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Lock K, Wilson K, Murphy D, Riesco JA. A cost-effectiveness model of smoking cessation based on a randomised controlled trial of varenicline versus placebo in patients with chronic obstructive pulmonary disease. Expert Opin Pharmacother 2011; 12:2613-26. [DOI: 10.1517/14656566.2011.628935] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Bolin K, Borgman B, Gip C, Wilson K. Current and future avoidable cost of smoking--estimates for Sweden 2007. Health Policy 2011; 103:83-91. [PMID: 21959339 DOI: 10.1016/j.healthpol.2011.08.011] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2010] [Revised: 08/28/2011] [Accepted: 08/30/2011] [Indexed: 10/17/2022]
Abstract
OBJECTIVE To estimate current and future avoidable smoking-attributable costs in Sweden for the year 2007. DESIGN Disease specific smoking-attributable proportions were calculated for Swedish smoking patterns and applied to estimate costs for smoking-related diseases based on data from public registers. Avoidable future effects of smoking were calculated employing a Markov simulation model. RESULTS The estimated total cost in 2007 was USD 1.6 billion, or USD 181 per capita. Healthcare (direct) cost accounted for 30% of the total cost. The number of deaths was 97 per 100,000 inhabitants (79 in 2001); the number of years of potential life lost 1,227 per 100,000 inhabitants (1012 in 2001); and the number of years of potential productive life lost 226 (185 in 2001) per 100,000 inhabitants. Avoidable future lifetime costs, per 100,000 inhabitants, amounted to USD 19 million (healthcare), 14,000 years of potential life lost, corresponding to a present value of USD 158 million. Total avoidable cost of current smoking amounted to USD 16 billion. CONCLUSION In spite of declining smoking-prevalence rates during the last 30 years, smoking-attributable deaths increased between 2001 and 2007. The number of life years lost per death decreased somewhat, indicating that the age distribution of those dying shifted further towards older age. Simulations indicate that smoking-cessation among young smokers yields considerable more benefits each year than smoking-cessation among older smokers. The health benefits that accrued in 2007, as a result of declining smoking prevalence since 1980, correspond to more than the total cost of smoking in that year.
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Simard T, Hibbert B, Pourdjabbar A, Wilson K, Hawken S, O'Brien E. 440 Percutaneous coronary intervention with or without on-site coronary artery bypass surgery: A meta-analysis. Can J Cardiol 2011. [DOI: 10.1016/j.cjca.2011.07.373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Wilson K, Hettle R, Marbaix S, Diaz Cerezo S, Ines M, Santoni L, Annemans L, Prignot J, Lopez de Sa E. An economic evaluation based on a randomized placebo-controlled trial of varenicline in smokers with cardiovascular disease: results for Belgium, Spain, Portugal, and Italy. Eur J Prev Cardiol 2011; 19:1173-83. [PMID: 21840967 DOI: 10.1177/1741826711420345] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND An estimated 17.2% of patients continue to smoke following diagnosis of cardiovascular disease (CVD). To reduce the risk of further morbidity or mortality in cardiovascular patients, smoking cessation has been shown to reduce the risk of mortality by 36% and myocardial infarction by 32%. The objective of this study was to evaluate the long-term health and economic consequences of smoking cessation in patients with CVD. DESIGN AND METHODS Results of a randomized clinical trial comparing varenicline plus counselling vs. placebo plus counselling were extrapolated using a Markov model to simulate the lifetime costs and health consequences of smoking cessation in patients with stable CVD. For the base case, we considered a payer's perspective including direct costs attributed to the healthcare provider, measuring cumulative life years (LY) and quality adjusted life (QALY) years as outcome measures. Secondary analyses were conducted from a societal perspective, evaluating lost productivity due to premature mortality. Sensitivity and subgroup analyses were also undertaken. Results were analysed for Belgium, Spain, Portugal, and Italy. RESULTS Varenicline plus counselling was associated with a gain in LY and QALY across all countries; relative to placebo plus counselling. From a payer's perspective, incremental cost effectiveness ratios were € 6120 (Belgium), € 5151 (Spain), € 5357 (Portugal), and € 5433 (Italy) per QALY gained. From a societal perspective, varenicline in addition to counselling was less costly than placebo and counselling in all cases. Sensitivity analyses showed little sensitivity in outcomes to model assumptions or uncertainty in model parameters. CONCLUSIONS Varenicline in addition to counselling is cost-effective compared to placebo and counselling in smokers with CVD.
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Langille D, Andreou P, Wilson K. P2-S1.09 Associations between early sexual debut and two types of sexual risk behaviour in Nova Scotia adolescents. Br J Vener Dis 2011. [DOI: 10.1136/sextrans-2011-050108.287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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van Dijk M, Wilson K, Contreras X, Ettenger A, Fukuda HD, Garcia S. P2-S7.03 Pregnancy and contraceptive experiences of women living with HIV in Mexico. Br J Vener Dis 2011. [DOI: 10.1136/sextrans-2011-050108.370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Khawaja MZ, Haran H, Nadra I, Wilson K, Clack L, Macgillivray K, Hancock J, Young C, Bapat V, Thomas M, Redwood S. 26 The effects of pre-existing significant coronary artery disease upon outcome after transcatheter aortic valve implantation using the Edwards bioprosthesis. Heart 2011. [DOI: 10.1136/heartjnl-2011-300198.26] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Weickhardt AJ, Williams D, Lee C, Simes J, Murone C, Wilson K, Cummins M, Asadi K, Price TJ, Mariadason J, Tebbutt NC. Vascular endothelial growth factors (VEGF) and VEGF receptor expression as predictive biomarkers for benefit with bevacizumab in metastatic colorectal cancer (mCRC): Analysis of the phase III MAX study. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.3531] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Salame G, Pradhan TS, Stevens E, Lee Y, Economos K, Gorelick C, Serur E, Ruffner N, Wilson K, Abulafia O. The validity of the MSKCC nomogram in predicting overall survival of black patients with uterine cancer. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.e15570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Price TJ, Zannino D, Wilson K, Simes J, Van Hazel GA, Robinson BA, Broad A, Ganju V, Ackland SP, Tebbutt NC. Outcome and dose intensity (DI) in the elderly subgroup of the AGITG MAX phase III trial of capecitabine (C), bevacizumab (B), and mitomycin C (M) in first-line metastatic colorectal cancer (CRC). J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.3621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Rehe K, Wilson K, Bomken S, Stanulla M, Heidenreich O, Vormoor J. In acute lymphoblastic leukaemia stemness is frequent and ubiquitous. Klin Padiatr 2011. [DOI: 10.1055/s-0031-1277087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Tung JP, Fung YL, Nataatmadja M, Colebourne KI, Esmaeel HM, Wilson K, Barnett AG, Wood P, Silliman CC, Fraser JF. A novel in vivo ovine model of transfusion-related acute lung injury (TRALI). Vox Sang 2011; 100:219-30. [PMID: 20667072 DOI: 10.1111/j.1423-0410.2010.01381.x] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND AND OBJECTIVES Even with the introduction of specific risk-reduction strategies, transfusion-related acute lung injury (TRALI) continues to be a leading cause of transfusion-related morbidity and mortality. Existing small animal models have not yet investigated TRALI resulting from the infusion of heat-treated supernatant from whole blood platelet concentrates. In this study, our objective was the development of a novel in vivo two-event model of TRALI in sheep. MATERIALS AND METHODS Lipopolysaccharide (LPS; 15 μg/kg) as a first event, modelled clinical infection. Transfusion (estimated at 10% of total blood volume) of heat-treated pooled supernatant from date-of-expire human whole blood platelet concentrates (d5-PLT-S/N) was used as a second event. TRALI was defined by both hypoxaemia that developed either during the transfusion or within two hours of its completion and post-mortem histological evidence of pulmonary oedema. RESULTS LPS infusion did not cause lung injury itself, but did result in decreased circulating levels of lymphocytes and neutrophils with evidence of the latter becoming sequestered in the lungs. Sheep that received LPS (first event) followed by d5-PLT-S/N (second event) displayed decreased pulmonary compliance, decreased end tidal CO(2) and increased arterial partial pressure of CO(2) relative to control sheep, and 80% of these sheep developed TRALI. CONCLUSIONS This novel ovine two-event TRALI model presents a new tool for the investigation of TRALI pathogenesis. It represents the first description of an in vivo large animal model of TRALI and the first description of TRALI caused by transfusion with heat-treated pooled supernatant from human whole blood platelet concentrates.
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Affiliation(s)
- J P Tung
- Research and Development Laboratory, Australian Red Cross Blood Service, Brisbane, Qld, Australia.
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Zimovetz EA, Wilson K, Samuel M, Beard SM. A review of cost-effectiveness of varenicline and comparison of cost-effectiveness of treatments for major smoking-related morbidities. J Eval Clin Pract 2011; 17:288-97. [PMID: 21029268 DOI: 10.1111/j.1365-2753.2010.01439.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
RATIONALE This review aims to examine economic evaluations of varenicline, to compare the reported cost-effectiveness of varenicline with that of treatments for major smoking-related diseases and to evaluate the findings for decision making. METHODS A literature search was performed to identify published articles in English indexed in MEDLINE and the Cochrane Library (Issue 1, 2009), which includes the Economic Evaluation Database. Additional sources also were searched to identify unpublished varenicline studies, including conference abstracts. The search for varenicline studies was limited from 2006 to October 2009; searches for all other types of studies were limited from 1990 to October 2009. RESULTS The search yielded a total of 20 relevant economic evaluations of varenicline. In addition, 37 reviews of economic evaluations in chronic obstructive pulmonary disease, non-small cell lung cancer and cardiovascular disease, as well as studies evaluating the impact of economic rewarding were considered in this review. From these identified economic evaluations, the incremental cost-effectiveness ratios for varenicline ranged from dominance (more effective and cost saving) to €18,582 per quality-adjusted life-year (including indirect costs). These estimates appeared substantially lower when compared with incremental cost-effectiveness ratios reported for secondary prevention of smoking-related diseases, which in some cases were as high as €66,218 per quality-adjusted life-year. CONCLUSIONS Varenicline appears to be cost-effective from the perspective of both health care payers and employers, because of reduced health care consumption and costs. The cost-effectiveness of varenicline also compares favourably to that of interventions recommended for the treatment and prevention of smoking-related diseases.
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Affiliation(s)
- Evelina A Zimovetz
- Senior Health Technology and Clinical Evidence Reviewer, Head of European Operations, RTI Health Solutions, Williams House, Manchester Science Park, Manchester, UK.
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Pier B, Huston L, Strenge K, Sundell Z, Wilson K, Burney R. A Cytoarchitectural Analysis of the Effects of Cigarette Smoke Exposure on Human Oviductal Epithelium. Fertil Steril 2011. [DOI: 10.1016/j.fertnstert.2011.01.067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Price TJ, Zannino D, Wilson K, Simes J, Van Hazel GA, Robinson BA, Broad A, Ganju V, Ackland SP, Tebbutt NC. Geriatric subgroup of AGITG MAX trial: International randomized phase III trial of capecitabine (C), bevacizumab (B), and mitomycin C (M) in first-line metastatic colorectal cancer (CRC). J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.4_suppl.510] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
510 Background: In an aging population a greater proportion of geriatric patients will be considered for systemic chemotherapy. CRC is a common cancer and will be a major health issue in geriatrics. Methods: MAX, a three arm study of C v CB v CBM, found an improvement in PFS with addition of B (± MMC) to C (Tebbutt NC et al. JCO 2010; 28(19): 3191–3198). This analysis assesses effect of adding B (± MMC) to C on PFS, OS, RR and toxicity in geriatric patients (age >75y). Results: 99 patients (21%) were >75y. Number/Median age: C 37/78.5y (75.2–86), CB 32/78.7y (75.2–84.9), CBM 30/80.2y (75.2–83.4). Baseline characteristics were well balanced. 88% commenced C dose of 2000mg/m2/day, d1–14, q21 (61% for <75y). ECOG 0–1 for 88%. Comorbidities were: (%) Ex/smoker 13/2, diabetes 15, HT 56, IHD 15, CVA/TIA 10. These are similar to reported rates ( http://www.aihw.gov.au/cdarf/data_pages/incidence_prevalence/index.cfm ) in this population. Proportion receiving all three chemotherapy drugs at some time (5FU/oxaliplatin/irinotecan) was 10% >75y v 20% <75y. RR, median PFS & OS reported in Table. Interaction test for OS, RR and PFS revealed no impact of age. Gd 3-4 tox for >75y C/CB/CBM respectively was (%); vomiting 5/13/3, diarrhea 19/22/20, stomatitis 3/0/3, HT 0/3/3, thrombosis/thrombus/embolism 5/6/13, cardiac 0/6 (3 Gd5)/3. There was one perforation (Gd5) in C. Grade 2/3 HFS (%) was 38/59/53. One Gd 3-4 neutropenia episode in CB, no Gd 3-4 thrombocytopenia. Overall, toxicity rate similar to <75 y. Conclusions: Significant improvement in PFS with addition of B to C was seen in this geriatric population, similar to results of ITT group and those <75yrs. Treatment was well tolerated with no signal of increased toxicity when compared to those <75yrs, including VTE/ATE. [Table: see text] [Table: see text]
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Affiliation(s)
- T. J. Price
- Queen Elizabeth Hospital, Adelaide, Australia; National Health and Medical Research Council Clinical Trials Centre, University of Sydney, Sydney, Australia; Perth Oncology, Mount Hospital, Perth, Australia; Christchurch Hospital, Christchurch, New Zealand; Geelong Hospital, Geelong, Australia; Frankston Hospital, Frankston, Australia; Calvary Mater Hospital, Newcastle, Australia; Austin Health, Heidelberg, Australia
| | - D. Zannino
- Queen Elizabeth Hospital, Adelaide, Australia; National Health and Medical Research Council Clinical Trials Centre, University of Sydney, Sydney, Australia; Perth Oncology, Mount Hospital, Perth, Australia; Christchurch Hospital, Christchurch, New Zealand; Geelong Hospital, Geelong, Australia; Frankston Hospital, Frankston, Australia; Calvary Mater Hospital, Newcastle, Australia; Austin Health, Heidelberg, Australia
| | - K. Wilson
- Queen Elizabeth Hospital, Adelaide, Australia; National Health and Medical Research Council Clinical Trials Centre, University of Sydney, Sydney, Australia; Perth Oncology, Mount Hospital, Perth, Australia; Christchurch Hospital, Christchurch, New Zealand; Geelong Hospital, Geelong, Australia; Frankston Hospital, Frankston, Australia; Calvary Mater Hospital, Newcastle, Australia; Austin Health, Heidelberg, Australia
| | - J. Simes
- Queen Elizabeth Hospital, Adelaide, Australia; National Health and Medical Research Council Clinical Trials Centre, University of Sydney, Sydney, Australia; Perth Oncology, Mount Hospital, Perth, Australia; Christchurch Hospital, Christchurch, New Zealand; Geelong Hospital, Geelong, Australia; Frankston Hospital, Frankston, Australia; Calvary Mater Hospital, Newcastle, Australia; Austin Health, Heidelberg, Australia
| | - G. A. Van Hazel
- Queen Elizabeth Hospital, Adelaide, Australia; National Health and Medical Research Council Clinical Trials Centre, University of Sydney, Sydney, Australia; Perth Oncology, Mount Hospital, Perth, Australia; Christchurch Hospital, Christchurch, New Zealand; Geelong Hospital, Geelong, Australia; Frankston Hospital, Frankston, Australia; Calvary Mater Hospital, Newcastle, Australia; Austin Health, Heidelberg, Australia
| | - B. A. Robinson
- Queen Elizabeth Hospital, Adelaide, Australia; National Health and Medical Research Council Clinical Trials Centre, University of Sydney, Sydney, Australia; Perth Oncology, Mount Hospital, Perth, Australia; Christchurch Hospital, Christchurch, New Zealand; Geelong Hospital, Geelong, Australia; Frankston Hospital, Frankston, Australia; Calvary Mater Hospital, Newcastle, Australia; Austin Health, Heidelberg, Australia
| | - A. Broad
- Queen Elizabeth Hospital, Adelaide, Australia; National Health and Medical Research Council Clinical Trials Centre, University of Sydney, Sydney, Australia; Perth Oncology, Mount Hospital, Perth, Australia; Christchurch Hospital, Christchurch, New Zealand; Geelong Hospital, Geelong, Australia; Frankston Hospital, Frankston, Australia; Calvary Mater Hospital, Newcastle, Australia; Austin Health, Heidelberg, Australia
| | - V. Ganju
- Queen Elizabeth Hospital, Adelaide, Australia; National Health and Medical Research Council Clinical Trials Centre, University of Sydney, Sydney, Australia; Perth Oncology, Mount Hospital, Perth, Australia; Christchurch Hospital, Christchurch, New Zealand; Geelong Hospital, Geelong, Australia; Frankston Hospital, Frankston, Australia; Calvary Mater Hospital, Newcastle, Australia; Austin Health, Heidelberg, Australia
| | - S. P. Ackland
- Queen Elizabeth Hospital, Adelaide, Australia; National Health and Medical Research Council Clinical Trials Centre, University of Sydney, Sydney, Australia; Perth Oncology, Mount Hospital, Perth, Australia; Christchurch Hospital, Christchurch, New Zealand; Geelong Hospital, Geelong, Australia; Frankston Hospital, Frankston, Australia; Calvary Mater Hospital, Newcastle, Australia; Austin Health, Heidelberg, Australia
| | - N. C. Tebbutt
- Queen Elizabeth Hospital, Adelaide, Australia; National Health and Medical Research Council Clinical Trials Centre, University of Sydney, Sydney, Australia; Perth Oncology, Mount Hospital, Perth, Australia; Christchurch Hospital, Christchurch, New Zealand; Geelong Hospital, Geelong, Australia; Frankston Hospital, Frankston, Australia; Calvary Mater Hospital, Newcastle, Australia; Austin Health, Heidelberg, Australia
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Garey C, Schropp K, Talboy G, McDonell J, Kurylo M, Wilson K, Keeling M, Nazir N, Brandt M, Moncure M. Stress In Surgery Residents: A Pilot Study For Evaluation And Intervention. J Surg Res 2011. [DOI: 10.1016/j.jss.2010.11.839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Tebbutt NC, Murphy F, Zannino D, Wilson K, Cummins MM, Abdi E, Strickland AH, Lowenthal RM, Marx G, Karapetis C, Shannon J, Goldstein D, Nayagam SS, Blum R, Chantrill L, Simes RJ, Price TJ. Risk of arterial thromboembolic events in patients with advanced colorectal cancer receiving bevacizumab. Ann Oncol 2011; 22:1834-8. [PMID: 21273347 DOI: 10.1093/annonc/mdq702] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND Bevacizumab is an antiangiogenic mAb with efficacy against several cancers, but it is associated with risk of arterial thromboembolism (ATE). Further data are needed to determine the safety of bevacizumab. PATIENTS AND METHODS We recorded grade 3, 4, or 5 ATE events and other data (including age, baseline cardiovascular risk factors, history of ATE, and aspirin use) from 471 patients with metastatic colorectal cancer in the MAX (Mitomycin, Avastin, Xeloda) trial of capecitabine monotherapy versus capecitabine with bevacizumab with or without mitomycin C. RESULTS Bevacizumab-treated patients had 12 grade 3, 4, or 5 ATEs (3.8% incidence). ATEs occurred in 2.1% of patients >65 years, 5% of those with a history of ATE, and 5% of those with cardiac risk factors. Age, history of ATE, or vascular risk factors did not increase risk. Aspirin users had a higher incidence than nonusers (8.9% versus 2.7%) but had higher rates of vascular risk factors. CONCLUSIONS Bevacizumab was associated with a modestly higher risk of ATE, but safety was not significantly worse in older patients or patients with a history of ATE or vascular risk factors. The effect of aspirin in preventing ATE in patients receiving bevacizumab could not be determined from this study.
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Affiliation(s)
- N C Tebbutt
- Department of Medical Oncology, Austin Health, Melbourne, Australia.
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Pittet D, Panesar SS, Wilson K, Longtin Y, Morris T, Allan V, Storr J, Cleary K, Donaldson L. Involving the patient to ask about hospital hand hygiene: a National Patient Safety Agency feasibility study. J Hosp Infect 2011; 77:299-303. [PMID: 21236515 DOI: 10.1016/j.jhin.2010.10.013] [Citation(s) in RCA: 90] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2010] [Accepted: 10/03/2010] [Indexed: 11/29/2022]
Abstract
Healthcare-associated infections (HAIs) affect at least 300,000 patients annually in the UK and represent a significant, yet largely preventable, burden to healthcare systems. Hand hygiene by healthcare workers (HCWs) is the leading prevention measure, but compliance with good practice is generally low. The UK National Patient Safety Agency surveyed the public, inpatients, and HCWs, particularly frontline clinical staff and infection control nurses, in five acute care hospitals to determine whether they agreed that a greater level of involvement and engagement with patients would contribute to increased compliance with hand hygiene and reduce HAIs. Fifty-seven percent (302/530) of the public were unlikely to question doctors on the cleanliness of their hands as they assumed that they had already cleaned them. Forty-three percent (90/210) of inpatients considered that HCWs should know to clean their hands and trusted them to do so, and 20% (42/210) would not want HCWs to think that they were questioning their professional ability to do their job correctly. Most HCWs surveyed (178/254, 71%) said that HAI could be reduced to a greater or lesser degree if patients asked HCWs if they had cleaned their hands before touching them. Inviting patients to remind HCWs about hand hygiene through the provision of individual alcohol-based hand-rub containers and actively supporting an 'It's OK to ask' attitude were perceived as the most useful interventions by both patients and HCWs. However, further work is required to refute the myth among HCWs that patient involvement undermines the doctor- or HCW-patient relationship.
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Affiliation(s)
- D Pittet
- Infection Control Programme and WHO Collaborating Centre on Patient Safety, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland.
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Patel SK, Mullins WA, O'Neil SH, Wilson K. Neuropsychological differences between survivors of supratentorial and infratentorial brain tumours. J Intellect Disabil Res 2011; 55:30-40. [PMID: 21121992 DOI: 10.1111/j.1365-2788.2010.01344.x] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
BACKGROUND The purpose of this study is to evaluate the relationship between brain tumour location and core areas of cognitive and behavioural functioning for paediatric brain tumour survivors. The extant literature both supports and refutes an association between paediatric brain tumour location and neurocognitive outcomes. We examined neuropsychological test data to identify any differences in neurocognitive and behavioural profile associated with supratentorial versus infratentorial tumour location. METHODS Following Institutional Review Board approval, the medical records and neuropsychological test data collected between 1997 and 2002 for 70 children treated for brain tumour at Children's Hospital Los Angeles were reviewed. Fifty-one per cent of the participants had tumours located in the supratentorial regions of the brain, whereas 49% had infratentorial tumours. Primary medical treatments involved tumour resection (90%), cranial radiation therapy (76%), chemotherapy (71%), and 59% all three medical procedures. The two tumour location groups did not differ significantly in the cumulative treatment dose of irradiation to the tumour bed or in the dose delivered to the whole brain. Neuropsychological test data included measures of verbal and non-verbal intellectual functioning, attention/working memory, processing speed, verbal and visual memory, fine motor skills, visual-motor integration, academic achievement, and social-emotional functioning. Differences between the two groups were evaluated using anova, t-tests and chi-squared statistical tests. RESULTS The supratentorial and infratentorial tumour location groups did not differ on measures of intellectual functioning. However, survivors of infratentorial tumours performed more poorly on selected measures of more specific cognitive functions and on parent-report of social-emotional functioning relative to survivors of supratentorial tumours, even when age at diagnosis was held as a covariate. Higher frequency of auditory deficits was noted in the infratentorial tumour group and was associated with lowered academic achievement scores. CONCLUSIONS The differences by location found in more specific neurocognitive and social-emotional variables, after controlling for age at diagnosis, may possibly reflect tumour location-specific effects. However, this interpretation remains tentative given the limitations in our study and inability to control for the range of medical and treatment-related factors that may have contributed towards the outcomes observed in our sample. At the same time, most of our findings appear consistent with reports from recent studies in this area.
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Affiliation(s)
- S K Patel
- City of Hope Medical Center and Beckman Research Institute, Duarte, CA, USA.
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Adamo M, Wilson K, Barense MD, Ferber S. Dissociating feature complexity from number of objects in VSTM storage using the contralateral delay activity. J Vis 2010. [DOI: 10.1167/10.7.719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Sharma G, Wilson K, van der Walle CF, Sattar N, Petrie JR, Ravi Kumar MNV. Microemulsions for oral delivery of insulin: design, development and evaluation in streptozotocin induced diabetic rats. Eur J Pharm Biopharm 2010; 76:159-69. [PMID: 20655382 DOI: 10.1016/j.ejpb.2010.07.002] [Citation(s) in RCA: 101] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2010] [Revised: 06/12/2010] [Accepted: 07/05/2010] [Indexed: 11/16/2022]
Abstract
Insulin loaded microemulsions were developed adopting a low shear reverse micellar approach using didoceyldimethylammonium bromide (DMAB) as the surfactant, propylene glycol (PG) as the co-surfactant, triacetin (TA) as the oil phase and insulin solution as the aqueous phase. A ternary phase diagram was constructed based on multiple cloud point titration to highlight the reverse micellar region. The droplet sizes of the microemulsions were 161.7±24.7nm with PDI of 0.447±0.076 and insulin entrapment of ∼85%. Transmission electron microscopy (TEM) revealed the spherical nature and size homogeneity of the microemulsion droplets. The conformational stability of the entrapped insulin within microemulsions was confirmed by fluorescence spectroscopy and circular dichroism. The microemulsions displayed a 10-fold enhancement in bioavailability compared with plain insulin solution administered per oral in healthy rats. The short-term in vivo efficacy in STZ induced diabetic rats provided the proof of concept by a modest glucose reduction at a dose of 20IU/kg. Together this preliminary data indicate the promise of microemulsions for oral delivery of insulin.
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Affiliation(s)
- G Sharma
- Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, Glasgow, UK
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Boyd C, Larkin MJ, Reid KA, Sharma ND, Wilson K. Metabolism of Naphthalene, 1-Naphthol, Indene, and Indole by Rhodococcus sp. Strain NCIMB 12038. Appl Environ Microbiol 2010; 63:151-5. [PMID: 16535479 PMCID: PMC1389094 DOI: 10.1128/aem.63.1.151-155.1997] [Citation(s) in RCA: 68] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The regulation of naphthalene and 1-naphthol metabolism in a Rhodococcus sp. (NCIMB 12038) has been investigated. The microorganism utilizes separate pathways for the degradation of these compounds, and they are regulated independently. Naphthalene metabolism was inducible, but not by salicylate, and 1-naphthol metabolism, although constitutive, was also repressed during growth on salicylate. The biochemistry of naphthalene degradation in this strain was otherwise identical to that found in Pseudomonas putida, with salicylate as a central metabolite and naphthalene initially being oxidized via a naphthalene dioxygenase enzyme to cis-(1R,2S)-1,2-dihydroxy-1,2-dihydronaphthalene (naphthalene cis-diol). A dioxygenase enzyme was not expressed under growth conditions which facilitate 1-naphthol degradation. However, biotransformations with indene as a substrate suggested that a monooxygenase enzyme may be involved in the degradation of this compound. Indole was transformed to indigo by both naphthalene-grown NCIMB 12038 and by cells grown in the absence of an inducer. Therefore, the presence of a naphthalene dioxygenase enzyme activity was not necessary for this reaction. Thus, the biotransformation of indole to indigo may be facilitated by another type of enzyme (possibly a monooxygenase) in this organism.
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176
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Mills E, Wilson K, Foster B, Phillips E, Walker S, Rachlis B, Montori VM, Myers SP, Clarke M, Gallicano S. Silybum marianum (milk thistle) and indinavir: an RCT and meta-analysis. ACTA ACUST UNITED AC 2010. [DOI: 10.1111/j.2042-7166.2004.tb04536.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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177
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Armenian S, Landier W, Sun C, Lee J, Zomorodi M, Francisco L, Wilson K, Bhatia S. Screening for cardiac dysfunction and cardiovascular risk factors in childhood cancer survivors using the Children's Oncology Group (COG) Long-term Follow-up (LTFU) Guidelines. J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.9034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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178
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Stockler M, Zannino D, Wilson K, Gebski V, Abdi EA, Strickland A, Lowenthal RM, Simes RJ, Price TJ, Tebbutt NC. Patient-rated outcomes (PRO) in a randomized trial of first-line chemotherapy with capecitabine (C), bevacizumab (B), and mitomycin-C (M) for metastatic colorectal cancer: The AGITG MAX trial. J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.e14036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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179
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Magiorakos AP, Leens E, Drouvot V, May-Michelangeli L, Reichardt C, Gastmeier P, Wilson K, Tannahill M, McFarlane E, Simon A. Pathways to clean hands: highlights of successful hand hygiene implementation strategies in Europe. Euro Surveill 2010. [DOI: 10.2807/ese.15.18.19560-en] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Hand hygiene is the most effective way to stop the spread of microorganisms and to prevent healthcare-associated infections (HAI). The World Health Organization launched the First Global Patient Safety Challenge - Clean Care is Safer Care - in 2005 with the goal to prevent HAI globally. This year, on 5 May, the WHO’s initiative SAVE LIVES: Clean Your Hands, which focuses on increasing awareness of and improving compliance with hand hygiene practices, celebrated its second global day. In this article, four Member States of the European Union describe strategies that were implemented as part of their national hand hygiene campaigns and were found to be noteworthy. The strategies were: governmental support, the use of indicators for hand hygiene benchmarking, developing national surveillance systems for auditing alcohol-based hand rub consumption, ensuring seamless coordination of processes between health regions in countries with regionalised healthcare systems, implementing the WHO's My Five Moments for Hand Hygiene, and auditing of hand hygiene compliance.
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Affiliation(s)
- A P Magiorakos
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - E Leens
- Scientific Institute of Public Health, Brussels, Belgium
| | - V Drouvot
- Ministry of Health, Youth and Sport, Paris, France
| | | | - C Reichardt
- Institute of Hygiene and Environmental Medicine, Charité, University Medicine, Berlin, Germany
| | - P Gastmeier
- Institute of Hygiene and Environmental Medicine, Charité, University Medicine, Berlin, Germany
| | - K Wilson
- National Patient Safety Agency, London, United Kingdom
| | - M Tannahill
- Health Protection Scotland, Glasgow, United Kingdom
| | - E McFarlane
- Health Protection Scotland, Glasgow, United Kingdom
| | - A Simon
- Cliniques Universitaires Saint Luc, Brussels, Belgium
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180
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Magiorakos AP, Leens E, Drouvot V, May-Michelangeli L, Reichardt C, Gastmeier P, Wilson K, Tannahill M, McFarlane E, Simon A. Pathways to clean hands: highlights of successful hand hygiene implementation strategies in Europe. Euro Surveill 2010; 15:19560. [PMID: 20460091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023] Open
Abstract
Hand hygiene is the most effective way to stop the spread of microorganisms and to prevent healthcare-associated infections (HAI). The World Health Organization launched the First Global Patient Safety Challenge - Clean Care is Safer Care - in 2005 with the goal to prevent HAI globally. This year, on 5 May, the WHO s initiative SAVE LIVES: Clean Your Hands, which focuses on increasing awareness of and improving compliance with hand hygiene practices, celebrated its second global day. In this article, four Member States of the European Union describe strategies that were implemented as part of their national hand hygiene campaigns and were found to be noteworthy. The strategies were: governmental support, the use of indicators for hand hygiene benchmarking, developing national surveillance systems for auditing alcohol-based hand rub consumption, ensuring seamless coordination of processes between health regions in countries with regionalised healthcare systems, implementing the WHO's My Five Moments for Hand Hygiene, and auditing of hand hygiene compliance.
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Affiliation(s)
- A P Magiorakos
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden.
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181
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Abstract
OBJECTIVES Varenicline is a licensed smoking cessation medication in the EU, USA and many other countries worldwide. This study was designed to assess its effectiveness in a UK general practice setting. METHODS The main outcome measure was the rate of smoking cessation, defined as the seven-day point prevalence after six months from starting varenicline. Varenicline users were identified from records in The Health Improvement Network (THIN) database. A questionnaire on smoking cessation was sent to patients who commenced treatment close to the selection date (six months prior to the date of questionnaire dispatch). RESULTS The response rate was 26.4%: 193 responses were received. Ninety percent had previously attempted to stop smoking and 87.4% had used nicotine replacement therapy during the previous attempt to stop smoking. The overall smoking cessation rate was 49.5%. There was a strong association between the duration of varenicline treatment and smoking cessation. Patients who reported using varenicline for 9-12 weeks were 11 times more likely to stop smoking than those who completed less than two weeks of treatment. There was some evidence that patients with a longer history of smoking were less likely to stop. No association was observed between smoking cessation and: previous number of cigarettes smoked per day; number of previous attempts to stop smoking; or motivations for stopping. CONCLUSIONS Varenicline appeared to be a useful pharmacological aid to smoking cessation in a general practice setting. The observed effectiveness was similar to the efficacy estimates from previously reported clinical trials. However, the response rate was lower than expected and responders tended to be older, more likely to suffer from chronic obstructive pulmonary disease and to live in more affluent areas than non-responders. Responses were self-reported and not clinically validated therefore recall bias may be an issue.
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182
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Linden K, Jormanainen V, Linna M, Sintonen H, Wilson K, Kotomäki T. Cost effectiveness of varenicline versus bupropion and unaided cessation for smoking cessation in a cohort of Finnish adult smokers. Curr Med Res Opin 2010; 26:549-60. [PMID: 20050814 DOI: 10.1185/03007990903542666] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVE To assess the cost effectiveness of varenicline compared with bupropion or unaided cessation for smoking cessation in Finnish adult smokers. RESEARCH DESIGN AND METHODS The BENESCO (BENEfits of Smoking Cessation on Outcomes) Markov model was used to follow a hypothetical cohort of smokers making a single quit attempt over a lifetime. Gender and age-specific data on the incidence and prevalence of five smoking-related diseases (chronic obstructive pulmonary disease [COPD], lung cancer, coronary heart disease [CHD], stroke and asthma exacerbations) were included in the model. Life-years (LYs), quality-adjusted life-years (QALYs), total treatment costs and the lifetime cumulative incidence of these parameters were the primary outcomes evaluated, and they were compared for varenicline versus bupropion and varenicline versus unaided cessation. The primary data were derived from Finnish publications and databases. Deterministic and probabilistic sensitivity analyses were performed to test the robustness of the base-case model. RESULTS The treatment cohort comprised 229 301 smokers making a quit attempt. In the lifetime simulation, use of varenicline prevented 1965 and 5057 additional cases of smoking-related disease, and 1184 and 3047 deaths attributable to smoking, when compared with bupropion and unaided cessation, respectively. Compared with bupropion and unaided cessation varenicline treatment yielded 4392 and 11 303 additional LYs (4851 and 12 485 QALYs), respectively. Varenicline resulted in cost savings of 15 million and 43 million euros (euro) compared with bupropion and unaided cessation, respectively. In the 20-year time horizon analysis, varenicline yielded an incremental cost-effectiveness ratio (ICER) of euro8791/QALY and euro7791/QALY gained in comparison to bupropion and unaided cessation, respectively. Sensitivity analyses supported the robustness of the base-case results for varenicline. CONCLUSION Varenicline dominated over its comparators, i.e. it was more effective and resulted in cost saving compared with bupropion and unaided cessation.
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183
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Fass R, Noelck N, Willis MR, Navarro-Rodriguez T, Wilson K, Powers J, Barkmeier-Kraemer JM. The effect of esomeprazole 20 mg twice daily on acoustic and perception parameters of the voice in laryngopharyngeal reflux. Neurogastroenterol Motil 2010; 22:134-41, e44-5. [PMID: 19740116 DOI: 10.1111/j.1365-2982.2009.01392.x] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Randomized, placebo-controlled studies have failed to demonstrate a significant treatment effect for laryngopharyngeal reflux (LPR) using traditional clinical endpoints. We compared the effect of esomeprazole 20 mg twice daily (b.i.d.) vs placebo on voice and acoustic-related measures in patients with LPR. METHODS Patients with LPR underwent endoscopy and pH testing. Subsequently, patients underwent videostroboscopic recordings of the larynx, acoustic voice and speech analysis. A voice use and quality diary and oesophageal symptom diary were completed at baseline. Thereafter, patients were randomized to esomeprazole 20 mg twice daily vs placebo for 3 months. The voice use and quality diary and oesophageal symptom dairy were repeated during the last week of treatment. Videostroboscopy and acoustic voice and speech analysis were also performed at the end of treatment. KEY RESULTS Twenty-four patients were randomized to the esomeprazole group and 17 to the placebo group. There was no significant difference in videostroboscopic reflux finding scores from baseline to post-treatment. Acoustic measures also failed to demonstrate significant differences within the same or between groups, even when a sub-group analysis of patients with endoscopically documented oesophageal inflammation at baseline was performed. Additionally, no significant differences were found between groups when using voice use and quality diary. CONCLUSIONS & INFERENCES Use of more specific laryngeal functional parameters such as voice-related acoustic measures of pitch range, fundamental frequency and intensity also failed to demonstrate a significant response to proton pump inhibitor treatment as compared to placebo in patients with suspected LPR.
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Affiliation(s)
- R Fass
- The Neuroenteric Clinical Research Group, Southern Arizona VA Health Care System and University of Arizona Health Sciences Center, Tucson, AZ 85723-0001, USA.
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Radkevich VZ, Sen’ko TL, Khaminets SG, Wilson K, Egiazarov YG. Catalytic systems based on carbon fiber materials for the low-temperature oxidation of carbon monoxide. Catal Ind 2010. [DOI: 10.1134/s2070050409040102] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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185
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Tintle SM, Wilson K, McKay PL, Andersen RC, Kumar AR. Simultaneous pedicled flaps for coverage of complex blast injuries to the forearm and hand (with supplemental external fixation to the iliac crest for immobilization). J Hand Surg Eur Vol 2010; 35:9-15. [PMID: 19843626 DOI: 10.1177/1753193409347428] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
The technique of two simultaneous pedicled flaps to a single extremity has recently proven useful in the care of war-injured military personnel. We present two cases of combat-injured Marines who underwent upper extremity reconstruction using simultaneous pedicled flaps. These cases illustrate a simple and successful alternative to free tissue transfer in providing coverage to complex soft tissue defects of the hand and forearm. Good outcomes were obtained in circumstances where free tissue transfer was not indicated.
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Affiliation(s)
- S M Tintle
- National Naval Medical Center, Bethesda, MD 20889, USA.
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Hurt C, Thomas B, Burn D, Hindle J, Landau S, Samuel M, Wilson K, Brown R. P1.138 Coping in Parkinson's disease: an examination of the coping inventory for stressful situations. Parkinsonism Relat Disord 2009. [DOI: 10.1016/s1353-8020(09)70260-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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187
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Brown R, Hurt C, Burn D, Hindle J, Landau S, Samuel M, Wilson K. P1.042 A prospective study of mood states in Parkinson's disease (PROMS-PD). Parkinsonism Relat Disord 2009. [DOI: 10.1016/s1353-8020(09)70164-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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188
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Whitehead D, Simpson A, Hurt C, Burn D, Hindle J, Landau S, Samuel M, Wilson K, Brown R. P1.026 Cognitive proflle and mild cognitive impairment (MCI) in Parkinson's disease: baseline data from the PROMS-PD cohort. Parkinsonism Relat Disord 2009. [DOI: 10.1016/s1353-8020(09)70148-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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189
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Tebbutt N, Gebski V, Wilson K, Cummins M, Robinson B, Broad A, Cunningham D, Simes J, Stockler M, Price T. 6001 International randomised phase III study of capecitabine (Cap), bevacizumab (Bev) and mitomycin C (MMC) in first line treatment of metastatic colorectal cancer (mCRC): final results of the AGITG MAX trial. EJC Suppl 2009. [DOI: 10.1016/s1359-6349(09)71096-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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190
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Fabricius V, Langa M, Wilson K. An exploratory investigation of co‐occurring substance‐related and psychiatric disorders. Journal of Substance Use 2009. [DOI: 10.1080/14659890701680877] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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191
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Fernández de Bobadilla Osorio J, Sánchez-Maestre C, Brosa Riestra M, Arroyo O, Sanz de Burgoa V, Wilson K. [Cost effectiveness analysis of varenicline (Champix) for the treatment of smoking in Spain]. ACTA ACUST UNITED AC 2009; 25:342-8. [PMID: 19295994 DOI: 10.4321/s0212-71992008000700006] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVE To analyse the efficiency of varenicline compared with bupropion, NRT (nicotine replacement therapy) and no pharmacological treatment in Spain. METHODS A Markov model was developed to analyse the health and economic consequences of smoking cessation therapies. The transition probabilities were taken from published studies. The model allows cost effectiveness analyses for different time frames (10 years, 20 years and life time). Outcomes are measured in terms of incremental life years gained (LYG) and QALYs. Pharmacological costs and costs of medical visits with varenicline and bupropion were considered. Treatment costs of smoking associated morbidity were taken from Spanish studies. RESULTS The analyses were done under the perspective of the National Health System, discounting costs and health benefits at 3%. The life time cost-effectiveness analysis shows that varenicline dominates all other smoking cessation interventions (more effective at a lower cost). This is due to the higher efficacy of varenicline associated with a reduction in smoking related morbimortality, which, in the long term, accounts for health care cost savings that overcome the extra cost of varenicline. Even when shorter timeframes are considered (20 years), vareniclin is cost-effective in comparison with any other alternative. CONCLUSIONS Varenicline is a dominant option (more effective at a lower cost) compared with all other smoking cessation treatments when the timeframe is the life span of the patient. Varenicline is cost-effective even when shorter timeframes are considered (20 years or more), with an estimated incremental cost per QALY far bellow any threshold commonly accepted in our environment.
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Bolin K, Wilson K, Benhaddi H, de Nigris E, Marbaix S, Mork AC, Aubin HJ. Cost-effectiveness of varenicline compared with nicotine patches for smoking cessation—results from four European countries. Eur J Public Health 2009; 19:650-4. [DOI: 10.1093/eurpub/ckp075] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Bolin K, Mörk AC, Wilson K. Smoking-cessation therapy using varenicline: the cost-utility of an additional 12-week course of varenicline for the maintenance of smoking abstinence. J Eval Clin Pract 2009; 15:478-85. [PMID: 19536915 DOI: 10.1111/j.1365-2753.2008.01045.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
STUDY OBJECTIVES To evaluate the cost-effectiveness of an additional 12-week treatment with varenicline for abstainers who had successfully completed an initial 12-week treatment. DESIGN The Benefits of Smoking Cessation on Outcomes simulation model was used to simulate both direct and indirect effects of smoking cessation. All calculations were performed in 2003 Swedish prices. SETTING Sweden in 2003. PATIENTS OR PARTICIPANTS The modelled cohort consisted of 25% of adult smokers motivated to quit smoking (168,844 males and 208,737 females). The age and sex distributions of the cohort reflect that of the Swedish population in 2003. INTERVENTIONS Smokers who had achieved abstinence for at least 7 days following 12-week open-label treatment with varenicline were randomized to receive an additional 12-week treatment with either varenicline or placebo. MEASUREMENTS AND RESULTS The incremental costs per quality-adjusted life-year (QALY) gained, for abstainers who received an additional 12-week varenicline treatment compared with only 12 weeks, were Euro 7066 for men and Euro 7108 for women, over a 50-year time horizon. (1 Euro approximately equal to SEK 9.12). These estimates excluded indirect effects on production and consumption of increased survival. The corresponding incremental costs per QALY including indirect effects were Euro 24,149 and Euro 24,436, respectively. Sensitivity analysis indicated that the estimated cost-utility ratios are robust, but relatively sensitive to treatment efficiency and intervention costs. CONCLUSIONS An additional 12-week course of varenicline treatment, provided to abstainers after an initial 12-week treatment, produces relatively low incremental cost-utility ratios in the spectrum of life-saving medical treatments.
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Affiliation(s)
- Kristian Bolin
- Lund University Centre for Health Economics, Lund, Sweden.
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Tebbutt NC, Gebski V, Wilson K, Cummins M, Chua Y, Robinson B, Broad A, Cunningham D, Simes J, Price T. International randomized phase III study of capecitabine (Cap), bevacizumab (Bev), and mitomycin C (MMC) in first-line metastatic colorectal cancer (mCRC): Final results of the AGITG MAX trial. J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.4023] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
4023 Background: The addition of Bev to oxaliplatin or irinotecan based doublet chemotherapy has shown benefit in mCRC. Cap± MMC are alternate chemotherapy regimens suitable for patients (pts) who are either unfit for or who do not require initial oxaliplatin/irinotecan. This phase III study compared Cap with Cap Bev and Cap Bev MMC. The aim was to develop a low toxicity regimen suitable for a broad population of pts with mCRC. Methods: Previously untreated pts with unresectable mCRC considered suitable for Cap monotherapy were randomised to arm A Cap (Cap 2000mg/m2/d or 2500mg/m2 d1–14 q21d), arm B Cap Bev (Bev 7.5mg/kg q3w) or arm C Cap Bev MMC (MMC 7mg/m2 q6w). Primary endpoint: PFS, secondary endpoints: RR, toxicity, OS, QoL . Randomisation was stratified by age, PS, centre and Cap dose. Response was assessed every 6w. The study was designed to detect an increase in the median PFS from 5.5m (arm A) to 8m (arm B or C) at p<0.025 with 80% power. Results: A total of 471 pts were randomised from July 2005-June 2007. Outcomes were evaluated on an intention to treat basis and included 15 ineligible pts. Baseline demographics were well balanced between arms with median age 67y (range 31–86y). Toxicity was reported: ASCO 2008 abstr 4029. The most common grade 3/4 toxicities were PPE (16%, 26%, 28%) and diarrhoea (11%, 17%, 16%) for arms (A,B,C). However, adjusted rates per cycle were similar as arms B & C received more cycles of Cap (A8.3, B10.8, C10.5). Other toxicity rates were generally <10%. The study achieved its primary endpoint with a highly significant improvement in PFS for arms B & C. RR and OS are summarized ( Table ). Conclusions: All treatment regimens were well tolerated in a relatively elderly patient cohort. The addition of Bev±MMC to Cap significantly improved PFS without significant additional toxicity. OS was similar for all arms. Cap Bev±MMC is an active, low toxicity regimen that may be considered as a treatment option for pts with mCRC. [Table: see text] [Table: see text]
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Affiliation(s)
- N. C. Tebbutt
- Austin Health, Heidelberg, Australia; NHMRC Clinical Trials Centre, Sydney, Australia; The Canberra Hospital, Canberra, Australia; Christchurch Hospital, Christchurch, New Zealand; The Geelong Hospital, Geelong, Australia; Royal Marsden Hospital, London, United Kingdom; Queen Elizabeth Hospital, Adelaide, Australia
| | - V. Gebski
- Austin Health, Heidelberg, Australia; NHMRC Clinical Trials Centre, Sydney, Australia; The Canberra Hospital, Canberra, Australia; Christchurch Hospital, Christchurch, New Zealand; The Geelong Hospital, Geelong, Australia; Royal Marsden Hospital, London, United Kingdom; Queen Elizabeth Hospital, Adelaide, Australia
| | - K. Wilson
- Austin Health, Heidelberg, Australia; NHMRC Clinical Trials Centre, Sydney, Australia; The Canberra Hospital, Canberra, Australia; Christchurch Hospital, Christchurch, New Zealand; The Geelong Hospital, Geelong, Australia; Royal Marsden Hospital, London, United Kingdom; Queen Elizabeth Hospital, Adelaide, Australia
| | - M. Cummins
- Austin Health, Heidelberg, Australia; NHMRC Clinical Trials Centre, Sydney, Australia; The Canberra Hospital, Canberra, Australia; Christchurch Hospital, Christchurch, New Zealand; The Geelong Hospital, Geelong, Australia; Royal Marsden Hospital, London, United Kingdom; Queen Elizabeth Hospital, Adelaide, Australia
| | - Y. Chua
- Austin Health, Heidelberg, Australia; NHMRC Clinical Trials Centre, Sydney, Australia; The Canberra Hospital, Canberra, Australia; Christchurch Hospital, Christchurch, New Zealand; The Geelong Hospital, Geelong, Australia; Royal Marsden Hospital, London, United Kingdom; Queen Elizabeth Hospital, Adelaide, Australia
| | - B. Robinson
- Austin Health, Heidelberg, Australia; NHMRC Clinical Trials Centre, Sydney, Australia; The Canberra Hospital, Canberra, Australia; Christchurch Hospital, Christchurch, New Zealand; The Geelong Hospital, Geelong, Australia; Royal Marsden Hospital, London, United Kingdom; Queen Elizabeth Hospital, Adelaide, Australia
| | - A. Broad
- Austin Health, Heidelberg, Australia; NHMRC Clinical Trials Centre, Sydney, Australia; The Canberra Hospital, Canberra, Australia; Christchurch Hospital, Christchurch, New Zealand; The Geelong Hospital, Geelong, Australia; Royal Marsden Hospital, London, United Kingdom; Queen Elizabeth Hospital, Adelaide, Australia
| | - D. Cunningham
- Austin Health, Heidelberg, Australia; NHMRC Clinical Trials Centre, Sydney, Australia; The Canberra Hospital, Canberra, Australia; Christchurch Hospital, Christchurch, New Zealand; The Geelong Hospital, Geelong, Australia; Royal Marsden Hospital, London, United Kingdom; Queen Elizabeth Hospital, Adelaide, Australia
| | - J. Simes
- Austin Health, Heidelberg, Australia; NHMRC Clinical Trials Centre, Sydney, Australia; The Canberra Hospital, Canberra, Australia; Christchurch Hospital, Christchurch, New Zealand; The Geelong Hospital, Geelong, Australia; Royal Marsden Hospital, London, United Kingdom; Queen Elizabeth Hospital, Adelaide, Australia
| | - T. Price
- Austin Health, Heidelberg, Australia; NHMRC Clinical Trials Centre, Sydney, Australia; The Canberra Hospital, Canberra, Australia; Christchurch Hospital, Christchurch, New Zealand; The Geelong Hospital, Geelong, Australia; Royal Marsden Hospital, London, United Kingdom; Queen Elizabeth Hospital, Adelaide, Australia
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Wullschleger ME, Steck R, Schuetz MA, Ito K, Wilson K, Webster J. TS05�*MINIMALLY INVASIVE PLATE OSTEOSYNTHESIS: ADVANCED EARLY FRACTURE HEALING IN A SHEEP TRAUMA MODEL. ANZ J Surg 2009. [DOI: 10.1111/j.1445-2197.2009.04934_5.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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196
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Magiorakos AP, Suetens C, Boyd L, Costa C, Cunney R, Drouvot V, Farrugia C, Fernandez-Maillo MM, Iversen BG, Leens E, Michael S, Moro ML, Reinhardt C, Serban R, Vatcheva-Dobrevska R, Wilson K, Heisbourg E, Maltezou HC, Strauss R, Böröcz K, Dolinšek M, Dumpis U, Erne S, Gudlaugsson O, Heczko P, Hedlova D, Holt J, Jõe L, Lyytikäinen O, Riesenfeld-Örn I, Stefkovikova M, Valinteliene R, Voss A, Monnet DL. National Hand Hygiene Campaigns in Europe, 2000-2009. Euro Surveill 2009. [DOI: 10.2807/ese.14.17.19190-en] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Hand hygiene represents the single most effective way to prevent healthcare-associated infections. The World Health Organization, as part of its First Global Patient Safety Challenge, recommends implementation of multi-faceted strategies to increase compliance with hand hygiene. A questionnaire was sent by the European Centre for Disease Prevention and Control to 30 European countries, regarding the availability and organisation of their national hand hygiene campaigns. All countries responded. Thirteen countries had organised at least one national campaign during the period 2000-2009 and three countries were in the process of organising a national campaign. Although the remaining countries did not have a national campaign, several reported regional and local hand hygiene activities or educational resources on national websites.
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Affiliation(s)
- A P Magiorakos
- European Centre for Disease Prevention and Control, Stockholm
| | - C Suetens
- European Centre for Disease Prevention and Control, Stockholm
| | - L Boyd
- National Services Scotland, Edinburgh, United Kingdom
| | - C Costa
- General Directorate of Health, Lisbon, Portugal
| | - R Cunney
- Health Protection Surveillance Centre, Dublin, Ireland
| | - V Drouvot
- Ministry of Health, Youth and Sport, Paris, France
| | | | | | - B G Iversen
- Norwegian Institute of Public Health, Oslo, Norway
| | - E Leens
- Scientific Institute of Public Health, Brussels, Belgium
| | | | - M L Moro
- Regional Health and Social Agency, Infectious Risk Unit, Region Emilia-Romagna, Bologna, Italy
| | - C Reinhardt
- Institute of Hygiene and Environmental Medicine, Berlin, Germany
| | - R Serban
- Institute of Public Health, Bucharest, Romania
| | | | - K Wilson
- National Patient Safety Agency, London, United Kingdom
| | | | - H C Maltezou
- Hellenic Centre for Disease Control and Prevention, Athens, Greece
| | - R Strauss
- National Ministry of Health, Vienna, Austria
| | - K Böröcz
- National Center for Epidemiology, Budapest, Hungary
| | - M Dolinšek
- University Medical Centre, Ljubljana, Slovenia
| | - U Dumpis
- Stradins University Hospital, Riga, Latvia
| | - S Erne
- Office for Public Health, Vaduz, Liechtenstein
| | | | - P Heczko
- Jagiellonian University Medical College, Cracow, Poland
| | - D Hedlova
- Central Military Hospital, Prague, Czech Republic
| | - J Holt
- Statens Serum Institut, Copenhagen, Denmark
| | - L Jõe
- Health Protection Inspectorate of Estonia, Tallinn, Estonia
| | - O Lyytikäinen
- National Institute for Health and Welfare, Helsinki, Finland
| | | | | | | | - A Voss
- Radboud University Nijmegen Medical Centre and Canisius-Wilhelmina Hospital, Department of Clinical Microbiology and Infectious Diseases, Nijmegen, The Netherlands
| | - D L Monnet
- European Centre for Disease Prevention and Control, Stockholm
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197
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Magiorakos AP, Suetens C, Boyd L, Costa C, Cunney R, Drouvot V, Farrugia C, Fernandez-Maillo MM, Iversen BG, Leens E, Michael S, Moro ML, Reinhardt C, Serban R, Vatcheva-Dobrevska R, Wilson K, Heisbourg E, Maltezou HC, Strauss R, Borocz K, Dolinsek M, Dumpis U, Erne S, Gudlaugsson O, Heczko P, Hedlova D, Holt J, Joe L, Lyytikainen O, Riesenfeld-Orn I, Stefkovikova M, Valinteliene R, Voss A, Monnet DL. National hand hygiene campaigns in Europe, 2000-2009. Euro Surveill 2009; 14:19190. [PMID: 19422767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023] Open
Abstract
Hand hygiene represents the single most effective way to prevent healthcare-associated infections. The World Health Organization, as part of its First Global Patient Safety Challenge, recommends implementation of multi-faceted strategies to increase compliance with hand hygiene. A questionnaire was sent by the European Centre for Disease Prevention and Control to 30 European countries, regarding the availability and organisation of their national hand hygiene campaigns. All countries responded. Thirteen countries had organised at least one national campaign during the period 2000-2009 and three countries were in the process of organising a national campaign. Although the remaining countries did not have a national campaign, several reported regional and local hand hygiene activities or educational resources on national websites.
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Affiliation(s)
- A P Magiorakos
- European Centre for Disease Prevention and Control, Stockholm.
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198
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Affiliation(s)
- S Cadell
- Lyle S. Hallman Faculty of Social Work, Wilfrid Laurier University, Kitchener, Ontario, Canada
| | - G Ho
- Department of Psychology, Simon Fraser University, British Columbia, Canada
| | - L Jacques
- School of Nursing, University of British Columbia, British Columbia, Canada
| | - K Wilson
- Lyle S. Hallman Faculty of Social Work, Wilfrid Laurier University, Kitchener, Ontario, Canada
| | - B Davies
- Department of Health Care Nursing, University of California, San Francisco, California, USA
| | - R Steele
- School of Nursing, York University, Toronto, Ontario, Canada
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199
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200
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Roy KM, Goldberg DJ, Wilson K, Cameron SO. Vaccination induced immunity to the hepatitis B virus among high-risk groups in Glasgow 1993-2001: evaluating the effectiveness of the United Kingdom's selective immunisation policy. Scott Med J 2009; 53:13-7. [PMID: 19051658 DOI: 10.1258/rsmsmj.53.4.13] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
BACKGROUND AND AIMS The United Kingdom has adopted a selective approach to the control of hepatitis B (HBV), vaccinating those at increased risk of infection through lifestyle, occupation or other factors such as close contact with a case or carrier. This paper sought to assess the effectiveness of the targeted HBV vaccination programme, by determining the level of immunity and exposure to HBV infection among three high risk groups (injecting drug users (IDUs), men who have sex with men (MSM) and heterosexuals attending genitourinary medicine clinics) at three time points between 1993-2001 in Glasgow, Scotland. METHODS Residual sera from i) IDUs having a named HIV test and ii) MSM and heterosexual men and women attending GUM clinics and undergoing routine syphilis serology testing, were tested anonymously for HBV infection. RESULTS The overall prevalence of HBV infection remained at a low level in all three risk groups. IDUs continue to be the group at greatest risk of infection. DISCUSSION Despite the implementation of new initiatives targeting high-risk groups, vaccination levels remain low in the populations studied.
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Affiliation(s)
- K M Roy
- Halth Protection Scotland, Clifton House, Clifton Place, Glasgow, G3 7LN.
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