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Sandhu P, Shah AB, Ahmad FB, Kerr J, Demeke HB, Graeden E, Marks S, Clark H, Bombard JM, Bolduc M, Hatfield-Timajchy K, Tindall E, Neri A, Smith K, Owens C, Martin T, Strona FV. Emergency Department and Intensive Care Unit Overcrowding and Ventilator Shortages in US Hospitals During the COVID-19 Pandemic, 2020-2021. Public Health Rep 2022; 137:796-802. [PMID: 35642664 PMCID: PMC9257510 DOI: 10.1177/00333549221091781] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [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] [Indexed: 01/08/2023] Open
Abstract
OBJECTIVE In 2020, the COVID-19 pandemic overburdened the US health care system because of extended and unprecedented patient surges and supply shortages in hospitals. We investigated the extent to which several US hospitals experienced emergency department (ED) and intensive care unit (ICU) overcrowding and ventilator shortages during the COVID-19 pandemic. METHODS We analyzed Health Pulse data to assess the extent to which US hospitals reported alerts when experiencing ED overcrowding, ICU overcrowding, and ventilator shortages from March 7, 2020, through April 30, 2021. RESULTS Of 625 participating hospitals in 29 states, 393 (63%) reported at least 1 hospital alert during the study period: 246 (63%) reported ED overcrowding, 239 (61%) reported ICU overcrowding, and 48 (12%) reported ventilator shortages. The number of alerts for overcrowding in EDs and ICUs increased as the number of COVID-19 cases surged. CONCLUSIONS Timely assessment and communication about critical factors such as ED and ICU overcrowding and ventilator shortages during public health emergencies can guide public health response efforts in supporting federal, state, and local public health agencies.
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Affiliation(s)
- Paramjit Sandhu
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Ami B Shah
- General Dynamics Information Technology, Falls Church, VA, USA
| | - Farida B Ahmad
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Justin Kerr
- Health Pulse, Talus Analytics, Boulder, CO, USA
| | - Hanna B Demeke
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | | | - Suzanne Marks
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Hollie Clark
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Jennifer M Bombard
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Michele Bolduc
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA, USA.,Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | | | - Erica Tindall
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Antonio Neri
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | | | - Chantelle Owens
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Tonya Martin
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Frank V Strona
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA, USA
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Marks S, Naidoo J. Antibody drug conjugates in non-small cell lung cancer: An emerging therapeutic approach. Lung Cancer 2021; 163:59-68. [PMID: 34923203 DOI: 10.1016/j.lungcan.2021.11.016] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2021] [Revised: 11/22/2021] [Accepted: 11/24/2021] [Indexed: 10/19/2022]
Abstract
The current standard-of-care for the treatment of advanced non-small cell lung cancer (NSCLC) incorporates targeted therapies, immune-checkpoint inhibitors (ICI) and systemic chemotherapy. Antibody-drug conjugates (ADC) are a class of anti-cancer therapy capable of transporting cytotoxic drugs directly to tumour cells, thus harnessing the strengths of both cytotoxic chemotherapy and targeted therapy. In this review we provide a comprehensive review the design, mode of action, and mechanisms of resistance to ADCs in NSCLC. We also summarize the clinical development of several promising ADCs in early phase clinical trials for the treatment NSCLC. including ADCs against well-established targets (e.g.HER2 in breast cancer, Nectin4 in urothelial cancer), novel antigenic targets (e.g. HER3, TROP2, PTK7, CEACAM5), as well as promising combinations with agents known to be active in NSCLC such as tyrosine kinase inhibitors and ICI therapy, as a strategy to overcome mechanisms of resistance to ADC therapy.
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Affiliation(s)
- S Marks
- Beaumont RCSI Cancer Centre, Dublin 9, Republic of Ireland.
| | - J Naidoo
- Beaumont RCSI Cancer Centre, Dublin 9, Republic of Ireland; Upper Aerodigestive Division, Sidney Kimmel Comprehensive Cancer Centre at Johns Hopkins University, Baltimore, MD, USA
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Hamed R, Marks S, Moloney C, Osman N, Korpanty G. P-180 Rectal cancer in the elderly: Characteristics, management and outcomes from a single centre retrospective cohort review. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.05.235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Demeke HB, Merali S, Marks S, Pao LZ, Romero L, Sandhu P, Clark H, Clara A, McDow KB, Tindall E, Campbell S, Bolton J, Le X, Skapik JL, Nwaise I, Rose MA, Strona FV, Nelson C, Siza C. Trends in Use of Telehealth Among Health Centers During the COVID-19 Pandemic - United States, June 26-November 6, 2020. MMWR Morb Mortal Wkly Rep 2021; 70:240-244. [PMID: 33600385 PMCID: PMC7891688 DOI: 10.15585/mmwr.mm7007a3] [Citation(s) in RCA: 111] [Impact Index Per Article: 37.0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Dunn HP, Kang CJ, Marks S, Witherow JL, Dunn SM, Healey PR, White AJ. Perceived usefulness and ease of use of fundoscopy by medical students: a randomised crossover trial of six technologies (eFOCUS 1). BMC Med Educ 2021; 21:41. [PMID: 33419444 PMCID: PMC7793394 DOI: 10.1186/s12909-020-02469-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Accepted: 12/21/2020] [Indexed: 06/02/2023]
Abstract
BACKGROUND Fundoscopy outside ophthalmology is in decline, and the technical demands of the traditional direct ophthalmoscope examination are likely contributing. Alternative fundoscopy technologies are increasingly available, yet valid comparisons between fundoscopy technologies are lacking. We aimed to assess medical students' perceptions of usefulness and ease of use of traditional and contemporary fundus-viewing technologies including smartphone fundoscopy. METHODS One hundred forty-six second-year medical students participated in a cross-sectional, randomised, cross-over study of fundoscopy methods. Medical students completed small group training sessions using six current fundoscopy technologies including: a non-mydriatic fundus camera; two types of direct fundoscopy; and three types of smartphone fundoscopy. A novel survey of perceived usefulness and ease of use was then completed by students. RESULTS Repeated-measures ANOVA found students rated both the perceived usefulness (p< 0.001) and ease of use (p< 0.001) of smartphone fundoscopy significantly higher than both the non-mydriatic camera and direct fundoscopy. CONCLUSIONS Smartphone fundoscopy was found to be significantly more useful and easier to use than other modalities. Educators should optimise student access to novel fundoscopy technologies such as smartphone fundoscopy which may mitigate the technical challenges of fundoscopy and reinvigorate use of this valuable clinical examination.
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Affiliation(s)
- H P Dunn
- Faculty of Medicine & Health, University of Sydney, Sydney, Australia.
- Department of Ophthalmology, Westmead Hospital, Sydney, Australia.
| | - C J Kang
- Faculty of Medicine & Health, University of Sydney, Sydney, Australia
| | - S Marks
- Faculty of Medicine & Health, University of Sydney, Sydney, Australia
| | - J L Witherow
- Discipline of Physiotherapy, Faculty of Medicine & Health Services, Macquarie University, Sydney, Australia
| | - S M Dunn
- Faculty of Medicine & Health, University of Sydney, Sydney, Australia
| | - P R Healey
- Faculty of Medicine & Health, University of Sydney, Sydney, Australia
- Department of Ophthalmology, Westmead Hospital, Sydney, Australia
- Centre for Vision Research, Westmead Institute for Medical Research, University of Sydney, Sydney, Australia
| | - A J White
- Faculty of Medicine & Health, University of Sydney, Sydney, Australia
- Department of Ophthalmology, Westmead Hospital, Sydney, Australia
- Centre for Vision Research, Westmead Institute for Medical Research, University of Sydney, Sydney, Australia
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Yelk Woodruff R, Hill A, Marks S, Navin T, Miramontes R. Estimated Latent Tuberculosis Infection Prevalence and Tuberculosis Reactivation Rates Among Non-U.S.-Born Residents in the United States, from the 2011-2012 National Health and Nutrition Examination Survey. J Immigr Minor Health 2020; 23:806-812. [PMID: 32761297 DOI: 10.1007/s10903-020-01065-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Increased testing and treatment of latent tuberculosis infection (LTBI) among US-residents who were born (or lived) in countries with high rates of TB can hasten progress toward TB elimination. We calculated LTBI prevalence using QuantiFERON®-TB Gold In-Tube results from the 2011 to 2012 National Health and Nutrition Examination Survey (NHANES). LTBI prevalence was highest for persons born in India (31.7%, 95% confidence interval [21.2, 44.5]). Non-Hispanic white persons had the lowest LTBI prevalence (6.3% [1.9, 18.9]). TB reactivation rate, defined as the number of TB cases not associated with recent transmission per 100 person-years of life with LTBI, was highest for persons born in Vietnam [0.183 (0.117, 0.303)]. Reactivation rates were lower among persons who had resided in the United States for ≥ 10 years than among those who had resided for < 10 years. Results among high risk populations can guide LTBI targeted testing and treatment among non-U.S.-born residents.
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Affiliation(s)
- Rachel Yelk Woodruff
- Division of Tuberculosis Elimination, Centers for Disease Control and Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Mailstop U.S.12-4, 1600 Clifton Road, Atlanta, GA, 30333, USA.
| | - Andrew Hill
- Division of Tuberculosis Elimination, Centers for Disease Control and Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Mailstop U.S.12-4, 1600 Clifton Road, Atlanta, GA, 30333, USA
| | - Suzanne Marks
- Division of Tuberculosis Elimination, Centers for Disease Control and Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Mailstop U.S.12-4, 1600 Clifton Road, Atlanta, GA, 30333, USA
| | - Thomas Navin
- Division of Tuberculosis Elimination, Centers for Disease Control and Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Mailstop U.S.12-4, 1600 Clifton Road, Atlanta, GA, 30333, USA
| | - Roque Miramontes
- Division of Tuberculosis Elimination, Centers for Disease Control and Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Mailstop U.S.12-4, 1600 Clifton Road, Atlanta, GA, 30333, USA
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Jo Y, Shrestha S, Gomes I, Marks S, Hill A, Asay G, Dowdy D. Model-Based Cost-Effectiveness of State-level Latent Tuberculosis Interventions in California, Florida, New York and Texas. Clin Infect Dis 2020; 73:e3476-e3482. [PMID: 32584968 DOI: 10.1093/cid/ciaa857] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Accepted: 06/19/2020] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Targeted testing and treatment (TTT) for latent tuberculosis infection (LTBI) is a recommended strategy to accelerate TB reductions and further tuberculosis elimination in the United States (US). Evidence on cost-effectiveness of TTT for key populations can help advance this goal. METHODS We used a model of TB transmission to estimate the numbers of individuals who could be tested by interferon-γ release assay (IGRA) and treated for LTBI with three months of self-administered rifapentine and isoniazid (3HP) under various TTT scenarios. Specifically, we considered rapidly scaling up TTT among people who are non-US-born, diabetic, HIV-positive, homeless or incarcerated in California, Florida, New York, and Texas - states where more than half of US TB cases occur. We projected costs (from the healthcare system perspective, in 2018 dollars), thirty-year reductions in TB incidence, and incremental cost effectiveness (cost per quality-adjusted life year [QALY] gained) for TTT in each modeled population. RESULTS The projected cost effectiveness of TTT differed substantially by state and population, while the health impact (number of TB cases averted) was consistently greatest among the non-US-born. TTT was most cost-effective among persons living with HIV (from $2,828/QALY gained in Florida to $11,265/QALY gained in New York) and least cost-effective among people with diabetes (from $223,041/QALY gained in California to $817,753 /QALY in New York). CONCLUSIONS The modeled cost-effectiveness of TTT for LTBI varies across states but was consistently greatest among people living with HIV, moderate among people who are non-US-born, incarcerated, or homeless, and least cost-effective among people living with diabetes.
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Affiliation(s)
- Youngji Jo
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Sourya Shrestha
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Isabella Gomes
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Suzanne Marks
- Division of Tuberculosis Elimination, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Andrew Hill
- Division of Tuberculosis Elimination, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Garrett Asay
- Division of Tuberculosis Elimination, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - David Dowdy
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
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Fanouriakis A, Kostopoulou M, Cheema K, Anders HJ, Aringer M, Bajema I, Boletis JN, Frangou E, Houssiau F, Hollis J, Karras A, Marchiori F, Marks S, Moroni G, Mosca M, Parodis I, Praga M, Schneider M, Smolen JS, Tesar V, Trachana M, Vollenhoven RV, Voskuyl A, Teng YKO, Van Leeuw B, Bertsias G, Jayne D, Boumpas D. OP0163 2019 UPDATE OF THE JOINT EUROPEAN LEAGUE AGAINST RHEUMATISM AND EUROPEAN RENAL ASSOCIATION–EUROPEAN DIALYSIS AND TRANSPLANT ASSOCIATION (EULAR/ERA-EDTA) RECOMMENDATIONS FOR THE MANAGEMENT OF LUPUS NEPHRITIS. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.3870] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:Up to 40% of systemic lupus erythematosus (SLE) patients develop kidney disease, which represents a major cause of morbidity.Objectives:To update the 2012 EULAR/ERA-EDTA recommendations for the management of lupus nephritis (LN).Methods:We followed the EULAR standardised operating procedures for the publication of treatment recommendations. Delphi-based methodology led to 15 questions for systematic literature review (SLR), which was undertaken by three fellows.Results:The changes include recommendations for treatment targets, use of glucocorticoids and calcineurin inhibitors (CNI), and management of end-stage-kidney-disease (ESKD). The target of therapy is complete response (proteinuria <0.5-0.7gr/24h with [near-]normal glomerular filtration rate) by 12 months, but this can be extended in patients with baseline nephrotic-range proteinuria. Hydroxychloroquine is recommended with regular ophthalmological monitoring. In active proliferative LN, initial (induction) treatment with mycophenolate mofetil (MMF 2-3g/day, or mycophenolic acid at equivalent dose) or low-dose intravenous cyclophosphamide (CY; 500mg x6 biweekly doses), both combined with glucocorticoids (pulses of intravenous methylprednisolone, then oral prednisone 0.3-0.5mg/kg/day) is recommended. MMF/CNI (especially tacrolimus) combination and high-dose CY are alternatives, for patients with nephrotic-range proteinuria and adverse prognostic factors. Subsequent long-term maintenance treatment with MMF or azathioprine should follow, with no or low-dose (<7.5 mg/day) glucocorticoids. The choice of agent depends on the initial regimen and plans for pregnancy. In non-responding disease, switch of induction regimens or rituximab are recommended. In pure membranous LN with nephrotic-range proteinuria or proteinuria >1g/24h despite renin-angiotensin-aldosterone blockade, MMF in combination with glucocorticoids is preferred. Assessment for kidney and extra-renal disease activity, and management of comorbidities is lifelong with repeat kidney biopsy in cases of incomplete response or nephritic flares. In ESKD, transplantation is the preferred kidney replacement option with immunosuppression guided by transplant protocols and/or extra-renal manifestations.Conclusion:The updated recommendations intend to inform rheumatologists, nephrologists, patients, national professional societies, hospital officials, social security agencies and regulators about the treatment of LN based on most recent evidence.Disclosure of Interests:Antonis Fanouriakis Paid instructor for: Paid instructor for Enorasis, Amgen, Speakers bureau: Paid speaker for Roche, Genesis Pharma, Mylan, Myrto Kostopoulou: None declared, Kim Cheema: None declared, Hans-Joachim Anders: None declared, Martin Aringer Consultant of: Boehringer Ingelheim, Roche, Speakers bureau: Boehringer Ingelheim, Roche, Ingeborg Bajema Consultant of: GSK, John N. Boletis Grant/research support from: GSK, Pfizer, Paid instructor for: GSK, Abbvie, UCB, Enorasis, Eleni Frangou: None declared, Frederic Houssiau Grant/research support from: UCB, Consultant of: GSK, Jane Hollis: None declared, Alexandre Karras: None declared, Francesca Marchiori: None declared, Stephen Marks: None declared, Gabriela Moroni: None declared, Marta Mosca: None declared, Ioannis Parodis: None declared, Manuel Praga: None declared, Matthias Schneider Grant/research support from: GSK, UCB, Abbvie, Consultant of: Abbvie, Alexion, Astra Zeneca, BMS, Boehringer Ingelheim, Gilead, Lilly, Sanofi, UCB, Speakers bureau: Abbvie, Astra Zeneca, BMS, Chugai, GSK, Lilly, Pfizer, Sanofi, Josef S. Smolen Grant/research support from: AbbVie, AstraZeneca, Celgene, Celltrion, Chugai, Eli Lilly, Gilead, ILTOO, Janssen, Novartis-Sandoz, Pfizer Inc, Samsung, Sanofi, Consultant of: AbbVie, AstraZeneca, Celgene, Celltrion, Chugai, Eli Lilly, Gilead, ILTOO, Janssen, Novartis-Sandoz, Pfizer Inc, Samsung, Sanofi, Vladimir Tesar: None declared, Maria Trachana: None declared, Ronald van Vollenhoven Grant/research support from: AbbVie, Amgen, Arthrogen, Bristol-Myers Squibb, GlaxoSmithKline (GSK), Janssen Research & Development, LLC, Lilly, Pfizer, Roche, and UCB, Consultant of: AbbVie, AstraZeneca, Biotest, Bristol-Myers Squibb, Celgene, Crescendo Bioscience, GSK, Janssen, Lilly, Medac, Merck, Novartis, Pfizer, Roche, UCB and Vertex, Speakers bureau: AbbVie, AstraZeneca, Biotest, Bristol-Myers Squibb, Celgene, Crescendo Bioscience, GlaxoSmithKline, Janssen, Lilly, Merck, Novartis, Pfizer, Roche, UCB, Vertex, Alexandre Voskuyl: None declared, Y.K. Onno Teng Grant/research support from: GSK, Consultant of: GSK, Aurinia Pharmaceuticals, Novartis, Bernadette van Leeuw: None declared, George Bertsias Grant/research support from: GSK, Consultant of: Novartis, David Jayne Grant/research support from: ChemoCentryx, GSK, Roche/Genentech, Sanofi-Genzyme, Consultant of: Astra-Zeneca, ChemoCentryx, GSK, InflaRx, Takeda, Insmed, Chugai, Boehringer-Ingelheim, Dimitrios Boumpas: None declared
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Khan A, Marks S, Katz D, Morris SB, Lambert L, Magee E, Bowman S, Grant G. Changes in Tuberculosis Disparities at a Time of Decreasing Tuberculosis Incidence in the United States, 1994-2016. Am J Public Health 2019; 108:S321-S326. [PMID: 30383425 DOI: 10.2105/ajph.2018.304606] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES To assess national progress in reducing disparities in rates of tuberculosis (TB) disease, which disproportionately affects minorities. METHODS We used Centers for Disease Control and Prevention (CDC) surveillance data and US Census data to calculate TB rates for 1994 through 2016 by race/ethnicity, national origin, and other TB risk factors. We assessed progress in reducing disparities with rate ratios (RRs) and indexes of disparity, defined as the average of the differences between subpopulation and all-population TB rates divided by the all-population rate. RESULTS Although TB rates decreased for all subpopulations, RRs increased or stayed the same for all minorities compared with Whites. For racial/ethnic groups, indexes of disparity decreased from 1998 to 2008 (P < .001) but increased thereafter (P = .33). The index of disparity by national origin increased an average of 1.5% per year. CONCLUSIONS Although TB rates have decreased, disparities have persisted and even increased for some populations. To address the problem, the CDC's Division of TB Elimination has focused on screening and treating latent TB infection, which is concentrated among minorities and is the precursor for more than 85% of TB cases in the United States.
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Affiliation(s)
- Awal Khan
- All of the authors are with the Centers for Disease Control and Prevention (CDC), Atlanta, GA
| | - Suzanne Marks
- All of the authors are with the Centers for Disease Control and Prevention (CDC), Atlanta, GA
| | - Dolly Katz
- All of the authors are with the Centers for Disease Control and Prevention (CDC), Atlanta, GA
| | - Sapna Bamrah Morris
- All of the authors are with the Centers for Disease Control and Prevention (CDC), Atlanta, GA
| | - Lauren Lambert
- All of the authors are with the Centers for Disease Control and Prevention (CDC), Atlanta, GA
| | - Elvin Magee
- All of the authors are with the Centers for Disease Control and Prevention (CDC), Atlanta, GA
| | - Sloane Bowman
- All of the authors are with the Centers for Disease Control and Prevention (CDC), Atlanta, GA
| | - Gail Grant
- All of the authors are with the Centers for Disease Control and Prevention (CDC), Atlanta, GA
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Shete PB, Boccia D, Dhavan P, Gebreselassie N, Lönnroth K, Marks S, Matteelli A, Posey DL, van der Werf MJ, Winston CA, Lienhardt C. Defining a migrant-inclusive tuberculosis research agenda to end TB. Int J Tuberc Lung Dis 2019; 22:835-843. [PMID: 29991390 DOI: 10.5588/ijtld.17.0503] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Pillar 3 of the End TB Strategy calls for the promotion of research and innovation at the country level to facilitate improved implementation of existing and novel interventions to end tuberculosis (TB). In an era of increasing cross-border migration, there is a specific need to integrate migration-related issues into national TB research agendas. The objective of the present review is to provide a conceptual framework to guide countries in the development and operationalization of a migrant-inclusive TB research agenda. METHODS We conducted a literature review, complemented by expert opinion and the previous articles in this State of the Art series, to identify important themes central to migration-related TB. We categorized these themes into a framework for a migration-inclusive global TB research agenda across a comprehensive spectrum of research. We developed this conceptual framework taking into account: 1) the biomedical, social and structural determinants of TB; 2) the epidemiologic impact of the migration pathway; and 3) the feasibility of various types of research based on a country's capacity. DISCUSSION The conceptual framework presented here is based on the key principle that migrants are not inherently different from other populations in terms of susceptibility to known TB determinants, but that they often have exacerbated or additional risks related to their country of origin and the migration process, which must be accounted for in developing comprehensive TB prevention and care strategies. A migrant-inclusive research agenda should systematically consider this wider context to have the highest impact.
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Affiliation(s)
- P B Shete
- Global Tuberculosis Programme, World Health Organization (WHO), Geneva, Switzerland, Division of Pulmonary and Critical Care Medicine, University of California San Francisco, San Francisco, California, USA
| | - D Boccia
- Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK
| | - P Dhavan
- International Organization of Migration, Geneva, Switzerland
| | - N Gebreselassie
- Global Tuberculosis Programme, World Health Organization (WHO), Geneva, Switzerland
| | - K Lönnroth
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
| | - S Marks
- Division of Tuberculosis Elimination, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, USA
| | - A Matteelli
- Department of Infectious and Tropical Diseases, WHO Collaborating Centre for TB/HIV collaborative activities and for the TB elimination strategy, University of Brescia, Brescia, Italy
| | - D L Posey
- Division Global Quarantine and Migration, CDC, Atlanta, Georgia, USA
| | - M J van der Werf
- European Centre for Disease Prevention and Control, Stockholm, Sweden
| | - C A Winston
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
| | - C Lienhardt
- Global Tuberculosis Programme, World Health Organization (WHO), Geneva, Switzerland, Institut de Recherche pour le Développement, Unité Mixte de Recherche 233, Montpellier, France
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Sandul AL, Nwana N, Holcombe JM, Lobato MN, Marks S, Webb R, Wang SH, Stewart B, Griffin P, Hunt G, Shah N, Marco A, Patil N, Mukasa L, Moro RN, Jereb J, Mase S, Chorba T, Bamrah-Morris S, Ho CS. High Rate of Treatment Completion in Program Settings With 12-Dose Weekly Isoniazid and Rifapentine for Latent Mycobacterium tuberculosis Infection. Clin Infect Dis 2019; 65:1085-1093. [PMID: 28575208 DOI: 10.1093/cid/cix505] [Citation(s) in RCA: 64] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2017] [Accepted: 05/26/2017] [Indexed: 12/15/2022] Open
Abstract
Background Randomized controlled trials have demonstrated that the newest latent tuberculosis (LTBI) regimen, 12 weekly doses of directly observed isoniazid and rifapentine (3HP), is as efficacious as 9 months of isoniazid, with a greater completion rate (82% vs 69%); however, 3HP has not been assessed in routine healthcare settings. Methods Observational cohort of LTBI patients receiving 3HP through 16 US programs was used to assess treatment completion, adverse drug reactions, and factors associated with treatment discontinuation. Results Of 3288 patients eligible to complete 3HP, 2867 (87.2%) completed treatment. Children aged 2-17 years had the highest completion rate (94.5% [155/164]). Patients reporting homelessness had a completion rate of 81.2% (147/181). In univariable analyses, discontinuation was lowest among children (relative risk [RR], 0.44 [95% confidence interval {CI}, .23-.85]; P = .014), and highest in persons aged ≥65 years (RR, 1.72 [95% CI, 1.25-2.35]; P < .001). In multivariable analyses, discontinuation was lowest among contacts of patients with tuberculosis (TB) disease (adjusted RR [ARR], 0.68 [95% CI, .52-.89]; P = .005) and students (ARR, 0.45 [95% CI, .21-.98]; P = .044), and highest with incarceration (ARR, 1.43 [95% CI, 1.08-1.89]; P = .013) and homelessness (ARR, 1.72 [95% CI, 1.25-2.39]; P = .001). Adverse drug reactions were reported by 1174 (35.7%) patients, of whom 891 (76.0%) completed treatment. Conclusions Completion of 3HP in routine healthcare settings was greater overall than rates reported from clinical trials, and greater than historically observed using other regimens among reportedly nonadherent populations. Widespread use of 3HP for LTBI treatment could accelerate elimination of TB disease in the United States.
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Affiliation(s)
- Amy L Sandul
- Division of Tuberculosis Elimination, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Nwabunie Nwana
- Division of Tuberculosis Elimination, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia
| | | | - Mark N Lobato
- Division of Tuberculosis Elimination, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia.,Connecticut Department of Public Health, Hartford
| | - Suzanne Marks
- Division of Tuberculosis Elimination, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Risa Webb
- Mississippi State Department of Health, Jackson.,University of Mississippi Medical Center, Jackson
| | | | - Brock Stewart
- Division of Tuberculosis Elimination, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Phil Griffin
- Kansas Department of Health and Environment, Topeka
| | | | - Neha Shah
- Division of Tuberculosis Elimination, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia.,California Department of Public Health, San Francisco ; and
| | | | | | | | - Ruth N Moro
- Division of Tuberculosis Elimination, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - John Jereb
- Division of Tuberculosis Elimination, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Sundari Mase
- Division of Tuberculosis Elimination, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Terence Chorba
- Division of Tuberculosis Elimination, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Sapna Bamrah-Morris
- Division of Tuberculosis Elimination, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Christine S Ho
- Division of Tuberculosis Elimination, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia
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12
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Marks S, van Ruitenbeek E, Fallon P, Johns P, Phadke R, Mein R, Mohammed S, Jungbluth H. Parental mosaicism in RYR1-related Central Core Disease. Neuromuscul Disord 2018; 28:422-426. [PMID: 29576327 DOI: 10.1016/j.nmd.2018.02.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2017] [Revised: 01/20/2018] [Accepted: 02/20/2018] [Indexed: 11/15/2022]
Abstract
Myopathies due to mutations in the skeletal muscle ryanodine receptor (RYR1) gene are amongst the most common non-dystrophic neuromuscular disorders and have been associated with both dominant and recessive inheritance. Several cases with apparently de novo dominant inheritance have been reported. Here we report two siblings with features of Central Core Disease (CCD) born to unaffected parents. Genetic testing revealed a heterozygous dominant RYR1 c.14582G>A (p. Arg4861His) mutation previously identified in other CCD pedigrees. The variant was absent in blood from the asymptomatic mother but detected at low but variable levels in blood- and saliva-derived DNA from the unaffected father, suggesting that this mutation has arisen as a paternal post-zygotic de novo event. These findings suggest that parental mosaicism should be considered in RYR1-related myopathies, and may provide one possible explanation for the marked intergenerational variability seen in some RYR1 pedigrees.
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Affiliation(s)
- S Marks
- Viapath, Guy's Hospital, London, UK
| | - E van Ruitenbeek
- Department of Paediatric Neurology, Neuromuscular Service, Evelina's Children Hospital, Guy's & St. Thomas' Hospital NHS Foundation Trust, London, UK; Radboud University Medical School, Nijmegen, The Netherlands
| | - P Fallon
- Department of Paediatric Neurology, St. George's Hospital, London, UK
| | - P Johns
- Department of Cellular Pathology, St. George's Hospital, London, UK
| | - R Phadke
- Dubowitz Neuromuscular Centre, Great Ormond Street Hospital for Children, London, UK
| | - R Mein
- Viapath, Guy's Hospital, London, UK
| | - S Mohammed
- Department of Clinical Genetics, Guy's Hospital, London, UK
| | - H Jungbluth
- Department of Paediatric Neurology, Neuromuscular Service, Evelina's Children Hospital, Guy's & St. Thomas' Hospital NHS Foundation Trust, London, UK; Randall Division for Cell and Molecular Biophysics, Muscle Signaling Section, King's College, London, UK; Department of Basic and Clinical Neuroscience, IoPPN, King's College London, London, UK.
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13
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Woodruff RY, Hill A, Marks S, Navin T, Miramontes R. Prevalence and Reactivation of Latent Tuberculosis Infection among Foreign-born Subpopulations, USA, 2011–2012. Open Forum Infect Dis 2017. [DOI: 10.1093/ofid/ofx163.1952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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14
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Rebollo‐Mesa I, Nova‐Lamperti E, Mobillo P, Runglall M, Christakoudi S, Norris S, Smallcombe N, Kamra Y, Hilton R, Bhandari S, Baker R, Berglund D, Carr S, Game D, Griffin S, Kalra PA, Lewis R, Mark PB, Marks S, Macphee I, McKane W, Mohaupt MG, Pararajasingam R, Kon SP, Serón D, Sinha MD, Tucker B, Viklický O, Lechler RI, Lord GM, Hernandez‐Fuentes MP. Biomarkers of Tolerance in Kidney Transplantation: Are We Predicting Tolerance or Response to Immunosuppressive Treatment? Am J Transplant 2016; 16:3443-3457. [PMID: 27328267 PMCID: PMC5132071 DOI: 10.1111/ajt.13932] [Citation(s) in RCA: 82] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2016] [Revised: 05/12/2016] [Accepted: 06/08/2016] [Indexed: 01/25/2023]
Abstract
We and others have previously described signatures of tolerance in kidney transplantation showing the differential expression of B cell-related genes and the relative expansions of B cell subsets. However, in all of these studies, the index group-namely, the tolerant recipients-were not receiving immunosuppression (IS) treatment, unlike the rest of the comparator groups. We aimed to assess the confounding effect of these regimens and develop a novel IS-independent signature of tolerance. Analyzing gene expression in three independent kidney transplant patient cohorts (232 recipients and 14 tolerant patients), we have established that the expression of the previously reported signature was biased by IS regimens, which also influenced transitional B cells. We have defined and validated a new gene expression signature that is independent of drug effects and also differentiates tolerant patients from healthy controls (cross-validated area under the receiver operating characteristic curve [AUC] = 0.81). In a prospective cohort, we have demonstrated that the new signature remained stable before and after steroid withdrawal. In addition, we report on a validated and highly accurate gene expression signature that can be reliably used to identify patients suitable for IS reduction (approximately 12% of stable patients), irrespective of the IS drugs they are receiving. Only a similar approach will make the conduct of pilot clinical trials for IS minimization safe and hence allow critical improvements in kidney posttransplant management.
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Affiliation(s)
- I. Rebollo‐Mesa
- Medical Research Council Centre for TransplantationKing's College LondonLondonUnited Kingdom,BiostatisticsInstitute of Psychiatry, Psychology and NeuroscienceKing's College LondonLondonUnited Kingdom,UCB CelltechUCB Pharma S.A.SloughUnited Kingdom
| | - E. Nova‐Lamperti
- Medical Research Council Centre for TransplantationKing's College LondonLondonUnited Kingdom
| | - P. Mobillo
- Medical Research Council Centre for TransplantationKing's College LondonLondonUnited Kingdom
| | - M. Runglall
- National Institute for Health Research Biomedical Research CentreGuy's and St. Thomas’ National Health Service Foundation TrustKing's College LondonLondonUnited Kingdom
| | - S. Christakoudi
- Medical Research Council Centre for TransplantationKing's College LondonLondonUnited Kingdom,BiostatisticsInstitute of Psychiatry, Psychology and NeuroscienceKing's College LondonLondonUnited Kingdom
| | - S. Norris
- Medical Research Council Centre for TransplantationKing's College LondonLondonUnited Kingdom,University College LondonLondonUnited Kingdom
| | - N. Smallcombe
- Medical Research Council Centre for TransplantationKing's College LondonLondonUnited Kingdom
| | - Y. Kamra
- Medical Research Council Centre for TransplantationKing's College LondonLondonUnited Kingdom,Peter Gorer Department of ImmunobiologyKing's College LondonLondonUnited Kingdom
| | - R. Hilton
- Guy's and St. Thomas’ NHS Foundation TrustLondonUnited Kingdom
| | - Indices of Tolerance EU Consortium
- King's College LondonLondonUnited Kingdom,Oxford UniversityOxfordUnited Kingdom,Imperial College LondonLondonUnited Kingdom,Institute for Medical Immunology, Université Libre de BruxellesBruxellesBelgium,Miltenyi BiotecBergisch GladbachGermany,University of NantesNantesFrance,Charité, Universitaatsmedizin BerlinBerlinGermany
| | - S. Bhandari
- Hull and East Yorkshire Hospitals NHS TrustHullUnited Kingdom
| | - R. Baker
- St. James's University HospitalLeedsUnited Kingdom
| | | | - S. Carr
- Leicester General HospitalLeicesterUnited Kingdom
| | - D. Game
- Guy's and St. Thomas’ NHS Foundation TrustLondonUnited Kingdom
| | - S. Griffin
- Cardiff and Vale University Health BoardCardiffUnited Kingdom
| | | | - R. Lewis
- Queen Alexandra HospitalPortsmouthUnited Kingdom
| | - P. B. Mark
- University of GlasgowGlasgowUnited Kingdom
| | - S. Marks
- Great Ormond Street Hospital for Children NHS Foundation TrustLondonUnited Kingdom
| | - I. Macphee
- St. George's HospitalLondonUnited Kingdom
| | - W. McKane
- Northern General HospitalSheffieldUnited Kingdom
| | - M. G. Mohaupt
- INSELSPITALUniversitätsspital BernKlinik für Nephrologie/Hypertonie Abteilung für HypertonieBernSwitzerland
| | | | - S. P. Kon
- King's College Hospital NHS Foundation TrustLondonUnited Kingdom
| | - D. Serón
- Hospital Universitari Vall d'Hebr_onBarcelonaSpain
| | - M. D. Sinha
- Evelina London Children's HospitalLondonUnited Kingdom
| | - B. Tucker
- King's College Hospital NHS Foundation TrustLondonUnited Kingdom
| | - O. Viklický
- Transplantační laboratoř IKEMPragueCzech Republic
| | - R. I. Lechler
- Medical Research Council Centre for TransplantationKing's College LondonLondonUnited Kingdom,King's Health PartnersLondonUnited Kingdom
| | - G. M. Lord
- Medical Research Council Centre for TransplantationKing's College LondonLondonUnited Kingdom,National Institute for Health Research Biomedical Research CentreGuy's and St. Thomas’ National Health Service Foundation TrustKing's College LondonLondonUnited Kingdom,Guy's and St. Thomas’ NHS Foundation TrustLondonUnited Kingdom
| | - M. P. Hernandez‐Fuentes
- Medical Research Council Centre for TransplantationKing's College LondonLondonUnited Kingdom,National Institute for Health Research Biomedical Research CentreGuy's and St. Thomas’ National Health Service Foundation TrustKing's College LondonLondonUnited Kingdom
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15
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16
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Höcker B, Zencke S, Pape L, Krupka K, Köster L, Fichtner A, Dello Strologo L, Guzzo I, Topaloglu R, Kranz B, König J, Bald M, Webb NJA, Noyan A, Dursun H, Marks S, Ozcakar ZB, Thiel F, Billing H, Pohl M, Fehrenbach H, Schnitzler P, Bruckner T, Ahlenstiel-Grunow T, Tönshoff B. Impact of Everolimus and Low-Dose Cyclosporin on Cytomegalovirus Replication and Disease in Pediatric Renal Transplantation. Am J Transplant 2016; 16:921-9. [PMID: 26613840 DOI: 10.1111/ajt.13649] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2015] [Revised: 11/16/2015] [Accepted: 11/20/2015] [Indexed: 01/25/2023]
Abstract
In order to investigate the hypothesis that the mammalian target of rapamycin inhibitor everolimus (EVR) shows anticytomegalovirus (CMV) activity in pediatric patients, we analyzed the impact of EVR-based immunosuppressive therapy on CMV replication and disease in a large cohort (n = 301) of pediatric kidney allograft recipients. The EVR cohort (n = 59), who also received low-dose cyclosporin, was compared with a control cohort (n = 242), who was administered standard-dose cyclosporin or tacrolimus and an antimetabolite, mostly mycophenolate mofetil (91.7%). Multivariate analysis revealed an 83% lower risk of CMV replication in the EVR cohort than in the control cohort (p = 0.005). In CMV high-risk (donor+/recipient-) patients (n = 88), the EVR-based regimen was associated with a significantly lower rate of CMV disease (0% vs. 14.3%, p = 0.046) than the standard regimen. In patients who had received chemoprophylaxis with (val-)ganciclovir (n = 63), the CMV-free survival rates at 1 year and 3 years posttransplant (100%) were significantly (p = 0.015) higher in the EVR cohort (n = 15) than in the control cohort (n = 48; 1 year, 75.0%; 3 years, 63.3%). Our data suggest that in pediatric patients at high risk of CMV, an EVR-based immunosuppressive regimen is associated with a lower risk of CMV disease than a standard-dose calcineurin inhibitor-based regimen.
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Affiliation(s)
- B Höcker
- Department of Pediatrics I, University Children's Hospital, Heidelberg, Germany
| | - S Zencke
- Department of Pediatrics I, University Children's Hospital, Heidelberg, Germany
| | - L Pape
- Hanover Medical School, Hanover, Germany
| | - K Krupka
- Department of Pediatrics I, University Children's Hospital, Heidelberg, Germany
| | - L Köster
- Department of Pediatrics I, University Children's Hospital, Heidelberg, Germany.,Institute of Medical Biometry and Informatics, University of Heidelberg, Heidelberg, Germany
| | - A Fichtner
- Department of Pediatrics I, University Children's Hospital, Heidelberg, Germany
| | | | - I Guzzo
- IRCCS Ospedale Pediatrico Bambino Gesù, Rome, Italy
| | - R Topaloglu
- Department of Pediatric Nephrology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - B Kranz
- Department of General Pediatrics, Pediatric Nephrology, University Children's Hospital, Münster, Germany
| | - J König
- Department of General Pediatrics, Pediatric Nephrology, University Children's Hospital, Münster, Germany
| | - M Bald
- Olga Children's Hospital, Clinic of Stuttgart, Stuttgart, Germany
| | - N J A Webb
- Royal Manchester Children's Hospital, Central Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Center, Manchester, UK
| | - A Noyan
- Department of Pediatric Nephrology, Adana Teaching and Research Center, Baskent University, Adana, Turkey
| | - H Dursun
- Department of Pediatric Nephrology, Adana Teaching and Research Center, Baskent University, Adana, Turkey
| | - S Marks
- Great Ormond Street Hospital, London, UK
| | - Z B Ozcakar
- Ankara University Faculty of Medicine, Ankara, Turkey
| | - F Thiel
- University Children's Hospital, Hamburg, Germany
| | - H Billing
- University Children's Hospital, Tübingen, Germany
| | - M Pohl
- University Children's Hospital, Freiburg, Germany
| | | | - P Schnitzler
- Department of Infectious Diseases, Virology, University Hospital Heidelberg, Heidelberg, Germany
| | - T Bruckner
- Institute of Medical Biometry and Informatics, University of Heidelberg, Heidelberg, Germany
| | | | - B Tönshoff
- Department of Pediatrics I, University Children's Hospital, Heidelberg, Germany
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17
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Nwana N, Ho C, Sandul A, Morris S, Marks S. Subpopulations at Risk for Not Completing Once Weekly 12-Dose Regimen of Isoniazid Plus Rifapentine for Treatment of Latent Tuberculosis Infection in United States Tuberculosis Programs. Open Forum Infect Dis 2015. [DOI: 10.1093/ofid/ofv133.434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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18
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Mountjoy M, Junge A, Alonso JM, Clarsen B, Pluim BM, Shrier I, van den Hoogenband C, Marks S, Gerrard D, Heyns P, Kaneoka K, Dijkstra HP, Khan KM. Consensus statement on the methodology of injury and illness surveillance in FINA (aquatic sports): Table 1. Br J Sports Med 2015; 50:590-6. [DOI: 10.1136/bjsports-2015-095686] [Citation(s) in RCA: 70] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/19/2015] [Indexed: 11/03/2022]
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Patel M, Oni L, Jeffers G, Smith E, Midgley A, Tullus K, Pilkington C, Marks S, Beresford M. THU0522 Plasma TNFR1 and TNFR2 in Active Paediatric Lupus Nephritis. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.4921] [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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20
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Ekdawy D, Smith E, Oni L, Midgley A, Corkhill R, Jones C, Marks S, Newland P, Pilkington C, Tullus K, Beresford M. FRI0500 Exploring the Relationship of Urinary Vascular Cell Adhesion Molecule-1 with Lupus Nephritis Disease Activity Over Time. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.4558] [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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21
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Smith E, Oni L, Midgley A, Ekdawy D, Corkhill R, Jones C, Marks S, Newland P, Pilkington C, Tullus K, Beresford M. THU0373 Demonstration of an “Excellent” Biomarker Panel for Identifying Active Lupus Nephritis in Children. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.3352] [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: 11/04/2022]
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22
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Steier C, Madur A, Bailey B, Berg K, Biocca A, Black A, Casey P, Colomb D, Gunion B, Li N, Marks S, Nishimura H, Pappas C, Petermann K, Portmann G, Prestemon S, Rawlins A, Robin D, Rossi S, Scarvie T, Schlueter R, Sun C, Tarawneh H, Wan W, Williams E, Yin L, Zhou Q, Jin J, Zhang J, Chen C, Wen Y, Wu J. Completion of the Brightness Upgrade of the ALS. ACTA ACUST UNITED AC 2014. [DOI: 10.1088/1742-6596/493/1/012030] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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23
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Sag E, Ravelli A, Batu ED, Tartaglione A, Khalil AS, Marks S, Ozen S. PReS-FINAL-2174: The performance of the new slicc criteria for the classification of sle in children. Pediatr Rheumatol Online J 2013. [PMCID: PMC4044175 DOI: 10.1186/1546-0096-11-s2-o9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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24
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Marks M, Perkins A, Russell H, Burrows P, Marks S. Antisperm antibodies: prevalance, patterns and impact on natural conception following vasectomy reversal. Fertil Steril 2013. [DOI: 10.1016/j.fertnstert.2013.07.755] [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: 11/30/2022]
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25
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Bertsias G, Tektonidou M, Amoura Z, Aringer M, Bajema I, Berden J, Boletis J, Cervera R, Dörner T, Doria A, Ferrario F, Flöge J, Houssiau F, Ioannidis J, Isenberg D, Kallenberg C, Lightstone L, Marks S, Martini A, Moroni G, Neumann I, Niaudet P, Praga M, Schneider M, Tesar V, Vasconcelos C, van Vollenhoven R, Zakharova E, Haubitz M, Gordon C, Jayne D, Boumpas D. OP0064 Joint EULAR/ERA-EDTA recommendations for the management of adult and pediatric lupus nephritis. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2012-eular.1747] [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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Lleva P, Ahluwalia BS, Marks S, Sahni R, Tenner M, Risucci DA, Lai HM, Li J. Traumatic and spontaneous carotid and vertebral artery dissection in a level 1 trauma center. J Clin Neurosci 2012; 19:1112-4. [PMID: 22705134 DOI: 10.1016/j.jocn.2011.11.018] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2011] [Accepted: 11/20/2011] [Indexed: 10/28/2022]
Abstract
This study aimed to compare traumatic and spontaneous carotid artery dissection (CAD) and vertebral artery dissection (VAD) with respect to age, pre-morbid risk factors, and site of dissection. Chart review was performed for 49 patients with CAD and VAD admitted to Westchester Medical Center, a level 1 trauma center, from 1999 to 2007. Presentation was categorized into traumatic (n=28, 57%) or spontaneous dissection (n=21, 43%). Pre-morbid risk factors were analyzed. Location of dissection was identified and categorized into four possible segments. Patients with spontaneous dissection were likely to be over the age of 50 years (p<0.05), and had significantly higher proportions of coronary artery disease (33% compared to 7%, p<0.05), hypertension (57% compared to 18%; p<0.01), and hypercholesterolemia (29% compared to 0%; p<0.01). Of the 49 patients, 42 had imaging studies available for segmental analysis. In both traumatic CAD and VAD, dissection at Segment III (corresponds with the first and second cervical vertebrae), was the most common site (37.5% and 50%, respectively, p<0.05). In contrast, Segment I (origin of the vessel to the fifth cervical vertebrae) was the most common site for spontaneous CAD and VAD (55% and 77%, respectively, p<0.05). This cross-sectional study suggests that etiology plays an important role in the location of dissection. Traumatic CAD and VAD occur most commonly in Segment III. Spontaneous CAD and VAD occur most commonly in Segment I and are associated with increasing age and premorbid cerebrovascular risk factors.
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Affiliation(s)
- P Lleva
- Department of Neurology, Munger Pavilion, 4th Floor, New York Medical College, Valhalla, NY 10595, USA
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McCord K, Morley P, Armstrong J, Simpson K, Rishniw M, Forman M, Biller D, Parnell N, Arnell K, Hill S, Avgeris S, Gittelman H, Moore M, Hitt M, Oswald G, Marks S, Burney D, Twedt D. A Multi-Institutional Study Evaluating the Diagnostic Utility of the Spec cPL™ and SNAP® cPL™ in Clinical Acute Pancreatitis in 84 Dogs. J Vet Intern Med 2012; 26:888-96. [DOI: 10.1111/j.1939-1676.2012.00951.x] [Citation(s) in RCA: 76] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2011] [Revised: 03/27/2012] [Accepted: 04/24/2012] [Indexed: 11/26/2022] Open
Affiliation(s)
- K. McCord
- Colorado State University; Fort Collins; CO
| | | | | | | | | | | | - D. Biller
- Kansas State University; Manhattan; KS
| | | | - K. Arnell
- Veterinary Specialty Hospital; San Diego; CA
| | - S. Hill
- Veterinary Specialty Hospital; San Diego; CA
| | - S. Avgeris
- Atlanta Veterinary Imaging and Diagnostics; Atlanta; GA
| | | | - M. Moore
- VCA All Care Referral Center; Fountain Valley; CA
| | - M. Hitt
- Atlantic Internal Medicine; Annapolis; MD
| | - G. Oswald
- Tampa Bay Veterinary Specialists; Largo; FL
| | - S. Marks
- University of California-Davis; Davis; CA
| | - D. Burney
- Gulf Coast Veterinary Specialists; Houston; TX
| | - D. Twedt
- Colorado State University; Fort Collins; CO
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Shi H, Wen J, LI Z, Elsayed M, Kamal K, LI Z, Wen J, Shi H, El Shal A, Youssef D, Caubet C, Lacroix C, Benjamin B, Bandin F, Bascands JL, Monsarrat B, Decramer S, Schanstra J, Laetitia DB, Ulinski T, Aoun B, Ozdemir K, Dincel N, Sozeri B, Mir S, Dincel N, Berdeli A, Mir S, Akyigit F, Mizerska-Wasiak M, Panczyk-Tomaszewska M, Szymanik-Grzelak H, Roszkowska-Blaim M, Jamin A, Dehoux L, Monteiro RC, Deschenes G, Bouts A, Davin JC, Dorresteijn E, Schreuder M, Lilien M, Oosterveld M, Kramer S, Gruppen M, Pintos-Morell G, Ramaswami U, Parini R, Rohrbach M, Kalkum G, Beck M, Carter M, Antwi S, Callegari J, Kotanko P, Levin NW, Rumjon A, Macdougall IC, Turner C, Booth CJ, Goldsmith D, Sinha MD, Camilla R, Camilla R, Loiacono E, Donadio ME, Conrieri M, Bianciotto M, Bosetti FM, Peruzzi L, Conti G, Bitto A, Amore A, Coppo R, Mizerska-Wasiak M, Roszkowska-Blaim M, Maldyk J, Chou HH, Chiou YY, Bochniewska V, Jobs K, Jung A, Fallahzadeh Abarghooei MH, Zare J, Sedighi Goorabi V, Derakhshan A, Basiratnia M, Fallahzadeh Abarghooei MA, Hosseini Al-Hashemi G, Fallahzadeh Abarghooei F, Kluska-Jozwiak A, Soltysiak J, Lipkowska K, Silska M, Fichna P, Skowronska B, Stankiewicz W, Ostalska-Nowicka D, Zachwieja J, Girisgen L, Sonmez F, Yenisey C, Kis E, Cseprekal O, Kerti A, Szabo A, Salvi P, Benetos A, Tulassay T, Reusz G, Makulska I, Szczepanska M, Drozdz D, Zwolnska D, Sozeri B, Berdeli A, Mir S, Tolstova E, Anis L, Ulinski T, Alber B, Edouard B, Gerard C, Seni K, Dunia Julienne Hadiza T, Christian S, Benoit T, Francois B, Adama L, Rosenberg A, Munro J, Murray K, Wainstein B, Ziegler J, Singh-Grewal D, Boros C, Adib N, Elliot E, Fahy R, Mackie F, Kainer G, Polak-Jonkisz D, Zwolinska D, Laszki-Szczachor K, Zwolinska D, Janocha A, Rusiecki L, Sobieszczanska M, Garzotto F, Ricci Z, Clementi A, Cena R, Kim JC, Zanella M, Ronco C, Polak-Jonkisz D, Zwolinska D, Purzyc L, Zwolinska D, Makulska I, Szczepanska M, Peco-Antic A, Kotur-Stevuljevic J, Paripovic D, Scekic G, Milosevski-Lomic G, Bogicevic D, Spasojevic-Dimitrijeva B, Hassan R, El-Husseini A, Sobh M, Ghoneim M, Harambat J, Bonthuis M, Van Stralen KJ, Ariceta G, Battelino N, Jahnukainen T, Sandes AR, Combe C, Jager KJ, Verrina E, Schaefer F, Espindola R, Bacchetta J, Cochat P, Stefanis C, Leroy S, Leroy S, Fernandez-Lopez A, Nikfar R, Romanello C, Bouissou F, Gervaix A, Gurgoze M, Bressan S, Smolkin V, Tuerlinkx D, Stefanidis C, Vaos G, Leblond P, Gungor F, Gendrel D, Chalumeau M, Rumjon A, Macdougall IC, Turner C, Rawlins D, Booth CJ, Simpson JM, Sinha MD, Arnaud G, Arnaud G, Anne M, Stephanie T, Flavio B, Veronique FB, Stephane D, Mumford L, Marks S, Ahmad N, Maxwell H, Tizard J, Vidal E, Amigoni A, Varagnolo M, Benetti E, Ghirardo G, Brugnolaro V, Murer L, Aoun B, Christine G, Alber B, Ulinski T, Aoun B, Decramer S, Bandin F, Ulinski T, Degi A, Degi A, Kerti A, Kis E, Cseprekal O, Szabo AJ, Reusz GS, Ghirardo G, Vidoni A, Vidal E, Benetti E, Ramondo G, Miotto D, Murer L. Paediatric nephrology. Nephrol Dial Transplant 2012. [DOI: 10.1093/ndt/gfs250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Fatkenheuer G, Duvivier C, Rieger A, Durant J, Rey D, Schmidt W, Hill A, van Delft Y, Marks S, Rieger A, Vetter N, Greil R, Pedersen C, Storgaard M, Morlat P, Katlama C, Durant J, Cotte L, Duvvier C, Rey D, Esser S, Stellbrink C, Schmidt W, Stoll M, Stephan C, Fatkenheuer G, Stoehr A, Rockstroh J, Banhegyi D, Itzchak L, Shahar E, Maayan S, Turner D, Lazzarin A, Antinori A, Carosi G, Minoli L, di Perri G, Filice G, Andreoni M, Duiculescu D, Rugina S, Erscoiu S, Streinu A, Pronin A, Pokrovsky V, Gruzdev B, Yakovlev A, Voronin E, Clotet B, Gatell J, Arribas J, Podzamczer D, Domingo P, Miralles Alvarez C, Hernandez Quero J, Furrer H, Feher J, Johnson M, Fox J, Nelson M, Fisher M, Orkin C. Lipid profiles for etravirine versus efavirenz in treatment-naive patients in the randomized, double-blind SENSE trial. J Antimicrob Chemother 2011; 67:685-90. [DOI: 10.1093/jac/dkr533] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Florence E, De Wit S, Castagna A, Ribera E, Hill A, Vanaken H, van Delft Y, Marks S. HIV RNA suppression rates after 24 weeks of treatment with etravirine, darunavir/ritonavir and raltegravir in the etravirine early access programme. Int J STD AIDS 2010; 21:224-5. [DOI: 10.1258/ijsa.2009.009425] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- E Florence
- Prince Leopold Institute of Tropical Medicine, Antwerp
| | - S De Wit
- St Pierre University Hospital, Brussels, Belgium
| | - A Castagna
- Department of Infectious Diseases, IRCCS, San Raffaele Hospital, Milan, Italy
| | - E Ribera
- Hopital Vall d'Hebron, Barcelona, Spain
| | - A Hill
- University of Liverpool, Liverpool, UK
| | | | - Y van Delft
- Janssen-Cilag B.V., Tilburg, The Netherlands
| | - S Marks
- Janssen-Cilag B.V., Tilburg, The Netherlands
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Agarwal S, Gabriel CM, Campbell VL, Marks S. Steroid responsive metastatic epidural nerve root infiltration with chronic lymphocytic leukaemia. QJM 2010; 103:55-6. [PMID: 19531729 DOI: 10.1093/qjmed/hcp074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- S Agarwal
- Department of Neurology, St. Mary's Hospital, Imperial College NHS Trust, Paddington, London W2 1NY, UK.
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Affiliation(s)
- Suzanne Marks
- Clinical and Health Systems Research Branch, Division of Tuberculosis Elimination, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, US Centers for Disease Control and Prevention.
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Qiao S, Ma D, Feng D, Marks S, Schlueter R, Prestemon S, Hussain Z. Knot undulator to generate linearly polarized photons with low on-axis power density. Rev Sci Instrum 2009; 80:085108. [PMID: 19725682 DOI: 10.1063/1.3204452] [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] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
Heat load on beamline optics is a serious obstacle for devices designed to generate pure linearly polarized photons in third generation synchrotron radiation facilities. For permanent magnet undulators, this problem can be overcome by implementing a figure-eight design configuration. As yet there has been no good method to tackle this problem for electromagnetic elliptical undulators. Here, a novel design and operational mode is suggested, which can generate pure linearly polarized photons with very low on-axis heat load. Additionally, the minimum photon energy capability of linearly polarized photons can be significantly extended by this method.
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Affiliation(s)
- S Qiao
- Department of Physics, Laboratory of Advanced Materials, Fudan University, Shanghai 200433, People's Republic of China
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Al Midani A, Rudarakanchana N, Marks S, Taylor J, Lord R. Change in practice from heparin to aspirin prophylaxis significantly reduced the thrombosis rate in renal paediatric recipients in a single centre. Br J Surg 2009. [DOI: 10.1002/bjs.6521] [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: 11/08/2022]
Affiliation(s)
- A Al Midani
- Royal Free Hospital, London; Great Ormond Street Hospital for Children, London
| | - N Rudarakanchana
- Royal Free Hospital, London; Great Ormond Street Hospital for Children, London
| | - S Marks
- Royal Free Hospital, London; Great Ormond Street Hospital for Children, London
| | - J Taylor
- Royal Free Hospital, London; Great Ormond Street Hospital for Children, London
| | - R Lord
- Royal Free Hospital, London; Great Ormond Street Hospital for Children, London
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Marks S, Varma R, Cantrell W, Chen SC, Gold M, Muellenhoff M, Elewski B. Diclofenac sodium 3% gel as a potential treatment for disseminated superficial actinic porokeratosis. J Eur Acad Dermatol Venereol 2009; 23:42-5. [DOI: 10.1111/j.1468-3083.2008.02943.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Ribera E, Florence E, De Wit S, Castagna A, Ryan B, Vanaken H, Hill AM, Marks S. Switching from enfuvirtide to etravirine – efficacy results from the etravirine expanded access programme. J Int AIDS Soc 2008. [DOI: 10.1186/1758-2652-11-s1-p37] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Florence E, De Wit S, Castagna A, Ribera E, Hill AM, Ryan R, Vanaken H, Marks S, van Delft Y. Antiretroviral treatment use and HIV-RNA suppression rates for 877 European patients in the etravirine expanded access programme. J Int AIDS Soc 2008. [DOI: 10.1186/1758-2652-11-s1-p36] [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: 11/10/2022] Open
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Abstract
We describe five babies, who were exclusively breast fed, with life-threatening complications of hypernatraemic dehydration secondary to inadequate breast feeding. An increased awareness among health professionals is required so that this potentially devastating condition can be prevented.
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Affiliation(s)
- R Shroff
- Department of Nephrourology, Great Ormond Street Hospital for Children, London, UK
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Peirone A, Lee K, Golding I, Marks S, Russell J, Benson L. Exercise performance and blood pressure responses in children after stenting of aortic coarctation. Progress in Pediatric Cardiology 2006. [DOI: 10.1016/j.ppedcard.2006.07.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Swinburn BA, Carey D, Hills AP, Hooper M, Marks S, Proietto J, Strauss BJ, Sullivan D, Welborn TA, Caterson ID. Effect of orlistat on cardiovascular disease risk in obese adults. Diabetes Obes Metab 2005; 7:254-62. [PMID: 15811142 DOI: 10.1111/j.1463-1326.2004.00467.x] [Citation(s) in RCA: 56] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
AIM The aim of this study is to compare the effect of orlistat vs. placebo on the predicted 10-year cardiovascular disease (CVD) risk in obese people with one or more cardiovascular risk factors treated for 12 months, in conjunction with a fat-reduced, but otherwise ad libitum, diet. METHODS A double-blind, randomized, placebo-controlled, parallel study was performed in conjunction with a fat-reduced diet and physical activity advice for 1 year. Participants (n = 339) from eight centres in Australia and New Zealand were randomized to either orlistat (120 mg) three times daily (n = 104 women, 66 men; mean +/- s.d. age = 52.0 +/- 7.5 years, body mass index (BMI) = 37.6 +/- 5.1 kg/m(2)) or placebo three times daily (n = 89 women, 80 men; age = 52.5 +/- 7.4 years, BMI = 38.0 +/- 4.9 kg/m(2)). The primary efficacy criterion was the 10-year risk of developing CVD calculated from the Framingham equation. Secondary efficacy criteria were body weight, waist circumference, blood pressure and serum concentrations of triglycerides, cholesterol (total, LDL and HDL), glucose, insulin and glycated haemoglobin and quality of life. RESULTS There was no difference in the change in 10-year CVD risk between orlistat and placebo groups over 1 year. The orlistat group, however, had significant favourable changes in many of the individual CVD risk factors (total cholesterol, LDL-cholesterol, glucose, glycated haemoglobin, insulin, body weight and waist circumference) and one of the domains of quality of life measured by means of the SF-36 questionnaire (vitality), compared to the placebo group. Significant reductions in medication use for hypertension and diabetes were observed in the orlistat group, compared to those in placebo, but there were no significant differences in medication use for blood lipids. CONCLUSIONS Orlistat may have reduced CVD risk, as judged by the favourable changes in individual risk factors and reductions in medication use, but the method used in order to measure absolute CVD risk in this study (Framingham CVD equation) was not sensitive enough to detect the changes in this relatively low-risk group (approximately 10% of risk of a CVD event over 10 years).
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Affiliation(s)
- B A Swinburn
- Department of Community Health, University of Auckland, Auckland, New Zealand.
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Wilce M, Shrestha-Kuwahara R, Taylor Z, Qualls N, Marks S. Tuberculosis contact investigation policies, practices, and challenges in 11 U.S. communities. J Public Health Manag Pract 2002; 8:69-78. [PMID: 12463053 PMCID: PMC5444206 DOI: 10.1097/00124784-200211000-00010] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [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: 11/27/2022]
Abstract
To describe the policies and procedures used by 11 urban tuberculosis control programs to conduct contact investigations, written policies were reviewed and semistructured interviews were conducted with program managers and staff. Qualitative analysis showed that contact investigation policies and procedures vary widely. Most policies address risk factor assessment and contact prioritization; however, none of the policies provide comprehensive guidance for the entire process. Staffing patterns vary, but, overall, staff receive little formal training; informal monitoring practices predominate. Comprehensive guidelines and programmatic support are needed to improve the quality of contact investigation processes.
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Affiliation(s)
- Maureen Wilce
- Division of Tuberculosis Elimination, Centers for Disease, Control and Prevention (CDC), Atlanta, Georgia, USA
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Young AT, Arenholz E, Marks S, Schlueter R, Steier C, Padmore HA, Hitchcock AP, Castner DG. Variable linear polarization from an X-ray undulator. J Synchrotron Radiat 2002; 9:270-274. [PMID: 12091739 DOI: 10.1107/s0909049502007161] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/12/2001] [Accepted: 04/18/2002] [Indexed: 05/23/2023]
Abstract
A new X-ray undulator has been designed and constructed which produces linearly polarized X-rays in which the plane of polarization can be oriented to a user selectable angle, from horizontal to vertical. Based on the Apple-II elliptically polarizing undulator (EPU), the undulator rotates the angle of the linear polarization by a simple longitudinal motion of the undulator magnets. Combined with the circular and elliptical polarization capabilities of the EPU operating in the standard mode, this new undulator produces soft X-ray radiation with versatile polarization control. This paper describes the magnetic structure of the device and presents an analysis of the magnetic field with varying undulator parameters. The variable linear polarization capability is then exhibited by measuring the X-ray absorption spectrum of an oriented polytetrafluoroethylene thin film. This experiment, which measures the linear dichroism of the sample at two peaks near the C 1s absorption edge, demonstrates the continuous polarization rotation capabilities of the undulator.
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Affiliation(s)
- A T Young
- Advanced Light Source Division, Lawrence Berkeley National Laboratory, Berkeley, CA 94720, USA.
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Abstract
Much of nursing practice is (and always has been) based on information generated through inquiry. Finding the best answers quickly and effectively for the questions that arise in the clinical setting facilitates care, increases nursing efficiency, and improves patient outcome and satisfaction. Posing clinical questions also can help nurses identify and fill in gaps in knowledge, keep up with advances in clinical practice, and strengthen interactions with their peers, team members, and patients and their families. Formulating clinical questions that lead to sound, evidence-based answers to resolve clinical problems or direct patient-care decisions takes time and practice. The information in this article will assist nurses to develop the skill of framing clinical questions efficiently and effectively.
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Affiliation(s)
- K A McKibbon
- Department of Clinical Epidemiology and Biostatistics, Health Information Research Unit, Room 3H7C, Health Science Centre, McMaster University, Faculty of Health Sciences, 1200 Main Street West, Hamilton, Ontario, Canada L8N 3Z5.
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Ciliska D, Cullum N, Marks S. Evaluation of systematic reviews of treatment or prevention interventions. Evid Based Nurs 2001; 4:100-4. [PMID: 11762092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/23/2023]
Affiliation(s)
- D Ciliska
- School of Nursing, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
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Stott T, Leeks G, Marks S, Sawyer A. Environmentally sensitive plot-scale timber harvesting: impacts on suspended sediment, bedload and bank erosion dynamics. J Environ Manage 2001; 63:3-25. [PMID: 11591028 DOI: 10.1006/jema.2001.0459] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
The impact on sediment pollution of environmentally sensitive harvesting of a 15 ha plot (20% of the catchment area) of mature coniferous plantation forest in the 0.89 km2 Afon Tanllwyth catchment, Plynlimon, was investigated for 12 months before harvesting began and a further 18 months after. The results revealed: (a) a steepening of the suspended sediment concentration vs. discharge rating curve resulting in a 39% increase in suspended sediment yield (as compared to the adjacent forested Hafren catchment) during the year in which the harvesting operations took place; (b) a statistically significant increase in main channel bank erosion rates, as compared with the nearby Afon Cyff; main channel banks are estimated to have contributed around 80% of the total catchment suspended sediment yield during the two year period (1995-1996), and (c) no significant change in bedload yields over the duration of the study, though a longer post-harvesting time series of bedload data will be required to properly assess the impact of the harvesting operation upon bedload yields. Forest management implications of these findings are discussed in detail with respect to the existing Forest and Water guidelines.
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Affiliation(s)
- T Stott
- Liverpool John Moores University, I. M. Marsh Campus, Barkhill Road, Liverpool L17 6BD, UK.
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Marks S. The role of orlistat in weight management. Aust Fam Physician 2001; 30:335-8. [PMID: 11355219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/16/2023]
Abstract
BACKGROUND Most antiobesity drugs act centrally to reduce appetite or increase satiety. Orlistat is the first in a new class of drugs targeted at a single dietary component, in this case dietary fat. OBJECTIVE To review the clinical actions and efficacy of orlistat and to discuss its place in overall weight management. DISCUSSION Orlistat is best used in long term weight management as an adjunct to dietary modification and increased physical activity. The reduction in fat absorption results in a slow but sustained weight reduction and improved metabolic parameters such as reduced total, and LDL cholesterol. Side effects are minimised by maintaining a low fat diet.
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Affiliation(s)
- S Marks
- Monash Medical Centre, Melbourne, Victoria
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