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Pugh C, Zeno RN, Stanek J, Gillespie M, Kopp BT, Creary SE. Description of a Colocated Comprehensive Care Model for People With Sickle Cell and Comorbid Pulmonary Disease. J Pediatr Hematol Oncol 2023; 45:e723-e727. [PMID: 36898038 DOI: 10.1097/mph.0000000000002655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Accepted: 02/08/2022] [Indexed: 03/12/2023]
Abstract
Comorbid pulmonary complications in people with sickle cell disease (pwSCD) are associated with high rates of morbidity and mortality, and poor access to care contributes to poor outcomes among this particularly high-risk pwSCD. Our purpose was to describe the population served and the resources required for hematology, pulmonary, nursing, respiratory therapy, social work, genetics, psychology, and school liaison providers to see these patients in an integrated clinic. We abstracted demographic, medication, clinical, and diagnostics data of the pwSCD seen at least once in this clinic from February 1, 2014 to December 10, 2020 from the electronic medical record and identified 145 unique pwSCD. Abnormal lung function and bronchodilator responsiveness were detected in 31% and 42% of participants respectively. Sleep abnormalities were found in over two-thirds of those screened and 65% had ≥1 previous acute chest syndrome episode. This clinic also allowed for direct provider communication and required relatively limited resources to serve a large number of severely affected pwSCD. Given the degree of abnormal respiratory variables detected and the limited resources required to implement this model, studies are warranted to evaluate whether it has the potential to improve outcomes in high-risk populations.
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Affiliation(s)
| | | | | | - Michelle Gillespie
- Division of Pulmonary Medicine, Nationwide Children's Hospital, Columbus, OH
| | - Benjamin T Kopp
- Center for Microbial Pathogenesis
- Division of Pulmonary Medicine, Nationwide Children's Hospital, Columbus, OH
| | - Susan E Creary
- Center for Child Health Equity and Outcomes Research, The Abigail Wexner Research Institute
- Division of Hematology/Oncology/BMT
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Parker CC, Clarke NW, Catton C, Kynaston H, Cook A, Cross W, Davidson C, Goldstein C, Logue J, Maniatis C, Petersen PM, Neville P, Payne H, Persad R, Pugh C, Stirling A, Saad F, Parulekar WR, Parmar MKB, Sydes MR. RADICALS-HD: Reflections before the Results are Known. Clin Oncol (R Coll Radiol) 2022; 34:593-597. [PMID: 35810050 DOI: 10.1016/j.clon.2022.06.004] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 06/01/2022] [Accepted: 06/15/2022] [Indexed: 11/16/2022]
Affiliation(s)
- C C Parker
- The Institute of Cancer Research, Royal Marsden NHS Foundation Trust, Sutton, UK.
| | - N W Clarke
- Genito-Urinary Cancer Research Group, Department of Surgery, The Christie Hospital, Manchester, UK; Department of Urology, Salford Royal Hospitals, Manchester, UK
| | - C Catton
- Radiation Oncology, Princess Margaret Cancer Centre, University Health Network, Toronto, Canada
| | - H Kynaston
- Cardiff University School of Medicine, Cardiff University, Cardiff, UK
| | - A Cook
- MRC Clinical Trials Unit at UCL, Institute of Clinical Trials and Methodology, UCL, London, UK
| | - W Cross
- Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - C Davidson
- Canadian Cancer Trials Group, Queen's University, Kingston, Canada
| | - C Goldstein
- MRC Clinical Trials Unit at UCL, Institute of Clinical Trials and Methodology, UCL, London, UK
| | - J Logue
- Oncology, The Christie Hospital, Manchester, UK
| | - C Maniatis
- MRC Clinical Trials Unit at UCL, Institute of Clinical Trials and Methodology, UCL, London, UK
| | - P M Petersen
- Department of Oncology, University of Copenhagen, Rigshospitalet, Copenhagen, Denmark
| | - P Neville
- MRC Clinical Trials Unit at UCL, Institute of Clinical Trials and Methodology, UCL, London, UK
| | - H Payne
- Oncology, University College London Hospitals, London, UK
| | - R Persad
- Bristol Urological Institute, North Bristol Hospitals, Bristol, UK
| | - C Pugh
- MRC Clinical Trials Unit at UCL, Institute of Clinical Trials and Methodology, UCL, London, UK
| | - A Stirling
- MRC Clinical Trials Unit at UCL, Institute of Clinical Trials and Methodology, UCL, London, UK
| | - F Saad
- University of Montreal Hospital Center (CHUM), Montréal, Canada
| | - W R Parulekar
- Canadian Cancer Trials Group, Queen's University, Kingston, Canada
| | - M K B Parmar
- MRC Clinical Trials Unit at UCL, Institute of Clinical Trials and Methodology, UCL, London, UK
| | - M R Sydes
- MRC Clinical Trials Unit at UCL, Institute of Clinical Trials and Methodology, UCL, London, UK
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Rodger J, Pugh C, Long J. 21: Laparoscopic uterosacral ligament suspension with use of barbed suture. Am J Obstet Gynecol 2019. [DOI: 10.1016/j.ajog.2019.01.156] [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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King C, Mohamadipanah H, Giles D, Pugh C. Application of Sensor Technology in the Objective Assessment of Vaginal Cuff Closure Utilizing a Validated Simulation Model. J Minim Invasive Gynecol 2018. [DOI: 10.1016/j.jmig.2018.09.087] [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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Pabbati A, Lingenfelter B, Pugh C, Long J. Comparison of the Modes of Hysterectomy with Risk of Future Pelvic Organ Prolapse Procedures: Associations and Possible Predictive Factors for Individualizing Her Hysterectomy. J Minim Invasive Gynecol 2017. [DOI: 10.1016/j.jmig.2017.08.633] [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: 10/18/2022]
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Pugh C, Hirsch J, Voss C, Sims-Gould J, Lear S, McKay H, Winters M. CHANGES IN PHYSICAL ACTIVITY AMONG OLDER ADULTS AFTER A NEW GREENWAY DEVELOPMENT IN VANCOUVER, BC. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.5160] [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: 11/13/2022] Open
Affiliation(s)
- C. Pugh
- Simon Fraser University, Vancouver, British Columbia, Canada,
- Centre for Hip Health and Mobility, Vancouver, British Columbia, Canada,
| | - J. Hirsch
- University of North Carolina, Chapel Hill, North Carolina
- Centre for Hip Health and Mobility, Vancouver, British Columbia, Canada,
| | - C. Voss
- University of British Columbia, Vancouver, British Columbia, Canada,
| | - J. Sims-Gould
- University of British Columbia, Vancouver, British Columbia, Canada,
- Centre for Hip Health and Mobility, Vancouver, British Columbia, Canada,
| | - S. Lear
- Simon Fraser University, Vancouver, British Columbia, Canada,
| | - H.A. McKay
- University of British Columbia, Vancouver, British Columbia, Canada,
- Centre for Hip Health and Mobility, Vancouver, British Columbia, Canada,
| | - M. Winters
- Simon Fraser University, Vancouver, British Columbia, Canada,
- Centre for Hip Health and Mobility, Vancouver, British Columbia, Canada,
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Parthasarathy K, Long J, Pugh C. 33: Mesh extrusion: Laparoscopic removal of sacral hysteropexy mesh. Am J Obstet Gynecol 2016. [DOI: 10.1016/j.ajog.2016.01.147] [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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Russman C, Long J, Pugh C, Martz S. Urinary Tract Infection After Mid-urethral Sling. J Minim Invasive Gynecol 2015; 22:S63. [DOI: 10.1016/j.jmig.2015.08.169] [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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Russman C, Lingenfelter B, Long J, Pugh C. Robotic Resection of Intravesical Polypropylene Mesh following Tension-Free Tape Procedure. J Minim Invasive Gynecol 2015. [DOI: 10.1016/j.jmig.2014.12.148] [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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Valmaggia LR, Day FL, Jones C, Bissoli S, Pugh C, Hall D, Bhattacharyya S, Howes O, Stone J, Fusar-Poli P, Byrne M, McGuire PK. Cannabis use and transition to psychosis in people at ultra-high risk. Psychol Med 2014; 44:2503-2512. [PMID: 25055169 DOI: 10.1017/s0033291714000117] [Citation(s) in RCA: 64] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
BACKGROUND Cannabis use is associated with an increased risk of developing a psychotic disorder but the temporal relationship between cannabis use and onset of illness is unclear. The objective of this study was to assess prospectively the influence of cannabis use on transition to psychosis in people at ultra-high risk (UHR) for the disorder. METHOD Lifetime and continued cannabis use was assessed in a consecutively ascertained sample of 182 people (104 male, 78 female) at UHR for psychosis. Individuals were then followed clinically for 2 years to determine their clinical outcomes. RESULTS Lifetime cannabis use was reported by 134 individuals (73.6%). However, most of these individuals had stopped using cannabis before clinical presentation (n=98, 73.1%), usually because of adverse effects. Among lifetime users, frequent use, early-onset use and continued use after presentation were all associated with an increase in transition to psychosis. Transition to psychosis was highest among those who started using cannabis before the age of 15 years and went on to use frequently (frequent early-onset use: 25%; infrequent or late-onset use: 5%; χ(2)1=10.971, p=0.001). However, within the whole sample, cannabis users were no more likely to develop psychosis than those who had never used cannabis (cannabis use: 12.7%; no use: 18.8%; χ(2)1=1.061, p=0.303). CONCLUSIONS In people at UHR for psychosis, lifetime cannabis use was common but not related to outcome. Among cannabis users, frequent use, early-onset use and continued use after clinical presentation were associated with transition to psychosis.
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Affiliation(s)
- L R Valmaggia
- Institute of Psychiatry, King's College London,London,UK
| | - F L Day
- Institute of Psychiatry, King's College London,London,UK
| | - C Jones
- Institute of Psychiatry, King's College London,London,UK
| | - S Bissoli
- Institute of Psychiatry, King's College London,London,UK
| | - C Pugh
- Institute of Psychiatry, King's College London,London,UK
| | - D Hall
- Institute of Psychiatry, King's College London,London,UK
| | | | - O Howes
- Institute of Psychiatry, King's College London,London,UK
| | - J Stone
- Institute of Psychiatry, King's College London,London,UK
| | - P Fusar-Poli
- Institute of Psychiatry, King's College London,London,UK
| | - M Byrne
- Institute of Psychiatry, King's College London,London,UK
| | - P K McGuire
- Institute of Psychiatry, King's College London,London,UK
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Rosenfeld RM, Baldassari C, Chandrasekhar SS, Chaudhary H, Grabarek CB, Pugh C. Getting Published: Tips for Residents, Young Physicians, and Practicing Clinicians. Otolaryngol Head Neck Surg 2014. [DOI: 10.1177/0194599814538403a24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Program Description: Getting published is a practical, results-oriented miniseminar that emphasizes success strategies for residents, young physicians, and practicing clinicians. Explicit tips are offered to motivate young authors and clinicians to share experience and insights by publishing in peer-reviewed journals. Myriad viewpoints will be presented, including editor-in-chief, managing editor, resident physician, young physician, and practicing clinician. Attendees will learn why publishing is important, how it can prepare them for fellowship and clinical practice, and how it fosters critical thinking skills that lead to better patient care. Time is allowed for questions and answers. Educational Objectives: (1) Recognize why publishing in journals is important for young physicians and practicing clinicians. (2) Use best practices associated with successful publishing in biomedical journals. (3) Avoid the top pitfalls when submitting a manuscript for publication consideration.
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Tarassenko L, Villarroel M, Guazzi A, Jorge J, Clifton DA, Pugh C. Non-contact video-based vital sign monitoring using ambient light and auto-regressive models. Physiol Meas 2014; 35:807-31. [DOI: 10.1088/0967-3334/35/5/807] [Citation(s) in RCA: 272] [Impact Index Per Article: 27.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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13
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Pugh C, Sprung V, Ono K, Spence A, Thijssen D, Carter H, Green D. The acute impact of exercise during water immersion on cerebral perfusion. J Sci Med Sport 2013. [DOI: 10.1016/j.jsams.2013.10.075] [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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14
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Galdi L, Long J, White S, Pugh C. An Unusual Case of Endometriosis. J Minim Invasive Gynecol 2013. [DOI: 10.1016/j.jmig.2013.08.399] [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: 10/26/2022]
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15
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Rosenfeld RM, Raol NM, Liu JC, Cavanagh E, Pugh C. Getting Published: Letters, Commentaries, and Social Media. Otolaryngol Head Neck Surg 2013. [DOI: 10.1177/0194599813493390a20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Program Description: Getting Published is a results-oriented miniseminar for clinicians seeking to publish in medical journals, with an emphasis this year on letters, commentaries, and social media. The goal is to offer explicit strategies that help authors understand the role of correspondence (commentaries, brief reports, and letters to the editor) in a peer-reviewed journal from a myriad of viewpoints: publisher, editor in chief, managing editor, resident physician, and young physician (junior faculty member). Writing correspondence is one of the best ways for residents and young physicians to experience the thrill of getting published, so specific presentations will be targeted to these groups. Educational Objectives: 1) Describe the roles of letters, commentaries, and social media in a peer-reviewed journal. 2) Apply current strategies to help authors maximize their success in getting correspondence published. 3) Avoid common pitfalls when submitting correspondence for publication.
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16
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Hopkins ND, Cuthbertson DJ, Kemp GJ, Pugh C, Green DJ, Cable NT, Jones H. Effects of 6 months glucagon-like peptide-1 receptor agonist treatment on endothelial function in type 2 diabetes mellitus patients. Diabetes Obes Metab 2013; 15:770-3. [PMID: 23451821 DOI: 10.1111/dom.12089] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [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: 10/08/2012] [Revised: 12/17/2012] [Accepted: 02/14/2013] [Indexed: 12/15/2022]
Abstract
Glucagon-like peptide-1 receptor agonists (GLP-1 RA) are used for treatment in type 2 diabetes mellitus (T2DM). Little is known about their cardiovascular (CV) impact. We sought to determine the effects of chronic treatment on vascular function in T2DM. Brachial artery endothelial-dependent flow-mediated dilation (FMD) and endothelial-independent glyceryl trinitrate (GTN) function and carotid intima-medial thickness (cIMT) were assessed in 11 severely obese T2DMs (4 females, 7 males: 55 ± 8 years, diabetes duration 8.3 ± 4.7 years mean ± s.d.) before and after 6 months GLP-1 RA. Body weight (5.3 ± 1.2 kg; p < 0.05) and magnetic resonance imaging determined total and subcutaneous fat, but not visceral fat, decreased. Glycaemic control improved. There were no significant changes in FMD, GTN and cIMT (-1.1 ± 0.4%, 0.3 ± 3.0% and 0.00 ± 0.04 mm, respectively). Despite significant improvements in body composition and glycaemic control, 6 months GLP-1 RA treatment did not modulate vascular function. Alternative strategies may therefore be needed to reduce the burden of CV risk in severely obese patients with long-standing T2DM.
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Affiliation(s)
- N D Hopkins
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK
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17
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Langley RE, Stephens RJ, Nankivell M, Pugh C, Moore B, Navani N, Wilson P, Faivre-Finn C, Barton R, Parmar MKB, Mulvenna PM. Interim data from the Medical Research Council QUARTZ Trial: does whole brain radiotherapy affect the survival and quality of life of patients with brain metastases from non-small cell lung cancer? Clin Oncol (R Coll Radiol) 2012; 25:e23-30. [PMID: 23211715 DOI: 10.1016/j.clon.2012.11.002] [Citation(s) in RCA: 68] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2012] [Revised: 10/01/2012] [Accepted: 10/02/2012] [Indexed: 10/27/2022]
Abstract
AIMS Over 30% of patients with non-small cell lung cancer (NSCLC) develop brain metastases. If inoperable, optimal supportive care (OSC), including steroids, and whole brain radiotherapy (WBRT) are generally considered to be standard care, although there is no randomised evidence demonstrating that the addition of WBRT to OSC improves survival or quality of life. MATERIALS AND METHODS QUARTZ is a randomised, non-inferiority, phase III trial comparing OSC + WBRT versus OSC in patients with inoperable brain metastases from NSCLC. The primary outcome measure is quality-adjusted life years (QALYs). QUARTZ was threatened with both loss of funding and early closure due to poor accrual. A lack of preliminary randomised data supporting the trial's hypotheses was thought to underlie the poor accrual, so, with no knowledge of the data, the independent trial steering committee agreed to the unusual step of releasing interim data. RESULTS Between March 2007 and April 2010, 151 (of the planned 534) patients were randomised (75 OSC + WBRT, 76 OSC). Participants' baseline demographics included median age 67 years (interquartile range 62-73), 60% male, 50% with a Karnofsky performance status <70; steroid usage was similar in the two groups; 64/75 (85%) received WBRT (20 Gy in five fractions). Median survival was: OSC + WBRT 49 days (95% confidence interval 39-61), OSC 51 days (95% confidence interval 27-57) - hazard ratio 1.11 (95% confidence interval 0.80-1.53) in favour of WBRT. Quality of life assessed using EQ-5D showed no evidence of a difference. The estimated mean QALYs was: OSC + WBRT 31 days and OSC 30 days, difference -1 day (95% confidence interval -12.0 to +13.2 days). CONCLUSION These interim data indicate no early evidence of detriment to quality of life, overall survival or QALYs for patients allocated to OSC alone. They provide key information for discussing the trial with patients and strengthen the argument for continuing QUARTZ to definitively answer this important clinical question.
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Rosenfeld RM, Pugh C, Cavanagh E, Schmalbach CE, McIntyre J. Getting Published: What’s New, What Works. Otolaryngol Head Neck Surg 2012. [DOI: 10.1177/0194599812449008a24] [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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Sebag-Montefiore D, Steele R, Monson J, Couture J, de Metz C, Pugh C, Nichols L, Thompson L, Quirke P. OC-0219 THE MRC CR07 TRIAL NCIC CO16 TRIAL AFTER A MEDIAN FOLLOW UP OF 8 YEARS. Radiother Oncol 2012. [DOI: 10.1016/s0167-8140(12)70558-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [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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20
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Issa N, Salud L, Woods K, Pugh C. Validity and Reliability of a Sensor Enabled Intubation Trainer. J Surg Res 2012. [DOI: 10.1016/j.jss.2011.11.073] [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: 10/14/2022]
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21
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Mulvenna P, Barton R, Wilson P, Faivre-Finn C, Pugh C, Nankivell M, Langley R. 159 Quality of life after treatment for brain metastases: An update on the QUARTZ trial – one year on from an interim data release. Lung Cancer 2012. [DOI: 10.1016/s0169-5002(12)70160-5] [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: 10/14/2022]
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22
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Ammoun S, Zhou L, Barczyk M, Hilton D, Hafizi S, Hanemann C, Lehnus KS, Donovan LK, Pilkington GJ, An Q, Anderson IA, Thomson S, Bailey M, Lekka E, Law J, Davis C, Banfill K, Loughrey C, Hatfield P, Bax D, Elliott R, Bishop R, Taylor K, Marshall L, Gaspar N, Viana-Pereira M, Reis R, Renshaw J, Ashworth A, Lord C, Jones C, Bellamy C, Shaw L, Alder J, Shorrocks A, Lea R, Birks S, Burnet M, Pilkington G, Bruch JD, Ho J, Watts C, Price SJ, Camp S, Apostolopoulos V, Mehta A, Roncaroli F, Nandi D, Clark B, Mackinnon M, MacLeod N, Stewart W, Chalmers A, Cole A, Hanna G, Bailie K, Conkey D, Harney J, Darlow C, Chapman S, Mohsen L, Price S, Donovan L, Birks S, Pilkington G, Dyer H, Lord H, Fletcher K, das Nair R, MacNiven J, Basu S, Byrne P, Glancz L, Critchley G, Grech-Sollars M, Saunders D, Phipps K, Clayden J, Clark C, Greco A, Acquati S, Marino S, Hammouche S, Wilkins SP, Smith T, Brodbelt A, Hammouche S, Clark S, Wong AHL, Eldridge P, Farah JO, Ho J, Bruch J, Watts C, Price S, Lamb G, Smith S, James A, Glegg M, Jeffcote T, Boulos S, Robbins P, Knuckey N, Banigo A, Brodbelt AR, Jenkinson MD, Jeyapalan JN, Mumin MA, Forshew T, Lawson AR, Tatevossian RG, Jacques TS, Sheer D, Kilday J, Wright K, Leavy S, Lowe J, Schwalbe E, Clifford S, Gilbertson R, Coyle B, Grundy R, Kinsella P, Clynes M, Amberger-Murphy V, Barron N, Lambert SR, Jones D, Pearson D, Ichimura I, Collins V, Steele L, Sinha P, Chumas P, Tyler J, Ogawa D, Chiocca E, DeLay M, Bronisz A, Nowicki M, Godlewski J, Lawler S, Lee MK, Javadpour M, Jenkinson MD, Lekka E, Abel P, Dawson T, Lea B, Davis C, Lim CSK, Grundy PL, Pendleton M, Lord H, Mackinnon M, Williamson A, James A, Stewart W, Clark B, Chalmers A, Merve A, Zhang X, Marino S, Miller S, Rogers HA, Lyon P, Rand V, Adamowicz-Brice M, Clifford SC, Hayden JT, Dyer S, Pfister S, Korshunov A, Brundler MA, Lowe J, Coyle B, Grundy RG, Nankivell M, Mulvenna P, Barton R, Wilson P, Faivre-Finn C, Pugh C, Langley R, Ngoga D, Tennant D, Williams A, Moss P, Cruickshank G, Owusu-Agyemang K, Bell S, Stewart W, St.George J, Piccirillo SG, Watts C, Qadri S, Pirola E, Jenkinson M, Brodbelt A, Rahman R, Rahman C, Smith S, MacArthur D, Rose F, Shakesheff K, Grundy R, Carroll C, Watson P, Hawkins M, Spoudeas H, Walker D, Holland T, Ring H, Rooney A, McNamara S, Mackinnon M, Fraser M, Rampling R, Carson A, Grant R, Royds J, Al Nadaf S, Ahn A, Chen YJ, Wiles A, Jellinek D, Braithwaite A, Baguley B, MacFarlane M, Hung N, Slatter T, Rusbridge S, Walmsley N, Griffiths S, Wilford P, Rees J, Ryan D, Watts C, Liu P, Galavotti S, Shaked-Rabi M, Tulchinsky E, Brandner S, Jones C, Salomoni P, Schulte A, Gunther HS, Zapf S, Riethdorf S, Westphal M, Lamszus K, Selvanathan SK, Hammouche S, Salminen HJ, Jenkinson MD, Setua S, Watts C, Welland ME, Shevtsov M, Khachatryan W, Kim A, Samochernych K, Pozdnyakov A, Guzhova IV, Romanova IV, Margulis B, Smith S, Rahman R, Rahman C, Barrow J, Macarthur D, Rose F, Grundy R, Smith S, Long A, Barrow J, Macarthur D, Coyle B, Grundy R, Maherally Z, Smith JR, Dickson L, Pilkington GJ, Prabhu S, Harris F, Lea R, Snape TJ, Sussman M, Wilne S, Whitehouse W, Chow G, Liu JF, Walker D, Snape T, Karakoula A, Rowther F, Warr T, Williamson A, Mackinnon M, Zisakis A, Varsos V, Panteli A, Karypidou O, Zampethanis A, Fotovati A, Abu-Ali S, Wang PS, Deleyrolle L, Lee C, Triscott J, Chen JY, Franciosi S, Nakamura Y, Sugita Y, Uchiumi T, Kuwano M, Leavitt BR, Singh SK, Jury A, Jones C, Wakimoto H, Reynolds BA, Pallen CJ, Dunn SE, Shepherd S, Scott S, Bowyer D, Wallace L, Hacking B, Mohsen L, Jena R, Gillard J, Price S, Lee C, Fotovati A, Verraeult M, Wakimoto H, Reynolds B, Dunham C, Bally M, Hukin J, Singhal S, Singh S, Dunn S. Abstracts from the 2011 BNOS Conference, June 29 - July 1, 2011, Homerton College, Cambridge. Neuro Oncol 2011. [DOI: 10.1093/neuonc/nor144] [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: 11/12/2022] Open
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Faivre-Finn C, Mulvenna P, Barton R, Wilson P, Pugh C, Nankivell M, Langley R. 9070 POSTER Whole Brain Radiotherapy for Inoperable Brain Metastases From Non-small Cell Lung Cancer – Individual Versus Community Uncertainty. Eur J Cancer 2011. [DOI: 10.1016/s0959-8049(11)72382-6] [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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Rosenfeld RM, Har-El G, Cavanagh E, Pugh C. Getting Published: How to Write Case Series and Case Reports. Otolaryngol Head Neck Surg 2011. [DOI: 10.1177/0194599811415818a30] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Program Description: This miniseminar, taught by editors, staff, and the publisher of the journal Otolaryngology–Head and Neck Surgery, will help attendees maximize their success in getting case reports and case series published. Tips and pointers will be presented on writing and organizing the manuscript, dealing with ethics review and patient privacy concerns, using the right terminology for the right message, and avoiding pitfalls that might delay or prevent manuscript acceptance. The best case reports describe a unique or nearly unique case, an important variation (outlier case), unexpected outcome or adverse event, or unexpected association between diseases or disorders. Manuscripts are most likely to be accepted if they state why the case is worth reading, describe the case and all relevant data, discuss why the case is unique or unexpected, provide alternative explanations for case features, and offer clinical implications. The best case series include a consecutive well-defined sample of subjects, report interventions with enough detail for reproduction, account for all patients initially assessed and enrolled, and provide adequate follow-up with descriptions of dropouts and losses. Manuscripts are most likely to be accepted it they include statistical analysis and reach justifiable conclusions devoid of efficacy claims. The goal of the session is to help attendees publish meaningful and valid research that can help journal readers provide enhanced patient care. Time is allotted at the end of the session for audience questions to the expert panel. Educational Objectives: 1) Learn strategies to maximize success in publishing case reports and case series. 2) Understand the role of ethics review and informed consent in observational research. 3) Avoid pitfalls that might delay or prevent acceptance of a manuscript for publication.
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Mulvenna P, Barton R, Faivre-Finn C, Wilson P, Langley R, Pugh C, Nankivell M. 111 Quality of life after treatment for brain metastases: interim data from the MRC QUARTZ clinical trial. Part two, symptoms, quality of life and data completion. Lung Cancer 2011. [DOI: 10.1016/s0169-5002(11)70111-8] [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: 10/18/2022]
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Azari A, Stanford E, Pugh C. Current Techniques and Instrumentation in Gynecologic Laparoscopy – A National Survey. J Minim Invasive Gynecol 2010. [DOI: 10.1016/j.jmig.2010.08.413] [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: 10/19/2022]
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Mulvenna P, Barton R, Wilson P, Faivre-Finn C, Pugh C, Langley R, Nankivell M. Quality of life in patients receiving optimal supportive care (including dexamethasone) plus whole-brain radiotherapy in the treatment of inoperable brain metastases from non-small cell lung cancer: The MRC QUARTZ randomised trial. Lung Cancer 2010. [DOI: 10.1016/s0169-5002(10)70095-7] [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: 11/28/2022]
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Barton R, Mulvenna P, Wilson P, Faivre-Finn C, Courtney C, Pugh C, Stephens R, Nankivell M. 168 QUALITY OF LIFE OF PATIENTS RECEIVING STEROIDS AND OPTIMAL SUPPORTIVE CARE WITH OR WITHOUT WHOLE BRAIN RADIOTHERAPY IN THE TREATMENT OF INOPERABLE BRAIN METASTASES FROM NON-SMALL CELL LUNG CANCER: THE MRC QUARTZ RANDOMIZED TRIAL. Radiother Oncol 2009. [DOI: 10.1016/s0167-8140(12)72555-0] [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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Deladisma AM, Kotranza A, Shah H, Fox P, Rossen B, Imam T, Wang S, Gucwa A, Pugh C, Lok B, Lind DS. The use of a mixed reality breast simulator with an innovative touch map feedback system to teach breast history-taking and examination skills. Cancer Res 2009. [DOI: 10.1158/0008-5472.sabcs-2105] [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
Abstract #2105
Introduction: Physical examination remains an important method of breast cancer detection. Unfortunately, many health care professionals express concerns about missing breast lesions and current methods of teaching this essential skill are limited. Through an interdisciplinary collaboration, we created an immersive virtual patient to teach health professions students history-taking and breast examination skills.
 Methods: Fifteen physician's assistant (PA) and 13 medical students (MS) interacted with a mixed reality human (MRH, a computer avatar with a mannequin-based breast simulator) with a breast complaint (Figure 1).
 
 Students spoke to and touched the MRH to take a history and examine a simulated breast with two masses of differing size and consistency. Subjects were surveyed regarding the usefulness of the virtual teaching tool and composed a patient note documenting pertinent history and physical examination findings. Students received feedback regarding the content of their patient note (number of 17 essential content items documented) and on the completeness of their breast examination (percentage area covered) using a color-coded touch map.
 Results: Student feedback related to the utility of this virtual educational tool was positive. Students only documented a mean of 7.8±2.7 (range=4-15) essential content items in the breast history. The completeness of the breast exam was a mean of 82% (range=62% to 97%) of total breast area examined (Figure 2, green=area examined, red=area missed).
 
 More clinically experienced students (MS 3 and 4, N=9) performed better than those with no clinical experience (MS 1 and PA 1, N=19) in both history-taking (58% vs. 40%, p<0.05) and completeness of exam (90% vs. 84%, p<0.05). Fifty percent of students were able to locate at least one mass but only 14% were able to correctly document the location of both lesions.
 Conclusions: The simulated experience differentiated performance among students with varying levels of clinical experience and identified a need for improved teaching and greater practice among all students. MRH scenarios provide a less anxious learning environment for students to practice breast history-taking and examination.
Citation Information: Cancer Res 2009;69(2 Suppl):Abstract nr 2105.
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Affiliation(s)
- AM Deladisma
- 1 Surgery, Medical College of Georgia, Augusta, GA
| | - A Kotranza
- 2 Computer Science, University of Florida, Gainesville, FL
| | - H Shah
- 1 Surgery, Medical College of Georgia, Augusta, GA
| | - P Fox
- 1 Surgery, Medical College of Georgia, Augusta, GA
| | - B Rossen
- 2 Computer Science, University of Florida, Gainesville, FL
| | - T Imam
- 1 Surgery, Medical College of Georgia, Augusta, GA
| | - S Wang
- 1 Surgery, Medical College of Georgia, Augusta, GA
| | - A Gucwa
- 1 Surgery, Medical College of Georgia, Augusta, GA
| | - C Pugh
- 3 Surgery, Northwestern University, Chicago, IL
| | - B Lok
- 2 Computer Science, University of Florida, Gainesville, FL
| | - DS Lind
- 1 Surgery, Medical College of Georgia, Augusta, GA
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Stephens R, Mulvenna P, Barton R, Pugh C, Courtney C. Quality of life after radiotherapy and steroids in patients with inoperable brain metastases from non-small cell lung cancer: the QUARTZ trial. Lung Cancer 2009. [DOI: 10.1016/s0169-5002(09)70102-3] [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]
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Affiliation(s)
| | - C. Pugh
- Textile Research Laboratory Courtaulds Ltd., booking
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Van Meerbeeck JP, Nicholson M, Gilligan D, Groen HJ, Nankivell M, Pugh C, Stephens R. Adjuvant or neoadjuvant chemotherapy in early-stage non-small cell lung cancer (NSCLC): How would staging affect the patients (pts) treated? J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.7509] [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: 11/20/2022] Open
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Pugh C, Mulvenna P, Barton R, Stephens R. Quality of life after radiotherapy and steroids in patients with inoperable brain metastases from non-small cell lung cancer: the QUARTZ trial. Lung Cancer 2008. [DOI: 10.1016/s0169-5002(08)70093-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: 11/25/2022]
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Stephens R, Hopwood P, Gilligan D, Nicolson M, Pugh C, Nankivell M. 1116 POSTER Impact of pre-operative chemotherapy on the Quality of Life of patients with resectable non-small cell lung cancer using data from the MRC LU22/NVALT 2/EORTC 08012 multicentre randomised clinical trial. EJC Suppl 2007. [DOI: 10.1016/s1359-6349(07)70635-3] [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] Open
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Gilligan D, Nicolson M, Smith I, Groen H, Manegold C, van Meerbeeck J, Hopwood P, Nankivell M, Pugh C, Stephens R. 6502 ORAL Pre-operative chemotherapy in patients with resectable non-small cell lung cancer (NSCLC): The MRC LU22/ NVALT 2/EORTC 08012 multi-centre randomised trial. EJC Suppl 2007. [DOI: 10.1016/s1359-6349(07)71330-7] [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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Muers M, Fisher P, Snee M, Lowry E, O'Brien M, Peake M, Rudd R, Nankivell M, Pugh C, Stephens RJ. A randomized phase III trial of active symptom control (ASC) with or without chemotherapy in the treatment of patients with malignant pleural mesothelioma: First results of the Medical Research Council (MRC) / British Thoracic Society (BTS) MS01 trial. J Clin Oncol 2007. [DOI: 10.1200/jco.2007.25.18_suppl.lba7525] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
LBA7525 Background: Although chemotherapy is widely used in the treatment of mesothelioma it has never been compared in a randomized trial with ASC alone. Two chemotherapy regimens that had shown good symptom palliation in phase II studies were chosen for investigation. Methods: Patients with malignant pleural mesothelioma were randomized to ASC alone (regular follow-up in a specialist clinic, and treatment could include steroids, analgesics, bronchodilators, palliative radiotherapy, etc), ASC+MVP (4 × 3-weekly cycles of mitomycin 6g/m2, vinblastine 6mg/m2, and cisplatin 50mg/m2), or ASC+N (12 weekly injections of vinorelbine 30mg/m2). 420 patients were required to detect a 3-month improvement in median survival with ASC+CT (both chemotherapy arms combined). Quality of Life (QL) was assessed using the EORTC QLQ-C30. Results: 409 patients were accrued (136 ASC, 137 ASC+MVP, 136 ASC+N). Median age: 65 years, male: 91%, Performance status 0: 23%, Epithelial histology: 73%, Stage III: 33%, Stage IV: 48%. In the ASC+MVP group 61% received all 4 cycles, and in the ASC+N group 49% received at least 10 weekly cycles. Good symptom palliation (defined as prevention, control or improvement) was achieved in all 3 groups, and no between-group differences were observed in 4 pre-defined QL subscales (physical functioning, dyspnoea, pain and global QL). A small (not conventionally significant) survival benefit was seen for ASC+CT (349 deaths, HR 0.89, 95%CI 0.72, 1.12, p=0.32). Median survival: ASC: 7.6 months, ASC+CT: 8.5 months. Exploratory analyses suggested a survival advantage for vinorelbine compared to ASC alone (HR 0.81, 95%CI 0.63, 1.05, p=0.11), with a median survival of 9.4 months, but no evidence of a benefit with MVP (HR 0.98, 95%CI 0.76, 1.28), p=0.91). Conclusions: This is the 2nd largest ever randomized trial in mesothelioma and the first to compare ASC with or without chemotherapy. Although the addition of chemotherapy to ASC did not result in a conventionally significant survival benefit, there was an indication that vinorelbine should be investigated further, and that MVP probably has no role in this disease. [Table: see text]
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Affiliation(s)
- M. Muers
- Leeds General Infirmary, Leeds, United Kingdom; Weston Park Hospital, Sheffield, United Kingdom; Cookridge Hospital, Leeds, United Kingdom; Papworth Hospital, Cambridge, United Kingdom; Royal Marsden Hospital, London, United Kingdom; Glenfield Hospital, Leicester, United Kingdom; St Bartholomews Hospital, London, United Kingdom; MRC Clinical Trials Unit, London, United Kingdom
| | - P. Fisher
- Leeds General Infirmary, Leeds, United Kingdom; Weston Park Hospital, Sheffield, United Kingdom; Cookridge Hospital, Leeds, United Kingdom; Papworth Hospital, Cambridge, United Kingdom; Royal Marsden Hospital, London, United Kingdom; Glenfield Hospital, Leicester, United Kingdom; St Bartholomews Hospital, London, United Kingdom; MRC Clinical Trials Unit, London, United Kingdom
| | - M. Snee
- Leeds General Infirmary, Leeds, United Kingdom; Weston Park Hospital, Sheffield, United Kingdom; Cookridge Hospital, Leeds, United Kingdom; Papworth Hospital, Cambridge, United Kingdom; Royal Marsden Hospital, London, United Kingdom; Glenfield Hospital, Leicester, United Kingdom; St Bartholomews Hospital, London, United Kingdom; MRC Clinical Trials Unit, London, United Kingdom
| | - E. Lowry
- Leeds General Infirmary, Leeds, United Kingdom; Weston Park Hospital, Sheffield, United Kingdom; Cookridge Hospital, Leeds, United Kingdom; Papworth Hospital, Cambridge, United Kingdom; Royal Marsden Hospital, London, United Kingdom; Glenfield Hospital, Leicester, United Kingdom; St Bartholomews Hospital, London, United Kingdom; MRC Clinical Trials Unit, London, United Kingdom
| | - M. O'Brien
- Leeds General Infirmary, Leeds, United Kingdom; Weston Park Hospital, Sheffield, United Kingdom; Cookridge Hospital, Leeds, United Kingdom; Papworth Hospital, Cambridge, United Kingdom; Royal Marsden Hospital, London, United Kingdom; Glenfield Hospital, Leicester, United Kingdom; St Bartholomews Hospital, London, United Kingdom; MRC Clinical Trials Unit, London, United Kingdom
| | - M. Peake
- Leeds General Infirmary, Leeds, United Kingdom; Weston Park Hospital, Sheffield, United Kingdom; Cookridge Hospital, Leeds, United Kingdom; Papworth Hospital, Cambridge, United Kingdom; Royal Marsden Hospital, London, United Kingdom; Glenfield Hospital, Leicester, United Kingdom; St Bartholomews Hospital, London, United Kingdom; MRC Clinical Trials Unit, London, United Kingdom
| | - R. Rudd
- Leeds General Infirmary, Leeds, United Kingdom; Weston Park Hospital, Sheffield, United Kingdom; Cookridge Hospital, Leeds, United Kingdom; Papworth Hospital, Cambridge, United Kingdom; Royal Marsden Hospital, London, United Kingdom; Glenfield Hospital, Leicester, United Kingdom; St Bartholomews Hospital, London, United Kingdom; MRC Clinical Trials Unit, London, United Kingdom
| | - M. Nankivell
- Leeds General Infirmary, Leeds, United Kingdom; Weston Park Hospital, Sheffield, United Kingdom; Cookridge Hospital, Leeds, United Kingdom; Papworth Hospital, Cambridge, United Kingdom; Royal Marsden Hospital, London, United Kingdom; Glenfield Hospital, Leicester, United Kingdom; St Bartholomews Hospital, London, United Kingdom; MRC Clinical Trials Unit, London, United Kingdom
| | - C. Pugh
- Leeds General Infirmary, Leeds, United Kingdom; Weston Park Hospital, Sheffield, United Kingdom; Cookridge Hospital, Leeds, United Kingdom; Papworth Hospital, Cambridge, United Kingdom; Royal Marsden Hospital, London, United Kingdom; Glenfield Hospital, Leicester, United Kingdom; St Bartholomews Hospital, London, United Kingdom; MRC Clinical Trials Unit, London, United Kingdom
| | - R. J. Stephens
- Leeds General Infirmary, Leeds, United Kingdom; Weston Park Hospital, Sheffield, United Kingdom; Cookridge Hospital, Leeds, United Kingdom; Papworth Hospital, Cambridge, United Kingdom; Royal Marsden Hospital, London, United Kingdom; Glenfield Hospital, Leicester, United Kingdom; St Bartholomews Hospital, London, United Kingdom; MRC Clinical Trials Unit, London, United Kingdom
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Hopwood P, Nankivell M, Pugh C, Gilligan D, Nicolson M, Stephens RJ. Impact of pre-operative chemotherapy on the quality of life (QL) of patients with resectable non-small cell lung cancer (NSCLC): Experience from the MRC LU22/NVALT/EORTC 08012 multicentre randomised trial. J Clin Oncol 2007. [DOI: 10.1200/jco.2007.25.18_suppl.9020] [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: 11/20/2022] Open
Abstract
9020 Aim: To evaluate QL during the first 2 years follow-up in patients randomised to receive 3 cycles of platinum-based chemotherapy (CT-S) prior to surgical resection of NSCLC compared to those receiving surgery alone (S). Methods: A total of 519 patients were entered into the LU22 trial from 70 centres in the UK, The Netherlands, Germany and Belgium. All patients were asked to complete the SF-36 QL questionnaire prior to randomisation and at 6 and 12 months then annually to 5 years. The scores from the SF-36 questionnaire were combined into 8 domains and also summarised as physical component summary (PCS) and mental component summary (MCS). The 6,12 and 24 month PCS and MCS scores were analysed using multivariable regression to identify prognostic factors and investigate the difference between the regimens. Results: 82% patients completed QL at baseline, and compliance at 6, 12 and 24 months was 59%, 60% and 67% respectively. Median age was 63 (range 25 to 79 years) and 72% were male. At 6 months patients in the S group reported somewhat better functioning in all domains except general health and mental health, but no differences were seen at 12 or 24 months. The regression analyses indicated that better physical health outcomes (PCS) were predicted by baseline PCS and MCS at all follow-up points (all p<0.05), whereas longer time since surgery predicted better PCS at 6 months (p<0.05), and younger age predicted better PCS at 24 months (p=0.07). For mental health, better MCS was predicted at all time points by baseline MCS (p<0.05). In addition, female gender (p=0.07), and PCS (p<0.05), were predictors at 6 months, and younger age predicted better MCS at 24 months (p<0.01). Treatment regimen had no effect on QL at any time point. At 1 and 2 years more than 50% patients considered their health comparable to others, and 45% were generally optimistic about their future health. Conclusions: Over 2 years follow-up, QL was not adversely affected by pre-operative chemotherapy and there were no significant differences between the regimens. Many patients saw themselves as fit as their contemporaries. [Table: see text]
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Affiliation(s)
- P. Hopwood
- Christie Hospital NHS Trust, Manchester, United Kingdom; MRC Clinical Trials Unit, London, United Kingdom; Addenbrooke's Hospital, Cambridge, United Kingdom; Aberdeen Royal Infirmary, Aberdeen, United Kingdom
| | - M. Nankivell
- Christie Hospital NHS Trust, Manchester, United Kingdom; MRC Clinical Trials Unit, London, United Kingdom; Addenbrooke's Hospital, Cambridge, United Kingdom; Aberdeen Royal Infirmary, Aberdeen, United Kingdom
| | - C. Pugh
- Christie Hospital NHS Trust, Manchester, United Kingdom; MRC Clinical Trials Unit, London, United Kingdom; Addenbrooke's Hospital, Cambridge, United Kingdom; Aberdeen Royal Infirmary, Aberdeen, United Kingdom
| | - D. Gilligan
- Christie Hospital NHS Trust, Manchester, United Kingdom; MRC Clinical Trials Unit, London, United Kingdom; Addenbrooke's Hospital, Cambridge, United Kingdom; Aberdeen Royal Infirmary, Aberdeen, United Kingdom
| | - M. Nicolson
- Christie Hospital NHS Trust, Manchester, United Kingdom; MRC Clinical Trials Unit, London, United Kingdom; Addenbrooke's Hospital, Cambridge, United Kingdom; Aberdeen Royal Infirmary, Aberdeen, United Kingdom
| | - R. J. Stephens
- Christie Hospital NHS Trust, Manchester, United Kingdom; MRC Clinical Trials Unit, London, United Kingdom; Addenbrooke's Hospital, Cambridge, United Kingdom; Aberdeen Royal Infirmary, Aberdeen, United Kingdom
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Nicolson M, Gilligan D, Smith I, Groen H, Manegold C, van Meerbeeck J, Hopwood P, Nankivell M, Pugh C, Stephens RJ. Pre-operative chemotherapy in patients with resectable non-small cell lung cancer (NSCLC): First results of the MRC LU22/NVALT/EORTC 08012 multi-centre randomised trial. J Clin Oncol 2007. [DOI: 10.1200/jco.2007.25.18_suppl.7518] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
7518 Aims: Although surgery offers the best chance of cure for patients with NSCLC, the overall 5-year survival rate is modest, and improvements are urgently required. This intergroup trial was designed to investigate whether, in patients with operable NSCLC of any stage, neo-adjuvant platinum-based chemotherapy prior to surgery would improve outcomes. Methods: Patients were randomised to receive either surgery alone (S), or 3 cycles of platinum-based chemotherapy prior to surgery (CT-S). Results: 519 patients were randomised (261 S, 258 CT-S) from 70 centres in the UK, the Netherlands, Germany and Belgium. The median age of the patients was 63 years, 72% were male, 59% were PS 0, and 50% had squamous cell histology. The majority were clinical stage I (17% Ia, 45% Ib, 3% IIa, 29% IIb, 7% IIIa), and 12% received mitomycin/vinblastine/cisplatin (MVP), 7% mitomycin/ifosfamide/cisplatin (MIC), 45% vinorelbine/cisplatin, 12% carboplatin/docetaxel, and 25% cisplatin/gemcitabine. The trial showed that neo-adjuvant chemotherapy was feasible (76% of patients received all 3 cycles of chemotherapy), resulted in a good response rate (4% CR, 45% PR, and only 2% PD), appeared to cause down-staging in about 20% of patients, and did not affect the type of surgery performed, the post-operative complication rate, or quality of life. However, there was no evidence of a benefit in terms of progression-free survival (282 events, HR 0.98, 95% CI 0.77,1.23) or overall survival (232 deaths, HR 1.04, 95% CI 0.81, 1.35), and more patients were reported as having brain metastases in the CT-S group (30 CT-S vs 11 S patients). Exploratory analyses showed no evidence that any subgroup of patients benefited from the addition of neo-adjuvant chemotherapy. Conclusions: This intergroup trial, which is the largest trial of neo-adjuvant chemotherapy in patients with resectable NSCLC, indicated that the addition of neo-adjuvant platinum-based chemotherapy did not lead to a benefit in overall survival. However, a 19% survival benefit or a 35% detriment cannot be excluded and this result needs to be considered in the context of all other relevant randomised trials of neo-adjuvant chemotherapy for NSCLC. [Table: see text]
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Affiliation(s)
- M. Nicolson
- Aberdeen Royal Infirmary, Aberdeen, United Kingdom; Addenbrooke's Hospital, Cambridge, United Kingdom; Royal Marsden Hospital, London, United Kingdom; University Hospital, Groningen, The Netherlands; University Medical Centre, Mannheim, Germany; University Hospital, Ghent, Belgium; Christie Hospital NHS Trust, Manchester, United Kingdom; MRC Clinical Trials Unit, London, United Kingdom
| | - D. Gilligan
- Aberdeen Royal Infirmary, Aberdeen, United Kingdom; Addenbrooke's Hospital, Cambridge, United Kingdom; Royal Marsden Hospital, London, United Kingdom; University Hospital, Groningen, The Netherlands; University Medical Centre, Mannheim, Germany; University Hospital, Ghent, Belgium; Christie Hospital NHS Trust, Manchester, United Kingdom; MRC Clinical Trials Unit, London, United Kingdom
| | - I. Smith
- Aberdeen Royal Infirmary, Aberdeen, United Kingdom; Addenbrooke's Hospital, Cambridge, United Kingdom; Royal Marsden Hospital, London, United Kingdom; University Hospital, Groningen, The Netherlands; University Medical Centre, Mannheim, Germany; University Hospital, Ghent, Belgium; Christie Hospital NHS Trust, Manchester, United Kingdom; MRC Clinical Trials Unit, London, United Kingdom
| | - H. Groen
- Aberdeen Royal Infirmary, Aberdeen, United Kingdom; Addenbrooke's Hospital, Cambridge, United Kingdom; Royal Marsden Hospital, London, United Kingdom; University Hospital, Groningen, The Netherlands; University Medical Centre, Mannheim, Germany; University Hospital, Ghent, Belgium; Christie Hospital NHS Trust, Manchester, United Kingdom; MRC Clinical Trials Unit, London, United Kingdom
| | - C. Manegold
- Aberdeen Royal Infirmary, Aberdeen, United Kingdom; Addenbrooke's Hospital, Cambridge, United Kingdom; Royal Marsden Hospital, London, United Kingdom; University Hospital, Groningen, The Netherlands; University Medical Centre, Mannheim, Germany; University Hospital, Ghent, Belgium; Christie Hospital NHS Trust, Manchester, United Kingdom; MRC Clinical Trials Unit, London, United Kingdom
| | - J. van Meerbeeck
- Aberdeen Royal Infirmary, Aberdeen, United Kingdom; Addenbrooke's Hospital, Cambridge, United Kingdom; Royal Marsden Hospital, London, United Kingdom; University Hospital, Groningen, The Netherlands; University Medical Centre, Mannheim, Germany; University Hospital, Ghent, Belgium; Christie Hospital NHS Trust, Manchester, United Kingdom; MRC Clinical Trials Unit, London, United Kingdom
| | - P. Hopwood
- Aberdeen Royal Infirmary, Aberdeen, United Kingdom; Addenbrooke's Hospital, Cambridge, United Kingdom; Royal Marsden Hospital, London, United Kingdom; University Hospital, Groningen, The Netherlands; University Medical Centre, Mannheim, Germany; University Hospital, Ghent, Belgium; Christie Hospital NHS Trust, Manchester, United Kingdom; MRC Clinical Trials Unit, London, United Kingdom
| | - M. Nankivell
- Aberdeen Royal Infirmary, Aberdeen, United Kingdom; Addenbrooke's Hospital, Cambridge, United Kingdom; Royal Marsden Hospital, London, United Kingdom; University Hospital, Groningen, The Netherlands; University Medical Centre, Mannheim, Germany; University Hospital, Ghent, Belgium; Christie Hospital NHS Trust, Manchester, United Kingdom; MRC Clinical Trials Unit, London, United Kingdom
| | - C. Pugh
- Aberdeen Royal Infirmary, Aberdeen, United Kingdom; Addenbrooke's Hospital, Cambridge, United Kingdom; Royal Marsden Hospital, London, United Kingdom; University Hospital, Groningen, The Netherlands; University Medical Centre, Mannheim, Germany; University Hospital, Ghent, Belgium; Christie Hospital NHS Trust, Manchester, United Kingdom; MRC Clinical Trials Unit, London, United Kingdom
| | - R. J. Stephens
- Aberdeen Royal Infirmary, Aberdeen, United Kingdom; Addenbrooke's Hospital, Cambridge, United Kingdom; Royal Marsden Hospital, London, United Kingdom; University Hospital, Groningen, The Netherlands; University Medical Centre, Mannheim, Germany; University Hospital, Ghent, Belgium; Christie Hospital NHS Trust, Manchester, United Kingdom; MRC Clinical Trials Unit, London, United Kingdom
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Pugh C, Percec V. Phase Transfer Pd(O) Catalyzed Polymerization Reactions. 2. Thermal Characterization of Liquid Crystalline 1,2-(4,4′-Dialkoxyaryl)acetylene Derivatives. ACTA ACUST UNITED AC 2006. [DOI: 10.1080/00268949008042719] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- C. Pugh
- Department of Macromolecular Science, Case Western Reserve University, Cleveland, Ohio, 44106, USA
| | - V. Percec
- Department of Macromolecular Science, Case Western Reserve University, Cleveland, Ohio, 44106, USA
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Percec V, Cho CG, Pugh C, Tomazos D. Synthesis and characterization of branched liquid-crystalline polyethers containing cyclotetraveratrylene-based disk-like mesogens. Macromolecules 2002. [DOI: 10.1021/ma00029a025] [Citation(s) in RCA: 81] [Impact Index Per Article: 3.7] [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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Abstract
We describe a new technique for arthroscopically assisted posterior cruciate ligament reconstruction. We use the TransFix (Arthrex, Naples, FL) pin to provide a single and strong tibial attachment point for the 4-stranded semitendinosus and gracilis tendons. The TransFix technique for anterior cruciate ligament reconstruction has been found to give better initial fixation strength than other techniques using semitendinosus and gracilis grafts, and it provides adequate graft length for secure fixation. Strong and secure graft fixation in knee ligament reconstruction is very important for early and fast rehabilitation.
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Affiliation(s)
- A F Foukas
- South Birmingham Trauma Unit, Selly Oak Hospital, Birmingham, England
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Raper SE, Haskal ZJ, Ye X, Pugh C, Furth EE, Gao GP, Wilson JM. Selective gene transfer into the liver of non-human primates with E1-deleted, E2A-defective, or E1-E4 deleted recombinant adenoviruses. Hum Gene Ther 1998; 9:671-9. [PMID: 9551615 DOI: 10.1089/hum.1998.9.5-671] [Citation(s) in RCA: 41] [Impact Index Per Article: 1.6] [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: 11/12/2022] Open
Abstract
Preclinical studies were designed to investigate the feasibility and safety of recombinant adenoviruses transduced into the hepatic artery of nonhuman primates. The vectors used are recombinant adenoviruses deleted in E1 and contain either a temperature-sensitive mutation in the E2a gene, which encodes a defective DNA-binding protein at nonpermissive temperatures, or a deletion of the E4 region, including open reading frame (ORF) 6. Six 8- to 10-kg baboons underwent femoral artery cannulation, and angiographic techniques were used to introduce vector selectively into either a portion of the right lobe of the liver via a branch of the right hepatic artery or the common hepatic artery. Necropsies were performed at 4, 29, or 61 days. Serial sequential liver biopsies were performed in the baboons that survived 29 or 61 days. In the 2 baboons with vector transduction into the right hepatic artery, X-Gal histochemical analysis of the liver showed evidence of quantitatively increased gene transfer in the targeted lobe; however, gene transfer was present throughout the liver. Quantitative analysis of histopathology showed that portal inflammation was present throughout both livers transduced with the highest dose of vector. No differences were seen in the level of portal inflammation in targeted and untargeted lobes despite the observed qualitative and quantitative differences in gene expression. Southern blot analysis of total cellular DNA isolated from targeted and nontargeted lobes showed similar levels of viral DNA throughout the liver. Polymerase chain reaction (PCR) analysis was able to detect viral DNA sequence in gonads and brain as well as many other tissues in baboons treated with high-dose vector. In baboons treated with lower doses of an E1-E4 deleted vector expressing the human ornithine transcarbamylase (OTC) gene, DNA was detectable by nested PCR in liver but not gonads at days 29 and 61. The data suggest that intraarterial administration of recombinant adenoviral E1-E4 deleted vector is feasible and safe. At high doses of vector, widespread dissemination of vector DNA is seen. At low doses, hepatic gene transfer is not associated with vector DNA dissemination to gonads.
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Affiliation(s)
- S E Raper
- Institute for Human Gene Therapy, Harrison Department of Surgical Research, University of Pennsylvania School of Medicine, Philadelphia 19104-6100, USA
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Pugh C, Del Fante P. Staying healthy while travelling. Aust Fam Physician 1994; 23:1686, 1689-90, 1693-5. [PMID: 7980168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
By ensuring that the issues raised in this article are appropriately discussed with each traveller at the pre-travel consultation, the chance of staying healthy while travelling is considerably enhanced. If all else fails, the traveller should be well equipped with a first aid medical kit (Table 2) and instructions on how and when to take medications. They should know how to treat travellers diarrhoea, recognise signs and symptoms of malaria and the difference between a bacterial infection and viral infection. Bon voyage!
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Affiliation(s)
- C Pugh
- Travellers Medical and Vaccination Centre, Adelaide, South Australia
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Kurtz A, Eckardt KU, Pugh C, Corvol P, Fabbro D, Ratcliffe P. Phorbol ester inhibits erythropoietin production in human hepatoma cells (Hep G2). Am J Physiol 1992; 262:C1204-10. [PMID: 1317101 DOI: 10.1152/ajpcell.1992.262.5.c1204] [Citation(s) in RCA: 15] [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] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Using the human hepatoma cell line Hep G2, we have studied a possible role of protein kinase C (PKC) activity for regulation of erythropoietin (EPO) production. During a 72-h incubation, EPO production by the cells was stimulated sevenfold by exposure to low oxygen tension (1%) and threefold by exposure to cobaltous chloride (100 microM). The phorbol ester phorbol 12-myristate-13 acetate (PMA) led to a concentration-dependent inhibition of basal and stimulated EPO formation (ED50 10 nM). This decrease of EPO production, which was apparent already after 1 h of incubation with PMA, reached its maximal effect after 24 h and held on for 72 h. It was paralleled by an inhibition of the increase of EPO mRNA levels in response to stimulation. A 24-h preincubation of the cells with PMA (100 nM) virtually blunted the effect of hypoxia on EPO formation. Recovery of EPO synthesis after removal of PMA took 48-72 h. The effect of PMA on EPO production was mimicked by phorbol 12,13-dibutyrate (ED50 1 microM) but not by 4 alpha-phorbol 12,13-didecanoate. The synthetic diacylglycerol analogues oleolyl-acetylglycerol and dioctanoylglycerol (2-200 microM) also had no effect on either basal or stimulated EPO production. Treatment with PMA caused a translocation of the alpha-isoenzyme of PKC from the cytosol to the membrane after 1 h and a disappearance of the membrane-bound form after 24 h of incubation. Staurosporine and 1-(5-isoquinolinylsulfonyl)-2-methylpiperazine, two structurally different inhibitors of PKC activity, inhibited basal and stimulated EPO production with ED50 values of 9 nM and 50 microM, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)
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Affiliation(s)
- A Kurtz
- Physiologisches Institut, Universität Regensburg, Germany
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Abstract
Reviews the economic and financial considerations relevant to
investment in shopping centre refurbishment. Considers the problems of
economic obsolescence through rising maintenance costs and falling
rents, and legal obsolescence through changes in legislation and safety
regulations, using case study examples. Concludes that refurbishment is
usually an attractive proposition, even a defensive necessity: the
financial implications of refurbishment can be analysed formally.
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Affiliation(s)
- O Sheil
- Nuffield Department of Obstetrics and Gynaecology, University of Oxford, John Radcliffe Hospital, Headington
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