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Villalobos R, Aylagas E, Pearman JK, Curdia J, Coker D, Bell AC, Brown SD, Rowe K, Lozano-Cortés D, Rabaoui LJ, Marshell A, Qurban M, Jones B, Berumen ML, Carvalho S. Biodiversity patterns of the coral reef cryptobiota around the Arabian Peninsula. Sci Rep 2024; 14:9532. [PMID: 38664507 PMCID: PMC11045746 DOI: 10.1038/s41598-024-60336-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Accepted: 04/22/2024] [Indexed: 04/28/2024] Open
Abstract
The Arabian Peninsula accounts for approximately 6% of the world's coral reefs. Some thrive in extreme environments of temperature and salinity. Using 51 Autonomous Reef Monitoring Structure (ARMS), a standardized non-destructive monitoring device, we investigated the spatial patterns of coral reef cryptobenthic diversity in four ecoregions around the Arabian Peninsula and analyzed how geographical and/or environmental drivers shape those patterns. The mitochondrial cytochrome c oxidase subunit I (COI) gene was used to identify Amplicon Sequence Variants and assign taxonomy of the cryptobenthic organisms collected from the sessile and mobile fractions of each ARMS. Cryptobenthic communities sampled from the two ecoregions in the Red Sea showed to be more diverse than those inhabiting the Arabian (Persian) Gulf and the Gulf of Oman. Geographic distance revealed a stronger relationship with beta diversity in the Mantel partial correlation than environmental distance. However, the two mobile fractions (106-500 µm and 500-2000 µm) also had a significant correlation between environmental distance and beta diversity. In our study, dispersal limitations explained the beta diversity patterns in the selected reefs, supporting the neutral theory of ecology. Still, increasing differences in environmental variables (environmental filtering) also had an effect on the distribution patterns of assemblages inhabiting reefs within short geographic distances. The influence of geographical distance in the cryptofauna assemblages makes these relevant, yet usually ignored, communities in reef functioning vulnerable to large scale coastal development and should be considered in ecosystem management of such projects.
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Affiliation(s)
- Rodrigo Villalobos
- King Abdullah University of Science and Technology (KAUST), Red Sea Research Center, 23955-6900, Thuwal, Kingdom of Saudi Arabia
| | - Eva Aylagas
- King Abdullah University of Science and Technology (KAUST), Red Sea Research Center, 23955-6900, Thuwal, Kingdom of Saudi Arabia
| | - John K Pearman
- King Abdullah University of Science and Technology (KAUST), Red Sea Research Center, 23955-6900, Thuwal, Kingdom of Saudi Arabia
- Coastal and Freshwater Group, Cawthron Institute, Nelson, New Zealand
| | - Joao Curdia
- King Abdullah University of Science and Technology (KAUST), Red Sea Research Center, 23955-6900, Thuwal, Kingdom of Saudi Arabia
| | - Darren Coker
- King Abdullah University of Science and Technology (KAUST), Red Sea Research Center, 23955-6900, Thuwal, Kingdom of Saudi Arabia
| | - Alyssa Clothilde Bell
- King Abdullah University of Science and Technology (KAUST), Red Sea Research Center, 23955-6900, Thuwal, Kingdom of Saudi Arabia
- Department of Biology, University of Konstanz, Konstanz, Germany
| | - Shannon D Brown
- King Abdullah University of Science and Technology (KAUST), Red Sea Research Center, 23955-6900, Thuwal, Kingdom of Saudi Arabia
- Cooperative Institute for Climate, Ocean, and Ecosystem Studies, University of Washington, Seattle, WA, USA
| | - Katherine Rowe
- King Abdullah University of Science and Technology (KAUST), Red Sea Research Center, 23955-6900, Thuwal, Kingdom of Saudi Arabia
- School of Science, The University of Waikato, Hamilton, New Zealand
| | | | - Lotfi J Rabaoui
- Center for Environment & Marine Studies, Research Institute, King Fahd University of Petroleum and Minerals, 31261, Dhahran, Eastern Province, Kingdom of Saudi Arabia
- National Center for Wildlife, Riyadh, Saudi Arabia
| | - Alyssa Marshell
- Sultan Qaboos University, Al Seeb Al Khoudh SQU SEPS, 123, Muscat, Oman
- Institute for Marine and Antarctic Studies, University of Tasmania, Hobart, TAS, 7053, Australia
| | - Mohammad Qurban
- Center for Environment & Marine Studies, Research Institute, King Fahd University of Petroleum and Minerals, 31261, Dhahran, Eastern Province, Kingdom of Saudi Arabia
- Ministry of Environment, Water and Agriculture, Riyadh, Saudi Arabia
| | - Burton Jones
- King Abdullah University of Science and Technology (KAUST), Red Sea Research Center, 23955-6900, Thuwal, Kingdom of Saudi Arabia
| | - Michael Lee Berumen
- King Abdullah University of Science and Technology (KAUST), Red Sea Research Center, 23955-6900, Thuwal, Kingdom of Saudi Arabia
| | - Susana Carvalho
- King Abdullah University of Science and Technology (KAUST), Red Sea Research Center, 23955-6900, Thuwal, Kingdom of Saudi Arabia.
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Josev EK, Chen J, Seal M, Scheinberg A, Cole RC, Rowe K, Lubitz L, Knight SJ. What lies beneath: White matter microstructure in pediatric myalgic encephalomyelitis/chronic fatigue syndrome using diffusion MRI. J Neurosci Res 2023; 101:1572-1585. [PMID: 37331007 DOI: 10.1002/jnr.25223] [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: 10/16/2022] [Revised: 04/28/2023] [Accepted: 05/27/2023] [Indexed: 06/20/2023]
Abstract
Recent studies in adults with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) suggest that changes in brain white matter microstructural organization may correlate with core ME/CFS symptoms, and represent a potential biomarker of disease. However, this has yet to be investigated in the pediatric ME/CFS population. We examined group differences in macrostructural and microstructural white matter properties, and their relationship with clinical measures, between adolescents recently diagnosed with ME/CFS and healthy controls. Forty-eight adolescents (25 ME/CFS, 23 controls, mean age 16 years) underwent brain diffusion MRI, and a robust multi-analytic approach was used to evaluate white and gray matter volume, regional brain volume, cortical thickness, fractional anisotropy, mean/axial/radial diffusivity, neurite dispersion and density, fiber density, and fiber cross section. From a clinical perspective, adolescents with ME/CFS showed greater fatigue and pain, poorer sleep quality, and poorer performance on cognitive measures of processing speed and sustained attention compared with controls. However, no significant group differences in white matter properties were observed, with the exception of greater white matter fiber cross section of the left inferior longitudinal fasciculus in the ME/CFS group compared with controls, which did not survive correction for intracranial volume. Overall, our findings suggest that white matter abnormalities may not be predominant in pediatric ME/CFS in the early stages following diagnosis. The discrepancy between our null findings and white matter abnormalities identified in the adult ME/CFS literature could suggest that older age and/or longer illness duration influence changes in brain structure and brain-behavior relationships that are not yet established in adolescence.
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Affiliation(s)
- Elisha K Josev
- Neurodisability and Rehabilitation, Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, Victoria, Australia
- Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia
| | - Jian Chen
- Developmental Imaging, Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, Victoria, Australia
| | - Marc Seal
- Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia
- Developmental Imaging, Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, Victoria, Australia
| | - Adam Scheinberg
- Neurodisability and Rehabilitation, Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, Victoria, Australia
- Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia
- Victorian Paediatric Rehabilitation Service, Royal Children's Hospital, Melbourne, Victoria, Australia
| | - Rebecca C Cole
- Neurodisability and Rehabilitation, Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, Victoria, Australia
| | - Katherine Rowe
- Department of General Medicine, Royal Children's Hospital, Melbourne, Victoria, Australia
| | - Lionel Lubitz
- Department of General Medicine, Royal Children's Hospital, Melbourne, Victoria, Australia
| | - Sarah J Knight
- Neurodisability and Rehabilitation, Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, Victoria, Australia
- Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia
- Victorian Paediatric Rehabilitation Service, Royal Children's Hospital, Melbourne, Victoria, Australia
- Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Victoria, Australia
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Valle L, Guo A, Ahmed S, Rowe K, Pritchard C, Montgomery B, Garraway I, Nickols NG, Maxwell K, Kelley M, Rettig M. Success of Liquid Tumor Biopsy in Men with Metastatic Prostate Cancer According to Self-Identified Race. Int J Radiat Oncol Biol Phys 2023; 117:e446-e447. [PMID: 37785441 DOI: 10.1016/j.ijrobp.2023.06.1628] [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: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Liquid biopsy using cell-free DNA (cfDNA) is increasingly used to identify somatic prostate cancer (PrCa) alterations when tissue biopsy of a metastatic lesion is infeasible or impractical. High-risk somatic alterations identified by cfDNA have been recently shown to predict the benefit of metastasis-directed therapy with stereotactic body radiation therapy in PrCa. However, given the older age of PrCa patients, liquid biopsy is often contaminated with alterations related to clonal hematopoiesis of indeterminate potential (CHIP), generating uncertainty in the clinical utility of the results. Given the higher incidence and aggressiveness of metastatic PrCa in Black men, we sought to determine if the success of cfDNA testing varied by race in a large and diverse cohort of United States Veterans with metastatic PrCa, hypothesizing that race would not influence the success of cfDNA testing. MATERIALS/METHODS Veterans with metastatic PrCa underwent next-generation sequencing of cfDNA biopsy specimens through the VA National Precision Oncology Program from February 2019 to November 2022. Successful identification of PrCa with cfDNA testing was defined as the identification of an alteration in one or more PrCa-related related genes in the gene panel tested (AR, CDK12, SPOP, MED12, CCND1, BRAF, AKT1, TMPRSS2, ERG, ETV1, and ETV4). Univariate logistic regression was employed to explore the association between patient self-identified race, as well as other patient and disease-specific factors at the time of cfDNA biopsy, with the likelihood of yielding a successful cfDNA biopsy result. RESULTS A total of 2066 cfDNA tests from 1985 Veterans were related to a diagnosis of PrCa, passed quality control measures, and were linkable to patient-level demographics. Median age at testing was 74, median PSA at testing was 22.7, median PSA doubling time (PSADT) was 3.6 months, and median Gleason score was 8. 57% of Veterans self-identified as White, 33% as Black, and 10% as Other. Eight hundred fourteen (39%) tests were deemed successful by finding a PrCa related gene alteration. Among successful tests, the most frequently encountered alterations were AR alterations in 60.4% White men and 33.9% Black men (p = 0.72), followed by TMPRSS2 alterations in 70.3% White men and 22.0% Black men (p<0.001). Despite a lower rate of PrCa-specific alterations in Black men, on univariate analysis, Veteran self-identified race was not associated with successful cfDNA testing (OR 0.95, 95% CI 0.78-1.14, p = 0.6), whereas PSA in quintiles 2-4, PSADT <12 months, and unit increase in Gleason score were associated with successful cfDNA testing (p<0.01 for all). CONCLUSION Successful cfDNA biopsy in metastatic PrCa is associated with PSA and PSADT, but not related to patient self-identified race. In appropriate clinical scenarios, patients who self-identify as Black or White are equally likely to have PrCa-specific alterations detected on cfDNA testing when evaluating metastatic PrCa patients for local and systemic therapies.
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Affiliation(s)
- L Valle
- Department of Radiation Oncology, University of California, Los Angeles, Los Angeles, CA
| | - A Guo
- Department of Veterans Affairs, Minneapolis, MN
| | - S Ahmed
- Northwestern University, Chicago, IL
| | - K Rowe
- Department of Veterans Affairs, Salt Lake City, UT
| | | | - B Montgomery
- University of Washington, Seattle, WA, United States
| | - I Garraway
- Department of Urology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA
| | - N G Nickols
- University of California Los Angeles, Department of Radiation Oncology, Los Angeles, CA
| | - K Maxwell
- University of Pennsylvania, Philadelphia, PA
| | | | - M Rettig
- Department of Medical Oncology, University of California, Los Angeles, Los Angeles, CA
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Byrne H, Josev EK, Knight SJ, Scheinberg A, Rowe K, Lubitz L, Seal ML. Hypothalamus volumes in adolescent Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS): impact of self-reported fatigue and illness duration. Brain Struct Funct 2023; 228:1741-1754. [PMID: 37537279 PMCID: PMC10471696 DOI: 10.1007/s00429-023-02682-3] [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: 05/15/2023] [Accepted: 07/06/2023] [Indexed: 08/05/2023]
Abstract
Adolescent Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) is a complex illness of unknown aetiology. Emerging theories suggest ME/CFS may reflect a progressive, aberrant state of homeostasis caused by disturbances within the hypothalamus, yet few studies have investigated this using magnetic resonance imaging in adolescents with ME/CFS. We conducted a volumetric analysis to investigate whether whole and regional hypothalamus volumes in adolescents with ME/CFS differed compared to healthy controls, and whether these volumes were associated with fatigue severity and illness duration. 48 adolescents (25 ME/CFS, 23 controls) were recruited. Lateralised whole and regional hypothalamus volumes, including the anterior-superior, superior tubular, posterior, anterior-inferior and inferior tubular subregions, were calculated from T1-weighted images. When controlling for age, sex and intracranial volume, Bayesian linear regression models revealed no evidence for differences in hypothalamus volumes between groups. However, in the ME/CFS group, a weak linear relationship between increased right anterior-superior volumes and fatigue severity was identified, which was absent in controls. In addition, Bayesian quantile regression revealed a likely-positive association between illness duration and right superior tubular volumes in the ME/CFS group. While these findings suggest overall comparability in regional and whole hypothalamus volumes between adolescents with ME/CFS and controls, preliminary evidence was identified to suggest greater fatigue severity and longer illness duration were associated with greater right anterior-superior and superior-tubular volumes, respectively. These regions contain the anterior and superior divisions of the paraventricular nucleus, involved in the neuroendocrine response to stress, suggesting involvement in ME/CFS pathophysiology. However, replication in a larger, longitudinal cohort is required.
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Affiliation(s)
- Hollie Byrne
- Developmental Imaging, Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, 3052, Australia.
- Neurodisability and Rehabilitation, Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, 3052, Australia.
- Department of Paediatrics, The University of Melbourne, Melbourne, 3052, Australia.
| | - Elisha K Josev
- Neurodisability and Rehabilitation, Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, 3052, Australia
- Department of Paediatrics, The University of Melbourne, Melbourne, 3052, Australia
| | - Sarah J Knight
- Neurodisability and Rehabilitation, Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, 3052, Australia
- Department of Paediatrics, The University of Melbourne, Melbourne, 3052, Australia
| | - Adam Scheinberg
- Neurodisability and Rehabilitation, Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, 3052, Australia
- Department of Paediatrics, The University of Melbourne, Melbourne, 3052, Australia
| | - Katherine Rowe
- Department of General Medicine, Royal Children's Hospital, Melbourne, 3052, Australia
| | - Lionel Lubitz
- Department of General Medicine, Royal Children's Hospital, Melbourne, 3052, Australia
| | - Marc L Seal
- Developmental Imaging, Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, 3052, Australia
- Department of Paediatrics, The University of Melbourne, Melbourne, 3052, Australia
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Baker A, Grobler A, Davies K, Griffiths A, Hiscock H, Kubba H, Peters RL, Ranganathan S, Rimmer J, Rose E, Rowe K, Simpson CM, Davidson A, Nixon G, Perrett KP. Effectiveness of Intranasal Mometasone Furoate vs Saline for Sleep-Disordered Breathing in Children: A Randomized Clinical Trial. JAMA Pediatr 2023; 177:240-247. [PMID: 36648937 PMCID: PMC9857783 DOI: 10.1001/jamapediatrics.2022.5258] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Accepted: 10/24/2022] [Indexed: 01/18/2023]
Abstract
Importance Obstructive sleep-disordered breathing (SDB) in children is characterized by snoring and difficulty breathing during sleep. SDB affects at least 12% of otherwise healthy children and is associated with significant morbidity. Evidence from small clinical trials suggests that intranasal corticosteroids improve SDB as measured by polysomnography; however, the effect on symptoms and quality of life is unclear. Objective To determine whether intranasal mometasone furoate is more effective than intranasal saline for improving symptoms and quality of life in children with SDB. Design, Setting, and Participants The MIST trial was a multicenter, randomized, double-blind, placebo-controlled trial, recruiting participants from June 8, 2018, to February 13, 2020. Children aged 3 to 12 years who were referred to a specialist for significant SDB symptoms were included; exclusions were previous adenotonsillectomy, body mass index greater than the 97th percentile, and severe SDB. Randomization was stratified by site, and data were analyzed on an intention-to-treat basis from October 28, 2020, to September 25, 2022. Interventions Participants were randomly assigned to receive mometasone furoate, 50 μg, or sodium chloride (saline), 0.9%, 1 spray per nostril daily, dispensed in identical bottles. Main Outcomes and Measures The primary outcome was resolution of significant SDB symptoms (ie, reduction to a level no longer requiring referral to a specialist as per the American Academy of Pediatrics guidelines) at 6 weeks, measured by parental report of symptoms using the SDB Score. Results A total of 276 participants (mean [SD] age, 6.1 [2.3] years; 146 male individuals [53%]) were recruited, 138 in each treatment arm. Resolution of significant SDB symptoms occurred in 56 of 127 participants (44%) in the mometasone group and 50 of 123 participants (41%) in the saline group (risk difference, 4%; 95% CI, -8% to 16%; P = .51) with 26 participants lost to follow-up and missing values managed by multiple imputation. The main adverse effects were epistaxis, affecting 12 of 124 participants (9.7%) in the mometasone group and 18 of 120 participants (15%) in the saline group, and nasal itch/irritation, affecting 12 of 124 participants (9.7%) in the mometasone group and 22 of 120 participants (18%) in the saline group. Conclusions and Relevance Results of this randomized clinical trial suggest that there was no difference in treatment effect between intranasal mometasone and saline for the management of SDB symptoms. The results suggest that almost one-half of children with SDB could be initially managed in the primary care setting and may not require referral to specialist services, as is currently recommended. Trial Registration Australian New Zealand Clinical Trials Registry: ANZCTRN12618000448246.
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Affiliation(s)
- Alice Baker
- Department of Paediatrics, University of Melbourne, Melbourne, Australia
- Murdoch Children's Research Institute, Melbourne, Australia
- Department of General Medicine, Royal Children’s Hospital, Melbourne, Australia
| | - Anneke Grobler
- Department of Paediatrics, University of Melbourne, Melbourne, Australia
- Murdoch Children's Research Institute, Melbourne, Australia
| | - Karen Davies
- Department of Otolaryngology, Royal Children’s Hospital, Melbourne, Australia
| | - Amanda Griffiths
- Department of Paediatrics, University of Melbourne, Melbourne, Australia
- Murdoch Children's Research Institute, Melbourne, Australia
- Department of Respiratory and Sleep Medicine, Royal Children’s Hospital, Melbourne, Australia
| | - Harriet Hiscock
- Department of Paediatrics, University of Melbourne, Melbourne, Australia
- Murdoch Children's Research Institute, Melbourne, Australia
- Health Services Research Unit, Royal Children’s Hospital, Melbourne, Australia
- Centre for Community Child Health, Royal Children’s Hospital, Melbourne, Australia
| | - Haytham Kubba
- Department of Otolaryngology, Royal Hospital for Children, Glasgow, Scotland
| | - Rachel L. Peters
- Department of Paediatrics, University of Melbourne, Melbourne, Australia
- Murdoch Children's Research Institute, Melbourne, Australia
| | - Sarath Ranganathan
- Department of Paediatrics, University of Melbourne, Melbourne, Australia
- Murdoch Children's Research Institute, Melbourne, Australia
- Department of Respiratory and Sleep Medicine, Royal Children’s Hospital, Melbourne, Australia
| | - Joanne Rimmer
- Department of Otolaryngology–Head and Neck Surgery, Monash Health, Melbourne, Australia
- Department of Surgery, Monash University, Melbourne, Australia
| | - Elizabeth Rose
- Murdoch Children's Research Institute, Melbourne, Australia
- Department of Otolaryngology, Royal Children’s Hospital, Melbourne, Australia
- Department of Otolaryngology, University of Melbourne, Melbourne, Australia
| | - Katherine Rowe
- Department of General Medicine, Royal Children’s Hospital, Melbourne, Australia
| | - Catherine M. Simpson
- Department of Paediatrics, University of Melbourne, Melbourne, Australia
- Murdoch Children's Research Institute, Melbourne, Australia
- Centre for Community Child Health, Royal Children’s Hospital, Melbourne, Australia
| | - Andrew Davidson
- Department of Paediatrics, University of Melbourne, Melbourne, Australia
- Murdoch Children's Research Institute, Melbourne, Australia
- Melbourne Children’s Trial Centre, Melbourne Children’s, Melbourne, Australia
| | - Gillian Nixon
- Melbourne Children's Sleep Centre, Monash Children’s Hospital, Monash Health, Melbourne, Australia
- Department of Paediatrics, Monash University, Melbourne, Australia
| | - Kirsten P. Perrett
- Department of Paediatrics, University of Melbourne, Melbourne, Australia
- Murdoch Children's Research Institute, Melbourne, Australia
- Melbourne Children’s Trial Centre, Melbourne Children’s, Melbourne, Australia
- Department of Allergy and Immunology, Royal Children’s Hospital, Melbourne, Australia
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Rowe K. Chronic Fatigue Syndrome/Myalgic Encephalomyelitis (CFS/ME) in Adolescents: Practical Guidance and Management Challenges. Adolesc Health Med Ther 2023; 14:13-26. [PMID: 36632532 PMCID: PMC9827635 DOI: 10.2147/ahmt.s317314] [Citation(s) in RCA: 1] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Accepted: 12/21/2022] [Indexed: 01/06/2023] Open
Abstract
This paper reviews the current understanding of myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), and whether any treatment strategies have been effective. ME/CFS is a condition of as yet unknown etiology that commonly follows an infective process. It includes a new onset of fatigue (of more than 3-6 month duration and not relieved by rest), post-exertional malaise, cognitive difficulties and unrefreshing sleep, and frequently orthostatic intolerance, somatic symptoms and pain. Long COVID has renewed interest in the condition and stimulated research with findings suggestive of a multisystem neuroimmune disease. There are no definitively effective treatments. Despite earlier recommendations regarding graded exercise therapy and cognitive behavior therapy, the current recommendations are managing symptoms, with lifestyle management and supportive care. This paper provides an outline of strategies that young people and their families have reported as helpful in managing a chronic illness that impacts their life socially, physically, emotionally, cognitively and educationally. As the illness frequently occurs at a time of rapid developmental changes, reducing these impacts is reported to be as important as managing the physical symptoms. Young people face a mean duration of 5 years illness (range 1-16 years) with a likely residual 20% having significant restrictions after 10 years. Their feedback has suggested that symptom management, self-management strategies, advocacy and educational liaison have been the most helpful. They value professionals who will listen and take them seriously, and after excluding alternative diagnoses, they explain the diagnosis, are supportive and assist in monitoring their progress. Remaining engaged in education was the best predictor of later functioning. This allowed for social connections, as well as potential independence and fulfilling some aspirations. The need to consider the impact of this chronic illness on all aspects of adolescent development, as part of management, is highlighted.
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Affiliation(s)
- Katherine Rowe
- Department of General Medicine, Royal Children’s Hospital, Melbourne, Victoria, Australia,Correspondence: Katherine Rowe, Department of General Medicine, Royal Children’s Hospital, Flemington Road Parkville, Melbourne, Victoria, 3052, Australia, Tel +61 412059283, Email
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7
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Nadarajah R, Ludman P, Appelman Y, Brugaletta S, Budaj A, Bueno H, Huber K, Kunadian V, Leonardi S, Lettino M, Milasinovic D, Gale CP, Budaj A, Dagres N, Danchin N, Delgado V, Emberson J, Friberg O, Gale CP, Heyndrickx G, Iung B, James S, Kappetein AP, Maggioni AP, Maniadakis N, Nagy KV, Parati G, Petronio AS, Pietila M, Prescott E, Ruschitzka F, Van de Werf F, Weidinger F, Zeymer U, Gale CP, Beleslin B, Budaj A, Chioncel O, Dagres N, Danchin N, Emberson J, Erlinge D, Glikson M, Gray A, Kayikcioglu M, Maggioni AP, Nagy KV, Nedoshivin A, Petronio AP, Roos-Hesselink JW, Wallentin L, Zeymer U, Popescu BA, Adlam D, Caforio ALP, Capodanno D, Dweck M, Erlinge D, Glikson M, Hausleiter J, Iung B, Kayikcioglu M, Ludman P, Lund L, Maggioni AP, Matskeplishvili S, Meder B, Nagy KV, Nedoshivin A, Neglia D, Pasquet AA, Roos-Hesselink JW, Rossello FJ, Shaheen SM, Torbica A, Gale CP, Ludman PF, Lettino M, Bueno H, Huber K, Leonardi S, Budaj A, Milasinovic (Serbia) D, Brugaletta S, Appelman Y, Kunadian V, Al Mahmeed WAR, Kzhdryan H, Dumont C, Geppert A, Bajramovic NS, Cader FA, Beauloye C, Quesada D, Hlinomaz O, Liebetrau C, Marandi T, Shokry K, Bueno H, Kovacevic M, Crnomarkovic B, Cankovic M, Dabovic D, Jarakovic M, Pantic T, Trajkovic M, Pupic L, Ruzicic D, Cvetanovic D, Mansourati J, Obradovic I, Stankovic M, Loh PH, Kong W, Poh KK, Sia CH, Saw K, Liška D, Brozmannová D, Gbur M, Gale CP, Maxian R, Kovacic D, Poznic NG, Keric T, Kotnik G, Cercek M, Steblovnik K, Sustersic M, Cercek AC, Djokic I, Maisuradze D, Drnovsek B, Lipar L, Mocilnik M, Pleskovic A, Lainscak M, Crncic D, Nikojajevic I, Tibaut M, Cigut M, Leskovar B, Sinanis T, Furlan T, Grilj V, Rezun M, Mateo VM, Anguita MJF, Bustinza ICM, Quintana RB, Cimadevilla OCF, Fuertes J, Lopez F, Dharma S, Martin MD, Martinez L, Barrabes JA, Bañeras J, Belahnech Y, Ferreira-Gonzalez I, Jordan P, Lidon RM, Mila L, Sambola A, Orvin K, Sionis A, Bragagnini W, Cambra AD, Simon C, Burdeus MV, Ariza-Solé A, Alegre O, Alsina M, Ferrando JIL, Bosch X, Sinha A, Vidal P, Izquierdo M, Marin F, Esteve-Pastor MA, Tello-Montoliu A, Lopez-Garcia C, Rivera-Caravaca JM, Gil-Pérez P, Nicolas-Franco S, Keituqwa I, Farhan HA, Silva L, Blasco A, Escudier JM, Ortega J, Zamorano JL, Sanmartin M, Pereda DC, Rincon LM, Gonzalez P, Casado T, Sadeghipour P, Lopez-Sendon JL, Manjavacas AMI, Marin LAM, Sotelo LR, Rodriguez SOR, Bueno H, Martin R, Maruri R, Moreno G, Moris C, Gudmundsdottir I, Avanzas P, Ayesta A, Junco-Vicente A, Cubero-Gallego H, Pascual I, Sola NB, Rodriguez OA, Malagon L, Martinez-Basterra J, Arizcuren AM, Indolfi C, Romero J, Calleja AG, Fuertes DG, Crespín Crespín M, Bernal FJC, Ojeda FB, Padron AL, Cabeza MM, Vargas CM, Yanes G, Kitai T, Gonzalez MJG, Gonzalez Gonzalez J, Jorge P, De La Fuente B, Bermúdez MG, Perez-Lopez CMB, Basiero AB, Ruiz AC, Pamias RF, Chamero PS, Mirrakhimov E, Hidalgo-Urbano R, Garcia-Rubira JC, Seoane-Garcia T, Arroyo-Monino DF, Ruiz AB, Sanz-Girgas E, Bonet G, Rodríguez-López J, Scardino C, 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Potpara T, Marinkovic M, Mihajlovic M, Mujovic N, Kocijancic A, Mijatovic Z, Radovanovic M, Matic D, Milosevic A, Savic L, Subotic I, Uscumlic A, Zlatic N, Antonijevic J, Vesic O, Vucic R, Martinovic SS, Kostic T, Atanaskovic V, Mitic V, Stanojevic D, Petrovic M. Cohort profile: the ESC EURObservational Research Programme Non-ST-segment elevation myocardial infraction (NSTEMI) Registry. Eur Heart J Qual Care Clin Outcomes 2022; 9:8-15. [PMID: 36259751 DOI: 10.1093/ehjqcco/qcac067] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Accepted: 10/11/2022] [Indexed: 11/12/2022]
Abstract
AIMS The European Society of Cardiology (ESC) EURObservational Research Programme (EORP) Non-ST-segment elevation myocardial infarction (NSTEMI) Registry aims to identify international patterns in NSTEMI management in clinical practice and outcomes against the 2015 ESC Guidelines for the management of acute coronary syndromes in patients presenting without ST-segment-elevation. METHODS AND RESULTS Consecutively hospitalised adult NSTEMI patients (n = 3620) were enrolled between 11 March 2019 and 6 March 2021, and individual patient data prospectively collected at 287 centres in 59 participating countries during a two-week enrolment period per centre. The registry collected data relating to baseline characteristics, major outcomes (in-hospital death, acute heart failure, cardiogenic shock, bleeding, stroke/transient ischaemic attack, and 30-day mortality) and guideline-recommended NSTEMI care interventions: electrocardiogram pre- or in-hospital, pre-hospitalization receipt of aspirin, echocardiography, coronary angiography, referral to cardiac rehabilitation, smoking cessation advice, dietary advice, and prescription on discharge of aspirin, P2Y12 inhibition, angiotensin converting enzyme inhibitor (ACEi)/angiotensin receptor blocker (ARB), beta-blocker, and statin. CONCLUSION The EORP NSTEMI Registry is an international, prospective registry of care and outcomes of patients treated for NSTEMI, which will provide unique insights into the contemporary management of hospitalised NSTEMI patients, compliance with ESC 2015 NSTEMI Guidelines, and identify potential barriers to optimal management of this common clinical presentation associated with significant morbidity and mortality.
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Affiliation(s)
- Ramesh Nadarajah
- Leeds Institute for Cardiovascular and Metabolic Medicine, University of Leeds, LS2 9JT Leeds, UK.,Leeds Institute of Data Analytics, University of Leeds, LS2 9JT Leeds, UK.,Department of Cardiology, Leeds Teaching Hospitals NHS Trust, LS1 3EX Leeds, UK
| | - Peter Ludman
- Institute of Cardiovascular Sciences, University of Birmingham, Birmingham, UK
| | - Yolande Appelman
- Department of Cardiology, Amsterdam UMC-Vrije Universiteit, Amsterdam Cardiovascular Sciences, Amsterdam, Netherlands
| | - Salvatore Brugaletta
- Hospital Clinic de Barcelona, Barcelona, Spain.,Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain
| | - Andrzej Budaj
- Department of Cardiology, Center of Postgraduate Medical Education, Grochowski Hospital, Warsaw, Poland
| | - Hector Bueno
- Cardiology Department, Hospital Universitario 12 de Octubre and Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Madrid, Spain.,Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain.,Facultad de Medicina, Universidad Complutense de Madrid, Madrid, Spain
| | - Kurt Huber
- 3rd Medical Department, Cardiology and Intensive Care Medicine, Clinic Ottakring (Wilhelminenhospital), Vienna, Austria.,Medical Faculty, Sigmund Freud University, Vienna, Austria
| | - Vijay Kunadian
- Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK.,Cardiothoracic Centre, Freeman Hospital, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Sergio Leonardi
- University of Pavia, Pavia, Italy.,Fondazione IRCCS Policlinico S.Matteo, Pavia, Italy
| | - Maddalena Lettino
- Cardio-Thoracic and Vascular Department, San Gerardo Hospital, ASST-Monza, Monza, Italy
| | - Dejan Milasinovic
- Department of Cardiology, University Clinical Center of Serbia and Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Chris P Gale
- Leeds Institute for Cardiovascular and Metabolic Medicine, University of Leeds, LS2 9JT Leeds, UK.,Leeds Institute of Data Analytics, University of Leeds, LS2 9JT Leeds, UK.,Department of Cardiology, Leeds Teaching Hospitals NHS Trust, LS1 3EX Leeds, UK
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| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | 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8
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Voolstra CR, Valenzuela JJ, Turkarslan S, Cárdenas A, Hume BCC, Perna G, Buitrago-López C, Rowe K, Orellana MV, Baliga NS, Paranjape S, Banc-Prandi G, Bellworthy J, Fine M, Frias-Torres S, Barshis DJ. Contrasting heat stress response patterns of coral holobionts across the Red Sea suggest distinct mechanisms of thermal tolerance. Mol Ecol 2021; 30:4466-4480. [PMID: 34342082 DOI: 10.1111/mec.16064] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 06/04/2021] [Accepted: 06/30/2021] [Indexed: 12/18/2022]
Abstract
Corals from the northern Red Sea, in particular the Gulf of Aqaba (GoA), have exceptionally high bleaching thresholds approaching >5℃ above their maximum monthly mean (MMM) temperatures. These elevated thresholds are thought to be due to historical selection, as corals passed through the warmer Southern Red Sea during recolonization from the Arabian Sea. To test this hypothesis, we determined thermal tolerance thresholds of GoA versus central Red Sea (CRS) Stylophora pistillata corals using multi-temperature acute thermal stress assays to determine thermal thresholds. Relative thermal thresholds of GoA and CRS corals were indeed similar and exceptionally high (~7℃ above MMM). However, absolute thermal thresholds of CRS corals were on average 3℃ above those of GoA corals. To explore the molecular underpinnings, we determined gene expression and microbiome response of the coral holobiont. Transcriptomic responses differed markedly, with a strong response to the thermal stress in GoA corals and their symbiotic algae versus a remarkably muted response in CRS colonies. Concomitant to this, coral and algal genes showed temperature-induced expression in GoA corals, while exhibiting fixed high expression (front-loading) in CRS corals. Bacterial community composition of GoA corals changed dramatically under heat stress, whereas CRS corals displayed stable assemblages. We interpret the response of GoA corals as that of a resilient population approaching a tipping point in contrast to a pattern of consistently elevated thermal resistance in CRS corals that cannot further attune. Such response differences suggest distinct thermal tolerance mechanisms that may affect the response of coral populations to ocean warming.
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Affiliation(s)
| | | | | | - Anny Cárdenas
- Department of Biology, University of Konstanz, Konstanz, Germany
| | | | - Gabriela Perna
- Department of Biology, University of Konstanz, Konstanz, Germany
| | | | - Katherine Rowe
- School of Science, The University of Waikato, Hamilton, New Zealand
| | - Monica V Orellana
- Institute for Systems Biology, Seattle, USA.,Polar Science Center, University of Washington, Seattle, USA
| | - Nitin S Baliga
- Institute for Systems Biology, Seattle, USA.,Departments of Biology and Microbiology, University of Washington, Seattle, USA.,Molecular and Cellular Biology Program, University of Washington, Seattle, USA.,Lawrence Berkeley National Laboratory, Berkeley, USA
| | | | - Guilhem Banc-Prandi
- The Interuniversity Institute for Marine Sciences (IUI), Eilat, Israel.,The Goodman Faculty of Life Sciences, Bar Ilan University, Ramat-Gan, Israel
| | - Jessica Bellworthy
- The Interuniversity Institute for Marine Sciences (IUI), Eilat, Israel.,The Goodman Faculty of Life Sciences, Bar Ilan University, Ramat-Gan, Israel
| | - Maoz Fine
- The Interuniversity Institute for Marine Sciences (IUI), Eilat, Israel.,The Goodman Faculty of Life Sciences, Bar Ilan University, Ramat-Gan, Israel
| | | | - Daniel J Barshis
- Department of Biological Sciences, Old Dominion University, Norfolk, USA
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9
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Cober N, Deng Y, Rowe K, Stewart D. Microencapsulation of small extracellular vesicles with nanoporous biomaterials results in a sustained-release preparation to enhance targeting and persistence after intravascular delivery. Cytotherapy 2020. [DOI: 10.1016/j.jcyt.2020.03.056] [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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10
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Rowe K. Paediatric patients with myalgic encephalomyelitis/chronic fatigue syndrome value understanding and help to move on with their lives. Acta Paediatr 2020; 109:790-800. [PMID: 31854020 PMCID: PMC7154625 DOI: 10.1111/apa.15054] [Citation(s) in RCA: 8] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2019] [Revised: 09/27/2019] [Accepted: 10/08/2019] [Indexed: 12/29/2022]
Abstract
AIM The aim of this study was to document qualitative questionnaire feedback regarding management from a cohort observational study of young people with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). METHODS Between 1991 and 2009, 784 paediatric patients, age 6-18 years, were diagnosed with ME/CFS following referral to a specialised clinic at the Royal Children's Hospital, Melbourne. Over a 14-year period, feedback was requested on up to seven occasions. Management included the following: symptom management and a self-management lifestyle plan that included social, educational, physical and a pleasurable activity outside of home. They adjusted it by severity of illness, stage of education, family circumstances and life interests. RESULTS Questionnaires were returned from 626 (80%) with 44% providing feedback more than once. They reported that their management plan allowed them to regain control over their lives. They cited early diagnosis, empathetic, informed physicians, self-management strategies and educational liaison as helping them to function and remain socially engaged. Ongoing support, particularly assistance to navigate the education system, was essential for general well-being and ability to cope. CONCLUSION Young people valued regaining the control over their lives that was lost through illness, support to maintain social contacts and assistance to achieve educational and/or life goals.
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Affiliation(s)
- Katherine Rowe
- Royal Children’s Hospital Murdoch Children’s Research Institute Melbourne Vic. Australia
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11
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Kubba H, Rowe K, Pinczower G, Sloane R, Waterham M, Weiss E, Harwood R. Our experience of a paediatrician‐led clinic for the medical management of children with obstructive sleep‐disordered breathing. Clin Otolaryngol 2019; 45:190-196. [DOI: 10.1111/coa.13479] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Revised: 10/08/2019] [Accepted: 11/09/2019] [Indexed: 11/30/2022]
Affiliation(s)
- Haytham Kubba
- Department of Otolaryngology Royal Children's Hospital Parkville Vic. Australia
| | - Katherine Rowe
- Department of General Paediatrics Royal Children's Hospital Parkville Vic. Australia
| | - Gideon Pinczower
- Department of General Paediatrics Royal Children's Hospital Parkville Vic. Australia
| | - Robert Sloane
- Department of General Paediatrics Royal Children's Hospital Parkville Vic. Australia
| | - Michelle Waterham
- Department of General Paediatrics Royal Children's Hospital Parkville Vic. Australia
| | - Emma Weiss
- Department of General Paediatrics Royal Children's Hospital Parkville Vic. Australia
| | - Rachel Harwood
- Department of General Paediatrics Royal Children's Hospital Parkville Vic. Australia
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12
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Florian M, Rowe K, Mei S. A novel flow cytometry-based method to characterize transfection efficiency in genetically engineered mesenchymal stem cells. Cytotherapy 2019. [DOI: 10.1016/j.jcyt.2019.04.041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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13
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Soh HJ, Rowe K, Davey MJ, Horne RSC, Nixon GM. The OSA-5: Development and validation of a brief questionnaire screening tool for obstructive sleep apnea in children. Int J Pediatr Otorhinolaryngol 2018; 113:62-66. [PMID: 30174012 DOI: 10.1016/j.ijporl.2018.07.029] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [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: 05/31/2018] [Accepted: 07/17/2018] [Indexed: 10/28/2022]
Abstract
OBJECTIVE To develop and test a screening tool based on the OSA-18 questionnaire for triage of referrals for sleep-disordered breathing (SDB) in children. STUDY DESIGN Consecutive children aged >2y without major comorbidities referred for polysomnography (PSG) or overnight oximetry for suspected obstructive sleep apnea (OSA) between 11 January and 31 May 2017 were included. OSA was defined by an obstructive apnea/hypopnea index (OAHI) >1event/h on PSG or an abnormal overnight oximetry (McGill Oximetry Score 2-4). An 11-item questionnaire derived from a previous validation study of the OSA-18 underwent exploratory factor analysis (EFA) with varimax rotation. ANOVA identified questions associated with the presence of OSA. This informed a 5-question, 4-category instrument, scored 0-15 (the OSA-5), that was tested prospectively on 112 children having PSG. RESULTS 420 children (2.0-17.9y, 43% female) met the inclusion criteria, including 366 complete questionnaires. EFA resulted in a 3-factor structure. ANOVA identified 5 questions from one factor that were independently associated with a diagnosis of OSA: snoring, breath holding, choking, mouth breathing and parental concern. Mean OSA-5 scores with and without OSA were 7.7 vs 4.5 (p < 0.001). Thirty-four percent (60/178) had a total score <5/15, with a sensitivity at this threshold for OSA of 82% and negative predictive value (NPV) of 70%. Similar results were obtained when tested prospectively, including a sensitivity of 82% and NPV of 81% for the presence of moderate/severe OSA (OAHI>5/h). CONCLUSION The OSA-5 is a simple questionnaire that performs well as a triage screening tool to identify those children at risk of OSA among large numbers of referrals for SDB.
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Affiliation(s)
- Han Jie Soh
- The Ritchie Centre, Department of Paediatrics, Monash University and Hudson Institute of Medical Research, Melbourne, Australia
| | - Katherine Rowe
- Department of General Medicine, Royal Children's Hospital, Melbourne, Australia
| | - Margot J Davey
- The Ritchie Centre, Department of Paediatrics, Monash University and Hudson Institute of Medical Research, Melbourne, Australia; Melbourne Children's Sleep Centre, Monash Children's Hospital, Melbourne, Australia
| | - Rosemary S C Horne
- The Ritchie Centre, Department of Paediatrics, Monash University and Hudson Institute of Medical Research, Melbourne, Australia
| | - Gillian M Nixon
- The Ritchie Centre, Department of Paediatrics, Monash University and Hudson Institute of Medical Research, Melbourne, Australia; Melbourne Children's Sleep Centre, Monash Children's Hospital, Melbourne, Australia.
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14
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Cober N, Chaudhary K, Deng Y, Lee C, Rowe K, Benavente A, Godin M, Courtman D, Stewart D. ENDOTHELIAL PROGENITOR CELLS ENCAPSULATED IN MATRIX-SUPPLEMENTED MICROGEL IMPROVES CELL RETENTION AND THERAPEUTIC EFFICACY IN PULMONARY ARTERIAL HYPERTENSION. Can J Cardiol 2018. [DOI: 10.1016/j.cjca.2018.07.201] [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: 10/28/2022] Open
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15
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Farashahi S, Rowe K, Aslami Z, Gobbini MI, Soltani A. Influence of learning strategy on response time during complex value-based learning and choice. PLoS One 2018; 13:e0197263. [PMID: 29787566 PMCID: PMC5963802 DOI: 10.1371/journal.pone.0197263] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2017] [Accepted: 04/30/2018] [Indexed: 11/18/2022] Open
Abstract
Measurements of response time (RT) have long been used to infer neural processes underlying various cognitive functions such as working memory, attention, and decision making. However, it is currently unknown if RT is also informative about various stages of value-based choice, particularly how reward values are constructed. To investigate these questions, we analyzed the pattern of RT during a set of multi-dimensional learning and decision-making tasks that can prompt subjects to adopt different learning strategies. In our experiments, subjects could use reward feedback to directly learn reward values associated with possible choice options (object-based learning). Alternatively, they could learn reward values of options' features (e.g. color, shape) and combine these values to estimate reward values for individual options (feature-based learning). We found that RT was slower when the difference between subjects' estimates of reward probabilities for the two alternative objects on a given trial was smaller. Moreover, RT was overall faster when the preceding trial was rewarded or when the previously selected object was present. These effects, however, were mediated by an interaction between these factors such that subjects were faster when the previously selected object was present rather than absent but only after unrewarded trials. Finally, RT reflected the learning strategy (i.e. object-based or feature-based approach) adopted by the subject on a trial-by-trial basis, indicating an overall faster construction of reward value and/or value comparison during object-based learning. Altogether, these results demonstrate that the pattern of RT can be informative about how reward values are learned and constructed during complex value-based learning and decision making.
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Affiliation(s)
- Shiva Farashahi
- Department of Psychological and Brain Sciences, Dartmouth College, Hanover, NH, United States of America
| | - Katherine Rowe
- Department of Psychological and Brain Sciences, Dartmouth College, Hanover, NH, United States of America
| | - Zohra Aslami
- Department of Psychological and Brain Sciences, Dartmouth College, Hanover, NH, United States of America
| | - Maria Ida Gobbini
- Department of Psychological and Brain Sciences, Dartmouth College, Hanover, NH, United States of America
- Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale (DIMES), Medical School, University of Bologna, Bologna, Italy
| | - Alireza Soltani
- Department of Psychological and Brain Sciences, Dartmouth College, Hanover, NH, United States of America
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16
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Cober N, Chaudhary K, Deng Y, Lee C, Rowe K, Benavente A, Godin M, Courtman D, Stewart D. Single-cell matrix-supplemented hydrogel cocooning of endothelial progenitor cells improves retention and therapeutic efficacy in pulmonary arterial hypertension. Cytotherapy 2018. [DOI: 10.1016/j.jcyt.2018.02.335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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17
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Lester J, Rees T, Parry D, Davies H, Rowe K, Everson R, Dickinson M, Butler R, Jewitt K. 29: The NHS Wales–Novartis joint working project on lung cancer. Lung Cancer 2017. [DOI: 10.1016/s0169-5002(17)30079-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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18
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Knight SJ, Harvey A, Hennel S, Lubitz L, Rowe K, Reveley C, Dean N, Clarke C, Scheinberg A. Measuring quality of life and fatigue in adolescents with chronic fatigue syndrome: estimates of feasibility, internal consistency and parent–adolescent agreement of the PedsQLTM. Fatigue: Biomedicine, Health & Behavior 2015. [DOI: 10.1080/21641846.2015.1090816] [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] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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19
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Abernethy AP, Herndon JE, Coan A, Staley T, Wheeler JL, Rowe K, Smith SK, Shaw H, Lyerly HK. Erratum: Phase 2 pilot study of Pathfinders: a psychosocial intervention for cancer patients. Support Care Cancer 2011. [DOI: 10.1007/s00520-010-1076-6] [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: 10/18/2022]
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20
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Rowe K, Fletcher SJ. The emergency management of the patient presenting with shock. Acute Med 2011; 10:103-105. [PMID: 22041615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
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21
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Rowe K, Fletcher SJ. Critical care outreach: a review of current practice and evidence. Acute Med 2010; 9:8-12. [PMID: 21597560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Critical Care Outreach teams have been developed in most acute hospitals within the UK. This article aims to summarise the evidence behind the development of this service and some of the outcomes which have been demonstrated to-date.
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Affiliation(s)
- Katherine Rowe
- MBCHB MRCP FRCA Specialist Registrar in Anaesthesia and Intensive Care Medicine, Broomfield Hospital, Chelmsford, Essex, CM1 7ET
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22
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Lyerly HK, Staley T, Herndon JE, Coan A, Wheeler JL, Rowe K, Horne B, Abernethy AP. Impact of a psychosocial intervention on performance status and coping. J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.9611] [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
9611 Background: Psychosocial distress is a critical cancer comorbidity; new interventions are needed. Pathfinders, a manualized psychosocial care program, provides patient navigation, counseling, coping skills training, mind/body techniques, and lifestyle advice. Methods: This prospective, single-arm, pilot study enrolled adult metastatic breast cancer patients with prognosis ≥6 months. Consenting participants met with a Pathfinder (trained social worker) at least monthly, with interim phone/email contact. Pathfinders worked with patients to identify inner strengths, teach coping skills, engage complementary/alternative providers, employ mind/body techniques, and support healthy lifestyle. At baseline, month 3 and month 6, patients completed surveys including Patient Care Monitor (PCM; a review of systems with 6 subscales and a global quality of life [QOL] score), and Functional Assessment of Chronic Illness Therapy - Fatigue subscale (FACIT-F). Results: Participants (n=50) were: mean age 51.2 years (SD 11.5); 24% non-white; 74% married; 50% did not complete college; the cohort had advanced cancer and short prognosis with 6-month attrition from death, 18%. Scores on the PCM Distress subscale improved from baseline to 3 months with a mean change of -3.42 (n=36; p=0.008) and from baseline to 6 months of -4.11 (n=28; p=0.002). PCM Despair subscale scores also improved: mean change of -4.53 (p=0.006) and -6.93 (p=0.016), respectively. PCM QOL and FACIT-F scores improved from baseline to 3 months; however, the change at 6 months, with smaller sample, was not statistically significant. Mean change in QOL from baseline to 3 and 6 months was 2.88 (n=30; p=0.006) and 2.66 (n=25; p=0.079), respectively. Mean change in FACIT-F from baseline to 3 and 6 months was 2.91 (n=39; p=0.020) and 1.29 (n=32; p=0.407), respectively. Conclusions: Pathfinders had significant positive effect on key psychosocial and QOL outcomes, notably distress and despair, for cancer patients despite advanced disease and worsening symptoms. No significant financial relationships to disclose.
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Affiliation(s)
| | - T. Staley
- Duke University Medical Center, Durham, NC
| | | | - A. Coan
- Duke University Medical Center, Durham, NC
| | | | - K. Rowe
- Duke University Medical Center, Durham, NC
| | - B. Horne
- Duke University Medical Center, Durham, NC
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Abernethy AP, Zafar SY, Coeytaux R, Rowe K, Wheeler JL, Lyerly HK. Electronic patient-reported data capture as the foundation of a learning health care system. J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.6522] [Citation(s) in RCA: 4] [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] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
6522 Background: In a “learning healthcare system” clinical decisions are supported by accurate information delivered at point of care; information gathered today iteratively informs future care and research. Methods: Customized software on wireless tablet personal computers presented a review of systems (ROS) instrument, validated research surveys (e.g., quality of life [QOL]), and a satisfaction survey, tailored by user. The system was piloted in the Duke Cancer Clinics and affiliated hospitals. We previously demonstrated equivalence of electronic and paper survey data. We conducted a series of studies using similar procedures to evaluate feasibility, acceptability, and utility. Results: First, we assessed the ability to collect ROS data at point of care to inform the clinic visit for participating breast (n = 65), gastrointestinal (n = 113), and lung (n = 97) cancer patients. Duke physicians reported that the system's clinical reports informed care and increased dictation efficiency. Second, we assessed patient satisfaction in the breast cancer cohort. Participants found the computers easy to read (94%), navigate (99%), and use (98%); the system helped 74% remember forgotten concerns to report to their clinician. Third, we assessed whether these data could contribute to current research. If the patient was on another clinical trial, PRO data (e.g., pain, QOL) were delivered to the investigator for research purposes in real time; data governance rules provided assurance to investigators. Fourth, we identified whether the PRO data could inform future research directions. Symptoms monitored longitudinally in aggregate uncovered unmet needs. Sexual distress was an underserved concern; intervention studies were initiated. Warehoused PRO data were integrated with clinical trials, genomic, biomarker, radiology, and administrative datasets for analyses. The approach has been scaled to 4 clinics and 3 hospitals. Conclusions: An integrated, real-time, electronic data capture system that interdigitates PROs with clinical and other data allows creation of a learning oncology environment that continuously improves care and research. Advantages include: patient-centeredness, description of the PRO phenotype, interoperability, and interface with caBIG infrastructure. No significant financial relationships to disclose.
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Affiliation(s)
| | | | | | - K. Rowe
- Duke University Medical Center, Durham, NC
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Abernethy AP, Zafar Y, Marcello J, Wheeler J, Rowe K, Morse MA, Herndon JE. Treatment-related toxicity and supportive care in metastatic colorectal cancer (mCRC). J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.15087] [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: 11/20/2022] Open
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25
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Herndon JE, Zafar Y, Marcello J, Wheeler J, Rowe K, Morse MA, Abernethy AP. Longitudinal patterns of chemotherapy (CT) use in metastatic colorectal cancer (mCRC). J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.15082] [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: 11/20/2022] Open
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27
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Zafar Y, Abernethy AP, Abbott DH, Herndon JE, Rowe K, Kolimaga J, Conner L, Patwardhan M, Grambow S, Provenzale D. Comorbidity, age and stage at diagnosis in colorectal cancer (CRC). J Clin Oncol 2007. [DOI: 10.1200/jco.2007.25.18_suppl.6554] [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
6554 Background: Stage at diagnosis is a crucial predictor of outcome in CRC. The purpose of this study is to determine if comorbidity and age affect the stage at which CRC is diagnosed. Identifying variables that influence stage might improve outcomes in CRC. Due to frequent contact with the health care system, we hypothesize that patients with greater comorbidity and older age are more likely to be diagnosed with early-stage disease. Methods: We present data from two distinct patient populations: using the Cancer Care Outcomes Research and Surveillance Consortium (CanCORS) database, we identified CRC patients treated at 15 Veterans Administration (VA) hospitals from 2003-present. We also identified CRC patients treated from 2003-present at 10 non-VA, fee-for-service (FFS) practices in North and South Carolina. Data were abstracted by retrospective chart review. Comorbidity was calculated by the Charlson comorbidity index (CCI) with high comorbidity defined as CCI =3. Older age was defined as age =70 years. Data were analyzed using logistic regression where the odds of late stage at diagnosis were modeled as influenced by older age, high CCI, and race. The analysis included estimation of adjusted and unadjusted odds ratios. Results: 347 VA and 282 FFS patients were included. 98% VA vs 50% FFS were male; 43% VA vs 27% FFS were aged =70; 56% VA vs 70% FFS were white; 26% VA vs 44% FFS presented with metastatic CRC; and 21% VA vs 6% FFS had a CCI =3. In both patient populations, regression analysis showed that older age, high CCI and white race were not significant predictors of stage at diagnosis. VA 95% confidence intervals (CI's) were 0.52–1.41 (age =70), 0.50–1.75 (CCI =3), and 0.42–1.11 (white race). FFS 95% CI's were 0.52–1.53 (age =70), 0.36–2.78 (CCI =3), and 0.74–2.11 (white race). Broader 95% CI's in the FFS analysis were due to smaller sample size. Conclusions: In CRC patients, age and comorbidity were not related to stage at diagnosis. The findings are similar whether the patients were treated in a fee-for-service or VA health system. While older age and greater illness might provide more contact with the health care system, this exposure did not result in earlier diagnosis of CRC. Future studies will examine the impact of comorbidity on CRC treatment and survival. No significant financial relationships to disclose.
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Affiliation(s)
- Y. Zafar
- Duke University Medical Center, Durham, NC; Durham Veterans Administration Medical Center, Durham, NC
| | - A. P. Abernethy
- Duke University Medical Center, Durham, NC; Durham Veterans Administration Medical Center, Durham, NC
| | - D. H. Abbott
- Duke University Medical Center, Durham, NC; Durham Veterans Administration Medical Center, Durham, NC
| | - J. E. Herndon
- Duke University Medical Center, Durham, NC; Durham Veterans Administration Medical Center, Durham, NC
| | - K. Rowe
- Duke University Medical Center, Durham, NC; Durham Veterans Administration Medical Center, Durham, NC
| | - J. Kolimaga
- Duke University Medical Center, Durham, NC; Durham Veterans Administration Medical Center, Durham, NC
| | - L. Conner
- Duke University Medical Center, Durham, NC; Durham Veterans Administration Medical Center, Durham, NC
| | - M. Patwardhan
- Duke University Medical Center, Durham, NC; Durham Veterans Administration Medical Center, Durham, NC
| | - S. Grambow
- Duke University Medical Center, Durham, NC; Durham Veterans Administration Medical Center, Durham, NC
| | - D. Provenzale
- Duke University Medical Center, Durham, NC; Durham Veterans Administration Medical Center, Durham, NC
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Rowe K, Patwardhan M, Herndon JE, Martin MG, Zafar Y, Morse M, Abernethy AP. Choice of adjuvant and first-line metastatic chemotherapy (CT) for colorectal cancer (CRC) treated in the Carolinas. J Clin Oncol 2007. [DOI: 10.1200/jco.2007.25.18_suppl.17039] [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
17039 Background: CT choice is influenced by many factors including published evidence, guidelines, cost, reimbursement, patient considerations, key opinion leaders, and anecdote. Substantial locoregional variation in practice patterns can exist, and therefore studies of locoregional practice provide important information on local drivers of care. Methods: Using a population-based strategy, we identified CRC patients who developed metastatic disease since 6/1/03 from 9 Duke Oncology Network community practices and 1 academic practice in North and South Carolina. Demographic, comorbidity, diagnostic, stage, initial treatment, and metastatic treatment data were abstracted by retrospective chart review, double-entered and verified for accuracy. Results: Of the first 743 charts screened, 306 were eligible (mean age 61 (SD 13), 49% male; 65% white; 22% black; 77% colon cancer and 19% rectal; stages II 8%, III 16%, IV 64%). 26 earlier stage rectal cancer patients received neoadjuvant treatment, 50% infusional fluorouracil (5FU) and 42% capecitabine (Cap). 46 colon cancer patients received adjuvant CT, including 5FU/leucovorin (LVN; 54%), 5FU/LVN/oxaliplatin (21%), Cap (9%), and 5FU/LVN/irinotecan (7%). First-line CT for metastatic colon cancer (n=149) included FOLFOX+-bevacizumab (Bev; 42%), Cap/oxaliplatin +- Bev (23%), 5FU/LVN + Bev (9%), FOLFIRI +- Bev (7%), IFL +- Bev (7%), clinical trial (7%), Cap (3%), and unknown (1%). 54% of patients received Bev overall, reflecting 49% usage before 6/05 and 69% after 6/05. CT was not offered for 25 (8%) at initial diagnosis. Conclusion: Locoregional practice patterns in the Carolinas suggest that for adjuvant treatment of CRC, oxaliplatin has been used in 21% of adjuvant and 75% of first-line metastatic colon CT regimens, and that bevacizumab use has increased to 69% of first-line metastatic CRC patients. No significant financial relationships to disclose.
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Affiliation(s)
- K. Rowe
- Duke University Medical Center, Durham, NC
| | | | | | | | - Y. Zafar
- Duke University Medical Center, Durham, NC
| | - M. Morse
- Duke University Medical Center, Durham, NC
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Abstract
OBJECTIVE To measure the cervical and breast screening coverage of south Asian women in Wakefield, compared with other city residents. DESIGN Pairwise measurement of screening histories of women whose names appeared to be south Asian, and of non-Asian women matched by date of birth and general practice. DATA SOURCE Computerised records of screening histories held by West Yorkshire Central Services Agency, for the eight general practices in central Wakefield. RESULTS 67% of south Asians and 75% of non-Asians had acceptable (not overdue) cervical screening histories (chi(2)=13.75, p<0.001). 53% of south Asians and 78% of non-Asians had acceptable breast screening histories (chi(2)=8.5, p<0.01) CONCLUSION Interventions should be designed to improve coverage for breast screening among south Asian women. The need for such interventions for cervical screening is equivocal.
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Affiliation(s)
- G C Sutton
- Nuffield Institute for Health, 71-5 Clarendon Rd, Leeds LS2 9PL, UK.
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30
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Abstract
With the introduction of the Patient's Charter, greater emphasis has been placed on 'named nursing' (Department of Health 1991). While there is much literature extolling the benefits of this method of delivering care to patients (Reed 1988; Manley 1989; Macguire 1991); there is a dearth of empirical studies exploring primary nursing in an adult intensive care unit (ICU). In addition, little is known about how nurses feel about being a 'primary nurse'. The aim of this study was to determine qualified nurses' perceptions and experiences of the effect of primary nursing on patient care in an intensive care environment (ICU) and to explore nurses' experiences of being a primary nurse. This study was carried out in an ICU in Northern Ireland. Primary team nursing was the system of organizing care within this unit. This system consisted of teams of 'primary' and 'associate' nurses. A total of 65 qualified nurses were surveyed. Sixteen nurses took part in focus group interviews. A combined methods approach comprising a questionnaire and focus group interviews was employed for the study. Part one of the questionnaire provided data on professional and demographic details. Part two facilitated nurses to elaborate on their feelings and perceptions of the concept of primary nursing. The focus groups facilitated in-depth exploration of the respondents' personal feelings and experiences about their role as a primary nurse. The data obtained from the two-part questionnaire were analysed using descriptive statistic and content analysis. The data obtained from the focus groups were analysed using content analysis and the development of emerging themes. Analysis of the data revealed that the nurses' views were similar to those highlighted in the existing literature. Nurses perceived primary nursing to relate to the responsibility for the care of one patient, from admission to discharge with the primary nurse assessing, planning, implementing and evaluating care and the associate nurse assisting in the delivery of this care. Thus, continuity of care was seen as the major advantage of primary nursing. The findings, however, suggested that further teaching on the concept of primary nursing was required. In addition, many of the nurses admitted they experienced considerable stress, particularly in relation to their close proximity over a long period of time, with patients and their relatives. This is an important finding and highlights the need for primary nurses in ICU to have the opportunity (in some instances), to be relieved of their responsibility for a named patient, thereby reducing some of the potential for stress. It is acknowledged that the findings of this study may not be generalized beyond the identified sample. Further empirical studies exploring nurses' perceptions and experiences of primary nursing in an ICU are therefore needed.
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Affiliation(s)
- D Goode
- Regional Intensive Care Unit, Royal Hospitals Trust, Belfast, Northern Ireland
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31
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Abstract
Hyperbaric oxygen therapy can be used for a variety of indications, ranging from decompression sickness to thermal burns. This article explains why it may improve healing in diabetic foot ulcers.
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Affiliation(s)
- K Rowe
- Epping Forest Primary Care Trust, Epping, UK
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32
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Moreno R, Waxman S, Rowe K, Verrier RL. Intrapericardial beta-adrenergic blockade with esmolol exerts a potent antitachycardic effect without depressing contractility. J Cardiovasc Pharmacol 2000; 36:722-7. [PMID: 11117371 DOI: 10.1097/00005344-200012000-00006] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Hyperadrenergic states of various etiologies can contribute to tachycardias. Systemic beta-adrenergic blockade suppresses sinus tachycardia but may adversely affect arterial blood pressure and contractility, because the drug gains access to myocardial cells as well as to the sinoatrial node. We examined whether intrapericardial beta-adrenergic blockade with esmolol could suppress tachycardia without reducing contractility as a result of limited drug diffusion, which would be sufficient to penetrate the superficial sinoatrial node but not the deeper myocardial layers. In five anesthetized pigs, we provoked a reflex heart rate increase of 50 beats/min with hemorrhage. The rapidly acting beta-adrenergic blocking agent esmolol (1 mg/kg) was administered intrapericardially using a new percutaneous transatrial access method and a catheter system that can be rapidly and safely introduced. Esmolol equivalently suppressed hemorrhage-induced sinus tachycardia when administered intrapericardially (from 192 to 158 beats/min at 5 min, p < 0.05) or intravenously (from 177 to 151 beats/min at 1 min, p < 0.05). The antitachycardic effect of intrapericardial esmolol was prolonged compared with intravenous esmolol (10 min vs. 3 min, p < 0.05). Intrapericardial esmolol did not affect blood pressure or left ventricular dP/dt max, an index of contractility, whereas intravenous esmolol decreased blood pressure at 1 min for 2 min (p < 0.05) and simultaneously decreased left ventricular dP/dt max at 1 min for < 2 min (p < 0.05). Intrapericardial esmolol suppresses adrenergically induced sinus tachycardia without decreasing contractility or blood pressure. The transatrial approach for intrapericardial delivery of certain 1-adrenergic blocking agents could be employed to control tachycardias in emergency care and surgical settings in patients with impaired cardiac contractility and propensity to hypotension.
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Affiliation(s)
- R Moreno
- Harvard Medical School, Boston, Massachusetts 02215, USA
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33
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Abstract
Over the years there has been an ongoing debate about the implications of the smoking behaviour of nurses in relation to their own health and in the context of their professional role and responsibilities. However it is difficult to determine with any degree of accuracy the current incidence of smoking amongst nurses and most of the available research is based on small samples which embrace nurses of different levels and status. Very few recent studies in the United Kingdom or elsewhere have focused on this issue. A confused picture therefore emerges. This paper presents a critical overview of the literature and where appropriate provides data about the incidence of smoking in comparable groups of the general population.
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Affiliation(s)
- K Rowe
- Lecturer, The School of Nursing and Midwifery, The Queen's University of Belfast, Northern Ireland
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34
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Abstract
The smoking behaviour of nurses has been widely debated in the context of their professional role and responsibilities. There has been much speculation about why nurses smoke and possible explanations include a stressful nursing environment, peer pressure and socio economic status and education. This paper provides an overview of the literature which offers insights into the reasons why nurses smoke and compares the findings from this literature with those studies examining the smoking behaviour of women in general and young women in particular. This review reveals that many students take up smoking before commencing their training and the factors which influence nurses smoking are similar to those that influence similar groups of females in the general population.
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Affiliation(s)
- K Rowe
- The School of Nursing and Midwifery, The Queen's University of Belfast, University Road, Belfast, Northern Ireland, UK
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35
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Bansal A, Hughes DC, Farnham JM, Bagi CM, O'Neil G, Rowe K, Shakib JH, Wood GC, Wyckoff JA, Cannon-Albright LA. Impact of correlated factors on bone density in individuals with a family history of osteoporosis. J Clin Densitom 2000; 3:333-8. [PMID: 11175913 DOI: 10.1385/jcd:3:4:333] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2000] [Revised: 08/07/2000] [Accepted: 08/11/2000] [Indexed: 11/11/2022]
Abstract
Previous studies have suggested that 14-47% of the variation in bone mineral density (BMD) can be predicted using clinical risk factors. The aim of our study was to determine, for the first time, the importance of these factors in individuals with evidence of a genetic predisposition to the disease. The subjects studied were 147 female and 86 male Caucasians, all with a family history of osteoporosis. Linear regression was used to determine whether age, height, weight, and years of reduced estrogen exposure were significant predictors of BMD. Males and females were examined separately, and BMD was measured at the hip and spine. The results show that these risk factors, known to be at work in the general population, are equally important in those with a family history of osteoporosis. It is clear, therefore, that they must be taken into account, and corrected for in genetic studies of the disease.
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Affiliation(s)
- A Bansal
- Department of Medical Informatics, University of Utah, USA.
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36
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Rowe K, Moreno R, Lau TR, Wallooppillai U, Nearing BD, Kocsis B, Quattrochi J, Hobson JA, Verrier RL. Heart rate surges during REM sleep are associated with theta rhythm and PGO activity in cats. Am J Physiol 1999; 277:R843-9. [PMID: 10484502 DOI: 10.1152/ajpregu.1999.277.3.r843] [Citation(s) in RCA: 17] [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] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Rapid eye movement (REM) sleep is characterized by periods of profound cardiac autonomic activation evident in heart rate surges in humans and canines. Our goals were to determine whether or not the heart rate surge phenomenon occurs in cats and to characterize concurrent central nervous system activity. Cortical and hippocampal electroencephalogram, electromyogram, electrooculogram, pontogeniculooccipital (PGO) waves, subcutaneous electrocardiogram, and respiration were recorded. Bouts of sinus tachycardia lasting >/=3.5 s achieved a rate of 210 beats/min and were present predominantly during REM sleep. Heart rate during the surges rose an average of 26.4% from 132.5 +/- 2.0 beats/min before the surge to 167.5 +/- 2.6 beats/min (P < 0.001) and returned to 130.7 +/- 2.6 beats/min (P < 0.001). The heart rate surges were invariably accompanied by increased incidence and frequency of hippocampal theta waves and increased PGO wave frequency and incidence of PGO wave clusters and eye movement clusters. The occurrence of surges was dramatically reduced from 0.11 +/- 0.03 to 0.01 +/- 0.01/15 s of REM sleep (P = 0.02) by atenolol (0.6 mg/kg iv), indicating that the phenomenon is beta(1)-adrenergically mediated. These findings suggest a coupling between central activation of cardiac sympathetic nerves and the generation of hippocampal theta waves and PGO activity.
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Affiliation(s)
- K Rowe
- Institute for Prevention of Cardiovascular Disease, Beth Israel Deaconess Medical Center, Boston, Massachusetts 02215, USA
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37
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Abstract
The purpose of this study was to evaluate the effectiveness of offering an individualised approach to smoking cessation to qualified nurses and student nurses in Northern Ireland. Twenty-two qualified nurses and 32 student nurses enrolled in the intervention. A further 23 qualified nurses and 33 student nurses expressed interest in giving up smoking, but did not wish to be included in the intervention. They were assigned to the comparison group. Objective verification utilising salivary cotinine measurements of continuous abstinence at 6 months and 1 year demonstrated that 24% of student and qualified nurses in the intervention groups stopped smoking compared with 7% of those in the comparison groups. Both of these differences are statistically significant (Fisher's Exact Probability Test p = < 0.05). This suggests that the individualised approach as used in this study is an appropriate method of helping motivated nurses to quit.
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Affiliation(s)
- K Rowe
- Queen's University of Belfast, UK
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38
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Chartres S, Doyle T, Elwood M, Nicoll J, Rowe K, Swann M, Watt A. Is mammography such a pain? N Z Med J 1998; 111:371. [PMID: 11039828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
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Sinclair M, Rowe K, Brown G. The minute paper: a quick guide to assessing student learning. NT Learn Curve 1998; 2:4-5. [PMID: 9644461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Affiliation(s)
- M Sinclair
- School of Nursing and Midwifery, Queen's University of Belfast
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40
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Abstract
Examined the validity of adolescents' reports of their mother's age. Most research on the validity of self-report focuses on personal behaviors such as alcohol and substance use, or response bias due to social desirability. Few studies investigate the validity of adolescents reporting of nonsensitive information. Data from 80 mother-adolescent pairs were collected. The sample included 9th graders from four high school English classes, equal numbers of males and females, and 15% African Americans. The correlation between mothers' reports and youths' reports of mother's age was .99, and 95% of the youth were within a year of their mother's correct age. No race or gender differences were found. These results allow researchers to examine adolescent outcomes for youth born to teen mothers without the expense of also collecting data from their mothers. Results also suggest that adolescents' self-reports of other nonsensitive familial data may also be valid.
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Affiliation(s)
- M A Zimmerman
- Department of Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor, 48109-2029, USA
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41
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Abstract
Twenty-two children (5-12 year old) who were profoundly, prelingually deaf were given two tests designed to tap their 'theory of mind', that is, their ability to attribute independent mental states to other people. The tests were versions of Baron-Cohen, Leslie, and Frith's Sally-Anne task and of Baron-Cohen's breakfast task. Seventy percent of the children were successful on all questions requiring belief attribution, a considerably and significantly larger percentage than the 29% obtained by Peterson and Siegal for a similar sample, though it is still lower than would be expected on the basis on chronological age. Children were universally successful on questions requiring the attribution of desire. We discuss implications of the findings.
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Affiliation(s)
- L Steeds
- Department of Experimental Psychology, University of Oxford, South Parks Road, Oxford OX1 3UD, UK
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42
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Abstract
Parents of children who suffer brain injuries are often surprised by the extent to which work and family finances are disrupted. In this paper, work and financial problems are described, predictors are identified, and ways to minimize problems are discussed. Eighty-two children treated at two Massachusetts trauma centres were given an extensive battery of medical, functional, and psychosocial tests during hospitalization. At 1 and 6 months post-discharge they were retested and their parents were surveyed about work and financial difficulties. Trouble maintaining regular work schedules and injury-related financial problems were common. At highest risk for work and financial problems were families of children with severe injuries who had four to nine impairments, along with children hospitalized > 2 weeks who were not discharged to home. Surprisingly, families with HMO coverage reported significantly fewer financial problems, and this relationship was not due to differences in socioeconomic status or injury severity. Health-care providers need to pay more attention to the potential impact of injury on work and family finances. Providers can help at-risk families muster child-care services, deal effectively with employers and insurance companies, and plan for the future.
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Affiliation(s)
- J S Osberg
- Department of Physical Medicine and Rehabilitation, Tufts University, School of Medicine, Boston, Massachusetts, USA
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43
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Osberg JS, Kahn P, Rowe K, Brooke MM. Pediatric trauma: impact on work and family finances. Pediatrics 1996; 98:890-7. [PMID: 8909482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
OBJECTIVES National data now exist on incidence, prevalence, and cost of injury. However, the personal impact of injury on work and family finances has not been thoroughly studied. We examine the extent and nature of work and financial problems after pediatric trauma and identify predictors. Clinicians are alerted so they can better counsel parents about potential postinjury work and financial difficulties. METHODS Staff collected comprehensive data on the acute care and short-term rehabilitation of 182 Massachusetts children with injuries. Consenting parents were surveyed and their children were given a battery of medical, functional, and psychosocial tests. Information on work and financial impact at 1 and 6 months postinjury was available from 120 parents. RESULTS Given these children's generally mild injuries, the impact on work and family finances was remarkable. For many families work and financial problems were short-lived; however, for others serious problems remained at 6 months postdischarge. Families whose children were severely injured were at highest risk for work and financial problems. Middle-class parents and parents on public assistance or in our other insurance category reported more work and financial problems than those in health maintenance organizations. Long acute hospital stay and four or more impairments at discharge were also strong predictors. CONCLUSION Childhood injury can lead to serious work and financial problems for families. Given the central role of the family in pediatric rehabilitation, clinicians and policymakers involved in acute trauma care and rehabilitation should pay greater attention to the financial repercussions of injury.
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Affiliation(s)
- J S Osberg
- Department of Physical Medicine & Rehabilitation, New England Medical Center, Boston, Massachusetts 02111, USA
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Abstract
The life-threatening experience of an acute myocardial infarction stimulates a wide variety of physical and psychological responses for both the person and his family. The nurse's role is to assist a person through a major life crisis from a dependent to an independent status. The Roper, Logan and Tierney model for nursing provides a suitable framework for nursing a person who has suffered a myocardial infarction. This approach to care ensures that maximum health potential is achieved.
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Cannon-Albright LA, Thomas A, Goldgar DE, Gholami K, Rowe K, Jacobsen M, McWhorter WP, Skolnick MH. Familiality of cancer in Utah. Cancer Res 1994; 54:2378-85. [PMID: 8162584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
The Utah Population Database allows examination of the genetic relationships among the 35.7% of all cancer cases in the state that have genealogical records. Familial clustering of cancer is measured by the Genealogical Index of Familiality and is examined by site, and within site by age of onset, histology, and gender. Most cancer sites examined show excess familiality for all cases considered together. Subsets of individuals with certain characteristics showed unusually high levels of familial clustering, specifically lymphocytic leukemias and especially chronic lymphocytic leukemia, lobular breast cancer, early lip cancer, early melanoma, and female lung cancers of alveolar/adenoma histology. These may represent characteristics of the most penetrant forms of inherited susceptibilities, those which are enhanced by environmental factors, chance aggregations, rare inherited syndromes, or a combination of these factors.
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Affiliation(s)
- L A Cannon-Albright
- Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City 84108
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Abstract
This study compared the recovery of Listeria monocytogenes from Fraser broth incubated 26 h versus 48 h. L. monocytogenes was isolated from 60 of 1,088 samples analyzed. Samples included meat products and environmental swabs from meat and dairy plants. Recovery of L. monocytogenes occurred in two samples after 48 h incubation but not at 26 h, resulting in 3.3% false negatives at 26 h. L. monocytogenes was detected in two samples at 26 h incubation in which the Fraser broth did not blacken. A 6.7% incidence of false negatives resulted if one considers only blackened Fraser broth. Additionally, 659 of the primary enrichments were streaked directly onto selective media. This procedure recovered L. monocytogenes in 76.7% of the total number of samples positive; failure to recover L. monocytogenes occurred in eight Fraser broth enrichments from positive primary enrichments.
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Affiliation(s)
- J L Kornacki
- Silliker Laboratories of Wisconsin, Inc., 3688 Kinsman Blvd., Madison, Wisconsin 53704
| | - D J Evanson
- Corporate Headquarters, 900 Maple St., Homewood, Illinois 60430
| | - W Reid
- Silliker Laboratories of Illinois, Inc., 1304 Halsted St., Chicago Heights, Illinois 60411
| | - K Rowe
- Silliker Laboratories of Illinois, Inc., 1304 Halsted St., Chicago Heights, Illinois 60411
| | - R S Flowers
- Corporate Headquarters, 900 Maple St., Homewood, Illinois 60430
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Pearson EG, Craig AM, Rowe K. Variability of serum bile acid concentrations over time in dairy cattle, and effect of feed deprivation on the variability. Am J Vet Res 1992; 53:1780-3. [PMID: 1456520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Twelve nonlactating dairy cows, free of signs of liver disease and with normal serum activities of liver-derived enzymes and normal liver biopsy tissue, were examined over a 72-hour period for serum total bile acid concentrations. The cattle were fed hay twice daily, and blood samples were obtained every hour for 24 hours, every other hour for 24 hours, then every hour for 24 hours. After 3 weeks, the study was repeated on 6 of the cattle, thus providing data for eighteen 72-hour periods. Serum bile acid concentration varied greatly over the 72 hours, with the range being from one third to 3 times the median. There were variations by as much as 60 mumol/L from 1 hour to the next. After another 3 weeks, 8 of the cattle were deprived of hay for 48 hours and then fed hay morning and afternoon of the third (last) day of the study. There was no significant reduction in bile acid concentration after withholding the hay, but the variability was reduced (P = 0.02) during the last 20 hours of the hay-deprivation period. In 3 ancillary studies, serum bile acid concentrations were examined over a 48-hour period in 2 cows in early lactation, 3 cows in midlactation, and two 6-month-old heifers. The cows were fed hay and grain twice daily, and the heifers were fed only hay twice daily. In comparison with values for the 12 nonlactating cows fed hay twice daily, mean serum bile acid concentration in the recently freshened cows was significantly (P < 0.002) higher (62.9 vs 22.0 mumol/L).(ABSTRACT TRUNCATED AT 250 WORDS)
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Affiliation(s)
- E G Pearson
- College of Veterinary Medicine, Oregon State University, Corvallis 97331
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Craig AM, Pearson EG, Rowe K. Serum bile acid concentrations in clinically normal cattle: comparison by type, age, and stage of lactation. Am J Vet Res 1992; 53:1784-6. [PMID: 1456521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Serum total bile acid concentrations were determined for various types and ages of cattle. There was extreme variability among all the cattle, but the variance was twice as large (0.50 vs 0.22 in logarithmic scale) for beef cattle than for dairy cattle. There was no significant difference in serum total bile acid concentrations between beef cattle and dairy cattle in midlactation. Values for calves < 6 weeks old and for 6-month-old heifers were significantly (P = < 0.05) lower than values for lactating dairy cows. The 5th to 95th percentile range of values (mumol/L) for beef cattle was 9 to 126; for lactating dairy cattle, 15 to 88; and for 6-month-old dairy heifers, 11 to 64.
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Affiliation(s)
- A M Craig
- College of Veterinary Medicine, Oregon State University, Corvallis 97331
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Rowe K. Physicians need to know more about environmental health risks. Mich Med 1989; 88:5. [PMID: 2586344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
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Rowe K. Infectious medical waste. A Michigan perspective. Mich Med 1989; 88:16-7. [PMID: 2586339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
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