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Soares Filho AM, Vasconcelos CH, Cunningham M, Ribeiro ALP, Naghavi M, Malta DC. Spatial association of homicide rate with violence, sociodemographic, and public security factors: global burden of disease study 2018 for municipalities in Brazil. Public Health 2024; 227:16-23. [PMID: 38103272 DOI: 10.1016/j.puhe.2023.10.052] [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: 05/18/2023] [Revised: 10/12/2023] [Accepted: 10/13/2023] [Indexed: 12/19/2023]
Abstract
OBJECTIVES To analyse spatial-temporal changes and spatial association of homicide rates with violence, sociodemographic, public security and human rights indicators in Brazilian municipalities. STUDY DESIGN An ecological study using homicide estimates from the Global Burden of Disease and population from the Brazilian Ministry of Health, 2000 to 2018. The explanatory variables come from the systems of mortality, notifications of violence and security, and the Brazilian Institute of Geography and Statistics. METHODS Moran indices and maps identified clusters of high and low risk for homicides in three trienniums (p < 0.05). Multivariate linear and spatial regressions estimated explanatory factors' contributions for the last triennium. RESULTS Municipalities with high rates of homicides (>34/100,000) doubled, reaching 21.5 %. Those rates were concentrated in big cities, and increased in smaller municipalities. Increases in critical areas were found in the Northeast and North regions: more than 40 % in the states of Sergipe, Bahia, Ceará, Rio Grande do Norte and Roraima. Decreases occurred in the Southeast and Midwest regions: more than 35 % in São Paulo and Rio de Janeiro states. The spatial model, with an 18.9 % higher R2 (0.706), showed a positive association for records of violence, Blacks, low-level education, municipalities >50,000 inhabitants and municipalities with homicide and municipal police. CONCLUSIONS An increase in and the interiorisation of homicide risk areas in Brazil was observed, with displacement among regions (from the Southeast to the North/Northeast). The level of violence was the main explanatory factor for homicides. Territorial space proved to be important to understand and prevent lethal crime.
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Affiliation(s)
- A M Soares Filho
- Postgraduate Program in Public Health, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
| | - C H Vasconcelos
- Ministry of Health, Health Surveillance Secretariat, Brasília, Distrito Federal, Brazil
| | - M Cunningham
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - A L P Ribeiro
- Postgraduate Program in Public Health, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - M Naghavi
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - D C Malta
- Postgraduate Program in Public Health, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
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Nicholson J, O'Neill BD, Thirion P, Cunningham M, McVey G, Coffey J, Mihai AM, Kelly PJ, Elbeltagi N, Dunne M, Noone E, Parker I, Shannon AM, McCague M, Alvarez-Iglesias A, Kelly H, O'Donovan R, Hajdaraj D, Lawler G, Armstrong JG. A Prospective Phase II Dose Escalation Study Using IMRT for High Risk N0M0 Prostate Cancer. Int J Radiat Oncol Biol Phys 2023; 117:e422. [PMID: 37785387 DOI: 10.1016/j.ijrobp.2023.06.1578] [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: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Published data supports the use of very high dose intensity modulated radiotherapy (IMRT) in achieving high efficacy and low toxicity for high-risk prostate cancer (HRPCa). This phase II multi-institutional non-randomized prospective dose escalation study using intensity modulated radiotherapy (IMRT) for high risk N0M0 prostate cancer was designed to investigate dose escalation using 1.8 Gy increments from baseline 75.6 Gy up to maximum 81 Gy, once dose volume constraints were adhered to. MATERIALS/METHODS Inclusion criteria were patients undergoing a radical course of RT for high and very high-risk disease, defined as one or more of the criteria ≥ T3*, ≥ Gleason 8, Prostate specific antigen (PSA) > 20ng/ml. All patients received Androgen Deprivation Therapy (ADT) and none had radiological evidence of distant metastatic disease. The primary objective was to determine if dose escalated IMRT for high risk localized prostate cancer could provide freedom from biochemical relapse (BR; PSA rising > nadir +2ng/mL or initiation of salvage hormone therapy) similar to that reported in the literature. The Kaplan-Meier method was used to estimate survival times. Secondary objectives included OS, Disease Free Survival (DFS), and the incidence and severity of Genito-urinary (GU), Gastro-intestinal (GI) and erectile dysfunction (ED) toxicities (CTCAE v.3). Toxicities and performance status were collected and graded weekly during RT, 2 months after completing RT, 8 months' post RT, and 6 monthly thereafter to year five and annually thereafter to year nine. RESULTS A total of 230 evaluable patients were enrolled between April 2009 and June 2016. The median follow-up was 7.3 years. The cumulative proportion of patients surviving without BR at 5 years was 91% (95% Confidence Interval (CI): 86% to 94%). Overall survival at 5 and 7 years was 92% (88% to 95%) and 89% (83% to 92%) respectively, while the cumulative proportion of patients free from disease was 89% (84% to 93%) at 5 years and 81% (75% to 86%) at 7 years. The incidence of acute G2 and G3 toxicities were; GU; 57.8% G2, 12.6% G3, GI; 15.2% G2, 0.4% G3, ED; 30.0% G2 and 61.7% G3. The incidence of late G2, G3 and G4 toxicities were; GU; 40.9% G2, 8.7% G3, GI; 36.5% G2, 2.2% G3, 0.4% G4, ED; 11.7% G2 and 86.1% G3. The percentage of patients receiving each dose level was; 3.5% received 75.6Gy in 42 fractions, 2.2% received 77.4Gy in 43 fractions, 93% received 81Gy in 45 fractions. CONCLUSION The findings indicate that high-dose IMRT is well tolerated and is associated with excellent long-term tumor-control outcomes in patients with localized high and very high-risk prostate cancer, with 91% of patients surviving at 5 years without biochemical relapse. The rates of long term G3 GU and GI toxicity were low at 8.7% and 0.4% respectively.
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Affiliation(s)
- J Nicholson
- St.Luke's Radiation Oncology Network, Dublin, Ireland
| | - B D O'Neill
- St.Luke's Radiation Oncology Network, Dublin, Ireland; Cancer Trials Ireland, Dublin, Ireland
| | - P Thirion
- Beacon Hospital, Dublin, Ireland; St Luke's Radiation Oncology Network, Dublin, Ireland
| | - M Cunningham
- St.Luke's Radiation Oncology Network, Dublin, Ireland
| | - G McVey
- St Luke's Radiation Oncology Network, Dublin, Ireland
| | - J Coffey
- St Luke's Radiation Oncology Network, Dublin, Ireland
| | | | - P J Kelly
- Cork University Hospital, Cork, Ireland
| | - N Elbeltagi
- St Luke's Radiation Oncology Network, Dublin, Ireland
| | - M Dunne
- St Luke's Radiation Oncology Network, Dublin, Ireland
| | - E Noone
- St Luke's Radiation Oncology Network, Dublin, Ireland
| | - I Parker
- Cancer Trials Ireland, Dublin, Ireland
| | | | - M McCague
- HRB Clinical Research Facility, NUI Galway, Galway, Ireland
| | | | - H Kelly
- HRB Clinical Research Facility, NUI Galway, Galway, Ireland
| | - R O'Donovan
- St Luke's Radiation Oncology Network, Dublin, Ireland
| | - D Hajdaraj
- St Luke's Radiation Oncology Network, Dublin, Ireland
| | - G Lawler
- Beacon Hospital, Dublin, Ireland
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Rangaswamy G, Nicholson J, Wallace N, Connolly E, Houlihan O, Monaghan O, Trousdell J, Skourou C, Rohan C, Foley D, Duane FK, O'Neill BD, Thirion P, Cunningham M, Brennan SM, McArdle O. Enhancing Specialist Training in Radiation Oncology through the Implementation of Structured Radiotherapy Contouring Workshops. Int J Radiat Oncol Biol Phys 2023; 117:e538-e539. [PMID: 37785664 DOI: 10.1016/j.ijrobp.2023.06.1829] [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: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Contouring tumor volumes and organs at risk is a key component of Radiation Oncology specialist training. As trainees rotate through different tumor sites, they are expected to develop proficiency in contouring skills relevant to their year of training. These skills have historically been acquired in an unstructured manner during supervised clinical work. However, trainees often struggle to learn these skills due to variability in practice and approach amongst senior colleagues. Research has shown that contouring workshops improve the standardization of contouring and can be an effective way of enhancing the learning experience through interaction, instant feedback and reflection. We present our experience of implementing structured contouring workshops and the feedback received from the trainees. MATERIALS/METHODS Eight contouring workshops were held in our institution over a period of 3 years between 2019 and 2022. These included Head & Neck (3), Prostate (1), SABR Lung (2), Breast (1), and Esophagus (1). Six were held in-person pre-COVID and two in a virtual format during the pandemic. Each workshop was 2 hours long and attended by trainees with varying levels of contouring experience. All the workshops were facilitated by a consultant radiation oncologist and a clinical tutor and followed a similar format consisting of a brief tutorial on the tumor site, followed by a contouring demonstration on an anonymized case on an Eclipse planning platform referencing published contouring atlases. Each of the trainees had access to a copy of the same case throughout the workshop and their contours were then reviewed both individually and collectively. A key component of the workshops was instant feedback, as trainees could compare their contours to that of the tutors and discuss any differences. Feedback on the contouring workshop was then collected through a post workshop questionnaire. RESULTS The workshops were attended by an average of 12 trainees (range 10 to 14). Regardless of their year of training, all trainees rated the content and format of the workshops highly and stated they were relevant to their daily practice. Their subjective level of confidence in contouring in that specific tumor site improved significantly, going from an average of 5.6 out of 10 (range of 4 to 7) before the workshop to 8.7 (range of 8 to 9) after the 8 workshops. All the workshops were conducted at no extra cost as they were held using our existing planning software. CONCLUSION The trainees indicated that the workshops were of definite educational benefit and strongly supported incorporating this approach to teaching contouring skills into the curriculum. Based on this feedback, these contouring workshops have been integrated into the recently revised higher specialist training curriculum on a more structured basis. This will ensure that trainees will continue to develop progressive expertise in contouring skills in keeping with best international practice as they advance through their training scheme.
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Affiliation(s)
- G Rangaswamy
- St.Luke's Radiation Oncology Network, Dublin, Ireland; Faculty of Radiologists and Radiation Oncologists, RCSI, Dublin, Ireland
| | - J Nicholson
- St.Luke's Radiation Oncology Network, Dublin, Ireland; Faculty of Radiologists and Radiation Oncologists, RCSI, Dublin, Ireland
| | - N Wallace
- Faculty of Radiologists and Radiation Oncologists, RCSI, Dublin, Ireland; Cork University Hospital, Cork, Ireland
| | - E Connolly
- St.Luke's Radiation Oncology Network, Dublin, Ireland
| | - O Houlihan
- St.Luke's Radiation Oncology Network, Dublin, Ireland
| | - O Monaghan
- St.Luke's Radiation Oncology Network, Dublin, Ireland
| | - J Trousdell
- St.Luke's Radiation Oncology Network, Dublin, Ireland
| | - C Skourou
- St.Luke's Radiation Oncology Network, Dublin, Ireland
| | - C Rohan
- St.Luke's Radiation Oncology Network, Dublin, Ireland
| | - D Foley
- St.Luke's Radiation Oncology Network, Dublin, Ireland
| | - F K Duane
- St.Luke's Radiation Oncology Network, Dublin, Ireland; Faculty of Radiologists and Radiation Oncologists, RCSI, Dublin, Ireland
| | - B D O'Neill
- St.Luke's Radiation Oncology Network, Dublin, Ireland
| | - P Thirion
- St.Luke's Radiation Oncology Network, Dublin, Ireland; Faculty of Radiologists and Radiation Oncologists, RCSI, Dublin, Ireland
| | - M Cunningham
- St.Luke's Radiation Oncology Network, Dublin, Ireland; Faculty of Radiologists and Radiation Oncologists, RCSI, Dublin, Ireland
| | - S M Brennan
- St.Luke's Radiation Oncology Network, Dublin, Ireland; Faculty of Radiologists and Radiation Oncologists, RCSI, Dublin, Ireland
| | - O McArdle
- St.Luke's Radiation Oncology Network, Dublin, Ireland; Faculty of Radiologists and Radiation Oncologists, RCSI, Dublin, Ireland
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Malta DC, Aquino ÉCD, Veloso GA, Teixeira RA, Cunningham M, Santos de Magalhães Cardoso L, Morais Neto OLD, Naghavi M. Mortality by road transport injury in Brazilian municipalities between 2000 and 2018. Public Health 2023; 220:120-126. [PMID: 37300976 DOI: 10.1016/j.puhe.2023.04.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Accepted: 04/22/2023] [Indexed: 06/12/2023]
Abstract
OBJECTIVES This study aimed to investigate patterns of mortality by road transport injury (RTI) in Brazilian municipalities, focused on deaths of motorcyclists, between 2000 and 2018, and their relation with population size and economic status. STUDY DESIGN This was an ecological epidemiological study with a descriptive and analytical nature. METHODS The age-standardized RTI mortality rates were calculated for the Brazilian municipalities, referring to the 3-year periods of 2000/2002 (T1), 2009/2011 (T2), and 2016/2018 (T3). The rates were stratified according to macroregion and population size and were compared in terms of percentage variation from one 3-year period to another. The Moran Global and Local indices were used in the spatial point-pattern analysis of the rates. To verify the association with the gross domestic product (GDP) per capita, the Spearman correlation coefficient was applied. RESULTS A decline in RTI mortality rates was found between 2000 and 2018, with the most significant declines observed in municipalities from the South and Southeast regions of Brazil. However, increases were observed among motorcyclists. Clusters of municipalities were detected, which presented high mortality rates among the motorcyclists in the Northeast region and in some states of the North and Midwest regions. The mortality rates showed a negative correlation with the GDP per capita of the Brazilian municipalities. CONCLUSIONS Although there were decreases in RTI mortality rates between 1990 and 2018, there was a significant increase in deaths among motorcyclists, especially in the Northeast, North, and Midwest regions of the country. Such differences can be explained by unequal growth in the size of the motorcycle fleet in those regions, by less law enforcement capability, and by the implementation of educational actions.
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Affiliation(s)
- D C Malta
- Universidade Federal de Minas Gerais, Departamento de Enfermagem Materno Infantil e Saúde Pública, Belo Horizonte, Minas Gerais, Brazil.
| | - É C de Aquino
- Universidade Federal de Goiás, Instituto de Patologia Tropical e Saúde Pública, Programa de Pós-graduação Em Medicina Tropical e Saúde Pública, Goiânia, Goiás, Brazil.
| | - G A Veloso
- Universidade Federal Fluminense, Instituto de Matemática e Estatística, Departamento de Estatística.
| | - R A Teixeira
- Programa de Pós-graduação Em Saúde Pública, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
| | - M Cunningham
- University of Washington, Institute for Health Metrics and Evaluation, Seattle, WA, USA.
| | - L Santos de Magalhães Cardoso
- Universidade Federal de Minas Gerais, Escola de Enfermagem, Programa de Pós-Graduação Em Enfermagem, Belo Horizonte, Minas Gerais, Brazil.
| | - O L de Morais Neto
- Universidade Federal de Goiás, Instituto de Patologia Tropical e Saúde Pública, Goiânia, Goiás, Brazil.
| | - M Naghavi
- University of Washington, Institute for Health Metrics and Evaluation, Seattle, WA, USA.
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Almousawi F, Butler M, Bedard P, Spreafico A, Siu L, Cunningham M. A242 DELAYED STEROID TAPER MAY REDUCE RISK OF RELAPSE IN PATIENTS WITH IMMUNE CHECKPOINT INHIBITOR ASSOCIATED HEPATOTOXICIT. J Can Assoc Gastroenterol 2023. [PMCID: PMC9991374 DOI: 10.1093/jcag/gwac036.242] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/09/2023] Open
Abstract
Background Immune checkpoint inhibitors (ICI) have become the cornerstone of treatment of certain malignancies. However, they can result in systemic toxicities including hepatitis. Societal guidelines recommend initial management with high dose steroids, then a slow taper as hepatitis resolves. However, there is significant variation in steroid response with some patients experiencing a relapse of hepatitis as steroid doses are tapered (“steroid relapse”). Purpose Identify clinical features that predict relapse, and to explore variations in steroid management, in patients with ICI hepatotoxicity. Method Patients receiving ICI in early phase clinical trials at Princess Margaret Cancer Centre, or treated at the Toronto Centre for Liver Disease for ICI hepatotoxicity, were included. Patients with CTCAE Grade (G)3 ICI hepatotoxicity (ALT >5 x ULN) were identified and clinical records reviewed for management and outcomes. Patients with an alternate cause for ALT elevation; who did not receive corticosteroids; or with HCC or viral hepatitis, were excluded. Result(s) Between August 2012 and December 2021, 36 patients with G3 ICI hepatotoxicity were identified. Most (23; 64%) had metastatic melanoma. Thirteen received anti-CTLA-4/PD-1; 18 anti-PD-1 or anti-PD-L1, and 5 anti-CTLA-4 monotherapy. All patients initially received corticosteroids (1-2mg/kg/day methylprednisone equivalent). Thirteen patients (36%) were steroid relapsers. Consistent steroid response was seen in 18 (50%). Age, sex, liver metastases, prior ICI exposure, peak ALT or starting dose of steroids (≤1.5 vs >1.5mg/kg/day methylprednisolone equivalents) did not predict relapse, although relapsers were more likely to have been treated with combination anti-CTLA-4/PD-1 (7 (54%) relapsers, vs 3 (16%) responders, p = 0.02). Relapse occurred after a median of 14.5 days (range 8-111), and after taper to median 54% (5-100) of initial steroid dose. In responders, ALT normalisation occurred after median 14 days (range 3-56). In 27 patients where sufficient data were available, societal guidelines on ALT thresholds to initiate steroid taper were followed in 13 (48%; 6 relapsers and 7 responders). However, initiation of steroid taper was delayed in responders compared to relapsers (after median 7 days (2-15) in responders vs 4 days (range 2-9) in relapsers, p = 0.04). Overall, 5 relapsers responded to re-escalation of steroids. Eight required additional treatment with MMF, and 4 required 3rd line therapy with Tacrolimus. Ultimately, hepatitis resolved in all patients. Conclusion(s) In patients with ICI hepatotoxicity, combination ICI therapy confers a higher risk of steroid relapse than monotherapy. There is significant heterogeneity in management of steroid dosing in patients with ICI hepatotoxicity. Delayed initiation of steroid taper may be associated with a reduced risk of relapse and warrants prospective evaluation as part of a standardised management algorithm. Please acknowledge all funding agencies by checking the applicable boxes below None Disclosure of Interest None Declared
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Affiliation(s)
| | - M Butler
- Princess Margaret Cancer Centre, UHN, Toronto , Canada
| | - P Bedard
- Princess Margaret Cancer Centre, UHN, Toronto , Canada
| | - A Spreafico
- Princess Margaret Cancer Centre, UHN, Toronto , Canada
| | - L Siu
- Princess Margaret Cancer Centre, UHN, Toronto , Canada
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Nicholson J, Wallace N, Rangaswamy G, Ibrahim N, Rock K, Cunningham M, Elbeltagi N. Revision and Implementation of a New National Training Curriculum for Radiation Oncology. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.1783] [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: 10/31/2022]
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Wallace N, Skourou C, Dunne M, Gillham C, McVey G, Armstrong J, Cunningham M, Rangaswamy G, Mahon M, Bradshaw S, Sharma D, Hennessy B, Mcdermott R, Shannon A, Osullivan L, Parker I, Toomey S, Marron J, O'Neill B. Acute Gastrointestinal Toxicity Results from a Multi-Institution, Phase 2, Randomized Controlled Trial Comparing 3D-Conformal Radiotherapy (3DCRT) Versus Intensity Modulated Radiotherapy (IMRT) for Locally-Advanced Rectal Cancer (TRI-LARC). Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.628] [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: 10/31/2022]
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Geary R, Gillham C, McVey G, Armstrong J, Cunningham M, Rangaswamy G, Sharma D, Wallace N, Skourou C, Dunne M, Mahon M, Bradshaw S, Osullivan L, Marron J, Parker I, Shannon A, Mcdermott R, Toomey S, Hennessy B, O'Neill B. Quality of Life Analysis of a Phase II Randomized Controlled Trial Comparing 3D-Conformal Radiotherapy (3D-CRT) and Intensity Modulated Radiotherapy (IMRT) in Locally Advanced Rectal Cancer (TRI-LARC). Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Sandel C, Myers J, Alvarez K, Stavrakis S, Gaffney P, Cunningham M. Cd4+ T cell phenotypes, autoantibodies and transcriptional signatures overlap between myocarditis, ischemic and nonischemic heart failure, suggesting shared inflammatory pathogenic mechanisms. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.2651] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Myocarditis may progress to heart failure (HF) often as a result of viral myocardial infection where cardiomyocyte damage exposes sequestered self-antigens including cardiac myosin (CM) leading to autoimmunity. CM acts as an adjuvant via activation of Toll-like receptor (TLR)2 and TLR8, and is a potent autoantigen promoting HF in myocarditis through elevated IL-6, IL-17A and Th17 differentiation concomitant with autoantibody responses against CM. Since cardiomyocyte damage also occurs in ischemic and nonischemic cardiomyopathies, we investigated the hypothesis that ischemic and nonischemic HF would have similar inflammatory phenotypes.
Purpose
We defined CD4+ T helper cell phenotypes, autoantibodies, and peripheral blood transcriptome of the inflammatory phenotypes in myocarditis, compared to ischemic, and nonischemic HF. The identification of immune phenotypes in myocarditis and HF are important for consideration of inflammatory interventions and immunotherapies in myocarditis and HF.
Methods
Peripheral blood was collected from myocarditis patients within 6 months of disease onset, and from clinically stable, chronic HF patients. CD4+ T helper cells (Th1, Th2, and Th17) were evaluated by flow cytometry after density gradient separation, and human CM autoantibody titers were determined by ELISA. Whole blood RNA sequencing, Ingenuity Pathway Analysis (IPA), as well as multi-contrast pathway enrichment were performed.
Results
(Fig. 1A) Significantly elevated human CM autoantibodies were observed in myocarditis, ischemic and nonischemic HF patients, and correlated with nonrecovered patients and poor outcomes. (Fig. 1B) Myocarditis and nonischemic HF patients had significantly elevated Th17 and Th2 frequencies. Ischemic HF patients had a trend toward elevated Th 17 and Th 2 CD4+ T cell frequencies. None of the cohorts demonstrated an elevation in Th1 (not shown) (Fig 2A), IPA canonical pathway enrichment for all cohorts together showed elevated pathways concordant with our proposed pathogenic mechanisms in myocarditis and HF, including TLR and inflammasome signaling and IL17A and IL13 pathways (Fig. 2B). Myocarditis and nonischemic HF shared more inflammatory pathway enrichment in common than ischemic HF (Fig. 2C) Multi contrast pathway enrichment demonstrated that males in each cohort shared TLR and IL1b signaling that was not observed in females.
Conclusion
Nonischemic HF patients have overlapping immunological features with myocarditis including elevated anti-CM autoantibodies, as well as Th17, and Th2 frequencies. Ischemic HF demonstrated elevated CM autoantibodies and fewer inflammatory genes and pathways. The transcriptome supported the immune phenotypes in myocarditis and heart failure suggesting pathogenic autoimmune and inflammatory mechanisms shared in myocarditis and ischemic HF. The results have implications for immunomodulatory therapies in myocarditis and HF.
Funding Acknowledgement
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): National Institutes of Health
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Affiliation(s)
- C Sandel
- The University of Oklahoma Health Sciences Center , Oklahoma City , United States of America
| | - J Myers
- The University of Oklahoma Health Sciences Center , Oklahoma City , United States of America
| | - K Alvarez
- The University of Oklahoma Health Sciences Center , Oklahoma City , United States of America
| | - S Stavrakis
- The University of Oklahoma Health Sciences Center , Oklahoma City , United States of America
| | - P Gaffney
- The University of Oklahoma Health Sciences Center , Oklahoma City , United States of America
| | - M Cunningham
- The University of Oklahoma Health Sciences Center , Oklahoma City , United States of America
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Patel S, Kingsford P, Valdivia D, Singhal P, Lee R, Cunningham M, Wolfson A, Vaidya A, DePasquale E. Outcomes of Patients Bridged to Heart Transplantation with ECMO Following the UNOS Allocation Policy Change. J Heart Lung Transplant 2022. [DOI: 10.1016/j.healun.2022.01.140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Mehta S, Khaksar S, Perna C, Otter S, Mikropoulos C, Cunningham M, Long M, Uribe-Lewis S, Uribe J, Langley S. Optimisation of rectal dosimetry in LDR prostate brachytherapy. Eur Urol 2022. [DOI: 10.1016/s0302-2838(22)01030-2] [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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Laino A, Romero S, Cunningham M, Molina G, Gabellone C, Trabalon M, Garcia CF. Can Wolf Spider Mothers Detect Insecticides in the Environment? Does the Silk of the Egg-Sac Protect Juveniles from Insecticides? Environ Toxicol Chem 2021; 40:2861-2873. [PMID: 34314524 DOI: 10.1002/etc.5157] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 04/19/2021] [Accepted: 07/08/2021] [Indexed: 06/13/2023]
Abstract
The use of pesticides for plague control in agroecosystems generates a threat to wildlife and a major problem for human health. Pesticide compounds are also an important source of water and atmosphere contamination. Although insecticides are effective on their target organisms, they often affect organisms that are not their target. The aim of the present study was to research the effects of 3 types of neurotoxic insecticides-a pyrethroid (cypermethrin), a neonicotinoid (imidacloprid), and an organophosphate (chlorpyrifos)-on behavioral and physiological parameters of Pardosa saltans spider (Lycosidae). Our study analyzed for the first time the exploratory behavior of the spider mothers in the presence of these 3 insecticides on their egg-sacs and also on the ground. We also evaluated the oxidative stress effects on the juveniles hatched in the egg-sac protected by silk in relation to variations in detoxification enzymes (catalase, glutathione reductase, superoxide dismutase, glutathione-S-transferase, and glutathione peroxidase) and lipid peroxidation (reactive oxygen species [ROS]). The results show that these insecticides are repellents for mothers (cypermethrin is the most repellent), and maternal behavior is modified after detection of an insecticide on their egg-sac but mothers do not abandon their egg-sacs. These neurotoxic insecticides affect the juveniles inside their egg-sac. Cypermethrin and chlorpyrifos caused more oxidative stress in juveniles than did imidacloprid. The ROS generated by these insecticides seemed to be adequately eliminated by the juveniles' antioxidant systems. Environ Toxicol Chem 2021;40:2861-2873. © 2021 SETAC.
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Affiliation(s)
- A Laino
- Instituto de Investigaciones Bioquímicas de La Plata "Prof. Dr. Rodolfo R. Brenner,", La Plata, Argentina
| | - S Romero
- Instituto de Investigaciones Bioquímicas de La Plata "Prof. Dr. Rodolfo R. Brenner,", La Plata, Argentina
| | - M Cunningham
- Instituto de Investigaciones Bioquímicas de La Plata "Prof. Dr. Rodolfo R. Brenner,", La Plata, Argentina
| | - G Molina
- Instituto de Investigaciones Bioquímicas de La Plata "Prof. Dr. Rodolfo R. Brenner,", La Plata, Argentina
| | - C Gabellone
- Centro de Estudios Parasitológicos y Vectores, La Plata, Argentina
| | - M Trabalon
- Université de Rennes 1, CNRS, EthoS-UMR 6552, Rennes, France
| | - C F Garcia
- Instituto de Investigaciones Bioquímicas de La Plata "Prof. Dr. Rodolfo R. Brenner,", La Plata, Argentina
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Mehta S, Langley S, Khaksar S, Perna C, Otter S, Mikropoulos C, Cunningham M, Uribe-Lewis S. PO-0212 Use of rectal spacing hydrogel significantly reduces rectal dose in prostate LDR brachytherapy. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)06371-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Steele L, Jeetle S, Kok K, Cunningham M, Goldsmith P. Pyodermatitis vegetans-pyostomatitis vegetans with ocular involvement. Clin Exp Dermatol 2020; 46:223-226. [PMID: 32975854 DOI: 10.1111/ced.14446] [Citation(s) in RCA: 1] [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] [Received: 08/16/2020] [Accepted: 08/26/2020] [Indexed: 11/30/2022]
Affiliation(s)
- L Steele
- Departments of, Department of, Dermatology, The Royal London Hospital, Barts Health NHS Trust, London, UK
| | - S Jeetle
- Department of, Histopathology, The Royal London Hospital, Barts Health NHS Trust, London, UK
| | - K Kok
- Department of, Gastroenterology, The Royal London Hospital, Barts Health NHS Trust, London, UK
| | - M Cunningham
- Departments of, Department of, Dermatology, The Royal London Hospital, Barts Health NHS Trust, London, UK
| | - P Goldsmith
- Departments of, Department of, Dermatology, The Royal London Hospital, Barts Health NHS Trust, London, UK
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Liu Y, Dash A, Krez A, Kim HJ, Cunningham M, Schwab F, Hughes A, Carlson B, Samuel A, Marty E, Moore H, McMahon DJ, Carrino JA, Bockman RS, Stein EM. Low volumetric bone density is a risk factor for early complications after spine fusion surgery. Osteoporos Int 2020; 31:647-654. [PMID: 31919536 DOI: 10.1007/s00198-019-05245-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2019] [Accepted: 11/20/2019] [Indexed: 12/17/2022]
Abstract
UNLABELLED This study aims to investigate lumbar spine (LS) volumetric bone density (vBMD) as a risk factor for complications (pseudoarthrosis, instrumentation failure, adjacent fractures), re-operation, and time to complication after fusion. INTRODUCTION Lumbar spine (LS) fusion surgery is increasingly performed worldwide. Complications after fusion result in significant morbidity and healthcare costs. Multiple factors, including osteoporosis, have been suggested to contribute to risk of complications and re-operation. However, most studies have used DXA, which is subject to artifact in patients with spine pathology, and none have investigated the relationship between BMD and timing of post-operative complications. This study aims to investigate LS volumetric bone density (vBMD) as a risk factor for complications (pseudoarthrosis, instrumentation failure, adjacent fractures), re-operation, and time to complication after fusion. METHODS We evaluated a cohort of 359 patients who had initial LS fusion surgery at our institution, had pre-operative LS CTs and post-operative imaging available for review. Demographic factors, smoking status, vBMD, and details of surgical procedure were related to likelihood and timing of post-operative complications. RESULTS Mean age was 60 ± 14 years, vBMD 122 ± 37 g/cm3. Median follow-up was 11 months. Skeletal complications occurred in 47 patients (13%); 34 patients (10%) required re-operation. Low vBMD (directly measured and estimated using HU) and smoking were associated with increased risk of skeletal complications. Each increase in baseline vBMD of 10 g/cm3 decreased the complication hazard and increased the complication-free duration in time-to-event analysis (hazard ratio 0.91, 95% CI 0.83-0.98, p < 0.02). CONCLUSIONS Low vBMD was a significant risk factor for early post-operative complications in patients undergoing LS fusion. Prospective studies are needed to confirm these findings and to elucidate the optimal timing for follow-up and strategies for prevention of post-operative complications in this population.
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Affiliation(s)
- Y Liu
- Division of Endocrinology and Metabolic Bone Disease, Hospital for Special Surgery, 535 East 70th Street, New York, NY, USA
- Department of Medicine, Lahey Clinic, Burlington, MA, USA
| | - A Dash
- Division of Endocrinology and Metabolic Bone Disease, Hospital for Special Surgery, 535 East 70th Street, New York, NY, USA
| | - A Krez
- Division of Endocrinology and Metabolic Bone Disease, Hospital for Special Surgery, 535 East 70th Street, New York, NY, USA
| | - H J Kim
- Department of Orthopedics, Hospital for Special Surgery, New York, NY, USA
| | - M Cunningham
- Department of Orthopedics, Hospital for Special Surgery, New York, NY, USA
| | - F Schwab
- Department of Orthopedics, Hospital for Special Surgery, New York, NY, USA
| | - A Hughes
- Department of Orthopedics, Hospital for Special Surgery, New York, NY, USA
| | - B Carlson
- Department of Orthopedics, Hospital for Special Surgery, New York, NY, USA
- Department of Orthopedics, University of Kansas Medical Center, Kansas City, KS, USA
| | - A Samuel
- Department of Orthopedics, Hospital for Special Surgery, New York, NY, USA
| | - E Marty
- Department of Orthopedics, Hospital for Special Surgery, New York, NY, USA
| | - H Moore
- Weill Cornell Medical College, New York, NY, USA
| | - D J McMahon
- Division of Endocrinology and Metabolic Bone Disease, Hospital for Special Surgery, 535 East 70th Street, New York, NY, USA
| | - J A Carrino
- Department of Radiology, Hospital for Special Surgery, New York, NY, USA
| | - R S Bockman
- Division of Endocrinology and Metabolic Bone Disease, Hospital for Special Surgery, 535 East 70th Street, New York, NY, USA
| | - E M Stein
- Division of Endocrinology and Metabolic Bone Disease, Hospital for Special Surgery, 535 East 70th Street, New York, NY, USA.
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Laino A, Cunningham M, Garcia F, Trabalon M. Residual vitellus and energetic state of wolf spiderlings Pardosa saltans after emergence from egg-sac until first predation. J Comp Physiol B 2020; 190:261-274. [PMID: 32078039 DOI: 10.1007/s00360-020-01265-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Revised: 01/10/2020] [Accepted: 02/07/2020] [Indexed: 11/29/2022]
Abstract
The aim of this study was to evaluate energetic source used by juveniles of a terrestrial oviparous invertebrate during the earliest periods of their life. Growth, behavioural activities and energy contents of Pardosa saltans spiderlings' residual vitellus were monitored during 8 days after their emergence from their egg-sac until they disperse autonomously. The life-cycle of juvenile after emergence can be divided into three periods: a gregarious while juveniles are aggregated on their mother, dismounting off their mother's back and dispersion. We present the first biochemical study of residual vitellus and energy expenditure during these three periods. At emergence, the mean weight of juveniles was 0.59 mg and energy stock from residual vitellus averaged 51 cal/g wet mass. During gregarious period, the weight of the juveniles aggregated on their mother did not vary significantly and juveniles utilized only 1 cal/day from their residual vitellus. During the period from dismounting until their first exogenous feed, juveniles lost weight and used 30% of their residual vitellus stock. Proteins from the residual vitellus contributed principally to their energy expenditure during this period: 1.5 µg protein/day. Juveniles' first exogenous feeding was observed 7-8 days after emergence, when 70% of residual vitellus energy had been utilized. Juveniles dispersed after eating, reconstituting an energy stock comparable to that observed at emergence from egg-sac (50 cal/g wet mass). This new energy stock contains mainly lipids unlike the energy stock from the residual vitellus.
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Affiliation(s)
- A Laino
- Instituto de Investigaciones Bioquímicas de La Plata "Prof. Dr. Rodolfo R. Brenner" (INIBIOLP), CCT-La Plata CONICET-UNLP, La Plata, Argentina
| | - M Cunningham
- Instituto de Investigaciones Bioquímicas de La Plata "Prof. Dr. Rodolfo R. Brenner" (INIBIOLP), CCT-La Plata CONICET-UNLP, La Plata, Argentina
| | - F Garcia
- Instituto de Investigaciones Bioquímicas de La Plata "Prof. Dr. Rodolfo R. Brenner" (INIBIOLP), CCT-La Plata CONICET-UNLP, La Plata, Argentina
| | - M Trabalon
- Université de Rennes 1, UMR-6552 CNRS EthoS, Campus de Beaulieu, 263 avenue du Général Leclerc, CS 74205, 35042, Rennes Cedex, France.
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Scott KP, Grimaldi R, Cunningham M, Sarbini SR, Wijeyesekera A, Tang MLK, Lee JCY, Yau YF, Ansell J, Theis S, Yang K, Menon R, Arfsten J, Manurung S, Gourineni V, Gibson GR. Developments in understanding and applying prebiotics in research and practice-an ISAPP conference paper. J Appl Microbiol 2019; 128:934-949. [PMID: 31446668 DOI: 10.1111/jam.14424] [Citation(s) in RCA: 49] [Impact Index Per Article: 9.8] [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: 05/31/2019] [Revised: 07/24/2019] [Accepted: 07/30/2019] [Indexed: 12/17/2022]
Abstract
AIMS The concept of using specific dietary components to selectively modulate the gut microbiota to confer a health benefit, defined as prebiotics, originated in 1995. In 2018, a group of scientists met at the International Scientific Association for Probiotics and Prebiotics annual meeting in Singapore to discuss advances in the prebiotic field, focussing on issues affecting functionality, research methodology and geographical differences. METHODS AND RESULTS The discussion ranged from examining scientific literature supporting the efficacy of established prebiotics, to the prospects for establishing health benefits associated with novel compounds, isolated from different sources. CONCLUSIONS While many promising candidate prebiotics from across the globe have been highlighted in preliminary research, there are a limited number with both demonstrated mechanism of action and defined health benefits as required to meet the prebiotic definition. Prebiotics are part of a food industry with increasing market sales, yet there are great disparities in regulations in different countries. Identification and commercialization of new prebiotics with unique health benefits means that regulation must improve and remain up-to-date so as not to risk stifling research with potential health benefits for humans and other animals. SIGNIFICANCE AND IMPACT OF STUDY This summary of the workshop discussions indicates potential avenues for expanding the range of prebiotic substrates, delivery methods to enhance health benefits for the end consumer and guidance to better elucidate their activities in human studies.
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Affiliation(s)
- K P Scott
- Rowett Institute, University of Aberdeen, Aberdeen, UK
| | - R Grimaldi
- Food and Nutritional Sciences, University of Reading, Reading, UK
| | - M Cunningham
- Metagenics (Aust) Pty Ltd., Virginia, Queensland, Australia
| | - S R Sarbini
- Department of Crop Science, Universiti Putra Malaysia, Bintulu Campus, Malaysia
| | - A Wijeyesekera
- Food and Nutritional Sciences, University of Reading, Reading, UK
| | - M L K Tang
- Department of Allergy and Immunology, The Royal Children's Hospital, Parkville, Melbourne, VIC, Australia
| | - J C-Y Lee
- School of Biological Sciences, The University of Hong Kong, Hong Kong, Hong Kong
| | - Y F Yau
- School of Biological Sciences, The University of Hong Kong, Hong Kong, Hong Kong
| | - J Ansell
- Zespri International Ltd, Mt Maunganui, New Zealand
| | - S Theis
- Beneo-Institute, Obrigheim, Germany
| | - K Yang
- Departments of Obstetrics and Gynaecology and Physiology and Pharmacology, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
| | - R Menon
- The Bell Institute of Health and Nutrition, General Mills Inc., Minneapolis, MN, USA
| | - J Arfsten
- Nestlé Product and Technology Center Dairy, Konolfingen, Switzerland
| | - S Manurung
- Reckitt Benckiser, Nijmegen, The Netherlands
| | - V Gourineni
- Ingredion Incorporated, Bridgewater, NJ, USA
| | - G R Gibson
- Food and Nutritional Sciences, University of Reading, Reading, UK
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Cunningham M. Frances Cunningham. Assoc Med J 2019. [DOI: 10.1136/bmj.l1883] [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: 11/03/2022]
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Romero S, Laino A, Arrighetti F, García CF, Cunningham M. Vitellogenesis in spiders: first analysis of protein changes in different reproductive stages of Polybetes pythagoricus. J Comp Physiol B 2019; 189:335-350. [PMID: 30953127 DOI: 10.1007/s00360-019-01217-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2019] [Revised: 03/15/2019] [Accepted: 03/20/2019] [Indexed: 10/27/2022]
Abstract
Vitellogenesis represents one of the most vital processes of oviparous species during which various proteins, carbohydrates, and lipids are synthesized and stored inside the developing oocytes. Through analyzing protein changes in the midgut diverticula, hemolymph, and ovaries of females throughout the different vitellogenic stages of the spider Polybetes pythagoricus, we determined the origin of the different proteins involved in the formation of lipovitellins (LVs) along with the existence of a linkage between the hemocyanin and this vital process. An increase in the total protein content of the midgut diverticula, hemolymph, and ovary occurred throughout vitellogenesis followed by a decrease in those levels after laying. The presence of hemocyanin in egg and in LV2, as well as its accumulation in the ovary throughout the vitellogenesis process, was determined. Considering that all biologic processes depend on the correct structure and function of proteins, this study establishes, for the first time for the Order Araneae, the coexistence of three different origins of vitellogenesis-related proteins: one predominantly ovarian involving peptides of 120, 75, 46, and 30 kDa; another extraovarian one originated from the midgut diverticula and represented by a 170 kDa peptide, and a third hemolymphatic one, represented by the 67 kDa peptide.
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Affiliation(s)
- S Romero
- Instituto de Investigaciones Bioquímicas de la Plata Prof. Dr. Rodolfo R. Brenner (INIBIOLP), Fac. Cs. Médicas, CCT-La Plata CONICET-UNLP, Calle 60 y 120, 1900, La Plata, Argentina
| | - A Laino
- Instituto de Investigaciones Bioquímicas de la Plata Prof. Dr. Rodolfo R. Brenner (INIBIOLP), Fac. Cs. Médicas, CCT-La Plata CONICET-UNLP, Calle 60 y 120, 1900, La Plata, Argentina
| | - F Arrighetti
- CONICET-Museo Argentino de Ciencias Naturales, Av. Ángel Gallardo 470, C1405DJR, Ciudad Autónoma de Buenos Aires, Argentina
| | - C F García
- Instituto de Investigaciones Bioquímicas de la Plata Prof. Dr. Rodolfo R. Brenner (INIBIOLP), Fac. Cs. Médicas, CCT-La Plata CONICET-UNLP, Calle 60 y 120, 1900, La Plata, Argentina.
| | - M Cunningham
- Instituto de Investigaciones Bioquímicas de la Plata Prof. Dr. Rodolfo R. Brenner (INIBIOLP), Fac. Cs. Médicas, CCT-La Plata CONICET-UNLP, Calle 60 y 120, 1900, La Plata, Argentina.
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Reid G, Kort R, Alvarez S, Bourdet-Sicard R, Benoit V, Cunningham M, Saulnier D, van Hylckama Vlieg J, Verstraelen H, Sybesma W. Expanding the reach of probiotics through social enterprises. Benef Microbes 2018; 9:707-715. [DOI: 10.3920/bm2018.0015] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
The rapid rise in microbiome and probiotic science has led to estimates of product creation and sales exceeding $50 billion within five years. However, many people do not have access to affordable products, and regulatory agencies have stifled progress. The objective of a discussion group at the 2017 meeting of the International Scientific Association for Probiotics and Prebiotics was to identify mechanisms to confer the benefits of probiotics to a larger portion of the world’s population. Three initiatives, built around fermented food, were discussed with different methods of targeting populations that face enormous challenges of malnutrition, infectious disease, poverty and violent conflict. As new candidate probiotic strains emerge, and the market diversifies towards more personalised interventions, manufacturing processes will need to evolve. Information dissemination through scientific channels and social media is projected to provide consumers and healthcare providers with rapid access to clinical results, and to identify the nearest location of sites making new and affordable probiotic food and supplements. This rapid translation of science to individual well-being will not only expand the beneficiaries of probiotics, but also fuel new social enterprises and economic business models.
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Affiliation(s)
- G. Reid
- Canadian Research and Development Centre for Probiotics, Microbiology & Immunology, and Surgery, University of Western Ontario, Room F3-106, P.O. Box 5777, STN B, London, N6A 4V2 Ontario, Canada
| | - R. Kort
- Yoba for Life foundation, Hunzestraat 133-A, 1079 WB Amsterdam, the Netherlands
- TNO Microbiology and Systems Biology, P.O. Box 360, 3700 AJ Zeist, the Netherlands
- VU University Amsterdam; Micropia, Natura Artis Magistra, Plantage Kerklaan 38-40, 1018 CZ Amsterdam, the Netherlands
| | - S. Alvarez
- Reference Centre for Lactobacilli (CERELA-CONICET), Chacabuco 145, Tucuman 4000, Argentina
| | - R. Bourdet-Sicard
- Danone Access, Africa & India, Danone Nutricia Research, Avenue de la Vauve, 91767 Palaiseau, France
| | - V. Benoit
- General Mills, Nutrition and Technology Solutions, 9000 Plymouth Avenue N, Minneapolis, MN 55427, USA
| | - M. Cunningham
- Research and Development, Metagenics (Aust) Pty Ltd., P.O. Box 675, Virginia BC, Queensland 4014, Australia
| | - D.M. Saulnier
- Novozymes A/S, Hillerødgade 42, 2200 Frederiksberg, Denmark
| | | | - H. Verstraelen
- Vulvovaginal Disease Clinic, Dept. of Obstetrics & Gynaecology, Ghent University Hospital 0P4, Corneel Heymanslaan 10, 9000 Gent, Belgium
| | - W. Sybesma
- Yoba for Life foundation, Hunzestraat 133-A, 1079 WB Amsterdam, the Netherlands
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Redondo MJ, Geyer S, Steck AK, Sharp S, Wentworth JM, Weedon MN, Antinozzi P, Sosenko J, Atkinson M, Pugliese A, Oram RA, Antinozzi P, Atkinson M, Battaglia M, Becker D, Bingley P, Bosi E, Buckner J, Colman P, Gottlieb P, Herold K, Insel R, Kay T, Knip M, Marks J, Moran A, Palmer J, Peakman M, Philipson L, Pugliese A, Raskin P, Rodriguez H, Roep B, Russell W, Schatz D, Wherrett D, Wilson D, Winter W, Ziegler A, Benoist C, Blum J, Chase P, Clare-Salzler M, Clynes R, Eisenbarth G, Fathman C, Grave G, Hering B, Kaufman F, Leschek E, Mahon J, Nanto-Salonen K, Nepom G, Orban T, Parkman R, Pescovitz M, Peyman J, Roncarolo M, Simell O, Sherwin R, Siegelman M, Steck A, Thomas J, Trucco M, Wagner J, Greenbaum ,CJ, Bourcier K, Insel R, Krischer JP, Leschek E, Rafkin L, Spain L, Cowie C, Foulkes M, Krause-Steinrauf H, Lachin JM, Malozowski S, Peyman J, Ridge J, Savage P, Skyler JS, Zafonte SJ, Kenyon NS, Santiago I, Sosenko JM, Bundy B, Abbondondolo M, Adams T, Amado D, Asif I, Boonstra M, Bundy B, Burroughs C, Cuthbertson D, Deemer M, Eberhard C, Fiske S, Ford J, Garmeson J, Guillette H, Browning G, Coughenour T, Sulk M, Tsalikan E, Tansey M, Cabbage J, Dixit N, Pasha S, King M, Adcock K, Geyer S, Atterberry H, Fox L, Englert K, Mauras N, Permuy J, Sikes K, Berhe T, Guendling B, McLennan L, Paganessi L, Hays B, Murphy C, Draznin M, Kamboj M, Sheppard S, Lewis V, Coates L, Moore W, Babar G, Bedard J, Brenson-Hughes D, Henderson C, Cernich J, Clements M, Duprau R, Goodman S, Hester L, Huerta-Saenz L, Karmazin A, Letjen T, Raman S, Morin D, Henry M, Bestermann W, Morawski E, White J, Brockmyer A, Bays R, Campbell S, Stapleton A, Stone N, Donoho A, Everett H, Heyman K, Hensley H, Johnson M, Marshall C, Skirvin N, Taylor P, Williams R, Ray L, Wolverton C, Nickels D, Dothard C, Hsiao B, Speiser P, Pellizzari M, Bokor L, Izuora K, Abdelnour S, Cummings P, Paynor S, Leahy M, Riedl M, Shockley S, Karges C, Saad R, Briones T, Casella S, Herz C, Walsh K, Greening J, Hay F, Hunt S, Sikotra N, Simons L, Keaton N, Karounos D, Oremus R, Dye L, Myers L, Ballard D, Miers W, Sparks R, Thraikill K, Edwards K, Fowlkes J, Kinderman A, Kemp S, Morales A, Holland L, Johnson L, Paul P, Ghatak A, Phelen K, Leyland H, Henderson T, Brenner D, Law P, Oppenheimer E, Mamkin I, Moniz C, Clarson C, Lovell M, Peters A, Ruelas V, Borut D, Burt D, Jordan M, Leinbach A, Castilla S, Flores P, Ruiz M, Hanson L, Green-Blair J, Sheridan R, Wintergerst K, Pierce G, Omoruyi A, Foster M, Linton C, Kingery S, Lunsford A, Cervantes I, Parker T, Price P, Urben J, Doughty I, Haydock H, Parker V, Bergman P, Liu S, Duncum S, Rodda C, Thomas A, Ferry R, McCommon D, Cockroft J, Perelman A, Calendo R, Barrera C, Arce-Nunez E, Lloyd J, Martinez Y, De la Portilla M, Cardenas I, Garrido L, Villar M, Lorini R, Calandra E, D’Annuzio G, Perri K, Minuto N, Malloy J, Rebora C, Callegari R, Ali O, Kramer J, Auble B, Cabrera S, Donohoue P, Fiallo-Scharer R, Hessner M, Wolfgram P, Maddox K, Kansra A, Bettin N, McCuller R, Miller A, Accacha S, Corrigan J, Fiore E, Levine R, Mahoney T, Polychronakos C, Martin J, Gagne V, Starkman H, Fox M, Chin D, Melchionne F, Silverman L, Marshall I, Cerracchio L, Cruz J, Viswanathan A, Miller J, Wilson J, Chalew S, Valley S, Layburn S, Lala A, Clesi P, Genet M, Uwaifo G, Charron A, Allerton T, Milliot E, Cefalu W, Melendez-Ramirez L, Richards R, Alleyn C, Gustafson E, Lizanna M, Wahlen J, Aleiwe S, Hansen M, Wahlen H, Moore M, Levy C, Bonaccorso A, Rapaport R, Tomer Y, Chia D, Goldis M, Iazzetti L, Klein M, Levister C, Waldman L, Muller S, Wallach E, Regelmann M, Antal Z, Aranda M, Reynholds C, Leech N, Wake D, Owens C, Burns M, Wotherspoon J, Nguyen T, Murray A, Short K, Curry G, Kelsey S, Lawson J, Porter J, Stevens S, Thomson E, Winship S, Wynn L, O’Donnell R, Wiltshire E, Krebs J, Cresswell P, Faherty H, Ross C, Vinik A, Barlow P, Bourcier M, Nevoret M, Couper J, Oduah V, Beresford S, Thalagne N, Roper H, Gibbons J, Hill J, Balleaut S, Brennan C, Ellis-Gage J, Fear L, Gray T, Pilger J, Jones L, McNerney C, Pointer L, Price N, Few K, Tomlinson D, Denvir L, Drew J, Randell T, Mansell P, Roberts A, Bell S, Butler S, Hooton Y, Navarra H, Roper A, Babington G, Crate L, Cripps H, Ledlie A, Moulds C, Sadler K, Norton R, Petrova B, Silkstone O, Smith C, Ghai K, Murray M, Viswanathan V, Henegan M, Kawadry O, Olson J, Stavros T, Patterson L, Ahmad T, Flores B, Domek D, Domek S, Copeland K, George M, Less J, Davis T, Short M, Tamura R, Dwarakanathan A, O’Donnell P, Boerner B, Larson L, Phillips M, Rendell M, Larson K, Smith C, Zebrowski K, Kuechenmeister L, Wood K, Thevarayapillai M, Daniels M, Speer H, Forghani N, Quintana R, Reh C, Bhangoo A, Desrosiers P, Ireland L, Misla T, Xu P, Torres C, Wells S, Villar J, Yu M, Berry D, Cook D, Soder J, Powell A, Ng M, Morrison M, Young K, Haslam Z, Lawson M, Bradley B, Courtney J, Richardson C, Watson C, Keely E, DeCurtis D, Vaccarcello-Cruz M, Torres Z, Alies P, Sandberg K, Hsiang H, Joy B, McCormick D, Powell A, Jones H, Bell J, Hargadon S, Hudson S, Kummer M, Badias F, Sauder S, Sutton E, Gensel K, Aguirre-Castaneda R, Benavides Lopez V, Hemp D, Allen S, Stear J, Davis E, Jones T, Baker A, Roberts A, Dart J, Paramalingam N, Levitt Katz L, Chaudhary N, Murphy K, Willi S, Schwartzman B, Kapadia C, Larson D, Bassi M, McClellan D, Shaibai G, Kelley L, Villa G, Kelley C, Diamond R, Kabbani M, Dajani T, Hoekstra F, Magorno M, Beam C, Holst J, Chauhan V, Wilson N, Bononi P, Sperl M, Millward A, Eaton M, Dean L, Olshan J, Renna H, Boulware D, Milliard C, Snyder D, Beaman S, Burch K, Chester J, Ahmann A, Wollam B, DeFrang D, Fitch R, Jahnke K, Bounmananh L, Hanavan K, Klopfenstein B, Nicol L, Bergstrom R, Noland T, Brodksy J, Bacon L, Quintos J, Topor L, Bialo S, Bream S, Bancroft B, Soto A, Lagarde W, Lockemer H, Vanderploeg T, Ibrahim M, Huie M, Sanchez V, Edelen R, Marchiando R, Freeman D, Palmer J, Repas T, Wasson M, Auker P, Culbertson J, Kieffer T, Voorhees D, Borgwardt T, 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Trunnel S, Transue D, Surhigh J, Bezzaire D, Moltz K, Zacharski E, Henske J, Desai S, Frizelis K, Khan F, Sjoberg R, Allen K, Manning P, Hendry G, Taylor B, Jones S, Couch R, Danchak R, Lieberman D, Strader W, Bencomo M, Bailey T, Bedolla L, Roldan C, Moudiotis C, Vaidya B, Anning C, Bunce S, Estcourt S, Folland E, Gordon E, Harrill C, Ireland J, Piper J, Scaife L, Sutton K, Wilkins S, Costelloe M, Palmer J, Casas L, Miller C, Burgard M, Erickson C, Hallanger-Johnson J, Clark P, Taylor W, Galgani J, Banerjee S, Banda C, McEowen D, Kinman R, Lafferty A, Gillett S, Nolan C, Pathak M, Sondrol L, Hjelle T, Hafner S, Kotrba J, Hendrickson R, Cemeroglu A, Symington T, Daniel M, Appiagyei-Dankah Y, Postellon D, Racine M, Kleis L, Barnes K, Godwin S, McCullough H, Shaheen K, Buck G, Noel L, Warren M, Weber S, Parker S, Gillespie I, Nelson B, Frost C, Amrhein J, Moreland E, Hayes A, Peggram J, Aisenberg J, Riordan M, Zasa J, Cummings E, Scott K, Pinto T, Mokashi A, McAssey K, Helden E, Hammond P, Dinning L, Rahman S, Ray S, Dimicri C, Guppy S, Nielsen H, Vogel C, Ariza C, Morales L, Chang Y, Gabbay R, Ambrocio L, Manley L, Nemery R, Charlton W, Smith P, Kerr L, Steindel-Kopp B, Alamaguer M, Tabisola-Nuesca E, Pendersen A, Larson N, Cooper-Olviver H, Chan D, Fitz-Patrick D, Carreira T, Park Y, Ruhaak R, Liljenquist D. A Type 1 Diabetes Genetic Risk Score Predicts Progression of Islet Autoimmunity and Development of Type 1 Diabetes in Individuals at Risk. Diabetes Care 2018; 41:1887-1894. [PMID: 30002199 PMCID: PMC6105323 DOI: 10.2337/dc18-0087] [Citation(s) in RCA: 86] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2018] [Accepted: 06/06/2018] [Indexed: 02/03/2023]
Abstract
OBJECTIVE We tested the ability of a type 1 diabetes (T1D) genetic risk score (GRS) to predict progression of islet autoimmunity and T1D in at-risk individuals. RESEARCH DESIGN AND METHODS We studied the 1,244 TrialNet Pathway to Prevention study participants (T1D patients' relatives without diabetes and with one or more positive autoantibodies) who were genotyped with Illumina ImmunoChip (median [range] age at initial autoantibody determination 11.1 years [1.2-51.8], 48% male, 80.5% non-Hispanic white, median follow-up 5.4 years). Of 291 participants with a single positive autoantibody at screening, 157 converted to multiple autoantibody positivity and 55 developed diabetes. Of 953 participants with multiple positive autoantibodies at screening, 419 developed diabetes. We calculated the T1D GRS from 30 T1D-associated single nucleotide polymorphisms. We used multivariable Cox regression models, time-dependent receiver operating characteristic curves, and area under the curve (AUC) measures to evaluate prognostic utility of T1D GRS, age, sex, Diabetes Prevention Trial-Type 1 (DPT-1) Risk Score, positive autoantibody number or type, HLA DR3/DR4-DQ8 status, and race/ethnicity. We used recursive partitioning analyses to identify cut points in continuous variables. RESULTS Higher T1D GRS significantly increased the rate of progression to T1D adjusting for DPT-1 Risk Score, age, number of positive autoantibodies, sex, and ethnicity (hazard ratio [HR] 1.29 for a 0.05 increase, 95% CI 1.06-1.6; P = 0.011). Progression to T1D was best predicted by a combined model with GRS, number of positive autoantibodies, DPT-1 Risk Score, and age (7-year time-integrated AUC = 0.79, 5-year AUC = 0.73). Higher GRS was significantly associated with increased progression rate from single to multiple positive autoantibodies after adjusting for age, autoantibody type, ethnicity, and sex (HR 2.27 for GRS >0.295, 95% CI 1.47-3.51; P = 0.0002). CONCLUSIONS The T1D GRS independently predicts progression to T1D and improves prediction along T1D stages in autoantibody-positive relatives.
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Affiliation(s)
- Maria J. Redondo
- Texas Children’s Hospital, Baylor College of Medicine, Houston, TX
| | | | - Andrea K. Steck
- Barbara Davis Center for Childhood Diabetes, University of Colorado School of Medicine, Aurora, CO
| | - Seth Sharp
- Institute of Biomedical and Clinical Science, University of Exeter, Exeter, U.K
| | - John M. Wentworth
- Walter and Eliza Hall Institute of Medical Research and Royal Melbourne Hospital, Parkville, Victoria, Australia
| | - Michael N. Weedon
- Institute of Biomedical and Clinical Science, University of Exeter, Exeter, U.K
| | | | | | | | | | - Richard A. Oram
- Institute of Biomedical and Clinical Science, University of Exeter, Exeter, U.K
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| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
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22
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Romero S, Laino A, Arrighetti F, Cunningham M, Garcia C. First study on lipid dynamics during the female reproductive cycle of Polybetes pythagoricus (Araneae: Sparassidae). CAN J ZOOL 2018. [DOI: 10.1139/cjz-2017-0222] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Spiders are valuable to humans, not only for their role in health but also as biologic pest controllers. In oviparous species, lipids are the main energy source for embryo development and the growth and survival of larvae. Using the spider Polybetes pythagoricus (Holmberg, 1875) as an experimental model, we studied the fluctuations in lipids and fatty acids occurring in tissues related to vitellogenesis. Different reproductive stages (previtellogenesis, early vitellogenesis, vitellogenesis, and postvitellogenesis) were determined histologically. Gonadosomatic and hepatosomatic indices were first used in spiders. The midgut diverticula proved to be the organ with the highest lipid concentration, with triacylglycerols as the major component. Phospholipids were the principal lipids transported. In vitellogenesis, a major accumulation of lipids occurred in the ovary, principally phosphatidylethanolamine (41%); it probably synthesized in the midgut diverticula before being released into the hemolymph for transport and accumulation in the ovary. Phosphatidylethanolamine is possibly involved in maintaining membrane fluidity and in the function of the electron transport chain. The principal fatty acids in the different organs were palmitic, stearic, oleic, and linoleic acids. During vitellogenesis, the ovaries become enriched in polyunsaturated fatty acids. The lipid patterns in the male midgut diverticula, muscle, and hemolymph were similar to those of the previtellogenic or postvitellogenic females.
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Affiliation(s)
- S. Romero
- Instituto de Investigaciones Bioquímicas de la Plata Prof. Dr. Rodolfo R. Brenner (INIBIOLP), CCT-La Plata CONICET-UNLP, Argentina
| | - A. Laino
- Instituto de Investigaciones Bioquímicas de la Plata Prof. Dr. Rodolfo R. Brenner (INIBIOLP), CCT-La Plata CONICET-UNLP, Argentina
| | - F. Arrighetti
- CONICET-Museo Argentino de Ciencias Naturales, Av. Ángel Gallardo 470, C1405DJR Ciudad Autónoma de Buenos Aires, Argentina
| | - M. Cunningham
- Instituto de Investigaciones Bioquímicas de la Plata Prof. Dr. Rodolfo R. Brenner (INIBIOLP), CCT-La Plata CONICET-UNLP, Argentina
| | - C.F. Garcia
- Instituto de Investigaciones Bioquímicas de la Plata Prof. Dr. Rodolfo R. Brenner (INIBIOLP), CCT-La Plata CONICET-UNLP, Argentina
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23
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Millar BC, Banks L, Bourke TW, Cunningham M, Dooley JSG, Elshibly S, Goldsmith CE, Fairley D, Jackson K, Lamont S, Jessop L, McCrudden E, McConnell D, McAuley K, McKenna JP, Moore PJA, Smithson R, Stirling J, Shields M, Moore JE. Meningococcal Disease Section 4: Post Disease Complications, Charity Support and Future Perspectives: MeningoNI Forum. THE ULSTER MEDICAL JOURNAL 2018; 87:99-101. [PMID: 29867263 PMCID: PMC5974664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Download PDF] [Subscribe] [Scholar Register] [Accepted: 03/05/2018] [Indexed: 11/30/2022]
Affiliation(s)
- BC Millar
- Department of Bacteriology, Belfast City Hospital, Lisburn Road, Belfast, BT9 7AD,School of Biomedical Science, Ulster University, Cromore Road, Coleraine, BT52 1SA
| | - L Banks
- Meningitis Now, Stroud, Gloucestershire GL5 3TJ
| | - TW Bourke
- The Royal Belfast Hospital for Sick Children, Belfast, BT12 6BE
| | - M Cunningham
- University Health Centre at Queen’s, 7 University Terrace, Belfast, BT7 1NP
| | - JSG Dooley
- School of Biomedical Science, Ulster University, Cromore Road, Coleraine, BT52 1SA
| | - S Elshibly
- Department of Microbiology, Antrim Area Hospital, Antrim, BT41 2RL
| | - CE Goldsmith
- Department of Bacteriology, Belfast City Hospital, Lisburn Road, Belfast, BT9 7AD
| | - D Fairley
- Department of Medical Microbiology, The Royal Group of Hospitals Belfast, BT12 6BA
| | - K Jackson
- The Royal Belfast Hospital for Sick Children, Belfast, BT12 6BE,School of Medicine, Dentistry and Biomedical Sciences, Queen’s University, University Road, Belfast, BT7 1NN
| | - S Lamont
- The Royal Belfast Hospital for Sick Children, Belfast, BT12 6BE
| | - L Jessop
- Northern Ireland Public Health Agency, Belfast, BT2 8BS
| | - E McCrudden
- The Royal Belfast Hospital for Sick Children, Belfast, BT12 6BE
| | - D McConnell
- Meningitis Research Foundation, 71 Botanic Avenue, Belfast, BT7 1JL
| | - K McAuley
- Meningitis Research Foundation, 71 Botanic Avenue, Belfast, BT7 1JL
| | - JP McKenna
- Department of Medical Microbiology, The Royal Group of Hospitals Belfast, BT12 6BA
| | - PJA Moore
- School of Medicine, Dentistry and Biomedical Sciences, Queen’s University, University Road, Belfast, BT7 1NN
| | - R Smithson
- Northern Ireland Public Health Agency, Belfast, BT2 8BS
| | - J Stirling
- Department of Bacteriology, Belfast City Hospital, Lisburn Road, Belfast, BT9 7AD
| | - M Shields
- The Royal Belfast Hospital for Sick Children, Belfast, BT12 6BE,School of Medicine, Dentistry and Biomedical Sciences, Queen’s University, University Road, Belfast, BT7 1NN
| | - JE Moore
- Department of Bacteriology, Belfast City Hospital, Lisburn Road, Belfast, BT9 7AD,School of Biomedical Science, Ulster University, Cromore Road, Coleraine, BT52 1SA,School of Medicine, Dentistry and Biomedical Sciences, Queen’s University, University Road, Belfast, BT7 1NN,Correspondence to Professor John E. Moore, Northern Ireland Public Health Laboratory, Department of Bacteriology, Belfast City Hospital, Lisburn Road, Belfast, BT9 7AD. E-mail:
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24
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Millar BC, Banks L, Bourke TW, Cunningham M, Dooley JSG, Elshibly S, Goldsmith CE, Fairley D, Jackson K, Lamont S, Jessop L, McCrudden E, McConnell D, McAuley K, McKenna JP, Moore PJA, Smithson R, Stirling J, Shields M, Moore JE. Meningococcal Disease Section 3: Diagnosis and Management: MeningoNI Forum. Ulster Med J 2018; 87:94-98. [PMID: 29867262 PMCID: PMC5974663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 03/05/2018] [Indexed: 10/29/2022]
Affiliation(s)
- BC Millar
- Department of Bacteriology, Belfast City Hospital, Lisburn Road, Belfast, BT9 7AD
- School of Biomedical Science, Ulster University, Cromore Road, Coleraine, BT52 1SA
| | - L Banks
- Meningitis Now, Stroud, Gloucestershire GL5 3TJ
| | - TW Bourke
- The Royal Belfast Hospital for Sick Children, Belfast, BT12 6BE
| | - M Cunningham
- University Health Centre at Queen’s, 7 University Terrace, Belfast, BT7 1NP
| | - JSG Dooley
- School of Biomedical Science, Ulster University, Cromore Road, Coleraine, BT52 1SA
| | - S Elshibly
- Department of Microbiology, Antrim Area Hospital, Antrim, BT41 2RL
| | - CE Goldsmith
- Department of Bacteriology, Belfast City Hospital, Lisburn Road, Belfast, BT9 7AD
| | - D Fairley
- Department of Medical Microbiology, The Royal Group of Hospitals Belfast, BT12 6BA
| | - K Jackson
- The Royal Belfast Hospital for Sick Children, Belfast, BT12 6BE
- School of Medicine, Dentistry and Biomedical Sciences, Queen’s University, University Road, Belfast, BT7 1NN
| | - S Lamont
- The Royal Belfast Hospital for Sick Children, Belfast, BT12 6BE
| | - L Jessop
- Northern Ireland Public Health Agency, Belfast, BT2 8BS
| | - E McCrudden
- The Royal Belfast Hospital for Sick Children, Belfast, BT12 6BE
| | - D McConnell
- Meningitis Research Foundation, 71 Botanic Avenue, Belfast, BT7 1JL
| | - K McAuley
- Meningitis Research Foundation, 71 Botanic Avenue, Belfast, BT7 1JL
| | - JP McKenna
- Department of Medical Microbiology, The Royal Group of Hospitals Belfast, BT12 6BA
| | - PJA Moore
- School of Medicine, Dentistry and Biomedical Sciences, Queen’s University, University Road, Belfast, BT7 1NN
| | - R Smithson
- Northern Ireland Public Health Agency, Belfast, BT2 8BS
| | - J Stirling
- Department of Bacteriology, Belfast City Hospital, Lisburn Road, Belfast, BT9 7AD
| | - M Shields
- The Royal Belfast Hospital for Sick Children, Belfast, BT12 6BE
- School of Medicine, Dentistry and Biomedical Sciences, Queen’s University, University Road, Belfast, BT7 1NN
| | - JE Moore
- Department of Bacteriology, Belfast City Hospital, Lisburn Road, Belfast, BT9 7AD
- School of Biomedical Science, Ulster University, Cromore Road, Coleraine, BT52 1SA
- School of Medicine, Dentistry and Biomedical Sciences, Queen’s University, University Road, Belfast, BT7 1NN
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25
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Millar BC, Banks L, Bourke TW, Cunningham M, Dooley JSG, Elshibly S, Goldsmith CE, Fairley D, Jackson K, Lamont S, Jessop L, McCrudden E, McConnell D, McAuley K, McKenna JP, Moore PJA, Smithson R, Stirling J, Shields M, Moore JE. Meningococcal Disease in Northern Ireland - Past, Present & Future: MeningoNI Forum. Ulster Med J 2018; 87:83. [PMID: 29867259 PMCID: PMC5974660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Subscribe] [Scholar Register] [Accepted: 03/05/2018] [Indexed: 11/23/2022]
Abstract
Meningococcal disease has had devastating consequences in Northern Ireland since its first description locally in 1859. The incidence of this disease has significantly declined in recent years, however it is important to understand reasons for this changing epidemiology and to acknowledge the diagnostic and clinical management developments that have been made locally. This review aims to examine the changing face of this disease in Northern Ireland over the years, with particular reference to local disease prevention, epidemiology, diagnosis, clinical treatment and management, post-disease sequelae and the role of meningitis charities locally, in terms of patient support and research.
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Affiliation(s)
- BC Millar
- Department of Bacteriology, Belfast City Hospital, Lisburn Road, Belfast, BT9 7AD,School of Biomedical Science, Ulster University, Cromore Road, Coleraine, BT52 1SA
| | - L Banks
- Meningitis Now, Stroud, Gloucestershire GL5 3TJ
| | - TW Bourke
- The Royal Belfast Hospital for Sick Children, Belfast, BT12 6BE
| | - M Cunningham
- University Health Centre at Queen’s, 7 University Terrace, Belfast, BT7 1NP
| | - JSG Dooley
- School of Biomedical Science, Ulster University, Cromore Road, Coleraine, BT52 1SA
| | - S Elshibly
- Department of Microbiology, Antrim Area Hospital, Antrim, BT41 2RL
| | - CE Goldsmith
- Department of Bacteriology, Belfast City Hospital, Lisburn Road, Belfast, BT9 7AD
| | - D Fairley
- Department of Medical Microbiology, The Royal Group of Hospitals Belfast, BT12 6BA
| | - K Jackson
- The Royal Belfast Hospital for Sick Children, Belfast, BT12 6BE,School of Medicine, Dentistry and Biomedical Sciences, Queen’s University, University Road, Belfast, BT7 1NN
| | - S Lamont
- The Royal Belfast Hospital for Sick Children, Belfast, BT12 6BE
| | - L Jessop
- Northern Ireland Public Health Agency, Belfast, BT2 8BS
| | - E McCrudden
- The Royal Belfast Hospital for Sick Children, Belfast, BT12 6BE
| | - D McConnell
- Meningitis Research Foundation, 71 Botanic Avenue, Belfast, BT7 1JL
| | - K McAuley
- Meningitis Research Foundation, 71 Botanic Avenue, Belfast, BT7 1JL
| | - JP McKenna
- Department of Medical Microbiology, The Royal Group of Hospitals Belfast, BT12 6BA
| | - PJA Moore
- School of Medicine, Dentistry and Biomedical Sciences, Queen’s University, University Road, Belfast, BT7 1NN
| | - R Smithson
- Northern Ireland Public Health Agency, Belfast, BT2 8BS
| | - J Stirling
- Department of Bacteriology, Belfast City Hospital, Lisburn Road, Belfast, BT9 7AD
| | - M Shields
- The Royal Belfast Hospital for Sick Children, Belfast, BT12 6BE,School of Medicine, Dentistry and Biomedical Sciences, Queen’s University, University Road, Belfast, BT7 1NN
| | - JE Moore
- Department of Bacteriology, Belfast City Hospital, Lisburn Road, Belfast, BT9 7AD,School of Biomedical Science, Ulster University, Cromore Road, Coleraine, BT52 1SA,School of Medicine, Dentistry and Biomedical Sciences, Queen’s University, University Road, Belfast, BT7 1NN,Correspondence to Professor John E. Moore, Northern Ireland Public Health Laboratory, Department of Bacteriology, Belfast City Hospital, Lisburn Road, Belfast, BT9 7AD,
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26
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Millar BC, Banks L, Bourke TW, Cunningham M, Dooley JSG, Elshibly S, Goldsmith CE, Fairley D, Jackson K, Lamont S, Jessop L, McCrudden E, McConnell D, McAuley K, McKenna JP, Moore PJA, Smithson R, Stirling J, Shields M, Moore JE. Meningococcal Disease Section 1: Microbiology And Historical Perspective: MeningoNI Forum. Ulster Med J 2018; 87:84-87. [PMID: 29867260 PMCID: PMC5974661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 03/05/2018] [Indexed: 12/05/2022]
Affiliation(s)
- BC Millar
- Department of Bacteriology, Belfast City Hospital, Lisburn Road, Belfast, BT9 7AD,School of Biomedical Science, Ulster University, Cromore Road, Coleraine, BT52 1SA
| | - L Banks
- Meningitis Now, Stroud, Gloucestershire GL5 3TJ
| | - TW Bourke
- The Royal Belfast Hospital for Sick Children, Belfast, BT12 6BE
| | - M Cunningham
- University Health Centre at Queen’s, 7 University Terrace, Belfast, BT7 1NP
| | - JSG Dooley
- School of Biomedical Science, Ulster University, Cromore Road, Coleraine, BT52 1SA
| | - S Elshibly
- Department of Microbiology, Antrim Area Hospital, Antrim, BT41 2RL
| | - CE Goldsmith
- Department of Bacteriology, Belfast City Hospital, Lisburn Road, Belfast, BT9 7AD
| | - D Fairley
- Department of Medical Microbiology, The Royal Group of Hospitals Belfast, BT12 6BA
| | - K Jackson
- The Royal Belfast Hospital for Sick Children, Belfast, BT12 6BE,School of Medicine, Dentistry and Biomedical Sciences, Queen’s University, University Road, Belfast, BT7 1NN
| | - S Lamont
- The Royal Belfast Hospital for Sick Children, Belfast, BT12 6BE
| | - L Jessop
- Northern Ireland Public Health Agency, Belfast, BT2 8BS
| | - E McCrudden
- The Royal Belfast Hospital for Sick Children, Belfast, BT12 6BE
| | - D McConnell
- Meningitis Research Foundation, 71 Botanic Avenue, Belfast, BT7 1JL
| | - K McAuley
- Meningitis Research Foundation, 71 Botanic Avenue, Belfast, BT7 1JL
| | - JP McKenna
- Department of Medical Microbiology, The Royal Group of Hospitals Belfast, BT12 6BA
| | - PJA Moore
- School of Medicine, Dentistry and Biomedical Sciences, Queen’s University, University Road, Belfast, BT7 1NN
| | - R Smithson
- Northern Ireland Public Health Agency, Belfast, BT2 8BS
| | - J Stirling
- Department of Bacteriology, Belfast City Hospital, Lisburn Road, Belfast, BT9 7AD
| | - M Shields
- The Royal Belfast Hospital for Sick Children, Belfast, BT12 6BE,School of Medicine, Dentistry and Biomedical Sciences, Queen’s University, University Road, Belfast, BT7 1NN
| | - JE Moore
- Department of Bacteriology, Belfast City Hospital, Lisburn Road, Belfast, BT9 7AD,School of Biomedical Science, Ulster University, Cromore Road, Coleraine, BT52 1SA,School of Medicine, Dentistry and Biomedical Sciences, Queen’s University, University Road, Belfast, BT7 1NN,Correspondence to Professor John E. Moore, Northern Ireland Public Health Laboratory, Department of Bacteriology, Belfast City Hospital, Lisburn Road, Belfast, BT9 7AD. E-mail:
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27
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Millar BC, Banks L, Bourke TW, Cunningham M, Dooley JSG, Elshibly S, Goldsmith CE, Fairley D, Jackson K, Lamont S, Jessop L, McCrudden E, McConnell D, McAuley K, McKenna JP, Moore PJA, Smithson R, Stirling J, Shields M, Moore JE. Meningococcal Disease Section 2: Epidemiology and Vaccination of Meningococcal Disease in Northern Ireland: MeningoNI Forum. Ulster Med J 2018; 87:88-93. [PMID: 29867261 PMCID: PMC5974662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 03/05/2018] [Indexed: 11/23/2022]
Affiliation(s)
- BC Millar
- Department of Bacteriology, Belfast City Hospital, Lisburn Road, Belfast, BT9 7AD,School of Biomedical Science, Ulster University, Cromore Road, Coleraine, BT52 1SA
| | - L Banks
- Meningitis Now, Stroud, Gloucestershire GL5 3TJ
| | - TW Bourke
- The Royal Belfast Hospital for Sick Children, Belfast, BT12 6BE
| | - M Cunningham
- University Health Centre at Queen’s, 7 University Terrace, Belfast, BT7 1NP
| | - JSG Dooley
- School of Biomedical Science, Ulster University, Cromore Road, Coleraine, BT52 1SA
| | - S Elshibly
- Department of Microbiology, Antrim Area Hospital, Antrim, BT41 2RL
| | - CE Goldsmith
- Department of Bacteriology, Belfast City Hospital, Lisburn Road, Belfast, BT9 7AD
| | - D Fairley
- Department of Medical Microbiology, The Royal Group of Hospitals Belfast, BT12 6BA
| | - K Jackson
- The Royal Belfast Hospital for Sick Children, Belfast, BT12 6BE,School of Medicine, Dentistry and Biomedical Sciences, Queen’s University, University Road, Belfast, BT7 1NN
| | - S Lamont
- The Royal Belfast Hospital for Sick Children, Belfast, BT12 6BE
| | - L Jessop
- Northern Ireland Public Health Agency, Belfast, BT2 8BS
| | - E McCrudden
- The Royal Belfast Hospital for Sick Children, Belfast, BT12 6BE
| | - D McConnell
- Meningitis Research Foundation, 71 Botanic Avenue, Belfast, BT7 1JL
| | - K McAuley
- Meningitis Research Foundation, 71 Botanic Avenue, Belfast, BT7 1JL
| | - JP McKenna
- Department of Medical Microbiology, The Royal Group of Hospitals Belfast, BT12 6BA
| | - PJA Moore
- School of Medicine, Dentistry and Biomedical Sciences, Queen’s University, University Road, Belfast, BT7 1NN
| | - R Smithson
- Northern Ireland Public Health Agency, Belfast, BT2 8BS
| | - J Stirling
- Department of Bacteriology, Belfast City Hospital, Lisburn Road, Belfast, BT9 7AD
| | - M Shields
- The Royal Belfast Hospital for Sick Children, Belfast, BT12 6BE,School of Medicine, Dentistry and Biomedical Sciences, Queen’s University, University Road, Belfast, BT7 1NN
| | - JE Moore
- Department of Bacteriology, Belfast City Hospital, Lisburn Road, Belfast, BT9 7AD,School of Biomedical Science, Ulster University, Cromore Road, Coleraine, BT52 1SA,School of Medicine, Dentistry and Biomedical Sciences, Queen’s University, University Road, Belfast, BT7 1NN,Correspondence to Professor John E. Moore, Northern Ireland Public Health Laboratory, Department of Bacteriology, Belfast City Hospital, Lisburn Road, Belfast, BT9 7AD. E-mail:
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28
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Otter S, Coates A, Franklin A, Brennan C, Cunningham M, Stewart A. EP-2216: The dosimetric impact of interstitial needles in HDR brachytherapy for cervical cancer. Radiother Oncol 2018. [DOI: 10.1016/s0167-8140(18)32525-8] [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: 10/14/2022]
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Trabalon M, Ruhland F, Laino A, Cunningham M, Garcia F. Embryonic and post-embryonic development inside wolf spiders’ egg sac with special emphasis on the vitellus. J Comp Physiol B 2017; 188:211-224. [DOI: 10.1007/s00360-017-1120-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2017] [Revised: 07/18/2017] [Accepted: 07/25/2017] [Indexed: 12/24/2022]
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Reynolds JV, Preston SR, O’Neill B, Baeksgaard L, Griffin SM, Mariette C, Cuffe S, Cunningham M, Crosby T, Parker I, Hofland K, Hanna G, Svendsen LB, Donohoe CL, Muldoon C, O’Toole D, Johnson C, Ravi N, Jones G, Corkhill AK, Illsley M, Mellor J, Lee K, Dib M, Marchesin V, Cunnane M, Scott K, Lawner P, Warren S, O’Reilly S, O’Dowd G, Leonard G, Hennessy B, Dermott RM. ICORG 10-14: NEOadjuvant trial in Adenocarcinoma of the oEsophagus and oesophagoGastric junction International Study (Neo-AEGIS). BMC Cancer 2017; 17:401. [PMID: 28578652 PMCID: PMC5457631 DOI: 10.1186/s12885-017-3386-2] [Citation(s) in RCA: 124] [Impact Index Per Article: 17.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2016] [Accepted: 05/25/2017] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Neoadjuvant therapy is increasingly the standard of care in the management of locally advanced adenocarcinoma of the oesophagus and junction (AEG). In randomised controlled trials (RCTs), the MAGIC regimen of pre- and postoperative chemotherapy, and the CROSS regimen of preoperative chemotherapy combined with radiation, were superior to surgery only in RCTs that included AEG but were not powered on this cohort. No completed RCT has directly compared neoadjuvant or perioperative chemotherapy and neoadjuvant chemoradiation. The Neo-AEGIS trial, uniquely powered on AEG, and including comprehensive modern staging, compares both these regimens. METHODS This open label, multicentre, phase III RCT randomises patients (cT2-3, N0-3, M0) in a 1:1 fashion to receive CROSS protocol (Carboplatin and Paclitaxel with concurrent radiotherapy, 41.4Gy/23Fr, over 5 weeks). The power calculation is a 10% difference in favour of CROSS, powered at 80%, two-sided alpha level of 0.05, requiring 540 patients to be evaluable, 594 to be recruited if a 10% dropout is included (297 in each group). The primary endpoint is overall survival, with a minimum 3-year follow up. Secondary endpoints include: disease free survival, recurrence rates, clinical and pathological response rates, toxicities of induction regimens, post-operative pathology and tumour regression grade, operative in-hospital complications, and health-related quality of life. The trial also affords opportunities for establishing a bio-resource of pre-treatment and resected tumour, and translational research. DISCUSSION This RCT directly compares two established treatment regimens, and addresses whether radiation therapy positively impacts on overall survival compared with a standard perioperative chemotherapy regimen Sponsor: Irish Clinical Research Group (ICORG). TRIAL REGISTRATION NCT01726452 . Protocol 10-14. Date of registration 06/11/2012.
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Affiliation(s)
- JV Reynolds
- St. James’s Hospital and Trinity College Dublin, Dublin, Ireland
| | - SR Preston
- Royal Surrey County Hospital, Guildford, UK
| | | | | | | | - C Mariette
- University Hospital C. Huriez Place de Verdun, Lille, France
| | - S Cuffe
- St. James’s Hospital and Trinity College Dublin, Dublin, Ireland
| | - M Cunningham
- St. James’s Hospital and Trinity College Dublin, Dublin, Ireland
| | - T Crosby
- Velindre Cancer Centre, Cardiff, Wales UK
| | - I Parker
- St Mary’s Hospital and Imperial College London, London, UK
| | | | - G Hanna
- St Mary’s Hospital and Imperial College London, London, UK
| | | | - CL Donohoe
- St. James’s Hospital and Trinity College Dublin, Dublin, Ireland
| | - C Muldoon
- St. James’s Hospital and Trinity College Dublin, Dublin, Ireland
| | - D O’Toole
- St. James’s Hospital and Trinity College Dublin, Dublin, Ireland
| | - C Johnson
- St. James’s Hospital and Trinity College Dublin, Dublin, Ireland
| | - N Ravi
- St. James’s Hospital and Trinity College Dublin, Dublin, Ireland
| | - G Jones
- Velindre Cancer Centre, Cardiff, Wales UK
| | - AK Corkhill
- Southampton Clinical Trials Unit, University of Southampton, Southampton, UK
| | - M Illsley
- Royal Surrey County Hospital, Guildford, UK
| | - J Mellor
- Southampton Clinical Trials Unit, University of Southampton, Southampton, UK
| | - K Lee
- Southampton Clinical Trials Unit, University of Southampton, Southampton, UK
| | - M Dib
- University Hospital C. Huriez Place de Verdun, Lille, France
| | - V Marchesin
- Irish Clinical Oncology Research Group (ICORG), Dublin, Ireland
| | - M Cunnane
- Irish Clinical Oncology Research Group (ICORG), Dublin, Ireland
| | - K Scott
- Irish Clinical Oncology Research Group (ICORG), Dublin, Ireland
| | - P Lawner
- Irish Clinical Oncology Research Group (ICORG), Dublin, Ireland
| | - S Warren
- St. James’s Hospital and Trinity College Dublin, Dublin, Ireland
| | - S O’Reilly
- Irish Clinical Oncology Research Group (ICORG), Dublin, Ireland
| | - G O’Dowd
- Irish Clinical Oncology Research Group (ICORG), Dublin, Ireland
| | - G Leonard
- Irish Clinical Oncology Research Group (ICORG), Dublin, Ireland
| | - B Hennessy
- Irish Clinical Oncology Research Group (ICORG), Dublin, Ireland
| | - R Mc Dermott
- Irish Clinical Oncology Research Group (ICORG), Dublin, Ireland
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Otter S, Coates A, Brennan C, Franklin A, Cunningham M, Stewart A. The use of MRI and interstitial needles to achieve dose targets in image guided brachytherapy for cervical cancer at the Royal Surrey County Hospital. Clin Oncol (R Coll Radiol) 2017. [DOI: 10.1016/j.clon.2017.04.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Farrell L, Cunningham M, Haigh V, Irozuru E, Cuffin TR. Virtual evidence: helping primary care practitioners access and implement evidence-based information. Health Informatics J 2016. [DOI: 10.1177/146045829900500403] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
e-STABLISH is a two-year pilot project funded by the UK’s NHS Executive (North West) to set up a Local Multidisciplinary Evidence Centre (LMEC) across Salford and Trafford district. The aim of e-STABLISH is to provide primary healthcare team members (PHCTs) and community staff based at 12 sites across the district with improved access to evidence-based information sources from their workplaces. During our first year (April 1998- March 1999) sites were linked and personnel trained - the second year will determine whether access to evidence-based information has been improved through an effective structure. The paper begins with an overview of the project, and then goes on to discuss its objectives in more detail, namely, the Information Technology infrstructure that has been set up, the training courses provided, and the library services that have been developed. We conclude with details of the major lessons learnt and evaluations that will be taking place.
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Affiliation(s)
- L. Farrell
- Salford and Trafford Health Authority, Peel House, Albert Street, Eccles, Manchester M30 0NJ, UK,
| | | | - V. Haigh
- Salford Royal Hospitals NHS Trust
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Kelly D, Hawdon G, Reeves J, Morris A, Cunningham M, Barrett J. Safety of intravenous metoprolol use in unmonitored wards: a single-centre observational study. Intern Med J 2016; 45:934-8. [PMID: 26109478 DOI: 10.1111/imj.12842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2015] [Accepted: 06/10/2015] [Indexed: 11/28/2022]
Abstract
BACKGROUND AND AIM This study aims to examine and quantify the risks associated with the use of intravenous metoprolol on unmonitored wards. METHOD This study was a retrospective single-centre observational study from 1 January 2009 to 31 December 2013. The study hospital was a 415-bed, private hospital in Melbourne, Victoria. The study population was all patients who received intravenous metoprolol on an unmonitored ward. The primary outcome measure was the rate of serious adverse events (SAE), defined as a complication of intravenous metoprolol resulting in transfer to a critical-care environment, a medical emergency team call or death. RESULTS Six hundred and nine patients received a total of 8260 doses of intravenous metoprolol. Seven cases were identified with a SAE deemed possibly related to beta-blocker use and there was one death. All SAE were hypotension, giving an overall rate of hypotension of 7/609 or 1.1% (95% confidence interval (CI), 0.5 to 2.4%) with a rate per dose delivered of 0.8/1000 doses (95% CI 0.3 to 1.7). The death occurred in a 94-year-old woman with abdominal sepsis. After case file review, consensus opinion deemed this to be unrelated to intravenous metoprolol. CONCLUSION The use of intravenous metoprolol on unmonitored wards appears to be safe. The complication rate was low, suggesting that this may be a sensible approach to the management of in-hospital populations at risk of beta-blocker withdrawal.
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Affiliation(s)
- D Kelly
- Intensive Care, Cabrini Hospital - Malvern, Melbourne, Victoria, Australia
| | - G Hawdon
- Intensive Care, Cabrini Hospital - Malvern, Melbourne, Victoria, Australia
| | - J Reeves
- Intensive Care, Cabrini Hospital - Malvern, Melbourne, Victoria, Australia
| | - A Morris
- Intensive Care, Cabrini Hospital - Malvern, Melbourne, Victoria, Australia
| | - M Cunningham
- Intensive Care, Cabrini Hospital - Malvern, Melbourne, Victoria, Australia
| | - J Barrett
- Intensive Care, Cabrini Hospital - Malvern, Melbourne, Victoria, Australia
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Houlihan O, O'Sullivan S, Dunne M, Salib O, Gillham C, McVey G, Faul C, Cunningham M, Armstrong J, McNamara D, O'Neill B. EP-1289: Anal squamous cell carcinoma; a retrospective case series. Radiother Oncol 2016. [DOI: 10.1016/s0167-8140(16)32539-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Zaaimi B, Cunningham M, Collins G, Baker S. Oscillatory activity in primate reticular formation. Clin Neurophysiol 2016. [DOI: 10.1016/j.clinph.2015.10.021] [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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Wells M, Cunningham M, Lang H, Swartzman S, Philp J, Taylor L, Thomson J. Distress, concerns and unmet needs in survivors of head and neck cancer: a cross-sectional survey. Eur J Cancer Care (Engl) 2015; 24:748-60. [DOI: 10.1111/ecc.12370] [Citation(s) in RCA: 67] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/17/2015] [Indexed: 12/12/2022]
Affiliation(s)
- M. Wells
- NMAHP Research Unit; Scion House; University of Stirling; Stirling UK
| | - M. Cunningham
- NMAHP Research Unit; Scion House; University of Stirling; Stirling UK
| | - H. Lang
- School of Nursing and Midwifery; University of Dundee; Dundee UK
| | - S. Swartzman
- School of Psychology; University of Dundee; Dundee UK
| | - J. Philp
- Head and Neck Cancer Service; Queen Margaret Hospital; Dunfermline UK
| | | | - J. Thomson
- Medicine & Surgery; King Abdulaziz Medical City; Jeddah Saudi Arabia
- NHS Forth Valley; UK
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O'Donovan A, O'Herlihy A, Cunningham M. Knowledge and attitudes of radiation therapists and undergraduate students towards older people. Radiography (Lond) 2015. [DOI: 10.1016/j.radi.2015.05.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Geletu Z, Cunningham M, Magalona S, Morgan K. Determinants of healthcare seeking for childhood illnesses and
vaccination in urban Ethiopia. Ann Glob Health 2015. [DOI: 10.1016/j.aogh.2015.02.755] [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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Geletu Z, Cunningham M, Magalona S, Morgan K. Determinants of maternal health service utilization in urban
Ethiopia. Ann Glob Health 2015. [DOI: 10.1016/j.aogh.2015.02.754] [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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O'Donovan A, Leech M, Gillham C, Cunningham C, Cunningham M, ElBeltagi N, Thirion P. Managing the elderly in radiotherapy using geriatric assessment (MERGE): A pilot study. J Geriatr Oncol 2014. [DOI: 10.1016/j.jgo.2014.09.084] [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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O'Connell C, Cunningham M, O'Donovan A. OC-0589: Knowledge and attitudes of healthcare professionals towards provision of information regarding erectile dysfuntion. Radiother Oncol 2014. [DOI: 10.1016/s0167-8140(15)30695-2] [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]
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Skrastins E, Cunningham M, Jindal P, Fitzpatrick R, Oneko O, Carpenter J, Booth C, Yeates K, Aronson K, Smith L, Kaufman J, Strumpf E, Levesque L, van Gaalen R, Zhongjie L, Shengjie L, Honglong Z, Biyun C, Lidong G, Hongjie Y, Weizhong Y, Buckeridge D, Peterson W, Deonandan R, Arole S, Premkumar R, Kamble R, Hobbins M, Miller C, Small W, Thielman J, Moher D, McDowell I, Kristjansson E, Poirier A, Dodds L, Johnson M, Dummer T, Rainham D, Braund R, Billard M, Pfister T, Wang Q, Kopciuk KA, Doyle-Baker P, McLaren L, Matthews CE, Courneya KS, Friedenreich CM, Chalifoux M, Brehaut JC, Kohen D, Carroll K, Hutton B, Fergusson D. The Canadian Society for Epidemiology and Biostatistics 2013 National Student Conference. Am J Epidemiol 2013. [DOI: 10.1093/aje/kwt259] [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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Evans L, Cunningham M, Tilakaratna P. Chlorhexidine droplet splash from a skin preparation gallipot: effect of height of pouring. Anaesthesia 2013; 68:1243-6. [DOI: 10.1111/anae.12449] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/30/2013] [Indexed: 11/30/2022]
Affiliation(s)
- L. Evans
- Department of Anaesthesia; Broomfield Hospital; Mid Essex Hospital Services NHS Trust; Chelmsford UK
| | - M. Cunningham
- Department of Anaesthesia; Great Ormond Street Hospital; London UK
| | - P. Tilakaratna
- Department of Anaesthesia; Broomfield Hospital; Mid Essex Hospital Services NHS Trust; Chelmsford UK
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Eisenberg D, Buring J, Hrbek A, Davis R, Connelly M, Cherkin D, Levy D, Cunningham M, O'Connor B, Post D. OA11.02. A model of integrative care for low back pain. Altern Ther Health Med 2012. [PMCID: PMC3373735 DOI: 10.1186/1472-6882-12-s1-o42] [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]
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Ayan A, Lu L, Rong Y, Cunningham M, Weldon M, Welliver M, Woollard J, Gupta N. SU-E-T-436: Feasibility of Using the ‘Irregular Surface Compensator’ Planning Feature of the Eclipse TPS for Total Body Irradiation (TBI) Treatment Planning. Med Phys 2012; 39:3805. [DOI: 10.1118/1.4735525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Barker JH, Allen F, Cunningham M, Basappa PS, Wiggins O, Banis JC, Alloway RR, Steve WE, Frank JM. Risk assessment and management in hand and facial tissue transplantation. Eur J Trauma Emerg Surg 2011; 37:469. [DOI: 10.1007/s00068-011-0131-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2011] [Accepted: 06/16/2011] [Indexed: 12/22/2022]
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Azimzadeh A, Newton A, Cheng X, Tahir K, Ward A, Zhang T, Kelishadi S, Fairweather D, Cunningham M, Pierson R. 97 Autoimmunity to Cardiac Myosin Is Associated with Acute and Chronic Rejection of Cardiac Allografts in Non-Human Primates. J Heart Lung Transplant 2011. [DOI: 10.1016/j.healun.2011.01.104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Onorato DP, Criffield M, Lotz M, Cunningham M, McBride R, Leone EH, Bass OL, Hellgren EC. Habitat selection by critically endangered Florida panthers across the diel period: implications for land management and conservation. Anim Conserv 2010. [DOI: 10.1111/j.1469-1795.2010.00415.x] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.4] [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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Pohn J, Heniche M, Fradette L, Cunningham M, McKenna T. Development of a Computational Framework to Model the Scale-up of High-Solid-Content Polymer Latex Reactors. Chem Eng Technol 2010. [DOI: 10.1002/ceat.201000297] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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