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Goetz MP, Bagegni NA, Batist G, Brufsky A, Cristofanilli MA, Damodaran S, Daniel BR, Fleming GF, Gradishar WJ, Graff SL, Grosse Perdekamp MT, Hamilton E, Lavasani S, Moreno-Aspitia A, O'Connor T, Pluard TJ, Rugo HS, Sammons SL, Schwartzberg LS, Stover DG, Vidal GA, Wang G, Warner E, Yerushalmi R, Plourde PV, Portman DJ, Gal-Yam EN. Lasofoxifene versus fulvestrant for ER+/HER2- metastatic breast cancer with an ESR1 mutation: results from the randomized, phase II ELAINE 1 trial. Ann Oncol 2023; 34:1141-1151. [PMID: 38072514 DOI: 10.1016/j.annonc.2023.09.3104] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 08/24/2023] [Accepted: 09/13/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND Acquired estrogen receptor alpha (ER/ESR1) mutations commonly cause endocrine resistance in ER+ metastatic breast cancer (mBC). Lasofoxifene, a novel selective ER modulator, stabilizes an antagonist conformation of wild-type and ESR1-mutated ER-ligand binding domains, and has antitumor activity in ESR1-mutated xenografts. PATIENTS AND METHODS In this open-label, randomized, phase II, multicenter, ELAINE 1 study (NCT03781063), we randomized women with ESR1-mutated, ER+/human epidermal growth factor receptor 2 negative (HER2-) mBC that had progressed on an aromatase inhibitor (AI) plus a cyclin-dependent kinase 4/6 inhibitor (CDK4/6i) to oral lasofoxifene 5 mg daily or IM fulvestrant 500 mg (days 1, 15, and 29, and then every 4 weeks) until disease progression/toxicity. The primary endpoint was progression-free survival (PFS); secondary endpoints were safety/tolerability. RESULTS A total of 103 patients received lasofoxifene (n = 52) or fulvestrant (n = 51). The most current efficacy analysis showed that lasofoxifene did not significantly prolong median PFS compared with fulvestrant: 24.2 weeks (∼5.6 months) versus 16.2 weeks (∼3.7 months; P = 0.138); hazard ratio 0.699 (95% confidence interval 0.434-1.125). However, PFS and other clinical endpoints numerically favored lasofoxifene: clinical benefit rate (36.5% versus 21.6%; P = 0.117), objective response rate [13.2% (including a complete response in one lasofoxifene-treated patient) versus 2.9%; P = 0.124], and 6-month (53.4% versus 37.9%) and 12-month (30.7% versus 14.1%) PFS rates. Most common treatment-emergent adverse events with lasofoxifene were nausea, fatigue, arthralgia, and hot flushes. One death occurred in the fulvestrant arm. Circulating tumor DNA ESR1 mutant allele fraction (MAF) decreased from baseline to week 8 in 82.9% of evaluable lasofoxifene-treated versus 61.5% of fulvestrant-treated patients. CONCLUSIONS Lasofoxifene demonstrated encouraging antitumor activity versus fulvestrant and was well tolerated in patients with ESR1-mutated, endocrine-resistant mBC following progression on AI plus CDK4/6i. Consistent with target engagement, lasofoxifene reduced ESR1 MAF, and to a greater extent than fulvestrant. Lasofoxifene may be a promising targeted treatment for patients with ESR1-mutated mBC and warrants further investigation.
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Affiliation(s)
- M P Goetz
- Department of Oncology, Mayo Clinic, Rochester.
| | - N A Bagegni
- Division of Oncology, Washington University School of Medicine, St. Louis, USA
| | - G Batist
- Segal Cancer Centre, Jewish General Hospital, McGill University, Montreal, Quebec, Canada
| | - A Brufsky
- University of Pittsburgh Medical Center-Magee Women's Hospital, Pittsburgh
| | - M A Cristofanilli
- Division of Hematology and Medical Oncology, Weill Cornell Medicine, New York
| | - S Damodaran
- The University of Texas MD Anderson Cancer Center, Department of Breast Medical Oncology, Houston
| | | | - G F Fleming
- The University of Chicago Medical Center, Chicago
| | - W J Gradishar
- Division of Hematology/Oncology, Northwestern University, Chicago
| | - S L Graff
- Lifespan Cancer Institute/Legorreta Cancer Center at Brown University, Providence
| | | | - E Hamilton
- Sarah Cannon Research Institute/Tennessee Oncology, Nashville
| | - S Lavasani
- Division of Hematology and Medical Oncology, UC Irvine, Orange
| | | | - T O'Connor
- Roswell Park Comprehensive Cancer Center, Department of Medicine, Buffalo
| | - T J Pluard
- Saint Luke's Cancer Institute, Kansas City
| | - H S Rugo
- Department of Medicine (Hematology/Oncology), University of California San Francisco, San Francisco
| | - S L Sammons
- Dana Farber Cancer Institute, Harvard Medical School, Boston
| | | | - D G Stover
- Ohio State University Comprehensive Cancer Center, Ohio State University, Columbus
| | - G A Vidal
- Breast Oncology Division, West Cancer Center, Memphis
| | - G Wang
- Medical Oncology, Miami Cancer Institute at Baptist Health, Miami, USA
| | - E Warner
- Division of Medical Oncology, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - R Yerushalmi
- Rabin Medical Center, Beilinson Hospital, Petah Tikva, Tel-Aviv University, Tel-Aviv, Israel
| | | | | | - E N Gal-Yam
- Breast Oncology Institute, Sheba Medical Center, Ramat Gan, Israel
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Martin MG, Chidebe RCW, Nwaneri MO, Miller E, Okoye I, Esiaka DK, Olasinde TA, Durosinmi-Etti FA, Igbinoba F, Adegboyega BC, Adenjii A, Aruah CS, Orjiakor TC, Abubakar BM, Atuwo D, O'Connor T. Impact of 10-Day Fulbright Specialist Program and Project Pink Blue Education Sessions on Medical Oncology Knowledge Among Physicians Who Treat Cancer in Nigeria. J Cancer Educ 2023; 38:378-382. [PMID: 35838882 DOI: 10.1007/s13187-021-02130-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/24/2021] [Indexed: 06/15/2023]
Abstract
Despite an estimated population of over 201 million and over 115,950 yearly diagnosed new cases of cancer, Nigeria does not have dedicated medical oncologists. Most oncology care is delivered through surgical and clinical oncologists, who are trained in both radiation and medical oncology and they number fewer than 50 in the country. With a limited number of oncology professionals, cancer patients in Nigeria experience poor health outcomes, with an estimated cancer mortality rate of 75,000 deaths per year. Participants from 15 Nigerian states were selected to attend the medical oncology training. Through the support of Fulbright Specialist Program and Project PINK BLUE, two of the authors delivered 10 days of lectures based on ASCO, ESMO, and NCCN guidelines. Mean scores of both the pre- and post-course tests as well as a 1-year follow-up test were compared using GraphPad Prism 7.0a by paired t-tests. Forty-four clinical oncologists were selected for participation. Twenty-five (57%) completed the pre- and post-course tests. Of the 25 that completed both tests, percentage of correct answers increased from 45 to 59% (2-sided p-value < 0.0001). Improvements were seen in attending doctors 45 to 59% (p = 0.0046) and resident doctors 45 to 59% (0.0007). Eleven doctors responded to the 1-year follow-up test. Although not statistically significant, a numerical pattern for the benefits was maintained 1 year after the program (45% pre-course versus 52% post-course correct answers, Fisher's exact, p = 0.4185). In the short term, the training improved medical oncology knowledge in Nigeria, regardless of the participant's carrier stage. Long-term benefits were not sustained in a small sample of participants, and continuing education strategies are necessary. Similar models may be employed across Africa.
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Affiliation(s)
- M G Martin
- West Cancer Center and Research Institute, Memphis, TN, USA.
- Fulbright Specialist Program, Washington, D.C., USA.
- West Cancer Center, 1588 Union Ave, Memphis, TN, 38104, USA.
- Birmingham City University, Birmingham, UK.
| | - R C W Chidebe
- Birmingham City University, Birmingham, UK
- Project PINK BLUE - Health & Psychological Trust Centre, Abuja, Nigeria
- National Cancer Control Programme, Federal Ministry of Health, Abuja, Nigeria
| | - M O Nwaneri
- Birmingham City University, Birmingham, UK
- Project PINK BLUE - Health & Psychological Trust Centre, Abuja, Nigeria
- University of Iowa Carver College of Medicine, Iowa City, IA, USA
| | - E Miller
- West Cancer Center and Research Institute, Memphis, TN, USA
- Birmingham City University, Birmingham, UK
| | - I Okoye
- Birmingham City University, Birmingham, UK
- Project PINK BLUE - Health & Psychological Trust Centre, Abuja, Nigeria
- University of Nigeria Teaching Hospital, Enugu, Nigeria
| | - D K Esiaka
- Birmingham City University, Birmingham, UK
- Union College, Schenectady, NY, USA
| | - T A Olasinde
- Birmingham City University, Birmingham, UK
- Ahmadu Bello University Teaching Hospital, Zaria, Nigeria
| | - F A Durosinmi-Etti
- Birmingham City University, Birmingham, UK
- Lagos University Teaching Hospital, Lagos, Nigeria
| | - F Igbinoba
- Birmingham City University, Birmingham, UK
- National Hospital, Abuja, Nigeria
| | - B C Adegboyega
- Birmingham City University, Birmingham, UK
- Lagos University Teaching Hospital, Lagos, Nigeria
| | - A Adenjii
- Birmingham City University, Birmingham, UK
- Lagos University Teaching Hospital, Lagos, Nigeria
| | - C S Aruah
- Birmingham City University, Birmingham, UK
- National Hospital, Abuja, Nigeria
- University of Abuja College of Medicine, Abuja, Nigeria
| | - T C Orjiakor
- Birmingham City University, Birmingham, UK
- University of Nigeria, Nsukka, Nigeria
| | - B M Abubakar
- Birmingham City University, Birmingham, UK
- National Hospital, Abuja, Nigeria
| | - D Atuwo
- Birmingham City University, Birmingham, UK
- National Cancer Control Programme, Federal Ministry of Health, Abuja, Nigeria
| | - T O'Connor
- Fulbright Specialist Program, Washington, D.C., USA
- Birmingham City University, Birmingham, UK
- Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
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3
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Skelly JR, O'Connor T. Guidelines for the use of the Attend Anywhere Platform for Telecommunications within the Pain Service. Ir Med J 2021; 114:403. [PMID: 34520346] [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: 06/13/2023]
Abstract
Introduction Remote consultation is of growing in importance and gaining popularity in both primary and secondary healthcare settings. Reduced necessity for a physical presence of the patient within the healthcare setting is of particular benefit in the current COVID-19 era. It is also of benefit to a diverse group of patients, for example: those who are geographically distant from the base hospital, those suffering from mobility issues or chronic illness, those who require chaperoning as well as those with limited access to transport. We have developed guidelines for the use of the medical telecommunications platform, Attend Anywhere, which has been utilised across the English and Scottish National Health Services, as well as with the Australian Health service, and is now available in Health Service Executive (HSE) settings. Herein we describe and recommend a process that we have found helpful, and we propose guidelines on how a Health Care Worker (HCW) might consider approaching a virtual consultation when initiating and safely executing a patient encounter on Attend Anywhere, in a secure and efficient manner. The guidelines were created following review of the literature on previous experience by others with this software, as well as recent guidance published by the Irish Medical Council. A proportion of this guidance is transferable to other platforms. Methods We also undertook a short survey of our patients and physicians in Sligo University Hospital, who used Attend Anywhere over a six-week period to gauge their satisfaction levels with the experience., We estimated distance that our patients would have travelled for their appointment had the traditional face-to-face consultation been carried out. We noted whether we considered the medium appropriate for the patient consultations. Results 53 patients took part and satisfaction was rated from satisfied to very satisfied on a 3-point scale for all stakeholders. In addition, we found that remote consultation, when compared to face-to-face consultation, alleviated an average of 144km of unnecessary travel per appointment. Remote consultation was deemed appropriate in all cases and no rescheduled face-to-face appointments were required due to failure of the consultation due to difficulties encountered. Conclusion The authors recommend the implementation of the described guidance, with suggested Checklist, Information leaflet and Consent form, as a means of ensuring the confidentiality of the consultation and to ensure that processes are adhered to that optimise protection for both the patient and the clinician, while reducing the burden of attendance to the healthcare location.
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Affiliation(s)
- J R Skelly
- Department of Anaesthesia, Intensive Care and Pain Medicine, Sligo University Hospital, Ireland
| | - T O'Connor
- Department of Anaesthesia, Intensive Care and Pain Medicine, Sligo University Hospital, Ireland
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Bengtsson J, Bullock JM, Egoh B, Everson C, Everson T, O'Connor T, O'Farrell PJ, Smith HG, Lindborg R. Grasslands-more important for ecosystem services than you might think. Ecosphere 2019. [DOI: 10.1002/ecs2.2582] [Citation(s) in RCA: 221] [Impact Index Per Article: 44.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Affiliation(s)
- J. Bengtsson
- Department of Ecology; Swedish University of Agricultural Sciences (SLU); Box 7044, SE-75007 Uppsala Sweden
- Stellenbosch Institute for Advanced Study (STIAS); Wallenberg research centre at Stellenbosch University; Marais Street Stellenbosch 7600 South Africa
| | - J. M. Bullock
- NERC Centre for Ecology & Hydrology; Benson Lane Wallingford, Oxfordshire OX10 8BB UK
| | - B. Egoh
- Department of Earth System Science; University of California Irvine; Irvine California 92697 USA
- Natural Resources and the Environment; CSIR; P.O. Box 320 Stellenbosch 7599 South Africa
| | - C. Everson
- Centre for Water Resources Research; School of Agriculture, Earth and Environmental Sciences; University of KwaZulu-Natal; Private Bag X01 Scottsville, Pietermaritzburg 3209 South Africa
| | - T. Everson
- School of Life Sciences; University of KwaZulu-Natal; Private Bag X01 Scottsville, Pietermaritzburg 3209 South Africa
| | - T. O'Connor
- South African Environmental Observation Network; PO Box 2600 Pretoria 0001 South Africa
| | - P. J. O'Farrell
- Natural Resources and the Environment; CSIR; P.O. Box 320 Stellenbosch 7599 South Africa
- Percy FitzPatrick Institute of African Ornithology; University of Cape Town; Private Baf X3 Rondebosch 7701 Cape Town South Africa
| | - H. G. Smith
- Department of Biology; Lund University; SE-223 62 Lund Sweden
- Centre for Environmental and Climate research; Lund University; SE-223 62 Lund Sweden
| | - R. Lindborg
- Stellenbosch Institute for Advanced Study (STIAS); Wallenberg research centre at Stellenbosch University; Marais Street Stellenbosch 7600 South Africa
- Department of Physical Geography; Stockholm University; SE-106 91 Stockholm Sweden
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Pattie R, Callahan N, Cude-Woods C, Adamek E, Adams M, Barlow D, Blatnik M, D. B, Broussard L, Clayton S, Currie S, Dees E, Ding X, Fellers D, Fox W, Fries E, Gonzalez F, Geltenbort P, Hickerson K, Hoffbauer M, Hoffman K, Holley A, Howard D, Ito T, Komives A, Liu C, M. M, Medina J, Morley D, Morris C, O'Connor T, Penttilä S, Ramsey J, Roberts A, Salvat D, Saunders A, Seestrom S, Sharapov E, Sjue S, Snow W, Sprow A, Vanderwerp J, Vogelaar B, P.L. W, Wang Z, Weaver H, Wexler J, Womack T, Young A, Zeck B. Status of the UCN τ experiment. EPJ Web Conf 2019. [DOI: 10.1051/epjconf/201921903004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
The neutron is the simplest nuclear system that can be used to probe the structure of the weak interaction and search for physics beyond the standard model. Measurements of neutron lifetime and β-decay correlation coefficients with precisions of 0.02% and 0.1%, respectively, would allow for stringent constraints on new physics. The UCNτ experiment uses an asymmetric magneto-gravitational UCN trap with in situ counting of surviving neutrons to measure the neutron lifetime, τn = 877.7s (0.7s)stat (+0.4/−0.2s)sys. We discuss the recent result from UCNτ, the status of ongoing data collection and analysis, and the path toward a 0.25 s measurement of the neutron lifetime with UCNτ.
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O'Connor T, Soto-Perez-de-Celis E, Blanchard S, Chapman A, Kimmick G, Muss H, Luu T, Waisman JR, Li D, Mortimer J, Yuan Y, Somlo G, Stewart D, Katheria V, Levi A, Hurria A. Abstract P5-21-08: Tolerability of the combination of lapatinib and trastuzumab in older patients with HER2 positive metastatic breast cancer. Cancer Res 2018. [DOI: 10.1158/1538-7445.sabcs17-p5-21-08] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Older adults are less likely to be included in clinical trials leading to the approval of novel cancer treatments. The Institute of Medicine and ASCO have identified therapeutic phase II trials as a key research priority to increase the evidence base for older adults with cancer. While targeted therapies may represent a less toxic option for older patients, few trials have studied their tolerability and efficacy in older adults. Here, we present a phase II study (NCT01273610) of the combination of trastuzumab and lapatinib in older patients with HER2+ metastatic breast cancer (MBC), incorporating geriatric oncology principles in the study design.
Methods: Patients age ≥ 60 years with MBC and any number of prior chemotherapy (CT) lines received trastuzumab (either 4mg/kg loading dose followed by 2mg/kg weekly or 8mg/kg followed by 6mg/kg q/3 weeks) plus lapatinib 1000 mg/m2 daily in 21-day cycles. Patients completed a pre-treatment geriatric assessment including measures of function, comorbidity, cognition, nutrition, and psychosocial status. A toxicity risk score developed for older adults receiving cytotoxic CT was calculated for each patient (Hurria et al. JCO 2011 & 2016). Relationships between tolerability (dose reductions and grade (G) ≥ 3 toxicity attributed to treatment) and risk score analyzed using a log2 transformation were assessed using generalized linear models, Student's t tests, and Fisher's exact test. Response rate (RR) and progression free survival (PFS) were evaluated.
Results: 40 patients (mean age 72 [60-92]) were accrued from 04/11 to 05/15. 25% (n = 10) were ≥ 75 years of age. 65% of patients (n = 26) had HR+ tumors and 35% (n = 14) were receiving ≥ 3rd line treatment. Median number of cycles was 4 (0-28). RR was 23% (n = 9, 95% CI 11-38%; 1 complete, 8 partial). 23% (n = 9) achieved stable disease. PFS was 2.7 months (95% CI 2.5-12). Based on the toxicity risk score, 21% (n = 8), 54% (n = 21), and 26% (n = 10) were at low, intermediate, and high risk. 70% (n = 28) of patients had G ≥ 2 toxicities and 20% (n = 8) G ≥ 3 toxicities. G 2 and 3 diarrhea occurred in 28% (n = 11) and 5% (n = 2) respectively. 5% (n = 2) were hospitalized due to treatment-related toxicity. No G ≥ 3 cardiac toxicities were observed. 23% of patients (n = 9) had treatment delays, and 43% (n = 17) required a lapatinib dose reduction. The mean toxicity risk score was higher in patients who required dose reductions (Student's t: p = 0.02). No statistically significant relationship was found between toxicity risk scores and the presence of G ≥ 3 treatment toxicity (logistic regression: OR = 3.08, 95% CI [0.54, 21.2], p = 0.22).
Conclusions: Among older patients with MBC (79% at intermediate or high risk of G ≥ 3 cytotoxic CT toxicity), trastuzumab and lapatinib were well tolerated, with only 20% experiencing G3 toxicities. The toxicity risk score was not found to be significantly related with treatment toxicity, which may be explained by the very low incidence of G3 events. Patients with a low toxicity risk score were not likely to require a lapatinib dose reduction.
Citation Format: O'Connor T, Soto-Perez-de-Celis E, Blanchard S, Chapman A, Kimmick G, Muss H, Luu T, Waisman JR, Li D, Mortimer J, Yuan Y, Somlo G, Stewart D, Katheria V, Levi A, Hurria A. Tolerability of the combination of lapatinib and trastuzumab in older patients with HER2 positive metastatic breast cancer [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P5-21-08.
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Affiliation(s)
- T O'Connor
- City of Hope, Duarte, CA; UNC Lineberger Cancer Center, Chapel Hill, NC; Thomas Jefferson University Hospital, Philadelphia, PA; Duke Cancer Center, Durham, NC; Roswell Park Cancer Institute, Buffalo, NY
| | - E Soto-Perez-de-Celis
- City of Hope, Duarte, CA; UNC Lineberger Cancer Center, Chapel Hill, NC; Thomas Jefferson University Hospital, Philadelphia, PA; Duke Cancer Center, Durham, NC; Roswell Park Cancer Institute, Buffalo, NY
| | - S Blanchard
- City of Hope, Duarte, CA; UNC Lineberger Cancer Center, Chapel Hill, NC; Thomas Jefferson University Hospital, Philadelphia, PA; Duke Cancer Center, Durham, NC; Roswell Park Cancer Institute, Buffalo, NY
| | - A Chapman
- City of Hope, Duarte, CA; UNC Lineberger Cancer Center, Chapel Hill, NC; Thomas Jefferson University Hospital, Philadelphia, PA; Duke Cancer Center, Durham, NC; Roswell Park Cancer Institute, Buffalo, NY
| | - G Kimmick
- City of Hope, Duarte, CA; UNC Lineberger Cancer Center, Chapel Hill, NC; Thomas Jefferson University Hospital, Philadelphia, PA; Duke Cancer Center, Durham, NC; Roswell Park Cancer Institute, Buffalo, NY
| | - H Muss
- City of Hope, Duarte, CA; UNC Lineberger Cancer Center, Chapel Hill, NC; Thomas Jefferson University Hospital, Philadelphia, PA; Duke Cancer Center, Durham, NC; Roswell Park Cancer Institute, Buffalo, NY
| | - T Luu
- City of Hope, Duarte, CA; UNC Lineberger Cancer Center, Chapel Hill, NC; Thomas Jefferson University Hospital, Philadelphia, PA; Duke Cancer Center, Durham, NC; Roswell Park Cancer Institute, Buffalo, NY
| | - JR Waisman
- City of Hope, Duarte, CA; UNC Lineberger Cancer Center, Chapel Hill, NC; Thomas Jefferson University Hospital, Philadelphia, PA; Duke Cancer Center, Durham, NC; Roswell Park Cancer Institute, Buffalo, NY
| | - D Li
- City of Hope, Duarte, CA; UNC Lineberger Cancer Center, Chapel Hill, NC; Thomas Jefferson University Hospital, Philadelphia, PA; Duke Cancer Center, Durham, NC; Roswell Park Cancer Institute, Buffalo, NY
| | - J Mortimer
- City of Hope, Duarte, CA; UNC Lineberger Cancer Center, Chapel Hill, NC; Thomas Jefferson University Hospital, Philadelphia, PA; Duke Cancer Center, Durham, NC; Roswell Park Cancer Institute, Buffalo, NY
| | - Y Yuan
- City of Hope, Duarte, CA; UNC Lineberger Cancer Center, Chapel Hill, NC; Thomas Jefferson University Hospital, Philadelphia, PA; Duke Cancer Center, Durham, NC; Roswell Park Cancer Institute, Buffalo, NY
| | - G Somlo
- City of Hope, Duarte, CA; UNC Lineberger Cancer Center, Chapel Hill, NC; Thomas Jefferson University Hospital, Philadelphia, PA; Duke Cancer Center, Durham, NC; Roswell Park Cancer Institute, Buffalo, NY
| | - D Stewart
- City of Hope, Duarte, CA; UNC Lineberger Cancer Center, Chapel Hill, NC; Thomas Jefferson University Hospital, Philadelphia, PA; Duke Cancer Center, Durham, NC; Roswell Park Cancer Institute, Buffalo, NY
| | - V Katheria
- City of Hope, Duarte, CA; UNC Lineberger Cancer Center, Chapel Hill, NC; Thomas Jefferson University Hospital, Philadelphia, PA; Duke Cancer Center, Durham, NC; Roswell Park Cancer Institute, Buffalo, NY
| | - A Levi
- City of Hope, Duarte, CA; UNC Lineberger Cancer Center, Chapel Hill, NC; Thomas Jefferson University Hospital, Philadelphia, PA; Duke Cancer Center, Durham, NC; Roswell Park Cancer Institute, Buffalo, NY
| | - A Hurria
- City of Hope, Duarte, CA; UNC Lineberger Cancer Center, Chapel Hill, NC; Thomas Jefferson University Hospital, Philadelphia, PA; Duke Cancer Center, Durham, NC; Roswell Park Cancer Institute, Buffalo, NY
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Malik M, Moore Z, Patton D, O'Connor T, Nugent LE. The impact of geriatric focused nurse assessment and intervention in the emergency department: A systematic review. Int Emerg Nurs 2018; 37:52-60. [PMID: 29429847 DOI: 10.1016/j.ienj.2018.01.008] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2017] [Revised: 12/04/2017] [Accepted: 01/31/2018] [Indexed: 01/24/2023]
Abstract
BACKGROUND Nursing assessment of elderly patients is imperative in Emergency Departments (ED) while providing interventions that increase independence facilitating discharge to primary healthcare. AIMS To systematically review the impact of geriatric focused nurse assessment and intervention in the ED on hospital utilisation in terms of admission rate, ED revisits and length of hospital stay (LOHS). METHODS Search strategy used following databases; Cochrane, Medline, CINAHL, Embase, Scopus and Web of Knowledge; And terms; geriatric nurse assessment, nurse discharge planning, geriatric nurse specialist, nurse intervention, emergency department, accident and emergency, patient outcomes, discharge, admissions, readmissions, hospital utilization, hospitalization, length of stay/hospital stay. RESULTS Nine studies were included: seven RCTs and two prospective pre/post-intervention designed studies. Geriatric focused nursing assessment and interventions did not have a statistical impact on hospitalization, readmissions, LOHS and ED revisits. Risk screening and comprehensive geriatric assessment extending into primary care may reduce readmission rates but not affect hospitalization. An increase in ED visits in the intervention group at 30 days post-intervention was noted. CONCLUSION Inconsistencies in assessment and interventions for the older person in ED are apparent. Further research evaluating a standardised risk assessment tool and innovative interventions extending into primary healthcare is required.
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Affiliation(s)
- M Malik
- Emergency Department, St. James's Hospital, James's Street, Dublin 8, Ireland.
| | - Z Moore
- School of Nursing and Midwifery, Royal College of Surgeons in Ireland, 123 St. Stephens Green, Dublin 2, Ireland; University of Ghent, Belgium.
| | - D Patton
- School of Nursing and Midwifery, Royal College of Surgeons in Ireland, 123 St. Stephens Green, Dublin 2, Ireland.
| | - T O'Connor
- School of Nursing and Midwifery, Royal College of Surgeons in Ireland, 123 St. Stephens Green, Dublin 2, Ireland.
| | - L E Nugent
- School of Nursing and Midwifery, Royal College of Surgeons in Ireland, 123 St. Stephens Green, Dublin 2, Ireland.
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8
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O'Connor T, Moore Z, Patton D, Wilson P, Gillen C, Hughes M, Reilly A. Combined use of modulated ultrasound and electric current stimulation for diabetic foot ulcers: a case series. J Wound Care 2017; 26:632-640. [PMID: 29131756 DOI: 10.12968/jowc.2017.26.11.632] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [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: 01/26/2023]
Abstract
OBJECTIVE Diabetic foot ulcers (DFUs) are a significant challenge in wound care practice. Our aim was to evaluate the combined use of of two therapies, ultrasound and electrostimulation, in the treatment of DFUs. METHOD This study employed a prospective, non-comparative, case series design, undertaken in a podiatry-led diabetic foot clinic, in an acute hospital setting, in an urban location in Ireland. We recruited patinets with hard-to-heal DFUs who were treated twice a week with combined modulated ultrasound and electric current stimulation. RESULTS We recruited seven patients with eight chronic DFUs. A mean wound size reduction of 71% was achieved and there were no adverse reactions to the therapy. CONCLUSION The results of this small case series indicate that combined modulated ultrasound and electric current stimulation offers promise as an adjunct therapy for DFUs. Further large scale trials are now warranted.
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Affiliation(s)
- T O'Connor
- Senior Lecturer, School of Nursing & Midwifery, Royal College of Surgeons in Ireland
| | - Z Moore
- Professor & Head of the School of Nursing & Midwifery, School of Nursing & Midwifery, Royal College of Surgeons in Ireland
| | - D Patton
- Senior Lecturer, School of Nursing & Midwifery, Royal College of Surgeons in Ireland
| | - P Wilson
- Podiatrist, St James's Hospital, Dublin
| | - C Gillen
- Podiatrist, St James's Hospital, Dublin
| | - M Hughes
- Podiatrist, St James's Hospital, Dublin
| | - A Reilly
- Research Assistant, School of Nursing & Midwifery, Royal College of Surgeons in Ireland
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Abstract
OBJECTIVE To assess the potential of measurements of pH, exudate composition and temperature in wounds to predict healing outcomes and to identify the methods that are employed to measure them. METHOD A systematic review based on the outcomes of a search strategy of quantitative primary research published in the English language was conducted. Inclusion criteria limited studies to those involving in vivo and human participants with an existing or intentionally provoked wound, defined as 'a break in the epithelial integrity of the skin', and excluded in vitro and animal studies. Data synthesis and analysis was performed using structured narrative summaries of each included study arranged by concept, pH, exudate composition and temperature. The Evidence Based Literature (EBL) Critical Appraisal Checklist was implemented to appraise the quality of the included studies. RESULTS A total of 23 studies, three for pH (mean quality score 54.48%), 12 for exudate composition (mean quality score 46.54%) and eight for temperature (mean quality score 36.66%), were assessed as eligible for inclusion in this review. Findings suggest that reduced pH levels in wounds, from alkaline towards acidic, are associated with improvements in wound condition. Metalloproteinase-9 (MMP-9), matrix metalloproteinase-2 (MMP-2), tissue inhibitor of metalloproteinase (TIMP), neutrophil elastase (NE) and albumin, in descending order, were the most frequently measured analytes in wounds. MMP-9 emerged as the analyte which offers the most potential as a biomarker of wound healing, with elevated levels observed in acute or non-healing wounds and decreasing levels in wounds progressing in healing. Combined measures of different exudate components, such as MMP/TIMP ratios, also appeared to offer substantial potential to indicate wound healing. Finally, temperature measurements are highest in non-healing, worsening or acute wounds and decrease as wounds progress towards healing. Methods used to measure pH, exudate composition and temperature varied greatly and, despite noting some similarities, the studies often yielded significantly contrasting results. Furthermore, a limitation to the generalisability of the findings was the overall quality scores of the research studies, which appeared suboptimal. CONCLUSION Despite some promising findings, there was insufficient evidence to confidently recommend the use of any of these measures as predictors of wound healing. pH measurement appeared as the most practical method for use in clinical practice to indicate wound healing outcomes. Further research is required to increase the strength of evidence and develop a greater understanding of wound healing dynamics.
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Affiliation(s)
- G Power
- Community Registered General Nurse, HSE Carlow/Kilkenny, Ireland
| | - Z Moore
- Royal College of Surgeons in Ireland, Dublin, Ireland
| | - T O'Connor
- Royal College of Surgeons in Ireland, Dublin, Ireland
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Pompili C, White J, Velikova G, O'Connor T, Ying JM, Dixon S, Kefaloyannis E, Brunelli A. O-025POOR PREOPERATIVE PATIENT-REPORTED QUALITY OF LIFE IS ASSOCIATED WITH COMPLICATIONS FOLLOWING PULMONARY LOBECTOMY FOR LUNG CANCER. Interact Cardiovasc Thorac Surg 2016. [DOI: 10.1093/icvts/ivw260.25] [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: 11/12/2022] Open
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11
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Abstract
The peptide derivative Ro 31-8959 has been shown to be a potent inhibitor of HIV proteinase with an IC50 of 2 × 10−9M, against HIV-1RF in acutely infected lymphoblastoid cells. This inhibition was not overcome by increasing the infectious dose or by extending the culture time. Similar antiviral activity was also obtained against HIV-2, SIV and several AZT-resistant strains of HIV-1. The time of addition of the inhibitor could be delayed for 22 h without significant loss of activity, supporting its mode of action as taking place late in the replication cycle of HIV-1. Ro 31-8959 also showed activity against chronically infected cells.
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Affiliation(s)
- S. Galpin
- Department of Virology, Medical College of St. Bartholomew's Hospital, 51-53 Bartholomew Close, West Smithfield, London EC1A 7BE, UK
| | - N. A. Roberts
- Roche Products UK Ltd, P.O. Box 8, Welwyn Garden City, Hertfordshire AL7 3AY, UK
| | | | | | - D. Kinchington
- Department of Virology, Medical College of St. Bartholomew's Hospital, 51-53 Bartholomew Close, West Smithfield, London EC1A 7BE, UK
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Holmes HC, Mahmood N, Karpas A, Petrik J, Kinchington D, O'Connor T, Jeffries DJ, Desmyter J, De Clercq E, Pauwels R, Hay A. Screening of Compounds for Activity against HIV: A Collaborative Study. ACTA ACUST UNITED AC 2016. [DOI: 10.1177/095632029100200503] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The collaborative study was undertaken to examine the sensitivity of a range of tests used in assessing the antiviral activities of compounds against human immunodeficiency virus (HIV). A panel of 20 compounds with diverse antiviral activities against HIV were tested under code at three antiviral testing centres supported by the Medical Research Council's AIDS Directed Programme and at the European Community Centralised Facility (ECCF) for New Antiviral Compounds against AIDS in Belgium. Compounds known to have major anti-HIV activity ranked high in all assays, with the exception of the glucosidase inhibitors and certain nucleoside analogues. Results of two assays based on MT4 cells (centre IV) showed a high degree of similarity, despite the use of distinct HIV-1 (HTLV-IIIB) and HIV-2 (ROD) viruses. Considerable similarity was also observed between the assays based on HTLV-IIIRF in C8166 cells (centres I and II). Other assays performed at centre II and at centre III had enhanced sensitivity for glycosidase inhibitors. The differences in anti-HIV activity that were observed may be attributable to specific properties of the cell lines used and particular testing methodologies. The use of more than one type of assay is advisable in order not to miss compounds with low to moderate activity against HIV.
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Affiliation(s)
- H. C. Holmes
- WHO Collaborating Centre for AIDS, National Institute for Biological Standards and Control, Blanche Lane, South Mimms, Potters Bar, Herts EN6 3QG, UK
| | - N. Mahmood
- MRC Collaborative Centre, Burtonhole Lane, Mill Hill, London NW7 1AD, UK
| | - A. Karpas
- Department of Haematology, Clinical School, University of Cambridge, Hills Road, Cambridge CB2 2QL, UK
| | - J. Petrik
- Department of Haematology, Clinical School, University of Cambridge, Hills Road, Cambridge CB2 2QL, UK
| | - D. Kinchington
- Department of Virology, Medical College of St Bartholomew's Hospital, West Smithfield, London EC1A 7BE, UK
| | - T. O'Connor
- Department of Virology, Medical College of St Bartholomew's Hospital, West Smithfield, London EC1A 7BE, UK
| | - D. J. Jeffries
- Department of Virology, Medical College of St Bartholomew's Hospital, West Smithfield, London EC1A 7BE, UK
| | - J. Desmyter
- Rega Institute for Medical Research, Katholieke Universität Leuven, Minderbroederstraat 10, B-3000 Leuven, Belgium
| | - E. De Clercq
- Rega Institute for Medical Research, Katholieke Universität Leuven, Minderbroederstraat 10, B-3000 Leuven, Belgium
| | - R. Pauwels
- Rega Institute for Medical Research, Katholieke Universität Leuven, Minderbroederstraat 10, B-3000 Leuven, Belgium
| | - A. Hay
- National Institute for Medical Research, The Ridgeway, Mill Hill, London NW7 1AA, UK
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Sleddens E, Mâsse L, Kremers S, O'Connor T, Thijs C, Sioen I, Michels N, Power T. Validation of the Comprehensive General Parenting Questionnaire and associations with children's eating behavior and BMI. Appetite 2016. [DOI: 10.1016/j.appet.2016.02.079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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14
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Waqas S, Galvin Z, Demirdal VD, O'Connor T, Windrim C, McCormick K, Doyle R, Chadwick G. Appropriateness of Medical Admissions and of Continued In-Patient Stay at an Acute Hospital. Ir Med J 2016; 109:380. [PMID: 27685827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Affiliation(s)
- S Waqas
- Department of Medicine, St Columcilles Hospital Loughlinstown, Co Dublin; Ireland
| | - Z Galvin
- Department of Medicine, St Columcilles Hospital Loughlinstown, Co Dublin; Ireland
| | - V D Demirdal
- Department of Medicine, St Columcilles Hospital Loughlinstown, Co Dublin; Ireland
| | - T O'Connor
- Department of Medicine, St Columcilles Hospital Loughlinstown, Co Dublin; Ireland
| | - C Windrim
- Department of Medicine, St Columcilles Hospital Loughlinstown, Co Dublin; Ireland
| | - K McCormick
- Department of Medicine, St Columcilles Hospital Loughlinstown, Co Dublin; Ireland
| | - R Doyle
- Department of Medicine, St Columcilles Hospital Loughlinstown, Co Dublin; Ireland
| | - G Chadwick
- Department of Medicine, St Columcilles Hospital Loughlinstown, Co Dublin; Ireland
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Mix M, Elmarzouky R, O'Connor T, Plunkett R, Prasad D. Clinical Outcomes in Patients With Brain Metastases From Breast Cancer Treated With Single Fraction Stereotactic Radiosurgery With or Without Whole-Brain Radiation Therapy. Int J Radiat Oncol Biol Phys 2015. [DOI: 10.1016/j.ijrobp.2015.07.773] [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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Teasdale MD, van Doorn NL, Fiddyment S, Webb CC, O'Connor T, Hofreiter M, Collins MJ, Bradley DG. Paging through history: parchment as a reservoir of ancient DNA for next generation sequencing. Philos Trans R Soc Lond B Biol Sci 2015; 370:20130379. [PMID: 25487331 PMCID: PMC4275887 DOI: 10.1098/rstb.2013.0379] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [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: 12/29/2022] Open
Abstract
Parchment represents an invaluable cultural reservoir. Retrieving an additional layer of information from these abundant, dated livestock-skins via the use of ancient DNA (aDNA) sequencing has been mooted by a number of researchers. However, prior PCR-based work has indicated that this may be challenged by cross-individual and cross-species contamination, perhaps from the bulk parchment preparation process. Here we apply next generation sequencing to two parchments of seventeenth and eighteenth century northern English provenance. Following alignment to the published sheep, goat, cow and human genomes, it is clear that the only genome displaying substantial unique homology is sheep and this species identification is confirmed by collagen peptide mass spectrometry. Only 4% of sequence reads align preferentially to a different species indicating low contamination across species. Moreover, mitochondrial DNA sequences suggest an upper bound of contamination at 5%. Over 45% of reads aligned to the sheep genome, and even this limited sequencing exercise yield 9 and 7% of each sampled sheep genome post filtering, allowing the mapping of genetic affinity to modern British sheep breeds. We conclude that parchment represents an excellent substrate for genomic analyses of historical livestock.
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Affiliation(s)
- M D Teasdale
- Smurfit Institute of Genetics, University of Dublin, Trinity College, Dublin 2, Ireland
| | | | - S Fiddyment
- BioArCh, University of York, York YO10 5DD, UK
| | - C C Webb
- Borthwick Institute for Archives, University of York, York YO10 5DD, UK
| | - T O'Connor
- BioArCh, University of York, York YO10 5DD, UK
| | - M Hofreiter
- BioArCh, University of York, York YO10 5DD, UK Institute for Biochemistry and Biology, Faculty of Natural Sciences, University of Potsdam, Karl-Liebknecht-Str. 24-25, Potsdam 14476, Germany
| | - M J Collins
- BioArCh, University of York, York YO10 5DD, UK
| | - D G Bradley
- Smurfit Institute of Genetics, University of Dublin, Trinity College, Dublin 2, Ireland
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Kulendra K, Upile T, Salim F, O'Connor T, Hasnie A, Phillips DE. Long-term recurrence rates following excision and cartilage rim shave of chondrodermatitis nodularis chronica helicis and antihelicis. Clin Otolaryngol 2015; 39:121-6. [PMID: 24684884 DOI: 10.1111/coa.12239] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/26/2014] [Indexed: 11/30/2022]
Affiliation(s)
- K Kulendra
- Department of Ear, Nose and Throat, Warwick Hospital, Warwick, UK
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Chandrashekar R, Beall MJ, Saucier J, O'Connor T, McCall JW, McCall SD. Experimental Dirofilaria immitis infection in dogs: effects of doxycycline and Advantage Multi® administration on immature adult parasites. Vet Parasitol 2014; 206:93-8. [PMID: 25218886 DOI: 10.1016/j.vetpar.2014.08.011] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2014] [Revised: 06/30/2014] [Accepted: 08/20/2014] [Indexed: 12/01/2022]
Abstract
To better understand the efficacy of doxycycline and 10% imidacloprid+2.5% moxidectin (Advantage Multi(®); Bayer Animal Health, Shawnee Mission, Kansas) on immature adult Dirofilaria immitis parasites and the results of antigen tests, 12 healthy, randomly selected dogs were experimentally infected with D. immitis and monitored for 407 days. Two dogs in each of three subgroups of four dogs were each infected with six (total of 6 dogs) or 12 (total of 6 dogs) D. immitis infective third-stage larvae (L3) obtained from infected mosquitoes. Doxycycline (10mg/kg per os twice daily×30 days) and 10% imidacloprid+2.5% moxidectin (1ml/kg by topical application every 30 days) treatment was initiated at 105 (Group A) and 149 (Group B) days post infection (PI) in two groups. One subgroup of two dogs given 6 L3 and one subgroup of two dogs given 12 L3 remained as untreated controls (GroupC). Serum obtained regularly throughout the study was evaluated by ELISA (PetChek(®) Heartworm-PF Antigen Test, IDEXX Laboratories, Inc.) for D. immitis adult circulating antigens. Six of the eight dogs in the treated groups had detectable antigenemia starting between 148 and 240 days post infection, but antigen was not detected in any treated dog at the end of the study. In the control subgroups, the dogs that received 6 L3 had no detectable antigen while the two dogs that received 12 L3 had detectable antigen beginning on Day 180 that persisted until the end of the study. None of the infected dogs had evidence of circulating microfilariae. At necropsy, no heartworms were recovered from the treated dogs, but all dogs in the untreated group had viable adult heartworms. These results indicate that early immature adult worms (3.5 and 5 months of age) of D. immitis were susceptible to a combined treatment regimen of doxycycline and 10% imidacloprid+2.5% moxidectin.
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Affiliation(s)
| | - M J Beall
- IDEXX Laboratories, Inc., Westbrook, ME 04092, USA
| | - J Saucier
- IDEXX Laboratories, Inc., Westbrook, ME 04092, USA
| | - T O'Connor
- IDEXX Laboratories, Inc., Westbrook, ME 04092, USA
| | - J W McCall
- University of Georgia, College of Veterinary Medicine, Athens, GA 30602, USA; TRS Labs, 215 Paradise Blvd., Athens, GA 30607, USA
| | - S D McCall
- TRS Labs, 215 Paradise Blvd., Athens, GA 30607, USA
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20
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DeNysschen C, Burton H, Ademuyiwa F, Levine E, Tetewsky S, O'Connor T. Exercise intervention in breast cancer patients with aromatase inhibitor-associated arthralgia: a pilot study. Eur J Cancer Care (Engl) 2013; 23:493-501. [DOI: 10.1111/ecc.12155] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/28/2013] [Indexed: 11/30/2022]
Affiliation(s)
| | - H. Burton
- Department of Exercise and Nutrition Science; State University of New York at Buffalo; Buffalo New York USA
| | - F. Ademuyiwa
- Department of Medicine; Division of Oncology; Washington University School of Medicine; St. Louis Missouri USA
| | - E. Levine
- Breast Cancer Unit; Roswell Park Cancer Institute; Buffalo New York USA
| | - S. Tetewsky
- Center for Health and Social Research; Buffalo State College; Buffalo New York USA
| | - T. O'Connor
- Breast Cancer Unit; Roswell Park Cancer Institute; Buffalo New York USA
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Khan F, Cotter O, Kennedy B, Clair J, O'Connor B, Collins J, Curran D, O'Connor T. The intensity of QuantiFERON TB-gold response does not differentiate active from latent tuberculosis. Ir Med J 2013; 106:308-310. [PMID: 24579411] [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: 06/03/2023]
Abstract
We analyzed positive QuantiFERON (QFT) assays, performed between July 2009 and April 2011 in the Mercy University Hospital, Cork, Ireland, which included, 94 patients with latent tuberculosis (LTBI) and 35 patients with active tuberculosis. There was no difference in the intensity of response between patients with LTBI and active tuberculosis (p = 0.1589). In patients with LTBI, there were no correlations between age (p = 0.353), sex (p = 0.476), smoking (p = 0.323), contact (p = 0.612), Mantoux response (p = 0.055), Irish nationality (p=0.768), previous BCG vaccination (p = 0.504), WCC (p = 0.187), lymphocyte count (p = 0.786), neutrophil count (p = 0.157) and the intensity of QFT response. Similarly in patients with active TB, there were no correlations between these variables and QFT response. The intensity of QFT response does not help to differentiate active from LTBI. The intensity of QFT response is not influenced by age, sex, smoking, remoteness of contact history, Mantoux response, nationality, CXR abnormalities, BCG vaccination and peripheral lymphocyte count.
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Affiliation(s)
- F Khan
- Department of Respiratory Medicine, Mercy University Hospital, Grenville Place, Cork.
| | - O Cotter
- Department of Respiratory Medicine, Mercy University Hospital, Grenville Place, Cork
| | - B Kennedy
- Department of Respiratory Medicine, Mercy University Hospital, Grenville Place, Cork
| | - J Clair
- Department of Respiratory Medicine, Mercy University Hospital, Grenville Place, Cork
| | - B O'Connor
- Department of Respiratory Medicine, Mercy University Hospital, Grenville Place, Cork
| | - J Collins
- Department of Respiratory Medicine, Mercy University Hospital, Grenville Place, Cork
| | - D Curran
- Department of Respiratory Medicine, Mercy University Hospital, Grenville Place, Cork
| | - T O'Connor
- Department of Respiratory Medicine, Mercy University Hospital, Grenville Place, Cork
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O'Connor T, Wilmut I, Taylor J. Quantitative Evaluation of Reference Genes for Real-Time PCR DuringIn VitroMaturation of Ovine Oocytes. Reprod Domest Anim 2012; 48:477-83. [DOI: 10.1111/rda.12112] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2012] [Accepted: 09/17/2012] [Indexed: 12/18/2022]
Affiliation(s)
- T O'Connor
- MRC Centre for Regenerative Medicine; The University of Edinburgh; Edinburgh; UK
| | - I Wilmut
- MRC Centre for Regenerative Medicine; The University of Edinburgh; Edinburgh; UK
| | - J Taylor
- MRC Centre for Regenerative Medicine; The University of Edinburgh; Edinburgh; UK
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Kennedy B, O'Connor B, Korn B, Gibbons N, O'Connor T, Keane J. Multi-drug resistant tuberculosis: experiences of two tertiary referral centres. Ir Med J 2011; 104:182-185. [PMID: 22111396] [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: 05/31/2023]
Abstract
Multi-drug resistant tuberculosis (MDR-TB) is associated with increased morbidity and mortality compared to drug-sensitive disease. Although MDR-TB is infrequent in Ireland, cases continue to be diagnosed in both Irish and foreign-born people. We conducted a clinical audit of 13 MDR-TB patients treated in two tertiary referral centers, the Mercy Hospital, Cork and St James's Hospital, Dublin between 2004 and 2009. The median age was 37 years. Eight patients (61.5%) were foreign-born, five (38.5%) were Irish-born. Seven patients (54%) have now stopped treatment; 6 (86%) were treated successfully and one (14%) defaulted. Mycobacterium tuberculosis isolates were resistant to a median of seven drugs. Eight patients (61.5%) developed ototoxicity from long-term aminoglycoside use. Our patients' treatment outcomes compare favourably with international reports despite a high degree of drug resistance. However, the high incidence of otoxicity is concerning.
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Armenian S, Ding Y, Sun C, Wong F, Wang S, O'Connor T, Forman S, Bhatia S. Genetic Susceptibility to Anthracycline-Related Congestive Heart Failure (A-CHF) in Survivors of Hematopoietic Cell Transplantation (HCT). Biol Blood Marrow Transplant 2011. [DOI: 10.1016/j.bbmt.2010.12.069] [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: 10/18/2022]
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Haybaeck J, O'Connor T, Spilka R, Spizzo G, Ensinger C, Mikuz G, Brunhuber T, Vogetseder A, Theurl I, Salvenmoser W, Draxl H, Bänziger R, Bachmann F, Schäfer G, Burger M, Obrist P. Overexpression of p150, a part of the large subunit of the eukaryotic translation initiation factor 3, in colon cancer. Anticancer Res 2010; 30:1047-1055. [PMID: 20530408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
BACKGROUND P150, a 150 kDa protein, was isolated from virally and oncogene-transformed mouse cell lines, partially purified and cloned. P150 is part of the large subunit of the eukaryotic translation initiation factor 3 with sequence homology to centrosomin A. A significant correlation between p150 expression and malignancy in breast, cervical and esophageal cancer have recently been demonstrated. MATERIALS AND METHODS Here, 110 colorectal carcinomas of different grades and stages, including lymph node and liver metastases were compared to adjacent normal mucosa by immunohistochemistry of P150. Western blot analysis of selected cases confirmed the expression levels determined by immunohistochemistry. Additionally, immuno-electron and laser scanning microscopy (LSM) was performed. RESULTS All investigated carcinomas revealed high levels of p150 protein compared to normal adjacent mucosa. The staining intensity was slightly heterogeneous, and positivity was correlated to the tumor grade with statistically significant differences of p150 expression between normal and neoplastic mucosa (p<0.0001, Kruskal-Wallis test). Western blots confirmed higher expression levels of p150 in the tumor. Immunogold labelling and LSM investigation showed high expression levels of p150 on the rough endoplasmic reticulum and polyribosomes, indicating that p150 is translationally active in these tumors. CONCLUSION Thus, we propose that p150 plays an important role in development and growth of colorectal carcinomas. Furthermore, p150 expression might provide us with reliable information on the biological behaviour of tumors and the clinical course of the disease.
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Affiliation(s)
- J Haybaeck
- Institute of Neuropathology, Department of Pathology, University Hospital Zurich, Switzerland
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O'Connor T, Yang SJ, Nicklas T. 143 BEVERAGE INTAKE AMONG PRESCHOOL CHILDREN AND ITS EFFECT ON WEIGHT STATUS. J Investig Med 2006. [DOI: 10.2310/6650.2005.x0008.142] [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: 11/18/2022]
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Hunt I, Chaudhry A, O'Connor T, Roxburgh J. A simple technique to assist in the minimally invasive harvesting of the saphenous vein in cardiac surgery. Ann R Coll Surg Engl 2005; 87:384-5. [PMID: 16402465 PMCID: PMC1964002] [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: 05/06/2023] Open
Affiliation(s)
- I Hunt
- Cardiothoracic Centre, St Thomas's Hospital, London, UK.
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Gilbert RL, O'Connor T, Mathew S, Allen K, Piper M, Gill ON. Hepatitis A vaccination--a prison-based solution for a community-based outbreak? Commun Dis Public Health 2004; 7:289-93. [PMID: 15779792] [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: 05/02/2023]
Abstract
In December 2001, an increase in cases of hepatitis A was observed in South Yorkshire. Cases were predominantly young males who reported injecting drug use. A community-based vaccination programme was introduced in November 2002, but new cases continued to occur. In March 2003, a vaccination campaign was implemented in the local prison for a four-week period. One thousand two hundred and thirty-six (91%) prisoners were vaccinated. Two thirds (895/1,363) of the prisoners came from the area affected by the outbreak and 52% (465/895) reported injecting drugs. The median age of injectors was 25 years. Notifications of cases of hepatitis A from South Yorkshire ceased in August 2003. Although on this occasion the prison vaccination campaign was probably implemented too late to have had a significant impact on the local outbreak, a large number of young male injectors from the local area were successfully vaccinated. This suggests that a prison-based intervention offers a potentially effective way of immunising the IDU population and interrupting a community-based outbreak.
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Affiliation(s)
- R L Gilbert
- Prison Surveillance Unit, Communicable Disease Surveillance Centre, Health Protection Agency Centre for Infections, 61 Colindale Avenue, London NW9 5EQ.
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O'Connor T. Proceedings of the American Chemical Society. J Am Chem Soc 2004. [DOI: 10.1021/ja02127a607] [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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O'Connor T. Proceedings of the American Chemical Society. J Am Chem Soc 2004. [DOI: 10.1021/ja02128a614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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O'Connor T. Proceedings of the American Chemical Society. J Am Chem Soc 2004. [DOI: 10.1021/ja02127a612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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O'Connor T. Proceedings of the American Chemical Society. J Am Chem Soc 2004. [DOI: 10.1021/ja02127a610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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O'Connor T. Proceedings of the American Chemical Society. J Am Chem Soc 2004. [DOI: 10.1021/ja02127a602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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O'Connor T. Proceedings of the Ameican Chemical Society. J Am Chem Soc 2004. [DOI: 10.1021/ja02128a608] [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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O'Connor T. Proceedings of the American Chemical Society. J Am Chem Soc 2004. [DOI: 10.1021/ja02128a610] [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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O'Connor T. Proceedings of General Meeting. J Am Chem Soc 2004. [DOI: 10.1021/ja02128a601] [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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O'Connor T. Proceedings of General Meeting. J Am Chem Soc 2004. [DOI: 10.1021/ja02128a604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Young W, McShane J, O'Connor T, Rewa G, Goodman S, Jaglal SB, Cash L, Coyte P. Registered nurses' experiences with an evidence-based home care pathway for myocardial infarction clients. Can J Cardiovasc Nurs 2004; 14:24-31. [PMID: 15460836] [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: 04/30/2023]
Abstract
OBJECTIVES To obtain home health nurses' comments on an evidence-based care pathway for post myocardial infarction. DESIGN A qualitative design was used. SETTING Culturally diverse, lower income area of a large city. PARTICIPANTS All home health nurses from one nursing agency who participated in a comparative study on the impact of the evidence-based care pathway. RESULTS The largest number of comments made by the nurses were related to the beneficial impact of the pathway on the provision of quality nursing care and on increased job satisfaction. The home health nurses reported that the pathway increased clients' knowledge of medications and diet. In addition, they commented that they were able to use the pathway effectively because of the training they received from the inpatient cardiac nurses. CONCLUSIONS This qualitative study demonstrates the benefits of investing in the implementation of best practice guidelines by home health nurses. However, nursing associations, such as the Canadian Community Health Nurses Initiatives Group, will need to continue to champion for additional funds to support the additional expenses incurred.
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Affiliation(s)
- W Young
- University of Toronto, Toronto, ON.
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O'Connor T. Reaching out to chronically ill children. Nurs N Z 2001; 7:20. [PMID: 12012975] [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: 02/25/2023]
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O'Connor T. Immunisation campaign almost completed. Nurs N Z 2001; 7:21. [PMID: 12012976] [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: 02/25/2023]
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O'Connor T. Treatment at Lake Alice was also caring. Nurs N Z 2001; 7:11. [PMID: 12012969] [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: 02/25/2023]
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O'Connor T. Getting to grips with the care of peri-operative patients. Nurs N Z 2001; 7:24-5. [PMID: 12012696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/25/2023]
Abstract
Impressions from a day at the five-day World Conference on Surgical Patient Care held in Christchurch last month.
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O'Connor T. Rebuilding a collective agreement and spirit. Nurs N Z 2001; 7:27. [PMID: 12012698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/25/2023]
Abstract
NZNO has embarked on rebuilding multi-employer collective agreements for nurses around the country.
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Manchester A, O'Connor T. NZNO launches campaign for safe staffing ratios. Nurs N Z 2001; 7:12-3. [PMID: 15462087] [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: 04/30/2023]
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O'Connor T. Centenary of registration celebrated in style. Nurs N Z 2001; 7:25. [PMID: 15462092] [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: 04/30/2023]
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O'Connor T. Regulating New Zealand nurses. Nurs N Z 2001; 7:20-1. [PMID: 15462091] [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: 04/30/2023]
MESH Headings
- Education, Nursing, Baccalaureate/history
- Education, Nursing, Baccalaureate/organization & administration
- Education, Nursing, Baccalaureate/standards
- Faculty, Nursing/history
- History, 20th Century
- History, 21st Century
- Humans
- New Zealand
- Nurse Administrators/history
- Schools, Nursing/history
- Schools, Nursing/organization & administration
- Schools, Nursing/standards
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Weber J, Nunn A, O'Connor T, Jeffries D, Kitchen V, McCormack S, Stott J, Almond N, Stone A, Darbyshire J. 'Chemical condoms' for the prevention of HIV infection: evaluation of novel agents against SHIV(89.6PD) in vitro and in vivo. AIDS 2001; 15:1563-8. [PMID: 11504989 DOI: 10.1097/00002030-200108170-00014] [Citation(s) in RCA: 61] [Impact Index Per Article: 2.7] [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: 11/26/2022]
Abstract
BACKGROUND Vaginal agents which are antiviral and/or inhibit the entry of HIV into the cell could prevent heterosexual transmission of HIV, and protect women who cannot negotiate condom use. METHODS Four agents have been investigated for activity in vitro and in vivo against SHIV(89.6PD): two anionic polymers, dextrin-2-sulphate (D2S) and PRO 2000 (P2K), and two virucidal agents; a non-ionic detergent, nonoxynol-9 (N9) and a cyclic peptide ionophore, gramicidin-D (GD). All four agents were investigated in rhesus macaques, using an intra-vaginal challenge of two inoculations of 1 x 104 50% tissue culture infectious doses (TCID)50 of SHIV(89.6PD). RESULTS D2S, P2K, GD and N9 all inhibited SHIV(89.6PD) in vitro. In vivo, three out of four control macaques were infected as judged by viral culture, seroconversion, DNA and RNA PCR; infection was confirmed in four out of eight macaques pre-treated with P2K, two out of four pre-treated with D2S, one out of four pre-treated with N9, two out of four pre-treated with GD and four out of four pre-treated with D2S + GD, a combination additive in vitro. INTERPRETATION D2S and PRO-2000, novel inhibitors of HIV entry, showed evidence of protection in vivo, comparable to that seen with the virucide, N9. These data, together with the results of phase I and phase II studies in healthy women which have shown minimal toxicity, support plans for a phase III efficacy trial of chemically simple inhibitors of HIV entry with low toxicity, for the prevention of HIV infection in women.
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Affiliation(s)
- J Weber
- Division of Medicine, Section of Infectious Diseases, Imperial College School of Medicine, St. Mary's Hospital, London UK.
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O'Connor T. Education review contains few surprises. Nurs N Z 2001; 7:20-1. [PMID: 12012899] [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: 02/25/2023]
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O'Connor T. Enrolled nurse training set to begin next year. Nurs N Z 2001; 7:19. [PMID: 12012897] [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: 02/25/2023]
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