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Mendenhall R, Lee MJ, Cole SW, Morrow R, Rodriguez-Zas SL, Henderson L, Turi KN, Greenlee A. Black Mothers in Racially Segregated Neighborhoods Embodying Structural Violence: PTSD and Depressive Symptoms on the South Side of Chicago. J Racial Ethn Health Disparities 2023; 10:2513-2527. [PMID: 36715821 PMCID: PMC9885931 DOI: 10.1007/s40615-022-01432-1] [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: 07/16/2022] [Revised: 10/12/2022] [Accepted: 10/12/2022] [Indexed: 01/31/2023]
Abstract
This study employs multi-level and mixed-methods approaches to examine how structural violence affects the health of low-income, single Black mothers. We use multilevel regression models to examine how feeling "trapped" in racially segregated neighborhoods with high levels of violence on the South Side of Chicago affects mothers' (N = 69) reports of posttraumatic stress disorder and depressive symptoms. The relationship between feeling "trapped" and variations in expression of mRNA for the glucocorticoid receptor gene NR3C1 using microarray assays was also examined. The regression models revealed that feeling "trapped" significantly predicted increased mental distress in the form of PTSD, depressive symptoms, and glucocorticoid receptor gene regulation. The mothers' voices revealed a nuanced understanding about how a lack of financial resources to move out of the neighborhood creates feelings of being "trapped" in dangerous situations.
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Affiliation(s)
- Ruby Mendenhall
- Department of African American Studies, Carle Illinois College of Medicine, 702 S. Wright Ave, Urbana, IL 61822 USA
- Department of Sociology, University of Illinois, Urbana-Champaign, 702 South Wright St, Champaign, IL 61820 USA
| | - Meggan J. Lee
- Department of Sociology, University of Illinois, Urbana-Champaign, 702 South Wright St, Champaign, IL 61820 USA
| | - Steven W. Cole
- Department of Psychiatry & Biobehavioral Sciences and Medicine, UCLA School of Medicine, 11-934 Factor Building, Los Angeles, CA 90095 USA
| | - Rebecca Morrow
- Department of Criminal Justice, Tarleton State University, 1333 Washington Street, Stephenville, TX T-0665 USA
| | - Sandra L. Rodriguez-Zas
- Department of Animal Sciences, University of Illinois, Urbana-Champaign, 306 Animal Sciences Laboratory, 1207 W. Gregory Dr., Urbana, IL 61801 USA
| | - Loren Henderson
- School of Public Policy, University of Maryland, Baltimore County, Public Policy Building, Fourth Floor, 1000 Hilltop Circle, Baltimore, MD 21250 USA
| | - Kedir N. Turi
- Center for Asthma Research, Vanderbilt University School of Medicine, 1215 21ts Ave South, 6000 Medical Center East, North Tower, Nashville, TN 37232 USA
| | - Andrew Greenlee
- Department of Urban and Regional Planning, University of Illinois, Urbana-Champaign 611 Taft Drive, Champaign, IL 61820 USA
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Smitherman EA, Chahine RA, Beukelman T, Lewandowski LB, Rahman AKMF, Wenderfer SE, Curtis JR, Hersh AO, Abulaban K, Adams A, Adams M, Agbayani R, Aiello J, Akoghlanian S, Alejandro C, Allenspach E, Alperin R, Alpizar M, Amarilyo G, Ambler W, Anderson E, Ardoin S, Armendariz S, Baker E, Balboni I, Balevic S, Ballenger L, Ballinger S, Balmuri N, Barbar‐Smiley F, Barillas‐Arias L, Basiaga M, Baszis K, Becker M, Bell‐Brunson H, Beltz E, Benham H, Benseler S, Bernal W, Beukelman T, Bigley T, Binstadt B, Black C, Blakley M, Bohnsack J, Boland J, Boneparth A, Bowman S, Bracaglia C, Brooks E, Brothers M, Brown A, Brunner H, Buckley M, Buckley M, Bukulmez H, Bullock D, Cameron B, Canna S, Cannon L, Carper P, Cartwright V, Cassidy E, Cerracchio L, Chalom E, Chang J, Chang‐Hoftman A, Chauhan V, Chira P, Chinn T, Chundru K, Clairman H, Co D, Confair A, Conlon H, Connor R, Cooper A, Cooper J, Cooper S, Correll C, Corvalan R, Costanzo D, Cron R, Curiel‐Duran L, Curington T, Curry M, Dalrymple A, Davis A, Davis C, Davis C, Davis T, De Benedetti F, De Ranieri D, Dean J, Dedeoglu F, DeGuzman M, Delnay N, Dempsey V, DeSantis E, Dickson T, Dingle J, Donaldson B, Dorsey E, Dover S, Dowling J, Drew J, Driest K, Du Q, Duarte K, Durkee D, Duverger E, Dvergsten J, Eberhard A, Eckert M, Ede K, Edelheit B, Edens C, Edens C, Edgerly Y, Elder M, Ervin B, Fadrhonc S, Failing C, Fair D, Falcon M, Favier L, Federici S, Feldman B, Fennell J, Ferguson I, Ferguson P, Ferreira B, Ferrucho R, Fields K, Finkel T, Fitzgerald M, Fleming C, Flynn O, Fogel L, Fox E, Fox M, Franco L, Freeman M, Fritz K, Froese S, Fuhlbrigge R, Fuller J, George N, Gerhold K, Gerstbacher D, Gilbert M, Gillispie‐Taylor M, Giverc E, Godiwala C, Goh I, Goheer H, Goldsmith D, Gotschlich E, Gotte A, Gottlieb B, Gracia C, Graham T, Grevich S, Griffin T, Griswold J, Grom A, Guevara M, Guittar P, Guzman M, Hager M, Hahn T, Halyabar O, Hammelev E, Hance M, Hanson A, Harel L, Haro S, Harris J, Harry O, Hartigan E, Hausmann J, Hay A, Hayward K, Heiart J, Hekl K, Henderson L, Henrickson M, Hersh A, Hickey K, Hill P, Hillyer S, Hiraki L, Hiskey M, Hobday P, Hoffart C, Holland M, Hollander M, Hong S, Horwitz M, Hsu J, Huber A, Huggins J, Hui‐Yuen J, Hung C, Huntington J, Huttenlocher A, Ibarra M, Imundo L, Inman C, Insalaco A, Jackson A, Jackson S, James K, Janow G, Jaquith J, Jared S, Johnson N, Jones J, Jones J, Jones J, Jones K, Jones S, Joshi S, Jung L, Justice C, Justiniano A, Karan N, Kaufman K, Kemp A, Kessler E, Khalsa U, Kienzle B, Kim S, Kimura Y, Kingsbury D, Kitcharoensakkul M, Klausmeier T, Klein K, Klein‐Gitelman M, Kompelien B, Kosikowski A, Kovalick L, Kracker J, Kramer S, Kremer C, Lai J, Lam J, Lang B, Lapidus S, Lapin B, Lasky A, Latham D, Lawson E, Laxer R, Lee P, Lee P, Lee T, Lentini L, Lerman M, Levy D, Li S, Lieberman S, Lim L, Lin C, Ling N, Lingis M, Lo M, Lovell D, Lowman D, Luca N, Lvovich S, Madison C, Madison J, Manzoni SM, Malla B, Maller J, Malloy M, Mannion M, Manos C, Marques L, Martyniuk A, Mason T, Mathus S, McAllister L, McCarthy K, McConnell K, McCormick E, McCurdy D, Stokes PM, McGuire S, McHale I, McMonagle A, McMullen‐Jackson C, Meidan E, Mellins E, Mendoza E, Mercado R, Merritt A, Michalowski L, Miettunen P, Miller M, Milojevic D, Mirizio E, Misajon E, Mitchell M, Modica R, Mohan S, Moore K, Moorthy L, Morgan S, Dewitt EM, Moss C, Moussa T, Mruk V, Murphy A, Muscal E, Nadler R, Nahal B, Nanda K, Nasah N, Nassi L, Nativ S, Natter M, Neely J, Nelson B, Newhall L, Ng L, Nicholas J, Nicolai R, Nigrovic P, Nocton J, Nolan B, Oberle E, Obispo B, O'Brien B, O'Brien T, Okeke O, Oliver M, Olson J, O'Neil K, Onel K, Orandi A, Orlando M, Osei‐Onomah S, Oz R, Pagano E, Paller A, Pan N, Panupattanapong S, Pardeo M, Paredes J, Parsons A, Patel J, Pentakota K, Pepmueller P, Pfeiffer T, Phillippi K, Marafon DP, Phillippi K, Ponder L, Pooni R, Prahalad S, Pratt S, Protopapas S, Puplava B, Quach J, Quinlan‐Waters M, Rabinovich C, Radhakrishna S, Rafko J, Raisian J, Rakestraw A, Ramirez C, Ramsay E, Ramsey S, Randell R, Reed A, Reed A, Reed A, Reid H, Remmel K, Repp A, Reyes A, Richmond A, Riebschleger M, Ringold S, Riordan M, Riskalla M, Ritter M, Rivas‐Chacon R, Robinson A, Rodela E, Rodriquez M, Rojas K, Ronis T, Rosenkranz M, Rosolowski B, Rothermel H, Rothman D, Roth‐Wojcicki E, Rouster – Stevens K, Rubinstein T, Ruth N, Saad N, Sabbagh S, Sacco E, Sadun R, Sandborg C, Sanni A, Santiago L, Sarkissian A, Savani S, Scalzi L, Schanberg L, Scharnhorst S, Schikler K, Schlefman A, Schmeling H, Schmidt K, Schmitt E, Schneider R, Schollaert‐Fitch K, Schulert G, Seay T, Seper C, Shalen J, Sheets R, Shelly A, Shenoi S, Shergill K, Shirley J, Shishov M, Shivers C, Silverman E, Singer N, Sivaraman V, Sletten J, Smith A, Smith C, Smith J, Smith J, Smitherman E, Soep J, Son M, Spence S, Spiegel L, Spitznagle J, Sran R, Srinivasalu H, Stapp H, Steigerwald K, Rakovchik YS, Stern S, Stevens A, Stevens B, Stevenson R, Stewart K, Stingl C, Stokes J, Stoll M, Stringer E, Sule S, Sumner J, Sundel R, Sutter M, Syed R, Syverson G, Szymanski A, Taber S, Tal R, Tambralli A, Taneja A, Tanner T, Tapani S, Tarshish G, Tarvin S, Tate L, Taxter A, Taylor J, Terry M, Tesher M, Thatayatikom A, Thomas B, Tiffany K, Ting T, Tipp A, Toib D, Torok K, Toruner C, Tory H, Toth M, Tse S, Tubwell V, Twilt M, Uriguen S, Valcarcel T, Van Mater H, Vannoy L, Varghese C, Vasquez N, Vazzana K, Vehe R, Veiga K, Velez J, Verbsky J, Vilar G, Volpe N, von Scheven E, Vora S, Wagner J, Wagner‐Weiner L, Wahezi D, Waite H, Walker J, Walters H, Muskardin TW, Waqar L, Waterfield M, Watson M, Watts A, Weiser P, Weiss J, Weiss P, Wershba E, White A, Williams C, Wise A, Woo J, Woolnough L, Wright T, Wu E, Yalcindag A, Yee M, Yen E, Yeung R, Yomogida K, Yu Q, Zapata R, Zartoshti A, Zeft A, Zeft R, Zhang Y, Zhao Y, Zhu A, Zic C. Childhood-Onset Lupus Nephritis in the Childhood Arthritis and Rheumatology Research Alliance Registry: Short-Term Kidney Status and Variation in Care. Arthritis Care Res (Hoboken) 2023; 75:1553-1562. [PMID: 36775844 PMCID: PMC10500561 DOI: 10.1002/acr.25002] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 07/14/2022] [Accepted: 08/16/2022] [Indexed: 11/10/2022]
Abstract
OBJECTIVE The goal was to characterize short-term kidney status and describe variation in early care utilization in a multicenter cohort of patients with childhood-onset systemic lupus erythematosus (cSLE) and nephritis. METHODS We analyzed previously collected prospective data from North American patients with cSLE with kidney biopsy-proven nephritis enrolled in the Childhood Arthritis and Rheumatology Research Alliance (CARRA) Registry from March 2017 through December 2019. We determined the proportion of patients with abnormal kidney status at the most recent registry visit and applied generalized linear mixed models to identify associated factors. We also calculated frequency of medication use, both during induction and ever recorded. RESULTS We identified 222 patients with kidney biopsy-proven nephritis, with 64% class III/IV nephritis on initial biopsy. At the most recent registry visit at median (interquartile range) of 17 (8-29) months from initial kidney biopsy, 58 of 106 patients (55%) with available data had abnormal kidney status. This finding was associated with male sex (odds ratio [OR] 3.88, 95% confidence interval [95% CI] 1.21-12.46) and age at cSLE diagnosis (OR 1.23, 95% CI 1.01-1.49). Patients with class IV nephritis were more likely than class III to receive cyclophosphamide and rituximab during induction. There was substantial variation in mycophenolate, cyclophosphamide, and rituximab ever use patterns across rheumatology centers. CONCLUSION In this cohort with predominately class III/IV nephritis, male sex and older age at cSLE diagnosis were associated with abnormal short-term kidney status. We also observed substantial variation in contemporary medication use for pediatric lupus nephritis between pediatric rheumatology centers. Additional studies are needed to better understand the impact of this variation on long-term kidney outcomes.
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Cairney T, Robertson S, Henderson L, Jacob SA, Forsyth P. Pharmacy technician-led general practice support hub: a feasibility study. International Journal of Pharmacy Practice 2022. [DOI: 10.1093/ijpp/riac089.009] [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: 12/03/2022]
Abstract
Abstract
Introduction
Workforce pressures in general practice have led to Scottish Government initiatives to integrate pharmacy teams into general practice. The focus is completion of prescribing management-related activities releasing general practitioner time for patient-focused workload.1 Activities include medicines reconciliation from immediate discharge letters (IDL), processing outpatient prescription requests (OPL) and special request prescriptions (SR). Pharmacists effectively mobilise GP capacity completing these tasks.2 However, pharmacists may aspire to advanced practice roles including medication review case-load management. Therefore, alternative workload delivery models including centralised pharmacy technician-led general practice support hubs to complete IDL, OPL and SR tasks must be considered. National guidance outlines that pharmacy technicians may complete these tasks autonomously with minimal supervision.3 Unknowns include whether pharmacy technicians can lead this service delivery and the definition of the supervisory support required.
Aim
To evaluate the feasibility of a pharmacy technician-led hub for completion of SR, IDL and OPL.
Methods
Feasibility was studied over 4 weeks (12 April – 7 May 2021) during routine service delivery across three medical practices (approx. 23 800 patients) in NHS Greater Glasgow and Clyde. Quantitative real-time self-reported data on the volume of tasks (SR/IDL/OPL), task completion time and volume of pharmacist referrals was collected by pharmacy technicians and pharmacists and analysed in Microsoft Excel®. Qualitative data describing why pharmacy technicians referred tasks to pharmacists was collected and categorized using thematic analysis and Microsoft Excel® by the lead author. Ethical approval was not required for this service evaluation.
Results
4485 total tasks were completed: SR 87% (n=3917); IDL 7% (n=323); OPL 6% (n=245). Pharmacy technicians completed most (71%; n=3181) prescribing management-related tasks. A service delivery gap (21%; n=921 of tasks) where workload exceeded technician resource, necessitated pharmacist support. Referral rate for tasks beyond technician competence was 11% (n=383). The locally agreed 48-hour benchmark turnaround to process tasks was achieved for the majority of tasks. Breaches of the target were noted: 53 (1%) SR; 10 (3%) IDL and 5 (2%) OPL. Technicians and pharmacists completed tasks in numerically similar times. 383 tasks were referred to a pharmacist. 134 (35%) tasks could only be completed by a pharmacists due to the need for a prescribing decision or pharmacist-specific knowledge. 226 (59%) could be completed by a technician with additional knowledge or training. Examples include queries requiring interpretation of clinical parameters or blood monitoring or answering medicines information enquiries. 6% (n=23) of referrals were uncategorised due to incomplete data collection.
Discussion/Conclusion
This study provides new information describing the workload volume achieved by pharmacy technicians and characterising the supervisory role of the pharmacist. Pharmacy technicians convincingly completed most activities. Service delivery gaps need addressed including maintenance of service delivery during periods of authorised absence and professional development time. Pharmacist referral rate can be improved by upskilling pharmacy technicians. The volume of SR tasks drives the workload and could be managed more effectively by converting suitable SR tasks to controlled repeats. A Health Improvement Scotland initiative is developing this work stream. Additional projects must identify training gaps to understand technician development needs and analyse achievement of advanced pharmacist activities where technician-led hub exists.
References
1. Scottish Government. Achieving Excellence in Pharmaceutical Care: A Strategy for Scotland. Edinburgh. The Scottish Government, 2017
2. Maskrey M, Johnson CF, Cormack J et al. Releasing GP capacity with pharmacy prescribing support and New Ways of Working: a prospective observational cohort study. Brit J Gen Pract. 2018;68(675):e735-e42
3. Scottish Pharmacy Practice and Prescribing Advisers Association. National Pharmacotherapy Service Specification V4, 2021
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Affiliation(s)
- T Cairney
- NHS Greater Glasgow and Clyde
- University of Strathclyde
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Hahn T, Daymont C, Beukelman T, Groh B, Hays K, Bingham CA, Scalzi L, Abel N, Abulaban K, Adams A, Adams M, Agbayani R, Aiello J, Akoghlanian S, Alejandro C, Allenspach E, Alperin R, Alpizar M, Amarilyo G, Ambler W, Anderson E, Ardoin S, Armendariz S, Baker E, Balboni I, Balevic S, Ballenger L, Ballinger S, Balmuri N, Barbar-Smiley F, Barillas-Arias L, Basiaga M, Baszis K, Becker M, Bell-Brunson H, Beltz E, Benham H, Benseler S, Bernal W, Beukelman T, Bigley T, Binstadt B, Black C, Blakley M, Bohnsack J, Boland J, Boneparth A, Bowman S, Bracaglia C, Brooks E, Brothers M, Brown A, Brunner H, Buckley M, Buckley M, Bukulmez H, Bullock D, Cameron B, Canna S, Cannon L, Carper P, Cartwright V, Cassidy E, Cerracchio L, Chalom E, Chang J, Chang-Hoftman A, Chauhan V, Chira P, Chinn T, Chundru K, Clairman H, Co D, Confair A, Conlon H, Connor R, Cooper A, Cooper J, Cooper S, Correll C, Corvalan R, Costanzo D, Cron R, Curiel-Duran L, Curington T, Curry M, Dalrymple A, Davis A, Davis C, Davis C, Davis T, De Benedetti F, De Ranieri D, Dean J, Dedeoglu F, DeGuzman M, Delnay N, Dempsey V, DeSantis E, Dickson T, Dingle J, Donaldson B, Dorsey E, Dover S, Dowling J, Drew J, Driest K, Du Q, Duarte K, Durkee D, Duverger E, Dvergsten J, Eberhard A, Eckert M, Ede K, Edelheit B, Edens C, Edens C, Edgerly Y, Elder M, Ervin B, Fadrhonc S, Failing C, Fair D, Falcon M, Favier L, Federici S, Feldman B, Fennell J, Ferguson I, Ferguson P, Ferreira B, Ferrucho R, Fields K, Finkel T, Fitzgerald M, Fleming C, Flynn O, Fogel L, Fox E, Fox M, Franco L, Freeman M, Fritz K, Froese S, Fuhlbrigge R, Fuller J, George N, Gerhold K, Gerstbacher D, Gilbert M, Gillispie-Taylor M, Giverc E, Godiwala C, Goh I, Goheer H, Goldsmith D, Gotschlich E, Gotte A, Gottlieb B, Gracia C, Graham T, Grevich S, Griffin T, Griswold J, Grom A, Guevara M, Guittar P, Guzman M, Hager M, Hahn T, Halyabar O, Hammelev E, Hance M, Hanson A, Harel L, Haro S, Harris J, Harry O, Hartigan E, Hausmann J, Hay A, Hayward K, Heiart J, Hekl K, Henderson L, Henrickson M, Hersh A, Hickey K, Hill P, Hillyer S, Hiraki L, Hiskey M, Hobday P, Hoffart C, Holland M, Hollander M, Hong S, Horwitz M, Hsu J, Huber A, Huggins J, Hui-Yuen J, Hung C, Huntington J, Huttenlocher A, Ibarra M, Imundo L, Inman C, Insalaco A, Jackson A, Jackson S, James K, Janow G, Jaquith J, Jared S, Johnson N, Jones J, Jones J, Jones J, Jones K, Jones S, Joshi S, Jung L, Justice C, Justiniano A, Karan N, Kaufman K, Kemp A, Kessler E, Khalsa U, Kienzle B, Kim S, Kimura Y, Kingsbury D, Kitcharoensakkul M, Klausmeier T, Klein K, Klein-Gitelman M, Kompelien B, Kosikowski A, Kovalick L, Kracker J, Kramer S, Kremer C, Lai J, Lam J, Lang B, Lapidus S, Lapin B, Lasky A, Latham D, Lawson E, Laxer R, Lee P, Lee P, Lee T, Lentini L, Lerman M, Levy D, Li S, Lieberman S, Lim L, Lin C, Ling N, Lingis M, Lo M, Lovell D, Lowman D, Luca N, Lvovich S, Madison C, Madison J, Manzoni SM, Malla B, Maller J, Malloy M, Mannion M, Manos C, Marques L, Martyniuk A, Mason T, Mathus S, McAllister L, McCarthy K, McConnell K, McCormick E, McCurdy D, Stokes PMC, McGuire S, McHale I, McMonagle A, McMullen-Jackson C, Meidan E, Mellins E, Mendoza E, Mercado R, Merritt A, Michalowski L, Miettunen P, Miller M, Milojevic D, Mirizio E, Misajon E, Mitchell M, Modica R, Mohan S, Moore K, Moorthy L, Morgan S, Dewitt EM, Moss C, Moussa T, Mruk V, Murphy A, Muscal E, Nadler R, Nahal B, Nanda K, Nasah N, Nassi L, Nativ S, Natter M, Neely J, Nelson B, Newhall L, Ng L, Nicholas J, Nicolai R, Nigrovic P, Nocton J, Nolan B, Oberle E, Obispo B, O’Brien B, O’Brien T, Okeke O, Oliver M, Olson J, O’Neil K, Onel K, Orandi A, Orlando M, Osei-Onomah S, Oz R, Pagano E, Paller A, Pan N, Panupattanapong S, Pardeo M, Paredes J, Parsons A, Patel J, Pentakota K, Pepmueller P, Pfeiffer T, Phillippi K, Marafon DP, Phillippi K, Ponder L, Pooni R, Prahalad S, Pratt S, Protopapas S, Puplava B, Quach J, Quinlan-Waters M, Rabinovich C, Radhakrishna S, Rafko J, Raisian J, Rakestraw A, Ramirez C, Ramsay E, Ramsey S, Randell R, Reed A, Reed A, Reed A, Reid H, Remmel K, Repp A, Reyes A, Richmond A, Riebschleger M, Ringold S, Riordan M, Riskalla M, Ritter M, Rivas-Chacon R, Robinson A, Rodela E, Rodriquez M, Rojas K, Ronis T, Rosenkranz M, Rosolowski B, Rothermel H, Rothman D, Roth-Wojcicki E, Rouster-Stevens K, Rubinstein T, Ruth N, Saad N, Sabbagh S, Sacco E, Sadun R, Sandborg C, Sanni A, Santiago L, Sarkissian A, Savani S, Scalzi L, Schanberg L, Scharnhorst S, Schikler K, Schlefman A, Schmeling H, Schmidt K, Schmitt E, Schneider R, Schollaert-Fitch K, Schulert G, Seay T, Seper C, Shalen J, Sheets R, Shelly A, Shenoi S, Shergill K, Shirley J, Shishov M, Shivers C, Silverman E, Singer N, Sivaraman V, Sletten J, Smith A, Smith C, Smith J, Smith J, Smitherman E, Soep J, Son M, Spence S, Spiegel L, Spitznagle J, Sran R, Srinivasalu H, Stapp H, Steigerwald K, Rakovchik YS, Stern S, Stevens A, Stevens B, Stevenson R, Stewart K, Stingl C, Stokes J, Stoll M, Stringer E, Sule S, Sumner J, Sundel R, Sutter M, Syed R, Syverson G, Szymanski A, Taber S, Tal R, Tambralli A, Taneja A, Tanner T, Tapani S, Tarshish G, Tarvin S, Tate L, Taxter A, Taylor J, Terry M, Tesher M, Thatayatikom A, Thomas B, Tiffany K, Ting T, Tipp A, Toib D, Torok K, Toruner C, Tory H, Toth M, Tse S, Tubwell V, Twilt M, Uriguen S, Valcarcel T, Van Mater H, Vannoy L, Varghese C, Vasquez N, Vazzana K, Vehe R, Veiga K, Velez J, Verbsky J, Vilar G, Volpe N, von Scheven E, Vora S, Wagner J, Wagner-Weiner L, Wahezi D, Waite H, Walker J, Walters H, Muskardin TW, Waqar L, Waterfield M, Watson M, Watts A, Weiser P, Weiss J, Weiss P, Wershba E, White A, Williams C, Wise A, Woo J, Woolnough L, Wright T, Wu E, Yalcindag A, Yee M, Yen E, Yeung R, Yomogida K, Yu Q, Zapata R, Zartoshti A, Zeft A, Zeft R, Zhang Y, Zhao Y, Zhu A, Zic C. Intraarticular steroids as DMARD-sparing agents for juvenile idiopathic arthritis flares: Analysis of the Childhood Arthritis and Rheumatology Research Alliance Registry. Pediatr Rheumatol Online J 2022; 20:107. [PMID: 36434731 PMCID: PMC9701017 DOI: 10.1186/s12969-022-00770-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Accepted: 11/08/2022] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Children with juvenile idiopathic arthritis (JIA) who achieve a drug free remission often experience a flare of their disease requiring either intraarticular steroids (IAS) or systemic treatment with disease modifying anti-rheumatic drugs (DMARDs). IAS offer an opportunity to recapture disease control and avoid exposure to side effects from systemic immunosuppression. We examined a cohort of patients treated with IAS after drug free remission and report the probability of restarting systemic treatment within 12 months. METHODS We analyzed a cohort of patients from the Childhood Arthritis and Rheumatology Research Alliance (CARRA) Registry who received IAS for a flare after a period of drug free remission. Historical factors and clinical characteristics and of the patients including data obtained at the time of treatment were analyzed. RESULTS We identified 46 patients who met the inclusion criteria. Of those with follow up data available 49% had restarted systemic treatment 6 months after IAS injection and 70% had restarted systemic treatment at 12 months. The proportion of patients with prior use of a biologic DMARD was the only factor that differed between patients who restarted systemic treatment those who did not, both at 6 months (79% vs 35%, p < 0.01) and 12 months (81% vs 33%, p < 0.05). CONCLUSION While IAS are an option for all patients who flare after drug free remission, it may not prevent the need to restart systemic treatment. Prior use of a biologic DMARD may predict lack of success for IAS. Those who previously received methotrexate only, on the other hand, are excellent candidates for IAS.
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Affiliation(s)
- Timothy Hahn
- Department of Pediatrics, Penn State Children's Hospital, 500 University Dr, Hershey, 90 Hope Drive, P.O. Box 855, Hershey, PA, 17033-0855, USA.
| | - Carrie Daymont
- grid.240473.60000 0004 0543 9901Department of Pediatrics, Penn State Children’s Hospital, 500 University Dr, Hershey, 90 Hope Drive, P.O. Box 855, Hershey, PA 17033-0855 USA
| | - Timothy Beukelman
- grid.265892.20000000106344187Department of Pediatrics, University of Alabama at Birmingham, CPPN G10, 1600 7th Ave South, Birmingham, AL 35233 USA
| | - Brandt Groh
- grid.240473.60000 0004 0543 9901Department of Pediatrics, Penn State Children’s Hospital, 500 University Dr, Hershey, 90 Hope Drive, P.O. Box 855, Hershey, PA 17033-0855 USA
| | | | - Catherine April Bingham
- grid.240473.60000 0004 0543 9901Department of Pediatrics, Penn State Children’s Hospital, 500 University Dr, Hershey, 90 Hope Drive, P.O. Box 855, Hershey, PA 17033-0855 USA
| | - Lisabeth Scalzi
- grid.240473.60000 0004 0543 9901Department of Pediatrics, Penn State Children’s Hospital, 500 University Dr, Hershey, 90 Hope Drive, P.O. Box 855, Hershey, PA 17033-0855 USA
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Soulsby WD, Balmuri N, Cooley V, Gerber LM, Lawson E, Goodman S, Onel K, Mehta B, Abel N, Abulaban K, Adams A, Adams M, Agbayani R, Aiello J, Akoghlanian S, Alejandro C, Allenspach E, Alperin R, Alpizar M, Amarilyo G, Ambler W, Anderson E, Ardoin S, Armendariz S, Baker E, Balboni I, Balevic S, Ballenger L, Ballinger S, Balmuri N, Barbar-Smiley F, Barillas-Arias L, Basiaga M, Baszis K, Becker M, Bell-Brunson H, Beltz E, Benham H, Benseler S, Bernal W, Beukelman T, Bigley T, Binstadt B, Black C, Blakley M, Bohnsack J, Boland J, Boneparth A, Bowman S, Bracaglia C, Brooks E, Brothers M, Brown A, Brunner H, Buckley M, Buckley M, Bukulmez H, Bullock D, Cameron B, Canna S, Cannon L, Carper P, Cartwright V, Cassidy E, Cerracchio L, Chalom E, Chang J, Chang-Hoftman A, Chauhan V, Chira P, Chinn T, Chundru K, Clairman H, Co D, Confair A, Conlon H, Connor R, Cooper A, Cooper J, Cooper S, Correll C, Corvalan R, Costanzo D, Cron R, Curiel-Duran L, Curington T, Curry M, Dalrymple A, Davis A, Davis C, Davis C, Davis T, De Benedetti F, De Ranieri D, Dean J, Dedeoglu F, DeGuzman M, Delnay N, Dempsey V, DeSantis E, Dickson T, Dingle J, Donaldson B, Dorsey E, Dover S, Dowling J, Drew J, Driest K, Du Q, Duarte K, Durkee D, Duverger E, Dvergsten J, Eberhard A, Eckert M, Ede K, Edelheit B, Edens C, Edens C, Edgerly Y, Elder M, Ervin B, Fadrhonc S, Failing C, Fair D, Falcon M, Favier L, Federici S, Feldman B, Fennell J, Ferguson I, Ferguson P, Ferreira B, Ferrucho R, Fields K, Finkel T, Fitzgerald M, Fleming C, Flynn O, Fogel L, Fox E, Fox M, Franco L, Freeman M, Fritz K, Froese S, Fuhlbrigge R, Fuller J, George N, Gerhold K, Gerstbacher D, Gilbert M, Gillispie-Taylor M, Giverc E, Godiwala C, Goh I, Goheer H, Goldsmith D, Gotschlich E, Gotte A, Gottlieb B, Gracia C, Graham T, Grevich S, Griffin T, Griswold J, Grom A, Guevara M, Guittar P, Guzman M, Hager M, Hahn T, Halyabar O, Hammelev E, Hance M, Hanson A, Harel L, Haro S, Harris J, Harry O, Hartigan E, Hausmann J, Hay A, Hayward K, Heiart J, Hekl K, Henderson L, Henrickson M, Hersh A, Hickey K, Hill P, Hillyer S, Hiraki L, Hiskey M, Hobday P, Hoffart C, Holland M, Hollander M, Hong S, Horwitz M, Hsu J, Huber A, Huggins J, Hui-Yuen J, Hung C, Huntington J, Huttenlocher A, Ibarra M, Imundo L, Inman C, Insalaco A, Jackson A, Jackson S, James K, Janow G, Jaquith J, Jared S, Johnson N, Jones J, Jones J, Jones J, Jones K, Jones S, Joshi S, Jung L, Justice C, Justiniano A, Karan N, Kaufman K, Kemp A, Kessler E, Khalsa U, Kienzle B, Kim S, Kimura Y, Kingsbury D, Kitcharoensakkul M, Klausmeier T, Klein K, Klein-Gitelman M, Kompelien B, Kosikowski A, Kovalick L, Kracker J, Kramer S, Kremer C, Lai J, Lam J, Lang B, Lapidus S, Lapin B, Lasky A, Latham D, Lawson E, Laxer R, Lee P, Lee P, Lee T, Lentini L, Lerman M, Levy D, Li S, Lieberman S, Lim L, Lin C, Ling N, Lingis M, Lo M, Lovell D, Lowman D, Luca N, Lvovich S, Madison C, Madison J, Manzoni SM, Malla B, Maller J, Malloy M, Mannion M, Manos C, Marques L, Martyniuk A, Mason T, Mathus S, McAllister L, McCarthy K, McConnell K, McCormick E, McCurdy D, Stokes PMC, McGuire S, McHale I, McMonagle A, McMullen-Jackson C, Meidan E, Mellins E, Mendoza E, Mercado R, Merritt A, Michalowski L, Miettunen P, Miller M, Milojevic D, Mirizio E, Misajon E, Mitchell M, Modica R, Mohan S, Moore K, Moorthy L, Morgan S, Dewitt EM, Moss C, Moussa T, Mruk V, Murphy A, Muscal E, Nadler R, Nahal B, Nanda K, Nasah N, Nassi L, Nativ S, Natter M, Neely J, Nelson B, Newhall L, Ng L, Nicholas J, Nicolai R, Nigrovic P, Nocton J, Nolan B, Oberle E, Obispo B, O’Brien B, O’Brien T, Okeke O, Oliver M, Olson J, O’Neil K, Onel K, Orandi A, Orlando M, Osei-Onomah S, Oz R, Pagano E, Paller A, Pan N, Panupattanapong S, Pardeo M, Paredes J, Parsons A, Patel J, Pentakota K, Pepmueller P, Pfeiffer T, Phillippi K, Marafon DP, Phillippi K, Ponder L, Pooni R, Prahalad S, Pratt S, Protopapas S, Puplava B, Quach J, Quinlan-Waters M, Rabinovich C, Radhakrishna S, Rafko J, Raisian J, Rakestraw A, Ramirez C, Ramsay E, Ramsey S, Randell R, Reed A, Reed A, Reed A, Reid H, Remmel K, Repp A, Reyes A, Richmond A, Riebschleger M, Ringold S, Riordan M, Riskalla M, Ritter M, Rivas-Chacon R, Robinson A, Rodela E, Rodriquez M, Rojas K, Ronis T, Rosenkranz M, Rosolowski B, Rothermel H, Rothman D, Roth-Wojcicki E, Rouster-Stevens K, Rubinstein T, Ruth N, Saad N, Sabbagh S, Sacco E, Sadun R, Sandborg C, Sanni A, Santiago L, Sarkissian A, Savani S, Scalzi L, Schanberg L, Scharnhorst S, Schikler K, Schlefman A, Schmeling H, Schmidt K, Schmitt E, Schneider R, Schollaert-Fitch K, Schulert G, Seay T, Seper C, Shalen J, Sheets R, Shelly A, Shenoi S, Shergill K, Shirley J, Shishov M, Shivers C, Silverman E, Singer N, Sivaraman V, Sletten J, Smith A, Smith C, Smith J, Smith J, Smitherman E, Soep J, Son M, Spence S, Spiegel L, Spitznagle J, Sran R, Srinivasalu H, Stapp H, Steigerwald K, Rakovchik YS, Stern S, Stevens A, Stevens B, Stevenson R, Stewart K, Stingl C, Stokes J, Stoll M, Stringer E, Sule S, Sumner J, Sundel R, Sutter M, Syed R, Syverson G, Szymanski A, Taber S, Tal R, Tambralli A, Taneja A, Tanner T, Tapani S, Tarshish G, Tarvin S, Tate L, Taxter A, Taylor J, Terry M, Tesher M, Thatayatikom A, Thomas B, Tiffany K, Ting T, Tipp A, Toib D, Torok K, Toruner C, Tory H, Toth M, Tse S, Tubwell V, Twilt M, Uriguen S, Valcarcel T, Van Mater H, Vannoy L, Varghese C, Vasquez N, Vazzana K, Vehe R, Veiga K, Velez J, Verbsky J, Vilar G, Volpe N, von Scheven E, Vora S, Wagner J, Wagner-Weiner L, Wahezi D, Waite H, Walker J, Walters H, Muskardin TW, Waqar L, Waterfield M, Watson M, Watts A, Weiser P, Weiss J, Weiss P, Wershba E, White A, Williams C, Wise A, Woo J, Woolnough L, Wright T, Wu E, Yalcindag A, Yee M, Yen E, Yeung R, Yomogida K, Yu Q, Zapata R, Zartoshti A, Zeft A, Zeft R, Zhang Y, Zhao Y, Zhu A, Zic C. Social determinants of health influence disease activity and functional disability in Polyarticular Juvenile Idiopathic Arthritis. Pediatr Rheumatol Online J 2022; 20:18. [PMID: 35255941 PMCID: PMC8903717 DOI: 10.1186/s12969-022-00676-9] [Citation(s) in RCA: 4] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Accepted: 02/07/2022] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Social determinants of health (SDH) greatly influence outcomes during the first year of treatment in rheumatoid arthritis, a disease similar to polyarticular juvenile idiopathic arthritis (pJIA). We investigated the correlation of community poverty level and other SDH with the persistence of moderate to severe disease activity and functional disability over the first year of treatment in pJIA patients enrolled in the Childhood Arthritis and Rheumatology Research Alliance Registry. METHODS In this cohort study, unadjusted and adjusted generalized linear mixed effects models analyzed the effect of community poverty and other SDH on disease activity, using the clinical Juvenile Arthritis Disease Activity Score-10, and disability, using the Child Health Assessment Questionnaire, measured at baseline, 6, and 12 months. RESULTS One thousand six hundred eighty-four patients were identified. High community poverty (≥20% living below the federal poverty level) was associated with increased odds of functional disability (OR 1.82, 95% CI 1.28-2.60) but was not statistically significant after adjustment (aOR 1.23, 95% CI 0.81-1.86) and was not associated with increased disease activity. Non-white race/ethnicity was associated with higher disease activity (aOR 2.48, 95% CI: 1.41-4.36). Lower self-reported household income was associated with higher disease activity and persistent functional disability. Public insurance (aOR 1.56, 95% CI 1.06-2.29) and low family education (aOR 1.89, 95% CI 1.14-3.12) was associated with persistent functional disability. CONCLUSION High community poverty level was associated with persistent functional disability in unadjusted analysis but not with persistent moderate to high disease activity. Race/ethnicity and other SDH were associated with persistent disease activity and functional disability.
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Affiliation(s)
- William Daniel Soulsby
- University of California, San Francisco, 550 16th Street, 4th Floor, Box #0632, San Francisco, CA, 94158, USA.
| | - Nayimisha Balmuri
- grid.239915.50000 0001 2285 8823Hospital for Special Surgery, New York, NY USA ,grid.5386.8000000041936877XWeill Cornell Medicine, New York, NY USA
| | - Victoria Cooley
- grid.5386.8000000041936877XWeill Cornell Medicine, New York, NY USA
| | - Linda M. Gerber
- grid.5386.8000000041936877XWeill Cornell Medicine, New York, NY USA
| | - Erica Lawson
- grid.266102.10000 0001 2297 6811University of California, San Francisco, 550 16th Street, 4th Floor, Box #0632, San Francisco, CA 94158 USA
| | - Susan Goodman
- grid.239915.50000 0001 2285 8823Hospital for Special Surgery, New York, NY USA ,grid.5386.8000000041936877XWeill Cornell Medicine, New York, NY USA
| | - Karen Onel
- grid.239915.50000 0001 2285 8823Hospital for Special Surgery, New York, NY USA ,grid.5386.8000000041936877XWeill Cornell Medicine, New York, NY USA
| | - Bella Mehta
- grid.239915.50000 0001 2285 8823Hospital for Special Surgery, New York, NY USA ,grid.5386.8000000041936877XWeill Cornell Medicine, New York, NY USA
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Wilson WT, Hopper GP, O'Boyle M, Henderson L, Blyth MJG. Quantifying graft impingement in anterior cruciate ligament reconstruction. Knee 2022; 34:270-278. [PMID: 35092940 DOI: 10.1016/j.knee.2022.01.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Revised: 12/07/2021] [Accepted: 01/06/2022] [Indexed: 02/02/2023]
Abstract
BACKGROUND Anterior cruciate ligament reconstructions (ACLR) fail at a rate of 10-15%, with graft impingement often a cause. In this study we investigate the prevalence and causes of impingement seen during ACLR surgery. METHODS We reviewed consecutive primary ACLR from 2012-2018. Graft impingement was estimated intraoperatively by placing the arthroscope through the tibial tunnel and passively extending the knee, observing how much was obscured by the lateral femoral condyle from an anterior and lateral direction. Preoperative MRI scans were used to measure the intercondylar notch; Notch Width Index (NWI) and Notch Depth Index (NDI). Positioning of the tunnels was determined on postoperative radiographs. RESULTS There were 283 ACLRs performed with 33 failures diagnosed on MRI (11.7%). 257 patients had complete imaging and follow up (91%). The mean age was 28 (±9) years and mean follow-up 5.3 (±1.8) years. The mean NWI was 0.26(±0.03), and NDI was 0.49(±0.06). The tibial tunnel aperture was located 42(±6) % of the way from anterior-posterior and 39(±6) % from medial-lateral. Impingement requiring a notchplasty was observed in 80% of cases, with lateral impingement more prominent. CONCLUSIONS The amount of impingement did not correlate with tunnel position, which was located within the recommended area. There was a weak negative correlation between NWI and lateral impingement (rs = -0.16, p = 0.01), and NDI and anterior impingement (rs = -0.12, p = 0.04), therefore a smaller notch is associated with greater impingement. Despite optimal tunnel positioning, impingement still occurs in a significant number of cases therefore notchplasty should always be considered to keep revision rates low.
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Affiliation(s)
- W T Wilson
- Department of Biomedical Engineering, University of Strathclyde, Glasgow, UK; Glasgow Royal Infirmary, NHS Greater Glasgow & Clyde, Glasgow, UK.
| | - G P Hopper
- Glasgow Royal Infirmary, NHS Greater Glasgow & Clyde, Glasgow, UK.
| | - M O'Boyle
- Glasgow Royal Infirmary, NHS Greater Glasgow & Clyde, Glasgow, UK.
| | - L Henderson
- Glasgow Royal Infirmary, NHS Greater Glasgow & Clyde, Glasgow, UK.
| | - M J G Blyth
- Glasgow Royal Infirmary, NHS Greater Glasgow & Clyde, Glasgow, UK.
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Chard S, Henderson L, Wallace BH, Roth EG, Eckert JK. 'How I Can Help Me': Self-Care Priorities and Structural Pressures Among Black Older Adults With Diabetes. Gerontologist 2021; 62:751-761. [PMID: 34698832 DOI: 10.1093/geront/gnab157] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Disparities in Type 2 diabetes mellitus (diabetes) represent an ongoing public health challenge. Black older adults are at high risk of diabetes and diabetes' complications. Diet, physical activity, and medication can control these risks, yet disease rates remain elevated. Utilizing an Intersectionality framework, we seek to extend understanding of the social dimensions of diabetes through an examination of the diabetes self-care process from the perspective of Black older adults. RESEARCH DESIGN AND METHODS This project involved a thematic analysis of diabetes illness narrative interviews with Black participants (N=41) in our National Institute on Aging-funded study of diabetes. In a narrative approach, the participant communicates the significance of actions and events. RESULTS The findings suggest that diabetes self-care involves interconnected struggles across four domains of care: 1) multimorbidity management, 2) financial well-being, 3) family support, and 4) formal health care. DISCUSSION AND IMPLICATIONS Black older adult self-care reflects an active process of pursuing meaningful social goals and critical health needs. An Intersectional framework, however, reveals the ongoing histories of inequity that shape this process. Further intervention to address the racist policies and practices found in Black older adults' communities and clinical care is needed to make true progress on diabetes disparities.
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Affiliation(s)
- Sarah Chard
- Department of Sociology, Anthropology and Public Health, University of Maryland Baltimore County, Baltimore, Maryland, USA
| | - Loren Henderson
- Department of Sociology, Anthropology and Public Health, University of Maryland Baltimore County, Baltimore, Maryland, USA
| | - Brandy Harris Wallace
- Department of Sociology, Anthropology and Public Health, University of Maryland Baltimore County, Baltimore, Maryland, USA
| | - Erin G Roth
- PATIENTS Program, Department of Pharmaceutical Health Services Research, University of Maryland School of Pharmacy, Baltimore, Maryland, USA
| | - J Kevin Eckert
- Department of Sociology, Anthropology and Public Health, Center for Aging Studies, University of Maryland Baltimore County, Baltimore, Maryland, USA
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Henderson L, Simpkins S, Nalagatla S. 966 Comparison of Lord and Jaboulay Procedure for Hydrocele Repair. Br J Surg 2021. [DOI: 10.1093/bjs/znab259.1099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Abstract
Aim
Hydrocele is a common surgical pathology with a variety of operative techniques described, including Lord plication and Jaboulay procedure. Whilst current evidence suggests no difference in the recurrence rate between different techniques, the Lord’s procedure is described as having the lowest complication rate. NICE guidelines state all men aged 20 - 40 should receive a pre-operative ultrasound scan. We aimed to audit the complication rate between the two procedures as well as the rate of pre-operative ultrasound assessment.
Method
A retrospective review of all elective hydrocele repairs was performed within one health board over a 17-month period. All elective patients over the age of twelve and three-quarters were included, with emergency repairs excluded. Patient records were accessed, and data collected including hydrocele side and size, procedure performed, co-morbidities, medication, pre-operative ultrasound, and incidence of immediate and late complications.
Results
83 cases were identified. All men aged 20 - 40 received pre-operative ultrasound assessment. 27 (33%) repairs utilised Lord’s technique, whilst 56 (67%) used Jaboulay’s technique. There was no statistical difference in complication rate for all complications (10% vs. 16% p = 0.48), haematoma (3.4% vs. 12% p = 0.16), infection (1.7% vs. 12% p = 0.08) or reoccurrence (1.7% vs 0% p = 1.0) between Jaboulay’s and Lord’s respectfully.
Conclusions
Analysis in this series showed the complication rate is higher for Lord’s procedure versus Jaboulay’s, however this was not found to be statistically significant. All patients aged 20-40 within our analysis received pre-operative ultrasound assessment.
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Affiliation(s)
- L Henderson
- University Hospital Monklands, Airdrie, United Kingdom
| | - S Simpkins
- University Hospital Monklands, Airdrie, United Kingdom
| | - S Nalagatla
- University Hospital Monklands, Airdrie, United Kingdom
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Henderson L, Birse E, Nalagatla S, Reid S. 1077 TELP In Urology: Hindrance or A Help During Covid-19 Pandemic? A Closed Loop Audit. Br J Surg 2021. [DOI: 10.1093/bjs/znab259.493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
Aim
TELP (Treatment Escalation/Limitation Plan) form is a novel clinical decision-making tool introduced during the COVID-19 pandemic in our health board to provide a standardised patient management plan in case of patient deterioration. A closed loop audit of its compliance in Urology patients was performed.
Method
Patient medical records were analysed over two periods (Cycle 1: 5/10/20 - 11/10/20 and Cycle 2: 23/11/20 – 29/11/20) for all Urology patients in our institution. Cycle 1 audit findings were presented at the Departmental Education Meeting. During Cycle 1, an anonymous questionnaire was sent to all Urology Medical and Nursing staff to gather their opinion on TELP.
Results
In total 100 patients were analysed. 66 were male and 34 females. Age ranged from 15 to 91 years. TELP form completion rate improved from 48% (Cycle 1) to 68% (Cycle 2), however, correct completion remained poor at 11.1% and 16.7% in Cycle 1 and Cycle 2 respectively. Commonly, there was no reporting of ‘discussion with patient or family’ or ‘patient capacity’. Majority of patients with a completed TELP had one to four underlying co-morbidities and were emergency admissions (65%). The questionnaire reported barriers to compliance including, time for completion, document size, and the feeling it was inappropriate for certain patient groups. Most felt it did not represent patients’ wishes (73%) or improved discussion regarding escalation status (50%).
Conclusions
TELP forms have sub-optimal correct completion rates and may not always represent patient’s wishes. Inherent barriers to its use need to be addressed, given limited resources during the COVID pandemic.
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Affiliation(s)
- L Henderson
- University Hospital Monklands, Airdrie, United Kingdom
| | - E Birse
- University Hospital Monklands, Airdrie, United Kingdom
| | - S Nalagatla
- University Hospital Monklands, Airdrie, United Kingdom
| | - S Reid
- University Hospital Monklands, Airdrie, United Kingdom
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10
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Chard S, Girling L, Henderson L, Eckert JK. Undiagnosed Diabetes: Identifying the Community Paths to Type 2 Diabetes Diagnostic Testing. Innov Aging 2020. [PMCID: PMC7740460 DOI: 10.1093/geroni/igaa057.1211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Over seven million U.S. adults are estimated to have undiagnosed diabetes and are at heightened risk of diabetes complications and poorer long-term glycemic control. Key to addressing undiagnosed diabetes is identifying how persons encounter diabetes testing in everyday life and the contextual factors that lead to consulting a health care provider. As part of the NIA-funded Subjective Experience of Diabetes Study we examined the pathways through which community-living African-American and non-Hispanic White older adults with type 2 diabetes (T2D) (N=75) received their T2D diagnosis. Systematic, thematic analyses using ATLAS.ti reveals three primary routes to diabetes diagnosis: diagnosis through continuity of primary care, diagnosis through happenstance testing, and diagnosis following the exacerbation of symptoms. While diagnosis as part of routine care was the least reported (N=13), participants’ accounts suggest diagnosis in primary care validates the patient-provider relationship and provides an occasion to calmly establish a treatment plan. More frequently, however, diagnosis occurs through fortuitous encounters with glucose tests, e.g., through work or community research projects (N=15) or after symptoms become alarming and disrupt daily life (N=47). Participants’ experiences in these latter two categories reveal the critical role of insurance and social prompts in the decision to consult a clinical provider regarding symptoms. At the same time, the abundance of over-the-counter therapies treating conditions commonly found early in the emergence of diabetes can delay clinical follow up. These findings highlight the importance of social prompts and community-based testing in the fight to reduce undiagnosed diabetes.
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Affiliation(s)
| | - Laura Girling
- University of Maryland, Baltimore County, Baltimore, Maryland, United States
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11
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Mendenhall R, Henderson L, Scott B, Butler L, Turi KN, Greenlee A, Robinson GE, Roberts BW, Rodriguez-Zas SL, Brooks JE, Lleras CL. Involving Urban Single Low-Income African American Mothers in Genomic Research: Giving Voice to How Place Matters in Health Disparities and Prevention Strategies. Fam Med Prim Care Open Access 2020; 4:148. [PMID: 35373191 PMCID: PMC8970351 DOI: 10.29011/2688-7460.100048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
This article describes the process of using principles from community-based participatory action research to involve low-income, single, African American mothers on the south side of Chicago in genomic research, including as citizen scientists. The South Chicago Black Mothers' Resiliency Project used a mixed methods design to investigate how the stress of living in neighborhoods with high levels of violence affects mothers' mental and physical health. This article seeks to serve as a model for physicians and scholars interested in successfully involving low-income African American mothers in genomic research, and other health-related activities in ways that are culturally sensitive and transformative. The lives of Black mothers who struggle under interlocking systems of oppression that are often hidden from view of most Americans are at the center of this article. Therefore, we provide extensive information about the procedures used to collect the various types of data, the rationale for our procedures, the setting, the responses of mothers in our sample and methodological challenges. This study also has implications for the current COVID-19 pandemic and the need to train a corps of citizen scientists in health and wellness to avoid future extreme loss of life such as the 106,195 lives lost in the United States as of June 1, 2020.
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Affiliation(s)
- Ruby Mendenhall
- Department of Sociology, African American Studies & Carle Illinois College of Medicine, University of Illinois at Urbana-Champaign, USA
| | - Loren Henderson
- Department of Sociology and Anthropology, University of Maryland, Baltimore County, USA
| | - Barbara Scott
- Department of Sociology, Northeastern Illinois University, USA
| | - Lisa Butler
- Independent Scholar, Northeastern Illinois University, USA
| | - Kedir N Turi
- Department of Medicine, Vanderbilt University, Nashville, USA
| | - Andrew Greenlee
- Urban and Regional Planning, University of Illinois at Urbana-Champaign, USA
| | - Gene E Robinson
- Institute for Genomic Biology, Integrative Biology, University of Illinois at Urbana-Champaign, USA
| | - Brent W Roberts
- Center for Social and Behavioral Science Psychology, University of Illinois at Urbana-Champaign, USA
| | | | | | - Christy L Lleras
- Human Development & Family Studies, University of Illinois at Urbana-Champaign, USA
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12
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van Rijn E, Walker SA, Knowland VC, Cairney SA, Gouws AD, Gaskell M, Henderson L. 0086 Daytime Napping and Memory Consolidation of Novel Word Learning in Children and Adults. Sleep 2020. [DOI: 10.1093/sleep/zsaa056.084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Introduction
Memory for novel words benefits from sleep, particularly non-rapid eye movement (NREM) sleep and its features, such as sleep spindles and slow oscillations. This is consistent with systems consolidation models, in which sleep supports transfer from hippocampal to neocortical memory networks. Larger amounts of slow wave sleep in children has been proposed to account for enhanced consolidation effects, but such studies have typically focused on nocturnal sleep. We examined whether daytime naps benefit word retention in adults and children aged 10–12 years, and whether this relationship in children is affected by differences in white matter pathway microstructure. We hypothesized that the link between memory consolidation and structural brain connectivity will be mediated by the degree of sleep spindles during the nap.
Methods
Adults (N = 31; mean age = 20.91, SD = 1.55) and children (N = 38; mean age = 11.95, SD = 0.88) learned spoken novel words, followed by a 90-minute nap opportunity monitored with polysomnography. Memory for the words was tested pre- and post-nap. Children’s structural brain connectivity was measured using diffusion tensor imaging (DTI).
Results
Word memory was preserved following sleep in adults, while an adult wake control condition showed deterioration. Similarly, in children memory performance was stable over the nap, with wake control data currently being collected. Analyses relating behavioral changes over the nap to NREM sleep features and structural brain connectivity will be presented.
Conclusion
In line with sleep-dependent memory consolidation models, daytime naps protect novel words from forgetting in adults and children. Examining potential relationships between nap-based consolidation and structural integrity has important theoretical implications, given the increase in brain connectivity in language areas during childhood, as well as white matter alterations in developmental populations.
Support
This research was supported by the UK Economic and Social Research Council, grant no. ES/N009924/1.
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Affiliation(s)
- E van Rijn
- Department of Psychology, University of York, York, UNITED KINGDOM
| | - S A Walker
- Department of Psychology, University of York, York, UNITED KINGDOM
| | - V C Knowland
- Department of Psychology, University of York, York, UNITED KINGDOM
| | - S A Cairney
- Department of Psychology, University of York, York, UNITED KINGDOM
| | - A D Gouws
- Department of Psychology, University of York, York, UNITED KINGDOM
| | - M Gaskell
- Department of Psychology, University of York, York, UNITED KINGDOM
| | - L Henderson
- Department of Psychology, University of York, York, UNITED KINGDOM
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Milligan D, Henderson L, Tucker A, Ballard J. Elastic nail fixation versus plate fixation of paediatric femoral fractures in school age patients - A retrospective observational study. J Orthop 2020; 19:153-157. [PMID: 32025124 PMCID: PMC6997651 DOI: 10.1016/j.jor.2019.11.033] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2019] [Accepted: 11/24/2019] [Indexed: 12/25/2022] Open
Abstract
INTRODUCTION The management of paediatric femoral fractures continues to spark debate in published literature, with poor quality evidence guiding current guidelines on the optimum treatment in children. Many centres report excellent results for both elastic intramedullary nailing and plate fixation of diaphyseal femoral fractures. This study aimed to investigate the outcomes of femoral fractures treated with elastic nail fixation versus those treated with plate fixation in a tertiary children's trauma unit, and discuss the advantages and disadvantages of each technique. MATERIALS AND METHODS A retrospective review of all femoral fractures undergoing fixation at a level one paeditric trauma and tertiary referral unit, between 1st April 2009 and 30th April 2017, was performed.Clinical notes and radiographs were reviewed to determine patient demographics and injury, operative and hospital stay data. Radiological union, defined as bridging callus present on at least three out of four cortices on orthogonal radiographs, was determined at 12 weeks. Outcomes were determined using the Flynn Criteria. Patients were followed up for a minimum of 2 years. Data was statistically analysed, and a p value < 0.05 was considered significant. RESULTS There were a total of 28 patients- 14 in each treatment group. Patients undergoing elastic nail fixation were significantly older than plate fixation (9.7 ± 1.9 Vs 7.7 ± 1.8; p = 0.008). A male preponderance was noted (21/28), with no difference between groups (10 Vs 11; p = 1.00). Plate fixation demonstrated a tendency towards shorter length of stay (6.3 ± 2.1 Vs 7.8 ± 3.0; p = 0.134), earlier radiological union at 12 weeks (14 Vs 10; p = 0.098), lower postoperative analgesia requirements (0.82 ± 0.45 Vs 1.12 ± 0.97; p = 0.200), and better outcomes, as determined by the Flynn criteria. CONCLUSIONS In the authors opinion, plate fixation is a safe, effective alternative to elastic nail fixation with equivocal outcomes as determined by the Flynn Criteria. Plate fixation may offer advantages in shorter length of stay, reduced postoperative pain and earlier weightbearing. Further large scale, prospective research is required to determine whether these are borne out in practice.
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Affiliation(s)
- D. Milligan
- C/O Fracture Clinic, Royal Belfast Hospital for Sick Children, Falls Road, Belfast, Northern Ireland, BT12 6BE, UK
| | - L. Henderson
- C/O Fracture Clinic, Royal Belfast Hospital for Sick Children, Falls Road, Belfast, Northern Ireland, BT12 6BE, UK
| | - A. Tucker
- C/O Fracture Clinic, Royal Belfast Hospital for Sick Children, Falls Road, Belfast, Northern Ireland, BT12 6BE, UK
| | - J. Ballard
- Royal Belfast Hospital for Sick Children, Falls Road, Belfast, Northern Ireland, BT12 6BE, UK
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14
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Henderson L, Wallis A, de Kruijf M, Fullwood C, Moualed D, Bruce IA, Freeman SR. Validation of the Manchester spoken language development scale (MSLDS). Cochlear Implants Int 2020; 21:239-245. [PMID: 32299308 DOI: 10.1080/14670100.2020.1751959] [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] [Indexed: 10/24/2022]
Abstract
Introduction: Standardized outcome measures are importantfor accurately monitoring the language development of pre-lingually deaf children receiving auditory implants. Current commonly used outcome measures are time-consuming,limiting the practicality of regular testing. To address these limitations, the Manchester Spoken Language Development Scale (MSLDS) was developed as a quick and easily applicable interim measurement. This is an 11-point scale designed to provide a streamlined overview of a child's expressive language development. This study describes the MSLDS, evaluates its ease of use and inter-rater reliability, and outlines its application in the paediatric auditory implant population. Methods: Sixteen speech therapists and teachers for the deaf reviewed videos of paediatric cochlear implant assessmentsand rehabilitation sessions at a UK auditory implant centre. Twenty-five videos from fourteen children were used in this validation study. Reviewers were asked to evaluate a child's language development using the MSLDS by assigning a score for each video and to evaluate the ease of use of the scale. Each video wasrated by three different reviewers. Results: MSLDS scores showed a high degree of consistency between raters for each child. 8/25 (32%) videos demonstrated perfect agreement on the MSLDS. In 15/25 (60%) videos, there was a one-point difference between MSLDS scores. The remaining 2/25 (8%) videos varied by 2 points. Statistical analysis demonstrated an intra-class correlation coefficient (ICC) of 0.987, indicating a high level of agreement between users of the scale. Qualitative feedback from the raters suggested further modifications which have been incorporated into the scale. Conclusion: The high inter-rater agreement reflects the potential for the MSLDS to be a reliable tool for monitoring language development in the paediatric auditory implant population.
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Affiliation(s)
- L Henderson
- Richard Ramsden Centre for Hearing Implants, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
| | - A Wallis
- Critical Care Department, Royal Liverpool University Hospital, Liverpool, UK
| | - M de Kruijf
- Paediatric ENT Department, Royal Manchester Children's Hospital, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
| | - C Fullwood
- Research & Innovation, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK.,Division of Population Health, Health Services Research and Primary Care, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | - D Moualed
- ENT Department, Great Western Hospital NHS Foundation Trust, Swindon, UK
| | - I A Bruce
- Richard Ramsden Centre for Hearing Implants, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK.,Paediatric ENT Department, Royal Manchester Children's Hospital, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK.,Division of Infection, Immunity and Respiratory Medicine, Faculty of Biology, Medicine and Health University of Manchester, Manchester, UK
| | - S R Freeman
- Richard Ramsden Centre for Hearing Implants, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
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Bicsak RC, Boles R, Cathey R, Collins V, Hannasious K, Haselhorst J, Henderson L, Jann L, Meschi L, Molloy R, Stillions M, Swanson K, Tate D, Webb J, Wilkins G. Comparison of Kjeldahl Method for Determination of Crude Protein in Cereal Grains and Oilseeds with Generic Combustion Method: Collaborative Study. J AOAC Int 2020. [DOI: 10.1093/jaoac/76.4.780] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Abstract
Seven laboratories participated in a collaborative study to extend the applicability of the AOAC generic combustion method for determination of crude protein in animal feed (990.03) to include determination in cereal grains and oilseeds. In the study, method 990.03 was compared with the AOAC mercury catalyst Kjeldahl method for determination of protein in grains (979.09) and crude protein in animal feed (954.01). The study also evaluated the effect on the results of fineness of grind. For determination of crude protein in grains and oilseeds by the combustion method, standard deviations for repeatability and reproducibility ranged from 0.10 to 0.37 and from 0.25 to 0.54, respectively, and relative standard deviations for repeatability and reproducibility ranged from 0.77 to 2.57% and from 1.24 to 3.15%, respectively. The combustion method was adopted first action by AOAC International for determination of crude protein in cereal grains and oilseeds containing 0.2- 20% nitrogen.
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Affiliation(s)
- Ronald C Bicsak
- U.S. Department of Agriculture, Federal Grain Inspection Service, Quality Assurance and Research Division, PO Box 20285, Kansas City, MO 64195
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16
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Nath A, Li G, Henderson L, Smith B, Reoma L, Jiao X, Santamaria U, Imamichi H, Lane C. CXCR4-usage HIV-1 strains isolated from blood and cerebrospinal fluid in subjects on suppressive antiretroviral therapy. J Virus Erad 2019. [DOI: 10.1016/s2055-6640(20)30147-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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17
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Chen C, Pinto C, Walmsley C, Allen R, Muzikansky A, Henderson L, Broudo M, Wolfgang J, Fitzgerald D, Hong T, Juric D. Response rates and lesion-level progression patterns of solid tumor patients in an academic phase I program: implications for tumour heterogeneity. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz244.052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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18
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Fitzgerald D, Muzikansky A, Pinto C, Henderson L, Walmsley C, Allen R, Ferraro G, Isakoff S, Moy B, Oh K, Shih H, Dias-Santagata D, Iafrate A, Bardia A, Brastianos P, Juric D. Association between PIK3CA mutation status and development of brain metastases in HR+/HER2- metastatic breast cancer. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz242.013] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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19
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Papanatsiou M, Petersen J, Henderson L, Wang Y, Christie JM, Blatt MR. Optogenetic manipulation of stomatal kinetics improves carbon assimilation, water use, and growth. Science 2019; 363:1456-1459. [PMID: 30923223 DOI: 10.1126/science.aaw0046] [Citation(s) in RCA: 151] [Impact Index Per Article: 30.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2018] [Accepted: 02/27/2019] [Indexed: 01/02/2023]
Abstract
Stomata serve dual and often conflicting roles, facilitating carbon dioxide influx into the plant leaf for photosynthesis and restricting water efflux via transpiration. Strategies for reducing transpiration without incurring a cost for photosynthesis must circumvent this inherent coupling of carbon dioxide and water vapor diffusion. We expressed the synthetic, light-gated K+ channel BLINK1 in guard cells surrounding stomatal pores in Arabidopsis to enhance the solute fluxes that drive stomatal aperture. BLINK1 introduced a K+ conductance and accelerated both stomatal opening under light exposure and closing after irradiation. Integrated over the growth period, BLINK1 drove a 2.2-fold increase in biomass in fluctuating light without cost in water use by the plant. Thus, we demonstrate the potential of enhancing stomatal kinetics to improve water use efficiency without penalty in carbon fixation.
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Affiliation(s)
- M Papanatsiou
- Laboratory of Plant Physiology and Biophysics, Institute of Molecular, Cell and Systems Biology, University of Glasgow, University Avenue, Glasgow G12 8QQ, UK.,Plant Science Group, Institute of Molecular, Cell and Systems Biology, University of Glasgow, University Avenue, Glasgow G12 8QQ, UK
| | - J Petersen
- Plant Science Group, Institute of Molecular, Cell and Systems Biology, University of Glasgow, University Avenue, Glasgow G12 8QQ, UK
| | - L Henderson
- Plant Science Group, Institute of Molecular, Cell and Systems Biology, University of Glasgow, University Avenue, Glasgow G12 8QQ, UK
| | - Y Wang
- Laboratory of Plant Physiology and Biophysics, Institute of Molecular, Cell and Systems Biology, University of Glasgow, University Avenue, Glasgow G12 8QQ, UK.,Institute of Crop Science, College of Agriculture and Biotechnology, Zijingang Campus, Zhejiang University, Hangzhou 310058, China
| | - J M Christie
- Plant Science Group, Institute of Molecular, Cell and Systems Biology, University of Glasgow, University Avenue, Glasgow G12 8QQ, UK.
| | - M R Blatt
- Laboratory of Plant Physiology and Biophysics, Institute of Molecular, Cell and Systems Biology, University of Glasgow, University Avenue, Glasgow G12 8QQ, UK. .,Plant Science Group, Institute of Molecular, Cell and Systems Biology, University of Glasgow, University Avenue, Glasgow G12 8QQ, UK.,Institute of Crop Science, College of Agriculture and Biotechnology, Zijingang Campus, Zhejiang University, Hangzhou 310058, China
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20
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McClarey A, Phelan P, O'Shea D, Henderson L, Gunson R, Laurenson IF. Lessons learned from a pneumocystis pneumonia outbreak at a Scottish renal transplant centre. J Hosp Infect 2019; 102:311-316. [PMID: 30802526 DOI: 10.1016/j.jhin.2019.02.013] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [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: 11/02/2018] [Accepted: 02/18/2019] [Indexed: 11/17/2022]
Abstract
BACKGROUND Pneumocystis pneumonia (PCP) is an opportunistic infection occurring in renal transplant patients. Over a 14-month period an increase in PCP cases was identified among our renal transplant cohort. AIM The outbreak population was studied to identify potential risk factors for the development of PCP. METHODS A retrospective analysis of hospital records was carried out, with each case being matched with two case-linked controls. Information was collected on patient demographics, laboratory tests, and hospital visits pre and post development of infection. FINDINGS No patients were receiving PCP prophylaxis at the time of infection and mean time from transplantation to developing PCP was 4.7 years (range: 0.51-14.5). The PCP group had a significantly lower mean estimated glomerular filtration rate than the control group (29.3 mL/min/1.73 m2 vs 70 mL/min-1 (P = 0.0007)). Three patients were treated for active cytomegalovirus (CMV) infection prior to PCP diagnosis and two had active CMV at the time of diagnosis compared to none in the control group (P = 0.001). Those who developed PCP were more likely to have shared a hospital visit with another patient who went on to develop PCP; 37% of clinic visits vs 19% (P = 0.014). CONCLUSION This study highlights the ongoing risk of opportunistic infection several years after transplantation and adds weight to potential person-to-person Pneumocystis jirovecii transmission. Risk factors have been identified which may highlight those most at risk, enabling targeted rather than blanket long-term PCP prophylaxis.
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Affiliation(s)
- A McClarey
- Department of Renal Medicine, Royal Infirmary of Edinburgh, Edinburgh, UK
| | - P Phelan
- Department of Renal Medicine, Royal Infirmary of Edinburgh, Edinburgh, UK
| | - D O'Shea
- NHS Lothian Infection Service, Regional Infectious Diseases Unit, Western General Hospital, Edinburgh, UK
| | - L Henderson
- Department of Renal Medicine, Royal Infirmary of Edinburgh, Edinburgh, UK
| | - R Gunson
- West of Scotland Specialist Virology Centre, Glasgow Royal Infirmary, Glasgow, UK
| | - I F Laurenson
- NHS Lothian Infection Service, Clinical Microbiology, Royal Infirmary of Edinburgh, Edinburgh, UK.
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21
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Innes-Hughes C, Henderson L, Kahnal S, Lukeis S, Rissel C. Invited talk: Key lessons from the Go4Fun program in NSW. Obes Res Clin Pract 2019. [DOI: 10.1016/j.orcp.2016.10.094] [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: 11/29/2022]
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22
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Chard S, Roth E, Henderson L, Girling L, Wallace B, Quinn C, Eckert K. “I CAN’T EAT THAT MUCH”: OLDER ADULTS’ LIVED EXPERIENCES OF DIABETES DIETARY RECOMMENDATIONS. Innov Aging 2018. [DOI: 10.1093/geroni/igy023.958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- S Chard
- Dept of Sociology, Anthropology, and Health Administration & Policy, UMBC
| | - E Roth
- Center for Aging Studies, UMBC
| | - L Henderson
- Department of Sociology, Anthropology, and Health Administration & Policy, UMBC
| | | | - B Wallace
- University of Maryland, Baltimore County
| | - C Quinn
- Dept of Epidemiology & Public Health, University of Maryland School of Medicine
| | - K Eckert
- Dept of Sociology, Anthropology, and Health Administration & Policy, UMBC
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23
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Schaefer SM, de Kruijf M, Henderson L, Metryka A, O’Driscoll M, Bruce IA. Improved speech and language development after unilateral cochlear implantation in children with a potentially useable contralateral ear. Cochlear Implants Int 2018; 20:39-46. [DOI: 10.1080/14670100.2018.1536408] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- SM. Schaefer
- Paediatric ENT Department, Royal Manchester Children’s Hospital, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
| | - M. de Kruijf
- Paediatric ENT Department, Royal Manchester Children’s Hospital, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
| | - L. Henderson
- Richard Ramsden Centre for Auditory Implants, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
| | - A. Metryka
- Paediatric ENT Department, Royal Manchester Children’s Hospital, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
| | - M. O’Driscoll
- Richard Ramsden Centre for Auditory Implants, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
| | - IA Bruce
- Paediatric ENT Department, Royal Manchester Children’s Hospital, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
- Richard Ramsden Centre for Auditory Implants, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
- Division of Infection, Immunity and Respiratory Medicine, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
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24
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Ward ST, Mytton J, Henderson L, Amin V, Tanner JR, Evison F, Radley S. Anti-TNF therapy is not associated with an increased risk of post-colectomy complications, a population-based study. Colorectal Dis 2018; 20:416-423. [PMID: 29059479 DOI: 10.1111/codi.13937] [Citation(s) in RCA: 14] [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: 06/27/2017] [Accepted: 10/03/2017] [Indexed: 01/11/2023]
Abstract
AIM Previous studies have raised concerns that the use of anti-tumour necrosis factor (anti-TNF) therapy in patients with ulcerative colitis (UC) undergoing surgery may increase the risk of postoperative complications. We have taken a population-based approach to investigate whether there is an association between anti-TNF therapy and postoperative complications in UC patients undergoing subtotal colectomy. METHOD Hospital Episode Statistics (HES) data and procedural coding were used to identify all patients in England between April 2006 and March 2015 undergoing subtotal colectomy for UC. Patients were grouped into those who received anti-TNF therapy within 12 or 4 weeks of surgery and those who did not. The incidence of postoperative complications was evaluated by HES coding and compared between groups. RESULTS In all, 6225 UC patients underwent subtotal colectomy. 753 patients received anti-TNF therapy within 12 weeks prior to surgery (418 within 4 weeks). There was no difference in postoperative complications between groups although groups were not comparable for age and comorbidities. Logistic regression with complications as the outcome variable did not show any significant association between anti-TNF therapy and complications. Colectomy performed during an unplanned admission (vs planned admission) and smoking were associated with complications. CONCLUSION This large population-based study does not demonstrate any association between preoperative anti-TNF therapy and postoperative complications in UC patients undergoing subtotal colectomy. The only variables associated with complications were colectomy performed during an unplanned admission and smoking.
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Affiliation(s)
- S T Ward
- Department of Colorectal Surgery, South Warwickshire NHS Foundation Trust, Warwick, UK
| | - J Mytton
- Department of Health Informatics, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - L Henderson
- Department of Colorectal Surgery, South Warwickshire NHS Foundation Trust, Warwick, UK
| | - V Amin
- Department of Colorectal Surgery, South Warwickshire NHS Foundation Trust, Warwick, UK
| | - J R Tanner
- Department of Health Informatics, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - F Evison
- Department of Health Informatics, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - S Radley
- Department of Colorectal Surgery, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
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Li G, Smith B, Imamichi H, Henderson L, Steinbach S, Lane C, Nath A. Infection of astrocytes by a virus isolated from CSF cells of an HIV-positive patient virologically suppressed with ART. J Virus Erad 2017. [DOI: 10.1016/s2055-6640(20)30622-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Henderson L, Zerai A, L. Morrow R. Intimate Partner Violence and HIV Status among Ever-Married and Cohabiting Zimbabwean Women: An Examination of Partners' Traits. Afr J Reprod Health 2017; 21:45-54. [PMID: 29624950 DOI: 10.29063/ajrh2017/v21i4.5] [Citation(s) in RCA: 52] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
This study examines the connection between intimate partner violence (IPV) and Human Immunodeficiency Virus status among married and cohabitating women in Zimbabwe using an African feminist framework. Stata 13.0 was used to analyze data from the 2010-2011 Zimbabwe Demographic and Health Survey, which used a national probability sample of households in the country of Zimbabwe. This study used logistic regression to analyze the 2,830 ever-married or cohabitating women who also answered the violence and spousal traits questionnaire as well as provided blood samples. The logistic regression revealed that women who had experienced any type of intimate partner violence (odds ratio=1.29, CI [1.00, 1.67]) or broken bones (odds ratio=2.39, CI [1.19, 4.77]) were more likely to be HIV positive; relative to those with bruises bruises (odds ratio=- .64 CI [.41, .99]) were less likely. Women with partners who are trackers (odds ratio=1.28, CI [1.04, 1.59]) were more likely to be HIV positive. Patriarchal, hypermasculist culture, shown through violence against women, contributes to the likelihood of HIV in wives and partners. A cultural shift at the highest levels may help to prevent IPV and reduce the spread of HIV.
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Stanley-Olson A, Gauthier J, Henderson L, Snider M, Sommerfeld D, Lande E. A-44Self-report Versus Observed Mood Symptoms in Individuals with Dementia Referred to Adult Protective Services. Arch Clin Neuropsychol 2017. [DOI: 10.1093/arclin/acx076.44] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Walmsley C, Juric D, Bardia A, Henderson L, Gurski J, Stone J, Pinto C, Isakoff S, Fitzgerald D, Gainor J, Goyal L, Broudo M. A systematic rapid autopsy program tracks temporal and spatial heterogeneity of human tumors and identifies mechanisms of resistance to targeted therapies. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx390.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Lande E, Gauthier J, Stanley-Olson A, Snider M, Sommerfeld D, Henderson L. C-69The Role of Cognition in Self-Advocacy in Adult Protective Services Cases. Arch Clin Neuropsychol 2017. [DOI: 10.1093/arclin/acx076.236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Stanley-Olson A, Gauthier J, Henderson L, Snider M, Sommerfeld D, Lande E. C-70The Role of Neuropsychological Testing in Identifying Differing Levels of Impairment Between Self-neglect Versus Other-neglect or Abuse in Adult Protective Services Referrals. Arch Clin Neuropsychol 2017. [DOI: 10.1093/arclin/acx076.237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Chard S, Girling L, Roth E, Harris-Wallace B, Henderson L, Quinn C, Eckert J. NEW IMPLICATIONS FOR DIABETES EDUCATION: PHYSICAL ACTIVITY BARRIERS AMONG DIABETIC OLDER ADULTS. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.897] [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: 11/15/2022] Open
Affiliation(s)
| | | | | | | | | | - C.C. Quinn
- School of Medicine, University of Maryland, Baltimore, Baltimore, Maryland
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Affiliation(s)
- L. Henderson
- Clarke Chapman Limited Advanced Technology Division, P.O. Box 13, Gateshead Tyne and Wear, England NE8 1YZ
| | - R. Stead
- Clarke Chapman Limited Advanced Technology Division, P.O. Box 13, Gateshead Tyne and Wear, England NE8 1YZ
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Resnick C, Dang R, Henderson L, Zander D, Daniels K, Nigrovic P, Kaban L. Frequency and morbidity of temporomandibular joint involvement in adult patients with a history of juvenile idiopathic arthritis. Int J Oral Maxillofac Surg 2017. [DOI: 10.1016/j.ijom.2017.02.795] [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: 10/19/2022]
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Redfern JV, Hatch LT, Caldow C, DeAngelis ML, Gedamke J, Hastings S, Henderson L, McKenna MF, Moore TJ, Porter MB. Assessing the risk of chronic shipping noise to baleen whales off Southern California, USA. ENDANGER SPECIES RES 2017. [DOI: 10.3354/esr00797] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Henderson L, Brachtel E, Fitzgerald D, Gadd M, Specht M, Thabet A, Gurski J, Sgroi D, Moy B, Isakoff S, Bardia A, Juric D. Abstract P1-06-03: Serial evolution of hormone receptor status and mutational profile among patients with metastatic breast cancer. Cancer Res 2017. [DOI: 10.1158/1538-7445.sabcs16-p1-06-03] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Introduction: Tumor heterogeneity presents a significant impediment to identifying appropriate treatments for patients. Genetic mutations and hormone receptors are frequently used as a guide for selecting appropriate targeted or hormonal therapies, however it is possible that these markers may change over time, leading to reduced effectiveness of these treatments. In this study, we review the results of serial and paired biopsies to identify receptor switch in estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor 2 (HER2) status as well as to identify changes in clinically relevant mutations, including spatial and temporal heterogeneity.
Methods: We identified a total of 237 patients initially presenting with ER+/HER2 negative breast cancer and who had multiple biopsies during the course of their treatment, including at least one in the metastatic setting. ER, PR, and HER2 status for each of these serial biopsies was gathered from chart reviews. HER2 results by both IHC and FISH were collected. PIK3CA mutations were also assessed by Snapshot utilizing multiplexed PCR of common hotspot mutations using DNA derived from formalin-fixed, paraffin-embedded (FFPE) tissue.
Results: From a total of 213 patients with known ER status for multiple serial biopsies, we identified 9.4% (N=20) who had at least one change in ER status over time. From a total of 198 patients who had documented PR status for multiple biopsies, 40.4% (N=80) had at least one change in PR status. Changes in HER2 status were similarly assessed, with 6.7% of patients having at least one change by IHC and 4.4% of patients having at least one change by FISH. Of those patients exhibiting changes in ER status, 6 were noted to have multiple changes over time. Of those with changes in PR status, 18 had multiple changes over time. Changes in hormone receptor status were also noted to occur between serial biopsies in the metastatic setting. A total of 128 patients had ER results available for multiple metastatic specimens, of which 8.6% (N=11) had at least one change in ER status. A total of 116 patients had PR results available for multiple metastatic biopsies, of which 38.8% (N=45) had at least one change in PR status. Changes were also noted in the metastatic setting in HER2 (IHC) with a frequency of 8.7% and in HER2 (FISH) with a frequency of 4.7%. A subset of 108 patients were identified as harboring a mutation in PIK3CA. Within this population, 9.6% of patients had at least one change in ER status over time and 34.1% had at least one change in PR status. 9.0% exhibited at least one change in HER2 (IHC) and 6.5% in HER2 (FISH). Serial changes in genotype, from pre- and post-treatment biopsies, were also detected using NGS based Foundation Medicine platform, including acquired alterations in the ESR1 and PI3K pathway.
Conclusion: Serial changes in hormone receptor status and mutation profile are not uncommon among patients initially diagnosed with ER+/HER2 negative breast cancer, and some patients have been noted to have multiple changes over time. Further studies are needed to understand the mechanistic underpinnings governing the emergence of these alterations and their relationship to therapeutic resistance in breast cancer.
Citation Format: Henderson L, Brachtel E, Fitzgerald D, Gadd M, Specht M, Thabet A, Gurski J, Sgroi D, Moy B, Isakoff S, Bardia A, Juric D. Serial evolution of hormone receptor status and mutational profile among patients with metastatic breast cancer [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P1-06-03.
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Affiliation(s)
| | - E Brachtel
- Massachusetts General Hospital, Boston, MA
| | | | - M Gadd
- Massachusetts General Hospital, Boston, MA
| | - M Specht
- Massachusetts General Hospital, Boston, MA
| | - A Thabet
- Massachusetts General Hospital, Boston, MA
| | - J Gurski
- Massachusetts General Hospital, Boston, MA
| | - D Sgroi
- Massachusetts General Hospital, Boston, MA
| | - B Moy
- Massachusetts General Hospital, Boston, MA
| | - S Isakoff
- Massachusetts General Hospital, Boston, MA
| | - A Bardia
- Massachusetts General Hospital, Boston, MA
| | - D Juric
- Massachusetts General Hospital, Boston, MA
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Wernli KJ, Ichikawa L, Kerlikowske K, Bush M, Johnson D, Buist DSM, Brandzel SD, DeMartini WB, Henderson L, Nekhlyudov L, Onega T, Sprague B, Miglioretti DL. Abstract P3-01-01: Comparative performance of surveillance mammography and breast MRI in women with a history of breast cancer. Cancer Res 2017. [DOI: 10.1158/1538-7445.sabcs16-p3-01-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
This abstract was withdrawn by the authors.
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Affiliation(s)
- KJ Wernli
- Group Health Cooperative, Seattle, WA; University of California, San Francisco, San Francisco, CA; University of Wisconsin School of Medicine, Madison, WI; Brigham and Women's Hospital, Boston, MA; Dartmouth Medical School, Hanover, NH; University of Vermont, Burlington, Burlington, VT; University of California, Davis, Davis, CA
| | - L Ichikawa
- Group Health Cooperative, Seattle, WA; University of California, San Francisco, San Francisco, CA; University of Wisconsin School of Medicine, Madison, WI; Brigham and Women's Hospital, Boston, MA; Dartmouth Medical School, Hanover, NH; University of Vermont, Burlington, Burlington, VT; University of California, Davis, Davis, CA
| | - K Kerlikowske
- Group Health Cooperative, Seattle, WA; University of California, San Francisco, San Francisco, CA; University of Wisconsin School of Medicine, Madison, WI; Brigham and Women's Hospital, Boston, MA; Dartmouth Medical School, Hanover, NH; University of Vermont, Burlington, Burlington, VT; University of California, Davis, Davis, CA
| | - M Bush
- Group Health Cooperative, Seattle, WA; University of California, San Francisco, San Francisco, CA; University of Wisconsin School of Medicine, Madison, WI; Brigham and Women's Hospital, Boston, MA; Dartmouth Medical School, Hanover, NH; University of Vermont, Burlington, Burlington, VT; University of California, Davis, Davis, CA
| | - D Johnson
- Group Health Cooperative, Seattle, WA; University of California, San Francisco, San Francisco, CA; University of Wisconsin School of Medicine, Madison, WI; Brigham and Women's Hospital, Boston, MA; Dartmouth Medical School, Hanover, NH; University of Vermont, Burlington, Burlington, VT; University of California, Davis, Davis, CA
| | - DSM Buist
- Group Health Cooperative, Seattle, WA; University of California, San Francisco, San Francisco, CA; University of Wisconsin School of Medicine, Madison, WI; Brigham and Women's Hospital, Boston, MA; Dartmouth Medical School, Hanover, NH; University of Vermont, Burlington, Burlington, VT; University of California, Davis, Davis, CA
| | - SD Brandzel
- Group Health Cooperative, Seattle, WA; University of California, San Francisco, San Francisco, CA; University of Wisconsin School of Medicine, Madison, WI; Brigham and Women's Hospital, Boston, MA; Dartmouth Medical School, Hanover, NH; University of Vermont, Burlington, Burlington, VT; University of California, Davis, Davis, CA
| | - WB DeMartini
- Group Health Cooperative, Seattle, WA; University of California, San Francisco, San Francisco, CA; University of Wisconsin School of Medicine, Madison, WI; Brigham and Women's Hospital, Boston, MA; Dartmouth Medical School, Hanover, NH; University of Vermont, Burlington, Burlington, VT; University of California, Davis, Davis, CA
| | - L Henderson
- Group Health Cooperative, Seattle, WA; University of California, San Francisco, San Francisco, CA; University of Wisconsin School of Medicine, Madison, WI; Brigham and Women's Hospital, Boston, MA; Dartmouth Medical School, Hanover, NH; University of Vermont, Burlington, Burlington, VT; University of California, Davis, Davis, CA
| | - L Nekhlyudov
- Group Health Cooperative, Seattle, WA; University of California, San Francisco, San Francisco, CA; University of Wisconsin School of Medicine, Madison, WI; Brigham and Women's Hospital, Boston, MA; Dartmouth Medical School, Hanover, NH; University of Vermont, Burlington, Burlington, VT; University of California, Davis, Davis, CA
| | - T Onega
- Group Health Cooperative, Seattle, WA; University of California, San Francisco, San Francisco, CA; University of Wisconsin School of Medicine, Madison, WI; Brigham and Women's Hospital, Boston, MA; Dartmouth Medical School, Hanover, NH; University of Vermont, Burlington, Burlington, VT; University of California, Davis, Davis, CA
| | - B Sprague
- Group Health Cooperative, Seattle, WA; University of California, San Francisco, San Francisco, CA; University of Wisconsin School of Medicine, Madison, WI; Brigham and Women's Hospital, Boston, MA; Dartmouth Medical School, Hanover, NH; University of Vermont, Burlington, Burlington, VT; University of California, Davis, Davis, CA
| | - DL Miglioretti
- Group Health Cooperative, Seattle, WA; University of California, San Francisco, San Francisco, CA; University of Wisconsin School of Medicine, Madison, WI; Brigham and Women's Hospital, Boston, MA; Dartmouth Medical School, Hanover, NH; University of Vermont, Burlington, Burlington, VT; University of California, Davis, Davis, CA
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Tucker A, Henderson L, Moffatt R, Abela R, Troughton J, McMullan R, Wilson A. Antibiotic Prophylaxis Regimens in Trauma and Orthopaedic Surgery: Are We Providing Adequate Cover Against Colonizing Organisms? Foot Ankle Spec 2016; 9:351-3. [PMID: 26596956 DOI: 10.1177/1938640015617529] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
UNLABELLED Trauma, elective orthopaedics, and an aging population will result in an increasing health burden and work load. The move to surgical podiatrists in the National Health Service within the United Kingdom will shift the surgical workload away from orthopaedic surgeons. A devastating complication of foot and ankle surgery is postoperative infection. While postoperative infection is multifactorial in etiology, concomitant diabetes mellitus increases the general risk of trauma and orthopaedic surgical site infections up to 8-fold. We therefore undertook a prospective study of our unit antibiotic prophylaxis regimes. Fifty patients participated. Swabs were obtained using aseptic technique from the plantar aspect of the feet, between the toes, and subsequently cultured on agar plates. Specimens were then incubated for 48 hours before being exposed to antibiotic plates. Cultured organisms were classified as susceptible to an antibiotic regimen if susceptibility to cefuroxime, or susceptibility to either drug of the flucloxacillin/gentamicin combination, was demonstrated. Statistical analysis e was performed. A P value <.05 was considered significant. Fifty patients were recruited, 26 (52%) were male. Mean age of 53 ± 19.4 years. The cohort included 15 diabetic, of which 11 (73.3%) insulin-dependent, and 35 nondiabetic patients. Comparing flucloxacillin/gentamicin against cefuroxime overall, susceptibility was noted in 84% and 70%, respectively (P = .096). Resistance to cefuroxime was significantly higher in diabetics than in nondiabetics (53% vs 25%, P = .046). The same pattern was observed for the flucloxacillin/gentamicin regimen (33% vs 9%, P = .049). While both regimens are active against colonizing organisms in this prospective observational study, flucloxacillin and gentamicin provide greater coverage overall. We have demonstrated that the use of flucloxacillin/gentamicin provides better coverage against commensal bacterial flora compared with cefuroxime alone. This is of even greater importance in the case of the specific high-risk subgroups, such as diabetic patients. LEVELS OF EVIDENCE Level IV: Case Series.
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Affiliation(s)
| | | | - R Moffatt
- Royal Victoria Hospital, Belfast, UK
| | - R Abela
- Royal Victoria Hospital, Belfast, UK
| | | | | | - A Wilson
- Royal Victoria Hospital, Belfast, UK
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Sinnathurai P, Capon A, Buchbinder R, Chand V, Henderson L, Lassere M, March L. SAT0133 Management of Cardiovascular Risk Factors in Rheumatoid and Psoriatic Arthritis: The Australian Rheumatology Association Database (ARAD) Heart Health Survey. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.3813] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Bailey PJ, Henderson L. Reviews: Speech Perception and Production: Studies in Selective Adaptation, Human Visual Cognition. Perception 2016. [DOI: 10.1068/p090725] [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: 10/27/2022]
Affiliation(s)
- P J Bailey
- Department of Psychology, University of York, Heslington, York YO1 5DD, England
| | - L Henderson
- School of Natural Sciences, Hatfield Polytechnic, PO Box 109, College Lane, Hatfield, Herts AL10 9AB
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Sadadcharam M, Warner L, Henderson L, Brown N, Bruce IA. Unilateral cochlear implantation in children with a potentially useable contralateral ear. Cochlear Implants Int 2016; 17 Suppl 1:55-8. [PMID: 27099113 DOI: 10.1080/14670100.2016.1155832] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Increasingly, children are considered for a unilateral CI, even if the contralateral ear falls outside current audiological guidelines, especially if they are not considered to be reaching their educational potential. The primary aim was to investigate the benefit of unilateral CI in children currently outside UK [National Institute for Health and Care Excellence Technology Appraisal Guidance. 2009. Cochlear implants for children and adults with severe to profound deafness. NICE technology appraisal guidance [TAG166]. Available January 29, 2016 from http://www.nice.org.uk/ta166 ] audiological guidelines in the contralateral ear. The secondary aim was to measure compliance. A retrospective case review with standard demographic data was performed. Forty-seven children were identified as having received a unilateral CI with the contralateral ear falling outside of current UK audiological criteria. These children were allocated to two groups; with hearing between 50 and 70 dB, and 70 and 90 dB at 2 and 4 kHz in the contralateral ear, respectively. Categories of auditory performance (CAP) were assessed. Pre- and post-operative CAP scores demonstrated a statistically significant improvement in auditory perception. We would suggest that assessing candidacy in individual ears and subsequent unilateral CI, has given these children a benefit they may not otherwise have acquired if they only had bilateral hearing aid.
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Affiliation(s)
- M Sadadcharam
- a Paediatric ENT Department, Royal Manchester Children's Hospital , Central Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre , UK
| | - L Warner
- a Paediatric ENT Department, Royal Manchester Children's Hospital , Central Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre , UK
| | - L Henderson
- b Richard Ramsden Centre for Auditory Implants , Central Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre , UK
| | - N Brown
- a Paediatric ENT Department, Royal Manchester Children's Hospital , Central Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre , UK
| | - I A Bruce
- a Paediatric ENT Department, Royal Manchester Children's Hospital , Central Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre , UK.,b Richard Ramsden Centre for Auditory Implants , Central Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre , UK
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Wernli KJ, Arao RF, Hubbard RA, Sprague BL, Alford-Teaster J, Haas JS, Henderson L, Hill D, Lee CI, Tosteson AN, Onega T. How Have Breast Cancer Screening Intervals Changed Since the 2009 USPSTF Guideline Update? Cancer Epidemiol Biomarkers Prev 2016. [DOI: 10.1158/1055-9965.epi-16-0079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Abstract
Background: Beginning in 2009, the U.S. Preventives Services Task Force (USPSTF) breast cancer screening guidelines recommended biennial mammography screening for women aged 50–74 years, and shared-decision making for women aged 40–49 years. We evaluated changes in screening interval after release of the 2009 recommendations. Methods: We compared screening intervals over the period between 2006 and 2012, expecting that the screening interval would lengthen over this time period, using data from the Breast Cancer Surveillance Consortium on 909,972 screening mammograms among 351,271 women aged 40–89 years. We stratified intervals based on whether the exam at the end of the interval occurred before or after the 2009 USPSTF decision. Differences in mean interval length by woman-level characteristics were compared using linear regression. Results: Contrary to expectations, the mean interval length (in months) minimally decreased after the 2009 USPSTF guideline compared to prior. Among women aged 40–49 years, the mean interval length decreased from 17.3 months to 17.1 months (difference −0.16, 95% confidence interval [CI] -0.30 to -0.01). Similar small reductions were seen for most age groups. The largest decreases in interval length in the post-USPSTF period were observed among women with a first-degree family history of breast cancer (difference −0.68, 95% CI, −0.82–−0.54) or a 5-year breast cancer risk ≥ 2.5% (difference −0.58, 95% CI, −0.73–−0.44). Conclusions: The 2009 USPSTF guideline update did not lengthen the average mammography screening interval among women routinely participating in mammography screening. Future studies should evaluate whether breast cancer screening intervals lengthen towards biennial intervals following new national 2015 breast cancer screening recommendations, particularly among women under 50 years.
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Scasta JD, Henderson L, Smith T. Drought effect on weaning weight and efficiency relative to cow size in semiarid rangeland1. J Anim Sci 2015; 93:5829-39. [DOI: 10.2527/jas.2015-9172] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
| | | | - T. Smith
- Beef Unit, Agriculture Experiment Station, University of Wyoming, Laramie 82071
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Li G, Traslavina R, Smith B, Henderson L, Steinbach S, Nath A. HIV isolated from CSF cells of a virologically controlled patient infects astrocytes. J Virus Erad 2015. [DOI: 10.1016/s2055-6640(20)31390-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Kobuch S, Fazalbhoy A, Henderson L, Macefield V. Activation of different cortical areas may be responsible for the divergent sympathetic responses to long-lasting experimental muscle pain in humans. Auton Neurosci 2015. [DOI: 10.1016/j.autneu.2015.07.134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Henderson L, Buxton P, Pherwani A. Ruptured AAA in the octogenarian and above: Is age a barrier to surgery? Int J Surg 2015. [DOI: 10.1016/j.ijsu.2015.07.623] [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: 10/22/2022]
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Phelan E, Pal R, Henderson L, Green KMJ, Bruce IA. The management of children with Down syndrome and profound hearing loss. Cochlear Implants Int 2015; 17:52-7. [DOI: 10.1179/1754762815y.0000000019] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Kydd ASR, Chen JS, Makovey J, Chand V, Henderson L, Buchbinder R, Lassere M, March LM. Smoking did not modify the effects of anti-TNF treatment on health-related quality of life among Australian ankylosing spondylitis patients. Rheumatology (Oxford) 2014; 54:310-7. [DOI: 10.1093/rheumatology/keu314] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Bruce IA, Markey A, Henderson L, Green KMJ. The need for specific outcome measures when evaluating cochlear implantation in hearing impaired children with cerebral palsy. Cochlear Implants Int 2013. [DOI: 10.1179/1467010013z.000000000112] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Hembrough T, Catenacci DVT, Liao W, Thyparambil S, Xu P, Henderson L, Burrows J. Development of Quantitative Gastrointestinal Carcinoma (GEC and CRC) SRM Assays for Use in FFPE Tumor Tissues. Ann Oncol 2013. [DOI: 10.1093/annonc/mdt046.9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Lynch JA, Choi CM, Park YS, Lee JC, Park MJ, Kim HR, Shih NY, Chang GC, Tseng SW, Liu KJ, Hsiao KC, Lin HC, Wang JY, Tsai HL, Barak V, Chen YJ, Hsieh YL, Chien PH, Chien YF, Huang WC, Lin SR, Chung FY, Yen LC, Tsai HL, Rixe O, Salkeni AM, Furgason JM, McPherson C, Warnick R, Bahassi M, Hembrough TA, Catenacci DVT, Liao WL, Thyparambil S, Xu P, Henderson L, Burrows J, Bebb DG, Elegbede AA, Kubota E, Petersen LF, Otsuka SM, Lees-Miller SP. Poster session 4. Molecular diagnosis & biomarkers. Ann Oncol 2013. [DOI: 10.1093/annonc/mdt046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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