7437 (95% confidence interval: 7021-7849) cases. CONCLUSION This study provides a unique overview of incidence of HAI and identifies the burden of HAI at the national level for the first time. Understanding the incidence in different clinical settings, at different times, will allow targeting of IPC measures to those patients who would benefit the most.
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Affiliation(s)
- S Stewart
- Safeguarding Health through Infection Prevention Research Group, Research Centre for Health (ReaCH), Glasgow Caledonian University, Glasgow, UK.
| | - C Robertson
- Department of Mathematics and Statistics, University of Strathclyde, Glasgow, UK
| | - J Pan
- Department of Mathematics and Statistics, University of Strathclyde, Glasgow, UK
| | | | - S Dancer
- Department of Microbiology, Hairmyres Hospital, NHS Lanarkshire, UK; School of Applied Sciences, Edinburgh Napier University, Edinburgh, UK
| | - L Haahr
- Safeguarding Health through Infection Prevention Research Group, Research Centre for Health (ReaCH), Glasgow Caledonian University, Glasgow, UK
| | - S Manoukian
- Yunus Centre for Social Business and Health, Glasgow Caledonian University, Glasgow, UK
| | - H Mason
- Yunus Centre for Social Business and Health, Glasgow Caledonian University, Glasgow, UK
| | - K Kavanagh
- Department of Mathematics and Statistics, University of Strathclyde, Glasgow, UK
| | - B Cook
- Departments of Anaesthesia and Critical Care, Royal Infirmary of Edinburgh, Edinburgh, UK
| | - J Reilly
- Safeguarding Health through Infection Prevention Research Group, Research Centre for Health (ReaCH), Glasgow Caledonian University, Glasgow, UK; National Services Scotland (NSS), UK
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Stewart S, Robertson C, Kennedy S, Kavanagh K, Haahr L, Manoukian S, Mason H, Dancer S, Cook B, Reilly J. Personalized infection prevention and control: identifying patients at risk of healthcare-associated infection. J Hosp Infect 2021; 114:32-42. [PMID: 34301394 DOI: 10.1016/j.jhin.2021.03.032] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 02/22/2021] [Accepted: 03/25/2021] [Indexed: 12/20/2022]
Abstract
BACKGROUND Few healthcare-associated infection (HAI) studies focus on risk of HAI at the point of admission. Understanding this will enable planning and management of care with infection prevention at the heart of the patient journey from the point of admission. AIM To determine intrinsic characteristics of patients at hospital admission and extrinsic events, during the two years preceding admission, that increase risk of developing HAI. METHODS An incidence survey of adults within two hospitals in NHS Scotland was undertaken for one year in 2018/19 as part of the Evaluation of Cost of Nosocomial Infection (ECONI) study. The primary outcome measure was developing any HAI using recognized case definitions. The cohort was derived from routine hospital episode data and linkage to community dispensed prescribing data. FINDINGS The risk factors present on admission observed as being the most significant for the acquisition of HAI were: being treated in a teaching hospital, increasing age, comorbidities of cancer, cardiovascular disease, chronic renal failure and diabetes; and emergency admission. Relative risk of developing HAI increased with intensive care unit, high-dependency unit, and surgical specialties, and surgery <30 days before admission and a total length of stay of >30 days in the two years to admission. CONCLUSION Targeting patients at risk of HAI from the point of admission maximizes the potential for prevention, especially when extrinsic risk factors are known and managed. This study proposes a new approach to infection prevention and control (IPC), identifying those patients at greatest risk of developing a particular type of HAI who might be potential candidates for personalized IPC interventions.
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Affiliation(s)
- S Stewart
- Safeguarding Health through Infection Prevention Research Group, Research Centre for Health (ReaCH), Glasgow Caledonian University, Glasgow, UK.
| | - C Robertson
- Department of Mathematics and Statistics, University of Strathclyde, Glasgow, UK
| | | | - K Kavanagh
- Department of Mathematics and Statistics, University of Strathclyde, Glasgow, UK
| | - L Haahr
- Safeguarding Health through Infection Prevention Research Group, Research Centre for Health (ReaCH), Glasgow Caledonian University, Glasgow, UK
| | - S Manoukian
- Yunus Centre for Social Business and Health, Glasgow Caledonian University, Glasgow, UK
| | - H Mason
- Yunus Centre for Social Business and Health, Glasgow Caledonian University, Glasgow, UK
| | - S Dancer
- Department of Microbiology, Hairmyres Hospital, NHS Lanarkshire, UK; School of Applied Science, Edinburgh Napier University, Edinburgh, UK
| | - B Cook
- Departments of Anaesthesia and Critical Care, Royal Infirmary of Edinburgh, Edinburgh, UK
| | - J Reilly
- Safeguarding Health through Infection Prevention Research Group, Research Centre for Health (ReaCH), Glasgow Caledonian University, Glasgow, UK; National Services Scotland (NSS), UK
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11
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Cuschieri K, Pan J, O Donnell M, Kirkwood K, Kavanagh K, Pollock KG, Bhatia R, Graham SV, Wakeham K. Penile cancer and the HPV attributable fraction in Scotland; A retrospective cohort study. J Clin Virol 2020; 134:104717. [PMID: 33360857 DOI: 10.1016/j.jcv.2020.104717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Revised: 12/07/2020] [Accepted: 12/09/2020] [Indexed: 10/22/2022]
Abstract
BACKGROUND Penile cancer (PeC) is a highly morbid disease which is rising in certain settings including Scotland. A component of PeC is associated with Human Papillomavirus (HPV) although its influence on clinical outcomes is debatable as is whether the fraction attributable to HPV is increasing. METHODS A total of 122 archived tissue samples derived from patients diagnosed with PeC between 2006-2015 were collated and tested for HPV DNA using molecular PCR. HPV positivity was determined for the overall population and by calendar year of diagnosis to determine any temporal trends. The influence of age, deprivation, smoking, tumour stage and tumour grade on likelihood of HPV positivity was determined by logistic regression. In addition, the influence of HPV status and the other clinical and demographics variables on all-cause death and death from PeC was assessed. RESULTS HPV was detected in 43 % (95 % CI: 34-52) of penile cancers and the majority of infections were HPV 16. The HPV component of PeC did not increase over the time period (p for linear trend - 0.226). No demographic or clinical variables were associated with HPV positivity neither was HPV status associated with improved all-cause or cancer-specific survival during the follow up period. CONCLUSION The rise in PeC in Scotland may not be attributable to a rise in HPV-associated cancer; this is consistent with oropharyngeal cancer (OPC) in the UK where there is an increase in both HPV positive and negative cancer. This work calls for a larger multi centre study to enable further detailed investigation into the implications of HPV infection in PeC.
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Affiliation(s)
- K Cuschieri
- Scottish HPV Reference Laboratory, Royal Infirmary of Edinburgh, EH16 4SA, Scotland, United Kingdom; HPV Research Group, Queens Medical Research Institute, University of Edinburgh, EH16 4TJ, Scotland, United Kingdom.
| | - J Pan
- Department of Mathematics and Statistics, Strathclyde University, 26 Richmond Street, Glasgow, G1 1XH, Scotland, United Kingdom
| | - M O Donnell
- Department of Pathology, Western General Hospital, Crewe Road, Edinburgh, EH4 2XU, United Kingdom
| | - K Kirkwood
- Department of Pathology, Western General Hospital, Crewe Road, Edinburgh, EH4 2XU, United Kingdom
| | - K Kavanagh
- Department of Mathematics and Statistics, Strathclyde University, 26 Richmond Street, Glasgow, G1 1XH, Scotland, United Kingdom
| | - K G Pollock
- School of Health and Life Sciences, Glasgow Caledonian University, G4 6OA, Scotland, United Kingdom
| | - R Bhatia
- Scottish HPV Reference Laboratory, Royal Infirmary of Edinburgh, EH16 4SA, Scotland, United Kingdom; HPV Research Group, Queens Medical Research Institute, University of Edinburgh, EH16 4TJ, Scotland, United Kingdom
| | - S V Graham
- MRC-University of Glasgow Centre for Virus Research, Institute of Infection Immunity and Inflammation, University of Glasgow, G61 1QH, Scotland, United Kingdom
| | - K Wakeham
- MRC-University of Glasgow Centre for Virus Research, Institute of Infection Immunity and Inflammation, University of Glasgow, G61 1QH, Scotland, United Kingdom; Sussex Cancer Centre, Brighton and Sussex University Hospital NHS Trust, 2 Bristol Gate, Brighton, BN2 5BD, United Kingdom
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12
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Robertson C, Pan J, Kavanagh K, Ford I, McCowan C, Bennie M, Marwick C, Leanord A. Cost burden of Clostridioides difficile infection to the health service: A retrospective cohort study in Scotland. J Hosp Infect 2020; 106:554-561. [PMID: 32717202 DOI: 10.1016/j.jhin.2020.07.019] [Citation(s) in RCA: 6] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Accepted: 07/15/2020] [Indexed: 12/19/2022]
Abstract
BACKGROUND Clostridioides difficile infection (CDI) is associated with high healthcare demands and related costs. AIM To evaluate the healthcare and economic burden of CDI in hospitalized patients with community- (HOCA-CDI) or hospital-associated CDI (HOHA-CDI) in the National Health Service in Scotland. METHODS A retrospective cohort study was conducted, examining data between August 2010 and July 2013 from four patient-level Scottish datasets, linked to death data. Data examined included prior antimicrobial prescriptions in the community, hospitalizations, length of stay and mortality. Each CDI case was matched to three hospital-based controls on the basis of age, gender, hospital and date of admission. Descriptive economic evaluations were based on bed-day costs for different types of wards. FINDINGS Overall, 3304 CDI cases were included in the study. CDI was associated with additional median lengths of stay of 7.2 days for HOCA-CDI and 12.0 days for HOHA-CDI compared with their respective, matched controls. The 30-day mortality rate was 6.8% for HOCA-CDI and 12.4% for HOHA-CDI. Overall, recurrence within 90 days of the first CDI episode occurred in 373/2740 (13.6%) survivors. The median additional expenditure for each initial CDI case compared with matched controls was £1713. In the 6 months after the index hospitalization, the cost associated with a CDI case was £5126 higher than for controls. CONCLUSION Using routinely collected national data, we demonstrated the substantial burden of CDI on healthcare services, including lengthy hospital stays and readmissions, which increased the costs of managing patients with CDI compared with matched controls.
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Affiliation(s)
- C Robertson
- Department of Mathematics and Statistics, University of Strathclyde, Glasgow, UK; Health Protection Scotland, NHS National Services Scotland, Glasgow, UK
| | - J Pan
- Department of Mathematics and Statistics, University of Strathclyde, Glasgow, UK
| | - K Kavanagh
- Department of Mathematics and Statistics, University of Strathclyde, Glasgow, UK
| | - I Ford
- Robertson Centre for Biostatistics, University of Glasgow, Glasgow, UK
| | - C McCowan
- School of Medicine, University of St Andrews, St Andrews, UK
| | - M Bennie
- Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, Glasgow, UK; Public Health and Intelligence, NHS National Services Scotland, Edinburgh, UK
| | - C Marwick
- Division of Population Health and Genomics, School of Medicine, University of Dundee, Dundee, UK
| | - A Leanord
- Institute of Infection, Immunity and Inflammation, University of Glasgow, Glasgow, UK; NHS Greater Glasgow and Clyde, Glasgow, UK.
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13
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Stevenson A, Wakeham K, Pan J, Kavanagh K, Millan D, Bell S, McLellan D, Graham SV, Cuschieri K. Droplet digital PCR quantification suggests that higher viral load correlates with improved survival in HPV-positive oropharyngeal tumours. J Clin Virol 2020; 129:104505. [PMID: 32604039 DOI: 10.1016/j.jcv.2020.104505] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Revised: 06/03/2020] [Accepted: 06/08/2020] [Indexed: 01/29/2023]
Abstract
BACKGROUND Although HPV-positive oropharyngeal cancer (OPC) patients have improved prognosis compared to HPV negative patients; there remains an HPV-positive group who have poor outcomes. Biomarkers to stratify discrete patient outcomes are thus desirable. Our objective was to analyse viral load (VL) by droplet digital PCR (ddPCR), in HPV-positive patients with OPC on whom clinical outcome data were available. METHODS In a cohort of patients that had previously tested HPV positive via conventional PCR, VL was determined using ddPCR assays for HPV16 L1 and E6 genes. VL was classed as "medium/high" if more than 5.57 copies or 8.68 copies of the HPV 16 L1 or E6 gene were detected respectively. Effect of VL on overall survival and hazard of death & disease progression was performed with adjustments made for sex, age, deprivation, smoking, alcohol consumption and stage. RESULTS L1 VL ranged from 0.0014-304 gene copies per cell with a mean of 30.9; comparatively E6 VL ranged from 0.0012-356 copies per cell with a mean of 37.9. Univariate analysis showed those with a medium/high VL had a lower hazard of death; this was significant for L1 (p = 0.02) but not for E6 (p = 0.67). The ratio of E6 to L1 deviated from n = 1 in most samples but had no influence on clinical outcomes. CONCLUSIONS HPV viral load may be informative for the further stratification of clinical outcomes in HPV positive OPC patients.
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Affiliation(s)
- A Stevenson
- Centre for Virus Research, Institute of Infection Immunity and Inflammation, College of Medical Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | | | - J Pan
- Department of Mathematics and Statistics, University of Strathclyde, Glasgow, UK
| | - K Kavanagh
- Department of Mathematics and Statistics, University of Strathclyde, Glasgow, UK
| | - D Millan
- Department of Pathology, The Queen Elizabeth University Hospital, NHS Greater Glasgow and Clyde, Glasgow, UK
| | - S Bell
- Department of Pathology, The Queen Elizabeth University Hospital, NHS Greater Glasgow and Clyde, Glasgow, UK
| | - D McLellan
- Department of Pathology, The Queen Elizabeth University Hospital, NHS Greater Glasgow and Clyde, Glasgow, UK
| | - S V Graham
- Centre for Virus Research, Institute of Infection Immunity and Inflammation, College of Medical Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - K Cuschieri
- Scottish HPV Reference Laboratory, Royal Infirmary of Edinburgh, 51 Little France Crescent, Edinburgh, UK.
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14
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Pan J, Kavanagh K, Marwick C, Davey P, Wuiff C, Bryson S, Robertson C, Bennie M. Residual effect of community antimicrobial exposure on risk of hospital onset healthcare-associated Clostridioides difficile infection: a case-control study using national linked data. J Hosp Infect 2019; 103:259-267. [PMID: 31173780 DOI: 10.1016/j.jhin.2019.05.016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2019] [Accepted: 05/29/2019] [Indexed: 11/28/2022]
Abstract
BACKGROUND Associations between antimicrobial exposure in the community and community-associated Clostridioides difficile infection (CA-CDI) are well documented but associations with healthcare-associated CDI (HA-CDI) are less clear. This study estimates the association between antimicrobial prescribing in the community and HA-CDI. METHODS A matched case-control study was conducted by linking three national patient level datasets covering CDI cases, community prescriptions and hospitalizations. All validated cases of HA-CDI (August 2010 to July 2013) were extracted and up to three hospital-based controls were matched to each case on the basis of gender, age, hospital and date of admission. Conditional logistic regression was applied to estimate the association between antimicrobial prescribing in the community and HA-CDI. A sensitivity analysis was conducted to consider the impact of unmeasured hospital antimicrobial prescribing. RESULTS Nine-hundred and thirty unique cases of HA-CDI with onset in hospital and no hospital discharge in the 12 weeks prior to index admission were linked with 1810 matched controls. Individuals with prior prescription of any antimicrobial in the community had an odds ratio (OR) = 1.41 (95% confidence interval (CI) 1.13-1.75) for HA-CDI compared with those without. Individuals exposed to high-risk antimicrobials (cephalosporins, clindamycin, co-amoxiclav or fluoroquinolones) had an OR = 1.86 (95% CI: 1.33-2.59). After accounting for the likely impact of unmeasured hospital prescribing, the community exposure, particulary to high-risk antimicrobials, was still associated with elevated HA-CDI risk. CONCLUSIONS Community antimicrobial exposure is an independent risk factor for HA-CDI and should be considered as part of the risk assessment of patients developing diarrhoea in hospital.
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Affiliation(s)
- J Pan
- Department of Mathematics and Statistics, University of Strathclyde, Glasgow, Scotland, UK.
| | - K Kavanagh
- Department of Mathematics and Statistics, University of Strathclyde, Glasgow, Scotland, UK; Information Services Division, NHS National Services Scotland, Edinburgh, Scotland, UK
| | - C Marwick
- Population Health Sciences, School of Medicine, University of Dundee, Dundee, Scotland, UK
| | - P Davey
- Population Health Sciences, School of Medicine, University of Dundee, Dundee, Scotland, UK
| | - C Wuiff
- Health Protection Scotland, NHS National Services Scotland, Glasgow, Scotland, UK
| | - S Bryson
- Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, Glasgow, Scotland, UK
| | - C Robertson
- Department of Mathematics and Statistics, University of Strathclyde, Glasgow, Scotland, UK; Health Protection Scotland, NHS National Services Scotland, Glasgow, Scotland, UK; International Prevention Research Institute, Lyon, France
| | - M Bennie
- Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, Glasgow, Scotland, UK; Information Services Division, NHS National Services Scotland, Edinburgh, Scotland, UK
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Kavanagh K, Hsu F, Davis A, Groban L, Kritchevsky S, Rejeski J, Kim S. BIOMARKERS OF LEAKY GUT ARE RELATED TO INFLAMMATION AND REDUCED PHYSICAL FUNCTION IN UNHEALTHY OLDER ADULTS. Innov Aging 2018. [DOI: 10.1093/geroni/igy023.354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
| | - F Hsu
- Wake Forest School of Medicine
| | - A Davis
- Wake Forest School of Medicine
| | | | | | | | - S Kim
- Wake Forest School of Medicine
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16
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Kennedy CA, Walsh C, Karczmarczyk M, O'Brien S, Akasheh N, Quirke M, Farrell-Ward S, Buckley T, Fogherty U, Kavanagh K, Parker CT, Sweeney T, Fanning S. Multi-drug resistant Escherichia coli in diarrhoeagenic foals: Pulsotyping, phylotyping, serotyping, antibiotic resistance and virulence profiling. Vet Microbiol 2018; 223:144-152. [PMID: 30173740 DOI: 10.1016/j.vetmic.2018.08.009] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2018] [Revised: 08/04/2018] [Accepted: 08/04/2018] [Indexed: 01/20/2023]
Abstract
Extraintestinal pathogenic E. coli (ExPEC) possess the ability to cause extraintestinal infections such as urinary tract infections, neonatal meningitis and sepsis. While information is readily available describing pathogenic E. coli populations in food-producing animals, studies in companion/sports animals such as horses are limited. In addition, many antimicrobial agents used in the treatment of equine infections are also utilised in human medicine, potentially contributing to the spread of antibiotic resistance determinants among pathogenic strains. The aim of this study was to phenotypically and genotypically characterise the multidrug resistance and virulence associated with 83 equine E. coli isolates recovered from foals with diarrhoeal disease. Serotyping was performed by both PCR and sequencing. Antibiotic resistance was assessed by disc diffusion. Phylogenetic groups, virulence genes, antibiotic resistance genes and integrons were determined by PCR. Thirty-nine (46%) of the isolates were classified as ExPEC and hence considered to be potentially pathogenic to humans and animals. Identified serogroups O1, O19a, O40, O101 and O153 are among previously reported human clinical ExPEC isolates. Over a quarter of the E. coli were assigned to pathogenic phylogroups B2 (6%) and D (23%). Class 1 and class 2 integrons were detected in 85% of E. coli, revealing their potential to transfer MDR to other pathogenic and non-pathogenic bacteria. With 65% of potentially pathogenic isolates harbouring one or more TEM, SHV and CTX-M-2 group β-lactamases, in addition to the high levels of resistance to fluoroquinolones observed, our findings signal the need for increased attention to companion/sport animal reservoirs as public health threats.
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Affiliation(s)
- C A Kennedy
- UCD Veterinary Sciences Centre, University College Dublin, Belfield, Dublin 4, Ireland
| | - C Walsh
- School of Food Science and Environmental Health, DIT, Cathal Brugha Street, Dublin, D01 HV58, Ireland; UCD-Center for Food Safety, School of Public Health, Physiotherapy & Sports Science, University College Dublin, Belfield, Dublin D04 N2E5, Ireland
| | - M Karczmarczyk
- UCD-Center for Food Safety, School of Public Health, Physiotherapy & Sports Science, University College Dublin, Belfield, Dublin D04 N2E5, Ireland
| | - S O'Brien
- UCD-Center for Food Safety, School of Public Health, Physiotherapy & Sports Science, University College Dublin, Belfield, Dublin D04 N2E5, Ireland
| | - N Akasheh
- Medical Directorate, St. James's Hospital, Dublin 8, Ireland
| | - M Quirke
- School of Food Science and Environmental Health, DIT, Cathal Brugha Street, Dublin, D01 HV58, Ireland
| | - S Farrell-Ward
- UCD-Center for Food Safety, School of Public Health, Physiotherapy & Sports Science, University College Dublin, Belfield, Dublin D04 N2E5, Ireland
| | - T Buckley
- Irish Equine Centre, Johnstown, Naas, Co. Kildare, W91 RH93, Ireland
| | - U Fogherty
- Irish Equine Centre, Johnstown, Naas, Co. Kildare, W91 RH93, Ireland
| | - K Kavanagh
- Irish Equine Centre, Johnstown, Naas, Co. Kildare, W91 RH93, Ireland
| | - C T Parker
- Produce Safety and Microbiology Research Unit, Agricultural Research Service, U.S. Department of Agriculture, 800 Buchanan Street, Albany, CA, 94710, USA
| | - T Sweeney
- UCD Veterinary Sciences Centre, University College Dublin, Belfield, Dublin 4, Ireland
| | - S Fanning
- UCD-Center for Food Safety, School of Public Health, Physiotherapy & Sports Science, University College Dublin, Belfield, Dublin D04 N2E5, Ireland.
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17
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Lapp L, Young D, Kavanagh K, Bouamrane MM, Schraag S. Using machine learning for predicting severe postoperative complications after cardiac surgery. J Cardiothorac Vasc Anesth 2018. [DOI: 10.1053/j.jvca.2018.08.156] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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18
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Exner D, Kavanagh K, Hruczkowski T, Hersi A, Thibault B, Philippon F, Yee R, Guertin M, Tang A, Huikuri H. CAN AMBULATORY ELECTROCARDIOGRAPHIC (HOLTER) TESTING ACCURATELY DIFFERENTIATE PATIENTS AT HIGHER VERSUS LOWER RISK OF DEATH AFTER MYOCARDIAL INFRACTION? Can J Cardiol 2017. [DOI: 10.1016/j.cjca.2017.07.220] [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] Open
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19
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Fanning KM, Pfisterer B, Davis AT, Presley TD, Williams IM, Wasserman DH, Cline JM, Kavanagh K. Changes in microvascular density differentiate metabolic health outcomes in monkeys with prior radiation exposure and subsequent skeletal muscle ECM remodeling. Am J Physiol Regul Integr Comp Physiol 2017; 313:R290-R297. [PMID: 28701320 DOI: 10.1152/ajpregu.00108.2017] [Citation(s) in RCA: 14] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2017] [Revised: 06/27/2017] [Accepted: 06/27/2017] [Indexed: 01/14/2023]
Abstract
Radiation exposure accelerates the onset of age-related diseases such as diabetes, cardiovascular disease, and neoplasia and, thus, lends insight into in vivo mechanisms common to these disorders. Fibrosis and extracellular matrix (ECM) remodeling, which occur with aging and overnutrition and following irradiation, are risk factors for development of type 2 diabetes mellitus. We previously demonstrated an increased incidence of skeletal muscle insulin resistance and type 2 diabetes mellitus in monkeys that had been exposed to whole body irradiation 5-9 yr prior. We hypothesized that irradiation-induced fibrosis alters muscle architecture, predisposing irradiated animals to insulin resistance and overt diabetes. Rhesus macaques (Macaca mulatta, n = 7-8/group) grouped as nonirradiated age-matched controls (Non-Rad-CTL), irradiated nondiabetic monkeys (Rad-CTL), and irradiated monkeys that subsequently developed diabetes (Rad-DM) were compared. Prior radiation exposure resulted in persistent skeletal muscle ECM changes, including a relative overabundance of collagen IV and a trend toward increased transforming growth factor-β1. Preservation of microvascular markers differentiated the irradiated diabetic and nondiabetic groups. Microvascular density and plasma nitrate and heat shock protein 90 levels were lower in Rad-DM than Rad-CTL. These results are consistent with a protective effect of abundant microvasculature in maintaining glycemic control within radiation-induced fibrotic muscle.
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Affiliation(s)
- K M Fanning
- Department of Pathology, Wake Forest University School of Medicine, Winston-Salem, North Carolina
| | - B Pfisterer
- Department of Pathology, Wake Forest University School of Medicine, Winston-Salem, North Carolina
| | - A T Davis
- Department of Pathology, Wake Forest University School of Medicine, Winston-Salem, North Carolina
| | - T D Presley
- Department of Chemistry, Winston Salem State University, Winston-Salem, North Carolina; and
| | - I M Williams
- Department of Molecular Physiology and Biophysics, Vanderbilt University, Nashville, Tennessee
| | - D H Wasserman
- Department of Molecular Physiology and Biophysics, Vanderbilt University, Nashville, Tennessee
| | - J M Cline
- Department of Pathology, Wake Forest University School of Medicine, Winston-Salem, North Carolina
| | - K Kavanagh
- Department of Pathology, Wake Forest University School of Medicine, Winston-Salem, North Carolina;
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Fanning K, Sherrill C, Davis A, Kavanagh K. HEALTHSPAN MEASURES IN A WESTERN DIET CONDITIONED, IRRADIATED RODENT MODEL OF ACCELERATED AGING. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.4441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- K. Fanning
- Pathology, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - C. Sherrill
- Pathology, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - A. Davis
- Pathology, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - K. Kavanagh
- Pathology, Wake Forest School of Medicine, Winston-Salem, North Carolina
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21
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Munro A, Gillespie C, Cotton S, Busby-Earle C, Kavanagh K, Cuschieri K, Cubie H, Robertson C, Smart L, Pollock K, Moore C, Palmer T, Cruickshank ME. The impact of human papillomavirus type on colposcopy performance in women offered HPV immunisation in a catch-up vaccine programme: a two-centre observational study. BJOG 2017; 124:1394-1401. [PMID: 28102931 DOI: 10.1111/1471-0528.14563] [Citation(s) in RCA: 14] [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] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/31/2016] [Indexed: 12/01/2022]
Abstract
OBJECTIVE To determine whether human papillomavirus (HPV) immunisation has affected the prevalence of HPV genotypes and colposcopic features of cervical intraepithelial neoplasia (CIN) in young women referred for colposcopy. DESIGN A two-centre observational study including vaccinated and unvaccinated women. SETTING Colposcopy clinics serving two health regions in Scotland, UK. POPULATION A total of 361 women aged 20-25 years attending colposcopy following an abnormal cervical cytology result at routine cervical screening. METHODS Cervical samples were obtained from women for HPV DNA genotyping and mRNA E6/E7 expression of HPV 16, 18, 31, 33, and 45. Demographic data, cytology, and histology results and colposcopic features were recorded. Chi-square analysis was conducted to identify associations between vaccine status, HPV genotypes, and colposcopic features. MAIN OUTCOME MEASURES Colposcopic features, HPV genotypes, mRNA expression, and cervical histology. RESULTS The prevalence of HPV 16 was significantly lower in the vaccinated group (8.6%) compared with the unvaccinated group (46.7%) (P = 0.001). The number of cases of CIN2+ was significantly lower in women who had been vaccinated (P = 0.006). The HPV vaccine did not have a statistically significant effect on commonly recognised colposcopic features, but there was a slight reduction in the positive predictive value (PPV) of colposcopy for CIN2+, from 74% (unvaccinated) to 66.7% (vaccinated). CONCLUSIONS In this group of young women with abnormal cytology referred to colposcopy, HPV vaccination via a catch-up programme reduced the prevalence of CIN2+ and HPV 16 infection. The reduced PPV of colposcopy for the detection of CIN2+ in women who have been vaccinated is at the lower acceptable level of the UK national cervical screening programme guidelines. TWEETABLE ABSTRACT Reduction of hrHPV positivity and CIN in immunised women consistent with lower PPV of colposcopy for CIN2+.
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Affiliation(s)
- A Munro
- University of Aberdeen, Aberdeen, UK
| | | | - S Cotton
- University of Aberdeen, Aberdeen, UK
| | | | | | - K Cuschieri
- Scottish Human Papillomavirus Reference Laboratory, Edinburgh, UK
| | - H Cubie
- Scottish Human Papillomavirus Reference Laboratory, Edinburgh, UK
| | | | | | - K Pollock
- Health Protection Scotland, Glasgow, UK
| | - C Moore
- Scottish Human Papillomavirus Reference Laboratory, Edinburgh, UK
| | - T Palmer
- University of Edinburgh, Edinburgh, UK
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22
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Cruickshank ME, Pan J, Cotton SC, Kavanagh K, Robertson C, Cuschieri K, Cubie H, Palmer T, Pollock KG. Reduction in colposcopy workload and associated clinical activity following human papillomavirus (HPV) catch-up vaccination programme in Scotland: an ecological study. BJOG 2017; 124:1386-1393. [DOI: 10.1111/1471-0528.14562] [Citation(s) in RCA: 14] [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] [Accepted: 12/31/2016] [Indexed: 01/08/2023]
Affiliation(s)
- ME Cruickshank
- Department of Obstetrics and Gynaecology; University of Aberdeen; Aberdeen UK
| | - J Pan
- Department of Mathematics and Statistics; University of Strathclyde; Glasgow UK
| | - SC Cotton
- Department of Obstetrics and Gynaecology; University of Aberdeen; Aberdeen UK
| | - K Kavanagh
- Department of Mathematics and Statistics; University of Strathclyde; Glasgow UK
| | - C Robertson
- Department of Mathematics and Statistics; University of Strathclyde; Glasgow UK
- Health Protection Scotland; Glasgow UK
| | - K Cuschieri
- Scottish Human Papillomavirus Reference Laboratory; Edinburgh UK
| | - H Cubie
- Scottish Human Papillomavirus Reference Laboratory; Edinburgh UK
| | - T Palmer
- Department of Pathology; University of Edinburgh; Edinburgh UK
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23
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Mitchell EL, Davis AT, Brass K, Dendinger M, Barner R, Gharaibeh R, Fodor AA, Kavanagh K. Reduced Intestinal Motility, Mucosal Barrier Function, and Inflammation in Aged Monkeys. J Nutr Health Aging 2017; 21:354-361. [PMID: 28346561 PMCID: PMC6057140 DOI: 10.1007/s12603-016-0725-y] [Citation(s) in RCA: 57] [Impact Index Per Article: 8.1] [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: 01/20/2023]
Abstract
OBJECTIVE We aimed to examine the general health and intestinal physiology of young and old non-human primates with comparable life histories and dietary environments. DESIGN Vervet monkeys (Chlorcebus aethiops sabaeus) in stable and comparable social and nutritional environments were selected for evaluation. Health phenotype, circulating cytokines and biomarkers of microbial translocation (MT) were measured (n=26-44). Subsets of monkeys additionally had their intestinal motility, intestinal permeability, and fecal microbiomes characterized. These outcomes document age-related intestinal changes present in the absence of nutritional stressors, which are all known to affect gastrointestinal motility, microbiome, and MT. RESULTS We found that old monkeys have greater systemic inflammation and poor intestinal barrier function as compared to young monkeys. Old monkeys have dramatically reduced intestinal motility, and all changes in motility and MT are present without large differences in fecal microbiomes. CONCLUSION We conclude that deteriorating intestinal function is a feature of normal aging and could represent the source of inflammatory burden yet to be explained by disease or diet in normal aging human primate populations. Intestinal changes were seen independent of dietary influences and aging within a consistent environment appears to avoid major microbiome shifts. Our data suggests interventions to promote intestinal motility and mucosal barrier function have the potential to support better health with aging.
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Affiliation(s)
- E L Mitchell
- Kylie Kavanagh, DVM, MS, MPH, Department of Pathology, Section on Comparative Medicine, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27107, , phone: (336) 713 1745, fax: (336) 716 1515
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Cuschieri K, Kavanagh K, Moore C, Bhatia R, Love J, Pollock KG. Impact of partial bivalent HPV vaccination on vaccine-type infection: a population-based analysis. Br J Cancer 2016; 114:1261-4. [PMID: 27115467 PMCID: PMC4891516 DOI: 10.1038/bjc.2016.97] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2015] [Revised: 03/06/2016] [Accepted: 03/13/2016] [Indexed: 02/01/2023] Open
Abstract
Background: Data on the effectiveness of one dose of HPV vaccine are lacking, particularly in population-based settings. Data from a national HPV immunisation catch-up programme of 14–18-year-old girls were used to assess the effectiveness of<3 doses of the bivalent vaccine on vaccine-type and cross-reactive-type HPV infection. Methods: Cervical samples from women attending for their first cervical smear, which had been genotyped for HPV as part of a longitudinal HPV surveillance programme were linked to immunisation records to establish the number of vaccine doses (0, 1, 2 and 3) administered. Vaccine effectiveness (VE) adjusted for deprivation and age at first dose, was assessed for prevalent HPV 16/18 and HPV 31/33/45 infection. Results: VE for prevalent HPV 16/18 infection associated with 1, 2 and 3 doses was 48.2% (95% CI 16.8, 68.9), 54.8% (95% CI 30.7, 70.8) and 72.8% (95% CI 62.8, 80.3). Equivalent VE for prevalent HPV 31/33/45 infection was −1.62% (95% CI −85.1, 45.3), 48.3% (95% CI 7.6, 71.8) and 55.2% (95% CI 32.6, 70.2). Conclusions: Consistent with recent aggregated trial data, we demonstrate the potential effectiveness of even one dose of HPV vaccine on vaccine-type infection. Given that these women were immunised as part of a catch-up campaign, the VE observed in this study is likely to be an underestimate of what will occur in girls vaccinated at younger ages. Further population-based studies which look at the clinical efficacy of one-dose schedules are warranted.
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Affiliation(s)
- K Cuschieri
- Scottish HPV Reference Laboratory, Division of Laboratory Medicine, Royal Infirmary of Edinburgh, Edinburgh EH16 4SA, Scotland.,HPV Research Group, Queens Medical Research Institute, University of Edinburgh, Edinburgh EH16 4TJ, Scotland
| | - K Kavanagh
- Department of Mathematics and Statistics, University of Strathclyde, 26 Richmond Street, Glasgow G1 1XH, Scotland
| | - C Moore
- Scottish HPV Reference Laboratory, Division of Laboratory Medicine, Royal Infirmary of Edinburgh, Edinburgh EH16 4SA, Scotland
| | - R Bhatia
- HPV Research Group, Queens Medical Research Institute, University of Edinburgh, Edinburgh EH16 4TJ, Scotland
| | - J Love
- Health Protection Scotland, Meridian Court, Glasgow G2 6QE, Scotland
| | - K G Pollock
- Health Protection Scotland, Meridian Court, Glasgow G2 6QE, Scotland
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Reyes L, Exner D, Kavanagh K, Hillier K, Yuen B, Cardiac Device Clinic Staff. IMPACT OF CENTRALIZED REMOTE MONITORING ON THE EFFICIENCY OF CARDIAC DEVICE PATIENT CARE. Can J Cardiol 2015. [DOI: 10.1016/j.cjca.2015.07.711] [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] Open
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Higgins K, Hooper S, Spence M, Kavanagh K, Hansen-Petrik M. Maternal Interactions with Young Children and Perceptions of Play with Toy Foods May Vary by Maternal Feeding Style. J Acad Nutr Diet 2015. [DOI: 10.1016/j.jand.2015.06.292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Bower K, Burnette T, Lewis D, Wright C, Kavanagh K. Mothers' Experiences Expressing Breastmilk for VLBW Infants: A Phenomenological Case Study. FASEB J 2015. [DOI: 10.1096/fasebj.29.1_supplement.581.6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- K Bower
- Nutrition Dept.Univ. of TNUnited States
| | - T Burnette
- Dept. of Obstetrics and Gynecology Univ. of TN Medical CenterUnited States
| | - D Lewis
- Nutrition Dept.Univ. of TNUnited States
| | - C Wright
- Nutrition Dept.Univ. of TNUnited States
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Simpson CR, Lone NI, Kavanagh K, Ritchie LD, Robertson C, Sheikh A, McMenamin J. Trivalent inactivated seasonal influenza vaccine effectiveness for the prevention of laboratory-confirmed influenza in a Scottish population 2000 to 2009. Euro Surveill 2015; 20. [DOI: 10.2807/1560-7917.es2015.20.8.21043] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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McMahon FW, Gallagher C, O'Reilly N, Clynes M, O'Sullivan F, Kavanagh K. Exposure of a Corneal Epithelial Cell Line (hTCEpi) to Demodex-Associated Bacillus Proteins Results in an Inflammatory Response. Invest Ophthalmol Vis Sci 2014; 55:7019-28. [DOI: 10.1167/iovs.14-15018] [Citation(s) in RCA: 14] [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: 11/24/2022] Open
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Kavanagh K, Pollock KGJ, Potts A, Love J, Cuschieri K, Cubie H, Robertson C, Donaghy M. Introduction and sustained high coverage of the HPV bivalent vaccine leads to a reduction in prevalence of HPV 16/18 and closely related HPV types. Br J Cancer 2014; 110:2804-11. [PMID: 24736582 PMCID: PMC4037824 DOI: 10.1038/bjc.2014.198] [Citation(s) in RCA: 136] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2013] [Revised: 03/10/2014] [Accepted: 03/16/2014] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND In 2008, a national human papillomavirus (HPV) immunisation programme began in Scotland for 12-13 year old females with a three-year catch-up campaign for those under the age of 18. Since 2008, three-dose uptake of bivalent vaccine in the routine cohort aged 12-13 has exceeded 90% annually, while in the catch-up cohort overall uptake is 66%. METHODS To monitor the impact of HPV immunisation, a programme of national surveillance was established (pre and post introduction) which included yearly sampling and HPV genotyping of women attending for cervical screening at age 20. By linking individual vaccination, screening and HPV testing records, we aim to determine the impact of the immunisation programme on circulating type-specific HPV infection particularly for four outcomes: (i) the vaccine types HPV 16 or 18 (ii) types considered to be associated with cross-protection: HPV 31, 33 or 45; (iii) all other high-risk types and (iv) any HPV. RESULTS From a total of 4679 samples tested, we demonstrate that three doses (n=1100) of bivalent vaccine are associated with a significant reduction in prevalence of HPV 16 and 18 from 29.8% (95% confidence interval 28.3, 31.3%) to 13.6% (95% confidence interval 11.7, 15.8%). The data also suggest cross-protection against HPV 31, 33 and 45. HPV 51 and 56 emerged as the most prevalent (10.5% and 9.6%, respectively) non-vaccine high-risk types in those vaccinated, but at lower rates than HPV 16 (25.9%) in those unvaccinated. CONCLUSIONS This data demonstrate the positive impact of bivalent vaccination on the prevalence of HPV 16, 18, 31, 33 and 45 in the target population and is encouraging for countries which have achieved high-vaccine uptake.
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Affiliation(s)
- K Kavanagh
- Department of Mathematics and Statistics, University of Strathclyde, Glasgow, Scotland
| | | | - A Potts
- Health Protection Scotland, Glasgow, Scotland
| | - J Love
- Health Protection Scotland, Glasgow, Scotland
| | - K Cuschieri
- Scottish Human Papillomavirus Reference Laboratory, Edinburgh, Scotland
| | - H Cubie
- Scottish Human Papillomavirus Reference Laboratory, Edinburgh, Scotland
| | - C Robertson
- Department of Mathematics and Statistics, University of Strathclyde, Glasgow, Scotland
- Health Protection Scotland, Glasgow, Scotland
- International Prevention Research Institute, Lyon, France
| | - M Donaghy
- Health Protection Scotland, Glasgow, Scotland
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Simpson CR, Lone N, Kavanagh K, Ritchie LD, Robertson C, Sheikh A, McMenamin J. Seasonal Influenza Vaccine Effectiveness (SIVE): an observational retrospective cohort study – exploitation of a unique community-based national-linked database to determine the effectiveness of the seasonal trivalent influenza vaccine. Health Services and Delivery Research 2013. [DOI: 10.3310/hsdr01100] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BackgroundGlobally, seasonal influenza is responsible for an estimated 3 to 5 million cases of severe illness and 250,000 to 500,000 deaths per year. It is uncertain to what extent national vaccination programmes can prevent this morbidity and mortality.ObjectiveTo determine the effectiveness of the seasonal trivalent inactivated influenza vaccine.DesignWe undertook a retrospective observational cohort study. A propensity score model was constructed and adjusted odds ratios (ORs) were calculated to assess differences in vaccine uptake according to a number of patient characteristics. Adjusted illness and mortality hazard ratios (HRs) were estimated from a Cox proportional hazards model adjusted for sex, age, socioeconomic status, smoking status, urban/rural location, clinical at-risk groups (i.e. patients with chronic respiratory, heart, kidney, liver or neurological disease, immunosuppression and diabetes), Charlson comorbidity index, previous pneumococcal and influenza vaccination, and number of previous primary care consultations, prescribed drugs and hospital admissions. We also included nursing home residence and social care support. Vaccine effectiveness (VE) was expressed as a percentage, and represents a reduction in risk provided by the vaccine for a given outcome (e.g. laboratory-confirmed influenza). This was calculated as 1 − HR, where HR is that of the measured clinical outcome in vaccinated compared with unvaccinated individuals. For estimates of VE derived from linked virological swab data, we carried out a nested case–control study design.SettingA national linkage of patient-level primary care, hospital, death certification and virological swab-linked data across nine influenza seasons (2000–9).ParticipantsA nationally representative sample of the Scottish population during 1,767,919 person-seasons of observation. Cases of influenza were confirmed using reverse transcription-polymerase chain reaction (RT-PCR) in a subset of the population (n = 3323).InterventionsTrivalent inactivated seasonal influenza vaccination (n = 274,071).Main outcome measuresVE, pooled across seasons and adjusting for confounders, was estimated by determining laboratory-confirmed influenza, influenza-related morbidity and mortality including primary care influenza-like illnesses, hospitalisation and death from influenza and pneumonia.ResultsMost vaccines (93.6%;n = 256,474 vaccines) were administered to at-risk patients targeted for vaccination, with a 69.3% uptake among those aged ≥ 65 years (178,754 vaccinations during 258,100 person-seasons). For at-risk patients aged < 65 years there was a 26.2% uptake (77,264 vaccinations during 295,116 person-seasons). VE in preventing RT-PCR laboratory-confirmed influenza was 57.1% [95% confidence interval (CI) 31.3% to 73.3%]. VE was 18.8% (95% CI –103.7% to 67.6%) in patients aged ≥ 65 years and 59.6% (95% CI 21.9% to 79.1%) in those aged < 65 years at risk of serious complications from influenza. In the matched analysis (156,096 person-seasons), adjusted VE for reducing primary care consultations for influenza-like illnesses was 16.3% (95% CI 5.7% to 26.0%). VE in reducing hospitalisations was 19.3% for influenza and pneumonia (95% CI 8.3% to 29.1%) and 26.7% for pneumonia and chronic obstructive pulmonary disease (95% CI 19.8% to 32.9%). VE in reducing death due to influenza and pneumonia was 37.9% (95% CI 29.5% to 45.4%).ConclusionsFew countries' health systems allow for the integrated and accessible data recording that made this study possible and made it feasible to collate centrally almost all hospitalisations and deaths attributed to influenza, thereby allowing completeness of reporting. Using these data, we found most influenza vaccines were administered to those at risk of serious complications from influenza. In a nationally representative cohort we found that the vaccine was associated with a significant decrease in the risk of RT-PCR-confirmed influenza (the decrease was substantial particularly for at-risk patients aged < 65 years) and complications arising from influenza (where more modest decreases were found). Although the modest size of our cohort made it possible to collate centrally almost all cases of influenza-related disease, analysis of subgroups (in particular older age groups) or by individual season resulted in poorer precision and wide CIs. Any future work should therefore aim to address this issue by ensuring adequate power to test VE in these subgroups of patients, while minimising the effect of bias, such as health-seeking behaviour.FundingThe National Institute for Health Research Health Services and Delivery Research programme.
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Affiliation(s)
- CR Simpson
- Allergy and Respiratory Research Group, Centre for Population Health Sciences, University of Edinburgh, Edinburgh, UK
| | - N Lone
- Allergy and Respiratory Research Group, Centre for Population Health Sciences, University of Edinburgh, Edinburgh, UK
| | - K Kavanagh
- Department of Mathematics and Statistics, University of Strathclyde, Glasgow, UK
| | - LD Ritchie
- Centre of Academic Primary Care, University of Aberdeen, Aberdeen, UK
| | - C Robertson
- Department of Mathematics and Statistics, University of Strathclyde, Glasgow, UK
- Health Protection Scotland, Glasgow, UK
- International Prevention Research Institute, Lyon, France
| | - A Sheikh
- Allergy and Respiratory Research Group, Centre for Population Health Sciences, University of Edinburgh, Edinburgh, UK
- School of Public Health and Primary Care (CAPHRI), University of Maastricht, Maastricht, the Netherlands
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Kavanagh K, Flynn DM, Jenkins KA, Wilson MD, Chilton FH. Stearidonic and γ-linolenic acids in echium oil improves glucose disposal in insulin resistant monkeys. Prostaglandins Leukot Essent Fatty Acids 2013; 89:39-45. [PMID: 23664597 PMCID: PMC4086843 DOI: 10.1016/j.plefa.2013.04.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2012] [Revised: 03/14/2013] [Accepted: 04/08/2013] [Indexed: 12/27/2022]
Abstract
Echium oil (EO) contains stearidonic acid (18:4), a n-3 polyunsaturated fatty acids (PUFAs), and gamma-linolenic acids (18:3), a n-6 PUFA that can be converted to long chain (LC)-PUFAs. We aimed to compare a safflower oil (SO)-enriched diet to EO- and fish oil (FO)-enriched diets on circulating and tissue PUFAs levels and glycemic, inflammatory, and cardiovascular health biomarkers in insulin resistant African green monkeys. In a Latin-square cross-over study, eight monkeys consumed matched diets for 6 weeks with 3-week washout periods. Monkeys consuming FO had significantly higher levels of n-3 LC-PUFAs and EO supplementation resulted in higher levels of circulating n-3 LC-PUFAs and a significant increase in dihomo-gamma linolenic acid (DGLA) in red blood cells and muscle. Glucose disposal was improved after EO consumption. These data suggest that PUFAs in EO supplementation have the capacity to alter circulating, RBC and muscle LC-PUFA levels and improve glucose tolerance in insulin-resistant monkeys.
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Affiliation(s)
- K Kavanagh
- Wake Forest School of Medicine, Department of Pathology, Winston-Salem, NC 27127, USA.
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O’Reilly N, Menezes N, Kavanagh K. Positive correlation between serum immunoreactivity toDemodex-associatedBacillusproteins and erythematotelangiectatic rosacea. Br J Dermatol 2012; 167:1032-6. [DOI: 10.1111/j.1365-2133.2012.11114.x] [Citation(s) in RCA: 60] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
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Coughlan C, Chotirmall S, Renwick J, Hassan T, Low T, Bergsson G, Bennett K, Eshwika A, Dunne K, Greene C, Gunaratnam C, Kavanagh K, Logan P, Murphy P, Reeves E, McElvaney N. WS17.7 Itraconazole up-regulates the vitamin D receptor and reduces T-helper 2 responses in individuals with cystic fibrosis colonized with Aspergillus fumigatus. J Cyst Fibros 2012. [DOI: 10.1016/s1569-1993(12)60125-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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McCann M, Kellett A, Kavanagh K, Devereux M, L.S. Santos A. Deciphering the Antimicrobial Activity of Phenanthroline Chelators. Curr Med Chem 2012; 19:2703-14. [DOI: 10.2174/092986712800609733] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2011] [Revised: 10/15/2011] [Accepted: 10/17/2011] [Indexed: 11/22/2022]
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Shoval O, Sheftel H, Shinar G, Hart Y, Ramote O, Mayo A, Dekel E, Kavanagh K, Alon U. Evolutionary Trade-Offs, Pareto Optimality, and the Geometry of Phenotype Space. Science 2012; 336:1157-60. [DOI: 10.1126/science.1217405] [Citation(s) in RCA: 417] [Impact Index Per Article: 34.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
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van Velzen EVH, Reilly JS, Kavanagh K, Leanord A, Edwards GFS, Girvan EK, Gould IM, Mackenzie FM, Masterton R. A retrospective cohort study into acquisition of MRSA and associated risk factors after implementation of universal screening in Scottish hospitals. Infect Control Hosp Epidemiol 2012; 32:889-96. [PMID: 21828969 DOI: 10.1086/661280] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
OBJECTIVE To estimate the proportion of patients who acquire methicillin-resistant Staphylococcus aureus (MRSA) while in hospital and to identify risk factors associated with acquisition of MRSA. DESIGN Retrospective cohort study. PATIENTS Adult patients discharged from 36 general specialty wards of 2 Scottish hospitals that had implemented universal screening for MRSA on admission. METHODS Patients were screened for MRSA on discharge from hospital by using multisite body swabs that were tested by culture. Discharge screening results were linked to admission screening results. Genotyping was undertaken to identify newly acquired MRSA in MRSA-positive patients on admission. RESULTS Of the 5,155 patients screened for MRSA on discharge, 2.9% (95% confidence interval [CI], 2.43-3.34) were found to be positive. In the subcohort screened on both admission and discharge (n = 2,724), 1.3% of all patients acquired MRSA while in hospital (incidence rate, 2.1/1,000 hospital bed-days in this cohort [95% CI, 1.5-2.9]), while 1.3% remained MRSA positive throughout hospital stay. Three risk factors for acquisition of MRSA were identified: age above 64 years, self-reported renal failure, and self-reported presence of open wounds. On a population level, the prevalence of MRSA colonization did not differ between admission and discharge. CONCLUSIONS Cross-transmission of MRSA takes place in Scottish hospitals that have implemented universal screening for MRSA. This study reinforces the importance of infection prevention and control measures to prevent MRSA cross-transmission in hospitals; universal screening for MRSA on admission will in itself not be sufficient to reduce the number of MRSA colonizations and subsequent MRSA infections.
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Adamson WE, McGregor EC, Kavanagh K, McMenamin J, McDonagh S, Molyneaux PJ, Templeton KE, Carman WF. Population exposure to a novel influenza A virus over three waves of infection. J Clin Virol 2011; 52:300-3. [PMID: 21924675 DOI: 10.1016/j.jcv.2011.08.019] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2011] [Revised: 08/19/2011] [Accepted: 08/20/2011] [Indexed: 11/17/2022]
Abstract
BACKGROUND The influenza A(H1N1)2009 virus has been spreading throughout the world since April 2009. Since then, several studies have been undertaken to measure the frequency of antibodies that react against the virus. Microneutralisation assays have regularly been used for these analyses, and titres of ≥40 have conventionally been taken to represent significant levels of antibodies (this significance is derived from it being four times the minimum level of antibodies that the assay can detect rather an established correlate of protection). However a microneutralisation titre that correlates with protection against influenza A(H1N1)2009 has not been established. OBJECTIVES Analysing influenza A(H1N1)2009 antibody seroprevalence in Scotland at multiple timepoints, and in different age groups and geographical locations, and comprehensively describing the spread of the virus in Scotland (taken alongside previously published data). This study presents for the first time the effects of a novel influenza virus on a naïve population that has been followed from the initial outbreak to a time when the majority of the population have reactive antibodies. STUDY DESIGN A microneutralisation titre ≥10 represents the minimum level of antibodies detectable by the assay. Blood samples (taken in April 2009 and April 2010 in Edinburgh (n=400 each year), and in February 2011 in Aberdeen, Edinburgh, Glasgow, and Inverness (n=1600)) were tested for the presence of influenza A(H1N1)2009 antibodies at this titre. This represents an effective indicator of the proportion of a population who have been exposed to the virus. RESULTS Following the 2010/2011 influenza season, there is evidence of exposure to influenza A(H1N1)2009 in approximately four fifths of the Scottish population. CONCLUSIONS This study provides impetus to the call for further research in establishing robust correlates of susceptibility to influenza infection and the development of clinical illness, provides useful information for future outbreaks, and is relevant to public health policy in planning for future influenza seasons.
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Affiliation(s)
- W E Adamson
- West of Scotland Specialist Virology Centre, Glasgow G12 0YN, Scotland, UK.
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Adamson WE, McGregor EC, Kavanagh K, McMenamin J, McDonagh S, Molyneaux PJ, Templeton KE, Carman WF. Influenza A(H1N1)2009 antibody seroprevalence in Scotland following the 2010/11 influenza season. Euro Surveill 2011; 16:19871. [PMID: 21616049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023] Open
Abstract
Following the 2010/11 influenza season, we determined the age- and location-specific seroprevalence of antibodies against the influenza A(H1N1)2009 virus in Scotland. Samples were analysed by microneutralisation assay. Age/seropositivity profiles varied significantly between cities. The increases in seroprevalence relative to the previous influenza season (2009/10) were similar across age groups and geographic locations. However, the increased seropositivity in older adults appeared to be driven by exposure to vaccination, indicating significantly lower levels of infection than in younger age groups.
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Affiliation(s)
- W E Adamson
- West of Scotland Specialist Virology Centre, Glasgow, Scotland.
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Adamson WE, McGregor EC, Kavanagh K, McMenamin J, McDonagh S, Molyneaux PJ, Templeton KE, Carman WF. Influenza A(H1N1)2009 antibody seroprevalence in Scotland following the 2010/11 influenza season. Euro Surveill 2011. [DOI: 10.2807/ese.16.20.19871-en] [Citation(s) in RCA: 4] [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: 11/20/2022] Open
Abstract
Following the 2010/11 influenza season, we determined the age- and location-specific seroprevalence of antibodies against the influenza A(H1N1)2009 virus in Scotland. Samples were analysed by microneutralisation assay. Age/seropositivity profiles varied significantly between cities. The increases in seroprevalence relative to the previous influenza season (2009/10) were similar across age groups and geographic locations. However, the increased seropositivity in older adults appeared to be driven by exposure to vaccination, indicating significantly lower levels of infection than in younger age groups.
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Affiliation(s)
- W E Adamson
- West of Scotland Specialist Virology Centre, Glasgow, Scotland
| | - E C McGregor
- West of Scotland Specialist Virology Centre, Glasgow, Scotland
| | - K Kavanagh
- University of Strathclyde, Glasgow, Scotland
| | - J McMenamin
- Health Protection Scotland, Glasgow, Scotland
| | - S McDonagh
- Microbiology Department, Raigmore Hospital, Inverness, Scotland
| | - P J Molyneaux
- Department of Medical Microbiology, Aberdeen Royal Infirmary, Aberdeen, Scotland
| | - K E Templeton
- Edinburgh Specialist Virology Centre, Edinburgh, Scotland
| | - W F Carman
- West of Scotland Specialist Virology Centre, Glasgow, Scotland
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Fisher JF, Kavanagh K, Sobel JD, Kauffman CA, Newman CA. Candida Urinary Tract Infection: Pathogenesis. Clin Infect Dis 2011; 52 Suppl 6:S437-51. [DOI: 10.1093/cid/cir110] [Citation(s) in RCA: 97] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
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Kavanagh K. Tuesdays with Morrie. West J Med 2011. [DOI: 10.1136/bmj.d1267] [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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Mckityrick J, Hoghooghi B, Dubbelday W, Kavanagh K, Kinsman K, Shea L, Sluzky E. Particle Size Effects in YAG:CR Phosphors. ACTA ACUST UNITED AC 2011. [DOI: 10.1557/proc-348-519] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
ABSTRACTChromium doped yttrium aluminum garnet (Y3Al5O12:Cr or YAG:Cr) phosphors were synthesized by hydrolysis of aqueous nitrate solutions. The resulting as-synthesized powder was amorphous and crystallized into the YAG structure at ~1000°C. The light output as a function of annealing temperature was found to increase with increasing temperature. Particle size, adsorbed surface species or residual impurities, lattice stability and chromium site occupation were investigated as possible explanations. It was found that there was a small decrease in lattice parameter upon annealing, the particle size increased roughly five times, and residual or adsorbed surface species were present for the low temperature annealed powders. There was no evidence that kinetic barriers to diffusion of Cr ions into the luminescent sites occurred.
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Abstract
BACKGROUND Causes of infant death remain unknown in significant proportions of human and non-human primate pregnancies. METHODS A closed breeding colony with high rates of infant mortality had pregnancies assessed (n=153) by fetal measurements and maternal characteristics. Infant outcome was classified as neonatal death (stillborn or died <48 hours from birth), postnatal death (died 2-30 days) or surviving (alive after 30 days). RESULTS Fetal size did not predict outcome. Poor maternal glycemic control and low social ranking increased odds for adverse outcome (OR=3.72, P=0.01 and 2.27, P=0.04, respectively). Male sex was over-represented in stillbirths (P=0.04), and many were macrosomic, but size did not associate with maternal glycemic control measured as glycated hemoglobin A1c. Postnatally dead infants were smaller (P<0.01), which associated with behavioral factors and glycemic control. CONCLUSIONS Fetal growth estimates predicted gestational age but not fetal outcome. Maternal social status and metabolic health, particularly glycemic control, increased risks of adverse pregnancy outcome.
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Affiliation(s)
- K Kavanagh
- Pathology, Wake Forest University School of Medicine, Medical Center Blvd., Winston-Salem, NC, USA.
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46
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Elliot AJ, Singh N, Loveridge P, Harcourt S, Smith S, Pnaiser R, Kavanagh K, Robertson C, Ramsay CN, McMenamin J, Kibble A, Murray V, Ibbotson S, Catchpole M, McCloskey B, Smith GE. Syndromic surveillance to assess the potential public health impact of the Icelandic volcanic ash plume across the United Kingdom, April 2010. Euro Surveill 2010; 15:19583. [PMID: 20546694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023] Open
Abstract
The Health Protection Agency and Health Protection Scotland used existing syndromic surveillance systems to monitor community health in the UK following the volcanic eruption in Iceland in April 2010.
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Affiliation(s)
- A J Elliot
- Real-time Syndromic Surveillance Team, Health Protection Agency, Birmingham, United Kingdom.
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47
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Elliot AJ, Singh N, Loveridge P, Harcourt S, Smith S, Pnaiser R, Kavanagh K, Robertson C, Ramsay CN, McMenamin J, Kibble A, Murray V, Ibbotson S, Catchpole M, McCloskey B, Smith GE. Syndromic surveillance to assess the potential public health impact of the Icelandic volcanic ash plume across the United Kingdom, April 2010. Euro Surveill 2010. [DOI: 10.2807/ese.15.23.19583-en] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Binary file ES_Abstracts_Final_ECDC.txt matches
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Affiliation(s)
- A J Elliot
- Real-time Syndromic Surveillance Team, Health Protection Agency, Birmingham, United Kingdom
| | - N Singh
- Real-time Syndromic Surveillance Team, Health Protection Agency, Birmingham, United Kingdom
| | - P Loveridge
- Real-time Syndromic Surveillance Team, Health Protection Agency, Birmingham, United Kingdom
| | - S Harcourt
- Real-time Syndromic Surveillance Team, Health Protection Agency, Birmingham, United Kingdom
| | - S Smith
- Real-time Syndromic Surveillance Team, Health Protection Agency, Birmingham, United Kingdom
| | - R Pnaiser
- Royal College of General Practitioners Research and Surveillance Centre, Birmingham, United Kingdom
- Real-time Syndromic Surveillance Team, Health Protection Agency, Birmingham, United Kingdom
| | - K Kavanagh
- Department of Mathematics and Statistics, University of Strathclyde, Glasgow, United Kingdom
- Health Protection Scotland, Glasgow, United Kingdom
| | - C Robertson
- Department of Mathematics and Statistics, University of Strathclyde, Glasgow, United Kingdom
- Health Protection Scotland, Glasgow, United Kingdom
| | - C N Ramsay
- Health Protection Scotland, Glasgow, United Kingdom
| | - J McMenamin
- Health Protection Scotland, Glasgow, United Kingdom
| | - A Kibble
- Centre for Radiation, Chemicals and Environmental Hazards, Health Protection Agency, Birmingham, United Kingdom
| | - V Murray
- Centre for Radiation, Chemicals and Environmental Hazards, Health Protection Agency, London, United Kingdom
| | - S Ibbotson
- Real-time Syndromic Surveillance Team, Health Protection Agency, Birmingham, United Kingdom
| | - M Catchpole
- Centre for Infections, Health Protection Agency, London, United Kingdom
| | - B McCloskey
- London Regional Director’s Office, Health Protection Agency, London, United Kingdom
| | - G E Smith
- Real-time Syndromic Surveillance Team, Health Protection Agency, Birmingham, United Kingdom
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48
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Cann JA, Kavanagh K, Jorgensen MJ, Mohanan S, Howard TD, Gray SB, Hawkins GA, Fairbanks LA, Wagner JD. Clinicopathologic characterization of naturally occurring diabetes mellitus in vervet monkeys. Vet Pathol 2010; 47:713-8. [PMID: 20460450 DOI: 10.1177/0300985810370011] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Diabetes mellitus (DM) is a group of chronic metabolic diseases characterized by persistent fasting hyperglycemia, and it can be of either polygenic or monogenic origin. Animal models have played an important role in elucidating the pathophysiology of the polygenic Type 1 and type 2 DM forms; however, useful animal models of the monogenic forms do not exist. The authors describe 4 cases of naturally occurring DM in vervet monkeys (Chlorocebus aethiops sabaeus), 1 of which has clinicopathologic findings consistent with type 2 DM, including persistent hyperglycemia, hypertriglyceridemia, islet amyloidosis, and reduced islet insulin immunostaining. In contrast, the 3 remaining animals have clinicopathologic similarities to a monogenic form of the disease, including a lack of islet amyloidosis and hypertriglyceridemia, as well as normal islet insulin immunostaining. In addition, pedigree analysis conducted on one of these animals is consistent with either an autosomal dominant or mitochondrial inheritance pattern, which supports a monogenic form of DM. The authors thus hypothesize that a naturally occurring monogenic form of diabetes may occur in vervet monkeys, making them a potential animal model for future studies.
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Affiliation(s)
- J A Cann
- Department of Pathology, Section on Comparative Medicine, Winston-Salem, NC 27157, USA.
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49
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Saisho Y, Butler AE, Manesso E, Galasso R, Zhang L, Gurlo T, Toffolo GM, Cobelli C, Kavanagh K, Wagner JD, Butler PC. Relationship between fractional pancreatic beta cell area and fasting plasma glucose concentration in monkeys. Diabetologia 2010; 53:111-4. [PMID: 19847395 PMCID: PMC2789926 DOI: 10.1007/s00125-009-1552-z] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2009] [Accepted: 08/27/2009] [Indexed: 12/17/2022]
Abstract
AIMS/HYPOTHESIS We sought to establish the relationship between fasting plasma glucose concentrations and pancreatic fractional beta cell area in adult cynomolgus monkeys (Macaca fascicularis). METHODS Fasting plasma glucose and pancreatic fractional beta cell area were measured in 18 control and 17 streptozotocin-treated adult primates (17.0 +/- 1.2 vs 15.4 +/- 1.2 years old). RESULTS Fasting plasma glucose was increased (12.0 +/- 2.0 vs 3.4 +/- 0.1 mmol/l, p < 0.01) and fractional beta cell area was decreased (0.62 +/- 0.13% vs 2.49 +/- 0.35%, p < 0.01) in streptozotocin-treated monkeys. The relationship between fasting plasma glucose and pancreatic fractional beta cell area was described by a wide range of beta cell areas in controls. In streptozotocin-treated monkeys there was an inflection of fasting blood glucose at approximately 50% of the mean beta cell area in controls with a steep increase in blood glucose for each further decrement in beta cell area. CONCLUSIONS/INTERPRETATION In adult non-human primates a decrement in fractional beta cell area of approximately 50% or more leads to loss of glycaemic control.
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Affiliation(s)
- Y. Saisho
- Larry Hillblom Islet Research Center, UCLA David Geffen School of Medicine, 900 Weyburn Place #A, Los Angeles, CA 90024-2852 USA
| | - A. E. Butler
- Larry Hillblom Islet Research Center, UCLA David Geffen School of Medicine, 900 Weyburn Place #A, Los Angeles, CA 90024-2852 USA
| | - E. Manesso
- Larry Hillblom Islet Research Center, UCLA David Geffen School of Medicine, 900 Weyburn Place #A, Los Angeles, CA 90024-2852 USA
- Department of Information Engineering, University of Padova, Padua, Italy
| | - R. Galasso
- Larry Hillblom Islet Research Center, UCLA David Geffen School of Medicine, 900 Weyburn Place #A, Los Angeles, CA 90024-2852 USA
| | - L. Zhang
- Department of Pathology, Wake Forest University School of Medicine, Winston-Salem, NC USA
| | - T. Gurlo
- Larry Hillblom Islet Research Center, UCLA David Geffen School of Medicine, 900 Weyburn Place #A, Los Angeles, CA 90024-2852 USA
| | - G. M. Toffolo
- Department of Information Engineering, University of Padova, Padua, Italy
| | - C. Cobelli
- Department of Information Engineering, University of Padova, Padua, Italy
| | - K. Kavanagh
- Department of Pathology, Wake Forest University School of Medicine, Winston-Salem, NC USA
| | - J. D. Wagner
- Department of Pathology, Wake Forest University School of Medicine, Winston-Salem, NC USA
| | - P. C. Butler
- Larry Hillblom Islet Research Center, UCLA David Geffen School of Medicine, 900 Weyburn Place #A, Los Angeles, CA 90024-2852 USA
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50
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Kavanagh K, Zhang L, Wagner JD. Tissue-specific regulation and expression of heat shock proteins in type 2 diabetic monkeys. Cell Stress Chaperones 2009; 14:291-9. [PMID: 18843550 PMCID: PMC2728265 DOI: 10.1007/s12192-008-0084-7] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2008] [Revised: 09/18/2008] [Accepted: 09/22/2008] [Indexed: 10/21/2022] Open
Abstract
The chaperone protein heat shock protein (HSP) 70 has been shown to protect against obesity-associated insulin resistance. Induction of HSPs is thus considered an exciting therapeutic strategy for diabetes (DM). The aims of this study were to (1) determine HSP levels in plasma, hepatic, and pancreatic tissues of type 2 DM primates and (2) assess the relationship between chaperone proteins of the HSP family and cellular protection. We collected plasma from 24 type 2 DM and 25 normoglycemic control (CTL) cynomolgus macaques. A subset of DM monkeys had liver and pancreas samples available which were compared to a second group of CTL monkeys. We found that DM monkeys had 32% lower HSP70 in circulation which remained significant even after adjustment for the greater age and bodyweight of these monkeys (p < 0.001). The liver demonstrated a similar reductions in both HSP70 and 90 that was related to 50% lower levels of the transcription factor, heat shock factor 1 (HSF1; p = 0.03). Pancreatic tissue had the opposite expression pattern with significantly higher HSF1 (p = 0.004) and accordingly higher HSP70 and 90. Pancreas from DM monkeys had less nitrosative oxidation (p = 0.03) which was unaccounted for by superoxide dismutases and was negatively associated with HSP levels (r = -0.57, p = 0.009). HSF1/HSP deficiency exists in DM liver which may contribute to hepatic insulin resistance and this deficiency was reflected in lower circulating concentrations. Pancreas maintains HSP levels despite hyperglycemia, likely in an attempt to protect vulnerable beta cells from exocrine pancreatic damage and from stress associated with insulin hypersecretion.
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Affiliation(s)
- K Kavanagh
- Department of Pathology, Wake Forest University, Winston-Salem, NC 27157, USA.
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