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Smyth P, Ferguson L, Burrows JF, Burden RE, Tracey SR, Herron ÚM, Kovaleva M, Williams R, Porter AJ, Longley DB, Barelle CJ, Scott CJ. Evaluation of variable new antigen receptors (vNARs) as a novel cathepsin S (CTSS) targeting strategy. Front Pharmacol 2023; 14:1296567. [PMID: 38116078 PMCID: PMC10728302 DOI: 10.3389/fphar.2023.1296567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Accepted: 11/16/2023] [Indexed: 12/21/2023] Open
Abstract
Aberrant activity of the cysteine protease Cathepsin S (CTSS) has been implicated across a wide range of pathologies. Notably in cancer, CTSS has been shown to promote tumour progression, primarily through facilitating invasion and migration of tumour cells and augmenting angiogenesis. Whilst an attractive therapeutic target, more efficacious CTSS inhibitors are required. Here, we investigated the potential application of Variable New Antigen Receptors (vNARs) as a novel inhibitory strategy. A panel of potential vNAR binders were identified following a phage display panning process against human recombinant proCTSS. These were subsequently expressed, purified and binding affinity confirmed by ELISA and SPR based approaches. Selected lead clones were taken forward and were shown to inhibit CTSS activity in recombinant enzyme activity assays. Further assessment demonstrated that our lead clones functioned by a novel inhibitory mechanism, by preventing the activation of proCTSS to the mature enzyme. Moreover, using an intrabody approach, we exhibited the ability to express these clones intracellularly and inhibit CTSS activity whilst lead clones were also noted to impede cell invasion in a tumour cell invasion assay. Collectively, these findings illustrate a novel mechanistic approach for inhibiting CTSS activity, with anti-CTSS vNAR clones possessing therapeutic potential in combating deleterious CTSS activity. Furthermore, this study exemplifies the potential of vNARs in targeting intracellular proteins, opening a range of previously "undruggable" targets for biologic-based therapy.
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Affiliation(s)
- P. Smyth
- Patrick G. Johnston Centre for Cancer Research, Queen’s University Belfast, Belfast, United Kingdom
| | | | - J. F. Burrows
- School of Pharmacy, Queen’s University Belfast, Belfast, United Kingdom
| | - R. E. Burden
- School of Pharmacy, Queen’s University Belfast, Belfast, United Kingdom
| | - S. R. Tracey
- Patrick G. Johnston Centre for Cancer Research, Queen’s University Belfast, Belfast, United Kingdom
| | - Ú. M. Herron
- Patrick G. Johnston Centre for Cancer Research, Queen’s University Belfast, Belfast, United Kingdom
| | | | - R. Williams
- Patrick G. Johnston Centre for Cancer Research, Queen’s University Belfast, Belfast, United Kingdom
| | - A. J. Porter
- Elasmogen Ltd., Aberdeen, United Kingdom
- Scottish Biologics Facility, Institute of Medical Sciences, School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, United Kingdom
| | - D. B. Longley
- Patrick G. Johnston Centre for Cancer Research, Queen’s University Belfast, Belfast, United Kingdom
| | | | - C. J. Scott
- Patrick G. Johnston Centre for Cancer Research, Queen’s University Belfast, Belfast, United Kingdom
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Haq M, Reyal Y, Tiffin N, Szakacs S, Ferguson L. T-cell pseudolymphoma secondary to ixazomib for multiple myeloma. Skin Health Dis 2021; 1:e57. [PMID: 35663138 PMCID: PMC9060122 DOI: 10.1002/ski2.57] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Revised: 05/24/2021] [Accepted: 05/25/2021] [Indexed: 11/13/2022]
Abstract
We present a case of a 54‐year‐old male with multiple myeloma (MM) who presented with widespread pruritic erythematous lesions following ixazomib treatment. This occurred after his third cycle of treatment with ixazomib, thalidomide and dexamethasone and was controlled by potent steroids and temporary cessation of ixazomib. The strong correlation between the timeline of the rash, ixazomib treatment and subsequent cessation led to a diagnosis of a drug‐induced rash. Skin biopsy histology, immunochemistry and the absence of monoclonal T‐cell receptor gene rearrangement further confirmed the diagnosis of a T‐cell pseudolymphoma secondary to ixazomib. Ixazomib is an oral proteasome inhibitor used in the treatment of MM. Other proteasome inhibitors have been reported to trigger cutaneous adverse effects. However, to our knowledge, this is the first report of pseudolymphoma following proteasome inhibitor use. Dermatologists should be aware of this potential effect and the possible management pathways such as cessation and dose reduction.
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Affiliation(s)
- M Haq
- Faculty of Medicine St George's, University of London London UK
| | - Y Reyal
- Department of Haematology St George's Healthcare NHS Trust London UK
| | - N Tiffin
- South West London Pathology St George's Healthcare NHS Trust London UK
| | - S Szakacs
- Department of Histopathology William Harvey Hospital, East Kent Hospitals University NHS Foundation Trust Ashford UK
| | - L Ferguson
- Department of Dermatology St George's Healthcare NHS Trust London UK
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Huang J, Bhargava E, Walsh M, Pennell D, Attya H, Jablenska L, Ferguson L, Lilly I, Pepper C, Tweedie D, Possamai V. 786 Retrospective analysis of paediatric ENT surgery outcomes during the COVID pandemic. Br J Surg 2021. [PMCID: PMC8135831 DOI: 10.1093/bjs/znab134.086] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
Introduction Studies show high morbidity/mortality for adults with peri-operative SARS-CoV-2 infection, leading to recommendations curtailing elective operations during the height of the pandemic. Our understanding of the risks associated with paediatric surgery is more limited, with preliminary data suggesting lower morbidity/mortality than in adults. A < 1% incidence of COVID-19 in paediatric patients undergoing preoperative universal screening is reported, and even in those testing positive, morbidity and mortality seem to be low. As waiting lists swell and the detriment associated with delaying surgery mounts, it is imperative to accurately quantify the risks of surgery in the paediatric population. Method Retrospective review of all paediatric ENT operations performed at the Evelina Children’s Hospital at the height of lockdown, from March to May 2020. Results 61 procedures were performed on 56 patients. 50% had a pre-operative SARS-CoV-2 nasopharyngeal swabs. All cases involved a change in anesthetic practice; 2 cases involved a change in surgical practice. We noted 2 medical complications and 1 surgical complication. All patients are currently extant. No staff or patients subsequently developed COVID. Conclusions Our perioperative infection rates and mortality/morbidity figures concord with figures published elsewhere in literature. We are cautiously optimistic regarding risks associated with paediatric ENT surgery.
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Affiliation(s)
- J Huang
- Guy's and St Thomas's NHS Foundation Trust, London, United Kingdom
| | - E Bhargava
- Guy's and St Thomas's NHS Foundation Trust, London, United Kingdom
| | - M Walsh
- Guy's and St Thomas's NHS Foundation Trust, London, United Kingdom
| | - D Pennell
- Guy's and St Thomas's NHS Foundation Trust, London, United Kingdom
| | - H Attya
- Guy's and St Thomas's NHS Foundation Trust, London, United Kingdom
| | - L Jablenska
- Guy's and St Thomas's NHS Foundation Trust, London, United Kingdom
| | - L Ferguson
- Guy's and St Thomas's NHS Foundation Trust, London, United Kingdom
| | - I Lilly
- Guy's and St Thomas's NHS Foundation Trust, London, United Kingdom
| | - C Pepper
- Guy's and St Thomas's NHS Foundation Trust, London, United Kingdom
| | - D Tweedie
- Guy's and St Thomas's NHS Foundation Trust, London, United Kingdom
| | - V Possamai
- Guy's and St Thomas's NHS Foundation Trust, London, United Kingdom
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Ferguson L, Ho B, Weir J, Francis N, West K, Rathbone B, Larkin J, Heelan K. Extensive mucocutaneous, oesophageal and otic lichen planus secondary to nivolumab therapy. Skin Health Dis 2021; 1:e8. [PMID: 35664814 PMCID: PMC9060137 DOI: 10.1002/ski2.8] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Revised: 10/19/2020] [Accepted: 10/23/2020] [Indexed: 02/01/2023]
Abstract
We report a 73-year-old female with metastatic renal cell carcinoma who developed a widespread lichenoid reaction following nivolumab treatment. The timeline of the reaction strongly correlated with the nivolumab treatment and subsequent cessation. Our patient had cutaneous, mucosal, otic, ophthalmic and oesophageal involvement, demonstrating the potentially extensive nature of lichenoid reactions to anti-programmed cell death receptor-1 (anti-PD1) therapies. Although lichenoid reactions to anti-PD1 therapies are now well recognized, there have been no previous reports of otic or oesophageal involvement in the literature. Although cutaneous lichenoid reactions do not tend to be severe or treatment limiting, more widespread systemic lichenoid reactions are challenging to manage, particularly in the context of malignancy. This very unusual case highlights the importance of considering involvement beyond the skin in all lichenoid skin reactions.
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Affiliation(s)
| | - B. Ho
- Dermatology DepartmentSt George's University Hospitals NHS Foundation TrustLondonUK
| | - J. Weir
- Department of HistopathologyImperial College Healthcare NHS TrustLondonUK
| | - N. Francis
- Department of HistopathologyImperial College Healthcare NHS TrustLondonUK
| | - K. West
- Histopathology DepartmentLeicester Royal InfirmaryLeicesterUK
| | - B. Rathbone
- Gastroenterology DepartmentLeicester Royal InfirmaryLeicesterUK
| | - J. Larkin
- Royal Marsden Hospital NHS TrustLondonUK
| | - K. Heelan
- Royal Marsden Hospital NHS TrustLondonUK
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Cato-Addison WB, Ferguson L, Strachan RD, Clark R, Murray JS, Moore I. Intra-dialytic intracranial pressure monitoring in a patient with lumbo-peritoneal shunt for idiopathic intracranial hypertension. Br J Neurosurg 2020:1-3. [DOI: 10.1080/02688697.2020.1774509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- W. B. Cato-Addison
- Department of Neurosurgery, James Cook University Hospital, Middlesbrough, UK
| | - L. Ferguson
- Department of Neurosurgery, Royal Victoria Infirmary, Newcastle Upon Tyne, UK
| | - R. D. Strachan
- Department of Neurosurgery, James Cook University Hospital, Middlesbrough, UK
| | - R. Clark
- Renal Unit, James Cook University Hospital, Middlesbrough, UK
| | - J. S. Murray
- Renal Unit, James Cook University Hospital, Middlesbrough, UK
| | - I. Moore
- Renal Unit, James Cook University Hospital, Middlesbrough, UK
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De Brito M, Ferguson L, Mansour S, Khan I. An unusual manifestation of X‐linked hypohidrotic ectodermal dysplasia with palmoplantar keratoderma. Clin Exp Dermatol 2020; 45:352-353. [DOI: 10.1111/ced.14096] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Accepted: 09/11/2019] [Indexed: 11/30/2022]
Affiliation(s)
- M. De Brito
- Department of Dermatology St George’s Healthcare NHS Trust London UK
| | - L. Ferguson
- Department of Dermatology St George’s Healthcare NHS Trust London UK
| | - S. Mansour
- St George’s Healthcare NHS Trust St George’s, University of London London UK
| | - I. Khan
- Department of Dermatology St George’s Healthcare NHS Trust London UK
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Coleman KA, Boscan P, Ferguson L, Twedt D, Monnet E. Evaluation of gastric motility in nine dogs before and after prophylactic laparoscopic gastropexy: a pilot study. Aust Vet J 2019; 97:225-230. [PMID: 31236930 DOI: 10.1111/avj.12829] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2018] [Revised: 03/22/2019] [Accepted: 04/07/2019] [Indexed: 11/28/2022]
Abstract
BACKGROUND The purpose of this study was to evaluate the effect of a prophylactic laparoscopic gastropexy on gastric motility in healthy large-breed dogs. METHODS This was a prospective pilot study with nine healthy client-owned dogs. Each dog was its own control. Gastric motility was evaluated before and after laparoscopic gastropexy. Dogs were fed a standard diet three weeks before and after surgery. Gastric motility was measured before and 3 weeks after surgery. A wireless motility capsule (WMC) was used to measure gastric pH, intragastric pressure, temperature, frequency of contractions, motility index (MI) and transit time. Non-parametric statistical analysis was used to compare the paired data. Clients were contacted for follow-up information 2 years postoperatively. RESULTS Median frequency of gastric contractions was 1.3 (range, 0.6-1.9 contractions/min) before gastropexy and 1.0 (range, 0.3-2.6 contractions/min) after gastropexy (P = 0.820). Median MI was 49.2 (range, 23.7-96.6) before gastropexy and 28.1 (range, 12.2-148.9) after gastropexy (P = 0.652). Median gastric emptying time was 1140 (range, 486-1230 min) before gastropexy and 1110 (range, 306-2610 min) after gastropexy (P = 0.570). During the hour before the WMC passed through the pylorus, median MI was 72.2 (range, 48.2-549.3) before gastropexy and 52.9 (range, 15.20-322.8) after gastropexy (P = 0.734), and frequency of contractions was 1.1 (range, 0.9-4.1 contractions/min) before gastropexy and 1.2 (range, 0.5-3.0 contractions/min) after gastropexy (P = 0.652). CONCLUSION Motility in the stomach did not change in healthy dogs after prophylactic laparoscopic gastropexy. We conclude that preventive laparoscopic gastropexy does not induce gastroparesis.
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Affiliation(s)
- K A Coleman
- Department of Clinical Sciences, Colorado State University Veterinary Teaching Hospital, 300 West Drake Road, Fort Collins, CO 80523, USA
| | - P Boscan
- Department of Clinical Sciences, Colorado State University Veterinary Teaching Hospital, 300 West Drake Road, Fort Collins, CO 80523, USA
| | - L Ferguson
- Department of Clinical Sciences, Colorado State University Veterinary Teaching Hospital, 300 West Drake Road, Fort Collins, CO 80523, USA
| | - D Twedt
- Department of Clinical Sciences, Colorado State University Veterinary Teaching Hospital, 300 West Drake Road, Fort Collins, CO 80523, USA
| | - E Monnet
- Department of Clinical Sciences, Colorado State University Veterinary Teaching Hospital, 300 West Drake Road, Fort Collins, CO 80523, USA
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García-Ruiz NS, Nejad B, Wilson M, Ferguson L. 2485 Identifying Barriers for Same-Day Discharge of Minimally Invasive Hysterectomies. J Minim Invasive Gynecol 2019. [DOI: 10.1016/j.jmig.2019.09.250] [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: 10/25/2022]
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Greco T, Ferguson L, Giza C, Prins ML. Mechanisms underlying vulnerabilities after repeat mild traumatic brain injuries. Exp Neurol 2019; 317:206-213. [PMID: 30853388 DOI: 10.1016/j.expneurol.2019.01.012] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2018] [Revised: 01/17/2019] [Accepted: 01/20/2019] [Indexed: 11/16/2022]
Abstract
Traumatic brain injury (TBI) has drawn national attention for its high incidence and mechanistic complexity. The majority of TBI cases are "mild" in nature including concussions and mild TBI (mTBI). Concussions are a distinct form of mTBI where diagnosis is difficult, quantification of the incidence is challenging and there is greater risk for subsequent injuries. While concussions occur in the general population, it has become a hallmark injury consistently observed among adolescent and young adult athletes and the risks for repeat TBI (rTBI) is significant. Clinical and experimental evidence shows that the magnitude and duration of deficits is dependent on the number and the interval between injuries. Several studies suggest that metabolic vulnerabilities after injury may contribute to the window for cerebral vulnerability from rTBI. In addition to metabolism, this review addresses how age, sex and hormones also play an important role in the response to repeat concussions. Understanding how these factors collectively contribute to concussion and rTBI recovery is critically important in establishing age/sex appropriate return to play guidelines, injury prevention, therapeutic interventions and mitigation of long-term consequences of rTBI.
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Affiliation(s)
- T Greco
- UCLA Department of Neurosurgery, 300 Stein Plaza, Los Angeles, CA 90095, United States
| | - L Ferguson
- UCLA Department of Neurosurgery, 300 Stein Plaza, Los Angeles, CA 90095, United States
| | - C Giza
- UCLA Department of Neurosurgery, 300 Stein Plaza, Los Angeles, CA 90095, United States
| | - M L Prins
- UCLA Department of Neurosurgery, 300 Stein Plaza, Los Angeles, CA 90095, United States.
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Malone V, Ezard N, Hodge S, Ferguson L, Schembri A, Bonevski B. Nurse provision of support to help inpatients quit smoking. Health Promot J Austr 2019; 28:251-254. [PMID: 28002718 DOI: 10.1071/he16082] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2016] [Accepted: 10/13/2016] [Indexed: 11/23/2022] Open
Abstract
Issue addressed Identification of the factors that facilitate nurses to provide smoking cessation advice to hospitalised patients. Method Six semistructured focus groups with 26 nurses were conducted in June 2015. Participants completed a structured survey to collect patient demographic data and assess attitudes towards their role in addressing smoking cessation among inpatients. Results Important themes that emerged from the qualitative data were: nurses' negative perceptions of smokers, nurses' confidence in their knowledge of smoking cessation care and nurses' uncertainty around whose role it is to provide smoking cessation care. Conclusion Nurses require training in order to confidently and competently address smoking among inpatients as part of routine care. Formal ways to document the smoking status of inpatients and the offer of smoking cessation support from a nurse to an inpatient would enhance the communication between nurses around which inpatients had been asked about their smoking status and which had not. For patients who are resistant to conventional cessation strategies, innovative ways are needed to reduce the harm caused to them by tobacco use. So what? Nurses need to be provided with education and training around smoking cessation to increase their confidence and skills to provide smoking cessation care to inpatients.
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Affiliation(s)
- V Malone
- Level 2, The O'Brien Centre, St Vincent's Hospital, 390 Victoria Street, Darlinghurst, Sydney, NSW 2010, Australia
| | - N Ezard
- Level 2, The O'Brien Centre, St Vincent's Hospital, 390 Victoria Street, Darlinghurst, Sydney, NSW 2010, Australia
| | - S Hodge
- Network of Alcohol and Other Drugs Agencies, PO Box 2345, Strawberry Hills, NSW 2012, Australia
| | - L Ferguson
- Level 2, The O'Brien Centre, St Vincent's Hospital, 390 Victoria Street, Darlinghurst, Sydney, NSW 2010, Australia
| | - A Schembri
- Level 2, The O'Brien Centre, St Vincent's Hospital, 390 Victoria Street, Darlinghurst, Sydney, NSW 2010, Australia
| | - B Bonevski
- University of Newcastle, 5014 Level 5, McAuley Centre, Calvary Mater Hospital, Edith Street, Waratah, NSW 2298, Australia
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Affiliation(s)
- L. Ferguson
- Dermatology Department Chelsea and Westminster Hospital London UK
| | - L. Fearfield
- Dermatology Department Chelsea and Westminster Hospital London UK
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12
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Ferguson L, Fearfield L. Paraneoplastic pemphigus foliaceus related to underlying breast cancer. Clin Exp Dermatol 2018; 43:817-818. [PMID: 29770472 DOI: 10.1111/ced.13602] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/01/2017] [Indexed: 11/29/2022]
Affiliation(s)
- L Ferguson
- Department of Dermatology, Chelsea and Westminster Hospital, 369 Fulham Road, London, SW10 9NH, UK
| | - L Fearfield
- Department of Dermatology, Chelsea and Westminster Hospital, 369 Fulham Road, London, SW10 9NH, UK
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13
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Palmer J, Patel T, Eldredge-Hindy H, Keith S, Patel T, Malatesta T, DiNome J, Lowther A, Ferguson L, Wagenborg S, Smyles J, Babaria U, Stabile R, Gressen E, Rudoler S, Fisher S. EP-1675: Patients undergoing radiation therapy at risk for financial toxicity: A prospective survey study. Radiother Oncol 2018. [DOI: 10.1016/s0167-8140(18)31984-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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14
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Ferguson L, Chong H, Singh M. Ecthyma gangrenosum without bacteraemia: evidence in favour of a broader definition. Clin Exp Dermatol 2017; 42:324-327. [PMID: 28239902 DOI: 10.1111/ced.13064] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/01/2016] [Indexed: 11/29/2022]
Abstract
Ecthyma gangrenosum (EG) is often defined as a cutaneous manifestation of Pseudomonas aeruginosa septicaemia, typically secondary to neutropenia. There is increasing recognition that a broader definition is warranted, as numerous causative organisms and predisposing conditions have been reported. We describe two cases of EG that occurred without bacteraemia. In this atypical subset of cases, the skin is thought to represent the primary inoculation site from which haematogenous spread can occur. The first case occurred in the context of human immunodeficiency virus (HIV) infection, a rarely reported association. The evidence base guiding clinicians on management of EG is very limited, particularly in relation to patients with HIV, in whom recurrence risk may be higher than normal. Recurrent EG is described in our second case, in an individual with Good syndrome, a rare association of thymoma and immunodeficiency.
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Affiliation(s)
- L Ferguson
- Department of Dermatology, St George's Hospital, London, UK
| | - H Chong
- Department of Cellular Pathology, St George's Hospital, London, UK
| | - M Singh
- Department of Dermatology, St George's Hospital, London, UK
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15
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Ferguson L, MacAndie C. From the bathroom to the bone-anchored hearing aid: an idea on how to remove a stripped abutment screw from a bone-anchored hearing aid. Clin Otolaryngol 2015; 41:620-1. [PMID: 26585704 DOI: 10.1111/coa.12446] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/15/2015] [Indexed: 11/28/2022]
Affiliation(s)
- L Ferguson
- Department of Otolaryngology and Head and Neck Surgery, Royal Alexandra Hospital, Paisley, UK.
| | - C MacAndie
- Department of Otolaryngology and Head and Neck Surgery, Royal Alexandra Hospital, Paisley, UK
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Ferguson L, Patel S, Holden C. Pachydermodactyly. Assoc Med J 2015. [DOI: 10.1136/bmj.h2889] [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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De Rita F, Hasan A, Haynes S, Peng E, Gandolfo F, Ferguson L, Kirk R, Smith J, Griselli M. Outcome of mechanical cardiac support in children using more than one modality as a bridge to heart transplantation. Eur J Cardiothorac Surg 2015; 48:917-22; discussion 922. [DOI: 10.1093/ejcts/ezu544] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2014] [Accepted: 12/15/2014] [Indexed: 11/13/2022] Open
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de Rita F, Gandolfo F, Haynes S, Kirk R, Ferguson L, Smith JH, Hasan A, Griselli M. 279 * OUTCOME OF MECHANICAL CARDIAC SUPPORT IN CHILDREN USING MORE THAN ONE MODALITY AS BRIDGE TO HEART TRANSPLANTATION. Interact Cardiovasc Thorac Surg 2014. [DOI: 10.1093/icvts/ivu276.279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Ferguson L, Murphy GH. The effects of training on the ability of adults with an intellectual disability to give informed consent to medication. J Intellect Disabil Res 2014; 58:864-873. [PMID: 24341991 DOI: 10.1111/jir.12101] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/29/2013] [Indexed: 06/03/2023]
Abstract
BACKGROUND This study had two aims: to investigate the capacity of individuals with intellectual disabilities (ID) to make decisions about their medications, and to evaluate whether the provision of training (information) sessions on medications would increase their capacity. METHOD Twenty-eight adults (18 male and 10 female), with a mild to moderate ID were included in this study and they were taking either Epilim, Metformin or Haloperidol medications. The participants were split into groups that comprised of participants taking the same medications. Each of the groups received three training sessions on their own medications. Capacity to consent was measured by the Adapted - Assessment of Capacity Questionnaire (A-ACQ), which was specially adapted for each medication type from the original measure (ACQ). Receptive language ability was measured by the British Picture Vocabulary Scale-II (BPVS-II). RESULTS A two-factor mixed anova analysis indicated that the provision of training had improved the capacity of the participants to give informed consent to taking their medications. Analysis using Pearson's correlations indicated that increased levels of receptive language ability correlated with greater ability to give informed consent to taking medication. CONCLUSIONS The provision of information that is formatted in a way that individuals with ID can understand may be a useful way to increase knowledge on medications. Further research that investigates the provision of information with larger samples is warranted.
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Affiliation(s)
- L Ferguson
- Institute for Health Research, University of Lancaster, Lancaster, UK
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Njai H, Shimakawa Y, Ferguson L, Sanneh B, Dalessandro U, Mendy M, Thursz M, Njie R, Lemoine M. Validation of hepatitis B surface antigen (HBsAg) rapid test to screen HBV infection in rural Gambia. Int J Infect Dis 2014. [DOI: 10.1016/j.ijid.2014.03.984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Grove JR, Main LC, Partridge K, Bishop DJ, Russell S, Shepherdson A, Ferguson L. Training distress and performance readiness: laboratory and field validation of a brief self-report measure. Scand J Med Sci Sports 2014; 24:e483-490. [PMID: 24646366 DOI: 10.1111/sms.12214] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/15/2014] [Indexed: 11/28/2022]
Abstract
Three studies were conducted to validate the Training Distress Scale (TDS), a 19-item measure of training-related distress and performance readiness. Study 1 was a randomized, controlled laboratory experiment in which a treatment group undertook daily interval training until a 25% decrement occurred in time-to-fatigue performance. Comparisons with a control group showed that TDS scores increased over time within the treatment group but not in the control group. Study 2 was a randomized, controlled field investigation in which performance capabilities and TDS responses were compared across a high-intensity interval training group and a control group that continued normal training. Running performance decreased significantly in the training group but not in the control group, and scores on the TDS mirrored those changes in performance capabilities. Study 3 examined the relationship between TDS scores obtained over a 2-week period before major swimming competitions and subsequent performance in those competitions. Significantly, better performance was observed for swimmers with low TDS scores compared with those with moderate or high TDS scores. These findings provide both laboratory and field evidence for the validity of the TDS as a measure of short-term training distress and performance readiness.
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Affiliation(s)
- J R Grove
- School of Sport Science, Exercise & Health, The University of Western Australia, Crawley, Western Australia, Australia
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Sanden B, Ferguson L, Corwin D. DEVELOPMENT AND LONG-TERM SALT TOLERANCE OF PISTACHIOS FROM PLANTING TO MATURITY USING SALINE GROUNDWATER. ACTA ACUST UNITED AC 2014. [DOI: 10.17660/actahortic.2014.1028.53] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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De Rita F, Hasan A, Haynes S, Crossland D, Kirk R, Ferguson L, Peng E, Griselli M. Mechanical cardiac support in children with congenital heart disease with intention to bridge to heart transplantation. Eur J Cardiothorac Surg 2014; 46:656-62; discussion 662. [DOI: 10.1093/ejcts/ezu039] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Borthwick D, Smith A, McPhelim J, Byers J, Devlin J, Docherty K, Jones K, Ferguson L. 106 The patient experience of lung cancer in Scotland. Lung Cancer 2014. [DOI: 10.1016/s0169-5002(14)70106-0] [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: 10/25/2022]
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Cassidy J, Wagh A, Haynes S, Kirk R, Ferguson L, Smith J, Guillen M, Thiru Y, Griselli M, Hasan A. 337 Mechanical Circulatory Support (MCS) as a Bridge to Paediatric Heart Transplant: Does the End Justify the Means? J Heart Lung Transplant 2012. [DOI: 10.1016/j.healun.2012.01.346] [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: 10/28/2022] Open
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Cassidy J, Ferguson L, Guillen M, Haynes S, Smith J, Thiru Y, Kirk R, Kesteven P, Griselli M, Hasan A. 821 Heparin Free VADs: Can It Be Done? J Heart Lung Transplant 2012. [DOI: 10.1016/j.healun.2012.01.838] [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: 11/15/2022] Open
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27
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Fan M, Ferguson L, Rohan L, Meyn L, Hillier S. P2-S9.06 Vaginal film microbicides for HIV prevention: a mixed methods study of women's preferences. Sex Transm Infect 2011. [DOI: 10.1136/sextrans-2011-050108.392] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
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Ferguson L, Bradshaw R, Wolstenholme R, Clench M, Francese S. Two-Step Matrix Application for the Enhancement and Imaging of Latent Fingermarks. Anal Chem 2011; 83:5585-91. [DOI: 10.1021/ac200619f] [Citation(s) in RCA: 68] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- L. Ferguson
- Biomedical Research Centre, Sheffield Hallam University, Howard Street S1 1WB, Sheffield, United Kingdom
| | - R. Bradshaw
- Biomedical Research Centre, Sheffield Hallam University, Howard Street S1 1WB, Sheffield, United Kingdom
| | - R. Wolstenholme
- Biomedical Research Centre, Sheffield Hallam University, Howard Street S1 1WB, Sheffield, United Kingdom
| | - M. Clench
- Biomedical Research Centre, Sheffield Hallam University, Howard Street S1 1WB, Sheffield, United Kingdom
| | - S. Francese
- Biomedical Research Centre, Sheffield Hallam University, Howard Street S1 1WB, Sheffield, United Kingdom
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Ferguson L, Vasani S, Sandhu G. The use of lesion localization needles in tracheal resections. Clin Otolaryngol 2011; 36:187. [PMID: 21518286 DOI: 10.1111/j.1749-4486.2011.02268.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Irving C, Parry G, Crossland D, Cassidy J, Ferguson L, Guillen M, Thiru Y, Hasan A, Griselli M, Kirk R. 262 Experience with ABO-Incompatible Cardiac Transplantation in Sensitised Patients. J Heart Lung Transplant 2011. [DOI: 10.1016/j.healun.2011.01.269] [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: 11/26/2022] Open
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Cassidy J, Kirk R, Haynes S, Ferguson L, Guillen M, Thiru Y, Hayden-Smith J, Chaudhari M, Griselli M, Hasan A. 329 Mechanical Circulatory Support (MCS) as a Bridge To Transplant in Children with Univentricular Physiology: What Have We Learned? J Heart Lung Transplant 2011. [DOI: 10.1016/j.healun.2011.01.336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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Ferguson L, Chipp E, Rayatt S. Gravitational retrograde venous perfusion - a technique for limb extremity salvage when microvascular arterial repair is not possible. J Plast Reconstr Aesthet Surg 2010; 63:e422-3. [DOI: 10.1016/j.bjps.2009.10.022] [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] [Received: 10/09/2009] [Accepted: 10/21/2009] [Indexed: 11/16/2022]
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Tibby S, Durward A, Ferguson L, Bangalore H, Murdoch I. Relationship between effective osmolality changes and neurological status during treatment for severe paediatric diabetic ketoacidosis. Crit Care 2009. [PMCID: PMC4083999 DOI: 10.1186/cc7277] [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: 12/03/2022] Open
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Langley J, Frenette L, Ferguson L, Riff D, Folkerth S, Sheldon E, Segall N, Risi G, Middleton R, Johnson C, Li P, Innis B, Fries L. Safety and Cross-Reactive Immunogenicity of Two H5N1 A/Indonesia/5/2005 (Clade 2.1) AS-Adjuvanted Prepandemic Candidate Influenza Vaccines: A Phase I/II Clinical Trial. Int J Infect Dis 2008. [DOI: 10.1016/j.ijid.2008.05.365] [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] Open
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36
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Bailey FA, Ferguson L, Williams BR, Woodby LL, Redden DT, Durham RM, Goode PS, Burgio KL. Palliative Care Intervention for Choice and Use of Opioids in the Last Hours of Life. J Gerontol A Biol Sci Med Sci 2008; 63:974-8. [DOI: 10.1093/gerona/63.9.974] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Ferguson L, Oden M, Kaye K, Engemann J, McDonald J, Trofi W. Reprocessing disposable single-use devices: From skepticism to success. Am J Infect Control 2005. [DOI: 10.1016/j.ajic.2005.04.034] [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: 10/25/2022]
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Goodacre S, Helgason A, Nicholson J, Southam L, Ferguson L, Hickey E, Vega E, Stefánsson K, Ward R, Sykes B. Genetic evidence for a family-based Scandinavian settlement of Shetland and Orkney during the Viking periods. Heredity (Edinb) 2005; 95:129-35. [PMID: 15815712 DOI: 10.1038/sj.hdy.6800661] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
The Viking age witnessed the expansion of Scandinavian invaders across much of northwestern Europe. While Scandinavian settlements had an enduring cultural impact on North Atlantic populations, the nature and extent of their genetic legacy in places such as Shetland and Orkney is not clear. In order to explore this question further, we have made an extensive survey of both Y-chromosomal and mitochondrial DNA (mtDNA) variation in the North Atlantic region. Our findings indicate an overall Scandinavian ancestry of approximately 44% for Shetland and approximately 30% for Orkney, with approximately equal contributions from Scandinavian male and female subjects in both cases. This contrasts with the situation for the Western Isles, where the overall Scandinavian ancestry is less ( approximately 15%) and where there is a disproportionately high contribution from Scandinavian males. In line with previous studies, we find that Iceland exhibits both the greatest overall amount of Scandinavian ancestry (55%) and the greatest discrepancy between Scandinavian male and female components. Our results suggest that while areas close to Scandinavia, such as Orkney and Shetland, may have been settled primarily by Scandinavian family groups, lone Scandinavian males, who later established families with female subjects from the British Isles, may have been prominent in areas more distant from their homeland.
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Affiliation(s)
- S Goodacre
- Weatherall Institute of Molecular Medicine, University of Oxford, Oxford OX3 9DS, UK.
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Epstein L, Beede R, Kaur S, Ferguson L. Rootstock Effects on Pistachio Trees Grown in Verticillium dahliae-Infested Soil. Phytopathology 2004; 94:388-395. [PMID: 18944115 DOI: 10.1094/phyto.2004.94.4.388] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
ABSTRACT In a field trial in soil infested with Verticillium dahliae, we compared the yield, growth, incidence of symptoms of Verticillium wilt, and mortality of two interspecific hybrid pistachio tree rootstocks (UCBI and PGII) with the standard rootstocks: the V. dahliae-resistant and susceptible Pistacia integerrima and P. atlantica, respectively. After 10 years, the trees were destructively sampled for V. dahliae in the xylem at the graft union. The results indicate that trees on the (P. atlantica 'KAC' x P. integerrima) hybrid UCBI rootstock grew and yielded as well as those on P. integerrima. Trees on the hybrid PGII yielded the least. Analysis of variance and log-linear models indicate that in soil infested with V. dahliae, three associations significantly affect pistachio nut yield. Rootstock affects scion vigor and extent of infection. Third, the extent of infection and scion vigor are inversely associated. Although trees on the P. integerrima rootstock had the highest ratings in a visual assessment of vigor, 65% were infected with V. dahliae in the trunk in the graft region compared with 73% in P. atlantica and 25% in UCBI. Thus, P. integerrima and UCBI have at least one different mechanism for resistance to V. dahliae.
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Firrincieli V, Geldmaker B, Custis N, Ehrensberger R, Erwin E, Riposo D, Shufflebarger C, Ferguson L, Platts-Mills T. Risk factors for asthma among head start children: Evaluation of physical activity and allergy. J Allergy Clin Immunol 2003. [DOI: 10.1016/s0091-6749(03)80675-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Tibby S, West J, Ferguson L, Durward A, Murdoch I. Crit Care 2003; 7:P246. [DOI: 10.1186/cc2135] [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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42
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Goumon Y, Casares F, Pryor S, Ferguson L, Brownawell B, Cadet P, Rialas CM, Welters ID, Sonetti D, Stefano GB. Ascaris suum, an intestinal parasite, produces morphine. J Immunol 2000; 165:339-43. [PMID: 10861070 DOI: 10.4049/jimmunol.165.1.339] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
The parasitic worm Ascaris suum contains the opiate alkaloid morphine as determined by HPLC coupled to electrochemical detection and by gas chromatography/mass spectrometry. The level of this material is 1168 +/- 278 ng/g worm wet weight. Furthermore, Ascaris maintained for 5 days contained a significant amount of morphine, as did their medium, demonstrating their ability to synthesize the opiate alkaloid. To determine whether the morphine was active, we exposed human monocytes to the material, and they immediately released nitric oxide in a naloxone-reversible manner. The anatomic distribution of morphine immunoreactivity reveals that the material is in the subcuticle layers and in the animals' nerve chords. Furthermore, as determined by RT-PCR, Ascaris does not express the transcript of the neuronal mu receptor. Failure to demonstrate the expression of this opioid receptor, as well as the morphine-like tissue localization in Ascaris, suggests that the endogenous morphine is intended for secretion into the microenvironment.
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Affiliation(s)
- Y Goumon
- Neuroscience Research Institute, State University of New York, Old Westbury, NY 11568, USA
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Briles DE, Hollingshead S, Brooks-Walter A, Nabors GS, Ferguson L, Schilling M, Gravenstein S, Braun P, King J, Swift A. The potential to use PspA and other pneumococcal proteins to elicit protection against pneumococcal infection. Vaccine 2000; 18:1707-11. [PMID: 10689153 DOI: 10.1016/s0264-410x(99)00511-3] [Citation(s) in RCA: 104] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Pneumococcal proteins, alone, in combination with each other, or in combination with capsular polysaccharide-protein conjugates may be useful pneumococcal vaccine components. Four proteins with a potential for use in vaccines are PspA, pneumolysin, PsaA, and PspC. In a mouse model of carriage, PsaA and PspC were the most efficacious vaccine proteins. Of these, PsaA was the best at eliciting protection against carriage. However, a combination of PspA and pneumolysin may elicit stronger immunity to pulmonary infection and possibly sepsis than either protein alone. Recently, a phase one trial of a recombinant family 1 PspA was completed in man. PspA was observed to be safe and immunogenic. Injection of 0.1 ml of immune serum diluted to 1/400 was able to protect mice from fatal infection with S. pneumoniae. Under these conditions, pre-immune serum was not protective. The immune human serum protected mice from infections with pneumococci expressing either of the major PspA families (1 and 2) and both of the pneumococcal capsular types tested: 3 and 6.
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Affiliation(s)
- D E Briles
- Department of Microbiology, University of Alabama at Birmingham, 658 BBLB, 845 19th Street South, Birmingham, AL 35294, USA.
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Ferguson L, Golden WE. Outpatient chart documentation in Arkansas: a report from Medicaid managed care services. J Ark Med Soc 1999; 96:180-3. [PMID: 10544551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/14/2023]
Affiliation(s)
- L Ferguson
- Arkansas Foundation for Medical Care, USA
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Dimigen G, Del Priore C, Butler S, Evans S, Ferguson L, Swan M. Psychiatric disorder among children at time of entering local authority care: questionnaire survey. BMJ 1999; 319:675. [PMID: 10480823 PMCID: PMC28219 DOI: 10.1136/bmj.319.7211.675] [Citation(s) in RCA: 96] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- G Dimigen
- Department of Psychology, University of Glasgow, Glasgow G12 8RT.
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Greenspan SL, Parker RA, Ferguson L, Rosen HN, Maitland-Ramsey L, Karpf DB. Early changes in biochemical markers of bone turnover predict the long-term response to alendronate therapy in representative elderly women: a randomized clinical trial. J Bone Miner Res 1998; 13:1431-8. [PMID: 9738515 DOI: 10.1359/jbmr.1998.13.9.1431] [Citation(s) in RCA: 151] [Impact Index Per Article: 5.8] [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] [Indexed: 11/18/2022]
Abstract
Although the antiresorptive agent alendronate has been shown to increase bone mineral density (BMD) at the hip and spine and decrease the incidence of osteoporotic fractures in older women, few data are available regarding early prediction of long-term response to therapy, particularly with regard to increases in hip BMD. Examining short-term changes in biochemical markers incorporates physiologic response with therapeutic compliance and should provide useful prognostic information for patients. The objective of this study was to examine whether early changes in biochemical markers of bone turnover predict long-term changes in hip BMD in elderly women. The study was a double-blind, placebo-controlled, randomized clinical trial which took place in a community-based academic hospital. One hundred and twenty community-dwelling, ambulatory women 65 years of age and older participated in the study. Intervention consisted of alendronate versus placebo for 2.5 years. All patients received appropriate calcium and vitamin D supplementation. The principal outcome measures included BMD of the hip (total hip, femoral neck, trochanter, and intertrochanter), spine (posteroanterior [PA] and lateral), total body, and radius. Biochemical markers of bone resorption included urinary N-telopeptide cross-linked collagen type I and free deoxypyridinoline; markers of bone formation included serum osteocalcin and bone-specific alkaline phosphatase. Long-term alendronate therapy was associated with increased BMD at the total hip (4.0%), femoral neck (3.1%), trochanter (5.5%), intertrochanter (3.8%), PA spine (7.8%), lateral spine (10.6%), total body (2.2%), and one-third distal radius (1.3%) in elderly women (all p < 0.01). In the placebo group, bone density increased 1.9-2.1% at the spine (p < 0.05) and remained stable at all other sites. At 6 months, there were significant decreases in all markers of bone turnover (-10% to -53%, p < 0.01) in women on alendronate. The changes in urinary cross-linked collagen at 6 months correlated with long-term bone density changes at the hip (r = -0.35, p < 0.01), trochanter (r = -0.36, p < 0.01), PA spine (r = -0.41, p < 0.01), and total body (r = -0.34, p < 0.05). At 6 months, patients with the greatest drop in urinary cross-linked collagen (65% or more) demonstrated the greatest gains in total hip, trochanteric, and vertebral bone density (all p < 0.05). A 30% decrease in urinary cross-linked collagen at 6 months predicted a bone density increase of 2.8-4.1% for the hip regions and 5.8-6.9% for the spine views at the 2.5-year time point (p < 0.05). There were no substantive associations between changes in biochemical markers and bone density in the placebo group. Alendronate therapy was associated with significant long-term gains in BMD at all clinically relevant sites, including the hip, in elderly women. Moreover, these improvements were associated with early decreases in biochemical markers of bone turnover. Early dynamic decreases in urinary cross-linked collagen can be used to monitor and predict long-term response to bisphosphonate therapy in elderly women. Future studies are needed to determine if early assessment improves long-term patient compliance or uncovers poor compliance, thereby aiding the physician in maximizing the benefits of therapy.
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Affiliation(s)
- S L Greenspan
- Department of Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts 02215, USA
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Rosen HN, Moses AC, Garber J, Ross DS, Lee SL, Ferguson L, Chen V, Lee K, Greenspan SL. Randomized trial of pamidronate in patients with thyroid cancer: bone density is not reduced by suppressive doses of thyroxine, but is increased by cyclic intravenous pamidronate. J Clin Endocrinol Metab 1998; 83:2324-30. [PMID: 9661603 DOI: 10.1210/jcem.83.7.4782] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [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] [Indexed: 02/08/2023]
Abstract
Patients taking suppressive doses of T4 are thought to have accelerated bone loss and increased risk of osteoporosis. We therefore randomize 55 patients taking suppressive doses of T4 to treatment with pamidronate (APD) 30 mg i.v. every 3 months for 2 yr (APD/T4), or placebo (placebo/T4). Patients had measurements of bone mineral density (BMD) of the spine, hip, radius, and total body every 6 months for 2 yr. There was no significant bone loss at any site in the placebo/T4 group. Ninety five percent confidence intervals excluded a rate of bone loss > 0.89%/yr for the spine and > 0.31%/yr at the total hip. When men were excluded from the analysis, there still was no significant bone loss for the placebo/T4 group, and confidence intervals did not change. The APD/T4 group showed increases in spine (4.3%, P = 0.0001), total hip (1.4%, P < 0.05), and trochanteric (3.0%, P = 0.0001) BMDs. In conclusion, premenopausal women and men on suppressive therapy with T4 do not lose bone rapidly, and are not at increased risk of developing osteoporosis. A regimen of 30 mg APD given every 3 months for 2 yr causes significant suppression of bone resorption and increases in BMD, and may be an acceptable alternative treatment for osteoporosis in patients who cannot tolerate oral bisphosphonates.
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Affiliation(s)
- H N Rosen
- Charles A. Dana Research Institute, Boston, Massachusetts, USA
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De Flora S, Camoirano A, Cartiglia C, Ferguson L. Modulation of the potency of promutagens and direct acting mutagens in bacteria by inhibitors of the multidrug resistance mechanism. Mutagenesis 1997; 12:431-5. [PMID: 9412996 DOI: 10.1093/mutage/12.6.431] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Multiple drug resistance (MDR) mechanisms are known to limit the effectiveness of some cancer chemotherapies, probably through enhancing P-glycoprotein-mediated drug efflux from mammalian cells. Similar mechanisms appear to act in other organisms, including bacteria, and may affect not only the toxicity but also the mutagenicity of certain chemicals. At least in some experimental situations, MDR can be overcome through concomitant treatment of the cells with various types of inhibitors. Two MDR inhibitors, verapamil, a calcium channel blocker, and trifluoperazine, a calmodulin inhibitor, were assayed for their ability to modulate the potency of nine mutagens with varying mechanisms of action in various Salmonella typhimurium his- strains. Neither verapamil nor trifluoperazine affected the direct mutagenicity of sodium dichromate and 2-methoxy-6-chloro-9[3-(2-chloroethyl)amino-propyl-amino] dihydrochloride (ICR 191) or the S9-mediated mutagenicity of benzo[a]pyrene and 2-amino-3,4-dimethyl-amidazo[4,5-f]quinoline (MeIQ). Both modulators enhanced the direct mutagenicity of doxorubicin. Moreover, trifluoperazine sharply increased the S9-mediated mutagenicity of cyclophosphamide and 2-aminofluorene, while it consistently decreased the mutagenicity of 3-amino-1-methyl-5H-pyrido[4,3-b]indole (Trp-P-2). The contrasting effect towards the aromatic amine 2-aminofluorene and the heterocyclic amine Trp-P-2, representative of important chemical families responsible for the bacterial mutagenicity of cigarette smoke, may explain the observed lack of influence of trifluoperazine on the mutagenicity of a cigarette smoke condensate. These observations extend the known range of chemical types whose mutagenicity can be modulated by inhibitors of MDR and suggest that there may be value in adding MDR inhibitors, especially trifluoperazine, to optimize the detection of mutagenicity by certain types of chemicals in the Salmonella/mammalian microsome mutagenicity test.
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Affiliation(s)
- S De Flora
- Institute of Hygiene and Preventive Medicine, University of Genoa, Italy.
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