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Patrick S, James D. Clinical description of two cases of Cowden syndrome and the implication regarding thyroid cancer. Endocrinol Diabetes Metab Case Rep 2024; 2024:23-0105. [PMID: 38513346 PMCID: PMC10959054 DOI: 10.1530/edm-23-0105] [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: 09/01/2023] [Accepted: 03/01/2024] [Indexed: 03/23/2024] Open
Abstract
Summary Thyroid cancer is one of the most common manifestations of Cowden syndrome, yet the syndrome is rare. The incidence of Cowden syndrome is 1 in 200,000. The diagnosis can be made clinically when patients present with a combination of symptoms such as mucocutaneous lesions with a strong personal or family history of thyroid, breast, endometrial, and colorectal cancer. A high index of suspicion is required to provide a clinical diagnosis utilizing major and minor criteria. Once a clinical diagnosis is made, genetic testing for a PTEN mutation, a tumor suppressor gene, is recommended. Cancer surveillance should be performed for those with positive genetic testing as well as those with negative genetic testing who still meet clinical diagnostic criteria. We present two cases of Cowden syndrome: one case involving an increasing number of thyroid nodules in a patient with known Cowden syndrome and another patient with a strong family history of cancer, personal history of follicular thyroid cancer, and numerous colonic polyps on screening colonoscopy. These cases demonstrate how early diagnosis of Cowden syndrome can help detect early cancer in both the patient and affected relatives. Learning points Diagnosing Cowden syndrome helps pre-risk stratification for early cancer screening. The diagnosis of Cowden syndrome can be made with a combination of major and minor criteria: any two major criteria with or without a minor criterion; one major and one minor criterion; or three minor criteria. Patients who meet the diagnostic criteria for Cowden syndrome should undergo genetic screening.
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Affiliation(s)
- Stephanie Patrick
- Division of Endocrinology, Department of Medicine, The University of Tennessee, Memphis, Tennessee, USA
| | - Deirdre James
- Division of Endocrinology, Department of Medicine, The University of Tennessee, Memphis, Tennessee, USA
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Abstract
This article examines the media framing of and relations to the 2014 iCloud hack, wherein hundreds of female celebrities' private photos were stolen and distributed online. In particular, I problematize the reading of this event as merely signalling the misogyny of 'toxic' online cultures and contextualize it as part of a larger political economy of female celebrity. I argue that, while the growth in feminist discourses emanating from both the mainstream media and celebrity women is encouraging, it perhaps occludes the broader power relations that extend across both new and traditional media, ensuring maintenance of the status quo. This event exemplifies problems with a popular form of feminism that seeks inclusion into these systems, rather than wider systemic change. Therefore, in addition to examining the celebrity and/or her audience as the site of political (feminist) work, I call for an excavation of the systems in which she is embedded and her relations to the means of media production and profit.
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Affiliation(s)
- Stephanie Patrick
- Stephanie Patrick, Institute of Feminist and Gender Studies, University of Ottawa, 120 University, Social Sciences Bldg, Room 11002, Ottawa, ON K1N 6N5, Canada.
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Alexeyev OA, Dekio I, Layton AM, Li H, Hughes H, Morris T, Zouboulis CC, Patrick S. Why we continue to use the name Propionibacterium acnes. Br J Dermatol 2018; 179:1227. [PMID: 30101491 DOI: 10.1111/bjd.17085] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [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)
- O A Alexeyev
- Department of Pathology, Umeå University, Umeå, Sweden
| | - I Dekio
- Microbe Division/Japan Collection of Microorganisms, RIKEN BioResource Research Center, Tsukuba, Japan
| | - A M Layton
- Department of Dermatology, Harrogate and District NHS Foundation Trust, Harrogate, U.K
| | - H Li
- Department of Molecular and Medical Pharmacology, Crump Institute for Molecular Imaging, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA,, U.S.A
| | - H Hughes
- Anaerobe Reference Unit, Public Health Wales Microbiology Cardiff, University Hospital of Wales, Cardiff, U.K
| | - T Morris
- Anaerobe Reference Unit, Public Health Wales Microbiology Cardiff, University Hospital of Wales, Cardiff, U.K
| | - C C Zouboulis
- Departments of Dermatology, Venereology, Allergology and Immunology, Dessau Medical Center, Brandenburg Medical School Theodor Fontane, Dessau, Germany
| | - S Patrick
- The Wellcome-Wolfson Institute for Experimental Medicine, Queen's University Belfast, Belfast, U.K
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Stewart L, D M Edgar J, Blakely G, Patrick S. Antigenic mimicry of ubiquitin by the gut bacterium Bacteroides fragilis: a potential link with autoimmune disease. Clin Exp Immunol 2018; 194:153-165. [PMID: 30076785 PMCID: PMC6194340 DOI: 10.1111/cei.13195] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2018] [Revised: 07/18/2018] [Accepted: 07/28/2018] [Indexed: 01/09/2023] Open
Abstract
Ubiquitin is highly conserved across eukaryotes and is essential for normal eukaryotic cell function. The bacterium Bacteroides fragilis is a member of the normal human gut microbiota, and the only bacterium known to encode a homologue of eukaryotic ubiquitin. The B. fragilis gene sequence indicates a past horizontal gene transfer event from a eukaryotic source. It encodes a protein (BfUbb) with 63% identity to human ubiquitin which is exported from the bacterial cell. The aim of this study was (i) to determine if there was antigenic cross‐reactivity between B. fragilis ubiquitin and human ubiquitin and (ii) to determine if humans produced antibodies to BfUbb. Molecular model comparisons of BfUbb and human ubiquitin predicted a high level (99·8% confidence) of structural similarity. Linear epitope mapping identified epitopes in BfUbb and human ubiquitin that cross‐react. BfUbb also has epitope(s) that do not cross‐react with human ubiquitin. The reaction of human serum (n = 474) to BfUbb and human ubiquitin from the following four groups of subjects was compared by enzyme‐linked immunosorbent assay (ELISA): (1) newly autoantibody‐positive patients, (2) allergen‐specific immunoglobulin (Ig)E‐negative patients, (3) ulcerative colitis patients and (4) healthy volunteers. We show that the immune system of some individuals has been exposed to BfUbb which has resulted in the generation of IgG antibodies. Serum from patients referred for first‐time testing to an immunology laboratory for autoimmune disease are more likely to have a high level of antibodies to BfUbb than healthy volunteers. Molecular mimicry of human ubiquitin by BfUbb could be a trigger for autoimmune disease.
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Affiliation(s)
- L Stewart
- School School of Biological Sciences, Queen's University Belfast, Belfast, UK
| | - J D M Edgar
- Regional Immunology Laboratory, Belfast Health and Social Care Trust, Belfast, UK.,The Wellcome-Wolfson Institute for Experimental Medicine, Queen's University Belfast, Belfast, UK
| | - G Blakely
- School of Biological Sciences, University of Edinburgh, Edinburgh, UK
| | - S Patrick
- School of Biological Sciences, University of Edinburgh, Edinburgh, UK.,The Wellcome-Wolfson Institute for Experimental Medicine, Queen's University Belfast, Belfast, UK
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Haller MJ, Schatz DA, Skyler JS, Krischer JP, Bundy BN, Miller JL, Atkinson MA, Becker DJ, Baidal D, DiMeglio LA, Gitelman SE, Goland R, Gottlieb PA, Herold KC, Marks JB, Moran A, Rodriguez H, Russell W, Wilson DM, Greenbaum CJ, Greenbaum C, Atkinson M, Baidal D, Battaglia M, Becker D, Bingley P, Bosi E, Buckner J, Clements M, Colman P, DiMeglio L, Evans-Molina C, Gitelman S, Goland R, Gottlieb P, Herold K, Knip M, Krischer J, Lernmark A, Moore W, Moran A, Muir A, Palmer J, Peakman M, Philipson L, Raskin P, Redondo M, Rodriguez H, Russell W, Spain L, Schatz D, Sosenko J, Wherrett D, Wilson D, Winter W, Ziegler A, Anderson M, Antinozzi P, Benoist C, Blum J, Bourcier K, Chase P, Clare-Salzler M, Clynes R, Cowie C, Eisenbarth G, Fathman C, Grave G, Harrison L, Hering B, Insel R, Jordan S, Kaufman F, Kay T, Kenyon N, Klines R, Lachin J, Leschek E, Mahon J, Marks J, Monzavi R, Nanto-Salonen K, Nepom G, Orban T, Parkman R, Pescovitz M, Peyman J, Pugliese A, Ridge J, Roep B, Roncarolo M, Savage P, Simell O, Sherwin R, Siegelman M, Skyler J, Steck A, Thomas J, Trucco M, Wagner J, Bourcier K, Greenbaum CJ, Krischer JP, Leschek E, Rafkin L, Spain L, Cowie C, Foulkes M, Insel R, Krause-Steinrauf H, Lachin JM, Malozowski S, Peyman J, Ridge J, Savage P, Skyler JS, Zafonte SJ, Greenbaum CJ, Rafkin L, Sosenko JM, Skyler JS, Kenyon NS, Santiago I, Krischer JP, Bundy B, Abbondondolo M, Adams T, Amado D, Asif I, Boonstra M, Boulware D, Bundy B, Burroughs C, Cuthbertson D, Eberhard C, Fiske S, Ford J, Garmeson J, Guillette H, Geyer S, Hays B, Henderson C, Henry M, Heyman K, Hsiao B, Karges C, Kinderman A, Lane L, Leinbach A, Liu S, Lloyd J, Malloy J, Maddox K, Martin J, Miller J, Moore M, Muller S, Nguyen T, O’Donnell R, Parker M, Pereyra M, Reed N, Roberts A, Sadler K, Stavros T, Tamura R, Wood K, Xu P, Young K, Alies P, Badias F, Baker A, Bassi M, Beam C, Boulware D, Bounmananh L, Bream S, Deemer M, Freeman D, Gough J, Ginem J, Granger M, Holloway M, Kieffer M, Lane P, Law P, Linton C, Nallamshetty L, Oduah V, Parrimon Y, Paulus K, Pilger J, Ramiro J, Luvon AQ, Ritzie A, Sharma A, Shor X, Song A, Terry J, Weinberger M, Wootten J, Fradkin E, Leschek L, Spain C, Cowie S, Malozowski P, Savage G, Beck E, Blumberg R, Gubitosi-Klug L, Laffel R, Veatch D, Wallace J, Braun D, Brillon A, Lernmark B, Lo H, Mitchell A, Naji J, Nerup T, Orchard M, Steffes A, Tsiatis B, Zinman B, Loechelt L, Baden M, Green A, Weinberg S, Marcovina JP, Palmer A, Weinberg L, Yu W, Winter GS, Eisenbarth A, Shultz E, Batts K, Fitzpatrick M, Ramey R, Guerra C, Webb M, Romasco C, Greenbaum S, Lord D, VanBuecken W, Hao M, McCulloch D, Hefty K, Varner R, Goland E, Greenberg S, Pollack B, Nelson L, Looper L, DiMeglio M, Spall C, Evans-Molina M, Mantravadi J, Sanchez M, Mullen V, Patrick S, Woerner DM, Wilson T, Aye T, Esrey K, Barahona B, Baker H, Bitar C, Ghodrat M, Hamilton SE, Gitelman CT, Ferrara S, Sanda R, Wesch C, Torok P, Gottlieb J, Lykens C, Brill A, Michels A, Schauwecker MJ, Haller DA, Schatz MA, Atkinson LM, Jacobsen M, Cintron TM, Brusko CH, Wasserfall CE, Mathews JS, Skyler JM, Marks D, Baidal C, Blaschke D, Matheson A, Moran B, Nathan A, Street J, Leschyshyn B, Pappenfus B, Nelson N, Flaherty D, Becker K, Delallo D, Groscost K, Riley H, Rodriguez D, Henson E, Eyth W, Russell A, Brown F, Brendall K, Herold, Feldman L. Low-Dose Anti-Thymocyte Globulin (ATG) Preserves β-Cell Function and Improves HbA 1c in New-Onset Type 1 Diabetes. Diabetes Care 2018; 41:1917-1925. [PMID: 30012675 PMCID: PMC6105329 DOI: 10.2337/dc18-0494] [Citation(s) in RCA: 96] [Impact Index Per Article: 16.0] [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: 03/06/2018] [Accepted: 06/12/2018] [Indexed: 02/03/2023]
Abstract
OBJECTIVE A pilot study suggested that combination therapy with low-dose anti-thymocyte globulin (ATG) and pegylated granulocyte colony-stimulating factor (GCSF) preserves C-peptide in established type 1 diabetes (T1D) (duration 4 months to 2 years). We hypothesized that 1) low-dose ATG/GCSF or 2) low-dose ATG alone would slow the decline of β-cell function in patients with new-onset T1D (duration <100 days). RESEARCH DESIGN AND METHODS A three-arm, randomized, double-masked, placebo-controlled trial was performed by the Type 1 Diabetes TrialNet Study Group in 89 subjects: 29 subjects randomized to ATG (2.5 mg/kg intravenously) followed by pegylated GCSF (6 mg subcutaneously every 2 weeks for 6 doses), 29 to ATG alone (2.5 mg/kg), and 31 to placebo. The primary end point was mean area under the curve (AUC) C-peptide during a 2-h mixed-meal tolerance test 1 year after initiation of therapy. Significance was defined as one-sided P value < 0.025. RESULTS The 1-year mean AUC C-peptide was significantly higher in subjects treated with ATG (0.646 nmol/L) versus placebo (0.406 nmol/L) (P = 0.0003) but not in those treated with ATG/GCSF (0.528 nmol/L) versus placebo (P = 0.031). HbA1c was significantly reduced at 1 year in subjects treated with ATG and ATG/GCSF, P = 0.002 and 0.011, respectively. CONCLUSIONS Low-dose ATG slowed decline of C-peptide and reduced HbA1c in new-onset T1D. Addition of GCSF did not enhance C-peptide preservation afforded by low-dose ATG. Future studies should be considered to determine whether low-dose ATG alone or in combination with other agents may prevent or delay the onset of the disease.
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Affiliation(s)
| | | | - Jay S. Skyler
- Diabetes Research Institute, University of Miami Miller School of Medicine, Miami, FL
| | | | | | | | | | | | - David Baidal
- Diabetes Research Institute, University of Miami Miller School of Medicine, Miami, FL
| | | | | | | | - Peter A. Gottlieb
- University of Colorado Barbara Davis Center for Childhood Diabetes, Aurora, CO
| | | | - Jennifer B. Marks
- Diabetes Research Institute, University of Miami Miller School of Medicine, Miami, FL
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Patrick S, McDowell A, Lee A, Frau A, Martin U, Gardner E, McLorinan G, Eames N. Antisepsis of the skin before spinal surgery with povidone iodine-alcohol followed by chlorhexidine gluconate-alcohol versus povidone iodine-alcohol applied twice for the prevention of contamination of the wound by bacteria: a randomised controlled trial. Bone Joint J 2017; 99-B:1354-1365. [PMID: 28963158 DOI: 10.1302/0301-620x.99b10.bjj-2017-0291.r1] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [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: 04/27/2017] [Accepted: 06/05/2017] [Indexed: 11/05/2022]
Abstract
AIMS The aim of this study was to determine whether the sequential application of povidone iodine-alcohol (PVI) followed by chlorhexidine gluconate-alcohol (CHG) would reduce surgical wound contamination to a greater extent than PVI applied twice in patients undergoing spinal surgery. PATIENTS AND METHODS A single-centre, interventional, two arm, parallel group randomised controlled trial was undertaken, involving 407 patients who underwent elective spinal surgery. For 203 patients, the skin was disinfected before surgery using PVI (10% [w/w (1% w/w available iodine)] in 95% industrial denatured alcohol, povidone iodine; Videne Alcoholic Tincture) twice, and for 204 patients using PVI once followed by CHG (2% [w/v] chlorhexidine gluconate in 70% [v/v] isopropyl alcohol; Chloraprep with tint). The primary outcome measure was contamination of the wound determined by aerobic and anaerobic bacterial growth from samples taken after disinfection. RESULTS The detection of viable bacteria in any one of the samples taken after disinfection (culture-positive) was significantly lower in the group treated with both PVI and CHG than in the group treated with PVI alone (59 (29.1%) versus 85 (41.7%), p = 0.009; odds ratio 0.574; 95% confidence interval, 0.380 to 0.866). CONCLUSIONS Antisepsis of the skin with the sequential application of PVI and CHG more effectively reduces the contamination of a surgical wound than PVI alone. Cite this article: Bone Joint J 2017;99-B:1354-65.
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Affiliation(s)
- S Patrick
- Centre for Experimental Medicine, School of Medicine Dentistry and Biomedical Sciences, Queen's University of Belfast, 97 Lisburn Road, Belfast, BT9 7BL, UK
| | - A McDowell
- Centre for Experimental Medicine, School of Medicine Dentistry and Biomedical Sciences, Queen's University of Belfast, 97 Lisburn Road, Belfast, BT9 7BL, UK
| | - A Lee
- Centre for Experimental Medicine, School of Medicine Dentistry and Biomedical Sciences, Queen's University of Belfast, 97 Lisburn Road, Belfast, BT9 7BL, UK
| | - A Frau
- Centre for Experimental Medicine, School of Medicine Dentistry and Biomedical Sciences, Queen's University of Belfast, 97 Lisburn Road, Belfast, BT9 7BL, UK
| | - U Martin
- Royal Victoria and Musgrave Park Hospitals, Belfast Health and Social Care Trust, Belfast, UK
| | - E Gardner
- Northern Ireland Clinical Trials Unit, The Royal Hospitals , Belfast, UK
| | - G McLorinan
- Royal Victoria and Musgrave Park Hospitals, Belfast Health and Social Care Trust, Belfast, UK
| | - N Eames
- Regional Trauma and Orthopaedic Service, Royal Victoria and Musgrave Park Hospitals, Belfast Health and Social Care Trust, Belfast, UK
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Baquero-Ruiz M, Avino F, Chellai O, Fasoli A, Furno I, Jacquier R, Manke F, Patrick S. Dual Langmuir-probe array for 3D plasma studies in TORPEX. Rev Sci Instrum 2016; 87:113504. [PMID: 27910384 DOI: 10.1063/1.4968024] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/15/2016] [Accepted: 11/06/2016] [Indexed: 06/06/2023]
Abstract
We have designed and installed a new Langmuir-probe (LP) array diagnostic to determine basic three-dimensional (3D) features of plasmas in TORPEX. The diagnostic consists of two identical LP arrays, placed on opposite sides of the apparatus, which provide comprehensive coverage of the poloidal cross section at the two different toroidal locations. Cross correlation studies of signals from the arrays provide a basic way to extract 3D information from the plasmas, as experiments show. Moreover, the remarkable signal-to-noise performance of the front-end electronics allows us to follow a different approach in which we combine information from all probes in both arrays to reconstruct elementary 3D plasma structures at each acquisition time step. Then, through data analysis, we track the structures as they evolve in time. The LP arrays include a linear-motion mechanism that can displace radially the probes located on the low field side for experiments that require fine-tuning of the probe locations, and for operational compatibility with the recently installed in-vessel toroidal conductor.
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Affiliation(s)
- M Baquero-Ruiz
- Swiss Plasma Center (SPC), Ecole Polytechnique Fédérale de Lausanne (EPFL), CH-1015 Lausanne, Switzerland
| | - F Avino
- Swiss Plasma Center (SPC), Ecole Polytechnique Fédérale de Lausanne (EPFL), CH-1015 Lausanne, Switzerland
| | - O Chellai
- Swiss Plasma Center (SPC), Ecole Polytechnique Fédérale de Lausanne (EPFL), CH-1015 Lausanne, Switzerland
| | - A Fasoli
- Swiss Plasma Center (SPC), Ecole Polytechnique Fédérale de Lausanne (EPFL), CH-1015 Lausanne, Switzerland
| | - I Furno
- Swiss Plasma Center (SPC), Ecole Polytechnique Fédérale de Lausanne (EPFL), CH-1015 Lausanne, Switzerland
| | - R Jacquier
- Swiss Plasma Center (SPC), Ecole Polytechnique Fédérale de Lausanne (EPFL), CH-1015 Lausanne, Switzerland
| | - F Manke
- Swiss Plasma Center (SPC), Ecole Polytechnique Fédérale de Lausanne (EPFL), CH-1015 Lausanne, Switzerland
| | - S Patrick
- Swiss Plasma Center (SPC), Ecole Polytechnique Fédérale de Lausanne (EPFL), CH-1015 Lausanne, Switzerland
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Asmatulu R, Patrick S, Ceylan M, Ahmed I, Yang SY, Nuraje N. Antibacterial Polycaprolactone/Natural Hydroxyapatite Nanocomposite Fibers for Bone Scaffoldings. ACTA ACUST UNITED AC 2015. [DOI: 10.1166/jbns.2015.1286] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Weber IB, Turabelidze G, Patrick S, Griffith KS, Kugeler KJ, Mead PS. Clinical Recognition and Management of Tularemia in Missouri: A Retrospective Records Review of 121 Cases. Clin Infect Dis 2012; 55:1283-90. [DOI: 10.1093/cid/cis706] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
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Serrano MA, Li Z, Dangeti M, Musich PR, Patrick S, Roginskaya M, Cartwright B, Zou Y. DNA-PK, ATM and ATR collaboratively regulate p53-RPA interaction to facilitate homologous recombination DNA repair. Oncogene 2012; 32:2452-62. [PMID: 22797063 PMCID: PMC3651755 DOI: 10.1038/onc.2012.257] [Citation(s) in RCA: 76] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Homologous recombination (HR) and nonhomologous end-joining (NHEJ) are two distinct DNA double-strand break (DSB) repair pathways. Here we report that DNA-dependent protein kinase (DNA-PK), the core component of NHEJ, partnering with DNA-damage checkpoint kinases ataxia telangiectasia mutated (ATM) and ATM- and Rad3-related (ATR), regulates HR repair of DSBs. The regulation was accomplished through modulation of the p53 and replication protein A (RPA) interaction. We show that upon DNA damage, p53 and RPA were freed from a p53-RPA complex by simultaneous phosphorylations of RPA at the N-terminus of RPA32 subunit by DNA-PK and of p53 at Ser37 and Ser46 in a Chk1/Chk2-independent manner by ATR and ATM, respectively. Neither the phosphorylation of RPA nor of p53 alone could dissociate p53 and RPA. Furthermore, disruption of the release significantly compromised HR repair of DSBs. Our results reveal a mechanism for the crosstalk between HR repair and NHEJ through the co-regulation of p53-RPA interaction by DNA-PK, ATM and ATR.
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Affiliation(s)
- M A Serrano
- Department of Biochemistry and Molecular Biology, JH Quillen College of Medicine, East Tennessee State University, Johnson City, TN 37614, USA
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Jahns A, Lundskog B, Ganceviciene R, Palmer R, Golovleva I, Zouboulis C, McDowell A, Patrick S, Alexeyev O. An increased incidence of Propionibacterium acnes biofilms in acne vulgaris: a case-control study. Br J Dermatol 2012; 167:50-8. [DOI: 10.1111/j.1365-2133.2012.10897.x] [Citation(s) in RCA: 150] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Tunney MM, Ramage G, Patrick S, Curran M, Nixon JR, Gorman SP. Use of 16S ribosomal (rRNA) genes and immunofluorescence microscopy to detect prosthetic hip infection. J Pharm Pharmacol 2011. [DOI: 10.1111/j.2042-7158.1998.tb02237.x] [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] [Indexed: 11/27/2022]
Affiliation(s)
- M M Tunney
- Department of Microbiology and Immunobiology, School of Clinical Medicine, The Queen’s University of Belfast
- School of Pharmacy, The Queen’s University of Belfast
| | - G Ramage
- Department of Microbiology and Immunobiology, School of Clinical Medicine, The Queen’s University of Belfast
| | - S Patrick
- Department of Microbiology and Immunobiology, School of Clinical Medicine, The Queen’s University of Belfast
| | - M Curran
- Regional Histocompatability and Immunogenetic Laboratory, Belfast City Hospital
| | - J R Nixon
- Musgrave Park Hospital, Belfast BT9 7BL
| | - S P Gorman
- School of Pharmacy, The Queen’s University of Belfast
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Tunney MM, Ramage G, Patrick S, Nixon JR, Murphy PG, Gorman SP. Improved antibiotic therapy for elimination and prevention of prosthetic hip infection. J Pharm Pharmacol 2011. [DOI: 10.1111/j.2042-7158.1998.tb02240.x] [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] [Indexed: 11/28/2022]
Affiliation(s)
- M M Tunney
- Schools of Pharmacy, The Queen’s University of Belfast, Belfast BT9 7BL
- Clinical Medicine, The Queen’s University of Belfast, Belfast BT9 7BL
| | - G Ramage
- Clinical Medicine, The Queen’s University of Belfast, Belfast BT9 7BL
| | - S Patrick
- Clinical Medicine, The Queen’s University of Belfast, Belfast BT9 7BL
| | - J R Nixon
- Musgrave Park Hospital, Belfast BT9 7BL
| | | | - S P Gorman
- Schools of Pharmacy, The Queen’s University of Belfast, Belfast BT9 7BL
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Daly A, Michael P, Johnson EQ, Harrington CC, Patrick S, Bender T. Diabetes White Paper: Defining the Delivery of Nutrition Services in Medicare Medical Nutrition Therapy vs Medicare Diabetes Self-Management Training Programs. ACTA ACUST UNITED AC 2009; 109:528-39. [DOI: 10.1016/j.jada.2008.11.004] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2008] [Indexed: 11/30/2022]
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Patrick S. What Went Right? The Story of US Medicare Medical Nutrition Therapy. Nestlé Nutrition Institute Workshop Series: Clinical & Performance Program 2009; 12:137-158. [DOI: 10.1159/000235676] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
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Patrick S, Shiels H, White E. The presence of mechanosensitive channels in the rainbow trout (Oncorhynchus mykiss) heart. Comp Biochem Physiol A Mol Integr Physiol 2008. [DOI: 10.1016/j.cbpa.2008.04.195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Dunne NJ, Hill J, McAfee P, Kirkpatrick R, Patrick S, Tunney M. Incorporation of large amounts of gentamicin sulphate into acrylic bone cement: Effect on handling and mechanical properties, antibiotic release, and biofilm formation. Proc Inst Mech Eng H 2008; 222:355-65. [DOI: 10.1243/09544119jeim355] [Citation(s) in RCA: 63] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Bacterial infection remains a significant complication following total joint replacement. If infection is suspected when revision surgery is being performed, a large dose of antibiotic, usually gentamicin sulphate, is often blended with the acrylic bone cement powder in an attempt to reduce the risk of recurrent infection. In this in-vitro study the effect of small and large doses of gentamicin sulphate on the handling and mechanical properties of the cement, gentamicin release from the cement, and in-vitro biofilm formation by clinical Staphylococcus spp. isolates on the cement was determined. An increase in gentamicin loading of 1, 2, 3, or 4 g, in a cement powder mass of 40 g, resulted in a significant decrease in the compressive and four-point bending strength, but a significant increase in the amount of gentamicin released over a 72 h period. When overt infection was modelled, using Staphylococcus spp. clinical isolates at an inoculum of 1×107 colony-forming units/ml, an increase in the amount of gentamicin (1, 2, 3, or 4 g) added to 40 g of poly(methyl methacrylate) cement resulted in an initial decrease in bacterial colonization but this beneficial effect was no longer apparent by 72 h, with the bacterial strains forming biofilms on the cements despite the release of high levels of gentamicin. The findings suggest that orthopaedic surgeons should carefully consider the clinical consequences of blending large doses (1 g or more per 40 g of poly(methyl methacrylate)) of gentamicin into Palacos® R bone cement for use in revision surgery as the increased gentamicin loading does not prevent bacterial biofilm formation and the effect on the mechanical properties could be important to the longevity of the prosthetic joint.
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Affiliation(s)
- N J Dunne
- School of Mechanical and Aerospace Engineering, Queen's University Belfast, Belfast, UK
| | - J Hill
- School of Mechanical and Aerospace Engineering, Queen's University Belfast, Belfast, UK
| | - P McAfee
- School of Mechanical and Aerospace Engineering, Queen's University Belfast, Belfast, UK
| | - R Kirkpatrick
- School of Pharmacy, Queen's University Belfast, Belfast, UK
| | - S Patrick
- School of Medicine and Dentistry, Queen's University Belfast, Belfast, UK
| | - M Tunney
- School of Pharmacy, Queen's University Belfast, Belfast, UK
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Patrick S, White E, Shiels H. 35.P4. The effect of stretch on the electrical activity of the rainbow trout (Oncorhynchus mykiss) heart. Comp Biochem Physiol A Mol Integr Physiol 2007. [DOI: 10.1016/j.cbpa.2007.06.387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Ambolt P, Bowden J, Cooper M, Henry A, McCormack S, Morgan A, Patrick S, Thompson R, Thwaites D. Commissioning a Superposition Dose Calculation Model for 6 MV Photon Beams on a Radiotherapy Treatment Planning System. Clin Oncol (R Coll Radiol) 2007. [DOI: 10.1016/j.clon.2007.01.399] [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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Tunney MM, Dunne N, Einarsson G, McDowell A, Kerr A, Patrick S. Biofilm formation by bacteria isolated from retrieved failed prosthetic hip implants in an in vitro model of hip arthroplasty antibiotic prophylaxis. J Orthop Res 2007; 25:2-10. [PMID: 17001707 DOI: 10.1002/jor.20298] [Citation(s) in RCA: 56] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Bacterial infection primarily with Staphylococcus spp. and Propionibacterium acnes remains a significant complication following total hip replacement. In this in vitro study, we investigated the efficacy of gentamicin loading of bone cement and pre- and postoperative administration of cefuroxime in the prevention of biofilm formation by clinical isolates. High and low initial inocula, representative of the number of bacteria that may be present at the operative site as a result of overt infection and skin contamination, respectively, were used. When a high initial inoculum was used, gentamicin loading of the cement did not prevent biofilm formation by the 10 Staphylococcus spp. and the 10 P. acnes isolates tested. Similarly, the use of cefuroxime in the fluid phase with gentamicin-loaded cement did not prevent biofilm formation by four Staphylococcus spp. and four P. acnes isolates tested. However, when a low bacterial inoculum was used, a combination of both gentamicin-loaded cement and cefuroxime prevented biofilm formation by these eight isolates. Our results indicate that this antibiotic combination may protect against infection after intra-operative challenge with bacteria present in low numbers as a result of contamination from the skin but would not protect against bacteria present in high numbers as a result of overt infection of an existing implant.
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Affiliation(s)
- M M Tunney
- Clinical and Practice Research Group, School of Pharmacy, Queen's University Belfast, Belfast BT9 7BL, United Kingdom.
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Eline M, Joël G, Patrick S, Armelle L, Jacques M, Bernard M, Vincent J. P-867 Treatment of thymic carcinomas: Analysis of 9 cases. Lung Cancer 2005. [DOI: 10.1016/s0169-5002(05)81360-1] [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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Paley G, Shapiro DA, Myers J, Patrick S, Reid E. Personal reflections of mental health nurses training to use Hobson's Conversational Model (psychodynamic-interpersonal) of psychotherapy. J Psychiatr Ment Health Nurs 2003; 10:735-42. [PMID: 15005488 DOI: 10.1046/j.1365-2850.2003.00671.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [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: 11/20/2022]
Abstract
Current mental health policy documents highlight the need for mental health nurses to become increasingly involved in the delivery of evidence-based psychological interventions. However, substantial evidence exists indicating that there is a paucity of training to adequately equip nurses to deliver these interventions and, even when training is available, there are barriers to their implementation into routine clinical practice. This paper reports on the personal reflections and experiences of a group of four mental health nurses undertaking training in the Conversational Model of psychotherapy (also known as psychodynamic-interpersonal 'PI' psychotherapy). These reflections highlight the rewards and challenges arising from the effort to undertake training in an evidence-based model of psychological intervention and from attempting to implement and sustain this training into routine practice.
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Affiliation(s)
- G Paley
- Leeds Mental Health Trust, Leeds, UK.
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Paley G, Myers J, Patrick S, Reid E, Shapiro DA. Practice development in psychological interventions: mental health nurse involvement in the Conversational Model of psychotherapy. J Psychiatr Ment Health Nurs 2003; 10:494-8. [PMID: 12887642 DOI: 10.1046/j.1365-2850.2003.00622.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [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: 11/20/2022]
Abstract
This paper describes a mental health nurse led practice development initiative in psychotherapy. Four mental health nurses have been trained to deliver the Conversational Model of psychotherapy (also known as psychodynamic-interpersonal (PI) psychotherapy) a non-cognitive behavioural therapy (CBT) with a robust evidence base. We report on the robust range of both processes and outcome measures being used to evaluate this initiative. We conclude that good quality evidence-based practice requires careful planning and preparation, adequate financial resources from Trusts, as well as commitment and motivation from the staff expected to be involved in such initiatives.
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Affiliation(s)
- G Paley
- Leeds Mental Health Trust, Leeds, UK
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Riordan T, Cartwright K, Logan M, Cunningham R, Patrick S, Coleman T. How do microbiology consultants undertake their jobs? A survey of consultant time and tasks in South West England. J Clin Pathol 2002; 55:735-40. [PMID: 12354797 PMCID: PMC1769771 DOI: 10.1136/jcp.55.10.735] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [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: 11/04/2022]
Abstract
AIMS To measure the total consultant medical microbiologist (CMM) weekly workload, to identify time spent on different activities, and to differentiate those tasks that were viewed by a consensus of consultants as core activities from those that could be accorded a lower priority. METHODS A self administered questionnaire completed by consultant medical microbiologists in the Public Health Laboratory Service South West Group. RESULTS Reported hours worked by respondents ranged from 41 to 65 hours each week, excluding on call activities. Eleven of 20 respondents reported working in excess of 48 hours each week. There was no correlation between hours worked and laboratory workload as measured by numbers of specimens. Clinical liaison, result authorisation, infection control, and management activities took up most time. Working practices varied widely between individuals, partly reflecting their differing roles in the laboratory. A consensus was reached regarding the relative importance and priority of many regular CMM activities. CONCLUSIONS Consultant microbiologists can identify, with consensus, both high and lower priority activities in their daily practice. If such clinical priorities can be more widely agreed across the profession, this would provide a rational approach to workload control.
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Affiliation(s)
- T Riordan
- Public Health Laboratory, Church Lane, Heavitree, Exeter EX2 5AD, UK.
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Connery N, Thompson AS, Patrick S, Larkin MJ. Studies of Microthrix parvicella in situ and in laboratory culture: production and use of specific antibodies. Water Sci Technol 2002; 46:115-118. [PMID: 12216611] [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: 05/23/2023]
Abstract
Physiological studies on M. parvicella have been conducted to determine the rate of growth of this organism in pure culture. The organism displayed a doubling time of 128 days despite its profuse abundance in a local Wastewater Treatment Plant (WWTW). An extensive survey has been ongoing since February 2000 into the extent of M. parvicella in the WWTW. A suite of monoclonal and polyclonal antibodies has been developed to detect and quantify M. parvicella.
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Affiliation(s)
- N Connery
- The QUESTOR Centre & School of Biology and Biochemistry, The Queen's University of Belfast, United Kingdom
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Thang PT, Patrick S, Teik LS, Yung CS. Anti-oxidant effects of the extracts from the leaves of Chromolaena odorata on human dermal fibroblasts and epidermal keratinocytes against hydrogen peroxide and hypoxanthine–xanthine oxidase induced damage. Burns 2001; 27:319-27. [PMID: 11348739 DOI: 10.1016/s0305-4179(00)00137-6] [Citation(s) in RCA: 73] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
In cutaneous tissue repair, oxidants and antioxidants play very important roles. In local acute and chronic wounds, oxidants are known to have the ability to cause as cell damage and may function as inhibitory factors to wound healing. The administration of anti-oxidants or free radical scavengers is reportedly helpful, notably in order to limit the delayed sequelae of thermal trauma and to enhance the healing process. Extracts from the leaves of Chromolaena odorata have been shown to be beneficial for treatment of wounds. Studies in vitro of these extracts demonstrated enhanced proliferation of fibroblasts, endothelial cells and keratinocytes, stimulation of keratinocyte migration in an in vitro wound assay, up-regulation of production by keratinocytes of extracellular matrix proteins and basement membrane components, and inhibition of collagen lattice contraction by fibroblasts. In this study, the anti-oxidant effects of both total ethanol and polyphenolic extracts from the plant leaves on hydrogen peroxide and hypoxanthine-xanthine oxidase induced damage to human fibroblasts and keratinocytes were investigated. Cell viability was monitored by a colorimetric assay. The results showed that for fibroblasts, toxicity of hydrogen peroxide or hypoxanthine xanthine oxidase on cells was dose-dependent. Total ethanol extract (TEE) at 400 and 800 microg/ml showed maximum and consistent protective cellular effect on oxidant toxicity at low or high doses of oxidants. The 50 microg/ml concentration of TEE also had significant and slightly protective effects on fibroblasts against hydrogen peroxide and hypoxanthine-xanthine oxidase induced damage, respectively. For keratinocytes, a dose-dependent relationship of oxidant toxicity was only seen with hydrogen peroxide but the protective action of the extract correlated with oxidant dosage. TEE at 400 and 800 microg/ml showed dose-dependent effects with both low and high concentration of oxidants. TEE at 50 microg/ml had no effect on keratinocytes. Pre-treatment with the extracts did not show a protective effect on cells. Polyphenolic extract exhibited a slight anti-oxidant effect. Protection of cells against destruction by inflammatory mediators may be one of the ways in which the extracts from the plant, C. odorata, contribute to wound healing.
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Affiliation(s)
- P T Thang
- Department of Plastic Surgery/National Burns Centre, Singapore General Hospital, Outram Road, 169 608, Singapore, Singapore.
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Łuczak M, Obuch-Woszczatyński P, Pituch H, Leszczyński P, Martirosian G, Patrick S, Poxton I, Wintermans RG, Dubreuil L, Meisel-Mikołajczyk F. Search for enterotoxin gene in Bacteroides fragilis strains isolated from clinical specimens in Poland, Great Britain, The Netherlands and France. Med Sci Monit 2001; 7:222-5. [PMID: 11257725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/19/2023] Open
Abstract
BACKGROUND Bacteroides fragilis is a member of normal human flora and well known pathogenic agent. This bacterium produces many virulence factors. In 1984 new virulence factor--enterotoxin was described. The aim of the study was to search for enterotoxin gene in B. fragilis strains isolated from clinical specimens. MATERIAL AND METHODS Strains isolated in Poland, Great Britain, France and the Netherlands were cultured on BBE medium. For DNA isolation Genomic DNA PREP PLUS isolation kit manufactured by A&A Biotechnology (Poland) was used. In order to detect enterotoxin (fragilysin) gene, polymerase chain reaction (PCR) was applied utilizing the following primers: 404 (GAG CGG AAG ACG GTG TAT GTG ATT TGT) and 407 (TGC TCA GCG CCC AGT ATA TGA CCT AGT). DNA obtained from bacterial cells was amplified in thermocycler Techne. The amplification products were detected by the electrophoresis in 1% agarose gel. RESULTS Among 65 investigated B. fragilis strains, the enterotoxin gene was detected in DNA isolated from 12 strains. CONCLUSION The enterotoxin producing B. fragilis strains were detected among strains isolated from different clinical specimens in Poland, Great Britain, the Netherlands and France.
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Affiliation(s)
- M Łuczak
- Department of Medical Microbiology, Center of Biostructure Research, Medical University of Warsaw, 5 Chałubińskiego St., 02-004 Warsaw, Poland
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Chatterjee A, Fiechtner HB, Patrick S. Facts and fallacies about varicella and the varicella vaccine. S D J Med 2000; 53:193-7. [PMID: 10835949] [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: 02/16/2023]
Abstract
Varicella is a nearly ubiquitous infection that results in significant morbidity and occasional mortality. The varicella vaccine has been licensed in the United States for the past five years. While varicella vaccination rates are slowly growing nationally, the immunization rate for South Dakota remains abysmally low. The legislature has recently mandated this vaccine for school entry in South Dakota, to promote its increased use. There are many fallacies about varicella and the varicella vaccine and questions about how new requirements of varicella vaccination before school entry will be met. This article identifies these common misconceptions and can serve as a resource for answers to questions commonly asked of vaccine providers.
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Affiliation(s)
- A Chatterjee
- Department of Pediatrics, University of South Dakota School of Medicine, Sioux Falls, USA
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Patrick S. Proposed dietary guidelines 2000 generate comments, controversy. J Am Diet Assoc 2000; 100:518. [PMID: 10812374 DOI: 10.1016/s0002-8223(00)00160-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Tunney MM, Patrick S, Curran MD, Ramage G, Anderson N, Davis RI, Gorman SP, Nixon JR. Detection of prosthetic joint biofilm infection using immunological and molecular techniques. Methods Enzymol 1999; 310:566-76. [PMID: 10547820 DOI: 10.1016/s0076-6879(99)10044-2] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/14/2023]
MESH Headings
- Animals
- Antibodies, Monoclonal
- Bacterial Infections/diagnosis
- Bacterial Infections/etiology
- Bacteriological Techniques
- Base Sequence
- Biofilms
- DNA Primers/genetics
- DNA, Bacterial/genetics
- DNA, Bacterial/isolation & purification
- Hip Prosthesis/adverse effects
- Humans
- Immunologic Techniques
- Mice
- Microscopy, Electron, Scanning
- Microscopy, Fluorescence
- Polymerase Chain Reaction
- Polymorphism, Single-Stranded Conformational
- Prosthesis-Related Infections/diagnosis
- Prosthesis-Related Infections/etiology
- RNA, Bacterial/genetics
- RNA, Ribosomal, 16S/genetics
- Reoperation
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Affiliation(s)
- M M Tunney
- School of Pharmacy, Queen's University of Belfast, United Kingdom
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Tunney MM, Patrick S, Curran MD, Ramage G, Hanna D, Nixon JR, Gorman SP, Davis RI, Anderson N. Detection of prosthetic hip infection at revision arthroplasty by immunofluorescence microscopy and PCR amplification of the bacterial 16S rRNA gene. J Clin Microbiol 1999; 37:3281-90. [PMID: 10488193 PMCID: PMC85548 DOI: 10.1128/jcm.37.10.3281-3290.1999] [Citation(s) in RCA: 384] [Impact Index Per Article: 15.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
In this study the detection rates of bacterial infection of hip prostheses by culture and nonculture methods were compared for 120 patients with total hip revision surgery. By use of strict anaerobic bacteriological practice during the processing of samples and without enrichment, the incidence of infection by culture of material dislodged from retrieved prostheses after ultrasonication (sonicate) was 22%. Bacteria were observed by immunofluorescence microscopy in 63% of sonicate samples with a monoclonal antibody specific for Propionibacterium acnes and polyclonal antiserum specific for Staphylococcus spp. The bacteria were present either as single cells or in aggregates of up to 300 bacterial cells. These aggregates were not observed without sonication to dislodge the biofilm. Bacteria were observed in all of the culture-positive samples, and in some cases in which only one type of bacterium was identified by culture, both coccoid and coryneform bacteria were observed by immunofluorescence microscopy. Bacteria from skin-flake contamination were readily distinguishable from infecting bacteria by immunofluorescence microscopy. Examination of skin scrapings did not reveal large aggregates of bacteria but did reveal skin cells. These were not observed in the sonicates. Bacterial DNA was detected in 72% of sonicate samples by PCR amplification of a region of the bacterial 16S rRNA gene with universal primers. All of the culture-positive samples were also positive for bacterial DNA. Evidence of high-level infiltration either of neutrophils or of lymphocytes or macrophages into associated tissue was observed in 73% of patients. Our results indicate that the incidence of prosthetic joint infection is grossly underestimated by current culture detection methods. It is therefore imperative that current clinical practice with regard to the detection and subsequent treatment of prosthetic joint infection be reassessed in the light of these results.
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Affiliation(s)
- M M Tunney
- Department of Microbiology and Immunobiology, School of Clinical Medicine, The Queen's University of Belfast, Belfast BT12 6BN, United Kingdom
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Stoddard JL, Jeffries DS, Lükewille A, Clair TA, Dillon PJ, Driscoll CT, Forsius M, Johannessen M, Kahl JS, Kellogg JH, Kemp A, Mannio J, Monteith DT, Murdoch PS, Patrick S, Rebsdorf A, Skjelkvåle BL, Stainton MP, Traaen T, van Dam H, Webster KE, Wieting J, Wilander A. Regional trends in aquatic recovery from acidification in North America and Europe. Nature 1999. [DOI: 10.1038/44114] [Citation(s) in RCA: 620] [Impact Index Per Article: 24.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Patrick S, Gilpin D, Stevenson L. Detection of intrastrain antigenic variation of Bacteroides fragilis surface polysaccharides by monoclonal antibody labelling. Infect Immun 1999; 67:4346-51. [PMID: 10456873 PMCID: PMC96751 DOI: 10.1128/iai.67.9.4346-4351.1999] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Bacteroides fragilis is a constituent of the normal resident microbiota of the human intestine and is the gram-negative obligately anaerobic bacterium most frequently isolated from clinical infection. Surface polysaccharides are implicated as potential virulence determinants. We present evidence of within strain immunochemical variation of surface polysaccharides in populations that are noncapsulate by light microscopy as determined by monoclonal antibody labelling. Expression of individual epitopes can be enriched from a population of an individual strain by use of immunomagnetic beads. Also, individual colonies in which either >94% or <7% of the bacteria carry an individual epitope retain this level of expression when subcultured into broth. In broth cultures where >94% of the bacteria carry a given epitope, there is no enrichment for other epitopes recognized by different polysaccharide-specific monoclonal antibodies. This intrastrain variation has important implications for the development of potential vaccines or immunodiagnostic tests.
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Affiliation(s)
- S Patrick
- Department of Microbiology and Immunobiology, School of Medicine, Queen's University of Belfast, Belfast BT12 6BN, United Kingdom.
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Tunney MM, Ramage G, Patrick S, Nixon JR, Murphy PG, Gorman SP. Antimicrobial susceptibility of bacteria isolated from orthopedic implants following revision hip surgery. Antimicrob Agents Chemother 1998; 42:3002-5. [PMID: 9797241 PMCID: PMC105981 DOI: 10.1128/aac.42.11.3002] [Citation(s) in RCA: 98] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The susceptibilities of 49 isolates recovered from orthopedic implants to seven antimicrobial agents were evaluated by the broth microdilution method. Ciprofloxacin and vancomycin were more active than gentamicin, representing aminoglycosides which are routinely incorporated into bone cement, and also more active than the peroperative antimicrobial agents cefamandole and erythromycin. The use of ciprofloxacin and vancomycin in vivo, therefore, warrants further evaluation.
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Affiliation(s)
- M M Tunney
- Department of Microbiology and Immunobiology, School of Clinical Medicine, The Queen's University of Belfast, Belfast BT12 6BN, Belfast BT9 7BL, United Kingdom
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Abstract
Our aim was to determine if the detection rate of infection of total hip replacements could be improved by examining the removed prostheses. Immediate transfer of prostheses to an anaerobic atmosphere, followed by mild ultrasonication to dislodge adherent bacteria, resulted in the culture of quantifiable numbers of bacteria, from 26 of the 120 implants examined. The same bacterial species were cultured by routine microbiological techniques from only five corresponding tissue samples. Tissue removed from 18 of the culture-positive implants was suitable for quantitative tissue pathology and inflammatory cells were present in all samples. Furthermore, inflammatory cells were present in 87% of tissue samples taken from patients whose implants were culture-negative. This suggests that these implants may have been infected by bacteria which were not isolated by the techniques of culture used. The increased detection of bacteria from prostheses by culture has improved postoperative antibiotic therapy and should reduce the need for further revision.
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Affiliation(s)
- M. M. Tunney
- Department of Microbiology and Immunobiology, School of Clinical Medicine, The Queen’s University of Belfast, Royal Victoria Hospital Site, Grosvenor Road, Belfast BT12 6BN, UK
- School of Pharmacy, The Queen’s University of Belfast, 97 Lisburn Road, Belfast BT9 7BL, UK
| | - S. Patrick
- Department of Microbiology and Immunobiology, School of Clinical Medicine, The Queen’s University of Belfast, Royal Victoria Hospital Site, Grosvenor Road, Belfast BT12 6BN, UK
| | - S. P. Gorman
- School of Pharmacy, The Queen’s University of Belfast, 97 Lisburn Road, Belfast BT9 7BL, UK
| | - J. R. Nixon
- Withers Orthopaedic Centre, Musgrave Park Hospital, Stockmans Lane, Belfast BT9 7JB, UK
| | - N. Anderson
- The Royal Group of Hospitals and Dental Hospital Health and Social Services Trust, Grosvenor Road, Belfast BT12 6BA, UK
| | - R. I. Davis
- Belfast City Hospital, Lisburn Road, Belfast BT9 7BL, UK
| | - D. Hanna
- Department of Microbiology and Immunobiology, School of Clinical Medicine, The Queen’s University of Belfast, Royal Victoria Hospital Site, Grosvenor Road, Belfast BT12 6BN, UK
| | - G. Ramage
- Department of Microbiology and Immunobiology, School of Clinical Medicine, The Queen’s University of Belfast, Royal Victoria Hospital Site, Grosvenor Road, Belfast BT12 6BN, UK
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Tunney MM, Patrick S, Gorman SP, Nixon JR, Anderson N, Davis RI, Hanna D, Ramage G. Improved detection of infection in hip replacements. A currently underestimated problem. J Bone Joint Surg Br 1998; 80:568-72. [PMID: 9699813 DOI: 10.1302/0301-620x.80b4.8473] [Citation(s) in RCA: 227] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Our aim was to determine if the detection rate of infection of total hip replacements could be improved by examining the removed prostheses. Immediate transfer of prostheses to an anaerobic atmosphere, followed by mild ultrasonication to dislodge adherent bacteria, resulted in the culture of quantifiable numbers of bacteria, from 26 of the 120 implants examined. The same bacterial species were cultured by routine microbiological techniques from only five corresponding tissue samples. Tissue removed from 18 of the culture-positive implants was suitable for quantitative tissue pathology and inflammatory cells were present in all samples. Furthermore, inflammatory cells were present in 87% of tissue samples taken from patients whose implants were culture-negative. This suggests that these implants may have been infected by bacteria which were not isolated by the techniques of culture used. The increased detection of bacteria from prostheses by culture has improved postoperative antibiotic therapy and should reduce the need for further revision.
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Affiliation(s)
- M M Tunney
- Queen's University, Belfast, Northern Ireland, UK
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Abstract
We have demonstrated that pure cultures of Bacteroides fragilis can be riboprobed with the oligoprobes BAC303 and EUB338, whilst simultaneously immunolabelled with either the mAb QUBF7, or polyclonal antiserum specific for a common antigen of B. fragilis. We were also able to distinguish between pure cultures of B. fragilis and Escherichia coli, by means of combined immunolabelling and riboprobing. The success of the combined technique is critically dependent on the size of the bacterial capsules, bacterial growth phase, antibody diluent and the length of the washing steps. The combined FISH and immunolabelling of bacteria has potential applications in studies of bacteria of medical and veterinary importance, as well as bacteria from other environments, as it yields information about both the identity and antigen expression of individual bacterial cells.
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Affiliation(s)
- G Ramage
- Department of Microbiology and Immunobiology, School of Clinical Medicine, The Queen's University of Belfast, Northern Ireland, UK
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Patrick S, McKenna JP, O'Hagan S, Dermott E. A comparison of the haemagglutinating and enzymic activities of Bacteroides fragilis whole cells and outer membrane vesicles. Microb Pathog 1996; 20:191-202. [PMID: 8737489 DOI: 10.1006/mpat.1996.0018] [Citation(s) in RCA: 60] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
The haemagglutinating and enzymic activities of the obligately anaerobic pathogenic bacterium Bacteroides fragilis were examined. Outer membrane vesicles are released from the surface of B. fragilis. They can be detected by electron microscopy in ultrathin sections and bacterial suspensions after negative staining. Electron microscopy and immunogold labelling with a MAb specific for surface polysaccharide of B. fragilis confirmed that the vesicles carried outer membrane associated epitopes. The haemagglutinating activity of whole cells from populations of B. fragilis strains NCTC9343, BE3 and LS66 enriched by Percoll density gradient centrifugation for a large capsule (LC), electron dense layer (EDL); non-capsulate by light microscopy) and outer membrane vesicles (OMV) which had been purified by centrifugation from EDL-enriched populations were compared using human and horse erythrocytes. The enzymic activity of OMV, LC- and EDL-enriched populations, as detected by the API ZYM kit, was compared for strains NCTC 9343 and BE3. Purified OMV from the strains examined exhibited both haemagglutinating and enzymatic activity. Haemagglutination by the EDL-enriched population was sensitive to treatment with sodium periodate. The LC-enriched population haemagglutinated only after ultrasonic removal of the capsule. This indicates that the LC masks a haemagglutinin. The results suggest a potential role for OMV in the virulence of B. fragilis.
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Affiliation(s)
- S Patrick
- Department of Microbiology and Immunobiology, School of Clinical Medicine, Queen's University of Belfast, U.K
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Abstract
This study investigated the influence of a conditioned care environment per se on bacterial colonization of burn wounds. Two cohorts of burn patients were treated in the successive years 1992 and 1993, the first group in a (permanent) purpose-designed unit and the second in wards of traditional 'open' design, during renovation of the unit. Patients who were admitted to the permanent and temporary units numbered 224 and 231 respectively, the groups being similar in features that generally influence the course and outcome of burn injuries. The principles and practice of treatment by the burn care team remained the same in both years. No significant difference in wound colonization rates was found between the two groups. We conclude that while the other known advantages of managing burn patients in purpose-designed units remain valid, a conditioned care environment per se does not influence bacterial colonization rates of burn wounds.
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Affiliation(s)
- A Adeniran
- Department of Plastic Surgery, Salisbury District Hospital, UK
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Patrick S, Stewart LD, Damani N, Wilson KG, Lutton DA, Larkin MJ, Poxton I, Brown R. Immunological detection of Bacteroides fragilis in clinical samples. J Med Microbiol 1995; 43:99-109. [PMID: 7629860 DOI: 10.1099/00222615-43-2-99] [Citation(s) in RCA: 24] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
A monospecific polyclonal antiserum, prepared against Bacteroides fragilis common polysaccharide antigen purified by polyacrylamide gel immunoblot detected B. fragilis, B. thetaiotaomicron, B. ovatus and Prevotella melaninogenica in pus samples from various anatomical sites by immunofluorescence microscopy of the pus. With standard clinical laboratory culture methods, 36% of 147 samples were positive for one or more of the above bacteria. Of these, B. fragilis accounted for 33%. By immunofluorescent labelling of pus with the common antigen antiserum the detection of these bacteria in the samples increased to 50%. All nine of the blood cultures in which B. fragilis was detected by culture contained bacteria positive for the common antigen. Immunofluorescent labelling of pus samples with a selection of monoclonal antibodies specific for surface polysaccharides which are known to be antigenically variable in culture in vitro and in an animal model of infection showed that these polysaccharides are also variable in natural infection. The results indicate that the common polysaccharide antigen, in contrast to the variable surface polysaccharides, is a suitable target for the immunodetection of B. fragilis in clinical samples from a range of anatomical sites.
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Affiliation(s)
- S Patrick
- Department of Microbiology and Immunobiology, School of Clinical Medicine, Queen's University of Belfast
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Abstract
The significance of the EEG after epilepsy surgery is not fully understood. We investigated the association between postoperative EEG abnormalities and persistent seizures after epilepsy surgery as they relate to pathologic lesions. Among 254 patients who underwent epilepsy surgery between 1987 and 1991, we identified 78 patients who had mesiotemporal sclerosis (MTS) and 47 patients who had low-grade brain tumors, all of whom had 6- to 18-month postoperative follow-up including EEG. Patients who had other pathology, multiple operations, callosotomy, or hemispherectomy, or who were aged < 18 years or who had insufficient EEG data, were excluded. Patients were classified as having persistent seizures or being seizure-free since operation. EEG abnormalities were abstracted from EEG reports 6-18 months postoperatively. Seizures persisted in 24% of the MTS group and in 27% of the tumor group. Of those with normal EEGs, none of the MTS patients and only 1 of the tumor patients had persistent seizures (p = 0.03 for MTS and p = 0.42 for tumor). Epileptiform discharges and focal slowing were associated with seizure persistence in both groups, but to a significant extent only in the MTS group. In the MTS group, patients who had both epileptiform discharges and focal slowing were more likely to have persistent seizures than were those with either abnormality alone.
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Affiliation(s)
- S Patrick
- Department of Neurology, Yale University School of Medicine, New Haven, CT 06520-8018, USA
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Brown WJ, Hudson MJ, Patrick S, Matthews SC, Hill MJ, Gent AE, Grace RH, Hellier MD, Swarbrick ET. Search for enteric microbial pathogens in patients with ulcerative colitis. Digestion 1992; 53:121-8. [PMID: 1363319 DOI: 10.1159/000200985] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.5] [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: 02/04/2023]
Abstract
Microbial pathogens were sought in faeces of patients with active ulcerative colitis and again after 3 months treatment. 64 patients were examined during their first episode of ulcerative colitis and 30 with relapse of chronic disease. At presentation, bacterial pathogens were not found; 1 patient had cryptosporidiosis. In 10 patients treatment appeared to result in some loss of colonisation resistance as evidenced by colonisation with beta-haemolytic streptococci, Staphylococcus aureus, candida and Clostridium difficile. Unidentified cytotoxic activity was present in the faeces of 4 patients at presentation and 2 patients during or after treatment. We conclude that enteric infection is an uncommon finding in patients with active ulcerative colitis.
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Affiliation(s)
- W J Brown
- Public Health Laboratory, Odstock Hospital, Salisbury, UK
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