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Kearney R, McKeown R, Parsons N, Parsons H, Haque A, Brown J, Kefford S, Underwood M, Redmond A, Mason J, Nwankwo H, Costa M. Ankle Injury Rehabilitation (AIR): A multicentre randomised controlled trial and economic evaluation. Physiotherapy 2022. [DOI: 10.1016/j.physio.2021.12.295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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77
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Pope C, Harrop-Griffiths W, Brown J. Aerosol-generating procedures and the anaesthetist. BJA Educ 2022; 22:52-59. [PMID: 35035993 PMCID: PMC8749387 DOI: 10.1016/j.bjae.2021.11.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/01/2021] [Indexed: 02/03/2023] Open
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Gal-Yam A, Bruch R, Schulze S, Yang Y, Perley DA, Irani I, Sollerman J, Kool EC, Soumagnac MT, Yaron O, Strotjohann NL, Zimmerman E, Barbarino C, Kulkarni SR, Kasliwal MM, De K, Yao Y, Fremling C, Yan L, Ofek EO, Fransson C, Filippenko AV, Zheng W, Brink TG, Copperwheat CM, Foley RJ, Brown J, Siebert M, Leloudas G, Cabrera-Lavers AL, Garcia-Alvarez D, Marante-Barreto A, Frederick S, Hung T, Wheeler JC, Vinkó J, Thomas BP, Graham MJ, Duev DA, Drake AJ, Dekany R, Bellm EC, Rusholme B, Shupe DL, Andreoni I, Sharma Y, Riddle R, van Roestel J, Knezevic N. A WC/WO star exploding within an expanding carbon-oxygen-neon nebula. Nature 2022; 601:201-204. [PMID: 35022591 DOI: 10.1038/s41586-021-04155-1] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Accepted: 10/15/2021] [Indexed: 11/09/2022]
Abstract
The final fate of massive stars, and the nature of the compact remnants they leave behind (black holes and neutron stars), are open questions in astrophysics. Many massive stars are stripped of their outer hydrogen envelopes as they evolve. Such Wolf-Rayet stars1 emit strong and rapidly expanding winds with speeds greater than 1,000 kilometres per second. A fraction of this population is also helium-depleted, with spectra dominated by highly ionized emission lines of carbon and oxygen (types WC/WO). Evidence indicates that the most commonly observed supernova explosions that lack hydrogen and helium (types Ib/Ic) cannot result from massive WC/WO stars2,3, leading some to suggest that most such stars collapse directly into black holes without a visible supernova explosion4. Here we report observations of SN 2019hgp, beginning about a day after the explosion. Its short rise time and rapid decline place it among an emerging population of rapidly evolving transients5-8. Spectroscopy reveals a rich set of emission lines indicating that the explosion occurred within a nebula composed of carbon, oxygen and neon. Narrow absorption features show that this material is expanding at high velocities (greater than 1,500 kilometres per second), requiring a compact progenitor. Our observations are consistent with an explosion of a massive WC/WO star, and suggest that massive Wolf-Rayet stars may be the progenitors of some rapidly evolving transients.
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Butters A, Do J, Stafford F, Krishnan N, Brown J, Hespe S, Richardson E, Bagnall R, Bhaskaran A, Burns C, Driscoll T, Fatkin D, Gray B, Iglesias C, Isbister J, Jabbour A, Johnson R, Kumar S, Leslie F, MacArthur D, Nowak N, Pouliopoulos J, Puranik R, Semsarian C, Sweeting J, Sy R, Ugander M, Yeates L, Ingles J. NSW HEARTS: The NSW Inherited Cardiomyopathy Cohort Study protocol. Heart Lung Circ 2022. [DOI: 10.1016/j.hlc.2022.04.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Barnes H, Gillen AM, Brown J, Archer DC. Surgical repair and reconstruction of a nasal fistula following intra‐lesional formalin injection. EQUINE VET EDUC 2021. [DOI: 10.1111/eve.13447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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81
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Porter I, Theodoulou E, Holen I, Harper-Wynne C, Baron-Hay S, Wilson C, Brown J. Adoption of adjuvant bisphosphonates for early breast cancer into standard clinical practice: Challenges and lessons learnt from comparison of the UK and Australian experience. J Bone Oncol 2021; 31:100402. [PMID: 34804788 PMCID: PMC8581365 DOI: 10.1016/j.jbo.2021.100402] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Revised: 10/27/2021] [Accepted: 10/30/2021] [Indexed: 11/18/2022] Open
Abstract
Adoption of adjuvant bisphosphonates for early breast cancer into standard clinical practice. UK and Australian experience of adjuvant bisphosphonates in early breast cancer. Pathway taken for adjuvant bisphosphonates implementation in the UK. Steps to increase update of adjuvant bisphosphonates in early breast cancer. Improve the care of women with early breast cancer.
International guidelines recommend adjuvant bisphosphonates (BPs) for post-menopausal women with early breast cancer to reduce recurrence and mortality. However, globally, wide variation exists in their adoption. In the UK, adjuvant BPs were a recommendation in the breast cancer Clinical Reference Group service specification and were included as a priority for implementation by the national oncologists group UK Breast Cancer Group in November 2015, promoting national uptake, guidance and funding arrangements. In 2018, adjuvant BPs were recommended by the UKs National Institute for Health and Care Excellence. In Australia, adjuvant BPs are still ‘off-label’ and do not receive national reimbursement or endorsement. To date there has been no research into the prescribing habits of these agents in Australia. With the aim to gather data on adjuvant BPs prescribing practices, online surveys were developed and disseminated to breast oncologists in both countries between December 2018 and June 2019. Almost all of the UK oncologists prescribed adjuvant BPs, demonstrating that education, endorsement from professional bodies, presence of national guidelines and funding decisions have been critical to implementation. In contrast, only 48% of the Australian responders prescribed adjuvant BPs, while 83% reported that they would prescribe them if funding was available. Lack of local protocol guidance was also seen as a major barrier. This study was intended to assess the pathway taken for adjuvant BP implementation in the UK and how it might inform changes in Australian practice and also guide other countries with similar issues with the ultimate aim of improving the care of women with early breast cancer globally.
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Ladores S, Corcoran J, Campbell C, Bray L, Brown J, Woods B, Li P. 230: State of fertility preservation counseling: Knowledge, experiences, and preferences of partners of women with cystic fibrosis. J Cyst Fibros 2021. [DOI: 10.1016/s1569-1993(21)01655-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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83
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Contos G, Baca Y, Xiu J, Brown J, Holloway R, Korn WM, Herzog TJ, Jones N, Winer I. Assessment of immune biomarkers and establishing a triple negative phenotype in gynecologic cancers. Gynecol Oncol 2021; 163:312-319. [PMID: 34563366 DOI: 10.1016/j.ygyno.2021.09.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Revised: 09/14/2021] [Accepted: 09/15/2021] [Indexed: 12/30/2022]
Abstract
OBJECTIVE Immuno-oncology (IO) has rapidly evolved, with many IO therapies either approved or under investigation for multiple malignancies. Biomarkers exist that can predict response to IO therapies including PD-L1 expression, microsatellite instability (MSI), and total mutation burden (TMB). This paper serves to analyze the presence of these biomarkers across gynecologic cancers. METHODS A total of 16,300 gynecologic cancer specimens submitted for molecular profiling to Caris Life Sciences were reviewed. Immunohistochemistry was performed using the SP142 anti-PD-L1 clone and assessed for intensity. Next-generation sequencing, immunohistochemistry, and fragment analysis were used to determine MSI status. TMB was measured by counting all non-synonymous missense mutations found per tumor not previously described as germline alterations. Chi-Square, Fisher Exact, and the Kruskal-Wallis test were used to compare cohorts. RESULTS Of 16,300 specimens, 54.1% were ovarian, 37.2% uterine, 7.2% cervical, 0.3% vulvar, 1.2% vaginal, with 0.1% unspecified. MSI-H was most frequent in uterine cancer (17.7%) and only 1% of ovarian cancers. PD-L1 expression was present in 38.3% of cervical and 62.5% of vulvar cancers, but less than 8% of ovarian and uterine cancers. TMB-H was present in 21.1% cervical, 19.7% uterine, and 5% ovarian cancers. Few specimens exhibited a "triple positive" phenotype - 0.3% ovarian, 1.5% uterine, and 1.5% cervical. Associations were seen between MSI, TMB, and PD-L1 across all cancer types. CONCLUSIONS The frequency of individual biomarkers pertinent to IO therapy varies by cancer type. HPV-driven genital tract cancers have higher frequencies of PD-L1 expression, MSI-H, and TMBH. Endometrial cancers are characterized by MSI-H and TMB, whereas ovarian cancers have a low frequency of MSI-H and modest PD-L1 or TMBH. The incidence of 'triple positive" cases was less than 2%.
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Brown J, Royle KL, Ralph C, Meads D, Martin A, Howard H, Linsley C, Swain J, Powles T, Jones R, Eisen T, Maraveyas A, Griffiths R, Din O, Goh V, Wah T, Selby P, Hewison J, Brown J, Collinson F. LBA28 STAR: A randomised multi-stage phase II/III trial of standard first-line therapy (sunitinib or pazopanib) comparing temporary cessation with allowing continuation, in the treatment of locally advanced and/or metastatic renal Cancer (RCC). Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.2104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Oaknin A, Gilbert L, Tinker A, Brown J, Mathews C, Press J, Sabatier R, O'Malley D, Samouelian V, Boni V, Duska L, Ghamande S, Ghatage P, Kristeleit R, Leath C, Han X, Kumar S, Duan T, Im E, Pothuri B. 76P Analysis of antitumor activity of dostarlimab by tumor mutational burden (TMB) in patients (pts) with endometrial cancer (EC) in the GARNET trial. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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86
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Cannon J, Sammi S, Syeda T, Brown J. H – Linking primary mechanisms of environmentally induced neurotoxicity to human neurological disease relevance. Toxicol Lett 2021. [DOI: 10.1016/s0378-4274(21)00264-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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87
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Haider MA, Brown J, Yao X, Chin J, Perlis N, Schieda N, Loblaw A. Multiparametric Magnetic Resonance Imaging in the Diagnosis of Clinically Significant Prostate Cancer: an Updated Systematic Review. Clin Oncol (R Coll Radiol) 2021; 33:e599-e612. [PMID: 34400038 DOI: 10.1016/j.clon.2021.07.016] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 07/05/2021] [Accepted: 07/27/2021] [Indexed: 12/20/2022]
Abstract
There has been growing utilisation of multiparametric magnetic resonance imaging (MPMRI) as a non-invasive tool to diagnose and localise clinically significant prostate cancer (CSPCa). This updated systematic review examines the use of MPMRI in patients with an elevated risk of CSPCa who have had a prior negative transrectal ultrasound systematic biopsy (TRUS-SB) and who were biopsy naïve. MEDLINE, EMBASE and the Cochrane Database of Systematic Reviews were searched for existing systematic reviews published up to September 2020. The literature search of the electronic databases combined disease-specific terms (prostate cancer, prostate carcinoma, etc.) and treatment-specific terms (magnetic resonance, etc.). Studies were included if they were randomised controlled trials (RCTs) comparing MPMRI to template transperineal mapping biopsy (TPMB) or to TRUS-SB. Thirty-six RCTs were eligible. For biopsy-naïve men, accuracy of diagnosis of CSPCa showed sensitivities from 87 to 96% and specificities ranging from 29 to 45%. Meta-analyses for CSPCa showed increased detection favouring MPMRI-targeted biopsy over TRUS-SB by 3% (95% confidence interval 0-7%, P = 0.03) and decreased detection of clinically insignificant prostate cancer (CISPCa) favouring MPMRI by 8% (95% confidence interval -11 to 5%, P < 0.00001). Accuracy of MPMRI for men with prior negative biopsy showed sensitivities of 78-100% and specificities of 30-100%. Meta-analyses comparing MPMRI to TRUS-SB showed increased detection of 5% (95% confidence interval 3-7%, P < 0.0001) with a reduction of CISPCa detection of 7% (95% confidence interval 4-9%, P < 0.00001). The growing acceptance of MPMRI utilisation internationally and the recent publication of several RCTs regarding MPMRI in reducing CISPCa detection rates, particularly in biopsy-naïve men, without loss of sensitivity for CSPCa necessitates the synthesis of updated evidence examining MPMRI in the diagnosis of CSPCa.
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Mcgaffin S, Taggart M, Smyth D, O"doherty D, Brown J, Teague S, Slevin C, Montgomery L, Coll M, Lindsay C, Crumley B, Gibson L, Elliott H, Hughes S, Connolly S. Transitioning a cardiovascular health and rehabilitation programme to a virtual platform during covid 19. Eur J Cardiovasc Nurs 2021. [DOI: 10.1093/eurjcn/zvab060.073] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
OnBehalf
Our Hearts Our Minds
Purpose
Can a virtual cardiovascular prevention and rehabilitation programme be as effective as face-to-face programme.
Background
The Our Hearts Our Minds (OHOM) prevention and rehabilitation programme rapidly transitioned to a virtual platform in the covid era. Here we compare if a virtual programme potentially could offer the same standard of the nursing intervention (education, smoking cessation, medical risk factor management and psychosocial health) as the previous face to face programme
Methods
Both the initial assessment (IA) and end of programme (EOP) assessments were conducted via telephone/video as per patient preference. The following measures were recorded at both time points (home blood pressure (BP) monitors were provided)
Smoking (self report) BP/Heart rate, Lipids/HbA1c (facilitated by phlebotomy hub), cardio protective drugs (doses, adherence), Hospital Anxiety and Depression score, EuroQoL
Nursing Intervention Smoking cessation counselling and pharmacotherapy where appropriate
Weekly meeting with cardiologist to optimise BP and lipid management and up titration cardio protective drugs
Bimonthly virtual coaching consultation for monitoring/goal resetting
Bimonthly group video education sessions
Results
From April to November 2020, of the 432 referrals received 400 were eligible with 377 accepting the offer of an IA (94% response rate). 262 have had an IA with the remaining 115 awaiting an assessment date. Of the completed IA’s 257 were willing to attend the programme (98% uptake). 120 had been offered an end of programme assessment with 114 attending (96% of those offered). The results for the virtual programme were then compared to the same period one year previously when the programme was fully face to face and are outlined in the table below.
The comparison of results delivered via remote delivery are remarkably similar to those achieved in the previous year delivered via face to face.
Conclusion
Initial data has shown that virtual delivery of the nursing component of the OHOM prevention/rehabilitation programme was highly acceptable to patients and was as effective as that of the traditional face to face service.
Table 1 below exhibits the clinical and patient-reported outcomes.
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Shrivastava M, Brown J, Sun L, Rajagopal R. 357 Improving Surgical Consent – A Quality Improvement Project to Enhance the Consenting Process. Br J Surg 2021. [DOI: 10.1093/bjs/znab134.412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Abstract
Introduction
RCS guidelines on consent, recently updated, encourage a dialogue where all risks material to that patient are discussed and are clear. An audit was performed to assess whether practice at Oxford Hospitals is compliant with these guidelines – that all patients for elective surgery are consented prior to admission.
Method
Thirty-two undergoing elective Functional Endoscopic Sinus Surgery (FESS), Tonsillectomy and Septoplasty were interviewed in May-June 2019. Baseline data were presented at a local educational meeting, along with education on the recent changes to the RCS guidelines. Repeat audit took place in August-September 2020.
Results
All 32 patients were consented as per RCS guidelines and understood the reason for their surgery, but only 31% could explain the risks, and 56% could explain alternative options. Twenty (63%) consent forms were easily legible on randomised heuristic assessment. After education and change in department practice, understanding of the operation was much improved (80-100%). One outcome was to create pre-filled consent forms for common ENT operations.
Conclusions
Whilst RCS policy on completing consent prior to admission is being achieved, patient interviews suggest a lack of understanding of the operation. Standardised consent forms have the potential to enhance this understanding, as well as saving time.
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Avdieiev S, Tordesillas L, Chavez-Chiang O, Chen Z, Silva-Simoes L, Chen A, Gatenby R, Flores E, Brown J, Tsai K. 062 Eco-evolutionary aspects of UV-induced clonal dynamics during skin carcinogenesis. J Invest Dermatol 2021. [DOI: 10.1016/j.jid.2021.02.079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Ehrhardt J, Brown J, French S, Kelly GN, Mikkelsen T, Müller H. RODOS: Decision-making support for off-site emergency management after nuclear accidents / Entscheidungshilfesystem RODOS für den externen Notfallschutz nach kerntechnischen Unfällen. KERNTECHNIK 2021. [DOI: 10.1515/kern-1996-622-320] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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92
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Shrivastava M, Brown J, Sun L, Rajagopal R. P64 Improving surgical consent – a quality improvement project to enhance the consenting process. BJS Open 2021. [PMCID: PMC8030172 DOI: 10.1093/bjsopen/zrab032.063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Introduction RCS guidelines on consent, recently updated, encourage a dialogue where all risks material to that patient are discussed and are clear. An audit was performed to assess whether practice at Oxford Hospitals is compliant with these guidelines – that all patients for elective surgery are consented prior to admission. Method Thirty-two undergoing elective Functional Endoscopic Sinus Surgery (FESS), Tonsillectomy and Septoplasty were interviewed in May-June 2019. Baseline data were presented at a local educational meeting, along with education on the recent changes to the RCS guidelines. Repeat audit took place in August-September 2020. Results All 32 patients were consented as per RCS guidelines and understood the reason for their surgery, but only 31% could explain the risks, and 56% could explain alternative options. Twenty (63%) consent forms were easily legible on randomised heuristic assessment. After education and change in department practice, understanding of the operation was much improved (80-100%). One outcome was to create pre-filled consent forms for common ENT operations. Conclusions Whilst RCS policy on completing consent prior to admission is being achieved, patient interviews suggest a lack of understanding of the operation. Standardised consent forms have the potential to enhance this understanding, as well as saving time.
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Pivot X, Chartier F, Chouaki N, Brown J, Williams R, Rider A. Real-world study on HR+, HER2−, node-positive, high-risk early breast cancer (EBC) in France: patient profiles, management and treatment patterns. Breast 2021. [DOI: 10.1016/s0960-9776(21)00135-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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Christensen J, Miliken A, Brown J, Dhillon G. Abdominal Malakoplakia Secondary to Disseminated Mycobacterium Avium Complex after Lung Transplant. J Heart Lung Transplant 2021. [DOI: 10.1016/j.healun.2021.01.2066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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95
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Town C, Strand H, Johnson J, Brown J, Pelecanos A, Van Zundert A. Ultrasound-guided Fascia Iliaca Plane Block for the treatment of donor site pain in the burn injured patient: a randomized control trial. J Burn Care Res 2021; 42:981-985. [PMID: 33517454 DOI: 10.1093/jbcr/irab021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Burn injuries requiring surgical intervention often result in split- thickness skin grafting procedures, with donor skin frequently harvested from the patient's anterolateral thigh. The donor site is often reported as the primary site of post-operative pain due to the damage sustained to localised nociceptors.A randomised control trial was undertaken to evaluate the impact an ultrasound-guided regional nerve block would have on patient reported pain scores in donor site wounds, and associated rescue analgesia consumption. Twenty participants requiring split-skin grafting for burn injuries of <15% total body surface area were enrolled from a tertiary burns unit and randomised to control (10 participants) or intervention group (10 participants). The intervention group received the addition of an ultrasound-guided facia iliaca plane block prior to their surgery. Primary outcome was pain score in the donor site during the postoperative phase; while secondary outcome was pain on day 1 post-surgery as measured by the numeric pain score (0-10). During the post-operative phase, the intervention group had a significantly lower median donor site pain score of 0 (interquartile range (IQR) 0 - 0), compared to the control group median 6 (IQR 4 - 7) (p < 0.001). Day 1 post-surgery the intervention group had a median pain score of 0 (IQR 0 - 4) compared to control group median 4.5 (IQR 2 - 6) (p= 0.043).The study findings demonstrated that regional anaesthesia was an effective way to reduce pain scores and requirement for additional analgesics during the postoperative phase.
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Shrimpton A, Brown J, Cook TM, Pickering AE. Airway procedures: the importance of distinguishing between high risk and aerosol generation. Anaesthesia 2021; 76 Suppl 3:28-29. [PMID: 33464563 PMCID: PMC8014328 DOI: 10.1111/anae.15383] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/16/2020] [Indexed: 12/20/2022]
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Crawley JAH, Liehrmann O, Franco dos Santos DJ, Brown J, Nyein UK, Aung HH, Htut W, Oo ZM, Seltmann MW, Webb JL, Lahdenperä M, Lummaa V. Influence of handler relationships and experience on health parameters, glucocorticoid responses and behaviour of semi-captive Asian elephants. CONSERVATION PHYSIOLOGY 2021; 9:coaa116. [PMID: 34676079 PMCID: PMC8528106 DOI: 10.1093/conphys/coaa116] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Revised: 11/04/2020] [Accepted: 11/21/2020] [Indexed: 05/27/2023]
Abstract
Declining wild populations combined with accumulating captive populations of e.g. livestock, pets, draught and zoo animals have resulted in some threatened species with substantial proportions of their populations in captivity. The interactions animals have with humans in captivity depend on handler familiarity and relationship quality and can affect animal health, growth and reproduction with consequences for the success of conservation programmes. However, assessments of how specific human-animal relationships affect a range of physiological and behavioural outcomes are rare. Here, we studied semi-captive Asian elephants with detailed records of elephant-handler (mahout) relationships and veterinary management, allowing assessment of multiple welfare indicators in relation to specific mahout-elephant relationship lengths and mahout experience. These included measures of physiological stress (faecal glucocorticoid metabolite [FGM], heterophil:lymphocyte ratio [H:L]), muscle damage (creatine kinase [CK]), immunological health (total white blood cell count [TWBC]) and behaviour (response to mahout verbal commands). We found no evidence that FGM or H:L related to aspects of the mahout-elephant relationship. Longer overall mahout experience (i.e. years of being a mahout) was linked to increased muscle damage and inflammation, but the lengths of specific mahout-elephant relationships were inversely associated with muscle damage in working-age elephants. Elephants responded more to familiar mahouts in behavioural tasks and faster to mahouts they had known for longer. In summary, our results found little evidence that the mahout-elephant relationship affects physiological stress in this population based on FGM and H:L, but mahout experience and relationships were linked to other physiological responses (CK, TWBC), and elephants require behavioural adjustment periods following mahout changes.
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Shrimpton A, Gregson FKA, Cook TM, Brown J, Bzdek BR, Reid JP, Pickering AE. A quantitative evaluation of aerosol generation during tracheal intubation and extubation: a reply. Anaesthesia 2020; 76 Suppl 3:16-18. [PMID: 33368170 DOI: 10.1111/anae.15345] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/17/2020] [Indexed: 11/26/2022]
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Newman L, Brown J, Kerawala C, Patel M, Woodwards B, Lavery K, Courtney D, Stewart A, Herold J, Hyde N. Our specialty. The future. Is the writing on the wall? Br J Oral Maxillofac Surg 2020; 58:1219-1221. [DOI: 10.1016/j.bjoms.2019.10.322] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Accepted: 10/19/2019] [Indexed: 10/24/2022]
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100
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Choudhury B, Brown J, Ransy DG, Brophy J, Kakkar F, Bitnun A, Samson L, Read S, Soudeyns H, Vaudry W, Houston S, Hawkes MT. Endothelial activation is associated with intestinal epithelial injury, systemic inflammation and treatment regimen in children living with vertically acquired HIV-1 infection. HIV Med 2020; 22:273-282. [PMID: 33151601 DOI: 10.1111/hiv.13012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Revised: 08/17/2020] [Accepted: 10/09/2020] [Indexed: 12/19/2022]
Abstract
BACKGROUND Premature development of cardiovascular disease in children living with HIV-1 (CLWH) may be associated with compromised gut barrier function, microbial translocation, immune activation, systemic inflammation and endothelial activation. Biomarkers of these pathways may provide insights into pathogenesis of atherosclerotic disease in CLWH. METHODS This was a cross-sectional study of CLWH enrolled in the multicentre Early Pediatric Initiation-Canadian Child Cure Cohort (EPIC4 ) who were on antiretroviral therapy (ART) with undetectable viral load. Plasma biomarkers of intestinal epithelial injury [intestinal fatty acid binding protein-1 (IFABP)], systemic inflammation [tumour necrosis factor (TNF) and interleukin-6 (IL-6)] and endothelial activation [angiopoietin-2 (Ang2), soluble vascular endothelial growth factor-1 (sVEGFR1) and soluble endoglin (sEng)] were quantified by enzyme-linked immunosorbent assay. Correlation and factor analysis of biomarkers were used to examine associations between innate immune pathways. RESULTS Among 90 CLWH, 16% of Ang2, 15% of sVEGFR1 and 23% of sEng levels were elevated relative to healthy historic controls. Pairwise rank correlations between the three markers of endothelial activation were statistically significant (ρ = 0.69, ρ = 0.61 and ρ = 0.65, P < 0.001 for all correlations). An endothelial activation index, derived by factor analysis of the three endothelial biomarkers, was correlated with TNF (ρ = 0.47, P < 0.001), IL-6 (ρ = 0.60, P < 0.001) and intestinal fatty acid binding protein-1 (ρ = 0.67, P < 0.001). Current or past treatment with ritonavir-boosted lopinavir (LPV/r) was associated with endothelial activation (odds ratio = 5.0, 95% CI: 1.7-17, P = 0.0020). CONCLUSIONS Endothelial activation is prevalent in CLWH despite viral suppression with combination ART and is associated with intestinal epithelial injury, systemic inflammation and treatment with LPV/r.
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