25 results on '"Tweed K."'
Search Results
2. Improving Stem Cell Delivery to the Trabecular Meshwork Using Magnetic Nanoparticles
- Author
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Snider, E. J., Kubelick, K. P., Tweed, K., Kim, R. K., Li, Y., Gao, K., Read, A. T., Emelianov, S., and Ethier, C. R.
- Published
- 2018
- Full Text
- View/download PDF
3. CT Pericoronary Adipose Tissue Density Predicts Coronary Allograft Vasculopathy And Adverse Clinical Outcomes After Cardiac Transplantation
- Author
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Wall, C., Weir-McCall, J., Tweed, K., Hoole, S., Gopalan, D., Huang, Y., Corovic, A., Peverelli, M., Dey, D., Bennettt, M., Rudd, J., Kydd, A., Bhagra, S., and Tarkin, J.
- Published
- 2024
- Full Text
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4. Fall-related risk factors and osteoporosis in women with rheumatoid arthritis
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Kaz, H. Kaz, Johnson, D., Kerry, S., Chinappen, U., Tweed, K., and Patel, S.
- Published
- 2004
5. RELATIVE CONTRIBUTIONS OF FALL RISK AND FEMORAL NECK BONE DENSITY TO HIP FRACTURE RISK IN WOMEN WITH RHEUMATOID ARTHRITIS
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Patel, S, Johnson, D, Tweed, K, Chinappen, U, and Kaz, H Kaz
- Published
- 2003
6. Feasibility of Coronary Computed Tomography Angiography Assessment of Explanted Donor Hearts
- Author
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Tweed, K., Agrawal, B., Messer, S., Clements, L., Butler, J., Catarino, P., and Large, S.R.
- Published
- 2020
- Full Text
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7. (477) - One Year- Outcomes Following Heart Transplantation from Donation After Circulatory Determined Death (DCD) Donors
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Hudson, V., Messer, S., Page, A., Berman, M., Dunning, J., Pavlushkov, E., Tweed, K., Parameshwar, J., Abu Omar, Y., Goddard, M., Pettit, S., Lewis, C., Kydd, A., Jenkins, D., Sudarshan, C., Catarino, P., Ali, A., Tsui, S., Large, S.R., and Bhagra, S.
- Published
- 2018
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8. (12) - Post-Transplant Assessment of Donation after Circulatory Death (DCD) Cardic Allografts with MRI - An Update
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Pavlushkov, E., Page, A., Messer, S., Kydd, A., Abu-Omar, Y., Ali, A., Berman, M., Catarino, P., Dunning, J., Jenkins, D., Bhagra, S., Lewis, C., Parameshwar, J., Pettit, S., Sudarshan, C., Tsui, S., Large, S., and Tweed, K.
- Published
- 2018
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9. Laundering single-use gowns in the event of critical shortage: experience of a UK acute trust.
- Author
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Poller, B., Lynch, C., Ramsden, R., Jessop, K., Evans, C., Tweed, K., Drew, C., and Bates, C.
- Published
- 2020
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10. 47: Exposure of patients to ionising radiation during lung cancer diagnostic work-up.
- Author
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Atherton, R., Tweed, K., Bird, N., Chilvers, E.R., and Rintoul, R.C.
- Subjects
- *
LUNG cancer diagnosis , *IONIZING radiation , *LUNG cancer patients , *CANCER radiotherapy , *RADIATION exposure - Published
- 2017
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11. Computed tomography pericoronary adipose tissue density predicts coronary allograft vasculopathy and adverse clinical outcomes after cardiac transplantation.
- Author
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Wall C, Weir-McCall J, Tweed K, Hoole SP, Gopalan D, Huang Y, Corovic A, Peverelli M, Dey D, Bennett MR, Rudd JHF, Kydd A, Bhagra S, and Tarkin JM
- Subjects
- Humans, Female, Male, Middle Aged, Retrospective Studies, Coronary Angiography, Adult, Predictive Value of Tests, Case-Control Studies, Allografts, Risk Assessment, Postoperative Complications diagnostic imaging, Epicardial Adipose Tissue, Adipose Tissue diagnostic imaging, Heart Transplantation adverse effects, Coronary Artery Disease diagnostic imaging, Coronary Artery Disease surgery, Computed Tomography Angiography methods
- Abstract
Aims: To assess pericoronary adipose tissue (PCAT) density on coronary computed tomography angiography (CCTA) as a marker of inflammatory disease activity in coronary allograft vasculopathy (CAV)., Methods and Results: PCAT density, lesion volumes, and total vessel volume-to-myocardial mass ratio (V/M) were retrospectively measured in 126 CCTAs from 94 heart transplant patients [mean age 49 (SD 14.5) years, 40% female] who underwent imaging between 2010 and 2021; age- and sex-matched controls; and patients with atherosclerosis. PCAT density was higher in transplant patients with CAV [n = 40; -73.0 HU (SD 9.3)] than without CAV [n = 86; -77.9 HU (SD 8.2)], and controls [n = 12; -86.2 HU (SD 5.4)], P < 0.01 for both. Unlike patients with atherosclerotic coronary artery disease (n = 32), CAV lesions were predominantly non-calcified and comprised of mostly fibrous or fibrofatty tissue. V/M was lower in patients with CAV than without [32.4 mm3/g (SD 9.7) vs. 41.4 mm3/g (SD 12.3), P < 0.0001]. PCAT density and V/M improved the ability to predict CAV from area under the receiver operating characteristic curve (AUC) 0.75-0.85 when added to donor age and donor hypertension status (P < 0.0001). PCAT density above -66 HU was associated with a greater incidence of all-cause mortality {odds ratio [OR] 18.0 [95% confidence interval (CI) 3.25-99.6], P < 0.01} and the composite endpoint of death, CAV progression, acute rejection, and coronary revascularization [OR 7.47 (95% CI 1.8-31.6), P = 0.01] over 5.3 (SD 2.1) years., Conclusion: Heart transplant patients with CAV have higher PCAT density and lower V/M than those without. Increased PCAT density is associated with adverse clinical outcomes. These CCTA metrics could be useful for the diagnosis and monitoring of CAV severity., Competing Interests: Conflict of interest: None declared., (© The Author(s) 2024. Published by Oxford University Press on behalf of the European Society of Cardiology.)
- Published
- 2024
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12. Autofluorescence is a biomarker of neural stem cell activation state.
- Author
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Morrow CS, Tweed K, Farhadova S, Walsh AJ, Lear BP, Roopra A, Risgaard RD, Klosa PC, Arndt ZP, Peterson ER, Chi MM, Harris AG, Skala MC, and Moore DL
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- Mice, Animals, Neurogenesis physiology, Neurons, Biomarkers metabolism, Neural Stem Cells metabolism
- Abstract
Neural stem cells (NSCs) must exit quiescence to produce neurons; however, our understanding of this process remains constrained by the technical limitations of current technologies. Fluorescence lifetime imaging (FLIM) of autofluorescent metabolic cofactors has been used in other cell types to study shifts in cell states driven by metabolic remodeling that change the optical properties of these endogenous fluorophores. Using this non-destructive, live-cell, and label-free strategy, we found that quiescent NSCs (qNSCs) and activated NSCs (aNSCs) have unique autofluorescence profiles. Specifically, qNSCs display an enrichment of autofluorescence localizing to a subset of lysosomes, which can be used as a graded marker of NSC quiescence to predict cell behavior at single-cell resolution. Coupling autofluorescence imaging with single-cell RNA sequencing, we provide resources revealing transcriptional features linked to deep quiescence and rapid NSC activation. Together, we describe an approach for tracking mouse NSC activation state and expand our understanding of adult neurogenesis., Competing Interests: Declaration of interests The authors declare no competing interests., (Copyright © 2024 Elsevier Inc. All rights reserved.)
- Published
- 2024
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13. Surgical intervention for left ventricular assist device outflow graft obstruction due to external compression.
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Wang L, Rafiq M, Tweed K, Kydd A, Kaul P, Jenkins D, Tsui S, and Berman M
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- Humans, Heart Ventricles surgery, Stents adverse effects, Heart-Assist Devices adverse effects, Heart Transplantation, Thrombosis etiology, Thrombosis surgery, Heart Failure etiology, Heart Failure surgery
- Abstract
Left ventricular assist device outflow graft obstruction is an uncommon but serious complication. The causes of left ventricular assist device outflow graft obstruction include thrombus, outflow graft kink or torsion and external compression. The HeartMate 3 left ventricular assist device was reported to have a low risk of thromboembolic events. However, the deposition of bio-debris between the semi-permeable left ventricular assist device outflow graft and the impermeable bend relief has been increasingly recognized as a cause of external compression. The potential treatment options include percutaneous insertion of a stent, surgical removal of the bio-debris, change of left ventricular assist device, and an urgent heart transplant. We report a case of left ventricular assist device outflow graft compression successfully treated by removal of the bio-debris via a subxiphoid approach., (© The Author 2023. Published by MMCTS on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.)
- Published
- 2023
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14. Graft function and incidence of cardiac allograft vasculopathy in donation after circulatory-determined death heart transplant recipients.
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Cheshire C, Messer S, Martinez L, Vokshi I, Ali J, Cernic S, Page A, Andal R, Berman M, Kaul P, Osman M, Rafiq M, Goddard M, Tweed K, Jenkins D, Tsui S, Large S, Kydd A, Lewis C, Parameshwar J, Pettit S, and Bhagra S
- Subjects
- Humans, Graft Survival, Retrospective Studies, Incidence, Stroke Volume, Ventricular Function, Left, Tissue Donors, Brain Death, Allografts, Death, Heart Transplantation adverse effects, Tissue and Organ Procurement
- Abstract
Experience in donation after circulatory-determined death (DCD) heart transplantation (HTx) is expanding. There is limited information on the functional outcomes of DCD HTx recipients. We sought to evaluate functional outcomes in our cohort of DCD recipients. We performed a single-center, retrospective, observational cohort study comparing outcomes in consecutive DCD and donation after brain death (DBD) HTx recipients between 2015 and 2019. Primary outcome was allograft function by echocardiography at 12 and 24 months. Secondary outcomes included incidence of cardiac allograft vasculopathy, treated rejection, renal function, and survival. Seventy-seven DCD and 153 DBD recipients were included. There was no difference in left ventricular ejection fraction at 12 months (59% vs 59%, P = .57) and 24 months (58% vs 58%, P = .87). There was no significant difference in right ventricular function at 12 and 24 months. Unadjusted survival between DCD and DBD recipients at 5 years (85.7% DCD and 81% DBD recipients; P = .45) was similar. There were no significant differences in incidence of cardiac allograft vasculopathy (odds ratio 1.59, P = .21, 95% confidence interval 0.77-3.3) or treated rejection (odds ratio 0.60, P = .12, 95% confidence interval 0.32-1.15) between DBD and DCD recipients. Post-transplant renal function was similar at 1 and 2 years. In conclusion, cardiac allografts from DCD donors perform similarly to a contemporary population of DBD allografts in the medium term., Competing Interests: Disclosure The authors of this manuscript have conflicts of interest to disclose, as described by the American Journal of Transplantation. S. Messer and S.R. Large have applied for a patent for organ perfusion system and methods. S.R. Large has a patent awarded for apparatus for testing, assessment and maintenance of procured hearts for transplantation. Remaining authors of this manuscript have no conflicts of interest to disclose as described by the American Journal of Transplantation., (Copyright © 2023 American Society of Transplantation & American Society of Transplant Surgeons. Published by Elsevier Inc. All rights reserved.)
- Published
- 2023
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15. Comparing Cardiac Mechanics and Myocardial Fibrosis in DBD and DCD Heart Transplant Recipients.
- Author
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Burrage MK, Cheshire C, Hey CY, Azam S, Watson WD, Bhagra S, Berman M, D'Errico L, Jenkins DP, Kaul P, Large S, Lewis C, Martinez L, Messer S, Page A, Parameshwar J, Pettit S, Rafiq M, Tsui S, Tweed K, Weir-McCall JR, and Kydd A
- Subjects
- Humans, Female, Male, Contrast Media, Gadolinium, Fibrosis, Retrospective Studies, Tissue Donors, Heart Failure diagnostic imaging, Heart Failure surgery, Cardiomyopathies, Heart Transplantation adverse effects
- Abstract
Background: Heart transplantation (HTx) after donation after circulatory death (DCD) is an expanding practice but is associated with increased warm ischemic time. The impact of DCD HTx on cardiac mechanics and myocardial fibrosis has not been reported. We aimed to compare cardiac mechanics and myocardial fibrosis using cardiovascular magnetic resonance (CMR) imaging in donation after brain death (DBD) and DCD HTx recipients and healthy controls., Methods and Results: Consecutive HTx recipients between March 2015 and March 2021 who underwent routine surveillance CMR imaging were included. Cardiac mechanics were assessed using CMR feature tracking to compute global longitudinal strain, global circumferential strain, and right ventricular free-wall longitudinal myocardial strain. Fibrosis was assessed using late gadolinium enhancement imaging and estimation of extracellular volume. There were 82 (DBD n = 42, DCD n = 40) HTx recipients (aged 53 years, interquartile range 41-59 years, 24% female) who underwent CMR imaging at median of 9 months (interquartile range 6-14 months) after transplantation. HTx recipients had increased extracellular volume (29.7 ± 3.6%) compared with normal ranges (25.9%, interquartile range 25.4-26.5). Myocardial strain was impaired after transplantation compared with controls (global longitudinal strain -12.6 ± 3.1% vs -17.2 ± 1.8%, P < .0001; global circumferential strain -16.9 ± 3.1% vs -19.2 ± 2.0%, P = .002; right ventricular free-wall longitudinal strain -15.7 ± 4.5% vs -21.6 ± 4.7%, P < .0001). There were no differences in fibrosis burden (extracellular volume 30.6 ± 4.4% vs 29.2 ± 3.2%; P = .39) or cardiac mechanics (global longitudinal strain -13.1 ± 3.0% vs -12.1 ± 3.1%, P = .14; global circumferential strain -17.3 ± 2.9% vs -16.6 ± 3.1%, P = .27; right ventricular free-wall longitudinal strain -15.9 ± 4.9% vs -15.5 ± 4.1%, P = .71) between DCD and DBD HTx., Conclusions: HTx recipients have impaired cardiac mechanics compared with controls, with increased myocardial fibrosis. There were no differences in early CMR imaging characteristics between DBD and DCD heart transplants, providing further evidence that DCD and DBD HTx outcomes are comparable., Competing Interests: Disclosures Royal Papworth Hospital has received grants from the European Society of Organ Transplantation, The Freemasons Grand Charity, the Masonic Samaritan Fund, the Evelyn Trust, RPH Charity, NHSBT, and the Gledhill Fellowship to fund the early DCD research programme. J.R.W.M. is supported by the NIHR Cambridge Biomedical Research Centre (BRC-1215-20014). The views expressed are those of the authors and not necessarily those of the NIHR or the Department of Health and Social Care., (Crown Copyright © 2022. Published by Elsevier Inc. All rights reserved.)
- Published
- 2023
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16. Extracellular pH affects the fluorescence lifetimes of metabolic co-factors.
- Author
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Schmitz R, Tweed K, Walsh C, Walsh AJ, and Skala MC
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- Fluorescence, HeLa Cells, Humans, Hydrogen-Ion Concentration, NADP, Flavin-Adenine Dinucleotide, NAD
- Abstract
Significance: Autofluorescence measurements of the metabolic cofactors NADH and flavin adenine dinucleotide (FAD) provide a label-free method to quantify cellular metabolism. However, the effect of extracellular pH on flavin lifetimes is currently unknown., Aim: To quantify the relationship between extracellular pH and the fluorescence lifetimes of FAD, flavin mononucleotide (FMN), and reduced nicotinamide adenine dinucleotide (phosphate) [NAD(P)H]., Approach: Human breast cancer (BT474) and HeLa cells were placed in pH-adjusted media. Images of an intracellular pH indicator or endogenous fluorescence were acquired using two-photon fluorescence lifetime imaging. Fluorescence lifetimes of FAD and FMN in solutions were quantified over the same pH range., Results: The relationship between intracellular and extracellular pH was linear in both cell lines. Between extracellular pH 4 to 9, FAD mean lifetimes increased with increasing pH. NAD(P)H mean lifetimes decreased with increasing pH between extracellular pH 5 to 9. The relationship between NAD(P)H lifetime and extracellular pH differed between the two cell lines. Fluorescence lifetimes of FAD, FAD-cholesterol oxidase, and FMN solutions decreased, showed no trend, and showed no trend, respectively, with increasing pH., Conclusions: Changes in endogenous fluorescence lifetimes with extracellular pH are mostly due to indirect changes within the cell rather than direct pH quenching of the endogenous molecules.
- Published
- 2021
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17. Carbomer-based adjuvant elicits CD8 T-cell immunity by inducing a distinct metabolic state in cross-presenting dendritic cells.
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Lee W, Kingstad-Bakke B, Paulson B, Larsen A, Overmyer K, Marinaik CB, Dulli K, Toy R, Vogel G, Mueller KP, Tweed K, Walsh AJ, Russell J, Saha K, Reyes L, Skala MC, Sauer JD, Shayakhmetov DM, Coon J, Roy K, and Suresh M
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- Animals, Antigen Presentation drug effects, CD8-Positive T-Lymphocytes drug effects, CD8-Positive T-Lymphocytes metabolism, Dendritic Cells drug effects, Dendritic Cells metabolism, Kruppel-Like Transcription Factors genetics, Kruppel-Like Transcription Factors metabolism, Mice, Mice, Inbred C57BL, Mice, Knockout, ATP Binding Cassette Transporter, Subfamily B, Member 2 physiology, Acrylic Resins chemistry, Adjuvants, Immunologic pharmacology, Antigen Presentation immunology, CD8-Positive T-Lymphocytes immunology, Dendritic Cells immunology, NADPH Oxidase 2 physiology
- Abstract
There is a critical need for adjuvants that can safely elicit potent and durable T cell-based immunity to intracellular pathogens. Here, we report that parenteral vaccination with a carbomer-based adjuvant, Adjuplex (ADJ), stimulated robust CD8 T-cell responses to subunit antigens and afforded effective immunity against respiratory challenge with a virus and a systemic intracellular bacterial infection. Studies to understand the metabolic and molecular basis for ADJ's effect on antigen cross-presentation by dendritic cells (DCs) revealed several unique and distinctive mechanisms. ADJ-stimulated DCs produced IL-1β and IL-18, suggestive of inflammasome activation, but in vivo activation of CD8 T cells was unaffected in caspase 1-deficient mice. Cross-presentation induced by TLR agonists requires a critical switch to anabolic metabolism, but ADJ enhanced cross presentation without this metabolic switch in DCs. Instead, ADJ induced in DCs, an unique metabolic state, typified by dampened oxidative phosphorylation and basal levels of glycolysis. In the absence of increased glycolytic flux, ADJ modulated multiple steps in the cytosolic pathway of cross-presentation by enabling accumulation of degraded antigen, reducing endosomal acidity and promoting antigen localization to early endosomes. Further, by increasing ROS production and lipid peroxidation, ADJ promoted antigen escape from endosomes to the cytosol for degradation by proteasomes into peptides for MHC I loading by TAP-dependent pathways. Furthermore, we found that induction of lipid bodies (LBs) and alterations in LB composition mediated by ADJ were also critical for DC cross-presentation. Collectively, our model challenges the prevailing metabolic paradigm by suggesting that DCs can perform effective DC cross-presentation, independent of glycolysis to induce robust T cell-dependent protective immunity to intracellular pathogens. These findings have strong implications in the rational development of safe and effective immune adjuvants to potentiate robust T-cell based immunity., Competing Interests: The authors have declared that no competing interests exist.
- Published
- 2021
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18. Classification of T-cell activation via autofluorescence lifetime imaging.
- Author
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Walsh AJ, Mueller KP, Tweed K, Jones I, Walsh CM, Piscopo NJ, Niemi NM, Pagliarini DJ, Saha K, and Skala MC
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- Cells, Cultured, Humans, Lymphocyte Activation physiology, Optical Imaging methods, T-Lymphocytes classification, T-Lymphocytes cytology, T-Lymphocytes physiology
- Abstract
The function of a T cell depends on its subtype and activation state. Here, we show that imaging of the autofluorescence lifetime signals of quiescent and activated T cells can be used to classify the cells. T cells isolated from human peripheral blood and activated in culture using tetrameric antibodies against the surface ligands CD2, CD3 and CD28 showed specific activation-state-dependent patterns of autofluorescence lifetime. Logistic regression models and random forest models classified T cells according to activation state with 97-99% accuracy, and according to activation state (quiescent or activated) and subtype (CD3
+ CD8+ or CD3+ CD4+ ) with 97% accuracy. Autofluorescence lifetime imaging can be used to non-destructively determine T-cell function.- Published
- 2021
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19. CASPA (CArdiac Sarcoidosis in PApworth) improving the diagnosis of cardiac involvement in patients with pulmonary sarcoidosis: protocol for a prospective observational cohort study.
- Author
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Quijano-Campos JC, Williams L, Agarwal S, Tweed K, Parker R, Lalvani A, Chiu YD, Dorey K, Devine T, Stoneman V, Toshner M, and Thillai M
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- Electrocardiography, Ambulatory, Humans, Observational Studies as Topic, Prospective Studies, Cardiomyopathies diagnostic imaging, Sarcoidosis diagnosis, Sarcoidosis, Pulmonary diagnostic imaging
- Abstract
Introduction: Sarcoidosis is a multisystem disease, predominantly affecting the lungs but can involve the heart, resulting in cardiac sarcoidosis (CS). Patients require MRI/Positron Emission Tomography (PET) scans for diagnosis. Echocardiography, ECG and Holter monitoring may be indicative but not diagnostic alone. Patients can present late with conduction defects, heart failure or sudden death. The CASPA (CArdiac Sarcoidosis in PApworth) study protocol aims to (1) use MRI to identify CS prevalence; (2) use speckle-tracking echocardiography, signal averaged ECG and Holter monitoring to look for diagnostic pathways; and (3) identify serum proteins which may be associated with CS., Methods and Analysis: Participants with pulmonary sarcoidosis (and no known cardiac disease) from Royal Papworth Hospital will have the following: cardiac MRI with late gadolinium, two-dimensional transthoracic echocardiography with speckle tracking, signal averaged ECG and 24-hour Holter monitor. They will provide a serum sample for brain natriuretic peptide levels and proteomics by liquid chromatography coupled to high-resolution mass spectrometry. All data will be collected on OpenClinica platform and analysed approximately 6 months after final patient recruitment., Ethics and Dissemination: The Camden & Kings Cross Research Ethics Committee approved the protocol (REC number: 17/LO/0667). Integrated Research Approval System (IRAS) 222 720. Dissemination of findings will be via conference presentations and submitted to peer-reviewed journals., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)
- Published
- 2020
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20. Imaging in Suspected Cardiac Sarcoidosis: A Diagnostic Challenge.
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Ha FJ, Agarwal S, Tweed K, Palmer SC, Adams HS, Thillai M, and Williams L
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- Female, Humans, Male, Cardiomyopathies diagnostic imaging, Contrast Media therapeutic use, Fluorodeoxyglucose F18 metabolism, Magnetic Resonance Imaging methods, Sarcoidosis diagnostic imaging
- Abstract
Cardiac Sarcoidosis (CS) represents a unique diagnostic dilemma. Guidelines have been recently revised to reflect the established role of sophisticated imaging techniques. Trans-thoracic Echocardiography (TTE) is widely adopted for initial screening of CS. Contemporary TTE techniques could enhance detection of subclinical Left Ventricular (LV) dysfunction, particularly LV global longitudinal strain assessment which predicts event-free survival (meta-analysis of 5 studies, hazard ratio 1.28, 95% confidence interval 1.18-1.37, p < 0.0001). However, despite the wide availability of TTE, it has limited sensitivity and specificity for CS diagnosis. Cardiac Magnetic resonance Imaging (CMR) is a crucial diagnostic modality for suspected CS. Presence of late gadolinium enhancement signifies myocardial scar and enables risk stratification. Fluorodeoxyglucose Positron Emission Tomography (FDG-PET) coupled with myocardial perfusion imaging can identify active CS and guide immunosuppressant therapy. Gallium scintigraphy may be considered although FDG-PET is often preferred. While CMR and FDG-PET provide complementary information in CS evaluation, current guidelines do not recommend which imaging modalities are essential in suspected CS and if so, which modality should be performed first. The utility of hybrid imaging combining both advanced imaging modalities in a single scan is currently being explored, although not yet widely available. In view of recent, significant advances in cardiac imaging techniques, this review aims to discuss changes in guidelines for CS diagnosis, the role of various cardiac imaging modalities and the future direction in CS., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)
- Published
- 2020
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21. Catastrophic antiphospholipid syndrome causing ST-segment elevation myocardial infarction with non-obstructive coronary arteries.
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Cranley J, Krishnan U, Tweed K, and Duehmke RM
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- Adrenal Cortex Hormones administration & dosage, Adrenal Cortex Hormones therapeutic use, Adrenal Insufficiency complications, Antiphospholipid Syndrome diagnosis, Antiphospholipid Syndrome drug therapy, Chest Pain diagnosis, Chest Pain etiology, Coronary Angiography methods, Coronary Vessels anatomy & histology, Early Diagnosis, Echocardiography methods, Electrocardiography, Female, Humans, Kidney Diseases pathology, Middle Aged, Myocardial Infarction diagnostic imaging, Myocardial Infarction pathology, Platelet Aggregation Inhibitors administration & dosage, Platelet Aggregation Inhibitors therapeutic use, Thrombosis, Treatment Outcome, Troponin I metabolism, Antiphospholipid Syndrome complications, Coronary Vessels diagnostic imaging, Myocardial Infarction diagnosis, ST Elevation Myocardial Infarction physiopathology
- Abstract
A 51-year-old woman with known primary antiphospholipid syndrome presented with a 4-day history of chest and abdominal pain, inferior ST-segment elevation on a 12-lead ECG and a subtherapeutic international normalised ratio. In view of a significantly raised high-sensitivity troponin I assay, inferior wall hypokinesis on transthoracic echocardiography and despite unobstructed epicardial vessels on emergency coronary angiography, a diagnosis of myocardial infarction was made. Furthermore, the patient also developed both bilateral adrenal haemorrhages leading to acute adrenal insufficiency and microvascular thrombotic renal disease concurrently. The patient therefore fulfilled the diagnostic criteria for catastrophic antiphospholipid syndrome presenting with cardiac, endocrine and renal involvement. Early diagnosis permitted appropriate treatment with anticoagulation, dual antiplatelet therapy, secondary prevention and corticosteroid replacement therapy and led to a full recovery. This case highlights first the importance of adequate anticoagulation in antiphospholipid syndrome and, second, the potentially fatal, multiorgan complication of failure to do so., Competing Interests: Competing interests: None declared., (© BMJ Publishing Group Limited 2019. No commercial re-use. See rights and permissions. Published by BMJ.)
- Published
- 2019
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22. Exposure of patients to ionising radiation during lung cancer diagnostic work-up.
- Author
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Rintoul RC, Atherton R, Tweed K, Yates S, and Chilvers ER
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- Adult, Aged, Aged, 80 and over, Female, Humans, Male, Middle Aged, Neoplasms, Radiation-Induced etiology, Neoplasms, Second Primary etiology, Radiation Dosage, Radiography, Thoracic adverse effects, Retrospective Studies, Lung Neoplasms diagnostic imaging
- Abstract
We examined the dose of radiation received during diagnosis of lung cancer as this may add to the risk of a second primary cancer. Patients undergoing surgery (n=40) or (chemo)radiotherapy (n=40) received comparable doses (28.6 and 25.8 mSv, respectively), significantly higher than that for supportive care (n=40; 15.1 mSv). The effective dose of radiation received was higher for early stage disease than for those with metastatic disease. The mean lifetime attributable risk of malignancy for those receiving treatment with curative intent in our cohort was 0.059%, and lung-specific risk 0.019%., Competing Interests: Competing interests: None declared., (Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.)
- Published
- 2017
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23. Risk factors for fractures and falls in older women with type 2 diabetes mellitus.
- Author
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Patel S, Hyer S, Tweed K, Kerry S, Allan K, Rodin A, and Barron J
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- Absorptiometry, Photon, Aged, Aged, 80 and over, Bone Density, Calcaneus diagnostic imaging, Calcaneus metabolism, Cross-Sectional Studies, Diabetes Mellitus, Type 2 epidemiology, Diabetes Mellitus, Type 2 metabolism, Female, Femur Neck diagnostic imaging, Femur Neck metabolism, Fractures, Bone epidemiology, Fractures, Bone metabolism, Humans, Lumbar Vertebrae diagnostic imaging, Lumbar Vertebrae metabolism, Osteoporosis, Postmenopausal complications, Osteoporosis, Postmenopausal epidemiology, Registries, Retrospective Studies, Risk Factors, Ultrasonography, United Kingdom epidemiology, Accidental Falls statistics & numerical data, Diabetes Mellitus, Type 2 complications, Fractures, Bone etiology
- Abstract
Type 2 diabetes mellitus (DM) is associated with an increased risk of hip fractures despite patients with this condition having normal to high bone mineral density (BMD). Therefore, nonskeletal risk factors may be important in the etiology of fractures in these patients. The aim of this cross-sectional retrospective study was to determine risk factors for falling and fracture in older women with type 2 DM. We randomly recruited 150 women from a community-based diabetes register. They underwent detailed clinical assessment, and BMD was measured by dual-energy X-ray absorptiometry (DXA) and heel quantitative ultrasound (QUS). Mean age was 74 years, mean duration of DM 11 years, mean body mass index 30 kg/m2, and mean HbA1c 7.6%. Mean BMD Z scores were significantly higher than the manufacturer's reference range for all skeletal sites. Previously, 53/150 (35%) of the women had reported a low trauma fracture. The fracture group did not differ significantly from the nonfracture group by age, diabetes-related risk factors or DXA BMD Z scores. However, QUS variables were lower in the fracture group (P = 0.04). A history of one or more falls in the previous 12 months was reported by 61/89 (41%) women. Fallers had a higher vibration perception threshold vs. nonfallers (mean 21.1 vs. 17.6 volts, respectively; P = 0.05). There were no other differences in diabetes or fall-related risk factors. These data suggest that reduced vibration perception (a measure of peripheral neuropathy) is an important risk factor for falling and that QUS, as opposed to DXA, may be a more useful method for fracture risk prediction in older women with type 2 DM. These findings need to be confirmed prospectively.
- Published
- 2008
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24. Fall-related risk factors and osteoporosis in older women referred to an open access bone densitometry service.
- Author
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Patel S, Tweed K, and Chinappen U
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- Absorptiometry, Photon, Aged, Aged, 80 and over, Female, Femoral Neck Fractures etiology, Humans, Osteoporosis, Postmenopausal diagnosis, Risk Factors, Accidental Falls, Bone Density, Fractures, Bone etiology, Osteoporosis, Postmenopausal complications
- Abstract
Objective: Both falls and low bone density are important in the pathogenesis of osteoporotic fractures. Whilst bone density is routinely measured to assess fracture risk, little attention is given to the assessment of fall risk. In this study we have determined the prevalence and explored relationships between fall-related risk factors and osteoporosis in women referred to our open access bone densitometry service., Design: Cross-sectional study., Setting: Teaching hospital in south-west London, UK., Subjects: Older women referred for open access bone densitometry., Measurements: Bone densitometry by dual-energy X-ray absorptiometry and fall risk assessment (visual acuity, ability to do five stand-ups without arm use and ability to perform heel-toe walking)., Results: Data for 558 women seen over an 18 month period were examined. Their mean age was 74.8 years (range 65-93). Fall risk and femoral neck (FN) osteoporosis increased with age, with fall-related risk factors being more prevalent than FN osteoporosis at each tertile of age. Women with both FN osteoporosis and fall-related risk factors ranged from 7% in the youngest tertile to 22% in the oldest tertile. In women with FN osteoporosis, increased fall risk was found in 37% in the youngest tertile, increasing to 63% in the oldest tertile., Conclusions: Fall-related risk factors are common in older women referred for open access bone densitometry. We recommend that both bone density and fall risk assessment, using simple screening tests for falls, are essential to determine fracture risk in older people referred for bone densitometry. Subsequent management to reduce fracture risk should be individualised for each patient.
- Published
- 2005
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25. A detailed lectin analysis of IgG glycosylation, demonstrating disease specific changes in terminal galactose and N-acetylglucosamine.
- Author
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Bond A, Alavi A, Axford JS, Bourke BE, Bruckner FE, Kerr MA, Maxwell JD, Tweed KJ, Weldon MJ, Youinou P, and Hay FC
- Subjects
- Adult, Aged, Aged, 80 and over, Arthritis, Rheumatoid immunology, Arthritis, Rheumatoid metabolism, Glycosylation, Humans, Lectins metabolism, Middle Aged, Oligosaccharides metabolism, Sjogren's Syndrome immunology, Sjogren's Syndrome metabolism, Acetylglucosamine metabolism, Galactose metabolism, Immunoglobulin G metabolism
- Abstract
Serum IgG from rheumatoid arthritis patients contains a decreased number of oligosaccharide structures ending in galactose and thus there is an increase in N-acetylglucosamine as the terminal sugar, compared with healthy individuals. The relationship between these two sugars varies depending on the disease examined: IgG from patients with rheumatoid arthritis, juvenile onset chronic arthritis and Crohn's disease are at one extreme, and exhibit a reciprocal galactose:N-acetylglucosamine relationship, while Sjögren's syndrome and osteoarthritis IgG are at the other extreme, exhibiting a parallel increase in the expression of both galactose and N-acetylglucosamine. These results may occur as a consequence of more than one glycosylation site which is differentially glycosylated, but more likely by changes in the level of bisecting N-acetylglucosamine.
- Published
- 1997
- Full Text
- View/download PDF
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