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Smith O, Mierzwinski M, Oliver-Jenkins V, MacLeod T, Chitsabesan P, Chintapatla S. Novel insights into patient's thoughts about their body image in a bdominal wall hernia. Hernia 2024; 28:43-51. [PMID: 37910297 DOI: 10.1007/s10029-023-02896-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Accepted: 09/18/2023] [Indexed: 11/03/2023]
Abstract
BACKGROUND Abdominal wall hernias (AWH) are frequently large and deforming. Despite this, little is known about how AWH impact upon body image. This study is the first study to qualitatively examine patients' subjective lived experiences of how AWH affects their body image. METHODS Fifteen patients were interviewed from a purposive sample of AWH patients awaiting surgery until no new narrative themes emerged. Interviews explored patient thoughts and experiences of AWH and body image. Data were examined using interpretative phenomenological analysis (IPA). RESULTS Two key themes pertaining to body image were identified: "Changes to perceptions of self" and "Fears concerning other's perceptions of them". Both themes were often interrelated and displayed detrimental effects AWH had on patients' body image. CONCLUSIONS Our findings illustrate that AWH detrimentally affected patients' body image. This aspect of patient care can be treated and managed through better pre-operative information, including on body image as part of a holistic needs assessment (HNA), and ensuring the results are addressed in a patient care package. These development suggestions may positively affect the AWH patient's experience and outcomes in terms of Quality of Life (QoL) by preparing patients better for realistic results regarding what can be achieved in terms of form, function thus making a more holistic recovery from surgery.
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Affiliation(s)
- O Smith
- Department of General Surgery, York Teaching Hospital, York, UK
| | - M Mierzwinski
- School of Science, Technology and Health, York St. John University, York, UK
| | - V Oliver-Jenkins
- Department of Psychological Medicine, York Teaching Hospital, Wigginton Road, York, YO31 8HE, UK
| | - T MacLeod
- Department of Plastic Surgery, York Teaching Hospital, York, UK
| | - P Chitsabesan
- York Abdominal Wall Unit, York and Scarborough Teaching Hospitals NHS Foundation Trust, Wigginton Road, York, YO31 8HE, UK
| | - S Chintapatla
- York Abdominal Wall Unit, York and Scarborough Teaching Hospitals NHS Foundation Trust, Wigginton Road, York, YO31 8HE, UK.
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2
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Warmington E, Smith G, Chortis V, Liang R, Lippert J, Steinhauer S, Landwehr LS, Hantel C, Kiseljak-Vassiliades K, Wierman ME, Altieri B, Foster PA, Ronchi CL. PLK1 inhibitors as a new targeted treatment for adrenocortical carcinoma. Endocr Connect 2024; 13:e230403. [PMID: 37992487 PMCID: PMC10762563 DOI: 10.1530/ec-23-0403] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Accepted: 11/22/2023] [Indexed: 11/24/2023]
Abstract
Adrenocortical carcinoma (ACC) is an aggressive malignancy with limited treatment options. Polo-like kinase 1 (PLK1) is a promising drug target; PLK1 inhibitors (PLK1i) have been investigated in solid cancers and are more effective in TP53-mutated cases. We evaluated PLK1 expression in ACC samples and the efficacy of two PLK1i in ACC cell lines with different genetic backgrounds. PLK1 protein expression was investigated by immunohistochemistry in tissue samples and correlated with clinical data. The efficacy of rigosertib (RGS), targeting RAS/PI3K, CDKs and PLKs, and poloxin (Pol), specifically targeting the PLK1 polo-box domain, was tested in TP53-mutated NCI-H295R, MUC-1, and CU-ACC2 cells and in TP53 wild-type CU-ACC1. Effects on proliferation, apoptosis, and viability were determined. PLK1 immunostaining was stronger in TP53-mutated ACC samples vs wild-type (P = 0.0017). High PLK1 expression together with TP53 mutations correlated with shorter progression-free survival (P= 0.041). NCI-H295R showed a time- and dose-dependent reduction in proliferation with both PLK1i (P< 0.05at 100 nM RGS and 30 µM Pol). In MUC-1, a less pronounced decrease was observed (P< 0.05at 1000 nM RGS and 100 µM Pol). 100 nM RGS increased apoptosis in NCI-H295R (P< 0.001), with no effect on MUC-1. CU-ACC2 apoptosis was induced only at high concentrations (P < 0.05 at 3000 nM RGS and 100 µM Pol), while proliferation decreased at 1000 nM RGS and 30 µM Pol. CU-ACC1 proliferation reduced, and apoptosis increased, only at 100 µM Pol. TP53-mutated ACC cell lines demonstrated better response to PLK1i than wild-type CU-ACC1. These data suggest PLK1i may be a promising targeted treatment of a subset of ACC patients, pre-selected according to tumour genetic signature.
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Affiliation(s)
- Emily Warmington
- Institute of Metabolism and System Research, University of Birmingham, Birmingham, UK
| | - Gabrielle Smith
- Institute of Metabolism and System Research, University of Birmingham, Birmingham, UK
| | - Vasileios Chortis
- Institute of Metabolism and System Research, University of Birmingham, Birmingham, UK
| | - Raimunde Liang
- Division of Endocrinology and Diabetes, University Hospital of Wuerzburg, Wuerzburg, Germany
- Department of Neurosurgery, Technical University Munich (TMU), Munich, Germany
| | - Juliane Lippert
- Division of Endocrinology and Diabetes, University Hospital of Wuerzburg, Wuerzburg, Germany
| | - Sonja Steinhauer
- Division of Endocrinology and Diabetes, University Hospital of Wuerzburg, Wuerzburg, Germany
| | - Laura-Sophie Landwehr
- Division of Endocrinology and Diabetes, University Hospital of Wuerzburg, Wuerzburg, Germany
| | - Constanze Hantel
- Department of Endocrinology, Diabetology and Clinical Nutrition, University Hospital Zurich (USZ) and University of Zurich (UZH), Zurich, Switzerland
- Medizinische Klinik Und Poliklinik III, University Hospital Carl Gustav Carus, Dresden, Germany
| | - Katja Kiseljak-Vassiliades
- Division of Endocrinology Metabolism and Diabetes, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Margaret E Wierman
- Division of Endocrinology Metabolism and Diabetes, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Barbara Altieri
- Division of Endocrinology and Diabetes, University Hospital of Wuerzburg, Wuerzburg, Germany
| | - Paul A Foster
- Institute of Metabolism and System Research, University of Birmingham, Birmingham, UK
- Centre for Endocrinology, Diabetes and Metabolism, Birmingham Health Partners, Birmingham, UK
| | - Cristina L Ronchi
- Institute of Metabolism and System Research, University of Birmingham, Birmingham, UK
- Centre for Endocrinology, Diabetes and Metabolism, Birmingham Health Partners, Birmingham, UK
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3
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Kalra S, Pathan F, Kshanti IAM, Bay NQ, Nagase T, Oliveria T, Bajpai S. Optimising Insulin Injection Techniques to Improve Diabetes Outcomes. Diabetes Ther 2023; 14:1785-1799. [PMID: 37715887 PMCID: PMC10570228 DOI: 10.1007/s13300-023-01460-y] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Accepted: 08/04/2023] [Indexed: 09/18/2023] Open
Abstract
The effectiveness of therapy in patients with diabetes depends on the correct use of the insulin injection technique. However, despite many established recommendations and evidence that an effective insulin injection technique is essential to improve glycaemic control and minimise the risk associated with diabetes, there is still a need to identify impediments to the insulin injection technique among patients and create awareness among patients and healthcare professionals about the importance of the optimisation of insulin injection techniques. This review focuses on the recent advancements in delivery devices, insulin injection technique teaching methods, monitoring, and complication management and highlights regional best practices and recommendations for optimising injection techniques to improve diabetes outcomes.
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Affiliation(s)
- Sanjay Kalra
- Department of Endocrinology, Bharti Hospital, Karnal, India
- University Center for Research and Development, Chandigarh University, Mohali, India
| | - Faruque Pathan
- Department of Endocrinology, BIRDEM General Hospital, Dhaka, Bangladesh
| | - Ida Ayu Made Kshanti
- Division of Endocrinology, Metabolism, and Diabetes, Fatmawati National General Hospital, Jakarta, Indonesia
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4
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Amado A, Teixeira E, Canberk S, Macedo S, Castro B, Pereira H, Varanda J, Graça S, Tavares A, Soares C, Oliveira MJ, Oliveira M, Soares P, Sobrinho Simões M, Póvoa AA. Subcentimetric papillary thyroid carcinoma with extensive lymph node and brain metastasis: case report and review of literature. Endocrinol Diabetes Metab Case Rep 2023; 2023:23-0025. [PMID: 38108305 PMCID: PMC10762550 DOI: 10.1530/edm-23-0025] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Accepted: 10/27/2023] [Indexed: 12/19/2023] Open
Abstract
Summary We report a 61-year-old male patient without personal history of thyroid carcinoma or radiation exposure. In 2011, he presented with a cervical mass whose biopsy diagnosed a papillary thyroid carcinoma (PTC) in a lymph node metastasis (LNM). Total thyroidectomy with lymphadenectomy of central and ipsilateral compartment was performed. Histopathology identified a 2 mm follicular variant of PTC and LNM in 25/25 lymph nodes. The patient was treated with 150 mCi of radioactive iodine (RAI), followed by levothyroxine suppressive therapy. In 2016, a retrotracheal mass was diagnosed, suggesting local recurrence; patient was submitted to surgical excision and RAI therapy (120 mCi). Due to seizures, in 2019, a brain CT was performed that diagnosed brain metastases. The patient underwent debulking of the main lesion. Histopathology analysis confirmed a metastatic lesion with variated morphology: classical PTC and follicular pattern and hobnail and tall cell features. Molecular analysis revealed BRAFV600E in LNM at presentation and BRAFV600E and TERT promoter (TERTp) mutations in the recurrent LNM and brain metastasis. Based upon this experience we review the reported cases of subcentimetric PTC with brain metastases and discuss the molecular progression of the present case. Learning points Papillary microcarcinoma (PMCs) usually have very good prognosis with low impact on patient survival. PMCs presenting in elderly patients with LNM at diagnosis may carry a guarded outcome. Brain metastasis although rare indicate aggressive phenotypic features. Patient risk stratification of PMCs based on histopathological analysis and genetic testing may have a significant impact on prognosis providing therapeutic markers, that may predict disease progression and overall outcome.
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Affiliation(s)
- Andreia Amado
- Centro Hospitalar Vila Nova de Gaia/Espinho, Portugal, R. Conceição Fernandes S/N, 4434-502 Vila Nova de Gaia, Portugal
| | - Elisabete Teixeira
- i3S - Instituto de Investigação e Inovação em Saúde, Universidade do Porto, R. Alfredo Allen 208, 4200-135 Porto, Portugal
- IPATIMUP - Instituto de Patologia e Imunologia Molecular da Universidade do Porto, Rua Júlio Amaral de Carvalho 45, 4200-135 Porto, Portugal
- Faculdade de Medicina da Universidade do Porto, Alameda Prof. Hernâni Monteiro, 4200-319 Porto, Portugal
| | - Sule Canberk
- i3S - Instituto de Investigação e Inovação em Saúde, Universidade do Porto, R. Alfredo Allen 208, 4200-135 Porto, Portugal
- IPATIMUP - Instituto de Patologia e Imunologia Molecular da Universidade do Porto, Rua Júlio Amaral de Carvalho 45, 4200-135 Porto, Portugal
- Faculdade de Medicina da Universidade do Porto, Alameda Prof. Hernâni Monteiro, 4200-319 Porto, Portugal
| | - Sofia Macedo
- i3S - Instituto de Investigação e Inovação em Saúde, Universidade do Porto, R. Alfredo Allen 208, 4200-135 Porto, Portugal
- IPATIMUP - Instituto de Patologia e Imunologia Molecular da Universidade do Porto, Rua Júlio Amaral de Carvalho 45, 4200-135 Porto, Portugal
- Instituto de Ciências Biomédicas de Abel Salazar, Universidade do Porto, R. Jorge de Viterbo Ferreira 228, 4050-313 Porto, Portugal
| | - Bárbara Castro
- Centro Hospitalar Vila Nova de Gaia/Espinho, Portugal, R. Conceição Fernandes S/N, 4434-502 Vila Nova de Gaia, Portugal
| | - Hugo Pereira
- Centro Hospitalar Vila Nova de Gaia/Espinho, Portugal, R. Conceição Fernandes S/N, 4434-502 Vila Nova de Gaia, Portugal
| | - João Varanda
- Centro Hospitalar Vila Nova de Gaia/Espinho, Portugal, R. Conceição Fernandes S/N, 4434-502 Vila Nova de Gaia, Portugal
| | - Susana Graça
- Centro Hospitalar Vila Nova de Gaia/Espinho, Portugal, R. Conceição Fernandes S/N, 4434-502 Vila Nova de Gaia, Portugal
| | - Amélia Tavares
- Centro Hospitalar Vila Nova de Gaia/Espinho, Portugal, R. Conceição Fernandes S/N, 4434-502 Vila Nova de Gaia, Portugal
- i3S - Instituto de Investigação e Inovação em Saúde, Universidade do Porto, R. Alfredo Allen 208, 4200-135 Porto, Portugal
- IPATIMUP - Instituto de Patologia e Imunologia Molecular da Universidade do Porto, Rua Júlio Amaral de Carvalho 45, 4200-135 Porto, Portugal
- Faculdade de Medicina da Universidade do Porto, Alameda Prof. Hernâni Monteiro, 4200-319 Porto, Portugal
| | - Carlos Soares
- Centro Hospitalar Vila Nova de Gaia/Espinho, Portugal, R. Conceição Fernandes S/N, 4434-502 Vila Nova de Gaia, Portugal
| | - Maria João Oliveira
- Centro Hospitalar Vila Nova de Gaia/Espinho, Portugal, R. Conceição Fernandes S/N, 4434-502 Vila Nova de Gaia, Portugal
| | - Manuel Oliveira
- Centro Hospitalar Vila Nova de Gaia/Espinho, Portugal, R. Conceição Fernandes S/N, 4434-502 Vila Nova de Gaia, Portugal
| | - Paula Soares
- i3S - Instituto de Investigação e Inovação em Saúde, Universidade do Porto, R. Alfredo Allen 208, 4200-135 Porto, Portugal
- IPATIMUP - Instituto de Patologia e Imunologia Molecular da Universidade do Porto, Rua Júlio Amaral de Carvalho 45, 4200-135 Porto, Portugal
- Faculdade de Medicina da Universidade do Porto, Alameda Prof. Hernâni Monteiro, 4200-319 Porto, Portugal
| | - Manuel Sobrinho Simões
- i3S - Instituto de Investigação e Inovação em Saúde, Universidade do Porto, R. Alfredo Allen 208, 4200-135 Porto, Portugal
- IPATIMUP - Instituto de Patologia e Imunologia Molecular da Universidade do Porto, Rua Júlio Amaral de Carvalho 45, 4200-135 Porto, Portugal
- Faculdade de Medicina da Universidade do Porto, Alameda Prof. Hernâni Monteiro, 4200-319 Porto, Portugal
- Centro Hospitalar Universitário São João, Porto, Alameda Prof. Hernâni Monteiro, 4200-319 Porto, Portugal
| | - Antónia Afonso Póvoa
- Centro Hospitalar Vila Nova de Gaia/Espinho, Portugal, R. Conceição Fernandes S/N, 4434-502 Vila Nova de Gaia, Portugal
- i3S - Instituto de Investigação e Inovação em Saúde, Universidade do Porto, R. Alfredo Allen 208, 4200-135 Porto, Portugal
- IPATIMUP - Instituto de Patologia e Imunologia Molecular da Universidade do Porto, Rua Júlio Amaral de Carvalho 45, 4200-135 Porto, Portugal
- Faculdade de Medicina da Universidade do Porto, Alameda Prof. Hernâni Monteiro, 4200-319 Porto, Portugal
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5
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Krall JS, Childs B, Mehrotra N. Mobile Applications to Support Diabetes Self-Management Education: Patient Experiences and Provider Perspectives. J Diabetes Sci Technol 2023; 17:1206-1211. [PMID: 37162000 PMCID: PMC10563538 DOI: 10.1177/19322968231174037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
BACKGROUND Diabetes self-management education and support (DSMES) is a critical component of diabetes care, but time for it is often limited. Digital tools, such as mobile applications (apps), show promise in extending efforts and supporting self-management education, but have not been fully used. Objectives of this multi-phase study were to (1) evaluate an app designed to support patients with insulin therapy and (2) examine provider perspectives on DSMES apps. METHODS Phase 1: Thirty-two adult patients with type 2 diabetes new to or having difficulties with insulin therapy were introduced to the BDTM Diabetes Care App. Three-month app use and satisfaction and changes in hemoglobin A1c (HbA1c) and diabetes distress were assessed. Phase 2: Sixty diabetes providers completed a survey about their experiences with and perspectives on DSMES apps. RESULTS Phase 1: Patients reported satisfaction with the app, and significant improvements in HbA1c and diabetes distress were observed. Phase 2: Most providers viewed apps as adjuncts to diabetes education. Only 33% had previous app experience; however, 100% would consider recommending apps to their patients. Most would spend 5-15 minutes introducing apps to patients. All respondents agreed that the following DSMES app features-evidence-based educational content, data logging and tracking features, customizable user experience, digital coaching via goal setting or reminders, and ability to share data with providers-are key components to consider. CONCLUSIONS Findings suggest DSMES apps can play a role in self-management support and provide guidance on factors to consider when introducing digital tools into clinical practice. TRIAL REGISTRATION Clinicaltrials.gov, #NCT03999268.
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Affiliation(s)
- Jodi S. Krall
- University of Pittsburgh Medical
Center, Pittsburgh, PA, USA
- Division of Endocrinology and
Metabolism, Department of Medicine, University of Pittsburgh, Pittsburgh, PA,
USA
| | | | - Neha Mehrotra
- University of Pittsburgh Medical
Center, Pittsburgh, PA, USA
- Division of Endocrinology and
Metabolism, Department of Medicine, University of Pittsburgh, Pittsburgh, PA,
USA
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6
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Salvini CLA, Darlot B, Davison J, Martin MP, Tudhope SJ, Turberville S, Kawamura A, Noble MEM, Wedge SR, Crawford JJ, Waring MJ. Fragment expansion with NUDELs - poised DNA-encoded libraries. Chem Sci 2023; 14:8288-8294. [PMID: 37564419 PMCID: PMC10411621 DOI: 10.1039/d3sc01171b] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Accepted: 07/11/2023] [Indexed: 08/12/2023] Open
Abstract
Optimisation of the affinity of lead compounds is a critical challenge in the identification of drug candidates and chemical probes and is a process that takes many years. Fragment-based drug discovery has become established as one of the methods of choice for drug discovery starting with small, low affinity compounds. Due to their low affinity, the evolution of fragments to desirable levels of affinity is often a key challenge. The accepted best method for increasing the potency of fragments is by iterative fragment growing, which can be very time consuming and complex. Here, we introduce a paradigm for fragment hit optimisation using poised DNA-encoded chemical libraries (DELs). The synthesis of a poised DEL, a partially constructed library that retains a reactive handle, allows the coupling of any active fragment for a specific target protein, allowing rapid discovery of potent ligands. This is illustrated for bromodomain-containing protein 4 (BRD4), in which a weakly binding fragment was coupled to a 42-member poised DEL via Suzuki-Miyaura cross coupling resulting in the identification of an inhibitor with 51 nM affinity in a single step, representing an increase in potency of several orders of magnitude from an original fragment. The potency of the compound was shown to arise from the synergistic combination of substructures, which would have been very difficult to discover by any other method and was rationalised by X-ray crystallography. The compound showed attractive lead-like properties suitable for further optimisation and demonstrated BRD4-dependent cellular pharmacology. This work demonstrates the power of poised DELs to rapidly optimise fragments, representing an attractive generic approach to drug discovery.
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Affiliation(s)
- Catherine L A Salvini
- Cancer Research Horizons Therapeutic Innovation Newcastle Drug Discovery Group, Chemistry, School of Natural and Environmental Sciences, Newcastle University Bedson Building NE1 7RU UK
| | - Benoit Darlot
- Chemistry, School of Natural and Environmental Sciences, Newcastle University Bedson Building NE1 7RU UK
- Department of Chemistry, University of Oxford 12 Mansfield Road Oxford OX1 3TA UK
| | - Jack Davison
- Cancer Research Horizons Therapeutic Innovation Newcastle Drug Discovery Group, Chemistry, School of Natural and Environmental Sciences, Newcastle University Bedson Building NE1 7RU UK
| | - Mathew P Martin
- Cancer Research Horizons Therapeutic Innovation Newcastle Drug Discovery Group, Translational and Clinical Research Institute, Newcastle University Paul O'Gorman Building NE2 4HH UK
| | - Susan J Tudhope
- Cancer Research Horizons Therapeutic Innovation Newcastle Drug Discovery Group, Translational and Clinical Research Institute, Newcastle University Paul O'Gorman Building NE2 4HH UK
| | - Shannon Turberville
- Cancer Research Horizons Therapeutic Innovation Newcastle Drug Discovery Group, Translational and Clinical Research Institute, Newcastle University Paul O'Gorman Building NE2 4HH UK
| | - Akane Kawamura
- Chemistry, School of Natural and Environmental Sciences, Newcastle University Bedson Building NE1 7RU UK
- Department of Chemistry, University of Oxford 12 Mansfield Road Oxford OX1 3TA UK
| | - Martin E M Noble
- Cancer Research Horizons Therapeutic Innovation Newcastle Drug Discovery Group, Translational and Clinical Research Institute, Newcastle University Paul O'Gorman Building NE2 4HH UK
| | - Stephen R Wedge
- Cancer Research Horizons Therapeutic Innovation Newcastle Drug Discovery Group, Translational and Clinical Research Institute, Newcastle University Paul O'Gorman Building NE2 4HH UK
| | - James J Crawford
- Genentech Inc. 1 DNA Way South San Francisco California 94080 USA
| | - Michael J Waring
- Cancer Research Horizons Therapeutic Innovation Newcastle Drug Discovery Group, Chemistry, School of Natural and Environmental Sciences, Newcastle University Bedson Building NE1 7RU UK
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Bauer KA, Puzniak LA, Yu KC, Klinker KP, Watts JA, Moise PA, Finelli L, Gupta V. Association of SARS-CoV-2 status and antibiotic-resistant bacteria with inadequate empiric therapy in hospitalized patients: a US multicenter cohort evaluation (July 2019 - October 2021). BMC Infect Dis 2023; 23:490. [PMID: 37488478 PMCID: PMC10367264 DOI: 10.1186/s12879-023-08453-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 07/10/2023] [Indexed: 07/26/2023] Open
Abstract
BACKGROUND Antibiotic usage and antibiotic resistance (ABR) patterns changed during the COVID-19 pandemic. Inadequate empiric antibiotic therapy (IET) is a significant public health problem and contributes to ABR. We evaluated factors associated with IET before and during the COVID-19 pandemic to determine the impact of the pandemic on antibiotic management. METHODS This multicenter, retrospective cohort analysis included hospitalized US adults who had a positive bacterial culture (specified gram-positive or gram-negative bacteria) from July 2019 to October 2021 in the BD Insights Research Database. IET was defined as antibacterial therapy within 48 h that was not active against the bacteria. ABR results were based on susceptibility testing and reports from local facilities. Multivariate analysis was used to identify risk factors associated with IET in patients with any positive bacterial culture and ABR-positive cultures, including multidrug-resistant (MDR) bacteria. RESULTS Of 278,344 eligible patients in 269 hospitals, 56,733 (20.4%) received IET; rates were higher in patients with ABR-positive (n = 93,252) or MDR-positive (n = 39,000) cultures (34.9% and 45.0%, respectively). Severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2)-positive patients had significantly higher rates of IET (25.9%) compared with SARS-CoV-2-negative (20.3%) or not tested (19.7%) patients overall and in the ABR and MDR subgroups. Patients with ABR- or MDR-positive cultures had more days of therapy and longer lengths of stay. In multivariate analyses, ABR, MDR, SARS-CoV-2-positive status, respiratory source, and prior admissions were identified as key IET risk factors. CONCLUSIONS IET remained a persistent problem during the COVID-19 pandemic and occurred at higher rates in patients with ABR/MDR bacteria or a co-SARS-CoV-2 infection.
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Affiliation(s)
| | | | - Kalvin C Yu
- Becton, Dickinson and Company, 1 Becton Drive, Franklin Lakes, NJ, USA
| | | | - Janet A Watts
- Becton, Dickinson and Company, 1 Becton Drive, Franklin Lakes, NJ, USA
| | | | | | - Vikas Gupta
- Becton, Dickinson and Company, 1 Becton Drive, Franklin Lakes, NJ, USA.
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8
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Correction to: Macrotroponin Complex as a Cause for Cardiac Troponin Increase after COVID-19 Vaccination and Infection. Clin Chem 2023; 69:776. [PMID: 37158283 DOI: 10.1093/clinchem/hvad059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
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9
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Sihota A, Barrett B, Bonell C, Chehade A, Dhaliwal J, Kani M, Kellar J, Kwong C, Ravinatarajan P, Schwartz KL, Smith S, Thiffault J, Woit C, Vaisman A. SARS-CoV-2 rapid diagnostic testing: Canadian consensus guidance for pharmacists. Can Pharm J (Ott) 2023; 156:128-136. [PMID: 37197090 PMCID: PMC10116221 DOI: 10.1177/17151635231164631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/19/2023]
Affiliation(s)
| | - Brett Barrett
- School of Pharmacy, University of Waterloo and
Grand River Hospital, Kitchener, Ontario
| | - Cameron Bonell
- Interior Health Authority and Faculty of
Pharmaceutical Sciences, University of British Columbia, Kelowna, British
Columbia
| | | | | | | | - Jamie Kellar
- Leslie Dan Faculty of Pharmacy, University of
Toronto, Toronto, Ontario
| | - Conny Kwong
- Rexall Pharmacy Group Ltd., Winnipeg,
Manitoba
| | | | - Kevin L. Schwartz
- Dalla Lana School of Public Health, University
of Toronto, Toronto, Ontario
- Division of Infectious Diseases, Unity Health
Toronto, St. Joseph’s Health Centre, Toronto, Ontario
| | | | | | | | - Alon Vaisman
- Department of Medicine, University of Toronto,
Toronto, Ontario
- Division of Infectious Diseases, University
Health Network, Toronto, Ontario
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10
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Shaydyuk Y, Bashmakova NV, Klishevich GV, Dmytruk AM, Kachkovsky OD, Kuziv IB, Dubey IY, Belfield KD, Bondar MV. Nature of Linear Spectral Properties and Fast Relaxations in the Excited States and Two-Photon Absorption Efficiency of 3-Thiazolyl and 3-Phenyltiazolyl Coumarin Derivatives. ACS Omega 2023; 8:11564-11573. [PMID: 37008079 PMCID: PMC10061630 DOI: 10.1021/acsomega.3c00654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 03/07/2023] [Indexed: 06/19/2023]
Abstract
Coumarin-based fluorescent agents play an important role in the manifold fundamental scientific and technological areas and need to be carefully studied. In this research, linear photophysics, photochemistry, fast vibronic relaxations, and two-photon absorption (2PA) of the coumarin derivatives, methyl 4-[2-(7-methoxy-2-oxo-chromen-3-yl)thiazol-4-yl]butanoate (1) and methyl 4-[4-[2-(7-methoxy-2-oxo-chromen-3-yl)thiazol-4-yl]phenoxy]butanoate (2), were comprehensively analyzed using stationary and time-resolved spectroscopic techniques, along with quantum-chemical calculations. The steady-state one-photon absorption, fluorescence emission, and excitation anisotropy spectra, as well as 3D fluorescence maps of 3-hetarylcoumarins 1 and 2 were obtained at room temperature in solvents of different polarities. The nature of relatively large Stokes shifts (∼4000-6000 cm-1), specific solvatochromic behavior, weak electronic π → π* transitions, and adherence to Kasha's rule were revealed. The photochemical stability of 1 and 2 was explored quantitatively, and values of photodecomposition quantum yields, on the order of ∼10-4, were determined. A femtosecond transient absorption pump-probe technique was used for the investigation of fast vibronic relaxation and excited-state absorption processes in 1 and 2, while the possibility of efficient optical gain was shown for 1 in acetonitrile. The degenerate 2PA spectra of 1 and 2 were measured by an open aperture z-scan method, and the maximum 2PA cross-sections of ∼300 GM were obtained. The electronic nature of the hetaryl coumarins was analyzed by quantum-chemical calculations using DFT/TD-DFT level of theory and was found to be in good agreement with experimental data.
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Affiliation(s)
- Yevgeniy
O. Shaydyuk
- Institute
of Physics National Academy of Sciences of Ukraine, Prospect Nauki, 46, Kyiv 03028, Ukraine
| | - Nataliia V. Bashmakova
- Taras
Shevchenko National University of Kyiv, Volodymyrska Street, 60, Kyiv 01601, Ukraine
| | - George V. Klishevich
- Institute
of Physics National Academy of Sciences of Ukraine, Prospect Nauki, 46, Kyiv 03028, Ukraine
| | - Andriy M. Dmytruk
- Institute
of Physics National Academy of Sciences of Ukraine, Prospect Nauki, 46, Kyiv 03028, Ukraine
| | - Olexiy D. Kachkovsky
- V.P.
Kukhar Institute of Bioorganic Chemistry and Petrochemistry of the
NAS of Ukraine, Murmanskaya
Street, 1, Kyiv 02660, Ukraine
| | - Iaroslav B. Kuziv
- Institute
of Molecular Biology and Genetics of the NAS of Ukraine, Zabolotnogo Street, 150, Kyiv 03141, Ukraine
| | - Igor Ya. Dubey
- Institute
of Molecular Biology and Genetics of the NAS of Ukraine, Zabolotnogo Street, 150, Kyiv 03141, Ukraine
| | - Kevin D. Belfield
- Department
of Chemistry and Environmental Science, College of Science and Liberal
Arts, New Jersey Institute of Technology, University Heights, Newark, New Jersey 07102, United States
| | - Mykhailo V. Bondar
- Institute
of Physics National Academy of Sciences of Ukraine, Prospect Nauki, 46, Kyiv 03028, Ukraine
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11
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Heinemann L, Nguyen T, Bailey TS, Hassoun A, Kulzer B, Oliveria T, Reznik Y, de Valk HW, Mader JK. Needle Technology for Insulin Administration: A Century of Innovation. J Diabetes Sci Technol 2023; 17:449-457. [PMID: 34889142 PMCID: PMC10012366 DOI: 10.1177/19322968211059564] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Innovations in syringe and pen needle (PN) technology over the last 100 years have led to important advances in insulin delivery for people with diabetes, paralleling the strides made in developing recombinant DNA human insulin and insulin analogs with varying onset and duration of action. In this review, the history of advances in insulin delivery is described, focusing on progress in syringe, needle, and PN technologies. The early glass and metal syringes that required sterilization by boiling have been replaced by disposable, single-use syringes or pens with clear labeling for precise insulin dosing. The early needles ranging in length from 19 to 26 mm that required manual sharpening against a whetstone have been replaced by syringe needles of 6 mm and PNs of 4 mm in length as slender as 34 gauge. Imaging studies using ultrasound and computed tomography measured the thickness of skin and subcutaneous tissue layers to show feasibility of targeted insulin administration with shorter needles. These developments, coupled with innovations in needle/PN wall and tip structure, have led to improved injection experience for people with diabetes. It is also important to acknowledge the role of injection technique education, together with these advances in injection technology, for improving clinical outcomes and patient satisfaction. With continued projected growth of diabetes prevalence, particularly in developing countries where expensive and complex insulin delivery systems may not be practical, insulin syringes and pens will continue to serve as reliable and cost-effective means of insulin delivery for people with diabetes.
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Affiliation(s)
| | - Trung Nguyen
- Becton, Dickinson and Company,
Eysins, Switzerland
- Trung Nguyen, PharmD, Becton,
Dickinson and Company, Sàrl Terre Bonne, Route de Crassier 17, 1262
Eysins, Switzerland.
| | | | - Ahmed Hassoun
- Division of Endocrinology,
Department of Internal Medicine, Fakeeh University Hospital, Dubai, United
Arab Emirates
| | - Bernd Kulzer
- Research Institute Diabetes
Academy Mergentheim, Bad Mergentheim, Germany
- Diabetes Center Mergentheim, Bad
Mergentheim, Germany
- University Bamberg, Bamberg,
Germany
| | | | - Yves Reznik
- Department of Endocrinology and
Diabetology, CHU Côte de Nacre, Caen, France
- Medical School, University of
Caen Basse-Normandie, Caen, France
| | - Harold W. de Valk
- Department of Internal
Medicine, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Julia K. Mader
- Division of Endocrinology &
Diabetology, Department of Internal Medicine, Medical University of Graz,
Graz, Austria
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12
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Smith OAM, Mierzwinski M, McVey J, Chitsabesan P, Chintapatla S. A bdominal wall hernia and mental health: patients lived experiences and implications for patient care. Hernia 2023; 27:55-62. [PMID: 36284067 PMCID: PMC9595579 DOI: 10.1007/s10029-022-02699-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2022] [Accepted: 10/11/2022] [Indexed: 11/26/2022]
Abstract
BACKGROUND Abdominal wall hernia (AWH) affects mental health and mental health questions are frequently included within Patient-Reported Outcome Measures (PROMS) for this patient population. However, these questions have not been informed by the subjective lived experiences of mental health in AWH patients. This study is the first to qualitatively examine how AWH affects patients' mental health. METHODS Fifteen patients were interviewed from a purposive sample of AWH patients until no new themes emerged. Interviews explored patient thoughts and experiences of AWH and mental health. Data were examined using Interpretative Phenomenological Analysis (IPA). RESULTS Three key themes pertaining to mental health were identified: "psychological and emotional distress", "identity disruption" and "coping mechanisms and support systems". CONCLUSION Our findings illustrate that AWH is a pathology that can have a significant detrimental impact on people's mental health. This impact has implications for patient care and can be treated and managed through better psychological support. This support may positively affect AWH patient's experience and outcomes in terms of quality of life. This paper provides recommendations for improved AWH patient care in regard to mental health.
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Affiliation(s)
- O A M Smith
- York Abdominal Wall Unit, York and Scarborough Teaching Hospitals, Wigginton Road, Clifton, YO31 8HE, York, UK.
| | - M Mierzwinski
- School of Science, Technology and Health, York St. John University, York, UK
| | - J McVey
- Department of Psychological Medicine, York and Scarborough Teaching Hospitals, Wigginton Road, Clifton, YO31 8HE, York, UK
| | - P Chitsabesan
- York Abdominal Wall Unit, York and Scarborough Teaching Hospitals, Wigginton Road, Clifton, YO31 8HE, York, UK
| | - S Chintapatla
- York Abdominal Wall Unit, York and Scarborough Teaching Hospitals, Wigginton Road, Clifton, YO31 8HE, York, UK
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13
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Maunoury F, Drugeon B, Boisson M, Marjanovic N, Couvreur R, Mimoz O, Guenezan J. Cost-effectiveness analysis of bundled innovative devices versus standard approach in the prevention of unscheduled peripheral venous catheters removal due to complications in France. PLoS One 2022; 17:e0269750. [PMID: 35700207 PMCID: PMC9197036 DOI: 10.1371/journal.pone.0269750] [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] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Accepted: 05/25/2022] [Indexed: 12/29/2022] Open
Abstract
The objective of the study was to perform a cost-effectiveness analysis of bundled devices (BDs) versus standard devices (SDs) for the prevention of unscheduled peripheral venous catheter (PVC) removal due to complication from a French investigator-initiated, open-label, single center, randomized-controlled, two-by-two factorial trial (CLEAN-3 study). A 14-day time non homogeneous semi-markovian model was performed to be fitted to longitudinal individual patient data from CLEAN-3 database. This model includes five health states and eight transitional events; a base case scenario, two scenario analyses and bootstrap sensitivity analyses were performed. The cost-effectiveness criterion was the cost per patient with unscheduled PVC removal avoided. 989 adult (age≥18 years) patients were analyzed to compare the BDs group (494 patients), and the SDs group (495 patients). The assessed intervention was a combination of closed integrated catheters, positive displacement needleless-connectors, disinfecting caps, and single-use prefilled flush syringes compared with the use of open catheters and three-way stopcocks for treatment administration. For the base case scenario, an unscheduled 1st PVC removal before discharge was significantly more frequent in the SDs group (235 patients (47.5%) in the SDs group and 172 patients (34.8%) in the BDs group, p = 0.00006). After adjustment for 1st catheter time, the number of patients with unscheduled PVC removal per day was of 16 (95%CI: 15; 18) patients (out of 100) in the BDs group and of 26 (95%CI: 24; 28) patients (out of 100) in the SDs group. The mean cost per patient (adjusted on catheter-time) was of €144 (95%CI: €135-€154) for patients in the SDs group versus €102 (95%CI: €95-€109) for patients in the BDs group; the mean saving per patient was of €42 (95%CI: €32-€54). As a consequence, the assessed BDs strategy was less costly and more effective than the SDs strategy. Trail registration: CLEAN-3 study is registered with ClinicalTrials.gov, NCT03757143.
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Affiliation(s)
- Franck Maunoury
- Statesia, Le Mans, France
- University of Le Mans, GAINS, IRA, Le Mans, France
- * E-mail:
| | - Bertrand Drugeon
- Emergency Department and Pre-Hospital Care, University Hospital of Poitiers, Poitiers, France
| | - Matthieu Boisson
- School of Medicine and Pharmacy, University of Poitiers, Poitiers, France
- Intensive Care and Peri-Operative Medicine Department, University Hospital of Poitiers, Anesthesia, Poitiers, France
| | - Nicolas Marjanovic
- Emergency Department and Pre-Hospital Care, University Hospital of Poitiers, Poitiers, France
| | - Raphael Couvreur
- Emergency Department and Pre-Hospital Care, University Hospital of Poitiers, Poitiers, France
- School of Medicine and Pharmacy, University of Poitiers, Poitiers, France
| | - Olivier Mimoz
- Emergency Department and Pre-Hospital Care, University Hospital of Poitiers, Poitiers, France
- School of Medicine and Pharmacy, University of Poitiers, Poitiers, France
- INSERM U1070, Pharmacology of anti-infective drugs, Poitiers, France
| | - Jeremy Guenezan
- Emergency Department and Pre-Hospital Care, University Hospital of Poitiers, Poitiers, France
- School of Medicine and Pharmacy, University of Poitiers, Poitiers, France
- INSERM U1070, Pharmacology of anti-infective drugs, Poitiers, France
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14
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Smith OA, Mierzwinski MF, Chitsabesan P, Chintapatla S. Health-related quality of life in a bdominal wall hernia: let's ask patients what matters to them? Hernia 2022; 26:795-808. [PMID: 35412193 PMCID: PMC9003180 DOI: 10.1007/s10029-022-02599-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2021] [Accepted: 03/11/2022] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Quality of Life (QoL) is an important consideration in patients with abdominal wall hernia (AWH). What matters to patients and their everyday experience living with AWH may depend on a variety of personal, psychological, social and environmental factors. At present, no study has addressed what is important to this particular group of patients by asking the patients themselves. This study aims to determine QoL from the patient's perspective by examining the lived experience in this patient population. METHODS We interviewed 15 patients with AWH until thematic saturation. The patients were purposively sampled from AWH clinic between February 2020 and June 2020 using topic guides and interview schedules. Verbatim interview transcripts were coded and analysed using NVivo12 software and Interpretative Phenomenological Analysis (IPA). We adhered to consolidated criteria for reporting qualitative research (COREQ). RESULTS Fifteen participants (8 men and 7 women) of age range 36-85 years, median 65 years, covering all Ventral Hernia Working Group (VHWG) grades. Five superordinate themes were identified each with several subordinate themes, as follows: (1) body image (subthemes-'changes to perceptions of self' and 'fears concerning perceptions of others'). (2) Mental health (subthemes-'emotional responses', 'disruptions to previously solid aspects of identity', 'developing coping strategies'). (3) Symptoms (subthemes-'managing pain', 'freedom of movement', 'restriction and adaptation of function'). (4) Interpersonal relationships (subthemes-'difficulties socially connecting' and 'changes in sexual relations'). (5) Employment (subthemes-'financial pressure', 'return to work issues' and 'costs to family'). CONCLUSION This is the first phenomenological qualitative study in the field of AWH and presents a rich account of what is important to these patients in terms of QoL. Developed from the patients' own words, the themes are interrelated and should shape our understanding of patients with AWH. This study provides qualitative examples of each theme. This study has identified new themes (body image, interpersonal relationships and employment) that are not incorporated in existing AWH-specific QoL instruments. This is important for surgeons because the study suggests that we are currently not capturing all data relevant to QoL in this specific patient group with current tools. The wider impact of this would be to help counsel patients and support them more holistically through the disease process and it's management. Further research is needed to generate a standardised AWH QoL instrument which incorporates bio-psycho-emotional-social themes important to patients, as identified by patients.
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Affiliation(s)
- O A Smith
- York Abdominal Wall Unit (YAWU), Department of General Surgery, York & Scarborough Teaching Hospitals NHS Foundation Trust, Wigginton Road, YO31 8HE, York, UK
| | - M F Mierzwinski
- School of Science, Technology and Health, York St. John University, York, YO31 7EX, UK
| | - P Chitsabesan
- York Abdominal Wall Unit (YAWU), Department of General Surgery, York & Scarborough Teaching Hospitals NHS Foundation Trust, Wigginton Road, YO31 8HE, York, UK
| | - S Chintapatla
- York Abdominal Wall Unit (YAWU), Department of General Surgery, York & Scarborough Teaching Hospitals NHS Foundation Trust, Wigginton Road, YO31 8HE, York, UK.
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15
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Parikh A, Cooper L, Frogel D, Le Benger K, Cooper CK, Parvu V. Large-Scale SARS-CoV-2 Antigen Testing With Real-World Specimens. Front Public Health 2022; 10:836328. [PMID: 35450121 PMCID: PMC9016156 DOI: 10.3389/fpubh.2022.836328] [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] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Accepted: 02/21/2022] [Indexed: 12/19/2022] Open
Abstract
Real-world data are needed to establish SARS-CoV-2 rapid antigen testing (RAT) as an effective and reliable approach for SARS-CoV-2 screening. This study included 1,952,931 individuals who provided upper respiratory specimens during SARS-CoV-2 screening at CityMD urgent care locations in the New York metropolitan area from October 2020 to March 2021. Positive and negative results, as determined by the BD Veritor™ System for Rapid Detection of SARS-CoV-2 antigen (Veritor), were obtained for all individuals, with reflex reverse transcriptase-polymerase chain reaction (RT-PCR) testing performed on a case-by-case basis, per standard of care. Using verification bias adjustment, two alternative model assumptions were utilized for RAT results with missing reflex RT-PCR results. The worst antigen diagnostic performance estimates asserted that missing RT-PCR results would show a distribution similar to those RT-PCR results actually obtained, based on symptom category. The best antigen diagnostic performance estimates asserted that individuals without RT-PCR results had a clinical presentation consistent with RAT results, and, therefore, missing RT-PCR results would agree with RAT results. For patients with symptoms or high-risk exposure, 25.3% (n = 86,811/343,253) of RAT results were positive; vs. 3.4% (n = 53,046/1,559,733) positive for asymptomatic individuals without high-risk exposure. Reflex RT-PCR results were obtained from 46.3% (n = 158,836/343,253) and 13.8% (n = 215,708/1,559,733) of symptomatic and asymptomatic individuals, respectively. RT-PCR confirmed 94.4% (4,265/4,518) of positive and 90.6% (139,759/154,318) of negative RAT results in symptomatic individuals; and confirmed 83.4% (6,693/8,024) of positive and 95.3% (197,955/207,684) of negative RAT results in asymptomatic individuals. Applied assumptions for missing reflex RT-PCR results led to worst performance sensitivity estimates of 77.2 and 38.5% in the symptomatic and asymptomatic populations, respectively; assumptions for best performance estimates led to sensitivity values of 85.6 and 84.2%, respectively. Specificity values, regardless of assumptions or symptom category, ranged from 97.9-99.9%. At 10% SARS-CoV-2 prevalence, RAT positive predictive value was 86.9 and 99.0% for worst and best performance estimates across the total population, respectively; negative predictive values were >95% regardless of the applied assumption. Veritor test performance was consistent with that listed in the manufacturer instructions for use for symptomatic individuals. Real-world evidence should be gathered on RATs to support their efficacy as SARS-CoV-2 persists.
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Affiliation(s)
- Ashish Parikh
- CityMD/Summit Medical Group, New York, NY, United States
| | - Lauren Cooper
- Becton, Dickinson and Company, BD Life Sciences—Integrated Diagnostic Solutions, Sparks, MD, United States
| | - Daniel Frogel
- CityMD/Summit Medical Group, New York, NY, United States
| | | | - Charles K. Cooper
- George Mason University, School of Systems Biology, Manassas, VA, United States
| | - Valentin Parvu
- Becton, Dickinson and Company, BD Life Sciences—Integrated Diagnostic Solutions, Sparks, MD, United States
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Bates DW, Cheng HY, Cheung NT, Jew R, Mir F, Tamblyn R, Li YC. ‘Improving smart medication management’: an online expert discussion. BMJ Health Care Inform 2022; 29:bmjhci-2021-100540. [PMID: 35477691 PMCID: PMC9047882 DOI: 10.1136/bmjhci-2021-100540] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Accepted: 04/18/2022] [Indexed: 11/04/2022] Open
Abstract
Medication safety continues to be a problem inside and outside the hospital, partly because new smart technologies can cause new drug-related challenges to prescribers and patients. Better integrated digital and information technology (IT) systems, improved education on prescribing for prescribers and greater patient-centred care that empowers patients to take control of their medications are all vital to safer and more effective prescribing. In July 2021, a roundtable discussion was held as a spin-off meeting of the International Forum on Quality and Safety in Health Care Europe 2021 to discuss challenges and future direction in smart medication management. This manuscript summarises the discussion focusing on the aspects of digital and IT systems, safe prescribing, improved communication and education, and drug adherence.
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Affiliation(s)
- David W Bates
- Division of General Internal Medicine and Primary Care, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | | | - N T Cheung
- Hong Kong Hospital Authority, Hong Kong, Hong Kong
| | - Rita Jew
- ISMP, Horsham, Pennsylvania, USA
| | - Fraz Mir
- Addenbrooke's Hospital, Cambridge, UK
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17
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Kim H, Kwon S, Son SM, Jeong E, Kim JY. Tailored approach to the choice of long-term vascular access in breast cancer patients. PLoS One 2021; 16:e0255004. [PMID: 34293064 PMCID: PMC8297812 DOI: 10.1371/journal.pone.0255004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2021] [Accepted: 07/07/2021] [Indexed: 01/14/2023] Open
Abstract
This study compared the possible options for vascular access in breast cancer patients by analyzing the complications of each method. We retrospectively evaluated the vascular access procedures for intravenous chemotherapy in breast cancer patients from 2016 to 2018. A total of 300 consecutive patients were included, 100 each who received peripherally inserted central catheters (PICCs), arm ports, and chest ports. When selecting a catheter, a PICC was considered when four cycles of chemotherapy were expected. Otherwise, patient preference was considered. All but one patient with an arm port were women, with mean age of 51.7 ± 9.1 years. The total mean complication-free catheter indwelling time was 1357.6 days for chest ports, 997.8 days for arm ports, and 366.8 days for PICCs (p = 0.004). There were 11 catheter-related complications (3.7%), one in a chest port patient, five in arm port patients, and eight in PICC patients. There was no patient with catheter related blood stream infection or deep vein thrombosis. All three types of catheters could be used in breast cancer patients without causing serious complications. The selection of catheter considering the clinical situation was effective for providing a safe and secure chemotherapy delivery route.
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Affiliation(s)
- Hyangkyoung Kim
- Division of Vascular Surgery, Department of Surgery, College of Medicine, University of Ulsan and Asan Medical Center, Seoul, Korea
| | - Sukyung Kwon
- Division of Vascular Surgery, Department of Surgery, College of Medicine, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Soo Mi Son
- Division of Vascular and Transplantation Surgery, Department of Surgery, College of Medicine, Seoul St. Mary’s Hospital, The Catholic University of Korea, Seoul, Korea
| | - Eunseon Jeong
- Division of Vascular and Transplantation Surgery, Department of Surgery, College of Medicine, Seoul St. Mary’s Hospital, The Catholic University of Korea, Seoul, Korea
| | - Jang-Yong Kim
- Division of Vascular and Transplantation Surgery, Department of Surgery, College of Medicine, Seoul St. Mary’s Hospital, The Catholic University of Korea, Seoul, Korea
- * E-mail:
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18
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Whooley S, Briskin T, Gibney MA, Blank LR, Berube J, Pflug BK. Evaluating the User Performance and Experience with a Re-Engineered 4 mm × 32G Pen Needle: A Randomized Trial with Similar Length/Gauge Needles. Diabetes Ther 2019; 10:697-712. [PMID: 30809762 PMCID: PMC6437253 DOI: 10.1007/s13300-019-0585-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2019] [Indexed: 12/20/2022] Open
Abstract
INTRODUCTION Since insulin pens were first introduced in 1985, many advances have been made in pen needles (PNs). In this study we evaluated patient-reported outcomes of an investigational newly re-engineered 4 mm × 32G PN, the BD Nano™ 2nd Gen (also known by its "PRO" brand extension in many markets outside of the USA). In place of a conventional cylindrical posted hub, the investigational PN's hub is contoured with an expanded surface area. The investigational PN also includes a redesigned inner shield that includes tactile ridges and a remodeled outer cover with improved proportions and attachment grips. METHODS This was a multi-site, prospective, open-label, two-period crossover trial. Individuals with type 1 and type 2 diabetes using 32G PNs of ≤ 6 mm in length for ≥ 4 months were eligible. Subjects using 31G PNs of a similar length were eligible after a 2-week wash-in period. Subjects were assigned to one of four groups, with each group using a commercially available PN to which the investigational PN was compared. Each of the two study periods were 15 days: one with the investigational PN and the other with a comparator PN. After completing both study periods, subjects compared experiences between the two PN types. A 150-mm comparative visual analog scale (VAS) was used to evaluate overall preference (primary endpoint) and several secondary endpoints, including overall comfort, injection pain, and ease of use. Data from the four PN groups were combined after poolability was verified. Subgroup analyses were also conducted on each PN group. For VAS responses, a two-sided 95% confidence interval (CI) was calculated for average rating. Threshold for non-inferiority or superiority was established at the lower bound CI of > - 10 mm or > 0 mm, respectively. RESULTS At baseline, average age of subjects was 55.6 years; 51.6% were female; and 85.1% has type 2 diabetes mellitus. Average diabetes duration was 14.2 years, and average duration of injecting was 7.8 years. The investigational PN demonstrated superiority for all outcomes, both primary and secondary, for all groups combined (p < 0.05). CONCLUSIONS The investigational PN was rated as being overall preferred, more comfortable, less painful, and easier to use when compared to comparator PNs of similar gauge and length, in all groups combined. CLINICAL TRIAL REGISTRATION Clinicaltrials.gov (NCT03267264). FUNDING BD (Becton, Dickinson, and Company).
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Affiliation(s)
| | | | | | - Lydia R Blank
- BD (Becton, Dickinson and Company), Franklin Lakes, NJ, USA
| | - Julie Berube
- BD (Becton, Dickinson and Company), Franklin Lakes, NJ, USA
| | - Brian K Pflug
- BD (Becton, Dickinson and Company), Franklin Lakes, NJ, USA
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