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Abstract
All organisms are exposed constantly to a variety of infectious and injurious stimuli. These induce inflammatory responses tailored to the threat posed. While the innate immune system is the front line of response to each stimulant, it has been considered traditionally to lack memory, acting in a generic fashion until the adaptive immune arm can take over. This outmoded simplification of the roles of innate and acquired arms of the immune system has been challenged by evidence of myeloid cells altering their response to subsequent encounters based on earlier exposure. This concept of 'innate immune memory' has been known for nearly a century, and is accepted among myeloid biologists. In recent years other innate immune cells, such as natural killer cells, have been shown to display memory, suggesting that innate immune memory is a trait common to several cell types. During the last 30 years, evidence has slowly accumulated in favour of not only haematopoietic cells, but also stromal cells, being imbued with memory following inflammatory episodes. A recent publication showing this also to be true in epithelial cells suggests innate immune memory to be widespread, if under-appreciated, in non-haematopoietic cells. In this review, we will examine the evidence supporting the existence of innate immune memory in stromal cells. We will also discuss the ramifications of memory in long-lived tissue-resident cells. Finally, we will pose questions we feel to be important in the understanding of these forgotten cells in the field of innate memory.
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Affiliation(s)
- T. Crowley
- Institute of Inflammation and Ageing, College of Medical and Dental SciencesUniversity of BirminghamBirmingham, UK
| | - C. D. Buckley
- Institute of Inflammation and Ageing, College of Medical and Dental SciencesUniversity of BirminghamBirmingham, UK
- Kennedy Institute of Rheumatology, University of Oxford, Oxford, UKUniversity of OxfordOxfordUK
| | - A. R. Clark
- Institute of Inflammation and Ageing, College of Medical and Dental SciencesUniversity of BirminghamBirmingham, UK
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Hunt EB, Murphy B, Murphy C, Crowley T, Cronin O, Hay S, Stack M, Bowen B, Ronan NJ, Greene E, Eustace JA, Plant BJ, Murphy DM. A Study To Assess The Prevalence Of Exercise-Induced Bronchoconstriction In Inter-County Hurling. Ir Med J 2017; 110:655. [PMID: 29465845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Exercise-Induced Bronchoconstriction (EIB) is an acute, transient airway narrowing occurring after exercise which may impact athletic performance. Studies report 10% of the general population and up to 90% of asthmatics experience EIB. Ninety-two players from three elite hurling squads underwent a spirometric field-based provocation test with real-time heart rate monitoring and lactate measurements to ensure adequate exertion. Players with a new diagnosis of EIB and those with a negative field-test but with a previous label of EIB or asthma underwent further reversibility testing and if negative, methacholine challenge. Eight (8.7%) of players had EIB, with one further athlete having asthma with a negative field test. Interestingly, only three out of 12 players who had previously been physician-labelled with EIB or asthma had their diagnosis objectively confirmed. Our study highlights the role of objective testing in EIB.
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Affiliation(s)
- E B Hunt
- Department of Respiratory Medicine, Cork University Hospital
- Health Research Board Clinical Research Facility, University College Cork, Cork
| | | | | | | | - O Cronin
- Department of Respiratory Medicine, Cork University Hospital
| | - S Hay
- Department of Respiratory Medicine, Cork University Hospital
| | - M Stack
- Department of Respiratory Medicine, Cork University Hospital
| | - B Bowen
- Department of Respiratory Medicine, Cork University Hospital
| | - N J Ronan
- Department of Respiratory Medicine, Cork University Hospital
| | - E Greene
- Department of Respiratory Medicine, Cork University Hospital
| | - J A Eustace
- Health Research Board Clinical Research Facility, University College Cork, Cork
| | - B J Plant
- Department of Respiratory Medicine, Cork University Hospital
- Health Research Board Clinical Research Facility, University College Cork, Cork
| | - D M Murphy
- Department of Respiratory Medicine, Cork University Hospital
- Health Research Board Clinical Research Facility, University College Cork, Cork
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Ross EA, Naylor AJ, O'Neil JD, Crowley T, Ridley ML, Crowe J, Smallie T, Tang TJ, Turner JD, Norling LV, Dominguez S, Perlman H, Verrills NM, Kollias G, Vitek MP, Filer A, Buckley CD, Dean JL, Clark AR. Treatment of inflammatory arthritis via targeting of tristetraprolin, a master regulator of pro-inflammatory gene expression. Ann Rheum Dis 2016; 76:612-619. [PMID: 27597652 PMCID: PMC5446007 DOI: 10.1136/annrheumdis-2016-209424] [Citation(s) in RCA: 51] [Impact Index Per Article: 6.4] [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: 02/23/2016] [Revised: 08/10/2016] [Accepted: 08/11/2016] [Indexed: 02/07/2023]
Abstract
OBJECTIVES Tristetraprolin (TTP), a negative regulator of many pro-inflammatory genes, is strongly expressed in rheumatoid synovial cells. The mitogen-activated protein kinase (MAPK) p38 pathway mediates the inactivation of TTP via phosphorylation of two serine residues. We wished to test the hypothesis that these phosphorylations contribute to the development of inflammatory arthritis, and that, conversely, joint inflammation may be inhibited by promoting the dephosphorylation and activation of TTP. METHODS The expression of TTP and its relationship with MAPK p38 activity were examined in non-inflamed and rheumatoid arthritis (RA) synovial tissue. Experimental arthritis was induced in a genetically modified mouse strain, in which endogenous TTP cannot be phosphorylated and inactivated. In vitro and in vivo experiments were performed to test anti-inflammatory effects of compounds that activate the protein phosphatase 2A (PP2A) and promote dephosphorylation of TTP. RESULTS TTP expression was significantly higher in RA than non-inflamed synovium, detected in macrophages, vascular endothelial cells and some fibroblasts and co-localised with MAPK p38 activation. Substitution of TTP phosphorylation sites conferred dramatic protection against inflammatory arthritis in mice. Two distinct PP2A agonists also reduced inflammation and prevented bone erosion. In vitro anti-inflammatory effects of PP2A agonism were mediated by TTP activation. CONCLUSIONS The phosphorylation state of TTP is a critical determinant of inflammatory responses, and a tractable target for novel anti-inflammatory treatments.
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Affiliation(s)
- E A Ross
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
| | - A J Naylor
- Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK
| | - J D O'Neil
- Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK
| | - T Crowley
- Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK
| | - M L Ridley
- Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK
| | - J Crowe
- Kennedy Institute of Rheumatology, University of Oxford, Oxford, UK
| | - T Smallie
- Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK
| | - T J Tang
- Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK
| | - J D Turner
- Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK
| | - L V Norling
- William Harvey Research Institute, QMUL, London, UK
| | - S Dominguez
- Division of Rheumatology, Northwestern University, Chicago, Illinois, USA
| | - H Perlman
- Division of Rheumatology, Northwestern University, Chicago, Illinois, USA
| | - N M Verrills
- School of Biomedical Sciences and Pharmacy, University of Newcastle, Callaghan, New South Wales, Australia
| | - G Kollias
- Division of Immunology, Biomedical Sciences Research Center 'Alexander Fleming', Vari, Greece
| | - M P Vitek
- Cognosci Inc., Research Triangle Park, North Carolina, USA
| | - A Filer
- Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK
| | - C D Buckley
- Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK
| | - J L Dean
- Kennedy Institute of Rheumatology, University of Oxford, Oxford, UK
| | - A R Clark
- Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK
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Bell C, Richardson D, Goldmeier D, Crowley T, Kocsis A, Hill S. Persistent sexual arousal in a woman with associated cardiac defects and raised atrial natriuretic peptide. Int J STD AIDS 2016; 18:130-1. [PMID: 17331290 DOI: 10.1258/095646207779949592] [Citation(s) in RCA: 23] [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] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
The persistent sexual arousal syndrome (PSAS) is a newly described entity where the woman becomes involuntarily genitally aroused for extended periods of time in the absence of sexual desire and is distressed by this situation. The cause of this sexual problem is not well understood. We describe such a case where the subjective feelings were confirmed by observing genital engorgement. In her case, PSAS came on after initiation of fludrocortisone given for hypotension and bradycardia that was associated with an atrial septal defect (ASD). We argue that the combined effect of the ASD and fludrocortisone may be associated with an increase in her levels of atrial natriuretic peptide (ANP). ANP causes profound vasodilation and vascular leakage. We postulate that the high serum levels of ANP in her case may be contributory to her PSAS.
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Affiliation(s)
- C Bell
- The Jane Wadsworth Clinic, St Mary's Hospital, London, UK
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Goldmeier D, Mears A, Hiller J, Crowley T. Persistent genital arousal disorder: a review of the literature and recommendations for management. Int J STD AIDS 2009; 20:373-7. [PMID: 19451319 DOI: 10.1258/ijsa.2009.009087] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Persistent genital arousal disorder is a newly recognized condition that is poorly understood. There is a paucity of research in this area and there are concerns as to the validity of the results of what little research there has been. This article aims to draw together current literature on this topic and provide readers with guidance on the management of this condition. This includes a working definition, an exploration of possible aetiologies within the confines of current knowledge, practical advice regarding assessment, management and auditable outcomes of practice.
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Affiliation(s)
- D Goldmeier
- Jefferiss Wing, Imperial College NHS Trust, London.
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Hennessy B, Murray I, O'Connor K, Crowley T, Higgins T, Kent D. Prevailing attitude amongst current senior intercounty hurlers to head and facial protection: a pilot study. Ir J Med Sci 2007; 176:279-81. [PMID: 17704966 DOI: 10.1007/s11845-007-0073-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2006] [Accepted: 07/18/2007] [Indexed: 10/22/2022]
Abstract
BACKGROUND Head and facial injury is a major cause of morbidity associated with the game of hurling. Yet, little is known about either players' experience of these injuries and their prevention with safety devices. AIMS To survey the attitude of some of the country's senior intercounty players towards the use of protective head and facial devices and their experience of injuries relating to the head and face. METHODS A questionnaire-based study. Player attitude to the use of protective devices will be reported here. RESULTS Forty-five players completed the survey. Thirty-two (71%) players currently wear helmets with 28 (87.5%) of these also wearing faceguards. Twenty-four (75%) players have been injured despite wearing a helmet and/or faceguard. Thirteen (40.6%) players expressed frustration with helmet performance. CONCLUSIONS Injury is an unavoidable feature of hurling. To this end perhaps more should be done to involve players in overall apparatus design and safety.
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Affiliation(s)
- B Hennessy
- Tullaroan GAA Club, Tullaroan, Co, Kilkenny, Ireland
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O'Connor K, Hennessy B, Murray I, Crowley T, Higgins T, Kent D. Prevalence of head and facial trauma in current senior intercounty hurlers. Ir Med J 2006; 99:17-8. [PMID: 16506685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
Head and facial injury are a major cause of morbidity associated with the game of hurling. A questionnaire-based study was undertaken to survey the attitude of some of the country's top senior intercounty players towards the use of protective head and facial wear and their experience of injuries relating to the head and face. Player's experience of head and facial injury will be reported here. Forty five players completed the survey. Thirty nine players (86.7%) have received injuries to the head and face during their careers. Thirteen (33.3%) of these players received such injuries on at least 5 occasions. Twenty five players (64.1%) have received eye injuries, 14 (56%) of which were described as serious by the players. Only 6 (42.9%) of these 14 players underwent a subsequent eye examination. In conclusion, these findings underscore the necessity of both compulsory head and facial protection and less haphazard access to specialist care.
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Affiliation(s)
- K O'Connor
- Glanbia PLC, Dungarvan, Co Waterford, UK
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Mostyn PA, Crowley T, Keane FEA. Private Prescription Costs for Sildenafil within the NHS: A Telephone Survey. Int J STD AIDS 2004; 15:314-5. [PMID: 15117499 DOI: 10.1177/095646240401500507] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Because of the restrictions on prescribing for impotence within the NHS, doctors routinely write private prescriptions for sildenafil. The aim of this study was to determine the variation in cost of a private prescription of four 100mg tablets of sildenafil, A selection of different pharmacy types within five areas in England was surveyed. We telephoned a total of 86 pharmacies and we were quoted prices ranging from £28.20 to £42.33. There was a significant difference in price between area and between pharmacy type. Best prices are not necessarily found at the major pharmacy chains or hospital pharmacies, as might be expected. NHS doctors and patients need to be aware of this significant difference in cost.
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Affiliation(s)
- P A Mostyn
- Department of Sexual Health, King's College Hospital, and Victoria Sexual Health Clinic, Chelsea & Westminster Healthcare, UK
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Cahill D, Crowley T, Fleming C, Paul I, Horner P, Caul O. Elevated serum antibodies to C. trachomatis: upper genital tract damage and other associated findings in women not seeking fertility. Fertil Steril 2001. [DOI: 10.1016/s0015-0282(01)02545-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Crowley T, Low N, Turner A, Harvey I, Bidgood K, Horner P. Antibiotic prophylaxis to prevent post-abortal upper genital tract infection in women with bacterial vaginosis: randomised controlled trial. BJOG 2001; 108:396-402. [PMID: 11305547 DOI: 10.1111/j.1471-0528.2001.00091.x] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To determine the prevalence of bacterial vaginosis in women undergoing first trimester suction termination of pregnancy and to evaluate the efficacy of metronidazole in reducing the risk of post abortal pelvic infection in women with bacterial vaginosis. DESIGN Randomised double-blind placebo-controlled trial. SETTING Two teaching hospitals and one district general hospital. SAMPLE Two hundred and seventy-three women with bacterial vaginosis undergoing termination of pregnancy. METHODS Women with bacterial vaginosis, diagnosed using modified Spiegel's criteria, were individually randomised to receive either a 2 g metronidazole suppository or identical placebo per-operatively. Participants, doctors and investigators were blinded to treatment allocation. Participants were asked to complete a questionnaire about post-operative symptoms, visits to the general practitioner, antibiotic treatment, readmission to hospital, contraception and emotional response after one month. RESULTS The prevalence of bacterial vaginosis was 29.3% (326/1,111). Intention-to-treat analysis showed that post-operative upper genital tract infection developed in 12/142 (8.5%) women allocated to metronidazole and 21/131 (16.0%) women randomised to placebo, a difference of 7.6% (95% confidence intervals -15.4 to +0.2%; relative risk 0.53. 0.27 to 1.03, P = 0.055). The effect of prophylaxis was similar when the analysis was restricted to women receiving the allocated treatment and with complete follow up. There was no difference in the risk of readmission to hospital and the frequencies of self reported symptoms in the two groups were similar. CONCLUSION This randomised placebo-controlled trial among women with bacterial vaginosis provides weak evidence that metronidazole decreases the risk of upper genital tract infection after first trimester suction termination of pregnancy but a chance finding could not confidently be excluded. Large well-conducted randomised trials with long term outcome measures are now needed to determine the most effective antibiotic combinations and strategy for prevention of post-abortal pelvic infection.
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Affiliation(s)
- T Crowley
- Department of Sexual Health Medicine, Bristol Royal Infirmary, UK
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Crowley T, Horner P, Greenhouse P, Price J, Carey H, Foley D. Sexual health of adolescents in the UK. Int J STD AIDS 2000; 11:759-60. [PMID: 11089793 DOI: 10.1258/0956462001915093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Caul EO, Paul I, Herring AJ, Horner PJ, Crowley T. Screening for chlamydia. Commun Dis Public Health 2000; 3:220. [PMID: 11014043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
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Wiggins R, Crowley T, Horner PJ, Soothill PW, Millar MR, Corfield AP. Use of 5-bromo-4-chloro-3-indolyl-alpha-D-N-acetylneuraminic acid in a novel spot test To identify sialidase activity in vaginal swabs from women with bacterial vaginosis. J Clin Microbiol 2000; 38:3096-7. [PMID: 10921986 PMCID: PMC87196 DOI: 10.1128/jcm.38.8.3096-3097.2000] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The validity of measuring vaginal sialidase activity to identify bacterial vaginosis (BV) was determined by using 5-bromo-4-chloro-3-indolyl-alpha-D-N-acetylneuraminic acid in a near-patient test. The sensitivity and specificity of the test for prediction of BV were 95.6 and 96.3%, respectively. Positive and negative predictive values were 95.6 and 96.3%, respectively. This test may be an alternative to Gram staining.
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Affiliation(s)
- R Wiggins
- Dorothy Crowfoot Hodgkin Laboratories, Division of Medicine, Bristol Royal Infirmary, Bristol BS2 8HW, United Kingdom
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Abstract
Erectile dysfunction is a common and distressing medical condition that is now highly amenable to treatment almost irrespective of the cause. Safe, non-surgical treatments with unequivocal efficacy are psychological therapy, intracorporeal injection of vasoactive drugs, transurethral vasodilators and oral sildenafil, all of which have been reported to have a 50-70% overall response rate. Vacuum constriction devices are acceptable for some, usually older patients and oral yohimbine is thought to have marginal efficacy. Local creams to induce or enhance erectile function are currently being investigated. There is no place for androgen supplementation unless the patient is profoundly hypogonadal. Treatment of hyperprolactinaemia is very effective but is a rare cause of erectile dysfunction. As intercourse may entail an unfamiliar level of physical activity, it is sensible to ensure that the patient is able to climb a flight or two of stairs comfortably without provoking undue breathlessness or chest pain and to provide suitable advice about technique before commencing treatment. Once it is clear to the patients that erectile dysfunction can be satisfactorily overcome, the long-term use of treatments to do so tends to wane. Thus, although the prospect of effective treatment for what had been for many a distressing life sentence has the potential to place new demands on the health service, there is no evidence that restrictions on prescribing will prove economically rational.
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Affiliation(s)
- A Levy
- University Research Centre for Neuroendocrinology, Bristol Royal Infirmary Division of Medicine, Southmead Hospital, Bristol, UK.
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Sarnthein M, Kennett JP, Chappell J, Crowley T, Curry W, Dupessy JC, Grootes P, Hendy I, Laj C, Negendank J, Schulz M, Shackleton NJ, Voelker A, Zolitschka B. Exploring Late Pleistocene climate variations. ACTA ACUST UNITED AC 2000. [DOI: 10.1029/eo081i051p00625-01] [Citation(s) in RCA: 11] [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: 11/10/2022]
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Macleod J, Rowsell R, Horner P, Crowley T, Caul EO, Low N, Smith GD. Postal urine specimens: are they a feasible method for genital chlamydial infection screening? Br J Gen Pract 1999; 49:455-8. [PMID: 10562745 PMCID: PMC1313443] [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] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/14/2023] Open
Abstract
BACKGROUND A United Kingdom (UK) screening programme for Chlamydia trachomatis has recently been announced. Pilot projects involving the opportunistic testing of women attending health facilities are due to commence in several sites. There is a danger that this approach will fail to obtain adequate population coverage. The alternative--true systematic population screening--is generally assumed to be unfeasible. Studies in Denmark using postal urine specimens have challenged this assumption. No such studies have been reported from the UK. AIM To assess the potential of urine specimens sent by post as the basis for a UK population screening strategy for genital chlamydial infection. METHOD Two hundred patients (100 men, 100 women) aged 18 to 45 years were randomly sampled from the list of one urban group practice. Subjects were mailed an explanatory letter, a urine sample container, a sexual lifestyle questionnaire, and a prepaid return envelope. Non-responders were contacted by telephone; persistent non-responders were visited at home. Samples were tested for Chlamydia by DNA amplification and enzyme immunoassay. RESULTS Sixty-four (32%) subjects were no longer living at their GP registered address. Of the remaining 136, 126 (93%) responded to the survey and 113 (83%) accepted the request for a urine sample and completed a questionnaire. Acceptance rates were similar for men and women and across age groups. Four samples (3%) were Chlamydia positive. CONCLUSION Home mailed urine specimen collection in conjunction with a self-completed postal questionnaire is feasible. This could provide a viable basis both for determining population Chlamydia prevalence and for a UK Chlamydia population screening strategy. Overall cost effectiveness of such a strategy will depend on the cost of the test used. Comparative performance characteristics of the different currently available tests in this setting have yet to be fully determined.
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Affiliation(s)
- J Macleod
- Department of Social Medicine, University of Bristol
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Crowley T, Berry J, Horner PJ, Gough KR, Turner A. Can a laboratory diagnosis of bacterial vaginosis be made from a transported high vaginal swab using anaerobic culture and microscopy of a wet preparation? Sex Transm Infect 1998; 74:228. [PMID: 9849564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2023] Open
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Crowley T, Horner P, Hughes A, Berry J, Paul I, Caul O. Hormonal factors and the laboratory detection of Chlamydia trachomatis in women: implications for screening? Int J STD AIDS 1997; 8:25-31. [PMID: 9043977 DOI: 10.1258/0956462971918724] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
One thousand and fifty-six new and re-registered consecutive women attending a genitourinary medicine clinic requiring speculum examination were screened for Chlamydia trachomatis by enzyme immunoassay (IDEIA, Dako Diagnostics Ltd). Of 1022 women who had results available for both cervix and urethra C. trachomatis was detected in 8.8% (89/1022) in any site, 2.3% (23/1022) in both sites, 4.9% (51/1022) at the cervix alone and 1.5% (15/1022) at the urethra alone. Thus sampling at the urethra increased detection by 17% (15/89). Analysis of 808 women with a regular menstrual cycle showed a significant association of combined oral contraceptive use, age and ectropion with the detection of C. trachomatis. The detection of C. trachomatis showed a significant variation with the menstrual cycle (P = 0.023) (relative risk (rr) 1.7 (95% confidence intervals (CI) 1.0-2.8)). It was detected significantly more often in the latter part. Stepwise logistic regression analysis revealed that ectropion and age were the stronger determinants of C. trachomatis detection and not oral contraceptive use or menstrual cycle. The variation in detection of C. trachomatis with the menstrual cycle was independently associated with combined oral contraceptive use and the lack of a cervical ectropion. The increased detection at the cervix was present after the second week in combined oral contraceptive users (P = 0.008) (rr = 2.3 (1.2-4.5)) but only after the 3rd week in women without an ectropion (P = 0.004) (rr = 2.7 (1.3-5.5)). Combined oral contraceptives, ectropion and youth, are markers for the carriage of C. trachomatis in the lower genital tract of women. It is also detected significantly more often in the latter part of the menstrual cycle in women who are oral contraceptive users.
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Affiliation(s)
- T Crowley
- Department of Genitourinary Medicine, Bristol Royal Infirmary, UK
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Berry J, Crowley T, Horner P, Clifford J, Paul ID, Caul EO. Screening for asymptomatic Chlamydia trachomatis infection in male students by examination of first catch urine. Genitourin Med 1995; 71:329-31. [PMID: 7490057 PMCID: PMC1195556 DOI: 10.1136/sti.71.5.329] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
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Cottler LB, Schuckit MA, Helzer JE, Crowley T, Woody G, Nathan P, Hughes J. The DSM-IV field trial for substance use disorders: major results. Drug Alcohol Depend 1995; 38:59-69; discussion 71-83. [PMID: 7648998 DOI: 10.1016/0376-8716(94)01091-x] [Citation(s) in RCA: 109] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Affiliation(s)
- L B Cottler
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO 63110-1093, USA
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Crowley T, Horner P, Nelki J, Caul EO. Chlamydia trachomatis infection. Screening associated with reduced infection rates. BMJ 1994; 308:716-7. [PMID: 8185737 PMCID: PMC2539360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
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Connor S, Crowley T. Quality assurance: a prescription for success. Int J Health Care Qual Assur 1992; 6:4-7. [PMID: 10131450 DOI: 10.1108/09526869310041402] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Provides a theoretical and practical overview of one organization's total quality management initiative. Concentrates particularly on the pursuit and achievement of registration against the quality assurance standard BS 5750/ISO 9002. The organization is a public sector trading agency providing a financial internal audit service to a range of clients within the NHS.
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Affiliation(s)
- S Connor
- Mersey Internal Audit Agency, Liverpool, UK
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Abstract
We carried out a two-phased study comparing the effectiveness of first-catch early morning urine (FCU) samples against urethral swabs for the detection of C. trachomatis in men. Four hundred and seventeen new and re-booked consecutive men, who attended the Department of Genito-Urinary Medicine, Bristol, having held their urine overnight, were recruited. Patients who had received antimicrobial chemotherapy in the preceding 2 months were excluded. Early morning FCU samples were obtained from 208 men followed by urethral swabs for the detection of C. trachomatis (phase I) and this order of collection was reversed for the remaining 209 patients (phase 2). A last-catch urine (LCU) was also obtained from all patients. All urethral and urine samples were examined by an amplified enzyme immunoassay (IDEIA, Dako Diagnostics Ltd). Initially, discordant samples were critically examined by direct immunofluorescence (Syva, 'Microtrak') which was used as the 'gold' standard in this study. We have shown that overall 42 and 4.7% of our symptomatic and asymptomatic male patients respectively were positive for C. trachomatis antigen by IDEIA. Furthermore 86.4 and 91.0% (phases 1 and 2) of the total C. trachomatis positive samples were detected by examination of an FCU sample. In contrast only 66.0 and 65.5% (phases 1 and 2) of the total positives were identified by examination of an urethral swab. These results show that an FCU sample not only has the advantage of being a non-invasive procedure but is also a very sensitive method, compared to swabbing the urethra for the detection of C. trachomatis.(ABSTRACT TRUNCATED AT 250 WORDS)
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Affiliation(s)
- T Crowley
- Department of Genito-Urinary Medicine, Bristol Royal Infirmary, UK
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30
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Abstract
Histological examination was performed on the anterior penile urethra from 21 asymptomatic trans-sexual patients taking oestrogens prior to surgery. Squamous metaplasia was present in 15 of these patients and in 1 man taking progesterones. Immunohistochemical staining for oestrogen receptors in the urethra was negative. Severe squamous metaplasia was associated with patchy chronic inflammatory cell infiltration but this was also present in normal controls. The lack of recognised complications of squamous metaplasia at this site suggests that it is an incidental observation in men taking oestrogens.
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Affiliation(s)
- G A Russell
- Department of Histopathology, Royal Infirmary, Bristol
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31
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Schuckit M, Helzer J, Crowley T, Nathan P, Woody G, Davis W. Substance use disorders. Hosp Community Psychiatry 1991; 42:471-3. [PMID: 2060911 DOI: 10.1176/ps.42.5.471] [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] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Affiliation(s)
- M Schuckit
- American Psychiatric Association, Washington, D.C. 20005
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32
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Crowley T. Oral mucosal changes in women with genital HPV infection. J Oral Maxillofac Surg 1991. [DOI: 10.1016/0278-2391(91)90242-e] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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33
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Horgan PG, Couse NF, Crowley T, Delaney C, Fitzpatrick JM, Gorey TF. The role of 3 hour distal oesophageal pH monitoring in gastro-oesophageal reflux. Ir J Med Sci 1991; 160:42-4. [PMID: 1917420 DOI: 10.1007/bf02947641] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
It has been suggested in the literature that an eight hour period of distal oesophageal monitoring is adequate for the diagnosis of reflux in symptomatic patients. The aim of this study was to investigate whether 3 hour intra-oesophageal pH-metry could be substituted for the eight hour test period without loss of sensitivity in the diagnosis of GOR. Twenty patients were tested, 10 of whom had classical De Meester symptoms of GOR and 10 asymptomatic patients served as controls. All were commenced on 3 hour ambulant pH monitoring of the distal oesophagus. This was followed by a separate period of 8 hour testing. Each test had a 50% supine time period. The following variables were determined: (i) number of reflux episodes (ii) number longer than 5 minutes (iii) longest episode of reflux, (iv) percent of time that pH was below 4. Results are analysed using the 'Esophogram' computer program. 8 hour monitoring resulted in a positive diagnosis of GOR in 10 of 10 patients, giving an overall sensitivity of 100%. 3 hour testing was positive in 8 patients (sensitivity of 80%). The best correlations were obtained when comparing total reflux episodes, and the percent of total time pH less than 4, but overall the tests correlate poorly for individual variables. None of the controls had positive 3 or 8 hour testing. We conclude therefore, that 3 hour pH metry may be a useful screening test to confirm symptomatic reflux, and can be performed within a single clinic visit. If negative, arrangements must be made for more prolonged monitoring.
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Affiliation(s)
- P G Horgan
- Department of Surgery, Mater Misericordiae Hospital, University College Dublin
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34
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Crowley T. Evaluation of oral and laryngeal specimens for human papillomavirus (HPV) DNA by dot blot hybridization. J Oral Maxillofac Surg 1991. [DOI: 10.1016/0278-2391(91)90289-x] [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]
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35
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Crowley T. Effects of systemic administration of nicotine on capillaries in rat oral mucosa. J Oral Maxillofac Surg 1990. [DOI: 10.1016/0278-2391(90)90077-f] [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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36
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Crowley T. The crystallinity of human deciduous teeth in hypophosphataemic vitamin D-resistant rickets. J Oral Maxillofac Surg 1990. [DOI: 10.1016/0278-2391(90)90414-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Crowley T. Quantifications and analysis of the glycosaminoglycans in human odontogenic cyst linings. J Oral Maxillofac Surg 1989. [DOI: 10.1016/0278-2391(89)90313-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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39
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Hopwood V, Crowley T, Horrocks CT, Milne JD, Taylor PK, Warnock DW. Vaginal candidosis: relation between yeast counts and symptoms and clinical signs in non-pregnant women. Genitourin Med 1988; 64:331-4. [PMID: 3060423 PMCID: PMC1194254 DOI: 10.1136/sti.64.5.331] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Of 277 non-pregnant women, 67 (24%) harboured Candida albicans in the genital tract. Of 56 women yielding C albicans who had no other infection diagnosed, 14 were symptomless and 10 had no clinical signs of vulval redness, vaginitis, or discharge. Symptoms and signs tended to be more severe in women with higher yeast counts. Of 22 women with moderate or severe symptoms (pruritus with or without discharge) and signs, 15 had yeast counts of more than 10(3) colony forming units (cfu)/ml, whereas six of nine women with no symptoms or signs had counts of fewer than 10(3) cfu/ml.
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Affiliation(s)
- V Hopwood
- Department of Microbiology, Royal Infirmary, Bristol
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Hopwood V, Warnock DW, Milne JD, Crowley T, Horrocks CT, Taylor PK. Evaluation of a new slide latex agglutination test for diagnosis of vaginal candidosis. Eur J Clin Microbiol 1987; 6:392-4. [PMID: 3665894 DOI: 10.1007/bf02013092] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
A new commercial slide latex particle agglutination test for rapid (2 min) diagnosis of vaginal candidosis was evaluated and compared with conventional methods. Of the 263 women studied, 63 (23.9%) had yeasts in the vagina. Clinical signs of vulvitis or vaginitis were seen in 23 women (8.8%) and 40 (15.2%) were harbouring yeasts without clinical signs. Yeast counts were generally higher in women with clinical signs of vaginal candidosis than in those without. The test was positive in 15 of the 23 women (65.2%) with clinical signs, the incidence of a positive test increasing in direct proportion to the amount of yeasts isolated. The test's sensitivity, specificity and predictive values were comparable to those of microscopy and culture. Being both rapid and simple to perform, this new test offers a useful alternative to conventional methods for the diagnosis of vaginal candidosis.
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Affiliation(s)
- V Hopwood
- Department of Microbiology, Bristol Royal Infirmary, UK
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Gomer RH, Datta S, Mehdy M, Crowley T, Sivertsen A, Nellen W, Reymond C, Mann S, Firtel RA. Regulation of cell-type-specific gene expression in Dictyostelium. Cold Spring Harb Symp Quant Biol 1985; 50:801-12. [PMID: 3868507 DOI: 10.1101/sqb.1985.050.01.098] [Citation(s) in RCA: 31] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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