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Munk N, Daggy JK, Slaven JE, Evans E, Foote T, Laws B, Matthias MS, Bair MJ. Care ally-assisted massage for veterans with chronic neck pain: TOMCATT results. Contemp Clin Trials 2024:107561. [PMID: 38704120 DOI: 10.1016/j.cct.2024.107561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2023] [Revised: 04/23/2024] [Accepted: 05/01/2024] [Indexed: 05/06/2024]
Abstract
PURPOSE Chronic neck pain (CNP) is prevalent and challenging to treat. Despite evidence of massage's effectiveness for CNP, multiple accessibility barriers exist. The Trial Outcomes for Massage: Care Ally-Assisted vs. Therapist Treated (TOMCATT) study examined a care ally-assisted massage (CA-M) approach compared to a waitlist control prior to a study design modification (WL-C0). METHODS CA-M consisted of in-person training for veteran/care-ally dyads to learn a standardized 30-minue massage routine, instructional DVD, and printed treatment manual. Participants were to complete three care ally-assisted massage sessions weekly for 12-weeks. Outcomes collected at baseline, 1-, 3-, and 6-months included validated measures of neck pain severity and associated disability. Linear mixed-model approaches were used for analysis with 3-months as the primary outcome timepoint. RESULTS Participants (N = 203) were 56.7 ± 14 years old, 75% White, 15% female, and 75% married/partnered. Among 102 CA-M participants, 45% did not attend the in-person training and subsequently withdrew from the study and were more likely to be younger (p = .016) and employed (p = .004). Compared to WL-C0, CA-M participants had statistically significant reductions in pain-related disability at 3-months (-3.4, 95%CI = [-5.8, -1.0]; p = .006) and 6-months (-4.6, 95%CI = [-7.0, -2.1]; p < .001) and pain severity at 3-months (-1.3, 95%CI = [-1.9, -0.8]; p < .001) and 6-months (-1.0, 95%CI = [-1.6, -0.4]; p = .007), respectively. CONCLUSION In this analysis, CA-M led to greater reductions in CNP with disability and pain severity compared to WL-C0, despite treatment engagement and retention challenges. Future work is needed to determine how to better engage Veterans and their care-allies to attend CA-M training.
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Affiliation(s)
- N Munk
- Indiana University School of Health and Human Sciences, Indianapolis, Indiana, USA; Department of Health Sciences, USA; Australian Research Centre in Complementary and Integrative Medicine (ARCCIM), Massage & Myotherapy Australia Fellow and Visiting Faculty of Health, University of Technology Sydney, Sydney, Australia.
| | - J K Daggy
- Indiana University School of Medicine, Department of Biostatistics and Health Data Science, Indianapolis, IN, United States
| | - J E Slaven
- Indiana University School of Medicine, Department of Biostatistics and Health Data Science, Indianapolis, IN, United States
| | - E Evans
- Richard L. Roudebush VA Medical Center, USA; Center for Health Information and Communication, USA
| | - T Foote
- Richard L. Roudebush VA Medical Center, USA; Center for Health Information and Communication, USA
| | - B Laws
- Richard L. Roudebush VA Medical Center, USA; Center for Health Information and Communication, USA
| | - M S Matthias
- Richard L. Roudebush VA Medical Center, USA; Center for Health Information and Communication, USA; Indiana University School of Medicine and Regenstrief Institute, USA
| | - M J Bair
- Richard L. Roudebush VA Medical Center, USA; Center for Health Information and Communication, USA; Indiana University School of Medicine and Regenstrief Institute, USA
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Arndt T, Keresztes M, Olivier B, Boone L, Chanut F, Ennulat D, Evans E, Freyberger A, Johannes S, Kuper CF, Maliver P, O'Brien P, Ramaiah L, Roman I, Strauss V, Vinken P, Walker D, Winter M, Pohlmeyer-Esch G, Tomlinson L. Considerations for the Identification and Conveyance of Clinical Pathology Findings in Preclinical Toxicity Studies: Results From the 9th ESTP International Expert Workshop. Toxicol Pathol 2024:1926233241245108. [PMID: 38661116 DOI: 10.1177/01926233241245108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/26/2024]
Abstract
The European Society of Toxicologic Pathology (ESTP) organized a panel of 24 international experts from many fields of toxicologic clinical pathology (e.g., industry, academia, and regulatory) that came together in 2021 to align the use of terminology to convey the importance of clinical pathology findings in preclinical toxicity studies. An additional goal consisted of how to identify important findings in standard and nonstandard clinical pathology associated endpoints. This manuscript summarizes the information and opinions discussed and shared at the ninth ESTP International Expert Workshop, April 5 to 6, 2022. In addition to terminology usage, the workshop considered topics related to the identification and conveyance of the importance of test item-related findings. These topics included sources of variability, comparators, statistics, reporting, correlations to other study data, nonstandard biomarkers, indirect/secondary findings, and an overall weight-of-evidence approach.
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Affiliation(s)
- Tara Arndt
- Altasciences Preclinical, Laval, Quebec, Canada
- Altasciences Preclinical, Seattle, Washington, USA
| | | | | | - L Boone
- Labcorp, Madison, Wisconsin, USA
| | | | - D Ennulat
- GlaxoSmithKline (Retired), King of Prussia, Pennsylvania, USA
| | - Ellen Evans
- Pfizer (Retired), Waterford, Connecticut, USA
| | | | | | | | - Pierre Maliver
- Roche Pharma Research and Early Development, Basel, Switzerland
| | | | - Lila Ramaiah
- Janssen Research & Development, Spring House, Pennsylvania, USA
| | - Ian Roman
- GlaxoSmithKline, Ware, United Kingdom
| | | | | | - Dana Walker
- Novartis Institutes for Biomedical Research, Cambridge, Massachusetts, USA
| | - Michael Winter
- Roche Pharma Research and Early Development, Basel, Switzerland
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Dupré M, Spruce R, Evans E, Meshaka R, Shelmerdine SC. Paediatric radiology training in the UK: a national trainee survey by the British Society of Paediatric Radiologists (BSPR). Clin Radiol 2024; 79:312-318. [PMID: 38302376 DOI: 10.1016/j.crad.2024.01.002] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Revised: 01/05/2024] [Accepted: 01/14/2024] [Indexed: 02/03/2024]
Abstract
AIM To survey current UK radiology trainee experiences and opinions regarding the quality of paediatric radiology training encountered in their core years, and assess their career ambitions with regards to paediatric radiology. MATERIALS AND METHODS A 22-question online survey, approved by the BSPR committee, was promoted over 12 months (1 February 2022 to 31 January 2023) across current radiology trainees and fellows via regional radiology training programme directors (TPDs), Junior Radiology Forum (JRF) trainee representatives, at BSPR Junior Forum webinar teaching sessions, and via social media/word of mouth. RESULTS Eighty-three UK survey responses were received from 17/19 (89%) training schemes. Sixty of the 83 (72%) had taken or were due to take a 2-4 month core paediatric radiology placement partly at tertiary centres (66/83, 80%), with 67/83 (81%) receiving dedicated didactic teaching. Only 26/83 (31%) reported fulfilling core curriculum competencies and 32/83 (39%) reported not receiving enough paediatric radiology training. Almost a quarter (18/83, 22%) reported <2 months of paediatric radiology rotation during core training and 12% (10/83) across six training schemes, reported no dedicated paediatric teaching sessions. Respondents who left negative comments around their experience were more likely to reject paediatric radiology as a future career option (p<0.05). CONCLUSIONS Only 31% of UK radiology trainees reported having enough paediatric radiology training to achieve core competencies. Standardised training, teaching, and increased on-call support could improve confidence in dealing with emergency cases and encourage interest in paediatric radiology beyond junior years.
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Affiliation(s)
- M Dupré
- Department of Clinical Radiology, Royal Hospital for Children, Glasgow, Scotland, UK
| | - R Spruce
- Department of Clinical Radiology, Imperial College Healthcare NHS Trust, London, UK
| | - E Evans
- Department of Clinical Radiology, University Hospital Coventry and Warwickshire, UK
| | - R Meshaka
- Department of Clinical Radiology, Great Ormond Street Hospital, London, UK
| | - S C Shelmerdine
- Department of Clinical Radiology, Great Ormond Street Hospital, London, UK; UCL Great Ormond Street Institute of Child Health, Great Ormond Street Hospital for Children, London, UK; NIHR Great Ormond Street Hospital Biomedical Research Centre, London, UK.
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Kouli O, Murray V, Bhatia S, Cambridge WA, Kawka M, Shafi S, Knight SR, Kamarajah SK, McLean KA, Glasbey JC, Khaw RA, Ahmed W, Akhbari M, Baker D, Borakati A, Mills E, Thavayogan R, Yasin I, Raubenheimer K, Ridley W, Sarrami M, Zhang G, Egoroff N, Pockney P, Richards T, Bhangu A, Creagh-Brown B, Edwards M, Harrison EM, Lee M, Nepogodiev D, Pinkney T, Pearse R, Smart N, Vohra R, Sohrabi C, Jamieson A, Nguyen M, Rahman A, English C, Tincknell L, Kakodkar P, Kwek I, Punjabi N, Burns J, Varghese S, Erotocritou M, McGuckin S, Vayalapra S, Dominguez E, Moneim J, Salehi M, Tan HL, Yoong A, Zhu L, Seale B, Nowinka Z, Patel N, Chrisp B, Harris J, Maleyko I, Muneeb F, Gough M, James CE, Skan O, Chowdhury A, Rebuffa N, Khan H, Down B, Fatimah Hussain Q, Adams M, Bailey A, Cullen G, Fu YXJ, McClement B, Taylor A, Aitken S, Bachelet B, Brousse de Gersigny J, Chang C, Khehra B, Lahoud N, Lee Solano M, Louca M, Rozenbroek P, Rozitis E, Agbinya N, Anderson E, Arwi G, Barry I, Batchelor C, Chong T, Choo LY, Clark L, Daniels M, Goh J, Handa A, Hanna J, Huynh L, Jeon A, Kanbour A, Lee A, Lee J, Lee T, Leigh J, Ly D, McGregor F, Moss J, Nejatian M, O'Loughlin E, Ramos I, Sanchez B, Shrivathsa A, Sincari A, Sobhi S, Swart R, Trimboli J, Wignall P, Bourke E, Chong A, Clayton S, Dawson A, Hardy E, Iqbal R, Le L, Mao S, Marinelli I, Metcalfe H, Panicker D, R HH, Ridgway S, Tan HH, Thong S, Van M, Woon S, Woon-Shoo-Tong XS, Yu S, Ali K, Chee J, Chiu C, Chow YW, Duller A, Nagappan P, Ng S, Selvanathan M, Sheridan C, Temple M, Do JE, Dudi-Venkata NN, Humphries E, Li L, Mansour LT, Massy-Westropp C, Fang B, Farbood K, Hong H, Huang Y, Joan M, Koh C, Liu YHA, Mahajan T, Muller E, Park R, Tanudisastro M, Wu JJG, Chopra P, Giang S, Radcliffe S, Thach P, Wallace D, Wilkes A, Chinta SH, Li J, Phan J, Rahman F, Segaran A, Shannon J, Zhang M, Adams N, Bonte A, Choudhry A, Colterjohn N, Croyle JA, Donohue J, Feighery A, Keane A, McNamara D, Munir K, Roche D, Sabnani R, Seligman D, Sharma S, Stickney Z, Suchy H, Tan R, Yordi S, Ahmed I, Aranha M, El Sabawy D, Garwood P, Harnett M, Holohan R, Howard R, Kayyal Y, Krakoski N, Lupo M, McGilberry W, Nepon H, Scoleri Y, Urbina C, Ahmad Fuad MF, Ahmed O, Jaswantlal D, Kelly E, Khan MHT, Naidu D, Neo WX, O'Neill R, Sugrue M, Abbas JD, Abdul-Fattah S, Azlan A, Barry K, Idris NS, Kaka N, Mc Dermott D, Mohammad Nasir MN, Mozo M, Rehal A, Shaikh Yousef M, Wong RH, Curran E, Gardner M, Hogan A, Julka R, Lasser G, Ní Chorráin N, Ting J, Browne R, George S, Janjua Z, Leung Shing V, Megally M, Murphy S, Ravenscroft L, Vedadi A, Vyas V, Bryan A, Sheikh A, Ubhi J, Vannelli K, Vawda A, Adeusi L, Doherty C, Fitzgerald C, Gallagher H, Gill P, Hamza H, Hogan M, Kelly S, Larry J, Lynch P, Mazeni NA, O'Connell R, O'Loghlin R, Singh K, Abbas Syed R, Ali A, Alkandari B, Arnold A, Arora E, Azam R, Breathnach C, Cheema J, Compton M, Curran S, Elliott JA, Jayasamraj O, Mohammed N, Noone A, Pal A, Pandey S, Quinn P, Sheridan R, Siew L, Tan EP, Tio SW, Toh VTR, Walsh M, Yap C, Yassa J, Young T, Agarwal N, Almoosawy SA, Bowen K, Bruce D, Connachan R, Cook A, Daniell A, Elliott M, Fung HKF, Irving A, Laurie S, Lee YJ, Lim ZX, Maddineni S, McClenaghan RE, Muthuganesan V, Ravichandran P, Roberts N, Shaji S, Solt S, Toshney E, Arnold C, Baker O, Belais F, Bojanic C, Byrne M, Chau CYC, De Soysa S, Eldridge M, Fairey M, Fearnhead N, Guéroult A, Ho JSY, Joshi K, Kadiyala N, Khalid S, Khan F, Kumar K, Lewis E, Magee J, Manetta-Jones D, Mann S, McKeown L, Mitrofan C, Mohamed T, Monnickendam A, Ng AYKC, Ortu A, Patel M, Pope T, Pressling S, Purohit K, Saji S, Shah Foridi J, Shah R, Siddiqui SS, Surman K, Utukuri M, Varghese A, Williams CYK, Yang JJ, Billson E, Cheah E, Holmes P, Hussain S, Murdock D, Nicholls A, Patel P, Ramana G, Saleki M, Spence H, Thomas D, Yu C, Abousamra M, Brown C, Conti I, Donnelly A, Durand M, French N, Goan R, O'Kane E, Rubinchik P, Gardiner H, Kempf B, Lai YL, Matthews H, Minford E, Rafferty C, Reid C, Sheridan N, Al Bahri T, Bhoombla N, Rao BM, Titu L, Chatha S, Field C, Gandhi T, Gulati R, Jha R, Jones Sam MT, Karim S, Patel R, Saunders M, Sharma K, Abid S, Heath E, Kurup D, Patel A, Ali M, Cresswell B, Felstead D, Jennings K, Kaluarachchi T, Lazzereschi L, Mayson H, Miah JE, Reinders B, Rosser A, Thomas C, Williams H, Al-Hamid Z, Alsadoun L, Chlubek M, Fernando P, Gaunt E, Gercek Y, Maniar R, Ma R, Matson M, Moore S, Morris A, Nagappan PG, Ratnayake M, Rockall L, Shallcross O, Sinha A, Tan KE, Virdee S, Wenlock R, Donnelly HA, Ghazal R, Hughes I, Liu X, McFadden M, Misbert E, Mogey P, O'Hara A, Peace C, Rainey C, Raja P, Salem M, Salmon J, Tan CH, Alves D, Bahl S, Baker C, Coulthurst J, Koysombat K, Linn T, Rai P, Sharma A, Shergill A, Ahmed M, Ahmed S, Belk LH, Choudhry H, Cummings D, Dixon Y, Dobinson C, Edwards J, Flint J, Franco Da Silva C, Gallie R, Gardener M, Glover T, Greasley M, Hatab A, Howells R, Hussey T, Khan A, Mann A, Morrison H, Ng A, Osmond R, Padmakumar N, Pervaiz F, Prince R, Qureshi A, Sawhney R, Sigurdson B, Stephenson L, Vora K, Zacken A, Cope P, Di Traglia R, Ferarrio I, Hackett N, Healicon R, Horseman L, Lam LI, Meerdink M, Menham D, Murphy R, Nimmo I, Ramaesh A, Rees J, Soame R, Dilaver N, Adebambo D, Brown E, Burt J, Foster K, Kaliyappan L, Knight P, Politis A, Richardson E, Townsend J, Abdi M, Ball M, Easby S, Gill N, Ho E, Iqbal H, Matthews M, Nubi S, Nwokocha JO, Okafor I, Perry G, Sinartio B, Vanukuru N, Walkley D, Welch T, Yates J, Yeshitila N, Bryans K, Campbell B, Gray C, Keys R, Macartney M, Chamberlain G, Khatri A, Kucheria A, Lee STP, Reese G, Roy choudhury J, Tan WYR, Teh JJ, Ting A, Kazi S, Kontovounisios C, Vutipongsatorn K, Amarnath T, Balasubramanian N, Bassett E, Gurung P, Lim J, Panjikkaran A, Sanalla A, Alkoot M, Bacigalupo V, Eardley N, Horton M, Hurry A, Isti C, Maskell P, Nursiah K, Punn G, Salih H, Epanomeritakis E, Foulkes A, Henderson R, Johnston E, McCullough H, McLarnon M, Morrison E, Cheung A, Cho SH, Eriksson F, Hedges J, Low Z, May C, Musto L, Nagi S, Nur S, Salau E, Shabbir S, Thomas MC, Uthayanan L, Vig S, Zaheer M, Zeng G, Ashcroft-Quinn S, Brown R, Hayes J, McConville R, French R, Gilliam A, Sheetal S, Shehzad MU, Bani W, Christie I, Franklyn J, Khan M, Russell J, Smolarek S, Varadarassou R, Ahmed SK, Narayanaswamy S, Sealy J, Shah M, Dodhia V, Manukyan A, O'Hare R, Orbell J, Chung I, Forenc K, Gupta A, Agarwal A, Al Dabbagh A, Bennewith R, Bottomley J, Chu TSM, Chu YYA, Doherty W, Evans B, Hainsworth P, Hosfield T, Li CH, McCullagh I, Mehta A, Thaker A, Thompson B, Virdi A, Walker H, Wilkins E, Dixon C, Hassan MR, Lotca N, Tong KS, Batchelor-Parry H, Chaudhari S, Harris T, Hooper J, Johnson C, Mulvihill C, Nayler J, Olutobi O, Piramanayagam B, Stones K, Sussman M, Weaver C, Alam F, Al Rawi M, Andrew F, Arrayeh A, Azizan N, Hassan A, Iqbal Z, John I, Jones M, Kalake O, Keast M, Nicholas J, Patil A, Powell K, Roberts P, Sabri A, Segue AK, Shah A, Shaik Mohamed SA, Shehadeh A, Shenoy S, Tong A, Upcott M, Vijayasingam D, Anarfi S, Dauncey J, Devindaran A, Havalda P, Komninos G, Mwendwa E, Norman C, Richards J, Urquhart A, Allan J, Cahya E, Hunt H, McWhirter C, Norton R, Roxburgh C, Tan JY, Ali Butt S, Hansdot S, Haq I, Mootien A, Sanchez I, Vainas T, Deliyannis E, Tan M, Vipond M, Chittoor Satish NN, Dattani A, De Carvalho L, Gaston-Grubb M, Karunanithy L, Lowe B, Pace C, Raju K, Roope J, Taylor C, Youssef H, Munro T, Thorn C, Wong KHF, Yunus A, Chawla S, Datta A, Dinesh AA, Field D, Georgi T, Gwozdz A, Hamstead E, Howard N, Isleyen N, Jackson N, Kingdon J, Sagoo KS, Schizas A, Yin L, Aung E, Aung YY, Franklin S, Han SM, Kim WC, Martin Segura A, Rossi M, Ross T, Tirimanna R, Wang B, Zakieh O, Ben-Arzi H, Flach A, Jackson E, Magers S, Olu abara C, Rogers E, Sugden K, Tan H, Veliah S, Walton U, Asif A, Bharwada Y, Bowley D, Broekhuizen A, Cooper L, Evans N, Girdlestone H, Ling C, Mann H, Mehmood N, Mulvenna CL, Rainer N, Trout I, Gujjuri R, Jeyaraman D, Leong E, Singh D, Smith E, Anderton J, Barabas M, Goyal S, Howard D, Joshi A, Mitchell D, Weatherby T, Badminton R, Bird R, Burtle D, Choi NY, Devalia K, Farr E, Fischer F, Fish J, Gunn F, Jacobs D, Johnston P, Kalakoutas A, Lau E, Loo YNAF, Louden H, Makariou N, Mohammadi K, Nayab Y, Ruhomaun S, Ryliskyte R, Saeed M, Shinde P, Sudul M, Theodoropoulou K, Valadao-Spoorenberg J, Vlachou F, Arshad SR, Janmohamed AM, Noor M, Oyerinde O, Saha A, Syed Y, Watkinson W, Ahmadi H, Akintunde A, Alsaady A, Bradley J, Brothwood D, Burton M, Higgs M, Hoyle C, Katsura C, Lathan R, Louani A, Mandalia R, Prihartadi AS, Qaddoura B, Sandland-Taylor L, Thadani S, Thompson A, Walshaw J, Teo S, Ali S, Bawa JH, Fox S, Gargan K, Haider SA, Hanna N, Hatoum A, Khan Z, Krzak AM, Li T, Pitt J, Tan GJS, Ullah Z, Wilson E, Cleaver J, Colman J, Copeland L, Coulson A, Davis P, Faisal H, Hassan F, Hughes JT, Jabr Y, Mahmoud Ali F, Nahaboo Solim ZN, Sangheli A, Shaya S, Thompson R, Cornwall H, De Andres Crespo M, Fay E, Findlay J, Groves E, Jones O, Killen A, Millo J, Thomas S, Ward J, Wilkins M, Zaki F, Zilber E, Bhavra K, Bilolikar A, Charalambous M, Elawad A, Eleni A, Fawdon R, Gibbins A, Livingstone D, Mala D, Oke SE, Padmakumar D, Patsalides MA, Payne D, Ralphs C, Roney A, Sardar N, Stefanova K, Surti F, Timms R, Tosney G, Bannister J, Clement NS, Cullimore V, Kamal F, Lendor J, McKay J, Mcswiggan J, Minhas N, Seneviratne K, Simeen S, Valverde J, Watson N, Bloom I, Dinh TH, Hirniak J, Joseph R, Kansagra M, Lai CKN, Melamed N, Patel J, Randev J, Sedighi T, Shurovi B, Sodhi J, Vadgama N, Abdulla S, Adabavazeh B, Champion A, Chennupati R, Chu K, Devi S, Haji A, Schulz J, Testa F, Davies P, Gurung B, Howell S, Modi P, Pervaiz A, Zahid M, Abdolrazaghi S, Abi Aoun R, Anjum Z, Bawa G, Bhardwaj R, Brown S, Enver M, Gill D, Gopikrishna D, Gurung D, Kanwal A, Kaushal P, Khanna A, Lovell E, McEvoy C, Mirza M, Nabeel S, Naseem S, Pandya K, Perkins R, Pulakal R, Ray M, Reay C, Reilly S, Round A, Seehra J, Shakeel NM, Singh B, Vijay Sukhnani M, Brown L, Desai B, Elzanati H, Godhaniya J, Kavanagh E, Kent J, Kishor A, Liu A, Norwood M, Shaari N, Wood C, Wood M, Brown A, Chellapuri A, Ferriman A, Ghosh I, Kulkarni N, Noton T, Pinto A, Rajesh S, Varghese B, Wenban C, Aly R, Barciela C, Brookes T, Corrin E, Goldsworthy M, Mohamed Azhar MS, Moore J, Nakhuda S, Ng D, Pillay S, Port S, Abdullah M, Akinyemi J, Islam S, Kale A, Lewis A, Manjunath T, McCabe H, Misra S, Stubley T, Tam JP, Waraich N, Chaora T, Ford C, Osinkolu I, Pong G, Rai J, Risquet R, Ainsworth J, Ayandokun P, Barham E, Barrett G, Barry J, Bisson E, Bridges I, Burke D, Cann J, Cloney M, Coates S, Cripps P, Davies C, Francis N, Green S, Handley G, Hathaway D, Hurt L, Jenkins S, Johnston C, Khadka A, McGee U, Morris D, Murray R, Norbury C, Pierrepont Z, Richards C, Ross O, Ruddy A, Salmon C, Shield M, Soanes K, Spencer N, Taverner S, Williams C, Wills-Wood W, Woodward S, Chow J, Fan J, Guest O, Hunter I, Moon WY, Arthur-Quarm S, Edwards P, Hamlyn V, McEneaney L, N D G, Pranoy S, Ting M, Abada S, Alawattegama LH, Ashok A, Carey C, Gogna A, Haglund C, Hurley P, Leelo N, Liu B, Mannan F, Paramjothy K, Ramlogan K, Raymond-Hayling O, Shanmugarajah A, Solichan D, Wilkinson B, Ahmad NA, Allan D, Amin A, Bakina C, Burns F, Cameron F, Campbell A, Cavanagh S, Chan SMZ, Chapman S, Chong V, Edelsten E, Ekpete O, El Sheikh M, Ghose R, Hassane A, Henderson C, Hilton-Christie S, Husain M, Hussain H, Javid Z, Johnson-Ogbuneke J, Johnston A, Khalil M, Leung TCC, Makin I, Muralidharan V, Naeem M, Patil P, Ravichandran S, Saraeva D, Shankey-Smith W, Sharma N, Swan R, Waudby-West R, Wilkinson A, Wright K, Balasubramanian A, Bhatti S, Chalkley M, Chou WK, Dixon M, Evans L, Fisher K, Gandhi P, Ho S, Lau YB, Lowe S, Meechan C, Murali N, Musonda C, Njoku P, Ochieng L, Pervez MU, Seebah K, Shaikh I, Sikder MA, Vanker R, Alom J, Bajaj V, Coleman O, Finch G, Goss J, Jenkins C, Kontothanassis A, Liew MS, Ng K, Outram M, Shakeel MM, Tawn J, Zuhairy S, Chapple K, Cinnamond A, Coleman S, George HA, Goulder L, Hare N, Hawksley J, Kret A, Luesley A, Mecia L, Porter H, Puddy E, Richardson G, Sohail B, Srikaran V, Tadross D, Tobin J, Tokidis E, Young L, Ashdown T, Bratsos S, Koomson A, Kufuor A, Lim MQ, Shah S, Thorne EPC, Warusavitarne J, Xu S, Abigail S, Ahmed A, Ahmed J, Akmal A, Al-Khafaji M, Amini B, Arshad M, Bogie E, Brazkiewicz M, Carroll M, Chandegra A, Cirelli C, Deng A, Fairclough S, Fung YJ, Gornell C, Green RL, Green SV, Gulamhussein AHM, Isaac AG, Jan R, Jegatheeswaran L, Knee M, Kotecha J, Kotecha S, Maxwell-Armstrong C, McIntyre C, Mendis N, Naing TKP, Oberman J, Ong ZX, Ramalingam A, Saeed Adam A, Tan LL, Towell S, Yadav J, Anandampillai R, Chung S, Hounat A, Ibrahim B, Jeyakumar G, Khalil A, Khan UA, Nair G, Owusu-Ayim M, Wilson M, Kanani A, Kilkelly B, Ogunmwonyi I, Ong L, Samra B, Schomerus L, Shea J, Turner O, Yang Y, Amin M, Blott N, Clark A, Feather A, Forrest M, Hague S, Hamilton K, Higginbotham G, Hope E, Karimian S, Loveday K, Malik H, McKenna O, Noor A, Onsiong C, Patel B, Radcliffe N, Shah P, Tye L, Verma K, Walford R, Yusufi U, Zachariah M, Casey A, Doré C, Fludder V, Fortescue L, Kalapu SS, Karel E, Khera G, Smith C, Appleton B, Ashaye A, Boggon E, Evans A, Faris Mahmood H, Hinchcliffe Z, Marei O, Silva I, Spooner C, Thomas G, Timlin M, Wellington J, Yao SL, Abdelrazek M, Abdelrazik Y, Bee F, Joseph A, Mounce A, Parry G, Vignarajah N, Biddles D, Creissen A, Kolhe S, K T, Lea A, Ledda V, O'Loughlin P, Scanlon J, Shetty N, Weller C, Abdalla M, Adeoye A, Bhatti M, Chadda KR, Chu J, Elhakim H, Foster-Davies H, Rabie M, Tailor B, Webb S, Abdelrahim ASA, Choo SY, Jiwa A, Mangam S, Murray S, Shandramohan A, Aghanenu O, Budd W, Hayre J, Khanom S, Liew ZY, McKinney R, Moody N, Muhammad-Kamal H, Odogwu J, Patel D, Roy C, Sattar Z, Shahrokhi N, Sinha I, Thomson E, Wonga L, Bain J, Khan J, Ricardo D, Bevis R, Cherry C, Darkwa S, Drew W, Griffiths E, Konda N, Madani D, Mak JKC, Meda B, Odunukwe U, Preest G, Raheel F, Rajaseharan A, Ramgopal A, Risbrooke C, Selvaratnam K, Sethunath G, Tabassum R, Taylor J, Thakker A, Wijesingha N, Wybrew R, Yasin T, Ahmed Osman A, Alfadhel S, Carberry E, Chen JY, Drake I, Glen P, Jayasuriya N, Kawar L, Myatt R, Sinan LOH, Siu SSY, Tjen V, Adeboyejo O, Bacon H, Barnes R, Birnie C, D'Cunha Kamath A, Hughes E, Middleton S, Owen R, Schofield E, Short C, Smith R, Wang H, Willett M, Zimmerman M, Balfour J, Chadwick T, Coombe-Jones M, Do Le HP, Faulkner G, Hobson K, Shehata Z, Beattie M, Chmielewski G, Chong C, Donnelly B, Drusch B, Ellis J, Farrelly C, Feyi-Waboso J, Hibell I, Hoade L, Ho C, Jones H, Kodiatt B, Lidder P, Ni Cheallaigh L, Norman R, Patabendi I, Penfold H, Playfair M, Pomeroy S, Ralph C, Rottenburg H, Sebastian J, Sheehan M, Stanley V, Welchman J, Ajdarpasic D, Antypas A, Azouaghe O, Basi S, Bettoli G, Bhattarai S, Bommireddy L, Bourne K, Budding J, Cookey-Bresi R, Cummins T, Davies G, Fabelurin C, Gwilliam R, Hanley J, Hird A, Kruczynska A, Langhorne B, Lund J, Lutchman I, McGuinness R, Neary M, Pampapathi S, Pang E, Podbicanin S, Rai N, Redhouse White G, Sujith J, Thomas P, Walker I, Winterton R, Anderson P, Barrington M, Bhadra K, Clark G, Fowler G, Gibson C, Hudson S, Kaminskaite V, Lawday S, Longshaw A, MacKrill E, McLachlan F, Murdeshwar A, Nieuwoudt R, Parker P, Randall R, Rawlins E, Reeves SA, Rye D, Sirkis T, Sykes B, Ventress N, Wosinska N, Akram B, Burton L, Coombs A, Long R, Magowan D, Ong C, Sethi M, Williams G, Chan C, Chan LH, Fernando D, Gaba F, Khor Z, Les JW, Mak R, Moin S, Ng Kee Kwong KC, Paterson-Brown S, Tew YY, Bardon A, Burrell K, Coldwell C, Costa I, Dexter E, Hardy A, Khojani M, Mazurek J, Raymond T, Reddy V, Reynolds J, Soma A, Agiotakis S, Alsusa H, Desai N, Peristerakis I, Adcock A, Ayub H, Bennett T, Bibi F, Brenac S, Chapman T, Clarke G, Clark F, Galvin C, Gwyn-Jones A, Henry-Blake C, Kerner S, Kiandee M, Lovett A, Pilecka A, Ravindran R, Siddique H, Sikand T, Treadwell K, Akmal K, Apata A, Barton O, Broad G, Darling H, Dhuga Y, Emms L, Habib S, Jain R, Jeater J, Kan CYP, Kathiravelupillai A, Khatkar H, Kirmani S, Kulasabanathan K, Lacey H, Lal K, Manafa C, Mansoor M, McDonald S, Mittal A, Mustoe S, Nottrodt L, Oliver P, Papapetrou I, Pattinson F, Raja M, Reyhani H, Shahmiri A, Small O, Soni U, Aguirrezabala Armbruster B, Bunni J, Hakim MA, Hawkins-Hooker L, Howell KA, Hullait R, Jaskowska A, Ottewell L, Thomas-Jones I, Vasudev A, Clements B, Fenton J, Gill M, Haider S, Lim AJM, Maguire H, McMullan J, Nicoletti J, Samuel S, Unais MA, White N, Yao PC, Yow L, Boyle C, Brady R, Cheekoty P, Cheong J, Chew SJHL, Chow R, Ganewatta Kankanamge D, Mamer L, Mohammed B, Ng Chieng Hin J, Renji Chungath R, Royston A, Sharrad E, Sinclair R, Tingle S, Treherne K, Wyatt F, Maniarasu VS, Moug S, Appanna T, Bucknall T, Hussain F, Owen A, Parry M, Parry R, Sagua N, Spofforth K, Yuen ECT, Bosley N, Hardie W, Moore T, Regas C, Abdel-Khaleq S, Ali N, Bashiti H, Buxton-Hopley R, Constantinides M, D'Afflitto M, Deshpande A, Duque Golding J, Frisira E, Germani Batacchi M, Gomaa A, Hay D, Hutchison R, Iakovou A, Iakovou D, Ismail E, Jefferson S, Jones L, Khouli Y, Knowles C, Mason J, McCaughan R, Moffatt J, Morawala A, Nadir H, Neyroud F, Nikookam Y, Parmar A, Pinto L, Ramamoorthy R, Richards E, Thomson S, Trainer C, Valetopoulou A, Vassiliou A, Wantman A, Wilde S, Dickinson M, Rockall T, Senn D, Wcislo K, Zalmay P, Adelekan K, Allen K, Bajaj M, Gatumbu P, Hang S, Hashmi Y, Kaur T, Kawesha A, Kisiel A, Woodmass M, Adelowo T, Ahari D, Alhwaishel K, Atherton R, Clayton B, Cockroft A, Curtis Lopez C, Hilton M, Ismail N, Kouadria M, Lee L, MacConnachie A, Monks F, Mungroo S, Nikoletopoulou C, Pearce L, Sara X, Shahid A, Suresh G, Wilcha R, Atiyah A, Davies E, Dermanis A, Gibbons H, Hyde A, Lawson A, Lee C, Leung-Tack M, Li Saw Hee J, Mostafa O, Nair D, Pattani N, Plumbley-Jones J, Pufal K, Ramesh P, Sanghera J, Saram S, Scadding S, See S, Stringer H, Torrance A, Vardon H, Wyn-Griffiths F, Brew A, Kaur G, Soni D, Tickle A, Akbar Z, Appleyard T, Figg K, Jayawardena P, Johnson A, Kamran Siddiqui Z, Lacy-Colson J, Oatham R, Rowlands B, Sludden E, Turnbull C, Allin D, Ansar Z, Azeez Z, Dale VH, Garg J, Horner A, Jones S, Knight S, McGregor C, McKenna J, McLelland T, Packham-Smith A, Rowsell K, Spector-Hill I, Adeniken E, Baker J, Bartlett M, Chikomba L, Connell B, Deekonda P, Dhar M, Elmansouri A, Gamage K, Goodhew R, Hanna P, Knight J, Luca A, Maasoumi N, Mahamoud F, Manji S, Marwaha PK, Mason F, Oluboyede A, Pigott L, Razaq AM, Richardson M, Saddaoui I, Wijeyendram P, Yau S, Atkins W, Liang K, Miles N, Praveen B, Ashai S, Braganza J, Common J, Cundy A, Davies R, Guthrie J, Handa I, Iqbal M, Ismail R, Jones C, Jones I, Lee KS, Levene A, Okocha M, Olivier J, Smith A, Subramaniam E, Tandle S, Wang A, Watson A, Wilson C, Chan XHF, Khoo E, Montgomery C, Norris M, Pugalenthi PP, Common T, Cook E, Mistry H, Shinmar HS, Agarwal G, Bandyopadhyay S, Brazier B, Carroll L, Goede A, Harbourne A, Lakhani A, Lami M, Larwood J, Martin J, Merchant J, Pattenden S, Pradhan A, Raafat N, Rothwell E, Shammoon Y, Sudarshan R, Vickers E, Wingfield L, Ashworth I, Azizi S, Bhate R, Chowdhury T, Christou A, Davies L, Dwaraknath M, Farah Y, Garner J, Gureviciute E, Hart E, Jain A, Javid S, Kankam HK, Kaur Toor P, Kaz R, Kermali M, Khan I, Mattson A, McManus A, Murphy M, Nair K, Ngemoh D, Norton E, Olabiran A, Parry L, Payne T, Pillai K, Price S, Punjabi K, Raghunathan A, Ramwell A, Raza M, Ritehnia J, Simpson G, Smith W, Sodeinde S, Studd L, Subramaniam M, Thomas J, Towey S, Tsang E, Tuteja D, Vasani J, Vio M, Badran A, Adams J, Anthony Wilkinson J, Asvandi S, Austin T, Bald A, Bix E, Carrick M, Chander B, Chowdhury S, Cooper Drake B, Crosbie S, D Portela S, Francis D, Gallagher C, Gillespie R, Gravett H, Gupta P, Ilyas C, James G, Johny J, Jones A, Kinder F, MacLeod C, Macrow C, Maqsood-Shah A, Mather J, McCann L, McMahon R, Mitham E, Mohamed M, Munton E, Nightingale K, O'Neill K, Onyemuchara I, Senior R, Shanahan A, Sherlock J, Spyridoulias A, Stavrou C, Stokes D, Tamang R, Taylor E, Trafford C, Uden C, Waddington C, Yassin D, Zaman M, Bangi S, Cheng T, Chew D, Hussain N, Imani-Masouleh S, Mahasivam G, McKnight G, Ng HL, Ota HC, Pasha T, Ravindran W, Shah K, Vishnu K S, Zaman S, Carr W, Cope S, Eagles EJ, Howarth-Maddison M, Li CY, Reed J, Ridge A, Stubbs T, Teasdaled D, Umar R, Worthington J, Dhebri A, Kalenderov R, Alattas A, Arain Z, Bhudia R, Chia D, Daniel S, Dar T, Garland H, Girish M, Hampson A, Kyriacou H, Lehovsky K, Mullins W, Omorphos N, Vasdev N, Venkatesh A, Waldock W, Bhandari A, Brown G, Choa G, Eichenauer CE, Ezennia K, Kidwai Z, Lloyd-Thomas A, Macaskill Stewart A, Massardi C, Sinclair E, Skajaa N, Smith M, Tan I, Afsheen N, Anuar A, Azam Z, Bhatia P, Davies-kelly N, Dickinson S, Elkawafi M, Ganapathy M, Gupta S, Khoury EG, Licudi D, Mehta V, Neequaye S, Nita G, Tay VL, Zhao S, Botsa E, Cuthbert H, Elliott J, Furlepa M, Lehmann J, Mangtani A, Narayan A, Nazarian S, Parmar C, Shah D, Shaw C, Zhao Z, Beck C, Caldwell S, Clements JM, French B, Kenny R, Kirk S, Lindsay J, McClung A, McLaughlin N, Watson S, Whiteside E, Alyacoubi S, Arumugam V, Beg R, Dawas K, Garg S, Lloyd ER, Mahfouz Y, Manobharath N, Moonesinghe R, Morka N, Patel K, Prashar J, Yip S, Adeeko ES, Ajekigbe F, Bhat A, Evans C, Farrugia A, Gurung C, Long T, Malik B, Manirajan S, Newport D, Rayer J, Ridha A, Ross E, Saran T, Sinker A, Waruingi D, Allen R, Al Sadek Y, Alves do Canto Brum H, Asharaf H, Ashman M, Balakumar V, Barrington J, Baskaran R, Berry A, Bhachoo H, Bilal A, Boaden L, Chia WL, Covell G, Crook D, Dadnam F, Davis L, De Berker H, Doyle C, Fox C, Gruffydd-Davies M, Hafouda Y, Hill A, Hubbard E, Hunter A, Inpadhas V, Jamshaid M, Jandu G, Jeyanthi M, Jones T, Kantor C, Kwak SY, Malik N, Matt R, McNulty P, Miles C, Mohomed A, Myat P, Niharika J, Nixon A, O'Reilly D, Parmar K, Pengelly S, Price L, Ramsden M, Turnor R, Wales E, Waring H, Wu M, Yang T, Ye TTS, Zander A, Zeicu C, Bellam S, Francombe J, Kawamoto N, Rahman MR, Sathyanarayana A, Tang HT, Cheung J, Hollingshead J, Page V, Sugarman J, Wong E, Chiong J, Fung E, Kan SY, Kiang J, Kok J, Krahelski O, Liew MY, Lyell B, Sharif Z, Speake D, Alim L, Amakye NY, Chandrasekaran J, Chandratreya N, Drake J, Owoso T, Thu YM, Abou El Ela Bourquin B, Alberts J, Chapman D, Rehnnuma N, Ainsworth K, Carpenter H, Emmanuel T, Fisher T, Gabrel M, Guan Z, Hollows S, Hotouras A, Ip Fung Chun N, Jaffer S, Kallikas G, Kennedy N, Lewinsohn B, Liu FY, Mohammed S, Rutherfurd A, Situ T, Stammer A, Taylor F, Thin N, Urgesi E, Zhang N, Ahmad MA, Bishop A, Bowes A, Dixit A, Glasson R, Hatta S, Hatt K, Larcombe S, Preece J, Riordan E, Fegredo D, Haq MZ, Li C, McCann G, Stewart D, Baraza W, Bhullar D, Burt G, Coyle J, Deans J, Devine A, Hird R, Ikotun O, Manchip G, Ross C, Storey L, Tan WWL, Tse C, Warner C, Whitehead M, Wu F, Court EL, Crisp E, Huttman M, Mayes F, Robertson H, Rosen H, Sandberg C, Smith H, Al Bakry M, Ashwell W, Bajaj S, Bandyopadhyay D, Browlee O, Burway S, Chand CP, Elsayeh K, Elsharkawi A, Evans E, Ferrin S, Fort-Schaale A, Iacob M, I K, Impelliziere Licastro G, Mankoo AS, Olaniyan T, Otun J, Pereira R, Reddy R, Saeed D, Simmonds O, Singhal G, Tron K, Wickstone C, Williams R, Bradshaw E, De Kock Jewell V, Houlden C, Knight C, Metezai H, Mirza-Davies A, Seymour Z, Spink D, Wischhusen S. Evaluation of prognostic risk models for postoperative pulmonary complications in adult patients undergoing major abdominal surgery: a systematic review and international external validation cohort study. Lancet Digit Health 2022; 4:e520-e531. [PMID: 35750401 DOI: 10.1016/s2589-7500(22)00069-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2021] [Revised: 01/07/2022] [Accepted: 04/06/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Stratifying risk of postoperative pulmonary complications after major abdominal surgery allows clinicians to modify risk through targeted interventions and enhanced monitoring. In this study, we aimed to identify and validate prognostic models against a new consensus definition of postoperative pulmonary complications. METHODS We did a systematic review and international external validation cohort study. The systematic review was done in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We searched MEDLINE and Embase on March 1, 2020, for articles published in English that reported on risk prediction models for postoperative pulmonary complications following abdominal surgery. External validation of existing models was done within a prospective international cohort study of adult patients (≥18 years) undergoing major abdominal surgery. Data were collected between Jan 1, 2019, and April 30, 2019, in the UK, Ireland, and Australia. Discriminative ability and prognostic accuracy summary statistics were compared between models for the 30-day postoperative pulmonary complication rate as defined by the Standardised Endpoints in Perioperative Medicine Core Outcome Measures in Perioperative and Anaesthetic Care (StEP-COMPAC). Model performance was compared using the area under the receiver operating characteristic curve (AUROCC). FINDINGS In total, we identified 2903 records from our literature search; of which, 2514 (86·6%) unique records were screened, 121 (4·8%) of 2514 full texts were assessed for eligibility, and 29 unique prognostic models were identified. Nine (31·0%) of 29 models had score development reported only, 19 (65·5%) had undergone internal validation, and only four (13·8%) had been externally validated. Data to validate six eligible models were collected in the international external validation cohort study. Data from 11 591 patients were available, with an overall postoperative pulmonary complication rate of 7·8% (n=903). None of the six models showed good discrimination (defined as AUROCC ≥0·70) for identifying postoperative pulmonary complications, with the Assess Respiratory Risk in Surgical Patients in Catalonia score showing the best discrimination (AUROCC 0·700 [95% CI 0·683-0·717]). INTERPRETATION In the pre-COVID-19 pandemic data, variability in the risk of pulmonary complications (StEP-COMPAC definition) following major abdominal surgery was poorly described by existing prognostication tools. To improve surgical safety during the COVID-19 pandemic recovery and beyond, novel risk stratification tools are required. FUNDING British Journal of Surgery Society.
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Malley T, Jackman J, Manderson S, Saldana Pena L, Evans E, Barrett J, Soni A, Luqmani R. POS0152-HPR REMOTE CLINICAL MANAGEMENT: INCORPORATING ELECTRONIC ASSESSMENT OF PATIENTS WITH RHEUMATIC DISEASES INTO STANDARD CLINICAL PATHWAYS DURING THE COVID-19 PANDEMIC: A PILOT STUDY. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.309] [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: 11/03/2022]
Abstract
Background:Many patients with rheumatic disease require immunosuppressive medication putting them at high risk of COVID-19 infection. Reduced staffing in rheumatology due to redeployment to COVID-19 work, limited out patient capacity and patient vulnerability have had a major impact on our ability to review our patients to assess their condition and treatment (by face-to-face, video or telephone consultations). Novel strategies are essential to safely and effectively treat patients with rheumatic disease whilst minimising their risk of exposure to COVID-19 infection.Objectives:The objective was to develop a digital solution to help deliver safe, efficient and effective care for patients with rheumatic diseases. The aim was to produce a system that allowed us to integrate data recorded directly by patients with information held in our electronic health records to provide a virtual review of care.Methods:An online questionnaire was used to collect clinical information, including validated disease activity measures, to conduct a remote assessment in 175 patients awaiting follow-up appointments. This assessment was integrated within our electronic health records (EHR). The questionnaire contained measures of disease activity (DAS28 or BASDAI); patient reported outcomes; patient preferences regarding the urgency and type of appointment; any recent problems or changes in medication. This information was imported into a database for clinician review, together with previous clinical records and results of relevant investigations, to inform clinical decisions and to decide on the safest and most appropriate timing for follow-up. Report letters were sent to the patient and their primary care providers.Results:Of the 175 patients (149 with RA and 26 with AS), 108 patients (89/149 [60%] with RA [mean age=64; female=65%] and 19/26 [73%] with AS [mean age=45; female=54%]) submitted responses over a 6-week period based on which clinical decisions were made. The mean questionnaire completion time was 19 minutes for RA responders and 16 minutes for AS responders. Non responders (67/175 [mean age=61; female=63%]) remained on our list of patients awaiting follow-up arrangements to be made. Sixty-nine responders (64%) had stable disease therefore did not require any changes to their treatment and were offered an appointment within the next 6 months, of whom 12 (11%) requested face-to-face follow-up. Of the remaining 39 – with less stable disease – requiring more rapid follow-up assessment, 22 patients (56%) required a face-to-face consultation to consider treatment change. So far 9 of these patients have had follow-up, of whom 6 necessitated treatment escalation (Methotrexate increase n=2; anti-inflammatory increase n=2; intramuscular steroid n=1; anti-TNF escalation n=1). Thirty-nine patients (36%) provided feedback on the process of completing the questionnaire, 85% of whom used a mobile phone and the remainder used a computer or tablet. The majority (70%) found it “extremely easy” or “somewhat easy” to complete; remaining responses: “neutral” 20%, “somewhat difficult” 10%, “extremely difficult” 0%.Conclusion:We have created and tested a system of remote clinical management for patients with RA and AS. Amongst the 108 responders, just 31% required a face-to-face appointment, with treatment changes made accordingly. With a backlog of 3,800 awaiting allocation to follow-up appointments, remote clinical management will allow us to safely and efficiently prioritise patients requiring urgent follow-up for treatment optimisation. We will integrate this system into our standard care pathway beyond the COVID-19 pandemic to streamline our service, deliver effective care and provide evidence to support the use of costly biologic drugs.1 We plan to investigate the barriers for non-responders.References:[1]Holroyd CR, Seth R, Bukhari M, et al. The British Society for Rheumatology biologic DMARD safety guidelines in inflammatory arthritis. Rheumatology. 2019; 58 (2): e3–e42.Disclosure of Interests:Tamir Malley: None declared, John Jackman: None declared, Sarah Manderson: None declared, Larissa Saldana Pena Grant/research support from: Pfizer’s Global Medical Grants program, Ellie Evans: None declared, Joe Barrett Grant/research support from: Pfizer’s Global Medical Grants program, Anushka Soni Grant/research support from: Pfizer’s Global Medical Grants program, Raashid Luqmani Grant/research support from: Pfizer’s Global Medical Grants program
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Robson M, Evans E. P.114 Survey of current practices for stopping clear fluids before an elective caesarean birth. Int J Obstet Anesth 2021. [DOI: 10.1016/j.ijoa.2021.103112] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Abstract
Chronic pelvic pain represents a major public health problem for women and impacts significantly on their quality of life. Yet it is under-researched and a challenge to manage. Women who suffer from chronic pelvic pain frequently describe their healthcare journey as long, via a variety of specialists and frustrating, with their pain often dismissed. Aetiological factors and associations are best conceptualised using the 'three P's' model of predisposing, precipitating and perpetuating factors. This integrates the numerous biological, psychological and social contributors to the complex, multifactorial nature of chronic pelvic pain. Overall management involves analgesia, hormonal therapies, physiotherapy, psychological approaches and lifestyle advice, which like other chronic pain conditions relies on a multidisciplinary team approach delivered by professionals experienced and trained in managing chronic pelvic pain.
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Affiliation(s)
- K Vincent
- Nuffield Department of Women's and Reproductive Health, University of Oxford, Oxford, UK
| | - E Evans
- Department of Gynaecology, Oxford University Foundation Hospitals Trust, Oxford, UK
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Piazzese C, Evans E, Spezi E, Staffurth J, Gwynne S. PO-1937: A new software for advanced education and assessment of tumour volume delineation in radiotherapy. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)01954-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: 10/22/2022]
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McLean KA, Ahmed WUR, Akhbari M, Claireaux HA, English C, Frost J, Henshall DE, Khan M, Kwek I, Nicola M, Rehman S, Varghese S, Drake TM, Bell S, Nepogodiev D, McLean KA, Drake TM, Glasbey JC, Borakati A, Drake TM, Kamarajah S, McLean KA, Bath MF, Claireaux HA, Gundogan B, Mohan M, Deekonda P, Kong C, Joyce H, Mcnamee L, Woin E, Burke J, Khatri C, Fitzgerald JE, Harrison EM, Bhangu A, Nepogodiev D, Arulkumaran N, Bell S, Duthie F, Hughes J, Pinkney TD, Prowle J, Richards T, Thomas M, Dynes K, Patel M, Patel P, Wigley C, Suresh R, Shaw A, Klimach S, Jull P, Evans D, Preece R, Ibrahim I, Manikavasagar V, Smith R, Brown FS, Deekonda P, Teo R, Sim DPY, Borakati A, Logan AE, Barai I, Amin H, Suresh S, Sethi R, Bolton W, Corbridge O, Horne L, Attalla M, Morley R, Robinson C, Hoskins T, McAllister R, Lee S, Dennis Y, Nixon G, Heywood E, Wilson H, Ng L, Samaraweera S, Mills A, Doherty C, Woin E, Belchos J, Phan V, Chouari T, Gardner T, Goergen N, Hayes JDB, MacLeod CS, McCormack R, McKinley A, 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Livesey C, McLachlan G, Mohammad M, Pranesh N, Richards C, Ross F, Sajid M, Brooke M, Francombe J, Gresly J, Hutchinson S, Kerrigan K, Matthews E, Nur S, Parsons L, Sandhu A, Vyas M, White F, Zulkifli A, Zuzarte L, Al-Mousawi A, Arya J, Azam S, Yahaya AA, Gill K, Hallan R, Hathaway C, Leptidis I, McDonagh L, Mitrasinovic S, Mushtaq N, Pang N, Peiris GB, Rinkoff S, Chan L, Christopher E, Farhan-Alanie MMH, Gonzalez-Ciscar A, Graham CJ, Lim H, McLean KA, Paterson HM, Rogers A, Roy C, Rutherford D, Smith F, Zubikarai G, Al-Khudairi R, Bamford M, Chang M, Cheng J, Hedley C, Joseph R, Mitchell B, Perera S, Rothwell L, Siddiqui A, Smith J, Taylor K, Wright OW, Baryan HK, Boyd G, Conchie H, Cox L, Davies J, Gardner S, Hill N, Krishna K, Lakin F, Scotcher S, Alberts J, Asad M, Barraclough J, Campbell A, Marshall D, Wakeford W, Cronbach P, D'Souza F, Gammeri E, Houlton J, Hall M, Kethees A, Patel R, Perera M, Prowle J, Shaid M, Webb E, Beattie S, Chadwick M, El-Taji O, Haddad S, Mann M, Patel M, Popat K, Rimmer L, Riyat H, Smith H, Anandarajah C, Cipparrone M, Desai K, Gao C, Goh ET, Howlader M, Jeffreys N, Karmarkar A, Mathew G, Mukhtar H, Ozcan E, Renukanthan A, Sarens N, Sinha C, Woolley A, Bogle R, Komolafe O, Loo F, Waugh D, Zeng R, Crewe A, Mathias J, Mills A, Owen A, Prior A, Saunders I, Baker A, Crilly L, McKeon J, Ubhi HK, Adeogun A, Carr R, Davison C, Devalia S, Hayat A, Karsan RB, Osborne C, Scott K, Weegenaar C, Wijeyaratne M, Babatunde F, Barnor-Ahiaku E, Beattie G, Chitsabesan P, Dixon O, Hall N, Ilenkovan N, Mackrell T, Nithianandasivam N, Orr J, Palazzo F, Saad M, Sandland-Taylor L, Sherlock J, Ashdown T, Chandler S, Garsaa T, Lloyd J, Loh SY, Ng S, Perkins C, Powell-Chandler A, Smith F, Underhill R. Perioperative intravenous contrast administration and the incidence of acute kidney injury after major gastrointestinal surgery: prospective, multicentre cohort study. Br J Surg 2020; 107:1023-1032. [PMID: 32026470 DOI: 10.1002/bjs.11453] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Revised: 09/21/2019] [Accepted: 11/08/2019] [Indexed: 01/14/2023]
Abstract
BACKGROUND This study aimed to determine the impact of preoperative exposure to intravenous contrast for CT and the risk of developing postoperative acute kidney injury (AKI) in patients undergoing major gastrointestinal surgery. METHODS This prospective, multicentre cohort study included adults undergoing gastrointestinal resection, stoma reversal or liver resection. Both elective and emergency procedures were included. Preoperative exposure to intravenous contrast was defined as exposure to contrast administered for the purposes of CT up to 7 days before surgery. The primary endpoint was the rate of AKI within 7 days. Propensity score-matched models were adjusted for patient, disease and operative variables. In a sensitivity analysis, a propensity score-matched model explored the association between preoperative exposure to contrast and AKI in the first 48 h after surgery. RESULTS A total of 5378 patients were included across 173 centres. Overall, 1249 patients (23·2 per cent) received intravenous contrast. The overall rate of AKI within 7 days of surgery was 13·4 per cent (718 of 5378). In the propensity score-matched model, preoperative exposure to contrast was not associated with AKI within 7 days (odds ratio (OR) 0·95, 95 per cent c.i. 0·73 to 1·21; P = 0·669). The sensitivity analysis showed no association between preoperative contrast administration and AKI within 48 h after operation (OR 1·09, 0·84 to 1·41; P = 0·498). CONCLUSION There was no association between preoperative intravenous contrast administered for CT up to 7 days before surgery and postoperative AKI. Risk of contrast-induced nephropathy should not be used as a reason to avoid contrast-enhanced CT.
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Simpson P, McCart Reed A, Kutasovic J, Coorey C, Kuo L, Nguyen H, Pei W, Ong J, Sokolova A, Evans E, Porter A, Lakhani S. 52P Characterising clinicopathological and biological parameters predictive of outcome for patients diagnosed with invasive lobular carcinoma. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.03.186] [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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11
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Robson M, Higgins N, Evans E. Anaesthetic management of emergency caesarean section with isolated cortical vein thrombosis and subacute intracerebral haemorrhage. Anaesth Rep 2020; 8:44-47. [DOI: 10.1002/anr3.12046] [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] [Accepted: 05/03/2020] [Indexed: 11/06/2022] Open
Affiliation(s)
- M. Robson
- St George’s University Hospitals NHS Foundation Trust London UK
| | - N. Higgins
- St George’s University Hospitals NHS Foundation Trust London UK
| | - E. Evans
- St George’s University Hospitals NHS Foundation Trust London UK
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12
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Evans E, Hu W, Cao F, Hoeflich K, Dorsch M. P2.03-44 BLU-667 Demonstrates Robust Activity in RET Fusion-Driven Intracranial Tumor Models. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.1491] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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13
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Guha M, Ji C, Zhu X, Whritenour J, Hemkens M, Tse S, Walker G, Evans E, Khan N, Finkelstein M, Callegari E, Obach R. Enzalutamide (ENZA) and apalutamide (APA) In vitro chemical reactivity studies and activity in a mouse drug allergy model (MDAM). Ann Oncol 2019. [DOI: 10.1093/annonc/mdz268.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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14
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Ji C, Guha M, Zhu X, Whritenour J, Hemkens M, Tse S, Walker GS, Evans E, Khan NK, Finkelstein MB, Callegari E, Obach RS. Enzalutamide and Apalutamide: In Vitro Chemical Reactivity Studies and Activity in a Mouse Drug Allergy Model. Chem Res Toxicol 2019; 33:211-222. [DOI: 10.1021/acs.chemrestox.9b00247] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Affiliation(s)
- Changhua Ji
- Drug Safety Research and Development, Pfizer Inc., La Jolla, California 92037, United States
| | - Mausumee Guha
- Drug Safety Research and Development, Pfizer Inc., La Jolla, California 92037, United States
| | - Xu Zhu
- Drug Safety Research and Development, Pfizer Inc., Groton, Connecticut 06340, United States
| | - Jessica Whritenour
- Drug Safety Research and Development, Pfizer Inc., Groton, Connecticut 06340, United States
| | - Michelle Hemkens
- Drug Safety Research and Development, Pfizer Inc., La Jolla, California 92037, United States
| | - Susanna Tse
- Pharmacokinetics, Dynamics, and Drug Metabolism, Pfizer Inc., Groton, Connecticut 06340, United States
| | - Gregory S. Walker
- Pharmacokinetics, Dynamics, and Drug Metabolism, Pfizer Inc., Groton, Connecticut 06340, United States
| | - Ellen Evans
- Drug Safety Research and Development, Pfizer Inc., Groton, Connecticut 06340, United States
| | - Nasir K. Khan
- Drug Safety Research and Development, Pfizer Inc., Pearl River, New York 10965, United States
| | - Martin B. Finkelstein
- Drug Safety Research and Development, Pfizer Inc., Pearl River, New York 10965, United States
| | - Ernesto Callegari
- Pharmacokinetics, Dynamics, and Drug Metabolism, Pfizer Inc., Groton, Connecticut 06340, United States
| | - R. Scott Obach
- Pharmacokinetics, Dynamics, and Drug Metabolism, Pfizer Inc., Groton, Connecticut 06340, United States
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15
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Essel K, Vetter M, Doo D, Greenwade M, Vesely S, Evans E, Strope B, Opara G, Powell M, Arend R, Salani R, Moore K. Prognostic factors associated with survival following platinum based therapy in advanced/recurrent endometrial cancer. Gynecol Oncol 2019. [DOI: 10.1016/j.ygyno.2019.03.212] [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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16
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Sokolowski C, Higgins S, Vishwanathan M, Schmidt M, Lewis R, Evans E. Associations Among Dietary Protein Intake, Physical Activity, and Muscle Quality in Young Adults. Med Sci Sports Exerc 2019. [DOI: 10.1249/01.mss.0000562140.95871.d8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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17
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Salyer R, Frederick G, Reed R, Berg A, Straight C, Brady A, Higgins L, Evans E. Can A Simple Transfer Task Predict Lower-extremity Physical Function As Measured By Standardized Clinical Measures? Med Sci Sports Exerc 2019. [DOI: 10.1249/01.mss.0000563351.23524.6c] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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18
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Erickson JE, Fedewa M, Hathaway E, Higgins S, Evans E, Schmidt M. Utility of Anthropometric Indices to Estimate Changes in Adiposity in Response to an Exercise Intervention. Med Sci Sports Exerc 2019. [DOI: 10.1249/01.mss.0000563233.48182.6a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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19
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Evans E, Radhakrishna G, Gilson D, Hoskin P, Miles E, Yuille F, Dickson J, Gwynne S. Target Volume Delineation Training for Clinical Oncology Trainees: The Role of ARENA and COPP. Clin Oncol (R Coll Radiol) 2019; 31:341-343. [DOI: 10.1016/j.clon.2019.03.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2018] [Accepted: 02/19/2019] [Indexed: 11/25/2022]
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20
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Essel K, Vetter M, Doo D, Greenwade M, Machiorlatti M, Evans E, Strope B, Opara G, Vesely S, Powell M, Arend R, Salani R, Moore K. Prognostic factors associated with survival following platinum-based therapy in advanced/recurrent endometrial cancer. Gynecol Oncol 2019. [DOI: 10.1016/j.ygyno.2019.04.550] [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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21
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Essel K, Behbakht K, Lai T, Hand L, Evans E, Dvorak J, Ding K, Konecny G, Moore K. PARPi after PARPi in epithelial ovarian cancer. Gynecol Oncol 2019. [DOI: 10.1016/j.ygyno.2019.04.022] [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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22
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Doo D, Essel K, Vetter M, Machiorlatti M, Evans E, Strope B, Vesely S, Powell M, Salani R, Moore K, Arend R. The effect of adjuvant therapy for high intermediate-risk endometrial cancer on patients with recurrent disease. Gynecol Oncol 2019. [DOI: 10.1016/j.ygyno.2019.03.120] [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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23
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Abstract
Inflammation is a complex and necessary component of the response to biological, chemical, or physical stimuli, and the cellular and molecular events that initiate and regulate the interactions between the various players in the inflammatory process remain a source of ongoing investigation. In the acute phase of the inflammatory response, cells of the immune system migrate to the site of injury in a carefully orchestrated sequence of events that is facilitated by soluble mediators such as cytokines, chemokines, and acute-phase proteins. Depending on the degree of injury, this acute phase may be sufficient to resolve the damage and initiate healing processes. Persistent inflammation, either as a result of prolonged exposure to stimulation or an inappropriate reaction against self-molecules, can lead to the chronic phase, in which tissue damage and fibrosis can occur. Chronic inflammation has been reported to contribute to numerous diseases, including arthritis, asthma, atherosclerosis, autoimmune diseases, diabetes, and cancer, and to conditions of aging. Hematology and clinical chemistry data from standard toxicology studies can provide an initial indication of the presence and sometimes the location of inflammation. These data may suggest more specific immune function assays that are necessary to determine the presence and/or mechanism(s) of immunomodulation. Although changes in hematology dynamics, acute-phase proteins, complement factors, and cytokines are common to virtually all inflammatory conditions, and can be measured by a variety of techniques, individual biomarkers have yet to be strongly associated with specific pathologic events. Thus, although sensitive indicators of inflammation, these factors generally lack the specificity to identify the offending cause. The profile seen in a given inflammatory condition is dependent on the severity, chronicity, and mechanisms involved in the inflammatory process, as well as the species and the capacity of the individual's immune system to respond and adapt.
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Affiliation(s)
- Dori R Germolec
- Toxicology Branch, National Toxicology Program, National Institute of Environmental Health Sciences, Research Triangle Park, NC, USA.
| | - Kelly A Shipkowski
- Toxicology Branch, National Toxicology Program, National Institute of Environmental Health Sciences, Research Triangle Park, NC, USA
| | - Rachel P Frawley
- Toxicology Branch, National Toxicology Program, National Institute of Environmental Health Sciences, Research Triangle Park, NC, USA
| | - Ellen Evans
- Immunotoxicology Center of Emphasis, Pfizer, Inc., Groton, CT, USA
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24
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Hillier NK, Evans E, Evans RC. Novel Insect Florivory Strategy Initiates Autogamy in Unopened Allogamous Flowers. Sci Rep 2018; 8:17077. [PMID: 30459317 PMCID: PMC6244157 DOI: 10.1038/s41598-018-35191-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2018] [Accepted: 10/26/2018] [Indexed: 11/29/2022] Open
Abstract
Insects may influence plant development via pollination, galling, and a range of herbivorous interactions, including florivory. Here, we report a novel form of insect-plant interaction in the form of florivory-initiated autogamy. Mompha capella larvae, feeding on petal bases of Crocanthemum canadense before flowers open, while providing no benefit to the plant, cause autogamy and subsequent seed and fruit development. This interaction provides a clear benefit to the florivore because it enters the developing fruit and consumes most seeds; however, surviving seeds are viable. This novel interaction is discussed with respect to the dimorphic cleistogamous reproduction employed by this plant species. Moreover, this represents a previously undocumented insect-plant interaction in the form of a florivory-initiated pollination.
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Affiliation(s)
| | - E Evans
- Acadia University, Wolfville, NS, Canada
| | - R C Evans
- Acadia University, Wolfville, NS, Canada
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25
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Klein AA, Evans E. Association of Anaesthetists guidelines on cell salvage: a reply. Anaesthesia 2018; 73:1577. [PMID: 30412296 DOI: 10.1111/anae.14492] [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: 11/28/2022]
Affiliation(s)
- A A Klein
- Royal Papworth Hospital, Cambridge, UK
| | - E Evans
- St George's University Hospitals NHS Foundation Trust, London, UK
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26
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DiBenedetti D, Meckley L, Evans E. DEVELOPMENT OF A PATIENT-REPORTED OUTCOME MEASURING PATIENTS’ EXPERIENCE WITH IMMUNOGLOBULIN TREATMENT. Ann Allergy Asthma Immunol 2018. [DOI: 10.1016/j.anai.2018.09.154] [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]
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27
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Piotrowska Z, Isozaki H, Lennerz J, Digumarthy S, Gainor J, Marcoux N, Banwait M, Dias-Santagata D, Iafrate A, Mino-Kenudson M, Nagy R, Lanman R, Evans E, Clifford C, Wolf B, Hata A, Sequist L. MA26.03 Activity of Osimertinib and the Selective RET Inhibitor BLU-667 in an EGFR-Mutant Patient with Acquired RET Rearrangement. J Thorac Oncol 2018. [DOI: 10.1016/j.jtho.2018.08.540] [Citation(s) in RCA: 1] [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: 11/26/2022]
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28
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Affiliation(s)
- E. S. Chapman
- Department of Biology, Allengheny College, Meadville, Pennsylvania 16335
| | - E. Evans
- Department of Biology, Allengheny College, Meadville, Pennsylvania 16335
| | - M. C. Jacobelli
- Department of Biology, Allengheny College, Meadville, Pennsylvania 16335
| | - A. A. Logan
- Department of Biology, Allengheny College, Meadville, Pennsylvania 16335
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29
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Klein AA, Bailey CR, Charlton AJ, Evans E, Guckian-Fisher M, McCrossan R, Nimmo AF, Payne S, Shreeve K, Smith J, Torella F. Association of Anaesthetists guidelines: cell salvage for peri-operative blood conservation 2018. Anaesthesia 2018; 73:1141-1150. [DOI: 10.1111/anae.14331] [Citation(s) in RCA: 79] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/20/2018] [Indexed: 01/03/2023]
Affiliation(s)
- A. A. Klein
- Department of Anaesthesia and Intensive Care; Royal Papworth Hospital; Cambridge UK
| | - C. R. Bailey
- Department of Anaesthesia, Guys and St; Thomas' NHS Foundation Trust; London UK
| | - A. J. Charlton
- NHS Blood and Transplant; Newcastle upon Tyne NHS Foundation Trust; Newcastle UK
| | - E. Evans
- Department of Obstetric Anaesthesia; St George's University Hospitals NHS Foundation Trust; London UK
| | - M. Guckian-Fisher
- Immediate Past President; The Association for Peri-operative Practice (AFPP); UK
| | - R. McCrossan
- Northern School of Anaesthesia; Royal Victoria Infirmary; Newcastle upon Tyne NHS Foundation Trust; Newcastle UK
| | - A. F. Nimmo
- Department of Anaesthesia; Royal Infirmary of Edinburgh; Edinburgh UK
| | | | - K. Shreeve
- Better Blood Transfusion Team; Welsh Blood Service; Co-chair of UK Cell Salvage Action Group; UK
| | - J. Smith
- Department of Paediatric Cardiothoracic Anaesthesia and Intensive Care; Freeman Hospital; Newcastle upon Tyne NHS Foundation Trust; Newcastle UK
| | - F. Torella
- Liverpool Vascular and Endovascular Service; Liverpool UK
- School of Physical Sciences; University of Liverpool; Liverpool UK
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30
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31
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Evans E, Brain S, Philpott M, Caton P, Hannen R. 1005 The skin: A new player in the control of whole-body glucose homeostasis. J Invest Dermatol 2018. [DOI: 10.1016/j.jid.2018.03.1017] [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: 10/17/2022]
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32
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Dawe H, Wendler R, Evans E, Hammond S. Peripartum anaesthetic management of a patient with Brugada syndrome and myoadenylate deaminase deficiency. Int J Obstet Anesth 2018; 35:96-98. [PMID: 29655994 DOI: 10.1016/j.ijoa.2018.02.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [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: 05/20/2017] [Revised: 02/21/2018] [Accepted: 02/23/2018] [Indexed: 11/27/2022]
Abstract
Brugada syndrome is a rare electrophysiological cardiac disease which can result in serious arrhythmias and sudden cardiac death. Peripartum management is centred around avoiding arrhythmogenic drugs, including high doses of sodium channel blocking drugs such as bupivacaine. Myoadenylate deaminase deficiency, also known as adenosine monophosphate deaminase deficiency, is the commonest cause of myopathy in Caucasians. There is evidence that myoadenylate deaminase deficiency can predispose patients to developing malignant hyperthermia when exposed to specific anaesthetic agents. We present a case of a pregnant patient with both Brugada syndrome and myoadenylate deaminase deficiency, in which analgesic and general anaesthetic options for each condition presented potentially conflicting dilemmas for the delivery of intrapartum care.
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Affiliation(s)
- H Dawe
- St George's Hospital, London, United Kingdom.
| | - R Wendler
- St George's Hospital, London, United Kingdom
| | - E Evans
- St George's Hospital, London, United Kingdom
| | - S Hammond
- St George's Hospital, London, United Kingdom
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33
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Gooding M, Smith A, Peressutti D, Aljabar P, Evans E, Gwynne S, Hammer C, Meijer H, Speight R, Welgemoed C, Lustberg T, Van Soest J, Dekker A, Van Elmpt W. PV-0531: Multi-centre evaluation of atlas-based and deep learning contouring using a modified Turing Test. Radiother Oncol 2018. [DOI: 10.1016/s0167-8140(18)30841-7] [Citation(s) in RCA: 1] [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: 10/14/2022]
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34
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Evans E, Jones G, Rackley T, Maggs R, Radhakrishna G, Mukherjee S, Hawkins M, Crosby T, Gwynne S. PO-0769: NeoSCOPE RTTQA: pre-accrual and on-trial review of all patients in a UK oesophageal RT trial. Radiother Oncol 2018. [DOI: 10.1016/s0167-8140(18)31079-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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35
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Stewart K, Evans E, Singh V. Introduction of an ENT Nurse Led Clinic: A Joint Community & Secondary Care Project. Int J Surg 2017. [DOI: 10.1016/j.ijsu.2017.08.246] [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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36
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Beauchamp K, Grauman P, Hogan G, Haas K, Gould G, Wong K, Lazarin G, Evans E, Muzzey D. Copy number variant calling on a 177 gene expanded carrier screening panel reveals impact of hbb deletions. Fertil Steril 2017. [DOI: 10.1016/j.fertnstert.2017.07.836] [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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37
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McCart Reed AE, Kutasovic JR, Nones K, da Silva L, Melville L, Jayanthan J, Vargas AC, Reid LE, Saunus JM, Cummings MM, Porter A, Evans E, Waddell N, Lakhani SR, Simpson PT. Abstract P1-07-08: Mixed ductal-lobular carcinomas of the breast: Abrogated cell adhesion in the clonal evolution from ductal to lobular morphology. Cancer Res 2017. [DOI: 10.1158/1538-7445.sabcs16-p1-07-08] [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
Mixed ductal-lobular carcinomas (MDL) display both ductal and lobular morphology, and are a clear example of intratumour morphological heterogeneity. The evolution of MDL carcinomas is not well understood. There is a paucity of data surrounding the genetic origin of the different morphological compartments and it remains to be seen whether the coincident presentation of these distinct morphological entities represents two independent tumours that have collided (so called 'collision tumours'), or whether they arise from a common clone. We propose that clonal progression during the evolution of these tumours is associated with a change in phenotype. To address this, a cohort of 82 MDLs was studied for clinical, morphological and molecular features. Key findings include: i) MDLs more frequently co-exist with ductal carcinoma in situ (DCIS) than lobular carcinoma in situ (LCIS); ii) the E-cadherin-catenin complex was recurrently normal in the ductal component but aberrantly localised in the lobular component of the same tumour; iii) E-cadherin deregulation in the lobular component was almost always aberrantly located to the cytoplasm, conversely classic ILCs are typically completely negative for this molecule; iv) epithelial to mesenchymal transition marker expression was not associated with E-cadherin deregulation. Comparative Genomic Hybridsation (CGH) and exome sequencing was performed to investigate clonal relationships between the different intratumour morphologies and identify mechanisms underlying the change in phenotype. Our analysis revealed that i) all morphological components within a case are clonally related; ii) divergence of the morphological components may occur early during tumour evolution (where both DCIS and LCIS are present) or later during tumour progression (cases with only DCIS detectible); and iii) mutations were identified in genes such as CDH1 and ESR1, and other breast cancer driver genes. Together, these data strongly support the concept that the disparate morphological components of these mixed tumours are clonally related, and are not the result of a collision event. Furthermore, we show that lobular morphology can arise via a 'ductal' pathway of tumour progression. The mechanisms driving the change in phenotype are yet to be fully elucidated, but there is significant intertumour heterogeneity and each case may utilise a unique molecular mechanism.
Citation Format: McCart Reed AE, Kutasovic JR, Nones K, da Silva L, Melville L, Jayanthan J, Vargas AC, Reid LE, Saunus JM, Cummings MM, Porter A, Evans E, Waddell N, Lakhani SR, Simpson PT. Mixed ductal-lobular carcinomas of the breast: Abrogated cell adhesion in the clonal evolution from ductal to lobular morphology [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P1-07-08.
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Affiliation(s)
- AE McCart Reed
- The University of Queensland, UQ Centre for Clinical Research, Brisbane, QLD, Australia; QIMR Clive Berghofer Medical Research Institute, Brisbane, QLD, Australia; Pathology Queensland, The Royal Brisbane and Women's Hospital, Brisbane, QLD, Australia; The University of Queensland, School of Medicine, Brisbane, QLD, Australia; The Wesley Breast Clinic, The Wesley Hospital, Brisbane, Brisbane, QLD, Australia
| | - JR Kutasovic
- The University of Queensland, UQ Centre for Clinical Research, Brisbane, QLD, Australia; QIMR Clive Berghofer Medical Research Institute, Brisbane, QLD, Australia; Pathology Queensland, The Royal Brisbane and Women's Hospital, Brisbane, QLD, Australia; The University of Queensland, School of Medicine, Brisbane, QLD, Australia; The Wesley Breast Clinic, The Wesley Hospital, Brisbane, Brisbane, QLD, Australia
| | - K Nones
- The University of Queensland, UQ Centre for Clinical Research, Brisbane, QLD, Australia; QIMR Clive Berghofer Medical Research Institute, Brisbane, QLD, Australia; Pathology Queensland, The Royal Brisbane and Women's Hospital, Brisbane, QLD, Australia; The University of Queensland, School of Medicine, Brisbane, QLD, Australia; The Wesley Breast Clinic, The Wesley Hospital, Brisbane, Brisbane, QLD, Australia
| | - L da Silva
- The University of Queensland, UQ Centre for Clinical Research, Brisbane, QLD, Australia; QIMR Clive Berghofer Medical Research Institute, Brisbane, QLD, Australia; Pathology Queensland, The Royal Brisbane and Women's Hospital, Brisbane, QLD, Australia; The University of Queensland, School of Medicine, Brisbane, QLD, Australia; The Wesley Breast Clinic, The Wesley Hospital, Brisbane, Brisbane, QLD, Australia
| | - L Melville
- The University of Queensland, UQ Centre for Clinical Research, Brisbane, QLD, Australia; QIMR Clive Berghofer Medical Research Institute, Brisbane, QLD, Australia; Pathology Queensland, The Royal Brisbane and Women's Hospital, Brisbane, QLD, Australia; The University of Queensland, School of Medicine, Brisbane, QLD, Australia; The Wesley Breast Clinic, The Wesley Hospital, Brisbane, Brisbane, QLD, Australia
| | - J Jayanthan
- The University of Queensland, UQ Centre for Clinical Research, Brisbane, QLD, Australia; QIMR Clive Berghofer Medical Research Institute, Brisbane, QLD, Australia; Pathology Queensland, The Royal Brisbane and Women's Hospital, Brisbane, QLD, Australia; The University of Queensland, School of Medicine, Brisbane, QLD, Australia; The Wesley Breast Clinic, The Wesley Hospital, Brisbane, Brisbane, QLD, Australia
| | - AC Vargas
- The University of Queensland, UQ Centre for Clinical Research, Brisbane, QLD, Australia; QIMR Clive Berghofer Medical Research Institute, Brisbane, QLD, Australia; Pathology Queensland, The Royal Brisbane and Women's Hospital, Brisbane, QLD, Australia; The University of Queensland, School of Medicine, Brisbane, QLD, Australia; The Wesley Breast Clinic, The Wesley Hospital, Brisbane, Brisbane, QLD, Australia
| | - LE Reid
- The University of Queensland, UQ Centre for Clinical Research, Brisbane, QLD, Australia; QIMR Clive Berghofer Medical Research Institute, Brisbane, QLD, Australia; Pathology Queensland, The Royal Brisbane and Women's Hospital, Brisbane, QLD, Australia; The University of Queensland, School of Medicine, Brisbane, QLD, Australia; The Wesley Breast Clinic, The Wesley Hospital, Brisbane, Brisbane, QLD, Australia
| | - JM Saunus
- The University of Queensland, UQ Centre for Clinical Research, Brisbane, QLD, Australia; QIMR Clive Berghofer Medical Research Institute, Brisbane, QLD, Australia; Pathology Queensland, The Royal Brisbane and Women's Hospital, Brisbane, QLD, Australia; The University of Queensland, School of Medicine, Brisbane, QLD, Australia; The Wesley Breast Clinic, The Wesley Hospital, Brisbane, Brisbane, QLD, Australia
| | - MM Cummings
- The University of Queensland, UQ Centre for Clinical Research, Brisbane, QLD, Australia; QIMR Clive Berghofer Medical Research Institute, Brisbane, QLD, Australia; Pathology Queensland, The Royal Brisbane and Women's Hospital, Brisbane, QLD, Australia; The University of Queensland, School of Medicine, Brisbane, QLD, Australia; The Wesley Breast Clinic, The Wesley Hospital, Brisbane, Brisbane, QLD, Australia
| | - A Porter
- The University of Queensland, UQ Centre for Clinical Research, Brisbane, QLD, Australia; QIMR Clive Berghofer Medical Research Institute, Brisbane, QLD, Australia; Pathology Queensland, The Royal Brisbane and Women's Hospital, Brisbane, QLD, Australia; The University of Queensland, School of Medicine, Brisbane, QLD, Australia; The Wesley Breast Clinic, The Wesley Hospital, Brisbane, Brisbane, QLD, Australia
| | - E Evans
- The University of Queensland, UQ Centre for Clinical Research, Brisbane, QLD, Australia; QIMR Clive Berghofer Medical Research Institute, Brisbane, QLD, Australia; Pathology Queensland, The Royal Brisbane and Women's Hospital, Brisbane, QLD, Australia; The University of Queensland, School of Medicine, Brisbane, QLD, Australia; The Wesley Breast Clinic, The Wesley Hospital, Brisbane, Brisbane, QLD, Australia
| | - N Waddell
- The University of Queensland, UQ Centre for Clinical Research, Brisbane, QLD, Australia; QIMR Clive Berghofer Medical Research Institute, Brisbane, QLD, Australia; Pathology Queensland, The Royal Brisbane and Women's Hospital, Brisbane, QLD, Australia; The University of Queensland, School of Medicine, Brisbane, QLD, Australia; The Wesley Breast Clinic, The Wesley Hospital, Brisbane, Brisbane, QLD, Australia
| | - SR Lakhani
- The University of Queensland, UQ Centre for Clinical Research, Brisbane, QLD, Australia; QIMR Clive Berghofer Medical Research Institute, Brisbane, QLD, Australia; Pathology Queensland, The Royal Brisbane and Women's Hospital, Brisbane, QLD, Australia; The University of Queensland, School of Medicine, Brisbane, QLD, Australia; The Wesley Breast Clinic, The Wesley Hospital, Brisbane, Brisbane, QLD, Australia
| | - PT Simpson
- The University of Queensland, UQ Centre for Clinical Research, Brisbane, QLD, Australia; QIMR Clive Berghofer Medical Research Institute, Brisbane, QLD, Australia; Pathology Queensland, The Royal Brisbane and Women's Hospital, Brisbane, QLD, Australia; The University of Queensland, School of Medicine, Brisbane, QLD, Australia; The Wesley Breast Clinic, The Wesley Hospital, Brisbane, Brisbane, QLD, Australia
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Hurwich M, Zimmer D, Guerra E, Evans E, Shire T, Abernathy M, Shreve J, Kolettis G, McCurdy M, Castellino F, Walsh M. A Case of Successful Thromboelastographic Guided Resuscitation after Postpartum Hemorrhage and Cardiac Arrest. J Extra Corpor Technol 2016; 48:194-197. [PMID: 27994260 PMCID: PMC5153306] [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] [Subscribe] [Scholar Register] [Received: 06/20/2016] [Accepted: 10/13/2016] [Indexed: 06/06/2023]
Abstract
Amniotic fluid embolism (AFE) is an unusual cause of life threatening peri partum hemorrhage (PPH). AFE resuscitation is often associated with renal and respiratory insufficiency, and a coagulopathy similar to disseminated intravascular coagulation (DIC). Resuscitation requires immediate recognition and limited use of crystalloid. We present a case of PPH caused by AFE with resultant cardiac arrest, renal and respiratory failure, and DIC-like coagulopathy, whose successful resuscitation was guided by perfusionist-directed serial thromboelastography (TEG). Viscoelastic tests (VET)s, including the TEG and rotational thromboelastometry (ROTEM), may provide more individualized blood component therapy (BCT) in the treatment of severe PPH associated with AFE as has been previously noted with trauma resuscitation in the literature. However, VET's efficacy is often limited by a lack of standardization, quality assurance norms, and consistent operator proficiency. We suggest that there may be a role for perfusionsts adept at utilizing TEG in the optimization of BCT and adjunctive hemostatic agents in severely hemorrhagic patients. This patient's successful resuscitation demonstrates the importance of resuscitation guided by the perfusionist or other medical professionals with expertise in TEG guided resuscitation and how the administration of specific blood products and hemostatic agents guided by the TEG can help optimize patient outcomes in comparison to traditional 1:1:1 packed red blood cells (PRBC) /fresh frozen plasma (FFP) /platelets ratios given to severely hemorrhaging patients.
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Affiliation(s)
- M. Hurwich
- Department of Anesthesiology, Memorial Hospital, South Bend, Indiana
| | - D. Zimmer
- Indiana University School of Medicine, South Bend at the Notre Dame Campus, South Bend, Indiana
| | - E. Guerra
- Department of Anesthesiology, Memorial Hospital, South Bend, Indiana
| | - E. Evans
- Department of Anesthesiology, Memorial Hospital, South Bend, Indiana
| | - T. Shire
- Department of Anesthesiology, Memorial Hospital, South Bend, Indiana
| | - M. Abernathy
- Depatrment of Maternal-Fetal Medicine, St. Vincent Hospital, Indianapolis, Indiana
| | - J.T. Shreve
- Indiana University School of Medicine, South Bend at the Notre Dame Campus, South Bend, Indiana
| | - G.R. Kolettis
- Indiana University School of Medicine, South Bend at the Notre Dame Campus, South Bend, Indiana
| | - M.T. McCurdy
- Departments of Critical Care and Emergency Medicine, University of Maryland School of Medicine Baltimore, Maryland
| | - F.J. Castellino
- Indiana University School of Medicine, South Bend at the Notre Dame Campus, South Bend, Indiana
- W.M. Keck Center for Transgene Research, University of Notre Dame, Notre Dame, Indiana
| | - M. Walsh
- Indiana University School of Medicine, South Bend at the Notre Dame Campus, South Bend, Indiana
- W.M. Keck Center for Transgene Research, University of Notre Dame, Notre Dame, Indiana
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Richard F, Khan DR, Girard CL, Leclerc H, Evans E. 1150 Effects of a dietary supplementation of rumen-protected B vitamins on reproduction of dairy cows by measuring nutrigenomic parameters. J Anim Sci 2016. [DOI: 10.2527/jam2016-1150] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Wood KM, Evans E, Girard CL, Leclerc H, Doepel L, Penner GB. 1466 The effects of supplementing a ruminally protected B-vitamin complex on preweaning growth and performance of Holstein heifer calves. J Anim Sci 2016. [DOI: 10.2527/jam2016-1466] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Abstract
Early warning scoring systems are tools for nurses to help monitor their patients and improve how quickly a patient experiencing a sudden decline receives clinical care. Nurse leaders and frontline staff at a major academic medical center implemented a new early warning system that gives clear guidelines to nurses, nursing assistants, and other clinicians about vital-sign parameters and changes in patients' mental status.
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Schulte M, Hser Y, Saxon A, Evans E, Li L, Huang D, Hillhouse M, Thomas C, Ling W. Risk Factors Associated with HCV Among Opioid-Dependent Patients in a Multisite Study. J Community Health 2016; 40:940-7. [PMID: 25814381 DOI: 10.1007/s10900-015-0016-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
We examined risk factors associated with hepatitis C virus (HCV) infection among opioid-dependent patients enrolled into medication-assisted therapy (buprenorphine or methadone) to determine factors affecting chronic infection. Patients (N = 1039) were randomized as part of a larger, multisite clinical trial sponsored by the National Drug Abuse Treatment Clinical Trials Network assessing liver function. HCV status was first assessed with an antibody screen; if positive, then current infection was determined with an antigen screen testing for detectable virus. Patients were classified as HCV negative, HCV positive but have cleared the virus, or as having chronic HCV. Logistic regression analysis was used to examine demographic and behavioral correlates of the three groups. Thirty-four percent of patients were classified with chronic infection and 14% had evidence of prior infection with apparent clearing of the virus. Chronic infection was associated with recent injection drug use and cocaine use. Chronic HCV infection was also associated with being older and Hispanic. Age, ethnicity, and current drug use increase the likelihood of being chronically infected with HCV. Strategies targeting high risk subgroups can aid in preventing further disease escalation.
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Affiliation(s)
- M Schulte
- UCLA Integrated Substance Abuse Programs, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, 11075 Santa Monica Blvd., Suite 200, Los Angeles, CA, 90025, USA,
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Rash N, Robillard S, Joudou L, Lopez-Alvarez M, Evans E, Robinson C, Waller A, Paillot R. SzeQ, a novel Streptococcus zooepidemicus superantigen that stimulates both T-lymphocytes and Antigen Presenting Cells. J Equine Vet Sci 2016. [DOI: 10.1016/j.jevs.2016.02.195] [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: 11/27/2022]
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Odor PM, Bampoe S, Hayward J, Chis Ster I, Evans E. Intrapartum epidural fixation methods: a randomised controlled trial of three different epidural catheter securement devices. Anaesthesia 2015; 71:298-305. [DOI: 10.1111/anae.13351] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/17/2015] [Indexed: 01/22/2023]
Affiliation(s)
- P. M. Odor
- Department of Anaesthesia; St. George's University Hospital; London UK
| | - S. Bampoe
- Department of Anaesthesia; St. George's University Hospital; London UK
| | - J. Hayward
- Department of Anaesthesia; St. George's University Hospital; London UK
| | - I. Chis Ster
- Institute of Infection and Immunity; St. George's University of London; London UK
| | - E. Evans
- Department of Anaesthesia; St. George's University Hospital; London UK
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Evans E, Kellegan A, Li L, Min J, Huang D, Urada D, Hser YI, Nosyk B. Gender differences in mortality among treated opioid dependent patients. Drug Alcohol Depend 2015; 155:228-35. [PMID: 26282107 PMCID: PMC4581957 DOI: 10.1016/j.drugalcdep.2015.07.010] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [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: 05/11/2015] [Revised: 07/06/2015] [Accepted: 07/07/2015] [Indexed: 02/03/2023]
Abstract
AIMS To assess gender differences in characteristics, mortality rates, and the causes and predictors of death among treated opioid-dependent individuals. METHODS Linked vital statistics data were obtained for all individuals first enrolled in publicly funded pharmacological treatment for opioid dependence in California from 2006 to 2010. Standardized mortality ratios (SMR) were calculated by gender. Cox proportional hazards models with time-varying covariates were fitted to determine the effect of gender on the hazard of all-cause mortality, controlling for covariates. RESULTS Over a median 2.6 years (interquartile range: 1.4-3.7), 1.031 deaths were observed, including 2.2% (259/11,564) of women and 3.7% (772/20,758) of men. Women had a greater increased risk of mortality compared to the general population (SMR 5.1 95% CI: 4.5, 5.7) than men (SMR 4.3 95% CI: 4.0, 4.6). The relative risk of death for women compared with men was 1.18 (95% CI: 1.02, 1.36). Women had a lower instantaneous hazard of all-cause mortality than men (HR 0.58, 95% CI 0.50, 0.68), controlling for other factors. Significant interaction effects indicated that among men, mortality risk was decreased by full-time employment and increased by non-daily heroin use (relative to daily use) and medical problems. Concurrent opioid and methamphetamine/cocaine use increased mortality risk among women and decreased it among men. CONCLUSIONS Treatment for opioid dependence is likely to reduce mortality risk among men by addressing employment and medical problems, and via interventions to reduce overdose risk after heroin abstinence, and among women by attending to the concurrent use of methamphetamine/cocaine and opioids.
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Affiliation(s)
- E Evans
- UCLA Integrated Substance Abuse Programs, United States.
| | - A Kellegan
- UCLA Integrated Substance Abuse Programs
| | - L Li
- UCLA Integrated Substance Abuse Programs
| | - J Min
- British Columbia Centre for Excellence in HIV/AIDS
| | - D Huang
- UCLA Integrated Substance Abuse Programs
| | - D Urada
- UCLA Integrated Substance Abuse Programs
| | - YI Hser
- UCLA Integrated Substance Abuse Programs
| | - B Nosyk
- British Columbia Centre for Excellence in HIV/AIDS,Simon Fraser University, Faculty of Health Sciences
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Renfroe J, Ward-Ritacco C, Adrian A, Evans E. Lean Soft Tissue Mass is a Stronger Predictor of Bone Mineral Density than Fat Mass. Med Sci Sports Exerc 2015. [DOI: 10.1249/01.mss.0000478393.81267.97] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Straight C, Brady A, Evans E. Can A Simple Transfer Task Predict Global Lower-extremity Physical Function In Community-dwelling Older Women? Med Sci Sports Exerc 2015. [DOI: 10.1249/01.mss.0000476551.53393.2c] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Freese E, Gist N, Acitelli R, McConnell W, Beck C, Hausman D, Murrow J, Cureton K, Evans E. Acute and Chronic Effects of Sprint Interval Training on Postprandial Lipemia in Women At‐Risk for Metabolic Syndrome. FASEB J 2015. [DOI: 10.1096/fasebj.29.1_supplement.1055.7] [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: 11/11/2022]
Affiliation(s)
- Eric Freese
- KinesiologyUniversity of GeorgiaAthensGAUnited States
| | - Nicholas Gist
- Physical EducationUnited States Military AcademyWest PointNYUnited States
| | | | | | | | - Dorothy Hausman
- Foods and NutritionUniversity of GeorgiaAthensGAUnited States
| | - Jonathan Murrow
- Georgia Regents UniversityUniversity of Georgia Medical PartnershipAthensGAUnited States
| | - Kirk Cureton
- KinesiologyUniversity of GeorgiaAthensGAUnited States
| | - Ellen Evans
- KinesiologyUniversity of GeorgiaAthensGAUnited States
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Mauldin EA, Wang P, Evans E, Cantner CA, Ferracone JD, Credille KM, Casal ML. Autosomal Recessive Congenital Ichthyosis in American Bulldogs Is Associated With NIPAL4 (ICHTHYIN) Deficiency. Vet Pathol 2014; 52:654-62. [PMID: 25322746 DOI: 10.1177/0300985814551425] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
A minority of patients with nonsyndromic autosomal recessive congenital ichthyosis (ARCI) display mutations in NIPAL4 (ICHTHYIN). This protein plays a role in epidermal lipid metabolism, although the mechanism is unknown. The study describes a moderate form of ARCI in an extended pedigree of American Bulldogs that is linked to the gene encoding ichthyin. The gross phenotype was manifest as a disheveled pelage shortly after birth, generalized scaling, and adherent brown scale with erythema of the abdominal skin. Pedigree analysis indicated an autosomal recessive mode of inheritance. Ultrastructurally, the epidermis showed discontinuous lipid bilayers, unprocessed lipid within corneocytes, and abnormal lamellar bodies. Linkage analysis, performed by choosing simple sequence repeat markers and single-nucleotide polymorphisms near genes known to cause ACRI, revealed an association with NIPAL4. NIPAL4 was identified and sequenced using standard methods. No mutation was identified within the gene, but affected dogs had a SINE element 5' upstream of exon 1 in a highly conserved region. Of 545 DNA samples from American Bulldogs, 32 dogs (17 females, 15 males) were homozygous for the polymerase chain reaction fragment. All affected dogs were homozygous, with parents heterozygous for the insertion. Immunolabeling revealed an absence of ichthyin in the epidermis. This is the first description of ARCI associated with decreased expression of NIPAL4 in nonhuman species.
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Affiliation(s)
- E A Mauldin
- Department of Pathobiology, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - P Wang
- Department of Pathobiology, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - E Evans
- Department of Clinical Studies, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - C A Cantner
- Brandywine Veterinary Hospital, University of Pennsylvania, Chadds Ford, PA, USA
| | - J D Ferracone
- Department of Pathobiology, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - K M Credille
- Eli Lilly and Co, University of Pennsylvania, Indianapolis, IN, USA
| | - M L Casal
- Department of Clinical Studies, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA, USA
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