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Carranco S, Bohac S, Casey S, Sangi-Haghpeykar H, Conrad S. A survey of contraceptive method use among patients with delayed permanent contraception due to the COVID-19 pandemic. Contraception 2024; 132:110369. [PMID: 38224828 DOI: 10.1016/j.contraception.2024.110369] [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: 11/19/2023] [Revised: 01/08/2024] [Accepted: 01/09/2024] [Indexed: 01/17/2024]
Abstract
OBJECTIVES Evaluate contraception usage in patients awaiting permanent contraception during COVID-19 pandemic. STUDY DESIGN Patients awaiting permanent contraception between March 2020 and July 2022 completed a survey assessing contraceptive usage. Descriptive statistics were analyzed. RESULTS One hundred and twenty-three patients consented to the survey. Ninety seven percent identified as Black, Indigenous, and people of color. Eighty three percent used alternative forms of contraception, with 31% using long acting, reversible contraceptives. Eighty nine percent still desired surgery. CONCLUSIONS Despite delays, most patients still desired surgery. Patients alternatively chose intrauterine devices and implants. IMPLICATIONS Hospitals should prioritize permanent contraception to avoid delays in access to desired reproductive healthcare options.
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Affiliation(s)
- Sara Carranco
- Baylor College of Medicine, Department of Obstetrics and Gynecology, Houston, TX, USA.
| | - Sarah Bohac
- Baylor College of Medicine, Department of Obstetrics and Gynecology, Houston, TX, USA
| | - Sarah Casey
- Baylor College of Medicine, Department of Obstetrics and Gynecology, Houston, TX, USA
| | | | - Sarah Conrad
- Baylor College of Medicine, Department of Obstetrics and Gynecology, Houston, TX, USA
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Sunkara S, Jackson J, Casey S, Erfani H, Thigpen B, Zhang C, Guan X. Postoperative Incisional Complications in Gynaecologic Single-Incision Laparoscopic Surgery: Comparing Closure Techniques. J Obstet Gynaecol Can 2024; 46:102416. [PMID: 38401880 DOI: 10.1016/j.jogc.2024.102416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Revised: 02/04/2024] [Accepted: 02/07/2024] [Indexed: 02/26/2024]
Abstract
OBJECTIVES Single-incision laparoscopic surgery (SILS) and robotic SILS (rSILS) have been found to be safe, minimally invasive techniques in gynaecology. However, one major perceived drawback of these techniques is the increased risk of incisional hernia, compared to multiport laparoscopy or robotic surgery. This study's aim was to determine the optimal technique to reduce postoperative incisional complications such as hernia. METHODS A retrospective cohort study was performed at an academic centre from November 2014 to June 2022 on 1036 women who underwent SILS and rSILS gynaecologic procedures with various closure techniques. Techniques included running absorbable sutures without tagging incision apices (standard closure) and tagging incision apices at the beginning of surgery with the use of permanent suture, absorbable suture, or a combination. RESULTS Rates of hernia (primary outcome) and incisional issues (secondary outcome) such as separation or infection were analyzed by technique. Hernia rates were lower when incision apices were tagged compared to when not tagged (P < 0.001). Cellulitis/abscess rates were not significantly different. Incision separation was higher when apices were tagged with absorbable and a combination of permanent and absorbable sutures than if apices were tagged with all permanent sutures or not at all. In multivariate analysis, hernia rate decreased in groups with tagged apices, although other incision complications did not vary. CONCLUSIONS The incidence of incisional hernia after SILS procedures is low, though it does vary by technique. Tagging apices for closure, regardless of suture type, can mitigate one of the biggest concerns of performing SILS by reducing postoperative incisional hernia risk.
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Affiliation(s)
- Sowmya Sunkara
- Minimally Invasive Gynecologic Surgery, Baylor College of Medicine, Houston, TX
| | - Josef Jackson
- Obstetrics and Gynecology, Baylor College of Medicine, Houston, TX
| | - Sarah Casey
- Obstetrics and Gynecology, Baylor College of Medicine, Houston, TX
| | - Hadi Erfani
- Obstetrics and Gynecology, Baylor College of Medicine, Houston, TX
| | - Brooke Thigpen
- Minimally Invasive Gynecologic Surgery, Baylor College of Medicine, Houston, TX
| | - Chunghua Zhang
- The Huaian Maternity and Child Clinical College of Xuzhou Medical University, Xuzhou, China
| | - Xiaoming Guan
- Minimally Invasive Gynecologic Surgery, Baylor College of Medicine, Houston, TX.
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Goulding AN, Meeks K, Shay L, Casey S, Applegarth C, McKinney J. Antiretroviral Therapy in Pregnancy: A 2023 Review of the Literature. Curr HIV/AIDS Rep 2024; 21:1-10. [PMID: 38277098 DOI: 10.1007/s11904-024-00688-y] [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] [Accepted: 01/04/2024] [Indexed: 01/27/2024]
Abstract
PURPOSE OF REVIEW Selection of antiretroviral therapy during pregnancy must consider maternal physiology and resulting pharmacokinetic changes in pregnancy, resistance and efficacy profiles, tolerability and frequency of adverse effects, teratogenicity, and maternal, neonatal, and pregnancy outcomes. The objective of this review is to summarize the underlying data that informs the current clinical perinatal guidelines in the USA. RECENT FINDINGS Data now supports the use of dolutegravir at all stages of pregnancy with no significant increase in neural tube defects. Safety and pharmacokinetic data on newer antiretroviral medications in pregnancy continue to lag behind the general population. While there are multiple safety and tolerability concerns with older regimens, there are now multiple options of regimens that are highly efficacious and have good safety data in pregnancy. Most pregnant patients who are virally suppressed on a well-tolerated regimen are able to safely continue those medications during pregnancy.
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Affiliation(s)
- Alison N Goulding
- Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, Baylor College of Medicine, 1 Baylor Plaza, Houston, TX, 77030, USA
| | - Kasey Meeks
- School of Medicine, Saint Louis University, Saint Louis, MO, USA
| | - Lena Shay
- Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, Baylor College of Medicine, 1 Baylor Plaza, Houston, TX, 77030, USA
| | - Sarah Casey
- School of Medicine, Baylor College of Medicine, Houston, TX, USA
| | - Colton Applegarth
- School of Medicine, University of California San Diego, San Diego, CA, USA
| | - Jennifer McKinney
- Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, Baylor College of Medicine, 1 Baylor Plaza, Houston, TX, 77030, USA.
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Crowley P, Casey S, Kelleher E, Roche E, Behan C, Cannon M, Lyne J. Survey of consultant psychiatrists about the draft heads of a bill to amend the mental health act. Ir J Med Sci 2023; 192:1769-1770. [PMID: 37032395 DOI: 10.1007/s11845-023-03355-0] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Accepted: 03/27/2023] [Indexed: 04/11/2023]
Affiliation(s)
- Paul Crowley
- Health Service Executive, Newcastle Hospital, Greystones, Co. Wicklow, Ireland.
| | - Sarah Casey
- St Patrick's University Hospital, Dublin 8, Ireland
- Trinity College Dublin, Dublin 2, Ireland
| | - Eric Kelleher
- Liaison Psychiatry Service, Cork University Hospital, Cork, Ireland
- Liaison Psychiatry Service, Mercy University Hospital, Cork, Ireland
- Department of Psychiatry, School of Medicine, University College Cork, Cork, Ireland
| | - Eric Roche
- Department of Psychiatry, Royal College of Surgeons in Ireland, 123 St. Stephen's Green, Dublin, Ireland
- Cluain Mhuire Community Mental Health Service, Blackrock, Dublin, Ireland
| | - Caragh Behan
- Department of Psychiatry, Royal College of Surgeons in Ireland, 123 St. Stephen's Green, Dublin, Ireland
| | - Mary Cannon
- Department of Psychiatry, Royal College of Surgeons in Ireland, 123 St. Stephen's Green, Dublin, Ireland
- Department of Psychiatry, Beaumont Hospital, Dublin, Ireland
| | - John Lyne
- Health Service Executive, Newcastle Hospital, Greystones, Co. Wicklow, Ireland
- Department of Psychiatry, Royal College of Surgeons in Ireland, 123 St. Stephen's Green, Dublin, Ireland
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Desai AS, Webb DJ, Taubel J, Casey S, Cheng Y, Robbie GJ, Foster D, Huang SA, Rhyee S, Sweetser MT, Bakris GL. Zilebesiran, an RNA Interference Therapeutic Agent for Hypertension. N Engl J Med 2023; 389:228-238. [PMID: 37467498 DOI: 10.1056/nejmoa2208391] [Citation(s) in RCA: 36] [Impact Index Per Article: 36.0] [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] [Indexed: 07/21/2023]
Abstract
BACKGROUND Angiotensinogen is the sole precursor of angiotensin peptides and has a key role in the pathogenesis of hypertension. Zilebesiran, an investigational RNA interference therapeutic agent with a prolonged duration of action, inhibits hepatic angiotensinogen synthesis. METHODS In this phase 1 study, patients with hypertension were randomly assigned in a 2:1 ratio to receive either a single ascending subcutaneous dose of zilebesiran (10, 25, 50, 100, 200, 400, or 800 mg) or placebo and were followed for 24 weeks (Part A). Part B assessed the effect of the 800-mg dose of zilebesiran on blood pressure under low- or high-salt diet conditions, and Part E the effect of that dose when coadministered with irbesartan. End points included safety, pharmacokinetic and pharmacodynamic characteristics, and the change from baseline in systolic and diastolic blood pressure, as measured by 24-hour ambulatory blood-pressure monitoring. RESULTS Of 107 patients enrolled, 5 had mild, transient injection-site reactions. There were no reports of hypotension, hyperkalemia, or worsening of renal function resulting in medical intervention. In Part A, patients receiving zilebesiran had decreases in serum angiotensinogen levels that were correlated with the administered dose (r = -0.56 at week 8; 95% confidence interval, -0.69 to -0.39). Single doses of zilebesiran (≥200 mg) were associated with decreases in systolic blood pressure (>10 mm Hg) and diastolic blood pressure (>5 mm Hg) by week 8; these changes were consistent throughout the diurnal cycle and were sustained at 24 weeks. Results from Parts B and E were consistent with attenuation of the effect on blood pressure by a high-salt diet and with an augmented effect through coadministration with irbesartan, respectively. CONCLUSIONS Dose-dependent decreases in serum angiotensinogen levels and 24-hour ambulatory blood pressure were sustained for up to 24 weeks after a single subcutaneous dose of zilebesiran of 200 mg or more; mild injection-site reactions were observed. (Funded by Alnylam Pharmaceuticals; ClinicalTrials.gov number, NCT03934307; EudraCT number, 2019-000129-39.).
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Affiliation(s)
- Akshay S Desai
- From the Division of Cardiovascular Medicine, Brigham and Women's Hospital, Boston (A.S.D.), and Alnylam Pharmaceuticals, Cambridge (Y.C., G.J.R., D.F., S.A.H., S.R., M.T.S.) - both in Massachusetts; the Centre for Cardiovascular Science, University of Edinburgh, Edinburgh (D.J.W.), Richmond Pharmacology and St. George's University of London, London (J.T.), and the Medicines Evaluation Unit, Manchester University NHS Foundation Trust, Wythenshawe Hospital, Manchester (S.C.) - all in the United Kingdom; and University Chicago Medicine, Chicago (G.L.B.)
| | - David J Webb
- From the Division of Cardiovascular Medicine, Brigham and Women's Hospital, Boston (A.S.D.), and Alnylam Pharmaceuticals, Cambridge (Y.C., G.J.R., D.F., S.A.H., S.R., M.T.S.) - both in Massachusetts; the Centre for Cardiovascular Science, University of Edinburgh, Edinburgh (D.J.W.), Richmond Pharmacology and St. George's University of London, London (J.T.), and the Medicines Evaluation Unit, Manchester University NHS Foundation Trust, Wythenshawe Hospital, Manchester (S.C.) - all in the United Kingdom; and University Chicago Medicine, Chicago (G.L.B.)
| | - Jorg Taubel
- From the Division of Cardiovascular Medicine, Brigham and Women's Hospital, Boston (A.S.D.), and Alnylam Pharmaceuticals, Cambridge (Y.C., G.J.R., D.F., S.A.H., S.R., M.T.S.) - both in Massachusetts; the Centre for Cardiovascular Science, University of Edinburgh, Edinburgh (D.J.W.), Richmond Pharmacology and St. George's University of London, London (J.T.), and the Medicines Evaluation Unit, Manchester University NHS Foundation Trust, Wythenshawe Hospital, Manchester (S.C.) - all in the United Kingdom; and University Chicago Medicine, Chicago (G.L.B.)
| | - Sarah Casey
- From the Division of Cardiovascular Medicine, Brigham and Women's Hospital, Boston (A.S.D.), and Alnylam Pharmaceuticals, Cambridge (Y.C., G.J.R., D.F., S.A.H., S.R., M.T.S.) - both in Massachusetts; the Centre for Cardiovascular Science, University of Edinburgh, Edinburgh (D.J.W.), Richmond Pharmacology and St. George's University of London, London (J.T.), and the Medicines Evaluation Unit, Manchester University NHS Foundation Trust, Wythenshawe Hospital, Manchester (S.C.) - all in the United Kingdom; and University Chicago Medicine, Chicago (G.L.B.)
| | - Yansong Cheng
- From the Division of Cardiovascular Medicine, Brigham and Women's Hospital, Boston (A.S.D.), and Alnylam Pharmaceuticals, Cambridge (Y.C., G.J.R., D.F., S.A.H., S.R., M.T.S.) - both in Massachusetts; the Centre for Cardiovascular Science, University of Edinburgh, Edinburgh (D.J.W.), Richmond Pharmacology and St. George's University of London, London (J.T.), and the Medicines Evaluation Unit, Manchester University NHS Foundation Trust, Wythenshawe Hospital, Manchester (S.C.) - all in the United Kingdom; and University Chicago Medicine, Chicago (G.L.B.)
| | - Gabriel J Robbie
- From the Division of Cardiovascular Medicine, Brigham and Women's Hospital, Boston (A.S.D.), and Alnylam Pharmaceuticals, Cambridge (Y.C., G.J.R., D.F., S.A.H., S.R., M.T.S.) - both in Massachusetts; the Centre for Cardiovascular Science, University of Edinburgh, Edinburgh (D.J.W.), Richmond Pharmacology and St. George's University of London, London (J.T.), and the Medicines Evaluation Unit, Manchester University NHS Foundation Trust, Wythenshawe Hospital, Manchester (S.C.) - all in the United Kingdom; and University Chicago Medicine, Chicago (G.L.B.)
| | - Don Foster
- From the Division of Cardiovascular Medicine, Brigham and Women's Hospital, Boston (A.S.D.), and Alnylam Pharmaceuticals, Cambridge (Y.C., G.J.R., D.F., S.A.H., S.R., M.T.S.) - both in Massachusetts; the Centre for Cardiovascular Science, University of Edinburgh, Edinburgh (D.J.W.), Richmond Pharmacology and St. George's University of London, London (J.T.), and the Medicines Evaluation Unit, Manchester University NHS Foundation Trust, Wythenshawe Hospital, Manchester (S.C.) - all in the United Kingdom; and University Chicago Medicine, Chicago (G.L.B.)
| | - Stephen A Huang
- From the Division of Cardiovascular Medicine, Brigham and Women's Hospital, Boston (A.S.D.), and Alnylam Pharmaceuticals, Cambridge (Y.C., G.J.R., D.F., S.A.H., S.R., M.T.S.) - both in Massachusetts; the Centre for Cardiovascular Science, University of Edinburgh, Edinburgh (D.J.W.), Richmond Pharmacology and St. George's University of London, London (J.T.), and the Medicines Evaluation Unit, Manchester University NHS Foundation Trust, Wythenshawe Hospital, Manchester (S.C.) - all in the United Kingdom; and University Chicago Medicine, Chicago (G.L.B.)
| | - Sean Rhyee
- From the Division of Cardiovascular Medicine, Brigham and Women's Hospital, Boston (A.S.D.), and Alnylam Pharmaceuticals, Cambridge (Y.C., G.J.R., D.F., S.A.H., S.R., M.T.S.) - both in Massachusetts; the Centre for Cardiovascular Science, University of Edinburgh, Edinburgh (D.J.W.), Richmond Pharmacology and St. George's University of London, London (J.T.), and the Medicines Evaluation Unit, Manchester University NHS Foundation Trust, Wythenshawe Hospital, Manchester (S.C.) - all in the United Kingdom; and University Chicago Medicine, Chicago (G.L.B.)
| | - Marianne T Sweetser
- From the Division of Cardiovascular Medicine, Brigham and Women's Hospital, Boston (A.S.D.), and Alnylam Pharmaceuticals, Cambridge (Y.C., G.J.R., D.F., S.A.H., S.R., M.T.S.) - both in Massachusetts; the Centre for Cardiovascular Science, University of Edinburgh, Edinburgh (D.J.W.), Richmond Pharmacology and St. George's University of London, London (J.T.), and the Medicines Evaluation Unit, Manchester University NHS Foundation Trust, Wythenshawe Hospital, Manchester (S.C.) - all in the United Kingdom; and University Chicago Medicine, Chicago (G.L.B.)
| | - George L Bakris
- From the Division of Cardiovascular Medicine, Brigham and Women's Hospital, Boston (A.S.D.), and Alnylam Pharmaceuticals, Cambridge (Y.C., G.J.R., D.F., S.A.H., S.R., M.T.S.) - both in Massachusetts; the Centre for Cardiovascular Science, University of Edinburgh, Edinburgh (D.J.W.), Richmond Pharmacology and St. George's University of London, London (J.T.), and the Medicines Evaluation Unit, Manchester University NHS Foundation Trust, Wythenshawe Hospital, Manchester (S.C.) - all in the United Kingdom; and University Chicago Medicine, Chicago (G.L.B.)
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Casey S, Regan S, Gale E, Adams ZM, Lambert E, Omede FO, Wakeman SE. Rapid Methadone Induction in a General Hospital Setting: A Retrospective, Observational Analysis. Subst Abus 2023; 44:177-183. [PMID: 37728091 DOI: 10.1177/08897077231185655] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/21/2023]
Abstract
BACKGROUND Outpatient methadone guidelines recommend starting at a low dose and titrating slowly. As fentanyl prevalence and opioid-related mortality increases, there is a need for individuals to rapidly achieve a therapeutic methadone dose. Hospitalization offers a monitored setting for methadone initiation, however dosing practices and safety are not well described. METHODS Retrospective, observational analysis of hospitalized patients with opioid use disorder seen by an inpatient addiction consult team in an academic medical center who were newly initiated on methadone between 2016 and 2022. We calculated initial daily dose, maximum daily dose, timing interval of dose escalation, whether patients were connected to an opioid treatment program (OTP) prior to discharge, whether adverse effects or safety events occurred during the hospitalization, and whether such events were definitely or probably related versus possibly related or unrelated to methadone. RESULTS One hundred twelve patients were included. The mean initial daily methadone dose administered was 32 mg (range: 10-90 mg). The mean maximum dose reached was 76.8 mg (range 30-165 mg). The mean number of days from initial to peak dose was 5.6 days (range 1-19 days). Overall, 30% of patients experienced a safety event, most commonly sedation. Only 4 safety events were deemed probably or definitely related to methadone. In regression analyses, there was no significant difference between starting doses among patients with or without sedation but there was a relationship between last dose and the likelihood of any possibly related event, with those ending at a dose of 100 mg or higher having a higher likelihood event, compared to those ending at lower doses (47.8% vs 12.4%, P < .001). Seventy-six percent were connected to OTP before discharge. CONCLUSION Among hospitalized patients initiating methadone, rapid dose titration was infrequently associated with related safety events and most were connected to community-based methadone treatment before discharge.
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Affiliation(s)
- Sarah Casey
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
| | - Susan Regan
- Department of Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Evan Gale
- Department of Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Zoe M Adams
- Department of Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Eugene Lambert
- Department of Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Faith O Omede
- Department of Internal Medicine, Mass General Community Physicians, Salem, MA, USA
| | - Sarah E Wakeman
- Department of Medicine, Massachusetts General Hospital, Boston, MA, USA
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Goulding AN, Casey S, Reed CC, Shamshirsaz AA, Lombaard H, Belfort MA, Noll L, Fox KA. Perinatal mental healthcare utilization among patients with placenta accreta spectrum. Am J Obstet Gynecol 2023. [DOI: 10.1016/j.ajog.2022.11.465] [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: 01/09/2023]
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8
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Mcloughlin C, Abdalla A, O'Callaghan AK, Casey S, Barrett E. The Impact of COVID-19 on Burnout, Psychological Well-being, and Work Satisfaction in Psychiatry Trainees in Ireland. Acad Psychiatry 2022; 46:701-709. [PMID: 35441349 PMCID: PMC9018053 DOI: 10.1007/s40596-022-01633-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Accepted: 04/01/2022] [Indexed: 06/02/2023]
Abstract
OBJECTIVE Prior to the pandemic, trainee doctors were at higher risk of psychological ill health. There is limited evidence measuring the impact of COVID-19 on psychiatry trainees. This study evaluates levels of burnout, work satisfaction, and psychological well-being in psychiatry junior doctors in Ireland and identifies potential contributing factors. METHODS The authors carried out a cross-sectional online survey measuring demographic and work-related variables. Questions including exposure to COVID-19 and stress-related factors were included. We evaluated burnout, work satisfaction, and psychological well-being using the Abbreviated-Maslach Burnout Inventory, Basic Needs Satisfaction at Work Scale, and WHO-5 Well-being Index. RESULTS One hundred and five doctors responded (21%). The biggest stressor reported was reduced face-to-face contact with family and friends (73%). Forty one percent reported weekly supervision changes. Sixty five percent met the criteria for burnout, compared with 36.2% in 2018. Significant factors associated with burnout included staff shortages, longer hours, and less experience. Changes in supervision and working in non-European Working Time Directive compliant rotas were associated with lower scores across all subdomains of the BNSW Scale. The WHO-5 Well-being Index identified 48% scored low in personal well-being, indicating these trainees met the threshold for depression. Changes in regular supervision (p=0.010) were a significant predictor of low personal well-being. CONCLUSIONS High prevalence of burnout and low levels of well-being in this vulnerable cohort, particularly those who are inexperienced, have changes in supervision, and working longer hours is concerning. This study highlights the importance of regular supervision and support for this group.
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Affiliation(s)
| | | | | | - Sarah Casey
- Daughters of Charity Disability Services, Dublin 7, Ireland
| | - Elizabeth Barrett
- University College Dublin/Children's University Hospital, Dublin 1, Ireland
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9
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Carroll P, Dervan A, Maher A, McCarthy C, Woods I, Kavanagh R, Beirne C, Harte G, O'Flynn D, O'Connor C, McGuire T, Leahy LM, Gonzalez JG, Stasiewicz M, Maughan J, Gouveia PJ, Murphy PJ, Quinlan J, Casey S, Holton A, Smith É, Moriarty F, O'Brien FJ, Flood M. Applying Patient and Public Involvement in preclinical research: A co-created scoping review. Health Expect 2022; 25:2680-2699. [PMID: 36217557 DOI: 10.1111/hex.13615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 08/29/2022] [Accepted: 09/08/2022] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Patient and Public Involvement (PPI) in research aims to improve the quality, relevance and appropriateness of research. PPI has an established role in clinical research where there is evidence of benefit, and where policymakers and funders place continued emphasis on its inclusion. However, for preclinical research, PPI has not yet achieved the same level of integration. As more researchers, including our team, aim to include PPI in preclinical research, the development of an evidence-based approach is important. Therefore, this scoping review aimed to identify and map studies where PPI has been used in preclinical research and develop principles that can be applied in other projects. METHODS A scoping review was conducted to search the literature in Medline (PubMed), EMBASE, CINAHL, PsycInfo and Web of Science Core Collection to identify applied examples of preclinical PPI. Two independent reviewers conducted study selection and data extraction separately. Data were extracted relating to PPI in terms of (i) rationale and aims, (ii) approach used, (iii) benefits and challenges, (iv) impact and evaluation and (v) learning opportunities for preclinical PPI. Findings were reviewed collaboratively by PPI contributors and the research team to identify principles that could be applied to other projects. RESULTS Nine studies were included in the final review with the majority of included studies reporting PPI to improve the relevance of their research, using approaches such as PPI advisory panels and workshops. Researchers report several benefits and challenges, although evidence of formal evaluation is limited. CONCLUSION Although currently there are few examples of preclinical research studies reporting empirical PPI activity, their findings may support those aiming to use PPI in preclinical research. Through collaborative analysis of the scoping review findings, several principles were developed that may be useful for other preclinical researchers. PATIENT OR PUBLIC CONTRIBUTION This study was conducted as part of a broader project aiming to develop an evidence base for preclinical PPI that draws on a 5-year preclinical research programme focused on the development of advanced biomaterials for spinal cord repair as a case study. A PPI Advisory Panel comprising seriously injured rugby players, clinicians, preclinical researchers and PPI facilitators collaborated as co-authors on the conceptualization, execution and writing of this review, including refining the findings into the set of principles reported here.
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Affiliation(s)
- Pádraig Carroll
- School of Pharmacy and Biomolecular Sciences, RCSI University of Medicine and Health Sciences, Dublin, Ireland.,Tissue Engineering Research Group (TERG), Department of Anatomy and Regenerative Medicine, RCSI University of Medicine and Health Sciences, Dublin, Ireland.,Science Foundation Ireland (SFI) Advanced Materials and BioEngineering Research (AMBER) Centre, Trinity College Dublin (TCD) and RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Adrian Dervan
- Tissue Engineering Research Group (TERG), Department of Anatomy and Regenerative Medicine, RCSI University of Medicine and Health Sciences, Dublin, Ireland.,Science Foundation Ireland (SFI) Advanced Materials and BioEngineering Research (AMBER) Centre, Trinity College Dublin (TCD) and RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Anthony Maher
- School of Pharmacy and Biomolecular Sciences, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Ciarán McCarthy
- c/o Irish Rugby Football Union (IRFU) Charitable Trust, Dublin, Ireland
| | - Ian Woods
- Tissue Engineering Research Group (TERG), Department of Anatomy and Regenerative Medicine, RCSI University of Medicine and Health Sciences, Dublin, Ireland.,Science Foundation Ireland (SFI) Advanced Materials and BioEngineering Research (AMBER) Centre, Trinity College Dublin (TCD) and RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Rachel Kavanagh
- Science Foundation Ireland (SFI) Advanced Materials and BioEngineering Research (AMBER) Centre, Trinity College Dublin (TCD) and RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Cliff Beirne
- Faculty of Sports and Exercise Medicines, RCSI University of Medicine and Health Sciences & Royal College of Physicians in Ireland, Dublin, Ireland
| | - Geoff Harte
- c/o Irish Rugby Football Union (IRFU) Charitable Trust, Dublin, Ireland
| | - Dónal O'Flynn
- c/o Irish Rugby Football Union (IRFU) Charitable Trust, Dublin, Ireland
| | - Cian O'Connor
- Tissue Engineering Research Group (TERG), Department of Anatomy and Regenerative Medicine, RCSI University of Medicine and Health Sciences, Dublin, Ireland.,Science Foundation Ireland (SFI) Advanced Materials and BioEngineering Research (AMBER) Centre, Trinity College Dublin (TCD) and RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Tara McGuire
- Tissue Engineering Research Group (TERG), Department of Anatomy and Regenerative Medicine, RCSI University of Medicine and Health Sciences, Dublin, Ireland.,Science Foundation Ireland (SFI) Advanced Materials and BioEngineering Research (AMBER) Centre, Trinity College Dublin (TCD) and RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Liam M Leahy
- Tissue Engineering Research Group (TERG), Department of Anatomy and Regenerative Medicine, RCSI University of Medicine and Health Sciences, Dublin, Ireland.,Science Foundation Ireland (SFI) Advanced Materials and BioEngineering Research (AMBER) Centre, Trinity College Dublin (TCD) and RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Javier Gutierrez Gonzalez
- Tissue Engineering Research Group (TERG), Department of Anatomy and Regenerative Medicine, RCSI University of Medicine and Health Sciences, Dublin, Ireland.,Science Foundation Ireland (SFI) Advanced Materials and BioEngineering Research (AMBER) Centre, Trinity College Dublin (TCD) and RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Martyna Stasiewicz
- Tissue Engineering Research Group (TERG), Department of Anatomy and Regenerative Medicine, RCSI University of Medicine and Health Sciences, Dublin, Ireland.,Science Foundation Ireland (SFI) Advanced Materials and BioEngineering Research (AMBER) Centre, Trinity College Dublin (TCD) and RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Jack Maughan
- Tissue Engineering Research Group (TERG), Department of Anatomy and Regenerative Medicine, RCSI University of Medicine and Health Sciences, Dublin, Ireland.,Science Foundation Ireland (SFI) Advanced Materials and BioEngineering Research (AMBER) Centre, Trinity College Dublin (TCD) and RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Pedro Jose Gouveia
- Tissue Engineering Research Group (TERG), Department of Anatomy and Regenerative Medicine, RCSI University of Medicine and Health Sciences, Dublin, Ireland.,Science Foundation Ireland (SFI) Advanced Materials and BioEngineering Research (AMBER) Centre, Trinity College Dublin (TCD) and RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Paul J Murphy
- RCSI Library, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | | | - Sarah Casey
- Tissue Engineering Research Group (TERG), Department of Anatomy and Regenerative Medicine, RCSI University of Medicine and Health Sciences, Dublin, Ireland.,Science Foundation Ireland (SFI) Advanced Materials and BioEngineering Research (AMBER) Centre, Trinity College Dublin (TCD) and RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Alice Holton
- School of Pharmacy and Biomolecular Sciences, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Éimear Smith
- National Rehabilitation Hospital, Dún Laoghaire, Ireland
| | - Frank Moriarty
- School of Pharmacy and Biomolecular Sciences, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Fergal J O'Brien
- Tissue Engineering Research Group (TERG), Department of Anatomy and Regenerative Medicine, RCSI University of Medicine and Health Sciences, Dublin, Ireland.,Science Foundation Ireland (SFI) Advanced Materials and BioEngineering Research (AMBER) Centre, Trinity College Dublin (TCD) and RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Michelle Flood
- School of Pharmacy and Biomolecular Sciences, RCSI University of Medicine and Health Sciences, Dublin, Ireland.,Tissue Engineering Research Group (TERG), Department of Anatomy and Regenerative Medicine, RCSI University of Medicine and Health Sciences, Dublin, Ireland.,Science Foundation Ireland (SFI) Advanced Materials and BioEngineering Research (AMBER) Centre, Trinity College Dublin (TCD) and RCSI University of Medicine and Health Sciences, Dublin, Ireland
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10
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Hauser R, Casey S, Sengupta J. Tricuspid valve complications during leadless pacemaker implantation. Europace 2022. [DOI: 10.1093/europace/euac053.398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: Foundation. Main funding source(s): Minneapolis Heart Institute Foundation
Background
The implantation of a leadless right ventricular pacemaker (LPM) may be complicated by tricuspid valve injury or interference with tricuspid valve function.
Purpose
Characterize the nature, causes, and outcomes of tricuspid valve injury and functional interference due to LPM implantation.
Methods
The Food and Drug Administration’s Manufacturers and User Facility Device Experience (MAUDE) database was queried for tricuspid valve adverse events involving the Medtronic Micra LPM that were reported by the manufacturer.
Results
From 2016-October 2021, 19 patients suffered a tricuspid valve adverse event, including damage to the leaflets, papillary muscle, or chordae tendineae (n=14; 74%); interference with valve closure (n=3; 16%); and 2 LPMs were irretrievably wedged in the tricuspid valve apparatus. Damaged valves included: 1) torn leaflet or chordal tissue found in the delivery system (n=6) after complicated or failed LPM recapture that necessitated removal without the LPM retracted into the delivery system; all patients developed tricuspid regurgitation, and one patient died. 2) valve damage by the delivery system either directly (n=6) or during LPM recapture (n=1) or removal by a snare (n=1); all patients had new or worsening tricuspid regurgitation; one patient died, 2 had valve repair, and one valve was replaced. In three patients the LPM interfered with valve closure; one patient had valve replacement, one underwent LPM removal, and one was treated medically. Of the 2 LPMs wedged in the tricuspid valve apparatus, one required surgical removal and one was abandoned.
Conclusion
Tricuspid valve trauma during LPM implantation may cause significant regurgitation that results in poor outcomes and requires medical or surgical intervention. Mechanisms include direct valve injury by the delivery system, complications of difficult or unsuccessful LPM recapture, and LPM interference with valve function.
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Affiliation(s)
- R Hauser
- Minneapolis Heart Institute Foundation, Minneapolis, United States of America
| | - S Casey
- Minneapolis Heart Institute Foundation, Minneapolis, United States of America
| | - J Sengupta
- Minneapolis Heart Institute Foundation, Minneapolis, United States of America
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11
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Grobler S, Casey S, Farrell E. Making information accessible for people with aphasia in healthcare. ACNR 2022. [DOI: 10.47795/wkdo3084] [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: 11/18/2022] Open
Abstract
People with aphasia are often unable to access healthcare due to difficulties understanding and using spoken and written language, which impacts every step of their healthcare journey and outcomes. This article argues that it is important to apply the principles of the NHS England Accessible Information Standards (2017) to people with aphasia so they can meet their health information needs and rights. The processes to enable people with aphasia to access and participate in spoken and written communication in healthcare and the methods for training and supporting healthcare staff need to be considered at an individual, service, and organisational level.
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12
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Intini C, Lemoine M, Hodgkinson T, Casey S, Gleeson JP, O'Brien FJ. A highly porous type II collagen containing scaffold for the treatment of cartilage defects enhances MSC chondrogenesis and early cartilaginous matrix deposition. Biomater Sci 2022; 10:970-983. [DOI: 10.1039/d1bm01417j] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
The combination of type II collagen (CII) and hyaluronic acid (HyA) resulted in the development of a CII-containing scaffold with improved chondrogenic benefits for simple and effective “off-the-shelf” application for enhanced cartilage repair.
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Affiliation(s)
- Claudio Intini
- Tissue Engineering Research Group, Department of Anatomy & Regenerative Medicine, Royal College of Surgeons in Ireland (RCSI), Dublin, Ireland
- Advanced Materials and Bioengineering Research (AMBER) Centre, RCSI & TCD, Ireland
| | - Mark Lemoine
- Tissue Engineering Research Group, Department of Anatomy & Regenerative Medicine, Royal College of Surgeons in Ireland (RCSI), Dublin, Ireland
- Advanced Materials and Bioengineering Research (AMBER) Centre, RCSI & TCD, Ireland
| | - Tom Hodgkinson
- Tissue Engineering Research Group, Department of Anatomy & Regenerative Medicine, Royal College of Surgeons in Ireland (RCSI), Dublin, Ireland
- Advanced Materials and Bioengineering Research (AMBER) Centre, RCSI & TCD, Ireland
| | - Sarah Casey
- Tissue Engineering Research Group, Department of Anatomy & Regenerative Medicine, Royal College of Surgeons in Ireland (RCSI), Dublin, Ireland
- Advanced Materials and Bioengineering Research (AMBER) Centre, RCSI & TCD, Ireland
| | - John P. Gleeson
- Tissue Engineering Research Group, Department of Anatomy & Regenerative Medicine, Royal College of Surgeons in Ireland (RCSI), Dublin, Ireland
- Fraunhofer Project Centre for Embedded Bioanalytical Systems, Dublin City University, Glasnevin, Dublin 9, Ireland
| | - Fergal J. O'Brien
- Tissue Engineering Research Group, Department of Anatomy & Regenerative Medicine, Royal College of Surgeons in Ireland (RCSI), Dublin, Ireland
- Advanced Materials and Bioengineering Research (AMBER) Centre, RCSI & TCD, Ireland
- Trinity Centre for Biomedical Engineering, Trinity College Dublin (TCD), Dublin 2, Ireland
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13
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McIllhatton A, Lanting S, Lambkin D, Leigh L, Casey S, Chuter V. Reliability of recommended non-invasive chairside screening tests for diabetes-related peripheral neuropathy: a systematic review with meta-analyses. BMJ Open Diabetes Res Care 2021; 9:e002528. [PMID: 34952841 PMCID: PMC8710873 DOI: 10.1136/bmjdrc-2021-002528] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Accepted: 11/14/2021] [Indexed: 01/08/2023] Open
Abstract
The objective is to determine, by systematic review, the reliability of testing methods for diagnosis of diabetes-related peripheral neuropathy (DPN) as recommended by the most recent guidelines from the International Diabetes Foundation, International Working Group on the Diabetic Foot and American Diabetes Association. Electronic searches of Cochrane Library, EBSCO Megafile Ultimate and EMBASE were performed to May 2021. Articles were included if they reported on the reliability of recommended chairside tests in diabetes cohorts. Quality appraisal was performed using a Quality Appraisal of Reliability Studies checklist and where possible, meta-analyses, with reliability reported as estimated Cohen's kappa (95% CI). Seventeen studies were eligible for inclusion. Pooled analysis found acceptable inter-rater reliability of vibration perception threshold (VPT) (κ=0.61 (0.50 to 0.73)) and ankle reflex testing (κ=0.60 (0.55 to 0.64)), but weak inter-rater reliability for pinprick (κ=0.45 (0.22 to 0.69)) and 128 Hz tuning fork (κ=0.42 (0.15 to 0.70)), though intra-rater reliability of the 128 Hz tuning fork was moderate (κ=0.54 (0.37 to 0.73)). Inter-rater reliability of the four-site monofilament was acceptable (κ=0.61 (0.45 to 0.77)). These results support the clinical use of VPT, ankle reflexes and four-site monofilament for screening and ongoing monitoring of DPN as recommended by the latest guidelines. The reliability of temperature perception, pinprick, proprioception, three-site monofilament and Ipswich touch test when performed in people with diabetes remains unclear.
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Affiliation(s)
- Ally McIllhatton
- Discipline of Podiatry, The University of Newcastle Faculty of Health and Medicine, Ourimbah, New South Wales, Australia
| | - Sean Lanting
- Discipline of Podiatry, The University of Newcastle Faculty of Health and Medicine, Ourimbah, New South Wales, Australia
| | - David Lambkin
- Hunter Medical Research Institute, The University of Newcastle, New Lambton, New South Wales, Australia
| | - Lucy Leigh
- Hunter Medical Research Institute, The University of Newcastle, New Lambton, New South Wales, Australia
| | - Sarah Casey
- Discipline of Podiatry, The University of Newcastle Faculty of Health and Medicine, Ourimbah, New South Wales, Australia
| | - Vivienne Chuter
- Discipline of Podiatry, The University of Newcastle Faculty of Health and Medicine, Ourimbah, New South Wales, Australia
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14
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Carroll P, Dervan A, Maher A, McCarthy C, Woods I, Kavanagh R, Beirne C, Harte G, O'Flynn D, Murphy P, Quinlan J, Holton A, Casey S, Moriarty F, Smith É, O'Brien FJ, Flood M. Patient and Public Involvement (PPI) in preclinical research: A scoping review protocol. HRB Open Res 2021; 4:61. [PMID: 34522837 PMCID: PMC8420886 DOI: 10.12688/hrbopenres.13303.2] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/23/2021] [Indexed: 11/20/2022] Open
Abstract
Introduction: Patient and public involvement (PPI) aims to improve the quality, relevance, and appropriateness of research and ensure that it meets the needs and expectations of those affected by particular conditions to the greatest possible degree. The evidence base for the positive impact of PPI on clinical research continues to grow, but the role of PPI in preclinical research (an umbrella term encompassing 'basic', 'fundamental', 'translational' or 'lab-based' research) remains limited. As funding bodies and policymakers continue to increase emphasis on the relevance of PPI to preclinical research, it is timely to map the PPI literature to support preclinical researchers involving the public, patients, or other service users in their research. Therefore, the aim of this scoping review is to explore the literature on patient and public involvement in preclinical research from any discipline. Methods: This scoping review will search the literature in Medline (PubMed), Embase, CINAHL, PsycINFO, Web of Science Core Collection, Scopus, and OpenGrey.net to explore the application of PPI in preclinical research. This review will follow the Joanna Briggs Institute (JBI) guidelines for scoping reviews. It will be reported according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). Two reviewers will independently review articles for inclusion in the final review. Data extraction will be guided by the research questions. The PPI advisory panel will then collaboratively identify themes in the extracted data. Discussion: This scoping review will provide a map of current evidence surrounding preclinical PPI, and identify the body of literature on this topic, which has not been comprehensively reviewed to date. Findings will inform ongoing work of the research team, support the work of other preclinical researchers aiming to include PPI in their own research, and identify knowledge and practice gaps. Areas for future research will be identified.
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Affiliation(s)
- Pádraig Carroll
- School of Pharmacy and Biomolecular Sciences, Royal College of Surgeons in Ireland, University of Medicine and Health Sciences, Dublin, D02 YN77, Ireland.,Tissue Engineering Research Group (TERG), Department of Anatomy and Regenerative Medicine, Royal College of Surgeons in Ireland, University of Medicine and Health Sciences, Dublin, D02 YN77, Ireland.,Advanced Materials and Bioengineering Research (AMBER) Centre, Trinity College Dublin, D02 W085 & RCSI Dublin, Dublin, D02 YN77, Ireland
| | - Adrian Dervan
- Tissue Engineering Research Group (TERG), Department of Anatomy and Regenerative Medicine, Royal College of Surgeons in Ireland, University of Medicine and Health Sciences, Dublin, D02 YN77, Ireland
| | - Anthony Maher
- School of Pharmacy and Biomolecular Sciences, Royal College of Surgeons in Ireland, University of Medicine and Health Sciences, Dublin, D02 YN77, Ireland
| | - Ciarán McCarthy
- c/o Irish Rugby Football Union (IRFU) Charitable Trust, Dublin, D04 F720, Ireland
| | - Ian Woods
- Tissue Engineering Research Group (TERG), Department of Anatomy and Regenerative Medicine, Royal College of Surgeons in Ireland, University of Medicine and Health Sciences, Dublin, D02 YN77, Ireland
| | - Rachel Kavanagh
- Advanced Materials and Bioengineering Research (AMBER) Centre, Trinity College Dublin, D02 W085 & RCSI Dublin, Dublin, D02 YN77, Ireland
| | - Cliff Beirne
- Faculty of Sports and Exercise Medicine, (RCPI & RCSI), RCSI House, 121 St Stephen's Green, Dublin 2, D02 H903, Ireland
| | - Geoff Harte
- c/o Irish Rugby Football Union (IRFU) Charitable Trust, Dublin, D04 F720, Ireland
| | - Dónal O'Flynn
- c/o Irish Rugby Football Union (IRFU) Charitable Trust, Dublin, D04 F720, Ireland
| | - Paul Murphy
- RCSI Library, Royal College of Surgeons in Ireland, University of Medicine and Health Sciences, Dublin, D02 P796, Ireland
| | - John Quinlan
- Tallaght University Hospital, Tallaght, Dublin, D24 NR04, Ireland
| | - Alice Holton
- School of Pharmacy and Biomolecular Sciences, Royal College of Surgeons in Ireland, University of Medicine and Health Sciences, Dublin, D02 YN77, Ireland
| | - Sarah Casey
- Tissue Engineering Research Group (TERG), Department of Anatomy and Regenerative Medicine, Royal College of Surgeons in Ireland, University of Medicine and Health Sciences, Dublin, D02 YN77, Ireland
| | - Frank Moriarty
- School of Pharmacy and Biomolecular Sciences, Royal College of Surgeons in Ireland, University of Medicine and Health Sciences, Dublin, D02 YN77, Ireland
| | - Éimear Smith
- National Rehabilitation Hospital, Dún Laoghaire, Dublin, Ireland
| | - Fergal J O'Brien
- Tissue Engineering Research Group (TERG), Department of Anatomy and Regenerative Medicine, Royal College of Surgeons in Ireland, University of Medicine and Health Sciences, Dublin, D02 YN77, Ireland
| | - Michelle Flood
- School of Pharmacy and Biomolecular Sciences, Royal College of Surgeons in Ireland, University of Medicine and Health Sciences, Dublin, D02 YN77, Ireland.,Tissue Engineering Research Group (TERG), Department of Anatomy and Regenerative Medicine, Royal College of Surgeons in Ireland, University of Medicine and Health Sciences, Dublin, D02 YN77, Ireland.,Advanced Materials and Bioengineering Research (AMBER) Centre, Trinity College Dublin, D02 W085 & RCSI Dublin, Dublin, D02 YN77, Ireland
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15
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McLoughlin C, Casey S, Feeney A, Weir D, Abdalla AA, Barrett E. Burnout, Work Satisfaction, and Well-being Among Non-consultant Psychiatrists in Ireland. Acad Psychiatry 2021; 45:322-328. [PMID: 33420699 PMCID: PMC7794076 DOI: 10.1007/s40596-020-01366-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Accepted: 10/28/2020] [Indexed: 06/02/2023]
Abstract
OBJECTIVE The aim of this study was to explore the areas of psychological well-being, satisfaction at work, and burnout among non-consultant psychiatrists in Ireland, and to assess for potential contributory factors. METHODS The College of Psychiatrists of Ireland distributed the survey online to 100 non-consultant psychiatry doctors working in Ireland. The survey contained questions relating to demographic and work-related variables, the Abbreviated-Maslach Burnout Inventory (a-MBI), Basic Needs Satisfaction at Work (BNSW) scale, and WHO-5 Well-being Index. Descriptive statistics were used by the authors to summarize the data and univariate associations were explored between baseline data and subscales. RESULTS Sixty-nine percent of our sample completed the survey. Thirty-six percent of the sample met the criteria for burnout, with lack of supervision the only variable significantly associated with this. Lack of regular supervision was associated with lower scores across all work satisfaction domains of the BNSW scale. The WHO-5 Well-being Index identified that 30% of respondents scored low in personal well-being, indicating that this proportion screened positive for depression, based on international diagnostic criteria. Lack of regular supervision was found to be significantly associated with low psychological well-being. CONCLUSION This study indicates that lack of supervision is significantly associated with burnout, lower satisfaction at work, and poorer psychological well-being. Close evaluation of these areas is important to identify vulnerable individuals and areas of training which can be improved upon, which may lead to relevant measures being implemented for the benefit of psychiatrists, patients, and the wider society.
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Affiliation(s)
| | - Sarah Casey
- Temple St University Hospital, Dublin, Ireland
| | - Anna Feeney
- St Patricks University Hospital, Dublin, Ireland
| | - David Weir
- Cavan Monaghan Mental Health Services, Monaghan, Ireland
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16
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Carroll P, Dervan A, Maher A, McCarthy C, Woods I, Kavanagh R, Beirne C, Harte G, O'Flynn D, Murphy P, Quinlan J, Holton A, Casey S, Moriarty F, Smith É, O'Brien FJ, Flood M. Patient and Public Involvement (PPI) in preclinical research: A scoping review protocol. HRB Open Res 2021; 4:61. [DOI: 10.12688/hrbopenres.13303.1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/17/2021] [Indexed: 11/20/2022] Open
Abstract
Introduction: Patient and public involvement (PPI) aims to improve the quality, relevance, and appropriateness of research and ensure that it meets the needs and expectations of those affected by particular conditions to the greatest possible degree. The evidence base for the positive impact of PPI on clinical research continues to grow, but the role of PPI in preclinical research (an umbrella term encompassing ‘basic’, ‘fundamental’, ‘translational’ or ‘lab-based’ research) remains limited. As funding bodies and policymakers continue to increase emphasis on the relevance of PPI to preclinical research, it is timely to map the PPI literature to support preclinical researchers involving the public, patients, or other service users in their research. Therefore, the aim of this scoping review is to explore the literature on patient and public involvement in preclinical research from any discipline. Methods: This scoping review will search the literature in Medline (PubMed), Embase, CINAHL, PsycINFO, Web of Science Core Collection, Scopus, and OpenGrey.net to explore the application of PPI in preclinical research. This review will follow the Joanna Briggs Institute (JBI) guidelines for scoping reviews. It will be reported according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). Two reviewers will independently review articles for inclusion in the final review. Data extraction will be guided by the research questions. The PPI advisory panel will then collaboratively identify themes in the extracted data. Discussion: This scoping review will provide a map of current evidence surrounding preclinical PPI, and identify the body of literature on this topic, which has not been comprehensively reviewed to date. Findings will inform ongoing work of the research team, support the work of other preclinical researchers aiming to include PPI in their own research, and identify knowledge and practice gaps. Areas for future research will be identified.
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17
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Peteet B, Belliard J, Abdul-Mutakabbir J, Casey S, Simmons K. Community-academic partnerships to reduce COVID-19 vaccine hesitancy in minoritized communities. EClinicalMedicine 2021; 34:100834. [PMID: 33880441 PMCID: PMC8049608 DOI: 10.1016/j.eclinm.2021.100834] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 03/19/2021] [Accepted: 03/23/2021] [Indexed: 12/04/2022] Open
Affiliation(s)
- B. Peteet
- Department of Psychology, Loma Linda University, Loma Linda, CA 92350, United States
- Corresponding author.
| | - J.C Belliard
- Department of Psychology, Loma Linda University, Loma Linda, CA 92350, United States
| | - J. Abdul-Mutakabbir
- Congregations Organized for Prophetic Engagement (COPE), 1505 West Highland Avenue; Suite 1 San Bernardino, CA 92411, United States
| | - S. Casey
- Congregations Organized for Prophetic Engagement (COPE), 1505 West Highland Avenue; Suite 1 San Bernardino, CA 92411, United States
| | - K. Simmons
- Inland Empire Concerned African American Churches, 1505W. Highland Ave., San Bernardino, CA 92411, United States
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18
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Gault EJ, Cole TJ, Casey S, Hindmarsh PC, Betts P, Dunger DB, Donaldson MDC. Effect of oxandrolone and timing of pubertal induction on final height in Turner syndrome: final analysis of the UK randomised placebo-controlled trial. Arch Dis Child 2021; 106:74-76. [PMID: 31862699 DOI: 10.1136/archdischild-2019-317695] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
The UK Turner syndrome (TS) study examined the effect on final height of oxandrolone 0.05 mg/kg/day (maximum dose 2.5 mg) versus placebo from 9 years of age; and delaying ethinylestradiol induction of puberty by 2 years from 12 (E12) to 14 (E14) years in growth hormone-treated girls with TS. The study ran from 1999 to 2013. By 2011, eighty-two of 92 participants had reached final height and an interim analysis using the Super-Imposition by Translation And Rotation model showed significant increases in final height with both oxandrolone and E14. The analysis has been repeated now that all 92 patients have reached final height. Oxandrolone still significantly increased final height by 4.1 cm (95% CI 1.6 to 6.6, n=92) compared with 4.6 cm previously. However, the E14 effect was no longer significant at 2.7 cm (95% CI -0.8 to 6.1, n=56) compared with 3.8 cm previously.
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Affiliation(s)
- Emma Jane Gault
- University of Glasgow College of Medical, Veterinary and Life Sciences, Glasgow, UK
| | - Tim J Cole
- Policy and Practice Programme, UCL Great Ormond Street, Institute of Child Health, London, UK
| | - Sarah Casey
- Pharmacy (Clinical Trials) Department, NHS Greater Glasgow and Clyde, Glasgow, UK
| | - Peter C Hindmarsh
- Clinical and Molecular Genetics Unit, UCL Great Ormond Street Institute of Child Health, London, UK
| | - Peter Betts
- Paediatrics, Southampton University Hospitals NHS Trust, Southampton, UK
| | | | - Malcolm D C Donaldson
- Section of Child Health, Royal Hospital for Sick Children, University of Glasgow School of Medicine, Glasgow, UK
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19
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Raziee H, Gulstene S, Lohrisch C, Lovedeep G, Speers C, Kwan W, Balkwill S, Cheung A, Casey S, Nichol A. Resection Margin Status and Radiation Boost to Surgical Cavity after Breast Conserving Surgery, a Pattern-of-Practice Study in British Columbia, Canada. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.07.1082] [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: 11/24/2022]
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20
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Almahmudi M, Atwal P, Casey S, Canlas R, Hsu F. Pattern of Practice and Comparison of Thoracic Radiotherapy for the Radical Treatment of Limited-Stage Small Cell Lung Cancer. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.07.1248] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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21
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Levy D, Casey S, Zemtsov G, Whiteside JL. Salpingectomy versus Tubal Occlusion for Permanent Contraception during Cesarean Delivery: Outcomes and Physician Attitudes. J Minim Invasive Gynecol 2020; 28:860-864. [PMID: 32745622 DOI: 10.1016/j.jmig.2020.07.025] [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] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 07/26/2020] [Accepted: 07/28/2020] [Indexed: 11/19/2022]
Abstract
STUDY OBJECTIVE Compare clinical outcomes and physician attitudes toward tubal occlusion and salpingectomy during cesarean section. DESIGN Retrospective cohort study with survey. SETTING Private hospital in Cincinnati, Ohio. PATIENTS Women aged ≥18 years undergoing permanent contraception during cesarean delivery with and without salpingectomy from January 2016 to December 2017. INTERVENTIONS Rate measurements of permanent contraception during cesarean section by salpingectomy versus tubal occlusion. Online survey assessment of study population physicians' attitudes toward salpingectomy. MEASUREMENTS AND MAIN RESULTS Study subjects identified using Current Procedural Terminology codes. Subject demographics, operative details, and perioperative morbidity indicators were identified by chart review. A total of 363 subjects were included: 116 (32%) had salpingectomies, and 247 (68%) had tubal occlusions. Study variables were compared using Wilcoxon rank sum and Fisher exact tests. Despite similar cohort demographics, salpingectomy increased mean operative time by 6.5 minutes compared with tubal occlusion (p = .001). Compared with subjects who had a salpingectomy, those who had a tubal occlusion had more postoperative symptomatic anemia (5.7% vs 0.9%) and infection (6.9% vs 1.7%). The primary surgeon was identified by logistic regression as the factor most predictive of salpingectomy (p <.001). Of 30 physicians, 23 (77%) completed the survey, and these physicians performed 80% of procedures. Physicians did not differ by sex, age, years of practice, solo vs group practice, or hospital-employed vs private practice when compared with the number or rate of salpingectomies performed. Cancer risk reduction was the most common physician-identified salpingectomy benefit (17 of 23, 74%). A total of 65% believed that salpingectomy posed additional risks, but 70% believed the benefits were equal to or greater than the risks. Of the 23 (87%) who completed the survey, 20 believed that salpingectomy added no additional operative time and was cost-neutral. CONCLUSION Relative to tubal ligation, salpingectomy during cesarean section increases operative time but not perioperative morbidity. Physicians do not seem biased against salpingectomy and express awareness of published benefits and risks, yet it is not the dominant surgical approach.
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Affiliation(s)
- Deborah Levy
- Department of Obstetrics and Gynecology, College of Medicine, University of Cincinnati, Cincinnati, Ohio (Drs. Levy and Whiteside).
| | - Sarah Casey
- Department of Obstetrics and Gynecology, Advocate Aurora Health, Grafton, Wisconsin (Dr. Casey)
| | - Gregory Zemtsov
- Department of Obstetrics and Gynecology, School of Medicine, Duke University, Durham, North Carolina (Dr. Zemtsov)
| | - James L Whiteside
- Department of Obstetrics and Gynecology, College of Medicine, University of Cincinnati, Cincinnati, Ohio (Drs. Levy and Whiteside)
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de Oliveira Nunes M, Witt D, Casey S, Hoekstra N, Han B. Multi-modality Assessment Of Anatomic And Myocardial Tissue Characteristics Of Anomalous Aortic Origin Of The Right Coronay Artery In A Teenage Patient Presenting With Resuscited Sudden Cardiac Arrest. J Cardiovasc Comput Tomogr 2020. [DOI: 10.1016/j.jcct.2020.06.040] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Mohamed S, Kunz M, Casey S, Katsiyiannis W, Abdelhadi R, Storey K, Berg A, Schmidt C, Sengupta J. P1077Late gadolinium enhancement with cardiac magnetic resonance imaging demonstrates left ventricular involvement is under-recognized in arrhythmogenic right ventricular cardiomyopathy. Europace 2020. [DOI: 10.1093/europace/euaa162.138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Funding Acknowledgements
The study is partially funded by Medtronic and the Minneapolis Heart Institute Foundation.
Background/Introduction: Arrhythmogenic right ventricular cardiomyopathy (ARVC) is characterized by replacement of the myocardium with fibrous and fatty tissue that may lead to an increased risk of ventricular arrhythmias and heart failure. Although left ventricular (LV) and biventricular forms have been identified post-mortem resulting in the increased use of the term arrhythmogenic cardiomyopathy, there is only inclusion of right ventricular wall motion abnormalities in the taskforce diagnostic criteria.
Purpose
The aim of our study was to examine the utility of cardiac magnetic resonance (CMR) imaging in characterizing LV or biventricular involvement with late gadolinium enhancement (LGE) in a large cohort of patients with suspected ARVC.
Methods
Retrospective, single-institution, chart review of 76 patients diagnosed with ARVC between January 2009 and July 2019. Data collection and analysis included baseline demographics and parameters specific to diagnosis (definite, borderline, or possible) and risk stratification of ARVC based on 2019 modified taskforce criteria, as well as detailed CMR evaluation.
Results
Of the 76 patients with ARVC, 66 (87%) had at least one CMR with gadolinium administered. In that subset of patients, 27 (41%) had LGE. Of those with LGE, LV involvement was identified in 23 (85%) patients. The pattern of LGE was not localized to one myocardial region but demonstrated variable LV enhancement patterns including anterior, inferior, lateral, septal, basal, mid, apical, and from the sub-epicardium into the mid-myocardium.
Conclusions
Left ventricular involvement reflected by LGE was identified in a high percentage of patients with suspected ARVC, and there was significant variation in the pattern of distribution in terms of region and depth of myocardial involvement. While post-mortem examination of patients with ARVC demonstrates a high prevalence of left ventricular involvement, this study shows that CMR can consistently detect late gadolinium enhancement, and ARVC should be considered in the differential diagnosis for biventricular cardiomyopathy. The identification of variable locations of LGE within the LV suggests there is more than one phenotype, and this imaging modality may help to clarify the implications of left ventricular involvement in disease progression.
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Affiliation(s)
- S Mohamed
- Minneapolis Heart Institute Foundation, Minneapolis, United States of America
| | - M Kunz
- Minneapolis Heart Institute Foundation, Minneapolis, United States of America
| | - S Casey
- Minneapolis Heart Institute Foundation, Minneapolis, United States of America
| | - W Katsiyiannis
- Minneapolis Heart Institute at Abbott Northwestern Hospital, Minneapolis, United States of America
| | - R Abdelhadi
- Minneapolis Heart Institute at Abbott Northwestern Hospital, Minneapolis, United States of America
| | - K Storey
- Minneapolis Heart Institute Foundation, Minneapolis, United States of America
| | - A Berg
- Children"s Minnesota, Minneapolis, United States of America
| | - C Schmidt
- Minneapolis Heart Institute Foundation, Minneapolis, United States of America
| | - J Sengupta
- Minneapolis Heart Institute at Abbott Northwestern Hospital, Minneapolis, United States of America
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Abstract
Background The ankle brachial index (ABI) is widely used in clinical practice as a non-invasive method to detect the presence and severity of peripheral arterial disease (PAD). Current guidelines suggest that it should be used to monitor potential progression of PAD in affected individuals. As such, it is important that the test is reliable when used for repeated measurements, by the same or different health practitioners. This systematic review aims to examine the literature to evaluate the inter- and intra-rater reliability of the ABI. Methods A systematic search of MEDLINE, EMBASE and CINAHL Complete was conducted to 20 January 2019. Two authors independently reviewed and selected relevant studies and extracted the data. Methodological quality was determined using the Quality Appraisal of Reliability (QAREL) Checklist. Results Fifteen studies of ABI reliability in a range of patient populations were identified as suitable for inclusion in the review: seven considered inter-rater reliability, four intra-rater reliability, and four studies evaluated both inter- and intra-rater reliability. Inter-rater reliability was found to be highly variable, with intraclass correlation coefficients (ICC's) ranging from poor to excellent (ICC 0.42-1.00), while intra-rater also demonstrated considerable variation, with ICCs from 0.42-0.98. Meta-analysis was not possible due to the lack of statistical information reported. Conclusions Results of included studies suggest the inter- and intra-tester reliability of the ABI is acceptable. However, inconsistencies in obtaining systolic pressure measurements, calculating ABI values, and incomplete reporting of methodologies and statistical analysis make it difficult to determine the validity of the results of included studies. Further research, with more consistent reliability methodology, statistical analysis and reporting conducted in populations at risk of PAD is needed to conclusively determine the ABI reliability.
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Abstract
In a previous paper one of us (4) has elaborated a theory relating drug action to personality. According to this theory, depressant drugs increase cortical inhibition (Pavlov) or reactive inhibition (Hull), thus producing an extraverting effect on personality, while stimulant drugs decrease inhibition and produce an introverting effect in behaviour. It was also suggested in this paper that a direct proof of the hypothesis might be obtained by making predictions regard ing the effects of stimulant and depressant drugs on a variety of experimental laboratory situations connected with the general theory of inhibition and excitation.
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Murphy C, Elliott J, Casey S, King S, Docherty N, Ravi N, Beddy P, Reynolds J, le Roux C. Risk Factors for Loss of Bone Mineral Density After Curative Oesophagectomy. Int J Surg 2017. [DOI: 10.1016/j.ijsu.2017.08.047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Ackermann CL, Asa CS, Krisher R, Bauman K, Casey S, Lopes MD. Evaluation of follicular growth and tissue viability in vitrified/warmed domestic dog ovaries after in vitro culture. Reprod Domest Anim 2016; 52 Suppl 2:77-81. [DOI: 10.1111/rda.12823] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- CL Ackermann
- Department of Animal Reproduction and Veterinary Radiology; FMVZ; UNESP; Botucatu Brazil
| | - CS Asa
- Research Department; Saint Louis Zoo; Saint Louis MO USA
| | - R Krisher
- National Foundation for Fertility Research; Lone Tree CO USA
| | - K Bauman
- Research Department; Saint Louis Zoo; Saint Louis MO USA
| | - S Casey
- Research Department; Saint Louis Zoo; Saint Louis MO USA
| | - MD Lopes
- Department of Animal Reproduction and Veterinary Radiology; FMVZ; UNESP; Botucatu Brazil
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Abstract
The number of people forced to flee their homes and move around the world is increasing rapidly. Such refugee populations are not only more likely to have poor physical, mental and social health outcomes but also to experience difficulties accessing health services in their new country. In particular, children from refugee backgrounds are at increased risk of poor oral health which in time is associated with poor adult oral health and impacts on child health (e.g. growth and development) and well-being. To date, there is little evidence about the nature and extent of their oral health problems nor interventions to improve their oral health status. This article summarises the evidence surrounding the oral health status of children from refugee backgrounds. In addition, a systematic review of the international literature over the past 10 years is presented which identifies interventions to improve the oral health of these vulnerable paediatric populations. Based on this evidence, potential strategies available to dental service providers to optimise provision of responsive dental care are discussed.
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Affiliation(s)
- E Riggs
- Healthy Mothers Healthy Families, Murdoch Childrens Research Institute, The Royal Children's Hospital, Victoria, Australia.,General Practice and Primary Health Care Academic Centre, University of Melbourne, Victoria, Australia
| | - S Rajan
- Melbourne Dental School, The University of Melbourne, Melbourne, Victoria, Australia
| | - S Casey
- Sector Development & Partnerships, Foundation House, The Victorian Foundation for Survivors of Torture Inc, Melbourne, Victoria, Australia
| | - N Kilpatrick
- Cleft Services, Royal Children's Hospital, Melbourne, Victoria, Australia.,Department of Paediatrics, Murdoch Childrens Research Institute, University of Melbourne, Melbourne, Victoria, Australia
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29
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Walsh SM, Casey S, Kennedy R, Ravi N, Reynolds JV. Does the modified Glasgow Prognostic Score (mGPS) have a prognostic role in esophageal cancer? J Surg Oncol 2016; 113:732-7. [PMID: 27004839 DOI: 10.1002/jso.24225] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [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: 08/03/2015] [Accepted: 03/01/2016] [Indexed: 01/27/2023]
Abstract
BACKGROUND The modified Glasgow Prognostic Score (mGPS), which combines indices of decreased plasma albumin and elevated CRP, has reported independent prognostic significance in colorectal cancer, but its value in upper gastrointestinal cancer is unclear. The aim of this study was to assess the prognostic significance of mGPS in patients with operable esophageal malignancy. METHODS Patients undergoing resection with curative intent between January 2008 and June 2013 were included. The mGPS was scored as 0, 1, or 2 based on CRP(>10 mg/L) and albumin(<35g/L). The mGPS score (0 vs. 1/2 combined) was correlated with patient and tumor characteristics, and operative and oncologic outcomes. RESULTS Two hundred and twenty-three patients were included. Median (range) follow-up was 21(12-70) months. The mGPS was 0 in 174 patients(78%). mGPS was significantly associated with positive nodal status(P = 0.008) and stage ≥III (P = 0.017). There was a significant improvement in overall survival in patients with mGPS = 0 (47.8 vs. 37.5 months, P = 0.014) but in multivariate analysis, only TNM-stage and nodal status were found to be independent prognostic indicators. CONCLUSIONS mGPS is associated with advanced stage but has no independent prognostic significance and does not impact on operative outcomes. Consequently, this data does not support its routine application in patient selection or prognostication. J. Surg. Oncol. 2016;113:732-737. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Siun M Walsh
- National Centre for Esophageal and Gastric Cancer, St. James's Hospital, Dublin, Ireland
| | - Sarah Casey
- National Centre for Esophageal and Gastric Cancer, St. James's Hospital, Dublin, Ireland
| | - Raymond Kennedy
- National Centre for Esophageal and Gastric Cancer, St. James's Hospital, Dublin, Ireland
| | - Narayanasamy Ravi
- National Centre for Esophageal and Gastric Cancer, St. James's Hospital, Dublin, Ireland
| | - John V Reynolds
- National Centre for Esophageal and Gastric Cancer, St. James's Hospital, Dublin, Ireland
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Merkel K, Quick R, Casey S, Pillutla K, Ragsdale C, Fernandez M, Hauger S. Case Report: Application of Acyclovir Serum Concentrations and Herpes Simplex Virus Inhibitory Concentrations in the Treatment of Neonatal Disseminated Herpes Simplex Virus With Concomitant Extracorporeal Membrane Oxygenation and Continuous Veno-Venous Hemodiafiltration. Open Forum Infect Dis 2015. [DOI: 10.1093/ofid/ofv133.768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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31
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Fortune DG, Walsh RS, Waldron B, McGrath C, Harte M, Casey S, McClean B. Changes in aspects of social functioning depend upon prior changes in neurodisability in people with acquired brain injury undergoing post-acute neurorehabilitation. Front Psychol 2015; 6:1368. [PMID: 26441744 PMCID: PMC4561758 DOI: 10.3389/fpsyg.2015.01368] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2015] [Accepted: 08/25/2015] [Indexed: 11/30/2022] Open
Abstract
Post-acute community-based rehabilitation is effective in reducing disability. However, while social participation and quality of life are valued as distal outcomes of neurorehabilitation, it is often not possible to observe improvements on these outcomes within the limited time-frames used in most investigations of rehabilitation. The aim of the current study was to examine differences in the sequence of attainments for people with acquired brain injury (ABI) undergoing longer term post-acute neurorehabilitation. Participants with ABI who were referred to comprehensive home and community-based neurorehabilitation were assessed at induction to service, at 6 months and again at 1.5 years while still in service on the Mayo-Portland Adaptability Index (MPAI-4), Community Integration Questionnaire, Hospital Anxiety and Depression Scale, and World Health Organisation Quality of Life measure. At 6 months post-induction to service, significant differences were evident in MPAI abilities, adjustment, and total neurodisability; and in anxiety and depression. By contrast, there was no significant effect at 6 months on more socially oriented features of experience namely quality of life (QoL), Community Integration and Participation. Eighteen month follow-up showed continuation of the significant positive effects with the addition of QoL-related to physical health, Psychological health, Social aspects of QoL and Participation at this later time point. Regression analyses demonstrated that change in QoL and Participation were dependent upon prior changes in aspects of neurodisability. Age, severity or type of brain injury did not significantly affect outcome. Results suggest that different constructs may respond to neurorehabilitation at different time points in a dose effect manner, and that change in social aspects of experience may be dependent upon the specific nature of prior neurorehabilitation attainments.
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Affiliation(s)
- Dónal G Fortune
- Centre for Social Issues, Department of Psychology, University of Limerick Limerick, Ireland ; Acquired Brain Injury Ireland Dun Laoghaire, Ireland
| | - R Stephen Walsh
- Centre for Social Issues, Department of Psychology, University of Limerick Limerick, Ireland ; Acquired Brain Injury Ireland Dun Laoghaire, Ireland
| | - Brian Waldron
- Acquired Brain Injury Ireland Dun Laoghaire, Ireland
| | | | - Maurice Harte
- Acquired Brain Injury Ireland Dun Laoghaire, Ireland
| | - Sarah Casey
- Acquired Brain Injury Ireland Dun Laoghaire, Ireland
| | - Brian McClean
- Acquired Brain Injury Ireland Dun Laoghaire, Ireland
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Sonter JA, Chuter V, Casey S. Intratester and Intertester Reliability of Toe Pressure Measurements in People with and Without Diabetes Performed by Podiatric Physicians. J Am Podiatr Med Assoc 2015; 105:201-8. [PMID: 26147086 DOI: 10.7547/0003-0538-105.3.201] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
BACKGROUND Toe pressures and the toe brachial index (TBI) represent possible screening tools for peripheral arterial disease; however, limited evidence is available regarding their reliability. The aim of this study was to determine intratester and intertester reliability of toe systolic pressure and the TBI in participants with and without diabetes performed by podiatric physicians. METHODS Two podiatric physicians performed toe and brachial pressure measurements on 80 participants, 40 with and 40 without diabetes, during two testing sessions using photoplethysmography and Doppler probe. Intraclass correlation coefficients (ICCs) and 95% limits of agreement were determined. RESULTS In people with diabetes, intratester reliability of toe pressure measurement was excellent for both testers (ICCs, 0.84 and 0.82). Reliability of the TBI was good (ICCs, 0.72 and 0.75) and brachial pressure fair (ICCs, 0.43 and 0.55). The intertester reliability of toe pressure (ICC, 0.82) and the TBI (ICC, 0.80) was excellent. Intertester reliability of brachial pressure was reduced in people with diabetes (ICC, 0.49). In age-matched participants, intratester reliability of toe pressure measurement was excellent for both testers (ICCs, 0.83 and 0.87), and reliability of the TBI (ICCs, 0.74 and 0.80) and brachial pressure (ICCs, 0.73 and 0.78) was good to excellent. Intertester reliability of toe pressure (ICC, 0.84), the TBI (ICC, 0.81), and brachial pressure (ICC, 0.77) was excellent. CONCLUSIONS Toe pressures and the TBI demonstrated excellent reliability in people with and without diabetes and can be an effective component of lower-extremity vascular screening. However, wide limits of agreement relative to blood pressure values for both cohorts indicate that results should be interpreted with caution.
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Affiliation(s)
- Jennifer A. Sonter
- University of Newcastle, School of Health Sciences, Ourimbah, New South Wales, Australia
| | - Vivienne Chuter
- University of Newcastle, School of Health Sciences, Ourimbah, New South Wales, Australia
| | - Sarah Casey
- University of Newcastle, School of Health Sciences, Ourimbah, New South Wales, Australia
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Casey S, Louie A, Rodrigues G, Palma D, Yaremko B, Dar A, Yu E, Aivas I, Warner A, Gaede S. The Impact of Respiratory Gating on Toxicity Outcomes for Locally-Advanced Lung Cancer Treated With Radical Intensity Modulated Radiation Therapy and Chemotherapy. Int J Radiat Oncol Biol Phys 2013. [DOI: 10.1016/j.ijrobp.2013.06.1399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Woodell A, Coughlin B, Kunchithapautham K, Casey S, Williamson T, Ferrell WD, Atkinson C, Jones BW, Rohrer B. Alternative complement pathway deficiency ameliorates chronic smoke-induced functional and morphological ocular injury. PLoS One 2013; 8:e67894. [PMID: 23825688 PMCID: PMC3692454 DOI: 10.1371/journal.pone.0067894] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.0] [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: 01/11/2013] [Accepted: 05/23/2013] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Age-related macular degeneration (AMD), a complex disease involving genetic variants and environmental insults, is among the leading causes of blindness in Western populations. Genetic and histologic evidence implicate the complement system in AMD pathogenesis; and smoking is the major environmental risk factor associated with increased disease risk. Although previous studies have demonstrated that cigarette smoke exposure (CE) causes retinal pigment epithelium (RPE) defects in mice, and smoking leads to complement activation in patients, it is unknown whether complement activation is causative in the development of CE pathology; and if so, which complement pathway is required. METHODS Mice were exposed to cigarette smoke or clean, filtered air for 6 months. The effects of CE were analyzed in wildtype (WT) mice or mice without a functional complement alternative pathway (AP; CFB(-/-) ) using molecular, histological, electrophysiological, and behavioral outcomes. RESULTS CE in WT mice exhibited a significant reduction in function of both rods and cones as determined by electroretinography and contrast sensitivity measurements, concomitant with a thinning of the nuclear layers as measured by SD-OCT imaging and histology. Gene expression analyses suggested that alterations in both photoreceptors and RPE/choroid might contribute to the observed loss of function, and visualization of complement C3d deposition implies the RPE/Bruch's membrane (BrM) complex as the target of AP activity. RPE/BrM alterations include an increase in mitochondrial size concomitant with an apical shift in mitochondrial distribution within the RPE and a thickening of BrM. CFB(-/-) mice were protected from developing these CE-mediated alterations. CONCLUSIONS Taken together, these findings provide clear evidence that ocular pathology generated in CE mice is dependent on complement activation and requires the AP. Identifying animal models with RPE/BrM damage and verifying which aspects of pathology are dependent upon complement activation is essential for developing novel complement-based treatment approaches for the treatment of AMD.
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Affiliation(s)
- Alex Woodell
- Division of Research, Department of Neurosciences, Medical University of South Carolina, Charleston, South Carolina, United States of America
| | - Beth Coughlin
- Department of Ophthalmology, Medical University of South Carolina, Charleston, South Carolina, United States of America
| | - Kannan Kunchithapautham
- Department of Ophthalmology, Medical University of South Carolina, Charleston, South Carolina, United States of America
| | - Sarah Casey
- Department of Microbiology and Immunology, Medical University of South Carolina, Charleston, South Carolina, United States of America
| | - Tucker Williamson
- Department of Microbiology and Immunology, Medical University of South Carolina, Charleston, South Carolina, United States of America
| | - W. Drew Ferrell
- Moran Eye Center, University of Utah, Salt Lake City, Utah, United States of America
| | - Carl Atkinson
- Department of Microbiology and Immunology, Medical University of South Carolina, Charleston, South Carolina, United States of America
| | - Bryan W. Jones
- Moran Eye Center, University of Utah, Salt Lake City, Utah, United States of America
| | - Bärbel Rohrer
- Division of Research, Department of Neurosciences, Medical University of South Carolina, Charleston, South Carolina, United States of America
- Department of Ophthalmology, Medical University of South Carolina, Charleston, South Carolina, United States of America
- Research Service, Ralph H. Johnson VA Medical Center, Charleston, South Carolina, United States of America
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Atkinson C, Floerchinger B, Qiao F, Casey S, Williamson T, Moseley E, Stoica S, Goddard M, Ge X, Tullius SG, Tomlinson S. Donor brain death exacerbates complement-dependent ischemia/reperfusion injury in transplanted hearts. Circulation 2013; 127:1290-9. [PMID: 23443736 DOI: 10.1161/circulationaha.112.000784] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
BACKGROUND Brain death (BD) can immunologically prime the donor organ and is thought to lead to exacerbated ischemia/reperfusion injury after transplantation. Using a newly developed mouse model of BD, we investigated the effect of donor BD on posttransplantation cardiac ischemia/reperfusion injury. We further investigated the therapeutic effect of a targeted complement inhibitor in recipients of BD donor hearts and addressed the clinical relevance of these studies by analyzing human heart biopsies from BD and domino (living) donors. METHODS AND RESULTS Hearts from living or BD donor C57BL/6 mice were transplanted into C57BL/6 or BALB/c recipients. Recipient mice were treated with the complement inhibitor CR2-Crry or vehicle control (n=6). Isografts were analyzed 48 hours after transplantation for injury, inflammation, and complement deposition, and allografts were monitored for graft survival. Human cardiac biopsies were analyzed for complement deposition and inflammatory cell infiltration. In the murine model, donor BD exacerbated ischemia/reperfusion injury and graft rejection, as demonstrated by increased myocardial injury, serum cardiac troponin, cellular infiltration, complement deposition, inflammatory chemokine and cytokine levels, and by decreased graft survival. CR2-Crry treatment of recipients significantly reduced all measured outcomes in grafts from both BD and living donors compared with controls. Analysis of human samples documented the relevance of our experimental findings and revealed exacerbated complement deposition and inflammation in grafts from BD donors compared with grafts from living donors. CONCLUSIONS BD exacerbates posttransplantation cardiac ischemia/reperfusion injury in mice and humans and decreases survival of mouse allografts. Furthermore, targeted complement inhibition in recipient mice ameliorates BD-exacerbated ischemia/reperfusion injury.
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Affiliation(s)
- Carl Atkinson
- Department of Microbiology and Immunology, Medical University of South Carolina, Charleston, SC 29425, USA
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Casey S, Louie A, Rodrigues G, Palma D, Yaremko B, Dar A, Yu E, Aivas I, Warner A, Gaede S. Impact of Respiratory Gating on Toxicity Outcomes for Locally Advanced Lung Cancer Treated With Radical Chemoradiation Therapy. Int J Radiat Oncol Biol Phys 2012. [DOI: 10.1016/j.ijrobp.2012.07.1479] [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: 10/27/2022]
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Shanmugam G, Casey S, Barrowman N, Neira V, Maharajh G. 100 Comparison of the Aristotle and RACHS Scores to Predict Morbidity in Congenital Cardiac Surgery. Can J Cardiol 2012. [DOI: 10.1016/j.cjca.2012.07.109] [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: 10/27/2022] Open
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Ngoyi E, Casey S, Gallagher M, Meyers J. Increasing family planning use in conflict-affected Democratic Republic of the Congo: results from a population-based survey in Kasongo health zone. Contraception 2012. [DOI: 10.1016/j.contraception.2012.04.045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Gault EJ, Perry RJ, Cole TJ, Casey S, Paterson WF, Hindmarsh PC, Betts P, Dunger DB, Donaldson MDC. Effect of oxandrolone and timing of pubertal induction on final height in Turner's syndrome: randomised, double blind, placebo controlled trial. BMJ 2011; 342:d1980. [PMID: 21493672 PMCID: PMC3076731 DOI: 10.1136/bmj.d1980] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVE To examine the effect of oxandrolone and the timing of pubertal induction on final height in girls with Turner's syndrome receiving a standard dose of growth hormone. DESIGN Randomised, double blind, placebo controlled trial. Setting 36 paediatric endocrinology departments in UK hospitals. PARTICIPANTS Girls with Turner's syndrome aged 7-13 years at recruitment, receiving recombinant growth hormone therapy (10 mg/m(2)/week). INTERVENTIONS Participants were randomised to oxandrolone (0.05 mg/kg/day, maximum 2.5 mg/day) or placebo from 9 years of age. Those with evidence of ovarian failure at 12 years were further randomised to oral ethinylestradiol (year 1, 2 µg daily; year 2, 4 μg daily; year 3, 4 months each of 6, 8, and 10 μg daily) or placebo; participants who received placebo and those recruited after the age of 12.25 years started ethinylestradiol at age 14. MAIN OUTCOME MEASURE Final height. Results 106 participants were recruited, of whom 14 withdrew and 82/92 reached final height. Both oxandrolone and late pubertal induction increased final height: by 4.6 (95% confidence interval 1.9 to 7.2) cm (P = 0.001, n = 82) for oxandrolone and 3.8 (0.0 to 7.5) cm (P = 0.05, n = 48) for late pubertal induction with ethinylestradiol. In the 48 children who were randomised twice, the effects on final height (compared with placebo and early induction of puberty) of oxandrolone alone, late induction alone, and oxandrolone plus late induction were similar, averaging 7.1 (3.4 to 10.8) cm (P < 0.001). No cases of virilisation were reported. CONCLUSION Oxandrolone had a positive effect on final height in girls with Turner's syndrome treated with growth hormone, as did late pubertal induction with ethinylestradiol at age 14 years. However, these effects were not additive, so using both had no advantage. Oxandrolone could, therefore, be offered as an alternative to late pubertal induction for increasing final height in Turner's syndrome. Trial registration Current Controlled Trials ISRCTN50343149.
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Affiliation(s)
- Emma Jane Gault
- University of Glasgow Department of Child Health, Royal Hospital for Sick Children, Glasgow G3 8SJ, UK
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Atkinson C, He S, Morris K, Qiao F, Casey S, Goddard M, Tomlinson S. Targeted complement inhibitors protect against posttransplant cardiac ischemia and reperfusion injury and reveal an important role for the alternative pathway of complement activation. J Immunol 2010; 185:7007-13. [PMID: 20962256 DOI: 10.4049/jimmunol.1001504] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Ischemia reperfusion injury (IRI) is an unavoidable event during solid organ transplantation and is a major contributor to early graft dysfunction and subsequent graft immunogenicity. In a therapeutic paradigm using targeted complement inhibitors, we investigated the role of complement, and specifically the alternative pathway of complement, in IRI to heart isografts. Mouse heterotopic isograft heart transplants were performed in C57BL/6 mice treated with a single injection of either CR2-Crry (inhibits all complement pathways) or CR2-fH (inhibits alternative complement pathway) immediately posttransplantation. Transplanted hearts were harvested at 12 and 48 h for analysis. Both inhibitors resulted in a significant reduction in myocardial IRI, as measured by histology and serum cardiac troponin I levels. Furthermore, compared with untreated controls, both inhibitors reduced graft complement deposition, neutrophil and macrophage infiltration, adhesion molecule expression (P-selectin, E-selectin, and I-CAM-1), and proinflammatory cytokine expression (TNF-α, IL-1β, KC, and MCP-1). The reduction in myocardial damage and cellular infiltration was not significantly different between CR2-Crry- and CR2-fH-treated mice, although adhesion molecule and cytokine levels were significantly lower in CR2-Crry-treated mice compared with CR2-fH-treated mice. In conclusion, the alternative complement pathway plays a major contributing role in myocardial IRI after heart transplantation, and local (targeted) complement inhibition has the potential to provide an effective and safe therapeutic strategy to reduce graft injury. Although total complement blockade may be somewhat more efficacious in terms of reducing inflammation, specific blockade of the alternative pathway is likely to be less immunosuppressive in an already immunocompromised recipient.
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Affiliation(s)
- Carl Atkinson
- Department of Microbiology and Immunology, Children's Research Institute, Medical University of South Carolina, Charleston, SC 29425, USA
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Atkinson C, He S, Morris K, Casey S, Goddard M, Tomlinson S. Targeted complement inhibition significantly ameliorates ischemia reperfusion induced isograft inflammation in a murine model of cardiac transplantation. Mol Immunol 2010. [DOI: 10.1016/j.molimm.2010.05.026] [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: 11/24/2022]
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Casey S, Qiao F, Elvington A, Tomlinson S, Atkinson C. Complement deficiency ameliorates cigarette smoke induced lung injury. Mol Immunol 2010. [DOI: 10.1016/j.molimm.2010.05.263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Awad S, Simpson E, Wright J, Casey S, Macdonald I, Lobo D. OP050 ORAL 13C-BICARBONATE TRACER TECHNIQUE VERSUS INDIRECT CALORIMETRY FOR MEASUREMENT OF ENERGY EXPENDITURE AT REST AND DURING EXERCISE IN HEALTHY ADULTS: A PROSPECTIVE RANDOMISED VALIDATION STUDY. ACTA ACUST UNITED AC 2010. [DOI: 10.1016/s1744-1161(10)70076-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Borowitz D, Konstan M, Goss C, Limauro S, Murray E, Casey S. 242 Treatment with ALTU-135 results in a positive inverse relationship between coefficient of fat absorption with stool weight in subjects with Cystic Fibrosis-related pancreatic insufficiency. J Cyst Fibros 2006. [DOI: 10.1016/s1569-1993(06)80219-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Heywood D, Vrettou C, Wood J, Hill J, Casey S, Cornwell P. Investigating the relationship between the hair fiber proteome and hair quality. Int J Cosmet Sci 2004. [DOI: 10.1111/j.1467-2494.2004.00230_3.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Affiliation(s)
- S. Casey
- Joule Laboratory, Department of Physics, University of Salford, Salford M5 4WT, U.K.
| | - E. Hill
- University of Manchester, School of Engineering, Division of Electrical Engineering, Manchester M13 9PL, U.K.
| | - J. Miles
- University of Manchester, School of Engineering, Division of Electrical Engineering, Manchester M13 9PL, U.K.
| | - P. Sivasamy
- University of Manchester, School of Engineering, Division of Electrical Engineering, Manchester M13 9PL, U.K.
| | - K. Birtwistle
- University of Manchester, School of Engineering, Division of Electrical Engineering, Manchester M13 9PL, U.K.
| | - B. Middleton
- University of Manchester, School of Engineering, Division of Electrical Engineering, Manchester M13 9PL, U.K.
| | - D. Joyce
- Joule Laboratory, Department of Physics, University of Salford, Salford M5 4WT, U.K.
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Brown MA, Goldstein-Shirley J, Robinson J, Casey S. The effects of a multi-modal intervention trial of light, exercise, and vitamins on women's mood. Women Health 2002; 34:93-112. [PMID: 11708689 DOI: 10.1300/j013v34n03_06] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
The purpose of this study was to test the efficacy of a tri-modal intervention (LEVITY) to improve women's mood. This eight-week randomized experiment with a placebo-control group targeted women with symptoms of mild to moderate depression. Women in the intervention group were instructed to take a brisk 20-minute outdoor walk at target heart rate of 60% of maximum heart rate, to increase light exposure throughout the day and to take a specific vitamin regimen. Women in the control group took a daily placebo vitamin. The sample consisted of 112 women ages 19-78 who reported mild to moderate depressive symptoms. They were in otherwise good health and were not currently taking any mood-altering medication. Pre- and post-intervention assessment utilized live measures of mood: Center for Epidemiology Studies Depression Scale, Profile of Mood States, Depression-Happiness Scale, Rosenberg Self-Esteem Scale, and the General Well-Being Schedule. Analysis of covariance indicated that the intervention was effective in improving women's overall mood, self-esteem, and general sense of well-being and in decreasing symptoms on two measures of depression. Of particular note, the data from all five outcome measures supported the efficacy of the intervention. In addition, a high level of adherence to the intervention protocol was observed with two-thirds of the women reporting 100% adherence. Study implications suggest that this type of intervention may provide an effective, clinically manageable therapy for mild-to-moderately depressed women who prefer a self-directed approach or who have difficulties with the cost or side-effects of medication or psychotherapy.
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Affiliation(s)
- M A Brown
- University of Washington, Seattle 98195, USA
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Casey S. "T2 washout": an explanation for normal diffusion-weighted images despite abnormal apparent diffusion coefficient maps. AJNR Am J Neuroradiol 2001; 22:1450-1. [PMID: 11559488 PMCID: PMC7974568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/21/2023]
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