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Wood HAC, Ehrlich K, Yerolatsitis S, Kufcsák A, Quinn TM, Fernandes S, Norberg D, Jenkins NC, Young V, Young I, Hamilton K, Seth S, Akram A, Thomson RR, Finlayson K, Dhaliwal K, Stone JM. Tri-mode optical biopsy probe with fluorescence endomicroscopy, Raman spectroscopy, and time-resolved fluorescence spectroscopy. J Biophotonics 2023; 16:e202200141. [PMID: 36062395 DOI: 10.1002/jbio.202200141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 07/30/2022] [Accepted: 09/01/2022] [Indexed: 06/15/2023]
Abstract
We present an endoscopic probe that combines three distinct optical fibre technologies including: A high-resolution imaging fibre for optical endomicroscopy, a multimode fibre for time-resolved fluorescence spectroscopy, and a hollow-core fibre with multimode signal collection cores for Raman spectroscopy. The three fibers are all enclosed within a 1.2 mm diameter clinical grade catheter with a 1.4 mm end cap. To demonstrate the probe's flexibility we provide data acquired with it in loops of radii down to 2 cm. We then use the probe in an anatomically accurate model of adult human airways, showing that it can be navigated to any part of the distal lung using a commercial bronchoscope. Finally, we present data acquired from fresh ex vivo human lung tissue. Our experiments show that this minimally invasive probe can deliver real-time optical biopsies from within the distal lung - simultaneously acquiring co-located high-resolution endomicroscopy and biochemical spectra.
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Affiliation(s)
- Harry Alexander Charles Wood
- Centre for Photonics and Photonic Materials, University of Bath, Bath, UK
- Translational Healthcare Technologies Group, Centre for Inflammation Research, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, UK
| | - Katjana Ehrlich
- Translational Healthcare Technologies Group, Centre for Inflammation Research, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, UK
- Scottish Universities Physics Alliance (SUPA), Institute of Photonics and Quantum Science, Heriot-Watt University, Edinburgh, UK
| | - Stephanos Yerolatsitis
- Centre for Photonics and Photonic Materials, University of Bath, Bath, UK
- Translational Healthcare Technologies Group, Centre for Inflammation Research, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, UK
- The College of Optics and Photonics (CREOL), University of Central Florida, Orlando, Florida, USA
| | - András Kufcsák
- Translational Healthcare Technologies Group, Centre for Inflammation Research, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, UK
| | - Tom Michael Quinn
- Translational Healthcare Technologies Group, Centre for Inflammation Research, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, UK
| | - Susan Fernandes
- Translational Healthcare Technologies Group, Centre for Inflammation Research, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, UK
| | - Dominic Norberg
- Translational Healthcare Technologies Group, Centre for Inflammation Research, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, UK
| | - Nia Caitlin Jenkins
- Translational Healthcare Technologies Group, Centre for Inflammation Research, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, UK
| | - Vikki Young
- Translational Healthcare Technologies Group, Centre for Inflammation Research, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, UK
| | - Irene Young
- Translational Healthcare Technologies Group, Centre for Inflammation Research, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, UK
| | - Katie Hamilton
- Translational Healthcare Technologies Group, Centre for Inflammation Research, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, UK
| | - Sohan Seth
- Translational Healthcare Technologies Group, Centre for Inflammation Research, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, UK
| | - Ahsan Akram
- Translational Healthcare Technologies Group, Centre for Inflammation Research, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, UK
| | - Robert Rodrick Thomson
- Translational Healthcare Technologies Group, Centre for Inflammation Research, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, UK
- Scottish Universities Physics Alliance (SUPA), Institute of Photonics and Quantum Science, Heriot-Watt University, Edinburgh, UK
| | - Keith Finlayson
- Translational Healthcare Technologies Group, Centre for Inflammation Research, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, UK
| | - Kevin Dhaliwal
- Translational Healthcare Technologies Group, Centre for Inflammation Research, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, UK
| | - James Morgan Stone
- Centre for Photonics and Photonic Materials, University of Bath, Bath, UK
- Translational Healthcare Technologies Group, Centre for Inflammation Research, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, UK
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Jenkins NC, Ehrlich K, Kufcsak A, Yerolatsitis S, Fernandes S, Young I, Hamilton K, Wood HAC, Quinn T, Young V, Akram AR, Stone JM, Thomson RR, Finlayson K, Dhaliwal K, Seth S. Computational Fluorescence Suppression in Shifted Excitation Raman Spectroscopy. IEEE Trans Biomed Eng 2023; PP. [PMID: 37022914 DOI: 10.1109/tbme.2023.3243866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
Abstract
Fiber-based Raman spectroscopy in the context of in vivo biomedical application suffers from the presence of background fluorescence from the surrounding tissue that might mask the crucial but inherently weak Raman signatures. One method that has shown potential for suppressing the background to reveal the Raman spectra is shifted excitation Raman spectroscopy (SER). SER collects multiple emission spectra by shifting the excitation by small amounts and uses these spectra to computationally suppress the fluorescence background based on the principle that Raman spectrum shifts with excitation while fluorescence spectrum does not. We introduce a method that utilizes the spectral characteristics of the Raman and fluorescence spectra to estimate them more effectively, and compare this approach against existing methods on real world datasets.
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Affiliation(s)
- Nia C. Jenkins
- School of Informatics, University of Edinburgh, 10 Crichton Street, Edinburgh, U.K
| | - Katjana Ehrlich
- Translational Healthcare Technology Group, Centre for Inflammation Research, Queen's Medical Research Institute, University of Edinburgh, 47 Little France Crescent, Edinburgh, U.K
| | - Andras Kufcsak
- Translational Healthcare Technology Group, Centre for Inflammation Research, Queen's Medical Research Institute, University of Edinburgh, 47 Little France Crescent, Edinburgh, U.K
| | - Stephanos Yerolatsitis
- Centre for Photonics and Photonic Materials, University of Bath, Claverton Down, Bath, U.K
| | - Susan Fernandes
- Translational Healthcare Technology Group, Centre for Inflammation Research, Queen's Medical Research Institute, University of Edinburgh, 47 Little France Crescent, Edinburgh, U.K
| | - Irene Young
- Translational Healthcare Technology Group, Centre for Inflammation Research, Queen's Medical Research Institute, University of Edinburgh, 47 Little France Crescent, Edinburgh, U.K
| | - Katie Hamilton
- Translational Healthcare Technology Group, Centre for Inflammation Research, Queen's Medical Research Institute, University of Edinburgh, 47 Little France Crescent, Edinburgh, U.K
| | - Harry A. C. Wood
- Centre for Photonics and Photonic Materials, University of Bath, Claverton Down, Bath, U.K
| | - Tom Quinn
- Translational Healthcare Technology Group, Centre for Inflammation Research, Queen's Medical Research Institute, University of Edinburgh, 47 Little France Crescent, Edinburgh, U.K
| | - Vikki Young
- Translational Healthcare Technology Group, Centre for Inflammation Research, Queen's Medical Research Institute, University of Edinburgh, 47 Little France Crescent, Edinburgh, U.K
| | - Ahsan R. Akram
- Translational Healthcare Technology Group, Centre for Inflammation Research, Queen's Medical Research Institute, University of Edinburgh, 47 Little France Crescent, Edinburgh, U.K
| | - James M. Stone
- Centre for Photonics and Photonic Materials, University of Bath, Claverton Down, Bath, U.K
| | - Robert R. Thomson
- Translational Healthcare Technology Group, Centre for Inflammation Research, Queen's Medical Research Institute, University of Edinburgh, 47 Little France Crescent, Edinburgh, U.K
| | - Keith Finlayson
- Translational Healthcare Technology Group, Centre for Inflammation Research, Queen's Medical Research Institute, University of Edinburgh, 47 Little France Crescent, Edinburgh, U.K
| | - Kevin Dhaliwal
- Translational Healthcare Technology Group, Centre for Inflammation Research, Queen's Medical Research Institute, University of Edinburgh, 47 Little France Crescent, Edinburgh, U.K
| | - Sohan Seth
- School of Informatics, University of Edinburgh, 10 Crichton Street, Edinburgh, U.K
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Spartera M, Stracquadanio A, Von Ende A, Pessoa-Amorim G, Hess A, Young V, Mazzucco S, Kennedy J, Ferreira V, Neubauer S, Casadei B, Wijesurendra R. Left atrial vorticity is independently associated with embolic brain infarcts and represents a promising imaging biomarker of cardioembolism in sinus rhythm and atrial fibrillation. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Atrial fibrillation (AF) is associated with embolic stroke, but risk scores such as CHA2DS2-VASc perform only modestly (C statistics 0.6–0.7). Meanwhile, up to 25% of embolic strokes in patients without AF have no identifiable cause, and occult left atrial (LA) thromboembolism may be a relevant mechanism in such cases.
Purpose
We hypothesised that imaging of left atrial blood flow could improve embolic risk prediction in patients with and without AF. We used 4D flow magnetic resonance imaging (MRI) to identify a biomarker that is: (a) independently associated with embolic brain infarction by brain MRI, (b) able to stratify blood flow characteristics both during AF and in sinus rhythm (SR), and (c) reproducible.
Methods
We recruited 3 patient cohorts to respectively address each aim. Firstly, to assess the association between LA flow parameters and embolic brain infarcts, we recruited cohort A, consisting of 134 patients (41% female; age 70±9 years) with a history of ischaemic stroke (N=44) or no history of stroke but with CHA2DS2VASc score ≥1 (N=90). Next, the sensitivity of 4D flow parameters to rhythm change was assessed in cohort B: 37 patients with persistent AF studied before and after cardioversion, whose results were compared with those of 23 healthy controls in SR [CHA2DS2-VASc = 0.0 (0.0–0.0)]. Finally, scan-rescan coefficients of variation (CV) and interval-scan CV at 30 days were determined in Cohort C (86 subjects; 64 in SR, 22 in AF). Brain MRI was used to identify large non-cortical or cortical brain infarcts (LNCCI) – i.e. infarcts likely to be embolic in origin.
Results
At least one LNCCI was present in 39 of 134 patients in cohort A. Lower LA vorticity was significantly associated with higher risk of prevalent LNCCIs (Figure 1), after adjustment for AF, age, and CHA2DS2VASc score [OR=2.10 (95% CI 1.12–3.92) per SD, P=0.02]. This association remained significant after further adjustment for other cardiac parameters (all P<0.05, Figure 1). By contrast, there was no significant association between peak velocity and LNCCIs (P=0.21).
LA vorticity was sensitive to rhythm change, improving significantly in patients in cohort B in SR at ≥4 weeks after cardioversion (CV) of persistent AF (Figure 2A, paired P<0.001 vs pre-CV), but remained impaired compared to healthy controls (Figure 2B, P<0.01).
Finally, reproducibility studies in cohort C showed that LA vorticity had a same-day scan-rescan CV of 7% without significant differences between SR and AF subjects (P>0.05), and also showed no significant temporal variability on interval scanning (P>0.05).
Conclusions
LA vorticity is reproducible, sensitive to changes in heart rhythm, and independently associated with embolic brain infarcts, suggesting a promising imaging biomarker of cardioembolism in SR and AF. LA blood flow imaging could improve stroke prediction and the personalisation of decisions about anticoagulation, regardless of heart rhythm.
Funding Acknowledgement
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Oxford BRC, BHF
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Affiliation(s)
- M Spartera
- University of Oxford , Oxford , United Kingdom
| | | | - A Von Ende
- University of Oxford , Oxford , United Kingdom
| | | | - A Hess
- University of Oxford , Oxford , United Kingdom
| | - V Young
- University of Oxford , Oxford , United Kingdom
| | - S Mazzucco
- University of Oxford , Oxford , United Kingdom
| | - J Kennedy
- University of Oxford , Oxford , United Kingdom
| | - V Ferreira
- University of Oxford , Oxford , United Kingdom
| | - S Neubauer
- University of Oxford , Oxford , United Kingdom
| | - B Casadei
- University of Oxford , Oxford , United Kingdom
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Gaughan E, Quinn T, Bruce A, Antonelli J, Young V, Mair J, Akram A, Hirani N, Koch O, Mackintosh C, Norrie J, Dear JW, Dhaliwal K. Evaluation of new or repurposed treatments for COVID-19: protocol for the phase Ib/IIa DEFINE trial platform. BMJ Open 2021; 11:e054442. [PMID: 34911721 PMCID: PMC8678561 DOI: 10.1136/bmjopen-2021-054442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Accepted: 10/04/2021] [Indexed: 11/03/2022] Open
Abstract
INTRODUCTION COVID-19 is a new viral-induced pneumonia caused by infection with a novel coronavirus, SARS-CoV-2. At present, there are few proven effective treatments. This early-phase experimental medicine protocol describes an overarching and adaptive trial designed to provide safety data in patients with COVID-19, pharmacokinetic (PK)/pharmacodynamic (PD) information and exploratory biological surrogates of efficacy, which may support further development and deployment of candidate therapies in larger scale trials of patients positive for COVID-19. METHODS AND ANALYSIS Define is an ongoing exploratory multicentre-platform, open-label, randomised study. Patients positive for COVID-19 will be recruited from the following cohorts: (a) community cases; (b) hospitalised patients with evidence of COVID-19 pneumonitis; and (c) hospitalised patients requiring assisted ventilation. The cohort recruited from will be dependent on the experimental therapy, its route of administration and mechanism of action. Randomisation will be computer generated in a 1:1:n ratio. Twenty patients will be recruited per arm for the initial two arms. This is permitted to change as per the experimental therapy. The primary statistical analyses are concerned with the safety of candidate agents as add-on therapy to standard of care in patients with COVID-19. Secondary analysis will assess the following variables during treatment period: (1) the response of key exploratory biomarkers; (2) change in WHO ordinal scale and National Early Warning Score 2 (NEWS2) score; (3) oxygen requirements; (4) viral load; (5) duration of hospital stay; (6) PK/PD; and (7) changes in key coagulation pathways. ETHICS AND DISSEMINATION The Define trial platform and its initial two treatment and standard of care arms have received a favourable ethical opinion from Scotland A Research Ethics Committee (REC) (20/SS/0066), notice of acceptance from The Medicines and Healthcare Products Regulatory Agency (MHRA) (EudraCT 2020-002230-32) and approval from the relevant National Health Service (NHS) Research and Development (R&D) departments (NHS Lothian and NHS Greater Glasgow and Clyde). Appropriate processes are in place in order to be able to consent adults with and without capacity while following the necessary COVID-19 safe procedures. Patients without capacity could be recruited via a legal representative. Witnessed electronic consent of participants or their legal representatives following consent discussions was established. The results of each study arm will be submitted for publication in a peer-reviewed journal as soon as the treatment arm has finished recruitment, data input is complete and any outstanding patient safety follow-ups have been completed. Depending on the results of these or future arms, data will be shared with larger clinical trial networks, including the Randomised Evaluation of COVID-19 Therapy trial (RECOVERY), and to other partners for rapid roll-out in larger patient cohorts. TRIAL REGISTRATION NUMBER ISRCTN14212905, NCT04473053.
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Affiliation(s)
- Erin Gaughan
- Centre for Inflammation Research, Queen's Medical Research Institute, The University of Edinburgh, Edinburgh, UK
- Royal Infirmary of Edinburgh, NHS Lothian, Edinburgh, UK
| | - Tom Quinn
- Centre for Inflammation Research, Queen's Medical Research Institute, The University of Edinburgh, Edinburgh, UK
- Royal Infirmary of Edinburgh, NHS Lothian, Edinburgh, UK
| | - Annya Bruce
- Centre for Inflammation Research, Queen's Medical Research Institute, The University of Edinburgh, Edinburgh, UK
| | - Jean Antonelli
- Centre for Inflammation Research, Queen's Medical Research Institute, The University of Edinburgh, Edinburgh, UK
| | - Vikki Young
- Centre for Inflammation Research, Queen's Medical Research Institute, The University of Edinburgh, Edinburgh, UK
| | - Joanne Mair
- Centre for Inflammation Research, Queen's Medical Research Institute, The University of Edinburgh, Edinburgh, UK
| | - Ahsan Akram
- Centre for Inflammation Research, Queen's Medical Research Institute, The University of Edinburgh, Edinburgh, UK
- Royal Infirmary of Edinburgh, NHS Lothian, Edinburgh, UK
| | - Nik Hirani
- Centre for Inflammation Research, Queen's Medical Research Institute, The University of Edinburgh, Edinburgh, UK
- Royal Infirmary of Edinburgh, NHS Lothian, Edinburgh, UK
| | - Oliver Koch
- Regional Infectious Diseases Unit, NHS Lothian, Edinburgh, UK
| | | | - John Norrie
- Edinburgh Clinical Trials Unit, The University of Edinburgh, Edinburgh, UK
| | - James W Dear
- Royal Infirmary of Edinburgh, NHS Lothian, Edinburgh, UK
- Centre for Cardiovascular Science, Queen's Medical Research Institute, The University of Edinburgh, Edinburgh, UK
| | - Kevin Dhaliwal
- Centre for Inflammation Research, Queen's Medical Research Institute, The University of Edinburgh, Edinburgh, UK
- Royal Infirmary of Edinburgh, NHS Lothian, Edinburgh, UK
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5
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Yerolatsitis S, Kufcsák A, Ehrlich K, Wood HAC, Fernandes S, Quinn T, Young V, Young I, Hamilton K, Akram AR, Thomson RR, Finlayson K, Dhaliwal K, Stone JM. Sub millimetre flexible fibre probe for background and fluorescence free Raman spectroscopy. J Biophotonics 2021; 14:e202000488. [PMID: 33855811 DOI: 10.1002/jbio.202000488] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Revised: 03/26/2021] [Accepted: 04/11/2021] [Indexed: 06/12/2023]
Abstract
Using the shifted-excitation Raman difference spectroscopy technique and an optical fibre featuring a negative curvature excitation core and a coaxial ring of high numerical aperture collection cores, we have developed a portable, background and fluorescence free, endoscopic Raman probe. The probe consists of a single fibre with a diameter of less than 0.25 mm packaged in a sub-millimetre tubing, making it compatible with standard bronchoscopes. The Raman excitation light in the fibre is guided in air and therefore interacts little with silica, enabling an almost background free transmission of the excitation light. In addition, we used the shifted-excitation Raman difference spectroscopy technique and a tunable 785 nm laser to separate the fluorescence and the Raman spectrum from highly fluorescent samples, demonstrating the suitability of the probe for biomedical applications. Using this probe we also acquired fluorescence free human lung tissue data.
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Affiliation(s)
| | - András Kufcsák
- Translational Healthcare Technologies Team, Centre for Inflammation Research, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, UK
| | - Katjana Ehrlich
- Translational Healthcare Technologies Team, Centre for Inflammation Research, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, UK
- Scottish Universities Physics Alliance (SUPA), Institute of Photonics and Quantum Sciences, Heriot-Watt University, Edinburgh, UK
| | | | - Susan Fernandes
- Translational Healthcare Technologies Team, Centre for Inflammation Research, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, UK
| | - Tom Quinn
- Translational Healthcare Technologies Team, Centre for Inflammation Research, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, UK
| | - Vikki Young
- Translational Healthcare Technologies Team, Centre for Inflammation Research, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, UK
| | - Irene Young
- Translational Healthcare Technologies Team, Centre for Inflammation Research, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, UK
| | - Katie Hamilton
- Translational Healthcare Technologies Team, Centre for Inflammation Research, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, UK
| | - Ahsan R Akram
- Translational Healthcare Technologies Team, Centre for Inflammation Research, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, UK
| | - Robert R Thomson
- Scottish Universities Physics Alliance (SUPA), Institute of Photonics and Quantum Sciences, Heriot-Watt University, Edinburgh, UK
| | - Keith Finlayson
- Translational Healthcare Technologies Team, Centre for Inflammation Research, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, UK
| | - Kevin Dhaliwal
- Translational Healthcare Technologies Team, Centre for Inflammation Research, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, UK
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Raborn J, Monroe E, Annam A, Ladd P, Young V, Lungren M, Temple M, Gunn A. Abstract No. 80 Inferior vena cava filter placement and retrieval in pediatric patients: a multicenter retrospective analysis. J Vasc Interv Radiol 2021. [DOI: 10.1016/j.jvir.2021.03.503] [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] Open
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7
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McKee K, Carter K, Bassis C, Young V, Reed B, Harper D, Ruffin M, Bell J. The vaginal microbiota, high-risk human papillomavirus infection, and cervical intraepithelial neoplasia: results from a population-based study. Am J Obstet Gynecol 2019. [DOI: 10.1016/j.ajog.2019.10.077] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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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McKee K, Bassis C, Murali S, Bell J, Young V. The vaginal microbiota in pregnancy and spontaneous preterm birth. Am J Obstet Gynecol 2019. [DOI: 10.1016/j.ajog.2019.10.060] [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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9
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Feldsine PT, Lienau AH, Leung SC, Mui LA, Humbert F, Bohnert M, Mooijman K, Schulten S, Veld PI, Rollier P, Leuschner R, Capps K, Agin J, Allaert C, Asmundson R, Asperger H, Bohnert M, Bound A, Dixon L, Donda S, Espersen M, Foster K, Gangar V, Hammack T, Humbert F, Humes L, in’t Veld P, James L, Jost-Keating K, Kalinowski R, Kwan J, Lamb J, Leung S, Lienau A, Littell A, Mooijman K, Mui L, Ott M, Qvist S, Roberts D, Ruby R, Rude R, Santos C, Schulten S, Sellers R, Smith M, Solis D, Stecchini ML, Stegeman H, Steneryd A, Suktankar V, Wiberg C, Young V. Detection of Salmonella in Fresh Cheese, Poultry Products, and Dried Egg Products by the ISO 6579 Salmonella Culture Procedure and the AOAC Official Method: Collaborative Study. J AOAC Int 2019. [DOI: 10.1093/jaoac/86.2.275] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Abstract
Three food types were analyzed for the presence of Salmonella by the AOAC culture method and by the International Organization for Standardization (ISO 6579:2002) culture method. Paired test portions of each food type were simultaneously analyzed by both methods. A total of 21 laboratories representing federal government agencies and private industry, in the United States and Europe, participated in this interlaboratory study. Foods were artificially contaminated with Salmonella and competing microflora if naturally contaminated sources were not available. No statistical differences (p < 0.05) were observed between the AOAC and ISO culture methods for fresh cheese and dried egg products. A statistically significant difference was observed for one of the 2 lots of poultry from the first trial. The poultry meat used in this run was radiation sterilized, artificially contaminated with Salmonella and competitive flora, and then lyophilized. A second trial was conducted with 2 separate lots of raw ground chicken that were naturally contaminated. The results from the second trial showed no statistical difference between the 2 culture methods. A third trial involving 4 laboratories was conducted on 2 separate lots of naturally contaminated raw poultry. Again, no statistically significant differences occurred. It is recommended that ISO 6579:2002 culture method for Salmonella be adopted Official First Action for the analysis of fresh cheese, fresh chilled and frozen poultry, and dried egg products.
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Affiliation(s)
| | - Andrew H Lienau
- BioControl Systems, Inc., 12822 SE 32nd St, Bellevue, WA 98005
| | | | - Linda A Mui
- BioControl Systems, Inc., 12822 SE 32nd St, Bellevue, WA 98005
| | - Florence Humbert
- Agence Française de Sécurité Sanitaire des Aliments, Laboratoire d'Étude et de Recherches Avicoles et Porcines, BP 53, 22440, Ploufragan, France
| | - Marylène Bohnert
- Agence Française de Sécurité Sanitaire des Aliments, Laboratoire d'Étude et de Recherches Avicoles et Porcines, BP 53, 22440, Ploufragan, France
| | - Kirsten Mooijman
- National Institut of Public Health and Environment, Microbiological Laboratory for Health Protection, PO Box 1, 3720 BA Bilthoven, The Netherlands
| | - Saskia Schulten
- National Institut of Public Health and Environment, Microbiological Laboratory for Health Protection, PO Box 1, 3720 BA Bilthoven, The Netherlands
| | - Paul In’t Veld
- Regional Inspectorate South, PO Box 2280, 5202 CG's-Hertogenbosch, Rijzertlaan 19, 's-Hertogenbosch, The Netherlands
| | - Patricia Rollier
- Centre d'Étude et de Controle des Analyses en Industrie Laitière, BP 89, 39801 Poligny, France
| | - Renata Leuschner
- Ministry of Agriculture, Fisheries, and Food, Control Science Laboratory, Sand Hutton, Y041 1LZ York, United Kingdom
| | - Katherine Capps
- Ministry of Agriculture, Fisheries, and Food, Control Science Laboratory, Sand Hutton, Y041 1LZ York, United Kingdom
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10
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O'Connor CT, O'Rourke S, Buckley A, Murphy R, Crean P, Foley B, Maree A, Ryan R, Tolan M, Young V, O'Connell B, Daly C. Infective endocarditis: a retrospective cohort study. QJM 2019; 112:663-667. [PMID: 31147713 DOI: 10.1093/qjmed/hcz134] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2019] [Revised: 05/21/2019] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Infective endocarditis (IE) is a potentially life-threatening infection of the heart's endocardial surface. Despite advances in the diagnosis and management of IE, morbidity and mortality remain high. AIM To characterize the demographics, bacteriology and outcomes of IE cases presenting to an Irish tertiary referral centre. DESIGN Retrospective cohort study. METHODS Patients were identified using Hospital Inpatient Enquiry and Clinical Microbiology inpatient consult data, from January 2005 to January 2014. Patients were diagnosed with IE using Modified Duke Criteria. Standard Bayesian statistics were employed for analysis and cases were compared to contemporary international registries. RESULTS Two hundred and two patients were diagnosed with IE during this period. Mean age 54 years. Of these, 136 (67%) were native valve endocarditis (NVE), 50 (25%) were prosthetic valve endocarditis (PVE) and 22 (11%) were cardiovascular implantable electronic device-associated endocarditis. Culprit organism was identified in 176 (87.1%) cases and Staphylococcal species were the most common (57.5%). Fifty-nine per cent of NVE required surgery compared to 66% of PVE. Mean mortality rate was 17.3%, with NVE being the lowest (12.5%) and PVE the highest (32%). Increasing age was also associated with increased mortality. Fifty-three (26.2%) patients had embolic complications. CONCLUSIONS This Irish cohort exhibited first-world demographic patterns comparable to those published in contemporary international literature. PVE required surgery more often and was associated with higher rates of mortality than NVE. Embolic complications were relatively common and represent important sequelae, especially in the intravenous drug user population. It is also pertinent to aggressively treat older cohorts as they were associated with increased mortality.
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Affiliation(s)
- C T O'Connor
- Department of Cardiology, St. James's Hospital, James's Street, Dublin D08 FD2W
| | - S O'Rourke
- Department of Microbiology, St. James's Hospital, James's Street, Dublin D08 K0Y5
| | - A Buckley
- Department of Cardiology, St. James's Hospital, James's Street, Dublin D08 FD2W
| | - R Murphy
- Department of Cardiology, St. James's Hospital, James's Street, Dublin D08 FD2W
| | - P Crean
- Department of Cardiology, St. James's Hospital, James's Street, Dublin D08 FD2W
| | - B Foley
- Department of Cardiology, St. James's Hospital, James's Street, Dublin D08 FD2W
| | - A Maree
- Department of Cardiology, St. James's Hospital, James's Street, Dublin D08 FD2W
| | - R Ryan
- Department of Cardiothoracic Surgery, St. James's Hospital, James's Street, Dublin D08 FD2W, Ireland
| | - M Tolan
- Department of Cardiothoracic Surgery, St. James's Hospital, James's Street, Dublin D08 FD2W, Ireland
| | - V Young
- Department of Cardiothoracic Surgery, St. James's Hospital, James's Street, Dublin D08 FD2W, Ireland
| | - B O'Connell
- Department of Microbiology, St. James's Hospital, James's Street, Dublin D08 K0Y5
| | - C Daly
- Department of Cardiology, St. James's Hospital, James's Street, Dublin D08 FD2W
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Nichol K, Kudla I, Young V, Eriksson J, Budd D, Holness DL. Testing the joint health and safety committee assessment tool in the education sector. Arch Environ Occup Health 2019; 75:209-215. [PMID: 30990391 DOI: 10.1080/19338244.2019.1594662] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Joint Health and Safety Committee (JHSC) effectiveness has been identified as an area of concern for Ontario's education sector. The JHSC Assessment Tool has been previously tested in hospitals with positive results. This study assessed the feasibility and usability of the JHSC Assessment Tool in the education sector. Members of multi-workplace JHSCs from Ontario school boards used the tool to assess their committees' effectiveness before, during and after a committee meeting with usability testing conducted pre and post meeting. Results suggested that the JHSC Assessment Tool was feasible to use during a regular JHSC meeting, groups were able to come to consensus on the majority of items, and usability scores were high overall. Participant feedback provided insight that informed the development of a version relevant to multi-workplace committees.
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Affiliation(s)
- K Nichol
- VHA Home HealthCare, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Centre for Research Expertise in Occupational Disease, Toronto, Ontario, Canada
- Lawerence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
| | - I Kudla
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Centre for Research Expertise in Occupational Disease, Toronto, Ontario, Canada
- St. Michael's Hospital, Occupational Health Clinic, Toronto, Ontario, Canada
| | - V Young
- Elementary Teachers' Federation of Ontario, Toronto, Ontario, Canada
| | - J Eriksson
- Collaborative Academic Practice, University Health Network, Toronto, Ontario, Canada
| | - D Budd
- Centre for Research Expertise in Occupational Disease, Toronto, Ontario, Canada
- Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada
| | - D L Holness
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Centre for Research Expertise in Occupational Disease, Toronto, Ontario, Canada
- Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada
- Division of Occupational Medicine, Department of Medicine, St. Michael's Hospital, Toronto, Ontario, Canada
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Carter K, Bassis C, McKee K, Bullock K, Eastman A, Young V, Bell J. The impact of tampon use on the vaginal microbiota across four menstrual cycles. Am J Obstet Gynecol 2018. [DOI: 10.1016/j.ajog.2018.10.078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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13
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Barr M, Farrell R, Singh S, Foley E, He Y, Brady L, Young V, Ryan R, Nicholson S, Leonard N, Cuffe S, Finn S. MA06.09 XRCC6BP1: A DNA Repair Gene in Cisplatin Resistant Lung Cancer Stem Cells That May Predict Survival Outcomes in Patients. J Thorac Oncol 2018. [DOI: 10.1016/j.jtho.2018.08.364] [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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Young V, Lewandowski R, Thornburg B, Riaz A, Mouli S, Salem R, Desai K. Abstract No. 562 Paclitaxel drug-coated balloon cholangioplasty in the treatment of biliary-enteric anastomotic stricture. J Vasc Interv Radiol 2018. [DOI: 10.1016/j.jvir.2018.01.607] [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: 10/17/2022] Open
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15
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Young V, Stalley P, Anderson L, Mahar A. Cutaneous ciliated cysts: A case report with immunohistochemical evidence for Mullerian origin. Pathology 2018. [DOI: 10.1016/j.pathol.2017.11.065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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16
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MacDonagh L, Gray S, Cuffe S, Finn S, Nicholson S, Ryan R, Young V, Leonard N, O’Byrne K, Barr M. In with the old! Repurposing disulfiram to target cancer stem cells (CSCs) and the root of cisplatin resistance. Lung Cancer 2018. [DOI: 10.1016/s0169-5002(18)30031-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: 11/27/2022]
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17
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MacDonagh L, Gray S, Gallagher M, French B, Gasch C, Young V, Ryan R, Nicholson S, Leonard N, Finn S, Cuffe S, O’Byrne K, Barr M. Big applications for a microRNA signature: the diagnostic, prognostic and predictive biomarker potential of a novel 5-miR signature associated with cisplatin resistant NSCLC. Lung Cancer 2018. [DOI: 10.1016/s0169-5002(18)30037-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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18
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Donagh LM, Gray S, Gallagher M, Ffrench B, Gasch C, Young V, Ryan R, Nicholson S, Leonard N, Finn S, Cuffe S, O’Byrne K, Barr M. P2.02-064 A Novel 5-miR Signature Shows Potential as a Diagnostic Tool and as a Predictive Biomarker of Cisplatin Response in NSCLC. J Thorac Oncol 2017. [DOI: 10.1016/j.jtho.2017.09.1242] [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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McCann ME, Withington DE, Arnup SJ, Davidson AJ, Disma N, Frawley G, Morton NS, Bell G, Hunt RW, Bellinger DC, Polaner DM, Leo A, Absalom AR, von Ungern-Sternberg BS, Izzo F, Szmuk P, Young V, Soriano SG, de Graaff JC. Differences in Blood Pressure in Infants After General Anesthesia Compared to Awake Regional Anesthesia (GAS Study-A Prospective Randomized Trial). Anesth Analg 2017; 125:837-845. [PMID: 28489641 DOI: 10.1213/ane.0000000000001870] [Citation(s) in RCA: 60] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND The General Anesthesia compared to Spinal anesthesia (GAS) study is a prospective randomized, controlled, multisite, trial designed to assess the influence of general anesthesia (GA) on neurodevelopment at 5 years of age. A secondary aim obtained from the blood pressure data of the GAS trial is to compare rates of intraoperative hypotension after anesthesia and to identify risk factors for intraoperative hypotension. METHODS A total of 722 infants ≤60 weeks postmenstrual age undergoing inguinal herniorrhaphy were randomized to either bupivacaine regional anesthesia (RA) or sevoflurane GA. Exclusion criteria included risk factors for adverse neurodevelopmental outcome and infants born at <26 weeks of gestation. Moderate hypotension was defined as mean arterial pressure measurement of <35 mm Hg. Any hypotension was defined as mean arterial pressure of <45 mm Hg. Epochs were defined as 5-minute measurement periods. The primary outcome was any measured hypotension <35 mm Hg from start of anesthesia to leaving the operating room. This analysis is reported primarily as intention to treat (ITT) and secondarily as per protocol. RESULTS The relative risk of GA compared with RA predicting any measured hypotension of <35 mm Hg from the start of anesthesia to leaving the operating room was 2.8 (confidence interval [CI], 2.0-4.1; P < .001) by ITT analysis and 4.5 (CI, 2.7-7.4, P < .001) as per protocol analysis. In the GA group, 87% and 49%, and in the RA group, 41% and 16%, exhibited any or moderate hypotension by ITT, respectively. In multivariable modeling, group assignment (GA versus RA), weight at the time of surgery, and minimal intraoperative temperature were risk factors for hypotension. Interventions for hypotension occurred more commonly in the GA group compared with the RA group (relative risk, 2.8, 95% CI, 1.7-4.4 by ITT). CONCLUSIONS RA reduces the incidence of hypotension and the chance of intervention to treat it compared with sevoflurane anesthesia in young infants undergoing inguinal hernia repair.
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Affiliation(s)
- M E McCann
- From the *Department of Anesthesiology, Perioperative and Pain Medicine, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts; †Department of Anesthesia, Montreal Children's Hospital, Montreal, Canada; ‡Department of Anesthesia, McGill University, Montreal, Canada; §Clinical Epidemiology and Biostatistics Unit, Murdoch Children's Research Institute, Melbourne, Victoria, Australia; ‖Anaesthesia and Pain Management Research Group, Murdoch Children's Research Institute, Melbourne, Victoria, Australia; ¶Department of Anaesthesia and Pain Management, the Royal Children's Hospital, Melbourne, Victoria, Australia; #Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia; **Department of Anaesthesia, Istituto Giannina Gaslini, Genoa, Italy; ††Academic Unit of Anaesthesia, Pain and Critical Care, University of Glasgow, Glasgow, United Kingdom; ‡‡Department of Anaesthesia, Royal Hospital for Sick Children, Glasgow, United Kingdom; §§Department of Neonatal Medicine, The Royal Children's Hospital, Melbourne, Victoria, Australia; ‖‖Neonatal Research Group, Murdoch Children's Research Institute, Melbourne, Victoria, Australia; ¶¶Department of Neurology, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts; ##Department of Psychiatry, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts; ***Department of Environmental Health, Harvard T. H. Chan School of Public Health, Boston, Massachusetts; †††Departments of Anesthesiology and Pediatrics, Children's Hospital Colorado, University of Colorado School of Medicine, Aurora, Colorado; ‡‡‡Department of Anaesthesia, Royal Children's Hospital, Melbourne, Australia; §§§University Medical Center Groningen, Groningen University, the Netherlands; ‖‖‖Pharmacology, Pharmacy, Anaesthesiology Unit, School of Medicine and Pharmacology, the University of Western Australia, Perth, Western Australia, Australia; ¶¶¶Department of Anaesthesia and Pain Management, Princess Margaret Hospital for Children, Perth, Western Australia, Australia; ###Department of Anaesthesiology and Intensive Care, Paediatric Intensive Care Unit Children Hospital 'Vittore Buzzi', Milano, Italy; ****Department of Anesthesiology and Pain Management, University of Texas Southwestern and Children's Health Medical Center, Dallas, Texas; ††††Outcome Research Consortium, Cleveland, Ohio; ‡‡‡‡Department of Anaesthesiology, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, the Netherlands; §§§§Brain Center Rudolph Magnus, University Medical Centre Utrecht, the Netherlands; and ‖‖‖‖Department of Anesthesia, Sophia Children's Hospital, Erasmus Medical Center Rotterdam, the Netherlands
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Lin R, Reid G, Mutti L, Ryan A, Nicholson S, Leonard N, Young V, Ryan R, Finn S, Cuffe S, Gray S. 8: Are circRNAs potentially useful for the early detection of lung cancer? Lung Cancer 2017. [DOI: 10.1016/s0169-5002(17)30058-2] [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: 10/20/2022]
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21
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Barr M, Singh S, Foley E, He Y, Young V, Ryan R, Nicholson S, Leonard N, O'Byrne K, Cuffe S, Finn S. 2: XRCC6BP1: A key player in cisplatin resistance and lung cancer stem cells. Lung Cancer 2017. [DOI: 10.1016/s0169-5002(17)30052-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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22
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Chen J, Carletti F, Young V, Mckean D, Quaghebeur G. MRI differential diagnosis of suspected multiple sclerosis. Clin Radiol 2016; 71:815-27. [DOI: 10.1016/j.crad.2016.05.010] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2015] [Revised: 04/08/2016] [Accepted: 05/11/2016] [Indexed: 10/21/2022]
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23
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Barr M, Foley E, He Y, Young V, Ryan R, Nicholson S, Leonard N, O'Byrne K, Cuffe S, Finn S. 80P XRCC6BP1: A key DNA repair gene in platinum-resistant NSCLC. J Thorac Oncol 2016. [DOI: 10.1016/s1556-0864(16)30193-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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24
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MacDonagh L, Gray S, Cuffe S, Finn S, Young V, Ryan R, Nicholson S, Leonard N, O'Byrne K, Barr M. 6 Cisplatin induces the emergence and expansion of a distinct cancer stem cell (CSC) population in NSCLC. Lung Cancer 2016. [DOI: 10.1016/s0169-5002(16)30023-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: 11/28/2022]
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25
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Barr M, Foley E, He Y, Young V, Ryan R, Nicholson S, Leonard N, O'Byrne K, Finn S, Cuffe S. 4 Identification and targeting of the DNA repair gene, XRCC6BP1, in cisplatin resistant NSCLC. Lung Cancer 2016. [DOI: 10.1016/s0169-5002(16)30021-6] [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: 11/17/2022]
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26
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Makris GC, Teng Z, Patterson AJ, Lin JM, Young V, Graves MJ, Gillard JH. Advances in MRI for the evaluation of carotid atherosclerosis. Br J Radiol 2015; 88:20140282. [PMID: 25826233 DOI: 10.1259/bjr.20140282] [Citation(s) in RCA: 13] [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: 12/25/2022] Open
Abstract
Carotid artery atherosclerosis is an important source of mortality and morbidity in the Western world with significant socioeconomic implications. The quest for the early identification of the vulnerable carotid plaque is already in its third decade and traditional measures, such as the sonographic degree of stenosis, are not selective enough to distinguish those who would really benefit from a carotid endarterectomy. MRI of the carotid plaque enables the visualization of plaque composition and specific plaque components that have been linked to a higher risk of subsequent embolic events. Blood suppressed T1 and T2 weighted and proton density-weighted fast spin echo, gradient echo and time-of-flight sequences are typically used to quantify plaque components such as lipid-rich necrotic core, intraplaque haemorrhage, calcification and surface defects including erosion, disruption and ulceration. The purpose of this article is to review the most important recent advances in MRI technology to enable better diagnostic carotid imaging.
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Affiliation(s)
- G C Makris
- Department of Radiology, University of Cambridge, Cambridge, UK
| | - Z Teng
- Department of Radiology, University of Cambridge, Cambridge, UK
| | - A J Patterson
- Department of Radiology, University of Cambridge, Cambridge, UK
| | - J-M Lin
- Department of Radiology, University of Cambridge, Cambridge, UK
| | - V Young
- Department of Radiology, University of Cambridge, Cambridge, UK
| | - M J Graves
- Department of Radiology, University of Cambridge, Cambridge, UK
| | - J H Gillard
- Department of Radiology, University of Cambridge, Cambridge, UK
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Eiser C, Johnson B, Brierley S, Ayling K, Young V, Bottrell K, Whitehead V, Elliott J, Scott A, Heller S. Using the Medical Research Council framework to develop a complex intervention to improve delivery of care for young people with type 1 diabetes. Diabet Med 2013; 30:e223-8. [PMID: 23510142 DOI: 10.1111/dme.12185] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/13/2013] [Indexed: 01/06/2023]
Abstract
AIMS We describe how we have used the development phase of the Medical Research Council (MRC) Guidelines to construct a complex intervention to improve physical and psychological health among young people (16-21 years) with Type 1 diabetes. METHODS We consulted previous reviews where available and conducted systematic searches of electronic databases to determine physical and mental health among the population, audited medical records, surveyed self-reported psychological health among our clinic population; and interviewed staff (n = 13), young people (n = 27) and parents (n = 18) about their views of current care. RESULTS Our audit (n = 96) confirmed a high HbA1c [86 mmol/mol (10.0%)] and one third (36.1%) reported significant eating problems. Young people did not attend 12% of their clinic appointments. Staff described difficulties communicating with young people who wanted staff to take account of their individual lifestyle when giving information. CONCLUSION Based on the findings of the systematic reviews and our audit, we concluded that there was sufficient evidence to justify development of a model of care specific to this age group. The components of the complex intervention include changes to standard care, an optional 5-day self-management course directed at young people and a separate family communication programme. The MRC Guidelines provided a valuable structure to guide development and evaluation of this intervention.
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Affiliation(s)
- C Eiser
- Department of Psychology, University of Sheffield, Sheffield, UK.
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Abstract
AIMS To determine: (1) prevalence of depression among young people with Type 1 diabetes compared with control groups or population norms; (2) implications of depression for HbA(1c) level; and (3) the relationship between history of depressive symptoms and future depressive symptoms. BACKGROUND Among adults with Type 1 diabetes depression is higher than the general population, and has been associated with adverse implications for self-care and HbA(1c) level. The last published review of depression among young people with Type 1 diabetes only included studies up to 1999. METHOD Systematic searches were conducted for articles published from January 1999 to December 2011 including young people (up to 25 years old) with Type 1 diabetes. RESULTS Twenty-three articles met the inclusion criteria. Of five studies that reported prevalence of depression compared with control groups, three found no differences. Of the three studies that investigated prevalence of depression making reference to population norms, all three showed higher rates of depressive symptoms. Fourteen of 15 studies found associations between more depressive symptoms and higher HbA(1c) level either cross-sectionally or longitudinally. Past depressive symptoms were associated with later depressive symptoms. CONCLUSIONS Current evidence is inconclusive about whether there is increased prevalence of depression among young adults with Type 1 diabetes, as established among adults, but those who are more depressed have higher HbA(1c) level. This review is limited by methodological problems and no identified work in the UK met the inclusion criteria. Given the adverse clinical outcomes, we conclude there is a case for routine mental health screening for young adults with Type 1 diabetes.
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Affiliation(s)
- B Johnson
- NIHR CLAHRC for South Yorkshire, Department of Psychology, University of Sheffield, Sheffield, UK.
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Abstract
AIMS We report a systematic review to determine (1) prevalence of eating problems compared with peers and (2) the association between eating problems and glycaemic control in young adults with Type 1 diabetes. METHOD We conducted a systematic literature search via electronic databases and meta-analysis. Cohen's d (the mean difference score between Type 1 diabetes and comparison groups) was calculated for 13 studies that met inclusion criteria. RESULTS Eating problems [both disordered eating behaviour (39.3 and 32.5%; d = 0.52, 95% CI 0.10-0.94) and eating disorders (7.0 and 2.8%; d = 0.46, 95% CI 0.10-0.81)] were more common in adolescents with Type 1 diabetes compared with peers and both were associated with poorer glycaemic control (d = 0.40, 95% CI 0.17-0.64). In restricted analyses involving measures adapted for diabetes, associations between eating problems and poorer glycaemic control remained (d = 0.54, 95% CI 0.32-0.76). Disordered eating behaviour (51.8 and 48.1%; d = 0.06, 95% CI -0.05 to 0.21) and eating disorders (6.4 and 3.0%; d = 0.43, 95% CI -0.06 to 0.91) were more common in adolescents with Type 1 diabetes compared with peers, but differences were non-significant. CONCLUSIONS Eating problems are common among this age group. Future work in populations with Type 1 diabetes should develop sensitive measures of eating problems and interventions, and establish predictors of eating problems. Screening in clinics is recommended.
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Affiliation(s)
- V Young
- Department of Psychology, NIHR CLAHRC for South Yorkshire, Medical School, University of Sheffield, Sheffield, UK.
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Brierley S, Eiser C, Johnson B, Young V, Heller S. Working with young adults with Type 1 diabetes: views of a multidisciplinary care team and implications for service delivery. Diabet Med 2012; 29:677-81. [PMID: 22375561 DOI: 10.1111/j.1464-5491.2012.03601.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
AIMS Young adults with Type 1 diabetes experience difficulties achieving glucose targets. Clinic attendance can be poor, although health and self-care tend to be better among those who attend regularly. Our aims were to describe staff views about challenges working with this age-group (16-21 years). METHODS Semistructured interviews were conducted with 14 staff from Sheffield Teaching Hospitals diabetes care team. Interviews were audio-recorded, transcribed and analysed using thematic analysis. RESULTS Three main themes emerged. Unique challenges working with young adults included staff emotional burden, the low priority given to self-care by young adults and the complexity of the diabetes regimen. Working in a multidisciplinary team was complicated by differences in consultation styles, poor team cohesion and communication. An ideal service should include psychological support for the professional team, identification of key workers, and development of individualized care plans. CONCLUSIONS Staff differed in their views about how to achieve optimal management for young adults, but emphasized the need for greater patient-centred care and a range of interventions appropriate for individual levels of need. They also wanted to increase their own skills and confidence working with this age-group. While these results reflect the views of staff working in only one diabetes centre, they are likely to reflect the views of professionals delivering care to individuals of this age; replication is needed to determine their generalizability.
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Affiliation(s)
- S Brierley
- Department of Psychology Department of Human Metabolism, University of Sheffield, Sheffield NIHR CLAHRC for South Yorkshire, UK.
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Smith SJ, Young V, Robertson C, Dancer SJ. Where do hands go? An audit of sequential hand-touch events on a hospital ward. J Hosp Infect 2012; 80:206-11. [PMID: 22297169 DOI: 10.1016/j.jhin.2011.12.007] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2011] [Accepted: 12/14/2011] [Indexed: 11/25/2022]
Abstract
BACKGROUND Reservoirs of pathogens could establish themselves at forgotten sites on a ward, posing a continued risk for transmission to patients via unwashed hands. AIM To track potential spread of organisms between surfaces and patients, and to gain a greater understanding into transmission pathways of pathogens during patient care. METHODS Hand-touch activities were audited covertly for 40 × 30 min sessions during summer and winter, and included hand hygiene on entry; contact with near-patient sites; patient contact; contact with clinical equipment; hand hygiene on exit; and contact with sites outside the room. FINDINGS There were 104 entries overall: 77 clinical staff (59 nurses; 18 doctors), 21 domestic staff, one pharmacist and five relatives. Hand-hygiene compliance among clinical staff before and after entry was 25% (38/154), with higher compliance during 20 summer periods [47%; 95% confidence interval (CI): 35.6-58.8] than during 20 winter periods (7%; 95% CI: 3.2-14.4; P < 0.0001). More than half of the staff (58%; 45/77) touched the patient. Staff were more likely to clean their hands prior to contact with a patient [odds ratio (OR): 3.44; 95% CI: 0.94-16.0); P = 0.059] and sites beside the patient (OR: 6.76; 95% CI: 1.40-65.77; P = 0.0067). Nearly half (48%; 37/77) handled patient notes and 25% touched the bed. Most frequently handled equipment inside the room were intravenous drip (30%) and blood pressure stand (13%), and computer (26%), notes trolley (23%) and telephone (21%) outside the room. CONCLUSION Hand-hygiene compliance remains poor during covert observation; understanding the most frequent interactions between hands and surfaces could target sites for cleaning.
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Affiliation(s)
- S J Smith
- Department of Surgery, Hairmyres Hospital, Lanarkshire, UK
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Paquet L, Verma S, Collins B, Song X, Wheatley-Price P, Hopkins S, Segal R, Dent S, Mirsky D, Goel R, Young V, Clemons M, Keller O, Chinneck A, Young R, Bedard M. P4-15-01: High Prevalence of Prospective Memory (PM) Impairment in Early Breast Cancer (EBC) Survivors within 1 Year of Adjuvant Chemotherapy Completion: Novel Findings Concerning Post Chemotherapy Cognitive Effects. Cancer Res 2011. [DOI: 10.1158/0008-5472.sabcs11-p4-15-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background Numerous studies have demonstrated that EBC survivors report more memory problems than healthy controls. However, evidence of impairment on objective tests of memory remains inconclusive. Past research has focussed exclusively on retrospective memory (remembering information from the past when asked to do so), but the complaints of EBC patients appear better described as “prospective memory” failures defined as forgetting to carry out in the future previously formed intentions. The effective performance of many day-to-day activities relies on PM and its impairment has negative consequences in everyday life. Despite its high ecological relevance, no study has evaluated PM functioning in EBC survivors. Consequently, we assessed the prevalence of PM impairment among EBC survivors in the year following completion of chemotherapy. Methods We undertook a cross sectional quantitative case-control study aiming to recruit 80 patients from the Ottawa Hospital Regional Cancer Centre and 80 matched healthy controls from the community. Patients were within 1 year of having completed a first course of chemotherapy. A standardized test of prospective memory (Memory for Intention Screening Test) was administered to both groups. Following the International Cognition and Cancer Task Force recommendation (2008), impairment was defined as a score that fell one standard deviation below the mean performance of the control group. Standardized measures of depression (CESD), anxiety (STAI) and fatigue (Fact-F) were also completed. Results Data are available on 36 patients and 18 controls. Age was well balanced between the groups (case-control mean age 54y vs. 51y, respectively, p=.204). Overall PM impairment was observed in 41% of the participants. More importantly, the rate of PM impairment was significantly higher in the EBC group than controls (53% vs 17%; p < 0.005; odds ratio = 5.588; 95% CI=1.376 to 22.7). Multivariate logistic regression showed that PM performance was unaffected by age (p=0.459), depression (p=0.358), anxiety (p=0.512) or fatigue (p=0.595). Conclusions These preliminary findings provide further support for the hypothesis that breast cancer treatment can impair cognitive processes and yield new and important insights into the type of memory problems experienced by EBC survivors. They suggest that a significant proportion of patients exhibit deficits in PM, an aspect of memory involved in effective daily functioning. Our results also suggest that emotional distress and fatigue do not contribute to PM functioning. Further studies in this area should be directed at understanding the severity and duration of PM impairment. Acknowledging and studying this vexing problem in EBC survivors will aid in developing appropriate rehabilitation strategies.
Citation Information: Cancer Res 2011;71(24 Suppl):Abstract nr P4-15-01.
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Affiliation(s)
- L Paquet
- 1Carleton University, Ottawa, ON, Canada; The Ottawa Hospital Cancer Center, Ottawa, ON, Canada; The Ottawa Hospital, Ottawa, ON, Canada
| | - S Verma
- 1Carleton University, Ottawa, ON, Canada; The Ottawa Hospital Cancer Center, Ottawa, ON, Canada; The Ottawa Hospital, Ottawa, ON, Canada
| | - B Collins
- 1Carleton University, Ottawa, ON, Canada; The Ottawa Hospital Cancer Center, Ottawa, ON, Canada; The Ottawa Hospital, Ottawa, ON, Canada
| | - X Song
- 1Carleton University, Ottawa, ON, Canada; The Ottawa Hospital Cancer Center, Ottawa, ON, Canada; The Ottawa Hospital, Ottawa, ON, Canada
| | - P Wheatley-Price
- 1Carleton University, Ottawa, ON, Canada; The Ottawa Hospital Cancer Center, Ottawa, ON, Canada; The Ottawa Hospital, Ottawa, ON, Canada
| | - S Hopkins
- 1Carleton University, Ottawa, ON, Canada; The Ottawa Hospital Cancer Center, Ottawa, ON, Canada; The Ottawa Hospital, Ottawa, ON, Canada
| | - R Segal
- 1Carleton University, Ottawa, ON, Canada; The Ottawa Hospital Cancer Center, Ottawa, ON, Canada; The Ottawa Hospital, Ottawa, ON, Canada
| | - S Dent
- 1Carleton University, Ottawa, ON, Canada; The Ottawa Hospital Cancer Center, Ottawa, ON, Canada; The Ottawa Hospital, Ottawa, ON, Canada
| | - D Mirsky
- 1Carleton University, Ottawa, ON, Canada; The Ottawa Hospital Cancer Center, Ottawa, ON, Canada; The Ottawa Hospital, Ottawa, ON, Canada
| | - R Goel
- 1Carleton University, Ottawa, ON, Canada; The Ottawa Hospital Cancer Center, Ottawa, ON, Canada; The Ottawa Hospital, Ottawa, ON, Canada
| | - V Young
- 1Carleton University, Ottawa, ON, Canada; The Ottawa Hospital Cancer Center, Ottawa, ON, Canada; The Ottawa Hospital, Ottawa, ON, Canada
| | - M Clemons
- 1Carleton University, Ottawa, ON, Canada; The Ottawa Hospital Cancer Center, Ottawa, ON, Canada; The Ottawa Hospital, Ottawa, ON, Canada
| | - O Keller
- 1Carleton University, Ottawa, ON, Canada; The Ottawa Hospital Cancer Center, Ottawa, ON, Canada; The Ottawa Hospital, Ottawa, ON, Canada
| | - A Chinneck
- 1Carleton University, Ottawa, ON, Canada; The Ottawa Hospital Cancer Center, Ottawa, ON, Canada; The Ottawa Hospital, Ottawa, ON, Canada
| | - R Young
- 1Carleton University, Ottawa, ON, Canada; The Ottawa Hospital Cancer Center, Ottawa, ON, Canada; The Ottawa Hospital, Ottawa, ON, Canada
| | - M Bedard
- 1Carleton University, Ottawa, ON, Canada; The Ottawa Hospital Cancer Center, Ottawa, ON, Canada; The Ottawa Hospital, Ottawa, ON, Canada
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Dunican E, Uzbeck M, Clince J, Toner S, Royston D, Logan MP, Breathnach O, Young V, Linnane SI, Morgan RK. Outcomes of patients presenting to a dedicated rapid access lung cancer clinic. Ir Med J 2011; 104:265-268. [PMID: 22132593] [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
We examined the outcomes of the first 500 patients referred to a dedicated Rapid Access Lung Cancer Clinic. A total of 206 patients (41.2%) were diagnosed with a thoracic malignancy; 179 had primary lung cancer and 27 had secondary or other thoracic cancers. Pulmonary nodules requiring ongoing surveillance were found in a further 79 patients (15.8%). Of those patients found to have primary lung cancer, 24 (13.4%) had Small Cell and 145 (81%) had Non Small Cell Lung Cancer. In patients with Non small cell tumours, 26 (21.1%) were stage 1, 14 (11.4%) stage II, 37 (30.1%) stage III and 46 (37.4%) stage IV at diagnosis. For the 129 patients (72%) in whom the thoracic MDT recommended active treatment, primary therapy was surgical resection in 44 (24.6%), combined chemoradiation in 31 patients (17.3%), chemotherapy alone in 39 (21.8%) and radiation in 15 (8.4%).
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Affiliation(s)
- E Dunican
- Department of Respiratory Medicine and Thoracic Oncology, Beaumont Hospital, Beaumont, Dublin 9
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Anderson R, Young V, Stewart M, Robertson C, Dancer S. Cleanliness audit of clinical surfaces and equipment: who cleans what? J Hosp Infect 2011; 78:178-81. [DOI: 10.1016/j.jhin.2011.01.030] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2010] [Accepted: 01/21/2011] [Indexed: 11/26/2022]
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Sadat U, Mohsen L, Young V, Teng Z, Gillard J. MS556 HIGH RESOLUTION MRI-BASED BIOMECHANICAL STRESS ANALYSIS OF CAROTID PLAQUES CAN PREDICT SEVERITY OF WHITE MATTER LESIONS. ATHEROSCLEROSIS SUPP 2010. [DOI: 10.1016/s1567-5688(10)71056-4] [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: 10/19/2022]
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Sadat U, Teng Z, Young V, Gillard J. MS558 HIGH RESOLUTION MRI-BASED BIOMECHANICAL STRESS ANALYSIS OF CAROTID ATHEROMA: A COMPARISON OF TRANSIENT ISCHEMIC ATTACK AND STROKE PATIENT GROUPS. ATHEROSCLEROSIS SUPP 2010. [DOI: 10.1016/s1567-5688(10)71058-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Soo A, Aziz R, Buckley M, Young V. Bronchoplastic procedure for an unusual indication - Wegener's granulomatosis. Interact Cardiovasc Thorac Surg 2009; 9:530-1. [DOI: 10.1510/icvts.2009.205591] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
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Li ZY, Taviani V, Tang T, Sadat U, Young V, Patterson A, Graves M, Gillard JH. The mechanical triggers of plaque rupture: shear stressvspressure gradient. Br J Radiol 2009; 82 Spec No 1:S39-45. [DOI: 10.1259/bjr/15036781] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
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Al-Sarraf N, Thalib L, Hughes A, Tolan M, Young V, McGovern E. Lack of Correlation between Smoking Status and Early Postoperative Outcome following Valve Surgery. Thorac Cardiovasc Surg 2008; 56:449-55. [DOI: 10.1055/s-2008-1038693] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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O'Callaghan D, Breen D, Young V. Angiosarcoma of the Right Atrium Masquerading as Recurrent Pulmonary Embolism. Thorac Cardiovasc Surg 2008; 56:488-90. [PMID: 19012217 DOI: 10.1055/s-2007-989292] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Young V, Brem R, Lebovic G, Schuster R. Trilucent™ Breast Implants: Indications and Limitations. Semin Plast Surg 2008. [DOI: 10.1055/s-2008-1080280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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42
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Young V. Overview of the Development and Testing of Trilucent™ Breast Implants. Semin Plast Surg 2008. [DOI: 10.1055/s-2008-1080271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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McDermott JH, Thabit H, Hickey N, Thompson C, Gaffney E, Young V, Sreenan S. ACTH-secreting bronchial carcinoid: a diagnostic and therapeutic challenge. Ir J Med Sci 2008; 177:269-72. [PMID: 18516660 DOI: 10.1007/s11845-008-0171-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2007] [Accepted: 04/25/2008] [Indexed: 11/30/2022]
Abstract
OBJECTIVE We describe a case of Cushing's syndrome due to ectopic ACTH secretion, where the only potential source on conventional imaging was a tiny benign-appearing lung nodule, which failed to take up radiolabelled octreotide. DESIGN AND METHODS To determine whether the patient might respond to therapeutic administration of octreotide, a test dose was given. RESULTS Compared to ACTH and cortisol levels on a control day, the levels following the test dose of octreotide were lower. Subsequent therapeutic administration of subcutaneous octreotide normalised urine free cortisol, with symptomatic improvement, pending evaluation for surgery. Eventual resection of the lung nodule resulted in cure of hypercortisolism. Histological examination of the resected specimen confirmed bronchial carcinoid staining positive for ACTH. CONCLUSIONS This is one of the few cases described where ectopic ACTH secretion secondary to bronchial carcinoid responded to somatostatin analogue therapy. The case was also unusual in that the tumour responded despite not taking up radiolabelled octreotide.
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Affiliation(s)
- J H McDermott
- Department of Endocrinology, Royal College of Surgeons, Connolly Hospital Blanchardstown, Dublin 15, Ireland.
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Abstract
We present a case of pyoderma gangrenosum (PG) mimicking a lung carcinoma. A 52-year-old woman presented with an unremitting cough. Computed tomography revealed a cavitating lung lesion. Bronchoscopy and biopsy were interpreted as squamous cell carcinoma. Following a staging mediastinoscopy, a sleeve lobectomy and chest-wall resection was performed. The pulmonary histopathological features suggested Wegener's granulomatosis; no malignancy was found. Three months postoperatively, wound breakdown led to dermatological review. A clinical diagnosis of cutaneous PG was made on the basis of the classic appearance of the surgical wounds and an ulcer on the upper back that had been present before surgery. The patient has been consistently negative for cytoplasmic-staining antineutrophil cytoplasmic antibodies, which supports the diagnosis of PG with cutaneous and pulmonary involvement. Lung manifestations of PG are rare. PG is amenable to systemic therapy. Pulmonary PG is a rare but important differential diagnosis that is not familiar to many physicians and surgeons in this type of presentation.
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Affiliation(s)
- S Field
- Department of Dermatology, Mater Misericordiae Hospital, Dublin, Ireland
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Al-Sarraf N, Doddakula K, Nicholson S, Young V. Primary carinal sarcoma causing airway obstruction. Thorac Cardiovasc Surg 2008; 56:179-81. [PMID: 18365983 DOI: 10.1055/s-2007-965403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- N Al-Sarraf
- Department of Cardiothoracic Surgery, St. James's Hospital, James's Street, Dublin 8, Ireland.
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Parissis H, Leotsinidis M, Charokopos N, Mcgovern E, Young V. CLC067 POSTER Comparison of sleeve resection vs pneumonectomy for NSSLC. Lung Cancer 2007. [DOI: 10.1016/s0169-5002(07)70067-3] [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: 10/23/2022]
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Fortner K, Zite N, Young V, Wallace L. Knowledge and beliefs about pap smears and colposcopy among low-income women attending university-based colposcopy clinics. Contraception 2006. [DOI: 10.1016/j.contraception.2006.05.042] [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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Coate LE, Gately K, Barr MP, Meaney J, O’Connell F, Nicholson S, McGovern E, Young V, O’Byrne K. Phase II pilot study of neoadjuvant cetuximab in combination with cisplatin and gemcitabine in patients with resectable IB-IIIA non small cell lung cancer. J Clin Oncol 2006. [DOI: 10.1200/jco.2006.24.18_suppl.17107] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
17107 Background: Adjuvant and neoadjuvant chemotherapy play a role in optimising long term outcome of patients with resectable non small cell lung cancer (NSCLC). The epidermal growth factor receptor (EGFR) is a receptor tyrosine kinase which is overexpressed NSCLC. Cetuximab is a monoclonal antibody which attaches to the extracellular domain of the EGFR preventing ligand binding. Preclinical data and phase II evidence in advanced NSCLC suggest cetuximab potentiates the effect of conventional cytotoxic agents. Methods: Patients with histologically confirmed resectable stage IB-IIIA NSCLC and adequate end-organ function, giving informed written consent are eligible. Three weekly cycles of cisplatin 80 mg/m2 D1, gemcitabine 1250 mg/m2 D1,D8 and cetuximab loading dose of 400 mg/m2 on first infusion, thereafter weekly 250 mg/m2 are used. The primary endpoint is response rate (radiological and pathological). Secondary endpoints are safety and tolerability of the combination, resection rate following therapy, overall survival and relapse free survival. In addition, molecular prognostic and predictive biomarkers of response are being assessed. Sequential samples of tissue, plasma, serum and white blood cells are being collected before, during and after therapy on all patients. Results: 16 patients have been recruited to date. (10 men, 6 women). Median age 66 (range 29–76). 3 patients stage I, 4 patients, stage II, 9 patients stage III. 11 have completed treatment. Response (RECIST guidelines); PR - 6 patients, SD - 4 patients, PD - 1 patient. The most common toxicity was skin rash (100%). Grade 3/4 toxicities were neutropenia (73%), thrombocytopenia (45%). There were 2 grade 3 and 2 grade 4 cardiovascular toxicities in patients with significant co-morbid cardiovascular histories. Conclusion: The response rate is consistent with that established for neoadjuvant chemotherapy. Ongoing biomarker studies may identify those patients most likely to benefit from induction treatment. No significant financial relationships to disclose.
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Affiliation(s)
| | - K. Gately
- St. James’ Hospital, Dublin, Ireland
| | | | - J. Meaney
- St. James’ Hospital, Dublin, Ireland
| | | | | | | | - V. Young
- St. James’ Hospital, Dublin, Ireland
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Holeva R, Phillips MS, Neilson R, Brown DJF, Young V, Boutsika K, Blok VC. Real-time PCR detection and quantification of vector trichodorid nematodes and Tobacco rattle virus. Mol Cell Probes 2006; 20:203-11. [PMID: 16563695 DOI: 10.1016/j.mcp.2005.12.004] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2005] [Accepted: 12/21/2005] [Indexed: 11/26/2022]
Abstract
This report describes a novel diagnostic method for virus-vector trichodorid nematodes and associated Tobacco rattle virus (TRV) based on a real-time fluorogenic 5' nuclease PCR assay (TaqMan). Two independent primer/probe sets were designed targeting the 18S gene of the ribosomal cistron for the trichodorid species, Paratrichodorus pachydermus and Trichodorus similis. Assays using purified plasmid DNA containing clones of the 18S region and genomic DNA extracted from individuals from both nematode species displayed high specificity as no cros s-reaction was observed between the species or with two non-target trichodorid species Paratrichodorus anemones and Trichodorus primitivus. Relative quantification of target DNA present in unknown samples was performed by comparison of the fluorescence signals of the samples to those obtained from plasmid standard dilutions. Three primer/probe sets were also used to target TRV; one set for RNA1 and the two other sets for RNA2 of specific isolates (TRV-PpK20 and TRV-TpO1). Detection of both trichodorid species and TRV RNA1 and RNA2 from a single sample was achieved and field samples were used to demonstrate the potential of this assay to provide rapid, accurate and sensitive molecular information in relation to risk assessment in the field.
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Affiliation(s)
- R Holeva
- Scottish Crop Research Institute, Invergowrie, Dundee, Scotland DD2 5DA, UK
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Cosgrave J, Foley JB, Kelly R, McGovern E, Bennett K, Young V, Tolan M, Crean P, Kelleher D, Walsh MJ. Perioperative serum inflammatory response and the development of atrial fibrillation after coronary artery bypass surgery. Heart 2005; 91:1475-6. [PMID: 16230451 PMCID: PMC1769158 DOI: 10.1136/hrt.2004.054262] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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