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Wade Skoien, Katie Page, William Parsonage, Sarah Ashover, Tanya Milburn, Louise Cullen
BACKGROUND: The translation of healthcare research into practice is typically challenging and limited in effectiveness. The Theoretical Domains Framework (TDF) identifies 12 domains of behaviour determinants which can be used to understand the principles of behavioural change, a key factor influencing implementation. The Accelerated Chest pain Risk Evaluation (ACRE) project has successfully translated research into practice, by implementing an intervention to improve the assessment of low to intermediate risk patients presenting to emergency departments (EDs) with chest pain...
October 12, 2016: Implementation Science: IS
Hardeep S Kainth, Ankit A Patel, Raymund V Millan
No abstract text is available yet for this article.
September 2016: PM & R: the Journal of Injury, Function, and Rehabilitation
Arden Perkins, Derek Parsonage, Kimberly J Nelson, O Maduka Ogba, Paul Ha-Yeon Cheong, Leslie B Poole, P Andrew Karplus
Peroxiredoxins (Prxs) are ubiquitous cysteine-based peroxidases that guard cells against oxidative damage, are virulence factors for pathogens, and are involved in eukaryotic redox regulatory pathways. We have analyzed catalytically active crystals to capture atomic resolution snapshots of a PrxQ subfamily enzyme (from Xanthomonas campestris) proceeding through thiolate, sulfenate, and sulfinate species. These analyses provide structures of unprecedented accuracy for seeding theoretical studies, and reveal conformational intermediates giving insight into the reaction pathway...
October 4, 2016: Structure
James Prueter, Shawn M Stevens, Norberto Andaluz, Ravi N Samy
OBJECTIVE: In this patient report, Parsonage-Turner syndrome (acute brachial neuropathy) developed in our patient 1 day after resection of a vestibular schwannoma by a middle cranial fossa approach. Aiming to increase awareness of this rare disorder among neurotologists, we describe differential diagnoses, work-up, and management strategies. PATIENT: A 67-year-old man treated for vestibular schwannoma at a single tertiary referral center. INTERVENTION: Surgery for vestibular schwannoma, electromyography for confirmation of diagnosis, and physical therapy...
September 2016: Otology & Neurotology
Alessandro Iliceto, Sara Louise Berndt, Jaimi H Greenslade, William A Parsonage, Christopher Hammett, Martin Than, Tracey Hawkins, Kate Parker, Shannen O'Kane, Louise Cullen
OBJECTIVE: Obtaining an accurate medical history is essential in the assessment of patients, particularly in emergency department (ED) patients with acute chest pain, as there can be a time imperative for diagnosis and commencement of treatment. We aimed to evaluate reliability of patient-reported compared with physician-adjudicated medical history by assessing patient's recall and communication of personal events and its influence on the accuracy of the medical history. METHODS: A total of 776 patients presenting at ED with suspected cardiac chest pain were recruited...
September 2016: Critical Pathways in Cardiology
Edward Carlton, Jaimi Greenslade, Louise Cullen, Richard Body, Martin Than, John W Pickering, Sally Aldous, Simon Carley, Christopher Hammett, Jason Kendall, Brian Keevil, Sarah Lord, William Parsonage, Kim Greaves
IMPORTANCE: Low concentrations of high-sensitivity cardiac troponin I determined on presentation to the emergency department (ED) have been shown to have an excellent negative predictive value (NPV) for the identification of acute myocardial infarction. The sensitivity, and therefore clinical applicability, of such testing strategies is unknown. OBJECTIVE: To determine the diagnostic performance of low concentrations of high-sensitivity cardiac troponin I in patients with suspected cardiac chest pain and an electrocardiogram showing no ischemia as an indicator of acute myocardial infarction...
July 1, 2016: JAMA Cardiology
Johannes Tobias Neumann, Nils Arne Sörensen, Tjark Schwemer, Francisco Ojeda, Rafael Bourry, Vanessa Sciacca, Sarina Schaefer, Christoph Waldeyer, Christoph Sinning, Thomas Renné, Martin Than, William Parsonage, Karin Wildi, Nataliya Makarova, Renate B Schnabel, Ulf Landmesser, Christian Mueller, Louise Cullen, Jaimi Greenslade, Tanja Zeller, Stefan Blankenberg, Mahir Karakas, Dirk Westermann
IMPORTANCE: Rapid and accurate diagnosis of acute myocardial infarction (AMI) currently constitutes an unmet need. OBJECTIVE: To test a 1-hour diagnostic algorithm to diagnose AMI using a high-sensitivity troponin I assay with a new cutoff level of 6 ng/L. DESIGN, SETTING, AND PARTICIPANTS: The Biomarkers in Acute Cardiac Care study is a prospective study that investigated the application of the troponin I assay for the diagnosis of AMI in 1040 patients presenting to the emergency department with acute chest pain from July 19, 2013, to December 31, 2014...
July 1, 2016: JAMA Cardiology
Dylan Flaws, Martin Than, Frank Xavier Scheuermeyer, James Christenson, Barbara Boychuk, Jaimi H Greenslade, Sally Aldous, Christopher J Hammett, William A Parsonage, Joanne M Deely, John W Pickering, Louise Cullen
OBJECTIVE: The emergency department assessment of chest pain score accelerated diagnostic pathway (EDACS-ADP) facilitates low-risk ED chest pain patients early to outpatient investigation. We aimed to validate this rule in a North American population. METHODS: We performed a retrospective validation of the EDACS-ADP using 763 chest pain patients who presented to St Paul's Hospital, Vancouver, Canada, between June 2000 and January 2003. Patients were classified as low risk if they had an EDACS <16, no new ischaemia on ECG and non-elevated serial 0-hour and 2-hour cardiac troponin concentrations...
September 2016: Emergency Medicine Journal: EMJ
Andrés A Maldonado, Kimberly K Amrami, Michelle L Mauermann, Robert J Spinner
INTRODUCTION: Different hypotheses have been proposed for the pathophysiology of anterior interosseous nerve (AIN) palsy: compression, fascicular constriction or nerve inflammation (Parsonage-Turner Syndrome). We hypothesized that critical reinterpretation of electrodiagnostic studies (EDX) and MRIs of patients with a diagnosis of AIN palsy could provide insight into the pathophysiology and treatment. MATERIALS AND METHODS: A retrospective review was performed of all patients with a diagnosis of non-traumatic AIN palsy and an upper extremity MRI performed at our institution...
July 5, 2016: Plastic and Reconstructive Surgery
Chris S Milner, Kumar Kannan, Vasudeva G Iyer, Sunil M Thirkannad
BACKGROUND: Parsonage-Turner Syndrome (PTS) is a rare but serious condition characterized by spontaneous paresis of the upper extremity, typically lasting several months with variable recovery. With little literature on the behavior of PTS from a hand surgeon's perspective, accurate diagnosis and subsequent counseling of patients with PTS can be challenging. METHODS: This study is a retrospective evaluation of the clinical features of all PTS patients seen over a 9-year period...
June 2016: Hand: Official Journal of the American Association for Hand Surgery
Ebru Ertekin, Iris M van Hagen, Amar M Salam, Titia P E Ruys, Mark R Johnson, Jana Popelova, William A Parsonage, Zeinab Ashour, Avraham Shotan, José M Oliver, Gruschen R Veldtman, Roger Hall, Jolien W Roos-Hesselink
OBJECTIVES: To describe the incidence, onset, predictors and outcome of ventricular tachyarrhythmia (VTA) in pregnant women with heart disease. BACKGROUND: VTA during pregnancy will cause maternal morbidity and even mortality and will have impact on fetal outcome. Insufficient data exist on the incidence and outcome of VTA in pregnancy. METHODS AND RESULTS: From January 2007 up to October 2013, 99 hospitals in 39 countries enrolled 2966 pregnancies in women with structural heart disease...
October 1, 2016: International Journal of Cardiology
Nata Parnes, Maryellen I Blevins, Paul Carey, Darren J Friedman
Pectoralis major injuries are relatively uncommon and can pose a diagnostic challenge. Deformity and weakness of this muscle in weight lifters is typically due to traumatic tendon rupture and often requires surgical repair. However, there are other less common etiologies that can mimic the clinical presentation of pectoralis major wasting and weakness that require different treatment approaches. This article describes a case of a 48-year-old recreational weight lifter who presented with severe pectoralis major wasting and weakness secondary to isolated mononeuropathy of the lateral pectoral nerve possibly due to Parsonage Turner syndrome...
July 1, 2016: Orthopedics
Joanna Parsonage, Josh Secomb, Tai Tran, Oliver Farley, Sophia Nimphius, Lina Lundgren, Jeremy M Sheppard
The purpose of this study was to describe and compare the gender differences in physical performance characteristics of elite surfers. Twenty competitive female surfers (CFS) and twenty competitive male surfers (CMS) performed a battery of physical performance tests: squat Jump (SJ), isometric mid-thigh pull (IMTP), 15m-sprint paddle and 400m-endurance paddle) during a single testing session. All performance measures were significantly different between CFS and CMS (p<0.01). Specifically, CMS produced greater peak force production (28...
March 21, 2016: Journal of Strength and Conditioning Research
Iris M van Hagen, Eric Boersma, Mark R Johnson, Sara A Thorne, William A Parsonage, Pilar Escribano Subías, Agata Leśniak-Sobelga, Olga Irtyuga, Khaled A Sorour, Nasser Taha, Aldo P Maggioni, Roger Hall, Jolien W Roos-Hesselink
AIMS: To validate the modified World Health Organization (mWHO) risk classification in advanced and emerging countries, and to identify additional risk factors for cardiac events during pregnancy. METHODS AND RESULTS: The ongoing prospective worldwide Registry Of Pregnancy And Cardiac disease (ROPAC) included 2742 pregnant women (mean age ± standard deviation, 29.2 ± 5.5 years) with established cardiac disease: 1827 from advanced countries and 915 from emerging countries...
May 2016: European Journal of Heart Failure
John W Pickering, Jaimi H Greenslade, Louise Cullen, Dylan Flaws, William Parsonage, Peter George, Andrew Worster, Peter A Kavsak, Martin P Than
OBJECTIVE: International guidelines to rule-in acute myocardial infarction (AMI) in patients presenting with chest pain to the emergency department (ED) recommend an algorithm using high-sensitivity cardiac troponin (hs-cTn) sampling on presentation and 3 h following presentation. We tested the diagnostic accuracy of this algorithm by pooling data from five distinct cohorts from three countries of prospectively recruited patients with independently adjudicated outcomes. METHOD: We measured high-sensitivity cardiac troponin I (hs-cTnI) and high-sensitivity cardiac troponin T (hs-cTnT) on presentation (0 h) and 3 h post-presentation samples in adult patients attending an ED with possible AMI to validate the European Society of Cardiology (ESC) Working Group on Acute Cardiac Care rule-in algorithm (ESC-rule-in)...
August 15, 2016: Heart: Official Journal of the British Cardiac Society
M Rodríguez-Hornillo, M C de la Riva, R Ojeda
Neuralgic amyotrophy, brachial neuritis or Parsonage-Turner syndrome is a rare neuromuscular involvement of unknown aetiology. When it onsets in connection with a health care act, such as childbirth or surgery, a malpractice argument is often used as a cause of adverse outcome, usually due to an incorrect position of the patient on the operating table, a circumstance which directly involves the anesthesia area. Three cases are presented of Parsonage-Turner syndrome following very different surgery, with different results as regards prognosis...
August 2016: Revista Española de Anestesiología y Reanimación
Qinglu Cheng, Jaimi H Greenslade, William A Parsonage, Adrian G Barnett, Katharina Merollini, Nicholas Graves, W Frank Peacock, Louise Cullen
OBJECTIVE: To compare health service cost and length of stay between a traditional and an accelerated diagnostic approach to assess acute coronary syndromes (ACS) among patients who presented to the emergency department (ED) of a large tertiary hospital in Australia. DESIGN, SETTING AND PARTICIPANTS: This historically controlled study analysed data collected from two independent patient cohorts presenting to the ED with potential ACS. The first cohort of 938 patients was recruited in 2008-2010, and these patients were assessed using the traditional diagnostic approach detailed in the national guideline...
2016: BMJ Open
Derek Parsonage, Fang Sheng, Ken Hirata, Anjan Debnath, James H McKerrow, Sharon L Reed, Ruben Abagyan, Leslie B Poole, Larissa M Podust
The anti-arthritic gold-containing drug Auranofin is lethal to the protozoan intestinal parasite Entamoeba histolytica, the causative agent of human amebiasis, in both culture and animal models of the disease. A putative mechanism of Auranofin action proposes that monovalent gold, Au(I), released from the drug, can bind to the redox-active dithiol group of thioredoxin reductase (TrxR). Au(I) binding in the active site is expected to prevent electron transfer to the downstream substrate thioredoxin (Trx), thus interfering with redox homeostasis in the parasite...
May 2016: Journal of Structural Biology
K A Russ, P Elvati, T L Parsonage, A Dews, J A Jarvis, M Ray, B Schneider, P J S Smith, P T F Williamson, A Violi, M A Philbert
There continues to be a significant increase in the number and complexity of hydrophobic nanomaterials that are engineered for a variety of commercial purposes making human exposure a significant health concern. This study uses a combination of biophysical, biochemical and computational methods to probe potential mechanisms for uptake of C60 nanoparticles into various compartments of living immune cells. Cultures of RAW 264.7 immortalized murine macrophage were used as a canonical model of immune-competent cells that are likely to provide the first line of defense following inhalation...
February 21, 2016: Nanoscale
C Cejas, C Rollán, G Michelin, M Nogués
The study of the structures that make up the brachial plexus has benefited particularly from the high resolution images provided by 3T magnetic resonance scanners. The brachial plexus can have mononeuropathies or polyneuropathies. The mononeuropathies include traumatic injuries and trapping, such as occurs in thoracic outlet syndrome due to cervical ribs, prominent transverse apophyses, or tumors. The polyneuropathies include inflammatory processes, in particular chronic inflammatory demyelinating polyneuropathy, Parsonage-Turner syndrome, granulomatous diseases, and radiation neuropathy...
March 2016: Radiología
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