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Ragnhildstveit A, Tuteja N, Seli P, Smart L, Uzun N, Bass LC, Miranda AC, Ford TJ, Neufeld SAS. Transitions from child and adolescent to adult mental health services for eating disorders: an in-depth systematic review and development of a transition framework. J Eat Disord 2024; 12:36. [PMID: 38454528 PMCID: PMC10921655 DOI: 10.1186/s40337-024-00984-3] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2023] [Accepted: 02/02/2024] [Indexed: 03/09/2024] Open
Abstract
BACKGROUND Eating disorders (EDs) peak in mid-to-late adolescence and often persist into adulthood. Given their early onset and chronicity, many patients transition from child and adolescent mental health services (CAMHS) to adult mental health services (AMHS) for ongoing, speciality ED care. This transition typically occurs at 18 years of age, when important biological, psychosocial, and vocational changes take place. Thus, smooth and effective transitions are paramount for ensuring service continuity, as well as reducing the risk of ED relapse and premature death. Here, we synthesized evidence on transitions from CAMHS to AMHS for young people with EDs, aiming to inform future research, clinical practice, and healthcare policy. METHODS A systematic review of the literature was conducted. This adhered to PRISMA guidelines. PubMed, Embase, and Scopus electronic databases were queried from inception to December 3, 2023. Leveraging the PICOS framework, study eligibility was evaluated in the qualitative synthesis. Data regarding methodology, analytic approach, and associated outcomes were then extracted. The quality of evidence was examined using critical appraisal tools. Finally, concept mapping was applied to organize findings into a transition framework. RESULTS The search returned 76 articles. Of these, 14 were included in the final review. Articles were grouped into 'qualitative' (n = 10), 'cross-sectional' (n = 2), and 'longitudinal cohort' (n = 2) studies based on research design. Overall, ED transitions were complex, multifaceted, and challenging for patients, caregivers, and providers alike. This resulted from an interplay of temporal- (e.g., timing of ED onset and transition), stakeholder- (e.g., patient ambivalence towards recovery) and systemic- (e.g., differences between services) related factors. Most studies were of moderate-to-high quality. Findings informed the development of five transition strategies designed to facilitate effective transfers across ED care: Timely talks, Readiness, Inclusion, Preparation, and Synergy (TRIPS). CONCLUSIONS Transitions from CAMHS to AMHS appear problematic for young people with EDs and other involved stakeholders. The field stands to benefit from TRIPS, an actionable, evidence-based framework that aims to alleviate challenges of transitioning and subsequently improve ED trajectories. As a logical next step, future work should empirically test the TRIPS framework, exploring its predictive utility and clinical value.
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Affiliation(s)
| | - Nandita Tuteja
- Department of Neurobiology and Behavior, University of California, Irvine, Irvine, CA, USA
| | - Paul Seli
- Department of Psychology and Neuroscience, Duke University, Durham, NC, USA
| | - Leo Smart
- Neuroscience Program, Bates College, Lewiston, ME, USA
| | - Naz Uzun
- Department of Psychology, University of Manchester, Manchester, England, UK
| | - Lisa C Bass
- Neuroscience Interdepartmental Program, University of California, Los Angeles, Los Angeles, CA, USA
| | - Alyssa C Miranda
- Consciousness and Transformative Studies, National University, San Diego, CA, USA
| | - Tamsin J Ford
- Department of Psychiatry, University of Cambridge, Cambridge, England, UK
| | - Sharon A S Neufeld
- Department of Psychiatry, University of Cambridge, Cambridge, England, UK
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Brendle M, Ragnhildstveit A, Slayton M, Smart L, Cunningham S, Zimmerman MH, Seli P, Gaffrey MS, Averill LA, Robison R. Registered clinical trials investigating ketamine and esketamine for treatment-resistant depression: A systematic review. JPS 2023. [DOI: 10.1556/2054.2022.00234] [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] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
AbstractBackground and AimsKetamine and esketamine have garnered interest in both psychiatric research and clinical practice for treatment-resistant depression (TRD). In this review, we examined registered trials investigating the therapeutic use of ketamine or esketamine for TRD, with the aim of characterizing emerging trends and knowledge gaps.MethodsThe ClinicalTrials.gov electronic registry and results database was queried from inception to February 5, 2022, adhering to elements of the PRISMA guideline, we evaluated trial eligibility in the qualitative synthesis. Data regarding study design, drug regimens, and measures were subsequently abstracted and descriptively analyzed.ResultsThe search returned 86 records, of which 56 trials were included in the final review. The number of trials investigating ketamine and esketamine for TRD increased since 2008, with higher peaks observed in 2015 (n = 9) and 2021 (n = 9). Most trials were Phase 2 (13, 23.2%) or Phase 3 (11, 19.6%), gathering preliminary data on efficacy and/or further data on safety and efficacy with variant dosing and pharmacological approaches. By and large, trials examined ketamine and esketamine as individual versus combination treatments (45% and 25%, respectively). The Montgomery-Asberg Depression Rating Scale (MADRS) was most commonly used to assess clinical outcomes (75%).ConclusionsThere are increasingly large-scale and late-phase trials of esketamine over ketamine for TRD, coupled with efforts to centralize evidence on these medications. Yet several trials do not assess patient characteristics that may affect treatment response, such as age, sex, and race. By understanding these design limitations, scientists and clinicians can avoid research waste and funding bodies can judiciously direct support towards high priority research.
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Affiliation(s)
- Madeline Brendle
- Integrated Research Literacy Group, Draper, UT, USA
- Department of Pharmacotherapy, University of Utah College of Pharmacy, SLC, UT, USA
- Numinus Wellness, Draper, UT, USA
- Department of Psychology and Neuroscience, Duke University, Durham, NC, USA
| | - Anya Ragnhildstveit
- Integrated Research Literacy Group, Draper, UT, USA
- Department of Psychology and Neuroscience, Duke University, Durham, NC, USA
- Department of Pyschiatry, University of Cambridge, Cambridge, England, UK
| | - Matthew Slayton
- Integrated Research Literacy Group, Draper, UT, USA
- Department of Psychology and Neuroscience, Duke University, Durham, NC, USA
| | - Leo Smart
- Integrated Research Literacy Group, Draper, UT, USA
- Numinus Wellness, Draper, UT, USA
- Department of Neuroscience, Bates College, Lewiston, ME, USA
| | | | | | - Paul Seli
- Department of Psychology and Neuroscience, Duke University, Durham, NC, USA
| | | | - Lynnette Astrid Averill
- Menninger Department of Psychiatry, Baylor College of Medicine, Houston, TX, USA
- Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX, USA
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
- US Department of Veterans Affairs, National Center for PTSD – Clinical Neuroscience Division, West Haven, CT, USA
| | - Reid Robison
- Numinus Wellness, Draper, UT, USA
- Department of Psychiatry, University of Utah School of Medicine, UT, USA
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Ahuja S, Brendle M, Smart L, Moore C, Thielking P, Robison R. Real-world depression, anxiety and safety outcomes of intramuscular ketamine treatment: a retrospective descriptive cohort study. BMC Psychiatry 2022; 22:634. [PMID: 36192794 PMCID: PMC9528178 DOI: 10.1186/s12888-022-04268-5] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2022] [Accepted: 09/20/2022] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Ketamine has emerged as a promising pharmacotherapy for depression and other mental illnesses, and the intramuscular (IM) administration of ketamine is now offered at many North American outpatient psychiatric clinics. However, a characterization of the outpatient population receiving IM ketamine treatment and an evaluation of the real-world depression, anxiety, and safety outcomes of long-term psychiatric IM ketamine treatment has not been reported. This study aimed to evaluate the clinical characteristics, treatment patterns, clinical outcomes, and adverse events of patients receiving IM ketamine treatment. METHODS Patient data from the electronic health records of a private outpatient psychiatric clinic network in the United States were collected and analyzed retrospectively. Adults with any psychiatric diagnosis who received ketamine treatment only by IM administration from January 2018 to June 2021 were included. A total of 452 patients were included in the cohort. RESULTS Patients receiving IM ketamine treatment had a mean of 2.8 (SD 1.4) psychiatric diagnoses. 420 (93%) patients had a diagnosis of major depressive disorder, 243 (54%) patients had a diagnosis of generalized anxiety disorder, and 126 (28%) patients had a diagnosis of post-traumatic stress disorder. Patients received a median of 4 (range 1-48) IM ketamine treatments. Median depression scores (PHQ-9) improved 38% from 16.0 (IQR 11.3-21.8) at baseline to 10.0 (IQR 6.0-15.0) at last treatment (p < .001). Median anxiety scores (GAD-7) improved 50% from 14.0 (IQR 8.0-17.0) at baseline to 7.0 (IQR 4.3-11.8) at last treatment (p < .001). With maintenance ketamine treatments, average improvements in depression (PHQ-9) and anxiety (GAD-7) scores of at least 4.7 and 4.9 points were maintained for over 7 months. An adverse event occurred during 59 of 2532 treatments (2.3%). CONCLUSIONS IM ketamine is being utilized to treat psychiatric outpatients with multiple mental illnesses not limited to depression. Average depression and anxiety levels significantly improve throughout IM ketamine treatment and do not regress to baseline during patients' maintenance treatment phase. Prospective studies are recommended to confirm the long-term effectiveness and safety of IM ketamine.
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Affiliation(s)
| | - Madeline Brendle
- Cedar Psychiatry, Springville, UT USA ,grid.223827.e0000 0001 2193 0096Department of Pharmacotherapy, University of Utah College of Pharmacy, Salt Lake City, UT USA
| | - Leo Smart
- Cedar Psychiatry, Springville, UT USA
| | - Claire Moore
- Cedar Psychiatry, Springville, UT USA ,Numinus Wellness, Vancouver, British Columbia Canada
| | - Paul Thielking
- Cedar Psychiatry, Springville, UT USA ,Numinus Wellness, Vancouver, British Columbia Canada ,grid.223827.e0000 0001 2193 0096University of Utah School of Medicine, DraperSalt Lake City, UT 721 E 12200 S, 84020 USA
| | - Reid Robison
- Cedar Psychiatry, Springville, UT, USA. .,Numinus Wellness, Vancouver, British Columbia, Canada. .,University of Utah School of Medicine, DraperSalt Lake City, UT, 721 E 12200 S, 84020, USA.
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Turner K, Boyd C, Stander N, Smart L. Clinical characteristics of two-hundred thirty-two dogs (2006-2018) treated for suspected anaphylaxis in Perth, Western Australia. Aust Vet J 2021; 99:505-512. [PMID: 34541658 DOI: 10.1111/avj.13114] [Citation(s) in RCA: 3] [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: 10/06/2020] [Revised: 05/28/2021] [Accepted: 08/04/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To describe the clinical features of dogs treated for suspected anaphylaxis in Perth, Western Australia. DESIGN Single-centre observational case series with retrospective and prospective phases. METHODS This was a two-phase study of dogs with clinical suspicion of anaphylaxis presenting to the emergency service of a university teaching hospital. Dogs required evidence of, and appropriate treatment of, a type 1 hypersensitivity reaction as well as two or more organs affected (or cardiovascular signs alone) to be included. Phase 1 includes retrospective case series of 186 dogs (March 2006-December 2018). Phase 2 includes prospective descriptive case series of 46 dogs (October 2017-July 2018) focused on clinical signs. RESULTS In phase 1, 88 (47%) dogs had evidence of insect exposure prior to the acute event. One hundred forty (75%) dogs had dermatological signs, 141 (76%) had gastrointestinal signs and 129 (69%) had cardiovascular signs. Ninety-two (49%) dogs had vasoconstrictive shock (5 with bradycardia), 24 (13%) had vasodilatory shock, 8 (4%) had mixed vasodilatory and vasoconstrictive shock and 5 (3%) had unclassifiable shock. On focused abdominal ultrasound, 42 of 71 (59%) dogs had gallbladder wall oedema and 3 of 71 (4%) dogs had peritoneal free fluid. In phase 2, the distributions of insect exposure, organ dysfunction and sonographic abnormalities were similar to phase 1. CONCLUSION Dogs presenting with suspected anaphylaxis showed a broad range of presentations. Dermatological signs were absent in a proportion of dogs, vasoconstrictive shock was more frequent than vasodilatory and unique features of shock were identified. This study highlights the challenges of diagnosis based on presenting features alone.
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Affiliation(s)
- K Turner
- College of Science, Health, Engineering and Education, Murdoch University, Perth, Western Australia, Australia
| | - C Boyd
- College of Science, Health, Engineering and Education, Murdoch University, Perth, Western Australia, Australia
| | - N Stander
- Vet Imaging Specialists, The Animal Hospital at Murdoch University, Perth, Western Australia, Australia
| | - L Smart
- College of Science, Health, Engineering and Education, Murdoch University, Perth, Western Australia, Australia
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Poh D, Claus M, Smart L, Sharp CR. Transfusion practice in Australia: an internet-based survey. Aust Vet J 2021; 99:108-113. [PMID: 33442882 DOI: 10.1111/avj.13049] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2020] [Revised: 11/15/2020] [Accepted: 12/05/2020] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To describe small animal transfusion practices in Australia, including access to blood products and frequency of pre-transfusion compatibility testing and medication administration. METHODS An online survey was disseminated to target Australian veterinarians treating dogs and cats. Information collected included demographics, sources of blood products, blood storage, recipient compatibility testing and administration of medications pre-transfusion. Associations between the use of compatibility tests and premedications were assessed using the χ2 test. Significance was set at P < 0.05. RESULTS A total of 199 Australian veterinarians were included; however, there was some attrition of respondents over the course of the survey. The majority of respondents were in general practice (n = 133/199). Access to fresh whole blood was commonly reported for dogs (n = 179/199) and cats (n = 131/198), whereas blood components were less commonly available (canine red blood cells [RBC], n = 52/199 and plasma, n = 157/199; feline RBC, n = 9/198 and plasma, n = 21/198). Most blood was sourced from the pets of owners affiliated with the veterinary clinic (n = 179/196). The respondents who did not blood type or crossmatch dogs were significantly more likely to use premedication than those who did these tests (both comparisons: P < 0.001). Likewise, the respondents who did not blood-type cats were significantly more likely to use premedication (P = 0.003); however, there was no association between crossmatching and using premedication in cats (P = 0.183). CONCLUSION This is the first survey to describe transfusion practices across a variety of practice types throughout Australia. Future work is needed to determine how representative these results are of current transfusion practices across Australia, and if so, what can be done to optimise them.
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Affiliation(s)
- D Poh
- Comparative Health Research Group, School of Veterinary Medicine, Murdoch University, Perth, Western Australia, Australia
| | - M Claus
- Comparative Health Research Group, School of Veterinary Medicine, Murdoch University, Perth, Western Australia, Australia
| | - L Smart
- Comparative Health Research Group, School of Veterinary Medicine, Murdoch University, Perth, Western Australia, Australia
| | - C R Sharp
- Comparative Health Research Group, School of Veterinary Medicine, Murdoch University, Perth, Western Australia, Australia
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6
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Robveille C, Smart L, Boyd CJ. Obstructive shock caused by right atrial thrombosis secondary to malignant pheochromocytoma in a dog. Aust Vet J 2020; 98:462-466. [PMID: 32794177 DOI: 10.1111/avj.12992] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Revised: 05/17/2020] [Accepted: 06/05/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND Obstructive shock can be caused by any lesion leading to extraluminal compression or intraluminal occlusion of the cardiac chambers or major vessels. CASE REPORT A 12-year-old, male castrated, Border Collie cross dog presented to a veterinary teaching hospital for collapse. A physical examination revealed severe vasoconstrictive shock and abdominal distension. Abnormalities on blood tests were consistent with systemic hypoperfusion. Cardiac underfilling, hepatomegaly with distended vasculature and ascites were identified by focused ultrasonography, raising suspicion of obstructive shock. This was supported by the radiographic findings of microcardia and a distended caudal vena cava (CVC). There was transient response to fluid therapy for blood volume expansion. Repeat focused ultrasonography during rapid intravenous fluid administration identified a right intra-atrial mass, assessed as likely to be causing obstruction of venous return. The dog was humanely euthanased given the guarded prognosis. At postmortem evaluation, a malignant pheochromocytoma in the left adrenal gland with tumour thrombus extending to the tricuspid valve through the CVC was found. The extensive thrombus caused the obstructive shock in this case. Metastasis in a peripheral lymph node and neoplastic emboli in the heart and lungs were also visible at the histopathological evaluation. CONCLUSION To the best of authors' knowledge, this is the first report of severe obstructive shock secondary to extension of caval tumour thrombus into the right atrium in a dog with malignant pheochromocytoma. Tumour thrombus from a malignant pheochromocytoma should be included as a differential diagnosis of obstructive shock, with or without a visible right intra-atrial mass, in dogs. Serial focused ultrasonography during intravenous fluid administration can aid diagnosis.
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Affiliation(s)
- C Robveille
- School of Veterinary Medicine, Murdoch University, Perth, Western Australia, Australia
| | - L Smart
- School of Veterinary Medicine, Murdoch University, Perth, Western Australia, Australia
| | - C J Boyd
- School of Veterinary Medicine, Murdoch University, Perth, Western Australia, Australia
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7
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Boller M, Kelers K, Stevenson MA, Winkel KD, Hardjo S, Heller J, Judge PR, Ong HM, Padula AM, Reddrop C, Santos L, Sharp CR, Smart L, Swindells KL, Tabrett D, Wierenga JR. SnakeMap: four years of experience with a national small animal snake envenomation registry. Aust Vet J 2020; 98:442-448. [PMID: 32743816 DOI: 10.1111/avj.12993] [Citation(s) in RCA: 4] [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: 03/21/2020] [Accepted: 06/10/2020] [Indexed: 11/29/2022]
Abstract
SnakeMap is a national cloud-based, veterinary snakebite registry. It was designed to prospectively collect data of the clinical circumstances and temporospatial information on cases of snake envenomation in dogs and cats. We herein introduce the project and summarise the data from the first 4 years of SnakeMap. The registry is a veterinary community-based online database allowing case entry from veterinary hospitals across Australia. Registry data comprise hospital characteristics, patient characteristics, envenoming snake type, treatment and outcome variables, including time and geolocation of the snake bite. We present summative information on select key variables from the SnakeMap registry (1 July 2015 to 30 June 2019). Twenty-eight hospitals from 6 states/territories entered 624 cases into the registry, including 419 dogs (67%) and 205 cats (33%). Bite time was available in 216 animals of which 90 (42%) were reported to be bitten in the 3 hours between 03:00 pm and 05:59 pm; median bite to presentation interval was 60 (interquartile range [IQR] 30, 211) minutes in dogs and 95 (IQR 41, 238) minutes in cats. Bites occurred in the owner's yard in 356 dogs (85%) and 53 cats (26%). A snake venom detection kit was used in 172 cases (28%) and antivenom was administered in 523 cases (85%). Most animals (n = 534, 88%) survived to discharge (median hospitalisation of 25 [IQR 16, 62] hours). SnakeMap effectively collects relevant clinical data from dogs and cats with presumed snake bite and provides locally specific information on the epidemiology of snake envenomation in small animals.
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Affiliation(s)
- M Boller
- Veterinary Hospital, Melbourne Veterinary School, University of Melbourne, Werribee, Victoria, 3030, Australia
| | - K Kelers
- Veterinary Hospital, Melbourne Veterinary School, University of Melbourne, Werribee, Victoria, 3030, Australia
| | - M A Stevenson
- Veterinary Hospital, Melbourne Veterinary School, University of Melbourne, Werribee, Victoria, 3030, Australia
| | - K D Winkel
- Melbourne School of Population and Global Health, University of Melbourne, Parkville, Victoria, 3010, Australia
| | - S Hardjo
- UQ VETS Small Animal Hospital, Corner Main Drive and Outer Ring Road, Gatton, Queensland, 4343, Australia
| | - J Heller
- School of Animal and Veterinary Sciences, Charles Sturt University, Wagga Wagga, New South Wales, 2650, Australia.,Graham Centre for Agricultural Innovation, Charles Sturt University, Wagga Wagga, New South Wales, 2650, Australia
| | - P R Judge
- Vet Education Pty Ltd, Douglas, Queensland, 4814, Australia.,JCUVet, James Cook University, Douglas, Queensland, 4811, Australia
| | - H M Ong
- Veterinary Hospital, Melbourne Veterinary School, University of Melbourne, Werribee, Victoria, 3030, Australia
| | - A M Padula
- Australian Venom Research Unit, Department of Pharmacology and Therapeutics, University of Melbourne, Parkville, Victoria, Australia
| | - C Reddrop
- Animal Emergency Service, Carrara, Queensland, 4211, Australia
| | - Lcp Santos
- School of Animal and Veterinary Sciences, The University of Adelaide, Roseworthy, South Australia, 5371, Australia
| | - C R Sharp
- School of Veterinary Medicine, College of Science, Health, Engineering and Education, Murdoch University, Murdoch, Western Australia, 6150, Australia
| | - L Smart
- School of Veterinary Medicine, College of Science, Health, Engineering and Education, Murdoch University, Murdoch, Western Australia, 6150, Australia
| | - K L Swindells
- Western Australian Veterinary Emergency and Specialty, Success, Western Australia, 6164, Australia
| | - D Tabrett
- Animal Referral and Emergency Centre, Broadmeadow, New South Wales, 2292, Australia
| | - J R Wierenga
- School of Veterinary Sciences, Massey University, Palmerston North, 4442, New Zealand
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Petrushina I, Litvinenko VN, Jing Y, Ma J, Pinayev I, Shih K, Wang G, Wu YH, Altinbas Z, Brutus JC, Belomestnykh S, Di Lieto A, Inacker P, Jamilkowski J, Mahler G, Mapes M, Miller T, Narayan G, Paniccia M, Roser T, Severino F, Skaritka J, Smart L, Smith K, Soria V, Than Y, Tuozzolo J, Wang E, Xiao B, Xin T, Ben-Zvi I, Boulware C, Grimm T, Mihara K, Kayran D, Rao T. High-Brightness Continuous-Wave Electron Beams from Superconducting Radio-Frequency Photoemission Gun. Phys Rev Lett 2020; 124:244801. [PMID: 32639812 DOI: 10.1103/physrevlett.124.244801] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Accepted: 05/29/2020] [Indexed: 06/11/2023]
Abstract
Continuous-wave photoinjectors operating at high accelerating gradients promise to revolutionize many areas of science and applications. They can establish the basis for a new generation of monochromatic x-ray free electron lasers, high-brightness hadron beams, or a new generation of microchip production. In this Letter we report on the record-performing superconducting rf electron gun with CsK_{2}Sb photocathode. The gun is generating high charge electron bunches (up to 10 nC/bunch) and low transverse emittances, while operating for months with a single photocathode. This achievement opens a new era in generating high-power beams with a very high average brightness.
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Affiliation(s)
- I Petrushina
- Department of Physics and Astronomy, Stony Brook University, Stony Brook, New York 11794, USA
- Collider-Accelerator Department, Brookhaven National Laboratory, Upton, New York 11973, USA
| | - V N Litvinenko
- Department of Physics and Astronomy, Stony Brook University, Stony Brook, New York 11794, USA
- Collider-Accelerator Department, Brookhaven National Laboratory, Upton, New York 11973, USA
| | - Y Jing
- Department of Physics and Astronomy, Stony Brook University, Stony Brook, New York 11794, USA
- Collider-Accelerator Department, Brookhaven National Laboratory, Upton, New York 11973, USA
| | - J Ma
- Collider-Accelerator Department, Brookhaven National Laboratory, Upton, New York 11973, USA
| | - I Pinayev
- Collider-Accelerator Department, Brookhaven National Laboratory, Upton, New York 11973, USA
| | - K Shih
- Department of Physics and Astronomy, Stony Brook University, Stony Brook, New York 11794, USA
| | - G Wang
- Department of Physics and Astronomy, Stony Brook University, Stony Brook, New York 11794, USA
- Collider-Accelerator Department, Brookhaven National Laboratory, Upton, New York 11973, USA
| | - Y H Wu
- Department of Physics and Astronomy, Stony Brook University, Stony Brook, New York 11794, USA
| | - Z Altinbas
- Collider-Accelerator Department, Brookhaven National Laboratory, Upton, New York 11973, USA
| | - J C Brutus
- Collider-Accelerator Department, Brookhaven National Laboratory, Upton, New York 11973, USA
| | - S Belomestnykh
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - A Di Lieto
- Collider-Accelerator Department, Brookhaven National Laboratory, Upton, New York 11973, USA
| | - P Inacker
- Collider-Accelerator Department, Brookhaven National Laboratory, Upton, New York 11973, USA
| | - J Jamilkowski
- Collider-Accelerator Department, Brookhaven National Laboratory, Upton, New York 11973, USA
| | - G Mahler
- Collider-Accelerator Department, Brookhaven National Laboratory, Upton, New York 11973, USA
| | - M Mapes
- Collider-Accelerator Department, Brookhaven National Laboratory, Upton, New York 11973, USA
| | - T Miller
- Collider-Accelerator Department, Brookhaven National Laboratory, Upton, New York 11973, USA
| | - G Narayan
- Collider-Accelerator Department, Brookhaven National Laboratory, Upton, New York 11973, USA
| | - M Paniccia
- Collider-Accelerator Department, Brookhaven National Laboratory, Upton, New York 11973, USA
| | - T Roser
- Collider-Accelerator Department, Brookhaven National Laboratory, Upton, New York 11973, USA
| | - F Severino
- Collider-Accelerator Department, Brookhaven National Laboratory, Upton, New York 11973, USA
| | - J Skaritka
- Collider-Accelerator Department, Brookhaven National Laboratory, Upton, New York 11973, USA
| | - L Smart
- Collider-Accelerator Department, Brookhaven National Laboratory, Upton, New York 11973, USA
| | - K Smith
- Collider-Accelerator Department, Brookhaven National Laboratory, Upton, New York 11973, USA
| | - V Soria
- Collider-Accelerator Department, Brookhaven National Laboratory, Upton, New York 11973, USA
| | - Y Than
- Collider-Accelerator Department, Brookhaven National Laboratory, Upton, New York 11973, USA
| | - J Tuozzolo
- Collider-Accelerator Department, Brookhaven National Laboratory, Upton, New York 11973, USA
| | - E Wang
- Collider-Accelerator Department, Brookhaven National Laboratory, Upton, New York 11973, USA
| | - B Xiao
- Collider-Accelerator Department, Brookhaven National Laboratory, Upton, New York 11973, USA
| | - T Xin
- Collider-Accelerator Department, Brookhaven National Laboratory, Upton, New York 11973, USA
| | - I Ben-Zvi
- Collider-Accelerator Department, Brookhaven National Laboratory, Upton, New York 11973, USA
| | - C Boulware
- Niowave Inc., Lansing, Michigan 48906, USA
| | - T Grimm
- Niowave Inc., Lansing, Michigan 48906, USA
| | - K Mihara
- Department of Physics and Astronomy, Stony Brook University, Stony Brook, New York 11794, USA
| | - D Kayran
- Department of Physics and Astronomy, Stony Brook University, Stony Brook, New York 11794, USA
- Collider-Accelerator Department, Brookhaven National Laboratory, Upton, New York 11973, USA
| | - T Rao
- Collider-Accelerator Department, Brookhaven National Laboratory, Upton, New York 11973, USA
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Fedotov AV, Altinbas Z, Belomestnykh S, Ben-Zvi I, Blaskiewicz M, Brennan M, Bruno D, Brutus C, Costanzo M, Drees A, Fischer W, Fite J, Gaowei M, Gassner D, Gu X, Halinski J, Hamdi K, Hammons L, Harvey M, Hayes T, Hulsart R, Inacker P, Jamilkowski J, Jing Y, Kewisch J, Kankiya P, Kayran D, Lehn R, Liaw CJ, Litvinenko V, Liu C, Ma J, Mahler G, Mapes M, Marusic A, Mernick K, Mi C, Michnoff R, Miller T, Minty M, Narayan G, Nayak S, Nguyen L, Paniccia M, Pinayev I, Polizzo S, Ptitsyn V, Rao T, Robert-Demolaize G, Roser T, Sandberg J, Schoefer V, Schultheiss C, Seletskiy S, Severino F, Shrey T, Smart L, Smith K, Song H, Sukhanov A, Than R, Thieberger P, Trabocchi S, Tuozzolo J, Wanderer P, Wang E, Wang G, Weiss D, Xiao B, Xin T, Xu W, Zaltsman A, Zhao H, Zhao Z. Experimental Demonstration of Hadron Beam Cooling Using Radio-Frequency Accelerated Electron Bunches. Phys Rev Lett 2020; 124:084801. [PMID: 32167359 DOI: 10.1103/physrevlett.124.084801] [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] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Revised: 01/24/2020] [Accepted: 02/03/2020] [Indexed: 06/10/2023]
Abstract
Cooling of beams of gold ions using electron bunches accelerated with radio-frequency systems was recently experimentally demonstrated in the Relativistic Heavy Ion Collider at Brookhaven National Laboratory. Such an approach is new and opens the possibility of using this technique at higher energies than possible with electrostatic acceleration of electron beams. The challenges of this approach include generation of electron beams suitable for cooling, delivery of electron bunches of the required quality to the cooling sections without degradation of beam angular divergence and energy spread, achieving the required small angles between electron and ion trajectories in the cooling sections, precise velocity matching between the two beams, high-current operation of the electron accelerator, as well as several physics effects related to bunched-beam cooling. Here we report on the first demonstration of cooling hadron beams using this new approach.
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Affiliation(s)
- A V Fedotov
- Brookhaven National Laboratory, Upton, New York 11973, USA
| | - Z Altinbas
- Brookhaven National Laboratory, Upton, New York 11973, USA
| | - S Belomestnykh
- Brookhaven National Laboratory, Upton, New York 11973, USA
| | - I Ben-Zvi
- Brookhaven National Laboratory, Upton, New York 11973, USA
| | - M Blaskiewicz
- Brookhaven National Laboratory, Upton, New York 11973, USA
| | - M Brennan
- Brookhaven National Laboratory, Upton, New York 11973, USA
| | - D Bruno
- Brookhaven National Laboratory, Upton, New York 11973, USA
| | - C Brutus
- Brookhaven National Laboratory, Upton, New York 11973, USA
| | - M Costanzo
- Brookhaven National Laboratory, Upton, New York 11973, USA
| | - A Drees
- Brookhaven National Laboratory, Upton, New York 11973, USA
| | - W Fischer
- Brookhaven National Laboratory, Upton, New York 11973, USA
| | - J Fite
- Brookhaven National Laboratory, Upton, New York 11973, USA
| | - M Gaowei
- Brookhaven National Laboratory, Upton, New York 11973, USA
| | - D Gassner
- Brookhaven National Laboratory, Upton, New York 11973, USA
| | - X Gu
- Brookhaven National Laboratory, Upton, New York 11973, USA
| | - J Halinski
- Brookhaven National Laboratory, Upton, New York 11973, USA
| | - K Hamdi
- Brookhaven National Laboratory, Upton, New York 11973, USA
| | - L Hammons
- Brookhaven National Laboratory, Upton, New York 11973, USA
| | - M Harvey
- Brookhaven National Laboratory, Upton, New York 11973, USA
| | - T Hayes
- Brookhaven National Laboratory, Upton, New York 11973, USA
| | - R Hulsart
- Brookhaven National Laboratory, Upton, New York 11973, USA
| | - P Inacker
- Brookhaven National Laboratory, Upton, New York 11973, USA
| | - J Jamilkowski
- Brookhaven National Laboratory, Upton, New York 11973, USA
| | - Y Jing
- Brookhaven National Laboratory, Upton, New York 11973, USA
| | - J Kewisch
- Brookhaven National Laboratory, Upton, New York 11973, USA
| | - P Kankiya
- Brookhaven National Laboratory, Upton, New York 11973, USA
| | - D Kayran
- Brookhaven National Laboratory, Upton, New York 11973, USA
| | - R Lehn
- Brookhaven National Laboratory, Upton, New York 11973, USA
| | - C J Liaw
- Brookhaven National Laboratory, Upton, New York 11973, USA
| | - V Litvinenko
- Brookhaven National Laboratory, Upton, New York 11973, USA
| | - C Liu
- Brookhaven National Laboratory, Upton, New York 11973, USA
| | - J Ma
- Brookhaven National Laboratory, Upton, New York 11973, USA
| | - G Mahler
- Brookhaven National Laboratory, Upton, New York 11973, USA
| | - M Mapes
- Brookhaven National Laboratory, Upton, New York 11973, USA
| | - A Marusic
- Brookhaven National Laboratory, Upton, New York 11973, USA
| | - K Mernick
- Brookhaven National Laboratory, Upton, New York 11973, USA
| | - C Mi
- Brookhaven National Laboratory, Upton, New York 11973, USA
| | - R Michnoff
- Brookhaven National Laboratory, Upton, New York 11973, USA
| | - T Miller
- Brookhaven National Laboratory, Upton, New York 11973, USA
| | - M Minty
- Brookhaven National Laboratory, Upton, New York 11973, USA
| | - G Narayan
- Brookhaven National Laboratory, Upton, New York 11973, USA
| | - S Nayak
- Brookhaven National Laboratory, Upton, New York 11973, USA
| | - L Nguyen
- Brookhaven National Laboratory, Upton, New York 11973, USA
| | - M Paniccia
- Brookhaven National Laboratory, Upton, New York 11973, USA
| | - I Pinayev
- Brookhaven National Laboratory, Upton, New York 11973, USA
| | - S Polizzo
- Brookhaven National Laboratory, Upton, New York 11973, USA
| | - V Ptitsyn
- Brookhaven National Laboratory, Upton, New York 11973, USA
| | - T Rao
- Brookhaven National Laboratory, Upton, New York 11973, USA
| | | | - T Roser
- Brookhaven National Laboratory, Upton, New York 11973, USA
| | - J Sandberg
- Brookhaven National Laboratory, Upton, New York 11973, USA
| | - V Schoefer
- Brookhaven National Laboratory, Upton, New York 11973, USA
| | - C Schultheiss
- Brookhaven National Laboratory, Upton, New York 11973, USA
| | - S Seletskiy
- Brookhaven National Laboratory, Upton, New York 11973, USA
| | - F Severino
- Brookhaven National Laboratory, Upton, New York 11973, USA
| | - T Shrey
- Brookhaven National Laboratory, Upton, New York 11973, USA
| | - L Smart
- Brookhaven National Laboratory, Upton, New York 11973, USA
| | - K Smith
- Brookhaven National Laboratory, Upton, New York 11973, USA
| | - H Song
- Brookhaven National Laboratory, Upton, New York 11973, USA
| | - A Sukhanov
- Brookhaven National Laboratory, Upton, New York 11973, USA
| | - R Than
- Brookhaven National Laboratory, Upton, New York 11973, USA
| | - P Thieberger
- Brookhaven National Laboratory, Upton, New York 11973, USA
| | - S Trabocchi
- Brookhaven National Laboratory, Upton, New York 11973, USA
| | - J Tuozzolo
- Brookhaven National Laboratory, Upton, New York 11973, USA
| | - P Wanderer
- Brookhaven National Laboratory, Upton, New York 11973, USA
| | - E Wang
- Brookhaven National Laboratory, Upton, New York 11973, USA
| | - G Wang
- Brookhaven National Laboratory, Upton, New York 11973, USA
| | - D Weiss
- Brookhaven National Laboratory, Upton, New York 11973, USA
| | - B Xiao
- Brookhaven National Laboratory, Upton, New York 11973, USA
| | - T Xin
- Brookhaven National Laboratory, Upton, New York 11973, USA
| | - W Xu
- Brookhaven National Laboratory, Upton, New York 11973, USA
| | - A Zaltsman
- Brookhaven National Laboratory, Upton, New York 11973, USA
| | - H Zhao
- Brookhaven National Laboratory, Upton, New York 11973, USA
| | - Z Zhao
- Brookhaven National Laboratory, Upton, New York 11973, USA
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Purcell SL, Claus M, Hosgood G, Smart L. Interleukin-8, interleukin-1β and tumour necrosis factor-α in sequential units of packed red blood cells collected from retired racing Greyhounds. Aust Vet J 2018; 95:26-32. [PMID: 28124417 DOI: 10.1111/avj.12549] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [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: 02/13/2016] [Revised: 05/01/2016] [Accepted: 06/05/2016] [Indexed: 11/30/2022]
Abstract
BACKGROUND We hypothesised that concentrations of interleukin-8 (IL-8), interleukin-1β (IL-1β) and tumour necrosis factor-α (TNF-α) would increase during storage in the third sequential unit (U3) of canine packed red blood cells (PRBC) collected from terminal donors in haemorrhagic shock. We further hypothesised that leucoreduction would prevent cytokine accumulation in U3 and that cytokine concentrations in U3 would be higher than in the first units (U1) collected from the same dogs. METHODS U1 and U3 were each collected from 12 anaesthetised healthy Greyhounds. Removal of leucocytes from half of each PRBC unit produced one leucoreduced (LR) and one non-leucoreduced (NLR) unit. Canine IL-8, IL-1β and TNF-α concentrations were measured in samples collected from the units during storage on days 0, 10, 20, 30 and 37. RESULTS The IL-8 concentration in U3 NLR units was significantly higher on days 10, 20, 30 and 37 than on day 0 and was significantly higher than in the LR units at all time points. The IL-1β concentration in U3 did not change over time, or between LR and NLR units. TNF-α was not detected in any unit. There were no significant differences in IL-8 or IL-1β concentrations between U3 and U1 at any time point; however, some NLR U3 units had markedly elevated IL-8 concentrations at day 37 (2060-20,682 pg/mL) compared with NLR U1 units (3369-5280 pg/mL). CONCLUSION NLR U3 units collected from dogs in haemorrhagic shock showed a significant increase in IL-8 concentrations during storage. Leucoreduction was effective at preventing the accumulation of IL-8. There was no difference detected between U3 and U1.
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Affiliation(s)
- S L Purcell
- Comparative Health Research Group, College of Veterinary Medicine, School of Veterinary and Life Sciences, Murdoch University, Murdoch, Western Australia 6150, Australia
| | - M Claus
- Comparative Health Research Group, College of Veterinary Medicine, School of Veterinary and Life Sciences, Murdoch University, Murdoch, Western Australia 6150, Australia
| | - G Hosgood
- Comparative Health Research Group, College of Veterinary Medicine, School of Veterinary and Life Sciences, Murdoch University, Murdoch, Western Australia 6150, Australia
| | - L Smart
- Comparative Health Research Group, College of Veterinary Medicine, School of Veterinary and Life Sciences, Murdoch University, Murdoch, Western Australia 6150, Australia
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Bryleva EY, Keaton SA, Grit J, Madaj Z, Sauro-Nagendra A, Smart L, Halstead S, Achtyes E, Brundin L. The acute-phase mediator serum amyloid A is associated with symptoms of depression and fatigue. Acta Psychiatr Scand 2017; 135:409-418. [PMID: 28374419 DOI: 10.1111/acps.12730] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/01/2017] [Indexed: 12/11/2022]
Abstract
OBJECTIVE Establish whether inflammatory biomarkers-serum amyloid A (SAA), C-reactive protein (CRP), interleukin-6 (IL-6), and tumor necrosis factor-α (TNF-α)-are related to key symptoms of depression, including anxiety and fatigue, in a cross-sectional, out-patient setting to identify biomarkers that reflect psychiatric symptomatology in a naturalistic, real-life population. METHODS We measured SAA, CRP, IL-6, and TNF-α in plasma samples from 89 adult psychiatric out-patients by multiplex, high-sensitivity electrochemiluminescent assays. Psychiatric symptoms were evaluated using the Hamilton Depression Rating Scale (HAMD-17), the Patient Health Questionnaire (PHQ-9), and the Center for Epidemiological Studies Depression Scale (CES-D). RESULTS Plasma SAA was most robustly associated with depressive symptoms across diagnostic boundaries in this cohort of out-patients. Elevated SAA was significantly associated with higher total scores on the HAMD-17 scale and correlated with multiple scale items that rated symptoms of fatigue and depressed mood, but not with anxiety-related items. CONCLUSIONS SAA might constitute a cross-diagnostic marker indicative of depressed mood and fatigue in a naturalistic patient setting. Because SAA activates Toll-like receptors 2 and 4, present on macrophages and glial cells, its association with depression severity could also implicate this inflammatory mediator in the pathogenesis of mood disorders.
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Affiliation(s)
- E Y Bryleva
- Center for Neurodegenerative Science, Van Andel Research Institute, Grand Rapids, MI, USA
| | - S A Keaton
- Center for Neurodegenerative Science, Van Andel Research Institute, Grand Rapids, MI, USA.,Division of Psychiatry and Behavioral Medicine, Michigan State University, Grand Rapids, MI, USA.,Department of Physiology, Michigan State University, East Lansing, MI, USA
| | - J Grit
- Center for Neurodegenerative Science, Van Andel Research Institute, Grand Rapids, MI, USA
| | - Z Madaj
- Bioinformatics and Biostatistics Core, Van Andel Research Institute, Grand Rapids, MI, USA
| | - A Sauro-Nagendra
- Center for Neurodegenerative Science, Van Andel Research Institute, Grand Rapids, MI, USA
| | - L Smart
- Pine Rest Christian Mental Health Services, Grand Rapids, MI, USA
| | - S Halstead
- Pine Rest Christian Mental Health Services, Grand Rapids, MI, USA
| | - E Achtyes
- Division of Psychiatry and Behavioral Medicine, Michigan State University, Grand Rapids, MI, USA.,Pine Rest Christian Mental Health Services, Grand Rapids, MI, USA
| | - L Brundin
- Center for Neurodegenerative Science, Van Andel Research Institute, Grand Rapids, MI, USA.,Pine Rest Christian Mental Health Services, Grand Rapids, MI, USA
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12
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Munro A, Gillespie C, Cotton S, Busby-Earle C, Kavanagh K, Cuschieri K, Cubie H, Robertson C, Smart L, Pollock K, Moore C, Palmer T, Cruickshank ME. The impact of human papillomavirus type on colposcopy performance in women offered HPV immunisation in a catch-up vaccine programme: a two-centre observational study. BJOG 2017; 124:1394-1401. [PMID: 28102931 DOI: 10.1111/1471-0528.14563] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/31/2016] [Indexed: 12/01/2022]
Abstract
OBJECTIVE To determine whether human papillomavirus (HPV) immunisation has affected the prevalence of HPV genotypes and colposcopic features of cervical intraepithelial neoplasia (CIN) in young women referred for colposcopy. DESIGN A two-centre observational study including vaccinated and unvaccinated women. SETTING Colposcopy clinics serving two health regions in Scotland, UK. POPULATION A total of 361 women aged 20-25 years attending colposcopy following an abnormal cervical cytology result at routine cervical screening. METHODS Cervical samples were obtained from women for HPV DNA genotyping and mRNA E6/E7 expression of HPV 16, 18, 31, 33, and 45. Demographic data, cytology, and histology results and colposcopic features were recorded. Chi-square analysis was conducted to identify associations between vaccine status, HPV genotypes, and colposcopic features. MAIN OUTCOME MEASURES Colposcopic features, HPV genotypes, mRNA expression, and cervical histology. RESULTS The prevalence of HPV 16 was significantly lower in the vaccinated group (8.6%) compared with the unvaccinated group (46.7%) (P = 0.001). The number of cases of CIN2+ was significantly lower in women who had been vaccinated (P = 0.006). The HPV vaccine did not have a statistically significant effect on commonly recognised colposcopic features, but there was a slight reduction in the positive predictive value (PPV) of colposcopy for CIN2+, from 74% (unvaccinated) to 66.7% (vaccinated). CONCLUSIONS In this group of young women with abnormal cytology referred to colposcopy, HPV vaccination via a catch-up programme reduced the prevalence of CIN2+ and HPV 16 infection. The reduced PPV of colposcopy for the detection of CIN2+ in women who have been vaccinated is at the lower acceptable level of the UK national cervical screening programme guidelines. TWEETABLE ABSTRACT Reduction of hrHPV positivity and CIN in immunised women consistent with lower PPV of colposcopy for CIN2+.
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Affiliation(s)
- A Munro
- University of Aberdeen, Aberdeen, UK
| | | | - S Cotton
- University of Aberdeen, Aberdeen, UK
| | | | | | - K Cuschieri
- Scottish Human Papillomavirus Reference Laboratory, Edinburgh, UK
| | - H Cubie
- Scottish Human Papillomavirus Reference Laboratory, Edinburgh, UK
| | | | | | - K Pollock
- Health Protection Scotland, Glasgow, UK
| | - C Moore
- Scottish Human Papillomavirus Reference Laboratory, Edinburgh, UK
| | - T Palmer
- University of Edinburgh, Edinburgh, UK
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13
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Boyd C, Claus M, Hosgood G, Smart L. Survival of two dogs with pyothorax secondary to perforating oesophageal foreign body. Aust Vet J 2017; 95:41-45. [DOI: 10.1111/avj.12548] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2015] [Revised: 02/22/2016] [Accepted: 04/22/2016] [Indexed: 11/26/2022]
Affiliation(s)
- C Boyd
- College of Veterinary Medicine; Murdoch University; 90 South St Murdoch Western Australia 6150 Australia
| | - M Claus
- College of Veterinary Medicine; Murdoch University; 90 South St Murdoch Western Australia 6150 Australia
| | - G Hosgood
- College of Veterinary Medicine; Murdoch University; 90 South St Murdoch Western Australia 6150 Australia
| | - L Smart
- College of Veterinary Medicine; Murdoch University; 90 South St Murdoch Western Australia 6150 Australia
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Yam E, Hosgood G, Smart L. Comparison of the use of sodium carbonate (washing soda crystals) and apomorphine for inducing emesis in dogs. Aust Vet J 2016; 94:474-477. [DOI: 10.1111/avj.12530] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2015] [Revised: 03/14/2016] [Accepted: 04/14/2016] [Indexed: 11/28/2022]
Affiliation(s)
- E Yam
- Comparative Health Research Group, College of Veterinary Medicine; Murdoch University; 90 South St, Murdoch, Western Australia 6150 Australia
| | - G Hosgood
- Comparative Health Research Group, College of Veterinary Medicine; Murdoch University; 90 South St, Murdoch, Western Australia 6150 Australia
| | - L Smart
- Comparative Health Research Group, College of Veterinary Medicine; Murdoch University; 90 South St, Murdoch, Western Australia 6150 Australia
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15
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Sim YT, Litherland J, Lindsay E, Hendry P, Brauer K, Dobson H, Cordiner C, Gagliardi T, Smart L. Upgrade of ductal carcinoma in situ on core biopsies to invasive disease at final surgery: a retrospective review across the Scottish Breast Screening Programme. Clin Radiol 2015; 70:502-6. [PMID: 25649441 DOI: 10.1016/j.crad.2014.12.019] [Citation(s) in RCA: 15] [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] [Received: 10/02/2014] [Revised: 11/19/2014] [Accepted: 12/29/2014] [Indexed: 11/27/2022]
Abstract
AIM To identify factors affecting upgrade rates from B5a (non-invasive) preoperative core biopsies to invasive disease at surgery and ways to improve screening performance. MATERIAL AND METHODS This was a retrospective analysis of 1252 cases of B5a biopsies across all six Scottish Breast Screening Programmes (BSPs), ranging between 2004 and 2012. Final surgical histopathology was correlated with radiological and biopsy factors. Data were analysed using basic Microsoft Excel and standard Chi-squared test used for evaluating statistical significance. RESULTS B5a upgrade rates for the units ranged from 19.2% to 29.2%, with an average of 23.6%. Mean sizes of invasive tumours were small (3-11 mm). The upgrade rate was significantly higher for cases where the main mammographic abnormality was mass, distortion, or asymmetry, compared with micro-calcification alone (33.2% versus 21.7%, p = 0.0004). The upgrade rate was significantly lower with the use of large-volume vacuum-assisted biopsy (VAB) devices than 14 G core needles (19.9% versus 26%, p = 0.013); in stereotactic than ultrasound-guided biopsies (21.2% versus 36.1%, p < 0.001). Heterogeneity of data from different centres limited evaluation of other potential factors. CONCLUSION Upgrade rates are lower for cases with micro-calcification as the sole mammographic feature with the use of VAB devices. Nevertheless, there is variation in practice across Scottish BSPs, including first-line biopsy technique and/or device; and it is of interest that a few centres maintain low upgrade rates despite not using VAB routinely for biopsy of micro-calcification.
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Affiliation(s)
- Y T Sim
- Scottish Breast Screening Programme, West Scotland Breast Screening Centre, Stock Exchange Court, 77 Nelson Mandela Place, Glasgow G2 1QT, UK
| | - J Litherland
- Scottish Breast Screening Programme, West Scotland Breast Screening Centre, Stock Exchange Court, 77 Nelson Mandela Place, Glasgow G2 1QT, UK.
| | - E Lindsay
- Scottish Breast Screening Programme, West Scotland Breast Screening Centre, Stock Exchange Court, 77 Nelson Mandela Place, Glasgow G2 1QT, UK
| | - P Hendry
- Scottish Breast Screening Programme, West Scotland Breast Screening Centre, Stock Exchange Court, 77 Nelson Mandela Place, Glasgow G2 1QT, UK
| | - K Brauer
- Scottish Breast Screening Programme, West Scotland Breast Screening Centre, Stock Exchange Court, 77 Nelson Mandela Place, Glasgow G2 1QT, UK
| | - H Dobson
- Scottish Breast Screening Programme, West Scotland Breast Screening Centre, Stock Exchange Court, 77 Nelson Mandela Place, Glasgow G2 1QT, UK
| | - C Cordiner
- Scottish Breast Screening Programme, West Scotland Breast Screening Centre, Stock Exchange Court, 77 Nelson Mandela Place, Glasgow G2 1QT, UK
| | - T Gagliardi
- Scottish Breast Screening Programme, West Scotland Breast Screening Centre, Stock Exchange Court, 77 Nelson Mandela Place, Glasgow G2 1QT, UK
| | - L Smart
- Scottish Breast Screening Programme, West Scotland Breast Screening Centre, Stock Exchange Court, 77 Nelson Mandela Place, Glasgow G2 1QT, UK
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MacKay I, Craig W, Smart L, Krukowski Z. Reprint of: Long term outcome of non-operative management of cytologically benign thyroid swellings. Eur J Surg Oncol 2014. [DOI: 10.1016/j.ejso.2014.11.029] [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] Open
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Cruickshank ME, Cotton SC, Sharp L, Smart L, Walker LG, Little J. Management of women with low grade cytology: how reassuring is a normal colposcopy examination? BJOG 2014; 122:380-6. [PMID: 24947656 DOI: 10.1111/1471-0528.12932] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/01/2014] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To determine the rate of cervical intraepithelial neoplasia grade 2 (CIN2+) in women with low grade cervical cytology and a normal colposcopy examination over 3 years of follow-up. DESIGN Cohort study within a randomised controlled trial. SETTING NHS Cervical Screening Programmes in Grampian, Tayside and Nottingham. POPULATION Eight hundred and eighty-four women aged 20-59 years with borderline nuclear abnormalities (BNA) or mild dyskaryosis with a normal and adequate colposcopy examination. METHODS Samples at baseline were tested for 14 high-risk (Hr) types using GP5+6+ methodology and for HPV 16 and 18 using type-specific primers. Women were followed up post-colposcopy by cervical cytology at 6-month intervals in primary care. After 3 years, women were invited for an exit colposcopy examination and underwent LLETZ if any colposcopic abnormality was identified. MAIN OUTCOME MEASURES Absolute and relative risks of CIN2+ during follow-up and/or at exit colposcopy. RESULTS The median age was 36 years. The absolute risk of developing CIN2+ within 3 years was 1.86 per 100 woman years and for CIN3+, 0.64 per 100 woman years. One microinvasive cancer was identified. The relative risk (RR) was highest for women with initial mild dyskaryosis who were HrHPV-positive (RR 5.86, 95% confidence interval 2.53-13.56) compared with women with BNA who were HrHPV-negative. CONCLUSION For women with low grade cervical cytology, the risk of a high grade CIN within 3 years of a normal colposcopy examination is low. Women can be reassured that, even with a positive HPV test, the risk of developing CIN2 or worse is sufficiently low to return to the routine 3-year recall.
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Affiliation(s)
- M E Cruickshank
- Obstetrics & Gynaecology, University of Aberdeen, Aberdeen, UK
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Toshova TB, Subchev MA, Atanasova DI, Velázquez de Castro AJ, Smart L. SitonaWeevils (Coleoptera: Curculionidae) Caught by Traps in Alfalfa Fields in Bulgaria. BIOTECHNOL BIOTEC EQ 2014. [DOI: 10.1080/13102818.2009.10818383] [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: 10/25/2022] Open
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19
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Balasubramanian SP, Brignall J, Lin HY, Stephenson TJ, Wadsley J, Harrison BJ, Craig WL, Smart L, Krukowski Z. Sentinel node biopsy in papillary thyroid cancer--what is the potential? Langenbecks Arch Surg 2014; 399:245-51. [PMID: 24446015 DOI: 10.1007/s00423-014-1168-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2013] [Accepted: 01/12/2014] [Indexed: 10/25/2022]
Abstract
PURPOSE Sentinel node biopsy (SNB) may identify lymph node metastases in patients with papillary thyroid cancer (PTC), enabling selective application of central node dissection (CND). The aim of this study was to assess the feasibility of implementing SNB in patients undergoing thyroidectomy for a cytologically indeterminate/suspicious/malignant thyroid nodule and to determine the potential improvement in clinical outcomes and the costs associated with the SNB technique. METHODS The treatment strategies and clinical and pathological outcomes of two retrospective cohorts of patients who underwent preoperative thyroid FNA over a 5-year period in two different centres were studied. The potential for implementing the SNB technique and the benefits and costs associated with implementation were estimated. RESULTS In centre 1, in 819 adult patients who had thyroid fine-needle aspiration cytology, the final cytology was indeterminate, suspicious and diagnostic of malignancy in 113, 29 and 28 patients, respectively. One hundred eight patients were 'suitable' for SNB. Twenty-three of these patients had PTC, six of whom underwent CND. Of these six patients, node metastasis was absent in five--the cohort in whom prophylactic CND may have been avoided consequent to a negative 'sentinel node' biopsy. Morbidity attributable to CND may have been avoided in up to four patients over a 5-year period. Costs associated with implementation of SNB outweighed any potential savings. Analysis of 491 patients in centre 2 confirmed that the benefit of SNB in PTC was similarly limited; morbidity attributable to CND may have been avoided in up to seven patients over a 5-year period. CONCLUSIONS Even under ideal conditions (assuming 100 % node identification rate and 0 % false negative rate), the potential short- to medium-term benefit of sentinel node biopsy in patients with thyroid cancer in centres implementing a policy of selective or routine prophylactic CND is low.
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Peacock RE, Smart L. False hyperchloraemia in a dog secondary to ingestion of horse feed supplemented with potassium bromide. Aust Vet J 2013; 91:320-2. [DOI: 10.1111/avj.12079] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/03/2013] [Indexed: 11/30/2022]
Affiliation(s)
- RE Peacock
- School of Veterinary and Biomedical Sciences; Murdoch University; Murdoch; Western Australia; Australia
| | - L Smart
- School of Veterinary and Biomedical Sciences; Murdoch University; Murdoch; Western Australia; Australia
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Peacock RE, Hosgood G, Swindells KL, Smart L. Aplysia giganteatoxicosis in 72 dogs in Western Australia. Aust Vet J 2013; 91:292-5. [DOI: 10.1111/avj.12074] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/08/2012] [Indexed: 11/29/2022]
Affiliation(s)
- RE Peacock
- School of Veterinary and Biomedical Sciences; Murdoch University; Murdoch; Western Australia; Australia
| | - G Hosgood
- School of Veterinary and Biomedical Sciences; Murdoch University; Murdoch; Western Australia; Australia
| | - KL Swindells
- School of Veterinary and Biomedical Sciences; Murdoch University; Murdoch; Western Australia; Australia
| | - L Smart
- School of Veterinary and Biomedical Sciences; Murdoch University; Murdoch; Western Australia; Australia
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Sharp L, Cotton S, Thornton A, Gray N, Whynes D, Smart L, Waugh N, Duncan I, Cruickshank M, Little J. Which women default from follow-up cervical cytology tests? A cohort study within the TOMBOLA trial. Cytopathology 2011; 23:150-60. [PMID: 21366734 DOI: 10.1111/j.1365-2303.2011.00848.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
OBJECTIVE To identify factors associated with default from follow-up cervical cytology tests. METHODS A cohort study was conducted involving 2166 women, aged 20-59, with recent low-grade cervical cytology taken within the NHS Cervical Screening Programmes in Scotland and England, and managed by 6-monthly cytology in primary care. For the first (6-month) and second (12-month) surveillance cytology tests separately, women were categorized as 'on-time attendees' (attended ≤6 months of test being due), 'late attendees' (attended greater than 6 months after test was due) or 'non-attendees' (failed to attend). Multivariate odds ratios (ORs) were computed for factors associated with late and non-attendance. RESULTS For the first surveillance test, risk of non-attendance was significantly higher in younger women, those without post-secondary education, and non-users of prescribed contraception. Factors significantly associated with late attendance for the first test were the same as for non-attendance, plus current smoking and having children. The most important predictor of non-attendance for the second surveillance test was late attendance for the first test (OR = 9.65; 95% CI, 6.60-16.62). Non-attendance for the second test was also significantly higher among women who were younger, smokers and had negative cytology on the first surveillance test. Late attendance for the second surveillance test was higher in women who were younger, smokers, had children and attended late for the first test. CONCLUSIONS Women at highest risk of default from follow-up cytology tend to be young, smoke, lack post-secondary education, and have defaulted from a previous surveillance appointment. Tackling default will require development of targeted strategies to encourage attendance and research to better understand the reasons underpinning default.
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Affiliation(s)
- L Sharp
- National Cancer Registry Ireland, Cork, Ireland.
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Cotton S, Sharp L, Little J, Cruickshank M, Seth R, Smart L, Duncan I, Harrild K, Neal K, Waugh N. The role of human papillomavirus testing in the management of women with low-grade abnormalities: multicentre randomised controlled trial. BJOG 2010; 117:645-59. [PMID: 20374607 DOI: 10.1111/j.1471-0528.2010.02519.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To assess the value of a single human papillomavirus (HPV) test in making decisions on management of women with cervical cytology showing borderline nuclear abnormality (BNA) or mild dyskaryosis. In particular, to determine whether information on high-risk (hr) HPV status would be valuable in the choice between (1) cytological surveillance versus immediate referral to colposcopy, and (2) at colposcopy, between biopsy and recall versus immediate large loop excision of the transformation zone (LLETZ). DESIGN Multicentre individually randomised controlled trial, nested within the NHS Cervical Screening Programmes, investigating the value of HPV testing by testing for interactions between HPV status and (1) cytological surveillance versus colposcopy, and (2) biopsy and recall versus immediate LLETZ. Setting Grampian, Tayside and Nottingham. Population Women (n = 4439), aged 20-59 years, with a cytology test showing borderline nuclear abnormalities or mild dyskaryosis during October 1999 to October 2002. METHODS High-risk HPV status was determined at recruitment using the polymerase chain reaction assay with the GP5+/6+ general primer system. The results of this HPV testing were not disclosed to either the participating women or to those involved in their management. Women were randomised to either (1) 6-monthly cytological screening in primary care or (2) referral for colposcopy. Human papillomavirus status was used to stratify both randomisations. All women were followed for 3 years, concluding with an invitation to an exit appointment at which colposcopic examination was undertaken. In addition, in women who were randomised to initial colposcopy and underwent colposcopy, the association between hrHPV status and presence of cervical intraepithelial neoplasia (CIN) grade 2 or more severe disease (henceforth CIN2 or worse) was examined. MAIN OUTCOME MEASURES Sensitivity, specificity, positive and negative predictive values of the HPV test for predicting CIN2 or worse and the implications for the choice of management between cytological surveillance and immediate referral for colposcopy. RESULTS There were no significant interactions between management and HPV status. Hence, in women with mild dyskaryosis or BNA who are HPV positive, there is no advantage of (1) immediate colposcopy over cytological surveillance (P = 0.76) or (2) immediate LLETZ over biopsy and recall (P = 0.27). The sensitivity of HPV testing for detection of CIN2 or worse was 75.2% (95% CI 68.8-81.0%) among women with mild dyskaryosis and 69.9% (95% CI 61.7-77.3%) among those with BNA. Specificity was higher in those with BNA (71.3%; 95% CI 68.5-74.1%) than in those with mild dyskaryosis (46.9%; 95% CI 42.2-51.6%). Sensitivity decreased with increasing age whereas specificity increased. The negative predictive value was high, particularly among women with BNA (94.5%; 95% CI 92.9-96.0%). Across all ages, 22% of women who had CIN2 or worse were HPV negative. Conversely, 40% of those who were HPV positive did not have CIN. HPV was a much more reliable predictor in women aged over 40 years. CONCLUSIONS We conclude that in younger women with low-grade cytological abnormalities, a single HPV test would not be useful in determining who should be referred for colposcopy or the most effective management at colposcopy. In women over 40, a negative HPV test could be used to rule out further investigation.
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Affiliation(s)
- S Cotton
- Department of Public Health, University of Aberdeen, Aberdeen, UK
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McCorkell RB, Paziuk W, Smart L, Woodbury MR, Adams GP. 198 EXOGENOUS CONTROL OF FOLLICULAR WAVE EMERGENCE IN WOOD BISON (BISON BISON ATHABASCAE). Reprod Fertil Dev 2010. [DOI: 10.1071/rdv22n1ab198] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Two methods for synchronizing ovarian follicular development in both wood bison (Bison bison athabascae) and plains bison (Bison bison bison) were tested as part of a project to conserve wood bison through the application of advanced reproductive technologies. A secondary objective was to test the effect of a long-acting neurolept tranquilizer, pipothiazine palmitate, on ovarian function in bison. Female wood bison (4 years old; n = 14) and plains bison (2-8 years old, n = 10), previously conditioned to daily examination in a chute, were divided randomly into 3 groups in which 1) ovarian follicles ≥5 mm were ablated by ultrasound-guided transvaginal follicle aspiration, 2) 5 mg of estradiol-17β in canola oil was given i.m. or 3) no treatment was given (control). The experiment was conducted in 3 replicates so that each animal rotated through each of the groups. Half of the bison, blocked by subspecies and treatment group, were given a single dose (150 mg) of pipothiazine palmitate i.m. The ovaries were examined daily by transrectal ultrasonography beginning 4 days before treatment and continuing until the dominant follicle of a new wave reached a diameter of 10 mm. No effect of treatment with pipothiazine palmitate was detected for any end point. In addition, no differences were detected between wood and plains bison for any end point. Consequently the pipothiazine palmitate and subspecies treatment groups were collapsed for further analyses. The interval and variation in the interval to new follicular wave emergence were compared by ANOVA. Wave emergence was detected on Day 1.0 ± 0.2 (mean ± SEM; Day 0 = day of treatment) in the follicle ablation group, and was earlier (P < 0.05) than in both the estradiol (Day 3.3 ± 0.3) and control (Day 4.0 ± 0.4) groups. The interval to follicle wave emergence was least variable in the follicle ablation group (P < 0.05) and tended to be less variable in the estradiol group (P = 0.09) than in the control group (residuals, 0.1 ± 0.04, 1.0 ± 0.2, and 1.6 ± 0.3 days, respectively). Ovulations occurred subsequent to estradiol administration in 10 of 23 (43%) bison. In conclusion, ovarian follicular wave emergence can be synchronized in bison during the anovulatory season. Follicular ablation consistently shortened and decreased the variability in the interval to new wave emergence. The synchronizing effect of estradiol was confounded by the induction of ovulation. Progesterone will be added in future studies to control the ovulatory effect of estradiol. Pipothiazine palmitate had no discernable effect on ovarian function and maybe useful in reducing the effects of handling stress on untrained animals.
Supported by a grants from the Advancing Canadian Agriculture and Agri-Food Fund, the Agri-Food Innovation Fund, Parks Canada, the World Wildlife Fund, and the Northwest Territories.
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MacDuff A, MacDuff R, Du Plessis J, Murchison J, Fergusson R, Turnbull R, Brown D, Choi E, Duddy L, Hill L, Kelly L, Noble C, Smart L. Can multislice CT predict endobronchial disease at fibre optic bronchoscopy in patients with suspected lung cancer? Cancer Imaging 2010. [DOI: 10.1102/1470-7330.2010.9042] [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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Smart L, Hopper K, Aldrich J, George J, Kass P, Haskins S. The Effect of Hetastarch (670/0.75) on Urine Specific Gravity and Osmolality in the Dog. J Vet Intern Med 2009; 23:388-91. [DOI: 10.1111/j.1939-1676.2008.0252.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Stoff-Khalili MA, Bhatia S, Odaka Y, Li XL, Podduturi J, Smart L, Mallmann P, Schmutzler RK, Curiel DT, Mathis MJ. Ligand-mediated selective targeting of adenovirus in metastatic breast cancer. Cancer Res 2009. [DOI: 10.1158/0008-5472.sabcs-2126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Abstract #2126
The success of gene therapy relies on efficient and targeted delivery systems. Adenovirus vectors have a number of advantages for gene therapy. However, because of their lack of tumor tropism and their tendency to induce liver infection following systemic administration, they cannot be used for systemic attack on metastatic disease. Many solid tumors (e.g., colon, lung, and breast) and hematopoietic tumors over express the chemokine receptor CXCR4. CXCR4 belongs to the large superfamily of G protein-coupled receptors, and is known to participate in a number of biological processes including organogenesis, hematopoiesis, and immune response. Recent evidence has highlighted the role of CXCR4 in cancer, particularly in cancer metastasis due to dysregulation of the receptor leading to enhanced signaling. The present study addresses this issue by retargeting adenovirus to the breast cancer cells overexpressing CXCR4 receptor. We used sCAR-T4-CXCL12, a bispecific adaptor molecule with the ectodomain of CAR linked by the T4 fibritin trimerization motif to the human CXCR4 ligand CXCL12 (also known as SDF-1). The sCAR-T4-CXCL12 should therefore be useful in retargeting adenovirus vectors to CXCR4-positive metastases. Infectivity assays in the absence as well as presence of ligand were performed in human breast cancer MDA-MB-435 cells. Cells were infected with different titres of Ad-CMV-GFP-Luc with and without ligand. Forty-eight hours post-infection, cells were harvested and analysed for the GFP expression by fluorescent microscopy and flow cytometry. It was further interesting to observe the time-dependence of infectivity curve. For this purpose, MDA-MB-435 cells were incubated with optimum titre of Ad-CMV-GFP-Luc vector in the presence of CXCR4 targeting ligand at different time intervals. This was followed by expression analysis of GFP protein by fluorescent microscopy and flow cytometry. Quantification by flow cytometry demonstrated a dramatic 20- to 40-fold increase in the infectivity of MDA-MB-435 cells both in a dose-dependent and time-dependent manner using the sCAR-T4-CXCL12 targeted adenovirus compared to the untargeted vector. In this report, we show that sCAR-T4-CXCL12 can significantly redirect an adenoviral gene therapy vector to CXCR4-positive breast cancer cells in culture. This bispecific ligand should, therefore, be a powerful agent to retarget adenovirus vectors to tumor metastases. The future goal is to investigate the capacity of this agent to re-direct adenoviral vectors in vivo using breast cancer metastasis models.
Citation Information: Cancer Res 2009;69(2 Suppl):Abstract nr 2126.
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Affiliation(s)
- MA Stoff-Khalili
- 1 Heriditary Breast and Ovarian Cancer, University of Cologne, Department of Obstetrics and Gynecology, Cologne, NRW, Germany
| | - S Bhatia
- 2 Health Sciences Center, Lousiana State University, Shreveport, LA
| | - Y Odaka
- 2 Health Sciences Center, Lousiana State University, Shreveport, LA
| | - XL Li
- 2 Health Sciences Center, Lousiana State University, Shreveport, LA
| | - J Podduturi
- 2 Health Sciences Center, Lousiana State University, Shreveport, LA
| | - L Smart
- 2 Health Sciences Center, Lousiana State University, Shreveport, LA
| | - P Mallmann
- 1 Heriditary Breast and Ovarian Cancer, University of Cologne, Department of Obstetrics and Gynecology, Cologne, NRW, Germany
| | - RK Schmutzler
- 1 Heriditary Breast and Ovarian Cancer, University of Cologne, Department of Obstetrics and Gynecology, Cologne, NRW, Germany
| | - DT Curiel
- 3 Division of Human Gene Therapy, University of Alabama at Birmingham, Birmingham, AL
| | - MJ Mathis
- 1 Heriditary Breast and Ovarian Cancer, University of Cologne, Department of Obstetrics and Gynecology, Cologne, NRW, Germany
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Cotton S, Smart L. O-1 Results from TOMBOLA (trial of management of borderline and other low-grade abnormal smears). Cytopathology 2007. [DOI: 10.1111/j.1365-2303.2007.00500_1.x] [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: 11/27/2022]
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Cochran C, Cotton SC, Sharp L, Gray NM, Cruickshank ME, Smart L. P-17 FREQUENCY OF AFTER-EFFECTS REPORTED BY WOMEN FOLLOWING A CERVICAL SMEAR TEST. Cytopathology 2006. [DOI: 10.1111/j.1365-2303.2006.00392_13_17.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Campbell FE, Atwell RB, Smart L. Effects of the paralysis tick, Ixodes holocyclus, on the electrocardiogram of the Spectacled Flying Fox, Pteropus conspicillatus. Aust Vet J 2004; 81:328-31. [PMID: 15080451 DOI: 10.1111/j.1751-0813.2003.tb11505.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To evaluate cardiac electrical function in the Spectacled Flying Fox (bat) infested with Ixodes holocyclus. DESIGN Prospective clinical investigation of bats treated for naturally occurring tick toxicity. PROCEDURE ECGs were performed on bats with tick toxicity (n = 33), bats that recovered slowly (n = 5) and normally (n = 5) following treatment for tick toxicity, and on normal bats with no history of tick toxicity (n = 9). RESULTS Bats with tick toxicity had significantly prolonged corrected QT intervals, bradycardia and rhythm disturbances which included sinus bradydysrhythmia, atrial standstill, ventricular premature complexes, and idioventricular bradydysrhythmia. CONCLUSIONS The QT prolongation observed on ECG traces of bats with tick toxicity reflected delayed ventricular repolarisation and predisposed to polymorphic ventricular tachycardia and sudden cardiac death in response to sympathetic stimulation. The inability to document ventricular tachycardia in bats shortly before death from tick toxicity may be explained by a lack of sympathetic responsiveness attributable to the unique parasympathetic innervation of the bat heart, or hypothermia-induced catecholamine receptor down-regulation. Bradycardia and rhythm disturbances may be attributable to hypothermia.
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Affiliation(s)
- F E Campbell
- School of Veterinary Science, The University of Queensland, Queensland 4072
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Lee L, White V, Ball J, Gill K, Smart L, McEwan K, Chilton P, Pickering P. An audit of oral care practice and staff knowledge in hospital palliative care. Int J Palliat Nurs 2001; 7:395-400. [PMID: 11951784 DOI: 10.12968/ijpn.2001.7.8.9011] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Mouth care is considered one of the most basic of nursing activities, and palliative care patients are especially vulnerable to oral problems (Macmillan Practice Development Unit, 1995). This article describes a project on developing oral care practice and staff knowledge, by nursing staff and Macmillan nurses at a hospital in central England. A baseline audit (audit I) was carried out to examine all aspects of current oral care practice and nursing knowledge, including assessment, implementation, prescribing and evaluation of care. Oral care guidelines and a programme of ward-based teaching were then introduced. Several months later a follow-up audit (audit II) was conducted. Results showed an improvement in all aspects of oral care and staff knowledge. Additional benefits of this process included improved professional relationships and the promotion of further audits in hospital palliative care. Recommendations include the need for further nursing research into oral care to build the evidence base further. Additionally, it is suggested that nurses must recognize their important and central role in improving this aspect of palliative care. Education and training is pivotal to this process.
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Affiliation(s)
- L Lee
- Newark Hospital, Newark, UK
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Clarke KA, Smart L, Still J. Ground reaction force and spatiotemporal measurements of the gait of the mouse. Behav Res Methods Instrum Comput 2001; 33:422-6. [PMID: 11591074 DOI: 10.3758/bf03195396] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Measurement of ground reaction forces with force plates permits quantification of the subtle changes in movement associated with a variety of pathophysiological states. The apparatus used here permits simultaneous recording of other spatial and temporal characteristics of gait. Since the mouse is becoming increasingly important for modeling human disorders, we have recorded ground reaction forces (P) in this species. To date, we have measured the vertical component (Pz) and found it to be similar to that of other species, in that a greater Pz is exerted via the forelimb, although the areas under the force/time curves, are not different. Different points of discontinuity are seen in the forelimb and hindlimb curves, indicating differential deployment. Pz varies consistently with stance time and is consistent across the adult life of the mouse. It is suggested that the technique has potential for the study of a variety of mouse models of disease and of their therapies.
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Affiliation(s)
- K A Clarke
- Department of Biomedical Science, University of Sheffield, Western Bank, Sheffield S10 2TN, England.
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Abstract
In these studies the authors examined the effects of concealing a stigma in a social interaction relevant to the stigma. An interview paradigm called for undergraduate female participants who either did or did not have eating disordered characteristics to play the role of someone who did or did not have an eating disorder (ED) while answering stigma-relevant questions. The data suggest that the participants who concealed their stigmas become preoccupied with the control of stigma-relevant thoughts. In Study 1, participants with an ED who role-played not having an ED exhibited more secrecy, suppression, and intrusive thoughts of their ED and more projection of ED-related thoughts onto the interviewer than did those with an ED who role-played someone with an ED or those without an ED who role-played someone without an ED. This finding was replicated in Study 2, and the authors found both increasing accessibility of ED-related words among those participants with concealed stigmas during the interview and high levels of accessibility following the interview.
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Affiliation(s)
- L Smart
- Department of Psychology, University of Virginia, USA.
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34
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Abstract
In these studies the authors examined the effects of concealing a stigma in a social interaction relevant to the stigma. An interview paradigm called for undergraduate female participants who either did or did not have eating disordered characteristics to play the role of someone who did or did not have an eating disorder (ED) while answering stigma-relevant questions. The data suggest that the participants who concealed their stigmas become preoccupied with the control of stigma-relevant thoughts. In Study 1, participants with an ED who role-played not having an ED exhibited more secrecy, suppression, and intrusive thoughts of their ED and more projection of ED-related thoughts onto the interviewer than did those with an ED who role-played someone with an ED or those without an ED who role-played someone without an ED. This finding was replicated in Study 2, and the authors found both increasing accessibility of ED-related words among those participants with concealed stigmas during the interview and high levels of accessibility following the interview.
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Affiliation(s)
- L Smart
- Department of Psychology, University of Virginia, USA.
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35
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Stewart GL, Na H, Smart L, Seelig LL. The temporal relationship among anti-parasite immune elements expressed during the early phase of infection of the rat with Trichinella spiralis. Parasitol Res 1999; 85:672-7. [PMID: 10431731 DOI: 10.1007/s004360050613] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Immunological parameters were measured during the first 20 days of infection with Trichinella spiralis in the rat. Expulsion of adult worms was complete by day 15 postinfection. Eosinophil and neutrophil numbers rose in the blood of infected rats above preinfection levels on days 3 and 6, respectively, and remained high to day 20 postinfection. Release of cytokines by Trichinella-antigen-stimulated mesenteric lymph node cells was measured, and a significant elevation in interferon (IFN)-gamma release was detected during the early stage of infection. Although initiated later, interleukin (IL)-10 release showed a pattern similar to IFN-gamma. Biphasic release of IL-5 was seen with significant elevation above the preinfection level on day 3 and after day 6 postinfection to the end of the study. IL-4 and IL-2 showed biphasic secretion as well, with the level of IL-4 high in the early and middle part of infection, while the level of IL-2 was detectable only at days 2, 3 and 6 postinfection. Serum anti-parasite IgE rose above preinfection levels after day 6 postinfection. Anti-parasite Ig-positive mesenteric lymph node (MLN) cells were evident by day 3 postinfection for IgM, and day 9 postinfection for IgA and total IgG. The number of Ig-positive MLN cells for all antibody classes returned to preinfection levels by day 20 postinfection. Evaluation of the temporal interactions of the key anti-parasite immune components with which the host engages Trichinella shows a complex interplay between Th1 and Th2 helper subsets.
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Affiliation(s)
- G L Stewart
- Center for Parasitology, The University of Texas at Arlington, 76019, USA.
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Abstract
Deep cognitive activation occurs when a thought is so accessible as to have measurable effects on behavior or judgement, but is yet not consciously reportable. This state of mind has unique properties mimicking some characteristics of the psychoanalytic unconscious, but following theoretically from a consideration of processes of cognitive activation. The sources and consequences of deep cognitive activation are examined, with a view toward understanding how this state is implicated in the assessment, etiology, and treatment of psychopathology.
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Affiliation(s)
- D M Wegner
- Department of Psychology, University of Virginia, Charlottesville 22903, USA.
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Abstract
Deep cognitive activation occurs when a thought is so accessible as to have measurable effects on behavior or judgement, but is yet not consciously reportable. This state of mind has unique properties mimicking some characteristics of the psychoanalytic unconscious, but following theoretically from a consideration of processes of cognitive activation. The sources and consequences of deep cognitive activation are examined, with a view toward understanding how this state is implicated in the assessment, etiology, and treatment of psychopathology.
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Affiliation(s)
- D M Wegner
- Department of Psychology, University of Virginia, Charlottesville 22903, USA.
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Borrow R, Claus H, Guiver M, Smart L, Jones DM, Kaczmarski EB, Frosch M, Fox AJ. Non-culture diagnosis and serogroup determination of meningococcal B and C infection by a sialyltransferase (siaD) PCR ELISA. Epidemiol Infect 1997; 118:111-7. [PMID: 9129587 PMCID: PMC2808779 DOI: 10.1017/s0950268896007261] [Citation(s) in RCA: 100] [Impact Index Per Article: 3.7] [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: 02/04/2023] Open
Abstract
Rapid, non-culture, serogroup determination of meningococcal infection is important in contact management where vaccination may be possible. The impending availability of polysaccharide-protein conjugate vaccines for serogroup C disease requires maximal case ascertainment, with serogroup determination, at a time when the number of culture confirmed meningococcal infections is decreasing. A polymerase chain reaction assay (PCR), based on a restriction fragment length polymorphism (RFLP) in the meningococcal serogroup B and C sialytransferase (siaD) gene, was developed to combine the non-culture diagnosis of meningococcal infection from CSF, whole blood and serum with serogroup (B and C) identification. The PCR assay was adapted to an ELISA format incorporating hybridization with serogroup-specific B and C oligonucleotide probes. Specificity for CSFs was 100% and sensitivities were respectively 81, 63 and 30% for CSFs, whole blood and sera. The serogroup-specific PCR ELISA is a significant addition to currently available tests for non-culture diagnosis of meningococcal infection and outbreak investigation.
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Affiliation(s)
- R Borrow
- Manchester Public Health Laboratory, Withington Hospital, UK
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Abstract
Conventional wisdom has regarded low self-esteem as an important cause of violence, but the opposite view is theoretically viable. An interdisciplinary review of evidence about aggression, crime, and violence contradicted the view that low self-esteem is an important cause. Instead, violence appears to be most commonly a result of threatened egotism--that is, highly favorable views of self that are disputed by some person or circumstance. Inflated, unstable, or tentative beliefs in the self's superiority may be most prone to encountering threats and hence to causing violence. The mediating process may involve directing anger outward as a way of avoiding a downward revision of the self-concept.
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Affiliation(s)
- R F Baumeister
- Department of Psychology, Case Western Reserve University, Cleveland, Ohio 44106-7123, USA.
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Ellis S, Smart L. HIV awareness at work. Health Serv Manage 1993; 89:12-3. [PMID: 10125622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
Abstract
Shared personal and professional awareness of and commitment to HIV issues in employment prompted Sue Ellis and Liz Smart to set up a project which, through collaborative working between health promotion, personnel functions and trade unionists, would devise training materials to address employment issues and reduce concern about HIV infection in the workplace.
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Abstract
BACKGROUND Familial cold urticaria is a rare cutaneous and systemic reaction to cold with autosomal dominant inheritance, distinctive clinical features, and unknown pathogenesis. Release of a chymotrypsinlike substance has been postulated. To date, no effective treatment has been reported. OBSERVATIONS Eight cases from a large family pedigree are described. Three members showed a very favorable response in their cold urticaria, when treated with stanozolol; the response was reproducible. Histologic examination of an early lesion in one case revealed evidence of mast cell degranulation. CONCLUSIONS The biochemical observations are probably secondary epiphenomena. Correction of a deficiency of an inhibitory protein is a possible mechanism of action of stanozolol as in hereditary angioedema.
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Affiliation(s)
- A D Ormerod
- Department of Dermatology, University of Aberdeen, United Kingdom
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Abstract
A patient with Felty's syndrome who developed bilateral knee septic arthritis and septicaemia due to Streptococcus pneumoniae is described. She had had a previous splenectomy for symptomatic thrombocytopenia, having received pneumococcal vaccine before the operation. Measurement of antibody to the 23 vaccine serotypes showed protective concentrations before infection to just two. The infecting serotype was not represented in the vaccine, but a vigorous antibody response to this serotype occurred. The patient also developed glomerulonephritis due to immune complex deposition.
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Affiliation(s)
- M Brzeski
- Centre for Rheumatic Diseases, University Department of Medicine, Royal Infirmary, Glasgow
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Abstract
We report the association of erythema elevatum diutinum (EED) with ulcerative colitis (UC). The patient, whose history included rheumatoid disease, diabetes mellitus (type I) and hypothyroidism developed EED during a severe acute exacerbation of UC which resolved following colectomy. To our knowledge this is the first report of such an association. Also of interest was the observation of Köebner phenomenon occurring at the sites where blood vessels were damaged.
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Affiliation(s)
- K Buahene
- Department of Dermatology, Aberdeen Royal Infirmary, UK
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Abstract
Breast milk intake by babies on the third and the sixth postpartum day was measured by a test-weigh procedure in a group of 47 mothers and babies. Women who gave the largest amount of breast milk to their babies on the third postpartum day continued to breast feed for longer than women who gave smaller amounts. These mothers also suckled most frequently, gave least additional fluid to their babies, and their infants regained their birth weight most rapidly. However, an increased early milk intake and duration of breast feeding were both associated with higher social class. These results suggest that, although practices in the initiation of breast feeding are relevant, factors in the background and environment of the mother are also of fundamental importance. Thus recent emphasis on the importance of breast-feeding practices in the immediate puerperium should not divert attention from the equally important task of establishing the optimum conditions for breast feeding in the home environment of mothers.
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Rodmell S, Smart L. Pregnant at work. Midwives Chron 1982; 95:408-9. [PMID: 6924064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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Smart L. RCM Annual Meetings. Hands across the divide. Nurs Times 1982; 78:suppl 8-11. [PMID: 6920710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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Abstract
The binding of radiolabelled choline to lysed rat hippocampal synaptosomes was investigated. A portion of the binding sites was (a) detectable only when sodium ions were present, (b) sensitive to low concentrations of hemicholinium-3 (KD less than or equal to 70 nM), and (c) significantly reduced following electrolytic lesion of the septum. The similarity between this component of choline binding and the requirements of the sodium-dependent high affinity choline uptake process suggests that these binding sites are related to the choline transport system.
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Abstract
The actions of five harmala alkaloids on the sodium dependent high affinity choline uptake activity in rat striatal synaptosomes was investigated. All five compounds were found to be competitive inhibitors of the uptake system. Harmalol (Ki approximately 3.4 microM) and 2-methylharmine (Ki approximately 5.7 microM) were found to be relatively potent inhibitors in a series with an ascending order of inhibitory potency of harmaline less than 2-methylharmaline less than harmine less than 2-methylharmine less than harmalol.
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