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Chambers A, Emmott EH, Myers S, Page AE. Emotional and informational social support from health visitors and breastfeeding outcomes in the UK. Int Breastfeed J 2023; 18:14. [PMID: 36882844 PMCID: PMC9990566 DOI: 10.1186/s13006-023-00551-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Accepted: 02/11/2023] [Indexed: 03/09/2023] Open
Abstract
BACKGROUND Shorter breastfeeding duration is associated with detrimental consequences for infant health/development and maternal health. Previous studies suggest social support is essential in maintaining breast/chest-feeding and helping to improve general infant feeding experiences. Public health bodies therefore work to support breastfeeding in the UK, yet UK breastfeeding rates continue to be one of the lowest globally. With this, a better understanding of the effectiveness and quality of infant feeding support is required. In the UK, health visitors (community public health nurses specialising in working with families with a child aged 0-5 years) have been positioned as one of the key providers of breast/chest-feeding support. Research evidence suggests that both inadequate informational support and poor/negative emotional support can lead to poor breastfeeding experiences and early breastfeeding cessation. Thus, this study tests the hypothesis that emotional support from health visitors moderates the relationship between informational support and breastfeeding duration/infant feeding experience among UK mothers. METHODS We ran cox and binary logistic regression models on data from 565 UK mothers, collected as part of a 2017-2018 retrospective online survey on social support and infant feeding. RESULTS Informational support, compared to emotional support, was a less important predictor of both breastfeeding duration and experience. Supportive emotional support with unhelpful or absent informational support was associated with the lowest hazard of breastfeeding cessation before 3 months. Results for breastfeeding experience followed similar trends, where positive experience was associated with supportive emotional and unhelpful informational support. Negative experiences were less consistent; however, a higher probability of negative experience was found when both types of support were reported as unsupportive. CONCLUSIONS Our findings point to the importance of health visitors providing emotional support to bolster the continuation of breastfeeding and encourage a positive subjective experience of infant feeding. The emphasis of emotional support in our results encourages increased allocation of resources and training opportunities to ensure health visitors are able to provide enhanced emotional support. Lowering health visitors caseloads to allow for personalised care is just one actionable example that may improve breastfeeding outcomes in the UK.
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Affiliation(s)
- A Chambers
- Department of Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - E H Emmott
- UCL Anthropology, University College London, London, UK
| | - S Myers
- UCL Anthropology, University College London, London, UK.,BirthRites Independent Max Planck Research Group, Max Planck Institute for Evolutionary Anthropology, Leipzig, Germany
| | - A E Page
- Department of Population Health, London School of Hygiene and Tropical Medicine, London, UK.
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2
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Ueda Y, Zhao W, Ihara H, Imahori Y, Tsantili E, Wendakoon SK, Chambers A, Bai J. Functional Characteristics of Aldehyde Dehydrogenase and Its Involvement in Aromatic Volatile Biosynthesis in Postharvest Banana Ripening. Foods 2022; 11:foods11030347. [PMID: 35159498 PMCID: PMC8833912 DOI: 10.3390/foods11030347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Revised: 01/22/2022] [Accepted: 01/23/2022] [Indexed: 12/02/2022] Open
Abstract
Butanol vapor feeding to ripe banana pulp slices produced abundant butyl butanoate, indicating that a portion of butanol molecules was converted to butanoate/butanoyl-CoA via butanal, and further biosynthesized to ester. A similar phenomenon was observed when feeding propanol and pentanol, but was less pronounced when feeding hexanol, 2-methylpropanol and 3-methylbutanol. Enzymes which catalyze the cascade reactions, such as alcohol dehydrogenase (ADH), acetyl-CoA synthetase, and alcohol acetyl transferase, have been well documented. Aldehyde dehydrogenase (ALDH), which is presumed to play a key role in the pathway to convert aldehydes to carboxylic acids, has not been reported yet. The conversion is an oxygen-independent metabolic pathway and is enzyme-catalyzed with nicotinamide adenine dinucleotide (NAD+) as the cofactor. Crude ALDH was extracted from ripe banana pulps, and the interference from ADH was removed by two procedures: (1) washing off elutable proteins which contain 95% of ADH, but only about 40% of ALDH activity, with the remaining ALDH extracted from the pellet residues at the crude ALDH extraction stage; (2) adding an ADH inhibitor in the reaction mixture. The optimum pH of the ALDH was 8.8, and optimum phosphate buffer concentration was higher than 100 mM. High affinity of the enzyme was a straight chain of lower aldehydes except ethanal, while poor affinity was branched chain aldehydes.
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Affiliation(s)
- Yoshinori Ueda
- Center for Research and Development of Bioresources, Osaka Prefecture University, 1-1 Gakuen-cho, Nakaku, Sakai 599-8531, Osaka, Japan
| | - Wei Zhao
- U.S. Horticultural Research Laboratory, Agricultural Research Service, U.S. Department of Agriculture, 2001 S. Rock Rd., Ft Pierce, FL 34945, USA;
| | - Hideshi Ihara
- Department of Biological Science, Graduate School of Science, Osaka Prefecture University, 1-1 Gakuen-cho, Nakaku, Sakai 599-8531, Osaka, Japan;
| | - Yoshihiro Imahori
- Graduate School of Life and Environmental Science, Osaka Prefecture University, 1-1 Gakuen-cho, Nakaku, Sakai 599-8531, Osaka, Japan;
| | - Eleni Tsantili
- Laboratory of Pomology, Department of Crop Science, Agricultural University of Athens, Iera Odos 75, 118 55 Athens, Greece;
| | - Sumithra K. Wendakoon
- Department of Bioresource Science, Faculty of Agriculture, Ryukoku University, 1-5 Yokotani, Seta Oe-cho, Otsu 520-2194, Shiga, Japan;
| | - Alan Chambers
- Tropical Research and Education Center, University of Florida, 18905 SW 280th St., Homestead, FL 33031, USA;
| | - Jinhe Bai
- U.S. Horticultural Research Laboratory, Agricultural Research Service, U.S. Department of Agriculture, 2001 S. Rock Rd., Ft Pierce, FL 34945, USA;
- Correspondence: ; Tel.: +1-772-462-5880; Fax: +1-772-462-5986
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Cullen J, Chambers A, Smyth E, Mackey PL, Hunt L, Bamford R. 1277 A Closed-Loop Audit of the use of qFIT in Symptomatic “Two Week Wait” referrals in Somerset Foundation Trust. Br J Surg 2021. [DOI: 10.1093/bjs/znab259.425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Abstract
Introduction
Quantitative faecal immunochemical test (qFIT) is recommended as the replacement test for faecal occult blood testing by NICE. We audited qFIT use in two week-wait (2WW) referrals in Somerset Foundation Trust (SFT) following its introduction in 2019.
Method
Following qFIT being made available to general practitioners, all 2WW referrals received before (July 2019) and after (December 2019) the introduction of the new 2WW referral form were reviewed. Electronic patient records were analysed to determine investigations performed and if a diagnosis of cancer was made.
Results
July 2019: 288 2WW referrals with 74 patients eligible for qFIT – only 7 of these underwent qFIT; total of 93 qFIT performed by GPs with 11 positive tests. December 2019: 222 2WW referrals with 18 patients eligible for qFIT – all of whom underwent qFIT; total of 155 qFIT performed by GPs with 18 positive (and 137 negative) tests. 1 patient with a positive qFIT was found to have colorectal malignancy (qFIT = 267 g/dL, investigation showed benign TVA). An increase in qFIT was observed over time, coinciding with a reduction in 2WW referrals, including reduction in patients who were qFIT eligible. The 2WW service identified 11 (3.8%) cases of colorectal cancer in July 2019 compared to 12 (5.4%) cases in December 2019, showing an increased pickup rate.
Conclusions
High proportions of 2WW referrals undergo investigation. The results of this audit highlight the utility of qFIT in screening 2WW referrals and reducing burden on the service, particularly where access to investigations is severely restricted due to coronavirus.
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Affiliation(s)
- J Cullen
- Southmead Hospital, Bristol, United Kingdom
| | - A Chambers
- Musgrove Park Hospital, Taunton, United Kingdom
| | - E Smyth
- Musgrove Park Hospital, Taunton, United Kingdom
| | - P l Mackey
- Musgrove Park Hospital, Taunton, United Kingdom
| | - L Hunt
- Musgrove Park Hospital, Taunton, United Kingdom
| | - R Bamford
- Musgrove Park Hospital, Taunton, United Kingdom
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4
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Mantelakis A, Spiers H, Lee CW, Chambers A, Joshi A. 70 Availability of Personal Protective Equipment in NHS Hospitals During COVID-19: A National Survey. Br J Surg 2021. [DOI: 10.1093/bjs/znab259.437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Abstract
Introduction
The continuous supply of personal protective equipment (PPE) in the National Health Service (NHS) is paramount in order to sustain a safe level of staffing and to reduce transmission of COVID-19 to patients, public and staff.
Method
A 16-question survey was created to assess the availability and personal thoughts of healthcare professionals regarding PPE supply in England. The survey was distributed via social media (Facebook © and Twitter ©) to all UK COVID-19 healthcare professional groups, with responses collected over 3 weeks in March 2020 during the beginning of the pandemic.
Results
A total of 121 responses from physicians in 35 different hospitals were collected (105 inpatient wards, 16 from intensive care units). In inpatient wards, eye and face protection were unavailable to 19.1% of respondents. Masks were available to 97.7% of respondents and gloves in all respondents (100%). Body protection was available primarily as a plastic apron (83.8%). All of respondents working in intensive care had access to full-body PPE, except FFP3 respirator masks (available in 87.5%). PPE is ‘Always’ available for 29.8% of all respondents, and ‘Never’ or ‘Almost Never’ in 11.6%. There was a statistically significant difference between London and non-London responders that ‘Always’ had PPE available (43.9% versus 19.0%, p = 0.003).
Conclusions
This is the first survey to evaluate PPE supply in England during the COVID-19 pandemic. Our survey demonstrated an overall lack of PPE volume supply in the UK, with preferential distribution in London. Eye and full body protection are in most lack of supply.
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Affiliation(s)
- A Mantelakis
- Guys and St Thomas's NHS Foundation Trust, London, United Kingdom
| | - H Spiers
- Addinbrookes NHS Foundation Trust, Cambridge, United Kingdom
| | - C W Lee
- Newcastle Upon Thyne Hospitals NHS Foundation Trust, Newcastle, United Kingdom
| | - A Chambers
- University College Hospital NHS Foundation Trust, London, United Kingdom
| | - A Joshi
- Lewisham and Greenwich NHS Foundation Trust, London, United Kingdom
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5
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Chambers A, Cibrián-Jaramillo A, Karremans AP, Moreno Martinez D, Hernandez-Hernandez J, Brym M, Resende MFR, Moloney R, Sierra SN, Hasing T, Alomia YA, Hu Y. Genotyping-By-Sequencing diversity analysis of international Vanilla collections uncovers hidden diversity and enables plant improvement. Plant Sci 2021; 311:111019. [PMID: 34482920 DOI: 10.1016/j.plantsci.2021.111019] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Revised: 08/04/2021] [Accepted: 08/07/2021] [Indexed: 06/13/2023]
Abstract
Genomics-based diversity analysis of natural vanilla populations is important in order to guide conservation efforts and genetic improvement through plant breeding. Vanilla is a cultivated, undomesticated spice that originated in Mesoamerica prior to spreading globally through vegetative cuttings. Vanilla extract from the commercial species, mainly V. planifolia and V. × tahitensis, is used around the world as an ingredient in foods, beverages, cosmetics, and pharmaceuticals. The global reliance on descendants of a few foundational clones in commercial production has resulted in an industry at heightened risk of catastrophic failure due to extremely narrow genetic diversity. Conversely, national and institutional collections including those near the center of cultivation contain previously undiscovered diversity that could bolster the genetic improvement of vanilla and guide conservation efforts. Towards this goal, an international vanilla genotyping effort generated and analyzed 431,204 single nucleotide polymorphisms among 412 accessions and 27 species from eight collections. Phylogenetic and STRUCTURE analysis sorted vanilla by species and identified hybrid accessions. Principal Component Analysis and the Fixation Index (FST) were used to refine relationships among accessions and showed differentiation among species. Analysis of the commercial species split V. planifolia into three types with all V. × tahitensis accessions being most similar to V. planifolia type 2. Finally, an in-depth analysis of V. × tahitensis identified seven V. planifolia and six V. odorata accessions as most similar to the estimated parental genotypes providing additional data in support of the current hybrid theory. The prevalence of probable V. × tahitensis parental accessions from Belize suggests that V. × tahitensis could have originated from this area and highlights the need for vanilla conservation throughout Central and South America. The genetic groupings among accessions, particularly for V. planifolia, can now be used to focus breeding efforts on fewer accessions that capture the greatest diversity.
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Affiliation(s)
- Alan Chambers
- Tropical Research and Education Center, Horticultural Sciences Department, University of Florida, 18905 SW 280th St, Homestead, FL, 33033, USA.
| | - Angélica Cibrián-Jaramillo
- Ecological and Evolutionary Genomics Laboratory, Unidad de Genómica Avanzada (Langebio), CINVESTAV, Km 9.6 Carretera Irapuato-León, Guanajuato, CP 36824, Mexico.
| | - Adam P Karremans
- Lankester Botanical Garden, University of Costa Rica, P.O. Box 302-7050, Cartago, Costa Rica; Naturalis Biodiversity Center, Endless Forms Group, Sylviusweg 72, Leiden, 2333 BE, the Netherlands.
| | - David Moreno Martinez
- Posgrado en Ecología Tropical, Centro de Investigaciones Tropicales, Universidad Veracruzana, José María Morelos 44, Zona Centro, CP 91000, Xalapa, Veracruz, Mexico.
| | - Juan Hernandez-Hernandez
- Campo Experimental Ixtacuaco, Instituto Nacional de Investigaciones Forestales, Agrícolas y Pecuarias (INIFAP), Km 4.5 Carretera Martínez de la Torre-Tlapacoyan, Veracruz, CP 93600, Mexico.
| | - Maria Brym
- Tropical Research and Education Center, Horticultural Sciences Department, University of Florida, 18905 SW 280th St, Homestead, FL, 33033, USA.
| | - Marcio F R Resende
- Horticultural Sciences Department, University of Florida, Gainesville, FL, USA.
| | - Ruth Moloney
- Corridgeree Belize Ltd, Mile 6, Southern Highway, Silk Grass, Stann Creek District, Belize.
| | - Sheryl N Sierra
- College of Agriculture, Food, Environment and Natural Resources, Cavite State University, Indang, Cavite, 4122, Philippines.
| | | | - Yasmin A Alomia
- Department of Biological Sciences, Faculty of Sciences, Universidad de Los Andes, Cra. 1 Nº 18A - 12, Bogotá, Colombia.
| | - Ying Hu
- Horticultural Sciences Department, University of Florida, Gainesville, FL, USA.
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6
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Wang Z, Li J, Chambers A, Crane J, Wang Y. Rapid Structure-Based Annotation and Profiling of Dihydrochalcones in Star Fruit ( Averrhoa carambola) Using UHPLC/Q-Orbitrap-MS and Molecular Networking. J Agric Food Chem 2021; 69:555-567. [PMID: 33356228 DOI: 10.1021/acs.jafc.0c07362] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Dihydrochalcones are a subclass of flavonoids. There has been growing interest in dihydrochalcones for their health benefits and potential to modulate flavor, but their comprehensive profile in diverse plant species is lacking. Star fruit is a tropical fruit rich in dihydrochalcones. In this study, a systematic annotation using UHPLC/Q-Orbitrap-MS and molecular networking was established to rapidly identify dihydrochalcones in 12 star fruit cultivars. A total of 53 dihydrochalcones were characterized within a short retention time including one novel compound (phloretin-3'-C-(2-O-trans-p-coumaroyl)-β-d-fucopyranoside) and 23 compounds identified from the Averrhoa genus for the first time. 3-Hydroxyphloretin was the most abundant dihydrochalcone in star fruit. All the identified dihydrochalcones had a higher abundance in leaves compared to fruits. This is the first report that systematically investigates dihydrochalcones in star fruit of multiple cultivars, and the results could provide a useful reference for the future development and utilization of plant genetic resources.
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Affiliation(s)
- Zhixin Wang
- Citrus Research & Education Center, Institute of Food and Agricultural Sciences, University of Florida, 700 Experiment Station Road, Lake Alfred, Florida 33850, United States
| | - Jingwen Li
- Citrus Research & Education Center, Institute of Food and Agricultural Sciences, University of Florida, 700 Experiment Station Road, Lake Alfred, Florida 33850, United States
| | - Alan Chambers
- Tropical Research and Education Center, Institute of Food and Agricultural Sciences, University of Florida, 18905 SW 280 Street, Homestead, Florida 33031, United States
| | - Jonathan Crane
- Tropical Research and Education Center, Institute of Food and Agricultural Sciences, University of Florida, 18905 SW 280 Street, Homestead, Florida 33031, United States
| | - Yu Wang
- Citrus Research & Education Center, Institute of Food and Agricultural Sciences, University of Florida, 700 Experiment Station Road, Lake Alfred, Florida 33850, United States
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7
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Bottomley D, Scarsbrook A, Teoh E, Payne H, Afaq A, Bomanji J, van As N, Chua S, Hoskin P, Chambers A, Cook G, Chau A, Miller M, Gleeson F. Impact of Positron Emission Tomography (PET) with 18F-Fluciclovine on Management of Patients with Recurrence of Prostate Cancer: Results from the Falcon Trial. Int J Radiat Oncol Biol Phys 2019. [DOI: 10.1016/j.ijrobp.2019.06.128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Chambers A, Blane C, Vallance A, Al-Allak A. Neoadjuvant chemotherapy for breast cancer: 8 years experience. Eur J Surg Oncol 2019. [DOI: 10.1016/j.ejso.2018.10.333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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9
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Blane C, Chambers A, Vallence A, Massey E, Hunt R, Court F, Vestey S, Fowler C, Allak AA. A single centre experience with breast cancer patients aged over 80 years; what factors affect treatment options and what are the long-term outcomes? Eur J Surg Oncol 2019. [DOI: 10.1016/j.ejso.2018.10.335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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10
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Chambers A, Blane C, Al-Allak A. Primary hormonal therapy for breast cancer in patients aged over 80 years: single unit outcomes. Eur J Surg Oncol 2019. [DOI: 10.1016/j.ejso.2018.10.332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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11
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Andersen SK, Penner N, Chambers A, Trudeau ME, Chan KKW, Cheung MC. Conditional approval of cancer drugs in Canada: accountability and impact on public funding. ACTA ACUST UNITED AC 2019; 26:e100-e105. [PMID: 30853815 DOI: 10.3747/co.26.4397] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background We examined how conditional market approval of cancer pharmaceuticals by Health Canada (hc) affects public funding recommendations by the pan-Canadian Oncology Review (pcodr). We were also interested to see how often hc conditions are enforced. Methods Health Canada and pcodr databases for 2010-2017 were analyzed for patterns in hc conditional authorization and post-authorization reviews of cancer drugs and for correlation with pcodr reimbursement recommendations. Results Between 2010 and 2017, pcodr reviewed 105 unique drug-indication pairings; 21% (n = 22) had conditional hc authorization. In all cases, conditional authorization was given on the basis of preliminary data in a surrogate endpoint and was contingent on further data showing benefit in more robust outcome measures (for example, overall survival). Of those 22 drugs, 36% did not have updated data, 36% had updated data that met hc conditions, and 27% had data that met some, but not all, conditions. During the period considered, hc never revoked conditional authorization for failure to meet conditions. None of the 22 drugs was given an unconditional positive recommendation for public reimbursement by pcodr. A conditional recommendation was given to 11 of the drugs (50%), and reimbursement was not recommended for 6 drugs (27%) because of insufficient evidence. Conclusions One fifth of the cancer drugs reviewed for public reimbursement in Canada were conditionally authorized by hc based on preliminary data. Conditional authorization was associated with a recommendation against public funding by pcodr. No drugs had their conditional market authorization revoked for failure to meet conditions, suggesting that a more robust hc reappraisal framework is needed.
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Affiliation(s)
- S K Andersen
- Department of Medicine, University of Toronto, Toronto, ON
| | - N Penner
- pan-Canadian Oncology Drug Review, Canadian Agency for Drugs and Technologies in Health, Ottawa, ON
| | - A Chambers
- pan-Canadian Oncology Drug Review, Canadian Agency for Drugs and Technologies in Health, Ottawa, ON
| | - M E Trudeau
- Canadian Centre for Applied Research in Cancer Control, Toronto, ON.,Department of Medicine, University of Toronto, Toronto, ON.,Division of Hematology and Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, ON
| | - K K W Chan
- Department of Medicine, University of Toronto, Toronto, ON.,pan-Canadian Oncology Drug Review, Canadian Agency for Drugs and Technologies in Health, Ottawa, ON.,Division of Hematology and Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, ON
| | - M C Cheung
- Department of Medicine, University of Toronto, Toronto, ON.,Division of Hematology and Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, ON
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12
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Chambers A, Al-Allak A, Lyburn I. Imaging in neoadjuvant breast cancer treatment: single centre experience. Eur J Surg Oncol 2019. [DOI: 10.1016/j.ejso.2018.10.345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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13
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Batool I, Chambers A. Re: Radiology-led Lung cancer escalation pathway: a streamlined innovative service. Clin Radiol 2018; 73:981. [PMID: 30237065 DOI: 10.1016/j.crad.2018.07.108] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2018] [Accepted: 07/24/2018] [Indexed: 11/25/2022]
Affiliation(s)
- I Batool
- London North West University Healthcare NHS Trust, London, UK.
| | - A Chambers
- London North West University Healthcare NHS Trust, London, UK
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14
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Lam J, Kim Y, Cecchi F, Woo S, Chambers A, Tan I, Ling CCW, Si-Lin K, Qiang LW, Hon TLK, Jacobsen SAM, Hembrough T. The prognostic role of microsatellite status, tumor mutational burden and protein expression in CRC. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy149.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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15
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Binzel K, Adelaja A, Wright CL, Scharre D, Zhang J, Knopp MV, Teoh EJ, Bottomley D, Scarsbrook A, Payne H, Afaq A, Bomanji J, van As N, Chua S, Hoskin P, Chambers A, Cook GJ, Warbey VS, Chau A, Ward P, Miller MP, Stevens DJ, Wilson L, Gleeson FV, Scheidhauer K, Seidl C, Autenrieth M, Bruchertseifer F, Apostolidis C, Kurtz F, Horn T, Pfob C, Schwaiger M, Gschwend J, D'Alessandria C, Morgenstern A, Uprimny C, Kroiss A, Decristoforo C, von Guggenberg E, Nilica B, Horninger W, Virgolini I, Rasul S, Poetsch N, Woehrer A, Preusser M, Mitterhauser M, Wadsak W, Widhalm G, Mischkulnig M, Hacker M, Traub-Weidinger T, Wright CL, Binzel K, Wuthrick EJ, Miller ED, Maniawski P, Zhang J, Knopp MV, Rep S, Hocevar M, Vaupotic J, Zdesar U, Zaletel K, Lezaic L, Mairinger S, Filip T, Sauberer M, Flunkert S, Wanek T, Stanek J, Okamura N, Langer O, Kuntner C, Fornito MC, Balzano R, Di Martino V, Cacciaguerra S, Russo G, Seifert D, Kleinova M, Cepa A, Ralis J, Hanc P, Lebeda O, Mosa M, Vandenberghe S, Mikhaylova E, Borys D, Viswanath V, Stockhoff M, Efthimiou N, Caribe P, Van Holen R, Karp JS, Binzel K, Zhang J, Wright CL, Maniawski P, Knopp MV, Haller PM, Farhan C, Piackova E, Jäger B, Knoll P, Kiss A, Podesser BK, Wojta J, Huber K, Mirzaei S, Traxl A, Komposch K, Glitzner E, Wanek T, Mairinger S, Sibilia M, Langer O, Fornito MC, Russello M, Russo G, Balzano R, Sorko S, Gallowitsch HJ, Kohlfuerst S, Matschnig S, Rieser M, Sorschag M, Lind P, Ležaič L, Rep S, Žibert J, Frelih N, Šuštar S, Binzel K, Adelaja A, Wright CL, Scharre D, Zhang J, Knopp MV, Baum RP, Langbein T, Singh A, Shahinfar M, Schuchardt C, Volk GF, Kulkarni HR, Fornito MC, Cacciaguerra S, Balzano R, Di Martino GV, Russo G, Thomson WH, Kudlacek M, Karik M, Farhan C, Rieger H, Pokieser W, Glaser K, Mirzaei S, Petz V, Tugendsam C, Buchinger W, Schmoll-Hauer B, Schenk IP, Rudolph K, Krebs M, Zettinig G, Zoufal V, Wanek T, Krohn M, Mairinger S, Stanek J, Sauberer M, Filip T, Pahnke J, Langer O, Weitzer F, Pernthaler B, Salamon S, Aigner R, Koranda P, Henzlová L, Kamínek M, Váchalová M, Bachleda P, Summer D, Garousi J, Oroujeni M, Mitran B, Andersson KG, Vorobyeva A, Löfblom JN, Orlova A, Tolmachev V, Decristoforo C, Kaeopookum P, Summer D, Orasch T, Lechner B, Petrik M, Novy Z, Rangger C, Haas H, Decristoforo C. Abstracts of the 33rd International Austrian Winter Symposium : Zell am See, Austria. 24-27 January 2018. EJNMMI Res 2018; 8:5. [PMID: 29362999 PMCID: PMC5780335 DOI: 10.1186/s13550-017-0354-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Affiliation(s)
- K Binzel
- Wright Center of Innovation in Biomedical Imaging, Department of Radiology, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - A Adelaja
- Wright Center of Innovation in Biomedical Imaging, Department of Radiology, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - C L Wright
- Wright Center of Innovation in Biomedical Imaging, Department of Radiology, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - D Scharre
- Department of Neurology, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - J Zhang
- Wright Center of Innovation in Biomedical Imaging, Department of Radiology, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - M V Knopp
- Wright Center of Innovation in Biomedical Imaging, Department of Radiology, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - E J Teoh
- Departments of Radiology and Nuclear Medicine, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - D Bottomley
- The Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - A Scarsbrook
- The Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - H Payne
- University College London, London, UK
| | - A Afaq
- University College London, London, UK
| | - J Bomanji
- University College London, London, UK
| | - N van As
- The Royal Marsden NHS Foundation Trust, London, UK
| | - S Chua
- The Royal Marsden NHS Foundation Trust, London, UK
| | - P Hoskin
- Mount Vernon Cancer Centre, London, UK
| | | | - G J Cook
- King's College London, London, UK
| | | | - A Chau
- Blue Earth Diagnostics, Oxford, UK
| | - P Ward
- Blue Earth Diagnostics, Oxford, UK
| | | | | | - L Wilson
- Blue Earth Diagnostics, Oxford, UK
| | - F V Gleeson
- Departments of Radiology and Nuclear Medicine, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - K Scheidhauer
- TU München, Klinikum rechts der Isar, Nuklearmedizin, München, Germany
| | - C Seidl
- TU München, Klinikum rechts der Isar, Nuklearmedizin, München, Germany
| | - M Autenrieth
- TU München, Klinikum rechts der Isar, Urologie, München, Germany
| | | | | | - F Kurtz
- TU München, Klinikum rechts der Isar, Urologie, München, Germany
| | - T Horn
- TU München, Klinikum rechts der Isar, Urologie, München, Germany
| | - C Pfob
- TU München, Klinikum rechts der Isar, Nuklearmedizin, München, Germany
| | - M Schwaiger
- TU München, Klinikum rechts der Isar, Nuklearmedizin, München, Germany
| | - J Gschwend
- TU München, Klinikum rechts der Isar, Urologie, München, Germany
| | - C D'Alessandria
- TU München, Klinikum rechts der Isar, Nuklearmedizin, München, Germany
| | | | - C Uprimny
- Department of Nuclear Medicine, Medical University Innsbruck, Anichstrasse 32, 6020, Innsbruck, Austria
| | - A Kroiss
- Department of Nuclear Medicine, Medical University Innsbruck, Anichstrasse 32, 6020, Innsbruck, Austria
| | - C Decristoforo
- Department of Nuclear Medicine, Medical University Innsbruck, Anichstrasse 32, 6020, Innsbruck, Austria
| | - E von Guggenberg
- Department of Nuclear Medicine, Medical University Innsbruck, Anichstrasse 32, 6020, Innsbruck, Austria
| | - B Nilica
- Department of Nuclear Medicine, Medical University Innsbruck, Anichstrasse 32, 6020, Innsbruck, Austria
| | - W Horninger
- Department of Nuclear Medicine, Medical University Innsbruck, Anichstrasse 32, 6020, Innsbruck, Austria
| | - I Virgolini
- Department of Nuclear Medicine, Medical University Innsbruck, Anichstrasse 32, 6020, Innsbruck, Austria
| | - S Rasul
- Department of Biomedical Imaging and Image-guided Therapy, Division of Nuclear Medicine, Medical University of Vienna, Vienna, Austria
| | - N Poetsch
- Department of Biomedical Imaging and Image-guided Therapy, Division of Nuclear Medicine, Medical University of Vienna, Vienna, Austria
| | - A Woehrer
- Clinical Institute of Neurology, Medical University of Vienna, Vienna, Austria
| | - M Preusser
- Clinical University of Internal Medicine I, Medical University of Vienna, Vienna, Austria
| | - M Mitterhauser
- Department of Biomedical Imaging and Image-guided Therapy, Division of Nuclear Medicine, Medical University of Vienna, Vienna, Austria
| | - W Wadsak
- Department of Biomedical Imaging and Image-guided Therapy, Division of Nuclear Medicine, Medical University of Vienna, Vienna, Austria
- CBmed GmbH, Center for Biomarker Research in Medicine, Graz, Austria
| | - G Widhalm
- Clinical University of Neuro-surgery, Medical University of Vienna, Vienna, Austria
| | - M Mischkulnig
- Clinical University of Neuro-surgery, Medical University of Vienna, Vienna, Austria
| | - M Hacker
- Department of Biomedical Imaging and Image-guided Therapy, Division of Nuclear Medicine, Medical University of Vienna, Vienna, Austria
| | - T Traub-Weidinger
- Department of Biomedical Imaging and Image-guided Therapy, Division of Nuclear Medicine, Medical University of Vienna, Vienna, Austria
| | - C L Wright
- Wright Center of Innovation, The Ohio State University, Columbus, OH, USA
| | - K Binzel
- Wright Center of Innovation, The Ohio State University, Columbus, OH, USA
| | - E J Wuthrick
- Radiation Oncology, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - E D Miller
- Radiation Oncology, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - P Maniawski
- Clinical Science, Philips Healthcare, Cleveland, OH, USA
| | - J Zhang
- Wright Center of Innovation, The Ohio State University, Columbus, OH, USA
| | - M V Knopp
- Wright Center of Innovation, The Ohio State University, Columbus, OH, USA
| | - Sebastijan Rep
- Department of Nuclear Medicine, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - Marko Hocevar
- Department of Oncological Surgery, Oncology Institute Ljubljana, Ljubljana, Slovenia
| | | | - Urban Zdesar
- Institute of Occupational Safety Ljubljana, Ljubljana, Slovenia
| | - Katja Zaletel
- Department of Nuclear Medicine, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - Luka Lezaic
- Department of Nuclear Medicine, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - S Mairinger
- Biomedical Systems, Center for Health & Bioresources, AIT Austrian Institute of Technology GmbH, Seibersdorf, Austria
| | - Thomas Filip
- Biomedical Systems, Center for Health & Bioresources, AIT Austrian Institute of Technology GmbH, Seibersdorf, Austria
| | - M Sauberer
- Biomedical Systems, Center for Health & Bioresources, AIT Austrian Institute of Technology GmbH, Seibersdorf, Austria
| | - S Flunkert
- Neuropharmacology, QPS Austria GmbH, Grambach, Austria
| | - T Wanek
- Biomedical Systems, Center for Health & Bioresources, AIT Austrian Institute of Technology GmbH, Seibersdorf, Austria
| | - J Stanek
- Biomedical Systems, Center for Health & Bioresources, AIT Austrian Institute of Technology GmbH, Seibersdorf, Austria
- Department of Clinical Pharmacology, Medical University of Vienna, Vienna, Austria
| | - N Okamura
- Division of Pharmacology, Faculty of Medicine, Tohoku Medical and Pharmaceutical University, Sendai, Japan
| | - O Langer
- Biomedical Systems, Center for Health & Bioresources, AIT Austrian Institute of Technology GmbH, Seibersdorf, Austria
- Department of Clinical Pharmacology, Medical University of Vienna, Vienna, Austria
| | - C Kuntner
- Biomedical Systems, Center for Health & Bioresources, AIT Austrian Institute of Technology GmbH, Seibersdorf, Austria
| | - M C Fornito
- Nuclear Medicine Department PET/TC center Arnas Garibaldi Catania, Catania, Italy
| | - R Balzano
- Nuclear Medicine Department PET/TC center Arnas Garibaldi Catania, Catania, Italy
| | - V Di Martino
- Nuclear Medicine Department PET/TC center Arnas Garibaldi Catania, Catania, Italy
| | - S Cacciaguerra
- Pediatric Surgery Department Arnas Garibaldi Catania, Catania, Italy
| | - G Russo
- H. Pharmacy Department Arnas Garibaldi Catania, Catania, Italy
| | - D Seifert
- Nuclear Physics Institute of the CAS, Rez, Czech Republic
| | - M Kleinova
- Nuclear Physics Institute of the CAS, Rez, Czech Republic
| | - A Cepa
- Nuclear Physics Institute of the CAS, Rez, Czech Republic
| | - J Ralis
- Nuclear Physics Institute of the CAS, Rez, Czech Republic
| | - P Hanc
- Nuclear Physics Institute of the CAS, Rez, Czech Republic
| | - O Lebeda
- Nuclear Physics Institute of the CAS, Rez, Czech Republic
| | - M Mosa
- Charles university Faculty of Science Prague, Prague, Czech Republic
| | - S Vandenberghe
- MEDISIP research group, Ghent University, Ghent, Belgium
| | | | - D Borys
- Silesian University of Technology Gliwice, Gliwice, Poland
| | - V Viswanath
- PET instrumentation group, Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - M Stockhoff
- MEDISIP research group, Ghent University, Ghent, Belgium
| | - N Efthimiou
- MEDISIP research group, Ghent University, Ghent, Belgium
| | - P Caribe
- MEDISIP research group, Ghent University, Ghent, Belgium
| | - R Van Holen
- MEDISIP research group, Ghent University, Ghent, Belgium
| | - J S Karp
- PET instrumentation group, Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - K Binzel
- Wright Center of Innovation in Biomedical Imaging, Department of Radiology, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
| | - J Zhang
- Wright Center of Innovation in Biomedical Imaging, Department of Radiology, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
| | - C L Wright
- Wright Center of Innovation in Biomedical Imaging, Department of Radiology, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
| | | | - M V Knopp
- Wright Center of Innovation in Biomedical Imaging, Department of Radiology, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
| | - P M Haller
- 3rd Department of Medicine, Cardiology and Intensive Care Medicine, Chest Pain Unit, Wilhelminenhospital Vienna, Vienna, Austria
- Ludwig Boltzmann Cluster for Cardiovascular Research, Vienna, Austria
| | - C Farhan
- Department of Nuclear Medicine with PET-Center, Wilhelminenhospital, Vienna, Austria
| | - E Piackova
- 3rd Department of Medicine, Cardiology and Intensive Care Medicine, Chest Pain Unit, Wilhelminenhospital Vienna, Vienna, Austria
- Ludwig Boltzmann Cluster for Cardiovascular Research, Vienna, Austria
| | - B Jäger
- 3rd Department of Medicine, Cardiology and Intensive Care Medicine, Chest Pain Unit, Wilhelminenhospital Vienna, Vienna, Austria
- Ludwig Boltzmann Cluster for Cardiovascular Research, Vienna, Austria
- Department of Internal Medicine II, Division of Cardiology, Medical University of Vienna, Vienna, Austria
| | - P Knoll
- Department of Nuclear Medicine with PET-Center, Wilhelminenhospital, Vienna, Austria
| | - A Kiss
- Department of Biomedical Research, Medical University of Vienna, Vienna, Austria
| | - B K Podesser
- Ludwig Boltzmann Cluster for Cardiovascular Research, Vienna, Austria
- Department of Biomedical Research, Medical University of Vienna, Vienna, Austria
| | - J Wojta
- Ludwig Boltzmann Cluster for Cardiovascular Research, Vienna, Austria
- Department of Internal Medicine II, Division of Cardiology, Medical University of Vienna, Vienna, Austria
| | - K Huber
- 3rd Department of Medicine, Cardiology and Intensive Care Medicine, Chest Pain Unit, Wilhelminenhospital Vienna, Vienna, Austria
- Ludwig Boltzmann Cluster for Cardiovascular Research, Vienna, Austria
- Sigmund Freud University, Medical Faculty, Vienna, Austria
| | - S Mirzaei
- Department of Nuclear Medicine with PET-Center, Wilhelminenhospital, Vienna, Austria
| | - A Traxl
- Center for Health & Bioresources, Biomedical Systems, AIT Austrian Institute of Technology GmbH, Seibersdorf, Austria
| | - K Komposch
- Institute of Cancer Research, Department of Medicine I, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria
| | - Elisabeth Glitzner
- Institute of Cancer Research, Department of Medicine I, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria
| | - T Wanek
- Center for Health & Bioresources, Biomedical Systems, AIT Austrian Institute of Technology GmbH, Seibersdorf, Austria
| | - S Mairinger
- Center for Health & Bioresources, Biomedical Systems, AIT Austrian Institute of Technology GmbH, Seibersdorf, Austria
| | - M Sibilia
- Institute of Cancer Research, Department of Medicine I, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria
| | - O Langer
- Center for Health & Bioresources, Biomedical Systems, AIT Austrian Institute of Technology GmbH, Seibersdorf, Austria
- Department of Clinical Pharmacology, Medical University of Vienna, Vienna, Austria
- Department of Biomedical Imaging and Image-Guided Therapy, Division of Nuclear Medicine, Medical University of Vienna, Vienna, Austria
| | - M C Fornito
- Nuclear Medicine Department PET/TC Center ARNAS Garibaldi, Catania, Italy
| | - M Russello
- Liver Unit ARNAS Garibaldi, Catania, Italy
| | - G Russo
- H.Pharmacy Department ARNAS Garibaldi, Catania, Italy
| | - R Balzano
- Nuclear Medicine Department PET/TC Center ARNAS Garibaldi, Catania, Italy
| | - S Sorko
- Department of Nuclear Medicine and Endocrinology, PET/CT Center, Klinikum Klagenfurt, Klagenfurt, Austria
| | - H J Gallowitsch
- Department of Nuclear Medicine and Endocrinology, PET/CT Center, Klinikum Klagenfurt, Klagenfurt, Austria
| | - S Kohlfuerst
- Department of Nuclear Medicine and Endocrinology, PET/CT Center, Klinikum Klagenfurt, Klagenfurt, Austria
| | - S Matschnig
- Department of Nuclear Medicine and Endocrinology, PET/CT Center, Klinikum Klagenfurt, Klagenfurt, Austria
| | - M Rieser
- Department of Nuclear Medicine and Endocrinology, PET/CT Center, Klinikum Klagenfurt, Klagenfurt, Austria
| | - M Sorschag
- Department of Nuclear Medicine and Endocrinology, PET/CT Center, Klinikum Klagenfurt, Klagenfurt, Austria
| | - P Lind
- Department of Nuclear Medicine and Endocrinology, PET/CT Center, Klinikum Klagenfurt, Klagenfurt, Austria
| | - L Ležaič
- Departments of Nuclear Medicine, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - S Rep
- Departments of Nuclear Medicine, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - J Žibert
- Faculty of Health Sciences, University of Ljubljana, Ljubljana, Slovenia
| | - N Frelih
- Departments of Nuclear Medicine, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - S Šuštar
- Departments of Nuclear Medicine, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - K Binzel
- Wright Center of Innovation in Biomedical Imaging, Department of Radiology, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - A Adelaja
- Wright Center of Innovation in Biomedical Imaging, Department of Radiology, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - C L Wright
- Wright Center of Innovation in Biomedical Imaging, Department of Radiology, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - D Scharre
- Department of Neurology, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - J Zhang
- Wright Center of Innovation in Biomedical Imaging, Department of Radiology, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - M V Knopp
- Wright Center of Innovation in Biomedical Imaging, Department of Radiology, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - R P Baum
- Theranostics Center for Molecular Radiotherapy and Molecular ImagZentralklinik Bad Berka, Bad Berka, Germany
| | - T Langbein
- Theranostics Center for Molecular Radiotherapy and Molecular ImagZentralklinik Bad Berka, Bad Berka, Germany
| | - A Singh
- Theranostics Center for Molecular Radiotherapy and Molecular ImagZentralklinik Bad Berka, Bad Berka, Germany
| | - M Shahinfar
- Theranostics Center for Molecular Radiotherapy and Molecular ImagZentralklinik Bad Berka, Bad Berka, Germany
| | - C Schuchardt
- Theranostics Center for Molecular Radiotherapy and Molecular ImagZentralklinik Bad Berka, Bad Berka, Germany
| | - G F Volk
- Department of Otorhinolaryngology, Jena University Hospital, Jena, Germany
| | - H R Kulkarni
- Theranostics Center for Molecular Radiotherapy and Molecular ImagZentralklinik Bad Berka, Bad Berka, Germany
| | - M C Fornito
- Nuclear Medicine Department Arnas Garibaldi, Catania, Italy
| | | | - R Balzano
- Nuclear Medicine Department Arnas Garibaldi, Catania, Italy
| | - G V Di Martino
- Department of Otorhinolaryngology, Jena University Hospital, Jena, Germany
| | - G Russo
- Pharmacy H. Department Arnas Garibaldi, Catania, Italy
| | - W H Thomson
- Physics and Nuclear Medicine, City Hospital, Birmingham, UK
| | - M Kudlacek
- Institute of Nuclear Medicine with PET-Center, Wilhelminenspital, Vienna, Austria
| | - M Karik
- Department of Viceral and General Surgery, Wilhelminenspital, Vienna, Austria
| | - C Farhan
- Institute of Nuclear Medicine with PET-Center, Wilhelminenspital, Vienna, Austria
| | - H Rieger
- Institute of Pathology and Microbiology, Wilhelminenspital, Vienna, Austria
| | - W Pokieser
- Institute of Pathology and Microbiology, Wilhelminenspital, Vienna, Austria
| | - K Glaser
- Department of Viceral and General Surgery, Wilhelminenspital, Vienna, Austria
| | - S Mirzaei
- Institute of Nuclear Medicine with PET-Center, Wilhelminenspital, Vienna, Austria
| | - V Petz
- Schilddruesenpraxis Josefstadt, Vienna, Austria
| | - C Tugendsam
- Schilddruesenpraxis Josefstadt, Vienna, Austria
| | - W Buchinger
- Schilddrueseninstitut Gleisdorf, Gleisdorf, Austria
| | - B Schmoll-Hauer
- Schilddruesenpraxis Josefstadt, Vienna, Austria
- Department of Nuclear Medicine, Krankenanstalt Rudolfstiftung, Vienna, Austria
| | - I P Schenk
- Schilddruesenpraxis Josefstadt, Vienna, Austria
- Department of Nuclear Medicine, Sozialmedizinisches Zentrum Hietzing, Vienna, Austria
| | - K Rudolph
- Schilddruesenpraxis Josefstadt, Vienna, Austria
| | - M Krebs
- Schilddruesenpraxis Josefstadt, Vienna, Austria
- Clinical Division of Endocrinology, Department of Medicine III, Medical University of Vienna, Vienna, Austria
| | - G Zettinig
- Schilddruesenpraxis Josefstadt, Vienna, Austria
| | - V Zoufal
- Center for Health & Bioresources, AIT Austrian Institute of Technology GmbH, Seibersdorf, Austria
| | - T Wanek
- Center for Health & Bioresources, AIT Austrian Institute of Technology GmbH, Seibersdorf, Austria
| | - M Krohn
- Department of Neuro-/Pathology, University of Oslo (UiO) and Oslo University Hospital (OUS), Oslo, Norway
| | - S Mairinger
- Center for Health & Bioresources, AIT Austrian Institute of Technology GmbH, Seibersdorf, Austria
| | - J Stanek
- Center for Health & Bioresources, AIT Austrian Institute of Technology GmbH, Seibersdorf, Austria
- Department of Clinical Pharmacology, Medical University of Vienna, Vienna, Austria
| | - M Sauberer
- Center for Health & Bioresources, AIT Austrian Institute of Technology GmbH, Seibersdorf, Austria
| | - T Filip
- Center for Health & Bioresources, AIT Austrian Institute of Technology GmbH, Seibersdorf, Austria
| | - J Pahnke
- Department of Neuro-/Pathology, University of Oslo (UiO) and Oslo University Hospital (OUS), Oslo, Norway
| | - O Langer
- Center for Health & Bioresources, AIT Austrian Institute of Technology GmbH, Seibersdorf, Austria
- Department of Clinical Pharmacology, Medical University of Vienna, Vienna, Austria
| | - F Weitzer
- Meduni Graz, Univ. Klinik für Radiologie, Abteilung für Nuklearmedizin, Graz, Austria
| | - B Pernthaler
- Meduni Graz, Univ. Klinik für Radiologie, Abteilung für Nuklearmedizin, Graz, Austria
| | - S Salamon
- Meduni Graz, Univ. Klinik für Radiologie, Abteilung für Nuklearmedizin, Graz, Austria
| | - R Aigner
- Meduni Graz, Univ. Klinik für Radiologie, Abteilung für Nuklearmedizin, Graz, Austria
| | - P Koranda
- Department of Nuclear Medicine, University Hospital Olomouc and Palacky University, Olomouc, Czech Republic
| | - L Henzlová
- Department of Nuclear Medicine, University Hospital Olomouc and Palacky University, Olomouc, Czech Republic
| | - M Kamínek
- Department of Nuclear Medicine, University Hospital Olomouc and Palacky University, Olomouc, Czech Republic
| | - Mo Váchalová
- Department of Vascular and Transplantation Surgery, University Hospital Olomouc and Palacky University, Olomouc, Czech Republic
| | - P Bachleda
- Department of Vascular and Transplantation Surgery, University Hospital Olomouc and Palacky University, Olomouc, Czech Republic
| | - D Summer
- Department of Nuclear Medicine, Medical University Innsbruck, Anichstrasse 35, A-6020, Innsbruck, Austria
| | - J Garousi
- Institute of Immunology, Genetic and Pathology, Uppsala University, SE-75185, Uppsala, Sweden
| | - M Oroujeni
- Institute of Immunology, Genetic and Pathology, Uppsala University, SE-75185, Uppsala, Sweden
| | - B Mitran
- Division of Molecular Imaging, Department of Medicinal Chemistry, Uppsala University, SE-751 83, Uppsala, Sweden
| | - K G Andersson
- Division of Protein Technology, KTH Royal Institute of Technology, SE-10691, Stockholm, Sweden
| | - A Vorobyeva
- Institute of Immunology, Genetic and Pathology, Uppsala University, SE-75185, Uppsala, Sweden
| | - J N Löfblom
- Division of Protein Technology, KTH Royal Institute of Technology, SE-10691, Stockholm, Sweden
| | - A Orlova
- Division of Molecular Imaging, Department of Medicinal Chemistry, Uppsala University, SE-751 83, Uppsala, Sweden
| | - V Tolmachev
- Institute of Immunology, Genetic and Pathology, Uppsala University, SE-75185, Uppsala, Sweden
| | - C Decristoforo
- Department of Nuclear Medicine, Medical University Innsbruck, Anichstrasse 35, A-6020, Innsbruck, Austria
| | - P Kaeopookum
- Department of Nuclear Medicine, Medical University Innsbruck, Innsbruck, Austria
- Research and Development Division, Thailand Institute of Nuclear Technology, Nakhonnayok, Thailand
| | - D Summer
- Department of Nuclear Medicine, Medical University Innsbruck, Innsbruck, Austria
| | - T Orasch
- Division of Molecular Biology, Biocenter, Medical University Innsbruck, Innsbruck, Austria
| | - B Lechner
- Division of Molecular Biology, Biocenter, Medical University Innsbruck, Innsbruck, Austria
| | - M Petrik
- Faculty of Medicine and Dentistry, Institute of Molecular and Translation Medicine, Palacky University, Olomouc, Czech Republic
| | - Z Novy
- Faculty of Medicine and Dentistry, Institute of Molecular and Translation Medicine, Palacky University, Olomouc, Czech Republic
| | - C Rangger
- Department of Nuclear Medicine, Medical University Innsbruck, Innsbruck, Austria
| | - H Haas
- Division of Molecular Biology, Biocenter, Medical University Innsbruck, Innsbruck, Austria
| | - C Decristoforo
- Department of Nuclear Medicine, Medical University Innsbruck, Innsbruck, Austria
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Trudeau M, Hoskins P, Reiman T, Chambers A, Mai H, Wheatley-Price P. Clinician participation in CADTH's pan-Canadian Oncology Drug Review: contribution and impact on cancer drug funding recommendations. ACTA ACUST UNITED AC 2017; 24:71-74. [PMID: 28490919 DOI: 10.3747/co.24.3644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
In any given week, media headlines publicize the benefits of a new “breakthrough” cancer drug, with patients and clinicians subsequently advocating for its use. [...]
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Affiliation(s)
- M Trudeau
- Division of Medical Oncology and Hematology, Sunnybrook Odette Cancer Centre, Toronto, ON
| | - P Hoskins
- Medical Oncology, BC Cancer Agency, Vancouver, BC
| | - T Reiman
- Department of Oncology, Saint John Regional Hospital, Saint John, NB; Department of Medicine, Dalhousie University, Halifax, NS; and Department of Biology, University of New Brunswick, Saint John, NB
| | - A Chambers
- Pan-Canadian Oncology Drug Review, Canadian Agency for Drugs and Technologies in Health, Toronto, ON
| | - H Mai
- Pan-Canadian Oncology Drug Review, Canadian Agency for Drugs and Technologies in Health, Toronto, ON
| | - P Wheatley-Price
- Pan-Canadian Oncology Drug Review, Canadian Agency for Drugs and Technologies in Health, Toronto, ON
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17
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Vohra RS, Pasquali S, Kirkham AJ, Marriott P, Johnstone M, Spreadborough P, Alderson D, Griffiths EA, Fenwick S, Elmasry M, Nunes Q, Kennedy D, Basit Khan R, Khan MAS, Magee CJ, Jones SM, Mason D, Parappally CP, Mathur P, Saunders M, Jamel S, Ul Haque S, Zafar S, Shiwani MH, Samuel N, Dar F, Jackson A, Lovett B, Dindyal S, Winter H, Fletcher T, Rahman S, Wheatley K, Nieto T, Ayaani S, Youssef H, Nijjar RS, Watkin H, Naumann D, Emeshi S, Sarmah PB, Lee K, Joji N, Heath J, Teasdale RL, Weerasinghe C, Needham PJ, Welbourn H, Forster L, Finch D, Blazeby JM, Robb W, McNair AGK, Hrycaiczuk A, Charalabopoulos A, Kadirkamanathan S, Tang CB, Jayanthi NVG, Noor N, Dobbins B, Cockbain AJ, Nilsen-Nunn A, Siqueira J, Pellen M, Cowley JB, Ho WM, Miu V, White TJ, Hodgkins KA, Kinghorn A, Tutton MG, Al-Abed YA, Menzies D, Ahmad A, Reed J, Khan S, Monk D, Vitone LJ, Murtaza G, Joel A, Brennan S, Shier D, Zhang C, Yoganathan T, Robinson SJ, McCallum IJD, Jones MJ, Elsayed M, Tuck L, Wayman J, Carney K, Aroori S, Hosie KB, Kimble A, Bunting DM, Fawole AS, Basheer M, Dave RV, Sarveswaran J, Jones E, Kendal C, Tilston MP, Gough M, Wallace T, Singh S, Downing J, Mockford KA, Issa E, Shah N, Chauhan N, Wilson TR, Forouzanfar A, Wild JRL, Nofal E, Bunnell C, Madbak K, Rao STV, Devoto L, Siddiqi N, Khawaja Z, Hewes JC, Gould L, Chambers A, Urriza Rodriguez D, Sen G, Robinson S, Carney K, Bartlett F, Rae DM, Stevenson TEJ, Sarvananthan K, Dwerryhouse SJ, Higgs SM, Old OJ, Hardy TJ, Shah R, Hornby ST, Keogh K, Frank L, Al-Akash M, Upchurch EA, Frame RJ, Hughes M, Jelley C, Weaver S, Roy S, Sillo TO, Galanopoulos G, Cuming T, Cunha P, Tayeh S, Kaptanis S, Heshaishi M, Eisawi A, Abayomi M, Ngu WS, Fleming K, Singh Bajwa D, Chitre V, Aryal K, Ferris P, Silva M, Lammy S, Mohamed S, Khawaja A, Hussain A, Ghazanfar MA, Bellini MI, Ebdewi H, Elshaer M, Gravante G, Drake B, Ogedegbe A, Mukherjee D, Arhi C, Giwa Nusrat Iqbal L, Watson NF, Kumar Aggarwal S, Orchard P, Villatoro E, Willson PD, Wa K, Mok 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S, Sinha S, Khan S, El-Hasani SS, Hussain AA, Bhattacharya V, Kansal N, Fasih T, Jackson C, Siddiqui MN, Chishti IA, Fordham IJ, Siddiqui Z, Bausbacher H, Geogloma I, Gurung K, Tsavellas G, Basynat P, Kiran Shrestha A, Basu S, Chhabra Mohan Harilingam A, Rabie M, Akhtar M, Kumar P, Jafferbhoy SF, Hussain N, Raza S, Haque M, Alam I, Aseem R, Patel S, Asad M, Booth MI, Ball WR, Wood CPJ, Pinho-Gomes AC, Kausar A, Rami Obeidallah M, Varghase J, Lodhia J, Bradley D, Rengifo C, Lindsay D, Gopalswamy S, Finlay I, Wardle S, Bullen N, Iftikhar SY, Awan A, Ahmed J, Leeder P, Fusai G, Bond-Smith G, Psica A, Puri Y, Hou D, Noble F, Szentpali K, Broadhurst J, Date R, Hossack MR, Li Goh Y, Turner P, Shetty V, Riera M, Macano CAW, Sukha A, Preston SR, Hoban JR, Puntis DJ, Williams SV, Krysztopik R, Kynaston J, Batt J, Doe M, Goscimski A, Jones GH, Smith SR, Hall C, Carty N, Ahmed J, Panteleimonitis S, Gunasekera RT, Sheel ARG, Lennon H, Hindley C, Reddy M, Kenny R, Elkheir N, McGlone ER, 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Shahin Y, Ali A, Luther A, Nicholson JA, Rajendran I, Boal M, Ritchie J. Population-based cohort study of variation in the use of emergency cholecystectomy for benign gallbladder diseases. Br J Surg 2016; 103:1716-1726. [PMID: 27748962 DOI: 10.1002/bjs.10288] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2016] [Revised: 06/21/2016] [Accepted: 07/06/2016] [Indexed: 01/05/2023]
Abstract
Abstract
Background
The aims of this prospective population-based cohort study were to identify the patient and hospital characteristics associated with emergency cholecystectomy, and the influences of these in determining variations between hospitals.
Methods
Data were collected for consecutive patients undergoing cholecystectomy in acute UK and Irish hospitals between 1 March and 1 May 2014. Potential explanatory variables influencing the performance of emergency cholecystectomy were analysed by means of multilevel, multivariable logistic regression modelling using a two-level hierarchical structure with patients (level 1) nested within hospitals (level 2).
Results
Data were collected on 4744 cholecystectomies from 165 hospitals. Increasing age, lower ASA fitness grade, biliary colic, the need for further imaging (magnetic retrograde cholangiopancreatography), endoscopic interventions (endoscopic retrograde cholangiopancreatography) and admission to a non-biliary centre significantly reduced the likelihood of an emergency cholecystectomy being performed. The multilevel model was used to calculate the probability of receiving an emergency cholecystectomy for a woman aged 40 years or over with an ASA grade of I or II and a BMI of at least 25·0 kg/m2, who presented with acute cholecystitis with an ultrasound scan showing a thick-walled gallbladder and a normal common bile duct. The mean predicted probability of receiving an emergency cholecystectomy was 0·52 (95 per cent c.i. 0·45 to 0·57). The predicted probabilities ranged from 0·02 to 0·95 across the 165 hospitals, demonstrating significant variation between hospitals.
Conclusion
Patients with similar characteristics presenting to different hospitals with acute gallbladder pathology do not receive comparable care.
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Affiliation(s)
| | - R S Vohra
- Trent Oesophago-Gastric Unit, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - S Pasquali
- Surgical Oncology Unit, Veneto Institute of Oncology IOV-IRCCS, Padova, Italy
| | - A J Kirkham
- Cancer Research UK Clinical Trials Unit, University of Birmingham, Birmingham, UK
| | - P Marriott
- West Midlands Research Collaborative, Academic Department of Surgery, University of Birmingham, Birmingham, UK
| | - M Johnstone
- West Midlands Research Collaborative, Academic Department of Surgery, University of Birmingham, Birmingham, UK
| | - P Spreadborough
- West Midlands Research Collaborative, Academic Department of Surgery, University of Birmingham, Birmingham, UK
| | - D Alderson
- Academic Department of Surgery, University of Birmingham, Birmingham, UK
| | - E A Griffiths
- Department of Upper Gastrointestinal Surgery, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - S Fenwick
- Aintree University Hospital NHS Foundation Trust
| | - M Elmasry
- Aintree University Hospital NHS Foundation Trust
| | - Q Nunes
- Aintree University Hospital NHS Foundation Trust
| | - D Kennedy
- Aintree University Hospital NHS Foundation Trust
| | | | | | | | | | - D Mason
- Wirral University Teaching Hospital
| | | | | | | | - S Jamel
- Barnet and Chase Farm Hospital
| | | | - S Zafar
- Barnet and Chase Farm Hospital
| | | | - N Samuel
- Barnsley District General Hospital
| | - F Dar
- Barnsley District General Hospital
| | | | | | | | | | | | | | - K Wheatley
- Sandwell and West Birmingham Hospitals NHS Trust
| | - T Nieto
- Sandwell and West Birmingham Hospitals NHS Trust
| | - S Ayaani
- Sandwell and West Birmingham Hospitals NHS Trust
| | - H Youssef
- Heart of England Foundation NHS Trust
| | | | - H Watkin
- Heart of England Foundation NHS Trust
| | - D Naumann
- Heart of England Foundation NHS Trust
| | - S Emeshi
- Heart of England Foundation NHS Trust
| | | | - K Lee
- Heart of England Foundation NHS Trust
| | - N Joji
- Heart of England Foundation NHS Trust
| | - J Heath
- Blackpool Teaching Hospitals NHS Foundation Trust
| | - R L Teasdale
- Blackpool Teaching Hospitals NHS Foundation Trust
| | | | - P J Needham
- Bradford Teaching Hospitals NHS Foundation Trust
| | - H Welbourn
- Bradford Teaching Hospitals NHS Foundation Trust
| | - L Forster
- Bradford Teaching Hospitals NHS Foundation Trust
| | - D Finch
- Bradford Teaching Hospitals NHS Foundation Trust
| | | | - W Robb
- University Hospitals Bristol NHS Trust
| | | | | | | | | | | | | | | | - B Dobbins
- Calderdale and Huddersfield NHS Trust
| | | | | | | | - M Pellen
- Hull and East Yorkshire NHS Trust
| | | | - W-M Ho
- Hull and East Yorkshire NHS Trust
| | - V Miu
- Hull and East Yorkshire NHS Trust
| | - T J White
- Chesterfield Royal Hospital NHS Foundation Trust
| | - K A Hodgkins
- Chesterfield Royal Hospital NHS Foundation Trust
| | - A Kinghorn
- Chesterfield Royal Hospital NHS Foundation Trust
| | - M G Tutton
- Colchester Hospital University NHS Foundation Trust
| | - Y A Al-Abed
- Colchester Hospital University NHS Foundation Trust
| | - D Menzies
- Colchester Hospital University NHS Foundation Trust
| | - A Ahmad
- Colchester Hospital University NHS Foundation Trust
| | - J Reed
- Colchester Hospital University NHS Foundation Trust
| | - S Khan
- Colchester Hospital University NHS Foundation Trust
| | - D Monk
- Countess of Chester NHS Foundation Trust
| | - L J Vitone
- Countess of Chester NHS Foundation Trust
| | - G Murtaza
- Countess of Chester NHS Foundation Trust
| | - A Joel
- Countess of Chester NHS Foundation Trust
| | | | - D Shier
- Croydon Health Services NHS Trust
| | - C Zhang
- Croydon Health Services NHS Trust
| | | | | | | | - M J Jones
- North Cumbria University Hospitals Trust
| | - M Elsayed
- North Cumbria University Hospitals Trust
| | - L Tuck
- North Cumbria University Hospitals Trust
| | - J Wayman
- North Cumbria University Hospitals Trust
| | - K Carney
- North Cumbria University Hospitals Trust
| | | | | | | | | | | | | | | | | | | | | | - M P Tilston
- Northern Lincolnshire and Goole NHS Foundation Trust
| | - M Gough
- Northern Lincolnshire and Goole NHS Foundation Trust
| | - T Wallace
- Northern Lincolnshire and Goole NHS Foundation Trust
| | - S Singh
- Northern Lincolnshire and Goole NHS Foundation Trust
| | - J Downing
- Northern Lincolnshire and Goole NHS Foundation Trust
| | - K A Mockford
- Northern Lincolnshire and Goole NHS Foundation Trust
| | - E Issa
- Northern Lincolnshire and Goole NHS Foundation Trust
| | - N Shah
- Northern Lincolnshire and Goole NHS Foundation Trust
| | - N Chauhan
- Northern Lincolnshire and Goole NHS Foundation Trust
| | - T R Wilson
- Doncaster and Bassetlaw Hospitals NHS Foundation Trust
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- Doncaster and Bassetlaw Hospitals NHS Foundation Trust
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- Doncaster and Bassetlaw Hospitals NHS Foundation Trust
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- Doncaster and Bassetlaw Hospitals NHS Foundation Trust
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- Doncaster and Bassetlaw Hospitals NHS Foundation Trust
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- Doncaster and Bassetlaw Hospitals NHS Foundation Trust
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- Dorset County Hospital NHS Foundation Trust
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- Dorset County Hospital NHS Foundation Trust
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- Dorset County Hospital NHS Foundation Trust
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- Dorset County Hospital NHS Foundation Trust
| | | | | | | | | | | | | | | | | | - D M Rae
- Frimley Park Hospital NHS Trust
| | | | | | | | | | - O J Old
- Gloucestershire Hospitals NHS Trust
| | | | - R Shah
- Gloucestershire Hospitals NHS Trust
| | | | - K Keogh
- Gloucestershire Hospitals NHS Trust
| | - L Frank
- Gloucestershire Hospitals NHS Trust
| | - M Al-Akash
- Great Western Hospitals NHS Foundation Trust
| | | | - R J Frame
- Harrogate and District NHS Foundation Trust
| | - M Hughes
- Harrogate and District NHS Foundation Trust
| | - C Jelley
- Harrogate and District NHS Foundation Trust
| | | | | | | | | | - T Cuming
- Homerton University Hospital NHS Trust
| | - P Cunha
- Homerton University Hospital NHS Trust
| | - S Tayeh
- Homerton University Hospital NHS Trust
| | | | | | - A Eisawi
- Tees Hospitals NHS Foundation Trust
| | | | - W S Ngu
- Tees Hospitals NHS Foundation Trust
| | | | | | - V Chitre
- Paget University Hospitals NHS Foundation Trust
| | - K Aryal
- Paget University Hospitals NHS Foundation Trust
| | - P Ferris
- Paget University Hospitals NHS Foundation Trust
| | | | | | | | | | | | | | | | - H Ebdewi
- Kettering General Hospital NHS Foundation Trust
| | - M Elshaer
- Kettering General Hospital NHS Foundation Trust
| | - G Gravante
- Kettering General Hospital NHS Foundation Trust
| | - B Drake
- Kettering General Hospital NHS Foundation Trust
| | - A Ogedegbe
- Barking, Havering and Redbridge University Hospitals NHS Trust
| | - D Mukherjee
- Barking, Havering and Redbridge University Hospitals NHS Trust
| | - C Arhi
- Barking, Havering and Redbridge University Hospitals NHS Trust
| | | | | | | | | | | | | | - K Wa
- Kingston Hospital NHS Foundation Trust
| | - J Mok
- Kingston Hospital NHS Foundation Trust
| | - T Woodman
- Kingston Hospital NHS Foundation Trust
| | - J Deguara
- Kingston Hospital NHS Foundation Trust
| | - G Garcea
- University Hospitals of Leicester NHS Trust
| | - B I Babu
- University Hospitals of Leicester NHS Trust
| | | | - D Malde
- University Hospitals of Leicester NHS Trust
| | - D Lloyd
- University Hospitals of Leicester NHS Trust
| | | | - O Al-Taan
- University Hospitals of Leicester NHS Trust
| | - A Boddy
- University Hospitals of Leicester NHS Trust
| | - J P Slavin
- Leighton Hospital, Mid Cheshire Hospitals NHS Foundation Trust
| | - R P Jones
- Leighton Hospital, Mid Cheshire Hospitals NHS Foundation Trust
| | - L Ballance
- Leighton Hospital, Mid Cheshire Hospitals NHS Foundation Trust
| | - S Gerakopoulos
- Leighton Hospital, Mid Cheshire Hospitals NHS Foundation Trust
| | - P Jambulingam
- Luton and Dunstable University Hospital NHS Foundation Trust
| | - S Mansour
- Luton and Dunstable University Hospital NHS Foundation Trust
| | - N Sakai
- Luton and Dunstable University Hospital NHS Foundation Trust
| | - V Acharya
- Luton and Dunstable University Hospital NHS Foundation Trust
| | - M M Sadat
- Macclesfield District General Hospital
| | - L Karim
- Macclesfield District General Hospital
| | - D Larkin
- Macclesfield District General Hospital
| | - K Amin
- Macclesfield District General Hospital
| | - A Khan
- Central Manchester NHS Foundation Trust
| | - J Law
- Central Manchester NHS Foundation Trust
| | - S Jamdar
- Central Manchester NHS Foundation Trust
| | - S R Smith
- Central Manchester NHS Foundation Trust
| | - K Sampat
- Central Manchester NHS Foundation Trust
| | | | - M Manu
- Royal Wolverhampton Hospitals NHS Trust
| | | | - N S Malik
- Royal Wolverhampton Hospitals NHS Trust
| | - J Chang
- Royal Wolverhampton Hospitals NHS Trust
| | | | - M Lewis
- Norfolk and Norwich University Hospitals NHS Foundation Trust
| | - G P Roberts
- Norfolk and Norwich University Hospitals NHS Foundation Trust
| | - B Karavadra
- Norfolk and Norwich University Hospitals NHS Foundation Trust
| | - E Photi
- Norfolk and Norwich University Hospitals NHS Foundation Trust
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - J Hornsby
- North Tees and Hartlepool NHS Foundation Trust
| | | | | | - K Seymour
- Northumbria Healthcare NHS Foundation Trust
| | - S Robinson
- Northumbria Healthcare NHS Foundation Trust
| | - H Hawkins
- Northumbria Healthcare NHS Foundation Trust
| | - S Bawa
- Northumbria Healthcare NHS Foundation Trust
| | | | - A Reid
- Northumbria Healthcare NHS Foundation Trust
| | - P Wood
- Northumbria Healthcare NHS Foundation Trust
| | - J G Finch
- Northampton General Hospital NHS Trust
| | - J Parmar
- Northampton General Hospital NHS Trust
| | | | | | - A Al-Muhktar
- Sheffield Teaching Hospitals NHS Foundation Trust
| | - M Peterson
- Sheffield Teaching Hospitals NHS Foundation Trust
| | - A Majeed
- Sheffield Teaching Hospitals NHS Foundation Trust
| | | | | | - A Choy
- Peterborough City Hospital
| | | | - N Pore
- United Lincolnshire Hospitals NHS Trust
| | | | | | - C Taylor
- United Lincolnshire Hospitals NHS Trust
| | | | | | | | | | | | | | | | - S Tate
- Portsmouth Hospitals NHS Trust
| | | | | | - V Vijay
- The Princess Alexandra Hospital NHS Trust
| | | | - S Sinha
- The Princess Alexandra Hospital NHS Trust
| | - S Khan
- The Princess Alexandra Hospital NHS Trust
| | | | - A A Hussain
- King's College Hospital NHS Foundation Trust
| | | | - N Kansal
- Gateshead Health NHS Foundation Trust
| | - T Fasih
- Gateshead Health NHS Foundation Trust
| | - C Jackson
- Gateshead Health NHS Foundation Trust
| | | | | | | | | | | | | | - K Gurung
- Queen Elizabeth Hospital NHS Trust
| | - G Tsavellas
- East Kent Hospitals University NHS Foundation Trust
| | - P Basynat
- East Kent Hospitals University NHS Foundation Trust
| | | | - S Basu
- East Kent Hospitals University NHS Foundation Trust
| | | | - M Rabie
- East Kent Hospitals University NHS Foundation Trust
| | - M Akhtar
- East Kent Hospitals University NHS Foundation Trust
| | - P Kumar
- Burton Hospitals NHS Foundation Trust
| | | | - N Hussain
- Burton Hospitals NHS Foundation Trust
| | - S Raza
- Burton Hospitals NHS Foundation Trust
| | - M Haque
- Royal Albert Edward Infirmary, Wigan Wrightington and Leigh NHS Trust
| | - I Alam
- Royal Albert Edward Infirmary, Wigan Wrightington and Leigh NHS Trust
| | - R Aseem
- Royal Albert Edward Infirmary, Wigan Wrightington and Leigh NHS Trust
| | - S Patel
- Royal Albert Edward Infirmary, Wigan Wrightington and Leigh NHS Trust
| | - M Asad
- Royal Albert Edward Infirmary, Wigan Wrightington and Leigh NHS Trust
| | - M I Booth
- Royal Berkshire NHS Foundation Trust
| | - W R Ball
- Royal Berkshire NHS Foundation Trust
| | | | | | | | | | - J Varghase
- Royal Bolton Hospital NHS Foundation Trust
| | - J Lodhia
- Royal Bolton Hospital NHS Foundation Trust
| | - D Bradley
- Royal Bolton Hospital NHS Foundation Trust
| | - C Rengifo
- Royal Bolton Hospital NHS Foundation Trust
| | - D Lindsay
- Royal Bolton Hospital NHS Foundation Trust
| | | | | | | | | | | | - A Awan
- Royal Derby NHS Foundation Trust
| | - J Ahmed
- Royal Derby NHS Foundation Trust
| | - P Leeder
- Royal Derby NHS Foundation Trust
| | | | | | | | | | - D Hou
- Hampshire Hospital NHS Foundation Trust
| | - F Noble
- Hampshire Hospital NHS Foundation Trust
| | | | | | - R Date
- Lancashire Teaching Hospitals NHS Foundation Trust
| | - M R Hossack
- Lancashire Teaching Hospitals NHS Foundation Trust
| | - Y Li Goh
- Lancashire Teaching Hospitals NHS Foundation Trust
| | - P Turner
- Lancashire Teaching Hospitals NHS Foundation Trust
| | - V Shetty
- Lancashire Teaching Hospitals NHS Foundation Trust
| | | | | | | | - S R Preston
- Royal Surrey County Hospital NHS Foundation Trust
| | - J R Hoban
- Royal Surrey County Hospital NHS Foundation Trust
| | - D J Puntis
- Royal Surrey County Hospital NHS Foundation Trust
| | - S V Williams
- Royal Surrey County Hospital NHS Foundation Trust
| | | | | | - J Batt
- Royal United Hospital Bath NHS Trust
| | - M Doe
- Royal United Hospital Bath NHS Trust
| | | | | | | | - C Hall
- Salford Royal NHS Foundation Trust
| | - N Carty
- Salisbury Hospital Foundation Trust
| | - J Ahmed
- Salisbury Hospital Foundation Trust
| | | | | | | | - H Lennon
- Southport and Ormskirk Hospital NHS Trust
| | - C Hindley
- Southport and Ormskirk Hospital NHS Trust
| | - M Reddy
- St George's Healthcare NHS Trust
| | - R Kenny
- St George's Healthcare NHS Trust
| | | | | | | | - K Hancorn
- St Helens and Knowsley Teaching Hospitals NHS Trust
| | - A Hargreaves
- St Helens and Knowsley Teaching Hospitals NHS Trust
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- Imperial College Healthcare NHS Trust
| | | | - G Yeldham
- Imperial College Healthcare NHS Trust
| | - E Read
- Imperial College Healthcare NHS Trust
| | | | | | | | | | - M A Khan
- Mid Staffordshire NHS Foundation Trust
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- Mid Staffordshire NHS Foundation Trust
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- City Hospitals Sunderland NHS Foundation Trust
| | - V Kanakala
- City Hospitals Sunderland NHS Foundation Trust
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- Tunbridge Wells and Maidstone NHS Trust
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- Tunbridge Wells and Maidstone NHS Trust
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- University Hospital Birmingham NHS Foundation Trust
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- University Hospital Birmingham NHS Foundation Trust
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- University Hospital Birmingham NHS Foundation Trust
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- University Hospital Birmingham NHS Foundation Trust
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- University Hospital Birmingham NHS Foundation Trust
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- University Hospital Coventry and Warwickshire NHS Trust
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- University Hospital Coventry and Warwickshire NHS Trust
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- University Hospital Coventry and Warwickshire NHS Trust
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- University Hospital of North Staffordshire NHS Trust
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- University Hospital of North Staffordshire NHS Trust
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- University Hospital of North Staffordshire NHS Trust
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- University Hospital Southampton NHS Foundation Trust
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- University Hospital Southampton NHS Foundation Trust
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- University Hospital Southampton NHS Foundation Trust
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- University Hospital Southampton NHS Foundation Trust
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- University Hospital South Manchester NHS Foundation Trust
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- University Hospital South Manchester NHS Foundation Trust
| | - K Newton
- University Hospital South Manchester NHS Foundation Trust
| | - J Mbuvi
- University Hospital South Manchester NHS Foundation Trust
| | - A Farooq
- Warrington and Halton Hospitals NHS Trust
| | | | - Z Zafrani
- Warrington and Halton Hospitals NHS Trust
| | - D Brett
- Warrington and Halton Hospitals NHS Trust
| | | | | | - J Barnes
- South Warwickshire NHS Foundation Trust
| | - M Cheung
- South Warwickshire NHS Foundation Trust
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - M Wadley
- Worcestershire Acute Hospitals NHS Trust
| | - E Hamilton
- Worcestershire Acute Hospitals NHS Trust
| | - S Jaunoo
- Worcestershire Acute Hospitals NHS Trust
| | - R Padwick
- Worcestershire Acute Hospitals NHS Trust
| | - M Sayegh
- Western Sussex Hospitals NHS Foundation Trust
| | - R C Newton
- Western Sussex Hospitals NHS Foundation Trust
| | - M Hebbar
- Western Sussex Hospitals NHS Foundation Trust
| | - S F Farag
- Western Sussex Hospitals NHS Foundation Trust
| | | | | | | | - C Blane
- Yeovil District Hospital NHS Trust
| | - M Giles
- York Teaching Hospital NHS Foundation Trust
| | - M B Peter
- York Teaching Hospital NHS Foundation Trust
| | - N A Hirst
- York Teaching Hospital NHS Foundation Trust
| | - T Hossain
- York Teaching Hospital NHS Foundation Trust
| | - A Pannu
- York Teaching Hospital NHS Foundation Trust
| | | | | | - G W Taylor
- York Teaching Hospital NHS Foundation Trust
| | | | | | | | | | | | | | | | | | | | | | | | | | - T Diamond
- Belfast City Hospital, Mater Infirmorum Hospital Belfast and Royal Victoria Hospital
| | - P Davey
- Belfast City Hospital, Mater Infirmorum Hospital Belfast and Royal Victoria Hospital
| | - C Jones
- Belfast City Hospital, Mater Infirmorum Hospital Belfast and Royal Victoria Hospital
| | - J M Clements
- Belfast City Hospital, Mater Infirmorum Hospital Belfast and Royal Victoria Hospital
| | - R Digney
- Belfast City Hospital, Mater Infirmorum Hospital Belfast and Royal Victoria Hospital
| | - W M Chan
- Belfast City Hospital, Mater Infirmorum Hospital Belfast and Royal Victoria Hospital
| | - S McCain
- Belfast City Hospital, Mater Infirmorum Hospital Belfast and Royal Victoria Hospital
| | - S Gull
- Belfast City Hospital, Mater Infirmorum Hospital Belfast and Royal Victoria Hospital
| | - A Janeczko
- Belfast City Hospital, Mater Infirmorum Hospital Belfast and Royal Victoria Hospital
| | - E Dorrian
- Belfast City Hospital, Mater Infirmorum Hospital Belfast and Royal Victoria Hospital
| | - A Harris
- Belfast City Hospital, Mater Infirmorum Hospital Belfast and Royal Victoria Hospital
| | - S Dawson
- Belfast City Hospital, Mater Infirmorum Hospital Belfast and Royal Victoria Hospital
| | - D Johnston
- Belfast City Hospital, Mater Infirmorum Hospital Belfast and Royal Victoria Hospital
| | - B McAree
- Belfast City Hospital, Mater Infirmorum Hospital Belfast and Royal Victoria Hospital
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- University Hospital Limerick
| | | | - A D K Hill
- Louth County Hospital and Our Lady of Lourdes Hospital
| | - E Khogali
- Louth County Hospital and Our Lady of Lourdes Hospital
| | - W Shabo
- Louth County Hospital and Our Lady of Lourdes Hospital
| | - E Iskandar
- Louth County Hospital and Our Lady of Lourdes Hospital
| | | | | | | | | | | | | | | | | | - P Balfe
- St Luke's General Hospital Kilkenny
| | - M Lee
- St Luke's General Hospital Kilkenny
| | - D C Winter
- St Vincent's University and Private Hospitals, Dublin
| | - M E Kelly
- St Vincent's University and Private Hospitals, Dublin
| | - E Hoti
- St Vincent's University and Private Hospitals, Dublin
| | - D Maguire
- St Vincent's University and Private Hospitals, Dublin
| | - P Karunakaran
- St Vincent's University and Private Hospitals, Dublin
| | - J G Geoghegan
- St Vincent's University and Private Hospitals, Dublin
| | - S T Martin
- St Vincent's University and Private Hospitals, Dublin
| | - F McDermott
- St Vincent's University and Private Hospitals, Dublin
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - S Gibson
- Crosshouse Hospital, Ayrshire and Arran
| | | | - D G Vass
- Crosshouse Hospital, Ayrshire and Arran
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - H C C Lim
- Glangwili General and Prince Philip Hospital
| | - D Duke
- Glangwili General and Prince Philip Hospital
| | - T Ahmed
- Glangwili General and Prince Philip Hospital
| | - W D Beasley
- Glangwili General and Prince Philip Hospital
| | | | - G Maharaj
- Glangwili General and Prince Philip Hospital
| | - C Malcolm
- Glangwili General and Prince Philip Hospital
| | | | | | | | - R Radwan
- Morriston and Singleton Hospitals
| | | | - S Wood
- Princess of Wales Hospital
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Chaudhry A, Hallam S, Chambers A, Sahu AK, Govindarajulu S, Cawthorn S. Improving postoperative pain management in subpectoral tissue expander implant reconstruction of the breast using an elastomeric pump. Ann R Coll Surg Engl 2015; 97:364-8. [PMID: 26264088 DOI: 10.1308/003588415x14181254789484] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION Postoperative pain after breast surgery is one of the major factors contributing to delay in mobilisation and prolonged hospital stay. A retrospective analysis was performed of patients undergoing skin sparing mastectomy and insertion of a subpectoral implant. The aim was to determine whether the use of an elastomeric local anaesthetic pump improved pain control and length of stay. METHODS Twenty-five consecutive patients undergoing the above procedure were sited with an elastomeric local anaesthetic infusion pump intraoperatively, in addition to standard regular and pro re nata analgesia. The control group comprised 25 patients undergoing the same procedure in the same year who received standard analgesia alone. Visual analogue scale scores were recorded for the duration of inpatient stay, as was any further analgesic requirement. RESULTS The median age was 51 years (range: 26-75 years) in the intervention group and 50 years (range: 28-70 years) in the control group. The mean visual analogue scale score was 0.28 (standard deviation [SD]: 0.61) at 24 hours for the intervention group and 1.84 (SD: 0.37) for the control group (p<0.0001). The mean length of stay was 1.8 days (SD: 0.71 days) for the intervention group and 2.28 days (SD: 0.94 days) for the control group (p=0.15). There were no complications involving catheter placement, leakage or toxicity relating to use of the local anaesthetic. CONCLUSIONS There was significantly reduced pain with the use of the local anaesthetic infusion pump. The elastomeric pump is a step towards enhanced patient recovery after breast surgery in the case of skin sparing mastectomy and subpectoral tissue expander reconstruction.
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Affiliation(s)
- A Chaudhry
- Great Western Hospitals NHS Foundation Trust , UK
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Potter S, Chambers A, Govindajulu S, Sahu A, Warr R, Cawthorn S. Early complications and implant loss in implant-based breast reconstruction with and without acellular dermal matrix (Tecnoss Protexa®): A comparative study. Eur J Surg Oncol 2015; 41:113-9. [DOI: 10.1016/j.ejso.2013.08.016] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2013] [Revised: 08/08/2013] [Accepted: 08/13/2013] [Indexed: 11/26/2022] Open
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Gill G, Butt P, Reade MC, Crozier J, Williams A, Thomas T, Flint B, Matthews G, Duff N, Brown G, Chambers A, Courtenay B, Innes D, Malley BO. HOSPEX in the antipodes. J ROY ARMY MED CORPS 2014; 161:336-40. [PMID: 25512440 DOI: 10.1136/jramc-2014-000378] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2014] [Accepted: 11/09/2014] [Indexed: 11/04/2022]
Abstract
The Australian Army recently adopted the British concept of hospital exercise (HOSPEX) as a means of evaluating the capabilities of its deployable NATO Role 2E hospital, the 2nd General Health Battalion. The Australian approach to HOSPEX differs from the original UK model. This article describes the reasons why the Australian Army needed to adopt the HOSPEX concept, how it was adapted to suit local circumstances and how the concept may evolve to meet the needs of the wider Australian Defence Force and our allies.
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Affiliation(s)
- Gerard Gill
- 3rd Health Support Battalion, Keswick Barracks, Keswick, South Australia, Australia
| | - P Butt
- 3rd Health Support Battalion, Keswick Barracks, Keswick, South Australia, Australia
| | - M C Reade
- 3rd Health Support Battalion, Keswick Barracks, Keswick, South Australia, Australia Joint Health Command, Australian Defence Force, Herston, Queensland, Australia
| | - J Crozier
- Joint Health Command, Australian Defence Force, Herston, Queensland, Australia
| | - A Williams
- Directorate Army Health, Russell Offices Canberra ACT 2600, Russell, Australian Capital Territory, Australia
| | - T Thomas
- 3rd Health Support Battalion, Keswick Barracks, Keswick, South Australia, Australia
| | - B Flint
- 2nd General Health Battalion, Gallipoli Barracks, Enoggera, Queensland, Australia
| | - G Matthews
- 3rd Health Support Battalion, Keswick Barracks, Keswick, South Australia, Australia
| | - N Duff
- 2nd General Health Battalion, Gallipoli Barracks, Enoggera, Queensland, Australia
| | - G Brown
- 3rd Health Support Battalion, Keswick Barracks, Keswick, South Australia, Australia
| | - A Chambers
- 3rd Health Support Battalion, Keswick Barracks, Keswick, South Australia, Australia
| | - B Courtenay
- HQ 5th Brigade, Holsworthy Barracks, Holsworthy, New South Wales, Australia
| | - D Innes
- 3rd Health Support Battalion, Keswick Barracks, Keswick, South Australia, Australia
| | - B O Malley
- 3rd Health Support Battalion, Keswick Barracks, Keswick, South Australia, Australia
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Abstract
A new chemoselective reductive nitro-Mannich cyclization reaction sequence of nitroalkyl-tethered lactams has been developed. Relying on the rapid and chemoselective iridium(I)-catalyzed reduction of lactams to the corresponding enamine, subsequent nitro-Mannich cyclization of tethered nitroalkyl functionality provides direct access to important alkaloid natural-product-like structures in yields up to 81 % and in diastereoselectivities that are typically good to excellent. An in-depth understanding of the reaction mechanism has been gained through NMR studies and characterization of reaction intermediates. The new methodology has been applied to the total synthesis of (±)-epi-epiquinamide in four steps.
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Affiliation(s)
- Alex W Gregory
- Department of Chemistry, Chemistry Research Laboratory, University of Oxford, Mansfield Road, Oxford OX1 3TA (UK)
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Chambers A, Bowen JM. Electrical stimulation for drug-resistant epilepsy: an evidence-based analysis. Ont Health Technol Assess Ser 2013; 13:1-37. [PMID: 24228081 PMCID: PMC3817921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
OBJECTIVE The objective of this analysis was to evaluate the effectiveness of deep brain stimulation (DBS) and vagus nerve stimulation (VNS) for the treatment of drug-resistant epilepsy in adults and children. DATA SOURCES A literature search was performed using MEDLINE, EMBASE, the Cochrane Library, and the Centre for Reviews and Dissemination database, for studies published from January 2007 until December 2012. REVIEW METHODS Systematic reviews, meta-analyses, randomized controlled trials (RCTs), and observational studies (in the absence of RCTs) of adults or children were included. DBS studies were included if they specified that the anterior nucleus of thalamus was the area of the brain stimulated. Outcomes of interest were seizure frequency, health resource utilization, and safety. A cost analysis was also performed. RESULTS The search identified 6 studies that assessed changes in seizure frequency after electrical stimulation: 1 RCT on DBS in adults, 4 RCTs on VNS in adults, and 1 RCT on VNS in children. The studies of DBS and VNS in adults found significantly improved rates of seizure frequency, but the study of VNS in children did not find a significant difference in seizure frequency between the high and low stimulation groups. Significant reductions in hospitalizations and emergency department visits were found for adults and children who received VNS. No studies addressed the use of health resources for patients undergoing DBS. Five studies reported on adverse events, which ranged from serious to transient for both procedures in adults and were mostly transient in the 1 study of VNS in children. LIMITATIONS We found no evidence on DBS in children or on health care use related to DBS. The measurement of seizure frequency is self-reported and is therefore subject to bias and issues of compliance. CONCLUSIONS Based on evidence of low to moderate quality, both DBS and VNS seemed to reduce seizure frequency in adults. In children, VNS did not appear to be as effective at reducing seizure frequency, but children had significantly fewer hospitalizations and ED visits after VNS implantation. Despite the considerable risks associated with these invasive procedures, long-term adverse events appear to be limited. PLAIN LANGUAGE SUMMARY Electrical stimulation of specific areas of the brain is a procedure used to control epileptic seizures when more conventional treatments are not working. Most adults and children with epilepsy are able to control their seizures with medication, but for some patients, drugs are not effective and surgery to remove the part of the brain where the seizures start is not an appropriate option. This study looked at the research available on the effectiveness, safety, and cost of two types of electrical stimulation devices currently licensed for treatment of epilepsy for adults and children in Canada: vagus nerve stimulation (VNS) and deep brain stimulation (DBS). Both approaches appear to be effective at reducing the frequency of seizures in adults. However, the evidence on DBS is limited to a single study with adults; we found no studies of DBS with children. Studies on VNS showed that both adults and children had fewer hospitalizations and emergency department visits after the procedure. Both procedures carry serious risks, but several longer-term studies have found that adverse events appear to be limited. The cost of VNS, including the process of assessing whether or not patients are good candidates for the procedure, is estimated to be about $40,000 per person (and higher for DBS because the device is more expensive and the operating time is longer). Of the 70,000 people in Ontario with epilepsy, about 1,400 (300 children and 1,110 adults) may be candidates for VNS to reduce their seizures.
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Burda B, Chambers A. P132 Quality of Guidelines Developed by the World Health Organization: Preliminary Results. BMJ Qual Saf 2013. [DOI: 10.1136/bmjqs-2013-002293.175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Brackstone M, Chambers A, Guo B, Vandenberg T, Potvin K, Perea F, Parissenti A. Abstract P1-14-13: Increased Pathologic Complete Response Rate and Reduced Tumour RNA Levels Upon Treatment of Locally Advanced Breast Cancer with Neoadjuvant Concurrent Chemotherapy and Radiation. Cancer Res 2012. [DOI: 10.1158/0008-5472.sabcs12-p1-14-13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Introduction: Patients with locally advanced breast cancer (LABC) have a 5-year survival rate of 50% using standard treatment that includes neo-adjuvant chemotherapy, surgery and adjuvant radiation. Given this poor prognosis, we proposed use of an adjuvant regimen in the neoadjuvant setting, involving radiation with docetaxel for radiosensitization. Pathological complete response (pCR) at surgery (the best surrogate for overall survival) was the primary end-point of this single-arm prospective Phase II trial. Given that dose-dependent reductions in tumour RNA integrity mid-treatment were correlated with post-treatment pCRs in similar patients in the NCIC-CTG-MA.22 clinical trial (Breast Cancer Research and Treatment 119:347–56), we also assessed whether changes in tumour RNA integrity and concentration could be observed following this regimen.
Methodology: Thirty-two patients with stage III non-metastatic LABC were enrolled at a single institution from 2009–2011. They were treated with neoadjuvant 5-Fluoro-uracil, Epirubicin, and Cyclophosphamide (FEC) q3 weekly for 4 cycles followed by weekly Docetaxel (35 mg/m2) concurrently with regional radiation (45 Gy with 16 Gy boost in 25 & 5 fractions) for the first 6 of 9 weeks (D/R). Serial 14 gauge tumour core biopsies were taken from the patients pre-, mid- and post-treatment and 1 mm3 samples used to assess RNA quantity and quality using an Agilent 2100 Bioanalyzer. This was followed by a modified radical mastectomy.
Results: Treatment-related toxicities included grade 3 resolving pneumonitis (6 patients), grade 3 dermatitis (6 patients) and one treatment-related death. The pCR rate was 23%–about twice the provincial rate for LABC. At a mean 21 months follow-up, the relapse-free survival was 100% in the pCR cohort and 65% among partial responders (PRs). While biopsies were not normalized for mass, little difference in RNA concentration was observed between pre-treatment and post-FEC tumour biopsies (means of 50 ± 15 nanograms/microliter and 50 ± 12 nanograms/microliter, respectively). In contrast, the mean tumour RNA concentration was reduced to 10 ± 2.1 nanograms/microliter post-D/R. While the post-treatment biopsies often yielded insufficient RNA for assignment of tumour RNA integrity (RIN) values, treatment response appeared to be associated with low tumour RNA integrity, since patients with disease progression or stable disease had higher RIN values than patients exhibiting PRs or pCRs.
Conclusions: This is the first study to use a full chemotherapy regimen with radiation in the neo-adjuvant setting for LABC. Although not without toxicity, the regimen appeared to significantly improve the pCR rate for this high-risk group, resulting in a much-improved outcome even at short-term follow-up. In addition, the FEC→D/R regimen produced reductions in tumour RNA concentration, and treatment response appeared to be associated with reduced RNA integrity.
Citation Information: Cancer Res 2012;72(24 Suppl):Abstract nr P1-14-13.
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Affiliation(s)
- M Brackstone
- London Health Sciences Centre, London, ON, Canada; Health Sciences North, Sudbury, ON, Canada; RNA Diagnostics, Inc., Sudbury, ON, Canada
| | - A Chambers
- London Health Sciences Centre, London, ON, Canada; Health Sciences North, Sudbury, ON, Canada; RNA Diagnostics, Inc., Sudbury, ON, Canada
| | - B Guo
- London Health Sciences Centre, London, ON, Canada; Health Sciences North, Sudbury, ON, Canada; RNA Diagnostics, Inc., Sudbury, ON, Canada
| | - T Vandenberg
- London Health Sciences Centre, London, ON, Canada; Health Sciences North, Sudbury, ON, Canada; RNA Diagnostics, Inc., Sudbury, ON, Canada
| | - K Potvin
- London Health Sciences Centre, London, ON, Canada; Health Sciences North, Sudbury, ON, Canada; RNA Diagnostics, Inc., Sudbury, ON, Canada
| | - F Perea
- London Health Sciences Centre, London, ON, Canada; Health Sciences North, Sudbury, ON, Canada; RNA Diagnostics, Inc., Sudbury, ON, Canada
| | - A Parissenti
- London Health Sciences Centre, London, ON, Canada; Health Sciences North, Sudbury, ON, Canada; RNA Diagnostics, Inc., Sudbury, ON, Canada
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Fayez R, AlMuntashery A, Bodie G, Almamar A, Gill R, Raîche I, Mueller C, AlMuntashery A, Fayez R, AlMuntashery A, Moustarah F, Khokhotva M, Anvari M, Kwong J, Elkassem S, Bonrath E, Zevin B, Sockalingam S, Smith C, Smith C, Whitlock K, Gill R, Suri M, Palter V, Wakeam E, Khan R, Martelli V, Malik A, Young P, Daigle C, McCreery G, Seth R, Paskar D, Sudarshan M, Richardson D, Haggar F, Davis V, Rivard J, Agzarian J, Racz J, Winocour J, Zilbert N, Decker C, Neumann K, Gosney J, Wissanji H, Chadi S, Alhabboubi M, Partridge E, Alhabboubi M, Olszewski M, Chan R, Nadler A, Hameed U, Brotherhood H, Menezes A, MacDonald B, Rakovich G, Hilsden R, Merani S, Davis P, Davis P, Cools-Lartigue J, Ojah J, Julien F, Carter D, Pitt D, Banks B, Rudovics A, Ravichandran P, Anantha R, Aad I, Kholdebarin R, Aird L, Wong S, Payne J, Hallet J, Farries L, Raiche I, Botkin C, Morency D, Berger-Richardson D, Isa A, Dupuis I, Schweigert M, Koubi S, Ernjakovic M, Grant K, Cools-Lartigue J, Carrott P, Stafford T, Malthaner R, Sudarshan M, Hanna W, Lee L, Markar S, Razzak R, Bharadwaj S, Ashrafi A, Ouellette D, Fergusson D, Forster A, Boushey R, Porter G, Johnson P, Gomes T, Chan B, Auer R, Moloo H, Mamdani M, Markar S, Al-Omran M, Al-Obaid O, Boushey R, Lim DR, Min BS, Baik SH, Gordon P, Kim NK, Lo A, Pinsk I, Bottoni D, Brown C, Raval M, Cheng H, Wong C, Johnston N, Farrokhyar F, Stephen W, Kelly S, Lindsay L, Forbes S, Knickle C, Bouchard A, Parry N, Leslie K, Ott M, Coughlin S, Gazala S, Gazala S, Donahoe L, Walker K, Li C, Alnasser S, Schweigert M, Schweigert M, Zhuruk A, Hanouf A, Vanounou T, Karanicolas P, Aubin JM, Yeung J, Dumitra S, Simoneau E, Vanounou T, Howe B, Hawel J, Jang JH, Bertens K, Rekman J, Wei A, Dumitra S, Koubi S, Ouellet JF, Wei A, Covelli A, Maniar R, Sun S, Davis V, Brackstone M, Boissonneault R, Kim S, Baliski C, Gazala S, Hameed U, Sudarshan M, Arnaout A, Wedman D, Nostedt M, Hebbard P, Shetty S, Dixon M, Wei A, Dixon M, Kazazian K, Lemke M, Wells B, Musselman R, Zih FSW, Menezes A, Nassif M, Leon-Carlyle M, Wei A, Krotneva S, Bradley N, Trabulsi N, Trabulsi N, Chin-Lenn L, Cheng H, Petrucci A, Sandhu L, Neville A, Lee L, Li C, Yang I, Prabhu KL, Melich G, Knowles S, Richardson D, Borowiec A, Hallet J, Boissonneault R, Kolozsvari N, Hallet J, Tuttle P, VanHouwelingen L, Haggar F, Boulanger-Gobeil C, Chan B, Chan B, Richardson D, Musselman R, Melich G, Phang P, Goldstein L, Wen C, Lebrun A, Chadi S, Roy M, Villeneuve S, AlMuntashery A, Demyttenaere S, Christou N, Court O, Fayez R, Demyttenaere S, Christou N, Court O, Bonrath E, Hagen J, Okrainec A, Sullivan P, Grantcharov T, Sharma A, Karmali S, Birch D, Majumdar S, Wang X, Tuepah R, Klarenbach S, Birch D, Karmali S, Sharma A, Padwal R, Smith C, Haggar F, Moloo H, Poulin E, Martel G, Yelle JD, Mamazza J, Jackson T, Penner T, Pitzul K, Urbach D, Okrainec A, Villeneuve S, Roy M, Fayez R, Demyttenaere S, Christou N, Court O, Roy M, Villeneuve S, AlMuntashery A, Demyttenaere S, Christou N, Court O, Fayez R, Demyttenaere S, Court O, Christou N, Biertho L, Hould FS, Lebel S, Lescelleur O, Marceau S, Marceau P, Biron S, Grantcharov T, Sharma A, Yusuf S, Okrainec A, Pitzul K, Urbach D, Jackson T, Lindsay D, Sullivan P, Smith L, Zevin B, Dedy N, Grantcharov T, Bonrath E, Aggarwal R, Grantcharov T, Cassin S, Crawford S, Pitzul K, Khan A, Hawa R, Jackson T, Okrainec A, Brar B, Mamazza J, Raîche I, Yelle JD, Haggar F, Moloo H, Brar B, Haggar F, Dent R, Mamazza J, Raîche I, Moloo H, Gill R, Ali T, Shi X, Birch D, Karmali S, Whitlock K, Shi X, Sarkhosh K, Birch D, Karmali S, Turner J, Nation P, Wizzard P, Brubaker P, Gisalet D, Wales P, Grantcharov T, Tien H, Spencer F, Brenneman F, Kowal J, Wiseman S, Fraser S, Vedel I, Deban M, Holcroft C, Monette M, Monette J, Bergman S, Bell C, Stukel T, Urbach D, Mueller T, Lucykx V, Lukowski C, Compston C, Churchill T, Khadaroo R, Grantcharov T, Vogt K, Dubois L, Gray D, Ananth A, Tai LH, Lam T, Falls T, Souza C, Bell J, Auer R, Crawford S, Parry N, Leslie K, Alhabboubi M, St-Louis E, Deckelbaum D, Razek T, Feldman L, Khwaja K, Porter G, Johnson P, Boushey R, Moloo H, Raiche I, Mamazza J, Schiller D, Eurich D, Sawyer M, Vergis A, Unger B, Hardy K, Andrew C, Gillman L, Park J, Prodger J, Kelly W, Kelly S, Prodger D, Ewara E, Martin J, Sarma S, Chu M, Schlachta C, Zaric G, Al-Ali K, Briggs K, George R, Murnaghan M, Leung A, Regehr G, Moulton CA, Mahmud S, Metcalfe J, McKay A, Park J, Hochman D, Burkle F, Redmond A, McQueen K, Desrosiers E, Gilbert A, Leslie K, Ott M, Sudarshan M, Jessula S, Alburakan A, Deckelbaum D, Razek T, Iqbal S, Khwaja K, Aikins C, Sudarshan M, Deckelbaum D, Iqbal S, Khwaja K, Razek T, Roberts N, Moulton CA, Murnaghan M, Cil T, Marshall J, Pederson K, Erichsen S, White J, Aarts MA, Okrainec A, Victor J, Pearsall E, McLeod R, Jackson T, Okrainec A, Penner T, Urbach D, Karimuddin A, Hall C, Bawan S, Malik S, Hayashi A, Gill R, McAlister C, Zhang N, DesRosiers E, Mills A, Crozier M, Lee L, Maxwell J, Partridge E, Chad S, Steigerwald S, Mapiour D, Roberts D, MacPherson C, Donahoe L, Mercer D, Hopman W, Latulippe JF, Knowles S, Moffat B, Parry N, Leslie K, Switzer N, Khadaroo R, Tul Y, Widder S, Molinari M, Levy A, Johnson P, Bailey J, Molinari M, Hayden J, Johnson P, Benlolo S, Marcus V, Ferri L, Finley R, Anderson D, Gagné JP, Chan S, Wong S, Li J, Michael A, Choi D, Liu E, Hoogenes J, Dath D, Aubin JM, Mew D, McConnell Y, Classen D, Kanthan S, Croome K, Kovacs M, Lazo-Langner A, Hernandez-Alejandro R, Vogt K, Crawford S, Parry N, Leslie K, Khoshgoo N, Iwasiow B, Keijzer R, Brown C, Isa D, Pace D, Widder S, Tul Y, Primrose M, Hudson D, Khadaroo R, Lauzier F, Mailloux O, Trottier V, ARchambault P, Zarychanski R, Turgeon A, Mailloux O, Hardy P, Muirhead R, Masters J, Haggar F, Poulin HME, Martel G, Mamazza J, Milbrandt C, Keijzer R, Sideris L, Grenier-Vallée P, Latulippe JF, Dubé P, Kurashima Y, Kaneva P, Feldman L, Fried G, Vassiliou M, Kwan AL, Fraser S, Solymosi N, Rauh N, Dubecz A, Renz M, Ofner D, Stein H, Borgaonkar M, Crystal P, Easson A, Escallon J, Reedijk M, Cil T, Leong W, McCready D, Clifton J, Mayo J, Finley R, Noreau-Nguyen M, Mulder D, Ferri L, Markar S, Hong J, Low D, Maslow A, Davignon K, Ng T, Tan L, Aruranian J, Kosa S, Ferri L, Murphy G, Allison F, Moshonov H, Darling G, Waddell T, De Perrot M, Cypel M, Yasufuku K, Keshavjee S, Paul N, Pierre A, Darling G, Pedneault C, Marcus V, Mulder D, Ferri L, Low D, Roa W, Löbenberg R, McEwan S, Bédard E, Louie B, Farivar A, McHugh S, Aye R, Tan-Tam C, De Vera M, Bond R, Ong S, Johal B, Schellenberg D, Po M, Nissar S, Lund C, Ahmadi S, Wakil N, Rakovich G, Beauchamps G, Preston S, Baker C, Low D, Campbell G, Malthaner R, Bethune D, Henteleff H, Johnston M, Buduhan G, Coughlin HE, Roth L, Bhandari M, Malthaner R, Johnson J, Kutsogiannis J, Bédard E, Rammohan K, Stewart K, Bédard E, Buduhan G, Gruchy J, Xu Z, Buduhan G, Ferri L, Mulder D, Ncuti A, Neville A, Kaneva P, Watson D, Vassiliou M, Carli F, Feldman L, Av R, Mayrand S, Franco E, Ferri L, Dubecz A, Renz M, Stadlhuber R, Ofner D, Stein H, Renz M, Dubecz A, Solymosi N, Thumfart L, Ofner D, Stein H, Croome K, Leeper R, Hernandez R, Livingstone S, Sapp J, Woodhall D, Alwayn I, Bergman S, Lam-McCulloch J, Balaa F, Jayaraman S, Quan D, Wei A, Guyatt G, Rekman J, Fairfull-Smith R, Mimeault R, Balaa F, Martel G, Boehnert M, Bazerbachi F, Knaak J, Selzner N, McGilvray I, Rotstein O, Adeyi O, Levy G, Keshavjee S, Grant D, Selzner M, Khalil JA, Jamal M, Chaudhury P, Zogopoulos G, Petrakos P, Tchervenkov J, Barkun J, Jamal M, Hassanain M, Chaudhury P, Wong S, Salman A, Tran T, Metrakos P, Groeschl R, Geller D, Marsh J, Gamblin T, Croome K, Croome K, Quan D, Hernandez R, Kim P, Greig PD, Gallinger S, Moulton CA, Wei A, Fischer S, Cleary S, Vogt K, Hernandez-Alejandro R, Gray D, Aubin J, Fairfull-Smith J, Mimeault R, Balaa F, Martel G, Devitt K, Ramjaun A, Gallingher S, Alabbad S, Constantinos D, Hassanein M, Barkun J, Metrakos P, Paraskevas S, Chaudhury P, Tchervenkov J, Borgaonkar M, Tanyingoh D, Dixon E, Kaplan G, Myers R, Howard T, Sutherland F, Zyromski N, Ball C, Coburn N, Moulton CA, Cleary S, Law C, Greig P, Steven G, Baxter N, Fitch M, Wright F, Hochman D, Wirtzfeld D, McKay A, Yaffe C, Yip B, Silverman R, Park J, McConnell Y, Temple W, Mack L, Schiller D, Bathe O, Sawyer M, Scott L, Vandenberg T, Perera F, Potvin K, Chambers A, Loungnarath R, DeBroux É, Lavertu S, Donath D, Ayoub JP, Tehfé M, Richard C, Cornacchi S, Heller B, Farrokhyar F, Babra M, Lovrics P, Liberto C, Ghosh S, McLean R, Schiller D, Jackson T, Okrainec A, Penner T, Urbach D, Dumitra S, Duplisea J, Wexler S, Seely J, Smylie J, Knight K, Robertson S, Watters J, Zhang T, Arneout A, Hochman D, Wirtzfeld D, McKay A, Yip B, Yaffe C, Silverman R, Park J, Baxter N, Yun L, Rakovitch E, Wright F, Warner E, McCready D, Hodgson N, Quan M, Natarajan B, Govindarajan V, Thomas P, Loggie B, Brar S, Mahar A, Law C, Coburn N, Devitt K, Wiebe M, Bathe O, McLeod R, Baxter N, Gagliardi A, Kennedy E, Urbach D, Brar S, Mahar A, Law C, Coburn N, Zih F, Rosario C, Dennis J, Gingras AC, Swallow C, Ko YJ, Rowsell C, Law C, Saskin R, Quan ML, Xie M, McLaughlin K, Marginean C, Moyana T, Moloo H, Boushey R, Auer R, Razik R, Haase E, Mathieson A, Smith A, Swallow C, Barnes A, Scheer A, Moloo H, Boushey R, Sabri E, Auer R, Reidel K, Trabulsi N, Meterissian S, Tamblyn R, Mayo N, Meguerditchian A, Brown J, Hamm J, Phang P, Raval M, Brown C, Devitt K, Wiebe M, Bathe O, McLeod R, Taylor B, Urbach D, Reidel K, Mayo N, Tamblyn R, Meguerditchian A, Hamm J, Wiseman S, Patakfalvi L, Nassif M, Turcotte R, Nichols A, Meguerditchian A, Riedel K, Winslade N, Grégoire JP, Meterissian S, Abrahamovicz M, Megueerditchian A, Pasieka J, McMillan C, Lipa J, Snell L, Sudarshan M, Dumitra S, Duplisea J, Wexler S, Meterissian S, Tomlinson G, Kennedy E, Wei A, Baxter N, Urbach D, Liberman A, Charlebois P, Stein B, Ncuti A, Vassiliou M, Fried G, Feldman L, Capretti G, Power A, Liberman A, Charlebois P, Stein B, Kaneva P, Carli F, Fried G, Feldman L, Carli F, Charlebois P, Stein B, Liberman A, Kaneva P, Augustin B, Gamsa A, Kim DJ, Vassiliou M, Feldman L, Boushey R, Moloo H, Vu L, Chan S, Phang P, Gown A, Jones S, Wiseman S, Jeong DH, Hur H, Baik SH, Kim NK, Faria J, Min BS, Lumb K, Colquhoun P, Porter G, Johnson P, Baxter N, Schmocker S, Huang H, Victor J, Krzyzanowska MK, Brierley J, McLeod R, Kennedy E, Milot H, Desrosiers E, Lebrun A, Drolet S, Bouchard A, Grégoire R, Vuong T, Loungnarath R, DeBroux E, Liberman A, Charlebois P, Stein B, Richard C, Capretti G, Kaneva P, Neville A, Carli F, Liberman S, Charlebois P, Stein B, Vassiliou M, Fried G, Feldman L, Milot H, Drolet S, Bouchard A, Grégoire R, Powell R, Fowler A, Mathieson A, Martin K, Vogt K, Ott M, Pereira G, Einarsdottir K, Moloo H, Boushey R, Mamazza J, Bouchard A, Gagné J, Grégoire R, Thibault C, Bouchard P, Gomes T, Musselman R, Auer R, Moloo H, Mamdani M, Al-Omran M, Boushey R, AlObeed O, Armstrong J. Canadian Surgery Forum1 Is laparoscopic sleeve gastrectomy a reasonable stand-alone procedure for super morbidly obese patients?2 Postoperative monitoring requirements of patients with obstructive sleep apnea undergoing bariatric surgery3 Role of relaparoscopy in the diagnosis and treatment of bariatric complications in the early postoperative period4 Changes of active and total ghrelin, GLP-1 and PYY following restrictive bariatric surgery and their impact on satiety: comparison of sleeve gastrectomy and adjustable gastric banding5 Prioritization and willingness to pay for bariatric surgery: the patient perspective6 Ventral hernia at the time of laparoscopic gastric bypass surgery: Should it be repaired?7 Linear stapled gastrojejunostomy with transverse handsewn enterotomy closure significantly reduces strictures for laparoscopic Roux-en-Y bypass8 Laparoscopic biliopancreatic diversion with duodenal switch as second stage for super super morbidly obese patients. Do all patients benefit?9 Sleeve gastrectomy in the super super morbidly obese (BMI > 60 kg/m2): a Canadian experience10 Laparoscopic gastric bypass for the treatment of refractory idiopathic gastroparesis: a report of 2 cases11 Duodeno-ileal switch as a primary bariatric and metabolic surgical option for the severely obese patient with comorbidities: review of a single-institution case series of duodeno-ileal intestinal bypass12 Management of large paraesophageal hernias in morbidly obese patients with laparoscopic sleeve gastrectomy: a case series13 Early results of the Ontario bariatric surgical program: using the bariatric registry14 Improving access to bariatric surgical care: Is universal health care the answer?15 Early and liberal postoperative exploration can reduce morbidity and mortality in patients undergoing bariatric surgery16 Withdrawn17 Identification and assessment of technical errors in laparoscopic Roux-en-Y gastric bypass18 A valid and reliable tool for assessment of surgical skill in laparoscopic Roux-en-Y gastric bypass19 Psychiatric predictors of presurgery drop-out following suitability assessment for bariatric surgery20 Predictors of outcomes following Roux-en-Y gastric bypass surgery at The Ottawa Hospital21 Prophylactic management of cholelithiasis in bariatric patients: Is routine cholecystectomy warranted?22 Early outcomes of Roux-en-Y gastric bypass in a publicly funded obesity program23 Similar incidence of gastrojejunal anastomotic stricture formation with hand-sewn and 21 mm circular stapler techniques during Roux-en-Y gastric bypass24 (CAGS Basic Science Award) Exogenous glucagon-like peptide-1 improves clinical, morphological and histological outcomes of intestinal adaptation in a distal-intestinal resection piglet model of short bowel syndrome25 (CAGS Clinical Research Award) Development and validation of a comprehensive curriculum to teach an advanced minimally invasive procedure: a randomized controlled trial26 Negative-pressure wound therapy (iVAC) on closed, high-risk incisions following abdominal wall reconstruction27 The impact of seed granting on research in the University of British Columbia Department of Surgery28 Quality of surgical care is inadequate for elderly patients29 Recurrence of inguinal hernia in general and hernia specialty hospitals in Ontario, Canada30 Oncostatin M receptor deficiency results in increased mortality in an intestinal ischemia reperfusion model in mice31 Laparoscopic repair of large paraesophageal hernias with anterior gastropexy: a multicentre trial32 Response to preoperative medical therapy predicts success of laparoscopic splenectomy for immune thrombocytopenic purpura33 Perioperative sepsis, but not hemorrhagic shock, promotes the development of cancer metastases in a murine model34 Measuring the impact of implementing an acute care surgery service on the management of acute biliary disease35 Patient flow and efficiency in an acute care surgery service36 The relationship between treatment factors and postoperative complications after radical surgery for rectal cancer37 Risk of ventral hernia after laparoscopic colon surgery38 Urinary metabolomics as a tool for early detection of Barrett’s and esophageal cancer39 Construct validity of individual and summary performance metrics associated with a computer-based laparo-scopic simulator40 Impact of a city-wide health system reorganization on emergency department visits in hospitals in surrounding communities41 Transcatheter aortic valve implantation for the nonoperative management of aortic stenosis: a cost-effectiveness analysis42 Breast cancer: racial differences in age of onset. A potential confounder in Canadian screening recommendations43 Risk taking in surgery: in and out of the comfort zone44 A tumour board in the office: Track those cancer patients!45 Increased patient BMI is not associated with advanced colon cancer stage or grade on presentation: a retrospective chart review46 Consensus statements regarding the multidisciplinary care of limb amputation patients in disasters or humanitarian emergencies. Report of the 2011 Humanitarian Action Summit Surgical Working Group on amputations following disasters or conflict47 Learning the CanMEDS role of professional: a pilot project of supervised discussion groups addressing the hidden curriculum48 Assessing the changing scope of training in Canadian general surgery programs: expected versus actual experience49 Predicting need for surgical management for massive gastrointestinal hemorrhage50 International health care experience: using CanMEDS to evaluate learning outcomes following a surgical mission in Mampong, Ghana51 The open abdomen: risk factors for mortality and rates of closure52 How surgeons think: an exploration of mental practice in surgical preparation53 The surgery wiki: a novel method for delivery of under-graduate surgical education54 Understanding surgical residents’ postoperative practices before implementing an enhanced recovery after surgery (ERAS) guideline at the University of Toronto55 From laparoscopic transabdominal to posterior retroperitoneal adrenalectomy: a paradigm shift in operative approach56 A retrospective audit of outcomes in patients over the age of 80 undergoing acute care abdominal surgery57 Canadian general surgery residents’ perspectives on work-hour regulations58 Timing of surgical intervention and its outcomes in acute appendicitis59 Preparing surgical trainees to deal with adverse events. An outline of learning issues60 Acute care surgical service: surgeon agreement at the time of handover61 Predicting discharge of elderly patients to prehospitalization residence following emergency general surgery62 Morbidity and mortality after emergency abdominal surgery in octo- and nonagenarians63 The impact of acute abdominal illness and urgent admission to hospital on the living situation of elderly patients64 A comparison of laparoscopic versus open subtotal gastrectomy for antral gastric adenocarcinoma: a North American perspective65 Minimally invasive excision of ectopic mediastinal parathyroid adenomas66 Perioperative outcomes of laparoscopic hernia repair in a tertiary care centre: a single institution’s experience67 Evaluation of a student-run, practical and didactic curriculum for preclerkship medical students68 Joseph Lister: Father of Modern Surgery69 Comparisons of melanoma sentinel lymph node biopsy prediction nomograms in a cohort of Canadian patients70 Local experience with myocutaneous flaps after extensive pelvic surgery71 The treatment of noncirrhotic splanchnic vein thrombosis: Is anticoagulation enough?72 Implementation of an acute care surgery service does not affect wait-times for elective cancer surgeries: an institutional experience73 Use of human collagen mesh for closure of a large abdominal wall defect, after colon cancer surgery, a case report74 The role of miR-200b in pulmonary hypoplasia associated with congenital diaphragmatic hernia75 Systematic review and meta-analysis of electrocautery versus scalpel for incising epidermis and dermis76 Accuracy of sentinel lymph node biopsy for early breast cancer in the community setting in St. John’s, New-foundland: results of a retrospective review77 Acute surgical outcomes in the 80 plus population78 The liberal use of platelets transfusions in the acute phase of trauma resuscitation: a systematic review79 Implementation of an acute care surgical on call program in a Canadian community hospital80 Short-term outcomes following paraesophageal hernia repair in the elderly patient81 First experience with single incision surgery: feasibility in the pediatric population and cost evaluation82 The impact of the establishment of an acute care surgery unit on the outcomes of appendectomies and cholecystectomies83 Description and preliminary evaluation of a low-cost simulator for training and evaluation of flexible endoscopic skills84 Tumour lysis syndrome in metastatic colon cancer: a case report85 Acute care surgery service model implementation study at a single institution86 Colonic disasters approached by emergent subtotal and total colectomy: lessons learned from 120 consecutive cases87 Acellular collagen matrix stent to protect bowel anastomoses88 Lessons we learned from preoperative MRI-guided wire localization of breast lesions: the University Health Network (UHN) experience89 Interim cost comparison for the use of platinum micro-coils in the operative localization of small peripheral lung nodules90 Routine barium esophagram has minimal impact on the postoperative management of patients undergoing esophagectomy for esophageal cancer91 Iron deficiency anemia is a common presenting issue with giant paraesophageal hernia and resolves following repair92 A randomized comparison of different ventilation strategies during thoracotomy and lung resection93 The Canadian Lung Volume Reduction Surgery study: an 8-year follow-up94 A comparison of minimally invasive versus open Ivor-Lewis esophagectomy95 A new paradigm in the follow-up after curative resection for lung cancer: minimal-dose CT scan allows for early detection of asymptomatic cancer activity96 Predictors of lymph node metastasis in early esophageal adenocarcinoma: Is endoscopic resection worth the risk?97 How well can thoracic surgery residents operate? Comparing resident and program director opinions98 The impact of extremes of age on short- and long-term outcomes following surgical resection of esophageal malignancy99 Epidermal growth factor receptor targeted gold nanoparticles for the enhanced radiation treatment of non–small cell lung cancer100 Laparoscopic Heller myotomy results in excellent outcomes in all subtypes of achalasia as defined by the Chicago classification101 Neoadjuvant chemoradiation versus surgery in managing esophageal cancer102 Quality of life postesophagectomy for cancer!103 The implementation, evolution and translocation of standardized clinical pathways can improve perioperative outcomes following surgical treatment of esophageal cancer104 A tissue-mimicking phantom for applications in thoracic surgical simulation105 Sublobar resection compared with lobectomy for early stage non–small cell lung cancer: a single institution study106 Not all reviews are equal: the quality of systematic reviews and meta-analyses in thoracic surgery107 Do postoperative complications affect health-related quality of life after video-assisted thoracoscopic lobectomy for patients with lung cancer? A cohort study108 Thoracoscopic plication for palliation of dyspnea secondary to unilateral diaphragmatic paralysis: A worthwhile venture?109 Thoracic surgery experience in Canadian general surgery residency programs110 Perioperative morbidity and pathologic response rates following neoadjuvant chemotherapy and chemoradiation for locally advanced esophageal carcinoma111 An enhanced recovery pathway reduces length of stay after esophagectomy112 Predictors of dysplastic and neoplastic progression of Barrett’s esophagus113 Recurrent esophageal cancer complicated by tracheoesophageal fistula: management by means of palliative airway stenting114 Pancreaticopleural fistula-induced empyema thoracis: principles and results of surgical management115 Prognostic factors of early postoperative mortality following right extended hepatectomy116 Optimizing steatotic livers for transplantation using a cell-penetrating peptide CPP-fused heme oxygenase117 Video outlining the technical steps for a robot-assisted laparoscopic pancreaticoduodenectomy118 Establishment of a collaborative group to conduct innovative clinical trials in Canada119 Hepatic resection for metastatic malignant melanoma: a systematic review and meta-analysis120 Acellular normothermic ex vivo liver perfusion for donor liver preservation121 Pancreatic cancer and predictors of survival: comparing the CA 19–9/bilirubin ratio with the McGill Brisbane Scoring System122 Staged liver resections for bilobar hepatic colorectal metastases: a single centre experience123 Economic model of observation versus immediate resection of hepatic adenomas124 Resection of colorectal liver metastasis in the elderly125 Acceptable long-term survival in patients undergoing liver resection for metastases from noncolorectal, non-neuroendocrine, nonsarcoma malignancies126 Patient and clinicopathological features and prognosis of CK19+ hepatocellular carcinomas: a case–control study127 The management of blunt hepatic trauma in the age of angioembolization: a single centre experience128 Liver resections for noncolorectal and non-neuroendocrine metastases: an evaluation of oncologic outcomes129 Developing an evidence-based clinical pathway for patients undergoing pancreaticoduodenectomy130 Hepatitis C infection and hepatocellular carcinoma in liver transplant: a 20 year experience131 The effect of medication on the risk of post-ERCP pancreatitis132 Temporal trends in the use of diagnostic imaging for patients with hepato-pancreato-biliary (HPB) conditions: How much ionizing radiation are we really using?196 A phase II study of aggressive metastasectomy for intra-and extrahepatic metastases from colorectal cancer133 Why do women choose mastectomy for breast cancer treatment? A conceptual framework for understanding surgical decision-making in early-stage breast cancer134 Synoptic operative reporting: documentation of quality of care data for rectal cancer surgery135 Learning curve analysis for cytoreductive surgery: a useful application of the cumulative sum (CUSUM) method136 Pancreatic cancer is strongly associated with a unique urinary metabolomic signature137 Concurrent neoadjuvant chemo/radiation in locally advanced breast cancer138 Impact of positron emission tomography on clinical staging of newly diagnosed rectal cancer: a specialized single centre retrospective study139 An evaluation of intraoperative Faxitron microradiography versus conventional specimen radiography for the excision of nonpalpable breast lesions140 Comparison of breast cancer treatment wait-times in the Southern Interior of British Columbia in 2006 and 2010141 Factors affecting lymph nodes harvest in colorectal carcinoma142 Laparoscopic adrenalectomy for metastases143 You have a message! Social networking as a motivator for fundamentals of laparoscopic surgery (FLS) training144 The evaluation and validation of a rapid diagnostic and support clinic for women assessment for breast cancer145 Oncoplastic breast surgery: oncologic benefits and limitations146 A qualitative study on rectal cancer patients’ preferences for location of surgical care147 The effect of surgery on local recurrence in young women with breast cancer148 Elevated IL-6 and IL-8 levels in tumour microenvironment is not associated with increased serum levels in humans with Pseudomyxoma peritonei and peritoneal mesothelioma149 Conversion from laparoscopic to open approach during gastrectomy: a population-based analysis150 A scoping review of surgical process improvement tools (SPITs) in cancer surgery151 Splenectomy during gastric cancer surgery: a population-based study152 Defining the polo-like kinase 4 (Plk4) interactome in cancer cell protrusions153 Neoadjuvant imatinib mesylate for locally advanced gastrointestinal stromal tumours154 Implementing results from ACOSOG Z0011: Practice-changing or practice-affirming?155 Should lymph node retrieval be a surgical quality indicator in colon cancer?156 Long-term outcomes following resection of retroperitoneal recurrence of colorectal cancer157 Clinical research in surgical oncology: an analysis of clinicaltrials.gov158 Radiation therapy after breast conserving surgery: When are we missing the mark?159 The accuracy of endorectal ultrasound in staging rectal lesions in patients undergoing transanal endoscopic microsurgery160 Quality improvement in gastrointestinal cancer surgery: expert panel recommendations for priority research areas161 Factors influencing the quality of local management of ductal carcinoma in situ: a cohort study162 Papillary thyroid microcarcinoma: Does size matter?163 Hyperthermic isolated limb perfusion for extremity soft tissue sarcomas: systematic review of clinical efficacy and quality assessment of reported trials164 Adherence to antiestrogen therapy in seniors with breast cancer: How well are we doing?165 Parathyroid carcinoma: Challenging the surgical dogma?166 A qualitative assessment of the journey to delayed breast reconstruction195 The role of yoga therapy in breast cancer patients167 Outcomes reported in comparative studies of surgical interventions168 Enhanced recovery pathways decrease length of stay following colorectal surgery, but how quickly do patients actually recover?169 The impact of complications on bed utilization after elective colorectal resection170 Impact of trimodal prehabilitation program on functional recovery after colorectal cancer surgery: a pilot study171 Complex fistula-in-ano: Should the plug be abandoned in favour of the LIFT or BioLIFT?172 Prognostic utility of cyclooxygenase-2 expression by colon and rectal cancer173 Laparoscopic right hemicolectomy with complete mesocolic excision provides acceptable perioperative outcomes but is complex and time-consuming: analysis of learning curves for a novice minimally invasive surgeon174 Intraoperative quality assessment following double stapled circular colorectal anastomosis175 Improving patient outcomes through quality assessment of rectal cancer care176 Are physicians willing to accept a decrease in treatment effectiveness for improved functional outcomes for low rectal cancer?177 Turnbull-Cutait delayed coloanal anastomosis for the treatment of distal rectal cancer: a prospective cohort study178 Preoperative high-dose rate brachytherapy in preparation for sphincter preservation surgery for patients with advanced cancer of the lower rectum179 Impact of an enhanced recovery program on short-term outcomes after scheduled laparoscopic colon resection180 The clinical results of the Turnbull-Cutait delayed coloanal anastomosis: a systematic review181 Is a vertical rectus abdominus flap (VRAM) necessary? An analysis of perineal wound complications182 Fistula plug versus endorectal anal advancement flap for the treatment of high transsphincteric cryptoglandular anal fistulas: a systematic review and meta-analysis183 Maternal and neonatal outcomes following colorectal cancer surgery184 Transanal drainage to treat anastomotic leaks after low anterior resection for rectal cancer: a valuable option185 Trends in colon cancer in Ontario: 2002–2009186 Validation of electronically derived short-term outcomes in colorectal surgery187 A population-based assessment of transanal and endoscopic resection for adenocarcinoma of the rectum188 Laparoscopic colorectal surgery in the emergency setting: trends in the province of Ontario from 2002 to 2009189 Prevention of perineal hernia after laparoscopic and robotic abdominoperineal resection: review with case series of internal hernia through pelvic mesh which was placed in attempt to prevent perineal hernia190 Effect of rectal cancer treatments on quality of life191 The use of antibacterial sutures as an adjunctive preventative strategy for surgical site infection in Canada: an economic analysis192 Impact of socioeconomic status on colorectal cancer screening and stage at presentation: preliminary results of a population-based study from an urban Canadian centre193 Initial perioperative results of the first transanal endoscopic microsurgery (TEM) program in the province of Quebec194 Use of negative pressure wound therapy decreases perineal wound infections following abdominal perineal resection. Can J Surg 2012; 55:S63-S135. [DOI: 10.1503/cjs.016712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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Quyn AJ, Johnston C, Hall D, Chambers A, Arapova N, Ogston S, Amin AI. The open abdomen and temporary abdominal closure systems--historical evolution and systematic review. Colorectal Dis 2012; 14:e429-38. [PMID: 22487141 DOI: 10.1111/j.1463-1318.2012.03045.x] [Citation(s) in RCA: 105] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
AIM Several techniques for temporary abdominal closure have been developed. We systematically review the literature on temporary abdominal closure to ascertain whether the method can be tailored to the indication. METHOD Medline, Embase, the Cochrane Central Register of Controlled Trials and relevant meeting abstracts until December 2009 were searched using the following headings: open abdomen, laparostomy, VAC (vacuum assisted closure), TNP (topical negative pressure), fascial closure, temporary abdominal closure, fascial dehiscence and deep wound dehiscence. The data were analysed by closure technique and aetiology. The primary end-points included delayed fascial closure and in-hospital mortality. The secondary end-points were intra-abdominal complications. RESULTS The search identified 106 papers for inclusion. The techniques described were VAC (38 series), mesh/sheet (30 series), packing (15 series), Wittmann patch (eight series), Bogotá bag (six series), dynamic retention sutures (three series), zipper (15 series), skin only and locking device (one series each). The highest facial closure rates were seen with the Wittmann patch (78%), dynamic retention sutures (71%) and VAC (61%). CONCLUSION Temporary abdominal closure has evolved from simple packing to VAC based systems. In the absence of sepsis Wittmann patch and VAC offered the best outcome. In its presence VAC had the highest delayed primary closure and the lowest mortality rates. However, due to data heterogeneity only limited conclusions can be drawn from this analysis.
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Affiliation(s)
- A J Quyn
- Department of General Surgery, Victoria Hospital, Fife NHS Trust, Kirkcaldy, UK.
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Colakoglu M, Toy H, Icen MS, Vural M, Mahmoud AS, Yazici F, Buendgen N, Cordes T, Schultze-Mosgau A, Diedrich K, Beyer D, Griesinger G, Oude Loohuis EJ, Nahuis MJ, Bayram N, Hompes PGA, Oosterhuis GJE, Bossuyt PM, van der Veen F, Mol BWJ, van Wely M, Nahuis MJ, Oude Loohuis EJ, Kose N, Bayram N, Hompes PGA, Oosterhuis GJE, Bossuyt PM, van der Veen F, Mol BWJ, van Wely M, Yaba A, Demir N, Allegra A, Pane A, Marino A, Scaglione P, Ruvolo G, Manno M, Volpes A, Lunger F, Wildt L, Seeber B, Kolibianakis EM, Venetis CA, Bosdou J, Toulis K, Goulis DG, Tarlatzi TB, Tarlatzis BC, Franz M, Keck C, Daube S, Pietrowski D, Demir N, Yaba A, Iannetta R, Santos RDS, Lima TP, Giolo F, Iannetta O, Martins WP, Paula FJ, Ferriani RA, Rosa e Silva ACJS, Martinelli CE, Reis RM, Devesa M, Rodriguez I, Coroleu B, Tur R, Gonzalez C, Barri PN, Nardo LG, Mohiyiddeen L, Mulugeta B, McBurney H, Roberts SA, Newman WG, Grynberg M, Lamazou F, Even M, Gallot V, Frydman R, Fanchin R, Abdalla H, Nicopoullos J, Leader A, Pang S, Witjes H, Gordon K, Devroey P, Arrivi C, Ferraretti AP, Magli MC, Tartaglia ML, Fasolino MC, Gianaroli L, Macek sr. M, Feldmar P, Kluckova H, Hrehorcak M, Diblik J, Cernikova J, Paulasova P, Turnovec M, Macek jr. M, Hillensjo T, Yeko T, Witjes H, Elbers J, Devroey P, Mardesic T, Abuzeid M, Witjes H, Mannaerts B, Okubo T, Matsuo R, Kuwayama M, Teramoto S, Chakraborty P, Goswami SK, Chakravarty BN, Nandi SS, Kabir SN, Ramos Vidal J, Prados N, Caligara C, Garcia J, Carranza FJ, Gonzalez-Ravina A, Salazar A, Tocino A, Rodriguez I, Fernandez-Sanchez M, Ito H, Iwasa T, Hasegawa E, Hatano K, Nakayama D, Kazuka M, Usuda S, Isaka K, Ventura V, Doria S, Fernandes S, Barros A, Valkenburg O, Lao O, Schipper I, Louwers YV, Uitterlinden AG, Kayser M, Laven JSE, Sharma S, Goswami S, Goswami SK, Ghosh S, Chattopadhyay R, Sarkar A, Chakravarty BN, Louwers YV, Valkenburg O, Lie Fong S, van Dorp W, de Jong FH, Laven JSE, Ghosh S, Chattopadhyay R, Goswami SK, Radhika KL, Chakravarty BN, Benkhalifa M, Demirol A, Montjeant D, Delagrange P, Gentien D, Giakoumakis G, Menezo Y, Dattilo M, Gurgan T, Engels S, Blockeel C, Haentjens P, De Vos M, Camus M, Devroey P, Dimitraki M, Koutlaki N, Gioka T, Messini CI, Dafopoulos K, Messinis IE, Gurlek B, Batioglu S, Ozyer S, Nafiye Y, Kale I, Karayalcin R, Uncu G, Kasapoglu I, Uncu Y, Celik N, Ozerkan K, Ata B, Ferrero H, Gomez R, Delgado F, Simon C, Gaytan F, Pellicer A, Osborn JC, Fien L, Wolyncevic J, Esler JH, Choi D, Kim N, Choi J, Jo M, Lee E, Lee D, Fujii R, Neyatani N, Waseda T, Oka Y, Takagi H, Tomizawa H, Sasagawa T, Makinoda S, Ajina M, Zorgati H, Ben Salem A, Ben Ali H, Mehri S, Touhami M, Saad A, Piouka A, Karkanaki A, Katsikis I, Delkos D, Mousatat T, Daskalopoulos G, Panidis D, Pantos K, Stavrou D, Sfakianoudis K, Angeli E, Chronopoulou M, Vaxevanoglou T, Jones R GMJ, Lee WD, Kim SD, Jee BC, Kim KC, Kim KH, Kim SH, Kim YJ, Park KA, Chae SJ, Lim KS, Hur CY, Kang YJ, Lee WD, Lim JH, Tomizawa H, Makinoda S, Fujita S, Waseda T, Fujii R, Utsunomiya R T, Vieira C, Martins WP, Fernandes JBF, Soares GM, Reis RM, Silva de Sa MF, Ferriani R RA, Yoo JH, Kim HO, Cha SH, Koong MK, Song IO, Kang IS, Hatakeyama N, Jinno M, Watanabe A, Hirohama J, Hiura R, Konig TE, Beemsterboer SN, Overbeek A, Hendriks ML, Heymans MW, Hompes P, Homburg R, Schats R, Lambalk CB, van der Houwen L, Konig TE, Overbeek A, Hendriks ML, Beemsterboer SN, Kuchenbecker WK, Renckens CNM, Bernardus RE, Schats R, Homburg R, Hompes P, Lambalk CB, Potdar N, Gelbaya TA, Nardo LG, de Groot PCM, Dekkers OM, Romijn JA, Dieben SWM, Helmerhorst FM, Guivarch Leveque A, Homer L, Broux PL, Moy L, Priou G, Vialard J, Colleu D, Arvis P, Dewailly D, Aghahosseini M, Aleyasin A, Sarvi F, Safdarian L, Rahmanpour H, Akhtar MA, Navaratnam K, Ankers D, Sharma SD, Son WY, Chung JT, Reinblatt S, Dahan M, Demirtas M, Holzer H, Aspichueta F, Exposito A, Crisol L, Prieto B, Mendoza R, Matorras R, Kim K, Lee J, Jee B, Lee W, Suh C, Moon J, Kim S, Sarapik A, Velthut A, Haller-Kikkatalo K, Faure GC, Bene MC, de Carvalho M, Massin F, Uibo R, Salumets A, Alhalabi M, Samawi S, Taha A, Kafri N, Modi S, Khatib A, Sharif J, Othman A, Hamamah S, Assou S, Anahory T, Loup V, Dechaud H, Dewailly D, Mousavi Fatemi H, Doody K, Witjes H, Mannaerts B, Basconi V, Jungblut L, Young E, Van Thillo G, Paz D, Pustovrh MC, Fabbri R, Pasquinelli G, Magnani V, Macciocca M, Parazza I, Battaglia C, Paradisi R, Venturoli S, Ono M, Teranisi A, Fumino T, Ohama N, Hamai H, Chikawa A, Takata R, Teramura S, Iwahasi K, Shigeta M, Heidari M, Farahpour M, Talebi S, Edalatkhah H, Zarnani AH, Ardekani AM, Pietrowski D, Szabo L, Sator M, Just A, Franz M, Egarter C, Hope N, Motteram C, Rombauts LJ, Lee W, Chang E, Han J, Won H, Yoon T, Seok H, Diao FY, Mao YD, Wang W, Ding W, Liu JY, Chang E, Yoon T, Lee W, Cho J, Kwak I, Kim Y, Afshan I, Cartwright R, Trew G, Lavery S, Lockwood G, Niyani K, Banerjee S, Chambers A, Pados G, Tsolakidis D, Billi H, Athanatos D, Tarlatzis B, Salumets A, Laanpere M, Altmae S, Kaart T, Stavreus-Evers A, Nilsson TK, van Dulmen-den Broeder E, van der Stroom E, Konig TE, van Montfrans J, Overbeek A, van den Berg MH, van Leeuwen FE, Lambalk CB, Taketani T, Tamura H, Tamura I, Asada H, Sugino N, Al - Azemi M, Kyrou D, Papanikolaou EG, Polyzos NP, Devroey P, Fatemi HM, Qiu Z, Yang L, Yan G, Sun H, Hu Y, Mohiyiddeen L, Higgs J, Roberts S, Newman W, Nardo LG, Ho C, Guijarro JA, Nunez R, Alonso J, Garcia A, Cordeo C, Cortes S, Caballero P, Soliman S, Baydoun R, Wang B, Shreeve N, Cagampang F, Sadek K, Hill CM, Brook N, Macklon N, Cheong Y, Santana R, Setti AS, Maldonado LG, Valente FM, Iaconelli C, Braga DPAF, Iaconelli Jr. A, Borges Jr. E, Yoon JS, Won MY, Kim SD, Jung JH, Yang SH, Lim JH, Kavrut M, Kahraman S, Sadek KH, Bruce KB, Macklon N, Cagampang FR, Cheong YC, Cota AMM, Oliveira JBA, Petersen CG, Mauri AL, Massaro FC, Silva LFI, Vagnini LD, Nicoletti A, Pontes A, Cavagna M, Baruffi RLR, Franco Jr. JG, Won MY, Kim SD, Yoon JS, Jung JH, Yang SH, Lim JH, Kim SD, Kim JW, Yoon TK, Lee WS, Han JE, Lyu SW, Shim SH, Kuwabara Y, Katayama A, Tomiyama R, Piao H, Ono S, Shibui Y, Abe T, Ichikawa T, Mine K, Akira S, Takeshita T, Hatzi E, Lazaros L, Xita N, Kaponis A, Makrydimas G, Sofikitis N, Stefos T, Zikopoulos K, Georgiou I, Guimera M, Casals G, Fabregues F, Estanyol JM, Balasch J, Mochtar MH, Van den Wijngaard L, Van Voorst S, Koks CAM, Van Mello NM, Mol BWJ, Van der Veen F, Van Wely M, Fabregues F, Iraola A, Casals G, Creus M, Carmona F, Balasch J, Villarroel C, Lopez P, Merino P, Iniguez G, Codner E, Xu B, Cui Y, Gao L, Xue KAI, Li MEI, Zhang YUAN, Diao F, Ma X, Liu J, Leonhardt H, Gull B, Kishimoto K, Kataoka M, Stener-Victorin E, Hellstrom M, Cui Y, Wang X, Zhang Z, Ding G, HU X, Sha J, Zhou Z, Liu J, Liu J, Kyrou D, Kolibianakis EM, Fatemi HM, Camus M, Tournaye H, Tarlatzis BC, Devroey P, Davari F, Rashidi B, Rahmanpour Zanjani H, Al-Inany H, Youssef M, Aboulghar M, Broekmans F, Sterrenburg M, Smit J, Abousetta A, Van Dessel H, Van Leeuwen J, McGee EA, Bodri D, Guillen JJ, Rodriguez A, Trullenque M, Coll O, Vernaeve V, Snajderova M, Keslova P, Sedlacek P, Formankova R, Kotaska K, Stary J, Weghofer A, Dietrich W, Barad DH, Gleicher N, Rustamov O, Pemberton P, Roberts S, Smith A, Yates A, Patchava S, Nardo L, Toulis KA, Mintziori G, Goulis DG, Kintiraki E, Eukarpidis E, Mouratoglou SA, Pavlaki A, Stergianos S, Poulasouhidou M, Tzellos TG, Tarlatzis BC, Nasiri R, Ramezanzadeh F, Sarafraz Yazdi M, Baghrei M, Lee RKK, Wu FS, Lin S, Lin MH, Hwu YM. POSTER VIEWING SESSION - REPRODUCTIVE ENDOCRINOLOGY. Hum Reprod 2011. [DOI: 10.1093/humrep/26.s1.90] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Abstract
QUESTIONS Should patients with confirmed single brain metastasis undergo surgical resection? Should patients with single brain metastasis undergoing surgical resection receive adjuvant whole-brain radiation therapy (wbrt)? What is the role of stereotactic radiosurgery (srs) in the management of patients with single brain metastasis? PERSPECTIVES Approximately 15%-30% of patients with cancer will develop cerebral metastases over the course of their disease. Patients identified as having single brain metastasis generally undergo more aggressive treatment than do those with multiple metastases; however, in the province of Ontario, management of patients with single brain metastasis varies. Given that conflicting evidence has been reported, the Neuro-oncology Disease Site Group (dsg) of the Cancer Care Ontario Program in Evidence-based Care felt that a systematic review of the evidence and a practice guideline were warranted. OUTCOMES Outcomes of interest were survival, local control of disease, quality of life, and adverse effects. METHODOLOGY The medline, cancerlit, embase, and Cochrane Library databases and abstracts published in the proceedings of the annual meetings of the American Society of Clinical Oncology (1997-2005) and American Society for Therapeutic Radiology and Oncology (1998-2004) were systematically searched for relevant evidence. The review included fully published reports or abstracts of randomized controlled trials (rcts), nonrandomized prospective studies, and retrospective studies. The present systematic review and practice guideline has been reviewed and approved by the Neuro-oncology dsg, which comprises medical and radiation oncologists, surgeons, neurologists, a nurse, and a patient representative. External review by Ontario practitioners was obtained through an electronic survey. Final approval of the guideline report was obtained from the Report Approval Panel and the Neuro-oncology dsg. RESULTS QUALITY OF EVIDENCE The literature search found three rcts that compared surgical resection plus wbrt with wbrt alone. In addition, a Cochrane review, including a meta-analysis of published data from those three rcts, was obtained. One rct compared surgical resection plus wbrt with surgical resection alone. One rct compared wbrt plus srs with wbrt alone. Evidence comparing srs with surgical resection or examining srs with or without wbrt was limited to prospective case series and retrospective studies. BENEFITS Two of three rcts reported a significant survival benefit for patients who underwent surgical resection as compared with those who received wbrt alone. Pooled results of the three rcts indicated no significant difference in survival or likelihood of dying from neurologic causes; however, significant heterogeneity was detected between the trials. The rct that compared surgical resection plus wbrt with surgical resection alone reported no significant difference in overall survival or length of functional independence; however, tumour recurrence at the site of the metastasis and anywhere in the brain was less frequent in patients who received wbrt as compared with patients in the observation group. In addition, patients who received wbrt were less likely to die from neurologic causes. Results of the rct that compared wbrt plus srs with wbrt alone indicated a significant improvement in median survival in patients who received srs. No quality evidence compares the efficacy of srs with surgical resection or examines the question of whether patients who receive srs should also receive wbrt. HARMS Pooled results of the three rcts that examined surgical resection indicated no significant difference in adverse effects between groups. Postoperative complications included respiratory problems, intracerebral hemorrhage, and infection. One rct reported no significant difference in adverse effects between patients who received wbrt plus srs and those who received wbrt alone. PRACTICE GUIDELINE TARGET POPULATION The recommendations that follow apply to adults with confirmed cancer and a single brain metastasis. This practice guideline does not apply to patients with metastatic lymphoma, small-cell lung cancer, germ-cell tumour, leukemia, or sarcoma. RECOMMENDATIONS Surgical excision should be considered for patients with good performance status, minimal or no evidence of extracranial disease, and a surgically accessible single brain metastasis amenable to complete excision. Because treatment in cases of single brain metastasis is considered palliative, invasive local treatments must be individualized. Patients with lesions requiring emergency decompression because of intracranial hypertension were excluded from the rcts, but should be considered candidates for surgery. To reduce the risk of tumour recurrence for patients who have undergone resection of a single brain metastasis, postoperative wbrt should be considered. The optimal dose and fractionation schedule for wbrt is 3000 cGy in 10 fractions or 2000 cGy in 5 fractions. As an alternative to surgical resection, wbrt followed by srs boost should be considered for patients with single brain metastasis. The evidence is insufficient to recommend srs alone as a single-modality therapy. QUALIFYING STATEMENTS No high-quality data are available regarding the choice of surgery versus radiosurgery for single brain metastasis. In general, the size and location of the metastasis determine the optimal approach. The standard wbrt regimen for management of patients with single brain metastasis in the United States is 3000 cGy in 10 fractions, and this treatment is usually the standard arm in randomized studies of radiation in patients with brain metastases. Based solely on evidence, the understanding that no reason exists to choose 3000 cGy in 10 fractions over 2000 cGy in 5 fractions is correct; however, fraction size is believed to be important, and therefore 300 cGy daily (3000/10) is believed to be associated with fewer long-term neurocognitive effects than 400 cGy daily (2000/5) in the occasional long-term survivor. For that reason, many radiation oncologists in Ontario prefer 3000 cGy in 10 fractions. No data exist to either support or refute that preference; therefore, finding a resolution to this issue is not currently possible. The Neuro-oncology dsg will update the recommendations as new evidence becomes available.
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Affiliation(s)
- A. Mintz
- University of Pittsburgh, Department of Neurological Surgery, Pittsburgh, Pennsylvania, U.S.A
| | - J. Perry
- Toronto–Sunnybrook Regional Cancer Centre, Toronto, Ontario
- Correspondence to: James Perry, c/o Karen Spithoff, Cancer Care Ontario, Program in Evidence-Based Care, McMaster University, Courthouse T-27, 3rd Floor, Room 319, 1280 Main Street West, Hamilton, Ontario L8S 4L8. E-mail:
| | - K. Spithoff
- Cancer Care Ontario, Program in Evidence-Based Care, McMaster University, Hamilton, Ontario
| | - A. Chambers
- Cancer Care Ontario, Program in Evidence-Based Care, McMaster University, Hamilton, Ontario
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Abstract
Question What is the safety and efficacy of interstitial chemotherapy with carmustine-loaded polymers (Gliadel wafers: MGI Pharma, Bloomington, MN, U.S.A.) in the treatment of newly diagnosed or recurrent malignant glioma (that is, glioblastoma multiforme, anaplastic astrocytoma, anaplastic oligoastrocytoma, and anaplastic oligodendroglioma)? Perspectives Malignant glioma is the most common type of primary brain tumour in adults. In general, efficacy of systemic therapy in this patient population has been disappointing, and novel treatment approaches are needed. Because several randomized controlled trials (rcts) investigating the safety and efficacy of Gliadel are available, the Neuro-oncology Disease Site Group of Cancer Care Ontario’s Program in Evidence-Based Care decided that a systematic review of the evidence was necessary. Outcomes The outcomes of interest for this review were overall survival, adverse events, and quality of life. Methodology Systematic searches of the medline, embase, and Cochrane Library databases were conducted for relevant evidence. Fully-published reports of rcts comparing treatment with Gliadel wafers to placebo or alternative treatment were selected for inclusion. Prospective cohort studies were also included. Results Two rcts that compared Gliadel to placebo in patients with newly diagnosed malignant glioma were obtained. Both rcts reported a significant survival benefit for patients who received Gliadel as compared with patients in the control group. One rct and one prospective cohort study were obtained that examined the role of Gliadel in patients with recurrent malignant glioma. The rct demonstrated a significant survival benefit for Gliadel only after adjustment for prognostic factors, and the prospective cohort study reported no survival benefit for Gliadel as compared with a historical control group. All three rcts reported similar rates of adverse events in the treatment and control groups. The most frequently reported adverse events were convulsions, confusion, brain edema, infection, hemiparesis, aphasia, and visual field defects. Conclusions Gliadel is an option for selected patients with newly diagnosed malignant glioma where a near gross total resection is possible. No evidence is available comparing Gliadel with systemic therapy, and a decision to combine Gliadel with systemic therapy should be made for patients individually. The patient population that would benefit from Gliadel (age, histology, and performance status) is unclear; further investigation is needed. Gliadel is also an option for patients with surgically resectable recurrent malignant glioma.
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Affiliation(s)
- J Perry
- Toronto-Sunnybrook Regional Cancer Centre, Toronto, Ontario
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Kenny D, Chakrabarti S, Ranasinghe A, Chambers A, Martin R, Stuart G. Single-centre use of implantable loop recorders in patients with congenital heart disease. Europace 2009; 11:303-7. [DOI: 10.1093/europace/eun380] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Perry J, Zinman L, Chambers A, Spithoff K, Lloyd N, Laperriere N. The Use of Prophylactic Anticonvulsants in Patients with Brain Tumours—A Systematic Review. Curr Oncol 2006. [DOI: 10.3747/co.v13i6.107] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Questions: Should patients with newly diagnosed brain tumours receive prophylactic anticonvulsants to reduce seizure risk? What is the best practice for patients with brain tumours who are taking anticonvulsant medications but who have never had a seizure? Perspectives: Patients with primary or metastatic brain tumours who have never had a seizure still have a 20% risk of experiencing a seizure over the course of their disease. Because considerable practice variation exists in regard to the management of patients with brain tumours who have never had a seizure, and because conflicting evidence has been reported, the Neuro-oncology Disease Site Group (DSG) of Cancer Care Ontario’s Program in Evidence-based Care felt that a systematic review of the evidence was warranted. Outcomes: Outcomes of interest were incidence of seizures and adverse effects of prophylactic anticonvulsant therapy. Methodology: The MEDLINE and Cochrane Library databases were systematically searched for relevant evidence. The review included fully published reports or abstracts of randomized controlled trials (RCTs), systematic reviews, meta-analyses, and practice guidelines. The present systematic review was reviewed and approved by the Neuro-oncology DSG, which comprises medical and radiation oncologists, surgeons, neurologists, a nurse, and a patient representative. Results: Quality of Evidence: The literature search located one evidence-based practice guideline, one systematic review, and five RCTs that addressed prophylactic anticonvulsants for patients with brain tumours. Evidence for the best management of seizure-naïve patients who are already taking anticonvulsants was limited to one retrospective study and exploratory analyses within several RCTs. Benefits and Harms: Pooled results of the five RCTs suggest that the incidence of seizures in patients who receive prophylactic anticonvulsants is not significantly different from that in patients who do not receive anticonvulsants (relative risk: 1.04; 95% confidence interval: 0.70 to 1.54; p = 0.84). This analysis accords with results from a published meta-analysis. Evidence is insufficient to determine whether patients who are currently taking anticonvulsants but who have never had a seizure should taper the anticonvulsants. Patients who received anticonvulsants reported adverse effects, including rash, nausea, and hypotension, but whether these effects are a result of the anticonvulsants or of other treatments could not be determined. Conclusions: Based on the available evidence, the routine use of postoperative anticonvulsants is not recommended in seizure-naïve patients with newly diagnosed primary or secondary brain tumours, especially in light of a significant risk of serious adverse effects and problematic drug interactions. Because data are insufficient to recommend whether anticonvulsants should be tapered in patients who are already taking anticonvulsants but who have never had a seizure, treatment must be individualized.
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Williams EW, Lindo JF, French S, Chambers A, Williams-Johnson J. Image and diagnosis. W INDIAN MED J 2006. [DOI: 10.1590/s0043-31442006000300016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Williams EW, Lindo JF, French S, Chambers A, Williams-Johnson J. Image and diagnosis. Cutaneous larva migrans (CLM). W INDIAN MED J 2006; 55:210-1. [PMID: 17087109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Affiliation(s)
- E W Williams
- Emergency Medicine Division, Department of Surgery, The University of the West Indies, Kingston 7, Jamaica, West Indies.
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Loblaw D, Perry J, Chambers A, Laperriere N. Systematic Review of the Diagnosis and Management of Malignant Extradural Spinal Cord Compression: The Cancer Care Ontario Practice Guidelines Initiative’s Neuro-Oncology Disease Site Group. J Urol 2006. [DOI: 10.1016/s0022-5347(05)00280-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- D.A. Loblaw
- Departments of Radiation Oncology and Medicine, Sunnybrook and Women’s College Health Science Centre and Department of Radiation Oncology. Princess Margaret Hospital/University Health Network, University of Toronto, Toronto and Program in Evidence-Based Caro, Cancer Care Ontario, McMaster University, Hamilton, Ontario, Canada
| | - J. Perry
- Departments of Radiation Oncology and Medicine, Sunnybrook and Women’s College Health Science Centre and Department of Radiation Oncology. Princess Margaret Hospital/University Health Network, University of Toronto, Toronto and Program in Evidence-Based Caro, Cancer Care Ontario, McMaster University, Hamilton, Ontario, Canada
| | - A. Chambers
- Departments of Radiation Oncology and Medicine, Sunnybrook and Women’s College Health Science Centre and Department of Radiation Oncology. Princess Margaret Hospital/University Health Network, University of Toronto, Toronto and Program in Evidence-Based Caro, Cancer Care Ontario, McMaster University, Hamilton, Ontario, Canada
| | - N.J. Laperriere
- Departments of Radiation Oncology and Medicine, Sunnybrook and Women’s College Health Science Centre and Department of Radiation Oncology. Princess Margaret Hospital/University Health Network, University of Toronto, Toronto and Program in Evidence-Based Caro, Cancer Care Ontario, McMaster University, Hamilton, Ontario, Canada
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Hill J, Harris AW, Manning M, Chambers A, Swanton SW. The effect of sodium chloride on the dissolution of calcium silicate hydrate gels. Waste Manag 2006; 26:758-68. [PMID: 16531035 DOI: 10.1016/j.wasman.2006.01.022] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/07/2005] [Accepted: 01/31/2006] [Indexed: 05/07/2023]
Abstract
The use of cement based materials will be widespread in the long-term management of radioactive materials in the United Kingdom. One of the applications could be the Nirex reference vault backfill (NRVB) as an engineered barrier within a deep geological repository. NRVB confers alkaline conditions, which would provide a robust chemical barrier through the control of the solubility of some key radionuclides, enhanced sorption and minimised corrosion of steel containers. An understanding of the dissolution of C-S-H gels in cement under the appropriate conditions (e.g., saline groundwaters) is necessary to demonstrate the expected evolution of the chemistry over time and to provide sufficient cement to buffer the porewater conditions for the required time. A programme of experimental work has been undertaken to investigate C-S-H gel dissolution behaviour in sodium chloride solutions and the effect of calcium/silicon ratio (C/S), temperature and cation type on this behaviour. Reductions in calcium concentration and pH values were observed with samples equilibrated at 45 degrees C compared to those prepared at 25 degrees C. The effect of salt cation type on salt-concentration dependence of the dissolution of C-S-H gels was investigated by the addition of lithium or potassium chloride in place of sodium chloride for gels with a C/S of 1.0 and 1.8. With a C/S of 1.0, similar increases in dissolved calcium concentration with increasing ionic strength were recorded for the different salts. However, at a C/S of 1.8, anomalously high calcium concentrations were observed in the presence of lithium.
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Affiliation(s)
- J Hill
- UK Nirex Limited, Curie Avenue, Harwell, Didcot Oxfordshire, OX11 0RH, United Kingdom.
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Spink K, Ho JCY, Tanaka K, Watts FZ, Chambers A. The telomere-binding protein Taz1p as a target for modification by a SUMO-1 homologue in fission yeast. Biochem Genet 2005; 43:103-17. [PMID: 15932060 DOI: 10.1007/s10528-005-1503-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
In fission yeast (Schizosaccharomyces pombe) the homologue of the mammalian SUMO-1 ubiquitin-like modifier is encoded by the pmt3 gene. A two-hybrid screen using the telomere-binding protein Taz1p as bait identified Pmt3p as an interacting factor. In vitro experiments using purified components of the fission yeast Pmt3p modification system demonstrated that Taz1p could be modified directly by Pmt3p. The amino acid sequence of Taz1p contains a close match to the consensus modification site for SUMO-1, and a PEST sequence similar to those found in established SUMO-1 targets. Although previous experiments have identified an increase in telomere length as one consequence of the pmt3--genotype, we could not detect Pmt3p modification of Taz1p in protein extracts made from exponentially growing haploid cells or any effect of Pmt3p on the localization of GFP-Taz1p at discrete foci in the haploid cell nucleus.
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Affiliation(s)
- K Spink
- Institute of Genetics, School of Biology, University of Nottingham, Queen's Medical Centre, Nottingham, United Kingdom
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Cochrane A, Chambers A, Duffy A, Harrison L, Stewart H, Selfe J, Ingman E. Development of a foundation degree in health and social care. International Journal of Therapy and Rehabilitation 2005. [DOI: 10.12968/ijtr.2005.12.6.18274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Health care in the UK is at present experiencing a shortfall of qualified health-care professionals. One initiative that has been proposed is to provide foundation degrees, which meet the needs of employers in a range of health and welfare settings and prepares students to support clients in maximizing their independence within a programme of care. This article describes the development of the foundation degree in health and social care at the University of Central Lancashire, UK. A two-stage consultative exercise with practitioners was undertaken in the form of focus groups. These were multidisciplinary and grouped according to practice area. This form of consultation has enabled clinicians to feel valued for their skills and opinions and has ensured a curriculum that is relevant and current to the needs of practice.
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Affiliation(s)
- A Cochrane
- Nursing, Department of Nursing, Faculty of Health, University of Central Lancashire, Preston PR1 2HE, UK
| | | | - A Duffy
- Physiotherapy, University of Central Lancashire
| | - L Harrison
- Physiotherapy, University of Central Lancashire, UK
| | - H Stewart
- Physiotherapy, University of Central Lancashire, UK
| | - J Selfe
- Physiotherapy, University of Central Lancashire, UK
| | - E Ingman
- Acute Services, Mersey Care NHS Trust, Liverpool, UK
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Kanjeekal S, Chambers A, Fung Kee Fung M, Verma S. Metastatic uterine sarcoma: A systematic review of the literature. J Clin Oncol 2004. [DOI: 10.1200/jco.2004.22.90140.5105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- S. Kanjeekal
- Ottawa Regional Cancer Centre, Ottawa, ON, Canada; Cancer Care Ontario Provinical Guidelines Initiati, Hamilton, ON, Canada
| | - A. Chambers
- Ottawa Regional Cancer Centre, Ottawa, ON, Canada; Cancer Care Ontario Provinical Guidelines Initiati, Hamilton, ON, Canada
| | - M. Fung Kee Fung
- Ottawa Regional Cancer Centre, Ottawa, ON, Canada; Cancer Care Ontario Provinical Guidelines Initiati, Hamilton, ON, Canada
| | - S. Verma
- Ottawa Regional Cancer Centre, Ottawa, ON, Canada; Cancer Care Ontario Provinical Guidelines Initiati, Hamilton, ON, Canada
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Bramwell V, Doig G, Tuck A, Wilson S, Tonkin K, Vandenberg T, Chambers A. Osteopontin (OPN): A novel tumor marker of potential utility in metastatic breast cancer. J Clin Oncol 2004. [DOI: 10.1200/jco.2004.22.90140.575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- V. Bramwell
- Tom Baker Cancer Centre, Calgary, AB, Canada; London Regional Cancer Centre, London, ON, Canada; Cross Cancer Institute, Edmonton, AB, Canada
| | - G. Doig
- Tom Baker Cancer Centre, Calgary, AB, Canada; London Regional Cancer Centre, London, ON, Canada; Cross Cancer Institute, Edmonton, AB, Canada
| | - A. Tuck
- Tom Baker Cancer Centre, Calgary, AB, Canada; London Regional Cancer Centre, London, ON, Canada; Cross Cancer Institute, Edmonton, AB, Canada
| | - S. Wilson
- Tom Baker Cancer Centre, Calgary, AB, Canada; London Regional Cancer Centre, London, ON, Canada; Cross Cancer Institute, Edmonton, AB, Canada
| | - K. Tonkin
- Tom Baker Cancer Centre, Calgary, AB, Canada; London Regional Cancer Centre, London, ON, Canada; Cross Cancer Institute, Edmonton, AB, Canada
| | - T. Vandenberg
- Tom Baker Cancer Centre, Calgary, AB, Canada; London Regional Cancer Centre, London, ON, Canada; Cross Cancer Institute, Edmonton, AB, Canada
| | - A. Chambers
- Tom Baker Cancer Centre, Calgary, AB, Canada; London Regional Cancer Centre, London, ON, Canada; Cross Cancer Institute, Edmonton, AB, Canada
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Chambers A, Halligan S, Goh V, Dhillon S, Hassan A. Therapeutic impact of abdominopelvic computed tomography in patients with acute abdominal symptoms. Acta Radiol 2004; 45:248-53. [PMID: 15239417 DOI: 10.1080/02841850410004553] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
PURPOSE To determine the diagnostic and therapeutic impact of abdominopelvic computed tomography (CT) in patients with acute abdominopelvic pain. MATERIAL AND METHODS Referring clinicians completed pre-CT and post-CT questionnaires for 50 patients in whom CT had been requested because of acute abdominopelvic pain. Clinicians recorded their leading diagnosis, confidence in this, and intended management. Following CT, clinicians again recorded these responses in the light of CT findings. Responses pre-CT and post-CT were compared in order to determine diagnostic and therapeutic impact. RESULTS Diagnostic confidence rose significantly following CT (mean score 6.8 pre-CT versus 8.3 post-CT; P<0.0001). Intended management changed because of CT findings in 29 (58%) patients: 14 (28%) subjects whose intended management was surgical were treated medically and an additional 2 were transferred to gynecological care; 4 patients whose intended management was medical were treated surgically; 2 patients whose intended management was medical were treated by percutaneous drainage; a patient whose intended management was percutaneous drainage was treated by surgery. Of 6 patients with uncertain management pre-CT, 2 were treated surgically and 4 medically. The leading diagnosis also changed as a consequence of CT in 7 (33%) of 21 patients in whom intended management did not alter. CONCLUSION CT in patients with acute abdominopelvic pain has considerable diagnostic and therapeutic impact, altering management in 58% of patients studied. The major effect is to avert intended laparotomy.
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Affiliation(s)
- A Chambers
- Department of Radiology, Northwick Park and St Mark's Hospitals, Harrow, Middlesex, UK
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Chambers A, Powell-Tuck J. Attitudes of nutrition nurse specialists (NNS) towards telemedicine (TM) in home parenteral nutrition (HPN) in the UK. Clin Nutr 2003. [DOI: 10.1016/s0261-5614(03)80365-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Dhillon S, Halligan S, Goh V, Matravers P, Chambers A, Remedios D. The therapeutic impact of abdominal ultrasound in patients with acute abdominal symptoms. Clin Radiol 2002; 57:268-71. [PMID: 12014871 DOI: 10.1053/crad.2001.0862] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
AIM The technical performance of abdominal ultrasound in the investigation of acute abdominal pain has been thoroughly investigated but its therapeutic effects are less well understood. We aimed to determine the therapeutic effect of abdominal ultrasound in the investigation of acute abdominal pain. MATERIAL AND METHODS A pre- and post-intervention observational study design was used to determine the diagnostic and therapeutic effects of abdominal ultrasound for acute abdominal pain. Referring clinicians completed a pre-ultrasound questionnaire that detailed their leading diagnosis, confidence in this and intended management in 100 consecutive adult patients. Following ultrasound a second questionnaire was completed. This again detailed the leading diagnosis, confidence in this and their intended management. Clinicians quantified the management contribution of ultrasound both for the individual case in question and in their clinical experience generally. RESULTS The leading diagnosis was either confirmed or rejected in 72 patients and a new diagnosis provided where no prior differential diagnosis existed in 10. Diagnostic confidence increased significantly following ultrasound (mean score 6.5 pre-ultrasound vs 7.6 post-ultrasound, P < 0.001). Intended management changed following ultrasound in 22 patients; 15 intended laparotomies were halted and a further seven patients underwent surgery where this was not originally intended. Ultrasound was rated either 'very' or 'moderately' helpful in 87% of patients, with 99% of clinicians finding it either 'very' or 'moderately' helpful generally. CONCLUSION Abdominal ultrasound has considerable diagnostic and therapeutic effect in the setting of acute abdominal pain.
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Affiliation(s)
- S Dhillon
- Department of Radiology, Northwick Park and St Mark's Hospitals, Harrow, UK
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Yu L, Sabet N, Chambers A, Morse RH. The N-terminal and C-terminal domains of RAP1 are dispensable for chromatin opening and GCN4-mediated HIS4 activation in budding yeast. J Biol Chem 2001; 276:33257-64. [PMID: 11413146 DOI: 10.1074/jbc.m104354200] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Repressor activator protein 1 (RAP1) assists GCN4-mediated HIS4 activation by overcoming some repressive aspect of chromatin structure to facilitate GCN4 binding. RAP1 also participates in other nuclear processes, and discrete domains of RAP1 have been shown to have specific properties including DNA binding, DNA bending, transcriptional activation, and silencing and telomere functions. To investigate whether specific domains of RAP1 are required to "open" chromatin and help GCN4 to activate the HIS4 gene, we examined the abilities of different truncated RAP1 proteins to perturb positioned nucleosomes via a nucleosomal RAP1 site in a yeast episome in vivo, and we tested HIS4 activation in yeast strains harboring truncated RAP1 mutants. We found that neither the DNA bending domain nor the putative activation domain of RAP1 is required for its ability to perturb the chromatin structure of a plasmid containing a RAP1 site. Similarly, neither the putative activation domain nor the N-terminal DNA-bending domain was required for GCN4-mediated activation of HIS4. We also used a rap1(ts) mutant to show that continuous occupancy of the HIS4 promoter by RAP1 is required for GCN4-mediated gene activation.
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Affiliation(s)
- L Yu
- Department of Biomedical Sciences, State University of New York at Albany School of Public Health, Albany, New York 12201-2002, USA
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McIntyre P, McLatchie LM, Chambers A, Phillips E, Clarke M, Savidge J, Toms C, Peacock M, Shah K, Winter J, Weerasakera N, Webb M, Rang HP, Bevan S, James IF. Pharmacological differences between the human and rat vanilloid receptor 1 (VR1). Br J Pharmacol 2001; 132:1084-94. [PMID: 11226139 PMCID: PMC1572656 DOI: 10.1038/sj.bjp.0703918] [Citation(s) in RCA: 161] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
Vanilloid receptors (VR1) were cloned from human and rat dorsal root ganglion libraries and expressed in Xenopus oocytes or Chinese Hamster Ovary (CHO) cells. Both rat and human VR1 formed ligand gated channels that were activated by capsaicin with similar EC(50) values. Capsaicin had a lower potency on both channels, when measured electrophysiologically in oocytes compared to CHO cells (oocytes: rat=1.90+/-0.20 microM; human=1.90+/-0.30 microM: CHO cells: rat=0.20+/-0.06 microM; human=0.19+/-0.08 microM). In CHO cell lines co-expressing either rat or human VR1 and the calcium sensitive, luminescent protein, aequorin, the EC(50) values for capsaicin-induced responses were similar in both cell lines (rat=0.35+/-0.06 microM, human=0.53+/-0.03 microM). The threshold for activation by acidic solutions was lower for human VR1 channels than that for rat VR1 (EC(50) pH 5.49+/-0.04 and pH 5.78+/-0.09, respectively). The threshold for heat activation was identical (42 degrees C) for rat and human VR1. PPAHV was an agonist at rat VR1 (EC(50) between 3 and 10 microM) but was virtually inactive at the human VR1 (EC(50)>10 microM). Capsazepine and ruthenium red were both more potent at blocking the capsaicin response of human VR1 than rat VR1. Capsazepine blocked the human but not the rat VR1 response to low pH. Capsazepine was also more effective at inhibiting the noxious heat response of human than of rat VR1.
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Affiliation(s)
- P McIntyre
- Novartis Institute for Medical Sciences, 5 Gower Place, London WC1E 6BN, UK.
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Trites J, Yoo J, Taylor M, Schmidt E, Morris V, MacDonald I, Chambers A, Groom A. Lymph node metastasis in malignant melanoma: an in vivo animal model. J Otolaryngol 2000; 29:233-8. [PMID: 11003076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
Affiliation(s)
- J Trites
- Department of Otolaryngology--Head and Neck Surgery, London Health Sciences Centre, The University of Western Ontario, London, Ontario
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Abstract
The fission yeast (Schizosaccharomyces pombe) taz1 gene encodes a telomere-associated protein. It contains a single copy of a Myb-like motif termed the telobox that is also found in the human telomere binding proteins TRF1 and TRF2, and Tbf1p, a protein that binds to sequences found within the sub-telomeric regions of budding yeast (Saccharomyces cerevisiae) chromosomes. Taz1p was synthesised in vitro and shown to bind to a fission yeast telomeric DNA fragment in a sequence specific manner that required the telobox motif. Like the mammalian TRF proteins, Taz1p bound to DNA as a preformed homodimer. The isolated Myb-like domain was also capable of sequence specific DNA binding, although with less specificity than the full-length dimer. Surprisingly, a protein extract produced from a taz1- fission yeast strain still contained the major telomere binding activity (complex I) we have characterised previously, suggesting that there could be other abundant telomere binding proteins in fission yeast. One candidate, SpX, was also synthesised in vitro, but despite the presence of two telobox domains, no sequence specific binding to telomeric DNA was detected.
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Affiliation(s)
- K G Spink
- Institute of Genetics, University of Nottingham, Queen's Medical Centre, Nottingham NG7 2UH, UK
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