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Dziva Chikwari C, Dauya E, Bandason T, Tembo M, Mavodza C, Simms V, Mackworth-Young CRS, Apollo T, Grundy C, Weiss H, Kranzer K, Mavimba T, Indravudh P, Doyle A, Mugurungi O, Machiha A, Bernays S, Busza J, Madzima B, Terris-Prestholt F, McCarthy O, Hayes R, Francis S, Ferrand RA. The impact of community-based integrated HIV and sexual and reproductive health services for youth on population-level HIV viral load and sexually transmitted infections in Zimbabwe: protocol for the CHIEDZA cluster-randomised trial. Wellcome Open Res 2023; 7:54. [PMID: 38162283 PMCID: PMC10755263 DOI: 10.12688/wellcomeopenres.17530.1] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/25/2023] [Indexed: 03/29/2024] Open
Abstract
BACKGROUND Youth have poorer HIV-related outcomes when compared to other age-groups. We describe the protocol for a cluster randomised trial (CRT) to evaluate the effectiveness of community-based, integrated HIV and sexual and reproductive health services for youth on HIV outcomes. PROTOCOL The CHIEDZA trial is being conducted in three provinces in Zimbabwe, each with eight geographically demarcated areas (clusters) (total 24 clusters) randomised 1:1 to standard of care (existing health services) or to the intervention. The intervention comprises community-based delivery of HIV services including testing, antiretroviral therapy, treatment monitoring and adherence support as well as family planning, syndromic management of sexually transmitted infections (STIs), menstrual health management, condoms and HIV prevention and general health counselling. Youth aged 16-24 years living within intervention clusters are eligible to access CHIEDZA services. A CRT of STI screening (chlamydia, gonorrhoea and trichomoniasis) is nested in two provinces (16 of 24 clusters). The intervention is delivered over a 30-month period by a multidisciplinary team trained and configured to provide high-quality, youth friendly services.Outcomes will be ascertained through a population-based survey of 18-24-year-olds. The primary outcome is HIV viral load <1000 copies/ml in those living with HIV and proportion who test positive for STIs (for the nested trial). A detailed process and cost evaluation of the trial will be conducted. ETHICS AND DISSEMINATION The trial protocol was approved by the Medical Research Council of Zimbabwe, the Biomedical Research and Training Institute Institutional Review Board and the London School of Hygiene & Tropical Medicine Research Ethics Committee. Results will be submitted to open-access peer-reviewed journals, presented at academic meetings and shared with participating communities and with national and international policy-making bodies. TRIAL REGISTRATION https://clinicaltrials.gov/: NCT03719521.
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Affiliation(s)
- Chido Dziva Chikwari
- Biomedical Research and Training Institute, Harare, Zimbabwe
- MRC International Statistics & Epidemiology Group, Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
| | - Ethel Dauya
- Biomedical Research and Training Institute, Harare, Zimbabwe
| | - Tsitsi Bandason
- Biomedical Research and Training Institute, Harare, Zimbabwe
| | - Mandikudza Tembo
- Biomedical Research and Training Institute, Harare, Zimbabwe
- MRC International Statistics & Epidemiology Group, Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
| | - Constancia Mavodza
- Biomedical Research and Training Institute, Harare, Zimbabwe
- Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, UK
| | - Victoria Simms
- Biomedical Research and Training Institute, Harare, Zimbabwe
- MRC International Statistics & Epidemiology Group, Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
| | | | - Tsitsi Apollo
- AIDS and TB Unit, Ministry of Health and Child Care, Harare, Zimbabwe
| | - Chris Grundy
- MRC International Statistics & Epidemiology Group, Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
| | - Helen Weiss
- MRC International Statistics & Epidemiology Group, Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
| | - Katharina Kranzer
- Biomedical Research and Training Institute, Harare, Zimbabwe
- Clinical Research Department, London School of Hygiene & Tropical Medicine, London, UK
- Division of Infectious Diseases and Tropical Medicine, University Hospital, LMU Munich, Munich, Germany
| | | | - Pitchaya Indravudh
- Department of Global Health and Development, London School of Hygiene & Tropical Medicine, London, UK
| | - Aoife Doyle
- Biomedical Research and Training Institute, Harare, Zimbabwe
- MRC International Statistics & Epidemiology Group, Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
| | - Owen Mugurungi
- AIDS and TB Unit, Ministry of Health and Child Care, Harare, Zimbabwe
| | - Anna Machiha
- AIDS and TB Unit, Ministry of Health and Child Care, Harare, Zimbabwe
| | - Sarah Bernays
- Department of Global Health and Development, London School of Hygiene & Tropical Medicine, London, UK
- School of Public Health, University of Sydney, Sydney, Australia
| | - Joanna Busza
- Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, UK
| | | | - Fern Terris-Prestholt
- Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, UK
| | - Ona McCarthy
- Department of Population Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Richard Hayes
- MRC International Statistics & Epidemiology Group, Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
| | - Suzanna Francis
- MRC International Statistics & Epidemiology Group, Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
| | - Rashida A. Ferrand
- Biomedical Research and Training Institute, Harare, Zimbabwe
- Clinical Research Department, London School of Hygiene & Tropical Medicine, London, UK
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Dziva Chikwari C, Dauya E, Bandason T, Tembo M, Mavodza C, Simms V, Mackworth-Young CRS, Apollo T, Grundy C, Weiss H, Kranzer K, Mavimba T, Indravudh P, Doyle A, Mugurungi O, Machiha A, Bernays S, Busza J, Madzima B, Terris-Prestholt F, McCarthy O, Hayes R, Francis S, Ferrand RA. The impact of community-based integrated HIV and sexual and reproductive health services for youth on population-level HIV viral load and sexually transmitted infections in Zimbabwe: protocol for the CHIEDZA cluster-randomised trial. Wellcome Open Res 2023; 7:54. [PMID: 38162283 PMCID: PMC10755263 DOI: 10.12688/wellcomeopenres.17530.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/25/2023] [Indexed: 01/03/2024] Open
Abstract
Background Youth have poorer HIV-related outcomes when compared to other age-groups. We describe the protocol for a cluster randomised trial (CRT) to evaluate the effectiveness of community-based, integrated HIV and sexual and reproductive health services for youth on HIV outcomes. Protocol The CHIEDZA trial is being conducted in three provinces in Zimbabwe, each with eight geographically demarcated areas (clusters) (total 24 clusters) randomised 1:1 to standard of care (existing health services) or to the intervention. The intervention comprises community-based delivery of HIV services including testing, antiretroviral therapy, treatment monitoring and adherence support as well as family planning, syndromic management of sexually transmitted infections (STIs), menstrual health management, condoms and HIV prevention and general health counselling. Youth aged 16-24 years living within intervention clusters are eligible to access CHIEDZA services. A CRT of STI screening (chlamydia, gonorrhoea and trichomoniasis) is nested in two provinces (16 of 24 clusters). The intervention is delivered over a 30-month period by a multidisciplinary team trained and configured to provide high-quality, youth friendly services.Outcomes will be ascertained through a population-based survey of 18-24-year-olds. The primary outcome is HIV viral load <1000 copies/ml in those living with HIV and proportion who test positive for STIs (for the nested trial). A detailed process and cost evaluation of the trial will be conducted. Ethics and Dissemination The trial protocol was approved by the Medical Research Council of Zimbabwe, the Biomedical Research and Training Institute Institutional Review Board and the London School of Hygiene & Tropical Medicine Research Ethics Committee. Results will be submitted to open-access peer-reviewed journals, presented at academic meetings and shared with participating communities and with national and international policy-making bodies. Trial Registration https://clinicaltrials.gov/: NCT03719521.
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Affiliation(s)
- Chido Dziva Chikwari
- Biomedical Research and Training Institute, Harare, Zimbabwe
- MRC International Statistics & Epidemiology Group, Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
| | - Ethel Dauya
- Biomedical Research and Training Institute, Harare, Zimbabwe
| | - Tsitsi Bandason
- Biomedical Research and Training Institute, Harare, Zimbabwe
| | - Mandikudza Tembo
- Biomedical Research and Training Institute, Harare, Zimbabwe
- MRC International Statistics & Epidemiology Group, Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
| | - Constancia Mavodza
- Biomedical Research and Training Institute, Harare, Zimbabwe
- Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, UK
| | - Victoria Simms
- Biomedical Research and Training Institute, Harare, Zimbabwe
- MRC International Statistics & Epidemiology Group, Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
| | | | - Tsitsi Apollo
- AIDS and TB Unit, Ministry of Health and Child Care, Harare, Zimbabwe
| | - Chris Grundy
- MRC International Statistics & Epidemiology Group, Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
| | - Helen Weiss
- MRC International Statistics & Epidemiology Group, Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
| | - Katharina Kranzer
- Biomedical Research and Training Institute, Harare, Zimbabwe
- Clinical Research Department, London School of Hygiene & Tropical Medicine, London, UK
- Division of Infectious Diseases and Tropical Medicine, University Hospital, LMU Munich, Munich, Germany
| | | | - Pitchaya Indravudh
- Department of Global Health and Development, London School of Hygiene & Tropical Medicine, London, UK
| | - Aoife Doyle
- Biomedical Research and Training Institute, Harare, Zimbabwe
- MRC International Statistics & Epidemiology Group, Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
| | - Owen Mugurungi
- AIDS and TB Unit, Ministry of Health and Child Care, Harare, Zimbabwe
| | - Anna Machiha
- AIDS and TB Unit, Ministry of Health and Child Care, Harare, Zimbabwe
| | - Sarah Bernays
- Department of Global Health and Development, London School of Hygiene & Tropical Medicine, London, UK
- School of Public Health, University of Sydney, Sydney, Australia
| | - Joanna Busza
- Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, UK
| | | | - Fern Terris-Prestholt
- Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, UK
| | - Ona McCarthy
- Department of Population Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Richard Hayes
- MRC International Statistics & Epidemiology Group, Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
| | - Suzanna Francis
- MRC International Statistics & Epidemiology Group, Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
| | - Rashida A. Ferrand
- Biomedical Research and Training Institute, Harare, Zimbabwe
- Clinical Research Department, London School of Hygiene & Tropical Medicine, London, UK
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Sturt A, Bristowe H, Webb E, Hansingo I, Phiri C, Mudenda M, Mapani J, Mweene T, Levecke B, Cools P, van Dam G, Corstjens P, Ayles H, Hayes R, Francis S, van Lieshout L, Vwalika B, Kjetland E, Bustinduy A. Visual diagnosis of female genital schistosomiasis in Zambian women from hand-held colposcopy: agreement of expert image review and association with clinical symptoms. Wellcome Open Res 2023; 8:14. [PMID: 36864924 PMCID: PMC9971661 DOI: 10.12688/wellcomeopenres.18737.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/17/2023] [Indexed: 05/09/2023] Open
Abstract
Background: Female genital schistosomiasis (FGS) can occur in S. haematobium infection and is caused by egg deposition in the genital tract. Confirming a diagnosis of FGS is challenging due to the lack of a diagnostic reference standard. A 2010 expert-led consensus meeting proposed visual inspection of the cervicovaginal mucosa as an adequate reference standard for FGS diagnosis. The agreement of expert human reviewers for visual-FGS has not been previously described. Methods: In two Zambian communities, non-menstruating, non-pregnant, sexually-active women aged 18-31 years participating in the HPTN 071 (PopART) Population-Cohort were enrolled in a cross-sectional study. Self-collected genital swabs and a urine specimen were collected at a home visit; trained midwives performed cervicovaginal lavage (CVL) and hand-held colposcopy at a clinic visit. S. haematobium eggs and circulating anodic antigen (CAA) were detected from urine. Two senior physicians served as expert reviewers and independently diagnosed visual-FGS as the presence of sandy patches, rubbery papules or abnormal blood vessels in cervicovaginal images obtained by hand-held colposcopy. PCR-FGS was defined as Schistosoma DNA detected by real-time PCR in any genital specimen (CVL or genital swab). Results: Of 527 women with cervicovaginal colposcopic images, 468/527 (88.8%) were deemed interpretable by Reviewer 1 and 417/527 (79.1%) by Reviewer 2. Visual-FGS was detected in 35.3% (165/468) of participants by expert review of colposcopic images by Reviewer 1 and in 63.6% (265/417) by Reviewer 2. Cohen's kappa statistic for agreement between the two reviewers was 0.16, corresponding to "slight" agreement. The reviewers made concordant diagnoses in 38.7% (204/527) participants (100 negative, 104 positive) and discordant diagnoses in 31.8% (168/527) participants. Conclusions: The unexpectedly low level of correlation between expert reviewers highlights the imperfect nature of visual diagnosis for FGS based on cervicovaginal images. This finding is a call to action for improved point-of-care diagnostics for female genital schistosomiasis.
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Affiliation(s)
- Amy Sturt
- Department of Medicine, Division of Infectious Diseases, Veterans Affairs Healthcare System, Palo Alto, CA, 94304, USA
- Department of Medicine, Division of Infectious Diseases and Geographic Medicine, Stanford University, Palo Alto, California, 94305, USA
| | | | - Emily Webb
- MRC International Statistic and Epidemiology Group, London School of Hygiene & Tropical Medicine, London, WC1E 7HT, UK
| | - Isaiah Hansingo
- Department of Obstetrics and Gynecology, Livingstone Central Hospital, Livingstone, Zambia
| | | | - Maina Mudenda
- Department of Obstetrics and Gynecology, Livingstone Central Hospital, Livingstone, Zambia
| | - Joyce Mapani
- Department of Obstetrics and Gynecology, Livingstone Central Hospital, Livingstone, Zambia
| | | | - Bruno Levecke
- Department of Translational Physiology, Infectiology, and Public Health, Ghent University, Merelbeke, B-9820, Belgium
| | - Piet Cools
- Department of Translational Physiology, Infectiology, and Public Health, Ghent University, Merelbeke, B-9820, Belgium
- Department of Diagnostic Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, B-9000, Belgium
| | - Govert van Dam
- Department of Parasitology, Leiden University Medical Center, Leiden, 2300 RC, The Netherlands
| | - Paul Corstjens
- Department of Cell and Chemical Biology, Leiden University Medical Center, Leiden, 2300 RC, The Netherlands
| | - Helen Ayles
- Zambart, Lusaka, Zambia
- Department of Clinical Research, London School of Hygiene & Tropical Medicine, London, WC1E 7HT, UK
| | - Richard Hayes
- MRC International Statistic and Epidemiology Group, London School of Hygiene & Tropical Medicine, London, WC1E 7HT, UK
| | - Suzanna Francis
- MRC International Statistic and Epidemiology Group, London School of Hygiene & Tropical Medicine, London, WC1E 7HT, UK
| | - Lisette van Lieshout
- Department of Parasitology, Leiden University Medical Center, Leiden, 2300 RC, The Netherlands
| | - Bellington Vwalika
- Department of Obstetrics and Gynecology, University of Lusaka, Lusaka, Zambia
| | - Eyrun Kjetland
- Department of Infectious Diseases, Oslo University Hospital, Oslo, 0450, Norway
- University of KwaZulu-Natal, Durban, 4041, South Africa
| | - Amaya Bustinduy
- Department of Clinical Research, London School of Hygiene & Tropical Medicine, London, WC1E 7HT, UK
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Whitworth HS, Baisley KJ, Nnko S, Irani J, Aguirre-Beltran A, Changalucha J, Crucitti T, Francis S, Hashim R, Hansen CH, Hayes RJ, Buvé A, Watson-Jones D. Associations between age of menarche, early sexual debut and high-risk sexual behaviour among urban Tanzanian schoolgirls: A cross-sectional study. Trop Med Int Health 2023; 28:237-246. [PMID: 36717965 DOI: 10.1111/tmi.13858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
OBJECTIVES This cross-sectional survey aimed to explore associations between age of menarche, early sexual debut and high-risk sexual behaviour among urban Tanzanian schoolgirls. METHODS Secondary schoolgirls aged 17-18 years from Mwanza, Tanzania, participated in structured face-to-face questionnaire-based interviews, conducted by nurses and clinicians. Age of menarche was evaluated in categories of 11-12, 13-14, 15-16 or ≥17 years. Primary outcome measures were self-reported early sexual debut (first vaginal sex at <16 years) and high-risk sexual behaviour, including non-use of condoms, having sex for gifts/money, having older sexual partners and/or other risky behaviours. RESULTS Of 401 girls enrolled, 174 (43.4%) reported prior vaginal sex. Prevalence of early sexual debut was 14.2% but pressured/forced sex and risky sexual behaviours were common. Adjusted for potential confounding, younger age at menarche was associated with early sexual debut (adjusted odds ratio for linear trend: 1.88 per category, 95% confidence interval: 1.21-2.92, p = 0.005). This association remained after excluding girls with first sex at <8 years or experiencing pressure or force at first sex. Further, adjusted for potential confounding (including ever experiencing forced sex), early sexual debut was associated with high-risk sexual behaviour (adjusted odds ratio: 2.85, 95% confidence interval: 1.38-5.88, p = 0.004). CONCLUSIONS Among urban Tanzanian school girls, younger age of menarche was associated with early sexual debut, and early sexual debut was associated with high-risk sexual behaviour. Researchers and public health professionals developing and delivering interventions aimed at preventing adverse sexual health outcomes should consider the impact of these early biological and sexual exposures.
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Affiliation(s)
- Hilary S Whitworth
- Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, UK
- Mwanza Intervention Trials Unit, National Institute for Medical Research, Mwanza, Tanzania
| | - Kathy J Baisley
- Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
| | - Soori Nnko
- National Institute for Medical Research, Mwanza, Tanzania
| | - Julia Irani
- Mwanza Intervention Trials Unit, National Institute for Medical Research, Mwanza, Tanzania
- Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium
| | - Aura Aguirre-Beltran
- Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, UK
- Mwanza Intervention Trials Unit, National Institute for Medical Research, Mwanza, Tanzania
| | - John Changalucha
- Mwanza Intervention Trials Unit, National Institute for Medical Research, Mwanza, Tanzania
- National Institute for Medical Research, Mwanza, Tanzania
| | - Tania Crucitti
- Experimental Bacteriology Unit, Institut Pasteur de Madagascar, Antananarivo, Madagascar
| | - Suzanna Francis
- Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
| | - Ramadhan Hashim
- Mwanza Intervention Trials Unit, National Institute for Medical Research, Mwanza, Tanzania
| | - Christian Holm Hansen
- Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
| | - Richard J Hayes
- Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
| | - Anne Buvé
- Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium
| | - Deborah Watson-Jones
- Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, UK
- Mwanza Intervention Trials Unit, National Institute for Medical Research, Mwanza, Tanzania
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5
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Sturt A, Bristowe H, Webb E, Hansingo I, Phiri C, Mudenda M, Mapani J, Mweene T, Levecke B, Cools P, van Dam G, Corstjens P, Ayles H, Hayes R, Francis S, van Lieshout L, Vwalika B, Kjetland E, Bustinduy A. Visual diagnosis of female genital schistosomiasis in Zambian women from hand-held colposcopy: agreement of expert image review. Wellcome Open Res 2023; 8:14. [PMID: 36864924 PMCID: PMC9971661 DOI: 10.12688/wellcomeopenres.18737.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/22/2022] [Indexed: 01/11/2023] Open
Abstract
Female genital schistosomiasis (FGS) can occur in S. haematobium infection and is caused by parasite egg deposition in the genital tract. Confirming a diagnosis of FGS is challenging due to the lack of a diagnostic reference standard. A 2010 expert-led consensus meeting proposed visual inspection of the cervicovaginal mucosa as an adequate reference standard for FGS diagnosis. The agreement of expert human reviewers for visual-FGS has not been previously described. Methods: In two Zambian communities, non-menstruating, non-pregnant, sexually-active women aged 18-31 years participating in the HPTN 071 (PopART) Population-Cohort were enrolled in a cross-sectional study. Self-collected genital swabs and a urine specimen were collected at a home visit; trained midwives performed CVL and hand-held colposcopy at a clinic visit. S. haematobium eggs and circulating anodic antigen (CAA) were detected from urine. Two expert reviewers independently diagnosed visual-FGS as the presence of sandy patches, rubbery papules or abnormal blood vessels in digital cervicovaginal images obtained by hand-held colposcopy. PCR-FGS was defined as Schistosoma DNA detected by real-time PCR in any genital specimen (CVL or genital swab). Results: Of 527 women with cervicovaginal colposcopic images, 468/527 (88.8%) were deemed interpretable by Reviewer 1 and 417/527 (79.1%) by Reviewer 2. Visual-FGS was detected in 35.3% (165/468) of participants by expert review of colposcopic images by Reviewer 1 and in 63.6% (265/417) by Reviewer 2. Cohen's kappa statistic for agreement between the two expert reviewers was 0.16, corresponding to "slight" agreement. The reviewers made concordant diagnoses in 38.7% (204/527) participants (100 negative, 104 positive) and discordant diagnoses in 31.8% (168/527) participants. Conclusions: The unexpectedly low level of correlation between expert reviewers highlights the imperfect nature of visual diagnosis for FGS based on cervicovaginal images obtained with a hand-held colposcope. This finding is a call to action for improved point-of-care diagnostics for female genital schistosomiasis.
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Affiliation(s)
- Amy Sturt
- Department of Medicine, Division of Infectious Diseases, Veterans Affairs Healthcare System, Palo Alto, CA, 94304, USA
- Department of Medicine, Division of Infectious Diseases and Geographic Medicine, Stanford University, Palo Alto, California, 94305, USA
| | | | - Emily Webb
- MRC International Statistic and Epidemiology Group, London School of Hygiene & Tropical Medicine, London, WC1E 7HT, UK
| | - Isaiah Hansingo
- Department of Obstetrics and Gynecology, Livingstone Central Hospital, Livingstone, Zambia
| | | | - Maina Mudenda
- Department of Obstetrics and Gynecology, Livingstone Central Hospital, Livingstone, Zambia
| | - Joyce Mapani
- Department of Obstetrics and Gynecology, Livingstone Central Hospital, Livingstone, Zambia
| | | | - Bruno Levecke
- Department of Translational Physiology, Infectiology, and Public Health, Ghent University, Merelbeke, B-9820, Belgium
| | - Piet Cools
- Department of Translational Physiology, Infectiology, and Public Health, Ghent University, Merelbeke, B-9820, Belgium
- Department of Diagnostic Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, B-9000, Belgium
| | - Govert van Dam
- Department of Parasitology, Leiden University Medical Center, Leiden, 2300 RC, The Netherlands
| | - Paul Corstjens
- Department of Cell and Chemical Biology, Leiden University Medical Center, Leiden, 2300 RC, The Netherlands
| | - Helen Ayles
- Zambart, Lusaka, Zambia
- Department of Clinical Research, London School of Hygiene & Tropical Medicine, London, WC1E 7HT, UK
| | - Richard Hayes
- MRC International Statistic and Epidemiology Group, London School of Hygiene & Tropical Medicine, London, WC1E 7HT, UK
| | - Suzanna Francis
- MRC International Statistic and Epidemiology Group, London School of Hygiene & Tropical Medicine, London, WC1E 7HT, UK
| | - Lisette van Lieshout
- Department of Parasitology, Leiden University Medical Center, Leiden, 2300 RC, The Netherlands
| | - Bellington Vwalika
- Department of Obstetrics and Gynecology, University of Lusaka, Lusaka, Zambia
| | - Eyrun Kjetland
- Department of Infectious Diseases, Oslo University Hospital, Oslo, 0450, Norway
- University of KwaZulu-Natal, Durban, 4041, South Africa
| | - Amaya Bustinduy
- Department of Clinical Research, London School of Hygiene & Tropical Medicine, London, WC1E 7HT, UK
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6
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Nowatzke J, Guedeney P, Palaskas N, Lehmann L, Ederhy S, Cautela J, Francis S, Courand PY, Aras M, Arangalage D, Fenioux C, Finke D, Huang S, Moslehi J, Salem JE. Coronary artery disease and revascularization associated with immune checkpoint blocker myocarditis – report from an international registry. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.2562] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Purpose
Immune-checkpoint-blocker (ICB) associated myocarditis (ICB-myocarditis) may present similarly and/or overlap with other cardiac pathology including acute coronary syndrome presenting a challenge for prompt clinical diagnosis.
Methods
An international registry was used to retrospectively identify cases of ICB-myocarditis. Presence of coronary artery disease (CAD) was defined as coronary artery stenosis >70% in patients undergoing coronary angiogram.
Results
Among 261 patients with clinically suspected ICB-myocarditis who underwent a coronary angiography, CAD was present in 59/261 (22.6%) (Table 1). Coronary revascularization was performed during the index hospitalization in 19/59 (32.2%) patients. Patients undergoing coronary revascularization less frequently received steroids administration within 24h of admission compared to the other groups (p=0.029). Myocarditis related 90-day mortality was 9/17 (52.7%) in the revascularized cohort, compared to 5/31 (16.1%) in those not revascularized and 25/156 (16.0%) in those without CAD (p=0.001). irAE-related 90-day mortality was 9/17 (52.7%) in the revascularized cohort, compared to 6/31 (19.4%) in those not revascularized and 31/156 (19.9%) in no CAD groups (p=0.007) (Figure 1). All-cause 90-day mortality was 11/17 (64.7%) in the revascularized cohort, compared to 13/31 (41.9%) in no revascularization and 60/158 (38.0%) in no CAD groups (p=0.10). After adjustment on age and sex, coronary revascularization remained associated with ICB-myocarditis-related death at 90 days (Hazard ratio [HR]=4.03, 95%confidence interval [CI] 1.84–8.84, p<0.001) and was marginally associated with all-cause death (HR=1.88, 95% CI 0.98–3.61, p=0.057).
Conclusion
CAD may exist concomitantly with ICB-myocarditis and portend a poorer outcome when revascularization is performed. This is potentially mediated thru delayed diagnosis and treatment or more severe presentation of ICB-myocarditis.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- J Nowatzke
- Vanderbilt University Medical Center, Department of internal medicine , Nashville , United States of America
| | - P Guedeney
- Hospital Pitie-Salpetriere , Paris , France
| | - N Palaskas
- The University of Texas Medical School, Department of cardiology , Houston , United States of America
| | - L Lehmann
- University Hospital of Heidelberg, Department of cardiology , Heidelberg , Germany
| | - S Ederhy
- Hospital Saint-Antoine, Department of cardiology , Paris , France
| | - J Cautela
- Hospital Nord of Marseille, Department of cardiology , Marseille , France
| | - S Francis
- Maine Medical Center, Cardiovascular disease service line , Portland , United States of America
| | - P Y Courand
- Croix-Rousse Hospital - HCL, Fédération de cardiologie , Lyon , France
| | - M Aras
- University of California San Francisco, Division of cardiology , San Francisco , United States of America
| | - D Arangalage
- Bichat APHP Site of Paris Nord University Hospital, Department of cardiology , Paris , France
| | - C Fenioux
- Hospital Pitie-Salpetriere, Department of Pharmacology and Clinical Investigation Centre , Paris , France
| | - D Finke
- University Hospital of Heidelberg, Department of cardiology , Heidelberg , Germany
| | - S Huang
- Vanderbilt University Medical Center, Department of internal medicine , Nashville , United States of America
| | - J Moslehi
- University of California San Francisco, Division of cardiology , San Francisco , United States of America
| | - J E Salem
- Hospital Pitie-Salpetriere, Department of Pharmacology and Clinical Investigation Centre , Paris , France
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Evans RA, Leavy OC, Richardson M, Elneima O, McAuley HJC, Shikotra A, Singapuri A, Sereno M, Saunders RM, Harris VC, Houchen-Wolloff L, Aul R, Beirne P, Bolton CE, Brown JS, Choudhury G, Diar-Bakerly N, Easom N, Echevarria C, Fuld J, Hart N, Hurst J, Jones MG, Parekh D, Pfeffer P, Rahman NM, Rowland-Jones SL, Shah AM, Wootton DG, Chalder T, Davies MJ, De Soyza A, Geddes JR, Greenhalf W, Greening NJ, Heaney LG, Heller S, Howard LS, Jacob J, Jenkins RG, Lord JM, Man WDC, McCann GP, Neubauer S, Openshaw PJM, Porter JC, Rowland MJ, Scott JT, Semple MG, Singh SJ, Thomas DC, Toshner M, Lewis KE, Thwaites RS, Briggs A, Docherty AB, Kerr S, Lone NI, Quint J, Sheikh A, Thorpe M, Zheng B, Chalmers JD, Ho LP, Horsley A, Marks M, Poinasamy K, Raman B, Harrison EM, Wain LV, Brightling CE, Abel K, Adamali H, Adeloye D, Adeyemi O, Adrego R, Aguilar Jimenez LA, Ahmad S, Ahmad Haider N, Ahmed R, Ahwireng N, Ainsworth M, Al-Sheklly B, Alamoudi A, Ali M, Aljaroof M, All AM, Allan L, Allen RJ, Allerton L, Allsop L, Almeida P, Altmann D, Alvarez Corral M, Amoils S, Anderson D, Antoniades C, Arbane G, Arias A, Armour C, Armstrong L, Armstrong N, Arnold D, Arnold H, Ashish A, Ashworth A, Ashworth M, Aslani S, Assefa-Kebede H, Atkin C, Atkin P, Aung H, Austin L, Avram C, Ayoub A, Babores M, Baggott R, Bagshaw J, Baguley D, Bailey L, Baillie JK, Bain S, Bakali M, Bakau M, Baldry E, Baldwin D, Ballard C, Banerjee A, Bang B, Barker RE, Barman L, Barratt S, Barrett F, Basire D, Basu N, Bates M, Bates A, Batterham R, Baxendale H, Bayes H, Beadsworth M, Beckett P, Beggs M, Begum M, Bell D, Bell R, Bennett K, Beranova E, Bermperi A, Berridge A, Berry C, Betts S, Bevan E, Bhui K, Bingham M, Birchall K, Bishop L, Bisnauthsing K, Blaikely J, Bloss A, Bolger A, Bonnington J, Botkai A, Bourne C, Bourne M, Bramham K, Brear L, Breen G, Breeze J, Bright E, Brill S, Brindle K, Broad L, Broadley A, Brookes C, Broome M, Brown A, Brown A, Brown J, Brown J, Brown M, Brown M, Brown V, Brugha T, Brunskill N, Buch M, Buckley P, Bularga A, Bullmore E, Burden L, Burdett T, Burn D, Burns G, Burns A, Busby J, Butcher R, Butt A, Byrne S, Cairns P, Calder PC, Calvelo E, Carborn H, Card B, Carr C, Carr L, Carson G, Carter P, Casey A, Cassar M, Cavanagh J, Chablani M, Chambers RC, Chan F, Channon KM, Chapman K, Charalambou A, Chaudhuri N, Checkley A, Chen J, Cheng Y, Chetham L, Childs C, Chilvers ER, Chinoy H, Chiribiri A, Chong-James K, Choudhury N, Chowienczyk P, Christie C, Chrystal M, Clark D, Clark C, Clarke J, Clohisey S, Coakley G, Coburn Z, Coetzee S, Cole J, Coleman C, Conneh F, Connell D, Connolly B, Connor L, Cook A, Cooper B, Cooper J, Cooper S, Copeland D, Cosier T, Coulding M, Coupland C, Cox E, Craig T, Crisp P, Cristiano D, Crooks MG, Cross A, Cruz I, Cullinan P, Cuthbertson D, Daines L, Dalton M, Daly P, Daniels A, Dark P, Dasgin J, David A, David C, Davies E, Davies F, Davies G, Davies GA, Davies K, Dawson J, Daynes E, Deakin B, Deans A, Deas C, Deery J, Defres S, Dell A, Dempsey K, Denneny E, Dennis J, Dewar A, Dharmagunawardena R, Dickens C, Dipper A, Diver S, Diwanji SN, Dixon M, Djukanovic R, Dobson H, Dobson SL, Donaldson A, Dong T, Dormand N, Dougherty A, Dowling R, Drain S, Draxlbauer K, Drury K, Dulawan P, Dunleavy A, Dunn S, Earley J, Edwards S, Edwardson C, El-Taweel H, Elliott A, Elliott K, Ellis Y, Elmer A, Evans D, Evans H, Evans J, Evans R, Evans RI, Evans T, Evenden C, Evison L, Fabbri L, Fairbairn S, Fairman A, Fallon K, Faluyi D, Favager C, Fayzan T, Featherstone J, Felton T, Finch J, Finney S, Finnigan J, Finnigan L, Fisher H, Fletcher S, Flockton R, Flynn M, Foot H, Foote D, Ford A, Forton D, Fraile E, Francis C, Francis R, Francis S, Frankel A, Fraser E, Free R, French N, Fu X, Furniss J, Garner L, Gautam N, George J, George P, Gibbons M, Gill M, Gilmour L, Gleeson F, Glossop J, Glover S, Goodman N, Goodwin C, Gooptu B, Gordon H, Gorsuch T, Greatorex M, Greenhaff PL, Greenhalgh A, Greenwood J, Gregory H, Gregory R, Grieve D, Griffin D, Griffiths L, Guerdette AM, Guillen Guio B, Gummadi M, Gupta A, Gurram S, Guthrie E, Guy Z, H Henson H, Hadley K, Haggar A, Hainey K, Hairsine B, Haldar P, Hall I, Hall L, Halling-Brown M, Hamil R, Hancock A, Hancock K, Hanley NA, Haq S, Hardwick HE, Hardy E, Hardy T, Hargadon B, Harrington K, Harris E, Harrison P, Harvey A, Harvey M, Harvie M, Haslam L, Havinden-Williams M, Hawkes J, Hawkings N, Haworth J, Hayday A, Haynes M, Hazeldine J, Hazelton T, Heeley C, Heeney JL, Heightman M, Henderson M, Hesselden L, Hewitt M, Highett V, Hillman T, Hiwot T, Hoare A, Hoare M, Hockridge J, Hogarth P, Holbourn A, Holden S, Holdsworth L, Holgate D, Holland M, Holloway L, Holmes K, Holmes M, Holroyd-Hind B, Holt L, Hormis A, Hosseini A, Hotopf M, Howard K, Howell A, Hufton E, Hughes AD, Hughes J, Hughes R, Humphries A, Huneke N, Hurditch E, Husain M, Hussell T, Hutchinson J, Ibrahim W, Ilyas F, Ingham J, Ingram L, Ionita D, Isaacs K, Ismail K, Jackson T, James WY, Jarman C, Jarrold I, Jarvis H, Jastrub R, Jayaraman B, Jezzard P, Jiwa K, Johnson C, Johnson S, Johnston D, Jolley CJ, Jones D, Jones G, Jones H, Jones H, Jones I, Jones L, Jones S, Jose S, Kabir T, Kaltsakas G, Kamwa V, Kanellakis N, Kaprowska S, Kausar Z, Keenan N, Kelly S, Kemp G, Kerslake H, Key AL, Khan F, Khunti K, Kilroy S, King B, King C, Kingham L, Kirk J, Kitterick P, Klenerman P, Knibbs L, Knight S, Knighton A, Kon O, Kon S, Kon SS, Koprowska S, Korszun A, Koychev I, Kurasz C, Kurupati P, Laing C, Lamlum H, Landers G, Langenberg C, Lasserson D, Lavelle-Langham L, Lawrie A, Lawson C, Lawson C, Layton A, Lea A, Lee D, Lee JH, Lee E, Leitch K, Lenagh R, Lewis D, Lewis J, Lewis V, Lewis-Burke N, Li X, Light T, Lightstone L, Lilaonitkul W, Lim L, Linford S, Lingford-Hughes A, Lipman M, Liyanage K, Lloyd A, Logan S, Lomas D, Loosley R, Lota H, Lovegrove W, Lucey A, Lukaschuk E, Lye A, Lynch C, MacDonald S, MacGowan G, Macharia I, Mackie J, Macliver L, Madathil S, Madzamba G, Magee N, Magtoto MM, Mairs N, Majeed N, Major E, Malein F, Malim M, Mallison G, Mandal S, Mangion K, Manisty C, Manley R, March K, Marciniak S, Marino P, Mariveles M, Marouzet E, Marsh S, Marshall B, Marshall M, Martin J, Martineau A, Martinez LM, Maskell N, Matila D, Matimba-Mupaya W, Matthews L, Mbuyisa A, McAdoo S, Weir McCall J, McAllister-Williams H, McArdle A, McArdle P, McAulay D, McCormick J, McCormick W, McCourt P, McGarvey L, McGee C, Mcgee K, McGinness J, McGlynn K, McGovern A, McGuinness H, McInnes IB, McIntosh J, McIvor E, McIvor K, McLeavey L, McMahon A, McMahon MJ, McMorrow L, Mcnally T, McNarry M, McNeill J, McQueen A, McShane H, Mears C, Megson C, Megson S, Mehta P, Meiring J, Melling L, Mencias M, Menzies D, Merida Morillas M, Michael A, Milligan L, Miller C, Mills C, Mills NL, Milner L, Misra S, Mitchell J, Mohamed A, Mohamed N, Mohammed S, Molyneaux PL, Monteiro W, Moriera S, Morley A, Morrison L, Morriss R, Morrow A, Moss AJ, Moss P, Motohashi K, Msimanga N, Mukaetova-Ladinska E, Munawar U, Murira J, Nanda U, Nassa H, Nasseri M, Neal A, Needham R, Neill P, Newell H, Newman T, Newton-Cox A, Nicholson T, Nicoll D, Nolan CM, Noonan MJ, Norman C, Novotny P, Nunag J, Nwafor L, Nwanguma U, Nyaboko J, O'Donnell K, O'Brien C, O'Brien L, O'Regan D, Odell N, Ogg G, Olaosebikan O, Oliver C, Omar Z, Orriss-Dib L, Osborne L, Osbourne R, Ostermann M, Overton C, Owen J, Oxton J, Pack J, Pacpaco E, Paddick S, Painter S, Pakzad A, Palmer S, Papineni P, Paques K, Paradowski K, Pareek M, Parfrey H, Pariante C, Parker S, Parkes M, Parmar J, Patale S, Patel B, Patel M, Patel S, Pattenadk D, Pavlides M, Payne S, Pearce L, Pearl JE, Peckham D, Pendlebury J, Peng Y, Pennington C, Peralta I, Perkins E, Peterkin Z, Peto T, Petousi N, Petrie J, Phipps J, Pimm J, Piper Hanley K, Pius R, Plant H, Plein S, Plekhanova T, Plowright M, Polgar O, Poll L, Porter J, Portukhay S, Powell N, Prabhu A, Pratt J, Price A, Price C, Price C, Price D, Price L, Price L, Prickett A, Propescu J, Pugmire S, Quaid S, Quigley J, Qureshi H, Qureshi IN, Radhakrishnan K, Ralser M, Ramos A, Ramos H, Rangeley J, Rangelov B, Ratcliffe L, Ravencroft P, Reddington A, Reddy R, Redfearn H, Redwood D, Reed A, Rees M, Rees T, Regan K, Reynolds W, Ribeiro C, Richards A, Richardson E, Rivera-Ortega P, Roberts K, Robertson E, Robinson E, Robinson L, Roche L, Roddis C, Rodger J, Ross A, Ross G, Rossdale J, Rostron A, Rowe A, Rowland A, Rowland J, Roy K, Roy M, Rudan I, Russell R, Russell E, Saalmink G, Sabit R, Sage EK, Samakomva T, Samani N, Sampson C, Samuel K, Samuel R, Sanderson A, Sapey E, Saralaya D, Sargant J, Sarginson C, Sass T, Sattar N, Saunders K, Saunders P, Saunders LC, Savill H, Saxon W, Sayer A, Schronce J, Schwaeble W, Scott K, Selby N, Sewell TA, Shah K, Shah P, Shankar-Hari M, Sharma M, Sharpe C, Sharpe M, Shashaa S, Shaw A, Shaw K, Shaw V, Shelton S, Shenton L, Shevket K, Short J, Siddique S, Siddiqui S, Sidebottom J, Sigfrid L, Simons G, Simpson J, Simpson N, Singh C, Singh S, Sissons D, Skeemer J, Slack K, Smith A, Smith D, Smith S, Smith J, Smith L, Soares M, Solano TS, Solly R, Solstice AR, Soulsby T, Southern D, Sowter D, Spears M, Spencer LG, Speranza F, Stadon L, Stanel S, Steele N, Steiner M, Stensel D, Stephens G, Stephenson L, Stern M, Stewart I, Stimpson R, Stockdale S, Stockley J, Stoker W, Stone R, Storrar W, Storrie A, Storton K, Stringer E, Strong-Sheldrake S, Stroud N, Subbe C, Sudlow CL, Suleiman Z, Summers C, Summersgill C, Sutherland D, Sykes DL, Sykes R, Talbot N, Tan AL, Tarusan L, Tavoukjian V, Taylor A, Taylor C, Taylor J, Te A, Tedd H, Tee CJ, Teixeira J, Tench H, Terry S, Thackray-Nocera S, Thaivalappil F, Thamu B, Thickett D, Thomas C, Thomas S, Thomas AK, Thomas-Woods T, Thompson T, Thompson AAR, Thornton T, Tilley J, Tinker N, Tiongson GF, Tobin M, Tomlinson J, Tong C, Touyz R, Tripp KA, Tunnicliffe E, Turnbull A, Turner E, Turner S, Turner V, Turner K, Turney S, Turtle L, Turton H, Ugoji J, Ugwuoke R, Upthegrove R, Valabhji J, Ventura M, Vere J, Vickers C, Vinson B, Wade E, Wade P, Wainwright T, Wajero LO, Walder S, Walker S, Walker S, Wall E, Wallis T, Walmsley S, Walsh JA, Walsh S, Warburton L, Ward TJC, Warwick K, Wassall H, Waterson S, Watson E, Watson L, Watson J, Welch C, Welch H, Welsh B, Wessely S, West S, Weston H, Wheeler H, White S, Whitehead V, Whitney J, Whittaker S, Whittam B, Whitworth V, Wight A, Wild J, Wilkins M, Wilkinson D, Williams N, Williams N, Williams J, Williams-Howard SA, Willicombe M, Willis G, Willoughby J, Wilson A, Wilson D, Wilson I, Window N, Witham M, Wolf-Roberts R, Wood C, Woodhead F, Woods J, Wormleighton J, Worsley J, Wraith D, Wrey Brown C, Wright C, Wright L, Wright S, Wyles J, Wynter I, Xu M, Yasmin N, Yasmin S, Yates T, Yip KP, Young B, Young S, Young A, Yousuf AJ, Zawia A, Zeidan L, Zhao B, Zongo O. Clinical characteristics with inflammation profiling of long COVID and association with 1-year recovery following hospitalisation in the UK: a prospective observational study. Lancet Respir Med 2022; 10:761-775. [PMID: 35472304 PMCID: PMC9034855 DOI: 10.1016/s2213-2600(22)00127-8] [Citation(s) in RCA: 144] [Impact Index Per Article: 72.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 03/23/2022] [Accepted: 03/31/2022] [Indexed: 11/25/2022]
Abstract
BACKGROUND No effective pharmacological or non-pharmacological interventions exist for patients with long COVID. We aimed to describe recovery 1 year after hospital discharge for COVID-19, identify factors associated with patient-perceived recovery, and identify potential therapeutic targets by describing the underlying inflammatory profiles of the previously described recovery clusters at 5 months after hospital discharge. METHODS The Post-hospitalisation COVID-19 study (PHOSP-COVID) is a prospective, longitudinal cohort study recruiting adults (aged ≥18 years) discharged from hospital with COVID-19 across the UK. Recovery was assessed using patient-reported outcome measures, physical performance, and organ function at 5 months and 1 year after hospital discharge, and stratified by both patient-perceived recovery and recovery cluster. Hierarchical logistic regression modelling was performed for patient-perceived recovery at 1 year. Cluster analysis was done using the clustering large applications k-medoids approach using clinical outcomes at 5 months. Inflammatory protein profiling was analysed from plasma at the 5-month visit. This study is registered on the ISRCTN Registry, ISRCTN10980107, and recruitment is ongoing. FINDINGS 2320 participants discharged from hospital between March 7, 2020, and April 18, 2021, were assessed at 5 months after discharge and 807 (32·7%) participants completed both the 5-month and 1-year visits. 279 (35·6%) of these 807 patients were women and 505 (64·4%) were men, with a mean age of 58·7 (SD 12·5) years, and 224 (27·8%) had received invasive mechanical ventilation (WHO class 7-9). The proportion of patients reporting full recovery was unchanged between 5 months (501 [25·5%] of 1965) and 1 year (232 [28·9%] of 804). Factors associated with being less likely to report full recovery at 1 year were female sex (odds ratio 0·68 [95% CI 0·46-0·99]), obesity (0·50 [0·34-0·74]) and invasive mechanical ventilation (0·42 [0·23-0·76]). Cluster analysis (n=1636) corroborated the previously reported four clusters: very severe, severe, moderate with cognitive impairment, and mild, relating to the severity of physical health, mental health, and cognitive impairment at 5 months. We found increased inflammatory mediators of tissue damage and repair in both the very severe and the moderate with cognitive impairment clusters compared with the mild cluster, including IL-6 concentration, which was increased in both comparisons (n=626 participants). We found a substantial deficit in median EQ-5D-5L utility index from before COVID-19 (retrospective assessment; 0·88 [IQR 0·74-1·00]), at 5 months (0·74 [0·64-0·88]) to 1 year (0·75 [0·62-0·88]), with minimal improvements across all outcome measures at 1 year after discharge in the whole cohort and within each of the four clusters. INTERPRETATION The sequelae of a hospital admission with COVID-19 were substantial 1 year after discharge across a range of health domains, with the minority in our cohort feeling fully recovered. Patient-perceived health-related quality of life was reduced at 1 year compared with before hospital admission. Systematic inflammation and obesity are potential treatable traits that warrant further investigation in clinical trials. FUNDING UK Research and Innovation and National Institute for Health Research.
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Zinzani PL, Santoro A, Gritti G, Brice P, Barr PM, Kuruvilla J, Cunningham D, Kline J, Johnson NA, Mehta‐Shah N, Fanale M, Francis S, Moskowitz AJ. NIVOLUMAB PLUS BRENTUXIMAB VEDOTIN FOR RELAPSED/REFRACTORY PRIMARY MEDIASTINAL LARGE B‐CELL LYMPHOMA: EXTENDED FOLLOW‐UP FROM THE PHASE 2 CHECKMATE 436 STUDY. Hematol Oncol 2021. [DOI: 10.1002/hon.51_2879] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- P. L. Zinzani
- “Seràgnoli" Bologna University Institute of Hematology Bologna Italy
| | - A. Santoro
- IRCCS Humanitas Research Center Humanitas University Rozzano–Milano Italy
| | - G. Gritti
- Ospedale Papa Giovanni XXIII Hematology and Bone Marrow Transplant Unit Bergamo Italy
| | - P. Brice
- Hôpital Saint‐Louis Service d’Hémato‐Oncologie Paris France
| | - P. M. Barr
- University of Rochester Department of Medicine Hematology/Oncology, Rochester New York USA
| | - J. Kuruvilla
- Princess Margaret Cancer Centre Division of Medical Oncology and Hematology Toronto Canada
| | - D. Cunningham
- Royal Marsden Hospital Gastrointestinal and Lymphoma Unit London UK
| | - J. Kline
- University of Chicago Department of Medicine Section of Hematology/Oncology Chicago Illinois USA
| | - N. A. Johnson
- Jewish General Hospital Division of Hematology Montreal Canada
| | - N. Mehta‐Shah
- Washington University in St. Louis School of Medicine Division of Oncology Department of Medicine St. Louis Missouri USA
| | - M. Fanale
- Seagen Inc. Medical Affairs, Bothell Washington USA
| | - S. Francis
- Bristol Myers Squibb, Global Biometrics and Data Sciences Princeton New Jersey USA
| | - A. J. Moskowitz
- Memorial Sloan Kettering Cancer Center Lymphoma Inpatient Unit New York, New York USA
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Warehime J, Francis S. 24 Robotic sacrohysteropexy following prior sacrorectopexy. Am J Obstet Gynecol 2021. [DOI: 10.1016/j.ajog.2021.04.167] [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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Brooke J, Safavi S, Prayle A, Ng C, Alappadan J, Bradley C, Cooper A, Munidasa S, Zanette B, Santyr G, Barr H, Major G, Smyth A, Gowland P, Francis S, Hall I. P109 Regional assessment of lung function using non-contrast MRI in people with cystic fibrosis. J Cyst Fibros 2021. [DOI: 10.1016/s1569-1993(21)01135-8] [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: 10/21/2022]
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Wlodarczyk J, Fahradyan A, Wexler A, Daneshgaran G, Francis S. Is Routine Use of Head CT in Evaluation of Craniosynostosis Necessary? J Oral Maxillofac Surg 2020. [DOI: 10.1016/j.joms.2020.07.045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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McLean KA, Ahmed WUR, Akhbari M, Claireaux HA, English C, Frost J, Henshall DE, Khan M, Kwek I, Nicola M, Rehman S, Varghese S, Drake TM, Bell S, Nepogodiev D, McLean KA, Drake TM, Glasbey JC, Borakati A, Drake TM, Kamarajah S, McLean KA, Bath MF, Claireaux HA, Gundogan B, Mohan M, Deekonda P, Kong C, Joyce H, Mcnamee L, Woin E, Burke J, Khatri C, Fitzgerald JE, Harrison EM, Bhangu A, Nepogodiev D, Arulkumaran N, Bell S, Duthie F, Hughes J, Pinkney TD, Prowle J, Richards T, Thomas M, Dynes K, Patel M, Patel P, Wigley C, Suresh R, Shaw A, Klimach S, Jull P, Evans D, Preece R, Ibrahim I, Manikavasagar V, Smith R, Brown FS, Deekonda P, Teo R, Sim DPY, Borakati A, Logan AE, Barai I, Amin H, Suresh S, Sethi R, Bolton W, Corbridge O, Horne L, Attalla M, Morley R, Robinson C, Hoskins T, McAllister R, Lee S, Dennis Y, Nixon G, Heywood E, Wilson H, Ng L, Samaraweera S, Mills A, Doherty C, Woin E, Belchos J, Phan V, Chouari T, Gardner T, Goergen N, Hayes JDB, MacLeod CS, McCormack R, McKinley A, McKinstry S, Milligan W, Ooi L, Rafiq NM, Sammut T, Sinclair E, Smith M, Baker C, Boulton APR, Collins J, Copley HC, Fearnhead N, Fox H, Mah T, McKenna J, Naruka V, Nigam N, Nourallah B, Perera S, Qureshi A, Saggar S, Sun L, Wang X, Yang DD, Caroll P, Doyle C, Elangovan S, Falamarzi A, Perai KG, Greenan E, Jain D, Lang-Orsini M, Lim S, O'Byrne L, Ridgway P, Van der Laan S, Wong J, Arthur J, Barclay J, Bradley P, Edwin C, Finch E, Hayashi E, Hopkins M, Kelly D, Kelly M, McCartan N, Ormrod A, Pakenham A, Hayward J, Hitchen C, Kishore A, Martins T, Philomen J, Rao R, Rickards C, Burns N, Copeland M, Durand C, Dyal A, Ghaffar A, Gidwani A, Grant M, Gribbon C, Gruhn A, Leer M, Ahmad K, Beattie G, Beatty M, Campbell G, Donaldson G, Graham S, Holmes D, Kanabar S, Liu H, McCann C, Stewart R, Vara S, Ajibola-Taylor O, Andah EJE, Ani C, Cabdi NMO, Ito G, Jones M, Komoriyama A, Patel P, Titu L, Basra M, Gallogly P, Harinath G, Leong SH, Pradhan A, Siddiqui I, Zaat S, Ali A, Galea M, Looi WL, Ng JCK, Atkin G, Azizi A, Cargill Z, China Z, Elliot J, Jebakumar R, Lam J, Mudalige G, Onyerindu C, Renju M, Babu VS, Hussain M, Joji N, Lovett B, Mownah H, Ali B, Cresswell B, Dhillon AK, Dupaguntla YS, Hungwe C, Lowe-Zinola JD, Tsang JCH, Bevan K, Cardus C, Duggal A, Hossain S, McHugh M, Scott M, Chan F, Evans R, Gurung E, Haughey B, Jacob-Ramsdale B, Kerr M, Lee J, McCann E, O'Boyle K, Reid N, Hayat F, Hodgson S, Johnston R, Jones W, Khan M, Linn T, Long S, Seetharam P, Shaman S, Smart B, Anilkumar A, Davies J, Griffith J, Hughes B, Islam Y, Kidanu D, Mushaini N, Qamar I, Robinson H, Schramm M, Tan CY, Apperley H, Billyard C, Blazeby JM, Cannon SP, Carse S, Göpfert A, Loizidou A, Parkin J, Sanders E, Sharma S, Slade G, Telfer R, Huppatz IW, Worley E, Chandramoorthy L, Friend C, Harris L, Jain P, Karim MJ, Killington K, McGillicuddy J, Rafferty C, Rahunathan N, Rayne T, Varathan Y, Verma N, Zanichelli D, Arneill M, Brown F, Campbell B, Crozier L, Henry J, McCusker C, Prabakaran P, Wilson R, Asif U, Connor M, Dindyal S, Math N, Pagarkar A, Saleem H, Seth I, Sharma S, Standfield N, Swartbol T, Adamson R, Choi JE, El Tokhy O, Ho W, Javaid NR, Kelly M, Mehdi AS, Menon D, Plumptre I, Sturrock S, Turner J, Warren O, Crane E, Ferris B, Gadsby C, Smallwood J, Vipond M, Wilson V, Amarnath T, Doshi A, Gregory C, Kandiah K, Powell B, Spoor H, Toh C, Vizor R, Common M, Dunleavy K, Harris S, Luo C, Mesbah Z, Kumar AP, Redmond A, Skulsky S, Walsh T, Daly D, Deery L, Epanomeritakis E, Harty M, Kane D, Khan K, Mackey R, McConville J, McGinnity K, Nixon G, Ang A, Kee JY, Leung E, Norman S, Palaniappan SV, Sarathy PP, Yeoh T, Frost J, Hazeldine P, Jones L, Karbowiak M, Macdonald C, Mutarambirwa A, Omotade A, Runkel M, Ryan G, Sawers N, Searle C, Suresh S, Vig S, Ahmad A, McGartland R, Sim R, Song A, Wayman J, Brown R, Chang LH, Concannon K, Crilly C, Arnold TJ, Burgin A, Cadden F, Choy CH, Coleman M, Lim D, Luk J, Mahankali-Rao P, Prudence-Taylor AJ, Ramakrishnan D, Russell J, 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Patil P, Peck FS, Reza N, Swan I, Whyte M, Chaudhry S, Hernon J, Khawar H, O'Brien J, Pullinger M, Rothnie K, Ujjal S, Bhatte S, Curtis J, Green S, Mayer A, Watkinson G, Chapple K, Hawthorne T, Khaliq M, Majkowski L, Malik TAM, Mclauchlan K, En BNW, Parton S, Robinson SD, Saat MI, Shurovi BN, Varatharasasingam K, Ward AE, Behranwala K, Bertelli M, Cohen J, Duff F, Fafemi O, Gupta R, Manimaran M, Mayhew J, Peprah D, Wong MHY, Farmer N, Houghton C, Kandhari N, Khan K, Ladha D, Mayes J, McLennan F, Panahi P, Seehra H, Agrawal R, Ahmed I, Ali S, Birkinshaw F, Choudhry M, Gokani S, Harrogate S, Jamal S, Nawrozzadeh F, Swaray A, Szczap A, Warusavitarne J, Abdalla M, Asemota N, Cullum R, Hartley M, Maxwell-Armstrong C, Mulvenna C, Phillips J, Yule A, Ahmed L, Clement KD, Craig N, Elseedawy E, Gorman D, Kane L, Livie J, Livie V, Moss E, Naasan A, Ravi F, Shields P, Zhu Y, Archer M, Cobley H, Dennis R, Downes C, Guevel B, Lamptey E, Murray H, Radhakrishnan A, Saravanabavan S, Sardar M, Shaw C, 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P, Tam J, Elias J, Ngaage M, Thompson J, Bristow S, Brock E, Davis H, Pantelidou M, Sathiyakeerthy A, Singh K, Chaudhry A, Dickson G, Glen P, Gregoriou K, Hamid H, Mclean A, Mehtaji P, Neophytou G, Potts S, Belgaid DR, Burke J, Durno J, Ghailan N, Hanson M, Henshaw V, Nazir UR, Omar I, Riley BJ, Roberts J, Smart G, Van Winsen K, Bhatti A, Chan M, D'Auria M, Green S, Keshvala C, Li H, Maxwell-Armstrong C, Michaelidou M, Simmonds L, Smith C, Wimalathasan A, Abbas J, Cairns C, Chin YR, Connelly A, Moug S, Nair A, Svolkinas D, Coe P, Subar D, Wang H, Zaver V, Brayley J, Cookson P, Cunningham L, Gaukroger A, Ho M, Hough A, King J, O'Hagan D, Widdison A, Brown R, Brown B, Chavan A, Francis S, Hare L, Lund J, Malone N, Mavi B, McIlwaine A, Rangarajan S, Abuhussein N, Campbell HS, Daniels J, Fitzgerald I, Mansfield S, Pendrill A, Robertson D, Smart YW, Teng T, Yates J, Belgaumkar A, Katira A, Kossoff J, Kukran S, Laing C, Mathew B, Mohamed T, Myers S, Novell R, Phillips BL, Thomas M, Turlejski T, Turner S, Varcada M, Warren L, Wynell-Mayow W, Church R, Linley-Adams L, Osborn G, Saunders M, Spencer R, Srikanthan M, Tailor S, Tullett A, Ali M, Al-Masri S, Carr G, Ebhogiaye O, Heng S, Manivannan S, Manley J, McMillan LE, Peat C, Phillips B, Thomas S, Whewell H, Williams G, Bienias A, Cope EA, Courquin GR, Day L, Garner C, Gimson A, Harris C, Markham K, Moore T, Nadin T, Phillips C, Subratty SM, Brown K, Dada J, Durbacz M, Filipescu T, Harrison E, Kennedy ED, Khoo E, Kremel D, Lyell I, Pronin S, Tummon R, Ventre C, Walls L, Wootton E, Akhtar A, Davies E, El-Sawy D, Farooq M, Gaddah M, Griffiths H, Katsaiti I, Khadem N, Leong K, Williams I, Chean CS, Chudek D, Desai H, Ellerby N, Hammad A, Malla S, Murphy B, Oshin O, Popova P, Rana S, Ward T, Abbott TEF, Akpenyi O, Edozie F, El Matary R, English W, Jeyabaladevan S, Morgan C, Naidu V, Nicholls K, Peroos S, Prowle J, Sansome S, Torrance HD, Townsend D, Brecher J, Fung H, Kazmi Z, Outlaw P, Pursnani K, Ramanujam N, Razaq A, Sattar M, Sukumar S, Tan TSE, Chohan K, Dhuna S, Haq T, Kirby S, Lacy-Colson J, Logan P, Malik Q, McCann J, Mughal Z, Sadiq S, Sharif I, Shingles C, Simon A, Burnage S, Chan SSN, Craig ARJ, Duffield J, Dutta A, Eastwood M, Iqbal F, Mahmood F, Mahmood W, Patel C, Qadeer A, Robinson A, Rotundo A, Schade A, Slade RD, De Freitas M, Kinnersley H, McDowell E, Moens-Lecumberri S, Ramsden J, Rockall T, Wiffen L, Wright S, Bruce C, Francois V, Hamdan K, Limb C, Lunt AJ, Manley L, Marks M, Phillips CFE, Agnew CJF, Barr CJ, Benons N, Hart SJ, Kandage D, Krysztopik R, Mahalingam P, Mock J, Rajendran S, Stoddart MT, Clements B, Gillespie H, Lee S, McDougall R, Murray C, O'Loane R, Periketi S, Tan S, Amoah R, Bhudia R, Dudley B, Gilbert A, Griffiths B, Khan H, McKigney N, Roberts B, Samuel R, Seelarbokus A, Stubbing-Moore A, Thompson G, Williams P, Ahmed N, Akhtar R, Chandler E, Chappelow I, Gil H, Gower T, Kale A, Lingam G, Rutler L, Sellahewa C, Sheikh A, Stringer H, Taylor R, Aglan H, Ashraf MR, Choo S, Das E, Epstein J, Gentry R, Mills D, Poolovadoo Y, Ward N, Bull K, Cole A, Hack J, Khawari S, Lake C, Mandishona T, Perry R, Sleight S, Sultan S, Thornton T, Williams S, Arif T, Castle A, Chauhan P, Chesner R, Eilon T, Kamarajah S, Kambasha C, Lock L, Loka T, Mohammad F, Motahariasl S, Roper L, Sadhra SS, Sheikh A, Toma T, Wadood Q, Yip J, Ainger E, Busti S, Cunliffe L, Flamini T, Gaffing S, Moorcroft C, Peter M, Simpson L, Stokes E, Stott G, Wilson J, York J, Yousaf A, Borakati A, Brown M, Goaman A, Hodgson B, Ijeomah A, Iroegbu U, Kaur G, Lowe C, Mahmood S, Sattar Z, Sen P, Szuman A, Abbas N, Al-Ausi M, Anto N, Bhome R, Eccles L, Elliott J, Hughes EJ, Jones A, Karunatilleke AS, Knight JS, Manson CCF, Mekhail I, Michaels L, Noton TM, Okenyi E, Reeves T, Yasin IH, Banfield DA, Harris R, Lim D, Mason-Apps C, Roe T, Sandhu J, Shafiq N, Stickler E, Tam JP, Williams LM, Ainsworth P, Boualbanat Y, Doull C, Egan E, Evans L, Hassanin K, Ninkovic-Hall G, Odunlami W, Shergill M, Traish M, Cummings D, Kershaw S, Ong J, Reid F, Toellner H, Alwandi A, Amer M, George D, Haynes K, Hughes K, Peakall L, Premakumar Y, Punjabi N, Ramwell A, Sawkins H, Ashwood J, Baker A, Baron C, Bhide I, Blake E, De Cates C, Esmail R, Hosamuddin H, Kapp J, Nguru N, Raja M, Thomson F, Ahmed H, Aishwarya G, Al-Huneidi R, Ali S, Aziz R, Burke D, Clarke B, Kausar A, Maskill D, Mecia L, Myers L, Smith ACD, Walker G, Wroe N, Donohoe C, Gibbons D, Jordan P, Keogh C, Kiely A, Lalor P, McCrohan M, Powell C, Foley MP, Reynolds J, Silke E, Thorpe O, Kong JTH, White C, Ali Q, Dalrymple J, Ge Y, Khan H, Luo RS, Paine H, Paraskeva B, Parker L, Pillai K, Salciccioli J, Selvadurai S, Sonagara V, Springford LR, Tan L, Appleton S, Leadholm N, Zhang Y, Ahern D, Cotter M, Cremen S, Durrigan T, Flack V, Hrvacic N, Jones H, Jong B, Keane K, O'Connell PR, O'sullivan J, Pek G, Shirazi S, Barker C, Brown A, Carr W, Chen Y, Guillotte C, Harte J, Kokayi A, Lau K, McFarlane S, Morrison S, Broad J, Kenefick N, Makanji D, Printz V, Saito R, Thomas O, Breen H, Kirk S, Kong CH, O'Kane A, Eddama M, Engledow A, Freeman SK, Frost A, Goh C, Lee G, Poonawala R, Suri A, Taribagil P, Brown H, Christie S, Dean S, Gravell R, Haywood E, Holt F, Pilsworth E, Rabiu R, Roscoe HW, Shergill S, Sriram A, Sureshkumar A, Tan LC, Tanna A, Vakharia A, Bhullar S, Brannick S, Dunne E, Frere M, Kerin M, Kumar KM, Pratumsuwan T, Quek R, Salman M, Van Den Berg N, Wong C, Ahluwalia J, Bagga R, Borg CM, Calabria C, Draper A, Farwana M, Joyce H, Khan A, Mazza M, Pankin G, Sait MS, Sandhu N, Virani N, Wong J, Woodhams K, Croghan N, Ghag S, Hogg G, Ismail O, John N, Nadeem K, Naqi M, Noe SM, Sharma A, Tan S, Begum F, Best R, Collishaw A, Glasbey J, Golding D, Gwilym B, Harrison P, Jackman T, Lewis N, Luk YL, Porter T, Potluri S, Stechman M, Tate S, Thomas D, Walford B, Auld F, Bleakley A, Johnston S, Jones C, Khaw J, Milne S, O'Neill S, Singh KKR, Smith R, Swan A, Thorley N, Yalamarthi S, Yin ZD, Ali A, Balian V, Bana R, Clark K, Livesey C, McLachlan G, Mohammad M, Pranesh N, Richards C, Ross F, Sajid M, Brooke M, Francombe J, Gresly J, Hutchinson S, Kerrigan K, Matthews E, Nur S, Parsons L, Sandhu A, Vyas M, White F, Zulkifli A, Zuzarte L, Al-Mousawi A, Arya J, Azam S, Yahaya AA, Gill K, Hallan R, Hathaway C, Leptidis I, McDonagh L, Mitrasinovic S, Mushtaq N, Pang N, Peiris GB, Rinkoff S, Chan L, Christopher E, Farhan-Alanie MMH, Gonzalez-Ciscar A, Graham CJ, Lim H, McLean KA, Paterson HM, Rogers A, Roy C, Rutherford D, Smith F, Zubikarai G, Al-Khudairi R, Bamford M, Chang M, Cheng J, Hedley C, Joseph R, Mitchell B, Perera S, Rothwell L, Siddiqui A, Smith J, Taylor K, Wright OW, Baryan HK, Boyd G, Conchie H, Cox L, Davies J, Gardner S, Hill N, Krishna K, Lakin F, Scotcher S, Alberts J, Asad M, Barraclough J, Campbell A, Marshall D, Wakeford W, Cronbach P, D'Souza F, Gammeri E, Houlton J, Hall M, Kethees A, Patel R, Perera M, Prowle J, Shaid M, Webb E, Beattie S, Chadwick M, El-Taji O, Haddad S, Mann M, Patel M, Popat K, Rimmer L, Riyat H, Smith H, Anandarajah C, Cipparrone M, Desai K, Gao C, Goh ET, Howlader M, Jeffreys N, Karmarkar A, Mathew G, Mukhtar H, Ozcan E, Renukanthan A, Sarens N, Sinha C, Woolley A, Bogle R, Komolafe O, Loo F, Waugh D, Zeng R, Crewe A, Mathias J, Mills A, Owen A, Prior A, Saunders I, Baker A, Crilly L, McKeon J, Ubhi HK, Adeogun A, Carr R, Davison C, Devalia S, Hayat A, Karsan RB, Osborne C, Scott K, Weegenaar C, Wijeyaratne M, Babatunde F, Barnor-Ahiaku E, Beattie G, Chitsabesan P, Dixon O, Hall N, Ilenkovan N, Mackrell T, Nithianandasivam N, Orr J, Palazzo F, Saad M, Sandland-Taylor L, Sherlock J, Ashdown T, Chandler S, Garsaa T, Lloyd J, Loh SY, Ng S, Perkins C, Powell-Chandler A, Smith F, Underhill R. Perioperative intravenous contrast administration and the incidence of acute kidney injury after major gastrointestinal surgery: prospective, multicentre cohort study. Br J Surg 2020; 107:1023-1032. [PMID: 32026470 DOI: 10.1002/bjs.11453] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Revised: 09/21/2019] [Accepted: 11/08/2019] [Indexed: 01/14/2023]
Abstract
BACKGROUND This study aimed to determine the impact of preoperative exposure to intravenous contrast for CT and the risk of developing postoperative acute kidney injury (AKI) in patients undergoing major gastrointestinal surgery. METHODS This prospective, multicentre cohort study included adults undergoing gastrointestinal resection, stoma reversal or liver resection. Both elective and emergency procedures were included. Preoperative exposure to intravenous contrast was defined as exposure to contrast administered for the purposes of CT up to 7 days before surgery. The primary endpoint was the rate of AKI within 7 days. Propensity score-matched models were adjusted for patient, disease and operative variables. In a sensitivity analysis, a propensity score-matched model explored the association between preoperative exposure to contrast and AKI in the first 48 h after surgery. RESULTS A total of 5378 patients were included across 173 centres. Overall, 1249 patients (23·2 per cent) received intravenous contrast. The overall rate of AKI within 7 days of surgery was 13·4 per cent (718 of 5378). In the propensity score-matched model, preoperative exposure to contrast was not associated with AKI within 7 days (odds ratio (OR) 0·95, 95 per cent c.i. 0·73 to 1·21; P = 0·669). The sensitivity analysis showed no association between preoperative contrast administration and AKI within 48 h after operation (OR 1·09, 0·84 to 1·41; P = 0·498). CONCLUSION There was no association between preoperative intravenous contrast administered for CT up to 7 days before surgery and postoperative AKI. Risk of contrast-induced nephropathy should not be used as a reason to avoid contrast-enhanced CT.
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Straubhar A, Parsons M, Francis S, Gaffney D, Maurer K. Refusal of Surgery by Young Women (Age <41) with Endometrial Cancer Does Not Impact Overall Survival. Gynecol Oncol 2020. [DOI: 10.1016/j.ygyno.2019.11.100] [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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Contrady A, Francis S, Montgomery D. Fresh Conversations: Helping Older Adults Make Lifestyle Changes. J Acad Nutr Diet 2019. [DOI: 10.1016/j.jand.2019.06.195] [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: 10/26/2022]
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Hockings P, Makvandi K, Jensen G, Unnerstall T, Leonhardt H, Jarl L, Frödén Löwenmark A, Englund C, Francis S, Baid-Agrawal S. MON-297 MAGNETIC RESONANCE IMAGING ALLOWS A NOVEL NON-INVASIVE FUNCTIONAL AND PATHOPHYSIOLOGIC ASSESSMENT OF CHRONIC KIDNEY DISEASE IN DIABETIC NEPHROPATHY. Kidney Int Rep 2019. [DOI: 10.1016/j.ekir.2019.05.1106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Baisley KJ, Andreasen A, Irani J, Nnko S, Changalucha J, Crucitti T, Francis S, Holm Hansen C, Hayes RJ, Buvé A, Watson-Jones D. HPV prevalence around the time of sexual debut in adolescent girls in Tanzania. Sex Transm Infect 2019; 96:211-219. [PMID: 31221744 DOI: 10.1136/sextrans-2019-054012] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2019] [Revised: 05/07/2019] [Accepted: 05/13/2019] [Indexed: 01/02/2023] Open
Abstract
OBJECTIVES Cervical cancer is the leading cause of cancer-related mortality among women in sub-Saharan Africa (SSA). Data on human papillomavirus (HPV) epidemiology in adolescent girls in SSA are essential to inform HPV vaccine policy recommendations for cervical cancer prevention. We assessed the burden of HPV infection, and risk factors for infection, among adolescent girls around the time of sexual debut. METHODS Cross-sectional study of secondary school girls aged 17-18 years in Tanzania. Consenting participants provided samples for HPV and STI testing. Vaginal swabs were tested for 37 HPV genotypes by Roche Linear Array. Logistic regression was used to identify factors associated with HPV infection. Y chromosome was tested as a marker of recent condomless sex. RESULTS 163/385 girls (42.3%) reported previous penetrative sex. HPV was detected in 125/385 (32.5%) girls, including 84/163 (51.5%) girls reporting previous sex and 41/222 (18.5%) reporting no previous sex. High-risk (HR) genotypes were detected in 70/125 (56.0%) girls with HPV infection. The most common HR genotype was HPV-16 (15/385; 3.9%). The prevalence of other HR HPV vaccine genotypes was between 0.8% and 3.1%. Among 186 girls who reported no previous sex, were negative for Y chromosome, and had no STI, 32 (17%) had detectable HPV. Lactobacillus sp and bacterial vaginosis-associated bacteria were negatively and positively associated, respectively, with HPV. CONCLUSIONS HPV prevalence among adolescent girls around the time of sexual debut was high. However, prevalence of most vaccine genotypes was low, indicating that extending the age range of HPV vaccination in this region may be cost-effective.
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Affiliation(s)
- Kathy J Baisley
- Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
| | - Aura Andreasen
- Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, UK.,Mwanza Intervention Trials Unit, National Institute for Medical Research, Mwanza, Tanzania
| | - Julia Irani
- Mwanza Intervention Trials Unit, National Institute for Medical Research, Mwanza, Tanzania.,Department of Microbiology, Institute of Tropical Medicine, Antwerp, Belgium
| | - Soori Nnko
- National Institute for Medical Research, Mwanza, Tanzania
| | | | - Tania Crucitti
- Department of Microbiology, Institute of Tropical Medicine, Antwerp, Belgium
| | - Suzanna Francis
- Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
| | - Christian Holm Hansen
- Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
| | - Richard J Hayes
- Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
| | - Anne Buvé
- Department of Microbiology, Institute of Tropical Medicine, Antwerp, Belgium
| | - Deborah Watson-Jones
- Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, UK.,Mwanza Intervention Trials Unit, National Institute for Medical Research, Mwanza, Tanzania
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17
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Zinzani P, Santoro A, Gritti G, Brice P, Barr P, Kuruvilla J, Cunningham D, Kline J, Johnson N, Mehta-Shah N, Manley T, Francis S, Sharma M, Moskowitz A. NIVOLUMAB COMBINED WITH BRENTUXIMAB VEDOTIN FOR RELAPSED/REFRACTORY PRIMARY MEDIASTINAL LARGE B-CELL LYMPHOMA: EFFICACY AND SAFETY FROM THE PHASE 2 CHECKMATE 436 STUDY. Hematol Oncol 2019. [DOI: 10.1002/hon.114_2629] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- P.L. Zinzani
- Institute of Hematology; “Seràgnoli" Bologna University; Bologna Italy
| | - A. Santoro
- Oncologia medica; Istituto Clinico Humanitas; Rozzano-Milano Italy
| | - G. Gritti
- Hematology and Bone Marrow Transplant Unit; Ospedale Papa Giovanni XXIII; Bergamo Italy
| | - P. Brice
- Service d'Hémato-Oncologie; Hôpital Saint-Louis; Paris France
| | - P.M. Barr
- Dept. of Hematology/Oncology; University of Rochester; Rochester United States
| | - J. Kuruvilla
- Division of Medical Oncology and Hematology; Princess Margaret Cancer Centre; Toronto Canada
| | - D. Cunningham
- Gastrointestinal and Lymphoma Unit; Royal Marsden Hospital; London United Kingdom
| | - J. Kline
- Hematology & Oncology (Cancer); University of Chicago; Chicago United States
| | - N.A. Johnson
- Division of Hematology; Jewish General Hospital; Montréal Canada
| | - N.A. Mehta-Shah
- Department of Oncology; Washington University School of Medicine; St Louis United States
| | - T. Manley
- Seattle Genetics; Bothell United States
| | - S. Francis
- Bristol-Myers Squibb; Princeton United States
| | - M. Sharma
- Bristol-Myers Squibb; Princeton United States
| | - A.J. Moskowitz
- Lymphoma Inpatient Unit; Memorial Sloan Kettering Cancer Center; New York United States
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18
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Kelly K, Daw S, Mauz-Körholz C, Mascarin M, Michel G, Cooper S, Beishuizen A, Leger K, Garaventa A, Buffardi S, Brugières L, Harker-Murray P, Cole P, Drachtman R, Manley T, Francis S, Sacchi M, Leblanc T. RESPONSE-ADAPTED TREATMENT WITH NIVOLUMAB AND BRENTUXIMAB VEDOTIN IN YOUNG PATIENTS WITH RELAPSED/REFRACTORY CLASSICAL HODGKIN LYMPHOMA: CHECKMATE 744 SUBGROUP ANALYSES. Hematol Oncol 2019. [DOI: 10.1002/hon.26_2629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- K.M. Kelly
- Department of Pediatric Oncology; Roswell Park Comprehensive Cancer Center; Buffalo United States
| | - S. Daw
- Paediatric and Adolescent Haemato-Oncology; University College Hospital; London United Kingdom
| | - C. Mauz-Körholz
- Department of Pediatric Hematology and Oncology; University Hospital Justus Liebig University; Giessen Germany
| | - M. Mascarin
- AYA and Pediatric Radiotherapy Unit; IRCCS Centro di Riferimento Oncologico; Aviano Italy
| | - G. Michel
- Service d'Hématologie pédiatrique; CHU de Marseille - Hôpital de la Timone; Maresille France
| | - S. Cooper
- Pediatric Oncology; Johns Hopkins Hospital; Baltimore United States
| | - A. Beishuizen
- Pediatric Oncology/Hematology; Princess Máxima Center for Pediatric Oncology; Utrecht Netherlands
| | - K.J. Leger
- Hematology-Oncology; Seattle Children's Hospital; Seattle United States
| | - A. Garaventa
- UOC Oncologia; Ematologia e Trapianto di Midollo, IRCCS Istituto Giannina Gaslini; Genoa Italy
| | - S. Buffardi
- Paediatric Haemato-Oncology; Santobono-Pausilipon Hospital; Naples Italy
| | - L. Brugières
- Department of Paediatrics; Institut Gustave Roussy; Villejuif France
| | - P. Harker-Murray
- Pediatric Hematology-Oncology; Children's Hospital of Wisconsin; Milwaukee United States
| | - P.D. Cole
- Division of Pediatric Hematology/Oncology; Rutgers Cancer Institute of New Jersey; New Brunswick United States
| | - R.A. Drachtman
- Division of Pediatric Hematology/Oncology; Rutgers Cancer Institute of New Jersey; New Brunswick United States
| | - T. Manley
- Seattle Genetics; Bothell United States
| | - S. Francis
- Bristol-Myers Squibb; Princeton United States
| | - M. Sacchi
- Bristol-Myers Squibb; Princeton United States
| | - T. Leblanc
- Service d'Hématologie Pédiatrique; Hôpital Robert-Debré APHP; Paris France
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19
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Triolo TM, Fouts A, Pyle L, Yu L, Gottlieb PA, Steck AK, Greenbaum CJ, Atkinson M, Baidal D, Battaglia M, Becker D, Bingley P, Bosi E, Buckner J, Clements M, Colman P, DiMeglio L, 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, Wentworth 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, Eisenbarth G, Fathman C, Grave G, Hering B, Insel R, Kaufman F, Kay T, Leschek E, Mahon J, Marks J, Nanto-Salonen K, Nepom G, Orban T, Parkman R, Pescovitz M, Peyman J, Pugliese A, Roep B, Roncarolo M, Savage P, Simell O, Sherwin R, Siegelman M, Skyler J, Steck A, Thomas J, Trucco M, Wagner J, Krischer JP, Leschek E, Rafkin L, Bourcier K, Cowie C, Foulkes M, Insel R, Krause-Steinrauf H, Lachin JM, Malozowski S, Peyman J, Ridge J, Savage P, Skyler JS, Zafonte SJ, Rafkin L, Sosenko JM, Kenyon NS, Santiago I, Krischer JP, Bundy B, Abbondondolo M, Dixit S, Pasha M, King K, Adcock H, Atterberry L, Fox K, Englert N, Mauras J, Permuy K, Sikes T, Adams T, Berhe B, Guendling L, McLennan L, Paganessi C, Murphy M, Draznin M, Kamboj S, Sheppard V, Lewis L, Coates W, Amado D, Moore G, Babar J, Bedard D, Brenson-Hughes J, Cernich M, Clements R, Duprau S, Goodman L, Hester L, Huerta-Saenz A, Asif I, Karmazin T, Letjen S, Raman D, Morin W, Bestermann E, Morawski J, White A, Brockmyer R, Bays S, Campbell A, Boonstra M, Stapleton N, Stone A, Donoho H, Everett H, Hensley M, Johnson C, Marshall N, Skirvin P, Taylor R, Williams L, Burroughs C, Ray C, Wolverton D, Nickels C, Dothard P, Speiser M, Pellizzari L, Bokor K, Izuora S, Abdelnour P, Cummings S, Cuthbertson D, Paynor M, Leahy M, Riedl S, Shockley R, Saad T, Briones S, Casella C, Herz K, Walsh J, Greening F, Deemer M, Hay S, Hunt N, Sikotra L, Simons D, Karounos R, Oremus L, Dye L, Myers D, Ballard W, Miers R, Eberhard C, Sparks K, Thraikill K, Edwards J, Fowlkes S, Kemp A, Morales L, Holland L, Johnson P, Paul A, Ghatak K, Fiske S, Phelen H, Leyland T, Henderson D, Brenner E, Oppenheimer I, Mamkin C, Moniz C, Clarson M, Lovell A, Peters V, Ford J, Ruelas D, Borut D, Burt M, Jordan S, Castilla P, Flores M, Ruiz L, Hanson J, Green-Blair R, Sheridan K, Garmeson J, Wintergerst G, Pierce A, Omoruyi M, Foster S, Kingery A, Lunsford I, Cervantes T, Parker P, Price J, Urben I, Guillette H, Doughty H, Haydock V, Parker P, Bergman S, Duncum C, Rodda A, Perelman R, Calendo C, Barrera E, Arce-Nunez Y, Geyer S, Martinez M, De la Portilla I, Cardenas L, Garrido M, Villar R, Lorini E, Calandra G, D’Annuzio K, Perri N, Minuto C, Hays B, Rebora R, Callegari O, Ali J, Kramer B, Auble S, Cabrera P, Donohoue R, Fiallo-Scharer M, Hessner P, Wolfgram A, Henderson C, Kansra N, Bettin R, McCuller A, Miller S, Accacha J, Corrigan E, Fiore R, Levine T, Mahoney C, Polychronakos V, Henry M, Gagne H, Starkman M, Fox D, Chin F, Melchionne L, Silverman I, Marshall L, Cerracchio J, Cruz A, Viswanathan J, Heyman K, Wilson S, Chalew S, Valley S, Layburn A, Lala P, Clesi M, Genet G, Uwaifo A, Charron T, Allerton W, Hsiao B, Cefalu L, Melendez-Ramirez R, Richards C, Alleyn E, Gustafson M, Lizanna J, Wahlen S, Aleiwe M, Hansen H, Wahlen C, Karges C, Levy A, Bonaccorso R, Rapaport Y, Tomer D, Chia M, Goldis L, Iazzetti M, Klein C, Levister L, Waldman E, Keaton N, Wallach M, Regelmann Z, Antal M, Aranda C, Reynholds A, Vinik P, Barlow M, Bourcier M, Nevoret J, Couper S, Kinderman A, Beresford N, Thalagne H, Roper J, Gibbons J, Hill S, Balleaut C, Brennan J, Ellis-Gage L, Fear T, Gray L, Law P, Jones C, McNerney L, Pointer N, Price K, Few D, Tomlinson N, Leech D, Wake C, Owens M, Burns J, Leinbach A, Wotherspoon A, Murray K, Short G, Curry S, Kelsey J, Lawson J, Porter S, Stevens E, Thomson S, Winship L, Liu S, Wynn E, Wiltshire J, Krebs P, Cresswell H, Faherty C, Ross L, Denvir J, Drew T, Randell P, Mansell S, Lloyd J, Bell S, Butler Y, Hooton H, Navarra A, Roper G, Babington L, Crate H, Cripps A, Ledlie C, Moulds R, Malloy J, Norton B, Petrova O, Silkstone C, Smith K, Ghai M, Murray V, Viswanathan M, Henegan O, Kawadry J, Olson L, Maddox K, Patterson T, Ahmad B, Flores D, Domek S, Domek K, Copeland M, George J, Less T, Davis M, Short A, Martin J, Dwarakanathan P, O’Donnell B, Boerner L, Larson M, Phillips M, Rendell K, Larson C, Smith K, Zebrowski L, Kuechenmeister M, Miller J, Thevarayapillai M, Daniels H, Speer N, Forghani R, Quintana C, Reh A, Bhangoo P, Desrosiers L, Ireland T, Misla C, Milliot E, Torres S, Wells J, Villar M, Yu D, Berry D, Cook J, Soder A, Powell M, Ng M, Morrison Z, Moore M, Haslam M, Lawson B, Bradley J, Courtney C, Richardson C, Watson E, Keely D, DeCurtis M, Vaccarcello-Cruz Z, Torres K, Muller S, Sandberg H, Hsiang B, Joy D, McCormick A, Powell H, Jones J, Bell S, Hargadon S, Hudson M, Kummer S, Nguyen T, Sauder E, Sutton K, Gensel R, Aguirre-Castaneda V, Benavides, Lopez D, Hemp S, Allen J, Stear E, Davis T, O’Donnell R, Jones A, Roberts J, Dart N, Paramalingam L, Levitt Katz N, Chaudhary K, Murphy S, Willi B, Schwartzman C, Kapadia D, Roberts A, Larson D, McClellan G, Shaibai L, Kelley G, Villa C, Kelley R, Diamond M, Kabbani T, Dajani F, Hoekstra M, Sadler K, Magorno J, Holst V, Chauhan N, Wilson P, Bononi M, Sperl A, Millward M, Eaton L, Dean J, Olshan H, Stavros T, Renna C, Milliard, Brodksy L, Bacon J, Quintos L, Topor S, Bialo B, Bancroft A, Soto W, Lagarde H, Tamura R, Lockemer T, Vanderploeg M, Ibrahim M, Huie V, Sanchez R, Edelen R, Marchiando J, Palmer T, Repas M, Wasson P, Wood K, Auker J, Culbertson T, Kieffer D, Voorhees T, Borgwardt L, DeRaad K, Eckert E, Isaacson H, Kuhn A, Carroll M, Xu P, Schubert G, Francis S, Hagan T, Le M, Penn E, Wickham C, Leyva K, Rivera J, Padilla I, Rodriguez N, Young K, Jospe J, Czyzyk B, Johnson U, Nadgir N, Marlen G, Prakasam C, Rieger N, Glaser E, Heiser B, Harris C, Alies P, Foster H, Slater K, Wheeler D, Donaldson M, Murray D, Hale R, Tragus D, Word J, Lynch L, Pankratz W, Badias F, Rogers R, Newfield S, Holland M, Hashiguchi M, Gottschalk A, Philis-Tsimikas R, Rosal S, Franklin S, Guardado N, Bohannon M, Baker A, Garcia T, Aguinaldo J, Phan V, Barraza D, Cohen J, Pinsker U, Khan J, Wiley L, Jovanovic P, Misra M, Bassi M, Wright D, Cohen K, Huang M, Skiles S, Maxcy C, Pihoker K, Cochrane J, Fosse S, Kearns M, Klingsheim N, Beam C, Wright L, Viles H, Smith S, Heller M, Cunningham A, Daniels L, Zeiden J, Field R, Walker K, Griffin L, Boulware D, Bartholow C, Erickson J, Howard B, Krabbenhoft C, Sandman A, Vanveldhuizen J, Wurlger A, Zimmerman K, Hanisch L, Davis-Keppen A, Bounmananh L, Cotterill J, Kirby M, Harris A, Schmidt C, Kishiyama C, Flores J, Milton W, Martin C, Whysham A, Yerka T, Bream S, Freels J, Hassing J, Webster R, Green P, Carter J, Galloway D, Hoelzer S, Roberts S, Said P, Sullivan H, Freeman D, Allen E, Reiter E, Feinberg C, Johnson L, Newhook D, Hagerty N, White L, Levandoski J, Kyllo M, Johnson C, Gough J, Benoit P, Iyer F, Diamond H, Hosono S, Jackman L, Barette P, Jones I, Sills S, Bzdick J, Bulger R, Ginem J, Weinstock I, Douek R, Andrews G, Modgill G, Gyorffy L, Robin N, Vaidya S, Crouch K, O’Brien C, Thompson N, Granger M, Thorne J, Blumer J, Kalic L, Klepek J, Paulett B, Rosolowski J, Horner M, Watkins J, Casey K, Carpenter C, Michelle Kieffer MH, Burns J, Horton C, Pritchard D, Soetaert A, Wynne C, Chin O, Molina C, Patel R, Senguttuvan M, Wheeler O, Lane P, Furet C, Steuhm D, Jelley S, Goudeau L, Chalmers D, Greer C, Panagiotopoulos D, Metzger D, Nguyen M, Horowitz M, Linton C, Christiansen E, Glades C, Morimoto M, Macarewich R, Norman K, Patin C, Vargas A, Barbanica A, Yu P, Vaidyanathan W, Nallamshetty L, Osborne R, Mehra S, Kaster S, Neace J, Horner G, Reeves C, Cordrey L, Marrs T, Miller S, Dowshen D, Oduah V, Doyle S, Walker D, Catte H, Dean M, Drury-Brown B, Hackman M, Lee S, Malkani K, 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A, Eisenbarth G, Fain P, Fiallo-Scharer R, Frank N, Goettle H, Haarhues M, Harris S, Horton L, Hutton J, Jeffrrey J, Jenison R, Jones K, Kastelic W, King MA, Lehr D, Lungaro J, Mason K, Maurer H, Nguyen L, Proto A, Realsen J, Schmitt K, Schwartz M, Skovgaard S, Smith J, Vanderwel B, Voelmle M, Wagner R, Wallace A, Walravens P, Weiner L, Westerhoff B, Westfall E, Widmer K, Wright H, Schatz D, Abraham A, Atkinson M, Cintron M, Clare-Salzler M, Ferguson J, Haller M, Hosford J, Mancini D, Rohrs H, Silverstein J, Thomas J, Winter W, Cole G, Cook R, Coy R, Hicks E, Lewis N, Marks J, Pugliese A, Blaschke C, Matheson D, Pugliese A, Sanders-Branca N, Ray Arce LA, Cisneros M, Sabbag S, Moran A, Gibson C, Fife B, Hering B, Kwong C, Leschyshyn J, Nathan B, Pappenfus B, Street A, Boes MA, Peterson Eck S, Finney L, Albright Fischer T, Martin A, Jacqueline Muzamhindo C, Rhodes M, Smith J, Wagner J, Wood B, Becker D, Delallo K, Diaz A, Elnyczky B, Libman I, Pasek B, Riley K, Trucco M, Copemen B, Gwynn D, Toledo F, Rodriguez H, Bollepalli S, Diamond F, Eyth E, Henson D, Lenz A, Shulman D, Raskin P, Adhikari S, Dickson B, Dunnigan E, Lingvay I, Pruneda L, Ramos-Roman M, Raskin P, Rhee C, Richard J, Siegelman M, Sturges D, Sumpter K, White P, Alford M, Arthur J, Aviles-Santa ML, Cordova E, Davis R, Fernandez S, Fordan S, Hardin T, Jacobs A, Kaloyanova P, Lukacova-Zib I, Mirfakhraee S, Mohan A, Noto H, Smith O, Torres N, Wherrett D, Balmer D, Eisel L, Kovalakovska R, Mehan M, Sultan F, Ahenkorah B, Cevallos J, Razack N, Jo Ricci M, Rhode A, Srikandarajah M, Steger R, Russell WE, Black M, Brendle F, Brown A, Moore D, Pittel E, Robertson A, Shannon A, Thomas JW, Herold K, Feldman L, Sherwin R, Tamborlane W, Weinzimer S, Toppari J, Kallio T, Kärkkäinen M, Mäntymäki E, Niininen T, Nurmi B, Rajala P, Romo M, Suomenrinne S, Näntö-Salonen K, Simell O, Simell T, Bosi E, Battaglia M, Bianconi E, Bonfanti R, Grogan P, Laurenzi A, Martinenghi S, Meschi F, Pastore M, Falqui L, Teresa Muscato M, Viscardi M, Bingley P, Castleden H, Farthing N, Loud S, Matthews C, McGhee J, Morgan A, Pollitt J, Elliot-Jones R, Wheaton C, Knip M, Siljander H, Suomalainen H, Colman P, Healy F, Mesfin S, Redl L, Wentworth J, Willis J, Farley M, Harrison L, Perry C, Williams F, Mayo A, Paxton J, Thompson V, Volin L, Fenton C, Carr L, Lemon E, Swank M, Luidens M, Salgam M, Sharma V, Schade D, King C, Carano R, Heiden J, Means N, Holman L, Thomas I, Madrigal D, Muth T, Martin C, Plunkett C, Ramm C, Auchus R, Lane W, Avots E, Buford M, Hale C, Hoyle J, Lane B, Muir A, Shuler S, Raviele N, Ivie E, Jenkins M, Lindsley K, Hansen I, Fadoju D, Felner E, Bode B, Hosey R, Sax J, Jefferies C, Mannering S, Prentis R, She J, Stachura M, Hopkins D, Williams J, Steed L, Asatapova E, Nunez S, Knight S, Dixon P, Ching J, Donner T, Longnecker S, Abel K, Arcara K, Blackman S, Clark L, Cooke D, Plotnick L, Levin P, Bromberger L, Klein K, Sadurska K, Allen C, Michaud D, Snodgrass H, Burghen G, Chatha S, Clark C, Silverberg J, Wittmer C, Gardner J, LeBoeuf C, Bell P, McGlore O, Tennet H, Alba N, Carroll M, Baert L, Beaton H, Cordell E, Haynes A, Reed C, Lichter K, McCarthy P, McCarthy S, Monchamp T, Roach J, Manies S, Gunville F, Marosok L, Nelson T, Ackerman K, Rudolph J, Stewart M, McCormick K, May S, Falls T, Barrett T, Dale K, Makusha L, McTernana C, Penny-Thomas K, Sullivan K, Narendran P, Robbie J, Smith D, Christensen R, Koehler B, Royal C, Arthur T, Houser H, Renaldi J, Watsen S, Wu P, Lyons L, House B, Yu J, Holt H, Nation M, Vickers C, Watling R, Heptulla R, Trast J, Agarwal C, Newell D, Katikaneni R, Gardner C, Del A, Rio A, Logan H, Collier C, Rishton G, Whalley A, Ali S, Ramtoola T, Quattrin L, Mastrandea A, House M, Ecker C, Huang C, Gougeon J, Ho D, Pacuad D, Dunger J, May C, O’Brien C, Acerini B, Salgin A, Thankamony R, Williams J, Buse G, Fuller M, Duclos J, Tricome H, Brown D, Pittard D, Bowlby A, Blue T, Headley S, Bendre K, Lewis K, Sutphin C, Soloranzo J, Puskaric H, Madison M, Rincon M, Carlucci R, Shridharani B, Rusk E, Tessman D, Huffman H, Abrams B, Biederman M, Jones V, Leathers W, Brickman P, Petrie D, Zimmerman J, Howard L, Miller R, Alemzadeh D, Mihailescu R, Melgozza-Walker N, Abdulla C, Boucher-Berry D, Ize-Ludlow R, Levy C, Swenson, Brousell N, Crimmins D, Edler T, Weis C, Schultz D, Rogers D, Latham C, Mawhorter C, Switzer W, Spencer P, Konstantnopoulus S, Broder J, Klein L, Knight L, Szadek G, Welnick B, Thompson R, Hoffman A, Revell J, Cherko K, Carter E, Gilson J, Haines G, Arthur B, Bowen W, Zipf P, Graves R, Lozano D, Seiple K, Spicer A, Chang J, Fregosi J, Harbinson C, Paulson S, Stalters P, Wright D, Zlock A, Freeth J, Victory H, Maheshwari A, Maheshwari T, Holmstrom J, Bueno R, Arguello J, Ahern L, Noreika V, Watson S, Hourse P, Breyer C, Kissel Y, Nicholson M, Pfeifer S, Almazan J, Bajaj M, Quinn K, Funk J, McCance E, Moreno R, Veintimilla A, Wells J, Cook S, Trunnel J, Henske S, Desai K, Frizelis F, Khan R, Sjoberg K, Allen P, Manning G, Hendry B, Taylor S, Jones W, Strader M, Bencomo T, Bailey L, Bedolla C, Roldan C, Moudiotis B, Vaidya C, Anning S, Bunce S, Estcourt E, Folland E, Gordon C, Harrill J, Ireland J, Piper L, Scaife K, Sutton S, Wilkins M, Costelloe J, Palmer L, Casas C, Miller M, Burgard C, Erickson J, Hallanger-Johnson P, Clark W, Taylor A, Lafferty S, Gillett C, Nolan M, Pathak L, Sondrol T, Hjelle S, Hafner J, Kotrba R, Hendrickson A, Cemeroglu T, Symington M, Daniel Y, Appiagyei-Dankah D, Postellon M, Racine L, Kleis K, Barnes S, Godwin H, McCullough K, Shaheen G, Buck L, Noel M, Warren S, Weber S, Parker I, Gillespie B, Nelson C, Frost J, Amrhein E, Moreland A, Hayes J, Peggram J, Aisenberg M, Riordan J, Zasa E, Cummings K, Scott T, Pinto A, Mokashi K, McAssey E, Helden P, Hammond L, Dinning S, Rahman S, Ray C, Dimicri S, Guppy H, Nielsen C, Vogel C, Ariza L, Morales Y, Chang R, Gabbay L, Ambrocio L, Manley R, Nemery W, Charlton P, Smith L, Kerr B, Steindel-Kopp M, Alamaguer D, Liljenquist G, Browning T, Coughenour M, Sulk E, Tsalikan M, Tansey J, Cabbage N. Identical and Nonidentical Twins: Risk and Factors Involved in Development of Islet Autoimmunity and Type 1 Diabetes. Diabetes Care 2019; 42:192-199. [PMID: 30061316 PMCID: PMC6341285 DOI: 10.2337/dc18-0288] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [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] [Received: 02/07/2018] [Accepted: 06/28/2018] [Indexed: 02/03/2023]
Abstract
OBJECTIVE There are variable reports of risk of concordance for progression to islet autoantibodies and type 1 diabetes in identical twins after one twin is diagnosed. We examined development of positive autoantibodies and type 1 diabetes and the effects of genetic factors and common environment on autoantibody positivity in identical twins, nonidentical twins, and full siblings. RESEARCH DESIGN AND METHODS Subjects from the TrialNet Pathway to Prevention Study (N = 48,026) were screened from 2004 to 2015 for islet autoantibodies (GAD antibody [GADA], insulinoma-associated antigen 2 [IA-2A], and autoantibodies against insulin [IAA]). Of these subjects, 17,226 (157 identical twins, 283 nonidentical twins, and 16,786 full siblings) were followed for autoantibody positivity or type 1 diabetes for a median of 2.1 years. RESULTS At screening, identical twins were more likely to have positive GADA, IA-2A, and IAA than nonidentical twins or full siblings (all P < 0.0001). Younger age, male sex, and genetic factors were significant factors for expression of IA-2A, IAA, one or more positive autoantibodies, and two or more positive autoantibodies (all P ≤ 0.03). Initially autoantibody-positive identical twins had a 69% risk of diabetes by 3 years compared with 1.5% for initially autoantibody-negative identical twins. In nonidentical twins, type 1 diabetes risk by 3 years was 72% for initially multiple autoantibody-positive, 13% for single autoantibody-positive, and 0% for initially autoantibody-negative nonidentical twins. Full siblings had a 3-year type 1 diabetes risk of 47% for multiple autoantibody-positive, 12% for single autoantibody-positive, and 0.5% for initially autoantibody-negative subjects. CONCLUSIONS Risk of type 1 diabetes at 3 years is high for initially multiple and single autoantibody-positive identical twins and multiple autoantibody-positive nonidentical twins. Genetic predisposition, age, and male sex are significant risk factors for development of positive autoantibodies in twins.
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Affiliation(s)
- Taylor M. Triolo
- Barbara Davis Center for Diabetes, University of Colorado School of Medicine, Aurora, CO
| | - Alexandra Fouts
- Barbara Davis Center for Diabetes, University of Colorado School of Medicine, Aurora, CO
| | - Laura Pyle
- Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, CO
| | - Liping Yu
- Barbara Davis Center for Diabetes, University of Colorado School of Medicine, Aurora, CO
| | - Peter A. Gottlieb
- Barbara Davis Center for Diabetes, University of Colorado School of Medicine, Aurora, CO
| | - Andrea K. Steck
- Barbara Davis Center for Diabetes, University of Colorado School of Medicine, Aurora, CO
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Bradley C, Scott RA, Cox E, Palaniyappan N, Thomson BJ, Ryder SD, Irving WL, Aithal GP, Guha IN, Francis S. Short-term changes observed in multiparametric liver MRI following therapy with direct-acting antivirals in chronic hepatitis C virus patients. Eur Radiol 2018; 29:3100-3107. [PMID: 30506214 PMCID: PMC6510871 DOI: 10.1007/s00330-018-5788-1] [Citation(s) in RCA: 11] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2018] [Revised: 09/04/2018] [Accepted: 09/21/2018] [Indexed: 12/11/2022]
Abstract
Methods We applied multiparametric MRI to assess changes in liver composition, perfusion and blood flow in 17 patients before direct-acting antiviral (DAA) therapy and after treatment completion (within 12 weeks of last DAA tablet swallowed). Results We observed changes in hepatic composition indicated by a reduction in both liver longitudinal relaxation time (T1, 35 ± 4 ms), transverse relaxation time (T2, 2.5 ± 0.8 ms; T2* 3.0 ± 0.7 ms), and liver perfusion (28.1 ± 19.7 ml/100 g/min) which we suggest are linked to reduced pro-inflammatory milieu, including interstitial oedema, within the liver. No changes were observed in liver or spleen blood flow, splenic perfusion, or superior mesenteric artery blood flow. Conclusion For the first time, our study has shown that treatment of HCV with DAAs in patients with cirrhosis leads to an acute reduction in liver T1, T2 and T2* and an increase in liver perfusion measured using MR parameters. The ability of MRI to characterise changes in the angio-architecture of patients with cirrhosis after intervention in the short term will enhance our understanding of the natural history of regression of liver disease and potentially influence clinical decision algorithms. Key Points • DAAs have revolutionised the treatment of hepatitis C and achieve sustained virological response in over 95% of patients, even with liver cirrhosis. • Currently available non-invasive measures of liver fibrosis are not accurate after HCV treatment with DAAs, this prospective single-centre study has shown that MRI can sensitively measure changes within the liver, which could reflect the reduction in inflammation with viral clearance. • The ability of MRI to characterise changes in structural and haemodynamic MRI measures in the liver after intervention will enhance our understanding of the progression/regression of liver disease and could potentially influence clinical decision algorithms.
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Affiliation(s)
- C Bradley
- Sir Peter Mansfield Imaging Centre, School of Physics and Astronomy, University of Nottingham, Nottingham, UK.,NIHR Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust and the University of Nottingham, Nottingham, UK
| | - R A Scott
- NIHR Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust and the University of Nottingham, Nottingham, UK
| | - E Cox
- Sir Peter Mansfield Imaging Centre, School of Physics and Astronomy, University of Nottingham, Nottingham, UK.,NIHR Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust and the University of Nottingham, Nottingham, UK
| | - N Palaniyappan
- NIHR Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust and the University of Nottingham, Nottingham, UK
| | - B J Thomson
- NIHR Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust and the University of Nottingham, Nottingham, UK
| | - S D Ryder
- NIHR Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust and the University of Nottingham, Nottingham, UK
| | - W L Irving
- NIHR Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust and the University of Nottingham, Nottingham, UK
| | - G P Aithal
- NIHR Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust and the University of Nottingham, Nottingham, UK.,Nottingham Digestive Diseases Centre, School of Medicine, the University Of Nottingham, Nottingham, UK
| | - I N Guha
- NIHR Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust and the University of Nottingham, Nottingham, UK.,Nottingham Digestive Diseases Centre, School of Medicine, the University Of Nottingham, Nottingham, UK
| | - S Francis
- Sir Peter Mansfield Imaging Centre, School of Physics and Astronomy, University of Nottingham, Nottingham, UK. .,NIHR Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust and the University of Nottingham, Nottingham, UK.
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Littlejohn E, Marder W, Lewis E, Francis S, Jackish J, McCune WJ, Somers EC. The ratio of erythrocyte sedimentation rate to C-reactive protein is useful in distinguishing infection from flare in systemic lupus erythematosus patients presenting with fever. Lupus 2018; 27:1123-1129. [PMID: 29546774 DOI: 10.1177/0961203318763732] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background Both C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) can be elevated in systemic lupus erythematosus (SLE) flare and infection, and are therefore of limited utility for distinguishing between the two conditions in febrile SLE patients. Methods A medical records review of hospitalizations (1997-2006) of SLE patients in the Michigan Lupus Cohort was performed. Eligible hospitalizations were those in which patients presented with a temperature of >100.3°F or with subjective fevers as a presenting complaint at admission. Detailed demographic, clinical, and laboratory data were collected. Multivariable logistic regression was used to examine the associations between ESR and CRP and the outcome of flare vs infection, adjusted for confounders. Results Among 557 SLE patients screened, there were 53 eligible hospitalizations (28 flares and 25 infections). Each unit increase in the ratio of ESR:CRP was associated with a 17% increase in the odds of fever being attributable to SLE flare compared to infection (OR 1.17, 95% CI 1.04, 1.31; p = 0.009), when adjusted for white blood cell count, SLE duration, sex, race, and age. ESR and CRP were not individually associated with flare vs infection when modeled with their ratio. Conclusions The ratio of ESR:CRP may provide diagnostic value beyond individual ESR and CRP levels in distinguishing flare vs infection in SLE patients presenting with fever.
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Affiliation(s)
- E Littlejohn
- 1 Division of Rheumatology, Department of Internal Medicine, 1259 University of Michigan , Ann Arbor, MI, USA
| | - W Marder
- 1 Division of Rheumatology, Department of Internal Medicine, 1259 University of Michigan , Ann Arbor, MI, USA.,2 Department of Obstetrics & Gynecology, 1259 University of Michigan , Ann Arbor, MI, USA
| | - E Lewis
- 1 Division of Rheumatology, Department of Internal Medicine, 1259 University of Michigan , Ann Arbor, MI, USA
| | - S Francis
- 1 Division of Rheumatology, Department of Internal Medicine, 1259 University of Michigan , Ann Arbor, MI, USA.,3 Orthopedics & Sports Medicine P.C., New Windsor, NY, USA
| | - J Jackish
- 1 Division of Rheumatology, Department of Internal Medicine, 1259 University of Michigan , Ann Arbor, MI, USA.,4 25214 Park Nicollet/Health Partners Methodist Hospital , St. Louis Park, MN, USA
| | - W J McCune
- 1 Division of Rheumatology, Department of Internal Medicine, 1259 University of Michigan , Ann Arbor, MI, USA
| | - E C Somers
- 1 Division of Rheumatology, Department of Internal Medicine, 1259 University of Michigan , Ann Arbor, MI, USA.,2 Department of Obstetrics & Gynecology, 1259 University of Michigan , Ann Arbor, MI, USA.,5 Department of Environmental Health Sciences, 1259 University of Michigan , Ann Arbor, MI, USA
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Miiro G, DeCelles J, Rutakumwa R, Nakiyingi-Miiro J, Muzira P, Ssembajjwe W, Musoke S, Gibson LJ, Hershow RB, Francis S, Torondel B, Ross DA, Weiss HA. Soccer-based promotion of voluntary medical male circumcision: A mixed-methods feasibility study with secondary students in Uganda. PLoS One 2017; 12:e0185929. [PMID: 29016651 PMCID: PMC5633183 DOI: 10.1371/journal.pone.0185929] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2017] [Accepted: 09/21/2017] [Indexed: 11/18/2022] Open
Abstract
The Ugandan government is committed to scaling-up proven HIV prevention strategies including safe male circumcision, and innovative strategies are needed to increase circumcision uptake. The aim of this study was to assess the acceptability and feasibility of implementing a soccer-based intervention (“Make The Cut”) among schoolboys in a peri-urban district of Uganda. The intervention was led by trained, recently circumcised “coaches” who facilitated a 60-minute session delivered in schools, including an interactive penalty shoot-out game using metaphors for HIV prevention, sharing of the coaches’ circumcision story, group discussion and ongoing engagement from the coach to facilitate linkage to male circumcision. The study took place in four secondary schools in Entebbe sub-district, Uganda. Acceptability of safe male circumcision was assessed through a cross-sectional quantitative survey. The feasibility of implementing the intervention was assessed by piloting the intervention in one school, modifying it, and implementing the modified version in a second school. Perceptions of the intervention were assessed with in-depth interviews with participants. Of the 210 boys in the cross-sectional survey, 59% reported being circumcised. Findings showed high levels of knowledge and generally favourable perceptions of circumcision. The initial implementation of Make The Cut resulted in 6/58 uncircumcised boys (10.3%) becoming circumcised. Changes made included increasing engagement with parents and improved liaison with schools regarding the timing of the intervention. Following this, uptake improved to 18/69 (26.1%) in the second school. In-depth interviews highlighted the important role of family and peer support and the coach in facilitating the decision to circumcise. This study showed that the modified Make The Cut intervention may be effective to increase uptake of safe male circumcision in this population. However, the intervention is time-intensive, and further work is needed to assess the cost-effectiveness of the intervention conducted at scale.
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Affiliation(s)
- George Miiro
- Uganda Virus Research Institute, Entebbe, Uganda
| | - Jeff DeCelles
- Grassroot Soccer, Cape Town, South Africa
- University of North Carolina Gillings School of Global Public Health, Chapel Hill, North Carolina, United States of America
| | - Rwamahe Rutakumwa
- Medical Research Council/Uganda Virus Research Institute Uganda Research Unit on AIDS, Entebbe, Uganda
| | - Jessica Nakiyingi-Miiro
- Medical Research Council/Uganda Virus Research Institute Uganda Research Unit on AIDS, Entebbe, Uganda
| | | | | | | | - Lorna J. Gibson
- Medical Research Council Tropical Epidemiology Group, Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Rebecca B. Hershow
- University of North Carolina Gillings School of Global Public Health, Chapel Hill, North Carolina, United States of America
| | - Suzanna Francis
- Medical Research Council Tropical Epidemiology Group, Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Belen Torondel
- Department of Disease Control, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - David A. Ross
- Department of Maternal, Newborn, Child and Adolescent Health, World Health Organisation, Geneva, Swizterland
| | - Helen A. Weiss
- Medical Research Council Tropical Epidemiology Group, Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom
- * E-mail:
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Francis S, Limkakeng A, Zheng H, Parry B, Chang A, Singer A, Zeserson E, Giordano N, Gentile N, Kabrhel C. 54 Physician Gestalt is the Most Predictive Component of the Wells' Deep Venous Thrombosis Score in Diagnosing Subsequent Deep Venous Thrombosis. Ann Emerg Med 2017. [DOI: 10.1016/j.annemergmed.2017.07.079] [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: 11/17/2022]
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Francis S, Limkakeng A, Zheng H, Parry B, Chang A, Prochaska J, Kümpers P, Fermann G, Cohen J, Kabrhel C. 53 Analyzing the Components of the Wells' Score for Pulmonary Embolus Can Strengthen Unstructured Physician Gestalt. Ann Emerg Med 2017. [DOI: 10.1016/j.annemergmed.2017.07.078] [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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Francis S, Limkakeng A, Zheng H, Parry B, Fermann G, Hollander J, Lovecchio F, Werner N, Schellong S, Kabrhel C. 12 Highly Elevated Quantitative D-Dimer Assay Values Increase the Likelihood of Venous Thromboembolism. Ann Emerg Med 2017. [DOI: 10.1016/j.annemergmed.2017.07.036] [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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Ives AK, Antaki E, Stewart K, Francis S, Jay-Russell MT, Sithole F, Kearney MT, Griffin MJ, Soto E. Detection of Salmonella enterica Serovar Montevideo and Newport in Free-ranging Sea Turtles and Beach Sand in the Caribbean and Persistence in Sand and Seawater Microcosms. Zoonoses Public Health 2016; 64:450-459. [PMID: 28009107 DOI: 10.1111/zph.12324] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [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] [Received: 07/14/2016] [Indexed: 12/01/2022]
Abstract
Salmonellae are Gram-negative zoonotic bacteria that are frequently part of the normal reptilian gastrointestinal flora. The main objective of this project was to estimate the prevalence of non-typhoidal Salmonella enterica in the nesting and foraging populations of sea turtles on St. Kitts and in sand from known nesting beaches. Results suggest a higher prevalence of Salmonella in nesting leatherback sea turtles compared with foraging green and hawksbill sea turtles. Salmonella was cultured from 2/9 and identified by molecular diagnostic methods in 3/9 leatherback sea turtle samples. Salmonella DNA was detected in one hawksbill turtle, but viable isolates were not recovered from any hawksbill sea turtles. No Salmonella was detected in green sea turtles. In samples collected from nesting beaches, Salmonella was only recovered from a single dry sand sample. All recovered isolates were positive for the wzx gene, consistent with the O:7 serogroup. Further serotyping characterized serovars Montevideo and Newport present in cloacal and sand samples. Repetitive-element palindromic PCR (rep-PCR) fingerprint analysis and pulsed-field gel electrophoresis of the 2014 isolates from turtles and sand as well as archived Salmonella isolates recovered from leatherback sea turtles in 2012 and 2013, identified two distinct genotypes and four different pulsotypes, respectively. The genotyping and serotyping were directly correlated. To determine the persistence of representative strains of each serotype/genotype in these environments, laboratory-controlled microcosm studies were performed in water and sand (dry and wet) incubated at 25 or 35°C. Isolates persisted for at least 32 days in most microcosms, although there were significant decreases in culturable bacteria in several microcosms, with the greatest reduction in dry sand incubated at 35°C. This information provides a better understanding of the epizootiology of Salmonella in free-ranging marine reptiles and the potential public health risks associated with human interactions with these animals in the Caribbean.
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Affiliation(s)
- A-K Ives
- Department of Biomedical Sciences, Ross University School of Veterinary Medicine, Basseterre, St. Kitts
| | - E Antaki
- Western Center for Food Safety, University of California, Davis, CA, USA
| | - K Stewart
- Department of Biomedical Sciences, Ross University School of Veterinary Medicine, Basseterre, St. Kitts
- St. Kitts Sea Turtle Monitoring Network, Basseterre, St Kitts
| | - S Francis
- Department of Biomedical Sciences, Ross University School of Veterinary Medicine, Basseterre, St. Kitts
| | - M T Jay-Russell
- Western Center for Food Safety, University of California, Davis, CA, USA
| | - F Sithole
- Department of Biomedical Sciences, Ross University School of Veterinary Medicine, Basseterre, St. Kitts
| | - M T Kearney
- Department of Pathobiological Sciences, School of Veterinary Medicine, Louisiana State University, Baton Rouge, LA, USA
| | - M J Griffin
- Department of Pathobiology and Population Medicine, College of Veterinary Medicine, Mississippi State University, Stoneville, MS, USA
| | - E Soto
- Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California-Davis, Davis, CA, USA
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Soto E, Zayas M, Tobar J, Illanes O, Yount S, Francis S, Dennis M. Laboratory-controlled Challenges of Nile Tilapia (Oreochromis niloticus) with Streptococcus agalactiae: Comparisons between Immersion, Oral, Intracoelomic and Intramuscular Routes of Infection. J Comp Pathol 2016; 155:339-345. [DOI: 10.1016/j.jcpa.2016.09.003] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2016] [Revised: 09/07/2016] [Accepted: 09/29/2016] [Indexed: 10/20/2022]
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Klinger-Bowen R, Tamaru C, McGovern-Hopkins K, Li Y, Sithole F, Kearney MT, Francis S, Soto E. Dynamics of piscine francisellosis differs amongst tilapia species (Oreochromis spp.) in a controlled challenge with Francisella noatunensis subsp. orientalis. J Fish Dis 2016; 39:1305-1312. [PMID: 26916547 DOI: 10.1111/jfd.12461] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/21/2015] [Revised: 12/21/2015] [Accepted: 12/22/2015] [Indexed: 06/05/2023]
Abstract
A 25-week immersion challenge was conducted exposing Oreochromis mossambicus, Oreochromis aureus and Oreochromis urolepis hornorum to Francisella noatunensis subsp. orientalis (Fno). Two populations were compared for each fish species; 'resident fish' were defined as fish maintained in tanks since week 0 of challenge, whereas 'naïve fish' were defined as fish added to tanks once temperature in water reached <26 °C at 21 weeks post-challenge. Fno genome equivalents (GEs) in water were similar in all treatments 1 h post-challenge; however, significantly lower Fno GEs were detected 2 weeks post-challenge in all tanks, and the only treatment with detectable Fno GE after 4 weeks of challenge were the O. mossambicus tanks. Twenty-one weeks post-challenge, naïve fish were stocked with 'resident' cohorts. Over a 4-week period, mortalities occurred consistently only in O. mossambicus naïve cohorts. Overall presence of granulomas in spleen of survivors was similar (>55%) in all resident populations; however, in naïve populations, only O. mossambicus presented granulomas. Similarly, only O. mossambicus presented viable Fno in the spleen of survivors, and Fno GEs were only detected in O. mossambicus, and in resident O. aureus. In conclusion, the results of this study suggest different susceptibility of tilapia species to piscine francisellosis.
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Affiliation(s)
- R Klinger-Bowen
- Department of Molecular Biosciences and Bioengineering, College of Tropical Agriculture and Human Resources, University of Hawaii Manoa, Honolulu, HI, USA
- Office of Research Compliance, Animal Veterinary Services, University of Hawaii Manoa, Honolulu, HI, USA
| | - C Tamaru
- Department of Molecular Biosciences and Bioengineering, College of Tropical Agriculture and Human Resources, University of Hawaii Manoa, Honolulu, HI, USA
| | - K McGovern-Hopkins
- Department of Molecular Biosciences and Bioengineering, College of Tropical Agriculture and Human Resources, University of Hawaii Manoa, Honolulu, HI, USA
| | - Y Li
- Department of Human Nutrition, Food and Animal Science, College of Tropical Agriculture and Human Resources, University of Hawaii Manoa, Honolulu, HI, USA
| | - F Sithole
- Department of Biomedical Sciences, Ross University-School of Veterinary Medicine, Basseterre, Saint Kitts and Nevis
| | - M T Kearney
- Department of Pathobiology, Louisiana State University-School of Veterinary Medicine, Baton Rouge, LA, USA
| | - S Francis
- Department of Biomedical Sciences, Ross University-School of Veterinary Medicine, Basseterre, Saint Kitts and Nevis
| | - E Soto
- Department of Biomedical Sciences, Ross University-School of Veterinary Medicine, Basseterre, Saint Kitts and Nevis.
- Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California, Davis, CA, USA.
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van de Wijgert JHHM, Borgdorff H, Verhelst R, Crucitti T, Francis S, Verstraelen H, Jespers V. The vaginal microbiota: what have we learned after a decade of molecular characterization? PLoS One 2016. [PMID: 25148517 DOI: 10.1371/joumal.pone.0105998] [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] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2023] Open
Abstract
We conducted a systematic review of the Medline database (U.S. National Library of Medicine, National Institutes of Health, Bethesda, MD, U.S.A) to determine if consistent molecular vaginal microbiota (VMB) composition patterns can be discerned after a decade of molecular testing, and to evaluate demographic, behavioral and clinical determinants of VMB compositions. Studies were eligible when published between 1 January 2008 and 15 November 2013, and if at least one molecular technique (sequencing, PCR, DNA fingerprinting, or DNA hybridization) was used to characterize the VMB. Sixty three eligible studies were identified. These studies have now conclusively shown that lactobacilli-dominated VMB are associated with a healthy vaginal micro-environment and that bacterial vaginosis (BV) is best described as a polybacterial dysbiosis. The extent of dysbiosis correlates well with Nugent score and vaginal pH but not with the other Amsel criteria. Lactobacillus crispatus is more beneficial than L. iners. Longitudinal studies have shown that a L. crispatus-dominated VMB is more likely to shift to a L. iners-dominated or mixed lactobacilli VMB than to full dysbiosis. Data on VMB determinants are scarce and inconsistent, but dysbiosis is consistently associated with HIV, human papillomavirus (HPV), and Trichomonas vaginalis infection. In contrast, vaginal colonization with Candida spp. is more common in women with a lactobacilli-dominated VMB than in women with dysbiosis. Cervicovaginal mucosal immune responses to molecular VMB compositions have not yet been properly characterized. Molecular techniques have now become more affordable, and we make a case for incorporating them into larger epidemiological studies to address knowledge gaps in etiology and pathogenesis of dysbiosis, associations of different dysbiotic states with clinical outcomes, and to evaluate interventions aimed at restoring and maintaining a lactobacilli-dominated VMB.
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Affiliation(s)
| | - Hanneke Borgdorff
- Academic Medical Center and Amsterdam Institute of Global Health and Development, Amsterdam, The Netherlands
| | - Rita Verhelst
- International Centre for Reproductive Health, Ghent University Hospital, Ghent, Belgium
| | - Tania Crucitti
- Prince Leopold Institute of Tropical Medicine, Antwerp, Belgium
| | - Suzanna Francis
- London School for Hygiene and Tropical Medicine, London, United Kingdom
| | - Hans Verstraelen
- Department of Obstetrics and Gynecology, Ghent University Hospital, Ghent, Belgium
| | - Vicky Jespers
- Prince Leopold Institute of Tropical Medicine, Antwerp, Belgium
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Bielby L, Akers C, Francis S, Darby S, Campbell L, Hollis L, Quested B, Hogan C. The role of the transfusion safety coordinator in Australia. ACTA ACUST UNITED AC 2016. [DOI: 10.1111/voxs.12201] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- L. Bielby
- Blood Matters Program; Department of Health & Human Services; Australian Red Cross Blood Service; Melbourne Vic. Australia
| | - C. Akers
- Blood Matters Program; Department of Health & Human Services; Australian Red Cross Blood Service; Melbourne Vic. Australia
| | - S. Francis
- Clinical Excellence Commission; Sydney NSW Australia
| | - S. Darby
- Sir Charles Gairdner Hospital; Nedlands WA Australia
| | - L. Campbell
- Sir Charles Gairdner Hospital; Nedlands WA Australia
| | - L. Hollis
- Sunshine Coast Hospital & Health Service; Nambour Qld Australia
| | - B. Quested
- BloodSafe; South Australian Department of Health; Adelaide SA Australia
- Australian Red Cross Blood Service; Adelaide SA Australia
| | - C. Hogan
- Australian Red Cross Blood Service; Melbourne Vic. Australia
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Pickworth J, Shay S, Gladson S, Iremonger J, Rothman AMK, Francis S, West J, Lawrie A. S3 Reduced BMPR2 expression potentiates a pulmonary artery smooth muscle cell specific IL-1ß response. Thorax 2015. [DOI: 10.1136/thoraxjnl-2015-207770.9] [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: 11/03/2022]
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Bowers J, Richardson M, Spencer K, Contreras J, Francis S, Bennion N, Lomas H, Larner J, Kersh R. Stereotactic Body Radiation Therapy (SBRT) For Centrally Located Primary and Recurrent Non-Small Cell Lung Cancer: Analysis of Toxicity and Local Control. Int J Radiat Oncol Biol Phys 2015. [DOI: 10.1016/j.ijrobp.2015.07.1614] [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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Belcaro G, Dugall M, Luzzi R, Ledda A, Pellegrini L, Hosoi M, Errichi BM, Francis S, Cornelli U. Supplementary management of benign prostatic hypertrophy with Prostaquil. An 8-week registry. MINERVA GASTROENTERO 2015:R08Y9999N00A150023. [PMID: 26492588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
The aim of this registry was to evaluate the management of initial symptoms of benign prostatic hyperthrophy (BPH) in otherwise healthy subjects, using Prostaquil® (Alchem) in a 8-week registry. Prostaquil was used at the dosage of 200 mg/day. The product includes Pygeum extract (100 mg) and Saw palmetto oil (35 mg). The two resulting groups standard management and supplement) were comparable. RESULTS No side effects or comparability problems were observed and compliance was optimal with more than 95% of the capsules correctly used. Empting, frequency, intermittency, urgency, weak flow, straining, nocturia were all significantly improved with Prostaquil (p<0.05) and the improvement - globally and evaluating any single item - was significantly superior to the one observed in controls (p<0.05). Quality of life with the supplement was also significantly better in comparison with controls (p<0.05). The residual vescical volume was 94.7;5,8 ml in the supplement group at inclusion and decreased to 39.3;5 ml (p<0.05) at 8 weeks. This decrease was equivalent to a reduction of 58.5%(vs a decrease of 27.9% in controls)(p<0.05; ANOVA). In conclusion, the most common symptoms of BPH are controlled by Prostaquil a new standardized supplement including Pygeum.
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Affiliation(s)
- G Belcaro
- Department of Biomedical Sciences, Irvine3 Labs, Circulation Sciences, Chieti-Pescara University, Italy -
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Angyal A, Ilyas Z, Hadadi E, Johnston J, Ariaans M, Kraus R, Wilson H, Bauer R, Rader D, Francis S, Kiss-Toth E. Does myeloid expression of TRIB1 regulate plasma lipid levels? Atherosclerosis 2015. [DOI: 10.1016/j.atherosclerosis.2015.04.125] [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: 11/30/2022]
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Dawson S, Pickworth J, Rothman A, Iremonger J, Arnold N, Francis S, Lawrie A. T5 Opg Regulates Pulmonary Arterial Smooth Muscle Cell Proliferation And The Expression Of Pah-associated Genes Via Fas. Thorax 2014. [DOI: 10.1136/thoraxjnl-2014-206260.5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Belcaro G, Dugall M, Luzzi R, Ledda A, Pellegrini L, Cesarone MR, Hosoi M, Errichi M, Francis S, Cornelli U. FlexiQule (Boswellia extract) in the supplementary management of osteoarthritis: a supplement registry. Minerva Med 2014; 105:9-16. [PMID: 26076376] [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: 06/04/2023]
Abstract
UNLABELLED The aim of the present pilot, registry study was an assessment in a supplement study of FlexiQule (standardized Boswellia extract) capsules in the supplementary management of patients with symptomatic knee osteoarthritis (OA) also treated with the "standard management" (SM) in comparison with a group of patients only managed with SM. METHODS This 4-week study included patients with symptomatic knee arthrosis (X-ray). Registry subjects were able to perform a treadmill walking test and to understand questions from the WOMAC questionnaire. Exclusion criteria were conditions requiring drug treatment, Body Mass Index >25, metabolic disorders, surgery within three months prior to inclusion, oncological condition or inability to walk. RESULTS Twenty-seven registry subjects using the supplement+SM and 28 using only SM completed the registry; at inclusion, the two groups were comparable including Karnofsky scale, WOMAC Score and the Treadmill Test. Of the subjects completing the registry 24 preferred to use the combination SM and the supplement. Safety evaluation: no problems - indicating the suspension of the supplementation ‑ were observed. Routine blood tests were normal at inclusion and did not significantly vary at 4 weeks. The Karnofski Scale at 4 weeks was improved in both groups: from 74.3;3.1 to 88.9;5.3 (P<0.05) in the Boswellia group in comparison with a variation from 75.3;5.2 to 79.4;3.3 (P<0.05) in the SM. The effects of the supplement were significantly higher (P<0.05). The WOMAC Score was decreased significantly more in the supplement+SM group in comparison with controls considering pain, stiffness and physical functions (P<0.05). Social/emotional functions improved better with the supplement (P<0.05). Both groups improved their walking distance at 4 weeks. The improvement was higher (P<0.05) in the Boswellia group. The need for other drugs or tests during the registry period was reduced more in the supplement group (P<0.05). CONCLUSION The difference between SM and the supplementation associated to SM was significant) in favor of the supplementation with Boswellia for all target measurements evaluated in the registry at 4 weeks.
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Affiliation(s)
- G Belcaro
- Department of Biomedical Sciences Irvine3 Labs, Circulation Sciences and the International Irvine Network, Chieti‑Pescara University, Italy
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Mathur A, Awin N, Adisasmita A, Jayaratne K, Francis S, Sharma S, Myint T. Maternal death review in selected countries of South East Asia Region. BJOG 2014; 121 Suppl 4:67-70. [PMID: 25236636 DOI: 10.1111/1471-0528.13001] [Citation(s) in RCA: 11] [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] [Subscribe] [Scholar Register] [Accepted: 05/29/2014] [Indexed: 11/27/2022]
Abstract
Understanding the underlying factors that led to maternal deaths through a maternal death review (MDR) throws light on the causes, characteristics and circumstances of the death. We reviewed and report on the implementation of MDR in India, Indonesia, Myanmar, Nepal and Sri Lanka, capturing the experiences of MDR initiatives, follow-up actions and lessons learnet. Overall, while the findings from MDRs have been used to design or change policies and strategies for improvement of services provided, there are still challenges in scaling up these initiatives, particularly in the larger countries.
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Affiliation(s)
- A Mathur
- Department of Family Health and Research, WHO South East Asia Regional Office (SEARO), New Delhi, India
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Joseph S, Abbai N, Delaney-Moretlwe S, Gafos M, Kapiga S, Chisembele M, Abaasa A, Jensch U, Francis S, McCormack S, Hayes R, Crook A. Bacterial Vaginosis and HIV: An Analysis of the MDP301 Trial. AIDS Res Hum Retroviruses 2014. [DOI: 10.1089/aid.2014.5510.abstract] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Sarah Joseph
- MRC Clinical Trials Unit at UCl, HIV Prevention, London, United Kingdom
| | - Nathlee Abbai
- Medical Research Council, HIV Prevention Research Unit, Durban, South Africa
| | | | - Mitzy Gafos
- MRC Clinical Trials Unit at UCl, HIV Prevention, London, United Kingdom
| | - Saidi Kapiga
- Mwanza Interventions Trials Unit, Mwanza, Tanzania, United Republic of
| | - Maureen Chisembele
- University Teaching Hospital, Obstetrics and Gynaecology, Lusaka, Zambia
| | - Andrew Abaasa
- MRC/UVRI, Uganda Research Unit on AIDS, Entebbe, Uganda
| | - Ute Jensch
- Clinical Laboratory Services, University of Witwatersrand, School of Pathology, Johannesburg, South Africa
| | - Suzanna Francis
- London School of Hygiene & Tropical Medicine, MRC Tropical Epidemiology Group, London, United Kingdom
| | - Sheena McCormack
- MRC Clinical Trials Unit at UCl, HIV Prevention, London, United Kingdom
| | - Richard Hayes
- London School of Hygiene & Tropical Medicine, MRC Tropical Epidemiology Group, London, United Kingdom
| | - Angela Crook
- MRC Clinical Trials Unit at UCl, HIV Prevention, London, United Kingdom
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Gafos M, Crook A, Pool R, Mzimela MA, Morar N, Vallely A, Abaasa A, Palanee T, Mweemba O, Ramjee G, Francis S, Kamali A, Rees H, Chisembele M, Mccormack S. Exploring Post-coital Intravaginal Cleansing Practices among Women Enrolled in the Microbicides Development Programme MDP 301 Clinical Trial. AIDS Res Hum Retroviruses 2014. [DOI: 10.1089/aid.2014.5008.abstract] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Mitzy Gafos
- MRC Clinical Trials Unit at UCL, London, United Kingdom
| | - Angela Crook
- MRC Clinical Trials Unit at UCL, London, United Kingdom
| | | | | | - Neetha Morar
- HIV Prevention Research Unit, Medical Research Council, Durban, South Africa
| | - Andrew Vallely
- Mwanza Intervention Trials Unit, National Institute for Medical Research, Mwanza, Tanzania, United Republic of
| | - Andrew Abaasa
- MRC/UVRI Uganda Research Unit on AIDS, Kampala, Uganda
| | - Thesla Palanee
- Wits Reproductive Health and HIV Institute (WRHI), Johannesburg, South Africa
| | | | - Gita Ramjee
- HIV Prevention Research Unit, Medical Research Council, Durban, South Africa
| | - Suzanna Francis
- Mwanza Intervention Trials Unit, National Institute for Medical Research, Mwanza, Tanzania, United Republic of
| | | | - Helen Rees
- Wits Reproductive Health and HIV Institute (WRHI), Johannesburg, South Africa
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Wirth L, Tahara M, Robinson B, Francis S, Brose M, Habra M, Newbold K, Kiyota N, Dutcus C, Heras B, Zhu J, Sherman S, Schlumberger M. Treatment-Emergent Hypertension and Efficacy in the Phase 3 Study of (E7080) Lenvatinib in Differentiated Cancer of the Thyroid (Select). Ann Oncol 2014. [DOI: 10.1093/annonc/mdu340.45] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Goncalves N, Ban H, Sanchez-Panchuelo R, Francis S, Schluppeck D, Welchman A. Cortical organization of binocular disparity in human V3A. J Vis 2014. [DOI: 10.1167/14.10.970] [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] Open
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van de Wijgert JHHM, Borgdorff H, Verhelst R, Crucitti T, Francis S, Verstraelen H, Jespers V. The vaginal microbiota: what have we learned after a decade of molecular characterization? PLoS One 2014; 9:e105998. [PMID: 25148517 PMCID: PMC4141851 DOI: 10.1371/journal.pone.0105998] [Citation(s) in RCA: 294] [Impact Index Per Article: 29.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2014] [Accepted: 07/25/2014] [Indexed: 11/19/2022] Open
Abstract
We conducted a systematic review of the Medline database (U.S. National Library of Medicine, National Institutes of Health, Bethesda, MD, U.S.A) to determine if consistent molecular vaginal microbiota (VMB) composition patterns can be discerned after a decade of molecular testing, and to evaluate demographic, behavioral and clinical determinants of VMB compositions. Studies were eligible when published between 1 January 2008 and 15 November 2013, and if at least one molecular technique (sequencing, PCR, DNA fingerprinting, or DNA hybridization) was used to characterize the VMB. Sixty three eligible studies were identified. These studies have now conclusively shown that lactobacilli-dominated VMB are associated with a healthy vaginal micro-environment and that bacterial vaginosis (BV) is best described as a polybacterial dysbiosis. The extent of dysbiosis correlates well with Nugent score and vaginal pH but not with the other Amsel criteria. Lactobacillus crispatus is more beneficial than L. iners. Longitudinal studies have shown that a L. crispatus-dominated VMB is more likely to shift to a L. iners-dominated or mixed lactobacilli VMB than to full dysbiosis. Data on VMB determinants are scarce and inconsistent, but dysbiosis is consistently associated with HIV, human papillomavirus (HPV), and Trichomonas vaginalis infection. In contrast, vaginal colonization with Candida spp. is more common in women with a lactobacilli-dominated VMB than in women with dysbiosis. Cervicovaginal mucosal immune responses to molecular VMB compositions have not yet been properly characterized. Molecular techniques have now become more affordable, and we make a case for incorporating them into larger epidemiological studies to address knowledge gaps in etiology and pathogenesis of dysbiosis, associations of different dysbiotic states with clinical outcomes, and to evaluate interventions aimed at restoring and maintaining a lactobacilli-dominated VMB.
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Affiliation(s)
| | - Hanneke Borgdorff
- Academic Medical Center and Amsterdam Institute of Global Health and Development, Amsterdam, The Netherlands
| | - Rita Verhelst
- International Centre for Reproductive Health, Ghent University Hospital, Ghent, Belgium
| | - Tania Crucitti
- Prince Leopold Institute of Tropical Medicine, Antwerp, Belgium
| | - Suzanna Francis
- London School for Hygiene and Tropical Medicine, London, United Kingdom
| | - Hans Verstraelen
- Department of Obstetrics and Gynecology, Ghent University Hospital, Ghent, Belgium
| | - Vicky Jespers
- Prince Leopold Institute of Tropical Medicine, Antwerp, Belgium
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Nagaraja V, Fox D, Francis S, Khanna P, Laing T, Marks R, Monrad S, Ognenovski V, Phillips K, Singer O, Khanna D. SAT0102 Interpretation of Patient Reported Outcomes Measurement Information System (PROMIS®) by Rheumatologists. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.2626] [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: 11/04/2022]
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Jolly M, Francis S, Aggarwal R, Mikolaitis RA, Niewold TB, Chubinskaya S, Block JA, Scanzello C, Sequeira W. Serum free light chains, interferon-alpha, and interleukins in systemic lupus erythematosus. Lupus 2014; 23:881-8. [PMID: 24786785 DOI: 10.1177/0961203314530793] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [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: 09/26/2013] [Accepted: 03/14/2014] [Indexed: 12/20/2022]
Abstract
OBJECTIVE Interleukin-6 (IL-6), interleukin-10 (IL-10), interferon-alpha (IFN-α), and free light chains (FLCs: lambda, kappa) have all been noted to be of importance in systemic lupus erythematosus (SLE). Herein, we quantified and explored the relationship between these inflammatory mediators and disease activity in SLE; and stratified by their current anti-dsDNA antibody status. METHODS Seventy-seven SLE patients underwent assessment of disease activity using the SLE disease activity index (SLEDAI). Serum FLC (lambda, kappa, and total), IL-6, IL-10, and IFN-α were quantified. Demographics of disease characteristics were determined by chart reviews. Statistical analyses included Mann-Whitney test, chi square, and linear regression analyses. RESULTS Mean (SD) age of the patients was 44.9 ± 12.7 years; SLEDAI (mean ± SD) was 3.4 ± 4.0. Serum lambda FLC levels had a moderate correlation (r = 0.46 with physician global assessment, 0.44 with SLEDAI) and the strongest correlation with disease activity as compared with other inflammatory mediators including current dsDNA antibody status. After adjusting for prednisone use, the correlation of lambda FLC with PGA (r = 0.48) and SLEDAI (r = 0.52) was better than of current dsDNA antibody status with PGA (r = 0.33) and adjusted SLEDAI (r = 0.24), respectively. IL-10 and IFN-α activity did not correlate with disease activity. Serum FLC and IL-6 levels could differentiate between active and inactive SLE patients. Serum lambda FLC and IL-6 levels differed significantly among patients with and without current dsDNA antibodies. Serum lambda FLC levels accounted for 31% of variance in SLEDAI scores. CONCLUSION Serum FLC and IL-6 are potentially useful biomarkers of disease activity in SLE. Further studies, with larger study sample and longitudinal design, are indicated.
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Affiliation(s)
- M Jolly
- Rush University Medical Center, Section of Rheumatology, Chicago, IL, USA
| | - S Francis
- Central Dupage Hospital, Section of Rheumatology, Winfield, IL, USA
| | - R Aggarwal
- University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - R A Mikolaitis
- Rush University Medical Center, Section of Rheumatology, Chicago, IL, USA
| | | | - S Chubinskaya
- Rush University Medical Center, Section of Rheumatology, Chicago, IL, USA
| | - J A Block
- Rush University Medical Center, Section of Rheumatology, Chicago, IL, USA
| | - C Scanzello
- Rush University Medical Center, Section of Rheumatology, Chicago, IL, USA
| | - W Sequeira
- Rush University Medical Center, Section of Rheumatology, Chicago, IL, USA
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Klepper KB, Nilsen O, Francis S, Fjellvåg H. Guidance of growth mode and structural character in organic–inorganic hybrid materials – a comparative study. Dalton Trans 2014; 43:3492-500. [DOI: 10.1039/c3dt52391h] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
We investigated the influence of the functionality of organic ligands on film properties in organic–inorganic hybrid thin films deposited by atomic layer deposition.
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Affiliation(s)
- K. B. Klepper
- Department of Chemistry and Centre for Materials Science and Nanotechnology
- University of Oslo
- Blindern, Norway
| | - O. Nilsen
- Department of Chemistry and Centre for Materials Science and Nanotechnology
- University of Oslo
- Blindern, Norway
| | - S. Francis
- Department of Chemistry and Centre for Materials Science and Nanotechnology
- University of Oslo
- Blindern, Norway
| | - H. Fjellvåg
- Department of Chemistry and Centre for Materials Science and Nanotechnology
- University of Oslo
- Blindern, Norway
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Francis S. Antony Frank Francis. Assoc Med J 2013. [DOI: 10.1136/bmj.f7262] [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: 11/03/2022]
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Ambady P, Holdhoff M, Ferrigno C, Grossman S, Anderson MD, Liu D, Conrad C, Penas-Prado M, Gilbert MR, Yung AWK, de Groot J, Aoki T, Nishikawa R, Sugiyama K, Nonoguchi N, Kawabata N, Mishima K, Adachi JI, Kurisu K, Yamasaki F, Tominaga T, Kumabe T, Ueki K, Higuchi F, Yamamoto T, Ishikawa E, Takeshima H, Yamashita S, Arita K, Hirano H, Yamada S, Matsutani M, Apok V, Mills S, Soh C, Karabatsou K, Arimappamagan A, Arya S, Majaid M, Somanna S, Santosh V, Schaff L, Armentano F, Harrison C, Lassman A, McKhann G, Iwamoto F, Armstrong T, Yuan Y, Liu D, Acquaye A, Vera-Bolanos E, Diefes K, Heathcock L, Cahill D, Gilbert M, Aldape K, Arrillaga-Romany I, Ruddy K, Greenberg S, Nayak L, Avgeropoulos N, Avgeropoulos G, Riggs G, Reilly C, Banerji N, Bruns P, Hoag M, Gilliland K, Trusheim J, Bekaert L, Borha A, Emery E, Busson A, Guillamo JS, Bell M, Harrison C, Armentano F, Lassman A, Connolly ES, Khandji A, Iwamoto F, Blakeley J, Ye X, Bergner A, Dombi E, Zalewski C, Follmer K, Halpin C, Fayad L, Jacobs M, Baldwin A, Langmead S, Whitcomb T, Jennings D, Widemann B, Plotkin S, Brandes AA, Mason W, Pichler J, Nowak AK, Gil M, Saran F, Revil C, Lutiger B, Carpentier AF, Milojkovic-Kerklaan B, Aftimos P, Altintas S, Jager A, Gladdines W, Lonnqvist F, Soetekouw P, van Linde M, Awada A, Schellens J, Brandsma D, Brenner A, Sun J, Floyd J, Hart C, Eng C, Fichtel L, Gruslova A, Lodi A, Tiziani S, Bridge CA, Baldock A, Kumthekar P, Dilfer P, Johnston SK, Jacobs J, Corwin D, Guyman L, Rockne R, Sonabend A, Cloney M, Canoll P, Swanson KR, Bromberg J, Schouten H, Schaafsma R, Baars J, Brandsma D, Lugtenburg P, van Montfort C, van den Bent M, Doorduijn J, Spalding A, LaRocca R, Haninger D, Saaraswat T, Coombs L, Rai S, Burton E, Burzynski G, Burzynski S, Janicki T, Marszalek A, Burzynski S, Janicki T, Burzynski G, Marszalek A, Cachia D, Smith T, Cardona AF, Mayor LC, Jimenez E, Hakim F, Yepes C, Bermudez S, Useche N, Asencio JL, Mejia JA, Vargas C, Otero JM, Carranza H, Ortiz LD, Cardona AF, Ortiz LD, Jimenez E, Hakim F, Yepes C, Useche N, Bermudez S, Asencio JL, Carranza H, Vargas C, Otero JM, Bartels C, Quintero A, Restrepo CE, Gomez S, Bernal-Vaca L, Lema M, Cardona AF, Ortiz LD, Useche N, Bermudez S, Jimenez E, Hakim F, Yepes C, Mejia JA, Bernal-Vaca L, Restrepo CE, Gomez S, Quintero A, Bartels C, Carranza H, Vargas C, Otero JM, Carlo M, Omuro A, Grommes C, Kris M, Nolan C, Pentsova E, Pietanza M, Kaley T, Carrabba G, Giammattei L, Draghi R, Conte V, Martinelli I, Caroli M, Bertani G, Locatelli M, Rampini P, Artoni A, Carrabba G, Bertani G, Cogiamanian F, Ardolino G, Zarino B, Locatelli M, Caroli M, Rampini P, Chamberlain M, Raizer J, Soffetti R, Ruda R, Brandsma D, Boogerd W, Taillibert S, Le Rhun E, Jaeckle K, van den Bent M, Wen P, Chamberlain M, Chinot OL, Wick W, Mason W, Henriksson R, Saran F, Nishikawa R, Carpentier AF, Hoang-Xuan K, Kavan P, Cernea D, Brandes AA, Hilton M, Kerloeguen Y, Guijarro A, Cloughsey T, Choi JH, Hong YK, Conrad C, Yung WKA, deGroot J, Gilbert M, Loghin M, Penas-Prado M, Tremont I, Silberman S, Picker D, Costa R, Lycette J, Gancher S, Cullen J, Winer E, Hochberg F, Sachs G, Jeyapalan S, Dahiya S, Stevens G, Peereboom D, Ahluwalia M, Daras M, Hsu M, Kaley T, Panageas K, Curry R, Avila E, Fuente MDL, Omuro A, DeAngelis L, Desjardins A, Sampson J, Peters K, Ranjan T, Vlahovic G, Threatt S, Herndon J, Boulton S, Lally-Goss D, McSherry F, Friedman A, Friedman H, Bigner D, Gromeier M, Prust M, Kalpathy-Cramer J, Poloskova P, Jafari-Khouzani K, Gerstner E, Dietrich J, Fabi A, Villani V, Vaccaro V, Vidiri A, Giannarelli D, Piludu F, Anelli V, Carapella C, Cognetti F, Pace A, Flowers A, Flowers A, Killory B, Furuse M, Miyatake SI, Kawabata S, Kuroiwa T, Garciarena P, Anderson MD, Hamilton J, Schellingerhout D, Fuller GN, Sawaya R, Gilbert MR, Gilbert M, Pugh S, Won M, Blumenthal D, Vogelbaum M, Aldape K, Colman H, Chakravarti A, Jeraj R, Dignam J, Armstrong T, Wefel J, Brown P, Jaeckle K, Schiff D, Brachman D, Werner-Wasik M, Tremont-Lukats I, Sulman E, Mehta M, Gill B, Yun J, Goldstein H, Malone H, Pisapia D, Sonabend AM, Mckhann GK, Sisti MB, Sims P, Canoll P, Bruce JN, Girvan A, Carter G, Li L, Kaltenboeck A, Chawla A, Ivanova J, Koh M, Stevens J, Lahn M, Gore M, Hariharan S, Porta C, Bjarnason G, Bracarda S, Hawkins R, Oudard S, Zhang K, Fly K, Matczak E, Szczylik C, Grossman R, Ram Z, Hamza M, O'Brien B, Mandel J, DeGroot J, Han S, Molinaro A, Berger M, Prados M, Chang S, Clarke J, Butowski N, Hashimoto N, Chiba Y, Tsuboi A, Kinoshita M, Hirayama R, Kagawa N, Oka Y, Oji Y, Sugiyama H, Yoshimine T, Hawkins-Daarud A, Jackson PR, Swanson KR, Sarmiento JM, Ly D, Jutla J, Ortega A, Carico C, Dickinson H, Phuphanich S, Rudnick J, Patil C, Hu J, Iglseder S, Nowosielski M, Nevinny-Stickel M, Stockhammer G, Jain R, Poisson L, Scarpace L, Mikkelsen T, Kirby J, Freymann J, Hwang S, Gutman D, Jaffe C, Brat D, Flanders A, Janicki T, Burzynski S, Burzynski G, Marszalek A, Jiang C, Wang H, Jo J, Williams B, Smolkin M, Wintermark M, Shaffrey M, Schiff D, Juratli T, Soucek S, Kirsch M, Schackert G, Kakkar A, Kumar S, Bhagat U, Kumar A, Suri A, Singh M, Sharma M, Sarkar C, Suri V, Kaley T, Barani I, Chamberlain M, McDermott M, Raizer J, Rogers L, Schiff D, Vogelbaum M, Weber D, Wen P, Kalita O, Vaverka M, Hrabalek L, Zlevorova M, Trojanec R, Hajduch M, Kneblova M, Ehrmann J, Kanner AA, Wong ET, Villano JL, Ram Z, Khatua S, Fuller G, Dasgupta S, Rytting M, Vats T, Zaky W, Khatua S, Sandberg D, Foresman L, Zaky W, Kieran M, Geoerger B, Casanova M, Chisholm J, Aerts I, Bouffet E, Brandes AA, Leary SES, Sullivan M, Bailey S, Cohen K, Mason W, Kalambakas S, Deshpande P, Tai F, Hurh E, McDonald TJ, Kieran M, Hargrave D, Wen PY, Goldman S, Amakye D, Patton M, Tai F, Moreno L, Kim CY, Kim T, Han JH, Kim YJ, Kim IA, Yun CH, Jung HW, Koekkoek JAF, Reijneveld JC, Dirven L, Postma TJ, Vos MJ, Heimans JJ, Taphoorn MJB, Koeppen S, Hense J, Kong XT, Davidson T, Lai A, Cloughesy T, Nghiemphu PL, Kong DS, Choi YL, Seol HJ, Lee JI, Nam DH, Kool M, Jones DTW, Jager N, Northcott PA, Pugh T, Hovestadt V, Markant S, Esparza LA, Bourdeaut F, Remke M, Taylor MD, Cho YJ, Pomeroy SL, Schuller U, Korshunov A, Eils R, Wechsler-Reya RJ, Lichter P, Pfister SM, Krel R, Krutoshinskaya Y, Rosiello A, Seidman R, Kowalska A, Kudo T, Hata Y, Maehara T, Kumthekar P, Bridge C, Patel V, Rademaker A, Helenowski I, Mrugala M, Rockhill J, Swanson K, Grimm S, Raizer J, Meletath S, Bennett M, Nestor VA, Fink KL, Lee E, Reardon D, Schiff D, Drappatz J, Muzikansky A, Hammond S, Grimm S, Norden A, Beroukhim R, McCluskey C, Chi A, Batchelor T, Smith K, Gaffey S, Gerard M, Snodgras S, Raizer J, Wen P, Leeper H, Johnson D, Lima J, Porensky E, Cavaliere R, Lin A, Liu J, Evans J, Leuthardt E, Dacey R, Dowling J, Kim A, Zipfel G, Grubb R, Huang J, Robinson C, Simpson J, Linette G, Chicoine M, Tran D, Liubinas SV, D'Abaco GM, Moffat B, Gonzales M, Feleppa F, Nowell CJ, Gorelick A, Drummond KJ, Morokoff AP, O'Brien TJ, Kaye AH, Loghin M, Melhem-Bertrandt A, Penas-Prado M, Zaidi T, Katz R, Lupica K, Stevens G, Ly I, Hamilton S, Rostomily R, Rockhill J, Mrugala M, Mandel J, Yust-Katz S, de Groot J, Yung A, Gilbert M, Burzynski S, Janicki T, Burzynski G, Marszalek A, Pachow D, Kliese N, Kirches E, Mawrin C, McNamara MG, Lwin Z, Jiang H, Chung C, Millar BA, Sahgal A, Laperriere N, Mason WP, Megyesi J, Salehi F, Merker V, Slusarz K, Muzikansky A, Francis S, Plotkin S, Mishima K, Adachi JI, Suzuki T, Uchida E, Yanagawa T, Watanabe Y, Fukuoka K, Yanagisawa T, Wakiya K, Fujimaki T, Nishikawa R, Moiyadi A, Kannan S, Sridhar E, Gupta T, Shetty P, Jalali R, Alshami J, Lecavalier-Barsoum M, Guiot MC, Tampieri D, Kavan P, Muanza T, Nagane M, Kobayashi K, Takayama N, Shiokawa Y, Nakamura H, Makino K, Hideo T, Kuroda JI, Shinojima N, Yano S, Kuratsu JI, Nambudiri N, Arrilaga I, Dunn I, Folkerth R, Chi S, Reardon D, Nayak L, Omuro A, DeAngelis L, Robins HI, Govindan R, Gadgeel S, Kelly K, Rigas J, Reimers HJ, Peereboom D, Rosenfeld S, Garst J, Ramnath N, Wing P, Zheng M, Urban P, Abrey L, Wen P, Nayak L, DeAngelis LM, Wen PY, Brandes AA, Soffietti R, Peereboom DM, Lin NU, Chamberlain M, Macdonald D, Galanis E, Perry J, Jaeckle K, Mehta M, Stupp R, van den Bent M, Reardon DA, Norden A, Hammond S, Drappatz J, Phuphanich S, Reardon D, Wong E, Plotkin S, Lesser G, Raizer J, Batchelor T, Lee E, Kaley T, Muzikansky A, Doherty L, LaFrankie D, Ruland S, Smith K, Gerard M, McCluskey C, Wen P, Norden A, Schiff D, Ahluwalia M, Lesser G, Nayak L, Lee E, Muzikansky A, Dietrich J, Smith K, Gaffey S, McCluskey C, Ligon K, Reardon D, Wen P, Bush NAO, Kesari S, Scott B, Ohno M, Narita Y, Miyakita Y, Arita H, Matsushita Y, Yoshida A, Fukushima S, Ichimura K, Shibui S, Okamura T, Kaneko S, Omuro A, Chinot O, Taillandier L, Ghesquieres H, Soussain C, Delwail V, Lamy T, Gressin R, Choquet S, Soubeyran P, Maire JP, Benouaich-Amiel A, Lebouvier-Sadot S, Gyan E, Barrie M, del Rio MS, Gonzalez-Aguilar A, Houllier C, Tanguy ML, Hoang-Xuan K, Omuro A, Abrey L, Raizer J, Paleologos N, Forsyth P, DeAngelis L, Kaley T, Louis D, Cairncross JG, Matasar M, Mehta J, Grimm S, Moskowitz C, Sauter C, Opinaldo P, Torcuator R, Ortiz LD, Cardona AF, Hakim F, Jimenez E, Yepes C, Useche N, Bermudez S, Mejia JA, Asencio JL, Carranza H, Vargas C, Otero JM, Lema M, Pace A, Villani V, Fabi A, Carapella CM, Patel A, Allen J, Dicker D, Sheehan J, El-Deiry W, Glantz M, Tsyvkin E, Rauschkolb P, Pentsova E, Lee M, Perez A, Norton J, Uschmann H, Chamczuck A, Khan M, Fratkin J, Rahman R, Hempfling K, Norden A, Reardon DA, Nayak L, Rinne M, Doherty L, Ruland S, Rai A, Rifenburg J, LaFrankie D, Wen P, Lee E, Ranjan T, Peters K, Vlahovic G, Friedman H, Desjardins A, Reveles I, Brenner A, Ruda R, Bello L, Castellano A, Bertero L, Bosa C, Trevisan E, Riva M, Donativi M, Falini A, Soffietti R, Saran F, Chinot OL, Henriksson R, Mason W, Wick W, Nishikawa R, Dahr S, Hilton M, Garcia J, Cloughesy T, Sasaki H, Nishiyama Y, Yoshida K, Hirose Y, Schwartz M, Grimm S, Kumthekar P, Fralin S, Rice L, Drawz A, Helenowski I, Rademaker A, Raizer J, Schwartz K, Chang H, Nikolai M, Kurniali P, Olson K, Pernicone J, Sweeley C, Noel M, Sharma M, Gupta R, Suri V, Singh M, Sarkar C, Shibahara I, Sonoda Y, Saito R, Kanamori M, Yamashita Y, Kumabe T, Watanabe M, Suzuki H, Watanabe T, Ishioka C, Tominaga T, Shih K, Chowdhary S, Rosenblatt P, Weir AB, Shepard G, Williams JT, Shastry M, Hainsworth JD, Singer S, Riely GJ, Kris MG, Grommes C, Sanders MWCB, Arik Y, Seute T, Robe PAJT, Leijten FSS, Snijders TJ, Sturla L, Culhane JJ, Donahue J, Jeyapalan S, Suchorska B, Jansen N, Wenter V, Eigenbrod S, Schmid-Tannwald C, Zwergal A, Niyazi M, Bartenstein P, Schnell O, Kreth FW, LaFougere C, Tonn JC, Taillandier L, Wittwer B, Blonski M, Faure G, De Carvalho M, Le Rhun E, Tanaka K, Sasayama T, Nishihara M, Mizukawa K, Kohmura E, Taylor S, Newell K, Graves L, Timmer M, Cramer C, Rohn G, Goldbrunner R, Turner S, Gergel T, Lacroix M, Toms S, Ueki K, Higuchi F, Sakamoto S, Kim P, Salgado MAV, Rueda AG, Urzaiz LL, Villanueva MG, Millan JMS, Cervantes ER, Pampliega RA, de Pedro MDA, Berrocal VR, Mena AC, van Zanten SV, Jansen M, van Vuurden D, Huisman M, Hoekstra O, van Dongen G, Kaspers GJ, Schlamann A, von Bueren AO, Hagel C, Kramm C, Kortmann RD, Muller K, Friedrich C, Muller K, von Hoff K, Kwiecien R, Pietsch T, Warmuth-Metz M, Gerber NU, Hau P, Kuehl J, Kortmann RD, von Bueren AO, Rutkowski S, von Bueren AO, Friedrich C, von Hoff K, Kwiecien R, Muller K, Pietsch T, Warmuth-Metz M, Kuehl J, Kortmann RD, Rutkowski S, Walker J, Tremont I, Armstrong T, Wang H, Jiang C, Wang H, Jiang C, Warren P, Robert S, Lahti A, White D, Reid M, Nabors L, Sontheimer H, Wen P, Yung A, Mellinghoff I, Lamborn K, Ramkissoon S, Cloughesy T, Rinne M, Omuro A, DeAngelis L, Gilbert M, Chi A, Batchelor T, Colman H, Chang S, Nayak L, Massacesi C, DiTomaso E, Prados M, Reardon D, Ligon K, Wong ET, Elzinga G, Chung A, Barron L, Bloom J, Swanson KD, Elzinga G, Chung A, Wong ET, Wu W, Galanis E, Wen P, Das A, Fine H, Cloughesy T, Sargent D, Yoon WS, Yang SH, Chung DS, Jeun SS, Hong YK, Yust-Katz S, Milbourne A, Diane L, Gilbert M, Armstrong T, Zaky W, Weinberg J, Fuller G, Ketonen L, McAleer MF, Ahmed N, Khatua S, Zaky W, Olar A, Stewart J, Sandberg D, Foresman L, Ketonen L, Khatua S. NEURO/MEDICAL ONCOLOGY. Neuro Oncol 2013; 15:iii98-iii135. [PMCID: PMC3823897 DOI: 10.1093/neuonc/not182] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/14/2023] Open
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Kapiga SH, Ewings FM, Ao T, Chilongani J, Mongi A, Baisley K, Francis S, Andreasen A, Hashim R, Watson-Jones D, Changalucha J, Hayes R. The epidemiology of HIV and HSV-2 infections among women participating in microbicide and vaccine feasibility studies in Northern Tanzania. PLoS One 2013; 8:e68825. [PMID: 23874780 PMCID: PMC3715536 DOI: 10.1371/journal.pone.0068825] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2013] [Accepted: 06/03/2013] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVES To prepare for future HIV prevention trials, we conducted prospective cohort studies among women working in food and recreational facilities in northern Tanzania. We examined the prevalence and incidence of HIV and HSV-2, and associated risk factors. METHODS Women aged 18-44 years working in food and recreational facilities were screened to determine their eligibility for the studies. Between 2008-2010, HIV-negative women were enrolled and followed for 12 months. At enrolment and 3-monthly, we collected socio-demographic and behavioural data, and performed clinical examinations for collection of biological specimens that were tested for reproductive tract infections. Risk factors for HIV and HSV-2 incidence were investigated using Poisson regression models. RESULTS We screened 2,229 and enrolled 1,378 women. The median age was 27 years (interquartile range, IQR 22, 33), and median duration working at current facility was 2 years. The prevalences of HIV at screening and HSV-2 at enrolment were 16% and 67%, respectively. Attendance at the 12-month visit was 86%. HIV and HSV-2 incidence rates were 3.7 (95% confidence interval, CI: 2.8,5.1) and 28.6 (95% CI: 23.5,35.0)/100 person-years, respectively. Women who were separated, divorced, or widowed were at increased risk of HIV (adjusted incidence rate ratio, aRR = 6.63; 95% CI: 1.97,22.2) and HSV-2 (aRR = 2.00; 95% CI: 1.15,3.47) compared with married women. Women reporting ≥3 partners in the past 3 months were at higher HIV risk compared with women with 0-1 partner (aRR = 4.75; 95% CI: 2.10,10.8), while those who had reached secondary education or above were at lower risk of HSV-2 compared with women with incomplete primary education (aRR = 0.42; 95% CI: 0.22,0.82). CONCLUSIONS HIV and HSV-2 rates remain substantially higher in this cohort than in the general population, indicating urgent need for effective interventions. These studies demonstrate the feasibility of conducting trials to test new interventions in this highly-mobile population.
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Affiliation(s)
- Saidi H Kapiga
- London School of Hygiene and Tropical Medicine, London, United Kingdom.
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West L, Francis S, Storey R. YIA6: VESSEL WALL, BUT NOT PLATELET, P2Y12 CONTRIBUTES TO EARLY ATHEROGENESIS. Heart 2013. [DOI: 10.1136/heartjnl-2013-304019.273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Alfaidi M, Wilson H, Burnett A, Chamberlain J, Francis S. 172 IL-1 BETA SECRETION IN CORONARY VASCULAR ENDOTHELIUM IS MEDIATED BY NEUTROPHIL SERINE PROTEASE AND IS INDEPENDENT OF CASPASE-1. Heart 2013. [DOI: 10.1136/heartjnl-2013-304019.172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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