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Bieleman H, Stewart R, Reneman M, van Ittersum M, van der Schans C, Oosterveld F. Does the physical work capacity of subjects with early osteoarthritis of hip and knee decline in five years? Physiotherapy 2015. [DOI: 10.1016/j.physio.2015.03.297] [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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102
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Saleeb R, Faragalla H, Yousef GM, Stewart R, Streutker CJ. Malignancies arising in allograft kidneys, with a first reported translocation RCC post-transplantation: A case series. Pathol Res Pract 2015; 211:584-7. [PMID: 26008778 DOI: 10.1016/j.prp.2015.04.009] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2014] [Revised: 04/11/2015] [Accepted: 04/17/2015] [Indexed: 01/14/2023]
Abstract
BACKGROUND The increased risk of malignancy in the post-renal transplant population has been well documented. Renal carcinoma is more common in this population, usually arising in native kidneys. Rarely, tumors arise in the transplanted kidney. Our case series reports four cases of malignancy in allograft kidneys, one of which is a first reported case of translocation RCC in a transplanted kidney. METHODS The renal transplantation database (1584 patients) at St. Michael's Hospital was reviewed for malignancies arising in allograft kidneys: reports and pathology slides were reviewed. RESULTS Four cases of malignancies arising in the allograft kidney were identified among our kidney transplant population. One patient developed a high grade urothelial carcinoma in the donor kidney post BK virus infection. The other 3 cases were renal cell carcinomas: one clear cell renal cell carcinoma, one translocation renal cell carcinoma, and one papillary renal cell carcinoma. The translocation renal cell cancer had confirmed TFE3 protein over-expression by immunohistochemistry. Molecular testing of the tumors in all 4 cases identified two separate genetic profiles, favored to represent tumors arising from donor tissues along with infiltrating recipient lymphocytes. DISCUSSION Previous reports suggested that epithelial malignancies in allograft kidneys are rare. We identified 4 such tumors in 1584 transplant patients. Further, we identified the first reported case of translocation RCC in an allograft kidney. While the rate of malignancy in allograft kidneys is low, screening of the donor kidneys by ultrasound and/or urine cytology may be of use in detecting these lesions.
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103
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Stewart R. Developing Electronic Health Records Databases for Mental Health Research. Eur Psychiatry 2015. [DOI: 10.1016/s0924-9338(15)30123-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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104
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Wu SI, Kao KL, Chen SC, Juang JJM, Lin CJ, Fang CK, Wu CS, Dewey M, Prince MJ, Stewart R. Antipsychotic exposure prior to acute myocardial infarction in patients with serious mental illness. Acta Psychiatr Scand 2015; 131:213-22. [PMID: 25311084 DOI: 10.1111/acps.12345] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/11/2014] [Indexed: 01/20/2023]
Abstract
OBJECTIVE To investigate the association between acute myocardial infarction (AMI) and recent exposure to antipsychotic agents in people with serious mental illness (SMI), and modifying influences. METHOD A case-crossover design was applied using the Taiwan National Health Insurance Research Database (NHIRD) to compare the exposure frequency of antipsychotic agents within individuals of schizophrenia or bipolar disorder between 60-day case and control periods prior to their first AMI episode during 1996-2007. RESULTS A sample of 834 patients with incident AMI was analysed. AMI was significantly associated with more recent antipsychotic exposure in schizophrenia after adjustment (OR 1.87, 95% confidence interval 1.15-3.03) bipolar disorder (OR 1.06, 0.51-2.21). This association in schizophrenia was significantly stronger in men and in patients without previous diagnoses of cardiovascular risk factors. CONCLUSION These findings are consistent with a short-term risk effect of antipsychotic exposure on risk of AMI and identify potentially vulnerable groups. Further research is required to clarify underlying biological mechanisms.
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Pfaeffli Dale L, Whittaker R, Jiang Y, Rolleston A, Stewart R, Maddison R. Effects of an mHealth cardiac rehabilitation intervention on lifestyle change: results from the Text4Heart randomised controlled trial. Heart Lung Circ 2015. [DOI: 10.1016/j.hlc.2015.04.067] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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106
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Looi K, Stewart R, Lee M, Kerr A. Contemporary management of acute coronary syndrome in patients with atrial fibrillation: An ANZACS-QI registry study. Heart Lung Circ 2015. [DOI: 10.1016/j.hlc.2015.04.111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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107
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Wang T, Stewart R, Choi D, Harrmos S, Gamble G, Ramanathan T, White H. Utility of high-sensitivity troponins after combined aortic valve replacement and coronary artery bypass grafting towards defining myocardial infarction. Heart Lung Circ 2015. [DOI: 10.1016/j.hlc.2015.06.707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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108
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Gladding P, Erogbogbo F, Swihart M, Smart K, El-Jack S, Korcyk D, Webster M, Stewart R, Zeng I, Jullig M, Bakeev K, Jamieson M, Kasabov N, Liang L, Hu R, Schliebs S, Gopalan B, Villas-Boas S. Bioengineering silicon quantum dot theranostics using a network analysis of metabolomic and proteomic data in cardiac ischaemia. Heart Lung Circ 2015. [DOI: 10.1016/j.hlc.2015.04.097] [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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109
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Stewart R, Colquhoun D, Marshner S, Simes J, Sathananthan J, Kirby A, Nestel P, Glozier N, O’Neil A, Oldenburg B, Tonkin A, White H. Persistent psychological distress and mortality in patients with stable coronary artery disease in the LIPID trial. Heart Lung Circ 2015. [DOI: 10.1016/j.hlc.2015.06.643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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110
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Wang T, Stewart R, Gamble G, Ramanathan T, White H. Prognostic value of post-operative aspartate aminotransferase levels after isolated coronary artery bypass grafting and isolated isolated aortic valve replacement. Heart Lung Circ 2015. [DOI: 10.1016/j.hlc.2015.06.704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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111
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Sultana J, Chang CK, Hayes RD, Broadbent M, Stewart R, Corbett A, Ballard C. Associations between risk of mortality and atypical antipsychotic use in vascular dementia: a clinical cohort study. Int J Geriatr Psychiatry 2014; 29:1249-54. [PMID: 24633896 DOI: 10.1002/gps.4101] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2013] [Revised: 02/13/2014] [Accepted: 02/19/2014] [Indexed: 12/17/2022]
Abstract
OBJECTIVES People with vascular dementia (VaD) are frequently prescribed atypical antipsychotics to treat behavioural and psychological symptoms, but there is an alarming lack of evidence regarding their safety or efficacy in VaD. This study sought to identify the mortality risk associated with the most commonly prescribed atypical antipsychotics in people with VaD compared with people not exposed to these drugs. METHODS A clinical cohort study of 1531 people with VaD performed using anonymised versions of full electronic health records from the Clinical Record Interactive Search application at the South London and Maudsley NHS Foundation Trust. Patients were identified from 2007 to 2010, of whom 337 were exposed to quetiapine, risperidone or olanzapine. The main outcome measure was mortality. RESULTS Patients exposed to atypical antipsychotics were not at increased risk of mortality [hazard ratio (HR) 1.05, 95% confidence interval (CI): 0.87-1.26]. Exposure to risperidone did not result in an increased risk of mortality (HR = 0.85; 95% CI: 0.59-1.24), and patients exposed to quetiapine had a non-significant numerical increase in mortality risk (HR = 1.14; 95% CI: 0.93-1.39; p-value = 0.20) compared with untreated patients. Too few patients were exposed to olanzapine alone to provide reliable results. CONCLUSIONS The absence of a significant increase in mortality risk associated with atypical antipsychotics in people with VaD indicates that a clinical trial of antipsychotics focussing on the treatment of aggression and agitation in this patient group will be justified and feasible following further consideration of possible confounders, which will be critical to determine the role of antipsychotics in treatment of VaD.
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Stewart R, Fielden L, Muir Z, McNeil L, Morgan H. 30 * WEIGHT LOSS AND NUTRITIONAL ASSESSMENT IN MOVEMENT DISORDER CLINICS (MDCS) IN THE WEST OF SCOTLAND. Age Ageing 2014. [DOI: 10.1093/ageing/afu124.30] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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114
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McNeil L, Morgan H, Stewart R, Fielden L, Muir Z. 16 * FALLS ASSESSMENT IN MOVEMENT DISORDER CLINICS IN THE WEST OF SCOTLAND. Age Ageing 2014. [DOI: 10.1093/ageing/afu124.16] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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115
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Chamberlain M, Koilpillai C, Stewart R, Ramer S. ROUTINE TRANSESOPHAGEAL ECHO PRIOR TO ATRIAL FIBRILLATION/FLUTTER ABLATIONS IN LOW RISK PATIENTS - ARE THEY NECESSARY? Can J Cardiol 2014. [DOI: 10.1016/j.cjca.2014.07.359] [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] Open
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Illidge T, Lipowska-Bhalla G, Cheadle E, Honeychurch J, Poon E, Morrow M, Stewart R, Wilkinson R, Dovedi S. Radiation Therapy Induces an Adaptive Upregulation of PD-L1 on Tumor Cells Which May Limit the Efficacy of the Anti-Tumor Immune Response But Can Be Circumvented by Anti-PD-L1. Int J Radiat Oncol Biol Phys 2014. [DOI: 10.1016/j.ijrobp.2014.05.2247] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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118
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Cross D, D'Cruz C, Eberlein C, Spitzler P, Ichihara E, Meador C, Ashton S, Mellor M, Stewart R, Smith P, Schuller A, Frigault M, Pao W, Jewsbury P. Targeting Resistance in Egfr-Mutant Non-Small Cell Lung Cancer (Nsclc): Preclinical Evidence Supporting the Combination of Egfr Tyrosine Kinase Inhibitors (Tkis) Azd9291 and Gefitinib with Molecularly Targeted Agents and Immunotherapeutics. Ann Oncol 2014. [DOI: 10.1093/annonc/mdu331.26] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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119
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Bogdanowicz KM, Stewart R, Broadbent M, Hatch SL, Hotopf M, Strang J, Hayes R. OR03-4 * PSYCHIATRIC COMORBIDITY AND EXCESS ALL-CAUSE AND CAUSE-SPECIFIC MORTALITY IN OPIOID ADDICTS. Alcohol Alcohol 2014. [DOI: 10.1093/alcalc/agu053.14] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Begum A, Dewey M, Hassiotis A, Prince M, Wessely S, Stewart R. Subjective cognitive complaints across the adult life span: a 14-year analysis of trends and associations using the 1993, 2000 and 2007 English Psychiatric Morbidity Surveys. Psychol Med 2014; 44:1977-1987. [PMID: 24074262 DOI: 10.1017/s0033291713002444] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Cognitive complaints are common in all age groups but most often researched in old age. We aimed to investigate prevalences and time trends over 14 years of subjective memory complaints (SMC) and subjective concentration complaints (SCC) in adults and investigate associations with mood disorders and cognitive function. METHOD Data from three English national mental health surveys carried out in 1993, 2000 and 2007 were analysed. SMC and SCC were measured using the Clinical Interview Schedule-Revised and cognitive function using the modified Telephone Interview for Cognitive Status. RESULTS Both SMC and SCC increased up to middle age and then declined, followed by a second rise in the very oldest age groups. Age-specific prevalence of both increased across survey years but relationships with mental health and cognitive outcomes were relatively stable. CONCLUSIONS Cognitive complaints are most common in middle age and have become more prevalent over time.
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Su YP, Chang CK, Hayes RD, Harrison S, Lee W, Broadbent M, Taylor D, Stewart R. Retrospective chart review on exposure to psychotropic medications associated with neuroleptic malignant syndrome. Acta Psychiatr Scand 2014; 130:52-60. [PMID: 24237642 DOI: 10.1111/acps.12222] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/15/2013] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To investigate the association between neuroleptic malignant syndrome (NMS) and levels of antipsychotic exposure. METHOD Electronic health record data systematically screened from a large mental health service provider in southeast London provided 67 NMS cases which were individually matched with 254 controls on age, gender, and primary psychiatric diagnosis. Data on psychotropic agents, combinations, dose, and dose change of antipsychotic prescriptions over the preceding 5 (oral agents) or 15 days (depot agents) were extracted and compared between groups using conditional logistic regression models. RESULTS NMS was associated with higher number of antipsychotic agents used, use of first-generation agents or aripiprazole, use of first-generation agents only or cross-generation agents, and higher mean and maximum daily doses. In further analyses, associations with antipsychotics type remained significant when adjusted for dose, but those with dose were attenuated following adjustment for type. The specific use of haloperidol, aripiprazole, depot flupentixol, and benzodiazepines was independently associated with NMS. Non-white ethnicity was also found to be associated with NMS. CONCLUSION NMS was primarily associated with type of antipsychotic and polypharmacy rather than overall dose. Variation in risk by ethnicity requires further research.
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Stewart R, Breckenridge A. 56 * CAN WE IMPROVE THE QUALITY OF OUR ADMISSION DOCUMENTATION IN OUR GERIATRIC MEDICINE ASSESSMENT UNIT? Age Ageing 2014. [DOI: 10.1093/ageing/afu036.56] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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124
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Paganetti H, Stewart R, Carabe-Fernandez A. TU-A-BRE-01: The Relative Biological Effectiveness of Proton Beams Relative to Photon Beams. Med Phys 2014. [DOI: 10.1118/1.4889231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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125
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Aston K, Savage E, Pathiraja M, Millar A, Stewart R, Ong G, Pendleton A. AB1065 A Regional Audit of Joint Aspirates from Hot, Swollen Joints; Experiences in Northern Ireland. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.2251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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