1
|
Dawson R, Wands DIF, Logan M, Bremner G, Efklides S, Benn L, Henderson P, Grant H, Meredith J, Armstrong K, Wilson DC, Gerasimidis K, Alex G, Russell RK. Comparing Effectiveness of a Generic Oral Nutritional Supplement With Specialized Formula in the Treatment of Active Pediatric Crohn's Disease. Inflamm Bowel Dis 2022; 28:1859-1864. [PMID: 35259266 DOI: 10.1093/ibd/izac039] [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: 11/22/2021] [Indexed: 12/09/2022]
Abstract
BACKGROUND Exclusive enteral nutrition (EEN) is the recommended induction treatment of mild to moderate active pediatric Crohn's disease (CD). This study compared outcomes of 2 proprietary polymeric formulas. Treatment effectiveness was examined along with practical aspects of formula delivery and differences in estimated treatment costs. METHODS Data were retrospectively collected from patients with CD who received a generic oral nutritional supplement (Fortisip) across 2 centers (RCH, Melbourne and RHSC, Edinburgh). This was compared with a prospective cohort (RHC, Glasgow) that used a specialized formula (Modulen IBD). The data collected included patient demographics, remission rates, biochemical markers, administration method, and anthropometrics. The estimated treatment cost was performed by comparing price per kcal between each formula. RESULTS One hundred seventy-one patients were included (106 Fortisip, 65 Modulen IBD, 70 female; median age 13.3 yrs). No difference was demonstrated in remission rate (Fortisip n = 67 of 106 [63%] vs Modulen IBD n = 41 of 64 [64%], P = .89), nonadherence rate (Fortisip n = 7 of 106 [7%] vs Modulen IBD 3 of 64 [5%], P = .57) or method of administration (NGT Fortisip use n = 16 of 106 [12%] vs Modulen IBD 14 of 65 [22%]; P = .31). There was no difference in reduction of biochemical disease markers between the groups (C-reactive protein , P = .13; erythrocyte sedimentation rate, P = .49; fecal calprotectin, P = .94). However, there was a cost-saving of around £500/patient/course if the generic oral nutritional supplement was used. CONCLUSIONS The generic oral nutritional supplement and specialized formulas both had similar clinical effectiveness in induction of remission in pediatric CD. However, there is considerable cost-saving when using a generic oral nutritional supplement.
Collapse
Affiliation(s)
- R Dawson
- Department of Paediatric Gastroenterology and Nutrition, Royal Hospital for Children & Young people, Edinburgh, UK
| | - D I F Wands
- Department of Paediatric Gastroenterology and Nutrition, Royal Hospital for Children & Young people, Edinburgh, UK
- Department of Gastroenterology, Hepatology and Clinical Nutrition, The Royal Children's Hospital, Melbourne, Victoria, Australia
| | - M Logan
- School of Medicine, Dentistry and Nursing, University of Glasgow, Glasgow Royal Infirmary, Glasgow, UK
| | - G Bremner
- Department of Paediatric Gastroenterology and Nutrition, Royal Hospital for Children & Young people, Edinburgh, UK
| | - S Efklides
- Department of Nutrition and Food Services, The Royal Children's Hospital, Melbourne, Victoria, Australia
| | - L Benn
- Department of Nutrition and Food Services, The Royal Children's Hospital, Melbourne, Victoria, Australia
| | - P Henderson
- Department of Paediatric Gastroenterology and Nutrition, Royal Hospital for Children & Young people, Edinburgh, UK
- Child Life and Health, University of Edinburgh, Royal Hospital for Children & Young people, Edinburgh, UK
| | - H Grant
- Department of Paediatric Gastroenterology and Nutrition, Royal Hospital for Children & Young people, Edinburgh, UK
| | - J Meredith
- Department of Paediatric Gastroenterology and Nutrition, Royal Hospital for Children & Young people, Edinburgh, UK
| | - K Armstrong
- Department of Paediatric Gastroenterology and Nutrition, Royal Hospital for Children & Young people, Edinburgh, UK
| | - D C Wilson
- Department of Paediatric Gastroenterology and Nutrition, Royal Hospital for Children & Young people, Edinburgh, UK
- Child Life and Health, University of Edinburgh, Royal Hospital for Children & Young people, Edinburgh, UK
| | - K Gerasimidis
- School of Medicine, Dentistry and Nursing, University of Glasgow, Glasgow Royal Infirmary, Glasgow, UK
| | - G Alex
- Department of Gastroenterology, Hepatology and Clinical Nutrition, The Royal Children's Hospital, Melbourne, Victoria, Australia
| | - R K Russell
- Department of Paediatric Gastroenterology and Nutrition, Royal Hospital for Children & Young people, Edinburgh, UK
- School of Medicine, Dentistry and Nursing, University of Glasgow, Glasgow Royal Infirmary, Glasgow, UK
- Child Life and Health, University of Edinburgh, Royal Hospital for Children & Young people, Edinburgh, UK
| |
Collapse
|
2
|
Kuenzig E, Fung SG, Marderfeld L, Mak JW, Kaplan GG, Ng SC, Wilson DC, Cameron FL, Henderson P, Kotze PG, Benchimol EI. A25 THE RISING GLOBAL INCIDENCE OF PEDIATRIC INFLAMMATORY BOWEL DISEASE: A SYSTEMATIC REVIEW OF POPULATION-BASED STUDIES. J Can Assoc Gastroenterol 2021. [DOI: 10.1093/jcag/gwab002.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
The incidence of inflammatory bowel disease (IBD), including Crohn’s disease (CD) and ulcerative colitis (UC), is increasing internationally, particularly in developing nations where rates were historically low. Previous reports of the incidence and prevalence of pediatric-onset IBD have identified a paucity of population-based studies.
Aims
We reviewed the global trends in incidence of pediatric IBD using evidence from population-based studies.
Methods
(PROSPERO CRD42019125193) We systematically reviewed studies indexed in MEDLINE, EMBASE, Airiti Library, and SciELO from 01/2010-02/2020 to identify population-based studies reporting the incidence of pediatric-onset IBD, CD, and UC. Included studies combined childhood and adolescent-onset IBD (onset <21y). Changes in incidence since 2000 were plotted by continent, with data from 2000–09 provided by our previous systematic review1. To depict trends, multiple times points reported in single studies were connected on graphs. When incidence was reported as an aggregated estimate over a range of years, data was plotted using the midpoint of the interval.
Results
Of 8096 abstracts screened, 74 studies described the incidence of IBD, CD, or UC in 33 countries (Figure panel A). The incidence of pediatric-onset IBD is highest in Northern Europe and North America, and lowest in Southern Europe, Asia, and the Middle East. This geographical distribution is similar in UC, while incidence of pediatric-onset CD is highest in North America and Northern Europe, followed by Australia. Trends in incidence over time, stratified by continent, are reported in Figure, panel B. Significantly increasing incidence of IBD, CD, and/or UC was reported in China, Bahrain, Canada, New Zealand, Australia, Singapore, Saudi Arabia, and most European countries. Very Early Onset (VEO) IBD significantly increased in Canada, however Saudi Arabia reported decreasing incidence of VEO-CD but stable incidence of VEO-UC.
Conclusions
Conclusion: Incidence of pediatric-onset IBD are highest in Northern Europe and North American and are increasing globally. There remains a paucity of studies from many parts of the world on the incidence pediatric IBD. Further research is needed to understand the pathogenesis of the rising incidence of pediatric IBD, including work to understand the genetic, environmental, immunological and microbiome alterations leading to the increasing rates in children.
References: 1Benchimol, Fortinsky et al. Inflamm Bowel Dis 2011;17:423–39.
Funding Agencies
None
Collapse
Affiliation(s)
- E Kuenzig
- Children’s Hospital of Eastern Ontario Research Institute, Ottawa, ON, Canada
| | - S G Fung
- Children’s Hospital of Eastern Ontario Research Institute, Ottawa, ON, Canada
| | - L Marderfeld
- Children’s Hospital of Eastern Ontario Research Institute, Ottawa, ON, Canada
| | - J W Mak
- Chinese University of Hong Kong, Shatin, Hong Kong
| | - G G Kaplan
- University of Calgary Cumming School of Medicine, Calgary, AB, Canada
| | - S C Ng
- Chinese University of Hong Kong, Shatin, Hong Kong
| | - D C Wilson
- University of Edinburgh, Edinburgh, Scotland, United Kingdom
| | - F L Cameron
- Alder Hey Children’s Hospital, Liverpool, Merseyside, United Kingdom
| | - P Henderson
- University of Edinburgh, Edinburgh, Scotland, United Kingdom
| | - P G Kotze
- Pontifícia Universidade Católica do Paraná (PUC-PR), Curitiba, Brazil
| | - E I Benchimol
- SickKids IBD Centre, The Hospital for Sick Children, Department of Paediatrics, University of Toronto, Toronto, ON, Canada
| | | |
Collapse
|
3
|
Oliva EM, Bowe T, Manhapra A, Kertesz S, Hah JM, Henderson P, Robinson A, Paik M, Sandbrink F, Gordon AJ, Trafton JA. Associations between stopping prescriptions for opioids, length of opioid treatment, and overdose or suicide deaths in US veterans: observational evaluation. BMJ 2020; 368:m283. [PMID: 32131996 PMCID: PMC7249243 DOI: 10.1136/bmj.m283] [Citation(s) in RCA: 128] [Impact Index Per Article: 32.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
OBJECTIVE To examine the associations between stopping treatment with opioids, length of treatment, and death from overdose or suicide in the Veterans Health Administration. DESIGN Observational evaluation. SETTING Veterans Health Administration. PARTICIPANTS 1 394 102 patients in the Veterans Health Administration with an outpatient prescription for an opioid analgesic from fiscal year 2013 to the end of fiscal year 2014 (1 October 2012 to 30 September 2014). MAIN OUTCOME MEASURES A multivariable Cox non-proportional hazards regression model examined death from overdose or suicide, with the interaction of time varying opioid cessation by length of treatment (≤30, 31-90, 91-400, and >400 days) as the main covariates. Stopping treatment with opioids was measured as the time when a patient was estimated to have no prescription for opioids, up to the end of the next fiscal year (2014) or the patient's death. RESULTS 2887 deaths from overdose or suicide were found. The incidence of stopping opioid treatment was 57.4% (n=799 668) overall, and based on length of opioid treatment was 32.0% (≤30 days), 8.7% (31-90 days), 22.7% (91-400 days), and 36.6% (>400 days). The interaction between stopping treatment with opioids and length of treatment was significant (P<0.001); stopping treatment was associated with an increased risk of death from overdose or suicide regardless of the length of treatment, with the risk increasing the longer patients were treated. Hazard ratios for patients who stopped opioid treatment (with reference values for all other covariates) were 1.67 (≤30 days), 2.80 (31-90 days), 3.95 (91-400 days), and 6.77 (>400 days). Descriptive life table data suggested that death rates for overdose or suicide increased immediately after starting or stopping treatment with opioids, with the incidence decreasing over about three to 12 months. CONCLUSIONS Patients were at greater risk of death from overdose or suicide after stopping opioid treatment, with an increase in the risk the longer patients had been treated before stopping. Descriptive data suggested that starting treatment with opioids was also a risk period. Strategies to mitigate the risk in these periods are not currently a focus of guidelines for long term use of opioids. The associations observed cannot be assumed to be causal; the context in which opioid prescriptions were started and stopped might contribute to risk and was not investigated. Safer prescribing of opioids should take a broader view on patient safety and mitigate the risk from the patient's perspective. Factors to address are those that place patients at risk for overdose or suicide after beginning and stopping opioid treatment, especially in the first three months.
Collapse
Affiliation(s)
- Elizabeth M Oliva
- Veterans Affairs Program Evaluation and Resource Center, Veterans Affairs Office of Mental Health and Suicide Prevention, Menlo Park, CA, USA
- Veterans Affairs Center for Innovation to Implementation, Veterans Affairs Palo Alto Health Care System, 795 Willow Road, Building 324, Menlo Park, CA 94025, USA
| | - Thomas Bowe
- Veterans Affairs Program Evaluation and Resource Center, Veterans Affairs Office of Mental Health and Suicide Prevention, Menlo Park, CA, USA
- Veterans Affairs Center for Innovation to Implementation, Veterans Affairs Palo Alto Health Care System, 795 Willow Road, Building 324, Menlo Park, CA 94025, USA
| | - Ajay Manhapra
- Advanced PACT Pain Clinic, Veterans Affairs Hampton Medical Center, Hampton, VA, USA
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
- New England MIRECC, West Haven, CT, USA
- Departments of Physical Medicine and Rehabilitation and Psychiatry, Eastern Virginia Medical School, Norfolk, VA, USA
| | - Stefan Kertesz
- Birmingham Veterans Affairs Medical Center, Birmingham, AL, USA
- University of Alabama at Birmingham School of Medicine, Birmingham, AL, USA
| | - Jennifer M Hah
- Division of Pain Medicine, Department of Anesthesiology, Perioperative, and Pain Medicine, Stanford University, Stanford, CA, USA
| | - Patricia Henderson
- Veterans Affairs Program Evaluation and Resource Center, Veterans Affairs Office of Mental Health and Suicide Prevention, Menlo Park, CA, USA
| | - Amy Robinson
- Pharmacy Services, Veterans Affairs Sierra Pacific Network, Palo Alto, CA, USA
| | - Meenah Paik
- Veterans Affairs Program Evaluation and Resource Center, Veterans Affairs Office of Mental Health and Suicide Prevention, Menlo Park, CA, USA
| | - Friedhelm Sandbrink
- National Pain Management Program, Veterans Health Administration, Washington, DC, USA
- Department of Neurology, Washington DC Veterans Affairs Medical Center, Washington, DC, USA
- Uniformed Services University, Bethesda, MD; George Washington University, Washington, DC, USA
| | - Adam J Gordon
- Program for Addiction Research, Clinical Care, Knowledge and Advocacy (PARCKA), Salt Lake City, UT, USA
- Division of Epidemiology, Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, UT, USA
- Informatics, Decision-Enhancement, and Analytic Sciences Center (IDEAS), Veterans Affairs Salt Lake City Health Care System, Salt Lake City, UT, USA
| | - Jodie A Trafton
- Veterans Affairs Program Evaluation and Resource Center, Veterans Affairs Office of Mental Health and Suicide Prevention, Menlo Park, CA, USA
- Veterans Affairs Center for Innovation to Implementation, Veterans Affairs Palo Alto Health Care System, 795 Willow Road, Building 324, Menlo Park, CA 94025, USA
- Department of Psychiatry, Stanford University School of Medicine, Stanford, CA, USA
| |
Collapse
|
4
|
Kegler MC, Anderson K, Bundy LT, Knauf D, Halfacre J, Escoffery C, Cramblit A, Henderson P. A Qualitative Study about Creating Smoke-free Home Rules in American Indian and Alaska Native Households. J Community Health 2019; 44:684-693. [PMID: 31025142 PMCID: PMC6612306 DOI: 10.1007/s10900-019-00666-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Smoke-free homes can reduce exposure to secondhand smoke (SHS) and support smoking cessation. The current study seeks to understand perspectives, including barriers and facilitators, on smoke-free homes among five American Indian/Alaska Native (AI/AN) communities. Guided by a national work group of tribal partners, ten focus groups were conducted with AI/AN adult smokers and nonsmokers (n = 95) in Alaska, California, Michigan and Oklahoma, stratified by smoking status. The majority of participants lived in single unit detached homes (70.5%). Most of the nonsmokers had a smoke-free home rule (92.9%) and a majority of smokers did as well (64.7%). The most common reasons for smoke-free home rules were protecting children and grandchildren, including children with health problems. Challenges to a smoke-free home included weather and visitors who smoked, along with the inconvenience of going outside, the habit of smoking inside, the need to watch a young child, safety concerns, and smokers who break the rules. Respecting rules and respecting elders emerged as important themes. Traditional use of tobacco in the home was viewed as quite distinct from recreational or everyday use. Over half (58.2%) reported never using tobacco for ceremonial, prayer or traditional reasons in their homes. Given unique considerations for the adoption of smoke-free homes in AI/AN communities, particularly regarding the use of sacred tobacco for traditional, ceremonial, or medicinal purposes, it is important to learn which barriers and facilitators are similar to the general population and which may be unique to tribal communities in the U.S.
Collapse
Affiliation(s)
- Michelle C Kegler
- Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, 1518 Clifton Road NE, Atlanta, GA, 30322, USA.
- Department of Behavioral Sciences and Health Education, Emory Prevention Research Center, Rollins School of Public Health, Emory University, 1518 Clifton Road NE, Atlanta, GA, USA.
| | - Katherine Anderson
- Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, 1518 Clifton Road NE, Atlanta, GA, 30322, USA
| | - Lucja T Bundy
- Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, 1518 Clifton Road NE, Atlanta, GA, 30322, USA
| | | | - June Halfacre
- Cherokee Nation, 17675 S Muskogee, P. O. Box 948, Tahlequah, OK, 74464, USA
| | - Cam Escoffery
- Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, 1518 Clifton Road NE, Atlanta, GA, 30322, USA
| | - Andre Cramblit
- United Indian Health Services: Potawot Health Village, 1600 Weeot Way, Arcata, CA, 95521, USA
| | - Patricia Henderson
- Black Hills Center for American Indian Health, 701 St. Joseph Street, Suite 204, Rapid City, SD, 57701, USA
| |
Collapse
|
5
|
Anderson KM, Kegler MC, Bundy LT, Henderson P, Halfacre J, Escoffery C. Adaptation of a brief smoke-free homes intervention for American Indian and Alaska Native families. BMC Public Health 2019; 19:981. [PMID: 31337379 PMCID: PMC6651935 DOI: 10.1186/s12889-019-7301-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2019] [Accepted: 07/10/2019] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND The goal of adaptation is to maintain the effectiveness of the original intervention by preserving the core elements that account for its success while delivering an intervention that is tailored to the new community and/or cultural context. The current study describes the process of adapting an evidence-based smoke-free homes (SFH) intervention for use in American Indian/Alaska Native (AI/AN) households. METHODS We followed a systematic adaptation process. We first assessed the community through focus groups coordinated in collaboration with tribal partners. Because our team included the original developers of the intervention, the steps of understanding the intervention, selecting the intervention and consulting with experts were simplified. Additional steps included consulting with stakeholders through a national work group and collaboratively deciding what needed adaptation. RESULTS A number of key themes pertinent to the adaptation of the SFH intervention were identified in the focus groups. These included the gravity of messaging about commercial tobacco use; respect, familialism, and intergenerationalism; imagery, including significant symbolism, colors, and representative role models; whether and how to address traditional tobacco; and, barriers to a SFH not adequately addressed in the original materials. CONCLUSIONS Adaptation of an intervention to create smoke-free homes in AI/AN families necessitated both surface structure changes such as appearance of role models and deep structure changes that addressed core values, and beliefs and traditions.
Collapse
Affiliation(s)
- Katherine M. Anderson
- Department of Behavioral Sciences and Health Education, Emory Prevention Research Center, Rollins School of Public Health, Emory University, Atlanta, GA USA
| | - Michelle C. Kegler
- Department of Behavioral Sciences and Health Education, Emory Prevention Research Center, Rollins School of Public Health, Emory University, Atlanta, GA USA
| | - Lucja T. Bundy
- Department of Behavioral Sciences and Health Education, Emory Prevention Research Center, Rollins School of Public Health, Emory University, Atlanta, GA USA
| | | | | | - Cam Escoffery
- Department of Behavioral Sciences and Health Education, Emory Prevention Research Center, Rollins School of Public Health, Emory University, Atlanta, GA USA
| |
Collapse
|
6
|
McPeake JM, Henderson P, Darroch G, Iwashyna TJ, MacTavish P, Robinson C, Quasim T. Social and economic problems of ICU survivors identified by a structured social welfare consultation. Crit Care 2019; 23:153. [PMID: 31046813 PMCID: PMC6498562 DOI: 10.1186/s13054-019-2442-5] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/31/2019] [Accepted: 04/15/2019] [Indexed: 11/12/2022]
Affiliation(s)
- J M McPeake
- Glasgow Royal Infirmary, ICU, NHS Greater Glasgow and Clyde, Glasgow, G31 2ER, UK. .,School of Medicine, Dentistry and Nursing, University of Glasgow, Glasgow, UK.
| | - P Henderson
- School of Medicine, Dentistry and Nursing, University of Glasgow, Glasgow, UK
| | - G Darroch
- Glasgow Royal Infirmary, ICU, NHS Greater Glasgow and Clyde, Glasgow, G31 2ER, UK
| | - T J Iwashyna
- Center for Clinical Management Research, VA Ann Arbor Health System, Ann Arbor, MI, USA.,Department of Internal Medicine, Division of Pulmonary and Critical Care, University of Michigan, Ann Arbor, MI, USA
| | - P MacTavish
- Glasgow Royal Infirmary, ICU, NHS Greater Glasgow and Clyde, Glasgow, G31 2ER, UK
| | - C Robinson
- Glasgow Royal Infirmary, ICU, NHS Greater Glasgow and Clyde, Glasgow, G31 2ER, UK
| | - T Quasim
- Glasgow Royal Infirmary, ICU, NHS Greater Glasgow and Clyde, Glasgow, G31 2ER, UK.,School of Medicine, Dentistry and Nursing, University of Glasgow, Glasgow, UK
| |
Collapse
|
7
|
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
| |
Collapse
|
8
|
Oliva EM, Bowe T, Tavakoli S, Martins S, Lewis ET, Paik M, Wiechers I, Henderson P, Harvey M, Avoundjian T, Medhanie A, Trafton JA. Development and applications of the Veterans Health Administration’s Stratification Tool for Opioid Risk Mitigation (STORM) to improve opioid safety and prevent overdose and suicide. Psychol Serv 2017; 14:34-49. [DOI: 10.1037/ser0000099] [Citation(s) in RCA: 115] [Impact Index Per Article: 16.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
|
9
|
|
10
|
Andreasson A, Karamanou D, Gillespie C, Borthwick L, Jiwa K, Henderson P, Özalp F, Butt T, Clark S, Pauli H, Corris P, Ali S, Dark J, Fisher A. Treating Donor Lung Inflammation by Blocking Interleukin-1Β - An In Vitro Therapy Testing Platform for Ex Vivo Lung Perfusion. J Heart Lung Transplant 2016. [DOI: 10.1016/j.healun.2016.01.275] [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: 10/22/2022] Open
|
11
|
Ross FC, Henderson P, McDougall KL, Cousins T. Not knowing endings: an epilogue. Anthropology Southern Africa 2014. [DOI: 10.1080/23323256.2014.940186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
|
12
|
Love KA, Henderson P, Garrick V, Barclay AR, McGrogan P, Russell RK. Letter: Epstein-Barr virus status may be especially important in paediatric IBD populations. Aliment Pharmacol Ther 2014; 39:231-2. [PMID: 24330243 DOI: 10.1111/apt.12558] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2013] [Accepted: 10/30/2013] [Indexed: 02/05/2023]
Affiliation(s)
- K A Love
- Department of Paediatric Gastroenterology, Yorkhill Hospital, Glasgow, UK.
| | | | | | | | | | | |
Collapse
|
13
|
Yang J, Zhu Y, Cole SA, Haack K, Zhang Y, Beebe LA, Howard BV, Best LG, Devereux RB, Henderson JA, Henderson P, Lee ET, Zhao J. A gene-family analysis of 61 genetic variants in the nicotinic acetylcholine receptor genes for insulin resistance and type 2 diabetes in American Indians. Diabetes 2012; 61:1888-94. [PMID: 22586585 PMCID: PMC3379651 DOI: 10.2337/db11-1393] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Cigarette smoking is a risk factor for type 2 diabetes. Genetic variants in the nicotinic acetylcholine receptor (nAChR) genes have been associated with smoking phenotypes and are likely to influence diabetes. Although each single variant may have only a minor effect, the joint contribution of multiple single nucleotide polymorphisms (SNPs) to the occurrence of disease may be larger. In this study, we conducted a gene-family analysis to investigate the joint impact of 61 tag SNPs in 7 nAChRs genes on insulin resistance and type 2 diabetes in 3,665 American Indians recruited by the Strong Heart Family Study. Results show that although multiple SNPs showed marginal individual association with insulin resistance and type 2 diabetes, only a few can pass adjustment for multiple testing. However, a gene-family analysis considering the joint impact of all 61 SNPs reveals significant association of the nAChR gene family with both insulin resistance and type 2 diabetes (both P < 0.0001), suggesting that genetic variants in the nAChR genes jointly contribute to insulin resistance and type 2 diabetes among American Indians. The effects of these genetic variants on insulin resistance and diabetes are independent of cigarette smoking per se.
Collapse
Affiliation(s)
- Jingyun Yang
- University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
| | - Yun Zhu
- University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
| | | | - Karin Haack
- Texas Biomedical Research Institute, San Antonio, Texas
| | - Ying Zhang
- Center for American Indian Health Research, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
| | - Laura A. Beebe
- University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
| | - Barbara V. Howard
- MedStar Health Research Institute, Hyattsville, Maryland; the Georgetown-Howard Universities Center for Clinical and Translational Sciences, Washington, District of Columbia
| | - Lyle G. Best
- Missouri Breaks Industries Research Inc, Timber Lake, South Dakota
| | | | | | | | - Elisa T. Lee
- University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
- Center for American Indian Health Research, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
| | - Jinying Zhao
- University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
- Corresponding author: Jinying Zhao,
| |
Collapse
|
14
|
|
15
|
Harris AHS, Lembke A, Henderson P, Gupta S, Moos R, Bradley KA. Risk of future trauma based on alcohol screening scores: a two-year prospective cohort study among US veterans. Addict Sci Clin Pract 2012; 7:6. [PMID: 22966411 PMCID: PMC3414833 DOI: 10.1186/1940-0640-7-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2011] [Accepted: 04/30/2012] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Severe alcohol misuse as measured by the Alcohol Use Disorders Identification Test-Consumption (AUDIT-C) is associated with increased risk of future fractures and trauma-related hospitalizations. This study examined the association between AUDIT-C scores and two-year risk of any type of trauma among US Veterans Health Administration (VHA) patients and assessed whether risk varied by age or gender. METHODS Outpatients (215, 924 male and 9168 female) who returned mailed AUDIT-C questionnaires were followed for 24 months in the medical record for any International Statistical Classification of Diseases and Related Health Problems (ICD-9) code related to trauma. The two-year prevalence of trauma was examined as a function of AUDIT-C scores, with low-level drinking (AUDIT-C 1-4) as the reference group. Men and women were examined separately, and age-stratified analyses were performed. RESULTS Having an AUDIT-C score of 9-12 (indicating severe alcohol misuse) was associated with increased risk for trauma. Mean (SD) ages for men and women were 68.2 (11.5) and 57.2 (15.8), respectively. Age-stratified analyses showed that, for men≤50 years, those with AUDIT-C scores≥9 had an increased risk for trauma compared with those with AUDIT-C scores in the 1-4 range (adjusted prevalence, 25.7% versus 20.8%, respectively; OR=1.24; 95% confidence interval [CI], 1.03-1.50). For men≥65 years with average comorbidity and education, those with AUDIT-C scores of 5-8 (adjusted prevalence, 7.9% versus 7.4%; OR=1.16; 95% CI, 1.02-1.31) and 9-12 (adjusted prevalence 11.1% versus 7.4%; OR=1.68; 95% CI, 1.30-2.17) were at significantly increased risk for trauma compared with men≥65 years in the reference group. Higher AUDIT-C scores were not associated with increased risk of trauma among women. CONCLUSIONS Men with severe alcohol misuse (AUDIT-C 9-12) demonstrate an increased risk of trauma. Men≥65 showed an increased risk for trauma at all levels of alcohol misuse (AUDIT-C 5-8 and 9-12). These findings may be used as part of an evidence-based brief intervention for alcohol use disorders. More research is needed to understand the relationship between AUDIT-C scores and risk of trauma in women.
Collapse
Affiliation(s)
- Alex H S Harris
- Center for Health Care Evaluation, VA Palo Alto Health Care System, 795 Willow Road, Menlo Park, CA, 94025, USA
| | - Anna Lembke
- Center for Health Care Evaluation, VA Palo Alto Health Care System, 795 Willow Road, Menlo Park, CA, 94025, USA
| | - Patricia Henderson
- Center for Health Care Evaluation, VA Palo Alto Health Care System, 795 Willow Road, Menlo Park, CA, 94025, USA
| | - Shalini Gupta
- Center for Health Care Evaluation, VA Palo Alto Health Care System, 795 Willow Road, Menlo Park, CA, 94025, USA
| | - Rudolf Moos
- Center for Health Care Evaluation, VA Palo Alto Health Care System, 795 Willow Road, Menlo Park, CA, 94025, USA
| | - Katharine A Bradley
- Group Health Research Institute, and Health Services Research & Development (HSR&D) Northwest Center of Excellence, Center of Excellence in Substance Abuse Treatment and Education (CESATE), Veterans Affairs (VA) Puget Sound Health Care System, 1100 Olive Way, 14th Floor, Seattle, WA, 98101, USA
- Departments of Medicine and Health Services, University of Washington, 1959 NE Pacific Street, Seattle, WA, 98195, USA
| |
Collapse
|
16
|
Henderson P, Wilson DC, Satsangi J. Differences in phenotype and disease course in adult and paediatric inflammatory bowel disease. Aliment Pharmacol Ther 2012; 35:391-2; discussion 392-3. [PMID: 22221081 DOI: 10.1111/j.1365-2036.2011.04921.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Affiliation(s)
- P Henderson
- Department of Child Life and Health, University of Edinburgh, UK.
| | | | | |
Collapse
|
17
|
Affiliation(s)
- J Satsangi
- Centre for Molecular Medicine, University of Edinburgh, Edinburgh, UK.
| | | | | | | | | |
Collapse
|
18
|
|
19
|
Abstract
We sought to determine the sex- and age-specific risk of mortality associated with scores on the 3-item Alcohol Use Disorder Identification Test-Consumption (AUDIT-C) questionnaire using data from a national sample of Veterans Health Administration (VHA) patients. Men (N = 215,924) and women (N = 9168) who completed the AUDIT-C in a patient survey were followed for 24 months. AUDIT-C categories (0, 1-4, 5-8, 9-12) were evaluated as predictors of mortality in logistic regression models, adjusted for age, race, education, marital status, smoking, depression, and comorbidities. For women, AUDIT-C scores of 9-12 were associated with a significantly increased risk of death compared to the AUDIT-C 1-4 group (odds ratio [OR] 7.09; 95% confidence interval [CI] = 2.67, 18.82). For men overall, AUDIT-C scores of 5-8 and 9-12 were associated with increased risk of death compared to the AUDIT-C 1-4 group (OR 1.13, 95% CI = 1.05, 1.21, and OR 1.63, 95% CI = 1.45, 1.84, respectively) but these associations varied by age. These results provide sex- and age-tailored risk information that clinicians can use in evidence-based conversations with patients about the health-related risks of their alcohol consumption. This study adds to the growing literature establishing the AUDIT-C as a scaled marker of alcohol-related risk or "vital sign" that might facilitate the detection and management of alcohol-related risks and problems.
Collapse
Affiliation(s)
- Alex H S Harris
- Center for Health Care Evaluation, VA Palo Alto Health Care System and Stanford University School of Medicine . Menlo Park, CA 94025, USA.
| | | | | | | | | |
Collapse
|
20
|
Abstract
Sexual health can be described as enjoying and fulfilling sexual desires without causing harm, physical or psychological, to oneself or others. Psychosexual problems affect about 40% of the population and sexual functioning is an important part of a patient's health and well-being. Patients often present late due to embarrassment and commonly with an alternative problem. Learning to recognize and act upon both verbal and non-verbal clues, with empathy, is essential in their management. This article aims to give an overview of common psychosexual problems, specific circumstances where they present more frequently and management options.
Collapse
Affiliation(s)
| | - Patricia Henderson
- General Practitioner with interest in Family Planning and Sexual Health, Doune Health Centre, Doune
| |
Collapse
|
21
|
Hinnie J, Vass JK, Rolfe E, Marchesi VA, MacFarlane FC, McShea L, McKibbin CC, Henderson P, Gaffney D. Two Novel Mutations Causing Familial Benign Hypocalciuric Hypercalcaemia in Three Scottish Families. Scott Med J 2009; 54:11-4. [DOI: 10.1258/rsmsmj.54.4.11] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Background and Aims Familial benign hypocalciuric hypercalcaemia (FBHH) is a benign autosomal dominantly inherited condition which results in elevated serum calcium and low urinary calcium. This condition is of clinical interest because it can be mistakenly diagnosed as primary hyperparathyroidism (PHP). In most cases FBHH can be shown to be due to a mutation in the calcium sensing receptor (CASR) gene and we aimed to find the causative mutation in three Scottish kindreds with FBHH. Methods We used a combination of denaturing gradient gel electrophoresis and direct DNA sequencing to detect mutations in the CASR gene. Results We detected a mutation in the CASR gene in each of the three kindreds. Two different mutations were detected (the same one was present in two kindreds). Neither mutation has been reported previously. All hypercalcaemic individuals from each kindred had the appropriate mutation while all normocalcaemic individuals did not. Conclusion In the vast majority of kindreds with FBHH which have been reported previously, the CASR mutation responsible is private to that kindred. In three Scottish kindreds we have identified two new mutations.
Collapse
Affiliation(s)
- J Hinnie
- Department of Endocrinology and Diabetes, Victoria Infirmary, Glasgow, G42 9TY
| | - JK Vass
- The Beatson Institute for Cancer Research, Garscube Estate, G61 1BD
| | - E Rolfe
- Department of Biochemistry, Macewan Building, Glasgow Royal Infirmary, Glasgow, G4 OSF
| | - VA Marchesi
- Department of Biochemistry, Macewan Building, Glasgow Royal Infirmary, Glasgow, G4 OSF
| | - FC MacFarlane
- Department of Biochemistry, Macewan Building, Glasgow Royal Infirmary, Glasgow, G4 OSF
| | - L McShea
- Department of Biochemistry, Macewan Building, Glasgow Royal Infirmary, Glasgow, G4 OSF
| | - CC McKibbin
- Department of Biochemistry, Macewan Building, Glasgow Royal Infirmary, Glasgow, G4 OSF
| | - P Henderson
- Clinical Chemistry Department, Royal Alexandra Hospital, Paisley, PA2 9PN
| | - D Gaffney
- Department of Biochemistry, Macewan Building, Glasgow Royal Infirmary, Glasgow, G4 OSF
| |
Collapse
|
22
|
Kadouch D, Henderson P, Singh S, Zawaneh P, Putnam D, Spector J. In vivo efficacy of the novel hemostatic agent Poly DHA in an experimental rat model. J Plast Reconstr Aesthet Surg 2009. [DOI: 10.1016/j.bjps.2009.02.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|
23
|
Pan C, Li T, He M, de Vere White R, Gandara D, Mack P, Lara PN, Turteltaub K, Henderson P. Design of a phase 0 microdosing trial for correlation of platinum-induced DNA damage to chemotherapy outcomes. J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.2543] [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: 11/20/2022] Open
Abstract
2543 Background: DNA damage is the critical step in cancer cell response to platinum (Pt) chemotherapy. We hypothesize that low levels of Pt-induced DNA damage are predictive of chemoresistance. Accelerator mass spectrometry (AMS), an ultrasensitive method for measuring radiocarbon, can detect [14C]carboplatin bound to the DNA of cancer cells from cell culture, mice bearing tumor xenografts and patients receiving subtoxic microdoses of compound. Methods: Cancer cells and mice bearing tumor xenografts were treated with one microdose (1/100th of the therapeutic dose) or one therapeutic dose of [14C]carboplatin. Relevant parameters such as drug influx/efflux, intracellular drug inactivation, DNA damage and repair, were measured and correlated with response to chemotherapy. A Phase 0 microdosing trial has been designed to study patients with non-small cell lung or bladder transitional cell cancers who are planning to receive Pt-based chemotherapy. One microdose of [14C]carboplatin is administered to these patients 4 hours before biopsy. Pt-induced DNA damage and repair in tumor biopsy specimens and other relevant parameters will be measured and correlated with the response and toxicity of chemotherapy. Results: Preclinical studies showed that AMS can detect Pt-DNA damage when cancer cells and mice with tumor xenografts are exposed to one microdose of [14C]carboplatin. The levels of microdose-induced DNA damage are directly proportional to the damage caused by a therapeutic drug dose (p<0.001); and these levels of DNA damage correlate with chemoresistance as measured by MTT assay. Measuring drug uptake/efflux and intracellular inactivation allows insights into resistance mechanisms. These data support the conclusion that the levels of DNA damage induced by microdosing can potentially predict chemoresistance in patients. Consequently, a Phase 0 microdosing trial is in progress. Conclusions: These results support a phase 0 microdosing trial employing AMS to identify chemoresistance and determine the underlying chemoresistant mechanisms for personalized therapy before patients receive cytotoxic chemotherapy. [Table: see text]
Collapse
Affiliation(s)
- C. Pan
- University of California at Davis, Sacramento, CA; Lawrence Livermore National Laboratory, Livermore, CA
| | - T. Li
- University of California at Davis, Sacramento, CA; Lawrence Livermore National Laboratory, Livermore, CA
| | - M. He
- University of California at Davis, Sacramento, CA; Lawrence Livermore National Laboratory, Livermore, CA
| | - R. de Vere White
- University of California at Davis, Sacramento, CA; Lawrence Livermore National Laboratory, Livermore, CA
| | - D. Gandara
- University of California at Davis, Sacramento, CA; Lawrence Livermore National Laboratory, Livermore, CA
| | - P. Mack
- University of California at Davis, Sacramento, CA; Lawrence Livermore National Laboratory, Livermore, CA
| | - P. N. Lara
- University of California at Davis, Sacramento, CA; Lawrence Livermore National Laboratory, Livermore, CA
| | - K. Turteltaub
- University of California at Davis, Sacramento, CA; Lawrence Livermore National Laboratory, Livermore, CA
| | - P. Henderson
- University of California at Davis, Sacramento, CA; Lawrence Livermore National Laboratory, Livermore, CA
| |
Collapse
|
24
|
Hellman P, Henderson P. Geochemical and stratigraphic evidence against an oceanic crust interpretation for the Tumut ‘greenstone’ occurrence. ACTA ACUST UNITED AC 2007. [DOI: 10.1080/00167617708728982] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
|
25
|
Kumar S, Schuhmacher P, Henderson P, Rego J, Ringsdorf H. Synthesis of New Functionalized Discotic Liquid Crystals for Photoconducting Aplications. ACTA ACUST UNITED AC 2006. [DOI: 10.1080/10587259608034598] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- S. Kumar
- a Institut für Organische Chemie der Universiät Mainz , J. J. Becher-Weg 18-20, D-55099 , Mainz , Germany
| | - P. Schuhmacher
- b Centre for Liquid Crystal research , P. O. Box 1329, Jalahalli, Bangalore , India
| | - P. Henderson
- b Centre for Liquid Crystal research , P. O. Box 1329, Jalahalli, Bangalore , India
| | - J. Rego
- b Centre for Liquid Crystal research , P. O. Box 1329, Jalahalli, Bangalore , India
| | - H. Ringsdorf
- b Centre for Liquid Crystal research , P. O. Box 1329, Jalahalli, Bangalore , India
| |
Collapse
|
26
|
Henderson P, Kollbaum E, Kovacich S. HISTOPLASMOSIS IN THE HEADLINES. Optom Vis Sci 2002. [DOI: 10.1097/00006324-200212001-00289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
|
27
|
Abstract
OBJECTIVE To describe an exercise, the structure and content of which assists medical students to conduct potentially embarrassing conversations concerning sexual health which require expression of empathy, to integrate previous learning, to identify their further learning needs, and to develop and test strategies to meet these needs. METHOD Students' role play, sequentially, speakers (patients) and listeners (clinical students) in a "carousel," in which all students are engaged at all times in a sequence of pairings which change at rapid intervals. Half way through the exercise, students reflect on the experience, identify difficulties and successes, and develop and share strategies for experimental use in the second half of the exercise. RESULTS Qualitative comments from the written student evaluations are reported. CONCLUSIONS The exercise provides a formative student centred approach to the integration and further development of previously learnt knowledge and skills of value for promoting sexual health education. It is useful for educators interested in promoting more open and informed learning about sexual health.
Collapse
Affiliation(s)
- P Henderson
- Department of Anatomy, Downing Street, Cambridge CB2 3DY, UK
| | | |
Collapse
|
28
|
Abstract
OBJECTIVE To describe an exercise, the structure and content of which assists medical students to conduct potentially embarrassing conversations concerning sexual health which require expression of empathy, to integrate previous learning, to identify their further learning needs, and to develop and test strategies to meet these needs. METHOD Students' role play, sequentially, speakers (patients) and listeners (clinical students) in a "carousel," in which all students are engaged at all times in a sequence of pairings which change at rapid intervals. Half way through the exercise, students reflect on the experience, identify difficulties and successes, and develop and share strategies for experimental use in the second half of the exercise. RESULTS Qualitative comments from the written student evaluations are reported. CONCLUSIONS The exercise provides a formative student centred approach to the integration and further development of previously learnt knowledge and skills of value for promoting sexual health education. It is useful for educators interested in promoting more open and informed learning about sexual health.
Collapse
Affiliation(s)
- P Henderson
- Department of Anatomy, Downing Street, Cambridge CB2 3DY, UK
| | | |
Collapse
|
29
|
Jørgensen F, Bailey R, Williams S, Henderson P, Wareing DRA, Bolton FJ, Frost JA, Ward L, Humphrey TJ. Prevalence and numbers of Salmonella and Campylobacter spp. on raw, whole chickens in relation to sampling methods. Int J Food Microbiol 2002; 76:151-64. [PMID: 12038572 DOI: 10.1016/s0168-1605(02)00027-2] [Citation(s) in RCA: 206] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Salmonella and Campylobacter continue to be major foodborne pathogens and raw poultry is considered to be an important source of these bacteria. In this study, the prevalence and numbers of Salmonella and Campylobacter spp. in relation to isolation/sampling methods were determined in 241 whole raw chickens purchased from retail outlets in England during the winters of 1998/1999 (101 chickens) and 1999/2000 (140 chickens). The packaging of the 140 chickens was also examined for the presence of the above pathogens. The prevalence and numbers of enterococci were examined in 21 of the 101 chickens. In total, Salmonella and Campylobacter spp. were present in 25% and 83% of the chickens, respectively. Salmonella were isolated from a sample representing both the inside and outside of the packaging in 19% of the chickens, while the corresponding figure for Campylobacter spp. was 56%. Both of these pathogens were isolated from the outside of the packaging in 6% of the chickens. Salmonella was more frequently isolated from samples containing chicken skin in comparison with those containing carcass-rinse fluid only. Two chickens (0.8%) were positive for Salmonella by direct enumeration methods with contamination levels of log10 3.8 and 4.5 colony forming units (cfu) per carcass, respectively. The most prevalent serotypes were S. Hadar, S. Enteritidis and S. Indiana and two different serotypes were identified in 5/20 salmonella-positive chickens. Resistance to at least one antibiotic was found in 70% of the strains, 46% were multiresistant (resistant to > or = four drugs) and 52% showed a lowered susceptibility to ciprofloxacin. The likelihood of isolating Campylobacter spp. from neck-skin, carcass-rinse or carcass-rinse plus whole skin samples was similar, Campylobacter spp. were found in higher levels in carcass-rinse or carcass-rinse plus whole skin samples than in neck-skin. The log10 cfu of Campylobacter spp. were 2.70-4.99 in 18% of the chickens and 5.00-6.99 in 20%. Campylobacter isolates (425) comprised Campylobacter jejuni (98%) and C. coli (2%) and 98 different sero/phagetypes of these two species were identified. Resistance to at least one antibiotic was found in 73% of the strains and 13% were multiresistant. Thirteen percent of the strains showed lowered susceptibility to ciprofloxacin, while 4.9% were resistant to erythromycin. Vancomycin-resistant enterococci (VRE), able to grow on agar containing 15 mg l(-1) vancomycin (VRE15), were present in 19 chickens. The log10 cfu of VRE15 was 2.90-3.99 in 10 chickens and between 4.00 and 4.99 in two chickens. The data presented here contribute to risk assessment and highlight the need to continue to emphasise the safe handling of raw retail poultry.
Collapse
Affiliation(s)
- F Jørgensen
- Food Microbiology Rsearch Unit, Public Health Laboratory, Heavitree, Exeter, UK.
| | | | | | | | | | | | | | | | | |
Collapse
|
30
|
Kovacich S, Henderson P. VASALVA RETINOPATHY VS TERSONS SYNDROME IN A POSTPARTUM PATIENT. Optom Vis Sci 2001. [DOI: 10.1097/00006324-200112001-00472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
|
31
|
Quan L, Bennett E, Cummings P, Henderson P, Del Beccaro MA. Do parents value drowning prevention information at discharge from the emergency department? Ann Emerg Med 2001; 37:382-5. [PMID: 11275828 DOI: 10.1067/mem.2001.114091] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
STUDY OBJECTIVE We determined parent recall and perceived usefulness of drowning prevention messages included in routine computer-generated discharge instructions. METHODS All pediatric emergency department patients' computerized discharge instructions included 3 prevention messages: wear a life vest, swim in safe areas, and do not drink alcohol while swimming or boating. Parents were telephoned 1 to 2 weeks after the visit and asked to recall the prevention messages and rate the usefulness of the instructions. Responses were linked with patient characteristics and ED visit variables (day and time of visit, duration of ED visit, severity of condition, diagnostic category, number of tests, and treatments). RESULTS Of 914 parents who were contacted, 795 were eligible. Of those, 619 (78%) completed the interview. Fifty percent of parents recalled receiving drowning prevention information; of these, 41% recalled unaided the life vest messages and 35% of 155 parents who did not own a life vest stated they would subsequently consider buying their child a life vest. Most (88%) rated the prevention information useful or very useful. No patient or visit variables were associated with usefulness ratings. CONCLUSION Written injury prevention messages with discharge instructions were well received by parents of children in a pediatric ED. The ED may be a setting where families could receive injury prevention education.
Collapse
Affiliation(s)
- L Quan
- Department of Pediatrics, University of Washington School of Medicine, Seattle, WA, USA.
| | | | | | | | | |
Collapse
|
32
|
Ward A, Hoyle C, Palmer S, O'Reilly J, Griffith J, Pos M, Morrison S, Poolman B, Gwynne M, Henderson P. Prokaryote multidrug efflux proteins of the major facilitator superfamily: amplified expression, purification and characterisation. J Mol Microbiol Biotechnol 2001; 3:193-200. [PMID: 11321573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/19/2023] Open
Abstract
In bacterial genomes 3-12% of open reading frames are predicted to encode membrane transport proteins. These proteins can be vital for antibiotic efflux, protein/ toxin secretion, cell nutrition, environmental sensing, ATP synthesis, and other functions. Some, such as the multidrug efflux proteins, are potential targets for the development of new antibacterials and also for applications in biotechnology. In general membrane transport proteins are poorly understood, because of the technical difficulties involved in isolating sufficient protein for elucidation of their structure-activity relationships. We describe a general strategy for the amplified expression, purification and characterisation of prokaryotic multidrug efflux proteins of the 'Major facilitator superfamily' of transport proteins, using the Bacillus subtilis multidrug resistance protein, 'Bmr', as example.
Collapse
Affiliation(s)
- A Ward
- Astbury Centre for Structural Molecular Biology, School of Biochemistry and Molecular Biology, University of Leeds, UK
| | | | | | | | | | | | | | | | | | | |
Collapse
|
33
|
Variend D, MacKinnon E, Armstrong MJ, Gallagher B, Henderson P, Penn CRH, Davies P, Hunt W, Doshi R, Richman S, White MI, Walford S. John Lewis Emery John Killen Armstrong Francis Austin Brear Bronislaw Chudecki Gwilym Kenneth Davies Aldwyn Morgan George Prem Sarin Rahum Shoulman Leslie Stankler Patrick Arthur Thorn. West J Med 2000. [DOI: 10.1136/bmj.321.7260.574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
|
34
|
Abstract
Being knowledgeable about national health expenditures and sources of financing is essential for decision-making. This awareness also makes it possible to evaluate the equity of allocation and the efficiency of utilization of these resources. Changes in financing have been a substantial component of health sector reform in the Americas. The goal has shifted from merely one of financial sustainability to simultaneously seeking equitable access to quality services. In this article the Pan American Health Organization (PAHO) presents a proposal for analyzing and designing a policy on health financing. The aim of the policy is to identify the mix of financing mechanisms most likely to simultaneously produce financial sustainability, equity, access, and efficiency. The PAHO proposal combines traditional mechanisms for generating resources (public funds from taxes, as well as private health insurance, national health insurance, and user fees) with complementary subsidy mechanisms for vulnerable groups. Health financing strategies ought to explicitly consider the financing both of care for individuals and of health interventions for the general public good, for which public financing is the most equitable and efficient approach.
Collapse
Affiliation(s)
- R Molina
- Programa de Políticas Públicas y Salud, Organización Panamericana de la Salud/Organización Mundial de la Salud (OPS/OMS), Washington, D.C. 20037, USA.
| | | | | | | |
Collapse
|
35
|
Yang X, Zhang P, Tao K, Yang X, Chen S, Zou M, Le Bas MJ, Wilson RN, Ranson R, Campbell LS, Williams TC, Henderson P. Epitaxy of rare earth element fluorcarbonate minerals from carbonatite dyke at Bayan Obo, Inner Mongolia, China. Chin Sci Bull 1998. [DOI: 10.1007/bf02883082] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
36
|
Donlon J, Fallon B, Barrett P, Carroll O, Henderson P, Fairley JS. Hepatic phenylalanine hydroxylase of Clethrionomys glareolus Schreber as a bioindicator of pollution. Biochem Soc Trans 1998; 26:S64. [PMID: 10909822 DOI: 10.1042/bst026s064] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- J Donlon
- Department of Biochemistry, University College, Galway, Ireland
| | | | | | | | | | | |
Collapse
|
37
|
Chandler WL, Alessi MC, Aillaud MF, Henderson P, Vague P, Juhan-Vague I. Clearance of tissue plasminogen activator (TPA) and TPA/plasminogen activator inhibitor type 1 (PAI-1) complex: relationship to elevated TPA antigen in patients with high PAI-1 activity levels. Circulation 1997; 96:761-8. [PMID: 9264480 DOI: 10.1161/01.cir.96.3.761] [Citation(s) in RCA: 164] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND To evaluate the effect of plasminogen activator inhibitor type 1 (PAI-1) levels on the clearance of total tissue plasminogen activator (TPA) antigen, we studied the clearance of active TPA and TPA/PAI-1 complex in subjects with low (181+/-109 pmol/L; n=7) and high (1166+/-322 pmol/L; n=4) baseline active PAI-1. METHODS AND RESULTS A 5-microg/kg bolus of TPA was infused over a 15-second period followed by measurement of TPA activity, TPA antigen, TPA/PAI-1, TPA/C1 inhibitor, PAI-1 activity, and PAI-1 antigen over a 4-hour period. alpha-Phase clearance of total TPA antigen was faster in subjects with low PAI-1 (t(1/2) of 3.5+/-0.7 minutes) versus high PAI-1 (t(1/2) of 5.3+/-0.9 minutes) (P=.006). Clearance of all factors was best fit by a two-compartment pharmacokinetic model based on a computer-simulated human circulatory system. The average hepatic clearance fraction in the two-compartment model was greater for active TPA (89+/-10%, t(1/2) of 2.4+/-0.3 minutes) than for TPA/PAI-1 complex (48+/-17%, t(1/2) of 5.0+/-1.8 minutes) (P=.0006). CONCLUSIONS Plasma clearance of active TPA was faster than clearance of TPA/PAI-1 complex. High levels of active PAI-1 converted more TPA into TPA/PAI-1 complex, effectively slowing the clearance of total TPA antigen and explaining in part why high levels of PAI-1 activity are associated with increases in total TPA antigen.
Collapse
Affiliation(s)
- W L Chandler
- Department of Laboratory Medicine, University of Washington, Seattle 98195-7110, USA.
| | | | | | | | | | | |
Collapse
|
38
|
Padfield PJ, Panesar N, Henderson P, Baldassare JJ. Differential effects of G-protein activators on 5-hydroxytryptamine and platelet-derived growth factor release from streptolysin-O-permeabilized human platelets. Biochem J 1996; 314 ( Pt 1):123-8. [PMID: 8660272 PMCID: PMC1217014 DOI: 10.1042/bj3140123] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
In this paper we have used streptolysin O (SLO)-permeabilized human platelets to examine the G-protein(s) that control Ca2+-independent secretion from alpha and dense-core granules. As shown for electropermeabilized platelets, Ca2+ alone stimulated a concentration-dependent increase in 5-hydroxytryptamine (5-HT) (dense-core-granule marker) and platelet-derived growth factor (PDGF) (alpha-granule marker) release from the SLO-permeabilized cells. The EC50 values of Ca2+-dependent 5-HT and PDGF release were 5 microM and 10 microM respectively. Guanosine 5'-[gamma-thio]triphosphate (GTP[S]) (100 microM) stimulated Ca2+-independent release from both alpha and dense-core granules. In contrast, AlF4- had no effect on Ca2+-independent release from either alpha or dense-core granules. Neither GTP[S] nor AlF4- appeared to have a significant effect on Ca2+-dependent release from alpha and dense-core granules. GTP[S] can activate both heterotrimeric and low-molecular-mass G-proteins, whereas AlF4- activates only heterotrimeric G-proteins. Our results, therefore suggest that secretion in the human platelet is regulated by a small G-protein. Both GTP[S]- and Ca2+-dependent secretion were effected by extending the time between permeabilization with SLO and stimulation of secretion. GTP[S]-stimulated secretion from alpha and dense-core granules decreased rapidly after permeabilization. In contrast, Ca2+-dependent 5-HT and PDGF release ran down at a much lower rate. These observations indicate that GTP[S] and Ca2+ act through parallel pathways to stimulate secretion from SLO-permeabilized platelets.
Collapse
Affiliation(s)
- P J Padfield
- Department of Internal Medicine, St. Louis University Health Sciences Center, MO 63104, USA
| | | | | | | |
Collapse
|
39
|
Eckford S, Henderson P. Burch colposuspension facilitated by means of the Ferguson speculum. Br J Urol 1996; 77:172. [PMID: 8653309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
|
40
|
Henderson P, Lim BH. Management of cornual pregnancy with oral methotrexate. N Z Med J 1994; 107:227-8. [PMID: 8208486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Affiliation(s)
- P Henderson
- Department of Obstetrics and Gynaecology, Middlemore Hospital, Auckland
| | | |
Collapse
|
41
|
Henderson P, Lake Y. An unusual cause of polyhydramnios: congenital gastric teratoma. N Z Med J 1994; 107:133-4. [PMID: 8145962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Affiliation(s)
- P Henderson
- Department of Obstetrics and Gynaecology, Middlemore Hospital, Auckland
| | | |
Collapse
|
42
|
Wells PS, Blajchman MA, Henderson P, Wells MJ, Demers C, Bourque R, McAvoy A. Prevalence of antithrombin deficiency in healthy blood donors: a cross-sectional study. Am J Hematol 1994; 45:321-4. [PMID: 8178802 DOI: 10.1002/ajh.2830450409] [Citation(s) in RCA: 59] [Impact Index Per Article: 2.0] [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: 01/29/2023]
Abstract
The prevalence of antithrombin (AT) deficiency in the general population has been variously estimated to be between 0.05 and 5 per 1,000 in the population; 2,491 blood donors were screened in an attempt to clarify this issue using plasma samples taken from the blood donor units. From this initial population, 122 individuals were identified as having plasma AT levels lower than 2 standard deviations below the normal mean. Twenty-two samples had evidence that thrombin had been generated during blood collection and the remaining cohort of 100 blood donors were asked to return but only 59 complied. The data obtained from these 59 were compared with that from 51 age- and sex-matched control blood donors. Both groups of subjects were assessed for previous evidence, or family history, of thrombotic events, as well as exposure to risk factors associated with the development of deep vein thrombosis (DVT). All had venous blood samples taken from which the supernatant plasma was immediately removed and quick frozen for later assaying. Only 6 of the 59 subjects with initial low AT levels had repeat AT-Xa levels below 0.80 units/ml (normal range 0.94 +/- 0.14). Upon repeating the AT-Xa determinations on new samples from these six individuals, only three were found again to be low. One was found to have a type 3 AT deficiency (an Arg47Cys substitution). The other two with a low AT level had mean functional AT-Xa levels of 0.61 and 0.71 units/ml, respectively, with correspondingly low AT:Ag levels consistent with a type 1 AT deficiency. Two of these three subjects has been in high risk situations without evidence of having developed DVT and none had evidence of venous reflux on Doppler venography. In addition, none had personal or family histories of previous thrombotic events. These present data indicate that the prevalence of AT deficiency in our blood donor population is 2 per 1,000 (95% confidence intervals: 0.7-6/1,000).
Collapse
Affiliation(s)
- P S Wells
- Canadian Red Cross Society, Hamilton, Ontario, Canada
| | | | | | | | | | | | | |
Collapse
|
43
|
Demers C, Ginsberg J, Hirsh J, Henderson P, Blajchman M. Thrombosis in antithrombin-III-deficient persons. Report of a large kindred and literature review. Int J Gynaecol Obstet 1993. [DOI: 10.1016/0020-7292(93)90238-r] [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: 11/28/2022]
|
44
|
Mahaffey JA, Parkhurst MA, James AC, Cross FT, Alavanja MC, Boice JD, Ezrine S, Henderson P, Brownson RC. Estimating past exposure to indoor radon from household glass. Health Phys 1993; 64:381-391. [PMID: 8449720 DOI: 10.1097/00004032-199304000-00005] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
CR-39 plastic was attached to household glass objects to learn whether residual radioactivity from radon decay products could be measured and correlated with cumulative radon exposures over defined time periods. Such an approach could be used to increase the completeness of exposure data collected in epidemiologic studies of residential radon. Inability to estimate radon concentrations for all residences adversely effects statistical power and thus the ability to detect an effect of radon exposure on lung cancer risk. A feasibility study was performed to determine if affixing CR-39 surface monitors to selected glass, ceramic, or enameled objects provided comparable estimates of past residential radon exposure to those obtained from year-long ambient alpha track-etch measurements. The CR-39 measurements of alpha activity in the surface of selected objects correlated with ambient radon measurements (R2 = 0.48) provided that reliable information was obtained on the history and age of the objects. This technique has now been incorporated into an epidemiologic study of radon and lung cancer to more fully estimate past exposure to indoor radon.
Collapse
Affiliation(s)
- J A Mahaffey
- Pacific Northwest Laboratories, Richland, WA 99352
| | | | | | | | | | | | | | | | | |
Collapse
|
45
|
Demers C, Henderson P, Blajchman MA, Wells MJ, Mitchell L, Johnston M, Ofosu FA, Fernandez-Rachubinski F, Andrew M, Hirsh J. An antithrombin III assay based on factor Xa inhibition provides a more reliable test to identify congenital antithrombin III deficiency than an assay based on thrombin inhibition. Thromb Haemost 1993; 69:231-5. [PMID: 8470046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
OBJECTIVES To determine whether functional antithrombin III (AT-III) levels measured by a factor Xa inhibition (AT-III-Xa) assay identifies AT-III deficient individuals more reliably than functional AT-III levels measured by a thrombin inhibition (AT-III-IIa) assay. STUDY DESIGN Cross-sectional study. PATIENT POPULATION Sixty-seven members of a large family with type 2 AT-III deficiency. INTERVENTION DNA analysis was used as the reference diagnostic standard for AT-III status and subjects were classified as AT-III deficient or non deficient according to these results. Functional AT-III levels were measured in all subjects using: 1) a chromogenic substrate for thrombin and added human thrombin (AT-III-IIa), and 2) a chromogenic substrate for factor Xa and added bovine factor Xa (AT-III-Xa). Functional heparin cofactor II (HC-II) levels were measured using a commercially available kit. The proportions of 125I-alpha-thrombin complexed to AT-III and HC-II were measured by polyacrylamide gel electrophoresis and autoradiography. RESULTS Thirty-one (46%) individuals were classified as AT-III deficient and 36 (54%) as AT-III non deficient. AT-III-Xa assay measured a significantly lower mean AT-III value and a narrower range for individuals classified as AT-III deficient than the AT-III-IIa assay. Using the AT-III-IIa assay, six subjects had borderline AT-III levels compared to none with the AT-III-Xa assay.(ABSTRACT TRUNCATED AT 250 WORDS)
Collapse
Affiliation(s)
- C Demers
- Department of Medicine, McMaster University, Hamilton, Canada
| | | | | | | | | | | | | | | | | | | |
Collapse
|
46
|
Abstract
Adolescence is generally regarded as a time of transition demanding considerable adaptation. Failing to successfully negotiate the developmental hurdles associated with this period can have serious physical and psychosocial consequences (e.g., teenage pregnancy, suicide, disruption of social relationships, poor school performance). Efforts to identify problems that adolescents typically experience have been useful in facilitating a better understanding of this developmental phase. However, the perceived concerns or worries of adolescents themselves have been neglected as an additional source of useful information. This study assessed the worries of 622 adolescents between the ages of 12 and 20 years on an 80-item self-report measure, the "Things That Worry Me" scale. Findings indicated consistent concerns related to terrorism, adolescents' self-esteem, parents' physical and mental health, and adolescents' dating and sexual relationships. Gender- and race-specific differences are discussed and implications for future research and clinical applications are offered.
Collapse
Affiliation(s)
- K L Kaufman
- Department of Pediatrics and Psychology, Children's Hospital, Columbus, Ohio 43205
| | | | | | | | | |
Collapse
|
47
|
Michael S, Barker I, Henderson P, Griffiths RW, Reilly CS. Pharmacokinetics of lignocaine in children after infiltration for cleft palate surgery. Br J Anaesth 1992; 69:577-9. [PMID: 1467100 DOI: 10.1093/bja/69.6.577] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
We have studied the pharmacokinetics of lignocaine in children after local infiltration for cleft palate surgery. After induction of anaesthesia, lignocaine 2.5 mg kg-1 with adrenaline 1:200,000 was injected into the palate. Blood samples were collected before and at 2, 5, 10, 15, 20, 30, 60 and 120 min after infiltration. Plasma concentrations of lignocaine were measured by a gas-liquid chromatographic technique. There were no signs of systemic toxicity on routine monitoring of the patients and the peak plasma concentrations were less than the accepted toxic values. Mean half-life was 72.9 (SEM 9.9) min, similar to that found previously in adults and children. However differences in mean clearance (24.6 (2.04) ml kg-1 min-1) and volume of distribution (0.80 (0.07) litre kg-1) were found between this and previous studies.
Collapse
Affiliation(s)
- S Michael
- Department of Anaesthesia, University of Sheffield, Medical School
| | | | | | | | | |
Collapse
|
48
|
Demers C, Ginsberg JS, Henderson P, Ofosu FA, Weitz JI, Blajchman MA. Measurement of markers of activated coagulation in antithrombin III deficient subjects. Thromb Haemost 1992; 67:542-4. [PMID: 1519214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Functional antithrombin III levels were measured by factor Xa inhibition in 63 members of a large family with type 2 antithrombin III deficiency and individuals were classified as antithrombin III deficient or non-deficient according to the results. F1 + 2 and TAT complexes were measured using an ELISA and FPA levels were measured by radioimmunoassay. Thirty subjects (48%) were classified as antithrombin III deficient and 33 (52%) as antithrombin III non-deficient. The mean level of F1 + 2 was significantly higher in the deficient adults (0.87 +/- 0.26) compared to both the non-deficient adults (0.70 +/- 0.21) (p = 0.03) and the deficient adults receiving warfarin (0.16 +/- 0.01) (p less than 0.001). The differences in the mean values of TAT complexes and FPA between deficient and non-deficient individuals were not statistically significant. These findings suggest that untreated antithrombin III deficient subjects generate more thrombin than their non-deficient family members and that warfarin inhibits this thrombin formation. In this cross-sectional study, it is not possible to correlate the levels of the surrogate makers with future clinical outcome.
Collapse
Affiliation(s)
- C Demers
- Department of Medicine, McMaster University, Hamilton, Canada
| | | | | | | | | | | |
Collapse
|
49
|
Abstract
PURPOSE To estimate the prevalence of objectively proven thrombotic complications in antithrombin-III-deficient persons. STUDY DESIGN Cross-sectional study and a critical review of the literature. DATA SOURCES AND EXTRACTION The prevalence of thrombosis in antithrombin III-deficient and -nondeficient family members of a large kindred was estimated by history, review of diagnostic tests, and examination for venous reflux by Doppler ultrasonography, as an indicator of previous venous thrombosis. A MEDLINE search and literature review of the published English- and French-language literature from 1966 to 1990 that described antithrombin-III-deficient families was done, and the following information was obtained: the prevalence of thrombosis in deficient and nondeficient family members, the presence or absence of risk factors for thrombosis (surgery, pregnancy, the postpartum state, use of oral contraceptives, immobilization, metastatic cancer, major trauma) at the time of the thrombotic event, and age of onset of the first episode of thrombosis. The validity of the studies was assessed according to predetermined criteria. RESULTS Sixty-seven research subjects were evaluated. Six of 31 (19.4%) antithrombin-III-deficient subjects compared with none of 36 (0%) nondeficient subjects had had one or more thrombotic events. The initial episode in five of six subjects had occurred in association with risk factors for thrombosis. The literature search indicated that the pooled prevalence of symptomatic venous thrombosis among the deficient subjects was 51%, but objective testing was done in only 17% of these subjects at the time of presentation. CONCLUSION Based on the data from this antithrombin-III-deficient kindred, lifelong anticoagulant prophylaxis does not appear to be warranted in asymptomatic carriers, and prophylaxis could be limited to periods of high risk for thrombosis.
Collapse
Affiliation(s)
- C Demers
- McMaster University, Hamilton, Ontario, Canada
| | | | | | | | | |
Collapse
|
50
|
Tinant B, Declercq JP, Henderson P. N-{2-[(1-Cyanocyclohexyl)(tert-butyldimethylsilyloxy)amino]propionyl}-2,5-bis(methoxymethyl)pyrrolidine and N-(2-anilinopropionyl)-2,5-bis(methoxymethyl)pyrrolidine. Acta Crystallogr C 1992. [DOI: 10.1107/s0108270191009460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
|