76
|
Pournaras DJ, Hardwick RH, Safranek PM, Sujendran V, Bennett J, Macaulay GD, Hindmarsh A. Endoluminal Vacuum Therapy (E-Vac): A Treatment Option in Oesophagogastric Surgery. World J Surg 2018; 42:2507-2511. [PMID: 29372375 PMCID: PMC6060786 DOI: 10.1007/s00268-018-4463-7] [Citation(s) in RCA: 51] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Background Leaks from the upper gastrointestinal tract often pose a management challenge, particularly when surgical treatment has failed or is impossible. Vacuum therapy has revolutionised the treatment of wounds, and its role in enabling and accelerating healing is now explored in oesophagogastric surgery. Methods A piece of open cell foam is sutured around the distal end of a nasogastric tube using a silk suture. Under general anaesthetic, the foam covered tip is placed endoscopically through the perforation and into any extra-luminal cavity. Continuous negative pressure (125 mmHg) is then applied. Re-evaluation with change of the negative pressure system is performed every 48–72 h depending on the clinical condition. Patients are fed enterally and treated with broad-spectrum antibiotics and anti-fungal medication until healing, assessed endoscopically and/or radiologically, is complete. Results Since April 2011, twenty one patients have been treated. The cause of the leak was postoperative/iatrogenic complications (14 patients) and ischaemic/spontaneous perforation (seven patients). Twenty patients (95%) completed treatment successfully with healing of the defect and/or resolution of the cavity and were subsequently discharged from our care. One patient died from sepsis related to an oesophageal leak after withdrawing consent for further intervention following a single endoluminal vacuum (E-Vac) treatment. In addition, two patients who were successfully treated with E-Vac for their leak subsequently died within 90 days of E-Vac treatment from complications that were not associated with the E-Vac procedure. In two patients, E-Vac treatment was complicated by bleeding. The median number of E-Vac changes was 7 (range 3–12), and the median length of hospital stay was 35 days (range 23–152). Conclusions E-Vac therapy is a safe and effective treatment for upper gastrointestinal leaks and should be considered alongside more established therapies. Further research is now needed to understand the mechanism of action and to improve the ease with which E-Vac therapy can be delivered.
Collapse
|
77
|
Campbell N, Longley J, Pascalis A, Bennett J, Remer M, Stone R, Muller D, Karydis I, Donnelly O, Wheater M, Ottensmeier C. Immunotherapy in the immunodeficient: A treatment paradox? Ann Oncol 2018. [DOI: 10.1093/annonc/mdy288.082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
78
|
Crabb S, Danson S, Dunkley D, Kalevras M, Whitehead A, Hill S, Fines K, Robb C, Bennett J, Ksiazek L, Brown S, Evans L, Serra M, Jones K, McDowell C, Catto J, Huddart R, Griffths G. SPIRE: A phase Ib/ randomised IIa open label clinical trial combining guadecitabine with cisplatin and gemcitabine chemotherapy for solid malignancies including bladder cancer. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy279.412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
79
|
Foster L, Allchorne P, Fleure L, Clovis S, Gibbs E, Bennett J, Kinsella J, Carhill J, Green J. Are shared medical appointments an effective method of delivering discharge information to prepare prostate cancer patients for discharge from secondary care? Int J Surg 2018. [DOI: 10.1016/j.ijsu.2018.05.649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
|
80
|
Fountain MT, Bennett J, Cobo-Medina M, Conde Ruiz R, Deakin G, Delgado A, Harrison R, Harrison N. Alimentary microbes of winter-form Drosophila suzukii. INSECT MOLECULAR BIOLOGY 2018; 27:383-392. [PMID: 29469169 DOI: 10.1111/imb.12377] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Drosophila suzukii (Matsumura) (Diptera: Drosophilidae) is a damaging pest of fruit. Reproductively diapausing adults overwinter in woodlands and remain active on warmer winter days. It is unknown if this adult phase of the lifecycle feeds during the winter period, and what the food source may be. This study characterized the flora in the digestive tract of D. suzukii using a metagenomics approach. Live D. suzukii were trapped in four woodlands in the south of England and their guts dissected for DNA extraction and amplicon-based metagenomics sequencing (internal transcribed spacer and 16S rRNA). Analysis at genus and family taxonomic levels showed high levels of diversity with no differences in digestive tract bacterial or fungal biota between woodland sites of winter-form D. suzukii. Female D. suzukii at one site appeared to have higher bacterial diversity in the alimentary canal than males, but there was a site, sex interaction. Many of the biota were associated with cold, wet climatic conditions and decomposition. This study provides the first evidence that winter-form D. suzukii may be opportunistic feeders during the winter period and are probably exploiting food sources associated with moisture on decomposing vegetation during this time. A core gut microbiome has been identified for winter-form D. suzukii.
Collapse
|
81
|
Eberhard D, Bennett J, Davison D, Hammond C, Petty A, Pluenneke J, Dei Rossi A, Alexander G, Paragas D, Lopatin M. 147P Clinical testing of ctDNA from NSCLC patients using A 17-gene liquid biopsy mutation panel. J Thorac Oncol 2018. [DOI: 10.1016/s1556-0864(18)30421-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
|
82
|
Grayson DS, Bliss-Moreau E, Bennett J, Lavenex P, Amaral DG. Neural Reorganization Due to Neonatal Amygdala Lesions in the Rhesus Monkey: Changes in Morphology and Network Structure. Cereb Cortex 2018; 27:3240-3253. [PMID: 28383709 DOI: 10.1093/cercor/bhx080] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2016] [Indexed: 01/30/2023] Open
Abstract
It is generally believed that neural damage that occurs early in development is associated with greater adaptive capacity relative to similar damage in an older individual. However, few studies have surveyed whole brain changes following early focal damage. In this report, we employed multimodal magnetic resonance imaging analyses of adult rhesus macaque monkeys who had previously undergone bilateral, neurotoxic lesions of the amygdala at about 2 weeks of age. A deformation-based morphometric approach demonstrated reduction of the volumes of the anterior temporal lobe, anterior commissure, basal ganglia, and pulvinar in animals with early amygdala lesions compared to controls. In contrast, animals with early amygdala lesions had an enlarged cingulate cortex, medial superior frontal gyrus, and medial parietal cortex. Diffusion-weighted imaging tractography and network analysis were also used to compare connectivity patterns and higher-level measures of communication across the brain. Using the communicability metric, which integrates direct and indirect paths between regions, lesioned animals showed extensive degradation of network integrity in the temporal and orbitofrontal cortices. This work demonstrates both degenerative as well as progressive large-scale neural changes following long-term recovery from neonatal focal brain damage.
Collapse
|
83
|
Bennett J, Adriaenssens T, McCutcheon K, Dens J, Desmet W, Sinnaeve P, Vrolix M, Dubois C. 5-Year clinical follow-up of the COBRA (complex coronary bifurcation lesions: Randomized comparison of a strategy using a dedicated self-expanding biolimus A9-eluting stent vs. a culotte strategy using everolimus-eluting stents) study. Catheter Cardiovasc Interv 2018. [DOI: 10.1002/ccd.27597] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
|
84
|
Bennett J, Coburn A, Coupe A, Stedman D, Taylor A, Tyler A. Development of a zebrafish model for bitter taste assessment. Int J Pharm 2018. [DOI: 10.1016/j.ijpharm.2017.08.056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
|
85
|
Lopez F, Mistry P, Batchelor H, Bennett J, Ernest T, Gul MO, Tuleu C. Palatability and acceptability of multiparticulate formulations: Adults vs. children comparison. Int J Pharm 2018. [DOI: 10.1016/j.ijpharm.2017.08.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
|
86
|
Mistry P, Hodson J, Bennett J, Batchelor H. Evaluating the acceptability and mouthfeel of multiparticulates within a paediatric population. Int J Pharm 2018. [DOI: 10.1016/j.ijpharm.2017.08.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
87
|
Mussman GM, Lossius M, Wasif F, Bennett J, Shadman KA, Walley SC, Destino L, Nichols E, Ralston SL. Multisite Emergency Department Inpatient Collaborative to Reduce Unnecessary Bronchiolitis Care. Pediatrics 2018; 141:peds.2017-0830. [PMID: 29321255 DOI: 10.1542/peds.2017-0830] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/13/2017] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND AND OBJECTIVES There is high variation in the care of acute viral bronchiolitis. We sought to promote collaboration between emergency department (ED) and inpatient (IP) units with the goal of reducing unnecessary testing and treatment. METHODS Multisite collaborative with improvement teams co-led by ED and IP physicians and a 1-year period of active participation. The intervention consisted of a multicomponent change package, regular webinars, and optional coaching. Data were collected by chart review for December 2014 through March 2015 (baseline) and December 2015 to March 2016 (improvement period). Patients <24 months of age with a primary diagnosis of bronchiolitis and without ICU admission, prematurity, or chronic lung or heart disease were eligible for inclusion. Control charts were used to detect improvement. Achievable benchmarks of care were calculated for each measure. RESULTS Thirty-five hospitals with 5078 ED patients and 4389 IPs participated. Use of bronchodilators demonstrated special cause for the ED (mean centerline shift: 37.1%-24.5%, benchmark 5.8%) and IP (28.4%-17.7%, benchmark 9.1%). Project mean ED viral testing decreased from 42.6% to 25.4% after revealing special cause with a 3.9% benchmark, whereas chest radiography (30.9%), antibiotic use (6.2%), and steroid use (7.6%) in the ED units did not change. IP steroid use decreased from 7.2% to 4.0% after special cause with 0.0% as the benchmark. Within-site ED and IP performance was modestly correlated. CONCLUSIONS Collaboration between ED and IP units was associated with a decreased use of unnecessary tests and therapies in bronchiolitis; top performers used few unnecessary tests or treatments.
Collapse
|
88
|
Reay C, Cheung C, Lanka S, Little S, Ryanna K, Agrawal S, Panchal R, Bennett J, Tufail M. Use of a discharge lounge to facilitate ambulatory CT guided percutaneous lung biopsies for suspected lung cancer – an effective and cost effective pathway with high patient satisfaction. Lung Cancer 2018. [DOI: 10.1016/s0169-5002(18)30057-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
|
89
|
Nicoara D, Khan F, Panchal R, Bennett J, Tufail M. Rapid talc slurry pleurodesis for malignant pleural effusion reduces the length of stay whilst maintaining the pleurodesis success rate. Lung Cancer 2018. [DOI: 10.1016/s0169-5002(18)30201-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
|
90
|
Chang LL, Wynn JL, Pacella MJ, Rossignol CC, Banadera F, Alviedo N, Vargas A, Bennett J, Huene M, Copenhaver N, Sura L, Barnette K, Solomon J, Bliznyuk NA, Neu J, Weiss MD. Enteral Feeding as an Adjunct to Hypothermia in Neonates with Hypoxic-Ischemic Encephalopathy. Neonatology 2018; 113:347-352. [PMID: 29510382 DOI: 10.1159/000487848] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Accepted: 02/17/2018] [Indexed: 12/29/2022]
Abstract
BACKGROUND Withholding enteral feedings during hypothermia lacks supporting evidence. OBJECTIVES We aimed to determine if minimal enteral nutrition (MEN) during hypothermia in patients with hypoxic-ischemic encephalopathy was associated with a reduced duration of parenteral nutrition, time to full oral feeds, and length of stay, but would not be associated with increased systemic inflammation or feeding complications. METHODS We performed a pilot, retrospective, matched case-control study within the Florida Neonatal Neurologic Network from December 2012 to May 2016 of patients who received MEN during hypothermia (n = 17) versus those who were not fed (n = 17). Length of stay, feeding-related outcomes, and brain injury identified by MRI were compared. Serum inflammatory mediators were measured at 0-6, 24, and 96 h of life by multiplex assay. MRI were scored using the Barkovich system. RESULTS MEN subjects had a reduced length of hospital stay (mean 15 ± 11 vs. 24 ± 19 days, p < 0.05), days receiving parenteral nutrition (7 ± 2 vs. 11 ± 6, p < 0.05), and time to full oral feeds (8 ± 5 vs. 18 ± 18, p < 0.05). MEN was associated with a significantly reduced serum IL-12p70 at 24 and 96 h (p < 0.05). Brain MRI scores were not significantly different between groups. CONCLUSION MEN during hypothermia was associated with a reduced length of stay and time to full feeds, but did not increase feeding complications or systemic inflammation.
Collapse
|
91
|
Corliss BM, Bennett J, Brennan MM, Rosemaryam A, Hartman C, Stetler WR, Polifka AJ, Hoh BL, Arreola MM, Fox WC. The Patient Size Setting: A Novel Dose Reduction Strategy in Cerebral Endovascular Neurosurgery Using Biplane Fluoroscopy. World Neurosurg 2017; 110:e636-e641. [PMID: 29180081 DOI: 10.1016/j.wneu.2017.11.056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2017] [Revised: 11/10/2017] [Accepted: 11/11/2017] [Indexed: 11/28/2022]
Abstract
BACKGROUND In some fluoroscopy machines, the dose-rate output of the fluoroscope is tied to a selectable patient size. Although patient size may play a significant role in visceral or cardiac procedures, head morphology is less variable, and high dose outputs may not be necessary even in very obese patients. We hypothesized that very small patient size setting can be used to reduce dose for cerebral angiography without compromising image quality. METHODS Patients who underwent endovascular neurosurgical procedures during the 2015-2016 academic year were identified, and estimated procedural air kerma (AK) was tabulated retrospectively. Technologists were instructed to begin using the very small patient size setting for all procedures performed using our Philips Allura Xper FD20 biplane fluoroscopy system beginning in March 2016. No changes were made in a second procedure room using a Toshiba Infinix system. Student t tests and logistic regression models were used to compare radiation exposure before and after March 1, 2016, for both machines. RESULTS For diagnostic cerebral angiograms performed on the Philips system (n = 302), AK was reduced by approximately 17% (1277 vs. 1061 mGy; P = 0.0006.) Changes in table height, total fluoroscopy time, patient weight, and body mass index did not contribute to this difference. No significant change was seen in total AK using the Toshiba system (n = 237). Blinded review by a neuroradiologist did not demonstrate any change in image quality. CONCLUSIONS Using the very small patient size reduces fluoroscopy dose by 17% for cerebral angiography without impacting image quality.
Collapse
|
92
|
Bennett J, Sekar V, Flannery T. Investigation into the Cause of Delay in PICC Line Insertion for Neurosurgical Patients? Int J Surg 2017. [DOI: 10.1016/j.ijsu.2017.08.322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
|
93
|
Van Der Schee M, Dickson J, Ruparel M, Janes S, Dragonieri S, Fuller L, Grundy S, Baldwin D, Crosbie P, Prasad A, Haris M, Barlow A, Calvert L, Wight A, Bennett J, Gaga M, Chee S, Conteh V, Ledson M, Hodkinson C, Boschmans J, Smith R, Parris R, Apthorp D, Kitchen S, Allsworth M, Boyle B, Rintoul R. P3.05-001 Breath Analysis for Early Detection of Lung Cancer: The LuCID Study. J Thorac Oncol 2017. [DOI: 10.1016/j.jtho.2017.09.1672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
94
|
Bennett J. The insufficient integration of medicine into clinical dental education: a missed opportunity or an ethical dilemma? Oral Surg Oral Med Oral Pathol Oral Radiol 2017; 124:325-326. [PMID: 28754377 DOI: 10.1016/j.oooo.2017.06.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2017] [Accepted: 06/02/2017] [Indexed: 11/19/2022]
|
95
|
Sinha S, Bennett J, Bon J, Chalk T. ESTABLISHING THE EFFECTIVENESS OF AN ACUTE CARE FOR ELDERS (ACE) STRATEGIC DELIVERY MODEL. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.4944] [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
|
96
|
Bennett J. Dental education: Oral biology teaching. Br Dent J 2017; 222:407. [DOI: 10.1038/sj.bdj.2017.249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
|
97
|
Bennett J. Beneficial Redundancy-Did We Forget the Benefit of Auscultation of Breath Sounds? J Oral Maxillofac Surg 2017; 75:886-887. [PMID: 28174004 DOI: 10.1016/j.joms.2016.12.050] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2016] [Accepted: 12/23/2016] [Indexed: 11/29/2022]
|
98
|
|
99
|
Bennett J, Adriaenssens T, Desmet W, Dubois C. Complex bifurcation lesions: Randomized comparison of a fully bioresorbable modified t stenting strategy versus bifurcation reconstruction with a dedicated self-expanding stent in combination with bioresorbable scaffolds, an OCT study: Rationale and design of the COBRA II trial. Catheter Cardiovasc Interv 2016; 88:843-853. [PMID: 27184586 DOI: 10.1002/ccd.26571] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2016] [Revised: 04/11/2016] [Accepted: 04/22/2016] [Indexed: 11/09/2022]
Abstract
OBJECTIVE There is an ongoing controversy regarding the efficacy and safety of different percutaneous stenting techniques for coronary bifurcation lesions needing >1 stent. The promise of safe vessel restoration with bioresorbable scaffolds (BRS) may not be transferable to complex double BRS bifurcation techniques, and permanent metallic scaffolding of the bifurcation core may be needed. We identified modified-T stenting as the most promising fully bioresorbable 2-stent strategy in a preclinical setting. The objective of this study is to assess acute performance and compare long-term vessel healing with this strategy, versus an approach combining BRS with a dedicated metallic drug-eluting bifurcation stent. STUDY DESIGN In a single center, 60 consecutive patients with true and complex coronary bifurcation lesions will be randomly assigned to treatment with the dedicated self-expanding Axxess™ biolimus-eluting bifurcation stent in the proximal main vessel and additional Absorb™ everolimus-eluting BRS in the branches versus a modified T technique using Absorb™ only. Angiography and optical coherence tomography (OCT) will be performed immediately after implantation and at 30 months, and clinical follow-up is foreseen up to 5 years after implantation. The primary endpoint is the change in minimal luminal area assessed with OCT from baseline to 30 months in pre-specified bifurcation segments. CONCLUSION To date the use of Absorb™ BRS in complex coronary bifurcations has not been evaluated in a randomized clinical trial setting. The COBRA II study will examine the role and safety of a double BRS strategy in coronary bifurcations, alone or in combination with a metallic dedicated bifurcation device. © 2016 Wiley Periodicals, Inc.
Collapse
|
100
|
Leroy B, Maguire A, Russell S, Wellman J, Yu Z, Chung D, High K, Bennett J. Current gene therapy trials for inherited retinal disorders. Acta Ophthalmol 2016. [DOI: 10.1111/j.1755-3768.2016.0160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|