Publications by authors named "Mike Allen"

32 Publications

The heterogeneous causal effects of neonatal care: a model of endogenous demand for multiple treatment options based on geographical access to care.

Health Econ 2020 01 19;29(1):46-60. Epub 2019 Nov 19.

University of Exeter Medical School, Institute of Health Research, Exeter, UK.

Neonatal units in the UK are organised into three levels, from highest Neonatal Intensive Care Unit (NICU), to Local Neonatal Unit (LNU) to lowest Special Care Unit (SCU). We model the endogenous treatment selection of neonatal care unit of birth to estimate the average and marginal treatment effects of different neonatal designations on infant mortality, length of stay and hospital costs. We use prognostic factors, survival and hospital care use data on all preterm births in England for 2014-2015, supplemented by national reimbursement tariffs and instrumental variables of travel time from a geographic information system. The data were consistent with a model of demand for preterm birth care driven by physical access. In-hospital mortality of infants born before 32 weeks was 8.5% overall, and 1.2 (95% CI: -0.7, 3.2) percentage points lower for live births in hospitals with NICU or SCU compared to those with an LNU according to instrumental variable estimates. We find imprecise differences in average total hospital costs by unit designation, with positive unobserved selection of those with higher unexplained absolute and incremental costs into NICU. Our results suggest a limited scope for improvement in infant mortality by increasing in-utero transfers based on unit designation alone.
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http://dx.doi.org/10.1002/hec.3970DOI Listing
January 2020

Estimating the effectiveness and cost-effectiveness of establishing additional endovascular Thrombectomy stroke Centres in England: a discrete event simulation.

BMC Health Serv Res 2019 Nov 8;19(1):821. Epub 2019 Nov 8.

Institute of Neuroscience, Newcastle University, 3-4 Claremont Terrace, Newcastle upon Tyne, UK.

Background: We have previously modelled that the optimal number of comprehensive stroke centres (CSC) providing endovascular thrombectomy (EVT) in England would be 30 (net 6 new centres). We now estimate the relative effectiveness and cost-effectiveness of increasing the number of centres from 24 to 30.

Methods: We constructed a discrete event simulation (DES) to estimate the effectiveness and lifetime cost-effectiveness (from a payer perspective) using 1 year's incidence of stroke in England. 2000 iterations of the simulation were performed comparing baseline 24 centres to 30.

Results: Of 80,800 patients admitted to hospital with acute stroke/year, 21,740 would be affected by the service reconfiguration. The median time to treatment for eligible early presenters (< 270 min since onset) would reduce from 195 (IQR 155-249) to 165 (IQR 105-224) minutes. Our model predicts reconfiguration would mean an additional 33 independent patients (modified Rankin scale [mRS] 0-1) and 30 fewer dependent/dead patients (mRS 3-6) per year. The net addition of 6 centres generates 190 QALYs (95%CI - 6 to 399) and results in net savings to the healthcare system of £1,864,000/year (95% CI -1,204,000 to £5,017,000). The estimated budget impact was a saving of £980,000 in year 1 and £7.07 million in years 2 to 5.

Conclusion: Changes in acute stroke service configuration will produce clinical and cost benefits when the time taken for patients to receive treatment is reduced. Benefits are highly likely to be cost saving over 5 years before any capital investment above £8 million is required.
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http://dx.doi.org/10.1186/s12913-019-4678-9DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6842187PMC
November 2019

Opportunities for antimicrobial stewardship in patients with acute bacterial skin and skin structure infections who are unsuitable for beta-lactam antibiotics: a multicenter prospective observational study.

Ther Adv Infect Dis 2019 Jan-Dec;6:2049936118823655. Epub 2019 Feb 4.

Darent Valley Hospital, Dartford and Gravesham NHS Trust, Dartford, UK.

Purpose: The objective of this prospective, observational study was to describe the treatment, severity assessment and healthcare resources required for management of patients with acute bacterial skin and skin structure infections who were unsuitable for beta-lactam antibiotic treatments.

Methods: Patients were enrolled across five secondary care National Health Service hospitals. Eligible patients had a diagnosis of acute bacterial skin and skin structure infection and were considered unsuitable for beta-lactam antibiotics (e.g. confirmed/suspected methicillin-resistant , beta-lactam allergy). Data regarding diagnosis, severity of the infection, antibiotic treatment and patient management were collected.

Results: 145 patients with acute bacterial skin and skin structure infection were included; 79% ( = 115) patients received greater than two antibiotic regimens; median length of the first antibiotic regimen was 2 days (interquartile range of 1-5); median time to switch from intravenous to oral antibiotics was 4 days (interquartile range of 3-8, = 72/107); 25% ( = 10/40) patients with Eron class 1 infection had systemic inflammatory response syndrome, suggesting they were misclassified. A higher proportion of patients with systemic inflammatory response syndrome received treatment in an inpatient setting, and their length of stay was prolonged in comparison with patients without systemic inflammatory response syndrome.

Conclusion: There exists an urgent need for more focused antimicrobial stewardship strategies and tools for standardised clinical assessment of acute bacterial skin and skin structure infection severity in patients who are unsuitable for beta-lactam antibiotics. This will lead to optimised antimicrobial treatment strategies and ensure effective healthcare resource utilisation.
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http://dx.doi.org/10.1177/2049936118823655DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6365991PMC
February 2019

Comparative healthcare-associated costs of methicillin-resistant Staphylococcus aureus bacteraemia-infective endocarditis treated with either daptomycin or vancomycin.

Int J Antimicrob Agents 2016 May 19;47(5):357-61. Epub 2016 Mar 19.

Former Novartis Pharmaceuticals, UK.

Complex infection with methicillin-resistant Staphylococcus aureus (MRSA) is associated with high healthcare and societal costs; thus, evaluation of the costs and health benefits of interventions is an important consideration in a modern healthcare system. This study estimated the cost consequences of the use of daptomycin compared with vancomycin for the first-line treatment of patients with proven MRSA-induced bacteraemia-infective endocarditis (SAB-IE) with a vancomycin minimum inhibitory concentration (MIC) >1mg/L in the UK. A decision model was developed to assess total healthcare costs of treatment, including inpatient, outpatient and drug costs. Data were sourced from the literature (treatment efficacy and safety), a physician survey (resource use) and publicly available databases (unit costs). Assuming the same length of stay for daptomycin and vancomycin, the total healthcare costs per patient were £17917 for daptomycin and £17165 for vancomycin. However, extrapolating from published studies and supported by a physician survey, daptomycin was found to require fewer therapeutic switches and a shorter length of stay. When the length of stay was reduced from 42 days to 28 days, daptomycin saved £4037 per person compared with vancomycin. In conclusion, daptomycin is an effective and efficient alternative antibiotic for the treatment of SAB-IE. However, the level of cost saving depends on the extent to which local clinical practice allows early discharge of patients before the end of their antibiotic course when responding to treatment.
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http://dx.doi.org/10.1016/j.ijantimicag.2016.02.006DOI Listing
May 2016

9th GCC closed forum: CAPA in regulated bioanalysis; method robustness, biosimilars, preclinical method validation, endogenous biomarkers, whole blood stability, regulatory audit experiences and electronic laboratory notebooks.

Bioanalysis 2016 Mar 26;8(6):487-95. Epub 2016 Feb 26.

WuXi/XBL, 107 Morgan Lane, Plainsboro, NJ, USA.

The 9th GCCClosed Forum was held just prior to the 2015 Workshop on Recent Issues in Bioanalysis (WRIB) in Miami, FL, USA on 13 April 2015. In attendance were 58 senior-level participants, from eight countries, representing 38 CRO companies offering bioanalytical services. The objective of this meeting was for CRO bioanalytical representatives to meet and discuss scientific and regulatory issues specific to bioanalysis. The issues selected at this year's closed forum include CAPA, biosimilars, preclinical method validation, endogenous biomarkers, whole blood stability, and ELNs. A summary of the industry's best practices and the conclusions from the discussion of these topics is included in this meeting report.
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http://dx.doi.org/10.4155/bio.16.16DOI Listing
March 2016

Recognizing Success in the Chaplain Profession: Connecting Perceptions With Practice.

J Health Care Chaplain 2015 ;21(4):131-50

c Department of Communication , University of Wisconsin-Milwaukee , Milwaukee , Wisconsin , USA.

The current investigation examines the communicative hallmarks of successful chaplaincy work as articulated by professional chaplains providing spiritual care at the end-of-life. Data grounded in qualitative interviews with 32 chaplains of various denominations and lengths of service reveals a challenge in gauging success when working with dying patients and families. Chaplains reported nonverbal hallmarks of success consist of (a) intrapersonal sense of accomplishment, (b) progress in fulfilling patient needs, and (c) meaningful connection with patients. Verbal hallmarks of success include (a) patient affirmation, (b) family affirmation, and the (c) chaplain being asked to participate in religious rites. In practice, the authors conjecture, chaplains assess professional competency in the self, patient, and family domains. Implications and future directions are discussed.
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http://dx.doi.org/10.1080/08854726.2015.1071543DOI Listing
January 2016

National characteristics and variation in Arabic handwriting.

Forensic Sci Int 2015 Feb 12;247:89-96. Epub 2014 Dec 12.

University of Central Lancashire, Preston, UK.

From each of four Arabic countries; Morocco, Tunisia, Jordan and Oman, 150 participants produced handwriting samples which were examined to assess whether national characteristics were discernible. Ten characters, which have different configurations depending upon their position in the word, along with one short word, were classified into distinguishable forms, and these forms recorded for each handwriting sample. Tests of independence showed that character forms used were not independent of country (p<0.001) for all but one character-position (this was dropped from subsequent analyses). A correspondence analysis ordination plot and analysis of similarity (R=0.326, p=0.0002) showed that whole samples were discernibly grouped by country, and a tree analysis produced a classification which was 71% accurate for the original data and 83% accurate for 80 new handwriting samples that underwent 'blind' classification. When the countries were combined into two regions, North Africa and Middle East, the grouping was more marked. Thus, there appears to be some scope for narrowing down the nationality, and particularly the wider geographical region of an author based upon the character forms they use in Arabic handwriting.
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http://dx.doi.org/10.1016/j.forsciint.2014.12.004DOI Listing
February 2015

8th GCC: consolidated feedback to US FDA on the 2013 draft FDA guidance on bioanalytical method validation.

Bioanalysis 2014 ;6(22):2957-63

Covance Laboratories, Chantilly, VA, USA.

The 8th GCC Closed Forum for Bioanalysis was held in Baltimore, MD, USA on 5 December 2013, immediately following the 2013 AAPS Workshop (Crystal City V): Quantitative Bioanalytical Methods Validation and Implementation--The 2013 Revised FDA Guidance. This GCC meeting was organized to discuss the contents of the draft revised FDA Guidance on bioanalytical method validation that was published in September 2013 and consolidate the feedback of the GCC members. In attendance were 63 senior-level participants, from seven countries, representing 46 bioanalytical CRO companies/sites. This event represented a unique opportunity for CRO bioanalytical experts to share their opinions and concerns regarding the draft FDA Guidance, and to build unified comments to be provided to the FDA.
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http://dx.doi.org/10.4155/bio.14.287DOI Listing
July 2015

Talking about end-of-life preferences in marriage: applying the theory of motivated information management.

Health Commun 2015 29;30(4):409-18. Epub 2014 Jul 29.

a Department of Communication , University of Wisconsin-Milwaukee.

The theory of motivated information management (TMIM) provides one framework to examine information-seeking behaviors, especially in conversations involving sensitive or difficult information such as preferences for end-of-life (EOL) care. The spouse plays a significant role in decision making surrounding EOL care. Consequently, individuals need information about spouses' EOL preferences in order to ensure carrying out those desires. Our findings support the value of TMIM as a framework to understand factors that influence couples' EOL care information-seeking behaviors. In support of the theory, we provide factors that influence the initiation or avoidance of EOL conversations between spouses.
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http://dx.doi.org/10.1080/10410236.2014.889555DOI Listing
October 2016

Using daptomycin in hospitalised patients with cSSTI caused by Staphylococcus aureus has an impact on costs.

Chemotherapy 2013 19;59(6):427-34. Epub 2014 Jul 19.

Evidera, London, UK.

Background: The aim was to assess the cost impact of daptomycin compared to vancomycin treatment in patients hospitalised for complicated skin and soft-tissue infection (cSSTI) with suspected methicillin-resistant Staphylococcus aureus infection in the UK.

Methods: A decision model was developed to estimate the costs associated with cSSTI treatment. Data on efficacy, treatment duration and early discharge from published clinical trials were used, with data gaps on standard clinical practice being filled by means of clinician interviews.

Results: Total health-care costs per patient were GBP 6,214 and GBP 6,491 for daptomycin and vancomycin, respectively. A sensitivity analysis suggested that modifying the parameters within a reasonable range does not impact on the conclusion that the higher cost of daptomycin is likely to be offset by lower costs of monitoring and hospitalisation.

Conclusions: This study demonstrates that daptomycin not only provides an alternative treatment for multiple resistant infections, but may also reduce National Health Service costs.
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http://dx.doi.org/10.1159/000363280DOI Listing
May 2015

Translating spiritual care in the chaplain profession.

J Pastoral Care Counsel 2013 Mar;67(1)

Department of Communications, University of Wisconsin, Milwaukee, Wisconsin, USA.

Chaplains provide a much-needed service to patients and families requiring spiritual care in the healthcare setting. Despite evidence documenting improvements quality of life for patients using spiritual services, chaplains experience challenges in translating the benefits they provide into concepts understood by patients, team members, and administrators. A qualitative study using interviews with 19 chaplains found that translation problems occur in three main areas: (a) justifying the role to patients and families, (b) determinations of what constitutes a "productive" employee, and (c) effective collaboration with other members of the health care team. This study outlines several strategies used by chaplains to ease the process of translation, as well as some directions for future research.
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March 2013

Recommendations on bioanalytical method stability implications of co-administered and co-formulated drugs by Global CRO Council for Bioanalysis (GCC).

Bioanalysis 2012 Sep;4(17):2117-26

Advion Bioanalytical Laboratories, Quintiles, NY, USA.

An open letter written by the Global CRO Council for Bioanalysis (GCC) describing the GCC survey results on stability data from co-administered and co-formulated drugs was sent to multiple regulatory authorities on 14 December 2011. This letter and further discussions at different GCC meetings led to subsequent recommendations on this topic of widespread interest within the bioanalytical community over the past 2 years.
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http://dx.doi.org/10.4155/bio.12.192DOI Listing
September 2012

4th Global CRO Council for Bioanalysis: coadministered drugs stability, EMA/US FDA guidelines, 483s and carryover.

Bioanalysis 2012 Apr;4(7):763-8

The Global CRO Council for Bioanalysis (GCC) was formed in September 2010. Since then, the representatives of the member companies come together periodically to openly discuss bioanalysis and the regulatory challenges unique to the outsourcing industry. The 4th GCC Closed Forum brought together experts from bioanalytical CROs to share and discuss recent issues in regulated bioanalysis, such as the impact of coadministered drugs on stability, some differences between European Medicines Agency and US FDA bioanalytical guidance documents and lessons learned following recent Untitled Letters. Recent 483s and agency findings, as well as issues on method carryover, were also part of the topics discussed.
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http://dx.doi.org/10.4155/bio.12.48DOI Listing
April 2012

The effect of material choice on biofilm formation in a model warm water distribution system.

Biofouling 2011 Nov;27(10):1161-74

School of Biomedical and Biological Sciences, Plymouth University, Drake Circus, Plymouth, Devon, PL4 8AA, UK.

Water distribution systems (WDS) are composed of a variety of materials and may harbour potential pathogens within surface-attached microbial biofilms. Biofilm formation on four plumbing materials, viz. copper, stainless steel 316 (SS316), ethylene propylene diene monomer (EPDM) and cross-linked polyethylene (PEX), was investigated using scanning electron microscope (SEM)/confocal microscopy, ATP-/culture-based analysis, and molecular analysis. Material 'inserts' were incorporated into a mains water fed, model WDS. All materials supported biofilm growth to various degrees. After 84 days, copper and SS316 showed no significant overall differences in terms of the level of biofilm formation observed, whilst PEX supported a significantly higher level of biofilm. EPDM exhibited gross contamination by a complex, multispecies biofilm, at a level significantly higher than was observed on the other materials, regardless of the analytical method used. PCR-DGGE analysis showed clear differences in the composition of the biofilm community on all materials after 84 days. The primary conclusion of this study has been to identify EPDM as a potentially unsuitable material for use as a major component in WDS.
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http://dx.doi.org/10.1080/08927014.2011.636807DOI Listing
November 2011

Permanent draft genome sequence of Vibrio tubiashii strain NCIMB 1337 (ATCC19106).

Stand Genomic Sci 2011 Apr;4(2):183-90

Vibrio tubiashii NCIMB 1337 is a major and increasingly prevalent pathogen of bivalve mollusks, and shares a close phylogenetic relationship with both V. orientalis and V. coralliilyticus. It is a Gram-negative, curved rod-shaped bacterium, originally isolated from a moribund juvenile oyster, and is both oxidase and catalase positive. It is capable of growth under both aerobic and anaerobic conditions. Here we describe the features of this organism, together with the draft genome and annotation. The genome is 5,353,266 bp long, consisting of two chromosomes, and contains 4,864 protein-coding and 86 RNA genes.
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http://dx.doi.org/10.4056/sigs.1654066DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3111986PMC
April 2011

Identification of the class characteristics in the handwriting of Polish people writing in English.

J Forensic Sci 2010 Sep 25;55(5):1296-303. Epub 2010 Jun 25.

School of Forensic and Investigative Sciences, University of Central Lancashire, Preston, UK.

An investigation was carried out to identify the class characteristics of Polish people writing in English and to specifically identify those characteristics that separate Polish handwriting from English handwriting. In the first stage, 40 Polish and 40 English handwriting samples were collected and systematically examined. In total, 31 features were identified that occurred in ≥25% of the Polish handwriting samples and therefore considered class characteristics. Of these, chi-square analyses identified 21 class characteristics that occurred significantly more in Polish compared to English handwriting. Twenty-one of the class characteristics in the Polish handwriting had similar constructions to the copybook pattern thus supporting the theory that class characteristics frequently stem from the taught writing system. In the second stage, an algorithm was developed using seventeen of the class characteristics that successfully discriminated between a further 13 Polish and 12 English handwriting samples.
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http://dx.doi.org/10.1111/j.1556-4029.2010.01449.xDOI Listing
September 2010

An evaluation of the long-term effects of total plantar fasciotomy--a preliminary study.

Foot (Edinb) 2009 Jun 17;19(2):75-9. Epub 2009 Apr 17.

Podiatry Department, Kensington and Chelsea PCT, St Charles Hospital, Exmoor Street, London, United Kingdom.

Background: Plantar fascia release for chronic plantar fasciitis has given excellent pain relief and rapid return to activities with few reported complications. Cadaveric studies have led to the identification of some potential post-operative problems, commonly weakness of the medial longitudinal arch (MLA) and pain in the lateral midfoot.

Methods: Eight total plantar fasciotomy patients (five bilateral and three unilateral) were evaluated subjectively and objectively with regards to surgical outcome and biomechanical change. The centre of pressure (COP) and loading of the foot were measured using the F Scan mobile system and COM'nalysis software. In addition, five control subjects were evaluated with the F Scan. The reading for one foot of one of the control subjects was discarded due to a biomechanical abnormality.

Results: The results of this study were that the COP of the foot in post-total plantar fasciotomy subjects was significantly laterally deviated throughout the propulsive phase of gait compared to that of control subjects (p<0.05). There was no significant difference in plantar pressure at the rearfoot or the first metatarsophangeal joint (MTPJt) between the post-operative and control groups (p>0.05). Six of the eight of the post-operative patients (11 feet) considered the procedure to be successful in resolving their symptoms.

Conclusion: Total plantar fasciotomy may result in changes to the COP of the foot. It could be extrapolated from this data, in conjunction with subjective visual clinical observations of gait, that supination of the foot could occur post-operatively rather than the pronatory state secondary to a collapsed arch that, collectively, the results of cadaver studies have suggested. The conclusions drawn from this pilot study are to some extent speculative, as the measurements were only made post-operatively and a small number of subjects were studied. Further research is required in this area.
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http://dx.doi.org/10.1016/j.foot.2008.11.014DOI Listing
June 2009

An evidence base for patient-centered cancer care: a meta-analysis of studies of observed communication between cancer specialists and their patients.

Patient Educ Couns 2009 Dec;77(3):379-83

Department of Communication, Rutgers University, 4 Huntington Street, New Brunswick, NJ 08901, USA.

Objective: In the context of patients visiting cancer specialists, the objective is to test the association between both patient-centered communication (including Affective Behavior and Participation Behavior) and Instrumental Behavior and patients' post-visit satisfaction with a variety of visit phenomena.

Methods: Meta-analysis of 25 articles representing 10 distinct data sets.

Results: Both patient-centered- and instrumental behavior are significantly, positively associated with satisfaction, with patient-centered communication having a relatively stronger association.

Conclusion: There is an evidence base for the efficacy of patient-centered care.

Practice Implications: Cancer specialists need to train to improve their patient-centered communication.
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http://dx.doi.org/10.1016/j.pec.2009.09.015DOI Listing
December 2009

Biomechanical consequences of total plantar fasciotomy: a review of the literature.

J Am Podiatr Med Assoc 2009 Sep-Oct;99(5):422-30

School of Health, The University of Northampton, Northampton, England.

Background: Plantar fascia release for chronic plantar fasciitis has provided excellent pain relief and rapid return to activities with few reported complications. Cadaveric studies have led to the identification of some potential postoperative problems, most commonly weakness of the medial longitudinal arch and pain in the lateral midfoot.

Methods: An electronic search was conducted of the MEDLINE, ScienceDirect, SportDiscus, EMBASE, CINAHL, Cochrane, and AMED databases. The keywords used to search these databases were plantar fasciotomy and medial longitudinal arch. Articles published between 1976 and 2008 were identified.

Results: Collectively, results of cadaveric studies suggested that plantar fasciotomy leads to loss of integrity of the medial longitudinal arch and that total plantar fasciotomy is more detrimental to foot structure than is partial fasciotomy. In vivo studies, although limited in number, concluded that although clinical outcomes were satisfactory, medial longitudinal arch height decreased and the center of pressure of the weightbearing foot was excessively medially deviated postoperatively.

Conclusions: Plantar fasciotomy, in particular total plantar fasciotomy, may lead to loss of stability of the medial longitudinal arch and abnormalities in gait, in particular an excessively pronated foot. Further in vivo studies on the long-term biomechanical effects of plantar fasciotomy are required.
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http://dx.doi.org/10.7547/0990422DOI Listing
January 2010

Chronic exertional compartment syndrome of the foot.

Sports Med Arthrosc Rev 2009 Sep;17(3):198-202

Centre for Sports & Exercise Medicine, Queen Mary, University of London, England, UK.

Chronic exertional compartment syndrome (CECS) usually refers to myoneural ischemia from a reversible increase in tissue pressure within a myofascial compartment. CECS of the leg is well documented, as its first description by Mavor in 1956. CECS of the foot remains underdiagnosed, and has been reported in the literature only on an anecdotal basis. Wood Jones proposed that there were 4 compartments in the foot, but Manoli and Weber suggest that there are 9 separate compartments. Clinical signs and symptoms of CECS of the foot remain vague, diverse, and lack the consistency of its counterpart in the leg. The most effective treatment is a fasciotomy. We present a literature review of the condition to increase the awareness and high index of suspicion among the clinicians as the symptoms are often vague and, to consider the condition as part of the differential diagnosis.
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http://dx.doi.org/10.1097/JSA.0b013e3181a6a263DOI Listing
September 2009

No-touch taps help combat C. diff spread.

Authors:
Mike Allen

Health Estate 2007 May;61(5):55

Dart Valley's Mike Allen explains how no-touch taps can assist in the fight against an organism which continues to attract much attention.
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May 2007

Are complex psychotherapies more effective than biofeedback, progressive muscle relaxation, or both? A meta-analysis.

Psychol Rep 2007 Feb;100(1):303-24

Department of Psychology, University of Wisconsin-Milwaukee, P.O. Box 413, Milwaukee, WI 53201, USA.

A meta-analysis of 26 studies was conducted to assess whether more complex forms of psychotherapy would be superior to control treatments of either biofeedback, progressive muscle relaxation, or both. Consistent with hypotheses, more complex treatments provided a small, significant improvement over biofeedback and progressive muscle relaxation (r = .09). A subset of the more complex behavioral treatments accounted for most of this small incremental effectiveness of more complex treatments (r = .15). Possible sources of this incremental effectiveness are discussed.
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http://dx.doi.org/10.2466/pr0.100.1.303-324DOI Listing
February 2007

A series of bisaryl imidazolidin-2-ones has shown to be selective and orally active 5-HT2C receptor antagonists.

Bioorg Med Chem Lett 2005 Nov;15(22):4989-93

Psychiatry Centre of Excellence in Drug Discovery, GlaxoSmithkline Pharmaceuticals, Third Avenue, Harlow, Essex CM19 5AW, UK.

Bisaryl cyclic ureas have been identified as high affinity 5-HT2C receptor antagonists with selectivity over 5-HT2A and 5-HT2B. Compounds such as 8 and 22 have shown oral activity in a centrally mediated pharmacodynamic model of 5-HT2C function in rodents.
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http://dx.doi.org/10.1016/j.bmcl.2005.08.004DOI Listing
November 2005

Good practice in hospital hygiene.

Health Estate 2005 Jun;59(6):45-7

Dart Valley Systems.

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June 2005

A helping hand for infection control.

Authors:
Mike Allen

Health Estate 2004 Sep;58(8):48-9

Dart Valley Systems.

Despite considerable awareness amongst the healthcare community about the importance of hand hygiene in controlling Healthcare Acquired Infections (HAIs), the problem persists. Mike Allen of Dart Valley Systems explores the issues surrounding good hand hygiene practice in UK hospitals.
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September 2004

Outcome of surgical treatment of medial tibial stress syndrome.

J Bone Joint Surg Am 2003 Oct;85(10):1974-80

Leicester General Hospital, United Kingdom.

Background: Medial tibial stress syndrome is a common chronic sports injury characterized by exercise-induced pain along the posteromedial border of the tibia. The reported outcomes of surgical treatment of this condition have varied.

Methods: Of seventy-eight patients who underwent surgery for medial tibial stress syndrome, forty-six (thirty-one men and fifteen women) returned for follow-up. The outcomes of the surgery were determined by comparing preoperative and postoperative pain levels as indicated on a visual analog pain scale and ascertaining the ability of the athletes to return to presymptom levels of exercise.

Results: The mean duration of postoperative follow-up was thirty months (range, six to sixty-three months). Surgery significantly reduced pain levels (p < 0.001) by an average of 72% as indicated on the visual analog pain scale. An excellent result was achieved in 35% of the limbs; a good result, in 34%; a fair result, in 22%; and a poor result, in 9%. Despite the success with regard to pain reduction, for a variety of reasons only nineteen (41%) of the athletes fully returned to their presymptom sports activity.

Conclusions: Surgery can significantly reduce the pain associated with medial tibial stress syndrome. Despite this reduction in pain, athletes should be counseled that a full uninhibited return to sports is not always achieved.
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http://dx.doi.org/10.2106/00004623-200310000-00017DOI Listing
October 2003

When a celebrity contracts a disease: the example of Earvin "Magic" Johnson's announcement that he was HIV positive.

J Health Commun 2003 May-Jun;8(3):249-65

Department of Communication, University of Wisconsin--Milwaukee, 53201, USA.

This meta-analysis summarizes the available data concerning the impact that the public announcement that Earvin "Magic" Johnson, a National Basketball Association All-Star, had tested positive for HIV. The results demonstrate that the announcement increased the level of accurate knowledge in persons, the number of persons getting tested for HIV, and the desire to obtain more information about HIV and AIDS. For adults the impact of the announcement was to increase the perception of vulnerability while for children/adolescents the announcement diminished the perception of risk.
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http://dx.doi.org/10.1080/10810730305682DOI Listing
August 2003

Paracrine oxytocin and estradiol demonstrate a spatial increase in human intrauterine tissues with labor.

J Clin Endocrinol Metab 2003 Jul;88(7):3392-400

Biomedical Research Institute, Biological Sciences and Leicester Warwick Medical School, University of Warwick, Coventry, United Kingdom CV4 7AL.

In this study we investigated the spatial and temporal relationship among oxytocin (OT), oxytocin receptor (OTR), and estradiol (E2) at term, with (LAB) and without labor (NIL), in human amnion (AM), chorio-decidua (CD), fundal (FU), and lower segment (LS) myometrium. RT-PCR and RIA demonstrated a labor-associated increase in OT mRNA and peptide in CD, AM, and FU, but not LS. HPLC purification and mass spectrometry analysis confirmed that immunoreactive OT corresponded to alpha-amidated OT. Immunohistochemistry localized OT to chorionic trophoblast, decidual stroma, and glandular epithelium. RT-PCR analysis of OTR mRNA demonstrated a significant difference between FU and LS samples, which remained unchanged with labor in all tissues. Immunohistochemistry localized OTR to amniotic epithelium, decidual stroma, and myometrium. Tissue E2 concentrations, as determined by ELISA, demonstrated a significant increase with labor in all tissues. E2 was highest in CD, followed by FU, AM, and LS, respectively. E2 correlated with OT in samples of FU and CD taken from NIL women and in FU, CD, and AM taken from LAB women. We conclude that a significant increase in both OT and E2 occurs at the myometrial decidual interface with labor, and this increase is reflected in both the fundal and lower segments of the uterus. In contrast to OT and E2 the OTR is spatially regulated, with significantly greater expression in the fundal region of the uterus. Paracrine OT production stimulated by E2 may be important in activating the uterus at term.
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http://dx.doi.org/10.1210/jc.2002-021212DOI Listing
July 2003