Publications by authors named "Glenn Taylor"

70 Publications

Registered Nurses' experiences of psychological well-being and ill-being in their first year of practice: A qualitative meta-synthesis.

J Adv Nurs 2021 Mar 12;77(3):1172-1187. Epub 2020 Dec 12.

Department of Nursing, Melbourne School of Health Sciences, The University of Melbourne, Carlton, Vic., Australia.

Aim: To synthesize Registered Nurses' self-reported perceptions and experiences of psychological well-being and ill-being during their first year of practice.

Design: Qualitative meta-synthesis.

Data Sources: Databases included Cumulative Index of Nursing and Allied Health Literature, Excerpta Medica database, Medical Literature Analysis and Retrieval System Online and Psychological Information. Qualitative studies were considered for inclusion if published in English, from 2009-2019, reporting primary data analysis including psychological well-being and ill-being experiences of graduate nurses in first year of practice.

Review Methods: Qualitative studies were systematically identified and critically appraised. A meta-synthesis was applied using an open card sort technique to organize empirical data into a matrix of graduate nurses' voices of psychological well-being and ill-being.

Results: Twenty-two studies were included. Analysis revealed patterns of positive experiences and emotions. These included feeling valued and part of the team and learning from and feeling supported by other nurses. Negative experiences and emotions such as feeling overwhelmed, stressed, alone and inadequately prepared were also identified.

Conclusion: Graduate nurses' perceptions and experiences of their psychological well-being and ill-being revealed both positive and negative dimensions during this transition period. Specific examples of strategies that may promote transition nurses' well-being and prevent ill-being were identified such as social connection and support.

Impact: Increasing the numbers of new nursing graduates world-wide is required to strengthen health systems. Developing strategies to retain these graduates in the workforce is paramount. This review found some graduate nurses experience the transition period as a time of personal growth and fulfilment, for others this period was a stressor. These findings were illustrated in a model of 'ways to well-being'. The potential for knowledge translation of this model extends from graduate nurses as individuals, to nurse entry to practice programs and graduate nurse programs, to organizational policy targeting future health workforce.

Systematic Review Registration Number: CRD42020148812.
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http://dx.doi.org/10.1111/jan.14667DOI Listing
March 2021

Discriminative Multiple Instance Hyperspectral Target Characterization.

IEEE Trans Pattern Anal Mach Intell 2018 10 26;40(10):2342-2354. Epub 2017 Sep 26.

In this paper, two methods for discriminative multiple instance target characterization, MI-SMF and MI-ACE, are presented. MI-SMF and MI-ACE estimate a discriminative target signature from imprecisely-labeled and mixed training data. In many applications, such as sub-pixel target detection in remotely-sensed hyperspectral imagery, accurate pixel-level labels on training data is often unavailable and infeasible to obtain. Furthermore, since sub-pixel targets are smaller in size than the resolution of a single pixel, training data is comprised only of mixed data points (in which target training points are mixtures of responses from both target and non-target classes). Results show improved, consistent performance over existing multiple instance concept learning methods on several hyperspectral sub-pixel target detection problems.
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http://dx.doi.org/10.1109/TPAMI.2017.2756632DOI Listing
October 2018

Comparison of Immune Profiles in Fetal Hearts with Idiopathic Dilated Cardiomyopathy, Maternal Autoimmune-Associated Dilated Cardiomyopathy and the Normal Fetus.

Pediatr Cardiol 2016 Feb 20;37(2):353-63. Epub 2015 Oct 20.

Department of Pathology, Mount Sinai Hospital, Toronto, ON, Canada.

The etiology of idiopathic dilated cardiomyopathy (iDCM) remains unknown. Immune therapies have improved outcome in fetuses with DCM born to mothers with autoimmune disease (aDCM). The purpose of this retrospective study was to compare the myocardial B and T cell profiles in fetuses and neonates with idiopathic DCM (iDCM) versus autoimmune-mediated DCM (aDCM) and to describe the normal cell maturation within the human fetal myocardium. Of 60 fetal autopsy cases identified from institutional databases, 10 had aDCM (18-38 weeks), 12 iDCM (19-37 weeks) and 38 had normal hearts (11-40 weeks). Paraffin-embedded myocardium sections were stained for all lymphocyte (CD45), B cells (CD20, CD79a), T cells (CD3, CD4, CD7, CD8) and monocyte (CD68) surface markers. Two independent, blinded cell counts were performed. Normal hearts expressed all B and T cell markers in a bimodal fashion, with peaks at 22 and 37 weeks of gestation. The aDCM cohort was most distinct from normal hearts, with less overall T cell markers [EST -9.1 (2.6) cells/mm(2), p = 0.001], CD4 [EST -2.0 (0.6), p = 0.001], CD3 [EST -3.9 (1.0), p < 0.001], CD7 [EST -3.0 (1.1), p = 0.01] overall B cell markers [EST -4.9 (1.8), p = 0.01] and CD79a counts [EST -2.3 (0.9), p = 0.01]. The iDCM group had less overall B cell markers [EST -4.0 (1.8), p = 0.03] and CD79a [EST -1.7 (0.9), p = 0.05], but no difference in T cell markers. Autoimmune-mediated DCM fetuses have less B and T cell markers, whereas iDCM fetuses have less B cell markers compared with normal fetal hearts. The fetal immune system may play a role in the normal development of the heart and evolution of dilated cardiomyopathy.
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http://dx.doi.org/10.1007/s00246-015-1284-4DOI Listing
February 2016

Hobnail Hemangioma (Superficial Hemosiderotic Lymphovascular Malformation) in Children: A Series of 6 Pediatric Cases and Review of the Literature.

J Cutan Med Surg 2016 May 16;20(3):216-20. Epub 2015 Oct 16.

Division of Pediatric Dermatology, Hospital for Sick Kids, Toronto, Canada.

Background: Hobnail hemangioma is a small benign vascular malformation of the superficial and mid-dermis with variable clinical presentation.

Objectives: To review the clinical characteristics of hobnail hemangioma in pediatric patients.

Methods: A retrospective chart review performed of all histopathologically confirmed cases of hobnail hemangioma from May 2000 to December 2014. Data on demographics, clinical characteristics, and results of immunohistochemical staining were collected.

Results: Four male and 2 female patients identified. Congenital lesions were reported in 3 cases. The most common anatomic location was the extremities. Treatment options included observation and surgical excision.

Conclusions: Hobnail hemangioma is an uncommon benign vascular malformation. Due to its benign nature, treatment is not required. If treatment is indicated, complete surgical excision appears to be the most effective option.
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http://dx.doi.org/10.1177/1203475415612421DOI Listing
May 2016

Russian roulette with unlicensed fat-burner drug 2,4-dinitrophenol (DNP): evidence from a multidisciplinary study of the internet, bodybuilding supplements and DNP users.

Subst Abuse Treat Prev Policy 2015 Oct 14;10:39. Epub 2015 Oct 14.

Faculty of Science, Engineering and Computing, Kingston University London, Penrhyn Road, Kingston upon Thames, Surrey, KT1 2EE, United Kingdom.

Background: 2,4-Dinitrophenol (DNP) poses serious health-risks to humans. The aims of this three-stage multidisciplinary project were, for the first time, to assess the risks to the general public from fraudulent sale of or adulteration/contamination with DNP; and to investigate motives, reasons and risk-management among DNP-user bodybuilders and avid exercisers.

Methods: Using multiple search-engines and guidance for Internet research, online retailers and bodybuilding forums/blogs were systematically explored for availability of DNP, advice offered on DNP use and user profiles. Ninety-eight pre-workout and weight-loss supplements were purchased and analysed for DNP using liquid-chromatography-mass-spectrometry. Psychosocial variables were captured in an international sample of 35 DNP users (26.06 ± 6.10 years, 94.3 % male) with an anonymous, semi-qualitative self-reported survey.

Results: Although an industrial chemical, evidence from the Internet showed that DNP is sold 'as is', in capsules or tablets to suit human consumption, and is used 'uncut'. Analytical results confirmed that DNP is not on the supplement market disguised under fictitious supplement names, but infrequently was present as contaminant in some supplements (14/98) at low concentration (<100mcg/kg). Users make conscious and 'informed' decisions about DNP; are well-prepared for the side-effects and show nonchalant attitude toward self-experimentation with DNP. Steps are often taken to ensure that DNP is genuine. Personal experience with performance- and appearance enhancing substances appears to be a gateway to DNP. Advice on DNP and experiences are shared online. The significant discrepancy between the normative perception and the actual visibility suggests that DNP use is-contrary to the Internet accounts-a highly concealed and lonesome activity in real life. Positive experiences with the expected weight-loss prevail over the negative experiences from side effects (all but two users considered using DNP again) and help with using DNP safely is considered preferable over scare-tactics.

Conclusion: Legislation banning DNP sale for human consumption protects the general public but DNP is sold 'as is' and used 'uncut' by determined users who are not dissuaded from experimenting with DNP based on health threats. Further research with stakeholders' active participation is imperative for targeted, proactive public health policies and harm-reduction measures for DNP, and other illicit supplements.
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http://dx.doi.org/10.1186/s13011-015-0034-1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4607104PMC
October 2015

An immunosuppressed child with lesions on the scalp.

J Paediatr Child Health 2015 Sep;51(9):936-8

Division of Pathology, The Hospital for Sick Children and University of Toronto, Toronto, Ontario, Canada.

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http://dx.doi.org/10.1111/jpc.12585DOI Listing
September 2015

Combined hereditary and somatic mutations of replication error repair genes result in rapid onset of ultra-hypermutated cancers.

Nat Genet 2015 Mar 2;47(3):257-62. Epub 2015 Feb 2.

1] Program in Genetics and Genome Biology, The Hospital for Sick Children, Toronto, Ontario, Canada. [2] The Arthur and Sonia Labatt Brain Tumour Research Centre, The Hospital for Sick Children, Toronto, Ontario, Canada. [3] Division of Hematology/Oncology, The Hospital for Sick Children, Toronto, Ontario, Canada. [4] Department of Pediatrics, University of Toronto, Ontario, Canada.

DNA replication-associated mutations are repaired by two components: polymerase proofreading and mismatch repair. The mutation consequences of disruption to both repair components in humans are not well studied. We sequenced cancer genomes from children with inherited biallelic mismatch repair deficiency (bMMRD). High-grade bMMRD brain tumors exhibited massive numbers of substitution mutations (>250/Mb), which was greater than all childhood and most cancers (>7,000 analyzed). All ultra-hypermutated bMMRD cancers acquired early somatic driver mutations in DNA polymerase ɛ or δ. The ensuing mutation signatures and numbers are unique and diagnostic of childhood germ-line bMMRD (P < 10(-13)). Sequential tumor biopsy analysis revealed that bMMRD/polymerase-mutant cancers rapidly amass an excess of simultaneous mutations (∼600 mutations/cell division), reaching but not exceeding ∼20,000 exonic mutations in <6 months. This implies a threshold compatible with cancer-cell survival. We suggest a new mechanism of cancer progression in which mutations develop in a rapid burst after ablation of replication repair.
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http://dx.doi.org/10.1038/ng.3202DOI Listing
March 2015

The distribution and frequency of pulmonary neuroendocrine cells in Down syndrome fetal lungs.

Fetal Pediatr Pathol 2014 Jun;33(3):157-65

1Arcispedale S.Maria Nuova , Reggio Emilia , Italy.

The pulmonary neuroendocrine cells (PNEC) are located in the epithelial lining of the airways and consist of solitary neuroendocrine cells (NEC) and NEC clusters, the neuroepithelial bodies (NEB). During fetal life, PNEC are the first to differentiate within the primitive airway epithelium, and bombesin expression favors branching of the respiratory tree. We investigated PNEC in Down syndrome (DS), where the lungs often show enlarged and reduced number of alveoli. Immunohistochemistry for bombesin and synaptophysin, PNEC markers, was evaluated in fetal lungs from 15 cases of DS and 11 age-matched controls from the 17th to 23rd week of gestation. Morphometric analysis assessed PNEC in the mucosal lining of each lung, expressed as number/mm. Nonparametric Mann-Whitney U test showed no statistical difference in frequency of PNEC in DS and controls. Our findings suggest that, at least in late second trimester, the distribution and frequency of PNEC in DS fetuses is not altered.
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http://dx.doi.org/10.3109/15513815.2014.886001DOI Listing
June 2014

Congenital infantile fibrosarcoma: review of imaging features.

Pediatr Radiol 2014 Sep 6;44(9):1124-9. Epub 2014 Apr 6.

Department of Diagnostic Imaging, McMaster University Medical Centre and McMaster University, Hamilton, ON, Canada.

Background: Fibrosarcoma is a rare tumor in children with limited information on imaging features of these tumors in the literature.

Objective: To retrospectively review the imaging features of histologically proven congenital infantile fibrosarcoma.

Materials And Methods: The list of histologically confirmed congenital infantile fibrosarcomas between November 1999 and June 2013 was obtained from the oncology-pathology database. Imaging features and pathology reports of these tumors were reviewed. Patient charts were reviewed and clinical features, management and outcomes were recorded.

Results: During the study period, 13 children (9 girls and 4 boys; age range: 0 day-16 months, median age: 2.5 months) with congenital infantile fibrosarcomas were available for complete radiological review. The translocation (t[12;15]) was present in 11/13 (84.6%) and absent in 2/13. Eight/thirteen (61.5%) tumors were located in extremities (5 in lower and 3 in upper), 3/13 in thoracolumbar paraspinal regions, and one each in abdomen and sternocleidomastoid muscle. Imaging features included iso- to hyperintensity on T1-W, hyperintensity on T2-W as compared to skeletal muscles and heterogeneous enhancement. Six (37.5%) tumors showed hemorrhagic components and 2 (15.4%) showed low intensity foci. None of the patients had evidence of regional or distant metastases at diagnosis. Management included surgical resection only (1/13) and combined surgery and chemotherapy (10/13). Overall survival was 100% with a median follow-up of 49.3 months.

Conclusion: Congenital infantile fibrosarcoma has nonspecific imaging characteristics but should be high on the differential diagnosis in a soft-tissue tumor presenting in infancy, located in an extremity and showing tumoral hemorrhage. Patients have a favorable outcome.
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http://dx.doi.org/10.1007/s00247-014-2957-5DOI Listing
September 2014

Small patients, complex challenging cases: a reappraisal of the professional efforts in perinatal autopsies.

Arch Pathol Lab Med 2014 Jul 3;138(7):865-8. Epub 2014 Feb 3.

From the Division of Pathology Hospital for Sick Children, Toronto, Ontario, Canada (Dr Taylor); the Department of Pathology, University of Alabama at Birmingham (Dr Faye-Petersen); the Department of Pathology, Northwestern University, Chicago, Illinois (Dr Ernst); the Department of Pathology, University of Virginia, Charlottesville (Dr LeGallo); the Department of Pathology, Kaiser Oakland Medical Center, Oakland, California (Dr Schauer); the Department of Pathology & Laboratory Medicine, North Shore-LIJ Health System and Hofstra North Shore-LIJ School of Medicine, New Hyde Park, New York (Dr Williamson); and the Department of Pathology, Children's Hospital of Minnesota, Minneapolis (Dr Pacheco).

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http://dx.doi.org/10.5858/arpa.2013-0284-EDDOI Listing
July 2014

A multi-laboratory evaluation of a clinically-validated incurred quality control material for analysis of allergens in food.

Food Chem 2014 Apr 29;148:30-6. Epub 2013 Sep 29.

Institute of Inflammation and Repair, Manchester Academic Health Sciences Centre, Manchester Institute of Biotechnology, University of Manchester, 131, Princess Street, Manchester M1 7DN, UK; Institute of Food Research, Norwich Research Park, Colney Lane, Norwich NR4 7UA, UK. Electronic address:

A dessert matrix previously used for diagnosis of food allergies was incurred with pasteurised egg white or skimmed milk powder at 3, 6, 15 and 30 mg allergen protein per kg of dessert matrix and evaluated as a quality control material for allergen analysis in a multi-laboratory trial. Analysis was performed by immunoassay using five kits each for egg and milk (based on casein) and six 'other' milk kits (five based on β-lactoglobulin and one total milk). All kits detected allergen protein at the 3 mg kg(-1) level. Based on ISO criteria only one egg kit accurately determined egg protein at 3 mg kg(-1) (p=0.62) and one milk (casein) kit accurately determined milk at 6 (p=0.54) and 15 mg kg(-1) (p=0.83), against the target value. The milk "other" kits performed least well of all the kits assessed, giving the least precise analyses. The incurred dessert material had the characteristics required for a quality control material for allergen analysis.
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http://dx.doi.org/10.1016/j.foodchem.2013.09.115DOI Listing
April 2014

Hypopigmented micropapules in apparently quiescent morphea lesions: a manifestation of disease activity.

Dermatol Online J 2013 Aug 15;19(8):19268. Epub 2013 Aug 15.

University of Toronto.

We present two young patients with morphea or localized scleroderma undergoing systemic treatment, who developed papular lesions on pre-existing sclerotic plaques. Histology was compatible with a papular presentation of morphea and other entities in the differential diagnosis were ruled out. We believe this is a very uncommon presentation of activity in lesions of morphea and should be made known to clinicians so that activity and progression of the disease can be recognized and treated to avoid complications.
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August 2013

Become a NMHP champion.

Authors:
Glenn Taylor

Aust Nurs J 2013 Aug;21(2):23

Nursing & Midwifery Health Program, Victoria.

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August 2013

Recovery from addiction: making the successful transition back to health.

Authors:
Glenn Taylor

Aust Nurs J 2013 Jun;20(11):24

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June 2013

The role of diagnostic imaging and liver biopsy in the diagnosis of focal nodular hyperplasia in children.

Liver Int 2014 Feb 7;34(2):227-34. Epub 2013 Jul 7.

Division of Gastroenterology, Hepatology and Nutrition, The Hospital for Sick Children (SickKids), Toronto, Ontario, Canada; Department of Paediatrics, University of Toronto, Toronto, Ontario, Canada.

Background & Aims: Focal nodular hyperplasia (FNH), a benign liver tumour, has a characteristic appearance on diagnostic imaging (DI) and histology. The role of liver biopsy in children for the diagnosis of FNH is unclear. This study investigates the diagnostic accuracy of DI for FNH in children without comorbidities, compared to liver biopsy.

Methods: A total of 304 consecutive patients (age <18 years) with a biopsied liver mass were retrospectively ascertained (1990-2010). Individuals with a history of malignancy, liver disease or syndromes with increased malignancy risk were excluded. DI and biopsy data were reviewed.

Results: After excluding 205 cases, 99 liver masses were studied. Based on histology, the most common diagnosis was hepatoblastoma (46/99, 44%) followed by FNH (23/99, 23%). The mean age at FNH diagnosis was 11.1 ± 5.2 years, with female preponderance (78%), and a median follow-up of 1.35 years (interquartile range 0.54, 4.20 years). 19/23 biopsy-proven FNH met standard criteria for FNH on DI. In 4/23 cases of biopsy-proven FNH, imaging did not suggest FNH. Two false positive cases included adenoma and fibrolamellar hepatocellular carcinoma. On review of original reports, DI had 82.6% sensitivity and 97.4% specificity for the diagnosis of FNH. On blind review, the sensitivity of DI for FNH diagnosis was 81.3% for MRI (13/16), and 53.3% for CT (8/15).

Conclusions: In this cohort of children with liver masses and no comorbidities, a diagnosis of FNH by imaging was highly specific, and MRI was the most sensitive study for its diagnosis. Liver biopsy may be deferred in selected children if the DI, particularly MRI, is indicative of FNH.
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http://dx.doi.org/10.1111/liv.12241DOI Listing
February 2014

Workplace bullying: are you part of the solution?

Authors:
Glenn Taylor

Aust Nurs J 2013 Apr;20(9):31

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April 2013

A simple mechanical device reduces subglottic injury in ventilated animals.

Laryngoscope 2013 Nov 1;123(11):2742-8. Epub 2013 Apr 1.

Department of Otolaryngology-Head and Neck Surgery, University of Toronto, The Hospital for Sick Children, Toronto, Ontario, Canada.

Objectives/hypothesis: To test whether a simple inexpensive device that dynamically minimizes endotracheal cuff pressure throughout the respiratory cycle reduces endotracheal cuff pressure-related subglottic injury.

Study Design: Hypoxic animal model with one control and one experimental group.

Methods: Twelve S. scrofa domesticus piglets (14-16 kg) were intubated with standard endotracheal tubes and maintained in a hypoxic state to accelerate airway injury. Animals in the control group (n = 6) were ventilated with a constant pressure of 20 cm H₂O in the endotracheal tube cuff. Animals in the experimental group (n = 6) were ventilated using a custom-designed circuit that altered the pressure in the endotracheal tube cuff in synchrony with the ventilatory cycle. Larynges were harvested at the end of the experiment and examined histologically to determine the degree of airway injury induced by the endotracheal cuff.

Results: Animals in the experimental group suffered significantly less airway damage than those in the control group. The differences were seen primarily in the subglottis (aggregate damage score 6.5 vs. 12, P <0.05), where the experimental endotracheal tube cuff exerted the least pressure. There was no difference in damage to the glottic or supraglottic structures.

Conclusions: A simple, reliable, and inexpensive means of modulating endotracheal tube cuff pressure with the ventilatory cycle led to a substantial decrease in airway injury in our animal model. Such reduction in cuff pressure may prove important for humans, particularly those in intensive care units who tend to have underlying conditions predisposing them to tracheal damage from the endotracheal tube cuff.
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http://dx.doi.org/10.1002/lary.24069DOI Listing
November 2013

The Procrustean bed of EU food safety notifications via the Rapid Alert System for Food and Feed: does one size fit all?

Food Chem Toxicol 2013 Jun 14;56:411-8. Epub 2013 Mar 14.

Hampshire County Council, Scientific Service, Hyde Park Road, Southsea PO5 4LL, UK.

Previous reports demonstrated wide variations in contributions by EU Member States (MS) to the Rapid Alert System for Food and Feed (RASFF) especially for border notifications, emphasising that MS with major entry points play a vital role in ensuring that EU food imports meet EU standards. To further explore the variation this paper aimed to examine notification practices among MS by comparing the levels of detection as a function of the total food imported and population. RASFF notifications issued between 2003 and 2007 were analysed using descriptive statistics and network analysis for differences in notification practice between MS. Major variations in contributions to the RASFF database were observed, which did not correlate with MS size or population. For the key contrast of ratio: 'border: non-border notifications', variations between 7%:89% were observed for the average monthly contributions and, import tonnage per border notification revealed up to 129-fold differences between MS. In conclusion, wide variations in food safety practice exist between MS, including both number and type of contributions to the RASFF database, with some MS being relatively highly active in the key class of border notifications. These findings should inform EU food safety enforcement policies and practices; and central resource allocations.
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http://dx.doi.org/10.1016/j.fct.2013.02.055DOI Listing
June 2013

Substance dependent nurses.

Authors:
Glenn Taylor

Aust Nurs J 2012 Oct;20(4):24

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October 2012

Nurses' health.

Authors:
Glenn Taylor

Aust Nurs J 2012 Aug;20(2):16

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August 2012

Drugs, alcohol and nurses' mental health.

Aust Nurs J 2012 Sep;20(3):45

Department of Nursing, School of Health Sciences, University of Melbourne.

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September 2012

A sobering reflection!

Authors:
Glenn Taylor

Aust Nurs J 2012 Jun;19(11):20

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June 2012

Graduate succeeds against the odds!

Authors:
Glenn Taylor

Aust Nurs J 2012 Apr;19(9):18

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April 2012

Malignant pancreatic tumors in children: a single-institution series.

J Pediatr Surg 2012 Apr;47(4):681-7

Department of Hematology/Oncology, Queen Paola Children's Hospital, Antwerpen, Belgium.

Background: Pancreatic tumors in children represent a very rare entity. We reviewed the clinical and pathologic features of pediatric patients with pancreatic tumors at a single institution.

Methods: We conducted a retrospective review of cases diagnosed at the Hospital for Sick Children between 1986 and 2010.

Results: Twenty-seven patients were diagnosed during the study period: 18 with solid pseudopapillary neoplasm (SPN), 6 with pancreatic endocrine neoplasia, and 3 with other tumors. Of the 27 children, 3 had associated syndromes, in specific tuberous sclerosis, von Hippel-Lindau, and polycystic ovarian syndrome. The most common symptoms were pain and vomiting in SPN and hypoglycemia and seizures in insulinomas. Magnetic resonance imaging and computed tomographic scan were equally accurate in determining size and site of origin of the tumor, and both were better than ultrasound. All patients underwent surgery (distal pancreatectomy in 14 cases, Whipple procedure in 8, other procedures in 5), which represented the only treatment for all but 3 cases. Seventeen patients (94%) with SPN are alive (median follow-up, 32 months), 3 of whom had positive margins. Two patients died: 1 male with SPN with malignant transformation and 1 with fibrosarcoma.

Conclusions: We describe the largest single-institution study of pediatric pancreatic tumors. Females with SPN have an excellent outcome, even in presence of positive margins, suggesting that limited surgical resection may be appropriate for these patients.
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http://dx.doi.org/10.1016/j.jpedsurg.2011.11.046DOI Listing
April 2012

Health over the holiday season!

Authors:
Glenn Taylor

Aust Nurs J 2011 Dec-2012 Jan;19(6):21

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March 2012

Abnormal fatty acid metabolism in spinal muscular atrophy may predispose to perioperative risks.

Eur J Paediatr Neurol 2012 Sep 20;16(5):549-53. Epub 2012 Jan 20.

Division of Neurology, Department of Pediatrics, Hospital for Sick Children, University of Toronto, Toronto, ON, Canada.

A 15 year old boy with SMA type II underwent spinal fusion and suffered a mitochondrial Reye-like catabolic crisis 4 days postop with hypoketotic hypoglycemia, lactic acidaemia, hyperammonemia and liver failure, with 90% coagulative necrosis and diffuse macro- and microvesicular steatosis, requiring orthotopic liver transplantation. This crisis responded in part to mitochondrial therapy and anabolic rescue. He made a dramatic sustained neurological recovery, though his post-transplant liver biopsies revealed micro- and macrosteatosis. We hypothesize that a combination of surgical stress-catecholamine induced lipolysis, prolonged general anaesthesia with propofol and sevoflurane, and perioperative fasting on a background of decreased β-oxidation were potential risk factors for the mitochondrial decompensation.
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http://dx.doi.org/10.1016/j.ejpn.2012.01.004DOI Listing
September 2012

Supervision: a great addition to the wellbeing toolkit.

Authors:
Glenn Taylor

Aust Nurs J 2011 Oct;19(4):25

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October 2011

US-guided percutaneous needle biopsy of anterior mediastinal masses in children.

Pediatr Radiol 2012 Jan 24;42(1):40-9. Epub 2011 Aug 24.

Department of Diagnostic Imaging, Image Guided Therapy, The Hospital for Sick Children, 555 University Ave., Toronto, Canada.

Background: Anterior mediastinal masses in children are clinically challenging, requiring prompt histological diagnosis.

Objective: The purpose of this study was to review the experience with US-guided percutaneous core needle biopsy (PCNB) of anterior mediastinal masses in children, particularly with respect to safety and diagnostic accuracy.

Materials And Methods: We retrospectively reviewed the clinical presentation, imaging, sedation approach, procedural details and pathology results of US-guided PCNB of mediastinal masses that occurred during an 8-year period (2001-2008). Complications were graded and pathology was categorized into four groups based on adequacy and diagnostic yield.

Results: 32 US-guided PCNBs were performed on 32 children, mean age 12 years (range 18 months to 17 years), mean weight 48 kg (range 11.5 to 109 kg, median 49 kg). A coaxial US-guided technique was used, with a mean of 8.2 passes and a mean 7.6 cores obtained (range 2-15). There were no major complications. The biopsies were adequate in volume and quality of specimens in 29/32, and 25/32 were diagnostic. PCNB was diagnostic in all cases of non-Hodgkin disease.

Conclusions: Experience with anterior mediastinal masses suggests that US-guided PCNB can be considered a viable, safe and accurate method of reaching a diagnosis in the pediatric population.
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http://dx.doi.org/10.1007/s00247-011-2204-2DOI Listing
January 2012

Undiagnosed heart disease leading to sudden unexpected death in childhood: a retrospective study.

Pediatrics 2011 Sep 8;128(3):e513-20. Epub 2011 Aug 8.

Division of Pediatric Cardiology, Hospital for Sick Children, Toronto, Ontario, Canada.

Objectives: Heart disease accounts for a significant proportion of sudden unexpected deaths among children. We describe here demographic features, pathological conditions, and the frequency of premonitory symptoms in a retrospective series of cases of sudden unexpected cardiac death (SUCD) attributable to undiagnosed structural heart disease.

Methods: A chart review of autopsies involving children 0 to 17 years of age that were performed at the Hospital for Sick Children (Toronto, Ontario, Canada) between 1984 and 2003 was conducted. Cases of sudden unexpected death within 24 hours after clinical presentation with previously undetected fatal heart disease were included. Cases with multiple or thoracic trauma and chronic or multisystem disease were excluded.

Results: During the 20-year study period, 4926 autopsies were performed. A total of 103 cases (2.1%), involving 51 male patients and 52 female patients 1 day to 15 years of age (mean: 2.9 ± 4.2 years), were diagnosed as having SUCD. The most common diagnoses were myocarditis (n = 37 [35.9%]), hypoplastic left heart syndrome (HLHS) (n = 19 [18.4%]), dilated cardiomyopathy (DCM) (n = 16 [16.5%]), coronary artery anomalies (n = 6 [5.8%]), and aortic stenosis (n = 5 [4.9%]). There was a significant difference in the mean age of presentation between leading causes of SUCD (6.5 days for HLHS, 1.7 years for DCM, and 5.4 years for myocarditis; P < .0001). Of 103 cases, 27 (26.2%) had premonitory symptoms documented.

Conclusion: SUCD accounted for 2.1% of all autopsies, and HLHS, DCM, and myocarditis were the 3 most common diagnoses, which presented at increasing ages.
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http://dx.doi.org/10.1542/peds.2010-2307DOI Listing
September 2011

Prevention: a helpful addition to our health toolkit.

Authors:
Glenn Taylor

Aust Nurs J 2011 Jun;18(11):21

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June 2011