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Deschamp AR, Chen Y, Wang WF, Rasic M, Hatch J, Sanders DB, Ranganathan SC, Ferkol T, Perkins D, Finn P, Davis SD. The association between gut microbiome and growth in infants with cystic fibrosis. J Cyst Fibros 2023; 22:1010-1016. [PMID: 37598041 PMCID: PMC10840679 DOI: 10.1016/j.jcf.2023.08.001] [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: 02/20/2023] [Revised: 07/24/2023] [Accepted: 08/02/2023] [Indexed: 08/21/2023]
Abstract
BACKGROUND In cystic fibrosis (CF), pathophysiologic changes in the gastrointestinal tract lead to malnutrition and altered gut microbiome. Microbiome alterations have been linked to linear growth, gut inflammation and respiratory manifestations. Elucidating these gut microbiome alterations may provide insight into future nutritional management in CF. METHODS Infants were followed for 12-months at four sites in the United States (US-CF) and Australia (AUS-CF). 16S rRNA gene sequencing was performed on longitudinal stool samples. Associations between microbial abundance and age, antibiotic prophylaxis, malnutrition, and breast feeding were evaluated using generalized linear mixed models. Taxonomic and predictive functional features were compared between groups. RESULTS Infants with CF (N = 78) were enrolled as part of a larger study. AUS-CF infants had higher mean weight-for-age z-scores than US-CF infants (p = 0.02). A subset of participants (CF N = 40, non-CF disease controls N = 10) provided stool samples for microbiome analysis. AUS-CF infants had lower stool alpha diversity compared to US-CF infants (p < 0.001). AUS-CF infants had higher relative abundance of stool Proteobacteria compared to US-CF infants which was associated with antibiotic prophylaxis (p < 0.001). Malnutrition (weight-for-age <10th percentile) was associated with depleted Lactococcus (p < 0.001). Antibiotic prophylaxis (p = 0.002) and malnutrition (p = 0.012) were linked with predicted decreased activity of metabolic pathways responsible for short chain fatty acid processing. CONCLUSIONS In infants with CF, gut microbiome composition and diversity differed between the two continents. Gut microbial diversity was not linked to growth. The relationship between malnutrition and antibiotic prophylaxis with reduced SCFA fermentation could have implications for gut health and function and warrants additional investigation.
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Affiliation(s)
- A R Deschamp
- Indiana University School of Medicine, Riley Children's Hospital, 340 10th Street, Indianapolis, IN 46202, United States of America.
| | - Y Chen
- University of Illinois Chicago, 1200 West Harrison Street, Chicago, Illinois 60607, United States of America
| | - W F Wang
- University of Illinois Chicago, 1200 West Harrison Street, Chicago, Illinois 60607, United States of America
| | - M Rasic
- University of Illinois Chicago, 1200 West Harrison Street, Chicago, Illinois 60607, United States of America
| | - J Hatch
- Indiana University School of Medicine, Riley Children's Hospital, 340 10th Street, Indianapolis, IN 46202, United States of America
| | - D B Sanders
- Indiana University School of Medicine, Riley Children's Hospital, 340 10th Street, Indianapolis, IN 46202, United States of America
| | - S C Ranganathan
- Royal Children's Hospital, Murdoch Children's Research Institute, 50 Flemington Road, Parkville, Victoria 3052, Australia
| | - T Ferkol
- Washington University, 660 S Euclid Ave, St. Louis, MO 63110, United States of America
| | - D Perkins
- University of Illinois Chicago, 1200 West Harrison Street, Chicago, Illinois 60607, United States of America
| | - P Finn
- University of Illinois Chicago, 1200 West Harrison Street, Chicago, Illinois 60607, United States of America
| | - S D Davis
- Indiana University School of Medicine, Riley Children's Hospital, 340 10th Street, Indianapolis, IN 46202, United States of America
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Deschamp A, Chen Y, Wang W, Rasic M, Hatch J, Sanders D, Ranganathan S, Ferkol T, Perkins D, Davis S, Finn P. 200: The association of growth and the gut microbiome in infants with cystic fibrosis. J Cyst Fibros 2021. [DOI: 10.1016/s1569-1993(21)01625-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Mathevosian S, Yoshida T, Hassani C, Jalili M, Finn P, Bedayat A. Abstract No. 468 Evaluation of aortic stent endoleaks using ferumoxytol-enhanced magnetic resonance angiography. J Vasc Interv Radiol 2021. [DOI: 10.1016/j.jvir.2021.03.277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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Shahrouki P, Moriarty J, Kee S, Quinones-Baldrich W, DeRubertis B, Yoshida T, Finn P. 3:18 PM Abstract No. 25 Ferumoxytol- enhanced magnetic resonance angiography for preprocedural vascular planning in patients with chronic kidney disease. J Vasc Interv Radiol 2018. [DOI: 10.1016/j.jvir.2018.01.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Bhattacharya R, Birdsall PD, Finn P, Stothard J. A Randomized Controlled Trial of Knifelight and Open Carpal Tunnel Release. ACTA ACUST UNITED AC 2016; 29:113-5. [PMID: 15010154 DOI: 10.1016/j.jhsb.2003.09.001] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2003] [Accepted: 09/04/2003] [Indexed: 11/23/2022]
Abstract
A randomized controlled trial was done to compare the results of carpal tunnel decompression using the standard open approach and the Knifelight® technique. Twenty-six patients with bilateral carpal tunnel syndrome requiring operation were selected for the study and the operative technique was randomized for the first hand. Six weeks later, the second hand was operated upon using the alternate technique. There was little difference between the two techniques with regard to time taken to return to work, return of grip strength, symptom relief, complications, incidence of pillar pain and patient preference. However, the incidence of scar tenderness was significantly lower with the Knifelight® technique.
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Affiliation(s)
- R Bhattacharya
- Department of Trauma and Orthopaedic Surgery, Middlesbrough General Hospital, Ayresome Green Lane, Middlesbrough, TS5 5AZ, UK
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Abstract
Objectives: To evaluate a training programme aimed at improving lateral weight transference in patients following acute stroke to determine main treatment effects, if any, to inform the design of future studies. Design: A single-blind randomized controlled trial. Setting: The Stroke Unit at The James Cook University Hospital, Middlesbrough, UK. Subjects: Thirty-five patients with an acute stroke. Interventions: All subjects received their usual care, including physiotherapy. The treatment group (n / 17) received 12 additional therapy sessions (over four weeks) comprising exercises aimed at improving lateral weight transference in sitting delivered by trained physiotherapy assistants. Main outcome measures: Measures of dynamic reaching, sitting and standing, and static standing balance were undertaken by a blind independent observer. Results: Specific measures of weight displacement in standing and reaching, and timed standing up and sitting down did not detect any differences over time regardless of group. Neither were there any significant changes over time, except for sway during static standing (p B=0.01) and time to return to their original position during dynamic reaching (p / 0.01). Conclusions: A training programme aimed at improving lateral weight transference did not appear to enhance the rehabilitation of acute stroke patients. Improvements observed in postural control in standing and sitting may be attributable to usual care or natural recovery.
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Affiliation(s)
- T E Howe
- Teesside Centre for Rehabilitation Sciences, University of Teesside, Middlesbrough, UK.
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Nael K, Meshksar A, Ellingson B, Pirastehfar M, Salamon N, Finn P, Liebeskind DS, Villablanca JP. Combined low-dose contrast-enhanced MR angiography and perfusion for acute ischemic stroke at 3T: A more efficient stroke protocol. AJNR Am J Neuroradiol 2014; 35:1078-84. [PMID: 24503557 DOI: 10.3174/ajnr.a3848] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE There is need to improve image acquisition speed for MR imaging in evaluation of patients with acute ischemic stroke. The purpose of this study was to evaluate the feasibility of a 3T MR stroke protocol that combines low-dose contrast-enhanced MRA and dynamic susceptibility contrast perfusion, without additional contrast. METHODS Thirty patients with acute stroke who underwent 3T MR imaging followed by DSA were retrospectively enrolled. TOF-MRA of the neck and brain and 3D contrast-enhanced MRA of the craniocervical arteries were obtained. A total of 0.1 mmol/kg of gadolinium was used for both contrast-enhanced MRA (0.05 mmol/kg) and dynamic susceptibility contrast perfusion (0.05 mmol/kg) (referred to as half-dose). An age-matched control stroke population underwent TOF-MRA and full-dose (0.1 mmol/kg) dynamic susceptibility contrast perfusion. The cervicocranial arteries were divided into 25 segments. Degree of arterial stenosis on contrast-enhanced MRA and TOF-MRA was compared with DSA. Time-to-maximum maps (>6 seconds) were evaluated for image quality and hypoperfusion. Quantitative analysis of arterial input function curves, SNR, and maximum T2* effects were compared between half- and full-dose groups. RESULTS The intermodality agreements (k) for arterial stenosis were 0.89 for DSA/contrast-enhanced MRA and 0.63 for DSA/TOF-MRA. Detection specificity of >50% arterial stenosis was lower for TOF-MRA (89%) versus contrast-enhanced MRA (97%) as the result of overestimation of 10% (39/410) of segments by TOF-MRA. The DWI-perfusion mismatch was identified in both groups with high interobserver agreement (r = 1). There was no significant difference between full width at half maximum of the arterial input function curves (P = .14) or the SNR values (0.6) between the half-dose and full-dose groups. CONCLUSIONS In patients with acute stroke, combined low-dose contrast-enhanced MRA and dynamic susceptibility contrast perfusion at 3T is feasible and results in significant scan time and contrast dose reductions.
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Affiliation(s)
- K Nael
- From the Department of Medical Imaging (K.N., A.M.), University of Arizona, Tucson, Arizona
| | - A Meshksar
- From the Department of Medical Imaging (K.N., A.M.), University of Arizona, Tucson, Arizona
| | - B Ellingson
- Department of Radiological Sciences (B.E., M.P., N.S., P.F., J.P.V.)
| | - M Pirastehfar
- Department of Radiological Sciences (B.E., M.P., N.S., P.F., J.P.V.)
| | - N Salamon
- Department of Radiological Sciences (B.E., M.P., N.S., P.F., J.P.V.)
| | - P Finn
- Department of Radiological Sciences (B.E., M.P., N.S., P.F., J.P.V.)
| | - D S Liebeskind
- Department of Neurology, Stroke Center (D.S.L.), University of California, Los Angeles, Los Angeles, California
| | - J P Villablanca
- Department of Radiological Sciences (B.E., M.P., N.S., P.F., J.P.V.)
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Nguyen KL, Khan SN, Moriarty J, Mohajer K, Renella P, Satou G, Ayad I, Patel S, Boechat I, Finn P. Cardiac MR imaging and MR angiography in pediatric congenital heart disease: a comparison between 1.5T and 3.0T. J Cardiovasc Magn Reson 2013. [PMCID: PMC3560072 DOI: 10.1186/1532-429x-15-s1-w27] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Khan SN, DaSilva C, Renella P, Satou G, Ayad I, Patel S, Boechat I, Finn P. CEMRA in neonatal and pediatric congenital vascular diseases at 1.5T and 3.0T: comparison of an intravascular contrast agent (Gadofosveset) with an extracellular agent (Gadopentetate Dimeglumine). J Cardiovasc Magn Reson 2013. [PMCID: PMC3560090 DOI: 10.1186/1532-429x-15-s1-w32] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Khan SN, Meehan C, Plotnik A, Ayad I, Patel S, Boechat I, Finn P. Contrast enhanced magnetic resonance angiography in children: initial experience at 3.0 Tesla. J Cardiovasc Magn Reson 2013. [PMCID: PMC3560065 DOI: 10.1186/1532-429x-15-s1-w36] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Trachtman H, Goyal S, Finn P, Ledbetter S. Neutralizing TGF-beta in fibrotic renal disorders: Focus on fresolimumab. DRUG FUTURE 2012. [DOI: 10.1358/dof.2012.037.011.1888927] [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: 10/25/2022]
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Palermo A, Palmer R, So K, Zhang M, Richards B, Shah S, Finn P, Oba-Shinjo S, Pescatori M, Marie S, McVie-Wylie A, Mattaliano R, Pomponio R, Madden S, Klinger K. Transcriptional Response to GAA Deficiency in Mice and Humans. Clin Ther 2011. [DOI: 10.1016/j.clinthera.2011.05.066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Palmer R, Palermo A, So K, Zhang M, Richards B, Shah S, Finn P, Oba-Shinjo S, Pescatori M, Marie S, McVie-Wylie A, Mattaliano R, Pomponio R, Madden S, Klinger K. P4.52 Transcriptional response to GAA deficiency in mice and humans. Neuromuscul Disord 2010. [DOI: 10.1016/j.nmd.2010.07.248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Finn P, Royden C. The identification of a moving object by a moving observer. J Vis 2010. [DOI: 10.1167/7.9.749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Steele N, Finn P, Brown R, Plumb JA. Combined inhibition of DNA methylation and histone acetylation enhances gene re-expression and drug sensitivity in vivo. Br J Cancer 2009; 100:758-63. [PMID: 19259094 PMCID: PMC2653770 DOI: 10.1038/sj.bjc.6604932] [Citation(s) in RCA: 111] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Histone deacetylation and DNA methylation have a central role in the control of gene expression in tumours, including transcriptional repression of tumour suppressor genes and genes involved in sensitivity to chemotherapy. Treatment of cisplatin-resistant cell lines with an inhibitor of DNA methyltransferases, 2-deoxy-5′azacytidine (decitabine), results in partial reversal of DNA methylation, re-expression of epigenetically silenced genes including hMLH1 and sensitisation to cisplatin both in vitro and in vivo. We have investigated whether the combination of decitabine and a clinically relevant inhibitor of histone deacetylase activity (belinostat, PXD101) can further increase the re-expression of genes epigenetically silenced by DNA methylation and enhance chemo-sensitisation in vivo at well-tolerated doses. The cisplatin-resistant human ovarian cell line A2780/cp70 has the hMLH1 gene methylated and is resistant to cisplatin both in vitro and when grown as a xenograft in mice. Treatment of A2780/cp70 with decitabine and belinostat results in a marked increase in expression of epigenetically silenced MLH1 and MAGE-A1 both in vitro and in vivo when compared with decitabine alone. The combination greatly enhanced the effects of decitabine alone on the cisplatin sensitivity of xenografts. As the dose of decitabine that can be given to patients and hence the maximum pharmacodynamic effect as a demethylating agent is limited by toxicity and eventual re-methylation of genes, we suggest that the combination of decitabine and belinostat could have a role in the efficacy of chemotherapy in tumours that have acquired drug resistance due to DNA methylation and gene silencing.
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Affiliation(s)
- N Steele
- Centre for Oncology and Applied Pharmacology, University of Glasgow, UK
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Kessell G, Panchatsharam S, Kothmann E, Finn P, Fall A, Guhan A, Muir T. General anaesthesia for intralesional bleomycin therapy of vascular malformations: initial 3 yr experience. Br J Anaesth 2009; 102:431-2. [DOI: 10.1093/bja/aen395] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Abstract
The aim of this study was to determine the functional outcome and rate of re-tears following mini-open repair of symptomatic large and massive tears of the rotator cuff using a two-row technique. The 24 patients included in the study were assessed prospectively before and at a mean of 27 months (18 to 53) after surgery using the Constant and the Oxford Shoulder scores. Ultrasound examination was carried out at follow-up to determine the integrity of the repair. Patient satisfaction was assessed using a simple questionnaire. The mean Constant score improved significantly from 36 before to 68 after operation (p < 0.0001) and the mean Oxford Shoulder score from 39 to 20 (p < 0.0001). Four of the 24 patients (17%) had a re-tear diagnosed by ultrasound. A total of 21 patients (87.5%) were satisfied with the outcome of their surgery. The repair remained intact in 20 patients (83%). However, the small number of re-tears (four patients) in the study did not allow sufficient analysis to show a difference in outcome in relation to the integrity of the repair.
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Affiliation(s)
| | | | - P. Finn
- School of Health & Social Care University of Teesside, Middlesbrough TS1 3BA, UK
| | - A. Rangan
- Department of Trauma & Orthopaedics James Cook University Hospital, Marton Road, Middlesbrough TS4 3BW, UK
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Taylor FC, Irons LJ, Finn P, Summerbell CD. Controlled clinical trial of two weight reducing diets in a NHS hospital dietetic outpatient clinic - a pilot study. J Hum Nutr Diet 2007; 20:270-2. [PMID: 17539881 DOI: 10.1111/j.1365-277x.2007.00771.x] [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: 11/30/2022]
Abstract
BACKGROUND Outpatient dietary weight reduction for obesity is unsatisfactory. The objective of this study was to compare the efficacy of an energy prescription diet with usual care (a healthy eating diet) in adult overweight patients referred to a NHS hospital dietetic outpatient clinic, in terms of weight change over 12 weeks. METHODS Controlled clinical trial (systematic allocation). RESULTS Of the 53 patients who attended their first appointment, 27 completed the trial. Mean weight loss (kg) after 12 weeks was 4.2 (sd 3.8) on the energy prescription diet (n = 16) and 6.0 (sd 2.8) on the healthy eating diet (n = 11). CONCLUSIONS Patients on a weight reducing diet based on energy prescription or healthy eating lost, on average, clinically significant amounts of body weight by 12 weeks. Mean weight loss was greater by about 50% in the healthy eating group and supports the development of a larger trial to estimate true effect.
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Affiliation(s)
- F C Taylor
- Dietetic Department, Guisborough General Hospital, Guisborough, UK.
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Bhattacharya R, Kumar V, Safawi E, Finn P, Hui AC. The knee skyline radiograph: its usefulness in the diagnosis of patello-femoral osteoarthritis. Int Orthop 2006; 31:247-52. [PMID: 16783548 PMCID: PMC2267568 DOI: 10.1007/s00264-006-0167-y] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/24/2006] [Revised: 03/28/2006] [Accepted: 03/30/2006] [Indexed: 10/24/2022]
Abstract
The aim of this study was to determine the usefulness of the skyline radiograph in the diagnosis of patellofemoral osteoarthritis. Additionally, we wanted to assess the usefulness of patello-femoral crepitus as a clinical sign of this condition. Seventy-seven patients scheduled to undergo knee surgery had standard antero-posterior, lateral and skyline X-rays of their affected knee. The presence of clinical patello-femoral crepitus was also documented preoperatively. At the operation, their patellofemoral joints were graded into two groups according to the presence or absence of osteoarthritis. The lateral and skyline view X-rays as well as patello-femoral crepitus were compared individually against the operative findings. The skyline view had a sensitivity of 79% and a specificity of 80%. The lateral view had a sensitivity of 82% and specificity of 65%. Patello-femoral crepitus as a sign had a sensitivity of 89% and a specificity of 82%. There was no statistically significant difference between the two radiological views in terms of sensitivity and specificity in the diagnosis of patellofemoral osteoarthritis. Hence, we cannot recommend the skyline view as a routine radiological investigation in all cases of suspected patellofemoral osteoarthritis.
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Affiliation(s)
- R. Bhattacharya
- The James Cook University Hospital, Marton Road, Middlesbrough, TS4 3BW UK
| | - V. Kumar
- The James Cook University Hospital, Marton Road, Middlesbrough, TS4 3BW UK
- 32, Grosvenor Road, Billingham, Cleveland TS22 5HA UK
| | - E. Safawi
- The James Cook University Hospital, Marton Road, Middlesbrough, TS4 3BW UK
| | - P. Finn
- School of Health and Social Care, University of Teesside, Tees Valley, TS1 3BA Middlesbrough, UK
| | - A. C. Hui
- The James Cook University Hospital, Marton Road, Middlesbrough, TS4 3BW UK
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Lidstone JSM, Ells LJ, Finn P, Whittaker VJ, Wilkinson JR, Summerbell CD. Independent associations between weight status and disability in adults: Results from the health survey for England. Public Health 2006; 120:412-7. [PMID: 16566950 DOI: 10.1016/j.puhe.2005.12.003] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.8] [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: 01/28/2005] [Revised: 06/09/2005] [Accepted: 12/07/2005] [Indexed: 11/30/2022]
Abstract
OBJECTIVES While direct links between obesity and some illnesses are well-established, there is a relative paucity of research on associations between obesity and disabilities. The aim of this study was to test for significant associations between overweight and obesity and the presence of a wide range of disabling conditions in adults, controlling for sex, age, education, social class, income, cigarette smoking status and alcohol consumption. STUDY DESIGN Data were extracted from the Health Survey for England (2001); a cross-sectional survey of the community-dwelling population. In total, 8613 adult participants were included in the analysis. METHODS Multivariate logistic regression was employed to test whether the odds of having a range of disabling conditions are higher in the overweight and obese populations compared with those in the ideal weight range. RESULTS The risk of nearly all disabling conditions tested was elevated in the obese and morbidly obese groups. Of great importance for public health, the risks of musculoskeletal illness, arthritis and rheumatism, and personal care disability were significantly elevated, even in those in the overweight category (currently about half of the adult population living in the UK). CONCLUSIONS Obesity is independently associated with a range of disabling conditions in adults. The present study highlights the need for further research into the mechanisms by which these associations occur.
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Affiliation(s)
- J S M Lidstone
- School of Health and Social Care, University of Teesside, Middlesbrough TS1 3BA, UK.
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Abstract
We conducted a randomised, controlled trial to determine whether changing gloves at specified intervals can reduce the incidence of glove perforation and contamination in total hip arthroplasty. A total of 50 patients were included in the study. In the study group (25 patients), gloves were changed at 20-minute intervals or prior to cementation. In the control group (25 patients), gloves were changed prior to cementation. In addition, gloves were changed in both groups whenever there was a visible puncture. Only outer gloves were investigated. Contamination was tested by impression of gloved fingers on blood agar and culture plates were subsequently incubated at 37°C for 48 hours. The number of colonies and types of organisms were recorded. Glove perforation was assessed using the water test. The incidence of perforation and contamination was significantly lower in the study group compared with the control group. Changing gloves at regular intervals is an effective way to decrease the incidence of glove perforation and bacterial contamination during total hip arthroplasty.
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Affiliation(s)
- M Al-Maiyah
- Department of Orthopaedics, School of Health, University of Teeside, Middlesbrough TS1 3BA, UK.
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Abstract
OBJECTIVES To determine predictors of outcome after percutaneous coronary intervention (PCI) in patients with cardiogenic shock complicating acute myocardial infarction. METHODS Retrospective analysis of a cohort of 113 patients undergoing emergency coronary angiography and attempted PCI for cardiogenic shock complicating acute myocardial infarction in a regional cardiothoracic unit. RESULTS In-hospital mortality was 51% (58 patients). Adverse outcome was associated with previous myocardial infarction, age over 70 years, cardiogenic shock complicating failure to respond to thrombolytic treatment (failed thrombolysis), and multivessel coronary artery disease. Multivariate logistic regression analysis showed that the first three factors were independent predictors of in-hospital death with odds ratios of 5.21 (95% confidence interval (CI) 1.85 to 14.69), 4.02 (95% CI 1.14 to 14.12), and 3.78 (95% CI 1.43 to 9.96), respectively. CONCLUSION About 50% of patients with cardiogenic shock undergoing a strategy of urgent coronary angiography and PCI survive to hospital discharge. Survivors do well in the subsequent six months. Emergency PCI for cardiogenic shock reduces mortality from an expected 80% to about 50%. Clinical features can help determine which patients are most likely to gain from urgent coronary angiography and attempted PCI. Alternative strategies are needed to improve the outcome of patients who fare badly.
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Affiliation(s)
- A G C Sutton
- Cardiothoracic Division, The James Cook University Hospital, Marton Road, Middlesbrough TS4 3BW, UK.
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Abstract
Our study was undertaken to assess the inter- and intra-observer variability of the classification system of Sanders for calcaneal fractures. Five consultant orthopaedic surgeons with different subspecialty interests classified CT scans of 28 calcaneal fractures using this classification system. After six months, they reclassified the scans. Kappa statistics were used to analyse the two groups. The interobserver variability of the classification system was 0.32 (95% confidence interval (CI) 0.26 to 0.38). The subclasses were then combined and assessment of agreement between the general classes as a whole gave a kappa value of 0.33 (95% CI 0.25 to 0.41). The mean kappa value for intra-observer variability of the classification system was 0.42 (95% CI 0.22 to 0.62). When the subclasses were combined, it was 0.45 (95% CI 0.21 to 0.65). Our results show that, despite its popularity, the classification system of Sanders has only fair agreement among users.
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Abstract
BACKGROUND Recent research indicates that currently active or recently detoxified substance abusers make more disadvantageous decisions on a simulated gambling task (SGT). This study expands on the current literature by using the SGT to examine decision making in long-term abstinent alcoholics (mean of 6.6 years' abstinence) who do not have antisocial personality disorder or a history of conduct disorder. METHODS A total of 102 subjects (58 controls and 44 abstinent alcoholics) were tested on the SGT, in which subjects choose cards from 4 different decks that vary in terms of the magnitude of the immediate win (large or small) and the magnitude of long-term loss (large or small). The association of SGT performance with alcohol use variables, with the number of externalizing symptoms, and with personality measures of social deviance was examined. RESULTS Compared with controls, long-term abstinent alcohol-dependent subjects had more externalizing symptoms, had personality profiles associated with a proneness to social deviance, and made more disadvantageous decisions on the SGT. The magnitude of disadvantageous decision making was associated with the duration of peak alcohol use but was associated with only one measure (low socialization) of socially deviant personality traits. CONCLUSIONS The results suggest that alcoholics can achieve long-term abstinence despite persistent deficits in decision making and abnormal personality profiles. The decision-making deficits either may be the result of long-term alcoholism or may reflect a factor predisposing to alcoholism that persists with abstinence. The possibility is raised that alcoholics who cannot achieve long-term abstinence are even more impaired on their decision making and have more abnormal personality profiles than the abstinent alcoholics studied here.
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Affiliation(s)
- G Fein
- Neurobehavioral Research, Inc., Corte Madera, California 94925, USA.
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Taylor FC, Irons LJ, Finn P, Summerbell CD. Controlled clinical trial of two weight reducing diets in a NHS hospital dietetic outpatient clinic - a pilot study. J Hum Nutr Diet 2003; 16:85-7. [PMID: 12662366 DOI: 10.1046/j.1365-277x.2003.00415.x] [Citation(s) in RCA: 4] [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: 11/20/2022]
Abstract
BACKGROUND Outpatient dietary weight reduction for obesity is unsatisfactory. The objective of this study was to compare the efficacy of an energy prescription diet with usual care (a healthy eating diet) in adult overweight patients referred to a NHS hospital dietetic outpatient clinic, in terms of weight change over 12 weeks. METHODS Controlled clinical trial (systematic allocation). RESULTS Of the 53 patients who attended their first appointment, 27 completed the trial. Mean weight loss (kg) after 12 weeks was 4.2 (sd 3.8) on the energy prescription diet (n = 16) and 6.0 (sd 2.8) on the healthy eating diet (n = 11). CONCLUSIONS Patients on a weight reducing diet based on energy prescription or healthy eating lost, on average, clinically significant amounts of body weight by 12 weeks. Mean weight loss was greater by about 50% in the healthy eating group and supports the development of a larger trial to estimate true effect [corrected].
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Affiliation(s)
- F C Taylor
- Dietetic Department, Guisborough General Hospital, UK.
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Sutton AGC, Finn P, Campbell PG, Price DJA, Hall JA, Stewart MJ, Davies A, Linker NJ, De Belder MA. Early and late reactions following the use of iopamidol 340, iomeprol 350 and iodixanol 320 in cardiac catheterization. J Invasive Cardiol 2003; 15:133-8. [PMID: 12612387] [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: 03/01/2023]
Abstract
GOAL To investigate the incidence of early (< 24 hours) and late (> 24 hours to 7 days) reactions to 3 contrast agents commonly used in cardiac catheterization. METHODS AND RESULTS A total of 2,108 patients undergoing cardiac catheterization in a Regional Cardiothoracic Unit were randomly assigned to receive 1 of 3 commonly used contrast agents in a prospective, double-blind study. The contrast agents were iopamidol 340 (Niopam ), a nonionic monomer; iomeprol 350 (Iomeron ), a nonionic dimer; and iodixanol 320 (Visipaque ), a nonionic dimer. The main outcome measures were the incidence of early (< 24 hours) reactions following catheterization and the incidence of late (24 hours to 7 days) reactions. Early reactions, excluding patients with heat on left ventriculography as the sole symptom, were relatively common (7.4%), but there was no significant difference between the 3 agents (p = 0.35). Late skin reactions, excluding reactions solely at the site of the arterial puncture and continuations of early urticarial reactions, were also relatively common (5.4%), but the incidence differed between the 3 agents. Such reactions occurred in 2.7% of those receiving iopamidol 340 (Niopam ), 3.5% of those receiving iomeprol 350 (Iomeron ) and 10.4% of those receiving iodixanol 320 (Visipaque ) (p < 0.01). CONCLUSION The incidence of early adverse reactions is similar with these 3 contrast agents. However, late skin reactions are significantly more common with iodixanol 320 (Visipaque ) than with the other 2 agents. Although such reactions were rarely troublesome, patients should be advised accordingly.
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Affiliation(s)
- A G C Sutton
- Cardiothoracic Division, the James Cook University Hospital, Middlesbrough, England, United Kingdom
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Abstract
BACKGROUND Renal itch is a relatively common and distressing problem for patients with chronic renal failure. Ondansetron, a serotonin type 3 receptor antagonist was developed for relief of chemotherapy induced nausea. Recently, anecdotal reports describe relief of renal itch with ondansetron. OBJECTIVES We performed a double-blind randomized placebo-controlled trial to objectively assess the effectiveness of ondansetron in renal itch. PATIENTS AND METHODS With approval from the local ethical committee, 24 patients on haemodialysis were enrolled in the trial. On a random basis 14 patients were blindly allocated to the ondansetron-placebo sequence and 10 to the placebo-ondansetron sequence. Baseline values for itch were obtained for 7 days before the treatment period and there was a 7-day washout between the treatment periods. During the treatment patients received either 8 mg of ondansetron three times a day or a placebo tablet three times a day for 2 weeks. Patients were asked to record the severity of their pruritus on a visual analogue scale (VAS) twice a day. At the end of the study patients were asked blindly which treatment they had preferred. RESULTS Seventeen patients completed the trial. Pruritus decreased by 16% (95% CI: 0.5-32%) during active treatment and by 25% (95% CI: 9-41%) during treatment with placebo. The change in VAS scores during treatment with ondansetron (P = 0.04) and placebo (P = 0.01) were both significant. Eleven patients expressed a preference, seven for placebo and four for ondansetron. CONCLUSIONS Our results show that ondansetron is no better than placebo in controlling renal itch.
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Affiliation(s)
- M Murphy
- Department of Dermatology, South Cleveland Hospital, Middlesbrough, TS4 3BW, UK.
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30
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Abstract
Concern exists over recent unexplained deaths among intravenous drug users. This report describes a patient with crepitant cellulitis who was admitted complaining of severe pain in the right forearm. Ultrasonography demonstrated gas in the tissues and he was referred for early surgical debridement of the arm. He was treated with intravenous benzyl penicillin, gentamicin and metronidazole and made a full recovery. Aspirate samples grew Bacillus cereus, morphologically similar to the isolate obtained from a sample of the patient's own heroin. Antibiogram and API 50CHB profiles were also similar. Further typing included 'H' flagellar serotyping, which found both blood and heroin strains to be non-typable, and amplified fragment polymorphism analysis, which showed that the strains were indistinguishable. Genotyping of two selected genes from B. cereus confirmed almost certain identity between the two strains. This case illustrates the potential virulence of B. cereus when inoculated into tissues, and to our knowledge, is the first report to demonstrate a conclusive microbiological link between contaminated heroin and serious sepsis in a drug user due to B. cereus.
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Affiliation(s)
| | | | - P Finn
- Departments of Microbiology and Surgery*, Vale of Leven Hospital, Alexandria, Dunbartonshire, G83 OUA and †Biotechnology Centre of Oslo and Institute of Pharmacy, University of Oslo, 1125 Blindern, 0316 Oslo, Norway
| | - A-B Kolsto
- Departments of Microbiology and Surgery*, Vale of Leven Hospital, Alexandria, Dunbartonshire, G83 OUA and †Biotechnology Centre of Oslo and Institute of Pharmacy, University of Oslo, 1125 Blindern, 0316 Oslo, Norway
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Ingham RJ, Sato W, Finn P, Belknap H. The modification of speech naturalness during rhythmic stimulation treatment of stuttering. J Speech Lang Hear Res 2001; 44:841-852. [PMID: 11521776 DOI: 10.1044/1092-4388(2001/066)] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
This study investigated the modification of speech naturalness during stuttering treatment. It systematically replicated an earlier study (Ingham & Onslow, 1985) that demonstrated that unnatural-sounding stutter-free speech could be shaped into more natural-sounding stutter-free speech by using regular feedback of speech-naturalness ratings during speaking tasks. In the present study, the some procedure was used with three persons who stutter-2 adolescent girls and 1 adult man-during rhythmic stimulation conditions. The two adolescent participants spoke only English, but Spanish was the first and English the second language (ESL) of the adult participant. For the 2 adolescents, it was demonstrated that their unnatural-sounding rhythmic speech could be shaped to levels found among normally fluent speakers without losing the fluency-inducing benefits of rhythmic speech. The findings indicate that speech-naturalness feedback may be a powerful procedure for overcoming a problematic aspect of rhythmic speech treatments of stuttering. However, it was not possible to deliver reliable speech-naturalness feedback to the adult ESL speaker, who also displayed a strong dialect. The study highlights the need to find strategies to improve interjudge agreement when using speech naturalness ratings with speakers who display a strong dialect.
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Affiliation(s)
- R J Ingham
- Department of Speech and Hearing Sciences, University of California, Santa Barbara 93106, USA.
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32
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Fischer TA, Ludwig S, Flory E, Gambaryan S, Singh K, Finn P, Pfeffer MA, Kelly RA, Pfeffer JM. Activation of Cardiac c-Jun NH
2
-Terminal Kinases and p38-Mitogen–Activated Protein Kinases With Abrupt Changes in Hemodynamic Load. Hypertension 2001; 37:1222-8. [PMID: 11358932 DOI: 10.1161/01.hyp.37.5.1222] [Citation(s) in RCA: 40] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
—The role of mitogen-activated protein kinase (MAPK) pathways as signal transduction intermediates of hemodynamic stress leading to cardiac hypertrophy in the adult heart is not fully established. In a rat model of pressure-overload hypertrophy, we examined whether activation of MAPK pathways, namely, the extracellular signal–regulated protein kinase (ERK), c-Jun NH
2
-terminal kinase (JNK), and the p38-MAPK pathways, occurs during rapid changes in hemodynamic load in vivo. A slight activation of ERK2 and marked increases in JNK1 and p38-MAPK activities were observed 30 minutes after aortic banding. The increase in p38-MAPK activity was accompanied by an increase in the phosphorylation of the p38 substrate MAPK–activated protein kinases 2 and 3. Activation of these kinases was coincident with an increase in phosphorylation of c-Jun and activating transcription factor-2 (ATF-2) and enhanced DNA binding of activator protein-1 factors. Thus, hemodynamic stress of the adult rat heart in vivo results in rapid activation of several parallel MAPK kinase cascades, particularly stress-activated MAPK and p38-MAPK and their target transcription factors c-Jun and ATF-2.
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Affiliation(s)
- T A Fischer
- Department of Medicine II, University of Mainz, Mainz, Germany
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33
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Sutton AG, Finn P, Grech ED, Hall JA, Stewart MJ, Davies A, de Belder MA. Early and late reactions after the use of iopamidol 340, ioxaglate 320, and iodixanol 320 in cardiac catheterization. Am Heart J 2001; 141:677-83. [PMID: 11275937 DOI: 10.1067/mhj.2001.113570] [Citation(s) in RCA: 71] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
BACKGROUND Although modern contrast agents have tolerability superior to older agents, significant differences remain between the agents currently in use. METHODS To investigate the incidence of early (<24 hours) and late (>24 hours to 7 days) reactions to 3 contrast agents commonly used in cardiac catheterization, we performed a randomized, prospective, double-blind trial in which 2001 patients received one of the following agents: iopamidol 340, a nonionic monomer; ioxaglate 320, an ionic dimer; and iodixanol 320, a nonionic dimer. Possible reactions to contrast were recorded during the hospital admission and after discharge by means of a questionnaire, telephone follow-up, or both. RESULTS Early reactions occurred in 22.2% of those receiving ioxaglate, 7.6% of those receiving iodixanol, and 8.8% of those receiving iopamidol (P <.0001). Late skin reactions occurred in 12.2% of those receiving iodixanol, 4.3% of those receiving ioxaglate, and 4.2% of those receiving iopamidol (P <.0001). CONCLUSIONS The early side effect profile of certain ionic contrast agents suggests that these agents should no longer be used routinely in cardiac catheterization. The use of nonionic agents, however, is associated with late skin reactions, but there are notable differences between the monomeric and dimeric compounds. Although the skin reactions are generally benign, this is not always the case. Patients should be advised accordingly.
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Affiliation(s)
- A G Sutton
- Cardiothoracic Division, South Cleveland Hospital, Marton Road, Middlesbrough, TS4 3BW, UK
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34
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Vogel-Sprott M, Easdon C, Fillmore M, Finn P, Justus A. Alcohol and behavioral control: cognitive and neural mechanisms. Alcohol Clin Exp Res 2001; 25:117-21. [PMID: 11198706] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
Abstract
This article represents the proceedings of a symposium at the 2000 RSA Meeting in Denver, Colorado. The organizer/chair was Muriel Vogel-Sprott. The presentations were (1) Alcohol-induced impairment of inhibitory control: Some commonalities with attention deficit hyperactivity disorder, by Mark Fillmore; (2) Neural interactions that underlie response inhibition under alcohol: A functional magnetic resonance imaging investigation, by Craig Easdon; (3) Intentional control of behavior under alcohol, by Muriel Vogel-Sprott; and (4) Working memory and the disinhibiting effects of alcohol on passive avoidance learning, by Alicia Justius and Peter Finn.
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Affiliation(s)
- M Vogel-Sprott
- Department of Psychology, University of Waterloo, Ontario, Canada.
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35
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36
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Solomon SD, Greaves SC, Rayan M, Finn P, Pfeffer MA, Pfeffer JM. Temporal dissociation of left ventricular function and remodeling following experimental myocardial infarction in rats. J Card Fail 1999; 5:213-23. [PMID: 10496194 DOI: 10.1016/s1071-9164(99)90006-4] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND Left ventricular function early after myocardial infarction (MI) predicts subsequent clinical outcome. Nevertheless, the relationship between early changes in left ventricular function and subsequent left ventricular remodeling has not been well defined. METHODS AND RESULTS To explore the temporal relationship between left ventricular function and remodeling after MI, rats (n = 63) underwent coronary artery ligation with and without reperfusion at 45 or 180 minutes or a sham operation. All animals were followed up by serial echocardiography preligation; 4, 24, and 48 hours; and 1, 2, 3, 4, 6, and 9 weeks after MI. Measures of global left ventricular size and function and regional wall motion were obtained at physiological heart rates. Histological infarct sizes (range, 0% to 52%) were determined in all animals. Within 4 hours of MI, fractional area change (FAC) decreased dramatically in association with an increase in left ventricular systolic cavity area, whereas diastolic area increased more gradually. Early FAC was related to infarct size (r = -0.82; P < .000), predicted the extent of left ventricular enlargement (P = .0001), and remained depressed throughout the duration of follow-up. Regional wall motion excursion and systolic wall thickness decreased in the infarcted and noninfarcted regions in animals with large infarctions. CONCLUSIONS The rate of left ventricular dilatation after MI in rats is proportional to initial left ventricular function, although left ventricular function remains relatively constant as the ventricle progressively enlarges. Regional myocardial function after a large MI is abnormal in noninfarcted as well as infarcted regions.
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Affiliation(s)
- S D Solomon
- Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts 02115, USA
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37
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Witt E, Cunningham C, Dudek B, Finn P, Henderson N, Plomin R, Samson H. Gene-environment interactions in alcohol research: round table discussion of conceptual and methodological issues using animal models. Alcohol Clin Exp Res 1998; 22:1719-23. [PMID: 9835286 DOI: 10.1111/j.1530-0277.1998.tb03971.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- E Witt
- Division of Basic Research, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, Maryland 20892-7003, USA
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Abstract
Levo-Alpha Acetyl Methadol, or LAAM, is a medication therapy for individuals addicted to opiates that provides an alternative to methadone. Because it is administered only three times a week and, therefore, requires fewer clinic trips, patient acceptance can be higher than with methadone. While blocking the effects of other opiates and preventing withdrawal, LAAM does not produce a subjective high. However, because most patients are not familiar with LAAM, they may be initially more anxious and need more counseling and support when receiving the medication than they would with the more familiar methadone medication. On balance, LAAM enables clinic administrators and counselors to offer an alternative medication to methadone that some clients prefer once they become adjusted to it because of LAAM's even, stable effect. Through hypothetical but true-to-life case studies of LAAM use, it is possible to gain a clearer understanding of the advantages and drawbacks of using LAAM.
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Affiliation(s)
- P Finn
- Abt Associates Inc., Cambridge, MA 02138-1168, USA
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39
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Fischer TA, McNeil PL, Khakee R, Finn P, Kelly RA, Pfeffer MA, Pfeffer JM. Cardiac myocyte membrane wounding in the abruptly pressure-overloaded rat heart under high wall stress. Hypertension 1997; 30:1041-6. [PMID: 9369253 DOI: 10.1161/01.hyp.30.5.1041] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
The potential role of transient sarcolemmal membrane wounding as a signal transduction event for cardiomyocyte hypertrophy was evaluated in rats with short-term pressure overload caused by banding of the proximal aorta. This procedure resulted in significant increases in left ventricular systolic (1.5-fold) and end-diastolic (2.6-fold) pressures and wall stresses that were associated with significant wall thinning and cavitary enlargement. Quantitative image analysis of frozen sections of the stressed ventricles obtained 60 minutes after banding demonstrated a 6- to 10-fold increase in cytosolic staining with a horseradish peroxidase-labeled anti-albumin antibody compared with sham-operated controls, indicating that an increase in transient sarcolemmal membrane permeability (wounding) is an early response to an abrupt increase in hemodynamic load in vivo. We conclude that an intense hemodynamic stress in vivo can result in histologically detectable cardiomyocyte wounding.
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Affiliation(s)
- T A Fischer
- Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Mass 02115, USA
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40
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Finn P, Ingham RJ, Ambrose N, Yairi E. Children recovered from stuttering without formal treatment: perceptual assessment of speech normalcy. J Speech Lang Hear Res 1997; 40:867-876. [PMID: 9263950 DOI: 10.1044/jslhr.4004.867] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
Current evidence suggests that young children who recover from stuttering are essentially stutter-free. However, there is no evidence to indicate if their speech is perceptually indistinguishable from normally fluent peers or whether they retain perceptually unusual speech. One important example of recovery from stuttering is children who have recovered without receiving formal treatment. An investigation was conducted to determine if the speech of these children is perceptually different from the speech of children who have never stuttered. Speakers consisted of 10 preschool and early school-age children documented as recovered from stuttering without benefit of formal treatment. In a series of studies they were compared with 10 children who had never stuttered. Three groups of judges-sophisticated, unsophisticated, and experienced-were separately asked, using videotaped speech samples of the children, to decide which samples were from children who used to stutter. Results revealed that the children who recovered from stuttering were perceptually indistinguishable from the normal controls. The same result was obtained regardless of whether the samples were presented in paired-stimulus or single-stimulus mode. Two of the groups of judges were also instructed to rate the speech naturalness of the speech samples. The speakers were not distinguished on this measure either. Methodological issues and the implications of the findings are discussed.
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Affiliation(s)
- P Finn
- Department of Speech and Hearing Sciences, University of New Mexico, Albuquerque 87131, USA.
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41
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Abstract
The purpose of this study was to determine if the speech of adults who self-judged that they were recovered from stuttering without the assistance of treatment is perceptually different from that of adults who never stuttered. Fifteen adult speakers verified as persons who had recovered from a valid stuttering problem without the assistance of treatment were compared with 15 adult speakers verified as persons with normally fluent speech. Judges viewed videotaped speech samples of all speakers and were instructed to decide whether a speaker used to stutter or never stuttered. A separate group of judges rated the same samples for speech naturalness. Various speech behavior measures were also obtained. Results revealed that the speech of speakers who used to stutter was perceptually different from that of speakers who never stuttered. This difference was correlated with unnatural sounding speech and a high frequency of part-word repetitions.
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Affiliation(s)
- P Finn
- Department of Speech and Hearing Sciences, University of New Mexico, Albuquerque, NM 87131, USA.
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42
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Mackey LS, Finn P, Ingham RJ. Effect of speech dialect on speech naturalness ratings: a systematic replication of Martin, Haroldson, and Triden (1984). J Speech Lang Hear Res 1997; 40:349-360. [PMID: 9130203 DOI: 10.1044/jslhr.4002.349] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
This study investigated the effect of speech dialect on listeners' speech naturalness ratings by systematically replicating Martin, Haroldson, and Triden's (1984) study using three groups of speaker samples. Two groups consisted of speakers with General American dialect--one with persons who stutter and the other with persons who do not stutter. The third group also consisted of speakers who do not stutter but who spoke non-General American dialect. The results showed that speech naturalness ratings distinguished among the three speaker groups. The variables that appeared to influence speech naturalness ratings were type of dialect, speech fluency, and speaking rate, though they differed across speaker groups. The findings also suggested that strength of speech dialect may be a scaleable dimension that judges can rate with acceptable levels of reliability. Dialect may also be an important factor that needs to be incorporated or controlled within systems designed to train speech naturalness ratings. It may also be an important factor in determining the extent to which stuttering treatment produces natural sounding speech.
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Affiliation(s)
- L S Mackey
- Claremore Regional Hospital, Home Health, OK, USA
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43
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Abstract
There is no empirical basis for determining goals for stuttering treatment. One approach that might resolve this issue is to systematically investigate persons who claim to have recovered from stuttering without the assistance of treatment. However, critical methodological and conceptual issues must be overcome first in order to assure these persons had a valid stuttering problem and that their recovery was independent of treatment. This study examined a validation procedure for solving these issues based on the combination of two methods: independent verification and self-reports. Forty-two subjects participated: 14 adults who recovered from stuttering without assistance, 14 adults with persistent stuttering, and 14 adults who were normally fluent speakers. For the independent verification, a Speech Behavior Checklist was administered to 42 individuals familiar with the recovered subjects' past speech and the other subjects' current speech. Results indicated that persons who knew the recovered subjects when they used to stutter recalled speech behaviors consistent with subjects who still stuttered, but not the same as speech behaviors consistent with subjects who never stuttered. These findings were supported by an objective analysis of the recovered subjects' descriptions of their past stuttering. Furthermore, a content analysis of subjects' self-reports indicated that recovery was independent of treatment.
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Affiliation(s)
- P Finn
- University of New Mexico, Albuquerque, USA
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Abstract
Binge drinking is a serious problem on many college campuses. A number of schools have established substance-free residence halls as one strategy for coping with the problem. The schools have configured these halls very differently. Administrators agree that following certain guidelines can help ensure that substance-free housing succeeds. These guidelines include starting small, involving students in their design and development, keeping the areas separate, considering carefully whether to offer special programming, and enforcing the rules. Administrators have identified effective responses to the various concerns and objections to establishing substance-free residence halls that have sometimes been heard.
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Affiliation(s)
- P Finn
- Abt Associates, Cambridge, Massachusetts, USA
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45
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Ragsdale KG, Cox RD, Finn P, Eisler RM. Effectiveness of short-term specialized inpatient treatment for war-related posttraumatic stress disorder: a role for adventure-based counseling and psychodrama. J Trauma Stress 1996; 9:269-83. [PMID: 8731547 DOI: 10.1007/bf02110660] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Psychological tests were administered to 24 participants of an inpatient posttraumatic stress disorder (PTSD) treatment program both immediately before and following completion of treatment. Responses were compared to a treatment/wait list comparison group composed of 24 subjects awaiting entry into the program. All treatment/wait list comparison group subjects received weekly PTSD outpatient group therapy. Significant improvements were found in the inpatient treatment group in areas of hopelessness, feelings of guilt and shame, loneliness, and emotional expressiveness. Other indices of psychological functional, including interpersonal skills, gender role stress, anxiety, anger, and PTSD symptomatology did not change significantly in response to treatment. No positive changes in any area of psychological function occurred in the treatment/wait list comparison group. Implications for PTSD and areas of future research are discussed.
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Affiliation(s)
- K G Ragsdale
- Psychology/Psychiatry Service, Department of Veterans Affairs Medical Center, Salem, Virginia 24153, USA
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46
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Abstract
There is growing interest in a number of medications with proven clinical efficacy or potential for treating substance abuse. At the same time, many treatment programs make little, if any, use of pharmacotherapy. The reasons for this circumstance are not clear. An exploratory survey using focus groups and telephone interviews with medical personnel and administrators from 38 programs and three professional associations suggests that program staff perceive a variety of drawbacks to pharmacotherapy, which may help account for the lack of more widespread use of this treatment modality.
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Affiliation(s)
- P Finn
- Abt Associates Inc., Cambridge, Massachusetts 02138-1168, USA
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47
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Abstract
Many drug user treatment programs have difficulty recruiting, retaining, and successfully treating minority clients. Coupled with the fact that cultural diversity among clients is likely to increase, this consideration makes it critical that programs take steps to increase their responsiveness to minority clients. Among the steps which administrators and clinicians recommend that programs take are conducting a needs assessment; implementing special outreach approaches; hiring additional minority staff; providing staff training and education in cultural sensitivity; and identifying client cultural characteristics at intake.
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Affiliation(s)
- P Finn
- Abt Associates Inc., Cambridge, Massachusetts 02138-1168, USA
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48
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Abstract
Many drug treatment programs have difficulty recruiting, retaining, and successfully treating minority clients. Coupled with the fact that cultural diversity among clients is likely to increase, this consideration makes it critical that counselors systematically consider the client's ethnic and racial background during treatment. Experienced clinicians have recommended a number of approaches that counselors can adopt for increasing their cultural responsiveness to minority clients, thereby improving treatment effectiveness with this population of substance abusers.
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Affiliation(s)
- P Finn
- Abt Associates Inc., Cambridge, MA 02138-1168
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49
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Abstract
The efficacy of stuttering treatment has been a contentious issue in recent years. Two issues of primary concern include the treated stutterer's abnormal speech quality and the problem of continually self-monitoring fluency skills. One approach to addressing these issues is to obtain stutterers' self-ratings of speech quality and levels of speech monitoring. However, the reliability and validity of such self-ratings need to be assessed before they are suitable for use in stuttering treatment. The present study investigated one method of estimating the reliability and validity of stutterers' self-ratings of how natural their speech sounds (speech naturalness), and how natural they feel about the amount of attention they are paying to the way they are speaking (feel naturalness). Twelve adult stutterers were instructed to self-rate the speech and feel naturalness of their speech under a variety of rhythmic stimulation conditions across repeated rating occasions. With some qualifications, the results showed that stutterers were relatively consistent and valid self-raters of speech quality and levels of speech monitoring.
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Affiliation(s)
- P Finn
- Department of Communicative Disorders, University of New Mexico, Albuquerque 87131-1191
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Abstract
Postoperative fatigue (POF) appears to be less following laparoscopic surgery but this has not been proven previously. This study compared a group of patients who had undergone open cholecystectomy with a group undergoing laparoscopic cholecystectomy. Postoperative fatigue was found to be decreased in duration in the patients having laparoscopic surgery, returning to pre-operative fatigue levels by 14 days, compared to 28 days for open surgery. Postoperative pain in the first 24 h and the early metabolic response to surgery were similar for both groups. The authors conclude that laparoscopic surgery is associated with decreased POF and that this is unlikely to be accounted for by a decrease in the early metabolic response to surgery.
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Affiliation(s)
- A G Hill
- Department of Surgery, Waikato Hospital, Hamilton, New Zealand
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