13 results on '"Kerr, Simon"'
Search Results
2. Falls and Fall-Related Injury Are Common in Older People with Chronic Liver Disease.
- Author
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Frith, James, Kerr, Simon, Robinson, Lisa, Elliott, Chris, Wilton, Katharine, Jones, David, Day, Christopher, and Newton, Julia
- Subjects
- *
LIVER diseases , *ACCIDENTAL falls , *MUSCLE abnormalities , *DISEASES in older people , *QUALITY of life , *WOUND care , *DISEASE prevalence - Abstract
Background: Improved survival with chronic liver disease (CLD) and increased incidence in the older has led to a rapidly expanding population which faces similar 'geriatric syndromes' as the general population. With risk factors such as autonomic dysfunction, cognitive impairment, and muscle abnormalities in CLD it is expected that falls and injury will be common. Aim: To determine prevalence of falls and injury in chronic liver disease and to identify potential modifiable fall associations. Methods: Falls prevalence was estimated by providing patients aged ≥65 years with CLD a falls data collection tool, via the post or in the clinic. A younger CLD cohort and age-matched and sex-matched community controls was used for comparison. A sub-group underwent multidisciplinary falls assessment to identify modifiable fall associations. Results: Falls were significantly more common in older people with CLD (47 % in previous year) than in controls; incidence of injury did not differ. Regression identified orthostatic symptoms, lower-limb strength, and fear of falling as being independently associated with falls in CLD. Those who had fallen had significantly greater difficulty with daily activities. Conclusion: Falls are prevalent in older people with CLD, and are potentially preventable with multifactorial intervention. Services must prepare for expansion in the older CLD population; here we demonstrate how this expansion may affect falls services and provide a potential therapeutic target. [ABSTRACT FROM AUTHOR]
- Published
- 2012
- Full Text
- View/download PDF
3. Carotid Sinus Hypersensitivity in Asymptomatic Older Persons.
- Author
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Kerr, Simon R. J., Pearce, Mark S., Brayne, Carol, Davis, Richard J., and Kenny, Rose Anne
- Subjects
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SYNCOPE , *ALLERGIES , *CAROTID sinus , *DISEASES in older people - Abstract
The article determines the prevalence of carotid sinus hypersensitivity an unselected community sample of older people with no history of syncope in the U.S. A study reveals that carotid sinus hypersensitivity is common in older persons including those with no history of syncope and is typically present among males. Results suggests that hypersensitive response should not necessarily preclude further investigation for other causes of syncope.
- Published
- 2006
- Full Text
- View/download PDF
4. Consider Several Key Factors When Assessing Robotic Technology.
- Author
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Cherf, John and Kerr, Simon
- Subjects
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ROBOTICS , *TOTAL knee replacement , *TOTAL hip replacement - Abstract
Although robotic technology is associated with incrediblyaccurate placement of knee and hip arthroplasty implants, thepublished literature has not yet substantiated that roboticsurgeries have led to improved clinical outcomes comparedto manual or computer-assisted surgeries. Smith & Nephew's NAVIO Surgical System is currently theonly handheld robotics system for knee surgery and featuresthe largest portfolio of compatible implants for total andpartial knee arthroplasty, according to the manufacturer. [Extracted from the article]
- Published
- 2020
5. Activin type I receptor polymorphisms and body composition in older individuals with sarcopenia—Analyses from the LACE randomised controlled trial.
- Author
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Bashir, Tufail, Achison, Marcus, Adamson, Simon, Akpan, Asangaedem, Aspray, Terry, Avenell, Alison, Band, Margaret M., Burton, Louise A., Cvoro, Vera, Donnan, Peter T., Duncan, Gordon W., George, Jacob, Gordon, Adam L., Gregson, Celia L., Hapca, Adrian, Hume, Cheryl, Jackson, Thomas A., Kerr, Simon, Kilgour, Alixe, and Masud, Tahir
- Subjects
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BODY composition , *OLDER people , *SARCOPENIA , *MUSCLE mass , *ADIPOSE tissues , *FAT , *ACTIVIN receptors - Abstract
Background: Ageing is associated with changes in body composition including an overall reduction in muscle mass and a proportionate increase in fat mass. Sarcopenia is characterised by losses in both muscle mass and strength. Body composition and muscle strength are at least in part genetically determined, consequently polymorphisms in pathways important in muscle biology (e.g., the activin/myostatin signalling pathway) are hypothesised to contribute to the development of sarcopenia. Methods: We compared regional body composition measured by DXA with genotypes for two polymorphisms (rs10783486, minor allele frequency (MAF) = 0.26 and rs2854464, MAF = 0.26) in the activin 1B receptor (ACVR1B) determined by PCR in a cross-sectional analysis of DNA from 110 older individuals with sarcopenia from the LACE trial. Results: Neither muscle mass nor strength showed any significant associations with either genotype in this cohort. Initial analysis of rs10783486 showed that males with the AA/AG genotype were taller than GG males (174±7cm vs 170±5cm, p = 0.023) and had higher arm fat mass, (median higher by 15%, p = 0.008), and leg fat mass (median higher by 14%, p = 0.042). After correcting for height, arm fat mass remained significantly higher (median higher by 4% padj = 0.024). No associations (adjusted or unadjusted) were seen in females. Similar analysis of the rs2854464 allele showed a similar pattern with the presence of the minor allele (GG/AG) being associated with greater height (GG/AG = 174±7 cm vs AA = 170 ±5cm, p = 0.017) and greater arm fat mass (median higher by 16%, p = 0.023). Again, the difference in arm fat remained after correction for height. No similar associations were seen in females analysed alone. Conclusion: These data suggest that polymorphic variation in the ACVR1B locus could be associated with body composition in older males. The activin/myostatin pathway might offer a novel potential target to prevent fat accumulation in older individuals. [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
- View/download PDF
6. Evidence-based Savings Opportunities Exist with TJR Devices.
- Author
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Cherf, John and Kerr, Simon
- Subjects
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AMBULATORY surgery , *ARTIFICIAL joints , *SAVINGS , *ELECTRONIC health records , *HEALTH facilities ,POPULATION health management - Published
- 2019
7. ACE I/D genotype associates with strength in sarcopenic men but not with response to ACE inhibitor therapy in older adults with sarcopenia: Results from the LACE trial.
- Author
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Rossios, Christos, Bashir, Tufail, Achison, Marcus, Adamson, Simon, Akpan, Asangaedem, Aspray, Terry, Avenell, Alison, Band, Margaret M., Burton, Louise A., Cvoro, Vera, Donnan, Peter T., Duncan, Gordon W., George, Jacob, Gordon, Adam L., Gregson, Celia L., Hapca, Adrian, Hume, Cheryl, Jackson, Thomas A., Kerr, Simon, and Kilgour, Alixe
- Subjects
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SARCOPENIA , *MUSCLE mass , *ACE inhibitors , *OLDER people , *ANGIOTENSIN converting enzyme , *BODY composition , *GENOTYPES - Abstract
Background: Angiotensin II (AII), has been suggested to promote muscle loss. Reducing AII synthesis, by inhibiting angiotensin converting enzyme (ACE) activity has been proposed as a method to inhibit muscle loss. The LACE clinical trial was designed to determine whether ACE inhibition would reduce further muscle loss in individuals with sarcopenia but suffered from low recruitment and returned a negative result. Polymorphic variation in the ACE promoter (I/D alleles) has been associated with differences in ACE activity and muscle physiology in a range of clinical conditions. This aim of this analysis was to determine whether I/D polymorphic variation is associated with muscle mass, strength, in sarcopenia or contributed to the lack of response to treatment in the LACE study. Methods: Sarcopenic individuals were recruited into a 2x2 factorial multicentre double-blind study of the effects of perindopril and/or leucine versus placebo on physical performance and muscle mass. DNA extracted from blood samples (n = 130 72 women and 58 men) was genotyped by PCR for the ACE I/D polymorphism. Genotypes were then compared with body composition measured by DXA, hand grip and quadriceps strength before and after 12 months' treatment with leucine and/or perindopril in a cross-sectional analysis of the influence of genotype on these variables. Results: Allele frequencies for the normal UK population were extracted from 13 previous studies (I = 0.473, D = 0.527). In the LACE cohort the D allele was over-represented (I = 0.412, D = 0.588, p = 0.046). This over-representation was present in men (I = 0.353, D = 0.647, p = 0.010) but not women (I = 0.458, D = 0.532, p = 0.708). In men but not women, individuals with the I allele had greater leg strength (II/ID = 18.00 kg (14.50, 21.60) vs DD = 13.20 kg (10.50, 15.90), p = 0.028). Over the 12 months individuals with the DD genotype increased in quadriceps strength but those with the II or ID genotype did not. Perindopril did not increase muscle strength or mass in any polymorphism group relative to placebo. Conclusion: Our results suggest that although ACE genotype was not associated with response to ACE inhibitor therapy in the LACE trial population, sarcopenic men with the ACE DD genotype may be weaker than those with the ACE I/D or II genotype. [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
- View/download PDF
8. A prospective study of the association between orthostatic hypotension and falls: definition matters.
- Author
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MCDONALD, CLAIRE, PEARCE, MARK, KERR, SIMON R., and NEWTON, JULIA
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BLOOD pressure , *ACCIDENTAL falls , *ORTHOSTATIC hypotension , *LONGITUDINAL method , *COMORBIDITY - Abstract
Background: falls are a common cause of morbidity and mortality in older people. Orthostatic hypotension (OH) is considered an important risk factor for falls, but longitudinal studies have failed to show a clear association. This disparity may be because conventional methods of measuring blood pressure (BP) changes are too imprecise and/or the diagnostic criteria for OH are inappropriate. Over recent years, beat-to-beat BP monitoring techniques, which enabled accurate measurement of vasodepression, have become widely used and in 2011 the American Academy of Neurology produced revised diagnostic criteria for OH. Objective: to use beat-to-beat monitoring to compare the prevalence of OH using the standard and revised diagnostic criteria and to establish which criteria are most valuable in predicting future falls. Design: two hundred and ninety-seven community-dwelling older people aged ≥65 years underwent assessment. Active stand using digital photoplethysmography was used to record postural change in BP. One hundred participants were asked to complete prospective weekly falls diaries for 12 months. Results: OH, defined according to the revised American Academy of Neurology diagnostic criteria, affected 25% of participants and was an independent predictor of falls (odds ratio 10.299, 95% confidence interval [95% CI]: 1.703-61.43, P = 0.011) and time to first fall (hazard ratio 3.017, 95% CI: 1.291-7.050, P = 0.011). OH, defined according to standard criteria, affected 80% of the population and was not associated with falls. Conclusion: OH, defined according to 2011 criteria, is associated with falls and time to first fall. These findings indicate that beat-to-beat monitoring and the 2011 criteria for OH are valuable in the clinical assessment of older fallers. [ABSTRACT FROM AUTHOR]
- Published
- 2017
- Full Text
- View/download PDF
9. Reduced heart rate variability and baroreflex sensitivity in primary biliary cirrhosis.
- Author
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Newton, Julia L., Allen, John, Kerr, Simon, and Jones, David E. J.
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HEART beat , *HEART conduction system , *BAROREFLEXES , *HEART disease related mortality , *MORTALITY , *BLOOD pressure - Abstract
Standardized mortality ratio for primary biliary cirrhosis (PBC) is 2.87. Even after accounting for liver and cancer-related deaths there is an unexplained excess mortality associated with PBC. We have assessed heart rate variability (HRV) and baroreflex sensitivity (BRS) risk factors associated with cardiovascular mortality, in 57 PBC patients and age- and sex-matched normal controls. Methods: HRV and BRS were measured non-invasively in subjects and controls. Beat to beat RR interval and ‘Portapres’ blood pressure data were processed using power spectral analysis. Power was calculated in very low frequency (VLF), low-frequency (LF) and high-frequency (HF) bands according to international guidelines. BRS (α) was computed using cross-spectrum analysis. Patients also underwent fatigue severity assessment using a measure validated for use in PBC. Results: PBC patients had significantly lower total HRV compared with controls ( P=0.02), with the reduction occurring predominantly in the LF domain ( P=0.03). BRS was also significantly reduced compared with controls ( P=0.02). There were no significant differences in HRV or BRS between cirrhotic and non-cirrhotic patients. Within the PBC patient group HRV was significantly lower in fatigued than in non-fatigued patients ( P<0.05). Conclusion: Abnormalities of HRV and BRS in PBC are not specific to advanced disease but are associated with fatigue severity. Abnormalities could be associated with increased risk of sudden cardiac death, potentially contributing to the excess mortality seen in PBC. [ABSTRACT FROM AUTHOR]
- Published
- 2006
- Full Text
- View/download PDF
10. Brain oxygenation responses to an autonomic challenge: a quantitative fMRI investigation of the Valsalva manoeuvre.
- Author
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Bohr, Iwo, McDonald, Claire, He, Jiabao, Kerr, Simon, Newton, Julia L., and Blamire, Andrew M.
- Subjects
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FUNCTIONAL magnetic resonance imaging , *AUTONOMIC nervous system , *HYPOXEMIA , *DEOXYGENATION , *WHITE matter (Nerve tissue) - Abstract
In late age, the autonomic nervous system (ANS) has diminished ability to maintain physiological homeostasis in the brain in response to challenges such as to systemic blood pressure changes caused by standing. We devised an fMRI experiment aiming to map the cerebral effects of an ANS challenge (Valsalva manoeuvre (VM)). We used dual-echo fMRI to measure the effective transverse relaxation rate (R2*, which is inversely proportional to brain tissue oxygenation levels) in 45 elderly subjects (median age 80 years old, total range 75–89) during performance of the VM. In addition, we collected fluid-attenuated inversion recovery (FLAIR) data from which we quantified white matter hyperintensity (WMH) volumes. We conducted voxelwise analysis of the dynamic changes in R2* during the VM to determine the distribution of oxygenation changes due to the autonomic stressor. In white matter, we observed significant decreases in oxygenation levels. These effects were predominantly located in posterior white matter and to a lesser degree in the right anterior brain, both concentrated around the border zones (watersheds) between cerebral perfusion territories. These areas are known to be particularly vulnerable to hypoxia and are prone to formation of white matter hyperintensities. Although we observed overlap between localisation of WMH and triggered deoxygenation on the group level, we did not find significant association between these independent variables using subjectwise statistics. This could suggest other than recurrent transient hypoxia mechanisms causing/contributing to the formation of WMH. [ABSTRACT FROM AUTHOR]
- Published
- 2015
- Full Text
- View/download PDF
11. Cardiac Iodine-123-Meta-Iodo-Benzylguanidine Uptake in Carotid Sinus Hypersensitivity.
- Author
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Tan, Maw Pin, Murray, Alan, Hawkins, Terry, Chadwick, Thomas J., Kerr, Simon R. J., and Parry, Steve W.
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CAROTID sinus syndrome , *SYNCOPE , *DISEASES in older people , *IODINE isotopes , *RADIONUCLIDE imaging , *SYMPTOMS , *DIAGNOSIS - Abstract
Background: Carotid sinus syndrome is the association of carotid sinus hypersensitivity with syncope, unexplained falls and drop attacks in generally older people. We evaluated cardiac sympathetic innervation in this disorder in individuals with carotid sinus syndrome, asymptomatic carotid sinus hypersensitivity and controls without carotid sinus hypersensitivity. Methods: Consecutive patients diagnosed with carotid sinus syndrome at a specialist falls and syncope unit were recruited. Asymptomatic carotid sinus hypersensitivity and non-carotid sinus hypersensitivity control participants recruited from a community-dwelling cohort. Cardiac sympathetic innervation was determined using Iodine-123-metaiodobenzylguanidine (123-I-MIBG) scanning. Heart to mediastinal uptake ratio (H:M) were determined for early and late uptake on planar scintigraphy at 20 minutes and 3 hours following intravenous injection of 123-I-MIBG. Results: Forty-two subjects: carotid sinus syndrome (n = 21), asymptomatic carotid sinus hypersensitivity (n = 12) and no carotid sinus hypersensitivity (n = 9) were included. Compared to the non- carotid sinus hypersensitivity control group, the carotid sinus syndrome group had significantly higher early H:M (estimated mean difference, B = 0.40; 95% confidence interval, CI = 0.13 to 0.67, p = 0.005) and late H:M (B = 0.32; 95%CI = 0.03 to 0.62, p = 0.032). There was, however, no significant difference in early H:M (p = 0.326) or late H:M (p = 0.351) between the asymptomatic carotid sinus hypersensitivity group and non- carotid sinus hypersensitivity controls. Conclusions: Cardiac sympathetic neuronal activity is increased relative to age-matched controls in individuals with carotid sinus syndrome but not those with asymptomatic carotid sinus hypersensitivity. Blood pressure and heart rate measurements alone may therefore represent an over simplification in the assessment for carotid sinus syndrome and the relative increase in cardiac sympathetic innervation provides additional clues to understanding the mechanisms behind the symptomatic presentation of carotid sinus hypersensitivity. [ABSTRACT FROM AUTHOR]
- Published
- 2015
- Full Text
- View/download PDF
12. Symptoms During Carotid Sinus Massage, Not Hemodynamic Change, Are Associated with White Matter Hyperintensity Volume on Magnetic Resonance Imaging.
- Author
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McDonald, Claire, Firbank, Michael, Pearce, Mark, Blamire, Andrew M., Newton, Julia L., and Kerr, Simon
- Subjects
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MASSAGE therapy , *CAROTID sinus syndrome , *MAGNETIC resonance imaging , *STATISTICS , *DATA analysis , *DATA analysis software , *DESCRIPTIVE statistics , *OLD age , *THERAPEUTICS - Abstract
The article discusses research which was conducted to investigate whether symptoms associated with carotid sinus hypersensitivity indicate cerebral hypoperfusion and whether patients with carotid sinus hypersensitivity are at a greater risk of white matter hyperintensities. Researchers evaluated 272 subjects. They found that symptoms during carotid sinus massage and not hemodynamic change are associated with white matter hyperintensity volume.
- Published
- 2014
- Full Text
- View/download PDF
13. Falls and fall-related injury are common in older people with chronic liver disease.
- Author
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Frith J, Kerr S, Robinson L, Elliott CS, Wilton K, Jones DE, Day CP, Newton JL, Frith, James, Kerr, Simon, Robinson, Lisa, Elliott, Chris S, Wilton, Katharine, Jones, David E J, Day, Christopher P, and Newton, Julia L
- Abstract
Background: Improved survival with chronic liver disease (CLD) and increased incidence in the older has led to a rapidly expanding population which faces similar "geriatric syndromes" as the general population. With risk factors such as autonomic dysfunction, cognitive impairment, and muscle abnormalities in CLD it is expected that falls and injury will be common.Aim: To determine prevalence of falls and injury in chronic liver disease and to identify potential modifiable fall associations.Methods: Falls prevalence was estimated by providing patients aged ≥ 65 years with CLD a falls data collection tool, via the post or in the clinic. A younger CLD cohort and age-matched and sex-matched community controls was used for comparison. A sub-group underwent multidisciplinary falls assessment to identify modifiable fall associations.Results: Falls were significantly more common in older people with CLD (47 % in previous year) than in controls; incidence of injury did not differ. Regression identified orthostatic symptoms, lower-limb strength, and fear of falling as being independently associated with falls in CLD. Those who had fallen had significantly greater difficulty with daily activities.Conclusion: Falls are prevalent in older people with CLD, and are potentially preventable with multifactorial intervention. Services must prepare for expansion in the older CLD population; here we demonstrate how this expansion may affect falls services and provide a potential therapeutic target. [ABSTRACT FROM AUTHOR]- Published
- 2012
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