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Shah N, Radford K, Durant S, Shoucri R, Stone J, Persaud N, Pinto AD. Advocating for Policy Change: Examples Emerging From a Medical-Legal Partnership in Primary Care. J Health Care Poor Underserved 2024; 35:8-17. [PMID: 38661856 DOI: 10.1353/hpu.2024.a919804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/26/2024]
Abstract
Medical-legal partnerships bring legal services directly into clinical settings. Policy advocacy is often opportunistic and varies across partnerships. Our objective was to study policy advocacy that emerged from a medical-legal partnership in Toronto over a four-year period. This study consisted of a document review and thematic analysis, triangulated with data from interviews with legal team members and health providers. We defined policy advocacy as actions associated with attempts to change policy or legislation. The medical-legal partnership engaged in seven distinct cases of policy advocacy: disability support form requirements, changing workplace review, challenging barriers to citizenship, housing, publicly funded medication program (pharma care), safe injection sites, and the need for increased social assistance. Actions taken included presentations at conferences and submissions of briefs to government. We found that a medical-legal partnership resulted in policy advocacy with issues arising from both the health and the legal team with impacts likely greater than if each group had acted alone.
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Fletcher K, Wydera S, Thorpe N, Radford K, das Nair R, Booth V. A rapid realist review of clinical neuropsychology rehabilitation programmes to improve psychological wellbeing and quality of life for people with acquired brain injuries. Neuropsychol Rehabil 2023:1-36. [PMID: 37975854 DOI: 10.1080/09602011.2023.2273580] [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: 02/12/2023] [Accepted: 10/03/2023] [Indexed: 11/19/2023]
Abstract
Approximately 20% of acquired brain injury (ABI) survivors experience reduced psychological wellbeing (PWB). Neuropsychological rehabilitation (NPR) is one approach supporting people with ABI to participate meaningfully in activities despite challenges. Although literature supports NPR effectiveness, little is known about change mechanisms. This systematic realist review identifies what NPR programmes have been designed, delivered, and evaluated for people with ABI to improve PWB and/or quality of life (QOL), as well as providing a context-relevant understanding of what NPR includes and how NPR might lead to positive outcomes. A rapid realist review was conducted in three phases: (1) structured retrieval and evidence extraction; (2) stakeholder consultation; (3) analysis and synthesis. Searches were completed, and findings from 35 publications and one stakeholder consultation were synthesized into a refined logic model. Six context-mechanism-outcome chains (CMOCs) were identified. Participants' relationships to internal experiences, and feelings of self-worth, mastery, and connection appeared to be mechanisms that led to improved PWB and QOL. Adaptation and individualized programmes were also key mechanisms to explain successful NPR. Embedding CMOCs into NPR could improve PWB and/or QOL for people with ABI. The logic model will inform ongoing development of a new online, group-based, NPR programme.
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Affiliation(s)
- K Fletcher
- Division of Rehabilitation & Ageing, University of Nottingham, Nottingham, UK
- Midlands Partnership NHS Foundation Trust, Stafford, UK
| | | | - N Thorpe
- Nottinghamshire Healthcare NHS Foundation Trust, Nottingham, UK
| | - K Radford
- Division of Rehabilitation & Ageing, University of Nottingham, Nottingham, UK
| | - R das Nair
- Nottinghamshire Healthcare NHS Foundation Trust, Nottingham, UK
- SINTEF, Trondheim, Norway
- Institute of Mental Health, University of Nottingham, Nottingham, UK
| | - V Booth
- Division of Rehabilitation & Ageing, University of Nottingham, Nottingham, UK
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Abstract
Sucrase deficiency has been implicated in chronic abdominal pain. Testing for sucrase deficiency generally involves invasive procedures or lengthy clinical visits, but now noninvasive kits that allow home testing are available to test for sucrase deficiency. In order to assess feasibility and utility of at-home testing, we reviewed our experience in 75 consecutive patients. All patients seen in the abdominal pain clinic had histories obtained in a standardized fashion and all had sucrase breath tests completed at home utilizing a commercially available kit. Testing was completed by 46 patients (61.3%). Tests were abnormal indicating sucrase deficiency in 34.8% of those completing testing. No symptoms were predictive of a positive test although there were trends of an association of an abnormal test with diarrhea and bloating. Our findings suggest that sucrase deficiency occurs frequently enough that more widespread testing and/or an empiric trial of sucrose and starch restriction should be considered.
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Affiliation(s)
- Sandeep Rathod
- Kansas City University of Medicine and Biosciences, Kansas City, MO, USA
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Vecchio N, Comans T, Harris P, Graham V, Cully A, Harris N, Fitzgerald J, Cartmel J, Golenko X, Radford K. Economic Evaluation of Intergenerational Programs: Suggested Measures and Design. Journal of Intergenerational Relationships 2020. [DOI: 10.1080/15350770.2020.1810194] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- N. Vecchio
- Menzies Health Institute Queensland, Brisbane, Australia
- Griffith University, Brisbane, Australia
| | | | - P. Harris
- Griffith University, Brisbane, Australia
| | - V. Graham
- Griffith University, Brisbane, Australia
| | - A. Cully
- Griffith University, Brisbane, Australia
| | - N. Harris
- Griffith University, Brisbane, Australia
| | | | - J. Cartmel
- Griffith University, Brisbane, Australia
- Griffith Health School
| | - X. Golenko
- Griffith University, Brisbane, Australia
| | - K. Radford
- Griffith University, Brisbane, Australia
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Tuffaha H, Radford K, Chai A, Rutherford S, Harris N, Scuffham P. PNS23 Setting Health Priorities in Low-Income and Middle-Income Countries in the ASIA-Pacific Region: The Case of Papua New Guinea. Value Health Reg Issues 2020. [DOI: 10.1016/j.vhri.2020.07.442] [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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Wolfe MG, Mukherjee M, Radford K, Brennan JD, Nair P. Rapid quantification of sputum eosinophil peroxidase on a lateral flow test strip. Allergy 2019; 74:1176-1178. [PMID: 30593667 DOI: 10.1111/all.13711] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Affiliation(s)
- M. G. Wolfe
- Biointerfaces Institute; McMaster University; Hamilton ON Canada
| | - M. Mukherjee
- Department of Medicine Hamilton; Firestone Institute for Respiratory Health, St. Joseph's Healthcare; Hamilton and McMaster University; ON Canada
| | - K. Radford
- Department of Medicine Hamilton; Firestone Institute for Respiratory Health, St. Joseph's Healthcare; Hamilton and McMaster University; ON Canada
| | - J. D. Brennan
- Biointerfaces Institute; McMaster University; Hamilton ON Canada
| | - P. Nair
- Department of Medicine Hamilton; Firestone Institute for Respiratory Health, St. Joseph's Healthcare; Hamilton and McMaster University; ON Canada
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Drozdzal G, Shoucri R, Macdonald J, Radford K, Pinto AD, Persaud N. Integrating legal services with primary care: The Health Justice Program. Can Fam Physician 2019; 65:246-248. [PMID: 30979753 PMCID: PMC6467680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Affiliation(s)
- Gregory Drozdzal
- Was at the time of writing, a research assistant at the Centre for Urban Health Solutions at St Michael's Hospital in Toronto, Ont
| | - Rami Shoucri
- Family physician with St Michael's Academic Family Health Team and Assistant Professor in the Department of Family and Community Medicine at the University of Toronto
| | - Johanna Macdonald
- Was at the time of writing, the on-site lawyer for the Health Justice Program and worked for Neighbourhood Legal Services in Toronto
| | - Kim Radford
- Research coordinator at the Centre for Urban Health Solutions at St Michael's Hospital
| | - Andrew David Pinto
- Family physician with St Michael's Academic Family Health Team, Scientist at the Centre for Urban Health Solutions at St Michael's Hospital, and Assistant Professor in the Department of Family and Community Medicine at the University of Toronto
| | - Nav Persaud
- Family physician with St Michael's Academic Family Health Team, Scientist at the Centre for Urban Health Solutions at St Michael's Hospital, and Assistant Professor in the Department of Family and Community Medicine at the University of Toronto.
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Drozdzal G, Shoucri R, Macdonald J, Radford K, Pinto AD, Persaud N. [Not Available]. Can Fam Physician 2019; 65:e129-e131. [PMID: 30979768 PMCID: PMC6467674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Affiliation(s)
- Gregory Drozdzal
- Était au moment de la rédaction de l'article, assistant de recherche au Centre for Urban Health Solutions de l'Hôpital St Michael à Toronto (Ontario)
| | - Rami Shoucri
- Médecin de famille dans l'Équipe universitaire de santé familiale St Michael et professeur adjoint au Département de médecine familiale et communautaire de l'Université de Toronto
| | - Johanna Macdonald
- Était au moment de la rédaction de l'article, l'avocate attitrée au Programme Justice Santé et travaillait pour les Neighbourhood Legal Services à Toronto
| | - Kim Radford
- Coordonnatrice de la recherche au Centre for Urban Health Solutions de l'Hôpital St Michael
| | - Andrew David Pinto
- Médecin de famille dans l'Équipe universitaire de santé familiale St Michael, scientifique au Centre for Urban Health Solutions de l'Hôpital St Michael, et professeur adjoint au Département de médecine familiale et communautaire de l'Université de Toronto
| | - Nav Persaud
- Médecin de famille dans l'Équipe universitaire de santé familiale St Michael, scientifique au Centre for Urban Health Solutions de l'Hôpital St Michael, et professeur adjoint au Département de médecine familiale et communautaire de l'Université de Toronto.
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Masterman KA, Pearson F, Tullett K, Haigh O, Walpole C, Daraj G, Lahoud M, Leal Rojas I, Radford K. Targeting human CD141+ DC using CLEC9A antibodies for cancer immunotherapy. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy487.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Vecchio N, Radford K, Fitzgerald JA, Comans T, Harris P, Harris N. Intergenerational care: an exploration of consumer preferences and willingness to pay for care. Aging Ment Health 2018; 22:990-998. [PMID: 28541798 DOI: 10.1080/13607863.2017.1330873] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVES To identify feasible models of intergenerational care programmes, that is, care of children and older people in a shared setting, to determine consumer preferences and willingness to pay. METHOD Feasible models were constructed in extensive consultations with a panel of experts using a Delphi technique (n = 23) and were considered based on their practical implementation within an Australian setting. This informed a survey tool that captured the preferences and willingness to pay for these models by potential consumers, when compared to the status quo. Information collected from the surveys (n = 816) was analysed using regression analysis to identify fundamental drivers of preferences and the prices consumers were willing to pay for intergenerational care programmes. RESULTS The shared campus and visiting models were identified as feasible intergenerational care models. Key attributes of these models included respite day care; a common educational pedagogy across generations; screening; monitoring; and evaluation of participant outcomes. Although parents were more likely to take up intergenerational care compared to the status quo, adult carers reported a higher willingness to pay for these services. Educational attainment also influenced the likely uptake of intergenerational care. CONCLUSIONS The results of this study show that there is demand for the shared campus and the visiting campus models among the Australian community. The findings support moves towards consumer-centric models of care, in line with national and international best practice. This consumer-centric approach is encapsulated in the intergenerational care model and enables greater choice of care to match different consumer demands.
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Affiliation(s)
- N Vecchio
- a Griffith Business School, Menzies Health Institute Queensland , Griffith University , Gold Coast , Australia
| | - K Radford
- b Griffith Business School , Griffith University , Gold Coast , Australia
| | - J A Fitzgerald
- b Griffith Business School , Griffith University , Gold Coast , Australia
| | - T Comans
- c Menzies Health Institute Queensland, School of Medicine, Nathan Campus , Griffith University , Nathan , Australia
| | - P Harris
- d School of Human Services and Social Work, Logan Campus , Griffith University , Logan , Australia
| | - N Harris
- e Public Health, School of Medicine, Gold Coast Campus , Griffith University , Gold Coast , Australia
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Obucina M, Harris N, Fitzgerald JA, Chai A, Radford K, Ross A, Carr L, Vecchio N. The application of triple aim framework in the context of primary healthcare: A systematic literature review. Health Policy 2018; 122:900-907. [PMID: 29935730 DOI: 10.1016/j.healthpol.2018.06.006] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [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: 01/16/2018] [Revised: 06/04/2018] [Accepted: 06/08/2018] [Indexed: 01/17/2023]
Abstract
The Triple Aim framework is an increasingly popular tool for designing and assessing quality improvements in the health care sector. We systematically reviewed the empirical evidence on the application of the Triple Aim framework within primary healthcare settings since its inception almost a decade ago. Results show that primary healthcare providers varied in their interpretation of the Triple Aim framework and generally struggled with a lack of guidance and an absence of composite sets of measures for performance assessment. Greater clarity around application of the Triple Aim framework in primary healthcare is needed, especially around the selection and implementation of purposeful measures from locally available data. This review highlights areas for improvement and makes recommendations intended to guide future applications of the Triple Aim in the context of primary healthcare.
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Affiliation(s)
- M Obucina
- Griffith Business School, Gold Coast campus, Griffith University, Parklands Drive, Southport QLD 4215, Australia.
| | - N Harris
- Menzies Health Institute Queensland, Gold Coast campus, Griffith University, Parklands Drive, Southport QLD 4215, Australia.
| | - J A Fitzgerald
- Griffith Business School, Gold Coast campus, Griffith University, Parklands Drive, Southport QLD 4215, Australia.
| | - A Chai
- Griffith Business School, Gold Coast campus, Griffith University, Parklands Drive, Southport QLD 4215, Australia.
| | - K Radford
- Griffith Business School, Gold Coast campus, Griffith University, Parklands Drive, Southport QLD 4215, Australia.
| | - A Ross
- Gold Coast Primary Health Network, Australia
| | - L Carr
- Gold Coast Primary Health Network, Australia
| | - N Vecchio
- Griffith Business School, Gold Coast campus, Griffith University, Parklands Drive, Southport QLD 4215, Australia.
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Sehmi R, Smith SG, Kjarsgaard M, Radford K, Boulet LP, Lemiere C, Prazma CM, Ortega H, Martin JG, Nair P. Role of local eosinophilopoietic processes in the development of airway eosinophilia in prednisone-dependent severe asthma. Clin Exp Allergy 2017; 46:793-802. [PMID: 26685004 DOI: 10.1111/cea.12695] [Citation(s) in RCA: 82] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2015] [Revised: 12/07/2015] [Accepted: 12/13/2015] [Indexed: 11/27/2022]
Abstract
BACKGROUND In severe asthmatics with persistent airway eosinophilia, blockade of interleukin-5 has significant steroid-sparing effects and attenuates blood and sputum eosinophilia. The contribution of local maturational processes of progenitors within the airways relative to the recruitment of mature cells from the peripheral circulation to the development of airway eosinophilia is not known. We hypothesize that local eosinophilopoiesis may be the predominant process that drives persistent airway eosinophilia and corticosteroid requirement in severe asthmatics. OBJECTIVES In a cross-sectional study, the number and growth potential of eosinophil-lineage-committed progenitors (EoP) were assayed in 21 severe eosinophilic asthmatics, 19 mild asthmatics, eight COPD patients and eight normal subjects. The effect of anti-IL-5 treatment on mature eosinophils and EoP numbers was made in severe eosinophilic asthmatics who participated in a randomized clinical trial of mepolizumab (substudy of a larger GSK sponsored global phase III trial, MEA115575) where subjects received mepolizumab (100 mg, n = 9) or placebo (n = 8), as six monthly subcutaneous injections. RESULTS Mature eosinophil and EoP numbers were significantly greater in the sputum of severe asthmatics compared with all other subject groups. In colony-forming assays, EoP from blood of severe asthmatics demonstrated a greater response to IL-5 than mild asthmatics. Treatment of severe asthmatics with mepolizumab significantly attenuated blood eosinophils and increased EoP numbers consistent with blockade of systemic eosinophilopoiesis. There was however no significant treatment effect on mature eosinophils, sputum EoP numbers or the prednisone maintenance dose. CONCLUSIONS AND CLINICAL RELEVANCE Patients with severe eosinophilic asthma have an exaggerated eosinophilopoeitic process in their airways. Treatment with 100 mg subcutaneous mepolizumab significantly attenuated systemic differentiation of eosinophils, but did not suppress local airway eosinophil differentiation to mature cells. Targeting IL-5-driven eosinophil differentiation locally within the lung maybe of relevance for optimal control of airway eosinophilia and asthma.
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Affiliation(s)
- R Sehmi
- Department of Medicine, McMaster University and Firestone Institute for Respiratory Health, St. Joseph's Healthcare, Hamilton, ON, Canada
| | - S G Smith
- Department of Medicine, McMaster University and Firestone Institute for Respiratory Health, St. Joseph's Healthcare, Hamilton, ON, Canada
| | - M Kjarsgaard
- Department of Medicine, McMaster University and Firestone Institute for Respiratory Health, St. Joseph's Healthcare, Hamilton, ON, Canada
| | - K Radford
- Department of Medicine, McMaster University and Firestone Institute for Respiratory Health, St. Joseph's Healthcare, Hamilton, ON, Canada
| | - L-P Boulet
- Institut Universitaire de cardiologie et de pneumologie de Québec, Québec, QC, Canada
| | - C Lemiere
- Division of Pneumologie, University of Montreal, Montreal, QC, Canada
| | - C M Prazma
- GlaxoSmithKline, Research Triangle Park, NC, USA
| | - H Ortega
- GlaxoSmithKline, Research Triangle Park, NC, USA
| | - J G Martin
- Meakins-Christie Laboratories, Research Institute of the McGill University Health Center, Montreal, QC, Canada
| | - P Nair
- Department of Medicine, McMaster University and Firestone Institute for Respiratory Health, St. Joseph's Healthcare, Hamilton, ON, Canada
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McDermott S, Long J, Radford K, Kitching A. EFFECTIVE PARTNERSHIPS: WHAT IS REQUIRED? Innov Aging 2017. [DOI: 10.1093/geroni/igx004.3585] [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)
- S. McDermott
- University of Sydney, Hornsby, New South Wales, Australia,
| | - J. Long
- Macquarie University, Sydney, New South Wales, Australia,
| | - K. Radford
- Griffith University, Brisbane, Queensland, Australia
| | - A. Kitching
- University of Sydney, Hornsby, New South Wales, Australia,
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Zuccaro L, Cox A, Pray C, Radford K, Novakowski K, Dorrington M, Surette MG, Bowdish D, Nair P. Histone deacetylase activity and recurrent bacterial bronchitis in severe eosinophilic asthma. Allergy 2016; 71:571-5. [PMID: 26715426 DOI: 10.1111/all.12831] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [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: 12/25/2015] [Indexed: 12/19/2022]
Abstract
An increase in P13 Kinase activity and an associated reduction in histone deacetylase activity may contribute to both relative steroid insensitivity in patients with severe eosinophilic asthma and impaired macrophage scavenger function and susceptibility to recurrent infective bronchitis that may, in turn, contribute to further steroid insensitivity.
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Affiliation(s)
- L. Zuccaro
- Division of Respirology; Department of Medicine; McMaster University; Hamilton ON Canada
| | - A. Cox
- Division of Respirology; Department of Medicine; McMaster University; Hamilton ON Canada
| | - C. Pray
- Division of Respirology; Department of Medicine; McMaster University; Hamilton ON Canada
| | - K. Radford
- Division of Respirology; Department of Medicine; McMaster University; Hamilton ON Canada
| | - K. Novakowski
- Department of Pathology and Molecular Medicine; McMaster University; Hamilton ON Canada
| | - M. Dorrington
- Department of Pathology and Molecular Medicine; McMaster University; Hamilton ON Canada
| | - M. G. Surette
- Department of Pathology and Molecular Medicine; McMaster University; Hamilton ON Canada
- Division of Gastroenterology; Department of Medicine; McMaster University; Hamilton ON Canada
| | - D. Bowdish
- Department of Pathology and Molecular Medicine; McMaster University; Hamilton ON Canada
| | - P. Nair
- Division of Respirology; Department of Medicine; McMaster University; Hamilton ON Canada
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Nair P, Denis S, Cancelliere L, Radford K, Efthimiadis A, Rosano M, Hanrahan J. The effects of an epithelial barrier protective cationic aerosol on allergen-induced airway inflammation in asthma: a randomized, placebo-controlled clinical trial. Clin Exp Allergy 2015; 44:1200-3. [PMID: 25132278 DOI: 10.1111/cea.12383] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2014] [Accepted: 10/11/2014] [Indexed: 11/30/2022]
Abstract
Inhaled cationic airway lining modulator (iCALM) is a cationic aerosol therapy comprised of 1.29% calcium chloride dissolved in 0.9% isotonic saline that enhances the biophysical barrier function of the airway lining fluid and primes the host defense response. It's ability to attenuate bronchitis caused by inhaled particles was investigated using an allergen-inhalation model in a proof-of-concept study. In a randomized, double-blind, placebo-controlled cross-over trial of 6 mild atopic steroid-naïve asthmatic subjects, 3 doses of iCALM were well tolerated and they attenuated allergen-induced increase in sputum eosinophils, and levels of IL-5, MCP-1 and eotaxin. This study provides an opportunity to investigate the role of enhancing epithelial barrier to decrease airway inflammation provoked by inhaled particles in a variety of airway diseases.
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Affiliation(s)
- P Nair
- Firestone Institute for Respiratory Health, St Joseph's Healthcare & Department of Medicine, McMaster University, Hamilton, ON, Canada
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Hammond A, Prior Y, O'Brien R, Woodbridge S, Radford K. FRI0592-HPR Work Rehabilitation in Inflammatory Arthritis: A Pilot Randomised Controlled Trial:. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.5378] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Nair P, Ochkur SI, Protheroe C, Radford K, Efthimiadis A, Lee NA, Lee JJ. Eosinophil peroxidase in sputum represents a unique biomarker of airway eosinophilia. Allergy 2013; 68:1177-84. [PMID: 23931643 DOI: 10.1111/all.12206] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [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: 05/10/2013] [Indexed: 11/28/2022]
Abstract
BACKGROUND Sputum eosinophilia has been shown to be a predictor of response to anti-eosinophil therapies in patients with airway diseases. However, quantitative cell counts and differentials of sputum are labor intensive. The objective of this study was to validate a novel ELISA-based assay of eosinophil peroxidase (EPX) in sputum as a rapid and reliable marker of airway eosinophils. METHODS The utility of EPX-based ELISA as an eosinophil-specific assay was achieved through comparisons with sputum eosinophil differential counts in freshly prepared and archived patient samples from a variety of clinical settings. RESULTS EPX levels in sputum correlated with eosinophil percentage (r(s) = 0.84) in asthma patients with varying degrees of airway eosinophilia. Significantly, unlike assays of other eosinophil granule proteins (e.g., ECP and EDN), which often detect the presence of these proteins even in asthma patients with neutrophilic bronchitis, EPX-based ELISA levels are not increased in this subset of asthma patients or in COPD patients lacking evidence of an airway eosinophilia. Moreover, sputum EPX was a surrogate marker of airway eosinophilia in other patient studies (e.g., allergen inhalation and treatment trials the anti-(IL-5) therapeutic Mepolizumab™). Finally, EPX levels in cytocentrifuged prepared sputum supernatants correlated with those from rapidly prepared noncentrifuged filtrates of sputum (r(s) = 0.94). CONCLUSION AND CLINICAL IMPLICATION EPX-based ELISA is a valid, reliable, repeatable, and specific surrogate marker of eosinophils and/or eosinophil degranulation in the sputum of respiratory patients. The novel EPX assay is a valid and reproducible eosinophil-specific assay that can potentially be developed into a point-of-care assessment of eosinophil activity in airway secretions.
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Affiliation(s)
- P. Nair
- Department of Medicine; St. Joseph's Healthcare & McMaster University; Hamilton; ON; Canada
| | - S. I. Ochkur
- Division of Pulmonary Medicine; Department of Biochemistry and Molecular Biology Mayo Clinic Arizona; Scottsdale; AZ; USA
| | - C. Protheroe
- Division of Hematology and Oncology; Department of Biochemistry and Molecular Biology Mayo Clinic Arizona; Scottsdale; AZ; USA
| | - K. Radford
- Department of Medicine; St. Joseph's Healthcare & McMaster University; Hamilton; ON; Canada
| | - A. Efthimiadis
- Department of Medicine; St. Joseph's Healthcare & McMaster University; Hamilton; ON; Canada
| | - N. A. Lee
- Division of Hematology and Oncology; Department of Biochemistry and Molecular Biology Mayo Clinic Arizona; Scottsdale; AZ; USA
| | - J. J. Lee
- Division of Pulmonary Medicine; Department of Biochemistry and Molecular Biology Mayo Clinic Arizona; Scottsdale; AZ; USA
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Baraliakos X, Braun J, Laurent D, Baeten D, van der Heijde D, Sieper J, Emery P, McInnes I, van Laar J, Landewe R, Wordsworth P, Wollenhaupt J, Kellner H, Wright A, Vandenhende F, Radford K, Borah B, Hueber W. FRI0420 Long term inhibition of IL-17a with secukinumab reduces spinal inflammation but has no influence on fatty lesions as assessed by magnetic resonance imaging in patients with ankylosing spondylitis. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2013-eular.1547] [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: 11/03/2022]
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Grigoriadis S, VonderPorten EH, Mamisashvili L, Tomlinson G, Dennis CL, Koren G, Steiner M, Mousmanis P, Cheung A, Radford K, Martinovic J, Ross LE. The impact of maternal depression during pregnancy on perinatal outcomes: a systematic review and meta-analysis. J Clin Psychiatry 2013; 74:e321-41. [PMID: 23656857 DOI: 10.4088/jcp.12r07968] [Citation(s) in RCA: 509] [Impact Index Per Article: 46.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2012] [Accepted: 10/31/2012] [Indexed: 02/08/2023]
Abstract
OBJECTIVE Depression often remains undertreated during pregnancy and there is growing evidence that untoward perinatal outcomes can result. Our systematic review and meta-analysis was conducted to determine whether maternal depression during pregnancy is associated with adverse perinatal and infant outcomes. DATA SOURCES MEDLINE, EMBASE, CINAHL, and PsycINFO were searched from their start dates to June 2010. Keywords utilized included depressive/mood disorder, postpartum/postnatal, pregnancy/pregnancy trimesters, prenatal or antenatal, infant/neonatal outcomes, premature delivery, gestational age, birth weight, NICU, preeclampsia, breastfeeding, and Apgar. STUDY SELECTION English language studies reporting on perinatal or child outcomes associated with maternal depression were included, 3,074 abstracts were reviewed, 735 articles retrieved, and 30 studies included. DATA EXTRACTION Two independent reviewers extracted data and assessed article quality. All studies were included in the primary analyses, and between-group differences for subanalyses are also reported. RESULTS Thirty studies were eligible for inclusion. Premature delivery and decrease in breastfeeding initiation were significantly associated with maternal depression (odds ratio [OR] = 1.37; 95% CI, 1.04 to 1.81; P = .024; and OR = 0.68; 95% CI, 0.61 to 0.76; P < .0001, respectively). While birth weight (mean difference = -19.53 g; 95% CI, -64.27 to 25.20; P = .392), low birth weight (OR = 1.21; 95% CI, 0.91 to 1.60; P = .195), neonatal intensive care unit admissions (OR = 1.43; 95% CI, 0.83 to 2.47; P = .195), and preeclampsia (OR = 1.35; 95% CI, 0.95 to 1.92; P = .089) did not show significant associations in the main analyses, some subanalyses were significant. Gestational age (mean difference = -0.19 weeks; 95% CI, -0.53 to 0.14; P = .262) and Apgar scores at 1 (mean difference = -0.05; 95% CI, -0.28 to 0.17; P = .638) and 5 minutes (mean difference = 0.01; 95% CI, -0.08 to 0.11; P = .782) did not demonstrate any significant associations with depression. For premature delivery, a convenience sample study design was associated with higher ORs (OR = 2.43; 95% CI, 1.47 to 4.01; P = .001). CONCLUSIONS Maternal depression during pregnancy is associated with increased odds for premature delivery and decreased breastfeeding initiation; however, the effects are modest. More research of higher methodological quality is needed.
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Affiliation(s)
- Sophie Grigoriadis
- Women's Mood and Anxiety Clinic: Reproductive Transitions, Department of Psychiatry, FG 29, Sunnybrook Health Sciences Centre, 2075 Bayview Ave, Toronto, ON M4N 3M5, Canada.
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McCusker E, Gunn D, Epping E, Loy C, Long J, Radford K, Griffith J, Mills J, Paulsen J. I01 Unawareness of motor phenoconversion in huntington disease. J Neurol Psychiatry 2012. [DOI: 10.1136/jnnp-2012-303524.100] [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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Friesen CA, Neilan N, Daniel JF, Radford K, Schurman JV, Li DY, Andre L, St Peter SD, Holcomb GW. Mast cell activation and clinical outcome in pediatric cholelithiasis and biliary dyskinesia. BMC Res Notes 2011; 4:322. [PMID: 21896203 PMCID: PMC3224507 DOI: 10.1186/1756-0500-4-322] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2011] [Accepted: 09/06/2011] [Indexed: 12/18/2022] Open
Abstract
Background The current study was undertaken to determine the degree of activation of gallbladder mucosal mast cells, whether mast cell (MC) density or activation differ between patients with and without a positive clinical response to cholecystectomy, and whether either density or activation correlate with gallbladder emptying. Results Fifteen biliary dyskinesia (BD) and 13 symptomatic cholelithiasis (CL) patients undergoing cholecystectomy were prospectively enrolled. Gallbladder wall MC density (by immunohistochemistry) and activation (by electron microscopy) were determined. Clinical response was evaluated 30 days post-cholecystectomy on a 5-point Likert-type scale. A complete or nearly complete clinical response was seen in 100% of CL and in 87% of BD patients. The overall degranulation indices were 49.4 ± 18.7% for CL patients and 44.2 ± 16.8% for BD patients. Neither MC density nor activation correlated with the gallbladder ejection fraction. A complete clinical response was associated with lower epithelial MC density. Conclusion Cholecystectomy is efficacious in relieving pain in both CL and BD patients. BD and CL are associated not only with increased MC density but a moderate to high degree of MC activation. A possible relationship between MC density and outcome for BD warrants further investigation.
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Affiliation(s)
- Craig A Friesen
- Department of Pediatrics, The Children's Mercy Hospital, 2401 Gillham Rd,, Kansas City, Missouri, USA.
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Abstract
INTRODUCTION Human airway smooth muscle (HASM) cells in culture synthesize cytokines and chemokines that may orchestrate the tissue homing and in situ differentiation of haemopoietic progenitor cells from the peripheral circulation. OBJECTIVE To study the effect of a supernatant from cultured HASM cells on the differentiative and transmigrational responses of haemopoietic progenitor cells. METHODS HASM cells were grown to confluence and stimulated with a cytomix of TNF-alpha, IL-1beta and IFN-gamma. Peripheral blood-derived progenitors from atopic asthmatics (n=12) and non-atopic controls (n=11) were grown in a methylcellulose culture with a supernatant from stimulated HASM cells to assess clonogenic potential. The ability of HASM cells to stimulate directional migration and adhesion to fibronectin of blood progenitors was also investigated. RESULTS HASM cells stimulated significant growth of eosinophil/basophil colony forming units (Eo/B CFUs) from blood progenitor cells from both groups of subjects. This activity was significantly attenuated in the presence of anti-IL-5 and anti-granulocyte macrophage-colony forming factor blocking antibodies and by pre-treatment with SB202190 [p38 mitogen-activated protein kinase (MAPK) inhibitor]. An src kinase (srcK) inhibitor (Pyrazolopyrimidine 1) was less effective at attenuating IL-5- and HASM-stimulated Eo/B CFU growth from both groups of subjects. Examination of the phosphorylation of these kinases in CD34(+) cells following co-incubation with the major constituents of HASM showed activation of p38 MAPK but not that of the srcK pathway. The HASM supernatant had no significant effect on the migrational and adhesive responses of haemopoietic progenitor cells in vitro. CONCLUSION We have shown that HASM cell-derived cytokines promote eosinophil differentiation that is dependent on p38 MAPK but not on the srcK pathway. This study shows that a major structural cell of the lungs, airway smooth muscle, has the capability to direct eosinophil differentiation and maturation from progenitor cells, which in turn may perpetuate an eosinophilic inflammation and consequently tissue remodelling in patients with chronic asthma.
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Affiliation(s)
- A I Fanat
- Asthma Research Group, Firestone Institute for Respiratory Health, St Joseph's Healthcare, Department of Medicine, McMaster University, Hamilton, ON, Canada
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Spahr JE, Love RB, Francois M, Radford K, Meyer KC. Lung transplantation for cystic fibrosis: Current concepts and one center's experience. J Cyst Fibros 2007; 6:334-50. [PMID: 17418647 DOI: 10.1016/j.jcf.2006.12.010] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2006] [Revised: 12/14/2006] [Accepted: 12/20/2006] [Indexed: 10/23/2022]
Abstract
BACKGROUND Although new approaches to the treatment of patients with cystic fibrosis (CF) are significantly prolonging their lives, most patients will eventually develop respiratory failure due to progressive bronchiectasis caused by chronic lung infection and inflammation and die from to respiratory failure. We examined our center's (University of Wisconsin Hospital and Clinics) experience with lung transplantation for patients with CF and reviewed the literature to examine current and evolving approaches to transplantation for this indication. METHODS We reviewed all published literature pertaining to lung transplantation for CF through 2006, and we reviewed all aspects of transplantation for patients with CF at our institution from 1994 to 2005. RESULTS Major complications following lung transplantation include acute rejection, bacterial infection, and bronchiolitis obliterans. Five-year survival at UWHC (Kaplan-Meier) is 67%, and survival was not adversely affected by transplanting patients receiving mechanical ventilation. The major cause of death for transplant recipients was bronchiolitis obliterans syndrome (BOS). CONCLUSIONS Lung transplantation for CF is associated with acceptable survival rates and can improve quality of life. Lung transplant should be offered to all patients with advanced CF lung disease if they meet currently accepted inclusion and exclusion criteria.
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Affiliation(s)
- J E Spahr
- University of Wisconsin School of Medicine and Public Health, WI, USA.
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Abstract
BACKGROUND we evaluated a specialist community-based dementia service to establish whether high quality care was being delivered and the conditions for doing so. The service was in an urban part of Rushcliffe Primary Care Trust, Nottinghamshire, United Kingdom. The service comprised an assessment team of an occupational therapist, a community psychiatric nurse and a community care officer, supported by 235 h per week of care delivered by a team of specially trained community care workers. METHODS a qualitative study was performed using non-participant observation, semi-structured interviews and focus groups, and analysed using a thematic framework approach. There were 2 focus groups involving staff, 11 interviews of staff and stakeholders, and interviews of 15 carers of people with dementia. RESULTS the care provided was appreciated by carers, and the service was approved by staff and stakeholders. Care was delivered using a rehabilitative style that aimed to maintain personhood, rather than to promote independence. Clients were usually referred with the object of preventing unwanted admission to institutional care but, over time, moving into an institution ceased to be a uniformly undesirable outcome. The service's resources were reduced during the evaluation period, in part to meet mental health needs in intermediate care services. CONCLUSIONS an appropriately resourced and constructed specialist service using an adaptive rehabilitation approach aimed at maintaining personhood can deliver good individualised care to people with dementia, but specific and appropriate commissioning for these services is needed to nurture them.
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Affiliation(s)
- J R F Gladman
- Division of Rehabilitation and Ageing, B Floor Medical School, Queen's Medical Centre, Nottingham, NG7 2UH, UK.
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Prue R, Rosetti T, Fitzpatrick S, Wilkinson R, Radford K, Swindle P, Mainwaring P, Hart DN. A phase I clinical trial of a BDCA-1 + blood dendritic cell preparation loaded with control and tumour-associated antigens, for immune therapy of metastatic refractory prostate cancer. J Clin Oncol 2005. [DOI: 10.1200/jco.2005.23.16_suppl.2599] [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: 11/20/2022] Open
Affiliation(s)
- R. Prue
- Mater Medcl Research Institute, Brisbane QLD, Australia
| | - T. Rosetti
- Mater Medcl Research Institute, Brisbane QLD, Australia
| | | | - R. Wilkinson
- Mater Medcl Research Institute, Brisbane QLD, Australia
| | - K. Radford
- Mater Medcl Research Institute, Brisbane QLD, Australia
| | - P. Swindle
- Mater Medcl Research Institute, Brisbane QLD, Australia
| | - P. Mainwaring
- Mater Medcl Research Institute, Brisbane QLD, Australia
| | - D. N. Hart
- Mater Medcl Research Institute, Brisbane QLD, Australia
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Abstract
Extracellular matrix proteins regulate the survival and proliferation of smooth muscle cells. Their effect on airway smooth muscle cell migration is not known. Their role in leukotriene-primed (0.1 microM leukotriene E4) chemotaxis of cultured human airway smooth muscle cells towards platelet-derived growth factor BB (1 ng.mL(-1)) was investigated. Migration of cells was greater on membranes coated with collagens III and V and fibronectin compared to collagen I, elastin and laminin (all 10 microg.mL(-1)). Concentration-dependent promotion of migration was observed on collagen I (1,000>10 microg.mL(-1)), which was associated with increased phosphorylation of Src kinase. This was not observed on laminin or elastin. The role of Src kinase was further confirmed by demonstrating that its inhibitor, PP1 analogue (1 microM), inhibited chemotaxis. Collagen I itself was not a chemoattractant; however, haptokinesis was observed when cells were primed with leukotriene E4, and haptotaxis when cells were primed with platelet-derived growth factor. The priming effect of leukotrienes on chemotaxis was not elicited by promoting adhesion, increasing surface expression of beta1, alphav and alpha5 integrin, or Src kinase phosphorylation. These experiments demonstrate that the extracellular matrix, along with growth factors and cysteinyl leukotrienes, can regulate human airway smooth muscle cell migration. This may be relevant in the remodelling process in chronic airway diseases, such as asthma.
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Affiliation(s)
- K Parameswaran
- Asthma Research Group, Firestone Institute for Respiratory Health, St. Joseph's Healthcare, McMaster University, Hamilton, Canada
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Abstract
Speech and swallowing are important components of health-related quality of life following head and neck cancer treatment. The aim of this study was to demonstrate the value of prospective multi-centre evaluation by Speech and Language Therapists and to compare health-related quality of life with speech and swallowing impairments. The University of Washington Head and Neck questionnaire version 4 (UW-QOL) and Therapy Outcome Measures (TOM) were rated before and 6 months after cancer treatment in 95 patients from 12 centres. There was deterioration in TOM scores at 6 months. Pretreatment UW-QOL swallowing was ranked equal first, with speech fourth. At 6 months speech was first and swallowing second. There were positive correlations between UW-QOL swallowing and TOM dysphagia and between UW-QOL speech and TOM laryngectomy, voice, phonology and dysarthria disorders. Both outcome measures are suitable for routine practice. Adaptation of TOM scales for use with head and neck cancer patients may improve sensitivity, validity and therapist compliance.
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Affiliation(s)
- K Radford
- Speech and Language Therapy Department, City Hospital, Sandwell and West Birmingham Trusts, Birmingham, UK
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Ahmad I, Kumar BN, Radford K, O'Connell J, Batch AJ. Surgical voice restoration following ablative surgery for laryngeal and hypopharyngeal carcinoma. J Laryngol Otol 2000; 114:522-5. [PMID: 10992934 DOI: 10.1258/0022215001906282] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Surgical voice restoration is an important part of functional rehabilitation of patients following ablative surgery for laryngeal and hypopharyngeal carcinoma. The aim of this retrospective study was to assess the functional status with regard to speech of a cohort of 100 patients (age ranged 34-84 years), who underwent laryngectomy and laryngopharyngectomy over a 10-year period (1989-1999). Ninety-two patients consented to surgical voice restoration. Primary tracheoesophageal punctures were performed in 70 and secondary punctures in 22 (mainly after jejunal flap reconstruction). Nine patients were excluded from this analysis (seven patients died prior to assessment, one had the prosthesis removed at her request and one patient had insufficient follow-up). Tracheoesophageal speech was assessed in the remaining 83 patients using a rating scale measuring the number of syllables per breath, use of voice and intelligibility by non-professional listeners. Currently, Provox 2 valves are being used in the majority of patients. Overall tracheoesophageal speech results were good in 45/83 (54.2 per cent), average in 22/83 (26.5 per cent) and poor in 15/83 (18 per cent). One patient could not develop tracheoesophageal speech. The majority of laryngectomy patients had good speech but in patients who had complex reconstructions tracheoesophageal speech was mostly rated as average. Average to good speech in more than two-thirds of the cohort of patients show that surgical voice restoration is a highly successful and valuable technique to restore speech functions after ablative surgery for laryngeal and hypopharyngeal carcinoma.
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Affiliation(s)
- I Ahmad
- Department of Otolaryngology, City Hospital, Birmingham, UK.
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Smith M, Bleijs R, Radford K, Hersey P. Immunogenicity of CD63 in a patient with melanoma. Melanoma Res 1997; 7 Suppl 2:S163-70. [PMID: 9578433] [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: 02/07/2023]
Abstract
CD63 is a member of the tetraspan family of molecules that is expressed in melanoma and which appears to be involved in regulation of motility and adhesion of melanoma cells. In the present study we have screened a cDNA library from a melanoma cell with antisera from a patient with melanoma and have shown that one of the antigens identified was CD63. The clone isolated contained a mutation in the transmembrane region, but this did not appear to be involved in immunogenicity of the molecule. Antisera from the patient showed weak reactivity with CD63 from melanoma and recombinant CD63 in Western blots. The latter studies showed marked variation in the fractions of CD63 identified with monoclonal antibodies to CD63 consistent with variable glycosylation of CD63. We suggest that glycosylation may account for its recognition by the human immune system. Further studies are required to assess the role of CD63 as an immunogen in melanoma.
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Affiliation(s)
- M Smith
- Oncology and Immunology Unit, David Maddison Clinical Sciences Building, Newcastle, NSW, Australia
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Abstract
Biological motion displays depict a moving human figure by means of just a few isolated points of light attached to the major joints of the body. Naive observers readily interpret the moving pattern of dots as representing a human figure, despite the complete absence of form cues. This paper reports a series of experiments which investigated the visual processes underlying the phenomenon. Results suggest that (i) the effect relies upon responses in low-level motion-detecting processes, which operate over short temporal and spatial intervals and respond to local modulations in image intensity; and (ii) the effect does not involve hierarchical visual analysis of motion components, nor does it require the presence of dots which move in rigid relation to each other. Instead, movements of the extremities are crucial. Data are inconsistent with current theoretical treatments.
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Affiliation(s)
- G Mather
- Laboratory of Experimental Psychology, University of Sussex, Brighton, U.K
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Abstract
We present three cases of dysphonia in which gastro-oesophageal reflux (GOR) appeared to be a precipitating factor. In all cases reflux was clinically occult. We discuss the theory and implications of GOR presenting atypically with laryngeal symptoms, and outline our current approach to laryngeal symptoms of clinically evident or occult GOR.
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Affiliation(s)
- G M Weiner
- Department of Otorhinolaryngology, City of NHS Trust, Birmingham, UK
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Radford K, Batch A. Surgeon's workshop: changing the indwelling Provox tracheoesophageal voice prosthesis as an out-patient procedure. Clin. Otolaryngol. 18, 145-149. Clin Otolaryngol 1994; 19:175. [PMID: 8026100 DOI: 10.1111/j.1365-2273.1994.tb01207.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
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Radford K. Planning surgical care. Nurs N Z (1993) 1994; 2:19-20. [PMID: 8167766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
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Rogers SN, Batch A, Powell D, Radford K. 'The holiday plug': a temporary solution to the problem of the leaking voice prosthesis. J Laryngol Otol 1993; 107:1149-50. [PMID: 8289006 DOI: 10.1017/s0022215100125514] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Tracheo-oesophageal prostheses are commonly inserted in patients following total laryngectomy to improve the quality of the voice. Unfortunately the device eventually fails and requires replacement. A valve change, although well tolerated by patients, necessitates an out-patient visit and delay in its replacement can lead to problems of pneumonia or dehydration. In this short paper we describe a simple temporary solution for a leaking valve and recommend its use in patients who are delayed in returning to the unit for example when on holiday.
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Affiliation(s)
- S N Rogers
- Department of Otolaryngology and Head and Neck Oncology, Dudley Road Hospital, Birmingham
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Abstract
A general weaning procedure is described which allowed a range of hybridomas to be weaned readily off serum without loss of antibody production. Initial work was carried out with one cell line only (SPO1 cells) and one serum substitute containing a final protein concentration of 40 mg l-1. The SPO1 cells were first adapted to a range of readily available basal media and then weaned off serum by a range of protocols. From this work an optimal weaning protocol and basal medium for weaning were determined. These were then used to wean the SPO1 cells and two other cell lines off serum with a second, protein free, serum substitute with varying concentrations of defined proteins added. All three cell lines investigated were readily weaned off serum by this protocol at protein concentrations as low as 1 mg l-1. No loss of antibody production was observed with any of the cell lines. The weaning procedure outlined in both simple and rapid and has been successfully adopted in our laboratory by relatively inexperienced cell culture technicians.
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Affiliation(s)
- K Radford
- Department of Chemical Engineering, University of Queensland, Brisbane
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