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Oderinde O, Cornwell T, Owens M, Tian S, Yang X, Higgins K, Da Silva A, Shirvani S. Utilizing Biology-Guided Radiotherapy for Coronary Artery Avoidance During Free-Breathing External Beam Radiation Delivery. Int J Radiat Oncol Biol Phys 2021. [DOI: 10.1016/j.ijrobp.2021.07.1476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Vogt EL, Welch BM, Bunnell BE, Barrera JF, Paige SR, Owens M, Coffey P, Diazgranados N, Goldman D. Quantifying COVID-19's Impact on Telemedicine Utilization. Interact J Med Res 2021; 11:e29880. [PMID: 34751158 PMCID: PMC8797150 DOI: 10.2196/29880] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Revised: 08/06/2021] [Accepted: 09/06/2021] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND While telemedicine has been expanding over the past decade, the COVID-19 pandemic era restrictions regarding in-person care have led to unprecedented levels of telemedicine utilization. To the authors' knowledge, no studies to date have quantitatively analyzed both national and regional trends in telemedicine utilization during COVID-19, both of which have key implications for informing health policy. OBJECTIVE To investigate how trends in telemedicine utilization changed across the course of the COVID-19 pandemic. METHODS Using data from doxy.me, the largest free telemedicine platform, and the NIH Clinical Center, the largest U.S. clinical research hospital, we assessed changes in total telemedicine minutes, new provider registrations, monthly sessions, and average session length from March-November 2020. We also conducted state-level analysis of how telemedicine expansion differed by region. RESULTS National telemedicine utilization peaked in April 2020 at 291 million minutes and stabilized at 200-220 million monthly minutes from May to November 2020. Surges were strongest in New England and weakest in the South and West. Greater telemedicine expansion during COVID-19 was geographically associated with lower COVID-19 cases per capita. The nature of telemedicine visits also changed, as the average monthly visits per provider doubled and average visit length decreased by 60%. CONCLUSIONS The COVID-19 pandemic led to an abrupt and subsequently sustained uptick in telemedicine utilization. Regional and institute-level differences in telemedicine utilization should be further investigated to inform policy and procedures for sustaining meaningful telemedicine use in clinical practice.
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Affiliation(s)
- Emily Louise Vogt
- University of Michigan Medical School, Michigan Medicine, Ann Arbor, US.,Office of the Clinical Director, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, US
| | - Brandon M Welch
- Biomedical Informatics Center, Medical University of South Carolina, Charleston, US.,Doxy.me Research, Doxy.me, LLC, Rochester, US
| | - Brian E Bunnell
- Department of Psychiatry and Behavioral Neurosciences, University of South Florida, Tampa, US.,Doxy.me Research, Doxy.me, LLC, Rochester, US
| | - Janelle F Barrera
- Department of Psychiatry and Behavioral Neurosciences, University of South Florida, Tampa, US.,Doxy.me Research, Doxy.me, LLC, Rochester, US
| | | | - Marisa Owens
- Clinical Center, National Institutes of Health, Bethesda, US
| | - Patricia Coffey
- Clinical Center, National Institutes of Health, Bethesda, US
| | - Nancy Diazgranados
- Office of the Clinical Director, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, US
| | - David Goldman
- Office of the Clinical Director, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, US.,Lab of Neurogenetics, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, 5625 Fishers LaneRm 3S-32: MSC 9412, Rockville, US
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Owens M, Watkins E, Bot M, Brouwer IA, Roca M, Kohls E, Penninx BWJH, Grootheest G, Hegerl U, Gili M, Visser M. Nutrition and depression: Summary of findings from the EU‐funded MooDFOOD depression prevention randomised controlled trial and a critical review of the literature. NUTR BULL 2020. [DOI: 10.1111/nbu.12447] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Affiliation(s)
- M. Owens
- Department of Psychology University of Exeter Exeter UK
| | - E. Watkins
- Department of Psychology University of Exeter Exeter UK
| | - M. Bot
- Amsterdam UMC Vrije Universiteit, Psychiatry Amsterdam Public Health Research Institute GGZ in Geest Specialized Mental Health Care Amsterdam The Netherlands
| | - I. A. Brouwer
- Department of Health Sciences Faculty of Science Amsterdam Public Health Research Institute Vrije Universiteit Amsterdam Amsterdam The Netherlands
| | - M. Roca
- Institut Universitari d’ Investigació en Ciències de la Salut (IUNICS/IDISBA) Rediapp University of Balearic Islands Palma de Mallorca Spain
| | - E. Kohls
- Department of Psychiatry and Psychotherapy Medical Faculty University Leipzig Leipzig Germany
| | - B. W. J. H. Penninx
- Amsterdam UMC Vrije Universiteit, Psychiatry Amsterdam Public Health Research Institute GGZ in Geest Specialized Mental Health Care Amsterdam The Netherlands
| | - G. Grootheest
- Amsterdam UMC Vrije Universiteit, Psychiatry Amsterdam Public Health Research Institute GGZ in Geest Specialized Mental Health Care Amsterdam The Netherlands
| | - U. Hegerl
- Department of Psychiatry, Psychosomatics and Psychotherapy Goethe‐University Frankfurt Germany
| | - M. Gili
- Institut Universitari d’ Investigació en Ciències de la Salut (IUNICS/IDISBA) Rediapp University of Balearic Islands Palma de Mallorca Spain
| | - M. Visser
- Department of Health Sciences Faculty of Science Amsterdam Public Health Research Institute Vrije Universiteit Amsterdam Amsterdam The Netherlands
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Owens M, West DJ. Hospice and Palliative Medicine in the Republic of Poland, Romania & the Slovak Republic: Policy Implementation, Medical Economics, & Clinical Outcomes. cswhi 2019. [DOI: 10.22359/cswhi_10_2_12] [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: 11/23/2022]
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Bernardes TP, Zwertbroek EF, Broekhuijsen K, Koopmans C, Boers K, Owens M, Thornton J, van Pampus MG, Scherjon SA, Wallace K, Langenveld J, van den Berg PP, Franssen MTM, Mol BWJ, Groen H. Delivery or expectant management for prevention of adverse maternal and neonatal outcomes in hypertensive disorders of pregnancy: an individual participant data meta-analysis. Ultrasound Obstet Gynecol 2019; 53:443-453. [PMID: 30697855 PMCID: PMC6594064 DOI: 10.1002/uog.20224] [Citation(s) in RCA: 45] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/05/2018] [Revised: 12/31/2018] [Accepted: 01/04/2019] [Indexed: 06/09/2023]
Abstract
OBJECTIVE Hypertensive disorders affect 3-10% of pregnancies. Delayed delivery carries maternal risks, while early delivery increases fetal risk, so appropriate timing is important. The aim of this study was to compare immediate delivery with expectant management for prevention of adverse maternal and neonatal outcomes in women with hypertensive disease in pregnancy. METHODS CENTRAL, PubMed, MEDLINE and ClinicalTrials.gov were searched for randomized controlled trials comparing immediate delivery to expectant management in women presenting with gestational hypertension or pre-eclampsia without severe features from 34 weeks of gestation. The primary neonatal outcome was respiratory distress syndrome (RDS) and the primary maternal outcome was a composite of HELLP syndrome and eclampsia. The PRISMA-IPD guideline was followed and a two-stage meta-analysis approach was used. Relative risks (RR) and numbers needed to treat or harm (NNT/NNH) with 95% CI were calculated to evaluate the effect of the intervention. RESULTS Main outcomes were available for 1724 eligible women. Compared with expectant management, immediate delivery reduced the composite risk of HELLP syndrome and eclampsia in all women (0.8% vs 2.8%; RR, 0.33 (95% CI, 0.15-0.73); I2 = 0%; NNT, 51 (95% CI, 31.1-139.3)) as well as in the pre-eclampsia subgroup (1.1% vs 3.5%; RR, 0.39 (95% CI, 0.15-0.98); I2 = 0%). Immediate delivery increased RDS risk (3.4% vs 1.6%; RR, 1.94 (95% CI 1.05-3.6); I2 = 24%; NNH, 58 (95% CI, 31.1-363.1)), but depended upon gestational age. Immediate delivery in the 35th week of gestation increased RDS risk (5.1% vs 0.6%; RR, 5.5 (95% CI, 1.0-29.6); I2 = 0%), but immediate delivery in the 36th week did not (1.5% vs 0.4%; RR, 3.4 (95% CI, 0.4-30.3); I2 not applicable). CONCLUSION In women with hypertension in pregnancy, immediate delivery reduces the risk of maternal complications, whilst the effect on the neonate depends on gestational age. Specifically, women with a-priori higher risk of progression to HELLP, such as those already presenting with pre-eclampsia instead of gestational hypertension, were shown to benefit from earlier delivery. © 2019 The Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of the International Society of Ultrasound in Obstetrics and Gynecology.
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Affiliation(s)
- T. P. Bernardes
- Epidemiology, University of GroningenUniversity Medical Center GroningenGroningenThe Netherlands
| | - E. F. Zwertbroek
- Obstetrics and Gynaecology, University of GroningenUniversity Medical Center GroningenGroningenThe Netherlands
| | - K. Broekhuijsen
- ObstetricsLeiden University Medical CenterLeidenThe Netherlands
| | - C. Koopmans
- Obstetrics and Gynaecology, University of GroningenUniversity Medical Center GroningenGroningenThe Netherlands
| | - K. Boers
- Obstetrics and GynaecologyBronovo HospitalThe HagueThe Netherlands
| | - M. Owens
- Obstetrics and GynecologyUniversity of Mississippi Medical CenterJacksonMIUSA
| | - J. Thornton
- Obstetrics and GynaecologyUniversity of NottinghamNottinghamUK
| | - M. G. van Pampus
- Obstetrics and GynaecologyOnze Lieve Vrouwe GasthuisAmsterdamThe Netherlands
| | - S. A. Scherjon
- Obstetrics and Gynaecology, University of GroningenUniversity Medical Center GroningenGroningenThe Netherlands
| | - K. Wallace
- Obstetrics and GynecologyUniversity of Mississippi Medical CenterJacksonMIUSA
| | - J. Langenveld
- Obstetrics and GynaecologyZuyderland Medical CentreHeerlenThe Netherlands
| | - P. P. van den Berg
- Obstetrics and Gynaecology, University of GroningenUniversity Medical Center GroningenGroningenThe Netherlands
| | - M. T. M. Franssen
- Obstetrics and Gynaecology, University of GroningenUniversity Medical Center GroningenGroningenThe Netherlands
| | - B. W. J. Mol
- Obstetrics and GynaecologyMonash UniversityClaytonVictoriaAustralia
| | - H. Groen
- Epidemiology, University of GroningenUniversity Medical Center GroningenGroningenThe Netherlands
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Triolo TM, Fouts A, Pyle L, Yu L, Gottlieb PA, Steck AK, Greenbaum CJ, Atkinson M, Baidal D, Battaglia M, Becker D, Bingley P, Bosi E, Buckner J, Clements M, Colman P, DiMeglio L, Gitelman S, Goland R, Gottlieb P, Herold K, Knip M, Krischer J, Lernmark A, Moore W, Moran A, Muir A, Palmer J, Peakman M, Philipson L, Raskin P, Redondo M, Rodriguez H, Russell W, Spain L, Schatz D, Sosenko J, Wentworth J, Wherrett D, Wilson D, Winter W, Ziegler A, Anderson M, Antinozzi P, Benoist C, Blum J, Bourcier K, Chase P, Clare-Salzler M, Clynes R, Eisenbarth G, Fathman C, Grave G, Hering B, Insel R, Kaufman F, Kay T, Leschek E, Mahon J, Marks J, Nanto-Salonen K, Nepom G, Orban T, Parkman R, Pescovitz M, Peyman J, Pugliese A, Roep B, Roncarolo M, Savage P, Simell O, Sherwin R, Siegelman M, Skyler J, Steck A, Thomas J, Trucco M, Wagner J, Krischer JP, Leschek E, Rafkin L, Bourcier K, Cowie C, Foulkes M, Insel R, Krause-Steinrauf H, Lachin JM, Malozowski S, Peyman J, Ridge J, Savage P, Skyler JS, Zafonte SJ, Rafkin L, Sosenko JM, Kenyon NS, Santiago I, Krischer JP, Bundy B, Abbondondolo M, Dixit S, Pasha M, King K, Adcock H, Atterberry L, Fox K, Englert N, Mauras J, Permuy K, Sikes T, Adams T, Berhe B, Guendling L, McLennan L, Paganessi C, Murphy M, Draznin M, Kamboj S, Sheppard V, Lewis L, Coates W, Amado D, Moore G, Babar J, Bedard D, Brenson-Hughes J, Cernich M, Clements R, Duprau S, Goodman L, Hester L, Huerta-Saenz A, Asif I, Karmazin T, Letjen S, Raman D, Morin W, Bestermann E, Morawski J, White A, Brockmyer R, Bays S, Campbell A, Boonstra M, Stapleton N, Stone A, Donoho H, Everett H, Hensley M, Johnson C, Marshall N, Skirvin P, Taylor R, Williams L, Burroughs C, Ray C, Wolverton D, Nickels C, Dothard P, Speiser M, Pellizzari L, Bokor K, Izuora S, Abdelnour P, Cummings S, Cuthbertson D, Paynor M, Leahy M, Riedl S, Shockley R, Saad T, Briones S, Casella C, Herz K, Walsh J, Greening F, Deemer M, Hay S, Hunt N, Sikotra L, Simons D, Karounos R, Oremus L, Dye L, Myers D, Ballard W, Miers R, Eberhard C, Sparks K, Thraikill K, Edwards J, Fowlkes S, Kemp A, Morales L, Holland L, Johnson P, Paul A, Ghatak K, Fiske S, Phelen H, Leyland T, Henderson D, Brenner E, Oppenheimer I, Mamkin C, Moniz C, Clarson M, Lovell A, Peters V, Ford J, Ruelas D, Borut D, Burt M, Jordan S, Castilla P, Flores M, Ruiz L, Hanson J, Green-Blair R, Sheridan K, Garmeson J, Wintergerst G, Pierce A, Omoruyi M, Foster S, Kingery A, Lunsford I, Cervantes T, Parker P, Price J, Urben I, Guillette H, Doughty H, Haydock V, Parker P, Bergman S, Duncum C, Rodda A, Perelman R, Calendo C, Barrera E, Arce-Nunez Y, Geyer S, Martinez M, De la Portilla I, Cardenas L, Garrido M, Villar R, Lorini E, Calandra G, D’Annuzio K, Perri N, Minuto C, Hays B, Rebora R, Callegari O, Ali J, Kramer B, Auble S, Cabrera P, Donohoue R, Fiallo-Scharer M, Hessner P, Wolfgram A, Henderson C, Kansra N, Bettin R, McCuller A, Miller S, Accacha J, Corrigan E, Fiore R, Levine T, Mahoney C, Polychronakos V, Henry M, Gagne H, Starkman M, Fox D, Chin F, Melchionne L, Silverman I, Marshall L, Cerracchio J, Cruz A, Viswanathan J, Heyman K, Wilson S, Chalew S, Valley S, Layburn A, Lala P, Clesi M, Genet G, Uwaifo A, Charron T, Allerton W, Hsiao B, Cefalu L, Melendez-Ramirez R, Richards C, Alleyn E, Gustafson M, Lizanna J, Wahlen S, Aleiwe M, Hansen H, Wahlen C, Karges C, Levy A, Bonaccorso R, Rapaport Y, Tomer D, Chia M, Goldis L, Iazzetti M, Klein C, Levister L, Waldman E, Keaton N, Wallach M, Regelmann Z, Antal M, Aranda C, Reynholds A, Vinik P, Barlow M, Bourcier M, Nevoret J, Couper S, Kinderman A, Beresford N, Thalagne H, Roper J, Gibbons J, Hill S, Balleaut C, Brennan J, Ellis-Gage L, Fear T, Gray L, Law P, Jones C, McNerney L, Pointer N, Price K, Few D, Tomlinson N, Leech D, Wake C, Owens M, Burns J, Leinbach A, Wotherspoon A, Murray K, Short G, Curry S, Kelsey J, Lawson J, Porter S, Stevens E, Thomson S, Winship L, Liu S, Wynn E, Wiltshire J, Krebs P, Cresswell H, Faherty C, Ross L, Denvir J, Drew T, Randell P, Mansell S, Lloyd J, Bell S, Butler Y, Hooton H, Navarra A, Roper G, Babington L, Crate H, Cripps A, Ledlie C, Moulds R, Malloy J, Norton B, Petrova O, Silkstone C, Smith K, Ghai M, Murray V, Viswanathan M, Henegan O, Kawadry J, Olson L, Maddox K, Patterson T, Ahmad B, Flores D, Domek S, Domek K, Copeland M, George J, Less T, Davis M, Short A, Martin J, Dwarakanathan P, O’Donnell B, Boerner L, Larson M, Phillips M, Rendell K, Larson C, Smith K, Zebrowski L, Kuechenmeister M, Miller J, Thevarayapillai M, Daniels H, Speer N, Forghani R, Quintana C, Reh A, Bhangoo P, Desrosiers L, Ireland T, Misla C, Milliot E, Torres S, Wells J, Villar M, Yu D, Berry D, Cook J, Soder A, Powell M, Ng M, Morrison Z, Moore M, Haslam M, Lawson B, Bradley J, Courtney C, Richardson C, Watson E, Keely D, DeCurtis M, Vaccarcello-Cruz Z, Torres K, Muller S, Sandberg H, Hsiang B, Joy D, McCormick A, Powell H, Jones J, Bell S, Hargadon S, Hudson M, Kummer S, Nguyen T, Sauder E, Sutton K, Gensel R, Aguirre-Castaneda V, Benavides, Lopez D, Hemp S, Allen J, Stear E, Davis T, O’Donnell R, Jones A, Roberts J, Dart N, Paramalingam L, Levitt Katz N, Chaudhary K, Murphy S, Willi B, Schwartzman C, Kapadia D, Roberts A, Larson D, McClellan G, Shaibai L, Kelley G, Villa C, Kelley R, Diamond M, Kabbani T, Dajani F, Hoekstra M, Sadler K, Magorno J, Holst V, Chauhan N, Wilson P, Bononi M, Sperl A, Millward M, Eaton L, Dean J, Olshan H, Stavros T, Renna C, Milliard, Brodksy L, Bacon J, Quintos L, Topor S, Bialo B, Bancroft A, Soto W, Lagarde H, Tamura R, Lockemer T, Vanderploeg M, Ibrahim M, Huie V, Sanchez R, Edelen R, Marchiando J, Palmer T, Repas M, Wasson P, Wood K, Auker J, Culbertson T, Kieffer D, Voorhees T, Borgwardt L, DeRaad K, Eckert E, Isaacson H, Kuhn A, Carroll M, Xu P, Schubert G, Francis S, Hagan T, Le M, Penn E, Wickham C, Leyva K, Rivera J, Padilla I, Rodriguez N, Young K, Jospe J, Czyzyk B, Johnson U, Nadgir N, Marlen G, Prakasam C, Rieger N, Glaser E, Heiser B, Harris C, Alies P, Foster H, Slater K, Wheeler D, Donaldson M, Murray D, Hale R, Tragus D, Word J, Lynch L, Pankratz W, Badias F, Rogers R, Newfield S, Holland M, Hashiguchi M, Gottschalk A, Philis-Tsimikas R, Rosal S, Franklin S, Guardado N, Bohannon M, Baker A, Garcia T, Aguinaldo J, Phan V, Barraza D, Cohen J, Pinsker U, Khan J, Wiley L, Jovanovic P, Misra M, Bassi M, Wright D, Cohen K, Huang M, Skiles S, Maxcy C, Pihoker K, Cochrane J, Fosse S, Kearns M, Klingsheim N, Beam C, Wright L, Viles H, Smith S, Heller M, Cunningham A, Daniels L, Zeiden J, Field R, Walker K, Griffin L, Boulware D, Bartholow C, Erickson J, Howard B, Krabbenhoft C, Sandman A, Vanveldhuizen J, Wurlger A, Zimmerman K, Hanisch L, Davis-Keppen A, Bounmananh L, Cotterill J, Kirby M, Harris A, Schmidt C, Kishiyama C, Flores J, Milton W, Martin C, Whysham A, Yerka T, Bream S, Freels J, Hassing J, Webster R, Green P, Carter J, Galloway D, Hoelzer S, Roberts S, Said P, Sullivan H, Freeman D, Allen E, Reiter E, Feinberg C, Johnson L, Newhook D, Hagerty N, White L, Levandoski J, Kyllo M, Johnson C, Gough J, Benoit P, Iyer F, Diamond H, Hosono S, Jackman L, Barette P, Jones I, Sills S, Bzdick J, Bulger R, Ginem J, Weinstock I, Douek R, Andrews G, Modgill G, Gyorffy L, Robin N, Vaidya S, Crouch K, O’Brien C, Thompson N, Granger M, Thorne J, Blumer J, Kalic L, Klepek J, Paulett B, Rosolowski J, Horner M, Watkins J, Casey K, Carpenter C, Michelle Kieffer MH, Burns J, Horton C, Pritchard D, Soetaert A, Wynne C, Chin O, Molina C, Patel R, Senguttuvan M, Wheeler O, Lane P, Furet C, Steuhm D, Jelley S, Goudeau L, Chalmers D, Greer C, Panagiotopoulos D, Metzger D, Nguyen M, Horowitz M, Linton C, Christiansen E, Glades C, Morimoto M, Macarewich R, Norman K, Patin C, Vargas A, Barbanica A, Yu P, Vaidyanathan W, Nallamshetty L, Osborne R, Mehra S, Kaster S, Neace J, Horner G, Reeves C, Cordrey L, Marrs T, Miller S, Dowshen D, Oduah V, Doyle S, Walker D, Catte H, Dean M, Drury-Brown B, Hackman M, Lee S, Malkani K, Cullen K, Johnson P, Parrimon Y, Hampton M, McCarrell C, Curtis E, Paul, Zambrano Y, Paulus K, Pilger J, Ramiro J, Luvon Ritzie AQ, Sharma A, Shor A, Song X, Terry A, Weinberger J, Wootten M, Lachin JM, Foulkes M, Harding P, Krause-Steinrauf H, McDonough S, McGee PF, Owens Hess K, Phoebus D, Quinlan S, Raiden E, Batts E, Buddy C, Kirpatrick K, Ramey M, Shultz A, Webb C, Romesco M, Fradkin J, Leschek E, Spain L, Savage P, Aas S, Blumberg E, Beck G, Brillon D, Gubitosi-Klug R, Laffel L, Vigersky R, Wallace D, Braun J, Lernmark A, Lo B, Mitchell H, Naji A, Nerup J, Orchard T, Steffes M, Tsiatis A, Veatch R, Zinman B, Loechelt B, Baden L, Green M, Weinberg A, Marcovina S, Palmer JP, Weinberg A, Yu L, Babu S, Winter W, Eisenbarth GS, Bingley P, Clynes R, DiMeglio L, Eisenbarth G, Hays B, Leschek E, Marks J, Matheson D, Rafkin L, Rodriguez H, Spain L, Wilson D, Redondo M, Gomez D, McDonald A, Pena S, Pietropaolo M, Shippy K, Batts E, Brown T, Buckner J, Dove A, Hammond M, Hefty D, Klein J, Kuhns K, Letlau M, Lord S, McCulloch-Olson M, Miller L, Nepom G, Odegard J, Ramey M, Sachter E, St. Marie M, Stickney K, VanBuecken D, Vellek B, Webber C, Allen L, Bollyk J, Hilderman N, Ismail H, Lamola S, Sanda S, Vendettuoli H, Tridgell D, Monzavi R, Bock M, Fisher L, Halvorson M, Jeandron D, Kim M, Wood J, Geffner M, Kaufman F, Parkman R, Salazar C, Goland R, Clynes R, Cook S, Freeby M, Pat Gallagher M, Gandica R, Greenberg E, Kurland A, Pollak S, Wolk A, Chan M, Koplimae L, Levine E, Smith K, Trast J, DiMeglio L, Blum J, Evans-Molina C, Hufferd R, Jagielo B, Kruse C, Patrick V, Rigby M, Spall M, Swinney K, Terrell J, Christner L, Ford L, Lynch S, Menendez M, Merrill P, Pescovitz M, Rodriguez H, Alleyn C, Baidal D, Fay S, Gaglia J, Resnick B, Szubowicz S, Weir G, Benjamin R, Conboy D, deManbey A, Jackson R, Jalahej H, Orban T, Ricker A, Wolfsdorf J, Zhang HH, Wilson D, Aye T, Baker B, Barahona K, Buckingham B, Esrey K, Esrey T, Fathman G, Snyder R, Aneja B, Chatav M, Espinoza O, Frank E, Liu J, Perry J, Pyle R, Rigby A, Riley K, Soto A, Gitelman S, Adi S, Anderson M, Berhel A, Breen K, Fraser K, Gerard-Gonzalez A, Jossan P, Lustig R, Moassesfar S, Mugg A, Ng D, Prahalod P, Rangel-Lugo M, Sanda S, Tarkoff J, Torok C, Wesch R, Aslan I, Buchanan J, Cordier J, Hamilton C, Hawkins L, Ho T, Jain A, Ko K, Lee T, Phelps S, Rosenthal S, Sahakitrungruang T, Stehl L, Taylor L, Wertz M, Wong J, Philipson L, Briars R, Devine N, Littlejohn E, Grant T, Gottlieb P, Klingensmith G, Steck A, Alkanani A, Bautista K, Bedoy R, Blau A, Burke B, Cory L, Dang M, Fitzgerald-Miller L, Fouts A, Gage V, Garg S, Gesauldo P, Gutin R, Hayes C, Hoffman M, Ketchum K, Logsden-Sackett N, Maahs D, Messer L, Meyers L, Michels A, Peacock S, Rewers M, Rodriguez P, Sepulbeda F, Sippl R, Steck A, Taki I, Tran BK, Tran T, Wadwa RP, Zeitler P, Barker J, Barry S, Birks L, Bomsburger L, Bookert T, Briggs L, Burdick P, Cabrera R, Chase P, Cobry E, Conley A, Cook G, Daniels J, DiDomenico D, Eckert J, Ehler A, Eisenbarth G, Fain P, Fiallo-Scharer R, Frank N, Goettle H, Haarhues M, Harris S, Horton L, Hutton J, Jeffrrey J, Jenison R, Jones K, Kastelic W, King MA, Lehr D, Lungaro J, Mason K, Maurer H, Nguyen L, Proto A, Realsen J, Schmitt K, Schwartz M, Skovgaard S, Smith J, Vanderwel B, Voelmle M, Wagner R, Wallace A, Walravens P, Weiner L, Westerhoff B, Westfall E, Widmer K, Wright H, Schatz D, Abraham A, Atkinson M, Cintron M, Clare-Salzler M, Ferguson J, Haller M, Hosford J, Mancini D, Rohrs H, Silverstein J, Thomas J, Winter W, Cole G, Cook R, Coy R, Hicks E, Lewis N, Marks J, Pugliese A, Blaschke C, Matheson D, Pugliese A, Sanders-Branca N, Ray Arce LA, Cisneros M, Sabbag S, Moran A, Gibson C, Fife B, Hering B, Kwong C, Leschyshyn J, Nathan B, Pappenfus B, Street A, Boes MA, Peterson Eck S, Finney L, Albright Fischer T, Martin A, Jacqueline Muzamhindo C, Rhodes M, Smith J, Wagner J, Wood B, Becker D, Delallo K, Diaz A, Elnyczky B, Libman I, Pasek B, Riley K, Trucco M, Copemen B, Gwynn D, Toledo F, Rodriguez H, Bollepalli S, Diamond F, Eyth E, Henson D, Lenz A, Shulman D, Raskin P, Adhikari S, Dickson B, Dunnigan E, Lingvay I, Pruneda L, Ramos-Roman M, Raskin P, Rhee C, Richard J, Siegelman M, Sturges D, Sumpter K, White P, Alford M, Arthur J, Aviles-Santa ML, Cordova E, Davis R, Fernandez S, Fordan S, Hardin T, Jacobs A, Kaloyanova P, Lukacova-Zib I, Mirfakhraee S, Mohan A, Noto H, Smith O, Torres N, Wherrett D, Balmer D, Eisel L, Kovalakovska R, Mehan M, Sultan F, Ahenkorah B, Cevallos J, Razack N, Jo Ricci M, Rhode A, Srikandarajah M, Steger R, Russell WE, Black M, Brendle F, Brown A, Moore D, Pittel E, Robertson A, Shannon A, Thomas JW, Herold K, Feldman L, Sherwin R, Tamborlane W, Weinzimer S, Toppari J, Kallio T, Kärkkäinen M, Mäntymäki E, Niininen T, Nurmi B, Rajala P, Romo M, Suomenrinne S, Näntö-Salonen K, Simell O, Simell T, Bosi E, Battaglia M, Bianconi E, Bonfanti R, Grogan P, Laurenzi A, Martinenghi S, Meschi F, Pastore M, Falqui L, Teresa Muscato M, Viscardi M, Bingley P, Castleden H, Farthing N, Loud S, Matthews C, McGhee J, Morgan A, Pollitt J, Elliot-Jones R, Wheaton C, Knip M, Siljander H, Suomalainen H, Colman P, Healy F, Mesfin S, Redl L, Wentworth J, Willis J, Farley M, Harrison L, Perry C, Williams F, Mayo A, Paxton J, Thompson V, Volin L, Fenton C, Carr L, Lemon E, Swank M, Luidens M, Salgam M, Sharma V, Schade D, King C, Carano R, Heiden J, Means N, Holman L, Thomas I, Madrigal D, Muth T, Martin C, Plunkett C, Ramm C, Auchus R, Lane W, Avots E, Buford M, Hale C, Hoyle J, Lane B, Muir A, Shuler S, Raviele N, Ivie E, Jenkins M, Lindsley K, Hansen I, Fadoju D, Felner E, Bode B, Hosey R, Sax J, Jefferies C, Mannering S, Prentis R, She J, Stachura M, Hopkins D, Williams J, Steed L, Asatapova E, Nunez S, Knight S, Dixon P, Ching J, Donner T, Longnecker S, Abel K, Arcara K, Blackman S, Clark L, Cooke D, Plotnick L, Levin P, Bromberger L, Klein K, Sadurska K, Allen C, Michaud D, Snodgrass H, Burghen G, Chatha S, Clark C, Silverberg J, Wittmer C, Gardner J, LeBoeuf C, Bell P, McGlore O, Tennet H, Alba N, Carroll M, Baert L, Beaton H, Cordell E, Haynes A, Reed C, Lichter K, McCarthy P, McCarthy S, Monchamp T, Roach J, Manies S, Gunville F, Marosok L, Nelson T, Ackerman K, Rudolph J, Stewart M, McCormick K, May S, Falls T, Barrett T, Dale K, Makusha L, McTernana C, Penny-Thomas K, Sullivan K, Narendran P, Robbie J, Smith D, Christensen R, Koehler B, Royal C, Arthur T, Houser H, Renaldi J, Watsen S, Wu P, Lyons L, House B, Yu J, Holt H, Nation M, Vickers C, Watling R, Heptulla R, Trast J, Agarwal C, Newell D, Katikaneni R, Gardner C, Del A, Rio A, Logan H, Collier C, Rishton G, Whalley A, Ali S, Ramtoola T, Quattrin L, Mastrandea A, House M, Ecker C, Huang C, Gougeon J, Ho D, Pacuad D, Dunger J, May C, O’Brien C, Acerini B, Salgin A, Thankamony R, Williams J, Buse G, Fuller M, Duclos J, Tricome H, Brown D, Pittard D, Bowlby A, Blue T, Headley S, Bendre K, Lewis K, Sutphin C, Soloranzo J, Puskaric H, Madison M, Rincon M, Carlucci R, Shridharani B, Rusk E, Tessman D, Huffman H, Abrams B, Biederman M, Jones V, Leathers W, Brickman P, Petrie D, Zimmerman J, Howard L, Miller R, Alemzadeh D, Mihailescu R, Melgozza-Walker N, Abdulla C, Boucher-Berry D, Ize-Ludlow R, Levy C, Swenson, Brousell N, Crimmins D, Edler T, Weis C, Schultz D, Rogers D, Latham C, Mawhorter C, Switzer W, Spencer P, Konstantnopoulus S, Broder J, Klein L, Knight L, Szadek G, Welnick B, Thompson R, Hoffman A, Revell J, Cherko K, Carter E, Gilson J, Haines G, Arthur B, Bowen W, Zipf P, Graves R, Lozano D, Seiple K, Spicer A, Chang J, Fregosi J, Harbinson C, Paulson S, Stalters P, Wright D, Zlock A, Freeth J, Victory H, Maheshwari A, Maheshwari T, Holmstrom J, Bueno R, Arguello J, Ahern L, Noreika V, Watson S, Hourse P, Breyer C, Kissel Y, Nicholson M, Pfeifer S, Almazan J, Bajaj M, Quinn K, Funk J, McCance E, Moreno R, Veintimilla A, Wells J, Cook S, Trunnel J, Henske S, Desai K, Frizelis F, Khan R, Sjoberg K, Allen P, Manning G, Hendry B, Taylor S, Jones W, Strader M, Bencomo T, Bailey L, Bedolla C, Roldan C, Moudiotis B, Vaidya C, Anning S, Bunce S, Estcourt E, Folland E, Gordon C, Harrill J, Ireland J, Piper L, Scaife K, Sutton S, Wilkins M, Costelloe J, Palmer L, Casas C, Miller M, Burgard C, Erickson J, Hallanger-Johnson P, Clark W, Taylor A, Lafferty S, Gillett C, Nolan M, Pathak L, Sondrol T, Hjelle S, Hafner J, Kotrba R, Hendrickson A, Cemeroglu T, Symington M, Daniel Y, Appiagyei-Dankah D, Postellon M, Racine L, Kleis K, Barnes S, Godwin H, McCullough K, Shaheen G, Buck L, Noel M, Warren S, Weber S, Parker I, Gillespie B, Nelson C, Frost J, Amrhein E, Moreland A, Hayes J, Peggram J, Aisenberg M, Riordan J, Zasa E, Cummings K, Scott T, Pinto A, Mokashi K, McAssey E, Helden P, Hammond L, Dinning S, Rahman S, Ray C, Dimicri S, Guppy H, Nielsen C, Vogel C, Ariza L, Morales Y, Chang R, Gabbay L, Ambrocio L, Manley R, Nemery W, Charlton P, Smith L, Kerr B, Steindel-Kopp M, Alamaguer D, Liljenquist G, Browning T, Coughenour M, Sulk E, Tsalikan M, Tansey J, Cabbage N. Identical and Nonidentical Twins: Risk and Factors Involved in Development of Islet Autoimmunity and Type 1 Diabetes. Diabetes Care 2019; 42:192-199. [PMID: 30061316 PMCID: PMC6341285 DOI: 10.2337/dc18-0288] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [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] [Received: 02/07/2018] [Accepted: 06/28/2018] [Indexed: 02/03/2023]
Abstract
OBJECTIVE There are variable reports of risk of concordance for progression to islet autoantibodies and type 1 diabetes in identical twins after one twin is diagnosed. We examined development of positive autoantibodies and type 1 diabetes and the effects of genetic factors and common environment on autoantibody positivity in identical twins, nonidentical twins, and full siblings. RESEARCH DESIGN AND METHODS Subjects from the TrialNet Pathway to Prevention Study (N = 48,026) were screened from 2004 to 2015 for islet autoantibodies (GAD antibody [GADA], insulinoma-associated antigen 2 [IA-2A], and autoantibodies against insulin [IAA]). Of these subjects, 17,226 (157 identical twins, 283 nonidentical twins, and 16,786 full siblings) were followed for autoantibody positivity or type 1 diabetes for a median of 2.1 years. RESULTS At screening, identical twins were more likely to have positive GADA, IA-2A, and IAA than nonidentical twins or full siblings (all P < 0.0001). Younger age, male sex, and genetic factors were significant factors for expression of IA-2A, IAA, one or more positive autoantibodies, and two or more positive autoantibodies (all P ≤ 0.03). Initially autoantibody-positive identical twins had a 69% risk of diabetes by 3 years compared with 1.5% for initially autoantibody-negative identical twins. In nonidentical twins, type 1 diabetes risk by 3 years was 72% for initially multiple autoantibody-positive, 13% for single autoantibody-positive, and 0% for initially autoantibody-negative nonidentical twins. Full siblings had a 3-year type 1 diabetes risk of 47% for multiple autoantibody-positive, 12% for single autoantibody-positive, and 0.5% for initially autoantibody-negative subjects. CONCLUSIONS Risk of type 1 diabetes at 3 years is high for initially multiple and single autoantibody-positive identical twins and multiple autoantibody-positive nonidentical twins. Genetic predisposition, age, and male sex are significant risk factors for development of positive autoantibodies in twins.
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Affiliation(s)
- Taylor M. Triolo
- Barbara Davis Center for Diabetes, University of Colorado School of Medicine, Aurora, CO
| | - Alexandra Fouts
- Barbara Davis Center for Diabetes, University of Colorado School of Medicine, Aurora, CO
| | - Laura Pyle
- Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, CO
| | - Liping Yu
- Barbara Davis Center for Diabetes, University of Colorado School of Medicine, Aurora, CO
| | - Peter A. Gottlieb
- Barbara Davis Center for Diabetes, University of Colorado School of Medicine, Aurora, CO
| | - Andrea K. Steck
- Barbara Davis Center for Diabetes, University of Colorado School of Medicine, Aurora, CO
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Owens M, Coogle C, Gentili A, Marrs S, Slattum P, Parsons P, Waters L, Ansello E. EVIDENCE-BASED FALLS PREVENTION TRAINING AT A REGIONAL MEDICAL CENTER. Innov Aging 2018. [DOI: 10.1093/geroni/igy023.2835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- M Owens
- Virginia Commonwealth University
| | - C Coogle
- Virginia Commonwealth University
| | | | - S Marrs
- Virginia Commonwealth University
| | - P Slattum
- School of Pharmacy, Virginia Commonwealth University
| | | | - L Waters
- Virginia Commonwealth University
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Barlow N, Owens M. Participatory action research into implementing open access in musculoskeletal X-ray: Management and staff perspectives. Radiography (Lond) 2018; 24:224-233. [PMID: 29976335 DOI: 10.1016/j.radi.2018.01.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2017] [Revised: 01/16/2018] [Accepted: 01/28/2018] [Indexed: 11/27/2022]
Abstract
INTRODUCTION Neighbouring Trusts have implemented open access (walk-in) services to shorten waiting times in x-ray. Despite this, staff perceptions of their effectiveness have not yet been studied. This study forms the initial baseline evaluation phase of wider participatory action research investigating the implementation of an open access service for general practitioner musculoskeletal x-ray referrals. Staff perceptions regarding effectiveness of the current service were gathered, including their opinions regarding the effectiveness of open access services. METHODS Qualitative data were obtained via three semi-structured interviews with radiology management and two (cross-site) staff focus groups over a 2 month period. Template analysis was used to interpret the data with the aid of NVIVO 11 to facilitate analysis. RESULTS Template analysis uncovered several drivers for changing the current service including waiting times, external pressures, patient choice and administrative delays. 'Flexibility' was the key theme to arise during discussion regarding the effectiveness of the current service. Potential for improved access was highlighted as a major benefit to the implementation of open access, however 'workload', 'staffing' and 'communication' were all identified as potential barriers to its implementation. CONCLUSION Although several staff members were satisfied with current service several drivers for change were identified that need to be addressed in order to truly deliver a service that fulfils the patients' needs. Results will inform the wider participatory action research that will investigate the barriers to implementing an open access service and identify whether this is indeed a suitable method of addressing the drivers for change.
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Affiliation(s)
- N Barlow
- Pinderfields Hospital, Aberford Road, Wakefield WF1 4DG, United Kingdom.
| | - M Owens
- Pinderfields Hospital, Aberford Road, Wakefield WF1 4DG, United Kingdom
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Owens M, Sawchuk N, Harbeck-Weber C. Disruption of school attendance among adolescents/young adults with POTS and chronic pain. The Journal of Pain 2018. [DOI: 10.1016/j.jpain.2017.12.257] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Long N, Ng S, Donnelly G, Owens M, McNicholas M, McCarthy K, McCaul C. Anatomical characterisation of the cricothyroid membrane in females of childbearing age using computed tomography. Int J Obstet Anesth 2014; 23:29-34. [DOI: 10.1016/j.ijoa.2013.07.007] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2013] [Revised: 06/28/2013] [Accepted: 07/01/2013] [Indexed: 10/25/2022]
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Brodbeck J, Goodyer I, Abbott R, Dunn V, St Clair M, Owens M, Jones P, Croudace T. General distress, hopelessness-suicidal ideation and worrying in adolescence: concurrent and predictive validity of a symptom-level bifactor model for clinical diagnoses. J Affect Disord 2014; 152-154:299-305. [PMID: 24238952 PMCID: PMC3878575 DOI: 10.1016/j.jad.2013.09.029] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [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: 05/29/2013] [Revised: 09/19/2013] [Accepted: 09/20/2013] [Indexed: 11/28/2022]
Abstract
BACKGROUND Clinical disorders often share common symptoms and aetiological factors. Bifactor models acknowledge the role of an underlying general distress component and more specific sub-domains of psychopathology which specify the unique components of disorders over and above a general factor. METHODS A bifactor model jointly calibrated data on subjective distress from The Mood and Feelings Questionnaire and the Revised Children's Manifest Anxiety Scale. The bifactor model encompassed a general distress factor, and specific factors for (a) hopelessness-suicidal ideation, (b) generalised worrying and (c) restlessness-fatigue at age 14 which were related to lifetime clinical diagnoses established by interviews at ages 14 (concurrent validity) and current diagnoses at 17 years (predictive validity) in a British population sample of 1159 adolescents. RESULTS Diagnostic interviews confirmed the validity of a symptom-level bifactor model. The underlying general distress factor was a powerful but non-specific predictor of affective, anxiety and behaviour disorders. The specific factors for hopelessness-suicidal ideation and generalised worrying contributed to predictive specificity. Hopelessness-suicidal ideation predicted concurrent and future affective disorder; generalised worrying predicted concurrent and future anxiety, specifically concurrent generalised anxiety disorders. Generalised worrying was negatively associated with behaviour disorders. LIMITATIONS The analyses of gender differences and the prediction of specific disorders was limited due to a low frequency of disorders other than depression. CONCLUSIONS The bifactor model was able to differentiate concurrent and predict future clinical diagnoses. This can inform the development of targeted as well as non-specific interventions for prevention and treatment of different disorders.
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Affiliation(s)
- J. Brodbeck
- Developmental and Lifecourse Research Group, Department of Psychiatry, University of Cambridge, Cambridge, UK,Corresponding author. Tel.: +44 1223 746066; fax: +44 1223 746122.
| | - I.M. Goodyer
- Developmental and Lifecourse Research Group, Department of Psychiatry, University of Cambridge, Cambridge, UK,The Cambridge and Peterborough National Health Service (NHS) Foundation Trust, Douglas House, 18b Trumpington Road, Cambridge, CB2 8AH, UK,Corresponding author at: Developmental and Lifecourse Research Group, Department of Psychiatry, University of Cambridge, Douglas House, 18b Trumpington Road, Cambridge, CB2 8AH, UK.
| | - R.A. Abbott
- Developmental and Lifecourse Research Group, Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - V.J. Dunn
- Developmental and Lifecourse Research Group, Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - M.C. St Clair
- Developmental and Lifecourse Research Group, Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - M. Owens
- Developmental and Lifecourse Research Group, Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - P.B. Jones
- Developmental and Lifecourse Research Group, Department of Psychiatry, University of Cambridge, Cambridge, UK,The Cambridge and Peterborough National Health Service (NHS) Foundation Trust, Douglas House, 18b Trumpington Road, Cambridge, CB2 8AH, UK
| | - T.J. Croudace
- Developmental and Lifecourse Research Group, Department of Psychiatry, University of Cambridge, Cambridge, UK
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Long N, Ng S, Donnelly G, Owens M, McNicholas M, McCarthy K, McCaul C. Anatomical characterisation of the cricothyroid membrane in females of childbearing age using computed tomography. Int J Obstet Anesth 2013; 23:10-7. [PMID: 24291169 DOI: 10.1016/j.ijoa.2013.07.003] [Citation(s) in RCA: 62] [Impact Index Per Article: 5.6] [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: 01/06/2013] [Revised: 07/05/2013] [Accepted: 07/06/2013] [Indexed: 02/07/2023]
Abstract
BACKGROUND In the event of failure to secure the airway by conventional means, it may be necessary to perform invasive airway access via the cricothyroid membrane. No studies have addressed anatomy of this structure in the obstetric population. We aimed to review the anatomical variation of this structure in a population of childbearing age. METHODS We searched the radiology database for computed tomography studies of the neck performed in a 13-month period in consecutive patients aged 15-55 years. Studies on 18 females and 22 males were reviewed. Male patients were included for comparison. Data were reconstructed using a high spatial frequency algorithm to optimise spatial resolution. Five parameters were measured: distance from the skin to the membrane, maximum midline height of the membrane in the vertical plane, maximum transverse diameter of the membrane, neck diameter and cartilaginous calcification. RESULTS The distance (mean range) from skin to the membrane was similar in females and males (16.2 [3-33] vs. 13.9 [3-37] mm, P = 0.42). The vertical height (9.9 [7-17] vs. 11.4 [8-15] mm, P = 0.04) and maximum width of the membrane (14.5 [10-17] mm vs. 12.5 [10-15] mm, P < 0.01) were greater in males. Cartilaginous calcification was low and did not differ between genders. CONCLUSIONS The cricothyroid membrane is not necessarily a superficial structure and consequently may be difficult to palpate. The smallest dimensions of the membrane indicate that smaller than recommended cricothyroidotomy devices may be required in some patients as the external diameter of commercial trocar devices and tracheal tubes may exceed 7 mm.
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Affiliation(s)
- N Long
- Department of Radiology, The Mater Misericordiae University Hospital, Dublin, Ireland
| | - S Ng
- Department of Anaesthesia, The Rotunda Hospital, Dublin, Ireland
| | - G Donnelly
- Department of Anaesthesia, The Rotunda Hospital, Dublin, Ireland; Department of Anaesthesia, Mater Misericordiae, University Hospital, Dublin, Ireland
| | - M Owens
- Department of Anaesthesia, Mater Misericordiae, University Hospital, Dublin, Ireland
| | - M McNicholas
- Department of Radiology, The Mater Misericordiae University Hospital, Dublin, Ireland
| | - K McCarthy
- Department of Anaesthesia, The Rotunda Hospital, Dublin, Ireland
| | - C McCaul
- Department of Anaesthesia, The Rotunda Hospital, Dublin, Ireland; Department of Anaesthesia, Mater Misericordiae, University Hospital, Dublin, Ireland; School of Medicine and Medical Sciences, University College Dublin, Ireland.
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Ichimura H, Lihana R, Bi X, Ishizaki A, Ochieng W, Lwembe R, Panikulam A, Palakudy T, Owens M, Songok E. P270 Long term antiretroviral therapy outcome among HIV-1 vertically-infected Kenyan children. Int J Antimicrob Agents 2013. [DOI: 10.1016/s0924-8579(13)70511-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Owens M, Mohan H, Moloney MA, Roche-Nagle G, Baker J, Sheehan S, Mehigan D, Barry M. Patient knowledge of peripheral vascular disease in an outpatient setting: an Achilles heel? Ir Med J 2013; 106:116-118. [PMID: 23691846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Peripheral vascular disease (PVD) has numerous modifiable risk factors. This study aimed to establish patients' awareness of risk factors and causes of PVD and their understanding of mechanisms of secondary prevention. A prospective survey of awareness of PVD among patients attending a tertiary vascular clinic for management of peripheral vascular disease was undertaken. Institutional review board approval was granted. Statistical analysis was performed using SPSS version 18.0 software. There was a 100% response rate, with 97 participants (53 male). Seventeen patients (19%) reported an interval of greater than six months from the onset of symptoms to first seeking medical attention with their General Practitioner. Only 19 (20%) could correctly identify 3 or more risk factors for peripheral vascular disease. Patients have limited awareness of PVD and its consequences. Educational initiatives are needed to encourage patients to seek early medical attention and raise awareness of modifiable risk factors in the community.
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Affiliation(s)
- M Owens
- St Vincent's University Hospital, Elm Park, Dublin 4.
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Brooks AM, Owens M, Sayer JA, Salzmann M, Ellard S, Vaidya B. Pseudohypoaldosteronism type 2 presenting with hypertension and hyperkalaemia due to a novel mutation in the WNK4 gene. QJM 2012; 105:791-4. [PMID: 21764813 DOI: 10.1093/qjmed/hcr119] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- A M Brooks
- Department of Endocrinology, Royal Devon & Exeter Hospital, Exeter, UK
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Heathfield S, Parker B, Zeef L, Bruce I, Alexander Y, Collins F, Stone M, Wang E, Williams AS, Wright HL, Thomas HB, Moots RJ, Edwards SW, Bullock C, Chapman V, Walsh DA, Mobasheri A, Kendall D, Kelly S, Bayley R, Buckley CD, Young SP, Rump-Goodrich L, Middleton J, Chen L, Fisher R, Kollnberger S, Shastri N, Kessler BM, Bowness P, Nazeer Moideen A, Evans L, Osgood L, Williams AS, Jones SA, Nowell MA, Mahadik Y, Young S, Morgan M, Gordon C, Harper L, Giles JL, Paul Morgan B, Harris CL, Rysnik OJ, McHugh K, Kollnberger S, Payeli S, Marroquin O, Shaw J, Renner C, Bowness P, Nayar S, Cloake T, Bombardieri M, Pitzalis C, Buckley C, Barone F, Barone F, Nayar S, Cloake T, Lane P, Coles M, Buckley C, Williams EL, Edwards CJ, Cooper C, Oreffo RO, Dunn S, Crawford A, Wilkinson M, Le Maitre C, Bunning R, Daniels J, Phillips KLE, Chiverton N, Le Maitre CL, Kollnberger S, Shaw J, Ridley A, Wong-Baeza I, McHugh K, Keidel S, Chan A, Bowness P, Gullick NJ, Abozaid HS, Jayaraj DM, Evans HG, Scott DL, Choy EH, Taams LS, Hickling M, Golor G, Jullion A, Shaw S, Kretsos K, Bari SF, Rhys-Dillon B, Amos N, Siebert S, Phillips KLE, Chiverton N, Bunning RD, Haddock G, Cross AK, Le Maitre CL, Kate I, Phillips E, Cross A, Chiverton N, Haddock G, Bunning RAD, Le Maitre CL, Ceeraz S, Spencer J, Choy E, Corrigall V, Crilly A, Palmer H, Lockhart J, Plevin R, Ferrell WR, McInnes I, Hutchinson D, Perry L, DiCicco M, Humby F, Kelly S, Hands R, Buckley C, McInnes I, Taylor P, Bombardieri M, Pitzalis C, Mehta P, Mitchell A, Tysoe C, Caswell R, Owens M, Vincent T, Hashmi TM, Price-Forbes A, Sharp CA, Murphy H, Wood EF, Doherty T, Sheldon J, Sofat N, Goff I, Platt PN, Abdulkader R, Clunie G, Ismajli M, Nikiphorou E, Young A, Tugnet N, Dixey J, Banik S, Alcorn D, Hunter J, Win Maw W, Patil P, Hayes F, Main Wong W, Borg FA, Dasgupta B, Malaviya AP, Ostor AJ, Chana JK, Ahmed AA, Edmonds S, Hayes F, Coward L, Borg F, Heaney J, Amft N, Simpson J, Dhillon V, Ayalew Y, Khattak F, Gayed M, Amarasena RI, McKenna F, Amarasena RI, McKenna F, Mc Laughlin M, Baburaj K, Fattah Z, Ng N, Wilson J, Colaco B, Williams MR, Adizie T, Dasgupta B, Casey M, Lip S, Tan S, Anderson D, Robertson C, Devanny I, Field M, Walker D, Robinson S, Ryan S, Hassell A, Bateman J, Allen M, Davies D, Crouch C, Walker-Bone K, Gainsborough N, Gullick NJ, Lutalo PM, Davies UM, Walker-Bone K, Mckew JR, Millar AM, Wright SA, Bell AL, Thapper M, Roussou T, Cumming J, Hull RG, Thapper M, Roussou T, McKeogh J, O'Connor MB, Hassan AI, Bond U, Swan J, Phelan MJ, Coady D, Kumar N, Farrow L, Bukhari M, Oldroyd AG, Greenbank C, McBeth J, Duncan R, Brown D, Horan M, Pendleton N, Littlewood A, Cordingley L, Mulvey M, Curtis EM, Cole ZA, Crozier SR, Georgia N, Robinson SM, Godfrey KM, Sayer AA, Inskip HM, Cooper C, Harvey NC, Davies R, Mercer L, Galloway J, Low A, Watson K, Lunt M, Symmons D, Hyrich K, Chitale S, Estrach C, Moots RJ, Goodson NJ, Rankin E, Jiang CQ, Cheng KK, Lam TH, Adab P, Ling S, Chitale S, Moots RJ, Estrach C, Goodson NJ, Humphreys J, Ellis C, Bunn D, Verstappen SM, Symmons D, Fluess E, Macfarlane GJ, Bond C, Jones GT, Scott IC, Steer S, Lewis CM, Cope A, Mulvey MR, Macfarlane GJ, Symmons D, Lovell K, Keeley P, Woby S, Beasley M, McBeth J, Viatte S, Plant D, Lunt M, Fu B, Parker B, Galloway J, Solymossy C, Worthington J, Symmons D, Dixey J, Young A, Barton A, Williams FM, Osei-Bordom DC, Popham M, MacGregor A, Spector T, Little J, Herrick A, Pushpakom S, Ennis H, McBurney H, Worthington J, Newman W, Ibrahim I, Plant D, Hyrich K, Morgan A, Wilson A, Isaacs J, Barton A, Sanderson T, Hewlett S, Calnan M, Morris M, Raza K, Kumar K, Cardy CM, Pauling JD, Jenkins J, Brown SJ, McHugh N, Nikiphorou E, Mugford M, Davies C, Cooper N, Brooksby A, Bunn D, Symmons D, MacGregor A, Dures E, Ambler N, Fletcher D, Pope D, Robinson F, Rooke R, Hewlett S, Gorman CL, Reynolds P, Hakim AJ, Bosworth A, Weaver D, Kiely PD, Skeoch S, Jani M, Amarasena R, Rao C, Macphie E, McLoughlin Y, Shah P, Else S, Semenova O, Thompson H, Ogunbambi O, Kallankara S, Patel Y, Baguley E, Jani M, Halsey J, Severn A, Bukhari M, Selvan S, Price E, Husain MJ, Brophy S, Phillips CJ, Cooksey R, Irvine E, Siebert S, Lendrem D, Mitchell S, Bowman S, Price E, Pease CT, Emery P, Andrews J, Bombardieri M, Sutcliffe N, Pitzalis C, Lanyon P, Hunter J, Gupta M, McLaren J, Regan M, Cooper A, Giles I, Isenberg D, Griffiths B, Foggo H, Edgar S, Vadivelu S, Coady D, McHugh N, Ng WF, Dasgupta B, Taylor P, Iqbal I, Heron L, Pilling C, Marks J, Hull R, Ledingham J, Han C, Gathany T, Tandon N, Hsia E, Taylor P, Strand V, Sensky T, Harta N, Fleming S, Kay L, Rutherford M, Nicholl K, Kay L, Rutherford M, Nicholl K, Eyre T, Wilson G, Johnson P, Russell M, Timoshanko J, Duncan G, Spandley A, Roskell S, Coady D, West L, Adshead R, Donnelly SP, Ashton S, Tahir H, Patel D, Darroch J, Goodson NJ, Boulton J, Ellis B, Finlay R, Lendrem D, Mitchell S, Bowman S, Price E, Pease CT, Emery P, Andrews J, Bombardieri M, Sutcliffe N, Pitzalis C, Lanyon P, Hunter J, Gupta M, McLaren J, Regan M, Cooper A, Giles I, Isenberg D, Vadivelu S, Coady D, McHugh N, Griffiths B, Foggo H, Edgar S, Ng WF, Murray-Brown W, Priori R, Tappuni T, Vartoukian S, Seoudi N, Picarelli G, Fortune F, Valesini G, Pitzalis C, Bombardieri M, Ball E, Rooney M, Bell A, Merida AA, Isenberg D, Tarelli E, Axford J, Giles I, Pericleous C, Pierangeli SS, Ioannou J, Rahman A, Alavi A, Hughes M, Evans B, Bukhari M, Parker B, Zaki A, Alexander Y, Bruce I, Hui M, Garner R, Rees F, Bavakunji R, Daniel P, Varughese S, Srikanth A, Andres M, Pearce F, Leung J, Lim K, Regan M, Lanyon P, Oomatia A, Petri M, Fang H, Birnbaum J, Amissah-Arthur M, Gayed M, Stewart K, Jennens H, Braude S, Gordon C, Sutton EJ, Watson KD, Gordon C, Yee CS, Lanyon P, Jayne D, Isenberg D, Rahman A, Akil M, McHugh N, Ahmad Y, Amft N, D'Cruz D, Edwards CJ, Griffiths B, Khamashta M, Teh LS, Zoma A, Bruce I, Dey ID, Kenu E, Isenberg D, Pericleous C, Garza-Garcia A, Murfitt L, Driscoll PC, Isenberg D, Pierangeli S, Giles I, Ioannou Y, Rahman A, Reynolds JA, Ray DW, O'Neill T, Alexander Y, Bruce I, Segeda I, Shevchuk S, Kuvikova I, Brown N, Bruce I, Venning M, Mehta P, Dhanjal M, Mason J, Nelson-Piercy C, Basu N, Paudyal P, Stockton M, Lawton S, Dent C, Kindness K, Meldrum G, John E, Arthur C, West L, Macfarlane MV, Reid DM, Jones GT, Macfarlane GJ, Yates M, Loke Y, Watts R, MacGregor A, Adizie T, Christidis D, Dasgupta B, Williams M, Sivakumar R, Misra R, Danda D, Mahendranath KM, Bacon PA, Mackie SL, Pease CT. Basic science * 232. Certolizumab pegol prevents pro-inflammatory alterations in endothelial cell function. Rheumatology (Oxford) 2012. [DOI: 10.1093/rheumatology/kes108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Owens M, Barry M, Janjua AZ, Winter DC. A systematic review of laparoscopic port site hernias in gastrointestinal surgery. Surgeon 2011; 9:218-24. [PMID: 21672662 DOI: 10.1016/j.surge.2011.01.003] [Citation(s) in RCA: 64] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2010] [Revised: 12/23/2010] [Accepted: 01/03/2011] [Indexed: 01/11/2023]
Abstract
INTRODUCTION Port site hernia is an important yet under-recognised complication of laparoscopic surgery, which carries a high risk of strangulation due to the small size of the defect involved. The purpose of this study was to examine the incidence, classification, and pathogenesis of this complication, and to evaluate strategies to prevent and treat it. METHODS Medline was searched using the words "port site hernia", "laparoscopic port hernia" "laparoscopic complications" and "trocar site hernias". The search was limited to articles on cholecystectomy, colorectal, bariatric or anti-reflux surgery published in English. A total of 42 articles were analysed and of these 35 were deemed eligible for review. Inclusion criteria were laparoscopic gastrointestinal surgery in English only with reported incidence of port site herniation. Studies were excluded if insufficient data was provided. Eligible studies were also cross-referenced. RESULTS Analysis of 11,699 patients undergoing laparoscopic gastrointestinal procedures demonstrated an incidence of port site hernias of 0.74% with a mean follow-up of 23.9 months. The lowest incidence of port site herniation was for bariatric surgery with 0.57% in 2644 patients with a mean follow-up of 67.4 months while the highest incidence was for laparoscopic colorectal surgery with an incidence of 1.47% in 477 patients with a mean follow-up of 71.5 months. CONCLUSION All fascial defects larger than or equal to 10mm should be closed with peritoneum, while smaller defects may require closure in certain circumstances to prevent herniation. Laparoscopic port site herniation is a completely preventable cause of morbidity that requires a second surgical procedure to repair.
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Affiliation(s)
- M Owens
- Department of Surgery, St. Vincent's University Hospital, Dublin, Ireland
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Ploumis A, Kolli S, Patrick M, Owens M, Beris A, Marino RJ. Length of stay and medical stability for spinal cord-injured patients on admission to an inpatient rehabilitation hospital: a comparison between a model SCI trauma center and non-SCI trauma center. Spinal Cord 2010; 49:411-5. [DOI: 10.1038/sc.2010.132] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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McGowan B, Bennett K, Barry M, Owens M, O'Connor M. An analysis of the utilisation and expenditure of medicines dispensed for the management of severe asthma. Ir Med J 2009; 102:73-76. [PMID: 19489193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
There are approximately 6,300 people in Ireland with a diagnosis of Chronic Obstructive Pulmonary Disease (COPD) and with a fast growing elderly population the incidence of COPD is likely to increase. This study examines the prescribing patterns of medicines dispensed for the management Asthma/COPD in patients over the age of 35 years using the HSE-Primary Care Reimbursement Services (PCRS) prescribing databases. The HSE-PCRS pharmacy claims data, which covers all those over 70 years of age and means tested for those less than 70 years, was analysed for the years 2005/2006. Approximately 26,548 (17.9%) of patients who were prescribed a respiratory drug received inhaled short-acting beta2 agonists in combination with a regular standard-dose inhaled corticosteroid. A further 5,044 (3.4%) were also prescribed a regular inhaled long-acting beta2 agonist (salmeterol or formoterol). A total of 2506 patients (6.2%) on combination therapy were co-prescribed four different anti-asthmatic treatments inclusive of oral prednisolone. A small proportion of the patients prescribed a respiratory drug were co-prescribed nicotine replacement therapy (n = 5177, 3.5%). In total there were 9,728 (6.2%) patients prescribed a mucolytic drug in combination with a respiratory drug and the rate of co-prescribing with antibiotics was 22%. COPD is a debilitating disease that is primarily caused by smoking and is therefore largely preventable. The HSE-PCRS pharmacy claims data is a valuable tool for helping to assess the burden of this disease in the Irish context.
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Affiliation(s)
- B McGowan
- Department of Pharmacology and Therapeutics, Trinity Centre for Health Sciences, St James's Hospital, James's St, Dublin 8.
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Nollert P, Owens M, Kaminsky W, Vincent T, Mixon M. Preparation and imaging of lipidic cubic phase based protein crystallization experiments. Acta Crystallogr A 2008. [DOI: 10.1107/s0108767308093604] [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: 11/10/2022] Open
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Ellard S, Thomas K, Edghill EL, Owens M, Ambye L, Cropper J, Little J, Strachan M, Stride A, Ersoy B, Eiberg H, Pedersen O, Shepherd MH, Hansen T, Harries LW, Hattersley AT. Partial and whole gene deletion mutations of the GCK and HNF1A genes in maturity-onset diabetes of the young. Diabetologia 2007; 50:2313-7. [PMID: 17828387 DOI: 10.1007/s00125-007-0798-6] [Citation(s) in RCA: 53] [Impact Index Per Article: 3.1] [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: 05/17/2007] [Accepted: 07/02/2007] [Indexed: 10/22/2022]
Abstract
AIMS/HYPOTHESIS Heterozygous mutations of glucokinase (GCK) and hepatocyte nuclear factor-1 alpha (HNF1A; also known as hepatic transcription factor 1 [TCF1]) genes are the most common cause of MODY. Genomic deletions of the HNF1B (also known as TCF2) gene have recently been shown to account for one third of mutations causing renal cysts and diabetes syndrome. We investigated the prevalence of partial and whole gene deletions in UK patients meeting clinical criteria for GCK or HNF-1alpha/-4alpha MODY and in whom no mutation had been identified by sequence analysis. METHODS A multiplex ligation-dependent probe amplification (MLPA) assay was developed using synthetic oligonucleotide probes for 30 exons of the GCK, HNF1A and HNF4A genes. RESULTS Partial or whole gene deletions were identified in 1/29 (3.5%) probands using the GCK MLPA assay and 4/60 (6.7%) of probands using the HNF1A/-4A MLPA assay. Four different deletions were detected: GCK exon 2, HNF1A exon 1, HNF1A exons 2 to 10 and HNF1A exons 1 to 10. An additional Danish pedigree with evidence of linkage to HNF1A had a deletion of exons 2 to 10. Testing other family members confirmed co-segregation of the deletion mutations with diabetes in the pedigrees. CONCLUSIONS/INTERPRETATION Large deletions encompassing whole exons can cause GCK or HNF-1alpha MODY and will not be detected by sequencing. Gene dosage assays, such as MLPA, are a useful adjunct to sequence analysis when a diagnosis of MODY is strongly suspected.
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Affiliation(s)
- S Ellard
- Institute of Biomedical Science and Clinical Medicine, Peninsula Medical School, Exeter, UK.
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Edghill EL, Oram RA, Owens M, Stals KL, Harries LW, Hattersley AT, Ellard S, Bingham C. Hepatocyte nuclear factor-1 gene deletions--a common cause of renal disease. Nephrol Dial Transplant 2007; 23:627-35. [DOI: 10.1093/ndt/gfm603] [Citation(s) in RCA: 85] [Impact Index Per Article: 5.0] [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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Senzer N, Rosemurgy A, Javle M, Reid T, Posner MC, Chang KJ, Owens M, Shirinian M, Stephenson J, Hecht JR. The PACT trial: Interim results of a randomized trial of TNFerade biologic plus chemoradiation (CRT) compared to CRT alone in locally advanced pancreatic cancer (LAPC). J Clin Oncol 2006. [DOI: 10.1200/jco.2006.24.18_suppl.4102] [Citation(s) in RCA: 5] [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
4102 Background: TNFerade is a second-generation replication-deficient adenovector, carrying the transgene encoding human TNF-α, regulated by the stress-inducible promoter Egr-1. In a phase I trial of TNFerade + radiation in 36 patients with advanced or refractory solid tumors, a 47% objective tumor response rate was observed, including 100% complete responses in 3 stage 4 melanoma patients, with 2/3 disease-free at >3.5 years. Methods: This controlled phase II trial randomizes 74 patients with newly diagnosed unresectable LAPC to 5-wks of TNFerade (4 × 1011 pu via weekly intratumoral injection) + CRT (5-FU [200 mg/m2/day CIV × 5 days/wk] and 50.4 Gy radiation) or CRT alone. All patients receive maintenance gemcitabine. Endpoints: Progression-free survival, safety, radiographic tumor response, CA 19–9 and survival. Results: In dose escalation (n=50) dose-limiting toxicities occurred in 3 patients at 1 × 1012 pu (pancreatitis in 2 and biliary obstruction), setting the MTD at 4 × 1011 pu. Compared with the first two cohorts (n=30), the MTD (n = 11) was associated with greater locoregional control and progression-free survival, a higher rate of stable or decreasing CA 19–9, improved overall survival (median = 11.2), and a high (45%) resection rate. Accrual continues in the randomized phase of the study at 20+ centers. The most frequent adverse events in the first 16 enrolled patients have been nausea (75%), abdominal pain (63%), constipation (50%), anemia (38%), diarrhea (38%), vomiting (38%), and weight loss (38%), with no significant difference in severity or frequency between the TNFerade + CRT and CRT groups. No thromboembolic events have been reported. Serum TNF-alpha levels have remained low (peak = 45.3 pg/mL, in a CRT patient). CA 19–9 has been stable (no change > 100 U/mL) or decreased in all but one CRT patient. Conclusions: These initial data indicate that TNFerade plus CRT, given as weekly intratumoral injections to patients with LAPC, is feasible and tolerable compared to CRT alone. With continued accrual, comparative tumor response and toxicity data will be available and updated. No significant financial relationships to disclose.
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Affiliation(s)
- N. Senzer
- Mary Crowley Medical Research Center, Dallas, TX; University of South Florida, Tampa, FL; Roswell Park Cancer Institute, Buffalo, NY; University of California San Diego, San Diego, CA; University of Chicago, Chicago, IL; University of California Irvine, Irvine, CA; Providence St. Vincent Medical Center, Portland, OR; Glendale Adventist Hospital, Glendale, CA; Cancer Centers of the Carolinas, Greenville, SC; UCLA School of Medicine, Los Angeles, CA
| | - A. Rosemurgy
- Mary Crowley Medical Research Center, Dallas, TX; University of South Florida, Tampa, FL; Roswell Park Cancer Institute, Buffalo, NY; University of California San Diego, San Diego, CA; University of Chicago, Chicago, IL; University of California Irvine, Irvine, CA; Providence St. Vincent Medical Center, Portland, OR; Glendale Adventist Hospital, Glendale, CA; Cancer Centers of the Carolinas, Greenville, SC; UCLA School of Medicine, Los Angeles, CA
| | - M. Javle
- Mary Crowley Medical Research Center, Dallas, TX; University of South Florida, Tampa, FL; Roswell Park Cancer Institute, Buffalo, NY; University of California San Diego, San Diego, CA; University of Chicago, Chicago, IL; University of California Irvine, Irvine, CA; Providence St. Vincent Medical Center, Portland, OR; Glendale Adventist Hospital, Glendale, CA; Cancer Centers of the Carolinas, Greenville, SC; UCLA School of Medicine, Los Angeles, CA
| | - T. Reid
- Mary Crowley Medical Research Center, Dallas, TX; University of South Florida, Tampa, FL; Roswell Park Cancer Institute, Buffalo, NY; University of California San Diego, San Diego, CA; University of Chicago, Chicago, IL; University of California Irvine, Irvine, CA; Providence St. Vincent Medical Center, Portland, OR; Glendale Adventist Hospital, Glendale, CA; Cancer Centers of the Carolinas, Greenville, SC; UCLA School of Medicine, Los Angeles, CA
| | - M. C. Posner
- Mary Crowley Medical Research Center, Dallas, TX; University of South Florida, Tampa, FL; Roswell Park Cancer Institute, Buffalo, NY; University of California San Diego, San Diego, CA; University of Chicago, Chicago, IL; University of California Irvine, Irvine, CA; Providence St. Vincent Medical Center, Portland, OR; Glendale Adventist Hospital, Glendale, CA; Cancer Centers of the Carolinas, Greenville, SC; UCLA School of Medicine, Los Angeles, CA
| | - K. J. Chang
- Mary Crowley Medical Research Center, Dallas, TX; University of South Florida, Tampa, FL; Roswell Park Cancer Institute, Buffalo, NY; University of California San Diego, San Diego, CA; University of Chicago, Chicago, IL; University of California Irvine, Irvine, CA; Providence St. Vincent Medical Center, Portland, OR; Glendale Adventist Hospital, Glendale, CA; Cancer Centers of the Carolinas, Greenville, SC; UCLA School of Medicine, Los Angeles, CA
| | - M. Owens
- Mary Crowley Medical Research Center, Dallas, TX; University of South Florida, Tampa, FL; Roswell Park Cancer Institute, Buffalo, NY; University of California San Diego, San Diego, CA; University of Chicago, Chicago, IL; University of California Irvine, Irvine, CA; Providence St. Vincent Medical Center, Portland, OR; Glendale Adventist Hospital, Glendale, CA; Cancer Centers of the Carolinas, Greenville, SC; UCLA School of Medicine, Los Angeles, CA
| | - M. Shirinian
- Mary Crowley Medical Research Center, Dallas, TX; University of South Florida, Tampa, FL; Roswell Park Cancer Institute, Buffalo, NY; University of California San Diego, San Diego, CA; University of Chicago, Chicago, IL; University of California Irvine, Irvine, CA; Providence St. Vincent Medical Center, Portland, OR; Glendale Adventist Hospital, Glendale, CA; Cancer Centers of the Carolinas, Greenville, SC; UCLA School of Medicine, Los Angeles, CA
| | - J. Stephenson
- Mary Crowley Medical Research Center, Dallas, TX; University of South Florida, Tampa, FL; Roswell Park Cancer Institute, Buffalo, NY; University of California San Diego, San Diego, CA; University of Chicago, Chicago, IL; University of California Irvine, Irvine, CA; Providence St. Vincent Medical Center, Portland, OR; Glendale Adventist Hospital, Glendale, CA; Cancer Centers of the Carolinas, Greenville, SC; UCLA School of Medicine, Los Angeles, CA
| | - J. R. Hecht
- Mary Crowley Medical Research Center, Dallas, TX; University of South Florida, Tampa, FL; Roswell Park Cancer Institute, Buffalo, NY; University of California San Diego, San Diego, CA; University of Chicago, Chicago, IL; University of California Irvine, Irvine, CA; Providence St. Vincent Medical Center, Portland, OR; Glendale Adventist Hospital, Glendale, CA; Cancer Centers of the Carolinas, Greenville, SC; UCLA School of Medicine, Los Angeles, CA
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Pitas G, Laurenzana E, Owens M, Gentry B. Single Dose Anti-PCP IGG Alters Tissue Distribution of Bolus PCP Doses During A Continuous, High-Dose PCP Infusion in Rats. Clin Pharmacol Ther 2003. [DOI: 10.1016/s0009-9236(03)90646-1] [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: 10/25/2022]
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Gold BD, van Doorn LJ, Guarner J, Owens M, Pierce-Smith D, Song Q, Hutwagner L, Sherman PM, de Mola OL, Czinn SJ. Genotypic, clinical, and demographic characteristics of children infected with Helicobacter pylori. J Clin Microbiol 2001; 39:1348-52. [PMID: 11283055 PMCID: PMC87938 DOI: 10.1128/jcm.39.4.1348-1352.2001] [Citation(s) in RCA: 41] [Impact Index Per Article: 1.8] [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: 01/06/2023] Open
Abstract
Helicobacter pylori isolates vary between geographic regions. Certain H. pylori genotypes may be associated with disease outcome. Thirty-eight children underwent diagnostic upper endoscopy at four medical centers and were retrospectively analyzed to determine if H. pylori virulence genes were associated with endoscopic disease severity, histologic parameters, and host demographics. The H. pylori virulence genotype was analyzed by a reverse hybridization line probe assay and type-specific PCR. Endoscopic ulcers or erosions were found in 17 (45%) patients, with 13 (34%) of these patients having antral nodularity. Histological gastritis, of varying severity, was present in all children. Four patients harbored more than one H. pylori strain: one subject had both cagA(+) and cagA-negative strains, while three patients harbored either two different cagA-negative strains (two children) or two cagA(+) strains (one child). There were 28 (74%) cagA(+) isolates; 19 were associated with the vacA s1b genotype, 7 were associated with the vacA s1a genotype, 1 was associated with the vacA s1c genotype, and 1 was associated with the s2 genotype. Of 14 cagA-negative isolates, 6 were vacA s2 genotype, 4 were vacA s1b, 3 were vacA s1a, and 1 was vacA s1c. Nine of ten (90%) Hispanics had similar H. pylori strains (vacA s1b,m1), and all Asian-Canadian children were infected by strains with vacA s1c genotype. No correlation between H. pylori strain and endoscopic or histopathologic abnormalities was found. This study provides a baseline framework of North American children and their H. pylori strains, serving as a powerful epidemiological tool for prospective investigations to better understand the transmission and evolution of diverse disease outcomes.
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Affiliation(s)
- B D Gold
- Department of Pediatrics, Division of Pediatric Gastroenterology, Emory University School of Medicine, Children's Healthcare of Atlanta at Egleston, USA.
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Hisada M, Lee MG, Hanchard B, Owens M, Song Q, van Doorn LJ, Cutler AF, Gold BD. Characteristics of Helicobacter pylori infection in Jamaican adults with gastrointestinal symptoms. J Clin Microbiol 2001; 39:212-6. [PMID: 11136773 PMCID: PMC87704 DOI: 10.1128/jcm.39.1.212-216.2001] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [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: 12/18/2022] Open
Abstract
Helicobacter pylori infection is common in Jamaica. Describing its epidemiology in a population-based study depends largely on serology, but serologic assays have not been validated in this population. To address this issue, we examined the presence of H. pylori infection in 30 sequential adult patients with gastroduodenal symptoms by three biopsy-based methods (rapid urease test, histology, and culture) as well as by one research and two commercial enzyme-linked immunosorbent assays (ELISAs). A patient was considered H. pylori positive if the organism was detected by at least one biopsy-based method. Eighteen (60%) of the 30 patients were H. pylori positive by these criteria, whereas 21 (70%) were seropositive for H. pylori immunoglobulin G by our research ELISA. The presence of H. pylori infection in patients with gastric cancer and those with chronic gastritis was missed by biopsy-based methods but was detected by serologic assays. This observation indicates that serologic assays may be better suited for the detection of this infection in a population in which H. pylori-associated pathology is prevalent. The performance of our research ELISA in detecting biopsy-based H. pylori-positive cases was excellent, with a sensitivity and specificity of 100% and 75%, respectively. Molecular genotyping of the isolates revealed that the predominant H. pylori genotypes in this cohort of Jamaicans were cagA(+) vacA slb-m1, and iceA2. The validated serologic assay enables us to interpret epidemiologic data from population-based studies in Jamaica by comparison to those from other populations.
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Affiliation(s)
- M Hisada
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland, USA.
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Soria I, Myhre P, Horton V, Ellefson P, McCarville S, Schmitt K, Owens M. Effect of food on the pharmacokinetics and bioavailability of oral imiquimod relative to a subcutaneous dose. Int J Clin Pharmacol Ther 2000; 38:476-81. [PMID: 11073288 DOI: 10.5414/cpp38476] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVES The present study, the first clinical pharmacokinetic report of the immune response modifier imiquimod, was conducted to assess the effect of food on the oral absorption of imiquimod, to characterize its pharmacokinetics, and to estimate its oral bioavailability. SUBJECTS AND METHODS Sixteen healthy male volunteers completed this open-label, randomized, three-period crossover study. Subjects received a 100 mg oral dose of imiquimod after fasting in one period, after a standarized, high fat meal in another, and a 30 mg subcutaneous dose in the third period. RESULTS The oral bioavailability of imiquimod was on average 47%, and independent of whether imiquimod was administered with or without food. Oral imiquimod was absorbed in both fasted and non-fasted states with an absorption half-life of approximately 1 hour. However, there seemed to be a delay in the initiation of the absorption process when food was administered, which translated in to a Tmax of approximately 2.6 hours while fasting and one hour later in the non-fasted state. Imiquimod was rapidly eliminated with a half-life of approximately 2.5 hours and a total body clearance of approximately 970 ml/hxkg. Although equivalence could not be established due to the large intersubject variability, no significant differences in rate (Cmax) and extent (AUC) of oral absorption were observed between the fasted and non-fasted states. In addition, the Cmax, AUC and bioavailability values for individual subjects were consistent between both oral treatments. CONCLUSION This study suggests that food does not have a major effect on the rate, extent of absorption or bioavailability of oral imiquimod, and thus, it is suitable to administer imiquimod orally in either the fasted or non-fasted states.
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Affiliation(s)
- I Soria
- Department of Pharmacokinetics and Drug Metabolism, 3M Pharmaceuticals, St. Paul, MN 55144-1000, USA
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29
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Bay WH, Van Cleef S, Owens M. The hemodialysis access: preferences and concerns of patients, dialysis nurses and technicians, and physicians. Am J Nephrol 2000; 18:379-83. [PMID: 9730560 DOI: 10.1159/000013380] [Citation(s) in RCA: 58] [Impact Index Per Article: 2.4] [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: 11/19/2022]
Abstract
One hundred twenty-eight hemodialysis patients and 64 medical personnel consisting of dialysis nurses and technicians, hemodialysis access surgeons and nephrologists were surveyed about their preferences and concerns in regard to the hemodialysis vascular access. The access preferred by physicians was the A-V fistula in the lower arm. In contrast, the access preferred by dialysis nurses and technicians was the polytetrafluoroethylene (PTFE) graft in the lower arm. Patients desired a superficial access in the forearm which was easy to cannulate, had minimal effect on their appearance, provided quick hemostasis after dialysis and enabled arm comfort during dialysis. Physicians felt the most significant concerns about the access were thrombosis and infection. Nurses and technicians ranked difficult cannulation and insufficient access blood flows that prohibited dialysis adequacy as their major problems. For patients the most common problem was pain during needle insertion. This survey concluded that the A-V fistula remains the access of choice. However, appropriate maturation of the fistula must occur before needle insertion is attempted. An immature fistula is difficult to cannulate, has fragile veins resulting in blood leakage around the needle infiltrating the subcutaneous tissues and has inadequate blood flows for successful dialysis. Patients who are introduced to dialysis with inadequate access function or access failure from either an A-V fistula or a PTFE graft have increased morbidity, inadequate dialysis and enhanced anxiety about dialysis treatments. To increase the success and acceptance of A-V fistulas in hemodialysis patients it is incumbent upon the nephrologist to protect the future access arm from damage to the vasculature and to allow for fistula maturation before cannulation. Surgical protocols must improve the appropriate selection of a fistula or PTFE graft for various age groups and disease categories. Better patient preparation and selection of the proper access type for each patient will enhance early access function and subsequent access survival.
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Affiliation(s)
- W H Bay
- Division of Nephrology, Department of Internal Medicine, The Ohio State University, Columbus, Ohio 43210-1228, USA
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30
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Geer J, Owens M. Public relations as a means of public education on the role of bariatric surgery. Obes Surg 2000; 10:73-4. [PMID: 10715652 DOI: 10.1381/09608920060674193] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- J Geer
- Miller/Geer & Associates, Los Angeles, CA, USA
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31
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Manassis K, Owens M, Adam KS, West M, Sheldon-Keller AE. Assessing attachment: convergent validity of the adult attachment interview and the parental bonding instrument. Aust N Z J Psychiatry 1999; 33:559-67. [PMID: 10483852 DOI: 10.1080/j.1440-1614.1999.00560.x] [Citation(s) in RCA: 52] [Impact Index Per Article: 2.1] [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] [Indexed: 10/20/2022]
Abstract
OBJECTIVE The aim of this study was to determine whether or not the Parental Bonding Instrument (PBI) can provide information about parent-child attachment that is comparable to information obtained from the Adult Attachment Interview (AAI), a more complex measure of attachment. METHOD One hundred and thirty emotionally and/or behaviourally disturbed adolescents (73 male, 57 female; ages 13-19 years, x = 15.3 +/- 1.47 years) participating in a study of attachment and suicidality completed the PBI and the AAI. Data from these measures were compared within participants. RESULTS Maternal care and overprotection on the PBI differed significantly by AAI attachment classification (F3,122 = 2.79, p = 0.012), with autonomous participants showing the most optimal and unresolved participants the least optimal PBI results. Maternal love and maternal involvement/role reversal on the AAI were significant predictors of maternal care and maternal overprotection, respectively, on the PBI (R2 = 0.15; R2 = 0.16). These predictions improved when AAI scales measuring idealisation and involving anger towards the mother were included in the regression analyses (R2 = 0.35; R2 = 0.20). Autonomous participants on AAI showed the highest scale correlations across instruments. CONCLUSIONS Attachment information obtained from the PBI and the AAI is comparable in participants with optimal attachment histories, but not in participants showing idealisation or anger towards their mothers. Caution is, therefore, advisable when using the PBI to obtain attachment information in clinical samples where suboptimal attachment histories are likely.
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Affiliation(s)
- K Manassis
- Department of Psychiatry, Hospital for Sick Children, Toronto, ON, Canada.
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Goldstein D, Hertzog P, Tomkinson E, Couldwell D, McCarville S, Parrish S, Cunningham P, Newell M, Owens M, Cooper DA. Administration of imiquimod, an interferon inducer, in asymptomatic human immunodeficiency virus-infected persons to determine safety and biologic response modification. J Infect Dis 1998; 178:858-61. [PMID: 9728559 DOI: 10.1086/515343] [Citation(s) in RCA: 55] [Impact Index Per Article: 2.1] [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: 11/03/2022] Open
Abstract
A phase I study to determine safety, maximum tolerated dose, and biologic response during multiple once-a-week administration of oral imiquimod, an immune response modifier, was conducted in 12 adults with early human immunodeficiency virus (HIV) infection. All completed the dose-escalation phase of weekly dosing at 100-mg increments and received at least one maintenance dose, 100 mg below the patient's toxic dose, for 12 weeks. Dose-limiting toxicity occurred in 3 patients at 200-mg, 5 at 300-mg, and 3 at 400-mg dose levels. One tolerated the 500-mg dose without dose-limiting toxicity. Dose-limiting toxicities included fatigue, fever, malaise, increased transaminases, hypotension, vomiting, and depression. Seven of 12 completed 12 weeks of maintenance. At > or = 200 mg of imiquimod, all patients had biologic responses, measured by elevations in serum interferon, beta2-microglobulin, and neopterin levels. Imiquimod induced pronounced levels of circulating interferon in asymptomatic HIV-infected persons, with variable effect on virus load.
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Affiliation(s)
- D Goldstein
- Department of Medical Oncology, Prince of Wales Hospital, National Centre in HIV Epidemiology and Clinical Research, University of New South Wales, Sydney, Australia.
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Beutner K, Edwards L, Owens M, Fox T. Comparison of two vehicle-controlled trials of imiquimod 5% cream for the treatment of external genital warts. J Dermatol Sci 1998. [DOI: 10.1016/s0923-1811(98)84257-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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MacKenzie-Wood A, de Launey J, Kossard S, Svans R, Fox T, Owens M. Safety and efficacy of imiquimod 5% cream for the treatment of bowen's disease. J Dermatol Sci 1998. [DOI: 10.1016/s0923-1811(98)84271-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [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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Wallace W, Beshear S, Williams D, Hospadar S, Owens M. Perchlorate reduction by a mixed culture in an up-flow anaerobic fixed bed reactor. J Ind Microbiol Biotechnol 1998. [DOI: 10.1038/sj.jim.2900494] [Citation(s) in RCA: 68] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Abstract
Imiquimod is an orally active interferon inducer with anti-tumour activity in experimental animals. In this study the tolerability, toxicity and biological effects of daily oral imiquimod administration were investigated in 21 patients with refractory cancer. Patients were treated with doses of 25 mg, 50 mg, 100 mg or 200 mg on a projected 112 day course. Only three patients completed the course, all at the 50 mg dose. Treatment toxicities were dose related and mainly comprised flu-like symptoms, nausea and lymphopenia. Of the 21 patients, five received dose reductions and in five treatment was discontinued because of treatment-related toxicity. The biological activity of imiquimod was confirmed by significant and sustained rises in peripheral blood mononuclear cell (PBMC) 2-5A synthetase (2-5AS) levels at all doses. At 100 mg and 200 mg these occurred within the first 24 h of administration. Levels of neopterin and beta 2-microglobulin (beta 2M) were also significantly elevated when assessed after three weeks' treatment. Interferon production was not demonstrated within the first 24 h of the initial dose but, following repeated doses, ten of the patients developed detectable serum interferon concentrations with a maximum value of 5600 IU ml-1 recorded. Administration of imiquimod did not have any significant effect on serum levels of tumour necrosis factor (TNF) or interleukin 1 (IL-1), nor did it lead to development of detectable levels of antibodies to interferon. One mixed clinical response was observed after 4 weeks' treatment at 100 mg in a patient with renal cell cancer. Daily administration of imiquimod causes activation of the interferon production system but at higher doses results in unacceptable toxicity. Further investigation of imiquimod as an interferon-inducing agent in cancer patients is suggested at either the lower dose levels or employing alternative dosing schedules.
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Affiliation(s)
- P Savage
- Department of Medicine, Royal Marsden Hospital, London, UK
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Abstract
Care study Alice Bird is a 26-year-old women with Down's syndrome and a severe learning disability. Following a long illness, Alice's father passed away just before my involvement with the family. Alice now lives at home with her mother, aged 70, and an older sister, Janice, aged 34, who has a mild learning disability and is also being treated for mental health problems. Two other brothers live nearby and are in regular contact with the family. My initial contact with this family followed a request for help in planning long-term care for Alice in the event of the mother's death. Mrs Bird, having recently lost her husband, realised that her daughter would almost certainly live longer than her and wanted to feel that appropriate plans had been made.
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Ferrare RA, McGee TJ, Whiteman D, Burris J, Owens M, Butler J, Barnes RA, Schmidlin F, Komhyr W, Wang PH, McCormick MP, Miller AJ. Lidar measurements of stratospheric temperature during STOIC. ACTA ACUST UNITED AC 1995. [DOI: 10.1029/94jd02331] [Citation(s) in RCA: 23] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Margitan JJ, Barnes RA, Brothers GB, Butler J, Burris J, Connor BJ, Ferrare RA, Kerr JB, Komhyr WD, McCormick MP, McDermid IS, McElroy CT, McGee TJ, Miller AJ, Owens M, Parrish AD, Parsons CL, Torres AL, Tsou JJ, Walsh TD, Whiteman D. Stratospheric Ozone Intercomparison Campaign (STOIC) 1989: Overview. ACTA ACUST UNITED AC 1995. [DOI: 10.1029/95jd00509] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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Abstract
Although platelets stored by cryopreservation are effective in hemostasis, they acquire a number of functional defects during storage and preparation for transfusion. In addition to known acquired defects such as defective aggregation, decreased resistance to hypotonic shock, and disc-spherocyte transformation, we have shown that cryopreserved platelets have decreased capacity to adhere to subendothelium, compared to liquid-stored platelets. To investigate this decrease in adhesive capacity of cryopreserved platelets, we measured the major adhesive membrane glycoprotein, GPIb, and the principal aggregatory protein, GPIIb/IIIa, using flow cytometry in fresh platelets or in platelets cryopreserved in 5% DMSO. We also analyzed aggregation of cryopreserved platelets or liquid-stored platelets in response to ristocetin as another measurement of GPIb functional capacity. We found that approximately 15% of cryopreserved platelets lost surface-bound GPIb, while there was no measurable loss of GPIIB/IIIa during cryopreservation. The cryopreserved platelets also showed a significant decrease in aggregation to ristocetin, but no loss of response to the stronger agonist, thrombin. The loss of surface GPIb from cryopreserved platelets was modest in degree, approximately that reported for liquid-stored platelets, and does not seem great enough to account for the observed functional changes in aggregation and adhesion.
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Affiliation(s)
- M Owens
- Eastern Virginia Medical School, Department of Medicine, Norfolk
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43
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Owens M, Werner E, Holme S, Afflerbach C. Membrane Glycoproteins in Cryopreserved Platelets. Vox Sang 1994. [DOI: 10.1159/000462550] [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: 11/19/2022]
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Abstract
The management of the frontal sinus remains controversial for traumatic and inflammatory disease. The osteoplastic flap with fat obliteration has become the treatment standard, although late failures with infection and mucocele formation may arise. Theories for mucocele formation include regrowth of residual mucosa from the sinus and ingrowth of mucosa from a nonobliterated nasofrontal duct. A study to evaluate the means of nasofrontal duct obliteration was developed. Three cat groups were evaluated at 1, 2, and 3 months. Group 1 had the duct and sinus obliterated with fat. Group 2 had the duct obliterated with bone and the sinus with fat. Group 3 had only the duct obliterated with bone. There was no mucosal ingrowth in any of the sinuses for the intervals studied. In group 1, fat volume was seen to decrease over time with replacement by fibrous tissue within the duct. Groups 2 and 3 developed progressive obliteration of the duct with new bone formation. One may infer that fat obliteration alone does not provide a predictable stable situation as fat atrophies within the duct and may allow mucosal ingrowth. Bone obliteration was shown to be progressive within the duct from osteogenesis. This is the first experimental model to correlate clinical observations of the use of bone for sinus obliteration. This study concluded that bone obliterates the nasofrontal duct better than the accepted standard of fat, independent of the material used to obliterate the sinus.
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Affiliation(s)
- M Owens
- Division of Otolaryngology, University of South Florida College of Medicine, Tampa
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Abstract
Clostridium difficile is an opportunistic pathogen that causes a spectrum of disease ranging from antibiotic-associated diarrhea to pseudomembranous colitis. Although the disease was first described in 1893, the etiologic agent was not isolated and identified until 1978. Since clinical and pathological features of C. difficile-associated disease are not easily distinguished from those of other gastrointestinal diseases, including ulcerative colitis, chronic inflammatory bowel disease, and Crohn's disease, diagnostic methods have relied on either isolation and identification of the microorganism or direct detection of bacterial antigens or toxins in stool specimens. The current review focuses on the sensitivity, specificity, and practical use of several diagnostic tests, including methods for culture of the etiologic agent, cellular cytotoxicity assays, latex agglutination tests, enzyme immunoassay systems, counterimmunoelectrophoresis, fluorescent-antibody assays, and polymerase chain reactions.
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Affiliation(s)
- F C Knoop
- Department of Medical Microbiology, Creighton University School of Medicine, Omaha, Nebraska 68178-0001
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Ferguson G, Kaitner B, McKervey MA, Owens M. 5-Chloro-2-hydroxycarbonylmethoxy-1,3-xylyl-18-crown-5 and 5-chloro-2-ethoxycarbonylmethoxy-1,3-xylyl-18-crown-5. Acta Crystallogr C 1993. [DOI: 10.1107/s0108270192009971] [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: 11/10/2022] Open
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Owens M, Zellers-Jacobs L. Adenosine: the newest drug for PSVT. RN 1992; 55:38-41. [PMID: 1465540] [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: 12/27/2022]
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Abstract
In vitro experiments with granular pneumocytes suggest that surfactant protein-A (SP-A) inhibits secretion of pulmonary surfactant. We examined whether SP-A inhibits surfactant secretion induced by lung distention during lung lavage. Human SP-A was obtained by lung lavage in a patient with pulmonary alveolar proteinosis. After centrifugation of the lavagate, the pellet was repeatedly washed with saline and then extracted with chloroform:methanol. The methanol:saline phase was separated and lyophilized to yield the SP-A product. SDS-PAGE and immunoblot analysis indicated that our preparation of SP-A had only minor contamination with human plasma proteins. To examine secretion, we used freshly killed newborn rabbit pups of 29.5 days gestation and lavaged the lungs by 10 sequential, fresh saline washes. Littermate neighbor pairs were lavaged with SP-A or human plasma protein at concentrations of 1, 6, 10, and 50 micrograms/ml, and disaturated phosphatidylcholine (DSPC) was analyzed as a marker for surfactant. The inhibition of surfactant secretion was maximal at a concentration of 10 micrograms/ml; the average yield by the last two pairs of washes, an index of surfactant secretion, was 286 +/- 41 micrograms/g dry lung weight for SP-A, compared to 405 +/- 37 micrograms/g dry lung weight for controls, an inhibition of 30% (p < 0.005). There were no changes in the volumes of returned lavage or in the concentrations of lactate dehydrogenase or DNA. To test whether SP-A increased cellular uptake of DSPC in the lungs, we prepared radioactive exogenous surfactant, lavaged it into the lungs, and monitored recovery of radioactivity by continued lavage. Recovery was the same in treated and control lungs.(ABSTRACT TRUNCATED AT 250 WORDS)
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Affiliation(s)
- A Corbet
- Department of Pediatrics, Baylor College of Medicine, Houston, Texas
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Abstract
Escherichia coli produces a heat-stable (STa) enterotoxin that belongs to a family of peptides that mediate several diarrheal diseases, including traveler's diarrhea and epidemic diarrhea in infants and newborns. The STa enterotoxin consists of 18 or 19 amino acids and is encoded by genes specified on a transposon. Intestinal secretion is induced by specific binding to high affinity receptors that reside on the brush border cell membrane of the small intestine. Receptor activation by STa enterotoxin induces a sequence of events that culminate in the release of fluid and electrolytes into the intestinal lumen. These events include the stimulation of particulate guanylate cyclae and subsequent increase of intracellular cyclic GMP, involvement of particulate protein kinase, elevation of intracellular calcium, and activation of the phosphatidylinositol pathway. The release of archidonic acid and production of prostaglandins and/or leukotrienes have also been implicated in the action of STa. Evidence indicates that the STa enterotoxin receptor may be a single multifunctional membrane protein.
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Affiliation(s)
- F C Knoop
- Department of Medical Microbiology, Creighton University School of Medicine, Omaha, Nebraska 68178-0001
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50
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Abstract
A centrifugal method of red cell density separation was utilized for unit processing in these studies to determine the quality of the lighter fraction (neocytes) after storage for up to 42 d and to evaluate whether the heavier fraction (gerocytes) deteriorated more rapidly than neocytes during storage. Each unit was passed through a Leukotrap filter to remove white cells prior to density separation. Red cell recovery and survival were evaluated using double label technetium-99m with either chromium-51 or nonradioisotopic chromium which permitted concurrent paired analysis. In vivo neocyte red cell recovery, as tested on the same 11 donors on days 1, 7 and 42 of storage, was effectively unchanged. Recovery and survival half-life (that is, the number of days after transfusion at which half of the cells infused remain in the circulation) of 42 d stored gerocytes were significantly lower than similarly stored neocytes (75.5 +/- 7.2% and 20.1 +/- 6.5 d for gerocytes versus 84.4 +/- 4.9% and 39.0 +/- 9.0 d for neocytes). One-day stored neocytes showed a 16.5% increase in red cell availability over the combined average for 42 d stored neocytes and gerocytes. Statistically, while there were significantly higher ATP, 2,3-DPG, and lactate levels pre-storage by paired t-test for neocytes compared to gerocytes, by day 42 there were no significant differences detected between the two red cell fractions by any of the in vitro variables measured. These studies suggest that this simple separation technique for leucocyte-poor red cell units provides a neocyte population with improved viability and the potential for increased transfusion intervals in chronically transfused patients.
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Affiliation(s)
- T E Keegan
- American Red Cross, Mid-Atlantic Regional Blood Services, Norfolk, Virginia 23501
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