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Kouli O, Khalil M, Fathi A, Gill S, Headon E, Love G. Total Hip Replacement (THR) In Intracapsular Neck of Femur (NOF) Fracture Management in Ninewells Hospital. Int J Surg 2017. [DOI: 10.1016/j.ijsu.2017.08.413] [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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Chee L, Tang C, Bydder S, Dass J, Kernutt E, Vosikova E, Gill S. Clinical outcomes of primary lung cancer treated with cyberknife stereotactic body radiotherapy: A prospective cohort study. Respir Med 2017. [DOI: 10.1016/j.rmed.2017.07.040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Chee L, Tang C, Bydder S, Dass J, Kernutt E, Vosikova E, Gill S. Clinical outcomes of primary and metastatic lung cancer treated with cyberknife stereotactic body radiotherapy: A prospective cohort study. Respir Med 2017. [DOI: 10.1016/j.rmed.2017.07.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Chan E, Altendorff S, Khan S, Oliver R, Gill S, Healy C, Werring D, Cipolotti L. The test accuracy of the montreal cognitive assessment (MoCA) in stroke. J Neurol Sci 2017. [DOI: 10.1016/j.jns.2017.08.3356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Rasmussen S, Andersen-Ranberg K, Christensen K, Gill S. LEFT VENTRICULAR FUNCTION IN CENTENARIANS: FINDINGS FROM THE DANISH 1915-WEST BIRTH COHORT STUDY. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.4437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Hubert M, Karellis A, Sherman M, Gill S, Beecroft J, Sampalis J. Hospital cost savings with transarterial radioembolization with yttrium-90 glass microspheres compared with transarterial chemoembolization in the management of hepatocellular carcinoma. J Vasc Interv Radiol 2017. [DOI: 10.1016/j.jvir.2016.12.1125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Mulder KE, Ahmed S, Davies JD, Doll CM, Dowden S, Gill S, Gordon V, Hebbard P, Lim H, McFadden A, McGhie JP, Park J, Wong R. Report from the 17th Annual Western Canadian Gastrointestinal Cancer Consensus Conference; Edmonton, Alberta; 11-12 September 2015. ACTA ACUST UNITED AC 2016; 23:425-434. [PMID: 28050139 DOI: 10.3747/co.23.3384] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
The 17th annual Western Canadian Gastrointestinal Cancer Consensus Conference (wcgccc) was held in Edmonton, Alberta, 11-12 September 2015. The wcgccc is an interactive multidisciplinary conference attended by health care professionals from across Western Canada (British Columbia, Alberta, Saskatchewan, and Manitoba) who are involved in the care of patients with gastrointestinal cancer. Surgical, medical, and radiation oncologists; pathologists; radiologists; and allied health care professionals participated in presentation and discussion sessions for the purposes of developing the recommendations presented here. This consensus statement addresses current issues in the management of gastric cancer.
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Moore M, Gill S, Asmis T, Berry S, Burkes R, Zbuk K, Alcindor T, Jeyakumar A, Chan T, Rao S, Spratlin J, Tang PA, Rothenstein J, Chan E, Bendell J, Kudrik F, Kauh J, Tang S, Gao L, Kambhampati SRP, Nasroulah F, Yang L, Ramdas N, Binder P, Strevel E. Randomized phase II study of modified FOLFOX-6 in combination with ramucirumab or icrucumab as second-line therapy in patients with metastatic colorectal cancer after disease progression on first-line irinotecan-based therapy. Ann Oncol 2016; 27:2216-2224. [PMID: 27733377 DOI: 10.1093/annonc/mdw412] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2016] [Revised: 08/02/2016] [Accepted: 08/10/2016] [Indexed: 12/16/2023] Open
Abstract
BACKGROUND Icrucumab and ramucirumab are recombinant human IgG1 monoclonal antibodies that bind VEGF receptors 1 and 2 (VEGFR-1 and -2), respectively. This randomized phase II study evaluated the antitumor activity and safety of icrucumab and ramucirumab each in combination with mFOLFOX-6 in patients with metastatic colorectal cancer after disease progression on first-line therapy with a fluoropyrimidine and irinotecan. PATIENTS AND METHODS Eligible patients were randomly assigned to receive mFOLFOX-6 alone (mFOLFOX-6) or in combination with ramucirumab 8 mg/kg IV (RAM+mFOLFOX-6) or icrucumab 15 mg/kg IV (ICR+mFOLFOX-6) every 2 weeks. Randomization was stratified by prior bevacizumab therapy. The primary end point was progression-free survival (PFS). Secondary end points included overall survival (OS), tumor response, safety, and PK. RESULTS In total, 158 patients were randomized, but only 153 received treatment (49 on mFOLFOX-6, 52 on RAM+mFOLFOX-6, and 52 on ICR+mFOLFOX-6). Median PFS was 18.4 weeks on mFOLFOX-6, 21.4 weeks on RAM+mFOLFOX-6, and 15.9 weeks on ICR+mFOLFOX-6 (RAM+mFOLFOX-6 versus mFOLFOX-6, stratified hazard ratio [HR] 1.116 [95% CI 0.713-1.745], P = 0.623; ICR+mFOLFOX-6 versus mFOLFOX-6, stratified HR 1.603 [95% CI 1.011-2.543], P = 0.044). Median survival was 53.6 weeks on mFOLFOX-6, 41.7 weeks on RAM+mFOLFOX-6, and 42.0 weeks on ICR+mFOLFOX-6. The most frequent adverse events reported on the ramucirumab arm (RAM+mFOLFOX-6) were fatigue, nausea, and peripheral sensory neuropathy; those on the icrucumab arm (ICR+mFOLFOX-6) were fatigue, diarrhea, and peripheral sensory neuropathy. Grade ≥3 serious adverse events occurred at comparable frequency across arms. CONCLUSIONS In this study population, combining ramucirumab or icrucumab with mFOLFOX-6 did not achieve the predetermined improvement in PFS. CLINICALTRIALSGOV NCT01111604.
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Dhingra N, Manoharan R, Gill S, Nagar M. Peripapillary schisis in open-angle glaucoma. Eye (Lond) 2016; 31:499-502. [PMID: 27834967 DOI: 10.1038/eye.2016.235] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2016] [Accepted: 09/22/2016] [Indexed: 11/09/2022] Open
Abstract
PurposeTo report clinical features, topographic findings and outcome of 10 eyes with peripapillary schisis in open-angle glaucoma.Patients and methodsA retrospective review of patients with open-angle glaucoma who were noted to have peripapillary schisis on optical coherence tomography (OCT) were included. Serial peripapillary and macula infrared and OCT images, visual acuity, visual fields, and schisis appearance were reviewed.ResultsTen eyes of nine patients with open-angle glaucoma were detected to have the presence of peripapillary schisis. Nerve fibre layer schisis was detected in all eyes and one eye had an associated macular schisis. None of the eyes had an acquired pit of the optic nerve or pathological myopia. The mean intraocular pressures at detection was 18.3±4.3 mm Hg and the schisis resolved in four eyes after a mean follow-up of 21.2±8.8 months. Visual field worsening was noted in 4 of the 10 eyes and the resolution of schisis resulted in significant reduction in the retinal nerve fibre layer (RNFL) thickness.ConclusionsPeripapillary schisis detected during the normal course of open-angle glaucoma can resolve spontaneously and rarely involves the macula. Its resolution leads to reduction in RNFL thickness; therefore, caution is advised while interpreting serial scans.
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Siva S, Pham D, Tan T, Lam J, Bressel M, Price J, Gill S, Shaw M, Tai K, Violet J, Lau E, Parameswaran B, Chesson B, Lawrentschuck N, Goad J, Murphy D, Kron T, Foroudi F. Principal Analysis of a Phase Ib Trial of Stereotactic Body Radiation Therapy (SBRT) for Primary Kidney Cancer. Int J Radiat Oncol Biol Phys 2016. [DOI: 10.1016/j.ijrobp.2016.06.240] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Jonker D, Nott L, Yoshino T, Gill S, Shapiro J, Ohtsu A, Zalcberg J, Vickers M, Wei A, Gao Y, Tebbutt N, Markman B, Esaki T, Koski S, Hitron M, Magoski N, Simes J, Li C, Tu D, O'Callaghan C. A randomized phase III study of napabucasin [BBI608] (NAPA) vs placebo (PBO) in patients (pts) with pretreated advanced colorectal cancer (ACRC): the CCTG/AGITG CO.23 trial. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw370.03] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Gill S, Kavanagh M, Cherry W, Barker M, Weld M, Cooke G. Furan and its derivatives in foods: Characterising the hazard. Toxicol Lett 2016. [DOI: 10.1016/j.toxlet.2016.07.174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Ruella M, Kenderian SS, Shestova O, Klichinsky M, Melenhorst JJ, Wasik MA, Lacey SF, June CH, Gill S. Kinase inhibitor ibrutinib to prevent cytokine-release syndrome after anti-CD19 chimeric antigen receptor T cells for B-cell neoplasms. Leukemia 2016; 31:246-248. [PMID: 27677739 DOI: 10.1038/leu.2016.262] [Citation(s) in RCA: 100] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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Kanthasamy V, Gill S. Are we following the guidelines to prevent contrast induced acute kidney injury? A clinical audit on patients with chronic kidney disease (CKD) undergoing Coronary Angiogram. Atherosclerosis 2016. [DOI: 10.1016/j.atherosclerosis.2016.07.731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Katz D, Azraq Y, Eleyan F, Gill S, Peretz T, Merimsky O. Pazolimus: pazopanib plus sirolimus following progression on pazopanib, a retrospective case series analysis. BMC Cancer 2016; 16:616. [PMID: 27501793 PMCID: PMC4977830 DOI: 10.1186/s12885-016-2618-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2016] [Accepted: 07/26/2016] [Indexed: 11/16/2022] Open
Abstract
Background To explore the activity of pazopanib (P) + sirolimus (S) in patients who progressed after previous clinical benefit on pazopanib. Methods Eight patients with progressing metastatic high grade soft tissue sarcoma (STS) whose disease advanced on P following a response duration of at least 4 months were offered re-challenge of P supplemented by off-label S and a single patient with progressing metastatic chondrosarcoma was offered the combination as compassionate treatment. Patients were treated in two centers: Hadassah Medical Center and Tel Aviv Medical Center. Patients received oral P 200–600 mg once a day supplemented by S 3–4 mg taken separately, 12 h after the P dose. Results Patients received treatment from December 2012 to February 2016. Four progressed on the combination and their treatment was terminated. Two patients were undergoing treatment when data was summarized. Best Response Evaluation Criteria in Solid Tumour (RECIST) responses were: one partial response (PR), four stable disease (SD), and four progressive disease (PD), corresponding to five PR and four PD on the Choi criteria. Median progression free survival was 5.5 months (range 4–17). Conclusions Our series showed that the combination of P + S has activity in STS patients selected by previous response to P and in a patient with chondrosarcoma, suggesting this can serve as a mechanism to reverse resistance to P and extend the chemotherapy-free window.
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Renton A, Thomas BM, Gill S, Lowndes C, Taylor-Robinson D, Patterson K. Chlamydia trachomatis in cervical and vaginal swabs and urine specimens from women undergoing termination of pregnancy. Int J STD AIDS 2016; 17:443-7. [PMID: 16820072 DOI: 10.1258/095646206777689053] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
The study was devised to assess the prevalence of Chlamydia trachomatis in endocervical and vaginal swabs and first pass urine specimens from women presenting for termination of pregnancy (TOP) and to evaluate the performance of the tests used, namely the ligase chain reaction (LCR) and the direct fluorescence antibody (DFA) test. Eight hundred and sixty three (91%) of 948 women invited to participate agreed to do so; a complete set of results for all test-site combinations was achieved for 793 (92%). The overall prevalence of C. trachomatis was 8.54% (95% confidence interval [CI]: 7.6–10.5%) with a significant negative association with age. The sensitivity (95% CI) of the LCR test for cervical, vaginal and urine specimens was 97% (93–99%); 94% (88–99%) and 83% (75–92%), respectively. The sensitivity (95% CI) of the DFA test for cervical, vaginal and urine specimens was 93% (87–99%); 92% (86–99%) and 78% (68–88%), respectively. Concordance between the LCR and DFA test results was very high for specimens from the same site. The results indicate that nucleic acid amplification tests are appropriate for screening women seeking TOP and, indeed, other women in early pregnancy. The sensitivity of the LCR test for urine specimens was less, but the high levels of concordance observed between the LCR and DFA test results for urine specimens indicates that this was due to a lower organism load rather than inhibition of the LCR.
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Mansfield S, Quirk F, McLeod M, Gill S. HealthPathways: a web-based resource for GPs to deliver evidenced-based coordinated care. Eur J Public Health 2015. [DOI: 10.1093/eurpub/ckv175.135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Conniff K, van Moorleghem K, Gill S, Posecion L, Coopersmith L, Nunan-Saah J, Paulraj S, Gomez R. B-25Can Depression Predict Functional Impairment in Lewy Body Dementia? Arch Clin Neuropsychol 2015. [DOI: 10.1093/arclin/acv047.121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Ahmed S, Bathe O, Berry S, Buie D, Davies J, Doll C, Dowden S, Gill S, Gordon V, Hebbard P, Jones E, Kennecke H, Koski S, Krahn M, Le D, Lim H, Lund C, Luo Y, Mcffadden A, Mcghie J, Mulder K, Park J, Rashidi F, Sami A, Tan KT, Wong R. Consensus statement: the 16th Annual Western Canadian Gastrointestinal Cancer Consensus Conference; Saskatoon, Saskatchewan; September 5-6, 2014. ACTA ACUST UNITED AC 2015; 22:e113-23. [PMID: 25908916 DOI: 10.3747/co.22.2362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The 16th annual Western Canadian Gastrointestinal Cancer Consensus Conference was held in Saskatoon, Saskatchewan, September 4-5, 2014. The Consensus Conference is an interactive, multidisciplinary event attended by health care professionals from across western Canada (British Columbia, Alberta, Saskatchewan, and Manitoba) involved in the care of gastrointestinal cancer. Surgical, medical, and radiation oncologists; pathologists; radiologists; and allied health care professionals participated in presentation and discussion sessions for the purposes of developing the recommendations presented here. This consensus statement addresses current issues in the management of colorectal cancer.
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Cheng J, Ondracek RP, Mehedint DC, Kasza KA, Xu B, Gill S, Azabdaftari G, Yao S, Morrison CD, Mohler JL, Marshall JR. Association of fatty-acid synthase polymorphisms and expression with outcomes after radical prostatectomy. Prostate Cancer Prostatic Dis 2015; 18:182-9. [PMID: 25868764 DOI: 10.1038/pcan.2015.11] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2014] [Revised: 02/24/2015] [Accepted: 02/28/2015] [Indexed: 11/09/2022]
Abstract
BACKGROUND Fatty-acid synthase (FASN), selectively overexpressed in prostate cancer (PCa) cells, has been described as linked to the aggressiveness of PCa. Constitutional genetic variation of the FASN gene and the expression levels of FASN protein in cancer cells could thus be expected to predict outcome after radical prostatectomy (RP). This study evaluates the associations of malignant tissue status, neoadjuvant androgen deprivation therapy (NADT) and single-nucleotide polymorphisms (SNPs) of FASN with FASN protein expression in prostate tissue. The study then examines the associations of FASN SNPs and gene expression with three measures of post-prostatectomy outcome. METHODS Seven tagging FASN SNPs were genotyped in 659 European American men who underwent RP at Roswell Park Cancer Institute between 1993 and 2005. FASN protein expression was assessed using immunohistochemistry. The patients were followed for an average of 6.9 years (range: 0.1-20.6 years). Outcome was assessed using three end points: biochemical failure, treatment failure and development of distant metastatic PCa. Cox proportional hazards analyses were used to evaluate the associations of the tagging SNPs and FASN expression with these end points. Bivariate associations with outcomes were considered; the associations also were controlled for known aggressiveness indicators. RESULTS Overall, no SNPs were associated with any known aggressiveness indicators. FASN staining intensity was stronger in malignant than in benign tissue, and NADT was associated with decreased FASN staining in both benign and malignant tissue. The relationships of FASN SNPs and staining intensity with outcome were less clear. One SNP, rs4246444, showed a weak association with outcome. FASN staining intensity also showed a weak and seemingly contradictory relationship with outcome. CONCLUSIONS Additional study with longer follow-up and populations that include more metastatic patients is warranted.
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Gill S, Zhang Q, Haluska P, Bakkum-Gamez J, Cliby B, Weroha S. Comparison of MISR2 expression in patient and successive passages of patient-derived xenografts of ovarian cancer. Gynecol Oncol 2015. [DOI: 10.1016/j.ygyno.2015.01.340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Siva S, Jackson P, Kron T, Shaw M, Chander S, Gill S, Hardcastle N, Pham D, Hofman M, Foroudi F. PO-0716: Kidney function loss is directly dose dependent after SBRT for primary RCC as assessed by Cr-51 EDTA + DMSA SPECT/CT. Radiother Oncol 2015. [DOI: 10.1016/s0167-8140(15)40708-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Cattanach N, Sheedy R, Gill S, Hughes A. Physical activity levels and patients' expectations of physical activity during acute general medical admission. Intern Med J 2015; 44:501-4. [PMID: 24816309 DOI: 10.1111/imj.12411] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2013] [Accepted: 01/05/2014] [Indexed: 11/29/2022]
Abstract
Bedrest during hospital admission is common and might be harmful. There is scarce published evidence that quantifies physical activity levels and expectations regarding physical activity of general medical patients during an acute inpatient stay. The current study aimed to investigate physical activity levels and expectations regarding physical activity in general medical patients at a large Australian teaching hospital. A convenience sample of 24 general medical patients was observed at 10-min intervals in one day between 8:00 and 17:00 and their physical activity status recorded. Participants completed a questionnaire regarding their expectations of physical activity during illness and hospital admission. Patients were observed to be in bed 51% of the time, were sitting out of bed 43% of the time, were standing 1% of the time and were walking 5% of the time. One third of participants (n = 8) were not observed to walk during the observation period. Questionnaire data indicated that nine (38%) participants expected to remain in bed while in hospital. General medical patients had low levels of physical activity during their hospital stay, which was consistent with many participants' expectations of appropriate activity when in hospital. If physical activity is an important part of acute general medical patient management, then patient expectations of the appropriateness of physical activity need to be addressed and methods to increase physical activity implemented.
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Alesch F, Jain R, Chen L, Brücke T, Seijo F, Martin ESS, Haegelen C, Verin M, Maarouf M, Barbe M, Gill S, Whone A, Porta M, Servello D, Timmermann L. Essai VANTAGE : suivi de douze (12) mois d’une étude prospective multicentrique évaluant la stimulation cérébrale profonde avec un nouveau système rechargeable à sources de courant multiples indépendantes (Vercise™) dans la maladie de Parkinson. Neurochirurgie 2014. [DOI: 10.1016/j.neuchi.2014.10.054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Wells AJ, McLaughlin P, Simmonds JV, Prouse PJ, Prelevic G, Gill S, Chowdary P. A case-control study assessing bone mineral density in severe haemophilia A in the UK. Haemophilia 2014; 21:109-15. [PMID: 25382849 DOI: 10.1111/hae.12565] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/13/2014] [Indexed: 11/27/2022]
Abstract
It has been shown that bone mineral density (BMD) may be lower in patients with haemophilia (PWH). A comparison to control subjects is required to thoroughly assess current BMD in PWH in the UK. The objective of this study was to test the hypothesis that BMD is lower in PWH than in controls, and in patients with more severely affected joints or lower activity levels. In this case-control study, 37 patients with severe haemophilia A were recruited from two haemophilia centres in the UK. A group of 37 age, gender and ethnicity-matched control participants were recruited. All participants had a bone density scan, a musculoskeletal assessment, a blood test for vitamin D and completed a functional activity questionnaire. Of the case group, 5% had osteoporosis and 24% had BMD lower than expected for age. No control participants had osteoporosis, 3% had osteopenia and 14% had BMD lower than expected for age. Ninety one per cent of case participants and 92% of control participants had reduced 25(OH)D levels. Case participants had significantly lower BMD than control participants, and case participants with more severely affected joints, lower activity levels, HIV, history of hepatitis C or lower BMI had significantly lower BMD. Patients with severe haemophilia have a higher risk of low BMD than men without haemophilia. Patients with more severely affected joints and lower activity levels have lower BMD. It remains unclear whether patients with low BMD reached adequate peak bone mass. Low vitamin D may be present in the majority of PWH.
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