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Article ; Online: Recent advances in understanding the human host immune response in tuberculous meningitis.

Barnacle, James R / Davis, Angharad G / Wilkinson, Robert J

2024 Volume 14, Page(s) 1326651

Abstract: Tuberculous meningitis (TBM), the most severe form of tuberculosis, causes death in approximately 25% cases despite antibiotic therapy, and half of survivors are left with neurological disability. Mortality and morbidity are contributed to by a ... ...

Abstract	Tuberculous meningitis (TBM), the most severe form of tuberculosis, causes death in approximately 25% cases despite antibiotic therapy, and half of survivors are left with neurological disability. Mortality and morbidity are contributed to by a dysregulated immune response, and adjunctive host-directed therapies are required to modulate this response and improve outcomes. Developing such therapies relies on improved understanding of the host immune response to TBM. The historical challenges in TBM research of limited
MeSH term(s)	Adult ; Child ; Humans ; Tuberculosis, Meningeal ; MicroRNAs ; Central Nervous System ; Mycobacterium tuberculosis ; B-Lymphocytes
Chemical Substances	MicroRNAs
Language	English
Publishing date	2024-01-09
Publishing country	Switzerland
Document type	Journal Article ; Review ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
ZDB-ID	2606827-8
ISSN	1664-3224 ; 1664-3224
ISSN (online)	1664-3224
ISSN	1664-3224
DOI	10.3389/fimmu.2023.1326651
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: Needle in a haystack: a case report of splenic foreign body-associated sepsis.

Turner, Benedict R H / Barnacle, James / Sheth, Hemant

Journal of surgical case reports

2021 Volume 2021, Issue 11, Page(s) rjab525

Abstract: Instances of foreign bodies impacted in solid organs are rare, and rarer still are reports of objects in the spleen. A 42-year-old presented septic with abdominal pain, high inflammatory markers and haemodynamic instability. She was found to have a ... ...

Abstract	Instances of foreign bodies impacted in solid organs are rare, and rarer still are reports of objects in the spleen. A 42-year-old presented septic with abdominal pain, high inflammatory markers and haemodynamic instability. She was found to have a splenic haematoma and a 4-cm hyperdense foreign body within the spleen. Ultrasound-guided drainage of the haematoma isolated
Language	English
Publishing date	2021-11-29
Publishing country	England
Document type	Journal Article
ISSN	2042-8812
ISSN	2042-8812
DOI	10.1093/jscr/rjab525
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Article: Leptospirosis as an important differential of pulmonary haemorrhage on the intensive care unit: a case managed with VV-ECMO.

Barnacle, James / Gurney, Stefan / Ledot, Stephane / Singh, Suveer

Journal of intensive care

2020 Volume 8, Page(s) 31

Abstract: Background: Leptospirosis is a potentially fatal zoonosis. It can cause a wide range of symptoms, including diffuse alveolar haemorrhage which occurs in a minority of cases but carries a mortality of over 70%. These patients may present with severe ... ...

Abstract	Background: Leptospirosis is a potentially fatal zoonosis. It can cause a wide range of symptoms, including diffuse alveolar haemorrhage which occurs in a minority of cases but carries a mortality of over 70%. These patients may present with severe acute respiratory failure. The differential diagnosis for diffuse alveolar haemorrhage is broad whereas prompt diagnosis and treatment can be lifesaving. Case presentation: A 20-year-old previously fit and well trout farm worker presented with a 3-day history of malaise, fevers, diarrhoea, vomiting and jaundice. He developed haemoptysis, severe headaches, neck stiffness and photophobia on the day of emergency admission. He was anaemic and thrombocytopenic. Anuric acute kidney injury (urea 32, creat 507) required immediate haemofiltration. In view of progressive respiratory failure with four-quadrant lung infiltrates on imaging, he was given broad spectrum antibiotics and pulsed methylprednisolone empirically, in case of a vasculitic pulmonary-renal presentation. He was intubated within 48 h of admission. Despite attempted protective ventilatory management, he remained hypoxaemic and developed pneumomediastinum. He was retrieved to a specialist cardiorespiratory intensive care unit on femoro-femoral mobile VV-ECMO. Three days from admission, results showed positive Conclusions: Leptospirosis is a rare but important differential to be considered in diffuse alveolar haemorrhage presenting to the ICU, especially in young males. A thorough history for occupational or recreational risk factors may offer the diagnostic clue. Most patients recover fully with antibiotics. However, resulting acute severe respiratory failure can ensue. In this situation, early consideration for respiratory ECMO support offers time for clearance of endobronchial clot, parenchymal recovery, and prevention of ventilator-induced lung injury. Steroids have no clear evidence but may be used to avoid delay in treating suspected vasculitic or autoimmune causes of diffuse alveolar haemorrhage.
Keywords	covid19
Language	English
Publishing date	2020-04-26
Publishing country	England
Document type	Case Reports
ZDB-ID	2739853-5
ISSN	2052-0492
ISSN	2052-0492
DOI	10.1186/s40560-020-00447-2
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Article ; Online: Investigating competencies needed by European-trained doctors in rural South African hospitals.

Barnacle, James R / Johnson, Oliver / Couper, Ian

African journal of primary health care & family medicine

2020 Volume 12, Issue 1, Page(s) e1–e7

Abstract: Background: Many European-trained doctors (ETDs) recruited to work in rural district hospitals in South Africa have insufficient generalist competencies for the range of practice required. Africa Health Placements recruits ETDs to work in rural ... ...

Abstract	Background: Many European-trained doctors (ETDs) recruited to work in rural district hospitals in South Africa have insufficient generalist competencies for the range of practice required. Africa Health Placements recruits ETDs to work in rural hospitals in Africa. Many of these doctors feel inadequately prepared. The Stellenbosch University Ukwanda Centre for Rural Health is launching a Postgraduate Diploma in Rural Medicine to help prepare doctors for such work. Aim: To determine the competencies gap for ETDs working in rural district hospitals in South Africa to inform the curriculum of the PG Dip (Rural Medicine). Setting: Rural district hospitals in South Africa. Methods: Nine hospitals in the Eastern Cape, KwaZulu-Natal and Mpumalanga were purposefully selected by Africa Health Placements as receiving ETDs. An online survey was developed asking about the most important competencies and weaknesses for ETDs when working rurally. The clinical manager and any ETDs currently working in each hospital were invited to complete the survey. Results: Surveys were completed by 19 ETDs and five clinical managers. The top clinical competencies in relation to 10 specific domains were identified. The results also indicate broader competencies required, specific skills gaps, the strengths that ETDs bring to South Africa and how ETDs prepare themselves for working in this context. Conclusion: This study identifies the important competency gaps among ETDs and provides useful direction for the diploma and other future training initiatives. The diploma faculty must reflect on these findings and ensure the curriculum is aligned with these gaps.
MeSH term(s)	Adult ; Clinical Competence ; Curriculum ; Europe/ethnology ; Female ; Foreign Medical Graduates/psychology ; Hospitals, District ; Hospitals, Rural ; Humans ; Male ; South Africa ; Surveys and Questionnaires
Language	English
Publishing date	2020-08-25
Publishing country	South Africa
Document type	Journal Article
ZDB-ID	2526836-3
ISSN	2071-2936 ; 2071-2928
ISSN (online)	2071-2936
ISSN	2071-2928
DOI	10.4102/phcfm.v12i1.2322
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Article ; Online: Excess cost and inpatient stay of treating deep spinal surgical site infections.

Barnacle, James / Wilson, Dianne / Little, Christopher / Hoffman, Christopher / Raymond, Nigel

The New Zealand medical journal

2018 Volume 131, Issue 1475, Page(s) 27–34

Abstract: Aim: To determine the excess cost and hospitalisation associated with surgical site infections (SSI) following spinal operations in a New Zealand setting.: Methods: We identified inpatients treated for deep SSI following primary or revision spinal ... ...

Abstract	Aim: To determine the excess cost and hospitalisation associated with surgical site infections (SSI) following spinal operations in a New Zealand setting. Methods: We identified inpatients treated for deep SSI following primary or revision spinal surgery at a regional tertiary spinal centre between 2009 and 2016. Excess cost and excess length of stay (LOS) were calculated via a clinical costing system using procedure-matched controls. Results: Twenty-eight patients were identified. Twenty-five had metalware following spinal fusion surgery, while three had non-instrumented decompression and/or discectomy. Five were diagnosed during their index hospitalisation and 23 (82%) were re-admitted. The average excess SSI cost was NZ$51,434 (range $1,398-$262,206.16) and LOS 37.1 days (range 7-275 days). Infections following metalware procedures had a greater excess cost (average $56,258.90 vs. $11,228.61) and LOS (average 40.4 days vs. 9.7 days) than procedures without metalware. Conclusion: The costs associated with spinal SSI are significant and comparable to a previous New Zealand study of hip and knee prosthesis SSI. More awareness of the high costs involved should encourage research and implementation of infection prevention strategies.
MeSH term(s)	Adolescent ; Adult ; Aged ; Aged, 80 and over ; Decompression, Surgical/economics ; Diskectomy/economics ; Female ; Follow-Up Studies ; Gram-Negative Bacterial Infections/economics ; Gram-Negative Bacterial Infections/therapy ; Gram-Positive Bacterial Infections/economics ; Gram-Positive Bacterial Infections/therapy ; Hospital Costs/statistics & numerical data ; Humans ; Length of Stay/economics ; Male ; Middle Aged ; New Zealand ; Retrospective Studies ; Spinal Fusion/economics ; Surgical Wound Infection/economics ; Surgical Wound Infection/therapy ; Young Adult
Language	English
Publishing date	2018-05-18
Publishing country	New Zealand
Document type	Journal Article
ZDB-ID	390590-1
ISSN	1175-8716 ; 0028-8446 ; 0110-7704
ISSN (online)	1175-8716
ISSN	0028-8446 ; 0110-7704
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Ua VI Zs.396: Show issues

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Article: Cytomegalovirus Retinitis Screening and Treatment in Human Immunodeficiency Virus Patients in Malawi: A Feasibility Study.

Ocieczek, Paulina / Barnacle, James R / Gumulira, Joe / Phiri, Sam / Heller, Tom / Grabska-Liberek, Iwona

Open forum infectious diseases

2019 Volume 6, Issue 11, Page(s) ofz439

Abstract: Background: Cytomegalovirus retinitis is a treatable cause of blindness in people with human immunodeficiency virus (HIV) typically with CD4 counts <50 cells/mm: Methods: Patients with CD4 counts <200 cells/mm: Results: Five of the 102 people with ...

Abstract	Background: Cytomegalovirus retinitis is a treatable cause of blindness in people with human immunodeficiency virus (HIV) typically with CD4 counts <50 cells/mm Methods: Patients with CD4 counts <200 cells/mm Results: Five of the 102 people with HIV screened had cytomegalovirus retinitis (4.9%). All affected patients had CD4 counts <50 cells/mm Conclusions: Cytomegalovirus retinitis screening based on CD4 count is essential to early recognition because visual acuity and symptoms are unreliable. Cytomegalovirus retinitis is a significant yet neglected public health issue in Malawi. Oral valganciclovir is essential to reduce blindness and mortality in those diagnosed but is not yet available. Further screening and advocacy are needed.
Language	English
Publishing date	2019-11-06
Publishing country	United States
Document type	Journal Article
ZDB-ID	2757767-3
ISSN	2328-8957
ISSN	2328-8957
DOI	10.1093/ofid/ofz439
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Article: The first three reported cases of

Barnacle, James R / Chow, Yimmy J / Borman, Andrew M / Wyllie, Steven / Dominguez, Valentin / Russell, Katherine / Roberts, Helen / Armstrong-James, Darius / Whittington, Ashley M

Medical mycology case reports

2022 Volume 39, Page(s) 14–17

Abstract: An epidemic of cat-transmitted sporotrichosis caused ... ...

Abstract	An epidemic of cat-transmitted sporotrichosis caused by
Language	English
Publishing date	2022-12-20
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	2670415-8
ISSN	2211-7539
ISSN	2211-7539
DOI	10.1016/j.mmcr.2022.12.004
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Article ; Online: Changes in the hospital admission profile of COVID-19 positive patients at a central London trust.

Barnacle, James R / Cairney, Gary / Rainsley, James / Mercuri, Luca / Gibani, Malick M / Cooke, Graham S / Brett, Stephen J

The Journal of infection

2020 Volume 82, Issue 1, Page(s) 159–198

MeSH term(s)	COVID-19 ; Hospitalization ; Hospitals ; Humans ; London/epidemiology ; SARS-CoV-2
Keywords	covid19
Language	English
Publishing date	2020-07-24
Publishing country	England
Document type	Letter ; Comment
ZDB-ID	424417-5
ISSN	1532-2742 ; 0163-4453
ISSN (online)	1532-2742
ISSN	0163-4453
DOI	10.1016/j.jinf.2020.07.022
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Zs.A 1501: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (1.OG) ab Jg. 2022: Lesesaal (EG)
Zs.MG 48: Show issues

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Article ; Online: The clinical presentation of monkeypox: a retrospective case-control study of patients with possible or probable monkeypox in a West London cohort.

Rimmer, Stephanie / Barnacle, James / Gibani, Malick M / Wu, Meng-San / Dissanayake, Oshani / Mehta, Ravi / Herdman, Trent / Gilchrist, Mark / Muir, David / Ebrahimsa, Umar / Mora-Peris, Borja / Dosekun, Olamide / Garvey, Lucy / Peters, Joanna / Davies, Frances / Cooke, Graham / Abbara, Aula

International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases

2022 Volume 126, Page(s) 48–53

Abstract: Objectives: Since May 2022, cases of human monkeypox virus (hMPXV) with human-to-human cross-transmission have significantly increased in nonendemic countries. Our aim was to characterize diagnostic features of patients with confirmed and possible ... ...

Abstract	Objectives: Since May 2022, cases of human monkeypox virus (hMPXV) with human-to-human cross-transmission have significantly increased in nonendemic countries. Our aim was to characterize diagnostic features of patients with confirmed and possible monkeypox to guide future risk stratification and to describe a virtual care model. Methods: We performed a retrospective case-control study of 140 patients assessed and screened for suspected monkeypox; on hMPXV polymerase chain reaction testing, 70 were confirmed positive, and 70 were negative. Data were compared to generate odds ratios of demographic and clinical features. Results: Patients who tested positive were predominantly cis-male (99%) and self-identified as gay, bisexual, and other men who have sex with men (94%). Lymphadenopathy at presentation was associated with a higher likelihood of a positive result (odds ratio [OR] 7.69 [95% confidence interval (CI) 3.58, 16.51]). Patients who tested positive were more likely to have a rash affecting the genital (OR 5.38 [95% CI 2.57, 11.23]) or buttocks/perianal region (OR 3.79 [1.70, 8.45]) than negative controls. A total of 79% of patients were engaged with a virtual ward follow-up. Conclusion: These data can inform a risk-based approach to the management of suspected monkeypox in gay, bisexual, and other men who have sex with men populations. Lymphadenopathy at presentation and the location of the rash were more associated with a positive hMPXV result. Health authorities can consider a virtual ward approach in the hMPHXV outbreak.
MeSH term(s)	Humans ; Male ; Case-Control Studies ; Retrospective Studies ; Mpox (monkeypox)/diagnosis ; Mpox (monkeypox)/epidemiology ; Homosexuality, Male ; London ; Sexual and Gender Minorities ; Exanthema ; Lymphadenopathy
Language	English
Publishing date	2022-11-19
Publishing country	Canada
Document type	Journal Article
ZDB-ID	1331197-9
ISSN	1878-3511 ; 1201-9712
ISSN (online)	1878-3511
ISSN	1201-9712
DOI	10.1016/j.ijid.2022.11.020
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Zs.A 4516: Show issues

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Article: Changes in the hospital admission profile of COVID-19 positive patients at a central London trust

Barnacle, James R / Cairney, Gary / Rainsley, James / Mercuri, Luca / Gibani, Malick M / Cooke, Graham S / Brett, Stephen J

J. infect

Keywords	covid19
Publisher	WHO
Document type	Article
Note	WHO #Covidence: #662832
Database	COVID19

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