Publications by authors named "E C A Abeln"

21 Publications

Potentially Inappropriate Medications in a Psychogeriatric Inpatient Ward: An Audit Based on Beers Criteria.

Neurol Ther 2020 Jun 17;9(1):151-157. Epub 2020 Apr 17.

Southern District Health Board, Dunedin, New Zealand.

Introduction: Older adults are often prescribed a high number of medications. Overcoming inaction in health care is difficult but essential to deprescribing potentially inappropriate medications (PIMs). Curbing the use of PIMs is urgent in older adults suffering from psychiatric illness, as cognitive, emotional and psychosocial adversity makes them an especially vulnerable group. We aimed to audit PIM usage and deprescribing in an old-age psychiatry inpatient service of a university-affiliated public hospital.

Methods: The 2015 American Geriatrics Society (AGS) Beers Criteria were used in the present study. Computerized medical records were reviewed for all patients discharged from the Dunedin Public Hospital Inpatient Psychogeriatric Ward during the period January 2017 to December 2017.

Results: During the 1-year study period, 136 patients were discharged from our psychogeriatrics inpatient ward, including 87 women and 49 men, with a mean age of 75.4 ± 8.6 years (range: 59-95). The mean number of medications prescribed per patient at the time of admission was 7.7. At discharge, a mean of 8.9 medications were recorded. Analysis focused on 120 complete patient records. Of the 49 patients with 63 high-risk medications, 16 patients (prescribed 19 high-risk medications) had their high-risk medication stopped, 23 patients (prescribed 24 high-risk medications) had high-risk medications started and 10 (prescribed 20 high-risk medications) had no change to high-risk medications between admission and discharge. In 56 of 120 patients (47%), benzodiazepines (BZDs) were started, stopped or unchanged.

Conclusion: Older adults suffering from severe psychiatric disorders are frequently prescribed PIMs. However, clinical decision-making for this vulnerable population needs to take into account safety as reflected by the Beers Criteria, but also the complexity of managing psychogeriatric problems.
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http://dx.doi.org/10.1007/s40120-020-00188-2DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7229050PMC
June 2020

Surgical Outcomes of Lobular Neoplasia Diagnosed in Core Biopsy: Prospective Study of 316 Cases.

Clin Breast Cancer 2016 12 14;16(6):507-513. Epub 2016 Jun 14.

Allina Health Laboratories, Hospital Pathology Associates HPA, Minneapolis, MN.

Background: Management recommendations for lobular neoplasia (LN) including lobular carcinoma-in-situ (LCIS) and atypical lobular hyperplasia (ALH) diagnosed in core biopsies (CB) are controversial. Our aim was to prospectively identify a subset of patients who do not require subsequent surgical excision (SE).

Patients And Methods: All patients diagnosed with LN on CB were enrolled and referred for SE. Cases with coexistent ductal carcinoma-in-situ or invasive carcinoma were excluded. Cases with coexistent ductal atypia (LN-DA) and LCIS variants (LN-V) were separated from pure classic LN (LN-C). Dedicated breast pathologists and radiologists reviewed cases with careful imaging/pathology correlation.

Results: Of 13,772 total percutaneous breast CB procedures, 302 of 370 patients diagnosed with LN underwent SE. Upgrade to carcinoma was present in 3.5% (8/228) LN-C, 26.7% LN-V (4/15), and 28.3% LN-DA (15/53). Calcifications were the imaging target for 180 (79%) of 228 LN-C cases; 7 were associated with upgrade (3.9%). Upgrades were rare for mass lesions (1/32) and magnetic resonance imaging-targeted lesions (0/14). Upgrades were similar for ALH and LCIS (3.4% vs. 4.5%). During postsurgical follow-up (mean, 34.5 months), 6.5% LN-C patients developed carcinoma in either breast.

Conclusion: Although LN with nonclassic morphology or with associated ductal atypia requires SE, this can be avoided in LN-C diagnosed on CB targeting calcifications when careful imaging/pathology correlation is applied. Until larger numbers are studied, excising LN-C diagnosed as masses or magnetic resonance imaging-detected lesions may be prudent. Regardless of their selection for surgical management, LN patients need close surveillance in view of their long-term risk of breast cancer.
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http://dx.doi.org/10.1016/j.clbc.2016.06.003DOI Listing
December 2016

Molecular diagnostics for the sigatoka disease complex of banana.

Phytopathology 2007 Sep;97(9):1112-8

ABSTRACT The Sigatoka disease complex of banana involves three related ascomycetous fungi, Mycosphaerella fijiensis, M. musicola, and M. eumusae. The exact distribution of these three species and their disease epidemiology remain unclear, because their symptoms and life cycles are rather similar. Disease diagnosis in the Mycosphaerella complex of banana is based on the presence of host symptoms and fungal fruiting structures, which hamper preventive management strategies. In the present study, we have developed rapid and robust species-specific molecular-based diagnostic tools for detection and quantification of M. fijiensis, M. musicola, and M. eumusae. Conventional species-specific polymerase chain reaction (PCR) primers were developed based on the actin gene that detected DNA at as little as 100, 1, and 10 pg/mul from M. fijiensis, M. musicola, and M. eumusae, respectively. Furthermore, TaqMan real-time quantitative PCR assays were developed based on the beta-tubulin gene and detected quantities of DNA as low as 1 pg/mul for each Mycosphaerella sp. from pure cultures and DNA at 1.6 pg/mul per milligram of dry leaf tissue for M. fijiensis that was validated using naturally infected banana leaves.
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http://dx.doi.org/10.1094/PHYTO-97-9-1112DOI Listing
September 2007

Multiple gene genealogies and phenotypic characters differentiate several novel species of Mycosphaerella and related anamorphs on banana.

Persoonia 2008 Jun 21;20:19-37. Epub 2008 Mar 21.

CBS Fungal Biodiversity Centre, Uppsalalaan 8, 3584 CT Utrecht, The Netherlands;

Three species of Mycosphaerella, namely M. eumusae, M. fijiensis, and M. musicola are involved in the Sigatoka disease complex of bananas. Besides these three primary pathogens, several additional species of Mycosphaerella or their anamorphs have been described from Musa. However, very little is known about these taxa, and for the majority of these species no culture or DNA is available for study. In the present study, we collected a global set of Mycosphaerella strains from banana, and compared them by means of morphology and a multi-gene nucleotide sequence data set. The phylogeny inferred from the ITS region and the combined data set containing partial gene sequences of the actin gene, the small subunit mitochondrial ribosomal DNA and the histone H3 gene revealed a rich diversity of Mycosphaerella species on Musa. Integration of morphological and molecular data sets confirmed more than 20 species of Mycosphaerella (incl. anamorphs) to occur on banana. This study reconfirmed the previously described presence of Cercospora apii, M. citri and M. thailandica, and also identified Mycosphaerella communis, M. lateralis and Passalora loranthi on this host. Moreover, eight new species identified from Musa are described, namely Dissoconium musae, Mycosphaerella mozambica, Pseudocercospora assamensis, P. indonesiana, P. longispora, Stenella musae, S. musicola, and S. queenslandica.
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http://dx.doi.org/10.3767/003158508X302212DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2865351PMC
June 2008

Isolation and characterization of the mating type locus of Mycosphaerella fijiensis, the causal agent of black leaf streak disease of banana.

Mol Plant Pathol 2007 Jan;8(1):111-20

Centro de Investigación Científica de Yucatán (CICY), Calle 43 no. 130, Chuburná de Hidalgo, C.P. 97200, Mérida, Yucatán, México.

SUMMARY Idiomorphs mat1-1 and mat1-2 from Mycosphaerella fijiensis, the causal agent of black leaf streak disease of banana, were isolated. Degenerate oligos were used to amplify the HMG box of the mat1-2 idiomorph from M. fijiensis, showing homology with the HMG box of Mycosphaerella graminicola. Using a DNA walking strategy, anchored on the DNA lyase gene towards the HMG box, a 9-kb-long region of mat1-2 was obtained. A 5-kb fragment from the mat1-1 region was obtained by long-range PCR using primers on the flanking regions, which have close to 100% identity between both idiomorphs. High-identity (77-89%), inverted regions within both idiomorphs were found, which suggest unique inversion events, which have not been found before, and that could have been significant in the evolution of this species. The predicted genes showed the conserved introns in both idiomorphs as well as an additional intron within the alpha box. The implications for the evolution of species in the Mycosphaerella complex on banana are discussed.
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http://dx.doi.org/10.1111/j.1364-3703.2006.00376.xDOI Listing
January 2007