1
|
Raman B, McCracken C, Cassar MP, Moss AJ, Finnigan L, Samat AHA, Ogbole G, Tunnicliffe EM, Alfaro-Almagro F, Menke R, Xie C, Gleeson F, Lukaschuk E, Lamlum H, McGlynn K, Popescu IA, Sanders ZB, Saunders LC, Piechnik SK, Ferreira VM, Nikolaidou C, Rahman NM, Ho LP, Harris VC, Shikotra A, Singapuri A, Pfeffer P, Manisty C, Kon OM, Beggs M, O'Regan DP, Fuld J, Weir-McCall JR, Parekh D, Steeds R, Poinasamy K, Cuthbertson DJ, Kemp GJ, Semple MG, Horsley A, Miller CA, O'Brien C, Shah AM, Chiribiri A, Leavy OC, Richardson M, Elneima O, McAuley HJC, Sereno M, Saunders RM, Houchen-Wolloff L, Greening NJ, Bolton CE, Brown JS, Choudhury G, Diar Bakerly N, Easom N, Echevarria C, Marks M, Hurst JR, Jones MG, Wootton DG, Chalder T, Davies MJ, De Soyza A, Geddes JR, Greenhalf W, Howard LS, Jacob J, Man WDC, Openshaw PJM, Porter JC, Rowland MJ, Scott JT, Singh SJ, Thomas DC, Toshner M, Lewis KE, Heaney LG, Harrison EM, Kerr S, Docherty AB, Lone NI, Quint J, Sheikh A, Zheng B, Jenkins RG, Cox E, Francis S, Halling-Brown M, Chalmers JD, Greenwood JP, Plein S, Hughes PJC, Thompson AAR, Rowland-Jones SL, Wild JM, Kelly M, Treibel TA, Bandula S, Aul R, Miller K, Jezzard P, Smith S, Nichols TE, McCann GP, Evans RA, Wain LV, Brightling CE, Neubauer S, Baillie JK, Shaw A, Hairsine B, Kurasz C, Henson H, Armstrong L, Shenton L, Dobson H, Dell A, Lucey A, Price A, Storrie A, Pennington C, Price C, Mallison G, Willis G, Nassa H, Haworth J, Hoare M, Hawkings N, Fairbairn S, Young S, Walker S, Jarrold I, Sanderson A, David C, Chong-James K, Zongo O, James WY, Martineau A, King B, Armour C, McAulay D, Major E, McGinness J, McGarvey L, Magee N, Stone R, Drain S, Craig T, Bolger A, Haggar A, Lloyd A, Subbe C, Menzies D, Southern D, McIvor E, Roberts K, Manley R, Whitehead V, Saxon W, Bularga A, Mills NL, El-Taweel H, Dawson J, Robinson L, Saralaya D, Regan K, Storton K, Brear L, Amoils S, Bermperi A, Elmer A, Ribeiro C, Cruz I, Taylor J, Worsley J, Dempsey K, Watson L, Jose S, Marciniak S, Parkes M, McQueen A, Oliver C, Williams J, Paradowski K, Broad L, Knibbs L, Haynes M, Sabit R, Milligan L, Sampson C, Hancock A, Evenden C, Lynch C, Hancock K, Roche L, Rees M, Stroud N, Thomas-Woods T, Heller S, Robertson E, Young B, Wassall H, Babores M, Holland M, Keenan N, Shashaa S, Price C, Beranova E, Ramos H, Weston H, Deery J, Austin L, Solly R, Turney S, Cosier T, Hazelton T, Ralser M, Wilson A, Pearce L, Pugmire S, Stoker W, McCormick W, Dewar A, Arbane G, Kaltsakas G, Kerslake H, Rossdale J, Bisnauthsing K, Aguilar Jimenez LA, Martinez LM, Ostermann M, Magtoto MM, Hart N, Marino P, Betts S, Solano TS, Arias AM, Prabhu A, Reed A, Wrey Brown C, Griffin D, Bevan E, Martin J, Owen J, Alvarez Corral M, Williams N, Payne S, Storrar W, Layton A, Lawson C, Mills C, Featherstone J, Stephenson L, Burdett T, Ellis Y, Richards A, Wright C, Sykes DL, Brindle K, Drury K, Holdsworth L, Crooks MG, Atkin P, Flockton R, Thackray-Nocera S, Mohamed A, Taylor A, Perkins E, Ross G, McGuinness H, Tench H, Phipps J, Loosley R, Wolf-Roberts R, Coetzee S, Omar Z, Ross A, Card B, Carr C, King C, Wood C, Copeland D, Calvelo E, Chilvers ER, Russell E, Gordon H, Nunag JL, Schronce J, March K, Samuel K, Burden L, Evison L, McLeavey L, Orriss-Dib L, Tarusan L, Mariveles M, Roy M, Mohamed N, Simpson N, Yasmin N, Cullinan P, Daly P, Haq S, Moriera S, Fayzan T, Munawar U, Nwanguma U, Lingford-Hughes A, Altmann D, Johnston D, Mitchell J, Valabhji J, Price L, Molyneaux PL, Thwaites RS, Walsh S, Frankel A, Lightstone L, Wilkins M, Willicombe M, McAdoo S, Touyz R, Guerdette AM, Warwick K, Hewitt M, Reddy R, White S, McMahon A, Hoare A, Knighton A, Ramos A, Te A, Jolley CJ, Speranza F, Assefa-Kebede H, Peralta I, Breeze J, Shevket K, Powell N, Adeyemi O, Dulawan P, Adrego R, Byrne S, Patale S, Hayday A, Malim M, Pariante C, Sharpe C, Whitney J, Bramham K, Ismail K, Wessely S, Nicholson T, Ashworth A, Humphries A, Tan AL, Whittam B, Coupland C, Favager C, Peckham D, Wade E, Saalmink G, Clarke J, Glossop J, Murira J, Rangeley J, Woods J, Hall L, Dalton M, Window N, Beirne P, Hardy T, Coakley G, Turtle L, Berridge A, Cross A, Key AL, Rowe A, Allt AM, Mears C, Malein F, Madzamba G, Hardwick HE, Earley J, Hawkes J, Pratt J, Wyles J, Tripp KA, Hainey K, Allerton L, Lavelle-Langham L, Melling L, Wajero LO, Poll L, Noonan MJ, French N, Lewis-Burke N, Williams-Howard SA, Cooper S, Kaprowska S, Dobson SL, Marsh S, Highett V, Shaw V, Beadsworth M, Defres S, Watson E, Tiongson GF, Papineni P, Gurram S, Diwanji SN, Quaid S, Briggs A, Hastie C, Rogers N, Stensel D, Bishop L, McIvor K, Rivera-Ortega P, Al-Sheklly B, Avram C, Faluyi D, Blaikely J, Piper Hanley K, Radhakrishnan K, Buch M, Hanley NA, Odell N, Osbourne R, Stockdale S, Felton T, Gorsuch T, Hussell T, Kausar Z, Kabir T, McAllister-Williams H, Paddick S, Burn D, Ayoub A, Greenhalgh A, Sayer A, Young A, Price D, Burns G, MacGowan G, Fisher H, Tedd H, Simpson J, Jiwa K, Witham M, Hogarth P, West S, Wright S, McMahon MJ, Neill P, Dougherty A, Morrow A, Anderson D, Grieve D, Bayes H, Fallon K, Mangion K, Gilmour L, Basu N, Sykes R, Berry C, McInnes IB, Donaldson A, Sage EK, Barrett F, Welsh B, Bell M, Quigley J, Leitch K, Macliver L, Patel M, Hamil R, Deans A, Furniss J, Clohisey S, Elliott A, Solstice AR, Deas C, Tee C, Connell D, Sutherland D, George J, Mohammed S, Bunker J, Holmes K, Dipper A, Morley A, Arnold D, Adamali H, Welch H, Morrison L, Stadon L, Maskell N, Barratt S, Dunn S, Waterson S, Jayaraman B, Light T, Selby N, Hosseini A, Shaw K, Almeida P, Needham R, Thomas AK, Matthews L, Gupta A, Nikolaidis A, Dupont C, Bonnington J, Chrystal M, Greenhaff PL, Linford S, Prosper S, Jang W, Alamoudi A, Bloss A, Megson C, Nicoll D, Fraser E, Pacpaco E, Conneh F, Ogg G, McShane H, Koychev I, Chen J, Pimm J, Ainsworth M, Pavlides M, Sharpe M, Havinden-Williams M, Petousi N, Talbot N, Carter P, Kurupati P, Dong T, Peng Y, Burns A, Kanellakis N, Korszun A, Connolly B, Busby J, Peto T, Patel B, Nolan CM, Cristiano D, Walsh JA, Liyanage K, Gummadi M, Dormand N, Polgar O, George P, Barker RE, Patel S, Price L, Gibbons M, Matila D, Jarvis H, Lim L, Olaosebikan O, Ahmad S, Brill S, Mandal S, Laing C, Michael A, Reddy A, Johnson C, Baxendale H, Parfrey H, Mackie J, Newman J, Pack J, Parmar J, Paques K, Garner L, Harvey A, Summersgill C, Holgate D, Hardy E, Oxton J, Pendlebury J, McMorrow L, Mairs N, Majeed N, Dark P, Ugwuoke R, Knight S, Whittaker S, Strong-Sheldrake S, Matimba-Mupaya W, Chowienczyk P, Pattenadk D, Hurditch E, Chan F, Carborn H, Foot H, Bagshaw J, Hockridge J, Sidebottom J, Lee JH, Birchall K, Turner K, Haslam L, Holt L, Milner L, Begum M, Marshall M, Steele N, Tinker N, Ravencroft P, Butcher R, Misra S, Walker S, Coburn Z, Fairman A, Ford A, Holbourn A, Howell A, Lawrie A, Lye A, Mbuyisa A, Zawia A, Holroyd-Hind B, Thamu B, Clark C, Jarman C, Norman C, Roddis C, Foote D, Lee E, Ilyas F, Stephens G, Newell H, Turton H, Macharia I, Wilson I, Cole J, McNeill J, Meiring J, Rodger J, Watson J, Chapman K, Harrington K, Chetham L, Hesselden L, Nwafor L, Dixon M, Plowright M, Wade P, Gregory R, Lenagh R, Stimpson R, Megson S, Newman T, Cheng Y, Goodwin C, Heeley C, Sissons D, Sowter D, Gregory H, Wynter I, Hutchinson J, Kirk J, Bennett K, Slack K, Allsop L, Holloway L, Flynn M, Gill M, Greatorex M, Holmes M, Buckley P, Shelton S, Turner S, Sewell TA, Whitworth V, Lovegrove W, Tomlinson J, Warburton L, Painter S, Vickers C, Redwood D, Tilley J, Palmer S, Wainwright T, Breen G, Hotopf M, Dunleavy A, Teixeira J, Ali M, Mencias M, Msimanga N, Siddique S, Samakomva T, Tavoukjian V, Forton D, Ahmed R, Cook A, Thaivalappil F, Connor L, Rees T, McNarry M, Williams N, McCormick J, McIntosh J, Vere J, Coulding M, Kilroy S, Turner V, Butt AT, Savill H, Fraile E, Ugoji J, Landers G, Lota H, Portukhay S, Nasseri M, Daniels A, Hormis A, Ingham J, Zeidan L, Osborne L, Chablani M, Banerjee A, David A, Pakzad A, Rangelov B, Williams B, Denneny E, Willoughby J, Xu M, Mehta P, Batterham R, Bell R, Aslani S, Lilaonitkul W, Checkley A, Bang D, Basire D, Lomas D, Wall E, Plant H, Roy K, Heightman M, Lipman M, Merida Morillas M, Ahwireng N, Chambers RC, Jastrub R, Logan S, Hillman T, Botkai A, Casey A, Neal A, Newton-Cox A, Cooper B, Atkin C, McGee C, Welch C, Wilson D, Sapey E, Qureshi H, Hazeldine J, Lord JM, Nyaboko J, Short J, Stockley J, Dasgin J, Draxlbauer K, Isaacs K, Mcgee K, Yip KP, Ratcliffe L, Bates M, Ventura M, Ahmad Haider N, Gautam N, Baggott R, Holden S, Madathil S, Walder S, Yasmin S, Hiwot T, Jackson T, Soulsby T, Kamwa V, Peterkin Z, Suleiman Z, Chaudhuri N, Wheeler H, Djukanovic R, Samuel R, Sass T, Wallis T, Marshall B, Childs C, Marouzet E, Harvey M, Fletcher S, Dickens C, Beckett P, Nanda U, Daynes E, Charalambou A, Yousuf AJ, Lea A, Prickett A, Gooptu B, Hargadon B, Bourne C, Christie C, Edwardson C, Lee D, Baldry E, Stringer E, Woodhead F, Mills G, Arnold H, Aung H, Qureshi IN, Finch J, Skeemer J, Hadley K, Khunti K, Carr L, Ingram L, Aljaroof M, Bakali M, Bakau M, Baldwin M, Bourne M, Pareek M, Soares M, Tobin M, Armstrong N, Brunskill N, Goodman N, Cairns P, Haldar P, McCourt P, Dowling R, Russell R, Diver S, Edwards S, Glover S, Parker S, Siddiqui S, Ward TJC, Mcnally T, Thornton T, Yates T, Ibrahim W, Monteiro W, Thickett D, Wilkinson D, Broome M, McArdle P, Upthegrove R, Wraith D, Langenberg C, Summers C, Bullmore E, Heeney JL, Schwaeble W, Sudlow CL, Adeloye D, Newby DE, Rudan I, Shankar-Hari M, Thorpe M, Pius R, Walmsley S, McGovern A, Ballard C, Allan L, Dennis J, Cavanagh J, Petrie J, O'Donnell K, Spears M, Sattar N, MacDonald S, Guthrie E, Henderson M, Guillen Guio B, Zhao B, Lawson C, Overton C, Taylor C, Tong C, Mukaetova-Ladinska E, Turner E, Pearl JE, Sargant J, Wormleighton J, Bingham M, Sharma M, Steiner M, Samani N, Novotny P, Free R, Allen RJ, Finney S, Terry S, Brugha T, Plekhanova T, McArdle A, Vinson B, Spencer LG, Reynolds W, Ashworth M, Deakin B, Chinoy H, Abel K, Harvie M, Stanel S, Rostron A, Coleman C, Baguley D, Hufton E, Khan F, Hall I, Stewart I, Fabbri L, Wright L, Kitterick P, Morriss R, Johnson S, Bates A, Antoniades C, Clark D, Bhui K, Channon KM, Motohashi K, Sigfrid L, Husain M, Webster M, Fu X, Li X, Kingham L, Klenerman P, Miiler K, Carson G, Simons G, Huneke N, Calder PC, Baldwin D, Bain S, Lasserson D, Daines L, Bright E, Stern M, Crisp P, Dharmagunawardena R, Reddington A, Wight A, Bailey L, Ashish A, Robinson E, Cooper J, Broadley A, Turnbull A, Brookes C, Sarginson C, Ionita D, Redfearn H, Elliott K, Barman L, Griffiths L, Guy Z, Gill R, Nathu R, Harris E, Moss P, Finnigan J, Saunders K, Saunders P, Kon S, Kon SS, O'Brien L, Shah K, Shah P, Richardson E, Brown V, Brown M, Brown J, Brown J, Brown A, Brown A, Brown M, Choudhury N, Jones S, Jones H, Jones L, Jones I, Jones G, Jones H, Jones D, Davies F, Davies E, Davies K, Davies G, Davies GA, Howard K, Porter J, Rowland J, Rowland A, Scott K, Singh S, Singh C, Thomas S, Thomas C, Lewis V, Lewis J, Lewis D, Harrison P, Francis C, Francis R, Hughes RA, Hughes J, Hughes AD, Thompson T, Kelly S, Smith D, Smith N, Smith A, Smith J, Smith L, Smith S, Evans T, Evans RI, Evans D, Evans R, Evans H, Evans J. Multiorgan MRI findings after hospitalisation with COVID-19 in the UK (C-MORE): a prospective, multicentre, observational cohort study. Lancet Respir Med 2023; 11:1003-1019. [PMID: 37748493 PMCID: PMC7615263 DOI: 10.1016/s2213-2600(23)00262-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 06/16/2023] [Accepted: 06/30/2023] [Indexed: 09/27/2023]
Abstract
INTRODUCTION The multiorgan impact of moderate to severe coronavirus infections in the post-acute phase is still poorly understood. We aimed to evaluate the excess burden of multiorgan abnormalities after hospitalisation with COVID-19, evaluate their determinants, and explore associations with patient-related outcome measures. METHODS In a prospective, UK-wide, multicentre MRI follow-up study (C-MORE), adults (aged ≥18 years) discharged from hospital following COVID-19 who were included in Tier 2 of the Post-hospitalisation COVID-19 study (PHOSP-COVID) and contemporary controls with no evidence of previous COVID-19 (SARS-CoV-2 nucleocapsid antibody negative) underwent multiorgan MRI (lungs, heart, brain, liver, and kidneys) with quantitative and qualitative assessment of images and clinical adjudication when relevant. Individuals with end-stage renal failure or contraindications to MRI were excluded. Participants also underwent detailed recording of symptoms, and physiological and biochemical tests. The primary outcome was the excess burden of multiorgan abnormalities (two or more organs) relative to controls, with further adjustments for potential confounders. The C-MORE study is ongoing and is registered with ClinicalTrials.gov, NCT04510025. FINDINGS Of 2710 participants in Tier 2 of PHOSP-COVID, 531 were recruited across 13 UK-wide C-MORE sites. After exclusions, 259 C-MORE patients (mean age 57 years [SD 12]; 158 [61%] male and 101 [39%] female) who were discharged from hospital with PCR-confirmed or clinically diagnosed COVID-19 between March 1, 2020, and Nov 1, 2021, and 52 non-COVID-19 controls from the community (mean age 49 years [SD 14]; 30 [58%] male and 22 [42%] female) were included in the analysis. Patients were assessed at a median of 5·0 months (IQR 4·2-6·3) after hospital discharge. Compared with non-COVID-19 controls, patients were older, living with more obesity, and had more comorbidities. Multiorgan abnormalities on MRI were more frequent in patients than in controls (157 [61%] of 259 vs 14 [27%] of 52; p<0·0001) and independently associated with COVID-19 status (odds ratio [OR] 2·9 [95% CI 1·5-5·8]; padjusted=0·0023) after adjusting for relevant confounders. Compared with controls, patients were more likely to have MRI evidence of lung abnormalities (p=0·0001; parenchymal abnormalities), brain abnormalities (p<0·0001; more white matter hyperintensities and regional brain volume reduction), and kidney abnormalities (p=0·014; lower medullary T1 and loss of corticomedullary differentiation), whereas cardiac and liver MRI abnormalities were similar between patients and controls. Patients with multiorgan abnormalities were older (difference in mean age 7 years [95% CI 4-10]; mean age of 59·8 years [SD 11·7] with multiorgan abnormalities vs mean age of 52·8 years [11·9] without multiorgan abnormalities; p<0·0001), more likely to have three or more comorbidities (OR 2·47 [1·32-4·82]; padjusted=0·0059), and more likely to have a more severe acute infection (acute CRP >5mg/L, OR 3·55 [1·23-11·88]; padjusted=0·025) than those without multiorgan abnormalities. Presence of lung MRI abnormalities was associated with a two-fold higher risk of chest tightness, and multiorgan MRI abnormalities were associated with severe and very severe persistent physical and mental health impairment (PHOSP-COVID symptom clusters) after hospitalisation. INTERPRETATION After hospitalisation for COVID-19, people are at risk of multiorgan abnormalities in the medium term. Our findings emphasise the need for proactive multidisciplinary care pathways, with the potential for imaging to guide surveillance frequency and therapeutic stratification. FUNDING UK Research and Innovation and National Institute for Health Research.
Collapse
|
2
|
Caffrey A, Lamers Y, Murphy MM, Letourneau N, Irwin RE, Pentieva K, Ward M, Tan A, Rojas‐Gómez A, Santos‐Calderón LA, Canals‐Sans J, Leung BMY, Bell R, Giesbrecht GF, Dewey D, Field CJ, Kobor M, Walsh CP, McNulty H. Epigenetic effects of folate and related B vitamins on brain health throughout life: Scientific substantiation and translation of the evidence for health improvement strategies. NUTR BULL 2023; 48:267-277. [PMID: 36807740 PMCID: PMC10946506 DOI: 10.1111/nbu.12611] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 01/15/2023] [Accepted: 01/23/2023] [Indexed: 02/23/2023]
Abstract
Suboptimal status of folate and/or interrelated B vitamins (B12 , B6 and riboflavin) can perturb one-carbon metabolism and adversely affect brain development in early life and brain function in later life. Human studies show that maternal folate status during pregnancy is associated with cognitive development in the child, whilst optimal B vitamin status may help to prevent cognitive dysfunction in later life. The biological mechanisms explaining these relationships are not clear but may involve folate-related DNA methylation of epigenetically controlled genes related to brain development and function. A better understanding of the mechanisms linking these B vitamins and the epigenome with brain health at critical stages of the lifecycle is necessary to support evidence-based health improvement strategies. The EpiBrain project, a transnational collaboration involving partners in the United Kingdom, Canada and Spain, is investigating the nutrition-epigenome-brain relationship, particularly focussing on folate-related epigenetic effects in relation to brain health outcomes. We are conducting new epigenetics analysis on bio-banked samples from existing well-characterised cohorts and randomised trials conducted in pregnancy and later life. Dietary, nutrient biomarker and epigenetic data will be linked with brain outcomes in children and older adults. In addition, we will investigate the nutrition-epigenome-brain relationship in B vitamin intervention trial participants using magnetoencephalography, a state-of-the-art neuroimaging modality to assess neuronal functioning. The project outcomes will provide an improved understanding of the role of folate and related B vitamins in brain health, and the epigenetic mechanisms involved. The results are expected to provide scientific substantiation to support nutritional strategies for better brain health across the lifecycle.
Collapse
Affiliation(s)
- A. Caffrey
- Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical SciencesUlster UniversityColeraineUK
| | - Y. Lamers
- British Columbia Children's Hospital Research Institute, Food Nutrition and Health Program, Faculty of Land and Food SystemsThe University of British ColumbiaVancouverBritish ColumbiaCanada
| | - M. M. Murphy
- Unit of Preventive Medicine & Public Health, Department of Basic Medical Sciences, Faculty of Medicine & Health SciencesUniversitat Rovira i Virgili, IISPVReusSpain
- CIBEROBN, ISCIIIMadridSpain
| | - N. Letourneau
- Faculty of Nursing and Cumming School of MedicineUniversity of CalgaryCalgaryAlbertaCanada
| | - R. E. Irwin
- Genomic Medicine Group, School of Biomedical SciencesUlster UniversityColeraineUK
| | - K. Pentieva
- Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical SciencesUlster UniversityColeraineUK
| | - M. Ward
- Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical SciencesUlster UniversityColeraineUK
| | - A. Tan
- British Columbia Children's Hospital Research Institute, Food Nutrition and Health Program, Faculty of Land and Food SystemsThe University of British ColumbiaVancouverBritish ColumbiaCanada
| | - A. Rojas‐Gómez
- Unit of Preventive Medicine & Public Health, Department of Basic Medical Sciences, Faculty of Medicine & Health SciencesUniversitat Rovira i Virgili, IISPVReusSpain
| | - L. A. Santos‐Calderón
- Unit of Preventive Medicine & Public Health, Department of Basic Medical Sciences, Faculty of Medicine & Health SciencesUniversitat Rovira i Virgili, IISPVReusSpain
| | - J. Canals‐Sans
- Department of Psychology, Faculty of Educational Sciences and PsychologyUniversitat Rovira i VirgiliTarragonaSpain
| | - B. M. Y. Leung
- Faulty of Health SciencesUniversity of LethbridgeLethbridgeAlbertaCanada
| | - R. Bell
- Faculty of Agricultural, Life and Environment ScienceUniversity of AlbertaEdmontonAlbertaCanada
| | - G. F. Giesbrecht
- Faculty of Nursing and Cumming School of MedicineUniversity of CalgaryCalgaryAlbertaCanada
| | - D. Dewey
- Faculty of Nursing and Cumming School of MedicineUniversity of CalgaryCalgaryAlbertaCanada
| | - C. J. Field
- Faculty of Agricultural, Life and Environment ScienceUniversity of AlbertaEdmontonAlbertaCanada
| | - M. Kobor
- British Columbia Children's Hospital Research Institute, Food Nutrition and Health Program, Faculty of Land and Food SystemsThe University of British ColumbiaVancouverBritish ColumbiaCanada
| | - C. P. Walsh
- Genomic Medicine Group, School of Biomedical SciencesUlster UniversityColeraineUK
| | - H. McNulty
- Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical SciencesUlster UniversityColeraineUK
| |
Collapse
|
3
|
Bell R. Is systematic formal crural repair mandatory at the time of magnetic sphincter augmentation implantation? Dis Esophagus 2023:6972914. [PMID: 36617229 DOI: 10.1093/dote/doac108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 10/21/2022] [Accepted: 12/06/2022] [Indexed: 01/09/2023]
Abstract
Laparoscopic placement of the LINX Magnetic Sphincter Augmentation (MSA) device has become an accepted alternative to fundoplication in appropriate patients. Initial studies of MSA targeted to patients with 'early' disease allowed for the most minimal dissection of the esophagus to place the device, without hiatal dissection or repair (NoHHR), in patients with no or minimal hernia findings at surgery. Subsequent studies have compared systematic formal hiatal dissection and repair (Formal HHR) with the original minimal dissection technique. Review of published literature on MSA includes discussion on treatment of hiatal hernia at the time of implantation, accompanying the review of the physiology of the crural diaphragm. Formal hiatal hernia repair at the time of MSA implantation results in better control of reflux with less dysphagia and risk of postoperative hernia than NoHHR, regardless of the presence or size of hiatal hernia. Systematic crural repair should accompany any MSA implantation regardless of the presence or size of hiatal hernia.
Collapse
Affiliation(s)
- Reginald Bell
- Institute of Esophageal and Reflux Surgery, Lone Tree, CO80124, USA
| |
Collapse
|
4
|
Almalki A, Arjun S, Bell R, Yellon D. The cardioprotective effect of inhibiting SGLT1 in hyperglycemia ischemia reperfusion injury. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.2918] [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: 11/13/2022] Open
Abstract
Abstract
Background
Diabetes clinical trials have shown SGLT inhibition improves cardiovascular outcomes, yet the mechanism is not fully understood. Hyperglycemia is a common finding in diabetic and non-diabetic patients presenting with ACS and is a powerful predictor of prognosis and mortality. The role of hyperglycemia in ischemia-reperfusion injury (IRI) is not fully understood, and whether the Sodium Glucose Co-Transporter 1 (SGLT1) plays a role in infarct augmentation, before and/or after reperfusion, remains to be elucidated.
Purpose
Investigate if SGLT1 is involved in a glucotoxicity injury during IRI and whether inhibiting SGLT1 with an SGLT1 inhibitor may reduce infarct size.
Method
RT-PCR and in-situ hybridization (RNAScope) combined with Immunofluorescence integrated co detection with different cell marker techniques were used to detect SGLT1 mRNA expression in Sprague-Dawley whole myocardium and isolated primary cardiomyocytes.
An Ex-vivo Langendorff ischemia-reperfusion perfusion model was used to study the effect of high glucose (22mmol) on myocardium at reperfusion. Canagliflozin (CANA) a non-selective SGLT inhibitor (1μmoL/L to block the SGLT1 receptor and SGLT2 and 5nmol/L to block only the SGLT2 receptor) and Mizagliflozin a selective SGLT1 inhibitor (100nmol/L) was introduced following ischemia at two different glucose concentration concentrations at reperfusion and its effect on infarct size measured using triphenyltetrazolium chloride (TTC) staining.
Results
We showed that SGLT1 is homogenously expressed throughout the myocardium and is particularly evident within the vasculature. we demonstrate that hyperglycemia at reperfusion is injurious to myocardium with an increase of myocardial infarction. Our data reveal that glucose exacerbation of injury appears to be mediated via SGLT1. We have also demonstrated that high-glucose mediated injury in the isolated, perfused heart model is abrogated through the administration of a clinically available mixed SGLT2/SGLT1 inhibitor, canagliflozin, at a dose that inhibits both SGLT2 and SGLT1, but by the SGLT2-selective concentration.
Conclusion
We have shown that SGLT1 is present in the myocardium. Hyperglycemia appears to augment myocardial infarction and inhibition of SGLT1 attenuates this incre
Funding Acknowledgement
Type of funding sources: Private grant(s) and/or Sponsorship. Main funding source(s): The government of saudi Arabia
Collapse
Affiliation(s)
- A Almalki
- University College London , London , United Kingdom
| | - S Arjun
- University College London , London , United Kingdom
| | - R Bell
- University College London , London , United Kingdom
| | - D Yellon
- University College London , London , United Kingdom
| |
Collapse
|
5
|
Boehme C, M MORAN, Do V, Lasso-Mendez J, Bell R, Fruitman D, Hornberger L. THE IMPACT OF GESTATIONAL DIABETES ON THE CARDIOVASCULAR HEALTH OF THE CHILD. Can J Cardiol 2022. [DOI: 10.1016/j.cjca.2022.08.171] [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: 11/02/2022] Open
|
6
|
Bell R, Anstrom C. The Influence of Sustainability Efforts on Sustainable Consumption Habits Amongst College Students. J Acad Nutr Diet 2022. [DOI: 10.1016/j.jand.2022.06.167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
|
7
|
Evans RA, Leavy OC, Richardson M, Elneima O, McAuley HJC, Shikotra A, Singapuri A, Sereno M, Saunders RM, Harris VC, Houchen-Wolloff L, Aul R, Beirne P, Bolton CE, Brown JS, Choudhury G, Diar-Bakerly N, Easom N, Echevarria C, Fuld J, Hart N, Hurst J, Jones MG, Parekh D, Pfeffer P, Rahman NM, Rowland-Jones SL, Shah AM, Wootton DG, Chalder T, Davies MJ, De Soyza A, Geddes JR, Greenhalf W, Greening NJ, Heaney LG, Heller S, Howard LS, Jacob J, Jenkins RG, Lord JM, Man WDC, McCann GP, Neubauer S, Openshaw PJM, Porter JC, Rowland MJ, Scott JT, Semple MG, Singh SJ, Thomas DC, Toshner M, Lewis KE, Thwaites RS, Briggs A, Docherty AB, Kerr S, Lone NI, Quint J, Sheikh A, Thorpe M, Zheng B, Chalmers JD, Ho LP, Horsley A, Marks M, Poinasamy K, Raman B, Harrison EM, Wain LV, Brightling CE, Abel K, Adamali H, Adeloye D, Adeyemi O, Adrego R, Aguilar Jimenez LA, Ahmad S, Ahmad Haider N, Ahmed R, Ahwireng N, Ainsworth M, Al-Sheklly B, Alamoudi A, Ali M, Aljaroof M, All AM, Allan L, Allen RJ, Allerton L, Allsop L, Almeida P, Altmann D, Alvarez Corral M, Amoils S, Anderson D, Antoniades C, Arbane G, Arias A, Armour C, Armstrong L, Armstrong N, Arnold D, Arnold H, Ashish A, Ashworth A, Ashworth M, Aslani S, Assefa-Kebede H, Atkin C, Atkin P, Aung H, Austin L, Avram C, Ayoub A, Babores M, Baggott R, Bagshaw J, Baguley D, Bailey L, Baillie JK, Bain S, Bakali M, Bakau M, Baldry E, Baldwin D, Ballard C, Banerjee A, Bang B, Barker RE, Barman L, Barratt S, Barrett F, Basire D, Basu N, Bates M, Bates A, Batterham R, Baxendale H, Bayes H, Beadsworth M, Beckett P, Beggs M, Begum M, Bell D, Bell R, Bennett K, Beranova E, Bermperi A, Berridge A, Berry C, Betts S, Bevan E, Bhui K, Bingham M, Birchall K, Bishop L, Bisnauthsing K, Blaikely J, Bloss A, Bolger A, Bonnington J, Botkai A, Bourne C, Bourne M, Bramham K, Brear L, Breen G, Breeze J, Bright E, Brill S, Brindle K, Broad L, Broadley A, Brookes C, Broome M, Brown A, Brown A, Brown J, Brown J, Brown M, Brown M, Brown V, Brugha T, Brunskill N, Buch M, Buckley P, Bularga A, Bullmore E, Burden L, Burdett T, Burn D, Burns G, Burns A, Busby J, Butcher R, Butt A, Byrne S, Cairns P, Calder PC, Calvelo E, Carborn H, Card B, Carr C, Carr L, Carson G, Carter P, Casey A, Cassar M, Cavanagh J, Chablani M, Chambers RC, Chan F, Channon KM, Chapman K, Charalambou A, Chaudhuri N, Checkley A, Chen J, Cheng Y, Chetham L, Childs C, Chilvers ER, Chinoy H, Chiribiri A, Chong-James K, Choudhury N, Chowienczyk P, Christie C, Chrystal M, Clark D, Clark C, Clarke J, Clohisey S, Coakley G, Coburn Z, Coetzee S, Cole J, Coleman C, Conneh F, Connell D, Connolly B, Connor L, Cook A, Cooper B, Cooper J, Cooper S, Copeland D, Cosier T, Coulding M, Coupland C, Cox E, Craig T, Crisp P, Cristiano D, Crooks MG, Cross A, Cruz I, Cullinan P, Cuthbertson D, Daines L, Dalton M, Daly P, Daniels A, Dark P, Dasgin J, David A, David C, Davies E, Davies F, Davies G, Davies GA, Davies K, Dawson J, Daynes E, Deakin B, Deans A, Deas C, Deery J, Defres S, Dell A, Dempsey K, Denneny E, Dennis J, Dewar A, Dharmagunawardena R, Dickens C, Dipper A, Diver S, Diwanji SN, Dixon M, Djukanovic R, Dobson H, Dobson SL, Donaldson A, Dong T, Dormand N, Dougherty A, Dowling R, Drain S, Draxlbauer K, Drury K, Dulawan P, Dunleavy A, Dunn S, Earley J, Edwards S, Edwardson C, El-Taweel H, Elliott A, Elliott K, Ellis Y, Elmer A, Evans D, Evans H, Evans J, Evans R, Evans RI, Evans T, Evenden C, Evison L, Fabbri L, Fairbairn S, Fairman A, Fallon K, Faluyi D, Favager C, Fayzan T, Featherstone J, Felton T, Finch J, Finney S, Finnigan J, Finnigan L, Fisher H, Fletcher S, Flockton R, Flynn M, Foot H, Foote D, Ford A, Forton D, Fraile E, Francis C, Francis R, Francis S, Frankel A, Fraser E, Free R, French N, Fu X, Furniss J, Garner L, Gautam N, George J, George P, Gibbons M, Gill M, Gilmour L, Gleeson F, Glossop J, Glover S, Goodman N, Goodwin C, Gooptu B, Gordon H, Gorsuch T, Greatorex M, Greenhaff PL, Greenhalgh A, Greenwood J, Gregory H, Gregory R, Grieve D, Griffin D, Griffiths L, Guerdette AM, Guillen Guio B, Gummadi M, Gupta A, Gurram S, Guthrie E, Guy Z, H Henson H, Hadley K, Haggar A, Hainey K, Hairsine B, Haldar P, Hall I, Hall L, Halling-Brown M, Hamil R, Hancock A, Hancock K, Hanley NA, Haq S, Hardwick HE, Hardy E, Hardy T, Hargadon B, Harrington K, Harris E, Harrison P, Harvey A, Harvey M, Harvie M, Haslam L, Havinden-Williams M, Hawkes J, Hawkings N, Haworth J, Hayday A, Haynes M, Hazeldine J, Hazelton T, Heeley C, Heeney JL, Heightman M, Henderson M, Hesselden L, Hewitt M, Highett V, Hillman T, Hiwot T, Hoare A, Hoare M, Hockridge J, Hogarth P, Holbourn A, Holden S, Holdsworth L, Holgate D, Holland M, Holloway L, Holmes K, Holmes M, Holroyd-Hind B, Holt L, Hormis A, Hosseini A, Hotopf M, Howard K, Howell A, Hufton E, Hughes AD, Hughes J, Hughes R, Humphries A, Huneke N, Hurditch E, Husain M, Hussell T, Hutchinson J, Ibrahim W, Ilyas F, Ingham J, Ingram L, Ionita D, Isaacs K, Ismail K, Jackson T, James WY, Jarman C, Jarrold I, Jarvis H, Jastrub R, Jayaraman B, Jezzard P, Jiwa K, Johnson C, Johnson S, Johnston D, Jolley CJ, Jones D, Jones G, Jones H, Jones H, Jones I, Jones L, Jones S, Jose S, Kabir T, Kaltsakas G, Kamwa V, Kanellakis N, Kaprowska S, Kausar Z, Keenan N, Kelly S, Kemp G, Kerslake H, Key AL, Khan F, Khunti K, Kilroy S, King B, King C, Kingham L, Kirk J, Kitterick P, Klenerman P, Knibbs L, Knight S, Knighton A, Kon O, Kon S, Kon SS, Koprowska S, Korszun A, Koychev I, Kurasz C, Kurupati P, Laing C, Lamlum H, Landers G, Langenberg C, Lasserson D, Lavelle-Langham L, Lawrie A, Lawson C, Lawson C, Layton A, Lea A, Lee D, Lee JH, Lee E, Leitch K, Lenagh R, Lewis D, Lewis J, Lewis V, Lewis-Burke N, Li X, Light T, Lightstone L, Lilaonitkul W, Lim L, Linford S, Lingford-Hughes A, Lipman M, Liyanage K, Lloyd A, Logan S, Lomas D, Loosley R, Lota H, Lovegrove W, Lucey A, Lukaschuk E, Lye A, Lynch C, MacDonald S, MacGowan G, Macharia I, Mackie J, Macliver L, Madathil S, Madzamba G, Magee N, Magtoto MM, Mairs N, Majeed N, Major E, Malein F, Malim M, Mallison G, Mandal S, Mangion K, Manisty C, Manley R, March K, Marciniak S, Marino P, Mariveles M, Marouzet E, Marsh S, Marshall B, Marshall M, Martin J, Martineau A, Martinez LM, Maskell N, Matila D, Matimba-Mupaya W, Matthews L, Mbuyisa A, McAdoo S, Weir McCall J, McAllister-Williams H, McArdle A, McArdle P, McAulay D, McCormick J, McCormick W, McCourt P, McGarvey L, McGee C, Mcgee K, McGinness J, McGlynn K, McGovern A, McGuinness H, McInnes IB, McIntosh J, McIvor E, McIvor K, McLeavey L, McMahon A, McMahon MJ, McMorrow L, Mcnally T, McNarry M, McNeill J, McQueen A, McShane H, Mears C, Megson C, Megson S, Mehta P, Meiring J, Melling L, Mencias M, Menzies D, Merida Morillas M, Michael A, Milligan L, Miller C, Mills C, Mills NL, Milner L, Misra S, Mitchell J, Mohamed A, Mohamed N, Mohammed S, Molyneaux PL, Monteiro W, Moriera S, Morley A, Morrison L, Morriss R, Morrow A, Moss AJ, Moss P, Motohashi K, Msimanga N, Mukaetova-Ladinska E, Munawar U, Murira J, Nanda U, Nassa H, Nasseri M, Neal A, Needham R, Neill P, Newell H, Newman T, Newton-Cox A, Nicholson T, Nicoll D, Nolan CM, Noonan MJ, Norman C, Novotny P, Nunag J, Nwafor L, Nwanguma U, Nyaboko J, O'Donnell K, O'Brien C, O'Brien L, O'Regan D, Odell N, Ogg G, Olaosebikan O, Oliver C, Omar Z, Orriss-Dib L, Osborne L, Osbourne R, Ostermann M, Overton C, Owen J, Oxton J, Pack J, Pacpaco E, Paddick S, Painter S, Pakzad A, Palmer S, Papineni P, Paques K, Paradowski K, Pareek M, Parfrey H, Pariante C, Parker S, Parkes M, Parmar J, Patale S, Patel B, Patel M, Patel S, Pattenadk D, Pavlides M, Payne S, Pearce L, Pearl JE, Peckham D, Pendlebury J, Peng Y, Pennington C, Peralta I, Perkins E, Peterkin Z, Peto T, Petousi N, Petrie J, Phipps J, Pimm J, Piper Hanley K, Pius R, Plant H, Plein S, Plekhanova T, Plowright M, Polgar O, Poll L, Porter J, Portukhay S, Powell N, Prabhu A, Pratt J, Price A, Price C, Price C, Price D, Price L, Price L, Prickett A, Propescu J, Pugmire S, Quaid S, Quigley J, Qureshi H, Qureshi IN, Radhakrishnan K, Ralser M, Ramos A, Ramos H, Rangeley J, Rangelov B, Ratcliffe L, Ravencroft P, Reddington A, Reddy R, Redfearn H, Redwood D, Reed A, Rees M, Rees T, Regan K, Reynolds W, Ribeiro C, Richards A, Richardson E, Rivera-Ortega P, Roberts K, Robertson E, Robinson E, Robinson L, Roche L, Roddis C, Rodger J, Ross A, Ross G, Rossdale J, Rostron A, Rowe A, Rowland A, Rowland J, Roy K, Roy M, Rudan I, Russell R, Russell E, Saalmink G, Sabit R, Sage EK, Samakomva T, Samani N, Sampson C, Samuel K, Samuel R, Sanderson A, Sapey E, Saralaya D, Sargant J, Sarginson C, Sass T, Sattar N, Saunders K, Saunders P, Saunders LC, Savill H, Saxon W, Sayer A, Schronce J, Schwaeble W, Scott K, Selby N, Sewell TA, Shah K, Shah P, Shankar-Hari M, Sharma M, Sharpe C, Sharpe M, Shashaa S, Shaw A, Shaw K, Shaw V, Shelton S, Shenton L, Shevket K, Short J, Siddique S, Siddiqui S, Sidebottom J, Sigfrid L, Simons G, Simpson J, Simpson N, Singh C, Singh S, Sissons D, Skeemer J, Slack K, Smith A, Smith D, Smith S, Smith J, Smith L, Soares M, Solano TS, Solly R, Solstice AR, Soulsby T, Southern D, Sowter D, Spears M, Spencer LG, Speranza F, Stadon L, Stanel S, Steele N, Steiner M, Stensel D, Stephens G, Stephenson L, Stern M, Stewart I, Stimpson R, Stockdale S, Stockley J, Stoker W, Stone R, Storrar W, Storrie A, Storton K, Stringer E, Strong-Sheldrake S, Stroud N, Subbe C, Sudlow CL, Suleiman Z, Summers C, Summersgill C, Sutherland D, Sykes DL, Sykes R, Talbot N, Tan AL, Tarusan L, Tavoukjian V, Taylor A, Taylor C, Taylor J, Te A, Tedd H, Tee CJ, Teixeira J, Tench H, Terry S, Thackray-Nocera S, Thaivalappil F, Thamu B, Thickett D, Thomas C, Thomas S, Thomas AK, Thomas-Woods T, Thompson T, Thompson AAR, Thornton T, Tilley J, Tinker N, Tiongson GF, Tobin M, Tomlinson J, Tong C, Touyz R, Tripp KA, Tunnicliffe E, Turnbull A, Turner E, Turner S, Turner V, Turner K, Turney S, Turtle L, Turton H, Ugoji J, Ugwuoke R, Upthegrove R, Valabhji J, Ventura M, Vere J, Vickers C, Vinson B, Wade E, Wade P, Wainwright T, Wajero LO, Walder S, Walker S, Walker S, Wall E, Wallis T, Walmsley S, Walsh JA, Walsh S, Warburton L, Ward TJC, Warwick K, Wassall H, Waterson S, Watson E, Watson L, Watson J, Welch C, Welch H, Welsh B, Wessely S, West S, Weston H, Wheeler H, White S, Whitehead V, Whitney J, Whittaker S, Whittam B, Whitworth V, Wight A, Wild J, Wilkins M, Wilkinson D, Williams N, Williams N, Williams J, Williams-Howard SA, Willicombe M, Willis G, Willoughby J, Wilson A, Wilson D, Wilson I, Window N, Witham M, Wolf-Roberts R, Wood C, Woodhead F, Woods J, Wormleighton J, Worsley J, Wraith D, Wrey Brown C, Wright C, Wright L, Wright S, Wyles J, Wynter I, Xu M, Yasmin N, Yasmin S, Yates T, Yip KP, Young B, Young S, Young A, Yousuf AJ, Zawia A, Zeidan L, Zhao B, Zongo O. Clinical characteristics with inflammation profiling of long COVID and association with 1-year recovery following hospitalisation in the UK: a prospective observational study. Lancet Respir Med 2022; 10:761-775. [PMID: 35472304 PMCID: PMC9034855 DOI: 10.1016/s2213-2600(22)00127-8] [Citation(s) in RCA: 144] [Impact Index Per Article: 72.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 03/23/2022] [Accepted: 03/31/2022] [Indexed: 11/25/2022]
Abstract
BACKGROUND No effective pharmacological or non-pharmacological interventions exist for patients with long COVID. We aimed to describe recovery 1 year after hospital discharge for COVID-19, identify factors associated with patient-perceived recovery, and identify potential therapeutic targets by describing the underlying inflammatory profiles of the previously described recovery clusters at 5 months after hospital discharge. METHODS The Post-hospitalisation COVID-19 study (PHOSP-COVID) is a prospective, longitudinal cohort study recruiting adults (aged ≥18 years) discharged from hospital with COVID-19 across the UK. Recovery was assessed using patient-reported outcome measures, physical performance, and organ function at 5 months and 1 year after hospital discharge, and stratified by both patient-perceived recovery and recovery cluster. Hierarchical logistic regression modelling was performed for patient-perceived recovery at 1 year. Cluster analysis was done using the clustering large applications k-medoids approach using clinical outcomes at 5 months. Inflammatory protein profiling was analysed from plasma at the 5-month visit. This study is registered on the ISRCTN Registry, ISRCTN10980107, and recruitment is ongoing. FINDINGS 2320 participants discharged from hospital between March 7, 2020, and April 18, 2021, were assessed at 5 months after discharge and 807 (32·7%) participants completed both the 5-month and 1-year visits. 279 (35·6%) of these 807 patients were women and 505 (64·4%) were men, with a mean age of 58·7 (SD 12·5) years, and 224 (27·8%) had received invasive mechanical ventilation (WHO class 7-9). The proportion of patients reporting full recovery was unchanged between 5 months (501 [25·5%] of 1965) and 1 year (232 [28·9%] of 804). Factors associated with being less likely to report full recovery at 1 year were female sex (odds ratio 0·68 [95% CI 0·46-0·99]), obesity (0·50 [0·34-0·74]) and invasive mechanical ventilation (0·42 [0·23-0·76]). Cluster analysis (n=1636) corroborated the previously reported four clusters: very severe, severe, moderate with cognitive impairment, and mild, relating to the severity of physical health, mental health, and cognitive impairment at 5 months. We found increased inflammatory mediators of tissue damage and repair in both the very severe and the moderate with cognitive impairment clusters compared with the mild cluster, including IL-6 concentration, which was increased in both comparisons (n=626 participants). We found a substantial deficit in median EQ-5D-5L utility index from before COVID-19 (retrospective assessment; 0·88 [IQR 0·74-1·00]), at 5 months (0·74 [0·64-0·88]) to 1 year (0·75 [0·62-0·88]), with minimal improvements across all outcome measures at 1 year after discharge in the whole cohort and within each of the four clusters. INTERPRETATION The sequelae of a hospital admission with COVID-19 were substantial 1 year after discharge across a range of health domains, with the minority in our cohort feeling fully recovered. Patient-perceived health-related quality of life was reduced at 1 year compared with before hospital admission. Systematic inflammation and obesity are potential treatable traits that warrant further investigation in clinical trials. FUNDING UK Research and Innovation and National Institute for Health Research.
Collapse
|
8
|
Bell R, Mandalia R. Corrigendum to ‘Diuretics and the kidney’[BJA education 22 (2022) 216–23]. BJA Educ 2022; 22:449. [DOI: 10.1016/j.bjae.2022.06.001] [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] Open
|
9
|
James TJ, Burke JF, Putnam LR, Pan J, Bildzukewicz NA, Bell R, Lipham JC. Loosening the belt on magnetic sphincter augmentation indications: does body mass index matter? Surg Endosc 2021; 36:4878-4884. [PMID: 34750701 DOI: 10.1007/s00464-021-08839-7] [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: 05/14/2021] [Accepted: 10/21/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Magnetic sphincter augmentation (MSA) is an effective treatment for gastroesophageal reflux disease (GERD). However, the impact of obesity on MSA outcomes is unknown. The objective of this study was to evaluate the effectiveness of MSA in patients with GERD and obesity. METHODS A retrospective cohort study was performed of consecutive patients who underwent laparoscopic MSA at three high-volume centers from 2016 to 2019. Patients were grouped into four cohorts according to the World Health Organization body mass index (BMI) classification: BMI < 25 (normal weight), BMI 25-29.9 (overweight), BMI 30-34.9 (obese class I), and BMI > 35 (obese class II-III). Preoperative, operative, and postoperative data were compared between groups. RESULTS A total of 621 patients underwent laparoscopic MSA during the study period. Follow-up with endoscopy or video esophagram was available for 361 patients (58%) with a median follow-up of 15.4 months. Baseline characteristics of the groups were similar except the BMI > 35 group had more females and a higher preoperative median DeMeester score. There were no significant differences in outcomes between normal weight, overweight, and obese patient groups undergoing MSA. All groups experienced significant reductions in acid suppressive medication use, low GERD-HRQL scores, low DeMeester scores, few intraoperative and postoperative complications, and low rates of hiatal hernia recurrence after MSA. CONCLUSIONS Magnetic sphincter augmentation is safe and effective in improving GERD symptoms, reducing esophageal acid exposure, and preventing hiatal hernia recurrence, irrespective of patient BMI. MSA should be considered an acceptable treatment option for obese patients with GERD.
Collapse
Affiliation(s)
- Tayler J James
- Keck Medical Center of University of Southern California, 1510 San Pablo Street, HCC I, Suite 514, Los Angeles, CA, 90033, USA
| | - Jocelyn F Burke
- Institute of Esophageal and Reflux Surgery, Englewood, CO, USA
| | - Luke R Putnam
- Keck Medical Center of University of Southern California, 1510 San Pablo Street, HCC I, Suite 514, Los Angeles, CA, 90033, USA
| | - Jennifer Pan
- Keck Medical Center of University of Southern California, 1510 San Pablo Street, HCC I, Suite 514, Los Angeles, CA, 90033, USA
| | - Nikolai A Bildzukewicz
- Keck Medical Center of University of Southern California, 1510 San Pablo Street, HCC I, Suite 514, Los Angeles, CA, 90033, USA
| | - Reginald Bell
- Institute of Esophageal and Reflux Surgery, Englewood, CO, USA
| | - John C Lipham
- Keck Medical Center of University of Southern California, 1510 San Pablo Street, HCC I, Suite 514, Los Angeles, CA, 90033, USA.
| |
Collapse
|
10
|
Smith L, Thomas N, Arnold A, Bell R, Zayed H, Tyrrell M, Padayachee S. A Comparison of Computed Tomography Angiography and Colour Duplex Ultrasound Surveillance Post Infrarenal Endovascular Aortic Aneurysm Repair: Financial Implications and Impact of Different International Surveillance Guidelines. J Vasc Surg 2021. [DOI: 10.1016/j.jvs.2021.07.095] [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]
|
11
|
Wan S, Speechly-Dick ME, Menezes LJ, Endozo R, Bell R, Walker M, Ganeshan B, Dickson J, Kayani I, Groves AM. Survival Outcome with Routine Clinical Use of 82Rb PET/CT Myocardial Blood Flow (MBF) Quantification. Eur Heart J Cardiovasc Imaging 2021. [DOI: 10.1093/ehjci/jeab111.067] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: Public Institution(s). Main funding source(s): NIHR Biomedical Research Centre, University College London Hospitals
Background
The prognostic value of 82Rb PET/CT derived myocardial blood flow (MBF) is increasingly recognised in both general and specific cardiovascular populations.
Purpose
This study investigates the prognostic potential of MBF in a large cohort of patients undergoing routine 82Rb PET/CT examination.
Methods
1148 consecutive patients (687 males, mean age 64 +/- 12 years) whom had been referred for 82Rb PET/CT examination in a single centre were included in this study. All patients completed a stress 82Rb PET/CT with adenosine infusion, paired with a rest study. Dynamic PET acquisitions were performed in both. Cardiovascular risk factors were documented as per clinical routine. Images were checked for quality and analysed using a proprietary software by an experienced operator to derive MBF parameters. Overall survival was recorded following the study.
Results
Median follow-up period was 71 +/- 28 months. Mean survival was 121 (95% CI: 118-124) months. On univariate analysis, global myocardial flow reserve <1.77 was associated with a higher all-cause mortality (p < 0.001). Other parameters including higher age (> =76 years), lower BMI (<21), qualitative abnormality on the myocardial perfusion scan (MPS), low hyperaemic ejection fraction on the gated studies (stress < 37 and rest < 34). Patients being on cardiac glycosides and diuretics were also significant predictor of poor prognosis (p < 0.001) on univariate analysis, presumably reflecting underlying arrhythmia and heart failure. A multivariate Cox regression analysis (step-wise Forward Wald), comprising of the above significant univariate markers, highlighted global myocardial flow reserve (HR: 2.6, 95%CI: 1.8-3.6, p < 0.001), age (HR: 2.8, 95%CI: 2.0-3.9, p < 0.001),, BMI (HR: 2.7, 95%CI: 1.7-4.1, p < 0.001),, ejection fraction (stress - HR: 3.3, 95%CI: 2.3-4.8, p < 0.001), MPS (HR: 1.5, 95%CI: 1.1-2.1, p = 0.024), and patients on diuretics (HR: 1.8, 95%CI: 1.2-2.5, p = 0.003) were independent predictors of overall survival (overall model: p < 0.001)
Discussion
We show that high volume routinely derived MBF in patients undergoing 82Rb PET/CT is a strong predictor of mortality and independent of other risk factors. This has important clinical implication for measuring not only interventional treatment but also measuring the effect of lifestyle and medical strategies.
Collapse
Affiliation(s)
- S Wan
- University College London Hospitals, Institute of Nuclear Medicine, London, United Kingdom of Great Britain & Northern Ireland
| | - ME Speechly-Dick
- University College London Hospitals, Department of Cardiology, London, United Kingdom of Great Britain & Northern Ireland
| | - LJ Menezes
- University College London Hospitals, Institute of Nuclear Medicine, London, United Kingdom of Great Britain & Northern Ireland
| | - R Endozo
- University College London Hospitals, Institute of Nuclear Medicine, London, United Kingdom of Great Britain & Northern Ireland
| | - R Bell
- University College London, Hatter Cardiovascular Institute, London, United Kingdom of Great Britain & Northern Ireland
| | - M Walker
- University College London, Hatter Cardiovascular Institute, London, United Kingdom of Great Britain & Northern Ireland
| | - B Ganeshan
- University College London Hospitals, Institute of Nuclear Medicine, London, United Kingdom of Great Britain & Northern Ireland
| | - J Dickson
- University College London Hospitals, Institute of Nuclear Medicine, London, United Kingdom of Great Britain & Northern Ireland
| | - I Kayani
- University College London Hospitals, Institute of Nuclear Medicine, London, United Kingdom of Great Britain & Northern Ireland
| | - AM Groves
- University College London Hospitals, Institute of Nuclear Medicine, London, United Kingdom of Great Britain & Northern Ireland
| |
Collapse
|
12
|
Kelly J, Patel A, Onadim I, Abisi S, Bell R, Tyrrell M, Sallam M, Salih M, Mayr M, Bradbury E, Cho J, Gworzdz A, Booth T, Smith A, Modarai B. O15: DISRUPTION OF THE BLOOD-SPINAL CORD BARRIER PREDICTS PERMANENT PARAPLEGIA AFTER THORACOABDOMINAL AORTIC ANEURYSM REPAIR. Br J Surg 2021. [DOI: 10.1093/bjs/znab117.015] [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: 11/13/2022]
Abstract
Abstract
Introduction
Paraplegia post-thoracoabdominal aortic aneurysm (TAAA) repair remains both a devastating and poorly understood complication. We related temporal changes in cellular and protein composition of cerebrospinal fluid (CSF) to neurological outcomes after TAAA repair to gain mechanistic insights driving paraplegia.
Method
Patients undergoing TAAA repair (open or endovascular) with a CSF drain were prospectively recruited between 2016-2018. CSF was collected pre-operatively and 24-hourly until removal. Daily neurological examinations were performed by blinded neurologists to the study. CSF cell content was characterised by flow cytometry and proteome analysed by tandem-mass-tag proteomics. An in-vivo rat model was modified using 15 minutes of aortic occlusion to produce consistent paraplegia. Rats were analysed neuro-behaviourally and histologically.
Result
CSF was analysed from 52 patients (age: 70.27+/-11.4; 66% male; open (n=9), endovascular (n=43)). 12 developed paraplegia of whom 5 remained permanently-paraplegic. Demographics were comparable between paraplegics, those who recovered and without post-op neurology. Permanent paraplegia was associated with a significant infiltration of CSF CD45+ leucocytes (P<0.0001). Levels of ADVS-1 was >3-fold higher in permanent-paraplegics CSF versus those who recovered (P=0.0008). ADVS-1 >15ng/ml predicted permanent paraplegia with 100% specificity. Pre-treatment with ADVS-1 inhibition significantly improved walking (<0.001) and increased astrocytic staining in the lateral corticospinal, reticulospinal and rubrospinal tracts versus controls (P=0.03, 0.04, 0.04 respectively).
Conclusion
Permanent paraplegia is associated with shedding of ADVS-1 from parenchymal cord into CSF and blood/spinal-cord barrier disruption leading to cord oedema/leucocyte infiltration. Pre-treatment with ADVS-1 inhibition led to neurobehavioural and histological improvements offering translational hope for this devastating complication.
Take-home message
ADVS-1 is a novel biomarker of paraplegia where accurate biomarkers have proven challenging but more importantly it has proven a therapeutic target with genuine translational potential.
Collapse
|
13
|
Rogers BD, Valdovinos LR, Crowell MD, Bell R, Vela MF, Gyawali CP. Number of reflux episodes on pH-impedance monitoring associates with improved symptom outcome and treatment satisfaction in gastro-oesophageal reflux disease (GERD) patients with regurgitation. Gut 2021; 70:450-455. [PMID: 32467089 DOI: 10.1136/gutjnl-2020-321395] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Revised: 04/29/2020] [Accepted: 05/11/2020] [Indexed: 01/10/2023]
Abstract
OBJECTIVE Number of reflux episodes, an adjunctive metric on pH-impedance monitoring, is incompletely studied. We aimed to determine if number of reflux episodes associates with therapeutic outcome in regurgitation predominant gastro-oesophageal reflux disease (GERD). DESIGN We performed post hoc analysis of postintervention pH-impedance data from adult patients with moderate/severe regurgitation despite QD proton pump inhibitor (PPI), randomised to either two times a day PPI or magnetic sphincter augmentation (MSA) in 2:1 allocation. After 6 and 12 months, symptom response was defined by improvement in Foregut Symptom Questionnaire (FSQ) regurgitation score to none or minimal, ≥50% reduction in GERD health-related quality of life (HRQL) score and satisfaction with therapy. Univariate and multivariate analyses were performed to determine predictors of symptom improvement. RESULTS Of 152 randomised patients, 123 (age 46.9±1.2 year, 43% female) had complete data. Symptom and satisfaction scores significantly improved after MSA compared with two times a day PPI. Both acid exposure time (13.4%±0.7% to 1.3±0.2%, p<0.001) and reflux episodes (86±4 to 48±4, p<0.001) declined with therapy. Reduction to <40 reflux episodes was significantly more frequent in those with symptom response by FSQ regurgitation score, GERD HRQL score and satisfaction with therapy (p≤0.03 for each); <35 episodes performed better on receiver operating characteristic analysis. On multivariate analysis, improvement in regurgitation score remained independently predictive of satisfaction with therapy (p<0.001 for each). In patients crossing over to MSA, >80 episodes pretreatment predicted improvement. CONCLUSIONS Reduction of reflux episodes on pH-impedance to physiological levels associates with improved outcomes, while pathological levels predict improvement with MSA in regurgitation predominant GERD. TRAIL REGISTRATION NUMBER ClinicalTrials.gov: NCT02505945.
Collapse
Affiliation(s)
- Benjamin D Rogers
- Division of Gastroenterology, Washington University in Saint Louis, Saint Louis, Missouri, USA
| | - Luis R Valdovinos
- Division of Gastroenterology and Hepatology, Mayo Clinic Arizona, Scottsdale, Arizona, USA
| | | | - Reginald Bell
- Institute of Esophageal and Reflux Surgery, Englewood, Colorado, USA
| | - Marcelo F Vela
- Gastroenterology, Mayo Clinic Arizona, Scottsdale, Arizona, USA
| | - C Prakash Gyawali
- Division of Gastroenterology, Washington University in Saint Louis, Saint Louis, Missouri, USA
| |
Collapse
|
14
|
Khaitan L, Abu Dayyeh BK, Lipham J, Bell R, Kahrilas P. Letter to the editor by the American Foregut Society Bariatric Committee on Combined Magnetic Sphincter Augmentation and Bariatric Surgery. Surg Obes Relat Dis 2021; 17:1034-1035. [PMID: 33744159 DOI: 10.1016/j.soard.2021.02.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Accepted: 02/07/2021] [Indexed: 11/25/2022]
Affiliation(s)
- Leena Khaitan
- Case Western Reserve University School of Medicine, University Hospital Cleveland Medical Center, Cleveland, Ohio
| | - Barham K Abu Dayyeh
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota
| | - John Lipham
- Department of General Surgery, Keck Medical Center of the University of Southern California, Los Angeles, California
| | - Reginald Bell
- Institute of Esophageal and Reflux Surgery, Englewood, Colorado
| | - Peter Kahrilas
- Department of Medicine, Division of Gastroenterology and Hepatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | | |
Collapse
|
15
|
Walker I, Trompeter S, Howard J, Williams A, Bell R, Bingham R, Bankes M, Vercueil A, Dalay S, Whitaker D, Elton C. Guideline on the peri-operative management of patients with sickle cell disease: Guideline from the Association of Anaesthetists. Anaesthesia 2021; 76:805-817. [PMID: 33533039 DOI: 10.1111/anae.15349] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/18/2020] [Indexed: 11/30/2022]
Abstract
Sickle cell disease is a multisystem disease characterised by chronic haemolytic anaemia, painful vaso-occlusive crises and acute and chronic end-organ damage. It is one of the most common serious inherited single gene conditions worldwide and has a major impact on the health of affected individuals. Peri-operative complications are higher in patients with sickle cell disease compared with the general population and may be sickle or non-sickle-related. Complications may be reduced by meticulous peri-operative care and transfusion, but unnecessary transfusion should be avoided, particularly to reduce the risk of allo-immunisation. Planned surgery and anaesthesia for patients with sickle cell disease should ideally be undertaken in centres with experience in caring for these patients. In an emergency, advice should be sought from specialists with experience in sickle cell disease through the haemoglobinopathy network arrangements. Emerging data suggest that patients with sickle cell disease are at increased risk of COVID-19 infection but may have a relatively mild clinical course. Outcomes are determined by pre-existing comorbidities, as for the general population.
Collapse
Affiliation(s)
- I Walker
- Working Party, on behalf of the Association of Anaesthetists
| | - S Trompeter
- Department of Haematology, University College London NHS Foundation Trust and NHS Blood and Transplant, London, UK
| | - J Howard
- Department of Haematology, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - A Williams
- Department of Anaesthesia, Bart's Health NHS Trust, London, UK
| | - R Bell
- Department of Anaesthesia, University College London NHS Foundation Trust, London, UK
| | - R Bingham
- 6Department of Paediatric Anaesthesia, Great Ormond Street Hospital NHS Trust and Association of Paediatric Anaesthetists of Great Britain and Ireland, London, UK
| | - M Bankes
- Department of Orthopaedic Surgery, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - A Vercueil
- Department of Anaesthesia, Department of Critical Care Medicine, King's College Hospital NHS Foundation Trust, London, UK
| | - S Dalay
- Department of Anaesthesia, Worcestershire Acute Hospitals NHS Trust UK and Association of Anaesthetists Trainee Committee
| | - D Whitaker
- Manchester and Royal College of Anaesthetists
| | - C Elton
- Department of Anaesthesia, University Hospitals of Leicester NHS Trust and Obstetric Anaesthetists' Association, Leicester, UK
| |
Collapse
|
16
|
Almalki A, Harding I, Jasem H, Arjun S, Yellon D, Bell R. Investigating sodium-glucose co-transporters 1 (SGLT1) in myocardium and its role in hyperglycaemia ischaemia-reperfusion injury. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.1577] [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
Hyperglycaemia is a common finding in diabetic and non-diabetic patients presenting with ACS, and is a powerful predictor of prognosis and mortality. The role of hyperglycaemia in ischemia-reperfusion injury (IRI) is not fully understood, and whether the Sodium Glucose co-Transporter 1 (SGLT1) plays a role in infarct augmentation, before and/or after reperfusion, remains to be elucidated. However, diabetes clinical trials have shown SGLT inhibition improves cardiovascular outcomes, yet the mechanism is not fully understood.
Purpose
(1) Characterise the expression of SGLT1 in the myocardium, (2) determine the role of high glucose during IRI, (3) whether SGLT1 is involved in a glucotoxicity injury during IRI, and (4) whether inhibiting SGLT1 with an SGLT inhibitor may reduce infarct size.
Methods
RT-PCR and in-situ hybridization (RNAScope) techniques were used to detect SGLT1 mRNA expression in Sprague-Dawley whole myocardium and isolated primary cardiomyocytes. An Ex-vivo Langendorff ischemia-reperfusion perfusion model was used to study the effect of high glucose (22mmol) on the myocardium at reperfusion compared to normoglycaemia (11mmol). The mixed SGLT1&2 inhibitor, Phlorizin was introduced following ischaemia, at reperfusion and its effect on infarct size measured using triphenyltetrazolium chloride (TTC) staining.
Results
RT-PCR found SGLT1 mRNA is expressed in whole myocardium and in individual cardiac chambers. SGLT1 expression was not detected in isolated cardiomyocyte but it is detected in the non-cardiomyocyte population. Cardiomyocytes were found to express mRNA SGLT1 if incubated overnight. RNAscope detected SGLT1 mRNA within intact myocardium: not in the cardiomyocyte, but rather in a perivascular distribution. Importantly, hyperglycaemia (22mmol) at reperfusion increased infarct size (51.80±3.52% vs. 40.80±2.89%; p-value: 0.026) compared to normoglycaemia, and the mixed SGLT inhibitor, Phlorizin, significantly attenuated infarct size (from 64.7±4.2%to 36.6±5.8%; p-value<0.01) when given at reperfusion.
Conclusion
We have shown that SGLT1 is present in the myocardium, but not expressed in cardiomyocytes. The cell type is yet to be determined, but the distribution of SGLT1 is perivascular. Hyperglycaemia appears augment myocardial infarction and inhibition of SGLT1&2 attenuates this increase. We suspect SGLT1 may plays a role in exacerbating the injurious effect of glucotoxicity during ischemia-reperfusion.
Funding Acknowledgement
Type of funding source: Foundation. Main funding source(s): British Heart Foundation
Collapse
Affiliation(s)
- A Almalki
- University College London, London, United Kingdom
| | - I Harding
- King's College Hospital, London, United Kingdom
| | - H Jasem
- University of Glasgow, Glasgow, United Kingdom
| | - S Arjun
- University College London, London, United Kingdom
| | - D Yellon
- University College London, London, United Kingdom
| | - R Bell
- University College Hospital, London, United Kingdom
| |
Collapse
|
17
|
Sesti F, Minardi V, Baglio G, Bell R, Goldblatt P, Marceca M, Masocco M, Carrozzi G, Fateh-Moghadam P, Marmot M. Education as a contradictory determinant of mental health between migrant and national adulthood. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa165.829] [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: 11/13/2022] Open
Abstract
Abstract
The Social Determinants of Health (SDHs) are well known for their interaction on health outcomes and they can have a stronger impact on migrant health whom have higher probability to live in precarious living and working conditions compared to the hosting population. Migrant health is a public health issue which has to be considered taking into account the SDHs and complementary, including cultural issues is fundamental for addressing health equity in the society as a whole. Recognising this challenge, this study aims to evaluate the interactions between education and mental health of resident population in Italy, including Italians and immigrants.
This study examined the respondents in 2014-17 to the Italian “Progressi delle Aziende Sanitarie per la Salute in Italia” (PASSI) surveillance system. The sample of 118,639 respondents is composed by the residing working adults aged 25-69 with Italian citizenship (n = 112,345) and foreign citizenship (n = 6,294). Looking at SDHs, if for Italians high level of education appears to be a protective factor of mental health in accordance with the international evidence (adjPR: tertiary education 0,87 95%IC 079-0,97), among immigrants higher level of education it is more associated with the presence of depressive symptoms (adjPR: tertiary education: 1.77 95%IC: 1.19-2.63). Longer the length of stay in Italy for PFPM immigrants higher the risk of depressive symptoms: adjPR for 10+ years: 5.1 95%IC: 1.29-4.3.
The data show that high education could represent a risk factor for mental health of immigrants. Considering that health is related to the nature of society as well as to access to technical solutions, multicultural societies require culturally oriented interventions for tackling health inequities. This means developing evidence-based policies in order to tackle health inequalities in the population as a whole, including culturally oriented measures in the larger framework of developing diversity sensitive services.
Key messages
For some groups of population, such as migrants, high education could represent a risk factor for mental health. Developing diverse sensitive policies is needed in order to tackle health inequities in the population as a whole.
Collapse
Affiliation(s)
- F Sesti
- Italian Society of Migration Medicine, Rome, Italy
| | - V Minardi
- Italian National Institute of Health, Rome, Italy
| | - G Baglio
- Italian Society of Migration Medicine, Rome, Italy
| | - R Bell
- UCL Institute of Health Equity, London, UK
| | | | - M Marceca
- Italian Society of Migration Medicine, Rome, Italy
- Sapienza University of Rome, Rome, Italy
| | - M Masocco
- Italian National Institute of Health, Rome, Italy
| | - G Carrozzi
- Local Health Unit of Modena, Modena, Italy
| | | | - M Marmot
- UCL Institute of Health Equity, London, UK
| |
Collapse
|
18
|
Micheletti SJ, Bryc K, Ancona Esselmann SG, Freyman WA, Moreno ME, Poznik GD, Shastri AJ, Beleza S, Mountain JL, Agee M, Aslibekyan S, Auton A, Bell R, Clark S, Das S, Elson S, Fletez-Brant K, Fontanillas P, Gandhi P, Heilbron K, Hicks B, Hinds D, Huber K, Jewett E, Jiang Y, Kleinman A, Lin K, Litterman N, McCreight J, McIntyre M, McManus K, Mozaffari S, Nandakumar P, Noblin L, Northover C, O’Connell J, Petrakovitz A, Pitts S, Shelton J, Shringarpure S, Tian C, Tung J, Tunney R, Vacic V, Wang X, Zare A. Genetic Consequences of the Transatlantic Slave Trade in the Americas. Am J Hum Genet 2020; 107:265-277. [PMID: 32707084 PMCID: PMC7413858 DOI: 10.1016/j.ajhg.2020.06.012] [Citation(s) in RCA: 74] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Accepted: 06/15/2020] [Indexed: 01/07/2023] Open
Abstract
According to historical records of transatlantic slavery, traders forcibly deported an estimated 12.5 million people from ports along the Atlantic coastline of Africa between the 16th and 19th centuries, with global impacts reaching to the present day, more than a century and a half after slavery's abolition. Such records have fueled a broad understanding of the forced migration from Africa to the Americas yet remain underexplored in concert with genetic data. Here, we analyzed genotype array data from 50,281 research participants, which-combined with historical shipping documents-illustrate that the current genetic landscape of the Americas is largely concordant with expectations derived from documentation of slave voyages. For instance, genetic connections between people in slave trading regions of Africa and disembarkation regions of the Americas generally mirror the proportion of individuals forcibly moved between those regions. While some discordances can be explained by additional records of deportations within the Americas, other discordances yield insights into variable survival rates and timing of arrival of enslaved people from specific regions of Africa. Furthermore, the greater contribution of African women to the gene pool compared to African men varies across the Americas, consistent with literature documenting regional differences in slavery practices. This investigation of the transatlantic slave trade, which is broad in scope in terms of both datasets and analyses, establishes genetic links between individuals in the Americas and populations across Atlantic Africa, yielding a more comprehensive understanding of the African roots of peoples of the Americas.
Collapse
|
19
|
Lovegrove C, Musbahi O, Ranasinha N, Omer A, Campbell A, Bryant R, Leslie T, Bell R, Brewster S, Hamdy F, Wright B, Lamb A. Implications of celebrity endorsement of prostate cancer awareness in a tertiary referral unit: The “Fry-Turnbull” effect. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)33949-5] [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
|
20
|
Gawron AJ, Bell R, Dayyeh BKA, Buckley FP, Chang K, Dunst CM, Edmundowicz SA, Jobe B, Lipham JC, Lister D, Canto MI, Smith MS, Starpoli AA, Triadafilopoulos G, Watson TJ, Wilson E, Pandolfino JE, Kaizer A, Van De Voorde Z, Yadlapati R. Surgical and endoscopic management options for patients with GERD based on proton pump inhibitor symptom response: recommendations from an expert U.S. panel. Gastrointest Endosc 2020; 92:78-87.e2. [PMID: 32007519 PMCID: PMC7321870 DOI: 10.1016/j.gie.2020.01.037] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Accepted: 01/22/2020] [Indexed: 02/08/2023]
Abstract
BACKGROUND AND AIMS The objective of this study was to examine expert opinion and agreement on the treatment of distinct GERD profiles from surgical and therapeutic endoscopy perspectives. METHODS We used the RAND/University of California, Los Angeles Appropriateness Method over 6 months (July 2018 to January 2019) to assess the appropriateness of antireflux interventions among foregut surgeons and therapeutic gastroenterologists. Patients with primary atypical or extraesophageal symptoms were not considered. Patient scenarios were grouped according to their symptom response to proton pump inhibitor (PPI) therapy. The primary outcome was appropriateness of an intervention. RESULTS Antireflux surgery with laparoscopic fundoplication (LF) and magnetic sphincter augmentation (MSA) were ranked as appropriate for all complete and partial PPI responder scenarios. Transoral incisionless fundoplication was ranked as appropriate in complete and partial PPI responders without a hiatal hernia. Radiofrequency energy was not ranked as appropriate for complete or partial responders. There was lack of agreement between surgery and interventional gastroenterology groups on the appropriateness of LF and MSA for PPI nonresponders. Rankings for PPI nonresponders were similar when results from impedance-pH testing on PPI therapy were available, except that LF and MSA were not ranked as appropriate for PPI nonresponders if the impedance-pH study was negative. CONCLUSIONS This work highlights areas of agreement for invasive therapeutic approaches for GERD and provides impetus for further interdisciplinary collaboration and trials to compare and generate novel and effective treatment approaches and care pathways, including the role of impedance-pH testing in PPI nonresponders.
Collapse
Affiliation(s)
- Andrew J. Gawron
- University of Utah, Salt Lake City UT, Salt Lake City VA Medical
Center
| | - Reginald Bell
- Institute of Esophageal and Reflux Surgery, Denver CO
| | | | | | | | | | | | | | | | - Dan Lister
- Arkansas Heartburn Treatment Center, Heber Springs, AR
| | | | - Michael S. Smith
- Mount Sinai West & Mount Sinai St. Luke’s Hospitals,
New York, NY New York, NY
| | | | | | | | - Erik Wilson
- University of Texas McGovern Medical School, Houston, TX
| | | | | | | | - Rena Yadlapati
- University of Colorado, Aurora, CO; University of California San
Diego, San Diego, CA
| |
Collapse
|
21
|
Bell R, Lipham J, Louie BE, Williams V, Luketich J, Hill M, Richards W, Dunst C, Lister D, McDowell-Jacobs L, Reardon P, Woods K, Gould J, Buckley FP, Kothari S, Khaitan L, Smith CD, Park A, Smith C, Jacobsen G, Abbas G, Katz P. Magnetic Sphincter Augmentation Superior to Proton Pump Inhibitors for Regurgitation in a 1-Year Randomized Trial. Clin Gastroenterol Hepatol 2020; 18:1736-1743.e2. [PMID: 31518717 DOI: 10.1016/j.cgh.2019.08.056] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [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: 06/24/2019] [Revised: 08/19/2019] [Accepted: 08/30/2019] [Indexed: 02/07/2023]
Abstract
BACKGROUND & AIMS Regurgitative gastroesophageal reflux disease (GERD) refractive to medical treatment is common and caused by mechanical failure of the anti-reflux barrier. We compared the effects of magnetic sphincter augmentation (MSA) with those of proton-pump inhibitors (PPIs) in a randomized trial. METHODS Patients with moderate to severe regurgitation (assessed by the foregut symptom questionnaire) despite once-daily PPI therapy (n = 152) were randomly assigned to groups given twice-daily PPIs (n = 102) or laparoscopic MSA (n = 50) at 20 sites, from July 2015 through February 2017. Patients answered questions from the foregut-specific reflux disease questionnaire and GERD health-related quality of life survey about regurgitation, heartburn, dysphagia, bloating, diarrhea, flatulence, and medication use, at baseline and 6 and 12 months after treatment. Six months after PPI therapy, MSA was offered to patients with persistent moderate to severe regurgitation and excess reflux episodes during impedance or pH testing on medication. Regurgitation, foregut scores, esophageal acid exposure, and adverse events were evaluated at 1 year. RESULTS Patients in the MSA group and those who crossed over to the MSA group after PPI therapy (n = 75) had similar outcomes. MSA resulted in control of regurgitation in 72/75 patients (96%); regurgitation control was independent of preoperative response to PPIs. Only 8/43 patients receiving PPIs (19%) reported control of regurgitation. Among the 75 patients who received MSA, 61 (81%) had improvements in GERD health-related quality of life improvement scores (greater than 50%) and 68 patients (91%) discontinued daily PPI use. Proportions of patients with dysphagia decreased from 15% to 7% (P < .005), bloating decreased from 55% to 25%, and esophageal acid exposure time decreased from 10.7% to 1.3% (P < .001) from study entry to 1-year after MSA (Combined P < .001). Seventy percent (48/69) of patients had pH normalization at study completion. MSA was not associated with any peri-operative events, device explants, erosions, or migrations. CONCLUSIONS In a prospective study, we found MSA to reduce regurgitation in 95% of patients with moderate to severe regurgitation despite once-daily PPI therapy. MSA is superior to twice-daily PPIs therapy in reducing regurgitation. Relief of regurgitation is sustained over 12 months. ClinicalTrials.gov no: NCT02505945.
Collapse
Affiliation(s)
- Reginald Bell
- Institute of Esophageal and Reflux Surgery, Englewood, Colorado.
| | - John Lipham
- Department of Surgery, University of Southern California, Los Angeles, California
| | - Brian E Louie
- Division of Thoracic Surgery, Swedish Medical Center, Seattle, Washington
| | - Valerie Williams
- Thoracic Surgery Department, St. Elizabeth's Healthcare, Edgewood, Kentucky
| | - James Luketich
- Division of Thoracic Surgery, University of Pittsburgh Medical Center Health System, Pittsburgh, Pennsylvania
| | - Michael Hill
- Department of Surgery, Adirondack Medical Center and Adirondack Surgical Group, Saranac Lake, New York
| | - William Richards
- Department of Surgery, University of South Alabama, Mobile, Alabama
| | - Christy Dunst
- Department of Surgery, Oregon Clinic, Portland, Oregon
| | - Dan Lister
- Arkansas Heartburn Treatment Center, Baptist Health Medical Center, Heber Springs, Arkansas
| | | | - Patrick Reardon
- Department of Surgery, Houston Methodist Hospital, Houston, Texas
| | - Karen Woods
- Department of Medicine, Houston Methodist Hospital, Houston, Texas
| | - Jon Gould
- Department of Surgery, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - F Paul Buckley
- Department of Surgery and Perioperative Care, University of Texas at Austin, Austin, Texas
| | - Shanu Kothari
- Department of Surgery, Prisma Health, Greenville, South Carolina
| | - Leena Khaitan
- Department of Surgery, Digestive Health Institute, University Hospitals, Cleveland Medical Center, Cleveland, Cleveland, Ohio
| | | | - Adrian Park
- Department of Surgery, Anne Arundel Health System and Johns Hopkins Medicine, Annapolis, Maryland
| | | | - Garth Jacobsen
- Department of Surgery, University of California, San Diego, San Diego, California
| | - Ghulam Abbas
- Division of Thoracic Surgery, West Virginia University School of Medicine, Morgantown, West Virginia
| | - Philip Katz
- Department of Gastroenterology, Weill Cornell Medicine, New York, New York
| |
Collapse
|
22
|
Bell R, Michael A. 6 Perioperative Urinary Catheterisation in Hip Fracture Patients. Age Ageing 2020. [DOI: 10.1093/ageing/afz183.06] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Introduction
There are currently no national guidelines, in the UK, advising when to catheterize hip fracture patients and when to trial without a catheter (TWOC). We audited the practice in a UK teaching hospital where there is a consultants’ consensus that all patients should be catheterized on the day of admission (or day of surgery; which is usually within 36 hours of admission) and TWOC as soon as possible within 72 hours postoperatively. We also correlated delays in TWOC with urinary tract infection (UTI) rates.
Methods
Audit of consecutive hip fracture patients who had undergone surgery. Patients who had long term indwelling urinary catheter were excluded. Data collected include: demographics and date and time of admission, catheterisation, operation and TWOC, also duration of catheter post operatively, reason if TWOC delayed and whether the patient had a UTI.
Results
43 patients were included; 30 males and 13 females with a mean age of 82.9 and 83.9 years respectively. Urinary catheters were inserted in 100% of patients preoperatively. Overall 23% of patients had a UTI. There were more UTIs with prolonged catheterization. The results are summarised in the table. The reason for delaying a TWOC was not documented in any of patients’ notes.
Discussion
The low rate of TWOC within 72 hours can be attributed to:Lack of clear guidelinesReluctance to have a TWOC for older patients with poor postoperative mobility with concerns regarding inability to reach the toilet timely.Reluctance to have a TWOC for those who did not open their bowels postoperatively.Time and resources pressure.
Conclusion and recommendations
National guidelines for urinary catheterisation in hip fracture patients are needed meanwhile Orthopaedic Department guidelines will improve the care in these patients. Patients should have a urinary catheter “passport” documenting the date of insertion, expected date of TWOC and the reasons for delaying TWOC. It is important to educate the team about the importance of TWOC as early as possible and improve communication.
Collapse
Affiliation(s)
- R Bell
- Birmingham University; Russells Hall Hospital, Dudley
| | - A Michael
- Birmingham University; Russells Hall Hospital, Dudley
| |
Collapse
|
23
|
Iliodromiti S, Wang W, Lumsden MA, Hunter MS, Bell R, Mishra G, Hickey M. Variation in menopausal vasomotor symptoms outcomes in clinical trials: a systematic review. BJOG 2019; 127:320-333. [PMID: 31621155 PMCID: PMC6972542 DOI: 10.1111/1471-0528.15990] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [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] [Accepted: 10/10/2019] [Indexed: 12/16/2022]
Abstract
BACKGROUND There is substantial variation in how menopausal vasomotor symptoms are reported and measured among intervention studies. This has prevented meaningful comparisons between treatments and limited data synthesis. OBJECTIVES To review systematically the outcome reporting and measures used to assess menopausal vasomotor symptoms from randomised controlled trials of treatments. SEARCH STRATEGY We searched MEDLINE, Embase, and Cochrane Central Register of Controlled Trials from inception to May 2018. SELECTION CRITERIA Randomised controlled trials with a primary outcome of menopausal vasomotor symptoms in women and a sample size of at least 20 women per study arm. DATA COLLECTION AND ANALYSIS Data about study characteristics, primary vasomotor-related outcomes and methods of measuring them. MAIN RESULTS The search identified 5591 studies, 214 of which were included. Forty-nine different primary reported outcomes were identified for vasomotor symptoms and 16 different tools had been used to measure these outcomes. The most commonly reported outcomes were frequency (97/214), severity (116/214), and intensity (28/114) of vasomotor symptoms or a composite of these outcomes (68/214). There was little consistency in how the frequency and severity/intensity of vasomotor symptoms were defined. CONCLUSIONS There is substantial variation in how menopausal vasomotor symptoms have been reported and measured in treatment trials. Future studies should include standardised outcome measures which reflect the priorities of patients, clinicians, and researchers. This is most effectively achieved through the development of a Core Outcome Set. This systematic review is the first step towards development of a Core Outcome Set for menopausal vasomotor symptoms. TWEETABLE SUMMARY Menopausal hot flushes and night sweats have been reported in 49 different ways in clinical research. A core outcome set is urgently required.
Collapse
Affiliation(s)
- S Iliodromiti
- Women's Health Division, Blizard Institute, Queen Mary University London, London, UK.,School of Medicine, University of Glasgow, Glasgow, UK
| | - W Wang
- Department of Obstetrics, Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, Shanghai, China
| | - M A Lumsden
- School of Medicine, University of Glasgow, Glasgow, UK
| | - M S Hunter
- Institute of Psychiatry, Psychology and Neuroscience, Kings College London, London, UK
| | - R Bell
- Women's Health Research Program, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - G Mishra
- Faculty of Medicine, School of Public Health, University of Queensland, Brisbane, Australia
| | - M Hickey
- Department of Obstetrics and Gynaecology, University of Melbourne and The Royal Women's Hospital, Victoria, Australia
| |
Collapse
|
24
|
Stegeman I, Strube R, Bell R, Zvěřinová I, Staatsen B. A future for all to INHERIT: taking integrated action on the environment, health and equity. Eur J Public Health 2019. [DOI: 10.1093/eurpub/ckz185.390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
The need to act on climate change, and to modify how we live, move and consume is urgent; failure to do so will have catastrophic effects on health and wellbeing over the medium and long term. INHERIT, a large multi-sectoral research initiative (2016-2019) has explored what can be done to seize this as an opportunity to encourage and enable people to modify their behaviours towards ones that simultaneously protect the environment and promote health and health equity (the ‘INHERIT triple-win’).
One strand of INHERIT’s work has involved the identification, implementation and evaluation (qualitative, quantitative and cost-benefit) of 15 promising ‘triple-win’ interventions across the EU. INHERIT has also developed four positive scenarios of more sustainable futures, questioned 183 people about these, and surveyed 10,288 people from five countries across the EU about their current behaviours and incentives for change.
The results of these investigations paint a complex picture of what can be done to encourage and enable more people across the socio-economic gradient to adapt their behaviours. They reflect that improving health is a powerful motivator for action to protect the environment, yet there is often confusion about what is considered ‘sustainable’, whether this is always ‘healthy’ and vice-versa, let alone equitable. There is resistance in some countries to modifying some behaviours, like meat consumption. Many people fear that technological solutions will drive up isolation and inequities, and desire stronger community ownership over processes like food and energy production.
INHERIT outcomes reflect that it is possible to conjure common visions of the kinds of societies we want to transition to, and a willingness and potential to work across sectors to achieve these. This requires stronger individual and collective leadership, also from public health actors, who can play a key role in bringing together different actors and sectors to achieve these visions.
Key messages
The urgent need to address the environmental crisis presents an opportunity to simultaneously manage closely related societal challenges linked to health and equity. Public health actors can play a key role by bringing together the sectors, evidence and examples to instigate change, around the common interest of promoting human, which depends on planetary, health.
Collapse
|
25
|
Sesti F, Rosano A, Ingleby D, Baglio G, Bell R, Geraci S, Marceca M. Policies for tackling health inequities in migrants in an irregular situation: learning from Italy. Eur J Public Health 2019. [DOI: 10.1093/eurpub/ckz186.031] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Issue
With increasing of numbers of people moving in Europe and around the world, the health of migrants has become a key global public-health issue. Migrants in an irregular situation (MIS) represent an important part of the migration phenomenon, whether they have become irregular by entering a country without authorisation or by overstaying a visa, including whose applied unsuccessfully for asylum.
Description of the problem
Overstaying of visas is not unusual in EU countries and during 2015 and 2016 in particular, many countries experienced a large number of unauthorised entrants. Health policies for MIS are increasingly a matter of concern. Using the 2015 Migrant Integration Policy Index Health strand (MIPEX HS) it is possible to conduct an analysis of health policies, focusing on access to health services by MIS.
Results
Among the 34 European countries covered by the MIPEX HS, Italy’s overall score of 65 is exceeded only by Switzerland (70) and Norway (67). Averaging the indicators of access for MIS, Italy obtains the highest score (83), followed by Denmark, France, the Netherlands, Romania, Spain, Sweden and Switzerland with 67. Its score for legal entitlements to health care is 75 (the same as Sweden), while reporting of MIS to the immigration authorities is prohibited and there are no sanctions against helping them. However, legislation introduced by the new government in 2018 has restricted some of their rights.
Lessons
Current migration to Europe requires dealing with short-term health needs as well as strengthening public health and health systems in the long term. This presentation will discuss the lessons that can be learned from the comparative analysis of health policies for MIS using the MIPEX HS.
Key messages
Affordable health care is a human right, which should not be denied to any migrant. Policy analysis plays a key role in identifying interventions for promoting health equity.
Collapse
Affiliation(s)
- F Sesti
- Italian Society of Migration Medicine, Rome, Italy
| | - A Rosano
- National Institute for Public Policies Analysis, Rome, Italy
| | - D Ingleby
- University of Amsterdam, Amsterdam, Netherlands
| | - G Baglio
- Italian Society of Migration Medicine, Rome, Italy
| | - R Bell
- UCL Institute of Health Equity, London, UK
| | - S Geraci
- Caritas Diocese of Rome, Rome, Italy
- Italian Society of Migration Medicine, Rome, Italy
| | - M Marceca
- Sapienza University of Rome, Rome, Italy
- Italian Society of Migration Medicine, Rome, Italy
| |
Collapse
|
26
|
Affiliation(s)
- A. D. Cochrane
- Haemato‐Oncology Group, Department of Clinical Pharmacology and Therapeutics, The Royal Melbourne Hospital, Vic. 3050
| | - R. Bell
- Haemato‐Oncology Group, Department of Clinical Pharmacology and Therapeutics, The Royal Melbourne Hospital, Vic. 3050
| | - J. R. Sullivan
- Haemato‐Oncology Group, Department of Clinical Pharmacology and Therapeutics, The Royal Melbourne Hospital, Vic. 3050
| | - J. Shaw
- Haemato‐Oncology Group, Department of Clinical Pharmacology and Therapeutics, The Royal Melbourne Hospital, Vic. 3050
| |
Collapse
|
27
|
Bell R, Lipham J, Louie B, Williams V, Luketich J, Hill M, Richards W, Dunst C, Lister D, McDowell-Jacobs L, Reardon P, Woods K, Gould J, Buckley FP, Kothari S, Khaitan L, Smith CD, Park A, Smith C, Jacobsen G, Abbas G, Katz P. Laparoscopic magnetic sphincter augmentation versus double-dose proton pump inhibitors for management of moderate-to-severe regurgitation in GERD: a randomized controlled trial. Gastrointest Endosc 2019; 89:14-22.e1. [PMID: 30031018 DOI: 10.1016/j.gie.2018.07.007] [Citation(s) in RCA: 60] [Impact Index Per Article: 12.0] [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] [Received: 04/18/2018] [Accepted: 07/11/2018] [Indexed: 02/08/2023]
Abstract
BACKGROUND AND AIMS GERD patients frequently complain of regurgitation of gastric contents. Medical therapy with proton-pump inhibitors (PPIs) is frequently ineffective in alleviating regurgitation symptoms, because PPIs do nothing to restore a weak lower esophageal sphincter. Our aim was to compare effectiveness of increased PPI dosing with laparoscopic magnetic sphincter augmentation (MSA) in patients with moderate-to-severe regurgitation despite once-daily PPI therapy. METHODS One hundred fifty-two patients with GERD, aged ≥21 years with moderate-to-severe regurgitation despite 8 weeks of once-daily PPI therapy, were prospectively enrolled at 21 U.S. sites. Participants were randomized 2:1 to treatment with twice-daily (BID) PPIs (N = 102) or to laparoscopic MSA (N = 50). Standardized foregut symptom questionnaires and ambulatory esophageal reflux monitoring were performed at baseline and at 6 months. Relief of regurgitation, improvement in foregut questionnaire scores, decrease in esophageal acid exposure and reflux events, discontinuation of PPIs, and adverse events were the measures of efficacy. RESULTS Per protocol, 89% (42/47) of treated patients with MSA reported relief of regurgitation compared with 10% (10/101) of the BID PPI group (P < .001) at the 6-month primary endpoint. By intention-to-treat analysis, 84% (42/50) of patients in the MSA group and 10% (10/102) in the BID PPI group met this primary endpoint (P < .001). Eighty-one percent (38/47) of patients with MSA versus 8% (7/87) of patients with BID PPI had ≥50% improvement in GERD-health-related quality of life scores (P < .001), and 91% (43/47) remained off of PPI therapy. A normal number of reflux episodes and acid exposures was observed in 91% (40/44) and 89% (39/44) of MSA patients, respectively, compared with 58% (46/79) (P < .001) and 75% (59/79) (P = .065) of BID PPI patients at 6 months. No significant safety issues were observed. In MSA patients, 28% reported transient dysphagia; 4% reported ongoing dysphagia. CONCLUSION Patients with GERD with moderate-to-severe regurgitation, especially despite once-daily PPI treatment, should be considered for minimally invasive treatment with MSA rather than increased PPI therapy. (Clinical trial registration number: NCT02505945.).
Collapse
Affiliation(s)
- Reginald Bell
- Institute of Esophageal and Reflux Surgery, Englewood, Colorado, USA
| | - John Lipham
- Department of Surgery, University of Southern California, Los Angeles, California, USA
| | - Brian Louie
- Swedish Cancer Institute and Medical Center, Seattle, Washington, USA
| | | | - James Luketich
- University of Pittsburgh Medical Center Health System, Pittsburgh, Pennsylvania, USA
| | - Michael Hill
- Adirondack Surgical Group, Saranac Lake, New York, USA
| | | | | | - Dan Lister
- Arkansas Heartburn Treatment Center, Heber Springs, Arkansas, USA
| | | | | | | | - Jon Gould
- Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | | | | | - Leena Khaitan
- University Hospitals, Cleveland, Cleveland, Ohio, USA
| | | | - Adrian Park
- Anne Arundel Health System, Annapolis, Maryland, USA
| | | | - Garth Jacobsen
- University of California, San Diego, San Diego, California, USA
| | - Ghulam Abbas
- West Virginia University School of Medicine, Morgantown, West Virginia, USA
| | | |
Collapse
|
28
|
Adair S, Baus M, Bell R, Boero M, Bussy C, Cardenas F, Casey T, Castro J, Davis W, Erskine M, Farr R, Fischer A, Forbes B, Ford T, Genovese R, Gottschalk R, Hoge M, Honnas C, Hunter G, Joyce J, Kaneps A, Keegan K, Kramer J, Labens R, Lischer C, Marshall J, Oosterlinck M, Radue P, Redding R, Reed S, Rick M, Santschi E, Schoonover M, Schramme M, Schumacher J, Stephenson R, Thaler R, Nielsen JV, Wilson D. Letter to the Editor: A response to 'What is lameness and what (or who) is the gold standard to detect it?'. Equine Vet J 2018; 51:270-272. [PMID: 30570777 DOI: 10.1111/evj.13043] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [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 Adair
- University of Tennessee, Knoxville, Tennessee, USA
| | - M Baus
- Gran Prix Equine, Hawleyville, Connecticut, USA
| | - R Bell
- Park Equine Hospital, Lexington, Kentucky, USA
| | | | - C Bussy
- Clinique Vétérinaire du Grand Renaud, Saint Saturnin, France
| | - F Cardenas
- 3H Equine Hospital and Mobile Veterinary Services, New Hill, North Carolina, USA
| | - T Casey
- Fourways Equine Clinic, Johannesburg, South Africa
| | - J Castro
- Davie County Large Animal Hospital, Mocksville, North Carolina, USA
| | - W Davis
- Palm Beach Equine Clinic, Wellington, Florida, USA
| | - M Erskine
- Virginia Tech, Leesburg, Virginia, USA
| | - R Farr
- Farr and Pursey Equine Veterinary Services, Aldbury, Hertfordshire, UK
| | - A Fischer
- Chino Valley Equine Hospital, Chino Hills, California, USA
| | - B Forbes
- Singapore Turf Club, Singapore, Singapore
| | - T Ford
- Ford Veterinary Surgery Center, Clovis, California, USA
| | - R Genovese
- Cleveland Equine Clinic, Ravenna, Ohio, USA
| | - R Gottschalk
- Witbos Veterinary Clinic, Blue Hills AH, South Africa
| | - M Hoge
- Murrieta Equine, Murrieta, California, USA
| | - C Honnas
- Texas Equine Hospital, Bryan, Texas, USA
| | - G Hunter
- Ardene House Veterinary Practice, Aberdeen, UK
| | - J Joyce
- Total Equine Veterinary Associates, Leesburg, Virginia, USA
| | - A Kaneps
- Kaneps Equine Sports Medicine and Surgery, Beverly, Massachusetts, USA
| | - K Keegan
- University of Missouri, Columbia, Missouri, USA
| | - J Kramer
- University of Missouri, Columbia, Missouri, USA
| | - R Labens
- Charles Sturt University, Albury, New South Wales, Australia
| | - C Lischer
- Freie Universität Berlin, Berlin, Germany
| | | | | | - P Radue
- Damascus Equine Associates, Mount Airy, Maryland, USA
| | - R Redding
- North Carolina State University, Raleigh, North Carolina, USA
| | - S Reed
- Ohio State University, Columbus, Ohio, USA
| | - M Rick
- Alamo Pintado Equine Medical Centre, Los Olivos, California, USA
| | - E Santschi
- Kansas State University, Manhattan, Kansas, USA
| | - M Schoonover
- Oklahoma State University, Stillwater, Oklahoma, USA
| | | | | | | | - R Thaler
- Metamora Equine PC, Metamora, Michigan, USA
| | - J V Nielsen
- Ansager Veterinary Hospital, Ansager, Denmark
| | - D Wilson
- University of Missouri, Columbia, Missouri, USA
| |
Collapse
|
29
|
Harcourt M, Smith C, Bell R, Young A. Magnetic resonance and radiographic imaging of a case of bilateral bipartite navicular bones in a horse. Aust Vet J 2018; 96:464-469. [DOI: 10.1111/avj.12760] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2018] [Revised: 06/26/2018] [Accepted: 07/25/2018] [Indexed: 11/30/2022]
Affiliation(s)
- M Harcourt
- Wollondilly Equine; Oakbank NSW Australia
| | - C Smith
- Agnes Banks Equine Clinic; Agnes Banks NSW Australia
| | - R Bell
- University Veterinary Teaching Hospital Camden; University of Sydney; Camden NSW Australia
| | - A Young
- School of Veterinary Science; University of Queensland; Gatton Queensland Australia
| |
Collapse
|
30
|
Sonnenblick A, Bailey A, Uziely B, Untch M, Smith I, Gianni L, Baselga J, Jackisch C, Cameron D, Bell R, Zardavas D, Al-Sakaff N, Gelber R, Dowsett M, Leyland-jones B, Piccart M, de Azambuja E. Autoimmunity and benefit from trastuzumab treatment in breast cancer: Results from the HERA phase III trial. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy270.213] [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: 11/12/2022] Open
|
31
|
Coleman RE, Collinson M, Gregory W, Marshall H, Bell R, Dodwell D, Keane M, Gil M, Barrett-Lee P, Ritchie D, Bowman A, Liversedge V, De Boer RH, Passos-Coelho JL, O'Reilly S, Bertelli G, Joffe J, Brown JE, Wilson C, Tercero JC, Jean-Mairet J, Gomis R, Cameron D. Benefits and risks of adjuvant treatment with zoledronic acid in stage II/III breast cancer. 10 years follow-up of the AZURE randomized clinical trial (BIG 01/04). J Bone Oncol 2018; 13:123-135. [PMID: 30591866 PMCID: PMC6303395 DOI: 10.1016/j.jbo.2018.09.008] [Citation(s) in RCA: 56] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2018] [Revised: 09/07/2018] [Accepted: 09/16/2018] [Indexed: 12/28/2022] Open
Abstract
Adjuvant bisphosphonates improve disease outcomes in postmenopausal early breast cancer (EBC) but the long-term effects are poorly described. The AZURE trial (ISRCTN79831382) was designed to determine whether adjuvant zoledronic acid (ZOL) improves disease outcomes in EBC. Previous analyses showed no effect on overall outcomes but identified benefits in postmenopausal women. Here we present the long-term risks and benefits of adjuvant ZOL with 10-years follow-up. Patients and methods 3360 patients with stage II/III breast cancer were included in an academic, international, phase III, randomized, open label trial. Patients were followed up on a regular schedule until 10 years. Patients were randomized on a 1:1 basis to standard adjuvant systemic therapy +/− intravenous ZOL 4 mg every 3–4 weeks x6, and then at reduced frequency to complete 5 years treatment. The primary outcome was disease free survival (DFS). Secondary outcomes included invasive DFS (IDFS), overall survival (OS), sites of recurrence, skeletal morbidity and treatment outcomes according to primary tumor amplification of the transcription factor, MAF. Pre-planned subgroup analyses focused on interactions between menopausal status and treatment effects. Results With a median follow up of 117 months [IQR 70.4–120.4), DFS and IDFS were similar in both arms (HRDFS = 0.94, 95%CI = 0.84–1.06, p = 0.340; HRIDFS = 0.91, 95%CI = 0.82–1.02, p = 0.116). However, outcomes remain improved with ZOL in postmenopausal women (HRDFS = 0.82, 95%CI = 0.67–1.00; HRIDFS = 0.78, 95%CI = 0.64–0.94). In the 79% of tested women with a MAF FISH negative tumor, ZOL improved IDFS (HRIDFS = 0.75, 95%CI = 0.58–0.97) and OS HROS = 0.69, 95%CI = 0.50–0.94), irrespective of menopause. ZOL did not improve disease outcomes in MAF FISH + tumors. Bone metastases as a first DFS recurrence (BDFS) were reduced with ZOL (HRB-DFS = 0.76, 95%CI = 0.63–0.92, p = 0.005). ZOL reduced skeletal morbidity with fewer fractures and skeletal events after disease recurrence. 30 cases of osteonecrosis of the jaw in the ZOL arm (1.8%) have occurred. Conclusions Disease benefits with adjuvant ZOL in postmenopausal early breast cancer persist at 10 years of follow-up. The biomarker MAF identified a patient subgroup that derived benefit from ZOL irrespective of menopausal status.
Collapse
Affiliation(s)
- R E Coleman
- Academic Unit of Clinical Oncology and Sheffield Experimental Cancer Medicine Center, Weston Park Hospital, University of Sheffield, Sheffield S10 2SJ, UK
| | - M Collinson
- Clinical Trials Research Unit, University of Leeds, Leeds, UK
| | - W Gregory
- Clinical Trials Research Unit, University of Leeds, Leeds, UK
| | - H Marshall
- Clinical Trials Research Unit, University of Leeds, Leeds, UK
| | - R Bell
- Andrew Love Cancer Centre, Geelong, Australia
| | - D Dodwell
- St James Institute of Oncology, University of Leeds, UK
| | - M Keane
- University Hospital Galway, Ireland
| | - M Gil
- Institut Català d´Oncologia - IDIBELL. L'Hospitalet de Llobregat, Barcelona, Spain
| | | | - D Ritchie
- Beatson West of Scotland Cancer Centre, Glasgow, UK
| | - A Bowman
- Edinburgh Cancer Research Centre, Western General Hospital, University of Edinburgh, UK
| | - V Liversedge
- Clinical Trials Research Unit, University of Leeds, Leeds, UK
| | - R H De Boer
- Royal Melbourne Hospital, Melbourne, Australia
| | | | | | | | - J Joffe
- Huddersfield Royal Infirmary, Huddersfield, UK
| | - J E Brown
- Academic Unit of Clinical Oncology and Sheffield Experimental Cancer Medicine Center, Weston Park Hospital, University of Sheffield, Sheffield S10 2SJ, UK
| | - C Wilson
- Academic Unit of Clinical Oncology and Sheffield Experimental Cancer Medicine Center, Weston Park Hospital, University of Sheffield, Sheffield S10 2SJ, UK
| | | | | | - R Gomis
- Institute for Research in Biomedicine (IRB Barcelona), Barcelona Science and Technology Institute, CIBERONC and Institució Catalana de Recerca i Estudis Avançats (ICREA), Barcelona, Spain
| | - D Cameron
- Edinburgh Cancer Research Centre, Western General Hospital, University of Edinburgh, UK
| |
Collapse
|
32
|
Bell R, Robles-Harris M, Anderson M, Laudier D, Schaffler M, Flatow E, Andarawis-Puri N. Inhibition of apoptosis exacerbates fatigue-damage tendon injuries in an in vivo rat model. Eur Cell Mater 2018; 36:44-56. [PMID: 30058060 PMCID: PMC6350530 DOI: 10.22203/ecm.v036a04] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
Tendinopathy is a common and progressive musculoskeletal disease. Increased apoptosis is an end-stage tendinopathy manifestation, but its contribution to the pathology of the disease is unknown. A previously established in vivo model of fatigue damage accumulation shows that increased apoptosis is correlated with the severity of induced tendon damage, even in early onset of the disease, supporting its implication in the pathogenesis of the disease. Consequently, this study aimed to determine: (1) whether apoptosis could be inhibited after fatigue damage and (2) whether its inhibition could lead to remodeling of the extracellular matrix (ECM) and pericellular matrix (PCM), to ultimately improve the mechanical properties of fatigue-damaged tendons. The working hypothesis was that, despite the low vascular nature of the tendon, apoptosis would be inhibited, prompting increased production of matrix proteins and restoring tendon mechanical properties. Rats received 2 or 5 d of systemic pan-caspase inhibitor (Q-VD-OPh) or dimethyl sulfoxide (DMSO) carrier control injections starting immediately prior to fatigue loading and were sacrificed at days 7 and 14 post-fatigue-loading. Systemic pan-caspase inhibition for 2 d led to a surprising increase in apoptosis, but inhibition for 5 d increased the population of live cells that could repair the fatigue damage. Further analysis of the 5 d group showed that effective inhibition led to an increased population of cells producing ECM and PCM proteins, although typically in conjunction with oxidative stress markers. Ultimately, inhibition of apoptosis led to further deterioration in mechanical properties of fatigue-damaged tendons.
Collapse
Affiliation(s)
- R. Bell
- Sibley School of Mechanical and Aerospace Engineering, Cornell University, Ithaca, NY, USA
| | - M.A. Robles-Harris
- Nancy E. and Peter C. Meinig School of Biomedical Engineering, Cornell University, Ithaca, NY, USA
| | - M. Anderson
- Leni and Peter W. May Department of Orthopedics, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - D. Laudier
- Leni and Peter W. May Department of Orthopedics, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - M.B. Schaffler
- Department of Biomedical Engineering, City College of New York, New York, NY, USA
| | - E.L. Flatow
- Leni and Peter W. May Department of Orthopedics, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - N. Andarawis-Puri
- Sibley School of Mechanical and Aerospace Engineering, Cornell University, Ithaca, NY, USA,Nancy E. and Peter C. Meinig School of Biomedical Engineering, Cornell University, Ithaca, NY, USA,Hospital for Special Surgery, New York, NY, USA,Address for correspondence: Nelly Andarawis-Puri, PhD, Sibley School of Mechanical and Aerospace Engineering, Cornell University, Ithaca, 14850, NY, USA.
| |
Collapse
|
33
|
Bell R, Barraclough R, Vasieva O. Gene Expression Meta-Analysis of Potential Metastatic Breast Cancer Markers. Curr Mol Med 2018; 17:200-210. [PMID: 28782484 PMCID: PMC5748874 DOI: 10.2174/1566524017666170807144946] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [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: 04/11/2017] [Revised: 07/20/2017] [Accepted: 07/30/2017] [Indexed: 12/15/2022]
Abstract
Background: Breast cancer metastasis is a highly prevalent cause of death for European females. DNA microarray analysis has established that primary tumors, which remain localized, differ in gene expression from those that metastasize. Cross-analysis of these studies allow to revile the differences that may be used as predictive in the disease prognosis and therapy. Objective: The aim of the project was to validate suggested prognostic and therapeutic markers using meta-analysis of data on gene expression in metastatic and primary breast cancer tumors. Method: Data on relative gene expression values from 12 studies on primary breast cancer and breast cancer metastasis were retrieved from Genevestigator (Nebion) database. The results of the data meta-analysis were compared with results of literature mining for suggested metastatic breast cancer markers and vectors and consistency of their reported differential expression. Results: Our analysis suggested that transcriptional expression of the COX2 gene is significantly downregulated in metastatic tissue compared to normal breast tissue, but is not downregulated in primary tumors compared with normal breast tissue and may be used as a differential marker in metastatic breast cancer diagnostics. RRM2 gene expression decreases in metastases when compared to primary breast cancer and could be suggested as a marker to trace breast cancer evolution. Our study also supports MMP1, VCAM1, FZD3, VEGFC, FOXM1 and MUC1 as breast cancer onset markers, as these genes demonstrate significant differential expression in breast neoplasms compared with normal breast tissue. Conclusion: COX2 and RRM2 are suggested to be prominent markers for breast cancer metastasis. The crosstalk between upstream regulators of genes differentially expressed in primary breast tumors and metastasis also suggests pathways involving p53, ER1, ERB-B2, TNF and WNT, as the most promising regulators that may be considered for new complex drug therapeutic interventions in breast cancer metastatic progression.
Collapse
Affiliation(s)
- R Bell
- Institute of Integrative Biology, University of Liverpool, Crown Street, Liverpool, L69 7ZB. United Kingdom
| | - R Barraclough
- Institute of Integrative Biology, University of Liverpool, Crown Street, Liverpool, L69 7ZB. United Kingdom
| | - O Vasieva
- Institute of Integrative Biology, University of Liverpool, Crown Street, Liverpool, L69 7ZB. United Kingdom
| |
Collapse
|
34
|
Phythian CJ, Jackson B, Bell R, Citer L, Barwell R, Windsor PA. Abattoir surveillance of Sarcocystis spp., Cysticercosis ovis and Echinococcus granulosus in Tasmanian slaughter sheep, 2007-2013. Aust Vet J 2018; 96:62-68. [PMID: 29479682 DOI: 10.1111/avj.12670] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [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: 12/27/2016] [Revised: 06/12/2017] [Accepted: 07/31/2017] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To estimate the prevalence of macroscopic Sarcocystis spp., Cysticercus ovis and Echinococcus granulosus recorded at routine postmortem inspection of Tasmanian slaughter sheep during 2007 to 2013. METHODS A retrospective analysis of routine postmortem meat inspection data maintained on 352,325 Tasmanian adult slaughter sheep inspected across nine abattoirs in Tasmania, Victoria and South Australia as part of the National Sheep Health Monitoring Project (NSHMP). RESULTS During the period 1 September 2007 to 30 June 2013, the estimated prevalence of macroscopic Sarcocystis spp. was 14.3%, C. ovis was 3.2% and E. granulosus was 0.01%. Mean Sarcocystis spp. line prevalence ranged from 0% to 33.5%. Significant between-abattoir differences in the level of sarcosporidiosis (P < 0.001) and C. ovis were found (P < 0.001). Overall, very low levels of hydatidosis were recorded throughout the surveillance period. Predicted within-line prevalence of macroscopic sarcocysts in animals coming from a known/recorded local government area (LGA) (P < 0.001) was lower than that of lines where the LGA was unknown or not recorded. A higher prevalence of sarcocystosis was recorded in lines of sheep aged ≥ 2 years compared with those < 2 years (P < 0.001). CONCLUSION Reasons for the significant between-abattoir differences in recorded levels of ovine sarcosporidiosis and cysticercosis remain unknown, but may represent sampling bias, with subsets of slaughter sheep going to abattoirs with different tiers or access to markets. Further investigation into apparent differences, including epidemiological studies of properties with high lesion prevalence, comparing meat inspector diagnostic sensitivity, assessing the effect of line speed and tiers and market access in different abattoirs, may be useful.
Collapse
Affiliation(s)
- C J Phythian
- Norwegian University of Life Sciences, Faculty of Veterinary Medicine, Institute for Production Animal Clinical Medicine, Section for Small Ruminants, 4325 Sandnes, Norway
| | - B Jackson
- Biosecurity Tasmania, Department for Primary Industries, Parks, Water and Environment, Tasmanian Government, Launceston, Tasmania
| | - R Bell
- Biosecurity Tasmania, Department for Primary Industries, Parks, Water and Environment, Tasmanian Government, Launceston, Tasmania
| | - L Citer
- Animal Health Australia, Braddon Australia Capital Territory, Australia
| | - R Barwell
- Animal Health Australia, Braddon Australia Capital Territory, Australia
| | - P A Windsor
- University of Sydney, Faculty of Veterinary Science, Camden, New South Wales, Australia
| |
Collapse
|
35
|
Sesti F, Bell R, Mirisola C, Marceca M. 1.3-O6Health policies for tackling inequities in migrant health. What can the United Kingdom and Italy learn from each other? Eur J Public Health 2018. [DOI: 10.1093/eurpub/cky047.021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- F Sesti
- National Institute for Health, Migration and Poverty, Rome, Italy
| | - R Bell
- Institute of Health Equity. Department of Epidemiology & Public Health UCL, London, United Kingdom
| | - C Mirisola
- National Institute for Health, Migration and Poverty, Rome, Italy
| | - M Marceca
- Department of Public Health and Infectious Disease. Sapienza University of Rome, Italy
| |
Collapse
|
36
|
Wilson C, Bell R, Hinsley S, Marshall H, Brown J, Cameron D, Dodwell D, Coleman R. Adjuvant zoledronic acid reduces fractures in breast cancer patients; an AZURE (BIG 01/04) study. Eur J Cancer 2018; 94:70-78. [PMID: 29544162 DOI: 10.1016/j.ejca.2018.02.004] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2017] [Revised: 02/05/2018] [Accepted: 02/07/2018] [Indexed: 11/27/2022]
Abstract
The fracture impact of adjuvant bisphosphonates in breast cancer is not defined with most trials reporting changes in bone mineral density as a surrogate. The AZURE trial (ISRCTN79831382) evaluated the impact of adjuvant zoledronic acid (ZOL) on fractures. The AZURE trial is an academic, multi-centre, randomised phase III study evaluating the addition of ZOL 4 mg to standard therapy (neo/adjuvant chemotherapy and/or endocrine therapy) for 5 years (administered by intravenous (iv) infusion every 3-4 weeks for 6 doses, then 3 monthly × 8 and 6 monthly × 5) in patients with stage II/III early breast cancer. Fracture data collected as part of skeletal-related adverse event reporting were analysed after a median of 84.2 months of follow-up and 966 disease-free survival (DFS) events. We assessed number of fractures, time-to-first fracture and the incidence of fractures before and after disease recurrence. Two hundred forty-four patients reported ≥1 fracture, 140 (8.3%) in the control arm (171 fractures) and 104 (6.2%) in the ZOL arm (120 fractures). Of the 291 fractures reported, 207 fractures occurred in the absence of recurrence (control 111, ZOL 96), 80 after recurrence (control 59, ZOL 21). The 5-year fracture rate was reduced from 5.9% (95%CI 4.8, 7.1%; control) to 3.8% (95%CI 2.9, 4.7%) with ZOL. ZOL significantly increased time-to-first fracture (HR 0.69, 95%CI 0.53-0.90; P = 0.0053) but the majority of fracture prevention benefit occurred after a DFS event (HR 0.3; 95%CI 0.17, 0.53; P < 0.001). Fracture benefits from ZOL were similar across menopausal sub-groups. In conclusion, adjuvant ZOL reduced the risk of clinical fractures, the majority of this protection occurred after disease recurrence.
Collapse
Affiliation(s)
- C Wilson
- Academic Unit of Clinical Oncology, Weston Park Hospital, University of Sheffield, Sheffield, UK.
| | - R Bell
- Deakin University, Geelong, Australia
| | - S Hinsley
- Clinical Trials Research Unit, Leeds, UK
| | - H Marshall
- Clinical Trials Research Unit, Leeds, UK
| | - J Brown
- Academic Unit of Clinical Oncology, Weston Park Hospital, University of Sheffield, Sheffield, UK
| | - D Cameron
- Cancer Research UK Edinburgh Centre, Western General Hospital, University of Edinburgh, UK
| | - D Dodwell
- Institute of Oncology, Bexley Wing, St James Hospital, Leeds, UK
| | - R Coleman
- Academic Unit of Clinical Oncology, Weston Park Hospital, University of Sheffield, Sheffield, UK
| |
Collapse
|
37
|
Adair S, Baus M, Belknap J, Bell R, Boero M, Bussy C, Cardenas F, Casey T, Castro J, Davis W, Erskine M, Farr R, Fischer T, Forbes B, Ford T, Genovese R, Gottschalk R, Hoge M, Honnas C, Hunter G, Joyce J, Kaneps A, Keegan K, Kramer J, Lischer C, Marshall J, Oosterlinck M, Radue P, Redding R, Reed SK, Rick M, Santschi E, Schoonover M, Schramme M, Schumacher J, Stephenson R, Thaler R, Vedding Neilsen J, Wilson DA. Response to Letter to the Editor: Do we have to redefine lameness in the era of quantitative gait analysis. Equine Vet J 2018; 50:415-417. [PMID: 29633362 DOI: 10.1111/evj.12820] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- S Adair
- University of Tennessee, USA
| | - M Baus
- Gran Prix Equine, Connecticut, USA
| | | | - R Bell
- Park Equine Hospital, Kentucky, USA
| | | | | | - F Cardenas
- 3H Equine Hospital and Mobile Veterinary Services, North Carolina, USA
| | - T Casey
- Fourways Equine Clinic, South Africa
| | | | - W Davis
- Palm Beach Equine Clinic, Florida, USA
| | | | - R Farr
- Farr and Pursey Equine Veterinary Services, Hertfordshire, UK
| | - T Fischer
- Chino Valley Equine Hospital, California, USA
| | | | - T Ford
- Ford Veterinary Surgery Center, California, USA
| | | | | | - M Hoge
- Murrieta Equine, California, USA
| | | | - G Hunter
- Ardene House Veterinary Practice, Aberdeen, UK
| | - J Joyce
- Total Equine Veterinary Associates, Virginia, USA
| | - A Kaneps
- Kaneps Equine Sports Medicine and Surgery, Massachusetts, USA
| | | | | | | | | | | | - P Radue
- Damascus Equine Associates, Maryland, USA
| | - R Redding
- North Carolina State University, USA
| | | | - M Rick
- Alamo Pintado Equine Medical Centre, California, USA
| | | | | | | | | | | | - R Thaler
- Metamora Equine PC, Michigan, USA
| | | | | |
Collapse
|
38
|
Murphy HR, Bell R, Dornhorst A, Forde R, Lewis-Barned N. Pregnancy in Diabetes: challenges and opportunities for improving pregnancy outcomes. Diabet Med 2018; 35:292-299. [PMID: 29337383 DOI: 10.1111/dme.13579] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/10/2018] [Indexed: 01/02/2023]
Abstract
Our aim was to review the data from the National Pregnancy in Diabetes (NPID) audit, and to identify the challenges and opportunities for improving pregnancy outcomes in women with diabetes. We reviewed three years of NPID data and relevant diabetes and obstetric literature, and found that there has been little change in pregnancy preparation or outcomes over the past 3 years, with substantial clinic-to clinic variations in care. Women with Type 2 diabetes remain less likely to take 5 mg preconception folic acid (22.8% vs. 41.8%; P < 0.05), and more likely to take potentially harmful medications (statin and/or ACE inhibitor 13.0% vs. 1.8%; P < 0.05) than women with Type 1 diabetes. However, women with Type 1 diabetes are less likely to achieve the recommended glucose control target of HbA1c < 48 mmol/mol (6.5%) (14.9% vs. 38.1%; P < 0.05). The following opportunities for improvement were identified. First, the need to integrate reproductive health into the diabetes care plans of all women with diabetes aged 15-50 years. Second, to develop more innovative approaches to improve uptake of pre-pregnancy care in women with Type 2 diabetes in primary care settings. Third, to integrate insulin pump, continuous glucose monitoring and automated insulin delivery technologies into the pre-pregnancy and antenatal care of women with Type 1 diabetes. Fourth, to improve postnatal care with personalized approaches targeting women with previous pregnancy loss, congenital anomaly and perinatal mortality. A nationwide commitment to delivering integrated reproductive and diabetes healthcare interventions is needed to improve the health outcomes of women with diabetes.
Collapse
Affiliation(s)
- H R Murphy
- Norwich Medical School, University of East Anglia, Norwich
- Division of Women's & Children's Health, Kings College London
| | - R Bell
- Institute of Health and Society, Newcastle University, Newcastle upon Tyne
| | - A Dornhorst
- Department of Medicine, Imperial College London
| | - R Forde
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London
| | - N Lewis-Barned
- Northumbria Diabetes and Endocrinology Service, Wansbeck Hospital, Ashington, UK
| |
Collapse
|
39
|
Kent F, Ambler G, Bosanquet D, Twine C, Bell R, Bicknell C, Coughlin P, Hayes P, Jenkins M, Lewis D, Vallabhaneni R, Zayed H. The Safety of Device Registries for Endovascular Abdominal Aortic Aneurysm Repair: Systematic Review and Meta-regression. J Vasc Surg 2018. [DOI: 10.1016/j.jvs.2018.01.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
40
|
Ellis J, Bell R, Barnes DC, Miller R. Prevalence and disease associations in feline thrombocytopenia: a retrospective study of 194 cases. J Small Anim Pract 2018; 59:531-538. [PMID: 29355998 DOI: 10.1111/jsap.12814] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2017] [Revised: 11/27/2017] [Accepted: 12/22/2017] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To assess the prevalence of thrombocytopenia in a referral population of cats in the UK, to identify disease processes associated with thrombocytopenia and to assess the proportion of thrombocytopenic cats that tested positive for feline leukaemia virus or feline immunodeficiency virus. MATERIALS AND METHODS Retrospective analysis of medical records at a UK referral hospital. Cats were grouped by mechanism of thrombocytopenia and disease process (where known). RESULTS Prevalence of thrombocytopenia was 5·9%. The most common disease processes associated with thrombocytopenia were haematological or infectious disease and neoplasia; 11% of thrombocytopenic cats tested were positive for feline leukaemia virus, which is lower than reported previously. Cats presenting with unexplained haemorrhage had significantly lower platelet counts than other thrombocytopenic cats. Primary immune-mediated thrombocytopenia was less commonly diagnosed than in dogs and associated with the most severe platelet depletion in this study. CLINICAL SIGNIFICANCE Thrombocytopenia in cats may be more prevalent than previously reported and severe thrombocytopenia may be associated with spontaneous haemorrhage. Severe thrombocytopenia in cats appears less commonly immune-mediated than in dogs. Thrombocytopenia did not appear to be associated with retroviral infections.
Collapse
Affiliation(s)
- J Ellis
- Department of Internal Medicine, Dick White Referrals, Cambridgeshire CB8 0UH, UK
| | - R Bell
- Department of Internal Medicine, Wear Referrals, Stockton-on-Tees TS21 2ES, UK
| | - D C Barnes
- Department of Internal Medicine, Dick White Referrals, Cambridgeshire CB8 0UH, UK
| | - R Miller
- Department of Internal Medicine, Dick White Referrals, Cambridgeshire CB8 0UH, UK
| |
Collapse
|
41
|
Hawryluk R, Barnes CW, Batha S, Beer M, Bell M, Bell R, Berk H, Bitter M, Bretz N, Budny R, Bush C, Cauffman S, Chang CS, Chang Z, Cheng C, Darrow D, Dendy R, Dorland W, Dudek L, Duong H, Durst R, Efthimion P, Evenson H, Fisch N, Fisher R, Fonck R, Forrest C, Fredrickson E, Fu G, Furth H, Gorelenkov N, Grek B, Grisham L, Hammett G, Heidbrink W, Herrmann H, Herrmann M, Hill K, Hooper B, Hosea J, Houlberg W, Hughes M, Jassby D, Jobes F, Johnson D, Kaita R, Kamperschroer J, Kesner J, Krazilniknov A, Kugel H, Kumar A, LaMarche P, LeBlanc B, Levine J, Levinton F, Lin Z, Machuzak J, Majeski R, Mansfield D, Mazzucato E, Mauel M, McChesney J, McGuire K, McKee G, Meade D, Medley S, Mikkelsen D, Mimov S, Mueller D, Navratil G, Nazikian R, Nevins B, Okabayashi M, Osakabe M, Owens D, Park H, Park W, Paul S, Petrov M, Phillips C, Phillips M, Phillips P, Ramsey A, Redi M, Rewoldt G, Rice B, Rogers J, Roquemore A, Ruskov E, Sabbagh S, Sasao M, Schilling G, Schmidt G, Scott S, Semenov I, Skinner C, Spong D, Strachan J, Strait E, Stratton B, Synakowski E, Takahashi H, Tang W, Taylor G, Goeler SV, Halle AV, White R, Williams M, Wilson J, Wong K, Wurden G, Young K, Zarnstorff M, Zweben S. Review of D-T Results from TFTR. ACTA ACUST UNITED AC 2018. [DOI: 10.13182/fst96-a11963011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
|
42
|
Yossa N, Arce G, Smiley J, Jo Huang MC, Yin L, Bell R, Tallent S, Brown E, Hammack T. Survival and detection ofBacillus cereusin the presence ofEscherichia coli,Salmonella enteritidis, Staphylococcus aureus, Pseudomonas aeruginosaandCandida albicansafter rechallenge in make-up removers. Int J Cosmet Sci 2017; 40:67-74. [DOI: 10.1111/ics.12434] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2017] [Accepted: 10/06/2017] [Indexed: 02/06/2023]
Affiliation(s)
- N. Yossa
- Oak Ridge Institute for Science and Education; Oak Ridge 1299 Bethel Valley Rd Oak Ridge TN 37830 USA
- U.S. Food and Drug Administration; Office of Regulatory Science; 5001 Campus Dr College Park MD 20740 USA
| | - G. Arce
- Oak Ridge Institute for Science and Education; Oak Ridge 1299 Bethel Valley Rd Oak Ridge TN 37830 USA
- U.S. Food and Drug Administration; Office of Regulatory Science; 5001 Campus Dr College Park MD 20740 USA
| | - J. Smiley
- Oak Ridge Institute for Science and Education; Oak Ridge 1299 Bethel Valley Rd Oak Ridge TN 37830 USA
- U.S. Food and Drug Administration; Office of Regulatory Science; 5001 Campus Dr College Park MD 20740 USA
| | - M.-C. Jo Huang
- U.S. Food and Drug Administration; Office of Cosmetics and Colors; 5001 Campus Dr College Park MD 20740 USA
| | - L. Yin
- U.S. Food and Drug Administration; Office of Analytics and Outreach; 5001 Campus Dr College Park MD 20740 USA
| | - R. Bell
- U.S. Food and Drug Administration; Office of Regulatory Science; 5001 Campus Dr College Park MD 20740 USA
| | - S. Tallent
- U.S. Food and Drug Administration; Office of Regulatory Science; 5001 Campus Dr College Park MD 20740 USA
| | - E. Brown
- U.S. Food and Drug Administration; Office of Regulatory Science; 5001 Campus Dr College Park MD 20740 USA
| | - T. Hammack
- U.S. Food and Drug Administration; Office of Regulatory Science; 5001 Campus Dr College Park MD 20740 USA
| |
Collapse
|
43
|
Staatsen B, van der NVL, Kruize HI, Stegeman I, Morris G, Bell R. Inter-sectoral opportunities for protecting the environment, promote health and health equity. Eur J Public Health 2017. [DOI: 10.1093/eurpub/ckx189.115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
| | | | | | | | - G Morris
- University of Exeter, Exeter, UK
| | | |
Collapse
|
44
|
Hawryluk RJ, Mueller D, Hosea J, Barnes CW, Beer M, Bell MG, Bell R, Biglari H, Bitter M, Boivin R, Bretz NL, Budny R, Bush CE, Chen L, Cheng CZ, Cowley S, Dairow DS, Efthimion PC, Fonck RJ, Fredrickson E, Furth HP, Greene G, Grek B, Grisham LR, Hammett G, Heidbrink W, Hill KW, Hoffman D, Hulse RA, Hsuan H, Janos A, Jassby DL, Jobes FC, Johnson DW, Johnson LC, Kamperschroer J, Kesner J, Phillips CK, Kilpatrick SJ, Kugel H, LaMarche PH, LeBlanc B, Manos DM, Mansfield DK, Marmar ES, Mazzucato E, McCarthy MP, Machuzak J, Mauel M, McCune D, McGuire KM, Medley SS, Monticello DR, Mikkelsen D, Nagayama Y, Navratil GA, Nazikian R, Owens DK, Park H, Park W, Paul S, Perkins F, Pitcher S, Rasmussen D, Redi MH, Rewoldt G, Roberts D, Roquemore AL, Sabbagh S, Schilling G, Schivell J, Schmidt GL, Scott SD, Snipes J, Stevens J, Stratton BC, Strachan JD, Stodiek W, Synakowski E, Tang W, Taylor G, Terry J, Timberlake JR, Ulrickson HH, Towner M, von Goeler S, Wieland R, Wilson JR, Wong KL, Woskov P, Yamada M, Young KM, Zamstorff MC, Zweben SJ. Status and Plans for TFTR. ACTA ACUST UNITED AC 2017. [DOI: 10.13182/fst92-a29907] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- R. J. Hawryluk
- Plasma Physics Laboratory, Princeton University P.O. Box 451 Princeton, N.J. 08543 USA (609) 243-3306
| | - D. Mueller
- Plasma Physics Laboratory, Princeton University P.O. Box 451 Princeton, N.J. 08543 USA (609) 243-3306
| | - J. Hosea
- Plasma Physics Laboratory, Princeton University P.O. Box 451 Princeton, N.J. 08543 USA (609) 243-3306
| | | | - M. Beer
- Plasma Physics Laboratory, Princeton University P.O. Box 451 Princeton, N.J. 08543 USA (609) 243-3306
| | - M. G. Bell
- Plasma Physics Laboratory, Princeton University P.O. Box 451 Princeton, N.J. 08543 USA (609) 243-3306
| | - R. Bell
- Plasma Physics Laboratory, Princeton University P.O. Box 451 Princeton, N.J. 08543 USA (609) 243-3306
| | - H. Biglari
- Plasma Physics Laboratory, Princeton University P.O. Box 451 Princeton, N.J. 08543 USA (609) 243-3306
| | - M. Bitter
- Plasma Physics Laboratory, Princeton University P.O. Box 451 Princeton, N.J. 08543 USA (609) 243-3306
| | - R. Boivin
- Massachusetts Institute of Technology, Cambridge, MA
| | - N. L. Bretz
- Plasma Physics Laboratory, Princeton University P.O. Box 451 Princeton, N.J. 08543 USA (609) 243-3306
| | - R. Budny
- Plasma Physics Laboratory, Princeton University P.O. Box 451 Princeton, N.J. 08543 USA (609) 243-3306
| | - C. E. Bush
- Oak Ridge National Laboratory, Oak Ridge, TN
| | - L. Chen
- Plasma Physics Laboratory, Princeton University P.O. Box 451 Princeton, N.J. 08543 USA (609) 243-3306
| | - C. Z. Cheng
- Plasma Physics Laboratory, Princeton University P.O. Box 451 Princeton, N.J. 08543 USA (609) 243-3306
| | - S. Cowley
- Plasma Physics Laboratory, Princeton University P.O. Box 451 Princeton, N.J. 08543 USA (609) 243-3306
| | - D. S. Dairow
- Plasma Physics Laboratory, Princeton University P.O. Box 451 Princeton, N.J. 08543 USA (609) 243-3306
| | - P. C. Efthimion
- Plasma Physics Laboratory, Princeton University P.O. Box 451 Princeton, N.J. 08543 USA (609) 243-3306
| | | | - E. Fredrickson
- Plasma Physics Laboratory, Princeton University P.O. Box 451 Princeton, N.J. 08543 USA (609) 243-3306
| | - H. P. Furth
- Plasma Physics Laboratory, Princeton University P.O. Box 451 Princeton, N.J. 08543 USA (609) 243-3306
| | - G. Greene
- Plasma Physics Laboratory, Princeton University P.O. Box 451 Princeton, N.J. 08543 USA (609) 243-3306
| | - B. Grek
- Plasma Physics Laboratory, Princeton University P.O. Box 451 Princeton, N.J. 08543 USA (609) 243-3306
| | - L. R. Grisham
- Plasma Physics Laboratory, Princeton University P.O. Box 451 Princeton, N.J. 08543 USA (609) 243-3306
| | - G. Hammett
- Plasma Physics Laboratory, Princeton University P.O. Box 451 Princeton, N.J. 08543 USA (609) 243-3306
| | | | - K. W. Hill
- Plasma Physics Laboratory, Princeton University P.O. Box 451 Princeton, N.J. 08543 USA (609) 243-3306
| | - D. Hoffman
- Oak Ridge National Laboratory, Oak Ridge, TN
| | - R. A. Hulse
- Plasma Physics Laboratory, Princeton University P.O. Box 451 Princeton, N.J. 08543 USA (609) 243-3306
| | - H. Hsuan
- Plasma Physics Laboratory, Princeton University P.O. Box 451 Princeton, N.J. 08543 USA (609) 243-3306
| | - A. Janos
- Plasma Physics Laboratory, Princeton University P.O. Box 451 Princeton, N.J. 08543 USA (609) 243-3306
| | - D. L. Jassby
- Plasma Physics Laboratory, Princeton University P.O. Box 451 Princeton, N.J. 08543 USA (609) 243-3306
| | - F. C. Jobes
- Plasma Physics Laboratory, Princeton University P.O. Box 451 Princeton, N.J. 08543 USA (609) 243-3306
| | - D. W. Johnson
- Plasma Physics Laboratory, Princeton University P.O. Box 451 Princeton, N.J. 08543 USA (609) 243-3306
| | - L. C. Johnson
- Plasma Physics Laboratory, Princeton University P.O. Box 451 Princeton, N.J. 08543 USA (609) 243-3306
| | - J. Kamperschroer
- Plasma Physics Laboratory, Princeton University P.O. Box 451 Princeton, N.J. 08543 USA (609) 243-3306
| | - J. Kesner
- Massachusetts Institute of Technology, Cambridge, MA
| | - C. K. Phillips
- Plasma Physics Laboratory, Princeton University P.O. Box 451 Princeton, N.J. 08543 USA (609) 243-3306
| | - S. J. Kilpatrick
- Plasma Physics Laboratory, Princeton University P.O. Box 451 Princeton, N.J. 08543 USA (609) 243-3306
| | - H. Kugel
- Plasma Physics Laboratory, Princeton University P.O. Box 451 Princeton, N.J. 08543 USA (609) 243-3306
| | - P. H. LaMarche
- Plasma Physics Laboratory, Princeton University P.O. Box 451 Princeton, N.J. 08543 USA (609) 243-3306
| | - B. LeBlanc
- Plasma Physics Laboratory, Princeton University P.O. Box 451 Princeton, N.J. 08543 USA (609) 243-3306
| | - D. M. Manos
- Plasma Physics Laboratory, Princeton University P.O. Box 451 Princeton, N.J. 08543 USA (609) 243-3306
| | - D. K. Mansfield
- Plasma Physics Laboratory, Princeton University P.O. Box 451 Princeton, N.J. 08543 USA (609) 243-3306
| | - E. S. Marmar
- Massachusetts Institute of Technology, Cambridge, MA
| | - E. Mazzucato
- Plasma Physics Laboratory, Princeton University P.O. Box 451 Princeton, N.J. 08543 USA (609) 243-3306
| | - M. P. McCarthy
- Plasma Physics Laboratory, Princeton University P.O. Box 451 Princeton, N.J. 08543 USA (609) 243-3306
| | - J. Machuzak
- Massachusetts Institute of Technology, Cambridge, MA
| | - M. Mauel
- Columbia University, New York, NY
| | - D.C. McCune
- Plasma Physics Laboratory, Princeton University P.O. Box 451 Princeton, N.J. 08543 USA (609) 243-3306
| | - K. M. McGuire
- Plasma Physics Laboratory, Princeton University P.O. Box 451 Princeton, N.J. 08543 USA (609) 243-3306
| | - S. S. Medley
- Plasma Physics Laboratory, Princeton University P.O. Box 451 Princeton, N.J. 08543 USA (609) 243-3306
| | - D. R. Monticello
- Plasma Physics Laboratory, Princeton University P.O. Box 451 Princeton, N.J. 08543 USA (609) 243-3306
| | - D. Mikkelsen
- Plasma Physics Laboratory, Princeton University P.O. Box 451 Princeton, N.J. 08543 USA (609) 243-3306
| | | | | | - R. Nazikian
- Plasma Physics Laboratory, Princeton University P.O. Box 451 Princeton, N.J. 08543 USA (609) 243-3306
| | - D. K. Owens
- Plasma Physics Laboratory, Princeton University P.O. Box 451 Princeton, N.J. 08543 USA (609) 243-3306
| | - H. Park
- Plasma Physics Laboratory, Princeton University P.O. Box 451 Princeton, N.J. 08543 USA (609) 243-3306
| | - W. Park
- Plasma Physics Laboratory, Princeton University P.O. Box 451 Princeton, N.J. 08543 USA (609) 243-3306
| | - S. Paul
- Plasma Physics Laboratory, Princeton University P.O. Box 451 Princeton, N.J. 08543 USA (609) 243-3306
| | - F. Perkins
- Plasma Physics Laboratory, Princeton University P.O. Box 451 Princeton, N.J. 08543 USA (609) 243-3306
| | - S. Pitcher
- Canadian Fusion Fuels Technology Project, Toronto, Canada
| | | | - M. H. Redi
- Plasma Physics Laboratory, Princeton University P.O. Box 451 Princeton, N.J. 08543 USA (609) 243-3306
| | - G. Rewoldt
- Plasma Physics Laboratory, Princeton University P.O. Box 451 Princeton, N.J. 08543 USA (609) 243-3306
| | | | - A. L. Roquemore
- Plasma Physics Laboratory, Princeton University P.O. Box 451 Princeton, N.J. 08543 USA (609) 243-3306
| | | | - G. Schilling
- Plasma Physics Laboratory, Princeton University P.O. Box 451 Princeton, N.J. 08543 USA (609) 243-3306
| | - J. Schivell
- Plasma Physics Laboratory, Princeton University P.O. Box 451 Princeton, N.J. 08543 USA (609) 243-3306
| | - G. L. Schmidt
- Plasma Physics Laboratory, Princeton University P.O. Box 451 Princeton, N.J. 08543 USA (609) 243-3306
| | - S. D. Scott
- Plasma Physics Laboratory, Princeton University P.O. Box 451 Princeton, N.J. 08543 USA (609) 243-3306
| | - J. Snipes
- Massachusetts Institute of Technology, Cambridge, MA
| | - J. Stevens
- Plasma Physics Laboratory, Princeton University P.O. Box 451 Princeton, N.J. 08543 USA (609) 243-3306
| | - B. C. Stratton
- Plasma Physics Laboratory, Princeton University P.O. Box 451 Princeton, N.J. 08543 USA (609) 243-3306
| | - J. D. Strachan
- Plasma Physics Laboratory, Princeton University P.O. Box 451 Princeton, N.J. 08543 USA (609) 243-3306
| | - W. Stodiek
- Plasma Physics Laboratory, Princeton University P.O. Box 451 Princeton, N.J. 08543 USA (609) 243-3306
| | - E. Synakowski
- Plasma Physics Laboratory, Princeton University P.O. Box 451 Princeton, N.J. 08543 USA (609) 243-3306
| | - W. Tang
- Plasma Physics Laboratory, Princeton University P.O. Box 451 Princeton, N.J. 08543 USA (609) 243-3306
| | - G. Taylor
- Plasma Physics Laboratory, Princeton University P.O. Box 451 Princeton, N.J. 08543 USA (609) 243-3306
| | - J. Terry
- Massachusetts Institute of Technology, Cambridge, MA
| | - J. R. Timberlake
- Plasma Physics Laboratory, Princeton University P.O. Box 451 Princeton, N.J. 08543 USA (609) 243-3306
| | - H. H. Ulrickson
- Plasma Physics Laboratory, Princeton University P.O. Box 451 Princeton, N.J. 08543 USA (609) 243-3306
| | - M. Towner
- Plasma Physics Laboratory, Princeton University P.O. Box 451 Princeton, N.J. 08543 USA (609) 243-3306
| | - S. von Goeler
- Plasma Physics Laboratory, Princeton University P.O. Box 451 Princeton, N.J. 08543 USA (609) 243-3306
| | - R. Wieland
- Plasma Physics Laboratory, Princeton University P.O. Box 451 Princeton, N.J. 08543 USA (609) 243-3306
| | - J. R. Wilson
- Plasma Physics Laboratory, Princeton University P.O. Box 451 Princeton, N.J. 08543 USA (609) 243-3306
| | - K. L. Wong
- Plasma Physics Laboratory, Princeton University P.O. Box 451 Princeton, N.J. 08543 USA (609) 243-3306
| | - P. Woskov
- Massachusetts Institute of Technology, Cambridge, MA
| | - M. Yamada
- Plasma Physics Laboratory, Princeton University P.O. Box 451 Princeton, N.J. 08543 USA (609) 243-3306
| | - K. M. Young
- Plasma Physics Laboratory, Princeton University P.O. Box 451 Princeton, N.J. 08543 USA (609) 243-3306
| | - M. C. Zamstorff
- Plasma Physics Laboratory, Princeton University P.O. Box 451 Princeton, N.J. 08543 USA (609) 243-3306
| | - S. J. Zweben
- Plasma Physics Laboratory, Princeton University P.O. Box 451 Princeton, N.J. 08543 USA (609) 243-3306
| |
Collapse
|
45
|
Huxford KE, Dart AJ, Perkins NR, Bell R, Jeffcott LB. A pilot study comparing the effect of orally administered esomeprazole and omeprazole on gastric fluid pH in horses. N Z Vet J 2017; 65:318-321. [PMID: 28738738 DOI: 10.1080/00480169.2017.1359125] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
AIMS To compare the efficacy of an enteric coated esomeprazole paste with an enteric coated omeprazole paste to increase gastric pH after oral administration in horses. METHODS Nine adult Standardbred horses were randomly assigned to three groups, each containing three horses, for a study comprising three phases of 10 days, with an 18-day washout period between each phase. In each phase, three horses received either 0.5 mg/kg esomeprazole, 1 mg/kg omeprazole or a placebo, as an oral paste, once daily for 10 days (Days 0-9). Over the course of study all horses received all three treatments. Gastric fluid samples were collected using a gastroscope on Days 1, 3, 5, 8 and 10, with food and water withheld for 16 hours prior to collection of samples. The pH of all samples was measured immediately after collection. RESULTS Mean pH (3.38; SD 1.75) of the gastric fluid samples in the horses that received the placebo was lower than in the horses that received esomeprazole (6.28; SD 1.75) or omeprazole (6.13; SD 1.75) (p<0.001). There was no difference in the mean pH between horses receiving esomeprazole and those receiving omeprazole (p=0.56). CONCLUSIONS AND CLINICAL RELEVANCE Under these study conditions, esomeprazole paste was equally as effective as omeprazole paste in increasing gastric pH in horses. Enteric coated esomeprazole, may be a therapeutic alternative to omeprazole for the prevention of gastric ulcers in horses.
Collapse
Affiliation(s)
- K E Huxford
- a University Veterinary Teaching Hospital Camden , University of Sydney , Camden , NSW 2567 , Australia
| | - A J Dart
- a University Veterinary Teaching Hospital Camden , University of Sydney , Camden , NSW 2567 , Australia
| | - N R Perkins
- b School of Veterinary Science , University of Queensland , Gatton , QLD 4343 , Australia
| | - R Bell
- a University Veterinary Teaching Hospital Camden , University of Sydney , Camden , NSW 2567 , Australia
| | - L B Jeffcott
- a University Veterinary Teaching Hospital Camden , University of Sydney , Camden , NSW 2567 , Australia
| |
Collapse
|
46
|
Canham S, Battersby L, Wada M, Fang M, Bell R, Sixsmith A. COMMUNITY MAPPING WORKSHOPS TO IDENTIFY SENIOR-SPECIFIC HOUSING FIRST RESOURCES. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.3948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- S.L. Canham
- Gerontology Research Centre, Simon Fraser University, Vancouver, British Columbia, Canada,
| | - L. Battersby
- Gerontology Research Centre, Simon Fraser University, Vancouver, British Columbia, Canada,
| | - M. Wada
- Gerontology Research Centre, Simon Fraser University, Vancouver, British Columbia, Canada,
| | - M. Fang
- STAR Institute, Simon Fraser University, Vancouver, British Columbia, Canada,
| | - R. Bell
- Greater Vancouver Shelter Strategy, Vancouver, British Columbia, Canada
| | - A. Sixsmith
- STAR Institute, Simon Fraser University, Vancouver, British Columbia, Canada,
| |
Collapse
|
47
|
Partridge J, Harari D, Martin F, Peacock J, Bell R, Mohammed A. Randomized Clinical Trial of Comprehensive Geriatric Assessment and Optimization in Vascular Surgery. J Vasc Surg 2017. [DOI: 10.1016/j.jvs.2017.04.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
|
48
|
Bell R, Brown J, Parmar M, Toi M, Suter T, Steger GG, Pivot X, Mackey J, Jackisch C, Dent R, Hall P, Xu N, Morales L, Provencher L, Hegg R, Vanlemmens L, Kirsch A, Schneeweiss A, Masuda N, Overkamp F, Cameron D. Final efficacy and updated safety results of the randomized phase III BEATRICE trial evaluating adjuvant bevacizumab-containing therapy in triple-negative early breast cancer. Ann Oncol 2017; 28:754-760. [PMID: 27993816 DOI: 10.1093/annonc/mdw665] [Citation(s) in RCA: 68] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background The purpose of this analysis was to assess the long-term impact of adding bevacizumab to adjuvant chemotherapy for early triple-negative breast cancer (TNBC). Methods Patients eligible for the open-label randomized phase III BEATRICE trial had centrally confirmed triple-negative operable primary invasive breast cancer (pT1a-pT3). Investigators selected anthracycline- and/or taxane-based chemotherapy for each patient. After definitive surgery, patients were randomized 1:1 to receive ≥4 cycles of chemotherapy alone or with 1 year of bevacizumab (5 mg/kg/week equivalent). Stratification factors were nodal status, selected chemotherapy, hormone receptor status, and type of surgery. The primary end point was invasive disease-free survival (IDFS; previously reported). Secondary outcome measures included overall survival (OS) and safety. Results After 56 months' median follow-up, 293 of 2591 randomized patients had died. There was no statistically significant difference in OS between treatment arms in either the total population (hazard ratio 0.93, 95% confidence interval [CI] 0.74-1.17; P = 0.52) or pre-specified subgroups. The 5-year OS rate was 88% (95% CI 86-90%) in both treatment arms. Updated IDFS results were consistent with the primary IDFS analysis. Five-year IDFS rates were 77% (95% CI 75-79%) with chemotherapy alone versus 80% (95% CI 77-82%) with bevacizumab. From 18 months after first study dose to study end, new grade ≥3 adverse events occurred in 4.6% and 4.5% of patients in the two arms, respectively. Conclusion Final OS results showed no significant benefit from bevacizumab therapy for early TNBC. Late-onset toxicities were rare in both groups. Five-year OS and IDFS rates suggest that the prognosis for patients with TNBC is better than previously thought. ClinicalTrials.gov NCT00528567.
Collapse
Affiliation(s)
- R Bell
- Faculty of Medicine, Deakin University, Geelong, Australia
| | - J Brown
- Clinical Trials Research Unit, University of Leeds, Leeds
| | - M Parmar
- Medical Research Council Clinical Trials Unit, London, UK
| | - M Toi
- Faculty of Medicine, Kyoto University, Kyoto, Japan
| | - T Suter
- Swiss Cardiovascular Center, Bern University Hospital, Bern, Switzerland
| | - G G Steger
- Department of Internal Medicine I, Division of Oncology, Medical University of Vienna, Vienna, Austria
| | - X Pivot
- Medical Oncology Service, University Hospital Jean Minjoz, Besançon, France
| | - J Mackey
- Medical Oncology, Cross Center Institute, Edmonton, Canada
| | - C Jackisch
- Department of Obstetrics and Gynecology and Breast Cancer Center, Sana Klinikum Offenbach, Offenbach, Germany
| | - R Dent
- Department of Medical Oncology, National Cancer Center, Singapore, Singapore, and Sunnybrook Health Sciences Center, University of Toronto, Toronto, Canada
| | - P Hall
- Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
| | - N Xu
- Product Development Oncology, F Hoffmann-La Roche Ltd, Basel, Switzerland
| | - L Morales
- Product Development Oncology, F Hoffmann-La Roche Ltd, Basel, Switzerland
| | - L Provencher
- Centre des Maladies du Sein Deschênes-Fabia, CHU de Québec-Hôpital du Saint-Sacrement, Ville de Québec, Québec, Canada
| | - R Hegg
- Oncology Department, Perola Byington Hospital/FMUSP, São Paulo, Brazil
| | - L Vanlemmens
- Department of Medical Oncology, Centre Oscar Lambret, Lille, France
| | - A Kirsch
- Onkologischer Schwerpunktam Oskar-Helene-Heim, Berlin, Germany
| | - A Schneeweiss
- Division of Gynecologic Oncology, National Center for Tumor Diseases, University Hospital, Heidelberg, Germany
| | - N Masuda
- Department of Surgery, Breast Oncology NHO Osaka National Hospital, Osaka, Japan
| | | | - D Cameron
- Edinburgh University Cancer Research Centre, University of Edinburgh and Cancer Services, NHS Lothian, Edinburgh, UK
| |
Collapse
|
49
|
Peng YKM, Neumeyer CA, Fogarty PJ, Kessel C, Strickler DJ, Rutherford P, Mikkelsen D, Burgess TW, Sabbagh S, Menard J, Gates D, Bell R, LeBlanc B, Mitarai O, Schmidt J, Synakowski E, Tsai J, Grisham L, Nelson BE, Cheng ET, El-Guebaly L. Fusion Engineering and Plasma Science Conditions of Spherical Torus Component Test Facility. Fusion Science and Technology 2017. [DOI: 10.13182/fst05-a718] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- Y.-K. M. Peng
- Oak Ridge National Laboratory – UT Battelle, P.O. Box 2009, Oak Ridge, Tennessee 37831
- on assignment at Princeton Plasma Physics Laboratory
| | - C. A. Neumeyer
- Princeton Plasma Physics Laboratory, P.O. Box 451, Princeton, New Jersey 08543
| | - P. J. Fogarty
- Oak Ridge National Laboratory – UT Battelle, P.O. Box 2009, Oak Ridge, Tennessee 37831
| | - C. Kessel
- Princeton Plasma Physics Laboratory, P.O. Box 451, Princeton, New Jersey 08543
| | - D. J. Strickler
- Oak Ridge National Laboratory – UT Battelle, P.O. Box 2009, Oak Ridge, Tennessee 37831
| | - P. Rutherford
- Princeton Plasma Physics Laboratory, P.O. Box 451, Princeton, New Jersey 08543
| | - D. Mikkelsen
- Princeton Plasma Physics Laboratory, P.O. Box 451, Princeton, New Jersey 08543
| | - T. W. Burgess
- Oak Ridge National Laboratory – UT Battelle, P.O. Box 2009, Oak Ridge, Tennessee 37831
| | - S Sabbagh
- Columbia University, New York, New York
- on assignment at Princeton Plasma Physics Laboratory
| | - J. Menard
- Princeton Plasma Physics Laboratory, P.O. Box 451, Princeton, New Jersey 08543
| | - D Gates
- Princeton Plasma Physics Laboratory, P.O. Box 451, Princeton, New Jersey 08543
| | - R Bell
- Princeton Plasma Physics Laboratory, P.O. Box 451, Princeton, New Jersey 08543
| | - B LeBlanc
- Princeton Plasma Physics Laboratory, P.O. Box 451, Princeton, New Jersey 08543
| | - O. Mitarai
- Kyushu Tokai University, Kumamoto, Japan
| | - J. Schmidt
- Princeton Plasma Physics Laboratory, P.O. Box 451, Princeton, New Jersey 08543
| | - E. Synakowski
- Princeton Plasma Physics Laboratory, P.O. Box 451, Princeton, New Jersey 08543
| | - J. Tsai
- Oak Ridge National Laboratory – UT Battelle, P.O. Box 2009, Oak Ridge, Tennessee 37831
| | - L. Grisham
- Princeton Plasma Physics Laboratory, P.O. Box 451, Princeton, New Jersey 08543
| | - B. E. Nelson
- Oak Ridge National Laboratory – UT Battelle, P.O. Box 2009, Oak Ridge, Tennessee 37831
| | - E. T. Cheng
- TSI Research, Solano Beach, California 92075
| | | |
Collapse
|
50
|
Kaita R, Lucia M, Allain J, Bedoya F, Bell R, Boyle D, Capece A, Jaworski M, Koel B, Majeski R, Roszell J, Schmitt J, Scotti F, Skinner C, Soukhanovskii V. Hydrogen retention in lithium on metallic walls from “in vacuo” analysis in LTX and implications for high-Z plasma-facing components in NSTX-U. Fusion Engineering and Design 2017. [DOI: 10.1016/j.fusengdes.2016.06.056] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|