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Thompson D, Williams A, Whitfield PC, Hutchinson P, Phillips N, Cromwell D, Helmy A. Surgical recovery from the COVID-19 pandemic in English adult neurosurgical centres. Br J Neurosurg 2024:1-7. [PMID: 38639005 DOI: 10.1080/02688697.2024.2339355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Accepted: 03/26/2024] [Indexed: 04/20/2024]
Abstract
OBJECTIVES The COVID-19 pandemic required a change in resource priority from Neurosurgical care in order to treat medically unwell patients suffering from the complications of COVID-19 infections. We demonstrate the impact of COVID-19 on total bed days in 24 Neurosurgical centres in England offering adult Neurosurgery as well as the total spells (single inpatient episodes) for operative Neurosurgical patients between 2020 and 2022 when compared with 2019. METHODS We used Capse Healthcare Knowledge System software iCompare in order to show the change in total spells for patients undergoing a primary or secondary Neurosurgical procedure as defined using the National Neurosurgical Audit Programme (NNAP) OPCS-4 coding framework between 2019 and 2022. RESULTS The overall mortality rate of COVID-19 patients was 12.3% and the percentage of total bed days taken up by COVID-19 patients in hospitals at large was on average 7.7%. The total number of spells for all procedures over the 24 centres in 2022 was 39,019 compared with 45,742 in 2019. There was a cumulative deficit of 24,904 spells. The loss of spells was not equally distributed across regions and hospital Trusts. The average number of referral to treatment pathways completed within 18 weeks has declined from 76% to 57% over the study period and the referral to treatment clearance time has risen from 17 to 24 weeks. CONCLUSIONS The mean elective cranial output in 2022 compared with 2019 is at 88% with spinal output lagging at 69%. If the rate of change year on year were to remain at current levels then we would reach pre-pandemic levels of output by 2026.
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Affiliation(s)
- Daniel Thompson
- Department of Neurosurgery, North Bristol NHS Trust, Bristol, UK
- Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK
| | - Adam Williams
- Department of Neurosurgery, North Bristol NHS Trust, Bristol, UK
| | - Peter C Whitfield
- Department of Neurosurgery, University Hospitals Plymouth NHS Trust, Plymouth, UK
| | - Peter Hutchinson
- Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK
| | | | - David Cromwell
- Department of Health Services Research and Policy, London School of Tropical Medicine, London, UK
| | - Adel Helmy
- Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK
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Emery A, Moore S, Crowe J, Murray J, Peacock O, Thompson D, Betts F, Rapps S, Ross L, Rothschild-Rodriguez D, Arana Echarri A, Davies R, Lewis R, Augustine DX, Whiteway A, Afzal Z, Heaney J, Drayson MT, Turner JE, Campbell JP. The effects of short-term, progressive exercise training on disease activity in smouldering multiple myeloma and monoclonal gammopathy of undetermined significance: a single-arm pilot study. BMC Cancer 2024; 24:174. [PMID: 38317104 PMCID: PMC10840198 DOI: 10.1186/s12885-024-11817-6] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Accepted: 01/01/2024] [Indexed: 02/07/2024] Open
Abstract
BACKGROUND High levels of physical activity are associated with reduced risk of the blood cancer multiple myeloma (MM). MM is preceded by the asymptomatic stages of monoclonal gammopathy of undetermined significance (MGUS) and smouldering multiple myeloma (SMM) which are clinically managed by watchful waiting. A case study (N = 1) of a former elite athlete aged 44 years previously indicated that a multi-modal exercise programme reversed SMM disease activity. To build from this prior case study, the present pilot study firstly examined if short-term exercise training was feasible and safe for a group of MGUS and SMM patients, and secondly investigated the effects on MGUS/SMM disease activity. METHODS In this single-arm pilot study, N = 20 participants diagnosed with MGUS or SMM were allocated to receive a 16-week progressive exercise programme. Primary outcome measures were feasibility and safety. Secondary outcomes were pre- to post-exercise training changes to blood biomarkers of MGUS and SMM disease activity- monoclonal (M)-protein and free light chains (FLC)- plus cardiorespiratory and functional fitness, body composition, quality of life, blood immunophenotype, and blood biomarkers of inflammation. RESULTS Fifteen (3 MGUS and 12 SMM) participants completed the exercise programme. Adherence was 91 ± 11%. Compliance was 75 ± 25% overall, with a notable decline in compliance at intensities > 70% V̇O2PEAK. There were no serious adverse events. There were no changes to M-protein (0.0 ± 1.0 g/L, P =.903), involved FLC (+ 1.8 ± 16.8 mg/L, P =.839), or FLC difference (+ 0.2 ± 15.6 mg/L, P =.946) from pre- to post-exercise training. There were pre- to post-exercise training improvements to diastolic blood pressure (- 3 ± 5 mmHg, P =.033), sit-to-stand test performance (+ 5 ± 5 repetitions, P =.002), and energy/fatigue scores (+ 10 ± 15%, P =.026). Other secondary outcomes were unchanged. CONCLUSIONS A 16-week progressive exercise programme was feasible and safe, but did not reverse MGUS/SMM disease activity, contrasting a prior case study showing that five years of exercise training reversed SMM in a 44-year-old former athlete. Longer exercise interventions should be explored in a group of MGUS/SMM patients, with measurements of disease biomarkers, along with rates of disease progression (i.e., MGUS/SMM to MM). REGISTRATION https://www.isrctn.com/ISRCTN65527208 (14/05/2018).
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Affiliation(s)
- A Emery
- Department for Health, University of Bath, Bath, UK
| | - S Moore
- Department for Haematology, Royal United Hospitals Bath NHS Foundation Trust, Bath, UK
| | - J Crowe
- Department for Haematology, Royal United Hospitals Bath NHS Foundation Trust, Bath, UK
| | - J Murray
- Department for Haematology, Royal United Hospitals Bath NHS Foundation Trust, Bath, UK
| | - O Peacock
- Department for Health, University of Bath, Bath, UK
| | - D Thompson
- Department for Health, University of Bath, Bath, UK
| | - F Betts
- Department for Health, University of Bath, Bath, UK
| | - S Rapps
- Department for Health, University of Bath, Bath, UK
| | - L Ross
- Department for Health, University of Bath, Bath, UK
| | | | | | - R Davies
- Department for Health, University of Bath, Bath, UK
| | - R Lewis
- Department for Physiotherapy, Royal United Hospitals Bath NHS Foundation Trust, Bath, UK
| | - D X Augustine
- Department for Health, University of Bath, Bath, UK
- Department for Cardiology, Royal United Hospitals Bath NHS Foundation Trust, Bath, UK
| | - A Whiteway
- Department for Haematology, North Bristol NHS Trust, Bristol, UK
| | - Z Afzal
- Clinical Immunology Service, Institute of Immunity and Immunotherapy, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
| | - Jlj Heaney
- Clinical Immunology Service, Institute of Immunity and Immunotherapy, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
| | - M T Drayson
- Clinical Immunology Service, Institute of Immunity and Immunotherapy, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
| | - J E Turner
- Department for Health, University of Bath, Bath, UK
- School of Sport, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, Edgbaston, Birmingham, UK
| | - J P Campbell
- Department for Health, University of Bath, Bath, UK.
- School of Medical and Health Sciences, Edith Cowan University, WA, Joondalup, Australia.
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Djaïleb L, Armstrong WR, Thompson D, Gafita A, Farolfi A, Rajagopal A, Grogan TR, Nguyen K, Benz MR, Hotta M, Barbato F, Ceci F, Schwarzenböck SM, Unterrainer M, Zacho HD, Juarez R, Cooperberg M, Carroll P, Washington S, Reiter RE, Eiber M, Herrmann K, Fendler WP, Czernin J, Hope TA, Calais J. Presurgical 68Ga-PSMA-11 Positron Emission Tomography for Biochemical Recurrence Risk Assessment: A Follow-up Analysis of a Multicenter Prospective Phase 3 Imaging Trial. Eur Urol 2023; 84:588-596. [PMID: 37482512 DOI: 10.1016/j.eururo.2023.06.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Revised: 05/24/2023] [Accepted: 06/20/2023] [Indexed: 07/25/2023]
Abstract
BACKGROUND In the initial staging of patients with high-risk prostate cancer (PCa), prostate-specific membrane antigen positron emission tomography (PSMA-PET) has been established as a front-line imaging modality. The increasing number of PSMA-PET scans performed in the primary staging setting might be associated with decreases in biochemical recurrence (BCR)-free survival (BCR-FS). OBJECTIVE To assess the added prognostic value of presurgical PSMA-PET for BCR-FS compared with the presurgical Cancer of the Prostate Risk Assessment (CAPRA) and postsurgical CAPRA-Surgery (CAPRA-S) scores in patients with intermediate- to high-risk PCa treated with radical prostatectomy (RP) and pelvic lymph node dissection. DESIGN, SETTING, AND PARTICIPANTS This is a follow-up study of the surgical cohort evaluated in the multicenter prospective phase 3 imaging trial (n = 277; NCT03368547, NCT02611882, and NCT02919111). OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS Each 68Ga-PSMA-11-PET scan was read by three blinded independent readers. PSMA-PET prostate uptake (low vs high), PSMA-PET extraprostatic disease (N1/M1), and CAPRA and CAPRA-S scores were used to assess the risk of BCR. Patients were followed after RP by local investigators using electronic medical records. BCR was defined by a prostate-specific antigen (PSA) level increasing to ≥0.2 ng/ml after RP or initiation of PCa-specific secondary treatment (>6 mo after surgery). Univariate and multivariable Cox models, and c-statistic index were performed to assess the prognostic value of PSMA-PET and for a comparison with the CAPRA and CAPRA-S scores. RESULTS AND LIMITATIONS From December 2015 to December 2019, 277 patients underwent surgery after PSMA-PET. Clinical follow-up was obtained in 240/277 (87%) patients. The median follow-up after surgery was 32.4 (interquartile range 23.3-42.9) mo. Of 240 BCR events, 91 (38%) were observed. PSMA-PET N1/M1 was found in 41/240 (17%) patients. PSMA-PET prostate uptake, PSMA-PET N1/M1, and CAPRA and CAPRA-S scores were significant univariate predictors of BCR. The addition of PSMA-PET N1/M1 status to the presurgical CAPRA score improved the risk assessment for BCR significantly in comparison with the presurgical CAPRA score alone (c-statistic 0.70 [0.64-0.75] vs 0.63 [0.57-0.69]; p < 0.001). The C-index of the postsurgical model utilizing the postsurgical CAPRA-S score alone was not significantly different from the presurgical model combining the presurgical CAPRA score and PSMA-PET N1/M1 status (p = 0.19). CONCLUSIONS Presurgical PSMA-PET was a strong prognostic biomarker improving BCR-FS risk assessment. Its implementation in the presurgical risk assessment with the CAPRA score improved the performance and reduced the difference with the reference standard (postsurgical CAPRA-S score). PATIENT SUMMARY The use prostate-specific membrane antigen positron emission tomography improved the assessment of biochemical recurrence risk in patients with intermediate- and high-risk prostate cancer who were treated with radical prostatectomy and pelvic lymph node dissection.
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Affiliation(s)
- Loïc Djaïleb
- Ahmanson Translational Theranostics Division, Department of Molecular and Medical Pharmacology, University of California Los Angeles, Los Angeles, CA, USA.
| | - Wesley R Armstrong
- Ahmanson Translational Theranostics Division, Department of Molecular and Medical Pharmacology, University of California Los Angeles, Los Angeles, CA, USA; ULCA-Caltech Medical Scientist Training Program, David Geffen School of Medicine, Los Angeles, CA, USA
| | - Daniel Thompson
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA, USA
| | - Andrei Gafita
- Ahmanson Translational Theranostics Division, Department of Molecular and Medical Pharmacology, University of California Los Angeles, Los Angeles, CA, USA
| | - Andrea Farolfi
- Ahmanson Translational Theranostics Division, Department of Molecular and Medical Pharmacology, University of California Los Angeles, Los Angeles, CA, USA; Nuclear Medicine, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Abhejit Rajagopal
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA, USA
| | - Tristan R Grogan
- Department of Medicine Statistics Core, University of California Los Angeles, Los Angeles, CA, USA
| | - Kathleen Nguyen
- Ahmanson Translational Theranostics Division, Department of Molecular and Medical Pharmacology, University of California Los Angeles, Los Angeles, CA, USA
| | - Matthias R Benz
- Ahmanson Translational Theranostics Division, Department of Molecular and Medical Pharmacology, University of California Los Angeles, Los Angeles, CA, USA; Department of Radiological Sciences, University of California Los Angeles, Los Angeles, CA, USA
| | - Masatoshi Hotta
- Ahmanson Translational Theranostics Division, Department of Molecular and Medical Pharmacology, University of California Los Angeles, Los Angeles, CA, USA
| | - Francesco Barbato
- Department of Nuclear Medicine, Technical University Munich, Klinikum rechts der Isar, Munich, Germany
| | - Francesco Ceci
- Division of Nuclear Medicine, IEO European Institute of Oncology IRCCS, Milan, Italy; Department of Oncology and Haemato-Oncology, University of Milan, Milan, Italy
| | | | - Marcus Unterrainer
- Department of Radiology, University Hospital, LMU Munich, Munich, Germany
| | - Helle D Zacho
- Department of Nuclear Medicine and Clinical Cancer Research Centre, Aalborg University Hospital, Aalborg, Denmark
| | - Roxanna Juarez
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA, USA
| | - Matthew Cooperberg
- Department of Urology, University of California San Francisco, San Francisco, CA, USA
| | - Peter Carroll
- Department of Urology, University of California San Francisco, San Francisco, CA, USA; Helen Diller Family Comprehensive Cancer Center, University of California San Francisco, San Francisco, CA, USA
| | - Samuel Washington
- Department of Urology, University of California San Francisco, San Francisco, CA, USA
| | - Robert E Reiter
- Institute of Urologic Oncology, University of California Los Angeles, Los Angeles, CA, USA; Jonsson Comprehensive Cancer Center, University of California Los Angeles, Los Angeles, CA, USA
| | - Matthias Eiber
- Department of Nuclear Medicine, Technical University Munich, Klinikum rechts der Isar, Munich, Germany
| | - Ken Herrmann
- Department of Nuclear Medicine, University of Duisburg-Essen, Essen, Germany; German Cancer Consortium (DKTK)-University Hospital Essen, Essen, Germany
| | - Wolfgang P Fendler
- Department of Nuclear Medicine, University of Duisburg-Essen, Essen, Germany; German Cancer Consortium (DKTK)-University Hospital Essen, Essen, Germany
| | - Johannes Czernin
- Ahmanson Translational Theranostics Division, Department of Molecular and Medical Pharmacology, University of California Los Angeles, Los Angeles, CA, USA; Institute of Urologic Oncology, University of California Los Angeles, Los Angeles, CA, USA
| | - Thomas A Hope
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA, USA; Helen Diller Family Comprehensive Cancer Center, University of California San Francisco, San Francisco, CA, USA
| | - Jeremie Calais
- Ahmanson Translational Theranostics Division, Department of Molecular and Medical Pharmacology, University of California Los Angeles, Los Angeles, CA, USA; Institute of Urologic Oncology, University of California Los Angeles, Los Angeles, CA, USA
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4
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Hope TA, Benz M, Jiang F, Thompson D, Barbato F, Juarez R, Hernandez Pampaloni M, Allen-Auerbach M, Gupta P, Fendler WP, Calais J. Do Bone Scans Overstage Disease Compared with PSMA PET at Initial Staging? An International Multicenter Retrospective Study with Masked Independent Readers. J Nucl Med 2023; 64:1744-1747. [PMID: 37591547 DOI: 10.2967/jnumed.123.265916] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Revised: 07/05/2023] [Indexed: 08/19/2023] Open
Abstract
Prostate-specific membrane antigen (PSMA) PET has a higher accuracy than CT and bone scans to stage patients with prostate cancer. We do not understand how to apply clinical trial data based on conventional imaging to patients staged using PSMA PET. Therefore, we aimed to evaluate the ability of bone scans to detect osseous metastases using PSMA PET as a reference standard. Methods: In this multicenter retrospective diagnostic study, 167 patients with prostate cancer, who were imaged with bone scans and PSMA PET performed within 100 d, were included for analysis. Each study was interpreted by 3 masked readers, and the results of the PSMA PET were used as the reference standard. Endpoints were positive predictive value (PPV), negative predictive value (NPV), and specificity for bone scans. Additionally, interreader reproducibility, positivity rate, uptake on PSMA PET, and the number of lesions were evaluated. Results: In total, 167 patients were included, with 77 at initial staging, 60 in the biochemical recurrence and castration-sensitive prostate cancer setting, and 30 in the castration-resistant prostate cancer setting. In all patients, the PPV, NPV, and specificity for bone scans were 0.73 (95% CI, 0.61-0.82), 0.82 (95% CI, 0.74-0.88), and 0.82 (95% CI, 0.74-0.88), respectively. In patients at initial staging, the PPV, NPV, and specificity for bone scans were 0.43 (95% CI, 0.26-0.63), 0.94 (95% CI, 0.85-0.98), and 0.80 (95% CI, 0.68-0.88), respectively. Interreader agreement for bone disease was moderate for bone scans (Fleiss κ, 0.51) and substantial for the PSMA PET reference standard (Fleiss κ, 0.80). Conclusion: In this multicenter retrospective study, the PPV of bone scans was low in patients at initial staging, with 57% of positive bone scans being false positives. This suggests that a large proportion of patients considered low-volume metastatic by the bone scan actually had localized disease, which is critical when applying clinical data from trials such as the STAMPEDE M1 radiation therapy trial to patients being staged with PSMA PET.
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Affiliation(s)
- Thomas A Hope
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, California;
- Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, San Francisco, California
| | - Matthias Benz
- Ahmanson Translational Theranostics Division, Department of Molecular and Medical Pharmacology, David Geffen School of Medicine, UCLA, Los Angeles, California
| | - Fei Jiang
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, California; and
| | - Daniel Thompson
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, California
| | - Francesco Barbato
- Department of Nuclear Medicine, University of Duisburg-Essen and German Cancer Consortium, University Hospital Essen, Essen, Germany
| | - Roxana Juarez
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, California
| | - Miguel Hernandez Pampaloni
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, California
| | - Martin Allen-Auerbach
- Ahmanson Translational Theranostics Division, Department of Molecular and Medical Pharmacology, David Geffen School of Medicine, UCLA, Los Angeles, California
| | - Pawan Gupta
- Ahmanson Translational Theranostics Division, Department of Molecular and Medical Pharmacology, David Geffen School of Medicine, UCLA, Los Angeles, California
| | - Wolfgang P Fendler
- Department of Nuclear Medicine, University of Duisburg-Essen and German Cancer Consortium, University Hospital Essen, Essen, Germany
| | - Jeremie Calais
- Ahmanson Translational Theranostics Division, Department of Molecular and Medical Pharmacology, David Geffen School of Medicine, UCLA, Los Angeles, California
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Kiray G, Panteli V, Enright N, Handley S, Marmoy O, Thompson D, Henderson R. 8 Unexpected retinopathy in a patient presenting with bilateral optic disc swelling. BMJ Open Ophthalmol 2023; 8:A3. [PMID: 37797989 DOI: 10.1136/bmjophth-2023-biposa.8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/07/2023] Open
Abstract
A 12-year-old boy presented with 5 day history of blurry vision, 'wobbly eyes', tinnitus and difficulty seeing at night. Local ophthalmology noted bilateral optic disc swelling and referred him urgently for neurological investigations.Clinical Findings: At presentation VA was RE 0.00 and LE 0.2 with normal Ishihara colour vision. His extraocular movements were full without manifest strabismus. Fundoscopy showed bilateral optic disc swelling. Electrophysiology unexpectedly revealed a functionally cone isolated retina with markedly abnormal rod function. Pattern VEPs indicated bilateral macular pathway dysfunction affecting left eye more than right eye. Wide field imaging showed bilateral diffusely scattered yellow-white flecks in the midperiphery of each eye. His kinetic visual fields were moderately restricted bilaterally. MRI showed a Chiari 1 malformation with cerebellar tonsil herniation, but LP opening pressure was normal.Differential diagnosis included RDH5 retinopathy or vitamin A deficiency. On questioning he reported a diet restricted to only meat and biscuits. His vitamin A levels were subnormal at 0.14 umol/L (reference range 0.9-2.5umol/l) and he was started on high-dose Vitamin A supplements.Four months after supplementation retinal appearances had normalised, the rod ERGs recovered, nyctalopia and visual field restriction resolved. PVEPs had improved but an element of LE macular pathway dysfunction remained. Optic disc swelling settled leaving mild temporal pallor, particularly of the LE with some RNFL loss.It is important to recognise nutritional Vitamin A deficiency in children as prompt recognition and treatment can improve symptoms, reverse retinal pathology which we have demonstrated with electrophysiological findings.
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Affiliation(s)
- G Kiray
- Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - V Panteli
- Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - N Enright
- Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - S Handley
- Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - O Marmoy
- Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - D Thompson
- Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - R Henderson
- Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
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Geary RS, Thompson D, Mizen A, Akbari A, Garrett JK, Rowney FM, Watkins A, Lyons RA, Stratton G, Lovell R, Nieuwenhuijsen M, Parker SC, Song J, Tsimpida D, White J, White MP, Williams S, Wheeler BW, Fry R, Rodgers SE. Ambient greenness, access to local green spaces, and subsequent mental health: a 10-year longitudinal dynamic panel study of 2·3 million adults in Wales. Lancet Planet Health 2023; 7:e809-e818. [PMID: 37821160 DOI: 10.1016/s2542-5196(23)00212-7] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 07/27/2023] [Accepted: 08/25/2023] [Indexed: 10/13/2023]
Abstract
BACKGROUND Living in greener areas, or close to green and blue spaces (GBS; eg, parks, lakes, or beaches), is associated with better mental health, but longitudinal evidence when GBS exposures precede outcomes is less available. We aimed to analyse the effect of living in or moving to areas with more green space or better access to GBS on subsequent adult mental health over time, while explicitly considering health inequalities. METHODS A cohort of the people in Wales, UK (≥16 years; n=2 341 591) was constructed from electronic health record data sources from Jan 1, 2008 to Oct 31, 2019, comprising 19 141 896 person-years of follow-up. Household ambient greenness (Enhanced Vegetation Index [EVI]), access to GBS (counts, distance to nearest), and common mental health disorders (CMD, based on a validated algorithm combining current diagnoses or symptoms of anxiety or depression [treated or untreated in the preceding 1-year period], or treatment of historical diagnoses from before the current cohort [up to 8 years previously, to 2000], where diagnosis preceded treatment) were record-linked. Cumulative exposure values were created for each adult, censoring for CMD, migration out of Wales, death, or end of cohort. Exposure and CMD associations were evaluated using multivariate logistic regression, stratified by area-level deprivation. FINDINGS After adjustment, exposure to greater ambient greenness over time (+0·1 increased EVI on a 0-1 scale) was associated with lower odds of subsequent CMD (adjusted odds ratio 0·80, 95% CI 0·80-0·81), where CMD was based on a combination of current diagnoses or symptoms (treated or untreated in the preceding 1-year period), or treatments. Ten percentile points more access to GBS was associated with lower odds of a later CMD (0·93, 0·93-0·93). Every additional 360 m to the nearest GBS was associated with higher odds of CMD (1·05, 1·04-1·05). We found that positive effects of GBS on mental health appeared to be greater in more deprived quintiles. INTERPRETATION Ambient exposure is associated with the greatest reduced risk of CMD, particularly for those who live in deprived communities. These findings support authorities responsible for GBS, who are attempting to engage planners and policy makers, to ensure GBS meets residents' needs. FUNDING National Institute for Health and Care Research Public Health Research programme.
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Affiliation(s)
- Rebecca S Geary
- Department of Public Health, Policy and Systems, University of Liverpool, Liverpool, UK
| | - Daniel Thompson
- Department of Health Data Science, Swansea University, Swansea, UK
| | - Amy Mizen
- Department of Health Data Science, Swansea University, Swansea, UK
| | - Ashley Akbari
- Department of Health Data Science, Swansea University, Swansea, UK
| | - Joanne K Garrett
- European Centre for Environment and Human Health, University of Exeter Medical School, University of Exeter, Truro, UK
| | - Francis M Rowney
- European Centre for Environment and Human Health, University of Exeter Medical School, University of Exeter, Truro, UK
| | - Alan Watkins
- Department of Health Data Science, Swansea University, Swansea, UK
| | - Ronan A Lyons
- Department of Health Data Science, Swansea University, Swansea, UK
| | | | - Rebecca Lovell
- European Centre for Environment and Human Health, University of Exeter Medical School, University of Exeter, Truro, UK
| | | | - Sarah C Parker
- Department of Health Data Science, Swansea University, Swansea, UK
| | - Jiao Song
- Department of Health Data Science, Swansea University, Swansea, UK
| | - Dialechti Tsimpida
- Department of Public Health, Policy and Systems, University of Liverpool, Liverpool, UK
| | - James White
- Centre for Trials Research, School of Medicine, Cardiff University, Cardiff, UK
| | - Mathew P White
- Cognitive Science Hub, University of Vienna, Vienna, Austria
| | | | - Benedict W Wheeler
- European Centre for Environment and Human Health, University of Exeter Medical School, University of Exeter, Truro, UK
| | - Richard Fry
- Department of Health Data Science, Swansea University, Swansea, UK
| | - Sarah E Rodgers
- Department of Public Health, Policy and Systems, University of Liverpool, Liverpool, UK.
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Panteli V, Alwis A, Desai N, Marmoy O, Thompson D, Prabhakar P. 9 MOG associated encephalitis presenting as idiopathic intracranial hypertension. BMJ Open Ophthalmol 2023; 8:A3. [PMID: 37797998 DOI: 10.1136/bmjophth-2023-biposa.9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/07/2023] Open
Abstract
A young Caucasian male (7y) with normal BMI was atypical for his provisional diagnosis of Idiopathic Intracranial Hypertension (IIH), that resolved following a Lumbar Puncture (LP). At 8y he presented with a 2-week history of headaches and vomiting that started some weeks after flu vaccination and an upper respiratory infection.Visual Acuity (VA) and colour vision were normal. Ocular motility was full. Fundoscopy and OCT showed recurrence of papilloedema, with enlarged blind spots on Kinetic perimetry.LP opening pressure was 30cm H2O and CSF white cells were elevated (23). Repeat brain and spine imaging showed new white matter signal changes in keeping with neuroinflammation, as well as enhancement of the left optic nerve extending to the chiasm and optic tract. VA, colour vision and pupillary reactions remained normal.Pattern VEP peak times were prolonged from the left eye compared to right eye to small check widths, consistent with relative macular-cortex pathway dysfunction. Hemifield PVEPs were slightly prolonged and reduced from the bitemporal fields indicating chiasmal dysfunction. Normal PERGs excluded PVEP delay associated with primary RGC disease.Further investigations showed oligoclonal band and serum-MOG antibody positivity.Management: Initial treatment with Acetazolamide 125mg bd for a week, following LP, was changed to IV methylprednisolone followed by oral prednisolone.Symptoms improved significantly following LP and steroid treatment. He will be followed in a Demyelination Clinic.MOG-associated disease has been reported with raised intracranial pressure and should be considered especially in children with atypical clinical phenotype for IIH.
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Affiliation(s)
- V Panteli
- Great Ormond Street Hospital for Children and Institute of Child Health, University College London, London, UK
| | - A Alwis
- Great Ormond Street Hospital for Children and Institute of Child Health, University College London, London, UK
| | - N Desai
- Great Ormond Street Hospital for Children and Institute of Child Health, University College London, London, UK
| | - O Marmoy
- Great Ormond Street Hospital for Children and Institute of Child Health, University College London, London, UK
| | - D Thompson
- Great Ormond Street Hospital for Children and Institute of Child Health, University College London, London, UK
| | - P Prabhakar
- Great Ormond Street Hospital for Children and Institute of Child Health, University College London, London, UK
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Hall H, Williams T, Florey J, Moreno MP, Black V, Thompson D, Skelly B. Prevalence of hypercalcemia in primary hypoadrenocorticism in dogs: Multicenter, retrospective study. J Vet Intern Med 2023; 37:1685-1693. [PMID: 37382221 PMCID: PMC10472996 DOI: 10.1111/jvim.16786] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2022] [Accepted: 05/21/2023] [Indexed: 06/30/2023] Open
Abstract
BACKGROUND Hypoadrenocorticism is an important differential for hypercalcemia. The etiology of hypercalcemia in hypoadrenocorticism in dogs is unclear. OBJECTIVE To review the prevalence of hypercalcemia and use statistical models to identify clinical, demographic, and biochemical variables associated with hypercalcemia in dogs with primary hypoadrenocorticism. ANIMALS One hundred ten dogs with primary hypoadrenocorticism; 107 with recorded total calcium (TCa), 43 recorded ionized calcium (iCa). METHODS Multicenter retrospective observational study at 4 UK referral hospitals. Univariable logistic regression analyses were performed to assess the association between independent variables of signalment, hypoadrenocorticism type (glucocorticoid only deficient hypoadrenocorticism [GHoC] vs glucocorticoid and mineralocorticoid deficient hypoadrenocorticism [GMHoC]), clinicopathological variables and hypercalcemia. Hypercalcemia was defined as elevated TCa, an elevated iCa, or both elevated TCa and iCa (Model 1) or as elevated iCa (Model 2). RESULTS Overall prevalence of hypercalcemia was 34.5% (38/110). The odds of hypercalcemia (Model 1) were increased (P < .05) in dogs with GMHoC ([vs GHoC], OR [odds ratio] = 3.86, 95% confidence interval [CI] 1.105-13.463), higher serum creatinine (OR = 1.512, 95% CI 1.041-2.197), and higher serum albumin (OR = 4.187, 95% CI 1.744-10.048). The odds of ionized hypercalcemia (Model 2) were increased (P < .05) with reduced serum potassium concentration (OR = 0.401, 95% CI 0.184-0.876) and younger age (OR = 0.737, 95% CI 0.558-0.974). CONCLUSIONS AND CLINICAL IMPORTANCE This study identified several key clinical and biochemical variables associated with hypercalcemia in dogs with primary hypoadrenocorticism. These findings aid understanding of the pathophysiology and etiology of hypercalcemia in dogs with primary hypoadrenocorticism.
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Affiliation(s)
- Harriet Hall
- Department of Veterinary Medicine, Queen's Veterinary School HospitalUniversity of CambridgeCambridgeUnited Kingdom
- Dick White Referrals, Six Mile BottomCambridgeshireUnited Kingdom
| | - Timothy Williams
- Department of Veterinary Medicine, Queen's Veterinary School HospitalUniversity of CambridgeCambridgeUnited Kingdom
| | - Jessica Florey
- Dick White Referrals, Six Mile BottomCambridgeshireUnited Kingdom
| | | | - Victoria Black
- Langford VetsBristol Veterinary School, Langford HouseLangford BS40 5DUUnited Kingdom
| | - Daniel Thompson
- Davies Veterinary Specialists, Manor Farm Business Park, Higham GobionHitchinUnited Kingdom
| | - Barbara Skelly
- Department of Veterinary Medicine, Queen's Veterinary School HospitalUniversity of CambridgeCambridgeUnited Kingdom
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Cooke DL, Shen H, Duvvuri M, Thompson D, Neylan T, Wolfe W, Hetts S, Ovbiagele B, Whooley M, Cohen B. Association of select psychiatric disorders with incident brain aneurysm and subarachnoid hemorrhage among veterans. Front Integr Neurosci 2023; 17:1207610. [PMID: 37600234 PMCID: PMC10433370 DOI: 10.3389/fnint.2023.1207610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Accepted: 07/19/2023] [Indexed: 08/22/2023] Open
Abstract
Background Brain aneurysms represent a significant cause of hemorrhagic stroke. Prior research has demonstrated links between stress and stroke, including brain aneurysms. We aimed to determine relationships between select psychiatric disorders and aneurysms and aneurysmal SAH. Methods We performed retrospective, case-control study of a National Veterans Affairs population with two experimental groups (aneurysm-only and aneurysmal SAH) and 10-fold controls per group matched by age, date, and clinical data source. The studied the presence of 4 psychiatric disorders: Posttraumatic stress disorder (PTSD), major depressive disorder (MDD), generalized anxiety disorder (GAD), and other mood disorders. Our main outcomes Unadjusted and multivariable adjusted ORs of PTSD, MDD, GAD, and mood disorders within aneurysm-only and aSAH groups. Results In 6,320,789 US Veterans who were enrolled for at least 5 years in Medicare and/or the Veterans Health Administration, we identified 35,094 cases of aneurysm without SAH and 5,749 cases of aneurysm with SAH between 1/2005 and 12/2019. In analyses adjusted for sex, hypertension, and tobacco use, patients with aneurysm were more likely than matched controls to have a history of PTSD (OR 1.48), MDD (OR 1.33), GAD (OR 1.26), and other mood disorders (OR 1.34) (all p-values < 0.0001). Similarly, patients with aSAH were more likely than controls to have a history of PTSD (OR 1.35), MDD (OR 1.38), GAD (OR 1.18), and other mood disorders (OR 1.30) (all p-values < 0.0001). Conclusion The study, the largest of its kind, further suggests links between psychiatric disorders and stroke. This is important as patients with aneurysms are not routinely screened for such psychiatric risk factors. Additional research on this topic could lead to novel strategies to improve stroke prevention.
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Affiliation(s)
- Daniel L. Cooke
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, United States
| | - Hui Shen
- San Francisco Veterans Affairs Medical Center, School of Medicine, University of California, San Francisco, San Francisco, CA, United States
| | - Madhavi Duvvuri
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, United States
| | - Daniel Thompson
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, United States
| | - Thomas Neylan
- Department of Psychiatry, San Francisco Veterans Affairs Medical Center, University of California, San Francisco, San Francisco, CA, United States
| | - William Wolfe
- Department of Psychiatry, San Francisco Veterans Affairs Medical Center, University of California, San Francisco, San Francisco, CA, United States
| | - Steven Hetts
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, United States
| | - Bruce Ovbiagele
- Department of Neurology, San Francisco Veterans Affairs Medical Center, University of California, San Francisco, San Francisco, CA, United States
| | - Mary Whooley
- Department of Medicine, San Francisco Veterans Affairs Medical Center, University of California, San Francisco, San Francisco, CA, United States
| | - Beth Cohen
- Department of Medicine, San Francisco Veterans Affairs Medical Center, University of California, San Francisco, San Francisco, CA, United States
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Thompson D, Pescaroli G. Buying electricity resilience: using backup generator sales in the United States to understand the role of the private market in resilience. J Infrastruct Preserv Resil 2023; 4:11. [PMID: 37192962 PMCID: PMC10163284 DOI: 10.1186/s43065-023-00078-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/10/2022] [Revised: 03/29/2023] [Accepted: 03/31/2023] [Indexed: 05/18/2023]
Abstract
Disruptions to key lifelines, especially electrical power, can cause outsized impacts on human functioning. The state of the art on developed countries has focused on enhancing resilience to electrical grid infrastructure but has neglected to track changes regarding how the private market has developed electricity continuity measures over time. Backup generators are among the most accessible tools to maintain electricity continuity in case of power failure, but their role as a buffer remains understudied outside the technical domain, along with the humanitarian and emergency response sectors. This paper analyzes generator sales across the U.S. to understand some underlying trends that may have influenced changes in consumer preference for electricity resilience. Reports from major backup generator sellers and import data of backup generators reveal an increase in backup generators across the U.S. and find that private demand for energy resilience is likely increasing due to consumers' perceived risk and rising levels of intolerance to power disruptions. The discussion finds that an increase in private demand and use of backup generators may be impacting electricity resilience at a communal and societal level, which seems to be underexamined by studies focusing on private generator usage in the U.S..
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Affiliation(s)
- Daniel Thompson
- Institute for Risk and Disaster Reduction, University College London, London, UK
| | - Gianluca Pescaroli
- Institute for Risk and Disaster Reduction, University College London, London, UK
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Djaïleb L, Armstrong W, Thompson D, Gafita A, Farolfi A, Grogan T, Fendler W, Czernin J, Hope T, Calais J. Pre-surgical 68Ga-PSMA-11 PET for biochemical recurrence risk assessment: Follow-up analysis of a multicenter prospective phase 3 imaging trial. Médecine Nucléaire 2023. [DOI: 10.1016/j.mednuc.2023.01.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/06/2023]
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12
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Philips R, Chase D, Thompson D, Hardcastle M, Kiupel M. An extradural cyst in a French Bulldog. N Z Vet J 2023; 71:145-151. [PMID: 36735932 DOI: 10.1080/00480169.2023.2176937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
CASE HISTORY A 7-year-old, male neutered French Bulldog was referred to a specialist veterinary hospital for evaluation of progressive paraparesis of 6-months' duration. The owners reported both faecal and urinary incontinence at home. CLINICAL FINDINGS The dog presented with ambulatory paraparesis and pelvic limb ataxia that was more pronounced in the right pelvic limb. The pelvic limb withdrawal response and sciatic myotatic response were reduced bilaterally. Postural reaction responses were delayed in both pelvic limbs, and this was more obvious in the right pelvic limb. The anal tone and perineal sensation were normal at the time of examination.An L4-S3 myelopathy was suspected. CT of the spine revealed a compressive, bilobed, extramedullary, cyst-like structure within the vertebral canal, between L7 and S3. Surgical removal of the cyst via a L7-S1 dorsal laminectomy was performed. Histopathological examination and additional immunohistochemistry of the excised structure indicated a probable ependymal cyst with a ciliated lining. The dog recovered well post-operatively, and at follow-up 3 weeks later had some improvement of his neurological signs. The paraparesis and pelvic limb ataxia had improved; however, the remaining neurological examination was similar to the pre-surgical examination. DIAGNOSIS Extradural cyst. CLINICAL RELEVANCE Spinal cysts can contribute to clinical signs that resemble other common chronic spinal cord diseases, such as intervertebral disc disease. Therefore, this disease should be considered as a differential when dealing with cases of progressive paraparesis and pelvic limb ataxia. This case report may potentially provide opportunities in the future for further understanding of the pathogenesis, behaviour, outcomes and subclassification of spinal cysts in dogs.
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Affiliation(s)
- R Philips
- Veterinary Specialists Aotearoa, Auckland, New Zealand
| | - D Chase
- Veterinary Specialists Aotearoa, Auckland, New Zealand
| | - D Thompson
- Veterinary Specialists Aotearoa, Auckland, New Zealand
| | - M Hardcastle
- Gribbles Veterinary Pathology, Auckland, New Zealand
| | - M Kiupel
- Veterinary Diagnostic Laboratory, College of Veterinary Medicine, Michigan State University, Lansing, MI, USA
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Cann AA, Muñoz A, Lentini I, Benjamin T, Thompson D, Anne Harden L, Milanovich JR. Spatial and thermal ecology of juvenile head‐started Blanding's turtles
Emydoidea blandingii. Wildlife Biology 2023. [DOI: 10.1002/wlb3.01074] [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] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Affiliation(s)
- Armand A. Cann
- Dept of Biology, Loyola Univ. Chicago Chicago IL USA
- U.S. Fish and Wildlife Service Chicago IL USA
| | - Andrés Muñoz
- Dept of Biology, Loyola Univ. Chicago Chicago IL USA
| | - Isabella Lentini
- Dept of Biology, Loyola Univ. Chicago Chicago IL USA
- Nursing Dept, DePaul Univ. Chicago IL USA
| | | | - Daniel Thompson
- Dept of Natural Resources, Forest Preserve District of DuPage County Wheaton IL USA
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Siddall AG, Stokes KA, Thompson D, Izard R, Greeves J, Bilzon JLJ. Influence of smoking status on acute biomarker responses to successive days of arduous military training. BMJ Mil Health 2023; 169:52-56. [PMID: 32718978 DOI: 10.1136/bmjmilitary-2020-001533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2020] [Accepted: 05/21/2020] [Indexed: 01/29/2023]
Abstract
INTRODUCTION Habitual smoking is highly prevalent in military populations despite its association with poorer training outcomes. Smoking imposes challenges on the immune and endocrine systems which could alter how smokers acutely respond to, and recover from, intensive exercise particularly over multiple days of training. METHODS Over a two-day period, 35 male British Army recruits (age 22±3 years; mass 76.9±8.0 kg; height 1.78±0.06 m; 15 smokers) completed a 16.1 km loaded march (19.1 kg additional mass) on the first morning and a best-effort 3.2 km 'log race' (carrying a 60 kg log between six and eight people) on the subsequent morning. Blood samples were obtained on waking and immediately postexercise on both days and analysed for C reactive protein (CRP), interleukin 6 (IL-6), testosterone to cortisol ratio and insulin-like growth factor 1 (IGF-1). RESULTS Independent of smoking group, the exercise bouts on both days evoked significant increases in IL-6 (p<0.001) and decreases in testosterone to cortisol ratio (p<0.05). CRP concentrations on day 2 were significantly higher than both time points on day 1 (p<0.001), and a 9% decline in IGF-1 occurred over the two-day period, but was not significant (p=0.063). No significant differences were observed between smokers and non-smokers (p>0.05). CONCLUSIONS Military-specific tasks elicited inflammatory and endocrine responses, with systemic CRP and IGF-1 indicating that the physiological stress generated during the first training day was still evident on the second day. Despite the well-established impacts of smoking on resting levels of the markers examined, responses to two days of arduous military-specific training did not differ by smoking status.
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Affiliation(s)
- A G Siddall
- Occupational Performance Research Group, University of Chichester, Chichester, UK
| | - K A Stokes
- Department for Health, University of Bath, Bath, UK
| | - D Thompson
- Department for Health, University of Bath, Bath, UK
| | - R Izard
- Department of Occupational Medicine, Army Recruiting and Initial Training Command, Upavon, UK
| | - J Greeves
- Army Personnel Research Capability, Army Headquarters, Andover, UK
| | - J L J Bilzon
- Department for Health, University of Bath, Bath, UK
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Thompson D, Robinson T, Singleton W, Patel N, Wigfield C, Malcolm G. Post-operative tension spinal subdural extra-arachnoid hygroma of the lumbar spine: case series, literature review, and recommendations for clinical management. Br J Neurosurg 2022:1-6. [PMID: 36541810 DOI: 10.1080/02688697.2022.2154748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 03/24/2022] [Accepted: 11/29/2022] [Indexed: 12/24/2022]
Abstract
OBJECTIVE Case series presentation and literature review of patient group suffering from symptomatic tension subdural extra-arachnoid hygroma following decompressive surgery for degenerative lumbar stenosis or disc disease. The purpose was to better understand this rare post-operative complication with a pathognomic radiological sign to help recommend optimal strategies for clinical management. METHODS Retrospective case series comprising seven cases from one tertiary Neurosurgical centre spanning a 10-year period from 2011 to 2021. Patients included were those known to have undergone a spinal procedure and subsequently to have developed a symptomatic spinal subdural extra-arachnoid hygroma (SSEH). A literature review was conducted using PubMed, MEDLINE and EMBASE (keywords 'subdural hygroma', 'lumbar CSF hygroma', 'extra arachnoid hygroma', 'extra-arachnoid CSF collection', 'CSF tension hygroma', 'lumbar extra arachnoid hygroma', 'lumbar spinal hygroma', 'post-operating spinal hygroma', 'post-operative spinal CSF collection') and through reading references cited in relevant articles. Articles involving post-operative SSEH following lumbar spinal surgery were included. RESULTS Rare complication with only five other cases in the literature. Dural breach described intra-operatively in only 5 of 12 total cases from our series and the literature. 5 patients in our series were managed surgically with 2 being managed conservatively. All patients in our series improved symptomatically and radiologically following surgical or conservative management. CONCLUSIONS This is a rare post-lumbar surgery complication that can cause rapidly deteriorating lower limb and sphincteric function. Surgical management with wide durotomy and arachnoid marsupialisation can lead to reversal of neurological deterioration and excellent clinical results. A delayed presentation with pseudomeningocele formation may be managed conservatively if neurology is stable or improving. It is a condition that it is important for the clinician to recognise in order to instigate appropriate management in a time-dependent fashion.
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Affiliation(s)
| | - Tanya Robinson
- Department of Neurosurgery, Southmead Hospital, Bristol, UK
| | - Will Singleton
- Department of Neurosurgery, Bristol Children's Hospital, Bristol, UK
| | - Nitin Patel
- Department of Neurosurgery, Southmead Hospital, Bristol, UK
| | | | - George Malcolm
- Department of Neurosurgery, Southmead Hospital, Bristol, UK
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Aminzadeh A, Arhatari BD, Maksimenko A, Hall CJ, Hausermann D, Peele AG, Fox J, Kumar B, Prodanovic Z, Dimmock M, Lockie D, Pavlov KM, Nesterets YI, Thompson D, Mayo SC, Paganin DM, Taba ST, Lewis S, Brennan PC, Quiney HM, Gureyev TE. Imaging Breast Microcalcifications Using Dark-Field Signal in Propagation-Based Phase-Contrast Tomography. IEEE Trans Med Imaging 2022; 41:2980-2990. [PMID: 35584078 DOI: 10.1109/tmi.2022.3175924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Breast microcalcifications are an important primary radiological indicator of breast cancer. However, microcalcification classification and diagnosis may be still challenging for radiologists due to limitations of the standard 2D mammography technique, including spatial and contrast resolution. In this study, we propose an approach to improve the detection of microcalcifications in propagation-based phase-contrast X-ray computed tomography of breast tissues. Five fresh mastectomies containing microcalcifications were scanned at different X-ray energies and radiation doses using synchrotron radiation. Both bright-field (i.e. conventional phase-retrieved images) and dark-field images were extracted from the same data sets using different image processing methods. A quantitative analysis was performed in terms of visibility and contrast-to-noise ratio of microcalcifications. The results show that while the signal-to-noise and the contrast-to-noise ratios are lower, the visibility of the microcalcifications is more than two times higher in the dark-field images compared to the bright-field images. Dark-field images have also provided more accurate information about the size and shape of the microcalcifications.
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van den Bosch K, Witkowski E, Thompson D, Cron G. Reprappendixoductive ecology offers some answers to the pepperbark tree persistence puzzle in the Kruger National Park, South Africa. Glob Ecol Conserv 2022. [DOI: 10.1016/j.gecco.2022.e02330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Callender C, Johnson B, Musaad S, Thompson D. Baseline Diet Quality Using the Healthy Eating Index-2015 for African American Girls in an Online Obesity Prevention Program. J Acad Nutr Diet 2022. [DOI: 10.1016/j.jand.2022.08.089] [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: 10/14/2022]
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Thompson D, Huang P, Chan B, Koff J, Murray T. 494 Bacteriophage distribution on aerosolized particles. J Cyst Fibros 2022. [DOI: 10.1016/s1569-1993(22)01184-5] [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: 11/05/2022]
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Macdonald M, Thompson D, Perry R, Brooks R. Comparing asphyxia and unexplained causes of death: a retrospective cohort analysis of sleep-related infant death cases from a state child fatality review programme. BMJ Open 2022; 12:e059745. [PMID: 36104144 PMCID: PMC9476159 DOI: 10.1136/bmjopen-2021-059745] [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] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVES To examine the characteristics and circumstances of infants who died while sleeping or in a sleep environment and compare deaths classified as either unintentional asphyxia or an unexplained cause. DESIGN A retrospective cohort study. SETTING Data were extracted from the National Fatality Review Case Reporting System and Florida Vital Statistics databases. PARTICIPANTS Data on 778 sleep-related infant deaths occurring from 2014 to 2018 in Florida were analysed. PRIMARY OUTCOME MEASURE Cause of death classification as unintentional asphyxia or unexplained. RESULTS Overall, 36% (n=276) of sleep-related infant deaths in this study sample were classified as resulting from an unexplained cause compared with unintentional asphyxia. Most infants were reported to be in an adult bed (60%; n=464) and sharing a sleep surface with a person or animal (60%; n=468); less than half (44%; n=343) were reportedly placed to sleep on their back. After controlling for the influence of other independent variables, female sex (adjusted risk ratio: 1.36; 95% CI 1.06 to 1.74) and fully obstructed airway condition (adjusted risk ratio: 0.30; 95% CI 0.18 to 0.50) were associated with an unexplained cause of death. CONCLUSIONS The results of this analysis indicate that sleep environment hazards remain prevalent among infants who die suddenly and unexpectedly, regardless of the cause of death determination. While significant differences were observed for some factors, in many others the distributions of both demographic and incident characteristics were similar between unexplained deaths and those resulting from asphyxia. The results of this study support growing evidence that unsafe sleep environments contribute to all forms of sudden unexpected infant death, underscoring the need for standardising cause of death determination practices and promoting consistent, high-quality forensic investigations to accurately explain, monitor and prevent these deaths.
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Affiliation(s)
- Megan Macdonald
- Division of Children's Medical Services, Florida Department of Health, Tallahassee, Florida, USA
| | - Daniel Thompson
- Independent Statistical Consultant, Tallahassee, Florida, USA
| | - Robin Perry
- Social Work, Florida Agricultural and Mechanical University, Tallahassee, Florida, USA
| | - Robert Brooks
- Division of Children's Medical Services, Florida Department of Health, Tallahassee, Florida, USA
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Fox R, Klug J, Thompson D, Kellett A, Reilly A. Stability of co-crystals – a density functional theory study. Acta Cryst Sect A 2022. [DOI: 10.1107/s2053273322090957] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/19/2023]
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22
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Rutsch F, O'brien K, Nitschke Y, Sullivan C, Howe J, Lynch A, Schrier D, Thompson D, Sabbagh Y. INZ-701, a recombinant ENPP1-Fc protein, effectively treats and prevents neointimal proliferation in WT and ENPP1 Deficient mice. Cardiovasc Res 2022. [DOI: 10.1093/cvr/cvac066.235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: Private company. Main funding source(s): Inozyme Pharma
Inactivating mutations in ENPP1, which encodes the ecto-nucleotide pyrophosphatase/phosphodiesterase 1 (ENPP1), underlie the rare inherited disorder, generalized arterial calcification of infancy (GACI)/autosomal recessive hypophosphatemic rickets type 2 (ARHR2) also known as ENPP1 Deficiency. ENPP1 Deficiency is characterized by calcification of large and medium sized arteries and marked neointimal proliferation of arteries, leading to arterial stenosis and severe cardiovascular and skeletal complications. ENPP1 Deficiency is associated with a 50% mortality rate in the first six months of life, and there are no approved treatments.
Previous research demonstrated that INZ-701 protein prevented arterial calcification in an ENPP1 deficient mouse model (Enpp1 asj/asj). This study was designed to determine whether INZ-701 can prevent neointimal proliferation in WT and an ENPP1 deficient mouse model (ttw/ttw). Carotid ligation was performed to induce intimal proliferation in the mice.
In the preventive arm of the study, INZ-701 (10mg/kg) or vehicle was administered subcutaneously every other day starting in 6-week-old ttw/ttw-mice. Carotid ligation was performed in these mice at the age of 7 weeks and dosing continued for another 2 weeks. Carotid intimal and medial area caudal from the ligation were analyzed by histomorphometry 14 days and 21 days after carotid ligation. In the therapeutic arm of the study, INZ-701 (10 mg/kg) or vehicle was administered subcutaneously every other day starting 7 days after carotid ligation, when intimal proliferation had already developed, in 8-week-old ttw/ttw-mice. After one week of treatment, histomorphometry was performed.
Fourteen days after carotid ligation, ttw/ttw-mice preventatively treated with INZ-701 showed a significantly reduced intimal area (p<0.001) and intimal/medial (I/M) ratio (p<0.001) compared to those treated with vehicle. This effect was also observed in mice treated with INZ-701, which were treated for 28 days and were subsequently dissected 21 days after carotid ligation. Interestingly, similar effects of INZ-701 were found in WT mice in the preventative study. In the therapeutic arm of the study, subcutaneous injection of INZ-701 beginning at 7 days post carotid ligation also led to a significant reduction in the I/M ratio (p<0.001) in the INZ-701 treated group compared to vehicle treated ttw/ttw-mice.
These findings demonstrate that INZ-701 prevents neointimal proliferation after carotid injury in a murine model of ENPP1 Deficiency. INZ-701 is hypothesized to restore circulating levels of AMP and adenosine, both potent inhibitors of intimal hyperplasia. Neointimal proliferation is a key feature in the pathophysiology of ENPP1 Deficiency and our results build on prior evidence to support the potential of INZ-701 to treat this rare and life-threatening disease.
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Affiliation(s)
- F Rutsch
- Münster University Children’s Hospital , Münster , Germany
| | - K O'brien
- Inozyme Pharma , Boston , United States of America
| | - Y Nitschke
- Münster University Children’s Hospital , Münster , Germany
| | - C Sullivan
- Inozyme Pharma , Boston , United States of America
| | - J Howe
- Inozyme Pharma , Boston , United States of America
| | - A Lynch
- Inozyme Pharma , Boston , United States of America
| | - D Schrier
- Inozyme Pharma , Boston , United States of America
| | - D Thompson
- Inozyme Pharma , Boston , United States of America
| | - Y Sabbagh
- Inozyme Pharma , Boston , United States of America
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Djaileb L, Armstrong WR, Thompson D, Nguyen K, Gafita A, Farolfi A, Rajagopal A, Juarez R, Cooperberg MR, Carroll P, Washington SL, Czernin J, Reiter RE, Hope TA, Calais J. Predictive value of extra-prostatic disease detection by pre-operative PSMA-PET for biochemical recurrence-free survival in patients treated with radical prostatectomy: Follow-up analysis of a multicenter prospective phase 3 imaging trial. J Clin Oncol 2022. [DOI: 10.1200/jco.2022.40.16_suppl.5088] [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: 11/20/2022] Open
Abstract
5088 Background: To assess the predictive value of pre-operative PSMA-PET staging for biochemical recurrence (BCR) free-survival (BCR-FS) in patients treated with radical prostatectomy (RP) and pelvic lymph node dissection (PLND) with intermediate-risk (IR) to high-risk (HR) prostate cancer (PCa) included in the prospective trial used for the FDA approval of 68Ga-PSMA-11. Methods: This is a post-hoc follow-up study of the efficacy analysis cohort included in the multicenter prospective phase 3 imaging trial (n = 764; NCT03368547, NCT02611882, NCT02919111) which assessed the diagnostic accuracy of 68Ga-PSMA-11 PET for pelvic nodal metastasis detection prior to RP and PLND in patients with IR and HR PCa. Each PSMA-PET scan was read by three blinded independent readers. Readers assessed the presence of PCa (positive vs negative) by region: prostate bed (T), pelvic lymph nodes (N), extra-pelvic lymph nodes (M1a) bone (M1b) and visceral (M1c). A centralized per-region majority rule was used in case of disagreement. The surgical pathology report was used to assess the presence of pelvic lymph node metastasis by histopathology (pN0 vs pN1). The patients were followed up for biochemical progression after RP by the local investigators using electronic medical records. BCR was defined by a prostate-specific antigen (PSA) level > 0.2 ng/ml after RP or an initiation of PCa specific adjuvant/salvage therapy. Pairwise comparisons using Log-Rank test was performed to evaluate BCR-FS between the pre-operative PSMA scan reads (N0M0 vs. N+ and/or M+) and the histopathology status (pN0 vs. pN1). Results: From December 2015 to December 2019, a total of 764 patients were enrolled in the trial. 277/764 (36%) underwent RP after PSMA-PET. Clinical follow-up was obtained in 240/277 (87%) patients. The median age was 67 years (interquartile range, 61-71 years). The median follow-up time from RP was 21.4 months (IQR: 8.80 - 31.53). One hundred BCR events (41%) were observed, and 98/240 patients underwent salvage therapy or other treatment (40.6%). The BCR-FS was 24.3 (IQR: 7.8 - 48.8) in the whole cohort. 160/240 (66%), 28/240 (11.6%), 39/240 (16%), 13/240 (5.4%) patients were pN0/PSMA- (N0 and M0), pN+/PSMA+ (N+ and/or M+), pN+/PSMA-, and pN0/PSMA+, respectively. BCR-FS was higher in PSMA- than in PSMA+ patients (33 vs 7.3 months; p < 0.0001). BCR-FS was higher in pN0/PSMA- than in patients pN+/PSMA-, pN0/PSMA+ and pN+/PSMA+: 46 months vs 12.3, 11.7, and 3, respectively (p < 0.001). BCR-FS did not significantly differ between pN0/PSMA+ and pN+/PSMA- (11.7 vs 12.3; p = 0.64). Conclusions: PSMA PET staging information is predictive of BCR-FS after RP. Patients with extra-prostatic disease detected by pre-operative PSMA-PET scan have a high risk of biochemical relapse. Clinical trial information: NCT03368547.
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Affiliation(s)
- Loic Djaileb
- UCLA Ahmanson Translational Theranostics Division, Los Angeles, CA
| | - Wesley R Armstrong
- Ahmanson Translational Theranostics Division, University of California, Los Angeles, CA
| | - Daniel Thompson
- Department of Radiology and Biomedical Imaging. University of California, San Francisco, CA
| | - Kathleen Nguyen
- Ahmanson Translational Theranostics Division, University of California, Los Angeles, CA
| | - Andrei Gafita
- University of California-Los Angeles, Los Angeles, CA
| | | | - Abhejit Rajagopal
- Department of Radiology and Biomedical Imaging. University of California, San Francisco, CA
| | - Roxanna Juarez
- Department of Radiology and Biomedical Imaging. University of California, San Francisco, CA
| | | | - Peter Carroll
- University of California-San Francisco, San Francisco, CA
| | | | | | - Robert Evan Reiter
- University of California Los Angeles, Institute of Urologic Oncology, Los Angeles, CA
| | - Thomas A. Hope
- University of California, San Francisco, San Francisco, CA
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Thompson D, Nagel J, Gasteau D, Manohar S. Laser-induced ultrasound transmitters for large-volume ultrasound tomography. Photoacoustics 2022; 25:100312. [PMID: 34868873 PMCID: PMC8626690 DOI: 10.1016/j.pacs.2021.100312] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 10/27/2021] [Accepted: 10/27/2021] [Indexed: 06/13/2023]
Abstract
We present a protocol for the design, fabrication and characterisation of laser-induced ultrasound transmitters with a specific, user-defined frequency response for the purpose of ultrasound tomography of large-volume biomedical samples. Using an analytic solution to the photoacoustic equation and measurements of the optical and acoustic properties of the materials used in the transmitters, we arrive at a required mixture of carbon black and polydimethylsiloxane to achieve the desired frequency response. After an in-depth explanation of the fabrication and characterisation approaches we show the performance of the fabricated transmitter, which has a centre frequency of 0.9 MHz, 200% bandwidth and 45.8 ∘ opening angle, multi-kPa pressures over a large depth range in water.
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Affiliation(s)
- D. Thompson
- Correspondence to: University of Twente, Technical Medical centre, Enschede, Netherlands.
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Silva AHD, Constantinides M, Valetopoulou A, Sgardelis P, Mankad K, D'Arco F, Jankovic I, Thompson D. Paediatric spinal cord low-grade gliomas-evaluation and management of post-surgical residual disease. Childs Nerv Syst 2022; 38:577-586. [PMID: 34855000 DOI: 10.1007/s00381-021-05412-4] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Accepted: 11/06/2021] [Indexed: 11/25/2022]
Abstract
PURPOSE To assess the evaluation and management of post-surgical residual disease for low-grade intramedullary spinal cord tumours (IMSCT) in childhood. METHODS A single-centre retrospective review of low-grade IMSCTs treated between 2000 and 2019. All surgeries were performed with intent of safe maximal resection guided by intra-operative neurophysiological monitoring (IONM). Pre- and post-operative MRIs were reviewed to assess the extent of resection (EOR), recorded as follows: gross total resection (GTR), near total resection (NTR), sub-total resection (STR) and partial resection (PR). Outcome measures were time to recurrence, need for and modality of additional therapy and ambulatory status at last follow-up. RESULTS Thirty patients underwent surgery for IMSCT (median age 6.9 years). EOR was GTR = 8, NTR = 4, STR = 9, PR = 9. All patients were alive at last follow-up (median follow-up 73 months [IQR 93 months]). Eighteen patients (60%) remained radiologically stable. Twelve patients (40%) developed recurrence during surveillance. Progression free survival was significantly better in cases with GTR + NTR in comparison to either STR or PR (p = 0.039). 10/30 (33%) patients were treated with additional therapy. At last follow-up, 26/30 patients were independently mobile. CONCLUSION Survival rates for low-grade IMSCT are excellent. Radical micro-surgical resection, guided by IONM provides effective means of balancing the objectives of maximal safe resection, functional outcome and tumour control. Whilst evidence of 'residual disease' was identified in over 2/3 of immediate post-operative MRI scans, additional treatment was required in only 1/3 of cases. Critical appraisal of post-operative imaging findings is required to better define 'residual disease'. Small volume residual disease (< 5%) does not compromise progression-free survival.
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Affiliation(s)
- A H D Silva
- Department of Paediatric Neurosurgery, Great Ormond Street Hospital for Children NHS Foundation Trust, Great Ormond Street, London, WC1N 3JH, UK
| | - M Constantinides
- Department of Paediatric Neurosurgery, Great Ormond Street Hospital for Children NHS Foundation Trust, Great Ormond Street, London, WC1N 3JH, UK
| | - A Valetopoulou
- Department of Paediatric Neurosurgery, Great Ormond Street Hospital for Children NHS Foundation Trust, Great Ormond Street, London, WC1N 3JH, UK
| | - P Sgardelis
- Department of Paediatric Neurosurgery, Great Ormond Street Hospital for Children NHS Foundation Trust, Great Ormond Street, London, WC1N 3JH, UK
| | - K Mankad
- Department of Paediatric Neurosurgery, Great Ormond Street Hospital for Children NHS Foundation Trust, Great Ormond Street, London, WC1N 3JH, UK
| | - F D'Arco
- Department of Paediatric Neurosurgery, Great Ormond Street Hospital for Children NHS Foundation Trust, Great Ormond Street, London, WC1N 3JH, UK
| | - I Jankovic
- Department of Paediatric Neurosurgery, Great Ormond Street Hospital for Children NHS Foundation Trust, Great Ormond Street, London, WC1N 3JH, UK
| | - D Thompson
- Department of Paediatric Neurosurgery, Great Ormond Street Hospital for Children NHS Foundation Trust, Great Ormond Street, London, WC1N 3JH, UK.
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Thompson D. Carrier, Neil & TabeaScharrer (eds). Mobile urbanity: Somali presence in urban East Africa. xii, 252 pp., maps, illus., bibliogrs. Oxford, New York: Berghahn Books, 2019. £99.00 (cloth). Royal Anthropological Inst 2022. [DOI: 10.1111/1467-9655.13683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Phen HM, Godfrey WS, Edwards K, Thompson D, Bradbury TL. Use of a threaded-coupled femoral extraction device allows for higher extraction force when compared to loop or vice grip devices; A potted stem analysis. J Clin Orthop Trauma 2022; 26:101789. [PMID: 35211376 PMCID: PMC8844747 DOI: 10.1016/j.jcot.2022.101789] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Revised: 01/24/2022] [Accepted: 01/30/2022] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND Extraction of a well-fixed femoral stem during revision total hip arthroplasty presents a technical challenge to the operating surgeon. The option of several stem designs during implantation necessitates the availability of extraction tools to be utilised intra-operatively. This study aims to compare the amount of axial force generated from using a threaded-coupled extraction device, loop extraction device, and vice-grip universal extraction set on a potted total hip arthroplasty stem construct. METHODS A size 7 Stryker Accolade® II femoral stem (Stryker, Mahwah, NJ) was potted within a 5.20 cm inner diameter polyvinyl chloride pipe using a potting medium with tensile strength and lap shear of 1000psi. This construct was coupled to a material testing system whose force transducer was calibrated to a recording speed of 1000 frames per second. The extractors were coupled to the potted stem, and a force of 1.32 J was applied ten times sequentially to each construct. Force was recorded in Newtons. RESULTS The maximum average force for the threaded, loop, and Shukla extractors was 111.46 ± 1.77 N, 90.22 ± 0.87 N, and 64.70 ± 9.03 N (p < 0.01). Loss of coupling was not experienced with any extractor. CONCLUSION Within our study, the forces observed per constant load when utilising a threaded-coupled extraction device that attaches to the shoulder of the implant were significantly higher than those seen when using an extraction device that couples to the neck of the femoral stem.
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Thompson D, Zammit A, Yuen J, Hand C, Likeman M, Singleton W, Nelson R, Fellows G. Paediatric Cavernous Malformation of the Trigeminal Nerve: Case Report and Review of the Literature. Pediatr Neurosurg 2022; 57:207-212. [PMID: 35398849 DOI: 10.1159/000524522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Accepted: 04/06/2022] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Intradural, extra-axial cerebral cavernous malformations (CCMs) are rare entities and are mostly reported in relation to the optic apparatus or the facial/vestibulocochlear complex. Cranial nerve CCMs tend to follow a clinically aggressive course, with a tendency to progressive neurological dysfunction following intra-lesional haemorrhage or less commonly due to the effects of subarachnoid haemorrhage. CASE PRESENTATION We report the first case of a trigeminal CCM presenting in a child with otalgia and left-sided headaches. The patient was initially managed with radiological surveillance but required surgical management following deterioration. We describe the successful treatment of the lesion with microsurgical resection. CONCLUSION A CCM should be considered in the differential diagnosis of mass lesions arising in the region of the trigeminal nerve. Surgical resection is recommended to prevent neurological deterioration and may result in significant symptomatic improvement.
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Affiliation(s)
- Daniel Thompson
- Department of Neurosurgery, Bristol Children's Hospital, Bristol, United Kingdom
| | - Adrian Zammit
- Department of Neurosurgery, Southmead Hospital, Bristol, United Kingdom
| | - Jason Yuen
- Department of Neurosurgery, Bristol Children's Hospital, Bristol, United Kingdom
| | - Charles Hand
- Department of Neurosurgery, Southmead Hospital, Bristol, United Kingdom
| | - Marcus Likeman
- Department of Radiology, Bristol Children's Hospital, Bristol, United Kingdom
| | - William Singleton
- Department of Neurosurgery, Bristol Children's Hospital, Bristol, United Kingdom
| | - Richard Nelson
- Department of Neurosurgery, Southmead Hospital, Bristol, United Kingdom
| | - Greg Fellows
- Department of Neurosurgery, Bristol Children's Hospital, Bristol, United Kingdom
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Graby J, Khavandi A, Thompson D, Downie P, Antoniades C, Rodrigues JCL. CT coronary angiography-guided cardiovascular risk screening in asymptomatic patients: is it time? Clin Radiol 2021; 76:801-811. [PMID: 34404515 DOI: 10.1016/j.crad.2021.07.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Accepted: 07/13/2021] [Indexed: 12/14/2022]
Abstract
Cardiovascular disease (CVD) is the leading cause of death in the UK, whilst millions live with various forms of the disease. Coronary artery disease constitutes a significant portion of this morbidity and mortality, and is the leading cause of premature death. Increasing focus is thus being placed on the optimisation of CVD prevention, where risk screening plays a key role. Indeed, the decline in age-adjusted cardiovascular mortality achieved up to now has been largely attributed to primary preventative therapies (e.g., statins) introduced earlier in the disease process. National initiatives exist to improve cardiovascular health at a population level, but in its current form, CVD screening at the individual level is predominantly undertaken using multivariate risk scores based on population-based data. These have multiple innate flaws, highlighted in this review. Non-invasive imaging plays a key role in the screening of other disease processes, helping to personalise the screening process. Although the coronary artery calcium score as a screening tool has a role in national and international guidance, whether a shift to screening with computed tomography coronary angiography (CTCA) is now appropriate is open for discussion. Image acquisition techniques continue to improve with reducing radiation exposure and an ever-expanding evidence-base for additional prognostic data offered by CTCA. This enables the potential identification of sub-clinical atherosclerosis, including with novel artificial intelligence techniques. This review aims to report current guidelines regarding cardiac CT imaging in the asymptomatic primary prevention setting, advances in various CT technologies and future opportunities for progress in this field.
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Affiliation(s)
- J Graby
- Department of Cardiology, Royal United Hospital, Combe Park, Bath, BA1 3NG, UK; Department for Health, University of Bath, Claverton Down, Bath, BA2 7AY, UK
| | - A Khavandi
- Department of Cardiology, Royal United Hospital, Combe Park, Bath, BA1 3NG, UK
| | - D Thompson
- Department for Health, University of Bath, Claverton Down, Bath, BA2 7AY, UK
| | - P Downie
- Department of Laboratory Medicine, Salisbury District Hospital, Odstock Road, Salisbury, SP2 8BJ, UK
| | - C Antoniades
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford OX3 9DU, UK
| | - J C L Rodrigues
- Department for Health, University of Bath, Claverton Down, Bath, BA2 7AY, UK; Department of Radiology, Royal United Hospital, Combe Park, Bath, BA1 3NG, UK.
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Cann AA, Weber RR, Harden LA, Thompson D, Nadolski J, Mattes J, Karwowska A, Shahjahan S, Milanovich JR. Physiological Health and Survival of Captive-Reared and Released Juvenile Blanding's Turtles. Physiol Biochem Zool 2021; 94:411-428. [PMID: 34569914 DOI: 10.1086/716832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
AbstractConservation translocations are important in maintaining viable wildlife populations of vulnerable species within their indigenous ranges. To be effective, population restoration efforts (e.g., head start programs) must consider the species' life history, regional ecology, and physiology and the health status of wild and translocated populations. The decline of Blanding's turtles (Emydoidea blandingii) has prompted the initiation of head start programs, but the health and short-term survival of head-started juveniles released to the wild is largely unknown. From May to October 2016 and 2017, we radio tracked captive-reared, recently released juvenile Blanding's turtles and monitored their survivorship and monthly physiological health. We aimed to (1) compare physiological metrics of juveniles before and after release from captivity and between head-started cohorts, (2) identify seasonal trends in physiological metrics of recently released juveniles, (3) compare physiological metrics of recently released and formerly released juveniles, and (4) identify predictors of juvenile survivorship after release from captivity. Juvenile short-term survival was low compared with other studies. Most physiological metrics did not change after release from captivity, negating significant juvenile stress before or after release. Physiological metrics for recently released cohorts varied seasonally, suggesting that these juveniles were likely in good health. Some physiological metrics differed between recently released and formerly released juveniles, demonstrating a potential postrelease acclimatization period. Finally, no physiological metrics significantly predicted survival, but surviving juveniles had a higher percentage of fat. In all, juvenile deaths were not due to poor turtle health but rather to predation from human-subsidized mesocarnivores. Therefore, head-started juvenile Blanding's turtles released in suburban areas may benefit from antipredator training and mesocarnivore control at release sites.
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Palant A, Zippel-Schultz B, Ski CF, Brandts J, Eurlings C, Furtado Da Luz Brzychcyk E, Hill L, Dixon L, Fitzsimons D, Thompson D, Mueller-Wieland D, Schuett KA, Hoedemakers T, Brunner La-Rocca HP, Helms TM. Understanding needs and expectations of heart failure patients and their caregivers regarding digital health - the PASSION-HF project. Eur J Cardiovasc Nurs 2021. [DOI: 10.1093/eurjcn/zvab060.036] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: Public grant(s) – EU funding. Main funding source(s): INTERREG-NWE
Background/Introduction
Current heart failure (HF) healthcare provision is not sufficient. Due to demographic changes and subsequent increases in comorbidities, along with unequal distribution of medical care in rural areas, alternative approaches need be sought. The use of eHealth applications has potential to enable patients to become more self-sufficient. The "PASSION-HF" project aims to develop an interactive decision-making system – a virtual doctor – that provides solutions based on current guidelines and artificial intelligence. Patient independence is maximized through 24/7 access to personalized HF-management. Furthermore, the application defines decision points, where medical professionals need to be included.
Purpose
To understand needs and expectations of HF patients and their informal caregivers in regard to a virtual doctor.
Methods
We conducted an exploratory mixed-methods study within the Netherlands, UK, Ireland and Germany. Semi-structured qualitative interviews were supplemented by a standardized questionnaire. The interviews focused on i) acceptance and motivation to use a virtual doctor and ii) experience and perception of current health care provision. The interviews were analysed using the content analysis according to Mayring (2010) with the help of "ATLAS.TI" software. Additional information about the role of informal caregivers, technology acceptance and decision-making processes was collected via questionnaires.
Results
A total of 49 patients and 33 informal caregivers were interviewed. Most patients were male (76%), aged between 60 and 69 years (43%). Three key themes were identified in regard to an interactive decision-making system: 1) Reassurance, because patients felt uncertain about their condition and their symptoms, they had a strong desire for an application that could monitor their health 24/7, was able to spot deteriorations, before they occured and gave them instant feedback about their current health status; 2) Personalized advice, e.g. patients wanted the virtual doctor to adapt medication, sport activities and food recommendations to their current health status; and 3) Transparency, e.g. patients wanted to know, where the recommendations are coming from and justifications for management modifications. Interview findings also identified that the HF-nurses play a significant role in the care and management of the condition. Across all countries with HF-nurses, they were the primary point of contact, when patients had any HF related concerns.
Conclusion
The findings provide valuable information for the development and implementation of eHealth solutions. Patients want reassurance, independently of the availability of healthcare services, combined with personalized advice regarding day-to-day management of their HF. For the next step, we are planning a multicentre clinical trial to test the prototype of the application. Here all decisions are examined by a clinical committee and benefits are evaluated.
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Affiliation(s)
- A Palant
- German foundation for the chronically III, Berlin, Germany
| | | | - CF Ski
- University of Suffolk, Integrated Care Academy, Ipswich, United Kingdom of Great Britain & Northern Ireland
| | - J Brandts
- RWTH University Hospital Aachen, Department of Cardiology, Aachen, Germany
| | - C Eurlings
- Laurentius Hospital Roermond, Cardiology Department, Roermond, Netherlands (The)
| | | | - L Hill
- Belfast Health and Social Care Trust, Belfast, United Kingdom of Great Britain & Northern Ireland
| | - L Dixon
- Belfast Health and Social Care Trust, Belfast, United Kingdom of Great Britain & Northern Ireland
| | - D Fitzsimons
- Belfast Health and Social Care Trust, Belfast, United Kingdom of Great Britain & Northern Ireland
| | - D Thompson
- Belfast Health and Social Care Trust, Belfast, United Kingdom of Great Britain & Northern Ireland
| | - D Mueller-Wieland
- RWTH University Hospital Aachen, Department of Cardiology, Aachen, Germany
| | - KA Schuett
- RWTH University Hospital Aachen, Department of Cardiology, Aachen, Germany
| | | | - H-P Brunner La-Rocca
- Maastricht University Medical Centre (MUMC), Department of Cardiology, Maastricht, Netherlands (The)
| | - TM Helms
- German foundation for the chronically III, Berlin, Germany
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Jagun O, Banerjee P, Thompson D, Taylor M. The Skin of Colour Training Day UK: training the medical workforce in ethnic dermatology. Clin Exp Dermatol 2021; 47:245-246. [PMID: 34115898 DOI: 10.1111/ced.14800] [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] [Received: 06/09/2021] [Accepted: 06/10/2021] [Indexed: 12/01/2022]
Affiliation(s)
- O Jagun
- Department of Dermatology, East Kent Hospitals University Foundation Trust, Kent, UK
| | - P Banerjee
- Department of Dermatology, Lewisham and Greenwich NHS Trust and St John's Institute of Dermatology, Guy's Hospital, London, UK
| | - D Thompson
- Department of Dermatology, Sandwell and West Birmingham NHS Trust, Birmingham, UK
| | - M Taylor
- Department of Dermatology, Imperial College Healthcare NHS Trust, London, UK
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Gravas S, Palacios J, Thompson D, Concas F, Kamola P, Roehrborn C, Oelke M, Kattan M, Averbeck M, Manyak M, Lulic Z. A new risk calculator to predict changes in IPSS score and risk of AUR / BPH-related surgery in BPH patients with moderate-severe symptoms at risk of disease progression receiving placebo, dutasteride, tamsulosin, or combination therapy. Eur Urol 2021. [DOI: 10.1016/s0302-2838(21)00430-9] [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: 11/29/2022]
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Nelson K, Thompson D, Hopkinson C, Petrone R, Chasmer L. Peatland-fire interactions: A review of wildland fire feedbacks and interactions in Canadian boreal peatlands. Sci Total Environ 2021; 769:145212. [PMID: 33486170 DOI: 10.1016/j.scitotenv.2021.145212] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 01/08/2021] [Accepted: 01/11/2021] [Indexed: 06/12/2023]
Abstract
Boreal peatlands store a disproportionately large quantity of soil carbon (C) and play a critical role within the global C-climate system; however, with climatic warming, these C stores are at risk. Increased wildfire frequency and severity are expected to increase C loss from boreal peatlands, contributing to a shift from C sink to source. Here, we provide a comprehensive review of pre- and post-fire hydrological and ecological interactions that affect the likelihood of peatland burning, address the connections between peatland fires and the C-climate cycle, and provide a conceptual model of peatland processes as they relate to wildland fire, hydro-climate, and ecosystem change. Despite negative ecohydrological feedback mechanisms that may compensate for increased C loss initially, the cumulative effects of climatic warming, anthropogenic peatland fragmentation, and subsequent peatland drying will increase C loss to the atmosphere, driving a positive C feedback cycle. However, the extent to which negative and positive feedbacks will compensate for one another and the timelines for each remains unclear. We suggest that a multi-disciplinary approach of combining process knowledge with remotely sensed data and ecohydrological and wildland fire models is essential for better understanding the role of boreal peatlands and wildland fire in the global climate system.
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Affiliation(s)
- K Nelson
- Dept. of Geography and Environment, University of Lethbridge, Lethbridge, AB T1K 3M4, Canada.
| | - D Thompson
- Canadian Forest Service, Great Lakes Forestry Centre, Sault Ste. Marie, ON P6A 2E5, Canada
| | - C Hopkinson
- Dept. of Geography and Environment, University of Lethbridge, Lethbridge, AB T1K 3M4, Canada
| | - R Petrone
- Dept. of Geography and Environmental Management, University of Waterloo, Waterloo, ON N2L 3G1, Canada
| | - L Chasmer
- Dept. of Geography and Environment, University of Lethbridge, Lethbridge, AB T1K 3M4, Canada
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Thompson D. Utilization of the iOS Shortcuts App to Generate a Surgical Logbook Tool: Feasibility Study. JMIR Perioper Med 2021; 4:e24644. [PMID: 33983132 PMCID: PMC8160782 DOI: 10.2196/24644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Revised: 01/04/2021] [Accepted: 04/17/2021] [Indexed: 11/24/2022] Open
Abstract
Background Surgical audit is an essential aspect of modern reflective surgical practice and is key to improving surgical outcomes. The surgical logbook is an important method of data collection for both personal and unit audits; however, current electronic data collection tools, especially mobile apps, lack the minimum recommended data fields. Objective This feasibility study details the creation of a free, effective surgical logbook tool with the iOS Shortcuts app and investigates the time investment required to maintain a surgical logbook with this tool. In addition, we investigate the potential utility of the Shortcuts app in creating medical data collection tools. Methods Using the iOS Shortcuts app, we created a shortcut “Operation Note,” which collects surgical logbook data by using the minimum and extended audit data sets recommended by the Royal Australasian College of Surgeons. We practically assessed the feasibility of the tool, assessing the time requirement for entry, accuracy, and completeness of the entered data. Results The shortcut collected accurate and useful data for a surgical audit. Data entry took on average 65 seconds per case for the minimum data set, and 135 seconds per case for the extended data set, with a mean difference of 68 seconds (P<.001; 95% CI 61.6-77.7). Conclusions This feasibility study demonstrates the utility of the iOS Shortcuts app in the creation of a surgical logbook and the time-consuming nature of data collection for surgical audit. Our iOS Operation Note shortcut is a free, rapid, and customizable alternative to currently available logbook apps and offers surgical trainees and consultants a method for recording surgical operations, complications, and demographic data.
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Affiliation(s)
- Daniel Thompson
- Department of Vascular Surgery, St Vincent's Hospital Melbourne, Fitzroy, Australia
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Jacobs J, Li Q, Cheng Z, O'Brien K, Thompson D, Uitto J, Sabbagh Y. 167 INZ-701 prevents ectopic mineralization in an Abcc6 mouse model of pseudoxanthoma elasticum. J Invest Dermatol 2021. [DOI: 10.1016/j.jid.2021.02.187] [Citation(s) in RCA: 1] [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: 11/26/2022]
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Abstract
The B-cell receptor signaling pathway plays an integral role in the proliferation and survival of malignant B cells. Targeting the B-cell receptor pathway via the inhibition of Bruton tyrosine kinase (BTK) has evolved the treatment of a variety of B-cell malignancies, including chronic lymphocytic leukemia, mantle cell lymphoma, marginal zone lymphoma, and Waldenström macroglobulinemia. Currently, there are three BTK inhibitors approved by the U.S. Food and Drug Administration: ibrutinib, acalabrutinib, and zanubrutinib. This article reviews the pharmacology, clinical efficacy, safety, dosing, drug-drug interactions, and implications for advanced practitioners of BTK inhibitors in the treatment of B-cell malignancies.
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Affiliation(s)
- Donald C Moore
- Atrium Health, Levine Cancer Institute, Department of Pharmacy, Concord, North Carolina
| | - Daniel Thompson
- Atrium Health Cabarrus, Department of Pharmacy, Concord, North Carolina
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Hope TA, Graves CE, Calais J, Ehman E, Johnson GB, Thompson D, Aslam M, Duh QY, Gosnell J, Shen W, Roman S, Sosa JA, Kluijfhout W, Seib CS, Villanueva-Meyer J, Pampaloni MH, Suh I. Accuracy of 18F-fluorocholine PET for the detection of parathyroid adenomas: prospective single center study. J Nucl Med 2021; 62:1511-1516. [PMID: 33674400 DOI: 10.2967/jnumed.120.256735] [Citation(s) in RCA: 6] [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: 09/11/2020] [Accepted: 02/03/2021] [Indexed: 11/16/2022] Open
Abstract
Purpose: The purpose of this prospective study was to determine the correct localization rate (CLR) of 18F-fluorocholine (FCH) positron emission tomography (PET) for the detection of parathyroid adenomas in comparison to sestamibi imaging. Materials and Methods: This was a single-arm prospective trial. Ninety-eight patients with biochemical evidence of primary hyperparathyroidism were imaged prior to parathyroidectomy using FCH PET/MRI. Sestamibi imaging performed separately from the study was evaluated for comparison. The primary endpoint of the study was the CLR on a patient level. Each imaging study was interpreted by 3 blinded readers on a per-region basis. Lesions were validated by histopathologic analysis of surgical specimens. Results: Of the 98 patients who underwent FCH imaging, 77 subsequently underwent parathyroidectomy and 60 of those had sestamibi imaging. The CLR for FCH in patients who underwent parathyroidectomy based on the blinded reader consensus was 75% [0.63, 0.82]. In patients who underwent surgery and had an available sestamibi study, the CLR increased from 17% [0.10, 0.27] for sestamibi to 70% [0.59, 0.79] for FCH PET. Conclusion: In this prospective study using blinded readers, the CLR for FCH was 75%. In patients with paired sestamibi, the use of FCH PET increased the CLR from 17% to 70%. FCH PET is a superior imaging modality for the localization of parathyroid adenomas.
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Affiliation(s)
- Thomas A Hope
- University of California, San Francisco, United States
| | | | | | | | | | | | - Maya Aslam
- University of California, San Francisco, United States
| | - Quan-Yang Duh
- University of California, San Francisco, United States
| | | | - Wen Shen
- University of California, San Francisco, United States
| | | | - Julie A Sosa
- University of California, San Francisco, United States
| | | | | | | | | | - Insoo Suh
- University of California, San Francisco, United States
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Kunpalin Y, Richter J, Mufti N, Bosteels J, Ourselin S, De Coppi P, Thompson D, David AL, Deprest J. Cranial findings detected by second-trimester ultrasound in fetuses with myelomeningocele: a systematic review. BJOG 2021; 128:366-374. [PMID: 32926566 PMCID: PMC8436766 DOI: 10.1111/1471-0528.16496] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/03/2020] [Indexed: 12/14/2022]
Abstract
Background Abnormal intracranial findings are often detected at mid‐trimester ultrasound (US) in fetuses with myelomeningocele (MMC). It is unclear whether these findings constitute a spectrum of the disease or are an independent finding, which should contraindicate fetal surgery. Objective To ascertain the spectrum and frequency of US‐detected cranial findings in fetuses with MMC. Search strategy MEDLINE, Embase, Web of Science and CENTRAL were searched from January 2000 to June 2020. Selection criteria Study reporting incidence of cranial US findings in consecutive cases of second‐trimester fetuses with MMC. Data collection and analysis Publication quality was assessed by Newcastle–Ottawa Scale (NOS) and modified NOS. Meta‐analysis could not be performed as a result of high clinical diversity and study heterogeneity. Main results Fourteen cranial US findings were reported in 15 studies. Findings in classic Chiari II malformation (CIIM) spectrum included posterior fossa funnelling (96%), small transcerebellar diameter (82–96%), ‘banana’ sign (50–100%), beaked tectum (65%) and ‘lemon’ sign (53–100%). Additional cranial findings were small biparietal diameter (BPD) and head circumference (HC) (<5th centile; 53 and 71%, respectively), ventriculomegaly (45–89%), abnormal pointed shape of the occipital horn (77–78%), thinning of the posterior cerebrum, perinodular heterotopia (11%), abnormal gyration (3%), corpus callosum disorders (60%) and midline interhemispheric cyst (42%). Conclusions We identified 14 cranial findings by second‐trimester US in fetuses with MMC. The relatively high incidence of these findings and their unclear prognostic significance might not contraindicate fetal surgery in the case of normal fetal genetic testing. Some cranial findings may independently affect postnatal outcome, however. Long‐term detailed follow‐up is required to investigate this. Tweetable abstract A high rate of cranial abnormalities found on second‐trimester ultrasound in fetuses with myelomeningocele. A high rate of cranial abnormalities found on second‐trimester ultrasound in fetuses with myelomeningocele.
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Affiliation(s)
- Y Kunpalin
- Elizabeth Garrett Anderson Institute for Women's Health, University College London, London, UK.,Department of Development and Regeneration, Biomedical Sciences, KU Leuven, Leuven, Belgium
| | - J Richter
- Department of Development and Regeneration, Biomedical Sciences, KU Leuven, Leuven, Belgium.,Department of Obstetrics and Gynaecology, University Hospitals Leuven, Leuven, Belgium
| | - N Mufti
- Elizabeth Garrett Anderson Institute for Women's Health, University College London, London, UK
| | - J Bosteels
- Department of Development and Regeneration, Biomedical Sciences, KU Leuven, Leuven, Belgium.,Cochrane Belgium, Belgian Centre for Evidence-Based Medicine (Cebam), Leuven, Belgium
| | - S Ourselin
- School of Biomedical Engineering & imaging Sciences, King's College London, London, UK
| | - P De Coppi
- Department of Development and Regeneration, Biomedical Sciences, KU Leuven, Leuven, Belgium.,Department of General Paediatric Surgery, Great Ormond Street Institute of Child Health, University College London, London, UK
| | - D Thompson
- Department of Paediatric Neurosurgery, Great Ormond Street Institute of Child Health, University College London, London, UK
| | - A L David
- Elizabeth Garrett Anderson Institute for Women's Health, University College London, London, UK.,Department of Development and Regeneration, Biomedical Sciences, KU Leuven, Leuven, Belgium
| | - J Deprest
- Elizabeth Garrett Anderson Institute for Women's Health, University College London, London, UK.,Department of Development and Regeneration, Biomedical Sciences, KU Leuven, Leuven, Belgium.,Department of Obstetrics and Gynaecology, University Hospitals Leuven, Leuven, Belgium
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Thompson D, Perry LA, Renouf J, Vodanovich D, Hong Lee AH, Dimiri J, Wright G. Prognostic utility of inflammation-based biomarkers, neutrophil-lymphocyte ratio and change in neutrophil-lymphocyte ratio, in surgically resected lung cancers. Ann Thorac Med 2021; 16:148-155. [PMID: 34012481 PMCID: PMC8109682 DOI: 10.4103/atm.atm_382_20] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Accepted: 10/05/2020] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND/OBJECTIVE: Given the poor overall survival (OR) and progression-free survival (PFS) rates for lung cancers managed with surgical resection, there is a need to identify the prognostic markers that would improve the risk stratification of patients with operable lung cancer to inform treatment decisions. We investigate the prognostic utility of two established inflammation-based scores, the neutrophil–lymphocyte ratio (NLR) and the change in neutrophil–lymphocyte ratio (ΔNLR), throughout the operative period in a prospective cohort of patients with lung cancer who underwent surgical resection. METHODS: Demographic, clinical, and treatment details for 345 patients with lung cancer who underwent surgical resection between 2000 and 2019 at multiple centers across Melbourne, Victoria (Australia), were prospectively collected. Preoperative NLR and ΔNLR were calculated after which Cox univariate and multivariate analyses were conducted for OS and PFS against the known prognostic factors. RESULTS: Both univariate and multivariate analyses showed that preoperative NLR >4.54, as well as day 1 and day 2 postoperative NLR (P < 0.01), was associated with increased risk for postoperative mortality (hazard ratio 1.8; P < 0.01) and PFS (P < 0.05), whereas ΔNLR was not a significant predictor of OS or PFS. CONCLUSION: Elevated NLR among patients with lung cancer who underwent surgical resection was prognostic for poor OS and PFS, whereas ΔNLR was not found to be prognostic for either OS or PFS. Further research may yet reveal a prognostic value for ΔNLR when compared across a greater time period.
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Affiliation(s)
- Daniel Thompson
- Division of Cancer Surgery, Peter MacCallum Cancer Centre, Parkville, Australia.,Department of Vascular Surgery, St. Vincent's Hospital Melbourne, Melbourne, Australia
| | - Luke A Perry
- Division of Cancer Surgery, Peter MacCallum Cancer Centre, Parkville, Australia.,Department of Anaesthesia, Royal Melbourne Hospital, Parkville, Australia
| | - Jesse Renouf
- Division of Cancer Surgery, Peter MacCallum Cancer Centre, Parkville, Australia.,Department of Surgery, Monash University, Clayton, VIC, Geelong, Australia
| | - Domagoj Vodanovich
- Division of Cancer Surgery, Peter MacCallum Cancer Centre, Parkville, Australia.,Department of Vascular Surgery, St. Vincent's Hospital Melbourne, Melbourne, Australia
| | - Adele Hwee Hong Lee
- Division of Cancer Surgery, Peter MacCallum Cancer Centre, Parkville, Australia
| | - Jahan Dimiri
- Department of Surgery, Monash University, Clayton, VIC, Geelong, Australia.,Department of Surgery, Barwon Health, Geelong, Australia
| | - Gavin Wright
- Division of Cancer Surgery, Peter MacCallum Cancer Centre, Parkville, Australia.,Department of Surgical Oncology, St Vincent's Health, Fitzroy, Melbourne, Australia
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Haubold B, Klötzl F, Hellberg L, Thompson D, Cavalar M. Fur: Find Unique Genomic Regions for Diagnostic PCR. Bioinformatics 2021; 37:2081-2087. [PMID: 33515232 PMCID: PMC8352509 DOI: 10.1093/bioinformatics/btab059] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Revised: 12/04/2020] [Accepted: 01/26/2021] [Indexed: 11/12/2022] Open
Abstract
Motivation Unique marker sequences are highly sought after in molecular diagnostics. Nevertheless, there are only few programs available to search for marker sequences, compared to the many programs for similarity search. We therefore wrote the program Fur for Finding Unique genomic Regions. Results Fur takes as input a sample of target sequences and a sample of closely related neighbors. It returns the regions present in all targets and absent from all neighbors. The recently published program genmap can also be used for this purpose and we compared it to fur. When analyzing a sample of 33 genomes representing the major phylogroups of E.coli, fur was 40 times faster than genmap but used three times more memory. On the other hand, genmap yielded three times more markers, but they were less accurate when tested in silico on a sample of 237 E.coli genomes. We also designed phylogroup-specific PCR primers based on the markers proposed by genmap and fur, and tested them by analyzing their virtual amplicons in GenBank. Finally, we used fur to design primers specific to a Lactobacillus species, and found excellent sensitivity and specificity in vitro. Availability and implementation Fur sources and documentation are available from https://github.com/evolbioinf/fur. The compiled software is posted as a docker container at https://hub.docker.com/r/haubold/fox. Supplementary information Supplementary data are available at Bioinformatics online.
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Affiliation(s)
- Bernhard Haubold
- Department of Evolutionary Genetics, Max-Planck-Institute for Evolutionary Biology, Pl öon, Germany
| | - Fabian Klötzl
- Department of Evolutionary Genetics, Max-Planck-Institute for Evolutionary Biology, Pl öon, Germany
| | - Lars Hellberg
- Molecular Infection Diagnostics, Euroimmun Medizinische Labordiagnostika, Lüubeck, Germany
| | - Daniel Thompson
- Molecular Infection Diagnostics, Euroimmun Medizinische Labordiagnostika, Lüubeck, Germany
| | - Markus Cavalar
- Molecular Infection Diagnostics, Euroimmun Medizinische Labordiagnostika, Lüubeck, Germany
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Rodgers SE, Rowney F, Thompson D, Mizen A, White M, Lovell R, Fry R, Watkins A, Wheeler B, Akbari A, Stratton G, Lyons R, White R, Nieuwenhuijsen M, Geary R, Rodgers S. Is Wellbeing Associated with Time Spent in Nature? Int J Popul Data Sci 2020. [DOI: 10.23889/ijpds.v5i5.1619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Abstract
IntroductionGreen and blue spaces (GBS), such as parks, woodlands, rivers, and beaches, are thought to be important for mental health and wellbeing. Our longitudinal cohort contains objective household-level environment data linked at the invidual level to routinely recorded mental health data, augmented with cross sectional self-reported health behaviours, including leisure visits to the outdoors.
Objectives and ApproachOur overall approach will evaluate if residential proximity to GBS is associated with mental health and wellbeing, and if any associations aremodified by visits to outdoors spaces following individual-level data linkage. Here, we examined cross-sectional survey data on time spent visiting nature outdoors. Wellbeing outcomes were assessed using self-reported scores. Data were analysed using generalised additive models in the SAIL Databank.
ResultsUsing a sample of National Survey for Wales respondents (2016/17, n=3,481), over 40% of adults in Wales reported spending less than 30 minutes outdoors each week. Weekly time outdoors was positively associated with wellbeing (p=0.007) and life satisfaction (p=0.03) having adjusted for potential confounders including, age, rurality, loneliness, employment status. Confidence intervals varied along the fitted GAM model. Models using a second wave of survey data (n≈7,000), anonymously record-linked to residential environment and health data will explore these associations further.
ConclusionA previous study based in England (White et al. 2019) found an upper wellbeing benefit threshold of 2 hours per week for time spent in nature. This was not apparent in our preliminary models, but may be revealed in further analyses. We will next incorporate longitudinal mental health and environmental data for 2 million adults living in Wales, UK. Linking to ambient and accessible residential GBS, while taking into account changes due to migration and actual visits, will allow us to provide valuable guidance to local government, who are often responsible for provisioning and maintaining outdoor facilities.
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Thompson D, John A, Fry R, Watkins A. Self-Reported Well-Being Indicators and Case Identification of Common Mental Health Disorders in Routinely Collected Health Data. Int J Popul Data Sci 2020. [DOI: 10.23889/ijpds.v5i5.1618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Abstract
IntroductionCommon mental health disorders (CMD) are significant contributors to impaired health and well-being, and drive greater health resource utilisation. Electronic health records (EHR) are increasingly used for case identification of CMD when ascertaining social determinants of mental health. We seek to compare self-reported well-being indicators in groups identified using EHR-based CMD methods.
Objectives and ApproachThe National Survey for Wales (NSW) contains self-reported well-being indicators (Warwick Edinburgh Mental Well-being Scale, WEMWBS) recorded annually on ~7,000 individuals. We combined data from two NSWs and linked well-being indicators with Welsh Longitudinal General Practice (WLGP) data within the Secure Anonymised Information Linkage (SAIL) Databank, using individual response dates. We then used WGLP data to algorithmically derive identifiers of CMD cases within survey respondents. This individual-level linkage enables a comparison of NSW responses in CMD and non-CMD cases, and to assess sensitivity and specificity of the current CMD algorithm.
ResultsSurvey participants comprised 18,450 adults aged 16+ and living in Wales during 16/17 or 18/19. WEMWBS responses indicate 2,338 (12.6%) participants could be considered possibly depressed, and 2,268 (12.3%) probably depressed with low mental well-being (LMW). For participants with LMW, a 42/58 percentage split is observed between male/female respondents, compared to a 45/55 respective split of those not identified with LMW. Participants with LMW recorded low measures for overall satisfaction with life, 998 (44%) reported a value of 5 or less (/10) compared to 1123 (7%) participants not identified with LMW. Similarly, 828 (37%) participants identified with LMW reported 5 or less (/10) on the life worthwhile index, compared to 800 (5%) of non-LMW participants.
Conclusion / ImplicationsLinkage to the NSW provides a rich data source to compare objective well-being to algorithmically derived CMD cases from routinely collected primary care data. The individual-level linkage involved will allow for the wider determinants of mental health disorders to be examined.
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Lyons J, Akbari A, Torabi F, Davies GI, North L, Griffiths R, Bailey R, Hollinghurst J, Fry R, Turner SL, Thompson D, Rafferty J, Mizen A, Orton C, Thompson S, Au-Yeung L, Cross L, Gravenor MB, Brophy S, Lucini B, John A, Szakmany T, Davies J, Davies C, Thomas DR, Williams C, Emmerson C, Cottrell S, Connor TR, Taylor C, Pugh RJ, Diggle P, John G, Scourfield S, Hunt J, Cunningham AM, Helliwell K, Lyons R. Understanding and responding to COVID-19 in Wales: protocol for a privacy-protecting data platform for enhanced epidemiology and evaluation of interventions. BMJ Open 2020; 10:e043010. [PMID: 33087383 PMCID: PMC7580065 DOI: 10.1136/bmjopen-2020-043010] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [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] [Indexed: 12/16/2022] Open
Abstract
INTRODUCTION The emergence of the novel respiratory SARS-CoV-2 and subsequent COVID-19 pandemic have required rapid assimilation of population-level data to understand and control the spread of infection in the general and vulnerable populations. Rapid analyses are needed to inform policy development and target interventions to at-risk groups to prevent serious health outcomes. We aim to provide an accessible research platform to determine demographic, socioeconomic and clinical risk factors for infection, morbidity and mortality of COVID-19, to measure the impact of COVID-19 on healthcare utilisation and long-term health, and to enable the evaluation of natural experiments of policy interventions. METHODS AND ANALYSIS Two privacy-protecting population-level cohorts have been created and derived from multisourced demographic and healthcare data. The C20 cohort consists of 3.2 million people in Wales on the 1 January 2020 with follow-up until 31 May 2020. The complete cohort dataset will be updated monthly with some individual datasets available daily. The C16 cohort consists of 3 million people in Wales on the 1 January 2016 with follow-up to 31 December 2019. C16 is designed as a counterfactual cohort to provide contextual comparative population data on disease, health service utilisation and mortality. Study outcomes will: (a) characterise the epidemiology of COVID-19, (b) assess socioeconomic and demographic influences on infection and outcomes, (c) measure the impact of COVID-19 on short -term and longer-term population outcomes and (d) undertake studies on the transmission and spatial spread of infection. ETHICS AND DISSEMINATION The Secure Anonymised Information Linkage-independent Information Governance Review Panel has approved this study. The study findings will be presented to policy groups, public meetings, national and international conferences, and published in peer-reviewed journals.
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Affiliation(s)
- Jane Lyons
- Population Data Science, Swansea University Medical School, Swansea, UK
| | - Ashley Akbari
- Population Data Science, Swansea University Medical School, Swansea, UK
| | - Fatemeh Torabi
- Population Data Science, Swansea University Medical School, Swansea, UK
| | - Gareth I Davies
- Population Data Science, Swansea University Medical School, Swansea, UK
| | - Laura North
- Population Data Science, Swansea University Medical School, Swansea, UK
| | - Rowena Griffiths
- Population Data Science, Swansea University Medical School, Swansea, UK
| | - Rowena Bailey
- Population Data Science, Swansea University Medical School, Swansea, UK
| | | | - Richard Fry
- Population Data Science, Swansea University Medical School, Swansea, UK
| | - Samantha L Turner
- Population Data Science, Swansea University Medical School, Swansea, UK
| | - Daniel Thompson
- Population Data Science, Swansea University Medical School, Swansea, UK
| | - James Rafferty
- Population Data Science, Swansea University Medical School, Swansea, UK
| | - Amy Mizen
- Population Data Science, Swansea University Medical School, Swansea, UK
| | - Chris Orton
- Population Data Science, Swansea University Medical School, Swansea, UK
| | - Simon Thompson
- Population Data Science, Swansea University Medical School, Swansea, UK
| | - Lee Au-Yeung
- Population Data Science, Swansea University Medical School, Swansea, UK
| | - Lynsey Cross
- Population Data Science, Swansea University Medical School, Swansea, UK
| | - Mike B Gravenor
- Institute of Life Sciences, Swansea University Medical School, Swansea, UK
| | - Sinead Brophy
- Population Data Science, Swansea University Medical School, Swansea, UK
| | - Biagio Lucini
- Population Data Science, Swansea University Medical School, Swansea, UK
| | - Ann John
- Population Data Science, Swansea University Medical School, Swansea, UK
| | - Tamas Szakmany
- Department of Anaesthesia, Intensive Care and Pain Medicine, Division of Population Medicine, Cardiff University, Cardiff, UK
- Aneurin Bevan University Health Board, Newport, UK
| | | | | | | | | | | | | | - Thomas R Connor
- School of Biosciences, Cardiff University, Cardiff, South Glamorgan, UK
| | - Chris Taylor
- School of Social Sciences, Cardiff University, Cardiff, South Glamorgan, UK
| | - Richard J Pugh
- Glan Clwyd Hospital, Betsi Cadwaladr University Health Board, Rhyl, UK
| | - Peter Diggle
- Faculty of Health and Medicine, Lancaster University, Lancaster, Lancashire, UK
- Epidemiology and Population Health, University of Liverpool, Liverpool, Merseyside, UK
| | - Gareth John
- NHS Wales Informatics Service, Cardiff, Wales, UK
| | | | - Joe Hunt
- NHS Wales Informatics Service, Cardiff, Wales, UK
| | | | | | - Ronan Lyons
- Population Data Science, Swansea University Medical School, Swansea, UK
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Callender C, Velazquez D, Dave J, Olvera N, Chen T, Goldsworthy N, Thompson D. Comprehensive Nutrition and Cooking Education Programming Recommendations from Families in Underserved Communities. J Acad Nutr Diet 2020. [DOI: 10.1016/j.jand.2020.06.060] [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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Ledoux T, Cepni A, Taylor A, Crumbley C, Thompson D, Moran N, Olvera N, O'Connor D. Exploring Parent Feeding Practices, the Home Environment, and Toddler Diet. J Acad Nutr Diet 2020. [DOI: 10.1016/j.jand.2020.06.071] [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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Thompson D, Glowacki G, Ludwig D, Reklau R, Kuhns AR, Golba CK, King R. Benefits of Head‐starting for Blanding's Turtle Size Distributions and Recruitment. WILDLIFE SOC B 2020. [DOI: 10.1002/wsb.1054] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- Daniel Thompson
- Forest Preserve District of DuPage County Naperville IL 60563 USA
| | - Gary Glowacki
- Lake County Forest Preserve DistrictLibertyville IL 60048 USA
| | - Daniel Ludwig
- Forest Preserve District of DuPage County Naperville IL 60563 USA
| | - Rachel Reklau
- Forest Preserve District of DuPage County Naperville IL 60563 USA
| | - Andrew R. Kuhns
- Illinois Natural History Survey, Prairie Research Institute, University of IllinoisChampaign IL 61820 USA
| | - Callie Klatt Golba
- Department of Biological SciencesNorthern Illinois UniversityDeKalb IL 60115 USA
| | - Richard King
- Department of Biological Sciences and Institute for the Study of the Environment, Sustainability, and EnergyNorthern Illinois University DeKalb IL 60115 USA
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Madan A, Thompson D, Fowler JC, Ajami NJ, Salas R, Frueh BC, Bradshaw MR, Weinstein BL, Oldham JM, Petrosino JF. The gut microbiota is associated with psychiatric symptom severity and treatment outcome among individuals with serious mental illness. J Affect Disord 2020; 264:98-106. [PMID: 32056780 DOI: 10.1016/j.jad.2019.12.020] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Revised: 12/09/2019] [Accepted: 12/13/2019] [Indexed: 12/17/2022]
Abstract
BACKGROUND Emerging evidence implicates the gut microbiota in central nervous system functioning via its effects on inflammation, the hypothalamic-pituitary axis, and/or neurotransmission. Our understanding of the cellular underpinnings of the brain-gut relationship is based almost exclusively on animal models with some small-scale human studies. This study examined the relationship between the gut microbiota and psychiatric symptom severity and treatment response among inpatients with serious mental illness. METHOD We collected data from adult inpatients (N = 111). Measures of diagnoses, suicide severity, trauma, depression, and anxiety were collected shortly after admission, while self-collected fecal swabs were collected early in the course of hospitalization and processed using 16S rRNA gene sequencing and whole genome shotgun sequencing methods. RESULTS Results indicate that depression and anxiety severity shortly after admission were negatively associated with bacterial richness and alpha diversity. Additional analyses revealed a number of bacterial taxa associated with depression and anxiety severity. Gut microbiota richness and alpha diversity early in the course of hospitalization was a significant predictor of depression remission at discharge. CONCLUSIONS This study is among the first to demonstrate a gut microbiota relationship with symptom severity among psychiatric inpatients as well as a relationship to remission of depression post-treatment. These findings are consistent with animal models and limited human studies as well as with the broader literature implicating inflammation in the pathophysiology of depression. These findings offer the foundation for further studies of novel therapeutic approaches to the treatment, prevention of, or recurrence of serious mental illness.
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Affiliation(s)
- A Madan
- Houston Methodist Hospital, Houston, TX, USA; Psychiatry and Behavioral Sciences, University of Texas Health Science Center at Houston, Houston, TX, USA.
| | - D Thompson
- Alkek Center for Metagenomics and Microbiome Research, Baylor College of Medicine, Houston, TX, USA
| | - J C Fowler
- Houston Methodist Hospital, Houston, TX, USA; Psychiatry and Behavioral Sciences, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - N J Ajami
- Alkek Center for Metagenomics and Microbiome Research, Baylor College of Medicine, Houston, TX, USA
| | - R Salas
- Psychiatry & Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA; Michael E DeBakey VA Medical, Houston, TX, USA; The Menninger Clinic, Houston, TX, USA
| | - B C Frueh
- Psychiatry and Behavioral Sciences, University of Texas Health Science Center at Houston, Houston, TX, USA; Department of Psychology, University of Hawaii, Hilo, USA
| | - M R Bradshaw
- Houston Methodist Hospital, Houston, TX, USA; Psychiatry and Behavioral Sciences, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - B L Weinstein
- Houston Methodist Hospital, Houston, TX, USA; Psychiatry and Behavioral Sciences, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - J M Oldham
- Psychiatry & Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA; The Menninger Clinic, Houston, TX, USA
| | - J F Petrosino
- Alkek Center for Metagenomics and Microbiome Research, Baylor College of Medicine, Houston, TX, USA
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Khanna R, Fenton S, Cattran D, Thompson D, Deitel M, Oreopoulos D. Tuberculous Peritonitis in Patients Undergoing Continuous Ambulatory Peritoneal Dialysis (CAPD). Perit Dial Int 2020. [DOI: 10.1177/089686088000100302] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- R. Khanna
- Departments of Medicine, Toronto Western, Toronto General, and St. Joseph's Hospital, Toronto, and the Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - S.S. Fenton
- Departments of Medicine, Toronto Western, Toronto General, and St. Joseph's Hospital, Toronto, and the Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - D.C. Cattran
- Departments of Medicine, Toronto Western, Toronto General, and St. Joseph's Hospital, Toronto, and the Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - D. Thompson
- Departments of Medicine, Toronto Western, Toronto General, and St. Joseph's Hospital, Toronto, and the Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - M. Deitel
- Departments of Medicine, Toronto Western, Toronto General, and St. Joseph's Hospital, Toronto, and the Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - D.G. Oreopoulos
- Departments of Medicine, Toronto Western, Toronto General, and St. Joseph's Hospital, Toronto, and the Department of Medicine, University of Toronto, Toronto, Ontario, Canada
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50
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Thompson D, Albarki H, Lodhia C, Fitzpatrick N. A 3D printed smartphone adaptor for nasolaryngoscopy. Laryngoscope Investig Otolaryngol 2020; 5:31-36. [PMID: 32128428 PMCID: PMC7042649 DOI: 10.1002/lio2.355] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Revised: 01/11/2020] [Accepted: 01/20/2020] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE The objective of this project is to create a three-dimensional (3D) printed smartphone adaptor for flexible nasolaryngoscopy (FNL) to provide an affordable alternative to commercial options and a better fit than generic telescope phone adaptors. METHOD We designed an adaptor using computer aided software to connect an iPhone XS to an Olympus Rhino-Laryngo Fibre Scope. We experimented with various 3D printing materials and iterative designs to create a case that allowed for quality recording of a nasolaryngoscope exam using the iPhone's built in ×2 telescopic zoom lens. RESULTS Our 3D printed adaptor provides a cost-effective alternative to commercially available FNL smartphone adaptors and is capable of capturing high-quality images and videos of the nasopharynx and larynx. These images are useful for senior clinician review, decrease the need for repeat examination, can be utilized for education, avail telehealth review, and provides a way to digitally record examinations to electronic medical records for future comparison without the need for an endoscopy tower. CONCLUSION Smartphone adaptors for FNL have been established to be of clinical value. Despite being simple devices, they continue to be expensive. This potentially limits access to junior clinicians, who stand to gain most from the ability to review images of examinations with senior colleagues. Our 3D printed smartphone case provides a cost-effective alternative, with a better fit than generic adaptors, at a print cost of $29 AUD. This is $131 AUD less than the next cheapest commercial alternative. The files are freely available for use and modification. LEVEL OF EVIDENCE 4.
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Affiliation(s)
- Daniel Thompson
- ENT Head and Neck Surgery DepartmentSt. Vincent's Hospital MelbourneFitzroyVictoriaAustralia
| | - Hashm Albarki
- ENT Head and Neck Surgery DepartmentSt. Vincent's Hospital MelbourneFitzroyVictoriaAustralia
| | - Chetan Lodhia
- ENT Head and Neck Surgery DepartmentSt. Vincent's Hospital MelbourneFitzroyVictoriaAustralia
| | - Nicholas Fitzpatrick
- ENT Head and Neck Surgery DepartmentSt. Vincent's Hospital MelbourneFitzroyVictoriaAustralia
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