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  1. Article ; Online: Causes of mortality in individuals with tuberous sclerosis complex.

    Amin, Sam / Lux, Andrew / Calder, Nuala / Laugharne, Matthew / Osborne, John / O'callaghan, Finbar

    Developmental medicine and child neurology

    2017  Volume 59, Issue 6, Page(s) 612–617

    Abstract: Aim: The causes of death in patients with tuberous sclerosis complex (TSC) have rarely been studied, with only one published account, which was reported from the Mayo Clinic in 1991. We aimed to investigate mortality in a large cohort of patients with ... ...

    Abstract Aim: The causes of death in patients with tuberous sclerosis complex (TSC) have rarely been studied, with only one published account, which was reported from the Mayo Clinic in 1991. We aimed to investigate mortality in a large cohort of patients with TSC from one of two national referral clinics in the UK.
    Method: We identified 284 patients who attended Bath TSC clinic between 1981 and 2015, and ascertained causes of death by reviewing medical records, death certificates, and postmortem reports.
    Results: Sixteen patients died from complications of TSC: eight from TSC kidney diseases; four from sudden unexpected death in epilepsy (SUDEP); two from lymphangioleiomyomatosis; one from a subependymal giant cell astrocytoma; and one from a pancreatic malignancy. The median age of death was 33 years (interquartile range [IQR] 26-46). Mortality was significantly more common in patients with learning disabilities than in those without (13/135 [9%] vs 3/131 [2%]; two-tailed Fisher exact test p=0.020).
    Interpretation: Renal disease is a major cause of mortality in TSC. Lifelong surveillance and early intervention is warranted. SUDEP is also an important cause of mortality. Patients with learning disabilities are at significantly greater risk of early mortality and this implies the need for greater vigilance for TSC-related complications in this group. Female patients are vulnerable to pulmonary and renal disease. Pancreatic lesions are a rare but potentially treatable cause of mortality.
    MeSH term(s) Adolescent ; Adult ; Aged, 80 and over ; Cause of Death ; Cohort Studies ; Databases, Factual ; Epilepsy/complications ; Epilepsy/mortality ; Female ; Follow-Up Studies ; Humans ; Kidney Diseases/complications ; Kidney Diseases/mortality ; Learning Disorders/complications ; Learning Disorders/mortality ; Male ; Middle Aged ; Tuberous Sclerosis/complications ; Tuberous Sclerosis/mortality ; United Kingdom ; Young Adult
    Language English
    Publishing date 2017-06
    Publishing country England
    Document type Journal Article
    ZDB-ID 80369-8
    ISSN 1469-8749 ; 0012-1622
    ISSN (online) 1469-8749
    ISSN 0012-1622
    DOI 10.1111/dmcn.13352
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Modifying gut integrity and microbiome in children with severe acute malnutrition using legume-based feeds (MIMBLE): A pilot trial.

    Calder, Nuala / Walsh, Kevin / Olupot-Olupot, Peter / Ssenyondo, Tonny / Muhindo, Rita / Mpoya, Ayub / Brignardello, Jerusa / Wang, Xuedan / McKay, Eleanor / Morrison, Douglas / Holmes, Elaine / Frost, Gary / Maitland, Kathryn

    Cell reports. Medicine

    2021  Volume 2, Issue 5, Page(s) 100280

    Abstract: Case fatality among African children with severe acute malnutrition remains high. We report a 3-arm pilot trial in 58 Ugandan children, comparing feeds targeting disordered gastrointestinal function containing cowpea (CpF, n = 20) or inulin (InF, n = 20) ...

    Abstract Case fatality among African children with severe acute malnutrition remains high. We report a 3-arm pilot trial in 58 Ugandan children, comparing feeds targeting disordered gastrointestinal function containing cowpea (CpF, n = 20) or inulin (InF, n = 20) with conventional feeds (ConF, n = 18). Baseline measurements of gut permeability (lactulose:mannitol ratio 1.19 ± SD 2.00), inflammation (fecal calprotectin 539.0 μg/g, interquartile range [IQR] 904.8), and satiety (plasma polypeptide YY 62.6 pmol/l, IQR 110.3) confirm gastrointestinal dysfunction. By day 28, no differences are observable in proportion achieving weight gain >5 g/kg/day (87%, 92%, 86%; p > 0.05), mortality (16%, 30%, 17%; p > 0.05), or edema resolution (83%, 54%, 91%; p > 0.05) among CpF, InF, and ConF. Decreased fecal bacterial richness from day 1 (abundance-based coverage estimator [ACE] 53.2) to day 7 (ACE 40.8) is observed only in ConF (p = 0.025).
    MeSH term(s) Bacteria/drug effects ; Child ; Child, Preschool ; Fabaceae ; Feces/microbiology ; Gastrointestinal Microbiome/drug effects ; Gastrointestinal Microbiome/physiology ; Humans ; Infant ; Leukocyte L1 Antigen Complex/physiology ; Malnutrition/etiology ; Microbiota/genetics ; Microbiota/immunology ; Permeability ; Pilot Projects ; RNA, Ribosomal, 16S/drug effects ; RNA, Ribosomal, 16S/genetics
    Chemical Substances Leukocyte L1 Antigen Complex ; RNA, Ribosomal, 16S
    Language English
    Publishing date 2021-05-18
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ISSN 2666-3791
    ISSN (online) 2666-3791
    DOI 10.1016/j.xcrm.2021.100280
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Gallbladder agenesis with midgut malrotation.

    Calder, Nuala / Carneiro, Herman Anthony / Khwaja, Haris A / Thompson, Jeremy N

    BMJ case reports

    2012  Volume 2012

    Abstract: A 28-year-old female presented with a 4 year history of intermittent right upper quadrant pain. Clinical examination and ultrasound suggested a diagnosis of cholelithiasis and the patient was eventually booked for a laparoscopic cholecystectomy. ... ...

    Abstract A 28-year-old female presented with a 4 year history of intermittent right upper quadrant pain. Clinical examination and ultrasound suggested a diagnosis of cholelithiasis and the patient was eventually booked for a laparoscopic cholecystectomy. Intraoperatively the patient was found to have gallbladder agenesis and small bowel malrotation with the duodenojejunal flexure to right of midline. The gallbladder fossa was filled with fibrous tissue. Both gallbladder agenesis and midgut malrotation are rare congenital abnormalities. Gallbladder agenesis has a similar presentation to more common gallbladder pathologies, such as cholecystitis. This case illustrates the limitations of and our over reliance on radiological imaging. Moreover, it highlights the need to have a high index suspicion of gallbladder agenesis when ultrasound is inconclusive. Further investigations and imaging with modalities such as MRI should be used to reduce the risks associated with unnecessary surgical intervention.
    MeSH term(s) Abdominal Pain/etiology ; Adult ; Cholangiopancreatography, Magnetic Resonance ; Cholecystectomy, Laparoscopic ; Diagnosis, Differential ; Digestive System Abnormalities ; Female ; Gallbladder/abnormalities ; Gallstones/diagnosis ; Humans ; Intestinal Volvulus/congenital ; Intestinal Volvulus/diagnosis ; Intestinal Volvulus/surgery
    Language English
    Publishing date 2012-09-14
    Publishing country England
    Document type Case Reports ; Journal Article
    ISSN 1757-790X
    ISSN (online) 1757-790X
    DOI 10.1136/bcr.10.2011.5053
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article: M

    Walsh, Kevin / Calder, Nuala / Olupot-Olupot, Peter / Ssenyondo, Tonny / Okiror, William / Okalebo, Charles Bernard / Muhindo, Rita / Mpoya, Ayub / Holmes, Elaine / Marchesi, Julian / Delamare de la Villenaise de Chenevarin, Gael / Frost, Gary / Maitland, Kathryn

    Wellcome open research

    2018  Volume 3, Page(s) 95

    Abstract: Background: ...

    Abstract Background:
    Language English
    Publishing date 2018-08-02
    Publishing country England
    Document type Journal Article
    ISSN 2398-502X
    ISSN 2398-502X
    DOI 10.12688/wellcomeopenres.14706.1
    Database MEDical Literature Analysis and Retrieval System OnLINE

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