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Ian Piper

Fabian Güiza, Bart Depreitere, Ian Piper, Giuseppe Citerio, Philippe G Jorens, Andrew Maas, Martin U Schuhmann, Tsz-Yan Milly Lo, Rob Donald, Patricia Jones, Gottlieb Maier, Greet Van den Berghe, Geert Meyfroidt
OBJECTIVE: A model for early detection of episodes of increased intracranial pressure in traumatic brain injury patients has been previously developed and validated based on retrospective adult patient data from the multicenter Brain-IT database. The purpose of the present study is to validate this early detection model in different cohorts of recently treated adult and pediatric traumatic brain injury patients. DESIGN: Prognostic modeling. Noninterventional, observational, retrospective study...
September 14, 2016: Critical Care Medicine
Keaton Piper, Hanna Algattas, Ian A DeAndrea-Lazarus, Kristopher T Kimmell, Yan Michael Li, Kevin A Walter, Howard J Silberstein, G Edward Vates
OBJECTIVE Patients undergoing spinal surgery are at risk for developing venous thromboembolism (VTE). The authors sought to identify risk factors for VTE in these patients. METHODS The American College of Surgeons National Surgical Quality Improvement Project database for the years 2006-2010 was reviewed for patients who had undergone spinal surgery according to their primary Current Procedural Terminology code(s). Clinical factors were analyzed to identify associations with VTE. RESULTS Patients who underwent spinal surgery (n = 22,434) were identified...
September 2, 2016: Journal of Neurosurgery. Spine
Andrew R Green, Daniele Soria, Jacqueline Stephen, Desmond G Powe, Christopher C Nolan, Ian Kunkler, Jeremy Thomas, Gillian R Kerr, Wilma Jack, David Cameron, Tammy Piper, Graham R Ball, Jonathan M Garibaldi, Emad A Rakha, John Ms Bartlett, Ian O Ellis
The Nottingham Prognostic Index Plus (NPI+) is a clinical decision making tool in breast cancer (BC) that aims to provide improved patient outcome stratification superior to the traditional NPI. This study aimed to validate the NPI+ in an independent series of BC. Eight hundred and eighty five primary early stage BC cases from Edinburgh were semi-quantitatively assessed for 10 biomarkers [Estrogen Receptor (ER), Progesterone Receptor (PgR), cytokeratin (CK) 5/6, CK7/8, epidermal growth factor receptor (EGFR), HER2, HER3, HER4, p53, and Mucin 1] using immunohistochemistry and classified into biological classes by fuzzy logic-derived algorithms previously developed in the Nottingham series...
January 2016: Journal of Pathology. Clinical Research
Anna Teresa Mazzeo, Claudia Filippini, Rosalba Rosato, Vito Fanelli, Barbara Assenzio, Ian Piper, Timothy Howells, Ilaria Mastromauro, Maurizio Berardino, Alessandro Ducati, Luciana Mascia
BACKGROUND: Neuroinflammation has been proposed as a possible mechanism of brain damage after traumatic brain injury (TBI), but no consensus has been reached on the most relevant molecules. Furthermore, secondary insults occurring after TBI contribute to worsen neurological outcome in addition to the primary injury. We hypothesized that after TBI, a specific pattern of cytokines is related to secondary insults and outcome. METHODS: A prospective observational clinical study was performed...
2016: Journal of Neuroinflammation
Konstantinos Georgatzis, Partha Lal, Christopher Hawthorne, Martin Shaw, Ian Piper, Claire Tarbert, Rob Donald, Christopher K I Williams
INTRODUCTION: High-resolution, artefact-free and accurately annotated physiological data are desirable in patients with brain injury both to inform clinical decision-making and for intelligent analysis of the data in applications such as predictive modelling. We have quantified the quality of annotation surrounding artefactual events and propose a factorial switching linear dynamical systems (FSLDS) approach to automatically detect artefact in physiological data collected in the neurological intensive care unit (NICU)...
2016: Acta Neurochirurgica. Supplement
Laura Moss, Martin Shaw, Ian Piper, D K Arvind, Christopher Hawthorne
The non-surgical management of patients with traumatic brain injury is the treatment and prevention of secondary insults, such as low cerebral perfusion pressure (CPP). Most clinical pressure monitoring systems measure pressure relative to atmospheric pressure. If a patient is managed with their head tilted up, relative to their arterial pressure transducer, then a hydrostatic pressure gradient (HPG) can act against arterial pressure and cause significant errors in calculated CPP.To correct for HPG, the arterial pressure transducer should be placed level with the intracranial pressure transducer...
2016: Acta Neurochirurgica. Supplement
Bart Depreitere, Fabian Güiza, Greet Van den Berghe, Martin U Schuhmann, Gottlieb Maier, Ian Piper, Geert Meyfroidt
BACKGROUND: The concept of CPPopt, a variable cerebral perfusion pressure (CPP) target based on cerebrovascular autoregulatory capacity in severe traumatic brain injury (TBI), is promising. CPPopt calculation is based on the continuous plotting of the pressure reactivity Index (PRx) against CPP and requires processing of waveform quality data. The aim of this study is to investigate whether CPPopt can also be calculated based on minute-by-minute data. METHODS: A low-resolution autoregulation index (LAx) was defined as the minute-by-minute intracranial pressure-mean arterial pressure correlation over varying time intervals...
2016: Acta Neurochirurgica. Supplement
Flora McLennan, Christopher Hawthorne, Martin Shaw, Ian Piper
In neurological intensive care units (NICUs) we are collecting an ever increasing quantity of data. These range from patient demographics and physiological monitoring to treatment strategies and outcomes. The BrainIT database is an example of this type of rich data source. It contains validated data on 264 patients who suffered traumatic brain injury (TBI) admitted to 22 NICUs in 11 European countries between March 2003 and July 2005 [1, 6].
2016: Acta Neurochirurgica. Supplement
Martin Shaw, Ian Piper, Christopher Hawthorne
Intracranial pressure (ICP) monitoring is a key clinical tool in the assessment and treatment of patients in neurointensive care. ICP morphology analysis can be useful in the classification of waveform features.A methodology for the decomposition of an ICP signal into clinically relevant dimensions has been devised that allows the identification of important ICP waveform types. It has three main components. First, multi-resolution convolution analysis is used for the main signal decomposition. Then, an impulse function is created, with multiple parameters, that can represent any form in the signal under analysis...
2016: Acta Neurochirurgica. Supplement
Thomas Beez, Roddy O'Kane, Ian Piper, David Koppel, Meharpal Sangra
Syndromic and nonsyndromic craniosynostosis can be associated with raised intracranial pressure (ICP). After corrective surgery, raised ICP persists or reoccurs in a subgroup of patients. The standard procedure for monitoring ICP is insertion of a percutaneous intraparenchymal probe for a limited time, usually 24 to 48 hours. However, in selected patients repeated ICP measurements might be useful in the clinical setting, and a noninvasive method for achieving this would be desirable. The authors present the use of a telemetric ICP monitoring system implanted during cranial vault expansion in a child with syndromic craniosynostosis...
June 2016: Journal of Craniofacial Surgery
Rory J Piper, Shadia Mikhael, Joanna M Wardlaw, David H Laidlaw, Ian R Whittle, Mark E Bastin
Differentiation of cerebral tumor pathology currently relies on interpretation of conventional structural MRI and in some cases histology. However, more advanced MRI methods may provide further insight into the organization of cerebral tumors and have the potential to aid diagnosis. The objective of this study was to use multimodal quantitative MRI to measure the imaging signatures of meningioma and low-grade glioma (LGG). Nine adults with meningioma and 11 with LGG were identified, and underwent standard structural, quantitative longitudinal relaxation time (T1) mapping, magnetization transfer and diffusion tensor MRI...
May 2016: Magnetic Resonance Imaging
Betsy C Herold, Beatrice A Chen, Robert A Salata, Mark A Marzinke, Clifton W Kelly, Charlene S Dezzutti, Ian McGowan, Beth Galaska, Lisa Levy, Jeanna M Piper, Sharon Hillier, Craig W Hendrix
BACKGROUND: Tenofovir (TFV) gel partially protected against human immunodeficiency virus (HIV) in one but not subsequent trials. The disappointing results were attributed largely to poor adherence. However, timing of gel application relative to sex may impact pharmacokinetics and contribute to outcomes. Thus, we conducted a single-dose pharmacokinetic study of TFV gel applied 1 or 24 hours before or 1 hour before and 1 hour after (BAT) sex and compared results with dosing without sex...
February 1, 2016: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
Xin Wang, Maria Del C Valdés Hernández, Fergus Doubal, Francesca M Chappell, Rory J Piper, Ian J Deary, Joanna M Wardlaw
PURPOSE: Perivascular spaces (PVS) are associated with ageing, cerebral small vessel disease, inflammation and increased blood brain barrier permeability. Most studies to date use visual rating scales to assess PVS, but these are prone to observer variation. METHODS: We developed a semi-automatic computational method that extracts PVS on bilateral ovoid basal ganglia (BG) regions on intensity-normalised T2-weighted magnetic resonance images. It uses Analyze™10...
January 15, 2016: Journal of Neuroscience Methods
Fabian Güiza, Bart Depreitere, Ian Piper, Giuseppe Citerio, Iain Chambers, Patricia A Jones, Tsz-Yan Milly Lo, Per Enblad, Pelle Nillson, Bart Feyen, Philippe Jorens, Andrew Maas, Martin U Schuhmann, Rob Donald, Laura Moss, Greet Van den Berghe, Geert Meyfroidt
PURPOSE: To assess the impact of the duration and intensity of episodes of increased intracranial pressure on 6-month neurological outcome in adult and paediatric traumatic brain injury. METHODS: Analysis of prospectively collected minute-by-minute intracranial pressure and mean arterial blood pressure data of 261 adult and 99 paediatric traumatic brain injury patients from multiple European centres. The relationship of episodes of elevated intracranial pressure (defined as a pressure above a certain threshold during a certain time) with 6-month Glasgow Outcome Scale was visualized in a colour-coded plot...
June 2015: Intensive Care Medicine
Florian Hladik, Adam Burgener, Lamar Ballweber, Raphael Gottardo, Lucia Vojtech, Slim Fourati, James Y Dai, Mark J Cameron, Johanna Strobl, Sean M Hughes, Craig Hoesley, Philip Andrew, Sherri Johnson, Jeanna Piper, David R Friend, T Blake Ball, Ross D Cranston, Kenneth H Mayer, M Juliana McElrath, Ian McGowan
No abstract text is available yet for this article.
2015: ELife
Jeanne M Marrazzo, Gita Ramjee, Barbra A Richardson, Kailazarid Gomez, Nyaradzo Mgodi, Gonasagrie Nair, Thesla Palanee, Clemensia Nakabiito, Ariane van der Straten, Lisa Noguchi, Craig W Hendrix, James Y Dai, Shayhana Ganesh, Baningi Mkhize, Marthinette Taljaard, Urvi M Parikh, Jeanna Piper, Benoît Mâsse, Cynthia Grossman, James Rooney, Jill L Schwartz, Heather Watts, Mark A Marzinke, Sharon L Hillier, Ian M McGowan, Z Mike Chirenje
BACKGROUND: Reproductive-age women need effective interventions to prevent the acquisition of human immunodeficiency virus type 1 (HIV-1) infection. METHODS: We conducted a randomized, placebo-controlled trial to assess daily treatment with oral tenofovir disoproxil fumarate (TDF), oral tenofovir-emtricitabine (TDF-FTC), or 1% tenofovir (TFV) vaginal gel as preexposure prophylaxis against HIV-1 infection in women in South Africa, Uganda, and Zimbabwe. HIV-1 testing was performed monthly, and plasma TFV levels were assessed quarterly...
February 5, 2015: New England Journal of Medicine
Florian Hladik, Adam Burgener, Lamar Ballweber, Raphael Gottardo, Lucia Vojtech, Slim Fourati, James Y Dai, Mark J Cameron, Johanna Strobl, Sean M Hughes, Craig Hoesley, Philip Andrew, Sherri Johnson, Jeanna Piper, David R Friend, T Blake Ball, Ross D Cranston, Kenneth H Mayer, M Juliana McElrath, Ian McGowan
Tenofovir gel is being evaluated for vaginal and rectal pre-exposure prophylaxis against HIV transmission. Because this is a new prevention strategy, we broadly assessed its effects on the mucosa. In MTN-007, a phase-1, randomized, double-blinded rectal microbicide trial, we used systems genomics/proteomics to determine the effect of tenofovir 1% gel, nonoxynol-9 2% gel, placebo gel or no treatment on rectal biopsies (15 subjects/arm). We also treated primary vaginal epithelial cells from four healthy women with tenofovir in vitro...
2015: ELife
Christopher Hawthorne, Ian Piper
Since Monro published his observations on the nature of the contents of the intracranial space in 1783, there has been investigation of the unique relationship between the contents of the skull and the intracranial pressure (ICP). This is particularly true following traumatic brain injury (TBI), where it is clear that elevated ICP due to the underlying pathological processes is associated with a poorer clinical outcome. Consequently, there is considerable interest in monitoring and manipulating ICP in patients with TBI...
2014: Frontiers in Neurology
Bart Depreitere, Fabian Güiza, Greet Van den Berghe, Martin U Schuhmann, Gottlieb Maier, Ian Piper, Geert Meyfroidt
OBJECT: In severe traumatic brain injury, a universal target for cerebral perfusion pressure (CPP) has been abandoned. Attempts to identify a dynamic CPP target based on the patient's cerebrovascular autoregulatory capacity have been promising so far. Bedside monitoring of pressure autoregulatory capacity has become possible by a number of methods, Czosnyka's pressure reactivity index (PRx) being the most frequently used. The PRx is calculated as the moving correlation coefficient between 40 consecutive 5-second averages of intracranial pressure (ICP) and mean arterial blood pressure (MABP) values...
June 2014: Journal of Neurosurgery
Arminas Ragauskas, Laimonas Bartusis, Ian Piper, Rolandas Zakelis, Vaidas Matijosaitis, Kestutis Petrikonis, Daiva Rastenyte
OBJECTIVES: To compare the diagnostic reliability of optic nerve sheath diameter (ONSD) ultrasonography with a transcranial Doppler (TCD)-based absolute intracranial pressure (ICP) value measurement method for detection of elevated ICP in neurological patients. The ONSD method has been only tested previously on neurosurgical patients. METHODS: A prospective clinical study of a non-invasive ICP estimation method based on ONSD correlation with ICP and an absolute ICP value measurement method based on a two-depth TCD technology has recruited 108 neurological patients...
July 2014: Neurological Research
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