1
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Crooks R, Davidson L, Elliott K, O'Hara G, Gibson E, Kelly R, McAleese J, Masih I. Bedside physician led US-guided supra-clavicular lymph node biopsy and ROSE (rapid on-site evaluation): SVC obstruction swift management in lung cancer. Respir Med Case Rep 2024; 49:101978. [PMID: 38623376 PMCID: PMC11017039 DOI: 10.1016/j.rmcr.2024.101978] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Revised: 12/21/2023] [Accepted: 01/05/2024] [Indexed: 04/17/2024] Open
Abstract
Superior vena cava obstruction (SVCO) is an oncological emergency and can often be linked to an underlying lung malignancy. Due to the potential life-threatening risks associated with SVCO, it necessitates urgent diagnosis and management. In this report, we discuss 3 case studies where the use of ultrasound-guided supraclavicular lymph node biopsy was used to obtain a biopsy from patients with SVCO, followed by rapid on-site evaluation (ROSE). The benefits of this technique ensure a more rapid histological diagnosis, while also involving a less invasive procedure for the patient. The histological diagnosis is essential in improving patient outcomes when treating those with SVCO as the recommended treatments vary depending on the underlying type of lung malignancy. Having this information can help the clinician swiftly employ the optimal treatment pathway for the patient.
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Affiliation(s)
- R. Crooks
- Departments of Respiratory, Radiology and Histology, Antrim Hospital, Ireland
| | - L. Davidson
- Departments of Respiratory, Radiology and Histology, Antrim Hospital, Ireland
| | - K. Elliott
- Departments of Respiratory, Radiology and Histology, Antrim Hospital, Ireland
| | - G. O'Hara
- Departments of Respiratory, Radiology and Histology, Antrim Hospital, Ireland
| | - Eddie Gibson
- Departments of Respiratory, Radiology and Histology, Antrim Hospital, Ireland
| | - R. Kelly
- Departments of Respiratory, Radiology and Histology, Antrim Hospital, Ireland
| | - J. McAleese
- Departments of Respiratory, Radiology and Histology, Antrim Hospital, Ireland
| | - I. Masih
- Departments of Respiratory, Radiology and Histology, Antrim Hospital, Ireland
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2
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Andersen P, Barksdale S, Barclay RA, Smith N, Fernandes J, Besse K, Goldfarb D, Barbero R, Dunlap R, Jones-Roe T, Kelly R, Miao S, Ruhunusiri C, Munns A, Mosavi S, Sanson L, Munns D, Sahoo S, Swahn O, Hull K, White D, Kolb K, Noroozi F, Seelam J, Patnaik A, Lepene B. Magnetic hydrogel particles improve nanopore sequencing of SARS-CoV-2 and other respiratory viruses. Sci Rep 2023; 13:2163. [PMID: 36750714 PMCID: PMC9903261 DOI: 10.1038/s41598-023-29206-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Accepted: 01/31/2023] [Indexed: 02/09/2023] Open
Abstract
Presented here is a magnetic hydrogel particle enabled workflow for capturing and concentrating SARS-CoV-2 from diagnostic remnant swab samples that significantly improves sequencing results using the Oxford Nanopore Technologies MinION sequencing platform. Our approach utilizes a novel affinity-based magnetic hydrogel particle, circumventing low input sample volumes and allowing for both rapid manual and automated high throughput workflows that are compatible with Nanopore sequencing. This approach enhances standard RNA extraction protocols, providing up to 40 × improvements in viral mapped reads, and improves sequencing coverage by 20-80% from lower titer diagnostic remnant samples. Furthermore, we demonstrate that this approach works for contrived influenza virus and respiratory syncytial virus samples, suggesting that it can be used to identify and improve sequencing results of multiple viruses in VTM samples. These methods can be performed manually or on a KingFisher automation platform.
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Affiliation(s)
- P Andersen
- Ceres Nanosciences, Inc., Manassas, VA, 20110, USA.
| | - S Barksdale
- Ceres Nanosciences, Inc., Manassas, VA, 20110, USA
| | - R A Barclay
- Ceres Nanosciences, Inc., Manassas, VA, 20110, USA
| | - N Smith
- Ceres Nanosciences, Inc., Manassas, VA, 20110, USA
| | - J Fernandes
- Ceres Nanosciences, Inc., Manassas, VA, 20110, USA
| | - K Besse
- Ceres Nanosciences, Inc., Manassas, VA, 20110, USA
| | - D Goldfarb
- Ceres Nanosciences, Inc., Manassas, VA, 20110, USA
| | - R Barbero
- Ceres Nanosciences, Inc., Manassas, VA, 20110, USA
| | - R Dunlap
- Ceres Nanosciences, Inc., Manassas, VA, 20110, USA
| | - T Jones-Roe
- Ceres Nanosciences, Inc., Manassas, VA, 20110, USA
| | - R Kelly
- Ceres Nanosciences, Inc., Manassas, VA, 20110, USA
| | - S Miao
- Ceres Nanosciences, Inc., Manassas, VA, 20110, USA
| | - C Ruhunusiri
- Ceres Nanosciences, Inc., Manassas, VA, 20110, USA
| | - A Munns
- Ceres Nanosciences, Inc., Manassas, VA, 20110, USA
| | - S Mosavi
- Ceres Nanosciences, Inc., Manassas, VA, 20110, USA
| | - L Sanson
- Ceres Nanosciences, Inc., Manassas, VA, 20110, USA
| | - D Munns
- Ceres Nanosciences, Inc., Manassas, VA, 20110, USA
| | - S Sahoo
- Ceres Nanosciences, Inc., Manassas, VA, 20110, USA
| | - O Swahn
- Ceres Nanosciences, Inc., Manassas, VA, 20110, USA
| | - K Hull
- Ceres Nanosciences, Inc., Manassas, VA, 20110, USA
| | - D White
- Ceres Nanosciences, Inc., Manassas, VA, 20110, USA
| | - K Kolb
- Ceres Nanosciences, Inc., Manassas, VA, 20110, USA
| | - F Noroozi
- Ceres Nanosciences, Inc., Manassas, VA, 20110, USA
| | - J Seelam
- Ceres Nanosciences, Inc., Manassas, VA, 20110, USA
| | - A Patnaik
- Ceres Nanosciences, Inc., Manassas, VA, 20110, USA
| | - B Lepene
- Ceres Nanosciences, Inc., Manassas, VA, 20110, USA.
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3
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Oaks Z, Patel A, Huang N, Choudhary G, Winans T, Faludi T, Krakko D, Duarte M, Lewis J, Beckford M, Blair S, Kelly R, Landas SK, Middleton FA, Asara JM, Chung SK, Fernandez DR, Banki K, Perl A. Publisher Correction: Cytosolic aldose metabolism contributes to progression from cirrhosis to hepatocarcinogenesis. Nat Metab 2023; 5:349. [PMID: 36755183 DOI: 10.1038/s42255-023-00752-8] [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: 02/10/2023]
Affiliation(s)
- Z Oaks
- Departments of Medicine, State University of New York, Norton College of Medicine, Syracuse, NY, USA
- Departments of Biochemistry and Molecular Biology, State University of New York, Norton College of Medicine, Syracuse, NY, USA
| | - A Patel
- Departments of Medicine, State University of New York, Norton College of Medicine, Syracuse, NY, USA
- Departments of Biochemistry and Molecular Biology, State University of New York, Norton College of Medicine, Syracuse, NY, USA
| | - N Huang
- Departments of Medicine, State University of New York, Norton College of Medicine, Syracuse, NY, USA
- Departments of Biochemistry and Molecular Biology, State University of New York, Norton College of Medicine, Syracuse, NY, USA
| | - G Choudhary
- Departments of Medicine, State University of New York, Norton College of Medicine, Syracuse, NY, USA
- Departments of Biochemistry and Molecular Biology, State University of New York, Norton College of Medicine, Syracuse, NY, USA
| | - T Winans
- Departments of Medicine, State University of New York, Norton College of Medicine, Syracuse, NY, USA
- Departments of Biochemistry and Molecular Biology, State University of New York, Norton College of Medicine, Syracuse, NY, USA
| | - T Faludi
- Departments of Medicine, State University of New York, Norton College of Medicine, Syracuse, NY, USA
| | - D Krakko
- Departments of Medicine, State University of New York, Norton College of Medicine, Syracuse, NY, USA
| | - M Duarte
- Departments of Medicine, State University of New York, Norton College of Medicine, Syracuse, NY, USA
| | - J Lewis
- Departments of Medicine, State University of New York, Norton College of Medicine, Syracuse, NY, USA
| | - M Beckford
- Departments of Medicine, State University of New York, Norton College of Medicine, Syracuse, NY, USA
| | - S Blair
- Departments of Medicine, State University of New York, Norton College of Medicine, Syracuse, NY, USA
| | - R Kelly
- Departments of Medicine, State University of New York, Norton College of Medicine, Syracuse, NY, USA
| | - S K Landas
- Departments of Pathology, State University of New York, Norton College of Medicine, Syracuse, NY, USA
| | - F A Middleton
- Departments of Neuroscience, State University of New York, Norton College of Medicine, Syracuse, NY, USA
| | - J M Asara
- Division of Signal Transduction, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - S K Chung
- Faculty of Medicine, Macau University of Science and Technology, Taipa, China
| | - D R Fernandez
- Departments of Medicine, State University of New York, Norton College of Medicine, Syracuse, NY, USA
- Departments of Biochemistry and Molecular Biology, State University of New York, Norton College of Medicine, Syracuse, NY, USA
| | - K Banki
- Departments of Pathology, State University of New York, Norton College of Medicine, Syracuse, NY, USA
| | - A Perl
- Departments of Medicine, State University of New York, Norton College of Medicine, Syracuse, NY, USA.
- Departments of Biochemistry and Molecular Biology, State University of New York, Norton College of Medicine, Syracuse, NY, USA.
- Departments of Microbiology and Immunology, State University of New York, Norton College of Medicine, Syracuse, NY, USA.
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4
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Oaks Z, Patel A, Huang N, Choudhary G, Winans T, Faludi T, Krakko D, Duarte M, Lewis J, Beckford M, Blair S, Kelly R, Landas SK, Middleton FA, Asara JM, Chung SK, Fernandez DR, Banki K, Perl A. Cytosolic aldose metabolism contributes to progression from cirrhosis to hepatocarcinogenesis. Nat Metab 2023; 5:41-60. [PMID: 36658399 PMCID: PMC9892301 DOI: 10.1038/s42255-022-00711-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Accepted: 11/11/2022] [Indexed: 01/21/2023]
Abstract
Oxidative stress modulates carcinogenesis in the liver; however, direct evidence for metabolic control of oxidative stress during pathogenesis, particularly, of progression from cirrhosis to hepatocellular carcinoma (HCC), has been lacking. Deficiency of transaldolase (TAL), a rate-limiting enzyme of the non-oxidative branch of the pentose phosphate pathway (PPP), restricts growth and predisposes to cirrhosis and HCC in mice and humans. Here, we show that mitochondrial oxidative stress and progression from cirrhosis to HCC and acetaminophen-induced liver necrosis are critically dependent on NADPH depletion and polyol buildup by aldose reductase (AR), while this enzyme protects from carbon trapping in the PPP and growth restriction in TAL deficiency. Both TAL and AR are confined to the cytosol; however, their inactivation distorts mitochondrial redox homeostasis in opposite directions. The results suggest that AR acts as a rheostat of carbon recycling and NADPH output of the PPP with broad implications for disease progression from cirrhosis to HCC.
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Affiliation(s)
- Z Oaks
- Departments of Medicine, State University of New York, Norton College of Medicine, Syracuse, NY, USA
- Departments of Biochemistry and Molecular Biology, State University of New York, Norton College of Medicine, Syracuse, NY, USA
| | - A Patel
- Departments of Medicine, State University of New York, Norton College of Medicine, Syracuse, NY, USA
- Departments of Biochemistry and Molecular Biology, State University of New York, Norton College of Medicine, Syracuse, NY, USA
| | - N Huang
- Departments of Medicine, State University of New York, Norton College of Medicine, Syracuse, NY, USA
- Departments of Biochemistry and Molecular Biology, State University of New York, Norton College of Medicine, Syracuse, NY, USA
| | - G Choudhary
- Departments of Medicine, State University of New York, Norton College of Medicine, Syracuse, NY, USA
- Departments of Biochemistry and Molecular Biology, State University of New York, Norton College of Medicine, Syracuse, NY, USA
| | - T Winans
- Departments of Medicine, State University of New York, Norton College of Medicine, Syracuse, NY, USA
- Departments of Biochemistry and Molecular Biology, State University of New York, Norton College of Medicine, Syracuse, NY, USA
| | - T Faludi
- Departments of Medicine, State University of New York, Norton College of Medicine, Syracuse, NY, USA
| | - D Krakko
- Departments of Medicine, State University of New York, Norton College of Medicine, Syracuse, NY, USA
| | - M Duarte
- Departments of Medicine, State University of New York, Norton College of Medicine, Syracuse, NY, USA
| | - J Lewis
- Departments of Medicine, State University of New York, Norton College of Medicine, Syracuse, NY, USA
| | - M Beckford
- Departments of Medicine, State University of New York, Norton College of Medicine, Syracuse, NY, USA
| | - S Blair
- Departments of Medicine, State University of New York, Norton College of Medicine, Syracuse, NY, USA
| | - R Kelly
- Departments of Medicine, State University of New York, Norton College of Medicine, Syracuse, NY, USA
| | - S K Landas
- Departments of Pathology, State University of New York, Norton College of Medicine, Syracuse, NY, USA
| | - F A Middleton
- Departments of Neuroscience, State University of New York, Norton College of Medicine, Syracuse, NY, USA
| | - J M Asara
- Division of Signal Transduction, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - S K Chung
- Faculty of Medicine, Macau University of Science and Technology, Taipa, China
| | - D R Fernandez
- Departments of Medicine, State University of New York, Norton College of Medicine, Syracuse, NY, USA
- Departments of Biochemistry and Molecular Biology, State University of New York, Norton College of Medicine, Syracuse, NY, USA
| | - K Banki
- Departments of Pathology, State University of New York, Norton College of Medicine, Syracuse, NY, USA
| | - A Perl
- Departments of Medicine, State University of New York, Norton College of Medicine, Syracuse, NY, USA.
- Departments of Biochemistry and Molecular Biology, State University of New York, Norton College of Medicine, Syracuse, NY, USA.
- Departments of Microbiology and Immunology, State University of New York, Norton College of Medicine, Syracuse, NY, USA.
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5
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McKeown W, Kelly R, Eakin R, Hunter N. 13 FIGHTING FRAILTY FROM FOUNDATION UP. Age Ageing 2022. [DOI: 10.1093/ageing/afac218.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
In 2021 the UK Foundation Programme introduced a new curriculum for UK Foundation Doctors (FDs). For the first time, frailty has been designated as a core learning topic. This means that all FDs are expected to undertake dedicated frailty training. Subsequently, a virtual frailty workshop was developed and delivered by Zoom to all F2 doctors in Northern Ireland. Entitled ‘Taking a Better Approach to the Frailer Adult’, the three hour workshop familiarises FDs with core frailty concepts including Comprehensive Geriatric Assessment (CGA), delirium, and deprescribing.
Methods
All attendees completed an online survey after workshops. They were asked to provide free text comments about what they felt were the most successful and useful aspects of the workshop. Attendees were also were asked to numerically rate the workshop relevance, handout quality and venue suitability.
Results
The frailty workshop was delivered to 222 F2 doctors over eight months. On average, attendees rated the relevance of the workshop as 4.8/5. Attendees rated the quality of the handouts and the venue suitability at 4.4/5 and 4.2/5 respectively. Thematic analysis of qualitative feedback on the most successful elements of the workshop showed that attendees found the session to be useful, relevant, and engaging, with particular preference for use of cases. For example, one attendee wrote that, ‘use of cases and breakout rooms to discuss CGA [allowed] us to get a feel of how this applies to patients in clinical settings”. Thematic analysis of qualitative feedback on what could be done to make the workshop better showed attendees had preferences for greater use of cases and smaller breakout rooms. This feedback was used to develop and improve the workshop.
Conclusion
FDs value teaching on frailty and consider it highly relevant for clinical practice. Frailty education can be delivered successfully in a virtual setting. Junior doctors prefer interactive case based learning, with use of breakout rooms with small numbers of participants in each room.
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Affiliation(s)
- W McKeown
- Musgrave Park Hospital , Belfast, United Kingdom
| | - R Kelly
- Lagan Valley Hospital , Lisburn, United Kingdom
| | - R Eakin
- Northern Ireland Medical and Dental Training Agency (NIMDTA) , Belfast, United Kingdom
| | - N Hunter
- Northern Ireland Medical and Dental Training Agency (NIMDTA) , Belfast, United Kingdom
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6
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Murphy J, Kelly R, Cathasaigh CN, Murphy D, Cloney T, Hayes K, Arrigan G, O'Sullivan A, Barry P, James K, Healy L. 168 AN EXPLORATION OF ATRIAL FIBRILLATION AND ANTICOAGULATION IN STROKE PATIENTS WHO UNDERGO THROMBECTOMY IN A TERTIARY THROMBECTOMY CENTRE. Age Ageing 2022. [DOI: 10.1093/ageing/afac218.144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Atrial Fibrillation is a significant cause of ischaemic stroke. Prevalence of atrial fibrillation in patients requiring thrombectomy is approximately 33%. Embolic thrombi which develop due to Atrial fibrillation may become targets for clot removal by thrombectomy in appropriate patients. Anticoagulation is one of the mainstays of treatment for atrial fibrillation.
Methods
A list of patients who had thrombectomy performed for ischaemic stroke in 2021 was compiled. Charts were reviewed to establish the prevalence of atrial fibrillation and the rates of appropriate dosing of anticoagulant. Of those who were not anticoagulated, we aimed to establish if there was a clear reason for this. This was performed in a tertiary referral centre with 24/7 access to thrombectomy.
Results
97 patients had thrombectomy performed for ischaemic stroke in 2021. 34/97(35%) had atrial fibrillation (21/97 pre-existing , 13/97 newly diagnosed on admission). 15/21 were anticoagulated and 6/21 were not anticoagulated at the time of their stroke. 5/6 had a clear reason documented for stopping anticoagulation. One patient had stopped anticoagulation due to cost. Of those with atrial fibrillation who were anticoagulated at the time of their stroke, 11 were anticoagulated with a Direct-Acting AntiCoagulant (DOAC) and four were anticoagulated with Warfarin. Of the Warfarin group, just one patients’ INR was therapeutic at the time of their stroke. Of the DOAC group, all were on the appropriate dose.
Conclusion
Stroke patients requiring thrombectomy are a group who may suffer the largest strokes. Incidence of atrial fibrillation was similar to previous studies. It was encouraging that there was a documented reason for all patients who were not anticoagulated, and that the DOAC dose was appropriate. Issues with therapeutic levels of Warfarin are further highlighted here. This study concludes that we may not be as bad at anticoagulation as we may think.
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Affiliation(s)
- J Murphy
- Cork University Hospital Department of Geriatrics and Stroke Medicine, , Cork, Ireland
| | - R Kelly
- Cork University Hospital Department of Geriatrics and Stroke Medicine, , Cork, Ireland
| | - CN Cathasaigh
- Cork University Hospital Department of Geriatrics and Stroke Medicine, , Cork, Ireland
| | - D Murphy
- Cork University Hospital Department of Geriatrics and Stroke Medicine, , Cork, Ireland
| | - T Cloney
- Cork University Hospital Department of Geriatrics and Stroke Medicine, , Cork, Ireland
| | - K Hayes
- Cork University Hospital Department of Geriatrics and Stroke Medicine, , Cork, Ireland
| | - G Arrigan
- Cork University Hospital Department of Geriatrics and Stroke Medicine, , Cork, Ireland
| | - A O'Sullivan
- Cork University Hospital Department of Geriatrics and Stroke Medicine, , Cork, Ireland
| | - P Barry
- Cork University Hospital Department of Geriatrics and Stroke Medicine, , Cork, Ireland
| | - K James
- Cork University Hospital Department of Geriatrics and Stroke Medicine, , Cork, Ireland
| | - L Healy
- Cork University Hospital Department of Geriatrics and Stroke Medicine, , Cork, Ireland
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Svistunova V, Walsh G, Boyce A, Kelly R. Recombinant expression of a heparinase I enzyme derived from Bacteroides helcogenes. CHEM-ING-TECH 2022. [DOI: 10.1002/cite.202255377] [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: 11/05/2022]
Affiliation(s)
- V. Svistunova
- University of Limerick Chemical Sciences V94 Limerick Ireland
| | - G. Walsh
- University of Limerick Chemical Sciences V94 Limerick Ireland
| | - A. Boyce
- University of Limerick Chemical Sciences V94 Limerick Ireland
| | - R. Kelly
- Leo Pharma Cork T45 Cork Ireland
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8
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Fromonot J, Vahdat J, Maille B, Guieu R, Kelly R, Lalevée N, Miquerol L. Assessment of the atrial adenosinergic system in the onset of atrial fibrillation: A pre-clinical study in a mouse model with genetic susceptibility to atrial fibrillation. Archives of Cardiovascular Diseases Supplements 2021. [DOI: 10.1016/j.acvdsp.2021.04.211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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9
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Boulgakoff L, Sturny R, Kelly R, Miquerol L. Deciphering the potency of ventricular trabeculae to repair the heart during cardiac regeneration in the neonatal mouse. Archives of Cardiovascular Diseases Supplements 2021. [DOI: 10.1016/j.acvdsp.2021.04.120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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10
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Dasaraju S, Liu S, Kelly R, Mneimneh W. A Case Of Pancreatic Hamartoma Mimicking Malignancy: An Uncommon Pitfall. Am J Clin Pathol 2020. [DOI: 10.1093/ajcp/aqaa161.160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Casestudy
Hamartomas are benign, disordered, tumor-like growth of cellular constituents resembling the tissue of its origin. Hamartomas are usually seen in lung, heart, kidney and spleen. Pancreatic hamartomas (PH) are extremely rare, accounting for <1% of all hamartomas. PH occurs at any age (median: 50 years) without gender predilection. PH presents as single or multiple, solid and/or cystic mass composed of exocrine tissues. Admixed neuroendocrine cells may be seen, but well-formed islets are unusual. PH stroma is typically positive for CD34 by immunohistochemistry. We present a case of a PH resected for the clinical suspicion of malignancy, with the final diagnosis established postoperatively.
The case is that of a 74-year-old male with an incidental 2.3 x 1.7 x 1.1 cm hyperenhancing solid mass of the pancreatic uncinate process, found during anemia workup. The radiologic appearance was suspicious for a neuroendocrine tumor. Biopsy of the mass showed benign-appearing pancreatic ductal and acinar tissue. Given the clinical suspicion of malignancy, the patient elected to undergo a pancreaticoduodenectomy. Macroscopically the mass was well-circumscribed with solid, tan-white, firm cut surface. Microscopic examination revealed well- circumscribed proliferation of disorderly-arranged, well-differentiated, bland exocrine pancreatic tissue. Chromogranin, synaptophysin and CD56 immunostains did not highlight significant neuroendocrine component. Ki-67 proliferation index was low (1%). CD34 and CD117 immunostains were negative in the stroma. The findings were consistent with PH.
Conclusion
PH may mimic a malignant process of the pancreas. The preoperative diagnosis of PH is extremely challenging due to the lack of characteristic clinical and radiological features, therefore, the diagnosis of PH is often made on resection specimen. CD34 immunostain is not always helpful for the diagnosis as it may be negative in PH stroma. Although extremely rare, pancreatic hamartoma should be considered in the differential diagnosis of a pancreatic tumor.
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Affiliation(s)
- S Dasaraju
- Pathology, University of South Alabama medical center, Spanishfort, Alabama, UNITED STATES
| | - S Liu
- Pathology, University of South Alabama medical center, Spanishfort, Alabama, UNITED STATES
| | - R Kelly
- Pathology, University of South Alabama medical center, Spanishfort, Alabama, UNITED STATES
| | - W Mneimneh
- Pathology, University of South Alabama medical center, Spanishfort, Alabama, UNITED STATES
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11
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Kelly R, Contos G, Walker C, Ayoola-Adeola M, Winer I. Hysteroscopic morcellation in endometrial cancer diagnosis: Increased risk? Gynecol Oncol 2020. [DOI: 10.1016/j.ygyno.2020.05.400] [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: 10/23/2022]
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12
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Théveniau-Ruissy M, Rammah M, Kelly R, Rochais F. Role of the lipid sensor PPAR-gamma in cardiac progenitor cell deployment: First demonstration of the impact of environmental factor on cardiac progenitor cell development. Archives of Cardiovascular Diseases Supplements 2020. [DOI: 10.1016/j.acvdsp.2020.03.053] [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: 10/23/2022]
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13
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Boulgakoff L, Sturny R, Kelly R, Miquerol L. Deciphering the potency of ventricular trabeculae to repair the heart during cardiac regeneration in the mouse. Archives of Cardiovascular Diseases Supplements 2020. [DOI: 10.1016/j.acvdsp.2020.03.057] [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: 10/23/2022]
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14
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Kelly R, Cereceda-Monteoliva N, Frezzini C, Walker TWM, Cobb ARM, Ayliffe P. Rose-trellis periosteal release in oral mucosal advancement flaps in pigs. Br J Oral Maxillofac Surg 2020; 58:542-545. [PMID: 32245578 DOI: 10.1016/j.bjoms.2020.02.006] [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: 03/02/2019] [Accepted: 02/10/2020] [Indexed: 11/16/2022]
Abstract
The aims of this study were to find out whether scoring in a rose-trellis pattern improved the stretch of mucoperiosteal flaps more than conventional scoring in the horizontal plane, and to consider its application in the closure of oroantral communications. Sixteen sections of cadaveric porcine buccal mucoperiosteum were removed from the molar region of the maxilla and mandible. A three-sided flap was raised in the subperiosteal plane, excised, and pinned to a cork board with the periosteal side facing upwards. Eight samples were scored in the horizontal plane (control) using lines perpendicular to the line of simulated advancement, and eight in a rose-trellis or criss-cross pattern. Scoring using a rose-trellis pattern yielded a mean increase in stretch of 24.3% (p=0.0003) when compared with the conventional method. Buccal advancement flaps are widely used to close oroantral communications, and scoring of the mucoperiosteum facilitates the stretching of the tissue over the defect. To be successful, defects should be fully closed to prevent contamination, and closure should be tension-free. In this study, scoring in a rose-trellis pattern increased the stretch of the tissue sample more than scoring in the horizontal plane. The rose-trellis technique therefore could aid the effective closure of oroantral communications.
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Affiliation(s)
- R Kelly
- Oral & Maxillofacial Surgery, Great Western Hospital, Swindon.
| | - N Cereceda-Monteoliva
- Oral & Maxillofacial Surgery, Bristol Royal Infirmary, University Hospitals Bristol, NHS Foundation Trust, Bristol
| | - C Frezzini
- Oral & Maxillofacial Surgery, Royal Hallamshire Hospital, Sheffield Teaching Hospitals, Glossop Road, Sheffield
| | - T W M Walker
- Oral & Maxillofacial Surgery, Department of Oral & Maxillofacial Surgery, Bristol Royal Infirmary, Dental Hospital & Children's Hospital, University Hospitals Bristol, NHS Foundation Trust, Bristol
| | - A R M Cobb
- South West Cleft Service, Bristol Dental Hospital, Bristol
| | - P Ayliffe
- King Edward VII Hospital, Beaumont Street, London
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Finn DJ, Graham C, Holt DJ, Kelly R, Rajlawat BP, Yesudian PD. Management of mucous membrane pemphigoid in a joint oral medicine-dermatology clinic. Clin Exp Dermatol 2020; 45:685-690. [PMID: 32003042 DOI: 10.1111/ced.14188] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Accepted: 01/28/2020] [Indexed: 12/30/2022]
Abstract
BACKGROUND Mucous membrane pemphigoid (MMP) comprises a group of immunobullous diseases involving the mucosa and skin. Potential sequelae include painful mucosal erosions, vision loss and laryngeal stenosis. AIM To characterize the features of patients with MMP seen within an Oral Medicine setting, including clinical features, immunofluorescence results and response to treatment. METHODS A retrospective case note analysis was undertaken. Treatment effect was divided into response and nonresponse using predetermined adjective terms. RESULTS In total, 42 cases of MMP were identified (18 men, 24 women), mean age 65 years (range 36-85 years). Oral involvement was most common on the gingivae (n = 38; 90.5%) while the most common extraoral sites involved were ocular (n = 13; 31.0%) and skin (n = 12; 28.6%). Features of MMP were found in 21 of 34 (61.8%) of routine biopsies, 31 of 34 (91.2%) direct immunofluorescence samples and 8 of 25 (32.0%) indirect immunofluorescence samples. Topical corticosteroids provided effective symptom control in 9 of 42 cases (21.4%), while systemic therapy was used in 31 of 42 patients (73.8%). Dapsone was prescribed for 25 patients, of whom 18 (72.0%) responded. Mycophenolate mofetil was used in 13 cases and had a response rate of 46.2%. Overall, 27 of 42 patients (64.3%) achieved a response using a tolerable topical or systemic treatment. CONCLUSION This series demonstrates that MMP has a female predominance and is a disease of older age, with a predilection for specific oral sites. Direct immunofluorescence has a high sensitivity in detecting features of MMP. Although some patients achieve adequate symptom control with topical corticosteroids, many require systemic therapy.
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Affiliation(s)
- D J Finn
- Department of Oral Medicine, Liverpool University Dental Hospital, Liverpool, UK
| | - C Graham
- Department of Oral Medicine, Liverpool University Dental Hospital, Liverpool, UK
| | - D J Holt
- Department of Oral Medicine, Liverpool University Dental Hospital, Liverpool, UK
| | - R Kelly
- Department of Oral Medicine, Liverpool University Dental Hospital, Liverpool, UK
| | - B P Rajlawat
- Department of Oral Medicine, Liverpool University Dental Hospital, Liverpool, UK
| | - P D Yesudian
- Department of Oral Medicine, Liverpool University Dental Hospital, Liverpool, UK
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Hegarty M, Harvey G, Kearney E, Burns J, Wray M, Gibson E, Kelly R, Scott K, Masih I. Thoracic ultrasonic narration of Covid-19 pneumonia. Respir Med Case Rep 2020; 31:101305. [PMID: 33335829 PMCID: PMC7732861 DOI: 10.1016/j.rmcr.2020.101305] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2020] [Accepted: 11/22/2020] [Indexed: 01/08/2023] Open
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17
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Kelly R. IBS21.02 Real World Toxicities of Radiation Plus IO in NSCLC. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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18
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Guo C, Kelly R, Desai J, Tran B. Demonstrating the changing trends in phase I clinical trials. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz244.056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Castiglioni C, Kelly R, Heather M, Jofre J, Suarez B, Langley W, Nagy P, Fattori F, Bertini E. EP.111Identification of novel biallelic mutations in SPTBN4 in a child with NEDHND featuring a spinal muscular atrophy phenotype. Neuromuscul Disord 2019. [DOI: 10.1016/j.nmd.2019.06.569] [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: 11/26/2022]
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Walker T, Kelly R, Frezzini C, Cereceda-Monteoliva N, Clark R, Cobb A, Ayliffe P. The rose trellis mucoperiosteal scoring technique improves flap stretch for alveolar cleft and oro antral fistula repair. Int J Oral Maxillofac Surg 2019. [DOI: 10.1016/j.ijom.2019.03.947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Asmar A, Semenov I, Kelly R, Stacey M. Abnormal response of costal chondrocytes to acidosis in patients with chest wall deformity. Exp Mol Pathol 2018; 106:27-33. [PMID: 30485799 DOI: 10.1016/j.yexmp.2018.11.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2018] [Revised: 11/08/2018] [Accepted: 11/24/2018] [Indexed: 11/30/2022]
Abstract
Costal cartilage is much understudied compared to the load bearing cartilages. Abnormally grown costal cartilages are associated with the inherited chest wall deformities pectus excavatum and pectus carinatum resulting in sunken or pigeon chest respectively. A lack of understanding of the ultrastructural and molecular biology properties of costal cartilage is a major confounder in predicting causes and outcomes of these disorders. Due to the avascular nature of cartilage, chondrocytes metabolize glycolytically, producing an acidic environment. During physical activity hydrogen ions move within cartilage driven by compressive forces, thus at any one time, chondrocytes experience transient changes in pH. A variety of ion channels on chondrocytes plasma membrane equip them to function in the rapidly changing conditions they experience. In this paper we describe reduced expression of the ASIC2 gene encoding the acid sensing ion channel isoform 2 (previously referred to as ACCN1 or ACCN) in patients with chest wall deformities. We hypothesized that chondrocytes from these patients cannot respond normally to changes in pH that are an integral part of the biology of this tissue. Activation of ASICs indirectly creates a cascade ultimately dependent on intracellular calcium transients. The objective of this paper was to compare internal calcium signaling in response to external pH changes in costal chondrocytes from patients with chest wall deformities and healthy individuals. Although the molecular mechanism through which chondrocytes are regulated by acidosis remains unknown, we observed reduced amplitudes of calcium rise in patient chondrocytes exposed to low pH that become further impaired upon repeat exposure.
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Affiliation(s)
- A Asmar
- Frank Reidy Research Center for Bioelectrics, Old Dominion University, Norfolk, VA, USA
| | - I Semenov
- Frank Reidy Research Center for Bioelectrics, Old Dominion University, Norfolk, VA, USA
| | - R Kelly
- Department of Surgery, Eastern Virginia Medical School, Pediatric Surgery Division, Children's Hospital of the King's Daughters, Norfolk, VA, USA
| | - M Stacey
- Frank Reidy Research Center for Bioelectrics, Old Dominion University, Norfolk, VA, USA.
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Kutaimy R, Zhang L, Blok D, Kelly R, Kovacevic N, Levoska M, Gadivemula R, Levine D. Integrating patient safety education into early medical education utilizing cadaver, sponges, and an inter-professional team. BMC Med Educ 2018; 18:215. [PMID: 30227853 PMCID: PMC6145344 DOI: 10.1186/s12909-018-1325-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/05/2016] [Accepted: 09/11/2018] [Indexed: 06/08/2023]
Abstract
BACKGROUND Introducing patient safety and quality improvement science to medical students is integral to improving healthcare. However, developing and implementing a patient safety curriculum can be challenging in a medical school curriculum that is already densely packed. Our aim was to develop and evaluate the impact of a workshop introducing patient safety and quality improvement science to a large class of first-year medical students. METHOD As a part of an evolving longitudinal patient safety curriculum, an introductory workshop on patient safety was integrated into an anatomy course. A high impact event (a simulated "retained sponge" discovery during an anatomy dissection lab) was used to introduce medical error. The educational session which followed consisted of a presentation by an interprofessional team utilizing the retained sponge as example of an error. Use of safety tools was introduced and quality improvement science was discussed using the evolution of methods to decrease retained foreign objects during surgery. A patient's story told by a close family member about the personal impact of medical errors was presented. Students then participated in an interactive breakout activity and completed a module on safety. The impact of the workshop was assessed through pre- and post- session tests. RESULTS Quantitative and qualitative evaluation reflected a positive effect of the session in improving students' safety knowledge and attitudes. Students' mean total knowledge improved from 7.58 to 8.98 (p = 0.000). Mean total attitudes score improved from 47.73 to 50.56 (p = 0.000). Students' comments after the workshop reflected increased awareness and appreciation of the importance of addressing medical errors. CONCLUSION A workshop introducing patient safety and quality improvement to first year medical students improved knowledge and attitudes regarding safety and increased awareness of the importance of addressing medical errors in their future careers. Integrating patient safety education into an existing foundational science course is a model for teaching patient safety at other medical schools.
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Affiliation(s)
- R. Kutaimy
- Wayne State University, 4201 St. Antoine, 2E UHC, Detroit, MI 48201 USA
| | - L. Zhang
- Wayne State University, 4201 St. Antoine, 2E UHC, Detroit, MI 48201 USA
| | - D. Blok
- Wayne State University, 4201 St. Antoine, 2E UHC, Detroit, MI 48201 USA
| | - R. Kelly
- Wayne State University, 4201 St. Antoine, 2E UHC, Detroit, MI 48201 USA
| | - N. Kovacevic
- Wayne State University, 4201 St. Antoine, 2E UHC, Detroit, MI 48201 USA
| | - M. Levoska
- Wayne State University, 4201 St. Antoine, 2E UHC, Detroit, MI 48201 USA
| | - R. Gadivemula
- Wayne State University, 4201 St. Antoine, 2E UHC, Detroit, MI 48201 USA
| | - D. Levine
- Wayne State University, 4201 St. Antoine, 2E UHC, Detroit, MI 48201 USA
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Choquet C, Nguyen M, Sicard P, Kober F, Varlet I, Richard S, Bernard M, Kelly R, Lalevée N, Miquerol L. His-Purkinje system defects induced by Nkx2-5 deletion leads to progressive conduction defects and heart failure. Archives of Cardiovascular Diseases Supplements 2018. [DOI: 10.1016/j.acvdsp.2018.02.137] [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: 11/30/2022]
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Park HL, Columbus A, Kelly R, Alvarez A, Goodman D, Larsen K, Ziogas A, Anton-Culver H. Abstract P3-09-07: Breast cancer risk assessment in a multiethnic patient population. Cancer Res 2018. [DOI: 10.1158/1538-7445.sabcs17-p3-09-07] [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: 11/16/2022]
Abstract
Abstract
The United States Preventive Services Task Force recommends that women who are at increased risk for breast cancer and at low risk for adverse medication effects should be offered risk-reducing medications, such as tamoxifen or raloxifene, by their clinicians. In addition, the National Comprehensive Cancer Network recommends risk counseling for women with a 5-year risk of ≥1.7% as calculated by the NCI-developed Breast Cancer Risk Assessment Tool (BCRAT, based on the Gail model) or other risk model. Thus, breast cancer risk assessment is important for the identification of women at "high risk" who should be offered risk counseling and potentially intervention. The Athena Breast Health Network, which has served >120,000 breast screening patients across California and the midwest, has integrated breast cancer risk assessment into its clinical breast screening programs. The goal of our study was to characterize breast cancer risk for >10,000 mammography patients in the University of California Irvine Athena Breast Health Network, overall and by race/ethnicity, using several different risk models, including the BCRAT, BCSC, and IBIS models. Our cohort was comprised of 47% non-Hispanic White, 13% non-Hispanic Asian, 38% Hispanic, and 2% women of other race/ethnicities. Using data collected from electronic medical records and self-completed questionnaires, we determined that, as expected, non-Hispanic White and Asian women had higher breast cancer risk scores than Hispanic women for all risk models (5-year risks = 1.51-1.68% and 1.22-1.40% vs. 0.95-1.05%, respectively). In addition, when women were categorized as "increased risk" according to a given risk model if their 5-year risk score was ≥1.7%, the percentages of women at "increased risk" were higher in White women (26.5–42.2%) than in Asian (15.8–28.6%) and Hispanic (6.2–10.7%) women. However, the correlations between risk models were low to moderate in our cohort, overall (Pearson's r = 0.47-0.62) and especially for Asian women (Pearson's r = 0.29-0.49). Our results indicate that using only one risk model in a clinical breast cancer risk assessment program to identify "high risk" women would miss a significant proportion of women who would have been considered "high risk" according to another risk model. Conversely, some women who are identified as "high risk" according to one model may not need risk counseling and intervention since they are not considered "high risk" according to two other models. As our cohort expands and incident breast cancers occur, we will be able to determine which risk model or combination of risk models will have the highest discriminatory accuracy for predicting breast cancer risk in women of different race/ethnicities, which will enable our risk assessment programs to have a more targeted approach to risk counseling and intervention.
Citation Format: Park HL, Columbus A, Athena Breast Health Network Investigators and Advocate Partners, Kelly R, Alvarez A, Goodman D, Larsen K, Ziogas A, Anton-Culver H. Breast cancer risk assessment in a multiethnic patient population [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P3-09-07.
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Affiliation(s)
- HL Park
- University of California, Irvine, Irvine, CA; University of California, San Francisco, San Francisco, CA
| | - A Columbus
- University of California, Irvine, Irvine, CA; University of California, San Francisco, San Francisco, CA
| | - R Kelly
- University of California, Irvine, Irvine, CA; University of California, San Francisco, San Francisco, CA
| | - A Alvarez
- University of California, Irvine, Irvine, CA; University of California, San Francisco, San Francisco, CA
| | - D Goodman
- University of California, Irvine, Irvine, CA; University of California, San Francisco, San Francisco, CA
| | - K Larsen
- University of California, Irvine, Irvine, CA; University of California, San Francisco, San Francisco, CA
| | - A Ziogas
- University of California, Irvine, Irvine, CA; University of California, San Francisco, San Francisco, CA
| | - H Anton-Culver
- University of California, Irvine, Irvine, CA; University of California, San Francisco, San Francisco, CA
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McMurrough I, Kelly R, Byrne J, O'Brien M. Effect of the Removal of Sensitive Proteins and Proanthocyanidins on the Colloidal Stability of Lager Beer. Journal of the American Society of Brewing Chemists 2018. [DOI: 10.1094/asbcj-50-0067] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- I. McMurrough
- Guinness Brewing Worldwide Research Centre, St. James Gate, Dublin 8, Ireland
| | - R. Kelly
- Guinness Brewing Worldwide Research Centre, St. James Gate, Dublin 8, Ireland
| | - J. Byrne
- Guinness Brewing Worldwide Research Centre, St. James Gate, Dublin 8, Ireland
| | - M. O'Brien
- School of Chemical Sciences, Dublin City University, Glasnevin, Dublin 9, Ireland
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Martini K, Kelly R. The provision of first contact physiotherapy in GP surgeries with non-advanced practice clinicians: a service evaluation. Physiotherapy 2017. [DOI: 10.1016/j.physio.2017.11.192] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Kelly R, Walker TWM, Shanks L, McCann P. Re: Medical students' understanding of oral and maxillofacial surgery: an Irish perspective. Br J Oral Maxillofac Surg 2017; 55:e47. [PMID: 28712511 DOI: 10.1016/j.bjoms.2017.04.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2017] [Accepted: 04/11/2017] [Indexed: 10/19/2022]
Affiliation(s)
- R Kelly
- Dental Core Trainee in Oral & Maxillofacial Surgery, Bristol Royal infirmary, Children's Hospital and Dental Hospital, University Hospitals Bristol NHS foundation Trust, Bristol, UK.
| | - T W M Walker
- SpR in Oral & Maxillofacial Surgery, Bristol Royal infirmary, Children's Hospital and Dental Hospital, University Hospitals Bristol NHS foundation Trust, Bristol, UK.
| | - L Shanks
- SpR in Plastic & Reconstructive Surgery, Nottingham, UK.
| | - P McCann
- Consultant Oral & Maxillofacial Surgeon, University Hospital Galway, Ireland.
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Puurveen G, Kelly R. MAKING THE TRANSITION FROM RESIDENTIAL LONG-TERM CARE (RLTC) BACK TO THE COMMUNITY. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.3056] [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: 11/14/2022] Open
Affiliation(s)
- G. Puurveen
- School of Nursing, University of British Columbia, Vancouver, British Columbia, Canada,
| | - R. Kelly
- Fraserhealth Authority, Vancouver, British Columbia, Canada
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Nguyen M, Choquet C, Sicard P, Kober F, Varlet I, Rihet P, Richard S, Nguyen C, Bernard M, Kelly R, Lalevée N, Miquerol L. Temporal deletions of Nkx2-5 induce hypertrabeculation and progressive conduction defects and heart failure. Archives of Cardiovascular Diseases Supplements 2017. [DOI: 10.1016/s1878-6480(17)30515-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Choquet C, Kelly R, Miquerol L. Lineage analysis of ventricular trabeculae to decipher the role of Nkx2-5 in conduction system development. Archives of Cardiovascular Diseases Supplements 2017. [DOI: 10.1016/s1878-6480(17)30513-x] [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: 10/19/2022]
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Loor G, Huddleston S, Jackson S, Elde S, Grabowski T, Kelly R, Shumway S, Hertz M. Effect of Favorable Donor Factors on Outcomes After Bilateral Lung Transplantation: Preliminary Prospective Analysis of the University of Minnesota Donor Lung Quality Index (UMN-DLQI). J Heart Lung Transplant 2017. [DOI: 10.1016/j.healun.2017.01.1515] [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: 10/19/2022] Open
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McNamara C, Cullen P, Rackauskas M, Kelly R, O'Sullivan KE, Galvin J, Eaton D. Left cardiac sympathetic denervation: case series and technical report. Ir J Med Sci 2017; 186:607-613. [PMID: 28238200 DOI: 10.1007/s11845-017-1577-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2016] [Accepted: 02/02/2017] [Indexed: 11/29/2022]
Abstract
BACKGROUND Left cardiac sympathetic denervation (LCSD) is a surgical procedure that has been shown to have an antiarrhythmic and antifibrillatory effect. Evidence indicating its antiarrhythmic effect has been available for over 100 years. It involves the removal of the lower half of the stellate ganglion and T2-T4 of the sympathetic ganglia and is carried out as either a unilateral or bilateral procedure. With advancements in thoracic surgery, it can be safely performed via a minimally invasive Video-Assisted Thoracoscopic Surgery (VATS) approach resulting in significantly less morbidity and a shortened inpatient stay. LCSD provides a valuable treatment option for patients with life-threatening channelopathies and cardiomyopathies. AIMS AND METHODS This case series reports the preliminary paediatric and adult experience in the Republic of Ireland with LCSD and describes five cases recently treated in addition to an outline of the operative procedure employed. Of the five cases included, two were paediatric cases and three were adult cases. RESULTS One of the paediatric patients had a diagnosis of the rare catecholaminergic polymorphic ventricular tachycardia (CPVT) and the other a diagnosis of long-QT syndrome. Both paediatric patients experienced excellent outcomes. Of the three adult patients, two benefitted greatly and remain well at follow-up (one inappropriate sinus tachycardia and one CPVT). One patient with idiopathic ventricular fibrillation unfortunately passed away from intractable VF despite all attempts at resuscitation. CONCLUSION In this case series, we highlight that LCSD provides a critical adjunct to existing medical therapies and should be considered for all patients with life-threatening refractory arrhythmias especially those patients on maximal medical therapy.
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Affiliation(s)
- C McNamara
- Department of Cardiothoracic Surgery, Mater Misericordiae University Hospital, Eccles St., Dublin 7, Ireland
| | - P Cullen
- Department of Cardiothoracic Surgery, Mater Misericordiae University Hospital, Eccles St., Dublin 7, Ireland
| | - M Rackauskas
- Department of Cardiothoracic Surgery, Mater Misericordiae University Hospital, Eccles St., Dublin 7, Ireland
| | - R Kelly
- Department of Cardiothoracic Surgery, Our Lady's Children's Hospital, Crumlin, Dublin, Ireland
| | - K E O'Sullivan
- Department of Cardiothoracic Surgery, Mater Misericordiae University Hospital, Eccles St., Dublin 7, Ireland
| | - J Galvin
- Department of Cardiology, Mater Misericordiae University Hospital, Dublin, Ireland
| | - D Eaton
- Department of Cardiothoracic Surgery, Mater Misericordiae University Hospital, Eccles St., Dublin 7, Ireland.
- Department of Cardiothoracic Surgery, Our Lady's Children's Hospital, Crumlin, Dublin, Ireland.
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Scullion T, Gorman P, Gibson E, Kelly R, Murtagh E, Minnis P. ANTIFIBROTIC THERAPY IN IDIOPATHIC PULMONARY FIBROSIS. Ulster Med J 2017; 86:73. [PMID: 28298722 PMCID: PMC5324193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Moran D, Okada Y, Kernstock R, Spira A, Horn L, Weiss J, West H, Giaccone G, Evans T, Kelly R, Sakagami H, Desai B, Poondru S, Keating A, Oxnard G. Serial plasma genotyping of patients with EGFR-mutant lung cancer treated with ASP8273 demonstrates acquired resistance mediated by EGFR C797S. Eur J Cancer 2016. [DOI: 10.1016/s0959-8049(16)32660-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Moran J, McGovern A, Kelly R, Fallon A, Rafferty T, Guinan E. The ability of the Actigraph wGT3X-BT to accurately measure body position. Physiotherapy 2016. [DOI: 10.1016/j.physio.2016.10.131] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Tanabe M, Kelly R, de Lahunta A, Duffy MS, Wade SE, Divers TJ. Verminous Encephalitis in a Horse Produced by Nematodes in the Family Protostrongylidae. Vet Pathol 2016; 44:119-22. [PMID: 17197637 DOI: 10.1354/vp.44-1-119] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Parasitic granulomatous eosinophilic inflammation was observed in the central nervous system (CNS) of a 6-month-old Arabian colt from New York state. Inflammation was associated with eggs, larvae, and adult nematodes in the cerebellum. Nematodes had histological characteristics of the superfamily Metastrongyloidea. The presence of dorsal-spined larvae in the CNS was further indicative of infection with a nematode in the family Protostrongylidae. Infections were most compatible with Parelaphostrongylus tenuis but specific diagnosis was not possible. This is the first definitive report of a protostrongylid nematode infection in a horse.
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Affiliation(s)
- M Tanabe
- Antech Diagnostics, 17672-B Cowan Avenue, Irvine, CA 92614, USA.
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Abstract
Chondrocytes are the uniquely resident cells found in all types of cartilage and key to their function is the ability to respond to mechanical loads with changes of metabolic activity. This mechanotransduction property is, in part, mediated through the activity of a range of expressed transmembrane channels; ion channels, gap junction proteins, and porins. Appropriate expression of ion channels has been shown essential for production of extracellular matrix and differential expression of transmembrane channels is correlated to musculoskeletal diseases such as osteoarthritis and Albers-Schönberg. In this study we analyzed the consistency of gene expression between channelomes of chondrocytes from human articular and costal (teenage and fetal origin) cartilages. Notably, we found 14 ion channel genes commonly expressed between articular and both types of costal cartilage chondrocytes. There were several other ion channel genes expressed only in articular (6 genes) or costal chondrocytes (5 genes). Significant differences in expression of BEST1 and KCNJ2 (Kir2.1) were observed between fetal and teenage costal cartilage. Interestingly, the large Ca2+ activated potassium channel (BKα, or KCNMA1) was very highly expressed in all chondrocytes examined. Expression of the gap junction genes for Panx1, GJA1 (Cx43) and GJC1 (Cx45) was also observed in chondrocytes from all cartilage samples. Together, this data highlights similarities between chondrocyte membrane channel gene expressions in cells derived from different anatomical sites, and may imply that common electrophysiological signaling pathways underlie cellular control. The high expression of a range of mechanically and metabolically sensitive membrane channels suggest that chondrocyte mechanotransduction may be more complex than previously thought.
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Affiliation(s)
- A Asmar
- a Frank Reidy Research Center for Bioelectrics, Old Dominion University , Norfolk , VA , USA
| | - R Barrett-Jolley
- b Department of Musculoskeletal Biology , University of Liverpool , England , UK
| | - A Werner
- c Department of Pathology , Eastern Virginia Medical School and Med Director of Laboratories, Children's Hospital of The King's Daughters , Norfolk , VA , USA
| | - R Kelly
- d Department of Surgery , Eastern Virginia Medical School and Pediatric Surgery Division, Children's Hospital of the King's Daughters , Norfolk , VA , USA
| | - M Stacey
- a Frank Reidy Research Center for Bioelectrics, Old Dominion University , Norfolk , VA , USA
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Loor G, Brown R, Kelly R, Rudser K, Shumway S, Holley C, Cich I, Hertz M. Gender Differences in Long-Term Survival during the LAS Era: A Single Institution Analysis of 848 Transplant Recipients. J Heart Lung Transplant 2016. [DOI: 10.1016/j.healun.2016.01.871] [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] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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42
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Kelly R, Lyons F, Granahan A, Tolan M. 45 The anatomy of failure: can 100% repair rate of the degenerative mitral valve be achieved. Heart 2015. [DOI: 10.1136/heartjnl-2015-308621.45] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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43
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Carugati M, Franzetti F, Wiemken T, Kelley RR, Kelly R, Peyrani P, Blasi F, Ramirez J, Aliberti S. De-escalation therapy among bacteraemic patients with community-acquired pneumonia. Clin Microbiol Infect 2015; 21:936.e11-8. [PMID: 26115864 DOI: 10.1016/j.cmi.2015.06.015] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2015] [Revised: 06/05/2015] [Accepted: 06/12/2015] [Indexed: 10/23/2022]
Abstract
There is no evidence supporting the use of de-escalation therapy (DET) among patients with community-acquired pneumonia (CAP). We assessed the outcomes associated with DET among bacteraemic CAP patients. We performed a secondary analysis of the Community-Acquired Pneumonia Organization database, which contains data on 660 bacteraemic patients hospitalized because of CAP in 35 countries (2001-2013). Exclusion criteria were death within 72 h from admission and an inappropriate empirical antibiotic regimen. DET was defined as changing an appropriate empirical broad-spectrum regimen to a narrower-spectrum regimen according to culture results within 7 days from hospital admission. Two study groups were identified: patients whose antibiotic therapy was de-escalated (the DET group), and patients whose antibiotic therapy was not de-escalated (the N-DET group). The primary study outcome was 30-day mortality. Two hundred and sixty-one bacteraemic CAP patients were included. Gram-positive bacteria were responsible for 88.1% of the cases (Streptococcus pneumoniae, 75.9%). Gram-negative bacteria were responsible for for 7.3% of the cases. DET was performed in 165 patients (63.2%). The N-DET group was characterized by a more severe presentation at admission. After adjustment for confounders, DET was not associated with an increased risk of 30-day mortality. DET seems to be safe among bacteraemic patients with CAP. Randomized clinical trials are warranted to further explore these findings.
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Affiliation(s)
- M Carugati
- Department of Biomedical and Clinical Sciences, Università degli Studi di Milano, Milan, Italy.
| | - F Franzetti
- Department of Biomedical and Clinical Sciences, Università degli Studi di Milano, Milan, Italy
| | - T Wiemken
- Division of Infectious Diseases, University of Louisville, Louisville, KY, USA
| | | | - R Kelly
- Division of Infectious Diseases, University of Louisville, Louisville, KY, USA
| | - P Peyrani
- Division of Infectious Diseases, University of Louisville, Louisville, KY, USA
| | - F Blasi
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano, IRCCS Fondazione Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - J Ramirez
- Division of Infectious Diseases, University of Louisville, Louisville, KY, USA
| | - S Aliberti
- Department of Health Sciences, University of Milano - Bicocca, Respiratory Unit, AO San Gerardo, Monza, Italy
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Kelly R, Robar J, Parsons D. SU-E-T-244: Designing Low-Z Targets To Enhance Surface Dose: A Monte Carlo Simulation. Med Phys 2015. [DOI: 10.1118/1.4924606] [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: 11/07/2022] Open
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Loor G, Radosevich D, Cich I, Lyon C, Morrow J, Grabowski T, Holley C, Kelly R, Hertz M. The University of Minnesota Lung Donor Quality Index (UMN-DLQI): A Consensus-Based Scoring Tool for Lung Donor Evaluations. J Heart Lung Transplant 2015. [DOI: 10.1016/j.healun.2015.01.787] [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: 10/23/2022] Open
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46
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Loor G, Howard B, Iles T, Mattison L, Meyer P, Day T, Panoskaltsis-Mortari A, Kelly R, Iaizzo P. Prolonged Lung Preservation at 24 Hours Using Donor Whole Blood Perfusion in the Organ Care System (OCS). J Heart Lung Transplant 2015. [DOI: 10.1016/j.healun.2015.01.793] [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: 10/23/2022] Open
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Lankaputhra M, Kelly R, Negishi K. The association between heart rate variability and fine particulate air pollution: A systematic review of 9593 subjects. Heart Lung Circ 2015. [DOI: 10.1016/j.hlc.2015.06.801] [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: 10/23/2022]
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Holcombe H, Parry NM, Rick M, Brown DE, Albers TM, Refsal KR, Morris J, Kelly R, Marko ST. Hypervitaminosis D and Metastatic Calcification in a Colony of Inbred Strain 13 Guinea Pigs, Cavia porcellus. Vet Pathol 2014; 52:741-51. [PMID: 25281651 DOI: 10.1177/0300985814551423] [Citation(s) in RCA: 7] [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
A commercial diet fed to a colony of inbred strain 13 guinea pigs for approximately 6 weeks was subsequently recalled for excessive levels of vitamin D. Twenty-one of 62 animals exhibited clinical signs, including anorexia, lethargy, and poor body condition. Nine affected and 4 clinically normal animals were euthanized for further evaluation, including serum chemistry, urinalysis, and gross and/or histopathology. Macroscopic findings included white discoloration in multiple organs in 8 animals, and microscopic evaluation confirmed multiorgan mineralization in tissues from 7 animals. Serum 25-hydroxyvitamin D levels were elevated in 10 animals. Serum inorganic phosphorus and alkaline phosphatase levels were increased in all exposed animals; however, total calcium and ionized calcium levels were not significantly higher in exposed animals than in control strain 13 guinea pigs from a different institution. The data support a diagnosis of hypervitaminosis D with metastatic calcification. Following the diet recall, the remaining guinea pigs increased their food intake and regained body condition. Diagnostic testing of 8 animals euthanized approximately 3 months after returning to a normal diet demonstrated that serum parathyroid hormone remained significantly lower, and ionized calcium and ionized magnesium were significantly higher, in recovered animals compared to controls and exposed animals. These results indicate that diagnostic tests other than serum calcium are necessary for a diagnosis of hypervitaminosis D in guinea pigs.
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Affiliation(s)
- H Holcombe
- Division of Comparative Medicine, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - N M Parry
- Division of Comparative Medicine, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - M Rick
- Diagnostic Center for Population and Animal Health, Michigan State University, Lansing MI, USA
| | - D E Brown
- Center for Comparative Medicine. Massachusetts General Hospital, Boston, MA, USA Department of Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - T M Albers
- Research Models and Services, Charles River, Wilmington, MA, USA
| | - K R Refsal
- Diagnostic Center for Population and Animal Health, Michigan State University, Lansing MI, USA
| | - J Morris
- Center for Comparative Medicine. Massachusetts General Hospital, Boston, MA, USA
| | - R Kelly
- United States Army Medical Research Institute of Infectious Diseases, Fort Detrick, MD, USA
| | - S T Marko
- United States Army Medical Research Institute of Infectious Diseases, Fort Detrick, MD, USA
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Stringhini S, Polidoro S, Sacerdote C, Kelly R, van VeldhovenK K, Agnoli C, Grioni S, TuminoR R, Giurdanella MC, Panico S, Mattiello A, Palli D, Masala G, Gallo V, Castagne R, PaccaudF F, Campanella G, Chadeau-Hyam M, Vineis P. Association of lifecourse socioeconomic status with DNA methylation of genes regulating inflammation. Eur J Public Health 2014. [DOI: 10.1093/eurpub/cku164.008] [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: 11/14/2022] Open
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50
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Abstract
A 68-year-old lady with metastatic malignant melanoma was treated with Ipilimumab. She presented to Eye Casualty unable to move her eyes. Physical examination confirmed ophthalmoplegia and identified proptosis bilaterally. Radiological imaging showed bilateral enlargement of all the extra-ocular muscles suggestive of thyroid eye disease. Laboratory investigations found this patient to be euthyroid. A diagnosis of thyroid-like orbitopathy secondary to Ipilimumab therapy was made. Thyroid function tests should be performed for all patients prior to their commencement of Ipilimumab. Thyroid-like eye disease may develop in patients treated with Ipilimumab even if they remain euthyroid.
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Affiliation(s)
- Elizabeth McElnea
- Department of Ophthalmology, Mater Misericordiae University Hospital , Dublin , Ireland
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