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Shah AM, Myhre PL, Arthur V, Dorbala P, Rasheed H, Buckley LF, Claggett B, Liu G, Ma J, Nguyen NQ, Matsushita K, Ndumele C, Tin A, Hveem K, Jonasson C, Dalen H, Boerwinkle E, Hoogeveen RC, Ballantyne C, Coresh J, Omland T, Yu B. Large scale plasma proteomics identifies novel proteins and protein networks associated with heart failure development. Nat Commun 2024; 15:528. [PMID: 38225249 PMCID: PMC10789789 DOI: 10.1038/s41467-023-44680-3] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Accepted: 12/21/2023] [Indexed: 01/17/2024] Open
Abstract
Heart failure (HF) causes substantial morbidity and mortality but its pathobiology is incompletely understood. The proteome is a promising intermediate phenotype for discovery of novel mechanisms. We measured 4877 plasma proteins in 13,900 HF-free individuals across three analysis sets with diverse age, geography, and HF ascertainment to identify circulating proteins and protein networks associated with HF development. Parallel analyses in Atherosclerosis Risk in Communities study participants in mid-life and late-life and in Trøndelag Health Study participants identified 37 proteins consistently associated with incident HF independent of traditional risk factors. Mendelian randomization supported causal effects of 10 on HF, HF risk factors, or left ventricular size and function, including matricellular (e.g. SPON1, MFAP4), senescence-associated (FSTL3, IGFBP7), and inflammatory (SVEP1, CCL15, ITIH3) proteins. Protein co-regulation network analyses identified 5 modules associated with HF risk, two of which were influenced by genetic variants that implicated trans hotspots within the VTN and CFH genes.
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Affiliation(s)
- Amil M Shah
- Division of Cardiology, University of Texas Southwestern Medical Center, Dallas, TX, USA.
- Division of Cardiovascular Medicine, Brigham and Women's Hospital, Boston, MA, USA.
| | - Peder L Myhre
- Akershus University Hospital and K.G. Jebsen Center for Cardiac Biomarkers, University of Oslo, Oslo, Norway
| | - Victoria Arthur
- Division of Cardiology, University of Texas Southwestern Medical Center, Dallas, TX, USA
- Division of Cardiovascular Medicine, Brigham and Women's Hospital, Boston, MA, USA
| | - Pranav Dorbala
- Division of Cardiovascular Medicine, Brigham and Women's Hospital, Boston, MA, USA
| | - Humaira Rasheed
- Akershus University Hospital and K.G. Jebsen Center for Cardiac Biomarkers, University of Oslo, Oslo, Norway
- K.G. Jebsen Center for Genetic Epidemiology, Department of Public Health and Nursing, NTNU, Norwegian University of Science and Technology, Trondheim, Norway
- Department of Public Health and Nursing, HUNT Research Center, Norwegian University of Science and Technology, Trondheim, Norway
| | - Leo F Buckley
- Department of Pharmacy, Brigham and Women's Hospital, Boston, MA, USA
| | - Brian Claggett
- Division of Cardiovascular Medicine, Brigham and Women's Hospital, Boston, MA, USA
| | - Guning Liu
- Department of Epidemiology, Human Genetics, and Environmental Sciences, University of Texas Health Sciences Center at Houston, Houston, TX, USA
| | - Jianzhong Ma
- Department of Epidemiology, Human Genetics, and Environmental Sciences, University of Texas Health Sciences Center at Houston, Houston, TX, USA
| | - Ngoc Quynh Nguyen
- Department of Epidemiology, Human Genetics, and Environmental Sciences, University of Texas Health Sciences Center at Houston, Houston, TX, USA
| | - Kunihiro Matsushita
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Chiadi Ndumele
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Adrienne Tin
- University of Mississippi Medical Center, Jackson, MS, USA
| | - Kristian Hveem
- Department of Public Health and Nursing, HUNT Research Center, Norwegian University of Science and Technology, Trondheim, Norway
| | - Christian Jonasson
- Department of Public Health and Nursing, HUNT Research Center, Norwegian University of Science and Technology, Trondheim, Norway
| | - Håvard Dalen
- Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway
- Clinic of Cardiology, St Olavs University Hospital, Trondheim, Norway
- Department of Internal Medicine, Levanger Hospital, Levanger, Norway
| | - Eric Boerwinkle
- Department of Epidemiology, Human Genetics, and Environmental Sciences, University of Texas Health Sciences Center at Houston, Houston, TX, USA
| | - Ron C Hoogeveen
- Division of Cardiology, Baylor College of Medicine, Houston, TX, USA
| | | | - Josef Coresh
- Departments of Medicine and Population Health, NYU Langone Health, New York, NY, USA
| | - Torbjørn Omland
- Akershus University Hospital and K.G. Jebsen Center for Cardiac Biomarkers, University of Oslo, Oslo, Norway
| | - Bing Yu
- Department of Epidemiology, Human Genetics, and Environmental Sciences, University of Texas Health Sciences Center at Houston, Houston, TX, USA
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Nguyen NQ, Yang YN, Alotaibi M, Wu H, Hoogeveen RC, Ballantyne CM, Shah AM, Long T, Jain M, Cheng S, Yu B. Abstract P329: Eicosanoids and Heart Failure Risk in the Atherosclerosis Risk in Communities (ARIC) Study. Circulation 2023. [DOI: 10.1161/circ.147.suppl_1.p329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/16/2023]
Abstract
Introduction:
Eicosanoids play an important role in regulating inflammation response, which influences the development of heart failure (HF). However, the association between eicosanoids and the risk of HF remains unclear.
Hypothesis:
We hypothesize that eicosanoid metabolites are associated with incident HF and may improve HF prediction.
Methods:
We measured plasma eicosanoids via liquid chromatography-mass spectrometry among HF-free participants at visit 2 (1990-1992) from the Atherosclerosis Risk in Communities (ARIC) study. The Cox proportional hazard regression was performed to evaluate the relationship between eicosanoids and incident HF controlling for clinical risk factors. The least absolute shrinkage and selection operator was applied to identify a representative subset of eicosanoids towards constructing an eicosanoid risk score (ERS). We further conducted genome-wide association analyses to examine the genetic determinants for HF related eicosanoids in black and white participants respectively.
Results:
During an average of 21 years of follow up, 2,202 (28.0 % blacks, 50.3% women) out of 9,519 participants developed HF. Out of 200 eicosanoids analyzed, six with hazard ratio between 0.89 to 1.10 were found associated with the risk of HF (FDR <0.05) per SD change, namely 11-dehydro-2,3-dinor-TXB2, 5-hydroperoxyicosa-6,8,11,14,17-pentaenoic acid, 13-hydroperoxyoctadeca-9,11-dienoic acid, eicosapentaenoic acid (EPA) [M-H], and EPA [M-H+Acetate]. Genetic loci were identified for six HF related eicosanoids (p<8.3e-9). One locus, rs6600888, an intronic variant of
UGT2B7
, where its T allele was associated with lower EPA [M-H+Acetate] level while positively affect the risk of HF and systolic blood pressure level. ERS constructed from 52 eicosanoids showed a 39% increase in HF risk per SD increment and twice the risk between the highest and the lowest ERS quartile (p < 0.001). The addition of ERS to the HF 10-years prediction model modestly improved the C-statistics from 0.799 to 0.808, 95%CI
ΔC
: 0.004-0.015.
Conclusion:
We identified a set of eicosanoids that significantly associated with increased risk of HF. The contributing genetic variation of eicosanoids may depict the biological pathways related to HF.
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Affiliation(s)
| | | | | | | | | | | | | | - Tao Long
- Sapient Bioanalytics, San Diego, CA
| | - Mohit Jain
- Univ. of California - San Diego, La Jolla, CA
| | | | - Bing Yu
- UNIV OF TX HEALTH SCI CTR HOUSTON, Houston, TX
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Guo S, Wang Q, Hordofa TT, Kaur P, Nguyen NQ, Maneengam A. Does COVID-19 pandemic cause natural resources commodity prices volatility? Empirical evidence from China. Resour Policy 2022; 77:102721. [PMID: 35431399 PMCID: PMC9005441 DOI: 10.1016/j.resourpol.2022.102721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 03/13/2022] [Accepted: 04/09/2022] [Indexed: 06/14/2023]
Abstract
COVID-19 pandemic caused havoc around the globe in both economic and non-economic sectors. This paper, unlike previous studies, evaluates the role of COVID-19 on the volatility in natural resources. The volatility of natural resources commodity prices has been the center of discussion, especially during the pandemic. Unlike previous studies, this study aims to evaluate the role of the pandemic, i.e., Covid-19 and its possible impact on volatility in natural resources commodity prices for China. China has been the center of this epidemic disease and is considered one of the major economies affected by the Covid-19; therefore, it is better to conduct this study for China. This study uses data from January 2020 till September 2021 to capture the peak time of Covid-19. Moreover, this study employs the novel wavelet power spectrum and wavelet coherence approach to better capture volatility within commodity prices volatility and Covid-19 and evaluate the association between both variables. The empirical results reveal that only natural resources commodity prices are volatile and only short. While Covid-19 positive cases and Covid-19 deaths are not vulnerable during the study period. Moreover, the wavelet coherence conforms that both Covid-19 positive cases and Covid-19 deaths significantly cause volatility in natural resources commodity prices. Although, volatility is found at different periods; still, volatility is observed only in the short-run. The study also provides relevant policy implications to ensure a relevant and timely solution for the existing issue. Moreover, future research guidelines and the study's limitations are also provided.
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Affiliation(s)
- Shanwen Guo
- Institute of Political Economy, Taiwan ChengKung University, Tainan, Taiwan
| | - Qibin Wang
- Institute of Political Economy, Taiwan ChengKung University, Tainan, Taiwan
| | | | - Prabjot Kaur
- Department of Mathematics, Birla Institute of Technology Mesra, Ranchi, Jharkhand, India
| | | | - Apichit Maneengam
- Department of Mechanical Engineering Technology, College of Industrial Technology, King Mongkut's University of Technology North Bangkok, Wongsawang, Bangsue, Bangkok 10800, Thailand
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LI Y, Cheng Y, Consolato F, Schiano G, Chong M, Pietzner M, Quynh Nguyen N, Scherer N, Biggs M, Kleber ME, Haug S, Göçmen B, Pigeyre M, Sekula P, Steinbrenner I, Schlosser P, Joseph C, Brody J, Grams M, Hayward C, Schultheiß UT, Kraemer B, Kronenberg F, Peters A, Seissler J, Steubl D, Then C, Wuttke M, Maerz W, Eckardt KU, Gieger C, Boerwinkle E, Psaty B, Coresh J, Oefner P, Pare G, Langenberg C, Scherberich JE, Yu B, Akilesh S, Devuyst O, Rampoldi L, Köttgen A. MO048: Genome-wide studies reveal factors associated with circulating uromodulin and its relations with complex diseases. Nephrol Dial Transplant 2022. [DOI: 10.1093/ndt/gfac062.029] [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
BACKGROUND AND AIMS
UMOD is a major risk gene for monogenic and complex forms of kidney disease. The encoded kidney-specific protein uromodulin is the most abundant protein in urine and related to chronic kidney disease, hypertension and pathogen defense. Through basolateral release from kidney epithelial cells, uromodulin also reaches the blood, where its function is largely unknown. To gain insights into potential systemic roles, we performed genome-wide screens of circulating uromodulin in seven cohorts using two complementary assays.
METHOD
Separate genome-wide association study meta-analyses for circulating uromodulin were conducted for the antibody-based assay (five cohorts, N = 13 985) and the aptamer-based SOMAscan assay (two cohorts, N = 18 070). Genome-wide significant loci were placed into their functional genomic context using RNA-seq, ATAC-seq and Hi-C data generated from primary human kidney tissue. An array of downstream genetic analyses was then performed for significant loci, including fine-mapping, colocalization analyses and gene-by-gene interaction analyses. The B4GALNT2 p.Cys466Arg allele was expressed in MDCK cells and studied by immunofluorescence and Western blotting analyses.
RESULTS
We detected and replicated 13 genome-wide significant loci (P <5e−8; 12 novel). At the UMOD locus, functional genomics data of primary human kidney tissue highlighted an upstream regulatory variant with differential accessibility and UMOD transcription in uromodulin-synthesizing kidney cells. Shared association patterns with complex traits, including chronic kidney disease and blood pressure, placed the PRKAG2 locus in the same context as UMOD. Experimental validation of another locus, B4GALNT2, showed that the detected p.Cys466Arg variant of the encoded N-acetylgalactosaminyltransferase has a loss-of-function effect leading to higher serum uromodulin levels. Lastly, our results point to enzymes writing glycan marks present on uromodulin and to their receptors in the circulation.
CONCLUSION
This study provides human genetic evidence of new pathway members of uromodulin and delivers novel insights into its determinants and systemic role in the circulation.
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Affiliation(s)
- Yong LI
- Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany
| | - Yurong Cheng
- Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany
| | | | | | | | | | - Ngoc Quynh Nguyen
- University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Nora Scherer
- Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany
| | - Mary Biggs
- University of Washington, Seattle, WA, USA
| | - Marcus E Kleber
- Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Stefan Haug
- Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany
| | - Burulça Göçmen
- Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany
| | | | - Peggy Sekula
- Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany
| | - Inga Steinbrenner
- Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany
| | - Pascal Schlosser
- Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany
| | | | | | | | | | - Ulla T Schultheiß
- Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany
| | - Bernhard Kraemer
- Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | | | - Annette Peters
- Helmholtz Zentrum München—German Research Center for Environmental Health, Neuherberg, Germany
| | | | | | | | - Matthias Wuttke
- Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany
| | - Winfried Maerz
- Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | | | - Christian Gieger
- Helmholtz Zentrum München—German Research Center for Environmental Health, Neuherberg, Germany
| | - Eric Boerwinkle
- University of Texas Health Science Center at Houston, Houston, TX, USA
| | | | | | | | | | | | | | - Bing Yu
- University of Texas Health Science Center at Houston, Houston, TX, USA
| | | | | | | | - Anna Köttgen
- Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany
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5
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Nguyen TK, Nguyen VL, Nguyen TG, Mai DH, Nguyen NQ, Vu TA, Le AN, Nguyen QH, Nguyen CT, Nguyen DT. Lung-protective mechanical ventilation for patients undergoing abdominal laparoscopic surgeries: a randomized controlled trial. BMC Anesthesiol 2021; 21:95. [PMID: 33784987 PMCID: PMC8008676 DOI: 10.1186/s12871-021-01318-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2020] [Accepted: 03/17/2021] [Indexed: 11/10/2022] Open
Abstract
Background Pneumoperitoneum and Trendelenburg position in laparoscopic surgeries could contribute to postoperative pulmonary dysfunction. In recent years, intraoperative lung-protective mechanical ventilation (LPV) has been reportedly able to attenuate ventilator-induced lung injuries (VILI). Our objectives were to test the hypothesis that LPV could improve intraoperative oxygenation function, pulmonary mechanics and early postoperative atelectasis in laparoscopic surgeries. Methods In this randomized controlled clinical trial, 62 patients indicated for elective abdominal laparoscopic surgeries with an expected duration of greater than 2 h were randomly assigned to receive either lung-protective ventilation (LPV) with a tidal volume (Vt) of 7 ml kg− 1 ideal body weight (IBW), 10 cmH2O positive end-expiratory pressure (PEEP) combined with regular recruitment maneuvers (RMs) or conventional ventilation (CV) with a Vt of 10 ml kg− 1 IBW, 0 cmH2O in PEEP and no RMs. The primary endpoints were the changes in the ratio of PaO2 to FiO2 (P/F). The secondary endpoints were the differences between the two groups in PaO2, alveolar-arterial oxygen gradient (A-aO2), intraoperative pulmonary mechanics and the incidence of atelectasis detected on chest x-ray on the first postoperative day. Results In comparison to CV group, the intraoperative P/F and PaO2 in LPV group were significantly higher while the intraoperative A-aO2 was clearly lower. Cdyn and Cstat at all the intraoperative time points in LPV group were significantly higher compared to CV group (p < 0.05). There were no differences in the incidence of atelectasis on day one after surgery between the two groups. Conclusions Lung protective mechanical ventilation significantly improved intraoperative pulmonary oxygenation function and pulmonary compliance in patients experiencing various abdominal laparoscopic surgeries, but it could not ameliorate early postoperative atelectasis and oxygenation function on the first day after surgery. Trial registration https://www.clinicaltrials.gov/identifier: NCT04546932 (09/05/2020).
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Affiliation(s)
- Trung Kien Nguyen
- Center of Emergency, Critical Care Medicine and Clinical Toxicology, 103 Military Hospital, Vietnam Military Medical University, 261 Phung Hung road, Ha Dong District, Hanoi City, Vietnam
| | - Viet Luong Nguyen
- Critical Care Unit, National Burn Hospital, Vietnam Military Medical University, Hanoi, Vietnam
| | - Truong Giang Nguyen
- Department of Cardiothoracic surgery, 103 Military Hospital, Vietnam Military Medical University, Hanoi, Vietnam
| | - Duc Hanh Mai
- Department of Anesthesia and Pain Medicine, 103 Military Hospital, Vietnam Military Medical University, Hanoi, Vietnam
| | - Ngoc Quynh Nguyen
- Department of Anesthesia and Pain Medicine, Vietnam National Cancer Hospital, Hanoi, Vietnam
| | - The Anh Vu
- Department of Anesthesia and Pain Medicine, 103 Military Hospital, Vietnam Military Medical University, Hanoi, Vietnam.
| | - Anh Nguyet Le
- Department of Urology, 103 Military Hospital, Vietnam Military Medical University, Hanoi, Vietnam
| | - Quang Huy Nguyen
- Center of Emergency, Critical Care Medicine and Clinical Toxicology, 103 Military Hospital, Vietnam Military Medical University, 261 Phung Hung road, Ha Dong District, Hanoi City, Vietnam
| | - Chi Tue Nguyen
- Center of Emergency, Critical Care Medicine and Clinical Toxicology, 103 Military Hospital, Vietnam Military Medical University, 261 Phung Hung road, Ha Dong District, Hanoi City, Vietnam
| | - Dang Thu Nguyen
- Department of Anesthesia and Pain Medicine, 103 Military Hospital, Vietnam Military Medical University, Hanoi, Vietnam
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Selvanderan SP, Goldblatt F, Nguyen NQ, Costello SP. Faecal microbiota transplantation for Clostridium difficile infection resulting in a decrease in psoriatic arthritis disease activity. Clin Exp Rheumatol 2019; 37:514-515. [PMID: 30943129] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2018] [Accepted: 02/18/2019] [Indexed: 06/09/2023]
Affiliation(s)
- Shane P Selvanderan
- Centre for Nutrition and Gastrointestinal Disease Research, The University of Adelaide and South Australian Health and Medical Research Institute, South Australia, Australia.
| | - Fiona Goldblatt
- Department of Rheumatology, Flinders Medical Centre, South Australia, Australia
| | - N Q Nguyen
- Centre for Nutrition and Gastrointestinal Disease Research, The University of Adelaide and South Australian Health and Medical Research Institute, and Department of Gastroenterology and Hepatology, Royal Adelaide Hospital, South Australia, Australia
| | - Sam P Costello
- Centre for Nutrition and Gastrointestinal Disease Research, The University of Adelaide and South Australian Health and Medical Research Institute, and Department of Gastroenterology, The Queen Elizabeth Hospital, Woodville, South Australia, Australia
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Nguyen TA, Pham T, Vu HTT, Nguyen TX, Vu TT, Nguyen BTT, Nguyen NQ, Nguyen BT, Nguyen BT, Nguyen TN, Phan SV, Nguyen AT, Pham TL, Dang HT, Kalisch-Ellett L, Gillam M, Pratt N, Qiang S, Wang H, Kanjanarach T, Hassali MAA, Babar ZUD, Razak AA, Chinwong D, Roughead EE. Use of Potentially Inappropriate Medications in People With Dementia in Vietnam and Its Associated Factors. Am J Alzheimers Dis Other Demen 2018; 33:423-432. [PMID: 29642720 PMCID: PMC10852524 DOI: 10.1177/1533317518768999] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/03/2024]
Abstract
This study examined the use of potentially inappropriate medicines that may affect cognition (PIMcog) in people with dementia and its associated factors. Medical records of all outpatients with dementia attending a tertiary hospital in Vietnam between January 1, 2015, and December 31, 2016, were examined. Medicine use was assessed against a list of PIMcog. Variables associated with having a PIMcog were assessed using a multiple logistic regression. Of the 128 patients, 41% used a PIMcog, 39.1% used cholinesterase inhibitors (CEIs) concomitantly with anticholinergics, and 18% used antipsychotics. The number of hospital visits (adjusted odds ratio [OR]: 1.08; 95% confidence interval [CI]: 1.02-1.16) and number of treating specialists (adjusted OR: 0.61; 95% CI: 0.45-0.83) were associated with PIMcog use. This study highlights a high-level use of medicines that can further impair cognition or reduce the effectiveness of CEIs in people with dementia. Efforts to improve quality use of medicines for this population are warranted.
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Affiliation(s)
- Tuan Anh Nguyen
- Quality Use of Medicines and Pharmacy Research Centre, School of Pharmacy and Medical Sciences, Sansom Institute for Health Research, University of South Australia, Adelaide, South Australia, Australia
| | - Thang Pham
- National Geriatric Hospital of Vietnam, Hanoi, Vietnam
| | | | | | - Trinh Thi Vu
- National Geriatric Hospital of Vietnam, Hanoi, Vietnam
| | | | | | | | | | | | | | | | - Tuan Le Pham
- Hanoi Medical University and Ministry of Health of Vietnam, Hanoi, Vietnam
| | - Ha Thu Dang
- Quality Use of Medicines and Pharmacy Research Centre, School of Pharmacy and Medical Sciences, Sansom Institute for Health Research, University of South Australia, Adelaide, South Australia, Australia
| | - Lisa Kalisch-Ellett
- Quality Use of Medicines and Pharmacy Research Centre, School of Pharmacy and Medical Sciences, Sansom Institute for Health Research, University of South Australia, Adelaide, South Australia, Australia
| | - Marianne Gillam
- Quality Use of Medicines and Pharmacy Research Centre, School of Pharmacy and Medical Sciences, Sansom Institute for Health Research, University of South Australia, Adelaide, South Australia, Australia
| | - Nicole Pratt
- Quality Use of Medicines and Pharmacy Research Centre, School of Pharmacy and Medical Sciences, Sansom Institute for Health Research, University of South Australia, Adelaide, South Australia, Australia
| | - Sun Qiang
- Center for Health Management and Policy, School of Health Care Management, Shandong University, Jinan, China
| | - Haipeng Wang
- Center for Health Management and Policy, School of Health Care Management, Shandong University, Jinan, China
| | | | | | | | - Asrenee Ab Razak
- Department of Psychiatry, School of Medical Sciences, Universiti Sains Malaysia, Penang, Malaysia
| | - Dujrudee Chinwong
- Department of Pharmaceutical Care, Faculty of Pharmacy, Chiang Mai University, Chiang Mai, Thailand
| | - Elizabeth E. Roughead
- Quality Use of Medicines and Pharmacy Research Centre, School of Pharmacy and Medical Sciences, Sansom Institute for Health Research, University of South Australia, Adelaide, South Australia, Australia
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8
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Summers MJ, DI Bartolomeo AE, Zaknic AV, Chapman MJ, Nguyen NQ, Zacharakis B, Rayner CK, Horowitz M, Deane AM. Endogenous amylin and glucagon-like peptide-1 concentrations are not associated with gastric emptying in critical illness. Acta Anaesthesiol Scand 2014; 58:235-42. [PMID: 24410108 DOI: 10.1111/aas.12252] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/26/2013] [Indexed: 02/05/2023]
Abstract
BACKGROUND In health, the hormones amylin and glucagon-like peptide-1 (GLP-1) slow gastric emptying (GE) and modulate glycaemia. The aims of this study were to determine amylin and GLP-1 concentrations in the critically ill and their relationship with GE, glucose absorption and glycaemia. METHODS In fasted critically ill and healthy subjects (n = 26 and 23 respectively), liquid nutrient, containing 100 mg (13) C-sodium octanoate and 3 g 3-O-methlyglucose (3-OMG), was administered via a nasogastric tube. Amylin, GLP-1, glucose and 3-OMG concentrations were measured in blood samples taken during fasting, and 30 min and 60 min after the 'meal'. Breath samples were taken to determine gastric emptying coefficient (GEC). Intolerance to intragastric feeding was defined as a gastric residual volume of ≥ 250 ml and/or vomiting within the 24 h prior to the study. RESULTS Although GE was slower (GEC: critically ill 2.8 ± 0.9 vs. health, 3.4 ± 0.2; P = 0.002), fasting blood glucose was higher (7.0 ± 1.9 vs. 5.7 ± 0.2 mmol/l; P = 0.005) and overall glucose absorption was reduced in critically ill patients (3-OMG: 9.4 ± 8.0 vs. 17.7 ± 4.9 mmol/l.60 min; P < 0.001), there were no differences in fasting or postprandial amylin concentrations. Furthermore, although fasting [1.7 (0.4-7.2) vs. 0.7 (0.3-32.0) pmol/l; P = 0.04] and postprandial [3.0 (0.4-8.5) vs. 0.8 (0.4-34.3) pmol/l; P = 0.02] GLP-1 concentrations were increased in the critically ill and were greater in feed intolerant when compared with those tolerating feed [3.7 (0.4-7.2) vs. 1.2 (0.7-4.6) pmol/l; P = 0.02], there were no relationships between GE and fasting amylin or GLP-1 concentrations. CONCLUSION In the critically ill, fasting GLP-1, but not amylin, concentrations are elevated and associated with feed intolerance. Neither amylin nor GLP-1 appears to substantially influence the rate of GE.
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Affiliation(s)
- M J Summers
- Intensive Care Unit, Level 4, Emergency Services Building, Royal Adelaide Hospital, Adelaide, Australia
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9
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Nagrial AM, Chang DK, Nguyen NQ, Johns AL, Chantrill LA, Humphris JL, Chin VT, Samra JS, Gill AJ, Pajic M, Pinese M, Colvin EK, Scarlett CJ, Chou A, Kench JG, Sutherland RL, Horvath LG, Biankin AV. Adjuvant chemotherapy in elderly patients with pancreatic cancer. Br J Cancer 2014; 110:313-9. [PMID: 24263063 PMCID: PMC3899761 DOI: 10.1038/bjc.2013.722] [Citation(s) in RCA: 59] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2013] [Revised: 10/09/2013] [Accepted: 10/21/2013] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Adjuvant chemotherapy improves survival for patients with resected pancreatic cancer. Elderly patients are under-represented in Phase III clinical trials, and as a consequence the efficacy of adjuvant therapy in older patients with pancreatic cancer is not clear. We aimed to assess the use and efficacy of adjuvant chemotherapy in older patients with pancreatic cancer. METHODS We assessed a community cohort of 439 patients with a diagnosis of pancreatic ductal adenocarcinoma who underwent operative resection in centres associated with the Australian Pancreatic Cancer Genome Initiative. RESULTS The median age of the cohort was 67 years. Overall only 47% of all patients received adjuvant therapy. Patients who received adjuvant chemotherapy were predominantly younger, had later stage disease, more lymph node involvement and more evidence of perineural invasion than the group that did not receive adjuvant treatment. Overall, adjuvant chemotherapy was associated with prolonged survival (median 22.1 vs 15.8 months; P<0.0001). Older patients (aged ≥70) were less likely to receive adjuvant chemotherapy (51.5% vs 29.8%; P<0.0001). Older patients had a particularly poor outcome when adjuvant therapy was not delivered (median survival=13.1 months; HR 1.89, 95% CI: 1.27-2.78, P=0.002). CONCLUSION Patients aged ≥70 are less likely to receive adjuvant therapy although it is associated with improved outcome. Increased use of adjuvant therapy in older individuals is encouraged as they constitute a large proportion of patients with pancreatic cancer.
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Affiliation(s)
- A M Nagrial
- The Kinghorn Cancer Centre, and the Cancer Research Program, Garvan Institute of Medical Research, 384 Victoria Street, Darlinghurst, Sydney NSW 2010, Australia
| | - D K Chang
- The Kinghorn Cancer Centre, and the Cancer Research Program, Garvan Institute of Medical Research, 384 Victoria Street, Darlinghurst, Sydney NSW 2010, Australia
- Department of Surgery, Bankstown Hospital, Eldridge Road, Bankstown, Sydney NSW 2200, Australia
- South Western Sydney Clinical School, Faculty of Medicine, University of NSW, Liverpool NSW 2170, Australia
- Wolfson Wohl Cancer Research Centre, Institute of Cancer Sciences, University of Glasgow, Garscube Estate, Switchback Road, Glasgow G61 1BD, Scotland, UK
| | - N Q Nguyen
- The Kinghorn Cancer Centre, and the Cancer Research Program, Garvan Institute of Medical Research, 384 Victoria Street, Darlinghurst, Sydney NSW 2010, Australia
| | - A L Johns
- The Kinghorn Cancer Centre, and the Cancer Research Program, Garvan Institute of Medical Research, 384 Victoria Street, Darlinghurst, Sydney NSW 2010, Australia
| | - L A Chantrill
- The Kinghorn Cancer Centre, and the Cancer Research Program, Garvan Institute of Medical Research, 384 Victoria Street, Darlinghurst, Sydney NSW 2010, Australia
- Macarthur Cancer Therapy Centre, Campbelltown, NSW 2560, Australia
| | - J L Humphris
- The Kinghorn Cancer Centre, and the Cancer Research Program, Garvan Institute of Medical Research, 384 Victoria Street, Darlinghurst, Sydney NSW 2010, Australia
| | - V T Chin
- The Kinghorn Cancer Centre, and the Cancer Research Program, Garvan Institute of Medical Research, 384 Victoria Street, Darlinghurst, Sydney NSW 2010, Australia
| | - J S Samra
- Department of Surgery, Royal North Shore Hospital, St Leonards, Sydney, NSW 2065, Australia
| | - A J Gill
- Department of Anatomical Pathology, Royal North Shore Hospital, St Leonards, Sydney, NSW 2065, Australia
- Sydney Medical School, University of Sydney, Sydney, NSW 2006; Australia
| | - M Pajic
- The Kinghorn Cancer Centre, and the Cancer Research Program, Garvan Institute of Medical Research, 384 Victoria Street, Darlinghurst, Sydney NSW 2010, Australia
| | - Australian Pancreatic Cancer Genome Initiative
- The Kinghorn Cancer Centre, and the Cancer Research Program, Garvan Institute of Medical Research, 384 Victoria Street, Darlinghurst, Sydney NSW 2010, Australia
- Department of Surgery, Bankstown Hospital, Eldridge Road, Bankstown, Sydney NSW 2200, Australia
- South Western Sydney Clinical School, Faculty of Medicine, University of NSW, Liverpool NSW 2170, Australia
- Wolfson Wohl Cancer Research Centre, Institute of Cancer Sciences, University of Glasgow, Garscube Estate, Switchback Road, Glasgow G61 1BD, Scotland, UK
- Macarthur Cancer Therapy Centre, Campbelltown, NSW 2560, Australia
- Department of Surgery, Royal North Shore Hospital, St Leonards, Sydney, NSW 2065, Australia
- Department of Anatomical Pathology, Royal North Shore Hospital, St Leonards, Sydney, NSW 2065, Australia
- Sydney Medical School, University of Sydney, Sydney, NSW 2006; Australia
- School of Environmental and Life Sciences, University of Newcastle, Ourimbah, NSW 2258, Australia
- Department of Anatomical Pathology, St. Vincent's Hospital, Darlinghurst, Sydney, NSW 2010, Australia
- Department of Tissue Pathology and Diagnostic Oncology, Royal Prince Alfred Hospital, Sydney, NSW 2050, Australia
- St Vincent's Clinical School, Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia
- Department of Medical Oncology, Sydney Cancer Centre, Sydney, NSW 2050, Australia
| | - M Pinese
- The Kinghorn Cancer Centre, and the Cancer Research Program, Garvan Institute of Medical Research, 384 Victoria Street, Darlinghurst, Sydney NSW 2010, Australia
| | - E K Colvin
- The Kinghorn Cancer Centre, and the Cancer Research Program, Garvan Institute of Medical Research, 384 Victoria Street, Darlinghurst, Sydney NSW 2010, Australia
| | - C J Scarlett
- The Kinghorn Cancer Centre, and the Cancer Research Program, Garvan Institute of Medical Research, 384 Victoria Street, Darlinghurst, Sydney NSW 2010, Australia
- School of Environmental and Life Sciences, University of Newcastle, Ourimbah, NSW 2258, Australia
| | - A Chou
- The Kinghorn Cancer Centre, and the Cancer Research Program, Garvan Institute of Medical Research, 384 Victoria Street, Darlinghurst, Sydney NSW 2010, Australia
- Department of Anatomical Pathology, St. Vincent's Hospital, Darlinghurst, Sydney, NSW 2010, Australia
| | - J G Kench
- The Kinghorn Cancer Centre, and the Cancer Research Program, Garvan Institute of Medical Research, 384 Victoria Street, Darlinghurst, Sydney NSW 2010, Australia
- Department of Tissue Pathology and Diagnostic Oncology, Royal Prince Alfred Hospital, Sydney, NSW 2050, Australia
| | - R L Sutherland
- The Kinghorn Cancer Centre, and the Cancer Research Program, Garvan Institute of Medical Research, 384 Victoria Street, Darlinghurst, Sydney NSW 2010, Australia
- St Vincent's Clinical School, Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia
| | - L G Horvath
- The Kinghorn Cancer Centre, and the Cancer Research Program, Garvan Institute of Medical Research, 384 Victoria Street, Darlinghurst, Sydney NSW 2010, Australia
- Department of Medical Oncology, Sydney Cancer Centre, Sydney, NSW 2050, Australia
| | - A V Biankin
- The Kinghorn Cancer Centre, and the Cancer Research Program, Garvan Institute of Medical Research, 384 Victoria Street, Darlinghurst, Sydney NSW 2010, Australia
- Department of Surgery, Bankstown Hospital, Eldridge Road, Bankstown, Sydney NSW 2200, Australia
- South Western Sydney Clinical School, Faculty of Medicine, University of NSW, Liverpool NSW 2170, Australia
- Wolfson Wohl Cancer Research Centre, Institute of Cancer Sciences, University of Glasgow, Garscube Estate, Switchback Road, Glasgow G61 1BD, Scotland, UK
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Yi Mei SLC, Nguyen NQ. Education and Imaging. Gastrointesinal: colonic amyloidosis causing submucosal haematoma and bleeding from straining. J Gastroenterol Hepatol 2013; 28:1585. [PMID: 24215084 DOI: 10.1111/jgh.12342] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/09/2022]
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Nguyen NQ, Holloway RH, Smout AJ, Omari TI. Automated impedance-manometry analysis detects esophageal motor dysfunction in patients who have non-obstructive dysphagia with normal manometry. Neurogastroenterol Motil 2013; 25:238-45, e164. [PMID: 23113942 DOI: 10.1111/nmo.12040] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.5] [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: 02/08/2023]
Abstract
BACKGROUND Automated integrated analysis of impedance and pressure signals has been reported to identify patients at risk of developing dysphagia post fundoplication. This study aimed to investigate this analysis in the evaluation of patients with non-obstructive dysphagia (NOD) and normal manometry (NOD/NM). METHODS Combined impedance-manometry was performed in 42 patients (27F : 15M; 56.2 ± 5.1 years) and compared with that of 24 healthy subjects (8F : 16M; 48.2 ± 2.9 years). Both liquid and viscous boluses were tested. MATLAB-based algorithms defined the median intrabolus pressure (IBP), IBP slope, peak pressure (PP), and timing of bolus flow relative to peak pressure (TNadImp-PP). An index of pressure and flow (PFI) in the distal esophagus was derived from these variables. KEY RESULTS Diagnoses based on conventional manometric assessment: diffuse spasm (n = 5), non-specific motor disorders (n = 19), and normal (n = 11). Patients with achalasia (n = 7) were excluded from automated impedance-manometry (AIM) analysis. Only 2/11 (18%) patients with NOD/NM had evidence of flow abnormality on conventional impedance analysis. Several variables derived by integrated impedance-pressure analysis were significantly different in patients as compared with healthy: higher PNadImp (P < 0.01), IBP (P < 0.01) and IBP slope (P < 0.05), and shorter TNadImp_PP (P = 0.01). The PFI of NOD/NM patients was significantly higher than that in healthy (liquid: 6.7 vs 1.2, P = 0.02; viscous: 27.1 vs 5.7, P < 0.001) and 9/11 NOD/NM patients had abnormal PFI. Overall, the addition of AIM analysis provided diagnoses and/or a plausible explanation in 95% (40/42) of patients who presented with NOD. CONCLUSIONS & INFERENCES Compared with conventional pressure-impedance assessment, integrated analysis is more sensitive in detecting subtle abnormalities in esophageal function in patients with NOD and normal manometry.
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Affiliation(s)
- N Q Nguyen
- Department of Gastroenterology and Hepatology, Royal Adelaide Hospital, Adelaide, SA, Australia.
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Myers JC, Nguyen NQ, Jamieson GG, Van't Hek JE, Ching K, Holloway RH, Dent J, Omari TI. Susceptibility to dysphagia after fundoplication revealed by novel automated impedance manometry analysis. Neurogastroenterol Motil 2012; 24:812-e393. [PMID: 22616652 DOI: 10.1111/j.1365-2982.2012.01938.x] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
BACKGROUND Conventional measures of esophageal pressures or bolus transport fail to identify patients at risk of dysphagia after laparoscopic fundoplication. METHODS Liquid and viscous swallows were evaluated with impedance/manometry in 19 patients with reflux disease before and after surgery. A new method of automated impedance manometry (AIM) analysis correlated esophageal pressure with impedance data and automatically calculated a range of pressure and bolus movement variables. An iterative analysis determined whether any variables were altered in relation to dysphagia. Standard measures of esophago-gastric junction pressure, bolus presence time, and total bolus transit time were also evaluated. KEY RESULTS At 5 months postop, 15 patients reported some dysphagia, including 7 with new-onset dysphagia. For viscous boluses, three AIM-derived pressure-flow variables recorded preoperatively varied significantly in relation to postoperative dysphagia. These were: time from nadir esophageal impedance to peak esophageal pressure (TNadImp-PeakP), median intra-bolus pressure (IBP, mmHg), and the rate of bolus pressure rise (IBP slope, mmHgs(-1) ). These variables were combined to form a dysphagia risk index (DRI=IBP×IBP_slope/TNadImp-PeakP). DRI values derived from preoperative measurements were significantly elevated in those with postoperative dysphagia (DRI=58, IQR=21-408 vs no dysphagia DRI=9, IQR=2-19, P<0.02). A DRI >14 was optimally predictive of dysphagia (sensitivity 75% and specificity 93%). CONCLUSIONS & INFERENCES Before surgery, a greater and faster compression of a swallowed viscous bolus with less bolus flow time relates to postoperative dysphagia. Thus, susceptibility to postfundoplication dysphagia is related to a pre-existing sub-clinical variation of esophageal function.
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Affiliation(s)
- J C Myers
- Discipline of Surgery, University of Adelaide, Royal Adelaide Hospital, Adelaide, SA, Australia
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Affiliation(s)
- R V Bryant
- Royal Adelaide Hospital, Adelaide, South Australia, Australia
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14
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Lim K, Tam W, Worthley C, Nguyen NQ. Education and Imaging. Hepatobiliary and pancreatic: pancreatic vascular malformations in hereditary hemorrhagic telangiectasia. J Gastroenterol Hepatol 2012; 27:989. [PMID: 22515811 DOI: 10.1111/j.1440-1746.2012.07099.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/09/2022]
Affiliation(s)
- K Lim
- Department of Gastroenterology and Hepatology, Royal Adelaide Hospital, South Australia, Australia
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Chapman MJ, Besanko LK, Burgstad CM, Fraser RJ, Bellon M, O'Connor S, Russo A, Jones KL, Lange K, Nguyen NQ, Bartholomeusz F, Chatterton B, Horowitz M. Gastric emptying of a liquid nutrient meal in the critically ill: relationship between scintigraphic and carbon breath test measurement. Gut 2011; 60:1336-43. [PMID: 21450697 DOI: 10.1136/gut.2010.227934] [Citation(s) in RCA: 62] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE It is assumed that delayed gastric emptying (GE) occurs frequently in critical illness; however, the prevalence of slow GE has not previously been assessed using scintigraphy. Furthermore, breath tests could potentially provide a convenient method of quantifying GE, but have not been validated in this setting. The aims of this study were to (i) determine the prevalence of delayed GE in unselected, critically ill patients and (ii) evaluate the relationships between GE as measured by scintigraphy and carbon breath test. DESIGN Prospective observational study. SETTING Mixed medical/surgical intensive care unit. PATIENTS 25 unselected, mechanically ventilated patients (age 66 years (49-72); and 14 healthy subjects (age 62 years (19-84)). INTERVENTIONS GE was measured using scintigraphy and (14)C-breath test. A test meal of 100 ml Ensure (standard liquid feed) labelled with (14)C octanoic acid and (99m)Technetium sulphur colloid was placed in the stomach via a nasogastric tube. MAIN OUTCOME MEASURES Gastric 'meal' retention (scintigraphy) at 60, 120, 180 and 240 min, breath test t(50) (BTt(50)), and GE coefficient were determined. RESULTS Of the 24 patients with scintigraphic data, GE was delayed at 120 min in 12 (50%). Breath tests correlated well with scintigraphy in both patients and healthy subjects (% retention at 120 min vs BTt(50); r(2)=0.57 healthy; r(2)=0.56 patients; p≤0.002 for both). CONCLUSIONS GE of liquid nutrient is delayed in approximately 50% of critically ill patients. Breath tests correlate well with scintigraphy and are a valid method of GE measurement in this group.
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Affiliation(s)
- M J Chapman
- Department of Intensive Care Medicine, Royal Adelaide Hospital, South Australia, Australia.
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Nguyen NQ, Shah JN, Binmoeller KF. Diagnostic cholangioscopy with SpyGlass probe through an endoscopic retrograde cholangiopancreatography cannula. Endoscopy 2011; 42 Suppl 2:E288-9. [PMID: 21086256 DOI: 10.1055/s-0030-1255707] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [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: 12/10/2022]
Affiliation(s)
- N Q Nguyen
- Interventional Endoscopy Services, California Pacific Medical Center, San Francisco, California 94115, USA
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Nguyen NQ, Ching K, Tippett M, Smout AJPM, Holloway RH. Impact of nadir lower oesophageal sphincter pressure on bolus clearance assessed by combined manometry and multi-channel intra-luminal impedance measurement. Neurogastroenterol Motil 2010; 22:50-5, e9. [PMID: 19702840 DOI: 10.1111/j.1365-2982.2009.01387.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
This study aimed to assess the relationship between nadir lower oesophageal sphincter pressure (LOSP) and wave amplitude (WA) in oesophageal bolus clearance. Concurrent oesophageal manometry and impedance were performed in 146 subjects [41 healthy, 24 non-obstructive dysphagia (NOD) and 81 gastro-oesophageal reflux (GOR)]. Patients with achalasia and diffuse oesophageal spasm were excluded. Swallow responses were categorized by nadir LOSP. For each category of nadir LOSP, WA at the distal 2 recording sites were grouped into bins of 10 mmHg and the proportion of waves in each bin associated with a normal bolus presence time (BPT) was determined. Nadir LOSP, distal BPT, total bolus transit time and the proportion of impaired oesophageal clearance in patients with NOD were greater than those of healthy subjects and patients with GOR. Overall, responses with impaired oesophageal clearance had significantly lower WA (54 +/- 1 vs 81 +/- 1 mmHg; P < 0.0001) and higher nadir LOSP (2.7 +/- 0.4 vs 1.0 +/- 0.1 mmHg, P < 0.001). For each level of nadir LOSP, there was a direct relationship between distal WA and successful bolus clearance of both liquid and viscous boluses from the distal oesophagus. As nadir LOSP increased, the relationship between WA and bolus clearance shifted to the right and higher amplitudes were required to achieve the same effectiveness of clearance. Hypotensive responses with nadir LOSP > or = 3 mmHg were less likely to clear than those with nadir LOSP < 3 mmHg, for both liquid (7/29 vs 162/276; P < 0.001) or viscous boluses (11/46 vs 176/279; P < 0.0001). Nadir LOSP is an important determinant of bolus clearance from the distal oesophagus, particularly in patients with NOD.
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Affiliation(s)
- N Q Nguyen
- Department of Gastroenterology and Hepatology, Royal Adelaide Hospital, Adelaide, South Australia, Australia.
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Chapman MJ, Fraser RJ, Bryant LK, Vozzo R, Nguyen NQ, Tam W, Zacharakis B, Davidson G, Butler R, Horowitz M. Gastric emptying and the organization of antro-duodenal pressures in the critically ill. Neurogastroenterol Motil 2008; 20:27-35. [PMID: 18069967 DOI: 10.1111/j.1365-2982.2007.00984.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
The motor dysfunctions underlying delayed gastric emptying (GE) in critical illness are poorly defined. Our aim was to characterize the relationship between antro-duodenal (AD) motility and GE in critically ill patients. AD pressures were recorded in 15 mechanically ventilated patients and 10 healthy volunteers for 2 h (i) during fasting, (ii) following an intragastric nutrient bolus with concurrent assessment of GE using the (13)C-octanoate breath test and (iii) during duodenal nutrient infusion. Propagated waves were characterized by length and direction of migration. Critical illness was associated with: (i) slower GE (GEC: 3.47 +/- 0.1 vs 2.99 +/- 0.2; P = 0.046), (ii) fewer antegrade (duodenal: 44%vs 83%, AD: 16%vs 83%; P < 0.001) and more retrograde (duodenal: 46%vs 12%, AD: 38%vs 4%; P < 0.001) waves, (iii) shorter wave propagation (duodenal: 4.7 +/- 0.3 vs 6.0 +/- 0.4 cm; AD: 7.7 +/- 0.6 vs 10.9 +/- 0.9 cm; P = 0.004) and (iv) a close correlation between GE with the percentage of propagated phase 3 waves that were antegrade (r = 0.914, P = 0.03) and retrograde (r = -0.95, P = 0.014). In critical illness, the organization of AD pressure waves is abnormal and associated with slow GE.
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Affiliation(s)
- M J Chapman
- Intensive Care Unit, Royal Adelaide Hospital, Adelaide, SA, Australia.
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Nguyen NQ, Mangoni AA, Fraser RJ, Chapman M, Bryant L, Burgstad C, Holloway RH. Prokinetic therapy with erythromycin has no significant impact on blood pressure and heart rate in critically ill patients. Br J Clin Pharmacol 2007; 63:498-500. [PMID: 17378798 PMCID: PMC2203248 DOI: 10.1111/j.1365-2125.2006.02772.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
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Nguyen NQ, Fraser RJ, Bryant LK, Holloway RH. Functional association between proximal and distal gastric motility during fasting and duodenal nutrient stimulation in humans. Neurogastroenterol Motil 2007; 19:638-45. [PMID: 17640178 DOI: 10.1111/j.1365-2982.2007.00919.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
A functional integration exists between proximal and distal gastric motor activity in dogs but has not been demonstrated in humans. To determine the relationship between proximal and distal gastric motor activity in humans. Concurrent proximal (barostat) and distal (antro-pyloro-duodenal (APD) manometry) gastric motility were recorded in 10 healthy volunteers (28 +/- 3 years) during (i) fasting and (ii) two 60-min duodenal infusions of Ensure((R)) (1 and 2 kcal min(-1)) in random order. Proximal and APD motor activity and the association between fundic and propagated antral waves (PAWs) were determined. During fasting, 32% of fundic waves (FWs) were followed by a PAW. In a dose-dependent fashion, duodenal nutrients (i) increased proximal gastric volume, (ii) reduced fundic and antral wave (total and propagated) activity, and (iii) increased pyloric contractions. The proportion of FWs followed by a distal PAW was similar between both infusions and did not differ from fasting. During nutrient infusion, nearly all PAWs were antegrade, propagated over a shorter distance and less likely to traverse the pylorus, compared with fasting. In humans, a functional association exists between proximal and distal gastric motility during fasting and duodenal nutrient stimulation. This may have a role in optimizing intra-gastric meal distribution.
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Affiliation(s)
- N Q Nguyen
- Department of Gastroenterology and Hepatology, Royal Adelaide Hospital, Adelaide, SA 5000, Australia.
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Lam SW, Nguyen NQ, Ching K, Chapman M, Fraser RJ, Holloway RH. Gastric feed intolerance is not increased in critically ill patients with type II diabetes mellitus. Intensive Care Med 2007; 33:1740-5. [PMID: 17554523 DOI: 10.1007/s00134-007-0712-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2006] [Accepted: 05/02/2007] [Indexed: 12/13/2022]
Abstract
OBJECTIVE To examine the occurrence of feed intolerance in critically ill patients with previously diagnosed type II diabetes mellitus (DM) who received prolonged gastric feeding. DESIGN AND SETTING Retrospective study in a level 3 mixed ICU. PATIENTS All mechanically ventilated, enterally fed patients (n = 649), with (n = 118) and without type II DM (n = 531) admitted between January 2003 and July 2005. INTERVENTIONS Patients with at least 72 h of gastric feeding were identified by review of case notes and ICU charts. The proportion that developed feed intolerance was determined. All patient received insulin therapy. RESULTS The proportion of patients requiring gastric feeding for at least 72 h was similar between patients with and without DM (42%, 50/118, vs. 42%, 222/531). Data from patients with DM were also compared with a group of 50 patients matched for age, sex and APACHE II score, selected from the total non-diabetic group. The occurrence of feed intolerance (DM 52% vs. matched non-DM 50% vs. unselected non-diabetic 58%) and the time taken to develop feed intolerance (DM 62.6 +/- 43.8 h vs. matched non-DM 45.3 +/- 54.6 vs. unselected non-diabetic 50.6 +/- 59.5) were similar amongst the three groups. Feed intolerance was associated with a greater use of morphine/midazolam and vasopressor support, a lower feeding rate and a longer ICU length of stay. CONCLUSIONS In critically ill patients who require prolonged enteral nutrition, a prior history of DM type II does not appear to be a further risk factor for feed intolerance.
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Affiliation(s)
- S W Lam
- Department of Gastroenterology, Royal Adelaide Hospital, North Terrace, 5000, Adelaide, SA, Australia.
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Nguyen NQ, Rigda R, Tippett M, Conchillo J, Smout AJPM, Holloway RH. Assessment of oesophageal motor function using combined perfusion manometry and multi-channel intra-luminal impedance measurement in normal subjects. Neurogastroenterol Motil 2005; 17:458-65. [PMID: 15916634 DOI: 10.1111/j.1365-2982.2005.00646.x] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Multichannel intraluminal impedance (MII) is being used increasingly to assess oesophageal bolus clearance. However, there is no good standardization of the impedance parameters that define 'effective bolus clearance'. The aim of this study was to define these important impedance parameters and to determine their normal values. Concurrent perfusion manometry and MII were performed in 42 healthy volunteers. Ten, 5-mL liquid (saline) boluses and then, 10x5-mL low impedance viscous boluses were tested in each subject in the right-lateral position. Normal values for bolus presence time (BPT) at each site and total bolus transit time (TBTT) were determined from either 'normal' peristaltic responses (amplitude>or=30 mmHg in distal oesophagus) or 'super-normal' peristaltic responses (amplitudes>or=50 mmHg at all sites). The relationship between BPT and TBTT within a response and per-individual performance was determined. A total of 840 swallows of liquids and viscous responses were analysed. BPT and TBTT of viscous swallows were longer than those for liquids. Non-peristaltic responses were significantly more likely not to clear a viscous than a liquid bolus. Within a response, the number of sites with prolonged BPT strongly predicted the incidence of prolonged TBTT. Using impedance criteria, normal oesophageal bolus clearance is defined when an individual completely clears at least 70% of liquid responses and at least 60% of viscous responses. This study provides normal values for impedance measurement of bolus clearance when combined with perfusion manometry. These values will allow standardization of impedance application in oesophageal function testing, in both research and clinical setting.
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Affiliation(s)
- N Q Nguyen
- Department of Gastroenterology, Hepatology and General Medicine, Royal Adelaide Hospital, SA, Australia
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Nguyen NQ, Holloway RH. Images of interest. Gastrointestinal: Lymphomatous gastric ulcers. J Gastroenterol Hepatol 2004; 19:1212. [PMID: 15377302 DOI: 10.1111/j.1440-1746.2004.03619.x] [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: 12/09/2022]
Affiliation(s)
- N Q Nguyen
- Department of Gastroenterology, The Queen Elizabeth Hospital, Woodville South, South Australia 5011, Australia
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Nguyen NQ, Moy RL. The significance of articles appearing in dermatologic surgery. Dermatol Surg 2001; 27:999-1001. [PMID: 11849258 DOI: 10.1046/j.1524-4725.2001.00254.x] [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] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- N Q Nguyen
- VA West Los Angeles Medical Center, UCLA Division of Dermatology, Los Angeles, California 90024, USA
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Nguyen NQ, Moy RL. The impact of Dermatologic Surgery. Dermatol Surg 2000; 26:1089-91. [PMID: 11134982] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
Affiliation(s)
- N Q Nguyen
- VA West Los Angeles Medical Center, UCLA Division of Dermatology, Los Angeles, California, USA
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Nguyen NQ, Moy RL. Authors in Dermatologic Surgery. Dermatol Surg 2000; 26:1092-5. [PMID: 11134983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
Abstract
Authors of scientific papers have been evaluated in the past by how frequently the medical literature cites them. In this analysis, we specifically identify those individuals who have contributed to the field of cutaneous surgery through publications in Dermatologic Surgery. We further analyze those publications frequently cited in Dermatologic Surgery, allowing us to determine topics of utmost value and interest. Using a citation database provided by the Institute for Scientific Information, we first identify all publications and citations from 1981 to 1999 for Dermatologic Surgery and the Journal of Dermatologic Surgery and Oncology (the previous name for this journal). Of the original articles published during this time frame, 3099 authors published 2167 papers. We quantify the publications from each author, and identify 57 authors with at least 10 original articles. When expanding the database parameters to include original articles, reviews, notes, and proceedings (as defined by the Science Citation Index), we find that the eight authors with the greatest number of publications are the same individuals with the greatest number of original articles. This reflects significant contributions to the field of cutaneous surgery by these authors. This analysis further identifies source papers for authors in Dermatologic Surgery. Publications frequently cited include those papers discussing laser surgery, with Dermatologic Surgery serving as the most frequently cited journal.
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Affiliation(s)
- N Q Nguyen
- West Los Angeles Veteran's Administration Hospital, Division of Dermatology, University of California-Los Angeles, Los Angeles, California 90024, USA
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Affiliation(s)
- N Q Nguyen
- University of Adelaide, Department of Surgery, Queen Elizabeth Hospital, South Australia, Australia
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Abstract
Subacute sclerosing panencephalitis (SSPE) is a rare progressive neurologic disorder. A 9-year-old boy was seen who had progressive neurocognitive decline, myoclonic jerking of the extremities, and an abnormal result of an electroencephalogram (EEG). Ophthalmoscopic examination revealed multifocal subretinal lesions. The diagnosis of SSPE was made on the basis of the clinical examination and elevated serum and spinal fluid measles titer. We describe subretinal lesions in a patient with SSPE.
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Affiliation(s)
- N Q Nguyen
- Texas A & M University School of Medicine, College Station, USA
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Nguyen NQ, Tapchaisri P, Chongsa-nguan M, Cao VV, Doan TT, Sakolvaree Y, Srimanote P, Chaicumpa W. Diagnosis of enteric fever caused by Salmonella spp. in Vietnam by a monoclonal antibody-based dot-blot ELISA. Asian Pac J Allergy Immunol 1997; 15:205-12. [PMID: 9579614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Enteric fever caused by Salmonella spp. is prevalent in Vietnam. None of the currently available diagnostic methods meets the ideal criteria on rapidity, simplicity, sensitivity, specificity, cost-effectiveness and practicality for developing areas. In this study, a recently developed monoclonal antibody-based dot-blot ELISA was used in comparison with the hemoculture method and the classical Widal test for diagnosis of salmonellosis in 171 Vietnamese patients presenting with clinical features of enteric fever. Urine samples of 50 healthy counterparts were used as negative controls. Salmonella spp. were isolated from 77 of 171 patients (45%) while 98 and 111 patients were positive by dot-blot ELISA and Widal test, respectively. The diagnostic sensitivity, specificity, accuracy, positive predictive value and negative predictive value of the ELISA performed on three serial urine samples collected at 2 hour intervals of the 171 patients were 92.2%, 71.3%, 80.7%, 72.4% and 91.8%, respectively when compared with the culture method. The Widal test performed on acute and convalescence serum samples showed 87.0%, 46.8%, 68.4%, 60.4% and 83.3% diagnostic sensitivity, specificity, accuracy, and positive and negative predictive values, respectively when compared with the bacterial culture method. Kappa coefficience revealed very good agreement beyond chance between the MAb-based ELISA and the culture method. The ELISA was not reactive when tested on urine samples of 50 healthy individuals which indicates 100% specificity. The Salmonella antigenuria of the patients as detected by ELISA lasted 10.3+/-3.9 days after initiating antibiotic treatment. The MAb-based dot-blot ELISA is easy to perform. It is rapid, sensitive, specific, inexpensive, and non-invasive and does not require equipment, thus is suitable for developing areas. It can detect acute/recent infection and can be used for evaluation of the efficacy of the treatment.
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Affiliation(s)
- N Q Nguyen
- Department of Microbiology and Immunology, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
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Goldberg S, Ferrand P, Nguyen NQ, Boisvieux JF, Hazout S. Bi-dimensional scaling map (BDS-Map): an approach for building large genetic maps. Comput Appl Biosci 1997; 13:497-508. [PMID: 9367123 DOI: 10.1093/bioinformatics/13.5.497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
MOTIVATION The approaches usually used for building large genetic maps consist of dividing the marker set into linkage groups and provide local orders that can be tested by multi-point linkage analysis. To deal with the limitations of these approaches, a strategy taking the marker set into account globally is defined. RESULTS The paper presents a new approach called 'Bi-Dimensional Scaling Map (BDS-Map) for inferring marker orders and distances in genetic maps based on the use of an additional dimension orthogonal to the map into which markers are projected. Dynamical forces based on a two-point analysis are applied to tend to optimize the marker locations in space. The efficiency of the approach is exemplified on real data (16 and 70 markers on chromosomes 6 and 2, respectively) and simulated data (50 maps of 70 markers).
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Affiliation(s)
- S Goldberg
- Centre de Bioinformatique, INSERM U 155, Paris, France
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Saphier D, Welch JE, Farrar GE, Nguyen NQ, Aguado F, Thaller TR, Knight DS. Interactions between serotonin, thyrotropin-releasing hormone, and substance P in the CNS regulation of adrenocortical secretion. Psychoneuroendocrinology 1994; 19:779-97. [PMID: 7527566 DOI: 10.1016/0306-4530(94)90025-6] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Double-labeling immunohistochemical studies were performed to discern the morphological relationships between corticotropin-releasing factor-immunoreactive (CRF-ir) perikarya and afferent innervation in the hypothalamic paraventricular nucleus (PVN) of the rat. Attention was focussed on the local innervation by serotonin (5-hydroxytryptamine, 5-HT), thyrotropin-releasing hormone (TRH) and substance P (SP)-ir nerve terminal fibers. 5-HT-ir and SP-ir fibers were present in moderate numbers, in close apposition with CRF-ir perikarya. Sparse TRH-ir fibers were observed, but a population of TRH-ir perikarya was found in proximity with the CRF-ir cell bodies. TRH-ir perikarya in the PVN were surrounded by both 5-HT- and SP-ir fibers. Neuroendocrine studies were performed to investigate the interactions between 5-HT, TRH and SP in the regulation of hypothalamo-pituitary-adrenocortical (HPA) secretion. Male rats were prepared bearing cannulae for intracerebroventricular (ICV) or intra-PVN administration of drugs. 5-HT, at all doses tested (0.1, 40, or 80 nmol, ICV), caused increases in plasma corticosterone (CS) concentrations in tail-vein blood collected 20 min after injection. ICV injections of TRH caused dose-dependent increases in plasma CS, but did not further increase HPA responses when injected together with 5-HT. SP alone had little effect, although a significant reduction in plasma CS concentrations was observed in several individual experiments. However, SP (0.1 nmol) significantly attenuated CS responses following high doses of 5-HT (40 and 80 nmol, ICV), although the response to 0.1 nmol 5-HT was not affected. Combined injection of SP with TRH resulted in HPA responses not different from those following TRH alone. Similarly, SP did not reduce the HPA response observed with TRH and 40 nmol 5-HT in combination. Intra-PVN injections of 5-HT (0.1 or 40 nmol) and TRH also increased plasma CS concentrations. Intra-PVN injections of SP had little effect on plasma CS concentrations although a tendency toward a decrease in plasma CS was observed, as with the ICV injections. Combined intra-PVN injection of 5-HT (0.1 nmol) with TRH (0.1 nmol) did not significantly alter the response compared with that observed following TRH alone, although plasma CS concentrations were greater than with 0.1 nmol 5-HT. Combined intra-PVN injections of SP (0.1 nmol) with 5-HT (0.1 nmol) resulted in a significant decrease in plasma CS concentration compared with that following 5-HT alone, but SP did not prevent the CS response to a higher dose of 5-HT (40 nmol).(ABSTRACT TRUNCATED AT 400 WORDS)
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Affiliation(s)
- D Saphier
- Department of Pharmacology & Therapeutics, Louisiana State University Medical Center, Shreveport 71130-3932
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Vo Van JM, Husson JL, Meadeb J, Nguyen NQ. [High-dose ketoprofen in surgery of the spine]. Presse Med 1988; 17:341-2. [PMID: 2966359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
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Vo Van JM, Le Bervet JY, Saout H, Nguyen NQ. [Long-duration spinal anesthesia with tetracaine-metaraminol]. Cah Anesthesiol 1987; 35:529-33. [PMID: 3442741] [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] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Affiliation(s)
- J M Vo Van
- Département d'Anesthésie-Réanimation, Hôtel Dieu, Rennes
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Nguyen NQ, Le Roux A, Ozier K, Moureaud R. [Peridural anesthesia in vascular surgery in patients taking anticoagulants]. Cah Anesthesiol 1987; 35:507-11. [PMID: 3442737] [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] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Affiliation(s)
- N Q Nguyen
- Département d'Anesthésie-Réanimation, Hôpital Sud, Rennes
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Vo Van JM, Le Bervet JY, Nguyen NQ, Chalak A. [Tetracaine with the addition of metaraminol in spinal anesthesia]. Cah Anesthesiol 1985; 33:361-2. [PMID: 4052858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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Villon A, Foulon G, Ancelle R, Nguyen NQ, Martin-Bouyer G. [Incident of intestinal parasitosis in Martinique]. Bull Soc Pathol Exot Filiales 1983; 76:406-416. [PMID: 6627553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
A survey of intestinal parasitosis was conducted in Martinique by INSERM in 1978. The survey used a stratified sample of 823 households from the general population. The most prevalent parasitosis are: schistosomiasis 19%; ancylostomiasis 18%; trichuriasis 37%; ascaridiasis 7%; strongiloidiasis 3%. 70% of the 5 to 15 age group carries at least 1 parasite. The prevalence of trichuriasis, ascaridiasis and giardiasis is greatest in the 5 to 15 age group, Ancylostomiasis concerns mostly the 15 to 30 age group. Schistosomiasis, was most prevalent in adults over 30 years of age. Prevalence of parasitosis in rural regions is double that of urbanised regions. Schistosomiasis mostly occurs in the north. Ascaridiasis in the north-east. Rainfall and housing status, each influence on the rates of infestation.
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