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  1. Article: Case Report: A case of disseminated cutaneous listeriosis following appendicitis from Lao PDR.

    Evans, Terry John / Siratana, Vannavong / Venkatesan, Timothy / Davong, Viengmon / Thanadabouth, Khamphong / Ashley, Elizabeth A

    Wellcome open research

    2023  Volume 8, Page(s) 504

    Abstract: Background: Listeria monocytogenes: Case: A 41-year-old woman who initially presented to a hospital in Laos with appendicitis was diagnosed with disseminated cutaneous listeriosis without recognised risk factors. Intra-abdominal pathology probably ... ...

    Abstract Background: Listeria monocytogenes
    Case: A 41-year-old woman who initially presented to a hospital in Laos with appendicitis was diagnosed with disseminated cutaneous listeriosis without recognised risk factors. Intra-abdominal pathology probably contributed to bacterial bloodstream invasion. Initial treatment with meropenem was switched to ampicillin based on best practice, however our patient died 5 days after diagnosis.
    Conclusions: This case highlights listeriosis as an important cause of mortality in low- and middle-income countries, exacerbated by poor availability of laboratory diagnostics and ineffective empiric antibiotic regimens. Improvements in food hygiene, surveillance, and increased laboratory capacity are important strategies to reduce rates of infection and clinical outcomes.
    Language English
    Publishing date 2023-11-07
    Publishing country England
    Document type Case Reports
    ISSN 2398-502X
    ISSN 2398-502X
    DOI 10.12688/wellcomeopenres.20210.1
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Treatment of

    Evans, Terry John / Fernando, Samitha / Uberti, Micaela / Martin, Andrew J / Basarab, Marina

    BMJ case reports

    2022  Volume 15, Issue 5

    Abstract: A woman in her 50s developed meningitis following an endoscopic, endonasal resection of a clival meningioma which was complicated by a cerebrospinal fluid (CSF) leak through the nose. CSF analysis showed a raised white cell count, ... ...

    Abstract A woman in her 50s developed meningitis following an endoscopic, endonasal resection of a clival meningioma which was complicated by a cerebrospinal fluid (CSF) leak through the nose. CSF analysis showed a raised white cell count, and
    MeSH term(s) Capnocytophaga ; Central Nervous System Infections/complications ; Cerebrospinal Fluid Leak/etiology ; Chloramphenicol ; Female ; Humans ; Meningeal Neoplasms/complications ; Meningitis/complications ; Meningitis/drug therapy
    Chemical Substances Chloramphenicol (66974FR9Q1)
    Language English
    Publishing date 2022-05-25
    Publishing country England
    Document type Case Reports ; Journal Article
    ISSN 1757-790X
    ISSN (online) 1757-790X
    DOI 10.1136/bcr-2022-249821
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Treating chronic hepatitis E: when is enough enough?

    Evans, Terry John / Hilton, Rachel / Douthwaite, Sam

    BMJ case reports

    2018  Volume 2018

    Abstract: We present a 38-year-old white British man who was taking long-term immunosuppressive medication following kidney transplantation. On routine review, he was noted to have an isolated and asymptomatic rise in alanine aminotransferase. After thorough ... ...

    Abstract We present a 38-year-old white British man who was taking long-term immunosuppressive medication following kidney transplantation. On routine review, he was noted to have an isolated and asymptomatic rise in alanine aminotransferase. After thorough investigation, he was found to have positive IgM and IgG serology to hepatitis E virus-and given the duration of his transaminitis, he was determined to have chronic hepatitis E infection. Treatment options were complicated by the presence of his kidney transplant, by chronic anaemia and by his wish for concomitant fertility treatment. Ribavirin therapy was instituted with a dramatic and immediate drop in serum viral load, although stool viraemia persisted. No clear protocols guide duration of treatment in chronic hepatitis E infection, but protracted faecal virus shedding predicts viral recrudescence, and treatment should continue at least until the stool is clear of virus.
    MeSH term(s) Adult ; Alanine Transaminase/metabolism ; Antiviral Agents/therapeutic use ; Feces/virology ; Hepatitis E/drug therapy ; Hepatitis E/immunology ; Hepatitis E/physiopathology ; Hepatitis, Chronic/drug therapy ; Hepatitis, Chronic/immunology ; Hepatitis, Chronic/physiopathology ; Humans ; Immunocompromised Host ; Kidney Transplantation ; Male ; Opportunistic Infections/drug therapy ; Opportunistic Infections/immunology ; Opportunistic Infections/virology ; Ribavirin/therapeutic use ; Treatment Outcome ; Viral Load ; Virus Shedding
    Chemical Substances Antiviral Agents ; Ribavirin (49717AWG6K) ; Alanine Transaminase (EC 2.6.1.2)
    Language English
    Publishing date 2018-02-01
    Publishing country England
    Document type Case Reports ; Journal Article
    ISSN 1757-790X
    ISSN (online) 1757-790X
    DOI 10.1136/bcr-2017-223592
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article: Antibiotic usage and stewardship in patients with COVID-19: too much antibiotic in uncharted waters?

    Evans, Terry John / Davidson, Harriet Claire / Low, Jen Mae / Basarab, Marina / Arnold, Amber

    Journal of infection prevention

    2020  Volume 22, Issue 3, Page(s) 119–125

    Abstract: Background: Antimicrobial usage and stewardship programmes during COVID-19 have been poorly studied. Prescribing practice varies despite national guidelines, and there is concern that stewardship principles have suffered.: Aim: To analyse antibiotic ... ...

    Abstract Background: Antimicrobial usage and stewardship programmes during COVID-19 have been poorly studied. Prescribing practice varies despite national guidelines, and there is concern that stewardship principles have suffered.
    Aim: To analyse antibiotic prescriptions during the COVID-19 pandemic at a teaching hospital and to propose improved approaches to stewardship.
    Methods: We reviewed COVID-19 admissions to medical wards and intensive care units (ICUs) in a London teaching hospital to assess initial antibiotic usage and evidence of bacterial co-infection, and to determine if our current antibiotic guidelines were adhered to.
    Findings: Data from 130 inpatients (76% medical and 24% ICU) were obtained. On admission, 90% were treated with antibiotics. No microbiological samples taken on admission provided definitive evidence of respiratory co-infection. In 13% of cases, antibiotics were escalated, usually without supporting clinical, radiological or laboratory evidence. In 16% of cases, antibiotics were stopped or de-escalated within 72 h. Blood results and chest radiographs were characteristic of COVID-19 in 20% of ward patients and 42% of ICU patients. Overall mortality was 25% at 14 days - similar to rates described for the UK as a whole.
    Conclusion: The majority of patients received antibiotics despite limited evidence of co-infection. Most patients received narrower spectrum antibiotics than recommended by NICE. As understanding of the natural history of COVID-19 infections progresses, stewardship programmes will need to evolve; however, at this point, we feel that a more restrictive antibiotic prescribing approach is warranted. We propose strategies for effective stewardship and estimate the effect this may have on antibiotic consumption.
    Language English
    Publishing date 2020-12-10
    Publishing country England
    Document type Journal Article
    ZDB-ID 2595000-9
    ISSN 1757-1782 ; 1757-1774
    ISSN (online) 1757-1782
    ISSN 1757-1774
    DOI 10.1177/1757177420976813
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Response to Author Comments on "Clinical, microbiological characteristics and predictors of mortality in patients with carbapenemase-producing Enterobacterales blood stream infections".

    Anton-Vazquez, Vanesa / Evans, Terry John / Fernando, Samitha / Somasunderam, Donald / David, Kate / Melzer, Mark / Hawkins, Lois / Morris-Jones, Stephen / Arias, Mauricio / Drazho, Borana / Dall'Antonia, Martino / Planche, Timothy

    Infection prevention in practice

    2023  Volume 5, Issue 4, Page(s) 100327

    Language English
    Publishing date 2023-11-17
    Publishing country England
    Document type Journal Article
    ISSN 2590-0889
    ISSN (online) 2590-0889
    DOI 10.1016/j.infpip.2023.100327
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: Clinical, microbiological characteristics and predictors of mortality in patients with carbapenemase-producing Enterobacterales bloodstream infections: a multicentre study.

    Anton-Vazquez, Vanesa / Evans, Terry John / Fernando, Samitha / Somasunderam, Donald / David, Kate / Melzer, Mark / Hawkins, Lois / Morris-Jones, Stephen / Arias, Mauricio / Drazho, Borana / Dall'Antonia, Martino / Planche, Timothy

    Infection prevention in practice

    2023  Volume 5, Issue 3, Page(s) 100298

    Abstract: Objectives: To investigate the clinical, microbiological characteristics and outcomes of patients with bloodstream infections (BSI) due to carbapenemase-producing Enterobacterales (CPE).: Methods: A multicentre retrospective observational study of ... ...

    Abstract Objectives: To investigate the clinical, microbiological characteristics and outcomes of patients with bloodstream infections (BSI) due to carbapenemase-producing Enterobacterales (CPE).
    Methods: A multicentre retrospective observational study of patients with BSIs due to CPE admitted to six UK hospitals was conducted between 2011 and 2021. Multivariate analysis was used to identify factors predicting 30-day case fatality rate (CFR).
    Results: There were 84 episodes of CPE-BSIs, 37 (44%) due to OXA-48, 35 (42%) to metallo-betalactamases (MBL) and 12 (14%) to KPC. 63% of patients were male with a median age of 64 years. Common organisms included
    Conclusion: Strategies targeting high-risk patients and adherence to infection prevention bundles for urinary devices and central venous catheters can reduce OXA-48 and KPC-BSIs. Early recognition and management of severe sepsis, prompt initiation of appropriate antimicrobial therapy and development of novel antimicrobials are crucial to mitigate the high CFR associated with CPE-BSIs
    Language English
    Publishing date 2023-07-08
    Publishing country England
    Document type Journal Article
    ISSN 2590-0889
    ISSN (online) 2590-0889
    DOI 10.1016/j.infpip.2023.100298
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article ; Online: SUMOylation of PCNA by PIAS1 and PIAS4 promotes template switch in the chicken and human B cell lines.

    Mohiuddin, Mohiuddin / Evans, Terry John / Rahman, Md Maminur / Keka, Islam Shamima / Tsuda, Masataka / Sasanuma, Hiroyuki / Takeda, Shunichi

    Proceedings of the National Academy of Sciences of the United States of America

    2018  Volume 115, Issue 50, Page(s) 12793–12798

    Abstract: DNA damage tolerance (DDT) releases replication blockage caused by damaged nucleotides on template strands employing two alternative pathways, error-prone translesion DNA synthesis (TLS) and error-free template switch (TS). Lys164 of proliferating cell ... ...

    Abstract DNA damage tolerance (DDT) releases replication blockage caused by damaged nucleotides on template strands employing two alternative pathways, error-prone translesion DNA synthesis (TLS) and error-free template switch (TS). Lys164 of proliferating cell nuclear antigen (PCNA) is SUMOylated during the physiological cell cycle. To explore the role for SUMOylation of PCNA in DDT, we characterized chicken DT40 and human TK6 B cells deficient in the PIAS1 and PIAS4 small ubiquitin-like modifier (SUMO) E3 ligases. DT40 cells have a unique advantage in the phenotypic analysis of DDT as they continuously diversify their immunoglobulin (Ig) variable genes by TLS and TS [Ig gene conversion (GC)], both relieving replication blocks at abasic sites without accompanying by DNA breakage. Remarkably,
    MeSH term(s) Animals ; B-Lymphocytes/metabolism ; Cell Cycle/genetics ; Cell Line ; Chickens/genetics ; DNA Damage/genetics ; DNA Repair/genetics ; DNA Replication/genetics ; Gene Conversion/genetics ; Genes, Immunoglobulin/genetics ; Humans ; Immunoglobulin Variable Region/genetics ; Poly-ADP-Ribose Binding Proteins/genetics ; Proliferating Cell Nuclear Antigen/genetics ; Protein Inhibitors of Activated STAT/genetics ; Sumoylation/genetics ; Ubiquitin-Protein Ligases/genetics
    Chemical Substances Immunoglobulin Variable Region ; Poly-ADP-Ribose Binding Proteins ; Proliferating Cell Nuclear Antigen ; Protein Inhibitors of Activated STAT ; Ubiquitin-Protein Ligases (EC 2.3.2.27)
    Language English
    Publishing date 2018-11-28
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 209104-5
    ISSN 1091-6490 ; 0027-8424
    ISSN (online) 1091-6490
    ISSN 0027-8424
    DOI 10.1073/pnas.1716349115
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Article ; Online: Mutant cells defective in DNA repair pathways provide a sensitive high-throughput assay for genotoxicity.

    Evans, Terry John / Yamamoto, Kimiyo N / Hirota, Kouji / Takeda, Shunichi

    DNA repair

    2010  Volume 9, Issue 12, Page(s) 1292–1298

    Abstract: Chemicals used industrially and commercially are required by law to be assessed for their genotoxic potential. However, all currently used assays have major limitations and despite intense effort, there is no universal agreement on which tests should be ... ...

    Abstract Chemicals used industrially and commercially are required by law to be assessed for their genotoxic potential. However, all currently used assays have major limitations and despite intense effort, there is no universal agreement on which tests should be employed, or how to interpret results. We have developed a new assay system using the chicken DT40 B cell line that offers a number of significant advantages over current methodologies. Our assay could provide enhanced sensitivity using genetically defined and phenotypically characterized mutants defective in DNA repair pathways. Furthermore, analysis of the mutants, using DNA repair proficient wild-type cells as a negative control, minimizes false negative outcomes. Assessing the different responses of a panel of mutants representative of all repair pathways, mechanistic detail of genotoxicity can be determined. This unique feature, as well as reducing the false positive rate, strengthens positive identifications and is useful when extrapolating results to the human context. Our panel of mutants is likely to be useful in screening large compound libraries for an emerging class of chemotherapeutic drugs, which includes inhibitors of DNA repair enzymes such as PARP and DNA polymerases.
    MeSH term(s) Animals ; Cell Line ; Chickens ; DNA Damage ; DNA Repair/genetics ; DNA Replication/physiology ; Mutagenicity Tests/methods ; Mutagens/metabolism ; Mutation/genetics
    Chemical Substances Mutagens
    Language English
    Publishing date 2010-12-10
    Publishing country Netherlands
    Document type Journal Article ; Review
    ZDB-ID 2071608-4
    ISSN 1568-7856 ; 1568-7864
    ISSN (online) 1568-7856
    ISSN 1568-7864
    DOI 10.1016/j.dnarep.2010.09.017
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  9. Article ; Online: A novel genotoxicity assay of carbon nanotubes using functional macrophage receptor with collagenous structure (MARCO)-expressing chicken B lymphocytes.

    Mohiuddin / Keka, Islam Shamima / Evans, Terry John / Hirota, Kouji / Shimizu, Hiroyasu / Kono, Koichi / Takeda, Shunichi / Hirano, Seishiro

    Archives of toxicology

    2014  Volume 88, Issue 1, Page(s) 145–160

    Abstract: Although carbon nanotubes (CNTs) are promising nanomaterials, their potential carcinogenicity is a major concern. We previously established a genetic method of analyzing genotoxicity of chemical compounds, where we evaluated their cytotoxic effect on the ...

    Abstract Although carbon nanotubes (CNTs) are promising nanomaterials, their potential carcinogenicity is a major concern. We previously established a genetic method of analyzing genotoxicity of chemical compounds, where we evaluated their cytotoxic effect on the DT40 lymphoid cell line comparing DNA-repair-deficient isogenic clones with parental wild-type cells. However, application of our DT40 system for the cytotoxic and genotoxic evaluation of nanomaterials seemed to be difficult, because DT40 cells only poorly internalized nanoparticles. To solve this problem, we have constructed a chimeric gene encoding a trans-membrane receptor consisting of the 5' region of the transferrin receptor (TR) gene (to facilitate internalization of nanoparticles) and the 3' region of the macrophage receptor with collagenous structure (MARCO) gene (which is a receptor for environmental particles). We expressed the resulting MARCO-TR chimeric receptor on DNA-repair-proficient wild-type cells and mutants deficient in base excision repair (FEN1 (-/-)) and translesion DNA synthesis (REV3 (-/-)). We demonstrated that the chimera mediates uptake of particles such as fluorescence-tagged polystyrene particles and multi-walled carbon nanotubes (MWCNTs), with very poor uptake of those particles by DT40 cells not expressing the chimera. MWCNTs were cytotoxic and this effect was greater in FEN1 (-/-)and REV3 (-/-) cells than in wild-type cells. Furthermore, MWCNTs induced greater oxidative damage (measured as 8-OH-dG formation) and a larger number of mitotic chromosomal aberrations in repair-deficient cells compared to repair-proficient cells. Taken together, our novel assay system using the chimeric receptor-expressing DT40 cells provides a sensitive method to screen for genotoxicity of CNTs and possibly other nanomaterials.
    MeSH term(s) Animals ; B-Lymphocytes/drug effects ; Cell Line/drug effects ; Chickens ; Chromosome Aberrations ; DNA Repair/drug effects ; Deoxyguanosine/analogs & derivatives ; Deoxyguanosine/metabolism ; Mutagenicity Tests/methods ; Nanotubes, Carbon/toxicity ; Polystyrenes/pharmacokinetics ; Receptors, Immunologic/genetics ; Receptors, Immunologic/metabolism ; Receptors, Transferrin/genetics ; Receptors, Transferrin/metabolism ; Recombinant Proteins/genetics ; Recombinant Proteins/metabolism
    Chemical Substances Nanotubes, Carbon ; Polystyrenes ; Receptors, Immunologic ; Receptors, Transferrin ; Recombinant Proteins ; 8-oxo-7-hydrodeoxyguanosine (88847-89-6) ; Deoxyguanosine (G9481N71RO)
    Language English
    Publishing date 2014-01
    Publishing country Germany
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 124992-7
    ISSN 1432-0738 ; 0340-5761
    ISSN (online) 1432-0738
    ISSN 0340-5761
    DOI 10.1007/s00204-013-1084-7
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  10. Article ; Online: Evaluation of the Implementation of the 4C Mortality Score in United Kingdom hospitals during the second pandemic wave

    Blunsum, Andrew E / Perkins, Jonathan S. / Arshad, Areeb / Bajpai, Sukrit / Barclay-Elliott, Karen / Brito-Mutunayagam, Sanjita / Brooks, Rebecca / Chan, Terrence / Coates, Dominic / Corobana, Alina / Crocker-Buque, Tim / Evans, Terry John / Gordon-Brown, Jasmine / Hack, Berkin / Hiles, Heather / Khanijau, Aakash / Lalwani, Salina / Leong, Clare / MacKay, Kirsty /
    Macrae, Catriona / Martin, Bryony / Martin, Christopher A / McKemey, Emily / Nazareth, Joshua / Pan, Daniel / Scopazzini, Marcello / Simons, David / Swinhoe, Sophie / Thomas, Julia / Thorburn, Fiona / Walpole, Sarah / Warne, Esmie / Wilson, Rory / MacConnachie, Alisdair / Ho, Antonia

    medRxiv

    Abstract: ABSTRACT The 4C Mortality Score (4C Score) was designed to risk stratify hospitalised patients with COVID-19. We assessed inclusion of 4C Score in COVID-19 management guidance and its documentation in patients9 case notes in January 2021 in UK hospitals. ...

    Abstract ABSTRACT The 4C Mortality Score (4C Score) was designed to risk stratify hospitalised patients with COVID-19. We assessed inclusion of 4C Score in COVID-19 management guidance and its documentation in patients9 case notes in January 2021 in UK hospitals. 4C Score was included within guidance by 50% of sites, though score documentation in case notes was highly variable. Higher documentation of 4C Score was associated with score integration within admissions proformas, inclusion of 4C Score variables or link to online calculator, and management decisions. Integration of 4C Score within clinical pathways may encourage more widespread use.
    Keywords covid19
    Language English
    Publishing date 2021-12-19
    Publisher Cold Spring Harbor Laboratory Press
    Document type Article ; Online
    DOI 10.1101/2021.12.18.21268003
    Database COVID19

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