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Gillies M, Arnaud J. The unique challenges and opportunities of delivering a First Contact Physiotherapy (FCP) Service to remote island communities in NHS Highland. Physiotherapy 2021. [DOI: 10.1016/j.physio.2021.10.163] [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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Boyd JH, Randall SM, Brown AP, Maller M, Botes D, Gillies M, Ferrante A. Population Data Centre Profiles: Centre for Data Linkage. Int J Popul Data Sci 2020; 4:1139. [PMID: 32935041 PMCID: PMC7473267 DOI: 10.23889/ijpds.v4i2.1139] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
The Centre for Data Linkage (CDL) was established at Curtin University, Western Australia, to develop infrastructure to enable cross-jurisdictional record linkage in Australia. The CDL’s operating model makes use of the ‘separation principle’, with content data typically provided to researchers directly by the data custodian; jurisdictional linkage where available are used within the linkage process. Along with conducting record linkage, the team has also invested in establishing a research programme in record linkage methodology and in developing modern record linkage software which can handle the size and complexity of today’s workloads. The Centre has been instrumental in the development of practical methods for privacy-preserving record linkage, with this methodology now regularly used for real-world linkages. While the promise of a nation-wide linkage system in Australia has yet to be met, distributed models provide a potential solution.
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Affiliation(s)
- J H Boyd
- Centre for Data Linkage, School of Public Health, Curtin University.,Department of Public Health, School of Psychology and Public Health, College of Science, Health & Engineering, La Trobe University
| | - S M Randall
- Centre for Data Linkage, School of Public Health, Curtin University
| | - A P Brown
- Centre for Data Linkage, School of Public Health, Curtin University
| | - M Maller
- Centre for Data Linkage, School of Public Health, Curtin University
| | - D Botes
- Centre for Data Linkage, School of Public Health, Curtin University
| | - M Gillies
- Centre for Data Linkage, School of Public Health, Curtin University
| | - A Ferrante
- Centre for Data Linkage, School of Public Health, Curtin University
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Abbott TEF, Ahmad T, Phull MK, Fowler AJ, Hewson R, Biccard BM, Chew MS, Gillies M, Pearse RM. The surgical safety checklist and patient outcomes after surgery: a prospective observational cohort study, systematic review and meta-analysis. Br J Anaesth 2018; 120:146-155. [PMID: 29397122 DOI: 10.1016/j.bja.2017.08.002] [Citation(s) in RCA: 73] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2017] [Revised: 07/30/2017] [Accepted: 09/18/2017] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND The surgical safety checklist is widely used to improve the quality of perioperative care. However, clinicians continue to debate the clinical effectiveness of this tool. METHODS Prospective analysis of data from the International Surgical Outcomes Study (ISOS), an international observational study of elective in-patient surgery, accompanied by a systematic review and meta-analysis of published literature. The exposure was surgical safety checklist use. The primary outcome was in-hospital mortality and the secondary outcome was postoperative complications. In the ISOS cohort, a multivariable multi-level generalized linear model was used to test associations. To further contextualise these findings, we included the results from the ISOS cohort in a meta-analysis. Results are reported as odds ratios (OR) with 95% confidence intervals. RESULTS We included 44 814 patients from 497 hospitals in 27 countries in the ISOS analysis. There were 40 245 (89.8%) patients exposed to the checklist, whilst 7508 (16.8%) sustained ≥1 postoperative complications and 207 (0.5%) died before hospital discharge. Checklist exposure was associated with reduced mortality [odds ratio (OR) 0.49 (0.32-0.77); P<0.01], but no difference in complication rates [OR 1.02 (0.88-1.19); P=0.75]. In a systematic review, we screened 3732 records and identified 11 eligible studies of 453 292 patients including the ISOS cohort. Checklist exposure was associated with both reduced postoperative mortality [OR 0.75 (0.62-0.92); P<0.01; I2=87%] and reduced complication rates [OR 0.73 (0.61-0.88); P<0.01; I2=89%). CONCLUSIONS Patients exposed to a surgical safety checklist experience better postoperative outcomes, but this could simply reflect wider quality of care in hospitals where checklist use is routine.
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Affiliation(s)
- T E F Abbott
- William Harvey Research Institute, Queen Mary University of London, London EC1M 6BQ, UK
| | - T Ahmad
- William Harvey Research Institute, Queen Mary University of London, London EC1M 6BQ, UK
| | - M K Phull
- The Royal London Hospital, Barts Health NHS Trust, London E1 1BB, UK
| | - A J Fowler
- Guys and St. Thomas's NHS Foundation Trust, London SE1 7EH, UK
| | - R Hewson
- The Royal London Hospital, Barts Health NHS Trust, London E1 1BB, UK
| | - B M Biccard
- Department of Anaesthesia and Perioperative Medicine, Groote Schuur Hospital, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - M S Chew
- Department of Anaesthesia and Intensive Care, Faculty of Medicine and Health Sciences, Linköping University, 58185 Linköping, Sweden
| | - M Gillies
- Department of Anaesthesia, Critical Care and Pain Medicine, University of Edinburgh, Edinburgh EH48 3DF, UK
| | - R M Pearse
- William Harvey Research Institute, Queen Mary University of London, London EC1M 6BQ, UK.
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Daien V, Nguyen V, Essex RW, Morlet N, Barthelmes D, Gillies MC, Gillies M, Hunt A, Essex R, Dayajeewa C, Hunyor A, Fraser-Bell S, Younan C, Fung A, Guymer R, Louis D, Arnold J, Chan D, Cass H, Harper A, O’Day J, Daniell M, Field A, Chow L, Barthelmes D, Cohn A, Young S, Lal S, Ferrier R, Barnes R, Thompson A, Vincent A, Manning L, Lake S, Phillips R, Perks M, Chen J, Landers J, Niladri, Banerjee G, Swamy B, Windle P, Dunlop A, Tang K, McLean I, Amini A, Hunt A, Clark G, McAllister I, Chen F, Squirrell D, Ng C, Hinchcliffe P, Barry R, Ah-Chan J, Steiner H, Morgan M, Thompson C, Game J, Murray N. Incidence and Outcomes of Infectious and Noninfectious Endophthalmitis after Intravitreal Injections for Age-Related Macular Degeneration. Ophthalmology 2018; 125:66-74. [DOI: 10.1016/j.ophtha.2017.07.005] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2017] [Revised: 06/19/2017] [Accepted: 07/06/2017] [Indexed: 10/19/2022] Open
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Ng KT, Gillies M, Griffith DM. Effect of nicotine replacement therapy on mortality, delirium, and duration of therapy in critically ill smokers: a systematic review and meta-analysis. Anaesth Intensive Care 2017; 45:556-561. [PMID: 28911284 DOI: 10.1177/0310057x1704500505] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [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: 01/25/2023]
Abstract
Nicotine replacement therapy is widely used in critically ill smokers and its effect on delirium, mortality and duration of intensive care unit (ICU) admission is unknown. The aims of this review were to determine whether the management of nicotine withdrawal with nicotine replacement therapy reduces delirium, mortality or length of stay in critically ill smokers in ICU. The primary outcome was incidence of author-defined ICU delirium. Secondary outcomes were ICU or hospital mortality, ICU-free days at day 28, and ICU or hospital length of stay. We conducted a systematic review and meta-analysis of the data sources MEDLINE, EMBASE, CINAHL, and the Cochrane Database of Systematic Reviews for randomised controlled trials and observational studies. Clinical trials, observational studies and systematic reviews comparing nicotine replacement therapy with placebo or no treatment were included. Case reports, case series, non-systematic reviews and studies that involved children were excluded. Eight studies were eligible (n=2,636) for inclusion in the data synthesis. In a meta-analysis of observational studies, nicotine replacement therapy was associated with increased delirium (three studies; n=908; I2=0%; finite element method: odds ratio 4.03 [95% confidence interval 2.64, 6.15]; P <0.001). There was no difference in ICU mortality (three studies; n=1,309; P=0.10, I2=44%; finite element method: odds ratio 0.58; 95% confidence intervals 0.31-1.10) and hospital mortality or 28-day ICU-free days. In the absence of high-quality data, nicotine replacement therapy cannot currently be recommended for routine use to prevent delirium or to reduce hospital or ICU mortality in critically ill smokers.
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Affiliation(s)
- K T Ng
- Anaesthesia, Critical Care and Pain Medicine, University of Edinburgh, Edinburgh, Scotland
| | - M Gillies
- Consultant Anaesthetist and Senior Lecturer in Anaesthesia and Critical Care, Anaesthesia, Critical Care and Pain Medicine, University of Edinburgh, Royal Infirmary of Edinburgh, Scotland, United Kingdom
| | - D M Griffith
- Consultant Anaesthetist and Senior Lecturer in Anaesthesia and Critical Care, Anaesthesia, Critical Care and Pain Medicine, University of Edinburgh, Royal Infirmary of Edinburgh, Edinburgh, Scotland, United Kingdom
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Hindle E, Dunn M, Gillies M, Clegg G. Neuroprognostication following out of hospital cardiac arrest – A retrospective study of departmental practice. Resuscitation 2015; 94:e5-6. [DOI: 10.1016/j.resuscitation.2015.06.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2015] [Accepted: 06/24/2015] [Indexed: 11/25/2022]
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Thierry-Chef I, Richardson DB, Daniels RD, Gillies M, Hamra GB, Haylock R, Kesminiene A, Laurier D, Leuraud K, Moissonnier M, O'Hagan J, Schubauer-Berigan MK, Cardis E. Dose Estimation for a Study of Nuclear Workers in France, the United Kingdom and the United States of America: Methods for the International Nuclear Workers Study (INWORKS). Radiat Res 2015; 183:632-42. [PMID: 26010707 PMCID: PMC4908811 DOI: 10.1667/rr14006.1] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
In the framework of the International Nuclear Workers Study conducted in France, the UK and the U.S. (INWORKS), updated and expanded methods were developed to convert recorded doses of ionizing radiation to estimates of organ doses or individual personal dose equivalent [H(p)(10)] for a total number of 308,297 workers, including 40,035 women. This approach accounts for differences in dosimeter response to predominant workplace energy and geometry of exposure and for the recently published ICRP report on dose coefficients for men and women separately. The overall mean annual individual personal dose equivalent, including zero doses, is 1.73 mSv [median = 0.42; interquartile range (IQR): 0.07, 1.59]. Associated individual organ doses were estimated. INWORKS includes workers who had potential for exposure to neutrons. Therefore, we analyzed neutron dosimetry data to identify workers potentially exposed to neutrons. We created a time-varying indicator for each worker, classifying them according to whether they had a positive recorded neutron dose and if so, whether their neutron dose ever exceeded 10% of their total external penetrating radiation dose. The number of workers flagged as being exposed to neutrons was 13% for the full cohort, with 15% of the cohort in France, 12% of the cohort in the UK and 14% in the U.S. We also used available information on in vivo and bioassay monitoring to identify workers with known depositions or suspected internal contaminations. As a result of this work, information is now available that will allow various types of sensitivity analyses.
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Affiliation(s)
| | - D. B. Richardson
- Department of Epidemiology, University of North Carolina, Chapel Hill, North Carolina
| | - R. D. Daniels
- National Institute for Occupational Safety and Health, Cincinnati, Ohio
| | - M. Gillies
- Public Health England, Centre for Radiation, Chemical and Environmental Hazards (PHE-CRCE), Chilton, Didcot, Oxon, United Kingdom
| | - G. B. Hamra
- Department of Environmental and Occupational Health, Drexel University School of Public Health, Philadelphia, Pennsylvania
| | - R. Haylock
- Public Health England, Centre for Radiation, Chemical and Environmental Hazards (PHE-CRCE), Moor Row, Cumbria, United Kingdom
| | - A. Kesminiene
- International Agency for Research on Cancer, Lyon, France
| | - D. Laurier
- Institut de Radioprotection et de Sûreté Nucléaire (IRSN), PRP-HOM/SRBE/LEPID, Fontenay aux Roses, France
| | - K. Leuraud
- Institut de Radioprotection et de Sûreté Nucléaire (IRSN), PRP-HOM/SRBE/LEPID, Fontenay aux Roses, France
| | - M. Moissonnier
- International Agency for Research on Cancer, Lyon, France
| | - J. O'Hagan
- Public Health England, Centre for Radiation, Chemical and Environmental Hazards (PHE-CRCE), Moor Row, Cumbria, United Kingdom
| | | | - E. Cardis
- Center for Research in Environmental Epidemiology (CREAL), Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
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Arnold JJ, Campain A, Barthelmes D, Simpson JM, Guymer RH, Hunyor AP, McAllister IL, Essex RW, Morlet N, Gillies MC, Gillies M, Hunt A, Hunyor A, Arnold J, Young S, Clark G, Banerjee G, Phillips R, Perks M, Essex R, McAllister I, Constable I, Guymer R, Guymer R, Lim L, Harper A, Chow L, Wickremansinghe S, Wickremasinghe S, Wickremasinghe S. Two-year outcomes of "treat and extend" intravitreal therapy for neovascular age-related macular degeneration. Ophthalmology 2015; 122:1212-9. [PMID: 25846847 DOI: 10.1016/j.ophtha.2015.02.009] [Citation(s) in RCA: 138] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2014] [Revised: 02/06/2015] [Accepted: 02/06/2015] [Indexed: 11/25/2022] Open
Abstract
PURPOSE To report 24-month outcomes of anti-vascular endothelial growth factor (VEGF) therapy for treatment-naïve eyes with neovascular age-related macular degeneration (nAMD) using a treat and extend treatment regimen in routine clinical practice. DESIGN Database observational study. PARTICIPANTS We included treatment-naïve eyes receiving predominantly ranibizumab for nAMD in routine clinical practice treated using a treat and extend regimen that were tracked in the Fight Retinal Blindness observational registry. METHODS A cohort of eyes treated by practitioners using exclusively a treat and extend regimen was extracted from the Fight Retinal Blindness observational registry. MAIN OUTCOME MEASURES Change in visual acuity (VA) over 2 years and number of injections and visits. RESULTS Data from 1198 eyes from 1011 patients receiving anti-VEGF therapy using a treat and extend regimen for treatment-naïve nAMD between January 2007 and December 2012 and with 24-month follow-up were included in the analysis. Mean VA increased by +5.3 logarithm of the minimum angle of resolution letters from 56.5 letters (20/80+1) at initial visit to 61.8 (20/60+2) letters at 24 months. Mean VA gains improved and number of injections increased with successive years from +2.7 letters for eyes commencing in 2007 after a mean of 9.7 injections in 2 years, to +7.8 letters for eyes commencing in 2012 after a mean of 14.2 injections over 2 years. The proportion of eyes with VA >20/40 increased from 27% when starting treatment to 45% after 24 months; the proportion with vision of <20/200 remained unchanged (13% initial, 11% at 24 months). Of the included eyes, 90.5% avoided a vision loss of ≥15 letters. There was an overall mean of 13.0 injections over the 24 months, 7.5 injections in the first year and 5.5 in the second year, with a mean of 14.8 clinic visits. CONCLUSIONS These data indicate that eyes managed in routine clinical practice with a treat and extend regimen can achieve good visual outcomes while decreasing the burden of treatments and clinic visits.
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Affiliation(s)
| | - Anna Campain
- The Save Sight Institute, Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia
| | - Daniel Barthelmes
- The Save Sight Institute, Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia; Department of Ophthalmology, University Hospital Zurich, University of Zurich, Zurich, Switzerland.
| | - Judy M Simpson
- School of Public Health, University of Sydney, Sydney, New South Wales, Australia
| | - Robyn H Guymer
- Centre for Eye Research Australia, University of Melbourne, Royal Victorian Eye and Ear Hospital, Victoria, Australia
| | - Alex P Hunyor
- The Save Sight Institute, Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia; Retina Associates, Chatswood, New South Wales, Australia
| | - Ian L McAllister
- Lions Eye Institute, Centre for Ophthalmology and Vision Science, University of Western Australia, Western Australia
| | - Rohan W Essex
- Academic Unit of Ophthalmology, Australian National University, Acton, Canberra, Australia
| | - Nigel Morlet
- University of Western Australia Department of Population Health, Perth, Western Australia
| | - Mark C Gillies
- Marsden Eye Specialists, Parramatta, New South Wales, Australia
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Shaw R, Gillies M, Barber J, MacIntyre K, Harkins C, Findlay IN, McCloy K, Gillie A, Scoular A, MacIntyre PD. Pre-exercise screening and health coaching in CHD secondary prevention: a qualitative study of the patient experience. Health Educ Res 2012; 27:424-436. [PMID: 22313621 DOI: 10.1093/her/cys005] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Secondary prevention programmes can be effective in reducing morbidity and mortality from coronary heart disease (CHD). In particular, UK guidelines, including those from the Department of Health, emphasize physical activity. However, the effects of secondary prevention programmes with an exercise component are moderate and uptake is highly variable. In order to explore patients' experiences of a pre-exercise screening and health coaching programme (involving one-to-one consultations to support exercise behaviour change), semi-structured telephone interviews were undertaken with 84 CHD patients recruited from primary care. The interviews focused on patients' experiences of the intervention including referral and any recommendations for improvement. A thematic analysis of transcribed interviews showed that the majority of patients were positive about referral. However, patients also identified a number of barriers to attending and completing the programme, including a belief they were sufficiently active already, the existence of other health problems, feeling unsupported in community-based exercise classes and competing demands. Our findings highlight important issues around the choice of an appropriate point of intervention for programmes of this kind as well as the importance of appropriate patient selection, suggesting that the effectiveness of health coaching may be under-reported as a result of including patients who are not yet ready to change their behaviours.
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Affiliation(s)
- R Shaw
- Institute of Health and Wellbeing, University of Glasgow, Glasgow G12 8RZ, UK.
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Gillies M, Jhund PS, MacTeague K, MacIntyre P, Allardyce J, Batty GD, MacIntyre K. Prior psychiatric hospitalization is associated with excess mortality in patients hospitalized with non-cardiac chest pain: a data linkage study based on the full Scottish population (1991-2006). Eur Heart J 2011; 33:760-7. [DOI: 10.1093/eurheartj/ehr401] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Gillies M, MacTeague K, Jhund P, Batty D, Allardyce J, MacIntyre P, MacIntyre K. P2-98 Prior psychiatric hospitalisation predicts mortality in patients hospitalised with non-cardiac chest pain: a data linkage study based on the full Scottish population (1991-2006). Br J Soc Med 2011. [DOI: 10.1136/jech.2011.142976i.33] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Gillies M, Lewsey J, Starkie H, Briggs A, Shepherd M, MacIntyre K. P2-99 Time trends in first and subsequent hospitalisation for COPD in Scotland, 1991-2009. Br J Soc Med 2011. [DOI: 10.1136/jech.2011.142976i.34] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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McGeoghegan D, Whaley S, Binks K, Gillies M, Thompson K, McElvenny DM. Mortality and cancer registration experience of the Sellafield workers known to have been involved in the 1957 Windscale accident: 50 year follow-up. J Radiol Prot 2010; 30:407-431. [PMID: 20798473 DOI: 10.1088/0952-4746/30/3/001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
This paper studies the mortality and cancer morbidity of the 470 male workers involved in tackling the 1957 Sellafield Windscale fire or its subsequent clean-up. Workers were followed up for 50 years to 2007, extending the follow-up of a previously published cohort study on the Windscale fire by 10 years. The size of the study population is small, but the cohort is of interest because of the involvement of the workers in the accident. Significant excesses of deaths from diseases of the circulatory system (standardised mortality ratio (SMR) = 120, 95% CI = 103-138; 194 deaths) driven by ischaemic heart disease (IHD) (SMR = 133, 95% CI = 112-157, 141 deaths) were found when compared with the population of England and Wales but not when compared with the population of Northwest England (SMR = 105, 95% CI = 90-120 and SMR = 115, 95% CI = 97-136 respectively). When compared with those workers in post at the time of the fire but not directly involved in the fire the mortality rate from IHD among those involved in tackling the fire was raised but not statistically significantly (rate ratio (RR) = 1.11, 95% CI = 0.92-1.33). A RR of 1.11 is consistent with an excess relative risk of 0.65 Sv(-1) as reported in an earlier study of non-cancer mortality in the British Nuclear Fuels plc cohort of which these workers are a small but significant part. There was a statistically significant difference in lung cancer mortality (RR = 2.18, 95% CI = 1.05-4.52) rates between workers who had received higher recorded external doses during the fire and those who had received lower external doses. Comparison of the mortality rates of workers directly involved in the accident with workers in post, but not so involved, showed no significant differences overall. On the basis of the use of a propensity score the average effect of involvement in the Windscale fire on all causes of death was - 2.13% (se = 3.64%, p = 0.56) though this difference is not statistically significant. The average effect of involvement in the Windscale fire was - 5.53% (se = 3.81, p = 0.15) for all cancers mortality and 6.60% (se = 4.03%, p = 0.10) for IHD mortality though neither figure was statistically significant. This analysis of the mortality and cancer morbidity experience of those Sellafield workers involved in the 1957 Windscale fire does not reveal any measurable effect of the fire upon their health. Although this study has low statistical power for detecting small adverse effects, due to the relatively small number of workers, it does provide reassurance that no significant health effects are associated with the 1957 Windscale fire even after 50 years of follow-up.
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Affiliation(s)
- D McGeoghegan
- Westlakes Research Institute, Westlakes Science and Technology Park, Moor Row, Cumbria, UK
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Abstract
The new generation short-stem hip implants are designed to encourage physiological-like loading, to minimize stress—strain shielding and therefore implant loosening in the long term. As yet there are no long-term clinical studies available to prove the benefits of these short-stem implants. Owing to this lack of clinical data, numerical simulation may be used as a predictor of longer term behaviour. This finite element study predicted both the primary stability and long-term stability of a short-stem implant. The primary implant stability was evaluated in terms of interface micromotion. This study found primary stability to fall within the critical threshold for osseointegration to occur. Longer term stability was evaluated using a strain-adaptive bone remodelling algorithm to predict the long-term behaviour of the bone in terms of bone mineral density (BMD) changes. No BMD loss was observed in the classical Gruen zones 1 and 7 and bone remodelling patterns were comparable with hip resurfacing results in the literature.
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Affiliation(s)
| | - M Hogg
- Medical Device Research Australia, Sydney, Australia
| | - L Kohan
- Joint Orthopaedics Centre, Sydney, Australia
| | - M Gillies
- Medical Device Research Australia, Sydney, Australia
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Faatoese A, Pitama S, Gillies M, Robertson P, Huria T, Doughty R, Whalley G, Richards M, Troughton R, Wells E, Sheerin I, Cameron V. A Comparison of Metabolic Risk Profiles Among Rural and Urban Māori in New Zealand. Heart Lung Circ 2010. [DOI: 10.1016/j.hlc.2010.06.622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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McGeoghegan D, Binks K, Gillies M, Jones S, Whalley S. Author's Response Comments on the study of McGeoghegan et al. Int J Epidemiol 2009. [DOI: 10.1093/ije/dyn123] [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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Gillies M, Chohan G, Llewelyn CA, MacKenzie J, Ward HJT, Hewitt PE, Will RG. A retrospective case note review of deceased recipients of vCJD-implicated blood transfusions. Vox Sang 2009; 97:211-8. [PMID: 19671123 DOI: 10.1111/j.1423-0410.2009.01222.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND To date, four instances of probable transfusion-transmission of variant Creutzfeldt-Jakob disease (vCJD) infection have been described, and surviving recipients of vCJD-implicated blood components have been informed that they may be 'at risk' of vCJD. Nearly two-thirds of all recipients of vCJD-implicated blood components are deceased, and many died before the vCJD risk was known. The primary aim of this study was to determine retrospectively whether there was evidence that any of the other deceased recipients of vCJD-implicated blood components had any clinical signs or symptoms suggestive of vCJD in life. In addition, pathological material from recipients, stored at the time of surgery or autopsy, was sought to allow testing for evidence of vCJD infection. A secondary aim of the study was to obtain information on invasive healthcare procedures undertaken on recipients following the transfusion to identify the potential for onward transmission of infection. METHODS A retrospective review of medical case notes of deceased recipients of vCJD-implicated blood components was carried out, and relevant information was extracted. In cases undergoing post-mortem, details of the findings were obtained. RESULTS The medical case notes of 33 (83%) deceased recipients of vCJD-implicated blood components, not already known to be infected with vCJD, were reviewed. The median age of recipients was 68 years (interquartile range 57-79 years). Almost half (16) were male. The median time from transfusion to death was 175 days (interquartile range 43-701 days). Most (66%) recipients died in hospital. None of the recipients had documented evidence of clinical signs or symptoms suggestive of vCJD. Only two recipients, both of whom died within a year of transfusion, underwent autopsy examination. Neither brain nor peripheral lymphoreticular tissue was available from either recipient, and pathological material was unavailable from any of the other deceased recipients. Almost half of all recipients underwent at least one invasive healthcare procedure post-transfusion. CONCLUSIONS A retrospective review of the medical case notes of the deceased recipients of vCJD-implicated blood components found no evidence that any further cases expressed clinical signs or symptoms suggestive of vCJD during life, but only four of the recipients survived for more than 5 years post-transfusion.
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Affiliation(s)
- M Gillies
- Department of Public Health and Public Health Policy, University of Glasgow, Glasgow, UK
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Gillies M, Pratt R, Borg J, Brooks J, Mckenzie C, Tibby S. Does choice of sedative agent affect duration of ICU stay, mortality or neurological outcome in patients undergoing therapeutic hypothermia? Crit Care 2009. [PMCID: PMC4084286 DOI: 10.1186/cc7564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Gillies M, Smith J, Langrish C. Positioning the tracheal tube during percutaneous tracheostomy: another use for videolaryngoscopy. Br J Anaesth 2008; 101:129. [PMID: 18556702 DOI: 10.1093/bja/aen158] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Hayden P, Salam A, Beale R, Gillies M. A comparison of complications during therapeutic hypothermia between surface cooling and endovascular cooling techniques. Crit Care 2007. [PMCID: PMC4095386 DOI: 10.1186/cc5493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Binks K, Doll R, Gillies M, Holroyd C, Jones SR, McGeoghegan D, Scott L, Wakeford R, Walker P. Mortality experience of male workers at a UK tin smelter. Occup Med (Lond) 2005; 55:215-26. [PMID: 15757978 DOI: 10.1093/occmed/kqi026] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Between 1937 and 1991, Capper Pass and Sons Limited operated a tin smelter complex in North Humberside, UK, at which employees were potentially exposed to a number of substances, including lead, arsenic, cadmium and natural series radionuclides. Decommissioning and site clearance continued until 1995. Between 1967 and 1995 the company was a subsidiary of Rio Tinto plc. AIMS The aim was to identify any significant excess, or deficits, in mortality among former employees that might be attributable to factors associated with occupation. METHODS We defined a cohort of 1462 males who had been employed for at least 12 months between 1/11/1967 and 28/7/1995, followed-up through to 31/12/2001. The mortality of the cohort was compared against that expected for both national and regional populations. RESULTS Mortality from all causes and all cancers did not differ from that expected. Mortality from ischaemic heart disease showed a deficit and mortality from lung cancer showed a statistically significant excess. Mortality from smoking related diseases other than lung cancer showed a non-significant deficit. CONCLUSIONS The pattern of lung cancer mortality is consistent with the hypothesis that the risk of lung cancer has been enhanced by occupational exposure to one or more carcinogens, the effect of which diminishes with time since exposure. The deficit in ischaemic heart disease may be attributed to a protective effect from manual labour. The results provide no evidence for attribution of other excess or deficits in mortality to factors associated with employment.
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Affiliation(s)
- K Binks
- Weslakes Scientific Consulting, Westlakes Science and Technology Park, Moor Row, Cumbria CA24 3LN, UK
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McGeoghegan D, Gillies M, Riddell AE, Binks K. Mortality and cancer morbidity experience of female workers at the British Nuclear Fuels Sellafield plant, 1946-1998. Am J Ind Med 2003; 44:653-63. [PMID: 14635242 DOI: 10.1002/ajim.10316] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
BACKGROUND Studies of nuclear workers have focused mainly on the experience of male workers. To date, little has been published specifically on the experience of female workers in the nuclear industry. METHODS We report on the mortality, cancer morbidity, and tracing experience of the 6,376 females ever employed at the British Nuclear Fuels Ltd. plant at Sellafield to the end of 1998. These workers have accumulated 142,337 person-years of experience. RESULTS Radiation workers were exposed to low doses of radiation. No statistically significant associations were noted between mortality or cancer morbidity and cumulative assessed organ-specific internal plutonium dose or cumulative external whole body radiation dose overall, or for any of the individual disease groupings examined. The power of the study was insufficient to detect the risks indicated in other radiation studies. CONCLUSION This study offers reassurance that there is no detrimental effect on the health of the female workers from occupational exposures at Sellafield. Am. J. Ind. Med. 44:653-663, 2003.
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Affiliation(s)
- D McGeoghegan
- Department of Occupational Health and Medical Statistics, The Princess Royal Building, Westlakes Scientific Consulting Ltd., Westlakes Science and Technology Park, Moor Row, Cumbria, United Kingdom.
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Jones RB, Balfour F, Gillies M, Stobo D, Cawsey AJ, Donaldson K. The accessibility of computer-based health information for patients: kiosks and the web. Stud Health Technol Inform 2002; 84:1469-73. [PMID: 11604970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/21/2023]
Abstract
The Internet is a rich source of health information but it is not as accessible as many claim. This paper brings together three projects to illustrate technical and cost barriers and some options to overcome them. (1) A survey amongst a representative sample of 180 patients in rural Spain showed a marked age gradient in computer access. None over the age of 50 had, and less than 10% planned, access to the Internet whereas a quarter were prepared to use health centre based touchscreen kiosks. (2) Half the commonly used search engines did not include the two most relevant websites for Glasgow colorectal cancer patients in the first ten documents listed, showing the difficulty facing patients in finding relevant information. Selection of information would help patients avoid being overwhelmed with information. (3) One method to improve accessibility is to download websites to kiosks but two projects showed that considerable work is required to reformat the information. Public access computing, such as kiosks, could help make the Internet more accessible. We discuss whether Web sites which structure their information according to method of access, place and person provide a way forward.
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Affiliation(s)
- R B Jones
- Department of Public Health, University of Glasgow, Glasgow, Scotland.
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Affiliation(s)
- H Minnis
- Department of Child and Adolescent Psychiatry, Yorkhill NHS Trust, Glasgow, UK
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Gillies M, Gatherer L. Patient information on cancer. West J Med 2000. [DOI: 10.1136/bmj.321.7252.47/a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Gillies M. Patient information on cancer. Access to the information should be made easier. BMJ 2000; 321:47-8. [PMID: 10939814 PMCID: PMC1127690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
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Gillies M. When does neural degeneration occur in diabetic retinopathy? Clin Exp Ophthalmol 2000; 28:1-2. [PMID: 11345336 DOI: 10.1046/j.1442-9071.2000.00229.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Ardern-Holmes SL, Lennon D, Pinnock R, Nicholson R, Graham D, Teele D, Schousboe M, Gillies M, Hollis B, Clarkin AM, Lindeman J, Stewart J. Trends in hospitalization and mortality from rotavirus disease in New Zealand infants. Pediatr Infect Dis J 1999; 18:614-9. [PMID: 10440437 DOI: 10.1097/00006454-199907000-00009] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Rotavirus illness is associated with significant morbidity and mortality worldwide. We have examined trends in diarrheal disease in New Zealand children to determine the disease burden attributable to rotavirus and to estimate the proportion of hospitalizations preventable by vaccination. METHODS Hospital admissions data and laboratory records for 1994 to 1996, were obtained for children 0 to 4 years at four sites (serving -60% of the New Zealand population). Rotavirus disease burden was estimated using combined admissions and laboratory data. Severity of disease was estimated in a sample of 150 hospitalizations for rotavirus diarrhea, and the proportion of vaccine-preventable admissions was extrapolated. Mortality attributed to diarrheal causes was determined from national records for 1974 to 1993. RESULTS Between 1994 and 1996, 4436 children <5 years of age were hospitalized with diarrhea (1047/100000 children per year). Admissions associated with rotavirus were estimated at 1522 to 1535 (315 to 362/100000 annually). Infants between 6 and 17 months were most commonly affected (42% of all cases). More male children than female children were hospitalized (P < 0.001) and mean length of stay was calculated as 1.51 days (SD 2.35). Disease severity scoring revealed that 61.3 and 38.0% of admissions reviewed were severe and very severe, respectively. Deaths from diarrheal causes numbered 138 among children 0 to 4 years old for the 20-year period 1974 to 1993, with 18 deaths occurring between 1984 and 1993 (10 years). CONCLUSION Current vaccines control severe disease, suggesting that 72% of cases reviewed would be eligible for prevention. A full cost effectiveness analysis is required to demonstrate anticipated benefits of vaccination.
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Affiliation(s)
- S L Ardern-Holmes
- Community Paediatrics, School of Medicine, Faculty of Health Sciences, University of Auckland, New Zealand
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Gillies M. Attacking cataract blindness. Aust N Z J Ophthalmol 1999; 27:93-4. [PMID: 10379706 DOI: 10.1046/j.1440-1606.1999.00168.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/13/2023]
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Affiliation(s)
- M Gillies
- Department of Ophthalmology, University of Sydney, Australia
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Tobin S, Nguyen QD, Phàm B, La Nauze J, Gillies M. Extracapsular cataract surgery in Vietnam: a 1 year follow-up study. Aust N Z J Ophthalmol 1998; 26:13-7. [PMID: 9524025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
PURPOSE Unoperated cataract is the leading cause of blindness in the developing world. Many developing countries now use extracapsular cataract extraction (ECCE) with intra-ocular lens insertion (IOL) in their cataract blindness-prevention programmes. To date, little research has been directed at visual outcomes and complication rates of ECCE/IOL surgery in developing countries. METHODS We conducted a follow-up study of 155 eyes approximately 12 months after ECCE/IOL surgery by eight local eye surgeons in Central Vietnam. We report the findings for the 144 eyes (93%) successfully reviewed. All subjects underwent manual ECCE with insertion of a three-piece posterior chamber IOL. All eyes were also assessed for the presence and severity of posterior capsule opacification (PCO) using a newly developed grading system. RESULTS Overall, 110 eyes (75%) had uncorrected visual acuities > or = 6/24 and 107 eyes (74%) had best spherically corrected visual acuities > or = 6/18. Some degree of PCO was found in 40% of eyes, but was graded as visually significant in only 4% of eyes. No major sight-threatening complications were noted. A portable neodymium:yttrium aluminium garnet (Nd:YAG) laser was used to perform capsulotomies on all eyes with visually significant PCO. There were no laser complications noted. CONCLUSIONS At approximately 1 year after ECCE/IOL, the visual outcomes for subjects in this cohort were favourable and complication rates were low. Posterior chamber opacification was not a major cause of vision impairment in this cohort. Portable Nd:YAG lasers may provide an effective solution to the problem of visually significant PCO occurring in developing countries as a late complication of extracapsular surgery. These findings support an increasing role for ECCE/PCIOL surgery by trained local eye surgeons in developing countries.
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Affiliation(s)
- S Tobin
- Centre for Public Health, The University of New South Wales, Sydney, Australia.
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Gillies M, Brian G, La Nauze J, Le Mesurier R, Moran D, Taylor H, Ruit S. Modern surgery for global cataract blindness: preliminary considerations. Arch Ophthalmol 1998; 116:90-2. [PMID: 9445213 DOI: 10.1001/archopht.116.1.90] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Unoperated cataract in the developing world remains ophthalmology's major unsolved problem. Recent developments have brought into question the assumptions of those who have thought that extracapsular surgery with implantation of a posterior chamber intraocular lens is an unrealistic approach to the treatment of global cataract blindness. High-quality 1-piece posterior chamber intraocular lenses are being manufactured locally for approximately $10 each. Most ophthalmologists can be trained to perform extracapsular surgery in a 1-month course. This process is particularly effective if outstanding local surgeons receive intensive training to become instructors. While the incidence and treatment of posterior capsule opacification requires further study, the development of a low-cost YAG laser may be a solution. Imaginative ways to recover costs will need to be developed if the staggering prevalence of cataract blindness is to be effectively addressed. The improved result of modern surgery may make patients more willing to pay for their operation.
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Affiliation(s)
- M Gillies
- Medical Advisory Group, Fred Hollows Foundation, Rosebery, New South Wales, Australia
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Abstract
BACKGROUND Acute macular neuroretinopathy (AMNR) is an uncommon disease of uncertain aetiology. We report on four males who developed unilateral changes following trauma which closely resembled acute macular retinopathy. METHODS Retrospective review of selected cases. RESULTS Four male patients developed a central or paracentral scotoma immediately or soon after an accident in which they suffered moderately severe bodily injury without direct ocular trauma. Vision was reduced in three patients. All four patients had characteristic well-circumscribed, dark macular lesions best seen using red-free light. The lesions cleared slowly in the two cases who returned for review. CONCLUSIONS A picture that closely resembles AMNR may be seen after trauma. The mechanism may involve a sudden rise in ocular venous pressure. This may be an unrecognized cause of visual loss after non-ocular trauma which may be regarded as functional. The subtle retinal lesions may be overlooked unless the fundi are examined in red-free light and the macular dark areas are compared.
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Affiliation(s)
- M Gillies
- Department of Ophthalmology, Sydney University, New South Wales, Australia.
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Abstract
PURPOSE Breakdown of the blood-retinal barrier is a major cause of visual loss in diseases such as diabetic retinopathy, age-related macular degeneration and retinal vein occlusion. METHODS Human serum, fractionated by gel filtration, was screened for factors that enhance barrier activity by measuring electrical resistance across monolayers of human umbilical vein endothelial cells. RESULTS Two peaks of barrier-enhancing activity were detected. The larger peak was broad, contained a preponderance of albumin and increased barrier activity to 183% of controls. The barrier-enhancing properties of the larger peak, however, appeared to be associated with proteins in general and not just albumin. The fractions associated with elution of the larger peak induced maximal increase in resistance in under 1 h, relative to controls. The smaller peak was associated with molecular weights much smaller than those of proteins.
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Affiliation(s)
- J Langford-Smith
- Save Sight Institute/Department of Ophthalmology, University of Sydney, New South Wales, Australia
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Abstract
Limited research evidence is available concerning the spatial abilities of children with specific language impairments. This paper reports a study of the ability of such children to use plan drawings. The participants were 23 language-impaired (LI) children (12 from special boarding schools, 11 from language units within mainstream primary schools), whose performance was compared with that of 23 non-language-impaired (NLI) children. The children were matched for age, their overall age range being between 7;0-11;11 (mean age 8;6). Tasks involved the production and utilisation of plan drawings of a model house. With one exception, results indicated that the LI children showed no deficit in ability on such tasks, and indeed out-performed their NLI peers on many of them. Implications of these findings are discussed.
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Gillies M. The society journal. Aust N Z J Ophthalmol 1996; 24:1-2. [PMID: 8742997 DOI: 10.1111/j.1442-9071.1996.tb01543.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
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Gillies M, Su T, Sarossy M, Hollows F. Interferon-alpha 2b inhibits proliferation of human Tenon's capsule fibroblasts. Graefes Arch Clin Exp Ophthalmol 1993; 231:118-21. [PMID: 8444359 DOI: 10.1007/bf00920225] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
To evaluate the potential of interferon-alpha 2b (IFN-alpha) as an antifibrotic treatment after glaucoma filtering surgery, we studied its ability to inhibit mitogen-induced proliferation of human Tenon's capsule fibroblasts in vitro, as shown by [3H]-thymidine incorporation. IFN-alpha inhibited fetal calf serum-induced proliferation in a dose-dependent manner in concentrations ranging from 10 to 10,000 IU/ml (P < 0.001). Inhibition was also found when IFN-alpha was added prior to the mitogen (P = 0.001); this inhibitory effect lasted at least 3 days. We suggest that IFN-alpha deserves further evaluation as a possible agent for the control of ocular fibrosis.
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Affiliation(s)
- M Gillies
- Department of Ophthalmology, Prince of Wales Hospital, Randwick, NSW, Australia
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Gillies M. Teenage traumas. Nurs Times 1992; 88:26-9. [PMID: 1625972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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Voss L, Lennon D, Gillies M. Haemophilus influenzae type b disease in Auckland children 1981-87. N Z Med J 1989; 102:149-51. [PMID: 2784846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Haemophilus influenzae type b invasive disease was reviewed in the Auckland paediatric population. A total of 205 episodes were confirmed by sterile cavity culture in 203 patients under 15 years of age over a seven year period. The incidence of invasive disease was 14/100,000/year in those under 15 years and 41/100,000/year in under 5 year olds. The age range was from 1 month to 11 years, with 91% under 5 years and 64% under 2 years. Most cases were due to meningitis (63%). Other diseases included epiglottitis, pneumonia, cellulitis, arthritis, and occult bacteraemia. There was only one fatality. Beta lactamase production was found in 9% of meningeal isolates. Recently a new conjugated haemophilus vaccine has been licensed in the United States for use in children 18 months and older. Consideration should be given to introducing this vaccine in New Zealand.
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Affiliation(s)
- L Voss
- Princess Mary Hospital, Auckland
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Morris A, Gillies M, Patton K. Detection of Campylobacter pyloridis infection. N Z Med J 1986; 99:336. [PMID: 3459100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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Thomas MG, Gillies M, Roberts S, Lang SD. Comparison of the antistaphylococcal activity of serum from healthy subjects taking flucloxacillin or augmentin. N Z Med J 1985; 98:452-3. [PMID: 3858743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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Gillies M. Computers in nursing. Spreading the word. Nurs Times 1985; 81:54. [PMID: 3845516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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