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MacDonnell C, Bydalek F, Osborne TZ, Beard A, Barbour S, Leonard D, Makinia J, Inglett PW. Use of a wastewater recovery product (struvite) to enhance subtropical seagrass restoration. Sci Total Environ 2022; 838:155717. [PMID: 35525357 DOI: 10.1016/j.scitotenv.2022.155717] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Revised: 04/04/2022] [Accepted: 05/01/2022] [Indexed: 06/14/2023]
Abstract
Seagrasses are in decline worldwide, and their restoration is relatively expensive and unsuccessful compared to other coastal systems. Fertilization can improve seagrass growth in restoration but can also release nutrients and pollute the surrounding ecosystem. A slow-release fertilizer may reduce excessive nutrient discharge while still providing resources to the seagrass's rhizosphere. In this study, struvite (magnesium ammonium phosphate), a relatively insoluble, sustainable compound harvested in wastewater treatment plants, was compared to Osmocote™(14:14:14 Nitrogen: Phosphorus: Potassium, N:P:K), a popular polymer coated controlled release fertilizer commonly used in seagrass restoration. Two experiments compared the effectiveness of both fertilizers in a subtropical flow-through mesocosm setup. In the first experiment, single 0.5 mg of P per g dry weight (DW) doses of Osmocote™and struvite fertilizers were added to seagrass plots. Seagrass shoot counts were significantly higher in plots fertilized with struvite than both the Osmocote™and unfertilized controls (p< 0.0001). A significant difference in total P concentration was observed in porewater samples of Osmocote™vs struvite and controls (p< 0.0001), with struvite fertilized plots emitting more than controls (p ≤ 0.0001), but less than 2% of the total dissolved P (TDP) of Osmocote™fertilized plots (100+ mg/L versus x > 5 mg/L). A subsequent experiment, using smaller doses (0.01 and 0.025 mg of P per gram DW added), also found that the struvite treatments performed better than Osmocote™, with 16-114% more aboveground biomass (10-60% higher total biomass) while releasing less N and P. These results indicate the relatively rapid dissolution of Osmocote™may pose problems to restoration efforts, especially in concentrated doses and possibly leading to seagrass stress. In contrast, struvite may function as a slow-release fertilizer applicable in seagrass and other coastal restoration efforts.
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Affiliation(s)
- C MacDonnell
- University of Florida, Department of Soil, Water and Ecosystem Sciences, 1692 McCarty Drive, Gainesville, FL 32603, United States of America
| | - F Bydalek
- Department of Sanitary Engineering, Gdańsk University of Technology, 80-233 Gdansk, Poland
| | - T Z Osborne
- University of Florida, Department of Soil, Water and Ecosystem Sciences, 1692 McCarty Drive, Gainesville, FL 32603, United States of America; Whitney Laboratory for Biosciences, 9505 N Ocean Shore Blvd, St. Augustine, FL 32080, United States of America
| | - A Beard
- Whitney Laboratory for Biosciences, 9505 N Ocean Shore Blvd, St. Augustine, FL 32080, United States of America
| | - S Barbour
- University of Florida, Department of Soil, Water and Ecosystem Sciences, 1692 McCarty Drive, Gainesville, FL 32603, United States of America
| | - D Leonard
- University of Florida, Department of Soil, Water and Ecosystem Sciences, 1692 McCarty Drive, Gainesville, FL 32603, United States of America
| | - J Makinia
- Department of Sanitary Engineering, Gdańsk University of Technology, 80-233 Gdansk, Poland
| | - P W Inglett
- University of Florida, Department of Soil, Water and Ecosystem Sciences, 1692 McCarty Drive, Gainesville, FL 32603, United States of America.
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Proietti M, Romiti GF, Vitolo M, Harrison SL, Lane DA, Fauchier L, Marin F, Näbauer M, Potpara TS, Dan GA, Maggioni AP, Cesari M, Boriani G, Lip GYH, Ekmekçiu U, Paparisto V, Tase M, Gjergo H, Dragoti J, Goda A, Ciutea M, Ahadi N, el Husseini Z, Raepers M, Leroy J, Haushan P, Jourdan A, Lepiece C, Desteghe L, Vijgen J, Koopman P, Van Genechten G, Heidbuchel H, Boussy T, De Coninck M, Van Eeckhoutte H, Bouckaert N, Friart A, Boreux J, Arend C, Evrard P, Stefan L, Hoffer E, Herzet J, Massoz M, Celentano C, Sprynger M, Pierard L, Melon P, Van Hauwaert B, Kuppens C, Faes D, Van Lier D, Van Dorpe A, Gerardy A, Deceuninck O, Xhaet O, Dormal F, Ballant E, Blommaert D, Yakova D, Hristov M, Yncheva T, Stancheva N, Tisheva S, Tokmakova M, Nikolov F, Gencheva D, Shalganov T, Kunev B, Stoyanov M, Marchov D, Gelev V, Traykov V, Kisheva A, Tsvyatkov H, Shtereva R, Bakalska-Georgieva S, Slavcheva S, Yotov Y, Kubíčková M, Marni Joensen A, Gammelmark A, Hvilsted Rasmussen L, Dinesen P, Riahi S, Krogh Venø S, Sorensen B, Korsgaard A, Andersen K, Fragtrup Hellum C, Svenningsen A, Nyvad O, Wiggers P, May O, Aarup A, Graversen B, Jensen L, Andersen M, Svejgaard M, Vester S, Hansen S, Lynggaard V, Ciudad M, Vettus R, Muda P, Maestre A, Castaño S, Cheggour S, Poulard J, Mouquet V, Leparrée S, Bouet J, Taieb J, Doucy A, Duquenne H, Furber A, Dupuis J, Rautureau J, Font M, Damiano P, Lacrimini M, Abalea J, Boismal S, Menez T, Mansourati J, Range G, Gorka H, Laure C, Vassalière C, Elbaz N, Lellouche N, Djouadi K, Roubille F, Dietz D, Davy J, Granier M, Winum P, Leperchois-Jacquey C, Kassim H, Marijon E, Le Heuzey J, Fedida J, Maupain C, Himbert C, Gandjbakhch E, Hidden-Lucet F, Duthoit G, Badenco N, Chastre T, Waintraub X, Oudihat M, Lacoste J, Stephan C, Bader H, Delarche N, Giry L, Arnaud D, Lopez C, Boury F, Brunello I, Lefèvre M, Mingam R, Haissaguerre M, Le Bidan M, Pavin D, Le Moal V, Leclercq C, Piot O, Beitar T, Martel I, Schmid A, Sadki N, Romeyer-Bouchard C, Da Costa A, Arnault I, Boyer M, Piat C, Fauchier L, Lozance N, Nastevska S, Doneva A, Fortomaroska Milevska B, Sheshoski B, Petroska K, Taneska N, Bakrecheski N, Lazarovska K, Jovevska S, Ristovski V, Antovski A, Lazarova E, Kotlar I, Taleski J, Poposka L, Kedev S, Zlatanovik N, Jordanova S, Bajraktarova Proseva T, Doncovska S, Maisuradze D, Esakia A, Sagirashvili E, Lartsuliani K, Natelashvili N, Gumberidze N, Gvenetadze R, Etsadashvili K, Gotonelia N, Kuridze N, Papiashvili G, Menabde I, Glöggler S, Napp A, Lebherz C, Romero H, Schmitz K, Berger M, Zink M, Köster S, Sachse J, Vonderhagen E, Soiron G, Mischke K, Reith R, Schneider M, Rieker W, Boscher D, Taschareck A, Beer A, Oster D, Ritter O, Adamczewski J, Walter S, Frommhold A, Luckner E, Richter J, Schellner M, Landgraf S, Bartholome S, Naumann R, Schoeler J, Westermeier D, William F, Wilhelm K, Maerkl M, Oekinghaus R, Denart M, Kriete M, Tebbe U, Scheibner T, Gruber M, Gerlach A, Beckendorf C, Anneken L, Arnold M, Lengerer S, Bal Z, Uecker C, Förtsch H, Fechner S, Mages V, Martens E, Methe H, Schmidt T, Schaeffer B, Hoffmann B, Moser J, Heitmann K, Willems S, Willems S, Klaus C, Lange I, Durak M, Esen E, Mibach F, Mibach H, Utech A, Gabelmann M, Stumm R, Ländle V, Gartner C, Goerg C, Kaul N, Messer S, Burkhardt D, Sander C, Orthen R, Kaes S, Baumer A, Dodos F, Barth A, Schaeffer G, Gaertner J, Winkler J, Fahrig A, Aring J, Wenzel I, Steiner S, Kliesch A, Kratz E, Winter K, Schneider P, Haag A, Mutscher I, Bosch R, Taggeselle J, Meixner S, Schnabel A, Shamalla A, Hötz H, Korinth A, Rheinert C, Mehltretter G, Schön B, Schön N, Starflinger A, Englmann E, Baytok G, Laschinger T, Ritscher G, Gerth A, Dechering D, Eckardt L, Kuhlmann M, Proskynitopoulos N, Brunn J, Foth K, Axthelm C, Hohensee H, Eberhard K, Turbanisch S, Hassler N, Koestler A, Stenzel G, Kschiwan D, Schwefer M, Neiner S, Hettwer S, Haeussler-Schuchardt M, Degenhardt R, Sennhenn S, Steiner S, Brendel M, Stoehr A, Widjaja W, Loehndorf S, Logemann A, Hoskamp J, Grundt J, Block M, Ulrych R, Reithmeier A, Panagopoulos V, Martignani C, Bernucci D, Fantecchi E, Diemberger I, Ziacchi M, Biffi M, Cimaglia P, Frisoni J, Boriani G, Giannini I, Boni S, Fumagalli S, Pupo S, Di Chiara A, Mirone P, Fantecchi E, Boriani G, Pesce F, Zoccali C, Malavasi VL, Mussagaliyeva A, Ahyt B, Salihova Z, Koshum-Bayeva K, Kerimkulova A, Bairamukova A, Mirrakhimov E, Lurina B, Zuzans R, Jegere S, Mintale I, Kupics K, Jubele K, Erglis A, Kalejs O, Vanhear K, Burg M, Cachia M, Abela E, Warwicker S, Tabone T, Xuereb R, Asanovic D, Drakalovic D, Vukmirovic M, Pavlovic N, Music L, Bulatovic N, Boskovic A, Uiterwaal H, Bijsterveld N, De Groot J, Neefs J, van den Berg N, Piersma F, Wilde A, Hagens V, Van Es J, Van Opstal J, Van Rennes B, Verheij H, Breukers W, Tjeerdsma G, Nijmeijer R, Wegink D, Binnema R, Said S, Erküner Ö, Philippens S, van Doorn W, Crijns H, Szili-Torok T, Bhagwandien R, Janse P, Muskens A, van Eck M, Gevers R, van der Ven N, Duygun A, Rahel B, Meeder J, Vold A, Holst Hansen C, Engset I, Atar D, Dyduch-Fejklowicz B, Koba E, Cichocka M, Sokal A, Kubicius A, Pruchniewicz E, Kowalik-Sztylc A, Czapla W, Mróz I, Kozlowski M, Pawlowski T, Tendera M, Winiarska-Filipek A, Fidyk A, Slowikowski A, Haberka M, Lachor-Broda M, Biedron M, Gasior Z, Kołodziej M, Janion M, Gorczyca-Michta I, Wozakowska-Kaplon B, Stasiak M, Jakubowski P, Ciurus T, Drozdz J, Simiera M, Zajac P, Wcislo T, Zycinski P, Kasprzak J, Olejnik A, Harc-Dyl E, Miarka J, Pasieka M, Ziemińska-Łuć M, Bujak W, Śliwiński A, Grech A, Morka J, Petrykowska K, Prasał M, Hordyński G, Feusette P, Lipski P, Wester A, Streb W, Romanek J, Woźniak P, Chlebuś M, Szafarz P, Stanik W, Zakrzewski M, Kaźmierczak J, Przybylska A, Skorek E, Błaszczyk H, Stępień M, Szabowski S, Krysiak W, Szymańska M, Karasiński J, Blicharz J, Skura M, Hałas K, Michalczyk L, Orski Z, Krzyżanowski K, Skrobowski A, Zieliński L, Tomaszewska-Kiecana M, Dłużniewski M, Kiliszek M, Peller M, Budnik M, Balsam P, Opolski G, Tymińska A, 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M, Rimbas R, Grecu M, Cozma A, Boros F, Ille M, Tica O, Tor R, Corina A, Jeewooth A, Maria B, Georgiana C, Natalia C, Alin D, Dinu-Andrei D, Livia M, Daniela R, Larisa R, Umaar S, Tamara T, Ioachim Popescu M, Nistor D, Sus I, Coborosanu O, Alina-Ramona N, Dan R, Petrescu L, Ionescu G, Popescu I, Vacarescu C, Goanta E, Mangea M, Ionac A, Mornos C, Cozma D, Pescariu S, Solodovnicova E, Soldatova I, Shutova J, Tjuleneva L, Zubova T, Uskov V, Obukhov D, Rusanova G, Soldatova I, Isakova N, Odinsova S, Arhipova T, Kazakevich E, Serdechnaya E, Zavyalova O, Novikova T, Riabaia I, Zhigalov S, Drozdova E, Luchkina I, Monogarova Y, Hegya D, Rodionova L, Rodionova L, Nevzorova V, Soldatova I, Lusanova O, Arandjelovic A, Toncev D, Milanov M, Sekularac N, Zdravkovic M, Hinic S, Dimkovic S, Acimovic T, Saric J, Polovina M, Potpara T, Vujisic-Tesic B, Nedeljkovic M, Zlatar M, Asanin M, Vasic V, Popovic Z, Djikic D, Sipic M, Peric V, Dejanovic B, Milosevic N, Stevanovic A, Andric A, Pencic B, Pavlovic-Kleut M, Celic V, Pavlovic M, Petrovic M, Vuleta M, Petrovic N, Simovic S, Savovic Z, Milanov S, Davidovic G, Iric-Cupic V, Simonovic D, Stojanovic M, Stojanovic S, Mitic V, Ilic V, Petrovic D, Deljanin Ilic M, Ilic S, Stoickov V, Markovic S, Kovacevic S, García Fernandez A, Perez Cabeza A, Anguita M, Tercedor Sanchez L, Mau E, Loayssa J, Ayarra M, Carpintero M, Roldán Rabadan I, Leal M, Gil Ortega M, Tello Montoliu A, Orenes Piñero E, Manzano Fernández S, Marín F, Romero Aniorte A, Veliz Martínez A, Quintana Giner M, Ballesteros G, Palacio M, Alcalde O, García-Bolao I, Bertomeu Gonzalez V, Otero-Raviña F, García Seara J, Gonzalez Juanatey J, Dayal N, Maziarski P, Gentil-Baron P, Shah D, Koç M, Onrat E, Dural IE, Yilmaz K, Özin B, Tan Kurklu S, Atmaca Y, Canpolat U, Tokgozoglu L, Dolu AK, Demirtas B, Sahin D, Ozcan Celebi O, Diker E, Gagirci G, Turk UO, Ari H, Polat N, Toprak N, Sucu M, Akin Serdar O, Taha Alper A, Kepez A, Yuksel Y, Uzunselvi A, Yuksel S, Sahin M, Kayapinar O, Ozcan T, Kaya H, Yilmaz MB, Kutlu M, Demir M, Gibbs C, Kaminskiene S, Bryce M, Skinner A, Belcher G, Hunt J, Stancombe L, Holbrook B, Peters C, Tettersell S, Shantsila A, Lane D, Senoo K, Proietti M, Russell K, Domingos P, Hussain S, Partridge J, Haynes R, Bahadur S, Brown R, McMahon S, Y H Lip G, McDonald J, Balachandran K, Singh R, Garg S, Desai H, Davies K, Goddard W, Galasko G, Rahman I, Chua Y, Payne O, Preston S, Brennan O, Pedley L, Whiteside C, Dickinson C, Brown J, Jones K, Benham L, Brady R, Buchanan L, Ashton A, Crowther H, Fairlamb H, Thornthwaite S, Relph C, McSkeane A, Poultney U, Kelsall N, Rice P, Wilson T, Wrigley M, Kaba R, Patel T, Young E, Law J, Runnett C, Thomas H, McKie H, Fuller J, Pick S, Sharp A, Hunt A, Thorpe K, Hardman C, Cusack E, Adams L, Hough M, Keenan S, Bowring A, Watts J, Zaman J, Goffin K, Nutt H, Beerachee Y, Featherstone J, Mills C, Pearson J, Stephenson L, Grant S, Wilson A, Hawksworth C, Alam I, Robinson M, Ryan S, Egdell R, Gibson E, Holland M, Leonard D, Mishra B, Ahmad S, Randall H, Hill J, Reid L, George M, McKinley S, Brockway L, Milligan W, Sobolewska J, Muir J, Tuckis L, Winstanley L, Jacob P, Kaye S, Morby L, Jan A, Sewell T, Boos C, Wadams B, Cope C, Jefferey P, Andrews N, Getty A, Suttling A, Turner C, Hudson K, Austin R, Howe S, Iqbal R, Gandhi N, Brophy K, Mirza P, Willard E, Collins S, Ndlovu N, Subkovas E, Karthikeyan V, Waggett L, Wood A, Bolger A, Stockport J, Evans L, Harman E, Starling J, Williams L, Saul V, Sinha M, Bell L, Tudgay S, Kemp S, Brown J, Frost L, Ingram T, Loughlin A, Adams C, Adams M, Hurford F, Owen C, Miller C, Donaldson D, Tivenan H, Button H, Nasser A, Jhagra O, Stidolph B, Brown C, Livingstone C, Duffy M, Madgwick P, Roberts P, Greenwood E, Fletcher L, Beveridge M, Earles S, McKenzie D, Beacock D, Dayer M, Seddon M, Greenwell D, Luxton F, Venn F, Mills H, Rewbury J, James K, Roberts K, Tonks L, Felmeden D, Taggu W, Summerhayes A, Hughes D, Sutton J, Felmeden L, Khan M, Walker E, Norris L, O’Donohoe L, Mozid A, Dymond H, Lloyd-Jones H, Saunders G, Simmons D, Coles D, Cotterill D, Beech S, Kidd S, Wrigley B, Petkar S, Smallwood A, Jones R, Radford E, Milgate S, Metherell S, Cottam V, Buckley C, Broadley A, Wood D, Allison J, Rennie K, Balian L, Howard L, Pippard L, Board S, Pitt-Kerby T. Epidemiology and impact of frailty in patients with atrial fibrillation in Europe. Age Ageing 2022; 51:6670566. [PMID: 35997262 DOI: 10.1093/ageing/afac192] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [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: 03/17/2022] [Revised: 06/08/2022] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Frailty is a medical syndrome characterised by reduced physiological reserve and increased vulnerability to stressors. Data regarding the relationship between frailty and atrial fibrillation (AF) are still inconsistent. OBJECTIVES We aim to perform a comprehensive evaluation of frailty in a large European cohort of AF patients. METHODS A 40-item frailty index (FI) was built according to the accumulation of deficits model in the AF patients enrolled in the ESC-EHRA EORP-AF General Long-Term Registry. Association of baseline characteristics, clinical management, quality of life, healthcare resources use and risk of outcomes with frailty was examined. RESULTS Among 10,177 patients [mean age (standard deviation) 69.0 (11.4) years, 4,103 (40.3%) females], 6,066 (59.6%) were pre-frail and 2,172 (21.3%) were frail, whereas only 1,939 (19.1%) were considered robust. Baseline thromboembolic and bleeding risks were independently associated with increasing FI. Frail patients with AF were less likely to be treated with oral anticoagulants (OACs) (odds ratio 0.70, 95% confidence interval 0.55-0.89), especially with non-vitamin K antagonist OACs and managed with a rhythm control strategy, compared with robust patients. Increasing frailty was associated with a higher risk for all outcomes examined, with a non-linear exponential relationship. The use of OAC was associated with a lower risk of outcomes, except in patients with very/extremely high frailty. CONCLUSIONS In this large cohort of AF patients, there was a high burden of frailty, influencing clinical management and risk of adverse outcomes. The clinical benefit of OAC is maintained in patients with high frailty, but not in very high/extremely frail ones.
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Affiliation(s)
- Marco Proietti
- Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart & Chest Hospital, Liverpool, UK.,Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.,Geriatric Unit, IRCCS Istituti Clinici Scientifici Maugeri, Milan, Italy
| | - Giulio Francesco Romiti
- Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart & Chest Hospital, Liverpool, UK.,Department of Translational and Precision Medicine, Sapienza - University of Rome, Italy
| | - Marco Vitolo
- Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart & Chest Hospital, Liverpool, UK.,Cardiology Division, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Policlinico di Modena, Modena, Italy.,Clinical and Experimental Medicine PhD Program, University of Modena and Reggio Emilia, Modena, Italy
| | - Stephanie L Harrison
- Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart & Chest Hospital, Liverpool, UK
| | - Deirdre A Lane
- Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart & Chest Hospital, Liverpool, UK.,Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Laurent Fauchier
- Service de Cardiologie, Centre Hospitalier Universitaire Trousseau, Tours, France
| | - Francisco Marin
- Department of Cardiology, Hospital Universitario Virgen de la Arrixaca, IMIB-Arrixaca, University of Murcia, CIBER-CV, Murcia, Spain
| | - Michael Näbauer
- Department of Cardiology, Ludwig-Maximilians-University, Munich, Germany
| | - Tatjana S Potpara
- School of Medicine, University of Belgrade, Belgrade, Serbia.,Clinical Center of Serbia, Belgrade, Serbia
| | - Gheorghe-Andrei Dan
- University of Medicine, 'Carol Davila', Colentina University Hospital, Bucharest, Romania
| | - Aldo P Maggioni
- ANMCO Research Center, Heart Care Foundation, Florence, Italy
| | - Matteo Cesari
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.,Geriatric Unit, IRCCS Istituti Clinici Scientifici Maugeri, Milan, Italy
| | - Giuseppe Boriani
- Cardiology Division, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Policlinico di Modena, Modena, Italy
| | - Gregory Y H Lip
- Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart & Chest Hospital, Liverpool, UK.,Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
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di Summa PG, Higgins G, Cotrufo S, Sapino G, Reekie T, Leonard D, Shaw-Dunn J, Hart A. Distal Brachial Artery Perforator flap: a new chimeric option for complex hand and digits defects. J Plast Reconstr Aesthet Surg 2021; 75:613-620. [PMID: 34728156 DOI: 10.1016/j.bjps.2021.08.019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Revised: 06/11/2021] [Accepted: 08/26/2021] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Reconstruction of fingers pose unique challenges, as a thin and flexible flap is needed in order to guarantee a good functional outcome. For the first time, in this report, we present the DBAp (distal brachial artery perforator) flap, based on the distal perforator closer to the medial epicondyle. The DBAp flap was used to reconstruct complex digit defects as free flap, and to cover an elbow defect while raised as a propeller. METHODS Four patients underwent finger reconstruction (free flaps): two patients presented an unstable finger scar following previous surgery, whereas the other two patients presented a terminalized finger at the level of the middle phalanx. A further patient presented a post-traumatic loss of substance at the elbow and was reconstructed using a perforator propeller DBAP flap. RESULTS Loss of tissues included skin and subcutaneous tissue in all patients and in one patient it included a bone component. Flap dimensions ranged from 48 to 18 cm2 (average: 32 cm2). Among complications, patient n.2 flap presented a marginal flap necrosis requiring a small skin graft after necrosis debridement. CONCLUSION The DBAp flap provides a slim, glabrous and pliable skin tissue with a well-hidden donor site scar and thanks to the anatomic location of the distal perforator can be designed to include a vascularized bone graft from the medial epicondyle. Despite the low number of cases, we believe that this flap should be considered as a dependable and effective source for complex reconstructions of both soft tissue and bone in fingers.
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Affiliation(s)
- P G di Summa
- Canniesburn Plastic Surgery Unit, Glasgow Royal Infirmary, 84 Castle Street, Glasgow G40SF, UK; Department of Plastic and Hand Surgery, University Hospital of Lausanne (CHUV), University of Lausanne, Lausanne, CH
| | - G Higgins
- Canniesburn Plastic Surgery Unit, Glasgow Royal Infirmary, 84 Castle Street, Glasgow G40SF, UK
| | - S Cotrufo
- Canniesburn Plastic Surgery Unit, Glasgow Royal Infirmary, 84 Castle Street, Glasgow G40SF, UK; Department of Plastic and Reconstructive Surgery, University of Messina, Messina, IT
| | - G Sapino
- Department of Plastic and Reconstructive Surgery, University of Modena, Modena, IT; Department of Plastic and Hand Surgery, University Hospital of Lausanne (CHUV), University of Lausanne, Lausanne, CH
| | - T Reekie
- Canniesburn Plastic Surgery Unit, Glasgow Royal Infirmary, 84 Castle Street, Glasgow G40SF, UK; College of Medical Veterinery & Life Sciences, The University of Glasgow, University Avenue, Glasgow, United Kingdom
| | - D Leonard
- Canniesburn Plastic Surgery Unit, Glasgow Royal Infirmary, 84 Castle Street, Glasgow G40SF, UK; College of Medical Veterinery & Life Sciences, The University of Glasgow, University Avenue, Glasgow, United Kingdom
| | - J Shaw-Dunn
- College of Medical Veterinery & Life Sciences, The University of Glasgow, University Avenue, Glasgow, United Kingdom
| | - A Hart
- Canniesburn Plastic Surgery Unit, Glasgow Royal Infirmary, 84 Castle Street, Glasgow G40SF, UK; College of Medical Veterinery & Life Sciences, The University of Glasgow, University Avenue, Glasgow, United Kingdom.
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Sisco K, Plotkowski A, Yang Y, Leonard D, Stump B, Nandwana P, Dehoff RR, Babu SS. Microstructure and properties of additively manufactured Al-Ce-Mg alloys. Sci Rep 2021; 11:6953. [PMID: 33772051 PMCID: PMC7998028 DOI: 10.1038/s41598-021-86370-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Accepted: 03/01/2021] [Indexed: 11/17/2022] Open
Abstract
Additive manufacturing of aluminum alloys is largely dominated by a near-eutectic Al-Si compositions, which are highly weldable, but have mechanical properties that are not competitive with conventional wrought Al alloys. In addition, there is a need for new Al alloys with improved high temperature properties and thermal stability for applications in the automotive and aerospace fields. In this work, we considered laser powder bed fusion additive manufacturing of two alloys in the Al–Ce–Mg system, designed as near-eutectic (Al–11Ce–7Mg) and hyper-eutectic (Al–15Ce–9Mg) compositions with respect to the binary L → Al + Al11Ce eutectic reaction. The addition of magnesium is used to promote solid solution strengthening. A custom laser scan pattern was used to reduce the formation of keyhole porosity, which was caused by excessive vaporization due to the high vapor pressure of magnesium. The microstructure and tensile mechanical properties of the alloys were characterized in the as-fabricated condition and following hot isostatic pressing. The two alloys exhibit significant variations in solidification structure morphology. These variations in non-equilibrium solidification structure were rationalized using a combination of thermodynamic and thermal modeling. Both alloys showed higher yield strength than AM Al-10Si-Mg for temperatures up to 350 °C and better strength retention at elevated temperatures than additively manufactured Scalmaloy.
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Affiliation(s)
- K Sisco
- Material Science and Engineering, University of Tennessee-Knoxville, Knoxville, TN, USA.
| | - A Plotkowski
- Materials Science and Technology Division, Oak Ridge National Laboratory, Oak Ridge, TN, USA
| | - Y Yang
- Materials Science and Technology Division, Oak Ridge National Laboratory, Oak Ridge, TN, USA
| | - D Leonard
- Materials Science and Technology Division, Oak Ridge National Laboratory, Oak Ridge, TN, USA
| | - B Stump
- Materials Science and Technology Division, Oak Ridge National Laboratory, Oak Ridge, TN, USA
| | - P Nandwana
- Materials Science and Technology Division, Oak Ridge National Laboratory, Oak Ridge, TN, USA
| | - R R Dehoff
- Manufacturing Science Division, Oak Ridge National Laboratory, Oak Ridge, TN, USA
| | - S S Babu
- Mechanical, Aerospace and Biomedical Engineering, University of Tennessee-Knoxville, Knoxville, TN, USA
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Hartman A, Leonard D, Trefois C, Remue C, Bachmann R, Abbes Orabi N, Lupu I, Robu B, Steyaert A, Kartheuser A. Good compliance to enhanced recovery program improves outcome after colorectal surgery. Surg Endosc 2020; 35:4214-4221. [DOI: 10.1007/s00464-020-07903-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Accepted: 08/17/2020] [Indexed: 12/29/2022]
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Frodlund M, Reid S, Wetterö J, Dahlström Ö, Sjöwall C, Leonard D. The majority of Swedish systemic lupus erythematosus patients are still affected by irreversible organ impairment: factors related to damage accrual in two regional cohorts. Lupus 2019; 28:1261-1272. [PMID: 31296137 PMCID: PMC6710616 DOI: 10.1177/0961203319860198] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Background Although the survival of patients with systemic lupus erythematosus (SLE) has
improved, irreversible organ damage remains a critical concern. We aimed to
characterize damage accrual and its clinical associations and causes of
death in Swedish patients. Methods Accumulation of damage was evaluated in 543 consecutively recruited and
well-characterized cases during 1998−2017. The Systemic Lupus International
Collaborating Clinics (SLICC)/American College of Rheumatology damage index
(SDI) was used to estimate damage. Results Organ damage (SDI ≥ 1) was observed in 59%, and extensive damage (SDI ≥ 3) in
25% of cases. SDI ≥ 1 was significantly associated with higher age at onset,
SLE duration, the number of fulfilled SLICC criteria, neurologic disorder,
antiphospholipid antibody syndrome (APS), hypertension, hyperlipidemia,
depression and secondary Sjögren's syndrome (SS). In addition, SDI ≥ 3 was
associated with serositis, renal and haematological disorders and
interstitial lung disease. A multiple regression model identified not only
well-known risk factors like APS, antihypertensives and corticosteroids, but
pericarditis, haemolytic anaemia, lymphopenia and myositis as being linked
to SDI. Malignancy, infection and cardiovascular disease were the leading
causes of death. Conclusions After a mean SLE duration of 17 years, the majority of today's Swedish SLE
patients have accrued damage. We confirm previous observations and report
some novel findings regarding disease phenotypes and damage accrual.
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Affiliation(s)
- M Frodlund
- 1 Division of Neuro and Inflammation Sciences, Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden
| | - S Reid
- 2 Department of Medical Sciences, Science for Life Laboratory, Rheumatology, Uppsala University, Uppsala, Sweden
| | - J Wetterö
- 1 Division of Neuro and Inflammation Sciences, Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden
| | - Ö Dahlström
- 3 Swedish Institute for Disability Research, Department of Behavioural Sciences and Learning, Linköping University, Linköping, Sweden
| | - C Sjöwall
- 1 Division of Neuro and Inflammation Sciences, Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden
| | - D Leonard
- 2 Department of Medical Sciences, Science for Life Laboratory, Rheumatology, Uppsala University, Uppsala, Sweden
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Barbois S, Repullo D, Leonard D, Bohlok A, Van Den Audenaeren ET, Hendlisz A, Van den Eynde M, Kartheuser A, Liberale G. The role of perioperative chemotherapy for peritoneal metastases of colorectal cancer origin treated with curative intent. Eur J Surg Oncol 2019. [DOI: 10.1016/j.ejso.2018.10.392] [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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Bachmann R, Leonard D, Nachit M, Remue C, Abbes Orabi N, Desmet L, Faber B, Danse E, Trefois P, Kartheuser A. Comparison between abdominal fat measured by CT and anthropometric indices as prediction factors for mortality and morbidity after colorectal surgery. Acta Gastroenterol Belg 2018; 81:477-483. [PMID: 30645915] [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] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
AIM This study aims to determine which anthropometric (body mass index (BMI), waist-hip-ratio (WHR) and waist-to-height ratio (WHtR)) and radiological (visceral fat area (VFA) measured by CT scan) measurements of adiposity correlated better with postoperative outcome of colorectal cancer (CRC) surgery. We also assessed which of these measurements best predicted overall survival (OS) and disease-free survival (DFS). METHODS Data from 90 consecutive Caucasian CRC patients who underwent surgery for colorectal cancer between 2010 and 2011 with a median follow-up of 53.25 months were analysed. The correlations of different adiposity measurements and postoperative outcomes were determined using logistic regression models and multivariate analyses. RESULTS Higher WHtR (p = 0.007) and VFA (p = 0.01) significantly increased the risk of overall morbidity, especially of Clavien-Dindo III or IV. The WHtR correlated best with VFA (p <0.0001), which is considered the gold standard for measuring visceral fat, whereas BMI (p = 0.15) was not a good predictor of postoperative morbidity. Multivariate analyses showed consistently significant results for postoperative complications for VFA in combination with all of the other variables analysed and for WHtR, confirming that VFA and WHtR were reliable independent prognostic factors of morbidity. VFA had a significant effect on OS (p = 0.012) but did not correlate with DFS (p = 0.51). CONCLUSIONS Both VFA and WHtR independently provided predictive data for potential postoperative complications after CRC surgery. In case CT scan was used for diagnostic purposes, VFA should be used in routine clinical practice.
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Affiliation(s)
- R Bachmann
- Colorectal Surgery Unit, Cliniques universitaires Saint-Luc, Brussels, Belgium, Université Catholique de Louvain
| | - D Leonard
- Colorectal Surgery Unit, Cliniques universitaires Saint-Luc, Brussels, Belgium, Université Catholique de Louvain
| | - M Nachit
- Radiology Department, Cliniques universitaires Saint-Luc, Brussels, Belgium, Université Catholique de Louvain
| | - Ch Remue
- Colorectal Surgery Unit, Cliniques universitaires Saint-Luc, Brussels, Belgium, Université Catholique de Louvain
| | - N Abbes Orabi
- Colorectal Surgery Unit, Cliniques universitaires Saint-Luc, Brussels, Belgium, Université Catholique de Louvain
| | - L Desmet
- Plateforme Technologique de Support en Méthodologie et Calcul Statistique, Institut Multidisciplinaire pour la Modélisation et l'Analyse Quantitative (SMCS-IMMAQ), Université Catholique de Louvain
| | - B Faber
- Colorectal Surgery Unit, Cliniques universitaires Saint-Luc, Brussels, Belgium, Université Catholique de Louvain
| | - E Danse
- Radiology Department, Cliniques universitaires Saint-Luc, Brussels, Belgium, Université Catholique de Louvain
| | - P Trefois
- Radiology Department, Cliniques universitaires Saint-Luc, Brussels, Belgium, Université Catholique de Louvain
| | - A Kartheuser
- Colorectal Surgery Unit, Cliniques universitaires Saint-Luc, Brussels, Belgium, Université Catholique de Louvain
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Famiglietti F, Leonard D, Bachmann R, Remue C, Abbes Orabi N, van Maanen A, van den Eynde M, Kartheuser A. Single-incision laparoscopic surgery for locally advanced colorectal cancer : feasibility, short-term and oncologic outcomes. Acta Gastroenterol Belg 2018; 81:23-28. [PMID: 29562374] [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] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
BACKGROUND AND STUDY AIMS Data about single-incision laparoscopic surgery (SILS) in locally advanced colorectal cancers are scarce. This study aimed to evaluate perioperative and shortterm oncologic outcomes of SILS in pT3-T4 colorectal cancer. PATIENTS AND METHODS From 2011 to 2015 data from 249 SILS performed in our Colorectal Unit were entered into a prospective database. Data regarding patients with a pT3-T4 colorectal adenocarcinoma were compared to those with pTis-pT2. Factors influencing conversion were assessed by multivariate analysis. RESULTS There were 100 consecutive patients (T3-T4 = 70, Tis-T2 = 30). Demographics were similar. Tumor size was significantly larger in the T3-T4 group [3.9cm vs 2cm; p<0.001]. In T3-T4 patients we found a significant higher number of lymph nodes harvested [20 vs 13 ; p<0.001]. Early (<30 days) severe (Clavien-Dindo classification>2) postoperative complication rate was similar between groups (8.6% vs 10% ; p = 0.999), as well as conversion rate (18.6% vs 6.7% ; p = 0.220). Finally, there were no differences in terms of hospital stay and mortality rate. On multivariate analysis, age (OR = 1.06, 95%CI: 1.012-1.113 ; p = 0.015] and stage IV (OR = 5.372, 95%CI: 1.320-21.862, p = 0.019) were independently associated with conversion. CONCLUSIONS SILS for locally advanced colorectal cancer did not affect the short-term outcomes in this series and oncological clearance remained satisfactory. Age and stage IV disease are independent risk factors for conversion.
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Affiliation(s)
- F Famiglietti
- Colorectal Surgery Unit, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium
| | - D Leonard
- Colorectal Surgery Unit, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium
| | - R Bachmann
- Colorectal Surgery Unit, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium
| | - C Remue
- Colorectal Surgery Unit, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium
| | - N Abbes Orabi
- Colorectal Surgery Unit, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium
| | - A van Maanen
- Statistical Support Unit, Institut Roi Albert II, Brussels, Belgium
| | - M van den Eynde
- Departement of Oncology, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium
- Departement of Hepato-gatroenterology, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium
| | - A Kartheuser
- Colorectal Surgery Unit, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium
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Rethorst CD, Leonard D, Barlow CE, Willis BL, Trivedi MH, DeFina LF. Effects of depression, metabolic syndrome, and cardiorespiratory fitness on mortality: results from the Cooper Center Longitudinal Study. Psychol Med 2017; 47:2414-2420. [PMID: 28414015 PMCID: PMC6036919 DOI: 10.1017/s0033291717000897] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Depression and metabolic syndrome (MetS) are frequently comorbid disorders that are independently associated with premature mortality. Conversely, cardiorespiratory fitness (CRF) is associated with reduced mortality risk. These factors may interact to impact mortality; however, their effects have not been assessed concurrently. This analysis assessed the mortality risk of comorbid depression/MetS and the effect of CRF on mortality in those with depression/MetS. METHODS Prospective study of 47 702 adults in the Cooper Center Longitudinal Study. Mortality status was attained from the National Death Index. History of depression was determined by patient response (yes or no) to a standardized medical history questionnaire. MetS was categorized using the American Heart Association/National Heart, Lung, and Blood Institute criteria. CRF was estimated from the final speed/grade of a treadmill graded exercise test. RESULTS 13.9% reported a history of depression, 21.4% met criteria for MetS, and 3.0% met criteria for both MetS and history of depression. History of depression (HR = 1.24, p = 0.003) and MetS (HR = 1.28, p < 0.001) were independently associated with an increased mortality risk, with the greatest mortality risk among individuals with both a history of depression and MetS (HR = 1.59, p < 0.001). Higher CRF was associated with a significantly lower risk of mortality (p < 0.001) in all individuals, including those with MetS and/or a history of depression. CONCLUSIONS Those with higher levels CRF had reduced mortality risk in the context of depression/MetS. Interventions that improve CRF could have substantial impact on the health of persons with depression/MetS.
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Affiliation(s)
- C. D. Rethorst
- Department of Psychiatry, Center for Depression Research and Clinical Care, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | | | | | | | - M. H. Trivedi
- Department of Psychiatry, Center for Depression Research and Clinical Care, University of Texas Southwestern Medical Center, Dallas, TX, USA
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Shi D, Chen Y, LAM T, Leonard D, Balboni T, Schoenfeld A, Skamene S, Chi J, Cho C, Harris M, Ferrone M, Hertan L. Assessing the Utility of a Prognostication Model to Predict 1-Year Mortality in Patients Receiving Radiation Therapy for Spinal Metastases. Int J Radiat Oncol Biol Phys 2017. [DOI: 10.1016/j.ijrobp.2017.06.207] [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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Terlier T, Zappalà G, Marie C, Leonard D, Barnes JP, Licciardello A. ToF-SIMS Depth Profiling of PS-b-PMMA Block Copolymers Using Ar n+, C 60++, and Cs + Sputtering Ions. Anal Chem 2017; 89:6984-6991. [PMID: 28617583 DOI: 10.1021/acs.analchem.7b00279] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Time-of-flight secondary ion mass spectrometry (ToF-SIMS) is a high performance tool for molecular depth profiling of polymer films, in particular when they are structured in microphases. However, a major issue is the degradation of polymer materials under ion irradiation in reactions such as cross-linking, chain breaking, or reorganization processes of polymers which have been demonstrated for materials such as polystyrene (PS) and poly(methyl methacrylate) (PMMA). This work aims at comparing ToF-SIMS molecular depth profiling of structured polymers (polystyrene (PS)-b-polymethyl methacrylate (PMMA) block copolymers (BCP)) using either ultralow energy cesium or the more recently introduced C60++ (under NO dosing and with sample cooling) and argon cluster ion beams (using Ar1500+ ions at 5 keV). The latter improved the quality of the depth profiles, especially the argon cluster ion beam, as it is characterized by a greater homogeneity for the sputter yields of PS and PMMA. No significant artifacts were observed, and this was confirmed by the comparison of depth profiles obtained from films with variable thickness, annealing time, and morphology (cylindrical blocks vs spherical blocks). Comparison to a theoretical model (hexagonal centered pattern) ensured that the ToF-SIMS depth profiles described the real morphology and may thus be a relevant characterization tool to verify the morphology of the films as a function of the deposition parameters.
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Affiliation(s)
- T Terlier
- University Grenoble Alpes , F-38000 Grenoble, France.,CEA, LETI, MINATEC Campus, F-38054 Grenoble, France.,Univ Lyon, CNRS, Université Claude Bernard Lyon 1, ENS Lyon, Institut des Sciences Analytiques , UMR 5280, 5, rue de la Doua, F-69100 Villeurbanne, France
| | - G Zappalà
- Dipartimento di Scienze Chimiche, Università degli Studi di Catania and CSGI , Viale A. Doria 6, 95125 Catania, Italy
| | - C Marie
- University Grenoble Alpes , F-38000 Grenoble, France.,CEA, LETI, MINATEC Campus, F-38054 Grenoble, France
| | - D Leonard
- Univ Lyon, CNRS, Université Claude Bernard Lyon 1, ENS Lyon, Institut des Sciences Analytiques , UMR 5280, 5, rue de la Doua, F-69100 Villeurbanne, France
| | - J-P Barnes
- University Grenoble Alpes , F-38000 Grenoble, France.,CEA, LETI, MINATEC Campus, F-38054 Grenoble, France
| | - A Licciardello
- Dipartimento di Scienze Chimiche, Università degli Studi di Catania and CSGI , Viale A. Doria 6, 95125 Catania, Italy
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van den Eynde M, Mlecnik B, Bindea G, Machiels JP, Jouret-Mourin A, Baldin P, Kartheuser A, Leonard D, Remue C, Gigot JF, Hubert C, Humblet Y, Haicheur N, Marliot F, Pagès F, Galon J. Characterization of the immunoscore of synchronous resected primary tumor and liver colorectal cancer metastases. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw370.121] [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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14
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Leonard D, Remue C, Abbes Orabi N, van Maanen A, Danse E, Dragean A, Debetancourt D, Humblet Y, Jouret-Mourin A, Maddalena F, Medina Benites A, Scalliet P, Sempoux C, Van den Eynde M, De Schoutheete JC, Kartheuser A. Lymph node ratio and surgical quality are strong prognostic factors of rectal cancer: results from a single referral centre. Colorectal Dis 2016; 18:O175-84. [PMID: 27128602 DOI: 10.1111/codi.13362] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [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] [Received: 08/27/2015] [Accepted: 02/11/2016] [Indexed: 02/08/2023]
Abstract
AIM Nodal stage is a strong prognostic factor of oncological outcome of rectal cancer. To compensate for the variation in total number of harvested nodes, calculation of the lymph node ratio (LNR) has been advocated. The aim of the study was to compare the impact, on the long-term oncological outcome, of the LNR with other predictive factors, including the quality of total mesorectal excision (TME) and the state of the circumferential resection margin. METHOD Consecutive patients having elective surgery for nonmetastatic rectal cancer were extracted from a prospectively maintained database. Retrospective uni- and multivariate analyses were performed based on patient-, surgical- and tumour-related factors. The prognostic value of the LNR on overall survival (OS) and on overall recurrence-free survival (ORFS) was assessed and a cut-off value was determined. RESULTS From 1998 to 2013, out of 456 patients, 357 with nonmetastatic disease were operated on for rectal cancer. Neoadjuvant radiochemotherapy was administered to 66.7% of the patients. The mean number of lymph nodes retrieved was 12.8 ± 8.78 per surgical specimen. A lower lymph node yield was obtained in patients who received neoadjuvant chemoradiotherapy (11.8 vs 14.2; P = 0.014). The 5-year ORFS was 71.8% and the 5-year OS was 80.1%. Multivariate analysis confirmed LNR, the quality of TME and age to be independent prognostic factors of OS. LNR, age and perineural infiltration were independently associated with ORFS. Low- and high-risk patients could be discriminated using an LNR cut-off value of 0.2. CONCLUSION LNR is an independent prognostic factor of OS and ORFS. In line with the principles of optimal surgical management, the quality of TME and lymph node yield are essential technical requirements.
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Affiliation(s)
- D Leonard
- Colorectal Surgery Unit, Cliniques universitaires Saint-Luc, Brussels, Belgium.,Cliniques des Pathologies Tumorales du Colon et de Rectum (CPTCR), Institut Roi Albert II, Cliniques universitaires Saint Luc, Brussels, Belgium
| | - C Remue
- Colorectal Surgery Unit, Cliniques universitaires Saint-Luc, Brussels, Belgium.,Cliniques des Pathologies Tumorales du Colon et de Rectum (CPTCR), Institut Roi Albert II, Cliniques universitaires Saint Luc, Brussels, Belgium
| | - N Abbes Orabi
- Colorectal Surgery Unit, Cliniques universitaires Saint-Luc, Brussels, Belgium.,Cliniques des Pathologies Tumorales du Colon et de Rectum (CPTCR), Institut Roi Albert II, Cliniques universitaires Saint Luc, Brussels, Belgium
| | - A van Maanen
- Statistical Support Unit, Institut Roi Albert II, Cliniques universitaires Saint-Luc, Brussels, Belgium
| | - E Danse
- Cliniques des Pathologies Tumorales du Colon et de Rectum (CPTCR), Institut Roi Albert II, Cliniques universitaires Saint Luc, Brussels, Belgium.,Department of Radiology, Cliniques universitaires Saint-Luc, Brussels, Belgium
| | - A Dragean
- Cliniques des Pathologies Tumorales du Colon et de Rectum (CPTCR), Institut Roi Albert II, Cliniques universitaires Saint Luc, Brussels, Belgium.,Department of Radiology, Cliniques universitaires Saint-Luc, Brussels, Belgium
| | - D Debetancourt
- Cliniques des Pathologies Tumorales du Colon et de Rectum (CPTCR), Institut Roi Albert II, Cliniques universitaires Saint Luc, Brussels, Belgium
| | - Y Humblet
- Cliniques des Pathologies Tumorales du Colon et de Rectum (CPTCR), Institut Roi Albert II, Cliniques universitaires Saint Luc, Brussels, Belgium.,Department of Medical Oncology, Cliniques universitaires Saint-Luc, Brussels, Belgium
| | - A Jouret-Mourin
- Cliniques des Pathologies Tumorales du Colon et de Rectum (CPTCR), Institut Roi Albert II, Cliniques universitaires Saint Luc, Brussels, Belgium.,Department of Pathology, Cliniques universitaires Saint-Luc, Brussels, Belgium
| | - F Maddalena
- Cliniques des Pathologies Tumorales du Colon et de Rectum (CPTCR), Institut Roi Albert II, Cliniques universitaires Saint Luc, Brussels, Belgium
| | - A Medina Benites
- Cliniques des Pathologies Tumorales du Colon et de Rectum (CPTCR), Institut Roi Albert II, Cliniques universitaires Saint Luc, Brussels, Belgium
| | - P Scalliet
- Cliniques des Pathologies Tumorales du Colon et de Rectum (CPTCR), Institut Roi Albert II, Cliniques universitaires Saint Luc, Brussels, Belgium.,Department of Radiation Oncology, Cliniques universitaires Saint-Luc, Brussels, Belgium
| | - C Sempoux
- Cliniques des Pathologies Tumorales du Colon et de Rectum (CPTCR), Institut Roi Albert II, Cliniques universitaires Saint Luc, Brussels, Belgium.,Department of Pathology, Cliniques universitaires Saint-Luc, Brussels, Belgium
| | - M Van den Eynde
- Cliniques des Pathologies Tumorales du Colon et de Rectum (CPTCR), Institut Roi Albert II, Cliniques universitaires Saint Luc, Brussels, Belgium.,Department of Medical Oncology, Cliniques universitaires Saint-Luc, Brussels, Belgium
| | - J C De Schoutheete
- Colorectal Surgery Unit, Cliniques universitaires Saint-Luc, Brussels, Belgium
| | - A Kartheuser
- Colorectal Surgery Unit, Cliniques universitaires Saint-Luc, Brussels, Belgium.,Cliniques des Pathologies Tumorales du Colon et de Rectum (CPTCR), Institut Roi Albert II, Cliniques universitaires Saint Luc, Brussels, Belgium
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15
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Evnde MVD, Mlecnik B, Bindea G, Fredriksen T, Lafontaine L, Haicheur N, Marliot F, Debetancourt D, Jouret-Mourin A, Sempoux C, Gigot J, Hubert C, Kartheuser A, Remue C, Leonard D, Carrasco J, Humblet Y, Pages F, Machiels J, Galon J. 2154 Metastatic colorectal cancer has heterogeneous immune microenvironment and mutational expression. Eur J Cancer 2015. [DOI: 10.1016/s0959-8049(16)31075-9] [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: 10/22/2022]
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Kvarnström M, Antovic A, Turesson C, Ljung L, Södergren A, Leonard D, Henrohn D, Dehlin M, Wållberg-Jonsson S, Svenungsson E. AB0345 The Use of Cardiovascular Risk Module Within the Swedish Rheumatology Quality Registry (SRQ) Helps in Daily Clinical Praxis. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.4174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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17
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Leonard D, Penninckx F, Laenen A, Kartheuser A. Scoring the quality of total mesorectal excision for the prediction of cancer-specific outcome. Colorectal Dis 2015; 17:O115-22. [PMID: 25714054 DOI: 10.1111/codi.12931] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [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] [Received: 09/18/2014] [Accepted: 12/20/2014] [Indexed: 02/05/2023]
Abstract
AIM A three-grade system for macroscopic evaluation of the resection plane is used to describe the quality of total mesorectal excision (TME). In several studies, two of the three grades have been combined when analysing the outcome. The aim of our study was to compare the predictive value of the three-graded with that of a two-graded TME score. METHOD The quality of TME in 1382 patients who underwent elective resection for mid or low rectal adenocarcinoma was registered by 65 hospitals in PROCARE, a Belgian multidisciplinary improvement project. Prediction of outcome based on the classic three-grade score was compared with a two-grade scoring system in which intramesorectal resection (IMR) was combined with mesorectal (MRR) or with muscularis propria resection (MPR). End-points included the local recurrence rate, distant metastasis rate (DMR), disease-free survival (DFS) and overall survival (OS). RESULTS Among the 1382 resections, 63% were MRR, 27% IMR and 9% MPR. No significant differences were found in local recurrence between the different grades of TME. A two-grade score distinguishing MRR from the others was found to predict DMR, DFS and OS as well as the three-grade score. CONCLUSION The discriminatory and predictive value of a two-grade score, differentiating MRR from the combined IMR and MPR, was as good as the classic three-grade score.
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Affiliation(s)
- D Leonard
- Colorectal Surgery Unit, Cliniques universitaires Saint-Luc, Brussels, Belgium
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18
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Kvarnström M, Antovic A, Turesson C, Ljung L, Södergren A, Leonard D, Henrohn D, Dehlin M, Wållberg-Jonsson S, Svenungsson E. A5.8 The use of cardiovascular risk module within the swedish rheumatology quality registry (SRQ) helps in daily clinical praxis. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-207259.114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Abstract
In case of complex anal fistulae, the treatment can include muscular flaps. The gracilis transposition flap is the gold-standard in perineal reconstructive surgery, with wide use during the past decades. However, in some cases, this flap is too short to reach difficult locations such as the posterior perineum. The long head of the biceps femoris, which has already been studied in the electrically stimulated neosphincter formation, could be more appropriate in such clinical situations. Furthermore, its potential advantages, amongst which an excellent functional outcome, would be to allow persistent prone position, during both treatment and reconstruction, as well as a more favorable intramuscular vascularisation. We report the case of a 39-year-old man with a complex recurrent transphincteric posterior anal fistula with an external orifice in the right buttock and complicated with a severe cellulitis, treated with an endo-anal flap combined with a long head of biceps femoris pediculised flap.
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Sawyer T, Leonard D, Sierocka-Castaneda A, Chan D, Thompson M. Correlations between technical skills and behavioral skills in simulated neonatal resuscitations. J Perinatol 2014; 34:781-6. [PMID: 24831522 DOI: 10.1038/jp.2014.93] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [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] [Received: 12/06/2013] [Revised: 03/01/2014] [Accepted: 04/09/2014] [Indexed: 11/09/2022]
Abstract
OBJECTIVE Neonatal resuscitation requires both technical and behavioral skills. Key behavioral skills in neonatal resuscitation have been identified by the Neonatal Resuscitation Program. Correlations and interactions between technical skills and behavioral skills in neonatal resuscitation were investigated. STUDY DESIGN Behavioral skills were evaluated via blinded video review of 45 simulated neonatal resuscitations using a validated assessment tool. These were statistically correlated with previously obtained technical skill performance data. RESULT Technical skills and behavioral skills were strongly correlated (ρ=0.48; P=0.001). The strongest correlations were seen in distribution of workload (ρ=0.60; P=0.01), utilization of information (ρ=0.55; P=0.03) and utilization of resources (ρ=0.61; P=0.01). Teams with superior behavioral skills also demonstrated superior technical skills, and vice versa. CONCLUSION Technical and behavioral skills were highly correlated during simulated neonatal resuscitations. Individual behavioral skill correlations are likely dependent on both intrinsic and extrinsic factors.
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Affiliation(s)
- T Sawyer
- Department of Pediatrics, University of Washington School of Medicine, Seattle, WA, USA
| | - D Leonard
- Sacred Heart Medical Center, Eugene, OR, USA
| | | | - D Chan
- Department of Pediatrics, Tripler Army Medical Center, Honolulu, HI, USA
| | - M Thompson
- Department of Pediatrics, Tripler Army Medical Center, Honolulu, HI, USA
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Leonard D, Penninckx F, Kartheuser A, Laenen A, Van Eycken E. Effect of hospital volume on quality of care and outcome after rectal cancer surgery. Br J Surg 2014; 101:1475-82. [PMID: 25142810 DOI: 10.1002/bjs.9624] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2014] [Revised: 06/05/2014] [Accepted: 06/30/2014] [Indexed: 01/13/2023]
Abstract
BACKGROUND Research on the relationship between hospital volume and quality of care in the treatment of rectal cancer is limited. METHODS Process and outcome indicators were assessed in patients with rectal adenocarcinoma who underwent total mesorectal excision, registered on a voluntary basis in the PROCARE clinical database. Volume was derived from an administrative database and analysed as a continuous variable. Sphincter preservation, 30-day mortality and survival rates were cross-checked against population-based data. RESULTS A total of 1469 patients registered in PROCARE between 2006 and 2011 were included in this study. A volume effect was observed regarding neoadjuvant therapy for stage II-III disease, reporting of the circumferential resection margin, R0 resection rate, sphincter preservation rate, and number of nodes examined after chemoradiotherapy. The global estimate of quality of care was highly variable, but surgery was the single domain in which quality correlated with volume. No volume effect was observed for recurrence and overall survival rates. In the population-based data set (5869 patients), volume was associated with 30-day mortality adjusted for age (odds ratio 0·99, 95 per cent confidence interval (c.i.) 0·98 to 1·00; P = 0·014) and adjusted overall survival (HR 0·99 (95 per cent c.i. 0·99 to 1·00) per additional procedure; P = 0·001), but not with the sphincter preservation rate. Because of incomplete and biased registration on a voluntary basis, results from a clinical database could not be extrapolated to the population. CONCLUSION Some volume effects were observed, but their effect size was limited.
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Affiliation(s)
- D Leonard
- Colorectal Surgery Unit, Cliniques universitaires Saint-Luc, Brussels, Belgium
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Madariaga M, Michel S, La Muraglia G, Sihag S, Leonard D, Powell H, Farkash E, Colvin R, Cetrulo C, Huang C, Sachs D, Madsen J, Allan J. Recipient-Matching of Passenger Leukocytes Prolongs Survival of Donor Lung Allografts in Miniature Swine. Transplantation 2014. [DOI: 10.1097/00007890-201407151-01337] [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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Gandhi M, Freitas D, Lewis M, Bolton L, Bhasin S, Leonard D, Marsh A. Who should answer the question: “Can I drive with this plaster cast?”. Surgeon 2014; 12:26-31. [DOI: 10.1016/j.surge.2013.05.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2013] [Revised: 05/20/2013] [Accepted: 05/21/2013] [Indexed: 10/26/2022]
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Abstract
We present a case of distal venous embolisation of a peripheral intravenous cannula tip that had lost its structural integrity through repeated failed attempts of insertion of the same cannula, contrary to protocols for intravenous access. Radiological imaging confirmed the presence of a foreign body in the middle finger and the patient was brought to theatre. A 2.2cm long catheter tube was removed via a venotomy from the dorsal digital vein.
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Affiliation(s)
- M F Khadim
- South Eastern Health and Social Care Trust, UK
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Leonard D, Svenungsson E, Sandling JK, Berggren O, Jönsen A, Bengtsson C, Wang C, Jensen-Urstad K, Granstam SO, Bengtsson AA, Gustafsson JT, Gunnarsson I, Rantapää-Dahlqvist S, Nordmark G, Eloranta ML, Syvänen AC, Rönnblom L. THU0309 Coronary Heart Disease in Systemic Lupus Erythematosus is Associated with Interferon Regulatory Factor 8 Gene Variants. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2013-eular.837] [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: 11/04/2022]
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Vikerfors A, Johansson AB, Gustafsson J, Jonsen A, Leonard D, Zickert A, Nordmark G, Sturfelt G, Bengtsson A, Rönnblom L, Gunnarsson I, Elvin K, Svenungsson E. THU0167 Evaluation of two assays for antiphospholipid antibodies in 712 SLE patients; clinical associations depend on isotypes and cut-off levels. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2012-eular.2132] [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: 11/04/2022]
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Foschini M, Marletta A, Faria RC, Leonard D, Bessueille F, Jaffrezic-Renault N, Gonçalves D. Electrochemically Prepared Polypyrrole-2-Carboxylic Acid Films: Synthesis Protocols and Studies on Biosensors. ELECTROANAL 2013. [DOI: 10.1002/elan.201200574] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Borisevich AY, Morozovska AN, Kim YM, Leonard D, Oxley MP, Biegalski MD, Eliseev EA, Kalinin SV. Exploring mesoscopic physics of vacancy-ordered systems through atomic scale observations of topological defects. Phys Rev Lett 2012; 109:065702. [PMID: 23006281 DOI: 10.1103/physrevlett.109.065702] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/25/2012] [Indexed: 06/01/2023]
Abstract
Vacancy-ordered transition metal oxides have multiple similarities to classical ferroic systems including ferroelectrics and ferroelastics. The expansion coefficients for corresponding Ginzburg-Landau-type free energies are readily accessible from bulk phase diagrams. Here, we demonstrate that the gradient and interfacial terms can quantitatively be determined from the atomically resolved scanning transmission electron microscopy data of the topological defects and interfaces in model lanthanum-strontium cobaltite. With this knowledge, the interplay between ordering, chemical composition, and mechanical effects at domain walls, interfaces and structural defects can be analyzed.
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Affiliation(s)
- A Y Borisevich
- Oak Ridge National Laboratory, Oak Ridge, Tennessee 37831, USA.
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Leonard D, Wolthuis A, D'Hoore A, Bruyninx L, Van De Stadt J, Van Cutsem E, Kartheuser A. Different surgical strategies in the treatment of familial adenomatous polyposis: what's the role of the ileal pouch-anal anastomosis? Acta Gastroenterol Belg 2011; 74:427-434. [PMID: 22103049] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
BACKGROUND AND STUDY AIMS Restorative coloproctectomy (RCP) with ileal pouch-anal anastomosis (IPAA), is one of the surgical responses to the crucial question of prophylactic treatment in familial adenomatous polyposis (FAP). No consensus has been reached, until now, to choose between IPAA and ileo-rectal anastomosis (IRA), the rectal sparing prophylactic colectomy. This paper aims to review the latest issues related to IPAA and highlights its specificities compared to IRA. METHODS PubMed database was searched using the following search items: familial adenomatous polyposis, surgery, ileal pouch-anal anastomosis, ileo-rectal anastomosis. Papers published between 1978 and 2010 were selected. RESULTS Absence of mortality, acceptable morbidity and good functional results combined to high quality of life have promoted the IPAA technique. New technical issues such as the double stapled technique, mesenteric lengthening, omission of temporary protective stoma can be addressed almost systematically for these patients. A laparoscopic approach, lessening the body image impact, has proven to be as effective and safe as the open approach to perform IPAA. Further advantages of laparoscopic IPAA rely on the lower adhesion formation resulting in less small bowel occlusion. Sexuality, fertility and childbirth are important functional issues often cited as threatened by the pelvic manoeuvres of the IPAA technique which can be prevented by close rectal wall dissection and a laparoscopic approach. CONCLUSION IPAA offers the best available prophylaxis in FAP patients. Technical enhancements in IPAA will most probably decrease the functional risks. Thus IPAA remains the alternative to IRA for the prophylactic treatment of FAP.Nevertheless, based on the latest evidence, the choice between both procedures is still matter of debate.
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Affiliation(s)
- D Leonard
- Belgian Polyposis Project, Familial Adenomatous Polyposis Association (FAPA), Brussels
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Cost NG, Lubahn JD, Penn HA, Granberg CF, Schlomer BJ, Wickiser JE, Rakheja D, Gargollo PC, Leonard D, Baker LA, Raj G, Margulis V. Oncologic outcomes of partial versus radical nephrectomy for unilateral Wilms tumor. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.9561] [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: 11/20/2022] Open
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Leonard D, Akhter T, Nordmark G, Rönnblom L, Naessen T. Increased carotid intima thickness and decreased media thickness in premenopausal women with systemic lupus erythematosus: an investigation by non-invasive high-frequency ultrasound. Scand J Rheumatol 2011; 40:279-82. [DOI: 10.3109/03009742.2011.556146] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Messaoud M, Chadeau E, Brunon C, Ballet T, Rappenne L, Roussel F, Leonard D, Oulahal N, Langlet M. Photocatalytic generation of silver nanoparticles and application to the antibacterial functionalization of textile fabrics. J Photochem Photobiol A Chem 2010. [DOI: 10.1016/j.jphotochem.2010.08.003] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.4] [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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Leonard D, Pendlimari R, Larson DW, Dozois EJ. Currarino syndrome: typical images of a rare condition. Tech Coloproctol 2010; 14:289-90. [PMID: 20502931 DOI: 10.1007/s10151-010-0588-x] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2010] [Accepted: 05/06/2010] [Indexed: 10/19/2022]
Affiliation(s)
- D Leonard
- Division of Colon and Rectal Surgery, Mayo Clinic, Gonda 9 South, 200 First Street SW, Rochester, MN 55905, USA
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Leonard D, Webster M. Cone-specific gain changes compensate color appearance for differences in spectral sensitivity. J Vis 2010. [DOI: 10.1167/7.9.790] [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: 11/24/2022] Open
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Greene M, Merhige M, Leonard D. Abstract: P879 DIFFERENTIAL EXPRESSION OF INTERLEUKIN-5 RECEPTOR ISOFORMS IN PATIENTS WITH OBSTRUCTIVE CORONARY ARTERY DISEASE. ATHEROSCLEROSIS SUPP 2009. [DOI: 10.1016/s1567-5688(09)71000-1] [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: 10/20/2022]
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Hnaiein M, Hassen W, Abdelghani A, Fournier-Wirth C, Coste J, Bessueille F, Leonard D, Jaffrezic-Renault N. A conductometric immunosensor based on functionalized magnetite nanoparticles for E. coli detection. Electrochem commun 2008. [DOI: 10.1016/j.elecom.2008.04.009] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.8] [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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Manno CS, Arruda VR, Pierce GF, Glader B, Ragni M, Rasko J, Ozelo MC, Hoots K, Blatt P, Konkle B, Dake M, Kaye R, Razavi M, Zajko A, Zehnder J, Nakai H, Chew A, Leonard D, Wright JF, Lessard RR, Sommer JM, Tigges M, Sabatino D, Luk A, Jiang H, Mingozzi F, Couto L, Ertl HC, High KA, Kay MA. Erratum: CORRIGENDUM: Successful transduction of liver in hemophilia by AAV-Factor IX and limitations imposed by the host immune response. Nat Med 2006. [DOI: 10.1038/nm0506-592b] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Wadia F, Malik MH, Leonard D, Porter ML. Cement pressurisation in the acetabulum. Int Orthop 2006; 30:237-42. [PMID: 16639594 PMCID: PMC2532135 DOI: 10.1007/s00264-006-0101-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/26/2005] [Revised: 12/13/2005] [Accepted: 12/13/2005] [Indexed: 11/29/2022]
Abstract
Cement pressurisation is an important step in total hip arthroplasty that determines the long-term integration at the cement-bone interface. Our aim was to evaluate the performance of a new pressuriser designed by us against the standard existing pressurisers in an in vitro experimental set-up using two parameters: cement penetration and cement pressurisation. A polypropylene cup model was designed to represent the acetabulum. DePuy's T-handle, Exeter and our own plunger type pressuriser were each tested for cement pressurisation in this acetabular model. Cement penetration and pressures were measured. The cement intrusion into the capillaries with the DePuy pressuriser was found to vary between 2 and 8 mm (mean: 5 mm at the pole and 4.6 mm at the rim), with the Exeter pressuriser it varied between 3 and 9 mm (mean: 5.8 mm at the pole and 7.8 mm at the rim) and with the plunger type pressuriser it varied between 4 and 6 mm (mean 5.2 mm at the pole and 4.8 mm at the rim). The peak pressure achieved with the DePuy pressuriser was 60 kPa whereas it was 70 kPa with the plunger type pressuriser. The mean penetration with the plunger type pressuriser was found to be better than the other types. The penetration was found to be more uniform with equal penetration at the rim as well as at the pole.
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Affiliation(s)
- F. Wadia
- Centre for Hip Surgery, Wrightington Hospital, Hall Lane, Appley Bridge, Wigan, WN6 9EP UK
| | - M. H.A Malik
- Centre for Hip Surgery, Wrightington Hospital, Hall Lane, Appley Bridge, Wigan, WN6 9EP UK
- Centre for Integrated Genomic Research, Stopford Building, The University of Manchester, Oxford Road, Manchester, M13 9TP UK
- 14 The Boulevard, Didsbury Point, Manchester, M20 2EU UK
| | - D. Leonard
- Centre for Hip Surgery, Wrightington Hospital, Hall Lane, Appley Bridge, Wigan, WN6 9EP UK
| | - M. L. Porter
- Centre for Hip Surgery, Wrightington Hospital, Hall Lane, Appley Bridge, Wigan, WN6 9EP UK
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Dunne NJ, Leonard D, Daly C, Buchanan FJ, Orr JF. Validation of the small-punch test as a technique for characterizing the mechanical properties of acrylic bone cement. Proc Inst Mech Eng H 2006; 220:11-21. [PMID: 16459442 DOI: 10.1243/095441105x68980] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
This paper examines the validity of using the small-punch test technique as a means of quantifying the mechanical properties of acrylic bone cement under different test conditions. The elastic moduli calculated using the small-punch test method were compared with data measured using the international standard for acrylic bone resin, ISO 5833. Conclusions from the study indicate that the small-punch test is a reproducible miniature specimen test method that can be used to characterize the mechanical properties of retrieved acrylic bone cement as used in total joint replacement surgery. Moreover, the test conditions were found to influence the elastic modulus of acrylic bone cement. The test temperature had a greater effect on the elastic behaviour of the bone cement than the test medium.
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Affiliation(s)
- N J Dunne
- School of Mechanical and Manufacturing Engineering, Queen's University of Belfast, Belfast, Northern Ireland.
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Araki T, Enomoto S, Furuno K, Gando Y, Ichimura K, Ikeda H, Inoue K, Kishimoto Y, Koga M, Koseki Y, Maeda T, Mitsui T, Motoki M, Nakajima K, Ogawa H, Ogawa M, Owada K, Ricol JS, Shimizu I, Shirai J, Suekane F, Suzuki A, Tada K, Takeuchi S, Tamae K, Tsuda Y, Watanabe H, Busenitz J, Classen T, Djurcic Z, Keefer G, Leonard D, Piepke A, Yakushev E, Berger BE, Chan YD, Decowski MP, Dwyer DA, Freedman SJ, Fujikawa BK, Goldman J, Gray F, Heeger KM, Hsu L, Lesko KT, Luk KB, Murayama H, O'Donnell T, Poon AWP, Steiner HM, Winslow LA, Mauger C, McKeown RD, Vogel P, Lane CE, Miletic T, Guillian G, Learned JG, Maricic J, Matsuno S, Pakvasa S, Horton-Smith GA, Dazeley S, Hatakeyama S, Rojas A, Svoboda R, Dieterle BD, Detwiler J, Gratta G, Ishii K, Tolich N, Uchida Y, Batygov M, Bugg W, Efremenko Y, Kamyshkov Y, Kozlov A, Nakamura Y, Karwowski HJ, Markoff DM, Nakamura K, Rohm RM, Tornow W, Wendell R, Chen MJ, Wang YF, Piquemal F. Experimental investigation of geologically produced antineutrinos with KamLAND. Nature 2005; 436:499-503. [PMID: 16049478 DOI: 10.1038/nature03980] [Citation(s) in RCA: 296] [Impact Index Per Article: 15.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2005] [Accepted: 07/04/2005] [Indexed: 11/09/2022]
Abstract
The detection of electron antineutrinos produced by natural radioactivity in the Earth could yield important geophysical information. The Kamioka liquid scintillator antineutrino detector (KamLAND) has the sensitivity to detect electron antineutrinos produced by the decay of 238U and 232Th within the Earth. Earth composition models suggest that the radiogenic power from these isotope decays is 16 TW, approximately half of the total measured heat dissipation rate from the Earth. Here we present results from a search for geoneutrinos with KamLAND. Assuming a Th/U mass concentration ratio of 3.9, the 90 per cent confidence interval for the total number of geoneutrinos detected is 4.5 to 54.2. This result is consistent with the central value of 19 predicted by geophysical models. Although our present data have limited statistical power, they nevertheless provide by direct means an upper limit (60 TW) for the radiogenic power of U and Th in the Earth, a quantity that is currently poorly constrained.
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Affiliation(s)
- T Araki
- Research Center for Neutrino Science, Tohoku University, Sendai 980-8578, Japan
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Weinstein D, Probst B, Lyons E, Leonard D. Emergency medical services for children assessment of all-terrain vehicle–related injuries in Illinois. Ann Emerg Med 2004. [DOI: 10.1016/j.annemergmed.2004.07.134] [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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Gheriani H, Leonard D, Donnelly M, Kane R. Vertigo & driving--between the law and ethics. Ir Med J 2004; 97:102. [PMID: 15200216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/29/2023]
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Affiliation(s)
- D Leonard
- Department of Internal Medicine, Denver Health, Denver, CO 80204, USA
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Bangser M, Leonard D, Mach L. Restoring girls' and women's lives to dignity in Bugando. Safe Mother 2002:6. [PMID: 12322287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/26/2023]
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Healy C, Leonard D, Cahill R, Quinlan D. Complete posterior urethral disruption: current endoscopic management. Ir J Med Sci 2002. [DOI: 10.1007/bf03170092] [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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Abstract
BACKGROUND Dental amalgamators may become contaminated internally with metallic mercury. This contamination may result from mercury leakage from capsules during trituration or from the long-term accrual from microscopic exterior contaminants that result from the industrial assembly process. The potential health risk to dental personnel from this contamination is unknown. METHODS The authors assessed used amalgamators from the federal service inventory for the amounts of mercury vapor levels, as well as the visual presence of mercury contamination. They evaluated these amalgamators for potential mercury vapor health risk, using established National Institute for Occupational Safety and Health methods and American Conference of Governmental Industrial Hygienists standards. RESULTS Ten of the 11 amalgamators assessed had measurable mercury vapor levels. Four amalgamators were found to have internal static mercury vapor levels above Occupational Safety and Health Administration ceiling limit thresholds. During a simulated worst-case clinical use protocol, the authors found that no amalgamators produced mercury vapor in the breathing space of dental personnel that exceeded established time-weighted federal mercury vapor limits. CONCLUSIONS Amalgamators may be contaminated internally with metallic mercury. Although the authors detected mercury vapor from these units during aggressive, simulated clinical use, dilution factors combined with room air exchange were found to keep health risks below established federal safety thresholds. CLINICAL IMPLICATIONS Dental personnel should be aware that amalgamators may be contaminated with mercury and produce minute amounts of mercury vapor. These contaminated amalgamators may require disposal as environmentally hazardous waste.
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Affiliation(s)
- H W Roberts
- USAF Dental Investigation Service, Detachment 1, USAFSAM, 310C B St., Building 1H, Great Lakes, Ill. 60088, USA.
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Leonard D, Swap W. Gurus in the garage. Harv Bus Rev 2000; 78:71-82. [PMID: 11184978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
Before the days of the Internet, it was primarily venture capitalists who coached young entrepreneurs in Silicon Valley. Today, because of the phenomenal number of new companies, venture capitalists are just too busy. The largest firms still take on a few carefully selected, highly promising zero-stage start-ups, but they simply can't spend the time on ones that aren't going to grow huge quickly. To fill the void, a new breed of adviser has stepped in to coach entrepreneurs. Called mentor capitalists, they help entrepreneurs with everything from recruiting top talent to attracting their first million in seed money. The mentor capitalists in Silicon Valley are cashed-out, highly successful business architects who no longer want to start businesses but who love the thrill of the entrepreneurial game. They spend hours and hours with first-time entrepreneurs, guiding them as they create and refine a business model, test their ideas in the marketplace, build business processes, raise money, and find talent. The authors of this article found through dozens of extensive interviews with entrepreneurs and their coaches that mentor capitalists play many roles: sculptor, psychologist, diplomat, kingmaker, talent magnet, process engineer, and rainmaker. In exchange for small equity stakes, the mentor capitalists wear these different hats, doling out expertise just in time, as situations arise, and in doses appropriate to the situation. Mentor capitalists seed Silicon Valley with expertise and knowledge, augmenting or even substituting for classes in entrepreneurship at local universities. But, as the authors note, the role of the mentor capitalist is essential to any start-up, anywhere.
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Rowley KG, Iser DM, Best JD, O'Dea K, Leonard D, McDermott R. Albuminuria in Australian Aboriginal people: prevalence and associations with components of the metabolic syndrome. Diabetologia 2000; 43:1397-403. [PMID: 11126409 DOI: 10.1007/s001250051545] [Citation(s) in RCA: 68] [Impact Index Per Article: 2.8] [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] [Indexed: 11/28/2022]
Abstract
AIMS/HYPOTHESIS To examine the prevalence and associations with the metabolic syndrome of albuminuria among Australian Aboriginal people. METHODS Early-morning urine specimens were collected as part of community-based risk factor surveys assessing the prevalence of diabetes and cardiovascular disease in eight remote communities, with a sample size of 1,075 people. Microalbuminuria was defined as urinary albumin : creatinine ratio 3.4-33.9 mg/mmol, macroalbuminuria as albumin: creatinine ratio equal to or greater than 34 mg/mmol. RESULTS There were high prevalences of microalbuminuria (men 22.2 %, women 26.9 %) and of macroalbuminuria (men 10.4%, women 13.5%). There were highly statistically significant linear associations of microalbuminuria and macroalbuminuria with increasing number of coexisting components of the metabolic syndrome (hypertension, glucose intolerance, dyslipidaemia, insulin resistance, abdominal obesity): among people with zero, one, two and three to five of these conditions, respectively, prevalence of microalbuminuria was 16%, 20%, 36% and 32% (p < 0.001); prevalence of macroalbuminuria was 2%, 6%, 12% and 32% (p < 0.001). There were independent associations of microalbuminuria with hypertension (odds ratio, 95% confidence interval = 2.36, 1.63-3.42) and diabetes (2.10, 1.28-3.45): macroalbuminuria was independently associated with hypertension (6.39, 3.93-10.4), diabetes (3.49, 1.93-6.28) and abdominal obesity (4.56, 2.40-8.64) and had a weaker association with insulin resistance (1.99, 1.12-3.54). Dyslipidaemia and impaired glucose tolerance were neither independently associated with microalbuminuria or macroalbuminuria, nor was insulin resistance or abdominal obesity independently associated with microalbuminuria. CONCLUSION/INTERPRETATION There was a strong clustering of albuminuria with components of the metabolic syndrome. Diabetes, hypertension and abdominal obesity are major contributors to high rates of albuminuria among Australian Aboriginal people.
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Affiliation(s)
- K G Rowley
- The University of Melbourne, Department of Medicine, St Vincent's Hospital, Fitzroy, VIC, Australia
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