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Carr P, Kevitt F. Service user satisfaction with telemedicine in an occupational healthcare setting. Occup Med (Lond) 2023; 73:205-207. [PMID: 37061841 DOI: 10.1093/occmed/kqad047] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/17/2023] Open
Abstract
BACKGROUND Telemedicine has existed pre-pandemic and has been used in some healthcare settings with high patient satisfaction. The COVID-19 pandemic increased the use of telemedicine to help minimize transmission while maintaining service provision. AIMS To assess service user satisfaction with telephone assessment and to assess distance/time saved by telephone assessment as services users did not have to travel to their appointment. METHODS Prospective review of service users attending one occupational health clinic over a 1-month period. Service users were asked two questions regarding method of travel, and satisfaction with telephone review. All data captured were anonymous, and distances and times for travel were calculated for driving using Google Maps. RESULTS Seventy-three service users were recruited to the review. Ninety per cent were reviewed by telephone and 10% reviewed in person. Eighty-eight per cent of service users were satisfied with telephone review. Seventy-eight per cent of service users planned to drive to Dr Steevens' Hospital. In total, 4058.4 km (77 h 6 min) of commuting was saved with phone reviews, and 2753.2 km (54 h 16 min) driving was saved. CONCLUSIONS Service user satisfaction with telephone review was found to be high, and telephone review resulted in saving of both commuting time for the healthcare worker, reduced time away from the workplace, as well as having a positive environmental impact.
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Affiliation(s)
- P Carr
- Occupational Health Department, Dr Steevens' Hospital, Steevens' Lane, Dublin 8, D08W2A8, Ireland
| | - F Kevitt
- Occupational Health Department, Dr Steevens' Hospital, Steevens' Lane, Dublin 8, D08W2A8, Ireland
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Carr P, Kelly S. Burnout in Doctors Practising in Ireland Post Covid-19. Ir Med J 2023; 116:761. [PMID: 37555571] [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: 08/10/2023]
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Gethin G, Vellinga A, McIntosh C, Sezgin D, Probst S, Murphy L, Carr P, Ivory J, Cunningham S, Oommen AM, Joshi L, Ffrench C. Systematic review of topical interventions for the management of odour in patients with chronic or malignant fungating wounds. J Tissue Viability 2023; 32:151-157. [PMID: 36376189 DOI: 10.1016/j.jtv.2022.10.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Revised: 10/06/2022] [Accepted: 10/31/2022] [Indexed: 11/11/2022]
Abstract
Chronic wounds adversely affect the quality of life of individuals and odour is a well-recognised associated factor. Odour can affect sleep, well-being, social interactions, diet and potentially wound healing. This systematic review aims to examine the effectiveness of topical interventions in the management of odour associated with chronic and malignant fungating wounds. A systematic review guided by PRISMA recommendations of randomised controlled trials where odour intensity/odour is the primary outcome was undertaken. Inclusion criteria were adults (18 years and over) with chronic venous, arterial, diabetic or pressure ulcers or with malignant fungating wounds where odour has been managed through topical application of pharmacological/non-pharmacological agents. Searches were conducted in CENTRAL, CINAHL, EMBASE, MEDLINE, Scopus, and Web of Science. Eligibility screening, risk of bias assessment and data extraction was completed by authors working independently. Searches retrieved 171 titles and abstracts (157 post de-duplication). Thirteen studies were retained for full text review of which five (n = 137 individuals) examining the following treatments remained: metronidazole (n = 4), silver (n = 1). Meta-analysis was not possible but individual studies suggest improved outcomes (i.e., reduced odour) using metronidazole. Treatment options to manage wound odour are limited and hampered by lack of clinical trials, small sample sizes, and absence of standardised outcomes and consistent measurement. Whereas metronidazole and silver may have a role in controlling wound odour, robust and well-designed interventions with rigorous procedures and standardised odour outcomes are necessary to evaluate their contribution.
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Affiliation(s)
- G Gethin
- School of Nursing and Midwifery, University of Galway, Galway, Ireland; Alliance for Research and Innovation in Wounds, University of Galway, Galway, Ireland; Geneva School of Health Science, HES-SO University of Applied Sciences and Arts, Western, Switzerland; Faculty of Medicine Nursing and Health Sciences, Monash University, Australia; CÚRAM, SFI Research Centre for Medical Devices, Ireland.
| | - A Vellinga
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Ireland.
| | - C McIntosh
- Alliance for Research and Innovation in Wounds, University of Galway, Galway, Ireland; Discipline of Podiatric Medicine, School of Health Science, University of Galway, Galway, Ireland.
| | - D Sezgin
- School of Nursing and Midwifery, University of Galway, Galway, Ireland; Alliance for Research and Innovation in Wounds, University of Galway, Galway, Ireland.
| | - S Probst
- Geneva School of Health Science, HES-SO University of Applied Sciences and Arts, Western, Switzerland; Faculty of Medicine Nursing and Health Sciences, Monash University, Australia; Care Directorate, University Hospital Geneva, Switzerland.
| | - L Murphy
- School of Nursing and Midwifery, University of Galway, Galway, Ireland
| | - P Carr
- School of Nursing and Midwifery, University of Galway, Galway, Ireland
| | - J Ivory
- School of Nursing and Midwifery, University of Galway, Galway, Ireland; Alliance for Research and Innovation in Wounds, University of Galway, Galway, Ireland; Irish Research Council (IRC), Government of Ireland, Dublin, Ireland; Centre for Diabetes, Endocrinology and Metabolism, Galway University Hospital, Galway, Ireland
| | - S Cunningham
- Advance Glycoscience Research Cluster, School of Natural Sciences, University of Galway, Galway, Ireland; CÚRAM, SFI Research Centre for Medical Devices, Ireland
| | - A M Oommen
- Advance Glycoscience Research Cluster, School of Natural Sciences, University of Galway, Galway, Ireland; CÚRAM, SFI Research Centre for Medical Devices, Ireland
| | - Lokesh Joshi
- Advance Glycoscience Research Cluster, School of Natural Sciences, University of Galway, Galway, Ireland; CÚRAM, SFI Research Centre for Medical Devices, Ireland
| | - C Ffrench
- School of Nursing and Midwifery, University of Galway, Galway, Ireland; CÚRAM, SFI Research Centre for Medical Devices, Ireland; Centre for Pain Research, University of Galway, Ireland.
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Lamidi S, Coe PO, Bordeianou LG, Hart AL, Hind D, Lindsay JO, Lobo AJ, Myrelid P, Raine T, Sebastian S, Fearnhead NS, Lee MJ, Adams K, Almer S, Ananthakrishnan A, Bethune RM, Block M, Brown SR, Cirocco WC, Cooney R, Davies RJ, Atici SD, Dhar A, Din S, Drobne D, Espin‐Basany E, Evans JP, Fleshner PR, Folkesson J, Fraser A, Graf W, Hahnloser D, Hager J, Hancock L, Hanzel J, Hargest R, Hedin CRH, Hill J, Ihle C, Jongen J, Kader R, Karmiris K, Katsanos KH, Keller DS, Kopylov U, Koutrabakis IE, Lamb CA, Landerholm K, Lee GC, Litta F, Limdi JK, Lopes EW, Madoff RD, Martin ST, Martin‐Perez B, Michalopoulos G, Millan M, Münch A, Nakov R, Noor NM, Oresland T, Paquette IM, Pellino G, Perra T, Porcu A, Roslani AC, Samaan MA, Sebepos‐Rogers GM, Segal JP, de Silva SD, Söderholm AM, Spinelli A, Speight RA, Steinhagen RM, Stenström P, Tsimogiannis KE, Varma MG, Verma AM, Verstockt B, Warden C, Yassin NA, Zawadzki A, Carr P, Devlin B, Avery MSP, Gecse KB, Goren I, Hellström PM, Kotze PG, McWhirter D, Naik AS, Sammour T, Selinger CP, Stein SL, Torres J, Wexner SD, Younge LC. Development of a core descriptor set for Crohn's anal fistula. Colorectal Dis 2022; 25:695-706. [PMID: 36461766 DOI: 10.1111/codi.16440] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 09/21/2022] [Accepted: 11/08/2022] [Indexed: 12/04/2022]
Abstract
AIM Crohn's anal fistula (CAF) is a complex condition, with no agreement on which patient characteristics should be routinely reported in studies. The aim of this study was to develop a core descriptor set of key patient characteristics for reporting in all CAF research. METHOD Candidate descriptors were generated from published literature and stakeholder suggestions. Colorectal surgeons, gastroenterologists and specialist nurses in inflammatory bowel disease took part in three rounds of an international modified Delphi process using nine-point Likert scales to rank the importance of descriptors. Feedback was provided between rounds to allow refinement of the next ratings. Patterns in descriptor voting were assessed using principal component analysis (PCA). Resulting PCA groups were used to organize items in rounds two and three. Consensus descriptors were submitted to a patient panel for feedback. Items meeting predetermined thresholds were included in the final set and ratified at the consensus meeting. RESULTS One hundred and thirty three respondents from 22 countries completed round one, of whom 67.0% completed round three. Ninety seven descriptors were rated across three rounds in 11 PCA-based groups. Forty descriptors were shortlisted. The consensus meeting ratified a core descriptor set of 37 descriptors within six domains: fistula anatomy, current disease activity and phenotype, risk factors, medical interventions for CAF, surgical interventions for CAF, and patient symptoms and impact on quality of life. CONCLUSION The core descriptor set proposed for all future CAF research reflects characteristics important to gastroenterologists and surgeons. This might aid transparent reporting in future studies.
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Affiliation(s)
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- Department of Oncology and Metabolism, The Medical School, University of Sheffield, Sheffield, UK
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Nanda S, Carr P, Noland M. Image Gallery: A case of botfly myiasis due to Dermatobia hominis in the U.S.A. with no history of international travel. Br J Dermatol 2020; 182:e184. [PMID: 31944260 DOI: 10.1111/bjd.18846] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- S Nanda
- Dr Philip Frost Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, U.S.A.,Department of Dermatology, University of Virginia, Charlottesville, VA, U.S.A
| | - P Carr
- Department of Dermatology, University of Virginia, Charlottesville, VA, U.S.A
| | - M Noland
- Department of Dermatology, University of Virginia, Charlottesville, VA, U.S.A
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Donohoe S, Carr P, Dave M, Mackie I, Machin S, Harrison C. Patients with Essential Thrombocythaemia have an Increased Prevalence of Antiphospholipid Antibodies which may be associated with Thrombosis. Thromb Haemost 2017. [DOI: 10.1055/s-0037-1613087] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
SummaryA significant proportion of patients with Essential Thrombocythaemia (ET) have thrombotic complications which have an important impact upon the quality, and duration of their life. We performed a retrospective cross sectional study of the prevalence of antiphospholipid antibodies (APA) in 68 ET patients. Compared to 200 “elderly” controls (> 50 years) there was a significant increase in anticardiolipin IgM (p < 0.0001) and anti β2 glycoprotein I (anti-β2GPI) IgM (p < 0.0001) antibodies in ET. Thrombosis occurred in 10/20 with APA and 12/48 without, p = 0.04, relative risk 2.0 (95% confidence intervals 1.03–3.86); these patients did not differ in terms of other clinical features. The prevalence of thrombosis in patients with dual APA (6/7) was significant when compared to those with single APA (p = 0.02) and the remaining patients (p < 0.0002). Also anti-β2GP1 IgM antibodies either alone, or in combination with another APA, were associated with thrombosis (p = 0.02). These results suggest that the prevalence of APA in ET and their influence upon thrombotic risk merit investigation in a larger study.
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Carr P, Carr M. A single-blind, parallel-group study of E45 Cream to treat asteatotic eczema. J DERMATOL TREAT 2009. [DOI: 10.3109/09546639709160947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Garner SF, Jones CI, Stephens J, Carr P, Walton J, Bernard A, Angenent W, Ouwehand WH, Goodall AH. P02 Inherent Variation in Donor Platelet Reactivity Contributes to the Quality of Apheresis Platelets. Transfus Med 2006. [DOI: 10.1111/j.1365-3148.2006.00694_2.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Macaulay IC, Tijssen MR, Thijssen-Timmer D, Gusnanto A, Carr P, Steward M, Langford C, Ellis P, Dudbridge F, Zwaginga J, Watkins NA, van der Schoot E, Ouwehand WH. P50 Novel Activatory and Inhibitory Platelet Receptors Identified Through Comparative Gene Expression Profiling of Megakaryocytes and Erythroblasts. Transfus Med 2006. [DOI: 10.1111/j.1365-3148.2006.00694_50.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Garner SF, Jones CI, Angenent W, Bernard A, Carr P, Rankin A, Stephens J, Tom BD, Walton J, Dudbridge F, Ouwehand WH, Goodall AH. P03 The Effect of Apheresis on the Donors' Platelets. Transfus Med 2006. [DOI: 10.1111/j.1365-3148.2006.00694_3.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Carr P, Gusnanto A, Macaulay IC, Dudbridge F, Langford C, Ouwehand WH, Watkins NA. YS03 Gene Expression Profiling of Platelet RNA Identifies Differentially Expressed Genes Associated with Collagen Signalling Responses. Transfus Med 2006. [DOI: 10.1111/j.1365-3148.2006.00693_37.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Garner SF, Jones CI, Angenent W, Bernard A, Carr P, Hogwood J, Rankin A, Stephens J, Tom BD, Walton J, Dudbridge F, Ouwehand WH, Goodall AH. SI09 Analysing Platelet Function in Blood Donors: Selection of Subjects for Functional Genetic Studies. Transfus Med 2006. [DOI: 10.1111/j.1365-3148.2006.00693_14.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Redon R, Rio M, Gregory SG, Cooper RA, Fiegler H, Sanlaville D, Banerjee R, Scott C, Carr P, Langford C, Cormier-Daire V, Munnich A, Carter NP, Colleaux L. Tiling path resolution mapping of constitutional 1p36 deletions by array-CGH: contiguous gene deletion or "deletion with positional effect" syndrome? J Med Genet 2006; 42:166-71. [PMID: 15689456 PMCID: PMC1735995 DOI: 10.1136/jmg.2004.023861] [Citation(s) in RCA: 50] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Gribble SM, Prigmore E, Burford DC, Porter KM, Ng BL, Douglas EJ, Fiegler H, Carr P, Kalaitzopoulos D, Clegg S, Sandstrom R, Temple IK, Youings SA, Thomas NS, Dennis NR, Jacobs PA, Crolla JA, Carter NP. The complex nature of constitutional de novo apparently balanced translocations in patients presenting with abnormal phenotypes. J Med Genet 2006; 42:8-16. [PMID: 15635069 PMCID: PMC1735914 DOI: 10.1136/jmg.2004.024141] [Citation(s) in RCA: 168] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVE To describe the systematic analysis of constitutional de novo apparently balanced translocations in patients presenting with abnormal phenotypes, characterise the structural chromosome rearrangements, map the translocation breakpoints, and report detectable genomic imbalances. METHODS DNA microarrays were used with a resolution of 1 Mb for the detailed genome-wide analysis of the patients. Array CGH was used to screen for genomic imbalance and array painting to map chromosome breakpoints rapidly. These two methods facilitate rapid analysis of translocation breakpoints and screening for cryptic chromosome imbalance. Breakpoints of rearrangements were further refined (to the level of spanning clones) using fluorescence in situ hybridisation where appropriate. RESULTS Unexpected additional complexity or genome imbalance was found in six of 10 patients studied. The patients could be grouped according to the general nature of the karyotype rearrangement as follows: (A) three cases with complex multiple rearrangements including deletions, inversions, and insertions at or near one or both breakpoints; (B) three cases in which, while the translocations appeared to be balanced, microarray analysis identified previously unrecognised imbalance on chromosomes unrelated to the translocation; (C) four cases in which the translocation breakpoints appeared simple and balanced at the resolution used. CONCLUSIONS This high level of unexpected rearrangement complexity, if generally confirmed in the study of further patients, will have an impact on current diagnostic investigations of this type and provides an argument for the more widespread adoption of microarray analysis or other high resolution genome-wide screens for chromosome imbalance and rearrangement.
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Affiliation(s)
- S M Gribble
- The Wellcome Trust Sanger Institute, Wellcome Trust Genome Campus, Hinxton, Cambridge, UK
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Abstract
Historical studies, using Northern blot hybridization, RT-PCR and cDNA library construction have demonstrated the presence of a variety of mRNA molecules in platelets. The development of microarray technology has allowed further characterization of the transcripts represented in the platelet transcriptome. In this review, these studies will be summarized and their findings in relation to the study of platelet function and the identification of disease risk genes discussed.
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Affiliation(s)
- I C Macaulay
- Division of Transfusion Medicine, University of Cambridge, UK
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Gribble SM, Fiegler H, Burford DC, Prigmore E, Yang F, Carr P, Ng BL, Sun T, Kamberov ES, Makarov VL, Langmore JP, Carter NP. Applications of combined DNA microarray and chromosome sorting technologies. Chromosome Res 2004; 12:35-43. [PMID: 14984100 DOI: 10.1023/b:chro.0000009325.69828.83] [Citation(s) in RCA: 23] [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] [Indexed: 11/12/2022]
Abstract
The sequencing of the human genome has led to the availability of an extensive mapped clone resource that is ideal for the construction of DNA microarrays. These genomic clone microarrays have largely been used for comparative genomic hybridisation studies of tumours to enable accurate measurement of copy number changes (array-CGH) at increased resolution. We have utilised these microarrays as the target for chromosome painting and reverse chromosome painting to provide a similar improvement in analysis resolution for these studies in a process we have termed array painting. In array painting, chromosomes are flow sorted, fluorescently labelled and hybridised to the microarray. The complete composition and the breakpoints of aberrant chromosomes can be analysed at high resolution in this way with a considerable reduction in time, effort and cytogenetic expertise required for conventional analysis using fluorescence in situ hybridisation. In a similar way, the resolution of cross-species chromosome painting can be improved and we present preliminary observations of the organisation of homologous DNA blocks between the white cheeked gibbon chromosome 14 and human chromosomes 2 and 17.
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Affiliation(s)
- S M Gribble
- The Wellcome Trust Sanger Institute, Wellcome Trust Genome Campus, Hinxton, Cambridge, CB10 1SA, UK
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Rost I, Fiegler H, Fauth C, Carr P, Bettecken T, Kraus J, Meyer C, Enders A, Wirtz A, Meitinger T, Carter NP, Speicher MR. Tetrasomy 21pter-->q21.2 in a male infant without typical Down's syndrome dysmorphic features but moderate mental retardation. J Med Genet 2004; 41:e26. [PMID: 14985397 PMCID: PMC1735700 DOI: 10.1136/jmg.2003.011833] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Fiegler H, Gribble SM, Burford DC, Carr P, Prigmore E, Porter KM, Clegg S, Crolla JA, Dennis NR, Jacobs P, Carter NP. Array painting: a method for the rapid analysis of aberrant chromosomes using DNA microarrays. J Med Genet 2003; 40:664-70. [PMID: 12960211 PMCID: PMC1735585 DOI: 10.1136/jmg.40.9.664] [Citation(s) in RCA: 77] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
OBJECTIVE The authors describe a method, termed array painting, which allows the rapid, high resolution analysis of the content and breakpoints of aberrant chromosomes. METHODS Array painting is similar in concept to reverse chromosome painting and involves the hybridisation of probes generated by PCR of small numbers of flow sorted chromosomes on large insert genomic clone DNA microarrays. RESULTS and CONCLUSIONS By analysing patients with cytogenetically balanced chromosome rearrangements, the authors show the effectiveness of array painting as a method to map breakpoints prior to cloning and sequencing chromosome rearrangements.
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MESH Headings
- Adult
- Cell Line
- Child
- Child, Preschool
- Chromosome Aberrations
- Chromosome Disorders/genetics
- Chromosome Disorders/pathology
- Chromosomes, Human, Pair 11/genetics
- Chromosomes, Human, Pair 12/genetics
- Chromosomes, Human, Pair 17/genetics
- Chromosomes, Human, Pair 22/genetics
- Female
- Flow Cytometry
- Humans
- In Situ Hybridization, Fluorescence/methods
- Karyotyping/methods
- Male
- Oligonucleotide Array Sequence Analysis/methods
- Translocation, Genetic
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Affiliation(s)
- H Fiegler
- The Wellcome Trust Sanger Institute, Wellcome Trust Genome Campus, Hinxton, Cambridge CB10 1SA, UK
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Harrison CN, Donohoe S, Carr P, Dave M, Mackie I, Machin SJ. Patients with essential thrombocythaemia have an increased prevalence of antiphospholipid antibodies which may be associated with thrombosis. Thromb Haemost 2002; 87:802-7. [PMID: 12038780] [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: 02/25/2023]
Abstract
A significant proportion of patients with Essential Thrombocythaemia (ET) have thrombotic complications which have an important impact upon the quality, and duration of their life. We performed a retrospective cross sectional study of the prevalence of antiphospholipid antibodies (APA) in 68 ET patients. Compared to 200 "elderly" controls (>50 years) there was a significant increase in anticardiolipin IgM (p < 0.0001) and anti beta2 glycoprotein I (anti-beta2GPI) IgM (p < 0.0001) antibodies in ET. Thrombosis occurred in 10/20 with APA and 12/48 without, p = 0.04, relative risk 2.0 (95% confidence intervals 1.03-3.86): these patients did not differ in terms of other clinical features. The prevalence of thrombosis in patients with dual APA (6/7) was significant when compared to those with single APA (p = 0.02) and the remaining patients (p < 0.0002). Also anti-beta2GP1 IgM antibodies either alone, or in combination with another APA, were associated with thrombosis (p = 0.02). These results suggest that the prevalence of APA in ET and their influence upon thrombotic risk merit investigation in a larger study.
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Affiliation(s)
- C N Harrison
- Department of Haematology, University College London Hospital, UK.
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Johnson GC, Esposito L, Barratt BJ, Smith AN, Heward J, Di Genova G, Ueda H, Cordell HJ, Eaves IA, Dudbridge F, Twells RC, Payne F, Hughes W, Nutland S, Stevens H, Carr P, Tuomilehto-Wolf E, Tuomilehto J, Gough SC, Clayton DG, Todd JA. Haplotype tagging for the identification of common disease genes. Nat Genet 2001; 29:233-7. [PMID: 11586306 DOI: 10.1038/ng1001-233] [Citation(s) in RCA: 908] [Impact Index Per Article: 39.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Genome-wide linkage disequilibrium (LD) mapping of common disease genes could be more powerful than linkage analysis if the appropriate density of polymorphic markers were known and if the genotyping effort and cost of producing such an LD map could be reduced. Although different metrics that measure the extent of LD have been evaluated, even the most recent studies have not placed significant emphasis on the most informative and cost-effective method of LD mapping-that based on haplotypes. We have scanned 135 kb of DNA from nine genes, genotyped 122 single-nucleotide polymorphisms (SNPs; approximately 184,000 genotypes) and determined the common haplotypes in a minimum of 384 European individuals for each gene. Here we show how knowledge of the common haplotypes and the SNPs that tag them can be used to (i) explain the often complex patterns of LD between adjacent markers, (ii) reduce genotyping significantly (in this case from 122 to 34 SNPs), (iii) scan the common variation of a gene sensitively and comprehensively and (iv) provide key fine-mapping data within regions of strong LD. Our results also indicate that, at least for the genes studied here, the current version of dbSNP would have been of limited utility for LD mapping because many common haplotypes could not be defined. A directed re-sequencing effort of the approximately 10% of the genome in or near genes in the major ethnic groups would aid the systematic evaluation of the common variant model of common disease.
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Affiliation(s)
- G C Johnson
- JDRF/WT Diabetes and Inflammation Laboratory, Cambridge Institute for Medical Research, University of Cambridge, Wellcome Trust/Medical Research Council Building, Hills Road, Cambridge, UK
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Cotten-Oldenburg NU, Carr P, DeBoer JM, Collison EK, Novotny G. Impact of pharmacy-based syringe access on injection practices among injecting drug users in Minnesota, 1998 to 1999. J Acquir Immune Defic Syndr 2001; 27:183-92. [PMID: 11404541 DOI: 10.1097/00126334-200106010-00014] [Citation(s) in RCA: 39] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
In Minnesota, state legislation, enacted July 1998, provided for voluntary pharmacy sales of syringes/needles without a prescription for an accompanying drug. The goal was to stem HIV transmission among injecting drug users (IDUs) by providing greater access to sterile syringes. We used a pre/post evaluation design to investigate the impact of less restrictive syringe/possession laws on IDUs' HIV-related syringe practices. Independent cross-sectional samples of IDUs were recruited from street sites and a correctional facility immediately before and 1 year after enactment of the laws. Of the 671 IDUs interviewed, 570 (270 prelegislation and 300 postlegislation) had injected at least once in the 30 days before the interview. IDUs were more likely to purchase syringes at pharmacies after enactment of the laws (odds ratio [OR], 2.66; 95% confidence interval [CI], 1.83-3.85), yet did not change their behaviors regarding carrying unused syringes (OR, 0.90; 95% CI, 0.63-1.28). After adjusting for speedball injection and criminal history, syringe sharing decreased among IDUs (adjusted OR, 0.67; 95% CI, 0.45-1.00) yet syringe reuse remained the same (adjusted OR, 0.67; 95% CI, 0.40-1.11). Safe disposal of syringes did not differ significantly across the sampling periods (adjusted OR, 1.32; 95% CI, 0.84-2.06). Increased access to pharmacy syringes offers a first step at reducing HIV-related syringe practices but must be coupled with strong HIV prevention messages, drug treatment referrals, and safe syringe disposal options.
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Affiliation(s)
- N U Cotten-Oldenburg
- AIDS/STD Prevention Services Section, Minnesota Department of Health, 717 Delaware Street S.E., Minneapolis, MN 55440-9441, U.S.A.
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Cotten-Oldenburg NU, Rosser BR, DeBoer J, Rugg DL, Carr P. Building strong linkages across the HIV prevention continuum: the practical lessons learned from a comprehensive evaluation effort in Minnesota. AIDS Educ Prev 2001; 13:29-41. [PMID: 11252452 DOI: 10.1521/aeap.13.1.29.18924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
This article describes practical lessons learned from an evaluation of a continuum of HIV prevention efforts and is intended to assist other states in strengthening their own HIV prevention evaluation activities. In 1996 Minnesota launched several evaluation activities and began to examine how they could be linked across the HIV prevention continuum. Although each evaluation activity generated its own findings, this article examines the challenges faced and the solutions created when integrating these findings into the original steps of the HIV prevention continuum. Key points are highlighted to guide HIV professionals in their endeavors to develop an integrated approach to evaluation and to establish clear and logical linkages across the HIV prevention continuum.
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Affiliation(s)
- N U Cotten-Oldenburg
- AIDS/STD Prevention Services Section, Minnesota Department of Health, Minneapolis 55440-9441, USA.
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Southgate HJ, Ward A, Taylor A, Carr P. Lessons to be learned: a case study approach. An unusual case of alveolar deposition from swallowing metallic mercury in an attempt at self-poisoning. J R Soc Promot Health 1998; 118:305-8. [PMID: 10076692 DOI: 10.1177/146642409811800518] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The authors report a case of deliberate self-poisoning in a drug addict who swallowed elemental mercury: in so doing he inadvertently acquired a permanent diffuse deposition of mercury particles throughout both lung fields. Swallowed mercury should be relatively harmless in small quantity but the high specific gravity and free flowing properties of elemental mercury allowed it to overcome the normal swallowing pathways--such that some of it passed into the bronchial tree instead of passing harmlessly through the gut. In that site its significant vapour pressure, together with its potential for oxidation to inorganic mercury--which may, in turn, be absorbed across the alveolar membrane, gives high potential for mercury poisoning.
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Affiliation(s)
- H J Southgate
- Department of Chemical Pathology, Worthing Hospital, West Sussex
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Abstract
Three rationally designed isomeric aryl-bridged bis-quinolines, N1,Nx-bis(7-chloroquinolin-4-yl)phenylene-1,x-diamines, where x=2, 3 or 4, i.e. o-, m- and p-substituted analogues respectively, were synthesized and evaluated against Plasmodium berghei in-vivo. The compound with x=2 had an ID50 of 30 mg kg(-1), whereas the p-substituted analogue (x=4) was not statistically schizonticidal at either of the two dose levels tested in olive oil-dimethylsulphoxide (5 and 25 mg kg(-1), ID50=60 mg kg(-1) approx.). When the delivery vehicle was changed to saline-DMSO, antimalarial potency increased for the p-substituted compound (ID50 17 mg kg(-1)). In contrast, the m-substituted analogue had marked antimalarial activity (ID50 1.2 mg kg(-1)), which compares favourably with that of chloroquine diphosphate (ID50 = 4.3 mg kg(-1)). The data presented show that the aminomethylene side chain in amodiaquine can be successfully replaced by a 7-halo-4-aminoquinoline, establishing that carbon bridges containing less than four contiguous carbon atoms can be present within highly active aryl-substituted 4-aminoquinoline antimalarials. These results confirm that the presence of an OH group in the aryl bridge is not necessary for antimalarial activity and substantiate the view that, despite the appearance of resistant strains, new and existing aminoquinolines still have an important role in treating malaria.
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Affiliation(s)
- F M Ismail
- Department of Physical Sciences, Faculty of Natural Sciences, University of Hertfordshire, Hatfield, UK.
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Shefchyk SJ, Espey MJ, Carr P, Nance D, Sawchuk M, Buss R. Evidence for a strychnine-sensitive mechanism and glycine receptors involved in the control of urethral sphincter activity during micturition in the cat. Exp Brain Res 1998; 119:297-306. [PMID: 9551830 DOI: 10.1007/s002210050345] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Micturition in the decerebrate cat is characterized by a coordinated bladder contraction and a simultaneous decrease in external urethral sphincter (EUS) efferent activity. Without the suppression of EUS activity, voiding is significantly impaired, resulting in a state sometimes referred to as bladder-sphincter dyssynergia. The aim of the present study was to determine whether glycinergic inhibition contributes to the suppression of EUS activity during micturition evoked by bladder distension or electrical stimulation of the pontine micturition center (PMC) in decerebrate cats. Using subconvulsive intravenous doses of strychnine (0.1-0.24 mg/kg), we examined changes in bladder and EUS electroneurographic (ENG) activity during micturition. Following subconvulsive doses of strychnine, tonic EUS ENG activity increased during bladder filling in five of six animals. In the presence of strychnine, it was possible to evoke reflex bladder contractions of similar duration and peak pressure to those observed before strychnine administration. However, there was an absence of suppression of EUS ENG activity during the bladder contractions in all the animals. To determine whether the changes in sphincter activity could be due to strychnine acting at glycine receptors on EUS motoneurons, sacral spinal tissue was processed for a structural protein (gephyrin) associated with the glycine receptor. Motoneurons in Onufs nucleus in S1 were identified using choline acetyltransferase immunohistochemistry and subsequently processed with a gephyrin monoclonal antibody. Abundant gephyrin labeling was evident throughout Onufs nucleus. Since Onufs nucleus is made up of EUS and other motoneuron populations, a sample of antidromically identified urethral and anal sphincter motoneurons were intracellularly labeled with tetramethylrhodamine dextran (TMR-D) and then processed with the gephyrin antibody. Using dual-beam confocal microscopy, gephyrin immunoreactivity was observed on the soma and proximal processes of individual EUS motoneurons in both male and female animals. It was concluded that a strychnine-sensitive mechanism contributes to the suppression of sphincter activity normally observed during voiding. Although glycinergic inhibition may affect several components of the circuitry responsible for micturition, it appears that the suppression of EUS motoneurons during micturition may be partly due to a direct glycinergic inhibition of the EUS motoneurons.
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Affiliation(s)
- S J Shefchyk
- Department of Physiology, University of Manitoba, Winnipeg, Canada.
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Barnett RC, Carr P, Boisnier AD, Ash A, Friedman RH, Moskowitz MA, Szalacha L. Relationships of gender and career motivation to medical faculty members' production of academic publications. Acad Med 1998; 73:180-186. [PMID: 9484191 DOI: 10.1097/00001888-199802000-00017] [Citation(s) in RCA: 31] [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] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
PURPOSE To evaluate the relationships between both internal and external career-motivating factors and academic productivity (as measured by the total numbers of publications) among full-time medical faculty, and whether these relationships differ for men and women. METHOD In 1995 a 177-item survey was mailed to 3,013 full-time faculty at 24 randomly selected U.S. medical schools stratified on area of medical specialization, length of service, and gender. Two-tailed t-tests and regression analyses were used to study the data. RESULTS A total of 1,764 faculty were used in the final analyses. The women had published two thirds as many articles as had the men (mean, 24.2 vs. 37.8). Intrinsic and extrinsic career motivation were rated similarly (on a three-point scale) by the women and the men: intrinsic career motivation was rated higher (women's mean rating: 2.8, men's mean rating: 2.9) than was extrinsic career motivation (mean rating: 2.1 for both). The main findings of the regression analyses were (1) intrinsic career motivation was positively associated, and extrinsic career motivation was negatively associated, with the number of publications; (2) publication rates were higher for the men than for the women after controlling for career motivation; and (3) there was no significant effect of gender on these relationships. CONCLUSION The women faculty published less than did their men colleagues, but this difference cannot be accounted for by gender differences in career motivation. Further research on institutional support, family obligations, harassment, and other factors that could affect academic productivity is necessary to understand the gender difference in numbers of publications.
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Affiliation(s)
- R C Barnett
- Women's Studies Program, Brandeis University, Waltham, Massachusetts, USA.
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Abstract
STUDY DESIGN Photographs were used to measure the residual spine motion in 71 women who had undergone spine fusion and instrumentation for spinal deformity or trauma. OBJECTIVES To accurately define the ability of the patient to flex, extend, and bend to the right and left, thus providing the surgeon some accurate information rather than speculation regarding spinal motion. METHODS The 71 patients had undergone spine fusion with instrumentation for scoliosis, kyphosis, or spine trauma. The average age of the patient at surgery was 22 years, ranging from 11 years to 62 years. The average time since surgery was 6 years, ranging from 1 year to 32 years. Each patient had six views photographed: flexion, extension, right and left side bending from the front, and right and left side bending from the back. Each photograph was measured independently by two research assistants. A total of 852 photographs were analyzed. RESULTS The average degree of right side bending was 22 degrees, that of left side bending was 23 degrees, that of flexion was 111 degrees, and that of extension was 30 degrees. For the 59 patients who underwent fusion of seven levels or more and who were fused down to T12, L1, L2, L3, or L4, there was no correlation of the range of motion with the lowermost level of fusion, except in patients with fusion to L4 who had significantly less motion. Flexion was primarily a function of hamstring tightness and was best in those who exercised regularly (aerobics, gymnastics, ballet), regardless of the number of levels fused or the lowermost level of fusion. CONCLUSION Typical spine fusions for deformity produce a moderate loss of functional motion, except in patients who undergo fusion to L4 who lose much more. The technique of analysis was found to be highly accurate and reproducible.
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Affiliation(s)
- R B Winter
- Minnesota Spine Foundation, Minneapolis, USA
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Affiliation(s)
- A V Crowe
- Wessex Renal and Transplantation Unit, St Mary's Hospital, Portsmouth, UK
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Wright DA, Forni LG, Carr P, Hilton PJ, Tungekar MF. Cholesterol embolization after systemic streptokinase. Br J Hosp Med (Lond) 1997; 57:51-2. [PMID: 9022828] [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: 02/03/2023]
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Edwards K, Suffolk P, Carr P, Cheah E, Ollis D. New crystal forms of Escherichia coliP IIcomplexed with various ligands and structure solution of P II/ATP/2-ketoglutarate. Acta Crystallogr A 1996. [DOI: 10.1107/s0108767396090095] [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: 11/10/2022] Open
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Ismail FM, Dascombe MJ, Carr P, North SE. An exploration of the structure-activity relationships of 4-aminoquinolines: novel antimalarials with activity in-vivo. J Pharm Pharmacol 1996; 48:841-50. [PMID: 8887736 DOI: 10.1111/j.2042-7158.1996.tb03985.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
The structure-activity relationships of bisquinolines, a potentially important group of novel antimalarial drugs, were studied. The high-temperature (180-250 degrees C) synthesis of 4-aminoquinolines, including bisquinolines, by nucleophilic displacement was both fast and efficient Several bisquinolines including (+/-)-trans-N1,N2-bis(7-trifluoroquinolin-4-yl)cyclohexane-1, 2-diamine and 1R,2R-(-)-, 1S,2S-(+)-, (+/-)-trans- and cis-N1, N2-bis(7-chloroquinolin-4-yl)cyclohexane-1,2-diamine exhibited potent activity against Plasmodium berghei in mice; (+/-)-trans-N1,N2-bis(7-chloroquinolin-4-yl)cyclohexane-1, 2-diamine was orally active. Our results indicate that these compounds conform to a putative receptor for quinoline antimalarials. In addition, a 7-haloquinoline linked by a heterocyclic bridge, at the 4-position, to another heterocycle (such as an acridine at the 9-position) maximally occupies the active site of our postulated target.
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Affiliation(s)
- F M Ismail
- Division of Chemical Sciences, School of Natural Sciences, University of Hertfordshire, Hatfield, UK
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Abstract
Two murine monoclonal antibodies (mAb), CT8 and AV14, have been shown to recognise the avian homologue of the mammalian CD8 alpha molecule. In previous flow cytometry studies we could discriminate two subpopulations of CD8+ T cells, expressing either a high level (CD8Bright+) or a low level (CD8Dim+) of CD8 molecules. The staining patterns of mAb AV14 and mAb CT8 were not always identical for individual chickens. In this study the discrepancy in the reactivity of these mAb was examined, using outbred White Leghorn chickens as well as (B14B14)-MHC inbred Wellcome chickens. The results show that mAb AV14 and mAb CT8 recognise different epitopes on the chicken CD8 alpha molecule. The CD8Bright+ cells appeared to express the CD8 alpha beta heterodimer and the CD8Dim+ cells the CD8 alpha alpha homodimer. Conformational differences between the alpha beta heterodimer and the alpha alpha homodimer could account for the differences in binding characteristics found for the two mAb. The existence of a polymorphism of the CD8 alpha molecule in outbred White Leghorn chickens was suggested by the failure of peripheral blood leucocytes from some chickens to react with mAb AV14. This heterogeneity was not observed in the Wellcome line.
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Affiliation(s)
- D G Breed
- Department of Parasitology, Intervet International BV, Boxmeer, Netherlands
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Wright DA, Forni LG, Carr P, Treacher DF, Hilton PJ. Use of continuous haemofiltration to assess the rate of lactate metabolism in acute renal failure. Clin Sci (Lond) 1996; 90:507-10. [PMID: 8697721 DOI: 10.1042/cs0900507] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
1. Whole-blood lactate levels were measured at different rates of haemofiltration in 10 patients with acute renal failure undergoing conventional continuous haemofiltration using lactate-buffered replacement fluid. 2. The results enable both basal production rates and the metabolic clearance of lactate to be estimated in man.
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Affiliation(s)
- D A Wright
- Department of Renal Medicine, St. Thomas' Hospital, London, U.K
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Forni LG, Wright DA, Hilton PJ, Carr P, Taub HA, Warburton F. Prognostic stratification in acute renal failure. Arch Intern Med 1996; 156:1023, 1027. [PMID: 8624168 DOI: 10.1001/archinte.156.9.1023] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
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Benoit D, Carr P. Partnership: the relationship between a hospital and its home health agency. Home Healthc Nurse 1996; 14:388-389. [PMID: 8847225 DOI: 10.1097/00004045-199605000-00011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
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Carr P. Functional limitations. Home Healthc Nurse 1996; 14:299, 301. [PMID: 8788685 DOI: 10.1097/00004045-199604000-00010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
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Carr P. Get ready for OASIS. Home Healthc Nurse 1996; 14:61-2. [PMID: 8698610 DOI: 10.1097/00004045-199601000-00011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
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Carr P. Some things change, some do not. Home Healthc Nurse 1995; 13:79-80. [PMID: 7591829 DOI: 10.1097/00004045-199509000-00012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
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Abstract
Intracellular pH (pHi) control and relationships between pHi and tension have been investigated in human subcutaneous small arteries. Isometric tension and pHi (using 2',7'-bis(carboxyethyl)- 5(6)-carboxyfluorescein) were estimated simultaneously. pHi recovery from an acute acid load was dependent on external Na+ and partially inhibited by the absence of HCO3(-) [N-2-hydroxyethylpiperazine-N'-2-ethanesulfonic acid (HEPES)-buffered solution] or by the anion transport inhibitor 4,4'-diisothiocyanostilbene-2,2'-disulfonic acid (DIDS). In an HCO3(-)-buffered physiological salt solution (PSS), pHi recovery was partially blocked by hexamethylene amiloride (HMA), an inhibitor of Na+/H+ exchange, and completely blocked by DIDS and HMA together. Intracellular Cl- depletion of arteries did not affect the rate of pHi recovery in PSS from an acid load. pHi recovery from acute alkalosis was unaffected by external Na+ removal, reduced in HEPES buffer, and abolished by removal of external Cl-. These data suggest that human small arteries maintain pHi by Na+/H+ exchange and Na(+)-dependent HCO3(-) exchange in response to an acid load, and Na(+)-independent Cl-/HCO3(-) exchange to counteract intracellular alkalosis. Norepinephrine (NE)-, endothelin-1 (ET-1)-, arginine vasopressin (AVP)-, and K(+)-induced tension did not alter pHi in PSS, but there was a small fall with angiotensin II (ANG II). In HEPES, stimulation with K+, NE, ANG II, or AVP led to a fall in pHi, but this did not occur with ET-1. It is therefore unlikely in vivo that an increase in pHi in these arteries would be involved in either tension development or growth induced by these agonists.
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Affiliation(s)
- P Carr
- Department of Medicine, United Medical and Dental School, St. Thomas' Hospital, London, United Kingdom
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Hill HM, Hawkins SR, Raposo M, Carr P. Relationship between multiple exposures to violence and coping strategies among African-American mothers. Violence Vict 1995; 10:55-71. [PMID: 8555120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
This exploratory study examined the relationship between coping strategies of 136 African-American mothers, their exposure to community violence, and their interpersonal victimization. It is suggested that the disproportionate victimization of African-American women produces a cumulative triple threat for those who live amidst conditions of community violence in the following manner: a) exposure through daily living in the midst of unpredictable community violence; b) exposure to violence from witnessing violence in the neighborhood; and c) exposure to violence from disproportionately high rates of personal victimization. The findings suggest that coping strategies are used differentially as a function of the amount of violence within the social context, and the education and financial resources of the mothers. Mothers who live in lower-violence areas with college education preferred activism as a coping strategy, whereas those in high-violence areas with comparable incomes and education preferred reliance on prayer and instituting safety practices. Coping strategies differed based on whether mothers had been physical victims and witnesses to violence or had no personal experience with violence. This study lays the groundwork for a model of exploring the impact of the cumulative effects of violence on African-American mothers parenting in urban America.
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Carr P. Healthcare reform. Home Healthc Nurse 1994; 12:60. [PMID: 8056610] [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: 01/28/2023]
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Carr P. Something to think about. Home Healthc Nurse 1994; 12:12. [PMID: 8194989 DOI: 10.1097/00004045-199403000-00003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
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Affiliation(s)
- P Carr
- Florida Home Health Services, Sarasota, Inc
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50
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Affiliation(s)
- P Carr
- Florida Home Health Services, Sarasota, Inc
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