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Wyrwoll MJ, Wabschke R, Röpke A, Wöste M, Ruckert C, Perrey S, Rotte N, Hardy J, Astica L, Lupiáñez DG, Wistuba J, Westernströer B, Schlatt S, Berman AJ, Müller AM, Kliesch S, Yatsenko AN, Tüttelmann F, Friedrich C. Analysis of copy number variation in men with non-obstructive azoospermia. Andrology 2022; 10:1593-1604. [PMID: 36041235 PMCID: PMC9605881 DOI: 10.1111/andr.13267] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [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: 01/20/2022] [Revised: 07/25/2022] [Accepted: 07/27/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND Recent findings demonstrate that single nucleotide variants can cause non-obstructive azoospermia (NOA). In contrast, copy number variants (CNVs) were only analysed in few studies in infertile men. Some have reported a higher prevalence of CNVs in infertile versus fertile men. OBJECTIVES This study aimed to elucidate if CNVs are associated with NOA. MATERIALS AND METHODS We performed array-based comparative genomic hybridisation (aCGH) in 37 men with meiotic arrest, 194 men with Sertoli cell-only phenotype, and 21 control men. We filtered our data for deletions affecting genes and prioritised the affected genes according to the literature search. Prevalence of CNVs was compared between all groups. Exome data of 2,030 men were screened to detect further genetic variants in prioritised genes. Modelling was performed for the protein encoded by the novel candidate gene TEKT5 and we stained for TEKT5 in human testicular tissue. RESULTS We determined the cause of infertility in two individuals with homozygous deletions of SYCE1 and in one individual with a heterozygous deletion of SYCE1 combined with a likely pathogenic missense variant on the second allele. We detected heterozygous deletions affecting MLH3, EIF2B2, SLX4, CLPP and TEKT5, in one subject each. CNVs were not detected more frequently in infertile men compared with controls. DISCUSSION While SYCE1 and MLH3 encode known meiosis-specific proteins, much less is known about the proteins encoded by the other identified candidate genes, warranting further analyses. We were able to identify the cause of infertility in one out of the 231 infertile men by aCGH and in two men by using exome sequencing data. CONCLUSION As aCGH and exome sequencing are both expensive methods, combining both in a clinical routine is not an effective strategy. Instead, using CNV calling from exome data has recently become more precise, potentially making aCGH dispensable.
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Affiliation(s)
- M. J. Wyrwoll
- Institute of Reproductive Genetics, University of Münster, Münster, Germany
| | - R. Wabschke
- Institute of Reproductive Genetics, University of Münster, Münster, Germany
| | - A. Röpke
- Institute of Human Genetics, University of Münster, Münster, Germany
| | - M. Wöste
- Institute of Medical Informatics, University of Münster, Münster, Germany
| | - C. Ruckert
- Institute of Human Genetics, University of Münster, Münster, Germany
| | - S. Perrey
- Institute for Bioinformatics and Chemoinformatics, Westphalian University of Applied Sciences, Recklinghausen, Germany
| | - N. Rotte
- Institute of Reproductive Genetics, University of Münster, Münster, Germany
| | - J. Hardy
- Department of Obstetrics, Gynecology and Reproductive Sciences, Magee-Women Research Institute, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - L. Astica
- Epigenetics and Sex Development Group, Berlin Institute for Medical Systems Biology, Max-Delbrück Center for Molecular Medicine, Berlin, Germany
| | - D. G. Lupiáñez
- Epigenetics and Sex Development Group, Berlin Institute for Medical Systems Biology, Max-Delbrück Center for Molecular Medicine, Berlin, Germany
| | - J. Wistuba
- Centre of Reproductive Medicine and Andrology, University Hospital Münster, Münster, Germany
| | - B. Westernströer
- Centre of Reproductive Medicine and Andrology, University Hospital Münster, Münster, Germany
| | - S. Schlatt
- Centre of Reproductive Medicine and Andrology, University Hospital Münster, Münster, Germany
| | - A. J. Berman
- Department of Biological Sciences, University of Pittsburgh, Pittsburgh, PA, USA
| | - A. M. Müller
- Practice for Pathology and Centre for Pediatric Pathology, University Hospital of Cologne, Cologne, Germany
| | - S. Kliesch
- Centre of Reproductive Medicine and Andrology, University Hospital Münster, Münster, Germany
| | - A. N. Yatsenko
- Department of Obstetrics, Gynecology and Reproductive Sciences, Magee-Women Research Institute, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - F. Tüttelmann
- Institute of Reproductive Genetics, University of Münster, Münster, Germany
| | - C. Friedrich
- Institute of Reproductive Genetics, University of Münster, Münster, Germany
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Hardy J, Pollock N, Gingrich T, Sweet P, Ramesh A, Kuong J, Basar A, Jiang H, Hwang K, Vukina J, Jaffe T, Olszewska M, Kurpisz M, Yatsenko AN. Genomic testing for copy number and single nucleotide variants in spermatogenic failure. J Assist Reprod Genet 2022; 39:2103-2114. [PMID: 35849255 PMCID: PMC9474750 DOI: 10.1007/s10815-022-02538-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [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: 02/16/2022] [Accepted: 06/06/2022] [Indexed: 10/17/2022] Open
Abstract
PURPOSE To identify clinically significant genomic copy number (CNV) and single nucleotide variants (SNV) in males with unexplained spermatogenic failure (SPGF). MATERIALS AND METHODS Peripheral blood DNA from 97/102 study participants diagnosed with oligozoospermia, severe oligozoospermia, or non-obstructive azoospermia (NOA) was analyzed for CNVs via array comparative genomic hybridization (aCGH) and SNVs using whole-exome sequencing (WES). RESULTS Of the 2544 CNVs identified in individuals with SPGF, > 90% were small, ranging from 0.6 to 75 kb. Thirty, clinically relevant genomic aberrations, were detected in 28 patients (~ 29%). These included likely diagnostic CNVs in 3/41 NOA patients (~ 7%): 1 hemizygous, intragenic TEX11 deletion, 1 hemizygous DDX53 full gene deletion, and 1 homozygous, intragenic STK11 deletion. High-level mosaicism for X chromosome disomy (~ 10% 46,XY and ~ 90% 47,XXY) was also identified in 3 of 41 NOA patients who previously tested normal with conventional karyotyping. The remaining 24 CNVs detected were heterozygous, autosomal recessive carrier variants. Follow-up WES analysis confirmed 8 of 27 (30%) CNVs (X chromosome disomy excluded). WES analysis additionally identified 13 significant SNVs and/or indels in 9 patients (~ 9%) including X-linked AR, KAL1, and NR0B1 variants. CONCLUSION Using a combined genome-wide aCGH/WES approach, we identified pathogenic and likely pathogenic SNVs and CNVs in 15 patients (15%) with unexplained SPGF. This value equals the detection rate of conventional testing for aneuploidies and is considerably higher than the prevalence of Y chromosome microdeletions. Our results underscore the importance of comprehensive genomic analysis in emerging diagnostic testing of complex conditions like male infertility.
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Affiliation(s)
- J Hardy
- Department of OBGYN and Reproductive Sciences, Magee-Womens Research Institute, School of Medicine, University of Pittsburgh, 204 Craft Avenue, Pittsburgh, PA, 15213, USA
| | - N Pollock
- Department of OBGYN and Reproductive Sciences, Magee-Womens Research Institute, School of Medicine, University of Pittsburgh, 204 Craft Avenue, Pittsburgh, PA, 15213, USA
| | - T Gingrich
- Department of OBGYN and Reproductive Sciences, Magee-Womens Research Institute, School of Medicine, University of Pittsburgh, 204 Craft Avenue, Pittsburgh, PA, 15213, USA
| | - P Sweet
- Department of OBGYN and Reproductive Sciences, Magee-Womens Research Institute, School of Medicine, University of Pittsburgh, 204 Craft Avenue, Pittsburgh, PA, 15213, USA
| | - A Ramesh
- Department of OBGYN and Reproductive Sciences, Magee-Womens Research Institute, School of Medicine, University of Pittsburgh, 204 Craft Avenue, Pittsburgh, PA, 15213, USA
| | - J Kuong
- Department of OBGYN and Reproductive Sciences, Magee-Womens Research Institute, School of Medicine, University of Pittsburgh, 204 Craft Avenue, Pittsburgh, PA, 15213, USA
| | - A Basar
- Department of OBGYN and Reproductive Sciences, Magee-Womens Research Institute, School of Medicine, University of Pittsburgh, 204 Craft Avenue, Pittsburgh, PA, 15213, USA
| | - H Jiang
- Department of OBGYN and Reproductive Sciences, Magee-Womens Research Institute, School of Medicine, University of Pittsburgh, 204 Craft Avenue, Pittsburgh, PA, 15213, USA
| | - K Hwang
- Department of Urology, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - J Vukina
- Department of Urology, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - T Jaffe
- Department of Urology, School of Medicine, West Virginia University, Morgantown, WV, USA
| | - M Olszewska
- Institute of Human Genetics, Polish Academy of Sciences, Poznan, Poland
| | - M Kurpisz
- Institute of Human Genetics, Polish Academy of Sciences, Poznan, Poland
| | - A N Yatsenko
- Department of OBGYN and Reproductive Sciences, Magee-Womens Research Institute, School of Medicine, University of Pittsburgh, 204 Craft Avenue, Pittsburgh, PA, 15213, USA.
- Department of Genetics, School of Public Health, University of Pittsburgh, Pittsburgh, PA, United States.
- Department of Pathology, School of Medicine, University of Pittsburgh, Pittsburgh, PA, United States.
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Sperry A, Hardy J, Goldfaden R, Hurst A, Ashchi A, Sutton D, Sheikh-Ali M, Huston J, Choksi R. Danuglipron. Glucagon-like peptide 1 receptor agonist, Treatment of type 2 diabetes, Treatment of obesity. DRUG FUTURE 2022. [DOI: 10.1358/dof.2022.47.6.3373535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Touhouche TA, Tournier E, Lamant L, Hardy J, Taieb A, Labreze C, Cony M, Lepreux S, Chiaverini C, Lacour JP, Cardot-Leccia N, Bedane C, Assikar S, Charissoux A, Mazereeuw-Hautier J. Annular lipoatrophy of the ankle: Four new pediatric cases and a review of the literature. Pediatr Dermatol 2021; 38:1292-1297. [PMID: 34418138 DOI: 10.1111/pde.14670] [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] [Indexed: 11/27/2022]
Abstract
Annular lipoatrophy of the ankle is a rare and unique acquired lipoatrophic panniculitis that mainly affects children. There is no consensus on treatment, and the long-term course is not well known. We present four new pediatric cases that contribute to the understanding of this rare disease.
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Affiliation(s)
- Timila Assia Touhouche
- University Hospital, Larrey Hospital, Dermatology Department, Paul Sabatier University, Reference Centre for Rare Skin Diseases Toulouse, Toulouse, France
| | - Emilie Tournier
- Department of Pathology, University Cancer Institute, Oncopole, Toulouse, France
| | - Laurence Lamant
- Department of Pathology, University Cancer Institute, Oncopole, Toulouse, France
| | - Juliette Hardy
- University Hospital, Larrey Hospital, Dermatology Department, Paul Sabatier University, Reference Centre for Rare Skin Diseases Toulouse, Toulouse, France
| | - Alain Taieb
- University Hospital Center, Dermatology Department, Reference Centre for Rare Skin Diseases, Bordeaux, France
| | - Christine Labreze
- University Hospital Center, Dermatology Department, Reference Centre for Rare Skin Diseases, Bordeaux, France
| | - Marianne Cony
- University Hospital Center, Dermatology Department, Reference Centre for Rare Skin Diseases, Bordeaux, France
| | - Sebastien Lepreux
- Department of Pathology, University Hospital Center, Bordeaux, France
| | - Christine Chiaverini
- University Hospital Center, Dermatology Department, Reference Centre for Rare Skin Diseases, Nice, France
| | - Jean Philippe Lacour
- University Hospital Center, Dermatology Department, Reference Centre for Rare Skin Diseases, Nice, France
| | | | - Christophe Bedane
- Department of Dermatology, Dupuytren Hospital, University Hospital Center, Limoges, France
| | - Safae Assikar
- Department of Dermatology, Dupuytren Hospital, University Hospital Center, Limoges, France
| | - Aurélie Charissoux
- Department of Dermatology, Dupuytren Hospital, University Hospital Center, Limoges, France
| | - Juliette Mazereeuw-Hautier
- University Hospital, Larrey Hospital, Dermatology Department, Paul Sabatier University, Reference Centre for Rare Skin Diseases Toulouse, Toulouse, France
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Bhanja A, Kerrissey M, Peabody C, Hardy J, Hayirli T, Stark N. 9 Managing Burnout in a Prolonged Crisis: A 2-Wave Cross-Sectional Analysis of Emergency Department Personnel Over 6 Months of the COVID-19 Pandemic. Ann Emerg Med 2021. [DOI: 10.1016/j.annemergmed.2021.07.010] [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: 11/16/2022]
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Sugito S, Ferreira D, Hardy J, Turner S, Boyle A, Cooke H. Global longitudinal strain and mechanical dispersion at rest in exercise stress echocardiography for detecting obstructive coronary artery disease: a pilot study. Eur Heart J Cardiovasc Imaging 2021. [DOI: 10.1093/ehjci/jeaa356.168] [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: 11/14/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
BACKGROUND
Exercise stress echocardiography (ESE) is a commonly used investigation for risk stratification in coronary artery disease (CAD). The added value of resting indices such as Global Longitudinal Strain (GLS) and Mechanical Dispersion (MD) to detect obstructive CAD is not well established and would be of significant clinical benefit.
PURPOSE
To evaluate the diagnostic value of GLS and MD at rest and post-exercise during ESE to detect obstructive CAD, defined by angiographic stenosis >70% in any major coronary artery.
METHODS
Retrospective cohort study of 80 consecutive patients who underwent ESE and had coronary angiography (invasive or CT) within 6 months. Retrospective speckle tracking strain analysis was performed on digitally archived video-loops, using vendor independent software. Data on demographics, medications, outcomes and ESE characteristics were collected and analysed.
RESULTS
In 49 (61.3%) patients with any CAD >70%, GLS at rest was lower (-13.9% ± 4.2 vs -16.1% ± 5.2, p-value = 0.04), and MD at rest was higher (81ms ± 43 vs 58ms ± 28, p-value = 0.008), when compared to patients without CAD >70%. GLS and MD measured post-exercise were not significantly different between groups. Ejection fraction (EF) and Wall Motion Score Index (WMSI) at rest and post-exercise were not significantly different between groups. A resting GLS cutpoint of -14% had a sensitivity and specificity of 57/68%, comparable to the development of new regional wall motion abnormalities (71/39%) and peak WMSI >1.2 (59/48%). Additionally, in 39 (48.8%) patients who had >70% stenosis in the left anterior descending (LAD) artery, LS in the LAD territory segments was lower (-16.2% ± 4.4 vs -18.3% ± 4.7, p-value = 0.04), when compared to patients without >70% stenosis in the LAD artery.
CONCLUSION
Resting GLS was lower and MD higher in patients undergoing ESE, who have any CAD >70% compared to patients who do not have any CAD >70%. Resting GLS and MD may increase diagnostic accuracy during ESE to predict obstructive CAD. Further prospective studies evaluating the utility of resting indices to predict functionally significant CAD are required.
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Affiliation(s)
- S Sugito
- John Hunter Hospital, Newcastle, Australia
| | - D Ferreira
- John Hunter Hospital, Newcastle, Australia
| | - J Hardy
- John Hunter Hospital, Newcastle, Australia
| | - S Turner
- John Hunter Hospital, Newcastle, Australia
| | - A Boyle
- John Hunter Hospital, Newcastle, Australia
| | - H Cooke
- John Hunter Hospital, Newcastle, Australia
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Ray M, Al-Omary M, Bamford P, Hardy J, Tierney M, Puller P, Boyle A, Collins N. Adoption of Coronary Invasive Physiological Assessment in a Regional Tertiary Centre. Heart Lung Circ 2021. [DOI: 10.1016/j.hlc.2021.06.454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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8
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Hardy J, Sperry A, Hartmann H, Goldfaden R, Ashchi M, Kim R, Huston J, Niman S, Choksi R. Abelacimab. Anti-factor XI/XIa monoclonal antibody, Treatment of atrial fibrillation, Treatment of thrombotic disorders. DRUG FUTURE 2021. [DOI: 10.1358/dof.2021.46.12.3349024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Escott-Price V, Myers A, Huentelman M, Shoai M, Hardy J. Polygenic Risk Score Analysis of Alzheimer's Disease in Cases without APOE4 or APOE2 Alleles. J Prev Alzheimers Dis 2020; 6:16-19. [PMID: 30569081 PMCID: PMC6399990 DOI: 10.14283/jpad.2018.46] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
The We and others have previously shown that polygenic risk score analysis (PRS)
has considerable predictive utility for identifying those at high risk of developing
Alzheimer’s disease (AD) with an area under the curve (AUC) of >0.8. However, by
far the greatest determinant of this risk is the apolipoprotein E locus with the E4
allele alone giving an AUC of ∼0.68 and the inclusion of the protective E2 allele
increasing this to ∼0.69 in a clinical cohort. An important question is to determine
how good PRS is at predicting risk in those who do not carry the E4 allele (E3
homozygotes, E3E2 and E2E2) and in those who carry neither the E4 or E2 allele (i.e.
E3 homozygotes). Previous studies have shown that PRS remains a significant
predictor of AD risk in clinical cohorts after controlling for APOE ε4 carrier
status. In this study we assess the accuracy of PRS prediction in a cohort of
pathologically confirmed AD cases and controls. The exclusion of APOE4 carriers has
surprisingly little effect on the PRS prediction accuracy (AUC ∼0.83 [95% CI:
0.80-0.86]), and the accuracy remained higher than that in clinical cohorts with
APOE included as a predictor. From a practical perspective this suggests that PRS
analysis will have predictive utility even in E4 negative individuals and may be
useful in clinical trial design.
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Affiliation(s)
- V Escott-Price
- John Hardy, Department of Molecular Neuroscience and Reta Lilla Weston Laboratories, Institute of Neurology, London, UK,
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Elisofon SA, Magee JC, Ng VL, Horslen SP, Fioravanti V, Economides J, Erinjeri J, Anand R, Mazariegos GV, Martin A, Mannino D, Flynn L, Mohammad S, Alonso E, Superina R, Brandt K, Riordan M, Lokar J, Ito J, Elisofon S, Zapata L, Jain A, Foristal E, Gupta N, Whitlow C, Naik K, Espinosa H, Miethke A, Hawkins A, Hardy J, Engels E, Schreibeis A, Ovchinsky N, Kogan‐Liberman D, Cunningham R, Malik P, Sundaram S, Feldman A, Garcia B, Yanni G, Kohli R, Emamaullee J, Secules C, Magee J, Lopez J, Bilhartz J, Hollenbeck J, Shaw B, Bartow C, Forest S, Rand E, Byrne A, Linguiti I, Wann L, Seidman C, Mazariegos G, Soltys K, Squires J, Kepler A, Vitola B, Telega G, Lerret S, Desai D, Moghe J, Cutright L, Daniel J, Andrews W, Fioravanti V, Slowik V, Cisneros R, Faseler M, Hufferd M, Kelly B, Sudan D, Mavis A, Moats L, Swan‐Nesbit S, Yazigi N, Buranych A, Hobby A, Rao G, Maccaby B, Gopalareddy V, Boulware M, Ibrahim S, El Youssef M, Furuya K, Schatz A, Weckwerth J, Lovejoy C, Kasi N, Nadig S, Law M, Arnon R, Chu J, Bucuvalas J, Czurda M, Secheli B, Almy C, Haydel B, Lobritto S, Emand J, Biney‐Amissah E, Gamino D, Gomez A, Himes R, Seal J, Stewart S, Bergeron J, Truxillo A, Lebel S, Davidson H, Book L, Ramstack D, Riley A, Jennings C, Horslen S, Hsu E, Wallace K, Turmelle Y, Nadler M, Postma S, Miloh T, Economides J, Timmons K, Ng V, Subramonian A, Dharmaraj B, McDiarmid S, Feist S, Rhee S, Perito E, Gallagher L, Smith K, Ebel N, Zerofsky M, Nogueira J, Greer R, Gilmour S, Robert C, Cars C, Azzam R, Boone P, Garbarino N, Lalonde M, Kerkar N, Dokus K, Helbig K, Grizzanti M, Tomiyama K, Cocking J, Alexopoulos S, Bhave C, Schillo R, Bailey A, Dulek D, Ramsey L, Ekong U, Valentino P, Hettiarachchi D, Tomlin R. Society of pediatric liver transplantation: Current registry status 2011-2018. Pediatr Transplant 2020; 24:e13605. [PMID: 31680409 DOI: 10.1111/petr.13605] [Citation(s) in RCA: 62] [Impact Index Per Article: 15.5] [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: 05/31/2019] [Revised: 08/08/2019] [Accepted: 09/27/2019] [Indexed: 11/29/2022]
Abstract
BACKGROUND SPLIT was founded in 1995 in order to collect comprehensive prospective data on pediatric liver transplantation, including waiting list data, transplant, and early and late outcomes. Since 2011, data collection of the current registry has been refined to focus on prospective data and outcomes only after transplant to serve as a foundation for the future development of targeted clinical studies. OBJECTIVE To report the outcomes of the SPLIT registry from 2011 to 2018. METHODS This is a multicenter, cross-sectional analysis characterizing patients transplanted and enrolled in the SPLIT registry between 2011 and 2018. All patients, <18 years of age, received a first liver-only, a combined liver-kidney, or a combined liver-pancreas transplant during this study period. RESULTS A total of 1911 recipients from 39 participating centers in North America were registered. Indications included biliary atresia (38.5%), metabolic disease (19.1%), tumors (11.7%), and fulminant liver failure (11.5%). Greater than 50% of recipients were transplanted as either Status 1A/1B or with a MELD/PELD exception score. Incompatible transplants were performed in 4.1%. Kaplan-Meier estimates of 1-year patient and graft survival were 97.3% and 96.6%. First 30 days of surgical complications included reoperation (31.7%), hepatic artery thrombosis (6.3%), and portal vein thrombosis (3.2%). In the first 90 days, biliary tract complications were reported in 13.6%. Acute cellular rejection during first year was 34.7%. At 1 and 2 years of follow-up, 39.2% and 50.6% had normal liver tests on monotherapy (tacrolimus or sirolimus). Further surgical, survival, allograft function, and complications are detailed.
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Affiliation(s)
- Scott A Elisofon
- Division of Gastroenterology, Hepatology and Nutrition, Boston Children's Hospital, Boston, Massachusetts
| | - John C Magee
- Division of Surgery, University of Michigan Transplant Center, Ann Arbor, Michigan
| | - Vicky L Ng
- Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Transplant and Regenerative Medicine Center, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
| | - Simon P Horslen
- Department of Pediatrics, Seattle Children's Hospital, University of Washington School of Medicine, Seattle, Washington
| | - Vicki Fioravanti
- Section of Hepatology and Liver Transplantation, Children's Mercy Hospital, Kansas City, Missouri
| | | | | | | | - George V Mazariegos
- Division of Pediatric Transplant Surgery, Hillman Center for Pediatric Transplantation, UPMC Children's Hospital of Pittsburgh, Pittsburgh, PA, USA
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Daunt P, Ballard CG, Creese B, Davidson G, Hardy J, Oshota O, Pither RJ, Gibson AM. Polygenic Risk Scoring is an Effective Approach to Predict Those Individuals Most Likely to Decline Cognitively Due to Alzheimer's Disease. J Prev Alzheimers Dis 2020; 8:78-83. [PMID: 33336228 DOI: 10.14283/jpad.2020.64] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND There is a clear need for simple and effective tests to identify individuals who are most likely to develop Alzheimer's Disease (AD) both for the purposes of clinical trial recruitment but also for improved management of patients who may be experiencing early pre-clinical symptoms or who have clinical concerns. OBJECTIVES To predict individuals at greatest risk of progression of cognitive impairment due to Alzheimer's Disease in individuals from the Alzheimer's Disease Neuroimaging Initiative (ADNI) using a polygenic risk scoring algorithm. To compare the performance of a PRS algorithm in predicting cognitive decline against that of using the pTau/Aß1-42 ratio CSF biomarker profile. DESIGN A longitudinal analysis of data from the Alzheimer's Disease Neuroimaging Initiative study conducted across over 50 sites in the US and Canada. SETTING Multi-center genetics study. PARTICPANTS 515 subjects who upon entry to the study were diagnosed as cognitively normal or with mild cognitive impairment. MEASUREMENTS Use of genotyping and/or whole genome sequencing data to calculate polygenic risk scores and assess ability to predict subsequent cognitive decline as measured by CDR-SB and ADAS-Cog13 over 4 years. RESULTS The overall performance for predicting those individuals who would decline by at least 15 ADAS-Cog13 points from a baseline mild cognitive impairment in 4 years was 72.8% (CI:67.9-77.7) AUC increasing to 79.1% (CI: 75.6-82.6) when also including cognitively normal participants. Assessing mild cognitive impaired subjects only and using a threshold of greater than 0.6, the high genetic risk participant group declined, on average, by 1.4 points (CDR-SB) more than the low risk group over 4 years. The performance of the PRS algorithm tested was similar to that of the pTau/Aß1-42 ratio CSF biomarker profile in predicting cognitive decline. CONCLUSION Calculating polygenic risk scores offers a simple and effective way, using DNA extracted from a simple mouth swab, to select mild cognitively impaired patients who are most likely to decline cognitively over the next four years.
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Affiliation(s)
- P Daunt
- Alex Gibson, Cytox Ltd., John Eccles House, Robert Robinson Avenue, Oxford Science Park, Oxford, OX4 4GP, United Kingdom. . Tel:+44 (0)1865 338018
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Sugito S, Ferreira D, Hardy J, Cooke H. 418 The Role of Global Longitudinal Strain at Rest During Exercise Stress Echocardiography to Predict Significant Coronary Artery Disease. Heart Lung Circ 2020. [DOI: 10.1016/j.hlc.2020.09.425] [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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13
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Beste KJ, Lawhon SD, Chamoun-Emanuelli AM, Duff AH, Coleman MC, Griffin CE, Hardy J, Whitfield-Cargile CM. Culture-independent and dependent evaluation of the equine paranasal sinus microbiota in health and disease. Equine Vet J 2019; 52:455-463. [PMID: 31437314 DOI: 10.1111/evj.13168] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2018] [Accepted: 08/15/2019] [Indexed: 12/26/2022]
Abstract
BACKGROUND Horses with bacterial sinusitis frequently undergo empirical treatment with antimicrobials, however, in some cases bacterial culture of the affected sinus is used to direct therapy. Data regarding which organisms are part of the commensal microbiota of the equine sinus are lacking making it difficult to interpret culture results and guide empiric antimicrobial selection. OBJECTIVES Our objectives were to describe the bacterial and fungal microbiota of the paranasal sinuses in clinically normal horses using culture-dependent and independent approaches and to compare the bacterial culture and susceptibility patterns of normal horses with those from horses affected with primary and secondary sinusitis. STUDY DESIGN Experimental study and descriptive retrospective review of case records. METHODS Sinus washes were collected from 23 healthy horses. Washes were submitted for routine culture and susceptibility testing and DNA was isolated for next generation sequencing of bacterial and fungal marker genes. For clinical cases of sinusitis, medical records from 2010 to 2017 were reviewed and horses diagnosed with primary and/or secondary sinusitis were included. RESULTS The paranasal sinus cavity hosts multiple bacterial and fungal organisms. The bacterial microbiota of healthy horses consists largely of uncultivable, aerobic bacteria. While few anaerobes were isolated from normal horses, the majority of clinical cases resulted in growth of anaerobic organisms with no difference in the proportion of aerobic and anaerobic bacteria isolated from clinical cases. MAIN LIMITATIONS Small sample size in both populations of horses and heterogeneity of the population prevent a more in-depth analysis. CONCLUSIONS The microbiota of the paranasal sinuses of horses consists primarily of aerobic bacteria and fungal organisms, the majority of which are uncultivable via common clinical methods. Anaerobic bacteria are found in the majority of horses with clinical sinusitis. These findings suggest anaerobic bacteria are associated with sinusitis and their presence should be considered when treating horses with sinusitis.
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Affiliation(s)
- K J Beste
- Department of Large Animal Clinical Sciences, College of Veterinary Medicine & Biomedical Sciences, Texas A&M University, College Station, Texas, USA
| | - S D Lawhon
- Department of Veterinary Pathobiology, College of Veterinary Medicine & Biomedical Sciences, Texas A&M University, College Station, Texas, USA
| | - A M Chamoun-Emanuelli
- Department of Large Animal Clinical Sciences, College of Veterinary Medicine & Biomedical Sciences, Texas A&M University, College Station, Texas, USA
| | - A H Duff
- Department of Large Animal Clinical Sciences, College of Veterinary Medicine & Biomedical Sciences, Texas A&M University, College Station, Texas, USA
| | - M C Coleman
- Department of Large Animal Clinical Sciences, College of Veterinary Medicine & Biomedical Sciences, Texas A&M University, College Station, Texas, USA
| | - C E Griffin
- Department of Large Animal Clinical Sciences, College of Veterinary Medicine & Biomedical Sciences, Texas A&M University, College Station, Texas, USA
| | - J Hardy
- Department of Large Animal Clinical Sciences, College of Veterinary Medicine & Biomedical Sciences, Texas A&M University, College Station, Texas, USA
| | - C M Whitfield-Cargile
- Department of Large Animal Clinical Sciences, College of Veterinary Medicine & Biomedical Sciences, Texas A&M University, College Station, Texas, USA
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Hardy J, Boralevi F, Mallet S, Cabrera N, Belot A, Phan A, Barbarot S, Duriez-Lasek A, Chiaverini C, Hubiche T, Mahé E, Bégon E, Bourrat E, Boccara O, Aubert H, Lerosey MG, Droitcourt C, Piram M, Mazereeuw-Hautier J. Clinical Profile of Methotrexate-resistant Juvenile Localised Scleroderma. Acta Derm Venereol 2019; 99:539-543. [PMID: 30810215 DOI: 10.2340/00015555-3155] [Citation(s) in RCA: 5] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Methotrexate has demonstrated its efficiency for the treatment of juvenile localized scleroderma but some patients may be resistant. The aim of our study was to define the profile of such patients. We performed an observational retrospective multicenter study between 2007 and 2016 and included all children seen in the French Paediatric Dermatology and Rheumatology departments with active localized scleroderma treated by methotrexate for a minimum of 4 months. Metho-trexate efficacy was assessed clinically and/or by imaging between the fourth to twelfth months of treatment. A total of 57 patients were included. Metho-trexate dosage ranged from 7 to 15 mg/m2/week. Only 4 patients were resistant. No common features could be identified between these 4 patients. Children with localized scleroderma are rarely resistant to metho-trexate and we did not identify a clinical profile for those resistant patients.
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Affiliation(s)
- Juliette Hardy
- Reference Centre of Rare Skin Diseases, Larrey Hospital, Paul Sabatier University, 31400 Toulouse, France.
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15
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Hardy J. Agreeing with every single point. Br Dent J 2019; 226:306. [DOI: 10.1038/s41415-019-0048-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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16
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Affiliation(s)
- M. C. Coleman
- Department of Large Animal Clinical Sciences; Texas A&M College of Veterinary Medicine & Biomedical Sciences; College Station Texas USA
| | - J. Hardy
- Department of Large Animal Clinical Sciences; Texas A&M College of Veterinary Medicine & Biomedical Sciences; College Station Texas USA
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17
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Fradet M, Hegazy S, Bulai-Livideanu C, Hardy J, Godillot C, Godeau M, Touhouche A, Deilhes F, Casassa E, Borjesson C, Albluwi S, Balica S, Maza A, Thomas-Pfaab M, Aquilina C, Gall Y, Chaput B, Paul C, Konstantinou MP. Laser épilatoire alexandrite dans le cadre de la prise en charge de l’hidradénite suppurée. Ann Dermatol Venereol 2018. [DOI: 10.1016/j.annder.2018.09.556] [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: 11/15/2022]
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18
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Hernandez Tejada M, Hardy J, Van Ravenstein K. ISSUES RELATED TO AGING IN PLACE: MENTAL AND PHYSICAL HEALTH PERCEPTIONS IN LOW INCOME OLDER ADULTS. Innov Aging 2018. [DOI: 10.1093/geroni/igy023.1398] [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: 11/12/2022] Open
Affiliation(s)
- M Hernandez Tejada
- Medical University of South Carolina, Charleston, South Carolina,United States
| | - J Hardy
- College of Nursing, Medical University of South Carolina, Charleston, SC, USA
| | - K Van Ravenstein
- College of Nursing, Medical University of South Carolina, Charleston, SC, USA
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Abstract
The Gene Ontology (GO) is widely recognised as the gold standard bioinformatics resource for summarizing functional knowledge of gene products in a consistent and computable, information-rich language. GO describes cellular and organismal processes across all species, yet until now there has been a considerable gene annotation deficit within the neurological and immunological domains, both of which are relevant to Parkinson’s disease. Here we introduce the Parkinson’s disease GO Annotation Project, funded by Parkinson’s UK and supported by the GO Consortium, which is addressing this deficit by providing GO annotation to Parkinson’s-relevant human gene products, principally through expert literature curation. We discuss the steps taken to prioritise proteins, publications and cellular processes for annotation, examples of how GO annotations capture Parkinson’s-relevant information, and the advantages that a topic-focused annotation approach offers to users. Building on the existing GO resource, this project collates a vast amount of Parkinson’s-relevant literature into a set of high-quality annotations to be utilized by the research community.
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Affiliation(s)
- R E Foulger
- Centre for Cardiovascular Genetics, Institute of Cardiovascular Science, University College London, London, UK.
| | - P Denny
- Centre for Cardiovascular Genetics, Institute of Cardiovascular Science, University College London, London, UK
| | - J Hardy
- Department of Molecular Neuroscience, Institute of Neurology, University College London, London, UK
| | - M J Martin
- European Molecular Biology Laboratory, European Bioinformatics Institute (EMBL-EBI), Wellcome Trust Genome Campus, Hinxton, Cambridgeshire, UK
| | - T Sawford
- European Molecular Biology Laboratory, European Bioinformatics Institute (EMBL-EBI), Wellcome Trust Genome Campus, Hinxton, Cambridgeshire, UK
| | - R C Lovering
- Centre for Cardiovascular Genetics, Institute of Cardiovascular Science, University College London, London, UK
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20
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Patel T, Brookes KJ, Turton J, Chaudhury S, Guetta-Baranes T, Guerreiro R, Bras J, Hernandez D, Singleton A, Francis PT, Hardy J, Morgan K. Whole-exome sequencing of the BDR cohort: evidence to support the role of the PILRA gene in Alzheimer's disease. Neuropathol Appl Neurobiol 2018; 44:506-521. [PMID: 29181857 DOI: 10.1111/nan.12452] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2017] [Accepted: 11/22/2017] [Indexed: 02/03/2023]
Abstract
AIM Late-onset Alzheimer's disease (LOAD) accounts for 95% of all Alzheimer's cases and is genetically complex in nature. Overlapping clinical and neuropathological features between AD, FTD and Parkinson's disease highlight the potential role of genetic pleiotropy across diseases. Recent genome-wide association studies (GWASs) have uncovered 20 new loci for AD risk; however, these exhibit small effect sizes. Using NGS, here we perform association analyses using exome-wide and candidate-gene-driven approaches. METHODS Whole-exome sequencing was performed on 132 AD cases and 53 control samples. Exome-wide single-variant association and gene burden tests were performed for 76 640 nonsingleton variants. Samples were also screened for known causative mutations in familial genes in AD and other dementias. Single-variant association and burden analysis was also carried out on variants in known AD and other neurological dementia genes. RESULTS Tentative single-variant and burden associations were seen in several genes with kinase and protease activity. Exome-wide burden analysis also revealed significant burden of variants in PILRA (P = 3.4 × 10-5 ), which has previously been linked to AD via GWAS, hit ZCWPW1. Screening for causative mutations in familial AD and other dementia genes revealed no pathogenic variants. Variants identified in ABCA7, SLC24A4, CD33 and LRRK2 were nominally associated with disease (P < 0.05) but did not withstand correction for multiple testing. APOE (P = 0.02) and CLU (P = 0.04) variants showed significant burden on AD. CONCLUSIONS In addition, polygenic risk scores (PRS) were able to distinguish between cases and controls with 83.8% accuracy using 3268 variants, sex, age at death and APOE ε4 and ε2 status as predictors.
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Affiliation(s)
- T Patel
- Human Genetics Group, University of Nottingham, Nottingham, UK
| | - K J Brookes
- Human Genetics Group, University of Nottingham, Nottingham, UK
| | - J Turton
- Human Genetics Group, University of Nottingham, Nottingham, UK
| | - S Chaudhury
- Human Genetics Group, University of Nottingham, Nottingham, UK
| | | | - R Guerreiro
- Department of Molecular Neuroscience, Institute of Neurology, University College London, London, UK.,UK Dementia Research Institute at UCL (UK DRI), London, UK.,Department of Medical Sciences, Institute of Biomedicine-iBiMED, University of Aveiro, Aveiro, Portugal
| | - J Bras
- Department of Molecular Neuroscience, Institute of Neurology, University College London, London, UK.,UK Dementia Research Institute at UCL (UK DRI), London, UK.,Department of Medical Sciences, Institute of Biomedicine-iBiMED, University of Aveiro, Aveiro, Portugal
| | - D Hernandez
- Laboratory of Neurogenetics, National Institute of Aging, National Institute of Health, Bethesda, MD, USA
| | - A Singleton
- Laboratory of Neurogenetics, National Institute of Aging, National Institute of Health, Bethesda, MD, USA
| | - P T Francis
- Brains for Dementia Research Resource, Wolfson Centre for Age Related Diseases, King's College London, London, UK
| | - J Hardy
- Department of Molecular Neuroscience, Institute of Neurology, University College London, London, UK.,UK Dementia Research Institute at UCL (UK DRI), London, UK
| | - K Morgan
- Human Genetics Group, University of Nottingham, Nottingham, UK
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Abstract
Alzheimer's disease, the commonest cause of dementia, is a growing global health concern with huge implications for individuals and society. In this review, current understanding of the epidemiology, genetics, pathology and pathogenesis of Alzheimer's disease is outlined, before its clinical presentation and current treatment strategies are discussed. Finally, the review discusses how our enhanced understanding of Alzheimer pathogenesis, including the recognition of a protracted preclinical phase, is informing new therapeutic strategies with the aim of moving from treatment to prevention.
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Affiliation(s)
- C A Lane
- Dementia Research Centre, UCL Institute of Neurology, London, UK
| | - J Hardy
- Reta Lila Weston Research Laboratories, Department of Molecular Neuroscience, UCL Institute of Neurology, London, UK
| | - J M Schott
- Dementia Research Centre, UCL Institute of Neurology, London, UK
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22
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Real D, Oldham CM, van Burgel A, Dobbe E, Hardy J. Tedera proves its value as a summer and autumn feed for sheep in Mediterranean-like climates. Anim Prod Sci 2018. [DOI: 10.1071/an16432] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Tedera (Bituminaria bituminosa C.H Stirt. vars. albomarginata and crassiuscula) is a traditional forage species for goats in the Canary Islands, Spain. It has agronomic characteristics ideally suited to Mediterranean-like climates that allows it to provide high quality green forage for grazing animals during summer and autumn. It can be used to extend the growing season into late spring and early summer and/or to reduce or eliminate the need for expensive hand feeding of grain and hay to sheep to fill the ‘feed gap’ during the dry season in southern Australian farming systems. Three sheep grazing experiments were carried out with the objective to evaluate sheep production during summer and autumn with tedera as the sole diet. A 3-ha site at Dandaragan, Western Australia was grazed during the summer and autumn of 2014–2015 and 2016 and a 2.4-ha site was grazed at Kojonup, Western Australia during the same period in 2016. At each site, two grazing treatments were evaluated, continuous grazing and rotational grazing with six plots (14 days of grazing and 70 days of recovery). The first hypothesis tested was that tedera plants would not survive continuous grazing during summer and autumn. The second hypothesis tested was that without hand feeding, 10 dry sheep equivalents/ha would be able to at least maintain weight and condition score during summer and autumn. The third hypothesis tested was that rotational grazing would improve the production of the sheep (liveweight and condition score) compared with continuous grazing. The first hypothesis was rejected, the population of tedera plants did not significantly decline due to being continuously grazed during summer and autumn. The second hypothesis was confirmed, at the three experimental sites, 10 dry sheep equivalents/ha were able to at least maintain weight and condition score without any hand feeding. The third hypothesis was partially rejected; continuous grazing had a better performance of the sheep than rotational grazing. However, the rotational grazing plots had more tedera on offer in the remaining grazing plots in the rotation with the potential for a longer grazing time. These three experiments clearly demonstrate that tedera can be used to reduce or eliminate expensive hand feeding during summer and autumn using the simplest and least expensive grazing management; continuous grazing.
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23
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Preza E, Hardy J, Warner T, Wray S. Review: Induced pluripotent stem cell models of frontotemporal dementia. Neuropathol Appl Neurobiol 2017; 42:497-520. [PMID: 27291591 DOI: 10.1111/nan.12334] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [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: 03/15/2016] [Revised: 06/09/2016] [Accepted: 06/13/2016] [Indexed: 12/11/2022]
Abstract
The increasing prevalence of dementia in the ageing population combined with the lack of treatments and the burden on national health care systems globally make dementia a public health priority. Despite the plethora of important research findings published over the past two decades, the mechanisms underlying dementia are still poorly understood and the progress in pharmacological interventions is limited. Recent advances in cellular reprogramming and genome engineering technologies offer an unprecedented new paradigm in disease modeling. Induced pluripotent stem cells (iPSCs) have enabled the study of patient-derived neurons in vitro, a significant progress in the field of dementia research. The first studies using iPSCs to model dementia have recently emerged, holding promise for elucidating disease pathogenic mechanisms and accelerating drug discovery. In this review, we summarize the major findings of iPSC-based studies in frontotemporal dementia (FTD) and FTD overlapping with amyotrophic lateral sclerosis (FTD/ALS). We also discuss some of the main challenges in the use of iPSCs to model complex, late-onset neurodegenerative diseases such as dementias.
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Affiliation(s)
- E Preza
- Department of Molecular Neuroscience, UCL Institute of Neurology, London, WC1N 1PJ, UK.
| | - J Hardy
- Department of Molecular Neuroscience, UCL Institute of Neurology, London, WC1N 1PJ, UK
| | - T Warner
- Reta Lila Weston Institute of Neurological Studies, UCL Institute of Neurology, London, WC1N 1PJ, UK
| | - S Wray
- Department of Molecular Neuroscience, UCL Institute of Neurology, London, WC1N 1PJ, UK
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24
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Hardy J, Skerman H, Franzen K, Foster K, Yates P. A randomised, controlled, double blind study of oral methotrimeprazine versus oral haloperidol in patients with cancer and nausea not related to anticancer therapy. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx676.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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25
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Mulvey M, Boland E, Bouhassira D, Freynhagen R, Hardy J, Hjermstad M, Mercadante S, Pérez C, Bennett M. Neuropathic pain in cancer: systematic review, performance of screening tools and analysis of symptom profiles. Br J Anaesth 2017; 119:765-774. [DOI: 10.1093/bja/aex175] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/11/2017] [Indexed: 11/13/2022] Open
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26
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Lampejo T, Turner R, Roberts C, Allen K, Watson L, Caverley-Frost L, Scott P, Ostridge E, Cooney G, Hardy J, Nulty K, Day S. Novel outreach settings to enhance sexually transmitted infection/HIV awareness, diagnosis and treatment in hard-to-reach populations. Int J STD AIDS 2017; 29:266-272. [PMID: 28768469 DOI: 10.1177/0956462417723816] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [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: 11/15/2022]
Abstract
Despite recent rises in the number of cases of sexually transmitted infections (STIs) such as syphilis and gonorrhoea in England and increasing rates of HIV diagnosis among several men who have sex with men populations, many individuals are still not engaging with sexual health services. The John Hunter Clinic for Sexual Health, Chelsea and Westminster Hospital, London set up outreach clinics at the two world's largest adult lifestyle exhibitions in 2013 and 2015. This was the first time that a sexual health screening and promotion service was available at these large-scale (over 10,000 attendees at each) adult lifestyle events. A total of 381 individuals underwent STI screening across the two events. Nineteen (5.0%) patients were diagnosed with an infection. Twelve (3.1%) patients with Chlamydia trachomatis, three (0.8%) patients with syphilis, one (0.3%) patient with Neisseria gonorrhoeae, one (0.3%) patient with HIV, one (0.3%) patient with hepatitis B and one (0.3%) patient with hepatitis C. All 19 patients were promptly contacted with their results and had arrangements made for treatment or were referred for specialist follow up. Where possible, contact tracing was also performed. Implementing such outreach-based projects is challenged by lack of on-site laboratory support, high staffing demands and potentially high costs. However, we achieved a total HIV screening uptake rate of 94.5% amongst our outreach clinic attendees (versus 67% nationally in conventional sexual health clinic attendees) with an HIV positivity rate of 0.3% (versus 0.2% nationally in high HIV prevalence band populations). Additionally, 30.7% had never been tested for HIV previously (versus 20.7% nationally). Our work demonstrates that these strategies can help to address issues related to lack of STI/HIV screening in hard-to-reach populations and promote risk reduction behaviour.
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Affiliation(s)
- T Lampejo
- John Hunter Clinic for Sexual Health, Chelsea and Westminster Hospital, London, UK
| | - R Turner
- John Hunter Clinic for Sexual Health, Chelsea and Westminster Hospital, London, UK
| | - C Roberts
- John Hunter Clinic for Sexual Health, Chelsea and Westminster Hospital, London, UK
| | - K Allen
- John Hunter Clinic for Sexual Health, Chelsea and Westminster Hospital, London, UK
| | - L Watson
- John Hunter Clinic for Sexual Health, Chelsea and Westminster Hospital, London, UK
| | - L Caverley-Frost
- John Hunter Clinic for Sexual Health, Chelsea and Westminster Hospital, London, UK
| | - P Scott
- John Hunter Clinic for Sexual Health, Chelsea and Westminster Hospital, London, UK
| | - E Ostridge
- John Hunter Clinic for Sexual Health, Chelsea and Westminster Hospital, London, UK
| | - G Cooney
- John Hunter Clinic for Sexual Health, Chelsea and Westminster Hospital, London, UK
| | - J Hardy
- John Hunter Clinic for Sexual Health, Chelsea and Westminster Hospital, London, UK
| | - K Nulty
- John Hunter Clinic for Sexual Health, Chelsea and Westminster Hospital, London, UK
| | - S Day
- John Hunter Clinic for Sexual Health, Chelsea and Westminster Hospital, London, UK
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27
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Volpe JJ, Hardy J, Klein D. A Comparison of Thermal-Neutron-Activation Measurements and Monte Carlo Calculations in Light-Water-Moderated Uranium Cells. NUCL SCI ENG 2017. [DOI: 10.13182/nse70-a18883] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- J. J. Volpe
- Westinghouse Electric Corporation, Bettis Atomic Power LaboratoryWest Mifflin, Pennsylvania 15122
| | - J. Hardy
- Westinghouse Electric Corporation, Bettis Atomic Power LaboratoryWest Mifflin, Pennsylvania 15122
| | - D. Klein
- Westinghouse Electric Corporation, Bettis Atomic Power LaboratoryWest Mifflin, Pennsylvania 15122
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Affiliation(s)
- J. Hardy
- Westinghouse Electric Corporation, Bettis Atomic Power LaboratoryWest Mifflin, Pennsylvania 15122
| | - D. Klein
- Westinghouse Electric Corporation, Bettis Atomic Power LaboratoryWest Mifflin, Pennsylvania 15122
| | - J. J. Volpe
- Westinghouse Electric Corporation, Bettis Atomic Power LaboratoryWest Mifflin, Pennsylvania 15122
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29
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Affiliation(s)
- J. Hardy
- Bettis Atomic Power Laboratory Pittsburgh, Pennsylvania
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Baer W, Hardy J, Klein D, Volpe JJ, Palowitch BL, Frantz FS. Study of a Slightly Enriched UO2 Lattice with H:U=0.42 — Measurement and Analysis. NUCL SCI ENG 2017. [DOI: 10.13182/nse65-a21073] [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: 11/12/2022]
Affiliation(s)
- W. Baer
- Bettis Atomic Power Laboratory, Pittsburgh, Pennsylvania
| | - J. Hardy
- Bettis Atomic Power Laboratory, Pittsburgh, Pennsylvania
| | - D. Klein
- Bettis Atomic Power Laboratory, Pittsburgh, Pennsylvania
| | - J. J. Volpe
- Bettis Atomic Power Laboratory, Pittsburgh, Pennsylvania
| | | | - F. S. Frantz
- Bettis Atomic Power Laboratory, Pittsburgh, Pennsylvania
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Hardy J, Volpe JJ, Klein D. Measurement and Analysis of Parameters in Tight 232Th-235U and 232Th-233U Lattices Moderated with Heavy Water. NUCL SCI ENG 2017. [DOI: 10.13182/nse74-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- J. Hardy
- Bettis Atomic Power Laboratory, Westinghouse Electric Corporation West Mifflin, Pennsylvania 15122
| | - J. J. Volpe
- Bettis Atomic Power Laboratory, Westinghouse Electric Corporation West Mifflin, Pennsylvania 15122
| | - D. Klein
- Bettis Atomic Power Laboratory, Westinghouse Electric Corporation West Mifflin, Pennsylvania 15122
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Hardy J, Klein D, Dannels R. Spatial Variation of the Fast Neutron Flux in Cells of Slightly 235U-Enriched-Uranium Water-Moderated Lattices. NUCL SCI ENG 2017. [DOI: 10.13182/nse66-a18417] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- J. Hardy
- Bettis Atomic Power Laboratory West Mifflin, Pennsylvania
| | - D. Klein
- Bettis Atomic Power Laboratory West Mifflin, Pennsylvania
| | - R. Dannels
- Westinghouse Electric Corporation Atomic Power Division, Pittsburgh, Pennsylvania
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33
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Affiliation(s)
- G. G. Smith
- Westinghouse Electric Corporation, Bettis Atomic Power Laboratory, Pittsburgh, Pennsylvania
| | - J. Hardy
- Westinghouse Electric Corporation, Bettis Atomic Power Laboratory, Pittsburgh, Pennsylvania
| | - D. Klein
- Westinghouse Electric Corporation, Bettis Atomic Power Laboratory, Pittsburgh, Pennsylvania
| | - J. A. Mitchell
- Westinghouse Electric Corporation, Bettis Atomic Power Laboratory, Pittsburgh, Pennsylvania
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34
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Affiliation(s)
- J. Hardy
- Westinghouse Electric Corporation, Bettis Atomic Power Laboratory, Pittsburgh, Pennsylvania
| | - D. Klein
- Westinghouse Electric Corporation, Bettis Atomic Power Laboratory, Pittsburgh, Pennsylvania
| | - G. G. Smith
- Westinghouse Electric Corporation, Bettis Atomic Power Laboratory, Pittsburgh, Pennsylvania
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35
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Affiliation(s)
- J. Hardy
- Westinghouse Electric Corporation Bettis Atomic Power Laboratory* West Mifflin, Pennsylvania 15122
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36
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Affiliation(s)
- J. Hardy
- Westinghouse Electric Corporation, Bettis Atomic Power Laboratory, Pittsburgh 30, Pennsylvania
| | - G. G. Smith
- Westinghouse Electric Corporation, Bettis Atomic Power Laboratory, Pittsburgh 30, Pennsylvania
| | - J. A. Mitchell
- Westinghouse Electric Corporation, Bettis Atomic Power Laboratory, Pittsburgh 30, Pennsylvania
| | - D. Klein
- Westinghouse Electric Corporation, Bettis Atomic Power Laboratory, Pittsburgh 30, Pennsylvania
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37
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Affiliation(s)
- J. Hardy
- Bettis Atomic Power Laboratory, Westinghouse Electric Corporation, Pittsburgh, Pennsylvania
| | - G. G. Smith
- Bettis Atomic Power Laboratory, Westinghouse Electric Corporation, Pittsburgh, Pennsylvania
| | - D. Klein
- Bettis Atomic Power Laboratory, Westinghouse Electric Corporation, Pittsburgh, Pennsylvania
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Smith G, Hardy J, Klein D. Comparison of Measurements with a Monte Carlo Calculated Spatial Distribution of Resonance Neutron Capture in a Uranium Rod. NUCL SCI ENG 2017. [DOI: 10.13182/nse60-a25829] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- G. Smith
- Bettis Atomic Power Laboratory Westinghouse Electric Corporation Pittsburgh, Pennsylvania
| | - J. Hardy
- Bettis Atomic Power Laboratory Westinghouse Electric Corporation Pittsburgh, Pennsylvania
| | - D. Klein
- Bettis Atomic Power Laboratory Westinghouse Electric Corporation Pittsburgh, Pennsylvania
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Affiliation(s)
- J. Hardy
- Westinghouse Electric Corporation, Bettis Atomic Power Laboratory, Pittsburgh, Pennsylvania
| | - D. Klein
- Westinghouse Electric Corporation, Bettis Atomic Power Laboratory, Pittsburgh, Pennsylvania
| | - G. G. Smith
- Westinghouse Electric Corporation, Bettis Atomic Power Laboratory, Pittsburgh, Pennsylvania
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Lubbe SJ, Escott-Price V, Brice A, Gasser T, Pittman AM, Bras J, Hardy J, Heutink P, Wood NM, Singleton AB, Grosset DG, Carroll CB, Law MH, Demenais F, Iles MM, Bishop DT, Newton-Bishop J, Williams NM, Morris HR. Rare variants analysis of cutaneous malignant melanoma genes in Parkinson's disease. Neurobiol Aging 2016; 48:222.e1-222.e7. [PMID: 27640074 PMCID: PMC5096891 DOI: 10.1016/j.neurobiolaging.2016.07.013] [Citation(s) in RCA: 16] [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: 02/26/2016] [Revised: 07/15/2016] [Accepted: 07/20/2016] [Indexed: 11/22/2022]
Abstract
A shared genetic susceptibility between cutaneous malignant melanoma (CMM) and Parkinson's disease (PD) has been suggested. We investigated this by assessing the contribution of rare variants in genes involved in CMM to PD risk. We studied rare variation across 29 CMM risk genes using high-quality genotype data in 6875 PD cases and 6065 controls and sought to replicate findings using whole-exome sequencing data from a second independent cohort totaling 1255 PD cases and 473 controls. No statistically significant enrichment of rare variants across all genes, per gene, or for any individual variant was detected in either cohort. There were nonsignificant trends toward different carrier frequencies between PD cases and controls, under different inheritance models, in the following CMM risk genes: BAP1, DCC, ERBB4, KIT, MAPK2, MITF, PTEN, and TP53. The very rare TYR p.V275F variant, which is a pathogenic allele for recessive albinism, was more common in PD cases than controls in 3 independent cohorts. Tyrosinase, encoded by TYR, is the rate-limiting enzyme for the production of neuromelanin, and has a role in the production of dopamine. These results suggest a possible role for another gene in the dopamine-biosynthetic pathway in susceptibility to neurodegenerative Parkinsonism, but further studies in larger PD cohorts are needed to accurately determine the role of these genes/variants in disease pathogenesis.
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Affiliation(s)
- S J Lubbe
- Department of Clinical Neuroscience, UCL Institute of Neurology, London, United Kingdom
| | - V Escott-Price
- Institute of Psychological Medicine and Clinical Neurosciences, Medical Research Council Centre for Neuropsychiatric Genetics and Genomics, Department of Psychological Medicine and Neurology, Cardiff University School of Medicine, Cardiff, United Kingdom
| | - A Brice
- INSERM U 1127, CNRS UMR 7225, Sorbonne Universités, UPMC Univ Paris 06 UMR S 1127, Institut du Cerveau et de la Moelle Epinière, ICM, France
| | - T Gasser
- Department for Neurodegenerative Diseases, Hertie Institute for Clinical Brain Research, and DZNE, German Center for Neurodegenerative Diseases, Tübingen, Germany
| | - A M Pittman
- Department of Molecular Neuroscience, UCL Institute of Neurology, London, United Kingdom
| | - J Bras
- Department of Molecular Neuroscience, UCL Institute of Neurology, London, United Kingdom
| | - J Hardy
- Department of Molecular Neuroscience, UCL Institute of Neurology, London, United Kingdom
| | - P Heutink
- Department of Clinical Genetics, Section of Medical Genomics, VU University Medical Centre, Amsterdam, The Netherlands
| | - N M Wood
- Department of Molecular Neuroscience, UCL Institute of Neurology, London, United Kingdom; UCL Genetics Institute, London, United Kingdom
| | - A B Singleton
- Laboratory of Neurogenetics, National Institute on Aging, National Institutes of Health, Bethesda, MD, USA
| | - D G Grosset
- Department of Neurology, Institute of Neurological Sciences, Queen Elizabeth University Hospital, Glasgow, United Kingdom
| | - C B Carroll
- Plymouth University Peninsula Schools of Medicine and Dentistry, Plymouth, United Kingdom
| | - M H Law
- Statistical Genetics, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
| | - F Demenais
- INSERM, UMR 946, Genetic Variation and Human Diseases Unit, Paris, France; Institut Universitaire d'Hématologie, Université Paris Diderot, Sorbonne, Paris, France
| | - M M Iles
- Section of Epidemiology and Biostatistics, Leeds Institute of Cancer and Pathology, Leeds, United Kingdom
| | - D T Bishop
- Section of Epidemiology and Biostatistics, Leeds Institute of Cancer and Pathology, Leeds, United Kingdom
| | - J Newton-Bishop
- Section of Epidemiology and Biostatistics, Leeds Institute of Cancer and Pathology, Leeds, United Kingdom
| | - N M Williams
- Institute of Psychological Medicine and Clinical Neurosciences, Medical Research Council Centre for Neuropsychiatric Genetics and Genomics, Department of Psychological Medicine and Neurology, Cardiff University School of Medicine, Cardiff, United Kingdom
| | - H R Morris
- Department of Clinical Neuroscience, UCL Institute of Neurology, London, United Kingdom.
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Heng S, Hardy J, Good P. 488P A retrospective audit on usage of oral water soluble contrast in patients with known advanced cancer. Ann Oncol 2016. [DOI: 10.1016/s0923-7534(21)00646-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Heng S, Hardy J, Good P. 488P A retrospective audit on usage of oral water soluble contrast in patients with known advanced cancer. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw595.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Hardy J. Oral health: Flossing has to be taught well. Br Dent J 2016; 221:371. [DOI: 10.1038/sj.bdj.2016.710] [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: 11/09/2022]
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Hardy J, Daniels KM, Winston DR. 0043 The impact of amount and quality of colostrum and subsequent transition milk on calf health and growth. J Anim Sci 2016. [DOI: 10.2527/jam2016-0043] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Marcheix PS, Delclaux S, Ehlinger M, Scheibling B, Dalmay F, Hardy J, Lebaron M, Bonnevialle P. Pre- and postoperative complications of adult forearm fractures treated with plate fixation. Orthop Traumatol Surg Res 2016; 102:781-4. [PMID: 27499115 DOI: 10.1016/j.otsr.2016.04.014] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [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: 11/26/2015] [Revised: 02/11/2016] [Accepted: 04/28/2016] [Indexed: 02/02/2023]
Abstract
INTRODUCTION Adult forearm fractures account for 1-2% of all fractures of the limbs. The main objective of this retrospective multicenter study was to evaluate pre- and postoperative complications of forearm fractures. The secondary objective was to evaluate functional and radiological results of plate osteosynthesis for these fractures. MATERIAL AND METHODS Between January 2008 and March 2014, 131 forearm fractures were reviewed retrospectively. Fractures were classified preoperatively according to the AO classification. Clinical outcomes were classified into four categories according to the Tschnerne and Oestern classification. Pre- and postoperative complications were sought systematically. RESULTS Before surgery, 12 patients had neurological impairment (9%). At the last follow-up, nine patients had persistent neurological disorders (6.9%). Union of forearm fractures was obtained in 122 patients at 4.6 months on average (±2.6). Nine patients with nonunion were observed (6.9%) and five patients had radioulnar synostosis (3.8%). DISCUSSION The frequency of neurological complications concomitant to forearm fractures is noteworthy. Similar cases with essentially irritative neurological disease have been reported in the literature, in particular for the ulnar nerve. Fracture nonunion is a relatively common complication: between 2 and 10% of cases depending on the study. LEVEL OF EVIDENCE IV.
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Affiliation(s)
- P-S Marcheix
- Service d'orthopédie-traumatologie, CHU de Limoges, 2, avenue Martin-Luther-King, 87042 Limoges, France.
| | - S Delclaux
- Département de chirurgie orthopédique et traumatologique, pôle institut locomoteur, hôpital Pierre-Paul-Riquet, place du Docteur-Baylac, TSA 40031, 31059 Toulouse cedex, France
| | - M Ehlinger
- Service d'orthopédie-traumatologie, hôpital de Hautepierre, CHU de Strasbourg, 1, avenue Molière, 67098 Strasbourg cedex, France
| | - B Scheibling
- Service d'orthopédie-traumatologie, hôpital de Hautepierre, CHU de Strasbourg, 1, avenue Molière, 67098 Strasbourg cedex, France
| | - F Dalmay
- Service d'orthopédie-traumatologie, CHU de Limoges, 2, avenue Martin-Luther-King, 87042 Limoges, France
| | - J Hardy
- Service d'orthopédie-traumatologie, CHU de Limoges, 2, avenue Martin-Luther-King, 87042 Limoges, France
| | - M Lebaron
- Service d'orthopédie-traumatologie, hôpital Nord Marseille, Marseille, France
| | - P Bonnevialle
- Département de chirurgie orthopédique et traumatologique, pôle institut locomoteur, hôpital Pierre-Paul-Riquet, place du Docteur-Baylac, TSA 40031, 31059 Toulouse cedex, France
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Guerreiro R, Brás J, Batista S, Pires P, Ribeiro MH, Almeida MR, Oliveira C, Hardy J, Santana I. Pseudohypoparathyroidism type I-b with neurological involvement is associated with a homozygous PTH1R mutation. Genes Brain Behav 2016; 15:669-77. [PMID: 27415614 PMCID: PMC5026059 DOI: 10.1111/gbb.12308] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [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] [Subscribe] [Scholar Register] [Received: 02/10/2016] [Revised: 07/11/2016] [Accepted: 07/11/2016] [Indexed: 12/16/2022]
Abstract
Pseudohypoparathyroidism type 1b (PHP1b) is characterized by hypocalcemia, hyperphosphatemia, increased levels of circulating parathyroid hormone (PTH), and no skeletal or developmental abnormalities. The goal of this study was to perform a full characterization of a familial case of PHP1b with neurological involvement and to identify the genetic cause of disease. The initial laboratory profile of the proband showed severe hypocalcemia, hyperphosphatemia and normal levels of PTH, which was considered to be compatible with primary hypoparathyroidism. With disease progression the patient developed cognitive disturbance, PTH levels were found to be slightly elevated and a picture of PTH resistance syndrome seemed more probable. The diagnosis of PHP1b was established after the study of family members and blunted urinary cAMP results were obtained in a PTH stimulation test. Integration of whole genome genotyping and exome sequencing data supported this diagnosis by revealing a novel homozygous missense mutation in PTH1R (p.Arg186His) completely segregating with the disease. Here, we demonstrate segregation of a novel mutation in PTH1R with a phenotype of PHP1b presenting with neurological symptoms, but no bone defects. This case represents the extreme end of the spectrum of cognitive impairment in PTH dysfunction and defines a possible novel form of PHP1b resulting from the impaired interaction between PTH and PTH1R.
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Affiliation(s)
- R Guerreiro
- Department of Molecular Neuroscience, UCL Institute of Neurology, London, UK.
- Department of Medical Sciences, Institute of Biomedicine - iBiMED, University of Aveiro, Aveiro, Portugal.
| | - J Brás
- Department of Molecular Neuroscience, UCL Institute of Neurology, London, UK
- Department of Medical Sciences, Institute of Biomedicine - iBiMED, University of Aveiro, Aveiro, Portugal
| | - S Batista
- Neurology Department, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - P Pires
- Hospital do Santo Espírito, Terceira, Portugal
| | - M H Ribeiro
- CNC - Center for Neuroscience and Cell Biology
- Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - M R Almeida
- CNC - Center for Neuroscience and Cell Biology
| | - C Oliveira
- CNC - Center for Neuroscience and Cell Biology
- Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - J Hardy
- Department of Molecular Neuroscience, UCL Institute of Neurology, London, UK
| | - I Santana
- Neurology Department, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
- CNC - Center for Neuroscience and Cell Biology
- Faculty of Medicine, University of Coimbra, Coimbra, Portugal
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Hardy J, Audouin-Pajot C, Abid A, Chiotasso D, Coustets B, Suc A, Timsit P, Mouthon L, Mazereeuw-Hautier J. [Pansclerotic morphea with a rapidly fatal outcome in an 11-year-old girl]. Ann Dermatol Venereol 2016; 143:836-840. [PMID: 27496274 DOI: 10.1016/j.annder.2016.06.010] [Citation(s) in RCA: 2] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2015] [Revised: 02/23/2016] [Accepted: 06/21/2016] [Indexed: 11/29/2022]
Abstract
BACKGROUND Pansclerotic morphea is a poorly described but extremely debilitating variant of localized scleroderma. We report a case with a rapidly fatal outcome in an 11-year-old girl. PATIENTS AND METHODS An 11-year-old girl with a 2-year history of morphea presented at our institution in April 2012. The sclerosis had started on her trunk and progressed rapidly to involve her entire skin. Initial treatment with corticosteroids was ineffective and she presented extremely painful ulcerations of the lower limbs. The outcome was rapidly fatal, in early 2014, due to cachexia and sepsis after two amputations and several failed treatments including methotrexate. DISCUSSION Pansclerotic morphea is characterized by rapidly progressing sclerosis involving the entire skin, trophic cutaneous ulcers, painful contraction and limited joint mobility. The prognosis is poor since the disease has an incapacitating and potentially fatal outcome. No reliably effective treatment has yet been established. CONCLUSION Our case highlights the clinical characteristics of this uncommon form of localized scleroderma, the extremely severe prognosis, and the therapeutic challenge involved.
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Affiliation(s)
- J Hardy
- Service de dermatologie, CHU Larrey-Toulouse, 24, chemin de Pouvourville, 31400 Toulouse, France.
| | - C Audouin-Pajot
- Service de médecine interne-rhumatologie, hôpital des enfants, 330, avenue de Grande-Bretagne, 31059 Toulouse, France
| | - A Abid
- Service de chirurgie orthopédique, traumatologique et plastique, hôpital des enfants, 330, avenue de Grande-Bretagne, 31059 Toulouse, France
| | - D Chiotasso
- Service d'anesthésie-réanimation, hôpital des enfants, 330, avenue de Grande-Bretagne, 31059 Toulouse, France
| | - B Coustets
- Service d'anesthésie-réanimation, hôpital des enfants, 330, avenue de Grande-Bretagne, 31059 Toulouse, France
| | - A Suc
- Service de douleur et soins palliatifs, hôpital des enfants, 330, avenue de Grande-Bretagne, 31059 Toulouse, France
| | - P Timsit
- Service de psychiatrie de l'enfant et de l'adolescent, hôpital La Grave, 7, place Lange, 31300 Toulouse, France
| | - L Mouthon
- Service de médecine interne, hôpital Cochin, 27, rue du Faubourg-Saint-Jacques, 75014 Paris, France
| | - J Mazereeuw-Hautier
- Service de dermatologie, CHU Larrey-Toulouse, 24, chemin de Pouvourville, 31400 Toulouse, France
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Abstract
We report a case of a mediastinal mass indenting the left lateral tracheal wall of a 35-year-old male who presented with weight loss, cough and breathlessness. Flow volume loop and thyroid function tests were normal and thyroid peroxidase antibodies were negative. Technetium scintigraphy and positron emission tomography both showed no uptake. Endobronchial ultrasound-guided fine needle aspiration confirmed ectopic mediastinal thyroid tissue. Mediastinal ectopic thyroid tissue is very rare. Most patients are asymptomatic and euthyroid with positive signals on scintigraphy. False negative technetium scintigraphy can occur in areas of necrosis, carcinoma and from substernal tissue. Ectopic thyroid tissue is a rare but important differential diagnosis when investigating mediastinal lesions and should be considered even if scintigraphy is negative in the right clinical context. Endobronchial ultrasound-guided fine needle aspiration can be used when scintigraphy is not diagnostic.
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Affiliation(s)
- J Hardy
- ARL Medford, North Bristol Lung Centre & University of Bristol Brunel Building, Southmead Hospital, Westbury-on-Trym, Bristol BS10 5NB, UK, E-mail
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Marcheix PS, Vergnenegre G, Chevalier C, Hardy J, Charissoux JL, Mabit C. Endoscopic ulnar nerve release at the elbow: Indications and outcomes. Orthop Traumatol Surg Res 2016; 102:41-5. [PMID: 26725214 DOI: 10.1016/j.otsr.2015.11.009] [Citation(s) in RCA: 2] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2014] [Revised: 09/27/2015] [Accepted: 11/02/2015] [Indexed: 02/02/2023]
Abstract
BACKGROUND Ulnar nerve entrapment at the elbow is the second most common nerve entrapment syndrome at the upper limp, after carpal tunnel syndrome. Many surgeons feel that ulnar nerve instability contra-indicates endoscopic nerve release. Published studies, however, found no evidence that pre-operative or intra-operative ulnar nerve instability adversely affected clinical outcomes. The objective of this prospective study was to define the indications and describe the outcomes of endoscopic ulnar nerve release at the elbow. HYPOTHESIS Endoscopic ulnar nerve release at the elbow is a valid option even in patients with ulnar nerve instability and regardless of the severity of the compression. MATERIAL AND METHODS We conducted a prospective single-centre study of patients scheduled for surgery based on clinical and electromyographic manifestations of ulnar nerve entrapment at the elbow. Ulnar nerve instability (incomplete dislocation, i.e., Childress A) before or during surgery was not a contra-indication to the procedure. The patients were re-evaluated 12 months after surgery. RESULTS Seventeen patients were included in the statistical analysis. The modified Bishop's score indicated excellent or good outcomes in 15 (88%) patients (excellent in 4 and good in 11) and a fair outcome in 2 patients. Functional outcomes were not associated with the presence of ulnar nerve instability before surgery. DISCUSSION We elected to include patients with Childress A ulnar nerve instability. Clinical outcomes in these patients were similar to those in patients without ulnar nerve instability. LEVEL OF EVIDENCE IV, open prospective study of treatment outcomes.
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Affiliation(s)
- P-S Marcheix
- Service d'orthopédie-traumatologie, CHU Dupuytren, 2, avenue Martin-Luther-King, 87000 Limoges, France.
| | - G Vergnenegre
- Service d'orthopédie-traumatologie, CHU Dupuytren, 2, avenue Martin-Luther-King, 87000 Limoges, France
| | - C Chevalier
- Service d'orthopédie-traumatologie, CHU Dupuytren, 2, avenue Martin-Luther-King, 87000 Limoges, France
| | - J Hardy
- Service d'orthopédie-traumatologie, CHU Dupuytren, 2, avenue Martin-Luther-King, 87000 Limoges, France
| | - J-L Charissoux
- Service d'orthopédie-traumatologie, CHU Dupuytren, 2, avenue Martin-Luther-King, 87000 Limoges, France
| | - C Mabit
- Service d'orthopédie-traumatologie, CHU Dupuytren, 2, avenue Martin-Luther-King, 87000 Limoges, France
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Hardy J, Carrington S, Turner C. ARE WE TALKING BUT NOT BEING HEARD? Arch Emerg Med 2015. [DOI: 10.1136/emermed-2015-205372.47] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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