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Naderi K, Jameel A, Low S, Wagh V, Bhogal M, Ritchie A, Robbie S, Hammond C, Mohamed M, Stanojcic N, Azan E, Lai L, Hull C, O'Brart D. 'Off the shelf' toric intraocular lenses to allow better access in public healthcare: a randomised control study. Eye (Lond) 2024:10.1038/s41433-024-03068-3. [PMID: 38600360 DOI: 10.1038/s41433-024-03068-3] [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: 10/25/2023] [Revised: 03/11/2024] [Accepted: 04/04/2024] [Indexed: 04/12/2024] Open
Affiliation(s)
- Khayam Naderi
- Department of Ophthalmology, St. Thomas' Hospital, Lambeth Palace Road, London, SE1 7EH, UK
- King's College, London, WC2R 2LS, UK
| | - Ashmal Jameel
- Department of Ophthalmology, St. Thomas' Hospital, Lambeth Palace Road, London, SE1 7EH, UK
- King's College, London, WC2R 2LS, UK
| | - Sancy Low
- Department of Ophthalmology, St. Thomas' Hospital, Lambeth Palace Road, London, SE1 7EH, UK
| | - Vijay Wagh
- Department of Ophthalmology, St. Thomas' Hospital, Lambeth Palace Road, London, SE1 7EH, UK
| | - Mani Bhogal
- Department of Ophthalmology, St. Thomas' Hospital, Lambeth Palace Road, London, SE1 7EH, UK
| | - Ailsa Ritchie
- Department of Ophthalmology, St. Thomas' Hospital, Lambeth Palace Road, London, SE1 7EH, UK
| | - Scott Robbie
- Department of Ophthalmology, St. Thomas' Hospital, Lambeth Palace Road, London, SE1 7EH, UK
| | - Chris Hammond
- Department of Ophthalmology, St. Thomas' Hospital, Lambeth Palace Road, London, SE1 7EH, UK
- King's College, London, WC2R 2LS, UK
| | - Moin Mohamed
- Department of Ophthalmology, St. Thomas' Hospital, Lambeth Palace Road, London, SE1 7EH, UK
| | - Nick Stanojcic
- Department of Ophthalmology, St. Thomas' Hospital, Lambeth Palace Road, London, SE1 7EH, UK
- King's College, London, WC2R 2LS, UK
| | - Elodie Azan
- Department of Ophthalmology, St. Thomas' Hospital, Lambeth Palace Road, London, SE1 7EH, UK
| | - Lily Lai
- Department of Ophthalmology, St. Thomas' Hospital, Lambeth Palace Road, London, SE1 7EH, UK
| | - Chris Hull
- Department of Optometry and Visual Science, School of Health and Psychological Sciences, City, University of London, Northampton Square, London, EC1V 0HB, UK
| | - David O'Brart
- Department of Ophthalmology, St. Thomas' Hospital, Lambeth Palace Road, London, SE1 7EH, UK.
- King's College, London, WC2R 2LS, UK.
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Hadian F, Low S, Vaid D, Oates AJ. Letter to the editor re: ultrasound as the first line investigation for midgut malrotation: a UK tertiary centre experience. Clin Radiol 2024:S0009-9260(24)00146-6. [PMID: 38631931 DOI: 10.1016/j.crad.2024.03.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2024] [Accepted: 03/01/2024] [Indexed: 04/19/2024]
Affiliation(s)
- F Hadian
- University Hospital Southampton, Tremona Road, Southampton, SO16 6YD, UK.
| | - S Low
- Norfolk and Norwich University Hospital, Colney Lane, Colney, Norwich, NR4 7UY, UK
| | - D Vaid
- Alder Hey Children's Hospital, E Prescot Road, Liverpool, L14 5AB, UK
| | - A J Oates
- Birmingham Children's Hospital, Steelhouse Lane, Queensway, Birmingham, B4 6NH, UK
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Jameel A, Dong L, Lam CFJ, Mahmood H, Naderi K, Low S, Azan E, Verma S, Robbie S, Bhogal M, O'Brart D. Attitudes and understanding of premium intraocular lenses in cataract surgery: a public health sector patient survey. Eye (Lond) 2024; 38:76-81. [PMID: 37355756 PMCID: PMC10764870 DOI: 10.1038/s41433-023-02633-6] [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: 10/25/2022] [Revised: 06/05/2023] [Accepted: 06/09/2023] [Indexed: 06/26/2023] Open
Abstract
OBJECTIVES To investigate patient understanding of, and attitudes to, premium (toric, extended depth of focus/multifocal) intraocular lenses (premIOLs) in public health sector patients undergoing cataract surgery (CS) in the UK. METHODS A 12 question survey with Likert scale questions was designed, to assess patient attitudes to post-operative spectacle dependence, refractive target and desirability of spectacle independence whilst considering possible complications of dysphotopsias and need for premIOL exchange/adjustment. RESULTS 360 surveys were collected. CS had not been performed in 66.5%. Separate spectacles were worn for reading and distance in 28.8%, 19.2% had varifocals, 11.2% bifocals, 22.9% reading glasses only and 1.6% computer glasses only. Contact lenses were not worn in 95.7%. Only 41.6% were drivers. Most patients (85.8%) did not mind wearing glasses after CS, with 78.9% preferring reading glasses, compared with 29.7% preferring distance glasses. Most patients (75.3%) were not familiar with premIOLs, with 58.9% not willing to consider them in the context of a 2% risk of debilitating dysphotopsia and 54.2% rejecting a 5% risk of second surgery. CONCLUSIONS There is a lack of awareness of premIOLs in public health sector (NHS) patients in the UK, suggesting limitations in the "fully informed" consent process for CS. Most NHS CS patients are currently willing to wear spectacles after CS, especially reading glasses. There is reluctance in such patients to consider premIOLs on a background of small risks of debilitating dysphotopsias and increased risks of a second operation.
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Affiliation(s)
- Ashmal Jameel
- Ophthalmology Dept, Guy's & St Thomas NHS Foundation Trust, St Thomas' Hospital, Westminster Bridge Road, London, SE1 7EH, UK
- Frost Research Clinic, Ophthalmology Dept, Kings College London, St Thomas' Hospital, Westminster Bridge Road, London, SE1 7EH, UK
| | - Lucia Dong
- Ophthalmology Dept, Guy's & St Thomas NHS Foundation Trust, St Thomas' Hospital, Westminster Bridge Road, London, SE1 7EH, UK
| | | | - Hana Mahmood
- Barts and The London School of Medicine and Dentistry, Queen Mary University of London, Turner Street, London, E1 2AD, UK
| | - Khayam Naderi
- Ophthalmology Dept, Guy's & St Thomas NHS Foundation Trust, St Thomas' Hospital, Westminster Bridge Road, London, SE1 7EH, UK
- Frost Research Clinic, Ophthalmology Dept, Kings College London, St Thomas' Hospital, Westminster Bridge Road, London, SE1 7EH, UK
| | - Sancy Low
- Ophthalmology Dept, Guy's & St Thomas NHS Foundation Trust, St Thomas' Hospital, Westminster Bridge Road, London, SE1 7EH, UK
| | - Elodie Azan
- Ophthalmology Dept, Guy's & St Thomas NHS Foundation Trust, St Thomas' Hospital, Westminster Bridge Road, London, SE1 7EH, UK
| | - Seema Verma
- Ophthalmology Dept, Guy's & St Thomas NHS Foundation Trust, St Thomas' Hospital, Westminster Bridge Road, London, SE1 7EH, UK
| | - Scott Robbie
- Ophthalmology Dept, Guy's & St Thomas NHS Foundation Trust, St Thomas' Hospital, Westminster Bridge Road, London, SE1 7EH, UK
| | - Mani Bhogal
- Ophthalmology Dept, Guy's & St Thomas NHS Foundation Trust, St Thomas' Hospital, Westminster Bridge Road, London, SE1 7EH, UK
| | - David O'Brart
- Ophthalmology Dept, Guy's & St Thomas NHS Foundation Trust, St Thomas' Hospital, Westminster Bridge Road, London, SE1 7EH, UK.
- Frost Research Clinic, Ophthalmology Dept, Kings College London, St Thomas' Hospital, Westminster Bridge Road, London, SE1 7EH, UK.
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Naderi K, Lam CFJ, Low S, Bhogal M, Jameel A, Theodoraki K, Lai L, Garcia LO, Roberts H, Robbie S, O'Brart D. Time and Motion Studies to assess surgical productivity in cataract theatre lists within the National Health Service: Immediate Sequential Bilateral Cataract Surgery versus Delayed Sequential Bilateral Cataract Surgery. Eye (Lond) 2023; 37:3751-3756. [PMID: 37277612 PMCID: PMC10239710 DOI: 10.1038/s41433-023-02593-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 05/09/2023] [Accepted: 05/17/2023] [Indexed: 06/07/2023] Open
Abstract
BACKGROUND To compare productivity of National Health Service cataract lists performing unilateral cataract (UC) surgery vs Immediate Sequential Bilateral Cataract Surgery (ISBCS). METHODS Five 4-hour lists with ISBCS cases and five with UC were observed using time and motion studies (TMS). Individual tasks and timings of each staff member in theatre was recorded by two observers. All operations were performed by consultant surgeons under local anaesthesia (LA). RESULTS Median number of eyes operated per 4-hour list was 8 (range 6-8) in the ISBCS group and 5 (5-7) in the UC group (p = 0.028). Mean total theatre time (defined as time between the entry of the first patient and the exit of the last patient from theatre) was 177.12 (SD 73.62) minutes in the ISBCS group and 139.16 (SD 47.73) minutes in the UC group (p = 0.36). Mean time to complete two consecutive unilateral cataract surgery operations was 48.71 minutes compared to 42.23 minutes for a single ISBCS case (13.30% time saved). Based on our collected TMS data, a possible 5 consecutive ISBCS cases and 1 UC (total 11 cataract surgeries) could be performed during a four-hour theatre session, with a theatre utilisation quotient of 97.20%, contrasting to nine consecutive UC, with a theatre utilisation quotient of 90.40%. DISCUSSION Performing consecutive ISBCS cases under LA on routine cataract surgery lists can increase surgical efficiency. TMS are a useful way to investigate surgical productivity and test theoretical models for efficiency improvements.
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Affiliation(s)
- Khayam Naderi
- Department of Ophthalmology, St. Thomas' Hospital, Lambeth Palace Road, London, SE1 7EH, UK.
- King's College London, London, WC2R 2LS, UK.
| | - Chun Fung Jeffrey Lam
- Department of Ophthalmology, St. Thomas' Hospital, Lambeth Palace Road, London, SE1 7EH, UK
- King's College London, London, WC2R 2LS, UK
| | - Sancy Low
- Department of Ophthalmology, St. Thomas' Hospital, Lambeth Palace Road, London, SE1 7EH, UK
| | - Mani Bhogal
- Department of Ophthalmology, St. Thomas' Hospital, Lambeth Palace Road, London, SE1 7EH, UK
| | - Ashmal Jameel
- Department of Ophthalmology, St. Thomas' Hospital, Lambeth Palace Road, London, SE1 7EH, UK
- King's College London, London, WC2R 2LS, UK
| | - Korina Theodoraki
- Department of Ophthalmology, St. Thomas' Hospital, Lambeth Palace Road, London, SE1 7EH, UK
| | - Lily Lai
- Department of Ophthalmology, St. Thomas' Hospital, Lambeth Palace Road, London, SE1 7EH, UK
| | - Luis Onrubia Garcia
- Department of Ophthalmology, St. Thomas' Hospital, Lambeth Palace Road, London, SE1 7EH, UK
| | - Harry Roberts
- West of England Eye Unit, Royal Devon and Exeter NHS Foundation Trust, Exeter, EX2 5DW, UK
| | - Scott Robbie
- Department of Ophthalmology, St. Thomas' Hospital, Lambeth Palace Road, London, SE1 7EH, UK
| | - David O'Brart
- Department of Ophthalmology, St. Thomas' Hospital, Lambeth Palace Road, London, SE1 7EH, UK.
- King's College London, London, WC2R 2LS, UK.
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Low S, Van Lancker L, Barwood C, Combe E, Sanhueza E, Lim KS. Reply. Ophthalmol Glaucoma 2023; 6:e4. [PMID: 37302548 DOI: 10.1016/j.ogla.2023.06.003] [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: 05/31/2023] [Accepted: 06/06/2023] [Indexed: 06/13/2023]
Affiliation(s)
- Sancy Low
- Department of Ophthalmology, Guys and St. Thomas' National Health Service Foundation Trust, London, UK.
| | - Lauren Van Lancker
- Department of Ophthalmology, Kings' College Hospital National Health Service Foundation Trust, London, UK
| | | | | | - Enrique Sanhueza
- Department of Ophthalmology, Guys and St. Thomas' National Health Service Foundation Trust, London, UK; Departamento de Glaucoma - Hospital del Salvador, Universidad de Chile, Providencia, Santiago, Chile
| | - Kin Sheng Lim
- Department of Ophthalmology, Guys and St. Thomas' National Health Service Foundation Trust, London, UK
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Van Lancker L, Saravanan A, Abu-Bakra M, Reid K, Quijano C, Goyal S, Rodrigues I, Lascaratos G, Trikha S, Barwood C, Combe E, Kulkarni A, Lim KS, Low S. Clinical Outcomes and Cost Analysis of PreserFlo versus Trabeculectomy for Glaucoma Management in the United Kingdom. Ophthalmol Glaucoma 2023; 6:342-357. [PMID: 36427750 DOI: 10.1016/j.ogla.2022.11.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [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: 07/21/2022] [Revised: 10/27/2022] [Accepted: 11/21/2022] [Indexed: 11/25/2022]
Abstract
PURPOSE Clinical evaluation and cost analysis of mitomycin-C-augmented PreserFlo MicroShunt versus trabeculectomy. DESIGN Retrospective cohort study across 3 teaching hospitals. PARTICIPANTS A total of 134 consecutive eyes of 129 patients (70 undergoing MicroShunt, 64 trabeculectomy). METHODS Primary and secondary glaucoma cases with uncontrolled intraocular pressure (IOP) were included. Neovascular glaucoma and surgery combined with cataract extraction were excluded. The cost analysis used results from the clinical study to estimate operative costs (equipment and staff costs) and postoperative costs (follow-up visits, nonglaucoma medications, and postoperative procedures) per eye for PreserFlo and trabeculectomy. MAIN OUTCOME MEASURES The primary clinical outcome measure was surgical failure (defined as IOP > 21 mmHg or < 20% reduction from baseline, IOP ≤ 5 mmHg, reoperation, or loss of light perception) or qualified and complete success (with or without medication) at 18 months. Secondary measures were IOP, glaucoma medications, visual acuity, mean deviation, time to cessation of steroid drops, complications, surgical time, follow-up visits, postoperative interventions, and reoperations. The cost analysis evaluated costs of PreserFlo compared with trabeculectomy. RESULTS Baseline characteristics were similar, except for more non-White patients in the trabeculectomy group (51% Black and Asian vs. 32% MicroShunt, P = 0.02) and more cases with prior ab externo glaucoma surgery in the MicroShunt group (19% vs. 3% in the trabeculectomy group, P = 0.004). Overall, 59% of eyes had primary open-angle glaucoma. Mean follow-up was 19.9 months for both groups. At 18 months, surgical failure was 25% for MicroShunt compared with 35% for trabeculectomy (P = 0.18). Failure in MicroShunt cases was due to inadequate IOP reduction (84%) or reoperation for glaucoma (16%). Failure in trabeculectomy cases was due to inadequate IOP reduction (58%), persistent hypotony (29%), or reoperation for glaucoma (13%). Combined blebitis and endophthalmitis rate was 1.4% for MicroShunt and 3.1% for trabeculectomy. Cost analysis showed a savings of £245 to £566 per eye in the MicroShunt group, driven mostly by reduced postoperative procedures and follow-up visits. This is in contrast to prior randomized controlled trial data reporting the incremental cost of $2058 of PreserFlo over trabeculectomy. CONCLUSIONS Our experience of introducing PreserFlo MicroShunt surgery showed it was safer than trabeculectomy and is a cost-saving and effective option that offers potential to free up highly limited National Health Service resources. FINANCIAL DISCLOSURE(S) Proprietary or commercial disclosure may be found after the references.
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Affiliation(s)
- Lauren Van Lancker
- Department of Ophthalmology, King's College Hospital NHS Foundation Trust, London, United Kingdom
| | - Amrita Saravanan
- Department of Ophthalmology, Guys and St. Thomas' NHS Foundation Trust, London, United Kingdom
| | - Mohammed Abu-Bakra
- Department of Ophthalmology, King's College Hospital NHS Foundation Trust, London, United Kingdom
| | - Kyle Reid
- Department of Ophthalmology, Guys and St. Thomas' NHS Foundation Trust, London, United Kingdom
| | - Claudia Quijano
- Department of Ophthalmology, Guys and St. Thomas' NHS Foundation Trust, London, United Kingdom
| | - Saurabh Goyal
- Department of Ophthalmology, Guys and St. Thomas' NHS Foundation Trust, London, United Kingdom
| | - Ian Rodrigues
- Department of Ophthalmology, Guys and St. Thomas' NHS Foundation Trust, London, United Kingdom
| | - Gerassimos Lascaratos
- Department of Ophthalmology, King's College Hospital NHS Foundation Trust, London, United Kingdom
| | - Sameer Trikha
- Department of Ophthalmology, King's College Hospital NHS Foundation Trust, London, United Kingdom
| | | | - Emily Combe
- FIECON, St. Albans, Hertfordshire, United Kingdom
| | - Avinash Kulkarni
- Department of Ophthalmology, King's College Hospital NHS Foundation Trust, London, United Kingdom
| | - Kin Sheng Lim
- Department of Ophthalmology, Guys and St. Thomas' NHS Foundation Trust, London, United Kingdom
| | - Sancy Low
- Department of Ophthalmology, Guys and St. Thomas' NHS Foundation Trust, London, United Kingdom.
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Liu C, Low S, Tran K. Anaesthesia for fetal interventions. BJA Educ 2023; 23:162-171. [PMID: 37124170 PMCID: PMC10140474 DOI: 10.1016/j.bjae.2023.01.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Accepted: 01/27/2023] [Indexed: 03/29/2023] Open
Affiliation(s)
- C.A. Liu
- Massachusetts General Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - S. Low
- Massachusetts General Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - K.M. Tran
- The Children's Hospital of Philadelphia, Philadelphia, PA, USA
- University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
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Ma N, Low S, Hasan S, Banna S, Patel S, Kalsi T. Correction to: Provision of eye care services and interventions in care homes: a narrative synthesis review. Eur Geriatr Med 2023; 14:403. [PMID: 36913107 DOI: 10.1007/s41999-023-00762-5] [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: 03/14/2023]
Affiliation(s)
- N Ma
- Ageing and Health Department, Guy's and St Thomas' NHS Foundation Trust, Westminster Bridge Road, London, SE1 7EH, UK.
| | - S Low
- Ageing and Health Department, Guy's and St Thomas' NHS Foundation Trust, Westminster Bridge Road, London, SE1 7EH, UK
| | - S Hasan
- Quay Health Solutions GP Care Home Service, London, UK
| | - S Banna
- Ageing and Health Department, Guy's and St Thomas' NHS Foundation Trust, Westminster Bridge Road, London, SE1 7EH, UK
| | | | - T Kalsi
- Ageing and Health Department, Guy's and St Thomas' NHS Foundation Trust, Westminster Bridge Road, London, SE1 7EH, UK.,King's College London, London, UK
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Ma N, Low S, Hasan S, Banna S, Patel S, Kalsi T. Provision of eye care services and interventions in care homes: a narrative synthesis review. Eur Geriatr Med 2023; 14:153-164. [PMID: 36645609 PMCID: PMC9841945 DOI: 10.1007/s41999-022-00741-2] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 12/29/2022] [Indexed: 01/17/2023]
Abstract
BACKGROUND The prevalence of eye disease and visual impairment in care home residents is disproportionately higher compared to the general population. Access to eye care services and treatment can be variable for this vulnerable population. OBJECTIVE This paper reviews the available evidence of services and interventions for delivering eye care to care home residents. The key review questions are: (1) What is the existing evidence for eye care interventions or services (including service configuration) for care home residents? (2) Does the provision of these interventions or services improve outcomes? METHODS Literature search of EMBASE/MEDLINE for original papers published since 1995. Two reviewers independently reviewed abstracts/papers. Data were extracted and evaluated using narrative synthesis. RESULTS 13 original papers met the inclusion criteria. Domiciliary optometrist services improved diagnosis and management of eye conditions, with one study showing 53% of residents benefited from direct ophthalmology intervention. Provision of interventions, such as cataract surgery, refractive error correction and low-vision rehabilitation, improved visual acuity and vision-related quality of life but did not improve cognitive or physical function, depression or health-related quality of life. There was little UK-based literature to inform eye service design or interventions to improve outcomes such as falls. CONCLUSION Care home-based eye assessments improve the management of eye conditions. Interventions improve visual acuity and vision-related quality of life. Further research is needed to better understand current UK services, access difficulties or examples of good practice as well as to identify and test cost-effective service models for this vulnerable group.
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Affiliation(s)
- N Ma
- Ageing and Health Department, Guy's and St Thomas' NHS Foundation Trust, Westminster Bridge Road, London, SE1 7EH, UK.
| | - S Low
- Ageing and Health Department, Guy's and St Thomas' NHS Foundation Trust, Westminster Bridge Road, London, SE1 7EH, UK
| | - S Hasan
- Quay Health Solutions GP Care Home Service, London, UK
| | - S Banna
- Ageing and Health Department, Guy's and St Thomas' NHS Foundation Trust, Westminster Bridge Road, London, SE1 7EH, UK
| | | | - T Kalsi
- Ageing and Health Department, Guy's and St Thomas' NHS Foundation Trust, Westminster Bridge Road, London, SE1 7EH, UK.,King's College London, London, UK
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Ma N, Low S, Hasan S, Banna S, Patel S, Kalsi T. 1210 PROVISION OF EYE CARE SERVICES AND INTERVENTIONS IN CARE HOMES - A NARRATIVE SYNTHESIS REVIEW. Age Ageing 2023. [DOI: 10.1093/ageing/afac322.090] [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: 01/18/2023] Open
Abstract
Abstract
Introduction
The prevalence of eye disease and visual impairment in care home residents is disproportionately higher compared to the general population. Access to eye care services and treatment can be variable for this vulnerable population.
Objective
This narrative synthesis reviews the available evidence of services and interventions for delivering eye care to care home residents. The key review questions:
Methods
Literature search of EMBASE/MEDLINE for original papers published since 1995. Two reviewers independently reviewed abstracts/papers. Data was extracted and evaluated using narrative synthesis.
Results
13 original papers met the inclusion criteria. On-site optometrist-led services improved diagnosis and management of eye conditions, with one study showing 53% of residents benefited from direct ophthalmology intervention. Provision of interventions such as cataract surgery, refractive error correction and low vision rehabilitation improved visual acuity and vision-related quality of life but did not improve cognitive or physical function, depression or health-related quality of life. There was little UK-based literature to inform eye service design or interventions to improve outcomes.
Conclusion
Care home-based eye assessments improve the management of eye conditions. Interventions improve visual acuity and vision-related quality of life. Further research and/or clinical service scoping is needed to better understand current UK services, access difficulties or examples of good practice as well as to identify and test cost-effective service models for this vulnerable group.
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Affiliation(s)
- N Ma
- Guy’s and St Thomas’ NHS Foundation Trust , London, United Kingdom
| | - S Low
- Guy’s and St Thomas’ NHS Foundation Trust , London, United Kingdom
| | - S Hasan
- Quay Health Solutions GP Care Home Service , Southwark
| | - S Banna
- Guy’s and St Thomas’ NHS Foundation Trust , London, United Kingdom
| | | | - T Kalsi
- Guy’s and St Thomas’ NHS Foundation Trust , London, United Kingdom
- King’s College London
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Ma N, Low S, Hasan S, Lawal A, Patel S, Nurse K, McNaughton G, Aggarwal R, Evans J, Koria R, Lam C, Chakravorty M, Stanley G, Banna S, Kalsi T. 1226 A MULTI-DISCIPLINARY APPROACH TO TRANSFORMING EYE CARE SERVICES FOR CARE HOME RESIDENTS. Age Ageing 2023. [DOI: 10.1093/ageing/afac322.114] [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: 01/18/2023] Open
Abstract
Abstract
Introduction
Care home residents can have variable access to eye care services and treatments. We developed a collaborative approach between optometrists, care homes, and primary and secondary care to enable personalised patient-centred care.
Objective
To develop and evaluate an integrated model of eye care for care home residents.
Methods
Small scale plan-do-study-act (PDSA) service tests were completed in three care-homes in Southwark (2 residential, 1 nursing) between November 2021 to May 2022. Processes were compared to historical feedback and hospital-based ophthalmology clinic attendances (Mar 2019-2020). Hospital-like assessments were piloted at two care homes for feasibility and acceptability. Further piloting utilised usual domiciliary optometry-led assessment with multidisciplinary meeting access (including optometrist, GP, geriatrician, ophthalmologist and care home nurse) to reduce duplication of assessments and to evaluate MDM processes and referral rates.
Results
Examination was 100% successful at home (visual acuity and pressure measurement) compared to hospital outpatients (71.7% success visual acuity, 54.5% pressures). Examination was faster than in hospital settings (16 minutes vs 45 minutes-1 hour). Residents were away from usual activities for 32 minutes vs 6 hours for hospital visits including transport. Residents were less distressed with home-based assessments. Did-Not-Attend (DNA) rates reduced (26.7% to 0%), secondary care discharge rates improved (8.4% to 32%). Hospital eye service referral were indicated in 19% -23%, half of which were for consideration of cataract surgery. Alternative conservative plans were agreed at MDM for nursing home residents who were clinically too frail or would not have been able to comply with treatments avoiding 33% unnecessary referrals.
Conclusions
Home-based eye care assessments appear better tolerated and are more efficient for residents, health and care staff. Utilising an MDM for optometrists to discuss residents with ophthalmologists and wider MDT members enabled personalised patient-centred decision-making. Future work to test this borough wide is in progress.
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Affiliation(s)
- N Ma
- Guy’s and St Thomas’ NHS Foundation Trust , London
| | - S Low
- Guy’s and St Thomas’ NHS Foundation Trust , London
| | - S Hasan
- Quay Health Solutions GP Care Home Service , Southwark, London
| | - A Lawal
- Quay Health Solutions GP Care Home Service , Southwark, London
| | | | | | | | | | - J Evans
- Minor Eye Conditions Scheme, Primary Ophthalmic Solutions , London
| | - R Koria
- Minor Eye Conditions Scheme, Primary Ophthalmic Solutions , London
| | - C Lam
- Guy’s and St Thomas’ NHS Foundation Trust , London
| | | | - G Stanley
- Quay Health Solutions GP Care Home Service , Southwark, London
| | - S Banna
- Guy’s and St Thomas’ NHS Foundation Trust , London
| | - T Kalsi
- Guy’s and St Thomas’ NHS Foundation Trust , London
- King’s College London
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Lim CSE, Hamilton L, Low S, Toms A, Macgregor A, Gaffney K. POS0035 ONE IN TWENTY INFLAMMATORY BOWEL DISEASE PATIENTS WHO UNDERWENT ABDOMINOPELVIC COMPUTED TOMOGRAPHY HAVE UNDIAGNOSED AXIAL SPONDYLOARTHRITIS. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.2047] [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: 11/04/2022]
Abstract
Background:The diagnosis of axial spondyloarthritis (axSpA) is challenging and hindered by delay. There may be an opportunity to identify sacroiliitis for further rheumatology review in inflammatory bowel disease (IBD) patients who undergo Computed Tomography (CT) for non-musculoskeletal (MSK) indications.Objectives:To identify what proportion of IBD patients who underwent abdominopelvic CT for non-MSK indications have axSpA and to explore the role of an imaging strategy for identifying axSpA.Methods:Abdominopelvic CT scans of verified IBD patients were identified retrospectively from eight years of imaging archive. Patients between 18-55 yrs. were selected as having the highest diagnostic yield for axSpA. CT review (using criteria from a validated CT screening tool developed by Chan1) was undertaken by a trained radiology team for presence of CT-defined sacroiliitis (CTSI). All CTSI patients were sent a screening questionnaire. Those with self-reported chronic back pain (CBP), duration > 3 months, onset < 45 years were invited for rheumatology review. This included a medical interview, physical examination (joint count, MASES, dactylitis count, BASMI), patient reported outcomes (BASDAI, BASFI, BASGI, Harvey-Bradshaw-Index, Partial-Mayo-Index), relevant laboratory tests (CRP, ESR, HLA-B27), axSpA protocol MRI, and remote review by a panel of experienced rheumatologists with a special interest in axSpA.Results:CTSI was identified in 60 of 301 patients. Thirty-two (53%) responded to the invitation to participate and 27 (84%) were enrolled. Of these, eight had a pre-existing axSpA diagnosis and five did not report chronic back pain. Fourteen patients underwent rheumatological assessment; three of 14 (21.4% [95% CI: 4.7%, 50.8%]) had undiagnosed axSpA. In total, 11 of 27 (40.7% [95% CI: 22.4%, 61.2%]) patients had a rheumatologist verified diagnosis of axSpA.Conclusion:One in five patients (60/301) with IBD who underwent abdominopelvic CT for non-MSK indications have CTSI and at least one in five (11/60) have axSpA. Five percent (3/60) were previously undiagnosed. This highlights a hidden disease burden and a potential strategy for identifying new cases.References:[1]Chan J, Sari I, Salonen D, Inman RD, Haroon N. Development of a Screening Tool for the Identification of Sacroiliitis in Computed Tomography Scans of the Abdomen. J Rheumatol 2016; 43(9); 1687-94.Acknowledgements:We are indebted to Baljeet Dhillon and Shin Azegami for their assistance in the scoring of the CTSI.Disclosure of Interests:Chong Seng Edwin Lim Grant/research support from: AbbVie, Louise Hamilton: None declared, Samantha Low: None declared, Andoni Toms: None declared, Alex MacGregor: None declared, Karl Gaffney Speakers bureau: AbbVie, Eli Lilly, Novartis, UCB Pharma, Consultant of: AbbVie, Eli Lilly, Novartis, UCB Pharma, Grant/research support from: AbbVie, Gilead, Eli Lilly, Novartis, UCB Pharma.
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Low S, Tran J, McGurk C, Gupta A, Roberts HW, O'Brart D. Cat-12 Tool to reduce intraoperative complications for phacoemulsification and femtosecond laser assisted cataract surgery. Curr Eye Res 2021; 46:1071-1072. [PMID: 33259754 DOI: 10.1080/02713683.2020.1857777] [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: 10/22/2022]
Affiliation(s)
- Sancy Low
- Department of Ophthalmology, Guy's and St. Thomas' NHS Foundation Trust, King's College London, Strand, London, UK.,Department of Ophthalmology, St. Thomas' Hospital, London, UK
| | - John Tran
- Department of Ophthalmology, Guy's and St. Thomas' NHS Foundation Trust, King's College London, Strand, London, UK
| | - Catherine McGurk
- Department of Ophthalmology, Guy's and St. Thomas' NHS Foundation Trust, King's College London, Strand, London, UK
| | - Ayushi Gupta
- Department of Ophthalmology, Guy's and St. Thomas' NHS Foundation Trust, King's College London, Strand, London, UK
| | - Harry W Roberts
- Department of Ophthalmology, Guy's and St. Thomas' NHS Foundation Trust, King's College London, Strand, London, UK.,Department of Ophthalmology, St. Thomas' Hospital, London, UK.,Department of Ophthalmology, Southend University Hospital NHS Foundation Trust, Prittlewell Chase, Westcilff-on-Sea, United Kingdom
| | - David O'Brart
- Department of Ophthalmology, Guy's and St. Thomas' NHS Foundation Trust, King's College London, Strand, London, UK.,Department of Ophthalmology, St. Thomas' Hospital, London, UK
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Moh A, Seah N, Low S, Ang K, Sum CF, Subramaniam T, Kwan PY, Lee S, Tang WE, Lim SC. Zinc-α2-glycoprotein is associated with non-albuminuric chronic kidney disease progression in type 2 diabetes: a retrospective study with 4-year follow-up. Diabet Med 2020; 37:1919-1926. [PMID: 32353891 DOI: 10.1111/dme.14313] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/27/2020] [Indexed: 12/11/2022]
Abstract
AIM To investigate the association between baseline plasma zinc-α2-glycoprotein and non-albuminuric chronic kidney disease progression in type 2 diabetes. METHODS Adults with normoalbuminuria at entry (n=341; age 57±10 years, 52% men) were analysed. Chronic kidney disease progression was defined as a decrease in chronic kidney disease stage and a decline of ≥25% in estimated GFR from baseline. Baseline plasma zinc-α2-glycoprotein levels were quantified by immunoassay, and analysed either as a continuous variable or by tertiles in Cox proportional hazards models. Model discrimination was assessed using Harrell's C-index. A sensitivity analysis was performed on a subset of individuals who maintained normoalbuminuria during follow-up. RESULTS Chronic kidney disease progression occurred in 54 participants (16%). Zinc-α2-glycoprotein levels were elevated in chronic kidney disease progressors (P = 0.011), and more progressors were assigned to the higher zinc-α2-glycoprotein tertile than non-progressors. In the unadjusted Cox model, zinc-α2-glycoprotein, both as a continuous variable (hazard ratio 1.72, 95% CI 1.08-2.75) and tertile 3 (vs tertile 1; hazard ratio 2.14, 95% CI 1.10-4.17), predicted chronic kidney disease progression. The association persisted after multivariable adjustment. The C-index of the Cox model increased significantly after incorporation of zinc-α2-glycoprotein into a base model comprising renin-angiotensin system antagonist usage. Sensitivity analysis showed that zinc-α2-glycoprotein independently predicted chronic kidney disease progression among individuals who maintained normoalbuminuria during follow-up. CONCLUSIONS Plasma zinc-α2-glycoprotein is associated with chronic kidney disease progression, and may serve as a useful early biomarker for predicting non-albuminuric chronic kidney disease progression in type 2 diabetes.
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Affiliation(s)
- A Moh
- Clinical Research Unit, Khoo Teck Puat Hospital, Singapore
| | - N Seah
- Clinical Research Unit, Khoo Teck Puat Hospital, Singapore
| | - S Low
- Clinical Research Unit, Khoo Teck Puat Hospital, Singapore
- Diabetes Centre, Admiralty Medical Centre, Khoo Teck Puat Hospital, Singapore
| | - K Ang
- Clinical Research Unit, Khoo Teck Puat Hospital, Singapore
| | - C F Sum
- Diabetes Centre, Admiralty Medical Centre, Khoo Teck Puat Hospital, Singapore
| | - T Subramaniam
- Clinical Research Unit, Khoo Teck Puat Hospital, Singapore
- Diabetes Centre, Admiralty Medical Centre, Khoo Teck Puat Hospital, Singapore
| | - P Y Kwan
- National Healthcare Group Polyclinics, Singapore
| | - S Lee
- National Healthcare Group Polyclinics, Singapore
| | - W E Tang
- National Healthcare Group Polyclinics, Singapore
| | - S C Lim
- Clinical Research Unit, Khoo Teck Puat Hospital, Singapore
- Diabetes Centre, Admiralty Medical Centre, Khoo Teck Puat Hospital, Singapore
- Saw Swee Hock School of Public Health, National University Hospital, Singapore
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Low S, Oates A, Patel H, Mcguirk S, Johnson K. Re: clinical characteristics and radiological features of children infected with the 2019 novel coronavirus. Clin Radiol 2020; 75:870-871. [PMID: 32811668 PMCID: PMC7392173 DOI: 10.1016/j.crad.2020.07.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Accepted: 07/07/2020] [Indexed: 11/29/2022]
Affiliation(s)
- S Low
- Birmingham Children's Hospital, Birmingham, UK.
| | - A Oates
- Birmingham Children's Hospital, Birmingham, UK
| | - H Patel
- Birmingham Children's Hospital, Birmingham, UK
| | - S Mcguirk
- Birmingham Children's Hospital, Birmingham, UK
| | - K Johnson
- Birmingham Children's Hospital, Birmingham, UK
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Berger O, Mohamed-Noriega J, Low S, Daniel MC, Petchyim S, Papadopoulos M, Brookes J. From Conventional Angle Surgery to 360-Degree Trabeculotomy in Pediatric Glaucoma. Am J Ophthalmol 2020; 219:77-86. [PMID: 32569736 DOI: 10.1016/j.ajo.2020.06.017] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Revised: 06/09/2020] [Accepted: 06/10/2020] [Indexed: 11/24/2022]
Abstract
PURPOSE To describe the transition from conventional angle surgery (CAS), trabeculotomy with rigid probe or goniotomy, to 360-degree trabeculotomy assisted with microcatheter (MCT). DESIGN Retrospective comparative interventional case series. METHODS Review of consecutive children with glaucoma undergoing angle surgery, including cases with previous surgery, from January 2012 until March 2018 at Moorfields Eye Hospital. Main outcome measure was success rate, defined as intraocular pressure (IOP) ≤21 mm Hg with a minimum of 20% of IOP reduction and no further glaucoma surgery (complete success: without the need of glaucoma drops; qualified success: drops were needed to keep the IOP under control). RESULTS Among the 106 eyes (77 patients) included were 54 MCT and 52 CAS eyes. At last visit, after a single surgery, qualified success was 85% (46 eyes) in MCT and 37% (19 eyes) in CAS. Complete success was 69% (37 cases) in MCT and 23% (12 cases) in CAS. The mean (95% confidence interval) change in axial length after surgery was -0.03 mm (-0.34 to 0.40) for MCT and +1.35 mm (-0.64 to 1.62) for CAS (P < .001). The percentage of IOP reduction was 52.1% in MCT and 45.5% in CAS (P = .1616). Further glaucoma surgery was required in 5.5% (3) in MCT and 63.4% (33) in CAS. At 1 year, 94.3% of MCT cases achieved qualified success compared to 34.6% of CAS (P < .0001). No significant complications were found on either group. CONCLUSION MCT achieved better results with significantly lower reoperation rates. The transition from CAS to MCT can be easily achieved, even in difficult cases or those previously operated.
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Shah V, Naderi K, Maubon L, Jameel A, Patel DS, Gormley J, Heemraz S, Azan E, Verma S, Low S, O'Brart D. Acceptability of immediate sequential bilateral cataract surgery (ISBCS) in a public health care setting before and after COVID-19: a prospective patient questionnaire survey. BMJ Open Ophthalmol 2020; 5:e000554. [PMID: 34192150 PMCID: PMC7482101 DOI: 10.1136/bmjophth-2020-000554] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Revised: 08/14/2020] [Accepted: 08/28/2020] [Indexed: 01/19/2023] Open
Abstract
Objective To ascertain patient acceptance of immediate sequential bilateral cataract surgery (ISBCS) in the National Health Service (NHS). Methods A survey was devised using a 5-point Likert scale for questions related to ISBCS, which patients undertook during their cataract outpatient appointment pre-COVID-19 lockdown and by telephone during the lockdown. Results Questionnaires were completed for 267 patients. Most respondents were aged over 71 (51%) and were female individuals (60%). Forty-five per cent agreed/strongly agreed with opting for ISBCS. A positive correlation was identified between opting for ISBCS and convenience to the patient (r=0.76, p<0.01) and family/carer/partner (r=0.71, p<0.01) and wanting to limit numbers of hospital visits (r=0.57, p<0.01). Fifty per cent agreed/strongly agreed that they were worried about the risk of simultaneous bilateral ocular complications, with this correlating with being less likely to opt for ISBCS (r=-0.49, p<0.01) and being scared of ISBCS (r=0.67, p<0.01). During COVID-19 lockdown, patients were less likely to want to minimise the time taken off work (p<0.05) and less intolerant of a prolonged hospital visit (p<0.05). Only 23% of respondents agreed/strongly agreed that they had familiarity with ISBCS. Conclusions ISBCS was acceptable to 45% of our sampled population, suggesting limited routine implementation in the NHS is possible. Convenience and reduction in hospital visits appeared to contribute to this acceptance. Half of the patients expressed concern regarding bilateral complications and such concerns need addressing. Some attitudes did appear to change during the COVID-19 lockdown period. The familiarity of the concept of ISBCS is low suggesting the need for patient education.
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Affiliation(s)
- Vishal Shah
- Department of Ophthalmology, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Khayam Naderi
- Department of Ophthalmology, Guy's and St Thomas' NHS Foundation Trust, London, UK.,King's College London, London, UK
| | - Laura Maubon
- Department of Ophthalmology, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Ashmal Jameel
- Department of Ophthalmology, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Darshak S Patel
- Department of Ophthalmology, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Jack Gormley
- Department of Ophthalmology, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Sanjeev Heemraz
- Department of Ophthalmology, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Elodie Azan
- Department of Ophthalmology, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Seema Verma
- Department of Ophthalmology, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Sancy Low
- Department of Ophthalmology, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - David O'Brart
- Department of Ophthalmology, Guy's and St Thomas' NHS Foundation Trust, London, UK.,King's College London, London, UK
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Waseem NH, Low S, Shah AZ, Avisetti D, Ostergaard P, Simpson M, Niemiec KA, Martin-Martin B, Aldehlawi H, Usman S, Lee PS, Khawaja AP, Ruddle JB, Shah A, Sackey E, Day A, Jiang Y, Swinfield G, Viswanathan A, Alfano G, Chakarova C, Cordell HJ, Garway-Heath DF, Khaw PT, Bhattacharya SS, Waseem A, Foster PJ. Mutations in SPATA13/ASEF2 cause primary angle closure glaucoma. PLoS Genet 2020; 16:e1008721. [PMID: 32339198 PMCID: PMC7233598 DOI: 10.1371/journal.pgen.1008721] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Revised: 05/18/2020] [Accepted: 03/17/2020] [Indexed: 11/18/2022] Open
Abstract
Current estimates suggest 50% of glaucoma blindness worldwide is caused by primary angle-closure glaucoma (PACG) but the causative gene is not known. We used genetic linkage and whole genome sequencing to identify Spermatogenesis Associated Protein 13, SPATA13 (NM_001166271; NP_001159743, SPATA13 isoform I), also known as ASEF2 (Adenomatous polyposis coli-stimulated guanine nucleotide exchange factor 2), as the causal gene for PACG in a large seven-generation white British family showing variable expression and incomplete penetrance. The 9 bp deletion, c.1432_1440del; p.478_480del was present in all affected individuals with angle-closure disease. We show ubiquitous expression of this transcript in cell lines derived from human tissues and in iris, retina, retinal pigment and ciliary epithelia, cornea and lens. We also identified eight additional mutations in SPATA13 in a cohort of 189 unrelated PACS/PAC/PACG samples. This gene encodes a 1277 residue protein which localises to the nucleus with partial co-localisation with nuclear speckles. In cells undergoing mitosis SPATA13 isoform I becomes part of the kinetochore complex co-localising with two kinetochore markers, polo like kinase 1 (PLK-1) and centrosome-associated protein E (CENP-E). The 9 bp deletion reported in this study increases the RAC1-dependent guanine nucleotide exchange factors (GEF) activity. The increase in GEF activity was also observed in three other variants identified in this study. Taken together, our data suggest that SPATA13 is involved in the regulation of mitosis and the mutations dysregulate GEF activity affecting homeostasis in tissues where it is highly expressed, influencing PACG pathogenesis.
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Affiliation(s)
- Naushin H. Waseem
- NIHR Biomedical Research Centre at Moorfields Eye Hospital and UCL Institute of Ophthalmology, London, United Kingdom
| | - Sancy Low
- Moorfields Eye Hospital NHS Foundation Trust, City Road, London, United Kingdom
- UCL Institute of Ophthalmology, Bath Street, London, United Kingdom
- Department of Ophthalmology, St. Thomas’ Hospital, Westminster Bridge Road, London, United Kingdom
| | - Amna Z. Shah
- UCL Institute of Ophthalmology, Bath Street, London, United Kingdom
| | - Deepa Avisetti
- Centre for Oral Immunobiology and Regenerative Medicine, Institute of Dentistry, Queen Mary University of London, London, United Kingdom
| | - Pia Ostergaard
- Medical Genetics Unit, St. George’s University of London, Cranmer Terrace, London, United Kingdom
| | - Michael Simpson
- Genetics and Molecular Medicine, King’s College London, Great Maze Pond, London, United Kingdom
| | - Katarzyna A. Niemiec
- Centre for Oral Immunobiology and Regenerative Medicine, Institute of Dentistry, Queen Mary University of London, London, United Kingdom
| | - Belen Martin-Martin
- Blizard Advanced Light Microscopy, Blizard Institute, Queen Mary University of London, London, United Kingdom
| | - Hebah Aldehlawi
- Centre for Oral Immunobiology and Regenerative Medicine, Institute of Dentistry, Queen Mary University of London, London, United Kingdom
| | - Saima Usman
- Centre for Oral Immunobiology and Regenerative Medicine, Institute of Dentistry, Queen Mary University of London, London, United Kingdom
| | - Pak Sang Lee
- NIHR Biomedical Research Centre at Moorfields Eye Hospital and UCL Institute of Ophthalmology, London, United Kingdom
- Moorfields Eye Hospital NHS Foundation Trust, City Road, London, United Kingdom
- UCL Institute of Ophthalmology, Bath Street, London, United Kingdom
| | - Anthony P. Khawaja
- NIHR Biomedical Research Centre at Moorfields Eye Hospital and UCL Institute of Ophthalmology, London, United Kingdom
- Moorfields Eye Hospital NHS Foundation Trust, City Road, London, United Kingdom
- UCL Institute of Ophthalmology, Bath Street, London, United Kingdom
| | - Jonathan B. Ruddle
- Department of Ophthalmology, University of Melbourne, Victoria, Australia
| | - Ameet Shah
- Department of Ophthalmology, Royal Free Hospital NHS Foundation Trust, Pond Street, London, United Kingdom
| | - Ege Sackey
- Medical Genetics Unit, St. George’s University of London, Cranmer Terrace, London, United Kingdom
| | - Alexander Day
- Moorfields Eye Hospital NHS Foundation Trust, City Road, London, United Kingdom
| | - Yuzhen Jiang
- Moorfields Eye Hospital NHS Foundation Trust, City Road, London, United Kingdom
| | - Geoff Swinfield
- Society of Genealogists, Goswell Road, London, United Kingdom
| | - Ananth Viswanathan
- NIHR Biomedical Research Centre at Moorfields Eye Hospital and UCL Institute of Ophthalmology, London, United Kingdom
- Moorfields Eye Hospital NHS Foundation Trust, City Road, London, United Kingdom
- UCL Institute of Ophthalmology, Bath Street, London, United Kingdom
| | - Giovanna Alfano
- UCL Institute of Ophthalmology, Bath Street, London, United Kingdom
| | | | - Heather J. Cordell
- Institute of Genetic Medicine, Newcastle University, Newcastle Upon Tyne, United Kingdom
| | - David F. Garway-Heath
- NIHR Biomedical Research Centre at Moorfields Eye Hospital and UCL Institute of Ophthalmology, London, United Kingdom
- Moorfields Eye Hospital NHS Foundation Trust, City Road, London, United Kingdom
- UCL Institute of Ophthalmology, Bath Street, London, United Kingdom
| | - Peng T. Khaw
- NIHR Biomedical Research Centre at Moorfields Eye Hospital and UCL Institute of Ophthalmology, London, United Kingdom
- Moorfields Eye Hospital NHS Foundation Trust, City Road, London, United Kingdom
- UCL Institute of Ophthalmology, Bath Street, London, United Kingdom
| | - Shomi S. Bhattacharya
- NIHR Biomedical Research Centre at Moorfields Eye Hospital and UCL Institute of Ophthalmology, London, United Kingdom
- UCL Institute of Ophthalmology, Bath Street, London, United Kingdom
| | - Ahmad Waseem
- Centre for Oral Immunobiology and Regenerative Medicine, Institute of Dentistry, Queen Mary University of London, London, United Kingdom
| | - Paul J. Foster
- NIHR Biomedical Research Centre at Moorfields Eye Hospital and UCL Institute of Ophthalmology, London, United Kingdom
- Moorfields Eye Hospital NHS Foundation Trust, City Road, London, United Kingdom
- UCL Institute of Ophthalmology, Bath Street, London, United Kingdom
- * E-mail:
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Stewart R, Castellano T, Low S, Walker J. Patterns of Opioid Use in Gynecologic Oncology Surgical and Cancer Surveillance Patients. Gynecol Oncol 2020. [DOI: 10.1016/j.ygyno.2019.11.120] [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: 10/24/2022]
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Machado RR, Low S, Germak A. CCM PILOT STUDY OVERVIEW: GEOMETRICAL MEASUREMENT OF THE ROCKWELL DIAMOND INDENTER. Acta IMEKO (2012) 2020; 9:10.21014/acta_imeko.v9i5.979. [PMID: 34858795 PMCID: PMC8634202 DOI: 10.21014/acta_imeko.v9i5.979] [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] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
This paper describes an overview of the capability of the NMIs that participated on the CCM Pilot Study measurement systems, conducted by the CIPM/CCM/Working Group on Hardness, to characterize the Rockwell hardness diamond indenter geometry, by measuring the included cone angle, the straightness of the generatrix, the spherical tip radius, the deviation of the local radius and the tilt angle. Nine NMIs took part in this study: INMETRO (Brazil); INRiM (Italy); KRISS (South Korea); NIM/PR (China); NIMT (Thailand); NIST (USA); PTB (Germany); TUBITAK UME (Turkey); VNIIFTRI (Russia), where INMETRO (Brazil) served as pilot laboratory.
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Goh K, Low S, Mun K, Tan C, Shahrizaila N, Nishino I, Wong K. EP.21Bcl-2-associated athanogene-3 (BAG3) myopathy in an ethnic-Indian Malaysian patient. Neuromuscul Disord 2019. [DOI: 10.1016/j.nmd.2019.06.151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Low S, Mohamed R, Ting M, Webster AR, Garway-Heath DF. The treatment of refractory angle-closure glaucoma in a patient with X-linked juvenile retinoschisis. Ophthalmic Genet 2018; 39:625-627. [PMID: 30081704 DOI: 10.1080/13816810.2018.1490961] [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: 10/28/2022]
Abstract
X-Linked Retinoschisis (XLRS) is a common genetically determined form of macular degeneration affecting young males. XLRS is due to mutations in the RS1 gene located on chromosome Xp22 which codes for retinoschisin and is estimated to affect between 1:5000 to 1:20000 individuals worldwide. We report a case of refractory angle-closure glaucoma in a thirty-nine-year-old Caucasian man with atypical XLRS. The patient presented with a two-day history of left eye pain, acutely reduced vision and a nine-month history of hemicranial pain. Examination identified left intraocular pressure (IOP) of 52mmHg. Gonioscopy confirmed complete angle closure. Following failure of medical management and persistently raised left IOP (43-46mmHg), the patient underwent left phacoemulsification and intraocular lens insertion without complication. After surgery, his IOP reduced to 10-14mmHg on all follow up examinations without the need for glaucoma drops. His iridocorneal angle remained open and vision improved to 20/100. Our case demonstrates the additional role of lens surgery in the treatment of secondary angle-closure glaucoma in the presence of an inherited retinal dystrophy. All patients with inherited retinopathy presenting with a headache or eye pain should undergo gonioscopic examination to exclude angle-closure glaucoma.
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Affiliation(s)
- Sancy Low
- a Moorfields Eye Hospital NHS Foundation Trust , London , United Kingdom.,b UCL Institute of Ophthalmology , London , United Kingdom
| | - Ryian Mohamed
- c Department of Ophthalmology , Abergele Hospital , Abergele , Wales
| | - Michelle Ting
- a Moorfields Eye Hospital NHS Foundation Trust , London , United Kingdom
| | - Andrew R Webster
- a Moorfields Eye Hospital NHS Foundation Trust , London , United Kingdom.,b UCL Institute of Ophthalmology , London , United Kingdom
| | - David F Garway-Heath
- a Moorfields Eye Hospital NHS Foundation Trust , London , United Kingdom.,b UCL Institute of Ophthalmology , London , United Kingdom
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23
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Low S, Machado RR. Technique to reduce bending issues in Rockwell B scale hardness reference blocks: preliminary results. J Phys Conf Ser 2018; 1065:10.1088/1742-6596/1065/6/062006. [PMID: 31555340 PMCID: PMC6759927 DOI: 10.1088/1742-6596/1065/6/062006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
This paper describes a new design for HRBW scale reference blocks, that has the potential to greatly reduce the bending of brass blocks and thus improve short time stability of the block's apparent reference value. The experimental results given here are preliminary and only reflect short time period stability effects. The work was carried out in 2017 at the National Institute of Standards and Technology (NIST) in Gaithersburg, USA.
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Affiliation(s)
- S Low
- National Institute of Standards and Technology (NIST), Gaithersburg, MD, USA
| | - R R Machado
- Instituto Nacional de Metrologia, Qualidade e Tecnologia (INMETRO), Duque de Caxias, RJ, Brazil
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Abstract
This report describes investigations carried out to determine test cycle sensitivity coefficients for the Rockwell HRA hardness scale. Sensitivity coefficients were determined for the preliminary-force, total-force and recovery-force dwell times. The work was carried out in 2017 at the National Institute of Standards and Technology (NIST) in Gaithersburg, USA.
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Affiliation(s)
- S Low
- National Institute of Standards and Technology (NIST), Gaithersburg, MD, USA
| | - R R Machado
- Instituto Nacional de Metrologia, Qualidade e Tecnologia (INMETRO), Duque de Caxias, RJ, Brazil
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Abstract
Objective: With the evolution of patient medical records from paper to electronic media and the changes to the way data is sourced, used, and managed, there is an opportunity for health information management (HIM) to learn and facilitate the increasing expanse of available patient data. Methods: This paper discusses the emerging trends and lessons learnt in relation with the following four areas: 1) data and information governance, 2) terminology standards certification, 3) International Classification of Diseases, 11th edition (ICD-11), and 4) data analytics and HIM. Results: The governance of patient data and information increasingly requires the HIM profession to incorporate the roles of data scientists and data stewards into its portfolio to ensure data analytics and digital transformation is appropriately managed. Not only are terminology standards required to facilitate the structure and primary use of this data, developments in Canada in relation with the standards, role descriptions, framework and curricula in the form of certification provide one prime example of ensuring the quality of the secondary use of patient data. The impending introduction of ICD-11 brings with it the need for the HIM profession to manage the transition between ICD versions and country modifications incorporating changes to standards and tools, and the availability and type of patient data available for secondary use. Conclusions: In summary, the health information management profession now requires abilities in leadership, data, and informatics in addition to health information science and coding skills to facilitate the expanding secondary use of patient data.
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Abstract
Isabel is a Web-based, diagnostic decision support tool designed to provide a differential diagnosis of a patient's condition for interpretation by a qualified health-care professional. We investigated the accuracy of the Isabel system in ophthalmic primary care. A total of 100 case histories were prospectively collected from ophthalmic primary care clinic records. The patient demographics and clinical features of each case were then entered into the Isabel system, and the results generated by the decision support tool for each case were compared with the diagnosis reached by the ophthalmic team. Of the 100 cases in the dataset, there was no matching diagnosis in the first 2 pages of Isabel results in 40 cases. Of the 60 cases in which there was a matching diagnosis on the first 2 pages of results, 31 had a >50% match between the terms of the query and the Isabel diagnosis reminder system's database. It remains to be established whether this is high enough to be clinically useful in a practice setting. Inclusion of specific ophthalmic knowledge would probably improve the accuracy of the Isabel clinical diagnostic decision support system.
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Affiliation(s)
| | - Lola Solebo
- Royal Free Hospital, Hampstead
- Royal London Hospital, Whitechapel, London, UK
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Liu JJ, Lim SC, Yeoh LY, Su C, Tai BC, Low S, Fun S, Tavintharan S, Chia KS, Tai ES, Sum CF. Ethnic disparities in risk of cardiovascular disease, end-stage renal disease and all-cause mortality: a prospective study among Asian people with Type 2 diabetes. Diabet Med 2016; 33:332-9. [PMID: 26514089 DOI: 10.1111/dme.13020] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/27/2015] [Indexed: 11/29/2022]
Abstract
AIM To study prospectively the ethnic-specific risks of cardiovascular disease, end-stage renal disease and all-cause mortality in patients with Type 2 diabetes mellitus among native Asian subpopulations. METHODS A total of 2337 subjects with Type 2 diabetes (70% Chinese, 17% Malay and 13% Asian Indian) were followed for a median of 4.0 years. Time-to-event analysis was used to study the association of ethnicity with adverse outcomes. RESULTS Age- and gender-adjusted hazard ratios for cardiovascular disease in ethnic Malay and Asian Indian subjects were 2.01 (1.40-2.88; P<0.0001) and 1.60 (1.07-2.41; P=0.022) as compared with Chinese subjects. Adjustment for conventional cardiovascular disease risk factors, including HbA1c , blood pressure and lipid profile, slightly attenuated the hazards in Malay (1.82, 1.23-2.71; P=0.003) and Asian Indian subjects (1.47, 0.95-2.30; P=0.086); However, further adjustment for baseline renal function (estimated GFR) and albuminuria weakened the cardiovascular disease risks in Malay (1.48, 0.98-2.26; P=0.065) but strengthened that in Asian Indian subjects (1.81, 1.14-2.87; P=0.012). Competing-risk regression showed that the age- and gender-adjusted sub-distribution hazard ratio for end-stage renal disease was 1.87 (1.27-2.73; P=0.001) in Malay and 0.39 (0.18-0.83; P=0.015) in Asian Indian subjects. Notably, the difference in end-stage renal disease risk among the three ethnic groups was abolished after further adjustment for baseline estimated GFR and albuminuria. There was no significant difference in risk of all-cause mortality among the three ethnic groups. CONCLUSIONS Risks of cardiovascular and end-stage renal diseases in native Asian subjects with Type 2 diabetes vary substantially among different ethnic groups. Differences in prevalence of diabetic kidney disease may partially explain the ethnic disparities.
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Affiliation(s)
- J J Liu
- Clinical Research Unit, Khoo Teck Puat Hospital, Singapore
| | - S C Lim
- Diabetes Centre, Khoo Teck Puat Hospital, Singapore
- Department of Medicine, Khoo Teck Puat Hospital, Singapore
| | - L Y Yeoh
- Department of Medicine, Khoo Teck Puat Hospital, Singapore
| | - C Su
- Clinical Research Unit, Khoo Teck Puat Hospital, Singapore
| | - B C Tai
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - S Low
- Clinical Research Unit, Khoo Teck Puat Hospital, Singapore
| | - S Fun
- Diabetes Centre, Khoo Teck Puat Hospital, Singapore
| | - S Tavintharan
- Diabetes Centre, Khoo Teck Puat Hospital, Singapore
- Department of Medicine, Khoo Teck Puat Hospital, Singapore
| | - K S Chia
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - E S Tai
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - C F Sum
- Diabetes Centre, Khoo Teck Puat Hospital, Singapore
- Department of Medicine, Khoo Teck Puat Hospital, Singapore
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Low S, Tham RK, Irwan B, Wong TKM. The effectiveness of a community programme with nurse-led intervention in Singapore. Eur J Public Health 2015. [DOI: 10.1093/eurpub/ckv168.060] [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: 11/13/2022] Open
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Porteous A, Low S, Younis S, Bloom P. Lens extraction and intraocular lens implant to manage iridoschisis. Clin Exp Ophthalmol 2014; 43:82-3. [PMID: 24827832 DOI: 10.1111/ceo.12361] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2014] [Accepted: 04/23/2014] [Indexed: 11/29/2022]
Affiliation(s)
- Alastair Porteous
- Department of Ophthalmology, Imperial College Healthcare NHS Trust, London, UK
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Shah A, Low S, Garway-Heath DF, Foster PJ, Barton K. Iris concavity, corneal biomechanics, and their correlations with ocular biometry in a cohort of 10- to 12-year-old UK school boys: baseline data. Invest Ophthalmol Vis Sci 2014; 55:3303-10. [PMID: 24744208 DOI: 10.1167/iovs.13-13756] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
PURPOSE Pigment dispersion syndrome is associated with iris concavity. This study investigated the prevalence of iris concavity, defined as a measurement of ≤-0.1 mm, in a cohort of 10- to 12-year-old boys, and explored the relationship between iris curvature and anterior segment biometry. Associations with corneal biomechanical parameters also were explored. METHODS A cohort of school boys (n = 96) was recruited from a local school. Anterior segment optical coherence tomography (AS-OCT) was performed under accommodative and nonaccommodative conditions, and iris curvature quantified. Corneal hysteresis (CH) and corneal resistance factor (CRF) were measured with the ocular response analyzer (ORA). Noncontact axial biometry was performed using laser interferometry. RESULTS The prevalence of iris concavity was 24% on distance fixation, increasing to 65% on accommodation. Variables significantly associated with nonaccommodating iris curvature were lens vault (P = 0.02) and mean keratometry (P = 0.02). For both variables acting jointly, R(2) = 0.30. Variables associated significantly with accommodating iris curvature were anterior chamber depth (P = 0.009), lens vault (P = 0.049), and mean scleral spur angle (P < 0.0001). For these three variables acting jointly, R(2) = 0.33. Significant association was found between CH and spur-to-spur distance (R(2) = 0.07, P = 0.025). CONCLUSIONS Iris concavity was a common finding in this cohort and related to anterior segment biometric parameters. Further work is required to clarify whether anatomical differences exist between iris concavity seen in the adolescent eye and that found in adults with pigment dispersion syndrome.
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Affiliation(s)
- Ameet Shah
- National Institute for Health Research (NIHR) Biomedical Research Centre at Moorfields Eye Hospital National Health Service (NHS) Foundation Trust and University College London (UCL) Institute of Ophthalmology, London, United Kingdom
| | - Sancy Low
- National Institute for Health Research (NIHR) Biomedical Research Centre at Moorfields Eye Hospital National Health Service (NHS) Foundation Trust and University College London (UCL) Institute of Ophthalmology, London, United Kingdom
| | - David F Garway-Heath
- National Institute for Health Research (NIHR) Biomedical Research Centre at Moorfields Eye Hospital National Health Service (NHS) Foundation Trust and University College London (UCL) Institute of Ophthalmology, London, United Kingdom
| | - Paul J Foster
- National Institute for Health Research (NIHR) Biomedical Research Centre at Moorfields Eye Hospital National Health Service (NHS) Foundation Trust and University College London (UCL) Institute of Ophthalmology, London, United Kingdom
| | - Keith Barton
- National Institute for Health Research (NIHR) Biomedical Research Centre at Moorfields Eye Hospital National Health Service (NHS) Foundation Trust and University College London (UCL) Institute of Ophthalmology, London, United Kingdom Department of Epidemiology and Genetics, Institute of Ophthalmology, London, United Kingdom
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Yuliaty, Low S, Fisher J, Dryden GM. Energy requirements for maintenance and growth of entire male Bali cattle in East Timor. Anim Prod Sci 2014. [DOI: 10.1071/an13092] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
The metabolisable energy (ME) requirements for maintenance and growth of entire male Bali cattle (Bos javanicus) were determined by regressing liveweight change on ME intake. Cattle were fed either a diet (DM basis) of 52.5% urea-treated rice straw plus 47.5% fresh leucaena forage (Expt 1), or fresh leucaena forage alone (Expt 2). In each experiment, liveweight change and feed intake were measured over 4 weeks, after a 1-week introductory period, and feed constituent digestibilities were measured during the final week. In Expt 1, 10 bulls between 1.5 and 3 years of age and weighing 123.7 ± 11.79 kg (mean ± s.d.) were allocated to DM intakes estimated to provide 0.75, 1.0, 1.25, 1.5, 1.75, or 2.0 times the estimated ME requirement for maintenance (based on calculations made from published CSIRO equations for tropical cattle species other than B. javanicus), with either one or two bulls per treatment. In Expt 2, the bulls were given treatments estimated to provide 0.85, 1.0, 1.4, 1.8, or 2.2 times the ME requirement for maintenance, with two bulls allocated to each treatment. The measured ME requirements for maintenance were 0.42 ± 0.369 and 0.40 ± 0.153 MJ/kg LW0.75.day (coefficient ± standard error, Expts 1 and 2, respectively). The ME requirement for ‘production’ (i.e. positive liveweight change of male Bali cattle under the specific conditions of the experiment) was calculated to be 39.2 MJ/kg liveweight gain in Expt 2. The calculated efficiency of use of dietary ME for production in Expt 2, was 0.34
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Day AC, Luben R, Khawaja AP, Low S, Hayat S, Dalzell N, Wareham NJ, Khaw KT, Foster PJ. Genotype-phenotype analysis of SNPs associated with primary angle closure glaucoma (rs1015213, rs3753841 and rs11024102) and ocular biometry in the EPIC-Norfolk Eye Study. Br J Ophthalmol 2013; 97:704-7. [PMID: 23505305 DOI: 10.1136/bjophthalmol-2012-302969] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
AIMS To investigate if the single nucleotide polymorphisms rs3753841, rs1015213 and rs11024102, recently implicated in the development of acute primary angle closure or primary angle closure glaucoma, are associated with ocular biometric characteristics of British adults in the European Prospective Investigation of Cancer-Norfolk eye study. METHODS Genotyping data on rs1015213 (between PCMTD1 and ST18), rs11024102 (at PLEKHA7) and rs3753841 (at COL11A1) were available on 3268 participants. Direct genotypic data was available for rs1015213 and rs3753841. Data was imputed for rs11024102. Ocular biometric data was available on 1137 participants who attended the third European Prospective Investigation of Cancer health examination and 988 (87%) of these participants had no previous cataract surgery either eye. Axial length (AL), anterior chamber depth (ACD) and corneal keratometry were measured by using the Zeiss IOLMaster. RESULTS Presence of at least one A allele (AG or AA genotype) for rs1015213 was associated with a shallower ACD (-0.07 mm, 95% CI -0.01 to -0.14 mm, p=0.028) after adjusting for age and sex (both p≤0.001). There was no association with AL or corneal keratometry for rs1015213 genotypes. AL, ACD and keratometry were not associated with rs3753841 or rs11024102 genotypes including after adjusting for age and sex. CONCLUSIONS This study suggests that primary angle closure glaucoma susceptibility at the PCMTD1-ST18 locus may be partly explained by an association between rs1015213 and ACD in European populations. This effect is equivalent to almost 20% of the SD of the mean ACD of phakic individuals in this cohort. We were not able to identify any association between rs3753841 or rs11024102 and ocular biometry.
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Affiliation(s)
- Alexander C Day
- The NIHR Biomedical Research Centre at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, UK
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Hrkach J, Von Hoff D, Ali MM, Andrianova E, Auer J, Campbell T, De Witt D, Figa M, Figueiredo M, Horhota A, Low S, McDonnell K, Peeke E, Retnarajan B, Sabnis A, Schnipper E, Song JJ, Song YH, Summa J, Tompsett D, Troiano G, Van Geen Hoven T, Wright J, LoRusso P, Kantoff PW, Bander NH, Sweeney C, Farokhzad OC, Langer R, Zale S. Preclinical Development and Clinical Translation of a PSMA-Targeted Docetaxel Nanoparticle with a Differentiated Pharmacological Profile. Sci Transl Med 2012; 4:128ra39. [DOI: 10.1126/scitranslmed.3003651] [Citation(s) in RCA: 872] [Impact Index Per Article: 72.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Maubaret C, Kosmaoglou M, Low S, Chakarova CF, Bidot S, Thauvin-Robinet C, Robson AG, Waseem N, Cheetham ME, Bhattacharya SS. Functional characterization of a novel c.614-622del rhodopsin mutation in a French pedigree with retinitis pigmentosa. Mol Vis 2012; 18:581-7. [PMID: 22419850 PMCID: PMC3298422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2011] [Accepted: 02/28/2012] [Indexed: 10/28/2022] Open
Abstract
PURPOSE To identify and functionally characterize the mutation responsible for autosomal dominant retinitis pigmentosa (adRP) in a large, six-generation French family. METHODS Twenty individuals from this family participated in the genetic investigation. Six affected and 14 unaffected individuals from three-generations were available for linkage analysis using microsatellite markers flanking the rhodopsin (RHO) gene. A two-point logarithm of odds (LOD) score calculation was undertaken using GENEMARKER and MLINK software. Sanger sequencing of RHO was performed. Cellular localization of the mutant protein was performed by transforming SK-N-SH cells with pEGFP-N1-Rho, pEGFP-N1-Rho(P23H), and pEGFP-N1-Rho(c.614-622del). RESULTS The proband had nyctalopia, visual field constriction, peripheral bone spicule pigmentation of the fundus, central acuity (6/24 RE; 6/12 LE) at 55 years of age. Linkage analysis of this family suggested RHO as a possible candidate since the flanking marker D3S1292 yielded a LOD score of 2.43 at θ=0. Cloning of an exon 3 PCR product and direct sequencing of single clones identified a novel deletion in the third exon of RHO, c.614-622del (p.Y206-F208del). The deleted mutant protein localized to the endoplasmic reticulum and formed inclusion bodies. CONCLUSIONS This novel deletion in exon 3 of the RHO gene, c.614-622del results in a classical form of adRP in a multi-generation French family. Protein expression analyses confirmed that the deletion led to protein misfolding and suggest this is a class II mutation, similar to P23H, the most common class II mutation seen in North America.
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Affiliation(s)
| | | | - Sancy Low
- UCL Institute of Ophthalmology, London, United Kingdom,Moorfields Eye Hospital, London, United Kingdom
| | | | | | | | - Anthony G. Robson
- UCL Institute of Ophthalmology, London, United Kingdom,Moorfields Eye Hospital, London, United Kingdom
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Grover S, Bell G, Edwards C, Huang S, Leong D, Joerg L, Madsen P, Bridgman C, Low S, Chakrabathy A, Figtree G, Selvanayagam J. Correlation of CMR and Biochemical Markers of Myocardial Injury in a Multi-centre Study: PROTECTION AMI CMR Substudy. Heart Lung Circ 2012. [DOI: 10.1016/j.hlc.2012.05.092] [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: 10/28/2022]
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Low S, Davidson AE, Holder GE, Hogg CR, Bhattacharya SS, Black GC, Foster PJ, Webster AR. Autosomal dominant Best disease with an unusual electrooculographic light rise and risk of angle-closure glaucoma: a clinical and molecular genetic study. Mol Vis 2011; 17:2272-82. [PMID: 21921978 PMCID: PMC3171497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2010] [Accepted: 08/18/2011] [Indexed: 11/16/2022] Open
Abstract
PURPOSE To describe the clinical and molecular characteristics of two families with autosomal dominant Best disease and atypical electrooculography (EOG). METHODS Four affected individuals from two families were ascertained. Detailed ophthalmic examinations, refraction, and biometry (anterior chamber depth [ACD] and axial length [AL]), gonioscopy, optical coherence tomography of the anterior segment and retina, retinal imaging, and electrophysiological assessment were performed. Arden ratios from EOG testing were calculated by direct measurement of the light peak to dark trough amplitudes. Mutations in bestrophin 1 (BEST1) were identified by bidirectional Sanger sequencing. In family 1, segregation of BEST1 alleles was performed by assaying four microsatellite markers (D11S935, D11S4102, D11S987, and D11S4162) that flank BEST1. RESULTS The proband from family 1 (three of four siblings affected with Best disease) was 42 years old with bilateral macular vitelliform lesions, advanced angle closure glaucoma (ACG), a normal electroretinogram, and no EOG light rise. Her 44-year-old brother had similar fundus appearances and an EOG light rise of 170%. Their 48-year-old sister had a normal left fundus, whereas the right fundus showed a vitelliform lesion and subretinal thickening. There was no EOG light rise detectable from either eye. Mutation analysis of BEST1 showed all affected siblings to be heterozygous for a missense mutation, c.914T>C, p.Phe305Ser. Their unaffected sister had an EOG light rise of 200%, a normal fundus appearance, and did not harbor the BEST1 mutation. Haplotype analysis of family 1 showed that the affected brother with the 170% EOG light rise had inherited the same nondiseased parental BEST1 allele as his unaffected sister. The other two affected sisters with undetectable EOG light rises shared a different nondiseased parental BEST1 allele. An unrelated 53-year-old female carrying the same c.914T>C, p.Phe305Ser mutation showed typical features of Best disease and an EOG light rise of 180%. All four siblings from family 1 had shorter axial biometry (ACD range 2.06-2.74 mm; AL range 20.46-22.60 mm) than the normal population, contributing to their risk of ACG development. Proband 2 had deeper ACDs (2.83 mm OD and 2.85 mm OS), but similar ALs (21.52 mm OD and 21.42 mm OS) compared to family 1. She had no gonioscopic evidence of angle closure. CONCLUSIONS A near normal EOG light rise is uncommon in molecularly confirmed Best disease, and in the present report is associated with the same mutation in two families, suggesting a specific role for this amino acid in the retinal pigment epithelium dysfunction associated with this disorder. Haplotype analysis in family 1 was consistent with an effect of the nondisease allele in mediating the presence of an EOG light rise. Clinical assessment of ACG risk is recommended for BEST1 mutation carriers and their first degree relatives.
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Affiliation(s)
- Sancy Low
- NIHR Biomedical Research Centre for Ophthalmology, Moorfields Eye Hospital and UCL Institute of Ophthalmology, London, UK
| | - Alice E. Davidson
- NIHR Biomedical Research Centre for Ophthalmology, Moorfields Eye Hospital and UCL Institute of Ophthalmology, London, UK,Genetic Medicine, The University of Manchester, Manchester Academic Health Science Centre, Central Manchester University Hospitals NHS Foundation Trust, Manchester, UK
| | - Graham E. Holder
- NIHR Biomedical Research Centre for Ophthalmology, Moorfields Eye Hospital and UCL Institute of Ophthalmology, London, UK
| | - Chris R. Hogg
- NIHR Biomedical Research Centre for Ophthalmology, Moorfields Eye Hospital and UCL Institute of Ophthalmology, London, UK
| | - Shomi S. Bhattacharya
- NIHR Biomedical Research Centre for Ophthalmology, Moorfields Eye Hospital and UCL Institute of Ophthalmology, London, UK
| | - Graeme C. Black
- Genetic Medicine, The University of Manchester, Manchester Academic Health Science Centre, Central Manchester University Hospitals NHS Foundation Trust, Manchester, UK
| | - Paul J. Foster
- NIHR Biomedical Research Centre for Ophthalmology, Moorfields Eye Hospital and UCL Institute of Ophthalmology, London, UK
| | - Andrew R. Webster
- NIHR Biomedical Research Centre for Ophthalmology, Moorfields Eye Hospital and UCL Institute of Ophthalmology, London, UK
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Davidson AE, Sergouniotis PI, Burgess-Mullan R, Hart-Holden N, Low S, Foster PJ, Manson FD, Black GC, Webster AR. A synonymous codon variant in two patients with autosomal recessive bestrophinopathy alters in vitro splicing of BEST1. Mol Vis 2010; 16:2916-22. [PMID: 21203346 PMCID: PMC3013070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2010] [Accepted: 12/25/2010] [Indexed: 11/05/2022] Open
Abstract
PURPOSE Autosomal recessive bestrophinopathy (ARB) is a newly defined retinal dystrophy caused by biallelic mutations in bestrophin-1 (BEST1) and is hypothesized to represent the null bestrophin-1 phenotype in humans. The aim was to determine whether a synonymous BEST1 variant, c.102C>T, identified in two unrelated ARB patients, alters pre-mRNA splicing of the gene. Additionally a detailed phenotypic characterization of this distinctive condition is presented for both patients. METHODS BEST1 was analyzed by direct sequencing. Patients underwent standard ophthalmic assessment. In silico and in vitro analysis using a minigene system was performed to assess whether a synonymous variant identified, c.102C>T p.Gly34Gly, alters pre-mRNA splicing of BEST1. RESULTS Both ARB patients harbored either proven (patient 1; c.102C>T p.Gly34Gly and c.572T>C p.Leu191Pro) or presumed (patient 2; c.102C>T p.Gly34Gly and c.1470_1471delCA, p.His490GlnfsX24) biallelic mutations in BEST1 and were found to have phenotypes consistent with ARB. In vitro analysis of the synonymous variant, c.102C>T p.Gly34Gly, demonstrated it to introduce a cryptic splice donor site 52 nucleotides upstream of the actual splice donor site. CONCLUSIONS The novel BEST1 variant identified, c.102C>T p.Gly34Gly, alters pre-mRNA splicing in vitro and is potentially pathogenic. In vivo this splicing variant is predicted to lead to the production of an mRNA transcript with a premature termination codon (p.Glu35TrpfsX11) that is predicted to be degraded by NMD.
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Affiliation(s)
- Alice E. Davidson
- School of Biomedicine, The University of Manchester, Manchester Academic Health Science Centre, Central Manchester University Hospitals NHS Foundation Trust, Manchester, UK,Institute of Ophthalmology, University College London, London, UK
| | | | - Rosemary Burgess-Mullan
- School of Biomedicine, The University of Manchester, Manchester Academic Health Science Centre, Central Manchester University Hospitals NHS Foundation Trust, Manchester, UK
| | - Nichola Hart-Holden
- School of Biomedicine, The University of Manchester, Manchester Academic Health Science Centre, Central Manchester University Hospitals NHS Foundation Trust, Manchester, UK
| | - Sancy Low
- Moorfields Eye Hospital, London, UK,Institute of Ophthalmology, University College London, London, UK
| | - Paul J. Foster
- Moorfields Eye Hospital, London, UK,Institute of Ophthalmology, University College London, London, UK
| | - Forbes D.C. Manson
- School of Biomedicine, The University of Manchester, Manchester Academic Health Science Centre, Central Manchester University Hospitals NHS Foundation Trust, Manchester, UK
| | - Graeme C.M. Black
- School of Biomedicine, The University of Manchester, Manchester Academic Health Science Centre, Central Manchester University Hospitals NHS Foundation Trust, Manchester, UK
| | - Andrew R. Webster
- Moorfields Eye Hospital, London, UK,Institute of Ophthalmology, University College London, London, UK
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Abstract
INTRODUCTION OR BACKGROUND A large number of drug classes have now been reported to provoke angle closure in high-risk individuals. The mechanism of action can be generalized into three main categories: sympathomimetic, parasympatholytic and idiosyndratic reactions. SOURCES OF DATA This review of the ophthalmic literature provides a clinical summary of primary angle-closure glaucoma (PACG) and its management. AREAS OF AGREEMENT External stimuli (pharmacological and environmental) may induce acute, and more often, asymptomatic angle closure, which carries a significant risk of glaucoma. GROWING POINTS Whenever in doubt, patients at risk of PACG who are starting on drug therapy known to provoke angle closure or aggravate the condition should be referred for detailed gonioscopic examination of the anterior chamber by an ophthalmologist. AREAS FOR DEVELOPING RESEARCH: The use of new imaging methods such as anterior segment optical coherence tomography to assess the presence or risk of angle closure is gaining popularity, and may offer a more rapid method of identifying people who are at risk of sight loss from angle-closure glaucoma precipitated by non-ophthalmological medication.
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Low S, Ang LW, Cutter J, James L, Chee CBE, Wang YT, Chew SK. Mortality among tuberculosis patients on treatment in Singapore. Int J Tuberc Lung Dis 2009; 13:328-334. [PMID: 19275792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023] Open
Abstract
OBJECTIVE To identify the risk factors associated with mortality among tuberculosis (TB) patients on treatment in Singapore. DESIGN A retrospective cohort study of 7433 TB patients notified and started on TB treatment from 2000 to 2006 was conducted. Cox regression analysis was used to determine independent risk factors for mortality. RESULTS Of 7433 patients who started TB treatment between 2000 and 2006, there were 884 deaths (11.9%) from any cause. Older age, male sex, being in a long-term care facility, having comorbidity, absence of cough, more than one site of TB, bacteriologically confirmed laboratory results, resistance to at least isoniazid (INH) and rifampicin (RMP) and absence of cavity were strongly associated with all-cause mortality among TB patients. A total of 203 patients (2.7%) died of TB. Risk factors for death due to TB were older age, male sex, Malay ethnicity, being in a long-term care facility, absence of cough, more than one site of TB, bacteriologically confirmed laboratory results and resistance to at least INH and RMP or to at least INH but not RMP. CONCLUSION It is important to identify TB patients with risk factors related to mortality so that appropriate and timely interventions can be instituted to prevent deaths among TB patients.
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Affiliation(s)
- S Low
- Health Services Research and Evaluation Division, Ministry of Health, Singapore.
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Chang L, Aung T, Low S, Wong TY, Khaw PT, Foster PJ. Is measurement of adult height useful in screening for primary angle closure? Eye (Lond) 2009; 23:1775-80. [PMID: 19136925 DOI: 10.1038/eye.2008.375] [Citation(s) in RCA: 9] [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: 11/09/2022] Open
Abstract
BACKGROUND Adult height is independently related to ocular dimensions and shorter people have shorter globes and shallower anterior chambers. We investigated the relationship between adult height and angle dimensions to explore measuring height as a possible screening test for angle closure. METHODS A population-based, cross-sectional survey of adult Chinese living in the Tanjong Pagar district, Singapore was conducted. Anterior chamber depth, gonioscopic angle width and height were assessed using standardized protocols. RESULTS Data were available for 996 persons. Shorter people had shallower anterior chamber depth (2.35 mm for persons <144 cm vs 2.72 mm for persons >170 cm, P=0.008) and smaller gonioscopic angles (22 degrees for <144 cm vs 30 degrees for >170 cm, P=0.079). After controlling for age and gender, adult height was significantly related to anterior chamber depth (P=0.008) but not significantly related to gonioscopic angle width (P=0.079). Female sex and age > or = 50 years used together correctly identified 45/66 (68.2%) individuals with an occludable angle (sensitivity 68.2%, specificity 61.3%). Fewer people, 41/66 (62.1%), were correctly identified when height <160 cm was added to female sex and age 50 > or = years (sensitivity was 62.1% and specificity was 64.7%). CONCLUSIONS Shorter adult height is significantly associated with a shallower anterior chamber depth, but the addition of height contributed little to demographics (age and gender) as the preliminary screening criteria to identify individuals at risk of an occludable angle.
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Affiliation(s)
- L Chang
- Department of Glaucoma, Moorfields Eye Hospital, London, UK.
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Low S, Chan FLF, Cutter J, Ma S, Goh KT, Chew SK. A national study of the epidemiology of pneumococcal disease among hospitalised patients in Singapore: 1995 to 2004. Singapore Med J 2007; 48:824-9. [PMID: 17728963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
INTRODUCTION Infections with Streptococcus pneumoniae cause significant morbidity and mortality. In this study, we describe the epidemiology of pneumococcal disease based on hospitalisation rates for all age groups in Singapore. This is important for evaluating prevention and control strategies of pneumococcal disease. METHODS We conducted a retrospective study of hospitalisation cases admitted to all public and private hospitals from 1995 to 2004. 4,275 hospitalisation records were extracted, based on the International Classification of Diseases, Ninth Revision (ICD-9) codes for pneumococcal disease. We analysed the demographics, type of pneumococcal disease, length of stay and case fatality of these cases. RESULTS Our study showed that the mean annual hospitalisation rate for pneumococcal disease was 10.9 per 100,000 population from 1995 to 2004. The mean annual hospitalisation rate was highest in the young and the elderly. CONCLUSION Baseline information on the epidemiology of pneumococcal disease is important for the formulation and evaluation of a national prevention and control programme.
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Affiliation(s)
- S Low
- Communicable Diseases Division, Ministry of Health, College of Medicine Building, Singapore.
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Hamada S, Low S, Walters BC, Nischal KK. Five-year experience of the 2-incision push-pull technique for anterior and posterior capsulorrhexis in pediatric cataract surgery. Ophthalmology 2006; 113:1309-14. [PMID: 16877070 DOI: 10.1016/j.ophtha.2006.03.057] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2005] [Revised: 03/28/2006] [Accepted: 03/30/2006] [Indexed: 11/17/2022] Open
Abstract
PURPOSE To describe the authors' 5-year experience of the 2-incision push-pull (TIPP) technique for pediatric anterior and posterior capsulorrhexis formation. DESIGN Retrospective descriptive study over a 5-year period. PARTICIPANTS A total of 84 eyes of 63 patients who had undergone cataract surgery in 1 center. METHODS Retrospective review of all consecutive patients who underwent pediatric cataract extraction with planned intraocular lens implantation and TIPP rhexis between January, 1999, and August, 2004. Any lost capsulorrhexis, or capsular tears at any stage of the operation, and the relation of optic size to anterior capsulorrhexis size were noted. MAIN OUTCOME MEASURES Complications during TIPP rhexis formation and any late complications at last visit. RESULTS The mean age at operation was 70.21 months (range, 4 weeks-18 years). All eyes had anterior TIPP rhexis; 41 eyes also had posterior TIPP rhexis, and there were no anterior or posterior capsulorrhexis loss or tears while performing the technique. In no patient in whom TIPP rhexis was performed for the posterior capsule was there an inadvertent vitreous loss during rhexis formation. All eyes had anterior rhexis diameters that were smaller than the optic diameter (5.5-6.0 mm), approximately 4 to 4.5 mm in diameter. Four capsular tears were reported; 1 tear occurred during irrigation and aspiration and the others during rigid lens insertion. No late complications were noted. CONCLUSIONS Our 5-year experience with the TIPP rhexis in pediatric cataract surgery has shown this to be a reliable method for producing a consistent-size capsulorrhexis opening in both anterior and posterior capsulorrhexis.
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Affiliation(s)
- Samer Hamada
- Great Ormond Street Hospital for Children, London, United Kingdom
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Robertson M, Scott P, Ellwood DA, Low S. Endocervical polyp in pregnancy: gray scale and color Doppler images and essential considerations in pregnancy. Ultrasound Obstet Gynecol 2005; 26:583-4. [PMID: 16180257 DOI: 10.1002/uog.1992] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Affiliation(s)
- M Robertson
- Fetal Medicine Unit, Women and Children's Health Services, The Canberra Hospital, and Department of Obstetrics and Gynaecology, Canberra Clinical School, Australian National University Medical School, Australia.
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Pauly T, Ding YH, Kamath A, Loh C, Low S, Mroczkowski B, Zhu J, Ermolieff J, Castro A, Rejto P. Structure of guinea pig 11β steroid dehydrogenase 1 with glycyrrhetinic acid. Acta Crystallogr A 2005. [DOI: 10.1107/s0108767305089488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Alroy J, Marshall CR, Bambach RK, Bezusko K, Foote M, Fursich FT, Hansen TA, Holland SM, Ivany LC, Jablonski D, Jacobs DK, Jones DC, Kosnik MA, Lidgard S, Low S, Miller AI, Novack-Gottshall PM, Olszewski TD, Patzkowsky ME, Raup DM, Roy K, Sepkoski JJ, Sommers MG, Wagner PJ, Webber A. Effects of sampling standardization on estimates of Phanerozoic marine diversification. Proc Natl Acad Sci U S A 2001; 98:6261-6. [PMID: 11353852 PMCID: PMC33456 DOI: 10.1073/pnas.111144698] [Citation(s) in RCA: 368] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Global diversity curves reflect more than just the number of taxa that have existed through time: they also mirror variation in the nature of the fossil record and the way the record is reported. These sampling effects are best quantified by assembling and analyzing large numbers of locality-specific biotic inventories. Here, we introduce a new database of this kind for the Phanerozoic fossil record of marine invertebrates. We apply four substantially distinct analytical methods that estimate taxonomic diversity by quantifying and correcting for variation through time in the number and nature of inventories. Variation introduced by the use of two dramatically different counting protocols also is explored. We present sampling-standardized diversity estimates for two long intervals that sum to 300 Myr (Middle Ordovician-Carboniferous; Late Jurassic-Paleogene). Our new curves differ considerably from traditional, synoptic curves. For example, some of them imply unexpectedly low late Cretaceous and early Tertiary diversity levels. However, such factors as the current emphasis in the database on North America and Europe still obscure our view of the global history of marine biodiversity. These limitations will be addressed as the database and methods are refined.
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Affiliation(s)
- J Alroy
- National Center for Ecological Analysis and Synthesis, University of California, Santa Barbara, CA 93101-3351, USA.
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Yu L, Jiang Y, Low S, Wang Z, Nam SJ, Liu W, Kwangac J. Characterization of three infectious bronchitis virus isolates from China associated with proventriculus in vaccinated chickens. Avian Dis 2001; 45:416-24. [PMID: 11417821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/20/2023]
Abstract
Outbreaks of an avian disease in infectious bronchitis-vaccinated chickens in China have led to the characterization of coronaviral isolates Q1, J2, and T3, which were isolated from proventricular tissues of the affected young layer flocks. Serologic analysis revealed that they could induce high titers of infectious bronchitis virus (IBV) antibodies in inoculated specific-pathogen-free (SPF) chickens in indirect enzyme-linked immunosorbent assay but were not neutralized by antisera specific to the IBV serotype M41 and the Australian T strain. In a pathogenicity experiment, the clinical signs and related gross lesions resembling those of field outbreaks were reproduced in SPF chickens, and viruses were reisolated from the damaged tissues, including trachea, proventriculus, duodenum, and cecal tonsil. Sequence data demonstrated the complete S1 amino acid sequences of these isolates were almost identical despite recovery from geographically different areas in China and had 47.3%-82.3% similarity in comparison with the 47 published S1 sequences. On the basis of genotyping and limited serology, the three isolates, which were responsible for field outbreaks of the disease, might be a new IBV variant.
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Affiliation(s)
- L Yu
- Animal Health Biotechnology Laboratory, Institute of Molecular Agrobiology, National University of Singapore, Singapore
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Yap LF, Low S, Liu W, Loh H, Teo TP, Kwang J. Detection and screening of Salmonella enteritidis-infected chickens with recombinant flagellin. Avian Dis 2001; 45:410-5. [PMID: 11417820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/20/2023]
Abstract
Screening and identification of Salmonella enteritidis in commercial poultry flocks have assumed principal roles in preventing transmission of this pathogen to humans from hen eggs. Serologic diagnosis of S. enteritidis infection in commercial flocks currently relies on laboratory-based tests for detection of antibodies to the lipopolysaccharide, whole flagella, and bacteria. We amplified a sequence from the g,m flagellin of S. enteritidis, followed by cloning, expression, and purification of the protein. The recombinant protein was first characterized by western blot and subsequently evaluated as enzyme-linked immunosorbent assay (ELISA) antigen for detection of S. enteritidis infection. A total number of 49 positive sera and 40 negative sera were tested for ELISA validation. A cutoff value of 0.14 was shown to be sufficient to discriminate the negative and positive sera. Results obtained by testing sera raised against different bacterial strains/serotypes further confirmed that this recombinant flagellin-based ELISA was indeed specific for the detection of S. enteritidis. Both sensitivity and specificity of the developed ELISA test were comparable with a commercially available test, indicating that it is a highly promising and reliable diagnostic tool for S. enteritidis infection.
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Affiliation(s)
- L F Yap
- Animal Health Biotechnology, Institute of Molecular Agrobiology, National University of Singapore, Singapore
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