Publications by authors named "M A Lomax"

217 Publications

Paediatric reference range for overnight urinary cortisol corrected for creatinine.

Clin Chem Lab Med 2021 May 19. Epub 2021 May 19.

Department of Biochemistry, Lillebaelt Hospital, Vejle, Denmark.

Objectives: Systemic activity of inhaled corticosteroids (ICS) may be assessed via urinary cortisol measurement. Overnight urinary free cortisol corrected for creatinine (OUFCC) has been extensively reported in adult studies. However, a paediatric mass spectrometric (MS) reference range for OUFCC is not established. MS methods for OUFCC avoid cross-reactivity with other steroid hormones and are thus preferable to immunoassays. The aim of the present study was to define an MS OUFCC normative range in children.

Methods: This was a cross-sectional study of healthy pre-pubertal children from 5 to 11 years. Children collected urine from 10 pm bedtime, whichever was earlier, until 8 am. Urinary free cortisol was measured via a liquid chromatography tandem mass spectrometry (LC-MS/MS) assay (Acquity UPLC with Xevo TQ-S Mass Spectrometer [Waters]) with in-house reagents. Urinary creatinine was measured using a commercial assay (Roche).

Results: Complete urine collections were obtained from 72 males and 70 females, mean age (SD) 8.6 (1.9) (range 5.0-11.8) years. The OUFCC 95% prediction interval was 1.7-19.8 nmol/mmol. Geometric mean OUFCC was 5.7; range 1.1-24.8 nmol/mmol.

Conclusions: The obtained normative LC-MS/MS OUFCC reference data facilitate the use of mass spectrometry OUFCC assays in assessment of systemic activity of endogenous and exogenous corticosteroids in children.
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http://dx.doi.org/10.1515/cclm-2021-0371DOI Listing
May 2021

Transjugular intrahepatic portosystemic stent-shunt in the management of portal hypertension.

Gut 2020 07 29;69(7):1173-1192. Epub 2020 Feb 29.

The Royal Free Sheila Sherlock Liver Centre, UCL Institute for Liver and Digestive Health, London, UK.

These guidelines on transjugular intrahepatic portosystemic stent-shunt (TIPSS) in the management of portal hypertension have been commissioned by the Clinical Services and Standards Committee (CSSC) of the British Society of Gastroenterology (BSG) under the auspices of the Liver Section of the BSG. The guidelines are new and have been produced in collaboration with the British Society of Interventional Radiology (BSIR) and British Association of the Study of the Liver (BASL). The guidelines development group comprises elected members of the BSG Liver Section, representation from BASL, a nursing representative and two patient representatives. The quality of evidence and grading of recommendations was appraised using the GRADE system. These guidelines are aimed at healthcare professionals considering referring a patient for a TIPSS. They comprise the following subheadings: indications; patient selection; procedural details; complications; and research agenda. They are not designed to address: the management of the underlying liver disease; the role of TIPSS in children; or complex technical and procedural aspects of TIPSS.
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http://dx.doi.org/10.1136/gutjnl-2019-320221DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7306985PMC
July 2020

Orthopedic Conditions in Adults with Cerebral Palsy.

Phys Med Rehabil Clin N Am 2020 02;31(1):171-183

Nemours A.I. duPont Hospital for Children, 1600 Rockland Road, Wilmington, DE 19807, USA. Electronic address:

Orthopedic conditions are common in adults with cerebral palsy (CP). Although CP is argued to be a nonprogressive condition of the brain, the musculoskeletal components tend to worsen and deteriorate over time leading to chronic pain, function limitation, and a decline in mobility. Orthopedic care of adults with CP has not been well documented in the literature. This article describes the common orthopedic conditions in adults with CP and discusses who should perform orthopedic surgery on adults.
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http://dx.doi.org/10.1016/j.pmr.2019.09.013DOI Listing
February 2020

Wearing body armour and backpack loads increase the likelihood of expiratory flow limitation and respiratory muscle fatigue during marching.

Ergonomics 2019 Sep 31;62(9):1181-1192. Epub 2019 Jul 31.

b Department of Sport and Exercise Science, University of Portsmouth , Portsmouth , UK.

The effect of load carriage on pulmonary function was investigated during a treadmill march of increasing intensity. 24 male infantry soldiers marched on six occasions wearing either: no load, 15 kg, 30 kg, 40 kg or 50 kg. Each loaded configuration included body armour which was worn as battle-fit or loose-fit (40 kg only). FVC and FEV were reduced by 6 to 15% with load. Maximal mouth pressures were reduced post load carriage by up to 11% (inspiratory) and 17% (expiratory). Increased ventilatory demands associated with carrying increased mass were met by increases in breathing frequency (from 3 to 26 breaths·min) with minimal changes to tidal volume. 72% of participants experienced expiratory flow limitation whilst wearing the heaviest load. Loosening the armour had minimal effects on pulmonary function. It was concluded that as mass and exercise intensity are increased, the degree of expiratory flow limitation also increases. This study investigated the effect of soldier load carriage on pulmonary function, to inform the trade-off between protection and burden. Load carriage caused an inefficient breathing pattern, respiratory muscle fatigue and expiratory flow limitation during marching. These effects were exacerbated by increases in mass carried and march intensity.
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http://dx.doi.org/10.1080/00140139.2019.1629638DOI Listing
September 2019

Impact of Weekly Swimming Training Distance on the Ergogenicity of Inspiratory Muscle Training in Well-Trained Youth Swimmers.

J Strength Cond Res 2019 Aug;33(8):2185-2193

Sport, Outdoor and Exercise Science, University of Derby, Derby, United Kingdom.

Lomax, M, Kapus, J, Brown, PI, and Faghy, M. Impact of weekly swimming training distance on the ergogenicity of inspiratory muscle training in well-trained youth swimmers. J Strength Cond Res 33(8): 2185-2193, 2019-The aim of this study was to examine the impact of weekly swimming training distance on the ergogenicity of inspiratory muscle training (IMT). Thirty-three youth swimmers were recruited and separated into a LOW and HIGH group based on weekly training distance (≤31 km·wk and >41 km·wk, respectively). The LOW and HIGH groups were further subdivided into control and IMT groups for a 6-week IMT intervention giving a total of 4 groups: LOWcon, LOWIMT, HIGHcon, and HIGHIMT. Before and after the intervention period, swimmers completed maximal effort 100- and 200-m front crawl swims, with maximal inspiratory and expiratory mouth pressures (PImax and PEmax, respectively) assessed before and after each swim. Inspiratory muscle training increased PImax (but not PEmax) by 36% in LOWIMT and HIGHIMT groups (p ≤ 0.05), but 100- and 200-m swims were faster only in the LOWIMT group (3 and 7% respectively, p ≤ 0.05). Performance benefits only occurred in those training up to 31 km·wk and indicate that the ergogenicity of IMT is affected by weekly training distance. Consequently, training distances are important considerations, among others, when deciding whether or not to supplement swimming training with IMT.
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http://dx.doi.org/10.1519/JSC.0000000000002375DOI Listing
August 2019