1
|
Brookes W, Payne R, Lea R. Reporting outcome measures in veterinary physiotherapy with particular reference to the treatment of canine and equine joint cases in the UK. Vet Rec 2024; 194:e3900. [PMID: 38469651 DOI: 10.1002/vetr.3900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Revised: 12/09/2023] [Accepted: 01/12/2024] [Indexed: 03/13/2024]
Abstract
BACKGROUND Outcome measures are extensively used within human physiotherapy, but a widely accepted issue in veterinary physiotherapy is that outcome measures lack sufficient evaluation and standardisation in terms of how they are implemented. This cross-sectional study aimed to provide clarity on (1) the current selection of outcome measures in canine and equine physiotherapy and (2) investigate external influences on outcome measure selection, including comparative literature availability, professional memberships and background. METHODS A structured scoping literature review consolidated current understanding and limitations. This informed a survey of qualified veterinary physiotherapists (n = 40). The statistical analysis comprised descriptive statistics. RESULTS Key observations included (1) a lack of difference in outcome measure application between veterinary physiotherapists with and without a human physiotherapy background, (2) enhanced outcome measure utilisation by registry body members and (3) an overall skew towards subjective, rather than objective, outcome measure use. LIMITATIONS The study was limited by the absence of a defined veterinary physiotherapist population and subsequent convenience sample size. CONCLUSION The apparent skew towards subjective outcome measures highlights objective outcome measure underutilisation and the need for a more extensive evidence base. In conclusion, there is a need to develop comprehensive professional development resources promoting the use of repeatable outcome measures such as goniometers and the Liverpool osteoarthritis scoring.
Collapse
Affiliation(s)
- William Brookes
- School of Veterinary Medicine and Science, University of Nottingham, Sutton Bonington, UK
| | - Richard Payne
- School of Veterinary Medicine and Science, University of Nottingham, Sutton Bonington, UK
| | - Richard Lea
- School of Veterinary Medicine and Science, University of Nottingham, Sutton Bonington, UK
| |
Collapse
|
2
|
Moxon R, Freeman SL, Payne R, Corr S, England GCW. Effect of neutering timing in relation to puberty on female dog behaviour-A scoping review. Vet Rec 2023; 193:e2882. [PMID: 37024260 DOI: 10.1002/vetr.2882] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Revised: 10/28/2022] [Accepted: 03/13/2023] [Indexed: 04/08/2023]
Abstract
BACKGROUND There are contradictory findings in the literature relating to the effects of timing of neutering on bitch behaviour that make decision making regarding neutering timing difficult. METHODS A scoping review was designed to identify and chart the evidence on the effect of neutering timing in relation to puberty on the behaviour of female domesticated dogs. A protocol was registered, and literature searches were conducted in CAB Abstracts, Medline and Web of Science. Studies were reviewed against the inclusion criteria. Data on study and population characteristics and behavioural outcomes were extracted for the final included studies. RESULTS A total of 1048 publications were reviewed; 13 were retained for inclusion and charting. Only one of the two studies that classified bitches as pre- or postpubertal presented results for the analysis of behaviours. The remaining 11 studies classified bitches by age at neutering. LIMITATIONS Since the scoping review searches were conducted, further relevant studies may have become available. The search strategy may not have identified all available literature; however, databases were used that provide high levels of coverage of veterinary literature. CONCLUSION This scoping review identified a lack of evidence to document the impact of neutering bitches before or after puberty on behaviour.
Collapse
Affiliation(s)
- Rachel Moxon
- Department of Canine Science, Guide Dogs National Centre, Warwickshire, UK
- School of Veterinary Medicine and Science, University of Nottingham, Leicestershire, UK
| | - Sarah L Freeman
- School of Veterinary Medicine and Science, University of Nottingham, Leicestershire, UK
| | - Richard Payne
- School of Veterinary Medicine and Science, University of Nottingham, Leicestershire, UK
| | - Sandra Corr
- School of Biodiversity, One Health and Veterinary Medicine, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - Gary C W England
- School of Veterinary Medicine and Science, University of Nottingham, Leicestershire, UK
| |
Collapse
|
3
|
Ricketts S, Digby NW, Greet T, Carson D, Pilsworth R, Steven N, McGladdery A, Barrelet A, Shepherd M, Ramzan P, Payne R, Bathe A, Cameron I, Pynn O, Dallas R, Foote A. Michael David Nicholas Hunt. Vet Rec 2023; 192:454. [PMID: 37265313 DOI: 10.1002/vetr.3149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
A dedicated and highly gifted equine clinician who helped found a remarkably successful practice.
Collapse
|
4
|
Alam F, Badminton R, Tsvetkov F, Hanif Z, Payne R. Safe insertion of Veress needle for the induction of pneumoperitoneum: a technical note. J Surg Case Rep 2023; 2023:rjad311. [PMID: 37274630 PMCID: PMC10234602 DOI: 10.1093/jscr/rjad311] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Accepted: 04/30/2023] [Indexed: 06/06/2023] Open
Abstract
Techniques for the induction of pneumoperitoneum for laparoscopic surgery remain varied as complication risk remains with all techniques. Veress needle is used for the induction of pneumoperitoneum as a technique of preference or when an open technique is considered challenging as in obese patients. We present a novel safe technique for insertion of Veress needle by measuring the depth of the anterior abdominal wall prior to insertion. Accurate measurements help in the safe insertion of the Veress needle for inducing pneumoperitoneum and hence reduce the incidence of intra-abdominal injuries.
Collapse
Affiliation(s)
- Fahreyar Alam
- Correspondence address. General Surgery Department, Great Western Hospital, Swindon SN3 6BB, UK. Tel: 0179364020-6206; Fax: 01793605631; E-mail:
| | | | | | | | - Richard Payne
- General Surgery, Great Western Hospital, Swindon, UK
| |
Collapse
|
5
|
Moxon R, Freeman SL, Payne R, Godfrey-Hunt J, Corr S, England GCW. A Prospective Cohort Study Investigating the Impact of Neutering Bitches Prepubertally or Post-Pubertally on Physical Development. Animals (Basel) 2023; 13:ani13091431. [PMID: 37174468 PMCID: PMC10177277 DOI: 10.3390/ani13091431] [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: 03/31/2023] [Revised: 04/20/2023] [Accepted: 04/21/2023] [Indexed: 05/15/2023] Open
Abstract
No previous large prospective cohort studies have been identified that have investigated the impact of the surgical neutering of bitches before or after known puberty on their growth and physical development. This study was designed to examine the data on physical development, vulval size, and conformation for bitches neutered by ovariohysterectomy before puberty (PPN, n = 155) or after puberty (control, n = 151) using a prospective cohort study design. Data were gathered at six- and 17-months of age using bespoke physical assessment forms and digital images of the vulva. PPN bitches had greater changes in height measurements (mean difference = 2.039, SEM = 0.334, 91% CI = 1.471 to 2.608, p < 0.001) and smaller changes in the measurements of vulval length (mean difference = -0.377, SEM = 0.079, 91% CI = -0.511 to -0.243, p < 0.001) and width (mean difference = -0.221, SEM = 0.063, 91% CI = -0.328 to -0.113, p < 0.001) between six- and 17-months of age than for the control bitches. Although not significant, the PPN bitches were taller (mean 58.5 vs. 56.6 cm) and heavier (mean 28.3 vs. 27.3 kg) with smaller vulval size measurements (mean vulval length 2.8 vs. 3.2 cm, mean vulval width 1.7 vs. 2.1 cm) at 17-months of age. At 17-months of age, significantly more PPN bitches had vulvas that appeared juvenile (Yates' Chi-square = 14.834, D.F. = 1, p < 0.001) and recessed (Yates' Chi-square = 7.792, D.F. = 1, p = 0.005) at the physical assessment, and significantly more PPN bitches had vulvas that appeared 'recessed/inverted' on the examination of digital images (Chi-square = 9.902, D.F. = 1, p = 0.002). The results from this study suggest no contraindications to prepubertal ovariohysterectomy for large breed bitches. However, any longer-term health implications of these differences in physical development need to be investigated and better understood prior to recommendations being made.
Collapse
Affiliation(s)
- Rachel Moxon
- Canine Science, Guide Dogs National Centre, Banbury Road, Leamington Spa CV33 9WF, UK
| | - Sarah L Freeman
- School of Veterinary Medicine and Science, University of Nottingham, College Road, Sutton Bonington LE12 5RD, UK
| | - Richard Payne
- School of Veterinary Medicine and Science, University of Nottingham, College Road, Sutton Bonington LE12 5RD, UK
| | - Jasmine Godfrey-Hunt
- School of Veterinary Medicine and Science, University of Nottingham, College Road, Sutton Bonington LE12 5RD, UK
| | - Sandra Corr
- School of Biodiversity, One Health and Veterinary Medicine, College of Medical, Veterinary and Life Sciences, University of Glasgow, Bearsden Road, Glasgow G61 1QH, UK
| | - Gary C W England
- School of Veterinary Medicine and Science, University of Nottingham, College Road, Sutton Bonington LE12 5RD, UK
| |
Collapse
|
6
|
Moxon R, Freeman SL, Payne R, Corr S, England GCW. A prospective cohort study investigating the peri- and postoperative outcomes following ovariohysterectomy in bitches neutered prepubertally or post-pubertally. Theriogenology 2023; 197:283-294. [PMID: 36527865 DOI: 10.1016/j.theriogenology.2022.11.047] [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: 09/30/2022] [Revised: 11/29/2022] [Accepted: 11/29/2022] [Indexed: 12/03/2022]
Abstract
The aim of this prospective cohort study was to investigate perioperative and postoperative outcomes for bitches that were neutered at different times in relation to puberty (rather than age). Three hundred and six Labrador and Golden Retriever crossbreed bitches were neutered before (prepubertal neuter [PPN], n = 155) or after puberty (Control, n = 151) by experienced veterinarians at one of four veterinary practices (VP1-4). Data were gathered from veterinarians at the time of neutering and from bitch caregivers for the 14-day period after neutering using purpose-designed questionnaires. PPN bitches had shorter surgery durations than Control bitches (OR = 0.877, 91% CI = 0.800 to 0.961, P = 0.015). Longer surgery durations were reported for bitches that had intraoperative complications (OR = 1.620, 91% CI = 1.397 to 1.879, P < 0.001). Shorter surgery durations were reported for VP1 compared to all other veterinary practices (OR = 1.189 to 1.534, P < 0.001). There was no difference in the number of PPN or Control bitches that had perioperative complications (PPN: 3.9%, n = 6; Control: 7.7%, n = 11) and no bitch had more than one perioperative complication reported. For the 14-day postoperative period, fewer PPN (1.3%, n = 2) compared to Control bitches (8.9%, n = 13) had wound discharge (Chi-square = 11.151, D.F = 1, P = 0.001) or showed inappetence (PPN: 2.9%, n = 4; Control: 17.3%, n = 19, Chi-square = 14.884, D.F. = 1, P < 0.001). There was no difference in the number of PPN and Control bitches that had redness or swelling of the wound (52 PPN, 48 Control), showed attention to the wound (6 PPN, 6 Control), required veterinary attention (25 PPN, 23 Control), or that showed any other unusual behaviours: discomfort (27 PPN, 16 Control), uncharacteristic irritability (2 PPN, 4 Control), or uncharacteristic licking or chewing of parts of the body (15 PPN, 6 Control). Bitches neutered at VP2-4 were more likely to have wound redness or swelling reported than those neutered at VP1 (OR = 3.109 to 4.076, P = 0.003). Future studies should consider the impact of veterinary practice on results. These results for peri and postoperative complications could suggest that prepubertal ovariohysterectomy may be a suitable option for neutering bitches. However, it is recommended that they be interpreted together with evidence relating to the impacts on other factors including behaviour and longer-term health in order to make fully informed decisions.
Collapse
Affiliation(s)
- Rachel Moxon
- Canine Science, Guide Dogs National Centre, Banbury Road, Leamington Spa, Warwickshire, CV33 9WF, UK.
| | - Sarah L Freeman
- School of Veterinary Medicine and Science, University of Nottingham, College Road, Sutton Bonington, Leicestershire, LE12 5RD, UK.
| | - Richard Payne
- School of Veterinary Medicine and Science, University of Nottingham, College Road, Sutton Bonington, Leicestershire, LE12 5RD, UK.
| | - Sandra Corr
- School of Biodiversity, One Health and Veterinary Medicine, College of Medical, Veterinary and Life Sciences, University of Glasgow, Bearsden Road, Glasgow, G61 1QH, UK.
| | - Gary C W England
- School of Veterinary Medicine and Science, University of Nottingham, College Road, Sutton Bonington, Leicestershire, LE12 5RD, UK.
| |
Collapse
|
7
|
Vigder N, Suarna C, Corcilius L, Nadel J, Chen W, Payne R, Tumanov S, Stocker R. An improved method for the detection of myeloperoxidase chlorinating activity in biological systems using the redox probe hydroethidine. Free Radic Biol Med 2023; 195:23-35. [PMID: 36565892 DOI: 10.1016/j.freeradbiomed.2022.12.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Revised: 12/06/2022] [Accepted: 12/13/2022] [Indexed: 12/24/2022]
Abstract
Conversion of the redox probe hydroethidine (HE) to 2-chloroethidium (2-Cl-E+) by myeloperoxidase (MPO)-derived hypochlorous acid (HOCl) provides comparable specificity and superior sensitivity to measurement of 3-chlorotyrosine (3-Cl-Tyr), the gold standard biomarker for MPO chlorinating activity in biological systems. However, a limitation of the former method is the complex mixture of products formed by the reaction of HE with reagent HOCl, coupled with the difficult purification of 2-Cl-E+ from this mixture for analytical purposes. This limitation prompted us to test whether 2-Cl-E+ could be formed by reaction of HE with the strong and widely used chlorinating agent, N-chlorosuccinimide (NCS). Unexpectedly, such reaction yielded 2-chlorohydroethidine (2-Cl-HE) as the major product in addition to 2-Cl-E+, as assessed by high performance liquid chromatography (HPLC), mass spectrometry (MS), and nuclear magnetic resonance (NMR). 2-Cl-HE was also observed to be the major chlorination product formed from HE with both reagent and enzymatically generated HOCl, just as it was formed ex vivo in different healthy and diseased mouse and human tissues upon incubation with glucose/glucose oxidase to generate a flux of hydrogen peroxide (H2O2). Quantification of 2-Cl-HE plus 2-Cl-E+ improved the sensitivity of the HE-based method compared with measurement of only 2-Cl-E+. Moreover, 2-chlorodimidium (2-Cl-D+) was developed as a practical internal standard instead of the previously used internal standard, deuterated 2-Cl-E+ (d5-2-Cl-E+). Overall, the present study describes an improved method for the detection of MPO/chlorinating activity in biological systems of health and disease.
Collapse
Affiliation(s)
- Niv Vigder
- Heart Research Institute, The University of Sydney, Sydney, New South Wales, Australia
| | - Cacang Suarna
- Heart Research Institute, The University of Sydney, Sydney, New South Wales, Australia
| | - Leo Corcilius
- School of Chemistry, The University of Sydney, Sydney, New South Wales, Australia; Australian Research Council Centre of Excellence for Innovations in Peptide and Protein Science, The University of Sydney, New South Wales, Australia
| | - James Nadel
- Heart Research Institute, The University of Sydney, Sydney, New South Wales, Australia; St Vincent's Hospital, Sydney, Australia; University of New South Wales, Sydney, Australia
| | - Weiyu Chen
- Heart Research Institute, The University of Sydney, Sydney, New South Wales, Australia; Faculty of Medicine and Health, The University of Sydney, New South Wales, Australia
| | - Richard Payne
- School of Chemistry, The University of Sydney, Sydney, New South Wales, Australia; Australian Research Council Centre of Excellence for Innovations in Peptide and Protein Science, The University of Sydney, New South Wales, Australia
| | - Sergey Tumanov
- Heart Research Institute, The University of Sydney, Sydney, New South Wales, Australia; Faculty of Medicine and Health, The University of Sydney, New South Wales, Australia
| | - Roland Stocker
- Heart Research Institute, The University of Sydney, Sydney, New South Wales, Australia; School of Life and Environmental Sciences, The University of Sydney, Sydney, New South Wales, Australia.
| |
Collapse
|
8
|
Alam F, How Saw Keng M, Haynes HR, Tsvetkov F, Tourky M, Payne R. An atypical presentation of gastrointestinal stromal tumour: a case report. J Surg Case Rep 2022; 2022:rjac471. [PMID: 36324765 PMCID: PMC9618307 DOI: 10.1093/jscr/rjac471] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Accepted: 09/20/2022] [Indexed: 01/24/2023] Open
Abstract
Gastrointestinal stromal tumours (GIST) occur more commonly in the stomach and make up ~80% of the GI mesenchymal neoplasms. They are very rare in young adults and in males. The diagnosis is confirmed histologically and immunohistochemically. Once diagnosed, survival rates are dependent on various factors. The main treatment is resection, but targeted therapy can be used pre or post-operatively. This case is of a 35-year-old female with no significant medical history presenting to her general practitioner with lethargy, malaise and mild weight loss. Initially, she was investigated for a haematological malignancy, but upon further investigations, her computed tomography (CT) scan showed an abdominal mass, which was resected and found to be a high-grade perforated gastrointestinal stromal tumour in her proximal ileum. This is a good example of an atypical presentation of GIST and emphasizes the importance of thorough workup and prompt surgical intervention in achieving a satisfactory outcome.
Collapse
Affiliation(s)
- Fahreyar Alam
- Correspondence address. Department of General Surgery, Great Western Hospital NHS Trust, Marlborough Road, Swindon SN36BB, UK. Tel: 01793604020-6206; E-mail:
| | | | - Harry R Haynes
- Department of General Surgery, Great Western Hospital NHS Trust, Swindon, UK
| | - Filip Tsvetkov
- Department of General Surgery, Great Western Hospital NHS Trust, Swindon, UK
| | - Mohamed Tourky
- Department of General Surgery, Great Western Hospital NHS Trust, Swindon, UK
| | - Richard Payne
- Department of General Surgery, Great Western Hospital NHS Trust, Swindon, UK
| |
Collapse
|
9
|
Fernandes K, Desplazes E, Kulkarni S, Payne R, Carter D. S3.4b Lactoferrin, a natural source of peptides that potentiate the antifungal activity of amphotericin B. Med Mycol 2022. [PMCID: PMC9511511 DOI: 10.1093/mmy/myac072.s3.4b] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
S3.4 Free oral paper session, September 21, 2022, 4:45 PM - 6:15 PM Objectives It is notoriously difficult to prevent and treat fungal infections, however, the natural world has come up with remedies that are non-toxic, effective, and evade resistance. Here we investigate lactoferrin, an iron-binding glycoprotein found in milk, tears, and sweat, for its capacity to inhibit fungi and to synergize with commonly used antifungal drugs, with the aim of determining its mode of action. Methods Lactoferrin (LF) was obtained from a commercial supplier and two dairy companies. LF was tested on suite of pathogenic yeast and mold species for inhibition using CLSI microdilution methods. Synergy was determined with antifungal drugs amphotericin B (AMB), nystatin (NYS), fluconazole (FLC), itraconazole (ITC), voriconazole (VRC), and 5-fluorocytosine (5FC). The effect of LF on fungal cells was analyzed using scanning electron microscopy (SEM). The active peptide/s within LF were then predicted from pepsin and in silico digestion, synthesized, and tested for synergy with amphotericin B (AMB). Tethered synthetic membranes were produced and were loaded with ergosterol or cholesterol to test the nature and specificity of membrane binding by LF and the synthetic peptide. Results LF demonstrated antifungal activity against yeast species Cryptococcus, Candida, and Saccharomyces and was much less effective against molds. Good synergy was achieved with AMB but not azole or echinocandin drugs. While the iron-chelating capacity of LF was important for the antifungal activity it was not involved in synergy. SEM revealed cell damage suggesting an interaction between AMB, LF and the fungal membrane or cell wall. A 30-residue peptide from the C lobe of LF was synthesized and tested for activity and synergy. This peptide, dubbed lactofungin (LFG) was inactive alone but was potently synergistic with AMB, indicating a direct role in augmenting AMB activity. Synthetic membranes loaded with ergosterol but not cholesterol were disrupted by AMB + LFG, demonstrating that activity was fungal-specific and was mediated through ergosterol binding. Conclusion LF is a complex molecule that causes fungal inhibition via iron binding and when cleaved by pepsin can produce active peptides. As AMB is a highly toxic treatment, the use of LFG as a synergent could help increase activity while lowering the effective dose, thereby reducing undesirable side effects. The action of AMB + LFG appears dependent on ergosterol, suggesting inhibition will be highly fungal-specific.
Collapse
Affiliation(s)
- Kenya Fernandes
- University of Sydney , Sydney , Australia
- Sydney Institute for Infectious Diseases , Sydney , Australia
| | | | - Sameer Kulkarni
- University of Sydney , Sydney , Australia
- Sydney Institute for Infectious Diseases , Sydney , Australia
| | - Richard Payne
- University of Sydney , Sydney , Australia
- Sydney Institute for Infectious Diseases , Sydney , Australia
| | - Dee Carter
- University of Sydney , Sydney , Australia
- Sydney Institute for Infectious Diseases , Sydney , Australia
| |
Collapse
|
10
|
Pusztaszeri MP, Florianova L, Payne R, Baloch ZW. Spindle cell variant of follicular thyroid carcinoma: an extremely unusual case and review of the literature. Diagn Cytopathol 2022; 50:E333-E338. [PMID: 35866458 DOI: 10.1002/dc.25018] [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: 04/05/2022] [Revised: 07/06/2022] [Accepted: 07/12/2022] [Indexed: 11/08/2022]
Abstract
Spindle cell proliferations originating in follicular derived thyroid neoplasms are rare and known to cause diagnostic conundrums. We describe a unique case of a spindle cell variant of follicular thyroid carcinoma (FTC) in a 48-year-old female without relevant past medical history, who was being followed for a 1.4 cm left thyroid nodule for the past 15 months. A fine needle aspiration (FNA) of the nodule was interpreted as benign (Bethesda II). On follow-up ultrasound the nodule demonstrated a slight increase in size (to 1.5 cm) and the appearance of coarse calcifications A repeat FNA was performed 12 months later and interpreted as malignant neoplasm (Bethesda VI), containing a population of spindle and epithelioid cells that could not be further classified. A left subtotal thyroidectomy showed an encapsulated tumor mainly composed of fibroblast-like spindle cells, extensive foci of calcifications and focal ossification, with minimal tumor capsule invasion without vascular invasion. Tumor cells expressed vimentin, ERG and SMA (focal), while being negative for pancytokeratin, thyroglobulin, TTF-1, Pax-8, calcitonin, CEA and other lineage-specific mesenchymal, neuroendocrine and melanocytic markers. Importantly, a few residual thyroid follicles were identified within the nodule, and a diagnosis of minimally invasive FTC with extensive spindle cell changes, calcification and osseous metaplasia was rendered. This is only the second cytologic report of a pure spindle cell FTC. The rarity of this neoplasm and its potential broad differential diagnosis create diagnostic difficulties both on cytology and histology.
Collapse
Affiliation(s)
| | | | - Richard Payne
- Department of Head and Neck Surgery, McGill University, Montreal, Canada
| | - Zubair W Baloch
- Department of Pathology, Perelman School of Medicine, University of Pennsylvania Medical Center, Philadelphia, Pennsylvania, USA
| |
Collapse
|
11
|
Moxon R, Freeman S, Payne R, Corr S, England GCW. A Prospective Cohort Study Investigating the Behavioural Development of Bitches in a Guide Dog Training Programme Neutered Prepubertally or Post-Pubertally. Front Vet Sci 2022; 9:902775. [PMID: 35873697 PMCID: PMC9301489 DOI: 10.3389/fvets.2022.902775] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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: 03/23/2022] [Accepted: 05/31/2022] [Indexed: 11/25/2022] Open
Abstract
There are few studies that investigate the effect of neutering bitches before or after puberty. The majority of current literature examining the impact of the timing of neutering on health and behaviour has used age rather than the onset of puberty as the key variable. The aim of this prospective cohort study was to investigate the effects of timing of neutering in relation to puberty on behaviour in female dogs reared and trained in an assistance dog programme. The study examined data for bitches neutered before or after puberty to compare scores for six behavioural factors (training and obedience, aggression, fear and anxiety, excitability, attachment and attention-seeking, and social behaviour) measured at 1 and 3 years of age. Labrador and Golden Retriever crossbreed bitches were neutered before (n = 155) or after (n = 151) puberty. Neutering before or after puberty had no impact on mean scores for the six behavioural factors at 1 or 3 years of age. When examining the change in behavioural factor scores between 1 and 3 years of age, only aggression behavioural factor scores were influenced by neutering before or after puberty. Bitches neutered after puberty were less likely to have aggression factor scores that increased between 1 and 3 years of age (OR = 0.959, 90% CI = 0.924 to 0.995, p = 0.06). However, the majority of bitches scored “0” for aggression at both time points (indicating no aggression behaviours were observed), and the number of bitches for which scores increased between 1 and 3 years of age was low (before puberty = 20, after puberty = 9). This is consistent with very mild aggressive behaviours being observed in a small number of animals and is, therefore, of questionable concern. The results suggest that, for Labrador and Golden Retriever crossbreed bitches, neutering before or after puberty has little to no effect on future behaviour. It is recommended that decisions about the timing of neutering are not informed solely by impacts on behaviour, but that they also consider evidence relating to the impacts on bitch health and well-being.
Collapse
Affiliation(s)
- Rachel Moxon
- Canine Science, Guide Dogs National Centre, Leamington Spa, United Kingdom
- *Correspondence: Rachel Moxon
| | - Sarah Freeman
- School of Veterinary Medicine and Science, University of Nottingham, Nottingham, United Kingdom
| | - Richard Payne
- School of Veterinary Medicine and Science, University of Nottingham, Nottingham, United Kingdom
| | - Sandra Corr
- School of Veterinary Medicine, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Gary C. W. England
- School of Veterinary Medicine and Science, University of Nottingham, Nottingham, United Kingdom
| |
Collapse
|
12
|
Stavas J, Filler G, Jain D, Ludlow JW, Basu J, Payne R, Butler E, Díaz-González de Ferris M, Bertram T. Renal Autologous Cell Therapy (REACT®) to Stabilize Function in Diabetes-Related Chronic Kidney Disease: Corroboration of Mechanistic Action with Cell Marker Analysis. Kidney Int Rep 2022; 7:1619-1629. [PMID: 35812284 PMCID: PMC9263255 DOI: 10.1016/j.ekir.2022.04.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2022] [Accepted: 04/11/2022] [Indexed: 10/31/2022] Open
Abstract
Introduction Methods Results Conclusion
Collapse
|
13
|
Turkdogan S, Roy CF, Chartier G, Payne R, Mlynarek A, Forest VI, Hier M. Effect of Perioperative Patient Education via Animated Videos in Patients Undergoing Head and Neck Surgery: A Randomized Clinical Trial. JAMA Otolaryngol Head Neck Surg 2022; 148:173-179. [PMID: 34967863 PMCID: PMC8719273 DOI: 10.1001/jamaoto.2021.3765] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Importance Patient education and engagement is a pivotal component of surgical recovery. Ensuring proper patient education involves a thorough understanding of one's diagnosis and recovery plan, while reducing language and learning barriers to help patients make informed decisions and improve their hospital experience. Objective To assess whether using an animated surgical guide will help patients who are undergoing head and neck surgery feel more satisfied with their surgery and recovery process. Design, Setting, and Participants A randomized clinical trial was conducted between January and August 2020 at a single tertiary care academic center in Montreal, Canada. A consecutive sample of individuals who were undergoing any of the following surgical procedures was recruited: head and neck cancer resection with or without reconstruction, parotidectomy, thyroidectomy, parathyroidectomy, laryngectomy, or transoral robotic resection. The treating team was masked to group allocation, while study participants in the nonintervention group were unaware of the multimedia platform to avoid introducing bias in their survey responses. Interventions Patients were randomly allocated to either the treatment arm, in which they obtained access to a multimedia patient education platform, or the control arm, in which they received traditional patient education methods via clinical visits. Main Outcomes and Measures Primary analysis compared patient satisfaction scores on the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire INFO 25, a validated questionnaire on the perceived quality of information received by patients with cancer (possible scores ranging from 20 to 80). Results A total of 100 patients (50 in each arm; 63 women [63%]; 6 African American [6%, 12 Hispanic/Latino [12%], 11 Middle Eastern [11%], and 78 White [78%] individuals) completed the preintervention and postintervention questionnaires. In those who received access to the patient education platform, there was an 11.3-point (Cohen d = 1.02; control group score, 61.1 of 80; treatment group score, 72.4 of 80) difference of greater postoperative satisfaction scores at 1 month. While both groups felt that they received an adequate amount of information concerning their disease process, patients in the treatment arm had significantly better satisfaction with information concerning their medical tests, treatments, and other services. Conclusions and Relevance This randomized clinical trial of patients undergoing head and neck cancer treatment demonstrates that multimedia patient education platforms may enhance current traditional methods, providing complementary information on patients' treatment plans and recovery process, mental health, family life, and supplementary services. Further research is currently underway to confirm whether this platform will lead to decreased hospital stay, shorter complication rates, and long-term effects. Trial Registration ClinicalTrials.gov Identifier: NCT04048538.
Collapse
Affiliation(s)
- Sena Turkdogan
- Department of Otolaryngology Head & Neck Surgery, McGill University Health Centre, Montreal, Québec, Canada
| | - Catherine F. Roy
- Department of Otolaryngology Head & Neck Surgery, McGill University Health Centre, Montreal, Québec, Canada
| | - Gabrielle Chartier
- Department of Otolaryngology Head & Neck Surgery, McGill University Health Centre, Montreal, Québec, Canada,Department of Nursing, Jewish General Hospital, Montreal, Québec, Canada
| | - Richard Payne
- Department of Otolaryngology Head & Neck Surgery, McGill University Health Centre, Montreal, Québec, Canada,Department of Otolaryngology Head & Neck Surgery, Jewish General Hospital, Montreal, Québec, Canada
| | - Alex Mlynarek
- Department of Otolaryngology Head & Neck Surgery, Jewish General Hospital, Montreal, Québec, Canada
| | | | - Michael Hier
- Department of Otolaryngology Head & Neck Surgery, Jewish General Hospital, Montreal, Québec, Canada
| |
Collapse
|
14
|
Hunt M, Ricketts S, Digby NW, Greet T, Carson D, McGladdery A, Barrelet F, Shepherd M, Ramzan P, Payne R, Bathe A, Cameron I, Pynn O, Dallas R, Foote A. Peter Daniel Rossdale. Vet Rec 2021. [PMID: 34918812 DOI: 10.1002/vetr.1308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
A dedicated equine clinician and scientist who had varied interests and published widely. He founded a remarkably successful practice and was one of the first to embrace evidence-based veterinary medicine.
Collapse
|
15
|
Alam F, Farooq D, Theofilis A, Wooler H, Payne R. TP7.2.1 Outcomes of Modified Karydakis flap in the surgical management of sacrococcygeal pilonidal disease: A single surgeon’s experience. Br J Surg 2021. [DOI: 10.1093/bjs/znab362.050] [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]
Abstract
Abstract
Aim
To determine the incidence of post-operative complications of patients with sacrococcygeal pilonidal disease who were treated with the Modified Karydakis flap with a specific management bundle. Primary outcomes assessed included the post-operative incidence of seroma, haematoma, SSI, deep SSI, wound dehiscence, re-admissions, return to theatre and flap necrosis. Secondary outcome evaluated was recurrence at 6 month follow up.
Method
It was a retrospective analysis of a single surgeon’s (FA’s) practice results of Modified Karydakis flaps on patients with sacrococcygeal pilonidal disease who were managed according to a specific protocol. Data was collected between June 2017 and June 2020. 96 patients were analysed, of which 9 were excluded as they had excision without closure. Pre, per and post-operative management for the remaining 87 patients was according to a standardised protocol. Data was collected from patient’s notes and from prospectively and retrospectively maintained patient data bases (Theatre System, Medway).
Results
Primary outcomes:
• Seroma: 8/87 (9.2%)
• Haematoma: 1/87 (1.2%)
• SSI: 10/87 (11.5%)
• Deep SSI: 4/87 (4.6%)
• Superficial dehiscence: 7/87 (8.0%)
• Re-admission: 4/87 (4.6%)
• Return to theatre: 0 (0%)
• Flap necrosis: 0 (0%)
Secondary outcome:
• Recurrence at 6 months: 2/87 (2.3%)
Conclusions
Good surgical results can be obtained with Modified Karadakis flap, provided meticulous surgical technique is applied. Placement of a suction drain for a minimum of 72 hours reduces incidence of post-operative haematoma and seroma formation. Three post-operative doses of broad spectrum intravenous antibiotics followed by 5 days of oral antibiotics helps reduce post-operative infections.
Collapse
|
16
|
Alam F, Farooq D, Theofilis A, Wooler H, Payne R. 269 Outcomes of Modified Karydakis Flap in The Surgical Management of Sacrococcygeal Pilonidal Disease: A Single Surgeon’s Experience. Br J Surg 2021. [DOI: 10.1093/bjs/znab259.408] [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]
Abstract
Abstract
Aim
To determine the incidence of post-operative complications of patients with sacrococcygeal pilonidal disease who were treated with the Modified Karydakis flap with a specific management bundle. Primary outcomes assessed included the post-operative incidence of seroma, haematoma, SSI, deep SSI, wound dehiscence, re-admissions, return to theatre and flap necrosis. Secondary outcome evaluated was recurrence at 6 months follow up.
Method
It was a retrospective analysis of a single surgeon’s (FA’s) practice results of Modified Karydakis flaps on patients with sacrococcygeal pilonidal disease who were managed according to a specific protocol (fig. 1). Data was collected between June 2017 and June 2020. 96 patients were analysed, of which 9 were excluded as they only had excision without closure. Pre, per and post-operative management of the remaining 87 patients was according to a standardised protocol (fig. 1). Data was collected from patient’s notes and from prospectively and retrospectively maintained patient data bases (Theatre System, Medway).
Results
Primary outcomes:
Secondary outcome:
Conclusions
Good surgical results can be obtained with Modified Karadakis flap, provided meticulous surgical technique is applied. Placement of a suction drain for a minimum of 72 hours reduces incidence of post-operative haematoma and seroma formation. Three post-operative doses of broad-spectrum intravenous antibiotics followed by 5 days of oral antibiotics helps reduce post-operative infections.
Collapse
Affiliation(s)
- F Alam
- Great Western Hospital, Swindon, United Kingdom
| | - D Farooq
- Great Western Hospital, Swindon, United Kingdom
| | - A Theofilis
- Great Western Hospital, Swindon, United Kingdom
| | - H Wooler
- Great Western Hospital, Swindon, United Kingdom
| | - R Payne
- Great Western Hospital, Swindon, United Kingdom
| |
Collapse
|
17
|
Alam F, Ng S, Farooq D, Haque A, Payne R. Late gastric band erosion mimicking diverticulitis and sepsis. Surg Pract 2021. [DOI: 10.1111/1744-1633.12512] [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: 11/29/2022]
Affiliation(s)
- Fahreyar Alam
- Department of General Surgery Great Western Hospital Swindon UK
| | - Sherwin Ng
- Department of General Surgery Great Western Hospital Swindon UK
| | - Dilawar Farooq
- Department of General Surgery Great Western Hospital Swindon UK
| | - Ali Haque
- Department of General Surgery Great Western Hospital Swindon UK
| | - Richard Payne
- Department of General Surgery Great Western Hospital Swindon UK
| |
Collapse
|
18
|
Aguirre-Portoles C, Payne R, Trautz A, Foskett J, Natale C, Seykora J, Ridky T. 056 Testosterone signaling through ZIP9 renders melanoma more aggressive in males than in females. J Invest Dermatol 2021. [DOI: 10.1016/j.jid.2021.02.073] [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]
|
19
|
Morey-Matamalas A, Corbetta D, Waine K, Payne R, Grau-Roma L, Baiker K. Exercise-induced Acute Abdominal Haemorrhage due to Iliopsoas Trauma in Racing Greyhounds. J Comp Pathol 2020; 177:42-46. [PMID: 32505239 DOI: 10.1016/j.jcpa.2020.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Revised: 03/31/2020] [Accepted: 04/06/2020] [Indexed: 10/24/2022]
Abstract
Post-mortem examination of 74 racing greyhounds with sudden, unexpected death was undertaken at the Veterinary School, University of Nottingham, UK, from 2015 to 2019. These investigations revealed severe, acute haemoabdomen with extensive retroperitoneal haemorrhage and an underlying severe, unilateral iliopsoas tear in four cases (5.4%). In all four cases, unilateral trauma and haemorrhage affecting the right iliopsoas muscle was common near the caudal insertion. Despite the acute clinical event, three cases demonstrated histological evidence of previous muscle damage with muscular regeneration, fibrosis and evidence of chronic haemorrhage. To our knowledge, this is the first detailed description of exercise-induced trauma to the iliopsoas muscle leading to extensive haemoretroperitoneum and haemoabdomen with subsequent hypovolaemic shock and death in racing greyhounds.
Collapse
Affiliation(s)
- A Morey-Matamalas
- School of Veterinary Medicine and Science, University of Nottingham, Sutton Bonington, UK.
| | - D Corbetta
- School of Veterinary Medicine and Science, University of Nottingham, Sutton Bonington, UK
| | - K Waine
- School of Veterinary Medicine and Science, University of Nottingham, Sutton Bonington, UK
| | - R Payne
- School of Veterinary Medicine and Science, University of Nottingham, Sutton Bonington, UK
| | - L Grau-Roma
- Institute of Animal Pathology, University of Bern, Bern, Switzerland
| | - K Baiker
- School of Veterinary Medicine and Science, University of Nottingham, Sutton Bonington, UK
| |
Collapse
|
20
|
Larouche V, Pusztaszeri MP, Filimon S, Payne R, Hier M, Tamilia M. Preoperative prediction of non-invasive follicular thyroid neoplasm with papillary-like nuclear features: a Canadian single-Centre experience. J Otolaryngol Head Neck Surg 2020; 49:1. [PMID: 31898554 PMCID: PMC6941342 DOI: 10.1186/s40463-019-0397-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [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: 12/06/2018] [Accepted: 12/23/2019] [Indexed: 12/14/2022] Open
Abstract
Background An international group of experts recommended reclassifying non-invasive follicular variant of papillary thyroid cancers (FVPTC) as ‘non-invasive follicular thyroid neoplasm with papillary-like nuclear features’ (NIFTP) in April 2016. The purpose of this study was to establish preoperative clinical, laboratory, ultrasonographic, and cytological variables, which can differentiate NIFTP from FVPTC. Methods We conducted a retrospective chart review of consecutive patients from a single institution evaluated between January 2012 and December 2017. 203 adult patients underwent lobectomy or total thyroidectomy for a FVPTC during that period. Each patient’s medical chart was reviewed and information on pre-operative variables was recorded. An expert pathologist reviewed all surgical specimens and reclassified a subset of FVPTC as NIFTP according to the specific criteria. Results Overall, 44 patients were included in the NIFTP group and 159 in the non-NIFTP group. Mean age was 50.1 years in the NIFTP group and 50.7 in the non-NIFTP group. Most patients were female (86.4% (38/44) in the NIFTP group vs 79.8% (127/159) in the non-NIFTP group). More patients underwent lobectomy in the NIFTP group (50% (22/44) vs 16.4% (26/159) in the non-NIFTP group, p = < 0.0001). Less patients received radioactive iodine in the NIFTP group (31.8% (14/44) vs 52.2% (83/159) in the non-NIFTP group, p = 0.0177). Preoperative thyroglobulin levels were lower in NIFTP patients (Median 25.55 mcg/L +/− 67.8 vs 76.06 mcg/L +/− 119.8 in Non-NIFTP, p = 0.0104). NIFTP nodules were smaller (Mean size 22.97 mm +/− 12.3 vs 25.88 mm +/− 11.2 for non-NIFTP, p = 0.0448) and more often solid than non-NIFTP (93.2% (41/44) vs 74.8% (119/159) for non-NIFTP, p = 0.0067). 2017 ACR TIRADS nodule category of 1–4 on ultrasound had a negative predictive value and a sensitivity of 100% for NIFTP. ROC Curve Analysis demonstrated that a preoperative thyroglobulin level of 31.3 mcg/L had a sensitivity of 75% and a specificity of 62.5% to differentiate NIFTP from non-NIFTP cancers. Conclusion Lower preoperative thyroglobulin levels, smaller nodule size, solid texture and 2017 ACR TIRADS Category of 1–4 are more strongly associated with NIFTP than FVPTC and can favour less invasive surgical options such as lobectomy.
Collapse
Affiliation(s)
- Vincent Larouche
- Division of Endocrinology and Metabolism, Jewish General Hospital, 3755, Chemin de la Côte-Sainte-Catherine, Montréal, QC, H3Y 1E2, Canada.
| | - Marc Philippe Pusztaszeri
- Division of Pathology, Jewish General Hospital, 3755, Chemin de la Côte-Sainte-Catherine, Montréal, QC, H3Y 1E2, Canada
| | - Sabin Filimon
- Internal Medicine Residency Training Program, McGill University, 3755, Chemin de la Côte-Sainte-Catherine, Montréal, QC, H3Y 1E2, Canada
| | - Richard Payne
- Division of Oto-Rhino-Laryngology, Jewish General Hospital, 3755, Chemin de la Côte-Sainte-Catherine, Montréal, QC, H3Y 1E2, Canada
| | - Michael Hier
- Division of Oto-Rhino-Laryngology, Jewish General Hospital, 3755, Chemin de la Côte-Sainte-Catherine, Montréal, QC, H3Y 1E2, Canada
| | - Michael Tamilia
- Division of Endocrinology and Metabolism, Jewish General Hospital, 3755, Chemin de la Côte-Sainte-Catherine, Montréal, QC, H3Y 1E2, Canada
| |
Collapse
|
21
|
Zhu Y, Edwards D, Kiddle S, Payne R. Characteristics and outcomes of clusters of multimorbid patients in UK general practice. Eur J Public Health 2019. [DOI: 10.1093/eurpub/ckz185.662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Current clinical specialities, guidelines and quality of care metrics are organised around single diseases and treatments of multiple conditions are rarely coordinated, resulting in insufficient or even conflicting care. This study uses large scale English general practice (GP) records to identify and characterise clusters of patients based on their multimorbidity to allow better design of health services and highlight groups that require additional interventions.
Methods
This is a retrospective cohort study that includes multimorbid adult patients (N = 113,211), from a random sample of 391,669 English patients with valid GP records in 2012 where 38 long-term conditions were defined. Latent class analysis, stratified by age groups, was used to identify multimorbidity clusters. Class solutions are validated and associations between multimorbidity clusters, patient characteristics, public health service utilisation and mortality are assessed.
Results
Poor socioeconomic status is associated with clusters with higher service use and mortality risk. Physical-mental health co-morbidity is a major component of multimorbidity across all age strata. The clusters with highest age-stratified mortality risk in under 65 year olds were linked to alcohol and substance misuse, whereas in over 65 year olds they were linked to cardiovascular disease. The largest cluster in the 85+ years strata (58%) has the lowest number of morbidities, a low degree of service use and mortality. Consistency was seen across identification and validation data.
Conclusions
We find a clear distinction between morbidity clusters, both in the prevalence of long term conditions within them, and in their associations with outcomes (service use and mortality). Specific health services and interventions might be more effective when targeted on the distinct types of multimorbidity we have identified, with a particular focus on the morbidity clusters associated with the worst patient outcomes.
Key messages
The first study to derive age stratified multimorbidity clusters from a large GP record system, whose patients are representative of the English population. Knowledge about particularly dangerous clusters of multimorbidity, such as those involving alcohol and drug use in 18–64 years old, and cardiovascular disease in those 65 years or older.
Collapse
Affiliation(s)
- Y Zhu
- MRC Biostatistics Unit, University of Cambridge, Cambridge, UK
| | - D Edwards
- The Primary Care Unit, University of Cambridge, Cambridge, UK
| | - S Kiddle
- MRC Biostatistics Unit, University of Cambridge, Cambridge, UK
| | - R Payne
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| |
Collapse
|
22
|
Sheppard J, Burt J, Lown M, Temple E, Lowe R, Todd O, Ford G, Hobbs FDR, Little P, Mant J, Mollison J, Payne R, Williams M, Yu LM, McManus RJ. P2649Do these data apply to me? Examining the applicability of trials assessing strategies for optimal management of blood pressure to older patients in UK primary care. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.0970] [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
There is debate as to what extent older patients (≥80 years) should be treated for high blood pressure. Existing trials show that blood pressure lowering in this population is effective at preventing stroke and heart failure but also results in an increased risk of adverse events. However, it has been suggested that these studies enrolled healthier patients, who are less representative of the general population and more likely to benefit from treatment.
Purpose
This study aimed to compare the characteristics of patients eligible for three blood pressure management trials and assess the likelihood of eligibility for each trial based on common characteristics of older patients.
Methods
Cross-sectional study of data extracted from the medical records of 15,376 patients aged ≥80 years, registered to 24 general practices in the south of England. Anonymised patient data relating to the eligibility criteria for two previous medication intensification trials (HYVET, SPRINT) and one medication reduction trial (OPTiMISE) were extracted. Patients eligible for each trial were defined according to criteria specified in each trial protocol. Descriptive statistics were used to define the characteristics of each trial population. A logistic regression model was constructed to estimate predictors of eligibility for each trial, with practice included as a random effect.
Results
Approximately 268 (1.7%), 5,290 (34.4%) and 3,940 (25.6%) patients were eligible for HYVET, SPRINT and OPTiMISE trials respectively. There was little overlap in eligibility for each trial (1.0% were eligible for HYVET and SPRINT; 0% were eligible for HYVET and OPTiMISE; 10.2% were eligible for SPRINT and OPTiMISE). Patients eligible for OPTiMISE were comparable to the general population in terms of frailty (eFI 0.12 [OPTiMISE] vs 0.11 [general population]), but had more morbidities (4 vs 3) and cardiovascular medications prescribed (4 vs 2). Patients in HYVET and SPRINT were less frail, multi-morbid and prescribed less cardiovascular medications. Overall, increasing frailty and a history of cardiovascular disease reduced the likelihood of being eligible for any trial.
Conclusions
Patients eligible for OPTiMISE appear to best represent the population aged ≥80 years attending UK primary care. Increasing frailty and/or multi-morbidity reduce the likelihood of eligibility for all three blood pressure trials. Caution should be exercised when applying the results from randomised controlled trials to management of blood pressure in frail and multi-morbid patients.
Acknowledgement/Funding
This study was funded by the National Institute for Health Research (NIHR) SPCR and Oxford CLAHRC
Collapse
Affiliation(s)
- J Sheppard
- University of Oxford, Nuffield Department of Primary Care Health Sciences, Oxford, United Kingdom
| | - J Burt
- University of Cambridge, Cambridge, United Kingdom
| | - M Lown
- University of Southampton, Southampton, United Kingdom
| | - E Temple
- University of Oxford, Nuffield Department of Primary Care Health Sciences, Oxford, United Kingdom
| | - R Lowe
- University of Oxford, Nuffield Department of Primary Care Health Sciences, Oxford, United Kingdom
| | - O Todd
- Bradford Teaching Hospitals NHS Trust, Bradford, United Kingdom
| | - G Ford
- University of Oxford, Oxford, United Kingdom
| | - F D R Hobbs
- University of Oxford, Nuffield Department of Primary Care Health Sciences, Oxford, United Kingdom
| | - P Little
- University of Southampton, Southampton, United Kingdom
| | - J Mant
- University of Cambridge, Cambridge, United Kingdom
| | - J Mollison
- University of Oxford, Nuffield Department of Primary Care Health Sciences, Oxford, United Kingdom
| | - R Payne
- University of Bristol, Bristol, United Kingdom
| | - M Williams
- Patient representative, London, United Kingdom
| | - L M Yu
- University of Oxford, Nuffield Department of Primary Care Health Sciences, Oxford, United Kingdom
| | - R J McManus
- University of Oxford, Nuffield Department of Primary Care Health Sciences, Oxford, United Kingdom
| |
Collapse
|
23
|
Abstract
In this issue of the Hastings Center Report, Joshua Rager and Peter Schwartz reframe the justification for the use of opioid treatment agreements. Instead of documents used to define the roles and responsibilities of doctors and patients to one another in the course of opioid treatment for chronic pain and to describe the risks and benefits of therapy for the individual, OTAs are now proposed for use as "surveillance and monitoring" instruments. As such, they are specifically meant to disclose the risks of opioid therapy and to describe the other processes and tools used to monitor abuse and diversion of medications. Given the crisis of the opioid overdose and death epidemic, along with this repurposing of OTAs as disclosure documents primarily, Rager and Schwartz argue that patient consent is not needed (although desired) and that OTAs should be universally applied in clinical practices. We can all agree on the big picture goal of limiting the number of opioid prescriptions in order to minimize the tragedy of opioid overdose deaths. We disagree, though, about the acceptable level of collateral damage to people in pain who fall victim to fighting the war against the so-called opioid epidemic.
Collapse
|
24
|
Masdeu JC, Aksamit AJ, Carver AC, Foley KM, Kass JS, Martin RA, McCusker EA, McQuillen MP, Mehanna R, Payne R, Victor SJ, Warach S. End of life. Neurology 2019; 93:729-734. [PMID: 31530709 PMCID: PMC6946468 DOI: 10.1212/wnl.0000000000008356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2018] [Accepted: 07/30/2019] [Indexed: 11/18/2022] Open
Abstract
In legal physician-hastened death, a physician prescribes medication with the primary intent of causing the death of a willing terminally ill patient. This practice differs radically from palliative sedation, intended to relieve a patient's suffering rather than cause a patient's death. In this position paper, we argue that the practice of physician-hastened death is contrary to the interests of patients, their families, and the sound ethical practice of medicine. Therefore, the American Academy of Neurology should advise its members against this practice, as it had done until 2018.
Collapse
Affiliation(s)
- Joseph C Masdeu
- From the Houston Methodist Neurological Institute (J.C.M), TX; Weill Cornell Medicine (J.C.M, A.C.C., K.M.F), New York, NY; Mayo Clinic (A.J.A.), Rochester, MN; Memorial Sloan Kettering Cancer Center (A.C.C., K.M.F), New York, NY; Baylor College of Medicine (J.S.K); McGovern Medical School (R.A.M., R.M.), University of Texas Health Science Center at Houston; Sydney University Medical School (E.A.M.), Australia; Stanford Health Care (M.P.M), Palo Alto, CA; private practice (S.J.V.), Erwinna, PA; and Dell Medical School (S.W.), University of Texas at Austin.
| | - Allen J Aksamit
- From the Houston Methodist Neurological Institute (J.C.M), TX; Weill Cornell Medicine (J.C.M, A.C.C., K.M.F), New York, NY; Mayo Clinic (A.J.A.), Rochester, MN; Memorial Sloan Kettering Cancer Center (A.C.C., K.M.F), New York, NY; Baylor College of Medicine (J.S.K); McGovern Medical School (R.A.M., R.M.), University of Texas Health Science Center at Houston; Sydney University Medical School (E.A.M.), Australia; Stanford Health Care (M.P.M), Palo Alto, CA; private practice (S.J.V.), Erwinna, PA; and Dell Medical School (S.W.), University of Texas at Austin
| | - Alan C Carver
- From the Houston Methodist Neurological Institute (J.C.M), TX; Weill Cornell Medicine (J.C.M, A.C.C., K.M.F), New York, NY; Mayo Clinic (A.J.A.), Rochester, MN; Memorial Sloan Kettering Cancer Center (A.C.C., K.M.F), New York, NY; Baylor College of Medicine (J.S.K); McGovern Medical School (R.A.M., R.M.), University of Texas Health Science Center at Houston; Sydney University Medical School (E.A.M.), Australia; Stanford Health Care (M.P.M), Palo Alto, CA; private practice (S.J.V.), Erwinna, PA; and Dell Medical School (S.W.), University of Texas at Austin
| | - Kathleen M Foley
- From the Houston Methodist Neurological Institute (J.C.M), TX; Weill Cornell Medicine (J.C.M, A.C.C., K.M.F), New York, NY; Mayo Clinic (A.J.A.), Rochester, MN; Memorial Sloan Kettering Cancer Center (A.C.C., K.M.F), New York, NY; Baylor College of Medicine (J.S.K); McGovern Medical School (R.A.M., R.M.), University of Texas Health Science Center at Houston; Sydney University Medical School (E.A.M.), Australia; Stanford Health Care (M.P.M), Palo Alto, CA; private practice (S.J.V.), Erwinna, PA; and Dell Medical School (S.W.), University of Texas at Austin
| | - Joseph S Kass
- From the Houston Methodist Neurological Institute (J.C.M), TX; Weill Cornell Medicine (J.C.M, A.C.C., K.M.F), New York, NY; Mayo Clinic (A.J.A.), Rochester, MN; Memorial Sloan Kettering Cancer Center (A.C.C., K.M.F), New York, NY; Baylor College of Medicine (J.S.K); McGovern Medical School (R.A.M., R.M.), University of Texas Health Science Center at Houston; Sydney University Medical School (E.A.M.), Australia; Stanford Health Care (M.P.M), Palo Alto, CA; private practice (S.J.V.), Erwinna, PA; and Dell Medical School (S.W.), University of Texas at Austin
| | - Raymond A Martin
- From the Houston Methodist Neurological Institute (J.C.M), TX; Weill Cornell Medicine (J.C.M, A.C.C., K.M.F), New York, NY; Mayo Clinic (A.J.A.), Rochester, MN; Memorial Sloan Kettering Cancer Center (A.C.C., K.M.F), New York, NY; Baylor College of Medicine (J.S.K); McGovern Medical School (R.A.M., R.M.), University of Texas Health Science Center at Houston; Sydney University Medical School (E.A.M.), Australia; Stanford Health Care (M.P.M), Palo Alto, CA; private practice (S.J.V.), Erwinna, PA; and Dell Medical School (S.W.), University of Texas at Austin
| | - Elizabeth A McCusker
- From the Houston Methodist Neurological Institute (J.C.M), TX; Weill Cornell Medicine (J.C.M, A.C.C., K.M.F), New York, NY; Mayo Clinic (A.J.A.), Rochester, MN; Memorial Sloan Kettering Cancer Center (A.C.C., K.M.F), New York, NY; Baylor College of Medicine (J.S.K); McGovern Medical School (R.A.M., R.M.), University of Texas Health Science Center at Houston; Sydney University Medical School (E.A.M.), Australia; Stanford Health Care (M.P.M), Palo Alto, CA; private practice (S.J.V.), Erwinna, PA; and Dell Medical School (S.W.), University of Texas at Austin
| | - Michael P McQuillen
- From the Houston Methodist Neurological Institute (J.C.M), TX; Weill Cornell Medicine (J.C.M, A.C.C., K.M.F), New York, NY; Mayo Clinic (A.J.A.), Rochester, MN; Memorial Sloan Kettering Cancer Center (A.C.C., K.M.F), New York, NY; Baylor College of Medicine (J.S.K); McGovern Medical School (R.A.M., R.M.), University of Texas Health Science Center at Houston; Sydney University Medical School (E.A.M.), Australia; Stanford Health Care (M.P.M), Palo Alto, CA; private practice (S.J.V.), Erwinna, PA; and Dell Medical School (S.W.), University of Texas at Austin
| | - Raja Mehanna
- From the Houston Methodist Neurological Institute (J.C.M), TX; Weill Cornell Medicine (J.C.M, A.C.C., K.M.F), New York, NY; Mayo Clinic (A.J.A.), Rochester, MN; Memorial Sloan Kettering Cancer Center (A.C.C., K.M.F), New York, NY; Baylor College of Medicine (J.S.K); McGovern Medical School (R.A.M., R.M.), University of Texas Health Science Center at Houston; Sydney University Medical School (E.A.M.), Australia; Stanford Health Care (M.P.M), Palo Alto, CA; private practice (S.J.V.), Erwinna, PA; and Dell Medical School (S.W.), University of Texas at Austin
| | - Richard Payne
- From the Houston Methodist Neurological Institute (J.C.M), TX; Weill Cornell Medicine (J.C.M, A.C.C., K.M.F), New York, NY; Mayo Clinic (A.J.A.), Rochester, MN; Memorial Sloan Kettering Cancer Center (A.C.C., K.M.F), New York, NY; Baylor College of Medicine (J.S.K); McGovern Medical School (R.A.M., R.M.), University of Texas Health Science Center at Houston; Sydney University Medical School (E.A.M.), Australia; Stanford Health Care (M.P.M), Palo Alto, CA; private practice (S.J.V.), Erwinna, PA; and Dell Medical School (S.W.), University of Texas at Austin
| | - Stephen J Victor
- From the Houston Methodist Neurological Institute (J.C.M), TX; Weill Cornell Medicine (J.C.M, A.C.C., K.M.F), New York, NY; Mayo Clinic (A.J.A.), Rochester, MN; Memorial Sloan Kettering Cancer Center (A.C.C., K.M.F), New York, NY; Baylor College of Medicine (J.S.K); McGovern Medical School (R.A.M., R.M.), University of Texas Health Science Center at Houston; Sydney University Medical School (E.A.M.), Australia; Stanford Health Care (M.P.M), Palo Alto, CA; private practice (S.J.V.), Erwinna, PA; and Dell Medical School (S.W.), University of Texas at Austin
| | - Steven Warach
- From the Houston Methodist Neurological Institute (J.C.M), TX; Weill Cornell Medicine (J.C.M, A.C.C., K.M.F), New York, NY; Mayo Clinic (A.J.A.), Rochester, MN; Memorial Sloan Kettering Cancer Center (A.C.C., K.M.F), New York, NY; Baylor College of Medicine (J.S.K); McGovern Medical School (R.A.M., R.M.), University of Texas Health Science Center at Houston; Sydney University Medical School (E.A.M.), Australia; Stanford Health Care (M.P.M), Palo Alto, CA; private practice (S.J.V.), Erwinna, PA; and Dell Medical School (S.W.), University of Texas at Austin
| |
Collapse
|
25
|
Sterk HP, Detrey I, Marshall C, Cowie NR, Payne R, McIlvenny J, Andersen R. Capturing Gas Fluxes on Your Phone: An iOS- and Android-based Data-Logging Setup for EGM-4 Environmental Gas Monitoring Systems. J Environ Qual 2019; 48:1557-1560. [PMID: 31589702 DOI: 10.2134/jeq2019.04.0163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Mobile devices have become increasingly important for field monitoring to improve data capture efficiency, increase storage capacity, and replace heavy equipment. We introduce a quick and straightforward protocol to capture greenhouse gas (GHG) emission rates on mobile devices. We developed our setup on the widely used infrared gas analyzer (IRGA) EGM-4 by PP Systems. This IRGA has a limited internal storage capacity and requires an external device such as a laptop to conduct even modest field sampling. Furthermore, when raw data storage is required, carbon dioxide concentration resolution is reduced by the internal EGM-4 software settings, making the equipment less suitable for high-frequency measurements. Our protocol lets the user bring either an iOS or Android mobile device in to the field to connect to the EGM-4's data stream. For both platforms, a mobile console application was used to read, log, and share flux data. The raw data can be processed in either Python, R, or Matlab using the provided scripts that give the user flexibility to amend further postprocessing steps to obtain GHG fluxes. We demonstrate the flexible applicability of mobile devices for field recording and show that a cost-effective solution can enhance the operational life of superseded field equipment while also increasing the quality of the captured data.
Collapse
|
26
|
Sulmasy DP, Finlay I, Fitzgerald F, Foley K, Payne R, Siegler M. Physician-Assisted Suicide: Against Medical Neutrality. J Gen Intern Med 2019; 34:1372. [PMID: 31098979 PMCID: PMC6667721 DOI: 10.1007/s11606-019-05019-1] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Daniel P Sulmasy
- Kennedy Institute of Ethics, Healy 419, Georgetown University, Washington, DC, USA.
| | | | | | - Kathleen Foley
- Emeritus, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Richard Payne
- Kennedy Institute of Ethics, Healy 419, Georgetown University, Washington, DC, USA
| | | |
Collapse
|
27
|
Abstract
We provide a detailed description of painful neural lesions in hospitalized patients with cancer. A total of 187 consecutive patients with cancer and pain, referred to the pain service of a cancer hospital, were evaluated within 24 hours by two neurologists and followed until discharge or death. Based on history, pain descriptors, physical examination, and radiological and electrophysiological studies, the pain was categorized as neuropathic in 103 patients. The most frequent sites of neurological injury were nerve roots, spinal cord and cauda equina, brachial and lumbosacral plexus, and peripheral nerves. There were no patients with pain caused by injury to the brain. In 93 of these patients, the pain was caused by ongoing neural injury, while, in 10 patients, the neural injury was old and stable. Within these two groups of patients with neuropathic pain, analgesic treatments differed. Prospective studies may determine if categorizing painful neurological injuries in cancer patients based on inferred pathophysiology is useful when deciding among different treatment options.
Collapse
Affiliation(s)
- Paolo L. Manfredi
- Department of Neuro-Oncology, Section of Pain and Symptom Management, MD Anderson Cancer Center, Houston, Texas, U.S.A
| | - Gilbert R. Gonzales
- Memorial Sloan-Kettering Cancer Center, Department of Neurology, Pain and Palliative Care Service, New York, New York
| | - Ribeiro Sady
- Department of Neuro-Oncology, Section of Pain and Symptom Management, MD Anderson Cancer Center, Houston, Texas, U.S.A
| | - Sonja Chandler
- Department of Neuro-Oncology, Section of Pain and Symptom Management, MD Anderson Cancer Center, Houston, Texas, U.S.A
| | - Richard Payne
- Department of Neuro-Oncology, Section of Pain and Symptom Management, MD Anderson Cancer Center, Houston, Texas, U.S.A
| |
Collapse
|
28
|
Qiao Y, Zhu X, Zhai L, Payne R, Li T. PSXVI-42 Dietary soybean meal level and β-mannanase supplementation affected serum biochemical constituents in nursery pigs. J Anim Sci 2018. [DOI: 10.1093/jas/sky404.741] [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: 11/12/2022] Open
Affiliation(s)
- Y Qiao
- Elanco Animal Health,Beijing, China (People’s Republic)
| | - X Zhu
- Institute of Subtropical Agriculture, Chinese Academy of Sciences,Hunan, China (People’s Republic)
| | - L Zhai
- Elanco Animal Health,Beijing, China (People’s Republic)
| | - R Payne
- Elanco Animal Health,Sunset, LA, United States
| | - T Li
- Elanco Animal Health,Beijing, China (People’s Republic)
| |
Collapse
|
29
|
Qiao Y, Zhu X, Zhai L, Payne R, Li T. 192 Dietary β-mannanase supplementation improved growth and health of nursery pigs fed high soybean meal diet. J Anim Sci 2018. [DOI: 10.1093/jas/sky404.670] [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)
- Y Qiao
- Elanco Animal Health,Beijing, China (People’s Republic)
| | - X Zhu
- Institute of Subtropical Agriculture, Chinese Academy of Sciences,Hunan, China (People’s Republic)
| | - L Zhai
- Elanco Animal Health,Beijing, China (People’s Republic)
| | - R Payne
- Elanco Animal Health,Sunset, LA, United States
| | - T Li
- Institute of Subtropical Agriculture, Chinese Academy of Sciences,Hunan, China (People’s Republic)
| |
Collapse
|
30
|
Qiao Y, Zhu X, Zhai L, Payne R, Li T. PSIII-36 Dietary soybean meal level and β-mannanase supplementation affected immunoproteins in carotid artery and morphology and aquaporin water channels in small intestine of nursery pigs. J Anim Sci 2018. [DOI: 10.1093/jas/sky404.690] [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: 11/12/2022] Open
Affiliation(s)
- Y Qiao
- Elanco Animal Health,Beijing, China (People’s Republic)
| | - X Zhu
- Institute of Subtropical Agriculture, Chinese Academy of Sciences,Hunan, China (People’s Republic)
| | - L Zhai
- Elanco Animal Health,Beijing, China (People’s Republic)
| | - R Payne
- Elanco Animal Health,Kennesaw, GA, United States
| | - T Li
- Institute of Subtropical Agriculture, Chinese Academy of Sciences,Hunan, China (People’s Republic)
| |
Collapse
|
31
|
Henry M, Chang Y, Frenkiel S, Chartier G, Payne R, MacDonald C, Loiselle C, Black MJ, Mlynarek AM, Ehrler A, Rosberger Z, Tamilia M, Hier MP. Feelings of Disenfranchisement and Support Needs Among Patients With Thyroid Cancer. Oncol Nurs Forum 2018; 45:639-652. [PMID: 30118450 DOI: 10.1188/18.onf.639-652] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [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: 11/17/2022]
Abstract
PURPOSE To offer a better understanding of the experiences, preferences, and needs of patients with thyroid cancer. PARTICIPANTS & SETTING 17 patients with thyroid cancer receiving treatment at a university-affiliated hospital in Montreal, Québec, Canada. METHODOLOGIC APPROACH Interviews were conducted with patients, and descriptive phenomenology was used to explore patients' lived experience. FINDINGS Coping with uncertainty was a major theme that emerged from interviews, with some of the main concerns being difficult treatment decisions, long surgery wait times, and fears about surgical complications, potential metastases, and death. Study participants reported that without a nurse and an interprofessional team, they would be lost in a system they believed minimized their illness and offered few resources to support them in a time of crisis. IMPLICATIONS FOR NURSING Nurses must understand how the needs of individuals with thyroid cancer are often overlooked because of the good prognosis associated with the disease and should work to meet these information and support needs.
Collapse
|
32
|
Rossdale P, Hunt M, Peace C, Ricketts S, Digby NW, Greet T, Steven N, Pilsworth R, McGladdery A, Carson D, Barrelet F, Shepherd M, Payne R, Ramzan P, Bathe A. Peter Robinson. Vet Rec 2018. [DOI: 10.1136/vr.k3395] [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: 11/04/2022]
|
33
|
Rossdale P, Hunt M, Peace C, Ricketts S, Digby NW, Greet T, Steven N, Pilsworth R, McGladdery A, Carson D, Barrelet F, Shepherd M, Payne R, Ramzan P, Bathe A. Raymond Hopes. Vet Rec 2018. [DOI: 10.1136/vr.k3281] [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: 11/04/2022]
|
34
|
|
35
|
Al Jassim A, Wallace T, Bouhabel S, Majdan A, Hier M, Forest VI, Payne R. A retrospective cohort study: do patients with graves' disease need to be euthyroid prior to surgery? J Otolaryngol Head Neck Surg 2018; 47:37. [PMID: 29784035 PMCID: PMC5963139 DOI: 10.1186/s40463-018-0281-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2017] [Accepted: 05/07/2018] [Indexed: 11/10/2022] Open
Abstract
Background The 2016 American Thyroid Association guidelines indicate that patients with Graves’ disease who undergo a thyroidectomy should be rendered euthyroid through the use of antithyroid drugs (ATD) prior to surgery to avoid complications such as a thyroid storm. At times, the use of ATDs can have limited efficacy and therefore some patients will inevitably remain biochemically hyperthyroid at the time of surgery. The aim of this study is to assess if hyperthyroid patients undergoing a thyroidectomy are at an increased risk of developing a thyroid storm in comparison to euthyroid patients. Furthermore, this study seeks to establish a correlation between thyroid storm identified by the levels of thyroid hormones (T3 and T4) and the level of thyroid stimulating hormone (TSH). Methods A retrospective cohort study was conducted at two Canadian centers, one in Montreal and the other in Nova Scotia. Sixty-seven patients undergoing thyroidectomy for Graves’ disease from January 2006 to December 2016 were evaluated. Results The study comprised 67 participants with a mean age of 46 years (range16–78 years). A total of 78% of patients were on methimazole, 34% on beta-blockers, 27% on potassium iodine solution, 10% on propylthiouracil and 7% on steroids. At the time of surgery 21% were in an overt hyperthyroid state and 33% were in a subclinical hyperthyroid state. The average TSH level of 0.03 mIUL/L (range 0.01–0.23 mIUL/L). Sixteen percent of patients had a TSH level less than 0.01 mIUL/L. The average free T4 level was 29.58 pmol/L (range 11.5–95.2 pmol/L). The average total T3 level was 11.52 nmol/L (range 4.5–29.1 nmol/L) and free T3 level was 6.35 pmol/L (range 6.1–6.6 pmol/L). No patient developed thyroid storm. Conclusions In our study, biochemically hyperthyroid patients undergoing thyroidectomy did not develop thyroid storm. Additional studies with larger sample sizes are needed to better understand the risk of thyroid storm in hyperthyroid patients.
Collapse
Affiliation(s)
- Abrar Al Jassim
- Department of Otolaryngology - Head and Neck surgery, Jewish General Hospital, McGill University, 3755 Côte-Sainte-Catherine Road, Montreal, Quebec, H3T 1E2, Canada.
| | - Tim Wallace
- Department of Otolaryngology - Head and Neck surgery, Cumberland Regional Health Care Center, Dalhousie University, Halifax, NS, Canada
| | - Sarah Bouhabel
- Department of Otolaryngology - Head and Neck surgery, Jewish General Hospital, McGill University, 3755 Côte-Sainte-Catherine Road, Montreal, Quebec, H3T 1E2, Canada
| | - Agnieszka Majdan
- Division of Endocrinology, Jewish General Hospital, McGill University, Montreal, Quebec, Canada
| | - Michael Hier
- Department of Otolaryngology - Head and Neck surgery, Jewish General Hospital, McGill University, 3755 Côte-Sainte-Catherine Road, Montreal, Quebec, H3T 1E2, Canada
| | - Veronique-Isabelle Forest
- Department of Otolaryngology - Head and Neck surgery, Jewish General Hospital, McGill University, 3755 Côte-Sainte-Catherine Road, Montreal, Quebec, H3T 1E2, Canada
| | - Richard Payne
- Department of Otolaryngology - Head and Neck surgery, Jewish General Hospital, McGill University, 3755 Côte-Sainte-Catherine Road, Montreal, Quebec, H3T 1E2, Canada
| |
Collapse
|
36
|
Coughlan L, Sridhar S, Payne R, Edmans M, Milicic A, Venkatraman N, Lugonja B, Clifton L, Qi C, Folegatti PM, Lawrie AM, Roberts R, de Graaf H, Sukhtankar P, Faust SN, Lewis DJM, Lambe T, Hill AVS, Gilbert SC. Corrigendum to "Heterologous Two-dose Vaccination with Simian Adenovirus and Poxvirus Vectors Elicits Long-lasting Cellular Immunity to Influenza Virus A in Healthy Adults" [EBioMedicine 29 (2018) 146-154]. EBioMedicine 2018; 31:321. [PMID: 29735416 PMCID: PMC6014575 DOI: 10.1016/j.ebiom.2018.05.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Affiliation(s)
- L Coughlan
- Icahn School of Medicine at Mount Sinai, Department of Microbiology, Annenberg Building, Room 16.30, One Gustave Levy Place, New York 10029, United States
| | - S Sridhar
- Sanofi Pasteur, MARCY l'ETOILE 69280, France
| | - R Payne
- The Jenner Institute, University of Oxford, ORCRB, Roosevelt Drive, Oxford OX3 7DQ, UK
| | - M Edmans
- The Jenner Institute, University of Oxford, ORCRB, Roosevelt Drive, Oxford OX3 7DQ, UK
| | - A Milicic
- The Jenner Institute, University of Oxford, ORCRB, Roosevelt Drive, Oxford OX3 7DQ, UK
| | - N Venkatraman
- The Jenner Institute, University of Oxford, ORCRB, Roosevelt Drive, Oxford OX3 7DQ, UK
| | - B Lugonja
- The Jenner Institute, University of Oxford, ORCRB, Roosevelt Drive, Oxford OX3 7DQ, UK
| | - L Clifton
- Centre for Statistics in Medicine, NDORMS, University of Oxford, Botnar Research Centre, Windmill Road, Oxford OX3 7LD, UK
| | - C Qi
- Centre for Statistics in Medicine, NDORMS, University of Oxford, Botnar Research Centre, Windmill Road, Oxford OX3 7LD, UK
| | - P M Folegatti
- The Jenner Institute, University of Oxford, ORCRB, Roosevelt Drive, Oxford OX3 7DQ, UK
| | - A M Lawrie
- The Jenner Institute, University of Oxford, ORCRB, Roosevelt Drive, Oxford OX3 7DQ, UK
| | - R Roberts
- The Jenner Institute, University of Oxford, ORCRB, Roosevelt Drive, Oxford OX3 7DQ, UK
| | - H de Graaf
- NIHR Wellcome Trust Clinical Research Facility, University of Southampton, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - P Sukhtankar
- NIHR Wellcome Trust Clinical Research Facility, University of Southampton, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - S N Faust
- NIHR Wellcome Trust Clinical Research Facility, University of Southampton, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - D J M Lewis
- Clinical Research Centre, University of Surrey, Guildford GU2 7AX, UK
| | - T Lambe
- The Jenner Institute, University of Oxford, ORCRB, Roosevelt Drive, Oxford OX3 7DQ, UK
| | - A V S Hill
- The Jenner Institute, University of Oxford, ORCRB, Roosevelt Drive, Oxford OX3 7DQ, UK
| | - S C Gilbert
- The Jenner Institute, University of Oxford, ORCRB, Roosevelt Drive, Oxford OX3 7DQ, UK.
| |
Collapse
|
37
|
Begen FM, Barnett J, Payne R, Gowland MH, DunnGalvin A, Lucas JS. Eating out with a food allergy in the UK: Change in the eating out practices of consumers with food allergy following introduction of allergen information legislation. Clin Exp Allergy 2018; 48:317-324. [PMID: 29220107 DOI: 10.1111/cea.13072] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2017] [Revised: 11/01/2017] [Accepted: 11/22/2017] [Indexed: 11/30/2022]
Abstract
BACKGROUND Strict allergen avoidance is important in day-to-day management of food allergy and avoidance when eating outside the home can present particular difficulties. EU legislation (EU FIC) introduced in December 2014 aimed to improve food allergen information provision for customers by requiring retailers of non-prepacked foods to provide information related to the content of one or more of 14 specified food allergens within their foods. OBJECTIVES To investigate the impact of EU FIC on the behaviours, experiences and attitudes of consumers with food allergy when eating out. METHODS As part of longitudinal research, participants with food allergy from across the UK took part in either (A) pre and post legislation in-depth interviews, or (B) pre and post legislation surveys. In-depth interviews were carried out with 28 participants pre and post legislation and analysed using the framework approach. Self-report surveys were completed by 129 participants pre and post legislation, and responses were subject to quantitative analyses. RESULTS Improvements in allergen information provision and raised awareness of food allergy in eating out venues were reported following introduction of EU FIC. Whilst participants favoured written allergen information, they expressed greater confidence in communicating with eating out staff and in trusting the allergen information that they provided. Improvements were judged to be gradual, sporadic or inconsistent in implementation. CONCLUSION & CLINICAL RELEVANCE For many participants, the "ideal" eating out experience was one in which a range of information resources were available and where written allergen information was complemented by proactive and accommodating staff within an allergy-aware environment. Whilst the onus is on legislators and food providers to ensure that adequate allergen information is provided, clinicians play an important role in encouraging patients with food allergy to pursue their legal right to make allergen enquiries to avoid accidental allergen ingestion when eating out.
Collapse
Affiliation(s)
- F M Begen
- Department of Psychology, University of Bath, Bath, UK
| | - J Barnett
- Department of Psychology, University of Bath, Bath, UK
| | - R Payne
- Creative Research Ltd, Bishops Castle, UK
| | | | - A DunnGalvin
- School of Applied Psychology, University College Cork, Cork City, Ireland
| | - J S Lucas
- Clinical & Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
| |
Collapse
|
38
|
Carqueijeiro I, Sepúlveda LJ, Mosquera A, Payne R, Corbin C, Papon N, de Bernonville TD, Besseau S, Lanoue A, Glévarec G, Clastre M, St-Pierre B, Atehortùa L, Giglioli-Guivarc'h N, O'Connor SE, Oudin A, Courdavault V. Vacuole-Targeted Proteins: Ins and Outs of Subcellular Localization Studies. Methods Mol Biol 2018; 1789:33-54. [PMID: 29916070 DOI: 10.1007/978-1-4939-7856-4_4] [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
Accurate and efficient demonstrations of protein localizations to the vacuole or tonoplast remain strict prerequisites to decipher the role of vacuoles in the whole plant cell biology and notably in defence processes. In this chapter, we describe a reliable procedure of protein subcellular localization study through transient transformations of Catharanthus roseus or onion cells and expression of fusions with fluorescent proteins allowing minimizing artefacts of targeting.
Collapse
Affiliation(s)
- Inês Carqueijeiro
- EA2106 "Biomolécules et Biotechnologies Végétales", UFR Sciences et Techniques, Université François-Rabelais de Tours, Tours, France
| | - Liuda J Sepúlveda
- EA2106 "Biomolécules et Biotechnologies Végétales", UFR Sciences et Techniques, Université François-Rabelais de Tours, Tours, France.,Laboratorio de Biotecnología, Sede de Investigación Universitaria, Universidad de Antioquia, Medellin, Colombia
| | - Angela Mosquera
- EA2106 "Biomolécules et Biotechnologies Végétales", UFR Sciences et Techniques, Université François-Rabelais de Tours, Tours, France.,Laboratorio de Biotecnología, Sede de Investigación Universitaria, Universidad de Antioquia, Medellin, Colombia
| | - Richard Payne
- Department of Biological Chemistry, The John Innes Centre, Norwich Research Park, Norwich, UK
| | - Cyrielle Corbin
- EA2106 "Biomolécules et Biotechnologies Végétales", UFR Sciences et Techniques, Université François-Rabelais de Tours, Tours, France
| | - Nicolas Papon
- EA3142 "Groupe d'Etude des Interactions Hôte-Pathogène", Université d'Angers, Angers, France
| | - Thomas Dugé de Bernonville
- EA2106 "Biomolécules et Biotechnologies Végétales", UFR Sciences et Techniques, Université François-Rabelais de Tours, Tours, France
| | - Sébastien Besseau
- EA2106 "Biomolécules et Biotechnologies Végétales", UFR Sciences et Techniques, Université François-Rabelais de Tours, Tours, France
| | - Arnaud Lanoue
- EA2106 "Biomolécules et Biotechnologies Végétales", UFR Sciences et Techniques, Université François-Rabelais de Tours, Tours, France
| | - Gaëlle Glévarec
- EA2106 "Biomolécules et Biotechnologies Végétales", UFR Sciences et Techniques, Université François-Rabelais de Tours, Tours, France
| | - Marc Clastre
- EA2106 "Biomolécules et Biotechnologies Végétales", UFR Sciences et Techniques, Université François-Rabelais de Tours, Tours, France
| | - Benoit St-Pierre
- EA2106 "Biomolécules et Biotechnologies Végétales", UFR Sciences et Techniques, Université François-Rabelais de Tours, Tours, France
| | - Lucia Atehortùa
- Laboratorio de Biotecnología, Sede de Investigación Universitaria, Universidad de Antioquia, Medellin, Colombia
| | - Nathalie Giglioli-Guivarc'h
- EA2106 "Biomolécules et Biotechnologies Végétales", UFR Sciences et Techniques, Université François-Rabelais de Tours, Tours, France
| | - Sarah E O'Connor
- Department of Biological Chemistry, The John Innes Centre, Norwich Research Park, Norwich, UK
| | - Audrey Oudin
- EA2106 "Biomolécules et Biotechnologies Végétales", UFR Sciences et Techniques, Université François-Rabelais de Tours, Tours, France
| | - Vincent Courdavault
- EA2106 "Biomolécules et Biotechnologies Végétales", UFR Sciences et Techniques, Université François-Rabelais de Tours, Tours, France.
| |
Collapse
|
39
|
Mughal Z, Payne R, Zaidi H. Evaluating Weekend Handover in General Surgery Using a Bespoke Proforma Tool. Int J Surg 2017. [DOI: 10.1016/j.ijsu.2017.08.312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
|
40
|
Judd A, Zangerle R, Touloumi G, Warszawski J, Meyer L, Dabis F, Mary Krause M, Ghosn J, Leport C, Wittkop L, Reiss P, Wit F, Prins M, Bucher H, Gibb D, Fätkenheuer G, Julia DA, Obel N, Thorne C, Mocroft A, Kirk O, Stephan C, Pérez-Hoyos S, Hamouda O, Bartmeyer B, Chkhartishvili N, Noguera-Julian A, Antinori A, d’Arminio Monforte A, Brockmeyer N, Prieto L, Rojo Conejo P, Soriano-Arandes A, Battegay M, Kouyos R, Mussini C, Tookey P, Casabona J, Miró JM, Castagna A, Konopnick D, Goetghebuer T, Sönnerborg A, Quiros-Roldan E, Sabin C, Teira R, Garrido M, Haerry D, de Wit S, Miró JM, Costagliola D, d’Arminio-Monforte A, Castagna A, del Amo J, Mocroft A, Raben D, Chêne G, Judd A, Pablo Rojo C, Barger D, Schwimmer C, Termote M, Wittkop L, Campbell M, Frederiksen CM, Friis-Møller N, Kjaer J, Raben D, Salbøl Brandt R, Berenguer J, Bohlius J, Bouteloup V, Bucher H, Cozzi-Lepri A, Dabis F, d’Arminio Monforte A, Davies MA, del Amo J, Dorrucci M, Dunn D, Egger M, Furrer H, Grabar S, Guiguet M, Judd A, Kirk O, Lambotte O, Leroy V, Lodi S, Matheron S, Meyer L, Miro JM, Mocroft A, Monge S, Nakagawa F, Paredes R, Phillips A, Puoti M, Rohner E, Schomaker M, Smit C, Sterne J, Thiebaut R, Thorne C, Torti C, van der Valk M, Wittkop L, Tanser F, Vinikoor M, Macete E, Wood R, Stinson K, Garone D, Fatti G, Giddy J, Malisita K, Eley B, Fritz C, Hobbins M, Kamenova K, Fox M, Prozesky H, Technau K, Sawry S, Benson CA, Bosch RJ, Kirk GD, Boswell S, Mayer KH, Grasso C, Hogg RS, Richard Harrigan P, Montaner JSG, Yip B, Zhu J, Salters K, Gabler K, Buchacz K, Brooks JT, Gebo KA, Moore RD, Moore RD, Rodriguez B, Horberg MA, Silverberg MJ, Thorne JE, Rabkin C, Margolick JB, Jacobson LP, D’Souza G, Klein MB, Rourke SB, Rachlis AR, Cupido P, Hunter-Mellado RF, Mayor AM, John Gill M, Deeks SG, Martin JN, Patel P, Brooks JT, Saag MS, Mugavero MJ, Willig J, Eron JJ, Napravnik S, Kitahata MM, Crane HM, Drozd DR, Sterling TR, Haas D, Rebeiro P, Turner M, Bebawy S, Rogers B, Justice AC, Dubrow R, Fiellin D, Gange SJ, Anastos K, Moore RD, Saag MS, Gange SJ, Kitahata MM, Althoff KN, Horberg MA, Klein MB, McKaig RG, Freeman AM, Moore RD, Freeman AM, Lent C, Kitahata MM, Van Rompaey SE, Crane HM, Drozd DR, Morton L, McReynolds J, Lober WB, Gange SJ, Althoff KN, Abraham AG, Lau B, Zhang J, Jing J, Modur S, Wong C, Hogan B, Desir F, Liu B, You B, Cahn P, Cesar C, Fink V, Sued O, Dell’Isola E, Perez H, Valiente J, Yamamoto C, Grinsztejn B, Veloso V, Luz P, de Boni R, Cardoso Wagner S, Friedman R, Moreira R, Pinto J, Ferreira F, Maia M, Célia de Menezes Succi R, Maria Machado D, de Fátima Barbosa Gouvêa A, Wolff M, Cortes C, Fernanda Rodriguez M, Allendes G, William Pape J, Rouzier V, Marcelin A, Perodin C, Tulio Luque M, Padgett D, Sierra Madero J, Crabtree Ramirez B, Belaunzaran P, Caro Vega Y, Gotuzzo E, Mejia F, Carriquiry G, McGowan CC, Shepherd BE, Sterling T, Jayathilake K, Person AK, Rebeiro PF, Giganti M, Castilho J, Duda SN, Maruri F, Vansell H, Ly PS, Khol V, Zhang FJ, Zhao HX, Han N, Lee MP, Li PCK, Lam W, Chan YT, Kumarasamy N, Saghayam S, Ezhilarasi C, Pujari S, Joshi K, Gaikwad S, Chitalikar A, Merati TP, Wirawan DN, Yuliana F, Yunihastuti E, Imran D, Widhani A, Tanuma J, Oka S, Nishijima T, Na S, Choi JY, Kim JM, Sim BLH, Gani YM, David R, Kamarulzaman A, Syed Omar SF, Ponnampalavanar S, Azwa I, Ditangco R, Uy E, Bantique R, Wong WW, Ku WW, Wu PC, Ng OT, Lim PL, Lee LS, Ohnmar PS, Avihingsanon A, Gatechompol S, Phanuphak P, Phadungphon C, Kiertiburanakul S, Sungkanuparph S, Chumla L, Sanmeema N, Chaiwarith R, Sirisanthana T, Kotarathititum W, Praparattanapan J, Kantipong P, Kambua P, Ratanasuwan W, Sriondee R, Nguyen KV, Bui HV, Nguyen DTH, Nguyen DT, Cuong DD, An NV, Luan NT, Sohn AH, Ross JL, Petersen B, Cooper DA, Law MG, Jiamsakul A, Boettiger DC, Ellis D, Bloch M, Agrawal S, Vincent T, Allen D, Smith D, Rankin A, Baker D, Templeton DJ, O’Connor CC, Thackeray O, Jackson E, McCallum K, Ryder N, Sweeney G, Cooper D, Carr A, Macrae K, Hesse K, Finlayson R, Gupta S, Langton-Lockton J, Shakeshaft J, Brown K, Idle S, Arvela N, Varma R, Lu H, Couldwell D, Eswarappa S, Smith DE, Furner V, Smith D, Cabrera G, Fernando S, Cogle A, Lawrence C, Mulhall B, Boyd M, Law M, Petoumenos K, Puhr R, Huang R, Han A, Gunathilake M, Payne R, O’Sullivan M, Croydon A, Russell D, Cashman C, Roberts C, Sowden D, Taing K, Marshall P, Orth D, Youds D, Rowling D, Latch N, Warzywoda E, Dickson B, Donohue W, Moore R, Edwards S, Boyd S, Roth NJ, Lau H, Read T, Silvers J, Zeng W, Hoy J, Watson K, Bryant M, Price S, Woolley I, Giles M, Korman T, Williams J, Nolan D, Allen A, Guelfi G, Mills G, Wharry C, Raymond N, Bargh K, Templeton D, Giles M, Brown K, Hoy J. Comparison of Kaposi Sarcoma Risk in Human Immunodeficiency Virus-Positive Adults Across 5 Continents: A Multiregional Multicohort Study. Clin Infect Dis 2017; 65:1316-1326. [PMID: 28531260 PMCID: PMC5850623 DOI: 10.1093/cid/cix480] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2017] [Accepted: 05/19/2017] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND We compared Kaposi sarcoma (KS) risk in adults who started antiretroviral therapy (ART) across the Asia-Pacific, South Africa, Europe, Latin, and North America. METHODS We included cohort data of human immunodeficiency virus (HIV)-positive adults who started ART after 1995 within the framework of 2 large collaborations of observational HIV cohorts. We present incidence rates and adjusted hazard ratios (aHRs). RESULTS We included 208140 patients from 57 countries. Over a period of 1066572 person-years, 2046 KS cases were diagnosed. KS incidence rates per 100000 person-years were 52 in the Asia-Pacific and ranged between 180 and 280 in the other regions. KS risk was 5 times higher in South African women (aHR, 4.56; 95% confidence intervals [CI], 2.73-7.62) than in their European counterparts, and 2 times higher in South African men (2.21; 1.34-3.63). In Europe, Latin, and North America KS risk was 6 times higher in men who have sex with men (aHR, 5.95; 95% CI, 5.09-6.96) than in women. Comparing patients with current CD4 cell counts ≥700 cells/µL with those whose counts were <50 cells/µL, the KS risk was halved in South Africa (aHR, 0.53; 95% CI, .17-1.63) but reduced by ≥95% in other regions. CONCLUSIONS Despite important ART-related declines in KS incidence, men and women in South Africa and men who have sex with men remain at increased KS risk, likely due to high human herpesvirus 8 coinfection rates. Early ART initiation and maintenance of high CD4 cell counts are essential to further reducing KS incidence worldwide, but additional measures might be needed, especially in Southern Africa.
Collapse
|
41
|
Tuffuor AN, Payne R. Isolation and Suffering Related to Serious and Terminal Illness: Metaphors and Lessons From Albert Camus' Novel, The Plague. J Pain Symptom Manage 2017; 54:400-403. [PMID: 28778561 DOI: 10.1016/j.jpainsymman.2017.07.046] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [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: 07/25/2017] [Accepted: 07/27/2017] [Indexed: 11/30/2022]
Abstract
Health care providers have much to learn from Albert Camus' great novel, The Plague. The Plague tells the story of a bubonic plague epidemic through the lens of doctor-narrator Rieux. In addition to Rieux, this essay also focuses on the perspective of Father Paneloux, a Jesuit priest, who provides important religious commentary on the epidemic, before falling victim to it and dying. Camus' masterful engagement of the metaphor of isolation and its profound impact on suffering emphasizes the important role of community and spiritual perspectives of patients and providers in coping with serious illness, death, and dying. The Plague is relevant today, particularly given the challenges of distancing, alienation, and isolation imposed by not only disease but also by technology and clinical and administrative practices that have unintended consequences of incentivizing separation between patient and healer, thus engendering greater stress and suffering in both.
Collapse
Affiliation(s)
- Akosua N Tuffuor
- The Divinity School, Duke University, Durham, North Carolina, USA
| | - Richard Payne
- The Divinity School, Duke University, Durham, North Carolina, USA.
| |
Collapse
|
42
|
Larsen B, Fuller VL, Pollier J, Van Moerkercke A, Schweizer F, Payne R, Colinas M, O’Connor SE, Goossens A, Halkier BA. Identification of Iridoid Glucoside Transporters in Catharanthus roseus. Plant Cell Physiol 2017; 58:1507-1518. [PMID: 28922750 PMCID: PMC5921532 DOI: 10.1093/pcp/pcx097] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/29/2017] [Accepted: 07/06/2017] [Indexed: 05/02/2023]
Abstract
Monoterpenoid indole alkaloids (MIAs) are plant defense compounds and high-value pharmaceuticals. Biosynthesis of the universal MIA precursor, secologanin, is organized between internal phloem-associated parenchyma (IPAP) and epidermis cells. Transporters for intercellular transport of proposed mobile pathway intermediates have remained elusive. Screening of an Arabidopsis thaliana transporter library expressed in Xenopus oocytes identified AtNPF2.9 as a putative iridoid glucoside importer. Eight orthologs were identified in Catharanthus roseus, of which three, CrNPF2.4, CrNPF2.5 and CrNPF2.6, were capable of transporting the iridoid glucosides 7-deoxyloganic acid, loganic acid, loganin and secologanin into oocytes. Based on enzyme expression data and transporter specificity, we propose that several enzymes of the biosynthetic pathway are present in both IPAP and epidermis cells, and that the three transporters are responsible for transporting not only loganic acid, as previously proposed, but multiple intermediates. Identification of the iridoid glucoside-transporting CrNPFs is an important step toward understanding the complex orchestration of the seco-iridioid pathway.
Collapse
Affiliation(s)
- Bo Larsen
- DynaMo Center, Department of Plant and Environmental Sciences, Faculty of Science, University of Copenhagen, Thorvaldsensvej 40, 1871 Frederiksberg C, Denmark
| | - Victoria L. Fuller
- DynaMo Center, Department of Plant and Environmental Sciences, Faculty of Science, University of Copenhagen, Thorvaldsensvej 40, 1871 Frederiksberg C, Denmark
| | - Jacob Pollier
- Department of Plant Systems Biology, VIB, B-9052 Gent, Belgium
- Department of Plant Biotechnology and Bioinformatics, Ghent University, B-9052 Gent, Belgium
| | - Alex Van Moerkercke
- Department of Plant Systems Biology, VIB, B-9052 Gent, Belgium
- Department of Plant Biotechnology and Bioinformatics, Ghent University, B-9052 Gent, Belgium
| | - Fabian Schweizer
- Department of Plant Systems Biology, VIB, B-9052 Gent, Belgium
- Department of Plant Biotechnology and Bioinformatics, Ghent University, B-9052 Gent, Belgium
| | - Richard Payne
- Department of Biological Chemistry, John Innes Centre, Norwich NR4 7UH, UK
| | - Maite Colinas
- Department of Plant Systems Biology, VIB, B-9052 Gent, Belgium
- Department of Plant Biotechnology and Bioinformatics, Ghent University, B-9052 Gent, Belgium
| | - Sarah E. O’Connor
- Department of Biological Chemistry, John Innes Centre, Norwich NR4 7UH, UK
| | - Alain Goossens
- Department of Plant Systems Biology, VIB, B-9052 Gent, Belgium
- Department of Plant Biotechnology and Bioinformatics, Ghent University, B-9052 Gent, Belgium
| | - Barbara A. Halkier
- DynaMo Center, Department of Plant and Environmental Sciences, Faculty of Science, University of Copenhagen, Thorvaldsensvej 40, 1871 Frederiksberg C, Denmark
- Corresponding author: E-mail, ; Fax, +45 35333333
| |
Collapse
|
43
|
Payne R, Halik L, Ma J, Zhang H, Zhang J, Conklin J, Gaylord M, Yokoyama K, Bahrainy Y, Ozgen N, Balderson J, Chase A, Gorman R, Plouffe B, Deflippi C. P2754Performance evaluation of the siemens advia centaur high sensitivity troponin i assay. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx502.p2754] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
|
44
|
Al-Bader A, Zawawi F, Singer Z, Mlynarek A, Hier M, Tamilia M, Payne R. Preoperative TSH and thyroglobulin levels: would it predict thyroid cancer? Otolaryngol Pol 2017; 69:21-5. [PMID: 26388246 DOI: 10.5604/00306657.1156331] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [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
OBJECTIVE The goal of this study is to determine whether preoperative TSH and Tg levels can be used as predictors of thyroid cancer. STUDY DESIGN Retrospective chart review. METHODS Charts of patients who had undergone thyroid surgery between 2006 and 2012 were subjected to review. Demographic data, preoperative TSH and Tg levels, and final histopathological results were recorded. Patients were divided depending on preoperative TSH and Tg levels. Group 1 consisted of patients with elevated TSH and Tg, Group 2 had elevated TSH only, Group 3 - elevated Tg only, and in Group 4 neither TSH nor Tg were elevated. RESULTS 653 patient charts were reviewed and 386 patients were excluded due to incomplete information. 212 patients were female. Mean age was 50 years. Group 1 included 52 patients, 25 of them (48%) had well-differentiated thyroid cancer (WDTC). Relative risk was 1.59 and the odds ratio amounted to 1.79. Group 2 included 80 patients, 36 (45%) of whom had WDTC. Group 3 consisted of 58 patients, 23 (39.6%) of them with WDTC. Group 4 comprised 77 patients, where WDTC was present in 16 (20.8%) cases. CONCLUSION TSH and Tg levels can aid in preoperative assessment of a thyroid nodule.
Collapse
|
45
|
Payne R. Racially Associated Disparities in Hospice and Palliative Care Access: Acknowledging the Facts While Addressing the Opportunities to Improve. J Palliat Med 2016; 19:131-3. [PMID: 26840847 DOI: 10.1089/jpm.2015.0475] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [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
|
46
|
Johnson KS, Payne R, Kuchibhatla MN. What are Hospice Providers in the Carolinas Doing to Reach African Americans in Their Service Area? J Palliat Med 2016; 19:183-9. [PMID: 26840854 DOI: 10.1089/jpm.2015.0438] [Citation(s) in RCA: 6] [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] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Experts and national organizations recommend that hospices work to increase service to African Americans, a group historically underrepresented in hospice. OBJECTIVE The study objective was to describe strategies among hospices in North and South Carolina to increase service to African Americans and identify hospice characteristics associated with these efforts. METHODS The study was a cross-sectional survey using investigator-developed scales to measure frequency of community education/outreach, directed marketing, efforts to recruit African American staff, cultural sensitivity training, and goals to increase service to African Americans. We used nonparametric Wilcoxon tests to compare mean scale scores by sample characteristics. RESULTS Of 118 eligible hospices, 79 (67%) completed the survey. Over 80% were at least somewhat concerned about the low proportion of African Americans they served, and 78.5% had set goals to increase service to African Americans. Most were engaged in community education/outreach, with 92.4% reporting outreach to churches, 76.0% to social services organizations, 40.5% to businesses, 35.4% to civic groups, and over half to health care providers; 48.0% reported directed marketing via newspaper and 40.5% via radio. The vast majority reported efforts to recruit African American staff, most often registered nurses (63.75%). Nearly 90% offered cultural sensitivity training to staff. The frequency of strategies to increase service to African Americans did not vary by hospice characteristics, such as profit status, size, or vertical integration, but was greater among hospices that had set goals to increase service to African Americans. CONCLUSIONS Many hospices are engaged in efforts to increase service to African Americans. Future research should determine which strategies are most effective.
Collapse
Affiliation(s)
- Kimberly S Johnson
- 1 Department of Medicine, Duke University , Durham, North Carolina.,2 Division of Geriatrics, Duke University , Durham, North Carolina.,3 Center for the Study of Aging and Human Development, Duke University , Durham, North Carolina.,4 Duke Palliative Care, Duke University , Durham, North Carolina.,5 Geriatrics Research, Education and Clinical Center, Veterans Affairs Medical Center , Durham, North Carolina
| | - Richard Payne
- 1 Department of Medicine, Duke University , Durham, North Carolina.,2 Division of Geriatrics, Duke University , Durham, North Carolina.,3 Center for the Study of Aging and Human Development, Duke University , Durham, North Carolina.,6 Duke Divinity School, Duke University , Durham, North Carolina
| | - Maragatha N Kuchibhatla
- 3 Center for the Study of Aging and Human Development, Duke University , Durham, North Carolina.,7 Department of Biostatistics and Bioinformatics, Duke University , Durham, North Carolina
| |
Collapse
|
47
|
James O, Payne R, Bathe A, Greet T, Wylie C. Arthroscopy of the Dorsal and Plantar Pouches of the Tarsocrural Joint for the Treatment of Osteochondritis Dissecans in the Horse: Clinical Features and Follow-Up. Vet Surg 2016; 45:1049-1055. [DOI: 10.1111/vsu.12560] [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: 10/02/2015] [Accepted: 06/28/2016] [Indexed: 11/29/2022]
Affiliation(s)
- Oliver James
- Royal (Dick) School of Veterinary Studies; The University of Edinburgh, Dick Vet Equine; Edinburgh United Kingdom
- Rossdales Equine Hospital; Newmarket, Suffolk United Kingdom
| | - Richard Payne
- Rossdales Equine Hospital; Newmarket, Suffolk United Kingdom
| | - Andrew Bathe
- Rossdales Equine Hospital; Newmarket, Suffolk United Kingdom
| | - Tim Greet
- Rossdales Equine Hospital; Newmarket, Suffolk United Kingdom
| | - Claire Wylie
- Rossdales Equine Hospital; Newmarket, Suffolk United Kingdom
| |
Collapse
|
48
|
Moryl N, Tamasdan C, Tarcatu D, Thaler HT, Correa D, Steingart R, Payne R, Obbens E. A phase I study of D-methadone in patients with chronic pain. J Opioid Manag 2016; 12:47-55. [PMID: 26908303 DOI: 10.5055/jom.2016.0311] [Citation(s) in RCA: 6] [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] [Indexed: 11/05/2022]
Abstract
D-Methadone is the d optical isomer of racemic mixture (DL-methadone) used clinically to treat pain and addiction in the United States. D-Methadone is practically devoid of opioid activity but maintains N-methyl-D-aspartate (NMDA) receptor antagonism. Evidence from extensive preclinical studies suggests that NMDA receptor antagonists attenuate neuronal plasticity, reverse opioid analgesic tolerance, and alleviate chronic pain states. The authors conducted a phase I open label study of D-methadone administered for the first time to patients with chronic pain to determine the safety and tolerability of D-methadone. In addition to their long-term regimen of opioids, the patients received 40 mg of D-methadone twice daily for 12 days. Analgesia and toxicity were recorded by the patients in a daily diary and assessed in clinic on days 1, 8, and 12. Eight patients of the 10 enrolled completed the study. Pain scores on Edmonton Symptom Assessment System (ESAS) did not change between days 1 and 12, but five of eight patients (62.5 percent) characterized D-methadone as moderately or very effective in relieving pain on the Global Assessment for pain. Five of the eight patients (62.5 percent) who completed the study requested to start treatment with commercially available methadone (DL-racemic methadone) after completing the study. D-Methadone at the dose of 40 mg PO Q 12 hours was well tolerated. Perspective: This is the first clinical study of D-methadone in patients suffering from chronic pain. Additional phase I and phase II studies are needed to confirm its safety and analgesic effects. If D-methadone is well tolerated, it is likely to become a useful adjuvant to the treatment of a wide spectrum of pain syndromes.
Collapse
Affiliation(s)
- Natalie Moryl
- Pain and Palliative Care Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York; Department of Neurology, Memorial Sloan-Kettering Cancer Center, New York, New York; Weil Cornell Medical College, New York, New York
| | - Cristina Tamasdan
- Department of Neurology, Memorial Sloan-Kettering Cancer Center, New York, New York
| | - Dana Tarcatu
- Department of Neurology, Memorial Sloan-Kettering Cancer Center, New York, New York
| | - Howard T Thaler
- Epidemiology and Biostatistics Department, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Denise Correa
- Department of Neurology, Memorial Sloan-Kettering Cancer Center, New York, New York
| | - Richard Steingart
- FACC, Cardiology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Richard Payne
- Pain and Palliative Care Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Eugenie Obbens
- Pain and Palliative Care Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York; Department of Neurology, Memorial Sloan-Kettering Cancer Center, New York, New York; Weil Cornell Medical College, New York, New York
| |
Collapse
|
49
|
Johnson KS, Payne R, Kuchibhatla MN, Tulsky JA. Are Hospice Admission Practices Associated With Hospice Enrollment for Older African Americans and Whites? J Pain Symptom Manage 2016; 51:697-705. [PMID: 26654945 PMCID: PMC4833599 DOI: 10.1016/j.jpainsymman.2015.11.010] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2015] [Revised: 11/09/2015] [Accepted: 11/13/2015] [Indexed: 11/30/2022]
Abstract
CONTEXT Hospices that enroll patients receiving expensive palliative therapies may serve more African Americans because of their greater preferences for aggressive end-of-life care. OBJECTIVES Examine the association between hospices' admission practices and enrollment of African Americans and whites. METHODS This was a cross-sectional study of 61 North and South Carolina hospices. We developed a hospice admission practices scale; higher scores indicate less restrictive practices, that is, greater frequency with which hospices admitted those receiving chemotherapy, inotropes, and so forth. In separate multivariate analyses for each racial group, we examined the relationship between the proportion of decedents (age ≥ 65) served by a hospice in their service area (2008 Medicare Data) and admission practices while controlling for health care resources (e.g., hospital beds) and market concentration in the area, ownership, and budget. RESULTS Nonprofit hospices and those with larger budgets reported less restrictive admission practices. In bivariate analyses, hospices with less restrictive admission practices served a larger proportion of patients in both racial groups (P < 0.001). However, in the multivariate models, nonprofit ownership and larger budgets but not admission practices predicted the outcome. CONCLUSION Hospices with larger budgets served a greater proportion of African Americans and whites in their service area. Although larger hospices reported less restrictive admission practices, they also may have provided other services that may be important to patients regardless of race, such as more in-home support or assistance with nonmedical expenses, and participated in more outreach activities increasing their visibility and referral base. Future research should explore factors that influence decisions about hospice enrollment among racially diverse older adults.
Collapse
Affiliation(s)
- Kimberly S Johnson
- Department of Medicine, Duke University, Durham, North Carolina, USA; Division of Geriatrics, Duke University, Durham, North Carolina, USA; Center for the Study of Aging and Human Development, Duke University, Durham, North Carolina, USA; Duke Palliative Care, Duke University, Durham, North Carolina, USA; Geriatrics Research, Education and Clinical Center, Veterans Affairs Medical Center, Durham, North Carolina, USA.
| | - Richard Payne
- Department of Medicine, Duke University, Durham, North Carolina, USA; Division of Geriatrics, Duke University, Durham, North Carolina, USA; Center for the Study of Aging and Human Development, Duke University, Durham, North Carolina, USA; Duke Divinity School, Duke University, Durham, North Carolina, USA
| | - Maragatha N Kuchibhatla
- Center for the Study of Aging and Human Development, Duke University, Durham, North Carolina, USA; Department of Biostatistics and Bioinformatics, Duke University, Durham, North Carolina, USA
| | - James A Tulsky
- Department of Medicine, Duke University, Durham, North Carolina, USA; Center for the Study of Aging and Human Development, Duke University, Durham, North Carolina, USA; Duke Palliative Care, Duke University, Durham, North Carolina, USA; Division of General Internal Medicine, Duke University, Durham, North Carolina, USA; Center for Health Services Research in Primary Care, Veterans Affairs Medical Center, Durham, North Carolina, USA
| |
Collapse
|
50
|
Christopher MJ, Payne R, Felix MRJ. Relieving Pain in St. Joseph, Missouri: A Health Services Partnership for Changing the Way Pain is Perceived, Judged and Treated. Pain Med 2015; 16:2049-52. [PMID: 26178015 DOI: 10.1111/pme.12806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
| | - Richard Payne
- Duke University, School of Divinity, Durham, North Carolina, USA
| | | |
Collapse
|