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Nicholson L, Piras IS, DeBoth MD, Siniard A, Heras-Garvin A, Stefanova N, Huentelman MJ. Transcriptomic insights into multiple system atrophy from a PLP-α-synuclein transgenic mouse model. Brain Res 2024; 1834:148912. [PMID: 38575106 DOI: 10.1016/j.brainres.2024.148912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Revised: 03/24/2024] [Accepted: 04/02/2024] [Indexed: 04/06/2024]
Abstract
Multiple system atrophy (MSA) is a rare, neurodegenerative disorder with rapid motor and non-motor symptom progression. MSA is characterized by protein aggregations of α-synuclein found in the cytoplasm of oligodendrocytes. Despite this pathological hallmark, there is still little known about the cause of this disease, resulting in poor treatment options and quality of life post-diagnosis. In this study, we investigated differentially expressed genes (DEGs) via RNA-sequencing of brain samples from a validated PLP-α-synuclein transgenic mouse model, identifying a total of 40 DEGs in the PLP group compared to wild-type (WT), with top detected genes being Gm15446, Mcm6, Aldh7a1 and Gm3435. We observed a significant enrichment of immune pathways and endothelial cell genes among the upregulated genes, whereas downregulated genes were significantly enriched for oligodendrocyte and neuronal genes. We then calculated possible overlap of these DEGs with previously profiled human MSA RNA, resulting in the identification of significant downregulation of the Tsr2 gene. Identifying key gene expression profiles specific to MSA patients is crucial to further understanding the cause, and possible prevention, of this rapidly progressive neurodegenerative disorder.
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Affiliation(s)
- L Nicholson
- Neurogenomics Division, Translational Genomics Research Institute, Phoenix, AZ, USA
| | - I S Piras
- Neurogenomics Division, Translational Genomics Research Institute, Phoenix, AZ, USA
| | - M D DeBoth
- Neurogenomics Division, Translational Genomics Research Institute, Phoenix, AZ, USA
| | - A Siniard
- Neurogenomics Division, Translational Genomics Research Institute, Phoenix, AZ, USA
| | - A Heras-Garvin
- Laboratory for Translational Neurodegeneration Research, Department of Neurology, Medical University of Innsbruck, Austria
| | - N Stefanova
- Laboratory for Translational Neurodegeneration Research, Department of Neurology, Medical University of Innsbruck, Austria.
| | - M J Huentelman
- Neurogenomics Division, Translational Genomics Research Institute, Phoenix, AZ, USA.
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Veeramani P, Pilar Martin-Gutierrez M, Agorogiannis E, Hamilton R, Griggs T, Nicholson L, Heng LZ. Efficacy and Safety outcomes of a novel model to assess new medical retina referrals in a high-volume medical retina virtual clinic. Eye (Lond) 2024; 38:168-172. [PMID: 37491441 PMCID: PMC10764806 DOI: 10.1038/s41433-023-02653-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Revised: 05/12/2023] [Accepted: 06/21/2023] [Indexed: 07/27/2023] Open
Abstract
BACKGROUND Ophthalmology outpatient attendances have significantly increased recently with rising pressure from backlogs arising from the pandemic. Medical retina digital surveillance clinics for stable follow-up appointments are well established. We present a model for assessing new referrals and evaluating clinical outcomes and long-term sustainability in a complex high-volume medical retina service. METHODS Suitable routine new patient referrals were identified from electronic referrals and referred to this new pathway. Structured history, visual acuities, and intraocular pressures were recorded, and widefield colour fundus and optical coherence tomography imaging were performed at a imaging hub for asynchronous consultant-led review. RESULTS 1458 patients were invited to attend over four months, with a 13.2% did-not-attend (DNA) rate. Common diagnoses included stable diabetic retinopathy (19.9%), early age-related macular degeneration (6.7%), central serous retinopathy (8.8%), and retinal vein occlusion (6.3%). 7 patients (0.05%) required urgent same-day review. 61 (5.0%) required urgent face-to-face (F2F) assessment within two weeks. A total of 727 (59.0%) were either discharged or remained in the virtual pathway following their first visit. CONCLUSION This study encourages the use of a digital model that efficiently assesses suitable newly referred medical retina patients in both complex and local eye unit settings. This decreased the need for F2F clinics and resources. Further patient satisfaction surveys for digital services are currently being evaluated to guide long-term sustainability of this model.
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Affiliation(s)
- P Veeramani
- Moorfields Eye Hospital NHS Foundation Trust, London, UK
| | | | - E Agorogiannis
- Manchester Royal Eye Hospital Manchester, Manchester, UK
| | - R Hamilton
- Moorfields Eye Hospital NHS Foundation Trust, London, UK
| | - T Griggs
- Moorfields Eye Hospital NHS Foundation Trust, London, UK
| | - L Nicholson
- Moorfields Eye Hospital NHS Foundation Trust, London, UK
| | - L Z Heng
- Moorfields Eye Hospital NHS Foundation Trust, London, UK.
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3
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Koshy T, Manista G, Nicholson L, Jones T, Roman M, Giesey L, Frei A. A Comparison of Two Multi-Layer Sacral Foam Dressings for the Prevention of Hospital-Acquired Pressure Injuries. Surg Technol Int 2022; 41:sti41/1644. [PMID: 36413789 DOI: 10.52198/22.sti.41.wh1544] [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: 06/16/2023]
Abstract
Hospital-acquired pressure injuries (HAPIs) represent a significant detriment to patient health by increasing mortality risk, negatively impacting quality of life, and increasing risk of complications such as infection. Prophylactic use of sacral foam dressings is known to decrease the occurrence of HAPIs in various patient populations. This retrospective study compared the effect of two multi-layer sacral foam dressings on HAPI incidence in patients admitted to a short-term, acute care hospital during the years 2015 (dressing one: Mepilex® Border Protect sacral dressing [Mölnlycke Healthcare AB, Göteborg, Sweden]) and 2017 (dressing two: Optifoam® Gentle LQ silicone faced foam < border sacral dressing [Medline Industries, LP, Northfield, Illinois]). Patient medical charts were examined for full sample (n=297) and subsample (n=284) analysis, respectively. The HAPI incidence for dressing two was found to be significantly less than dressing one (full sample: 5.12% compared to 10.79% [p=0.0001], and subsample: 4.07% compared to 9.31% [p=0.0001]). The incidence rate ratio (IRR) for dressing two was 0.39 for the full sample and 0.35 for the subsample, indicating that compared to dressing one, the HAPI count was approximately 40% lower for dressing two for the full sample and approximately 35% lower for dressing two for the subsample. These results demonstrate that dressing two performed better than dressing one in HAPI prevention. The results of this study may inform clinicians in their choice of prophylactic dressings.
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Affiliation(s)
- Thomas Koshy
- Medical Affairs, Medline Industries, LP, Northfield-Headquarters, Northfield, Illinois
| | - Gregory Manista
- Medical Affairs, Medline Industries, LP, Northfield-Headquarters, Northfield, Illinois
| | - Lisa Nicholson
- Medical Affairs, Medline Industries, LP, Northfield-Headquarters, Northfield, Illinois
| | - Trey Jones
- Medline Industries, LP, Northfield-Headquarters, Northfield, Illinois
| | - Martha Roman
- 3Advanced Wound Care, Medline Industries, LP, Northfield-Headquarters, Northfield, Illinois
| | | | - Anthony Frei
- 3Advanced Wound Care, Medline Industries, LP, Northfield-Headquarters, Northfield, Illinois
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4
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Cua CL, Low S, Sisco K, Nicholson L, McConnell PI. Echocardiographic changes in patients with a cylinder mitral valve replacement: Preliminary analysis. Echocardiography 2021; 38:1210-1217. [PMID: 34184329 DOI: 10.1111/echo.15132] [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: 01/17/2021] [Revised: 04/30/2021] [Accepted: 06/01/2021] [Indexed: 11/29/2022] Open
Abstract
AIMS Cylinder mitral valve construct (cMVC) is new technique for replacing the mitral valve compared to more traditional mitral valve replacement (MVR) procedures. Goal of this study was to describe echocardiographic changes over time in patients undergoing a cMVC. Secondary goal was to compare echocardiographic changes in patients that underwent a cMVC to a group of patients that underwent a MVR. METHODS Retrospective analysis of patients undergoing a cMVC was performed. Demographics, discharge echocardiogram, and recent echocardiogram vales were evaluated. Age matched patients undergoing a MVR were assessed. Discharge and recent echocardiographic parameters were compared within the cMVC group. cMVC and MVR values were compared between groups. RESULTS Five cMVC patients were studied. Age at surgery for the cMVC was 4.3 ± 4.2 years (median 2.2, .8-10.3 years). Time interval from hospital discharge echocardiogram to the most recent echocardiogram was 1.2 ± .7 years (median 1.0, .6-2.0 years). Mean mitral valve gradient significantly increased over time (3.6 ± 3.0 mm Hg vs 7.6 ± 2.9 mm Hg). There were significant improvements in left ventricular diameters, systolic sphericity index, shortening fraction, and ejection fraction over time. There were no significant differences in demographics, discharge echocardiogram values, and follow up echocardiogram values between the cMVC and MVR groups. CONCLUSION In conclusion, echocardiographic indices of left ventricular function improved over time in patients undergoing cMVC. In addition, there were no significant differences between cMVC and MVR patients in echocardiographic values. Studies with a larger patient sample with longer follow up are needed to determine if cMVC continues to have comparable echocardiographic results to MVR.
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Affiliation(s)
- Clifford L Cua
- Nationwide Children's Hospital, Heart Center, Columbus, Ohio, USA
| | - Samantha Low
- Nationwide Children's Hospital, Heart Center, Columbus, Ohio, USA
| | - Kacy Sisco
- Nationwide Children's Hospital, Heart Center, Columbus, Ohio, USA
| | - Lisa Nicholson
- Nationwide Children's Hospital, Heart Center, Columbus, Ohio, USA
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5
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Scott CK, Dennis ML, Grella CE, Nicholson L, Sumpter J, Kurz R, Funk R. Findings from the recovery initiation and management after overdose (RIMO) pilot study experiment. J Subst Abuse Treat 2020; 108:65-74. [PMID: 31493942 PMCID: PMC6893133 DOI: 10.1016/j.jsat.2019.08.004] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [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] [Received: 02/12/2019] [Revised: 07/17/2019] [Accepted: 08/06/2019] [Indexed: 01/24/2023]
Abstract
This pilot study evaluated the feasibility of the Recovery Initiation and Management after Overdose (RIMO) intervention to link individuals to medication-assisted treatment (MAT) following an opioid overdose. The study team worked with the Chicago Fire Department to train Emergency Medical Service (EMS) teams to request permission from individuals after an opioid overdose reversal to release their contact information; individuals were subsequently contacted by the study team for participation. A mixed-methods study design comprised: (1) an experimental pilot study that examined participation at each stage of the intervention and compared the odds of treatment received for individuals who were randomly assigned to either the RIMO intervention (n = 16) or a passive referral control (n = 17); and (2) a focus group that was subsequently conducted with participants in the RIMO group to obtain their feedback on the intervention components. Quantitative data was collected on participant characteristics at study intake and treatment received was based on self-report at a 30-day follow-up. The RIMO group had higher odds of receiving any treatment for opioid use (OR = 7.94) and any MAT (OR = 20.2), and received significantly more days of opioid treatment (Ms=15.2 vs. 3.4) and more days of MAT in the 30 days post-randomization (Ms=11.2 vs. 0.76), relative to the control group (all p < .05). Qualitative data illustrated that participants valued the assertive outreach, engagement, and persistent follow-up components of RIMO, which differed from their prior experiences. The pilot study suggests that the RIMO intervention is able to address the challenges of linking and engaging individuals into MAT after an opioid overdose.
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Affiliation(s)
- Christy K Scott
- Lighthouse Institute, Chestnut Health Systems, Chicago, IL 221 W. Walton, Chicago, IL 60610, United States of America.
| | - Michael L Dennis
- Chestnut Health Systems, 448 Wylie Drive, Normal, IL 61761, United States of America.
| | - Christine E Grella
- Chestnut Health Systems, Chicago, IL 221 W. Walton, Chicago, IL 60610, United States of America.
| | - Lisa Nicholson
- Chestnut Health Systems, Chicago, IL 221 W. Walton, Chicago, IL 60610, United States of America.
| | - Jamie Sumpter
- Chestnut Health Systems, Chicago, IL 221 W. Walton, Chicago, IL 60610, United States of America.
| | - Rachel Kurz
- Chestnut Health Systems, Chicago, IL 221 W. Walton, Chicago, IL 60610, United States of America.
| | - Rod Funk
- Chestnut Health Systems, 448 Wylie Drive, Normal, IL 61761, United States of America.
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6
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Groner JA, Nicholson L, Huang H, Bauer JA. Secondhand Smoke Exposure and Sleep-Related Breathing Problems in Toddlers. Acad Pediatr 2019; 19:835-841. [PMID: 30959225 DOI: 10.1016/j.acap.2019.03.008] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [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: 09/07/2018] [Revised: 03/15/2019] [Accepted: 03/31/2019] [Indexed: 10/27/2022]
Abstract
BACKGROUND Adequate sleep during childhood is an important component of overall health and wellbeing for children. Secondhand smoke (SHS) exposure has been linked to a greater risk of sleep-disordered breathing. OBJECTIVE Our objective was to investigate relationships between SHS exposure and sleep-related breathing problems in healthy toddlers aged 2 to 5 years. We hypothesized that there is an independent relationship between objectively measured SHS exposure and presence of sleep-related breathing problems by parental report. METHODS A convenience sample of 149 healthy children ages 2 to 5 years was recruited from an academic pediatric primary care center for this cross-sectional study; 138 had complete data that were analyzed. Current SHS exposure was determined by hair nicotine level. Presence of sleep-related breathing problems was assessed by 1 survey item. Inflammation was determined by serum C-reactive protein (CRP) level. Analysis in Stata 15 included a series of multivariate logistic regression models, controlling for individual-level demographics and body mass index z scores according to mediation analysis procedures for dichotomous outcomes. RESULTS Approximately 24% of parents reported their child snored, gasped, or had difficulty breathing at night sometimes, most of the time, or almost always. Regression models with mediation analysis indicate that SHS exposure significantly increased the odds of reporting the child had sleep-related breathing problems, and 18% of this relationship is explained by log serum CRP levels. CONCLUSIONS Although the cross-sectional nature of this study limits causality, evidence suggests a relationship exists between SHS exposure, as measured by log hair nicotine and sleep-related breathing problems at night.
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Affiliation(s)
- Judith A Groner
- AAP Julius B. Richmond Center of Excellence, Elk Grove Village, Ill (JA Groner and JA Bauer); Nationwide Children's Hospital, Department of Pediatrics, The Ohio State University College of Medicine, Columbus (JA Groner and L Nicholson).
| | - Lisa Nicholson
- Nationwide Children's Hospital, Department of Pediatrics, The Ohio State University College of Medicine, Columbus (JA Groner and L Nicholson)
| | - Hong Huang
- Kentucky Children's Hospital, Department of Pediatrics, University of Kentucky College of Medicine, Lexington (H Huang and JA Bauer)
| | - John Anthony Bauer
- AAP Julius B. Richmond Center of Excellence, Elk Grove Village, Ill (JA Groner and JA Bauer); Kentucky Children's Hospital, Department of Pediatrics, University of Kentucky College of Medicine, Lexington (H Huang and JA Bauer)
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7
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Malek-Ahmadi M, Belden C, Powell J, Zamrini E, Adler C, Sabbagh MN, Shill H, Jacobson S, Caselli RJ, Woodruff BK, Rapscak SZ, Ahern GL, Shi J, Caviness JN, Driver-Dunckley E, Mehta S, Shprecher D, Spann B, Tariot PN, Davis K, Long K, Nicholson L, Intorcia A, Glass M, Walker J, Callan M, Curry J, Cutler B, Oliver J, Arce R, Walker DG, Lue LF, Serrano GE, Sue LI, Reiman EM, Beach TG. P2-430: RELATIONSHIPS BETWEEN LONGITUDINAL RATES OF LEARNING AND MEMORY DECLINE AND DIFFERENT FORMS OF CEREBROVASCULAR PATHOLOGY IN COGNITIVELY UNIMPAIRED BRAIN DONORS. Alzheimers Dement 2019. [DOI: 10.1016/j.jalz.2019.06.2837] [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: 10/25/2022]
Affiliation(s)
- Michael Malek-Ahmadi
- Arizona Alzheimer's Consortium; Phoenix AZ USA
- Banner Alzheimer's Institute; Phoenix AZ USA
| | | | | | | | | | | | - Holly Shill
- Barrow Neurological Institute; Phoenix AZ USA
| | | | - Richard J. Caselli
- Arizona Alzheimer's Consortium; Phoenix AZ USA
- Mayo Clinic Arizona; Scottsdale AZ USA
| | - Bryan K. Woodruff
- Arizona Alzheimer's Consortium; Phoenix AZ USA
- Mayo Clinic Arizona; Scottsdale AZ USA
| | | | | | - Jiong Shi
- Barrow Neurological Institute; St Joseph Hospital and Medical Center; Phoenix AZ USA
| | | | | | | | | | - Bryan Spann
- Banner Sun Health Research Institute; Sun City AZ USA
| | - Pierre N. Tariot
- Arizona Alzheimer's Consortium; Phoenix AZ USA
- Banner Alzheimer's Institute; Phoenix AZ USA
- University of Arizona; Phoenix AZ USA
| | - Kathryn Davis
- Banner Sun Health Research Institute; Sun City AZ USA
| | - Kathy Long
- Banner Sun Health Research Institute; Sun City AZ USA
| | | | | | - Michael Glass
- Banner Sun Health Research Institute; Sun City AZ USA
| | | | | | - Jasmine Curry
- Banner Sun Health Research Institute; Sun City AZ USA
| | - Brett Cutler
- Banner Sun Health Research Institute; Sun City AZ USA
| | - Javon Oliver
- Banner Sun Health Research Center; Sun City AZ USA
| | - Richard Arce
- Banner Sun Health Research Institute; Sun City AZ USA
| | | | - Lih-Fen Lue
- Banner Sun Health Research Institute; Sun City AZ USA
- Arizona State University; Tempe AZ USA
| | | | - Lucia I. Sue
- Banner Sun Health Research Institute; Sun City AZ USA
| | - Eric M. Reiman
- Arizona Alzheimer's Consortium; Phoenix AZ USA
- Banner Alzheimer's Institute; Phoenix AZ USA
- University of Arizona; Tucson AZ USA
- Arizona State University; Tempe AZ USA
- Translational Genomics Research Institute; Phoenix AZ USA
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Grussu D, Conneely M, Nicholson L, Hirata K, Lamont D, Lunny D, McLean W, Hickerson R. 969 Wounding response and wound healing in a novel tension-based skin explant model. J Invest Dermatol 2019. [DOI: 10.1016/j.jid.2019.03.1045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Scott CK, Grella CE, Dennis ML, Nicholson L. Linking Individuals with Substance Use Disorders (SUDs) in Primary Care to SUD Treatment: the Recovery Management Checkups-Primary Care (RMC-PC) Pilot Study. J Behav Health Serv Res 2018; 45:160-173. [PMID: 29181779 PMCID: PMC5871558 DOI: 10.1007/s11414-017-9576-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [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] [Indexed: 12/27/2022]
Abstract
Linking individuals in primary care settings with substance use disorders (SUDs) to SUD treatment has proven to be challenging, despite the widespread use of Screening, Brief Intervention, and Referral to Treatment (SBIRT). This paper reports findings from a pilot study that examined the efficacy of the Recovery Management Checkups intervention adapted for primary care settings (RMC-PC), for assertively linking and engaging patients from Federally Qualified Health Centers into SUD treatment. Findings showed that patients in the RMC-PC (n=92) had significantly higher rates of SUD treatment entry and received more days of SUD treatment compared with those who receive the usual SBIRT referral (n=50). Receipt of RMC-PC had both direct and indirect effects, partially mediated through days of SUD treatment, on reducing days of drug use at 6 months post intake. RMC-PC is a promising intervention to address the need for more assertive methods for linking patients in primary care to SUD treatment.
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Affiliation(s)
- Christy K Scott
- Lighthouse Institute, Chestnut Health Systems, Chicago, IL 221 W. Walton, Chicago, IL 60610; Phone: (312) 664-4321; Fax: (312)664-4324;
| | - Christine E. Grella
- Chestnut Health Systems, Chicago, IL 221 W. Walton, Chicago, IL 60610; Phone: (310) 267-5451; Fax: (310) 473-7885;
| | - Michael L. Dennis
- Chestnut Health Systems, 448 Wylie Drive, Normal, IL 61761; Phone: (309)451-7801; Fax: (309)451-7765;
| | - Lisa Nicholson
- Chestnut Health Systems, Chicago, IL 221 W. Walton, Chicago, IL 60610; Phone: (312) 664-4321; Fax: (312)664-4324;
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10
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Sharma A, Contreras E, Sandoval K, Nicholson L, Waalen J, Bhangoo M. 223P Sarcomatoid lung carcinoma: An uncommon and deadly entity. J Thorac Oncol 2018. [DOI: 10.1016/s1556-0864(18)30495-7] [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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11
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Scott CK, Grella CE, Nicholson L, Dennis ML. Opioid recovery initiation: Pilot test of a peer outreach and modified Recovery Management Checkup intervention for out-of-treatment opioid users. J Subst Abuse Treat 2018; 86:30-35. [PMID: 29415848 PMCID: PMC5808598 DOI: 10.1016/j.jsat.2017.12.007] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [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] [Received: 09/06/2017] [Revised: 11/30/2017] [Accepted: 12/14/2017] [Indexed: 02/01/2023]
Abstract
The recent surge in opioid-related overdoses and related fatalities underscores the need for assertive mechanisms for linking individuals with opioid use disorders (OUD) to medication-assisted treatment (MAT). This pilot study investigated the feasibility of an intervention that used peer outreach workers to identify out-of-treatment individuals with OUD combined with a modified version of the Recovery Management Checkup to link individuals to methadone treatment. The study was conducted in high-risk communities in Chicago over 8weeks; peer outreach workers identified 88 active opioid/heroin users; 72 were screened as eligible, and 70 showed to the study intake/initial linkage meeting. Most participants were male (73%) and African American (94%), with an average age of 52.0 (sd=7.6). Nearly all (67/70, 96%) were admitted to methadone treatment; median time from initial linkage meeting to treatment admission was 2.6days. Most were still in treatment at 30 and 60days post-intake (69% and 70%, respectively). A high-risk sub-group was identified that had ever received naloxone for an opioid overdose; they had one third of the odds of being in treatment at 30days post-intake compared with others. The intervention model holds promise as an assertive method for identifying and engaging individuals with OUD into treatment.
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Affiliation(s)
- Christy K Scott
- Lighthouse Institute, Chestnut Health Systems, 221 W. Walton, Chicago, IL 60610, United States.
| | - Christine E Grella
- Lighthouse Institute, Chestnut Health Systems, 221 W. Walton, Chicago, IL 60610, United States.
| | - Lisa Nicholson
- Lighthouse Institute, Chestnut Health Systems, 221 W. Walton, Chicago, IL 60610, United States.
| | - Michael L Dennis
- Lighthouse Institute, Chestnut Health Systems, 448 Wylie Drive, Normal, IL 61761, United States.
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12
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Haider S, Hyde A, Vollbon S, Cable H, Lakey S, Nicholson L. The Lady Cilento Children's Hospital and Heartkids Queensland: Cardiac Parent Support Group. Heart Lung Circ 2018. [DOI: 10.1016/j.hlc.2018.06.871] [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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13
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Groner JA, Huang H, Joshi MS, Eastman N, Nicholson L, Bauer JA. Secondhand Smoke Exposure and Preclinical Markers of Cardiovascular Risk in Toddlers. J Pediatr 2017; 189:155-161. [PMID: 28711174 PMCID: PMC6446918 DOI: 10.1016/j.jpeds.2017.06.032] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2017] [Revised: 04/20/2017] [Accepted: 06/12/2017] [Indexed: 01/19/2023]
Abstract
OBJECTIVE To investigate relationships between secondhand smoke exposure in young children and several preclinical markers of cardiovascular risk that have been established as relevant to adult populations. STUDY DESIGN There were 139 children, 2-5 years of age, enrolled in a cross-sectional study. Secondhand smoke exposure was objectively determined by hair nicotine level; a comprehensive panel of clinical markers (morning blood pressure, fasting glucose and insulin, lipid profiles, inflammation) and research markers (markers of oxidation, endothelial stress, and endothelial repair) of cardiovascular risk status were assessed. Univariate and multivariate linear regression were used to evaluate relationships between secondhand smoke exposure and cardiovascular risk markers. RESULTS Hair nicotine levels were correlated directly with blood pressure and serum C-reactive protein, and inversely correlated with serum high-density lipoprotein cholesterol and endothelial cell progenitor cell prevalence. In multivariate analyses, these relationships remained when controlled for age, sex, body mass index z-score, maternal education, and method of payment. Additionally, in multivariate analyses, hair nicotine level was significantly negatively correlated with total antioxidant capacity. CONCLUSIONS These results support the view that secondhand smoke exposure in the very young has a detectable relationship with several markers of cardiovascular risk, long before the emergence of clinical disease. Further studies to define mechanisms and strategies to prevent and mitigate these risks early in life are warranted.
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Affiliation(s)
- Judith A. Groner
- AAP Julius B. Richmond Center of Excellence, Elk Grove Village, IL, USA;,Nationwide Children’s Hospital, Department of Pediatrics, The Ohio State University College of Medicine, Columbus, OH, USA
| | - Hong Huang
- AAP Julius B. Richmond Center of Excellence, Elk Grove Village, IL, USA;,Kentucky Children’s Hospital, Department of Pediatrics, University of Kentucky College of Medicine, Lexington, KY, USA
| | - Mandar S. Joshi
- Kentucky Children’s Hospital, Department of Pediatrics, University of Kentucky College of Medicine, Lexington, KY, USA
| | - Nicholas Eastman
- Kentucky Children’s Hospital, Department of Pediatrics, University of Kentucky College of Medicine, Lexington, KY, USA
| | - Lisa Nicholson
- Nationwide Children’s Hospital, Department of Pediatrics, The Ohio State University College of Medicine, Columbus, OH, USA
| | - John Anthony Bauer
- AAP Julius B. Richmond Center of Excellence, Elk Grove Village, IL, USA;,Kentucky Children’s Hospital, Department of Pediatrics, University of Kentucky College of Medicine, Lexington, KY, USA
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14
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Baldwin JN, McKay MJ, Simic M, Hiller CE, Moloney N, Nightingale EJ, Burns J, McKay M, Chard A, Ferreira P, Fong Yan A, Hiller C, Lee (nee Zheng) F, Mackey M, Mousavi S, Nicholson L, Nightingale E, Pourkazemi F, Raymond J, Rose K, Simic M, Sman A, Wegener C, Refshauge K, Burns J, Moloney N, North K, Hübscher M, Vanicek N, Quinlan K. Self-reported knee pain and disability among healthy individuals: reference data and factors associated with the Knee injury and Osteoarthritis Outcome Score (KOOS) and KOOS-Child. Osteoarthritis Cartilage 2017; 25:1282-1290. [PMID: 28323136 DOI: 10.1016/j.joca.2017.03.007] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2016] [Revised: 03/02/2017] [Accepted: 03/08/2017] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To develop normative reference data for the Knee injury and Osteoarthritis Outcome Score (KOOS) and KOOS-Child, as well as investigate socio-demographic, psychological and physical factors associated with knee pain and disability among healthy adults. METHOD The KOOS or KOOS-Child (each containing five subscales) was administered to participants aged 8-101 years within the 1000 Norms Project, an observational study of 1000 self-reported healthy individuals. Self-efficacy, physical activity, body mass index (BMI), lower limb alignment, knee frontal plane projection angle (FPPA), knee range of motion (ROM), knee and hip strength, six-minute walk, 30-second chair stand and timed up and down stairs tests were collected. KOOS data were dichotomised using established cut-off scores and logistic regression analyses were conducted for each subscale. RESULTS Socio-demographic characteristics were similar to the Australian population. Normative reference data were generated for children (8-17 years) and adults (18-101 years). Female adults were up to twice as likely to report knee pain, symptoms and sport/recreation (Sport/Rec) limitations compared to males (P < .05). Older age, lower self-efficacy, greater BMI, varus lower limb alignment, lower knee flexion ROM and lower hip external rotation (ER) strength were independently associated with knee pain and disability among adults. CONCLUSIONS Age- and gender-stratified reference data for the KOOS and KOOS-Child have been developed to guide interpretation of results in practice and research for individuals with knee disorders. Psychological and physical factors are linked with self-reported knee pain/disability among adults, and longitudinal studies to investigate causation are required.
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Affiliation(s)
- J N Baldwin
- Arthritis and Musculoskeletal Research Group, Faculty of Health Sciences, University of Sydney, Australia.
| | - M J McKay
- Arthritis and Musculoskeletal Research Group, Faculty of Health Sciences, University of Sydney, Australia
| | - M Simic
- Arthritis and Musculoskeletal Research Group, University of Sydney, Australia
| | - C E Hiller
- Arthritis and Musculoskeletal Research Group, Faculty of Health Sciences, University of Sydney, Australia
| | - N Moloney
- Arthritis and Musculoskeletal Research Group, Faculty of Health Sciences, University of Sydney, Australia; Department of Health Sciences, Faculty of Medicine and Health Sciences, Macquarie University, Sydney, Australia
| | - E J Nightingale
- Arthritis and Musculoskeletal Research Group, Faculty of Health Sciences, University of Sydney, Australia
| | - J Burns
- Arthritis and Musculoskeletal Research Group, Faculty of Health Sciences, University of Sydney, Australia; Paediatric Gait Analysis Service of New South Wales, Sydney Children's Hospitals Network (Randwick and Westmead), Australia
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Smith J, Nicholson L, Suwanpradid J, Glenn R, Gundry J, Alagesan P, Knape N, Atwater A, Gunn M, MacLeod A, Lefkowitz R, Rajagopal S. 678 Biased CXCR3 ligands differentially alter allergic contact hypersensitivity and chemotaxis. J Invest Dermatol 2017. [DOI: 10.1016/j.jid.2017.02.701] [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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Nicholson L, Patrao NV, Ramu J, Vazquez-Alfageme C, Muwas M, Rajendram R, Hykin PG, Sivaprasad S. Influence of baseline diabetic retinopathy status on initial anatomical response of intravitreal ranibizumab therapy for diabetic macular oedema. Eye (Lond) 2017; 31:1358-1364. [PMID: 28452992 DOI: 10.1038/eye.2017.69] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2016] [Accepted: 03/20/2017] [Indexed: 12/30/2022] Open
Abstract
PurposeIntraocular vascular endothelial growth factor (VEGF) levels increases with the severity of diabetic retinopathy. Response of diabetic macular oedema (DMO) to ranibizumab is driven by VEGF suppression. We hypothesised that the initial reduction of central macular thickness by ranibizumab should be maximum in severe diabetic retinopathy until the levels of VEGF decreases to the levels observed in eyes with mild retinopathy.MethodsConsecutive patients with centre-involving DMO (central subfield thickness (CSFT)>300 μm) who had three consecutive monthly ranibizumab injections followed by as needed therapy were included. Retinopathy status was graded as mild non-proliferative diabetic retinopathy (NPDR) (G1), moderate to severe NPDR with no prior panretinal photocoagulation (G2), and treated PDR (G3).ResultsTwo hundred and thirty-nine eyes from 204 patients with a mean age of 64.9 years were included. The distribution was 31.4 G1, 32.2 G2, and 36.4% G3. Mean baseline CSFT for all eyes was 458.5±110.8 μm. Baseline CSFT for G1, G2, and G3, respectively, were 437.6±90.9, 472.3±109.8, and 464.7±124.9 μm (P=0.2155). Mean change in CSFT after three consecutive injections was 128.5±116.6 μm. The mean changes were 95.8±101.4 μm for G1, 137.2±112.9 μm for G2, and 148.9±126.9 μm for G3. The changes in CSFT between groups adjusted for baseline CSFT were statistically significant (P=0.0473). At 6 and 12 months after a mean of 4.5 and 7.7 injections, the changes between groups were no longer significant, P=0.4783 and P=0.8271, respectively.ConclusionsThe initial anatomical response of DMO with intravitreal ranibizumab injections was maximum in eyes with treated PDR, suggesting that the higher the VEGF levels, the better the response with ranibizumab.
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Affiliation(s)
- L Nicholson
- Medical Retina, National Institute for Health Research Moorfields Biomedical Research Centre and University College London Institute of Ophthalmology, London, UK.,Moorfields Eye Hospital NHS Foundation Trust, London, UK
| | - N V Patrao
- Medical Retina, National Institute for Health Research Moorfields Biomedical Research Centre and University College London Institute of Ophthalmology, London, UK.,Moorfields Eye Hospital NHS Foundation Trust, London, UK
| | - J Ramu
- Medical Retina, National Institute for Health Research Moorfields Biomedical Research Centre and University College London Institute of Ophthalmology, London, UK.,Moorfields Eye Hospital NHS Foundation Trust, London, UK
| | - C Vazquez-Alfageme
- Medical Retina, National Institute for Health Research Moorfields Biomedical Research Centre and University College London Institute of Ophthalmology, London, UK.,Moorfields Eye Hospital NHS Foundation Trust, London, UK
| | - M Muwas
- Medical Retina, National Institute for Health Research Moorfields Biomedical Research Centre and University College London Institute of Ophthalmology, London, UK.,Moorfields Eye Hospital NHS Foundation Trust, London, UK
| | - R Rajendram
- Medical Retina, National Institute for Health Research Moorfields Biomedical Research Centre and University College London Institute of Ophthalmology, London, UK.,Moorfields Eye Hospital NHS Foundation Trust, London, UK
| | - P G Hykin
- Medical Retina, National Institute for Health Research Moorfields Biomedical Research Centre and University College London Institute of Ophthalmology, London, UK.,Moorfields Eye Hospital NHS Foundation Trust, London, UK
| | - S Sivaprasad
- Medical Retina, National Institute for Health Research Moorfields Biomedical Research Centre and University College London Institute of Ophthalmology, London, UK.,Moorfields Eye Hospital NHS Foundation Trust, London, UK
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Cua CL, Haque U, Santoro S, Nicholson L, Backes CH. Differences in mortality characteristics in neonates with Down's syndrome. J Perinatol 2017; 37:427-431. [PMID: 28079865 DOI: 10.1038/jp.2016.246] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2016] [Revised: 10/19/2016] [Accepted: 12/01/2016] [Indexed: 11/09/2022]
Abstract
OBJECTIVE Neonates with Down's syndrome (nDS) may have multiple medical issues that place them at increased risk for mortality during the newborn period. Goal of this study was to determine if there are differences in baseline characteristics, medical complications or procedures performed during hospitalization between nDS who survived versus those who died during initial hospitalization. STUDY DESIGN Data from 2000 to 2014 were reviewed using the Pediatric Health Information Systems (PHIS) database on all DS patients admitted to the hospital <30 days postnatal life. Baseline demographics, medical complications, procedures performed and mortality were recorded. Patients were divided into nDS patients who were discharged alive (nDS-a) versus nDS patients who died (nDS-d). Multivariate logistic analysis with odds ratios was performed to determine significant predictors of death. A P<0.05 was considered significant. RESULTS A total of 5737 nDS were evaluated. Overall mortality was 7.5% (431/5737). nDS-d were more likely than nDS-a to have a lower birth weight (1.0 (0.9 to 1.0)), presence of a diaphragmatic hernia (6.9 (1.9 to 25.1), or a cardiac diagnosis of a pulmonary venous abnormality (6.8 (1.9 to 24.4)), Ebstein's anomaly (3.2 (1.2 to 8.5)) or left-sided obstructive lesion (2.0 (1.3 to 3.0). nDS-d were more likely to develop hydrops (5.7 (3.5 to 9.5)) and necrotizing enterocolitis (1.7 (1.2 to 2.6)). In addition, nDS-d had significantly higher odds of requiring mechanical ventilation (20.7 (9.9 to 43.1)) or extracorporeal membrane oxygenation (8.7 (4.7 to 16.1)). CONCLUSIONS A number of characteristics, specifically certain cardiac diagnosis, place nDS at increased risk for mortality. Furthermore, development of specific medical complications or need for particular procedures increases the odds for mortality in nDS. Caregivers should be cognizant that they are taking care of a high-risk population nDS with an increased risk for mortality if these variables are present.
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Affiliation(s)
- C L Cua
- Department of Pediatrics, Heart Center, Nationwide Children's Hospital, Columbus Children's Hospital, Columbus, OH, USA
| | - U Haque
- Department of Pediatrics, Heart Center, Nationwide Children's Hospital, Columbus Children's Hospital, Columbus, OH, USA
| | - S Santoro
- Department of Pediatrics, Heart Center, Nationwide Children's Hospital, Columbus Children's Hospital, Columbus, OH, USA
| | - L Nicholson
- Department of Pediatrics, Heart Center, Nationwide Children's Hospital, Columbus Children's Hospital, Columbus, OH, USA
| | - C H Backes
- Department of Pediatrics, Heart Center, Nationwide Children's Hospital, Columbus Children's Hospital, Columbus, OH, USA
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Caris EC, Dempster N, Wernovsky G, Butz C, Neely T, Allen R, Stewart J, Miller-Tate H, Fonseca R, Texter K, Nicholson L, Cua CL. Anxiety Scores in Caregivers of Children with Hypoplastic Left Heart Syndrome. CONGENIT HEART DIS 2016; 11:727-732. [PMID: 27320439 DOI: 10.1111/chd.12387] [Citation(s) in RCA: 16] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/27/2016] [Indexed: 11/29/2022]
Abstract
OBJECTIVES Caring for children with congenital heart disease places significant stress on caregivers. Minimal data exist evaluating stress levels in caregivers of children with hypoplastic left heart syndrome (HLHS). The goal of this study was to obtain baseline stress scores for caregivers of children with HLHS and determine if associations exist between scores and specific caregiver factors. STUDY DESIGN A cross-sectional study using a web-based survey targeted towards caregivers of children with HLHS was performed. Baseline demographics of the caregiver and child with HLHS were obtained. Caregivers completed three validated questionnaires including the Pediatric Quality of Life Inventory (PedsQL), Parenting Stress Index- Short Form (PSI-SF) and the Pediatric Inventory for Parents (PIP). RESULTS Four hundred fifty-nine caregivers completed at least one questionnaire. PSI-SF total score was 80.5 ± 23.1 (> 86 = significant stress), PIP frequency total score was 119.0 ± 37.2, and PIP difficulty total score was 118.1 ± 35.7. Lower quality of life was significantly correlated with higher scores on the PSI-SF (r = -0.6), the presence of a developmental issue in the child (r = 0.3) as well as higher scores on the PIP frequency (r = -0.5) and difficulty scales (r = 0.4). Other demographic values for the caregiver and child did not significantly correlate with PSI or PIP total scores. CONCLUSIONS Anxiety/stress scores of caregivers with children with HLHS are correlated with how well the child is perceived to be doing physically and developmentally by the caregivers. Caregivers with physical and/or developmental concerns may need added psychosocial support.
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Affiliation(s)
| | | | | | | | - Trent Neely
- Nationwide Children's Hospital, Columbus, Ohio
| | - Robin Allen
- Nationwide Children's Hospital, Columbus, Ohio
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20
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Slater SJ, Nicholson L, Abu Zayd H, Chriqui JF. Does Pedestrian Danger Mediate the Relationship between Local Walkability and Active Travel to Work? Front Public Health 2016; 4:89. [PMID: 27242983 PMCID: PMC4861134 DOI: 10.3389/fpubh.2016.00089] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2015] [Accepted: 04/22/2016] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Environmental and policy factors play an important role in influencing people's lifestyles, physical activity (PA), and risks for developing obesity. Research suggests that more walkable communities are needed to sustain lifelong PA behavior, but there is a need to determine what local built environment features facilitate making being active the easy choice. PURPOSE This county-level study examined the association between local walkability (walkability and traffic calming scales), pedestrian danger, and the percent of adults who used active transport to work. METHODS Built environment and PA outcome measures were constructed for the 496 most populous counties representing 74% of the U.S. population. Geographic information system-based walkability scales were constructed and include a census of roads located within the counties using 2011 Navteq data. The pedestrian danger index (PDI) includes data collected from the Fatality Analysis Reporting System 2009-2011, and measures the likelihood of a pedestrian being hit and killed by a vehicle. Four continuous outcome measures were constructed using 2009-2013 American Community Survey county-level 5-year estimates. The measures represent the percentage of workers living in a county who worked away from home and (1) walked to work; (2) biked to work; (3) took public transit; and (4) used any form of active transport. Linear regression and mediation analyses were conducted to examine the association between walkability, PDI, and active transport. Models accounted for clustering within state with robust SEs, and controlled for median household income, families with children in poverty, race, ethnicity, urbanicity, and region. RESULTS The walkability scale was significantly negatively associated with the PDI (β = -0.06, 95% CI = -0.111, -0.002). In all models, the PDI was significantly negatively associated with all active travel-related outcomes at the p < 0.01 level. The walkability scale was positively associated with all four outcomes at the p < 0.01 level. Results showed that the significant positive relationship between local walkability and the four active transport outcome measures was partially mediated by the PDI. We found no association between traffic calming, the PDI, and the active transport outcomes. CONCLUSION Results from this study show that, at the county-level, walkability is associated with active travel, and this association is partially mediated by an index of pedestrian safety.
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Affiliation(s)
- Sandy J. Slater
- Division of Health Policy and Administration, Institute for Health Research and Policy, School of Public Health, University of Illinois at Chicago, Chicago, IL, USA
| | - Lisa Nicholson
- Institute for Health Research and Policy, Chicago, IL, USA
| | | | - Jamie Friedman Chriqui
- Division of Health Policy and Administration, Institute for Health Research and Policy, School of Public Health, University of Illinois at Chicago, Chicago, IL, USA
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21
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Kopp BT, Nicholson L, Paul G, Tobias J, Ramanathan C, Hayes D. The Geographic Impact on Hospitalization in Patients with Cystic Fibrosis. J Pediatr 2016; 170:246-52.e1-4. [PMID: 26690850 DOI: 10.1016/j.jpeds.2015.11.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2015] [Revised: 09/08/2015] [Accepted: 11/05/2015] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To assess whether geographic location influences hospitalizations for pulmonary exacerbations for patients with cystic fibrosis (CF) in the US, as there is no existing literature regarding this subject. STUDY DESIGN The CF Foundation Patient Registry was analyzed during the years 2007-2012 via geographic grouping of states. The impact of geographic region on recovery from hospitalization, hospitalization length, and time to next hospitalization were analyzed using multivariate models. RESULTS Posthospitalization lung function and nutritional measures were similar among regions for 1 year following hospitalization. The West region was associated with risk of longer hospital stays (OR 1.60, CI 1.45-1.77), however, dornase alfa use (OR 3.85, CI 1.15-12.92) was the only specific factor. History of allergic bronchopulmonary aspergillosis (OR 1.58, CI 1.11-2.25) and adult age (OR 2.48, CI 1.17-5.25) in the Northeast, chronic macrolide use in the South (OR 1.36, CI 1.03-1.79), and infection with Candida albicans (OR 1.47, CI 1.18-1.82) and Pseudomonas aeruginosa (OR 1.44, CI 1.02-2.04) in the Midwest were associated with increased hospitalization length. There was a significantly decreased risk for subsequent hospitalizations in the Northeast compared with other regions (P = .038). Sociodemographic analysis identified Caucasians in the South having a significantly lower risk of future hospitalization compared with African Americans (hazard ratio 0.79, CI 0.69-0.91, P = .0009). CONCLUSIONS There is significant regional variability in hospitalization length and risks for subsequent hospitalizations for patients with CF in the US. Regional variation should be subject to further study to determine if benchmarking standards can be achieved nationally.
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Affiliation(s)
- Benjamin T Kopp
- Section of Pulmonary Medicine, Nationwide Children's Hospital, Columbus, OH; Center for Microbial Pathogenesis, The Research Institute at Nationwide Children's Hospital, Columbus, OH.
| | - Lisa Nicholson
- Institute for Population Research, The Ohio State University, Columbus, OH
| | - Grace Paul
- Section of Pulmonary Medicine, Nationwide Children's Hospital, Columbus, OH
| | - Joseph Tobias
- Department of Anesthesiology and Pain Medicine, Nationwide Children's Hospital, Columbus, OH
| | - Chandar Ramanathan
- Section of Pulmonary Medicine, Nationwide Children's Hospital, Columbus, OH
| | - Don Hayes
- Section of Pulmonary Medicine, Nationwide Children's Hospital, Columbus, OH
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Groner JA, Huang H, Eastman N, Lewis L, Joshi MS, Schanbacher BL, Nicholson L, Bauer JA. Oxidative Stress in Youth and Adolescents With Elevated Body Mass Index Exposed to Secondhand Smoke. Nicotine Tob Res 2016; 18:1622-7. [PMID: 26903500 DOI: 10.1093/ntr/ntw025] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2015] [Accepted: 01/19/2016] [Indexed: 12/11/2022]
Abstract
INTRODUCTION Our objective was to investigate the relationships between secondhand smoke (SHS) exposure and oxidative stress in a group of youth and adolescents with elevated body mass index. METHODS Participants in this cross sectional study were healthy nonsmoking youth and adolescents ages 9 to 18 years old. Three-quarters of the participants were either overweight or obese. SHS exposure was determined by survey and hair nicotine level. Markers of oxidation were total antioxidant capacity and protein malondialdehyde adducts (MDA). RESULTS Ninety subjects were studied; adequate hair samples were available for 86. The mean hair nicotine level was 0.75ng/mg, the median was 0.58ng/mg and the range was 0.09-2.88ng/mg. There was a significant relationship between MDA and the three survey questions regarding smoke exposure ([mother smokes, r = 0.29, P = .006], [smoker lives in the home, r = 0.31, P = .004], and [number of smokers in the home, r = 0.36, P = .002]). There was a significant positive relationship between log-hair nicotine and MDA (Pearson r = 0.233, P = .031), which remained significant after controlling for age, sex, race, and method of insurance. No relationship was found between log-hair nicotine and total antioxidant capacity. However, there was a significant relationship between number of smokers in the home (r = 0.24, P = .042) and total antioxidant capacity. CONCLUSIONS We have demonstrated a significant positive relationship hair nicotine level and MDA in a group of youth with a high proportion of overweight/obese subjects. IMPLICATIONS We have shown a significant relationship between objectively measured SHS exposure and one marker of oxidative stress in a sample of youth and adolescents with a high proportion of overweight/obese subjects, and who were nonsmokers with relatively low tobacco exposure. This finding remains significant after controlling for age, sex, race, and type of medical insurance. Since the cardiovascular effects of SHS exposure are related to oxidative stress, this finding adds to our knowledge that the sequence of deleterious effects of tobacco exposure on the cardiovascular system begins long before clinical disease is evident.
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Affiliation(s)
- Judith A Groner
- Nationwide Children's Hospital, Ohio State University College of Medicine, Columbus, OH; American Academy of Pediatrics, Julius B. Richmond Center of Excellence, Elk Grove Village, IL;
| | - Hong Huang
- Department of Pediatrics, University of Kentucky College of Medicine, Lexington, KY
| | | | - Luke Lewis
- College of Medicine, University of Cincinnati, Cincinnati, OH
| | - Mandar S Joshi
- Department of Pediatrics, University of Kentucky College of Medicine, Lexington, KY
| | | | - Lisa Nicholson
- Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, IL
| | - John A Bauer
- Department of Pediatrics, University of Kentucky College of Medicine, Lexington, KY
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Stewart J, Dempster R, Allen R, Miller-Tate H, Dickson G, Fichtner S, Principe AJ, Fonseca R, Nicholson L, Cua CL. Caregiver anxiety due to interstage feeding concerns. CONGENIT HEART DIS 2016; 10:E98-106. [PMID: 25876670 DOI: 10.1111/chd.12257] [Citation(s) in RCA: 8] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/12/2015] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Improved weight gain during the interstage (IS) period has been shown to improve overall outcomes in patients with single ventricle physiology (SVP). This emphasis on nutrition may have untoward effects, such as increasing anxiety/stress levels in caregivers, who are already known to be at risk for increased anxiety/stress levels. The goal of this study was to evaluate anxiety/stress levels of caregivers as it pertains to feeding during the IS period and to determine if certain characteristics were associated with higher anxiety/stress scores. METHODS Caregivers of children with SVP who completed the IS period, defined as the time between the first and second cardiac surgeries, were recruited. Baseline demographics were obtained. Anxiety/stress levels were measured via eight questions using a 0- to 10-point scale. Correlations were performed between demographic variables and anxiety/stress level scores. RESULTS Fifty-six surveys were completed (39 males, 27 females) on 43 children. Fourteen children required tube feeds during the IS period. There were significant correlations between anxiety/stress scores and caregiver's gender, caregiver's age, caregiver's level of education, percent of time a caregiver spent feeding the child, if caregivers were taking medications for anxiety, and if the child was seen in the emergency room during the IS period. There were no correlation of anxiety/stress scores with caregiver's race, child's underlying cardiac diagnosis, age of child, route of feeding during the IS period, birth order of the child or number of children in the family, relationship status, or distance from the hospital. CONCLUSION In general, caregivers of children with SVP experience anxiety/stress during the IS period specifically due to feeding concerns. Certain intrinsic and extrinsic characteristics were associated with higher anxiety/stress levels. Future studies are needed to determine how to minimize anxiety/stress levels during this stressful time period.
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Affiliation(s)
- Jamie Stewart
- Heart Center, Nationwide Children's Hospital, Columbus, Ohio, USA
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Kopp BT, Nicholson L, Paul G, Tobias J, Ramanathan C, Hayes D. Geographic variations in cystic fibrosis: An analysis of the U.S. CF Foundation Registry. Pediatr Pulmonol 2015; 50:754-62. [PMID: 25825016 DOI: 10.1002/ppul.23185] [Citation(s) in RCA: 21] [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] [Received: 10/23/2014] [Revised: 12/29/2014] [Accepted: 01/23/2015] [Indexed: 11/12/2022]
Abstract
BACKGROUND Emerging evidence suggests that the prevalence of pathogens common in cystic fibrosis (CF) may be unevenly distributed across the United States (U.S.). However, very little is known regarding the U.S. distribution of other CF modifiers such as medication usage and patient demographics. Therefore, we sought to determine if regional differences exist in the distribution of demographic variables and patient disease characteristics in the U.S. that may play a role in differential CF outcomes. METHODS Data were analyzed from the 30,896 subjects in the U.S. CF Foundation Patient Registry during the years 2007-2012, via geographical grouping of states based upon the Nationwide Inpatient Sample classification. RESULTS Significant differences in racial distribution were seen, including half of the total U.S. African-American CF population residing in the South. Both African-Americans and Hispanics had increased Medicaid usage (52.2%, 41.8%, respectively). Culture-reported pathogens were markedly different across the U.S., with the highest percentage of patients with Methicillin-resistant Staphylococcus aureus (41.9%), Pseudomonas aeruginosa (71.2%), and non-tuberculous mycobacterium (10.0%) in the South. The South region also had the lowest mean body mass index and forced expiratory volume in one second. Chronic medication usage such as inhaled tobramycin or macrolides followed P. aeruginosa distribution, while inhaled dornase alfa was most used in the West (84.7%). Co-morbid conditions varied, with the highest percentage of depressed subjects in the Midwest (18.3%). Mean regional mortality rates were not statistically different among regions, although highest in each age grouping of the South. CONCLUSIONS The U.S. has significant regional variations in CF demographics, insurance, pathogens, medication usage, and co-morbidities, without an overall impact on regional mortality. Regional variations in care practices should be studied further based on the findings.
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Affiliation(s)
- Benjamin T Kopp
- Section of Pulmonary Medicine, Nationwide Children's Hospital, Columbus, Ohio.,Center for Microbial Pathogenesis, The Research Institute at Nationwide Children's Hospital, Columbus, Ohio
| | - Lisa Nicholson
- Institute for Population Research, The Ohio State University, Columbus, Ohio
| | - Grace Paul
- Section of Pulmonary Medicine, Nationwide Children's Hospital, Columbus, Ohio
| | - Joseph Tobias
- Department of Anesthesiology & Pain Medicine, Nationwide Children's Hospital, Columbus, Ohio
| | - Chandar Ramanathan
- Section of Pulmonary Medicine, Nationwide Children's Hospital, Columbus, Ohio
| | - Don Hayes
- Section of Pulmonary Medicine, Nationwide Children's Hospital, Columbus, Ohio
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Khan S, Nadorlik H, Kertesz N, Nicholson L, Ro PS, Cua CL. QRS Duration Changes in Patients with Single Ventricle Physiology: Birth to 10 Years. Pacing Clin Electrophysiol 2015; 38:1159-65. [PMID: 26096591 DOI: 10.1111/pace.12677] [Citation(s) in RCA: 3] [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] [Subscribe] [Scholar Register] [Received: 10/27/2014] [Revised: 04/20/2015] [Accepted: 05/26/2015] [Indexed: 11/28/2022]
Abstract
BACKGROUND QRS prolongation may be a predictor of mortality in certain forms of congenital heart disease. Minimal data exist describing changes in QRS duration in patients with single ventricles (SVs). The goal was to describe changes in QRS duration in patients with SV and to determine if differences existed between single right ventricle (sRV) versus single left ventricle (sLV) patients. METHODS Chart review was performed on patients with SV physiology. Patients were divided into sRV and sLV groups. QRS durations were measured monthly for the first 6 months, at 1 year, and then yearly until 10 years. t-tests were used for analysis. RESULTS One hundred sixty patients were evaluated (95 sRV, 65 sLV). The greatest change in QRS duration for the entire cohort occurred in the first 6 months of life versus 6 months to 10 years of age (1.81 ms/month vs 0.20 ms/month). sRV QRS durations were significantly longer than sLV QRS durations at 1 year (78.9 ± 12.6 ms vs 73.2 ± 11.9 ms), 2 year (81.7 ± 14.7 ms vs 73.4 ± 12.5 ms), 4 year (84.2 ± 12.1 ms vs 77.9 ± 16.4 ms), 6 year (90.8 ± 12.7 ms vs 83.4 ± 13.4 ms), 7 year (90.8 ± 16.5 ms vs 81.2 ± 16.6 ms), and 8 year (96.7 ± 13.6 ms vs 84.8 ± 13.9 ms) time points. CONCLUSION The greatest change in QRS duration in SV patients occurred in the first 6 months of life when these patients' ventricles were volume loaded. Differences in QRS duration between sRV and sLV patients occurred early in life. Further studies are needed to determine if minimizing volume load early in life decreases the rate of change in QRS duration.
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Affiliation(s)
- Sairah Khan
- Heart Center, Nationwide Children's Hospital, Columbus, Ohio
| | - Holly Nadorlik
- Heart Center, Nationwide Children's Hospital, Columbus, Ohio
| | - Naomi Kertesz
- Heart Center, Nationwide Children's Hospital, Columbus, Ohio
| | - Lisa Nicholson
- Heart Center, Nationwide Children's Hospital, Columbus, Ohio
| | - Pamela S Ro
- Heart Center, Nationwide Children's Hospital, Columbus, Ohio
| | - Clifford L Cua
- Heart Center, Nationwide Children's Hospital, Columbus, Ohio
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Nicholson L, Hotchin H. The relationship between area deprivation and contact with community intellectual disability psychiatry. J Intellect Disabil Res 2015; 59:487-492. [PMID: 24981260 DOI: 10.1111/jir.12149] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 06/05/2014] [Indexed: 06/03/2023]
Abstract
BACKGROUND People with intellectual disabilities (ID) have high rates of psychiatric illness and are known to live in more deprived areas than the general population. This study investigated the relationship between area deprivation and contact with ID psychiatry. METHOD Psychiatric case notes and electronic records were used to identify all patients who had face-to-face contact with community ID psychiatric services over 1 year in the North East Community Health Partnership of Greater Glasgow and Clyde (estimated population 177,867). The Scottish Index of Multiple Deprivation (SIMD) were determined for the patient sample and for the general population living in the same area. RESULTS Between 1 June 2012 and 1 June 2013, 184 patients were seen by ID psychiatry over a total of 553 contacts, with valid SIMD data for 179 patients and 543 contacts. Fifty-two per cent of patients (n = 93) lived in the most deprived SIMD decile, and 90.5% (n = 152) in the lowest 5 deciles. Compared with the general population, there were significantly more patients than expected living in the most deprived decile (Fisher's Exact test, P = 0.009) and in the most deprived 5 deciles (Fisher's Exact test, P = 0.001). The median number of contacts was 2 (interquartile range = 1-3). There was no significant association between the number of contacts and SIMD decile. Forty-eight point one per cent (n = 261) of all contacts were with patients living in the most deprived decile and 88.6% (n = 481) in the most deprived 5 deciles. This was significantly more than expected compared with general population data (Fisher's Exact test, P = 0.008 and Fisher's Exact test, P ≤ 0.001). CONCLUSIONS In the area under study, contact with ID psychiatry was greater in more deprived areas. Given the high psychiatric morbidity of people with ID, if services do not adjust for deprivation, this may lead to further discrimination in an already disadvantaged population.
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Affiliation(s)
- L Nicholson
- NHS Greater Glasgow and Clyde, Learning Disabilities Psychiatry, Stobhill Hospital, Glasgow, UK
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Voorheis G, Papathakis P, Nicholson L. Toddler Feeding Practices in Early Head Start and Migrant/Seasonal Early Head Start Mothers. FASEB J 2015. [DOI: 10.1096/fasebj.29.1_supplement.901.13] [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: 11/11/2022]
Affiliation(s)
- Grace Voorheis
- Food Science and NutritionCalifornia Polytechnic State UniversitySan Luis ObispoCAUnited States
| | - Peggy Papathakis
- Food Science and NutritionCalifornia Polytechnic State UniversitySan Luis ObispoCAUnited States
| | - Lisa Nicholson
- Food Science and NutritionCalifornia Polytechnic State UniversitySan Luis ObispoCAUnited States
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Arevalos L, Nicholson L, Papathakis P. Exclusive Breastfeeding Protective for Growth Trajectory to 5 Years in a WIC Cohort. FASEB J 2015. [DOI: 10.1096/fasebj.29.1_supplement.901.9] [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: 11/11/2022]
Affiliation(s)
- Lindsey Arevalos
- Food Science and NutritionCalifornia Polytechnic State UniversitySan Luis ObispoCaliforniaUnited States
| | - Lisa Nicholson
- Food Science and NutritionCalifornia Polytechnic State UniversitySan Luis ObispoCaliforniaUnited States
| | - Peggy Papathakis
- Food Science and NutritionCalifornia Polytechnic State UniversitySan Luis ObispoCaliforniaUnited States
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Kopp BT, Sarzynski L, Khalfoun S, Hayes D, Thompson R, Nicholson L, Long F, Castile R, Groner J. Detrimental effects of secondhand smoke exposure on infants with cystic fibrosis. Pediatr Pulmonol 2015; 50:25-34. [PMID: 24610820 DOI: 10.1002/ppul.23016] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2014] [Accepted: 01/30/2014] [Indexed: 11/06/2022]
Abstract
RATIONALE Secondhand smoke (SHS) has deleterious respiratory, immune, and nutritional effects in children, but there is little data regarding the effects of SHS exposure in infants with cystic fibrosis (CF). METHODS A retrospective chart review was undertaken from 2008 to 2012 of 75 infants with CF. Growth, lung function, Chest CT imaging, and microbiologic characteristics were compared between 4 and 12 months for SHS and non-SHS exposed patients. RESULTS SHS exposed infants with CF had decreased growth between 4 and 12 months compared to non-SHS exposed infants. SHS exposure was associated with increased bronchodilator responsiveness and air trapping, but no other lung function or radiologic differences. SHS exposure was also associated with increased methicillin resistant Staphylococcus aureus (MRSA) and anaerobic growth on respiratory culture. There was no difference in Pseudomonas aeruginosa between groups. There were no differences in antibiotic use or hospitalizations between the groups. CONCLUSIONS SHS exposure in CF infants is associated with diminished growth, increased air trapping and bronchodilator responsiveness, and propensity to culture MRSA and facultative anaerobic bacteria, suggesting the need for early, aggressive parental smoking cessation interventions to prevent SHS exposure complications.
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Affiliation(s)
- Benjamin T Kopp
- Section of Pediatric Pulmonology, Nationwide Children's Hospital, Columbus, Ohio; Center for Microbial Pathogenesis, The Research Institute at Nationwide Children's Hospital, Columbus, Ohio
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Stiver C, Nadorlik H, Nicholson L, Janevski I, Belfrage K, Wheller J, Cua CL. Diastolic Dyssynchrony Differences in Patients with Single Right Ventricles vs. Control Patients. CONGENIT HEART DIS 2014; 10:326-32. [DOI: 10.1111/chd.12234] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/02/2014] [Indexed: 11/30/2022]
Affiliation(s)
- Corey Stiver
- The Heart Center; Nationwide Children's Hospital; Columbus Ohio USA
| | - Holly Nadorlik
- The Heart Center; Nationwide Children's Hospital; Columbus Ohio USA
| | - Lisa Nicholson
- The Heart Center; Nationwide Children's Hospital; Columbus Ohio USA
| | - Ilija Janevski
- The Heart Center; Nationwide Children's Hospital; Columbus Ohio USA
| | | | - John Wheller
- The Heart Center; Nationwide Children's Hospital; Columbus Ohio USA
| | - Clifford L. Cua
- The Heart Center; Nationwide Children's Hospital; Columbus Ohio USA
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Dennis ML, Scott CK, Funk RR, Nicholson L. A Pilot Study to Examine the Feasibility and Potential Effectiveness of Using Smartphones to Provide Recovery Support for Adolescents. Subst Abus 2014; 36:486-92. [PMID: 25310057 DOI: 10.1080/08897077.2014.970323] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
BACKGROUND Smartphone applications can potentially provide recovery monitoring and support in real-time, real-life contexts. Study aims included determining feasibility of (a) adolescents completing ecological momentary assessments (EMAs) and utilizing phone-based ecological momentary interventions (EMIs); and (b) using EMA and EMI data to predict substance use in the subsequent week. METHODS Twenty-nine adolescents were recruited at discharge from residential treatment, regardless of their discharge status or length of stay. During the 6-week pilot, youth were prompted to complete an EMA at 6 random times per day and were provided access to a suite of recovery support EMI. Youth completed 87% of the 5580 EMAs. Based on use in the next 7 days, EMA observations were classified into 3 risk groups: "Current Use" in the past 30 minutes (3% of observations), "Unrecognized Risk" (42%), or "Recognized Risk" (55%). All youth had observations in 2 or more risk groups and 38% in all 3. Youth accessed an EMI on average 162 times each week. RESULTS Participants were 31% female, 48% African American, 21% Caucasian, 7% Hispanic, and 24% Mixed/Other; average age was 16.6 years. During the 90 days prior to entering treatment, youth reported using alcohol (38%), marijuana (41%), and other drugs (7%). When compared with the "Recognized Risk" group's use in the following week (31%), both the "Unrecognized Risk" (50%, odds ratio [OR]=2.08) and "Current Use" (96%, OR=50.30) groups reported significantly higher rates of use in the next week. When an EMI was accessed 2 or more times within the hour following an EMA, the rate of using during the next week was significantly lower than when EMIs were not accessed (32% vs. 43%, OR=0.62). CONCLUSIONS Results demonstrate the feasibility of using smartphones for recovery monitoring and support with adolescents, with potential to reduce use.
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Alexander M, King J, Bajel A, Doecke C, Fox P, Lingaratnam S, Mellor JD, Nicholson L, Roos I, Saunders T, Wilkes J, Zielinski R, Byrne J, MacMillan K, Mollo A, Kirsa S, Green M. Australian consensus guidelines for the safe handling of monoclonal antibodies for cancer treatment by healthcare personnel. Intern Med J 2014; 44:1018-26. [DOI: 10.1111/imj.12564] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2014] [Accepted: 06/24/2014] [Indexed: 11/30/2022]
Affiliation(s)
- M. Alexander
- Pharmacy Department; Peter MacCallum Cancer Centre; Melbourne Victoria Australia
| | - J. King
- Pharmacy Department; Western Health; Melbourne Victoria Australia
| | - A. Bajel
- Department of Haematology; Royal Melbourne Hospital; Melbourne Victoria Australia
| | - C. Doecke
- Pharmacy Department; Royal Adelaide Hospital; Adelaide South Australia Australia
- School of Pharmacy and Medical Sciences; University of South Australia; Adelaide South Australia Australia
| | - P. Fox
- Department of Medical Oncology; Central West Cancer Service; Orange New South Wales Australia
- School of Medicine; University of Western Sydney; Sydney New South Wales Australia
| | - S. Lingaratnam
- Pharmacy Department; Peter MacCallum Cancer Centre; Melbourne Victoria Australia
| | - J. D. Mellor
- Pharmacy Department; Peter MacCallum Cancer Centre; Melbourne Victoria Australia
- Roche Pty Ltd; Sydney New South Wales Australia
| | - L. Nicholson
- Oncology/Haematology Services; Royal Hobart Hospital; Hobart Tasmania Australia
| | - I. Roos
- Youth Research Centre; The University of Melbourne; Melbourne Victoria Australia
| | - T. Saunders
- Pharmacy Department; Peter MacCallum Cancer Centre; Melbourne Victoria Australia
- Cancer Nurses Society of Australia; National Executive Committee; Melbourne Victoria Australia
| | - J. Wilkes
- View Health Pty Ltd; Perth Western Australia Australia
- Chemo@home Pty Ltd; Perth Western Australia Australia
| | - R. Zielinski
- Department of Medical Oncology; Central West Cancer Service; Orange New South Wales Australia
- School of Medicine; University of Western Sydney; Sydney New South Wales Australia
| | - J. Byrne
- Western and Central Melbourne Integrated Cancer Service (WCMICS); Melbourne Victoria Australia
| | - K. MacMillan
- Pharmacy Department; Western Health; Melbourne Victoria Australia
| | - A. Mollo
- Pharmacy Department; Western Health; Melbourne Victoria Australia
| | - S. Kirsa
- Pharmacy Department; Peter MacCallum Cancer Centre; Melbourne Victoria Australia
| | - M. Green
- Cancer Services; Western Health; Melbourne Victoria Australia
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Nadorlik H, Fleishman C, Brown DW, Miller-Tate H, Lenahan P, Nicholson L, Wheller J, Cua CL. Survey of how pediatric cardiologists noninvasively evaluate patients with hypoplastic left heart syndrome. CONGENIT HEART DIS 2014; 10:E73-82. [PMID: 25266754 DOI: 10.1111/chd.12224] [Citation(s) in RCA: 10] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/11/2014] [Indexed: 11/30/2022]
Abstract
BACKGROUND The evaluation of right ventricular (RV) function is important in patients with hypoplastic left heart syndrome (HLHS). Echocardiographic qualitative grading has been the prevalent method used in the past, but newer technologies allowing for quantitative assessment of RV function may have changed this fact. The goal of this study was to determine the current routine noninvasive evaluation of patients with HLHS and what, if any, methods are used to assess systolic and diastolic function in this population. METHODS Web-based survey was conducted using various listservs. Timing of echocardiograms between surgical stages was assessed. Methods of assessing systolic and diastolic function were evaluated. RESULTS Two hundred seventy-seven physicians who averaged 12.8 ± 9.6 years removed from training responded. Largest percentage of respondents was echocardiographers (44.2%) in a university-based practice (73.3%) from North America (91.7%). There were 54.3% of respondents who performed echocardiograms monthly between stages I and II, 48.8% who performed echocardiograms every 6 months between stages II and III, and 67.0% who performed echocardiograms annually after stage III procedure. The main method for systolic grading was qualitative grading (95.5%) and for diastolic grading were tricuspid blood inflow velocities (56.8%). Qualitative grading was considered the method of choice for systolic grading for 38.8% of respondents and tissue Doppler velocities was the method of choice for diastolic grading for 35.3% of respondents. There were 4.0% of respondents who routinely perform a cardiac magnetic resonance imaging (cMRI) between stages I and II, 8.0% between stages II and III, and 24.2% after stage III procedure. CONCLUSION Variability in the noninvasive assessment of the RV in patients with HLHS continues to exist. Qualitative RV systolic assessment was still the predominant method used to assess function despite newer imaging techniques to allow for quantification. Future studies are needed to determine which values are most useful in reviewing function in this complex patient population.
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Affiliation(s)
- Holly Nadorlik
- Heart Center, Nationwide Children's Hospital, Columbus, Ohio, USA
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Ng VY, Arnott L, Li J, Hopkins R, Lewis J, Sutphen S, Nicholson L, Reader D, McShane MA. Comparison of custom to standard TKA instrumentation with computed tomography. Knee Surg Sports Traumatol Arthrosc 2014; 22:1833-42. [PMID: 23979518 DOI: 10.1007/s00167-013-2632-7] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2013] [Accepted: 08/18/2013] [Indexed: 02/01/2023]
Abstract
PURPOSE There is conflicting evidence whether custom instrumentation for total knee arthroplasty (TKA) improves component position compared to standard instrumentation. Studies have relied on long-limb radiographs limited to two-dimensional (2D) analysis and subjected to rotational inaccuracy. We used postoperative computed tomography (CT) to evaluate preoperative three-dimensional templating and CI to facilitate accurate and efficient implantation of TKA femoral and tibial components. METHODS We prospectively evaluated a single-surgeon cohort of 78 TKA patients (51 custom, 27 standard) with postoperative CT scans using 3D reconstruction and contour-matching technology to preoperative imaging. Component alignment was measured in coronal, sagittal and axial planes. RESULTS Preoperative templating for custom instrumentation was 87 and 79 % accurate for femoral and tibial component size. All custom components were within 1 size except for the tibial component in one patient (2 sizes). Tourniquet time was 5 min longer for custom (30 min) than standard (25 min). In no case was custom instrumentation aborted in favour of standard instrumentation nor was original alignment of custom instrumentation required to be adjusted intraoperatively. There were more outliers greater than 2° from intended alignment with standard instrumentation than custom for both components in all three planes. Custom instrumentation was more accurate in component position for tibial coronal alignment (custom: 1.5° ± 1.2°; standard: 3° ± 1.9°; p = 0.0001) and both tibial (custom: 1.4° ± 1.1°; standard: 16.9° ± 6.8°; p < 0.0001) and femoral (custom: 1.2° ± 0.9°; standard: 3.1° ± 2.1°; p < 0.0001) rotational alignment, and was similar to standard instrumentation in other measurements. CONCLUSIONS When evaluated with CT, custom instrumentation performs similar or better to standard instrumentation in component alignment and accurately templates component size. Tourniquet time was mildly increased for custom compared to standard.
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Affiliation(s)
- Vincent Y Ng
- Department of Orthopaedics, The Wexner Medical Center, The Ohio State University, 725 Prior Hall, 376 West 10th Avenue, Columbus, OH, 43210, USA,
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Husain N, Gokhale J, Nicholson L, Perkins A, Cooper AL, Cheatham JP, Holzer RJ, Cua CL. Comparing echocardiographic assessment of systolic function with catheterization data in patients with single right ventricles. Acta Cardiol 2014; 69:281-8. [PMID: 25029873 DOI: 10.1080/ac.69.3.3027831] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
PURPOSE Echocardiographic evaluation of systolic function in patients with single right ventricles (SRV) is important but remains challenging. Minimal data exist correlating echocardiographic indices with catheterization data in this population. The goal of this study was to evaluate which echocardiographic measurement correlated best with dP/dt (max) obtained by cardiac catheterization in SRV patients. METHODS Patients with SRV physiology who underwent simultaneous echocardiography and cardiac catheterization were evaluated. Echocardiographic data included fractional area change % (FAC), displacement, TDI s'wave, myocardial performance index (MPI), global systolic strain, and global SR s wave. Maximum positive rate of ventricular pressure change measured as dP/dt (max) was obtained from the cardiac catheterization report. Correlations of echocardiographic and catheterization variables were examined using the Pearson correlation. RESULTS Twenty-seven SRV patients were studied. Median age at the time of the catheterization was 11.4 months (range 0 - 132 months). dP/dt (max) values ranged from 337-1860 mmHg/s with a median of 994 mmHg/s. Mean FAC was 27.15 +/- 7.13%, displacement was 7.35 +/- 2.88 mm, TDI s' was 4.98 +/- 1.93 cm/sec, MPI was 0.41 +/- 0.17, global strain was-14.85 +/- 4.32%, and global SR s wave was -1.03 +/- 0.34 sec(-1). There were no significant correlations between dP/dt (max) and any of the echocardiographic measurements of systolic function in SRV patients. CONCLUSION In patients with SRV physiology, catheterization-derived dP/dt (max) did not correlate with echocardiographic measurements of systolic function. Larger studies are needed to determine which non-invasive parameter best describes systolic function in patients with SRV.
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Affiliation(s)
- Nazia Husain
- The Heart Center, Nationwide Children’s Hospital, Columbus, USA
| | - Janaki Gokhale
- The Heart Center, Nationwide Children’s Hospital, Columbus, USA
| | - Lisa Nicholson
- The Heart Center, Nationwide Children’s Hospital, Columbus, USA
| | - Ann Perkins
- The Heart Center, Nationwide Children’s Hospital, Columbus, USA
| | - Amy L. Cooper
- The Heart Center, Nationwide Children’s Hospital, Columbus, USA
| | | | - Ralf J. Holzer
- The Heart Center, Nationwide Children’s Hospital, Columbus, USA
| | - Clifford L. Cua
- The Heart Center, Nationwide Children’s Hospital, Columbus, USA
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Nicholson L, Turner L, Schneider L, Chriqui J, Chaloupka F. State farm-to-school laws influence the availability of fruits and vegetables in school lunches at US public elementary schools. J Sch Health 2014; 84:310-316. [PMID: 24707925 DOI: 10.1111/josh.12151] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/19/2012] [Revised: 06/04/2013] [Accepted: 06/04/2013] [Indexed: 06/03/2023]
Abstract
BACKGROUND State laws and farm-to-school programs (FTSPs) have the potential to increase fruit and vegetable (FV) availability in school meals. This study examined whether FV were more available in public elementary school lunches in states with a law requiring/encouraging FTSPs or with a locally grown-related law, and whether the relationship between state laws and FV availability could be explained by schools opting for FTSPs. METHODS A pooled, cross-sectional analysis linked a nationally representative sample of public elementary schools with state laws. A series of multivariate logistic regressions, controlling for school-level demographics were performed according to mediation analysis procedures for dichotomous outcomes. RESULTS Roughly 50% of schools reported FV availability in school lunches on most days of the week. Schools with the highest FV availability (70.6%) were in states with laws and schools with FTSPs. State laws requiring/encouraging FTSPs were significantly associated with increased FV availability in schools and a significant percentage (13%) of this relationship was mediated by schools having FTSPs. CONCLUSIONS Because state farm-to-school laws are associated with significantly higher FV availability in schools-through FTSPs, as well as independently-enacting more state legislation may facilitate increased FTSP participation by schools and increased FV availability in school meals.
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Affiliation(s)
- Lisa Nicholson
- University of Illinois at Chicago, Health Policy Center, Institute of Health Research and Policy, 1747 West Roosevelt Road, Chicago, IL 60608
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Mitchell E, Cheatham JP, Sisk JM, Nicholson L, Holzer R, Galantowicz M, Cua CL. Neutrophil/Lymphocyte Ratio and Association with Arch Intervention in Patients with Hypoplastic Left Heart Syndrome Undergoing Hybrid Procedure. CONGENIT HEART DIS 2014; 9:543-8. [DOI: 10.1111/chd.12174] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/28/2014] [Indexed: 11/28/2022]
Affiliation(s)
| | | | - James M. Sisk
- Heart Center; Nationwide Children's Hospital; Columbus Ohio USA
| | - Lisa Nicholson
- Heart Center; Nationwide Children's Hospital; Columbus Ohio USA
| | - Ralf Holzer
- Heart Center; Nationwide Children's Hospital; Columbus Ohio USA
| | | | - Clifford L. Cua
- Heart Center; Nationwide Children's Hospital; Columbus Ohio USA
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Mitchell E, Cheatham J, Sisk J, Nicholson L, Holzer R, Galantowicz M, Cua C. NEUTROPHIL/LYMPHOCYTE RATIO AND ASSOCIATION WITH ARCH INTERVENTION IN PATIENTS WITH HYPOPLASTIC LEFT HEART SYNDROME UNDERGOING HYBRID PROCEDURE. J Am Coll Cardiol 2014. [DOI: 10.1016/s0735-1097(14)60509-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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Stiver C, Gokhale J, Husain N, Nicholson L, Cordier J, Van Lente L, Holzer RJ, Cua CL. Catheterization diastolic pressures correlate with diastolic dyssynchrony in patients with single right ventricles. Echocardiography 2013; 31:370-4. [PMID: 24298988 DOI: 10.1111/echo.12373] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
INTRODUCTION Diastolic dyssynchrony has correlated with pulmonary capillary wedge pressures in patients with normal cardiac anatomy. No data exist in single right ventricle (sRV) patients. Goal of this study was to determine if diastolic dyssynchrony in sRV patients correlates with ventricular end-diastolic pressures (VEDP). METHODS Tissue Doppler imaging (TDI) and strain rate (SR) analysis of sRV patients undergoing catheterization were performed. Time interval from onset of QRS to peak TDI e'-wave was obtained. Differences in intervals were calculated: QRS (RV) - QRS (IVS) and QRS (RV) - QRS (LV). Time interval from onset of QRS to peak strain rate early diastolic wave (SRe) was obtained for the 6 segment model sRV. Standard deviation of the 6 SRe time intervals was calculated. Correlation of VEDP with timing intervals was analyzed. RESULTS Forty sRV patients were evaluated. Age was 2.8 ± 3.5 years. Catheterization VEDP of the sRV was 9.3 ± 3.9 mmHg (median 8 mmHg range 4-24 mmHg). QRS (RV) - QRS (IVS) was 22.3 ± 18.1 msec and QRS (RV) - QRS (LV) was 23.7 ± 19.0 msec. SRe standard deviation of the sRV was 61.6 ± 23.9 msec. There was no significant correlation with VEDP and QRS (RV) - QRS (IVS) (r = 0.1, P = NS) or with QRS (RV) - QRS (LV) (r = 0.2, P = NS). There was a significant correlation of VEDP with the SRe standard deviation value (r = 0.4, P < 0.05). CONCLUSION Diastolic dyssynchrony correlated with VEDP in patients with sRV physiology. Future studies are needed to determine the significance of these findings.
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Affiliation(s)
- Corey Stiver
- Heart Center, Nationwide Children's Hospital, Columbus, Ohio
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Sman A, Hiller C, Rae K, Linklater J, Black D, Nicholson L, Burns J, Refshauge K. Diagnostic accuracy of clinical tests for ankle syndesmosis injury. J Sci Med Sport 2013. [DOI: 10.1016/j.jsams.2013.10.066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Husain N, Gokhale J, Nicholson L, Cheatham JP, Holzer RJ, Cua CL. Noninvasive Estimation of Ventricular Filling Pressures in Patients with Single Right Ventricles. J Am Soc Echocardiogr 2013; 26:1330-6. [DOI: 10.1016/j.echo.2013.08.002] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2013] [Indexed: 11/29/2022]
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Nicholson L, Chana R. Vanishing corneal vessels. Case Reports 2013; 2013:bcr-2013-201584. [DOI: 10.1136/bcr-2013-201584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Cozzi C, Aldrink J, Nicol K, Nicholson L, Cua C. Intestinal location of necrotizing enterocolitis among infants with congenital heart disease. J Perinatol 2013; 33:783-5. [PMID: 23636100 DOI: 10.1038/jp.2013.49] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2013] [Revised: 03/30/2013] [Accepted: 04/03/2013] [Indexed: 11/09/2022]
Abstract
OBJECTIVE To determine whether differences exist in the location of necrotizing enterocolitis (NEC) in infants with congenital heart disease (CHD) versus those without CHD. STUDY DESIGN Retrospective cohort study utilizing 11 years of patient data. Inclusion criterion was surgical exploration for NEC. Presence or absence of CHD was determined. Surgical and/or pathology reports were reviewed to identify the location of NEC. Data were analyzed by t-tests and χ(2) analyses. RESULT One hundred and sixty-seven patients met the inclusion criteria. CHD infants had a higher percentage of mortality. There was no difference in the location of NEC between non-CHD and CHD patients, with the predominant location being the small intestine in both. In addition, there was no difference in the location of NEC between preterm non-CHD patients and full-term CHD patients with the small intestine again being the primary site. CONCLUSION Despite differences in gestational age between non-CHD and CHD patients, the location of NEC in these infants did not differ.
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Affiliation(s)
- C Cozzi
- Section for Perinatal Research, The Ohio State University of College and Medicine, Columbus, OH, USA
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Abstract
BACKGROUND Difficulties in the recruitment of adults with intellectual disability (ID) to research studies are well described but little studied. The aim of this study was to investigate the difficulties in recruiting to a specific research project, in order to inform future recruitment to ID research. METHODS Individual semi-structured interviews were held between September 2009 and May 2010 with people who had been involved as intermediaries in recruitment to the research project. These were transcribed verbatim and were independently analysed by two researchers using the Framework approach, who then agreed upon the key emerging themes. RESULTS Ten interviews were analysed. A number of themes arose, including participant factors (interview anxiety, difficulties in understanding the concept of research, worry about negative feedback), the importance of the researcher (using a personal approach, meeting potential participants prior to recruitment) and motivators [enjoyment of the research interview (participant), obtaining a medical assessment (carer)]. The themes were then used to generate strategies to improve recruitment to ID research: these include the research team applying a more personal approach, developing the recruitment process to allow for multiple meetings with potential participants, and considering motivators for both participants and carers. CONCLUSIONS This study has used the experiences of intermediaries to identify strategies for improving recruitment to future ID research. This has implications in terms of both time and money. However, successful recruitment is essential to ID research, and we hope that the study will be used by ID researchers to review and improve their recruitment processes.
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Affiliation(s)
- L Nicholson
- NHS Greater Glasgow and Clyde, Learning Disabilities Psychiatry, Glasgow, UK
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Abstract
BACKGROUND Research suggests that social exclusion is a problem both for people with intellectual disabilities (ID) and for people living in rural areas. This may give rise to a double disadvantage for people with ID living in rural areas. Conversely, aspects of rural life such as community spirit and social support may protect against social exclusion in this population. This study was designed to compare a number of measures of social exclusion in adults with ID living in rural and urban areas, with the aim of identifying whether a double disadvantage exists. METHOD Adults with ID were recruited from a rural and an urban area in Scotland. Participants participated in a face-to-face interview and their medical notes were accessed. Social exclusion was investigated using a number of measures comprising: daytime opportunities and physical access to community facilities (using part of the British Institute of Learning Disabilities questionnaire), recent contact with others and the quality of personal relationships (using a modified Interview Measure of Social Relationships questionnaire) and area deprivation by postcode (using the Scottish Index of Multiple Deprivation). The data were analysed using a series of binary logistic regression models that adjusted for variables including age, gender, level of ID, mental illhealth and common physical co-morbidities. RESULTS A representative sample of adults with ID from rural (n = 39) and urban (n = 633) areas participated. Participants from rural areas were significantly more likely to have any regular daytime opportunity [odds ratio (OR) = 10.8, 95% CI = 2.3-51.5] including employment (OR = 22.1, 95% CI = 5.7-85.5) and attending resource centres (OR = 6.7, 95% CI = 2.6-17.2) than were participants from urban areas. They were also more likely to have been on holiday (OR = 17.8, 95% CI = 4.9-60.1); however, were less likely to use community facilities on a regular basis. Participants from urban and rural areas had a similar number of contacts with other people in a wide range of situations, but the quality of relationships may have been less close in rural areas. Finally, participants lived in significantly less deprived areas when in rural compared with urban areas (Mann-Whitney U = 7826, Z = -3.675, P ≤ 0.001). CONCLUSIONS These results suggest that adults with ID living in rural areas have better opportunities and live in less deprived areas than adults with ID living in urban areas. However, they may not hold such positive or close relationships, and this may be important when considering the subjective experience of social exclusion.
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Affiliation(s)
- L Nicholson
- Learning Disabilities Psychiatry, NHS Greater Glasgow and Clyde, Glasgow, UK
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Husain N, Gokhale J, Nicholson L, Holzer R, Cua C. STRAIN RATE CORRELATES BETTER THAN TISSUE DOPPLER VALUES IN ESTIMATING VENTRICULAR FILLING PRESSURES IN PATIENTS WITH SINGLE RIGHT VENTRICLES. J Am Coll Cardiol 2013. [DOI: 10.1016/s0735-1097(13)60460-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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Slater SJ, Nicholson L, Chriqui J, Barker DC, Chaloupka FJ, Johnston LD. Walkable communities and adolescent weight. Am J Prev Med 2013; 44:164-8. [PMID: 23332334 PMCID: PMC3553501 DOI: 10.1016/j.amepre.2012.10.015] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2012] [Revised: 08/28/2012] [Accepted: 10/05/2012] [Indexed: 11/19/2022]
Abstract
BACKGROUND Neighborhood design features have been associated with health outcomes, including the prevalence of obesity. PURPOSE This study examined the association between walkability and adolescent weight in a national sample of public secondary school students and the communities in which they live. METHODS Data were collected through student surveys and community observations between February and August 2010, and analyses were conducted in Spring 2012. The sample size was 154 communities and 11,041 students. A community walkability index and measures of the prevalence of adolescent overweight and obesity were constructed. Multivariable analyses from a cross-sectional survey of a nationally representative sample of 8th-, 10th- and 12th-grade public school students in the U.S. were run. RESULTS The odds of students being overweight (AOR 0.98, 95% CI=0.95, 0.99) or obese (AOR=0.97, 95% CI=0.95, 0.99) decreased if they lived in communities with higher walkability index scores. CONCLUSIONS Results suggest that living in more-walkable communities is associated with reduced prevalence of adolescent overweight and obesity.
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Affiliation(s)
- Sandy J Slater
- Institute for Health Research and Policy, Chicago, Illinois, USA.
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Tedder RS, Tuke P, Wallis N, Wright M, Nicholson L, Grant PR. Therapy-induced clearance of HCV core antigen from plasma predicts an end of treatment viral response. J Viral Hepat 2013; 20:65-71. [PMID: 23231086 DOI: 10.1111/j.1365-2893.2012.01630.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
During viral assembly, viral proteins are released into plasma and can be used to infer viral load. The Architect hepatitis C virus (HCV) core antigen (Ag) assay is a potential alternative to HCV RNA quantification for measuring response to therapy and predicting an end of treatment viral response (EOTR). The HCVp22Ag assay was used to infer viral load in 68 window RNA-containing samples and in 284 samples from baseline to week 14 of ribavirin/interferon treatment in 23 patients with EOTR including three who relapsed, 20 not achieving EOTR and 11 controls. HCV Ag and RNA correlated well (r = 0.86) with linear dose responses on dilution. In patients on therapy and control patients, plasma HCV antigen was detected in 51 of 54 with an interpolated LOD cut off between 10(3) and 10(4) RNA IU/mL. Plasma HCV antigenaemia and plasma RNA levels were significantly different in EOTR from non-EOTR patients at 3 days after treatment start and all times thereafter. Positive and negative EOTR predictive values for HCV RNA >2 log drop and HCV Ag loss at 12 weeks were 70% and 74%, 85% and 93% respectively. HCV Ag reactivity has a linear dose response independent of genotype and correlates well with HCV RNA. The failure to clear HCV Ag is as accurate as the failure to clear HCV RNA at twelve weeks into therapy in predicting the likelihood of failure to achieve EOTR. HCV Ag potentially offers a convenient alternative to RNA measurement for defining a futility flag in HCV therapy.
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Affiliation(s)
- R S Tedder
- Virus Reference Department, Health Protection Agency, London, UK.
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Gokhale J, Husain N, Nicholson L, Texter KM, Zaidi AN, Cua CL. QRS duration and mechanical dyssynchrony correlations with right ventricular function after fontan procedure. J Am Soc Echocardiogr 2012; 26:154-9. [PMID: 23218964 DOI: 10.1016/j.echo.2012.10.018] [Citation(s) in RCA: 17] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2012] [Indexed: 11/17/2022]
Abstract
BACKGROUND In studies of adult patients, increased QRS duration and mechanical dyssynchrony have been associated with decreased ventricular function. The aim of this study was to test the hypothesis that similar findings would be present in a population of patients with hypoplastic left heart syndrome (HLHS) after the Fontan procedure. METHODS A retrospective cross-sectional study was conducted. All patients with HLHS after the Fontan procedure were eligible. QRS duration was measured using 12-lead electrocardiography. Echocardiographic measurements of mechanical dyssynchrony included Doppler tissue imaging (DTI) QRS to onset of s' wave difference between the left ventricle and the right ventricle, time to peak strain, time to peak systolic strain rate (SRs), the standard deviation of time to peak strain rate (modified Yu strain), and the standard deviation of time to peak SRs (modified Yu SRs). Right ventricular (RV) functional measurements included DTI s' wave, DTI RV myocardial performance index, global strain, global SRs, and RV fractional area change. Pearson's correlations were performed between the variables. RESULTS Thirty-one echocardiographic studies were performed on 26 patients. The median age was 5.3 years (range, 2.5-15.4 years). QRS duration was correlated significantly with global SRs (r = 0.42). Time to peak SRs was correlated significantly with DTI s' wave (r = -0.48) and global SRs (r = 0.37). Modified Yu SRs was correlated significantly with global strain (r = 0.35) and RV fractional area change (r = -0.35). CONCLUSIONS Both QRS duration and mechanical dyssynchrony were correlated with RV function, albeit weakly. The clinical significance of these findings is intriguing, but only larger studies will determine if these measurements are reliable in guiding treatment options for this complex patient population.
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Affiliation(s)
- Janaki Gokhale
- The Heart Center, Nationwide Children's Hospital, Columbus, Ohio, USA.
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Zaidi AN, White L, Holt R, Cismowski M, Nicholson L, Cook SC, Daniels CJ, Cua CL. Correlation of Serum Biomarkers in Adults with Single Ventricles with Strain and Strain Rate Using 2D Speckle Tracking. CONGENIT HEART DIS 2012; 8:255-65. [DOI: 10.1111/chd.12006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/11/2012] [Indexed: 12/01/2022]
Affiliation(s)
| | - Leah White
- The Davis Heart and Lung Research Institute; The Ohio State University; Columbus; Ohio; USA
| | - Roger Holt
- The Davis Heart and Lung Research Institute; The Ohio State University; Columbus; Ohio; USA
| | - Mary Cismowski
- The Center for Cardiovascular and Pulmonary Research; Nationwide Children's Hospital; Columbus; Ohio; USA
| | - Lisa Nicholson
- Institute for Health Research and Policy; The University of Illinois at Chicago; Chicago; Ill; USA
| | | | | | - Clifford L. Cua
- Columbus Ohio Adult Congenital Heart Disease Program; The Heart Center; Nationwide Children's Hospital; Columbus; Ohio; USA
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