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2. Feasibility of dynamic chest radiography to calculate lung volumes in adult people with cystic fibrosis: a pilot study

Author

Matthew Shaw, Thomas Simon FitzMaurice, Paul Stephen McNamara, Dilip Nazareth, Caroline McCann, Martin Walshaw, and Scott Hawkes

Subjects
Medicine, Diseases of the respiratory system, RC705-779
Abstract

Introduction Dynamic chest radiography (DCR) is a novel, low-dose, real-time digital imaging system where software identifies moving thoracic structures and can automatically calculate lung areas. In an observational, prospective, non-controlled, single-centre pilot study, we compared it with whole-body plethysmography (WBP) in the measurement of lung volume subdivisions in people with cystic fibrosis (pwCF).Methods Lung volume subdivisions were estimated by DCR using projected lung area (PLA) during deep inspiration, tidal breathing and full expiration, and compared with same-day WBP in 20 adult pwCF attending routine review. Linear regression models to predict lung volumes from PLA were developed.Results Total lung area (PLA at maximum inspiration) correlated with total lung capacity (TLC) (r=0.78, p

Published
2023
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3. Surveillance towards preventing paediatric incidence of respiratory syncytial virus attributable respiratory tract infection in primary and secondary/tertiary healthcare settings in Merseyside, Cheshire and Bristol, UK

Author

Adam Finn, David Lewis, James Dodd, Matthew Taylor, Maia Lesosky, Paul Stephen McNamara, Helen Hill, Emma Carter, Kelly Davies, Fred Fyles, Carla Solorzano, Daniela M Ferreira, Gregory Duncan, Lauren McLellan, Mathieu Bangert, Natalya Vassilouthis, and Andrea M Collins

Subjects
Medicine, Diseases of the respiratory system, RC705-779
Abstract

Introduction Respiratory syncytial virus (RSV) is a common respiratory virus, particularly affecting children, and can cause respiratory infections such as croup and bronchiolitis. The latter is a leading cause of paediatric hospitalisation within the UK. Children

Published
2023
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4. Utility and validity of dynamic chest radiography in cystic fibrosis (dynamic CF): an observational, non-controlled, non-randomised, single-centre, prospective study

Author

Matthew Shaw, Thomas Simon FitzMaurice, Paul Stephen McNamara, Dilip Nazareth, Caroline McCann, Ram Bedi, and Martin Walshaw

Subjects
Medicine, Diseases of the respiratory system, RC705-779
Abstract

Introduction Dynamic chest radiography (DCR) uses novel, low-dose radiographic technology to capture images of the thoracic cavity while in motion. Pulmonary function testing is important in cystic fibrosis (CF). The tolerability, rapid acquisition and lower radiation and cost compared with CT imaging may make DCR a useful adjunct to current standards of care.Methods and analysis This is an observational, non-controlled, non-randomised, single-centre, prospective study. This study is conducted at the Liverpool Heart and Chest Hospital (LHCH) adult CF unit. Participants are adults with CF. This study reviews DCR taken during routine CF Annual Review (n=150), validates DCR-derived lung volumes against whole body plethysmography (n=20) and examines DCR at the start and end of pulmonary exacerbations of CF (n=20). The primary objectives of this study are to examine if DCR provides lung function information that correlates with PFT, and lung volumes that correlate whole body plethysmography.Ethics and dissemination This study has received the following approvals: HRA REC (11 December 2019) and LHCH R&I (11 October 2019). Results are made available to people with CF, the funders and other researchers. Processed, anonymised data are available from the research team on request.Trial registration number ISRCTN 64994816.

Published
2020
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5. Feasibility of dynamic chest radiography to calculate lung volumes in adult people with cystic fibrosis: a pilot study

Author

Thomas Simon FitzMaurice, Caroline McCann, Dilip Nazareth, Scott Hawkes, Matthew Shaw, Paul Stephen McNamara, and Martin Walshaw

Subjects
Pulmonary and Respiratory Medicine
Abstract

IntroductionDynamic chest radiography (DCR) is a novel, low-dose, real-time digital imaging system where software identifies moving thoracic structures and can automatically calculate lung areas. In an observational, prospective, non-controlled, single-centre pilot study, we compared it with whole-body plethysmography (WBP) in the measurement of lung volume subdivisions in people with cystic fibrosis (pwCF).MethodsLung volume subdivisions were estimated by DCR using projected lung area (PLA) during deep inspiration, tidal breathing and full expiration, and compared with same-day WBP in 20 adult pwCF attending routine review. Linear regression models to predict lung volumes from PLA were developed.ResultsTotal lung area (PLA at maximum inspiration) correlated with total lung capacity (TLC) (r=0.78, pConclusionDCR is a promising new technology that can be used to estimate lung volume subdivisions. Plausible correlations between plethysmographic lung volumes and DCR lung areas were identified. Further studies are needed to build on this exploratory work in both pwCF and individuals without CF.Trial registration numberISRCTN64994816.

Published
2023
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6. Atmospheric particle abundance and sea salt aerosol observations in the springtime Arctic: a focus on blowing snow and leads

Author

Qianjie Chen, Jessica Mirrielees, Sham Thanekar, Nicole Loeb, Rachel Kirpes, Lucia Upchurch, Anna Barget, Nurun Lata, Angela Raso, Stephen McNamara, Swarup China, Patricia Quinn, Andrew Ault, Aaron Kennedy, Paul Shepson, Jose Fuentes, and Kerri Pratt

Subjects
human activities
Abstract

Sea salt aerosols play an important role in the radiation budget and atmospheric composition over the Arctic, where the climate is rapidly changing. Previous observational studies have shown Arctic sea ice leads to be an important source of sea salt aerosols, and modeling efforts have also proposed blowing snow sublimation as a source. In this study, size-resolved atmospheric particle number concentrations and chemical composition were measured at the Arctic coastal tundra site of Utqiaġvik, Alaska during spring (April 3 – May 7, 2016). Blowing snow conditions were observed during 25 % of the five-week study period and were over-predicted by a commonly used blowing snow parameterization based solely on wind speed and temperature. Throughout the study, open leads were present locally. During periods when blowing snow was observed, significant increases in the number concentrations of 0.01–0.06 μm particles (factor of six, on average) and 0.06–0.3 μm particles (67 %, on average), and a significant decrease (82 %, on average) in 1–4 μm particles, were observed, compared to low wind speed periods. These size distribution changes were likely caused by the generation of ultrafine particles from leads and/or blowing snow, with scavenging of supermicron particles by blowing snow. At elevated wind speeds, both submicron and supermicron sodium and chloride mass concentrations were enhanced, consistent with wind-dependent local sea salt aerosol production. At moderate wind speeds below the threshold for blowing snow, as well as during observed blowing snow, individual sea spray aerosol particles were measured. These individual salt particles were enriched in calcium relative to sodium in seawater, due to the binding of this divalent cation with organic matter in the sea surface microlayer and subsequent enrichment during seawater bubble bursting. The chemical composition of the surface snowpack also showed contributions from sea spray aerosol deposition. Overall, these results show the contribution of sea spray aerosol production from leads on both aerosols and the surface snowpack. Therefore, if blowing snow sublimation contributed to the observed sea salt aerosol, the snow being sublimed must have been impacted by sea spray aerosol deposition, rather than upward brine migration through the snowpack. Sea spray aerosol production from leads is expected to increase, with thinning and fracturing of sea ice in the rapidly warming Arctic.

Published
2022

11. Correlation of Planned Dose to Area Postrema and Dorsal Vagal Complex with Clinical Symptoms of Nausea and Vomiting in Oropharyngeal Cancer (OPC) patients treated with radiation alone using IMRT

Author

Stephen McNamara, Sandra Fontenla, Tony J. C. Wang, Patrick McCann, Robert J. Young, Nancy Y. Lee, James Mechalakos, and Shyam Rao

Subjects
Chemotherapy, business.industry, Nausea, medicine.medical_treatment, Cancer, medicine.disease, Asymptomatic, Article, Radiation therapy, Planned Dose, Anesthesia, Vomiting, Medicine, medicine.symptom, business, Complication
Abstract

This study aimed to correlate planned dose to the nausea center (NC)—area postrema (AP) and dorsal vagal complex (DVC)—with nausea and vomiting symptoms in oropharyngeal cancer (OPC) patients treated with intensity-modulated radiation therapy (IMRT) without chemotherapy. We also investigated whether it was possible to reduce doses to the NC without significant degradation of the clinically accepted treatment plan. From November 2004 to April 2009, 37 OPC patients were treated with definitive or adjuvant IMRT without chemotherapy. Of these, only 23 patients had restorable plans and were included in this analysis. We contoured the NC with the assistance of an expert, board-certified neuroradiologist. We searched for correlation between the delivered dose to the NC and patient-reported nausea and vomiting during IMRT. We used one-paired two-sample t test assuming equal variances to compare differences in dose to NC between symptomatic and asymptomatic patients. We then replanned each case to determine if reduced dose to the NC could be achieved without compromising coverage to target volumes, increasing unwarranted hotspots, or increasing dose to surrounding critical normal tissues. Acute symptoms of nausea were as follows: grade 0 (n = 6), grade 1 (n = 13), grade 2 (n = 3), and grade 3 (n = 1). Patients with no complaints of nausea had a median dose to the DVC of 34.2 Gy (range 4.6–46.6 Gy) and AP of 32.6 Gy (range 7.0–41.4 Gy), whereas those with any complaints of nausea had a median DVC dose of 40.4 Gy (range 19.3–49.4 Gy) and AP dose of 38.7 Gy (range 16.7–46.8 Gy) (p = 0.04). Acute vomiting was as follows: grade 0 (n = 17), grade 1 (n = 4), grade 2 (n = 1), and grade 3 (n = 1). There was no significant difference in DVC or AP dose among those with and without vomiting symptoms (p = 0.28). Upon replanning of each case to minimize dose to the NC, we were, on average, able to reduce the radiation dose to AP by 18 % and DVC by 17 %, while the average dose variations to the planning target volume (PTV) coverage, brainstem, cord, temporal lobes, and cochlea were never greater than 3 %. Hotspots increased by 2 % for three patients while hotspots for the remaining patients were less than 2 % variation. For OPC cancer patients treated with IMRT without chemotherapy, dose to AP and DVC may be associated with development of nausea. We were able to show that reducing doses substantially to the NC is achievable without significant alteration of the clinically accepted plan and may reduce the incidence and grade of nausea. As symptoms of nausea can be devastating to patients, one can consider routine contouring and constraining of the NC to minimize chances of having this complication.

Published
2017

12. Clinical practice considerations in facioscapulohumeral muscular dystrophy Sydney, Australia, 21 September 2015

Author

Rabi Tawil, Jean K. Mah, Scott Baker, Kathryn R. Wagner, Monique M. Ryan, Alistair Corbett, Baziel van Engelen, Stephen McNamara, John Rasko, Veena Raykar, Sabrina Sacconi, Stephen J. Tapscott, and Alan Watts

Subjects
0301 basic medicine, medicine.medical_specialty, Best practice, Alternative medicine, Disease, 03 medical and health sciences, 0302 clinical medicine, medicine, Facioscapulohumeral muscular dystrophy, Humans, Muscular dystrophy, Reference standards, Genetics (clinical), business.industry, Australia, medicine.disease, Disorders of movement Donders Center for Medical Neuroscience [Radboudumc 3], Muscular Dystrophy, Facioscapulohumeral, Clinical neurology, Clinical Practice, 030104 developmental biology, Neurology, Pediatrics, Perinatology and Child Health, Physical therapy, Neurology (clinical), business, 030217 neurology & neurosurgery
Abstract

• Best practice molecular diagnostic reference standards require international collaboration.

Published
2016

14. Paradoxical abdominal wall movement in bilateral diaphragmatic paralysis

Author

G. Michael Halmagyi, Stephen McNamara, Rebekah M. Ahmed, and Simon C. Gandevia

Subjects
Male, Palsy, business.industry, Abdominal Wall, Diaphragmatic breathing, General Medicine, Middle Aged, Diaphragmatic paralysis, Respiratory paralysis, Respiratory Paralysis, Abdominal wall, Phrenic Nerve, Radiography, medicine.anatomical_structure, Anesthesia, Breathing, Paralysis, medicine, Humans, Neurology (clinical), medicine.symptom, business, Phrenic nerve
Abstract

A 56-year-old man gave a 6-month history of progressive dyspnoea and orthopnoea. During breathing, his abdominal muscles showed paradoxical movement and he rapidly and reproducibly developed difficulty breathing when lying supine. The most likely explanation was severe weakness or paralysis of both hemidiaphragms. This was confirmed with electrophysiology and ultrasonography. Extensive investigation identified no underlying cause, suggesting this is a case of bilateral isolated phrenic neuropathy. We present a video showing how easily bilateral diaphragmatic palsy can be detected clinically through identifying paradoxical abdominal wall movement.

Published
2012

16. CONTRIBUTORS

Author

Judith A. Aberg, Amy P. Abernethy, Janet L. Abrahm, Michael Adolph, Michael Aherne, K. Allsopp, Rogelio Altisent, Carmen Fernandez Alvarez, Pablo Amigo, Wendy G. Anderson, Sik Kim Ang, Tiziana Antonelli, John Armstrong, Wendy S. Armstrong, Robert M. Arnold, Pilar Arranz, Koen Augustyns, Isabel Barreiro-Meiro Sáenz-Diez, Pilar Barreto, Debra Barton, Ursula Bates, Maria B. Fernandez-Creuchet Santos, Jacinto Bátiz, Costantino Benedetti, Nabila Bennani-Baiti, Michael I. Bennett, Kevin Berger, Mamta Bhatnagar, Lesley Bicanovsky, Lynda Blue, Barton Bobb, Jean-Jacques Body, Gian Domenico Borasio, Claudia Borreani, Federico Bozzetti, Valentina Bozzetti, Jason Braybrooke, William Breitbart, Barry Bresnihan, Bert Broeckaert, Eduardo Bruera, Kay Brune, Bradley Buckhout, Phyllis N. Butow, Ira Byock, Anthony Byrne, Clare Byrne, Beryl E. Cable-Williams, Sarah E. Callin, David Casarett, David Casper, Eric J. Cassell, Barrie Cassileth, Emanuele Castagno, Carlos Centeno, Walter Ceranski, Lucas Ceulemans, Meghna Chadha, Bruce H. Chamberlain, Eric L. Chang, Victor T. Chang, Harvey Max Chochinov, Edward Chow, Grace Christ, Katherine Clark, Stephen Clarke, Josephine M. Clayton, James F. Cleary, Lawrence J. Clein, Katri Elina Clemens, Libby Clemens, Robert Colebunders, Steven R. Connor, Viviane Conraads, Colm Cooney, Massimo Costantini, Azucena Couceiro, Holly Covington, John D. Cowan, Patrick Coyne, Garnet Crawford, Brian Creedon, Hilary Cronin, Garret Cullen, Jennifer E. Cummings, David C. Currow, Paul J. Daeninck, Pamela Dalinis, Prajnan Das, Mellar P. Davis, Sara N. Davison, Catherine Deamant, Liliana de Lima, Conor P. Delany, Peter Demeulenaere, Lena Dergham, Noël Derycke, Rajeev Dhupar, Mario Dicato, Edwin D. Dickerson, Andrew Dickman, Maria Dietrich, Pamela Dixon, Philip C. Dodd, James T. D'Olimpio, Per Dombernowsky, Michael Dooley, Deborah Dudgeon, Geoffrey P. Dunn, David Dunwoodie, Jane Eades, Badi El Osta, Katja Elbert-Avila, John Ellershaw, Bassam Estfan, Louise Exton, Alysa Fairchild, Matthew Farrelly, Konrad Fassbender, Jason Faulhaber, Kenneth C.H. Fearon, Lynda E. Fenelon, Peter F. Ferson, Petra Feyer, Marilene Filbet, Pam Firth, Susan F. FitzGerald, Hugh D. Flood, Francesca Crippa Floriani, Paul J. Ford, Barry Fortner, Darlene Foth, Bridget Fowler, Karen Frame, Thomas G. Fraser, Fred Frost, Michael J. Fulham, Pierre R. Gagnon, Lisa M. Gallagher, Maureen Gambles, Subhasis K. Giri, Paul Glare, Cynthia R. Goh, Xavier Gómez-Batiste, Leah Gramlich, Luigi Grassi, Phyllis A. Grauer, Claire Green, Gareth Griffiths, Yvona Griffo, Hunter Groninger, David A. Gruenewald, Jyothirmai Gubili, Terence L. Gutgsell, Elizabeth Gwyther, Paul S. Haber, Achiel Haemers, Mindi C. Haley, Mazen A. Hanna, Janet R. Hardy, Jodie Haselkorn, Katherine Hauser, Cathy Heaven, Michael Herman, Jørn Herrstedt, Stephen Higgins, Irene J. Higginson, Joanne M. Hilden, Kathryn L. Hillenbrand, Burkhard Hinz, Jade Homsi, Kerry Hood, Juliet Y. Hou, Guy Hubens, Peter Hudson, John G. Hughes, John Hunt, Craig A. Hurwitz, James Ibinson, Nora Janjan, Birgit Jaspers, Thomas Jehser, A. Mark Joffe, Laurence John, Jennie Johnstone, J. Stephen Jones, Javier R. Kane, Matthew T. Karafa, Andrew P. Keaveny, Dorothy M.K. Keefe, Catherine McVearry Kelso, Rose Anne Kenny, Martina Kern, Dilara Seyidova Khoshknabi, Jordanka Kirkova, Kenneth L. Kirsh, David W. Kissane, Eberhard Klaschik, Seref Komurcu, Kandice Kottke-Marchant, Kathryn M. Kozell, Sunil Krishnan, Deborah Kuban, Damian A. Laber, Ruth L. Lagman, Rajesh V. Lalla, Deforia Lane, Philip J. Larkin, Wael Lasheen, Peter Lawlor, Susan B. LeGrand, Vincent Lens, Dona Leskuski, Pamela Levack, Marcia Levetown, Jeanne G. Lewandowski, William R. Lewis, S. Lawrence Librach, Wendy G. Lichtenthal, J. Norelle Lickiss, Stefano Lijoi, Edward Lin, Arthur G. Lipman, Jean-Michel Livrozet, Mari Lloyd-Williams, Richard M. Logan, Francisco López-Lara Martín, Charles L. Loprinzi, John Loughnane, Michael Lucey, Laurie Lyckholm, Carol Macmillan, Frances Mair, Stephen N. Makoni, Bushra Malik, Kevin Malone, Marco Maltoni, Aruna Mani, Lucille R. Marchand, Darren P. Mareiniss, Anna L. Marsland, Joan Marston, Julia Romero Martinez, Isabel Martínez de Ubago, Lina M. Martins, Timothy S. Maughan, Catriona Mayland, Susan E. McClement, Ian McCutcheon, Michael F. McGee, Neil McGill, Stephen McNamara, Mary Lynn McPherson, Henry McQuay, Regina McQuillan, Robert E. McQuown, Michelle Meiring, Sebastiano Mercadante, Elaine C. Meyer, Randy D. Miller, Yvonne Millerick, Roberto Miniero, Armin Mohamed, Busi Mooka, Helen M. Morrison, J. Cameron Muir, Fiona Mulcahy, Hugh E. Mulcahy, Monica Muller, H. Christof Müller-Busch, Scott A. Murray, Friedemann Nauck, Katherine Neasham, Busisiwe Nkosi, Simon Noble, Antonio Noguera, Anna K. Nowak, Juan Nuñez-Olarte, Eugenie A.M.T. Obbens, Tony O'Brien, Megan Olden, Norma O'Leary, David Oliver, David Oliviere, Aurelius G. Omlin, Kaci Osenga, Diarmuid O'Shea, Christophe Ostgathe, Faith D. Ottery, Michel Ouellette, Edgar Turner Overton, Moné Palacios, Robert Palmer, Teresa Palmer, Carmen Paradis, Armida G. Parala, Antonio Pascual-López, Steven D. Passik, Timothy M. Pawlik, Malcolm Payne, Sheila Payne, Silvia Paz, José Pereira, George Perkins, Karin Peschardt, Hayley Pessin, Douglas E. Peterson, Vinod K. Podichetty, Robin Pollens, Eliza Pontifex, Susan Poole, Josep Porta-Sales, Graeme Poston, Ruth D. Powazki, William Powderly, Leopoldo Pozuelo, Eric Prommer, Christina M. Puchalski, Lukas Radbruch, David F.J. Raes, Jane Read, Anantha Reddy, Steven I. Reger, Susan J. Rehm, Stephen G. Reich, Javier Rocafort, Adam Rosenblatt, Cynda Hylton Rushton, K. Mitchell Russell, Karen Ryan, Lisa A. Rybicki, Paola Sacerdote, Vinod Sahgal, Mary Ann Sammon, Dirk Sandrock, Mark Sands, Denise L. Schilling, Valerie Nocent Schulz, Lisa N. Schum, Peter Selwyn, Joshua Shadd, Charles L. Shapiro, Aktham Sharif, Helen M. Sharp, Kirk V. Shepard, J. Timothy Sherwood, Nabin K. Shrestha, Richard J.E. Skipworth, Howard S. Smith, Mildred Z. Solomon, Diego Soto de Prado Otero, Denise Wells Spencer, Ron Spice, David Spiegel, Manish Srivastava, John N. Staffurth, Randall Starling, Grant D. Stewart, Jan Stjernswärd, Florian Strasser, Edna Strauss, Imke Strohscheer, Brett Taylor Summey, Graham Sutton, Nigel P. Sykes, Alan J. Taege, Marcello Tamburini, Yoko Tarumi, Davide Tassinari, Martin H.N. Tattersall, Karl S. Theil, Keri Thomas, Adrian Tookman, María P. Torrubia, Anna Towers, Daphne Tsoi, Rodney O. Tucker, James A. Tulsky, Rachel A. Tunick, Claire Turner, Martha L. Twaddle, Marie Twomey, Christina Ullrich, Catherine E. Urch, Mary L.S. Vachon, Bart Van den Eynden, Antonio Vigano, Erika Vlieghe, Angelo E. Volandes, Raymond Voltz, Paul W. Walker, Sharon Watanabe, Michael A. Weber, Elizabeth Weinstein, Sharon M. Weinstein, Kathryn L. Weise, Sherri Weisenfluh, John Welsh, Clare White, Donna M. Wilson, Joanne Wolfe, Tugba Yavuzsen, Albert J.M. Yee, Lisa M. Yerian, and Elena Zucchetti

Published
2009
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