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Gavvala SN, Jenko N, Stevenson J, Shirodkar K, Vaiyapuri S, Botchu R. Test Yourself question: Incidental hip lesion on PET-CT. Skeletal Radiol 2024; 53:1195-1197. [PMID: 38032363 DOI: 10.1007/s00256-023-04532-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2023] [Revised: 11/08/2023] [Accepted: 11/21/2023] [Indexed: 12/01/2023]
Affiliation(s)
- Sai Niharika Gavvala
- Department of Musculoskeletal Radiology, Royal Orthopedic Hospital, Birmingham, UK
| | - N Jenko
- Department of Musculoskeletal Radiology, Royal Orthopedic Hospital, Birmingham, UK
| | - J Stevenson
- Department of Orthopedic Oncology, Royal Orthopedic Hospital, Birmingham, UK
| | - K Shirodkar
- Department of Musculoskeletal Radiology, Royal Orthopedic Hospital, Birmingham, UK
| | - S Vaiyapuri
- Department of Musculoskeletal Pathology, University Hospitals of Birmingham, Birmingham, UK
| | - R Botchu
- Department of Musculoskeletal Radiology, Royal Orthopedic Hospital, Birmingham, UK.
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Gavvala SN, Jenko N, Stevenson J, Shirodkar K, Vaiyapuri S, Botchu R. Correction to: Test Yourself question: Incidental hip lesion on PET‑CT. Skeletal Radiol 2024; 53:1199. [PMID: 38095687 DOI: 10.1007/s00256-023-04540-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/10/2024]
Affiliation(s)
- Sai Niharika Gavvala
- Department of Musculoskeletal Radiology, Royal Orthopedic Hospital, Birmingham, UK
| | - N Jenko
- Department of Musculoskeletal Radiology, Royal Orthopedic Hospital, Birmingham, UK
| | - J Stevenson
- Department of Orthopedic Oncology, Royal Orthopedic Hospital, Birmingham, UK
| | - K Shirodkar
- Department of Musculoskeletal Radiology, Royal Orthopedic Hospital, Birmingham, UK
| | - S Vaiyapuri
- Department of Musculoskeletal Pathology, University Hospitals of Birmingham, Birmingham, UK
| | - R Botchu
- Department of Musculoskeletal Radiology, Royal Orthopedic Hospital, Birmingham, UK.
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Gavvala SN, Jenko N, Stevenson J, Shirodkar K, Vaiyapuri S, Botchu R. Test yourself answer: incidental hip lesion on PET-CT. Skeletal Radiol 2024; 53:1229-1231. [PMID: 38063891 DOI: 10.1007/s00256-023-04530-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2023] [Revised: 11/08/2023] [Accepted: 11/21/2023] [Indexed: 04/10/2024]
Affiliation(s)
- Sai Niharika Gavvala
- Department of Musculoskeletal Radiology, Royal Orthopedic Hospital, Birmingham, UK
| | - N Jenko
- Department of Musculoskeletal Radiology, Royal Orthopedic Hospital, Birmingham, UK
| | - J Stevenson
- Department of Orthopedic Oncology, Royal Orthopedic Hospital, Birmingham, UK
| | - K Shirodkar
- Department of Musculoskeletal Radiology, Royal Orthopedic Hospital, Birmingham, UK
| | - S Vaiyapuri
- Department of Musculoskeletal Pathology, University Hospitals of Birmingham, Birmingham, UK
| | - R Botchu
- Department of Musculoskeletal Radiology, Royal Orthopedic Hospital, Birmingham, UK.
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Shihabul Hassan M, Stevenson J, Gandikota G, Veeratterapillay A, Bhamidipaty K, Botchu R. Current updates in MSK infection imaging: A narrative review. J Clin Orthop Trauma 2024; 51:102396. [PMID: 38585385 PMCID: PMC10998214 DOI: 10.1016/j.jcot.2024.102396] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Revised: 02/28/2024] [Accepted: 03/18/2024] [Indexed: 04/09/2024] Open
Abstract
This article presents a comprehensive overview of the diagnostic utility of existing imaging techniques including radiography, computed tomography, ultrasonography, magnetic resonance imaging (MRI), and radionuclide imaging in the context of the most common orthopaedic or musculoskeletal infections. It also includes illustrative images showcasing significant findings in various musculoskeletal infections including osteomyelitis, cellulitis, septic arthritis, necrotising infections and peri-prosthetic joint infections and their associated complications.
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Affiliation(s)
- M. Shihabul Hassan
- College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
| | - J. Stevenson
- Department of Orthopedics, Royal Orthopedic Hospital, Birmingham, UK
| | - G. Gandikota
- Department of Radiology, University of North Carolina, USA
| | | | | | - R. Botchu
- Department of Musculoskeletal Radiology, Royal Orthopedic Hospital, Birmingham, UK
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Orchard L, Van M, Abbas J, Malik R, Stevenson J, Tolley N. Mixed-reality technology for clinical communication: objective assessment of the HoloLens 2 as a clinical communication device in a simulated on-call scenario. J Laryngol Otol 2023; 137:1165-1169. [PMID: 36992658 DOI: 10.1017/s0022215123000531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/31/2023]
Abstract
OBJECTIVE Specialty on-call clinicians cover large areas and complex workloads. This study aimed to assess clinical communication using the mixed-reality HoloLens 2 device within a simulated on-call scenario. METHOD This study was structured as a randomised, within-participant, controlled study. Thirty ENT trainees used either the HoloLens 2 or a traditional telephone to communicate a clinical case to a consultant. The quality of the clinical communication was scored objectively and subjectively. RESULTS Clinical communication using the HoloLens 2 scored statistically higher than telephone (n = 30) (11.9 of 15 vs 10.2 of 15; p = 0.001). Subjectively, consultants judged more communication episodes to be inadequate when using the telephone (7 of 30) versus the HoloLens 2 (0 of 30) (p = 0.01). Qualitative feedback indicates that the HoloLens 2 was easy to use and would add value during an on-call scenario with remote consultant supervision. CONCLUSION This study demonstrated the benefit that mixed-reality devices, such as the HoloLens 2 can bring to clinical communication through increasing the accuracy of communication and confidence of the users.
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Affiliation(s)
- L Orchard
- Department of ENT Surgery, St Mary's Hospital, Praed St, London, UK
| | - M Van
- Department of ENT Surgery, St Mary's Hospital, Praed St, London, UK
| | - J Abbas
- Human Factors Academy, Manchester University NHS Trust, University of Manchester, Manchester, UK
| | - R Malik
- Medical School, Imperial College London, London, UK
| | - J Stevenson
- Infomation Technology, Imperial College Healthcare NHS Trust, London, UK
| | - N Tolley
- Department of ENT Surgery, St Mary's Hospital, Praed St, London, UK
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Tavabie OD, Abbott J, Abeysekera KWM, Balachandrakumar VK, Bennett K, Brennan P, Buchanan R, Dhaliwal A, Galanakis V, Hardy T, Harris R, Kronsten VT, Leighton J, Li W, Yin JL, Macken L, Marjot T, Maurice JB, McDowell H, Navaratnam J, Pohl K, Nayagam JS, Saunsbury E, Scott J, Sheth A, Sinharay R, Sheiybani G, Subhani M, Tavabie OD, Turner L, White H, Zakeri N, Balachandrakumar VK, Cook C, Hardy T, Harris R, Navaratnam J, Saunsbury E, Tavabie OD, Abbas N, Abbasi A, Abdul R, Abdulaziz M, Abduljabbar D, Abeysekera KWM, Adamson R, Adebayo D, Adhikarla AK, Adler M, Ahmad S, Ahmed S, Afifi M, Akram A, Al Radhi B, Al-Talib I, Alele J, Ali AM, Almusai S, Appleby V, Asmat H, Astbury S, Atkinson A, Badrulhisham F, Balachandrakumar VK, Ball A, Banfa M, Barn J, Begum S, Belfield K, Bendall O, Bhandari R, Bhatti P, Bradley M, Brennan P, Brown E, Bryce K, Burke L, Campbell R, Cargill T, Carroll G, Cartledge J, Chatterjee D, Chaundry R, Choudhry Z, Clare K, Cobbold J, Coburn R, Corvan F, Cox R, Craig D, Creamer J, Curran C, De Silva S, Dean L, Dillon J, Dunn R, Eckersley R, Eike G, Elagib A, Elkholi A, Elshaarawy O, Faloon S, Fan F, Fazili M, Fernandes D, Fox J, Foxton M, Gaba W, Gaikwad G, Gairola A, Galanakis V, Gallaher C, Gautam N, Germain L, Giles B, Gill C, Glover B, Glover J, Gomez D, Gomez M, Gordon V, Gormley S, Goulder J, Goyal S, Greenham O, Guthrie S, Hackett R, Haddadin Y, Hadjinicolaou A, Hall J, Haque T, Hardy T, Harris R, Hart C, Hasnain Nadir SM, Hassall J, Hasan S, Hawker-Bond G, Hawkyard J, Healey S, Hornby C, Hamza M, Humayun M, Hutchison J, Iftikhar Z, Ismail A, James J, Jopson L, Juthani D, Kaina P, Karim A, Karim SM, Kashyap V, Kassab M, Katarey D, Kenny L, Kerry G, Khan A, Khan A, Khan A, Khan MT, Khan T, Khatib A, Khattak MF, King JJ, Korani M, Kotha S, Kooner E, Lam WL, Lateef M, Leith D, Li W, Liaros A, Lourenco F, Lyles A, Mahenthiran M, Magee C, Maggs D, Mahalingam A, Mahmood R, Mandour MO, Manocha N, Mansour D, Marks D, Marjot T, Martin C, Martin H, Martin I, Martin K, Maruthan S, Masin R, Mason D, Matthews C, Mavrou A, Maxan E, Maxfield D, McAvoy E, McColl K, McCaughan H, McCorry R, McGoran J, McDonald S, McDowell H, McIlwane S, Meakin O, Mebarek L, Merrill H, Michail S, Modarres P, Mohamedali A, Mohammed Y, Mohammed Z, Mohan J, Monnier C, Moran E, Morrison G, Moroni F, Msaddi A, Mutar S, Navaratnam J, Neto-Pereira L, Nahed I, Ng J, Nwoguh C, O’Kane R, Omar S, Ososanya A, Parambil JV, Patel J, Pericleous M, Pervais Z, Phoolchund A, Pietrzycki J, Pillay L, Prabhu K, Putri YRF, Qazi U, Rafique KK, Raman K, Ranade V, Rastelli F, Ratcliffe E, Rattehalli D, Raza T, Razak A, Raghuraman A, Read G, Robins A, Rushbrook S, Salama M, St. Aimee L, Saravan R, Sarkar S, Saunsbury E, Serna S, Shahzad H, Shamsaldeen M, Sharip M, Shearer J, Sheikh A, Sheiybani G, Sheth A, Sherwin M, Shintre N, Singhal S, Sinha R, Sinharay R, Smith G, Smith R, Spicer J, Spoor J, Sreenivasan S, Srinivasa A, Srivastava A, Stagg G, Stanley J, Stevenson J, Stokes D, Stroud R, Subhani M, Suliman H, Sultana M, Summers N, Sutherland C, Swann R, Sykes L, Taha M, Tan KE, Tariq Z, Ming Tay JJ, Taylor A, Thakor A, Tsang J, Tyler Z, Unitt E, Volcek E, Wischhusen J, Watson I, Watters C, Wells G, Widlak M, Williams M, Woodland H, Wren L, Xyda S, Yeh J, Young A, Jie Yuan JS, Abbott J, Abeysekera KWM, Galanakis V, Li W, Sheth A, Sinharay R, Sheiybani G, Tavabie OD, Abbott J, Abeysekera KWM, Galanakis V, Li W, Sheth A, Sinharay R, Sheiybani G, Tavabie OD, Abeysekera KWM, Brennan P, Li W, Marjot T, Tavabie OD, Aithal G, Bernal W, Dillon J, Hogan B, McPherson S, Jones R, Rowe I, Snowdon V. Defining characteristics and outcomes for patients with non-alcoholic fatty liver disease admitted to hospital with decompensated cirrhosis. J Hepatol 2023; 79:e165-e167. [PMID: 37315808 DOI: 10.1016/j.jhep.2023.05.035] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Accepted: 05/14/2023] [Indexed: 06/16/2023]
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Tavabie OD, Abeysekera KWM, Brennan PN, Marjot T, Kronsten VT, Li W, Nayagam JS, Dhaliwal A, Hardy T, Maurice JB, Zakeri N, Abbas N, Abbasi A, Abbott J, Abdul R, Abdulaziz M, Abduljabbar D, Adamson R, Adebayo D, Adhikarla AK, Adler M, Afifi M, Ahmad S, Ahmed S, Aithal G, Akram A, Al Radhi B, Al-Talib I, Alele J, Ali AM, Almusai S, Appleby V, Asmat H, Astbury S, Atkinson A, Badrulhisham F, Balachandrakumar VK, Ball A, Banfa M, Barn J, Begum S, Belfield K, Bendall O, Bennett K, Bernal W, Bhandari R, Bhatti P, Bradley M, Brown E, Bryce K, Buchanan R, Burke L, Campbell R, Cargill T, Carroll G, Cartledge J, Chatterjee D, Chaundry R, Choudhry Z, Clare K, Cobbold J, Coburn R, Cook C, Corvan F, Cox R, Craig D, Creamer J, Curran C, De Silva S, Dean L, Dillon J, Dillon J, Dunn R, Eckersley R, Eike G, Elagib A, Elkholi A, Elshaarawy O, Faloon S, Fan F, Fazili M, Fernandes D, Fox J, Foxton M, Gaba W, Gaikwad G, Gairola A, Galanakis V, Gallaher C, Gautam N, Germain L, Giles B, Gill C, Glover B, Glover J, Gomez D, Gomez M, Gordon V, Gormley S, Goulder J, Goyal S, Greenham O, Guthrie S, Hackett R, Haddadin Y, Hadjinicolaou A, Hall J, Hamza M, Haque T, Harris R, Hart C, Hasan S, Hasnain Nadir SM, Hassall J, Hawker-Bond G, Hawkyard J, Healey S, Hogan B, Hornby C, Humayun MD, Hutchison J, Iftikhar Z, Ismail A, James J, Jones R, Jopson L, Juthani D, Kaina P, Karim A, Karim SM, Kashyap V, Kassab M, Katarey D, Kenny L, Kerry G, Khan A, Khan A, Khan A, Khan MT, Khan T, Khatib A, Khattak MF, King JJ, Kooner E, Korani M, Kotha S, Lam WL, Lateef M, Leighton J, Leith D, Liaros A, Liu Yin J, Lourenco F, Lyles A, Macken L, Magee C, Maggs D, Mahalingam A, Mahenthiran M, Mahmood R, Mandour MO, Manocha N, Mansour D, Marks D, Martin C, Martin H, Martin I, Martin K, Maruthan S, Masin R, Mason D, Matthews C, Mavrou A, Maxan E, Maxfield D, McAvoy E, McCaughan H, McColl K, McCorry R, McDonald S, McDowell H, McGoran J, McIlwane S, McPherson S, Meakin O, Mebarek L, Merrill H, Michail S, Modarres P, Mohamedali A, Mohammed Y, Mohammed Z, Mohan J, Monnier C, Moran E, Moroni F, Morrison G, Msaddi A, Mutar S, Nahed I, Navaratnam J, Neto-Pereira L, Ng J, Nwoguh C, O'Kane R, Omar S, Ososanya A, Parambil JV, Patel J, Pericleous M, Pervais Z, Phoolchund A, Pietrzycki J, Pillay L, Pohl K, Prabhu K, Putri YRF, Qazi U, Rafique KK, Raghuraman A, Raman K, Ranade V, Rastelli F, Ratcliffe E, Rattehalli D, Raza T, Razak A, Read G, Robins A, Rowe I, Rushbrook S, Salama M, Saravan R, Sarkar S, Saunsbury E, Scott J, Serna S, Shahzad H, Shamsaldeen M, Sharip M, Shearer J, Sheikh A, Sheiybani G, Sherwin M, Sheth A, Shintre N, Singhal S, Sinha R, Sinharay R, Smith G, Smith R, Snowdon V, Spicer J, Spoor J, Sreenivasan S, Srinivasa A, Srivastava A, St. Aimee L, Stagg G, Stanley J, Stevenson J, Stokes D, Stroud R, Subhani M, Suliman H, Sultana M, Summers N, Sutherland C, Swann R, Sykes L, Taha M, Tan KE, Tariq Z, Tay JJM, Taylor A, Thakor A, Tsang J, Turner L, Tyler Z, Unitt E, Volcek E, Watson I, Watters C, Wells G, White H, Widlak M, Williams M, Wischhusen J, Woodland H, Wren L, Xyda S, Yeh J, Young A, Yuan JSJ. Regional variation in characteristics of patients with decompensated cirrhosis admitted to hospitals in the UK. Lancet Gastroenterol Hepatol 2023; 8:604-606. [PMID: 37148900 DOI: 10.1016/s2468-1253(23)00114-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 04/17/2023] [Indexed: 05/08/2023]
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Ali K, Mensah E, McDermott A, Stevenson J, Hamer V, Parekh N, Schiff R, Nyangoma S, Fowler-Davis S, Cammen T, Davies JG, Rajkumar C. 1285 IMPLEMENTATION OF A MEDICINE MANAGEMENT PLAN TO REDUCE MEDICATION-RELATED HARM IN OLDER PEOPLE POST-HOSPITAL DISCHARGE - AN RCT. Age Ageing 2023. [DOI: 10.1093/ageing/afac322.061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
Abstract
Introduction
Medication-related harm (MRH) events are increasing among older adults especially in the 8-weeks after hospital discharge. The Discharge Medical Service (DMS), a UK initiative, aims to reduce post-discharge MRH. In this study, we will compare the clinical, economic, and service outcomes of the DMS.
Method
Using a randomised control trial design, 682 older adults ≥ 65years due for hospital-discharge will be recruited. Participants will be randomized to either intervention arm (medicine management plan (MMP) and DMS), or control arm (DMS only) using a 1:1 stratification. The MMP includes patient and carer education about MRH, copy of discharge medications, and MRH risk score calculated using a validated prediction tool (1). Data collection includes patient clinical and social demographics, and admission and discharge medications. At 8-weeks post discharge, study pharmacist will verify MRH through patient telephone interview, and review of patients’ GP records.
Data Analysis
Univariate analysis will be done for baseline variables comparing the intervention and control arms. Variables known to be associated with MRH will be described by the randomisation groups. Further multivariate logistic regression will be done incorporating these variables. Economic evaluation will compare the cost-of-service use among the two arms and modelled to provide national estimates. Qualitative data from focus group interviews at participating hospital sites will explore practitioners’ understanding and acceptance of the DMS and MMP.
Conclusion
This study will inform the use of a validated MRH risk prediction tool, and provide a clinical, and economic evaluation of the DMS and MMP in the NHS. The study has ethics approval and is adopted in the national ageing research portfolio. We are seeking additional sites.
Reference
1. Parekh N, Ali K, Davies JG et al. Medication-related harm in older adults following hospital discharge: development and validation of a prediction tool. BMJ Quality and Safety 2020; 29: 142–53.
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Affiliation(s)
- K Ali
- Brighton and Sussex Medical School
| | | | | | | | | | - N Parekh
- Brighton and Sussex Medical School
| | - R Schiff
- Guys and St Thomas’s NHS Foundation
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Al-Aqeel M, Adlan A, Stevenson J. 626 What Is the Influence of Negative Pressure Wound Therapy (NPWT) on High-Risk Wounds in Pelvic Oncology? Br J Surg 2022. [DOI: 10.1093/bjs/znac269.381] [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: 11/06/2022]
Abstract
Abstract
Aim
Hindquarter amputation (HQA) has a high incidence of postoperative wound complications. We aim to use the HQA procedure as a model to investigate the potential advantages of negative pressure wound therapy (NPWT) on wound healing complications in high-risk pelvic oncology wounds.
Method
We conducted a retrospective analysis of all patients undergoing hindquarter amputation at a single tertiary centre between January 2009 and November 2020. Patients were divided into groups who had and hadn't undergone neoadjuvant radiotherapy (RT) to the pelvic tumour.
Results
One hundred six patients were included in the study. 43.4% had NPWT. There was no difference in the incidence of reoperation in the patient group without neo-adjuvant RT between NPWT and conventional dressings (odds ratio [OR], 1.01; p=0.983, 95% confidence interval [CI], 0.365–2.8). However, the use of NPWT decreased the incidence of reoperation among the patients who had NPWT who had received radiotherapy [OR], 0.087; p=0.033, 95% CI, 0.009–0.818). The incidence of wound complications has declined with the increasing use of NPWT between 2009–2020.
Conclusions
The application of NPWT reduces the incidence of wound complications in high-risk pelvic oncology wounds. We demonstrated a reduction in the incidence of reoperation due to wound complications in patients who received NPWT following HQA.
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Affiliation(s)
- M Al-Aqeel
- Royal Orthopaedic Hospital , Birmingham , United Kingdom
| | - A Adlan
- Royal Orthopaedic Hospital , Birmingham , United Kingdom
| | - J Stevenson
- Royal Orthopaedic Hospital , Birmingham , United Kingdom
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Stevenson J, DeGroote NP, Keller F, Brock KE, Bergsagel DJ, Miller TP, Cornwell P, Fasano R, Chonat S, Castellino SM. Characteristics and outcomes of pediatric oncology patients at risk for guardians declining transfusion of blood components. Cancer Rep (Hoboken) 2022; 6:e1665. [PMID: 35792092 PMCID: PMC9875642 DOI: 10.1002/cnr2.1665] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Revised: 06/01/2022] [Accepted: 06/17/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Transfusion of blood products is a necessary part of successful delivery of myelosuppressive regimens in pediatric cancer. There is a paucity of literature characterizing outcomes or management of pediatric patients with cancer when transfusion is declined. AIMS The objective of this paper is to describe the clinical characteristics, care, and outcomes of patients with cancer at risk for declining transfusion. METHODS AND RESULTS A retrospective cohort of patients aged 0-21 years with cancer managed at Children's Healthcare of Atlanta between 2006 and 2020 and with ICD-9 codes indicating risk of "transfusion refusal" or Jehovah's witness (JW) religion was identified. Demographics, disease, and management were abstracted. Descriptive statistics were performed to examine associations with transfusion receipt. Among 35 eligible patients identified as at risk for declining transfusion, 89% had primary guardians who identified as JW, and 45.7% identified as Black, non-Hispanic. Only 40% of guardians actively declined transfusion. Transfusion recipients had significantly lower hemoglobin (g/dl) and platelet counts (1000/μl) at initial presentation (9.6 vs. 11.9, p < .002 and 116.0 vs. 406.5, p = .001, respectively) and at nadir (5.9 vs. 8.7, p < .001 and ≤ 10 vs. 154, p < .001, respectively) than non-recipients. Legal intervention was required in 36.4% of those who ultimately received a transfusion. CONCLUSION Among pediatric cancer patients whose medical record initially indicated a preference for no transfusion, 60% of guardians accepted blood products when prescribed for oncology care. Guidelines for systematic management and transfusion sparing approaches are needed to honor guardian's preferences when possible yet while maintaining equitable cancer outcomes in this population.
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Affiliation(s)
- Jason Stevenson
- Department of Pediatrics, Division of Graduate Medical EducationEmory UniversityAtlantaGeorgiaUSA
| | - Nicholas P. DeGroote
- Aflac Cancer and Blood Disorders Center, Children's Healthcare of AtlantaAtlantaGeorgiaUSA
| | - Frank Keller
- Aflac Cancer and Blood Disorders Center, Children's Healthcare of AtlantaAtlantaGeorgiaUSA,Department of Pediatrics, Division of Pediatric Hematology/OncologyEmory UniversityAtlantaGeorgiaUSA
| | - Katharine E. Brock
- Aflac Cancer and Blood Disorders Center, Children's Healthcare of AtlantaAtlantaGeorgiaUSA,Department of Pediatrics, Division of Pediatric Hematology/OncologyEmory UniversityAtlantaGeorgiaUSA,Department of Pediatrics, Division of Pediatric Palliative CareEmory UniversityAtlantaGeorgiaUSA
| | - D. John Bergsagel
- Aflac Cancer and Blood Disorders Center, Children's Healthcare of AtlantaAtlantaGeorgiaUSA,Department of Pediatrics, Division of Pediatric Hematology/OncologyEmory UniversityAtlantaGeorgiaUSA
| | - Tamara P. Miller
- Aflac Cancer and Blood Disorders Center, Children's Healthcare of AtlantaAtlantaGeorgiaUSA,Department of Pediatrics, Division of Pediatric Hematology/OncologyEmory UniversityAtlantaGeorgiaUSA
| | - Patricia Cornwell
- Aflac Cancer and Blood Disorders Center, Children's Healthcare of AtlantaAtlantaGeorgiaUSA
| | - Ross Fasano
- Aflac Cancer and Blood Disorders Center, Children's Healthcare of AtlantaAtlantaGeorgiaUSA,Department of Pediatrics, Division of Pediatric Hematology/OncologyEmory UniversityAtlantaGeorgiaUSA
| | - Satheesh Chonat
- Aflac Cancer and Blood Disorders Center, Children's Healthcare of AtlantaAtlantaGeorgiaUSA,Department of Pediatrics, Division of Pediatric Hematology/OncologyEmory UniversityAtlantaGeorgiaUSA
| | - Sharon M. Castellino
- Aflac Cancer and Blood Disorders Center, Children's Healthcare of AtlantaAtlantaGeorgiaUSA,Department of Pediatrics, Division of Pediatric Hematology/OncologyEmory UniversityAtlantaGeorgiaUSA
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Ortega Franco A, Adamson-Raieste A, Rahman R, Pihlak R, Peters N, Scott JA, Aruketty S, Thomson C, Dransfield S, Henshaw A, Ward A, Cutts T, Carter L, Thistlethwaite F, Cook N, Graham D, Stevenson J, Krebs M. 44P Value of comprehensive genomic profiling in pre-screening patients for NTRK fusion in STARTRK2 trial: Single centre experience. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.2040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Sinclair C, Schnobrich M, Stevenson J, Kouba J. 108 A preliminary investigation of anti-Müllerian hormone as a biomarker for fertility in mares. J Equine Vet Sci 2021. [DOI: 10.1016/j.jevs.2021.103571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Shaw RJ, Yang Q, Barnes A, Hatch D, Crowley MJ, Vorderstrasse A, Vaughn J, Diane A, Lewinski AA, Jiang M, Stevenson J, Steinberg D. Self-monitoring diabetes with multiple mobile health devices. J Am Med Inform Assoc 2021; 27:667-676. [PMID: 32134447 DOI: 10.1093/jamia/ocaa007] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [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: 09/06/2019] [Revised: 01/09/2020] [Accepted: 01/15/2020] [Indexed: 12/18/2022] Open
Abstract
OBJECTIVE The purpose of this study was to examine the use of multiple mobile health technologies to generate and transmit data from diverse patients with type 2 diabetes mellitus (T2DM) in between clinic visits. We examined the data to identify patterns that describe characteristics of patients for clinical insights. METHODS We enrolled 60 adults with T2DM from a US healthcare system to participate in a 6-month longitudinal feasibility trial. Patient weight, physical activity, and blood glucose were self-monitored via devices provided at baseline. Patients also responded to biweekly medication adherence text message surveys. Data were aggregated in near real-time. Measures of feasibility assessing total engagement in device submissions and survey completion over the 6 months of observation were calculated. RESULTS It was feasible for participants from different socioeconomic, educational, and racial backgrounds to use and track relevant diabetes-related data from multiple mobile health devices for at least 6 months. Both the transmission and engagement of the data revealed notable patterns and varied by patient characteristics. DISCUSSION Using multiple mobile health tools allowed us to derive clinical insights from diverse patients with diabetes. The ubiquitous adoption of smartphones across racial, educational, and socioeconomic populations and the integration of data from mobile health devices into electronic health records present an opportunity to develop new models of care delivery for patients with T2DM that may promote equity as well.
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Affiliation(s)
- Ryan J Shaw
- School of Nursing, Duke University, Durham, North Carolina, USA.,Center for Applied Genomics & Precision Medicine, School of Medicine, Duke University, Durham, North Carolina, USA
| | - Q Yang
- School of Nursing, Duke University, Durham, North Carolina, USA
| | - A Barnes
- School of Nursing, Duke University, Durham, North Carolina, USA
| | - D Hatch
- School of Nursing, Duke University, Durham, North Carolina, USA
| | - M J Crowley
- Center of Innovation to Accelerate Discovery and Practice Transformation, Durham Veterans Affairs Medical Center, Durham, North Carolina, USA.,Division of Endocrinology, Diabetes and Metabolism, Duke University School of Medicine, Durham, North Carolina, USA
| | - A Vorderstrasse
- College of Nursing, New York University, New York, New York, USA
| | - J Vaughn
- School of Nursing, Duke University, Durham, North Carolina, USA
| | - A Diane
- School of Nursing, Duke University, Durham, North Carolina, USA
| | - A A Lewinski
- Center of Innovation to Accelerate Discovery and Practice Transformation, Durham Veterans Affairs Medical Center, Durham, North Carolina, USA
| | - M Jiang
- Department of Biostatistics & Bioinformatics, School of Medicine, Duke University, Durham, North Carolina, USA
| | - J Stevenson
- School of Nursing, Duke University, Durham, North Carolina, USA
| | - D Steinberg
- School of Nursing, Duke University, Durham, North Carolina, USA
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Mclachlan S, Chakravorty M, Odone J, Stevenson J, Minshul J, Schiff R. 28 Medication Compliance Aids and Acute Hospitals. Age Ageing 2021. [DOI: 10.1093/ageing/afab029.07] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Introduction
An estimated 64 million Medication Compliance Aids (MCAs) are dispensed by pharmacies in England each year as a method of reasonable adjustment to improve medication adherence (NICE 2009) and support medicines administration by carers (RPS 2013). Complexities exist when implementing medication changes for patients using MCAs, particularly at hospital discharge or outpatient appointments, where practices seem to vary. This National Survey is the first to determine the current policy and service provision of MCAs by acute hospitals in England.
Methods
An electronic survey was emailed to Chief Pharmacists via the Regional Medicines Information Services in Spring 2019. Initial non-responders were contacted by email and telephone.
Results
51% (73/144) of acute hospital trusts in England responded. 77% (56/73) dispensed medication in MCAs at discharge. Of these, 62.5% would initiate MCAs and 61% supplied a different length of MCA vs non-MCA prescription (see table).
41 hospitals had designated staff completing MCAs. The median time to complete an MCA was 59.5 minutes (range 10–200). The median time from prescription receipt in pharmacy to MCA arrival on ward was 144.5 minutes (range 60–1,440).
Of the 17 hospitals not providing MCAs, the majority would, upon discharge, contact the community pharmacy that provided the MCA pre-admission to update any medication changes and request the provision of a new supply of medicines.
Conclusion
Despite the ubiquitous nature of the MCA, there is no standard approach to the supply of these devices from acute hospitals across England. When hospitals do provide MCAs their preparation is time consuming, often requiring additional staff. A national approach to MCAs might help patients and carers, and reduce medication-related problems and costs.
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Affiliation(s)
- S Mclachlan
- Department of Ageing and Health, Guy’s and St Thomas’ NHS Foundation Trust
| | - M Chakravorty
- Department of Ageing and Health, Guy’s and St Thomas’ NHS Foundation Trust
| | - J Odone
- Department of Ageing and Health, Guy’s and St Thomas’ NHS Foundation Trust
| | - J Stevenson
- Institute of Pharmaceutical Science, King’s College London
- Pharmacy Department, Guy’s and St. Thomas’ NHS Foundation Trust
| | - J Minshul
- London Medicines Information Service, NHS Specialist Pharmacy
| | - R Schiff
- Department of Ageing and Health, Guy’s and St Thomas’ NHS Foundation Trust
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15
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Rao S, Arnold S, Carbone D, Salgia R, Tsao A, Niu J, Aggarwal C, Dragnev K, Awad M, Gainor J, Gubens M, Velcheti V, Telliho L, Akala O, Chartash E, Stevenson J. P75.03 KEYNOTE-U01: A Phase 2 Umbrella Study of Investigational Agents Plus Pembrolizumab-Based Therapy for Advanced NSCLC. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.01.1037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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16
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Tsoi K, Tan D, Stevenson J, Evans S, Jeys L, Botchu R. Indeterminate pulmonary nodules are not associated with worse overall survival in Ewing Sarcoma. J Clin Orthop Trauma 2021; 16:58-64. [PMID: 33717939 PMCID: PMC7920159 DOI: 10.1016/j.jcot.2020.12.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Revised: 10/26/2020] [Accepted: 12/16/2020] [Indexed: 11/26/2022] Open
Abstract
AIM Lung metastases are a negative prognostic factor in Ewing sarcoma, however, the incidence and significance of sub-centimetre pulmonary nodules at diagnosis is unclear. The aims of this study were to (1): determine the incidence of indeterminate pulmonary nodules (IPNs) in patients diagnosed with Ewing sarcoma (2); establish the impact of IPNs on overall and metastasis-free survival and (3) identify patient, oncological and radiological factors that correlate with poorer prognosis in patients that present with IPNs on their staging chest CT. MATERIALS & METHODS Between 2008 and 2016, 173 patients with a first presentation of Ewing sarcoma of bone were retrospectively identified from an institutional database. Staging and follow-up chest CTs for all patients with IPN were reviewed by a senior radiologist. Clinical and radiologic course were examined to determine overall- and metastasis-free survival for IPN patients and to identify demographic, oncological or nodule-specific features that predict which IPN represent true lung metastases. RESULTS Following radiologic re-review, IPN were found in 8.7% of patients. Overall survival for IPN patients was comparable to those with a normal staging chest CT (2-year overall survival of 73.3% [95% CI 43.6-89] and 89.4% [95% CI 81.6-94], respectively; p = 0.34) and was significantly better than for patients with clear metastases (46.0% [95% CI 31.9-59]; p < 0.0001). Similarly, there was no difference in metastasis-free survival between 'No Metastases' and 'IPN' patients (p = 0.16). Lung metastases developed in 40% of IPN patients at a median 9.6 months. Reduction of nodule size on neoadjuvant chemotherapy was associated with worse overall survival in IPN patients (p = 0.0084). CONCLUSION IPN are not uncommon in patients diagnosed with Ewing sarcoma. In this study, we were unable to detect a difference in overall- or metastasis-free survival between patients with IPN at diagnosis and patients with normal staging chest CTs.
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Affiliation(s)
- K.M. Tsoi
- Oncology Department, Royal Orthopaedic Hospital, Birmingham, UK
| | - D. Tan
- Oncology Department, Royal Orthopaedic Hospital, Birmingham, UK
| | - J. Stevenson
- Oncology Department, Royal Orthopaedic Hospital, Birmingham, UK,Aston University Medical School, Birmingham, UK
| | - S. Evans
- Oncology Department, Royal Orthopaedic Hospital, Birmingham, UK
| | - L.M. Jeys
- Oncology Department, Royal Orthopaedic Hospital, Birmingham, UK,Aston University Medical School, Birmingham, UK
| | - R. Botchu
- Department of Musculoskeletal Radiology, Royal Orthopaedic Hospital, Birmingham, UK,Corresponding author. Department of Musculoskeletal Radiology, The Royal Orthopedic Hospital, Bristol Road South, Northfield, Birmingham, UK.
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Southam S, Ayub M, Krebs M, Rothwell D, Graham D, Stevenson J. Application of variant interpretation software to decipher pathogenicity of mutations for a molecular tumour board (MTB). Ann Oncol 2019. [DOI: 10.1093/annonc/mdz413.037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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18
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Murphy L, Laurent J, Mathews K, Stevenson J, Thiele S, Vissing J, Walter M, Woods L, Straub V. P.389Global FKRP registry. Neuromuscul Disord 2019. [DOI: 10.1016/j.nmd.2019.06.551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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19
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Randall A, Stevenson J, Heaney S, Notaras S, Hoffman A, Choi P, Brown M, Sud K. SUN-103 PREVALENCE OF MALNUTRITION & NUTRITION-IMPACT SYMPTOM BURDEN IN PATIENTS ATTENDING RENAL SUPPORTIVE CARE. Kidney Int Rep 2019. [DOI: 10.1016/j.ekir.2019.05.500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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20
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RANDALL A, Stevenson J, Heaney S, Notaras S, Hoffman A, Choi P, Brown M, Sud K. SUN-102 NUTRITION-IMPACT SYMPTOM BURDEN IN PATIENTS ATTENDING RENAL SUPPORTIVE CARE. Kidney Int Rep 2019. [DOI: 10.1016/j.ekir.2019.05.499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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21
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Nandra R, Matharu G, Stevenson J, Parry M, Grimer R, Jeys L. Long-term outcomes after an initial experience of computer-navigated resection of primary pelvic and sacral bone tumours. Bone Joint J 2019; 101-B:484-490. [PMID: 30929483 DOI: 10.1302/0301-620x.101b4.bjj-2018-0981.r1] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Aims The aim of this study was to investigate the local recurrence rate at an extended follow-up in patients following navigated resection of primary pelvic and sacral tumours. Patients and Methods This prospective cohort study comprised 23 consecutive patients (nine female, 14 male) who underwent resection of a primary pelvic or sacral tumour, using computer navigation, between 2010 and 2012. The mean age of the patients at the time of presentation was 51 years (10 to 77). The rates of local recurrence and mortality were calculated using the Kaplan–Meier method. Results Bone resection margins were all clear and there were no bony recurrences. At a mean follow-up for all patients of 59 months (12 to 93), eight patients (34.8%) developed soft-tissue local recurrence, with a cumulative rate of local recurrence at six-years of 35.1% (95% confidence interval (CI) 19.3 to 58.1). The cumulative all-cause rate of mortality at six-years was 26.1% (95% CI 12.7 to 49.1). Conclusion Despite the positive early experience with navigated-assisted resection, local recurrence rates remain high. With increasing knowledge of the size of soft-tissue margins required to reduce local recurrence and the close proximity of native structures in the pelvis, we advise against compromising resection to preserve function, and encourage surgeons to reduce local recurrence by prioritizing wide resection margins of the tumour. Cite this article: Bone Joint J 2019;101-B:484–490.
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Affiliation(s)
- R. Nandra
- West Midlands Deanery, Birmingham, UK
| | | | - J. Stevenson
- The Royal Orthopaedic Hospital, Birmingham, UK
- School of Life and Health Sciences, Aston University, Birmingham, UK
| | - M. Parry
- The Royal Orthopaedic Hospital, Birmingham, UK
- School of Life and Health Sciences, Aston University, Birmingham, UK
| | - R. Grimer
- The Royal Orthopaedic Hospital, Birmingham, UK
- School of Life and Health Sciences, Aston University, Birmingham, UK
| | - L. Jeys
- The Royal Orthopaedic Hospital, Birmingham, UK
- School of Life and Health Sciences, Aston University, Birmingham, UK
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22
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Gunatillake T, Chui A, Fitzpatrick E, Ignjatovic V, Monagle P, Whitelock J, Zanten D, Eijsink J, Borg A, Stevenson J, Brennecke SP, Erwich JJHM, Said JM, Murthi P. Decreased placental glypican expression is associated with human fetal growth restriction. Placenta 2018; 76:6-9. [PMID: 30803713 DOI: 10.1016/j.placenta.2018.12.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [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: 12/21/2016] [Revised: 12/05/2018] [Accepted: 12/17/2018] [Indexed: 10/27/2022]
Abstract
Placental mediated fetal growth restriction (FGR) is a leading cause of perinatal morbidity and mortality. Heparan sulphate proteoglycans (HSPG) are highly expressed in placentae and regulate haemostasis. We hypothesise that altered expression of HSPGs, glypicans (GPC) may contribute to the development of FGR and small-for-gestational-age (SGA). GPC expression was determined in first-trimester chorionic villous samples collected from women with later SGA pregnancies and in placentae from third-trimester FGR and gestation-matched uncomplicated pregnancies. The expression of both GPC1 and GPC3 were significantly reduced in first-trimester SGA as well as in the third-trimester FGR placentae compared to controls. This is the first study to report a relationship between altered placental GPC expression and subsequent development of SGA/FGR.
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Affiliation(s)
- T Gunatillake
- Department of Obstetrics and Gynaecology, The University of Melbourne, Sunshine Hospital, St Albans, 3021, Australia.
| | - A Chui
- Department of Obstetrics and Gynaecology, The University of Melbourne, Sunshine Hospital, St Albans, 3021, Australia
| | - E Fitzpatrick
- Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, 3052, Australia
| | - V Ignjatovic
- Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, 3052, Australia; Department of Clinical Haematology, Royal Children's Hospital, Parkville, 3052, Australia
| | - P Monagle
- Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, 3052, Australia; Department of Paediatrics, The University of Melbourne, Royal Children's Hospital, Parkville, 3052, Australia; Department of Clinical Haematology, Royal Children's Hospital, Parkville, 3052, Australia
| | - J Whitelock
- Graduate School of Biomedical Engineering, University of New South Wales, Kensington, Australia
| | - D Zanten
- Department of Obstetrics and Gynaecology, University Medical Centre Groningen, University of Groningen, Groningen, the Netherlands
| | - J Eijsink
- Department of Obstetrics and Gynaecology, University Medical Centre Groningen, University of Groningen, Groningen, the Netherlands
| | - A Borg
- Department of Maternal-Fetal Medicine Pregnancy Research Centre, The Royal Women's Hospital, Parkville, 3052, Australia
| | - J Stevenson
- Department of Maternal-Fetal Medicine Pregnancy Research Centre, The Royal Women's Hospital, Parkville, 3052, Australia
| | - S P Brennecke
- Department of Maternal-Fetal Medicine Pregnancy Research Centre, The Royal Women's Hospital, Parkville, 3052, Australia
| | - J J H M Erwich
- Department of Obstetrics and Gynaecology, University Medical Centre Groningen, University of Groningen, Groningen, the Netherlands
| | - J M Said
- Department of Obstetrics and Gynaecology, The University of Melbourne, Sunshine Hospital, St Albans, 3021, Australia; Maternal Fetal Medicine, Sunshine Hospital, Western Health, St Albans, 3021, Australia
| | - P Murthi
- Department of Maternal-Fetal Medicine Pregnancy Research Centre, The Royal Women's Hospital, Parkville, 3052, Australia; Department of Obstetrics and Gynaecology, The University of Melbourne, Parkville, 3052, Australia; Department of Medicine, School of Clinical Sciences, Monash University, Clayton, 3168, Australia
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Rengan R, Mick R, Pryma D, Lin L, Plastaras J, Simone C, Gupta A, Evans T, Stevenson J, Langer C, Kucharczuk J, Friedberg J, Lam S, Patsch D, Hahn S, Maity A. Long-term Results of a Phase I/II Trial of Nelfinavir with Concurrent Chemoradiotherapy for Locally Advanced Non-Small Cell Lung Cancer. Int J Radiat Oncol Biol Phys 2018. [DOI: 10.1016/j.ijrobp.2018.06.135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Stevenson J, Howe C, Alexander G. A Cross-Sectional Study on MyPlate Awareness in Children 7-13 Years of Age. J Acad Nutr Diet 2018. [DOI: 10.1016/j.jand.2018.06.125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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25
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Stevenson J, Ayub M, Dransfield S, Shing E, Barley D, Dunne R, Westaway M, Landers D, Krebs M. PO-047 Etarget: a digital science solution to integrate clinical and genomic data for the manchester molecular tumour board (MTB). ESMO Open 2018. [DOI: 10.1136/esmoopen-2018-eacr25.580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
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26
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Argiris A, Lee JW, Stevenson J, Sulecki MG, Hugec V, Choong NW, Saltzman JN, Song W, Hansen RM, Evans TL, Ramalingam SS, Schiller JH. Phase II randomized trial of carboplatin, paclitaxel, bevacizumab with or without cixutumumab (IMC-A12) in patients with advanced non-squamous, non-small-cell lung cancer: a trial of the ECOG-ACRIN Cancer Research Group (E3508). Ann Oncol 2018; 28:3037-3043. [PMID: 28950351 DOI: 10.1093/annonc/mdx534] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [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: 02/06/2023] Open
Abstract
Background Cixutumumab is a fully human IgG1 monoclonal antibody to the insulin-like growth factor type I receptor that can potentially reverse resistance and enhance the efficacy of chemotherapy. Methods Bevacizumab-eligible patients with stage IV or recurrent non-squamous, non-small-cell lung cancer and good performance status were randomized to receive standard doses of paclitaxel, carboplatin, and bevacizumab to a maximum of six cycles followed by bevacizumab maintenance (CPB) until progression (arm A) or CPB plus cixutumumab 6 mg/kg i.v. weekly (arm B). Results Of 175 patients randomized, 153 were eligible and treated (78 in arm A; 75 in arm B). The median progression-free survival was 5.8 months (95% CI 5.4-7.1) in arm A versus 7 months (95% CI 5.7-7.6) in arm B (P = 0.33); hazard ratio 0.92 (95% CI 0.65-1.31). Objective response was 46.2% versus 58.7% in arm A versus arm B (P = 0.15). The median overall survival was 16.2 months in arm A versus 16.1 months in arm B (P = 0.95). Grade 3/4 neutropenia and febrile neutropenia, thrombocytopenia, fatigue, and hyperglycemia were increased with cixutumumab. Conclusions The addition of cixutumumab to CPB increased toxicity without improving efficacy and is not recommended for further development in non-small-cell lung cancer. Both treatment groups had longer OS than historical controls which may be attributed to several factors, and emphasizes the value of a comparator arm in phase II trials. ClinicalTrials.gov Identifier NCT00955305.
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Affiliation(s)
- A Argiris
- Medical Oncology, Hygeia Hospital, Athens, Greece.,Medical Oncology, Thomas Jefferson University, Philadelphia
| | - J W Lee
- Dana-Farber Cancer Institute, ECOG-ACRIN Biostatistics Center, Boston
| | - J Stevenson
- Medical Oncology, Cleveland Clinic Foundation, Cleveland
| | - M G Sulecki
- Medical Oncology, University of Pittsburgh Cancer Institute, Pittsburgh
| | - V Hugec
- Medical Oncology, Minnesota Oncology, Minneapolis, Lake Elmo
| | | | - J N Saltzman
- Medical Oncology, University Hospitals Seidman Cancer Center, Case Western Reserve University, Cleveland
| | - W Song
- Pottstown Memor Reg Cancer Ctr, Pottstown
| | - R M Hansen
- Medical Oncology, Oconomowoc Memorial Hospital, Oconomowoc
| | - T L Evans
- Medical Oncology, University of Pennsylvania, Philadelphia
| | - S S Ramalingam
- The Winship Cancer Institute of Emory University, Atlanta
| | - J H Schiller
- Medical Oncology, The University of Texas Southwestern Medical Center, Dallas, USA
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Kirolos A, Waugh C, Templeton K, McCormick D, Othieno R, Willocks LJ, Stevenson J. Imported case of measles in a university setting leading to an outbreak of measles in Edinburgh, Scotland from September to December 2016. Epidemiol Infect 2018; 146:741-746. [PMID: 29564994 PMCID: PMC9134365 DOI: 10.1017/s0950268818000602] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2017] [Revised: 02/03/2018] [Accepted: 02/17/2018] [Indexed: 11/07/2022] Open
Abstract
In September 2016, an imported case of measles in Edinburgh in a university student resulted in a further 17 confirmed cases during October and November 2016. All cases were genotype D8 and were associated with a virus strain most commonly seen in South East Asia. Twelve of the 18 cases were staff or students at a university in Edinburgh and 17 cases had incomplete or unknown measles mumps rubella (MMR) vaccination status. The public health response included mass follow-up of all identified contacts, widespread communications throughout universities in Edinburgh and prompt vaccination clinics at affected campuses. Imported cases of measles pose a significant risk to university student cohorts who may be undervaccinated, include a large number of international students and have a highly mobile population. Public health departments should work closely with universities to promote MMR uptake and put in place mass vaccination plans to prevent rapidly spreading measles outbreaks in higher educational settings in future.
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Affiliation(s)
- A. Kirolos
- National Health Service, Lothian, Directorate of Public Health and Health Policy, Edinburgh, UK
| | - C. Waugh
- National Health Service, Lothian, Directorate of Public Health and Health Policy, Edinburgh, UK
| | - K. Templeton
- Department of Virology, National Health Service, Lothian, Royal Infirmary Edinburgh, Edinburgh, UK
| | - D. McCormick
- National Health Service, Lothian, Directorate of Public Health and Health Policy, Edinburgh, UK
| | - R. Othieno
- National Health Service, Lothian, Directorate of Public Health and Health Policy, Edinburgh, UK
| | - L. J. Willocks
- National Health Service, Lothian, Directorate of Public Health and Health Policy, Edinburgh, UK
| | - J. Stevenson
- National Health Service, Lothian, Directorate of Public Health and Health Policy, Edinburgh, UK
- National Health Service, Lothian, Incident Management Team for the Outbreak of Measles in Edinburgh 2016, Edinburgh, UK
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28
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29
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Feinberg L, Srinivasan A, Singh JK, Parry M, Stevenson J, Jeys L, Grimer R, Peart F, Warner R, Ford S, Gourevitch D, Hallissey M, Desai A. Impact of specialist management on survival from radiation-associated angiosarcoma of the breast. Br J Surg 2018; 105:401-409. [PMID: 29405251 DOI: 10.1002/bjs.10696] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2017] [Revised: 05/26/2017] [Accepted: 08/20/2017] [Indexed: 12/18/2022]
Abstract
BACKGROUND Radiation-associated angiosarcoma of the breast (RAAS) is a rare complication of adjuvant radiotherapy associated with poor survival. The British Sarcoma Group guidelines recommend that all angiosarcomas are referred to a sarcoma multidisciplinary team, although there is no recommendation that patients are managed within a sarcoma service. The aims of this study were to compare survival, complete excision rates and local recurrence rates of patients managed within a sarcoma service and those managed within local hospitals. METHODS All patients with RAAS referred to a regional sarcoma service between 1998 and 2015 were identified from prospective databases. Patient records, and radiology, pathology and operation notes were reviewed retrospectively. RESULTS Thirty-six patients were operated on with curative intent; 26 were managed by the sarcoma service (of whom 21 underwent radical excision of the irradiated field followed by chest wall reconstruction) and ten were managed locally. Median age was 69·5 (range 43-85) years. Disease-specific survival was significantly longer in patients managed by the sarcoma service than in those managed locally: median 91·1 (range 69·2-113·0) versus 48·8 (18·6-79·1) months respectively (P = 0·012). Overall survival rates were similar (P = 0·112). There was no difference in complete excision rate (18 of 26 in sarcoma service versus 5 of 10 in local services; P = 0·456), although the local recurrence rate was significantly lower among patients managed by the sarcoma service (9 of 26 versus 8 of 10; P = 0·015). CONCLUSION Specialist management of RAAS leads to fewer local recurrences and improved disease-specific survival. Early referral and management within specialist units is recommended.
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Affiliation(s)
- L Feinberg
- Department of Upper Gastrointestinal Surgery, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - A Srinivasan
- Department of Upper Gastrointestinal Surgery, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - J K Singh
- Department of Upper Gastrointestinal Surgery, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - M Parry
- Royal Orthopaedic Hospital NHS Foundation Trust, Birmingham, UK
| | - J Stevenson
- Royal Orthopaedic Hospital NHS Foundation Trust, Birmingham, UK
| | - L Jeys
- Royal Orthopaedic Hospital NHS Foundation Trust, Birmingham, UK
| | - R Grimer
- Royal Orthopaedic Hospital NHS Foundation Trust, Birmingham, UK
| | - F Peart
- Department of Plastic Surgery, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - R Warner
- Department of Plastic Surgery, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - S Ford
- Midland Abdominal and Retroperitoneal Sarcoma Unit, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - D Gourevitch
- Midland Abdominal and Retroperitoneal Sarcoma Unit, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - M Hallissey
- Department of Upper Gastrointestinal Surgery, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - A Desai
- Midland Abdominal and Retroperitoneal Sarcoma Unit, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
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Kirolos A, Mark K, Waugh C, Shetty J, McCallum A, Templeton K, Stevenson J. Cluster of acute flaccid paralysis in children following enterovirus D68 infection in Scotland. Eur J Public Health 2017. [DOI: 10.1093/eurpub/ckx187.697] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
| | - K Mark
- NHS Lothian, Edinburgh, UK
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Velcheti V, Bordeaux J, Dakappagari N, Pennell N, Stevenson J, Khunger M, Kim J, Schalper K, Rimm D. MA 13.03 Quantitative Spatial Profiling of PD-1/PD-L1 Interaction Predicts Response to Adjuvant Chemotherapy Non–Small-Cell Lung Cancer. J Thorac Oncol 2017. [DOI: 10.1016/j.jtho.2017.09.562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Abstract
Introduction The aim of this study was to identify patients with malignant hand lesions, establish the proportions of those that were metastases and review their clinical course. Methods A retrospective search of a prospective tumour database was carried out to identify all patients treated at our unit with hand metastases. Patient demographics were recorded including site of primary malignancy, region of the hand involved, management of their metastasis and clinical outcome. Results Overall, 149 patients were identified with a malignant tumour of the hand. Ten had a metastatic lesion. There were 3 women and 7 men with a median age of 68 years (range: 28-91 years) at presentation. All presented with non-mechanical hand pain while four had pain and swelling. The median interval from symptom onset to diagnosis was eight weeks. The minimum follow-up duration was four months. Three patients had no history of malignancy. Of the remaining seven patients, three had other known metastases. Six patients underwent solely palliative radiotherapy. Three patients had amputation. One was treated with surgical excision and radiotherapy. One had an amputation and axillary node clearance. All but one patient had died by the time of the latest follow-up appointment. The median time to death following identification of acrometastases was 18 months. Sites of primary disease were skin (n=4), lung (n=3), kidney (n=2) and neuroendocrine system (n=1). The thumb was the most commonly affected location. Conclusions This study demonstrates that patients presenting with non-mechanical hand pain should be considered to have a malignant process until proved otherwise, particularly in patients with thumb symptoms and a history of prior malignancy.
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Affiliation(s)
- G Morris
- Royal Orthopaedic Hospital NHS Foundation Trust , UK
| | - S Evans
- Royal Orthopaedic Hospital NHS Foundation Trust , UK
| | - J Stevenson
- Royal Orthopaedic Hospital NHS Foundation Trust , UK
| | - A Kotecha
- Royal Orthopaedic Hospital NHS Foundation Trust , UK
| | - M Parry
- Royal Orthopaedic Hospital NHS Foundation Trust , UK
| | - L Jeys
- Royal Orthopaedic Hospital NHS Foundation Trust , UK
| | - R Grimer
- Royal Orthopaedic Hospital NHS Foundation Trust , UK
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Abstract
Introduction Malignant osseous foot tumours are uncommon. Their oncological outcomes have been poorly documented in the literature so far. The aim of this study was to establish the incidence and to evaluate the oncological outcomes of such patients. Methods Our large orthopaedic oncology database was used to review 70 malignant osseous foot tumour patients. Results The age at diagnosis of malignant osseous foot tumours demonstrated a bimodal distribution peaking in the second and eighth decades of life. Overall, 55 primary malignant bone tumours of the foot (79%) were identified. The median duration from onset of symptoms to diagnosis was 52 weeks (interquartile range [IQR]: 17-104). Eight primary tumours (15%) underwent an accidental excision (ie intralesional excision of a malignant bone tumour where some of the tumour has been left behind, also known as a 'whoops procedure') prior to referral to our unit. Forty-six patients (84%) underwent surgery overall and thirteen of these developed recurrence or metastases. Seven of eight patients with a previous accidental excision underwent amputation. Fifteen osseous metastatic foot lesions were identified. The median length of foot symptoms to diagnosis was 24 weeks (IQR: 20-36 weeks). The median time to death following diagnosis of osseous foot metastases was 20.1 months (IQR: 11.3-27.8 months). Conclusions A high index of suspicion and awareness of clinical features of malignant osseous foot tumours are both essential to avoid diagnostic delays. Amputation is associated with a respectable outcome for patients who have undergone previous accidental excisions.
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Affiliation(s)
- P Yang
- Royal Orthopaedic Hospital NHS Foundation Trust , UK
| | - S Evans
- Royal Orthopaedic Hospital NHS Foundation Trust , UK
| | - N Bali
- Royal Orthopaedic Hospital NHS Foundation Trust , UK
| | - A Ramasamy
- Royal Orthopaedic Hospital NHS Foundation Trust , UK
| | - R Evans
- Royal Orthopaedic Hospital NHS Foundation Trust , UK
| | - J Stevenson
- Royal Orthopaedic Hospital NHS Foundation Trust , UK
| | - L Jeys
- Professor of Health and Life Sciences, Aston University , UK
| | - R Grimer
- Royal Orthopaedic Hospital NHS Foundation Trust , UK
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Jeys L, Morris G, Evans S, Stevenson J, Parry M, Gregory J. Surgical Innovation in Sarcoma Surgery. Clin Oncol (R Coll Radiol) 2017; 29:489-499. [PMID: 28502707 DOI: 10.1016/j.clon.2017.04.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2017] [Revised: 03/30/2017] [Accepted: 04/05/2017] [Indexed: 12/24/2022]
Abstract
The field of orthopaedic oncology relies on innovative techniques to resect and reconstruct a bone or soft tissue tumour. This article reviews some of the most recent and important innovations in the field, including biological and implant reconstructions, together with computer-assisted surgery. It also looks at innovations in other fields of oncology to assess the impact and change that has been required by surgeons; topics including surgical margins, preoperative radiotherapy and future advances are discussed.
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Affiliation(s)
- L Jeys
- Royal Orthopaedic Hospital, Birmingham, UK; School of Health and Life Sciences, Aston University, Birmingham, UK.
| | - G Morris
- Royal Orthopaedic Hospital, Birmingham, UK
| | - S Evans
- Royal Orthopaedic Hospital, Birmingham, UK
| | | | - M Parry
- Royal Orthopaedic Hospital, Birmingham, UK
| | - J Gregory
- Royal Orthopaedic Hospital, Birmingham, UK
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Stevenson J, Kwon A, Scalia G. How Good is Stroke Volume Calculation by the Doppler Continuity Method? Heart Lung Circ 2016. [DOI: 10.1016/j.hlc.2016.06.546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Danial J, Ballard-Smith S, Horsburgh C, Crombie C, Ovens A, Templeton KE, Hardie A, Cameron F, Harvey L, Stevenson J, Johannessen I. Lessons learned from a prolonged and costly norovirus outbreak at a Scottish medicine of the elderly hospital: case study. J Hosp Infect 2016; 93:127-34. [PMID: 27005281 DOI: 10.1016/j.jhin.2016.02.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [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: 09/01/2014] [Accepted: 02/01/2016] [Indexed: 10/22/2022]
Abstract
BACKGROUND Norovirus outbreaks are a major burden for healthcare facilities globally. AIM Lessons learned to inform an action plan to improve facilities as well as responses to norovirus within the medicine of the elderly (MoE) hospital as well as other NHS (National Health Service) Lothian facilities. METHODS This study investigated the impact of a prolonged outbreak at an MoE hospital in one of the 14 Scottish health boards between February and March 2013. FINDINGS In all, 143 patients (14.80 cases per 1000 inpatient bed-days) and 30 healthcare staff (3.10 cases per 1000 inpatient bed-days) were affected clinically and 63 patients were confirmed virologically. Restricting new admissions to affected units resulted in 1192 lost bed-days. The cost due to lost bed-days in addition to staff absence and management of the outbreak was estimated at £341,534 for this incident alone. At certain points during the outbreak, the whole facility was closed with resulting major impact on the health board's acute care hospitals. CONCLUSION Due to the outbreak, new measures were implemented for the first time within NHS Lothian that included floor-by-floor (instead of individual) ward closures, enhanced cleaning with chlorine-based products throughout the hospital, reduction in bed capacity with enhanced bed-spacing and interruption to direct admissions from the Board's general practice surgeries, and temporary suspension of visitors to affected areas. Together with regular communication to staff, patients, relatives, and the public throughout the outbreak and good engagement of staff groups in management of the incident, the outbreak was gradually brought under control.
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Affiliation(s)
- J Danial
- Infection Prevention and Control Team, Royal Infirmary of Edinburgh, Edinburgh, UK.
| | - S Ballard-Smith
- NHS Lothian Directorate of Nursing, Waverley Gate, Edinburgh, UK
| | - C Horsburgh
- Infection Prevention and Control Team, Royal Infirmary of Edinburgh, Edinburgh, UK
| | - C Crombie
- Specialist Virology Centre, Royal Infirmary of Edinburgh, Edinburgh, UK
| | - A Ovens
- Specialist Virology Centre, Royal Infirmary of Edinburgh, Edinburgh, UK
| | - K E Templeton
- Specialist Virology Centre, Royal Infirmary of Edinburgh, Edinburgh, UK
| | - A Hardie
- Specialist Virology Centre, Royal Infirmary of Edinburgh, Edinburgh, UK
| | - F Cameron
- Infection Prevention and Control Team, Royal Infirmary of Edinburgh, Edinburgh, UK
| | - L Harvey
- Specialist Virology Centre, Royal Infirmary of Edinburgh, Edinburgh, UK
| | - J Stevenson
- NHS Lothian Public Health, Waverley Gate, Edinburgh, UK
| | - I Johannessen
- Specialist Virology Centre, Royal Infirmary of Edinburgh, Edinburgh, UK
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Cai L, Stevenson J, Peng C, Xin R, Rastogi R, Liu K, Geng X, Gao Z, Ji X, Rafols JA, Ji Z, Ding Y. Adjuvant therapies using normobaric oxygen with hypothermia or ethanol for reducing hyperglycolysis in thromboembolic cerebral ischemia. Neuroscience 2016; 318:45-57. [PMID: 26794589 DOI: 10.1016/j.neuroscience.2016.01.010] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2015] [Revised: 11/25/2015] [Accepted: 01/06/2016] [Indexed: 01/08/2023]
Abstract
BACKGROUND AND PURPOSE Normobaric oxygen (NBO), ethanol (EtOH), and therapeutic hypothermia (TH) delivered alone or in combination have neuroprotective properties after acute stroke. We used an autologous thromboembolic rat stroke model to assess the additive effects of these treatments for reducing the deleterious effects of hyperglycolysis post-stroke in which reperfusion is induced with recombinant tissue plasminogen activator (rt-PA). METHODS Sprague-Dawley rats were subjected to middle cerebral artery (MCA) occlusion with an autologous embolus. One hour after occlusion, rt-PA was administered alone or with NBO (60%), EtOH (1.0 g/kg), TH (33 °C), either singly or in combination. Infarct volume and neurological deficit were assessed at 24h after rt-PA-induced reperfusion with or without other treatments. The extent of hyperglycolysis, as determined by cerebral glucose and lactate levels was evaluated at 3 and 24h after rt-PA administration. At the same time points, expressions of glucose transporter 1 (Glut1), glucose transporter 3 (Glut3), phosphofructokinase1 (PFK-1), and lactate dehydrogenase were (LDH) measured by Western blotting. RESULTS Following rt-PA in rats with thromboembolic stroke, NBO combined with TH or EtOH most effectively decreased infarct volume and neurological deficit. As compared to rt-PA alone, EtOH or TH but not NBO monotherapies significantly reduced post-stroke hyperglycolysis. The increased utilization of glucose and production of lactate post-stroke was prevented most effectively when NBO was combined with either EtOH or TH after reperfusion with rt-PA, as shown by the significantly decreased Glut1, Glut3, PFK-1, and LDH levels. CONCLUSIONS In a rat thromboembolic stroke model, both EtOH and TH used individually offer neuroprotection after the administration of rt-PA. While NBO monotherapy does not appear to be effective, it significantly potentiates the efficacy of EtOH and TH. The similar neuroprotection and underlying mechanisms pertaining to the attenuation of hyperglycolysis provided by EtOH or TH in combination with NBO suggest a possibility of substituting EtOH for TH. Thus a combination of NBO and EtOH, which are widely available and easily used, could become a novel and effective neuroprotective strategy in the clinical setting.
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Affiliation(s)
- L Cai
- China-America Institute of Neuroscience, Department of Neurology, Luhe Hospital, Capital Medical University, Beijing, China; Department of Neurological Surgery, Wayne State University School of Medicine, Detroit, MI, USA
| | - J Stevenson
- Department of Neurological Surgery, Wayne State University School of Medicine, Detroit, MI, USA
| | - C Peng
- Department of Neurological Surgery, Wayne State University School of Medicine, Detroit, MI, USA
| | - R Xin
- Department of Neurological Surgery, Wayne State University School of Medicine, Detroit, MI, USA; Department of Radiology, Luhe Hospital, Capital Medical University, Beijing, China
| | - R Rastogi
- Department of Neurological Surgery, Wayne State University School of Medicine, Detroit, MI, USA
| | - K Liu
- Department of Neurological Surgery, Wayne State University School of Medicine, Detroit, MI, USA
| | - X Geng
- China-America Institute of Neuroscience, Department of Neurology, Luhe Hospital, Capital Medical University, Beijing, China; Department of Neurological Surgery, Wayne State University School of Medicine, Detroit, MI, USA
| | - Z Gao
- Cerebral Vascular Diseases Research Institute, Capital Medical University, Beijing, China
| | - X Ji
- Cerebral Vascular Diseases Research Institute, Capital Medical University, Beijing, China
| | - J A Rafols
- Department of Anatomy and Cell Biology, Wayne State University School of Medicine, Detroit, MI, USA
| | - Z Ji
- China-America Institute of Neuroscience, Department of Neurology, Luhe Hospital, Capital Medical University, Beijing, China.
| | - Y Ding
- China-America Institute of Neuroscience, Department of Neurology, Luhe Hospital, Capital Medical University, Beijing, China; Department of Neurological Surgery, Wayne State University School of Medicine, Detroit, MI, USA.
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Sterman DH, Alley E, Friedberg J, Metzger S, Stevenson J, Moon E, Haas AR, Vachani A, Katz SI, Cheng G, Sun J, Heitjan DF, Litzky L, Cengel K, Simone CB, Culligan M, Culligan M, Albelda SM. Abstract B56: An immuno-gene therapy clinical trial evaluating in situ vaccination of malignant pleural mesothelioma with intrapleural delivery of adenovirus-interferon-alpha-2b in combination with chemotherapy. Cancer Immunol Res 2015. [DOI: 10.1158/2326-6074.tumimm14-b56] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: “In situ vaccination” immune-gene therapy has the ability to induce broad, polyclonal anti-tumor responses directed by the patient's own immune system using standard “off the shelf” agents. In this trial, we activated endogenous tumor immunity by injection of an adenovirus expressing a Type I interferon into the pleural space of patients with malignant pleural mesothelioma (MM). Based on preclinical data showing synergy with chemotherapy, all patients then received standard systemic cytotoxic therapy.
Methods: Two doses of intrapleural administration of a replication-defective recombinant adenoviral vector containing the human interferon-alpha (hIFN-α2b) gene at a dose of 3x1011 viral particles were given concomitant with a 14-day course of high-dose cyclo-oxygenase-2 (COX-2) inhibitor (Celecoxib) to reduce side effects and to modify the tumor microenvironment by decreasing PGE- 2 levels. This was followed by standard first-line or second-line chemotherapy agents. Primary outcome measures were safety, overall best response rate, and survival. Bio-correlates were measured.
Results: Forty patients were treated in this study: 18 patients received first-line Pemetrexed-based chemotherapy; 7 patients who had previously received front-line Pemetrexed-based chemotherapy >6 months prior to enrollment received Pemetrexed-based second-line chemotherapy. Additionally, in the second-line chemotherapy arm, fifteen patients (n=15) received gemcitabine-based chemotherapy. Treatment was well tolerated and adverse events were comparable to historical controls. Follow-up chest CT scans demonstrated an overall response rate of 20% by Modified RECIST criteria and disease control rate (DCR) of 85% (partial and complete responses plus stable disease) at initial follow-up scan after the first two cycles of chemotherapy. Encouragingly, median survival for all patients with epithelial histology (including both first and second line) was 26 months (95% CI: 15-ND); median overall survival (MOS) for patients with non-epithelial histology (both first and second line) was 6.5 months (95% CI: 5.50 – ND). [See figure] Historical MOS with first line chemotherapy alone is 13.3 months. No clear predictors for response were identified including: baseline immunologic parameters (i.e. activated T cells or number of regulatory T cells); the presence of the immune-gene signature in their biopsies; peak levels of interferon in blood or pleural fluid; or induction of anti-tumor antibodies, activated T cells, or natural killer cells in peripheral blood.
Conclusions: The combination of intrapleural Ad.IFN-α2b vector, Celecoxib, and systemic chemotherapy proved safe in patients with unresectable malignant pleural mesothelioma. Overall survival rates were significantly higher than historical controls, particularly in the second-line groups. The results of this study support proceeding with a multi-center randomized clinical trial of chemo-immunogene therapy versus standard chemotherapy alone.
Citation Format: D. H. Sterman, E. Alley, J. Friedberg, S. Metzger, J. Stevenson, E. Moon, A. R. Haas, A. Vachani, S. I. Katz, G. Cheng, J. Sun, D. F. Heitjan, L. Litzky, K. Cengel, C. B. Simone, II, M. Culligan, M. Culligan, S. M. Albelda. An immuno-gene therapy clinical trial evaluating in situ vaccination of malignant pleural mesothelioma with intrapleural delivery of adenovirus-interferon-alpha-2b in combination with chemotherapy. [abstract]. In: Proceedings of the AACR Special Conference: Tumor Immunology and Immunotherapy: A New Chapter; December 1-4, 2014; Orlando, FL. Philadelphia (PA): AACR; Cancer Immunol Res 2015;3(10 Suppl):Abstract nr B56.
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Affiliation(s)
| | - E. Alley
- University of Pennsylvania, Philadelphia, PA
| | | | - S. Metzger
- University of Pennsylvania, Philadelphia, PA
| | | | - E. Moon
- University of Pennsylvania, Philadelphia, PA
| | - A. R. Haas
- University of Pennsylvania, Philadelphia, PA
| | - A. Vachani
- University of Pennsylvania, Philadelphia, PA
| | - S. I. Katz
- University of Pennsylvania, Philadelphia, PA
| | - G. Cheng
- University of Pennsylvania, Philadelphia, PA
| | - J. Sun
- University of Pennsylvania, Philadelphia, PA
| | | | - L. Litzky
- University of Pennsylvania, Philadelphia, PA
| | - K. Cengel
- University of Pennsylvania, Philadelphia, PA
| | | | - M. Culligan
- University of Pennsylvania, Philadelphia, PA
| | - M. Culligan
- University of Pennsylvania, Philadelphia, PA
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Jennings CS, Jones J, Mead A, Connolly S, Kotseva K, Holden A, Fiumicelli G, Stevenson J, Hunjan M, Turner E, Wood DA. 025 Lifestyle and health related quality of life changes in coronary and high CVD risk patients and their partners attending the MYACTION integrated vascular prevention programme in the community. Heart 2015. [DOI: 10.1136/hrt.2010.195941.25] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Perry MEO, Taylor GP, Sabin CA, Conway K, Flanagan S, Dwyer E, Stevenson J, Mulka L, McKendry A, Williams E, Barbour A, Dermont S, Roedling S, Shah R, Anderson J, Rodgers M, Wood C, Sarner L, Hay P, Hawkins D, deRuiter A. Lopinavir and atazanavir in pregnancy: comparable infant outcomes, virological efficacies and preterm delivery rates. HIV Med 2015. [PMID: 26200570 DOI: 10.1111/hiv.12277] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVES The aim of the study was to identify differences in infant outcomes, virological efficacy, and preterm delivery (PTD) outcome between women exposed to lopinavir/ritonavir (LPV/r) and those exposed to atazanavir/ritonavir (ATV/r). METHODS A retrospective case note review was carried out. The case notes of 493 women who conceived while on LPV/r or ATV/r or initiated LPV/r or ATV/r during pregnancy and who delivered between 1 September 2007 and 30 August 2012 were reviewed. Data collected included demographics, antiretroviral use, HIV markers, and pregnancy and infant outcomes. Infant outcomes, virological efficacies and PTD rates for LPV/r and ATV/r were compared. RESULTS A total of 306 women received LPV/r (82 conceiving while on the drug and 224 commencing it post-conception) and 187 received ATV/r (96 conceiving while on the drug and 91 commencing it post-conception). Comparing the two protease inhibitors (PIs), viral suppression rates were similar and, in women starting antiretroviral therapy (ART) post-conception, the median times to first undetectable HIV viral load were not significantly different (P = 0.64). PTD rates did not differ by therapy overall (ATV/r, 13%; LPV/r, 14%) or when considering the timing of first exposure (conceiving on ART, P = 0.81; commencing ART in pregnancy, P = 0.08). Poor fetal outcomes were very uncommon. There were two transmissions, giving a mother-to-child transmission (MTCT) rate of 0.4% (95% confidence interval 0.05-1.5%). CONCLUSIONS Both ART regimens were well tolerated and successful in preventing MTCT. No significant differences in tolerability or in pregnancy or infant outcomes were observed, which supports the provision of a choice of PI in pregnancy.
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Affiliation(s)
- M E O Perry
- Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - G P Taylor
- Imperial College Healthcare NHS Trust, London, UK
| | - C A Sabin
- Research Department of Infection and Population Health, University College London, London, UK
| | - K Conway
- Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - S Flanagan
- Homerton University Hospital NHS Foundation Trust, London, UK
| | - E Dwyer
- Croydon University Hospital NHS Trust, London, UK
| | - J Stevenson
- Croydon University Hospital NHS Trust, London, UK
| | - L Mulka
- Imperial College Healthcare NHS Trust, London, UK
| | - A McKendry
- The North Middlesex University Hospital NHS Trust, London, UK
| | | | | | - S Dermont
- Chelsea and Westminster Hospital NHS Foundation Trust, London, UK
| | - S Roedling
- (Mortimer Market Centre) Central and North West London NHS Foundation Trust, London, UK
| | - R Shah
- Barnet and Chase Farm Hospital NHS Trust, London, UK
| | - J Anderson
- Homerton University Hospital NHS Foundation Trust, London, UK
| | - M Rodgers
- Croydon University Hospital NHS Trust, London, UK
| | - C Wood
- The North Middlesex University Hospital NHS Trust, London, UK
| | - L Sarner
- Barts Health NHS Trust, London, UK
| | - P Hay
- St George's NHS Trust, London, UK
| | - D Hawkins
- Chelsea and Westminster Hospital NHS Foundation Trust, London, UK
| | - A deRuiter
- Guy's and St Thomas' NHS Foundation Trust, London, UK
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Kolasa MS, Stevenson J, Ossa A, Lutz J. Does closure of children's medical home impact their immunization coverage? Public Health 2014; 128:1106-11. [PMID: 25443105 DOI: 10.1016/j.puhe.2014.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2013] [Revised: 07/23/2014] [Accepted: 08/04/2014] [Indexed: 11/18/2022]
Abstract
OBJECTIVES Little is known about the impact closing a health care facility has on immunization coverage of children utilizing that facility as a medical home. The authors assessed the impact of closing a Medicaid managed care facility in Philadelphia on immunization coverage of children, primarily low income children from racial/ethnic minority groups, utilizing that facility for routine immunizations. STUDY DESIGN Observational longitudinal cohort case study. METHODS Eligible children were born 03/01/05-06/30/07, present in Philadelphia's immunization information system (IIS), and were active clients of the facility before it closed in September 2007. IIS-recorded immunization coverage at ages 5, 7, 13, 16 and 19 months through January 2009 was compared between clinic children age-eligible to receive specific vaccines before clinic closing (preclosure cohorts) and children not age-eligible to receive those vaccines prior to closing (postclosure cohorts). RESULTS Of 630 eligible children, 99 (16%) had no additional IIS-recorded immunizations. Third dose DTaP vaccine coverage at age seven months among preclosure cohorts was 54.4% vs. 40.3% among postclosure cohorts [risk ratio 1.31 (1.15,1.49)]. Fourth dose DTaP coverage at 19 months was 65.9% vs. 57.7% [risk ratio 1.24 (1.08,1.42)]. MMR coverage at 16 months was 79.5% vs. 69.9% [risk ratio 1.47 (1.22, 1.76)]. Coverage for the 431331 vaccination series at 19 months was 63.8% vs. 53.8% [risk ratio 1.28 (1.12,1.88)]. CONCLUSIONS Immunization coverage declined at key age milestones for active clients of a Medicaid managed care that closed as compared with preclosure cohorts of clients from the same facility. When a primary health care facility closes, efforts should be made to ensure that children who had received vaccinations at that facility quickly establish a new medical home.
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Affiliation(s)
- M S Kolasa
- Health Services Research and Evaluation Branch, National Center for Immunization and Respiratory Disease, Centers for Disease Control and Prevention, 1600 Clifton Rd, A19, Atlanta, GA 30333, USA.
| | - J Stevenson
- Health Services Research and Evaluation Branch, National Center for Immunization and Respiratory Disease, Centers for Disease Control and Prevention, 1600 Clifton Rd, A19, Atlanta, GA 30333, USA.
| | - A Ossa
- Philadelphia Department of Public Health, 500 S Broad St, 2nd Floor, Philadelphia, PA 19146, USA.
| | - J Lutz
- Program Operations Branch, National Center for Immunization and Respiratory Disease, Centers for Disease Control and Prevention, 1600 Clifton Rd, A19, Atlanta, GA 30333, USA.
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Varnold K, Calkins C, Nuttelmann B, Senaratne-Lenagala L, Stevenson J, Semler M, Chao M, Carr T, Erickson G. Background grazing, supplementation, finishing diet and aging affect biochemical constituents of beef bottom round steaks. Meat Sci 2014. [DOI: 10.1016/j.meatsci.2013.07.089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Potts A, Donaghy M, Marley M, Othieno R, Stevenson J, Hyland J, Pollock KG, Lindsay D, Edwards G, Hanson MF, Helgason KO. Cluster of Legionnaires’ disease cases caused by Legionella longbeachae serogroup 1, Scotland, August to September 2013. Euro Surveill 2013; 18:20656. [DOI: 10.2807/1560-7917.es2013.18.50.20656] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Binary file ES_Abstracts_Final_ECDC.txt matches
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Affiliation(s)
- A Potts
- Health Protection Scotland, Glasgow, Scotland, United Kingdom
| | - M Donaghy
- Health Protection Scotland, Glasgow, Scotland, United Kingdom
| | - M Marley
- Health Protection Scotland, Glasgow, Scotland, United Kingdom
| | - R Othieno
- Health Protection Team, NHS Lothian, Edinburgh, Scotland, United Kingdom
| | - J Stevenson
- Health Protection Team, NHS Lothian, Edinburgh, Scotland, United Kingdom
| | - J Hyland
- Health Protection Team, NHS Tayside, Dundee, Scotland, United Kingdom
| | - K G Pollock
- Health Protection Scotland, Glasgow, Scotland, United Kingdom
| | - D Lindsay
- Scottish Haemophilus Legionella Meningococcus Pneumococcus Reference Laboratory, Glasgow, Scotland, United Kingdom
| | - G Edwards
- Scottish Haemophilus Legionella Meningococcus Pneumococcus Reference Laboratory, Glasgow, Scotland, United Kingdom
| | - M F Hanson
- Microbiology Department, Royal Infirmary of Edinburgh, NHS Lothian, Edinburgh, Scotland, United Kingdom
| | - K O Helgason
- Microbiology Department, Royal Infirmary of Edinburgh, NHS Lothian, Edinburgh, Scotland, United Kingdom
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Conaglen PD, Laurenson IF, Sergeant A, Thorn SN, Rayner A, Stevenson J. Systematic review of tattoo-associated skin infection with rapidly growing mycobacteria and public health investigation of a cluster in Scotland, 2010. Euro Surveill 2013; 18:20553. [DOI: 10.2807/1560-7917.es2013.18.32.20553] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Sporadic cases and outbreaks of tattoo-associated skin infection with rapidly growing mycobacteria have been reported although they often contain few details of public health investigations and have not previously been systematically collated. We present the details of the public health investigation of a cluster of cases, which occurred in Scotland in 2010. Investigation of the cluster involved case finding, environmental investigation of the tattoo studio and pathological and microbiological investigation of possible cases and tattoo ink. Mycobacterium chelonae was isolated from one case and three probable cases were identified. M. chelonae was grown from an opened bottle of ink sourced from the studio these cases had attended. In addition, in order to identify all published cases, we conducted a systematic review of all reported cases of tattoo-associated skin infection with rapidly growing mycobacteria. A total of 25 reports were identified, describing 71 confirmed and 71 probable cases. Mycobacteria were isolated in 71 cases and M. chelonae was cultured from 48 of these. The most frequently postulated cause of infection was the dilution of black ink with tap water. Reports of tattoo-associated rapidly growing mycobacterial skin infection are increasing in frequency. Interested agencies must work with the tattoo industry to reduce the risk of contamination during tattoo ink manufacture, distribution and application.
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Affiliation(s)
- P D Conaglen
- NHS Fife, Department of Public Health, Cameron House, Leven, United Kingdom
| | - I F Laurenson
- NHS Lothian, Scottish Mycobacteria Reference Laboratory, Royal Infirmary of Edinburgh, Edinburgh, United Kingdom
| | - A Sergeant
- NHS Lothian, Department of Dermatology, Lauriston Building, Edinburgh, United Kingdom
| | - S N Thorn
- NHS Lothian, Department of Public Health, Waverley Gate, Edinburgh, United Kingdom
| | - A Rayner
- NHS Lothian, Scottish Mycobacteria Reference Laboratory, Royal Infirmary of Edinburgh, Edinburgh, United Kingdom
| | - J Stevenson
- NHS Lothian, Department of Public Health, Waverley Gate, Edinburgh, United Kingdom
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Abstract
AIM The aim of our study was to determine the effectiveness of contact tracing for both pulmonary and non-pulmonary tuberculosis (TB). METHODS The authors studied contact tracing in South East of Scotland, Edinburgh TB Clinic, UK, for 3 years. New index cases of both pulmonary and non-pulmonary TB were identified from reviewing TB nurses records. Pulmonary involvement was excluded from all non-pulmonary cases. Active TB was diagnosed as per the national TB guidelines. Latent TB was diagnosed based on history, tuberculin skin test and interferon γ release assay. TB contacts were identified from reviewing TB nurses notes on index TB patients. A positive screening episode was defined as identification of either active or latent TB in a contact following relevant investigations. RESULTS Total number of positive screening episodes for pulmonary TB was 43.1% and non-pulmonary TB was 26.1%. Of these, 78.8% were household contacts and 21.2% were casual contacts. CONCLUSION Contact tracing in low-prevalence TB countries, for both pulmonary and non-pulmonary TB, is an essential intervention to identify and reduce the number of infected patients that will progress to active disease. This is the key for effective TB control.
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Affiliation(s)
- P Mandal
- Centre for Inflammation Research, University of Edinburgh, Queen's Medical Research Institute, Edinburgh EH16 4TJ, UK.
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McCormick D, Thorn S, Milne D, Evans C, Stevenson J, Llano M, Donaghy M, on behalf of the Incident Management Team C. Public health response to an outbreak of Legionnaires’ disease in Edinburgh, United Kingdom, June 2012. Euro Surveill 2012; 17. [PMID: 22835439 DOI: 10.2807/ese.17.28.20216-en] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Binary file ES_Abstracts_Final_ECDC.txt matches
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Affiliation(s)
- D McCormick
- National Health Service, Lothian, Directorate of Public Health and Health Policy, Edinburgh, United Kingdom
| | - S Thorn
- National Health Service, Lothian, Directorate of Public Health and Health Policy, Edinburgh, United Kingdom
| | - D Milne
- National Health Service, Lothian, Directorate of Public Health and Health Policy, Edinburgh, United Kingdom
| | - C Evans
- National Health Service, Lothian, Directorate of Public Health and Health Policy, Edinburgh, United Kingdom
| | - J Stevenson
- National Health Service, Lothian, Directorate of Public Health and Health Policy, Edinburgh, United Kingdom
| | - M Llano
- National Health Service, Lothian, Directorate of Public Health and Health Policy, Edinburgh, United Kingdom
| | - M Donaghy
- Health Protection Scotland, National Health Service, National Services Scotland, Glasgow, United Kingdom
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Cheserem E, Stevenson J, Evason R, Brady M. O3 Gonorrhoea test of cure: outcomes in a large urban sexual health service. Br J Vener Dis 2012. [DOI: 10.1136/sextrans-2012-050601a.3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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de la Haye B, Wild SH, Stevenson J, Johnston F, Blatchford O, Laurenson IF. Tuberculosis and alcohol misuse in Scotland: a population-based study using enhanced surveillance data. Int J Tuberc Lung Dis 2012; 16:886-90. [PMID: 22583556 DOI: 10.5588/ijtld.11.0624] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE To identify for the first time in Scotland the epidemiological characteristics of tuberculosis (TB) patients who misuse alcohol. DESIGN A retrospective cohort study using Enhanced Surveillance of Mycobacterial Infections (ESMI) scheme data for adult (aged ≥ 18 years) TB cases notified in Scotland, 2001-2007. Characteristics and treatment outcomes of TB cases with and without recorded alcohol misuse were compared. RESULTS Of 2419 adult TB cases, alcohol misuse was recorded in 426 (18%). Alcohol misuse was associated with male sex, White ethnicity, birth in the United Kingdom, unemployment, urban residence and socio-economic deprivation. Alcohol misusers were more likely than other TB cases to have pulmonary TB (92% vs. 61%, P < 0.001), be sputum smear-positive (74% vs. 58%, P < 0.001) and be enrolled on directly observed treatment (30% vs. 3%, P < 0.001). Treatment completion rates were respectively 77% and 79% (P = 0.34) in alcohol misusers and other TB cases. CONCLUSION We have identified epidemiological characteristics associated with alcohol misuse among TB patients in Scotland, notably socio-economic deprivation. We suggest improvements in data collection to allow more robust findings to inform policy decisions to assist the prevention and management of alcohol misuse and reduce the TB incidence in Scotland.
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Affiliation(s)
- B de la Haye
- Centre for Population Health Sciences, University of Edinburgh, Edinburgh, UK.
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Wheeler QD, Knapp S, Stevenson DW, Stevenson J, Blum SD, Boom BM, Borisy GG, Buizer JL, De Carvalho MR, Cibrian A, Donoghue MJ, Doyle V, Gerson EM, Graham CH, Graves P, Graves SJ, Guralnick RP, Hamilton AL, Hanken J, Law W, Lipscomb DL, Lovejoy TE, Miller H, Miller JS, Naeem S, Novacek MJ, Page LM, Platnick NI, Porter-Morgan H, Raven PH, Solis MA, Valdecasas AG, Van Der Leeuw S, Vasco A, Vermeulen N, Vogel J, Walls RL, Wilson EO, Woolley JB. Mapping the biosphere: exploring species to understand the origin, organization and sustainability of biodiversity. SYST BIODIVERS 2012. [DOI: 10.1080/14772000.2012.665095] [Citation(s) in RCA: 59] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Tiernan JF, Gilhooley S, Jones ME, Chalmers JD, McSparron C, Laurenson I, Stevenson J, Hill AT. P15 Does an interferon-gamma release assay change practice in patients referred to clinic for possible latent tuberculosis infection? Thorax 2011. [DOI: 10.1136/thoraxjnl-2011-201054c.15] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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