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Staruch R, Naumann DN, Wordsworth M, Jeffery S, Rickard R. Understanding progressive tissue loss and wound burden in combat casualties: lessons learnt for future operational capability. BMJ Mil Health 2023:e002227. [PMID: 38053264 DOI: 10.1136/military-2022-002227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 09/14/2023] [Indexed: 12/07/2023]
Abstract
Understanding tissue loss following injury is important due to its prevalence among the war-wounded and the impact it has on subsequent treatment and rehabilitation. Progressive tissue loss is a type of tissue loss that has complicated extremity injury in recent conflicts. It has resulted in more proximal residual limb lengths and has influenced rehabilitation. Quantifying wound burden in combat casualties remains a challenge due to poor quality of data sets that lack the capacity for detailed analysis. The aims of this article are to outline the current hurdles in attempting to quantify wound burden in combat casualties and to propose simple interventions to improve data capture for future analysis.
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Affiliation(s)
- Robert Staruch
- Department of Plastic & Reconstructive Surgery, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
- Department of Engineering Science, University of Oxford, Oxford, UK
| | - D N Naumann
- Academic Department of Military Surgery and Trauma, Royal Centre for Defence Medicine, Birmingham, UK
- Department of Surgery, Queen Elizabeth Hospital Birmingham, Birmingham, UK
| | - M Wordsworth
- Department of Burns and Plastic Surgery, Queen Elizabeth Hospital Birmingham, Birmingham, UK
| | - S Jeffery
- Department of Health Sciences, Aston University, Birmingham, UK
| | - R Rickard
- Academic Department of Military Surgery and Trauma, Royal Centre for Defence Medicine, Birmingham, UK
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Jiménez-González MA, De la Rosa JM, Aksoy E, Jeffery S, Oliveira BRF, Verheijen FGA. Spatial distribution of pyrogenic carbon in Iberian topsoils estimated by chemometric analysis of infrared spectra. Sci Total Environ 2021; 790:148170. [PMID: 34380273 DOI: 10.1016/j.scitotenv.2021.148170] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Revised: 05/26/2021] [Accepted: 05/27/2021] [Indexed: 06/13/2023]
Abstract
Understanding the global carbon (C) cycle is critical to accurately model feedbacks between climate and soil. Thus, many climate change studies focused on soil organic carbon (SOC) stock changes. Pyrogenic carbon (PyC) is one of the most stable fractions of soil organic matter (SOM). Accurate maps based on measured PyC contents are required to facilitate future soil management decisions and soil-climate feedback modelling. However, consistent measurements that cover large areas are rare. Therefore, this study aimed to map the PyC content and stock of the Iberian Peninsula, which covers contrasting climatic zones and has long-term data on wildfire occurrence. A partial least square (PLS) regression using the mid-infrared spectra (1800-400 cm-1) was applied to a dataset composed of 2961 soil samples from the Iberian component of the LUCAS 2009 database. The values of PyC for LUCAS points were modelled to obtain a map of topsoil PyC by a random forest (RF) approach using 36 auxiliary variables. The results were validated through comparison with documented historical wildfire activity and anthropogenic energy production. A strong relationship was found between these sources and the distribution of PyC. Our study estimates that the accumulated PyC in Iberian Peninsula soils comprises between 3.09 and 20.39% of total organic carbon (TOC) in the topsoil. Forests have higher PyC contents than grasslands, followed by agricultural soils. The incidence of recurrent wildfires also has a notable influence on PyC contents. This study shows the potential of estimating PyC with a single, rapid, low cost, chemometric method using new or archived soil spectra, and has the ability to improve soil-climate feedback modelling. It also offers a possible tool for measuring, reporting and verifying soil C stocks, which is likely to be important moving forward if soils are used as sinks for C sequestration.
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Affiliation(s)
- M A Jiménez-González
- HERCULES Laboratory, University of Évora, Largo Marquês de Marialva, 8, 7000-809 Évora, Portugal; Department of Geology and Geochemistry, Autonomous University of Madrid, 28049 Madrid, Spain
| | - J M De la Rosa
- Instituto de Recursos Naturales y Agrobiología de Sevilla, Consejo Superior de Investigaciones Científicas (IRNAS-CSIC). Reina Mercedes Av., 10, 41012 Seville, Spain.
| | - E Aksoy
- Via Luigi Vanvitelli, 2, 00153 Rome, Italy
| | - S Jeffery
- Agriculture and Environment Department, Harper Adams University, Newport, Shropshire TF10 8NB, United Kingdom
| | - B R F Oliveira
- Earth Surface Processes Team, Centre for Environmental and Marine Studies (CESAM), Dept. Environment and Planning, University of Aveiro, 3810-193 Aveiro, Portugal
| | - F G A Verheijen
- Earth Surface Processes Team, Centre for Environmental and Marine Studies (CESAM), Dept. Environment and Planning, University of Aveiro, 3810-193 Aveiro, Portugal
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Mota T, Mccann C, Huang S, Dean M, Yanqin R, Thomas R, Colin K, David H, Jeffery S, Brad J. Histone deacetylase inhibitors induce transcription of unspliced but not multiply spliced HIV-1 RNA from proviral genomes during latency reversal, affecting antigen presentation and detection by CD8+ T cells. J Virus Erad 2019. [DOI: 10.1016/s2055-6640(20)30086-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Kirby M, Mirza M, Leigh T, Oldershaw L, Reilly M, Jeffery S. Destruction of Staphylococcus aureus and the impact of chlortetracycline on biomethane production during anaerobic digestion of chicken manure. Heliyon 2019; 5:e02749. [PMID: 31763470 PMCID: PMC6859293 DOI: 10.1016/j.heliyon.2019.e02749] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Revised: 07/29/2019] [Accepted: 10/25/2019] [Indexed: 11/25/2022] Open
Abstract
Research was undertaken to ascertain the effect on biogas potential during the anaerobic digestion of chicken manure containing Staphylococcus aureus and chlortetracycline (antibiotic) from infected chicken flocks. S. aureus is a pathogenic bacteria in chicken flocks that is usually treated with the broad-spectrum antibiotic, chlortetracycline. Veterinary antibiotics are often prescribed in the poultry sector for on-farm use at the flock level to control disease; consequently, significant quantities of antibiotics are excreted from the bird into the manure. Subsequent anaerobic digestion of this chicken manure could lead to pathogens and antibiotics affecting the digestion process. Anaerobic digestion biochemical methane potential assays were completed at 35°C for 39 days, with some assays receiving S. aureus and some receiving S. aureus and chlortetracycline. No viable S. aureus cells were detected after Day 0 of the experiment. A further experiment utilising an order of magnitude greater concentration of S. aureus demonstrated a significant reduction (>400 fold) in S. aureus within 24 h when inoculated into anaerobic digestate, with no viable S. aureus cells detected by the end of 3 days. Furthermore, the efficacy of chlortetracycline was significantly reduced when applied to anaerobic digestate compared to water alone. Total biogas yields from chicken manure were significantly lowered by the addition of S. aureus, with and without chlortetracycline. However, there was no significant difference in methane yields between treatments. The cellulose control assays showed a lag phase in methane production after receiving chlortetracycline. In comparison, the absence of a lag phase when the antibiotic were added to chicken manure may have been due to the relatively high nitrogen content of the feedstock reducing the inhibition of chlortetracycline on methanogens. Therefore, this study demonstrates that the addition of S. aureus and chlortetracycline does not have a commercially relevant effect on the digestion of chicken manure.
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Affiliation(s)
- M.E. Kirby
- Agricultural Centre for Sustainable Energy Systems (ACSES), Animal Production, Welfare and Veterinary Sciences Department, Harper Adams University, Newport, Shropshire, TF10 8NB, United Kingdom
| | - M.W. Mirza
- Agricultural Centre for Sustainable Energy Systems (ACSES), Animal Production, Welfare and Veterinary Sciences Department, Harper Adams University, Newport, Shropshire, TF10 8NB, United Kingdom
| | - T. Leigh
- Princess Margaret Science Laboratories, Harper Adams University, Newport, Shropshire, TF10 8NB, United Kingdom
| | - L. Oldershaw
- Princess Margaret Science Laboratories, Harper Adams University, Newport, Shropshire, TF10 8NB, United Kingdom
| | - M. Reilly
- Agricultural Centre for Sustainable Energy Systems (ACSES), Animal Production, Welfare and Veterinary Sciences Department, Harper Adams University, Newport, Shropshire, TF10 8NB, United Kingdom
| | - S. Jeffery
- Crop and Environmental Sciences Department, Harper Adams University, Newport, Shropshire, TF10 8NB, United Kingdom
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Fuller J, Peralta P, White-Alikakos D, Jeffery S, Breckenridge J, Mungovan S, Mills K. Is there a link between common adult movement screening tests and ankle or foot injury in junior netballers? J Sci Med Sport 2019. [DOI: 10.1016/j.jsams.2019.08.190] [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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Kjartansson H, Jeffery S, Baldursson BT, Magnusson S, Karason S, Astradsdottir K, Gunnarsson E, Audolfsson G, Sigurjonsson GF. 118 Omega-3 rich Fish Skin Grafts in the Treatment of Full Thickness Burns: A Comparative Trial of Fish Skin and Cadaver Skin in a Porcine Model. J Burn Care Res 2018. [DOI: 10.1093/jbcr/iry006.121] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- H Kjartansson
- Kerecis, Reykjavik, Iceland; The Royal Centre for Defense Medicine, Queen Elizabeth Hospital, Birmingham, United Kingdom; Landspitali - The National University Hospital of Iceland, Reykjavik, Iceland; Keldur - The Institute for Experimental Pathology, University of Iceland, Reykjavik, Icel
| | - S Jeffery
- Kerecis, Reykjavik, Iceland; The Royal Centre for Defense Medicine, Queen Elizabeth Hospital, Birmingham, United Kingdom; Landspitali - The National University Hospital of Iceland, Reykjavik, Iceland; Keldur - The Institute for Experimental Pathology, University of Iceland, Reykjavik, Icel
| | - B T Baldursson
- Kerecis, Reykjavik, Iceland; The Royal Centre for Defense Medicine, Queen Elizabeth Hospital, Birmingham, United Kingdom; Landspitali - The National University Hospital of Iceland, Reykjavik, Iceland; Keldur - The Institute for Experimental Pathology, University of Iceland, Reykjavik, Icel
| | - S Magnusson
- Kerecis, Reykjavik, Iceland; The Royal Centre for Defense Medicine, Queen Elizabeth Hospital, Birmingham, United Kingdom; Landspitali - The National University Hospital of Iceland, Reykjavik, Iceland; Keldur - The Institute for Experimental Pathology, University of Iceland, Reykjavik, Icel
| | - S Karason
- Kerecis, Reykjavik, Iceland; The Royal Centre for Defense Medicine, Queen Elizabeth Hospital, Birmingham, United Kingdom; Landspitali - The National University Hospital of Iceland, Reykjavik, Iceland; Keldur - The Institute for Experimental Pathology, University of Iceland, Reykjavik, Icel
| | - K Astradsdottir
- Kerecis, Reykjavik, Iceland; The Royal Centre for Defense Medicine, Queen Elizabeth Hospital, Birmingham, United Kingdom; Landspitali - The National University Hospital of Iceland, Reykjavik, Iceland; Keldur - The Institute for Experimental Pathology, University of Iceland, Reykjavik, Icel
| | - E Gunnarsson
- Kerecis, Reykjavik, Iceland; The Royal Centre for Defense Medicine, Queen Elizabeth Hospital, Birmingham, United Kingdom; Landspitali - The National University Hospital of Iceland, Reykjavik, Iceland; Keldur - The Institute for Experimental Pathology, University of Iceland, Reykjavik, Icel
| | - G Audolfsson
- Kerecis, Reykjavik, Iceland; The Royal Centre for Defense Medicine, Queen Elizabeth Hospital, Birmingham, United Kingdom; Landspitali - The National University Hospital of Iceland, Reykjavik, Iceland; Keldur - The Institute for Experimental Pathology, University of Iceland, Reykjavik, Icel
| | - G F Sigurjonsson
- Kerecis, Reykjavik, Iceland; The Royal Centre for Defense Medicine, Queen Elizabeth Hospital, Birmingham, United Kingdom; Landspitali - The National University Hospital of Iceland, Reykjavik, Iceland; Keldur - The Institute for Experimental Pathology, University of Iceland, Reykjavik, Icel
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Pujji O, Nizar B, Bechar J, North D, Jeffery S. Burns Centre and fire services: What information can be exchanged to manage the burn patient? Burns 2017; 44:573-581. [PMID: 29239735 DOI: 10.1016/j.burns.2017.10.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2017] [Revised: 10/24/2017] [Accepted: 10/24/2017] [Indexed: 11/26/2022]
Abstract
AIM To describe the experience of using a "Burns Extrication Form" at a regional Burns Centre. Communication between the fire services and burns team previously has been regarded as poor. Significant information is collected by the fire services at the scene and this can aid the management of the patient. METHODS The Burns Extrication Form was devised to provide a clear framework of communication between the two services. Information regarding time frames, exposure to heat & smoke, fire loading (potential severity of a fire in a given space by measuring amount of combustible material in confined space), building construction, chemicals involved is passed to the medical team through this form through a National Health Service mailbox. Also, treatment provided by the fire service was documented. All data collected by this form was collated for the purpose of this study. Data ranging from 2014 to 2017 was included in this descriptive study. RESULTS The patient journey following contact by fire services shows that out of the 598 persons who were involved in a fire only 92 (15%) attended the Accident and Emergency (A&E) department at the Queen Elizabeth Hospital. Signs of smoke inhalation, singed nose hair and coughing were found in 190 (32%) patients; the fire service administered oxygen to 106 (18%) of these patients although this may have been initiated by Ambulance crews who were on scene prior to the Fire Crew. The remaining 506 (85%) may have not attended A&E at UHB or may have attended another A&E in the West Midlands base on the location of the incident and clinical needs. Of the 92 patients who attended the A&E at UHB 48 (52%) were admitted to the Burns Centre in the hospital. Nine (19%) of these patients had smoke inhalation and three of these patients were managed by intubation. Birmingham North and Black Country North had the highest incidence of burns incidents, 120 and 103 respectively. Whilst, the lowest numbers were found in Birmingham South and Coventry and Solihull with 65 and 61 respectively. Additional results are described in the study. CONCLUSION Data provided by the Fire Extrication forms helps us to assess the magnitude of fire-related injury across the West Midlands. The fire services have been shown to provide important first aid as one of the first responders at the scene. Their value in assessing the environment in and patient status helps clinicians further down the patient's journey.
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Affiliation(s)
- O Pujji
- College of Medical and Dental Sciences, University of Birmingham, United Kingdom.
| | - B Nizar
- Queen Elizabeth Hospital Birmingham, United Kingdom
| | - J Bechar
- Queen Elizabeth Hospital Birmingham, United Kingdom
| | - D North
- West Midlands Fire Service, United Kingdom
| | - S Jeffery
- Queen Elizabeth Hospital Birmingham, United Kingdom
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Pujji O, Bharj I, Yim G, Jeffery S. Fluid Resuscitation of Bariatric Burns: Assessing the Value of the Neaman Scale. Int J Surg 2017. [DOI: 10.1016/j.ijsu.2017.08.344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Shen L, Jeffery S. 'What Goes Around, Comes Around...' An Assessment of Referral Patterns and National Compliance with NICE Guidance for Traumatic Brain Injury. Int J Surg 2017. [DOI: 10.1016/j.ijsu.2017.08.320] [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: 11/29/2022]
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Farrar E, Pujji O, Jeffery S. Three-dimensional wound mapping software compared to expert opinion in determining wound area. Burns 2017; 43:1736-1741. [PMID: 28801150 DOI: 10.1016/j.burns.2017.05.015] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [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: 01/27/2017] [Revised: 05/13/2017] [Accepted: 05/22/2017] [Indexed: 11/26/2022]
Abstract
INTRODUCTION New technologies in the field of burn wound and scar assessment are continually being evaluated. Accurate estimation of total body surface area (TBSA) burn wound is of paramount importance in fluid resuscitation to prevent complications which are associated with morbidity and mortality. Estimating the TBSA is performed by a multitude of different methods, however a gold standard would be ideal. The aim of this study was to compare the estimation of burned TBSA% between 3D photography by Panasonic FZ-M1 Toughpad in conjunction with WoundCare Lite software and expert opinion volunteered by burns doctors. METHODS Two life sized mannequins were used to simulate burns; an adult and a child. The burn was drawn to mimic real life burn patterns. Burns were measured prior to specialist assessment on the 3D camera. Burns doctors were asked to estimate the TBSA% of the burn. 10 burn sizes were assessed on the adult mannequin, and 8 on the child. RESULTS Wound size as estimated from the camera varied from 0.42% to 18.23%, with a mean of 5.246%. Each burn was assessed by a median of 3 assessors (ranging from 2 to 8). Burn TBSA assessments from the 3D camera and specialist assessment (compared using ICC) showed excellent agreement, 0.985 (95% CI 0.905, 0.996). CONCLUSIONS This study has demonstrated that the wound mapping software WoundCare Lite in conjunction with the Panasonic FZ-M1 Toughpad 3D camera compares well with expert opinion in determining burn surface area on a mannequin. Further research is needed to establish whether this is the case in burns on patients in an acute setting.
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Affiliation(s)
- E Farrar
- Burns & Plastic Surgery, Queen Elizabeth Hospital Birmingham, United Kingdom.
| | - O Pujji
- University of Birmingham Medical School, United Kingdom.
| | - S Jeffery
- Queen Elizabeth Hospital Birmingham, United Kingdom; Professor of Wound Study, Birmingham City University, United Kingdom.
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Jeffery S. Shewanella dysentery in a patient with underlying malignancy. Med J Malaysia 2014; 69:284-285. [PMID: 25934962] [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: 06/04/2023]
Abstract
Shewanella spp is a facultatively anaerobic, motile, gramnegative bacillus and can be found throughout the world mainly in marine environments and soil. It is a rare pathogen in human and infection by it is usually associated with underlying severe morbidities. We report a case of a 69- years old woman who presented with Shewanella putrefaciens dysentery and who was subsequently found to have underlying malignancy.
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Affiliation(s)
- S Jeffery
- Pejabat Kesihatan Bahagian Betong, Km 2, Jalan Betong-Sri Aman,95700 Betong, Sarawak.
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Phan TT, Khan S, Dewhurst M, Lee D, James S, de Belder M, Linker NJ, Thornley A, Turley AJ, Ahmed FZ, Arumugam P, Allen S, Daniels K, Clarke B, Mamas M, James J, Zaidi AM, Ullah W, Hunter R, Lovell M, Dhinoja M, Earley M, Sporton S, Schilling R, Raju H, Hedley P, Arno G, Ware J, Jeffery S, Cook S, Christiansen M, Behr ER, Sohal M, Chen Z, Sammut E, Jackson T, Child N, Wright M, O'Neill M, Cooklin M, Gill J, Carr-White G, Razavi R, Rinaldi CA, Nunn LM, Lopes L, Syrris P, Plagnol V, Firman E, Dalageorgou C, Domingo D, Zorio E, Murday V, Findlay I, Duncan A, Fynn S, White A, Goddard M, Carr-White G, Robert L, Bueser T, Langman C, Bundgaard H, Ferrero-Miliani L, Wheeldon N, O'Beirne A, Suvarna SK, Lowe MD, McKenna WJ, Elliott PM, Lambiase PD. YOUNG INVESTIGATORS COMPETITION, HRC 2013. Europace 2013. [DOI: 10.1093/europace/eut313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Connell FC, Gordon K, Brice G, Keeley V, Jeffery S, Mortimer PS, Mansour S, Ostergaard P. The classification and diagnostic algorithm for primary lymphatic dysplasia: an update from 2010 to include molecular findings. Clin Genet 2013; 84:303-14. [PMID: 23621851 DOI: 10.1111/cge.12173] [Citation(s) in RCA: 105] [Impact Index Per Article: 9.5] [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: 02/17/2013] [Revised: 04/19/2013] [Accepted: 04/19/2013] [Indexed: 12/17/2022]
Abstract
Historically, primary lymphoedema was classified into just three categories depending on the age of onset of swelling; congenital, praecox and tarda. Developments in clinical phenotyping and identification of the genetic cause of some of these conditions have demonstrated that primary lymphoedema is highly heterogenous. In 2010, we introduced a new classification and diagnostic pathway as a clinical and research tool. This algorithm has been used to delineate specific primary lymphoedema phenotypes, facilitating the discovery of new causative genes. This article reviews the latest molecular findings and provides an updated version of the classification and diagnostic pathway based on this new knowledge.
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Affiliation(s)
- F C Connell
- Clinical Genetics, Guy's and St Thomas' NHS Foundation Trust, Guy's Hospital, London, SE1 9RT, UK
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Brice G, Ostergaard P, Jeffery S, Gordon K, Mortimer PS, Mansour S. A novel mutation inGJA1causing oculodentodigital syndrome and primary lymphoedema in a three generation family. Clin Genet 2013; 84:378-81. [DOI: 10.1111/cge.12158] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2013] [Revised: 03/27/2013] [Accepted: 03/27/2013] [Indexed: 11/30/2022]
Affiliation(s)
| | | | | | - K Gordon
- Department of Clinical Sciences; St George's University of London; London SW17 0RE UK
| | - PS Mortimer
- Department of Clinical Sciences; St George's University of London; London SW17 0RE UK
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Jeffery S. I159 POST-OPERATIVE PAIN AND DYSPAREUNIA AFTER PELVIC ORGAN PROLAPSE SURGERY. Int J Gynaecol Obstet 2012. [DOI: 10.1016/s0020-7292(12)60189-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Jeffery S. O340 INCONTINENCE RESEARCH IN AFRICA. WHERE ARE WE IN 2012? Int J Gynaecol Obstet 2012. [DOI: 10.1016/s0020-7292(12)60770-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Connell FC, Kalidas K, Ostergaard P, Brice G, Murday V, Mortimer PS, Jeffrey I, Jeffery S, Mansour S. CCBE1 mutations can cause a mild, atypical form of generalized lymphatic dysplasia but are not a common cause of non-immune hydrops fetalis. Clin Genet 2012; 81:191-7. [PMID: 22239599 DOI: 10.1111/j.1399-0004.2011.01731.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Vig S, Dowsett C, Berg L, Caravaggi C, Rome P, Birke-Sorensen H, Bruhin A, Chariker M, Depoorter M, Dunn R, Duteille F, Ferreira F, Francos Martínez J, Grudzien G, Hudson D, Ichioka S, Ingemansson R, Jeffery S, Krug E, Lee C, Malmsjo M, Runkel N, Martin R, Smith J. Evidence-based recommendations for the use of negative pressure wound therapy in chronic wounds: Steps towards an international consensus. J Tissue Viability 2011; 20 Suppl 1:S1-18. [DOI: 10.1016/j.jtv.2011.07.002] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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Birke-Sorensen H, Malmsjo M, Rome P, Hudson D, Krug E, Berg L, Bruhin A, Caravaggi C, Chariker M, Depoorter M, Dowsett C, Dunn R, Duteille F, Ferreira F, Martínez JF, Grudzien G, Ichioka S, Ingemansson R, Jeffery S, Lee C, Vig S, Runkel N, Martin R, Smith J. Evidence-based recommendations for negative pressure wound therapy: Treatment variables (pressure levels, wound filler and contact layer) – Steps towards an international consensus. J Plast Reconstr Aesthet Surg 2011; 64 Suppl:S1-16. [DOI: 10.1016/j.bjps.2011.06.001] [Citation(s) in RCA: 86] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2011] [Revised: 05/22/2011] [Accepted: 06/03/2011] [Indexed: 01/14/2023]
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Ostergaard P, Simpson MA, Brice G, Mansour S, Connell FC, Onoufriadis A, Child AH, Hwang J, Kalidas K, Mortimer PS, Trembath R, Jeffery S. Rapid identification of mutations in GJC2 in primary lymphoedema using whole exome sequencing combined with linkage analysis with delineation of the phenotype. J Med Genet 2011; 48:251-5. [DOI: 10.1136/jmg.2010.085563] [Citation(s) in RCA: 75] [Impact Index Per Article: 5.8] [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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Connell F, Brice G, Jeffery S, Keeley V, Mortimer P, Mansour S. A new classification system for primary lymphatic dysplasias based on phenotype. Clin Genet 2010; 77:438-52. [DOI: 10.1111/j.1399-0004.2010.01394.x] [Citation(s) in RCA: 64] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
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Taylor C, Hettiaratchy S, Jeffery S, Evriviades D, Kay A. Contemporary Approaches To Definitive Extremity Reconstruction Of Military Wounds. J ROY ARMY MED CORPS 2009; 155:302-7. [DOI: 10.1136/jramc-155-04-12] [Citation(s) in RCA: 24] [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: 11/04/2022]
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Adam A, Arieff Y, De Jong P, Jeffery S. O9 Do urologists and gynaecologists manage posterior compartment prolapse differently? Int J Gynaecol Obstet 2009. [DOI: 10.1016/s0020-7292(09)60381-7] [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]
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Van den Berg J, Jeffery S. O964 Healing and functional outcomes after obstetric anal sphincter injury in HIV-positive vs HIV-negative patients. Int J Gynaecol Obstet 2009. [DOI: 10.1016/s0020-7292(09)61337-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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25
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Butt J, Jeffery S, Van Der Spuy Z. P925 Hysterectomy at a referral hospital in South Africa: Indications, complications and histopathology. Int J Gynaecol Obstet 2009. [DOI: 10.1016/s0020-7292(09)62412-7] [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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Doumouchtsis S, Jeffery S, Abboudi H, Wang K, Fynes M. O232 Compliance and voiding function in women with refractory overactive bladder (OAB) receiving intra-detrusor Botulinum Toxin A (Dysport®) injections. Int J Gynaecol Obstet 2009. [DOI: 10.1016/s0020-7292(09)60604-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Abstract
BACKGROUND A 23-year-old male was referred to our clinic with diagnosis of idiopathic isolated growth hormone deficiency. A detailed family history revealed short stature and swelling of legs which only affected females in four generations of his family. METHODS Combined pituitary function tests revealed growth hormone deficiency, secondary hypothyroidism and hypoprolactinemia in the proband. His mother had hypoprolactinemia and growth hormone deficiency. A diagnosis of inherited combined pituitary deficiency due to a PIT-1 mutation was suspected in view of the short stature with associated multiple pituitary hormone deficiencies. RESULTS A mutation was identified in PIT-1 (POU1F1), 196C>T, which produces the amino acid change P24L in exon 1. The mutation was also found in the mother of the proband but not in his phenotypically normal half-sister. CONCLUSION The case shows a novel association of two rare conditions Pit-1 mutation and lipoedema in a family that has not been described before. It also allows formulation of hypothesis on the interaction of growth hormone and sex steroids resulting in abnormal fat distribution in predisposed subjects at the time of puberty.
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Affiliation(s)
- G Bano
- Department of Cellular & Molecular Medicine, St George's University of London, Cranmer Terrace, London, UK.
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Syrris P, Schwartzman R, Jeffery S, Kaski JC, Carter N. Polymorphism in apolipoprotein(a) kringle IV 37(Met/Thr): frequency in a London population and its association with coronary artery disease. Clin Cardiol 2009; 20:870-2. [PMID: 9377824 PMCID: PMC6655524 DOI: 10.1002/clc.4960201014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND A raised concentration of lipoprotein(a) [Lp(a)] in human plasma has been considered as a risk factor for coronary artery disease (CAD). Apolipoprotein(a) and plasminogen genes are exceptionally similar to a variable number of plasminogen-like kringle IV repeats in the apo(a) gene. Polymorphisms have been previously identified in the apolipoprotein(a) kringle IV 37. HYPOTHESIS In order to determine the frequency of the apolipoprotein(a) kringle IV 37 Met66-->Thr polymorphism in a London-based population and to assess the relationship of this polymorphism with CAD in Caucasian patients, we genotyped two groups of people of different ethnic origin (Caucasian and Afro-Caribbean) for the mutation using standard polymerase chain reaction (PCR) techniques. METHODS The first group consisted of 182 unrelated Caucasian patients (107 men and 75 women, mean age 59.7 +/- 10.2 years) recruited at St. George's Hospital. They were defined as patients with 0, 1 or > or = 2 vessel disease patients depending on the degree of stenosis in none, one, or several major epicardial arteries. The second group comprised 64 unrelated patients of Afro-Caribbean origin attending a hypertension clinic at St. George's Hospital. RESULTS It was shown that the prevalence of the Met66-->Thr mutation is markedly higher in Caucasians than in Afro-Caribbeans and that this mutation is not associated with either Lp(a) levels or severity of CAD.
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Affiliation(s)
- P Syrris
- Medical Genetics Unit, St. George's Hospital Medical School, London, U.K
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Jeffery S, Kelling PJ, Lukaszyk A, Boriskin YS, Booth JC, Hodgson J, Davies MJ, McKenna WJ. Molecular evaluation of enteroviruses in the pathogenesis of idiopathic dilated cardiomyopathy. Clin Cardiol 2009; 20:857-63. [PMID: 9377822 PMCID: PMC6655876 DOI: 10.1002/clc.4960201012] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND There is great disparity in the literature as to the presence and relevance of enterovirus in heart tissue from patients with dilated cardiomyopathy (DCM). Published estimates of enteroviral positive tissue in DCM range from 0 to 50%. Very little sequence information is so far available on those samples which are positive. HYPOTHESIS Re-examination of fresh biopsy material from patients previously tested, plus 13 new cases of DCM, and sequencing the products would yield information on the validity of the technique and on the type of virus being detected. METHODS RNA from biopsy or explant tissue was tested for the presence of enterovirus using reverse transcriptase polymerase chain reaction (PCR). The nucleotide sequences of all positive PCR products were determined by direct sequencing. RESULTS Positive PCR signals were found in 10% of samples from patients with DCM and in 16% of control tissues. Two DCM and 12 control samples gave the same nucleotide sequence, which was different from the CB3 used as a positive control. The other 4 DCM samples all produced multiple bands on sequencing. CONCLUSION The results do not support a major role for enterovirus in DCM. There is need for some caution, however, as a review of the literature shows that studies using single biopsies, such as this one, produce consistently lower estimates for enterovirus than do those wherein multiple biopsies are examined.
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Affiliation(s)
- S Jeffery
- Department of Medical Genetics, St. George's Hospital Medical School, London, U.K
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Abstract
OBJECTIVE To define better the adult phenotype and natural history of Noonan syndrome. DESIGN A prospective observational study of a large cohort. RESULTS Data are presented for 112 individuals with Noonan syndrome (mean age 25.3 (range 12-71) years), who were followed up for a mean of 12.02 years. Mutations in PTPN11 were identified in 35% of probands. Ten subjects died during the study interval; three of these deaths were secondary to heart failure associated with hypertrophic cardiomyopathy. Pulmonary stenosis affected 73 (65%) subjects; 42 (58%) required no intervention, nine underwent balloon pulmonary valvuloplasty (three requiring further intervention) and 22 surgical valvuloplasty (three requiring further intervention). Hypertrophic cardiomyopathy affected 21 (19%) patients, which had remitted in two cases, but one subject required cardiac transplant. No subjects died suddenly or had symptoms suggestive of arrhythmia. The mean final adult height was 167.4 cm in males and 152.7 cm in females. Feeding problems in infancy were identified as a predictor of future outcome. The mean age of speaking in two-word phrases was 26 months for those with no feeding difficulties, compared with 39 months for those with severe problems requiring nasogastric feeding. Attendance at a school for children with special needs for the same groups was 12.5% and 58%, respectively. A statement of special educational need had been issued in 44% overall; however, academic achievement was broadly similar to that of the general population. IMPLICATIONS Although the morbidity for some patients with Noonan syndrome is low, early predictors of poorer outcome have been identified, which will help ascertain those most in need of intervention.
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Affiliation(s)
- A C Shaw
- Medical Genetics Unit, LG Floor, Jenner Wing, St George's, University of London, Cranmer Terrace, London, UK.
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Kumar S, Carver C, McCall S, Brice G, Ostergaard P, Mortimer P, Jeffery S. A family with lymphoedema-distichiasis where identical twins have a discordant phenotype. Clin Genet 2007; 71:285-7. [PMID: 17309653 DOI: 10.1111/j.1399-0004.2007.00758.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Athanasiou S, Chaliha C, Digesu A, Sotiropoulou M, Rodolakis A, Jeffery S, Antsaklis A. PD-03.06. Urology 2006. [DOI: 10.1016/j.urology.2006.08.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Abstract
Primary congenital lymphoedema (Milroy disease) is a rare autosomal dominant condition for which a major causative gene defect has recently been determined. Mutations in the vascular endothelial growth factor receptor 3 (VEGFR-3) gene have now been described in 13 families world-wide. This is a review of the condition based on the clinical findings in 71 subjects from 10 families. All 71 individuals have a mutation in VEGFR-3. Ninety per cent of the 71 individuals carrying a VEGFR-3 mutation showed signs of oedema, which was confined in all cases to the lower limbs. In all but two cases onset of swelling was from birth. Other symptoms and signs included cellulitis (20%), large calibre leg veins (23%), papillomatosis (10%), and upslanting toenails (10%). In males, hydrocoele was the next most common finding after oedema (37%). Thorough clinical examination of these patients indicates that there are few clinical signs in addition to lower limb oedema. Rigorous phenotyping of patients produces a high yield of VEGFR-3 mutations.
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Affiliation(s)
- G Brice
- SW Thames Regional Genetics Unit, St George's Hospital Medical School, Cranmer Terrace, London SW17 0RE, UK.
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35
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Ng MYM, Andrew T, Spector TD, Jeffery S. Linkage to the FOXC2 region of chromosome 16 for varicose veins in otherwise healthy, unselected sibling pairs. J Med Genet 2006; 42:235-9. [PMID: 15744037 PMCID: PMC1736007 DOI: 10.1136/jmg.2004.024075] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.2] [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: 12/30/2022]
Abstract
BACKGROUND The FOXC2 gene on 16q24 is mutated in lymphoedema distichiasis (LD), in which varicose veins (VV) are a common feature. We hypothesised that this gene might be implicated in the development of VV in the normal population, therefore, after performing a classical twin study, we tested for linkage and association in white women. We also tested for linkage with haemorrhoids (H), as a separate venous anomaly at the same locus. METHODS A total of 2060 complete female twin pairs aged 18-80 years from the St Thomas' Adult UK Twin registry replied to questions on VV and H as part of a broader postal survey of 6600 twins (62% response rate). Dizygotic female twin pairs were tested for linkage and association to the candidate marker D16S520 (1903 individuals genotyped), which is located about 80 kb from FOXC2. RESULTS Casewise concordance rates were significantly higher for monozygotic than dizygotic twins for both phenotypes (VV 67% v 45%; p = 2.2x10(-6); H 68% v 59%; p = 0.01; H including during pregnancy 73% v 64%; p = 2.1x10(-4)), corresponding to additive genetic heritabilities in liability of 86% (95% confidence interval (CI) 73% to 99%) for VV and 56-61% for H (95% CI 43% to 73%). The presence of VV and H were significantly correlated. We found significant evidence of linkage to the marker for VV (MLS(ASP) = 1.37, p = 0.01; GLM(ASP/DSP) Z = 3.17 p = 0.002), but no association. Both linkage and association tests were negative for H. The combined phenotype of having VV and H did not show any evidence of linkage or association. CONCLUSION These results demonstrate VV and H to be heritable, related conditions, and the data strongly suggest FOXC2 to be implicated in the development of VV in the general population.
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Affiliation(s)
- M Y M Ng
- Twin Research and Genetic Epidemiology Unit, St. Thomas' Hospital, London SE1 7EH
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36
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Mellor RH, Brice G, Stanton AWB, Mansour S, Child A, Jeffery S, Levick JR, Burnand K, Mortimer PS. OC17 PATIENTS WITH LYMPHOEDEMA DISTICHIASIS HAVE BOTH LYMPHATIC AND VENOUS ABNORMALITIES. Microcirculation 2004. [DOI: 10.1080/10739680490488274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Abstract
The CD14 receptor is a pattern recognition molecule in the innate immune response against microorganisms and other exogenous and endogenous stress factors. The most important CD14 signalling co-receptor is toll-like receptor 4 (TLR4), which activates, among others, the nuclear factor kappaB (NF-kappaB) inflammatory pathway. Besides its role in innate immunity and host defence, the proinflammatory cytokines expressed upon TLR4/NF-kappaB pathway activation exert proatherogenic effects. The CD14 C(-260)T promoter and TLR4 Asp299Gly functional polymorphisms have been recently implicated in the development of cardiovascular events, suggesting that the genetically determined inflammatory response against pathogens or their antigens may have a major role in atherogenesis and subsequent acute events. Is the association of these polymorphisms with cardiovascular disease more evidence for the implication of infection, especially by Gram negative bacteria, in the development of acute coronary events? This article reviews the molecular basis, biological functions, and clinical implications of the CD14/TLR4 polymorphisms in the development of cardiovascular events.
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Affiliation(s)
- R Arroyo-Espliguero
- Department of Cardiology, Hospital General Universitario, Guadalajara, Spain
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Evans AL, Bell R, Brice G, Comeglio P, Lipede C, Jeffery S, Mortimer P, Sarfarazi M, Child AH. Identification of eight novel VEGFR-3 mutations in families with primary congenital lymphoedema. J Med Genet 2003; 40:697-703. [PMID: 12960217 PMCID: PMC1735587 DOI: 10.1136/jmg.40.9.697] [Citation(s) in RCA: 49] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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40
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Dong YB, Plange-Rhule J, Owusu I, Micah F, Eastwood JB, Carter ND, Saggar-Malik AK, Cappuccio FP, Jeffery S. T594M mutation of the beta-subunit of the epithelial sodium channel in Ghanaian populations from Kumasi and London and a possible association with hypertension. Genet Test 2002; 6:63-5. [PMID: 12180079 DOI: 10.1089/109065702760093942] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
We have tested 186 individuals from Ghana, 95 indigenous and 91 who have settled in the United Kingdom, for the presence of the T594M mutation in the beta-subunit of the epithelial sodium channel, which is associated with hypertension in black populations. The group living in Ghana had a mean age of 27 years and were normotensive, but had an increased frequency of the T allele compared to the London-based population. If this is reflected in larger studies, and the link with hypertension is maintained in the Ghanaian population, this mutation could be a significant cause of hypertension in Ghana.
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Affiliation(s)
- Y B Dong
- Medical Genetics Unit, St. George's Medical School, Cranmer Terrace, Tooting, London, SW17ORE, UK
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41
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Affiliation(s)
- S Jeffery
- Medical Genetics Unit, St George's Hospital Medical School, Cranmer Terrace, Tooting, London SW17 0RE, UK.
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Murray A, Potet F, Bellocq C, Baró I, Reardon W, Hughes HE, Jeffery S. Mutation in KCNQ1 that has both recessive and dominant characteristics. J Med Genet 2002; 39:681-5. [PMID: 12205113 PMCID: PMC1735237 DOI: 10.1136/jmg.39.9.681] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Church MK, Griffiths TJ, Jeffery S, Ravell LC, Cowburn AS, Sampson AP, Clough GF. Are cysteinyl leukotrienes involved in allergic responses in human skin? Clin Exp Allergy 2002; 32:1013-9. [PMID: 12100047 DOI: 10.1046/j.1365-2222.2002.01436.x] [Citation(s) in RCA: 19] [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: 11/20/2022]
Abstract
BACKGROUND Cysteinyl leukotrienes have been suggested to be involved in producing the symptoms of both the early and late phases of the allergic response in the lung and other tissues. OBJECTIVE To use scanning laser Doppler imaging, microdialysis and immunocytochemistry to explore the mediator and cellular mechanisms of the dermal allergic response. METHODS Thirteen atopic volunteers received intradermal injections into the forearm of grass pollen or D. pteronyssinus extract. Changes in dermal blood flow up to 8 h were monitored by scanning laser Doppler imaging. The release of histamine, PGD2 and LTC4/D4/E4 was assessed by dermal microdialysis. Skin biopsies were taken at 6 h to determine numbers of mast cells, eosinophils, basophils, Langerhans' cells, and monocytes/macrophages, and the expression of COX-1, COX-2, 5-LO and FLAP. RESULTS Allergen provocation produced an immediate weal and flare response followed by an erythematous induration peaking at 6 h. During the first hour, c. 84 pmoles of histamine and c. 0.3 pmoles of PGD2 were recovered by microdialysis (both P < 0.001) but LTC4/D4/E4 was undetectable. No histamine, PGD2 or LTC4/D4/E4 was detectable at later times. Immunocytochemical examination of biopsies taken at 8 h showed increased numbers of eosinophils and basophils and in COX-2, 5-LO and FLAP, but not COX-1. Expression of 5-LO and FLAP was associated primarily with eosinophils. CONCLUSIONS These findings suggest that inflammatory cells recruited to the site of allergen injection are not activated to release detectable amounts of cysteinyl leukotrienes. Hence, it is unlikely that the late-phase erythematous induration is mediated by this autocoid.
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Affiliation(s)
- M K Church
- Division of Infection, Inflammation and Repair, School of Medicine, University of Southampton, Southampton, UK.
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Brice G, Mansour S, Bell R, Collin JRO, Child AH, Brady AF, Sarfarazi M, Burnand KG, Jeffery S, Mortimer P, Murday VA. Analysis of the phenotypic abnormalities in lymphoedema-distichiasis syndrome in 74 patients with FOXC2 mutations or linkage to 16q24. J Med Genet 2002; 39:478-83. [PMID: 12114478 PMCID: PMC1735188 DOI: 10.1136/jmg.39.7.478] [Citation(s) in RCA: 203] [Impact Index Per Article: 9.2] [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
INTRODUCTION Lymphoedema-distichiasis syndrome (LD) (OMIM 153400) is a rare, primary lymphoedema of pubertal onset, associated with distichiasis. Causative mutations have now been described in FOXC2, a forkhead transcription factor gene. Numerous clinical associations have been reported with this condition, including congenital heart disease, ptosis, varicose veins, cleft palate, and spinal extradural cysts. SUBJECTS We report clinical findings in 74 affected subjects from 18 families and six isolated cases. All of them were shown to have mutations in FOXC2 with the exception of one family who had two affected subjects with lymphoedema and distichiasis and linkage consistent with the 16q24 locus. RESULTS The presence of lymphoedema was highly penetrant. Males had an earlier onset of lymphoedema and a significantly increased risk of complications. Lymphatic imaging confirmed the earlier suggestion that LD is associated with a normal or increased number of lymphatic vessels rather than the hypoplasia or aplasia seen in other forms of primary lymphoedema. Distichiasis was 94.2% penetrant, but not always symptomatic. Associated findings included ptosis (31%), congenital heart disease (6.8%), and cleft palate (4%). Other than distichiasis, the most commonly occurring anomaly was varicose veins of early onset (49%). This has not been previously reported and suggests a possible developmental role for FOXC2 in both venous and lymphatic systems. This is the first gene that has been implicated in the aetiology of varicose veins. CONCLUSION Unlike previous publications, the thorough clinical characterisation of our patients permits more accurate prediction of various phenotypic abnormalities likely to manifest in subjects with FOXC2 mutations.
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Affiliation(s)
- G Brice
- Department of Cardiological Sciences, St George's Medical School, Cranmer Terrace, Tooting, London SW17 0RE, UK
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Bell R, Murday VA, Patton MA, Jeffery S. Two families with blepharophimosis/ptosis/epicanthus inversus syndrome have mutations in the putative forkhead transcription factor FOXL2. Genet Test 2002; 5:335-8. [PMID: 11960581 DOI: 10.1089/109065701753617499] [Citation(s) in RCA: 13] [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] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Blepharophimosis/ptosis/epicanthus inversus syndrome (BPES) is an autosomal dominant disorder that is characterized by distinctive eyelid abnormalities. Two clinical subtypes have been described in which type I, but not type II, is associated with premature ovarian failure. Both types of BPES are linked to 3q22-23, and the gene has recently been identified as the putative forkhead transcription factor FOXL2. We report mutation screening of FOXL2 in two families with this condition. The two mutations detected were frameshift mutations resulting from a small insertion or duplication within the gene. Both mutations would result in the production of novel carboxyl terminii, one terminating the predicted protein earlier than the wild type, and the other giving rise to a larger protein product, assuming these proteins or their mRNA were not degraded. Based on the present data, this would suggest that the first family should be type I and the second, type II. Although there is evidence of infertility in the first family, all 3 females in the youngest generation have normal pelvic ultrasound and hormone levels, suggesting that the divide between types I and II may not be as distinct as has been suggested.
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Affiliation(s)
- R Bell
- The Medical Genetics Unit, St. George's Hospital Medical School, Tooting, London SW17 ORE, UK
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Hoffmann PM, Jeffery S, Pethica JB, Ozer HO, Oral A. Energy dissipation in atomic force microscopy and atomic loss processes. Phys Rev Lett 2001; 87:265502. [PMID: 11800839 DOI: 10.1103/physrevlett.87.265502] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/24/2001] [Indexed: 05/23/2023]
Abstract
Atomic scale dissipation is of great interest in nanomechanics and atomic manipulation. We present dissipation measurements with a linearized, ultra-small amplitude atomic force microscope which is capable of measuring dissipation at chosen, fixed separations. We show that the dynamic dissipation in the noncontact regime is of the order of a few 10-100 meV per cycle. This dissipation is likely due to the motion of a bistable atomic defect in the tip-surface region. In the contact regime we observe dc hysteresis associated with nanoscale plasticity. We find the hysteretic energy loss to be 1 order of magnitude higher for a silicon surface than for copper.
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Affiliation(s)
- P M Hoffmann
- Department of Physics, Wayne State University, 666 W. Hancock, Detroit, Michigan 48201, USA.
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Thorne D, Jeffery S. Intermediate care. Homeward bound. Health Serv J 2001; 111:28-9. [PMID: 11810755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/23/2023]
Abstract
Establishing a community acute and rehabilitation team for stroke patients has reduced the length of acute inpatient stay from 23 to eight days, without adversely affecting outcomes. The numbers of GPs referring directly to the community stroke team exceeded expectations (37 per cent of all referrals), avoiding accident and emergency admissions. Establishing good inter-agency agreements was crucial to the success of the project.
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Tartaglia M, Mehler EL, Goldberg R, Zampino G, Brunner HG, Kremer H, van der Burgt I, Crosby AH, Ion A, Jeffery S, Kalidas K, Patton MA, Kucherlapati RS, Gelb BD. Mutations in PTPN11, encoding the protein tyrosine phosphatase SHP-2, cause Noonan syndrome. Nat Genet 2001; 29:465-8. [PMID: 11704759 DOI: 10.1038/ng772] [Citation(s) in RCA: 1140] [Impact Index Per Article: 49.6] [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: 11/09/2022]
Abstract
Noonan syndrome (MIM 163950) is an autosomal dominant disorder characterized by dysmorphic facial features, proportionate short stature and heart disease (most commonly pulmonic stenosis and hypertrophic cardiomyopathy). Webbed neck, chest deformity, cryptorchidism, mental retardation and bleeding diatheses also are frequently associated with this disease. This syndrome is relatively common, with an estimated incidence of 1 in 1,000-2,500 live births. It has been mapped to a 5-cM region (NS1) [corrected] on chromosome 12q24.1, and genetic heterogeneity has also been documented. Here we show that missense mutations in PTPN11 (MIM 176876)-a gene encoding the nonreceptor protein tyrosine phosphatase SHP-2, which contains two Src homology 2 (SH2) domains-cause Noonan syndrome and account for more than 50% of the cases that we examined. All PTPN11 missense mutations cluster in interacting portions of the amino N-SH2 domain and the phosphotyrosine phosphatase domains, which are involved in switching the protein between its inactive and active conformations. An energetics-based structural analysis of two N-SH2 mutants indicates that in these mutants there may be a significant shift of the equilibrium favoring the active conformation. This implies that they are gain-of-function changes and that the pathogenesis of Noonan syndrome arises from excessive SHP-2 activity.
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Affiliation(s)
- M Tartaglia
- Department of Pediatrics, Mount Sinai School of Medicine, New York, New York 10029, USA.
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Afzal AR, Jeffery S. Amplification of a 13.5-kb region of the PKD1 gene containing the 2.5-kb polypyrimidine tract in intron 21 facilitates mutation detection in this gene. Genet Test 2001; 5:57-9. [PMID: 11336403 DOI: 10.1089/109065701750168761] [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] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Mutation detection in the PKD1 gene proved to be difficult because two-thirds of the gene is reiterated several times on chromosome 16. Long-range PCR has been used previously to overcome this limitation, but due to a 2.5-kb polypyrimidine tract in intron 21, the screening capacity of the PKD1 gene using this technique was hindered. Here we report the measures that we have used to overcome this limitation.
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Affiliation(s)
- A R Afzal
- Department of Medical Genetics, St. George's Hospital Medical School, London UK
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Syrris P, Murray A, Carter ND, McKenna WM, Jeffery S. Mutation detection in long QT syndrome: a comprehensive set of primers and PCR conditions. J Med Genet 2001; 38:705-10. [PMID: 11594341 PMCID: PMC1734746 DOI: 10.1136/jmg.38.10.705] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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