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McNulty M, Hendry S. Paediatric knife crime: beware sharp object! Arch Dis Child 2023; 108:414. [PMID: 36609539 DOI: 10.1136/archdischild-2022-324824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/28/2022] [Indexed: 01/09/2023]
Affiliation(s)
- Marc McNulty
- Paediatric Emergency Department, Royal Hospital for Children, NHS Greater Glasgow and Clyde Yorkhill Division, Glasgow, UK
| | - Scott Hendry
- Paediatric Emergency Department, Royal Hospital for Children, NHS Greater Glasgow and Clyde Yorkhill Division, Glasgow, UK
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Rangaswamy G, McNulty M, Browne D, Sharma P, Walkins F, Burke M, Houlihan O, Skourou C, Dunne M, Fitzpatrick D, El Beltagi N, Faul C. PO-1142 Clinical outcomes following Stereotactic Radiosurgery for Brain Metastases from Ovarian Carcinoma. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)03106-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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McNulty M, Waldron O, Ather M, Rangaswamy G, Houlihan O, Dunne M, Curran B, Ryan S, Skourou C, El Beltagi N, Fitzpatrick D, O'Sullivan S, Faul C. PO-1141 Stereotactic ablative body radiation therapy for spinal metastases; A single institution study. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)03105-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: 11/30/2022]
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Waterfield T, Lyttle MD, Munday C, Foster S, McNulty M, Platt R, Barrett M, Rogers E, Durnin S, Jameel N, Maney JA, McGinn C, McFetridge L, Mitchell H, Puthucode D, Roland D. Validating clinical practice guidelines for the management of febrile infants presenting to the emergency department in the UK and Ireland. Arch Dis Child 2022; 107:329-334. [PMID: 34531196 DOI: 10.1136/archdischild-2021-322586] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Accepted: 09/03/2021] [Indexed: 12/24/2022]
Abstract
OBJECTIVE To report the performance of clinical practice guidelines (CPG) in the diagnosis of serious/invasive bacterial infections (SBI/IBI) in infants presenting with a fever to emergency care in the UK and Ireland. Two CPGs were from the National Institutes for Health and Care Excellence (NICE guidelines NG51 and NG143) and one was from the British Society for Antimicrobial Chemotherapy (BSAC). DESIGN Retrospective multicentre cohort study. PATIENTS Febrile infants aged 90 days or less attending between the 31 August 2018 to 1 September 2019. MAIN OUTCOME MEASURES The sensitivity, specificity and predictive values of CPGs in identifying SBI and IBI. SETTING Six paediatric Emergency Departments in the UK/Ireland. RESULTS 555 participants were included in the analysis. The median age was 53 days (IQR 32 to 70), 447 (81%) underwent blood testing and 421 (76%) received parenteral antibiotics. There were five participants with bacterial meningitis (1%), seven with bacteraemia (1%) and 66 (12%) with urinary tract infections. The NICE NG51 CPG was the most sensitive: 1.00 (95% CI 0.95 to 1.00). This was significantly more sensitive than NICE NG143: 0.91 (95% CI 0.82 to 0.96, p=0.0233) and BSAC: 0.82 (95% 0.72 to 0.90, p=0.0005). NICE NG51 was the least specific 0.0 (95% CI 0.0 to 0.01), and this was significantly lower than the NICE NG143: 0.09 (95% CI 0.07 to 0.12, p<0.0001) and BSAC: 0.14 (95% CI 0.1 to 0.17, p<0.0001). CONCLUSION None of the studied CPGs demonstrated ideal performance characteristics. CPGs should be improved to guide initial clinical decision making. TRIAL REGISTRATION NUMBER NCT04196192.
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Affiliation(s)
- Thomas Waterfield
- Wellcome-Wolfson Institute for Experimental Medicine, Queen's University Belfast, Belfast, UK
| | - Mark D Lyttle
- Emergency Department, Bristol Royal Hospital for Children, Bristol, UK.,Faculty of Health and Applied Sciences, University of the West of England, Bristol, UK
| | - Charlotte Munday
- Emergency Department, Bristol Royal Hospital for Children, Bristol, UK
| | - Steven Foster
- Emergency Department, Royal Hospital for Children, Glasgow, UK
| | - Marc McNulty
- Emergency Department, Royal Hospital for Children, Glasgow, UK
| | - Rebecca Platt
- Emergency Department, Barts Health NHS Trust, London, UK
| | - Michael Barrett
- Emergency Department, Children's Health Ireland at Crumlin, Crumlin, Ireland.,Women's and Children's Health, School of Medicine, University College Dublin, Dublin, Ireland
| | - Emma Rogers
- Emergency Department, Children's Health Ireland at Crumlin, Crumlin, Ireland
| | - Sheena Durnin
- Emergency Department, Children's Health Ireland at Tallaght, Dublin, Ireland.,Discipline of Paediatrics, Trinity College, University of Dublin, Dublin, Ireland
| | - Nida Jameel
- Emergency Department, Children's Health Ireland at Tallaght, Dublin, Ireland
| | - Julie-Ann Maney
- Emergency Department, Royal Belfast Hospital for Sick Children, Belfast, UK
| | - Claire McGinn
- Emergency Department, Royal Belfast Hospital for Sick Children, Belfast, UK
| | - Lisa McFetridge
- Mathematical Sciences Research Centre, Queen's University Belfast, Belfast, UK
| | - Hannah Mitchell
- Mathematical Sciences Research Centre, Queen's University Belfast, Belfast, UK
| | - Deepika Puthucode
- Children's Emergency Department, Leicester Royal Infirmary, Leicester, UK
| | - Damian Roland
- Department of Health Sciences, University of Leicester, Leicester, UK.,Paediatric Emergency Medicine Leicester Academic (PEMLA) Group, University Hospitals of Leicester NHS Trust, Leicester, UK
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MacCuish AH, McNulty M, Bryant C, Deaner A, Birns J. Simulation training for clinicians returning to practice. Br J Hosp Med (Lond) 2021; 82:1-13. [PMID: 33512294 DOI: 10.12968/hmed.2020.0587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Many doctors take time out of clinical practice, and then have decreased confidence and poor performance ratings on their return. Simulation training provides a safe and effective learning platform for healthcare professionals to become immersed in realistic scenarios that provide an opportunity to develop technical and non-technical skills. A standardised, 1-day, multi-fidelity, interprofessional, simulation training course was developed and delivered at four sites, focusing on human factors, patient safety and acute clinical scenarios relevant for clinicians returning to practice in internal medicine. A total of 56 participants, with a median time out of training of 3.6 years, attended seven courses. Quantitative and qualitative analysis showed a significant pre/post-course increase in candidates' self-reported confidence in returning to practice along with learning in non-technical skills. The carefully designed standardised format may facilitate wider expansion of such training.
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Affiliation(s)
- A H MacCuish
- Department of Ageing & Health, St Thomas' Hospital, London, UK
| | - M McNulty
- Health Education England, London, UK
| | - C Bryant
- Health Education England, London, UK
| | - A Deaner
- Health Education England, London, UK
| | - J Birns
- Department of Ageing & Health, St Thomas' Hospital, London, UK.,Health Education England, London, UK
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Ong Y, Dean A, Das A, Higgs D, McNulty M, Yusoff I, Johansson M, Tang C, White R. P-256 Survival rates of locally advanced and metastatic pancreatic cancer in Western Australia. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.04.338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Dean A, Das A, McNulty M, Travers N. The emerging role of third-line gemcitabine plus nab-paclitaxel in advanced pancreatic adenocarcinoma. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz422.058] [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: 11/14/2022] Open
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Das A, Dean A, McNulty M. Third-line re-treatment of advanced pancreatic adenocarcinoma with gemcitabine and nab-paclitaxel. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz155.302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Burin MJ, Caspary KJ, Edlund EM, Ezeta R, Gilson EP, Ji H, McNulty M, Squire J, Tynan GR. Turbulence and jet-driven zonal flows: Secondary circulation in rotating fluids due to asymmetric forcing. Phys Rev E 2019; 99:023108. [PMID: 30934347 DOI: 10.1103/physreve.99.023108] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2018] [Indexed: 11/06/2022]
Abstract
We report on experiments and modeling on a rotating confined liquid that is forced by circumferential jets coaxial with the rotation axis, wherein system-scale secondary flows are observed to emerge. The jets are evenly divided in number between inlets and outlets and have zero net mass transport. For low forcing strengths the sign of this flow depends on the sign of a sloped end cap, which simulates a planetary β plane. For increased forcing strengths the secondary flow direction is insensitive to the slope sign, and instead appears to be dominated by an asymmetry in the forcing mechanism, namely, the difference in radial divergence between the inlet and outlet jet profiles. This asymmetry yields a net radial velocity that is affected by the Coriolis force, inducing secondary zonal flow.
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Affiliation(s)
- M J Burin
- Department of Physics, California State University San Marcos, San Marcos, California 92096, USA
| | - K J Caspary
- Princeton Plasma Physics Laboratory, Princeton University, Princeton, New Jersey 08544, USA
| | - E M Edlund
- Department of Physics, State University of New York College at Cortland, Cortland, New York 13045, USA
| | - R Ezeta
- Max Planck Center for Complex Fluid Dynamics, Mesa+ Institute, and J. M. Burgers Centre for Fluid Dynamics, University of Twente, P.O. Box 217, 7500AE Enschede, The Netherlands
| | - E P Gilson
- Princeton Plasma Physics Laboratory, Princeton University, Princeton, New Jersey 08544, USA
| | - H Ji
- Department of Astrophysical Sciences and Princeton Plasma Physics Laboratory, Princeton University, Princeton, New Jersey 08544, USA
| | - M McNulty
- Department of Mathematics, University of California Riverside, Riverside, California 92521, USA
| | - J Squire
- Department of Physics, University of Otago, Dunedin 9016, New Zealand and Theoretical Astrophysics, California Institute of Technology, Pasadena, California 91125, USA
| | - G R Tynan
- Department of Mechanical Engineering and the Center for Energy Research, Jacobs School of Engineering, University of California, San Diego 92093, USA
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McNulty M, Dean A, Das A, Gordon M. Use of gemcitabine and nab-paclitaxel as a third-line treatment following failure of first line gemcitabine for advanced pancreatic adenocarcinoma. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy151.146] [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: 11/14/2022] Open
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Dean A, Higgs D, Das A, Rogers-Seeley M, Fennessy S, McGarvey C, McNulty M. Correlation of neutrophil lymphocyte ratio, platelet lymphocyte ratio and rate of change of CA 19.9 in predicting outcome for metastatic pancreatic cancer. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy151.157] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Dean A, Higgs D, Das A, Fennessy S, Rogers-Seeley M, McGarvey C, McNulty M. The use of NLR, PLR and CA19.9 as prognostic markers for locally advanced pancreatic cancer. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy151.132] [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: 11/14/2022] Open
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13
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Hemmige V, McNulty M, Silverman E, David MZ. Predictors of skin and soft tissue infections in HIV-infected outpatients in the community-associated methicillin-resistant Staphylococcus aureus era. Eur J Clin Microbiol Infect Dis 2014; 34:339-47. [PMID: 25213720 DOI: 10.1007/s10096-014-2237-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2014] [Accepted: 08/25/2014] [Indexed: 10/24/2022]
Abstract
Skin and soft tissue infections (SSTIs) are common in the era of community-associated methicillin-resistant Staphylococcus aureus (MRSA) among human immunodeficiency virus (HIV)-infected patients, but the risk factors are not well defined. We sought to elucidate the risk factors for SSTI occurrence in an HIV cohort. This investigation was a retrospective, single-center cohort study, carried out during the period 2005-2009. In this cohort of 511 HIV-infected individuals, 133 SSTIs occurred in 87 individuals over 1,228.6 person-years of follow-up, for an incidence of 108 SSTIs/1,000 person-years [95 % confidence interval (CI) 87-135]. The incidence declined significantly over time (p < 0.01). In a multivariable Cox regression, diabetes [hazard ratio (HR) 2.01; 95 % CI 1.04-3.89], psoriasis (HR 5.77; 95 % CI 1.86-17.9), lymphedema (HR 6.84; 95 % CI 2.59-18.1), intravenous catheter presence (HR 3.38; 95 % CI 1.00-11.5), and HIV viral load greater than 1,000 copies/mL (HR 2.13; 95 % CI 1.33-3.41) were most strongly associated with development of the first SSTI. Trends toward an association between SSTI risk and Medicaid insurance (HR 1.67; 95 % CI 0.98-2.83) and sexually transmitted disease during follow-up (HR 1.66; 0.99-2.78) were present. CD4+ count and trimethoprim-sulfamethoxazole use were not associated with SSTI risk. HIV-infected individuals are at high risk for SSTIs. In a primarily urban, African-American cohort, we found that a number of immunologic and demographic factors were associated with SSTI risk.
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Affiliation(s)
- V Hemmige
- Division of Infectious Diseases, Department of Medicine, Baylor College of Medicine, 6620 Main Street, Suite 1375, Houston, TX, 77030, USA,
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Teuteberg J, McNulty M, Holtz J, Kunz N, Lockard K, Dunn E, Bermudez C, Bhama J, Shullo M, Kormos R, Dew M. Impact of Mechanical Support on Quality of Life Measures Over Time - Is There a Differential Response Based Upon Indication? J Heart Lung Transplant 2014. [DOI: 10.1016/j.healun.2014.01.589] [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: 10/25/2022] Open
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Ulin K, Schmitter M, McNulty M. SU-GG-T-259: Validation of CERR for Use as a Digital Data Review Tool at the Quality Assurance Review Center. Med Phys 2010. [DOI: 10.1118/1.3468651] [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: 11/07/2022] Open
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Rayner K, Sun J, Chen Y, McNulty M, Simard T, O'Brien E. Abstract: P190 HEAT SHOCK PROTEIN 27 ATHEROPROTECTION IS MEDIATED BY ESTROGEN RECEPTOR B. ATHEROSCLEROSIS SUPP 2009. [DOI: 10.1016/s1567-5688(09)70497-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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McNulty M, Kingston M. Documentation of advice regarding safer sexual practices and partner notification within an HIV clinic. Int J STD AIDS 2009; 20:269-70. [PMID: 19304975 DOI: 10.1258/ijsa.2008.008385] [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: 11/18/2022]
Abstract
Guidelines for the sexual health care of our HIV patients and provision of post-exposure prophylaxis following sexual exposure have been produced by both British Association of Sexual Health & HIV and British HIV Association (BHIVA). In the light of recent criminal prosecutions, BHIVA produced guidance for HIV clinical teams regarding discussions with patients about HIV transmission and reducing the risk to sexual partners. This audit examined the advice given to HIV patients with regard to safer sexual practices, sexually transmitted infection screening and partner notification and found that, on the whole, the standards set by national guidelines were adhered to, although areas for improvement were identified. We hope that the introduction of proformas with specific prompts for these subjects for HIV clinic visits will improve clinical standards in this area.
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Affiliation(s)
- M McNulty
- Manchester Centre for Sexual Health, The Hathersage Centre, 280 Upper Brook Street, Manchester M13 OFH, UK
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Hutt E, Radcliff TA, Liebrecht D, Fish R, McNulty M, Kramer AM. Associations Among Nurse and Certified Nursing Assistant Hours per Resident per Day and Adherence to Guidelines for Treating Nursing Home-Acquired Pneumonia. J Gerontol A Biol Sci Med Sci 2008; 63:1105-11. [DOI: 10.1093/gerona/63.10.1105] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Lu J, Jin X, Xu J, McNulty M, Kim B, Zhu Y, Weber R. 55. Mapping of C7 dermatome following total C7 root transfer in humans. Clin Neurophysiol 2008. [DOI: 10.1016/j.clinph.2007.11.105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Kanter D, Zhu Y, McNulty M, Weber R. P07.10 Soleus H-reflex is depressed during passive stretch of soleus muscle. Clin Neurophysiol 2006. [DOI: 10.1016/j.clinph.2006.06.279] [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: 10/24/2022]
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McNulty M, Mahmud A, Spiers P, Feely J. Collagen type-I degradation is related to arterial stiffness in hypertensive and normotensive subjects. J Hum Hypertens 2006; 20:867-73. [PMID: 16598292 DOI: 10.1038/sj.jhh.1002015] [Citation(s) in RCA: 69] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Although arterial stiffness is an independent cardiovascular risk factor associated with both aging and hypertension, relatively little is known regarding the structural changes in the vessel wall that occur with vessel stiffening. We determined if collagen type-I metabolism is related to arterial stiffening in both hypertensive and normotensive subjects. Arterial stiffness was assessed by aortic pulse wave velocity (PWV) and augmentation index (AIx) in 46 subjects (48.7 +/- 2 years, 32 hypertensives) and related to circulating markers of collagen type-I turnover. Collagen synthesis was assessed by the measurement of carboxy-terminal peptide of procollagen type-I (PIP) and collagen degradation by the measurement of carboxy-terminal telopeptide of collagen type-I (ICTP), by quantitative immunoassay. Matrix metalloproteinase-1 (MMP-1) and the tissue inhibitor of metalloproteinase-1 (TIMP-1) were also quantified by immunoassay. The ratio of collagen type-I synthesis to degradation was negatively correlated with both PWV (P<0.05) and AIx (P<0.05), whereas plasma MMP-1 levels displayed a positive correlation with both PWV (P<0.01) and AIx (P<0.01), after adjustment for age and mean arterial pressure. The relationship between collagen type-I turnover and arterial stiffness was similar in both the normotensive and hypertensive subjects. Although circulating markers of collagen synthesis were increased in the hypertensive subjects, this was not related to arterial stiffness. Collagen type-I degradation is increased in relation to collagen type-I synthesis in subjects with stiffer arteries. Matrix metalloproteinase-1, the enzyme responsible for collagen type-I degradation, is positively related to both large elastic and muscular artery stiffness in normotensive and hypertensive subjects.
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Affiliation(s)
- M McNulty
- Department of Pharmacology and Therapeutics, St James's Hospital, Dublin, Ireland
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McNulty M, Puljung M, Jefford G, Dubreuil RR. Evidence that a copper-metallothionein complex is responsible for fluorescence in acid-secreting cells of the Drosophila stomach. Cell Tissue Res 2001; 304:383-9. [PMID: 11456415 DOI: 10.1007/s004410100371] [Citation(s) in RCA: 44] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Copper cells were originally identified in Drosophila midgut epithelium by their striking orange fluorescence in copper-fed larvae. Here, we examined copper cell fluorescence in light of the previous observations that (1) a similar fluorescent signal in yeast is produced by a complex between copper and metallothionein, and (2) metallothionein is expressed constitutively in the copper cell region and inducibly in other regions of the Drosophila midgut. Pulse-feeding experiments with 1 mM CuCl2 revealed that fluorescence appeared rapidly in copper cells (<5 min) and slowly in other cells of the midgut (days), suggesting a constitutive cofactor in the former and an inducible cofactor in the latter. Fluorescence was also detected in Drosophila S2 tissue culture cells after induction of metallothionein synthesis by addition of CuCl2 to the growth medium. Thus, fluorescence coincided spatially and temporally with the expression of metallothionein. Fluorescence was also linked to the acid-secreting activity of copper cells. Fluorescence was not observed when acid secretion was inhibited by a mutation in the alpha spectrin gene and acidification was blocked in copper-fed wild-type larvae. However, acidification was restored after a 1-day chase period in which the fluorescent signal became sequestered within a vesicular compartment. We therefore conclude that copper cell fluorescence is most probably attributable to a cytoplasmic copper-metallothionein complex, suggesting an unanticipated role for metallothionein in acid-secreting cells.
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Affiliation(s)
- M McNulty
- Department of Neurobiology, Pharmacology, and Physiology, University of Chicago, IL 60637, USA
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Ritchie JL, Crawford VL, McNulty M, Alexander HD, Stout RW. Effect of tourniquet pressure and intra-individual variability on plasma fibrinogen, platelet P-selectin and monocyte tissue factor. Clin Lab Haematol 2000; 22:369-72. [PMID: 11318805 DOI: 10.1046/j.1365-2257.2000.00337.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Small differences in levels of certain haemostatic components may be clinically significant. It is important therefore to eliminate potential sources of confounding variability. This study investigated the effect of removing tourniquet pressure prior to sample collection on plasma fibrinogen levels, platelet P-selectin and monocyte tissue factor expression. Blood was collected from the right arm under maintained tourniquet pressure and from the left arm following the release of pressure once the vein was sufficiently inflated for insertion of a needle. Whole blood was labelled within one hour of venepuncture to allow analysis of platelet P-selectin and monocyte tissue factor by flow cytometry. Plasma fibrinogen levels were analysed in samples stored at -70 degrees C, for all individuals at the end of the study using a method based on the Clauss technique. Intra-individual variability for each of the components was assessed by collecting samples under tourniquet pressure from four individuals on the same day on three consecutive weeks. Intra-individual variations were greater than assay CVs for all three components. There were no significant differences between the two tourniquet methods of collection for fibrinogen, P-selectin or tissue factor. In conclusion, there is no reason not to use a tourniquet during collection of blood for analysis of plasma fibrinogen, platelet P-selectin or monocyte tissue factor.
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Affiliation(s)
- J L Ritchie
- Department of Geriatric Medicine, Whitla Building, The Queen's University of Belfast, UK.
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Klein JD, Wilson KM, McNulty M, Kapphahn C, Collins KS. Access to medical care for adolescents: results from the 1997 Commonwealth Fund Survey of the Health of Adolescent Girls. J Adolesc Health 1999; 25:120-30. [PMID: 10447039 DOI: 10.1016/s1054-139x(98)00146-3] [Citation(s) in RCA: 166] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
PURPOSE This study examined the factors associated with access to care among adolescents, including gender, insurance coverage, and having a regular source of health care. METHODS Analyses were done on the 1997 Commonwealth Fund Survey of the Health of Adolescent Girls, a nationally representative sample of in-school adolescents in 5th through 12th grade. Access to health care, missing needed care, and whether the adolescent had private time with their provider were assessed. Cochran-Mantel-Haenszel chi-square statistics were computed using SUDAAN. RESULTS Nearly a third of the 6748 adolescents surveyed had missed needed care. The most common reason for missing care was not wanting a parent to know (35%). Girls were more likely than boys to miss care (29% vs. 24%). Most adolescents reported using a source of primary health care (92%); girls were more likely than boys to use a physician's office rather than another site (65% vs. 60%). Eleven percent of adolescents reported having no health insurance. Uninsured adolescents were more likely to have missed needed care (46% vs. 25%) [corrected]. CONCLUSIONS Certain groups of adolescents have less access to health care. Girls have more emotional barriers, such as not wanting parents to know about care, and embarrassment. Adolescents without health insurance are at high risk for missing care because of financial strain. States, insurers, and advocates can influence policies around confidentiality and insurance coverage to address these issues.
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Affiliation(s)
- J D Klein
- Division of Adolescent Medicine, University of Rochester School of Medicine and Dentistry, NY 14642, USA
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Yuen K, Barrington D, Headford N, McNulty M, Smith M. Educating doctors in palliative medicine: development of a competency-based training program. J Palliat Care 1998; 14:79-82. [PMID: 9770927] [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: 02/09/2023]
Affiliation(s)
- K Yuen
- Silver Chain Hospice Care Service, Curtin University, Western Australia
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Klein JD, McNulty M, Flatau CN. Adolescents' access to care: teenagers' self-reported use of services and perceived access to confidential care. Arch Pediatr Adolesc Med 1998; 152:676-82. [PMID: 9667540 DOI: 10.1001/archpedi.152.7.676] [Citation(s) in RCA: 112] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
BACKGROUND Most surveys on adolescents' use of health services rely on parental report, and this may underestimate adolescents' use of confidential services. OBJECTIVE To investigate adolescents' report of their own use of health services, access to care, and knowledge and use of confidential services. METHOD A random digit-dialed survey of 14- to 19-year-old adolescents was conducted in Monroe County, New York. We screened 11 800 numbers and identified 4449 households (40%) of which 393 families (8.8%) had eligible adolescents. Of these, 259 (66%) consented and completed an interviewer-administered survey. RESULTS Almost all adolescents (92%) rated their health as excellent or good and 90% had visited a health care provider within the year. Most (88%) identified a source of primary care. As many as 27% of adolescents had used more than one source of care. Many youth identify school personnel as important resources for health and counseling needs. Only 8.4% of respondents have used services confidentially, but nearly half of all youth did not know where they could obtain confidential care if they needed to. Adolescents were least likely to know where to obtain mental health or substance abuse and reproductive services. CONCLUSIONS While most youth have used primary care, a substantial minority have not. Many teenagers depend on multiple sources of care, and they rely on school personnel as important sources of health information. Many do not know where they could go to review confidential services or for other services that they may need. Managed care insurance and public health policies should recognize adolescents' access needs to meet them appropriately.
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Affiliation(s)
- J D Klein
- Division of Adolescent Medicine, Strong Children's Research Center, University of Rochester Medical Center, NY 14642, USA.
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Vance J, Allen B, Bramlett P, Moffett I, McNulty M, Hamrick L, Brown B, Carraway R, Johnson M, Hill W, McClusky DO, Hethcox J. AlaHA's living legacy. Favorite memories from those who have lived our healthcare history. Healthc Ala 1996; 9:4-5, 7-11, 24. [PMID: 10164124] [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: 02/11/2023]
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Abstract
One group of 12 rats received discrete 6-hydroxydopamine (6-OHDA) injections into the caudate nucleus on one side of the brain and sham infusions on the other. Following chronic daily injections of cocaine (20 mg/kg, i.p.) or saline (1 ml/kg, i.p.) for 15 days, the caudate nuclei were separately dissected, and the number of benzodiazepine receptors labeled with [3H]Ro 15-1788 were assessed using individual homogenate receptor binding assays. A second group of 24 rats received bilateral infusions of 6-hydroxydopamine or sham infusions into the lateral ventricles followed by chronic cocaine or saline administration as described above. The animals were sacrificed by cardiac perfusion, and the brains were sectioned and prepared for light microscopic quantitative autoradiography. The extent of the lesion was assessed by measuring dopaminergic and noradrenergic uptake sites visualized with [3H]mazindol, while [3H]Ro 15-1788 was used to estimate the number of benzodiazepine receptors. Chronic cocaine administration resulted in significant increases in benzodiazepine receptors in the caudate nucleus, and these effects were attenuated following dopamine depletion. These data suggest that the effects of cocaine on benzodiazepine receptors may be mediated, in part, through the effects of the drug on dopaminergic neuronal activity.
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Affiliation(s)
- N Goeders
- Department of Pharmacology and Therapeutics, Louisiana State University Medical Center, Shreveport 71130
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Lnqlis V, Black D, McNulty M, Gibson G. Helpful computer programs. Nurs Stand 1988; 2:8. [PMID: 27414539 DOI: 10.7748/ns.2.14.8.s18] [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: 06/06/2023]
Abstract
Computer programs used for health education have proved popular with nurses, according to a Glasgow study.
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Affiliation(s)
| | | | | | - G Gibson
- Micro-Computers in Health Education
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McNulty M. Nursing Mirror mental health forum. A framework for the future. Nurs Mirror 1984; 158:i-iv. [PMID: 6560621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/05/2023]
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Abstract
An investigation was carried out in dogs to determine how the acceleration of blood in the aorta (dV/dt), as a new index of myocardial contractility compared with existing indices and how they correlated with each other. It was found that the indices derived from velocity and flow of blood, dV/dt max and dQ/dt max, and from intraventricular pressure, dP/dt max, correlate well with each other but there is less agreement between them and the reciprocal of the Pre-Ejection Period, l/PEP. The ratio dP/dt max divided by I.P. correlated well with dQ/dt max divided by I.Q. and dQ/dt max divided by Q. max but not so well with dV/dt max divided by I.V. (instantaneous velocity) of dV/dt max divided by V. max and the ratios dQ/DT DIVIDED BY I.Q. and dQ/dt divided by Q max as well as l/PEP. In view of the lack of agreement of quantitative definition of myocardial contractility, the ratio dV/dt divided by V. max would have several practical advantages as an indicator of the inotropic state of the heart; these are that the probe used to establish descending aortic blood velocity does not require calibration, and the signal can be obtained by a relatively non-invasive technique that is suitable for patient care and yet agrees with other established indices of myocardial contractility.
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Taylor AW, McNulty M, Cary S, Garrod J, Secord DC. The effects of pair feeding and exercise upon blood and tissue energy substrates. Rev Can Biol 1974; 33:27-32. [PMID: 4837125] [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: 01/12/2023]
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Taylor AW, Cary S, McNulty M, Garrod J, Secord DC. Effects of food restriction and exercise upon the deposition and mobilization of energy stores in the rat. J Nutr 1974; 104:218-22. [PMID: 4810983 DOI: 10.1093/jn/104.2.218] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
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Evison G, McNulty M, Thomson C. The value of percutaneous cholangiography. Postgrad Med J 1973; 49:637-40. [PMID: 4788917 PMCID: PMC2495752 DOI: 10.1136/pgmj.49.575.637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Percutaneous cholangiograms performed on fifty patients in a district general hospital have been reviewed, and the advantages and limitations of the examination are described. The investigation is considered to have sufficient diagnostic value to warrant its inclusion in the diagnostic armamentarium of every general radiological department.
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