Publications by authors named "W J Rodgers"

290 Publications

Co-Infection with 4 Species of Mycobacteria Identified by Using Next-Generation Sequencing.

Emerg Infect Dis 2021 11;27(11):2948-2950

We identified co-infection with 4 species of mycobacteria in a woman in New York, New York, USA, by using next-generation sequencing. This procedure is useful for identifying co-infections with multiple mycobacteria, tracing the geographic origin of strains, investigating transmission dynamics in susceptible populations, and gaining insight into prevention and control.
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http://dx.doi.org/10.3201/eid2711.203458DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8544987PMC
November 2021

COVID-19 in Multiple Sclerosis: Clinically reported outcomes from the UK Multiple Sclerosis Register.

Mult Scler Relat Disord 2021 Oct 8;56:103317. Epub 2021 Oct 8.

Imperial College London, London, United Kingdom.

Background: In March 2020, the United Kingdom Multiple Sclerosis Register (UKMSR) established an electronic case return form, designed collaboratively by MS neurologists, to record data about COVID-19 infections in people with MS (pwMS).

Objectives: Examine how hospital admission and mortality are affected by disability, age and disease modifying treatments (DMTs) in people with Multiple Sclerosis with COVID-19.

Methods: Anonymised data were submitted by clinical teams. Regression models were tested for predictors of hospitalisation and mortality outcomes. Separate analyzes compared the first and second 'waves' of the pandemic.

Results: Univariable analysis found hospitalisation and mortality were associated with increasing age, male gender, comorbidities, severe disability, and progressive MS; severe disability showed the highest magnitude of association. Being on a DMT was associated with a small, lower risk. Multivariable analysis found only age and male gender were significant. Post hoc analysis demonstrated that factors were significant for hospitalisation but not mortality. In the second wave, hospitalisation and mortality were lower. Separate models of the first and second wave using age and gender found they had a more important role in the second wave.

Conclusions: Features associated with poor outcome in COVID-19 are similar to other populations and being on a DMT was not found to be associated with adverse outcomes, consistent with smaller studies. Once in hospital, no factors were predictive of mortality. Reassuringly, mortality appears lower in the second wave.
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http://dx.doi.org/10.1016/j.msard.2021.103317DOI Listing
October 2021

Transportation protocols for accurate assessment of microbial burden classification using molecular methods.

Sci Rep 2021 08 9;11(1):16069. Epub 2021 Aug 9.

GeneFluidics, Los Angeles, CA, USA.

Point-of-care testing is cost-effective, rapid, and could assist in avoiding hospital visits during a pandemic. However, they present some significant risks that current technologies cannot fully address. Skin flora contamination and insufficient specimen volume are two major limitations preventing self-collection microbiological testing outside of hospital settings. We are developing a hybrid testing procedure to bridge the laboratory test with patient-side specimen collection and transportation for molecular microbial classification of causative bacterial infection and early identification of microbial susceptibility profiles directly from whole blood or urine specimens collected patient-side by health care workers such as phlebotomists in nursing homes or family clinics. This feasibility study presents our initial development efforts, in which we tested various transportation conditions (tubes, temperature, duration) for direct-from-specimen viable pathogen detection to determine the ideal conditions that allowed for differentiation between contaminant and causative bacteria in urine specimens and optimal growth for low-concentration blood specimens after transportation. For direct-from-urine assays, the viable pathogen at the clinical cutoff of 10 CFU/mL was detected after transportation with molecular assays while contaminants (≤ 10 CFU/mL) were not. For direct-from-blood assays, contrived blood samples as low as 0.8 CFU/mL were reported positive after transportation without the need for blood culture.
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http://dx.doi.org/10.1038/s41598-021-95619-xDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8352943PMC
August 2021

Update on Noma: systematic review on classification, outcomes and follow-up of patients undergoing reconstructive surgery after Noma disease.

BMJ Open 2021 08 5;11(8):e046303. Epub 2021 Aug 5.

Department of Dental and Maxillofacial Surgery, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK.

Introduction: Noma is a significant yet neglected disease which affects some of the least developed countries in the world. The long-term benefit and safety of Noma surgical reconstructive missions have recently been under scrutiny due to a perceived lack of measurable outcomes and appropriate follow-up. This study analyses and reports on classifications, outcome measurement tools and follow-up for reconstructive surgery after Noma disease.

Methods: This systematic review was undertaken following Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. The three medical databases Medline, EMBASE and Web of Sciences were searched, articles published between 1 January 1983 and 15 April 2020 were included. All primary evidence on reconstructive surgery following Noma disease, reporting data on outcome after surgery, follow-up time and complications were included. Extracted data were aggregated to generate overall and population corrected mean outcomes and complication rates.

Results: Out of 1393 identified records, 31 studies including 1110 Noma patients were analysed. NOITULP and Montandon/WHO were the most commonly used classification systems. Mouth opening (MO) and complication rates were the two most often reported outcomes. Overall mean complication rate was 44%, reported by 24 studies. Postoperative MO was reported by eight publications, of which, five reported long-term outcomes (>12 months). Mean MO improved by 20 mm when compared with mean population weighted preoperative MO (7 mm). At long-term follow-up, MO decreased to 20 mm.

Conclusions: Studies reporting on neglected diseases in developing countries often lack methodological rigour. Surgeons should be mindful during patient examination by using a classification system that allows to compare preoperative versus postoperative state of disease. Short-term mission surgery is a vital part of healthcare delivery to underdeveloped and poor regions. Future missions should aim at sustainable partnerships with local healthcare providers to ensure postoperative care and long-term patient-oriented follow-up. A shift towards a diagonal treatment delivery approach, whereby local surgeons and healthcare staff are educated and empowered, should be actively promoted.

Prospero Registration Number: CRD42020181931.
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http://dx.doi.org/10.1136/bmjopen-2020-046303DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8344268PMC
August 2021

Willingness to receive a COVID-19 vaccine in people with multiple sclerosis - UK MS Register survey.

Mult Scler Relat Disord 2021 Oct 27;55:103175. Epub 2021 Jul 27.

UK MS Register, Swansea SA2 8PP, UK.

Background & Methods: We conducted an online COVID-19 survey as the vaccines became available, utilising the UK MS Register, to understand people with multiple sclerosis (pwMS) views on COVID-19 vaccination and the subsequent vaccine uptake rates.

Results & Conclusion: 94.4% of 3191 pwMS surveyed indicated they would get a COVID-19 vaccine, while 5.6% would not. PwMS who have previously had an influenza vaccine, increasing age and the perception of having sufficient information about the vaccine were associated with increased likelihood of getting a vaccine. 51.7% of 3191 pwMS completed a follow-up survey indicating they received at least 1 dose of a COVID-19 vaccine. The proportion having had the vaccination based on their prior opinions was 53.2% in 'Yes' group and 27.0% in 'No' group, the latter reflecting a change based on their initial views. More information on COVID-19 vaccine safety in pwMS would be helpful for people to make informed decisions.
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http://dx.doi.org/10.1016/j.msard.2021.103175DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8313796PMC
October 2021
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