Publications by authors named "Macintyre E"

Article Synopsis
  • Intravenous vasopressors are commonly used for unstable patients in critical care, but the potential of oral vasopressors like midodrine is still being explored.
  • A study was conducted at the University of Alberta Hospital to assess the feasibility of using midodrine in ICU patients who were reliant on IV vasopressors, involving random assignment to midodrine or placebo.
  • Results showed that midodrine had a slightly shorter ICU stay and lower hospital mortality compared to the placebo, indicating a need for further research on oral vasopressors in critically ill patients.
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Objectives: To summarize the efficacy of midodrine as an adjunctive therapy in critically ill patients. Safety of midodrine was assessed as a secondary outcome.

Data Sources: We performed a systematic review and meta-analysis using a peer-reviewed search strategy combining the themes of vasopressor-dependent shock, critical care, and midodrine and including MEDLINE, Ovid Embase, CINAHL, and Cochrane library databases until September 14, 2023.

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Alterations inactivating the tumor suppressor gene PTEN drive the development of solid and hematological cancers, such as T-cell acute lymphoblastic leukemia (T-ALL), whereby PTEN loss defines poor-prognosis patients. We investigated the metabolic rewiring induced by PTEN loss in T-ALL, aiming at identifying novel metabolic vulnerabilities. We showed that the enzyme ATP citrate lyase (ACLY) is strictly required for the transformation of thymic immature progenitors and for the growth of human T-ALL, which remain dependent on ACLY activity even upon transformation.

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The accurate diagnosis of haematolymphoid malignancies is crucial for effective cancer care, but major obstacles to diagnosis exist in low- and middle-income countries (LMICs). This article explores the global applicability of current haematolymphoid classification systems, which are predominantly derived from data generated in high-income countries (HICs). Although disproportionately burdened with poor cancer outcomes, LMICs are generally faced with limited diagnostic resources, suboptimal access to therapeutics, and inadequate healthcare infrastructure.

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T-lymphoblastic lymphoma (T-LBL) and thymoma are two rare primary tumors of the thymus deriving either from T-cell precursors or from thymic epithelial cells, respectively. Some thymoma subtypes (AB, B1, and B2) display numerous reactive terminal deoxynucleotidyl transferase-positive (TdT) T-cell precursors masking epithelial tumor cells. Therefore, the differential diagnosis between T-LBL and TdT T-lymphocyte-rich thymoma could be challenging, especially in the case of needle biopsy.

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Article Synopsis
  • Value-based laboratory medicine focuses on improving patient outcomes by enhancing the clinical utility of diagnostic tests while optimizing resources and reducing costs.
  • Key elements include the organization of diagnostics, translating lab data into meaningful clinical information, and addressing ethical considerations such as patient empowerment and big data analysis.
  • The paper summarizes insights from the EFLM Strategic Conference and highlights the importance of education, technological advancements, and future regulations in shaping the profession.
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Perception has been conceptualised as an active and adaptive process, based upon incoming sensory inputs, which are modified by top-down factors such as cognitions. Visuospatial perception is thought to be scaled based on threat, with highly threatening objects or contexts visually inflated to promote escape or avoidance behaviours. This meta-analytical systematic review quantified the effect and evidence quality of threat-evoked visuospatial scaling, as well as how visuospatial scaling relates to affordances (perceived action capabilities) and behavioural avoidance/escape outcomes.

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Article Synopsis
  • The study refines the prediction of outcomes in T-cell acute lymphoblastic leukemia (T-ALL) using next-generation sequencing (NGS) to identify genetic mutations associated with risk levels.
  • A classifier developed through whole-exome sequencing categorized patients into low-risk and high-risk groups based on specific mutations, revealing significant differences in their 5-year cumulative incidence of relapse (CIR).
  • Integrating this genetic stratification with clinical factors like white blood cell counts and minimal residual disease enhances prognosis and identifies potential patients for targeted therapies.
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Article Synopsis
  • - Obinutuzumab (O) and rituximab (R) were compared in a long-term study (LyMa-101) for treating newly diagnosed mantle cell lymphoma (MCL) patients, focusing on outcomes like measurable residual disease (MRD), progression-free survival (PFS), and overall survival (OS).
  • - Results showed that the O group had a higher rate of MRD negativity (83.1% vs 63.4%) and better long-term outcomes, with 5-year PFS at 82.8% and OS at 86.4%, compared to 66.6% and 71.4% for the R group, respectively.
  • - The study concluded that using
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Visuospatial perception is thought to be adaptive-ie, hills are perceived as steeper when capacity is low, or threat is high-guiding appropriate interaction with the environment. Pain (bodily threat) may similarly modulate visuospatial perception, with the extent of modulation influenced by threat magnitude (pain intensity, fear) and associated with behaviour (physical activity). We compared visuospatial perception of the environment between 50 people with painful knee osteoarthritis and 50 age-/sex-matched pain-free control participants using 3 virtual reality tasks (uphill steepness estimation, downhill steepness estimation, and a distance-on-hill measure), exploring associations between visuospatial perception, clinical characteristics (pain intensity, state and trait fear), and behaviour (wrist-worn accelerometry) within a larger knee osteoarthritis group (n = 85).

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Article Synopsis
  • * A comprehensive analysis of 97 BCP-LBL cases revealed a mutational profile closely resembling that of BCP-ALL, though with a higher frequency of mutations in epigenetic modifiers in BCP-LBL.
  • * The study found that most molecular subtypes from BCP-ALL are also present in BCP-LBL, suggesting that next-generation sequencing can help identify genetic subtypes in BCP-LBL, potentially
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Article Synopsis
  • This study investigates genomic imbalances in 317 newly diagnosed T-cell acute lymphoblastic leukemia (T-ALL) patients using single nucleotide polymorphism (SNP) array analysis, focusing on clinical features and outcomes.* -
  • The majority of patients (approximately 96%) showed at least one genomic imbalance, with del(9)(p21) being the most common, followed by other significant deletions involving various chromosomal regions.* -
  • The research identified specific genomic patterns related to age and subclassifications of T-ALL, and established a threshold of 15 imbalances for defining high- and low-risk relapse groups, highlighting the importance of genomic complexity in predicting survival outcomes.*
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This study provides an update on multidisciplinary staffing and clinical activity in Australian specialist persistent pain services. Of the 109 services identified, 57 responded, met inclusion criteria and completed a study-specific questionnaire detailing service characteristics, staff resources, and clinical activities. Where possible, data were compared between the 'Waiting in Pain' (WIP) investigations (WIP-I: Dec'08-Jan'10, WIP-II: Jul'16-Feb'18).

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Purpose: The outcome of older patients with mantle cell lymphoma (MCL) has improved by the introduction of immunochemotherapy, followed by rituximab (R)-maintenance. Assessment of minimal residual disease (MRD) represents a promising tool for individualized treatment decisions and was a prospectively planned part of the European MCL Elderly trial. We investigated how MRD status influenced the efficacy of R-maintenance and how MRD can enable tailored consolidation strategies.

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Purpose: To assess the impact of PHF6 alterations on clinical outcome and therapeutical actionability in T-cell acute lymphoblastic leukemia (T-ALL).

Experimental Design: We described PHF6 alterations in an adult cohort of T-ALL from the French trial Group for Research on Adult Acute Lymphoblastic Leukemia (GRAALL)-2003/2005 and retrospectively analyzed clinical outcomes between PHF6-altered (PHF6ALT) and wild-type patients. We also used EPIC and chromatin immunoprecipitation sequencing data of patient samples to analyze the epigenetic landscape of PHF6ALT T-ALLs.

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The prognostic value of F-Fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) at baseline or the predictive value of minimal residual disease (MRD) detection appear as potential tools to improve mantle cell lymphoma (MCL) patients' management. The LyMa-101, a phase 2 trial of the LYSA group (ClinicalTrials.gov:NCT02896582) reported induction therapy with obinutuzumab, a CD20 monoclonal antibody.

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Article Synopsis
  • Scientists are trying to understand how certain immune cells, called lymphocytes, develop in our bodies.
  • They found that there are different paths these cells can take, and new types of cells called multi-lymphoid progenitors (MLPs) form before becoming either NK, ILC, T cells, or B cells.
  • The way these cells grow and develop is really different depending on the kind of immune cell they will become, and the scientists discovered new important steps and controls in this process.
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Article Synopsis
  • - The study evaluated the effectiveness and costs of next-generation sequencing (NGS) in treating various hematological cancers in both pediatric and adult patients, collecting data from 26 laboratories with differing practices.
  • - Results showed that NGS influenced treatment management for 73.4% of cases, particularly providing prognostic information and aiding treatment adaptations, though about 18.9% of prescriptions had no immediate impact on therapy.
  • - The average cost for NGS samples was 191 €, with variations based on the type of panel used, highlighting the need for clear discussions about precision medicine's effects on patient care and financial implications.
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The reintegration of excised signal joints resulting from human V(D)J recombination was described as a potent source of genomic instability in human lymphoid cancers. However, such molecular events have not been recurrently reported in clinical patient lymphoma/leukemia samples. Using a specifically designed NGS-capture pipeline, we here demonstrated the reintegration of T-cell receptor excision circles (TRECs) in 20/1533 (1.

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Unlabelled: While opioids are part of usual care for analgesia in the ICU, there are concerns regarding excess use. This is a systematic review of nonsteroidal anti-inflammatory drugs (NSAIDs) use in postoperative critical care adult patients.

Data Sources: We searched Medical Literature Analysis and Retrieval System Online, Excerpta Medica database, Cumulative Index to Nursing and Allied Health Literature, Cochrane Library, trial registries, Google Scholar, and relevant systematic reviews through March 2023.

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Background: The European Society for Medical Oncology (ESMO)-Magnitude of Clinical Benefit Scale (MCBS) has been accepted as a robust tool to evaluate the magnitude of clinical benefit reported in trials for oncological therapies. However, the ESMO-MCBS hitherto has only been validated for solid tumours. With the rapid development of novel therapies for haematological malignancies, we aimed to develop an ESMO-MCBS version that is specifically designed and validated for haematological malignancies.

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Changes in lymphocyte production patterns occurring across human ontogeny remain poorly defined. In this study, we demonstrate that human lymphopoiesis is supported by three waves of embryonic, fetal, and postnatal multi-lymphoid progenitors (MLPs) differing in CD7 and CD10 expression and their output of CD127 early lymphoid progenitors (ELPs). In addition, our results reveal that, like the fetal-to-adult switch in erythropoiesis, transition to postnatal life coincides with a shift from multilineage to B lineage-biased lymphopoiesis and an increase in production of CD127 ELPs, which persists until puberty.

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Setting: In Ontario, local public health units (PHUs) are responsible for leading case investigations, contact tracing, and follow-up. The workforce capacity and operational requirements needed to maintain this public health strategy during the COVID-19 pandemic were unprecedented.

Intervention: Public Health Ontario's Contact Tracing Initiative (CTI) was established to provide a centralized workforce.

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