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Raff L, Blank AG, Crespo Regalado R, Bulik-Sullivan E, Phillips L, Moore C, Galvan Miranda L, Raff E. A Quality Improvement Project to Reduce Rapid Response System Inequities for Patients with Limited English Proficiency at a Quaternary Academic Medical Center. J Gen Intern Med 2024:10.1007/s11606-024-08678-x. [PMID: 38381243 DOI: 10.1007/s11606-024-08678-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Accepted: 02/06/2024] [Indexed: 02/22/2024]
Abstract
BACKGROUND Recognition of clinically deteriorating hospitalized patients with activation of rapid response (RR) systems can prevent patient harm. Patients with limited English proficiency (LEP), however, experience less benefit from RR systems than do their English-speaking counterparts. OBJECTIVE To improve outcomes among hospitalized LEP patients experiencing clinical deteriorations. DESIGN Quasi-experimental pre-post design using quality improvement (QI) statistics. PARTICIPANTS All adult hospitalized non-intensive care patients with LEP who were admitted to a large academic medical center from May 2021 through March 2023 and experienced RR system activation were included in the evaluation. All patients included after May 2022 were exposed to the intervention. INTERVENTIONS Implementation of a modified RR system for LEP patients in May 2022 that included electronic dashboard monitoring of early warning scores (EWSs) based on electronic medical record data; RR nurse initiation of consults or full RR system activation; and systematic engagement of interpreters. MAIN MEASURES Process of care measures included monthly rates of RR system activation, critical response nurse consultations, and disease severity scores prior to activation. Main outcomes included average post-RR system activation length of stay, escalation of care, and in-hospital mortality. Analyses used QI statistics to identify special cause variation in pre-post control charts based on monthly data aggregates. KEY RESULTS In total, 222 patients experienced at least one RR system activation during the study period. We saw no special cause variation for process measures, or for length of hospitalization or escalation of care. There was, however, special cause variation in mortality rates with an overall pre-post decrease in average monthly mortality from 7.42% (n = 8/107) to 6.09% (n = 7/115). CONCLUSIONS In this pilot study, prioritized tracking, utilization of EWS-triggered evaluations, and interpreter integration into the RR system for LEP patients were feasible to implement and showed promise for reducing post-RR system activation mortality.
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Affiliation(s)
- Lauren Raff
- Department of Surgery, Division of Trauma and Acute Care Surgery, University of North Carolina School of Medicine, 4008 Burnett-Womack Building, Campus Box 70, Chapel Hill, NC, 27599, USA
| | - Andrew G Blank
- Division of Hospital Medicine, Department of Medicine, University of North Carolina School of Medicine, 101 Manning Drive, Campus Box 7085, Chapel Hill, NC, 27599, USA
| | - Ricardo Crespo Regalado
- University of North Carolina School of Medicine, 321 South Columbia Street, Chapel Hill, NC, 27599, USA
| | - Emily Bulik-Sullivan
- University of North Carolina School of Medicine, 321 South Columbia Street, Chapel Hill, NC, 27599, USA
| | - Lindsey Phillips
- Division of Hospital Medicine, Department of Medicine, University of North Carolina School of Medicine, 101 Manning Drive, Campus Box 7085, Chapel Hill, NC, 27599, USA
| | - Carlton Moore
- Division of Hospital Medicine, Department of Medicine, University of North Carolina School of Medicine, 101 Manning Drive, Campus Box 7085, Chapel Hill, NC, 27599, USA
| | - Lilia Galvan Miranda
- Department of Interpreter Services, University of North Carolina Health, 101 Manning Drive, Chapel Hill, NC, 27514, USA
| | - Evan Raff
- Division of Hospital Medicine, Department of Medicine, University of North Carolina School of Medicine, 101 Manning Drive, Campus Box 7085, Chapel Hill, NC, 27599, USA.
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Xue A, Bernard A, Moreno V, Phillips L, Raff E. A Rare Case of Hydralazine-Induced Diffuse Alveolar Hemorrhage. Cureus 2023; 15:e47591. [PMID: 38022102 PMCID: PMC10665773 DOI: 10.7759/cureus.47591] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/20/2023] [Indexed: 12/01/2023] Open
Abstract
Hydralazine-induced anti-neutrophil cytoplasmic antibody (ANCA) vasculitis may occur any time after hydralazine initiation. General internists should recognize diffuse alveolar hemorrhage (DAH) as a rare complication of this condition, as early treatment reduces the associated high risk of mortality. We describe the case of an 82-year-old female with diastolic heart failure who presented with a one-month history of worsening dyspnea on exertion and a one-week history of scant hemoptysis and fatigue. Her medications included aspirin and hydralazine. She was hypoxic with bilateral expiratory wheezes on exam. Labs showed new anemia, elevated creatinine, proteinuria, and hematuria. Chest computed tomography showed asymmetric bilateral upper lobe ground-glass attenuation superimposed on interlobular septal thickening and intralobular lines. Further testing showed anti-nuclear antibody, positive ANCA, perinuclear ANCA (p-ANCA), and anti-myeloperoxidase ANCA (anti-MPO-ANCA). Renal biopsy revealed MPO-ANCA, pauci-immune, necrotizing, and crescentic glomerulonephritis. She was diagnosed with DAH secondary to hydralazine-induced ANCA-associated vasculitis (AAV). Hydralazine is an anti-hypertensive medication with known potential for autoimmune reactions. Of these, AAV is a rare sequela mediated by anti-MPO and most commonly affects the kidneys. In rare circumstances, patients with AAV can develop pulmonary-renal syndrome, resulting in both glomerulonephritis and DAH with an associated high risk of mortality. Diagnosis requires a high index of suspicion in patients with acute kidney injury of unclear etiology. Early diagnosis through immune work-up and kidney biopsy should be pursued, as prompt recognition of the vasculitis, cessation of hydralazine, immunosuppression, and early plasma exchange are essential to an improved prognosis.
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Affiliation(s)
- Angela Xue
- Medicine, University of North Carolina School of Medicine, Chapel Hill, USA
| | - Adele Bernard
- Medicine, University of North Carolina School of Medicine, Chapel Hill, USA
| | - Vanessa Moreno
- Pathology and Laboratory Medicine, University of North Carolina School of Medicine, Chapel Hill, USA
| | - Lindsey Phillips
- Medicine, University of North Carolina School of Medicine, Chapel Hill, USA
| | - Evan Raff
- Medicine, University of North Carolina School of Medicine, Chapel Hill, USA
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Harwood R, Bethell G, Eastwood MP, Hotonu S, Allin B, Boam T, Rees CM, Hall NJ, Rhodes H, Ampirska T, Arthur F, Billington J, Bough G, Burdall O, Burnand K, Chhabra S, Driver C, Ducey J, Engall N, Folaranmi E, Gracie D, Ford K, Fox C, Green P, Green S, Jawaid W, John M, Koh C, Lam C, Lewis S, Lindley R, Macafee D, Marks I, McNickle L, O’Sullivan BJ, Peeraully R, Phillips L, Rooney A, Thompson H, Tullie L, Vecchione S, Tyraskis A, Maldonado BN, Pissaridou M, Sanchez-Thompson N, Morris L, John M, Godse A, Farrelly P, Cullis P, McHoney M, Colvin D. The Blunt Liver and Spleen Trauma (BLAST) audit: national survey and prospective audit of children with blunt liver and spleen trauma in major trauma centres. Eur J Trauma Emerg Surg 2023; 49:2249-2256. [PMID: 35727342 PMCID: PMC10520113 DOI: 10.1007/s00068-022-01990-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Accepted: 04/24/2022] [Indexed: 11/29/2022]
Abstract
PURPOSE To compare the reported and observed management of UK children with blunt liver or spleen injury (BLSI) to the American Pediatric Surgical Association (APSA) 2019 BLSI guidance. METHODS UK Paediatric Major Trauma Centres (pMTCs) undertook 1 year of prospective data collection on children admitted to or discussed with those centres with BLSI and an online questionnaire was distributed to all consultants who care for children with BLSI in those centres. RESULTS All 21/21 (100%) pMTCs participated; 131 patients were included and 100/152 (65%) consultants responded to the survey. ICU care was reported and observed to be primarily determined using haemodynamic status or concomitant injuries rather than injury grade, in accordance with APSA guidance. Bed rest was reported to be determined by grade of injury by 63% of survey respondents and observed in a similar proportion of patients. Contrary to APSA guidance, follow-up radiological assessment of the injured spleen or liver was undertaken in 44% of patients before discharge and 32% after discharge, the majority of whom were asymptomatic. CONCLUSIONS UK management of BLSI differs from many aspects of APSA guidance. A shift towards using clinical features to determine ICU admission and readiness for discharge is demonstrated, in line with a strong evidence base. However, routine bed rest and re-imaging after BLSI is common, contrary to APSA guidance. This disparity may exist due to concern that evidence around the incidence, presentation and natural history of complications after conservatively managed BLSI, particularly bleeding from pseudoaneurysms, is weak.
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Raff L, Cole E, Phillips L, Raff E. Food Insecurity Leading to Superior Mesenteric Artery Syndrome Managed Successfully with Endoscopic Gastrojejunostomy Stent. Am J Case Rep 2023; 24:e939420. [PMID: 37422696 DOI: 10.12659/ajcr.939420] [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: 07/10/2023]
Abstract
BACKGROUND Food insecurity describes the lack of adequate and reliable access to food due to insufficient resources. The condition affects over one-quarter of the world's population and is exacerbated by factors such as conflicts, climate variability, rising costs of nutritious food, and economic slumps; these challenges are amplified by poverty and inequality. Food insecurity is associated with many negative health outcomes, such as iron deficiency anemia, poor oral health, and stunting of growth in children. CASE REPORT We present the case of a patient who had significant weight loss related to food insecurity then developed a rare adverse health outcome: superior mesenteric artery (SMA) syndrome. SMA syndrome is a condition in which reduction in the angle formed by the proximal SMA and aorta, most commonly from decreased mesenteric fat in the setting of significant weight loss, leads to compression of the third portion of the duodenum and resulting bowel obstruction. The patient underwent successful treatment with a novel approach: endoscopic placement of a gastrojejunostomy stent. CONCLUSIONS Food insecurity remains a wide-ranging public health issue that can have direct impact on the clinical outcomes of individuals. We describe SMA syndrome as a rare adverse outcome in a food insecure individual, adding to the growing list of health consequences associated with this condition. We also highlight endoscopic placement of a gastrojejunostomy stent as an emerging alternative to surgical treatment of SMA syndrome. The success of the procedure in this patient adds to the body of evidence supporting its efficacy and safety profile for this population.
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Affiliation(s)
- Lauren Raff
- Department of Surgery, The University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, USA
| | - Elizabeth Cole
- Department of Medicine, The University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, USA
| | - Lindsey Phillips
- Department of Medicine, The University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, USA
| | - Evan Raff
- Department of Medicine, The University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, USA
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Beckner AG, Voss AT, Phillips L, King K, Casasola M, Oakes LM. An investigation of mental rotation in infancy using change detection. Infant Behav Dev 2023; 71:101834. [PMID: 37080014 DOI: 10.1016/j.infbeh.2023.101834] [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: 01/21/2023] [Revised: 03/13/2023] [Accepted: 03/14/2023] [Indexed: 04/22/2023]
Abstract
Two experiments were conducted to examine mental rotation in 6- to 12-month-old infants (N = 166) using a change detection task. These experiments were replications of Lauer and Lourenco (Lauer et al., 2015; Lauer & Lourenco, 2016), using identical stimuli and variations of their procedure, including an exact replication conducted in a laboratory setting (Experiment 1), and an online assessment using Lookit (Scott et al.,2017; Scott & Schulz, 2017) (Experiment 2). Both experiments failed to replicate the results of the original study; in neither experiment did infants' behavior provide evidence that they mentally rotated the object. Results are discussed in terms of the robustness of mental rotation in infancy and about limits in our experimental procedures for uncovering perceptual and cognitive abilities in infants.
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Affiliation(s)
| | - Annika T Voss
- Center for Mind and Brain, University of California, Davis, USA
| | | | - Kathryn King
- Department of Psychology, University of California, Davis, USA
| | | | - Lisa M Oakes
- Department of Psychology, University of California, Davis, USA; Center for Mind and Brain, University of California, Davis, USA
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Spencer H, Gorecki A, Foley H, Phillips L, Abonnel MY, Meloni BP, Anderton RS. Poly-Arginine R18 Peptide Inhibits Heat-Induced Lysozyme Protein Aggregation: Implications for a Possible Therapeutic Role in Parkinson’s Disease. APPL BIOCHEM MICRO+ 2023. [DOI: 10.1134/s0003683823010118] [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: 03/28/2023]
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Odell I, Steach H, Gauld S, Carr T, Wetter J, Phillips L, Hinchcliff M, Flavell R. 045 An EGFR ligand maintains scleroderma skin and lung fibrosis. J Invest Dermatol 2022. [DOI: 10.1016/j.jid.2022.05.099] [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: 10/17/2022]
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Bowker K, Lewis S, Phillips L, Orton S, Ussher M, Naughton F, Bauld L, Coleman T, Sinclair L, McRobbie H, Khan A, Cooper S. Pregnant women's use of e-cigarettes in the UK: a cross-sectional survey. BJOG 2021; 128:984-993. [PMID: 33012050 DOI: 10.1111/1471-0528.16553] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/24/2020] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To estimate prevalence of vaping in pregnancy. Compare characteristics and attitudes between exclusive smokers and vapers, and between exclusive vapers and dual users (smoke and vape). DESIGN Cross-sectional survey. SETTING Hospitals across England and Scotland. POPULATION Pregnant women attending antenatal clinics in 2017. METHODS Women at 8-24 weeks' gestation completed screening questions about their smoking and vaping. Current or recent ex-smokers and/or vapers completed a full detailed survey about vaping and smoking. MAIN OUTCOME MEASURES The prevalence of vaping, characteristics and attitudes of women who vape and/or smoke. RESULTS Of 3360 pregnant women who completed screening questions, 515 (15.3%, 95% CI 14.1-16.6) were exclusive smokers, 44 (1.3%, 95% CI 1.0-1.8) exclusive vapers and 118 (3.5%, 95% CI 2.9-4.2) dual users. In total, 867 (25.8%) women completed the full survey; compared with smokers (n = 434), vapers (n = 140) were more likely to hold higher educational qualifications (odds ratio [OR) 1.51, 95% CI 1.01-2.25). Compared with exclusive vapers (n = 33), dual users (n = 107) were younger (OR 0.91 95% CI 0.85-0.98) and less likely to hold high qualifications (OR 0.43, 95% CI 0.20-0.96). Compared with smokers, dual users were more likely to be planning to quit smoking (OR 2.27, 95% CI 1.24-4.18). Compared with smokers, vapers were more likely to think vaping was safer than smoking (78.6% versus 36.4%). CONCLUSIONS One in 20 pregnant women report vaping, and most also smoke. Dual users are more motivated towards stopping smoking than smokers. Where women have tried but cannot stop smoking, clinicians could encourage them to consider vaping for smoking cessation. TWEETABLE EXTRACT One in 20 women report vaping during pregnancy but of those that do vape, most also smoke, despite having intentions to quit.
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Affiliation(s)
- K Bowker
- Division of Primary Care Research and UK Centre for Tobacco and Alcohol Studies, School of Medicine, University of Nottingham, Nottingham, UK
| | - S Lewis
- Division of Epidemiology and Public Health and UK Centre for Tobacco and Alcohol Studies, Nottingham City Hospital, University of Nottingham, Nottingham, UK
| | - L Phillips
- Division of Primary Care Research and UK Centre for Tobacco and Alcohol Studies, School of Medicine, University of Nottingham, Nottingham, UK
| | - S Orton
- Division of Primary Care Research and UK Centre for Tobacco and Alcohol Studies, School of Medicine, University of Nottingham, Nottingham, UK
| | - M Ussher
- Population Health Research Institute, St George's, University of London, London, UK
- Institute for Social Marketing and Health, University of Stirling, Stirling, UK
| | - F Naughton
- Faculty of Medicine and Health Sciences, University of East Anglia, Norwich, UK
| | - L Bauld
- Usher Institute, College of Medicine and Veterinary Medicine, University of Edinburgh, Edinburgh, UK
| | - T Coleman
- Division of Primary Care Research and UK Centre for Tobacco and Alcohol Studies, School of Medicine, University of Nottingham, Nottingham, UK
| | - L Sinclair
- Usher Institute, College of Medicine and Veterinary Medicine, University of Edinburgh, Edinburgh, UK
| | - H McRobbie
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, NSW, Australia
| | - A Khan
- Division of Primary Care Research and UK Centre for Tobacco and Alcohol Studies, School of Medicine, University of Nottingham, Nottingham, UK
| | - S Cooper
- Division of Primary Care Research and UK Centre for Tobacco and Alcohol Studies, School of Medicine, University of Nottingham, Nottingham, UK
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Topf A, Johnson K, Mroczek M, Phillips L, Duff J, Valkanas E, England E, MacArthur D, Straub V, MYO-SEQ consortium. E-POSTERS – NEXT GENERATION SEQUENCING. Neuromuscul Disord 2019. [DOI: 10.1016/j.nmd.2019.06.502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Topf A, Casasus A, Barresi R, Johnson K, Mroczek M, Duff J, Phillips L, England E, Xu L, Valkanas E, MacArthur D, Straub V, MYO-SEQ consortium. P.175Detection and interpretation of variants in dystroglycanopathy-causing genes in a cohort of 1,566 patients with unexplained limb-girdle muscle weakness. Neuromuscul Disord 2019. [DOI: 10.1016/j.nmd.2019.06.230] [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: 11/28/2022]
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Catapano F, Scaglioni D, Maresh K, Selby V, Ala P, Domingos J, Ricotti V, Phillips L, van der Holst M, Servais L, Seferian A, de Groot I, Krom Y, Voit T, Verschuuren J, Niks E, Straub V, Morgan J, Muntoni F. P.144A cross sectional and longitudinal miRNA profiling study identified a set of novel free-circulating and exosomal miRNAs dysregulated in plasma from Duchenne muscular dystrophy patients. Neuromuscul Disord 2019. [DOI: 10.1016/j.nmd.2019.06.200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Carballo O, Hall M, Phillips L, Lyman R. The Effects of Hyperbaric Oxygen Therapy on Edema after Stifle Surgery. Vet Comp Orthop Traumatol 2019. [DOI: 10.1055/s-0039-1692282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
| | - M. Hall
- AERC, Fort Pierce, Florida, United States
| | | | - R. Lyman
- AERC, Fort Pierce, Florida, United States
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Medin P, Hrycushko B, Phillips L, Sayre J, Folkert M, Vernino S, Foster R, Hassan Rezaeian N, Yamada Y, Van Der Kogel A. The Dose-Length Effect in Spinal Nerves Receiving Single-Session Stereotactic Ablative Radiation Therapy (SAbR). Int J Radiat Oncol Biol Phys 2018. [DOI: 10.1016/j.ijrobp.2018.06.198] [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: 10/28/2022]
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Woods D, Phillips L, Johnson R, Knox V. AN ANTIDOTE TO COMPASSION FATIGUE: DIRECT CARE STAFF USING CALM FOR ASSISTED LIVING RESIDENTS. Innov Aging 2018. [DOI: 10.1093/geroni/igy023.2667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Phillips L, Oyewusi C, Martin N, Youse L, Rantz M. IMPACT OF SURVEY READINESS TRAINING ON NURSING HOME QUALITY OF CARE. Innov Aging 2018. [DOI: 10.1093/geroni/igy023.2674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
| | | | | | - L Youse
- University of Missouri Sinclair School of Nursing
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Johnson K, Bertoli M, Phillips L, Blain A, Ensini M, Töpf A, Lek M, Xu L, Mullen T, Valkanas E, MacArthur D, Straub V. An international collaboration applying targeted whole exome sequencing to detect causative variants in 1001 patients affected by limb-girdle weakness of unknown origin. Neuromuscul Disord 2018. [DOI: 10.1016/s0960-8966(18)30407-3] [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: 10/17/2022]
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Catapano F, Domingos J, Perry M, Ricotti V, Phillips L, Servais L, de Groot I, Niks E, Verschuuren J, Straub V, Voit T, Morgan J, Muntoni F. Downregulation of miR-29 and miR-23 in urine of Duchenne muscular dystrophy patients. Neuromuscul Disord 2018. [DOI: 10.1016/s0960-8966(18)30344-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Phillips L, Opie J. The utility of bone marrow sampling in the diagnosis and staging of lymphoma in South Africa. Int J Lab Hematol 2018; 40:276-283. [PMID: 29427399 DOI: 10.1111/ijlh.12782] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2017] [Accepted: 12/19/2017] [Indexed: 02/01/2023]
Abstract
INTRODUCTION The bone marrow biopsy (BMB) is a diagnostic and staging tool in lymphoma that remains practically useful and relevant in resource-constrained settings, despite restricted applications in international staging guidelines, which favour less invasive nuclear medicine techniques. METHODS Retrospective laboratory data review of BMBs in adult lymphoma patients from 2005 to 2010 to determine subtypes, rates of bone marrow involvement (BMI), human immunodeficiency virus (HIV) seroprevalence and CD4 counts, trephine length and additional findings. RESULTS A total of 1215 BMBs reported in lymphoma included 759 newly diagnosed patients, with BMI in 43.6% of non-Hodgkin lymphoma (NHL) overall, 28.9% of high-grade B subtypes and 35.7% of Hodgkin lymphoma (HL). HIV seroprevalence was 38.8%, 53.0% and 33.9% in the 3 respective groups. There was a statistical association between BMI and HIV seropositivity in Burkitt lymphoma and HL, and BMI and CD4 count in HIV-related HL. Over 10% (n = 79) of new lymphoma cases were diagnosed by BMB with ancillary tests. Occasional histological discordance and transformation were reported in NHL. Focal/unilateral BMI was uncommon. Bilateral BMB and biopsy length exceeding 26 mm did not improve BMI detection. CONCLUSION In the South African public sector, high HIV prevalence leads to a different lymphoma pathology profile from the developed world. High BMI rates are encountered. Here, and in similar resource-constrained settings, international lymphoma staging guidelines can be logistically challenging and unaffordable. BMB remains useful in the staging and diagnosis of lymphoma. Unilateral sampling with a processed trephine length of at least 26 mm is recommended.
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Affiliation(s)
- L Phillips
- Department of Haematology, Red Cross War Memorial Children's Hospital Laboratory, National Health Laboratory Service, Cape Town, South Africa.,Division of Haematology, Department of Pathology, University of Cape Town, Cape Town, South Africa
| | - J Opie
- Division of Haematology, Department of Pathology, University of Cape Town, Cape Town, South Africa.,Department of Haematology, Groote Schuur Hospital Laboratory, National Health Laboratory Service, Cape Town, South Africa
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Abstract
SummaryA segmental radial defect model was used to radiographically and histologically evaluate response to ratite cancellous xenograft in pigeons. The control group showed little evidence of callus production with all fractures proceeding to nonunion. Lymphocytic response to xenograft peaked at four weeks and diminished thereafter. Fractures treated with cancellous xenograft had significant increases in new bone production.
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Van den Bergh PYK, Sznajer Y, Van Parys V, van Tol W, Wevers RA, Lefeber DJ, Xu L, Lek M, MacArthur DG, Johnson K, Phillips L, Töpf A, Straub V. Corrigendum to "A homozygous DPM3 mutation in a patient with alpha-dystroglycan-related limb girdle muscular dystrophy" [Neuromuscular disorders 27/11 (2017) 1043-1046]. Neuromuscul Disord 2017; 28:101. [PMID: 29246662 DOI: 10.1016/j.nmd.2017.11.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- P Y K Van den Bergh
- Neuromuscular Reference Centre, University Hospital St-Luc, University of Louvain, Brussels, Belgium.
| | - Y Sznajer
- Neuromuscular Reference Centre, University Hospital St-Luc, University of Louvain, Brussels, Belgium; Centre for Human Genetics, University Hospital St-Luc, University of Louvain, Brussels, Belgium
| | - V Van Parys
- Neuromuscular Reference Centre, University Hospital St-Luc, University of Louvain, Brussels, Belgium
| | - W van Tol
- Department of Neurology, Radboud University Medical Centre, Nijmegen, The Netherlands; Translational Metabolic Laboratory, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - R A Wevers
- Translational Metabolic Laboratory, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - D J Lefeber
- Department of Neurology, Radboud University Medical Centre, Nijmegen, The Netherlands; Translational Metabolic Laboratory, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - L Xu
- Analytic and Translational Genetics Unit, Massachusetts General Hospital, Boston, MA 02114, USA; Program in Medical and Population Genetics, Broad Institute of Harvard and MIT, Cambridge, MA 02142, USA
| | - M Lek
- Analytic and Translational Genetics Unit, Massachusetts General Hospital, Boston, MA 02114, USA; Program in Medical and Population Genetics, Broad Institute of Harvard and MIT, Cambridge, MA 02142, USA
| | - D G MacArthur
- Analytic and Translational Genetics Unit, Massachusetts General Hospital, Boston, MA 02114, USA; Program in Medical and Population Genetics, Broad Institute of Harvard and MIT, Cambridge, MA 02142, USA
| | - K Johnson
- The John Walton Muscular Dystrophy Research Centre, Institute of Genetic Medicine, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - L Phillips
- The John Walton Muscular Dystrophy Research Centre, Institute of Genetic Medicine, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - A Töpf
- The John Walton Muscular Dystrophy Research Centre, Institute of Genetic Medicine, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - V Straub
- The John Walton Muscular Dystrophy Research Centre, Institute of Genetic Medicine, Newcastle University, Newcastle upon Tyne, United Kingdom
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Durmus H, Scalco R, Gardiner A, Manole A, Schapira A, Morrow J, Houlden H, Holton J, Johnson K, Töpf A, Phillips L, Deymeer F, Parman Y, Straub V, Quinlivan R, Oflazer-Serdaoglu P. Anoctamin 5 muscular dystrophy mimicking metabolic myopathy. Neuromuscul Disord 2017. [DOI: 10.1016/j.nmd.2017.06.188] [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]
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22
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Medin P, Hrycushko B, Phillips L, Vernino S, Foster R, Sayre J, Yamada Y, Van Der Kogel A. Spinal Nerve Tolerance to Single-Session Stereotactic Ablative Radiotherapy (SAbR). Int J Radiat Oncol Biol Phys 2017. [DOI: 10.1016/j.ijrobp.2017.06.185] [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: 11/28/2022]
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23
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Johnson K, Töpf A, Bertoli M, Phillips L, De Ridder W, Baets J, De Jonghe P, Deconinck T, Rakocevic Stojanovic V, Perić S, Durmus H, Jamal-Omidi S, Nafissi S, Łusakowska A, Mongini T, Lek M, Valkanas E, Mullen T, Xu L, MacArthur D, Straub V. Detection of TRIM32 variants associated with LGMD2H in a large cohort of patients with unexplained limb-girdle weakness. Neuromuscul Disord 2017. [DOI: 10.1016/j.nmd.2017.06.182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Abstract
PURPOSE Progressive hip displacement is one of the most common orthopaedic pathologies in children with cerebral palsy (CP). Reconstructive hip surgery has become the standard treatment of care. Reported avascular necrosis (AVN) rates for hip reconstructive surgery in these patients vary widely in the literature. The purpose of this study is to identify the frequency and associated risk factors of AVN for reconstructive hip procedures. METHODS A retrospective analysis was performed of 70 cases of reconstructive hip surgery in 47 children with CP, between 2009 and 2013. All 70 cases involved varus derotation osteotomy (VDRO), with 60% having combined VDRO and pelvic osteotomies (PO), and 21% requiring open reductions. Mean age at time of surgery was 8.82 years and 90% of patients were Gross Motor Function Classification System (GMFCS) 4 and 5. Radiographic dysplasia parameters were analysed at selected intervals, to a minimum of one year post-operatively. Severity of AVN was classified by Kruczynski's method. Bivar- iate statistical analysis was conducted using Chi-square test and Student's t-test. RESULTS There were 19 (27%) noted cases of AVN, all radio- graphically identifiable within the first post-operative year. The majority of AVN cases (63%) were mild to moderate in severity. Pre-operative migration percentage (MP) (p = 0.0009) and post-operative change in MP (p = 0.002) were the most significant predictors of AVN. Other risk factors were: GMFCS level (p = 0.031), post-operative change in NSA (p = 0.02) and concomitant adductor tenotomy (0.028). CONCLUSION AVN was observed in 27% of patients. Severity of displacement correlates directly with AVN risk and we suggest that hip reconstruction, specifically VDRO, be performed early in the 'hip at risk' group to avoid this complication.
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Affiliation(s)
- L. Phillips
- Department of Orthopaedic Surgery, BC Children's Hospital, Vancouver, BC, Canada
| | - K. Hesketh
- Department of Orthopaedic Surgery, BC Children's Hospital, Vancouver, BC, Canada
| | - E. K. Schaeffer
- Department of Orthopaedic Surgery, BC Children's Hospital, Vancouver, BC, Canada,Department of Orthopaedics, University of British Columbia and Department of Orthopaedic Surgery, BC Children's Hospital, Vancouver, BC, Canada
| | - J. Andrade
- Department of Orthopaedic Surgery, BC Children's Hospital, Vancouver, BC, Canada
| | - J. Farr
- Department of Orthopaedic Surgery, BC Children's Hospital, Vancouver, BC, Canada
| | - K. Mulpuri
- Department of Orthopaedic Surgery, BC Children's Hospital, Vancouver, BC, Canada,Department of Orthopaedics, University of British Columbia and Department of Orthopaedic Surgery, BC Children's Hospital, Vancouver, BC, Canada,Correspondence should be sent to: Dr K. Mulpuri, Department of Orthopaedic Surgery, BC Children’s Hospital, 1D66-4480 Oak Street, Vancouver, BC, Canada.
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Van den Bergh PYK, Sznajer Y, Van Parys V, van Tol W, Wevers RA, Lefeber DJ, Xu L, Lek M, MacArthur DG, Johnson K, Phillips L, Töpf A, Straub V. A homozygous DPM3 mutation in a patient with alpha-dystroglycan-related limb girdle muscular dystrophy. Neuromuscul Disord 2017; 27:1043-1046. [PMID: 28803818 DOI: 10.1016/j.nmd.2017.07.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2017] [Revised: 06/27/2017] [Accepted: 07/12/2017] [Indexed: 10/19/2022]
Abstract
Defects of O-linked glycosylation of alpha-dystroglycan cause a wide spectrum of muscular dystrophies ranging from severe congenital muscular dystrophy associated with abnormal brain and eye development to mild limb girdle muscular dystrophy. We report a female patient who developed isolated pelvic girdle muscle weakness and wasting, which became symptomatic at age 42. Exome sequencing uncovered a homozygous c.131T > G (p.Leu44Pro) substitution in DPM3, encoding dolichol-P-mannose (DPM) synthase subunit 3, leading to a 50% reduction of enzymatic activity. Decreased availability of DPM as an essential donor substrate for protein O-mannosyltransferase (POMT) 1 and 2 explains defective skeletal muscle alpha-dystroglycan O-glycosylation. Our findings show that DPM3 mutations may lead to an isolated and mild limb girdle muscular dystrophy phenotype without cardiomyopathy.
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Affiliation(s)
- P Y K Van den Bergh
- Neuromuscular Reference Centre, University Hospital St-Luc, University of Louvain, Brussels, Belgium.
| | - Y Sznajer
- Neuromuscular Reference Centre, University Hospital St-Luc, University of Louvain, Brussels, Belgium; Centre for Human Genetics, University Hospital St-Luc, University of Louvain, Brussels, Belgium
| | - V Van Parys
- Neuromuscular Reference Centre, University Hospital St-Luc, University of Louvain, Brussels, Belgium
| | - W van Tol
- Department of Neurology, Radboud University Medical Centre, Nijmegen, The Netherlands; Translational Metabolic Laboratory, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - R A Wevers
- Translational Metabolic Laboratory, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - D J Lefeber
- Department of Neurology, Radboud University Medical Centre, Nijmegen, The Netherlands; Translational Metabolic Laboratory, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - L Xu
- Analytic and Translational Genetics Unit, Massachusetts General Hospital, Boston, MA 02114, USA; Program in Medical and Population Genetics, Broad Institute of Harvard and MIT, Cambridge, MA 02142, USA
| | - M Lek
- Analytic and Translational Genetics Unit, Massachusetts General Hospital, Boston, MA 02114, USA; Program in Medical and Population Genetics, Broad Institute of Harvard and MIT, Cambridge, MA 02142, USA
| | - D G MacArthur
- Analytic and Translational Genetics Unit, Massachusetts General Hospital, Boston, MA 02114, USA; Program in Medical and Population Genetics, Broad Institute of Harvard and MIT, Cambridge, MA 02142, USA
| | - K Johnson
- The John Walton Muscular Dystrophy Research Centre, Institute of Genetic Medicine, Newcastle University, Newcastle upon-Tyne, United Kingdom
| | - L Phillips
- The John Walton Muscular Dystrophy Research Centre, Institute of Genetic Medicine, Newcastle University, Newcastle upon-Tyne, United Kingdom
| | - A Töpf
- The John Walton Muscular Dystrophy Research Centre, Institute of Genetic Medicine, Newcastle University, Newcastle upon-Tyne, United Kingdom
| | - V Straub
- The John Walton Muscular Dystrophy Research Centre, Institute of Genetic Medicine, Newcastle University, Newcastle upon-Tyne, United Kingdom
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Guo G, Phillips L. DEVELOPING SENSITIVITY ABOUT TRANSITIONAL CARE AND COGNITIVE IMPAIRMENT. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.3310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- G. Guo
- Peking University School of Nursing, Bejing, China
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Phillips L, Cadogan M. CREATING PERFECT EMERGENCY DEPARTMENT (ED) TO HOME TRANSITIONS FOR FRAIL ELDERS. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.3311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- L. Phillips
- University of California School of Nursing,
Los Angeles, California
| | - M. Cadogan
- University of California School of Nursing,
Los Angeles, California
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Woods D, Phillips L, Brecht M. CHANGES IN OXYTOCIN AND MUTUALITY IN DIRECT CARE STAFF USING A CALMING INTERVENTION. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.4041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- D. Woods
- Azusa Pacific University, Azusa, California,
| | - L. Phillips
- University of California, Los Angeles, Los Angeles, California
| | - M. Brecht
- University of California, Los Angeles, Los Angeles, California
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Mach J, Huizer-Pajkos A, Mitchell S, Phillips L, Kane A, de Cabo R, Le Couteur D, Hilmer S. AGEING AND DRUG-INDUCED LIVER INJURY: INSIGHTS FROM ANIMAL STUDIES. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.1320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- J. Mach
- Kolling Institute of Medical Research, Sydney, New South Wales, Australia,
- University of Sydney, Sydney, New South Wales, Australia,
- Royal North Shore Hospital, Sydney, New South Wales, Australia,
| | - A. Huizer-Pajkos
- Kolling Institute of Medical Research, Sydney, New South Wales, Australia,
- Royal North Shore Hospital, Sydney, New South Wales, Australia,
| | - S. Mitchell
- National Institute of Aging, Baltimore, Maryland,
| | - L. Phillips
- Kolling Institute of Medical Research, Sydney, New South Wales, Australia,
| | - A.E. Kane
- Dalhousie University, Halifax, Nova Scotia, Canada
| | - R. de Cabo
- National Institute of Aging, Baltimore, Maryland,
| | - D.G. Le Couteur
- University of Sydney, Sydney, New South Wales, Australia,
- Centre for Education and Research on Ageing and Anzac Research Institute, Sydney, New South Wales, Australia,
- Concord Hospital, Sydney, New South Wales, Australia,
| | - S.N. Hilmer
- Kolling Institute of Medical Research, Sydney, New South Wales, Australia,
- University of Sydney, Sydney, New South Wales, Australia,
- Royal North Shore Hospital, Sydney, New South Wales, Australia,
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30
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Johnson K, Bertoli M, Phillips L, Blain A, Ensini M, Bushby K, Lochmüller H, Töpf A, Lek M, Xu L, Mullen T, Valkanas E, MacArthur D, Straub V. The MYO-SEQ project: application of exome sequencing technologies to 1000 patients affected by limb-girdle weakness of unknown origin. Neuromuscul Disord 2017. [DOI: 10.1016/s0960-8966(17)30337-1] [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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31
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Johnson K, Töpf A, Bertoli M, Phillips L, De Ridder W, De Jonghe P, Baets J, Deconinck T, Stojanovic V, Peric S, Durmus H, Omidi S, Nafissi S, Lusakowska A, Mongini T, Lek M, MacArthur D, Straub V. Detection of TRIM32 variants associated with LGMD2H in a large cohort of patients with unexplained limb-girdle weakness. Neuromuscul Disord 2017. [DOI: 10.1016/s0960-8966(17)30338-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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32
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Johnson K, Bertoli M, Phillips L, Töpf A, Lek M, Xu L, MacArthur D, Straub V. The MYO-SEQ project: Application of exome sequencing technologies to 1000 patients affected by limb-girdle weakness of unknown origin. Neuromuscul Disord 2016. [DOI: 10.1016/j.nmd.2016.06.273] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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33
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Van den Bergh P, Sznajer Y, Van Parijs V, van Tol W, Wevers R, Lefeber D, Xu L, Lek M, MacArthur D, Xu L, Lek M, MacArthur D, Johnson K, Phillips L, Topf A, Straub V. A homozygous DPM3 mutation in a patient with alpha-dystroglycan-related limb girdle muscular dystrophy. Neuromuscul Disord 2016. [DOI: 10.1016/j.nmd.2016.06.289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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34
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Phillips L, Töpf A, Johnson K, Bertoli M, Xu L, Lek M, Claeys K, Van den Bergh P, Vissing J, Colomer J, Wallgren-Patterson C, Lopez de Munain A, Vilchez J, Kostera-Pruszczyk A, MacArthur D, Straub V. Identification of sequence variants in eight genes associated with dystroglycanopathies using whole exome sequencing. Neuromuscul Disord 2016. [DOI: 10.1016/j.nmd.2016.06.291] [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: 10/21/2022]
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35
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Phillips L. MO-AB-201-01: Regulatory Compliance and Safety with New Radiotherapies: Spheres and Ra-223. Med Phys 2015. [DOI: 10.1118/1.4925287] [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: 11/07/2022] Open
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36
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Purcell R, Jorm AF, Hickie IB, Yung AR, Pantelis C, Amminger GP, Glozier N, Killackey E, Phillips L, Wood SJ, Mackinnon A, Scott E, Kenyon A, Mundy L, Nichles A, Scaffidi A, Spiliotacopoulos D, Taylor L, Tong JPY, Wiltink S, Zmicerevska N, Hermens D, Guastella A, McGorry PD. Transitions Study of predictors of illness progression in young people with mental ill health: study methodology. Early Interv Psychiatry 2015; 9:38-47. [PMID: 23889887 DOI: 10.1111/eip.12079] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2012] [Accepted: 06/09/2013] [Indexed: 11/28/2022]
Abstract
AIM An estimated 75% of mental disorders begin before the age of 24 and approximately 25% of 13-24-year-olds are affected by mental disorders at any one time. To better understand and ideally prevent the onset of post-pubertal mental disorders, a clinical staging model has been proposed that provides a longitudinal perspective of illness development. This heuristic model takes account of the differential effects of both genetic and environmental risk factors, as well as markers relevant to the stage of illness, course or prognosis. The aim of the Transitions Study is to test empirically the assumptions that underpin the clinical staging model. Additionally, it will permit investigation of a range of psychological, social and genetic markers in terms of their capacity to define current clinical stage or predict transition from less severe or enduring to more severe and persistent stages of mental disorder. METHOD This paper describes the study methodology, which involves a longitudinal cohort design implemented within four headspace youth mental health services in Australia. Participants are young people aged 12-25 years who have sought help at headspace and consented to complete a comprehensive assessment of clinical state and psychosocial risk factors. A total of 802 young people (66% female) completed baseline assessments. Annual follow-up assessments have commenced. CONCLUSIONS The results of this study may have implications for the way mental disorders are diagnosed and treated, and progress our understanding of the pathophysiologies of complex mental disorders by identifying genetic or psychosocial markers of illness stage or progression.
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Affiliation(s)
- R Purcell
- Orygen Youth Health Research Centre, Centre for Youth Mental Health, The University of Melbourne, Melbourne, Victoria
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Qualls SH, Klebe KJ, Berryman K, Williams A, Phillips L, Layton H, Hiroto K, Stephens M, Anderson L, Rogers M. Motivational and Cognitive Pathways to Medical Help-Seeking for Alzheimer's Disease: A Cognitive Impairment Response Model. J Gerontol B Psychol Sci Soc Sci 2014; 70:57-66. [DOI: 10.1093/geronb/gbu058] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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38
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Wang J, Molvin L, Marsh D, Zorich C, Chan F, Newman B, Larson D, Phillips L, Leung A, Fleischmann D. TH-C-18A-08: A Management Tool for CT Dose Monitoring, Analysis, and Protocol Review. Med Phys 2014. [DOI: 10.1118/1.4889632] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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39
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Goldsmith MR, Grulke CM, Brooks RD, Transue TR, Tan YM, Frame A, Egeghy PP, Edwards R, Chang DT, Tornero-Velez R, Isaacs K, Wang A, Johnson J, Holm K, Reich M, Mitchell J, Vallero DA, Phillips L, Phillips M, Wambaugh JF, Judson RS, Buckley TJ, Dary CC. Development of a consumer product ingredient database for chemical exposure screening and prioritization. Food Chem Toxicol 2013; 65:269-79. [PMID: 24374094 DOI: 10.1016/j.fct.2013.12.029] [Citation(s) in RCA: 62] [Impact Index Per Article: 5.6] [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: 10/16/2013] [Revised: 12/17/2013] [Accepted: 12/19/2013] [Indexed: 10/25/2022]
Abstract
Consumer products are a primary source of chemical exposures, yet little structured information is available on the chemical ingredients of these products and the concentrations at which ingredients are present. To address this data gap, we created a database of chemicals in consumer products using product Material Safety Data Sheets (MSDSs) publicly provided by a large retailer. The resulting database represents 1797 unique chemicals mapped to 8921 consumer products and a hierarchy of 353 consumer product "use categories" within a total of 15 top-level categories. We examine the utility of this database and discuss ways in which it will support (i) exposure screening and prioritization, (ii) generic or framework formulations for several indoor/consumer product exposure modeling initiatives, (iii) candidate chemical selection for monitoring near field exposure from proximal sources, and (iv) as activity tracers or ubiquitous exposure sources using "chemical space" map analyses. Chemicals present at high concentrations and across multiple consumer products and use categories that hold high exposure potential are identified. Our database is publicly available to serve regulators, retailers, manufacturers, and the public for predictive screening of chemicals in new and existing consumer products on the basis of exposure and risk.
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Affiliation(s)
- M-R Goldsmith
- United States Environmental Protection Agency (U.S. EPA), Office of Research and Development, RTP, NC 27711, United States.
| | - C M Grulke
- United States Environmental Protection Agency (U.S. EPA), Office of Research and Development, RTP, NC 27711, United States
| | - R D Brooks
- Student Services Contractor at U.S. EPA, RTP, NC, United States
| | - T R Transue
- Lockheed-Martin Information Technology, RTP, NC 27711, United States
| | - Y M Tan
- United States Environmental Protection Agency (U.S. EPA), Office of Research and Development, RTP, NC 27711, United States.
| | - A Frame
- United States Environmental Protection Agency (U.S. EPA), Office of Research and Development, RTP, NC 27711, United States; Oak Ridge Institute for Science and Education Fellow, United States
| | - P P Egeghy
- United States Environmental Protection Agency (U.S. EPA), Office of Research and Development, RTP, NC 27711, United States
| | - R Edwards
- North Carolina State University, 2200 Hillsborough St., Raleigh, NC 27695, United States
| | - D T Chang
- United States Environmental Protection Agency (U.S. EPA), Office of Research and Development, RTP, NC 27711, United States
| | - R Tornero-Velez
- United States Environmental Protection Agency (U.S. EPA), Office of Research and Development, RTP, NC 27711, United States
| | - K Isaacs
- United States Environmental Protection Agency (U.S. EPA), Office of Research and Development, RTP, NC 27711, United States.
| | - A Wang
- United States Environmental Protection Agency (U.S. EPA), Office of Research and Development, RTP, NC 27711, United States; Oak Ridge Institute for Science and Education Fellow, United States
| | - J Johnson
- United States Environmental Protection Agency (U.S. EPA), Office of Research and Development, RTP, NC 27711, United States
| | - K Holm
- United States Environmental Protection Agency (U.S. EPA), Office of Research and Development, RTP, NC 27711, United States
| | - M Reich
- University of North Carolina at Chapel Hill, Chapel Hill, NC 27514, United States
| | - J Mitchell
- Biosystems and Agricultural Engineering, Michigan State University, E. Lansing, MI 48824, United States
| | - D A Vallero
- United States Environmental Protection Agency (U.S. EPA), Office of Research and Development, RTP, NC 27711, United States
| | - L Phillips
- United States Environmental Protection Agency (U.S. EPA), Office of Research and Development, RTP, NC 27711, United States
| | - M Phillips
- United States Environmental Protection Agency (U.S. EPA), Office of Research and Development, RTP, NC 27711, United States
| | - J F Wambaugh
- United States Environmental Protection Agency (U.S. EPA), Office of Research and Development, RTP, NC 27711, United States
| | - R S Judson
- United States Environmental Protection Agency (U.S. EPA), Office of Research and Development, RTP, NC 27711, United States
| | - T J Buckley
- United States Environmental Protection Agency (U.S. EPA), Office of Research and Development, RTP, NC 27711, United States
| | - C C Dary
- United States Environmental Protection Agency (U.S. EPA), Office of Research and Development, RTP, NC 27711, United States
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Pollock W, Simmons S, Phillips L, McDonald S. Pattern and rate of massive transfusion for obstetric haemorrhage. Aust Crit Care 2013. [DOI: 10.1016/j.aucc.2013.02.018] [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: 10/26/2022] Open
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41
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Simmons S, Pollock WE, Phillips L, McDonald S. Massive blood transfusion for obstetric haemorrhage. Crit Care 2013. [PMCID: PMC3642736 DOI: 10.1186/cc12308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Abstract
Increased fibroblast activity and collagen production have been observed frequently in proliferative scars. Previous studies have demonstrated that interferons suppress collagen production by means of normal, keloid, and hypertrophic scar-derived fibroblasts. The fibroblast-populated collagen lattice is an in vitro model used to study fibroblast function. We used fibroblast-populated collagen lattices to evaluate the effect of interferon on fibroblasts harvested from normal human skin, human keloid, and hypertrophic scar tissues. Human recombinant interferon alfa-2b (1000 IU/ml) was added to the culture media. The collagen gel, prepared from rat tail tendon bundles, was overlaid with 5 x 10(4) fibroblast cells. Keloid fibroblast-populated collagen lattices showed the highest contraction. Contraction in all the groups appeared suppressed by interferon alfa-2b during the first 72 hours of study (p < 0.05). The reduction in fibroblast-populated collagen lattice contraction by interferon alfa-2b was similar among the groups. The contractile properties of fibroblasts taken from normal human skin, keloids, and hypertrophic scars in this in vitro study were suppressed by interferon alfa-2b. This suggested that interferon alfa-2b may be beneficial for the treatment of proliferative scars.
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Affiliation(s)
- K Sahara
- Division of Plastic Surgery, The University of Texas Medical Branch/Shriners Burns Institute, Galveston, Tex., USA
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Seaver S, Phillips L, Struthers C, Bowes B. N034 Why Do They Keep Coming Back? The Challenges of Heart Failure Readmission. Can J Cardiol 2012. [DOI: 10.1016/j.cjca.2012.07.780] [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] Open
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Kao R, Rajagopalan A, Beckett A, Beckett A, Rex R, Shah S, Waddell J, Boitano M, Faidi S, Babatunde O, Lawson F, Grant A, Sudarshan M, Sudarshan M, Takashashi M, Waggott M, Lampron J, Post A, Beale E, Bobrovitz N, Zakrison T, Smith A, Bawazeer M, Evans C, Leeper T, Kagedan D, Grenier T, Rezendo-Neto J, Roberts D, Roberts D, Stark P, Berg R, Mehta S, Gardner P, Moore L, Vassilyadi M, Moore L, Moore L, Hoshizaki B, Rezende-Neto J, Slaba I, Ramesh A, Grigorovich A, Parry N, Pajak C, Rosenbloom B, Grunfeld A, van Heest R, Fernandes J, Doucet J, Schooler S, Ali J, Klassen B, Santana M, McFarlan A, Ball C, Blackmore C, Rezende-Neto J, Kidane B, Hicks C, Brennan M, Brennan M, Harrington A, Sorvari A, Stewart TC, Biegler N, Chaubey V, Tsang B, Benjamin S, Hogan A, Fraser J, Martin M, Bridge J, Faidi S, Waligora M, Hsiao M, Sharma S, Sankarankutty A, Mckee J, Mckee J, Mckee J, Snider C, Szpakowski J, Brown R, Shah S, Shiu M, Chen M, Bell N, Besserer F, Bell N, Trudeau MO, Alhabboubi M, Rezende-Neto J, Rizoli S, Hill A, Joseph B, Lawless B, Jiao X, Xenocostas A, Rui T, Parry N, Driman D, Martin C, Stewart TC, Walsh J, Parry N, Merritt N, Elster E, Tien H, Phillips L, Bratu I, Nascimento B, Pinto R, Callum J, Tien H, Rizoli S, McMullan J, McGlasson R, Mahomed N, Flannery J, Bir C, Baillie F, Coates A, Asiri S, Foster P, Baillie F, Bhandari M, Phillips L, Bratu I, Schuurman N, Oliver L, Nathens A, Yazdani A, Alhabboubi M, St. Louis E, Tan X, Fata P, Deckelbaum D, Chughtai T, Razek T, Khwaja K, St. Louis E, Alhabboubi M, Tan X, Fata P, Deckelbaum D, Chughtai T, Razek T, Khwaja K, Takada M, Sawano M, Ito H, Tsutsumi H, Keenan A, Waggott M, Hoshizaki B, Brien S, Gilchrist M, Janis J, Phelan H, Minei J, Santana M, Stelfox H, McCredie V, Leung E, Garcia G, Rizoli S, Nathens A, Dixon E, Niven D, Kirkpatrick A, Feliciano D, D’Amours S, Ball C, Ahmed N, Izadi H, McFarlan A, Nathens A, Pavenski K, Nathens A, Bridge J, Tallon J, Leeper W, Vogt K, Stewart TC, Gray D, Parry N, Ameer A, Alhabboubi M, Alzaid S, Deckelbaum D, Fata P, Khwaja K, Razek T, Deckelbaum D, Drudi L, Boulva K, Rodrigue N, Khwaja K, Chughtai T, Fata P, Razek T, Rizoli S, Carreiro P, Lisboa T, Winter P, Ribeiro E, Cunha-Melo J, Andrade M, Zygun D, Grendar J, Ball C, Robertson H, Ouellet JF, Cheatham M, Kirkpatrick A, Ball C, Ouellet JF, McBeth P, Kirkpatrick A, Dixon E, Groff P, Inaba K, Okoye O, Pasley J, Demetriades D, Al-Harthi F, Cheng A, Lalani A, Mikrogianakis A, Cayne S, Knittel-Keren D, Gomez M, Stelfox H, Turgeon A, Lapointe J, Bourgeois G, Karton C, Rousseau P, Hoshizaki B, Stelfox H, Turgeon A, Bourgeois G, Lapointe J, Stelfox H, Turgeon A, Bourgeois G, Lapointe J, Rousseau P, Braga B, Faleiro R, Magaldi M, Cardoso G, Lozada W, Duarte L, Rizoli S, Ball C, Oddone-Paolucci E, Doig C, Kortbeek J, Gomez M, Fish J, Leach L, Leelapattana P, Fleming J, Bailey C, Nolan B, DeMestral C, McFarlan A, Zakirova R, Nathens A, Dabbs J, Duff D, Michalak A, Mitchell L, Nathens A, Singh M, Topolovec-Vranic J, Tymianski D, Yetman L, Canzian S, MacPhail I, Constable L, van Heest R, Tam A, Mahadevan P, Kim D, Bansal V, Casola G, Coimbra R, Gladwin C, Misra M, Kumar S, Gautam S, Sorvari A, Blackwood B, Coates A, Baillie F, Stelfox H, Nathens A, Wong C, Straus S, Haas B, Lenartowicz M, Parkovnick M, Parry N, Inaba K, Dixon E, Salim A, Pasley J, Kirkpatrick A, Ouellet JF, Niven D, Kirkpatrick A, Ball C, Neto C, Nogueira G, Fernandes M, Almeida T, de Abreu EMS, Rizoli S, Abrantes W, Taranto V, Parry N, Forbes T, Knight H, Keenan A, Yoxon H, Macpherson A, Bridge J, Topolovec-Vranic J, Mauceri J, Butorac E, Ahmed N, Holmes J, Gilliland J, Healy M, Tanner D, Polgar D, Fraser D, McBeth P, Crawford I, Tiruta C, Ball C, Kirkpatrick A, Roberts D, Ferri M, Bobrovitz N, Khandwala F, Stelfox H, Widder S, Mckee J, Hogan A, Benjamin S, Atkinson P, Benjamin S, Watson I, Hogan A, Benjamin S, Woodford S, Jaramillo DG, Nathens A, Alonazi N, Coates A, Baillie F, Zhang C, McFarlan A, Sorvari A, Chalklin K, Canzian S, Nathens A, DeMestral C, Hill A, Langer J, Nascimento B, Alababtain I, Fung SY, Passos E, Luz L, Brnjac E, Pinto R, Rizoli S, Widder S, Widder S, Widder S, Nathens A, Van Heest R, Constable L, Mancini F, Heidary B, Bell N, Appleton L, Hennecke P, Taunton J, Khwaja K, O’Connor M, Hameed M, Garraway N, Simons R, Evans D, Taulu T, Quinn L, Kuipers D, Rizoli S, Rogers C, Geerts W, Rhind S, Rizoli S, George K, Quinn L, Babcock C, Hameed M, Simons R, Caron N, Hameed M, Simons R, Prévost F, Razek T, Khwaja K, Sudarshan M, Razek T, Fata P, Deckelbaum D, Khwaja K, de Abreu EMS, Neto C, Almeida T, Pastore M, Taranto V, Fernandes M, Rizoli S, Nascimento B, Sankarankutty A, Pinto R, Callum J, Tremblay L, Tien H, Fowler R, Pinto R, Nathens A, Sadoun M, Harris J, Friese R, Kulvantunyou N, O’Keeffe T, Wynne J, Tang A, Green D, Rhee P, Trpkovski J, Blount V. Trauma Association of Canada Annual Scientific Meeting abstractsErythroopoietin resuscitated with normal saline, Ringer’s lactate and 7.5% hypertonic saline reduces small intestine injury in a hemorrhagic shock and resuscitation rat model.Analgesia in the management of pediatric trauma in the resuscitative phase: the role of the trauma centre.Multidisciplinary trauma team care in Kandahar, Afghanistan: current injury patterns and care practices.Does computed tomography for penetrating renal injury reduce renal exploration? An 8-year review at a Canadian level 1 trauma centre.The other side of pediatric trauma: violence and intent injury.Upregulation of activated protein C leads to factor V deficiency in early trauma coagulopathy.A provincial integrated model of improved care for patients following hip fracture.Sports concussion: an Olympic boxing model comparing sex with biomechanics and traumatic brain injury.A multifaceted quality improvement strategy to optimize monitoring and management of delirium in trauma patients: results of a clinician survey.Risk factors for severe all-terrain vehicle injuries in Alberta.Evaluating potential spatial access to trauma centre care by severely injured patients.Incidence of brain injury in facial fractures.Surgical outcomes and the acute care surgery service.The acute care general surgery population and prognostic factors for morbidity and mortality.Disaster preparedness of trauma.What would you like to know and how can we help you? Assessing the needs of regional trauma centres.Posttraumatic stress disorder screening for trauma patients at a level 1 trauma centre.Physical and finite element model reconstruction of a subdural hematoma event.Abdominal wall reconstruction in the trauma patient with an open abdomen.Development and pilot testing of a survey to measure patient and family experiences with injury care.Occult shock in trauma: What are Canadian traumatologists missing?Timeliness in obtaining emergent percutaneous procedures for the severely injured patient: How long is too long?97% of massive transfusion protocol activations do not include a complete hemorrhage panel.Trauma systems in Canada: What system components facilitate access to definitive care?The role of trauma team leaders in missed injuries: Does specialty matter?The adverse consequences of dabigatran among trauma and acute surgical patients.A descriptive study of bicycle helmet use in Montréal.Factor XIII, desmopressin and permissive hypotension enhance clot formation compared with normotensive resuscitation: uncontrolled hemorrhagic shock model.Negative pressure wound therapy for critically ill adults with open abdominal wounds: a systematic review.The “weekend warrior:” Fact or fiction for major trauma?Canadian injury preventon curriculum: a means to promote injury prevention.Penetrating splenic trauma: Safe for nonoperative management?The pediatric advanced trauma life support course: a national initiative.The effectiveness of a psycho-educational program among outpatients with burns or complex trauma.Trauma centre performance indicators for nonfatal outcomes: a scoping review.The evaluation of short track speed skating helmet performance.Complication rates as a trauma care performance indicator: a systematic review.Unplanned readmission following admission for traumatic injury: When, where and why?Reconstructions of concussive impacts in ice hockey.How does head CT correlate with ICP monitoring and impact monitoring discontinuation in trauma patients with a Marshall CT score of I–II?Impact of massive transfusion protocol and exclusion of plasma products from female donors on outcome of trauma patients in Calgary region of Alberta Health Services.Primary impact arthrodesis for a neglected open Weber B ankle fracture dislocation.Impact of depression on neuropsychological functioning in electrical injury patients.Predicting the need for tracheostomy in patients with cervical spinal cord injury.Predicting crumping during computed tomography imaging using base deficit.Feasibility of using telehomecare technology to support patients with an acquired brain injury and family care-givers.Program changes impact the outcomes of severely injured patients.Do trauma performance indicators accurately reflect changes in a maturing trauma program?One-stop falls prevention information for clinicians: a multidisciplinary interactive algorithm for the prevention of falls in older adults.Use of focused assessment with sonography for trauma (FAST) for combat casualties in forward facilities.Alberta All-terrain Vehicle Working Group: a call to action.Observations and potential role for the rural trauma team development course (RTTDC) in India.An electronic strategy to facilitate information-sharing among trauma team leaders.Development of quality indicators of trauma care by a consensus panel.An evaluation of a proactive geriatric trauma consultation service.Celebrity injury-related deaths: Is a gangster rapper really gangsta?Prevention of delirium in trauma patients: Are we giving thiamine prophylaxis a fair chance?Intra-abdominal injury in patients who sustain more than one gunshot wound to the abdomen: Should non-operative management be used?Retrospective review of blunt thoracic aortic injury management according to current treatment recommendations.Telemedicine for trauma resuscitation: developing a regional system to improve access to expert trauma care in Ontario.Comparing trauma quality indicator data between a pediatric and an adult trauma hospital.Using local injury data to influence injury prevention priorities.Systems saving lives: a structured review of pediatric trauma systems.What do students think of the St. Michael’s Hospital ThinkFirst Injury Prevention Strategy for Youth?An evidence-based method for targeting a shaken baby syndrome prevention media campaign.The virtual mentor: cost-effective, nurse-practitioner performed, telementored lung sonography with remote physician guidance.Quality indicators used by teaching versus nonteaching international trauma centres.Compliance to advanced trauma life support protocols in adult trauma patients in the acute setting.Closing the quality improvement loop: a collaborative approach.National Trauma Registry: “collecting” it all in New Brunswick.Does delay to initial reduction attempt affect success rates for anterior shoulder dislocation (pilot study)?Use of multidisciplinary, multi-site morbidity and mortality rounds in a provincial trauma system.Caring about trauma care: public awareness, knowledge and perceptions.Assessing the quality of admission dictation at a level 1 trauma centre.Trauma trends in older adults: a decade in review.Blunt splenic injury in patients with hereditary spherocytosis: a population-based analysis.Analysis of trauma team activation in severe head injury: an institutional experience.ROTEM results correlate with fresh frozen plasma transfusion in trauma patients.10-year trend of assault in Alberta.10-year trend in alcohol use in major trauma in Alberta.10-year trend in major trauma injury related to motorcycles compared with all-terrain vehicles in Alberta.Referral to a community program for youth injured by violence: a feasibility study.New impaired driving laws impact on the trauma population at level 1 and 3 trauma centres in British Columbia, Canada.A validation study of the mobile medical unit/polyclinic team training for the Vancouver 2010 Winter Games.Inferior vena cava filter use in major trauma: the Sunny-brook experience, 2000–2011.Relevance of cellular microparticles in trauma-induced coagulopathy: a systemic review.Improving quality through trauma centre collaboratives.Predictors of acute stress response in adult polytrauma patients following injury.Patterns of outdoor recreational injury in northern British Columbia.Risk factors for loss-to-follow up among trauma patients include functional, socio-economic, and geographic determinants: Would mandating opt-out consent strategies minimize these risks?Med-evacs and mortality rates for trauma from Inukjuak, Nunavik, Quebec.Review of open abdomens in McGill University Health Centre.Are surgical interventions for trauma associated with the development of posttraumatic retained hemothorax and empyema?A major step in understanding the mechanisms of traumatic coagulopathy: the possible role of thrombin activatable fibrinolysis inhibitor.Access to trauma centre care for patients with major trauma.Repeat head computed tomography in anticoagulated traumatic brain injury patients: still warranted.Improving trauma system governance. Can J Surg 2012. [DOI: 10.1503/cjs.006312] [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: 11/01/2022] Open
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Abstract
Strategies to reduce sexual assault on women patients in mental health inpatient acute wards have included effective policies, a consistent approach to recording and monitoring data relating to incidences of sexual assault, increased staff levels and improvements in the ward layout. A series of workshops were devised to enable mental health staff to work with greater awareness and sensitivity to keep women patients safer on inpatient wards. What emerged in particular during the training was the ways in which staff felt at loss as to how to build therapeutic relationships with women patients, particularly those with histories of sexual abuse. These patients may repeat early ways of relating which may at times be a challenge for the staff caring for them. This paper suggests that psychoanalytic insights offer an understanding of these ways of relating. This can be combined with frequent and supportive supervision to enable staff to safely articulate their often troubling responses to caring for women patients, this creating a caring and supportive environment for staff.
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Affiliation(s)
- L Phillips
- Department of Mental Health and Learning Disabilities, School of Health and Community Sciences, City University, London, UK.
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Phillips L, Struthers C, Curtin P, Cooper C, Frattini E, Pugliese C, Roberts A. N053 Heart failure (HF) and palliative care: Is using the LACE index helpful? Can J Cardiol 2011. [DOI: 10.1016/j.cjca.2011.08.054] [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: 11/28/2022] Open
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Chlebowski RT, McTiernan A, Aragaki AK, Rohan T, Wactawski-Wende J, Ipp E, Euhus D, Kaklamani VG, Vitolins M, Wallace RB, Liu S, Gunter MJ, Phillips L, Strickler H, Howard B. Metformin and breast cancer incidence in postmenopausal diabetic women in the Women’s Health Initiative (WHI). J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.1503] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Abstract
We investigated whether there was an association between recombinant activated factor VII (rFVIIa) use in cardiac surgery and thromboembolic events by comparing cases in two medical registries. The incidence of thromboembolic events in patients undergoing cardiac surgery (except isolated coronary artery bypass grafts) who had received rFVIIa and were entered into the Australian and New Zealand Haemostasis Registry was compared with the background incidence in patients entered in the Australasian Society for Cardiac and Thoracic Surgeons database. Mortality, length of hospital stay and thromboembolic complications such as stroke, perioperative myocardial infarction and pulmonary embolism data were analysed. A total of 705 patients in the Registry were compared with 6554 patients in the Thoracic Surgeons database. The use of rFVIIa was independently associated with higher mortality (odds ratio 2.55, P < 0.001) and longer hospital stay (odds ratio 1.54, P = 0.020). However multiple regression analyses showed no independent association between rFVIIa and stroke (odds ratio 1.0, P = 0.994) or perioperative myocardial infarction (odds ratio 0.29, P = 0.053), while the use of rFVIIa was associated with fewer pulmonary emboli (odds ratio 0.02, P < 0.001). These findings indicate that patients who received rFVIIa had increased mortality and length of hospital stay, as expected, but that rFVIIa use was not associated with an increased incidence of stroke or perioperative myocardial infarction. In the absence of randomised controlled clinical trials, this analysis suggests that the off-label use of rFVIIa in cardiac surgery does not significantly increase thromboembolic events.
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Affiliation(s)
- B Mitra
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
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Interrante V, Phillips L, Ries B, Kaeding M. Investigating the potential impact of presence on the accuracy of participants' distance judgments in photo-realistic and non-photorealistic immersive virtual environments. J Vis 2010. [DOI: 10.1167/10.7.1038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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