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Tietschert M, Higgins S, Haynes A, Sadun R, Singer SJ. Safe Surgery Checklist Implementation: Associations of Management Practice and Safety Culture Change. Adv Health Care Manag 2024; 22:117-140. [PMID: 38262013 DOI: 10.1108/s1474-823120240000022006] [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] [Indexed: 01/25/2024]
Abstract
Designing and developing safe systems has been a persistent challenge in health care, and in surgical settings in particular. In efforts to promote safety, safety culture, i.e., shared values regarding safety management, is considered a key driver of high-quality, safe healthcare delivery. However, changing organizational culture so that it emphasizes and promotes safety is often an elusive goal. The Safe Surgery Checklist is an innovative tool for improving safety culture and surgical care safety, but evidence about Safe Surgery Checklist effectiveness is mixed. We examined the relationship between changes in management practices and changes in perceived safety culture during implementation of safe surgery checklists. Using a pre-posttest design and survey methods, we evaluated Safe Surgery Checklist implementation in a national sample of 42 general acute care hospitals in a leading hospital network. We measured perceived management practices among managers (n = 99) using the World Management Survey. We measured perceived preoperative safety and safety culture among clinical operating room personnel (N = 2,380 (2016); N = 1,433 (2017)) using the Safe Surgical Practice Survey. We collected data in two consecutive years. Multivariable linear regression analysis demonstrated a significant relationship between changes in management practices and overall safety culture and perceived teamwork following Safe Surgery Checklist implementation.
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Gnoni V, Wasserman D, Duncan I, Tsai CC, Cash D, Higgins S, Drakatos P, Nesbitt A, Leschziner G, O'Regan D, Rosenzweig I. Cognitive dysfunction in ‘pure’ OSA patients without any other comorbidities. Sleep Med 2022. [DOI: 10.1016/j.sleep.2022.05.649] [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: 10/17/2022]
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Dryden B, Kerr WB, Higgins S, Tou K, Dhanjal ST. The Use of Intravenous Lidocaine as an Analgesic Modality in the Austere Environment: Two Cases. Wilderness Environ Med 2022; 33:348-350. [PMID: 35817674 DOI: 10.1016/j.wem.2022.04.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 04/28/2022] [Accepted: 04/29/2022] [Indexed: 11/30/2022]
Abstract
Providing effective analgesia for trauma in austere settings is particularly difficult and often complicated by equipment and medication limitations and harsh environmental conditions. Common modalities that are employed in conventional clinical practices may not be available or pragmatic in austere environments. Furthermore, side effects such as sedation, altered mentation, or hypoxemia require additional resources and attention. We report 2 cases that demonstrate the use of intravenous lidocaine for the management of acute pain, secondary to trauma, in an austere environment. In the first, the administration of intravenous lidocaine reduced pain, secondary to a tibia fracture, thereby facilitating splinting. In the second, a patient, who had sustained rib fractures, was also treated with intravenous lidocaine. In this case, the analgesic effects of the medication resulted in reduction in pain and improvement in pulmonary function. Of note, the narrow therapeutic window of this modality was made evident as both patients transiently experienced tinnitus following the initial lidocaine bolus. This report describes 2 cases in which intravenous lidocaine was used to manage acute pain, in an austere environment, while avoiding many of the detrimental effects that accompany alternative analgesics.
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Affiliation(s)
- Bryce Dryden
- Earth Mission, Siloam Springs, AR; Special Warfare Medical Group (Airborne), Joint Special Operations Medical Training Center, Fort Bragg, NC
| | - Win B Kerr
- Special Warfare Medical Group (Airborne), Joint Special Operations Medical Training Center, Fort Bragg, NC
| | - Sophie Higgins
- Anesthesiology, San Antonio Uniformed Services Health Education Consortium, JBSA Fort Sam, Houston, TX
| | - Kevin Tou
- Special Warfare Medical Group (Airborne), Joint Special Operations Medical Training Center, Fort Bragg, NC
| | - Sandeep T Dhanjal
- Anesthesiology, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC.
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James D, Kang P, Facey J, Toro M, Walker N, Higgins S, Cineus B. Barriers and Motivators to Participating in Online Weight Management Communities among African American Women. J Acad Nutr Diet 2021. [DOI: 10.1016/j.jand.2021.06.032] [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: 10/20/2022]
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Lobl M, Clarey D, Higgins S, Sutton A, Wysong A. 653 Sequencing of cutaneous squamous cell carcinoma primary tumors and patient-matched metastases reveals ALK as a driver in metastases and low mutational concordance in immunocompromised patients. J Invest Dermatol 2021. [DOI: 10.1016/j.jid.2021.02.683] [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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Zuniga C, Wollum A, Grindlay K, Douglas-Durham E, Higgins S, Barr-Walker J, Blanchard K. The impacts of contraceptive stock-outs on users, providers, and facilities: A systematic literature review. Glob Public Health 2020; 17:83-99. [PMID: 33253043 DOI: 10.1080/17441692.2020.1850829] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Contraceptive stock-outs are a world-wide problem, yet published research on the impacts of contraceptive stock-outs have not been comprehensively reviewed and synthesised. This systematic review highlights findings about the impacts of contraceptive stock-outs on users, providers, and facilities and identifies topics that should be explored to ensure everyone can access their preferred method of contraception. We systematically searched PubMed, Embase, Web of Science, Popline, and JSTOR for studies addressing the impacts of contraceptive stock-outs. Of 435 studies, 25 publications addressed the impacts of contraceptive stock-outs. Only two articles focused solely on contraceptive stock-outs; the remaining studies examined stock-outs alongside other factors that may influence contraceptive service provision. Studies discussed how stock-outs limited individuals' ability to use their preferred contraceptive method, influenced where contraceptive methods were obtained and how much they cost, and limited providers' and facilities' abilities to provide contraceptive care. Comparing the impacts of contraceptive stock-outs across studies was challenging, as reliability of stock was sometimes not distinguished from overall method availability, and studies used variable methods to measure stock-outs. Evidence presented in this review can inform efforts to ensure that preferred contraceptive methods are consistently available and accessible to all.
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Affiliation(s)
| | | | | | | | | | - Jill Barr-Walker
- ZSFG Library, University of California, San Francisco, MA, USA.,Department of Obstetrics, Gynecology & Reproductive Sciences, University of California, San Francisco, MA, USA
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Barker E, Leslie-Dakers M, Higgins S, Barnes T, McGrail S, Webster A, Goldsworthy S. PO-1936: Establishing the acceptability of a gold standard in IGRT assessment for radiation therapists. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)01953-8] [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: 10/22/2022]
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Treager C, Lopachin T, Higgins S, Friedrich E, Stuart S. 334 A Comparison of Novel Tourniquet Designs. Ann Emerg Med 2020. [DOI: 10.1016/j.annemergmed.2020.09.349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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9
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Pérez-Carbonell L, Higgins S, Koutroumanidis M, Leschziner G. [Sleep-disordered breathing as a consequence of vagus nerve stimulation]. Rev Neurol 2020; 70:179-182. [PMID: 32100278 DOI: 10.33588/rn.7005.2019332] [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: 11/24/2022]
Abstract
INTRODUCTION Vagus nerve stimulation (VNS) is indicated in cases of refractory epilepsy. Its side effects are frequently minor, however, breathing disturbances during sleep have been previously reported. CASE REPORTS Our three cases are representative of sleep-disordered breathing that occurred as a consequence of VNS activity in patients with refractory epilepsy. Sleep apnoea was observed in two patients and stridor in one patient. CONCLUSIONS Given the high prevalence of sleep apnoea-hypopnoea syndrome in patients with refractory epilepsy, implantation of VNS should be ideally preceded by an assessment of the breathing during sleep. Furthermore, sleep-disordered breathing should be considered as a rare complication of VNS, and sleep apnoea should be investigated alongside data regarding VNS firing.
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Affiliation(s)
| | - S Higgins
- Guy's and St Thomas' NHS Foundation Trust, London, Reino Unido
| | | | - G Leschziner
- Guy's and St Thomas' NHS Foundation Trust, London, Reino Unido
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Liao Y, Benson J, Higgins S, Drakatos P, Kaler J, O'Regan D, Tsai CC, Gnoni V, Muza R, Nesbitt A, Young A, Stokes P, Leschziner G, Rosenzweig I. Sleep architecture and comorbid sleep disorders in patients with bipolar affective disorder and recurrent depressive disorder. Sleep Med 2019. [DOI: 10.1016/j.sleep.2019.11.357] [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: 11/25/2022]
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Kang J, Tsai CC, Hasegawa H, Morris-Paterson T, Higgins S, Crum W, Gnoni V, Green D, Gunasinghe C, Nesbitt A, Williams S, Milosevic M, Ashkan K, Goadsby P, Leschziner G, Harridge S, Rosenzweig I. The effect of hyper-buoyancy floatation (HBF), a model of simulated microgravity, on sleep and cognitive function in humans. Sleep Med 2019. [DOI: 10.1016/j.sleep.2019.11.1091] [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: 11/25/2022]
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Garrity B, Berry J, Crofton C, Ward E, Cox J, Glader L, Bastianelli L, Emans J, Glotzbecker M, Emara N, Salem J, Jabur T, Higgins S, Shapiro J, Singer S. Parent-to-Parent Advice on Considering Spinal Fusion in Children with Neuromuscular Scoliosis. J Pediatr 2019; 213:149-154. [PMID: 31253410 DOI: 10.1016/j.jpeds.2019.05.055] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Revised: 05/03/2019] [Accepted: 05/21/2019] [Indexed: 12/27/2022]
Abstract
OBJECTIVES To convey advice from families whose children recently underwent spinal fusion to families whose children are under consideration for initial spinal fusion for neuromuscular scoliosis and to providers who counsel families on this decision. STUDY DESIGN We interviewed 18 families of children who underwent spinal fusion between August 2017 and January 2019 at a freestanding children's hospital. We conducted phone interviews a median of 65 (IQR 51-77) days after surgery. We audio recorded, transcribed, and coded (line-by-line) interviews using grounded theory by 2 independent reviewers, and discussed among investigators to induce themes associated with surgical decision making and preparation. RESULTS Six themes emerged about decision making and preparation for spinal fusion: (1) simplify risks and benefits; it is easy to get lost in the details; (2) families prolonging the decision whether or not to pursue spinal fusion surgery may not benefit the child; (3) anticipate anxiety and fear when making a decision about spinal fusion; (4) realize that your child might experience a large amount of pain; (5) anticipate a long recovery and healing process after spinal fusion; and (6) be engaged and advocate for your child throughout the perioperative spinal fusion process. CONCLUSIONS Parents of children who had recently undergone spinal fusion had strong perceptions about what information to convey to families considering surgery, which may improve communication between future parents and physicians. Further investigation is needed to assess how best to incorporate the wisdom and experiences of parent peers into shared decision making and preparation for spinal fusion in children with neuromuscular scoliosis.
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Affiliation(s)
- Brigid Garrity
- Division of General Pediatrics, Boston Children's Hospital, Harvard Medical School, Boston, MA
| | - Jay Berry
- Division of General Pediatrics, Boston Children's Hospital, Harvard Medical School, Boston, MA.
| | - Charis Crofton
- Division of General Pediatrics, Boston Children's Hospital, Harvard Medical School, Boston, MA
| | - Erin Ward
- Division of General Pediatrics, Boston Children's Hospital, Harvard Medical School, Boston, MA
| | - Joanne Cox
- Division of General Pediatrics, Boston Children's Hospital, Harvard Medical School, Boston, MA
| | - Laurie Glader
- Division of General Pediatrics, Boston Children's Hospital, Harvard Medical School, Boston, MA
| | | | - John Emans
- Department of Orthopaedic Surgery, Boston Children's Hospital, Boston, MA
| | | | - Norah Emara
- Division of General Pediatrics, Boston Children's Hospital, Harvard Medical School, Boston, MA
| | - Joseph Salem
- Healthcare Systems Engineering Institute, Northeastern University, Boston, MA; North Shore Medical Center, Salem, MA
| | - Tiago Jabur
- Department of Orthopaedic Surgery, Boston Children's Hospital, Boston, MA
| | | | - Jillian Shapiro
- Division of General Pediatrics, Boston Children's Hospital, Harvard Medical School, Boston, MA
| | - Sara Singer
- Department of Medicine, Stanford University School of Medicine, Stanford, CA
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Hochreiter A, Kelly J, Young M, Litkouhi B, Black J, Stromberger C, Higgins S, Schwartz P, Damast S. Outcomes of FIGO 2009 stage IB grade 2 or 3 endometrioid endometrial adenocarcinoma treated with adjuvant vaginal brachytherapy following comprehensive surgical staging. Gynecol Oncol 2019. [DOI: 10.1016/j.ygyno.2019.04.674] [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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Chowdhary M, Lee A, Gao S, Barry P, Diaz R, Bagadiya N, Park H, Yu J, Wilson L, Moran M, Higgins S, Knowlton C, Patel K. PV-0045 Is proton therapy a "pro" for breast cancer? A comparison of proton vs. non-proton RT using the NCDB. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)30465-7] [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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Pérez-Carbonell L, Higgins S, Koutroumanidis M, Leschziner G. TP3-7 Sleep-disordered breathing as a consequence of vagal nerve stimulation. J Neurol Neurosurg Psychiatry 2019. [DOI: 10.1136/jnnp-2019-abn.62] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
ObjectivesVagal nerve stimulation (VNS) is a neuromodulatory therapy indicated in drug-resistant epilepsy (DRE). Its side effects are frequently minor, however, sleep-disordered breathing (SDB) has been previously reported.1Obstructive sleep apnoea (OSA) is highly prevalent in individuals with refractory epilepsy, and may be a cause of poor control of seizures.2MethodsThree DRE patients with active VNS underwent a video-polysomnography with 21-channel montage electroencephalography in our centre.ResultsFirst and second patients showed OSA at the time of VNS activation. In the first patient, the apnoeic-induced arousals triggered VNS auto-firing and consequent respiratory events, perpetuating the SDB. The third patient had episodes of stridor, and an increased respiratory rate, coinciding with VNS activation. Our cases are representative of different forms of SDB that occurred as a consequence of the switch-on phase of the VNS device.ConclusionsSleep-related breathing disturbances should be considered before VNS implantation, and should be routinely assessed after having started the therapy. Changes in stimulation parameters, and positive airway pressure therapy, may be required to treat the SDB.
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Abstract
Trauma is the leading non-obstetric cause of maternal death. Optimal management of the pregnant trauma patient requires a multidisciplinary approach. The anaesthetist and critical care physician play a pivotal role in the entire continuum of fetomaternal care, from initial assessment, resuscitation and intraoperative management, to postoperative care that often involves critical care support and patient transfer. Primary goals are aggressive resuscitation of the mother and maintenance of uteroplacental perfusion and fetal oxygenation by the avoidance of hypoxia, hypotension, hypocapnia, acidosis and hypothermia. Recognizing and understanding the mechanisms of injury, the factors that may predict fetal outcome, and the pathophysiological changes that can result from trauma, will allow early identification and treatment of fetomaternal injury. This in turn should improve morbidity and mortality. A framework for the acute care of the pregnant trauma patient is presented.
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Affiliation(s)
- L Weinberg
- Department of Anaesthesia, Austin Health, Heidelberg, Victoria
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Smith V, Begley C, Newell J, Higgins S, Murphy DJ, White MJ, Morrison JJ, Canny S, O'Donovan D, Devane D. Admission cardiotocography versus intermittent auscultation of the fetal heart in low-risk pregnancy during evaluation for possible labour admission - a multicentre randomised trial: the ADCAR trial. BJOG 2018; 126:114-121. [PMID: 30126064 DOI: 10.1111/1471-0528.15448] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/02/2018] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To assess the effect of admission cardiotocography (ACTG) versus intermittent auscultation (IA) of the fetal heart (FH) in low-risk pregnancy during assessment for possible labour on caesarean section rates. DESIGN A parallel multicentre randomised trial. SETTING Three maternity units in the Republic of Ireland. POPULATION Healthy, low-risk pregnant women, at term and ≥ 18 years old, who provided written informed consent. METHODS Women were randomised to receive IA of the FH or 20 minutes ACTG on admission for possible labour onset, using remote telephone randomisation. Both groups received IA during labour, with conversion to continuous CTG as clinically indicated. MAIN OUTCOME MEASURES Caesarean section (primary outcome), obstetric interventions (e.g. continuous CTG during labour, fetal blood sampling, augmentation of labour) and neonatal morbidity (e.g. metabolic acidosis, admission to the neonatal intensive care unit, neonatal death). RESULTS Based on 3034 women (1513 and 1521 randomised to IA and ACTG, respectively), there was no statistical difference between the groups in caesarean section [130 (8.6%) and 105 (6.9%) for IA and ACTG groups, respectively; relative risk (RR) 1.24; 95% CI 0.97-1.58], or in any other outcome except for use of continuous CTG during labour, which was lower in the IA group (RR 0.90, 95% CI 0.86-0.93). CONCLUSION Our study demonstrates no differences in obstetric or neonatal outcomes between IA and ACTG for women with possible labour onset, other than an increased risk for continuous CTG in women receiving ACTG. TWEETABLE ABSTRACT No differences in outcomes between intermittent auscultation and admission cardiotocography for women with possible labour onset.
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Affiliation(s)
- V Smith
- School of Nursing and Midwifery, Trinity College Dublin, Dublin, Ireland
| | - C Begley
- School of Nursing and Midwifery, Trinity College Dublin, Dublin, Ireland
| | - J Newell
- School of Mathematics, Statistics and Applied Mathematics, National University of Ireland, Galway, Ireland
| | - S Higgins
- Department of Obstetrics and Gynaecology, National Maternity Hospital, Dublin, Ireland
| | - D J Murphy
- Department of Obstetrics, School of Medicine, Trinity College Dublin, Dublin, Ireland.,Department of Obstetrics and Gynaecology, Coombe Women and Infants University Hospital, Dublin 8, Ireland
| | - M J White
- Department of Neonatology/Paediatrics, Coombe Women and Infants University Hospital, Dublin 8, Ireland
| | - J J Morrison
- Department of Obstetrics and Gynaecology, University College Hospital Galway, Galway, Ireland
| | - S Canny
- Department of Obstetrics and Gynaecology, University College Hospital Galway, Galway, Ireland
| | - D O'Donovan
- Department of Neonatology/Paediatrics, University College Hospital Galway, Galway, Ireland
| | - D Devane
- School of Nursing and Midwifery, National University of Ireland, Galway, Ireland.,Health Research Board, Trials Methodology Research Network, National University of Ireland, Galway, Ireland
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Peyrin-Biroulet L, Baumgart DC, Armuzzi A, Gionchetti P, Sebastian S, Danese S, Magro F, Higgins S, Yaworksy A, Banderas B, Kachroo S. Quality of Care in Ulcerative Colitis: A Modified Delphi Panel Approach. Dig Dis 2018; 36:346-353. [PMID: 29969780 DOI: 10.1159/000489845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2018] [Accepted: 05/02/2018] [Indexed: 02/02/2023]
Abstract
OBJECTIVES To establish clinical consensus on important and relevant quality-of-care (QoC) attributes in ulcerative colitis (UC) treatment that may improve treatment outcomes and guide best practices. METHODS Thirty-eight QoC attributes were identified in a literature review. Sixteen European-based experts were selected based on their contributions to UC guidelines, publications, and patient care. A 3-round, modified Delphi panel was conducted including an interview round, and 2 web-based rounds to reach consensus and finalize a QoC attribute list. RESULTS The draft QoC attribute list derived from a literature review and Round 1, expert interviews, comprised 63 attributes. In Rounds 2 and 3, the QoC attributes frequently rated as critically important were diagnosis (n = 15, 93.8%), treatment adherence (n = 15, 93.8%), and access to care/treatment (Round 2: n = 14, 87.5%; Round 3: n = 15, 93.8%). The final QoC attribute list consisted of 61 attributes across 20 domains, with the most attributes reported in the "treatment goals" domain (n = 9). CONCLUSION QoC is a complex and evolving concept that can improve outcomes while maximizing healthcare resources. Limited time and resources hamper clinicians' ability to openly and empathetically communicate with patients; novel technology may help to offer solutions.
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Affiliation(s)
| | - Daniel C Baumgart
- Department of Gastroenterology and Hepatology, Inflammatory Bowel Disease Center, Charité Medical Center, Virchow Hospital, Medical School of the Humboldt-University of Berlin, Berlin, Germany
| | - Alessandro Armuzzi
- IBD Unit Presidio Columbus, Fondazione Policlinico Gemelli Università Cattolica, Rome, Italy
| | - Paolo Gionchetti
- S. Orsola-Malpighi Hospital University of Bologna, Via Massarenti, Bologna, Italy
| | - Shaji Sebastian
- BD Unit, Hull and East Yorkshire Hospitals NHS Trust, Hull, United Kingdom
| | - Silvio Danese
- Humanitas University IBD Center, Via Manzoni, Milan, Italy
| | - Fernando Magro
- Department of Pharmacology, Center of Medical Research Al, Porto, Portugal
| | | | | | | | - Sumesh Kachroo
- Center for Observational and Real-World Evidence (CORE), Merck & Co., Inc., Kenilworth, New Jersey, USA
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Johung K, Kann B, Lacy J, Stein S, Kortmansky J, Zaheer W, Cheng Y, Lam W, Liu S, Decker R, Hochster H, Higgins S. Pilot trial of YIV-906 with neoadjuvant chemoradiotherapy (CRT) in patients with locally advanced rectal cancer. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy151.319] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Frederick G, Fedewa M, Das B, McConnell W, Hathaway E, Salyer R, Higgins S, Schmidt M, Evans E. Waist Circumference Influences Associations Between Physical Activity And Metabolic Syndrome Risk In College-aged Females. Med Sci Sports Exerc 2018. [DOI: 10.1249/01.mss.0000535315.22762.94] [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: 11/21/2022]
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Taylor F, Higgins S, Carson RT, Eremenco S, Foley C, Lacy BE, Parkman HP, Reasner DS, Shields AL, Tack J, Talley NJ. Development of a Symptom-Focused Patient-Reported Outcome Measure for Functional Dyspepsia: The Functional Dyspepsia Symptom Diary (FDSD). Am J Gastroenterol 2018; 113:39-48. [PMID: 28925989 PMCID: PMC5770596 DOI: 10.1038/ajg.2017.265] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2017] [Accepted: 07/01/2017] [Indexed: 12/11/2022]
Abstract
OBJECTIVES The Functional Dyspepsia Symptom Diary (FDSD) was developed to address the lack of symptom-focused, patient-reported outcome (PRO) measures designed for use in functional dyspepsia (FD) patients and meeting Food and Drug Administration recommendations for PRO instrument development. METHODS Concept elicitation interviews were conducted with FD participants to identify symptoms important and relevant to FD patients. A preliminary version of the FDSD was constructed, then completed by FD participants on an electronic device in cognitive interviews to evaluate the readability, comprehensibility, relevance, and comprehensiveness of the FDSD, and to preliminarily evaluate its measurement properties. RESULTS During concept elicitation interviews, 45 participants spontaneously reported 19 symptom concepts. Of those, seven symptoms were selected for assessment by the eight-item FDSD. Cognitive interviews with 57 participants confirmed that participants were able to comprehend and provide meaningful responses to the FDSD, and that the handheld electronic FDSD format was suitable for use in the target population. Scores of the FDSD were well-distributed among response options, item discrimination indices suggested that the FDSD items differentiate among patients with varying degrees of FD severity, and inter-item correlations suggested that no items of the FDSD were capturing redundant information. Internal consistency estimates (0.87) and construct-related validity estimates using known-groups methods were within acceptable ranges. CONCLUSIONS The FDSD is a content-valid PRO measure, with preliminary psychometric evidence providing support for the FDSD's items and total score. Further psychometric evaluations are recommended to more fully test the FDSD's score performance and other measurement properties in the target patient population.
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Affiliation(s)
- Fiona Taylor
- Adelphi Values, Patient-Centered Outcomes, Boston, Massachusetts, USA,Adelphi Values, Patient-Centered Outcomes, 290 Congress Street, 7th Floor, Boston, Massachusetts 02210, USA. E-mail:
| | - Sophie Higgins
- Adelphi Values, Patient-Centered Outcomes, Boston, Massachusetts, USA
| | | | | | - Catherine Foley
- Adelphi Values, Patient-Centered Outcomes, Boston, Massachusetts, USA
| | - Brian E Lacy
- Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire, USA
| | - Henry P Parkman
- Temple University School of Medicine, Philadelphia, Pennsylvania, USA
| | - David S Reasner
- Ironwood Pharmaceuticals, Inc., Cambridge, Massachusetts, USA
| | - Alan L Shields
- Adelphi Values, Patient-Centered Outcomes, Boston, Massachusetts, USA
| | - Jan Tack
- University of Leuven, Leuven, Belgium
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Sakellariou D, Higgins S, Beniczky S, Gildeh N, Alekseichuk I, Drakatos P, Murphy P, Kent B, Nesbitt A, Williams A, Kryger M, Goadsby P, Richardson M, Leschziner G, Rosenzweig I. Exploding head syndrome: a co-activation of alpha-frequency band oscillations as a novel interictal fingerprint? Sleep Med 2017. [DOI: 10.1016/j.sleep.2017.11.849] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Wojcik KY, Escobedo LA, Miller KA, Hawkins M, Ahadiat O, Higgins S, Wysong A, Cockburn M. Conflicts and Contradictions in Current Skin Cancer Screening Guidelines. Curr Derm Rep 2017; 6:316-324. [DOI: 10.1007/s13671-017-0205-6] [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: 12/01/2022]
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Higgins S, Wysong A. Cosmetic Surgery and Body Dysmorphic Disorder - An Update. Int J Womens Dermatol 2017; 4:43-48. [PMID: 29872676 DOI: 10.1016/j.ijwd.2017.09.007] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2017] [Revised: 09/21/2017] [Accepted: 09/28/2017] [Indexed: 10/18/2022] Open
Abstract
With the increasing volume and popularity of cosmetic procedures and surgeries, physicians in related specialties are increasingly likely to encounter patients with body dysmorphic disorder. Given the ethical, safety, and legal considerations involved in aesthetic procedures in these patients, accurate identification and appropriate selection for procedures is crucial.
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Affiliation(s)
- S Higgins
- Department of Dermatology, Keck Medicine of University of Southern California, Los Angeles, CA
| | - A Wysong
- Department of Dermatology, Keck Medicine of University of Southern California, Los Angeles, CA
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Higgins S, Ahadiat O, Wysong A. LB936 Complementary and Alternative Medicine (CAM) as a chemopreventive strategy in skin cancer. J Invest Dermatol 2017. [DOI: 10.1016/j.jid.2017.07.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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O’Beirne J, Mitchell J, Sloss A, Kay B, Higgins S, Orme C. P44 Maximising access to hepatitis C (HCV) treatment: the Sunshine Coast experience. J Virus Erad 2017. [DOI: 10.1016/s2055-6640(20)30785-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Higgins S, Miller KA, Wojcik KY, Ahadiat O, Escobedo LA, Wysong A, Cockburn M. Phytochemicals and Naturally Occurring Substances in the Chemoprevention of Skin Cancer. Curr Derm Rep 2017. [DOI: 10.1007/s13671-017-0190-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Miller KA, In GK, Jiang SY, Ahadiat O, Higgins S, Wysong A, Cockburn MG. Skin Cancer Prevention Among Hispanics: a Review of the Literature. Curr Derm Rep 2017. [DOI: 10.1007/s13671-017-0191-8] [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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Campbell S, Clohessy A, O’Brien C, Higgins S, Higgins M, McAuliffe F. Fetal anhydramnios following maternal non-steroidal anti-inflammatory drug use in pregnancy. Obstet Med 2017; 10:93-95. [PMID: 28680471 PMCID: PMC5480648 DOI: 10.1177/1753495x16686466] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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: 11/07/2016] [Accepted: 11/15/2016] [Indexed: 10/31/2023] Open
Abstract
We present a case report of transient fetal anhydramnios following maternal non-steroidal anti-inflammatory drug use in pregnancy. This reduction in liquor volume resolved following cessation of the medication with no obvious ill-effect on neonatal outcome. The case report is followed by a comprehensive summary of the relevant literature.
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Affiliation(s)
- S Campbell
- Obstetrics & Gynaecology, National Maternity Hospital, Dublin, Ireland
| | - A Clohessy
- Pharmacy Department, National Maternity Hospital, Dublin, Ireland
| | - C O’Brien
- Ultrasound Department, National Maternity Hospital, Dublin, Ireland
| | - S Higgins
- University College Dublin/National Maternity Hospital, Dublin, Ireland
| | - M Higgins
- University College Dublin/National Maternity Hospital, Dublin, Ireland
| | - F McAuliffe
- University College Dublin/National Maternity Hospital, Dublin, Ireland
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Ireland G, Higgins S, Goorney B, Ward C, Ahmad S, Stewart C, Simmons R, Lattimore S, Lee V. Evaluation of hepatitis C testing in men who have sex with men, and associated risk behaviours, in Manchester, UK. Sex Transm Infect 2017; 93:404-409. [PMID: 28130506 DOI: 10.1136/sextrans-2016-052876] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2016] [Revised: 01/03/2017] [Accepted: 01/08/2017] [Indexed: 01/04/2023] Open
Abstract
OBJECTIVE To determine the prevalence of newly diagnosed hepatitis C virus (HCV) and associated risk behaviours among men who have sex with men (MSM) in Manchester. METHOD A survey among MSM attending four genitourinary medicine clinics in Manchester was carried out over 9 months in 2013. Participants were asked about recent sexual behaviour, recreational drug use and HIV status. All men were offered an HCV test. RESULTS Overall, 2030 MSM completed a questionnaire and accepted an HCV test. Of whom, 0.9% (18) were newly diagnosed with HCV, including 1.8% (13/735) of HIV-positive MSM, 0.7% (3/440) of MSM of unknown HIV status and 0.2% (2/855) of HIV-negative MSM. HCV positivity was significantly associated with HIV status (p<0.001). When compared with HIV-negative MSM, HIV-positive MSM had higher rates of sharing snorting drug equipment, injecting drugs/'slamming' and using recreational drugs (all p<0.05) but lower rates of five or more sexual partners and insertive unprotected anal intercourse (p<0.05). MSM newly diagnosed with HCV had significantly higher prevalence of unprotected sex, sex with someone HCV positive, fisting, group sex, ever injecting drugs/'slamming' and recreational drug use (p<0.002). CONCLUSIONS In this survey, HIV-positive MSM had significantly different drug use behaviour which may explain the higher HCV burden. However, HCV was also associated with HIV-negative MSM engaging in high-risk sexual practices. All MSM attending sexual health clinics must have a risk assessment and HCV screening should be offered based on the risk. Further studies are warranted to explore the interplay between HCV and HIV risk associated with drug use versus sexual practices.
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Affiliation(s)
- G Ireland
- National Infection Service, Public Health England, London, UK
| | - S Higgins
- Pennine Acute Hospitals NHS Trust, Manchester, UK
| | - B Goorney
- Salford Royal NHS Foundation Trust, Manchester, UK
| | - C Ward
- Central Manchester University Hospitals NHS Foundation Trust, Manchester, UK
| | - S Ahmad
- University Hospital of South Manchester NHS Foundation Trust, Manchester, UK
| | - C Stewart
- Salford Royal NHS Foundation Trust, Manchester, UK
| | - R Simmons
- National Infection Service, Public Health England, London, UK
| | - S Lattimore
- National Infection Service, Public Health England, London, UK
| | - V Lee
- Central Manchester University Hospitals NHS Foundation Trust, Manchester, UK
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Swan D, Hannigan A, Higgins S, McDonnell R, Meagher D, Cullen W. Development and implementation of a 'Mental Health Finder' software tool within an electronic medical record system. Ir J Med Sci 2017; 186:191-200. [PMID: 28050808 DOI: 10.1007/s11845-016-1541-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2016] [Accepted: 12/25/2016] [Indexed: 11/24/2022]
Abstract
BACKGROUND In Ireland, as in many other healthcare systems, mental health service provision is being reconfigured with a move toward more care in the community, and particularly primary care. Recording and surveillance systems for mental health information and activities in primary care are needed for service planning and quality improvement. AIMS We describe the development and initial implementation of a software tool ('mental health finder') within a widely used primary care electronic medical record system (EMR) in Ireland to enable large-scale data collection on the epidemiology and management of mental health and substance use problems among patients attending general practice. METHODS In collaboration with the Irish Primary Care Research Network (IPCRN), we developed the 'Mental Health Finder' as a software plug-in to a commonly used primary care EMR system to facilitate data collection on mental health diagnoses and pharmacological treatments among patients. The finder searches for and identifies patients based on diagnostic coding and/or prescribed medicines. It was initially implemented among a convenience sample of six GP practices. RESULTS Prevalence of mental health and substance use problems across the six practices, as identified by the finder, was 9.4% (range 6.9-12.7%). 61.9% of identified patients were female; 25.8% were private patients. One-third (33.4%) of identified patients were prescribed more than one class of psychotropic medication. Of the patients identified by the finder, 89.9% were identifiable via prescribing data, 23.7% via diagnostic coding. CONCLUSIONS The finder is a feasible and promising methodology for large-scale data collection on mental health problems in primary care.
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Affiliation(s)
- D Swan
- Graduate Entry Medical School, University of Limerick, Limerick, Ireland. .,Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK. .,School of Medicine and Medical Sciences, University College Dublin, Dublin 4, Ireland.
| | - A Hannigan
- Graduate Entry Medical School, University of Limerick, Limerick, Ireland
| | - S Higgins
- Irish Primary Care Research Network, The Irish College of General Practitioners, 4/5 Lincoln Place, Dublin 2, Ireland
| | - R McDonnell
- Irish Primary Care Research Network, The Irish College of General Practitioners, 4/5 Lincoln Place, Dublin 2, Ireland
| | - D Meagher
- Graduate Entry Medical School, University of Limerick, Limerick, Ireland
| | - W Cullen
- Graduate Entry Medical School, University of Limerick, Limerick, Ireland.,School of Medicine and Medical Sciences, University College Dublin, Dublin 4, Ireland
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Marqués FJ, Higgins S, Chapuis R, Waldner C. The Effect of Inadequate Presample Blood Volume Withdrawal from Intravenous Catheter and Extension Sets on Measured Circulating L-Blood Lactate Concentration in Horses Receiving Lactated Ringer's Solution. J Vet Intern Med 2016; 31:51-54. [PMID: 27997731 PMCID: PMC5259646 DOI: 10.1111/jvim.14623] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2016] [Revised: 10/25/2016] [Accepted: 11/02/2016] [Indexed: 11/27/2022] Open
Abstract
Background Circulating l‐lactate concentration is commonly measured in hospitalized horses by sampling from indwelling intravenous (IV) catheters. However, there are no published evidence‐based recommendations to prevent contamination by lactated Ringer's solution (LRS). Hypothesis Withdrawing 10 mL of blood from the LRS‐containing extension set connected to the IV catheter before obtaining the sample for analysis should be adequate to obtain accurate measurement of blood lactate concentration (BLC). Animals Thirty‐three adult hospitalized horses receiving constant rate infusion of LRS. Methods Immediately after disconnecting the LRS, 5 sequential 5 mL blood samples were obtained by aspiration from an extension set connected to an indwelling IV catheter, followed by 3 samples collected by direct venipuncture of the contralateral jugular vein. Samples were analyzed with 1 portable blood lactate analyzer. A linear mixed model was used to examine differences in lactate concentrations among samples collected from the catheter and by direct venipuncture. Results After considering differences in age, breed, sex, and reason for hospitalization, BLCs were higher (P < .001) in the first and second 5 mL samples collected through the extension set/catheter than in all other extension set/catheter samples or the direct venipuncture samples. The largest difference observed between the third and subsequent catheter or venipuncture samples was 0.34 mmol/L with an upper 95% CI of 1.12 mmol/L. Conclusions and Clinical Importance Withdrawing 15 mL of blood from a LRS‐containing extension set connected to an IV catheter (5.9 mL total volume capacity) before obtaining the sample for blood lactate analysis is suggested to optimize accuracy of BLC measurements.
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Affiliation(s)
- F J Marqués
- Department of Large Animal Clinical Sciences, Western College of Veterinary Medicine, University of Saskatchewan, Saskatoon, SK, Canada
| | - S Higgins
- Department of Large Animal Clinical Sciences, Western College of Veterinary Medicine, University of Saskatchewan, Saskatoon, SK, Canada
| | - R Chapuis
- Department of Large Animal Clinical Sciences, Western College of Veterinary Medicine, University of Saskatchewan, Saskatoon, SK, Canada
| | - C Waldner
- Department of Large Animal Clinical Sciences, Western College of Veterinary Medicine, University of Saskatchewan, Saskatoon, SK, Canada
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Hughes KJ, Rendle DI, Higgins S, Barron R, Cowling A, Love S, Durham AE. Effect of storage time and temperature on the results of analysis of synovial and mesothelial fluids. Equine Vet J 2016; 49:232-237. [DOI: 10.1111/evj.12587] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2015] [Accepted: 04/09/2016] [Indexed: 11/30/2022]
Affiliation(s)
- K. J. Hughes
- Weipers Centre for Equine Welfare School of Veterinary Medicine College of Medical Veterinary and Life Sciences University of Glasgow UK
| | - D. I. Rendle
- Weipers Centre for Equine Welfare School of Veterinary Medicine College of Medical Veterinary and Life Sciences University of Glasgow UK
- The Liphook Equine Hospital Hampshire UK
| | - S. Higgins
- Weipers Centre for Equine Welfare School of Veterinary Medicine College of Medical Veterinary and Life Sciences University of Glasgow UK
| | - R. Barron
- Veterinary Diagnostic Services School of Veterinary Medicine College of Medical Veterinary and Life Sciences University of Glasgow UK
| | - A. Cowling
- School of Animal and Veterinary Sciences Charles Sturt University Wagga Wagga New South Wales Australia
| | - S. Love
- Weipers Centre for Equine Welfare School of Veterinary Medicine College of Medical Veterinary and Life Sciences University of Glasgow UK
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Liu W, Zhu D, Trumpore S, Kenneth R, Higgins S, Nath R, Chen Z. SU-F-T-325: On the Use of Bolus in Dosimetry and Dose Reduction for Pacemaker and Defibrillator. Med Phys 2016. [DOI: 10.1118/1.4956510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Abu-Khalaf MM, Raza MA, Hatzis C, Wang H, Lin K, Higgins S, Ratner E, Silasi DA, Azodi M, Rutherford TJ, Santin AD, Schwartz PE. Efficacy and tolerability of combination cisplatin and ifosfamide chemotherapy with vaginal cuff brachytherapy in the first line treatment of uterine carcinosarcoma. EUR J GYNAECOL ONCOL 2016; 37:199-203. [PMID: 27172745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
PURPOSE OF INVESTIGATION A retrospective study to evaluate six cycles of cisplatin 40 mg/m2 on day 1 and ifosfamide 1,200 mg/m2 daily on days 1 to 4 with Mesna every four weeks as first line treatment for 29 patients with a diagnosis of uterine carcinosarcoma. MATERIALS AND METHODS A total of 23 of 29 patients received high dose rate intracavitary vaginal cuff brachytherapy (VCBT) with two fractions of seven Gy each. Median age was 65 years (range 40-82); 13 (44.8%) had Stage I disease, three (10.3%) had Stage II, eight (27.6%) had Stage III, and five (17.2%) patients had Stage IV disease. RESULTS Most common toxicities were anemia grade 1 (35%)/grade 2 (45%), and neutropenia grade 3 (17%)/grade 4 (6.9%). Eleven dose modifications, four treatment discontinuations, and one patient withdrawal occurred. At a median follow up of 45 months (range 9 to 144), Progression free survival (PFS) was 20% and overall survival (OS) was 40% for Stage IV, PFS 75% and OS 62.5% for Stage III, compared to a PFS 75% and OS 72.2% for Stages I-II. Median OS for the entire group was 12.43 years (95% CI 3.69 to inf); for Stage I-III 12.4 years (6.1 to inf), and for Stage IV 15.6 months (95% CI 9.4 to inf). CONCLUSIONS Cisplatin and ifosfamide chemotherapy with VCBT was well tolerated and has promising activity in uterine carcinosarcoma.
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Beyder A, Gibbons SJ, Mazzone A, Strege PR, Saravanaperumal SA, Sha L, Higgins S, Eisenman ST, Bernard CE, Geurts A, Kline CF, Mohler PJ, Farrugia G. Expression and function of the Scn5a-encoded voltage-gated sodium channel NaV 1.5 in the rat jejunum. Neurogastroenterol Motil 2016; 28:64-73. [PMID: 26459913 PMCID: PMC4688076 DOI: 10.1111/nmo.12697] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2015] [Accepted: 09/05/2015] [Indexed: 12/20/2022]
Abstract
BACKGROUND The SCN5A-encoded voltage-gated sodium channel NaV 1.5 is expressed in human jejunum and colon. Mutations in NaV 1.5 are associated with gastrointestinal motility disorders. The rat gastrointestinal tract expresses voltage-gated sodium channels, but their molecular identity and role in rat gastrointestinal electrophysiology are unknown. METHODS The presence and distribution of Scn5a-encoded NaV 1.5 was examined by PCR, Western blotting and immunohistochemistry in rat jejunum. Freshly dissociated smooth muscle cells were examined by whole cell electrophysiology. Zinc finger nuclease was used to target Scn5a in rats. Lentiviral-mediated transduction with shRNA was used to target Scn5a in rat jejunum smooth muscle organotypic cultures. Organotypic cultures were examined by sharp electrode electrophysiology and RT-PCR. KEY RESULTS We found NaV 1.5 in rat jejunum and colon smooth muscle by Western blot. Immunohistochemistry using two other antibodies of different portions of NaV 1.5 revealed the presence of the ion channel in rat jejunum. Whole cell voltage-clamp in dissociated smooth muscle cells from rat jejunum showed fast activating and inactivating voltage-dependent inward current that was eliminated by Na(+) replacement by NMDG(+) . Constitutive rat Scn5a knockout resulted in death in utero. NaV 1.5 shRNA delivered by lentivirus into rat jejunum smooth muscle organotypic culture resulted in 57% loss of Scn5a mRNA and several significant changes in slow waves, namely 40% decrease in peak amplitude, 30% decrease in half-width, and 7 mV hyperpolarization of the membrane potential at peak amplitude. CONCLUSIONS & INFERENCES Scn5a-encoded NaV 1.5 is expressed in rat gastrointestinal smooth muscle and it contributes to smooth muscle electrophysiology.
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Affiliation(s)
- A Beyder
- Enteric NeuroScience Program, Division of Gastroenterology and Hepatology, Department of Medicine, Mayo Clinic College of Medicine, Rochester, MN, USA
| | - S J Gibbons
- Enteric NeuroScience Program, Division of Gastroenterology and Hepatology, Department of Medicine, Mayo Clinic College of Medicine, Rochester, MN, USA
| | - A Mazzone
- Enteric NeuroScience Program, Division of Gastroenterology and Hepatology, Department of Medicine, Mayo Clinic College of Medicine, Rochester, MN, USA
| | - P R Strege
- Enteric NeuroScience Program, Division of Gastroenterology and Hepatology, Department of Medicine, Mayo Clinic College of Medicine, Rochester, MN, USA
| | - S A Saravanaperumal
- Enteric NeuroScience Program, Division of Gastroenterology and Hepatology, Department of Medicine, Mayo Clinic College of Medicine, Rochester, MN, USA
| | - L Sha
- Enteric NeuroScience Program, Division of Gastroenterology and Hepatology, Department of Medicine, Mayo Clinic College of Medicine, Rochester, MN, USA
| | - S Higgins
- College of Medicine, University of Nebraska Medical Center, Omaha, NE, USA
| | - S T Eisenman
- Enteric NeuroScience Program, Division of Gastroenterology and Hepatology, Department of Medicine, Mayo Clinic College of Medicine, Rochester, MN, USA
| | - C E Bernard
- Enteric NeuroScience Program, Division of Gastroenterology and Hepatology, Department of Medicine, Mayo Clinic College of Medicine, Rochester, MN, USA
| | - A Geurts
- Human and Molecular Genetics Center, Medical College of Wisconsin, Milwaukee, WI, USA
| | - C F Kline
- The Dorothy M. Davis Heart and Lung Research Institute and Departments of Physiology & Cell Biology and Internal Medicine, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - P J Mohler
- The Dorothy M. Davis Heart and Lung Research Institute and Departments of Physiology & Cell Biology and Internal Medicine, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - G Farrugia
- Enteric NeuroScience Program, Division of Gastroenterology and Hepatology, Department of Medicine, Mayo Clinic College of Medicine, Rochester, MN, USA
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Kingston M, French P, Higgins S, McQuillan O, Sukthankar A, Stott C, McBrien B, Tipple C, Turner A, Sullivan AK, Radcliffe K, Cousins D, FitzGerald M, Fisher M, Grover D, Higgins S, Kingston M, Rayment M, Sullivan A. UK national guidelines on the management of syphilis 2015. Int J STD AIDS 2015; 27:421-46. [PMID: 26721608 DOI: 10.1177/0956462415624059] [Citation(s) in RCA: 141] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2015] [Accepted: 12/02/2015] [Indexed: 12/12/2022]
Abstract
These guidelines are an update for 2015 of the 2008 UK guidelines for the management of syphilis. The writing group have piloted the new BASHH guideline methodology, notably using the GRADE system for assessing evidence and making recommendations. We have made significant changes to the recommendations for screening infants born to mothers with positive syphilis serology and to facilitate accurate and timely communication between the teams caring for mother and baby we have developed a birth plan. Procaine penicillin is now an alternative, not preferred treatment, for all stages of syphilis except neurosyphilis, but the length of treatment for this is shortened. Other changes are summarised at the start of the guideline.
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Affiliation(s)
- M Kingston
- Manchester Centre for Sexual Health, Manchester, UK
| | - P French
- Mortimer Market Centre, London, UK
| | - S Higgins
- North Manchester General Hospital, Manchester, UK
| | - O McQuillan
- Manchester Centre for Sexual Health, Manchester, UK
| | - A Sukthankar
- Manchester Centre for Sexual Health, Manchester, UK
| | - C Stott
- Manchester Centre for Sexual Health, Manchester, UK
| | - B McBrien
- Manchester Centre for Sexual Health, Manchester, UK
| | - C Tipple
- Jefferiss Wing Centre for Sexual Health, Imperial College Health Care NHS Trust, London, UK
| | - A Turner
- The Public Health England/Clinical Virology Laboratory, Manchester Royal Infirmary, Manchester, UK
| | | | | | - Keith Radcliffe
- Clinical Effectiveness Group, British Association for Sexual Health and HIV, Macclesfield, UK
| | - Darren Cousins
- Clinical Effectiveness Group, British Association for Sexual Health and HIV, Macclesfield, UK
| | - Mark FitzGerald
- Clinical Effectiveness Group, British Association for Sexual Health and HIV, Macclesfield, UK
| | - Martin Fisher
- Clinical Effectiveness Group, British Association for Sexual Health and HIV, Macclesfield, UK
| | - Deepa Grover
- Clinical Effectiveness Group, British Association for Sexual Health and HIV, Macclesfield, UK
| | - Stephen Higgins
- Clinical Effectiveness Group, British Association for Sexual Health and HIV, Macclesfield, UK
| | - Margaret Kingston
- Clinical Effectiveness Group, British Association for Sexual Health and HIV, Macclesfield, UK
| | - Michael Rayment
- Clinical Effectiveness Group, British Association for Sexual Health and HIV, Macclesfield, UK
| | - Ann Sullivan
- Clinical Effectiveness Group, British Association for Sexual Health and HIV, Macclesfield, UK
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Pengo MF, Higgins S, Drakatos P, Martin K, Gall N, Rossi GP, Leschziner G. Characterisation of sleep disturbances in postural orthostatic tachycardia syndrome: a polysomnography-based study. Sleep Med 2015; 16:1457-61. [PMID: 26611942 DOI: 10.1016/j.sleep.2015.08.003] [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] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2015] [Revised: 07/15/2015] [Accepted: 08/06/2015] [Indexed: 11/25/2022]
Abstract
BACKGROUND AND AIM Postural orthostatic tachycardia syndrome (PoTS) has been frequently associated with sleep disturbances but objective sleep data are lacking. In addition, although regional autonomic denervation has been described, less is known about autonomic nervous activity overnight in these patients. PATIENTS/METHODS A full polysomnography and heart rate variability were performed on 37 patients diagnosed with PoTS . In addition, a multiple sleep latency test (MSLT) was conducted on a subgroup of patients with excessive daytime sleepiness. RESULTS The polysomnographic data did not show major pathological findings except the percentage spent in rapid eye movement (REM) sleep which was slightly reduced at 18.4%. The MSLT did not confirm excessive daytime sleepiness as median mean sleep latency was 14.4 min (11.8-17.5). When comparing patients with and without subjective daytime sleepiness, it was found that the latter had a reduced parasympathetic activation at night as expressed by the average high frequency [6936.5 ms(2) (6028.2-8675.5) vs. 4689.5 (3922.7-7685.2) p < 0.05]. CONCLUSION Patients with PoTS do not exhibit polysomnographic findings consistent with relevant sleep pathologies nor objective daytime sleepiness. Subjective daytime sleepiness is associated with enhanced activation of the parasympathetic nervous system.
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Affiliation(s)
- M F Pengo
- Guy's and St. Thomas' NHS Foundation Trust, Sleep Disorders Centre, London, UK; Department of Medicine (DIMED), University of Padua, Padua, Italy.
| | - S Higgins
- Guy's and St. Thomas' NHS Foundation Trust, Sleep Disorders Centre, London, UK
| | - P Drakatos
- Guy's and St. Thomas' NHS Foundation Trust, Sleep Disorders Centre, London, UK
| | - K Martin
- Department of Cardiology, King's College London Hospital, Denmark Hill, London, UK
| | - N Gall
- Department of Cardiology, King's College London Hospital, Denmark Hill, London, UK
| | - G P Rossi
- Department of Medicine (DIMED), University of Padua, Padua, Italy
| | - G Leschziner
- Guy's and St. Thomas' NHS Foundation Trust, Sleep Disorders Centre, London, UK; Department of Clinical Neuroscience, Institute of Psychiatry, King's College London, London, UK
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Mone F, Quigley J, Doyle B, Lambert M, Woolfson M, Downey P, Carroll S, Higgins S, Mahony R, Mcauliffe FM, Fitzgerald J, Mcparland P. Clinical disparity of haemolytic disease of the fetus and newborn in twin pregnancy. Transfus Med 2015; 25:345-6. [DOI: 10.1111/tme.12230] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2015] [Revised: 07/15/2015] [Accepted: 07/16/2015] [Indexed: 11/30/2022]
Affiliation(s)
- F. Mone
- Department of Fetal Medicine; National Maternity Hospital; Dublin
- UCD Obstetrics and Gynaecology, School of Medicine and Medical Science; University College Dublin
| | - J. Quigley
- Department of Pathology and Laboratory Medicine; National Maternity Hospital; Dublin
| | - B. Doyle
- Irish Blood Transfusion Service; National Blood Centre; Dublin
| | - M. Lambert
- Irish Blood Transfusion Service; National Blood Centre; Dublin
| | - M. Woolfson
- Irish Blood Transfusion Service; National Blood Centre; Dublin
| | - P. Downey
- Department of Pathology and Laboratory Medicine; National Maternity Hospital; Dublin
| | - S. Carroll
- Department of Fetal Medicine; National Maternity Hospital; Dublin
| | - S. Higgins
- Department of Fetal Medicine; National Maternity Hospital; Dublin
- UCD Obstetrics and Gynaecology, School of Medicine and Medical Science; University College Dublin
| | - R. Mahony
- Department of Fetal Medicine; National Maternity Hospital; Dublin
| | - F. M. Mcauliffe
- Department of Fetal Medicine; National Maternity Hospital; Dublin
- UCD Obstetrics and Gynaecology, School of Medicine and Medical Science; University College Dublin
| | - J. Fitzgerald
- Department of Pathology and Laboratory Medicine; National Maternity Hospital; Dublin
| | - P. Mcparland
- Department of Fetal Medicine; National Maternity Hospital; Dublin
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Ahmed-Little Y, Bothra V, Cordwell D, Freeman Powell D, Ellis D, Klapper P, Scanlon S, Higgins S, Vivancos R. Attitudes towards HIV testing via home-sampling kits ordered online (RUClear pilots 2011-12). J Public Health (Oxf) 2015; 38:585-590. [PMID: 26045472 DOI: 10.1093/pubmed/fdv075] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND The burden of disease relating to undiagnosed HIV infection is significant in the UK. BHIVA (British HIV Association) recommends population screening in high prevalence areas, expanding outside traditional antenatal/GUM settings. METHODS RUClear 2011-12 piloted expanding HIV testing outside traditional settings using home-sampling kits (dry-blood-spot testing) ordered online. Greater Manchester residents (≥age 16) could request testing via an established, online chlamydia testing service (www.ruclear.co.uk). Participant attitudes towards this new service were assessed. Qualitative methods (thematic analysis) were used to analyse free-text data submitted by participants via hard copy questionnaires issued in all testing kits. RESULTS 79.9% (2447/3062) participants completed questionnaires, of which 30.9% (756/2447) provided free-text data. Participants overwhelmingly supported the service, valuing particularly accessibility and convenience, allowing individuals to order tests any time of day and self-sample comfortably at home; avoiding the invasive nature of venipuncture and avoiding the need for face-to-face interaction with health services. The pilot was also clinically and cost-effective. CONCLUSION Testing via home-sampling kits ordered online (dry-blood-spot testing) was felt to be an acceptable and convenient method for accessing a HIV test. Many individuals undertook HIV testing where they would otherwise not have been tested at all. Expansion of similar services may increase the uptake of HIV testing.
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Affiliation(s)
- Y Ahmed-Little
- Greater Manchester Health Protection Team, Public Health England, Manchester M1 3BN, UK
| | - V Bothra
- Greater Manchester Health Protection Team, Public Health England, Manchester M1 3BN, UK
| | - D Cordwell
- RUClear Chlamydia Screening Programme, Central Manchester University Hospitals NHS Foundation Trust, Manchester, UK
| | - D Freeman Powell
- RUClear Chlamydia Screening Programme, Central Manchester University Hospitals NHS Foundation Trust, Manchester, UK
| | - D Ellis
- Public Health Laboratory, Public Health England, Manchester, UK
| | - P Klapper
- Faculty of Medical and Human Sciences, The University of Manchester, Manchester, UK
| | - S Scanlon
- RUClear Chlamydia Screening Programme, Central Manchester University Hospitals NHS Foundation Trust, Manchester, UK
| | - S Higgins
- Department of Sexual Health and HIV, North Manchester General Hospital, Manchester, UK
| | - R Vivancos
- Cheshire and Mersey Health Protection Team, Public Health England, Manchester, UK
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Walsh CA, MacTiernan A, Farrell S, Mulcahy C, McMahon CJ, Franklin O, Coleman D, Mahony R, Higgins S, Carroll S, McParland P, McAuliffe FM. Mode of delivery in pregnancies complicated by major fetal congenital heart disease: a retrospective cohort study. J Perinatol 2014; 34:901-5. [PMID: 24875409 DOI: 10.1038/jp.2014.104] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2014] [Revised: 04/22/2014] [Accepted: 04/24/2014] [Indexed: 11/09/2022]
Abstract
OBJECTIVE To determine the mode of delivery in pregnancies complicated by complex fetal congenital heart disease (CHD). STUDY DESIGN Five-year retrospective cohort study at a tertiary fetal medicine center (2007 to 2011). Cases of complex fetal CHD (n=126) were compared with 45 069 non-anomalous singleton infants ⩾500 g to determine rates of emergency intrapartum cesarean section (CS), preterm delivery and induction of labor. RESULT Intrapartum CS is significantly higher in fetal CHD than non-anomalous controls (21% vs 13.5%, odds ratio (OR) 1.7, 95% confidence interval (CI): 1.0 to 2.7; P=0.035), predominantly related to CS for non-reassuring fetal status (OR 2.2, 95% CI: 1.1 to 4.1; P=0.022). Although fetal CHD did not increase emergency CS rates in nulliparous women, CS was significantly increased in multiparous pregnancies (OR 2.4, 95% CI: 1.8 to 4.6; P=0.014). Rates of preterm delivery (OR 3.4, 95% CI: 2.0 to 5.4; P<0.0001) and induction of labor (OR 1.9, 95% CI: 1.3 to 2.9; P=0.001) were higher in the CHD cases. CONCLUSION Emergency CS is increased in fetal CHD, attributed to a higher rate of CS for non-reassuring fetal status and seen mostly in multiparous women.
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Affiliation(s)
- C A Walsh
- Fetal Medicine Unit, National Maternity Hospital, Dublin, Ireland
| | - A MacTiernan
- UCD Obstetrics and Gynaecology, University College Dublin, National Maternity Hospital, Dublin, Ireland
| | - S Farrell
- UCD Obstetrics and Gynaecology, University College Dublin, National Maternity Hospital, Dublin, Ireland
| | - C Mulcahy
- Fetal Medicine Unit, National Maternity Hospital, Dublin, Ireland
| | - C J McMahon
- Department of Pediatric Cardiology, Our Lady's Hospital for Sick Children, Crumlin, Dublin, Ireland
| | - O Franklin
- Department of Pediatric Cardiology, Our Lady's Hospital for Sick Children, Crumlin, Dublin, Ireland
| | - D Coleman
- Department of Pediatric Cardiology, Our Lady's Hospital for Sick Children, Crumlin, Dublin, Ireland
| | - R Mahony
- Fetal Medicine Unit, National Maternity Hospital, Dublin, Ireland
| | - S Higgins
- Fetal Medicine Unit, National Maternity Hospital, Dublin, Ireland
| | - S Carroll
- Fetal Medicine Unit, National Maternity Hospital, Dublin, Ireland
| | - P McParland
- Fetal Medicine Unit, National Maternity Hospital, Dublin, Ireland
| | - F M McAuliffe
- 1] Fetal Medicine Unit, National Maternity Hospital, Dublin, Ireland [2] UCD Obstetrics and Gynaecology, University College Dublin, National Maternity Hospital, Dublin, Ireland
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Walsh CA, Doyle B, Quigley J, McAuliffe FM, Fitzgerald J, Mahony R, Higgins S, Carroll S, McParland P. Reassessing critical maternal antibody threshold in RhD alloimmunization: a 16-year retrospective cohort study. Ultrasound Obstet Gynecol 2014; 44:669-673. [PMID: 24706487 DOI: 10.1002/uog.13383] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/10/2013] [Revised: 03/02/2014] [Accepted: 03/26/2014] [Indexed: 06/03/2023]
Abstract
OBJECTIVE To determine the critical maternal antibody threshold for specialist referral in cases of RhD alloimmunization. METHODS This was a retrospective cohort study, covering a 16-year period at the national tertiary fetal medicine center for management of alloimmunization. Data concerning RhD alloimmunized pregnant women were extracted from an institutional database and maternal anti-D antibody levels were cross-checked with the national reference laboratory. Fetal hemoglobin (Hb) levels were determined only at the first intrauterine transfusion (IUT) and were compared with the pretransfusion maternal anti-D antibody level (IU/mL). Sensitivity, specificity and positive and negative predictive values of maternal antibody thresholds for detecting moderate to severe (Hb ≤ 0.64MoM) fetal anemia were calculated. RESULTS Between 1996 and 2011, 66 women underwent a first IUT for RhD alloimmunization at our institution. The highest serum anti-D antibody level was extracted for 208 RhD alloimmunized women who did not require IUT during the last 10 years of the study period. The traditional maternal antibody threshold of > 15 IU/mL failed to detect 20% of cases of moderate to severe fetal anemia. The ≥ 4 IU/mL threshold had 100% sensitivity but a 45% false-positive rate. The optimal anti-D antibody threshold for specialist referral in our population was ≥ 6 IU/mL; at this level, no case of moderate to severe anemia was missed and specificity was 61%. Use of this threshold would have eliminated 10% of referrals to our fetal medicine unit without compromising fetal outcomes. CONCLUSIONS Setting the critical maternal RhD antibody level at >15 IU/mL does not provide sufficient sensitivity. The lower threshold of ≥ 4 IU/mL, though sensitive, is associated with a 45% false-positive rate. In our population, a threshold of ≥ 6 IU/mL minimizes false-positive referrals while maintaining 100% sensitivity for moderate to severe fetal anemia.
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Affiliation(s)
- C A Walsh
- Fetal Medicine Unit, National Maternity Hospital, Dublin, Ireland
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Mulcahy C, McAuliffe FM, Breathnach F, Geary M, Daly S, Higgins J, Hunter A, Morrison J, Burke G, Higgins S, Dicker P, Mahony R, Tully E, Malone F. Umbilical and fetal middle cerebral artery Doppler reference ranges in a twin population followed longitudinally from 24 to 38 weeks' gestation. Ultrasound Obstet Gynecol 2014; 44:461-467. [PMID: 24407772 DOI: 10.1002/uog.13302] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [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: 08/22/2013] [Revised: 12/23/2013] [Accepted: 12/30/2013] [Indexed: 06/03/2023]
Abstract
OBJECTIVE To construct monochorionic diamniotic (MCDA) and dichorionic diamniotic (DCDA) twin reference ranges for umbilical artery (UA) pulsatility index (PI), UA resistance index (RI), fetal middle cerebral artery (MCA) PI and peak systolic velocity (PSV) and cerebroplacental ratio (CPR) from 24 weeks' to 38 weeks' gestation and compare these with published normal values for singleton pregnancies. METHODS This prospective multicenter cohort study included 1028 unselected twin pairs recruited over a 2-year period. Participants with dichorionic twins underwent fortnightly ultrasound surveillance from 24 weeks' gestation, with monochorionic twins being followed every 2 weeks from 16 weeks until delivery. A total of 7536 fetal Doppler examinations in 618 twin pregnancies were included in the analysis, with reference ranges for MCDA and DCDA pregnancies constructed for each of the Doppler indices using multilevel modeling. RESULTS UA-PI and UA-RI appear to be higher in twins than in singletons, and MCA-PI and MCA-PSV appear to be lower. The CPR also appears to be lower in twins than in singletons. Similar MCA indices were observed in MCDA and DCDA twins. CONCLUSION We have established longitudinal reference ranges for UA-PI and UA-RI, MCA-PI and MCA-PSV and CPR in twin pregnancies, which appear to differ from those in singleton pregnancies. The derived twin-specific reference ranges may be more appropriate in the surveillance of these high-risk pregnancies. Applying the singleton CPR cut-off of ≤ 1.0 may lead to a large number of false-positive diagnoses of cerebral redistribution in twin fetuses.
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Affiliation(s)
- C Mulcahy
- National Maternity Hospital, Dublin, Ireland
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Park H, Ratner E, Lucarelli L, Polizzi S, Higgins S, Damast S. Predictors of Vaginal Stenosis Following Intra-vaginal High-Dose-Rate Brachytherapy for Endometrial Carcinoma. Int J Radiat Oncol Biol Phys 2014. [DOI: 10.1016/j.ijrobp.2014.05.532] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [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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El Karoui K, Laurent B, Higgins S, Rabant M, Alamartine E. Réponse au traitement de la néphropathie à IgA selon les lésions de la classification d’Oxford. Nephrol Ther 2014. [DOI: 10.1016/j.nephro.2014.07.335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Buckingham S, Anthony S, Bellamy PH, Cardenas LM, Higgins S, McGeough K, Topp CFE. Review and analysis of global agricultural N₂O emissions relevant to the UK. Sci Total Environ 2014; 487:164-72. [PMID: 24784741 DOI: 10.1016/j.scitotenv.2014.02.122] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [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: 09/28/2012] [Revised: 02/26/2014] [Accepted: 02/26/2014] [Indexed: 05/11/2023]
Abstract
As part of a UK government funded research project to update the UK N2O inventory methodology, a systematic review of published nitrous oxide (N2O) emission factors was carried out of non-UK research, for future comparison and synthesis with the UK measurement based evidence base. The aim of the study is to assess how the UK IPCC default emission factor for N2O emissions derived from synthetic or organic fertiliser inputs (EF1) compares to international values reported in published literature. The availability of data for comparing and/or refining the UK IPCC default value and the possibility of analysing sufficient auxiliary data to propose a Tier 2 EF1 reporting strategy is evaluated. The review demonstrated a lack of consistency in reporting error bounds for fertiliser-derived EFs and N2O flux data with 8% and 44% of publications reporting EF and N2O flux error bounds respectively. There was also poor description of environmental (climate and soil) and experimental design auxiliary data. This is likely to be due to differences in study objectives, however potential improvements to soil parameter reporting are proposed. The review demonstrates that emission factors for agricultural-derived N2O emissions ranged -0.34% to 37% showing high variation compared to the UK Tier 1 IPCC EF1 default values of 1.25% (IPCC 1996) and 1% (IPPC 2006). However, the majority (83%) of EFs reported for UK-relevant soils fell within the UK IPCC EF1 uncertainty range of 0.03% to 3%. Residual maximum likelihood (REML) analysis of the data collated in the review showed that the type and rate of fertiliser N applied and soil type were significant factors influencing EFs reported. Country of emission, the length of the measurement period, the number of splits, the crop type, pH and SOC did not have a significant impact on N2O emissions. A subset of publications where sufficient data was reported for meta-analysis to be conducted was identified. Meta-analysis of effect sizes of 41 treatments demonstrated that the application of fertiliser has a significant effect on N2O emissions in comparison to control plots and that emission factors were significantly different to zero. However no significant relationships between the quantity of fertiliser applied and the effect size of the amount of N2O emitted from fertilised plots compared to control plots were found. Annual addition of fertiliser of 35 to 557 kg N/ha gave a mean increase in emissions of 2.02 ± 0.28 g N2O/ha/day compared to control treatments (p<0.01). Emission factors were significantly different from zero, with a mean emission factor estimated directly from the meta analysis of 0.17 ± 0.02%. This is lower than the IPCC 2006 Tier 1 EF1 value of 1% but falling within the uncertainty bound for the IPCC 2006 Tier 1 EF1 (0.03% to 3%). As only a small number of papers were viable for meta analysis to be conducted due to lack of reporting of the key controlling factors, the estimates of EF in this paper cannot include the true variability under conditions similar to the UK. Review-derived EFs of 0.34% to 37% and mean EF from meta-analysis of 0.17 ± 0.02% highlight variability in reporting EFs depending on the method applied and sample size. A protocol of systematic reporting of N2O emissions and key auxiliary parameters in publications across disciplines is proposed. If adopted this would strengthen the community to inform IPCC Tier 2 reporting development and reduce the uncertainty surrounding reported UK N2O emissions.
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Affiliation(s)
- S Buckingham
- Scotland's Rural College, West Mains Road, Edinburgh EH9 3JG, United Kingdom.
| | - S Anthony
- ADAS, Wobaston Road, Wolverhampton WV9 5AP, United Kingdom
| | - P H Bellamy
- Cranfield University, Cranfield MK43 0AL, United Kingdom
| | - L M Cardenas
- North Wyke, Rothamsted Research, Okehampton, Devon EX20 2SB, United Kingdom
| | - S Higgins
- Agri-Food and Biosciences Institute, Newforge Lane, Belfast BT9 5PX, United Kingdom
| | - K McGeough
- Agri-Food and Biosciences Institute, Newforge Lane, Belfast BT9 5PX, United Kingdom
| | - C F E Topp
- Scotland's Rural College, West Mains Road, Edinburgh EH9 3JG, United Kingdom
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Ryan R, Tracey G, Lawlor P, O'Siorain L, Higgins S. A retrospective review of specialist palliative care involvement in motor neurone disease. Ir Med J 2012; 105:335-338. [PMID: 23495545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
The provision of specialist palliative care to Irish patients suffering from motor neurone disease has not been described in the literature. The purpose of this study was to characterize the care provided at a Dublin hospice. Consecutive referrals between 1st January 1999 and 31st December 2008 (n=72) were reviewed. At the time of data collection, 61 (84.7%) were deceased, 9 (12.5%) were alive and the status of 2 (2.7%) was unknown. At first assessment, 48 (66%) had bulbar symptoms and 35 (49%) had respiratory symptoms, 50 (70%) were receiving Riluzole, 25 (35%) had a feeding tube and 13 (18%) were using non-invasive positive pressure ventilation (NIPPV). Median survival from the point of referral was 7 months (95% CI 4.5-9.4). Of the 61 deceased patients, 22 (36%) died at home, 22 (36%) died in the inpatient unit, 9 (15%) died in hospital and 8 (13%) died in a nursing home.
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Affiliation(s)
- R Ryan
- Our Lady's Hospice & Care Services, Harolds Cross, Dublin 6W.
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Birks S, Altinkaya M, Altinkaya A, Pilkington G, Kurian KM, Crosby C, Hopkins K, Williams M, Donovan L, Birks S, Eason A, Bosak V, Pilkington G, Birks S, Holliday J, Corbett I, Pilkington G, Keeling M, Bambrough J, Simpson J, Higgins S, Dogra H, Pilkington G, Kurian KM, Zhang Y, Bradley M, Schmidberger C, Hafizi S, Noorani I, Price S, Dubocq A, Jaunky T, Chatelain C, Evans L, Gaissmaier T, Pilkington GJ, An Q, Hurwitz V, Logan J, Bhangoo R, Ashkan K, Gullan A, Beaney R, Brazil L, Kokkinos S, Blake R, Singleton A, Shaw A, Iyer V, Kurian KM, Jeyapalan JN, Morley IC, Hill AA, Mumin MA, Tatevossian RG, Qaddoumi I, Ellison DW, Sheer D, Frary A, Price S, Jefferies S, Harris F, Burnet N, Jena R, Watts C, Haylock B, Leow-Dyke S, Rathi N, Wong H, Dunn J, Baborie A, Crooks D, Husband D, Shenoy A, Brodbelt A, Walker C, Bahl A, Larsen J, Craven I, Metherall P, McKevitt F, Romanowski C, Hoggard N, Jellinek DA, Bell S, Murray E, Muirhead R, James A, Hanzely Z, Jackson R, Stewart W, O'Brien A, Young A, Bell S, Hanzely Z, Stewart W, Shepherd S, Cavers D, Wallace L, Hacking B, Scott S, Bowyer D, Elmahdi A, Frary AJ, O'Donovan DG, Price SJ, Kia A, Przystal JM, Nianiaris N, Mazarakis ND, Mintz PJ, Hajitou A, Karakoula K, Phipps K, Harkness W, Hayward R, Thompson D, Jacques T, Harding B, Darling J, Warr T, Leow-Dyke S, Rathi N, Haylock B, Crooks D, Jenkinson M, Walker C, Brodbelt A, Zhou L, Ercolano E, Ammoun S, Schmid MC, Barczyk M, Hanemann CO, Rowther F, Dawson T, Ashton K, Darling J, Warr T, Maherally Z, Hatherell KE, Kroese K, Hafizi S, Pilkington GJ, Singh P, McQuaid S, Al-Rashid S, Prise K, Herron B, Healy E, Shoakazemi A, Donnelly M, McConnell R, Harney J, Conkey D, McGrath E, Lunsford L, Kondziolka D, Niranjan A, Kano H, Hamilton R, Flannery T, Majani Y, Smith S, Grundy R, Rahman R, Saini S, Hall G, Davis C, Rowther F, Lawson T, Ashton K, Potter N, Goessl E, Darling J, Warr T, Brodbelt A, Jenkinson M, Walker C, Leow-Dyke S, Haylock B, Dunn J, Wilkins S, Smith T, Petinou V, Nicholl I, Singh J, Lea R, Welsby P, Spiteri I, Sottoriva A, Marko N, Tavare S, Collins P, Price SJ, Watts C, Su Z, Gerhard A, Hinz R, Roncaroli F, Coope D, Thompson G, Karabatsou K, Sofat A, Leggate J, du Plessis D, Turkheimer F, Jackson A, Brodbelt A, Jenkinson M, Das K, Crooks D, Herholz K, Price SJ, Whittle IR, Ashkan K, Grundy P, Cruickshank G, Berry V, Elder D, Iyer V, Hopkins K, Cohen N, Tavare J, Zilidis G, Tibarewal P, Spinelli L, Leslie NR, Coope DJ, Karabatsou K, Green S, Wall G, Bambrough J, Brennan P, Baily J, Diaz M, Ironside J, Sansom O, Brunton V, Frame M, Young A, Thomas O, Mohsen L, Frary A, Lupson V, McLean M, Price S, Arora M, Shaw L, Lawrence C, Alder J, Dawson T, Hall G, Rada L, Chen K, Shivane A, Ammoun S, Parkinson D, Hanemann C, Pangeni RP, Warr TJ, Morris MR, Mackinnon M, Williamson A, James A, Chalmers A, Beckett V, Joannides A, Brock R, McCarthy K, Price S, Singh A, Karakoula K, Dawson T, Ashton K, Darling J, Warr T, Kardooni H, Morris M, Rowther F, Darling J, Warr T, Watts C, Syed N, Roncaroli F, Janczar K, Singh P, O'Neil K, Nigro CL, Lattanzio L, Coley H, Hatzimichael E, Bomalaski J, Szlosarek P, Crook T, Pullen NA, Anand M, Birks S, Van Meter T, Pullen NA, Anand M, Williams S, Boissinot M, Steele L, Williams S, Chiocca EA, Lawler S, Al Rashid ST, Mashal S, Taggart L, Clarke E, Flannery T, Prise KM. Abstracts from the 2012 BNOS Conference. Neuro Oncol 2012. [DOI: 10.1093/neuonc/nos198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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