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Himsworth JM, Wadsley J, Brown C, Hallam A, Singleton M. Day-case Treatment with Radioactive I-131 for Thyroid Cancer. Clin Oncol (R Coll Radiol) 2017; 29:e139. [PMID: 28242164 DOI: 10.1016/j.clon.2017.02.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2017] [Accepted: 02/09/2017] [Indexed: 11/18/2022]
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Sharp L, McDevitt J, Brown C, Comber H. Smoking at diagnosis significantly decreases 5-year cancer-specific survival in a population-based cohort of 18 166 colon cancer patients. Aliment Pharmacol Ther 2017; 45:788-800. [PMID: 28176335 DOI: 10.1111/apt.13944] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2016] [Revised: 06/15/2016] [Accepted: 12/26/2016] [Indexed: 12/12/2022]
Abstract
BACKGROUND Accumulating evidence suggests smoking may adversely affect cancer patients' outcomes. Previous studies of smoking and survival in colon cancer have been limited by size and/or lack of a population basis and results have been inconsistent. AIM To investigate in a large population-based cohort whether smoking status at diagnosis is an independent prognostic factor for cancer-specific survival in colon cancer and whether treatment modifies any impact of smoking. METHODS Colon adenocarcinomas diagnosed between 1994 and 2012 were abstracted from the National Cancer Registry Ireland, and classified by smoking status at diagnosis. Cancer-specific death rates over 5 years were compared in current, ex- and never smokers using multivariable Cox proportional hazards models, and subgroup analyses by treatment (combinations of cancer-directed surgery and chemotherapy) were conducted. RESULTS Of 18 166 colon cancers, 20% of patients were current smokers, 23% ex-smokers and 57% never smokers. Compared to never smokers, current smokers had a significantly raised cancer death rate [multivariable hazard ratio (HR) = 1.14, 95% CI: 1.07-1.12]. There was a significant interaction between treatment and smoking (P = 0.03). In those who had cancer-directed surgery only, but not other groups, current smokers had a significantly increased cancer death rate compared to never smokers (HR = 1.21, 95% CI: 1.09-1.34). CONCLUSIONS Smoking at diagnosis is an independent prognostic factor for colon cancer. The limitation of the association to surgically-treated patients suggests that the underlying mechanism(s) may be related to surgery. While further research is needed to elucidate mechanisms, continued efforts to encourage smoking prevention and cessation may yield benefits in terms of improved survival from colon cancer.
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Brown C, Rastogi S, Barrett S, Anderson H, Twichell E, Gralinski S, McDonald A, Brittain W. Differential azobenzene solubility increases equilibrium cis/trans ratio in water. J Photochem Photobiol A Chem 2017. [DOI: 10.1016/j.jphotochem.2016.12.013] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Lawrenson R, Lao C, Harvey V, Campbell I, Brown C, Seneviratne S, Edwards M, Scott N, Elwood M, Sarfati D, Kuper-Hommel M. Abstract P4-21-28: Trastuzumab improves outcomes of New Zealand women with HER2+ stage I-III breast cancer. Cancer Res 2017. [DOI: 10.1158/1538-7445.sabcs16-p4-21-28] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Introduction
HER2 status has been routinely ascertained for stage I-III breast cancer since late 2005. Trastuzumab was first funded in New Zealand for use in HER2+ breast cancer in July 2007. This observational study aims to compare the difference in outcome between women with HER2+ stage I-III breast cancer who received trastuzumab as adjuvant therapy versus those who did not. Differences in presentation, treatment and outcomes between Māori and NZ European were studied.
Methods
The combined Waikato and Auckland Breast Cancer Registries have clinical details of 12377 women diagnosed with breast cancer between June 2000 and May 2013. 9506 women with breast cancer were tested for HER2 receptor status. Proportion of women with HER2+ (FISH amplified or IHC 3+), stage I-III breast cancer were examined by age, ethnicity and stage. Differences in use of trastuzumab for women with stage I-III breast cancer with a tumour size equal or larger than 1 cm and aged less than 75 years were assessed by ethnicity and year of diagnosis. Patients who had inflammatory breast cancer or developed metastatic disease or local recurrence within 3 months after diagnosis were excluded. Kaplan-Meier method and Cox proportional hazards model were used to examine the breast cancer-specific survival between women treated with trastuzumab and chemotherapy and those treated with chemotherapy without trastuzumab.
Results
1454 patients with early invasive breast cancer were HER2+. The proportion of cases with HER2+, stage I-III breast cancer increased with stage (stage I-III: 11.5%-26.9%), but decreased with age (<40 years to 80+ years: 28.8%-9.7%). Māori women were more likely to have HER2+ cancers than NZ European (17.8% versus 14.9%; p=0.02). Among the eligible patients, 605 women received trastuzumab and chemotherapy within 12 months for stage I-III breast cancer, and 275 had chemotherapy without trastuzumab. A small proportion (10.2%, 34/333) of women diagnosed in 2000-2005 received trastuzumab as part of a clinical trial. The proportion of women who received trastuzumab increased to 60.3% in 2006-2009 and to 87.1% in 2010-2013. 46.2% of Māori women were treated with trastuzumab compared to 55.9% of NZ European (p=0.040). The cancer-specific survival estimated with Kaplan-Meier method is shown in Table 1. Women treated with chemotherapy without trastuzumab were 2.7 times (95% CI: 1.9-3.9) more likely to die of breast cancer compared to those treated with trastuzumab and chemotherapy, after adjustment for stage, tumour size and hormone therapy.
Table 1. Breast cancer-specific survival between women with HER2+ stage I-III breast cancer who received trastuzumab as adjuvant therapy versus those who did notTreatmentNumber of patientsMedian follow-up time (months)5-year survival10-year survivalTrastuzumab+chemotherapy6055389.6%84.3%Chemotherapy without trastuzumab27510775.6%69.1%
Conclusions
Trastuzumab improved the breast cancer-specific survival of women with HER2+ stage I-III breast cancer. Māori women were more likely to have HER2+ cancer and less likely to be treated with trastuzumab. Rates of treatment with trastuzumab and the adjusted survival between Māori women and NZ European women were not significantly different.
Citation Format: Lawrenson R, Lao C, Harvey V, Campbell I, Brown C, Seneviratne S, Edwards M, Scott N, Elwood M, Sarfati D, Kuper-Hommel M. Trastuzumab improves outcomes of New Zealand women with HER2+ stage I-III breast cancer [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P4-21-28.
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Dill J, Brown C, Heym K, Camus A. Lipoid liver disease, atherosclerosis and glomerular lipidosis in a Gulf flounder Paralichthys albigutta (Jordan & Gilbert 1882): a case report. JOURNAL OF FISH DISEASES 2017; 40:273-278. [PMID: 27111715 DOI: 10.1111/jfd.12486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/08/2016] [Revised: 03/09/2016] [Accepted: 03/09/2016] [Indexed: 06/05/2023]
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Holman I, Brown C, Janes V, Sandars D. Can we be certain about future land use change in Europe? A multi-scenario, integrated-assessment analysis. AGRICULTURAL SYSTEMS 2017; 151:126-135. [PMID: 28163353 PMCID: PMC5268336 DOI: 10.1016/j.agsy.2016.12.001] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/22/2016] [Revised: 11/30/2016] [Accepted: 12/02/2016] [Indexed: 05/09/2023]
Abstract
The global land system is facing unprecedented pressures from growing human populations and climatic change. Understanding the effects these pressures may have is necessary to designing land management strategies that ensure food security, ecosystem service provision and successful climate mitigation and adaptation. However, the number of complex, interacting effects involved makes any complete understanding very difficult to achieve. Nevertheless, the recent development of integrated modelling frameworks allows for the exploration of the co-development of human and natural systems under scenarios of global change, potentially illuminating the main drivers and processes in future land system change. Here, we use one such integrated modelling framework (the CLIMSAVE Integrated Assessment Platform) to investigate the range of projected outcomes in the European land system across climatic and socio-economic scenarios for the 2050s. We find substantial consistency in locations and types of change even under the most divergent conditions, with results suggesting that climate change alone will lead to a contraction in the agricultural and forest area within Europe, particularly in southern Europe. This is partly offset by the introduction of socioeconomic changes that change both the demand for agricultural production, through changing food demand and net imports, and the efficiency of agricultural production. Simulated extensification and abandonment in the Mediterranean region is driven by future decreases in the relative profitability of the agricultural sector in southern Europe, owing to decreased productivity as a consequence of increased heat and drought stress and reduced irrigation water availability. The very low likelihood (< 33% probability) that current land use proportions in many parts of Europe will remain unchanged suggests that future policy should seek to promote and support the multifunctional role of agriculture and forests in different European regions, rather than focusing on increased productivity as a route to agricultural and forestry viability.
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Muir C, Priestnall S, Hibbert A, Brown C, Garden O, Scase T. Ki67 Expression is not Correlated with Areal Density of Foxp3+ Cells in Affected Lymph Nodes of Treatment-Naïve Canine Diffuse Large B-Cell Lymphoma Cases. J Comp Pathol 2017. [DOI: 10.1016/j.jcpa.2016.11.197] [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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Dawson TP, Cutler MEJ, Brown C. The role of remote sensing in the development of SMART indicators for ecosystem services assessment. ACTA ACUST UNITED AC 2016. [DOI: 10.1080/14888386.2016.1246384] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Brown C, Adair R. Audit of red flag referrals from GPS for suspected head and neck cancer. Int J Surg 2016. [DOI: 10.1016/j.ijsu.2016.08.228] [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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Hopkins L, Gaines E, Brown C, Roberts M, Evans T, Lewis M. Comparison of functional outcomes post 10 week home exercise programme and a 10 week supervised exercise programme in intermittent claudication patients. Int J Surg 2016. [DOI: 10.1016/j.ijsu.2016.08.485] [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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Rosen A, Ko J, Brown C. A Multivariate Assessment of Clinical Contributions to the Severity of Perceived Dysfunction Measured by the Cumberland Ankle Instability Tool. Int J Sports Med 2016; 37:1154-1158. [DOI: 10.1055/s-0042-113464] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Murphy T, Forgie R, MacLeod J, Brown C, Hassan A, Pelletier M. SEVERE COAGULOPATHY AFTER CARDIAC SURGERY: IS FEIBA A VIABLE THERAPY? Can J Cardiol 2016. [DOI: 10.1016/j.cjca.2016.07.165] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Polin MR, Siddiqui NY, Brown C, Hesham H, Comstock BA, Lendvay TS, Martino MA. Crowdsourcing: A Valid Alternative to Expert Evaluation of Robotic Surgery Skills. J Minim Invasive Gynecol 2016; 22:S19-S20. [PMID: 27678998 DOI: 10.1016/j.jmig.2015.08.062] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Chung G, Billington S, Wilde R, Brown C. Human primary proximal tubule cell monolayers as a novel predictive model of nephrotoxicity. Toxicol Lett 2016. [DOI: 10.1016/j.toxlet.2016.06.1545] [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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Gogniat M, Puente A, Brown C, Robinson T, Miller L. A-01The Relationship Between Body Mass Index and Neuropsychological Functioning in Older Adults. Arch Clin Neuropsychol 2016. [DOI: 10.1093/arclin/acw043.01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Bjork J, Brown C, Friedlander H, Schiffman E, Neitzel D. Validation of Random Sampling as an Estimation Procedure for Lyme Disease Surveillance in Massachusetts and Minnesota. Zoonoses Public Health 2016; 65:266-274. [DOI: 10.1111/zph.12297] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2016] [Indexed: 11/28/2022]
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Gibbs H, Brown C, Wilson A, Doumtses J. Heart Failure Admissions and Readmissions in Victoria: Results From Dr Foster Intelligence. Heart Lung Circ 2016. [DOI: 10.1016/j.hlc.2016.06.265] [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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Byrnes EE, Brown C. Individual personality differences in Port Jackson sharks Heterodontus portusjacksoni. JOURNAL OF FISH BIOLOGY 2016; 89:1142-1157. [PMID: 27228221 DOI: 10.1111/jfb.12993] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/29/2015] [Accepted: 04/07/2016] [Indexed: 06/05/2023]
Abstract
This study examined interindividual personality differences between Port Jackson sharks Heterodontus portusjacksoni utilizing a standard boldness assay. Additionally, the correlation between differences in individual boldness and stress reactivity was examined, exploring indications of individual coping styles. Heterodontus portusjacksoni demonstrated highly repeatable individual differences in boldness and stress reactivity. Individual boldness scores were highly repeatable across four trials such that individuals that were the fastest to emerge in the first trial were also the fastest to emerge in subsequent trials. Additionally, individuals that were the most reactive to a handling stressor in the first trial were also the most reactive in a second trial. The strong link between boldness and stress response commonly found in teleosts was also evident in this study, providing evidence of proactive-reactive coping styles in H. portusjacksoni. These results demonstrate the presence of individual personality differences in sharks for the first time. Understanding how personality influences variation in elasmobranch behaviour such as prey choice, habitat use and activity levels is critical to better managing these top predators which play important ecological roles in marine ecosystems.
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Stewart DA, Guo D, Luider J, Auer I, Klassen J, Morris D, Chaudhry A, Brown C, Glück S, Russell JA. A Low CD34+ Cell Dose Predicts Relapse and Death Early following Autologous Blood Stem Cell Transplantation. Hematology 2016; 6:19-27. [DOI: 10.1080/10245332.2001.11746549] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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Jewett A, Bell T, Cohen NJ, Buckley K, Leino V, Even S, Beavers S, Brown C, Marano N. US college and university student health screening requirements for tuberculosis and vaccine-preventable diseases, 2012. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2016; 64:409-15. [PMID: 26730492 PMCID: PMC4879121 DOI: 10.1080/07448481.2015.1117465] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
OBJECTIVE Colleges are at risk for communicable disease outbreaks because of the high degree of person-to-person interactions and relatively crowded dormitory settings. This report describes the US college student health screening requirements among US resident and international students for tuberculosis (TB) and vaccine-preventable diseases (VPDs) as they relate to the American College Health Association (ACHA) guidelines. Methods/Participants: In April 2012, US college health administrators (N = 2,858) were sent online surveys to assess their respective school's TB screening and immunization requirements. RESULTS Surveys were completed by 308 (11%) schools. Most schools were aware of the ACHA immunization (78%) and TB screening (76%) guidelines. Schools reported having policies related to immunization screening (80.4%), immunization compliance (93%), TB screening (55%), and TB compliance (87%). CONCLUSION Most colleges were following ACHA guidelines. However, there are opportunities for improvement to fully utilize the recommendations and prevent outbreaks of communicable diseases among students in colleges.
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Malak TT, Broomfield JAJ, Palmer AJR, Hopewell S, Carr A, Brown C, Prieto-Alhambra D, Glyn-Jones S. Surrogate markers of long-term outcome in primary total hip arthroplasty: A systematic review. Bone Joint Res 2016; 5:206-14. [PMID: 27267795 PMCID: PMC4921042 DOI: 10.1302/2046-3758.56.2000568] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2015] [Accepted: 03/23/2016] [Indexed: 12/24/2022] Open
Abstract
Objectives High failure rates of metal-on-metal hip arthroplasty implants have highlighted the need for more careful introduction and monitoring of new implants and for the evaluation of the safety of medical devices. The National Joint Registry and other regulatory services are unable to detect failing implants at an early enough stage. We aimed to identify validated surrogate markers of long-term outcome in patients undergoing primary total hip arthroplasty (THA). Methods We conducted a systematic review of studies evaluating surrogate markers for predicting long-term outcome in primary THA. Long-term outcome was defined as revision rate of an implant at ten years according to National Institute of Health and Care Excellence guidelines. We conducted a search of Medline and Embase (OVID) databases. Separate search strategies were devised for the Cochrane database and Google Scholar. Each search was performed to include articles from the date of their inception to June 8, 2015. Results Our search strategy identified 1082 studies of which 115 studies were included for full article review. Following review, 17 articles were found that investigated surrogate markers of long-term outcome. These included one systematic review, one randomised control trial (RCT), one case control study and 13 case series. Validated surrogate markers included Radiostereometric Analysis (RSA) and Einzel-Bild-Röntgen-Analyse (EBRA), each measuring implant migration and wear. We identified five RSA studies (one systematic review and four case series) and four EBRA studies (one RCT and three case series). Patient Reported Outcome Measures (PROMs) at six months have been investigated but have not been validated against long-term outcomes. Conclusions This systematic review identified two validated surrogate markers of long-term primary THA outcome: RSA and EBRA, each measuring implant migration and wear. We recommend the consideration of RSA in the pre-market testing of new implants. EBRA can be used to investigate acetabular wear but not femoral migration. Further studies are needed to validate the use of PROMs for post-market surveillance. Cite this article: T. T. Malak, J. A. J. Broomfield, A. J. R. Palmer, S. Hopewell, A. Carr, C. Brown, D. Prieto-Alhambra, S. Glyn-Jones. Surrogate markers of long-term outcome in primary total hip arthroplasty: A systematic review. Bone Joint Res 2016;5:206–214. DOI: 10.1302/2046-3758.56.2000568.
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Ostrowsky B, Ruiz R, Brown S, Chung P, Koppelman E, van Deusen Lukas C, Guo Y, Jalon H, Sumer Z, Araujo C, Sirtalan I, Brown C, Riska P, Currie B. Lessons learned from implementing Clostridium difficile-focused antibiotic stewardship interventions. Infect Control Hosp Epidemiol 2016; 35 Suppl 3:S86-95. [PMID: 25222903 DOI: 10.1086/677828] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVE To determine whether controlling the prescription of targeted antibiotics would translate to a measurable reduction in hospital-onset Clostridium difficile infection (CDI) rates. DESIGN A multicenter before-and-after intervention comparative study. SETTING/PARTICIPANTS Ten medical centers in the greater New York region. Intervention group comprised of 6 facilities with early antimicrobial stewardship programs (ASPs). The 4 facilities without ASPs made up the nonintervention group. INTERVENTIONS/METHODS Intervention facilities identified target antibiotics using case-control studies and implemented ASP-based strategies to control their use. Pre- and postintervention hospital-onset CDI rates and antibiotic consumption were compared for a 20-month period from June 2010 to January 2012. Antibiotic usage was compared using defined daily dose, days of therapy, and number of courses prescribed. Comparisons used bivariate and regression techniques. RESULTS Intervention facilities identified piperacillin/tazobactam, fluoroquinolones, or cefepime (odds ratio, 2.0-9.8 in CDI case patients compared with those without CDI) as intervention targets and selected several interventions (all included a component of audit and feedback). Varying degrees of success were observed in reducing antibiotic consumption over time. Total target antibiotic use significantly decreased (P < .05) when measured by days of therapy and number of courses but not by defined daily dose. Intravenous moxifloxacin and oral ciprofloxacin use showed significant reduction when measured by defined daily dose and days of therapy (P ≤ .01). Number of courses with all forms of these antibiotics was reduced (P < .005). Intervention hospitals reported fewer hospital-onset CDI cases (2.8 rate point difference) compared with nonintervention hospitals; however, we were unable to show statistically significant decreases in aggregate hospital-onset CDI either between intervention and nonintervention groups or within the intervention group over time. CONCLUSIONS Although decreases in target antibiotic consumption did not translate into reductions of hospital-onset CDI in this study, many valuable lessons (including implementation strategies and antibiotic consumption measures) were learned. The findings can inform potential policy decisions regarding incorporating control of CDI and ASP as healthcare quality measures.
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Brown C, Brown K, Jackson D, Jones B, Scale T, Ashcroft R, Brooks O, Mikhail A. SO038NEW NICE GUIDANCE: TESTS FOR IRON DEFICIENCY - FRIEND OR FOE? Nephrol Dial Transplant 2016. [DOI: 10.1093/ndt/gfw123.06] [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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Camus A, Brown C, Field C, McDermott A. Amyloid-like renal lesions in a roughtail stingray Dasyatis centroura (Mitchill 1815). JOURNAL OF FISH DISEASES 2016; 39:613-617. [PMID: 26111349 DOI: 10.1111/jfd.12397] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/13/2015] [Revised: 05/13/2015] [Accepted: 05/13/2015] [Indexed: 06/04/2023]
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Rappold T, Laflam A, Hori D, Brown C, Brandt J, Mintz CD, Sieber F, Gottschalk A, Yenokyan G, Everett A, Hogue CW. Evidence of an association between brain cellular injury and cognitive decline after non-cardiac surgery. Br J Anaesth 2016; 116:83-9. [PMID: 26675953 DOI: 10.1093/bja/aev415] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Postoperative cognitive dysfunction (POCD) is common after non-cardiac surgery, but the mechanism is unclear. We hypothesized that decrements in cognition 1 month after non-cardiac surgery would be associated with evidence of brain injury detected by elevation of plasma concentrations of S100β, neuron-specific enolase (NSE), and/or the brain-specific protein glial fibrillary acid protein (GFAP). METHODS One hundred and forty-nine patients undergoing shoulder surgery underwent neuropsychological testing before and then 1 month after surgery. Plasma was collected before and after anaesthesia. We determined the relationship between plasma biomarker concentrations and individual neuropsychological test results and a composite cognitive functioning score (mean Z-score). RESULTS POCD (≥-1.5 sd decrement in Z-score from baseline) was present in 10.1% of patients 1 month after surgery. There was a negative relationship between higher plasma GFAP concentrations and lower postoperative composite Z-scores {estimated slope=-0.14 [95% confidence interval (CI) -0.24 to -0.04], P=0.005} and change from baseline in postoperative scores on the Rey Complex Figure Test copy trial (P=0.021), delayed recall trial (P=0.010), and the Symbol Digit Modalities Test (P=0.004) after adjustment for age, sex, history of hypertension and diabetes. A similar relationship was not observed with S100β or NSE concentrations. CONCLUSIONS Decline in cognition 1 month after shoulder surgery is associated with brain cellular injury as demonstrated by elevated plasma GFAP concentrations.
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