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Wood EM, Whitaker BI, Townsend M, Narayan S. How we forecast tomorrow's haemovigilance. Transfus Clin Biol 2024; 31:114-118. [PMID: 38460837 DOI: 10.1016/j.tracli.2024.03.001] [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] [Indexed: 03/11/2024]
Abstract
The field of haemovigilance continues to develop, building on more than forty years of international experience. This review considers the current scope and activities of haemovigilance around the world and explores aspects of preparation for the advent of new blood products and alternative therapies to transfusion; new tools for data acquisition (including patient- and donor-reported outcomes, and data from 'wearables') and the analysis and communication of haemovigilance results.
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Affiliation(s)
- Erica M Wood
- School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, Victoria 3004, Australia; Department of Clinical Haematology, Monash Health, Clayton Road, Clayton, Victoria 3168, Australia.
| | - Barbee I Whitaker
- Office of Biostatistics and Pharmacovigilance, Center for Biologics Evaluation and Research, Food and Drug Administration, Center for Biologics Evaluation and Research, 10903 New Hampshire Avenue, White Oak-71, Silver Spring, MD 20993, USA.
| | - Mary Townsend
- Vitalant, 9503 E Via de Ventura, Scottsdale, AZ 85259, USA.
| | - Shruthi Narayan
- Serious Hazards of Transfusion (SHOT), NHS Blood and Transplant, Manchester Blood Centre, Manchester M13 9LL, United Kingdom.
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Yu EA, Stone M, Bravo MD, Grebe E, Bruhn RL, Lanteri MC, Townsend M, Kamel H, Jones JM, Busch MP, Custer B. Associations of Temporal Cardiometabolic Patterns and Incident SARS-CoV-2 Infection Among U.S. Blood Donors With Serologic Evidence of Vaccination. AJPM Focus 2024; 3:100186. [PMID: 38304025 PMCID: PMC10832374 DOI: 10.1016/j.focus.2024.100186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/03/2024]
Abstract
Introduction Cardiometabolic diseases are associated with greater COVID-19 severity; however, the influences of cardiometabolic health on SARS-CoV-2 infections after vaccination remain unclear. Our objective was to investigate the associations between temporal blood pressure and total cholesterol patterns and incident SARS-CoV-2 infections among those with serologic evidence of vaccination. Methods In this prospective cohort of blood donors, blood samples were collected in 2020-2021 and assayed for binding antibodies of SARS-CoV-2 nucleocapsid protein antibody seropositivity. We categorized participants into intraindividual pattern subgroups of blood pressure and total cholesterol (persistently, intermittently, or not elevated [systolic blood pressure <130 mmHg, diastolic blood pressure <80 mmHg, total cholesterol <200 mg/dL]) across the study time points. Results Among 13,930 donors with 39,736 donations representing 1,127,071 person-days, there were 221 incident SARS-CoV-2 infections among those with serologic evidence of vaccination (1.6%). Intermittent hypertension was associated with greater SARS-CoV-2 infections among those with serologic evidence of vaccination risk (adjusted incidence rate ratio=2.07; 95% CI=1.44, 2.96; p<0.01) than among participants with consistent normotension on the basis of a multivariable Poisson regression. Among men, intermittently elevated total cholesterol (adjusted incidence rate ratio=1.90; 95% CI=1.32, 2.74; p<0.01) and higher BMI at baseline (adjusted hazard ratio=1.44; 95% CI=1.07, 1.93; p=0.01; per 10 units) were associated with greater SARS-CoV-2 infections among those with serologic evidence of vaccination probability; these associations were null among women (both p>0.05). Conclusions Our findings underscore that the benefits of cardiometabolic health, particularly blood pressure, include a lower risk of SARS-CoV-2 infection after vaccination.
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Affiliation(s)
- Elaine A. Yu
- Vitalant Research Institute, San Francisco, California
- Department of Laboratory Medicine, University of California San Francisco, San Francisco, California
| | - Mars Stone
- Vitalant Research Institute, San Francisco, California
- Department of Laboratory Medicine, University of California San Francisco, San Francisco, California
| | | | - Eduard Grebe
- Vitalant Research Institute, San Francisco, California
- Department of Laboratory Medicine, University of California San Francisco, San Francisco, California
| | - Roberta L. Bruhn
- Vitalant Research Institute, San Francisco, California
- Department of Laboratory Medicine, University of California San Francisco, San Francisco, California
| | - Marion C. Lanteri
- Department of Laboratory Medicine, University of California San Francisco, San Francisco, California
- Creative Testing Solutions, Tempe, Arizona
| | | | | | | | - Michael P. Busch
- Vitalant Research Institute, San Francisco, California
- Department of Laboratory Medicine, University of California San Francisco, San Francisco, California
- Vitalant, Scottsdale, Arizona
| | - Brian Custer
- Vitalant Research Institute, San Francisco, California
- Department of Laboratory Medicine, University of California San Francisco, San Francisco, California
- Vitalant, Scottsdale, Arizona
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Townsend M, Maryuningsih Soedarmono YS, Narayan S, Ashford P, Wood EM, Whitaker BI. Haemovigilance resources available for everyone: A report from the International Haemovigilance Tools Collaborative Project. Vox Sang 2024; 119:277-281. [PMID: 38126141 DOI: 10.1111/vox.13570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 11/06/2023] [Accepted: 11/14/2023] [Indexed: 12/23/2023]
Abstract
BACKGROUND AND OBJECTIVES Haemovigilance systems are intended to collect and analyse data, and report findings relating to transfusion complications, such as blood product safety, procedural incidents, and adverse reactions in donors and patients. A common problem among developing haemovigilance programs is the lack of resources and tools available to countries striving to establish or enhance their haemovigilance system. MATERIALS AND METHODS World Health Organization, in collaboration with International Society for Blood Transfusion (ISBT), International Haemovigilance Network and other haemovigilance experts embarked on a Haemovigilance Tools Project to collect and provide materials and resources to assist with the stepwise implementation of haemovigilance. RESULTS AND CONCLUSIONS Resources are housed as a virtual compendium on the ISBT website under the Haemovigilance Working Party. These are managed by a subcommittee of the Working Party and are freely available and downloadable to all without requiring ISBT membership.
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Affiliation(s)
| | | | - Shruthi Narayan
- NHS Blood and Transplant, Bristol, UK
- Manchester Blood Centre, Plymouth Grove, Manchester, UK
| | | | - Erica M Wood
- Transfusion Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
- Department of Haematology, Monash Health, Clayton, Victoria, Australia
| | - Barbee I Whitaker
- Division of Analytics and Benefit Risk Assessment, Office of Biostatistics and Pharmacovigilance, Center for Biologics Evaluation and Research, Silver Spring, Maryland, USA
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Vassallo R, Kamel H, Goel R, Al-Riyami AZ, Al Muharrmi Z, Jacquot C, Ramirez-Arcos S, Khandelwal A, Goldman M, Hands K, McLintock L, Mitchell H, Wendel S, Scuracchio P, Fachini R, Pettersson SM, Bengtsson J, Brailsford SR, Tossell J, Amorim L, Lopes ME, Pêcego M, Germain M, Renaud C, Morley SL, So R, Townsend M, Hopkins C, Harritshoej LH, Erikstrup C, Gosbell IB, Levin MH, Dennington PM, Dunbar N. International Forum on Management of Blood Donors with Culture-Positive Platelet Donations: Summary. Vox Sang 2023; 118:997-1003. [PMID: 37772636 DOI: 10.1111/vox.13519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Accepted: 08/14/2023] [Indexed: 09/30/2023]
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Vassallo R, Kamel H, Goel R, Al-Riyami AZ, Al-Muharrmi Z, Jacquot C, Ramirez-Arcos S, Khandelwal A, Goldman M, Hands K, McLintock L, Mitchell H, Wendel S, Scuracchio P, Fachini R, Pettersson SM, Bengtsson J, Brailsford SR, Tossell J, Amorim L, Lopes ME, Pêcego M, Germain M, Renaud C, Morley SL, So R, Townsend M, Hopkins C, Harritshoej LH, Erikstrup C, Gosbell IB, Levin MH, Dennington PM, Dunbar N. International Forum on Management of Blood Donors with Culture-Positive Platelet Donations: Responses. Vox Sang 2023; 118:1004-1023. [PMID: 37772625 DOI: 10.1111/vox.13520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Accepted: 08/14/2023] [Indexed: 09/30/2023]
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Marciniuk DD, Becker EA, Kaminsky DA, McCormack MC, Stanojevic S, Bhakta NR, Bime C, Comondore V, Cowl CT, Dell S, Haynes J, Jaffe F, Mottram C, Sederstrom N, Townsend M, Iaccarino JM. Effect of Race and Ethnicity on Pulmonary Function Testing Interpretation: An American College of Chest Physicians (CHEST), American Association for Respiratory Care (AARC), American Thoracic Society (ATS), and Canadian Thoracic Society (CTS) Evidence Review and Research Statement. Chest 2023; 164:461-475. [PMID: 36972760 PMCID: PMC10475820 DOI: 10.1016/j.chest.2023.03.026] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Revised: 03/15/2023] [Accepted: 03/18/2023] [Indexed: 03/29/2023] Open
Abstract
BACKGROUND Calls have been made to discontinue the routine use of race and ethnicity in medicine. Specific to respiratory medicine, the use of race- and ethnicity-specific reference equations for the interpretation of pulmonary function test (PFT) results has been questioned. RESEARCH QUESTIONS Three key questions were addressed: (1) What is the current evidence supporting the use of race- and ethnicity-specific reference equations for the interpretation of PFTs? (2) What are the potential clinical implications of the use or nonuse of race and ethnicity in interpreting PFT results? and (3) What research gaps and questions must be addressed and answered to understand better the effect of race and ethnicity on PFT results interpretation and potential clinical and occupational health implications? STUDY DESIGN AND METHODS A joint multisociety (American College of Chest Physicians, American Association for Respiratory Care, American Thoracic Society, and Canadian Thoracic Society) expert panel was formed to undertake a comprehensive evidence review and to develop a statement with recommendations to address the research questions. RESULTS Several assumptions and gaps, both in the published literature and in our evolving understanding of lung health, were identified. It seems that many past perceptions and practices regarding the effect of race and ethnicity on PFT results interpretation are based on limited scientific evidence and measures that lack reliability. INTERPRETATION A need exists for more and better research that will inform our field about these many uncertainties and will serve as a foundation for future recommendations in this area. The identified shortcomings should not be discounted or dismissed because they may enable flawed conclusions, unintended consequences, or both. Addressing the identified research gaps and needs would allow a better-a more informed-understanding of the effects of race and ethnicity on PFT results interpretation.
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Affiliation(s)
- Darcy D Marciniuk
- Division of Respirology, Critical Care and Sleep Medicine, Respiratory Research Center, University of Saskatchewan, Saskatoon, SK.
| | - Ellen A Becker
- Division of Respiratory Care, Department of Cardiopulmonary Sciences Rush University, Chicago, IL
| | - David A Kaminsky
- Pulmonary and Critical Care, University of Vermont Larner College of Medicine, Burlington, VT
| | | | - Sanja Stanojevic
- Department of Community Health and Epidemiology, Dalhousie University, Halifax, NS
| | - Nirav R Bhakta
- Division of Pulmonary, Critical Care, Allergy and Sleep Medicine, Department of Medicine, University of California, San Francisco, San Francisco, CA
| | | | - Vikram Comondore
- Division of Respirology, McMaster University, Hamilton, ON; Division of Respirology, William Osler Health System, Brampton, ON
| | - Clayton T Cowl
- Division of Public Health, Infectious Diseases and Occupational Medicine and the Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, MN
| | - Sharon Dell
- Department of Pediatrics and BC Children's Research Institute, University of British Columbia, Vancouver, BC, Canada
| | - Jeffrey Haynes
- Pulmonary Function Laboratory, Elliot Health System, Manchester, NH
| | - Fred Jaffe
- Temple University Hospital, Philadelphia, PA
| | | | | | - Mary Townsend
- M.C. Townsend Associates, LLC, Pittsburgh, PA; University of Pittsburgh School of Public Health, Pittsburgh, PA
| | - Jonathan M Iaccarino
- American College of Chest Physicians, Chicago, IL; Chobanian and Avedisian School of Medicine, Boston University, Boston, MA
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Mongiovi J, Townsend M, Vitonis A, Babic A, Hecht J, Conejo-Garcia J, Fridley B, Tworoger S, Terry K, Sasamoto N. Abstract 3017: Breastfeeding and ovarian cancer risk by tumor immune profiles. Cancer Res 2023. [DOI: 10.1158/1538-7445.am2023-3017] [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: 04/07/2023]
Abstract
Abstract
Introduction: Breastfeeding is associated with decreased ovarian cancer risk, yet the biological mechanisms are not fully understood. We conducted an agnostic investigation of tumor immune profiles to better understand the role of the tumor microenvironment in the protective association between breastfeeding and ovarian cancer risk.
Methods: Multiplex immunofluorescence was used to measure the abundance of T cells and B cells in ovarian tumor samples on tissue microarrays from the Nurses’ Health Study (NHS; n=337), NHSII (n=127), and New England Case Control Study (NECC; n=214). We averaged the percent of cells within the tumor epithelium that were positive for the immune cell of interest across 3 cores per tumor and categorized tumors as having high or low immune cell abundance based on the median value across all tumors. Controls were non-cases and did not provide tissue samples (n=2,045). Self-reported history of breastfeeding was used to define ever/never and total duration of breastfeeding. Polytomous logistic regression models adjusted for age, birth cohort, race, parity, oral contraception use, and study, was used to calculate odds ratios (ORs) and 95% confidence intervals (CIs) for breastfeeding and ovarian cancer risk by immune cell level.
Results: Overall, breastfeeding was associated with a reduced risk of tumors with low, but not high, subtypes of T cell abundance. Among parous women, history of ever breastfeeding decreased the risk of tumors with low helper T cells (CD3+CD4+; ORlow: 0.56, 95% CI: 0.41-0.77), but not high helper T cells (ORhigh: 0.85, 95% CI: 0.63-1.35; p-het=0.06). For total B cells (CD19+), having ever breastfed was associated with decreased risk of both low (ORlow: 0.64, 95% CI: 0.47-0.87) and high abundance in the tumor (ORhigh: 0.70, 95% CI: 0.62-0.96, p-het=0.67) among parous women. Similar results were observed for CD138+ plasma cells (ORlow:0.76, 95% CI: 0.56-0.99; ORhigh: 0.59, 95% CI: 0.37-0.94; p-het=0.34). Longer duration of breastfeeding was associated with decreased risk of developing tumors with low abundance of total B cells (CD19+, p-trend=0.02) and regulatory B cells (CD19+TNFR2+, p-trend=0.05), but not high abundance of CD19+ or CD19+TNFR2+ (p-het=0.01 and 0.03, respectively).
Conclusion: These results indicate that among parous women breastfeeding is associated with reduced risk of ovarian tumors with low infiltration of helper T cells while no heterogeneity was observed for risk by total B cells or plasma cells. Longer breastfeeding duration was associated with reduced risk of tumors low in regulatory B cells (CD19+TNFR+) with a dose-dependent response. Together, these results suggest breastfeeding may play a role in the activation of the tumor immune response. Further efforts are ongoing to disentangle the relationships between breastfeeding and parity with the tumor immune microenvironment.
Citation Format: Jennifer Mongiovi, Mary Townsend, Allison Vitonis, Ana Babic, Jonathan Hecht, Jose Conejo-Garcia, Brooke Fridley, Shelley Tworoger, Kathryn Terry, Naoko Sasamoto. Breastfeeding and ovarian cancer risk by tumor immune profiles [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 3017.
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Affiliation(s)
| | | | | | - Ana Babic
- 4Dana Farber Cancer Center, Boston, MA
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Van Buren NL, Rajbhandary S, Reynolds V, Gorlin JB, Stramer SL, Notari EP, Conti G, Katz L, Stubbs JR, van Buskirk CM, Kuttner K, Smith DL, Ngamsuntikul SG, Pandey S, Ward DC, Ziman A, Hiskey M, Townsend M, Sachais BS. Demographics of first-time donors returning for donation during the pandemic: COVID-19 convalescent plasma versus standard blood product donors. Transfusion 2023; 63:552-563. [PMID: 36550639 PMCID: PMC9880744 DOI: 10.1111/trf.17229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Revised: 11/30/2022] [Accepted: 12/01/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND Previous studies have demonstrated low first-time donor return rates (DRR) following catastrophic events. Little is known, however, about the influence of demographic factors on the DRR of first-time donors during the COVID-19 pandemic, including the unique motivation of COVID-19 convalescent plasma (CCP) donors as compared to non-CCP donors. STUDY DESIGN AND METHODS Thirteen blood collection organizations submitted deidentified data from first-time CCP and non-CCP donors returning for regular (non-CCP) donations during the pandemic. DRR was calculated as frequencies. Demographic factors associated with returning donors: race/ethnicity, gender, and generation (Gen Z: 19-24, Millennial: 25-40, Gen X: 41-56, and Boomer: ≥57 years old), within the CCP and non-CCP first-time cohorts were compared using chi-square test at p < .05 statistical significance. RESULTS From March 2020 through December 2021, there were a total of 44,274 first-time CCP and 980,201 first-time non-CCP donors. DRR were 14.6% (range 11.9%-43.3%) and 46.6% (range 10.0%-76.9%) for CCP and non-CCP cohorts, respectively. Age over 40 years (Gen X and Boomers), female gender, and White race were each associated with higher return in both donor cohorts (p < .001). For the non-CCP return donor cohort, the Millennial and Boomers were comparable. CONCLUSION The findings demonstrate differences in returning donor trends between the two donor cohorts. The motivation of a first-time CCP donor may be different than that of a non-CCP donor. Further study to improve first-time donor engagement would be worthwhile to expand the donor base with a focus on blood donor diversity emphasizing engagement of underrepresented minorities and younger donors.
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Affiliation(s)
- Nancy L. Van Buren
- Division of New York Blood CenterInnovative Blood ResourcesSaint PaulMinnesotaUSA
- Division of New York Blood CenterCommunity Blood Center of Greater Kansas CityKansas CityMissouriUSA
| | | | - Vanessa Reynolds
- Division of New York Blood CenterInnovative Blood ResourcesSaint PaulMinnesotaUSA
| | - Jed B. Gorlin
- Division of New York Blood CenterInnovative Blood ResourcesSaint PaulMinnesotaUSA
- Division of New York Blood CenterCommunity Blood Center of Greater Kansas CityKansas CityMissouriUSA
| | | | | | - Galen Conti
- Scientific AffairsAmerican Red CrossRockvilleMarylandUSA
| | | | - James R. Stubbs
- Division of Transfusion Medicine, Department of Laboratory Medicine and PathologyMayo ClinicRochesterMinnesotaUSA
| | - Camille M. van Buskirk
- Division of Transfusion Medicine, Department of Laboratory Medicine and PathologyMayo ClinicRochesterMinnesotaUSA
| | - Kip Kuttner
- Miller‐Keystone Blood CenterBethlehemPennsylvaniaUSA
| | | | | | | | - Dawn C. Ward
- Division of Transfusion Medicine, Department of Pathology and Laboratory MedicineDavid Geffen School of Medicine at UCLALos AngelesCaliforniaUSA
| | - Alyssa Ziman
- Division of Transfusion Medicine, Department of Pathology and Laboratory MedicineDavid Geffen School of Medicine at UCLALos AngelesCaliforniaUSA
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Wood EM, Whitaker BI, Townsend M. Haemovigilance: Giving it our best SHOT! Vox Sang 2023; 118:260-262. [PMID: 36807587 DOI: 10.1111/vox.13411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 02/02/2023] [Indexed: 02/23/2023]
Affiliation(s)
- Erica M Wood
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.,Department of Clinical Haematology, Monash Health, Melbourne, Australia
| | - Barbee I Whitaker
- Office of Biostatistics and Pharmacovigilance, Center for Biologics Evaluation and Research, Food and Drug Administration, Silver Spring, Maryland, USA
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Hopkins CK, Townsend M, Vassallo RR. Leukoreduction filters: Still stuck on sickle trait red cells. Transfusion 2022; 62:1683-1687. [PMID: 36039825 DOI: 10.1111/trf.17077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Accepted: 08/08/2022] [Indexed: 11/29/2022]
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Mehta S, Biswas S, Mandal G, Martin A, Sasamoto N, Terry K, Marchion D, Townsend M, Tworoger S, Wenham R, Conejo-Garcia J. Lymphocyte infiltration in histologic subtypes of epithelial ovarian carcinoma and its effect on survival (229). Gynecol Oncol 2022. [DOI: 10.1016/s0090-8258(22)01454-8] [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: 11/04/2022]
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Pandey S, Gorlin JB, Townsend M, Van Buren N, Leung JNS, Lee CK, van den Hurk K, Casamitjana N, Valles R, Alonso E, Miller YM, Richard P, Woimant G, Tiberghien P, Zhiburt E, Butler-Foster T, Goldman M, Nissen-Meyer LSH, Espinosa A, Kamel H, Bravo M, Filho LA, Pecego M, Germain M, Rabusseau I, Shinar E, Raz H, Choudhury N, Bhatnagar N, Hurt K, Lopez M, Reik RA, Nie Y, Hung Y, Pheello L, Dunbar N. International Forum on Gender Identification and Blood Collection: Responses. Vox Sang 2022; 117:E21-E43. [PMID: 34545590 DOI: 10.1111/vox.13193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Accepted: 07/21/2021] [Indexed: 12/01/2022]
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13
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Douglas EJ, Gammal J, Needham HR, Stephenson F, Townsend M, Pilditch CA, Lohrer AM. Combining Techniques to Conceptualise Denitrification Hot Spots and Hot Moments in Estuaries. Ecosystems 2022. [DOI: 10.1007/s10021-021-00732-7] [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: 11/03/2022]
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Pandey S, Gorlin JB, Townsend M, Van Buren N, Leung JNS, Lee CK, van den Hurk K, Casamitjana N, Valles R, Alonso E, Miller YM, Richard P, Woimant G, Tiberghien P, Zhiburt E, Butler-Foster T, Goldman M, Nissen-Meyer LSH, Espinosa A, Kamel H, Bravo M, Filho LA, Pecego M, Germain M, Rabusseau I, Shinar E, Raz H, Choudhury N, Bhatnagar N, Hurt K, Lopez M, Reik RA, Nie Y, Hung Y, Pheello L, Dunbar N. International Forum on Gender Identification and Blood Collection: Summary. Vox Sang 2021; 117:447-456. [PMID: 34545579 DOI: 10.1111/vox.13192] [Citation(s) in RCA: 2] [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] [Received: 07/20/2021] [Accepted: 07/21/2021] [Indexed: 11/28/2022]
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Lee TH, Chan A, Bryan W, Park L, Hashem M, Townsend M, Moylan C, Britt R, Choi S, Naggie S. Proton pump inhibitor usage reduces sustained viral response rates for veterans with HIV/HCV coinfection on ledipasvir/sofosbuvir: a real-world study from a multicentre VA cohort. J Viral Hepat 2021; 28:630-636. [PMID: 33378562 PMCID: PMC8054484 DOI: 10.1111/jvh.13462] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Revised: 10/04/2020] [Accepted: 12/07/2020] [Indexed: 01/20/2023]
Abstract
Previous studies have reported an association of proton pump inhibitor (PPI) use and decreased sustained viral response rate (SVR) in patients taking ledipasvir/sofosbuvir (LDV/SOF). The relationship between PPI usage and SVR is less clear in patients with HIV/HCV coinfection, where concomitant antiretrovirals may result in more complex drug interactions. This retrospective study evaluates the effects of acid suppression medications (PPI or H2 -receptor antagonist [H2 B]) use and SVR rates in patients with HIV/HCV or HCV and taking LDV/SOF in a large multicentre veteran cohort. Patients in the Veterans Affairs Health Care System who received LDV/SOF ± ribavirin from 10/10/2014 to 12/31/2015 were included. The odds ratios (OR) of PPI or H2 B use for SVR were adjusted for clinical factors and with inverse probability of treatment weighting for non-random treatment selection for acid suppression medication use. There were 9703 veterans included in our final analysis. After adjustment of other clinical factors, PPI use is associated with a lower SVR in the overall cohort (95.0% vs. 96.1%, OR: 0.86, 95% CI: 0.74-0.99, p = .03, number needed to harm 90.9) and HIV/HCV coinfection subgroup (93.4% vs. 96.9%, OR: 0.47, 95% CI: 0.26-0.85, p = .01, number needed to harm 28.6). This present study reveals PPI use is associated with reduced SVR after LDV/SOF treatment, with a more significant impact in the subgroup of patients with HIV/HCV coinfection. Precautions need to be taken when using PPI and LDV/SOF in this group of patients.
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Affiliation(s)
- Tzu-Hao Lee
- Division of Gastroenterology, Department of Medicine, Duke University School of Medicine, Durham, NC, USA,Durham Veterans Affairs Health Care System, Durham, NC, USA
| | - Austin Chan
- Department of Medicine, Morehouse School of Medicine, Atlanta, GA, USA
| | - William Bryan
- Durham Veterans Affairs Health Care System, Durham, NC, USA
| | - Lawrence Park
- Durham Veterans Affairs Health Care System, Durham, NC, USA,Division of infectious diseases, Department of Medicine, Duke University School of Medicine, Durham, NC, USA
| | - Mohamed Hashem
- Durham Veterans Affairs Health Care System, Durham, NC, USA
| | - Mary Townsend
- Durham Veterans Affairs Health Care System, Durham, NC, USA
| | - Cynthia Moylan
- Division of Gastroenterology, Department of Medicine, Duke University School of Medicine, Durham, NC, USA,Durham Veterans Affairs Health Care System, Durham, NC, USA
| | - Rachel Britt
- Durham Veterans Affairs Health Care System, Durham, NC, USA
| | - Steve Choi
- Division of Gastroenterology, Department of Medicine, Duke University School of Medicine, Durham, NC, USA,Durham Veterans Affairs Health Care System, Durham, NC, USA
| | - Susanna Naggie
- Durham Veterans Affairs Health Care System, Durham, NC, USA,Division of infectious diseases, Department of Medicine, Duke University School of Medicine, Durham, NC, USA
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16
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Wendel S, Land K, Devine DV, Daly J, Bazin R, Tiberghien P, Lee CK, Arora S, Patidar GK, Khillan K, Smid WM, Vrielink H, Oreh A, Al-Riyami AZ, Hindawi S, Vermeulen M, Louw V, Burnouf T, Bloch EM, Goel R, Townsend M, So-Osman C. Lessons learned in the collection of convalescent plasma during the COVID-19 pandemic. Vox Sang 2021; 116:872-879. [PMID: 33772791 PMCID: PMC8250874 DOI: 10.1111/vox.13096] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 02/23/2021] [Accepted: 02/24/2021] [Indexed: 12/22/2022]
Abstract
Background The lack of definitive treatment or preventative options for COVID‐19 led many clinicians early on to consider convalescent plasma (CCP) as potentially therapeutic. Regulators, blood centres and hospitals worldwide worked quickly to get CCP to the bedside. Although response was admirable, several areas have been identified to help improve future pandemic management. Materials and methods A multidisciplinary, multinational subgroup from the ISBT Working Group on COVID‐19 was tasked with drafting a manuscript that describes the lessons learned pertaining to procurement and administration of CCP, derived from a comprehensive questionnaire within the subgroup. Results While each country’s responses and preparedness for the pandemic varied, there were shared challenges, spanning supply chain disruptions, staffing, impact of social distancing on the collection of regular blood and CCP products, and the availability of screening and confirmatory SARS‐CoV‐2 testing for donors and patients. The lack of a general framework to organize data gathering across clinical trials and the desire to provide a potentially life‐saving therapeutic through compassionate use hampered the collection of much‐needed safety and outcome data worldwide. Communication across all stakeholders was identified as being central to reducing confusion. Conclusion The need for flexibility and adaptability remains paramount when dealing with a pandemic. As the world approaches the first anniversary of the COVID‐19 pandemic with rising rates worldwide and over 115 million cases and 2·55 million deaths, respectively, it is important to reflect on how to better prepare for future pandemics as we continue to combat the current one.
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Affiliation(s)
| | - Kevin Land
- Corporate Medical Affairs, Vitalant, Scottsdale, AZ, USA.,Department of Pathology, The University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Dana V Devine
- UBC Centre for Blood Research, Canadian Blood Services, Vancouver, BC, Canada
| | - James Daly
- Transfusion Medicine, Australian Red Cross, Brisbane, Australia
| | - Renée Bazin
- Research and Development, Héma-Québec, Quebec, Canada
| | | | - Cheuk-Kwong Lee
- Blood Collection and Donor Recruitment Department, Hong Kong Red Cross Blood Transfusion Service, Kowloon, Hong Kong
| | - Satyam Arora
- Transfusion Medicine, Super Speciality Paediatric Hospital and Postgraduate Teaching Institute, Noida, India
| | - Gopal K Patidar
- Transfusion Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Kamini Khillan
- Transfusion Medicine, Sir GangaRam Hospital, New Delhi, India
| | - Willem Martin Smid
- Consulting Services, Sanquin Blood Supply, Amsterdam, Netherlands.,Academic Institute IDTM, Groningen, Netherlands
| | - Hans Vrielink
- Clinical Service, Sanquin Blood Bank Northwest Region, Amsterdam, Netherlands
| | - Adaeze Oreh
- Federal Ministry of Health, National Blood Transfusion Service, Nigeria, Nigeria
| | | | - Salwa Hindawi
- Transfusion Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | | | - Vernon Louw
- Department of Medicine, Clinical Hematology, Groote Schuur Hospital, University of Cape Town, Cape Town, South Africa
| | - Thierry Burnouf
- College of Biomedical Engineering, Taipei Medical University, Taipei, Taiwan
| | - Evan M Bloch
- Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.,Department of Pathology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Ruchika Goel
- Transfusion Medicine, Johns Hopkins University, Baltimore, MD, USA
| | | | - Cynthia So-Osman
- Unit Transfusion Medicine, Sanquin Blood Supply Foundation, Amsterdam, Netherlands.,Haematology, Erasmus Medical Center, Rotterdam, Netherlands
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17
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Goldman M, Townsend M, Magnussen K, Lozano M, Nissen-Meyer LSH, Lee CK, Leung JNS, Takanashi M, McKay J, Kvist M, Robitaille N, Deschênes J, Di Angelantonio E, McMahon A, Roberts D, Maghsudlu M, Castrén J, Tiberghien P, Woimant G, Morel P, Kamel H, Bravo M, Shinar E, Gendelman V, Raz H, Wendel S, Fachini R, Quee F, van den Hurk K, Wiersum J, Grima KM, Speedy J, Bruun MT, Dunbar NM. International Forum on Mitigation Strategies to Prevent Faint and Pre-faint Adverse Reactions in Whole Blood Donors: Responses. Vox Sang 2021; 116:e1-e24. [PMID: 33754360 DOI: 10.1111/vox.13038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Accepted: 11/01/2020] [Indexed: 11/27/2022]
Affiliation(s)
| | | | | | | | | | - Cheuk Kwong Lee
- Hong Kong Red Cross Blood Transfusion Service, Kowloon, Hong Kong SAR
| | | | - Minoko Takanashi
- Japanese Red Cross Society, Blood Service Headquarters, Tokyo, Japan
| | | | | | | | | | | | - Amy McMahon
- National Health Service Blood and Transplant (NHSBT), Cambridge, UK
| | - David Roberts
- National Health Service Blood and Transplant (NHSBT), Cambridge, UK
| | | | | | | | | | - Pascal Morel
- Etablissement Français du Sang, La Plaine St-Denis, France
| | | | | | | | | | | | | | | | | | | | | | | | - Joanna Speedy
- Australian Red Cross Lifeblood, Melbourne, Vic., Australia
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18
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Goel R, Bloch EM, Pirenne F, Al-Riyami AZ, Crowe E, Dau L, Land K, Townsend M, Jecko T, Rahimi-Levene N, Patidar G, Josephson CD, Arora S, Vermeulen M, Vrielink H, Montemayor C, Oreh A, Hindawi S, van den Berg K, Serrano K, So-Osman C, Wood E, Devine DV, Spitalnik SL. ABO blood group and COVID-19: a review on behalf of the ISBT COVID-19 working group. Vox Sang 2021; 116:849-861. [PMID: 33578447 PMCID: PMC8014128 DOI: 10.1111/vox.13076] [Citation(s) in RCA: 82] [Impact Index Per Article: 27.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Revised: 12/23/2020] [Accepted: 12/23/2020] [Indexed: 12/30/2022]
Abstract
Growing evidence suggests that ABO blood group may play a role in the immunopathogenesis of SARS-CoV-2 infection, with group O individuals less likely to test positive and group A conferring a higher susceptibility to infection and propensity to severe disease. The level of evidence supporting an association between ABO type and SARS-CoV-2/COVID-19 ranges from small observational studies, to genome-wide-association-analyses and country-level meta-regression analyses. ABO blood group antigens are oligosaccharides expressed on red cells and other tissues (notably endothelium). There are several hypotheses to explain the differences in SARS-CoV-2 infection by ABO type. For example, anti-A and/or anti-B antibodies (e.g. present in group O individuals) could bind to corresponding antigens on the viral envelope and contribute to viral neutralization, thereby preventing target cell infection. The SARS-CoV-2 virus and SARS-CoV spike (S) proteins may be bound by anti-A isoagglutinins (e.g. present in group O and group B individuals), which may block interactions between virus and angiotensin-converting-enzyme-2-receptor, thereby preventing entry into lung epithelial cells. ABO type-associated variations in angiotensin-converting enzyme-1 activity and levels of von Willebrand factor (VWF) and factor VIII could also influence adverse outcomes, notably in group A individuals who express high VWF levels. In conclusion, group O may be associated with a lower risk of SARS-CoV-2 infection and group A may be associated with a higher risk of SARS-CoV-2 infection along with severe disease. However, prospective and mechanistic studies are needed to verify several of the proposed associations. Based on the strength of available studies, there are insufficient data for guiding policy in this regard.
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Affiliation(s)
- Ruchika Goel
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.,Division of Hematology/Oncology, Simmons Cancer Institute at SIU School of Medicine and Mississippi Valley Regional Blood Center, Springfield, IL, USA
| | - Evan M Bloch
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - France Pirenne
- Etablissement Français du Sang Ile de France, Hôpital Henri Mondor, Créteil, France
| | - Arwa Z Al-Riyami
- Department of Hematology, Sultan Qaboos University Hospital, Muscat, Sultanate of Oman
| | - Elizabeth Crowe
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Laetitia Dau
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Kevin Land
- Vitalant, Scottsdale, AZ, USA.,Department of Pathology, UT, San Antonio, TX, USA
| | | | | | | | - Gopal Patidar
- Department of Transfusion Medicine, All India Institute of Medical Sciences, New Delhi, India
| | | | - Satyam Arora
- Super Speciality Pediatric Hospital and Post Graduate Teaching Institute, Noida, India
| | - Marion Vermeulen
- The South African National Blood Service, Port Elizabeth, South Africa
| | - Hans Vrielink
- Dept Unit Transfusion Medicine, Sanquin Bloodbank, Amsterdam, the Netherlands
| | | | - Adaeze Oreh
- National Blood Transfusion Service, Department of Hospital Services, Federal Ministry of Health, Abuja, Nigeria
| | | | - Karin van den Berg
- Translational Research Department, Medical Division, South African National Blood Service, Port Elizabeth, South Africa.,Division of Clinical Haematology, Department of Medicine, University of Cape Town, Cape Town, South Africa
| | - Katherine Serrano
- Canadian Blood Services, Vancouver, BC, Canada.,Department of Pathology & Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Cynthia So-Osman
- Dept Unit Transfusion Medicine, Sanquin Bloodbank, Amsterdam, the Netherlands.,Dept. of Haematology, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Erica Wood
- Monash University, Melbourne, VIC, Australia
| | - Dana V Devine
- Canadian Blood Services, Vancouver, BC, Canada.,Department of Pathology & Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Steven L Spitalnik
- Department of Pathology & Cell Biology, Columbia University, New York, NY, USA
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19
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Madaras-Kelly K, Hostler C, Townsend M, Potter EM, Spivak ES, Hall SK, Goetz MB, Nevers M, Ying J, Haaland B, Rovelsky SA, Pontefract B, Fleming-Dutra K, Hicks LA, Samore MH. Impact of Implementation of the Core Elements of Outpatient Antibiotic Stewardship Within Veterans Health Administration Emergency Departments and Primary Care Clinics on Antibiotic Prescribing and Patient Outcomes. Clin Infect Dis 2020; 73:e1126-e1134. [PMID: 33289028 DOI: 10.1093/cid/ciaa1831] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The Core Elements of Outpatient Antibiotic Stewardship provide a framework to improve antibiotic use. We report the impact of core elements implementation within Veterans Health Administration sites. METHODS In this quasiexperimental controlled study, effects of an intervention targeting antibiotic prescription for uncomplicated acute respiratory tract infections (ARIs) were assessed. Outcomes included per-visit antibiotic prescribing, treatment appropriateness, ARI revisits, hospitalization, and ARI diagnostic changes over a 3-year pre-implementation period and 1-year post-implementation period. Logistic regression adjusted for covariates (odds ratio [OR], 95% confidence interval [CI]) and a difference-in-differences analysis compared outcomes between intervention and control sites. RESULTS From 2014-2019, there were 16 712 and 51 275 patient visits within 10 intervention and 40 control sites, respectively. Antibiotic prescribing rates pre- and post-implementation within intervention sites were 59.7% and 41.5%, compared to 73.5% and 67.2% within control sites, respectively (difference-in-differences, P < .001). Intervention site pre- and post-implementation OR to receive appropriate therapy increased (OR, 1.67; 95% CI, 1.31-2.14), which remained unchanged within control sites (OR,1.04; 95% CI, .91-1.19). ARI-related return visits post-implementation (-1.3% vs -2.0%; difference-in-differences P = .76) were not different, but all-cause hospitalization was lower within intervention sites (-0.5% vs -0.2%; difference-in-differences P = .02). The OR to diagnose non-specific ARI compared with non-ARI diagnoses increased post-implementation forintervention (OR, 1.27; 95% CI, 1.21 -1.34) but not control (OR, 0.97; 95% CI, .94-1.01) sites. CONCLUSIONS Implementation of the core elements was associated with reduced antibiotic prescribing for RIs and a reduction in hospitalizations. Diagnostic coding changes were observed.
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Affiliation(s)
- Karl Madaras-Kelly
- Pharmacy Service, Boise VA Medical Center, Boise, Idaho, USA.,Department of Pharmacy Practice, Pharmacy Practice, College of Pharmacy, Idaho State University, Meridian, Idaho, USA
| | - Christopher Hostler
- Department of Medicine- Hostler (Mary Townsend is Pharmacy Service), Infectious Diseases Section, Durham VA Health Care System, Durham, North Carolina, USA
| | - Mary Townsend
- Department of Medicine- Hostler (Mary Townsend is Pharmacy Service), Infectious Diseases Section, Durham VA Health Care System, Durham, North Carolina, USA
| | - Emily M Potter
- Pharmacy Service, Dwight D. Eisenhower Veterans Affairs Medical Center, Leavenworth, Kansas, USA
| | - Emily S Spivak
- Medicine Service Spivak (Sarah Hall is Primary Care), VA Salt Lake City Healthcare System, Salt Lake City, Utah, USA.,Department of Medicine, University of Utah School of Medicine, Salt Lake City, Utah, USA
| | - Sarah K Hall
- Medicine Service Spivak (Sarah Hall is Primary Care), VA Salt Lake City Healthcare System, Salt Lake City, Utah, USA.,Department of Medicine, University of Utah School of Medicine, Salt Lake City, Utah, USA
| | - Matthew Bidwell Goetz
- Medicine Service, VA Greater Los Angeles Healthcare System, Los Angeles, California, USA.,Department of Medicine, David Geffen School of Medicine at the University of California-Los Angeles, Los Angeles, California, USA
| | - McKenna Nevers
- Medicine Service Spivak (Sarah Hall is Primary Care), VA Salt Lake City Healthcare System, Salt Lake City, Utah, USA.,Department of Medicine, University of Utah School of Medicine, Salt Lake City, Utah, USA
| | - Jian Ying
- Medicine Service Spivak (Sarah Hall is Primary Care), VA Salt Lake City Healthcare System, Salt Lake City, Utah, USA.,Department of Medicine, University of Utah School of Medicine, Salt Lake City, Utah, USA
| | - Benjamin Haaland
- Medicine Service Spivak (Sarah Hall is Primary Care), VA Salt Lake City Healthcare System, Salt Lake City, Utah, USA.,Department of Medicine, University of Utah School of Medicine, Salt Lake City, Utah, USA
| | | | | | - Katherine Fleming-Dutra
- National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Lauri A Hicks
- National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Matthew H Samore
- Medicine Service Spivak (Sarah Hall is Primary Care), VA Salt Lake City Healthcare System, Salt Lake City, Utah, USA.,Department of Medicine, University of Utah School of Medicine, Salt Lake City, Utah, USA
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20
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Hughes JA, Bravo MD, Townsend M, Kamel H. Characterization of health issues in young first-time blood donors. Vox Sang 2020; 116:288-295. [PMID: 33277937 DOI: 10.1111/vox.13022] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [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: 05/29/2020] [Revised: 10/06/2020] [Accepted: 10/06/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND AND OBJECTIVES Blood donors, especially young donors, are considered a healthy segment of the population. We sought to identify medical issues that may warrant medical referral in young first-time blood donors. MATERIALS AND METHODS A retrospective cohort study was performed in first-time donors ages 16-22 who presented in a system of nineteen regional United States blood centres over 10 years. Donor health attributes characterized include body mass index, blood pressure, total cholesterol and pre-donation haemoglobin. Using standardized definitions, overweight and obese body mass, hypertension, elevated cholesterol and anaemia were identified and characterized in this donor population. RESULTS Among 825 041 young first-time donors presenting between January 2009 and December 2018, with available measurements, 46·9% were either overweight or obese, 59·8% demonstrated high blood pressure (22·2% elevated blood pressure, 37·6% stage 1 or 2 hypertension), elevated cholesterol was identified among 6·3% of males and 8·8% of females, and anaemia was present in 3·5% of males and 5·2% of females. During the study period, all unfavourable health outcomes significantly increased in prevalence (P < 0·0001) when comparing 2009 vs. 2018 rates. CONCLUSION Elevated weight and obesity are common in young first-time allogeneic United States blood donors, with fewer donors having elevated total cholesterol or anaemia. Such medical issues may have significant importance for future health and well-being as well as continued donor eligibility. Blood centres may be able to help support the identification and mitigation of important medical issues in donors and provide a public health benefit.
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Affiliation(s)
| | | | | | - Hany Kamel
- Vitalant Medical Affairs, Scottsdale, AZ, USA
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21
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Goldman M, Townsend M, Magnussen K, Lozano M, Nissen-Meyer LS, Lee CK, Leung JNS, Takanashi M, McKay J, Kvist M, Robitaille N, Deschênes J, Di Angelantonio E, McMahon A, Roberts D, Maghsudlu M, Castrén J, Tiberghien P, Woimant G, Morel P, Kamel H, Bravo M, Shinhar E, Gendelman V, Raz H, Wendel S, Fachini R, Quee F, van den Hurk K, Wiersum J, Grima K, Speedy J, Bruun M, Dunbar N. Vox Sanguinis International Forum on Mitigation Strategies to Prevent Faint and Pre-faint Adverse Reactions in Whole Blood Donors: Summary. Vox Sang 2020; 116:351-359. [PMID: 33245787 DOI: 10.1111/vox.13037] [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: 10/30/2020] [Accepted: 11/01/2020] [Indexed: 11/26/2022]
Affiliation(s)
- Mindy Goldman
- Donor and Clinical Services, Canadian Blood Services, Ottawa, ON, Canada
| | | | - Karin Magnussen
- Immunology & Transfusion Medicine, Innlandet Hospital Trust, Lillehammer, Norway
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Nancy Dunbar
- Blood Bank, Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA
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22
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Sasamoto N, Townsend M, Abbas-Aghababazadeh F, Terry KL, Johnson JO, Hecht JL, Fridley BL, Tworoger SS. Abstract 34: Predictors of discordance between image-based and manual scoring of immunohistochemical stains in ovarian cancer tissue microarrays. Cancer Res 2020. [DOI: 10.1158/1538-7445.am2020-34] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Digital image-based scoring of immunohistochemistry (IHC) staining allows faster, more objective and potentially more reproducible quantification of area stained or cell counts compared to manual scoring. However, predictors of discrepancies between these two assessment methods are not well understood. We examined clinical and pathological characteristics associated with discordance between image-based and manual scoring using ovarian cancer tissue microarrays (TMA) across a range of IHC stains. We evaluated 2,159 TMA cores from 681 ovarian cancer cases stained by four tissue cytoplasmic stains quantified as percentage of the tumor area stained (POSTN, CXCL14, ADH1B, COL11A1) and two immune cell markers quantified by cell count of infiltrating immune cells (CD68, CD163). The TMA slides were scored manually using semi-quantitative scoring by gynecologic pathologists as well as digitally using image-based Definiens automated platform. We used generalized linear mixed models with individual patients and TMAs included as random effects and stain as fixed effect to examine predictors of discordance, defined as absolute difference of ≥1SD in z-scores between image-based and manual scoring, overall and by each stain. The multi-level model included characteristics of the TMA, core, and tumor factors as predictors. Overall, TMA construction by automated robotic system (vs manual), smaller core size or area, borderline (vs invasive tumors), and having no geographic necrosis in the tumor were significantly associated with greater discordance between image-based and manual scoring. Interestingly, all these factors, except geographic necrosis, were differentially associated with discordance across the stains (p-interaction <0.05). Having multiple loci of geographic necrosis was associated with less discordance (OR=0.84, 95%CI=0.72-0.97). Invasive tumors compared to borderline tumors were less likely to be discordantly scored overall (OR=0.80, 95%CI=0.65-1.00) and for tissue cytoplasmic stains (OR range: 0.42-0.73), with associations in the opposite direction for immune cell markers (OR range: 1.21-2.37). Core areas in the lowest quartile vs all other cores were associated with greater discordance (OR=1.18, 95%CI=1.05-1.32), which was more notable for the tissue cytoplasmic stains (OR range: 1.18-2.00) compared to immune cell markers (OR range: 0.83-0.86). TMAs created by robot vs by hand had 64% higher odds of discordance (95%CI=1.20-2.25), which was more apparent when blank rows and columns were included on the TMA. Overall, TMA, core, and tumor level factors were related to discordance between image-based and manual scoring. Some stain types may be more susceptible to specific pre-analytic factors suggesting that reproducibility studies of manual vs image-based scoring should be conducted on a proportion of cases in large scale projects.
Citation Format: Naoko Sasamoto, Mary Townsend, Farnoosh Abbas-Aghababazadeh, Kathryn L. Terry, Joseph O. Johnson, Jonathan L. Hecht, Brooke L. Fridley, Shelley S. Tworoger. Predictors of discordance between image-based and manual scoring of immunohistochemical stains in ovarian cancer tissue microarrays [abstract]. In: Proceedings of the Annual Meeting of the American Association for Cancer Research 2020; 2020 Apr 27-28 and Jun 22-24. Philadelphia (PA): AACR; Cancer Res 2020;80(16 Suppl):Abstract nr 34.
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23
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Townsend M, Buccino T, Katz L. Evaluation of donor informed consents and associated predonationeducational materials in the United Statesand Canada: variability in elements of consent and measures of readability and reading burden. Transfusion 2020; 60:1747-1755. [DOI: 10.1111/trf.15867] [Citation(s) in RCA: 2] [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] [Received: 01/10/2020] [Revised: 04/04/2020] [Accepted: 04/05/2020] [Indexed: 11/30/2022]
Affiliation(s)
| | | | - Louis Katz
- Mississippi Valley Regional Blood Center Davenport Iowa USA
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24
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Wang T, Townsend M, Eliassen H, Terry K, Song M, Tworoger S. Abstract B47: Physical activity and survival following diagnosis with ovarian cancer. Clin Cancer Res 2020. [DOI: 10.1158/1557-3265.ovca19-b47] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Among the limited studies assessing the association between physical activity and ovarian cancer survival, results have been inconsistent. Therefore, we investigated the relation of pre- and postdiagnosis physical activity with risk of death among women with ovarian cancer in two prospective cohort studies, the Nurses’ Health Study (NHS) and NHSII. Analyses included 1,113 women with confirmed invasive, stage I-III epithelial ovarian cancer (611 ovarian cancer specific deaths). We used Cox proportional hazards regression models to estimate hazard ratios (HR) and 95% confidence intervals (CI) for ovarian cancer-specific mortality by physical activity levels, adjusting for age and year of diagnosis, tumor stage, histologic subtype, body mass index, and nonsteroidal anti-inflammatory use (postdiagnosis models only). Neither prediagnosis physical activity (assessed a median of 12 months before diagnosis) nor postdiagnosis physical activity (assessed a median of 19 months after diagnosis) was significantly associated with risk of ovarian cancer death. For example, comparing women participating in ≥27 vs. <3 MET-hours/week of physical activity, HRs were 1.19 (95%CI: 0.91-1.56) for prediagnosis activity and 0.74 (95%CI: 0.51-1.08) for postdiagnosis activity. In analyses stratified by tumor stage, higher physical activity before and after diagnosis was associated with lower ovarian cancer-specific mortality among stage I/II patients (≥27 vs. <3 MET-hours/week, HR=0.43, 95%CI: 0.21-0.88 for prediagnosis activity, HR=0.31, 95%CI: 0.13-0.72 for postdiagnosis activity), while an increased risk of death or no association was observed among stage III patients (≥27 vs. <3 MET-hours/week, HR=1.37, 95%CI: 1.02-1.84 for prediagnosis activity, HR=0.84, 95%CI: 0.56-1.25 for postdiagnosis activity). Results did not vary significantly by histologic subtype (serous vs. nonserous/unknown). Future analyses will evaluate prediagnosis physical activity reported at least four years prior to ovarian cancer diagnosis and postdiagnosis physical activity within four years after diagnosis. Overall, our analyses suggest that, among all stage I-III ovarian cancer patients, higher levels of physical activity, either before or after diagnosis, are not associated with improved survival. However, physical activity in women with early-stage disease may be related to improved outcomes.
Citation Format: Tianyi Wang, Mary Townsend, Heather Eliassen, Kathryn Terry, Mingyang Song, Shelley Tworoger. Physical activity and survival following diagnosis with ovarian cancer [abstract]. In: Proceedings of the AACR Special Conference on Advances in Ovarian Cancer Research; 2019 Sep 13-16, 2019; Atlanta, GA. Philadelphia (PA): AACR; Clin Cancer Res 2020;26(13_Suppl):Abstract nr B47.
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Affiliation(s)
- Tianyi Wang
- 1H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL,
| | - Mary Townsend
- 1H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL,
| | - Heather Eliassen
- 2Brigham and Women’s Hospital and Harvard Medical School, Boston, MA,
| | - Kathryn Terry
- 3Brigham and Women’s Hospital and Harvard Medical School; Harvard T.H. Chan School of Public Health, Boston, MA,
| | - Mingyang Song
- 4Harvard T.H. Chan School Of Public Health; Massachusetts General Hospital and Harvard Medical School, Boston, MA,
| | - Shelley Tworoger
- 5H. Lee Moffitt Cancer Center and Research Institute; University of South Florida, Tmpa, FL; Harvard T.H. Chan School of Public Health, Boston, MA
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25
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Townsend M, Kamel H, Van Buren N, Wiersum‐Osselton J, Rosa‐Bray M, Gottschall J, Rajbhandary S. Development and validation of donor adverse reaction severity grading tool: enhancing objective grade assignment to donor adverse events. Transfusion 2020; 60:1231-1242. [DOI: 10.1111/trf.15830] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Revised: 03/06/2020] [Accepted: 03/06/2020] [Indexed: 12/14/2022]
Affiliation(s)
| | | | | | - Johanna Wiersum‐Osselton
- TRIP Hemovigilance and Biovigilance Office Leiden the Netherlands
- Sanquin Blood Bank Amsterdam the Netherlands
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26
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Keating N, Tuakli E, Fornasari L, Townsend M, Conneally K. Physiotherapists can ́make every contact count́ to promote smoking cessation; a quality improvement project on a vascular ward. Physiotherapy 2020. [DOI: 10.1016/j.physio.2020.03.262] [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: 10/24/2022]
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Tait LW, Lohrer AM, Townsend M, Atalah J, Floerl O, Inglis GJ. Invasive ecosystem engineers threaten benthic nitrogen cycling by altering native infaunal and biofouling communities. Sci Rep 2020; 10:1581. [PMID: 32005953 PMCID: PMC6994685 DOI: 10.1038/s41598-020-58557-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2019] [Accepted: 01/15/2020] [Indexed: 11/13/2022] Open
Abstract
Predicting the effects of invasive ecosystem engineering species in new bioregions has proved elusive. In part this is because separating biological effects from purely physical mechanisms has been little studied and yet could help predict potentially damaging bioinvasions. Here we tested the effects of a large bio-engineering fanworm Sabella spallanzanii (Sabella) versus worm-like structures (mimics) on gas and nutrient fluxes in a marine soft bottom sediment. Experimental plots of sediment in Hauraki Gulf (New Zealand) were used to test the hypothesis that ecosystem engineers negatively influence benthic ecosystem function through autogenic mechanisms, facilitating activity by biofouling organisms and competitive exclusion of native infauna. Enhanced physical structure associated with Sabella and mimics increased nitrogen fluxes, community metabolism and reduced denitrification from 23 μmol m−2 h−1 to zero at densities greater than 25 m2. Sabella plots on average had greater respiration (29%), NH4 release (33%), and greater NO3 release (52%) compared to mimics, suggesting allogenic (biological) mechanisms occur, but play a secondary role to autogenic (physical) mechanisms. The dominance of autogenic mechanisms indicates that bio-engineers are likely to cause significant impacts when established, regardless of fundamental differences in recipient regions or identity of the introduced bio-engineer. In the case of Sabella spallanzanii, compromised denitrification has the potential to tip the balance of net solute and gas exchanges and cause further ecological degradation in an already eutrophic system.
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Affiliation(s)
- L W Tait
- National Institute of Water and Atmospheric Research, 10 Kyle St, Riccarton, Christchurch, 8011, New Zealand.
| | - A M Lohrer
- National Institute of Water and Atmospheric Research, 10 Silverdale Road Hillcrest, Hillcrest, Hamilton, 3216, New Zealand
| | - M Townsend
- National Institute of Water and Atmospheric Research, 10 Silverdale Road Hillcrest, Hillcrest, Hamilton, 3216, New Zealand.,Waikato Regional Council, 401 Grey St, Hamilton East, Hamilton, 3216, New Zealand
| | - J Atalah
- Cawthron Institute 98 Halifax St E, The Wood, Nelson, 7010, New Zealand
| | - O Floerl
- Cawthron Institute 98 Halifax St E, The Wood, Nelson, 7010, New Zealand
| | - G J Inglis
- National Institute of Water and Atmospheric Research, 10 Kyle St, Riccarton, Christchurch, 8011, New Zealand
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Mallen A, Townsend M, Boac B, Todd S, Gandhi A, Kuznicki M, Magliocco A, Fridley B, Tworoger S, Vadaparampil S, Wenham R. Predictive factors of genetic referral for advanced, epithelial ovarian cancer patients at a Single-Institution Cancer Center. Gynecol Oncol 2019. [DOI: 10.1016/j.ygyno.2019.03.191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Townsend M, Karthigan R, Kaderbhai H, Bailey C, Panchalingam D, Keane A, Nehra D, Burney K. Gastric ulceration causing thoracic spondylodiscitis: a first case of a rare complication post oesophagectomy. BJR Case Rep 2019; 5:20170074. [PMID: 31131113 PMCID: PMC6519485 DOI: 10.1259/bjrcr.20170074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2017] [Revised: 06/22/2018] [Accepted: 07/04/2018] [Indexed: 11/05/2022] Open
Abstract
We report the case of an 84-year-old male, who presented with septicaemia, abdominal and back pain. The patient had a background of oesophageal carcinoma and had undergone previous oesophagectomy and gastric pull-up operation 10 years ago. A computerised topography scan demonstrated a probable gastro-vertebral communication with a destructive process at the T8/T9 vertebral level. Further evaluation with MRI clearly showed the tract between the two structures and confirmed the diagnosis of spondylodiscitis at the adjacent spinal level. The patient was resuscitated, treated with intravenous antibiotics and kept nil by mouth. A subsequent gastroscopy demonstrated an eroding gastric ulcer at the enteric opening of the tract between the tubal stomach and the spinal column. The diagnosis was discussed with the patient, his family and the surgical multidisciplinary team. Given the extent of disease and his multiple medical co-morbidities, the decision was made for conservative management and symptom control. This is the first case of a gastro-vertebral communication causing spondylodiscitis to be described in the literature.
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Affiliation(s)
- M Townsend
- Epsom and St Helier’s NHS Trust, Carshalton, UK
| | - R Karthigan
- Epsom and St Helier’s NHS Trust, Carshalton, UK
| | - H Kaderbhai
- Epsom and St Helier’s NHS Trust, Carshalton, UK
| | - C Bailey
- Epsom and St Helier’s NHS Trust, Carshalton, UK
| | | | - A Keane
- Epsom and St Helier’s NHS Trust, Carshalton, UK
| | - D Nehra
- Epsom and St Helier’s NHS Trust, Carshalton, UK
| | - K Burney
- Epsom and St Helier’s NHS Trust, Carshalton, UK
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Madaras-Kelly K, Hruza H, Pontefract B, Mckie R, Hostler C, Townsend M, Potter EM, Spivak E, Hall S, Goetz M, Nevers M, Ying J, Haaland B, Fleming-Dutra K, Samore M. 213. Multi-centered Evaluation of an Acute Respiratory Tract Infection Audit-Feedback Intervention: Impact on Antibiotic Prescribing Rates and Patient Outcomes. Open Forum Infect Dis 2018. [PMCID: PMC6253724 DOI: 10.1093/ofid/ofy210.225] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Background Audit-feedback of antibiotic prescribing rates for acute respiratory infections (ARIs) is a promising approach to reduce antibiotic use; however, the generalizability and sustainability are unknown. We describe an audit-feedback intervention and outcomes across multiple seasons in different clinic settings. Methods Two VA Medical Centers distributed audit-feedback reports targeting providers with frequent ARI visits in emergency department (ED) and primary care (PC) during 2015–2016 and 2016–2017. An academic detailing visit delivered by local peers accompanied the initial audit-feedback report. The intervention was expanded to ED and PC clinics (n = 10) in three other VA facilities in 2017–2018. Outcomes included rates of antibiotics prescribed, recurrent visits for ARIs within 30 days, and adverse events. We assessed intervention sustainability in initiating VAs, and intervention generalizability in expansion VAs. Mixed-effect logistic regression models were used to assess intervention effect on antibiotic prescribing and outcomes. Results Antibiotic prescribing for uncomplicated ARI visits (n = 7,814) declined from 53.8% to 27.9% post intervention. The intervention was associated with a reduction in odds of prescribing antibiotics in initiating facilities (odds ratio [OR] 0.6 (95% CI 0.3, 0.9), which declined further with an annual OR 0.8 [95% CI 0.7, 1.1] per year. Preliminary 6-month postintervention results were available from pilot clinics (n = 3) within two of the expansion VAs, which indicated similar effectiveness (OR 0.5 [0.4, 0.7]). Recurrent visits for ARIs (8.2% vs. 8.6%, P = 0.14) and adverse events (2.3% vs. 2.1%, P = 0.90) were not different pre-/post-intervention. Receipt of an antibiotic was not associated with recurrent visits for ARI (8.6% vs. 8.0%, P = 0.45) or adverse events (1.9% vs. 1.7%, P = 0.11). Conclusion An audit-feedback intervention sustained a reduction in antibiotic prescribing for ARIs over 3 years, and resulted in similar reductions in antibiotic use in varied ED and PC settings without affecting ARI-related return visit rates. Disclosures All authors: No reported disclosures.
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Affiliation(s)
- Karl Madaras-Kelly
- Pharmacy Service, Boise Veterans Affairs Medical Center, Boise, Idaho, Pharmacy Practice, College of Pharmacy, Idaho State University, Meridian, Idaho
| | - Hayli Hruza
- Pharmacy, Boise VA Medical Center, Boise, Idaho
| | | | | | - Christopher Hostler
- Infectious Diseases Section, Durham VA Health Care System, Durham, North Carolina
| | | | - Emily M Potter
- Dwight D. Eisenhower Veterans Affairs Medical Center, Leavenworth, Kansas
| | - Emily Spivak
- Internal Medicine, University of Utah Health, Salt Lake City, Utah
| | - Sarah Hall
- VA Salt Lake City Healthcare System, Salt Lake City, Utah
| | - Matthew Goetz
- Infectious Diseases, VA Greater Los Angeles Healthcare System, Los Angeles, California
| | - McKenna Nevers
- Salt Lake City Veteran Affairs Medical Center, Salt Lake City, Utah
| | - Jian Ying
- Medicine, University of Utah School of Medicine, Division of Epidemiology, Salt Lake City, Utah
| | - Ben Haaland
- University of Utah, School of Medicine, Salt Lake City, Utah
| | | | - Matthew Samore
- University of Utah School of Medicine, Division of Epidemiology, Salt Lake City, Utah
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Land KJ, Townsend M, Goldman M, Whitaker BI, Perez GE, Wiersum-Osselton JC. International validation of harmonized definitions for complications of blood donations. Transfusion 2018; 58:2589-2595. [DOI: 10.1111/trf.14948] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2018] [Revised: 07/26/2018] [Accepted: 07/26/2018] [Indexed: 11/29/2022]
Affiliation(s)
- Kevin J. Land
- Blood Systems, Inc.; San Antonio Texas
- UT Health Science Center at San Antonio, Department of Pathology; San Antonio Texas
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Markland A, Chu H, Epperson CN, Nodora J, Shoham D, Smith A, Sutcliffe S, Townsend M, Zhou J, Bavendam T. Occupation and lower urinary tract symptoms in women: A rapid review and meta-analysis from the PLUS research consortium. Neurourol Urodyn 2018; 37:2881-2892. [PMID: 30272814 DOI: 10.1002/nau.23806] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [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: 04/11/2018] [Accepted: 08/11/2018] [Indexed: 12/30/2022]
Abstract
AIMS Chronic, infrequent voiding may be a risk factor for lower urinary tract symptoms (LUTS) in women. To inform this hypothesis, we conducted a rapid literature review and meta-analysis of LUTS by occupation as an indirect measure of infrequent voiding behaviors. METHODS Two independent medical librarians searched Pubmed.gov studies (1990-2017) on adult women for occupations, industries, and workplace environment and LUTS outcomes: overactive bladder (OAB), urinary incontinence (UI), urinary tract infections (UTIs), and individual voiding and storage LUTS. Two authors reviewed full text articles meeting content criteria. Among studies with similar UI definitions, we estimated the prevalence of monthly UI using a random effects meta-analysis model. RESULTS Of 1078 unique citations identified, 113 underwent full article review and 33 met inclusion criteria. Twenty-six of these studies examined specific occupation groups, including nurses/midwives (n = 6 studies), healthcare workers/support staff (n = 6), military personnel (n = 3), teachers (n = 3), and other groups (n = 7), whereas eight compared findings across broad occupation groups. UI was reported in 30 studies (23% using validated measures), OAB in 6 (50% validated), and UTIs in 2 (non-validated). In pooled models, the degree of heterogeneity was too high (I2 = 96.9-99.2%) among the studies to perform valid prevalence estimates for LUTS. CONCLUSIONS Current literature limits the ability to evaluate LUTS by occupation types. Future studies should characterize voiding frequency and toilet access in a consistent manner by occupation and explore its relation to LUTS development.
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Affiliation(s)
- Alayne Markland
- Department of Medicine, University of Alabama at Birmingham, Birmingham Geriatric Research, Education, and Clinical Center at the Birmingham VA Medical Center, Birmingham, Alabama
| | - Haitao Chu
- Division of Biostatistics, University of Minnesota, Minneapolis, Minnesota
| | - C Neill Epperson
- Departments of Psychiatry and Obstetrics and Gynecology, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Jesse Nodora
- Department of Family Medicine and Public Health, University of California San Diego, La Jolla, California
| | - David Shoham
- Public Health Sciences, Loyola University, Chicago, Illinois
| | - Ariana Smith
- Department of Surgery, Division of Urology, University of Pennsylvania, Philadelphia, PennsylvaniaPennsylvania
| | - Siobhan Sutcliffe
- Department of Surgery, Division of Public Health Sciences, Washington University School of Medicine, St. Louis, Missouri
| | | | - Jincheng Zhou
- Division of Biostatistics, University of Minnesota, Minneapolis, Minnesota
| | - Tamara Bavendam
- National Institutes of Diabetes and Digestive and Kidney Diseases, National Institute of Health, Bethesda, Maryland
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- National Institutes of Diabetes and Digestive and Kidney Diseases, National Institute of Health, Bethesda, Maryland
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Markland A, Bavendam T, Cain C, Epperson CN, LaCoursiere Y, Shoham D, Smith A, Sutcliffe S, Townsend M, Rudser K, (PLUS) Consortium FTPOLUTS. PD32-02 OCCUPATIONAL GROUPS AND LOWER URINARY TRACT SYMPTOMS IN WOMEN. J Urol 2018. [DOI: 10.1016/j.juro.2018.02.1545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Allen D, Townsend M, Drew R. Relationship between Vancomycin Area Under the Concentration-Time Curve (AUC) and Nephrotoxicity in Adults. Open Forum Infect Dis 2017. [DOI: 10.1093/ofid/ofx163.676] [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: 11/14/2022] Open
Abstract
Abstract
Background
While recent data correlate vancomycin’s ratio of the area under the 24 hour time-concentration curve (AUC0−24h) to the pathogen’s minimal inhibitory concentration (MIC) of > 400 mg*hours/L with a favorable clinical outcome, data are sparse to correlate vancomycin AUC0−24h to nephrotoxicity. Our primary objective was to evaluate the relationship between vancomycin AUC0−24h and nephrotoxicity.
Methods
This single-center, retrospective cohort study was conducted at a large US tertiary-care hospital. Adults hospitalized between 08/01/13 and 08/31/14 with normal baseline renal function receiving intravenous vancomycin ≥ 72 hours were included. Vancomycin AUC0−24h was calculated for each subject utilizing computer-based Bayesian pharmacokinetic methods (BestDose™). Subjects were divided into AUC0−24h of < 700 and > 700 mg*hours/L groups. The primary endpoint of nephrotoxicity (defined as a 50% relative increase or > 0.5 mg/dl absolute increase in SCr over at least 2 consecutive days) was compared between exposure groups. Secondary objectives were to compare the incidence of nephrotoxicity with and without the following risk factors: sepsis, concomitant nephrotoxins, vancomycin troughs > 20 mg/L or doses ≥ 4 g/day, and Charlson Comorbidity Index scores.
Results
Table 1. Multivariate Model of Nephrotoxicity and Clinical Characteristics
Conclusion
A significant increase in nephrotoxicity was observed in patients with a vancomycin AUC0−24h ≥ 700 mg*hours/L. Given that this exposure threshold is within the target for efficacy for organisms with elevated MICs, further studies should be conducted to better delineate the AUC0−24h values associated with nephrotoxicity.
Disclosures
All authors: No reported disclosures.
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Affiliation(s)
| | - Mary Townsend
- Campbell University College of Pharmacy & Health Sciences, Buies Creek, North Carolina
- Durham VA Medical Center, Durham, North Carolina
| | - Richard Drew
- Campbell University College of Pharmacy & Health Sciences, Buies Creek, North Carolina
- Division of Infectious Diseases, Duke University Medical Center, Durham, North Carolina
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Abstract
BACKGROUND Reports of septic transfusion reactions (STRs) after transfusion of culture-negative platelets (PLTs) justify more effective prevention strategies. Pathogen reduction technologies or performance of additional point-of-issue testing are proposed strategies to enhance safety through Day 5 of storage. STUDY DESIGN AND METHODS Trima leukoreduced apheresis PLTs (APs) were collected during two study periods (45 and 31 months) using standard procedures, with target settings adjusted during the second period to maintain split rate after increased culture volume. Primary testing for bacterial contamination was performed using BacT/ALERT 3D with sampling from the mother bag 24 to 36 hours after collection. Two culture approaches were compared: in Period A, an 8-mL sample in one aerobic culture bottle (CB), and in Period B a minimal proportional sample volume (PSV) of at least 3.8% of mother bag volume into one to three aerobic CBs (7-10 mL per bottle). RESULTS In Periods A and B, 188,389 and 159,098 AP collections were tested, respectively. The true-positive (TP) rate in Period A was 0.90 per 10,000 collections and in Period B was 1.83 per 10,000 (p < 0.05). In Period B, 12 of 29 (41%) TP results had discrepant CB results (DCBRs; at least one of multiple bottles without growth). The false-positive rate in Period B, 15.05 per 10,000 collections, was significantly higher than that of Period A, 3.66 per 10,000. One contaminated collection resulting in STR(s) was reported in each study period. Implementation of PSV was operationally successful and did not impact the AP split rate. CONCLUSION Proportional sample volume improved the sensitivity of primary testing and identified collections that could have escaped detection had only a single bottle with 8- to 10-mL volume been used. PSV may represent another approach to enhanced PLT safety for 5-day storage without a requirement for secondary testing.
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Humby F, Dicicco M, Kelly S, Bombardieri M, Hands R, Rocher V, Zou L, Myles L, Blighe K, Ng N, Ramamoorthi N, Hackney J, Zuckerman N, Townsend M, Landewe R, Van der Helm van Mihl A, van der Heijde D, Buckely C, Taylor P, McInnes I, Pitzalis C. OP0240 Synovial Lymphocytic Aggregates Associate with Highly Active RA and Predict Erosive Disease Progression at 12 Months: Results from The Pathobiology of Early Arthritis Cohort. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.3229] [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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Bravo M, Shaz BH, Kamel H, Vanderpool S, Tomasulo P, Custer B, Townsend M. Detection of bacterial contamination in apheresis platelets: is apheresis technology a factor? Transfusion 2015; 55:2113-22. [DOI: 10.1111/trf.13107] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2014] [Revised: 02/20/2015] [Accepted: 02/20/2015] [Indexed: 11/28/2022]
Affiliation(s)
| | | | | | | | | | - Brian Custer
- Blood Systems Research Institute
- University of California at San Francisco; San Francisco California
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Bruhn R, Custer B, Vanderpool S, Townsend M, Kamel H, Tomasulo P. Impact of increasing sample volume from 4 ml to 8 ml on bacterial detection rates in apheresis platelets: a meta-analysis. Vox Sang 2014; 108:318-20. [DOI: 10.1111/vox.12225] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2014] [Revised: 10/22/2014] [Accepted: 10/28/2014] [Indexed: 11/29/2022]
Affiliation(s)
- R. Bruhn
- Blood Systems Research Institute; San Francisco CA USA
| | - B. Custer
- Blood Systems Research Institute; San Francisco CA USA
| | | | | | - H. Kamel
- Blood Systems, Inc.; Scottsdale AZ USA
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Hankinson JL, Eschenbacher B, Townsend M, Stocks J, Quanjer PH. Use of forced vital capacity and forced expiratory volume in 1 second quality criteria for determining a valid test. Eur Respir J 2014; 45:1283-92. [PMID: 25537554 PMCID: PMC4416111 DOI: 10.1183/09031936.00116814] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2014] [Accepted: 10/23/2014] [Indexed: 11/21/2022]
Abstract
The 2005 American Thoracic Society (ATS)/European Respiratory Society (ERS) spirometry guidelines define valid tests as having three acceptable blows and a repeatable forced vital capacity (FVC) and forced expiratory volume in 1 s (FEV1). The aim of this study was to determine how reviewer and computer-determined ATS/ERS quality could affect population reference values for FVC and FEV1. Spirometry results from 7777 normal subjects aged 8–80 years (NHANES (National Health and Nutrition Examination Survey) III) were assigned quality grades A to F for FVC and FEV1 by a computer and one reviewer (reviewer 1). Results from a subgroup of 1466 Caucasian adults (aged 19–80 years) were reviewed by two additional reviewers. Mean deviations from NHANES III predicted for FVC and FEV1 were examined by quality grade (A to F). Reviewer 1 rejected (D and F grade) 5.2% of the 7777 test sessions and the computer rejected ∼16%, primarily due to end-of-test (EOT) failures. Within the subgroup, the computer rejected 11.5% of the results and the three reviewers rejected 3.7–5.9%. Average FEV1 and FVC were minimally influenced by grades A to C allocated by reviewer 1. Quality assessment of individual blows including EOT assessments should primarily be used as an aid to good quality during testing rather than for subsequently disregarding data. Reconsideration of EOT criteria and its application, and improved grading standards and training in over-reading are required. Present EOT criteria results in the exclusion of too many subjects while having minimal impact on predicted values. ATS/ERS end of test criteria for spirometry exclude too many subjects while having minimal impact on predicted valueshttp://ow.ly/DQRCD
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Affiliation(s)
| | | | | | - Janet Stocks
- Respiratory, Critical Care and Anaesthesia Section (Portex Unit), UCL Institute of Child Health, London, UK
| | - Philip H Quanjer
- Dept of Pulmonary Diseases, Erasmus University Medical Centre, Rotterdam, The Netherlands Dept of Paediatrics, Division of Respiratory Medicine, Erasmus University Medical Centre - Sophia Children's Hospital, Rotterdam, The Netherlands
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41
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Cho E, Townsend M, Selhub J, Paul L, Rosner B, Fuchs C, Willett W, Giovannucci E. Pre‐diagnostic plasma unmetabolized folic acid and the risk of colorectal cancer (136.5). FASEB J 2014. [DOI: 10.1096/fasebj.28.1_supplement.136.5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Eunyoung Cho
- Brigham and Women's Hospital and Harvard Medical SchoolBOSTONMAUnited States
| | - Mary Townsend
- Brigham and Women's Hospital and Harvard Medical SchoolBOSTONMAUnited States
| | | | - Ligi Paul
- Tufts UniversityBostonMAUnited States
| | - Bernard Rosner
- Brigham and Women's Hospital and Harvard Medical SchoolBOSTONMAUnited States
| | | | - Walter Willett
- Brigham and Women's Hospital and Harvard Medical SchoolBOSTONMAUnited States
| | - Edward Giovannucci
- Brigham and Women's Hospital and Harvard Medical SchoolBOSTONMAUnited States
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42
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Gibbs L, Staiger PK, Townsend M, Macfarlane S, Gold L, Block K, Johnson B, Kulas J, Waters E. Methodology for the evaluation of the Stephanie Alexander Kitchen Garden program. Health Promot J Austr 2013; 24:32-43. [PMID: 23575587 DOI: 10.1071/he12905] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2012] [Accepted: 10/21/2012] [Indexed: 11/23/2022] Open
Abstract
ISSUES ADDRESSED Community and school cooking and gardening programs have recently increased internationally. However, despite promising indications, there is limited evidence of their effectiveness. This paper presents the evaluation framework and methods negotiated and developed to meet the information needs of all stakeholders for the Stephanie Alexander Kitchen Garden (SAKG) program, a combined cooking and gardening program implemented in selectively funded primary schools across Australia. METHODS The evaluation used multiple aligned theoretical frameworks and models, including a public health ecological approach, principles of effective health promotion and models of experiential learning. The evaluation is a non-randomised comparison of six schools receiving the program (intervention) and six comparison schools (all government-funded primary schools) in urban and rural areas of Victoria, Australia. A mixed-methods approach was used, relying on qualitative measures to understand changes in school cultures and the experiential impacts on children, families, teachers, parents and volunteers, and quantitative measures at baseline and 1 year follow up to provide supporting information regarding patterns of change. RESULTS The evaluation study design addressed the limitations of many existing evaluation studies of cooking or garden programs. The multistrand approach to the mixed methodology maintained the rigour of the respective methods and provided an opportunity to explore complexity in the findings. Limited sensitivity of some of the quantitative measures was identified, as well as the potential for bias in the coding of the open-ended questions. CONCLUSION The SAKG evaluation methodology will address the need for appropriate evaluation approaches for school-based kitchen garden programs. It demonstrates the feasibility of a meaningful, comprehensive evaluation of school-based programs and also demonstrates the central role qualitative methods can have in a mixed-method evaluation. So what? This paper contributes to debate about appropriate evaluation approaches to meet the information needs of all stakeholders and will support the sharing of measures and potential comparisons between program outcomes for comparable population groups and settings.
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Affiliation(s)
- L Gibbs
- The McCaughey VicHealth Centre of Community Wellbeing, The University of Melbourne, Australia.
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43
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Kennedy W, Horn P, Su Z, Basu K, Herman A, Song A, Townsend M, Xiao J, Grogan J, Derby M, Simon-Campos JA, Davis J. SAT0110 Efficacy and Safety of Pateclizumab (Anti-Lymphotoxin-Alpha) in Dmard-Ir Patients: Results of a Randomized, Double-Blind, Placebo-Controlled Head-To-Head Phase 2 Study with Adalimumab. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2013-eular.1836] [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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44
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Herman A, Musselman D, Fischer S, Setiadi A, Gabay C, Kavanaugh A, Klearman M, Song A, Townsend M. THU0130 Distinct Biomarkers Enrich for Clinical Response to Tocilizumab (TCZ) and Adalimumab (ADA) in Adacta: A Head-to-Head Monotherapy Study in Patients (PTS) with Methotrexate (MTX)-IR Rheumatoid Arthritis (RA). Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2013-eular.658] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Herman AE, Kennedy WP, Townsend M, Williams M, Grogan J, Fischer S, Iyer S, Song A, Davis JC. FRI0170 Pharmacodynamic biomarkers demonstrate overlapping and distinct biological pathways for lymphotoxin-alpha and tumor necrosis factor-alpha in patients with rheumatoid arthritis. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2013-eular.1297] [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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Lee RW, Millward KE, Ossai FE, Ellis D, Townsend M. P195 Case Series: How Useful Are Fleischner Guidelines For Nodule Surveillance in a District General Hospital? Thorax 2012. [DOI: 10.1136/thoraxjnl-2012-202678.256] [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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Townsend M. Holistic leadership. Beginnings 2012; 32:2-17. [PMID: 23431921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
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Townsend M, Franke A, Li X, Hu F, Eliassen AH. Abstract 35: Within-person reproducibility of urinary bisphenol A and phthalate metabolites among women in the Nurses' Health Studies. Cancer Epidemiol Biomarkers Prev 2012. [DOI: 10.1158/1055-9965.gwas-35] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Abstract
The purpose of our study was to examine the long-term within-person reproducibility of bisphenol A (BPA) and 8 phthalate metabolites. Associations of BPA and phthalates with health are increasingly being investigated in epidemiologic studies, although existing studies are largely cross-sectional. Most previous studies of within-person variability in urinary BPA and phthalate metabolite concentrations have focused on stability over 3 months or less. Long-term reproducibility data are needed to assess the potential usefulness of these biomarkers for predicting risk of disease onset in prospective studies. We measured BPA and 8 phthalate metabolites in spot urine samples donated 1 to 3 years apart by women in the Nurses' Health Study and Nurses' Health Study II (n=80 for analyses of BPA; n=40 for phthalate metabolites); 86% of samples were first-morning urines. Specific phthalate metabolites were mono-ethyl phthalate (MEP), mono-isobutyl phthalate (MiBP), mono-n-butyl phthalate (MnBP), mono-benzyl phthalate (MBzP), mono-(2-ethylhexyl) phthalate (MEHP), mono-(2-ethyl-5-hydrohexyl) phthalate (MEHHP), mono-(2-ethyl-5-oxohexyl) phthalate (MEOHP), and mono-(2-ethyl-5carboxypentyl) phthalate (MECPP). To measure within-person reproducibility, we calculated Spearman rank correlation coefficients and intraclass correlations (ICCs) for creatinine-adjusted BPA and phthalate metabolite concentrations; ICCs were estimated using natural log-transformed values. Additional analyses were restricted to first-morning urine samples. Distributions (medians [5th to 95th percentiles]) of creatinine-adjusted analyte concentrations (ng/mg creatinine) were: 3 (1-6) for BPA, 141 (21-895) for MEP, 4 (1-12) for MiBP, 37 (10-177) for MnBP, 14 (4-97) for MBzP, 5 (2-26) for MEHP, 32 (9-163) for MEHHP, 26 (7-136) for MEOHP, and 43 (16-215) for MECPP. Over 1 to 3 years, within-person variability of BPA was high relative to total variability (ICC=0.14) and rankings of BPA levels between time-points were weakly correlated (Spearman correlation=0.19). All phthalate metabolites, except MEHP, demonstrated moderate within-person stability over time (Spearman correlation or ICC=0.39-0.55). Restricting analyses to first-morning urine samples did not alter results. Overall, we found that single measurements of BPA in spot urine samples were highly variable within women over 1 to 3 years. However, the majority of urinary phthalate metabolites appeared moderately reproducible within women over time. Our results suggest that investigation of associations between a single urinary BPA measurement and disease risk likely will be challenging in epidemiologic studies, while single measurements of urinary phthalate metabolites are reasonable measures of long-term exposure. Further, reproducibility data could be used to correct for within-person variability that results in the attenuation of estimates of relative risk.
Citation Format: Mary Townsend, Adrian Franke, Xingnan Li, Frank Hu, A. Heather Eliassen. Within-person reproducibility of urinary bisphenol A and phthalate metabolites among women in the Nurses' Health Studies. [abstract]. In: Proceedings of the AACR Special Conference on Post-GWAS Horizons in Molecular Epidemiology: Digging Deeper into the Environment; 2012 Nov 11-14; Hollywood, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2012;21(11 Suppl):Abstract nr 35.
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Affiliation(s)
- Mary Townsend
- 1Brigham and Women's Hospital, Boston, MA, 2Cancer Research Center of Hawaii, Honolulu, HI
| | - Adrian Franke
- 1Brigham and Women's Hospital, Boston, MA, 2Cancer Research Center of Hawaii, Honolulu, HI
| | - Xingnan Li
- 1Brigham and Women's Hospital, Boston, MA, 2Cancer Research Center of Hawaii, Honolulu, HI
| | - Frank Hu
- 1Brigham and Women's Hospital, Boston, MA, 2Cancer Research Center of Hawaii, Honolulu, HI
| | - A. Heather Eliassen
- 1Brigham and Women's Hospital, Boston, MA, 2Cancer Research Center of Hawaii, Honolulu, HI
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Patrick R, Capetola T, Townsend M, Nuttman S. Health promotion and climate change: exploring the core competencies required for action. Health Promot Int 2011; 27:475-85. [DOI: 10.1093/heapro/dar055] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [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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Bailey A, Snead M, Costenbader E, Townsend M, Anderson C, Warner L, Kong TH, Steiner M. P2-S9.09 Help me understand your lab results: "an exploratory, qualitative study of discordance between biologic and self-reported measures of semen exposure in Jamaica". Br J Vener Dis 2011. [DOI: 10.1136/sextrans-2011-050108.395] [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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