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Kaulback K, Schwellnus M, Sewry N, Jordaan E, Wood P. Rating of Perceived Exertion Associated With Acute Symptoms in Athletes With Recent SARS-CoV-2 Infection: Athletes With Acute Respiratory InfEction (AWARE) VI Study. J Athl Train 2024; 59:90-98. [PMID: 37347179 PMCID: PMC10783475 DOI: 10.4085/1062-6050-0632.22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/23/2023]
Abstract
CONTEXT SARS-CoV-2 infection can affect the exercise response in athletes. Factors associated with the exercise response have not been reported. OBJECTIVE To (1) describe heart rate (HR), systolic blood pressure (SBP), and rating of perceived exertion (RPE) responses to exercise in athletes with a recent SARS-CoV-2 infection and (2) identify factors affecting exercise responses. DESIGN Cross-sectional, experimental study. PATIENTS OR OTHER PARTICIPANTS Male and female athletes (age = 24.2 ± 6.3 years) with a recent (<28 days) SARS-CoV-2 infection (n = 72). SETTING A COVID-19 Recovery Clinic for athletes. MAIN OUTCOME MEASURE(S) Heart rate, SBP, and RPE were measured during submaximal exercise (modified Bruce protocol) at 10 to 28 days after SARS-CoV-2 symptom onset. Selected factors (demographics, sport, comorbidities, preinfection training variables, and symptoms during the acute phase of the infection) affecting the exercise response were analyzed using random coefficient (linear mixed) models. RESULTS Heart rate, SBP, and RPE increased progressively from rest to stage 5 of the exercise test (P = .0001). At stage 5 (10.1 metabolic equivalents), a higher HR and a higher SBP during exercise were associated with younger age (P = .0007) and increased body mass index (BMI; P = .009), respectively. Higher RPE during exercise was significantly associated with a greater number of whole-body (P = .006) and total number (P = .004) of symptoms during the acute phase of infection. CONCLUSIONS A greater number of symptoms during the acute infection was associated with a higher RPE during exercise in athletes at 10 to 28 days after SARS-CoV-2 infection. We recommend measuring RPE during the first exercise challenge after infection, as this may indicate disease severity and be valuable for tracking progress, recovery, and return to sport.
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Affiliation(s)
- Kelly Kaulback
- Department of Physiology, Faculty of Health Sciences, University of Pretoria, South Africa
- Sport, Exercise Medicine and Lifestyle Institute (SEMLI), Faculty of Health Sciences, University of Pretoria, South Africa
| | - Martin Schwellnus
- Sport, Exercise Medicine and Lifestyle Institute (SEMLI), Faculty of Health Sciences, University of Pretoria, South Africa
- International Olympic Committee Research Centre of South Africa, Pretoria
| | - Nicola Sewry
- Sport, Exercise Medicine and Lifestyle Institute (SEMLI), Faculty of Health Sciences, University of Pretoria, South Africa
- International Olympic Committee Research Centre of South Africa, Pretoria
| | - Esme Jordaan
- Biostatistics Unit, South African Medical Research Council (SAMRC), Cape Town
- Statistics and Population Studies Department, University of the Western Cape, Cape Town, South Africa
| | - Paola Wood
- Department of Physiology, Faculty of Health Sciences, University of Pretoria, South Africa
- Sport, Exercise Medicine and Lifestyle Institute (SEMLI), Faculty of Health Sciences, University of Pretoria, South Africa
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Kaulback K, Schwellnus M, Sewry N, Lombard C, Jordaan E, Wood P. The cardiovascular response to exercise in athletes recovering from SARS-CoV-2 infection: A prospective cohort study with repeated measures over 16 weeks - AWARE IX. J Sports Sci 2023; 41:2077-2087. [PMID: 38323527 DOI: 10.1080/02640414.2024.2312054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Accepted: 01/19/2024] [Indexed: 02/08/2024]
Abstract
Higher exercise heart rate (HR) and prolonged return-to-sport in athletes with SARS-CoV-2 infection are described, but the cardiovascular response to exercise during recovery is not understood. This prospective, cohort, experimental study with repeated measures evaluated the cardiovascular response to exercise over 16 weeks in athletes recovering from SARS-CoV-2 infection. Athletes (n = 82) completed 2-5 repeat assessments at regulated intervals over 16 weeks post-SARS-CoV-2 infection. Data from 287 assessments (submaximal exercise tests; Modified Bruce protocol) are included. HR (bpm), systolic blood pressure (SBP) (mmHg) and rating of perceived exertion (RPE) (Borg scale 6-20) were measured. Rates of change in HR, SBP and RPE over time are reported. Submaximal exercise HR, SBP and RPE decreased significantly over 16 weeks (p < 0.01). There was a steeper rate of decline for HR and RPE ≤30 days compared to >30 days after SARS-CoV-2 infection: HR at Stage 3: ≤30 days -0.53 (0.01); >30 days -0.06 (0.02) and Stage 5: ≤30 days -0.77 (0.12); >30 days -0.12 (0.02); RPE at Stage 3: ≤30 days -0.09 (0.02); >30 days -0.01 (0.0002) and Stage 5: ≤30 days -0.13 (0.02); >30 days -0.02 (0.004). The findings provide clinical recommendation for exercise prescription and monitoring RPE in response to exercise post-SARS-CoV-2 infection and contribute to the clinical understanding of recovery which can help manage athlete expectations.
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Affiliation(s)
- Kelly Kaulback
- Department of Physiology, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
- Sport, Exercise Medicine and Lifestyle Institute (SEMLI), Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - Martin Schwellnus
- Sport, Exercise Medicine and Lifestyle Institute (SEMLI), Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
- IOC Research Centre of South Africa, Pretoria, South Africa
| | - Nicola Sewry
- Sport, Exercise Medicine and Lifestyle Institute (SEMLI), Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
- IOC Research Centre of South Africa, Pretoria, South Africa
| | - Carl Lombard
- Biostatistics Research Unit, South African Medical Research Council (SAMRC), Cape Town, South Africa
- Division of Epidemiology and Biostatistics, Department of Global Health, Stellenbosch University, Cape Town, South Africa
| | - Esme Jordaan
- Biostatistics Research Unit, South African Medical Research Council (SAMRC), Cape Town, South Africa
- Statistics and Population Studies Department, University of the Western Cape, Cape Town, South Africa
| | - Paola Wood
- Department of Physiology, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
- Sport, Exercise Medicine and Lifestyle Institute (SEMLI), Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
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du Toit F, Schwellnus M, Jordaan E, Swanevelder S, Wood P. Clinical characteristics of gradual onset injuries in recreational road cyclists - SAFER XXVII study over 5 years in 62758 race entrants. PHYSICIAN SPORTSMED 2023; 51:564-571. [PMID: 36281474 DOI: 10.1080/00913847.2022.2136984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Accepted: 10/10/2022] [Indexed: 10/31/2022]
Abstract
OBJECTIVE Gradual onset injuries (GOIs) in recreational cyclists are common but not well described. The aim of this study is to describe the clinical characteristics of GOIs (main anatomical regions, specific anatomical sites, specific GOIs, tissue type, severity of GOIs, and treatment modalities) of GOIs among entrants participating in a community-based mass participation-cycling event over 5 years. METHODS During the 2016-2020 Cape Town Cycle Tour, 62,758 consenting race entrants completed an online pre-race medical screening questionnaire. 1879 reported GOIs in the previous 12 months. In this descriptive epidemiological study, we report frequency (% entrants) of GOIs by anatomical region/sites, specific GOI, tissue type, GOI severity, and treatment modalities used. RESULTS The main anatomical regions affected by GOIs were lower limb (47.4%), upper limb (20.1%), hip/groin/pelvis (10.0%), and lower back (7.8%). Specifically, GOI were common in the knee (32.1%), shoulder (10.6%), lower back (7.8%) and the hip/buttock muscles (5.2%). The most common specific GOI was anterior knee pain (17.2%). 57.0% of GOIs were in soft tissue. Almost half (43.9%) of cyclists with a GOI reported symptom duration >12 months, and 40.3% of GOIs were severe enough to reduce/prevent cycling. Main treatment modalities used for GOIs were rest (45.9%), physiotherapy (43.0%), stretches (33.2%), and strength exercises (33.1%). CONCLUSION In recreational cyclists, >50% of GOIs affect the knees, shoulders, hip/buttock muscles and lower back, and 40% are severe enough to reduce/prevent cycling. Almost 45% of cyclists with GOIs in the lower back; or hip/groin/pelvis; or lower limbs; or upper limb reported a symptom duration of >12 months. Risk factors associated with GOIs need to be determined and preventative programs for GOIs need to be designed, implemented, and evaluated.
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Affiliation(s)
- François du Toit
- Division of Biokinetics and Sports Science, Department of Physiology, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
- Sport, Exercise Medicine and Lifestyle Institute (SEMLI), Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - Martin Schwellnus
- Sport, Exercise Medicine and Lifestyle Institute (SEMLI), Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
- International Olympic Committee (IOC) Research Centre, Pretoria, South Africa
| | - Esme Jordaan
- Biostatistics Unit, South African Medical Research Council, Cape Town, South Africa
- Statistics and Population Studies Department, University of the Western Cape, Cape Town, South Africa
| | - Sonja Swanevelder
- Biostatistics Unit, South African Medical Research Council, Cape Town, South Africa
| | - Paola Wood
- Division of Biokinetics and Sports Science, Department of Physiology, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
- Sport, Exercise Medicine and Lifestyle Institute (SEMLI), Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
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du Toit F, Schwellnus M, Jordaan E, Swanevelder S, Wood P. Factors associated with patellofemoral pain in recreational road cyclists: A cross-sectional study in 59953 cyclists - SAFER XXXIII. Phys Ther Sport 2023; 59:136-143. [PMID: 36535111 DOI: 10.1016/j.ptsp.2022.12.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 12/07/2022] [Accepted: 12/08/2022] [Indexed: 12/14/2022]
Abstract
OBJECTIVE Patellofemoral pain (PFP) is a common cycling-related injury, and independent factors need to be identified to enable effective injury prevention strategies. We aim to determine factors associated with PFP in cyclists entering mass community-based events. DESIGN Cross-sectional study. SETTING 2016-2020 Cape Town Cycle Tour. PARTICIPANTS Consenting race entrants. MAIN OUTCOME MEASURES 62758 consenting race entrants completed a pre-race medical questionnaire, and 323 reported PFP. Selected factors associated with PFP (demographics, cycling experience and training, chronic disease history) were explored using multivariate analyses. RESULTS Prevalence ratio (PR) of PFP was similar for sex and age groups. Independent factors associated with PFP (adjusted for sex and age) were history of chronic disease [Composite Chronic Disease Score (0-10)(PR = 2.0, p < 0.0001) and any allergies (PR = 2.0, p < 0.0001)]. CONCLUSION A history of chronic diseases and allergies is associated with PFP in cyclists. Practical clinical recommendations are: 1) that prevention programs for PFP be considered when cycling is prescribed as a physical activity intervention for patients with chronic disease, and 2) that older cyclists presenting with PFP be assessed for the presence of risk factors or existing chronic disease.
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Affiliation(s)
- François du Toit
- Division of Biokinetics and Sports Science, Department of Physiology, Faculty of Health Sciences, University of Pretoria, South Africa; Sport, Exercise Medicine and Lifestyle Institute (SEMLI), Faculty of Health Sciences, University of Pretoria, South Africa
| | - Martin Schwellnus
- Sport, Exercise Medicine and Lifestyle Institute (SEMLI), Faculty of Health Sciences, University of Pretoria, South Africa; International Olympic Committee (IOC) Research Centre, South Africa.
| | - Esme Jordaan
- Biostatistics Unit, South African Medical Research Council, South Africa; Statistics and Population Studies Department, University of the Western Cape, South Africa
| | - Sonja Swanevelder
- Biostatistics Unit, South African Medical Research Council, South Africa
| | - Paola Wood
- Division of Biokinetics and Sports Science, Department of Physiology, Faculty of Health Sciences, University of Pretoria, South Africa; Sport, Exercise Medicine and Lifestyle Institute (SEMLI), Faculty of Health Sciences, University of Pretoria, South Africa
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du Toit FC, Schwellnus M, Wood P, Bayne H, Swanevelder S, Jordaan E. Increased Years, Training, Allergies And Chronic Diseases Are Risk Factors For Gradual Onset Cycling Injuries. Med Sci Sports Exerc 2022. [DOI: 10.1249/01.mss.0000883048.08527.58] [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: 11/21/2022]
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Wood P, Young J, Schwellnus M, Nolte K, Swanevelder S, Jordaan E. Chronic Disease, Allergies And Years Of Running Are Predictive Of Achilles Tendon Injuries In Runners. Med Sci Sports Exerc 2022. [DOI: 10.1249/01.mss.0000883092.98610.cb] [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: 11/21/2022]
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Schwellnus M, Sewry N, Snyders C, Kaulback K, Wood P, Seocharan I, Derman W, Esme J. Pre-Illness Training And Acute Symptom Clusters Predict Prolonged Return-To-Play In Athletes After Recent SARS-CoV-2 Infection. Med Sci Sports Exerc 2022. [DOI: 10.1249/01.mss.0000882600.84039.ea] [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: 11/21/2022]
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Kaulback K, Schwellnus M, Sewry N, Jordaan E, Wood P. Submaximal Exercise Heart Rate Is Increased In Athletes Recovering From Recent SARS-CoV-2 Infection. Med Sci Sports Exerc 2022. [DOI: 10.1249/01.mss.0000876824.59980.71] [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: 11/21/2022]
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Wilson C, Cervenka T, Wood P, Parsons S. Behaviour of occupied and void space in molecular crystal structures at high pressure. Acta Cryst Sect A 2022. [DOI: 10.1107/s2053273322091367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/19/2023]
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Pretorius A, Wood P, Becker P, Wenhold F. Physical Activity and Related Factors in Pre-Adolescent Southern African Children of Diverse Population Groups. Int J Environ Res Public Health 2022; 19:9912. [PMID: 36011543 PMCID: PMC9408511 DOI: 10.3390/ijerph19169912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/26/2022] [Revised: 08/05/2022] [Accepted: 08/06/2022] [Indexed: 06/15/2023]
Abstract
Tailored obesity management includes understanding physical activity (PA) and its context, ideally in childhood before the onset of health risk. This cross-sectional study determined, by sex and population, the PA of Southern African pre-adolescent urban primary school children. PA was measured objectively (step count: pedometer) and subjectively (Physical Activity Questionnaire for Older Children [PAQ-C]), taking confounders (phenotype, school-built environment, and socio-economic environment) into account. Body composition was measured with multifrequency bioelectrical impedance analysis (Seca mBCA). PA was adjusted for phenotypic confounders (body size and composition) using multivariate regression. Sex and population differences in PA were determined with two-way ANOVA. Ninety-four healthy pre-adolescents (60% girls, 52% black) with a similar socio-economic status and access to PA participated. Amidst phenotypic differences, average steps/day in girls (10,212) was lower than in boys (11,433) (p = 0.029), and lower in black (9280) than in white (12,258) (p < 0.001) participants. PAQ-C scores (5-point rating) were lower for girls (2.63) than boys (2.92) (p < 0.001) but higher for black (2.89) than white (2.58) (p < 0.001) participants. Objective and subjective measurements were, however, not significantly (r = −0.02; p = 0.876) related and PAQ-C failed to identify reactive changes in the step count. Objectively measured PA of black participants and of girls was consistently lower than for white participants and boys. Target-group specific interventions should therefore be considered.
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Affiliation(s)
- Adeline Pretorius
- Department of Human Nutrition, Faculty of Health Sciences, University of Pretoria, Private Bag X323, Arcadia 0007, South Africa
- Department of Consumer and Food Sciences, Faculty of Natural and Agricultural Sciences, University of Pretoria, Private Bag X20, Hatfield 0028, South Africa
| | - Paola Wood
- Department of Physiology, Faculty of Health Sciences, University of Pretoria, Private Bag X323, Arcadia 0007, South Africa
| | - Piet Becker
- Research Office, Faculty of Health Sciences, University of Pretoria, Private Bag X323, Arcadia 0007, South Africa
| | - Friede Wenhold
- Department of Human Nutrition, Faculty of Health Sciences, University of Pretoria, Private Bag X323, Arcadia 0007, South Africa
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Ngassa Piotie P, Wood P, Muchiri JW, Webb EM, Rheeder P. Using a nurse-driven and home-based telehealth intervention to improve insulin therapy for people with type 2 diabetes in primary care: a feasibility study. Journal of Endocrinology, Metabolism and Diabetes of South Africa 2022. [DOI: 10.1080/16089677.2022.2074122] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Patrick Ngassa Piotie
- School of Health Systems and Public Health, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
- University of Pretoria Diabetes Research Centre (UP DRC), Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - Paola Wood
- Division of Biokinetics, Department of Physiology, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - Jane W Muchiri
- Department of Human Nutrition, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - Elizabeth M Webb
- School of Health Systems and Public Health, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - Paul Rheeder
- University of Pretoria Diabetes Research Centre (UP DRC), Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
- Department of Internal Medicine, School of Medicine, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
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Hene N, Wood P, Schwellnus M, Jordaan E, Laubscher R. Social Network Lifestyle Interventions Reduce Non-Communicable Diseases Risk Factors in Financial Sector Employees: Randomized Controlled Trial. J Occup Environ Med 2022; 64:278-286. [PMID: 35467599 DOI: 10.1097/jom.0000000000002474] [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: 11/25/2022]
Abstract
OBJECTIVE To determine if scientifically based social network (Facebook) lifestyle interventions reduce 10-year cardiovascular disease (CVD) risk. METHODS Financial sector employees (n = 300) were equally randomly assigned: Facebook plus Health Professionals (FB+HP), Facebook (FB), or control (C). We report changes in 10-year Framingham risk score (FRS) for CVD (%) and risk factors over 12 months. RESULTS FRS did not change within and between groups. Overweight (-7.4% vs -5.6%, P = 0.005) and diabetes risk (-10.7% vs 0.2%, P = 0.011) reduced significantly in FB+HP versus FB and C, respectively. Inadequate fruit/vegetable intake (-9.4% vs 3.6%, P = 0.011) and smoking (-0.7% vs 14.9%) reduced significantly in FB versus C. No significant changes in physical activity, central obesity, hypertension, and hypercholesterolemia between groups. CONCLUSIONS Scientifically based social network lifestyle intervention programs could be included in workplace health promotional programmes to improve certain non-communicable disease risk factors.
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Affiliation(s)
- Nceba Hene
- Sport, Exercise Medicine and Lifestyle Institute (SEMLI) and Division of Biokinetics and Sports Science, Department of Physiology (Ms Hene, Mr Wood); Sport, Exercise Medicine and Lifestyle Institute (SEMLI) (Dr Schwellnus), Faculty of Health Sciences, University of Pretoria, Pretoria; International Olympic Committee (IOC) Research Centre (Dr Schwellnus); Biostatistics Unit, South African Medical Research Council (Ms Jordaan, Ms Laubscher); Statistics and Population Studies Department, University of the Western Cape (Ms Jordaan), South Africa
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Hene N, Wood P, Schwellnus M, Jordaan E, Laubscher R. Repeated Annual Health Risk Assessments With Intervention Did Not Reduce 10-year Cardiovascular Disease Risk: A 4-year Longitudinal Study in 13,737 Financial Sector Employees. J Occup Environ Med 2021; 63:881-888. [PMID: 34074955 DOI: 10.1097/jom.0000000000002251] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To determine if repeat annual health risk assessments (RAHRAs) with intervention reduce 10-year cardiovascular disease (CVD) risk in financial sector employees. METHODS Retrospective analysis from RAHRAs in 13,737 employees over 4 years. We report changes in 10-year FRS for CVD (%) and risk factors after 1 (GR1), 2 (GR2), and 3 (GR 3) RAHRAs. RESULTS Mean FRS increased with RAHRAs (GR1: +0.4%; GR2: +0.7%; GR3: +0.8%) (P < 0.001) and was higher for GR3 versus GR1 (P < 0.001) and GR2 (pairwise: P < 0.0355). RAHRAs were associated with increased inadequate fruit/vegetable intake (GR1: +5.4%; GR2: +9.8%; GR3: +15.8%) (all pairwise: P < 0.001) and overweight (GR1: +5.4% vs GR2: +9.8%) (P < 0.001) and only hypercholesterolemia decreased (GR1: -4.4% vs GR3: -9.6%) (P < 0.001). CONCLUSION RAHRAs did not reduce 10-year CVD risk in financial sector employees. Role of RAHRAs in chronic disease management requires further study.
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Affiliation(s)
- Nceba Hene
- Sport, Exercise Medicine and Lifestyle Institute (SEMLI) and Division of Biokinetics and Sports Science, Department of Physiology, Faculty of Health Sciences, University of Pretoria, South Africa (Mr Hene and Dr Wood); Sport, Exercise Medicine and Lifestyle Institute (SEMLI), Faculty of Health Sciences, University of Pretoria, South Africa (Dr Schwellnus); International Olympic Committee (IOC) Research Centre, South Africa (Dr Schwellnus); Biostatistics Unit, South African Medical Research Council, South Africa (Ms Jordaan and Ms Laubscher); Statistics and Population Studies Department, University of the Western Cape, South Africa (Ms Jordaan)
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Ngassa Piotie P, Wood P, Muchiri JW, Webb EM, Rheeder P. Attitudes and beliefs of South African primary healthcare practitioners on initiating insulin in people with type 2 diabetes: Findings from the Tshwane Insulin Project (TIP). Prim Care Diabetes 2021; 15:865-870. [PMID: 34167905 DOI: 10.1016/j.pcd.2021.06.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2021] [Revised: 06/08/2021] [Accepted: 06/17/2021] [Indexed: 12/20/2022]
Abstract
AIMS To investigate the attitudes and beliefs of primary healthcare practitioners (HCPs) towards initiating insulin therapy for people with type 2 diabetes (T2D) in South Africa. METHODS A cross-sectional survey was conducted amongst HCPs from 23 clinics. The nurses' questionnaire was administered by research nurses while doctors completed an online version about their attitudes, beliefs and perceived barriers to initiating insulin. RESULTS Of the 73 HCPs surveyed, 68% were nurses and 84% were women. Only 24% of HCPs believed that most patients would eventually need to initiate insulin regardless of their adherence to treatment regimens and 86% preferred to delay insulin therapy. Doctors were reluctant to initiate insulin, citing patient-related reasons such as low socio-economic level (41%), inability to refrigerate insulin (77%) and inability to self-monitor blood glucose (55%). Doctors mentioned that patient behaviour including not adhering to treatment regimen and appointments (91%) and reluctance to start insulin therapy (82%) influenced their prescription practices. Doctors mentioned that health system factors, including the pressure to see patients quickly (68%) and lack of continuity of care (64%) were barriers to initiating insulin. CONCLUSIONS Optimising insulin therapy in primary care requires health system changes including promoting person-centred care and continuing training for HCPs.
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Affiliation(s)
- Patrick Ngassa Piotie
- School of Health Systems and Public Health, Faculty of Health Sciences, University of Pretoria, Private Bag X323, Arcadia, 0007, City of Tshwane, South Africa.
| | - Paola Wood
- Division of Biokinetics, Department of Physiology, Faculty of Health Sciences, University of Pretoria, Private Bag 14760, Hatfield, 0001, City of Tshwane, South Africa.
| | - Jane W Muchiri
- Department of Human Nutrition, Faculty of Health Sciences, University of Pretoria, Private Bag X323, Arcadia, 0007, City of Tshwane, South Africa.
| | - Elizabeth M Webb
- School of Health Systems and Public Health, Faculty of Health Sciences, University of Pretoria, Private Bag X323, Arcadia, 0007, City of Tshwane, South Africa.
| | - Paul Rheeder
- Department of Internal Medicine, School of Medicine, Faculty of Health Sciences, University of Pretoria, P/Bag X323, Arcadia, 0007, City of Tshwane, South Africa.
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O'Sullivan M, Wood P, Kavanagh E, Moloney T. 876 A Sweeping Success – Management of Type 1A Endoleak Using A Chimney Graft Technique. Br J Surg 2021. [DOI: 10.1093/bjs/znab134.333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Abstract
Endoleak is a recognised complication after Endovascular Abdominal Aortic Aneurysm Repair (EVAR). In the setting of a rapidly expanding aneurysm – time is of the essence. Perfusion of the renal arteries, superior mesenteric artery (SMA) and coeliac artery must be maintained. To facilitate this a customised fenestrated endograft may be used or a chimney endovascular aortic repair (CHEVAR).
A 78-year-old female initially underwent EVAR in 2016 for a ruptured 6.9cm AAA. She made a good recovery at that time. She was enlisted in a surveillance programme. Her most recent duplex showed an aneurysmal sac of 10cm with associated type 1A endoleak. Given these findings waiting for a fenestrated graft posed an unacceptable delay. She underwent a CHEVAR with bilateral axillary and right femoral access. She had chimney stents deployed in the renal arteries and SMA with aortic cuff extension proximally. Her completion angiogram showed good proximal seal with patent stents. She was unexpectedly unstable post-operatively and had a CT scan which revealed a re-ruptured aneurysm. She was treated in ICU and recovered well. Repeat imaging showed good flow in all 4 grafts with no endoleak.
This case demonstrates the challenges of managing endoleak post EVAR and the importance of robust surveillance and appropriate, timely treatment.
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Affiliation(s)
| | - P Wood
- University Hospital Limerick, Limerick, Ireland
| | - E Kavanagh
- University Hospital Limerick, Limerick, Ireland
| | - T Moloney
- University Hospital Limerick, Limerick, Ireland
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Wrigley P, Wood P, O'Neill S, Hall R, Robertson D. Off-site modular construction and design in nuclear power: A systematic literature review. Progress in Nuclear Energy 2021. [DOI: 10.1016/j.pnucene.2021.103664] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Hene N, Wood P, Schwellnus M, Jordaan E, Laubscher R. High Prevalence of Non-Communicable Diseases Risk Factors in 36,074 South African Financial Sector Employees: A Cross-Sectional Study. J Occup Environ Med 2021; 63:159-165. [PMID: 33298754 DOI: 10.1097/jom.0000000000002104] [Citation(s) in RCA: 5] [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
OBJECTIVE To determine the prevalence of non-communicable disease (NCD) risk factors, total NCD risk category and 10-year risk for cardiovascular diseases (CVD) in financial sector employees. METHODS This descriptive observational cross-sectional analysis, data from 36,074 employees was analysed. NCD risk factor data was obtained from health risk assessments that included a questionnaire and clinical measures. The 10-year risk for CVD was calculated using the Framingham non-laboratory based equation. RESULTS Inadequate fruit and vegetable intake (89.3%), insufficient physical activity (77.4%), and being overweight (66.8%) were the most prevalent risk factors. Women had significantly higher prevalence ratios for central obesity (2.28; P < 0.001), insufficient physical activity (1.21; P < 0.001), hypercholesterolaemia (1.15; P < 0.001), and overweight (1.08; P < 0.001) compared with men. CONCLUSION A more concerted effort is required to provide employees with appropriate tools and education at the workplace to decrease and manage NCDs.
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Affiliation(s)
- Nceba Hene
- Sport, Exercise Medicine and Lifestyle Institute (SEMLI) and Division of Biokinetics and Sports Science, Department of Physiology (Mr Hene, Mr Wood); Sport, Exercise Medicine and Lifestyle Institute (SEMLI) (Dr Schwellnus), Faculty of Health Sciences, University of Pretoria; International Olympic Committee (IOC) Research Centre (Dr Schwellnus); Biostatistics Unit, South African Medical Research Council (Ms Jordaan, Ms Laubscher); Statistics and Population Studies Department, University of the Western Cape (Ms Jordaan), South Africa
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Ngassa Piotie P, Wood P, Webb EM, Hugo JF, Rheeder P. Designing an integrated, nurse-driven and home-based digital intervention to improve insulin management in under-resourced settings. Ther Adv Endocrinol Metab 2021; 12:20420188211054688. [PMID: 34733467 PMCID: PMC8558786 DOI: 10.1177/20420188211054688] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2021] [Accepted: 10/04/2021] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND In South Africa, initiating insulin for people with type 2 diabetes and subsequent titration is a major challenge for the resource-constrained healthcare system. Inadequate support systems in primary care, including not being able to access blood glucose monitors and test strips for self-monitoring of blood glucose, results in patients with type 2 diabetes being referred to higher levels of care. In primary care, initiation of insulin may be delayed due to a shortage of healthcare workers. The delayed initiation of insulin is also exacerbated by the reported resistance of both healthcare providers and people with type 2 diabetes to start insulin. In South Africa, telehealth provides an opportunity to overcome these challenges and manage insulin therapy in primary care. METHODS We describe the development of a digital health intervention including the framework used, the theoretical approach and subsequent implementation strategies. RESULTS This intervention is an innovative, nurse-driven and app-enabled intervention called 'the Tshwane Insulin Project intervention'. The Tshwane Insulin Project intervention was designed and evaluated using the framework recommended by the Medical Research Council for complex interventions. The Tshwane Insulin Project intervention was developed in four sequential phases: planning, design, implementation and evaluation. The Tshwane Insulin Project intervention followed the Integrated Chronic Disease Management framework to facilitate implementation and acceptability. The Tshwane Insulin Project comprises a facility-level intervention, where nurses evaluate patients and initiate insulin, an individual-level intervention where community healthcare workers visit patients at their homes to follow-up and provide educational information, while using telehealth to enable physician-directed insulin titration if needed, and a community-level intervention aimed at empowering community healthcare workers to support people living with diabetes and raise awareness of diabetes. CONCLUSION The technological advancements in digital health and telemedicine present an opportunity to improve diabetes care in resource-limited countries. This work can inform those intending to develop and implement complex interventions in primary healthcare in developing countries.
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Affiliation(s)
| | - Paola Wood
- Division of Biokinetics, Department of Physiology, Faculty of Health Sciences, University of Pretoria, Hatfield, South Africa
| | - Elizabeth M. Webb
- School of Health Systems and Public Health, Faculty of Health Sciences, University of Pretoria, Arcadia, South Africa
| | - Johannes F.M. Hugo
- Department of Family Medicine, School of Medicine, Faculty of Health Sciences, University of Pretoria, Arcadia, South Africa; UP COPC Research Unit, Faculty of Health Sciences, University of Pretoria, Arcadia, South Africa
| | - Paul Rheeder
- Department of Internal Medicine, School of Medicine, Faculty of Health Sciences, University of Pretoria, Arcadia, South Africa
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Khoury M, Phillips D, Wood P, Mott W, Stickland M, Boulanger P, Rempel G, Conway J, Mackie A, Khoo N. CARDIAC REHABILITATION IN THE PEDIATRIC FONTAN POPULATION: DEVELOPMENT OF A HOME-BASED HIGH-INTENSITY INTERVAL TRAINING PROGRAM. Can J Cardiol 2020. [DOI: 10.1016/j.cjca.2020.07.063] [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: 11/16/2022] Open
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Ngassa Piotie P, Wood P, Webb EM, Marcus TS, Rheeder P. Willingness of people with Type 2 diabetes to start insulin therapy: Evidence from the South African Tshwane Insulin Project (TIP). Diabetes Res Clin Pract 2020; 168:108366. [PMID: 32791159 DOI: 10.1016/j.diabres.2020.108366] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Revised: 06/22/2020] [Accepted: 08/05/2020] [Indexed: 12/13/2022]
Abstract
AIMS To determine factors associated with 'hypothetical willingness' to start insulin among people with Type 2 diabetes (T2DM). METHODS A quantitative cross-sectional study with insulin-naïve T2DM patients at 23 primary care facilities in the Tshwane Metropolitan Municipality. Data collected included demographic and clinical data, willingness to start insulin, attitudes and barriers to insulin therapy. Factors associated with unwillingness to start insulin therapy were explored using a multivariable logistic regression model. RESULTS Of 468 T2DM study patients (mean age 57.2, SD = 11.3 years), more than half (51.9%) expressed unwillingness to starting insulin therapy. Unwillingness was associated with negative attitudes (OR = 1.32, 95% CI = 1.12-1.55, p = 0.001) and reluctance (OR = 1.41, 95% CI = 1.27-1.57, p < 0.001) rather than age, sex, education or diabetes duration. The strongest reasons for patient unwillingness were injection anxieties, fear of needles, insufficient knowledge of insulin, feeling unable to cope with insulin and concerns about out-of-pocket costs. CONCLUSIONS The prospect of insulin therapy disturbs patients' sense of self and their psychological wellbeing. The high prevalence of psychological insulin resistance among these T2DM patients needs to be addressed for effective diabetes management.
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Affiliation(s)
- Patrick Ngassa Piotie
- School of Health Systems and Public Health, Faculty of Health Sciences, University of Pretoria, P/Bag x323, Arcadia 0007, City of Tshwane, South Africa.
| | - Paola Wood
- Division of Biokinetics, Department of Physiology, Faculty of Health Sciences, University of Pretoria, P/Bag 14760, Hatfield 0001, City of Tshwane, South Africa.
| | - Elizabeth M Webb
- School of Health Systems and Public Health, Faculty of Health Sciences, University of Pretoria, P/Bag x323, Arcadia 0007, City of Tshwane, South Africa.
| | - Tessa S Marcus
- Department of Family Medicine, School of Medicine, Faculty of Health Sciences, University of Pretoria, P/Bag x323, Arcadia 0007, City of Tshwane, South Africa.
| | - Paul Rheeder
- Department of Internal Medicine, School of Medicine, Faculty of Health Sciences, University of Pretoria, P/Bag x323, Arcadia 0007, City of Tshwane, South Africa.
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Gorham G, Howard K, Zhao Y, Ahmed AMS, Lawton PD, Sajiv C, Majoni SW, Wood P, Conlon T, Signal S, Robinson SL, Brown S, Cass A. Cost of dialysis therapies in rural and remote Australia - a micro-costing analysis. BMC Nephrol 2019; 20:231. [PMID: 31238898 PMCID: PMC6593509 DOI: 10.1186/s12882-019-1421-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2019] [Accepted: 06/12/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Maintenance dialysis is a costly and resource intense activity. In Australia, inadequate health infrastructure and poor access to technically skilled staff can limit service provision in remote areas where many Aboriginal dialysis patients live. With most studies based on urban service provision, there is little evidence to guide service development. However permanent relocation to an urban area for treatment can have significant social and financial impacts that are poorly quantified. This study is part of a broader project to quantify the costs and benefits of dialysis service models in urban and remote locations in Australia's Northern Territory (NT). METHODS We undertook a micro-costing analysis of dialysis service delivery costs in urban, rural and remote areas in the NT from the payer perspective. Recurrent maintenance costs (salaries, consumables, facility management and transportation) as well as capital costs were included. Missing and centralised costs were standardised; results were inflated to 2017 values and reported in Australian dollars. RESULTS There was little difference between the average annual cost for urban and rural services with respective median costs of $85,919 versus $84,629. However remote service costs were higher ($120,172 - $124,492), driven by higher staff costs. The inclusion of capital costs did not add substantially to annual costs. Annual home haemodialysis costs ($42,927) were similar to other jurisdictions despite the significant differences in program delivery and payment of expenses not traditionally borne by governments. Annual peritoneal dialysis costs ($58,489) were both higher than home and in-centre haemodialysis by recent national dialysis cost studies. CONCLUSION The cost drivers for staffed services were staffing models and patient attendance rates. Staff salaries and transport costs were significantly higher in remote models of care. Opportunities to reduce expenditure exist by encouraging community supported services and employing local staff. Despite the delivery challenges of home haemodialysis including high patient attrition, the program still provides a cost benefit compared to urban staffed services. The next component of this study will examine patient health service utilisation and costs by model of care to provide a more comprehensive analysis of the overall cost of providing services in each location.
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Affiliation(s)
- G Gorham
- Renal Program, Wellbeing & Preventable Chronic Diseases Division, Menzies School of Health Research, Darwin, Northern Territory, Australia.
| | - K Howard
- Sydney School of Public Health, University of Sydney, Sydney, New South Wales, Australia
| | - Y Zhao
- Department of Health, Northern Territory Government, Darwin, Northern Territory, Australia
| | | | - P D Lawton
- Renal Program, Wellbeing & Preventable Chronic Diseases Division, Menzies School of Health Research, Darwin, Northern Territory, Australia
| | - C Sajiv
- Department of Health, Northern Territory Government, Darwin, Northern Territory, Australia.,Flinders University Northern Territory Medical Program, Darwin, Northern Territory, Australia
| | - S W Majoni
- Renal Program, Wellbeing & Preventable Chronic Diseases Division, Menzies School of Health Research, Darwin, Northern Territory, Australia.,Department of Health, Northern Territory Government, Darwin, Northern Territory, Australia.,Flinders University Northern Territory Medical Program, Darwin, Northern Territory, Australia
| | - P Wood
- Department of Health, Northern Territory Government, Darwin, Northern Territory, Australia
| | - T Conlon
- Department of Health, Northern Territory Government, Darwin, Northern Territory, Australia
| | - S Signal
- Department of Health, Northern Territory Government, Darwin, Northern Territory, Australia
| | - S L Robinson
- Department of Health, Northern Territory Government, Darwin, Northern Territory, Australia
| | - S Brown
- Western Desert Nganampa Walytja Palyantjaku Tjutaku Northern Territory, Alice Springs, Australia
| | - A Cass
- Renal Program, Wellbeing & Preventable Chronic Diseases Division, Menzies School of Health Research, Darwin, Northern Territory, Australia
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Wieland M, Nydam D, Älveby N, Wood P, Virkler P. Erratum to “Short communication: Teat-end shape and udder-level milking characteristics and their associations with machine milking-induced changes in teat tissue condition” (J. Dairy Sci. 101:11447–11454). J Dairy Sci 2019; 102:1884. [DOI: 10.3168/jds.2019-102-2-1884] [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: 11/19/2022]
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23
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Wrigley P, Wood P, Stewart P, Hall R, Robertson D. Module layout optimization using a genetic algorithm in light water modular nuclear reactor power plants. Nuclear Engineering and Design 2019. [DOI: 10.1016/j.nucengdes.2018.10.023] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Wieland M, Nydam D, Älveby N, Wood P, Virkler P. Short communication: Teat-end shape and udder-level milking characteristics and their associations with machine milking-induced changes in teat tissue condition. J Dairy Sci 2018; 101:11447-11454. [DOI: 10.3168/jds.2018-15057] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2018] [Accepted: 08/23/2018] [Indexed: 11/19/2022]
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Affiliation(s)
- P Wood
- Department of Paediatric Gastroenterology, Royal Hospital for Sick Children, Edinburgh, UK
| | - P Henderson
- Department of Paediatric Gastroenterology, Royal Hospital for Sick Children, Edinburgh, UK.,Child Life and Health, University of Edinburgh, Edinburgh, UK
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Sutherland IA, Du Q, Wood P. THE RELATIONSHIP BETWEEN RETENTION, LINEAR FLOW, AND DENSITY DIFFERENCE IN COUNTERCURRENT CHROMATOGRAPHY. J LIQ CHROMATOGR R T 2017. [DOI: 10.1081/jlc-100104370] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- I. A. Sutherland
- a Brunel Institute for Bioengineering, Brunel University , Uxbridge , UB8 3PH , UK
| | - Q. Du
- b Department of Chemical Engineering , Zhejiang University , Hangzhou, Zhejiang , 310027 , P. R. China
| | - P. Wood
- a Brunel Institute for Bioengineering, Brunel University , Uxbridge , UB8 3PH , UK
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Filiou M, Wood P, Teplytska L, Otte D, Zimmer A, Turck C. Myelination changes in schizophrenia: Converging evidence from mice and humans. PHARMACOPSYCHIATRY 2017. [DOI: 10.1055/s-0037-1606423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- M Filiou
- Department Stress Neurobiology and Neurogenetics, Max Planck Institute of Psychiatry, Munich, Germany
| | - P Wood
- Veterinary Medicine, Licoln Memorial University, Harrogate, US
| | - L Teplytska
- Proteomics and Biomarkers, Max Planck Institute of Psychiatry, Munich, Germany
| | - D Otte
- Institute of Molecular Psychiatry, University of Bonn, Bonn, Germany
| | - A Zimmer
- Institute of Molecular Psychiatry, University of Bonn, Bonn, Germany
| | - C Turck
- Proteomics and Biomarkers, Max Planck Institute of Psychiatry, Munich, Germany
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Flinn I, van der Jagt R, Chang J, Wood P, Hawkins T, MacDonald D, Trotman J, Simpson D, Kolibaba K, Issa S, Hallman D, Chen L, Burke J. FIRST-LINE TREATMENT OF INHL OR MCL PATIENTS WITH BR OR R-CHOP/R-CVP: RESULTS OF THE BRIGHT 5-YEAR FOLLOW-UP STUDY. Hematol Oncol 2017. [DOI: 10.1002/hon.2437_130] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- I. Flinn
- Medical Oncology; Sarah Cannon Research Institute; Nashville Tennessee USA
| | | | - J. Chang
- Department of Medicine, Hematology & Oncology; University of Wisconsin School of Medicine and Public Health, Madison; Wisconsin USA
| | - P. Wood
- Hematology, Division of Cancer Services; Princess Alexandra Hospital; Woolloongabba Queensland Australia
| | - T. Hawkins
- Haematology; Auckland City Hospital; Auckland New Zealand
| | - D. MacDonald
- Division of Hematology; Queen Elizabeth II Health Sciences Centre; Halifax Nova Scotia Canada
| | - J. Trotman
- Oncology, Clinical Research Unit; Concord Repatriation General Hospital; Concord New South Wales Australia
| | - D. Simpson
- Haematology; North Shore Hospital; Auckland New Zealand
| | - K. Kolibaba
- Oncology/Hematology; US Oncology Research, The Woodlands; Texas USA
| | - S. Issa
- Haematology; Middlemore Hospital; Auckland New Zealand
| | - D. Hallman
- Global Clinical Operations; Teva Pharmaceuticals; Malvern Pennsylvania USA
| | - L. Chen
- Biometrics Operations; Teva Pharmaceuticals; Malvern Pennsylvania USA
| | - J.M. Burke
- Oncology/Hematology; US Oncology Research, The Woodlands; Texas USA
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Trotman J, Opat S, Marlton P, Gottlieb D, Simpson D, Cull G, Ritchie D, Verner E, Ratnasingam S, Anderson M, Wood P, Wang L, Xue L, Hedrick E, Huang J, Hilger J, Seymour J, Roberts A, Tam C. BRUTON'S TYROSINE KINASE (BTK) INHIBITOR BGB-3111 DEMONSTRATES HIGH VERY GOOD PARTIAL RESPONSE (VGPR) RATE IN PATIENTS WITH WALDENSTRÖM MACROGLOBULINEMIA (WM). Hematol Oncol 2017. [DOI: 10.1002/hon.2437_58] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- J. Trotman
- Department of Haematology; Concord Repatriation General Hospital; Concord Australia
| | - S. Opat
- Clinical Haematology; Monash Health; Clayton Australia
| | - P. Marlton
- Leukaemia and Lymphoma Services, Princess Alexandra Hospital; University of Queensland School of Medicine; Brisbane Australia
| | - D. Gottlieb
- Haematology Department; Westmead Hospital; Westmead Australia
| | - D. Simpson
- Department of Haematology; North Shore Hospital; Aukland New Zealand
| | - G. Cull
- Department of Haematology; Sir Charles Gairdner Hospital; Perth Australia
| | - D. Ritchie
- Department of Haematology; Peter MacCallum Cancer Centre; Melbourne Australia
| | - E. Verner
- Department of Haematology; Concord Repatriation General Hospital; Concord Australia
| | | | - M. Anderson
- Cancer and Haematology; University of Melbourne; Melbourne Australia
| | - P. Wood
- Leukaemia and Lymphoma Services, Princess Alexandra Hospital; University of Queensland School of Medicine; Brisbane Australia
| | - L. Wang
- Research and Development Center; BeiGene, Beijing and Emeryville; CA, US China
| | - L. Xue
- Research and Development Center; BeiGene, Beijing and Emeryville; CA, US China
| | - E. Hedrick
- Research and Development Center; BeiGene, Beijing and Emeryville; CA, US China
| | - J. Huang
- Research and Development Center; BeiGene, Beijing and Emeryville; CA, US China
| | - J. Hilger
- Research and Development Center; BeiGene, Beijing and Emeryville; CA, US China
| | - J.F. Seymour
- Department of Haematology; Peter MacCallum Cancer Centre; Melbourne Australia
| | - A.W. Roberts
- Cancer and Haematology; University of Melbourne; Melbourne Australia
| | - C.S. Tam
- Department of Haematology; Peter MacCallum Cancer Centre; Melbourne Australia
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Denman S, Ford K, Toolan J, Mistry A, Corps C, Wood P, Savic S. Home self-administration of omalizumab for chronic spontaneous urticaria. Br J Dermatol 2016; 175:1405-1407. [PMID: 27639259 DOI: 10.1111/bjd.15074] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- S Denman
- Department of Clinical Immunology and Allergy, St James's University Hospital, Beckett Street, Leeds, U.K
| | - K Ford
- Department of Clinical Immunology and Allergy, St James's University Hospital, Beckett Street, Leeds, U.K
| | - J Toolan
- Department of Clinical Immunology and Allergy, St James's University Hospital, Beckett Street, Leeds, U.K
| | - A Mistry
- Department of Clinical Immunology and Allergy, St James's University Hospital, Beckett Street, Leeds, U.K
| | - C Corps
- Department of Clinical Immunology and Allergy, St James's University Hospital, Beckett Street, Leeds, U.K
| | - P Wood
- Department of Clinical Immunology and Allergy, St James's University Hospital, Beckett Street, Leeds, U.K
| | - S Savic
- Department of Clinical Immunology and Allergy, St James's University Hospital, Beckett Street, Leeds, U.K.,National Institute for Health Research-Leeds Musculoskeletal Biomedical Research Unit (NIHR-LMBRU) and Leeds Institute of Rheumatic and Musculoskeletal Medicine (LIRMM), Wellcome Trust Brenner Building, St James's University Hospital, Beckett Street, Leeds, U.K
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Vohra RS, Pasquali S, Kirkham AJ, Marriott P, Johnstone M, Spreadborough P, Alderson D, Griffiths EA, Fenwick S, Elmasry M, Nunes Q, Kennedy D, Basit Khan R, Khan MAS, Magee CJ, Jones SM, Mason D, Parappally CP, Mathur P, Saunders M, Jamel S, Ul Haque S, Zafar S, Shiwani MH, Samuel N, Dar F, Jackson A, Lovett B, Dindyal S, Winter H, Fletcher T, Rahman S, Wheatley K, Nieto T, Ayaani S, Youssef H, Nijjar RS, Watkin H, Naumann D, Emeshi S, Sarmah PB, Lee K, Joji N, Heath J, Teasdale RL, Weerasinghe C, Needham PJ, Welbourn H, Forster L, Finch D, Blazeby JM, Robb W, McNair AGK, Hrycaiczuk A, Charalabopoulos A, Kadirkamanathan S, Tang CB, Jayanthi NVG, Noor N, Dobbins B, Cockbain AJ, Nilsen-Nunn A, Siqueira J, Pellen M, Cowley JB, Ho WM, Miu V, White TJ, Hodgkins KA, Kinghorn A, Tutton MG, Al-Abed YA, Menzies D, Ahmad A, Reed J, Khan S, Monk D, Vitone LJ, Murtaza G, Joel A, Brennan S, Shier D, Zhang C, Yoganathan T, Robinson SJ, McCallum IJD, Jones MJ, Elsayed M, Tuck L, Wayman J, Carney K, Aroori S, Hosie KB, Kimble A, Bunting DM, Fawole AS, Basheer M, Dave RV, Sarveswaran J, Jones E, Kendal C, Tilston MP, Gough M, Wallace T, Singh S, Downing J, Mockford KA, Issa E, Shah N, Chauhan N, Wilson TR, Forouzanfar A, Wild JRL, Nofal E, Bunnell C, Madbak K, Rao STV, Devoto L, Siddiqi N, Khawaja Z, Hewes JC, Gould L, Chambers A, Urriza Rodriguez D, Sen G, Robinson S, Carney K, Bartlett F, Rae DM, Stevenson TEJ, Sarvananthan K, Dwerryhouse SJ, Higgs SM, Old OJ, Hardy TJ, Shah R, Hornby ST, Keogh K, Frank L, Al-Akash M, Upchurch EA, Frame RJ, Hughes M, Jelley C, Weaver S, Roy S, Sillo TO, Galanopoulos G, Cuming T, Cunha P, Tayeh S, Kaptanis S, Heshaishi M, Eisawi A, Abayomi M, Ngu WS, Fleming K, Singh Bajwa D, Chitre V, Aryal K, Ferris P, Silva M, Lammy S, Mohamed S, Khawaja A, Hussain A, Ghazanfar MA, Bellini MI, Ebdewi H, Elshaer M, Gravante G, Drake B, Ogedegbe A, Mukherjee D, Arhi C, Giwa Nusrat Iqbal L, Watson NF, Kumar Aggarwal S, Orchard P, Villatoro E, Willson PD, Wa K, Mok J, Woodman T, Deguara J, Garcea G, Babu BI, Dennison AR, Malde D, Lloyd D, Satheesan S, Al-Taan O, Boddy A, Slavin JP, Jones RP, Ballance L, Gerakopoulos S, Jambulingam P, Mansour S, Sakai N, Acharya V, Sadat MM, Karim L, Larkin D, Amin K, Khan A, Law J, Jamdar S, Smith SR, Sampat K, M O'shea K, Manu M, Asprou FM, Malik NS, Chang J, Johnstone M, Lewis M, Roberts GP, Karavadra B, Photi E, Hewes J, Gould L, Chambers A, Rodriguez D, O'Reilly DA, Rate AJ, Sekhar H, Henderson LT, Starmer BZ, Coe PO, Tolofari S, Barrie J, Bashir G, Sloane J, Madanipour S, Halkias C, Trevatt AEJ, Borowski DW, Hornsby J, Courtney MJ, Virupaksha S, Seymour K, Robinson S, Hawkins H, Bawa S, Gallagher PV, Reid A, Wood P, Finch JG, Parmar J, Stirland E, Gardner-Thorpe J, Al-Muhktar A, Peterson M, Majeed A, Bajwa FM, Martin J, Choy A, Tsang A, Pore N, Andrew DR, Al-Khyatt W, Taylor C, Bhandari S, Chambers A, Subramanium D, Toh SKC, Carter NC, Mercer SJ, Knight B, Tate S, Pearce B, Wainwright D, Vijay V, Alagaratnam 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Shahin Y, Ali A, Luther A, Nicholson JA, Rajendran I, Boal M, Ritchie J. Population-based cohort study of variation in the use of emergency cholecystectomy for benign gallbladder diseases. Br J Surg 2016; 103:1716-1726. [PMID: 27748962 DOI: 10.1002/bjs.10288] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2016] [Revised: 06/21/2016] [Accepted: 07/06/2016] [Indexed: 01/05/2023]
Abstract
Abstract
Background
The aims of this prospective population-based cohort study were to identify the patient and hospital characteristics associated with emergency cholecystectomy, and the influences of these in determining variations between hospitals.
Methods
Data were collected for consecutive patients undergoing cholecystectomy in acute UK and Irish hospitals between 1 March and 1 May 2014. Potential explanatory variables influencing the performance of emergency cholecystectomy were analysed by means of multilevel, multivariable logistic regression modelling using a two-level hierarchical structure with patients (level 1) nested within hospitals (level 2).
Results
Data were collected on 4744 cholecystectomies from 165 hospitals. Increasing age, lower ASA fitness grade, biliary colic, the need for further imaging (magnetic retrograde cholangiopancreatography), endoscopic interventions (endoscopic retrograde cholangiopancreatography) and admission to a non-biliary centre significantly reduced the likelihood of an emergency cholecystectomy being performed. The multilevel model was used to calculate the probability of receiving an emergency cholecystectomy for a woman aged 40 years or over with an ASA grade of I or II and a BMI of at least 25·0 kg/m2, who presented with acute cholecystitis with an ultrasound scan showing a thick-walled gallbladder and a normal common bile duct. The mean predicted probability of receiving an emergency cholecystectomy was 0·52 (95 per cent c.i. 0·45 to 0·57). The predicted probabilities ranged from 0·02 to 0·95 across the 165 hospitals, demonstrating significant variation between hospitals.
Conclusion
Patients with similar characteristics presenting to different hospitals with acute gallbladder pathology do not receive comparable care.
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Affiliation(s)
| | - R S Vohra
- Trent Oesophago-Gastric Unit, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - S Pasquali
- Surgical Oncology Unit, Veneto Institute of Oncology IOV-IRCCS, Padova, Italy
| | - A J Kirkham
- Cancer Research UK Clinical Trials Unit, University of Birmingham, Birmingham, UK
| | - P Marriott
- West Midlands Research Collaborative, Academic Department of Surgery, University of Birmingham, Birmingham, UK
| | - M Johnstone
- West Midlands Research Collaborative, Academic Department of Surgery, University of Birmingham, Birmingham, UK
| | - P Spreadborough
- West Midlands Research Collaborative, Academic Department of Surgery, University of Birmingham, Birmingham, UK
| | - D Alderson
- Academic Department of Surgery, University of Birmingham, Birmingham, UK
| | - E A Griffiths
- Department of Upper Gastrointestinal Surgery, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - S Fenwick
- Aintree University Hospital NHS Foundation Trust
| | - M Elmasry
- Aintree University Hospital NHS Foundation Trust
| | - Q Nunes
- Aintree University Hospital NHS Foundation Trust
| | - D Kennedy
- Aintree University Hospital NHS Foundation Trust
| | | | | | | | | | - D Mason
- Wirral University Teaching Hospital
| | | | | | | | - S Jamel
- Barnet and Chase Farm Hospital
| | | | - S Zafar
- Barnet and Chase Farm Hospital
| | | | - N Samuel
- Barnsley District General Hospital
| | - F Dar
- Barnsley District General Hospital
| | | | | | | | | | | | | | - K Wheatley
- Sandwell and West Birmingham Hospitals NHS Trust
| | - T Nieto
- Sandwell and West Birmingham Hospitals NHS Trust
| | - S Ayaani
- Sandwell and West Birmingham Hospitals NHS Trust
| | - H Youssef
- Heart of England Foundation NHS Trust
| | | | - H Watkin
- Heart of England Foundation NHS Trust
| | - D Naumann
- Heart of England Foundation NHS Trust
| | - S Emeshi
- Heart of England Foundation NHS Trust
| | | | - K Lee
- Heart of England Foundation NHS Trust
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- Heart of England Foundation NHS Trust
| | - J Heath
- Blackpool Teaching Hospitals NHS Foundation Trust
| | - R L Teasdale
- Blackpool Teaching Hospitals NHS Foundation Trust
| | | | - P J Needham
- Bradford Teaching Hospitals NHS Foundation Trust
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- Bradford Teaching Hospitals NHS Foundation Trust
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- Bradford Teaching Hospitals NHS Foundation Trust
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- Bradford Teaching Hospitals NHS Foundation Trust
| | | | - W Robb
- University Hospitals Bristol NHS Trust
| | | | | | | | | | | | | | | | - B Dobbins
- Calderdale and Huddersfield NHS Trust
| | | | | | | | - M Pellen
- Hull and East Yorkshire NHS Trust
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- Hull and East Yorkshire NHS Trust
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- Hull and East Yorkshire NHS Trust
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- Chesterfield Royal Hospital NHS Foundation Trust
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- Chesterfield Royal Hospital NHS Foundation Trust
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- Chesterfield Royal Hospital NHS Foundation Trust
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- Colchester Hospital University NHS Foundation Trust
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- Colchester Hospital University NHS Foundation Trust
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- Colchester Hospital University NHS Foundation Trust
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- Colchester Hospital University NHS Foundation Trust
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- Colchester Hospital University NHS Foundation Trust
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- Colchester Hospital University NHS Foundation Trust
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- Countess of Chester NHS Foundation Trust
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- Countess of Chester NHS Foundation Trust
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- Countess of Chester NHS Foundation Trust
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- Countess of Chester NHS Foundation Trust
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- Croydon Health Services NHS Trust
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- Croydon Health Services NHS Trust
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- North Cumbria University Hospitals Trust
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- North Cumbria University Hospitals Trust
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- North Cumbria University Hospitals Trust
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- North Cumbria University Hospitals Trust
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- North Cumbria University Hospitals Trust
| | | | | | | | | | | | | | | | | | | | | | - M P Tilston
- Northern Lincolnshire and Goole NHS Foundation Trust
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- Northern Lincolnshire and Goole NHS Foundation Trust
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- Northern Lincolnshire and Goole NHS Foundation Trust
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- Northern Lincolnshire and Goole NHS Foundation Trust
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- Northern Lincolnshire and Goole NHS Foundation Trust
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- Northern Lincolnshire and Goole NHS Foundation Trust
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- Northern Lincolnshire and Goole NHS Foundation Trust
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- Northern Lincolnshire and Goole NHS Foundation Trust
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- Northern Lincolnshire and Goole NHS Foundation Trust
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- Doncaster and Bassetlaw Hospitals NHS Foundation Trust
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- Doncaster and Bassetlaw Hospitals NHS Foundation Trust
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- Doncaster and Bassetlaw Hospitals NHS Foundation Trust
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- Doncaster and Bassetlaw Hospitals NHS Foundation Trust
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- Dorset County Hospital NHS Foundation Trust
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- Dorset County Hospital NHS Foundation Trust
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- Dorset County Hospital NHS Foundation Trust
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- Dorset County Hospital NHS Foundation Trust
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- Frimley Park Hospital NHS Trust
| | | | | | | | | | - O J Old
- Gloucestershire Hospitals NHS Trust
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- Gloucestershire Hospitals NHS Trust
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- Gloucestershire Hospitals NHS Trust
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- Gloucestershire Hospitals NHS Trust
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- Great Western Hospitals NHS Foundation Trust
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- Harrogate and District NHS Foundation Trust
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- Harrogate and District NHS Foundation Trust
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- Harrogate and District NHS Foundation Trust
| | | | | | | | | | - T Cuming
- Homerton University Hospital NHS Trust
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- Homerton University Hospital NHS Trust
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- Homerton University Hospital NHS Trust
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- Tees Hospitals NHS Foundation Trust
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- Tees Hospitals NHS Foundation Trust
| | | | | | - V Chitre
- Paget University Hospitals NHS Foundation Trust
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- Paget University Hospitals NHS Foundation Trust
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- Paget University Hospitals NHS Foundation Trust
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- Kettering General Hospital NHS Foundation Trust
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- Kettering General Hospital NHS Foundation Trust
| | - G Gravante
- Kettering General Hospital NHS Foundation Trust
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- Kettering General Hospital NHS Foundation Trust
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- Barking, Havering and Redbridge University Hospitals NHS Trust
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- Barking, Havering and Redbridge University Hospitals NHS Trust
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- Barking, Havering and Redbridge University Hospitals NHS Trust
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- Kingston Hospital NHS Foundation Trust
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- Kingston Hospital NHS Foundation Trust
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- Kingston Hospital NHS Foundation Trust
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- Kingston Hospital NHS Foundation Trust
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- University Hospitals of Leicester NHS Trust
| | - B I Babu
- University Hospitals of Leicester NHS Trust
| | | | - D Malde
- University Hospitals of Leicester NHS Trust
| | - D Lloyd
- University Hospitals of Leicester NHS Trust
| | | | - O Al-Taan
- University Hospitals of Leicester NHS Trust
| | - A Boddy
- University Hospitals of Leicester NHS Trust
| | - J P Slavin
- Leighton Hospital, Mid Cheshire Hospitals NHS Foundation Trust
| | - R P Jones
- Leighton Hospital, Mid Cheshire Hospitals NHS Foundation Trust
| | - L Ballance
- Leighton Hospital, Mid Cheshire Hospitals NHS Foundation Trust
| | - S Gerakopoulos
- Leighton Hospital, Mid Cheshire Hospitals NHS Foundation Trust
| | - P Jambulingam
- Luton and Dunstable University Hospital NHS Foundation Trust
| | - S Mansour
- Luton and Dunstable University Hospital NHS Foundation Trust
| | - N Sakai
- Luton and Dunstable University Hospital NHS Foundation Trust
| | - V Acharya
- Luton and Dunstable University Hospital NHS Foundation Trust
| | - M M Sadat
- Macclesfield District General Hospital
| | - L Karim
- Macclesfield District General Hospital
| | - D Larkin
- Macclesfield District General Hospital
| | - K Amin
- Macclesfield District General Hospital
| | - A Khan
- Central Manchester NHS Foundation Trust
| | - J Law
- Central Manchester NHS Foundation Trust
| | - S Jamdar
- Central Manchester NHS Foundation Trust
| | - S R Smith
- Central Manchester NHS Foundation Trust
| | - K Sampat
- Central Manchester NHS Foundation Trust
| | | | - M Manu
- Royal Wolverhampton Hospitals NHS Trust
| | | | - N S Malik
- Royal Wolverhampton Hospitals NHS Trust
| | - J Chang
- Royal Wolverhampton Hospitals NHS Trust
| | | | - M Lewis
- Norfolk and Norwich University Hospitals NHS Foundation Trust
| | - G P Roberts
- Norfolk and Norwich University Hospitals NHS Foundation Trust
| | - B Karavadra
- Norfolk and Norwich University Hospitals NHS Foundation Trust
| | - E Photi
- Norfolk and Norwich University Hospitals NHS Foundation Trust
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - J Hornsby
- North Tees and Hartlepool NHS Foundation Trust
| | | | | | - K Seymour
- Northumbria Healthcare NHS Foundation Trust
| | - S Robinson
- Northumbria Healthcare NHS Foundation Trust
| | - H Hawkins
- Northumbria Healthcare NHS Foundation Trust
| | - S Bawa
- Northumbria Healthcare NHS Foundation Trust
| | | | - A Reid
- Northumbria Healthcare NHS Foundation Trust
| | - P Wood
- Northumbria Healthcare NHS Foundation Trust
| | - J G Finch
- Northampton General Hospital NHS Trust
| | - J Parmar
- Northampton General Hospital NHS Trust
| | | | | | - A Al-Muhktar
- Sheffield Teaching Hospitals NHS Foundation Trust
| | - M Peterson
- Sheffield Teaching Hospitals NHS Foundation Trust
| | - A Majeed
- Sheffield Teaching Hospitals NHS Foundation Trust
| | | | | | - A Choy
- Peterborough City Hospital
| | | | - N Pore
- United Lincolnshire Hospitals NHS Trust
| | | | | | - C Taylor
- United Lincolnshire Hospitals NHS Trust
| | | | | | | | | | | | | | | | - S Tate
- Portsmouth Hospitals NHS Trust
| | | | | | - V Vijay
- The Princess Alexandra Hospital NHS Trust
| | | | - S Sinha
- The Princess Alexandra Hospital NHS Trust
| | - S Khan
- The Princess Alexandra Hospital NHS Trust
| | | | - A A Hussain
- King's College Hospital NHS Foundation Trust
| | | | - N Kansal
- Gateshead Health NHS Foundation Trust
| | - T Fasih
- Gateshead Health NHS Foundation Trust
| | - C Jackson
- Gateshead Health NHS Foundation Trust
| | | | | | | | | | | | | | - K Gurung
- Queen Elizabeth Hospital NHS Trust
| | - G Tsavellas
- East Kent Hospitals University NHS Foundation Trust
| | - P Basynat
- East Kent Hospitals University NHS Foundation Trust
| | | | - S Basu
- East Kent Hospitals University NHS Foundation Trust
| | | | - M Rabie
- East Kent Hospitals University NHS Foundation Trust
| | - M Akhtar
- East Kent Hospitals University NHS Foundation Trust
| | - P Kumar
- Burton Hospitals NHS Foundation Trust
| | | | - N Hussain
- Burton Hospitals NHS Foundation Trust
| | - S Raza
- Burton Hospitals NHS Foundation Trust
| | - M Haque
- Royal Albert Edward Infirmary, Wigan Wrightington and Leigh NHS Trust
| | - I Alam
- Royal Albert Edward Infirmary, Wigan Wrightington and Leigh NHS Trust
| | - R Aseem
- Royal Albert Edward Infirmary, Wigan Wrightington and Leigh NHS Trust
| | - S Patel
- Royal Albert Edward Infirmary, Wigan Wrightington and Leigh NHS Trust
| | - M Asad
- Royal Albert Edward Infirmary, Wigan Wrightington and Leigh NHS Trust
| | - M I Booth
- Royal Berkshire NHS Foundation Trust
| | - W R Ball
- Royal Berkshire NHS Foundation Trust
| | | | | | | | | | - J Varghase
- Royal Bolton Hospital NHS Foundation Trust
| | - J Lodhia
- Royal Bolton Hospital NHS Foundation Trust
| | - D Bradley
- Royal Bolton Hospital NHS Foundation Trust
| | - C Rengifo
- Royal Bolton Hospital NHS Foundation Trust
| | - D Lindsay
- Royal Bolton Hospital NHS Foundation Trust
| | | | | | | | | | | | - A Awan
- Royal Derby NHS Foundation Trust
| | - J Ahmed
- Royal Derby NHS Foundation Trust
| | - P Leeder
- Royal Derby NHS Foundation Trust
| | | | | | | | | | - D Hou
- Hampshire Hospital NHS Foundation Trust
| | - F Noble
- Hampshire Hospital NHS Foundation Trust
| | | | | | - R Date
- Lancashire Teaching Hospitals NHS Foundation Trust
| | - M R Hossack
- Lancashire Teaching Hospitals NHS Foundation Trust
| | - Y Li Goh
- Lancashire Teaching Hospitals NHS Foundation Trust
| | - P Turner
- Lancashire Teaching Hospitals NHS Foundation Trust
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- Lancashire Teaching Hospitals NHS Foundation Trust
| | | | | | | | - S R Preston
- Royal Surrey County Hospital NHS Foundation Trust
| | - J R Hoban
- Royal Surrey County Hospital NHS Foundation Trust
| | - D J Puntis
- Royal Surrey County Hospital NHS Foundation Trust
| | - S V Williams
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| | | | | | - J Batt
- Royal United Hospital Bath NHS Trust
| | - M Doe
- Royal United Hospital Bath NHS Trust
| | | | | | | | - C Hall
- Salford Royal NHS Foundation Trust
| | - N Carty
- Salisbury Hospital Foundation Trust
| | - J Ahmed
- Salisbury Hospital Foundation Trust
| | | | | | | | - H Lennon
- Southport and Ormskirk Hospital NHS Trust
| | - C Hindley
- Southport and Ormskirk Hospital NHS Trust
| | - M Reddy
- St George's Healthcare NHS Trust
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- St George's Healthcare NHS Trust
| | | | | | | | - K Hancorn
- St Helens and Knowsley Teaching Hospitals NHS Trust
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- St Helens and Knowsley Teaching Hospitals NHS Trust
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- Imperial College Healthcare NHS Trust
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- Imperial College Healthcare NHS Trust
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- Imperial College Healthcare NHS Trust
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- Mid Staffordshire NHS Foundation Trust
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- City Hospitals Sunderland NHS Foundation Trust
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- Tunbridge Wells and Maidstone NHS Trust
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- University Hospital Coventry and Warwickshire NHS Trust
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- South Warwickshire NHS Foundation Trust
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- York Teaching Hospital NHS Foundation Trust
| | - T Hossain
- York Teaching Hospital NHS Foundation Trust
| | - A Pannu
- York Teaching Hospital NHS Foundation Trust
| | | | | | - G W Taylor
- York Teaching Hospital NHS Foundation Trust
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- Belfast City Hospital, Mater Infirmorum Hospital Belfast and Royal Victoria Hospital
| | - P Davey
- Belfast City Hospital, Mater Infirmorum Hospital Belfast and Royal Victoria Hospital
| | - C Jones
- Belfast City Hospital, Mater Infirmorum Hospital Belfast and Royal Victoria Hospital
| | - J M Clements
- Belfast City Hospital, Mater Infirmorum Hospital Belfast and Royal Victoria Hospital
| | - R Digney
- Belfast City Hospital, Mater Infirmorum Hospital Belfast and Royal Victoria Hospital
| | - W M Chan
- Belfast City Hospital, Mater Infirmorum Hospital Belfast and Royal Victoria Hospital
| | - S McCain
- Belfast City Hospital, Mater Infirmorum Hospital Belfast and Royal Victoria Hospital
| | - S Gull
- Belfast City Hospital, Mater Infirmorum Hospital Belfast and Royal Victoria Hospital
| | - A Janeczko
- Belfast City Hospital, Mater Infirmorum Hospital Belfast and Royal Victoria Hospital
| | - E Dorrian
- Belfast City Hospital, Mater Infirmorum Hospital Belfast and Royal Victoria Hospital
| | - A Harris
- Belfast City Hospital, Mater Infirmorum Hospital Belfast and Royal Victoria Hospital
| | - S Dawson
- Belfast City Hospital, Mater Infirmorum Hospital Belfast and Royal Victoria Hospital
| | - D Johnston
- Belfast City Hospital, Mater Infirmorum Hospital Belfast and Royal Victoria Hospital
| | - B McAree
- Belfast City Hospital, Mater Infirmorum Hospital Belfast and Royal Victoria Hospital
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- University Hospital Limerick
| | | | - A D K Hill
- Louth County Hospital and Our Lady of Lourdes Hospital
| | - E Khogali
- Louth County Hospital and Our Lady of Lourdes Hospital
| | - W Shabo
- Louth County Hospital and Our Lady of Lourdes Hospital
| | - E Iskandar
- Louth County Hospital and Our Lady of Lourdes Hospital
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- St Luke's General Hospital Kilkenny
| | - M Lee
- St Luke's General Hospital Kilkenny
| | - D C Winter
- St Vincent's University and Private Hospitals, Dublin
| | - M E Kelly
- St Vincent's University and Private Hospitals, Dublin
| | - E Hoti
- St Vincent's University and Private Hospitals, Dublin
| | - D Maguire
- St Vincent's University and Private Hospitals, Dublin
| | - P Karunakaran
- St Vincent's University and Private Hospitals, Dublin
| | - J G Geoghegan
- St Vincent's University and Private Hospitals, Dublin
| | - S T Martin
- St Vincent's University and Private Hospitals, Dublin
| | - F McDermott
- St Vincent's University and Private Hospitals, Dublin
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - S Gibson
- Crosshouse Hospital, Ayrshire and Arran
| | | | - D G Vass
- Crosshouse Hospital, Ayrshire and Arran
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - H C C Lim
- Glangwili General and Prince Philip Hospital
| | - D Duke
- Glangwili General and Prince Philip Hospital
| | - T Ahmed
- Glangwili General and Prince Philip Hospital
| | - W D Beasley
- Glangwili General and Prince Philip Hospital
| | | | - G Maharaj
- Glangwili General and Prince Philip Hospital
| | - C Malcolm
- Glangwili General and Prince Philip Hospital
| | | | | | | | - R Radwan
- Morriston and Singleton Hospitals
| | | | - S Wood
- Princess of Wales Hospital
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Levine B, Maude S, Zheng Z, Shaw P, Ambrose D, Aplenc R, Barker C, Barrett D, Brogdon J, Callahan C, Chen F, Chew A, Suhoski Davis M, Fesnak A, Finklestein J, Frey N, Lacey S, Lamontagne A, Lewitt L, Loew A, Marcucci K, Melenhorst J, Motley L, Mudambi M, Nazimuddin F, O'Rourke M, Porter D, Rheingold S, Scholler J, Tayor C, White C, Wood P, Young R, Teachey D, June C, Grupp S. Durable Remissions with Control of Cytokine Release Syndrome (CRS) Using T Cells Expressing CD19 Targeted Chimeric Antigen Receptor (CAR) CTL019 to Treat Relapsed/Refractory (R/R) Acute Lymphoid Leukemia (ALL). Cytotherapy 2016. [DOI: 10.1016/j.jcyt.2016.03.039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Levine B, Boyd J, Jinivizian K, Jeschke M, Suhoski Davis M, Zheng Z, Stark D, Keir C, Wood P. Successful Technology Transfer of Chimeric Antigen Receptor (CAR) Targeting CD19 (CTL019) Cell Processing From Academia to Industry Enables Scale-Up to Support Global Clinical Trials. Cytotherapy 2016. [DOI: 10.1016/j.jcyt.2016.03.047] [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]
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Filiou M, Wood P, Teplytska L, Otte D, Zimmer A, Turck C. Altered myelination in schizophrenia: Evidence from animal models and human cohorts. Pharmacopsychiatry 2015. [DOI: 10.1055/s-0035-1557955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Tran H, Joseph J, Young L, McRae S, Curnow J, Nandurkar H, Wood P, McLintock C. New oral anticoagulants: a practical guide on prescription, laboratory testing and peri-procedural/bleeding management. Australasian Society of Thrombosis and Haemostasis. Intern Med J 2015; 44:525-36. [PMID: 24946813 DOI: 10.1111/imj.12448] [Citation(s) in RCA: 113] [Impact Index Per Article: 12.6] [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: 07/23/2013] [Accepted: 03/19/2014] [Indexed: 01/08/2023]
Abstract
New oral anticoagulants (NOAC) are becoming available as alternatives to warfarin to prevent systemic embolism in patients with non-valvular atrial fibrillation and for the treatment and prevention of venous thromboembolism. An in-depth understanding of their pharmacology is invaluable for appropriate prescription and optimal management of patients receiving these drugs should unexpected complications (such as bleeding) occur, or the patient requires urgent surgery. The Australasian Society of Thrombosis and Haemostasis has set out to inform physicians on the use of the different NOAC based on current available evidence focusing on: (i) selection of the most suitable patient groups to receive NOAC, (ii) laboratory measurements of NOAC in appropriate circumstances and (iii) management of patients taking NOAC in the perioperative period, and strategies to manage bleeding complications or 'reverse' the anticoagulant effects for urgent invasive procedures.
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Affiliation(s)
- H Tran
- Haemostasis Thrombosis Unit, The Alfred Hospital, Melbourne, Victoria, Australia
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Edgar JDM, Buckland M, Guzman D, Conlon NP, Knerr V, Bangs C, Reiser V, Panahloo Z, Workman S, Slatter M, Gennery AR, Davies EG, Allwood Z, Arkwright PD, Helbert M, Longhurst HJ, Grigoriadou S, Devlin LA, Huissoon A, Krishna MT, Hackett S, Kumararatne DS, Condliffe AM, Baxendale H, Henderson K, Bethune C, Symons C, Wood P, Ford K, Patel S, Jain R, Jolles S, El-Shanawany T, Alachkar H, Herwadkar A, Sargur R, Shrimpton A, Hayman G, Abuzakouk M, Spickett G, Darroch CJ, Paulus S, Marshall SE, McDermott EM, Heath PT, Herriot R, Noorani S, Turner M, Khan S, Grimbacher B. The United Kingdom Primary Immune Deficiency (UKPID) Registry: report of the first 4 years' activity 2008-2012. Clin Exp Immunol 2014; 175:68-78. [PMID: 23841717 DOI: 10.1111/cei.12172] [Citation(s) in RCA: 74] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/04/2013] [Indexed: 12/11/2022] Open
Abstract
This report summarizes the establishment of the first national online registry of primary immune deficency in the United Kingdom, the United Kingdom Primary Immunodeficiency (UKPID Registry). This UKPID Registry is based on the European Society for Immune Deficiency (ESID) registry platform, hosted on servers at the Royal Free site of University College, London. It is accessible to users through the website of the United Kingdom Primary Immunodeficiency Network (www.ukpin.org.uk). Twenty-seven centres in the United Kingdom are actively contributing data, with an additional nine centres completing their ethical and governance approvals to participate. This indicates that 36 of 38 (95%) of recognized centres in the United Kingdom have engaged with this project. To date, 2229 patients have been enrolled, with a notable increasing rate of recruitment in the past 12 months. Data are presented on the range of diagnoses recorded, estimated minimum disease prevalence, geographical distribution of patients across the United Kingdom, age at presentation, diagnostic delay, treatment modalities used and evidence of their monitoring and effectiveness.
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Affiliation(s)
- J D M Edgar
- Regional Immunology Service, The Royal Hospitals, Belfast, East Yorkshire; Centre for Infection and Immunity, Queen's University Belfast, Belfast, East Yorkshire
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Wood P, De Clercq J, van Wyk J. Position specific rugby injuries at university level as related to frequency, severity and site. J Sci Med Sport 2013. [DOI: 10.1016/j.jsams.2013.10.138] [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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Faria A, Gabriel R, Abrantes J, Wood P, Moreira H. Mechanical properties of the triceps surae: Differences between football and non-football players. J Sports Sci 2013; 31:1559-67. [DOI: 10.1080/02640414.2013.789919] [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: 10/26/2022]
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Harrop-Griffiths W, Cook T, Gill H, Hill D, Ingram M, Makris M, Malhotra S, Nicholls B, Popat M, Swales H, Wood P. Regional anaesthesia and patients with abnormalities of coagulation. Anaesthesia 2013; 68:966-72. [DOI: 10.1111/anae.12359] [Citation(s) in RCA: 166] [Impact Index Per Article: 15.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/04/2013] [Indexed: 11/29/2022]
Affiliation(s)
| | | | - T. Cook
- Royal College of Anaesthetists
| | | | - D. Hill
- Obstetric Anaesthetists’ Association
| | | | | | | | | | | | - H. Swales
- Obstetric Anaesthetists’ Association
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Abstract
Over the past 12 years, the United Kingdom Defence Medical Services have evolved an integrated 'damage control resuscitation - damage control surgery' sequence for the management of patients sustaining complex injuries. During 2009, over 3200 units of blood products were administered as massive transfusions to severely injured UK personnel. An important part of the approach to traumatic bleeding is the early, empirical use of predefined ratios of blood and clotting products. As soon as control of bleeding is achieved, current practice is to switch towards a tailored transfusion, based on clinical and laboratory assessments, including point-of-care coagulation testing. A key goal is to provide resuscitation seamlessly throughout surgery, so that patients leave the operating room with their normal physiology restored. This article outlines the current management of haemorrhage and coagulation employed in Afghanistan from the point of wounding to transfer back to the National Health Service.
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Affiliation(s)
- S J Mercer
- Aintree University Hospitals NHS Foundation Trust, Liverpool, UK.
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Koese M, Rentero C, Kota BP, Hoque M, Cairns R, Wood P, Vilà de Muga S, Reverter M, Alvarez-Guaita A, Monastyrskaya K, Hughes WE, Swarbrick A, Tebar F, Daly RJ, Enrich C, Grewal T. Annexin A6 is a scaffold for PKCα to promote EGFR inactivation. Oncogene 2012; 32:2858-72. [PMID: 22797061 DOI: 10.1038/onc.2012.303] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Protein kinase Cα (PKCα) can phosphorylate the epidermal growth factor receptor (EGFR) at threonine 654 (T654) to inhibit EGFR tyrosine phosphorylation (pY-EGFR) and the associated activation of downstream effectors. However, upregulation of PKCα in a large variety of cancers is not associated with EGFR inactivation, and factors determining the potential of PKCα to downregulate EGFR are yet unknown. Here, we show that ectopic expression of annexin A6 (AnxA6), a member of the Ca(2+) and phospholipid-binding annexins, strongly reduces pY-EGFR levels while augmenting EGFR T654 phosphorylation in EGFR overexpressing A431, head and neck and breast cancer cell lines. Reduced EGFR activation in AnxA6 expressing A431 cells is associated with reduced EGFR internalization and degradation. RNA interference (RNAi)-mediated PKCα knockdown in AnxA6 expressing A431 cells reduces T654-EGFR phosphorylation, but restores EGFR tyrosine phosphorylation, clonogenic growth and EGFR degradation. These findings correlate with AnxA6 interacting with EGFR, and elevated AnxA6 levels promoting PKCα membrane association and interaction with EGFR. Stable expression of the cytosolic N-terminal mutant AnxA6(1-175), which cannot promote PKCα membrane recruitment, does not increase T654-EGFR phosphorylation or the association of PKCα with EGFR. AnxA6 overexpression does not inhibit tyrosine phosphorylation of the T654A EGFR mutant, which cannot be phosphorylated by PKCα. Most strikingly, stable plasma membrane anchoring of AnxA6 is sufficient to recruit PKCα even in the absence of EGF or Ca(2+). In summary, AnxA6 is a new PKCα scaffold to promote PKCα-mediated EGFR inactivation through increased membrane targeting of PKCα and EGFR/PKCα complex formation.
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Affiliation(s)
- M Koese
- Faculty of Pharmacy, University of Sydney, Sydney, New South Wales, Australia
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Affiliation(s)
- S Savic
- Clinical Immunology Department, St James's University Hospital, Leeds.
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Tung JP, Fung YL, Nataatmadja M, Colebourne KI, Esmaeel HM, Wilson K, Barnett AG, Wood P, Silliman CC, Fraser JF. A novel in vivo ovine model of transfusion-related acute lung injury (TRALI). Vox Sang 2011; 100:219-30. [PMID: 20667072 DOI: 10.1111/j.1423-0410.2010.01381.x] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND AND OBJECTIVES Even with the introduction of specific risk-reduction strategies, transfusion-related acute lung injury (TRALI) continues to be a leading cause of transfusion-related morbidity and mortality. Existing small animal models have not yet investigated TRALI resulting from the infusion of heat-treated supernatant from whole blood platelet concentrates. In this study, our objective was the development of a novel in vivo two-event model of TRALI in sheep. MATERIALS AND METHODS Lipopolysaccharide (LPS; 15 μg/kg) as a first event, modelled clinical infection. Transfusion (estimated at 10% of total blood volume) of heat-treated pooled supernatant from date-of-expire human whole blood platelet concentrates (d5-PLT-S/N) was used as a second event. TRALI was defined by both hypoxaemia that developed either during the transfusion or within two hours of its completion and post-mortem histological evidence of pulmonary oedema. RESULTS LPS infusion did not cause lung injury itself, but did result in decreased circulating levels of lymphocytes and neutrophils with evidence of the latter becoming sequestered in the lungs. Sheep that received LPS (first event) followed by d5-PLT-S/N (second event) displayed decreased pulmonary compliance, decreased end tidal CO(2) and increased arterial partial pressure of CO(2) relative to control sheep, and 80% of these sheep developed TRALI. CONCLUSIONS This novel ovine two-event TRALI model presents a new tool for the investigation of TRALI pathogenesis. It represents the first description of an in vivo large animal model of TRALI and the first description of TRALI caused by transfusion with heat-treated pooled supernatant from human whole blood platelet concentrates.
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Affiliation(s)
- J P Tung
- Research and Development Laboratory, Australian Red Cross Blood Service, Brisbane, Qld, Australia.
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Devonport L, Edwards D, Edwards C, Aldington D, Mahoney P, Wood P. Evolution of the Role 4 UK Military Pain Service. J ROY ARMY MED CORPS 2010; 156:398-401. [DOI: 10.1136/jramc-156-04s-22] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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