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D, Walsh JA, Liyanage K, Gummadi M, Dormand N, Polgar O, George P, Barker RE, Patel S, Price L, Gibbons M, Matila D, Jarvis H, Lim L, Olaosebikan O, Ahmad S, Brill S, Mandal S, Laing C, Michael A, Reddy A, Johnson C, Baxendale H, Parfrey H, Mackie J, Newman J, Pack J, Parmar J, Paques K, Garner L, Harvey A, Summersgill C, Holgate D, Hardy E, Oxton J, Pendlebury J, McMorrow L, Mairs N, Majeed N, Dark P, Ugwuoke R, Knight S, Whittaker S, Strong-Sheldrake S, Matimba-Mupaya W, Chowienczyk P, Pattenadk D, Hurditch E, Chan F, Carborn H, Foot H, Bagshaw J, Hockridge J, Sidebottom J, Lee JH, Birchall K, Turner K, Haslam L, Holt L, Milner L, Begum M, Marshall M, Steele N, Tinker N, Ravencroft P, Butcher R, Misra S, Walker S, Coburn Z, Fairman A, Ford A, Holbourn A, Howell A, Lawrie A, Lye A, Mbuyisa A, Zawia A, Holroyd-Hind B, Thamu B, Clark C, Jarman C, Norman C, Roddis C, Foote D, Lee E, Ilyas F, Stephens G, Newell H, Turton H, Macharia I, Wilson I, Cole J, McNeill J, Meiring J, Rodger J, Watson J, Chapman K, Harrington K, Chetham L, Hesselden L, Nwafor L, Dixon M, Plowright M, Wade P, Gregory R, Lenagh R, Stimpson R, Megson S, Newman T, Cheng Y, Goodwin C, Heeley C, Sissons D, Sowter D, Gregory H, Wynter I, Hutchinson J, Kirk J, Bennett K, Slack K, Allsop L, Holloway L, Flynn M, Gill M, Greatorex M, Holmes M, Buckley P, Shelton S, Turner S, Sewell TA, Whitworth V, Lovegrove W, Tomlinson J, Warburton L, Painter S, Vickers C, Redwood D, Tilley J, Palmer S, Wainwright T, Breen G, Hotopf M, Dunleavy A, Teixeira J, Ali M, Mencias M, Msimanga N, Siddique S, Samakomva T, Tavoukjian V, Forton D, Ahmed R, Cook A, Thaivalappil F, Connor L, Rees T, McNarry M, Williams N, McCormick J, McIntosh J, Vere J, Coulding M, Kilroy S, Turner V, Butt AT, Savill H, Fraile E, Ugoji J, Landers G, Lota H, Portukhay S, Nasseri M, Daniels A, Hormis A, Ingham J, Zeidan L, Osborne L, Chablani M, Banerjee A, David A, Pakzad A, Rangelov B, Williams B, Denneny E, Willoughby J, Xu M, Mehta P, Batterham R, Bell R, Aslani S, Lilaonitkul W, Checkley A, Bang D, Basire D, Lomas D, Wall E, Plant H, Roy K, Heightman M, Lipman M, Merida Morillas M, Ahwireng N, Chambers RC, Jastrub R, Logan S, Hillman T, Botkai A, Casey A, Neal A, Newton-Cox A, Cooper B, Atkin C, McGee C, Welch C, Wilson D, Sapey E, Qureshi H, Hazeldine J, Lord JM, Nyaboko J, Short J, Stockley J, Dasgin J, Draxlbauer K, Isaacs K, Mcgee K, Yip KP, Ratcliffe L, Bates M, Ventura M, Ahmad Haider N, Gautam N, Baggott R, Holden S, Madathil S, Walder S, Yasmin S, Hiwot T, Jackson T, Soulsby T, Kamwa V, Peterkin Z, Suleiman Z, Chaudhuri N, Wheeler H, Djukanovic R, Samuel R, Sass T, Wallis T, Marshall B, Childs C, Marouzet E, Harvey M, Fletcher S, Dickens C, Beckett P, Nanda U, Daynes E, Charalambou A, Yousuf AJ, Lea A, Prickett A, Gooptu B, Hargadon B, Bourne C, Christie C, Edwardson C, Lee D, Baldry E, Stringer E, Woodhead F, Mills G, Arnold H, Aung H, Qureshi IN, Finch J, Skeemer J, Hadley K, Khunti K, Carr L, Ingram L, Aljaroof M, Bakali M, Bakau M, Baldwin M, Bourne M, Pareek M, Soares M, Tobin M, Armstrong N, Brunskill N, Goodman N, Cairns P, Haldar P, McCourt P, Dowling R, Russell R, Diver S, Edwards S, Glover S, Parker S, Siddiqui S, Ward TJC, Mcnally T, Thornton T, Yates T, Ibrahim W, Monteiro W, Thickett D, Wilkinson D, Broome M, McArdle P, Upthegrove R, Wraith D, Langenberg C, Summers C, Bullmore E, Heeney JL, Schwaeble W, Sudlow CL, Adeloye D, Newby DE, Rudan I, Shankar-Hari M, Thorpe M, Pius R, Walmsley S, McGovern A, Ballard C, Allan L, Dennis J, Cavanagh J, Petrie J, O'Donnell K, Spears M, Sattar N, MacDonald S, Guthrie E, Henderson M, Guillen Guio B, Zhao B, Lawson C, Overton C, Taylor C, Tong C, Mukaetova-Ladinska E, Turner E, Pearl JE, Sargant J, Wormleighton J, Bingham M, Sharma M, Steiner M, Samani N, Novotny P, Free R, Allen RJ, Finney S, Terry S, Brugha T, Plekhanova T, McArdle A, Vinson B, Spencer LG, Reynolds W, Ashworth M, Deakin B, Chinoy H, Abel K, Harvie M, Stanel S, Rostron A, Coleman C, 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Francis C, Francis R, Hughes RA, Hughes J, Hughes AD, Thompson T, Kelly S, Smith D, Smith N, Smith A, Smith J, Smith L, Smith S, Evans T, Evans RI, Evans D, Evans R, Evans H, Evans J. Multiorgan MRI findings after hospitalisation with COVID-19 in the UK (C-MORE): a prospective, multicentre, observational cohort study. Lancet Respir Med 2023; 11:1003-1019. [PMID: 37748493 PMCID: PMC7615263 DOI: 10.1016/s2213-2600(23)00262-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 06/16/2023] [Accepted: 06/30/2023] [Indexed: 09/27/2023]
Abstract
INTRODUCTION The multiorgan impact of moderate to severe coronavirus infections in the post-acute phase is still poorly understood. We aimed to evaluate the excess burden of multiorgan abnormalities after hospitalisation with COVID-19, evaluate their determinants, and explore associations with patient-related outcome measures. METHODS In a prospective, UK-wide, multicentre MRI follow-up study (C-MORE), adults (aged ≥18 years) discharged from hospital following COVID-19 who were included in Tier 2 of the Post-hospitalisation COVID-19 study (PHOSP-COVID) and contemporary controls with no evidence of previous COVID-19 (SARS-CoV-2 nucleocapsid antibody negative) underwent multiorgan MRI (lungs, heart, brain, liver, and kidneys) with quantitative and qualitative assessment of images and clinical adjudication when relevant. Individuals with end-stage renal failure or contraindications to MRI were excluded. Participants also underwent detailed recording of symptoms, and physiological and biochemical tests. The primary outcome was the excess burden of multiorgan abnormalities (two or more organs) relative to controls, with further adjustments for potential confounders. The C-MORE study is ongoing and is registered with ClinicalTrials.gov, NCT04510025. FINDINGS Of 2710 participants in Tier 2 of PHOSP-COVID, 531 were recruited across 13 UK-wide C-MORE sites. After exclusions, 259 C-MORE patients (mean age 57 years [SD 12]; 158 [61%] male and 101 [39%] female) who were discharged from hospital with PCR-confirmed or clinically diagnosed COVID-19 between March 1, 2020, and Nov 1, 2021, and 52 non-COVID-19 controls from the community (mean age 49 years [SD 14]; 30 [58%] male and 22 [42%] female) were included in the analysis. Patients were assessed at a median of 5·0 months (IQR 4·2-6·3) after hospital discharge. Compared with non-COVID-19 controls, patients were older, living with more obesity, and had more comorbidities. Multiorgan abnormalities on MRI were more frequent in patients than in controls (157 [61%] of 259 vs 14 [27%] of 52; p<0·0001) and independently associated with COVID-19 status (odds ratio [OR] 2·9 [95% CI 1·5-5·8]; padjusted=0·0023) after adjusting for relevant confounders. Compared with controls, patients were more likely to have MRI evidence of lung abnormalities (p=0·0001; parenchymal abnormalities), brain abnormalities (p<0·0001; more white matter hyperintensities and regional brain volume reduction), and kidney abnormalities (p=0·014; lower medullary T1 and loss of corticomedullary differentiation), whereas cardiac and liver MRI abnormalities were similar between patients and controls. Patients with multiorgan abnormalities were older (difference in mean age 7 years [95% CI 4-10]; mean age of 59·8 years [SD 11·7] with multiorgan abnormalities vs mean age of 52·8 years [11·9] without multiorgan abnormalities; p<0·0001), more likely to have three or more comorbidities (OR 2·47 [1·32-4·82]; padjusted=0·0059), and more likely to have a more severe acute infection (acute CRP >5mg/L, OR 3·55 [1·23-11·88]; padjusted=0·025) than those without multiorgan abnormalities. Presence of lung MRI abnormalities was associated with a two-fold higher risk of chest tightness, and multiorgan MRI abnormalities were associated with severe and very severe persistent physical and mental health impairment (PHOSP-COVID symptom clusters) after hospitalisation. INTERPRETATION After hospitalisation for COVID-19, people are at risk of multiorgan abnormalities in the medium term. Our findings emphasise the need for proactive multidisciplinary care pathways, with the potential for imaging to guide surveillance frequency and therapeutic stratification. FUNDING UK Research and Innovation and National Institute for Health Research.
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Aguillard DP, Albahri T, Allspach D, Anisenkov A, Badgley K, Baeßler S, Bailey I, Bailey L, Baranov VA, Barlas-Yucel E, Barrett T, Barzi E, Bedeschi F, Berz M, Bhattacharya M, Binney HP, Bloom P, Bono J, Bottalico E, Bowcock T, Braun S, Bressler M, Cantatore G, Carey RM, Casey BCK, Cauz D, Chakraborty R, Chapelain A, Chappa S, Charity S, Chen C, Cheng M, Chislett R, Chu Z, Chupp TE, Claessens C, Convery ME, Corrodi S, Cotrozzi L, Crnkovic JD, Dabagov S, Debevec PT, Di Falco S, Di Sciascio G, Drendel B, Driutti A, Duginov VN, Eads M, Edmonds A, Esquivel J, Farooq M, Fatemi R, Ferrari C, Fertl M, Fienberg AT, Fioretti A, Flay D, Foster SB, Friedsam H, Froemming NS, Gabbanini C, Gaines I, Galati MD, Ganguly S, Garcia A, George J, Gibbons LK, Gioiosa A, Giovanetti KL, Girotti P, Gohn W, Goodenough L, Gorringe T, Grange J, Grant S, Gray F, Haciomeroglu S, Halewood-Leagas T, Hampai D, Han F, Hempstead J, Hertzog DW, Hesketh G, Hess E, Hibbert A, Hodge Z, Hong KW, Hong R, Hu T, Hu Y, Iacovacci M, Incagli M, Kammel P, Kargiantoulakis M, Karuza M, Kaspar J, Kawall D, Kelton L, Keshavarzi A, Kessler DS, Khaw KS, Khechadoorian Z, Khomutov NV, Kiburg B, Kiburg M, Kim O, Kinnaird N, Kraegeloh E, Krylov VA, Kuchinskiy NA, Labe KR, LaBounty J, Lancaster M, Lee S, Li B, Li D, Li L, Logashenko I, Lorente Campos A, Lu Z, Lucà A, Lukicov G, Lusiani A, Lyon AL, MacCoy B, Madrak R, Makino K, Mastroianni S, Miller JP, Miozzi S, Mitra B, Morgan JP, Morse WM, Mott J, Nath A, Ng JK, Nguyen H, Oksuzian Y, Omarov Z, Osofsky R, Park S, Pauletta G, Piacentino GM, Pilato RN, Pitts KT, Plaster B, Počanić D, Pohlman N, Polly CC, Price J, Quinn B, Qureshi MUH, Ramachandran S, Ramberg E, Reimann R, Roberts BL, Rubin DL, Santi L, Schlesier C, Schreckenberger A, Semertzidis YK, Shemyakin D, Sorbara M, Stöckinger D, Stapleton J, Still D, Stoughton C, Stratakis D, Swanson HE, Sweetmore G, Sweigart DA, Syphers MJ, Tarazona DA, Teubner T, Tewsley-Booth AE, Tishchenko V, Tran NH, Turner W, Valetov E, Vasilkova D, Venanzoni G, Volnykh VP, Walton T, Weisskopf A, Welty-Rieger L, Winter P, Wu Y, Yu B, Yucel M, Zeng Y, Zhang C. Measurement of the Positive Muon Anomalous Magnetic Moment to 0.20 ppm. Phys Rev Lett 2023; 131:161802. [PMID: 37925710 DOI: 10.1103/physrevlett.131.161802] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Accepted: 09/05/2023] [Indexed: 11/07/2023]
Abstract
We present a new measurement of the positive muon magnetic anomaly, a_{μ}≡(g_{μ}-2)/2, from the Fermilab Muon g-2 Experiment using data collected in 2019 and 2020. We have analyzed more than 4 times the number of positrons from muon decay than in our previous result from 2018 data. The systematic error is reduced by more than a factor of 2 due to better running conditions, a more stable beam, and improved knowledge of the magnetic field weighted by the muon distribution, ω[over ˜]_{p}^{'}, and of the anomalous precession frequency corrected for beam dynamics effects, ω_{a}. From the ratio ω_{a}/ω[over ˜]_{p}^{'}, together with precisely determined external parameters, we determine a_{μ}=116 592 057(25)×10^{-11} (0.21 ppm). Combining this result with our previous result from the 2018 data, we obtain a_{μ}(FNAL)=116 592 055(24)×10^{-11} (0.20 ppm). The new experimental world average is a_{μ}(exp)=116 592 059(22)×10^{-11} (0.19 ppm), which represents a factor of 2 improvement in precision.
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Affiliation(s)
| | - T Albahri
- University of Liverpool, Liverpool, United Kingdom
| | - D Allspach
- Fermi National Accelerator Laboratory, Batavia, Illinois, USA
| | - A Anisenkov
- Budker Institute of Nuclear Physics, Novosibirsk, Russia
| | - K Badgley
- Fermi National Accelerator Laboratory, Batavia, Illinois, USA
| | - S Baeßler
- University of Virginia, Charlottesville, Virginia, USA
| | - I Bailey
- Lancaster University, Lancaster, United Kingdom
| | - L Bailey
- Department of Physics and Astronomy, University College London, London, United Kingdom
| | - V A Baranov
- Joint Institute for Nuclear Research, Dubna, Russia
| | - E Barlas-Yucel
- University of Illinois at Urbana-Champaign, Urbana, Illinois, USA
| | - T Barrett
- Cornell University, Ithaca, New York, USA
| | - E Barzi
- Fermi National Accelerator Laboratory, Batavia, Illinois, USA
| | | | - M Berz
- Michigan State University, East Lansing, Michigan, USA
| | - M Bhattacharya
- Fermi National Accelerator Laboratory, Batavia, Illinois, USA
| | - H P Binney
- University of Washington, Seattle, Washington, USA
| | - P Bloom
- North Central College, Naperville, Illinois, USA
| | - J Bono
- Fermi National Accelerator Laboratory, Batavia, Illinois, USA
| | - E Bottalico
- University of Liverpool, Liverpool, United Kingdom
| | - T Bowcock
- University of Liverpool, Liverpool, United Kingdom
| | - S Braun
- University of Washington, Seattle, Washington, USA
| | - M Bressler
- Department of Physics, University of Massachusetts, Amherst, Massachusetts, USA
| | | | - R M Carey
- Boston University, Boston, Massachusetts, USA
| | - B C K Casey
- Fermi National Accelerator Laboratory, Batavia, Illinois, USA
| | - D Cauz
- Università di Udine, Udine, Italy
| | | | | | - S Chappa
- Fermi National Accelerator Laboratory, Batavia, Illinois, USA
| | - S Charity
- University of Liverpool, Liverpool, United Kingdom
| | - C Chen
- School of Physics and Astronomy, Shanghai Jiao Tong University, Shanghai, China
- Tsung-Dao Lee Institute, Shanghai Jiao Tong University, Shanghai, China
| | - M Cheng
- University of Illinois at Urbana-Champaign, Urbana, Illinois, USA
| | - R Chislett
- Department of Physics and Astronomy, University College London, London, United Kingdom
| | - Z Chu
- School of Physics and Astronomy, Shanghai Jiao Tong University, Shanghai, China
| | - T E Chupp
- University of Michigan, Ann Arbor, Michigan, USA
| | - C Claessens
- University of Washington, Seattle, Washington, USA
| | - M E Convery
- Fermi National Accelerator Laboratory, Batavia, Illinois, USA
| | - S Corrodi
- Argonne National Laboratory, Lemont, Illinois, USA
| | | | - J D Crnkovic
- Fermi National Accelerator Laboratory, Batavia, Illinois, USA
| | - S Dabagov
- INFN, Laboratori Nazionali di Frascati, Frascati, Italy
| | - P T Debevec
- University of Illinois at Urbana-Champaign, Urbana, Illinois, USA
| | | | | | - B Drendel
- Fermi National Accelerator Laboratory, Batavia, Illinois, USA
| | | | - V N Duginov
- Joint Institute for Nuclear Research, Dubna, Russia
| | - M Eads
- Northern Illinois University, DeKalb, Illinois, USA
| | - A Edmonds
- Boston University, Boston, Massachusetts, USA
| | - J Esquivel
- Fermi National Accelerator Laboratory, Batavia, Illinois, USA
| | - M Farooq
- University of Michigan, Ann Arbor, Michigan, USA
| | - R Fatemi
- University of Kentucky, Lexington, Kentucky, USA
| | | | - M Fertl
- Institute of Physics and Cluster of Excellence PRISMA+, Johannes Gutenberg University Mainz, Mainz, Germany
| | - A T Fienberg
- University of Washington, Seattle, Washington, USA
| | | | - D Flay
- Department of Physics, University of Massachusetts, Amherst, Massachusetts, USA
| | - S B Foster
- Boston University, Boston, Massachusetts, USA
| | - H Friedsam
- Fermi National Accelerator Laboratory, Batavia, Illinois, USA
| | | | | | - I Gaines
- Fermi National Accelerator Laboratory, Batavia, Illinois, USA
| | | | - S Ganguly
- Fermi National Accelerator Laboratory, Batavia, Illinois, USA
| | - A Garcia
- University of Washington, Seattle, Washington, USA
| | - J George
- Department of Physics, University of Massachusetts, Amherst, Massachusetts, USA
| | | | - A Gioiosa
- Università del Molise, Campobasso, Italy
| | - K L Giovanetti
- Department of Physics and Astronomy, James Madison University, Harrisonburg, Virginia, USA
| | | | - W Gohn
- University of Kentucky, Lexington, Kentucky, USA
| | - L Goodenough
- Fermi National Accelerator Laboratory, Batavia, Illinois, USA
| | - T Gorringe
- University of Kentucky, Lexington, Kentucky, USA
| | - J Grange
- University of Michigan, Ann Arbor, Michigan, USA
| | - S Grant
- Argonne National Laboratory, Lemont, Illinois, USA
- Department of Physics and Astronomy, University College London, London, United Kingdom
| | - F Gray
- Regis University, Denver, Colorado, USA
| | - S Haciomeroglu
- Center for Axion and Precision Physics (CAPP)/Institute for Basic Science (IBS), Daejeon, Republic of Korea
| | | | - D Hampai
- INFN, Laboratori Nazionali di Frascati, Frascati, Italy
| | - F Han
- University of Kentucky, Lexington, Kentucky, USA
| | - J Hempstead
- University of Washington, Seattle, Washington, USA
| | - D W Hertzog
- University of Washington, Seattle, Washington, USA
| | - G Hesketh
- Department of Physics and Astronomy, University College London, London, United Kingdom
| | - E Hess
- INFN, Sezione di Pisa, Pisa, Italy
| | - A Hibbert
- University of Liverpool, Liverpool, United Kingdom
| | - Z Hodge
- University of Washington, Seattle, Washington, USA
| | - K W Hong
- University of Virginia, Charlottesville, Virginia, USA
| | - R Hong
- Argonne National Laboratory, Lemont, Illinois, USA
- University of Kentucky, Lexington, Kentucky, USA
| | - T Hu
- School of Physics and Astronomy, Shanghai Jiao Tong University, Shanghai, China
- Tsung-Dao Lee Institute, Shanghai Jiao Tong University, Shanghai, China
| | - Y Hu
- School of Physics and Astronomy, Shanghai Jiao Tong University, Shanghai, China
| | | | | | - P Kammel
- University of Washington, Seattle, Washington, USA
| | | | - M Karuza
- INFN, Sezione di Trieste, Trieste, Italy
| | - J Kaspar
- University of Washington, Seattle, Washington, USA
| | - D Kawall
- Department of Physics, University of Massachusetts, Amherst, Massachusetts, USA
| | - L Kelton
- University of Kentucky, Lexington, Kentucky, USA
| | - A Keshavarzi
- Department of Physics and Astronomy, University of Manchester, Manchester, United Kingdom
| | - D S Kessler
- Department of Physics, University of Massachusetts, Amherst, Massachusetts, USA
| | - K S Khaw
- School of Physics and Astronomy, Shanghai Jiao Tong University, Shanghai, China
- Tsung-Dao Lee Institute, Shanghai Jiao Tong University, Shanghai, China
| | | | - N V Khomutov
- Joint Institute for Nuclear Research, Dubna, Russia
| | - B Kiburg
- Fermi National Accelerator Laboratory, Batavia, Illinois, USA
| | - M Kiburg
- Fermi National Accelerator Laboratory, Batavia, Illinois, USA
- North Central College, Naperville, Illinois, USA
| | - O Kim
- University of Mississippi, University, Mississippi, USA
| | - N Kinnaird
- Boston University, Boston, Massachusetts, USA
| | - E Kraegeloh
- University of Michigan, Ann Arbor, Michigan, USA
| | - V A Krylov
- Joint Institute for Nuclear Research, Dubna, Russia
| | | | - K R Labe
- Cornell University, Ithaca, New York, USA
| | - J LaBounty
- University of Washington, Seattle, Washington, USA
| | - M Lancaster
- Department of Physics and Astronomy, University of Manchester, Manchester, United Kingdom
| | - S Lee
- Center for Axion and Precision Physics (CAPP)/Institute for Basic Science (IBS), Daejeon, Republic of Korea
| | - B Li
- Argonne National Laboratory, Lemont, Illinois, USA
- School of Physics and Astronomy, Shanghai Jiao Tong University, Shanghai, China
| | - D Li
- School of Physics and Astronomy, Shanghai Jiao Tong University, Shanghai, China
| | - L Li
- School of Physics and Astronomy, Shanghai Jiao Tong University, Shanghai, China
| | - I Logashenko
- Budker Institute of Nuclear Physics, Novosibirsk, Russia
| | | | - Z Lu
- School of Physics and Astronomy, Shanghai Jiao Tong University, Shanghai, China
| | - A Lucà
- Fermi National Accelerator Laboratory, Batavia, Illinois, USA
| | - G Lukicov
- Department of Physics and Astronomy, University College London, London, United Kingdom
| | | | - A L Lyon
- Fermi National Accelerator Laboratory, Batavia, Illinois, USA
| | - B MacCoy
- University of Washington, Seattle, Washington, USA
| | - R Madrak
- Fermi National Accelerator Laboratory, Batavia, Illinois, USA
| | - K Makino
- Michigan State University, East Lansing, Michigan, USA
| | | | - J P Miller
- Boston University, Boston, Massachusetts, USA
| | - S Miozzi
- INFN, Sezione di Roma Tor Vergata, Rome, Italy
| | - B Mitra
- University of Mississippi, University, Mississippi, USA
| | - J P Morgan
- Fermi National Accelerator Laboratory, Batavia, Illinois, USA
| | - W M Morse
- Brookhaven National Laboratory, Upton, New York, USA
| | - J Mott
- Boston University, Boston, Massachusetts, USA
- Fermi National Accelerator Laboratory, Batavia, Illinois, USA
| | - A Nath
- INFN, Sezione di Napoli, Naples, Italy
| | - J K Ng
- School of Physics and Astronomy, Shanghai Jiao Tong University, Shanghai, China
- Tsung-Dao Lee Institute, Shanghai Jiao Tong University, Shanghai, China
| | - H Nguyen
- Fermi National Accelerator Laboratory, Batavia, Illinois, USA
| | - Y Oksuzian
- Argonne National Laboratory, Lemont, Illinois, USA
| | - Z Omarov
- Center for Axion and Precision Physics (CAPP)/Institute for Basic Science (IBS), Daejeon, Republic of Korea
- Department of Physics, Korea Advanced Institute of Science and Technology (KAIST), Daejeon, Republic of Korea
| | - R Osofsky
- University of Washington, Seattle, Washington, USA
| | - S Park
- Center for Axion and Precision Physics (CAPP)/Institute for Basic Science (IBS), Daejeon, Republic of Korea
| | | | | | - R N Pilato
- University of Liverpool, Liverpool, United Kingdom
| | - K T Pitts
- University of Illinois at Urbana-Champaign, Urbana, Illinois, USA
| | - B Plaster
- University of Kentucky, Lexington, Kentucky, USA
| | - D Počanić
- University of Virginia, Charlottesville, Virginia, USA
| | - N Pohlman
- Northern Illinois University, DeKalb, Illinois, USA
| | - C C Polly
- Fermi National Accelerator Laboratory, Batavia, Illinois, USA
| | - J Price
- University of Liverpool, Liverpool, United Kingdom
| | - B Quinn
- University of Mississippi, University, Mississippi, USA
| | - M U H Qureshi
- Institute of Physics and Cluster of Excellence PRISMA+, Johannes Gutenberg University Mainz, Mainz, Germany
| | | | - E Ramberg
- Fermi National Accelerator Laboratory, Batavia, Illinois, USA
| | - R Reimann
- Institute of Physics and Cluster of Excellence PRISMA+, Johannes Gutenberg University Mainz, Mainz, Germany
| | - B L Roberts
- Boston University, Boston, Massachusetts, USA
| | - D L Rubin
- Cornell University, Ithaca, New York, USA
| | - L Santi
- Università di Udine, Udine, Italy
| | - C Schlesier
- University of Illinois at Urbana-Champaign, Urbana, Illinois, USA
| | | | - Y K Semertzidis
- Center for Axion and Precision Physics (CAPP)/Institute for Basic Science (IBS), Daejeon, Republic of Korea
- Department of Physics, Korea Advanced Institute of Science and Technology (KAIST), Daejeon, Republic of Korea
| | - D Shemyakin
- Budker Institute of Nuclear Physics, Novosibirsk, Russia
| | - M Sorbara
- INFN, Sezione di Roma Tor Vergata, Rome, Italy
| | - D Stöckinger
- Institut für Kern- und Teilchenphysik, Technische Universität Dresden, Dresden, Germany
| | - J Stapleton
- Fermi National Accelerator Laboratory, Batavia, Illinois, USA
| | - D Still
- Fermi National Accelerator Laboratory, Batavia, Illinois, USA
| | - C Stoughton
- Fermi National Accelerator Laboratory, Batavia, Illinois, USA
| | - D Stratakis
- Fermi National Accelerator Laboratory, Batavia, Illinois, USA
| | - H E Swanson
- University of Washington, Seattle, Washington, USA
| | - G Sweetmore
- Department of Physics and Astronomy, University of Manchester, Manchester, United Kingdom
| | | | - M J Syphers
- Northern Illinois University, DeKalb, Illinois, USA
| | - D A Tarazona
- Cornell University, Ithaca, New York, USA
- Michigan State University, East Lansing, Michigan, USA
- University of Liverpool, Liverpool, United Kingdom
| | - T Teubner
- University of Liverpool, Liverpool, United Kingdom
| | - A E Tewsley-Booth
- University of Kentucky, Lexington, Kentucky, USA
- University of Michigan, Ann Arbor, Michigan, USA
| | - V Tishchenko
- Brookhaven National Laboratory, Upton, New York, USA
| | - N H Tran
- Boston University, Boston, Massachusetts, USA
| | - W Turner
- University of Liverpool, Liverpool, United Kingdom
| | - E Valetov
- Michigan State University, East Lansing, Michigan, USA
| | - D Vasilkova
- Department of Physics and Astronomy, University College London, London, United Kingdom
- University of Liverpool, Liverpool, United Kingdom
| | - G Venanzoni
- University of Liverpool, Liverpool, United Kingdom
| | - V P Volnykh
- Joint Institute for Nuclear Research, Dubna, Russia
| | - T Walton
- Fermi National Accelerator Laboratory, Batavia, Illinois, USA
| | - A Weisskopf
- Michigan State University, East Lansing, Michigan, USA
| | - L Welty-Rieger
- Fermi National Accelerator Laboratory, Batavia, Illinois, USA
| | - P Winter
- Argonne National Laboratory, Lemont, Illinois, USA
| | - Y Wu
- Argonne National Laboratory, Lemont, Illinois, USA
| | - B Yu
- University of Mississippi, University, Mississippi, USA
| | - M Yucel
- Fermi National Accelerator Laboratory, Batavia, Illinois, USA
| | - Y Zeng
- School of Physics and Astronomy, Shanghai Jiao Tong University, Shanghai, China
- Tsung-Dao Lee Institute, Shanghai Jiao Tong University, Shanghai, China
| | - C Zhang
- University of Liverpool, Liverpool, United Kingdom
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Lip A, Pateman M, Fullerton MM, Chen HM, Bailey L, Houle S, Davidson S, Constantinescu C. Vaccine hesitancy educational tools for healthcare providers and trainees: A scoping review. Vaccine 2023; 41:23-35. [PMID: 36437208 PMCID: PMC9688224 DOI: 10.1016/j.vaccine.2022.09.093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Revised: 09/27/2022] [Accepted: 09/29/2022] [Indexed: 11/27/2022]
Abstract
In the era of vaccine hesitancy, highlighted by the current SARS-CoV2 pandemic, there is an acute need to develop an approach to reduce and address apprehension towards vaccinations. We sought to map and present an overview of existing educational interventions for healthcare providers (HCPs) on strategies to engage in effective vaccine discussion. We applied the Joanna Briggs Institute methodology framework in this scoping review. We searched five relevant databases (MEDLINE, CINAHL, EMBASE, PsycInfo, and SCOPUS) and grey literature through the Google search engine using keywords and subject headings that were systematically identified. We identified 3384 citations in peer-reviewed literature and 41 citations in grey literature. After screening for our inclusion criteria, we included 28 citations from peer reviewed literature and 16 citations from grey literature for analysis. We identified a total of 41 unique education interventions. Interventions were available from multiple disciplines, training levels, clinical settings, and diseases/vaccines. Interventions predominantly centered around two foci: knowledge sharing and communication training. Most interventions identified from peer-reviewed literature were facilitated and were applied with multiple modes of delivery. Interventions from grey literature were more topical and generally self-directed. We identified several gaps in knowledge. Firstly, accessibility and generalizability of interventions was limited. Secondly, distribution of interventions did not adequately address nursing and pharmacy disciplines, and did not cover the breadth of medical specialties for whom vaccine discussions apply. Thirdly, no interventions addressed self monitoring and the clinicians' recognition and management of emotions during difficult conversations. There is a need to address this gap and provide available, credible and comprehensive educational interventions that will support our healthcare providers in effective communication with vaccine hesitant patients.
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Affiliation(s)
- A Lip
- Division of Respirology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada.
| | - M Pateman
- Faculty of Nursing, University of Calgary, Calgary, Alberta, Canada; 19 to Zero Inc., Rocky Mountain House, Alberta, Canada
| | - M M Fullerton
- Faculty of Nursing, University of Calgary, Calgary, Alberta, Canada; 19 to Zero Inc., Rocky Mountain House, Alberta, Canada
| | - H M Chen
- 19 to Zero Inc., Rocky Mountain House, Alberta, Canada
| | - L Bailey
- School of Nursing, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada
| | - S Houle
- School of Pharmacy, Faculty of Science, University of Waterloo, Waterloo, Ontario, Canada
| | - S Davidson
- Faculty of Nursing, University of Calgary, Calgary, Alberta, Canada
| | - C Constantinescu
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada; Pediatric Infectious Diseases, Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
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Bhat S, Arsenault T, Baydoun A, Bailey L, Amini A, George B, Nam K, Saieed G, Zeidane RA, Heo JU, Muzic R, Biswas T, Podder T. Synthetic FDG-Positron Emission Tomography Images for Patients with Non-Small Cell Lung Cancer: A Deep Learning-Based Approach Using Computed Tomography Images. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.953] [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: 10/31/2022]
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Buch M, Buckley P, Bularga A, Bullmore E, Burden L, Burdett T, Burn D, Burns G, Burns A, Busby J, Butcher R, Butt A, Byrne S, Cairns P, Calder PC, Calvelo E, Carborn H, Card B, Carr C, Carr L, Carson G, Carter P, Casey A, Cassar M, Cavanagh J, Chablani M, Chambers RC, Chan F, Channon KM, Chapman K, Charalambou A, Chaudhuri N, Checkley A, Chen J, Cheng Y, Chetham L, Childs C, Chilvers ER, Chinoy H, Chiribiri A, Chong-James K, Choudhury N, Chowienczyk P, Christie C, Chrystal M, Clark D, Clark C, Clarke J, Clohisey S, Coakley G, Coburn Z, Coetzee S, Cole J, Coleman C, Conneh F, Connell D, Connolly B, Connor L, Cook A, Cooper B, Cooper J, Cooper S, Copeland D, Cosier T, Coulding M, Coupland C, Cox E, Craig T, Crisp P, Cristiano D, Crooks MG, Cross A, Cruz I, Cullinan P, Cuthbertson D, Daines L, Dalton M, Daly P, Daniels A, Dark P, Dasgin J, David A, David C, Davies E, Davies F, Davies G, Davies GA, Davies K, Dawson J, Daynes E, Deakin B, Deans A, Deas C, Deery J, Defres S, Dell A, Dempsey 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Jastrub R, Jayaraman B, Jezzard P, Jiwa K, Johnson C, Johnson S, Johnston D, Jolley CJ, Jones D, Jones G, Jones H, Jones H, Jones I, Jones L, Jones S, Jose S, Kabir T, Kaltsakas G, Kamwa V, Kanellakis N, Kaprowska S, Kausar Z, Keenan N, Kelly S, Kemp G, Kerslake H, Key AL, Khan F, Khunti K, Kilroy S, King B, King C, Kingham L, Kirk J, Kitterick P, Klenerman P, Knibbs L, Knight S, Knighton A, Kon O, Kon S, Kon SS, Koprowska S, Korszun A, Koychev I, Kurasz C, Kurupati P, Laing C, Lamlum H, Landers G, Langenberg C, Lasserson D, Lavelle-Langham L, Lawrie A, Lawson C, Lawson C, Layton A, Lea A, Lee D, Lee JH, Lee E, Leitch K, Lenagh R, Lewis D, Lewis J, Lewis V, Lewis-Burke N, Li X, Light T, Lightstone L, Lilaonitkul W, Lim L, Linford S, Lingford-Hughes A, Lipman M, Liyanage K, Lloyd A, Logan S, Lomas D, Loosley R, Lota H, Lovegrove W, Lucey A, Lukaschuk E, Lye A, Lynch C, MacDonald S, MacGowan G, Macharia I, Mackie J, Macliver L, Madathil S, Madzamba G, Magee N, Magtoto MM, Mairs N, Majeed N, Major E, Malein F, Malim M, Mallison G, Mandal S, Mangion K, Manisty C, Manley R, March K, Marciniak S, Marino P, Mariveles M, Marouzet E, Marsh S, Marshall B, Marshall M, Martin J, Martineau A, Martinez LM, Maskell N, Matila D, Matimba-Mupaya W, Matthews L, Mbuyisa A, McAdoo S, Weir McCall J, McAllister-Williams H, McArdle A, McArdle P, McAulay D, McCormick J, McCormick W, McCourt P, McGarvey L, McGee C, Mcgee K, McGinness J, McGlynn K, McGovern A, McGuinness H, McInnes IB, McIntosh J, McIvor E, McIvor K, McLeavey L, McMahon A, McMahon MJ, McMorrow L, Mcnally T, McNarry M, McNeill J, McQueen A, McShane H, Mears C, Megson C, Megson S, Mehta P, Meiring J, Melling L, Mencias M, Menzies D, Merida Morillas M, Michael A, Milligan L, Miller C, Mills C, Mills NL, Milner L, Misra S, Mitchell J, Mohamed A, Mohamed N, Mohammed S, Molyneaux PL, Monteiro W, Moriera S, Morley A, Morrison L, Morriss R, Morrow A, Moss AJ, Moss P, Motohashi K, Msimanga N, Mukaetova-Ladinska E, Munawar U, Murira J, 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Qureshi H, Qureshi IN, Radhakrishnan K, Ralser M, Ramos A, Ramos H, Rangeley J, Rangelov B, Ratcliffe L, Ravencroft P, Reddington A, Reddy R, Redfearn H, Redwood D, Reed A, Rees M, Rees T, Regan K, Reynolds W, Ribeiro C, Richards A, Richardson E, Rivera-Ortega P, Roberts K, Robertson E, Robinson E, Robinson L, Roche L, Roddis C, Rodger J, Ross A, Ross G, Rossdale J, Rostron A, Rowe A, Rowland A, Rowland J, Roy K, Roy M, Rudan I, Russell R, Russell E, Saalmink G, Sabit R, Sage EK, Samakomva T, Samani N, Sampson C, Samuel K, Samuel R, Sanderson A, Sapey E, Saralaya D, Sargant J, Sarginson C, Sass T, Sattar N, Saunders K, Saunders P, Saunders LC, Savill H, Saxon W, Sayer A, Schronce J, Schwaeble W, Scott K, Selby N, Sewell TA, Shah K, Shah P, Shankar-Hari M, Sharma M, Sharpe C, Sharpe M, Shashaa S, Shaw A, Shaw K, Shaw V, Shelton S, Shenton L, Shevket K, Short J, Siddique S, Siddiqui S, Sidebottom J, Sigfrid L, Simons G, Simpson J, Simpson N, Singh C, Singh S, Sissons D, Skeemer J, Slack K, Smith A, Smith D, Smith S, Smith J, Smith L, Soares M, Solano TS, Solly R, Solstice AR, Soulsby T, Southern D, Sowter D, Spears M, Spencer LG, Speranza F, Stadon L, Stanel S, Steele N, Steiner M, Stensel D, Stephens G, Stephenson L, Stern M, Stewart I, Stimpson R, Stockdale S, Stockley J, Stoker W, Stone R, Storrar W, Storrie A, Storton K, Stringer E, Strong-Sheldrake S, Stroud N, Subbe C, Sudlow CL, Suleiman Z, Summers C, Summersgill C, Sutherland D, Sykes DL, Sykes R, Talbot N, Tan AL, Tarusan L, Tavoukjian V, Taylor A, Taylor C, Taylor J, Te A, Tedd H, Tee CJ, Teixeira J, Tench H, Terry S, Thackray-Nocera S, Thaivalappil F, Thamu B, Thickett D, Thomas C, Thomas S, Thomas AK, Thomas-Woods T, Thompson T, Thompson AAR, Thornton T, Tilley J, Tinker N, Tiongson GF, Tobin M, Tomlinson J, Tong C, Touyz R, Tripp KA, Tunnicliffe E, Turnbull A, Turner E, Turner S, Turner V, Turner K, Turney S, Turtle L, Turton H, Ugoji J, Ugwuoke R, Upthegrove R, Valabhji J, Ventura M, Vere J, Vickers C, Vinson B, Wade E, Wade P, Wainwright T, Wajero LO, Walder S, Walker S, Walker S, Wall E, Wallis T, Walmsley S, Walsh JA, Walsh S, Warburton L, Ward TJC, Warwick K, Wassall H, Waterson S, Watson E, Watson L, Watson J, Welch C, Welch H, Welsh B, Wessely S, West S, Weston H, Wheeler H, White S, Whitehead V, Whitney J, Whittaker S, Whittam B, Whitworth V, Wight A, Wild J, Wilkins M, Wilkinson D, Williams N, Williams N, Williams J, Williams-Howard SA, Willicombe M, Willis G, Willoughby J, Wilson A, Wilson D, Wilson I, Window N, Witham M, Wolf-Roberts R, Wood C, Woodhead F, Woods J, Wormleighton J, Worsley J, Wraith D, Wrey Brown C, Wright C, Wright L, Wright S, Wyles J, Wynter I, Xu M, Yasmin N, Yasmin S, Yates T, Yip KP, Young B, Young S, Young A, Yousuf AJ, Zawia A, Zeidan L, Zhao B, Zongo O. Clinical characteristics with inflammation profiling of long COVID and association with 1-year recovery following hospitalisation in the UK: a prospective observational study. Lancet Respir Med 2022; 10:761-775. [PMID: 35472304 PMCID: PMC9034855 DOI: 10.1016/s2213-2600(22)00127-8] [Citation(s) in RCA: 144] [Impact Index Per Article: 72.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 03/23/2022] [Accepted: 03/31/2022] [Indexed: 11/25/2022]
Abstract
BACKGROUND No effective pharmacological or non-pharmacological interventions exist for patients with long COVID. We aimed to describe recovery 1 year after hospital discharge for COVID-19, identify factors associated with patient-perceived recovery, and identify potential therapeutic targets by describing the underlying inflammatory profiles of the previously described recovery clusters at 5 months after hospital discharge. METHODS The Post-hospitalisation COVID-19 study (PHOSP-COVID) is a prospective, longitudinal cohort study recruiting adults (aged ≥18 years) discharged from hospital with COVID-19 across the UK. Recovery was assessed using patient-reported outcome measures, physical performance, and organ function at 5 months and 1 year after hospital discharge, and stratified by both patient-perceived recovery and recovery cluster. Hierarchical logistic regression modelling was performed for patient-perceived recovery at 1 year. Cluster analysis was done using the clustering large applications k-medoids approach using clinical outcomes at 5 months. Inflammatory protein profiling was analysed from plasma at the 5-month visit. This study is registered on the ISRCTN Registry, ISRCTN10980107, and recruitment is ongoing. FINDINGS 2320 participants discharged from hospital between March 7, 2020, and April 18, 2021, were assessed at 5 months after discharge and 807 (32·7%) participants completed both the 5-month and 1-year visits. 279 (35·6%) of these 807 patients were women and 505 (64·4%) were men, with a mean age of 58·7 (SD 12·5) years, and 224 (27·8%) had received invasive mechanical ventilation (WHO class 7-9). The proportion of patients reporting full recovery was unchanged between 5 months (501 [25·5%] of 1965) and 1 year (232 [28·9%] of 804). Factors associated with being less likely to report full recovery at 1 year were female sex (odds ratio 0·68 [95% CI 0·46-0·99]), obesity (0·50 [0·34-0·74]) and invasive mechanical ventilation (0·42 [0·23-0·76]). Cluster analysis (n=1636) corroborated the previously reported four clusters: very severe, severe, moderate with cognitive impairment, and mild, relating to the severity of physical health, mental health, and cognitive impairment at 5 months. We found increased inflammatory mediators of tissue damage and repair in both the very severe and the moderate with cognitive impairment clusters compared with the mild cluster, including IL-6 concentration, which was increased in both comparisons (n=626 participants). We found a substantial deficit in median EQ-5D-5L utility index from before COVID-19 (retrospective assessment; 0·88 [IQR 0·74-1·00]), at 5 months (0·74 [0·64-0·88]) to 1 year (0·75 [0·62-0·88]), with minimal improvements across all outcome measures at 1 year after discharge in the whole cohort and within each of the four clusters. INTERPRETATION The sequelae of a hospital admission with COVID-19 were substantial 1 year after discharge across a range of health domains, with the minority in our cohort feeling fully recovered. Patient-perceived health-related quality of life was reduced at 1 year compared with before hospital admission. Systematic inflammation and obesity are potential treatable traits that warrant further investigation in clinical trials. FUNDING UK Research and Innovation and National Institute for Health Research.
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Byrnes C, Botello-Harbaum M, Clemons T, Bailey L, Valdes K, Coleman-Cowger V. Process and strategies for patient engagement and outreach in the Sickle Cell Disease (SCD) community to promote clinical trial participation. J Natl Med Assoc 2022; 114:211-217. [PMID: 35093266 PMCID: PMC9058174 DOI: 10.1016/j.jnma.2022.01.003] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 12/29/2021] [Accepted: 01/10/2022] [Indexed: 10/19/2022]
Abstract
INTRODUCTION Sickle cell disease (SCD) is the most common inherited blood disorder in the United States. The Cure Sickle Cell Initiative (CureSCi) was created by the National Heart, Lung and Blood Institute (NHLBI) to improve the lives of people with SCD by accelerating the advancement of safe and promising genetic therapies, engaging the SCD community and healthcare providers, and encouraging collaboration among stakeholders. CureSCi is a collaborative, patient-focused research effort that includes patients at every level of the Initiative. Patient engagement is a key component, particularly during the development of clinical trials. OBJECTIVE To describe the processes and strategies utilized by the CureSCi to engage individuals living with SCD about genetic therapy clinical trials. METHODS The CureSCi Patient Engagement team conducted nine Community Outreach visits in 2019, each of which was structured to include separate group interviews with patients and medical providers. A set of guidance questions was developed for each audience and the interviews lasted approximately 60 minutes. RESULTS Patients were asked about their participation in a clinical trial, and approximately 50% had participated in a trial. SCD individuals reported trusting their medical provider to provide them with information relevant to trials. Medical providers emphasized the individual, family, and health aspects of SCD that warrant additional investigation. Providers reported barriers encountered by patients as transportation, childcare support, infertility, and trust in the healthcare system. CONCLUSION Lessons learned from the community have helped to influence recommendations for clinical trial design and key messaging development for the Cure Sickle Cell Initiative.
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Bailey L, Ward M, DiCosimo A, Lavan A, Briggs R. 166 HEALTH TRAJECTORIES OF FRAIL, OLDER PEOPLE WHILE COCOONING DURING THE COVID-19 PANDEMIC. Age Ageing 2021. [DOI: 10.1093/ageing/afab219.166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2023] Open
Abstract
Abstract
Background
Cocooning, i.e. staying at home and reducing interaction with others, was a key part of the strategy to protect older people during the COVID-19 pandemic.
Unfortunately, there are concerns this has had a negative impact on the physical and mental wellbeing of those who have been isolated.
Methods
We completed a survey of 150 patients (55% female, mean age 79.8 years, average Clinical Frailty Scale 4.8) attending ambulatory medical services in a large university hospital.
Questions were focused on: access to healthcare services, mental health, physical health, and attitudes to COVID-19 restrictions.
Results
Almost 40% reported that their mental health was ‘worse’ or ‘much worse’ while cocooning, while over 40% reported a decline in their physical health.
Over 57% had a scheduled healthcare-related visit cancelled while cocooning, most frequently hospital outpatient appointments.
Worryingly, almost 1/6 reported not seeking medical attention for an illness that they would usually. Of these, half did not as they were worried about catching COVID and 46% did not as this service was not currently available to them.
Conclusion
The COVID-19 pandemic and lack of access to essential services, both medical and social, has had a devastating impact on older people.
This is evident in both the acute presentations to hospital and the longer-term impact it has had on health and function.
It is important that in the future clear policies are in place to enable older people to access care when they need it.
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Affiliation(s)
- L Bailey
- Mercer's Institute for Successful Ageing, St James's Hospital , Dublin, Ireland
| | - M Ward
- Mercer's Institute for Successful Ageing, St James's Hospital , Dublin, Ireland
| | - A DiCosimo
- Mercer's Institute for Successful Ageing, St James's Hospital , Dublin, Ireland
| | - A Lavan
- Mercer's Institute for Successful Ageing, St James's Hospital , Dublin, Ireland
| | - R Briggs
- Mercer's Institute for Successful Ageing, St James's Hospital , Dublin, Ireland
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Bailey L, Ward M, DiCosimo A, Baunta S, Cunningham C, Romero-Ortuno R, Kenny RA, Purcell R, Lannon R, McCarroll K, Nee R, Robinson D, Lavan A, Briggs R. Physical and mental health of older people while cocooning during the COVID-19 pandemic. QJM 2021; 114:648-653. [PMID: 33471128 PMCID: PMC7928635 DOI: 10.1093/qjmed/hcab015] [Citation(s) in RCA: 77] [Impact Index Per Article: 25.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Revised: 01/07/2021] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Cocooning or shielding, i.e. staying at home and reducing face-to-face interaction with other people, was an important part of the response to the COVID-19 pandemic for older people. However, concerns exist regarding the long-term adverse effects cocooning may have on their physical and mental health. AIM To examine health trajectories and healthcare utilization while cocooning in a cohort of community-dwelling people aged ≥70 years. DESIGN Survey of 150 patients (55% female, mean age 80 years and mean Clinical Frailty Scale Score 4.8) attending ambulatory medical services in a large urban university hospital. METHODS The survey covered four broad themes: access to healthcare services, mental health, physical health and attitudes to COVID-19 restrictions. Survey data were presented descriptively. RESULTS Almost 40% (59/150) reported that their mental health was 'worse' or 'much worse' while cocooning, while over 40% (63/150) reported a decline in their physical health. Almost 70% (104/150) reported exercising less frequently or not exercising at all. Over 57% (86/150) of participants reported loneliness with 1 in 8 (19/150) reporting that they were lonely 'very often'. Half of participants (75/150) reported a decline in their quality of life. Over 60% (91/150) agreed with government advice for those ≥70 years but over 40% (61/150) reported that they disliked the term 'cocooning'. CONCLUSIONS Given the likelihood of further restrictions in coming months, clear policies and advice for older people around strategies to maintain social engagement, manage loneliness and continue physical activity and access timely medical care and rehabilitation services should be a priority.
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Affiliation(s)
- L Bailey
- From the Mercer’s Institute for Successful Ageing, St James’s Hospital, Dublin 1, Ireland
| | - M Ward
- The Irish Longitudinal Study on Ageing, Trinity College, Dublin 1, Ireland
| | - A DiCosimo
- Department of Medical Gerontology, School of Medicine, Trinity College Dublin, Dublin 1, Ireland
| | - S Baunta
- From the Mercer’s Institute for Successful Ageing, St James’s Hospital, Dublin 1, Ireland
| | - C Cunningham
- From the Mercer’s Institute for Successful Ageing, St James’s Hospital, Dublin 1, Ireland
- Department of Medical Gerontology, School of Medicine, Trinity College Dublin, Dublin 1, Ireland
| | - R Romero-Ortuno
- From the Mercer’s Institute for Successful Ageing, St James’s Hospital, Dublin 1, Ireland
- The Irish Longitudinal Study on Ageing, Trinity College, Dublin 1, Ireland
- Department of Medical Gerontology, School of Medicine, Trinity College Dublin, Dublin 1, Ireland
| | - R A Kenny
- From the Mercer’s Institute for Successful Ageing, St James’s Hospital, Dublin 1, Ireland
- The Irish Longitudinal Study on Ageing, Trinity College, Dublin 1, Ireland
- Department of Medical Gerontology, School of Medicine, Trinity College Dublin, Dublin 1, Ireland
| | - R Purcell
- From the Mercer’s Institute for Successful Ageing, St James’s Hospital, Dublin 1, Ireland
- Department of Medical Gerontology, School of Medicine, Trinity College Dublin, Dublin 1, Ireland
| | - R Lannon
- From the Mercer’s Institute for Successful Ageing, St James’s Hospital, Dublin 1, Ireland
- Department of Medical Gerontology, School of Medicine, Trinity College Dublin, Dublin 1, Ireland
| | - K McCarroll
- From the Mercer’s Institute for Successful Ageing, St James’s Hospital, Dublin 1, Ireland
- Department of Medical Gerontology, School of Medicine, Trinity College Dublin, Dublin 1, Ireland
| | - R Nee
- From the Mercer’s Institute for Successful Ageing, St James’s Hospital, Dublin 1, Ireland
- Department of Medical Gerontology, School of Medicine, Trinity College Dublin, Dublin 1, Ireland
| | - D Robinson
- From the Mercer’s Institute for Successful Ageing, St James’s Hospital, Dublin 1, Ireland
- Department of Medical Gerontology, School of Medicine, Trinity College Dublin, Dublin 1, Ireland
| | - A Lavan
- From the Mercer’s Institute for Successful Ageing, St James’s Hospital, Dublin 1, Ireland
- Department of Medical Gerontology, School of Medicine, Trinity College Dublin, Dublin 1, Ireland
| | - R Briggs
- From the Mercer’s Institute for Successful Ageing, St James’s Hospital, Dublin 1, Ireland
- The Irish Longitudinal Study on Ageing, Trinity College, Dublin 1, Ireland
- Department of Medical Gerontology, School of Medicine, Trinity College Dublin, Dublin 1, Ireland
- Address correspondence to Dr R. Briggs, The Irish Longitudinal Study on Ageing (TILDA), Mercer’s Institute for Successful Ageing, St James’s Hospital, Dublin 8, Ireland.
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Wong E, Molina-Cruz R, Rose C, Bailey L, Kauwell GPA, Rosenthal J. Prevalence and Disparities in Folate and Vitamin B12 Deficiency Among Preschool Children in Guatemala. Matern Child Health J 2021; 26:156-167. [PMID: 34637065 DOI: 10.1007/s10995-021-03257-6] [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] [Accepted: 09/30/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND AND OBJECTIVE Folate and vitamin B12 deficiencies can impair proper growth and brain development in children. Data on the folate and vitamin B12 status of children aged 6-59 months in Guatemala are scarce. Identification of factors associated with higher prevalence of these micronutrient deficiencies within the population is needed for national and regional policymakers. OBJECTIVE To describe national and regional post-fortification folate and vitamin B12 status of children aged 6-59 months in Guatemala. METHODS A multistage, cluster probability study was carried out with national and regional representation of children aged 6-59 months. Demographic and health information was collected for 1246 preschool children, but blood samples for red blood cell (RBC) folate and vitamin B12 were collected and analyzed for 1,245 and 1143 preschool children, respectively. We used the following deficiency criteria as cutoff points for the analyses: < 305 nmol/L for RBC folate, < 148 pmol/L for vitamin B12 deficiency, and 148-221 pmol/L for marginal vitamin B12 deficiency. Prevalence of RBC folate deficiency and vitamin B12 deficiency and marginal deficiency were estimated. Prevalence risk ratios of RBC folate and vitamin B12 deficiency were estimated comparing subpopulations of interest. RESULTS The national prevalence estimates of RBC folate deficiency among children was 33.5% [95% CI 29.1, 38.3]. The prevalence of RBC folate deficiency showed wide variation by age (20.3-46.6%) and was significantly higher among children 6-11 months and 12-23 months (46.6 and 37.0%, respectively), compared to older children aged 48-59 months (20.3%). RBC folate deficiency also varied widely by household wealth index (22.6-42.0%) and geographic region (27.2-46.7%) though the differences were not statistically significant. The national geometric mean for RBC folate concentrations was 354.2 nmol/L. The national prevalences of vitamin B12 deficiency and marginal deficiency among children were 22.5% [95% CI 18.2, 27.5] and 27.5% [95% CI 23.7, 31.7], respectively. The prevalence of vitamin B12 deficiency was significantly higher among indigenous children than among non-indigenous children (34.5% vs. 13.1%, aPRR 2.1 95% CI 1.4, 3.0). The prevalence of vitamin B12 deficiency also significantly varied between the highest and lowest household wealth index (34.3 and 6.0%, respectively). The national geometric mean for vitamin B12 concentrations was 235.1 pmol/L. The geometric means of folate and B12 concentrations were significantly lower among children who were younger, had a lower household wealth index, and were indigenous (for vitamin B12 only). Folate and vitamin B12 concentrations showed wide variation by region (not statistically significant), and the Petén and Norte regions showed the lowest RBC folate and vitamin B12 concentrations, respectively. CONCLUSIONS In this study, a third of all children had RBC folate deficiency and half were vitamin B12 deficient. Folate deficiency was more common in younger children and vitamin B12 deficiency was more common in indigenous children and those from the poorest families. These findings suggest gaps in the coverage of fortification and the need for additional implementation strategies to address these gaps in coverage to help safeguard the health of Guatemalan children.
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Affiliation(s)
- E Wong
- Department of Epidemiology, Gillings School of Public Health, The University of North Carolina, Chapel Hill, NC, USA
| | | | - C Rose
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, MS-Chamblee 106-3, Atlanta, GA, USA
| | - L Bailey
- Department of Nutritional Sciences, College of Family & Consumer Sciences, University of Georgia, Athens, GA, USA
| | - G P A Kauwell
- Department of Health Sciences, University of Central Florida, Orlando, FL, USA
| | - J Rosenthal
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, MS-Chamblee 106-3, Atlanta, GA, USA.
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Bailey L, Brewer L, Carroll J, Seebah S. 137 Specialist Medication Review as Part of the Comprehensive Geriatric Assessment in the Day Hospital Setting. Age Ageing 2021. [DOI: 10.1093/ageing/afab030.98] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
Medication use in older people is complex. Consequently, regular medication reviews as an integral part of healthcare provision for older people are necessary. Patients attending consultant-led, multidisciplinary, day hospital clinics have specialist medication reviews undertaken by our senior clinical pharmacist. “Pharmacy Interventions” (PIs) are suggested and typed prior to physician-led patient review.
Method
Data collected by our senior clinical pharmacist were reviewed including patient demographics, clinical characteristics, types of prescribed drugs and PIs. Clinical severity of PIs was assessed using the NCC MERP Medication error index and American Journal Health-Syst Pharm Medication error index. Scores, ranging in clinical severity from A-I (A = capacity to cause error, I = may have contributed to death) and 0–10 (0 = no potential effect, 10 = death) were assigned by the pharmacist and two physicians.
Results
100 patients were included, mean age 82y (range 65-99y). 62% were female and 63% were first time attenders. Mean number of regularly prescribed medications was 7.2 (range 1–16), 10% reported compliance issues. The most commonly prescribed drugs belonged to the “Alimentary tract and metabolism” class (24%), including PPIs, laxatives and blood-glucose lowering medications. 16% and 15% were on regularly prescribed neuroactive and psychoactive medications, respectively. Of suggested PIs, 46% were acted upon during physician review, a further 4% were acknowledged in clinical notes. PIs covered many prescribing issues including drug–drug interactions, incorrect dosing, drug monitoring and administration timing. The average PI scores assigned by the pharmacist, physicians 1 and 2 differed, at 6.4, 3.2 and 4.8, respectively.
Conclusion
PIs suggested at senior pharmacy level are an important component of the comprehensive geriatric assessment, highlighting multiple complex prescribing issues. Clinical severity of PIs was scored lower by physicians, perhaps indicating an underestimation of prescribing errors. Senior pharmacy involvement in the care of frail older outpatients is an invaluable resource.
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Affiliation(s)
- L Bailey
- Beaumont Hospital, Department of Geriatrics
| | - L Brewer
- Beaumont Hospital, Department of Geriatrics
| | - J Carroll
- Beaumont Hospital, Department of Geriatrics
| | - S Seebah
- Beaumont Hospital, Department of Geriatrics
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Melville A, MD Yusof MY, Fitton J, Bailey L, Emery P, Buch MH, Dass S, Saleem B. THU0175 REAL-WORLD EXPERIENCE OF SWITCHING FROM ORIGINATOR TO BIOSIMILAR RITUXIMAB IN RHEUMATOID ARTHRITIS. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.4534] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/17/2023]
Abstract
Background:Pre-clinical and trial data confirm biosimilar rituximab (RTX-B) has equivalent physicochemical properties, function, efficacy and safety as originator (RTX-O)1,2. However, real-world data are lacking, including non-medical switch to RTX-B in patients established on RTX-O. Loss of response (LOR) has been observed following open-label switch to other biosimilars3, and it is unclear how patients who develop LOR after switching should be managed.Objectives:To describe our real-world experience of non-medical switch from RTX-O to RTX-B in RA and explore treatment strategies for patients developing LOR to RTX-B (switch back to RTX-O versus other b/tsDMARDs).Methods:We conducted a retrospective observational study of RTX-treated RA patients in Leeds from May 2002–Jan 2020. From Oct 2017, all patients on RTX-O were switched to RTX-B unless specified by treating clinician or informed consent not obtained. Demographic and clinical data were collected from electronic health records. Effectiveness was assessed by DAS28-CRP and RTX retention (using Kaplan-Meier method). Changes in treatment were based on clinician judgment.Results:944 patients with RA received ≥1 cycle of RTX in Leeds over the past 17 years. Of these, 358 required RTX re-treatment during the study period (Oct 2017–Jan 2020); 263 (73.5%) switched to RTX-B, whilst 95 (26.5%) remained on RTX-O (medical reason=46.3%; patient decision=53.7%). 256/263 patients on RTX-B with 4-month data were analysed. 201/256 (78.5%) were female, mean (SD) age 63.1 (12.4), 97.7% seropositive, 81.6% on csDMARD (62.9% methotrexate), 14.8% oral steroid, 58.6% had previous bDMARDs, and mean (SD) RTX-O cycles pre-switch was 6 (3.6). Total follow-up was 378 patient-years. Mean (SD) DAS28-CRP was 3.01 (1.17) 4 months post-last cycle RTX-O and 3.32 (1.31) post-switch to RTX-B (mean diff +0.30, 95% CI 0.004-0.60; p=0.047), with increase in VAS (+5.7, 95% CI 0.09-11.37; p=0.047), but not SJC, TJC or CRP. At last follow-up, 185/256 (72.3%) patients remained on RTX-B [median (range) RTX-B cycles 2 (1-4)]. RTX-B retention rate estimates were 79.4% and 71.3% at 12 and 18 months respectively. Following RTX-B discontinuation, 33/256 patients (12.8%) switched back to RTX-O [LOR=30 (11.7%), adverse effects (AEs)=3 (1.2%)], 13/256 (5.1%) started other b/tsDMARDs, and 25/256 (9.7%) stopped treatment (no longer indicated=7, deaths=7, loss to follow-up=6, patient choice=3, new contraindication=2). Of 46 patients with LOR/AE to RTX-B, 39 discontinued after cycle 1 (C1), 5 after C2 and 2 after C3. 31/33 patients switched back to RTX-O remained on treatment but follow-up was limited [mean (SD) 7.5 (5.2) months; 23/33 had 1 cycle only]. Compared with patients treated with other b/tsDMARDs, those switched back to RTX-O had more previous RTX-O cycles [mean (SD) 6.67 (3.28) versus 2.62 (2.10); p<0.0001]. Compared with patients who remained on RTX-B (n=185), those who discontinued for LOR/AE/death (n=53) had more previous bDMARDs (mean 1.26 vs 0.83; difference 0.43, 95% CI 0.10-0.77, p=0.01), but no differences in other clinical characteristics, treatment or B-cell numbers.Conclusion:Our real-world single-centre experience of non-medical switch from RTX-O to RTX-B in RA showed approx. three quarters of patients remained on RTX-B and maintained stable disease activity. However, apparent LOR occurred in 16%. Of >10% switched back to RTX-O, the majority remained on treatment at short-term follow-up.References:[1]Lee at al, MAbs 2018.[2]Shim et al, Rheumatology 2019.[3]Tweehuysen et al, AR 2018.Disclosure of Interests:Andrew Melville: None declared, Md Yuzaiful Md Yusof: None declared, John Fitton Speakers bureau: Pfizer, Lynda Bailey Speakers bureau: Chugai, Sanofi, Paul Emery Grant/research support from: AbbVie, Bristol-Myers Squibb, Merck Sharp & Dohme, Pfizer, Roche (all paid to employer), Consultant of: AbbVie (consultant, clinical trials, advisor), Bristol-Myers Squibb (consultant, clinical trials, advisor), Lilly (clinical trials, advisor), Merck Sharp & Dohme (consultant, clinical trials, advisor), Novartis (consultant, clinical trials, advisor), Pfizer (consultant, clinical trials, advisor), Roche (consultant, clinical trials, advisor), Samsung (clinical trials, advisor), Sandoz (clinical trials, advisor), UCB (consultant, clinical trials, advisor), Maya H Buch Grant/research support from: Pfizer, Roche, and UCB, Consultant of: Pfizer; AbbVie; Eli Lilly; Gilead Sciences, Inc.; Merck-Serono; Sandoz; and Sanofi, Shouvik Dass Consultant of: Roche, Speakers bureau: Roche, Benazir Saleem Speakers bureau: Sanofi
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Ewa I, Bailey L, Ewa I, Gibson L, Bailey J, Celis M. A Quality Improvement Project Using PAINAD to Improve Pain Management and Opioid Reduction in Persons with Dementia. J Am Med Dir Assoc 2019. [DOI: 10.1016/j.jamda.2019.01.066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Triolo TM, Fouts A, Pyle L, Yu L, Gottlieb PA, Steck AK, Greenbaum CJ, Atkinson M, Baidal D, Battaglia M, Becker D, Bingley P, Bosi E, Buckner J, Clements M, Colman P, DiMeglio L, Gitelman S, Goland R, Gottlieb P, Herold K, Knip M, Krischer J, Lernmark A, Moore W, Moran A, Muir A, Palmer J, Peakman M, Philipson L, Raskin P, Redondo M, Rodriguez H, Russell W, Spain L, Schatz D, Sosenko J, Wentworth J, Wherrett D, Wilson D, Winter W, Ziegler A, Anderson M, Antinozzi P, Benoist C, Blum J, Bourcier K, Chase P, Clare-Salzler M, Clynes R, Eisenbarth G, Fathman C, Grave G, Hering B, Insel R, Kaufman F, Kay T, Leschek E, Mahon J, Marks J, Nanto-Salonen K, Nepom G, Orban T, Parkman R, Pescovitz M, Peyman J, Pugliese A, Roep B, Roncarolo M, Savage P, Simell O, Sherwin R, Siegelman M, Skyler J, Steck A, Thomas J, Trucco M, Wagner J, Krischer JP, Leschek E, Rafkin L, Bourcier K, Cowie C, Foulkes M, Insel R, Krause-Steinrauf H, Lachin JM, Malozowski S, Peyman J, Ridge J, Savage P, Skyler JS, 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Manning G, Hendry B, Taylor S, Jones W, Strader M, Bencomo T, Bailey L, Bedolla C, Roldan C, Moudiotis B, Vaidya C, Anning S, Bunce S, Estcourt E, Folland E, Gordon C, Harrill J, Ireland J, Piper L, Scaife K, Sutton S, Wilkins M, Costelloe J, Palmer L, Casas C, Miller M, Burgard C, Erickson J, Hallanger-Johnson P, Clark W, Taylor A, Lafferty S, Gillett C, Nolan M, Pathak L, Sondrol T, Hjelle S, Hafner J, Kotrba R, Hendrickson A, Cemeroglu T, Symington M, Daniel Y, Appiagyei-Dankah D, Postellon M, Racine L, Kleis K, Barnes S, Godwin H, McCullough K, Shaheen G, Buck L, Noel M, Warren S, Weber S, Parker I, Gillespie B, Nelson C, Frost J, Amrhein E, Moreland A, Hayes J, Peggram J, Aisenberg M, Riordan J, Zasa E, Cummings K, Scott T, Pinto A, Mokashi K, McAssey E, Helden P, Hammond L, Dinning S, Rahman S, Ray C, Dimicri S, Guppy H, Nielsen C, Vogel C, Ariza L, Morales Y, Chang R, Gabbay L, Ambrocio L, Manley R, Nemery W, Charlton P, Smith L, Kerr B, Steindel-Kopp M, Alamaguer D, Liljenquist G, Browning T, Coughenour M, Sulk E, Tsalikan M, Tansey J, Cabbage N. Identical and Nonidentical Twins: Risk and Factors Involved in Development of Islet Autoimmunity and Type 1 Diabetes. Diabetes Care 2019; 42:192-199. [PMID: 30061316 PMCID: PMC6341285 DOI: 10.2337/dc18-0288] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2018] [Accepted: 06/28/2018] [Indexed: 02/03/2023]
Abstract
OBJECTIVE There are variable reports of risk of concordance for progression to islet autoantibodies and type 1 diabetes in identical twins after one twin is diagnosed. We examined development of positive autoantibodies and type 1 diabetes and the effects of genetic factors and common environment on autoantibody positivity in identical twins, nonidentical twins, and full siblings. RESEARCH DESIGN AND METHODS Subjects from the TrialNet Pathway to Prevention Study (N = 48,026) were screened from 2004 to 2015 for islet autoantibodies (GAD antibody [GADA], insulinoma-associated antigen 2 [IA-2A], and autoantibodies against insulin [IAA]). Of these subjects, 17,226 (157 identical twins, 283 nonidentical twins, and 16,786 full siblings) were followed for autoantibody positivity or type 1 diabetes for a median of 2.1 years. RESULTS At screening, identical twins were more likely to have positive GADA, IA-2A, and IAA than nonidentical twins or full siblings (all P < 0.0001). Younger age, male sex, and genetic factors were significant factors for expression of IA-2A, IAA, one or more positive autoantibodies, and two or more positive autoantibodies (all P ≤ 0.03). Initially autoantibody-positive identical twins had a 69% risk of diabetes by 3 years compared with 1.5% for initially autoantibody-negative identical twins. In nonidentical twins, type 1 diabetes risk by 3 years was 72% for initially multiple autoantibody-positive, 13% for single autoantibody-positive, and 0% for initially autoantibody-negative nonidentical twins. Full siblings had a 3-year type 1 diabetes risk of 47% for multiple autoantibody-positive, 12% for single autoantibody-positive, and 0.5% for initially autoantibody-negative subjects. CONCLUSIONS Risk of type 1 diabetes at 3 years is high for initially multiple and single autoantibody-positive identical twins and multiple autoantibody-positive nonidentical twins. Genetic predisposition, age, and male sex are significant risk factors for development of positive autoantibodies in twins.
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Affiliation(s)
- Taylor M. Triolo
- Barbara Davis Center for Diabetes, University of Colorado School of Medicine, Aurora, CO
| | - Alexandra Fouts
- Barbara Davis Center for Diabetes, University of Colorado School of Medicine, Aurora, CO
| | - Laura Pyle
- Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, CO
| | - Liping Yu
- Barbara Davis Center for Diabetes, University of Colorado School of Medicine, Aurora, CO
| | - Peter A. Gottlieb
- Barbara Davis Center for Diabetes, University of Colorado School of Medicine, Aurora, CO
| | - Andrea K. Steck
- Barbara Davis Center for Diabetes, University of Colorado School of Medicine, Aurora, CO
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Winters ZE, Afzal M, Rutherford C, Holzner B, Rumpold G, da Costa Vieira RA, Hartup S, Flitcroft K, Bjelic-Radisic V, Oberguggenberger A, Panouilleres M, Mani M, Catanuto G, Douek M, Kokan J, Sinai P, King MT, Spillane A, Snook K, Boyle F, French J, Elder E, Chalmers B, Kabir M, Campbell I, Wong A, Flay H, Scarlet J, Weis J, Giesler J, Bliem B, Nagele E, del Angelo N, Andrade V, Assump¸ão Garcia D, Bonnetain F, Kjelsberg M, William-Jones S, Fleet A, Hathaway S, Elliott J, Galea M, Dodge J, Chaudhy A, Williams R, Cook L, Sethi S, Turton P, Henson A, Gibb J, Bonomi R, Funnell S, Noren C, Ooi J, Cocks S, Dawson L, Patel H, Bailey L, Chatterjee S, Goulden K, Kirk S, Osborne W, Harter L, Sharif MA, Corcoran S, Smith J, Prasad R, Doran A, Power A, Devereux L, Cannon J, Latham S, Arora P, Ridgway S, Coulding M, Roberts R, Absar M, Hodgkiss T, Connolly K, Johnson J, Doyle K, Lunt N, Cooper M, Fuchs I, Peall L, Taylor L, Nicholson A. International validation of the European Organisation for Research and Treatment of Cancer QLQ-BRECON23 quality-of-life questionnaire for women undergoing breast reconstruction. Br J Surg 2017; 105:209-222. [PMID: 29116657 DOI: 10.1002/bjs.10656] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2016] [Revised: 03/02/2017] [Accepted: 06/23/2017] [Indexed: 11/12/2022]
Abstract
Abstract
Background
The aim was to carry out phase 4 international field-testing of the European Organisation for Research and Treatment of Cancer (EORTC) breast reconstruction (BRECON) module. The primary objective was finalization of its scale structure. Secondary objectives were evaluation of its reliability, validity, responsiveness, acceptability and interpretability in patients with breast cancer undergoing mastectomy and reconstruction.
Methods
The EORTC module development guidelines were followed. Patients were recruited from 28 centres in seven countries. A prospective cohort completed the QLQ-BRECON15 before mastectomy and the QLQ-BRECON24 at 4–8 months after reconstruction. The cross-sectional cohort completed the QLQ-BRECON24 at 1–5 years after reconstruction, and repeated this 2–8 weeks later (test–retest reliability). All participants completed debriefing questionnaires.
Results
A total of 438 patients were recruited, 234 in the prospective cohort and 204 in the cross-sectional cohort. A total of 414 reconstructions were immediate, with a comparable number of implants (176) and donor-site flaps (166). Control groups comprised patients who underwent two-stage implant procedures (72, 75 per cent) or delayed reconstruction (24, 25 per cent). Psychometric scale validity was supported by moderate to high item-own scale and item-total correlations (over 0·5). Questionnaire validity was confirmed by good scale-to-sample targeting, and computable scale scores exceeding 50 per cent, except nipple cosmesis (over 40 per cent). In known-group comparisons, QLQ-BRECON24 scales and items differentiated between patient groups defined by clinical criteria, such as type and timing of reconstruction, postmastectomy radiotherapy and surgical complications, with moderate effect sizes. Prospectively, sexuality and surgical side-effects scales showed significant responsiveness over time (P < 0·001). Scale reliability was supported by high Cronbach's α coefficients (over 0·7) and test–retest (intraclass correlation more than 0·8). One item (finding a well fitting bra) was excluded based on high floor/ceiling effects, poor test–retest and weak correlations in factor analysis (below 0·3), thus generating the QLQ-BRECON23 questionnaire.
Conclusion
The QLQ-BRECON23 is an internationally validated tool to be used alongside the EORTC QLQ-C30 (cancer) and QLQ-BR23 (breast cancer) questionnaires for evaluating quality of life and satisfaction after breast reconstruction.
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Affiliation(s)
- Z E Winters
- Breast Cancer Surgery Patient-Reported and Clinical Outcomes Research Group, University of Bristol, School of Clinical Sciences, Southmead Hospital, Bristol, UK
- Surgical and Interventional Trials Unit, Division of Surgical Sciences, University College London, London, UK
- Quality of Life Office, School of Psychology, Faculty of Science, University of Sydney, New South Wales, Australia
| | - M Afzal
- Breast Cancer Surgery Patient-Reported and Clinical Outcomes Research Group, University of Bristol, School of Clinical Sciences, Southmead Hospital, Bristol, UK
| | - C Rutherford
- Quality of Life Office, School of Psychology, Faculty of Science, University of Sydney, New South Wales, Australia
| | - B Holzner
- Department of Psychiatry, Psychotherapy and Psychosomatics, Medical University of Innsbruck, Innsbruck, Austria
| | - G Rumpold
- Department of Medical Psychology, Evaluation Software Development, Rum, Austria
| | | | - S Hartup
- St James's University Hospital, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - K Flitcroft
- Breast and Surgical Oncology, Poche Centre, University of Sydney, New South Wales, Australia
| | - V Bjelic-Radisic
- Department of Breast Surgery and Gynaecology, Medical University Graz, Graz, Austria
| | - A Oberguggenberger
- Department of Psychiatry, Psychotherapy and Psychosomatics, Medical University of Innsbruck, Innsbruck, Austria
| | - M Panouilleres
- Department of Plastic Surgery, Besançon University Hospital, Besançon, France
| | - M Mani
- Department of Surgical Sciences, Plastic and Reconstructive Surgery, Uppsala University, Uppsala, Sweden
| | - G Catanuto
- Multidisciplinary Breast Care, Cannizzaro Hospital, Catania, Italy
| | - M Douek
- Department of Surgical Oncology, Guy's Hospital, London, London, UK
| | - J Kokan
- Cancer Resource Centre, Macclesfield Hospital, Macclesfield, UK
| | - P Sinai
- Breast Cancer Surgery Patient-Reported and Clinical Outcomes Research Group, University of Bristol, School of Clinical Sciences, Southmead Hospital, Bristol, UK
| | - M T King
- Quality of Life Office, School of Psychology, Faculty of Science, University of Sydney, New South Wales, Australia
- Sydney Medical School, Faculty of Medicine, University of Sydney, New South Wales, Australia
| | - A Spillane
- Poche Centre, Sydney, New South Wales, Australia
| | - K Snook
- Poche Centre, Sydney, New South Wales, Australia
| | - F Boyle
- Poche Centre, Sydney, New South Wales, Australia
| | - J French
- The Crown Princess Mary Westmead Breast Cancer Centre and Specialist Services, Sydney, New South Wales, Australia
| | - E Elder
- The Crown Princess Mary Westmead Breast Cancer Centre and Specialist Services, Sydney, New South Wales, Australia
| | - B Chalmers
- The Crown Princess Mary Westmead Breast Cancer Centre and Specialist Services, Sydney, New South Wales, Australia
| | - M Kabir
- The Crown Princess Mary Westmead Breast Cancer Centre and Specialist Services, Sydney, New South Wales, Australia
| | | | - A Wong
- Waikato Hospital, Hamilton, New Zealand
| | - H Flay
- Waikato Hospital, Hamilton, New Zealand
| | - J Scarlet
- Waikato Hospital, Hamilton, New Zealand
| | - J Weis
- University of Freiburg, Freiberg, Germany
| | - J Giesler
- University of Freiburg, Freiberg, Germany
| | - B Bliem
- Medical University Graz, Graz, Austria
| | - E Nagele
- Medical University Graz, Graz, Austria
| | | | - V Andrade
- Barretos Cancer Hospital, Sao Paolo, Brazil
| | | | - F Bonnetain
- Besançon University Hospital, Besançon, France
| | | | - S William-Jones
- Clinical Research Network, West Midlands, Queen-s Hospital, Burton upon Trent, UK
| | - A Fleet
- Clinical Research Network, West Midlands, Queen-s Hospital, Burton upon Trent, UK
| | - S Hathaway
- Clinical Research Network, West Midlands, Queen-s Hospital, Burton upon Trent, UK
| | - J Elliott
- Clinical Research Network, West Midlands, Queen-s Hospital, Burton upon Trent, UK
| | - M Galea
- Cancer Research Unit, Great Western Hospital, Swindon, UK
| | - J Dodge
- Cancer Research Unit, Great Western Hospital, Swindon, UK
| | - A Chaudhy
- Cancer Research Unit, Great Western Hospital, Swindon, UK
| | | | - L Cook
- Guy's Hospital, London, UK
| | | | - P Turton
- Leeds Teaching Hospital, Leeds, UK
| | - A Henson
- Leeds Teaching Hospital, Leeds, UK
| | - J Gibb
- Leeds Teaching Hospital, Leeds, UK
| | - R Bonomi
- Worthing Hospital, Western Sussex Hospitals, Worthing, UK
| | - S Funnell
- Worthing Hospital, Western Sussex Hospitals, Worthing, UK
| | - C Noren
- Worthing Hospital, Western Sussex Hospitals, Worthing, UK
| | - J Ooi
- Royal Bolton Hospital, Bolton, UK
| | - S Cocks
- Royal Bolton Hospital, Bolton, UK
| | - L Dawson
- Royal Bolton Hospital, Bolton, UK
| | - H Patel
- Royal Bolton Hospital, Bolton, UK
| | - L Bailey
- Royal Bolton Hospital, Bolton, UK
| | | | | | - S Kirk
- Salford Royal Hospital, UK
| | | | | | | | | | - J Smith
- Stepping Hill Hospital, Stockport, UK
| | - R Prasad
- Royal AlbertEdward Infirmary, Wigan, UK
| | - A Doran
- Royal AlbertEdward Infirmary, Wigan, UK
| | - A Power
- Royal AlbertEdward Infirmary, Wigan, UK
| | | | - J Cannon
- Royal AlbertEdward Infirmary, Wigan, UK
| | - S Latham
- Royal AlbertEdward Infirmary, Wigan, UK
| | - P Arora
- Tameside General Hospital, Ashton-under-Lyne, UK
| | - S Ridgway
- Tameside General Hospital, Ashton-under-Lyne, UK
| | - M Coulding
- Tameside General Hospital, Ashton-under-Lyne, UK
| | - R Roberts
- Tameside General Hospital, Ashton-under-Lyne, UK
| | - M Absar
- North ManchesterGeneral Hospital, Manchester, UK
| | - T Hodgkiss
- North ManchesterGeneral Hospital, Manchester, UK
| | - K Connolly
- North ManchesterGeneral Hospital, Manchester, UK
| | - J Johnson
- North ManchesterGeneral Hospital, Manchester, UK
| | - K Doyle
- North ManchesterGeneral Hospital, Manchester, UK
| | - N Lunt
- Cancer Resource Centre, Macclesfield Hospital, Macclesfield, UK
| | - M Cooper
- Bristol Breast Care Centre, Southmead Hospital, Bristol, UK
| | - I Fuchs
- Bristol Breast Care Centre, Southmead Hospital, Bristol, UK
| | - L Peall
- Bristol Breast Care Centre, Southmead Hospital, Bristol, UK
| | - L Taylor
- Bristol Breast Care Centre, Southmead Hospital, Bristol, UK
| | - A Nicholson
- Bristol Breast Care Centre, Southmead Hospital, Bristol, UK
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McGowan N, Pass C, Atkinson A, Fraser A, Hargreaves E, Bailey L, Doig S, Mitchell D, Dwyer B, MacRury C, Moroni F, Glover A, Barry J, Sharpe M, Mount N, Turner M, Campbell J, Forbes S. GMP translation, validation and clinical trial authorisation of a macrophage cell therapy product for liver cirrhosis. Cytotherapy 2017. [DOI: 10.1016/j.jcyt.2017.02.315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Bethel M, Weaver FM, Bailey L, Miskevics S, Svircev JN, Burns SP, Hoenig H, Lyles K, Carbone LD. Risk factors for osteoporotic fractures in persons with spinal cord injuries and disorders. Osteoporos Int 2016; 27:3011-21. [PMID: 27230522 DOI: 10.1007/s00198-016-3627-2] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2016] [Accepted: 05/02/2016] [Indexed: 01/15/2023]
Abstract
UNLABELLED Clinical risk factors for fracture were explored among Veterans with a spinal cord injury. At the end of 11 years of follow-up, the absolute risk of fracture was approximately 20 %. Among the clinical and SCI-related factors explored, a prior history of fracture was strongly associated with incident fracture. INTRODUCTION Few studies to date have comprehensively addressed clinical risk factors for fracture in persons with spinal cord injury (SCI). The purpose of this study was to identify risk factors for incident osteoporotic fractures in persons with a SCI that can be easily determined at the point of care. METHODS The Veteran's Affairs Spinal Cord Dysfunction Registry, a national database of persons with a SCI, was used to examine clinical and SCI-related risk factors for fracture. Incident fractures were identified in a cohort of persons with chronic SCI, defined as SCI present for at least 2 years. Cox regression models were used to estimate the risk of incident fractures. RESULTS There were 22,516 persons with chronic SCI included in the cohort with 3365 incident fractures. The mean observational follow-up time for the overall sample was 6.2 years (median 6.0, IQR 2.9-11.0). The mean observational follow-up time for the fracture group was 3.9 years (median 3.3, IQR 1.4-6.1) and 6.7 years (median 6.7, IQR 3.1-11.0) for the nonfracture group. By the end of the study, which included predominantly older Veterans with a SCI observed for a relatively short period of time, the absolute (i.e., cumulative hazard) for incident fractures was 0.17 (95%CI 0.14-0.21). In multivariable analysis, factors associated with an increased risk of fracture included White race, traumatic etiology of SCI, paraplegia, complete extent of SCI, longer duration of SCI, use of anticonvulsants and opioids, prevalent fractures, and higher Charlson Comorbidity Indices. Women aged 50 and older were also at higher risk of sustaining an incident fracture at any time during the 11-year follow-up period. CONCLUSIONS There are multiple clinical and SCI-related risk factors which can be used to predict fracture in persons with a SCI. Clinicians should be particularly concerned about incident fracture risk in persons with a SCI who have had a previous fracture.
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Affiliation(s)
- M Bethel
- Charlie Norwood Veterans Affairs Medical Center, Augusta, GA, USA.
- Department of Medicine, Medical College of Georgia, Augusta University, 1120 15th St, Augusta, GA, USA.
| | - F M Weaver
- Center of Innovation for Complex Chronic Healthcare, Edward J. Hines, Jr. VA Hospital, Hines, IL, USA
- Stritch School of Medicine, Loyola University, Maywood, IL, USA
| | - L Bailey
- Center of Innovation for Complex Chronic Healthcare, Edward J. Hines, Jr. VA Hospital, Hines, IL, USA
- Department of Epidemiology and Biostatistics, School of Public Health, University of Illinois at Chicago, Chicago, IL, USA
| | - S Miskevics
- Center of Innovation for Complex Chronic Healthcare, Edward J. Hines, Jr. VA Hospital, Hines, IL, USA
| | - J N Svircev
- VA Puget Sound Health Care System-Seattle Division, Seattle, WA, USA
- Department of Rehabilitation Medicine, University of Washington, Seattle, WA, USA
| | - S P Burns
- VA Puget Sound Health Care System-Seattle Division, Seattle, WA, USA
- Department of Rehabilitation Medicine, University of Washington, Seattle, WA, USA
| | - H Hoenig
- Durham VA Medical Center, Durham, NC, USA
| | - K Lyles
- Department of Medicine, Duke University, Durham, NC, USA
- Geriatric Research, Education, and Clinical Center, VAMC, Durham, NC, USA
| | - L D Carbone
- Charlie Norwood Veterans Affairs Medical Center, Augusta, GA, USA
- Department of Medicine, Medical College of Georgia, Augusta University, 1120 15th St, Augusta, GA, USA
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Green T, Bailey L, Sinclair H, Macdonald S, Macleod U. P75 Exploring public awareness and understandings of cancer through qualitative Methods. Br J Soc Med 2016. [DOI: 10.1136/jech-2016-208064.174] [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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Murdoch LE, Bailey L, Banham E, Watson F, Adams NMT, Chewins J. Evaluating different concentrations of hydrogen peroxide in an automated room disinfection system. Lett Appl Microbiol 2016; 63:178-82. [PMID: 27324207 DOI: 10.1111/lam.12607] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [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: 03/23/2016] [Revised: 05/23/2016] [Accepted: 06/14/2016] [Indexed: 12/01/2022]
Abstract
UNLABELLED A comparative study was made on the efficacy of 5, 10 and 35% weight by weight (w/w) hydrogen peroxide solutions when applied using an automated room disinfection system. Six-log biological indicators of methicillin-resistant Staphylococcus aureus (MRSA) and Geobacillus stearothermophilus were produced on stainless steel coupons and placed within a large, sealed, environmentally controlled enclosure. Five percent hydrogen peroxide was distributed throughout the enclosure using a Bioquell hydrogen peroxide vapour generator (BQ-50) for 40 min and left to reside for a further 200 min. Biological indicators were removed at 10-min intervals throughout the first 120 min of the process. The experiment was repeated for 10 and 35% hydrogen peroxide solutions. Five percent and 10% hydrogen peroxide solutions failed to achieve any reduction of MRSA, but achieved full kill of G. stearothermophilus spores at 70 and 40 min respectively. Thirty-five percent hydrogen peroxide achieved a 6-log reduction of MRSA after 30 min and full kill of G. stearothermophilus at 20 min. The concentration of 5% hydrogen peroxide within the enclosure after the 200-min dwell was measured at 9·0 ppm. This level exceeds the 15-min Short Term Exposure Limit (STEL) for hydrogen peroxide of 2·0 ppm. Users of automated hydrogen peroxide disinfection systems should review system efficacy and room re-entry protocols in light of these results. SIGNIFICANCE AND IMPACT OF THE STUDY This research allows hospital infection control teams to consider the impact and risks of using low concentrations of hydrogen peroxide for disinfection within their facilities, and to question automated room disinfection system providers on the efficacy claims they make. The evidence that low concentration hydrogen peroxide solutions do not rapidly, autonomously break down, is in contradiction to the claims made by some hydrogen peroxide equipment providers and raises serious health and safety concerns. Facilities using hydrogen peroxide systems that claim autonomous break down of hydrogen peroxide should introduce monitoring procedures to ensure rooms are safe for re-entry and patient occupation.
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Affiliation(s)
- L E Murdoch
- Wickham Laboratories, Gosport, Hampshire, UK
| | - L Bailey
- Wickham Laboratories, Gosport, Hampshire, UK
| | - E Banham
- Wickham Laboratories, Gosport, Hampshire, UK
| | - F Watson
- Wickham Laboratories, Gosport, Hampshire, UK
| | - N M T Adams
- Wickham Laboratories, Gosport, Hampshire, UK
| | - J Chewins
- Wickham Laboratories, Gosport, Hampshire, UK
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Bailey L, Gilvarry M, Holian M, Tzafriri A, Stanley J, Edelman E. E-080 Preclinical Evaluation of Mechanical Thrombectomy Devices in a Swine Clot Model. J Neurointerv Surg 2016. [DOI: 10.1136/neurintsurg-2016-012589.152] [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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Hasanato R, Brearton S, Alshebani M, Bailey L, Aldugashim S, Alothaim A, Tamimi W. Effects of serum indices interference on hormonal results from the Abbott Architect i2000 immunoassay analyser. Br J Biomed Sci 2016; 72:151-5. [PMID: 26738394 DOI: 10.1080/09674845.2015.11665744] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
The routine chemical assays are affected by sample haemolysis, icterus and lipaemia, collectively known as serum indices; however, little attention has been given to the consequences of these conditions on hormonal assays (immunoassays). In this study, we assess the impact of interferences from exogenous serum indices on various endocrine assays performed on the Abbott Architect i2000 system. The pool of 20 serum samples was derived from a hospitalised population. The diluted serum samples were spiked with red cell haemolysate, Intralipid and bilirubin. The interferences were studied at baseline; 12.5%, 25%, 50%, 75% and 100% of 5.0 g/L haemoglobin; 1% of 20% Intralipid; and 0.342 mmol/L of bilirubin according to the EP7-A2 guideline (Interference Testing in Clinical Chemistry; CLSI, USA). Aliquots were analysed in duplicate and/or triplicate for various hormones on the Abbott Architect i2000 immunoassay analyser. Serum ferritin (r2=0.84; P=0.074) and TSH (r2=0.81; P=0.52) levels showed a direct relationship with haemolysis and therefore overestimated because of the effects of haemolysis. The vitamin B12 level progressively decreased as the amount of haemolysis increased (r2=-0.76; P=0.136). There was a significant decrease in progesterone concentration owing to lipaemia (r2=-0.983; P=0.003). For icteric interferences, a strong inverse correlation was observed for folic acid and was shown to be statistically significant (r2=-0.94; P=0.017). Assays for ferritin, TSH, vitamin B12, folic acid and progesterone showed various degrees of interference because of the variability in serum indices.
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Samad T, Razzouk A, Bock M, Chinnock R, Bailey L, Hasaniya N, Kuhn M, Anthony H, Stoletniy L. Cardiac Allograft Vasculopathy in Pediatric Heart Transplant Recipients: Coronary Stenting as a Prognostic Indicator. J Heart Lung Transplant 2016. [DOI: 10.1016/j.healun.2016.01.060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Bailey L. Control of Amoeba Disease by the Fumigation of Combs and by Fumagillin. ACTA ACUST UNITED AC 2015. [DOI: 10.1080/0005772x.1955.11094896] [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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Gordon K, Bailey L, Caine-Bish N, Miracle A. Assessment of Disordered Eating Behaviors in College-Aged Female Health and Human Services Majors. J Acad Nutr Diet 2014. [DOI: 10.1016/j.jand.2014.06.102] [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: 10/24/2022]
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Copeland H, Beckham A, Razzouk A, Chinnock R, Hasaniya N, Bahjri K, Bailey L. Social Framework of Pediatric Heart Recipients Who Have Survived More Than 15 Post Transplant Years: A Single Center Experience. J Heart Lung Transplant 2014. [DOI: 10.1016/j.healun.2014.01.874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Copeland H, Inui T, Berumen J, Razzouk A, Bailey L, Chang D, Copeland J. Impact of Heart Donor “Inotrope” Support on 30-Day Graft Outcomes in Heart Transplantation. J Heart Lung Transplant 2013. [DOI: 10.1016/j.healun.2013.01.262] [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] Open
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Park CK, Kim YH, Kim JW, Kim TM, Choi SH, Kim YJ, Choi BS, Lee SH, Kim CY, Kim IH, Lee DZ, Kheder A, Forbes M, Craven I, Hadjivassiliou M, Shonka NA, Kessinger A, Aizenberg MR, Weller M, Meisner C, Platten M, Simon M, Nikkhah G, Papsdorf K, Sabel M, Braun C, Reifenberger G, Wick W, Alexandru D, Haghighi B, Muhonen MG, Chamberlain MC, Sumrall AL, Burri S, Brick W, Asher A, Murillo-Medina K, Guerrero-Maldonado A, Ramiro AJ, Cervantes-Sanchez G, Erazo-Valle-Solis AA, Garcia-Navarro V, Sperduto PW, Shanley R, Luo X, Kased N, Sneed PK, Roberge D, Chao S, Weil R, Suh J, Bhatt A, Jensen A, Brown PD, Shih H, Kirkpatrick J, Gaspar LE, Fiveash J, Chiang V, Knisely J, Sperduto CM, Lin N, Mehta MP, Anderson MD, Raghunathan A, Aldape KD, Fuller GN, Gilbert MR, Robins HI, Wang M, Gilbert MR, Chakravarti A, Grimm S, Penas-Prado M, Chaudhary R, Anderson PJ, Elinzano H, Gilbert RA, Mehta M, Aoki T, Ueba T, Arakawa Y, Miyatake SI, Tsukahara T, Miyamoto S, Nozaki K, Taki W, Matsutani M, Shakur SF, Bit-Ivan E, Watkin WG, Farhat HI, Merrell RT, Zwinkels H, Dorr J, Kloet A, Taphoorn MJ, Vecht CJ, Bogdahn U, Stockhammer G, Mahapatra A, Hau P, Schuknecht B, van den Bent M, Heinrichs H, Yust-Katz S, Liu V, Sanghee K, Groves M, Puduvalli V, Levin V, Conrad C, Colman H, Hsu S, Yung AW, Gilbert MR, Kunz M, Armbruster L, Thon N, Jansen N, Lutz J, Herms J, Egensperger R, Eigenbrod S, Kretzschmar H, La CF, Tonn JC, Kreth FW, Brandes AA, Franceschi E, Agati R, Poggi R, Dall'Occa P, Bartolotti M, Di Battista M, Marucci G, Girardi F, Ermani M, Sherman W, Raizer J, Grimm S, Ruckser R, Tatzreiter G, Pfisterer W, Oberhauser G, Honigschnabel S, Aboul-Enein F, Ausch C, Kitzweger E, Hruby W, Sebesta C, Green RM, Woyshner EA, Suchorska B, Jansen NL, Janssen H, Kretzschmar H, Simon M, Hentschel B, Poepperl G, Kreth FW, Linn J, LaFougere C, Weller M, Tonn JC, Suchorska B, Jansen NL, Graute V, Eigenbrod S, Bartenstein P, Kreth FW, LaFougere C, Tonn JC, Hassanzadeh B, Tohidi V, Levacic D, Landolfi JC, Singer S, DeBraganca K, Omuro A, Grommes C, Omar AI, Jalan P, Pandav V, Bekker S, Fuente MIDL, Kaley T, Zhao S, Chen X, Soffietti R, Magistrello M, Bertero L, Bosa C, Crasto SG, Garbossa D, Lolli I, Trevisan E, Ruda R, Ruda R, Bertero L, Bosa C, Trevisan E, Pace A, Carapella C, Dealis C, Caroli M, Faedi M, Bomprezzi C, Thomas AA, Dalmau J, Gresa-Arribas N, Fadul CE, Kumthekar PU, Raizer J, Grimm S, Herrada J, Antony N, Richards M, Gupta A, Landeros M, Arango C, Campos-Gines AF, Friedman P, Wilson H, Streeter JC, Cohen A, Gilreath J, Sageser D, Ye X, Bell SD, McGregor J, Bourekas E, Cavaliere R, Newton H, Sul J, Odia Y, Zhang W, Shih J, Butman JA, Hammoud D, Kreisl TN, Iwamoto F, Fine HA, Berriel LG, Santos FN, Levy AC, Fanelli MF, Chinen LT, da Costa AA, Bourekas E, Wayne Slone H, Bell SD, McGregor J, Bokstein F, Blumenthal DT, Shpigel S, Phishniak L, Yust-Katz S, Garciarena P, Liue D, Yuan Y, Groves MD, Wong ET, Villano JL, Engelhard HH, Ram Z, Sahebjam S, Millar BA, Sahgal A, Laperriere N, Mason W, Levin VA, Hess KR, Choucair AK, Flynn PJ, Jaeckle KA, Kyritsis AP, Yung WKA, Prados MD, Bruner JM, Ictech S, Nghiemphu PL, Lai A, Green RM, Cloughesy TF, Zaky W, Gilles F, Grimm J, Bluml S, Dhall G, Rosser T, Randolph L, Wong K, Olch A, Krieger M, Finlay J, Capellades J, Verger E, Medrano S, Gonzalez S, Gil M, Reynes G, Ribalta T, Gallego O, Segura PP, Balana C, Gwak HS, Joo J, Kim S, Yoo H, Shin SH, Han JY, Kim HT, Yun T, Lee JS, Lee SH, Kim W, Vogelbaum MA, Wang M, Peereboom DM, Macdonald DR, Giannini C, Suh JH, Jenkins RB, Laack NN, Brackman DG, Shrieve DC, Souhami L, Mehta MP, Leibetseder A, Wohrer A, Ackerl M, Flechl B, Sax C, Spiegl-Kreinecker S, Pichler J, Widhalm G, Dieckmann K, Preusser M, Marosi C, Sebastian C, Alejandro M, Bernadette C, Naomi A, Kavan P, Sahebjam S, Garoufalis E, Guiot MC, Muanza T, Del Maestro R, Petrecca K, Sharma R, Curry R, Joyce J, Rosenblum M, Jaffe E, Matasar M, Lin O, Fisher R, Omuro A, Yin C, Iwamoto FM, Fraum TJ, Nayak L, Diamond EL, DeAngelis LM, Pentsova E, Vera-Bolanos E, Gilbert MR, Aldape K, Necesito-Reyes MJ, Fouladi M, Gajjar A, Goldman S, Metellus P, Mikkelsen T, Omuro A, Packer R, Partap S, Pollack IF, Prados M, Ian Robins H, Soffietti R, Wu J, Armstrong TS, Nakada M, Hayashi Y, Miyashita K, Kinoshita M, Furuta T, Sabit H, Kita D, Hayashi Y, Uchiyam N, Kawakami K, Minamoto T, Hamada JI, Diamond EL, Rosenblum M, Heaney M, Carrasquillo J, Krauthammer A, Nolan C, Kaley TJ, Gil MJ, Fuster J, Balana C, Benavides M, Mesia C, Etxaniz O, Canellas J, Perez-Martin X, Hunter K, Johnston SK, Bridge CA, Rockne RC, Guyman L, Baldock AL, Rockhill JK, Mrugala MM, Beard BC, Adair JE, Kiem HP, Swanson KR, Ranjan T, Desjardins A, Peters KB, Alderson L, Kirkpatrick J, Herndon J, Bailey L, Sampson J, Friedman AH, Friedman H, Vredenburgh JJ, Theeler BJ, Ellezam B, Melguizo-Gavilanes I, Shonka NA, Bruner JM, Puduvalli VK, Taylor JW, Flanagan E, O'Neill B, Seigal T, Omuro A, DeAngelis L, Baerhing J, Hoang-Xuan K, Chamberlain M, Batchelor T, Nishikawa R, Pinto F, Blay JY, Korfel A, Schiff D, Fu BD, Kong XT, Bota D, Omuro A, Beal K, Ivy P, Gutin P, Wu N, Kaley T, Karimi S, DeAngelis L, Pentsova H, Nolan C, Grommes C, Chan T, Mathew R, Droms L, Shimizu F, Tabar V, Grossman S, Yovino S, Campian J, Wild A, Herman J, Brock M, Balmanoukian A, Ye X, Portnow J, Badie B, Synold T, Lacey S, D'Apuzzo M, Frankel P, Chen M, Aboody K, Letarte N, Gabay MP, Bressler LR, Stachnik JM, Villano JL, Jaeckle KA, Anderson SK, Willson A, Moreno-Aspitia A, Colon-Otero G, Patel T, Perez E, Peters KB, Reardon DA, Vredenburgh JJ, Desjardins A, Herndon JE, Coan A, McSherry F, Lipp E, Brickhouse A, Massey W, Friedman HS, Alderson LM, Desjardins A, Ranjan T, Peters KB, Friedman HS, Vredenburgh JJ, Ranjan T, Desjardins A, Peters KB, Alderson L, Kirkpatrick J, Herndon J, Bailey L, Sampson J, Friedman AH, Friedman H, Vredenburgh J, Welch MR, Omuro A, Grommes C, Westphal M, Bach F, Reuter D, Ronellenfitsch M, Steinbach J, Pietsch T, Connelly J, Hamza MA, Puduvalli V, Neal ML, Trister AD, Ahn S, Bridge C, Lange J, Baldock A, Rockne R, Mrugala M, Rockhill JK, Lai A, Cloughesy T, Swanson KR, Neuwelt AJ, Nguyen TM, Tyson RM, Nasseri M, Neuwelt EA, Bubalo JS, Barnes PD, Phuphanich S, Hu J, Rudnick J, Chu R, Yu J, Naruse R, Ljubimova J, Sanchez C, Guevarra A, Naor R, Black K, Mahta A, Bhavsar TM, Herath K, Huang C, McClain J, Rizzo K, Sheehan J, Chamberlain M, Glantz M, McClain J, Glantz MJ, Zoccoli C, Nicholas MK, Xie T, White D, Liker S, Gajewski T, Selfridge J, Piccioni DE, Zurayk M, Mody R, Quan J, Li S, Chen W, Chou A, Liau L, Green R, Cloughesy T, Lai A, Gomez-Molinar V, Ruiz-Gonzalez S, Valdez-Vazquez R, Arrieta O, Stenner JI. CLIN-NEURO/MEDICAL ONCOLOGY. Neuro Oncol 2012. [DOI: 10.1093/neuonc/nos229] [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: 11/13/2022] Open
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Michael B, Powell G, Hatch S, Bailey L, Almond S, Nightingale S, Cousins D, Hart IJ, Griffiths M, Solomon T. 069 Introduction of a simple lumbar puncture pack to a busy medical admissions unit improves diagnosis of central nervous system infections. J Neurol Neurosurg Psychiatry 2012. [DOI: 10.1136/jnnp-2011-301993.111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Snyder LA, Honea N, Coons SW, Eschbacher J, Smith KA, Spetzler RF, Sanai N, Groves MD, DeGroot J, Tremont I, Forman A, Kang S, Pei BL, Julie W, Schultz D, Yuan Y, Guha N, Hwu WJ, Papadopoulos N, Camphausen K, Yung WA, Ryken T, Johnston SK, Graham C, Grimm S, Colman H, Raizer J, Chamberlain MC, Mrugala MM, Adair JE, Beard BC, Silbergeld DL, Rockhill JK, Kiem HP, Lee EQ, Batchelor TT, Lassman AB, Schiff DS, Kaley TJ, Wong ET, Mikkelsen T, Purow BW, Drappatz J, Norden AD, Beroukhim R, Weiss S, Alexander BM, Sceppa C, Gerard M, Hallisey SD, Bochacki CA, Smith KH, Muzikansky AM, Wen PY, Peereboom DM, Mikkelson T, Sloan AE, Rich JN, Supko JG, Ye X, Brewer C, Lamborn K, Prados M, Grossman SA, Zhu JJ, Recht LD, Colman H, Kesari S, Kim LJ, Balch AH, Pope CC, Brulotte M, Beelen AP, Chamberlain MC, Wong ET, Ram Z, Gutin PH, Stupp R, Marsh J, McDonald K, Wheeler H, Teo C, Martin L, Palmer L, Rodriguez M, Buckland M, Koh ES, Back M, Robinson B, Joseph D, Nowak AK, Saito R, Sonoda Y, Yamashita Y, Kanamori M, Kumabe T, Tominaga T, Rodon J, Tawbi HA, Thomas AL, Amakye DD, Granvil C, Shou Y, Dey J, Buonamici S, Dienstmann R, Mita AC, Dummer R, Hutterer M, Martha N, Sabine E, Thaddaus G, Florian S, Christine M, Stefan O, Richard G, Martin M, Johanna B, Jochen T, Ullrich H, Wolfgang W, Peter V, Gunther S, Field KM, Cher L, Wheeler H, Hovey E, Nowak AK, Simes J, Sawkins K, France T, Brown C, Nicholas MK, Chmura S, Paleologos N, Krouwer H, Malkin M, Junck L, Vick NA, Lukas RV, Jaeckle KA, Anderson SK, Kosel M, Sarkaria J, Brown P, Flynn PJ, Buckner JC, Galanis E, Batchelor T, Grossman S, Brem S, Lesser G, Voloschin A, Nabors LB, Mikkelsen T, Desideri S, Supko J, Peereboom D, Westphal M, Pietsch T, Bach F, Heese O, Vredenburgh JJ, Desjardins A, Reardon DA, Peters KB, Kirkpatrick JP, Herndon JE, Coan AD, Bailey L, Janney D, Lu C, Friedman HS, Desjardins A, Reardon DA, Peters KB, Herndon JE, Gururangan S, Norfleet J, Friedman HS, Vredenburgh JJ, Lassman AB, Kaley TJ, DeAngelis LM, Hormigo A, Mellinghoff IK, Otap DD, Seger J, Doyle LA, Ludwig E, Lacouture ME, Panageas KS, Rezazadeh A, LaRocca RV, Vitaz TW, Villanueva WG, Hodes J, Haysley L, Pertschuk D, Cloughesy TF, Chang SM, Aghi MK, Vogelbaum MA, Liau LM, Shafa B, Jolly DJ, Ibanez CE, Perez OD, Robbins JM, Gruber HE, Maher EA, Stewart C, Hatanpaa K, Raisanen J, Mashimo T, Yang XL, Muralidhara C, Madden C, Ramachandran A, Mickey B, Bachoo R. ONGOING CLINICAL TRIALS. Neuro Oncol 2011; 13:iii85-iii91. [PMCID: PMC3199166 DOI: 10.1093/neuonc/nor154] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2023] Open
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Lou E, Reardon DA, Peters K, Desjardins A, Herndon JE, Coan AD, Turner SG, Sumrall AL, Bailey L, Friedman HS, Vredenburgh JJ. Upfront bevacizumab with temozolomide or with temozolomide and irinotecan for unresectable or multifocal glioblastoma. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.2055] [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: 11/20/2022] Open
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Vredenburgh JJ, Desjardins A, Reardon DA, Peters K, Kirkpatrick J, Coan AD, Bailey L, Janney D, Lu C, Friedman HS. Bevacizumab, temozolomide, and radiation therapy followed by bevacizumab, temozolomide, and oral topotecan for newly-diagnosed glioblastoma multiforme (GBM). J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.2098] [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: 11/20/2022] Open
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Sumrall AL, Reardon DA, Desjardins A, Peters K, Lou E, Turner SG, Bailey L, Friedman HS, Vredenburgh JJ. Venous thromboembolic complications in patients with malignant glioma treated on a bevacizumab clinical trial. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.9090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Vredenburgh JJ, Desjardins A, Reardon DA, Peters K, Kirkpatrick J, Herndon JE, Marcello J, Bailey L, Threatt S, Friedman HS. Bevacizumab (BEV) in combination with temozolomide (TMZ) and radiation therapy (XRT) followed by BEV, TMZ, and irinotecan for newly diagnosed glioblastoma multiforme (GBM). J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.2023] [Citation(s) in RCA: 3] [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: 11/20/2022] Open
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Bailey L, Greif J, Mandelke J. An intraductal approach to breast cancer risk assessment and screening in a diverse population. BMC Proc 2009. [PMCID: PMC2727098 DOI: 10.1186/1753-6561-3-s5-s24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Vredenburgh JJ, Desjardins A, Reardon DA, Peters K, Herndon JE, Kirkpatrick J, Gururangan S, Bailey L, Friedman AH, Friedman HS. Safety and efficacy of the addition of bevacizumab (BV) to temozolomide (TMZ) and radiation therapy (RT) followed by BV, TMZ, and irinotecan (CPT-11) for newly diagnosed glioblastoma multiforme (GBM). J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.2015] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [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
2015 Background: Standard GBM treatment includes TMZ and RT, and results in a median progression-free survival and median survival of 6.9 and 15.8 months, respectively. GBM have high concentrations of vascular endothelial growth factor (VEGF), higher levels are associated with poorer prognosis. BV is a humanized antibody to VEGF with activity in recurrent GBMs. This study aims to improve the survival of newly diagnosed GBM patients by incorporating an anti-angiogenic agent with RT and TMZ, and adding a topoisomerase I inhibitor, and an anti-angiogenic agent to TMZ post-RT therapy. Methods: Patients received standard RT and TMZ at 75 mg/m2/day, with BV at 10 mg/kg every 14 days beginning a minimum of 28 days post-operatively. Following the completion of RT, patients received 6 cycles of BV, TMZ and CPT-11. Each cycle was 28 days. BV was given at a dose of 10 mg/kg on days 1 and 15, TMZ at 200 mg/m2 on days 1–5 and CPT-11 on days 1 and 15 at 125 mg/m2 for patients not on an enzyme inducing anti-epileptic drug (EIAED) and 340 mg/m2 for patients on an EIAED. The study was designed to differentiate between a 16-month survival rate of 45% and 60% with type I and II error rates of 0.05. Results: 75 patients were enrolled between 8/07 and 9/08. All the patients have completed RT; 40 patients continue to receive BV, TMZ, and CPT-11. Twenty-two patients have completed 6 cycles of BV, TMZ, and CPT-11; 17 of them had a cold PET One patient developed a CNS hemorrhage (grade 2) necessitating stopping BV. Five patients developed thrombocytopenia for which TMZ was held (grade 3, n = 1; grade 4, n = 4). There were no other ≥ grade 3 toxicities, including no wound dehiscence during RT. Twelve patients had tumor progression, and 14 stopped because of toxicity, including: 6 with fatigue; 3 with PEs; 2 with grade 4 thrombocytopenia; the patient with CNS hemorrhage, and one each with a rectal abscess and sepsis. There have been 7 deaths: 5 from tumor progression; one each from sepsis and PEs. At a median follow-up of 9 months, 81% remain alive and progression-free. Conclusions: Adding BV to TMZ and RT followed by BV, TMZ with CPT-11 is tolerable and efficacious. No significant financial relationships to disclose.
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Affiliation(s)
| | | | | | - K. Peters
- Duke University Medical Center, Durham, NC
| | | | | | | | - L. Bailey
- Duke University Medical Center, Durham, NC
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Peters K, Desjardins A, Reardon DA, Perry S, Herndon JE, Bailey L, Friedman AH, Friedman HS, Bigner DD, Vredenburgh JJ. Temozolomide (TMZ) and bevacizumab (BV) as initial treatment for unresectable or multifocal glioblastoma multiforme (GBM). J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.e13025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
e13025 Background: GBMs are vascular tumors and inherently resistant to therapy. The prognosis for patients is poor with a median survival of 9–15 months. Patients with unresectable or multifocal GBMs have an even poorer prognosis, with a median survival of 6–8 months. Given the angiogenic phenotype of GBM, we conducted a phase II trial of upfront BV and 5-day TMZ in newly diagnosed unresectable or multifocal GBMs. Methods: Patients had histologically documented newly diagnosed GBMs that were unresectable or multifocal. Patients received up to 4 cycles of temozolomide at 200 mg/m2/d days 1–5 and BV at 10 mg/kg on days 1 and 14 in a 28 day cycle. An MRI was performed after every cycle and patients continued on therapy as long as there was no tumor progression, grade 4 non-hematologic toxicity or recurrent grade 4 hematologic toxicity after a dose reduction to 150 mg/m2/d. The primary endpoint was tumor response using the modified MacDonald criteria plus FLAIR and T2 sequences to evaluate non-enhancing tumor. Results were evaluated by two independent reviewers. Results: 41 patients were enrolled between October 2007 and September 2008 and 31 patients were analyzed after completion of cycle 2. As the best response, there were 8 (25.8%) partial responses, 19 (61.3 %) patients with stable disease, and 4(12.9 %) had disease progression. 19 of the 41 patients enrolled completed four cycles without tumor progression. The regimen was tolerable, with 3 grade 4 hematologic toxicities including neutropenia and thrombocytopenia. There were 2 grade 4 non-hematologic toxicities, including pulmonary embolism. There were two CNS hemorrhages. The median PFS was 3.6 months (2.9 months, 4.4 months) and the median OS was 4.5 months (3.7 months, 5.3 months). Conclusions: Upfront temozolomide and bevacizumab was well tolerated, but synergistic chemotherapy or growth factor inhibitors need to be added to produce meaningful clinical benefit, particularly for unresectable or multifocal GBM. No significant financial relationships to disclose.
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Affiliation(s)
- K. Peters
- Duke University Medical Center, Durham, NC
| | | | | | - S. Perry
- Duke University Medical Center, Durham, NC
| | | | - L. Bailey
- Duke University Medical Center, Durham, NC
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Loux T, Bailey L, Kang R, Basse P, Lotze M, Zeh H. 186. The Receptor for Advanced Glycation End-Products (RAGE) Limits NK Activity. J Surg Res 2009. [DOI: 10.1016/j.jss.2008.11.225] [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: 11/26/2022]
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