Prince Phillip Hospital

Llanelli, United Kingdom

Prince Phillip Hospital

Llanelli, United Kingdom
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Lewis P.D.,University of Swansea | Lewis K.E.,University of Swansea | Lewis K.E.,Prince Phillip Hospital | Ghosal R.,Prince Phillip Hospital | And 6 more authors.
BMC Cancer | Year: 2010

Background: Survival time for lung cancer is poor with over 90% of patients dying within five years of diagnosis primarily due to detection at late stage. The main objective of this study was to evaluate Fourier transform infrared spectroscopy (FTIR) as a high throughput and cost effective method for identifying biochemical changes in sputum as biomarkers for detection of lung cancer.Methods: Sputum was collected from 25 lung cancer patients in the Medlung observational study and 25 healthy controls. FTIR spectra were generated from sputum cell pellets using infrared wavenumbers within the 1800 to 950 cm-1"fingerprint" region.Results: A panel of 92 infrared wavenumbers had absorbances significantly different between cancer and normal sputum spectra and were associated with putative changes in protein, nucleic acid and glycogen levels in tumours. Five prominent significant wavenumbers at 964 cm-1, 1024 cm-1, 1411 cm-1, 1577 cm-1and 1656 cm-1separated cancer spectra from normal spectra into two distinct groups using multivariate analysis (group 1: 100% cancer cases; group 2: 92% normal cases). Principal components analysis revealed that these wavenumbers were also able to distinguish lung cancer patients who had previously been diagnosed with breast cancer. No patterns of spectra groupings were associated with inflammation or other diseases of the airways.Conclusions: Our results suggest that FTIR applied to sputum might have high sensitivity and specificity in diagnosing lung cancer with potential as a non-invasive, cost-effective and high-throughput method for screening. © 2010 Lewis et al; licensee BioMed Central Ltd.


Lewis M.J.,University of Swansea | Lewis M.J.,Prince Phillip Hospital | Balaji G.,Prince Phillip Hospital | Dixon H.,Prince Phillip Hospital | And 3 more authors.
Clinical Physiology and Functional Imaging | Year: 2010

Many smokers attempt to quit without using nicotine replacement therapy (NRT) or pharmacotherapy, i.e. 'cold-turkey'. The cardiac implications of this are important but are incompletely understood. Previous studies have associated smoking cessation with improvements in heart rate (HR) and its variability, but its influence on QT time-series is unclear. Furthermore, the relative influence on these parameters of acute nicotine withdrawal and of NRT has not been adequately compared. Additional insight might come from analysing the dynamic (e.g. fractal) properties of electrocardiographic data during different levels of nicotine exposure. We examined the influence of smoking cessation, during cold-turkey and subsequent NRT, on HR and QT time-series during 30 days of smoking abstinence. Seven smokers and sixteen healthy non-smokers received ECG monitoring at baseline (Day 0). Smokers subsequently refrained from smoking without using NRT for 24 h, and then received NRT for 29 days. ECG monitoring was repeated at Days 1, 7, 30. Following smoking cessation we observed that: HR and rate-corrected QT were both reduced, heart rate variability (HRV) increased (improved), and QT variability index (QTVI) showed signs of improvement (trend only). Improvements in HR and QT were maintained throughout NRT use, whilst improvements in HRV and QTVI were sustained for at least the early stages of NRT. The dynamic (multifractal) properties of HR and QT were similar for smokers and non-smokers, and were unchanged by smoking abstinence or NRT. Our results provide tentative evidence that electrocardiographic improvements during a cold-turkey smoking quit attempt (acute nicotine withdrawal) are maintained during NRT pharmacotherapy. © 2009 The Authors. Journal compilation © 2009 Scandinavian Society of Clinical Physiology and Nuclear Medicine.


Cameron S.J.S.,Institute of Biological | Lewis K.E.,Prince Phillip Hospital | Lewis K.E.,University of Swansea | Beckmann M.,Institute of Biological | And 4 more authors.
Lung Cancer | Year: 2016

Objectives: Developing screening and diagnosis methodologies based on novel biomarkers should allow for the detection of the lung cancer (LC) and possibly at an earlier stage and thereby increase the effectiveness of clinical interventions. Here, our primary objective was to evaluate the potential of spontaneous sputum as a source of non-invasive metabolomic biomarkers for LC status. Materials and methods: Spontaneous sputum was collected and processed from 34 patients with suspected LC, alongside 33 healthy controls. Of the 34 patients, 23 were subsequently diagnosed with LC (LC+, 16 NSCLC, six SCLC, and one radiological diagnosis), at various stages of disease progression. The 67 samples were analysed using flow infusion electrospray ion mass spectrometry (FIE-MS) and gas-chromatography mass spectrometry (GC-MS). Results: Principal component analysis identified negative mode FIE-MS as having the main separating power between samples from healthy and LC. Discriminatory metabolites were identified using ANOVA and Random Forest. Indications of potential diagnostic accuracy involved the use of receiver operating characteristic/area under the curve (ROC/AUC) analyses. This approach identified metabolites changes that were only observed with LC. Metabolites with AUC values of greater than 0.8 which distinguished between LC+/LC- binary classifications where identified and included Ganglioside GM1 which has previously been linked to LC. Conclusion: This study indicates that metabolomics based on sputum can yield metabolites that can be used as a diagnostic and/or discriminator tool. These could aid clinical intervention and targeted diagnosis of LC within an 'at risk' LC- population group. The use of sputum as a non-invasive source of metabolite biomarkers may aid in the development of an at-risk population screening programme for lung cancer or enhanced clinical diagnostic pathways. © 2016 Elsevier Ireland Ltd.


Kaczynski J.,University of Swansea | Wilczynska M.,Prince Phillip Hospital | Fligelstone L.,University of Swansea | Hilton J.,University of Swansea
European Journal of Trauma and Emergency Surgery | Year: 2015

Background: The acute coagulopathy of trauma and shock is associated with significant mortality and, currently, there are no validated laboratory tests which allow for a rapid recognition and treatment of this condition. Therefore, early detection of any clot abnormality in trauma could improve the diagnosis of trauma-associated coagulopathy and subsequent interventions. Methods: Review of the literature. Results: The standard laboratory tests, including prothrombin time and activated partial thromboplastin time, are unreliable and describe only an isolated fragment of the complex coagulation pathways. Additionally, thromboelastography and thromboelastometry operate in a non-linear regime which implies that clot formation is the product of both the clotting process and the effect of the measurement. The assessment of the clot microstructure using a scanning electron microscope has resulted in a subjective analysis of a clot structure, showing also poor correlation between the coagulation pathways and clot development. The fractal dimension provides information on the structure and quality of the initial clot, which subsequently acts as a template for how the mature clot will behave. However, these data require further verification in an in vivo setting. At present, the treatment of the coagulopathy is delivered by empirically administered massive transfusion protocols, which lack a specific target for replacement therapy. Conclusions: There is enough evidence to demonstrate that we urgently need a robust test, which would determine and quantify both the rate and the extent of coagulation abnormalities. This could help to tailor the treatment of coagulopathy according to the patient’s needs. © 2013, Springer-Verlag Berlin Heidelberg.


PubMed | Institute of Biological, University of Swansea and Prince Phillip Hospital
Type: | Journal: Lung cancer (Amsterdam, Netherlands) | Year: 2016

Developing screening and diagnosis methodologies based on novel biomarkers should allow for the detection of the lung cancer (LC) and possibly at an earlier stage and thereby increase the effectiveness of clinical interventions. Here, our primary objective was to evaluate the potential of spontaneous sputum as a source of non-invasive metabolomic biomarkers for LC status.Spontaneous sputum was collected and processed from 34 patients with suspected LC, alongside 33 healthy controls. Of the 34 patients, 23 were subsequently diagnosed with LC (LC(+), 16 NSCLC, six SCLC, and one radiological diagnosis), at various stages of disease progression. The 67 samples were analysed using flow infusion electrospray ion mass spectrometry (FIE-MS) and gas-chromatography mass spectrometry (GC-MS).Principal component analysis identified negative mode FIE-MS as having the main separating power between samples from healthy and LC. Discriminatory metabolites were identified using ANOVA and Random Forest. Indications of potential diagnostic accuracy involved the use of receiver operating characteristic/area under the curve (ROC/AUC) analyses. This approach identified metabolites changes that were only observed with LC. Metabolites with AUC values of greater than 0.8 which distinguished between LC(+)/LC(-) binary classifications where identified and included Ganglioside GM1 which has previously been linked to LC.This study indicates that metabolomics based on sputum can yield metabolites that can be used as a diagnostic and/or discriminator tool. These could aid clinical intervention and targeted diagnosis of LC within an at risk LC(-) population group. The use of sputum as a non-invasive source of metabolite biomarkers may aid in the development of an at-risk population screening programme for lung cancer or enhanced clinical diagnostic pathways.


Davison G.,University of Kent | Jones A.W.,Aberystwyth University | Jones A.W.,Prince Phillip Hospital
Applied Physiology, Nutrition and Metabolism | Year: 2015

 Neutrophil numbers and function (oxidative burst) were assessed in peripheral blood and oral samples before and after prolonged exercise. Blood neutrophil count increased (~3.5-fold, P < 0.001) and function decreased (30% ± 19% decrease, P = 0.005)  postexercise. Oral neutrophil count (P = 0.392) and function (P = 0.334) were unchanged. Agreement between oral and blood neutrophil function responses to exercise was poor. These findings highlight the importance of studying neutrophils within various compartments/sample types. ©, 2006 National Research Council of Canada. All rights reserved.


Davison G.,University of Kent | Kehaya C.,University of Kent | Wyn Jones A.,Aberystwyth University | Wyn Jones A.,Prince Phillip Hospital
American Journal of Lifestyle Medicine | Year: 2014

Physical activity and nutrition are important in a healthy lifestyle with potential benefits to immunity often overlooked. Infection of the upper respiratory tract, and the associated symptoms, are the most frequent presentations to general practitioners and may have significant economic and social impact. In this review, we consider the role of physical activity and nutrition in improving immunity. Evidence suggests that regular moderate activity is particularly beneficial for immune enhancement and reducing the risk of infection. We also discuss some nutritional strategies. Unfortunately, the evidence for many is weak. Avoiding nutritional deficiencies seems the most pragmatic recommendation. This can be achieved with a balanced diet. Including a variety of fruits and vegetables may help ensure adequate intake of essential nutrients with little risk of excess intake of any single nutrient. Supplementation with individual nutrients is generally not recommended. Multinutrients may be beneficial for those with a preexisting deficiency but not if normal dietary intake is sufficient. Further benefit may be gained from some supplements including probiotics, bovine colostrum, and some plant-derived products (Echinacea, black elderberry, and some polyphenols) but only in specific situations/contexts. Individuals should consider their personal needs, use caution, and avoid the indiscriminate use of supplements. © 2014, © 2014 The Author(s).


Jones A.W.,Aberystwyth University | Jones A.W.,Prince Phillip Hospital | Cameron S.J.S.,Aberystwyth University | Thatcher R.,Aberystwyth University | And 3 more authors.
Brain, Behavior, and Immunity | Year: 2014

Bovine colostrum (COL) has been advocated as a nutritional countermeasure to exercise-induced immune dysfunction and increased risk of upper respiratory illness (URI) in athletic populations, however, the mechanisms remain unclear. During winter months, under double-blind procedures, 53 males (mean training load±SD, 50.5±28.9 MET-hweek-1) were randomized to daily supplementation of 20g of COL (N=25) or an isoenergetic/isomacronutrient placebo (PLA) (N=28) for 12weeks. Venous blood was collected at baseline and at 12weeks and unstimulated saliva samples at 4 weeks intervals. There was a significantly lower proportion of URI days and number of URI episodes with COL compared to PLA over the 12weeks (p<0.05). There was no effect of COL on in vitro neutrophil oxidative burst, salivary secretory IgA or salivary antimicrobial peptides (p>0.05), which does not support previously suggested mechanisms. In a subset of participants (COL=14, PLA=17), real-time quantitative PCR, targeting the 16S rRNA gene showed there was an increase in salivary bacterial load over the 12 weeks period with PLA (p<0.05) which was not as evident with COL. Discriminant function analysis of outputs received from serum metabolomics showed changes across time but not between groups. This is the first study to demonstrate that COL limits the increased salivary bacterial load in physically active males during the winter months which may provide a novel mechanism of immune-modulation with COL and a relevant marker of in vivo (innate) immunity and risk of URI. © 2013 Elsevier Inc.


Schroll S.,University of Regensburg | Series F.,Laval University | Lewis K.,Prince Phillip Hospital | Benjamin A.,Prince Phillip Hospital | And 5 more authors.
Respirology | Year: 2014

Background and objective Continuous positive airway pressure (CPAP) has been used to treat patients with chronic heart failure (CHF) and sleep-disordered breathing (SDB). CPAP treatment in severe CHF with concomitant SDB and atrial fibrillation has been linked to impairment of cardiac output (CO) as a potential cause for adverse outcome. The aim of the present study was to test whether incremental CPAP application in awake CHF patients with SDB, with and without atrial fibrillation, induces acute alterations of blood pressure (BP), heart rate (HR) and CO. Methods During daytime, we applied incremental CPAP (4-10 cmH2O) in 37 stable patients with CHF and SDB. BP and HR were assessed after each 1 cmH2O CPAP increase in 5-min intervals in the entire sample, and CO was assessed at one centre (n = 11). Results Neither mean BP, HR nor CO changed significantly with incremental CPAP (at 0 and 10 cmH2O: 85 ± 2 and 84 ± 2 mm Hg, P = 1.0, 63 ± 1 to 61 ± 2 b.p.m., P = 0.88 and 2.03 ± 0.5 and 2.35 ± 0.8 L/min/m2, P = 0.92, respectively). No significant differences in maximum BP drop or HR drop between patients with sinus rhythm and atrial fibrillation were found. In 1 of 37 patients, a prespecified event of haemodynamic compromise (drop of mean BP >15 mm Hg) without clinical signs occurred. Conclusions These results contribute to the evidence that CPAP does not cause haemodynamic compromise in the vast majority of normotensive CHF patients with SDB. CPAP treatment in severe congestive heart failure (CHF) with concomitant SDB has been causally linked to CO impairment. We show that CPAP does not acutely change haemodynamic measures in most CHF patients with SDB, indicating that CPAP does not cause haemodynamic compromise in the vast majority of normotensive CHF patients with SDB. See Editorial, page 1 © 2013 The Authors. Respirology © 2013 Asian Pacific Society of Respirology.


Jones A.W.,Aberystwyth University | Jones A.W.,Prince Phillip Hospital | Thatcher R.,Aberystwyth University | March D.S.,Aberystwyth University | Davison G.,University of Kent
Scandinavian Journal of Medicine and Science in Sports | Year: 2015

Bovine colostrum (COL) has been advocated as a nutritional countermeasure to exercise-induced immune dysfunction. The aims of this study were to identify the effects of 4 weeks of COL supplementation on neutrophil responses and mucosal immunity following prolonged exercise. In a randomized double-blind, parallel group design, participants [age 28±8 years; body mass 79±7kg; height 182±6cm; maximal oxygen uptake ( V ˙ O 2 m a x ) 55±9mL/kg/min] were assigned to 20g per day of COL (n=10) or an isoenergetic/isomacronutrient placebo (PLA; n=10) for 4 weeks. Venous blood and unstimulated saliva samples were obtained before and after 2.5h of cycling at 15% Δ (∼55-60% V ˙ O 2 m a x ). A significantly greater formyl-methionyl-leucyl phenylalanine-stimulated oxidative burst was observed in the COL group compared with PLA group (P<0.05) and a trend toward a time×group interaction (P=0.06). However, there was no effect of COL on leukocyte trafficking, phorbol-12-myristate-13-acetate-stimulated oxidative burst, bacterial-stimulated neutrophil degranulation, salivary secretory IgA, lactoferrin or lysozyme (P>0.05). These findings provide further evidence of the beneficial effects of COL on receptor-mediated stimulation of neutrophil oxidative burst in a model of exercise-induced immune dysfunction. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

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