Publications by authors named "Critchley L"

Background: Intravenous [IV] infliximab is a well-established therapy for inflammatory bowel diseases [IBD] patients. A subcutaneous [SC] formulation of infliximab [CT-P13] has recently been shown to be as effective as IV infliximab after two doses of IV induction in a randomised trial, but there are no data to support elective switching of patients on maintenance IV infliximab therapy. We aimed to assess the effectiveness of an elective switching programme to SC CT-P13 in patients treated with IV infliximab.

View Article and Find Full Text PDF

The supply and fate of wrack (dead organic matter) is a critical determinant of the structure and function of shoreline ecosystems, and their role as carbon repositories. The increasingly common practise of armouring urbanised shorelines with seawalls impacts wrack deposits of unvegetated estuarine and coastal shorelines by truncating the intertidal zone and/or by modifying the physical and biological processes that deliver and remove wrack. This study tested whether such effects also extend to mangrove forests.

View Article and Find Full Text PDF

Background: There is growing public health concern around the potential impact of the opioid crisis on efforts to eradicate HIV. This secondary analysis seeks to determine if those who report opioids as their primary problem drug compared to those who report other drugs and/or alcohol differ in engagement in HIV primary care among a sample of hospitalized people with HIV (PWH) who use drugs and/or alcohol, a traditionally marginalized and difficult to engage population key to ending the HIV epidemic.

Setting And Participants: A total of 801 participants (67% male; 75% Black, non-Hispanic; mean age 44.

View Article and Find Full Text PDF

Background: Substance use can reduce care engagement for individuals with HIV. However, little is known as to whether heavy drinkers differ from drug users. This study compares heavy drinkers, drug users, and those drinking heavily and using drugs on their HIV care engagement.

View Article and Find Full Text PDF

Hemodynamic management is a mainstay of patient care in the operating room and intensive care unit (ICU). In order to optimize patient treatment, researchers investigate monitoring technologies, cardiovascular (patho-) physiology, and hemodynamic treatment strategies. The Journal of Clinical Monitoring and Computing (JCMC) is a well-established and recognized platform for publishing research in this field.

View Article and Find Full Text PDF

Hemodynamic monitoring provides the basis for the optimization of cardiovascular dynamics in intensive care medicine and anesthesiology. The Journal of Clinical Monitoring and Computing (JCMC) is an ideal platform to publish research related to hemodynamic monitoring technologies, cardiovascular (patho)physiology, and hemodynamic treatment strategies. In this review, we discuss selected papers published on cardiovascular and hemodynamic monitoring in the JCMC in 2017.

View Article and Find Full Text PDF

The assessment and optimization of cardiovascular and hemodynamic variables is a mainstay of patient management in the care for critically ill patients in the intensive care unit (ICU) or the operating room (OR). It is, therefore, of outstanding importance to meticulously validate technologies for hemodynamic monitoring and to study their applicability in clinical practice and, finally, their impact on treatment decisions and on patient outcome. In this regard, the Journal of Clinical Monitoring and Computing (JCMC) is an ideal platform for publishing research in the field of cardiovascular and hemodynamic monitoring.

View Article and Find Full Text PDF

To compare the performance of a bioreactance cardiac output (CO) monitor (NICOM) and transcutaneous Doppler (USCOM) during head up tilting (HUT). Healthy young adult subjects, age 22 ± 1 years, 7 male and 7 female, were tilted over 3-5 s from supine to 70° HUT, 30° HUT and back to supine. Positions were held for 3 min.

View Article and Find Full Text PDF

Background: Hypotension is a common side effect of general anesthesia induction, and when severe, it is related to adverse outcomes. Ultrasonography of inferior vena cava (IVC) is a reliable indicator of intravascular volume status. This study investigated whether preoperative ultrasound IVC measurements could predict hypotension after induction of anesthesia.

View Article and Find Full Text PDF

Background: The thoracic aorta elongates and unfolds with advancing age. Lateral displacement and tortuosity of the descending part may affect oesophageal Doppler monitoring (ODM) readings because probe alignment becomes slanted. This investigation aimed to relate aortic displacement as it appears on the chest radiograph with variations in ODM readings as the probe is inserted to different depths.

View Article and Find Full Text PDF

The demise of the pulmonary artery catheter as a gold standard in cardiac output measurement has created the need for new standard. Doppler cardiac output can be measured suprasternally (USCOM) and via the oesophagus (CardioQ). Use in tandem they may provide a reliable trend line of cardiac output changes against which new technologies can be assessed.

View Article and Find Full Text PDF

Background: Different mathematical approaches are used to calculate arterial pulse pressure wave analysis (PPWA) cardiac output. The CardioQ-Combi is a research oesophageal Doppler (COODM) monitor that includes these five fundamental PPWA algorithms. We compared these PPWA cardiac output readings to COODM and suprasternal USCOM Doppler (COUS) over a range of cardiac output values induced by dopamine infusion in patients undergoing major surgery.

View Article and Find Full Text PDF

Background: Minimally invasive continuous cardiac output measurements are recommended for use during anesthesia to guide fluid therapy, but such measurements must trend changes reliably. The NICOM Cheetah, a BioReactance monitor, is being recommended for intraoperative use. To validate its use, Doppler methods, suprasternal USCOM and esophageal CardioQ, were used in tandem to provide reliable estimates of changing trends in cardiac output.

View Article and Find Full Text PDF

Problem: The availability of less expensive and smaller ultrasound machines has enabled the use of ultrasound in virtually all major medical/surgical disciplines. Some medical schools have incorporated point-of-care ultrasound training into their undergraduate curriculum, whereas many postgraduate programs have made ultrasound training a standard. The Chinese University of Hong Kong has charged its Department of Anaesthesia and Intensive Care to spearhead the introduction of ultrasound into the final-year medical curriculum by introducing handheld transthoracic echocardiography as part of perioperative assessment.

View Article and Find Full Text PDF

Virtual patients are computerised representations of realistic clinical cases. They were developed to teach clinical reasoning skills through delivery of multiple standardized patient cases. The anesthesia course at The Chinese University of Hong Kong developed two novel types of virtual patients, formative assessment cases studies and storyline, to teach its final year medical students on a 2 week rotational course.

View Article and Find Full Text PDF

Minimally-invasive cardiac output (CO) monitoring to follow changes in CO would be helpful in anaesthesia practice. Two Doppler systems marketed for this purpose include the CardioQ (Deltex Medical Group, Chichester, United Kingdom), which uses an oesophageal probe, and the USCOM (USCOM Ltd., Sydney, NSW, Australia), which uses a hand-held probe.

View Article and Find Full Text PDF

Objective: To evaluate the risks of perioperative respiratory complications and postoperative morbidity associated with active and passive cigarette smoking.

Background: Environmental tobacco smoke is associated with perioperative respiratory events in children, but its effect in adults is unknown.

Methods: We conducted a cohort study of 736 adult patients receiving general anesthesia for major elective surgery.

View Article and Find Full Text PDF

Cardiac output can be measured non-invasively using supra-sternal Doppler (USCOM, Sydney, NSW, Australia). However, scanning can be difficult in practice in older patients, the reason for which has not been elucidated previously. Chest radiographs from 60 previously studied anaesthetised patients were reviewed and scored for aortic unfolding, enlargement and calcification, and cardiac enlargement.

View Article and Find Full Text PDF

Objective: The precision of thermodilution cardiac output measurement using a pulmonary artery catheter can be divided into random and systematic errors. This study determined the systematic component.

Design: Comparative validation against a transonic flow probe on the aortic root.

View Article and Find Full Text PDF