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Harwood R, Bethell G, Eastwood MP, Hotonu S, Allin B, Boam T, Rees CM, Hall NJ, Rhodes H, Ampirska T, Arthur F, Billington J, Bough G, Burdall O, Burnand K, Chhabra S, Driver C, Ducey J, Engall N, Folaranmi E, Gracie D, Ford K, Fox C, Green P, Green S, Jawaid W, John M, Koh C, Lam C, Lewis S, Lindley R, Macafee D, Marks I, McNickle L, O’Sullivan BJ, Peeraully R, Phillips L, Rooney A, Thompson H, Tullie L, Vecchione S, Tyraskis A, Maldonado BN, Pissaridou M, Sanchez-Thompson N, Morris L, John M, Godse A, Farrelly P, Cullis P, McHoney M, Colvin D. The Blunt Liver and Spleen Trauma (BLAST) audit: national survey and prospective audit of children with blunt liver and spleen trauma in major trauma centres. Eur J Trauma Emerg Surg 2023; 49:2249-2256. [PMID: 35727342 PMCID: PMC10520113 DOI: 10.1007/s00068-022-01990-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Accepted: 04/24/2022] [Indexed: 11/29/2022]
Abstract
PURPOSE To compare the reported and observed management of UK children with blunt liver or spleen injury (BLSI) to the American Pediatric Surgical Association (APSA) 2019 BLSI guidance. METHODS UK Paediatric Major Trauma Centres (pMTCs) undertook 1 year of prospective data collection on children admitted to or discussed with those centres with BLSI and an online questionnaire was distributed to all consultants who care for children with BLSI in those centres. RESULTS All 21/21 (100%) pMTCs participated; 131 patients were included and 100/152 (65%) consultants responded to the survey. ICU care was reported and observed to be primarily determined using haemodynamic status or concomitant injuries rather than injury grade, in accordance with APSA guidance. Bed rest was reported to be determined by grade of injury by 63% of survey respondents and observed in a similar proportion of patients. Contrary to APSA guidance, follow-up radiological assessment of the injured spleen or liver was undertaken in 44% of patients before discharge and 32% after discharge, the majority of whom were asymptomatic. CONCLUSIONS UK management of BLSI differs from many aspects of APSA guidance. A shift towards using clinical features to determine ICU admission and readiness for discharge is demonstrated, in line with a strong evidence base. However, routine bed rest and re-imaging after BLSI is common, contrary to APSA guidance. This disparity may exist due to concern that evidence around the incidence, presentation and natural history of complications after conservatively managed BLSI, particularly bleeding from pseudoaneurysms, is weak.
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Lam C, Ray A, Maresh G, Zhang X, Baer H, Haupt C, Simon J, Green H, Paruch J, Li L. Evaluating the effect of checkpoint inhibitors in microsatellite instability high and microsatellite stable colorectal cancer using a humanized murine model. Am J Med Sci 2023. [DOI: 10.1016/s0002-9629(23)00568-2] [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: 01/28/2023]
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Ma N, Low S, Hasan S, Lawal A, Patel S, Nurse K, McNaughton G, Aggarwal R, Evans J, Koria R, Lam C, Chakravorty M, Stanley G, Banna S, Kalsi T. 1226 A MULTI-DISCIPLINARY APPROACH TO TRANSFORMING EYE CARE SERVICES FOR CARE HOME RESIDENTS. Age Ageing 2023. [DOI: 10.1093/ageing/afac322.114] [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: 01/18/2023] Open
Abstract
Abstract
Introduction
Care home residents can have variable access to eye care services and treatments. We developed a collaborative approach between optometrists, care homes, and primary and secondary care to enable personalised patient-centred care.
Objective
To develop and evaluate an integrated model of eye care for care home residents.
Methods
Small scale plan-do-study-act (PDSA) service tests were completed in three care-homes in Southwark (2 residential, 1 nursing) between November 2021 to May 2022. Processes were compared to historical feedback and hospital-based ophthalmology clinic attendances (Mar 2019-2020). Hospital-like assessments were piloted at two care homes for feasibility and acceptability. Further piloting utilised usual domiciliary optometry-led assessment with multidisciplinary meeting access (including optometrist, GP, geriatrician, ophthalmologist and care home nurse) to reduce duplication of assessments and to evaluate MDM processes and referral rates.
Results
Examination was 100% successful at home (visual acuity and pressure measurement) compared to hospital outpatients (71.7% success visual acuity, 54.5% pressures). Examination was faster than in hospital settings (16 minutes vs 45 minutes-1 hour). Residents were away from usual activities for 32 minutes vs 6 hours for hospital visits including transport. Residents were less distressed with home-based assessments. Did-Not-Attend (DNA) rates reduced (26.7% to 0%), secondary care discharge rates improved (8.4% to 32%). Hospital eye service referral were indicated in 19% -23%, half of which were for consideration of cataract surgery. Alternative conservative plans were agreed at MDM for nursing home residents who were clinically too frail or would not have been able to comply with treatments avoiding 33% unnecessary referrals.
Conclusions
Home-based eye care assessments appear better tolerated and are more efficient for residents, health and care staff. Utilising an MDM for optometrists to discuss residents with ophthalmologists and wider MDT members enabled personalised patient-centred decision-making. Future work to test this borough wide is in progress.
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Affiliation(s)
- N Ma
- Guy’s and St Thomas’ NHS Foundation Trust , London
| | - S Low
- Guy’s and St Thomas’ NHS Foundation Trust , London
| | - S Hasan
- Quay Health Solutions GP Care Home Service , Southwark, London
| | - A Lawal
- Quay Health Solutions GP Care Home Service , Southwark, London
| | | | | | | | | | - J Evans
- Minor Eye Conditions Scheme, Primary Ophthalmic Solutions , London
| | - R Koria
- Minor Eye Conditions Scheme, Primary Ophthalmic Solutions , London
| | - C Lam
- Guy’s and St Thomas’ NHS Foundation Trust , London
| | | | - G Stanley
- Quay Health Solutions GP Care Home Service , Southwark, London
| | - S Banna
- Guy’s and St Thomas’ NHS Foundation Trust , London
| | - T Kalsi
- Guy’s and St Thomas’ NHS Foundation Trust , London
- King’s College London
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Ahmed K, Quick A, Bixel K, Kim Y, Lemerond E, Chon H, Chern J, Fernandez D, Hoffman M, Kim S, Lam C, Montejo M, Shahzad M, Wenham R. Atezolizumab and Stereotactic Body Radiation Therapy in Metastatic, Recurrent or Persistent Cervical Cancer: Interim Results from a Non-Randomized, Open-Label Phase II Multi-Institutional Study. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.501] [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: 11/25/2022]
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Azzopardi R, Nerlekar N, Chandramouli C, Scherer D, Lam C, Yeo K, Nicholls S, Nelson A. Temporal Trends in Seminal Cardiovascular and Cardiometabolic Clinical Trial Leadership and Collaboration in the Asia-Pacific Region. Heart Lung Circ 2022. [DOI: 10.1016/j.hlc.2022.06.385] [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: 11/29/2022]
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Goebel S, Wingerter A, Prochaska JH, Schulz A, Neu MA, Henninger N, Spix C, Beutel M, Lackner KJ, Muenzel T, Lam C, Merzenich H, Faber J, Wild PS. Development of heart failure in long-term survivors of childhood cancer: results from the cvss study. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.2880] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Long-term survivors of childhood cancer (CCS) are at increased risk for cardiovascular sequelae, including heart failure (HF) as the largest non-malignant contributor to excess death. Yet, little is known about the risk factors, mechanisms of cardiac dysfunction and prevalence of different stages of HF in these patients.
Purpose
To investigate the development and prevalence of HF phenotypes in CCS compared to the general population.
Methods
The CVSS study is a prospective single-center cohort study investigating cardiovascular sequelae of CCS. Patients were eligible for the study when they were diagnosed with a neoplasia according to the International Classification of Childhood Cancer (ICCC 3) at an age prior to 15 years between 1980 and 1990, survived more than five years after initial cancer diagnosis and received antineoplastic treatment. Between 2013 and 2016, study individuals underwent a comprehensive, standardized clinical investigation in the CVSS cohort study including echocardiographic examination. HF was categorized as stages A to D according to current HF guidelines of the American Heart Association (AHA). A population-based sample free of cancer (age- and sex matched) serves as control group.
Results
From 1,002 individuals, all CCS with history of chemo- or radiotherapy and no subsequent neoplasia (n=877) were included (mean age 34.2 (±5.5) years, 44.7% (N=392) female). Age at diagnosis was 6.28 years (±4.24) and the mean interval from the date of diagnosis of cancer to the date of completion of baseline examination 28.5±3.2 years. Based on echocardiographic examination, clinical data and biomarker assessment, 26.6% of CCS were diagnosed with HF stage A, 21.1% with HF stage B and 2.1% with symptomatic HF, i.e. HF stage C/D. Importantly, prevalence of different HF stages varied strongly by specific tumor history. Compared to the population, the prevalence ratio (PR) was 1.16 [95% confidence interval 1.02/1.31] for stage A HF and 1.91 [1.63/2.23] for the composite of stage B to D HF in an age- and sex-adjusted Poisson regression model. Multivariable linear regression with the systolic marker left ventricular ejection fraction as dependent variable and adjustment for tumor entities, age, sex, and cardiovascular risk factors (CVRF) revealed a lower EF in patients with history of bone tumors (β −6.0 [−8.1/−3.0]), soft tissue sarcoma (β −2.2 [−4.1/−0.35]), leukemia (β −0.84 [−1.8/0.08]) and renal tumors (β −1.8 [−4.0/0.27]) compared to the population. In contrast, the same model for the diastolic marker E/E', showed an association only with CVRF, but not with tumor entities.
Conclusion
The prevalence of stage B to D HF was significantly higher among long-term CCS in the 3rd to 5th age decade compared to the population and varied strongly by tumor entity. Systolic dysfunction was primarily associated with history of tumor entities, whereas diastolic dysfunction was associated with the higher burden of CVRF in CCS.
Funding Acknowledgement
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): This study is funded by the Deutsche Forschungsgemeinschaft (DFG) (SP 1381/2-1&2, FA 1038/2-1&2, WI 3881/2-1&2)
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Affiliation(s)
- S Goebel
- University Medical Center Mainz, Department of Cardiology, Mainz, Germany
| | - A Wingerter
- University Medical Center Mainz, Department of Pediatric Hematology and Oncology, Mainz, Germany
| | - J H Prochaska
- University Medical Center Mainz, Preventive Cardiology and Preventive Medicine, Mainz, Germany
| | - A Schulz
- University Medical Center Mainz, Preventive Cardiology and Preventive Medicine, Mainz, Germany
| | - M A Neu
- University Medical Center Mainz, Department of Pediatric Hematology and Oncology, Mainz, Germany
| | - N Henninger
- University Medical Center Mainz, Department of Pediatric Hematology and Oncology, Mainz, Germany
| | - C Spix
- University Medical Center Mainz, Institute for medical biostatistics, epidemiology and informatics, Mainz, Germany
| | - M Beutel
- University Medical Center Mainz, Clinic for Psychosomatic Medicine and Psychotherapy, Mainz, Germany
| | - K J Lackner
- University Medical Center Mainz, Institute of Clinical Chemistry and Laboratory Medicine, Mainz, Germany
| | - T Muenzel
- University Medical Center Mainz, Department of Cardiology, Mainz, Germany
| | - C Lam
- National University of Singapore, National Heart Center, Singapore, Singapore
| | - H Merzenich
- University Medical Center Mainz, Institute for medical biostatistics, epidemiology and informatics, Mainz, Germany
| | - J Faber
- University Medical Center Mainz, Department of Pediatric Hematology and Oncology, Mainz, Germany
| | - P S Wild
- University Medical Center Mainz, Preventive Cardiology and Preventive Medicine, Mainz, Germany
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Light A, Gallagher K, Bhatt N, Clement K, Kulkarni MA, Khadhouri S, Zimmermann E, Gao C, Lam C, Anbarasan T, Chan V, Rossi S, Jayaraajan K, Asif A, Shah T, Kasivisvanathan V. 377 Global Recruitment for The RESECT Study (Transurethral Resection and Single-Instillation Intravesical Chemotherapy Evaluation in Bladder Cancer Treatment): An International Observational Cohort Study Aiming to Improve the Quality of Surgery for Non-Muscle Invasive Bladder Cancer. Br J Surg 2021. [DOI: 10.1093/bjs/znab135.030] [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
Non-muscle invasive bladder cancer (NMIBC) can be curatively treated with ‘good quality’ transurethral resection of the bladder tumour (TURBT). However, despite evidence-based international guidelines, there is anecdotal evidence that practice varies widely, and this may affect oncological outcomes. Launching in 2020, RESECT aims to measure and report variation in TURBT quality globally, and determine if outcome reporting improves outcomes.
Method
RESECT was advertised internationally through social media, mailing lists, websites, and in person. Collaborators at each registered site will collect data about current practice and the experience of local TURBT surgeons. The primary outcome is the rate of achievement of key TURBT quality indicators.
Results
As of August 27, 508 collaborators have registered to participate. Collaborators represent 321 centres from 54 countries, with the highest number from the United Kingdom (54.5%), Spain (5.9%), and Argentina (3.7%). 51.2% are trainees, 29.9% consultants, and 17.5% medical students. Based on current registrations, patient recruitment will far exceed initial projections and considerably improve statistical power.
Conclusions
RESECT has attracted a large number of collaborators globally and from all training levels. Therefore, the RESECT study has the potential to improve the quality of TURBT surgery across the world.
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Affiliation(s)
- A Light
- British Urology Researchers in Surgical Training (BURST) research collaborative, London, United Kingdom
- Addenbrooke's Hospital, Cambridge, United Kingdom
| | - K Gallagher
- British Urology Researchers in Surgical Training (BURST) research collaborative, London, United Kingdom
- Western General Hospital, Edinburgh, United Kingdom
| | - N Bhatt
- British Urology Researchers in Surgical Training (BURST) research collaborative, London, United Kingdom
- Queen Elizabeth Hospital, King's Lynn, United Kingdom
| | - K Clement
- British Urology Researchers in Surgical Training (BURST) research collaborative, London, United Kingdom
- Royal Alexandra Hospital, Paisley, United Kingdom
| | - M a Kulkarni
- British Urology Researchers in Surgical Training (BURST) research collaborative, London, United Kingdom
- Guy's Hospital, London, United Kingdom
| | - S Khadhouri
- British Urology Researchers in Surgical Training (BURST) research collaborative, London, United Kingdom
- Aberdeen Royal Infirmary, Aberdeen, United Kingdom
| | - E Zimmermann
- British Urology Researchers in Surgical Training (BURST) research collaborative, London, United Kingdom
- Torbay Hospital, Torbay, United Kingdom
| | - C Gao
- British Urology Researchers in Surgical Training (BURST) research collaborative, London, United Kingdom
- William Harvey Hospital, Ashford, United Kingdom
| | - C Lam
- British Urology Researchers in Surgical Training (BURST) research collaborative, London, United Kingdom
- Bronglais Hospital, Aberystwyth, United Kingdom
| | - T Anbarasan
- British Urology Researchers in Surgical Training (BURST) research collaborative, London, United Kingdom
- NHS Lothian, Edinburgh, United Kingdom
| | - V Chan
- British Urology Researchers in Surgical Training (BURST) research collaborative, London, United Kingdom
- Leeds School of Medicine, Leeds, United Kingdom
| | - S Rossi
- British Urology Researchers in Surgical Training (BURST) research collaborative, London, United Kingdom
- Addenbrooke's Hospital, Cambridge, United Kingdom
| | - K Jayaraajan
- British Urology Researchers in Surgical Training (BURST) research collaborative, London, United Kingdom
- Imperial College School of Medicine, London, United Kingdom
| | - A Asif
- British Urology Researchers in Surgical Training (BURST) research collaborative, London, United Kingdom
- Leicester Medical School, Leicester, United Kingdom
| | - T Shah
- British Urology Researchers in Surgical Training (BURST) research collaborative, London, United Kingdom
- Charing Cross Hospital, London, United Kingdom
| | - V Kasivisvanathan
- British Urology Researchers in Surgical Training (BURST) research collaborative, London, United Kingdom
- University College London, London, United Kingdom
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ARNOLD M, Garcia Sanchez J, Carrero J, James G, Heerspink H, Abdul Sultan A, Lam C, Chen T, Nolan S, Pollock C, Pecoits-Filho R. POS-327 THE COST OF END OF LIFE INPATIENT ENCOUNTERS IN PATIENTS WITH CHRONIC KIDNEY DISEASE IN THE UNITED STATES. Kidney Int Rep 2021. [DOI: 10.1016/j.ekir.2021.03.343] [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: 10/21/2022] Open
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9
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Kawashima M, Teskey G, Joe B, Guan Z, Oliver J, Sachewsky N, Watanabe T, Buhari H, Lam C, Cypel M, Keshavjee S, Martinu T, Juvet S. A Protective Role of Donor B Cells against Ischemia-Reperfusion Injury in a Minor-Mismatched Mouse Lung Transplant Model. J Heart Lung Transplant 2021. [DOI: 10.1016/j.healun.2021.01.1875] [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] Open
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10
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GARCIA SANCHEZ J, Carrero J, Arnold M, Heerspink H, James G, Lam C, Abdul Sultan A, Pollock C, Chen T, Nolan S, Pecoits-Filho R. POS-319 EMERGENCY AND CRITICAL HEALTHCARE RESOURCE UTILISATION OF PATIENTS WITH CHRONIC KIDNEY DISEASE ACCORDING TO SEVERITY OF ALBUMINURIA: A REPORT FROM THE DISCOVER CKD RETROSPECTIVE COHORT. Kidney Int Rep 2021. [DOI: 10.1016/j.ekir.2021.03.335] [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: 11/15/2022] Open
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JAMES G, Carrero J, Kumar S, Fishbane S, Wittbrodt E, Kanda E, Hedman K, Kashihara N, Kosiborod M, Lainscak M, Lam C, Pollock C, Stenvinkel P, Wheeler D, Pecoits-Filho R. POS-328 THE BURDEN OF HYPERKALEMIA IN PATIENTS WITH CHRONIC KIDNEY DISEASE: A REPORT FROM THE DISCOVER CKD RETROSPECTIVE COHORT. Kidney Int Rep 2021. [DOI: 10.1016/j.ekir.2021.03.344] [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: 11/17/2022] Open
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12
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JAMES G, Carrero J, Kumar S, Fishbane S, Wittbrodt E, Kanda E, Hedman K, Kashihara N, Kosiborod M, Lainscak M, Lam C, Pollock C, Stenvinkel P, Wheeler D, Pecoits-Filho R. POS-329 TREATMENT PATTERNS IN CHRONIC KIDNEY DISEASE PATIENTS WITH HYPERKALEMIA: A REPORT FROM THE DISCOVER CKD RETROSPECTIVE COHORT. Kidney Int Rep 2021. [DOI: 10.1016/j.ekir.2021.03.345] [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: 10/21/2022] Open
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13
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Loggetto P, Ritter J, Lam C, Marx K, Metzger M. Equity as a consideration in National Cancer Control Plans from the American continent: a comparative content analysis. The Lancet Global Health 2021. [DOI: 10.1016/s2214-109x(21)00116-9] [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: 10/21/2022] Open
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Madhav N, Bosa HK, Agyarko RD, Stephenson N, Miller K, Gallivan M, Lam C, Meadows A, Sridharan V, Bah A, Béavogui M. Development of a risk modeling approach to enhance the effectiveness of epidemic preparedness, response, and financing strategies in African countries. Int J Infect Dis 2020. [DOI: 10.1016/j.ijid.2020.09.565] [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: 10/22/2022] Open
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Johnson E, Lam C, Bluthenthal R, Trotsky-Sirr R, Schneberk T. 57EMF X-Waiver Training for Resident Physicians Increases Emergency Department Buprenorphine Delivery: An Implementation Science Evaluation. Ann Emerg Med 2020. [DOI: 10.1016/j.annemergmed.2020.09.067] [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: 11/17/2022]
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16
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Vazquez A, Johnson E, Lam C, Diller D, Jain A, Shamoon M, Riddell J. 212 Do the Milestones Addressed by Faculty in Workplace-Based Narrative Assessments of Residents Differ by Sex? Ann Emerg Med 2020. [DOI: 10.1016/j.annemergmed.2020.09.225] [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: 11/30/2022]
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17
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Kuznicki M, Mallen A, Eggers E, Lam C, Regis J, Todd S, Tanner J, Anderson M, Rutherford T. Preliminary prospective quality of life and clinical outcomes with an opiate restrictive enhanced recovery protocol in a gynecologic oncology population. Gynecol Oncol 2020. [DOI: 10.1016/j.ygyno.2020.06.084] [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: 10/23/2022]
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Affiliation(s)
- W Xue
- Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong
| | - C Lam
- Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong
| | - H H Yeung
- Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong
| | - C S Wong
- Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong
| | - V L Y Chan
- Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong
| | - Y S Wong
- Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong
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Lo IL, Zeng W, Lei CI, Lam C, Lou HL. Knowledge, Attitude and Preventive Practice on Dementia Care among Primary Health Professionals in Macao. J Prev Alzheimers Dis 2020; 7:83-86. [PMID: 32236396 DOI: 10.14283/jpad.2020.10] [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] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The Macao Dementia Policy was recognized by Alzheimer Disease International as the 27th globally and one of the highest stage 5 to develop dementia friendly community and primary health professionals are in a pivotal position to enhance community-based dementia prevention and care quality. This study aimed to investigate the knowledge, attitude and preventive practice on dementia care among primary health professionals in Macao. A specially designed 30-item questionnaire was developed and validated for the study. The Content Validity Index (CVI) and Cronbach's α of the questionnaire were 0.973 and 0.808. The questionnaires were distributed to all 375 primary health professionals from 8 Health Centers throughout Macao and 234 valid questionnaires (62.4%) were returned. The score for dementia care knowledge was 87.02±14.01; attitude was 69.52±5.83; preventive practice was 77.88±13.18, of which doctors (79.89±13.77) was significantly higher (t=2.29, p=0.023) than nurses (75.91±12.33). There were positive relationships between preventive practice and attitude (r=0.163, p=0.014), and age (r=0.212, p=0.002), and a negative relationship between knowledge and age (r=-0.139, p=0.040). These findings have significant implications that most primary health professionals in Macao had sufficient knowledge, a positive attitude and appropriate preventive practice on dementia care. However, enhanced dementia education to improve knowledge and preventive practice was a strong agenda for the training for senior staff and nurses.
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Affiliation(s)
- I L Lo
- Lei Chin Ion, Macao Health Bureau,
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Cheuk N, Yeung C, Lam C. Into the circuit of a pioneering mind: An interview with Professor Vincent Mok. Hong Kong Med J 2020; 26:156-158. [PMID: 32300081 DOI: 10.12809/hkmj-hc202004] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023] Open
Affiliation(s)
- N Cheuk
- Year 4 (MB BS), University of Hong Kong
| | - C Yeung
- Year 4 (MB BS), University of Hong Kong
| | - C Lam
- Year 5 (MB ChB), Chinese University of Hong Kong
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22
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Lam C, Plosker S, Imudia A. 32: Laparoscopic management of a cornual ectopic pregnancy. Am J Obstet Gynecol 2020. [DOI: 10.1016/j.ajog.2019.12.181] [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: 10/24/2022]
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23
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Lam C, Loko G, Meunier B, Bourguignon A, Ifrim R, Ozier-Lafontaine N, Haustant-Andry L, Banydeen R, Neviere R, Inamo J. High blood pressure in adult patients with sickle cell disease: New insight from an ambulatory blood pressure monitoring pilot study. Archives of Cardiovascular Diseases Supplements 2020. [DOI: 10.1016/j.acvdsp.2019.09.396] [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]
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24
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Birley J, Summers Y, Taylor P, Beanland L, Lam C, Califano R, Cove-Smith L. Incidence of cardiovascular adverse events (AEs) in resected non-small cell lung cancer (NSCLC) patients receiving adjuvant platinum-based chemotherapy: a single institution experience from Wythenshawe Hospital, Manchester, UK. Lung Cancer 2020. [DOI: 10.1016/s0169-5002(20)30129-x] [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: 11/15/2022]
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Hung T, Rosales M, Kurobe T, Stevenson T, Ellison L, Tigan G, Sandford M, Lam C, Schultz A, Teh S. A pilot study of the performance of captive-reared delta smelt Hypomesus transpacificus in a semi-natural environment. J Fish Biol 2019; 95:1517-1522. [PMID: 31613989 PMCID: PMC6916271 DOI: 10.1111/jfb.14162] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/16/2019] [Accepted: 10/14/2019] [Indexed: 06/01/2023]
Abstract
A captive breeding programme was developed in 2008 for delta smelt Hypomesus transpacificus in reaction to dramatic population decline over several decades. We took 526 sub-adult captive-reared delta smelt and cultured them for 200 days without providing artificial food or water quality management to assess their performance once released in the wild. The results indicated captive-reared sub-adult delta smelt could survive in a semi-natural environment with uncontrolled water quality and naturally produced wild prey through spawning and into their post spawning phase.
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Affiliation(s)
- Tien‐Chieh Hung
- Department of Biological and Agricultural EngineeringUniversity of CaliforniaDavisCaliforniaUSA
| | - Marlin Rosales
- Department of Biological and Agricultural EngineeringUniversity of CaliforniaDavisCaliforniaUSA
| | - Tomofumi Kurobe
- Department of Anatomy, Physiology, and Cell BiologySchool of Veterinary Medicine, University of CaliforniaDavisCaliforniaUSA
| | - Troy Stevenson
- Department of Biological and Agricultural EngineeringUniversity of CaliforniaDavisCaliforniaUSA
| | - Luke Ellison
- Department of Biological and Agricultural EngineeringUniversity of CaliforniaDavisCaliforniaUSA
| | - Galen Tigan
- Department of Biological and Agricultural EngineeringUniversity of CaliforniaDavisCaliforniaUSA
| | - Marade Sandford
- Department of Biological and Agricultural EngineeringUniversity of CaliforniaDavisCaliforniaUSA
| | - Chelsea Lam
- Department of Anatomy, Physiology, and Cell BiologySchool of Veterinary Medicine, University of CaliforniaDavisCaliforniaUSA
| | - Andrew Schultz
- Mid‐Pacific Region, Bay‐Delta Office, U.S. Bureau of ReclamationSacramentoCaliforniaUSA
| | - Swee Teh
- Department of Anatomy, Physiology, and Cell BiologySchool of Veterinary Medicine, University of CaliforniaDavisCaliforniaUSA
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Lam C, Cheuk N, Yeung C. Healing hearts in paediatrics: an interview with Dr Adolphus Chau. Hong Kong Med J 2019; 25:416-418. [PMID: 31761758 DOI: 10.12809/hkmj-hc201910] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023] Open
Affiliation(s)
- C Lam
- Year 5 (MB ChB), The Chinese University of Hong Kong
| | - N Cheuk
- Year 4 (MB BS), The University of Hong Kong
| | - C Yeung
- Year 4 (MB BS), The University of Hong Kong
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Macaraig MM, Jalees M, Lam C, Burzynski J. Improved treatment completion with shorter treatment regimens for latent tuberculous infection. Int J Tuberc Lung Dis 2019; 22:1344-1349. [PMID: 30355415 DOI: 10.5588/ijtld.18.0035] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
SETTING Four New York City (NYC) Health Department tuberculosis (TB) clinics. OBJECTIVE To assess the effectiveness of preferentially offering two shorter treatment regimens-4 months of daily rifampin (4R) and 3 months of once-weekly isoniazid and rifapentine (3HP)-as an alternative to 9 months of daily isoniazid (9H) for the treatment of latent tuberculous infection (LTBI). DESIGN Retrospective analysis of patients treated for LTBI from January to June 2015. Poisson regression with robust standard error was used to examine the factors associated with treatment completion. RESULTS Of the patients on 9H, 49% (27/55) completed treatment compared with 70% (187/269) of patients on 4R (P = 0.003) and 79% (99/125) of patients on 3HP (P < 0.001). When adjusting for age, sex, and TB risk factors, patients on 4R (adjusted risk ratio [aRR] 1.39, 95%CI 1.07-1.81) and 3HP (aRR 1.67, 95%CI 1.27-2.19) were more likely to complete treatment than patients on 9H. Treatment was discontinued due to side effects in 1% (3/269) of patients on 4R, 2% (2/125) of patients on 3HP, and 4% (2/55) of patients on 9H. CONCLUSIONS Most patients were placed on shorter regimens for LTBI treatment, and higher treatment completion was observed. Encouraging community providers to use shorter regimens for LTBI treatment would reduce the TB disease burden in NYC.
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Affiliation(s)
- M M Macaraig
- New York City Department of Health and Mental Hygiene, New York, New York
| | - M Jalees
- New York City Department of Health and Mental Hygiene, New York, New York, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - C Lam
- New York City Department of Health and Mental Hygiene, New York, New York, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - J Burzynski
- New York City Department of Health and Mental Hygiene, New York, New York
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Lam C, Casamian-Sorrosal D, Monteith G, Fonfara S. Heart-fatty acid binding protein in dogs with degenerative valvular disease and dilated cardiomyopathy. Vet J 2019; 244:16-22. [PMID: 30825889 DOI: 10.1016/j.tvjl.2018.11.017] [Citation(s) in RCA: 1] [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: 03/21/2018] [Revised: 11/15/2018] [Accepted: 11/27/2018] [Indexed: 10/27/2022]
Abstract
The study objective was to investigate heart-fatty acid binding protein (HFABP) concentrations in dogs with degenerative valvular disease (MVD) and dilated cardiomyopathy (DCM), and its potential as a prognostic factor. Plasma HFABP, N-terminal pro brain natriuretic peptide (NTproBNP) and serum cardiac troponin I (cTnI) levels were measured in 21 control dogs, 23 dogs with MVD and 13 dogs with DCM, with repeated sampling at 1 and 3 months after initial presentation. All dogs were followed up after 6 and 12 months to verify survival. Heart-fatty acid binding protein concentrations were significantly higher in dogs with MVD and DCM than controls at initial presentation, and after 1 month in dogs with MVD. For dogs with DCM, a significant reduction in HFABP levels over time was observed. Comparing ACVIM stages, highest HFABP concentrations were detected in ACVIM stage C dogs compared to stage B, with the lowest levels seen in controls, and a reduction over time in stage C dogs was present. Similarly, cTnI concentrations were higher in DCM and stage C in comparison to control dogs and reduced over time, while NTproBNP concentrations were only higher in diseased dogs at 1 month. Heart-fatty acid binding protein and cTnI levels at initial presentation and ACVIM disease stage were independent predictors of survival in a univariate analysis. The elevation of HFABP in dogs with MVD and DCM in comparison to controls, its association with disease severity, and its potential in predicting reduced survival, suggest that HFABP might be useful as marker for canine MVD and DCM.
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Affiliation(s)
- C Lam
- Department of Clinical Studies, Ontario Veterinary College, University of Guelph, 50 Stone Road E., ON N1G 2W1, Canada.
| | - D Casamian-Sorrosal
- Companion Animal Studies, University of Bristol, Langford House, Langford, Bristol BS40 5DU, United Kingdom
| | - G Monteith
- Department of Clinical Studies, Ontario Veterinary College, University of Guelph, 50 Stone Road E., ON N1G 2W1, Canada
| | - S Fonfara
- Companion Animal Studies, University of Bristol, Langford House, Langford, Bristol BS40 5DU, United Kingdom
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Stephenson N, Miller K, Gallivan M, Lam C, Serhiyenko V, Madhav N. Risk management and preparedness: use of stochastic modeling and risk analytics to estimate frequency and severity of filovirus epidemics. Int J Infect Dis 2019. [DOI: 10.1016/j.ijid.2018.11.306] [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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Eastwood A, Lam C, Grinham R, Gupta H. A ‘mixed bag’ of nutrition in Lincoln county hospital. Clin Nutr ESPEN 2018. [DOI: 10.1016/j.clnesp.2018.09.056] [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: 10/28/2022]
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Potters L, Fearn P, Chergui J, Christodouleas J, Disawal S, Lam C, Leone M, May C, Mogavero J, Phillips M, Schymura M, Solis A, Teckie S, van der Pas M, Penberthy L. Enhancing the Reporting of Radiation Oncology Treatment Details to Central Cancer Registries and the SEER Program: A Report of Pilot Studies in Progress. Int J Radiat Oncol Biol Phys 2018. [DOI: 10.1016/j.ijrobp.2018.07.1233] [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]
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Pinson K, Myers E, Stark S, Shliakhtsitsava K, Lam C, Medica A, Whitcomb B, Su H. How long will it take? time to pregnancy in female young adult cancer survivors. Fertil Steril 2018. [DOI: 10.1016/j.fertnstert.2018.07.528] [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: 12/01/2022]
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Merola J, Wager C, Hamann S, Zhang X, Thai A, Roberts C, Lam C, Musselli C, Marsh G, Rabah D, Barbey C, Franchimont N, Reynolds T. 1096 Non-invasive tape sampling reveals a type I interferon RNA signature in cutaneous lupus erythematosus that distinguishes affected from unaffected and healthy volunteer skin. J Invest Dermatol 2018. [DOI: 10.1016/j.jid.2018.03.1109] [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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Low T, Chan S, Wai S, Zhou A, Kyu K, Lee K, Ching A, Comer S, Tan N, Thong E, Nang T, Dutta M, Lam C. The Women’s Heart Health Programme: A Pilot Trial Of Sex-Specific Cardiovascular Management. Can J Cardiol 2018. [DOI: 10.1016/j.cjca.2018.01.079] [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] Open
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Bautista J, Phung S, Nguyen I, Nguyen E, Der D, Vatakencherry G, Lam C. 3:50 PM Abstract No. 395 Comparison of alcohol ablation and radiofrequency ablation for treatment of hepatocellular carcinoma: A retrospective analysis of long-term overall and disease-free survival. J Vasc Interv Radiol 2018. [DOI: 10.1016/j.jvir.2018.01.438] [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: 11/29/2022] Open
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36
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Mak CM, Lam C, Siu W, Law C, Chan W, Lee HC, Chong Y, Chen SR, Ching C, Wong C, Lee M, Chow K, Lee K, Chan W, Chan K, Lee SY, Chan YW. OPathPaed service model for expanded newborn screening in Hong Kong SAR, China. Br J Biomed Sci 2018; 70:84-8. [DOI: 10.1080/09674845.2013.11978266] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- C. M. Mak
- Chemical Pathology Laboratory, Department of Pathology, Princess Margaret Hospital
| | - C. Lam
- Department of Pathology, Li Ka Shing Faculty of Medicine, The University of Hong Kong
| | - W. Siu
- Chemical Pathology Laboratory, Department of Pathology, Princess Margaret Hospital
| | - C. Law
- Chemical Pathology Laboratory, Department of Pathology, Princess Margaret Hospital
| | - W. Chan
- Chemical Pathology Laboratory, Department of Pathology, Princess Margaret Hospital
| | - H. C. Lee
- Chemical Pathology Laboratory, Department of Pathology, Princess Margaret Hospital
| | - Y. Chong
- Chemical Pathology Laboratory, Department of Pathology, Princess Margaret Hospital
| | - S. R. Chen
- Chemical Pathology Laboratory, Department of Pathology, Princess Margaret Hospital
| | - C. Ching
- Chemical Pathology Laboratory, Department of Pathology, Princess Margaret Hospital
| | - C. Wong
- Department of Clinical Pathology, Tuen Mun Hospital
| | - M. Lee
- Department of Clinical Pathology, Tuen Mun Hospital
| | - K. Chow
- Department of Obstetrics and Gynaecology
| | - K. Lee
- Department of Obstetrics and Gynaecology
| | - W. Chan
- Department of Paediatrics and Adolescent Medicine, Princess Margaret Hospital, Hong Kong SAR, China
| | - K. Chan
- Department of Paediatrics and Adolescent Medicine, Princess Margaret Hospital, Hong Kong SAR, China
| | - S. Y. Lee
- Department of Clinical Pathology, Tuen Mun Hospital
| | - Y. W. Chan
- Chemical Pathology Laboratory, Department of Pathology, Princess Margaret Hospital
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Lam C, Yu J, Li J, Pitney M, Ooi S, Jepson N. Clinical Outcomes of Women Undergoing Percutaneous Coronary Intervention at a Metropolitan Teaching Hospital. Heart Lung Circ 2018. [DOI: 10.1016/j.hlc.2018.06.906] [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: 10/28/2022]
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38
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Hamilton JL, Foxcroft S, Moyo E, Cooke-Lauder J, Spence T, Zahedi P, Bezjak A, Jaffray D, Lam C, Létourneau D, Milosevic M, Tsang R, Wong R, Liu FF. Strategic planning in an academic radiation medicine program. Curr Oncol 2017; 24:e518-e523. [PMID: 29270061 DOI: 10.3747/co.24.3725] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [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] Open
Abstract
Background In this paper, we report on the process of strategic planning in the Radiation Medicine Program (rmp) at the Princess Margaret Cancer Centre. The rmp conducted a strategic planning exercise to ensure that program priorities reflect the current health care environment, enable nimble responses to the increasing burden of cancer, and guide program operations until 2020. Methods Data collection was guided by a project charter that outlined the project goal and the roles and responsibilities of all participants. The process was managed by a multidisciplinary steering committee under the guidance of an external consultant and consisted of reviewing strategic planning documents from close collaborators and institutional partners, conducting interviews with key stakeholders, deploying a program-wide survey, facilitating an anonymous and confidential e-mail feedback box, and collecting information from group deliberations. Results The process of strategic planning took place from December 2014 to December 2015. Mission and vision statements were developed, and core values were defined. A final document, Strategic Roadmap to 2020, was established to guide programmatic pursuits during the ensuing 5 years, and an implementation plan was developed to guide the first year of operations. Conclusions The strategic planning process provided an opportunity to mobilize staff talents and identify environmental opportunities, and helped to enable more effective use of resources in a rapidly changing health care environment. The process was valuable in allowing staff to consider and discuss the future, and in identifying strategic issues of the greatest importance to the program. Academic programs with similar mandates might find our report useful in guiding similar processes in their own organizations.
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Affiliation(s)
- J L Hamilton
- Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network
| | - S Foxcroft
- Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network
| | - E Moyo
- Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network
| | - J Cooke-Lauder
- Health Industry Management Practice, Schulich School of Business, York University, and
| | - T Spence
- Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network
| | - P Zahedi
- Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network
| | - A Bezjak
- Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network
| | - D Jaffray
- Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network.,Department of Radiation Oncology, University of Toronto, Toronto, ON
| | - C Lam
- Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network.,Department of Radiation Oncology, University of Toronto, Toronto, ON
| | - D Létourneau
- Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network.,Department of Radiation Oncology, University of Toronto, Toronto, ON
| | - M Milosevic
- Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network.,Department of Radiation Oncology, University of Toronto, Toronto, ON
| | - R Tsang
- Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network.,Department of Radiation Oncology, University of Toronto, Toronto, ON
| | - R Wong
- Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network.,Department of Radiation Oncology, University of Toronto, Toronto, ON
| | - F F Liu
- Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network.,Department of Radiation Oncology, University of Toronto, Toronto, ON
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Peng X, Lin Y, Wang Y, Hui C, Lam C. Palliative treatment of refractory metastatic colorectal cancer using regorafenib: Macau experience. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx659.010] [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: 11/13/2022] Open
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40
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Makhijani R, Lam C, Wang S, Zhang Y, Huang Y, Alvero R. Creating a risk calculator for the prediction of ectopic pregnancies. Fertil Steril 2017. [DOI: 10.1016/j.fertnstert.2017.07.1107] [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: 11/30/2022]
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41
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Lam C, Liu WF, Bel RD, Chan K, Miller L, Brown MC, Chen Z, Cheng D, Patel D, Xu W, Darling GE, Liu G. Polymorphisms of the FOXF1 and MHC locus genes in individuals undergoing esophageal acid reflux assessments. Dis Esophagus 2017; 30:1-7. [PMID: 26822871 DOI: 10.1111/dote.12456] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Gastroesophageal reflux disease (GERD) may lead to Barrett's esophagus (BE). Previously, a large genome-wide association study found two germline markers to be associated with BE, FOXF1 rs9936833 (C allele) and MHC rs9257809 (A allele). This study evaluated whether these two polymorphisms are associated with gastroesphageal acid reflux as measured by 24-hour pH testing. Patients with acid reflux symptoms referred for esophageal manometry and 24-hour pH monitoring at University Health Network (Toronto, ON) were enrolled. DNA extracted from blood was genotyped using a Taqman Polymerase Chain Reaction (PCR) assay. DeMeester scores of ≥14.7 or prior evidence of reflux esophagitis on endoscopy defined individuals with esophageal acid reflux. Logistic regression analysis, adjusted for clinical risk factors, was used to calculate odds ratios with 95% confidence intervals for each polymorphism in relation to the presence of acid reflux. Of 182 patients, the median age was 50 years and 62% were female; 95 (52%) met the definition of GERD. In the multivariable analysis, both FOXF1 rs9936833 (OR = 1.82; 95%CI: 1.12-2.96; P = 0.02) and MHC rs9257809 (OR = 9.36; 95%CI: 2.92-29.99; P < 0.001) remained significantly associated with presence of acid reflux. When both polymorphisms were placed in the same model, the adjusted ORs were 2.10 (95%CI: 1.24-3.53; P = 0.005) and 10.95 (95%CI: 3.32-36.09; P < 0.001), respectively. The association for risk allele C in FOXF1 rs9936833 and risk allele A in MHC rs9257809 with the presence of acid reflux suggests a potential pathophysiologic mechanism for the role of genetic influences in BE development.
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Affiliation(s)
- C Lam
- Department of Medical Biophysics and Medicine, Princess Margaret Hospital-University Health Network, University of Toronto, Toronto, Ontario, Canada.,School of Medicine, University of Nottingham, Nottingham, UK
| | - W F Liu
- Department of Medical Biophysics and Medicine, Princess Margaret Hospital-University Health Network, University of Toronto, Toronto, Ontario, Canada.,Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
| | - R D Bel
- Biostatistics Department, Princess Margaret Hospital-University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - K Chan
- Department of Medical Biophysics and Medicine, Princess Margaret Hospital-University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - L Miller
- Department of Surgery (Thoracic Surgery), Toronto General Hospital-University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - M C Brown
- Department of Medical Biophysics and Medicine, Princess Margaret Hospital-University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - Z Chen
- Department of Medical Biophysics and Medicine, Princess Margaret Hospital-University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - D Cheng
- Department of Medical Biophysics and Medicine, Princess Margaret Hospital-University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - D Patel
- Department of Medical Biophysics and Medicine, Princess Margaret Hospital-University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - W Xu
- Biostatistics Department, Princess Margaret Hospital-University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - G E Darling
- Department of Surgery (Thoracic Surgery), Toronto General Hospital-University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - G Liu
- Department of Medical Biophysics and Medicine, Princess Margaret Hospital-University Health Network, University of Toronto, Toronto, Ontario, Canada
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Lerner V, Malacarne D, Lam C. Teaching Vaginal Hysterectomy Using Vaginal Hysterectomy Task Trainer. J Minim Invasive Gynecol 2016. [DOI: 10.1016/j.jmig.2016.08.060] [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: 11/17/2022]
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43
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Lam C, Chaddock G, Marciani L, Costigan C, Paul J, Cox E, Hoad C, Menys A, Pritchard S, Garsed K, Taylor S, Atkinson D, Gowland P, Spiller R. Colonic response to laxative ingestion as assessed by MRI differs in constipated irritable bowel syndrome compared to functional constipation. Neurogastroenterol Motil 2016; 28:861-70. [PMID: 26871949 PMCID: PMC4949702 DOI: 10.1111/nmo.12784] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2015] [Accepted: 12/31/2015] [Indexed: 12/20/2022]
Abstract
BACKGROUND Functional constipation (FC) and irritable bowel syndrome with constipation (IBS-C) share many symptoms but underlying mechanisms may be different. We have developed a magnetic resonance imaging (MRI) technique to measure intestinal volumes, transit, and motility in response to a laxative, Moviprep(®) . We aim to use these biomarkers to study the pathophysiology in IBS-C and FC. METHODS Twenty-four FC and 24 IBS-C were studied. Transit was assessed using the weighted average position score (WAPS) of five MRI marker pills, taken 24 h before MRI scanning. Following baseline scan, participants ingested 1 L of Moviprep(®) followed by hourly scans. Magnetic resonance imaging parameters and bowel symptoms were scored from 0 to 4 h. KEY RESULTS Weighted average position score for FC was 3.6 (2.5-4.2), significantly greater than IBS-C at 2.0 (1.5-3.2), p = 0.01, indicating slower transit for FC. Functional constipation showed greater fasting small bowel water content, 83 (63-142) mL vs 39 (15-70) mL in IBS-C, p < 0.01 and greater ascending colon volume (AC), 314 (101) mL vs 226 (71) mL in IBS-C, p < 0.01. FC motility index was lower at 0.055 (0.044) compared to IBS-C, 0.107 (0.070), p < 0.01. Time to first bowel movement following ingestion of Moviprep(®) was greater for FC, being 295 (116-526) min, compared to IBS-C at 84 (49-111) min, p < 0.01, and correlated with AC volume 2 h after Moviprep(®) , r = 0.44, p < 0.01. Using a cut-off >230 min distinguishes FC from IBS-C with low sensitivity of 55% but high specificity of 95%. CONCLUSION & INFERENCES Our objective MRI biomarkers allow a distinction between FC and IBS-C.
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Affiliation(s)
- C. Lam
- NIHR Nottingham Digestive Diseases Biomedical Research Unit and Nottingham Digestive Diseases CentreSchool of MedicineUniversity of NottinghamNottinghamUK
| | - G. Chaddock
- Sir Peter Mansfield Imaging CentreUniversity of NottinghamNottinghamUK
| | - L. Marciani
- NIHR Nottingham Digestive Diseases Biomedical Research Unit and Nottingham Digestive Diseases CentreSchool of MedicineUniversity of NottinghamNottinghamUK
| | - C. Costigan
- NIHR Nottingham Digestive Diseases Biomedical Research Unit and Nottingham Digestive Diseases CentreSchool of MedicineUniversity of NottinghamNottinghamUK
| | - J. Paul
- Sir Peter Mansfield Imaging CentreUniversity of NottinghamNottinghamUK
| | - E. Cox
- Sir Peter Mansfield Imaging CentreUniversity of NottinghamNottinghamUK
| | - C. Hoad
- NIHR Nottingham Digestive Diseases Biomedical Research Unit and Nottingham Digestive Diseases CentreSchool of MedicineUniversity of NottinghamNottinghamUK,Sir Peter Mansfield Imaging CentreUniversity of NottinghamNottinghamUK
| | - A. Menys
- Centre for Medical ImagingDivision of MedicineUniversity College LondonLondonUK
| | - S. Pritchard
- Sir Peter Mansfield Imaging CentreUniversity of NottinghamNottinghamUK
| | - K. Garsed
- Royal Derby Hospitals Foundation TrustDerbyUK
| | - S. Taylor
- Centre for Medical ImagingDivision of MedicineUniversity College LondonLondonUK
| | - D. Atkinson
- Centre for Medical ImagingDivision of MedicineUniversity College LondonLondonUK
| | - P. Gowland
- Sir Peter Mansfield Imaging CentreUniversity of NottinghamNottinghamUK
| | - R. Spiller
- NIHR Nottingham Digestive Diseases Biomedical Research Unit and Nottingham Digestive Diseases CentreSchool of MedicineUniversity of NottinghamNottinghamUK
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Martin P, Brown MC, Espin-Garcia O, Cuffe S, Pringle D, Mahler M, Villeneuve J, Niu C, Charow R, Lam C, Shani RM, Hon H, Otsuka M, Xu W, Alibhai S, Jenkinson J, Liu G. Patient preference: a comparison of electronic patient-completed questionnaires with paper among cancer patients. Eur J Cancer Care (Engl) 2015; 25:334-41. [PMID: 25899560 DOI: 10.1111/ecc.12318] [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] [Accepted: 03/09/2015] [Indexed: 12/15/2022]
Abstract
In this study, we compared cancer patients preference for computerised (tablet/web-based) surveys versus paper. We also assessed whether the understanding of a cancer-related topic, pharmacogenomics is affected by the survey format, and examined differences in demographic and medical characteristics which may affect patient preference and understanding. Three hundred and four cancer patients completed a tablet-administered survey and another 153 patients completed a paper-based survey. Patients who participated in the tablet survey were questioned regarding their preference for survey format administration (paper, tablet and web-based). Understanding was assessed with a 'direct' method, by asking patients to assess their understanding of genetic testing, and with a 'composite' score. Patients preferred administration with tablet (71%) compared with web-based (12%) and paper (17%). Patients <65 years old, non-Caucasians and white-collar professionals significantly preferred the computerised format following multivariate analysis. There was no significant difference in understanding between the paper and tablet survey with direct questioning or composite score. Age (<65 years) and white-collar professionals were associated with increased understanding (both P = 0.03). There was no significant difference in understanding between the tablet and print survey in a multivariate analysis. Patients overwhelmingly preferred computerised surveys and understanding of pharmacogenomics was not affected by survey format.
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Affiliation(s)
- P Martin
- Department of Medical Oncology, Princess Margaret Hospital, University of Toronto, Toronto, ON, Canada
| | - M C Brown
- Cancer Outcomes Medicine Biostatistics Informatics Epidemiology Laboratory, Princess Margaret Hospital, Toronto, ON, Canada
| | - O Espin-Garcia
- Department of Biostatistics, Princess Margaret Hospital, University of Toronto, Toronto, ON, Canada
| | - S Cuffe
- Department of Medical Oncology, Princess Margaret Hospital, University of Toronto, Toronto, ON, Canada
| | - D Pringle
- Cancer Outcomes Medicine Biostatistics Informatics Epidemiology Laboratory, Princess Margaret Hospital, Toronto, ON, Canada
| | - M Mahler
- Cancer Outcomes Medicine Biostatistics Informatics Epidemiology Laboratory, Princess Margaret Hospital, Toronto, ON, Canada
| | - J Villeneuve
- Cancer Outcomes Medicine Biostatistics Informatics Epidemiology Laboratory, Princess Margaret Hospital, Toronto, ON, Canada
| | - C Niu
- Cancer Outcomes Medicine Biostatistics Informatics Epidemiology Laboratory, Princess Margaret Hospital, Toronto, ON, Canada
| | - R Charow
- Cancer Outcomes Medicine Biostatistics Informatics Epidemiology Laboratory, Princess Margaret Hospital, Toronto, ON, Canada
| | - C Lam
- Cancer Outcomes Medicine Biostatistics Informatics Epidemiology Laboratory, Princess Margaret Hospital, Toronto, ON, Canada
| | - R M Shani
- Cancer Outcomes Medicine Biostatistics Informatics Epidemiology Laboratory, Princess Margaret Hospital, Toronto, ON, Canada
| | - H Hon
- Cancer Outcomes Medicine Biostatistics Informatics Epidemiology Laboratory, Princess Margaret Hospital, Toronto, ON, Canada
| | - M Otsuka
- Biomedical Communications Graduate Program, Institute of Medical Science, University of Toronto, Toronto, ON, Canada
| | - W Xu
- Department of Biostatistics, Princess Margaret Hospital, University of Toronto, Toronto, ON, Canada
| | - S Alibhai
- Department of Medicine, University Health Network, Toronto, ON, Canada
| | - J Jenkinson
- Biomedical Communications Graduate Program, Institute of Medical Science, University of Toronto, Toronto, ON, Canada
| | - G Liu
- Department of Medical Oncology, Princess Margaret Hospital, University of Toronto, Toronto, ON, Canada
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Hsu C, Roan J, Wang J, Huang C, Chen J, Lam C. Modulation of Circulating Endothelial Progenitor Cells and Hsp27 Following Application of Ampaltzer Occluder in Patients With Flow-Induced Pulmonary Hypertension. J Heart Lung Transplant 2015. [DOI: 10.1016/j.healun.2015.01.867] [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: 10/23/2022] Open
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Marciani L, Garsed KC, Hoad CL, Fields A, Fordham I, Pritchard SE, Placidi E, Murray K, Chaddock G, Costigan C, Lam C, Jalanka-Tuovinen J, De Vos WM, Gowland PA, Spiller RC. Stimulation of colonic motility by oral PEG electrolyte bowel preparation assessed by MRI: comparison of split vs single dose. Neurogastroenterol Motil 2014; 26:1426-36. [PMID: 25060551 PMCID: PMC4321061 DOI: 10.1111/nmo.12403] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2014] [Accepted: 06/23/2014] [Indexed: 02/06/2023]
Abstract
BACKGROUND Most methods of assessing colonic motility are poorly acceptable to patients. Magnetic resonance imaging (MRI) can monitor gastrointestinal motility and fluid distributions. We predicted that a dose of oral polyethylene glycol (PEG) and electrolyte solution would increase ileo-colonic inflow and stimulate colonic motility. We aimed to investigate the colonic response to distension by oral PEG electrolyte in healthy volunteers (HVs) and to evaluate the effect of single 2 L vs split (2 × 1 L) dosing. METHODS Twelve HVs received a split dose (1 L the evening before and 1 L on the study day) and another 12 HVs a single dose (2 L on the main study day) of PEG electrolyte. They underwent MRI scans, completed symptom questionnaires, and provided stool samples. Outcomes included small bowel water content, ascending colon motility index, and regional colonic volumes. KEY RESULTS Small bowel water content increased fourfold from baseline after ingesting both split (p = 0.0010) and single dose (p = 0.0005). The total colonic volume increase from baseline was smaller for the split dose at 35 ± 8% than for the single dose at 102 ± 27%, p = 0.0332. The ascending colon motility index after treatment was twofold higher for the single dose group (p = 0.0103). CONCLUSIONS & INFERENCES Ingestion of 1 and 2 L PEG electrolyte solution caused a rapid increase in the small bowel and colonic volumes and a robust rise in colonic motility. The increase in both volumes and motility was dose dependent. Such a challenge, being well-tolerated, could be a useful way of assessing colonic motility in future studies.
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Affiliation(s)
- L Marciani
- Nottingham Digestive Diseases Centre and NIHR Nottingham Digestive Diseases Biomedical Research Unit, Nottingham University Hospitals, University of NottinghamNottingham, UK,# Joint first author
| | - K C Garsed
- Nottingham Digestive Diseases Centre and NIHR Nottingham Digestive Diseases Biomedical Research Unit, Nottingham University Hospitals, University of NottinghamNottingham, UK,# Joint first author
| | - C L Hoad
- Sir Peter Mansfield Magnetic Resonance Centre, School of Physics and Astronomy, University of NottinghamNottingham, UK
| | - A Fields
- Nottingham Digestive Diseases Centre and NIHR Nottingham Digestive Diseases Biomedical Research Unit, Nottingham University Hospitals, University of NottinghamNottingham, UK
| | - I Fordham
- Nottingham Digestive Diseases Centre and NIHR Nottingham Digestive Diseases Biomedical Research Unit, Nottingham University Hospitals, University of NottinghamNottingham, UK
| | - S E Pritchard
- Sir Peter Mansfield Magnetic Resonance Centre, School of Physics and Astronomy, University of NottinghamNottingham, UK
| | - E Placidi
- Sir Peter Mansfield Magnetic Resonance Centre, School of Physics and Astronomy, University of NottinghamNottingham, UK
| | - K Murray
- Sir Peter Mansfield Magnetic Resonance Centre, School of Physics and Astronomy, University of NottinghamNottingham, UK
| | - G Chaddock
- Sir Peter Mansfield Magnetic Resonance Centre, School of Physics and Astronomy, University of NottinghamNottingham, UK
| | - C Costigan
- Sir Peter Mansfield Magnetic Resonance Centre, School of Physics and Astronomy, University of NottinghamNottingham, UK
| | - C Lam
- Nottingham Digestive Diseases Centre and NIHR Nottingham Digestive Diseases Biomedical Research Unit, Nottingham University Hospitals, University of NottinghamNottingham, UK
| | - J Jalanka-Tuovinen
- Department of Veterinary Biosciences, University of HelsinkiHelsinki, Finland
| | - W M De Vos
- Department of Veterinary Biosciences, University of HelsinkiHelsinki, Finland,Laboratory of Microbiology, Wageningen UniversityWageningen, The Netherlands
| | - P A Gowland
- Sir Peter Mansfield Magnetic Resonance Centre, School of Physics and Astronomy, University of NottinghamNottingham, UK
| | - R C Spiller
- Nottingham Digestive Diseases Centre and NIHR Nottingham Digestive Diseases Biomedical Research Unit, Nottingham University Hospitals, University of NottinghamNottingham, UK
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Rahman KM, Lovich JE, Lam C, Camp ME, Wiley AA, Bartol FF, Bagnell CA. Nursing supports neonatal porcine testicular development. Domest Anim Endocrinol 2014; 48:84-92. [PMID: 24906933 DOI: 10.1016/j.domaniend.2014.02.006] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2013] [Revised: 02/22/2014] [Accepted: 02/25/2014] [Indexed: 12/11/2022]
Abstract
The lactocrine hypothesis suggests a mechanism whereby milk-borne bioactive factors delivered to nursing offspring affect development of neonatal tissues. The objective of this study was to assess whether nursing affects testicular development in neonatal boars as reflected by: (1) Sertoli cell number and proliferation measured by GATA-4 expression and proliferating cell nuclear antigen immunostaining patterns; (2) Leydig cell development and steroidogenic activity as reflected by insulin-like factor 3 (INSL3), and P450 side chain cleavage (scc) enzyme expression; and (3) expression of estrogen receptor-alpha (ESR1), vascular endothelial growth factor (VEGF) A, and relaxin family peptide receptor (RXFP) 1. At birth, boars were randomly assigned (n = 6-7/group) to nurse ad libitum or to be pan fed porcine milk replacer for 48 h. Testes were collected from boars at birth, before nursing and from nursed and replacer-fed boars at 50 h on postnatal day (PND) 2. Sertoli cell proliferating cell nuclear antigen labeling index increased (P < 0.01) from birth to PND 2 in nursed, but not in replacer-fed boars. Sertoli cell number and testicular GATA-4 protein levels increased (P < 0.01) from PND 0 to PND 2 only in nursed boars. Neither age nor nursing affected testicular INSL3, P450scc, ESR1, or VEGFA levels. However, testicular relaxin family peptide receptor 1 (RXFP1) levels increased (P < 0.01) with age and were greater in replacer-fed boars on PND 2. Results suggest that nursing supports neonatal porcine testicular development and provide additional evidence for the importance of lactocrine signaling in pigs.
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Affiliation(s)
- K M Rahman
- Department of Animal Sciences, Endocrinology and Animal Biosciences Program, Rutgers University, New Brunswick, NJ, USA
| | - J E Lovich
- Department of Animal Sciences, Endocrinology and Animal Biosciences Program, Rutgers University, New Brunswick, NJ, USA
| | - C Lam
- Department of Animal Sciences, Endocrinology and Animal Biosciences Program, Rutgers University, New Brunswick, NJ, USA
| | - M E Camp
- Department of Animal Sciences, Endocrinology and Animal Biosciences Program, Rutgers University, New Brunswick, NJ, USA
| | - A A Wiley
- Department of Anatomy, Physiology and Pharmacology, Cellular and Molecular Biosciences Program, Auburn University, Auburn, AL, USA
| | - F F Bartol
- Department of Anatomy, Physiology and Pharmacology, Cellular and Molecular Biosciences Program, Auburn University, Auburn, AL, USA
| | - C A Bagnell
- Department of Animal Sciences, Endocrinology and Animal Biosciences Program, Rutgers University, New Brunswick, NJ, USA.
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Chaddock G, Lam C, Hoad CL, Costigan C, Cox EF, Placidi E, Thexton I, Wright J, Blackshaw PE, Perkins AC, Marciani L, Gowland PA, Spiller RC. Novel MRI tests of orocecal transit time and whole gut transit time: studies in normal subjects. Neurogastroenterol Motil 2014; 26:205-14. [PMID: 24165044 PMCID: PMC4285997 DOI: 10.1111/nmo.12249] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2013] [Accepted: 09/23/2013] [Indexed: 12/12/2022]
Abstract
BACKGROUND Colonic transit tests are used to manage patients with Functional Gastrointestinal Disorders. Some tests used expose patients to ionizing radiation. The aim of this study was to compare novel magnetic resonance imaging (MRI) tests for measuring orocecal transit time (OCTT) and whole gut transit time (WGT), which also provide data on colonic volumes. METHODS 21 healthy volunteers participated. Study 1: OCTT was determined from the arrival of the head of a meal into the cecum using MRI and the Lactose Ureide breath test (LUBT), performed concurrently. Study 2: WGT was assessed using novel MRI marker capsules and radio-opaque markers (ROMs), taken on the same morning. Studies were repeated 1 week later. KEY RESULTS OCTT measured using MRI and LUBT was 225 min (IQR 180-270) and 225 min (IQR 165-278), respectively, correlation r(s) = 0.28 (ns). WGT measured using MRI marker capsules and ROMs was 28 h (IQR 4-50) and 31 h ± 3 (SEM), respectively, correlation r(s) = 0.85 (p < 0.0001). Repeatability assessed using the intraclass correlation coefficient (ICC) was 0.45 (p = 0.017) and 0.35 (p = 0.058) for MRI and LUBT OCTT tests. Better repeatability was observed for the WGT tests, ICC being 0.61 for the MRI marker capsules (p = 0.001) and 0.69 for the ROM method (p < 0.001) respectively. CONCLUSIONS & INFERENCES The MRI WGT method is simple, convenient, does not use X-ray and compares well with the widely used ROM method. Both OCTT measurements showed modest reproducibility and the MRI method showed modest inter-observer agreement.
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Affiliation(s)
- G Chaddock
- Sir Peter Mansfield Magnetic Resonance Centre, School of Physics and Astronomy, University of NottinghamNottingham, UK
| | - C Lam
- Nottingham Digestive Diseases Centre, School of Medicine, University of NottinghamNottingham, UK,Nottingham Digestive Diseases Biomedical Research Unit, Nottingham University Hospitals, University of NottinghamNottingham, UK
| | - C L Hoad
- Sir Peter Mansfield Magnetic Resonance Centre, School of Physics and Astronomy, University of NottinghamNottingham, UK
| | - C Costigan
- Sir Peter Mansfield Magnetic Resonance Centre, School of Physics and Astronomy, University of NottinghamNottingham, UK
| | - E F Cox
- Sir Peter Mansfield Magnetic Resonance Centre, School of Physics and Astronomy, University of NottinghamNottingham, UK
| | - E Placidi
- Sir Peter Mansfield Magnetic Resonance Centre, School of Physics and Astronomy, University of NottinghamNottingham, UK
| | - I Thexton
- Sir Peter Mansfield Magnetic Resonance Centre, School of Physics and Astronomy, University of NottinghamNottingham, UK
| | - J Wright
- GI Surgery, Nottingham University HospitalsNottingham, UK
| | - P E Blackshaw
- Medical Physics & Clinical Engineering, Nottingham University HospitalsNottingham, UK
| | - A C Perkins
- Medical Physics & Clinical Engineering, Nottingham University HospitalsNottingham, UK,Radiological & Imaging Sciences, School of Medicine, University of NottinghamNottingham, UK
| | - L Marciani
- Nottingham Digestive Diseases Centre, School of Medicine, University of NottinghamNottingham, UK,Nottingham Digestive Diseases Biomedical Research Unit, Nottingham University Hospitals, University of NottinghamNottingham, UK
| | - P A Gowland
- Sir Peter Mansfield Magnetic Resonance Centre, School of Physics and Astronomy, University of NottinghamNottingham, UK
| | - R C Spiller
- Nottingham Digestive Diseases Centre, School of Medicine, University of NottinghamNottingham, UK,Nottingham Digestive Diseases Biomedical Research Unit, Nottingham University Hospitals, University of NottinghamNottingham, UK,Prof Robin C. Spiller, Nottingham Digestive Diseases Biomedical Research Unit, Queen's Medical Centre, E Floor, West Block, Nottingham University Hospitals, University of Nottingham, Nottingham NG7 2UH, UK., Tel: +44 (0) 115 8231090; fax: +44 (0) 115 8231409; e-mail:
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Chuang E, Stanton S, Ward MM, Christos P, Sanford R, Lam C, Cobham MV, Donovan D, Scheff R, Cigler T, Moore A, Vahdat LT, Lane ME. Abstract P6-05-06: Association of HER2/neu single nucleotide polymorphism with trastuzumab-related cardiotoxicity. Cancer Res 2013. [DOI: 10.1158/0008-5472.sabcs13-p6-05-06] [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
Background: Treatment with trastuzumab prolongs overall survival when given to patients (pts) with Her2/neu+ breast cancer (BC). The primary toxicity of trastuzumab is cardiotoxicity and the incidence is estimated at 2-4% in the adjuvant setting. The mechanism for trastuzumab-induced cardiotoxicity is not known. Although Her2neu expression is usually not seen on cardiac myocytes, its expression has been shown to be upregulated after chemotherapy. Trastuzumab is a monoclonal antibody that binds to the extracellular domain of Her2/neu. We hypothesized that single nucleotide polymorphisms (SNPs) in the Her2/neu receptor may play a role in trastuzumab associated cardiotoxicity.
Methods: 140 pts with BC who were treated with chemotherapy and trastuzumab were enrolled into an IRB approved protocol at the Weill Cornell Medical College between July 2008 and March 2013. Cardiotoxicity was defined as either symptomatic CHF, or a decline in LVEF of 15% (or if LVEF <55% a decline in LVEF of 10%) that required management with medications and led to temporary or permanent discontinuation of trastuzumab. 11 nonsynonomous human ErbB2 SNPs were identified in the National Center for Biotechnology Information SNP database (rs1136201, rs2172826, rs28933368, rs28933369, rs28933370, rs34602395, rs36085723, rs4252633, rs55943169, rs56366519, rs61552325). Genotyping of SNPs was performed on DNA prepared from blood or buccal washes. The relationship between SNP characteristics and cardiotoxicity status was assessed by the chi-square test and multivariable logistic regression analysis.
Results: 140 subjects (29 with cardiotoxicity and 111 without) had 11 SNPs sequenced. Median age of subjects was 56 years (range: 32-85), mean baseline LVEF was 65% (±6%). 16.4% of subjects had hypertension (HTN). 80% of patients were Caucasian, 10% East Asian, 7.1% African American, 2.9% South Asian. There were two SNPs for which there was variation seen among subjects: rs 1136201 (corresponding to codon 655) and rs61552325 (codon 1170). The frequencies of the codon 655 polymorphisms were: AA (Ile/Ile) 67.9%, AG (Ile/Val) 29.3%, and GG (Val/Val) 2.9%. The frequencies of the codon 1170 polymorphisms were: CC (Pro/Pro) 20.7%, GC (Ala/Pro) 45.7%, and GG (Ala/Ala) 33.6%. There was no association observed between the codon 655 polymorphism and cardiotoxicity (p = 0.96). A significant association between cardiotoxicity and the codon 1170 polymorphism was observed, with subjects having cardiotoxicity being more likely to carry the CC allele compared with subjects without cardiotoxicity (34.5% vs 17.1%, p = 0.04). This association persisted after multivariable adjustment for age, race, and HTN status (adjusted OR = 2.60, 95% CI = 1.02-6.62, p = 0.046).
Conclusion: In this study, the Her2/neu 1170 Pro/Pro polymorphism was associated with trastuzumab cardiotoxicity. If confirmed in a larger series, this polymorphism could be used to identify pts who may be at increased risk for cardiotoxicity and who may benefit from treatments associated with less cardiotoxicity. Furthermore, the Her2/neu 1170 SNP has previously been implicated as a minor histocompatibility antigen, and our findings raise the possibility that immune mediated mechanisms may play a role in trastuzumab related cardiotoxicity.
Citation Information: Cancer Res 2013;73(24 Suppl): Abstract nr P6-05-06.
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Affiliation(s)
- E Chuang
- Weill Cornell Medical College, New York, NY
| | - S Stanton
- Weill Cornell Medical College, New York, NY
| | - MM Ward
- Weill Cornell Medical College, New York, NY
| | - P Christos
- Weill Cornell Medical College, New York, NY
| | - R Sanford
- Weill Cornell Medical College, New York, NY
| | - C Lam
- Weill Cornell Medical College, New York, NY
| | - MV Cobham
- Weill Cornell Medical College, New York, NY
| | - D Donovan
- Weill Cornell Medical College, New York, NY
| | - R Scheff
- Weill Cornell Medical College, New York, NY
| | - T Cigler
- Weill Cornell Medical College, New York, NY
| | - A Moore
- Weill Cornell Medical College, New York, NY
| | - LT Vahdat
- Weill Cornell Medical College, New York, NY
| | - ME Lane
- Weill Cornell Medical College, New York, NY
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Lam C, Martinson N, Hepp L, Ambrose B, Msandiwa R, Wong ML, Apelberg B, Tamplin S, Golub JE. Prevalence of tobacco smoking in adults with tuberculosis in South Africa [Short communication]. Int J Tuberc Lung Dis 2013; 17:1354-7. [DOI: 10.5588/ijtld.13.0016] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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