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Siuba MT, Bhardwaj A, Kirincich J, Perez O, Flanagan P, Lane J, Toth D, Paul D, Lehr C, Duggal A, Tonelli AR. Does veno-arterial carbon dioxide gradient provide an adequate estimation of cardiac index in pulmonary hypertension? Eur Heart J Acute Cardiovasc Care 2023; 12:38-47. [PMID: 36301185 DOI: 10.1093/ehjacc/zuac139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 10/08/2022] [Accepted: 10/25/2022] [Indexed: 11/23/2022]
Abstract
AIMS Pulmonary hypertension (PH) management is dependent on cardiac output (CO) assessment. The gold standard Fick method for CO and cardiac index (CI) measurement is not widely available. An accessible and reliable method for CO/CI estimation is needed not only in catheterization labs but also in other environments such as the intensive care unit, where pulmonary artery catheters are less likely to be used. We hypothesized that veno-arterial carbon dioxide gradient (PvaCO2) is a reliable surrogate for Fick CI in patients with PH. METHODS AND RESULTS A single-centre retrospective analysis of patients with PH who underwent direct Fick CI (DFCI) measurement during right heart catheterization. The primary outcome was correlation between PvaCO2 and DFCI. To assess the agreement between central and mixed venous CO2 values, a separate prospective cohort of patients was analysed. Data from 186 patients with all haemodynamic types of PH were analysed. PvaCO2 moderately correlated with Fick CI, R = -0.51 [95% confidence interval (CI): -0.61, -0.39]. A higher PvaCO2 was associated with an increased risk of CI < 2.5 L/min/m2 (odds ratio: 1.88, 95% CI: 1.55, 2.35). Low thermodilution CI with normal veno-arterial carbon dioxide gradient values was associated with a thermodilution underestimation of Fick CI. In the prospective analysis of 32 patients, central venous CO2 overestimated mixed venous values (mean difference 3.3, 95% CI: 2.5, 4.0) and there was poor agreement overall (limits of agreement -1.10, 7.59). CONCLUSION Veno-arterial carbon dioxide gradient moderately correlates with Fick CI and may be useful to identify patients with low CI. Central and mixed venous CO2 values should not be used interchangeably in PH.
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Affiliation(s)
- Matthew T Siuba
- Department of Critical Care Medicine, Respiratory Institute, Cleveland Clinic, 9500 Euclid Ave L2-330, Cleveland, OH 44195, USA
| | - Abhishek Bhardwaj
- Department of Critical Care Medicine, Respiratory Institute, Cleveland Clinic, 9500 Euclid Ave L2-330, Cleveland, OH 44195, USA
| | - Jason Kirincich
- Department of Internal Medicine, Community Care Institute, Cleveland Clinic, Cleveland, OH 44195, USA
| | - Oscar Perez
- Department of Critical Care Medicine, Respiratory Institute, Cleveland Clinic, 9500 Euclid Ave L2-330, Cleveland, OH 44195, USA
| | - Patrick Flanagan
- Department of Internal Medicine, Community Care Institute, Cleveland Clinic, Cleveland, OH 44195, USA
| | - James Lane
- Nursing Institute, Cleveland Clinic, Cleveland, OH 44195, USA
| | - David Toth
- Nursing Institute, Cleveland Clinic, Cleveland, OH 44195, USA
| | - Deborah Paul
- Department of Pulmonary Medicine, Respiratory Institute, Cleveland Clinic, Cleveland, OH 44195, USA
| | - Carli Lehr
- Department of Pulmonary Medicine, Respiratory Institute, Cleveland Clinic, Cleveland, OH 44195, USA
| | - Abhijit Duggal
- Department of Critical Care Medicine, Respiratory Institute, Cleveland Clinic, 9500 Euclid Ave L2-330, Cleveland, OH 44195, USA
| | - Adriano R Tonelli
- Department of Critical Care Medicine, Respiratory Institute, Cleveland Clinic, 9500 Euclid Ave L2-330, Cleveland, OH 44195, USA.,Department of Pulmonary Medicine, Respiratory Institute, Cleveland Clinic, Cleveland, OH 44195, USA
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Santillan MK, Davis H, Crooks M, Flanagan P, Ortman C, Boeldt K, Hunter SK, Martini S, Knosp BM, Santillan DA. Development and Utility of a Novel Intergenerational Health Knowledgebase. FASEB J 2022. [DOI: 10.1096/fasebj.2022.36.s1.r5732] [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: 11/11/2022]
Affiliation(s)
| | - Heather Davis
- Institute for Clinical and Translational ScienceUniversity of Iowa Carver College of MedicineIowa CityIA
| | - Mark Crooks
- Institute for Clinical and Translational ScienceUniversity of Iowa Carver College of MedicineIowa CityIA
| | - Patrick Flanagan
- Institute for Clinical and Translational ScienceUniversity of Iowa Carver College of MedicineIowa CityIA
| | - Chris Ortman
- Institute for Clinical and Translational ScienceUniversity of Iowa Carver College of MedicineIowa CityIA
| | | | | | | | - Boyd M. Knosp
- Institute for Clinical and Translational ScienceUniversity of Iowa Carver College of MedicineIowa CityIA
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Aggarwal A, Patel D, Kumar A, Schoenhagen P, Flanagan P, Kalahasti V. A Very Unusual Cause for Presyncope after Bypass: What a Surprise. CASE 2022; 6:73-76. [PMID: 35492290 PMCID: PMC9050601 DOI: 10.1016/j.case.2021.11.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
VG aneurysms can present with varied symptoms such as dyspnea, chest pain, and syncope. Tomographic imaging can be complementary in noninvasive assessment of SVG pathology.
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Ming Wang TK, Chan N, Khayata M, Flanagan P, Grimm RA, Griffin BP, Husni ME, Littlejohn E, Xu B. Cardiovascular Manifestations, Imaging, and Outcomes in Systemic Lupus Erythematosus: An Eight-Year Single Center Experience in the United States. Angiology 2022; 73:877-886. [PMID: 35238664 DOI: 10.1177/00033197221078056] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Systemic lupus erythematosus (SLE) is a challenging autoimmune and multi-system condition. With advances in cardiovascular screening and therapies for SLE patients, we evaluated the cardiovascular characteristics, multi-modality imaging, and outcomes of SLE at our tertiary referral center over an 8 year period. Consecutive patients from our SLE registry from April 2012 to March 2020 were retrospectively analyzed. Data pertaining to cardiovascular manifestations, investigations, management, and outcomes were assessed. We studied 258 SLE patients (mean age 42.2 ± 14.7 years); 233 (90.3%) were female. The main cardiac manifestations at index SLE clinic were pericardial disease in 33.3%, valve disease in 18%, cardiomyopathy in 9.6%, and stroke in 7.4%. During a mean follow-up of 3.0 ± 2.2 years after index SLE clinic, there were 5 (1.9%) deaths, 24 (9.3%) cardiovascular events, and 44 (17.1%) SLE-related hospitalizations. A history of stroke and hypertension were independently associated with cardiovascular events, hazard ratio (HR) (95% confidence intervals (CI)) of 5.38 (1.41-20.6) and 3.31 (1.02-10.7), respectively, while younger age and lower albumin predicted SLE-related hospitalizations. Cardiovascular manifestations are prevalent in SLE, especially for pericardial, valvular, and atherosclerotic diseases. With contemporary SLE and cardiovascular management, subsequent adverse cardiovascular events were infrequent in this study.
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Affiliation(s)
- Tom Kai Ming Wang
- Section of Cardiovascular Imaging, Heart, Vascular and Thoracic Institute, 2569Cleveland Clinic, Cleveland, OH, USA
| | - Nicholas Chan
- Department of Internal Medicine, Cleveland Clinic, Cleveland, OH, USA
| | - Mohamed Khayata
- Section of Cardiovascular Imaging, Heart, Vascular and Thoracic Institute, 2569Cleveland Clinic, Cleveland, OH, USA.,Department of Cardiovascular Sciences, 33697University of South Florida Morsani College of Medicine, Tampa, FL, USA
| | - Patrick Flanagan
- Department of Internal Medicine, Cleveland Clinic, Cleveland, OH, USA
| | - Richard A Grimm
- Section of Cardiovascular Imaging, Heart, Vascular and Thoracic Institute, 2569Cleveland Clinic, Cleveland, OH, USA
| | - Brian P Griffin
- Section of Cardiovascular Imaging, Heart, Vascular and Thoracic Institute, 2569Cleveland Clinic, Cleveland, OH, USA
| | - M Elaine Husni
- Department of Rheumatic and Immunologic Diseases, Cleveland Clinic, Cleveland, OH, USA
| | - Emily Littlejohn
- Department of Rheumatic and Immunologic Diseases, Cleveland Clinic, Cleveland, OH, USA
| | - Bo Xu
- Section of Cardiovascular Imaging, Heart, Vascular and Thoracic Institute, 2569Cleveland Clinic, Cleveland, OH, USA
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Flanagan P, Costello L, Alsaleh E, Byrne L, Maguire P, Adams A, Flannery S. Best practice in male urinary catheterization – A systematic review. EUR UROL SUPPL 2021. [DOI: 10.1016/s2666-1683(21)00243-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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6
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Flanagan P, McAlpine L, Ramskill S, Smith A, Eglin R, Parry J, Mortimer P. Evaluation of a Combined
HIV-1/2 and HTLV-I/II Assay for Screening Blood Donors. Vox Sang 2017. [DOI: 10.1159/000462936] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [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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7
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Murphy N, O'Mahony B, Flanagan P, Noone D, White B, Bergin C, Norris S, Thornton L. Progression of hepatitis C in the haemophiliac population in Ireland, after 30 years of infection in the pre-DAA treatment era. Haemophilia 2017; 23:712-720. [PMID: 28752601 DOI: 10.1111/hae.13244] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/10/2017] [Indexed: 12/12/2022]
Abstract
INTRODUCTION Prior to the introduction of viral inactivation of factor concentrates and screening of blood, 225 people with haemophilia became infected with hepatitis C (HCV) in Ireland. AIM Our aim was to assess liver disease progression and mortality in this population after 30 years of infection. METHODS Demographic and clinical data were collected from medical records in five hepatology units and one infectious disease unit retrospectively in 2005, and on four subsequent occasions. RESULTS The participation rate was 73% (165/225). Eighty three percent of patients, who had been tested for RNA (n = 106/128), developed chronic HCV infection. Thirty four percent were co-infected with HIV. All-cause mortality, after approximately 30 years of infection with chronic HCV, was 44% in HIV positive patients and 29% in HIV negative patients. Liver-related mortality was 12.5% and did not vary significantly by HIV status. Thirty seven percent of patients had developed advanced liver disease, including 20% with cirrhosis and 9% with hepatocellular carcinoma. In the pre-interferon-free direct acting antivirals era, 57% (n = 60/106) of patients were treated for HCV, 65% of whom achieved a sustained virological response. Successfully treated patients had few adverse liver outcomes. CONCLUSION After 30 years of infection, 40% of the patients who had evidence of chronic HCV had developed advanced liver disease, such as cirrhosis and HCC, or had died from liver-related causes. This proportion is high relative to similar international cohorts despite good anti-HCV treatment uptake and responses.
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Affiliation(s)
- N Murphy
- HSE Health Protection Surveillance Centre, Dublin, Ireland
| | - B O'Mahony
- Irish Haemophilia Society, Dublin, Ireland
| | - P Flanagan
- HSE Health Protection Surveillance Centre, Dublin, Ireland
| | - D Noone
- Irish Haemophilia Society, Dublin, Ireland
| | - B White
- St James's Hospital, Dublin, Ireland
| | - C Bergin
- St James's Hospital, Dublin, Ireland
| | - S Norris
- St James's Hospital, Dublin, Ireland
| | - L Thornton
- HSE Health Protection Surveillance Centre, Dublin, Ireland
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Iqbal M, McCormick PA, Cannon M, Murphy N, Flanagan P, Kennelly JE, Thornton L. Long-term follow-up of patients with spontaneous clearance of hepatitis C: does viral clearance mean cure? Ir Med J 2017; 110:582. [PMID: 28952672] [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: 06/07/2023]
Abstract
Up to 40% of patients with hepatitis C virus (HCV) antibodies are negative for HCV RNA at initial evaluation. If there is a risk of viral re-activation, long term follow-up is required with attendant financial, psychological and medical implications. We investigated the risk of re-activation in the Irish anti-D cohort. Information was obtained from the national hepatitis C database which includes data on patients infected by anti-D immunoglobulin in two large outbreaks, 1977-9 and 1991-94. As part of a screening programme, starting in 1994, 64,907 females exposed to anti-D immunoglobulin were evaluated. Three hundred and forty-seven were found to be antibody positive but HCV RNA negative at initial assessment. 93% had subsequent RNA tests. There was no evidence of HCV recurrence in patients whose infection resolved spontaneously. It appears that two initial sequential negative results for HCV RNA are sufficient to confirm spontaneous viral clearance and probable cure of hepatitis C virus infection.
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Affiliation(s)
- M Iqbal
- National Liver Transplant Unit, St Vincent's University Hospital and University College Dublin
| | - P A McCormick
- National Liver Transplant Unit, St Vincent's University Hospital and University College Dublin
| | - M Cannon
- National Liver Transplant Unit, St Vincent's University Hospital and University College Dublin
| | - N Murphy
- Health Protection Surveillance Centre, Health Service Executive, Dublin, Ireland
| | - P Flanagan
- Health Protection Surveillance Centre, Health Service Executive, Dublin, Ireland
| | - J E Kennelly
- National Liver Transplant Unit, St Vincent's University Hospital and University College Dublin
| | - L Thornton
- Health Protection Surveillance Centre, Health Service Executive, Dublin, Ireland
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Qi Y, Peng J, Lo HC, Holt JR, Willemann M, Gaire C, Evans S, Flanagan P, Yu H, Hu O, Kennett M. In-Situ Boron Doped SiGe Epitaxy Optimization for FinFET Source/Drain. ACTA ACUST UNITED AC 2016. [DOI: 10.1149/07508.0265ecst] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Flanagan P, O'Lorcain P, Cotter S, Connell J, Lynch B, Cunney R, O'Flanagan D. Reporting of Acute Flaccid Paralysis in Children under 15 years of age: Improving Surveillance, January 2009 - December 2014. Ir Med J 2016; 109:357. [PMID: 27685691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Acute Flaccid Paralysis (AFP) surveillance, including case investigation and specimen collection is a gold standard method for poliomyelitis surveillance. The expected annual non-polio AFP rate <15 years of age in Ireland is = 1/100 000 population. This study reviewed all cases of AFP reported to the Irish Paediatric Surveillance Unit and the Health Protection Surveillance Centre between January 2009 and December 2014 and compared reporting rates with the expected incidence rate annually. We assessed quality of surveillance data in terms of completeness of investigation for each case reported. Forty-three AFP cases in children <15 years were notified; 35 of which were confirmed. Guillain-Barre Syndrome (GBS) accounted for 48.6% (n=17) of AFP notifications. In 2014, the expected annual AFP target rate was reached. This study identified possible under-reporting of AFP paediatric cases in Ireland between 2009-2013. Completeness of investigations has improved over time, but requires further work.
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Affiliation(s)
- P Flanagan
- Health Protection Surveillance Centre, 25-27 Middle Gardiner St, Dublin 1
| | - P O'Lorcain
- Health Protection Surveillance Centre, 25-27 Middle Gardiner St, Dublin 1
| | - S Cotter
- Health Protection Surveillance Centre, 25-27 Middle Gardiner St, Dublin 1
| | - J Connell
- National Virus Reference Laboratory, UCD, Belfield, Dublin 4
| | - B Lynch
- Department of Paediatric Neurology, Childrens University Hospital, Temple St, Dublin 1
| | - R Cunney
- Health Protection Surveillance Centre, 25-27 Middle Gardiner St, Dublin 1
| | - D O'Flanagan
- Health Protection Surveillance Centre, 25-27 Middle Gardiner St, Dublin 1
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Wang L, Flanagan P, Gleason R, Murphy C, Churilla T, Galloway T. One Size Does Not Fit All: Evaluating the Need for Separate Unilateral and Bilateral Radiation Therapy Normal Tissue Treatment Planning Goals for Oropharynx Cancer. Int J Radiat Oncol Biol Phys 2015. [DOI: 10.1016/j.ijrobp.2015.07.1994] [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: 11/24/2022]
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O'Connor L, Ward M, Bennett D, Mulhall R, O'Lorcain P, Cunney R, McDermott R, Neville E, Heslin J, FitzGerald R, Meyler K, Conlon M, Clarke A, Corcoran B, Fitzpatrick G, O'Connor B, Flanagan P, O'Flanagan D, Cotter S. A prolonged outbreak of invasive meningococcal disease in an extended Irish Traveller family across three Health Service Executive (HSE) areas in Ireland, 2010 to 2013. ACTA ACUST UNITED AC 2015; 20. [PMID: 26062560 DOI: 10.2807/1560-7917.es2015.20.21.21139] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [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]
Abstract
Between March 2010 and November 2013 eight laboratory-confirmed cases of serogroup B, invasive meningococcal disease (IMD) were identified in an extended Irish Traveller family across three Health Service Executive (HSE) areas of Ireland. Cases were aged between 5 and 46 months, and were either a cousin or sibling of another case. All eight cases survived. Chemoprophylaxis was given to relevant nuclear family members and close contacts on each occasion, but failed to prevent further cases. Neisseria meningitidis isolates from six cases were highly related, belonging to the ST-41/44 clonal complex, and shared the porA designation 7–2,4. In November 2013, the outbreak control team recommended that directly observed ciprofloxacin chemoprophylaxis be administered simultaneously to the extended family, and that the four component meningococcal B (4CMenB) vaccine be administered to family members aged 2 months to 23 years inclusive and relevant close contacts of the eighth case. Subsequently these recommendations were implemented at three regional clinics. Additionally pharyngeal swabs (n=112) were collected to assess carriage rates of N. meningitidis in this extended family. Pharyngeal carriage of N. meningitidis was detected in 15 (13%) family members. From the epidemiological investigation and carriage study overcrowding was the most likely risk factor identified in this outbreak. To date, the combination of directly observed ciprofloxacin chemoprophylaxis and use of 4CMenB vaccine have controlled the outbreak with no further cases diagnosed.
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Affiliation(s)
- L O'Connor
- Department of Public Health, HSE East, Dr Steevens Hospital, Dublin, Ireland
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Lieberman L, Devine DV, Reesink HW, Panzer S, Wong J, Raison T, Benson S, Pink J, Leitner GC, Horvath M, Compernolle V, Scuracchio PSP, Wendel S, Delage G, Nahirniak S, Dongfu X, Krusius T, Juvonen E, Sainio S, Cazenave JP, Guntz P, Kientz D, Andreu G, Morel P, Seifried E, Hourfar K, Lin CK, O'Riordan J, Raspollini E, Villa S, Rebulla P, Flanagan P, Teo D, Lam S, Ang AL, Lozano M, Sauleda S, Cid J, Pereira A, Ekermo B, Niederhauser C, Waldvogel S, Fontana S, Desborough MJ, Pawson R, Li M, Kamel H, Busch M, Qu L, Triulzi D. Prevention of transfusion-transmitted cytomegalovirus (CMV) infection: Standards of care. Vox Sang 2014; 107:276-311. [DOI: 10.1111/vox.12103] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Turner M, Robinson N, Wilkie G, Rivera N, Russell J, Fraser N, Clark D, Barry J, Robertson V, Turner D, Newlands H, Vickers M, van Tilburg C, Flanagan P. Establishment of a bank of blood donor derived epstein barr virus specific T cell lines for treatment of post-transplant lymphoproliferative disease. Cytotherapy 2013. [DOI: 10.1016/j.jcyt.2013.01.028] [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: 11/24/2022]
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Abstract
BACKGROUND The low, fluctuating levels of DNA characteristic of occult hepatitis B infection make its detection by nucleic acid testing (NAT) a challenge. METHODS Four year's routine use of the Ultrio and Ultrio Plus assays in blood donations in New Zealand was analysed. RESULTS 0·09% of donations tested with Ultrio and Ultrio Plus assays showed reactivity in the multiplex assay, but non-reactivity in all three discriminatory assays and relevant mandatory serological assays (anti-HIV, anti-HCV, HBsAg). These donations were more likely to be anti-HBc reactive (Ultrio, 13%; Ultrio Plus, 57%; random donors, 6·8%). Thirty-four per cent of these anti-HBc-reactive donations were also reactive in either an alternate NAT assay or on repeat multiplex testing. Thirteen per cent of the donors of the discriminatory-negative, anti-HBc-reactive donations who had given other Ultrio- or Ultrio Plus-tested donations had at least one other multiplex reactive donation. CONCLUSION These findings suggest that their HBV DNA levels are around the assay's limit of detection, that false reactivity cannot be presumed when a donor fails to discriminate and that caution should be applied when deciding whether to continue accepting donations from such donors.
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Affiliation(s)
- R Charlewood
- New Zealand Blood Service, Auckland, New Zealand.
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Price R, Koren S, Hossain M, Veltchev I, Galloway T, Flanagan P, Ma C. SU-E-T-554: PTV to Skin Proximity for Head and Neck IMRT Treatment Planning. Med Phys 2012; 39:3833. [DOI: 10.1118/1.4735643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Benjamin RJ, Bianco C, Goldman M, Seed CR, Yang H, Lee J, Keller AJ, Wendel S, Biagini S, Murray J, Devine DV, Zhu Y, Turek P, Moftah FM, Kullaste R, Pillonel J, Danic B, Bigey F, Folléa G, Seifried E, Mueller MM, Lin CK, Makroo RN, Grazzini G, Pupella S, Velati C, Tadokoro K, Bravo Lindoro A, D’Artote González A, Giner VT, Flanagan P, Olaussen RW, Letowska M, Rosiek A, Poglod R, Zhiburt E, Mali P, Rozman P, Gulube S, Castro Izaguirre E, Ekermo B, Barnes SM, McLaughlin L, Eder AF, Panzer S, Reesink HW. Deferral of males who had sex with other males. Vox Sang 2011; 101:339-67. [DOI: 10.1111/j.1423-0410.2011.01489.x] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Roth WK, Busch MP, Schuller A, Ismay S, Cheng A, Seed CR, Jungbauer C, Minsk PM, Sondag-Thull D, Wendel S, Levi JE, Fearon M, Delage G, Xie Y, Jukic I, Turek P, Ullum H, Tefanova V, Tilk M, Reimal R, Castren J, Naukkarinen M, Assal A, Jork C, Hourfar MK, Michel P, Offergeld R, Pichl L, Schmidt M, Schottstedt V, Seifried E, Wagner F, Weber-Schehl M, Politis C, Lin CK, Tsoi WC, O'Riordan J, Gottreich A, Shinar E, Yahalom V, Velati C, Satake M, Sanad N, Sisene I, Bon AH, Koppelmann M, Flanagan P, Flesland O, Brojer E, Lętowska M, Nascimento F, Zhiburt E, Chua SS, Teo D, Stezinar SL, Vermeulen M, Reddy R, Park Q, Castro E, Eiras A, Gonzales Fraile I, Torres P, Ekermo B, Niederhauser C, Chen H, Oota S, Brant LJ, Eglin R, Jarvis L, Mohabir L, Brodsky J, Foster G, Jennings C, Notari E, Stramer S, Kessler D, Hillyer C, Kamel H, Katz L, Taylor C, Panzer S, Reesink HW. International survey on NAT testing of blood donations: expanding implementation and yield from 1999 to 2009. Vox Sang 2011; 102:82-90. [PMID: 21933190 DOI: 10.1111/j.1423-0410.2011.01506.x] [Citation(s) in RCA: 146] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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21
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Newton C, Fisher S, Flanagan P. Development of national audit tools for hospice community services. BMJ Support Palliat Care 2011. [DOI: 10.1136/bmjspcare-2011-000105.26] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Rodgers C, Flanagan P, Thompson A. Pooling resources to drive quality; the evolution of the National Audit Tools Group (NATG). BMJ Support Palliat Care 2011. [DOI: 10.1136/bmjspcare-2011-000105.126] [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: 11/03/2022]
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Abstract
The accuracy with which a single source of sound can be localized has been examined in many studies, but very few studies have examined the ability of participants to determine the absolute locations of multiple sources of sound. The current study assessed participants' abilities to determine and remember the locations of up to six sources of environmental sound that were positioned at a range of azimuths and elevations in virtual auditory space. In experiment 1, a sequence of one to six sounds was presented one, three, or five times in each trial and the target sound was nominated following presentation of the last sequence. In experiment 2, memory load was held constant by nominating the target sound prior to a single sequence presentation. Localization accuracy was observed to decrease as the number of sounds was increased to three or more under the conditions of experiment 1, but not those of experiment 2. In experiment 1, localization was more accurate when sequences were presented more than once. Pronounced primacy and recency effects were observed for the six sound conditions in experiment 1. An analysis of errors for those conditions indicated that immediate temporal errors, but not immediate spatial errors, were over-represented.
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Affiliation(s)
- Russell L Martin
- Air Operations Division, Defence Science and Technology Organisation, Fishermans Bend 3207, Australia.
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Askar M, Flanagan P, Rybicki L, Kalaycio M, Pohlman B, Andresen S, Dean R, Duong H, Copelan E, Bolwell B, Sobecks R. The T-Cell Epitope (TCE) Algorithm for Classifying HLA-DPB1 Mismatches Does Not Predict Clinical Outcomes in HSCT. Biol Blood Marrow Transplant 2011. [DOI: 10.1016/j.bbmt.2010.12.220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Devine DV, Sher GD, Reesink HW, Panzer S, Hetzel PAS, Wong JK, Horvath M, Leitner GC, Schennach H, Nussbaumer W, Genoe K, Cioffi JM, Givisiez FN, Rogerson M, Howe D, Delage G, Sarappa C, Fu Y, Sarlija D, Vuk T, Strauss Patko M, Balija M, Jukić I, Ali A, Auvinen MK, Jaakonsalo E, Cazenave JP, Waller C, Kientz D, David B, Walther-Wenke G, Heiden M, Lin CK, Tsoi WC, Lee CK, Barotine-Toth K, Sawant RB, Murphy W, Quirke B, Bowler P, Shinar E, Yahalom V, Aprili G, Piccoli P, Gandini G, Tadokaro K, Nadarajan VS, de Kort W, Jansen N, Flanagan P, Forsberg PO, Hervig T, Letowska M, Lachert E, Dudziak K, Antoniewicz-Papis J, de Olim G, Nascimento F, Hindawi S, Teo D, Reddy R, Scholtz J, Swanevelder R, Rovira LP, Sauleda S, Carasa MAV, Vaquero MP, Ania MA, Gulliksson H, Holdsworth S, Cotton S, Howell C, Baldwin C, Cusick RM, Geele GA, Paden C, McEvoy P, Gottschall JL, McLaughlin LS, Benjamin RJ, Eder A, Draper NL, AuBuchon JP, León de González G. Inventory management. Vox Sang 2010; 98:e295-363. [PMID: 20432515 DOI: 10.1111/j.1423-0410.2009.01252.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
A critical aspect of blood transfusion is the timely provision of high quality blood products. This task remains a significant challenge for many blood services and blood systems reflecting the difficulty of balancing the recruitment of sufficient donors, the optimal utilization of the donor's gift, the increasing safety related restrictions on blood donation, a growing menu of specialized blood products and an ever-growing imperative to increase the efficiency of blood product provision from a cost perspective. As our industry now faces questions about our standard practices including whether or not the age of blood has a negative impact on recipients, it is timely to take a look at our collective inventory management practices. This International Forum represents an effort to get a snap shot of inventory management practices around the world, and to understand the range of different products provided for patients. In addition to sharing current inventory management practices, this Forum is intended to foster an exchange of ideas around where we see our field moving with respect to various issues including specialty products, new technologies, and reducing recipient risk from blood transfusion products.
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Banki F, Flanagan P, Zehetner J, Armstrong A, Hagen JA, Joshi A, Sinha R, Oh D, Oezcelik A, DeMeester SR, Abate E, Lipham JC, Chandrasoma P, Crookes PF, DeMeester TR. Progressive mucosal injury in patients with gastroesophageal reflux disease and increasing peripheral blood eosinophil counts. ACTA ACUST UNITED AC 2010; 145:363-6. [PMID: 20404287 DOI: 10.1001/archsurg.2010.44] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
HYPOTHESIS Peripheral blood eosinophil count increases with the degree of mucosal injury associated with gastroesophageal reflux disease (GERD). DESIGN Retrospective review. SETTING Single-institution tertiary hospital. PATIENTS Two hundred ninety-five patients (215 men and 80 women; median age, 57 years [interquartile range (IQR), 46-66 years]). One hundred had GERD without intestinal metaplasia, 100 had GERD with intestinal metaplasia, 40 had GERD with dysplasia, and 55 had GERD with intramucosal carcinoma. Results of complete blood count with differential and serum chemistry studies were compared among the groups using a nonparametric test for trend. RESULTS Patients with a higher degree of mucosal injury were older (P < .001). There were no differences between white blood count, percent neutrophil count, absolute neutrophil count, and hematocrit levels among the groups. Serum albumin level decreased as the degree of mucosal injury increased (P = .04) but lost significance when controlled for age (P = .53). Percent eosinophil counts were 2.0 (IQR, 1.3-2.8) in patients with GERD without intestinal metaplasia, 2.5 (IQR, 1.6-3.7) in GERD with intestinal metaplasia, 2.6 (IQR, 1.7-4.4) in GERD with dysplasia, and 2.7 (IQR, 1.5-4.3) in GERD with intramucosal carcinoma. This progressive increase in the percent eosinophil count was statistically significant (P = .006), remained significant after controlling for age (P = .04), and was also significant when measuring the absolute eosinophil count. CONCLUSION There is a progressive increase in the percent and absolute peripheral blood eosinophil count associated with progressive mucosal injury in patients with GERD.
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Reesink HW, Panzer S, Gonzalez CA, Lena N, Muntaabski P, Gimbatti S, Wood E, Lambermont M, Deneys V, Sondag D, Alport T, Towns D, Devine D, Turek P, Auvinen MK, Koski T, Lin CK, Lee CK, Tsoi WC, Lawlor E, Grazzini G, Piccinini V, Catalano L, Pupella S, Kato H, Takamoto S, Okazaki H, Hamaguchi I, Wiersum-Osselton JC, Van Tilborgh AJW, Zijlker-Jansen PY, Mangundap KM, Schipperus MR, Dinesh D, Flanagan P, Flesland Ø, Steinsvåg CT, Espinosa A, Letowska M, Rosiek A, Antoniewicz-Papis J, Lachert E, Koh MBC, Alcantara R, Corral Alonso M, Muñiz-Diaz E. Haemovigilance for the optimal use of blood products in the hospital. Vox Sang 2010; 99:278-93. [DOI: 10.1111/j.1423-0410.2010.01323.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Bettelheim D, Panzer S, Reesink HW, Csapo B, Pessoa C, Guerra F, Wendel S, Calda P, Sprogøe U, Dziegiel M, Aitokallio-Tallberg A, Koskinen S, Kuosmanen M, Legler TJ, Stein W, Villa S, Villa MA, Trespidi L, Acaia B, Vandenbussche FPHA, Brand A, De Haas M, Kanhai HHH, Gounder D, Flanagan P, Donegan R, Parry E, Sefonte C, Skulstad SM, Hervig T, Flesland Ø, Żupańska B, Uhrynowska M, Lapaire O, Zhong XY, Holzgreve W. Monitoring and treatment of anti-D in pregnancy. Vox Sang 2010; 99:177-92. [DOI: 10.1111/j.1423-0410.2010.01322.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Flanagan P. Emerging infections in Asia and its possible global effects. ISBT Science Series 2009; 4:188-191. [PMID: 32328163 PMCID: PMC7169329 DOI: 10.1111/j.1751-2824.2009.01236.x] [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] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- P Flanagan
- National Medical Director, New Zealand Blood Service, Auckland, New Zealand
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English S, Katzourakis A, Flanagan P, Duda A, Francis J, Matthews P, Prendergast A, Goulder P, Fidler S, Weber J, McClure M, Phillips R, Frater J. P07-09. Contemporaneous transmission of genetically distinct HIV variants from a single donor to two recipients. Retrovirology 2009. [PMCID: PMC2767590 DOI: 10.1186/1742-4690-6-s3-p107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Reesink HW, Engelfriet CP, Schennach H, Gassner C, Wendel S, Fontão-Wendel R, de Brito MA, Sistonen P, Matilainen J, Peyrard T, Pham BN, Rouger P, Le Pennec PY, Flegel WA, von Zabern I, Lin CK, Tsoi WC, Hoffer I, Barotine-Toth K, Joshi SR, Vasantha K, Yahalom V, Asher O, Levene C, Villa MA, Revelli N, Greppi N, Marconi M, Tani Y, Folman CC, de Haas M, Koopman MMW, Beckers E, Gounder DS, Flanagan P, Wall L, Aranburu Urtasun E, Hustinx H, Niederhauser C, Flickinger C, Nance SJ, Meny GM. Donors with a rare pheno (geno) type. Vox Sang 2008; 95:236-53. [PMID: 19121189 DOI: 10.1111/j.1423-0410.2008.01084.x] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Reesink HW, Engelfriet CP, Hyland CA, Coghlan P, Tait B, Wsolak M, Keller AJ, Henn G, Mayr WR, Thomas I, Osselaer JC, Lambermont M, Beaten M, Wendel S, Qiu Y, Georgsen J, Krusius T, Mäki T, Andreu G, Morel P, Lefrère JJ, Rebulla P, Giovanelli S, Butti B, Lecchi L, Mozzi F, Van Hilten JA, Zwaginga JJ, Flanagan P, Flesland Ø, Brojer E, Łętowska M, Åkerblom O, Norda R, Prowse C, Dow B, Jarvis L, Davidson F, Kleinman S, Bianco C, Stramer SL, Dodd RY, Busch MP. Biobanks of blood from donors and recipients of blood products. Vox Sang 2008; 94:242-260. [PMID: 18225990 DOI: 10.1111/j.1423-0410.2007.01020.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Flanagan P. Product traceability and lookback: assuring the integrity of the transfusion process. Dev Biol (Basel) 2007; 127:225-33. [PMID: 17486896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Affiliation(s)
- P Flanagan
- New Zealand Blood Service, Auckland, New Zealand.
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Garrett FE, Emelyanov AV, Sepulveda MA, Flanagan P, Volpi S, Li F, Loukinov D, Eckhardt LA, Lobanenkov VV, Birshtein BK. Chromatin architecture near a potential 3' end of the igh locus involves modular regulation of histone modifications during B-Cell development and in vivo occupancy at CTCF sites. Mol Cell Biol 2005; 25:1511-25. [PMID: 15684400 PMCID: PMC548023 DOI: 10.1128/mcb.25.4.1511-1525.2005] [Citation(s) in RCA: 104] [Impact Index Per Article: 5.5] [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: 11/20/2022] Open
Abstract
The murine Igh locus has a 3' regulatory region (3' RR) containing four enhancers (hs3A, hs1,2, hs3B, and hs4) at DNase I-hypersensitive sites. The 3' RR exerts long-range effects on class switch recombination (CSR) to several isotypes through its control of germ line transcription. By measuring levels of acetylated histones H3 and H4 and of dimethylated H3 (K4) with chromatin immunoprecipitation assays, we found that early in B-cell development, chromatin encompassing the enhancers of the 3' RR began to attain stepwise modifications typical of an open conformation. The hs4 enhancer was associated with active chromatin initially in pro- and pre-B cells and then together with hs3A, hs1,2, and hs3B in B and plasma cells. Histone modifications were similar in resting splenic B cells and in splenic B cells induced by lipopolysaccharide to undergo CSR. From the pro-B-cell stage onward, the approximately 11-kb region immediately downstream of hs4 displayed H3 and H4 modifications indicative of open chromatin. This region contained newly identified DNase I-hypersensitive sites and several CTCF target sites, some of which were occupied in vivo in a developmentally regulated manner. The open chromatin environment of the extended 3' RR in mature B cells was flanked by regions associated with dimethylated K9 of histone H3. Together, these data suggest that 3' RR elements are located within a specific chromatin subdomain that contains CTCF binding sites and developmentally regulated modules.
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Affiliation(s)
- Francine E Garrett
- Albert Einstein College of Medicine, Department of Cell Biology, Bronx, NY 10461, USA
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Freeman SRM, Mitra S, Malik TH, Flanagan P, Selby P. Expression of somatostatin receptors in arginine vasopressin hormone-secreting olfactory neuroblastoma--report of two cases. Rhinology 2005; 43:61-5. [PMID: 15844504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
OBJECTIVE Arginine vasopressin hormone-secreting olfactory neuroblastomas are extremely rare, with fewer than twenty cases reported in the literature. Two of these cases, both initially presenting with the syndrome of inappropriate antidiuretic hormone, are presented. The second tumour was successfully identified using somatostatin receptor (octreotide) radiographic scintography. METHOD The pathological specimens from both cases were examined immunohistochemically for somatostatin receptors. RESULTS Samples from both cases demonstrated positivity for somatostatin receptors. CONCLUSIONS This report demonstrates the potential use of somatastatin analogues in the investigation, follow-up and treatment of patients with olfactory neuroblastoma.
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Affiliation(s)
- S R M Freeman
- Department of Otolaryngology, Manchester Royal Infirmary, Manchester, UK
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Flanagan P, Markulev C. Spatio-temporal selectivity of loss of colour and luminance contrast sensitivity with multiple sclerosis and optic neuritis. Ophthalmic Physiol Opt 2005; 25:57-65. [PMID: 15649184 DOI: 10.1111/j.1475-1313.2004.00252.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [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: 11/27/2022]
Abstract
Colour and luminance-contrast thresholds were measured in the presence of dynamic Random Luminance-contrast Masking (RLM) in individuals who had had past diagnoses of optic neuritis (ON) some of whom have progressed to a diagnosis of multiple sclerosis (MS). To explore the spatio-temporal selectivity of chromatic and luminance losses in MS/ON, thresholds were measured using three different sizes and modulation rates of the RLM displays: small checks modulating slowly, medium-sized checks with moderate modulation and large checks modulating rapidly. The colour of the chromatic stimuli used were specified in a cone-excitation space to measure relative impairments in red-green and blue-yellow chromatic channels. These observers showed chromatic thresholds along the L/(L+M) axis that were higher than those along the S-cone axis for all display sizes/modulation rates and both red-green and blue-yellow colour thresholds were higher than luminance-contrast thresholds. The principal change in thresholds with spatio-temporal changes in the display was a reduction in thresholds for L/(L+M) and S-cones with increasing check size and modulation rate. However, luminance contrast thresholds did not change with display size/rate. These results are consistent with MS/ON selectively affecting processing in colour pathways rather than in the magnocellular pathway, and that within the colour pathways neurones with opposed L- and M-cone inputs are more damaged than colour-opponent neurons with input from S-cones.
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Affiliation(s)
- Patrick Flanagan
- School of Psychology, Deakin University, Victoria, 3217, Australia.
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Hill S, Flanagan P. Is 10iu/L anti-HBs protective after hepatitis B vaccination? Commun Dis Public Health 2004; 7:227-8. [PMID: 15481218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/30/2023]
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Flanagan P, Zele AJ. Chromatic and luminance losses with multiple sclerosis and optic neuritis measured using dynamic random luminance contrast noise. Ophthalmic Physiol Opt 2004; 24:225-33. [PMID: 15130171 DOI: 10.1111/j.1475-1313.2004.00191.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.9] [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: 11/29/2022]
Abstract
We measured thresholds for detecting changes in colour and in luminance contrast in observers with multiple sclerosis (MS) and/or optic neuritis (ON) to determine whether reduced sensitivity occurs principally in red-green or blue-yellow second-stage chromatic channels or in an achromatic channel. Colour thresholds for the observers with MS/ON were higher in the red-green direction than in the blue-yellow direction, indicating greater levels of red-green loss than blue-yellow loss. Achromatic thresholds were raised less than either red-green or blue-yellow thresholds, showing less luminance-contrast loss than chromatic loss. With the MS/ON observers, blue-yellow and red-green thresholds were positively correlated but increasing impairment was associated with more rapid changes in red-green thresholds than blue-yellow thresholds. These findings indicate that demyelinating disease selectively reduces sensitivity to colour vision over luminance vision and red-green colours over blue-yellow colours.
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Affiliation(s)
- Patrick Flanagan
- Department of Psychology, Deakin University, Victoria 3217, Australia.
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Boone D, Eisenbraun E, Flanagan P, Grigsby R. Correction. The Acid-Catalyzed Alkylation and Cyclialkylation of the Cymenes with Isobutylene and Related olefins. J Org Chem 2003. [DOI: 10.1021/jo00822a622] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Reesink HW, Engelfriet CP, Muylle L, Wendel S, Dickmeiss E, Krusius T, Mäki T, Lin CK, O'Riordan J, Prati D, Rebulla P, Shirato T, Nakajima K, Dupuis HM, Flanagan P, Carasa MAV, Gallastegui RA, Turek P, Hewitt P, Bernat JL, Bianco C, Dodd RY, Klein HG. Future counselling of donors and recipients of blood products concerning prion-related diseases. Vox Sang 2003; 85:126-48. [PMID: 12925171 DOI: 10.1046/j.1423-0410.2003.00343.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- H W Reesink
- Sanquin Blood Bank Region North-West, Amsterdam, The Netherlands.
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Engelfriet CP, Reesink HW, Klein HG, AuBuchon JP, Strauss RG, Krusius T, Mäki T, Rebulla P, Högman CF, Knutson F, Letowska M, Dickmeiss E, Winter M, Henn G, Menichetti E, Mayr WR, Flanagan P, Martin-Vega C, Massuet L, Wendel S, Turek P, Lin CK, Shirato T. The future use of pathogen-inactivated platelet concentrates. Vox Sang 2003; 85:54-66. [PMID: 12823735 DOI: 10.1046/j.1423-0410.2003.00315.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Drobniewski F, Strutt M, Smith G, Magee J, Flanagan P. Audit of scope and culture techniques applied to samples for the diagnosis of Mycobacterium bovis by hospital laboratories in England and Wales. Epidemiol Infect 2003; 130:235-7. [PMID: 12733491 PMCID: PMC2869970 DOI: 10.1017/s0950268802008105] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.5] [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: 11/07/2022] Open
Abstract
This audit examines the ability of English and Welsh laboratories to diagnose Mycobacterium bovis infection. All 164 clinical laboratories submitting samples to the PHLS Mycobacterium Reference Unit and Regional Centres for Mycobacteriology were surveyed. Twenty per cent of responding centres did not use a pyruvate-containing medium or incubate for the minimum recommended period of 8 weeks. This study demonstrates the potential for the underdiagnosis of M. bovis infection in England and Wales. Possible reasons for underdiagnosis are discussed together with strategies to optimize recovery of M. bovis.
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Affiliation(s)
- F Drobniewski
- PHLS Mycobacterium Reference Unit, South London Public Health Laboratory, Department of Infection Guy's, King's & St. Thomas' School of Medicine, Kings College Hospital (Dulwich), East Dulwich Grove, London SE22 8QF, UK
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Gavin TM, Carandang G, Havey R, Flanagan P, Ghanayem A, Patwardhan AG. Biomechanical analysis of cervical orthoses in flexion and extension: A comparison of cervical collars and cervical thoracic orthoses. ACTA ACUST UNITED AC 2003; 40:527-37. [PMID: 15077665 DOI: 10.1682/jrrd.2003.11.0527] [Citation(s) in RCA: 45] [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: 11/05/2022]
Abstract
The analysis of current cervical collars (Aspen and Miami J collars) and cervical thoracic orthoses (CTOs) (Aspen 2-post and Aspen 4-post CTOs) in reducing cervical intervertebral and gross range of motion in flexion and extension was performed using 20 normal volunteer subjects. The gross sagittal motion of the head was measured relative to the horizon with the use of an optoelectronic motion measurement system. Simultaneous measurement of cervical intervertebral motion was performed with the use of a video fluoroscopy (VF) machine. Intervertebral motion was described as (1) the angular motion of each vertebra and (2) the translational motion of the vertebral centroid. We used surface electromyographic (EMG) signal data to compare subject efforts between the two collars and between the two CTOs. Each orthosis significantly reduced gross and intervertebral motion in flexion and extension (p < 0.05). No statistically significant differences were found between the Miami J and Aspen collars in reducing gross or intervertebral sagittal motion, except at C5-6. Both CTOs provided significantly more restriction of gross and intervertebral flexion and extension motion as compared to the two collars (p < 0.05). The Aspen 2-post CTO and 4-post CTO performed similarly in flexion, but the Aspen 4-post CTO provided significantly more restriction of extension motion (p < 0.05).
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Affiliation(s)
- Thomas M Gavin
- Musculoskeletal Biomechanics Laboratory, Edward Hines Jr., Department of Veterans Affairs (VA) Hospital, Hines, IL, USA.
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Reesink HW, Engelfriet CP, Tegtmeier GE, O'Riordan J, Eglin R, Barbara JAJ, Flanagan P, Lin CK, Rawlinson W, Muylle L, Wendel S, Biagini S, Lazar AE, Krusius T, Alitupa E, Grillner L, Preiser W, Doerr HW, Brand A, Zupanska B, Brojer E, Degré M. Prevention of post-transfusion cytomegalovirus: leucoreduction or screening? Vox Sang 2002; 83:72-87. [PMID: 12100393 DOI: 10.1046/j.1423-0410.2002.t01-1-01851.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- H W Reesink
- Blood Bank North Holland (Sanquin) Plesmanlaan 125 NL - 1066 CX Amsterdam, The Netherlands
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Djuretic T, Herbert J, Drobniewski F, Yates M, Smith EG, Magee JG, Williams R, Flanagan P, Watt B, Rayner A, Crowe M, Chadwick MV, Middleton AM, Watson JM. Antibiotic resistant tuberculosis in the United Kingdom: 1993-1999. Thorax 2002; 57:477-82. [PMID: 12037221 PMCID: PMC1746361 DOI: 10.1136/thorax.57.6.477] [Citation(s) in RCA: 46] [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]
Abstract
BACKGROUND The re-emergence of tuberculosis as a global health problem over the past two decades, accompanied by an increase in tuberculosis drug resistance, prompted the development of a comprehensive national surveillance system for tuberculosis drug resistance in 1993. METHODS The UK Mycobacterial Resistance Network (Mycobnet), which includes all mycobacterial reference and regional laboratories in the UK, collects a minimum dataset on all individuals from whom an initial isolate of Mycobacterium tuberculosis complex has been isolated and submitted by source hospital laboratories. Data sought include susceptibility to first line antibiotics, demographic, geographical, and risk factor information. RESULTS There were 25 217 reports of initial isolates of M tuberculosis complex in the UK between 1993 and 1999. All were tested for sensitivity to isoniazid, rifampicin, and ethambutol and 12 692 of the isolates were also tested for sensitivity to pyrazinamide and streptomycin. A total of 1523 (6.1%) isolates were resistant to one or more drugs, 1397 isolates (5.6%) were resistant to isoniazid with or without resistance to other drugs, and 299 (1.2%) were multidrug resistant. Although the numbers of drug resistant isolates increased over the period, the proportions remained little changed. Certain groups of people were at a higher risk of acquiring drug resistant tuberculosis including younger men, residents of London, foreign born subjects, patients with a previous history of tuberculosis and those infected with HIV. CONCLUSION Although the proportion of drug resistant tuberculosis cases appears to be stable in the UK at present, more than one in 20 patients has drug resistant disease at diagnosis and more than one in 100 has multidrug resistant disease. Tuberculosis control measures should be strengthened to minimise the emergence of drug resistance through rapid diagnosis, rapid identification of drug resistance, supervised treatment, and maintenance of comprehensive surveillance.
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Affiliation(s)
- T Djuretic
- Public Health Laboratory Service Communicable Disease Surveillance Centre, London NW9 5EQ, UK
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Engelfriet CP, Reesink HW, Pietersz RN, Schwartz DW, Mayr WR, Blajchman MA, Goldman M, Décary F, Sher G, Georgsen J, Sprogøe-Jakobsen U, Kekomäki R, Kühnl P, Seitz R, Maniatis A, Pintér J, Baróti K, Shinar E, Rebulla P, Greppi N, Sirchia G, Faber JC, Flanagan P, Brand A, Lêtowska M, Nel T, Argelagues E, Martin-Vega C, AuBuchon JP, Williamson L, Wallington T. Universal leucocyte-depletion of blood components: cell concentrates and plasma. Vox Sang 2001; 81:56-77. [PMID: 11520421 DOI: 10.1046/j.1423-0410.2001.00043.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- C P Engelfriet
- Central Laboratory, Netherlands Red Cross, Blood Transfusion Service, Amsterdam, The Netherland
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