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Chapin WJ, Till JE, Hwang WT, Eads JR, Karasic TB, O'Dwyer PJ, Schneider CJ, Teitelbaum UR, Romeo J, Black TA, Christensen TE, Redlinger Tabery C, Anderson A, Slade M, LaRiviere M, Yee SS, Reiss KA, O'Hara MH, Carpenter EL. Multianalyte Prognostic Signature Including Circulating Tumor DNA and Circulating Tumor Cells in Patients With Advanced Pancreatic Adenocarcinoma. JCO Precis Oncol 2022; 6:e2200060. [PMID: 35939771 PMCID: PMC9384952 DOI: 10.1200/po.22.00060] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 03/24/2022] [Accepted: 06/15/2022] [Indexed: 12/22/2022] Open
Abstract
PURPOSE Pancreatic ductal adenocarcinoma (PDAC) is associated with a poor prognosis. Multianalyte signatures, including liquid biopsy and traditional clinical variables, have shown promise for improving prognostication in other solid tumors but have not yet been rigorously assessed for PDAC. MATERIALS AND METHODS We performed a prospective cohort study of patients with newly diagnosed locally advanced pancreatic cancer (LAPC) or metastatic PDAC (mPDAC) who were planned to undergo systemic therapy. We collected peripheral blood before systemic therapy and assessed circulating tumor cells (CTCs), cell-free DNA concentration (cfDNA), and circulating tumor KRAS (ctKRAS)-variant allele fraction (VAF). Association of variables with overall survival (OS) was assessed in univariate and multivariate survival analysis, and comparisons were made between models containing liquid biopsy variables combined with traditional clinical prognostic variables versus models containing traditional clinical prognostic variables alone. RESULTS One hundred four patients, 40 with LAPC and 64 with mPDAC, were enrolled. CTCs, cfDNA concentration, and ctKRAS VAF were all significantly higher in patients with mPDAC than patients with LAPC. ctKRAS VAF (cube root; 0.05 unit increments; hazard ratio, 1.11; 95% CI, 1.03 to 1.21; P = .01), and CTCs ≥ 1/mL (hazard ratio, 2.22; 95% CI, 1.34 to 3.69; P = .002) were significantly associated with worse OS in multivariate analysis while cfDNA concentration was not. A model selected by backward selection containing traditional clinical variables plus liquid biopsy variables had better discrimination of OS compared with a model containing traditional clinical variables alone (optimism-corrected Harrell's C-statistic 0.725 v 0.681). CONCLUSION A multianalyte prognostic signature containing CTCs, ctKRAS, and cfDNA concentration outperformed a model containing traditional clinical variables alone suggesting that CTCs, ctKRAS, and cfDNA provide prognostic information complementary to traditional clinical variables in advanced PDAC.
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Affiliation(s)
- William J. Chapin
- Division of Hematology-Oncology, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Jacob E. Till
- Division of Hematology-Oncology, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Wei-Ting Hwang
- Department of Biostatistics, Epidemiology and Informatics, University of Pennsylvania, Philadelphia, PA
| | - Jennifer R. Eads
- Division of Hematology-Oncology, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Thomas B. Karasic
- Division of Hematology-Oncology, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Peter J. O'Dwyer
- Division of Hematology-Oncology, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Charles J. Schneider
- Division of Hematology-Oncology, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Ursina R. Teitelbaum
- Division of Hematology-Oncology, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Janae Romeo
- Division of Hematology-Oncology, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Taylor A. Black
- Division of Hematology-Oncology, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Theresa E. Christensen
- Division of Hematology-Oncology, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Colleen Redlinger Tabery
- Division of Hematology-Oncology, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | | | | | - Michael LaRiviere
- Department of Radiation Oncology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Stephanie S. Yee
- Division of Hematology-Oncology, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Kim A. Reiss
- Division of Hematology-Oncology, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Mark H. O'Hara
- Division of Hematology-Oncology, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Erica L. Carpenter
- Division of Hematology-Oncology, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
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Leendertse JCP, Wierdsma AI, van den Berg D, Ruissen AM, Slade M, Castelein S, Mulder CL. Personal Recovery in People With a Psychotic Disorder: A Systematic Review and Meta-Analysis of Associated Factors. Front Psychiatry 2021; 12:622628. [PMID: 33708145 PMCID: PMC7940758 DOI: 10.3389/fpsyt.2021.622628] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Accepted: 01/13/2021] [Indexed: 12/26/2022] Open
Abstract
Background: Personal recovery (PR) is a subjective, multidimensional concept, and quantitative research using PR as an outcome is rapidly increasing. This systematic review is intended to support the design of interventions that contribute to PR in psychotic disorders, by providing an overview of associated factors and their weighted importance to PR: clinical factors, social factors, and socio-demographic characteristics are included, and factors related to the concept of PR (organized into CHIME dimensions). Methods: A systematic literature search was conducted from inception to March 2020. Quantitative studies that had used a validated questionnaire assessing the concept of PR were included. Mean effect sizes for the relationship between PR-scale total scores and related factors were calculated using meta-analyses. Sources of heterogeneity were examined using meta-regression tests. Results: Forty-six studies, that used (a total of) eight PR measures, showed that in clinical factors, affective symptoms had a medium negative association with PR-scale total scores (r = -0.44, 95%CI -0.50 to -0.37), while positive, negative and general symptoms had small negative correlations. No association was found with neuro-cognition. Social factors (support, work and housing, and functioning) showed small positive correlations. Gender and age differences had barely been researched. Large associations were found for PR-scale total scores with the CHIME dimensions hope (r = 0.56, 95%CI 0.48-0.63), meaning in life (r = 0.48, 95%CI 0.38-0.58) and empowerment (r = 0.53, 95%CI 0.42-0.63); while medium associations were found with connectedness (r = 0.34, 95%CI 0.43-0.65) and identity (r = 0.43, 95%CI 0.35-0.50). Levels of heterogeneity were high, sources included: the variety of PR measures, variations in sample characteristics, publication bias, variations in outcome measures, and cultural differences. Discussion: Most interventions in mental healthcare aim to reduce symptoms and improve functioning. With regard to stimulating PR, these interventions may benefit from also focusing on enhancing hope, empowerment, and meaning in life. The strength of these findings is limited by the challenges of comparing separate CHIME dimensions with questionnaires assessing the concept of PR, and by the high levels of heterogeneity observed. Future research should focus on the interaction between elements of PR and clinical and social factors over time.
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Affiliation(s)
- J C P Leendertse
- Emergis Institute for Mental Healthcare, Kloetinge, Netherlands.,Department of Psychiatry, Erasmus University Medical Centre, Rotterdam, Netherlands
| | - A I Wierdsma
- Department of Psychiatry, Erasmus University Medical Centre, Rotterdam, Netherlands
| | - D van den Berg
- Department of Clinical Psychology, VU University and Amsterdam Public Health Research Institute, Amsterdam, Netherlands.,Research and Innovation, Parnassia Psychiatric Institute, The Hague, Netherlands
| | - A M Ruissen
- Emergis Institute for Mental Healthcare, Kloetinge, Netherlands.,Department of Psychiatry, Erasmus University Medical Centre, Rotterdam, Netherlands.,Department of Psychiatry, Haaglanden Medical Centre, The Hague, Netherlands
| | - M Slade
- School of Health Sciences, Institute of Mental Health, University of Nottingham, Nottingham, United Kingdom
| | - S Castelein
- Lentis Research, Lentis Psychiatric Institute, Groningen, Netherlands.,Faculty of Behavioural and Social Sciences, Clinical Psychology, University of Groningen, Groningen, Netherlands
| | - C L Mulder
- Department of Psychiatry, Erasmus University Medical Centre, Rotterdam, Netherlands.,Research and Innovation, Parnassia Psychiatric Institute, The Hague, Netherlands
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Conteduca V, Ku SY, Puca L, Slade M, Fernandez L, Hess J, Bareja R, Vlachostergios PJ, Sigouros M, Mosquera JM, Sboner A, Nanus DM, Elemento O, Dittamore R, Tagawa ST, Beltran H. SLFN11 Expression in Advanced Prostate Cancer and Response to Platinum-based Chemotherapy. Mol Cancer Ther 2020; 19:1157-1164. [PMID: 32127465 DOI: 10.1158/1535-7163.mct-19-0926] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Revised: 12/07/2019] [Accepted: 02/13/2020] [Indexed: 11/16/2022]
Abstract
Expression of the DNA/RNA helicase schlafen family member 11 (SLFN11) has been identified as a sensitizer of tumor cells to DNA-damaging agents including platinum chemotherapy. We assessed the impact of SLFN11 expression on response to platinum chemotherapy and outcomes in patients with metastatic castration-resistant prostate cancer (CRPC). Tumor expression of SLFN11 was assessed in 41 patients with CRPC treated with platinum chemotherapy by RNA sequencing (RNA-seq) of metastatic biopsy tissue (n = 27) and/or immunofluorescence in circulating tumor cells (CTC; n = 20). Cox regression and Kaplan-Meier methods were used to evaluate the association of SLFN11 expression with radiographic progression-free survival (rPFS) and overall survival (OS). Multivariate analysis included tumor histology (i.e., adenocarcinoma or neuroendocrine) and the presence or absence of DNA repair aberrations. Patient-derived organoids with SLFN11 expression and after knockout by CRISPR-Cas9 were treated with platinum and assessed for changes in dose response. Patients were treated with platinum combination (N = 38) or platinum monotherapy (N = 3). Median lines of prior therapy for CRPC was two. Median OS was 8.7 months. Overexpression of SLFN11 in metastatic tumors by RNA-seq was associated with longer rPFS compared with those without overexpression (6.9 vs. 2.8 months, HR = 3.72; 95% confidence interval (CI), 1.56-8.87; P < 0.001); similar results were observed for patients with SLFN11-positive versus SLFN11-negative CTCs (rPFS 6.0 vs. 2.2 months, HR = 4.02; 95% CI, 0.77-20.86; P = 0.002). A prostate-specific antigen (PSA) decline of ≥50% was observed in all patients with SLFN11 overexpression. No association was observed between SLFN11 expression and OS. On multivariable analysis, SLFN11 was an independent factor associated with rPFS on platinum therapy. Platinum response of organoids expressing SLFN11 was reduced after SLFN11 knockout. Our data suggest that SLFN11 expression might identify patients with CRPC with a better response to platinum chemotherapy independent of histology or other genomic alterations. Additional studies, also in the context of PARP inhibitors, are warranted.
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Affiliation(s)
- Vincenza Conteduca
- Dana Farber Cancer Institute and Harvard Medical School, Boston, Massachusetts.,Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy
| | - Sheng-Yu Ku
- Dana Farber Cancer Institute and Harvard Medical School, Boston, Massachusetts
| | | | | | | | - Judy Hess
- Weill Cornell Medicine, New York, New York
| | | | | | | | | | | | | | | | | | | | - Himisha Beltran
- Dana Farber Cancer Institute and Harvard Medical School, Boston, Massachusetts. .,Weill Cornell Medicine, New York, New York
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4
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Goldsmith SR, Slade M, DiPersio JF, Westervelt P, Schroeder MA, Gao F, Romee R. Donor-lymphocyte infusion following haploidentical hematopoietic cell transplantation with peripheral blood stem cell grafts and PTCy. Bone Marrow Transplant 2017; 52:1623-1628. [PMID: 29035393 DOI: 10.1038/bmt.2017.193] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2017] [Revised: 07/17/2017] [Accepted: 07/28/2017] [Indexed: 11/09/2022]
Abstract
Donor-lymphocyte infusion (DLI) for relapse following haploidentical hematopoietic cell transplantation (haploHCT) with post-transplant cyclophosphamide (PTCy) has been described in recipients of bone marrow grafts, but not recipients of G-CSF mobilized peripheral blood (PB) grafts. We retrospectively identified patients who underwent DLI following PB-haploHCT with PTCy for relapse, or loss of chimerism (LOC). Twelve patients (57%) received DLI for hematologic relapse/persistent disease, seven (33%) for extramedullary relapse and two (10%) for LOC. Sixteen (76%) received chemotherapy prior to DLI, which did not correlate with response. The most common first dose was 1 × 106 CD3+ cells/kg. Two patients developed grade I aGvHD post DLI, one had grade II and two had grade III. One developed mild skin cGvHD 1361 days post DLI. Pre-DLI aGvHD predicted post-DLI aGvHD (P=0.025). Six patients achieved CR after DLI for overt relapse, one achieved full donor chimerism after LOC. Patients with LOC or EM relapse had superior relapse-free survival following DLI (P=0.029). DLI following PB-haploHCT with PTCy is a viable salvage therapy for overt relapse or LOC without a substantial increase in GvHD, and donor lymphocytes may be collected simultaneously with graft collection to facilitate availability in patients at high risk of relapse.
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Affiliation(s)
- S R Goldsmith
- Bone Marrow Transplantation and Leukemia Program, Department of Medicine, Washington University School of Medicine, St. Louis, MO, USA
| | - M Slade
- Bone Marrow Transplantation and Leukemia Program, Department of Medicine, Washington University School of Medicine, St. Louis, MO, USA
| | - J F DiPersio
- Bone Marrow Transplantation and Leukemia Program, Department of Medicine, Washington University School of Medicine, St. Louis, MO, USA
| | - P Westervelt
- Bone Marrow Transplantation and Leukemia Program, Department of Medicine, Washington University School of Medicine, St. Louis, MO, USA
| | - M A Schroeder
- Bone Marrow Transplantation and Leukemia Program, Department of Medicine, Washington University School of Medicine, St. Louis, MO, USA
| | - F Gao
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St. Louis, MO, USA
| | - R Romee
- Bone Marrow Transplantation and Leukemia Program, Department of Medicine, Washington University School of Medicine, St. Louis, MO, USA
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5
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Levy B, Moffat S, Resnick S, Slade M, Ferrucci L. CUMULATIVE STRESS BUFFER: POSITIVE AGING SELF-STEREOTYPES PREDICT LOWER CORTISOL ACROSS THIRTY YEARS. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.4589] [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: 11/14/2022] Open
Affiliation(s)
- B. Levy
- Social and Behavioral Sciences, Yale University, New Haven, Connecticut,
| | - S. Moffat
- Georgia Institute of Technology, Atlanta, Georgia
| | - S. Resnick
- National Institute on Aging, Baltimore, Maryland,
| | - M. Slade
- Social and Behavioral Sciences, Yale University, New Haven, Connecticut,
| | - L. Ferrucci
- National Institute on Aging, Baltimore, Maryland,
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6
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Zou J, Romee R, Slade M, Phelan D, Keller J, Mohanakumar T, Grossman BJ. Untreated donor specific antibodies against HLA are associated with poor outcomes in peripheral blood haploidentical hematopoietic cell transplantation. Bone Marrow Transplant 2017; 52:898-901. [PMID: 28218756 DOI: 10.1038/bmt.2017.7] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Affiliation(s)
- J Zou
- Department of Laboratory Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - R Romee
- Department of Medicine, Bone Marrow Transplant and Leukemia Section, Washington University, St Louis, MO, USA
| | - M Slade
- Department of Medicine, Bone Marrow Transplant and Leukemia Section, Washington University, St Louis, MO, USA
| | - D Phelan
- HLA Laboratory, Barnes-Jewish Hospital, St Louis, MO, USA
| | - J Keller
- Department of Medicine, Bone Marrow Transplant and Leukemia Section, Washington University, St Louis, MO, USA
| | - T Mohanakumar
- Norton Thoracic Institute Research Laboratory, St Joseph's Hospital &Medical Center, Phoenix, AZ, USA
| | - B J Grossman
- Department of Laboratory Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.,Department of Pathology and Immunology, Washington University, St Louis, MO, USA
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7
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Huselton E, Slade M, DiPersio JF, Westervelt P, Vij R, Uy GL, Fehniger TA, Abboud CN, Gao F, Schroeder MA, Romee R. Single institution experience with G-CSF mobilized T-cell replete haploidentical hematopoietic cell transplantation. Bone Marrow Transplant 2017; 52:769-771. [PMID: 28067881 DOI: 10.1038/bmt.2016.354] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- E Huselton
- Bone Marrow Transplant and Leukemia Program, Washington University School of Medicine, Saint Louis, MO, USA
| | - M Slade
- Bone Marrow Transplant and Leukemia Program, Washington University School of Medicine, Saint Louis, MO, USA
| | - J F DiPersio
- Bone Marrow Transplant and Leukemia Program, Washington University School of Medicine, Saint Louis, MO, USA
| | - P Westervelt
- Bone Marrow Transplant and Leukemia Program, Washington University School of Medicine, Saint Louis, MO, USA
| | - R Vij
- Bone Marrow Transplant and Leukemia Program, Washington University School of Medicine, Saint Louis, MO, USA
| | - G L Uy
- Bone Marrow Transplant and Leukemia Program, Washington University School of Medicine, Saint Louis, MO, USA
| | - T A Fehniger
- Bone Marrow Transplant and Leukemia Program, Washington University School of Medicine, Saint Louis, MO, USA
| | - C N Abboud
- Bone Marrow Transplant and Leukemia Program, Washington University School of Medicine, Saint Louis, MO, USA
| | - F Gao
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, Saint Louis, MO, USA
| | - M A Schroeder
- Bone Marrow Transplant and Leukemia Program, Washington University School of Medicine, Saint Louis, MO, USA
| | - R Romee
- Bone Marrow Transplant and Leukemia Program, Washington University School of Medicine, Saint Louis, MO, USA
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8
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Wollerton R, Goodliffe J, Slade M. P11 Utility of a novel prognostic tool in unselected patients with malignant pleural mesothelioma. Thorax 2016. [DOI: 10.1136/thoraxjnl-2016-209333.154] [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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9
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Leamy M, Clarke E, Le Boutillier C, Bird V, Choudhury R, MacPherson R, Pesola F, Sabas K, Williams J, Williams P, Slade M. Recovery practice in community mental health teams: national survey. Br J Psychiatry 2016; 209:340-346. [PMID: 27340113 PMCID: PMC5046739 DOI: 10.1192/bjp.bp.114.160739] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2014] [Accepted: 03/07/2015] [Indexed: 12/20/2022]
Abstract
BACKGROUND There is consensus about the importance of 'recovery' in mental health services, but the link between recovery orientation of mental health teams and personal recovery of individuals has been underresearched. AIMS To investigate differences in team leader, clinician and service user perspectives of recovery orientation of community adult mental health teams in England. METHOD In six English mental health National Health Service (NHS) trusts, randomly chosen community adult mental health teams were surveyed. A random sample of ten patients, one team leader and a convenience sample of five clinicians were surveyed from each team. All respondents rated the recovery orientation of their team using parallel versions of the Recovery Self Assessment (RSA). In addition, service users also rated their own personal recovery using the Questionnaire about Processes of Recovery (QPR). RESULTS Team leaders (n = 22) rated recovery orientation higher than clinicians (n = 109) or patients (n = 120) (Wald(2) = 7.0, P = 0.03), and both NHS trust and team type influenced RSA ratings. Patient-rated recovery orientation was a predictor of personal recovery (b = 0.58, 95% CI 0.31-0.85, P<0.001). Team leaders and clinicians with experience of mental illness (39%) or supporting a family member or friend with mental illness (76%) did not differ in their RSA ratings from other team leaders or clinicians. CONCLUSIONS Compared with team leaders, frontline clinicians and service users have less positive views on recovery orientation. Increasing recovery orientation may support personal recovery.
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Affiliation(s)
- M. Leamy
- Correspondence: Mary Leamy, King's College London, National Nursing Research Unit, Florence Nightingale School of Nursing and Midwifery, James Clerk Maxwell Building, 57 Waterloo Road, London SE1 8WA, UK.
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10
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Slade M, Fakhri B, Savani BN, Romee R. Halfway there: the past, present and future of haploidentical transplantation. Bone Marrow Transplant 2016; 52:1-6. [DOI: 10.1038/bmt.2016.190] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2016] [Revised: 05/19/2016] [Accepted: 05/20/2016] [Indexed: 02/03/2023]
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11
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Bär Deucher A, Hengartner MP, Kawohl W, Konrad J, Puschner B, Clarke E, Slade M, Del Vecchio V, Sampogna G, Égerházi A, Süveges Á, Krogsgaard Bording M, Munk-Jørgensen P, Rössler W. Participation in medical decision-making across Europe: An international longitudinal multicenter study. Eur Psychiatry 2016; 35:39-46. [PMID: 27061376 DOI: 10.1016/j.eurpsy.2016.02.001] [Citation(s) in RCA: 22] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2015] [Revised: 02/13/2016] [Accepted: 02/15/2016] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND The purpose of this paper was to examine national differences in the desire to participate in decision-making of people with severe mental illness in six European countries. METHODS The data was taken from a European longitudinal observational study (CEDAR; ISRCTN75841675). A sample of 514 patients with severe mental illness from the study centers in Ulm, Germany, London, England, Naples, Italy, Debrecen, Hungary, Aalborg, Denmark and Zurich, Switzerland were assessed as to desire to participate in medical decision-making. Associations between desire for participation in decision-making and center location were analyzed with generalized estimating equations. RESULTS We found large cross-national differences in patients' desire to participate in decision-making, with the center explaining 47.2% of total variance in the desire for participation (P<0.001). Averaged over time and independent of patient characteristics, London (mean=2.27), Ulm (mean=2.13) and Zurich (mean=2.14) showed significantly higher scores in desire for participation, followed by Aalborg (mean=1.97), where scores were in turn significantly higher than in Debrecen (mean=1.56). The lowest scores were reported in Naples (mean=1.14). Over time, the desire for participation in decision-making increased significantly in Zurich (b=0.23) and decreased in Naples (b=-0.14). In all other centers, values remained stable. CONCLUSIONS This study demonstrates that patients' desire for participation in decision-making varies by location. We suggest that more research attention be focused on identifying specific cultural and social factors in each country to further explain observed differences across Europe.
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Affiliation(s)
- A Bär Deucher
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, PO Box 1930, 8021 Zurich, Switzerland.
| | - M P Hengartner
- Department of Applied Psychology, Zurich University of Applied Sciences (ZHAW), Pfingstweidstrasse 96, PO Box 707, 8037 Zurich, Switzerland
| | - W Kawohl
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, PO Box 1930, 8021 Zurich, Switzerland
| | - J Konrad
- Section Process-Outcome Research, Department of Psychiatry II, Ulm University, Ludwig-Heilmeyer-Str. 2, 89312 Günzburg, Germany
| | - B Puschner
- Section Process-Outcome Research, Department of Psychiatry II, Ulm University, Ludwig-Heilmeyer-Str. 2, 89312 Günzburg, Germany
| | - E Clarke
- Kings College London, Section for Recovery, Institute of Psychiatry, Psychology & Neuroscience, 16 De Crespigny Park, London SE5 8AF, UK
| | - M Slade
- Kings College London, Section for Recovery, Institute of Psychiatry, Psychology & Neuroscience, 16 De Crespigny Park, London SE5 8AF, UK
| | - V Del Vecchio
- Department of Psychiatry, University of Naples SUN, Largo Madonna delle Grazie 1, 80138 Naples, Italy
| | - G Sampogna
- Department of Psychiatry, University of Naples SUN, Largo Madonna delle Grazie 1, 80138 Naples, Italy
| | - A Égerházi
- Department of Psychiatry, Medical and Health Science Centre, University of Debrecen, 98, Nagyerdei krt, 4012, Debrecen, Hungary
| | - Á Süveges
- Department of Psychiatry, Medical and Health Science Centre, University of Debrecen, 98, Nagyerdei krt, 4012, Debrecen, Hungary
| | - M Krogsgaard Bording
- Aalborg University Hospital, Psychiatry, Mølleparkvej 10, Aalborg, 9000, Denmark
| | - P Munk-Jørgensen
- Department M, Aarhus University Hospital, Skovagervej 2, 8240 Risskov, Denmark
| | - W Rössler
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, PO Box 1930, 8021 Zurich, Switzerland
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Clarke E, Puschner B, Jordan H, Williams P, Konrad J, Kawohl W, Bär A, Rössler W, Del Vecchio V, Sampogna G, Nagy M, Süveges A, Krogsgaard Bording M, Slade M. Empowerment and satisfaction in a multinational study of routine clinical practice. Acta Psychiatr Scand 2015; 131:369-78. [PMID: 25471821 DOI: 10.1111/acps.12365] [Citation(s) in RCA: 25] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/16/2014] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Decision-making between mental health clinicians and patients is under-researched. We tested whether mental health patients are more satisfied with a decision made (i) using their preferred decision-making style and (ii) with a clinician with the same decision-making style preference. METHOD As part of the CEDAR Study (ISRCTN75841675), a convenience sample of 445 patients with severe mental illness from six European countries were assessed for desired clinical decision-making style (rated by patients and paired clinicians), decision-specific experienced style and satisfaction. RESULTS Patients who experienced more involvement in decision-making than they desired rated higher satisfaction (OR=2.47, P=0.005, 95% CI 1.32-4.63). Decisions made with clinicians whose decision-making style preference was for more active involvement than the patient preference were rated with higher satisfaction (OR=3.17, P=0.003, 95% CI 1.48-6.82). CONCLUSION More active involvement in decision-making than the patient stated as desired was associated with higher satisfaction. A clinical orientation towards empowering, rather than shared, decision-making may maximise satisfaction.
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Affiliation(s)
- E Clarke
- King's College London, Institute of Psychiatry, Psychology & Neuroscience, London, UK
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Rezende Andrade M, Bandeira M, Slade M, Evans-Lacko S, Martin D, Andreoli S. Unmet Needs in Outpatients with Psychotic Disorders in Brazil. Eur Psychiatry 2015. [DOI: 10.1016/s0924-9338(15)32038-1] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Bibby A, Slade G, Morley A, Fallon J, Psallidas I, Clive A, Pepperall J, Slade M, Stanton A, Rahman N, Maskell N. S117 Survival In Patients With Malignant Pleural Effusions Who Developed Pleural Infection: A Retrospective Case Review From 6 Uk Centres. Thorax 2014. [DOI: 10.1136/thoraxjnl-2014-206260.123] [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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Schrank B, Brownell T, Tylee A, Slade M. Positive psychology: an approach to supporting recovery in mental illness. East Asian Arch Psychiatry 2014; 24:95-103. [PMID: 25316800] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
This paper reviews the literature on positive psychology with a special focus on people with mental illness. It describes the characteristics, critiques, and roots of positive psychology and positive psychotherapy, and summarises the existing evidence on positive psychotherapy. Positive psychology aims to refocus psychological research and practice on the positive aspects of experience, strengths, and resources. Despite a number of conceptual and applied research challenges, the field has rapidly developed since its introduction at the turn of the century. Today positive psychology serves as an umbrella term to accommodate research investigating positive emotions and other positive aspects such as creativity, optimism, resilience, empathy, compassion, humour, and life satisfaction. Positive psychotherapy is a therapeutic intervention that evolved from this research. It shows promising results for reducing depression and increasing well-being in healthy people and those with depression. Positive psychology and positive psychotherapy are increasingly being applied in mental health settings, but research evidence involving people with severe mental illness is still scarce. The focus on strengths and resources in positive psychology and positive psychotherapy may be a promising way to support recovery in people with mental illness, such as depression, substance abuse disorders, and psychosis. More research is needed to adapt and establish these approaches and provide an evidence base for their application.
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Affiliation(s)
- B Schrank
- King's College London, Institute of Psychiatry, London, United Kingdom; Medical University of Vienna, Department of Psychiatry and Psychotherapy, Vienna, Austria
| | - T Brownell
- King's College London, Institute of Psychiatry, London, United Kingdom
| | - A Tylee
- King's College London, Institute of Psychiatry, London, United Kingdom
| | - M Slade
- King's College London, Institute of Psychiatry, London, United Kingdom
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Slade M, Byford S, Barrett B, Lloyd-Evans B, Gilburt H, Osborn DPJ, Skinner R, Leese M, Thornicroft G, Johnson S. Alternatives to standard acute in-patient care in England: short-term clinical outcomes and cost-effectiveness. Br J Psychiatry 2014; 53:s14-9. [PMID: 20679274 DOI: 10.1192/bjp.bp.110.081059] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [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: 11/23/2022]
Abstract
BACKGROUND Outcomes following admission to residential alternatives to standard in-patient mental health services are underresearched. AIMS To explore short-term outcomes and costs of admission to alternative and standard services. METHOD Health of the Nation Outcome Scales (HoNOS), Threshold Assessment Grid (TAG), Global Assessment of Functioning (GAF) and admission cost data were collected for six alternative services and six standard services. RESULTS All outcomes improved during admission for both types of service (n = 433). Adjusted improvement was greater for standard services in scores on HoNOS (difference 1.99, 95% CI 1.12-2.86), TAG (difference 1.40, 95% CI 0.39-2.51) and GAF functioning (difference 4.15, 95% CI 1.08-7.22) but not GAF symptoms. Admissions to alternatives were 20.6 days shorter, and hence cheaper (UK pound3832 v. pound9850). Standard services cost an additional pound2939 per unit HoNOS improvement. CONCLUSIONS The absence of clear-cut advantage for either type of service highlights the importance of the subjective experience and longer-term costs.
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Affiliation(s)
- M Slade
- Health Service and Population Research Department, Box PO29, Institute of Psychiatry, King's College London, De Crespigny Park, Denmark Hill, London SE5 8AF, UK.
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Woolhouse IS, Stanley R, Slade M, Beckett P, Peake MD. P2 Trends in lung cancer diagnostics, does the timing of tests matter? Results from the National Lung Cancer Audit 2009–2011: Abstract P2 Table 1. Thorax 2013. [DOI: 10.1136/thoraxjnl-2013-204457.152] [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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Puschner B, Slade M. 2450 – The role of clinical decision making in mental health practice. Eur Psychiatry 2013. [DOI: 10.1016/s0924-9338(13)77219-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Williams J, Leamy M, Bird V, Harding C, Larsen J, Le Boutillier C, Oades L, Slade M. Measures of the recovery orientation of mental health services: systematic review. Soc Psychiatry Psychiatr Epidemiol 2012; 47:1827-35. [PMID: 22322983 DOI: 10.1007/s00127-012-0484-y] [Citation(s) in RCA: 87] [Impact Index Per Article: 7.3] [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] [Received: 10/05/2011] [Accepted: 01/28/2012] [Indexed: 11/26/2022]
Abstract
PURPOSE The review aimed to (1) identify measures that assess the recovery orientation of services; (2) discuss how these measures have conceptualised recovery, and (3) characterise their psychometric properties. METHODS A systematic review was undertaken using seven sources. The conceptualisation of recovery within each measure was investigated by rating items against a conceptual framework of recovery comprising five recovery processes: connectedness; hope and optimism; identity; meaning and purpose; and empowerment. Psychometric properties of measures were evaluated using quality criteria. RESULTS Thirteen recovery orientation measures were identified, of which six met eligibility criteria. No measure was a good fit with the conceptual framework. No measure had undergone extensive psychometric testing and none had data on test-retest reliability or sensitivity to change. CONCLUSIONS Many measures have been developed to assess the recovery orientation of services. Comparisons between the measures were hampered by the different conceptualisations of recovery used and by the lack of uniformity on the level of organisation at which services were assessed. This situation makes it a challenge for services and researchers to make an informed choice on which measure to use. Further work is needed to produce measures with a transparent conceptual underpinning and demonstrated psychometric properties.
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Affiliation(s)
- J Williams
- Section for Recovery, Health Service and Population Research Department, Institute of Psychiatry, King's College London, De Crespigny Park, London, Box PO29, SE5 8AF, UK.
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Toise S, Sears S, Schoenfeld M, Blitzer M, Marieb M, Drury J, Slade M, Donohue T. P02.35. Methodology in integrative medicine research: challenges and solutions from a randomized clinical control trial using adapted yoga. BMC Complement Altern Med 2012. [PMCID: PMC3373786 DOI: 10.1186/1472-6882-12-s1-p91] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Hampson FA, Slade M, Qureshi N. Mediastinal ganglioneuroma mimicking a bronchogenic cyst. Case Reports 2012; 2012:bcr.07.2011.4447. [DOI: 10.1136/bcr.07.2011.4447] [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] Open
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22
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Payne RE, Hava NL, Page K, Blighe K, Ward B, Slade M, Brown J, Guttery DS, Zaidi SAA, Stebbing J, Jacob J, Yagüe E, Shaw JA, Coombes RC. The presence of disseminated tumour cells in the bone marrow is inversely related to circulating free DNA in plasma in breast cancer dormancy. Br J Cancer 2012; 106:375-82. [PMID: 22166803 PMCID: PMC3261674 DOI: 10.1038/bjc.2011.537] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2011] [Revised: 09/29/2011] [Accepted: 11/10/2011] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND The aim of this study was to gain insight into breast cancer dormancy by examining different measures of minimal residual disease (MRD) over time in relation to known prognostic factors. METHODS Sixty-four primary breast cancer patients on follow-up (a median of 8.3 years post surgery) who were disease free had sequential bone marrow aspirates and blood samples taken for the measurement of disseminated tumour cells (DTCs), circulating tumour cells (CTCs) by CellSearch and qPCR measurement of overlapping (96-bp and 291-bp) amplicons in circulating free DNA (cfDNA). RESULTS The presence of CTCs was correlated with the presence of DTCs measured by immunocytochemistry (P=0.01) but both were infrequently detected. Increasing cfDNA concentration correlated with ER, HER2 and triple-negative tumours and high tumour grade, and the 291-bp amplicon was inversely correlated with DTCs measured by CK19 qRT-PCR (P=0.047). CONCLUSION Our results show that breast cancer patients have evidence of MRD for many years after diagnosis despite there being no overt evidence of disease. The inverse relationship between bone marrow CK19 mRNA and the 291-bp amplicon in cfDNA suggests that an inverse relationship between a measure of cell viability in the bone marrow (DTCs) and cell death in the plasma occurs during the dormancy phase of breast cancer.
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Affiliation(s)
- R E Payne
- Division of Cancer, Imperial College, MRC Cyclotron Building, Imperial College Healthcare NHS Trust, Hammersmith Hospital, Du Cane Road, London W12 ONN, UK
| | - N L Hava
- Division of Cancer, Imperial College, MRC Cyclotron Building, Imperial College Healthcare NHS Trust, Hammersmith Hospital, Du Cane Road, London W12 ONN, UK
| | - K Page
- Department of Cancer Studies and Molecular Medicine, University of Leicester, Robert Kilpatrick Building, PO Box 65, Leicester Royal Infirmary, Leicester LE2 7LX, UK
| | - K Blighe
- Department of Cancer Studies and Molecular Medicine, University of Leicester, Robert Kilpatrick Building, PO Box 65, Leicester Royal Infirmary, Leicester LE2 7LX, UK
| | - B Ward
- Department of Medical Oncology, Charing Cross Hospital, London W6 8RF, UK
| | - M Slade
- Division of Cancer, Imperial College, MRC Cyclotron Building, Imperial College Healthcare NHS Trust, Hammersmith Hospital, Du Cane Road, London W12 ONN, UK
| | - J Brown
- Department of Cancer Studies and Molecular Medicine, University of Leicester, Robert Kilpatrick Building, PO Box 65, Leicester Royal Infirmary, Leicester LE2 7LX, UK
| | - D S Guttery
- Department of Cancer Studies and Molecular Medicine, University of Leicester, Robert Kilpatrick Building, PO Box 65, Leicester Royal Infirmary, Leicester LE2 7LX, UK
| | - S A A Zaidi
- Division of Cancer, Imperial College, MRC Cyclotron Building, Imperial College Healthcare NHS Trust, Hammersmith Hospital, Du Cane Road, London W12 ONN, UK
| | - J Stebbing
- Division of Cancer, Imperial College, MRC Cyclotron Building, Imperial College Healthcare NHS Trust, Hammersmith Hospital, Du Cane Road, London W12 ONN, UK
| | - J Jacob
- Division of Cancer, Imperial College, MRC Cyclotron Building, Imperial College Healthcare NHS Trust, Hammersmith Hospital, Du Cane Road, London W12 ONN, UK
| | - E Yagüe
- Division of Cancer, Imperial College, MRC Cyclotron Building, Imperial College Healthcare NHS Trust, Hammersmith Hospital, Du Cane Road, London W12 ONN, UK
| | - J A Shaw
- Department of Cancer Studies and Molecular Medicine, University of Leicester, Robert Kilpatrick Building, PO Box 65, Leicester Royal Infirmary, Leicester LE2 7LX, UK
| | - R C Coombes
- Division of Cancer, Imperial College, MRC Cyclotron Building, Imperial College Healthcare NHS Trust, Hammersmith Hospital, Du Cane Road, London W12 ONN, UK
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Slade G, Haslop C, Slade M. 117 Establishing a mesothelioma support group. Lung Cancer 2012. [DOI: 10.1016/s0169-5002(12)70118-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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Morant N, Lloyd-Evans B, Gilburt H, Slade M, Osborn D, Johnson S. Implementing successful residential alternatives to acute in-patient psychiatric services: what can we learn from professional stakeholders' perspectives? Psychiat Prax 2011. [DOI: 10.1055/s-0031-1277831] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Brohan E, Slade M, Clement S, Rose D, Sartorius N, Thornicroft G. Further development and psychometric validation of the discrimination and stigma scale (DISC-12). Psychiat Prax 2011. [DOI: 10.1055/s-0031-1277768] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Oltmanns UH, Perera P, Slade M. P219 Is there a role for conventional transbronchial needle aspiration in the endobronchial ultrasound era? Thorax 2010. [DOI: 10.1136/thx.2010.151068.20] [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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27
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Ng B, Oltmanns U, Hardy C, Yip C, Slade M. P196 Cryo-recanalisation via day-case flexible bronchoscopy for central airway obstruction. Thorax 2010. [DOI: 10.1136/thx.2010.151043.47] [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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Haggerty H, Burleson F, Wells S, Slade M, Grubor B, Pilcher G, Sanderson T, Freebern W. P3‐293: A comprehensive immunotoxicologic investigation of a gamma secretase inhibitor in rats. Alzheimers Dement 2010. [DOI: 10.1016/j.jalz.2010.05.1793] [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: 11/28/2022]
Affiliation(s)
| | | | - S.Q. Wells
- Bristol-Myers Squibb CompanyEast Syracuse NY USA
| | - M. Slade
- Bristol-Myers Squibb CompanyEast Syracuse NY USA
| | - B. Grubor
- Bristol-Myers Squibb CompanyEast Syracuse NY USA
| | - G.D. Pilcher
- Bristol-Myers Squibb CompanyEast Syracuse NY USA
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Balasubramanian R, Rashied S, Filipovic A, Slade M, Yague E, Coombes C. Gammasecretase Inhibition Results in Both Caspase Dependant and Independent Apoptosis in Breast Cancer Cell Lines. Cancer Res 2009. [DOI: 10.1158/0008-5472.sabcs-09-3129] [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
BackgroundNotch signalling is normally involved in lateral inhibition during embryogenesis and is found to be de regulated in many breast cancers. Gamma-secretase is an enzyme complex formed by constitution of Nicastrin, APH1, Presenilin and Pen2 and is involved in the cleavage of notch proteins. We investigated the effects of γ-secretase inhibition and its mechanism of action in breast cancer cell lines.Materials and MethodsGrowth assay was performed using Gammasecretase inhibitor-1(Z-Leu-Leu-Nle-CHO) in MCF-7, MDA-MB-231, T47D and ZR-75 breast cancer cell lines and 226 U19 and MCF10A non tumourigenic epithelial cell lines at concentrations between10nM and 60uM. Expression of Bcl-2, Bcl-XL, P-Bad and XIAP were measured by Western blot and cell cycle analysis was done by FACS in MCF-7 and MDA-MB-231 cells treated with GSI-1 at 0.75μM, 2μM and 5μM for 48 hours. Caspase 3 and 7 activity was measured in MCF-7 and MDA-MB-231 cells treated with GSI-1 at 0.75μM, 2μM and 5μM for 24 and 48 hours using Promega assay kit. MCF-7 cells were also treated with 0.75μM GSI-1 and DMSO in five replicates for 48 hours and gene array was performed using 44K Agilent array. Fold changes of AKR1B10 and Osteopontin genes were confirmed by Real time PCR at 0.75μM of GSI-1 in MCF-7 and they were also measured at concentrations of 2μM and 5μM in MCF-7 and MDA MB 231 cells using Taqman.ResultsThe 4 cancer cell lines MCF-7, MDA-MB231, ZR-75 and T47D showed growth inhibition in a dose dependant manner and were killed at 5uM. However this concentration did not affect the non tumourigenic cell lines. Expression of Bcl-2, Bcl-XL, inhibitor of apoptosis (XIAP) and P-BAD went down with escalating doses of GSI-1 at 48 hours in both MCF-7 and MDA MB 231 cells. Cell cycle analysis confirmed increase in the percentage of cells in G2M arrest leading to apoptosis at 48 hours in the same cell lines. However we observed increase in Caspase 3 and 7 activity only in MDA-MB-231 not in MCF-7 cells. Gene array in MCF-7 cells treated with GSI1 showed 15 and 4 fold changes in the expression of AKR1B10 and Osteopontin. There was also dose dependant increase in the expression these two genes with GSI-1 in MCF-7 but no such change was observed in MDA MB 231 cells.DiscussionThis is the first time we are reporting the effect of GSI-1 and its possible mechanism of action in breast cancer cell lines. Apoptosis appears to be the main mechanism of cell death as evidenced by our Western blots and FACS analysis in MCF-7 and MDA MB 231 cell lines. However, MCF-7 did not show any Caspase 3/7 activity implying other mechanisms may be involved in the induction of apoptosis. Production of reactive oxygen species (ROS) triggers the damage to mitochondrial membrane and release of cytochrome c, Apoptosis inducing Factor and Endonuclease G resulting in the initiation of Caspase independent apoptosis. AKR1B10 and Osteopontin were shown to be highly expressed in conditions resulting in increased production of ROS. Thus inhibition of γ-secretase enzyme results in breast cancer cell death in a dose which was non lethal to non tumourigenic cell lines. Both Caspase dependant and independent apoptosis appear to be involved in the mechanism of cell death.
Citation Information: Cancer Res 2009;69(24 Suppl):Abstract nr 3129.
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Affiliation(s)
| | - S. Rashied
- 1Imperial College, London, United Kingdom
| | | | - M. Slade
- 1Imperial College, London, United Kingdom
| | - E. Yague
- 1Imperial College, London, United Kingdom
| | - C. Coombes
- 1Imperial College, London, United Kingdom
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Tobin C, Rahman N, Buttery R, Rintoul R, Slade M. Comparison of diagnostic sensitivity for thoracic malignancy with and without endobronchial ultrasound. Lung Cancer 2009. [DOI: 10.1016/s0169-5002(09)70069-8] [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: 11/24/2022]
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Slade G, Tobin C, Slade M. Starting an ambulatory pleural drainage service for malignant effusion. Lung Cancer 2009. [DOI: 10.1016/s0169-5002(09)70084-4] [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: 11/30/2022]
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Abstract
OBJECTIVE Hope has long been considered an important therapeutic factor in medicine, nursing and mental health and recently received attention as a central component of recovery. However, conceptual clarity, applicability and the predictive value of hope remain unclear. This review aims to define hope, review current approaches to assessment, and outline research evidence linking hope with effectiveness. METHOD We conducted a comprehensive review of publications on the conceptualisation and measurement of hope, and on its use as a predictive variable specifically in mental health patients. RESULTS Forty-nine definitions of hope were identified, which were grouped into seven emergent dimensions. Thirty-two measurement tools were identified, although few have been used in research involving mental health patients. Eleven studies investigated hope as a predictive variable for differing outcomes, with inconclusive results. CONCLUSION Many conceptual frameworks for hope have been proposed, but empirical evidence on its predictive power in mental health is lacking.
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Affiliation(s)
- B Schrank
- Department of Psychiatry, Medical University Vienna, Vienna, Austria.
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Balasubramanian R, Rashied S, Filipovic A, Slade M, Yague E, Coombes C. Gammasecretase is a potential therapeutic target in Breast cancer. Eur J Surg Oncol 2008. [DOI: 10.1016/j.ejso.2008.06.143] [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: 10/21/2022] Open
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Thomas C, Slade M. 5 The contribution of transbronchial needle aspiration (TBNA) to lung cancer staging — a four-year experience. Lung Cancer 2007. [DOI: 10.1016/s0169-5002(07)70331-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Vegso S, Cantley L, Slade M, Taiwo O, Sircar K, Rabinowitz P, Fiellin M, Russi MB, Cullen MR. Extended work hours and risk of acute occupational injury: A case-crossover study of workers in manufacturing. Am J Ind Med 2007; 50:597-603. [PMID: 17594716 DOI: 10.1002/ajim.20486] [Citation(s) in RCA: 60] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
OBJECTIVE This study was designed to determine whether injury risk among manufacturing workers was related to hours worked during the previous week. METHODS A case-crossover design was utilized to contrast hours worked prior to an injury shift with those worked prior to a non-injury shift for hourly workers. Paired t-tests were used to determine significance of the difference. Conditional logistic regression was used to assess dose-response. RESULTS Hours worked prior to injury significantly exceeded hours during the control week. Workers who worked more than 64 hr in the week before the shift had an 88% excess risk compared to those who worked 40 hr or fewer, P < 0.05. CONCLUSION The study provides evidence that injury risk is related to time worked during the previous week. Control of overtime in manufacturing may reduce risk of worker injury.
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Affiliation(s)
- S Vegso
- Yale Occupational and Environmental Medicine Program, Department of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut, USA
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Howard L, Hunt K, Thornicroft G, Slade M, Leese M, Seneviratne G, O'Keane V. Assessing the needs of pregnant women and mothers with severe mental illness. Eur Psychiatry 2007. [DOI: 10.1016/j.eurpsy.2007.01.1198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Howard L, Hunt K, Slade M, O'Keane V, Senevirante T, Leese M, Thornicroft G. Assessing the needs of pregnant women and mothers with severe mental illness: the psychometric properties of the Camberwell Assessment of Need - Mothers (CAN-M). Int J Methods Psychiatr Res 2007; 16:177-85. [PMID: 18188837 PMCID: PMC6878312 DOI: 10.1002/mpr.227] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
There is an absence of standardized validated instruments to assess the complex needs of pregnant women and mothers with severe mental illness. We aimed to develop a standardized assessment of need for pregnant women and mothers with severe mental illness. Staff and service users were asked to identify relevant domains of need. Professional experts and service users were then surveyed and asked to rate the importance of the domains of the Camberwell Assessment of Need - Mothers version (CAN-M). Reliability was established using 36 service user-staff pairs. Concurrent validity was assessed with the Global Assessment of Functioning. Inter-rater reliability (concordance) coefficients for unmet needs were 0.93 (95% confidence interval 0.89 to 0.98) (service users) and 0.83 (95% confidence interval 0.73 to 0.94) (staff); test-retest reliability coefficients were 0.91 (95% confidence interval 0.86 to 0.97) and 0.85 (95% confidence interval 0.73 to 0.96), respectively. Relevant CAN-M domains correlated with the Global Assessment of Functioning-symptom (Spearman's r correlation coefficient = -0.36, 95% confidence interval = -0.62 to -0.04, p = 0.05) and Global Assessment of Functioning-disability subscales (Spearman's r correlation coefficient = -0.52, confidence interval = -0.73 to -0.23, p < 0.01). We conclude that the CAN-M is a reliable and valid instrument for assessing the needs of pregnant women and mothers with severe mental illness.
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Affiliation(s)
- L Howard
- Section of Community Mental Health, Health Service and Population Research Department, PO29 Institute of Psychiatry, King's College London, De Crespigny Park, London, UK.
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Abstract
OBJECTIVE To compare different perspectives on evidence in relation to mental health care. METHOD The method and materials constitute a selective literature review comparing key elements of evidence-based medicine and evidence-based policy with perspectives on evidence from users, carers and professionals. The aim was to develop an argument concerning these comparisons. RESULTS What constitutes evidence from the perspectives of different stakeholders is a field of contestation. CONCLUSION It is timely for a multiple perspective paradigm on evidence in science to be developed and this paper initiates this process in relation to mental health care.
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Affiliation(s)
- D Rose
- Service User Research Enterprise (SURE), Health Services Research Department, Institute of Psychiatry, De Crespigny Park, London, UK.
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Martin G, Costello H, Leese M, Slade M, Bouras N, Higgins S, Holt G. An exploratory study of assertive community treatment for people with intellectual disability and psychiatric disorders: conceptual, clinical, and service issues. J Intellect Disabil Res 2005; 49:516-24. [PMID: 15966959 DOI: 10.1111/j.1365-2788.2005.00709.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
BACKGROUND Assertive community treatment (ACT) has been applied to a number of disorders in the adult population, such as schizophrenia, with some degree of success; its use in the treatment of people with intellectual disability (ID) and mental illness has received little attention. Despite the high costs of ID in health and social care, there has been very little evidence-based practice for people with ID and mental illness, and it remains a neglected area of research. Aims The aims of this study were an exploratory comparison of the effectiveness of an ACT model for the treatment of mental illness in people with ID (ACT-ID) with a standard community treatment (SCT-ID) approach. METHOD A Randomized controlled trial design was adopted and allocation was made by stratified randomization by an independent statistician. The prognostic factors used in the randomization were gender and psychiatric diagnosis (psychosis vs. affective). Service users were randomly allocated to either ACT-ID or SCT-ID. RESULTS There were no statistically significant differences between ACT-ID and SCT-ID in terms of the level of unmet needs, carer burden, functioning and quality of life, but borderline evidence of a difference between treatment groups in quality of life in favour of SCT-ID. Both SCT-ID and ACT-ID groups decreased level of unmet needs and carer burden, and increased functioning. SCT-ID also led to a small increase in quality of life.
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Affiliation(s)
- G Martin
- Estia Centre, Institute of Psychiatry and South London and Maudsley NHS Trust, London, UK
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Scarsbrook AF, Evans AL, Slade M, Gleeson FV. Recurrent solitary fibrous tumour of the pleura due to tumour seeding following ultrasound-guided transthoracic biopsy. Clin Radiol 2005; 60:130-2. [PMID: 15642305 DOI: 10.1016/j.crad.2004.08.015] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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Abstract
OBJECTIVE This study investigated the psychometric properties of the Threshold Assessment Grid (TAG), a new assessment of the severity of mental health problems. METHOD A total of 605 patients were recruited from 10 mental health adult and elderly services in London, UK. TAG ratings and other standardized definitions of severe mental illness were completed by referrers. TAG, Global Assessment of Functioning (GAF), Camberwell Assessment of Need Short Appraisal Schedule (CANSAS) and Health of the Nation Outcome Scale (HoNOS) ratings were completed by mental health service staff. Construct validation on extreme groups was investigated. RESULTS Construct and concurrent validity were good. Referrer TAG scores predicted mental health team view of referral suitability, but not whether assessments were offered. Test-retest reliability was good, interrater reliability ranged from good to poor in different domains (but adequate for total TAG score), internal consistency was appropriate. Sensitivity to change requires further investigation. CONCLUSION The TAG can be recommended for use by all agencies when making referrals to mental health services.
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Affiliation(s)
- M Slade
- Health Services Research Department, Institute of Psychiatry, London, UK.
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Thornicroft G, Slade M, Phelan M. A comparison of needs assessed by staff and by an epidemiologically representative sample of patients with psychosis. Eur Psychiatry 2002. [DOI: 10.1016/s0924-9338(02)80027-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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Slade M, Cahill S, Kelsey W, Powell R, Strathdee G, Valiakalayil A. Threshold 3: the feasibility of the Threshold Assessment Grid (TAG) for routine assessment of the severity of mental health problems. Soc Psychiatry Psychiatr Epidemiol 2001; 36:516-21. [PMID: 11768850 DOI: 10.1007/s001270170017] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.7] [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: 10/27/2022]
Abstract
BACKGROUND Evidence-based practice requires the development of measures which are suitable for everyday clinical use ('feasible'). There is no consensus as to how to establish feasibility. METHOD The feasibility of a new assessment - the Threshold Assessment Grid (TAG) - for use when making referrals to mental health services was tested by training mental health teams in using the TAG and other standardised assessments, asking referrers to ten mental health services in London also to complete a TAG, surveying TAG users, and evaluating a feedback meeting at which TAG data were presented. RESULTS One hundred and one (61%) mental health staff received training, and 445 (74%) referrers of 600 patients completed TAGs. Sixty-five (65%) questionnaires from TAG users were completed, and 24 (80%) people attending feedback meetings evaluated the TAG. These allowed the extent to which the TAG is brief, simple, relevant, acceptable, available and valuable to be investigated. CONCLUSION The TAG exhibited good feasibility when used by mental health staff, and moderate feasibility when used by referrers. This approach can be used to investigate the feasibility of other standardised assessments.
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Affiliation(s)
- M Slade
- Health Services Research Department, Institute of Psychiatry, London, UK.
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Ramahi TM, Longo MD, Cadariu AR, Rohlfs K, Slade M, Carolan S, Vallejo E, Wackers FJ. Dobutamine-induced augmentation of left ventricular ejection fraction predicts survival of heart failure patients with severe non-ischaemic cardiomyopathy. Eur Heart J 2001; 22:849-56. [PMID: 11350094 DOI: 10.1053/euhj.2001.2654] [Citation(s) in RCA: 51] [Impact Index Per Article: 2.2] [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: 11/11/2022] Open
Abstract
AIMS The prognosis of patients with severe non-ischaemic dilated cardiomyopathy is variable. The predictive value of currently utilized tests is suboptimal. The purpose of this study was to determine the prognostic value of dobutamine-induced augmentation of left ventricular ejection fraction in patients with non-ischaemic dilated cardiomyopathy. METHODS AND RESULTS Sixty-two patients with left ventricular ejection fraction < or =0.30 underwent exercise testing with gas exchange analysis and assessment of left ventricular ejection fraction at rest and after a 10-min intravenous infusion of dobutamine at 10 microg x kg(-1) x min(-1), using equilibrium radionuclide ventriculography. Age was 48+/-11 years, 32% females, functional class 2.6+/-0.6, resting left ventricular ejection fraction 0.20+/-0.06, and peak exercise oxygen consumption (mVO2) 19+/-6 ml x kg(-1) x min(-1). Mean dobutamine-induced augmentation of left ventricular ejection fraction (DeltaLVEF) was 0.09+/-0.06 (median 0.08, range -0.03 to 0.26). Follow-up was 25+/-15 months during which there were 12 deaths and five transplantations. Patients were divided into two groups based on median DeltaLVEF. The transplant-free survival was better in the group with higher DeltaLVEF (94% vs 64%, P<0.008). In multivariate analysis incorporating age, gender, duration of chronic heart failure, functional class, right and left ventricular ejection fraction, DeltaLVEF, left ventricular end-diastolic volume index, and mVO2, only DeltaLVEF was predictive of 1-year, 3-year, and overall transplant-free survival (RR 0.09, 0.03, and 0.13;P 0.03, 0.09, and 0.08 respectively). The linear correlation between DeltaLVEF and mVO2(r=0.3) and between DeltaLVEF and left ventricular ejection fraction (r=0.5) was weak. CONCLUSION Dobutamine-induced augmentation of left ventricular ejection fraction is a strong prognostic variable, independent of exercise capacity and resting ventriculographic variables, in severe non-ischaemic systolic dysfunctional heart failure.
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Affiliation(s)
- T M Ramahi
- Section of Cardiovascular Medicine, Yale School of Medicine, New Haven, CT, USA
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Slade M. Cognitive-behavioural techniques in practice. Br J Psychiatry 2001; 178:180. [PMID: 11157439 DOI: 10.1192/bjp.178.2.180] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Weir C, Vesey G, Slade M, Ferrari B, Veal DA, Williams K. An immunoglobulin G1 monoclonal antibody highly specific to the wall of Cryptosporidium oocysts. Clin Diagn Lab Immunol 2000; 7:745-50. [PMID: 10973448 PMCID: PMC95949 DOI: 10.1128/cdli.7.5.745-750.2000] [Citation(s) in RCA: 22] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/29/1999] [Accepted: 05/17/2000] [Indexed: 11/20/2022]
Abstract
The detection of Cryptosporidium oocysts in drinking water is critically dependent on the quality of immunofluorescent reagents. Experiments were performed to develop a method for producing highly specific antibodies to Cryptosporidium oocysts that can be used for water testing. BALB/c mice were immunized with six different antigen preparations and monitored for immunoglobulin G (IgG) and IgM responses to the surface of Cryptosporidium oocysts. One group of mice received purified oocyst walls, a second group received a soluble protein preparation extracted from the outside of the oocyst wall, and the third group received whole inactivated oocysts. Three additional groups were immunized with sequentially prepared oocyst extracts to provide for a comparison of the immune response. Mice injected with the soluble protein extract demonstrated an IgG response to oocysts surface that was not seen in the whole-oocyst group. Mice injected with whole oocysts showed an IgM response only, while mice injected with purified oocyst walls showed little increase in IgM or IgG levels. Of the additional reported preparations only one, BME (2-mercaptoethanol treated), produced a weak IgM response to the oocyst wall. A mouse from the soluble oocyst extract group yielding a high IgG response was utilized to produce a highly specific IgG(1) monoclonal antibody (Cry104) specific to the oocyst surface. Comparative flow cytometric analysis indicated that Cry104 has a higher avidity and specificity to oocysts in water concentrates than other commercially available antibodies.
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Affiliation(s)
- C Weir
- BioTechnology Frontiers, North Ryde BC, New South Wales 1670, Australia.
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