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Corrigan M, MacDonald NC, Musselman M, Pinto J, Skildum M, Smith AP. ASHP Statement on the Role of the Pharmacy Workforce in Emergency Preparedness. Am J Health Syst Pharm 2022; 79:2185-2189. [PMID: 36099081 DOI: 10.1093/ajhp/zxac226] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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2
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Hashmi ZZ, Ahmed R, Alijarad F, Madanur M, Razzaq Z, Majeed M, Bughio M, Cagney D, Aakif M, Mustafa H, Amin A, Khan A, Aftab F, Corrigan M, Redmond HP. P9: MANAGEMENT OF ESOPHAGEAL FOOD BOLUS OBSTRUCTION AT A UNIVERSITY TEACHING HOSPITAL – A RETROSPECTIVE ANALYSIS. Br J Surg 2021. [DOI: 10.1093/bjs/znab117.094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
Introduction
Despite the fact that esophageal food bolus obstruction is a common surgical problem, there are no clear guidelines on its management. Medical treatment with Buscopan and Glucagon is mostly in-effective, requiring a therapeutic Oesophago-Gastro-Duodenoscopy (OGD).
Method
All consecutive cases of food bolus obstructions (FBO) presenting to the Emergency Department (ED) for 18 month period between 01/01/2018 and 30/06/2019 were retrospectively reviewed.
Result
A total of 30 patients were admitted with food bolus obstruction via ED (1.67 per month). Females (67%) constituted most of these patients. Average age was 55 with range of 19-83. 84% of patients presented with Dysphagia, while Odynophagia (10%) and chest pain (6%) were other presenting symptoms. Average duration of symptoms was 17 hours (Range 2 – 48 hours). 44% of patients had OGD done under sedation while others (56%) had under General Anaesthesia (GA). In 70% of cases, food bolus was pushed into stomach, while it was retrieved out in 20%. In 10%, it had already spontaneously passed in stomach on OGD. The etiology of FBO was inflammatory in 60% cases, while an esophageal stricture was seen in 10% only. In 30% cases no cause of FBO was identified. Post-OGD length of stay was on average 1.15 days (range 12 hours – 7 days). 2 patients had aspiration pneumonia prolonging their hospital stay, there was no esophageal perforation or mortality.
Conclusion
Esophageal food bolus obstruction is a common surgical problem, OGD under GA is a safe recommended procedure, which often picks up an underlying pathology.
Take-home message
Esophageal food bolus obstruction is a common surgical problem, OGD under GA is a safe recommended procedure, which often picks up an underlying pathology.
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Affiliation(s)
- ZZ Hashmi
- Department of Emergency General Surgery, Cork University Hospital, Cork, Ireland
| | - R Ahmed
- Department of Emergency General Surgery, Cork University Hospital, Cork, Ireland
| | - F Alijarad
- Department of Emergency General Surgery, Cork University Hospital, Cork, Ireland
| | - M Madanur
- Department of Emergency General Surgery, Cork University Hospital, Cork, Ireland
| | - Z Razzaq
- Department of Emergency General Surgery, Cork University Hospital, Cork, Ireland
| | - M Majeed
- Department of Emergency General Surgery, Cork University Hospital, Cork, Ireland
| | - M Bughio
- Department of Emergency General Surgery, Cork University Hospital, Cork, Ireland
| | - D Cagney
- Department of Emergency General Surgery, Cork University Hospital, Cork, Ireland
| | - M Aakif
- Department of Emergency General Surgery, Cork University Hospital, Cork, Ireland
| | - H Mustafa
- Department of Emergency General Surgery, Cork University Hospital, Cork, Ireland
| | - A Amin
- Department of Emergency General Surgery, Cork University Hospital, Cork, Ireland
| | - A Khan
- Department of Emergency General Surgery, Cork University Hospital, Cork, Ireland
| | - F Aftab
- Department of Emergency General Surgery, Cork University Hospital, Cork, Ireland
| | - M Corrigan
- Department of Emergency General Surgery, Cork University Hospital, Cork, Ireland
| | - HP Redmond
- Department of Emergency General Surgery, Cork University Hospital, Cork, Ireland
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Walsh S, O'Mahony M, Lehane E, Farrell D, Taggart L, Kelly L, Sahm L, Byrne A, Corrigan M, Caples M, Martin AM, Tabirca S, Corrigan MA, Hegarty J. Cancer and breast cancer awareness interventions in an intellectual disability context: A review of the literature. J Intellect Disabil 2021; 25:131-145. [PMID: 31104540 DOI: 10.1177/1744629519850999] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
BACKGROUND Women with an intellectual disability (ID) have a similar risk of developing breast cancer as women in the general population yet present with later stage breast cancers, which have poorer outcomes. AIM To identify whether there is a need to develop a breast cancer awareness intervention for women with an ID. METHODS Interventions aimed at increasing cancer awareness and breast cancer awareness for people with an ID were identified and critically appraised. RESULTS Five interventions to increase cancer awareness or breast cancer awareness in people with an ID were identified. CONCLUSION The review highlighted the paucity of theoretically underpinned breast cancer awareness interventions specifically aimed at women with an ID. Facilitating breast cancer awareness for women with an ID could potentially lead to earlier presentation of potential symptoms of breast cancer, earlier treatment, better prognosis and ultimately, improved survival. This article establishes that there is a need for an intervention underpinned by theory to increase breast cancer awareness in women with an ID.
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Affiliation(s)
- S Walsh
- 8795University College Cork, Ireland
| | | | - E Lehane
- 8795University College Cork, Ireland
| | - D Farrell
- 8813Institute of Technology Tralee, Ireland
| | - L Taggart
- 2596Ulster University, Northern Ireland
| | - L Kelly
- 57983Cork Breast Research Centre-Cork University Hospital, Ireland
| | - L Sahm
- 8795University College Cork, Ireland
| | - A Byrne
- 63976Cope Foundation, Ireland
| | - M Corrigan
- St. John of God Hospitaller Ministries, Ireland
| | - M Caples
- 8795University College Cork, Ireland
| | | | - S Tabirca
- 8795University College Cork, Ireland
| | - M A Corrigan
- 57983Cork Breast Research Centre-Cork University Hospital, Ireland
| | - J Hegarty
- 8795University College Cork, Ireland
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Chester KW, Corrigan M, Schoeffler JM, Shah M, Toy F, Purdon B, Dillon GM. Making a case for the right '-ase' in acute ischemic stroke: alteplase, tenecteplase, and reteplase. Expert Opin Drug Saf 2019; 18:87-96. [PMID: 30712409 DOI: 10.1080/14740338.2019.1573985] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
INTRODUCTION Alteplase, reteplase, and tenecteplase are tissue plasminogen activators (TPA) approved for the management of acute myocardial infarction. Only alteplase is also approved for the treatment of acute ischemic stroke (AIS). The US Food and Drug Administration has received reports of accidental administration of tenecteplase or reteplase instead of alteplase in patients with AIS, which can result in failure to treat patients with the intended agent and lead to potential overdose. AREAS COVERED This review compares the molecular and clinical features of alteplase, reteplase, and tenecteplase (TNK), identifies factors contributing to medication errors among these agents, and provides steps to reduce medication errors. EXPERT OPINION Primary factors contributing to medication errors among tissue plasminogen activators include the use of the abbreviations 'TPA,' 'tPA,' or 'TNK' in written or verbal orders and use of these agents in similar settings (e.g. emergency departments and critical care areas). Steps to reduce the likelihood of accidental substitution of tenecteplase or reteplase for alteplase in patients with AIS include the use of full brand or generic names and inclusion of the indication in written and verbal orders, the addition of alerts in automated dispensing machines and ordering systems and use of stroke boxes containing alteplase and materials for administration.
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Affiliation(s)
- Katleen Wyatt Chester
- a Department of Pharmacy , Marcus Stroke and Neuroscience Center, Grady Health System , Atlanta , GA , USA
| | - Megan Corrigan
- b Advocate Good Samaritan Hospital , Downers Grove , IL , USA
| | | | | | - Florence Toy
- c Genentech, Inc , South San Francisco , CA , USA
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Narayanen N, Hogan G, Rettedal E, Murphy C, O'hanlon D, Corrigan M, Tangney M. Living microbes within tumours. Breast 2019. [DOI: 10.1016/s0960-9776(19)30453-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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6
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Walsh S, Lehane E, Hegarty J, O’mahony M, Farrell D, Taggart L, Kelly L, Sahm L, Byrne A, Corrigan M, Caples M, Martin A, Tabirca S, Corrigan M. Breast awareness amongst women with a mild/moderate intellectual disability: Linking theory to practice. Eur J Cancer 2018. [DOI: 10.1016/s0959-8049(18)30313-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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7
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Murphy L, Quinn E, O'leary D, Razzaq Z, Livingstone V, Redmond H, Corrigan M. Assessing the accuracy of MRI in measuring nodal response to neoadjuvant chemotherapy (NAC) in breast cancer. Eur J Cancer 2018. [DOI: 10.1016/s0959-8049(18)30524-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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8
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Shaffiq Izzad N, O'leary P, Quinn E, Butt A, Livingstone V, Redmond H, Corrigan M. A comparative analysis of breast cancer affecting young versus older women. Eur J Cancer 2018. [DOI: 10.1016/s0959-8049(18)30368-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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9
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Leong WL, Sharifpoor S, Battiston K, Charleton D, Corrigan M, McCready DR, Done SJ, Santerre JP. Abstract P2-12-15: ReFilx- synthetic biodegradable soft tissue fillers for breast conserving surgery in breast cancer. Cancer Res 2018. [DOI: 10.1158/1538-7445.sabcs17-p2-12-15] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Introduction: Breast conserving surgery (BCS) is the most common procedure performed in breast cancers, but it can often result in breast deformities that can have negative impacts on quality of life. With better treatments, more breast cancer survivors are expected to live longer, the demand for achieving optimal cosmetic outcomes has also increased accordingly. Currently, oncoplastic techniques involving local tissue rearrangement with or without contralateral balancing procedures are used in specialized centers to achieve breast symmetry in some patients. When a breast deformity occurs, corrective options include: fat grafting, autologous flap procedures and completion mastectomy with immediate reconstruction. These techniques have long operative times, longer length of hospital stay and higher complication rates. Commercially-available synthetic implants are fabricated in pre-determined sizes and thus are not suitable to reconstruct partial breast deformities of varying size and shape. We explored the use of amino-acid based biodegradable polyurethanes as tissue fillers for BCS due to their chemical versatility, superior mechanical properties and tailored biocompatibility. Objective: To evaluate novel biodegradable polymer constructs, referred to as ReFilx, as soft tissue fillers for BCS defects. Hypothesis: Implantation of ReFilx during BCS will maintain breast shape and size and promote tissue regeneration in and around the biodegradable biomaterial, in contrast to sham controls. Methods: Two ReFilx formulations with high porosity, mechanical properties (compressive modulus=45±6 kPa and 31±9 kPa) comparable to native breast tissue and a moderate degree of swelling (202±6% and 248±6%) were selected for implantation in porcine BCS defects. Three female Yucatan Minipigs (age=4 years, weight=100-120 kg, 12 breasts per pig) received BCS to remove normal breast tissue of approximately 2 cm diameter, after which the defects were filled with ReFilx Formulation A, ReFilx Formulation B, or no filler (sham control). At 6, 12, 24, and 36 weeks post-implantation (n=3 per group), ultrasound breast examinations and mastectomies of each selected group of breasts were performed. Samples were fixed in 10% buffered formalin and stained with H&E, Masson's Trichrome and immunohistomchemistry using CD31. Results: ReFilx formulations maintained breast size and shape, with similar stiffness to native breast tissue, while sham controls collapsed over 36 weeks. The ReFilx fillers supported cell and tissue infiltration and neovascularization, as indicated by Masson's Trichrome and CD31 staining, respectively, without eliciting foreign body giant cell formation, fibrosis, or chronic inflammation, commonly associated with implanted medical devices. Conclusions: ReFilx are promising soft tissue fillers for breast volume restoration, representing a simple, versatile, permanent, and aesthetically superior solution to prevent soft tissue deformities. Acknowledgements: MaRS PoP fund, grant # MI 2011-170, NSERC # SYN 430828. Haynes Connell Foundation Breast Cancer Fund.
Citation Format: Leong WL, Sharifpoor S, Battiston K, Charleton D, Corrigan M, McCready DR, Done SJ, Santerre JP. ReFilx- synthetic biodegradable soft tissue fillers for breast conserving surgery in breast cancer [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P2-12-15.
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Affiliation(s)
- WL Leong
- Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada; Institute of Biomaterials and Biomedical Engineering, University of Toronto, Toronto, ON, Canada; Translational Biology and Engineering Progra, University of Toronto, Toronto, ON, Canada; Campbell Family Institute of Breast Cancer Research, University Health Network, Toronto, ON, Canada; Laboratory Medicine Program, University of Toronto, Toronto, ON, Canada; University of Toronto, Toronto, ON, Canada; Faculty of Dentistry, University of Toronto, Toronto, ON, Canada; Cork Breast Research Centre, Cork, Munster, Ireland; Grand River Hospital, Kitchener, ON, Canada
| | - S Sharifpoor
- Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada; Institute of Biomaterials and Biomedical Engineering, University of Toronto, Toronto, ON, Canada; Translational Biology and Engineering Progra, University of Toronto, Toronto, ON, Canada; Campbell Family Institute of Breast Cancer Research, University Health Network, Toronto, ON, Canada; Laboratory Medicine Program, University of Toronto, Toronto, ON, Canada; University of Toronto, Toronto, ON, Canada; Faculty of Dentistry, University of Toronto, Toronto, ON, Canada; Cork Breast Research Centre, Cork, Munster, Ireland; Grand River Hospital, Kitchener, ON, Canada
| | - K Battiston
- Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada; Institute of Biomaterials and Biomedical Engineering, University of Toronto, Toronto, ON, Canada; Translational Biology and Engineering Progra, University of Toronto, Toronto, ON, Canada; Campbell Family Institute of Breast Cancer Research, University Health Network, Toronto, ON, Canada; Laboratory Medicine Program, University of Toronto, Toronto, ON, Canada; University of Toronto, Toronto, ON, Canada; Faculty of Dentistry, University of Toronto, Toronto, ON, Canada; Cork Breast Research Centre, Cork, Munster, Ireland; Grand River Hospital, Kitchener, ON, Canada
| | - D Charleton
- Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada; Institute of Biomaterials and Biomedical Engineering, University of Toronto, Toronto, ON, Canada; Translational Biology and Engineering Progra, University of Toronto, Toronto, ON, Canada; Campbell Family Institute of Breast Cancer Research, University Health Network, Toronto, ON, Canada; Laboratory Medicine Program, University of Toronto, Toronto, ON, Canada; University of Toronto, Toronto, ON, Canada; Faculty of Dentistry, University of Toronto, Toronto, ON, Canada; Cork Breast Research Centre, Cork, Munster, Ireland; Grand River Hospital, Kitchener, ON, Canada
| | - M Corrigan
- Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada; Institute of Biomaterials and Biomedical Engineering, University of Toronto, Toronto, ON, Canada; Translational Biology and Engineering Progra, University of Toronto, Toronto, ON, Canada; Campbell Family Institute of Breast Cancer Research, University Health Network, Toronto, ON, Canada; Laboratory Medicine Program, University of Toronto, Toronto, ON, Canada; University of Toronto, Toronto, ON, Canada; Faculty of Dentistry, University of Toronto, Toronto, ON, Canada; Cork Breast Research Centre, Cork, Munster, Ireland; Grand River Hospital, Kitchener, ON, Canada
| | - DR McCready
- Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada; Institute of Biomaterials and Biomedical Engineering, University of Toronto, Toronto, ON, Canada; Translational Biology and Engineering Progra, University of Toronto, Toronto, ON, Canada; Campbell Family Institute of Breast Cancer Research, University Health Network, Toronto, ON, Canada; Laboratory Medicine Program, University of Toronto, Toronto, ON, Canada; University of Toronto, Toronto, ON, Canada; Faculty of Dentistry, University of Toronto, Toronto, ON, Canada; Cork Breast Research Centre, Cork, Munster, Ireland; Grand River Hospital, Kitchener, ON, Canada
| | - SJ Done
- Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada; Institute of Biomaterials and Biomedical Engineering, University of Toronto, Toronto, ON, Canada; Translational Biology and Engineering Progra, University of Toronto, Toronto, ON, Canada; Campbell Family Institute of Breast Cancer Research, University Health Network, Toronto, ON, Canada; Laboratory Medicine Program, University of Toronto, Toronto, ON, Canada; University of Toronto, Toronto, ON, Canada; Faculty of Dentistry, University of Toronto, Toronto, ON, Canada; Cork Breast Research Centre, Cork, Munster, Ireland; Grand River Hospital, Kitchener, ON, Canada
| | - JP Santerre
- Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada; Institute of Biomaterials and Biomedical Engineering, University of Toronto, Toronto, ON, Canada; Translational Biology and Engineering Progra, University of Toronto, Toronto, ON, Canada; Campbell Family Institute of Breast Cancer Research, University Health Network, Toronto, ON, Canada; Laboratory Medicine Program, University of Toronto, Toronto, ON, Canada; University of Toronto, Toronto, ON, Canada; Faculty of Dentistry, University of Toronto, Toronto, ON, Canada; Cork Breast Research Centre, Cork, Munster, Ireland; Grand River Hospital, Kitchener, ON, Canada
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Wentworth L, Nice D, Corrigan M, Seymour-Brown H, Pattison N. 23SUPPORTED DISCHARGE THE KEY TO REDUCING HOSPITAL EMERGENCY ATTENDANCES AND ADMISSIONS. Age Ageing 2017. [DOI: 10.1093/ageing/afx055.23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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11
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Dubeau J, Heinmiller BE, Corrigan M. Multiple Methods for Assessing the Dose to Skin Exposed to Radioactive Contamination. Radiat Prot Dosimetry 2017; 174:371-376. [PMID: 27473702 DOI: 10.1093/rpd/ncw220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/24/2016] [Accepted: 06/29/2016] [Indexed: 06/06/2023]
Abstract
There is the possibility for a worker at a nuclear installation, such as a nuclear power reactor, a fuel production facility or a medical facility, to come in contact with radioactive contaminants. When such an event occurs, the first order of business is to care for the worker by promptly initiating a decontamination process. Usually, the radiation protection personnel performs a G-M pancake probe measurement of the contamination in situ and collects part or all of the radioactive contamination for further laboratory analysis. The health physicist on duty must then perform, using the available information, a skin dose assessment that will go into the worker's permanent dose record. The contamination situations are often complex and the dose assessment can be laborious. This article compares five dose assessment methods that involve analysis, new technologies and new software. The five methods are applied to 13 actual contamination incidents consisting of direct skin contact, contamination on clothing and contamination on clothing in the presence of an air gap between the clothing and the skin. This work shows that, for the cases studied, the methods provided dose estimates that were usually within 12% (1σ) of each other, for those cases where absolute activity information for every radionuclide was available. One method, which relies simply on a G-M pancake probe measurement, appeared to be particularly useful in situations where a contamination sample could not be recovered for laboratory analysis.
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Affiliation(s)
- J Dubeau
- DETEC, Gatineau, Quebec, CanadaJ8T 4J1
| | - B E Heinmiller
- Canadian Nuclear Laboratories, Chalk River, Ontario, CanadaK0J 1J0
| | - M Corrigan
- Canadian Nuclear Laboratories, Chalk River, Ontario, CanadaK0J 1J0
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12
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Jeffery HC, Jeffery LE, Lutz P, Corrigan M, Webb GJ, Hirschfield GM, Adams DH, Oo YH. Low-dose interleukin-2 promotes STAT-5 phosphorylation, T reg survival and CTLA-4-dependent function in autoimmune liver diseases. Clin Exp Immunol 2017; 188:394-411. [PMID: 28176332 PMCID: PMC5422719 DOI: 10.1111/cei.12940] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [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] [Accepted: 01/12/2017] [Indexed: 12/20/2022] Open
Abstract
CD4+CD25highCD127lowforkhead box protein 3 (FoxP3+) regulatory T cells (Treg) are essential for the maintenance of peripheral tolerance. Impaired Treg function and an imbalance between effector and Tregs contribute to the pathogenesis of autoimmune diseases. We reported recently that the hepatic microenvironment is deficient in interleukin (IL)−2, a cytokine essential for Treg survival and function. Consequently, few liver‐infiltrating Treg demonstrate signal transducer and activator of transcription‐5 (STAT‐5) phosphorylation. To establish the potential of IL‐2 to enhance Treg therapy, we investigated the effects of very low dose Proleukin (VLDP) on the phosphorylation of STAT‐5 and the subsequent survival and function of Treg and T effector cells from the blood and livers of patients with autoimmune liver diseases. VLDP, at less than 5 IU/ml, resulted in selective phosphorylation of STAT‐5 in Treg but not effector T cells or natural killer cells and associated with increased expression of cytotoxic T lymphocyte antigen‐4 (CTLA‐4), FoxP3 and CD25 and the anti‐apoptotic protein Bcl‐2 in Treg with the greatest enhancement of regulatory phenotype in the effector memory Treg population. VLDP also maintained expression of the liver‐homing chemokine receptor CXCR3. VLDP enhanced Treg function in a CTLA‐4‐dependent manner. These findings open new avenues for future VLDP cytokine therapy alone or in combination with clinical grade Treg in autoimmune liver diseases, as VLDP could not only enhance regulatory phenotype and functional property but also the survival of intrahepatic Treg.
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Affiliation(s)
- H C Jeffery
- Centre for Liver Research and National Institute for Health Research Liver Biomedical Research Unit, Institute of Immunology and Immunotherapy, University of Birmingham, UK
| | - L E Jeffery
- Institute of Metabolism and Systems Research, University of Birmingham, UK
| | - P Lutz
- Centre for Liver Research and National Institute for Health Research Liver Biomedical Research Unit, Institute of Immunology and Immunotherapy, University of Birmingham, UK
| | - M Corrigan
- Centre for Liver Research and National Institute for Health Research Liver Biomedical Research Unit, Institute of Immunology and Immunotherapy, University of Birmingham, UK.,Liver Transplant and Hepatobiliary Unit, University Hospital of Birmingham NHS Foundation Trust, Birmingham, UK
| | - G J Webb
- Centre for Liver Research and National Institute for Health Research Liver Biomedical Research Unit, Institute of Immunology and Immunotherapy, University of Birmingham, UK.,Liver Transplant and Hepatobiliary Unit, University Hospital of Birmingham NHS Foundation Trust, Birmingham, UK
| | - G M Hirschfield
- Centre for Liver Research and National Institute for Health Research Liver Biomedical Research Unit, Institute of Immunology and Immunotherapy, University of Birmingham, UK.,Liver Transplant and Hepatobiliary Unit, University Hospital of Birmingham NHS Foundation Trust, Birmingham, UK
| | - D H Adams
- Centre for Liver Research and National Institute for Health Research Liver Biomedical Research Unit, Institute of Immunology and Immunotherapy, University of Birmingham, UK.,Liver Transplant and Hepatobiliary Unit, University Hospital of Birmingham NHS Foundation Trust, Birmingham, UK
| | - Y H Oo
- Centre for Liver Research and National Institute for Health Research Liver Biomedical Research Unit, Institute of Immunology and Immunotherapy, University of Birmingham, UK.,Liver Transplant and Hepatobiliary Unit, University Hospital of Birmingham NHS Foundation Trust, Birmingham, UK
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Healy C, Brady C, Sze Yin Sui J, McSorley L, Barry J, Relihan N, Corrigan M, O’Connor T, O’Mahony T, O’Reilly S. An Irish regional cancer centre experience of impact of incidental pulmonary nodules detected during treatment for early stage breast cancer. Breast 2017. [DOI: 10.1016/s0960-9776(17)30273-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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14
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Corrigan M, Johnston JL, Reid H, Thomson C. Interdisciplinarity defines our identity as medical educators. MedEdPublish 2016. [DOI: 10.15694/mep.2016.000160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
This article was migrated. The article was marked as recommended. Medical education is a broad church. As a young interdisciplinary group of educationalists we discuss some aspects of the relevance of interdisciplinarity to medical education, using our own experiences as exemplars.
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O'Hanlon R, Choiseul J, Corrigan M, Catarame T, Destefanis M. Diversity and detections of Phytophthora
species from trade and non-trade environments in Ireland. ACTA ACUST UNITED AC 2016. [DOI: 10.1111/epp.12331] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- R. O'Hanlon
- Department of Agriculture, Food and the Marine; Celbridge Co. Kildare Ireland
| | - J. Choiseul
- Department of Agriculture, Food and the Marine; Celbridge Co. Kildare Ireland
| | - M. Corrigan
- Department of Agriculture, Food and the Marine; Celbridge Co. Kildare Ireland
| | - T. Catarame
- Department of Agriculture, Food and the Marine; Celbridge Co. Kildare Ireland
| | - M. Destefanis
- Department of Agriculture, Food and the Marine; Celbridge Co. Kildare Ireland
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Rafee S, McHugh D, Greally M, Ayodele O, Keegan N, Lim M, Hassan A, O'Mahony D, Hennessy B, Kelly C, Kennedy J, Walshe J, O'Connor M, Leonard G, Murphy V, Livingstone V, Corrigan M, O'Reilly S. Neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) as predictive biomarkers of pathologic complete response (pCR) in neoadjuvant breast cancer: an Irish Clinical Oncology Group study (ICORG 16-20). Ann Oncol 2016. [DOI: 10.1093/annonc/mdw392.20] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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17
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Corrigan M, Wilson SS, Hampton J. Safety and efficacy of intranasally administered medications in the emergency department and prehospital settings. Am J Health Syst Pharm 2016; 72:1544-54. [PMID: 26346210 DOI: 10.2146/ajhp140630] [Citation(s) in RCA: 53] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
PURPOSE The safety and efficacy of medications that may be administered via the intranasal route in adult patients in the prehospital and emergency department (ED) settings are reviewed. SUMMARY When medications of appropriate molecular character and concentration are delivered intranasally, they are quickly transported across this capillary network and delivered to the systemic circulation, thereby avoiding the absorption-limiting effects of first-pass metabolism. Therapeutic drug concentrations are rapidly attained in the cerebrospinal fluid, making intranasal administration a very effective mode of delivery. To optimize the bioavailability of intranasally administered drugs, providers must minimize the barriers to absorption, minimize the volume by maximizing the concentration, maximize the absorptive surface of the nasal mucosa, and use a delivery system that maximizes drug dispersion and minimizes drug runoff. Medications can be instilled into the nasal cavity with syringes or droppers by applying a few drops at a time or via atomization. The intranasal route of administration may be advantageous for patients who require analgesia, sedation, anxiolysis, termination of seizures, hypoglycemia management, narcotic reversal, and benzodiazepine reversal in the ED or prehospital settings. Medications that have been studied in the adult population include fentanyl, sufentanil, hydromorphone, ketamine, midazolam, haloperidol, naloxone, flumazenil, and glucagon. The available data do indicate, however, that intranasal administration may be a safe, effective, and well tolerated route of administration. CONCLUSION Based on the published literature, intranasal administration of fentanyl, sufentanil, ketamine, hydromorphone, midazolam, haloperidol, naloxone, glucagon, and, in limited cases, flumazenil may be a safe, effective, and well-tolerated alternative to intramuscular or intravenous administration in the prehospital and ED settings.
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Affiliation(s)
- Megan Corrigan
- Megan Corrigan, Pharm.D., BCPS, is Emergency Medicine Clinical Pharmacist, Department of Pharmacy, Advocate Illinois Masonic Medical Center, Chicago. Suprat Saely Wilson, Pharm.D., BCPS, is Emergency Medicine Clinical Pharmacist Specialist, Department of Pharmacy Services, Detroit Receiving Hospital, Detroit, MI. Jeremy Hampton, Pharm.D., BCPS, is Clinical Specialist Emergency Medicine, Truman Medical Center, Kansas City, MO, and Clinical Assistant Professor, School of Pharmacy, University of Missouri-Kansas City, Kansas City
| | - Suprat Saely Wilson
- Megan Corrigan, Pharm.D., BCPS, is Emergency Medicine Clinical Pharmacist, Department of Pharmacy, Advocate Illinois Masonic Medical Center, Chicago. Suprat Saely Wilson, Pharm.D., BCPS, is Emergency Medicine Clinical Pharmacist Specialist, Department of Pharmacy Services, Detroit Receiving Hospital, Detroit, MI. Jeremy Hampton, Pharm.D., BCPS, is Clinical Specialist Emergency Medicine, Truman Medical Center, Kansas City, MO, and Clinical Assistant Professor, School of Pharmacy, University of Missouri-Kansas City, Kansas City
| | - Jeremy Hampton
- Megan Corrigan, Pharm.D., BCPS, is Emergency Medicine Clinical Pharmacist, Department of Pharmacy, Advocate Illinois Masonic Medical Center, Chicago. Suprat Saely Wilson, Pharm.D., BCPS, is Emergency Medicine Clinical Pharmacist Specialist, Department of Pharmacy Services, Detroit Receiving Hospital, Detroit, MI. Jeremy Hampton, Pharm.D., BCPS, is Clinical Specialist Emergency Medicine, Truman Medical Center, Kansas City, MO, and Clinical Assistant Professor, School of Pharmacy, University of Missouri-Kansas City, Kansas City.
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Gardner J, Legako J, Gardner T, Dinh T, Menard S, Broadway R, Spivey K, Hutcheson J, Corrigan M, Hergenreder J, Johnson B. Effects of beta agonists and muscle type on polar lipid fatty acid concentration. Meat Sci 2016. [DOI: 10.1016/j.meatsci.2015.08.165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Corrigan M, Lee K, Labour M, Jacobs C, Hoey D. Fluid flow-induced bending of the primary cilium triggers a distinct intraciliary calcium flux in mesenchymal stem cells. Cilia 2015. [PMCID: PMC4519150 DOI: 10.1186/2046-2530-4-s1-p22] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/03/2023] Open
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20
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Woods CP, Corrigan M, Gathercole L, Taylor A, Hughes B, Gaoatswe G, Manolopoulos K, Hogan AE, O'Connell J, Stewart PM, Tomlinson JW, O'Shea D, Sherlock M. Tissue specific regulation of glucocorticoids in severe obesity and the response to significant weight loss following bariatric surgery (BARICORT). J Clin Endocrinol Metab 2015; 100:1434-44. [PMID: 25603461 DOI: 10.1210/jc.2014-4120] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
CONTEXT Tissue cortisol exposure is under the control of the isozymes of 11β-hydroxysteroid dehydrogenase (11β-HSD). 11β-HSD1 in vivo, acts as an oxoreductase converting inactive cortisone to active cortisol. We hypothesized that 11β-HSD1 activity is dysregulated in obesity and alters following bariatric surgery induced weight loss in different tissues. METHODS We recruited 21 patients prior to undergoing bariatric surgery and performed cortisol generation profiles (following oral cortisone administration), urinary corticosteroid metabolite analysis, adipose tissue microdialysis, and tissue gene expression before and after weight loss, following bariatric surgery. Archived tissue samples from 20 previous bariatric surgery patients were also used for tissue gene expression studies. RESULTS Gene expression showed a positive correlation with 11β-HSD1 and BMI in omental adipose tissue (OM) (r = +0.52, P = .0001) but not sc adipose tissue (r = +0.28, P = .17). 11β-HSD1 expression in liver negatively correlated with body mass index (BMI) (r = -0.37, P = .04). 11β-HSD1 expression in sc adipose tissue was significantly reduced after weight loss (0.41 ± 0.28 vs 0.17 ± 0.1 arbitrary units, P = .02). Following weight loss, serum cortisol generation increased during a cortisol generation profile (area under the curve 26 768 ± 16 880 vs 47 579 ± 16 086 nmol/L/minute, P ≤ .0001.) Urinary corticosteroid metabolites demonstrated a significant reduction in total cortisol metabolites after bariatric surgery (15 224 ± 6595 vs 8814 ± 4824 μg/24 h, P = .01). Microdialysis of sc adipose tissue showed a threefold reduction in cortisol/cortisone ratio after weight loss. CONCLUSIONS This study highlights the differences in tissue specific regulation of cortisol metabolism in obesity and after weight loss. Following bariatric surgery hepatic 11β-HSD1 activity increases, sc adipose tissue 11β-HSD1 activity is reduced and total urinary cortisol metabolites are reduced indicating a possible reduction in hypothalamic pituitary adrenal axis drive. 11β-HSD1 expression correlates positively with BMI in omental adipose tissue and negatively within hepatic tissue. 11β-HSD1 expression is reduced in sc adipose tissue after weight loss.
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Affiliation(s)
- C P Woods
- Education and Research Centre (C.P.W., M.C., G.G., A.E.H., J.O., D.O., M.S.), St Vincent's University Hospital and St Columcille's Hospital, Dublin, Ireland; Centre for Endocrinology (L.G., A.T., B.H., K.M., J.T., M.S.), Diabetes and Metabolism, Institute of Biomedical Research, University of Birmingham, United Kingdom; Department of Endocrinology (P.M.S.), University of Leeds, Leeds, United Kingdom; and Department of Endocrinology (M.S.), Tallaght Hospital, Dublin and Trinity College, Dublin, Ireland
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21
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O'Shea D, Corrigan M, Dunne MR, Jackson R, Woods C, Gaoatswe G, Moynagh PN, O'Connell J, Hogan AE. Changes in human dendritic cell number and function in severe obesity may contribute to increased susceptibility to viral infection. Int J Obes (Lond) 2013; 37:1510-3. [PMID: 23439322 DOI: 10.1038/ijo.2013.16] [Citation(s) in RCA: 59] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2012] [Revised: 01/04/2013] [Accepted: 01/09/2013] [Indexed: 02/03/2023]
Abstract
Dendritic cells (DCs) are key immune sentinels linking the innate and adaptive immune systems. DCs recognise danger signals and initiate T-cell tolerance, memory and polarisation. They are critical cells in responding to a viral illness. Obese individuals have been shown to have an impaired response to vaccinations against virally mediated conditions and to have an increased susceptibility to multi-organ failure in response to viral illness. We investigated if DCs are altered in an obese cohort (mean body mass index 51.7±7.3 kg m(-2)), ultimately resulting in differential T-cell responses. Circulating DCs were found to be significantly decreased in the obese compared with the lean cohort (0.82% vs 2.53%). Following Toll-like receptor stimulation, compared with lean controls, DCs generated from the obese cohort upregulated significantly less CD83 (40% vs 17% mean fluorescence intensity), a molecule implicated in the elicitation of T-cell responses, particularly viral responses. Obese DCs produced twofold more of the immunosuppressive cytokine interleukin (IL)-10 than lean controls, and in turn stimulated fourfold more IL-4-production from allogenic naive T cells. We conclude that obesity negatively impacts the ability of DCs to mature and elicit appropriate T-cell responses to a general stimulus. This may contribute to the increased susceptibility to viral infection observed in severe obesity.
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Affiliation(s)
- D O'Shea
- 1] Obesity Immunology Group, Education and Research Centre, St Vincent's University Hospital, University College Dublin, Dublin, Ireland [2] Department of Endocrinology, St Columcille's Hospital, Health Service Executive, Loughlinstown, Dublin, Ireland
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22
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Ahern T, Tobin AM, Corrigan M, Hogan A, Sweeney C, Kirby B, O'Shea D. Glucagon-like peptide-1 analogue therapy for psoriasis patients with obesity and type 2 diabetes: a prospective cohort study. J Eur Acad Dermatol Venereol 2012; 27:1440-3. [PMID: 22691169 DOI: 10.1111/j.1468-3083.2012.04609.x] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND Diabetes and obesity are more prevalent amongst psoriasis patients as is disturbance of the innate immune system. GLP-1 analogue therapy considerably improves weight and glycaemic control in people with type 2 diabetes and its receptor is present on innate immune cells. OBJECTIVE We aimed to determine the effect of liraglutide, a GLP-1 analogue, on psoriasis severity. METHODS Before and after 10 weeks of liraglutide therapy (1.2 mg subcutaneously daily) we determined the psoriasis area and severity index (PASI) and the dermatology life quality index (DLQI) in seven people with both psoriasis and diabetes (median age 48 years, median body mass index 48.2 kg/m(2) ). We also evaluated the immunomodulatory properties of liraglutide by measuring circulating lymphocyte subset numbers and monocyte cytokine production. RESULTS Liraglutide therapy decreased the median PASI from 4.8 to 3.0 (P = 0.03) and the median DLQI from 6.0 to 2.0 (P = 0.03). Weight and glycaemic control improved significantly. Circulating invariant natural killer T (iNKT) cells increased from 0.13% of T lymphocytes to 0.40% (P = 0.03). Liraglutide therapy also effected a non-significant 54% decrease in the proportion of circulating monocytes that produced tumour necrosis factor alpha (P = 0.07). CONCLUSION GLP-1 analogue therapy improves psoriasis severity, increases circulating iNKT cell number and modulates monocyte cytokine secretion. These effects may result from improvements in weight and glycaemic control as well as from direct immune effects of GLP-1 receptor activation. Prospective controlled trials of GLP-1 therapies are warranted, across all weight groups, in psoriasis patients with and without type 2 diabetes.
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Affiliation(s)
- T Ahern
- Obesity Research Group, andDermatology Research Group, St Vincent's University Hospital, Elm Park, Dublin 4, Ireland
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Allen CS, Deyle GD, Wilken JM, Gill NW, Baker SM, Rot JA, Cook CE, Beaty S, Kissenberth M, Siffri P, Hawkins R, Cook CE, Hegedus EJ, Ross MD, Cook CE, Beaty S, Kissenberth M, Siffri P, Pill S, Hawkins R, Erhardt JW, Harris KD, Deyle GD, Gill NW, Howes RR, Koch WK, Kramer CD, Kumar SP, Adhikari P, Jeganathan PS, D’Souza SC, Misri ZK, Manning DM, Dedrick GS, Sizer PS, Brismée JM, Matthijs OC, Dedrick GS, Brismée JM, McGalliard MK, James CR, Sizer PS, Ross MD, Childs JD, Middel C, Kujawa J, Brown D, Corrigan M, Parsons N, Schmidt SG, Grant R, Spryopolous P, Dansie D, Taylor J, Wang H, Silvernail JL, Gill NW, Teyhen DS, Allison SC, Sueki DG, Almaria SM, Bender MA, Kamara M, Magpali A, Mancilla A, McConnell BJ, Montoya RC, Murphy AW, Romero ML, Viti JA, Rot JA, Augustsson H, Werstine RJ, Birmingham T, Jenkyn T, Yung EY, Tonley JC. AAOMPT platform presentations selection. J Man Manip Ther 2011; 19:239-46. [DOI: 10.1179/106698111x12998437860712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
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Murphy RKJ, McHugh S, O'Farrell N, Dougherty B, Sheikh A, Corrigan M, Hill ADK. The financial imperative of physicians to control demand of laboratory testing. Ir Med J 2011; 104:15-17. [PMID: 21387879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
It is an integral component of doctor's duty of care to understand the significant impact laboratory testing has on the expense an ultimate quality of healthcare patients receive, yet the costs of these tests are poorly perceived. Utilising semi-structured interviews and questionnaires, we assessed surgeon's perceived costs of two commonly encountered clinical scenarios requiring out of hours laboratory testing. Of the 35 participants only 23.3% (n = 7) accurately estimated the overall cost. The most expensive test was "Type and Screen" at Euro 83, with 77.3% (n = 17) underestimating the cost. Non-consultant hospital doctors qualified for 3 years were more likely to underestimate on-call costs (p = 0.042). It is of utmost importance to improve the knowledge of all surgeons of the financial implications of investigations. Through education we can potentially reduce un-warranted costs and fulfill our duty of care in the most cost efficient manner.
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McHugh S, Corrigan M, Cowman S, Tierney S, Dimitrov B, Hill A, Humphreys H. P09.13 Development of a targeted e-learning programme for surgical infection prevention. J Hosp Infect 2010. [DOI: 10.1016/s0195-6701(10)60102-8] [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: 11/25/2022]
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Dhillon P, Murphy R, Burukan Z, Ali H, Corrigan M, Sheikh A, Hill ADK. Sticking to the rules: are you documenting your Irish Medical Council Registration Number? Ir Med J 2010; 103:284. [PMID: 21186756] [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: 05/30/2023]
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Czajkowski A, Alcock AJ, Bernard JE, Madej AA, Corrigan M, Chepurov S. Studies of saturated absorption and measurements of optical frequency for lines in the nu1 + nu3 and nu1 + 2nu4 bands of ammonia at 1.5 microm. Opt Express 2009; 17:9258-9269. [PMID: 19466177 DOI: 10.1364/oe.17.009258] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
A cavity-enhanced absorption spectrometer was used to saturate several lines of ammonia in the 1510 nm - 1560 nm region. Analysis of power broadening of the saturated absorption feature for one of the ammonia lines yielded a dipole moment value comparable to that of the lines in the nu(1)+nu(3) band in acetylene. Highly reproducible frequency measurements of four ammonia line centres were carried out using a frequency comb generated by a mode-locked Cr(4+):YAG laser. These results demonstrate the possible application of ammonia saturated absorption lines for frequency metrology and calibration in a spectral region lacking strong absorbers. To our knowledge, this is the first frequency measurement of saturated absorption lines in ammonia at near infrared frequencies and the first reported observation of saturated absorption lines in the nu(1)+2nu(4) band.
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Affiliation(s)
- A Czajkowski
- Physics Department, University of Ottawa, 150 Louis Pasteur, Ottawa, Ontario, K1N 6N5, Canada.
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Lucey M, McQuillan R, MacCallion A, Corrigan M, Flynn J, Connaire K. Access to medications in the community by patients in a palliative setting. A systems analysis. Palliat Med 2008; 22:185-9. [PMID: 18372383 DOI: 10.1177/0269216307085722] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This study performed a systems analysis of the process by which patients under the care of a specialist palliative home care obtained medications, and highlighted factors that delay this process. Systems analysis is the science dealing with analysis of complex, large-scale systems and the interactions within those systems. This study used a mixed-methods approach of questionnaires of general practitioners, pharmacists and patients, and a prospective observational study of delays experienced by patients referred to the home care team over a three-month period. This study found the main factors causing delay to be: medications not being in stock in pharmacies, medications not being available on state reimbursed schemes and inability of patients and carers to courier medications.
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Affiliation(s)
- M Lucey
- St Francis Hospice, Raheny, Dublin, Ireland.
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Abstract
Experience with management of drug-packers (mules) is variable among different centres. However, despite a recorded increase in drug trafficking in general, as yet, no unified, clear guidelines exist to guide the medical management of those who only occasionally encounter these individuals. We describe our recent experience with this growing problem and discuss the most salient points concerning the contemporary management of body packers. Our recent experience demonstrates that type IV packages may now be managed conservatively for the most part.
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Affiliation(s)
- J Kelly
- Department of Surgery, Cork University Hospital, Wilton, Cork, Ireland
| | - M Corrigan
- Department of Surgery, Cork University Hospital, Wilton, Cork, Ireland
| | - RA Cahill
- Department of Surgery, Cork University Hospital, Wilton, Cork, Ireland
| | - HP Redmond
- Department of Surgery, Cork University Hospital, Wilton, Cork, Ireland
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Corrigan M, Shields C, O'Leary D, Fraher J, Winter D, Wang J, Redmond P. 64 POSTER The induction of transient hypertonicity attenuates the pro metastatic affects of LPS by reducing tumour cell adhesion, proliferation and MMP-9 expression. Eur J Surg Oncol 2006. [DOI: 10.1016/s0748-7983(06)70499-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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McWilliams R, Prezant D, Wartenberg D, Hallman W, Corrigan M, Kelly K, Kipen H. Provision of Services to First-Responders. Am J Epidemiol 2006. [DOI: 10.1093/aje/163.suppl_11.s257-c] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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McClean B, Dench C, Grey I, Shanahan S, Fitzsimons E, Hendler J, Corrigan M. Person Focused Training: a model for delivering positive behavioural supports to people with challenging behaviours. J Intellect Disabil Res 2005; 49:340-352. [PMID: 15817051 DOI: 10.1111/j.1365-2788.2005.00669.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
BACKGROUND Person Focused Training is introduced as a model of service delivery for people with severe challenging behaviours. It is defined as training and supporting staff to conduct functional assessments and to design and implement positive behavioural support for specific individuals with challenging behaviours. METHOD Longitudinal outcome data are presented from 138 behaviour support plans developed by staff over a seven year period were analysed to determine reductions in frequency of challenging behaviours. Degree of behaviour change was determined across topography of behaviour, gender, age, level of disability, location of residence and role of course participant. RESULTS Results indicate that the implementation by staff of behaviour support plans are associated with significant improvement in 77% of cases at an average follow-up of 22 months after implementation of support plans. Only location of residence was identified as related to reduction in challenging behaviours with large residential centres being associated with lower rates of behavioural improvement. CONCLUSIONS It is argued that Person Focused training may represent an alternative to existing models of supporting individuals with challenging behaviours. The implications of front-line staff designing and implementing behaviour support plans for the organisation of services and the role of the clinical psychologist are considered.
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Affiliation(s)
- B McClean
- Brothers of Charity, Roscommon, Ireland.
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Newton JT, Corrigan M, Gibbons DE, Locker D. The self-assessed oral health status of individuals from White, Indian, Chinese and Black Caribbean communities in South-east England. Community Dent Oral Epidemiol 2003; 31:192-9. [PMID: 12752545 DOI: 10.1034/j.1600-0528.2003.00036.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVES To determine the level of self-assessed oral symptoms and the impact of such symptoms among individuals from four ethnic groups resident in South-east England and the relationship between self-assessed oral health status, age, gender, employment status, educational level and ethnicity. METHOD Cross-sectional survey of a convenience sample of 366 individuals drawn from four ethnic groups. MEASURES Subjective Oral Health Status Indicators (SOHSI). PARTICIPANTS Individuals were recruited through community groups. All participants self-classified their ethnicity. Only completed questionnaires from participants categorising themselves as White, Black Caribbean, Chinese or Indian were included in the data analysis. FINDINGS Univariate statistical analysis revealed significant differences between ethnic groups in all but one of the SOHSI scales. Age and ethnicity (in particular membership of the Chinese community) emerged as significant predictors of SOHSI scale scores. CONCLUSIONS Within the limitations imposed by convenience sampling, it has been found that differences exist among four ethnic groups in the UK in their reporting of self-assessed oral health status. Ethnicity and age, in particular, predict the reporting of self-assessed oral symptoms and the impact of such symptoms.
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Affiliation(s)
- J T Newton
- Division of Dental Public Health and Oral Health Services Research, Guy's Hospital, Guy's, King's, and St Thomas' Dental Institute, London SE1 9RT, UK.
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Gormley GJ, Corrigan M, Steele WK, Stevenson M, Taggart AJ. Joint and soft tissue injections in the community: questionnaire survey of general practitioners' experiences and attitudes. Ann Rheum Dis 2003; 62:61-4. [PMID: 12480671 PMCID: PMC1754290 DOI: 10.1136/ard.62.1.61] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES To investigate the numbers and types of joint and soft tissue injections performed by general practitioners (GPs) and to explore attitudes to training in joint and soft tissue injection and perceived barriers to performing injections. METHODS A self administered questionnaire was mailed to a random sample of 410 (30%) of 1367 GPs in Northern Ireland. Two mailings were used to increase the response rate. Questions explored the GPs' demographic characteristics, types and numbers of injections performed, previous training experience, attitudes towards training, and perceived barriers. RESULTS The overall response rate was 75%. Practitioners who were men, worked in a "rural" or "mixed" locality, and had had a previous post in rheumatology, orthopaedics, or sports medicine were more likely to perform joint and soft tissue injections. Forty six per cent of GPs did not currently perform any injections; 5% of GPs performed most of the injections in the community. Injections into the shoulder, knee, and lateral epicondylitis were found to be the most commonly performed injections. The GPs preferred to train on "real patients" rather than "mannequin models". Those GPs who had trained on "real patients" were more likely to perform injections. The main perceived barrier to performing joint and soft tissue injections in the community was the "inability to maintain injection skills". CONCLUSION Postgraduate training, methods of training, and the ability to maintain injection skills seemed to be determinants affecting GP confidence and the amount of joint and soft tissue injections that they performed. Most injections were performed by a few GPs in the community. These findings may have implications for the developing role of GP specialists in primary care trusts.
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Affiliation(s)
- G J Gormley
- Department of General Practice, Queens University Belfast, Dunluce Health Centre, 1 Dunluce Avenue, Belfast, Northern Ireland BT9 7HR.
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Flannery RB, Penk WE, Corrigan M. The Assaulted Staff Action Program (ASAP) and declines in the prevalence of assaults: community-based replication. Int J Emerg Ment Health 2001; 1:19-21. [PMID: 11227749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
Abstract
The Assaulted Staff Action Program (ASAP) has been associated with sharp reductions in the frequency of patient assaults on staff in four state hospital settings. Recent national trends in healthcare have resulted in an emphasis on community-based services. This case study sought to assess the effects of ASAP and findings of reduced assaults in a community-based program. In a single-case design, in which the facility served as its own control, an ASAP program was fielded in a community mental health center. A similar sharp reduction in violence was observed. The implications of the findings are presented.
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Corrigan M, Newton JT, Gibbons DE, Locker D. The mouth-body split: conceptual models of oral health and their relationship to general health among ethnic minorities in South Thames Health Region. Community Dent Health 2001; 18:42-6. [PMID: 11421405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/20/2023]
Abstract
OBJECTIVE To identify and describe conceptual models of oral health shared by people from different minority ethnic groups, in particular the relationship between 'oral health' and 'general health'. To identify how these conceptions vary across social factors. BASIC RESEARCH DESIGN In-depth interviews. Analysis of the interview data to identify the conceptual models used by participants in discussing oral health and its relationship to general health. PARTICIPANTS Ninety-five individuals from different ethnic groups. RESULTS Two models of 'health' were identified. The first reflected a traditional model which related health to the absence of disease. The second encompassed a broad definition of health including not only physical but social and psychological well-being and the ability to carry out everyday functions. The model within which an individual operated was influenced by ethnicity and gender. Additionally, two models of the relationship between oral health and general health were identified: one in which the two concepts were seen as separate but related; the other in which oral health and general health were viewed as inseparable aspects of a single dimension. CONCLUSIONS People from minority ethnic groups vary in their understanding of oral health and its relationship to general health. This variation can be explained in part by ethnic and cultural factors. This finding has important implications both for the design of measures which seek to assess oral health related quality of life, and for the development of health promotional materials.
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Affiliation(s)
- M Corrigan
- Department of Dental Public Health and Oral Health Services Research, Guy's Hospital, London, United Kingdom
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Abstract
OBJECTIVE To describe the working practices and level of job satisfaction of dental hygienists in the United Kingdom. DESIGN Postal questionnaire survey of 3,955 dental hygienists registered with the General Dental Council. Replies were received from 2,533 (64%). RESULTS At the time of the survey only a small proportion of respondents (11%) were not working as dental hygienists, the most common reason for a current career break being child rearing. The majority of dental hygienists (78%) were employed in general dental practices, and most worked in more than one practice (64%). Approximately half worked part-time (fewer than 30 hours per week), and part-time working was more common amongst those respondents with childcare responsibilities. In the region of 60% of respondents had taken one or more career breaks during their working life, and the average total duration of career breaks was 11 months, the most common reason for all career breaks was child rearing. Additional qualifications had been gained by 35% of the sample, a high proportion (75%) had attended training courses in the previous year. The respondents expressed a high degree of job satisfaction, those who were older and who had childcare responsibilities expressed higher levels of job satisfaction. CONCLUSIONS Dental hygienists express a high level of job satisfaction. A proportion take breaks in their career, most commonly for pregnancy and child rearing. The majority return to part-time employment after their career break. Planning of future requirements for the training of professionals complementary to dentistry should be informed by a consideration of the working patterns of dental hygienists.
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Affiliation(s)
- D E Gibbons
- Department of Dental Public Health and Oral Health Services Research, Guy's, King's and Thomas' School of Medicine and Dentistry, Guy's Hospital, London
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Abstract
OBJECTIVE To describe the working practices and level of job satisfaction of dental therapists in the United Kingdom. DESIGN Postal questionnaire survey of 380 dental therapists registered with the General Dental Council. RESULTS Only 13% of dental therapists are also qualified as dental hygienists. Around 75% of those registered with the GDC are currently employed as dental therapists. Of those not currently working as dental therapists most were either working as hygienists or caring for their children at home. Over 90% of those working as therapists are employed within the Community Dental Service. About half work part-time. Part-time working is more common among respondents with childcare responsibilities. Most dental therapists are employed in clinical roles, and perform a limited range of treatments. A small proportion appear to have been asked to undertake duties which are not currently legal for them to perform. Three-quarters of those who were currently working as dental therapists had taken career breaks at some point, the most common reasons for such a break being a change in career and/or child rearing. The respondents expressed a high level of job satisfaction, particularly among older dental therapists. CONCLUSIONS Dental therapy offers a potentially rewarding career in terms of job satisfaction. Any planned increase in the numbers of training places for dental therapists should their role be expanded, for example to include working in general dental practice, would need to take cognisance of the high rate of part-time working and the proportion who could be expected to take career breaks at some point in their working lives, as is the case with female dental practitioners.
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Affiliation(s)
- D E Gibbons
- Department of Dental Public Health & Oral Health Services Research, Guy's, King's and St Thomas' Dental Institute, King's College London, Guy's Hospital
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Arellano FM, Corrigan M. Falling asleep at the wheel: motor vehicle mishaps in people taking pramipexole and ropinirole. Neurology 2000; 54:275; author reply 276-7. [PMID: 10636183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/15/2023] Open
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Olanow CW, Schapira AHV, Roth T, Weiner WJ, Hoehn MM, Lledo A, Nash J, Arellano FM, Corrigan M, Arnold G, Rye DB, Bliwise DL, Frucht S, Rogers JD, Greene PE, Fahn S, Gordon MF. Falling asleep at the wheel: Motor vehicle mishaps in people taking pramipexole and ropinirole. Neurology 2000. [DOI: 10.1212/wnl.54.1.274] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Worrall SF, Corrigan M, High A, Starr D, Matthias C, Wolf CR, Jones PW, Hand P, Gilford J, Farrell WE, Hoban P, Fryer AA, Strange RC. Susceptibility and outcome in oral cancer: preliminary data showing an association with polymorphism in cytochrome P450 CYP2D6. Pharmacogenetics 1998; 8:433-9. [PMID: 9825835 DOI: 10.1097/00008571-199810000-00008] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Members of the cytochrome P450 and glutathione S-transferase supergene families are candidates for susceptibility and outcome in oral squamous cell cancer. We determined GSTM1, GSTM3, GSTT1, CYP1A1 and CYP2D6 genotypes in 100 Caucasian cases and 467 control individuals. The frequency of homozygosity for mutant CYP2D6 alleles was higher in the cases (P = 0.001, OR = 3.2, 95% CI = 1.6-6.5) than control individuals. In the cases, the frequency of homozygosity for mutant alleles was greater and that of homozygosity for wild-type CYP2D6 alleles was lower in those diagnosed at > or = 65 years (P = 0.009) than in those diagnosed at < or = 64 years. The older cases included relatively more women and patients who did not consume tobacco or alcohol. The association of CYP2D6 with outcome was assessed using the Cox's proportional hazards model. The time to first cervical node metastasis was shorter in heterozygotes and homozygotes for mutant CYP2D6 alleles compared with homozygotes for wild-type alleles after correction for age at diagnosis, gender, alcohol and tobacco consumption and tumour differentiation (P = 0.04, hazard ratio 3.6, 95% CI 1.1-12.5). The mechanism for the association of CYP2D6 alleles with susceptibility and outcome is unclear though the data are compatible with the view that homozygosity for mutant alleles confers impaired detoxication of an unknown carcinogen. No associations between GSTM1, GSTM3, GSTT1 or CYP1A1 genotypes and susceptibility or, time to node metastases were identified. We previously showed that CYP2D6 genotypes were not associated with susceptibility to squamous cell cancer in the pharynx or larynx. Therefore, the data presented suggest that susceptibility to squamous cell cancer in the various parts of the upper aerodigestive tract is associated with different genes and allelic variants.
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Affiliation(s)
- S F Worrall
- Department of Oral Maxillofacial Surgery, North Staffordshire Hospital, Stoke-on-Trent, UK
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Ruegg RG, Gilmore J, Ekstrom RD, Corrigan M, Knight B, Tancer M, Leatherman ME, Carson SW, Golden RN. Clomipramine challenge responses covary with Tridimensional Personality Questionnaire scores in healthy subjects. Biol Psychiatry 1997; 42:1123-9. [PMID: 9426882 DOI: 10.1016/s0006-3223(97)00009-7] [Citation(s) in RCA: 24] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Cloninger's Unified Biosocial Theory of Personality postulates a relationship between the relative functional activity of central serotonergic, dopaminergic, and noradrenergic neurotransmitter systems, and the strength of three elemental dimensions of personality. These dimensions are Harm Avoidance, Novelty Seeking, and Reward Dependence, respectively. Accordingly, we predicted that neuroendocrine responses to serotonergic challenge would correlate with Harm Avoidance scores, but not with Novelty Seeking or Reward Dependence scores. We examined the relationship between the prolactin and cortisol responses to a 12.5-mg intravenous clomipramine challenge and these personality dimensions as measured by Cloninger's Tridimensional Personality Questionnaire in 32 healthy subjects. The cortisol response correlated only with Harm Avoidance scores, as predicted; however, prolactin response did not correlate with Harm Avoidance scores. Instead, it demonstrated an inverse relationship with Novelty Seeking scores. There was a positive relationship of baseline prolactin with Harm Avoidance in a post hoc analysis. Cortisol response to serotonergic challenge may be a better indicator for responsivity of serotonergic systems as they relate to the personality dimension of Harm Avoidance than is prolactin. Prolactin responses may be overly affected by dopaminergic influences; however, baseline prolactin may still be a valid indicator of serotonergic tone.
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Affiliation(s)
- R G Ruegg
- Clinical Research Unit, University of North Carolina School of Medicine, Chapel Hill, USA
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Worrall SF, Corrigan M. An audit of one surgeon's experience of oral squamous cell carcinoma using computerised malignancy database. Ann R Coll Surg Engl 1995; 77:332-6. [PMID: 7486756 PMCID: PMC2502435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
The results of an audit of a single surgeon's experience of oral squamous cell carcinoma over a 5-year period is reported and the benefits of adopting a prospective computerized malignancy database outlined. Oral cancer occurred mainly in the 7th decade of life, women were on average 5 years younger than men at presentation. Men were affected 1.7 times as often as women and presented with more advanced disease than women. The mean delay from referral to histological diagnosis was 6.4 days and the mean delay from diagnosis to treatment was 25.8 days. The majority of patients consumed alcohol and smoked tobacco, but a significant minority were lifelong nondrinkers and non-smokers. While the incidence of most site-specific oral cancers were similar to the national averages the incidences of alveolar and floor of mouth cancers were higher than expected. The TNM stage at presentation was an unreliable prognostic indicator of future disease progression and outcome. Auditing treatment and outcome is a major component of the recent proposals to centralise the provision of cancer services in dedicated cancer centres and units (1). Audit can only be effective if it is based on current, reliable and accurate data and this can only be achieved by the use of a computerised malignancy database.
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Affiliation(s)
- S F Worrall
- Department of Oral & Maxillofacial Surgery, Leeds Dental Institute
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Cohen SR, Corrigan M, Wilmot J, Trotman CA. Cumulative operative procedures in patients aged 14 years and older with unilateral or bilateral cleft lip and palate. Plast Reconstr Surg 1995; 96:267-71. [PMID: 7624399 DOI: 10.1097/00006534-199508000-00003] [Citation(s) in RCA: 59] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Sixty-seven consecutive patients over the age of 14 with either unilateral (n = 38) cleft lip and palate or bilateral (n = 29) cleft lip and palate seen over a 15-month period at the University of Michigan Craniofacial Program were reviewed to determine the total number of surgical procedures performed over the course of treatment. The demographics of the two groups differed: There were 25 males and 13 females who were a mean age of 17 years and 9 months with unilateral cleft lip and palate and 23 males and 6 females who were a mean age of 18 years and 5 months with bilateral cleft lip and palate. Lip and palate repairs were carried out on all patients. Lip adhesions were performed in 29 and 62 percent; pharyngoplasties (either pharyngeal flap or modified Ortichochea) in 39 and 38 percent; alveolar bone grafts in 82 and 79 percent; Abbé flaps in 0 and 10 percent; and orthognathic surgery was done in 10.5 and 13.8 percent and recommended and/or done in 26 and 24 percent of patients with unilateral cleft lip and palate and bilateral cleft lip and palate, respectively. Lip revisions averaged 1.13 and 2.17 per patient and secondary nasal surgeries averaged 1.13 and 1.18 per patient in the unilateral cleft lip and palate and bilateral cleft lip and palate, respectively. All totaled, the average number of operations was 6.12 per patient (range 3 to 12) in the unilateral cleft lip and palate and 8.04 per patient (range 5 to 15) in the bilateral cleft lip and palate.(ABSTRACT TRUNCATED AT 250 WORDS)
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Affiliation(s)
- S R Cohen
- Center for Craniofacial Disorders, Scottish Rite Children's Medical Center, Atlanta, GA, USA
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Leatherman ME, Ekstrom RD, Corrigan M, Carson SW, Mason G, Golden RN. Central serotonergic changes following antidepressant treatment: a neuroendocrine assessment. Psychopharmacol Bull 1993; 29:149-154. [PMID: 8290659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
We employed a neuroendocrine challenge paradigm to study the effects of antidepressant treatment on serotonergic systems in depressed patients. We compared the maximum prolactin response to intravenous clomipramine (CMI) in depressed patients who responded to antidepressant treatment to that of nonresponders. Pretreatment baseline prolactin concentrations and pretreatment prolactin responses to clomipramine challenge were not different in responders compared to non-responders. However, following antidepressant treatment, the 6 responders demonstrated a significant change in their clomipramine challenge test results, as indicated by an increase in prolactin responses. In contrast, the 7 nonresponders did not demonstrate a change in their prolactin response to clomipramine challenge following treatment. These data support the hypothesis that serotonergic system dysfunction, as manifested by blunted prolactin response to clomipramine challenge, tends to normalize after successful treatment for depression, and that abnormal serotonergic function may be a state-dependent characteristic.
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Affiliation(s)
- M E Leatherman
- Department of Psychiatry, University of North Carolina School of Medicine, Chapel Hill 27599-7160
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Evans DL, Folds JD, Petitto JM, Golden RN, Pedersen CA, Corrigan M, Gilmore JH, Silva SG, Quade D, Ozer H. Circulating natural killer cell phenotypes in men and women with major depression. Relation to cytotoxic activity and severity of depression. Arch Gen Psychiatry 1992; 49:388-95. [PMID: 1534002 DOI: 10.1001/archpsyc.1992.01820050052009] [Citation(s) in RCA: 107] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
The effects of major depression on peripheral blood natural killer cell phenotypes and natural killer cell activity were studied by comparing depressed and normal control subjects. Depressed subjects exhibited (1) significant reductions in Leu-11 (CD16) natural killer effector cells and natural killer cell activity and (2) a dissociation of the normal positive correlation between the percentage of Leu-11 cells and natural killer cell activity. These findings suggest that alterations in the availability and the killing capacity of circulating Leu-11 natural killer cells appear to be responsible for depression-related reductions in natural killer cell activity. Moreover, men with major depression showed marked reductions in Leu-11 cells, natural killer cell activity, and Leu-7 (HNK-1) lymphocytes compared with normal control men. By contrast, depressed women did not differ significantly from normal control women on any of these three immune function measures. Severity of depression as assessed by Hamilton Rating Scale for Depression scores was not associated with natural killer cell activity or Leu-7 lymphocyte levels in either men or women with major depression. Hamilton Rating Scale for Depression severity ratings were, however, strongly inversely correlated with Leu-11 lymphocyte counts among men, but not women, with major depression. These data begin to elucidate the immunological mechanisms by which natural killer cell activity is altered in depression and suggest that some measures of immunity may be differentially affected in male and female subjects with the syndrome of major depression.
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Affiliation(s)
- D L Evans
- Department of Psychiatry, University of North Carolina, Chapel Hill
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Stein RW, Corrigan M, Yaciuk P, Whelan J, Moran E. Analysis of E1A-mediated growth regulation functions: binding of the 300-kilodalton cellular product correlates with E1A enhancer repression function and DNA synthesis-inducing activity. J Virol 1990; 64:4421-7. [PMID: 2143544 PMCID: PMC247911 DOI: 10.1128/jvi.64.9.4421-4427.1990] [Citation(s) in RCA: 215] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Adenovirus E1A transforming function requires two distinct regions of the protein. Transforming activity is closely linked with the presence of a region designated conserved domain 2 and the ability of this region to bind the product of the cellular retinoblastoma tumor suppressor gene. We have investigated the biological properties of the second transforming region of E1A, which is located near the N terminus. Transformation-defective mutants containing deletions in the N terminus (deletion of residues between amino acids 2 and 36) were deficient in the ability to induce DNA synthesis and repress insulin enhancer-stimulated activity. The function of the N-terminal region correlated closely with binding of the 300-kilodalton E1A-associated protein and not with binding of the retinoblastoma protein. These results indicate that transformation by E1A is mediated by two functionally independent regions of the protein which interact with different specific cellular proteins and suggest that the 300-kilodalton E1A-associated protein plays a major role in E1A-mediated cell growth control mechanisms.
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Affiliation(s)
- R W Stein
- Department of Molecular Physiology and Biophysics, Vanderbilt University School of Medicine, Nashville, Tennessee 37322-0615
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