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Ousey K, Edward KL, Lui S, Stephenson J, Walker K, Duff J, Leaper D. Perioperative, local and systemic warming in surgical site infection: a systematic review and meta-analysis. J Wound Care 2017; 26:614-624. [DOI: 10.12968/jowc.2017.26.11.614] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Ke X, Kavati A, Wertz D, Huang Q, Wang L, Willey V, Stephenson J, Ortiz B, Panettieri R, Corren J. P211 A real-world assessment of asthma exacerbations in asthma patients newly treated with omalizumab. Ann Allergy Asthma Immunol 2017. [DOI: 10.1016/j.anai.2017.08.249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Huang Q, Kavati A, Ke X, Wertz D, Wang L, Willey V, Stephenson J, Ortiz B, Panettieri R, Corren J. P210 Real-world comparisons of clinical characteristics and medication utilization pre- and post-omalizumab initiation in asthma patients. Ann Allergy Asthma Immunol 2017. [DOI: 10.1016/j.anai.2017.08.248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Ke X, Kavati A, Wertz D, Huang Q, Wang L, Willey V, Stephenson J, Ortiz B, Panettieri R, Corren J. P212 A real-world assessment of omalizumab treatment patterns in asthma patients newly treated with omalizumab. Ann Allergy Asthma Immunol 2017. [DOI: 10.1016/j.anai.2017.08.250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Harrison SJ, Messner J, Leeder DJ, Stephenson J, Sidhom SA. Are Albumin Levels a Good Predictor of Mortality in Elderly Patients with Neck of Femur Fractures? J Nutr Health Aging 2017; 21:699-703. [PMID: 28537335 DOI: 10.1007/s12603-016-0799-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Neck of femur (NOF) fractures are associated with significant morbidity and mortality in elderly people with multiple co-morbidities; making management of this patient subgroup challenging. Predictors of an increase in morbidity and mortality would therefore provide a useful framework for the assessment and management of this demographic. Within the current literature, hypoalbuminaemia (<35g/dl) has been highlighted as being a good biochemical predictor of short-term mortality (<12 months). Our aims were to assess whether there was an association between low albumin levels and mortality and whether the severity adversely affects outcomes. MATERIALS AND METHODS Patients admitted to our large district hospital between January 2011 and December 2012 who had sustained a NOF fracture, were over 65 years old and had a pre-operative albumin level were included. This retrospective, longitudinal, observational study concluded in July 2014. Demographic and pre-operative function and albumin data was collated retrospectively. An association with mortality was made. RESULTS 471 patients had usable data. Mean pre-operative albumin level was 29.5g/dl (SD 6.22g/dl) in patients who died and 32.8g/dl (SD 6.43g/dl) in patients who survived during the study period. Pre-operative albumin level was significantly associated with survival (hazard ratio 0.957: 95% CI (0.937, 0.978); p<0.001). Thus, a reduction of 1g/dl in pre-operative albumin is associated with an increased hazard of death of 4.3%. CONCLUSIONS Early identification of patients with hypoalbuminaemia on admission with a venous blood sample and timely input from orthogeriatrians could optimise these patients pre- and post-operatively. This may enable rates of morbidity and mortality to fall. Hypoalbuminaemia may be a reasonable predictor of shorter-term mortality in this patient subgroup. However, this may reflect existing co-morbidities rather than an isolated cause. This study supports an association between hypoalbuminaemia and poorer outcome for patients with NOF fractures.
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Kirshbaum MN, Dent J, Stephenson J, Topping AE, Allinson V, McCoy M, Brayford S. Open access follow-up care for early breast cancer: a randomised controlled quality of life analysis. Eur J Cancer Care (Engl) 2016; 26. [PMID: 27717057 PMCID: PMC5516199 DOI: 10.1111/ecc.12577] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/12/2016] [Indexed: 12/11/2022]
Abstract
This study evaluated the acceptability of a supportive model of follow‐up. One hundred and twelve women recovering from breast cancer were randomised to receive standard breast clinic aftercare (Control n = 56) or on demand by open access aftercare by breast care nurses (Intervention n = 56). Participants attended a support‐based psycho‐educational programme delivered in four half‐day group sessions. Three quality of life questionnaires (EORTC QLQ‐C30, QLQ‐BR23, HADS) were administered at baseline and 6‐monthly intervals for 2 years. Multilevel linear regression modelling methods were used for evaluation. Age was found to be a statistically significant predictor of quality of life in several sub‐scales. Increasing age was negatively associated with sexual functioning, systematic therapy side effects and physical functioning, and positively associated with future perspective. Aftercare assignment was not found to be a statistically significant predictor. Women treated for early breast cancer were not disadvantaged by allocation to the open access supportive care model in terms of quality of life experienced. The model for follow‐up was demonstrated to be a feasible alternative to routinised hospital‐based follow‐up and adds to the evidence for stratified follow‐up for low‐risk cancer patients, incorporating self‐management education. Stratified follow‐up pathways are viewed as a preferable approach.
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Atkinson R, Davies B, Jones A, van Popta D, Ousey K, Stephenson J. Survival of patients undergoing surgery for metastatic spinal tumours and the impact of surgical site infection. J Hosp Infect 2016; 94:80-5. [DOI: 10.1016/j.jhin.2016.06.009] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2016] [Accepted: 06/13/2016] [Indexed: 01/28/2023]
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Atkinson R, Stephenson J, Jones A, Ousey K. An assessment of key risk factors for surgical site infection in patients undergoing surgery for spinal metastases. J Wound Care 2016; 25 Suppl 9:S30-4. [DOI: 10.12968/jowc.2016.25.sup9.s30] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Ousey K, Kaye V, McCormick K, Stephenson J. Investigating staff knowledge of safeguarding and pressure ulcers in care homes. J Wound Care 2016; 25:5-6, 8-11. [PMID: 26762492 DOI: 10.12968/jowc.2016.25.1.5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVE To investigate whether nursing/care home staff regard pressure ulceration as a safeguarding issue; and to explore reporting mechanisms for pressure ulcers (PUs) in nursing/care homes. METHOD Within one clinical commissioning group, 65 staff members from 50 homes completed a questionnaire assessing their experiences of avoidable and unavoidable PUs, grading systems, and systems in place for referral to safeguarding teams. Understanding of safeguarding was assessed in depth by interviews with 11 staff members. RESULTS Staff observed an average of 2.72 PUs in their workplaces over the previous 12 months, judging 45.6% to be avoidable. Only a minority of respondents reported knowledge of a grading system (mostly the EPUAP/NPUAP system). Most respondents would refer PUs to the safeguarding team: the existence of a grading system, or guidance, appeared to increase that likelihood. Safeguarding was considered a priority in most homes; interviewees were familiar with the term safeguarding, but some confusion over its meaning was apparent. Quality of written documentation and verbal communication received before residents returned from hospital was highlighted. However, respondents expressed concern over lack of information regarding skin integrity. Most staff had received education regarding ulcer prevention or wound management during training, but none reported post-registration training or formal education programmes; reliance was placed on advice of district nurses or tissue viability specialists. CONCLUSION Staff within nursing/care homes understand the fundamentals of managing skin integrity and the importance of reporting skin damage; however, national education programmes are needed to develop knowledge and skills to promote patient health-related quality of life, and to reduce the health-care costs of pressure damage. Further research to investigate understanding, knowledge and skills of nursing/care home staff concerning pressure ulcer development and safeguarding will become increasingly necessary, as levels of the older population who may require assisted living continue to rise.
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Grant A, Bolton W, Stephenson J, Hale A, Ben-Or S. V-066ROBOTIC-ASSISTED THORACOSCOPIC BRONCHOPLASTY: A NOVEL TECHNIQUE. Interact Cardiovasc Thorac Surg 2015. [DOI: 10.1093/icvts/ivv204.66] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Coignard-Biehler H, Isakov A, Stephenson J. Pre-hospital transportation in Western countries for Ebola patients, comparison of guidelines. Intensive Care Med 2015; 41:1472-6. [PMID: 25800581 PMCID: PMC4502292 DOI: 10.1007/s00134-015-3734-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2014] [Accepted: 02/24/2015] [Indexed: 01/23/2023]
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Borad MJ, Reddy S, Uronis H, Sigal DS, Cohn AL, Schelman WR, Stephenson J, Chiorean EG, Rosen PJ, Ulrich B, Dragovich T, Prete SD, Rarick M, Eng C, Kroll S, Ryan D. Abstract LB-121: Randomized phase II study of the efficacy and safety of gemcitabine + TH-302 (G+T) vs gemcitabine (G) alone in previously untreated patients with advanced pancreatic cancer. Clin Trials 2014. [DOI: 10.1158/1538-7445.am2012-lb-121] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Whitehouse S, Stephenson J, Sinclair V, Gregory J, Tambe A, Verma R, Siddique I, Saeed M. A validation of the Oswestry Spinal Risk Index. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2014; 25:247-251. [PMID: 25391625 DOI: 10.1007/s00586-014-3665-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/30/2014] [Revised: 11/03/2014] [Accepted: 11/03/2014] [Indexed: 12/11/2022]
Abstract
PURPOSE The purpose of this study was to validate the Oswestry Spinal Risk Index (OSRI) in an external population. The OSRI predicts survival in patients with metastatic spinal cord compression (MSCC). METHODS We analysed the data of 100 patients undergoing surgical intervention for MSCC at a tertiary spinal unit and recorded the primary tumour pathology and Karnofsky performance status to calculate the OSRI. Logistic regression models and survival plots were applied to the data in accordance with the original paper. RESULTS Lower OSRI scores predicted longer survival. The OSRI score predicted survival accurately in 74% of cases (p = 0.004). CONCLUSIONS Our study has found that the OSRI is a significant predictor of survival at levels similar to those of the original authors and is a useful and simple tool in aiding complex decision making in patients presenting with MSCC.
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Evers J, Farley T, Gemzell-Danielsson K, Glasier A, Hannaford P, La Vecchia C, Moreau C, Stephenson J, Baird D, Crosignani P, Gianaroli L, Glasier A, Crosignani P. Simultaneous prevention of unintended pregnancy and STIs: a challenging compromise. Hum Reprod Update 2014; 20:952-63. [DOI: 10.1093/humupd/dmu030] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
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Pratt R, Stephenson J, Mann S. What influences contraceptive behaviour in women who experience unintended pregnancy? A systematic review of qualitative research. J OBSTET GYNAECOL 2014; 34:693-9. [DOI: 10.3109/01443615.2014.920783] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Rahman R, Stephenson J. Early surgery for epiretinal membrane preserves more vision for patients. Eye (Lond) 2014; 28:410-4. [PMID: 24406414 DOI: 10.1038/eye.2013.305] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2013] [Accepted: 11/20/2013] [Indexed: 02/06/2023] Open
Abstract
PURPOSE To establish whether early vitrectomy for epiretinal membrane (ERM) is preferable to delayed surgery. METHODS We carried out a retrospective study of 120 eyes from 120 patients with pre-operative visual acuity (VA) of 6/60 or better. Pre-operative logMAR score was considered to act as an appropriate proxy measure for time of surgical procedure, with scores of 0.3 or less considered to represent early surgery, scores of 0.4 or 0.5 considered to represent medium surgery, and scores of 0.6 or more considered to represent late surgery for ERM. Patients were either pseudophakic at the time of vitrectomy or underwent combined phaco-vitrectomy for symptomatic ERM. RESULTS Evaluation of parameter coefficients indicated that controlling for other factors, a delay of the surgical procedure from a state of early to medium corresponded to an increase (ie, disbenefit) of 0.074 units in post-operative logMAR score (95% confidence interval -0.001-0.15). A delay of the surgical procedure from a state of early to late corresponded to an increase (ie, disbenefit) of 0.21 units in post-operative logMAR score (95% confidence interval 0.13-0.29). Mean post-operative VA for early surgery was 0.16, out of which 36.2% of patients had a LogMAR score of 0.1 or better. This is in comparison to 17.2% in late ERM (those with a pre-operative logMAR score of 0.6 or more). CONCLUSION We conclude that early surgery is associated with a lower (ie, better) post-operative logMAR score. Vitrectomy for early symptomatic ERM, in carefully selected patients, is beneficial in preserving excellent vision and allows quicker visual rehabilitation.
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Ali M, Stephenson J, Naylor A. Delay Prior to Expedited Carotid Endarterectomy: A Prospective Audit of Practice. J Vasc Surg 2013. [DOI: 10.1016/j.jvs.2013.08.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Al-Leswas D, Eltweri A, Hall T, Stephenson J, Pollard C, Garcea G, Metcalfe M, Dennison A. PP075-SUN SAFETY AND TOLERABILITY OF TWO PARENTERAL LIPID EMULSIONS IN PATIENTS WITH SEVERE ACUTE PANCREATITIS AS MEASURED BY SERUM TRIGLYCERIDE AND CHOLESTEROL LEVELS: A RANDOMISED CONTROLLED TRIAL. Clin Nutr 2013. [DOI: 10.1016/s0261-5614(13)60120-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Al-Leswas D, Chung WY, Eltweri A, Stephenson J, Arshad A, Pollard C, Garcea G, Metcalfe M, Dennison A. OP004 EVALUATION OF THE CYTOKINES RESPONSE TO OMEGA-3 FATTY ACIDS IN PATIENTS WITH SEVERE ACUTE PANCREATITIS: A RANDOMISED CONTROLLED TRIAL. Clin Nutr 2013. [DOI: 10.1016/s0261-5614(13)60006-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Dave S, Svenstrup H, Carder C, Grant P, Morris-Jones S, Kidd I, Stephenson J. P3.062 Mycoplasma Genitalium Prevalence and Risk Factors Among Young Sexually Active Women in the General Population and Attending Sexually Transmitted Infection Clinics in London, UK. Br J Vener Dis 2013. [DOI: 10.1136/sextrans-2013-051184.0522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Graham CA, Panicker S, Shawe J, Stephenson J. Women's experiences with tailored use of a combined oral contraceptive: a qualitative study. Hum Reprod 2013; 28:1620-5. [DOI: 10.1093/humrep/det078] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Petrylak D, Kantoff P, Mega A, Stephenson J, Vogelzang N, Fleming M, Blattman S, Stambler N, D'Ambrosio P, Israel R. 244 Prostate Specific Membrane Antigen Antibody Drug Conjugate (PSMA ADC): a Phase 1 Trial in Castration-Resistant Metastatic Prostate Cancer (mCRPC). Eur J Cancer 2012. [DOI: 10.1016/s0959-8049(12)72042-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Borad M, Reddy S, Bahary N, Uronis H, Sigal D, Cohn A, Schelman W, Stephenson J, Eng C, Ryan D. TH-302 + Gemcitabine (G + T) vs Gemcitabine (G) in Patients with Previously Untreated advanced Pancreatic Cancer (PAC). Ann Oncol 2012. [DOI: 10.1093/annonc/mds398] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Caddick J, Green L, Stephenson J, Spyrou G. The psycho-social impact of facial skin cancers. J Plast Reconstr Aesthet Surg 2012; 65:e257-9. [DOI: 10.1016/j.bjps.2012.02.022] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2011] [Revised: 02/23/2012] [Accepted: 02/29/2012] [Indexed: 10/28/2022]
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Caddick J, Stephenson J, Green L, Spyrou G. Psychological outcomes following surgical excision of facial skin cancers. EUROPEAN JOURNAL OF PLASTIC SURGERY 2012. [DOI: 10.1007/s00238-012-0748-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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