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Gill C, Griffiths M, Easton A, Solomon T. Challenges for nurses in caring for patients with acute encephalitis: lack of knowledge, time and rehabilitation. Br J Nurs 2022; 31:40-45. [PMID: 35019745 DOI: 10.12968/bjon.2022.31.1.40] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
AIM To explore the experiences of registered nurses providing care to adult patients affected by encephalitis, from admission into hospital through to discharge. STUDY DESIGN A qualitative phenomenological methodology was used. Sample and setting: Eight registered nurses in a city centre teaching hospital. METHODS Data collection took place using in-depth, semi-structured interviews. Data were analysed and themes identified using framework analysis. FINDINGS Three key findings were identified: nurses felt that they lacked knowledge of encephalitis, lacked time to give these patients the care they needed, and they lacked access to rehabilitation for patients with encephalitis. CONCLUSION This study provides the first evidence on nurses' experiences of providing care to patients affected by encephalitis. It has shown that they often lack the knowledge and time to give adequate support to patients. They also lack access to rehabilitation for these patients.
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Affiliation(s)
- Claire Gill
- PhD Candidate, Department of Health Sciences, University of York
| | - Mike Griffiths
- Clinical Lecturer, Institute of Infection and Global Heath, University of Liverpool
| | - Ava Easton
- CEO Encephalitis Society, Encephalitis Society, Malton, North Yorkshire
| | - Tom Solomon
- Professor, Encephalitis Society, Malton, North Yorkshire
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2
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Adame MF, Vilas MP, Franklin H, Garzon-Garcia A, Hamilton D, Ronan M, Griffiths M. A conceptual model of nitrogen dynamics for the Great Barrier Reef catchments. Mar Pollut Bull 2021; 173:112909. [PMID: 34592504 DOI: 10.1016/j.marpolbul.2021.112909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Revised: 06/11/2021] [Accepted: 08/23/2021] [Indexed: 06/13/2023]
Abstract
Nitrogen (N) from anthropogenic sources has been identified as a major pollutant of the Great Barrier Reef (GBR), Australia. We developed a conceptual framework to synthesise and visualise the fate and transport of N from the catchments to the sea from a literature review. The framework was created to fit managers and policymakers' requirements to reduce N in the GBR catchments. We used this framework to determine the N stocks and transformations (input, sources, and outputs) for ecosystems commonly found in the GBR: rainforests, palustrine wetlands, lakes, rivers (in-stream), mangroves and seagrasses. We included transformations of N such as nitrogen fixation, nitrification, denitrification, mineralisation, anammox, sedimentation, plant uptake, and food web transfers. This model can be applied to other ecosystems to understand the transport and fate of N within and between catchments. Importantly, this approach can guide management actions that attenuate N at different scales and locations within the GBR ecosystems. Finally, when combined with local hydrological modelling, this framework can be used to predict outcomes of management activities.
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Affiliation(s)
- M F Adame
- Australian Rivers Institute, Griffith University, Nathan 4111, QLD, Australia.
| | - M P Vilas
- Department of Resources, Queensland Government, Brisbane, 4000, QLD, Australia
| | - H Franklin
- Australian Rivers Institute, Griffith University, Nathan 4111, QLD, Australia
| | - A Garzon-Garcia
- Australian Rivers Institute, Griffith University, Nathan 4111, QLD, Australia; Department of Environment and Science, Queensland Government, Brisbane, 4000, QLD, Australia
| | - D Hamilton
- Australian Rivers Institute, Griffith University, Nathan 4111, QLD, Australia
| | - M Ronan
- Department of Environment and Science, Queensland Government, Brisbane, 4000, QLD, Australia
| | - M Griffiths
- Department of Environment and Science, Queensland Government, Brisbane, 4000, QLD, Australia
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Kavehei E, Roberts ME, Cadier C, Griffiths M, Argent S, Hamilton DP, Lu J, Bayley M, Adame MF. Nitrogen processing by treatment wetlands in a tropical catchment dominated by agricultural landuse. Mar Pollut Bull 2021; 172:112800. [PMID: 34403923 DOI: 10.1016/j.marpolbul.2021.112800] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Revised: 04/23/2021] [Accepted: 07/29/2021] [Indexed: 06/13/2023]
Abstract
Agriculture is a major contributor to marine nitrogen pollution, and treatment wetlands can be a strategy to reduce it. However, few studies have assessed the potential of treatment wetlands to mitigate nitrogen pollution in tropical regions. We quantify the nitrogen removal rates of four recently constructed treatment wetlands in tropical Australia. We measured denitrification potential (Dt), the inflow-outflow of nutrients, and tested whether the environment in these tropical catchments is favourable for nitrogen removal. Dt was detected in three of the four systems with rates between 2.0 and 12.0 mg m-2 h-1; the highest rates were measured in anoxic soils (ORP -100 to 300 mV) that were rich in carbon and nitrogen (>2% and >0.2%, respectively). The highest nitrogen removal rates were measured when NO3--N concentrations were >0.4 mg L-1 and when water flows were slow. Treatment wetlands in tropical regions can deliver high removal rates of nitrogen and other pollutants when adequately managed. This strategy can reduce nutrient loads and their impacts on sensitive coastal zones such as the Great Barrier Reef.
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Affiliation(s)
- E Kavehei
- Australian Rivers Institute, Griffith University, Nathan 4111, QLD, Australia
| | - M E Roberts
- Australian Rivers Institute, Griffith University, Nathan 4111, QLD, Australia
| | - C Cadier
- Australian Rivers Institute, Griffith University, Nathan 4111, QLD, Australia
| | - M Griffiths
- Department of the Environment and Science, Queensland Government, Brisbane, QLD 4000, Australia
| | - S Argent
- Terrain Natural Resource Management, Cairns 4870, QLD, Australia
| | - D P Hamilton
- Australian Rivers Institute, Griffith University, Nathan 4111, QLD, Australia
| | - J Lu
- Australian Rivers Institute, Griffith University, Nathan 4111, QLD, Australia
| | - M Bayley
- Australian Wetlands Consulting Pty Ltd, Bangalow 2479, NSW, Australia
| | - M F Adame
- Australian Rivers Institute, Griffith University, Nathan 4111, QLD, Australia.
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Sharma E, Puthussery S, Tseng PC, Li L, Harden A, Griffiths M, Bamfo J. Ethnic minority women’s interactions with antenatal care providers in Europe. Eur J Public Health 2021. [DOI: 10.1093/eurpub/ckab165.516] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Ethnic minority women are at greater risk of maternal morbidity and mortality. Antenatal care reduces risks of adverse maternal and neonatal outcomes and supports a positive transition to motherhood. Important components of quality antenatal care are interactions between women and care providers which are supportive and empowering.
Methods
We conducted a systematic review to identify and synthesise qualitative evidence on ethnic minority women's experiences of accessing antenatal care in European countries. Following a comprehensive search of 8 databases and two-step screening process, we included 27 studies from various European countries. Study findings were coded and synthesised using a ‘best-fit' framework approach.
Findings
Overall women expressed satisfaction with their antenatal care, frequently framed in relation to experiences of maternity care in countries of origin. Women highly valued interactions with antenatal care providers which were supportive and trust-inducing, and when there was continuity of carer to facilitate this. However, studies frequently showed a dichotomy between reported satisfaction with antenatal care and experiences of interactions with care providers which could be discriminatory, stigmatising and disempowering. Some women blamed themselves for negative interactions. Language barriers were frequently identified by women as a factor which hindered their communication with antenatal care providers and the subsequent quality of care received, when suitable interpreters were not available. Negative interactions with antenatal care providers could result in a withdrawal from ongoing antenatal care for some women.
Conclusions
This review highlights the importance of quality interactions between ethnic minority women and antenatal care providers. Policy implications: Antenatal care should be provided in such a way as to facilitate trust, support and effective communication between women and care providers.
Key messages
Positive interactions with care providers form an important element of quality antenatal care for ethnic minority women in Europe. Trust, support and the provision of suitable interpreters, where needed, contribute to positive interactions with antenatal care providers for ethnic minority women in Europe.
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Affiliation(s)
- E Sharma
- Maternal and Child Health Research Centre, University of Bedfordshire, Luton, UK
| | - S Puthussery
- Maternal and Child Health Research Centre, University of Bedfordshire, Luton, UK
| | - PC Tseng
- Maternal and Child Health Research Centre, University of Bedfordshire, Luton, UK
| | - L Li
- UCL Great Ormond Street Institute of Child Health, University College London, London, UK
| | - A Harden
- School of Health Sciences, City University, London, UK
| | - M Griffiths
- Department of Obstetrics and Gynaecology, Bedfordshire Hospitals NHS Foundation Trust, Luton, UK
| | - J Bamfo
- Department of Obstetrics and Gynaecology, Bedfordshire Hospitals NHS Foundation Trust, Luton, UK
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Griffiths M, Perusseau-Lambert A, Bush A, Mittapalli D. 1469 Audit of Clinical Notes Filing in Vascular Surgery. Br J Surg 2021. [DOI: 10.1093/bjs/znab259.163] [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: 11/12/2022]
Abstract
Abstract
Aim
Assess the correctness of patient's notes filing following the Royal College of Physicians, Record Keeping Standards, and the General Medical Council, Good Medical Practice, guidance: medical notes must be filed in the correct section, in a chronological order, three key identifiers on each page.
Method
Over 3 months, the general surgical wards, using case notes and those using folders for the current admission were assessed to identify loose notes. The vascular surgery patients’ notes were reviewed for the following criteria: not loose, filed in the correct section, in chronological order, and had three key identifiers.
Results
Surgical wards using case notes had 28.6% of the notes filed (n = 21) compared with 78.9% filed on wards with admission folders (n = 57). Within vascular surgery (n = 15), 13.3% had all notes filed, 20% were in chronological order, 6.7% had notes filed in the correct section, and 20% had key identifiers on every page.
Conclusions
The filing of case notes on the vascular ward resulted in loose notes more than other wards that use admission folders. To resolve this, “Admission Folders” were introduced (alongside full case notes) to assist with filing and label sheets used to assist with fast identification of current admission documents. After implementation of Admission Folders, the staff found notes easier to access and follow, according to the staff surveys, and notes were correctly filed and given identifiers, ensuring continued quality care for the patients.
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Affiliation(s)
- M Griffiths
- Derriford Hospital, Plymouth, United Kingdom
| | | | - A Bush
- Derriford Hospital, Plymouth, United Kingdom
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Griffiths M, Marshall S, Cousins F, Care A, Winship A, Hutt K. P–416 Radiotherapy inflicts long-term damage upon the uterus, causing uterine artery endothelial dysfunction and pregnancy loss in mice. Hum Reprod 2021. [DOI: 10.1093/humrep/deab130.415] [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: 11/14/2022] Open
Abstract
Abstract
Study question
Does the uterus sustain direct and long-term damage following radiotherapy, independent of ovarian damage?
Summary answer
Radiotherapy causes direct and long-term uterine damage. Ovariectomised and hormonally supplemented mice experience uterine artery endothelial dysfunction and pregnancy loss following transfer of healthy blastocysts.
What is known already
The detrimental off-target impacts of cancer therapies on the ovary are well established, with some fertility preservation techniques available to ensure patients maintain their fertility following gonadotoxic treatment. Low doses of radiotherapy kill the majority of primordial follicle oocytes in the ovary, reducing the ovarian reserve and fertile lifespan. Patients who have received radiotherapy experience higher rates of pregnancy complications including preterm birth, low birth weight, and stillbirth. However, no studies have investigated if radiation inflicts direct, fertility compromising damage to the uterus.
Study design, size, duration
Adolescent female mice were untreated or exposed to whole body y-irradiation (7Gy), then ovariectomised. Immediate damage was assessed up to 24 hours post-irradiation (n = 4/group). Four weeks following treatment, mice were hormone primed to induce endometrial receptivity (n = 7/group), artificial decidualisation (n = 7–8/group), or receive embryo transfers from healthy, unexposed donor mice to assess embryo implantation (n = 11–13/group), and mid-gestation development (n = 8–10/group).
Participants/materials, setting, methods
Four week old C57BL6/CBA (F1) female mice were used for this study. Immunofluorescence and in situ hybridisation were utilised to localise markers of immediate DNA damage and cell death following irradiation, and markers of receptivity in hormone primed uteri. Measurements of uterine artery blood flow were recorded using Doppler ultrasonography, and indices of pulsatility and resistance calculated. Uterine artery wire myography was performed to assess competency of endothelial and smooth muscle compartments following irradiation.
Main results and the role of chance
Within 24 hours of irradiation, DNA damage (yH2AX) and apoptosis (Puma/TUNEL) were elevated in uteri, compared to control. Irradiated mice that received embryo transfers from untreated donors had similar numbers of implantation sites 3-days post-transfer versus controls, however uteri were pale and atrophic suggesting impaired vascularisation. By 10-days post-transfer, implantation sites in irradiated mice were resorbing (p < 0.001), although uterine artery Doppler ultrasound measurements demonstrated no change in pulsatility or resistance indices. When the brain was shielded from irradiation to protect the hypothalamic-pituitary-gonadal axis, resorption still occurred (p < 0.001), suggesting direct uterine damage is the likely cause of pregnancy loss. To investigate uterine damage in the absence of an embryo, endometrial receptivity was induced artificially. Uteri from irradiated animals were lighter compared to control (p < 0.05), however localisation of receptivity markers (E-cadherin, Mucin1, Ki67) was normal. When decidualisation was artificially induced irradiated uteri were also lighter (p < 0.01) indicating impaired decidualisation and reduced capacity to adapt to pregnancy. Wire myography performed on uterine arteries demonstrated endothelial dysfunction in irradiated mice (p < 0.0001).
Limitations, reasons for caution
Here, only a single age and dose of radiotherapy exposure are modelled. Patients of all ages can receive many doses of radiotherapy in combination with various chemotherapies. Our highly manipulable model enables any treatment variation to be modelled and the effect on the uterus and pregnancy examined.
Wider implications of the findings: Reproductive aged cancer patients need to be appropriately counselled regarding the risks to their long-term fertility following treatment. Until now, potential permanent impacts to the uterus following cancer treatment have not been considered. It is clear radiotherapy can impose long-term damage to the uterus and influence pregnancy success and fertility.
Trial registration number
NA
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Affiliation(s)
- M Griffiths
- Biomedicine Discovery Institute- Monash University, Anatomy and Developmental Biology, Clayton, Australia
| | - S Marshall
- Monash University, Obstetrics and Gynaecology, Clayton, Australia
| | - F Cousins
- Hudson Institute of Medical Research, The Ritchie Centre, Clayton, Australia
| | - A Care
- University of Adelaide, Robinson Research Institute, Adelaide, Australia
| | - A Winship
- Biomedicine Discovery Institute- Monash University, Anatomy and Developmental Biology, Clayton, Australia
| | - K Hutt
- Biomedicine Discovery Institute- Monash University, Anatomy and Developmental Biology, Clayton, Australia
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7
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Schaffer A, Parikh SV, Toma S, Thexton N, Kcomt A, Griffiths M, Yatham LN. Expanding the target audience for management guidelines: Co-development of the patient and family guide to the CANMAT and ISBD bipolar disorder guidelines. Bipolar Disord 2021; 23:528-530. [PMID: 33934453 DOI: 10.1111/bdi.13094] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Ayal Schaffer
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Sagar V Parikh
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
| | - Simina Toma
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Natasha Thexton
- Patient and Family Advisory Council, Department of Psychiatry, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - Andrew Kcomt
- Mood Disorders Association of Ontario, Toronto, ON, Canada
| | | | - Lakshmi N Yatham
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
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Thomas A, Griffiths M, Kalakoutas A, Yates M, Sanders J. Recovery from aortic valve surgery: the trajectory of muscle mass, strength, and quality, and health-related quality of life (HRQoL). Eur J Cardiovasc Nurs 2021. [DOI: 10.1093/eurjcn/zvab060.050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: Public Institution(s). Main funding source(s): Barts Charity
OnBehalf
Queen Mary University of London (QMUL) and Barts Health NHS Trust
Background/Introduction:
The impact of intensive care unit-acquired weakness (ICUAW) is considerable and is associated with reduced physical function and impaired health-related quality of life (HRQoL). Patients’ undergoing elective cardiac surgery are known to lose significant muscle mass and strength in the first seven days after surgery, but little is known beyond that time.
Purpose
We sought to investigate the effect of cardiac surgery on ICUAW (including muscle mass, strength, muscle quality) and HRQoL (including anxiety and depression and reintegration into society) until out-patient follow-up.
Methods
Eligible patients included adults undergoing a surgical elective aortic valve replacement without any pre-existing causes of severe muscle weakness or wasting. Muscle mass was measured using ultrasound of the rectus femoris cross-sectional area (RFcsa). Muscle quality was calculated using histogram analysis, specifically pixel intensity (PI), whereby a lower value is indicative of healthier muscle tissue. Muscle strength was measured using hand-held dynamometry specifically grip strength. HRQoL (EQ5D), anxiety and depression (hospital anxiety and depression scale (HADS)) and reintegration to normal living (RNLI index) were also collected. Measurements were assessed preoperatively, at day 7 and at out-patient follow-up.
Results
Thirty-one patients were recruited, with 22 (70.9%) patients attending follow-up. Patients lost 6.5% RFcsa (p= <0.0001) in the first seven days post-surgery and 10.1% (p = 0.0014) between preoperative assessment and follow-up. Hand-held grip strength decreased significantly (10.6%, p= <0.0001) in the first seven days post-surgery, however, differing to RFcsa, recovered considerably between day 7 and follow-up (7.7%, p = 0.018). Decreased muscle quality was observed solely in the first seven days after surgery (8.3%, p = 0.0094). The EQ5D visual analogue scale and crosswalk index increased significantly from preoperative assessment to follow-up (10%, p = 0.0250; 17.6%, p = 0.022 respectively) and day 7 to follow-up (11.7%, p = 0.0311; 27.9%, p = 0.011 respectively). While depression scores significantly decreased between the same time points as the EQ5D, changes in anxiety and RNLI scores, were non-significant.
Conclusion
Patients undergoing surgical aortic valve replacements lose considerable muscle mass in hospital, failing to recover even at out-patient follow-up. Furthermore, muscle quality decreases in the first seven days after surgery in line with the acute muscle loss. However, the impact on strength is less extensive as patients appear to recover the loss by follow-up. Patients’ health scores, function index and depression scores also improve, suggesting that muscle mass is the only outcome to not recover at follow-up. Therefore, patients appear to recover well from AVR surgery even surpassing some of their preoperative results, with the exception of the RFcsa.
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Affiliation(s)
- A Thomas
- St Bartholomews and Queen Mary University, Adult Critical Care Unit (ACCU), London, United Kingdom of Great Britain & Northern Ireland
| | - M Griffiths
- Barts Health NHS Trust, Adult Critical Care Unit (ACCU), London, United Kingdom of Great Britain & Northern Ireland
| | - A Kalakoutas
- Barts and The London School of Medicine and Dentistry, London, United Kingdom of Great Britain & Northern Ireland
| | - M Yates
- Barts Health NHS Trust, Cardiac Surgery, London, United Kingdom of Great Britain & Northern Ireland
| | - J Sanders
- Barts Health NHS Trust, Director of Nursing and Allied Health Professional Research, London, United Kingdom of Great Britain & Northern Ireland
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Kankam H, Hussain A, Griffiths M. Muscle-sparing transverse rectus abdominis musculocutaneous free flap breast reconstruction following cryolipolysis. Ann R Coll Surg Engl 2021; 104:e119-e121. [PMID: 34028299 DOI: 10.1308/rcsann.2021.0180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Cryolipolysis refers to the sub-physiological cooling of regional body parts (typically the abdomen) in order to reduce the volume of adipose tissue. It provides a non-invasive alternative to procedures such as liposuction, which have traditionally been considered as relative contraindications for future abdominal free flap-based reconstructions. We describe the first case of a patient undergoing skin-sparing mastectomy and a muscle-sparing transverse rectus abdominis musculocutaneous (msTRAM) free flap breast reconstruction, following cryolipolysis therapy. Pre- and intraoperative radiological investigations and clinical examination showed no obvious adverse effect of cryolipolysis on the flap. The patient recovered well, with no vascular complications noted on follow up.
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Friebel TR, Narayan N, Ramakrishnan V, Morgan M, Cellek S, Griffiths M. Comparison of PEAK PlasmaBlade™ to conventional diathermy in abdominal-based free-flap breast reconstruction surgery-A single-centre double-blinded randomised controlled trial. J Plast Reconstr Aesthet Surg 2020; 74:1731-1742. [PMID: 33422499 DOI: 10.1016/j.bjps.2020.12.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2020] [Revised: 11/08/2020] [Accepted: 12/02/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND Electrosurgery makes dissection with simultaneous haemostasis possible. The produced heat can cause injury to the surrounding tissue. The PEAK PlasmaBlade™(PPB) is a new electrosurgery device which may overcome this by having the ability to operate on a lower temperature, therefore reducing collateral thermal damage. METHOD A single-centre, double-blinded, randomised controlled trial (RCT) was conducted which included 108 abdominal-based free-flap breast reconstruction patients who had their flap raise performed using either the PPB (n = 56) or the conventional diathermy (n = 52). Data were collected during their in-patient stay and out-patient appointments. The primary outcome value was the number of days the abdominal drains were required. RESULTS Baseline characteristics were similar between the groups, except a significantly lower flap weight in the PPB group. The median number of days the drains were required did not differ significantly (p = 0.48; 6.0 days for the diathermy and 5.0 days for the PPB). The total drain output (p = 0.68), the inflammatory cytokine in the drain fluid (p>0.054) and complications (p>0.24) did not differ significantly between the two groups. At the 2-week follow-up appointment, there was a trend towards less abdominal seromas on abdominal ultrasound (p = 0.09) in the PPB group which were significantly smaller (p = 0.04). CONCLUSION The use of the PPB did not result in a significant reduction of drain requirement, total drain output or inflammatory cytokines but did reduce the size of seroma collections at the 2-week follow-up appointment. Therefore, the use of the PPB device could reduce early seroma formation after drain removal.
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Affiliation(s)
- T R Friebel
- St. Andrews Centre for Plastics and Burns, Court Road, Broomfield, Chelmsford CM17ET, United-Kingdom; Anglia Ruskin University, Bishop Hall Ln, Chelmsford CM11SQ, United Kingdom.
| | - N Narayan
- St. Andrews Centre for Plastics and Burns, Court Road, Broomfield, Chelmsford CM17ET, United-Kingdom
| | - V Ramakrishnan
- St. Andrews Centre for Plastics and Burns, Court Road, Broomfield, Chelmsford CM17ET, United-Kingdom
| | - M Morgan
- St. Andrews Centre for Plastics and Burns, Court Road, Broomfield, Chelmsford CM17ET, United-Kingdom
| | - S Cellek
- Anglia Ruskin University, Bishop Hall Ln, Chelmsford CM11SQ, United Kingdom
| | - M Griffiths
- St. Andrews Centre for Plastics and Burns, Court Road, Broomfield, Chelmsford CM17ET, United-Kingdom
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Tilden W, Griffiths M, Cross S. Vascular bowel and mesenteric injury in blunt abdominal trauma: a single centre experience. Clin Radiol 2020; 76:213-223. [PMID: 33081991 DOI: 10.1016/j.crad.2020.09.022] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Accepted: 09/30/2020] [Indexed: 11/30/2022]
Abstract
AIM To establish common patterns of injury in vascular bowel and mesenteric injury (VBMI) and to identify any factors that may lead to delayed treatment. METHODS AND MATERIALS Forty-one patients with blunt VBMI presented to the level 1 trauma centre of the The Royal London Hospital over 5 years. Computed tomography (CT) images were reviewed to identify the specific location of injury and additional features such as seatbelt bruising and lumbar hernias. Surgical reports were reviewed to record any pertinent surgical findings at laparotomy. RESULTS The commonest mechanism of injury was a restrained car occupant involved in a road traffic collision (49%, n=20). The ileocaecal mesenteric vasculature was most frequently injured (41.5%, n=17), followed by the mid ileum (17.1%, n=7). Seatbelt bruising was identified in 80% of restrained car occupants and lumbar hernias in 22% of all patients with VBMI. CONCLUSION Restrained car occupants involved in road traffic collisions are at increased risk of VBMI with particular susceptibility of the ileocaecal mesentery. This has implications for the reporting radiologist and trauma surgeon in deciding which patients require careful monitoring for the development of delayed bowel ischaemia.
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Affiliation(s)
- W Tilden
- Department of Radiology, The Royal London Hospital, Barts Health NHS Trust, Whitechapel Road, London, E1 1FR, UK.
| | - M Griffiths
- Department of Radiology, The Royal London Hospital, Barts Health NHS Trust, Whitechapel Road, London, E1 1FR, UK
| | - S Cross
- Department of Radiology, The Royal London Hospital, Barts Health NHS Trust, Whitechapel Road, London, E1 1FR, UK
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Lopez-Fernandez O, Kuss D, Pontes H, Griffiths M. Video game addiction: Providing evidence for Internet gaming disorder through a systematic review of clinical studies. Eur Psychiatry 2020. [DOI: 10.1016/j.eurpsy.2016.01.1047] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
IntroductionThe American Psychiatric Association introduced in Internet Gaming Disorder (IGD) in the appendix as a tentative disorder in the last edition of the Diagnostic and Statistical Manual of Mental Disorders. However, currently no systematic review exists about excessive gaming viewed from a clinical perspective.Objectives and aimsTo review clinical studies on gaming addiction in order to ascertain characteristics of both clinical and research studies to provide retrospective evidence in relation with the proposed IGD classification (including criteria, measures and therapies).MethodsA systematic literature review of studies published from 1980 to 2015 has been conducted using three major psychology databases: Academic Search Complete, PsycInfo, and PsycArticles. A total of 5033 results from peer-reviewed journals were obtained, where 32 were identified as empirical clinical papers focused on gaming addiction.ResultsThe clinical research studies on gaming identified were published between 1998 and 2015, most of which included patient samples. Categorizations identified in the research papers included: (i) patients’ characteristics (e.g., socio-demographics), (ii) criteria and measures used (e.g., scales to diagnose), (iii) types of gaming problems (e.g., game genre), (iv) and treatments (e.g., type of therapy).ConclusionsFindings will be discussed against the background of the controversial IGD diagnostic criteria proposed in the DSM-5 in order to assess the extent to which previously published clinical knowledge matched the current proposal for including gaming addiction as behavioral addiction in the next diagnostic manual.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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Affiliation(s)
- M. Griffiths
- Noble Research Institute, LLC, 2510 Sam Noble Parkway, Ardmore, OK 73401, USA
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14
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Ward DG, Gordon NS, Boucher RH, Pirrie SJ, Baxter L, Ott S, Silcock L, Whalley CM, Stockton JD, Beggs AD, Griffiths M, Abbotts B, Ijakipour H, Latheef FN, Robinson RA, White AJ, James ND, Zeegers MP, Cheng KK, Bryan RT. Targeted deep sequencing of urothelial bladder cancers and associated urinary DNA: a 23-gene panel with utility for non-invasive diagnosis and risk stratification. BJU Int 2019; 124:532-544. [PMID: 31077629 PMCID: PMC6772022 DOI: 10.1111/bju.14808] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
OBJECTIVES To develop a focused panel of somatic mutations (SMs) present in the majority of urothelial bladder cancers (UBCs), to investigate the diagnostic and prognostic utility of this panel, and to compare the identification of SMs in urinary cell-pellet (cp)DNA and cell-free (cf)DNA as part of the development of a non-invasive clinical assay. PATIENTS AND METHODS A panel of SMs was validated by targeted deep-sequencing of tumour DNA from 956 patients with UBC. In addition, amplicon and capture-based targeted sequencing measured mutant allele frequencies (MAFs) of SMs in 314 urine cpDNAs and 153 urine cfDNAs. The association of SMs with grade, stage, and clinical outcomes was investigated by univariate and multivariate Cox models. Concordance between SMs detected in tumour tissue and cpDNA and cfDNA was assessed. RESULTS The panel comprised SMs in 23 genes: TERT (promoter), FGFR3, PIK3CA, TP53, ERCC2, RHOB, ERBB2, HRAS, RXRA, ELF3, CDKN1A, KRAS, KDM6A, AKT1, FBXW7, ERBB3, SF3B1, CTNNB1, BRAF, C3orf70, CREBBP, CDKN2A, and NRAS; 93.5-98.3% of UBCs of all grades and stages harboured ≥1 SM (mean: 2.5 SMs/tumour). RAS mutations were associated with better overall survival (P = 0.04). Mutations in RXRA, RHOB and TERT (promoter) were associated with shorter time to recurrence (P < 0.05). MAFs in urinary cfDNA and cpDNA were highly correlated; using a capture-based approach, >94% of tumour SMs were detected in both cpDNA and cfDNA. CONCLUSIONS SMs are reliably detected in urinary cpDNA and cfDNA. The technical capability to identify very low MAFs is essential to reliably detect UBC, regardless of the use of cpDNA or cfDNA. This 23-gene panel shows promise for the non-invasive diagnosis and risk stratification of UBC.
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Affiliation(s)
- Douglas G. Ward
- Institute of Cancer and Genomic SciencesUniversity of BirminghamBirminghamUK
| | - Naheema S. Gordon
- Institute of Cancer and Genomic SciencesUniversity of BirminghamBirminghamUK
| | - Rebecca H. Boucher
- Institute of Cancer and Genomic SciencesUniversity of BirminghamBirminghamUK
| | - Sarah J. Pirrie
- Institute of Cancer and Genomic SciencesUniversity of BirminghamBirminghamUK
| | - Laura Baxter
- Department of Computer ScienceUniversity of WarwickCoventryUK
| | - Sascha Ott
- Department of Computer ScienceUniversity of WarwickCoventryUK
| | - Lee Silcock
- Nonacus LimtedBirmingham Research ParkBirminghamUK
| | - Celina M. Whalley
- Institute of Cancer and Genomic SciencesUniversity of BirminghamBirminghamUK
| | - Joanne D. Stockton
- Institute of Cancer and Genomic SciencesUniversity of BirminghamBirminghamUK
| | - Andrew D. Beggs
- Institute of Cancer and Genomic SciencesUniversity of BirminghamBirminghamUK
| | - Mike Griffiths
- West Midlands Regional Genetics LaboratoryBirmingham Women's and Children's NHS Foundation TrustBirminghamUK
| | - Ben Abbotts
- Institute of Cancer and Genomic SciencesUniversity of BirminghamBirminghamUK
| | - Hanieh Ijakipour
- Institute of Cancer and Genomic SciencesUniversity of BirminghamBirminghamUK
| | | | - Robert A. Robinson
- Institute of Cancer and Genomic SciencesUniversity of BirminghamBirminghamUK
| | - Andrew J. White
- Institute of Cancer and Genomic SciencesUniversity of BirminghamBirminghamUK
| | - Nicholas D. James
- Institute of Cancer and Genomic SciencesUniversity of BirminghamBirminghamUK
| | - Maurice P. Zeegers
- NUTRIM School for Nutrition and Translational Research in Metabolism and CAPHRI Care and Public Health Research InstituteMaastricht UniversityMaastrichtThe Netherlands
| | - K. K. Cheng
- Institute of Applied Health ResearchUniversity of BirminghamBirminghamUK
| | - Richard T. Bryan
- Institute of Cancer and Genomic SciencesUniversity of BirminghamBirminghamUK
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15
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Kinsella FAM, Inman CF, Gudger A, Chan YT, Murray DJ, Zuo J, McIlroy G, Nagra S, Nunnick J, Holder K, Wall K, Griffiths M, Craddock C, Nikolousis E, Moss P, Malladi R. Very early lineage-specific chimerism after reduced intensity stem cell transplantation is highly predictive of clinical outcome for patients with myeloid disease. Leuk Res 2019; 83:106173. [PMID: 31276965 DOI: 10.1016/j.leukres.2019.106173] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2019] [Revised: 05/27/2019] [Accepted: 06/17/2019] [Indexed: 12/19/2022]
Abstract
BACKGROUND The importance of chimerism status in the very early period after hematopoietic stem cell transplantation is unclear. We determined PBMC and T-cell donor chimerism 50 days after transplantation and related this to disease relapse and overall survival. METHODS 144 sequential patients underwent transplantation of which 90 had AML/MDS and 54 had lymphoma. 'Full donor chimerism' was defined as ≥99% donor cells and three patient groups were defined: 40% with full donor chimerism (FC) in both PBMC and T-cells; 25% with mixed chimerism (MC) within both compartments and 35% with 'split' chimerism (SC) characterised by full donor chimerism within PBMC and mixed chimerism within T-cells. RESULTS In patients with myeloid disease a pattern of mixed chimerism (MC) was associated with a one year relapse rate of 45% and a five year overall survival of 40% compared to values of 8% and 75%, and 17% and 60%, for those with SC or FC respectively. The pattern of chimerism had no impact on clinical outcome for lymphoma. CONCLUSION The pattern of lineage-specific chimerism at 50 days after transplantation is highly predictive of clinical outcome for patients with myeloid malignancy and may help to guide subsequent clinical management.
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Affiliation(s)
- Francesca A M Kinsella
- School of Cancer Sciences, University of Birmingham, Birmingham, UK; Centre for Clinical Haematology, Queen Elizabeth NHS Foundation Trust, Birmingham, UK
| | | | - Amy Gudger
- Heartlands Hospital, Heart of England NHS Foundation trust, Birmingham, UK
| | - Yuen T Chan
- School of Cancer Sciences, University of Birmingham, Birmingham, UK
| | - Duncan J Murray
- School of Cancer Sciences, University of Birmingham, Birmingham, UK
| | - Jianmin Zuo
- School of Cancer Sciences, University of Birmingham, Birmingham, UK
| | - Graham McIlroy
- Centre for Clinical Haematology, Queen Elizabeth NHS Foundation Trust, Birmingham, UK
| | - Sandeep Nagra
- Centre for Clinical Haematology, Queen Elizabeth NHS Foundation Trust, Birmingham, UK
| | - Jane Nunnick
- Centre for Clinical Haematology, Queen Elizabeth NHS Foundation Trust, Birmingham, UK
| | - Kathy Holder
- Heartlands Hospital, Heart of England NHS Foundation trust, Birmingham, UK
| | - Kerry Wall
- West Midlands Regional Genetics Laboratory, Birmingham Women's NHS Foundation Trust, Birmingham, UK
| | - Mike Griffiths
- School of Cancer Sciences, University of Birmingham, Birmingham, UK; West Midlands Regional Genetics Laboratory, Birmingham Women's NHS Foundation Trust, Birmingham, UK
| | - Charles Craddock
- Centre for Clinical Haematology, Queen Elizabeth NHS Foundation Trust, Birmingham, UK
| | | | - Paul Moss
- School of Cancer Sciences, University of Birmingham, Birmingham, UK; Centre for Clinical Haematology, Queen Elizabeth NHS Foundation Trust, Birmingham, UK.
| | - Ram Malladi
- School of Cancer Sciences, University of Birmingham, Birmingham, UK; Centre for Clinical Haematology, Queen Elizabeth NHS Foundation Trust, Birmingham, UK
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16
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Cole S, Simpson C, Okoye R, Griffiths M, Baeten D, Shaw S, Maroof A. 064 Mucosal-associated invariant T (MAIT) cell-derived IL-17A and IL-17F production is IL-23-independent and biased towards IL-17F. J Invest Dermatol 2019. [DOI: 10.1016/j.jid.2019.03.140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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17
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Millward CP, Tonder LV, Foster M, Williams D, Griffiths M, Kneen R, Sinha A, Mallucci C. P96 Screening for cerebrovascular pathology on the basis of positive family history in the paediatric population. J Neurol Neurosurg Psychiatry 2019. [DOI: 10.1136/jnnp-2019-abn.153] [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] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
ObjectivesNeurovascular disorders are uncommon, complex conditions in children. We reviewed the screening practice and outcome of children referred to the neurovascular service on the basis of positive family history.DesignRetrospective review of prospectively maintained database.SubjectsChildren referred to the neurovascular service on the basis of family history, for screening at our hospital.MethodsWe retrospectively examined our database between July 2008 and April 2018 for the reasons for referral, family history, investigations performed, and the outcome of the screening process.Results44 children were reviewed (23 male, median age 10). Thirty-one children had an MRI/MRA brain. One child subsequently had uncomplicated digital subtraction angiography. Thirty children were referred due to a family history of subarachnoid haemorrhage, of which 17 had a single first-degree relative, and two had two first-degree relatives. Nine children were referred with a family history of arteriovenous malformation, (2 were associated with hereditary haemorrhagic telangiectasia). Five children were discussed due to a family history of non-specific haemorrhagic stroke. Seven children had a history of headache, (4 were prescribed Pizotifen for migraine). No neurovascular pathology was detected following screening within our cohort.ConclusionsA consensus screening policy does not exist but is required both to guide clinical practice and to assuage parental or patient concerns. We will survey UK paediatric centres to commence this process.
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18
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Lindsay CR, Shaw EC, Blackhall F, Blyth KG, Brenton JD, Chaturvedi A, Clarke N, Dick C, Evans TRJ, Hall G, Hanby AM, Harrison DJ, Johnston SRD, Mason MD, Morton D, Newton-Bishop J, Nicholson AG, Oien KA, Popat S, Rassl D, Sharpe R, Taniere P, Walker I, Wallace WA, West NP, Butler R, Gonzalez de Castro D, Griffiths M, Johnson PWM. Somatic cancer genetics in the UK: real-world data from phase I of the Cancer Research UK Stratified Medicine Programme. ESMO Open 2018; 3:e000408. [PMID: 30233821 PMCID: PMC6135448 DOI: 10.1136/esmoopen-2018-000408] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2018] [Revised: 05/30/2018] [Accepted: 05/31/2018] [Indexed: 11/12/2022] Open
Abstract
INTRODUCTION Phase I of the Cancer Research UK Stratified Medicine Programme (SMP1) was designed to roll out molecular pathology testing nationwide at the point of cancer diagnosis, as well as facilitate an infrastructure where surplus cancer tissue could be used for research. It offered a non-trial setting to examine common UK cancer genetics in a real-world context. METHODS A total of 26 sites in England, Wales and Scotland, recruited samples from 7814 patients for genetic examination between 2011 and 2013. Tumour types involved were breast, colorectal, lung, prostate, ovarian cancer and malignant melanoma. Centralised molecular testing of surplus material from resections or biopsies of primary/metastatic tissue was performed, with samples examined for 3-5 genetic alterations deemed to be of key interest in site-specific cancers by the National Cancer Research Institute Clinical Study groups. RESULTS 10 754 patients (98% of those approached) consented to participate, from which 7814 tumour samples were genetically analysed. In total, 53% had at least one genetic aberration detected. From 1885 patients with lung cancer, KRAS mutation was noted to be highly prevalent in adenocarcinoma (37%). In breast cancer (1873 patients), there was a striking contrast in TP53 mutation incidence between patients with ductal cancer (27.3%) and lobular cancer (3.4%). Vast inter-tumour heterogeneity of colorectal cancer (1550 patients) was observed, including myriad double and triple combinations of genetic aberrations. Significant losses of important clinical information included smoking status in lung cancer and loss of distinction between low-grade and high-grade serous ovarian cancers. CONCLUSION Nationwide molecular pathology testing in a non-trial setting is feasible. The experience with SMP1 has been used to inform ongoing CRUK flagship programmes such as the CRUK National Lung MATRIX trial and TRACERx.
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Affiliation(s)
- Colin R Lindsay
- Department of Medical Oncology, The Christie NHS Foundation Trust, Manchester, UK
- Manchester Experimental Cancer Medicine Centre, Manchester, UK
- Division of Molecular and Clinical Cancer Sciences, University of Manchester, Manchester, UK
| | - Emily C Shaw
- Cancer Research UK, London, UK
- Southampton Experimental Cancer Medicine Centre, Southampton, UK
| | - Fiona Blackhall
- Department of Medical Oncology, The Christie NHS Foundation Trust, Manchester, UK
- Manchester Experimental Cancer Medicine Centre, Manchester, UK
- Division of Molecular and Clinical Cancer Sciences, University of Manchester, Manchester, UK
| | - Kevin G Blyth
- Glasgow Experimental Cancer Medicine Centre, Glasgow, UK
- Department of Respiratory Medicine, Queen Elizabeth University Hospital, Glasgow, UK
- Institute ofInfection, Immunity and Inflammation, University of Glasgow, Glasgow, UK
| | - James D Brenton
- Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge, UK
- Cancer Research UK Cambridge Centre and Cambridge Experimental Cancer Medicine Centre, Cambridge, UK
- Addenbrooke'sHospital, Cambridge University Hospital NHS Foundation Trust, Cambridge, UK
| | - Anshuman Chaturvedi
- Department of Histopathology, University Hospital of South Manchester NHS Foundation Trust, Manchester, UK
- Christie and Salford Royal NHS Foundation Trusts, Manchester, UK
| | - Noel Clarke
- Christie and Salford Royal NHS Foundation Trusts, Manchester, UK
| | - Craig Dick
- Glasgow Experimental Cancer Medicine Centre, Glasgow, UK
- Department of Pathology, Queen Elizabeth University Hospital, Glasgow, UK
| | - Thomas R J Evans
- Glasgow Experimental Cancer Medicine Centre, Glasgow, UK
- Cancer Research UK Beatson Institute, Glasgow, UK
- Institute of Cancer Sciences, University of Glasgow, Glasgow, UK
| | - Geoff Hall
- Leeds Experimental Cancer Medicine Centre, Leeds, UK
- St James's University Hospital, Cancer Research UK Clinical Cancer Centre, Leeds, UK
| | - Andrew M Hanby
- Leeds Experimental Cancer Medicine Centre, Leeds, UK
- Department of Cellular Pathology, Leeds Teaching Hospitals NHS Trust, Leeds, UK
- School of Medicine, University of Leeds, Leeds, UK
- Department of Pathology and Tumour Biology, Leeds Institute of Cancer and Pathology, University of Leeds, Leeds, UK
| | - David J Harrison
- School of Medicine, University of St Andrews, St Andrews, UK
- Edinburgh Experimental Cancer Medicine Centre, Edinburgh, UK
| | - Stephen R D Johnston
- Department of Medical Oncology, Royal Marsden Hospital, London, UK
- Institute of Cancer Research Experimental Cancer Medicine Centre, London, UK
| | - Malcolm D Mason
- Velindre Hospital, Cardiff University, Cardiff, UK
- School of Medicine, Cardiff University, Cardiff, UK
- Cardiff Experimental Cancer Medicine Centre, Cardiff, UK
| | - Dion Morton
- Academic Department of Surgery, University of Birmingham, Birmingham, UK
- Birmingham Experimental Cancer Medicine Centre, Birmingham, UK
| | - Julia Newton-Bishop
- Leeds Experimental Cancer Medicine Centre, Leeds, UK
- Section of Biostatistics and Epidemiology, Leeds Institute of Cancer and Pathology, University of Leeds, Leeds, UK
| | - Andrew G Nicholson
- Royal Brompton and Harefield NHS Foundation Trust, London, UK
- National Heart and Lung Institute, Imperial College, London, UK
| | - Karin A Oien
- Glasgow Experimental Cancer Medicine Centre, Glasgow, UK
- Institute of Cancer Sciences, University of Glasgow, Glasgow, UK
| | - Sanjay Popat
- Institute of Cancer Research Experimental Cancer Medicine Centre, London, UK
- National Heart and Lung Institute, Imperial College, London, UK
- Lung Unit, Royal Marsden Hospital, London, UK
| | - Doris Rassl
- Cancer Research UK Cambridge Centre and Cambridge Experimental Cancer Medicine Centre, Cambridge, UK
- Department of Histopathology, Papworth Hospital, Cambridge, UK
| | | | - Phillipe Taniere
- Birmingham Experimental Cancer Medicine Centre, Birmingham, UK
- Department of Histopathology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | | | - William A Wallace
- Edinburgh Experimental Cancer Medicine Centre, Edinburgh, UK
- Department of Pathology, Laboratory Medicine, Royal Infirmary of Edinburgh, Edinburgh, UK
| | - Nicholas P West
- Leeds Experimental Cancer Medicine Centre, Leeds, UK
- Department of Pathology and Tumour Biology, Leeds Institute of Cancer and Pathology, University of Leeds, Leeds, UK
| | | | - David Gonzalez de Castro
- Genomic Medicine, School of Medicine, Dentistry and Biomedical Sciences, Queen's University, Belfast, UK
| | - Mike Griffiths
- West Midlands Regional Genetics Laboratory, Birmingham Women's NHS Foundation Trust, Birmingham, UK
| | - Peter W M Johnson
- Cancer Research UK, London, UK
- Southampton Experimental Cancer Medicine Centre, Southampton, UK
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19
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Pratt G, Yap C, Oldreive C, Slade D, Bishop R, Griffiths M, Dyer MJS, Fegan C, Oscier D, Pettitt A, Matutes E, Devereux S, Allsup D, Bloor A, Hillmen P, Follows G, Rule S, Moss P, Stankovic T. A multi-centre phase I trial of the PARP inhibitor olaparib in patients with relapsed chronic lymphocytic leukaemia, T-prolymphocytic leukaemia or mantle cell lymphoma. Br J Haematol 2018; 182:429-433. [PMID: 28643365 DOI: 10.1111/bjh.14793] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
MESH Headings
- Aged
- Ataxia Telangiectasia Mutated Proteins/genetics
- DNA Damage/genetics
- Female
- Humans
- Leukemia, Lymphocytic, Chronic, B-Cell/drug therapy
- Leukemia, Lymphocytic, Chronic, B-Cell/mortality
- Leukemia, Prolymphocytic, T-Cell/drug therapy
- Leukemia, Prolymphocytic, T-Cell/mortality
- Lymphoma, Mantle-Cell/drug therapy
- Lymphoma, Mantle-Cell/mortality
- Lymphoproliferative Disorders/drug therapy
- Lymphoproliferative Disorders/mortality
- Male
- Maximum Tolerated Dose
- Middle Aged
- Phthalazines/administration & dosage
- Phthalazines/adverse effects
- Phthalazines/therapeutic use
- Piperazines/administration & dosage
- Piperazines/adverse effects
- Piperazines/therapeutic use
- Poly(ADP-ribose) Polymerase Inhibitors/adverse effects
- Poly(ADP-ribose) Polymerase Inhibitors/therapeutic use
- Recurrence
- Survival Analysis
- Tumor Suppressor Protein p53/genetics
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Affiliation(s)
- Guy Pratt
- University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Christina Yap
- Cancer Research UK Clinical Trials Unit, University of Birmingham, Birmingham, UK
| | - Ceri Oldreive
- Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, UK
| | - Daniel Slade
- Cancer Research UK Clinical Trials Unit, University of Birmingham, Birmingham, UK
| | - Rebecca Bishop
- Cancer Research UK Clinical Trials Unit, University of Birmingham, Birmingham, UK
| | - Mike Griffiths
- West Midlands Regional Genetics Laboratory, Birmingham, UK
| | - Martin J S Dyer
- Department of Cancer Studies, University of Leicester, Leicester, UK
| | - Chris Fegan
- Cardiff and Vale University Health board, University Hospital of Wales, Cardiff, UK
| | - David Oscier
- Royal Bournemouth and Christchurch NHS Foundation Trust, Bournemouth, UK
| | - Andrew Pettitt
- The Royal Liverpool and Broadgreen University Hospitals NHS Trust, Liverpool, UK
| | | | | | | | - Adrian Bloor
- The Christie NHS Foundation Trust, Manchester, UK
| | - Peter Hillmen
- St James University Hospital, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - George Follows
- Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Simon Rule
- Plymouth Hospitals NHS Trust, Plymouth, UK
| | - Paul Moss
- University of Birmingham, Birmingham, UK
| | - Tatjana Stankovic
- Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, UK
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20
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Adan G, Griffiths M, Bonnett L, Miller A, Geretti AM, Michael B, Beeching N, McKee D, McGill F, Solomon T. PO214 Neuropsychological sequelae of viral meningitis. J Neurol Neurosurg Psychiatry 2017. [DOI: 10.1136/jnnp-2017-abn.235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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21
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Davies NJ, Kwok M, Gould C, Oldreive CE, Mao J, Parry H, Smith E, Agathanggelou A, Pratt G, Taylor AMR, Moss P, Griffiths M, Stankovic T. Dynamic changes in clonal cytogenetic architecture during progression of chronic lymphocytic leukemia in patients and patient-derived murine xenografts. Oncotarget 2017; 8:44749-44760. [PMID: 28496009 PMCID: PMC5546515 DOI: 10.18632/oncotarget.17432] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2017] [Accepted: 03/29/2017] [Indexed: 01/08/2023] Open
Abstract
Subclonal heterogeneity and clonal selection influences disease progression in chronic lymphocytic leukemia (CLL). It is therefore important that therapeutic decisions are made based on an understanding of the CLL clonal architecture and its dynamics in individual patients. Identification of cytogenetic abnormalities by FISH remains the cornerstone of contemporary clinical practice and provides a simple means for prognostic stratification. Here, we demonstrate that multiplexed-FISH can enhance recognition of CLL subclonal repertoire and its dynamics during disease progression, both in patients and CLL patient-derived xenografts (PDX). We applied a combination of patient-specific FISH probes to 24 CLL cases before treatment and at relapse, and determined putative ancestral relationships between subpopulations with different cytogenetic features. We subsequently established 7 CLL PDX models in NOD/Shi-SCID/IL-2Rγctm1sug/Jic (NOG) mice. Application of multiplexed-FISH to these models demonstrated that all of the identified cytogenetic subpopulations had leukemia propagating activity and that changes in their representation during disease progression could be spontaneous, accelerated by treatment or treatment-induced. We conclude that multiplexed-FISH in combination with PDX models have the potential to distinguish between spontaneous and treatment-induced clonal selection, and therefore provide a valuable tool for the pre-clinical evaluation of novel therapies.
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MESH Headings
- Animals
- Chromosome Aberrations
- Clonal Evolution/genetics
- Combined Modality Therapy
- Disease Models, Animal
- Disease Progression
- Female
- Heterografts
- Humans
- In Situ Hybridization, Fluorescence
- Karyotyping
- Leukemia, Lymphocytic, Chronic, B-Cell/genetics
- Leukemia, Lymphocytic, Chronic, B-Cell/mortality
- Leukemia, Lymphocytic, Chronic, B-Cell/pathology
- Leukemia, Lymphocytic, Chronic, B-Cell/therapy
- Male
- Mice
- Prognosis
- Single-Cell Analysis
- Treatment Outcome
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Affiliation(s)
- Nicholas J. Davies
- Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, UK
| | - Marwan Kwok
- Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, UK
| | - Clive Gould
- West Midlands Regional Genetics Laboratory, Birmingham Women's NHS Foundation Trust, Birmingham, UK
| | - Ceri E. Oldreive
- Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, UK
| | - Jingwen Mao
- Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, UK
| | - Helen Parry
- Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham, UK
| | - Edward Smith
- Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, UK
| | - Angelo Agathanggelou
- Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, UK
| | - Guy Pratt
- Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, UK
| | | | - Paul Moss
- Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham, UK
| | - Mike Griffiths
- Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, UK
- West Midlands Regional Genetics Laboratory, Birmingham Women's NHS Foundation Trust, Birmingham, UK
| | - Tatjana Stankovic
- Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, UK
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23
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Abstract
BACKGROUND Handwashing is viewed as the most important barrier to cross-infection. Incorrect use of clinical handwash basins may lead to cross-infection either from contaminated water or due to failure to decontaminate hands. Elbow-operated taps used correctly prevent recontamination of hands during operation. Many elbow-operated taps are installed incorrectly, with the handle flush with the back panel, making it difficult to open using the elbow. AIM To determine the effect of altering the angle of the handle of elbow-operated taps on handwashing technique. METHODS An observational study was conducted using two rooms; in one the handles of the elbow-operated taps were flush with the inspection panel behind, and in the other they were set at 35°. FINDINGS Thirty-five staff members washed their hands in both rooms. Hands were used to turn on the taps in 97% of instances. In 57% of washes hands were recontaminated when used to turn the tap off. Only six individuals consistently used their elbows to turn outlets off. Surprisingly, more individuals used their elbows to operate taps whose handles were flush with the inspection panel behind. CONCLUSION Greater emphasis needs to be placed on correct use of elbow-operated outlets. The decision to use elbow- or sensor-operated outlets is not clear-cut, as each has pros and cons. There is much room for improvement in design and standardization of handwash basins. Given the importance of handwashing it is surprising that these gaps exist.
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Affiliation(s)
- M Weinbren
- Department of Microbiology, Chesterfield Royal Hospital Foundation Trust, Calow, Derbyshire, UK.
| | - L Bree
- Department of Infection Control, Chesterfield Royal Hospital Foundation Trust, Calow, Derbyshire, UK
| | - S Sleigh
- Department of Infection Control, Chesterfield Royal Hospital Foundation Trust, Calow, Derbyshire, UK
| | - M Griffiths
- Department of Estates/Engineering, Chesterfield Royal Hospital Foundation Trust, Calow, Derbyshire, UK
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24
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Thakuria L, Romano R, Goss V, Koster G, Townsend P, Popov A, de Robertis F, Pitt T, Carby M, Simon A, Marczin N, Griffiths M, Postle A, Reed A. Surfactant Metabolism During Normothermic Ex Vivo Lung Perfusion. J Heart Lung Transplant 2017. [DOI: 10.1016/j.healun.2017.01.229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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25
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Rollins K, Noorani A, Janeckova L, Jones T, Griffiths M, Baker MP, Boyle JR. Ascorbic acid ameliorates renal injury in a murine model of contrast-induced nephropathy. BMC Nephrol 2017; 18:101. [PMID: 28340561 PMCID: PMC5366137 DOI: 10.1186/s12882-017-0498-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2016] [Accepted: 03/02/2017] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Contrast induced nephropathy (CIN) is the commonest cause of iatrogenic renal injury and its incidence has increased with the advent of complex endovascular procedures. Evidence suggests that ascorbic acid (AA) has a nephroprotective effect in percutaneous coronary interventions when contrast media are used. A variety of biomarkers (NGAL, NGAL:creatinine, mononuclear cell infiltration, apoptosis and RBP-4) in both the urine and kidney were assayed using a mouse model of CIN in order to determine whether AA can reduce the incidence and/or severity of renal injury. METHODS Twenty-four BALB/c mice were divided into 4 groups. Three groups were exposed to high doses of contrast media (omnipaque) in a well-established model of CIN, and then treated with low or high dose AA or placebo (saline). CIN severity was determined by measurement of urinary neutrophil gelatinase-associated lipocalin (NGAL):creatinine at specific time intervals. Histological analysis was performed to determine the level of mononuclear inflammatory infiltration as well as immunohistochemistry to determine apoptosis in the glomeruli by staining for activated caspase-3 and DNA nicking (TUNEL assays). Reverse transcriptase PCR (rtPCR) of mRNA transcripts prepared from mRNA extracted from mouse kidneys was also performed for both lipocalin-2 (Lcn2) encoding NGAL and retinol binding protein-6 (RBP4) genes. NGAL protein expression was also confirmed by ELISA analysis of kidney lysates. RESULTS Urinary NGAL:creatinine ratio was significantly lower at 48 h with a 44% and 62% (204.3μg/mmol versus 533.6μg/mmol, p = 0.049) reduction in the low and high dose AA groups, respectively. The reduced urinary NGAL:creatinine ratio remained low throughout the time period assessed (up to 96 h) in the high dose AA group. In support of the urinary analysis ELISA analysis of NGAL in kidney lysates also showed a 57% reduction (12,576 ng/ml versus 29,393 ng/ml) reduction in the low dose AA group. Immunohistochemistry for apoptosis demonstrated decreased TUNEL and caspase-3 expression in both low and high dose AA groups. CONCLUSIONS Ascorbic acid reduced the frequency and severity of renal injury in this murine model of CIN. Further work is required to establish whether AA can reduce the incidence of CIN in humans undergoing endovascular procedures.
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Affiliation(s)
- K. Rollins
- National Institute for Health Research Nottingham Digestive Diseases Biomedical Research Unit, Nottingham University Hospitals NHS Trust, Queen’s Medical Centre, Nottingham, UK
| | - A. Noorani
- Cambridge Vascular Unit, Addenbrookes Hospital, Cambridge, UK
| | - L. Janeckova
- Antitope Ltd, Babraham Research Campus, Cambridge, UK
| | - T. Jones
- Antitope Ltd, Babraham Research Campus, Cambridge, UK
| | - M. Griffiths
- Department of Histopathology, Addenbrookes Hospital, Cambridge, UK
| | - M. P. Baker
- Antitope Ltd, Babraham Research Campus, Cambridge, UK
| | - J. R. Boyle
- Cambridge Vascular Unit, Addenbrookes Hospital, Cambridge, UK
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Parks M, Court S, Bowns B, Cleary S, Clokie S, Hewitt J, Williams D, Cole T, MacDonald F, Griffiths M, Allen S. Non-invasive prenatal diagnosis of spinal muscular atrophy by relative haplotype dosage. Eur J Hum Genet 2017; 25:416-422. [PMID: 28120840 PMCID: PMC5386415 DOI: 10.1038/ejhg.2016.195] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2016] [Revised: 11/02/2016] [Accepted: 11/22/2016] [Indexed: 11/10/2022] Open
Abstract
Although technically possible, few clinical laboratories across the world have implemented non-invasive prenatal diagnosis (NIPD) for selected single-gene disorders, mostly owing to the elevated costs incurred. Having previously proven that NIPD for X-linked disorders can be feasibly implemented in clinical practice, we have now developed a test for the NIPD of an autosomal-recessive disorder, spinal muscular atrophy (SMA). Cell-free DNA was extracted from maternal blood and prepared for massively parallel sequencing on an Illumina MiSeq by targeted capture enrichment of single-nucleotide polymorphisms across a 6 Mb genomic window on chromosome 5 containing the SMN1 gene. Maternal, paternal and proband DNA samples were also tested for haplotyping purposes. Sequencing data was analysed by relative haplotype dosage (RHDO). Six pregnant SMA carriers and 10 healthy pregnant donors were recruited through the NIPSIGEN study. Inheritance of the maternally and paternally derived alleles of the affected SMN1 gene was determined in the foetus by RHDO analysis for autosomal-recessive disorders. DNA from the proband (for SMA carriers) or an invasively obtained foetal sample (for healthy pregnant donors) was used to identify the maternal and paternal reference haplotypes associated with the affected SMN1 gene. Results for all patients correlated with known outcomes and showed a testing specificity and sensitivity of 100%. On top of showing high accuracy and reliability throughout the stages of validation, our novel test for NIPD of SMA is also affordable and viable for implementation into clinical service.
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Affiliation(s)
- Michael Parks
- West Midlands Regional Genetics Laboratory, Birmingham Women's NHS Foundation Trust, Birmingham, UK
| | - Samantha Court
- West Midlands Regional Genetics Laboratory, Birmingham Women's NHS Foundation Trust, Birmingham, UK
| | - Benjamin Bowns
- West Midlands Regional Genetics Laboratory, Birmingham Women's NHS Foundation Trust, Birmingham, UK
| | - Siobhan Cleary
- West Midlands Regional Genetics Laboratory, Birmingham Women's NHS Foundation Trust, Birmingham, UK
| | - Samuel Clokie
- West Midlands Regional Genetics Laboratory, Birmingham Women's NHS Foundation Trust, Birmingham, UK
| | - Julie Hewitt
- West Midlands Regional Genetics Service, Birmingham Women's NHS Foundation Trust, Birmingham, UK
| | - Denise Williams
- West Midlands Regional Genetics Service, Birmingham Women's NHS Foundation Trust, Birmingham, UK
| | - Trevor Cole
- West Midlands Regional Genetics Service, Birmingham Women's NHS Foundation Trust, Birmingham, UK
| | - Fiona MacDonald
- West Midlands Regional Genetics Laboratory, Birmingham Women's NHS Foundation Trust, Birmingham, UK
| | - Mike Griffiths
- West Midlands Regional Genetics Laboratory, Birmingham Women's NHS Foundation Trust, Birmingham, UK
| | - Stephanie Allen
- West Midlands Regional Genetics Laboratory, Birmingham Women's NHS Foundation Trust, Birmingham, UK
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27
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McNamee JJ, Gillies MA, Barrett NA, Agus AM, Beale R, Bentley A, Bodenham A, Brett SJ, Brodie D, Finney SJ, Gordon AJ, Griffiths M, Harrison D, Jackson C, McDowell C, McNally C, Perkins GD, Tunnicliffe W, Vuylsteke A, Walsh TS, Wise MP, Young D, McAuley DF. pRotective vEntilation with veno-venouS lung assisT in respiratory failure: A protocol for a multicentre randomised controlled trial of extracorporeal carbon dioxide removal in patients with acute hypoxaemic respiratory failure. J Intensive Care Soc 2016; 18:159-169. [PMID: 28979565 DOI: 10.1177/1751143716681035] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
One of the few interventions to demonstrate improved outcomes for acute hypoxaemic respiratory failure is reducing tidal volumes when using mechanical ventilation, often termed lung protective ventilation. Veno-venous extracorporeal carbon dioxide removal (vv-ECCO2R) can facilitate reducing tidal volumes. pRotective vEntilation with veno-venouS lung assisT (REST) is a randomised, allocation concealed, controlled, open, multicentre pragmatic trial to determine the clinical and cost-effectiveness of lower tidal volume mechanical ventilation facilitated by vv-ECCO2R in patients with acute hypoxaemic respiratory failure. Patients requiring intubation and mechanical ventilation for acute hypoxaemic respiratory failure will be randomly allocated to receive either vv-ECCO2R and lower tidal volume mechanical ventilation or standard care with stratification by recruitment centre. There is a need for a large randomised controlled trial to establish whether vv-ECCO2R in acute hypoxaemic respiratory failure can allow the use of a more protective lung ventilation strategy and is associated with improved patient outcomes.
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Affiliation(s)
- J J McNamee
- Regional Intensive Care Unit, Royal Victoria Hospital, Belfast Health and Social Care Trust, Belfast, UK.,Centre for Experimental Medicine, School of Medicine, Dentistry and Biomedical Sciences, Wellcome Wolfson Institute for Experimental Medicine, Queens University Belfast, Belfast, UK
| | - M A Gillies
- Department of Anaesthesia, Critical Care and Pain Medicine, Royal Infirmary of Edinburgh, Edinburgh, UK.,Chief Scientists Office NHS Research Scotland, Clydebank, UK
| | - N A Barrett
- Guy's and St Thomas' NHS Foundation Trust, King's College London, UK.,King's Health Partners Academic Health Science Centre, London, UK
| | - A M Agus
- Northern Ireland Clinical Trials Unit, The Royal Hospitals, Belfast, UK
| | - R Beale
- Guy's and St Thomas' NHS Foundation Trust, King's College London, UK.,King's Health Partners Academic Health Science Centre, London, UK
| | - A Bentley
- Acute Intensive Care Unit, University Hospital of South Manchester NHS Foundation Trust, Manchester, UK.,Centre for Respiratory Medicine & Allergy, University of Manchester, UK
| | - A Bodenham
- Leeds General Infirmary, Leeds Teaching Hospitals NHS Trust, UK
| | - S J Brett
- Centre for Perioperative Medicine and Critical Care Research, Imperial College Healthcare NHS Trust, London, UK
| | - D Brodie
- Columbia College of Physicians and Surgeons, New York-Presbyterian Hospital, New York, USA
| | - S J Finney
- Adult Intensive Care Unit, Royal Brompton Hospital, London, UK
| | - A J Gordon
- Section of Anaesthetics, Pain Medicine and Intensive Care, Imperial College London, Imperial College Healthcare NHS Trust, London, UK
| | - M Griffiths
- National Heart & Lung Institute, Imperial College, London, UK.,National Institute for Health Research Respiratory Biomedical Research Unit, Royal Brompton & Harefield NHS Foundation Trust, London, UK
| | - D Harrison
- Intensive Care National Audit and Research Centre, London, UK
| | - C Jackson
- Northern Ireland Clinical Trials Unit, The Royal Hospitals, Belfast, UK
| | - C McDowell
- Northern Ireland Clinical Trials Unit, The Royal Hospitals, Belfast, UK
| | - C McNally
- Northern Ireland Clinical Trials Unit, The Royal Hospitals, Belfast, UK
| | - G D Perkins
- Warwick Clinical Trials Unit, University of Warwick, Coventry, UK.,Heart of England NHS Foundation Trust, Birmingham, UK
| | - W Tunnicliffe
- University Hospitals Birmingham NHS Foundation Trust, UK
| | - A Vuylsteke
- Papworth Hospital NHS Foundation Trust, Cambridge, UK
| | - T S Walsh
- Anaesthetics, Critical Care and Pain Medicine, School of Clinical Sciences, College of Medicine, Edinburgh University, Edinburgh, UK
| | - M P Wise
- Adult Critical Care, University Hospital of Wales, Cardiff, UK
| | - D Young
- Kadoorie Centre for Critical Care Research and Education, John Radcliffe Hospital, University of Oxford, Oxford, UK
| | - D F McAuley
- Regional Intensive Care Unit, Royal Victoria Hospital, Belfast Health and Social Care Trust, Belfast, UK.,Centre for Experimental Medicine, School of Medicine, Dentistry and Biomedical Sciences, Wellcome Wolfson Institute for Experimental Medicine, Queens University Belfast, Belfast, UK
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28
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Brindle H, Choisy M, Tran M, Doorn R, Nadjm B, Christley R, Griffiths M, Nghia H, Thwaites G, Baker S. The Vietnam Initiative on Zoonotic Infections (VIZIONs): An interim analysis of the epidemiology and aetiology of central nervous system infections. Int J Infect Dis 2016. [DOI: 10.1016/j.ijid.2016.11.052] [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: 10/20/2022] Open
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29
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Togneri FS, Ward DG, Foster JM, Devall AJ, Wojtowicz P, Alyas S, Vasques FR, Oumie A, James ND, Cheng KK, Zeegers MP, Deshmukh N, O'Sullivan B, Taniere P, Spink KG, McMullan DJ, Griffiths M, Bryan RT. Genomic complexity of urothelial bladder cancer revealed in urinary cfDNA. Eur J Hum Genet 2016; 24:1167-74. [PMID: 26757983 PMCID: PMC4970693 DOI: 10.1038/ejhg.2015.281] [Citation(s) in RCA: 95] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2015] [Revised: 11/26/2015] [Accepted: 12/08/2015] [Indexed: 11/27/2022] Open
Abstract
Urothelial bladder cancers (UBCs) have heterogeneous clinical characteristics that are mirrored in their diverse genomic profiles. Genomic profiling of UBCs has the potential to benefit routine clinical practice by providing prognostic utility above and beyond conventional clinicopathological factors, and allowing for prediction and surveillance of treatment responses. Urinary DNAs representative of the tumour genome provide a promising resource as a liquid biopsy for non-invasive genomic profiling of UBCs. We compared the genomic profiles of urinary cellular DNA and cell-free DNA (cfDNA) from the urine with matched diagnostic formalin-fixed paraffin-embedded tumour DNAs for 23 well-characterised UBC patients. Our data show urinary DNAs to be highly representative of patient tumours, allowing for detection of recurrent clinically actionable genomic aberrations. Furthermore, a greater aberrant load (indicative of tumour genome) was observed in cfDNA over cellular DNA (P<0.001), resulting in a higher analytical sensitivity for detection of clinically actionable genomic aberrations (P<0.04) when using cfDNA. Thus, cfDNA extracted from the urine of UBC patients has a higher tumour genome burden and allows greater detection of key genomic biomarkers (90%) than cellular DNA from urine (61%) and provides a promising resource for robust whole-genome tumour profiling of UBC with potential to influence clinical decisions without invasive patient interventions.
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Affiliation(s)
- Fiona S Togneri
- West Midland Regional Genetics Laboratory, Birmingham Women's NHS Foundation Trust, Birmingham, UK
| | - Douglas G Ward
- Institute of Cancer & Genomic Sciences, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
| | | | - Adam J Devall
- Institute of Cancer & Genomic Sciences, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
| | - Paula Wojtowicz
- West Midland Regional Genetics Laboratory, Birmingham Women's NHS Foundation Trust, Birmingham, UK
| | - Sofia Alyas
- West Midland Regional Genetics Laboratory, Birmingham Women's NHS Foundation Trust, Birmingham, UK
| | - Fabiana Ramos Vasques
- West Midland Regional Genetics Laboratory, Birmingham Women's NHS Foundation Trust, Birmingham, UK
| | | | | | - K K Cheng
- School of Health and Population Sciences, University of Birmingham, Birmingham, UK
| | - Maurice P Zeegers
- Department of Complex Genetics, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre, The Netherlands
| | - Nayneeta Deshmukh
- Institute of Cancer & Genomic Sciences, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
| | - Brendan O'Sullivan
- Department of Histopathology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Philippe Taniere
- Department of Histopathology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | | | - Dominic J McMullan
- West Midland Regional Genetics Laboratory, Birmingham Women's NHS Foundation Trust, Birmingham, UK
| | - Mike Griffiths
- West Midland Regional Genetics Laboratory, Birmingham Women's NHS Foundation Trust, Birmingham, UK
| | - Richard T Bryan
- Institute of Cancer & Genomic Sciences, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
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30
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Durell J, Johal N, Burge D, Wheeler R, Griffiths M, Kitteringham L, Stanton M, Manoharan S, Steinbrecher H, Malone P, Griffin SJ. Testicular atrophy following paediatric primary orchidopexy: A prospective study. J Pediatr Urol 2016; 12:243.e1-4. [PMID: 27422375 DOI: 10.1016/j.jpurol.2016.05.023] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [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: 01/20/2016] [Accepted: 05/26/2016] [Indexed: 10/21/2022]
Abstract
BACKGROUND With the Nordic consensus statement advocating orchidopexy at an earlier age, the present study sought to investigate the outcomes of primary paediatric orchidopexy at a tertiary UK centre. OBJECTIVE To prospectively assess testicular atrophy following primary orchidopexy for undescended testes in a paediatric population. Secondary outcomes were complication rates and whether outcomes were dependent on grade of operating surgeon. STUDY DESIGN Prospective data regarding age at operation, classification of the undescended testis, length of follow-up, and subjective comparison of intraoperative and postoperative testicular volumes compared with the contralateral testis were collected. Testicular atrophy was defined as >50% loss of testicular volume or a postoperative testicular volume <25% of the volume of the contralateral testis. Patients were excluded for incomplete data and follow-up <6 months. RESULTS Data for 234 patients were analysed. Testicular atrophy occurred in 2.6% of cases. There was no reported testicular re-ascent. All secondary acquired cases underwent a previous ipsilateral hernia repair. There was no significant difference in outcomes comparing the grade of surgeon (consultant n = 8, trainee/staff-grade surgeon n = 7-8). There was a trend towards postoperative catch-up growth in approximately one fifth of cases. DISCUSSION Previous studies have reported a testicular atrophy rate of 5%. The present study reported a similar rate of 2.6%. In agreement with a previous publication, it was also found that testicular atrophy was not dependent on the grade of operating surgeon. The mechanism for testicular catch-up growth is not well understood. Animal studies have supported the hypothesis that increased temperature has a detrimental effect on testicular volume. However, follow-up in the present cohort was short (median 6.9 months), making interpretation of this finding difficult. It is acknowledged that clinical palpation alone to determine testicular volume potentially introduces intra-observer and inter-observer error. However, prospective studies using ultrasound to determine testicular volumes following orchidopexy have reported catch-up growth. CONCLUSION This study represented one of the larger collections of prospective assessments of outcomes following primary orchidopexy. It was acknowledged that subjectively assessing testicular volume is not ideal; however, the data correlated with similar studies.
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Affiliation(s)
- J Durell
- Department of Paediatric Surgery and Urology, Southampton Children's Hospital, University Hospital Southampton, Tremona Road, Southampton, UK
| | - N Johal
- Department of Paediatric Surgery and Urology, Southampton Children's Hospital, University Hospital Southampton, Tremona Road, Southampton, UK
| | - D Burge
- Department of Paediatric Surgery and Urology, Southampton Children's Hospital, University Hospital Southampton, Tremona Road, Southampton, UK
| | - R Wheeler
- Department of Paediatric Surgery and Urology, Southampton Children's Hospital, University Hospital Southampton, Tremona Road, Southampton, UK
| | - M Griffiths
- Department of Paediatric Surgery and Urology, Southampton Children's Hospital, University Hospital Southampton, Tremona Road, Southampton, UK
| | - L Kitteringham
- Department of Paediatric Surgery and Urology, Southampton Children's Hospital, University Hospital Southampton, Tremona Road, Southampton, UK
| | - M Stanton
- Department of Paediatric Surgery and Urology, Southampton Children's Hospital, University Hospital Southampton, Tremona Road, Southampton, UK
| | - S Manoharan
- Department of Paediatric Surgery and Urology, Southampton Children's Hospital, University Hospital Southampton, Tremona Road, Southampton, UK
| | - H Steinbrecher
- Department of Paediatric Surgery and Urology, Southampton Children's Hospital, University Hospital Southampton, Tremona Road, Southampton, UK
| | - P Malone
- Department of Paediatric Surgery and Urology, Southampton Children's Hospital, University Hospital Southampton, Tremona Road, Southampton, UK
| | - S J Griffin
- Department of Paediatric Surgery and Urology, Southampton Children's Hospital, University Hospital Southampton, Tremona Road, Southampton, UK.
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31
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Quek L, Otto GW, Garnett C, Lhermitte L, Karamitros D, Stoilova B, Lau IJ, Doondeea J, Usukhbayar B, Kennedy A, Metzner M, Goardon N, Ivey A, Allen C, Gale R, Davies B, Sternberg A, Killick S, Hunter H, Cahalin P, Price A, Carr A, Griffiths M, Virgo P, Mackinnon S, Grimwade D, Freeman S, Russell N, Craddock C, Mead A, Peniket A, Porcher C, Vyas P. Genetically distinct leukemic stem cells in human CD34- acute myeloid leukemia are arrested at a hemopoietic precursor-like stage. J Exp Med 2016; 213:1513-35. [PMID: 27377587 PMCID: PMC4986529 DOI: 10.1084/jem.20151775] [Citation(s) in RCA: 99] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2015] [Accepted: 05/19/2016] [Indexed: 12/16/2022] Open
Abstract
Quek and colleagues identify human leukemic stem cells (LSCs) present in CD34− AML. In-depth characterization of the functional and clonal aspects of CD34− LSCs indicates that most are similar to myeloid precursors. Our understanding of the perturbation of normal cellular differentiation hierarchies to create tumor-propagating stem cell populations is incomplete. In human acute myeloid leukemia (AML), current models suggest transformation creates leukemic stem cell (LSC) populations arrested at a progenitor-like stage expressing cell surface CD34. We show that in ∼25% of AML, with a distinct genetic mutation pattern where >98% of cells are CD34−, there are multiple, nonhierarchically arranged CD34+ and CD34− LSC populations. Within CD34− and CD34+ LSC–containing populations, LSC frequencies are similar; there are shared clonal structures and near-identical transcriptional signatures. CD34− LSCs have disordered global transcription profiles, but these profiles are enriched for transcriptional signatures of normal CD34− mature granulocyte–macrophage precursors, downstream of progenitors. But unlike mature precursors, LSCs express multiple normal stem cell transcriptional regulators previously implicated in LSC function. This suggests a new refined model of the relationship between LSCs and normal hemopoiesis in which the nature of genetic/epigenetic changes determines the disordered transcriptional program, resulting in LSC differentiation arrest at stages that are most like either progenitor or precursor stages of hemopoiesis.
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Affiliation(s)
- Lynn Quek
- Medical Research Council, Molecular Hematology Unit, Weatherall Institute of Molecular Medicine, University of Oxford, Oxford OX1 2JD, England, UK Department of Hematology, Oxford University Hospital National Health Service Trust, Oxford OX3 9DU, England, UK
| | - Georg W Otto
- Medical Research Council, Molecular Hematology Unit, Weatherall Institute of Molecular Medicine, University of Oxford, Oxford OX1 2JD, England, UK
| | - Catherine Garnett
- Medical Research Council, Molecular Hematology Unit, Weatherall Institute of Molecular Medicine, University of Oxford, Oxford OX1 2JD, England, UK
| | - Ludovic Lhermitte
- Medical Research Council, Molecular Hematology Unit, Weatherall Institute of Molecular Medicine, University of Oxford, Oxford OX1 2JD, England, UK
| | - Dimitris Karamitros
- Medical Research Council, Molecular Hematology Unit, Weatherall Institute of Molecular Medicine, University of Oxford, Oxford OX1 2JD, England, UK
| | - Bilyana Stoilova
- Medical Research Council, Molecular Hematology Unit, Weatherall Institute of Molecular Medicine, University of Oxford, Oxford OX1 2JD, England, UK
| | - I-Jun Lau
- Medical Research Council, Molecular Hematology Unit, Weatherall Institute of Molecular Medicine, University of Oxford, Oxford OX1 2JD, England, UK Department of Hematology, Oxford University Hospital National Health Service Trust, Oxford OX3 9DU, England, UK
| | - Jessica Doondeea
- Medical Research Council, Molecular Hematology Unit, Weatherall Institute of Molecular Medicine, University of Oxford, Oxford OX1 2JD, England, UK
| | - Batchimeg Usukhbayar
- Medical Research Council, Molecular Hematology Unit, Weatherall Institute of Molecular Medicine, University of Oxford, Oxford OX1 2JD, England, UK
| | - Alison Kennedy
- Medical Research Council, Molecular Hematology Unit, Weatherall Institute of Molecular Medicine, University of Oxford, Oxford OX1 2JD, England, UK
| | - Marlen Metzner
- Medical Research Council, Molecular Hematology Unit, Weatherall Institute of Molecular Medicine, University of Oxford, Oxford OX1 2JD, England, UK
| | - Nicolas Goardon
- Medical Research Council, Molecular Hematology Unit, Weatherall Institute of Molecular Medicine, University of Oxford, Oxford OX1 2JD, England, UK
| | - Adam Ivey
- Department of Genetics, King's College London, London WC2R 2LS, England, UK
| | - Christopher Allen
- Cancer Institute, University College London, London WC1E 6BT, England, UK
| | - Rosemary Gale
- Cancer Institute, University College London, London WC1E 6BT, England, UK
| | - Benjamin Davies
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, Oxford University Hospital National Health Service Trust, Oxford OX3 9DU, England, UK
| | - Alexander Sternberg
- Department of Hematology, Great Western Hospital National Health Service Foundation Trust, Swindon SN3 6BB, England, UK
| | - Sally Killick
- Department of Hematology, Royal Bournemouth and Christchurch Hospital National Health Service Trust, Bournemouth BH7 7DW, England, UK
| | - Hannah Hunter
- Department of Hematology, Plymouth Hospitals National Health Service Trust, Plymouth PL6 8DH, England, UK
| | - Paul Cahalin
- Department of Hematology, Blackpool, Fylde and Wyre Hospitals National Health Service Trust, Blackpool FY3 8NR, England, UK
| | - Andrew Price
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, Oxford University Hospital National Health Service Trust, Oxford OX3 9DU, England, UK
| | - Andrew Carr
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, Oxford University Hospital National Health Service Trust, Oxford OX3 9DU, England, UK
| | - Mike Griffiths
- West Midlands Regional Genetics Laboratory, Birmingham B15 2TG, England, UK
| | - Paul Virgo
- Department of Immunology, North Bristol National Health Service Trust, Bristol BS10 5NB, England, UK
| | - Stephen Mackinnon
- Cancer Institute, University College London, London WC1E 6BT, England, UK Department of Hematology, University College London Hospital National Health Service Foundation Trust, London NW1 2BU, England, UK
| | - David Grimwade
- Department of Genetics, King's College London, London WC2R 2LS, England, UK
| | - Sylvie Freeman
- School of Immunity and Infection, University of Birmingham, Birmingham B15 2TT, England, UK Department of Haematology, University Hospitals Birmingham National Health Service Foundation Trust, Birmingham B15 2TH, England, UK
| | - Nigel Russell
- Centre for Clinical Hematology, Nottingham University Hospitals National Health Service Trust, Nottingham NG5 1PB, England, UK
| | - Charles Craddock
- Department of Clinical Haematology, University of Birmingham, Birmingham B15 2TT, England, UK Department of Clinical Haematology, University Hospitals Birmingham National Health Service Foundation Trust, Birmingham B15 2TH, England, UK
| | - Adam Mead
- Medical Research Council, Molecular Hematology Unit, Weatherall Institute of Molecular Medicine, University of Oxford, Oxford OX1 2JD, England, UK Department of Hematology, Oxford University Hospital National Health Service Trust, Oxford OX3 9DU, England, UK
| | - Andrew Peniket
- Department of Hematology, Oxford University Hospital National Health Service Trust, Oxford OX3 9DU, England, UK
| | - Catherine Porcher
- Medical Research Council, Molecular Hematology Unit, Weatherall Institute of Molecular Medicine, University of Oxford, Oxford OX1 2JD, England, UK
| | - Paresh Vyas
- Medical Research Council, Molecular Hematology Unit, Weatherall Institute of Molecular Medicine, University of Oxford, Oxford OX1 2JD, England, UK Department of Hematology, Oxford University Hospital National Health Service Trust, Oxford OX3 9DU, England, UK
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Parks M, Court S, Cleary S, Clokie S, Hewitt J, Williams D, Cole T, MacDonald F, Griffiths M, Allen S. Non-invasive prenatal diagnosis of Duchenne and Becker muscular dystrophies by relative haplotype dosage. Prenat Diagn 2016; 36:312-20. [PMID: 26824862 PMCID: PMC4864947 DOI: 10.1002/pd.4781] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2015] [Revised: 01/25/2016] [Accepted: 01/26/2016] [Indexed: 12/26/2022]
Abstract
OBJECTIVE Development of an accurate and affordable test for the non-invasive prenatal diagnosis of Duchenne and Becker muscular dystrophies (DMD/BMD) to implement in clinical practice. METHOD Cell-free DNA was extracted from maternal blood and prepared for massively parallel sequencing on an Illumina MiSeq by targeted capture enrichment of single nucleotide polymorphisms (SNPs) across the dystrophin gene on chromosome X. Sequencing data were analysed by relative haplotype dosage. RESULTS Seven healthy pregnant donors and two pregnant DMD carriers all bearing a male fetus were recruited through the non-invasive prenatal diagnosis for single gene disorders study. Non-invasive prenatal diagnosis testing was conducted by relative haplotype dosage analysis for X-linked disorders where the genomic DNA from the chorionic villus sampling (for healthy pregnant donors) or from the proband (for pregnant DMD carriers) was used to identify the reference haplotype. Results for all patients showed a test accuracy of 100%, when the calculated fetal fraction was >4% and correlated with known outcomes. A recombination event was also detected in a DMD patient. CONCLUSION Our new test for NIPD of DMD/BMD has been shown to be accurate and reliable during initial stages of validation. It is also feasible for implementation into clinical service.
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Affiliation(s)
- Michael Parks
- West Midlands Regional Genetics Laboratory, Birmingham Women's NHS Foundation Trust, Birmingham, UK
| | - Samantha Court
- West Midlands Regional Genetics Laboratory, Birmingham Women's NHS Foundation Trust, Birmingham, UK
| | - Siobhan Cleary
- West Midlands Regional Genetics Laboratory, Birmingham Women's NHS Foundation Trust, Birmingham, UK
| | - Samuel Clokie
- West Midlands Regional Genetics Laboratory, Birmingham Women's NHS Foundation Trust, Birmingham, UK
| | - Julie Hewitt
- West Midlands Regional Genetics Laboratory, Birmingham Women's NHS Foundation Trust, Birmingham, UK
| | - Denise Williams
- West Midlands Regional Genetics Laboratory, Birmingham Women's NHS Foundation Trust, Birmingham, UK
| | - Trevor Cole
- West Midlands Regional Genetics Laboratory, Birmingham Women's NHS Foundation Trust, Birmingham, UK
| | - Fiona MacDonald
- West Midlands Regional Genetics Laboratory, Birmingham Women's NHS Foundation Trust, Birmingham, UK
| | - Mike Griffiths
- West Midlands Regional Genetics Laboratory, Birmingham Women's NHS Foundation Trust, Birmingham, UK
| | - Stephanie Allen
- West Midlands Regional Genetics Laboratory, Birmingham Women's NHS Foundation Trust, Birmingham, UK
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Ling T, Clayton T, Crawley J, Exton L, Goulden V, Ibbotson S, McKenna K, Mohd Mustapa M, Rhodes L, Sarkany R, Dawe R, McHenry P, Hughes J, Griffiths M, McDonagh A, Buckley D, Nasr I, Swale V, Duarte Williamson C, Levell N, Leslie T, Mallon E, Wakelin S, Hunasehally P, Cork M, Ungureanu S, Donnelly J, Towers K, Saunders C, Davis R, Brain A, Exton L, Mohd Mustapa M. British Association of Dermatologists and British Photodermatology Group guidelines for the safe and effective use of psoralen–ultraviolet A therapy 2015. Br J Dermatol 2016; 174:24-55. [DOI: 10.1111/bjd.14317] [Citation(s) in RCA: 62] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/19/2015] [Indexed: 01/28/2023]
Affiliation(s)
- T.C. Ling
- Dermatology Centre Faculty of Medical and Human Sciences Salford Royal NHS Foundation Trust Salford Manchester M6 8HD U.K
| | - T.H. Clayton
- Dermatology Centre Faculty of Medical and Human Sciences Salford Royal NHS Foundation Trust Salford Manchester M6 8HD U.K
| | - J. Crawley
- Department of Dermatology University College Hospital 235 Euston Road London NW1 2BU U.K
| | - L.S. Exton
- British Association of Dermatologists Willan House 4 Fitzroy Square London W1T 5HQ U.K
| | - V. Goulden
- Department of Dermatology Leeds Teaching Hospitals NHS Trust Leeds LS7 4SA U.K
| | - S. Ibbotson
- Department of Dermatology Ninewells Hospital and Medical School University of Dundee Dundee DD1 9SY U.K
| | - K. McKenna
- Department of Dermatology Belfast City Hospital Belfast BT9 7AB U.K
| | - M.F. Mohd Mustapa
- British Association of Dermatologists Willan House 4 Fitzroy Square London W1T 5HQ U.K
| | - L.E. Rhodes
- Dermatology Research Centre Faculty of Medical and Human Sciences Salford Royal NHS Foundation Trust Salford Manchester M6 8HD U.K
| | - R. Sarkany
- Department of Dermatology University College Hospital 235 Euston Road London NW1 2BU U.K
| | - R.S. Dawe
- Department of Dermatology Ninewells Hospital and Medical School University of Dundee Dundee DD1 9SY U.K
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Parry HM, Zuo J, Frumento G, Mirajkar N, Inman C, Edwards E, Griffiths M, Pratt G, Moss P. Cytomegalovirus viral load within blood increases markedly in healthy people over the age of 70 years. Immun Ageing 2016; 13:1. [PMID: 26734066 PMCID: PMC4700608 DOI: 10.1186/s12979-015-0056-6] [Citation(s) in RCA: 67] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/14/2015] [Accepted: 12/22/2015] [Indexed: 12/13/2022]
Abstract
Background Cytomegalovirus (CMV) is a highly prevalent herpesvirus, which maintains lifelong latency and places a significant burden on host immunity. Infection is associated with increased rates of vascular disease and overall mortality in the elderly and there is an urgent need for improved understanding of the viral-host balance during ageing. CMV is extremely difficult to detect in healthy donors, however, using droplet digital PCR of DNA from peripheral blood monocytes, we obtained an absolute quantification of viral load in 44 healthy donors across a range of ages. Results Viral DNA was detected in 24 % (9/37) of donors below the age of 70 but was found in all individuals above this age. Furthermore, the mean CMV load was only 8.6 copies per 10,000 monocytes until approximately 70 years of age when it increased by almost 30 fold to 249 copies in older individuals (p < 0.0001). CMV was found within classical CD14+ monocytes and was not detectable within the CD14-CD16+ subset. The titre of CMV-specific IgG increased inexorably with age indicating that loss of humoral immunity is not a determinant of the increased viral load. In contrast, although cellular immunity to the structural late protein pp65 increased with age, the T cell response to the immediate early protein IE1 decreased in older donors. Conclusion These data reveal that effective control of CMV is impaired during healthy ageing, most probably due to loss of cellular control of early viral reactivation. This information will be of value in guiding efforts to reduce CMV-associated health complications in the elderly. Electronic supplementary material The online version of this article (doi:10.1186/s12979-015-0056-6) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Helen M Parry
- Institute of Immunology and Immunotherapy, University of Birmingham, Vincent Drive, Birmingham, B152TT UK
| | - Jianmin Zuo
- Institute of Immunology and Immunotherapy, University of Birmingham, Vincent Drive, Birmingham, B152TT UK
| | - Guido Frumento
- Institute of Immunology and Immunotherapy, University of Birmingham, Vincent Drive, Birmingham, B152TT UK
| | - Nikhil Mirajkar
- University of Birmingham Medical and Dental School, Vincent Drive, Birmingham, B15 2TT UK
| | - Charlotte Inman
- Institute of Immunology and Immunotherapy, University of Birmingham, Vincent Drive, Birmingham, B152TT UK
| | - Emma Edwards
- Institute of Immunology and Immunotherapy, University of Birmingham, Vincent Drive, Birmingham, B152TT UK ; Charles Darwin Building, Henwick Grove, University of Worcester, Worcester, WR2 6AJ UK
| | - Mike Griffiths
- West Midlands Regional Genetics Laboratories, Birmingham Women's NHS Foundation Trust, Mindelsohn Way, Edgbaston, Birmingham, B15 2TG UK
| | - Guy Pratt
- Institute of Immunology and Immunotherapy, University of Birmingham, Vincent Drive, Birmingham, B152TT UK
| | - Paul Moss
- Institute of Immunology and Immunotherapy, University of Birmingham, Vincent Drive, Birmingham, B152TT UK ; University Hospitals NHS Foundation Trust, Birmingham, UK
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Affiliation(s)
- L Khan
- Mid Essex Hospital Services NHS Trust , UK
| | - G Oni
- Mid Essex Hospital Services NHS Trust , UK
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Robinson L, Griffiths M, Wray J, Ure C, Shires G, Stein-Hodgins J, Hill C, Hilton B. Preparing women for breast screening mammography: A feasibility study to determine the potential value of an on-line social network and information hub. Radiography (Lond) 2015. [DOI: 10.1016/j.radi.2015.07.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Moseley H, Allan D, Amatiello H, Coleman A, du Peloux Menagé H, Edwards C, Exton L, Ferguson J, Garibaldinos T, Martin C, Mohd Mustapa M, McHenry P, Griffiths M, Buckley D, Nasr I, Swale V, Duarte Williamson C, Leslie T, Mallon E, Towers K, Saunders C, Brain A. Guidelines on the measurement of ultraviolet radiation levels in ultraviolet phototherapy: report issued by the British Association of Dermatologists and British Photodermatology Group 2015. Br J Dermatol 2015; 173:333-50. [DOI: 10.1111/bjd.13937] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/17/2015] [Indexed: 11/26/2022]
Affiliation(s)
- H. Moseley
- The Photobiology Unit Ninewells Hospital and Medical School Dundee DD1 9SY U.K
| | - D. Allan
- The Christie NHS Foundation Trust and University of Manchester Manchester Academic Health Science Centre Wilmslow Road Manchester M20 4BX U.K
| | - H. Amatiello
- Radiation Physics and Protection Group Churchill Hospital Old Road Headington Oxford OX3 7LJ U.K
| | - A. Coleman
- Guy's and St Thomas' NHS Foundation Trust St Thomas' Hospital Westminster Bridge Road London SE1 7EH U.K
| | - H. du Peloux Menagé
- Guy's and St Thomas' NHS Foundation Trust St Thomas' Hospital Westminster Bridge Road London SE1 7EH U.K
- Lewisham and Greenwich NHS Trust High Street London SE13 6LH U.K
| | - C. Edwards
- Royal Gwent Hospital Cardiff Road Newport NP20 2UB U.K
| | - L.S. Exton
- British Association of Dermatologists Willan House, 4 Fitzroy Square London W1T 5HQ U.K
| | - J. Ferguson
- The Photobiology Unit Ninewells Hospital and Medical School Dundee DD1 9SY U.K
| | - T. Garibaldinos
- Guy's and St Thomas' NHS Foundation Trust St Thomas' Hospital Westminster Bridge Road London SE1 7EH U.K
| | - C. Martin
- Department of Clinical Physics and Bio‐Engineering University of Glasgow Glasgow G12 8QQ U.K
| | - M.F. Mohd Mustapa
- British Association of Dermatologists Willan House, 4 Fitzroy Square London W1T 5HQ U.K
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Foster JM, Oumie A, Togneri FS, Taylor M, Alyas S, Wojtowicz P, Wood H, Tinkler-Hundal E, Southward K, McMullan D, Quirke P, Keating KE, Griffiths M, Spink KG, Brew F, Fung E, Schmidt J. Abstract 626: Cross-site reproducibility and orthogonal validation of copy number and somatic mutation calls of OncoScan® FFPE Assay Kit in solid tumors. Cancer Res 2015. [DOI: 10.1158/1538-7445.am2015-626] [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
Objectives
Copy number (CN) and somatic mutation (SM) analysis in tumors is rapidly gaining importance in cancer management as a tool for differential diagnosis, determination of prognosis, and selection of therapeutic. Genome-wide copy number and LOH detection as well as a panel of frequently tested somatic mutations can be detected with OncoScan® FFPE Assay Kit. We report on a validation study of OncoScan FFPE Assay Kit CN and SM data by orthogonal technologies (FISH and NGS, respectively) to estimate the sensitivity and specificity parameters of the platform. In addition, we assessed the reproducibility of the platform across three different sites in the UK: Leeds Institute of Cancer and Pathology (LICP), West Midlands Regional Genetics Laboratory (WMRGL), and Almac Diagnostics (Almac).
Methods
Validation of CN data was performed on a cohort of cancer samples identified as Her2 positive/ambiguous by FISH. The panel of SMs available was validated by a custom targeted amplicon NGS panel on a diverse collection of samples derived from multiple cohorts across several tumor types sourced from both LICP and WMRGL. For the reproducibility study, 162 samples encompassing six different tumor types (breast, colorectal, lung, melanoma, prostate, and ovarian) were collected from LICP and WMRGL. DNA was extracted and plated in triplicate and distributed to the three testing sites: LICP, WMRGL, and Almac. Data from all sites was analyzed for reproducibility of genome-wide CN/LOH calls and SM calls.
Results
Cross-site comparisons of genome-wide CN and LOH profiles on 162 FFPE solid tumor samples showed greater than 95% average agreement between three sites (LICP, WMGRL, and Almac), while SM classification concordance between the sites averaged 97%. Initial orthogonal validation of Her2 amplification by FISH showed greater than 90% concordance, as did initial test samples used for validating OncoScan SM calls by a targeted amplicon NGS panel.
Conclusion
In this study we validated both CN and SM calls using OncoScan FFPE Assay Kit and demonstrated a high degree of agreement with orthogonal methods in all aspects. Reproducibility of whole-genome CN, LOH, and SM data using OncoScan FFPE Assay Kit has also been demonstrated for a range of FFPE samples, including highly degraded samples. This study is a step forward in evaluating the potential clinical utility of a platform combining genome-wide copy number and somatic mutation calls within the national health service of the UK.
Citation Format: Joseph M. Foster, Assa Oumie, Fiona S. Togneri, Morag Taylor, Sofia Alyas, Paula Wojtowicz, Henry Wood, Emma Tinkler-Hundal, Katie Southward, Dominic McMullan, Phil Quirke, Katherine E. Keating, Mike Griffiths, Karen G. Spink, Fiona Brew, Eric Fung, Jeanette Schmidt. Cross-site reproducibility and orthogonal validation of copy number and somatic mutation calls of OncoScan® FFPE Assay Kit in solid tumors. [abstract]. In: Proceedings of the 106th Annual Meeting of the American Association for Cancer Research; 2015 Apr 18-22; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Res 2015;75(15 Suppl):Abstract nr 626. doi:10.1158/1538-7445.AM2015-626
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Affiliation(s)
| | - Assa Oumie
- 1Affymetrix UK Ltd, Wooburn Green, United Kingdom
| | - Fiona S. Togneri
- 2West Midlands Regional Genetics Laboratory, Birmingham, United Kingdom
| | - Morag Taylor
- 3Leeds Institute of Cancer and Pathology, Leeds, United Kingdom
| | - Sofia Alyas
- 2West Midlands Regional Genetics Laboratory, Birmingham, United Kingdom
| | - Paula Wojtowicz
- 2West Midlands Regional Genetics Laboratory, Birmingham, United Kingdom
| | - Henry Wood
- 3Leeds Institute of Cancer and Pathology, Leeds, United Kingdom
| | | | - Katie Southward
- 3Leeds Institute of Cancer and Pathology, Leeds, United Kingdom
| | - Dominic McMullan
- 2West Midlands Regional Genetics Laboratory, Birmingham, United Kingdom
| | - Phil Quirke
- 3Leeds Institute of Cancer and Pathology, Leeds, United Kingdom
| | | | - Mike Griffiths
- 2West Midlands Regional Genetics Laboratory, Birmingham, United Kingdom
| | | | - Fiona Brew
- 1Affymetrix UK Ltd, Wooburn Green, United Kingdom
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Leff DR, Ho C, Thomas H, Daniels R, Side L, Lambert F, Knight J, Griffiths M, Banwell M, Aitken J, Clayton G, Dua S, Shaw A, Smith S, Ramakrishnan V. A multidisciplinary team approach minimises prophylactic mastectomy rates. Eur J Surg Oncol 2015; 41:1005-12. [PMID: 25986853 DOI: 10.1016/j.ejso.2015.02.017] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2014] [Revised: 01/22/2015] [Accepted: 02/12/2015] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Prophylactic mastectomy (PM) has become increasingly common but is not without complications especially if accompanied by reconstructive surgery. In patients with sporadic unilateral breast cancer, contralateral PM offers no survival advantage. Multidisciplinary team (MDT) communication and interaction may facilitate shared decision-making and curtail PM rates. The aim of this study was investigate the effect of a regional MDT meeting on PM decision-making. METHODS We conducted an observational study involving retrospective review of prospectively recorded MDT meeting records for a 151 patient requests for PM from 2011 to 2014. Final MDT decisions were recorded as PM 'accepted', 'declined' or 'pending'. For MDT sanctioned requests, the factors justifying PM were recorded. Where PM was declined, justification for MDT refusal was sought and recorded. RESULTS Approximately half of all requests for PM have been upheld (53.0%) and 1/3 of requests have been declined (32.5%). Of those declined, low risk of contralateral breast cancer versus relatively high risk of systemic relapse were commonly cited as justification for PM refusal (45.7%). A proportion of patients who initiated PM discussion subsequently changed their minds (19.6%), or failed to attend clinic appointments (6.5%). Some patients were deemed medically unfit for complex reconstructive surgery (13%), or were declined on the basis of an apparent cosmetic drive for surgery (6.5%), concerns regarding depression or anxiety (2.2%) and/or if family history could not be substantiated (6.5%). DISCUSSION MDT meetings facilitate cross-specialty interrogation of requests for PM, minimise unnecessary surgery and restrict PM to those likely to derive maximum benefit.
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Affiliation(s)
- D R Leff
- The Breast Unit, Broomfield Hospital, Chelmsford, Essex, United Kingdom
| | - C Ho
- The Breast Unit, Broomfield Hospital, Chelmsford, Essex, United Kingdom
| | - H Thomas
- The Breast Unit, Broomfield Hospital, Chelmsford, Essex, United Kingdom
| | - R Daniels
- The Breast Unit, Broomfield Hospital, Chelmsford, Essex, United Kingdom
| | - L Side
- Institute for Women's Health, University College Hospitals, London, United Kingdom
| | - F Lambert
- Psychological Therapies Department, Mid Essex Hospitals Services NHS Trust, Essex, United Kingdom
| | - J Knight
- Breast Reconstruction Awareness Group, United Kingdom
| | - M Griffiths
- St Andrew's Centre for Burns and Plastic Surgery, Chelmsford, Essex, United Kingdom
| | - M Banwell
- St Andrew's Centre for Burns and Plastic Surgery, Chelmsford, Essex, United Kingdom
| | - J Aitken
- West Suffolk NHS Foundation Trust, Bury St Edmunds, Suffolk, United Kingdom
| | - G Clayton
- The Breast Unit, Mid Essex Hospitals NHS Trust, Broomfield Hospital, Chelmsford, Essex, United Kingdom
| | - S Dua
- The Breast Unit, Broomfield Hospital, Chelmsford, Essex, United Kingdom
| | - A Shaw
- St Andrew's Centre for Burns and Plastic Surgery, Chelmsford, Essex, United Kingdom
| | - S Smith
- The Breast Unit, Broomfield Hospital, Chelmsford, Essex, United Kingdom
| | - V Ramakrishnan
- St Andrew's Centre for Burns and Plastic Surgery, Chelmsford, Essex, United Kingdom.
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Trim N, Huxley E, Griffiths M, Jeffries S. 157 THE CLINICAL UTILITY OF SNP ARRAY ANALYSIS IN MYELODYSPLASTIC SYNDROME PATIENTS: RESULTS FROM A UK DIAGNOSTIC GENETIC LABORATORY USING THE AFFYMETRIX CYTOSCAN HD 2.6M SNP ARRAY. Leuk Res 2015. [DOI: 10.1016/s0145-2126(15)30158-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Annamalai AK, Powlson AS, Kandasamy N, Lodge K, Graggaber J, Halsall DJ, Antoun NM, Cheow HK, Buttery PC, George E, Griffiths M, Price SJ, Pickard JD, Sivasothy P, Gurnell M. Hypopituitarism, pulmonary infiltration and a spontaneously resolving occipital mass. QJM 2015; 108:147-9. [PMID: 22855287 DOI: 10.1093/qjmed/hcs137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- A K Annamalai
- From the Metabolic Research Laboratories, Institute of Metabolic Science, Departments of Respiratory Medicine, Clinical Biochemistry, Radiology, University of Cambridge and National Institute of Health Research Cambridge Biomedical Research Centre, Addenbrooke's Hospital, Cambridge, Department of Neurology, Department of Endocrinology, Queen Elizabeth Hospital, Kings Lynn, Histopathology and Neurosurgery, University of Cambridge and National Institute of Health Research Cambridge Biomedical Research Centre, Addenbrooke's Hospital, Cambridge, UK
| | - A S Powlson
- From the Metabolic Research Laboratories, Institute of Metabolic Science, Departments of Respiratory Medicine, Clinical Biochemistry, Radiology, University of Cambridge and National Institute of Health Research Cambridge Biomedical Research Centre, Addenbrooke's Hospital, Cambridge, Department of Neurology, Department of Endocrinology, Queen Elizabeth Hospital, Kings Lynn, Histopathology and Neurosurgery, University of Cambridge and National Institute of Health Research Cambridge Biomedical Research Centre, Addenbrooke's Hospital, Cambridge, UK
| | - N Kandasamy
- From the Metabolic Research Laboratories, Institute of Metabolic Science, Departments of Respiratory Medicine, Clinical Biochemistry, Radiology, University of Cambridge and National Institute of Health Research Cambridge Biomedical Research Centre, Addenbrooke's Hospital, Cambridge, Department of Neurology, Department of Endocrinology, Queen Elizabeth Hospital, Kings Lynn, Histopathology and Neurosurgery, University of Cambridge and National Institute of Health Research Cambridge Biomedical Research Centre, Addenbrooke's Hospital, Cambridge, UK
| | - K Lodge
- From the Metabolic Research Laboratories, Institute of Metabolic Science, Departments of Respiratory Medicine, Clinical Biochemistry, Radiology, University of Cambridge and National Institute of Health Research Cambridge Biomedical Research Centre, Addenbrooke's Hospital, Cambridge, Department of Neurology, Department of Endocrinology, Queen Elizabeth Hospital, Kings Lynn, Histopathology and Neurosurgery, University of Cambridge and National Institute of Health Research Cambridge Biomedical Research Centre, Addenbrooke's Hospital, Cambridge, UK
| | - J Graggaber
- From the Metabolic Research Laboratories, Institute of Metabolic Science, Departments of Respiratory Medicine, Clinical Biochemistry, Radiology, University of Cambridge and National Institute of Health Research Cambridge Biomedical Research Centre, Addenbrooke's Hospital, Cambridge, Department of Neurology, Department of Endocrinology, Queen Elizabeth Hospital, Kings Lynn, Histopathology and Neurosurgery, University of Cambridge and National Institute of Health Research Cambridge Biomedical Research Centre, Addenbrooke's Hospital, Cambridge, UK
| | - D J Halsall
- From the Metabolic Research Laboratories, Institute of Metabolic Science, Departments of Respiratory Medicine, Clinical Biochemistry, Radiology, University of Cambridge and National Institute of Health Research Cambridge Biomedical Research Centre, Addenbrooke's Hospital, Cambridge, Department of Neurology, Department of Endocrinology, Queen Elizabeth Hospital, Kings Lynn, Histopathology and Neurosurgery, University of Cambridge and National Institute of Health Research Cambridge Biomedical Research Centre, Addenbrooke's Hospital, Cambridge, UK
| | - N M Antoun
- From the Metabolic Research Laboratories, Institute of Metabolic Science, Departments of Respiratory Medicine, Clinical Biochemistry, Radiology, University of Cambridge and National Institute of Health Research Cambridge Biomedical Research Centre, Addenbrooke's Hospital, Cambridge, Department of Neurology, Department of Endocrinology, Queen Elizabeth Hospital, Kings Lynn, Histopathology and Neurosurgery, University of Cambridge and National Institute of Health Research Cambridge Biomedical Research Centre, Addenbrooke's Hospital, Cambridge, UK
| | - H K Cheow
- From the Metabolic Research Laboratories, Institute of Metabolic Science, Departments of Respiratory Medicine, Clinical Biochemistry, Radiology, University of Cambridge and National Institute of Health Research Cambridge Biomedical Research Centre, Addenbrooke's Hospital, Cambridge, Department of Neurology, Department of Endocrinology, Queen Elizabeth Hospital, Kings Lynn, Histopathology and Neurosurgery, University of Cambridge and National Institute of Health Research Cambridge Biomedical Research Centre, Addenbrooke's Hospital, Cambridge, UK
| | - P C Buttery
- From the Metabolic Research Laboratories, Institute of Metabolic Science, Departments of Respiratory Medicine, Clinical Biochemistry, Radiology, University of Cambridge and National Institute of Health Research Cambridge Biomedical Research Centre, Addenbrooke's Hospital, Cambridge, Department of Neurology, Department of Endocrinology, Queen Elizabeth Hospital, Kings Lynn, Histopathology and Neurosurgery, University of Cambridge and National Institute of Health Research Cambridge Biomedical Research Centre, Addenbrooke's Hospital, Cambridge, UK
| | - E George
- From the Metabolic Research Laboratories, Institute of Metabolic Science, Departments of Respiratory Medicine, Clinical Biochemistry, Radiology, University of Cambridge and National Institute of Health Research Cambridge Biomedical Research Centre, Addenbrooke's Hospital, Cambridge, Department of Neurology, Department of Endocrinology, Queen Elizabeth Hospital, Kings Lynn, Histopathology and Neurosurgery, University of Cambridge and National Institute of Health Research Cambridge Biomedical Research Centre, Addenbrooke's Hospital, Cambridge, UK
| | - M Griffiths
- From the Metabolic Research Laboratories, Institute of Metabolic Science, Departments of Respiratory Medicine, Clinical Biochemistry, Radiology, University of Cambridge and National Institute of Health Research Cambridge Biomedical Research Centre, Addenbrooke's Hospital, Cambridge, Department of Neurology, Department of Endocrinology, Queen Elizabeth Hospital, Kings Lynn, Histopathology and Neurosurgery, University of Cambridge and National Institute of Health Research Cambridge Biomedical Research Centre, Addenbrooke's Hospital, Cambridge, UK
| | - S J Price
- From the Metabolic Research Laboratories, Institute of Metabolic Science, Departments of Respiratory Medicine, Clinical Biochemistry, Radiology, University of Cambridge and National Institute of Health Research Cambridge Biomedical Research Centre, Addenbrooke's Hospital, Cambridge, Department of Neurology, Department of Endocrinology, Queen Elizabeth Hospital, Kings Lynn, Histopathology and Neurosurgery, University of Cambridge and National Institute of Health Research Cambridge Biomedical Research Centre, Addenbrooke's Hospital, Cambridge, UK
| | - J D Pickard
- From the Metabolic Research Laboratories, Institute of Metabolic Science, Departments of Respiratory Medicine, Clinical Biochemistry, Radiology, University of Cambridge and National Institute of Health Research Cambridge Biomedical Research Centre, Addenbrooke's Hospital, Cambridge, Department of Neurology, Department of Endocrinology, Queen Elizabeth Hospital, Kings Lynn, Histopathology and Neurosurgery, University of Cambridge and National Institute of Health Research Cambridge Biomedical Research Centre, Addenbrooke's Hospital, Cambridge, UK
| | - P Sivasothy
- From the Metabolic Research Laboratories, Institute of Metabolic Science, Departments of Respiratory Medicine, Clinical Biochemistry, Radiology, University of Cambridge and National Institute of Health Research Cambridge Biomedical Research Centre, Addenbrooke's Hospital, Cambridge, Department of Neurology, Department of Endocrinology, Queen Elizabeth Hospital, Kings Lynn, Histopathology and Neurosurgery, University of Cambridge and National Institute of Health Research Cambridge Biomedical Research Centre, Addenbrooke's Hospital, Cambridge, UK
| | - M Gurnell
- From the Metabolic Research Laboratories, Institute of Metabolic Science, Departments of Respiratory Medicine, Clinical Biochemistry, Radiology, University of Cambridge and National Institute of Health Research Cambridge Biomedical Research Centre, Addenbrooke's Hospital, Cambridge, Department of Neurology, Department of Endocrinology, Queen Elizabeth Hospital, Kings Lynn, Histopathology and Neurosurgery, University of Cambridge and National Institute of Health Research Cambridge Biomedical Research Centre, Addenbrooke's Hospital, Cambridge, UK
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Alchi B, Griffiths M, Sivalingam M, Jayne D, Farrington K. Predictors of renal and patient outcomes in anti-GBM disease: clinicopathologic analysis of a two-centre cohort. Nephrol Dial Transplant 2015; 30:814-21. [DOI: 10.1093/ndt/gfu399] [Citation(s) in RCA: 68] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2014] [Accepted: 12/02/2014] [Indexed: 11/13/2022] Open
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Lobban F, Dodd AL, Dagnan D, Diggle PJ, Griffiths M, Hollingsworth B, Knowles D, Long R, Mallinson S, Morriss RM, Parker R, Sawczuk AP, Jones S. Feasibility and acceptability of web-based enhanced relapse prevention for bipolar disorder (ERPonline): trial protocol. Contemp Clin Trials 2015; 41:100-9. [PMID: 25602581 DOI: 10.1016/j.cct.2015.01.004] [Citation(s) in RCA: 13] [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] [Received: 10/14/2014] [Revised: 01/09/2015] [Accepted: 01/10/2015] [Indexed: 11/30/2022]
Abstract
BACKGROUND Relapse prevention interventions for Bipolar Disorder are effective but implementation in routine clinical services is poor. Web-based approaches offer a way to offer easily accessible access to evidence based interventions at low cost, and have been shown to be effective for other mood disorders. METHODS/DESIGN This protocol describes the development and feasibility testing of the ERPonline web-based intervention using a single blind randomised controlled trial. Data will include the extent to which the site was used, detailed feedback from users about their experiences of the site, reported benefits and costs to mental health and wellbeing of users, and costs and savings to health services. We will gain an estimate of the likely effect size of ERPonline on a range of important outcomes including mood, functioning, quality of life and recovery. We will explore potential mechanisms of change, giving us a greater understanding of the underlying processes of change, and consequently how the site could be made more effective. We will be able to determine rates of recruitment and retention, and identify what factors could improve these rates. DISCUSSION The findings will be used to improve the site in accordance with user needs, and inform the design of a large scale evaluation of the clinical and cost effectiveness of ERPonline. They will further contribute to the growing evidence base for web-based interventions designed to support people with mental health problems.
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Affiliation(s)
- F Lobban
- Spectrum Centre for Mental Health Research, Lancaster University, Lancaster, UK.
| | - A L Dodd
- Spectrum Centre for Mental Health Research, Lancaster University, Lancaster, UK
| | - D Dagnan
- Cumbria Partnership NHS Foundation Trust, UK
| | - P J Diggle
- Faculty of Medicine, Lancaster University, UK; Institution for Infection and Global Health, University of Liverpool, UK
| | - M Griffiths
- Spectrum Centre for Mental Health Research, Lancaster University, Lancaster, UK
| | - B Hollingsworth
- Division of Health Research, Lancaster University, Lancaster, UK
| | - D Knowles
- Spectrum Centre for Mental Health Research, Lancaster University, Lancaster, UK
| | - R Long
- Spectrum Centre for Mental Health Research, Lancaster University, Lancaster, UK
| | | | - R M Morriss
- School of Medicine, University of Nottingham, UK
| | - R Parker
- Spectrum Centre for Mental Health Research, Lancaster University, Lancaster, UK
| | - A P Sawczuk
- Spectrum Centre for Mental Health Research, Lancaster University, Lancaster, UK
| | - S Jones
- Spectrum Centre for Mental Health Research, Lancaster University, Lancaster, UK
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44
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Alcada J, Ng-Blichfeldt J, Proudfoot A, Griffiths M, Dean C, Hind M. S98 A Novel Human Model To Study Alveolar Injury And Repair. Thorax 2014. [DOI: 10.1136/thoraxjnl-2014-206260.104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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45
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Bloch S, Lee J, Syburrah T, Rosendahl U, Kemp P, Griffiths M, Polkey M. S140 Gdf-15 Down-regulation Of Muscle Microrna Drives Increased Sensitivity To Tgf- Signalling; A Novel Mechanism In Intensive Care Unit Acquired Weakness. Thorax 2014. [DOI: 10.1136/thoraxjnl-2014-206260.146] [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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46
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Millar F, Proudfoot A, Salman D, Summers C, Morley P, Cordy J, Bayliffe A, Dean C, Griffiths M. P19 The Role Of Differential Tnfr Signalling In Maintenance Of Alveolar Epithelial Homeostasis. Thorax 2014. [DOI: 10.1136/thoraxjnl-2014-206260.169] [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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47
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Proudfoot A, Juss J, Appleby S, Morley P, Cordy J, Bayliffe A, Hind M, Chilvers E, Griffiths M, Summers C. S99 Effects Of Differential Tnf Receptor Signalling In Modulating Neutrophil-endothelial Interactions In The Pulmonary Microvasculature. Thorax 2014. [DOI: 10.1136/thoraxjnl-2014-206260.105] [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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48
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Bloch S, Syburrah T, Rosendahl U, Kemp P, Griffiths M, Polkey M. S139 A Paradoxical Rise In Rectus Femoris Myostatin (gdf-8) And Gdf-15 In Response To Neuromuscular Electrical Stimulation In Critical Care. Thorax 2014. [DOI: 10.1136/thoraxjnl-2014-206260.145] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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49
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Bradbury C, Houlton AE, Akiki S, Gregg R, Rindl M, Khan J, Ward J, Khan N, Griffiths M, Nagra S, Hills R, Burnett A, Russell N, Vyas P, Grimwade D, Craddock C, Freeman SD. Prognostic value of monitoring a candidate immunophenotypic leukaemic stem/progenitor cell population in patients allografted for acute myeloid leukaemia. Leukemia 2014; 29:988-91. [PMID: 25425198 PMCID: PMC4391965 DOI: 10.1038/leu.2014.327] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Affiliation(s)
- C Bradbury
- Centre for Clinical Haematology, Queen Elizabeth Hospital, Birmingham, UK
| | - A E Houlton
- 1] Centre for Clinical Haematology, Queen Elizabeth Hospital, Birmingham, UK [2] Cancer Research UK Clinical Trials Unit, School of Cancer Sciences, University of Birmingham, Birmingham, UK
| | - S Akiki
- West Midlands Regional Genetics Laboratory, Birmingham Women's Hospital, Birmingham, UK
| | - R Gregg
- Centre for Clinical Haematology, Queen Elizabeth Hospital, Birmingham, UK
| | - M Rindl
- West Midlands Regional Genetics Laboratory, Birmingham Women's Hospital, Birmingham, UK
| | - J Khan
- Centre for Clinical Haematology, Queen Elizabeth Hospital, Birmingham, UK
| | - J Ward
- Centre for Clinical Haematology, Queen Elizabeth Hospital, Birmingham, UK
| | - N Khan
- Department of Clinical Immunology, University of Birmingham, Birmingham, UK
| | - M Griffiths
- West Midlands Regional Genetics Laboratory, Birmingham Women's Hospital, Birmingham, UK
| | - S Nagra
- Centre for Clinical Haematology, Queen Elizabeth Hospital, Birmingham, UK
| | - R Hills
- Department of Haematology, Cardiff University, Cardiff, UK
| | - A Burnett
- Department of Haematology, Cardiff University, Cardiff, UK
| | - N Russell
- Department of Haematology, Nottingham University Hospital NHS Trust, Nottingham, UK
| | - P Vyas
- 1] MRC Molecular Haematology Unit, WIMM, University of Oxford, Oxford, UK [2] Department of Haematology, Radcliffe Hospitals NHS Trust, Oxford, UK
| | - D Grimwade
- 1] Department of Medical & Molecular Genetics, King's College London, Faculty of Life Sciences and Medicine, London, UK [2] Department of Haematology, Guy's & St. Thomas' NHS Foundation Trust, London, UK
| | - C Craddock
- 1] Centre for Clinical Haematology, Queen Elizabeth Hospital, Birmingham, UK [2] Cancer Research UK Clinical Trials Unit, School of Cancer Sciences, University of Birmingham, Birmingham, UK
| | - S D Freeman
- 1] Centre for Clinical Haematology, Queen Elizabeth Hospital, Birmingham, UK [2] Department of Clinical Immunology, University of Birmingham, Birmingham, UK
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50
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Charokopou M, Vioix H, Verheggen B, Eddowes LA, Griffiths M, Gabriel Z, Tolley K, Sibartie M. Cost-Effectiveness of Saxagliptin Compared To Glp-1 Analogues As An Add-On To Insulin in the Treatment of Type 2 Diabetes Mellitus From A Uk Health Care Perspective. Value Health 2014; 17:A347. [PMID: 27200661 DOI: 10.1016/j.jval.2014.08.711] [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] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Affiliation(s)
- M Charokopou
- Pharmerit International, Rotterdam, The Netherlands
| | - H Vioix
- AstraZeneca UK Ltd., Luton, UK
| | - B Verheggen
- Pharmerit International, Rotterdam, The Netherlands
| | - L A Eddowes
- Costello Medical Consulting Ltd., Cambridge, UK
| | | | | | - K Tolley
- Tolley Health Economics Ltd., Buxton, Derbyshire, UK
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