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Lee M, Barnes J, Vermilyea S, Meints J, Martinez H. Soluble and insoluble lysates from the human A53T mutant α-synuclein transgenic mouse model induces α-synucleinopathy independent of injection site. Res Sq 2024:rs.3.rs-3982325. [PMID: 38496623 PMCID: PMC10942550 DOI: 10.21203/rs.3.rs-3982325/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/19/2024]
Abstract
Pathological aggregation of a-synuclein (aS) is implicated in the pathogenesis of Parkinson's disease (PD) and other a-synucleinopathies. The current view is that neuron-to-neuron spreading of aS pathology contributes to the progression of a-synucleinopathy. We used an A53T mutant human aS transgenic mouse model (TgA53T) to examine whether the site of pathogenic aS inoculation affects the pattern of neuropathology and whether soluble and insoluble fractions derived from crude pathogenic tissue lysates exhibit differential capacities to initiate aS pathology. To test whether the inoculation site impacts the ultimate spatial/temporal patterns of aS pathology, aS preformed fibrils (PFF), or brain homogenates from TgA53T mice with a-synucleinopathy, were injected into the cortex/striatum, brain stem, or skeletal muscle. In all cases, inoculation of pathogenic aS induced end-stage motor dysfunction within ~100 days post-inoculation (dpi). Significantly, irrespective of the inoculation sites, ultimate distribution of the aS pathology was like that seen in normally aged TgA53T mice at end-stage, indicating that the intrinsic neuronal vulnerability is a significant determinant in the induction of aS pathology, even when initiated by inoculation of pathogenic aS. Temporal analysis of brain stem injected TgA53T mice show that initial aS pathology was seen by 30 days post-inoculation and inflammatory changes occur at later stages. To determine if the aS species with differential solubility are differentially pathogenic, brain lysates from end-stage TgA53Tmice were fractionated into highly soluble (S150) and insoluble (P150) fractions, as well as the endoplasmic reticulum (ER)-enriched fraction (P100). Significantly, all fractions were able to seed de novo aS pathology in vivo, when injected unilaterally into TgA53Tmice with the ER fractions being most pathogenic. Our results suggest that multiple aS species from brain can initiate the development of progressive aS pathology.
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Harrogate S, Barnes J, Thomas K, Isted A, Kunst G, Gupta S, Rudd S, Banerjee T, Hinchliffe R, Mouton R. Peri-operative tobacco cessation interventions: a systematic review and meta-analysis. Anaesthesia 2023; 78:1393-1408. [PMID: 37656151 PMCID: PMC10952322 DOI: 10.1111/anae.16120] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/27/2023] [Indexed: 09/02/2023]
Abstract
Tobacco smoking is associated with a substantially increased risk of postoperative complications. The peri-operative period offers a unique opportunity to support patients to stop tobacco smoking, avoid complications and improve long-term health. This systematic review provides an up-to-date summary of the evidence for tobacco cessation interventions in surgical patients. We conducted a systematic search of randomised controlled trials of tobacco cessation interventions in the peri-operative period. Quantitative synthesis of the abstinence outcomes data was by random-effects meta-analysis. The primary outcome of the meta-analysis was abstinence at the time of surgery, and the secondary outcome was abstinence at 12 months. Thirty-eight studies are included in the review (7310 randomised participants) and 26 studies are included in the meta-analysis (5969 randomised participants). Studies were pooled for subgroup analysis in two ways: by the timing of intervention delivery within the peri-operative period and by the intensity of the intervention protocol. We judged the quality of evidence as moderate, reflecting the degree of heterogeneity and the high risk of bias. Overall, peri-operative tobacco cessation interventions increased successful abstinence both at the time of surgery, risk ratio (95%CI) 1.48 (1.20-1.83), number needed to treat 7; and 12 months after surgery, risk ratio (95%CI) 1.62 (1.29-2.03), number needed to treat 9. More work is needed to inform the design and optimal delivery of interventions that are acceptable to patients and that can be incorporated into contemporary elective and urgent surgical pathways. Future trials should use standardised outcome measures.
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Affiliation(s)
- S. Harrogate
- Elizabeth Blackwell InstituteUniversity of BristolBristolUK
- Department of Anaesthesia, North Bristol NHS TrustBristolUK
| | - J. Barnes
- Department of Anaesthesia, North Bristol NHS TrustBristolUK
| | - K. Thomas
- Department of Population Health Sciences, Bristol Medical SchoolUniversity of BristolBristolUK
| | - A. Isted
- Department of Anaesthesia, King's College Hospital NHS Foundation TrustLondonUK
| | - G. Kunst
- School of Cardiovascular and Metabolic Medicine and Sciences, King's College LondonLondonUK
- Department of Anaesthesia, King's College Hospital NHS Foundation TrustLondonUK
| | - S. Gupta
- Department of AnaesthesiaUniversity Hospitals Bristol and Weston NHS Foundation TrustBristolUK
| | - S. Rudd
- North Bristol NHS TrustBristolUK
| | | | - R. Hinchliffe
- Department of Translational Health Sciences, Bristol Medical SchoolUniversity of BristolBristolUK
- Department of Vascular Services, North Bristol NHS TrustBristolUK
| | - R. Mouton
- Department of Translational Health Sciences, Bristol Medical SchoolUniversity of BristolBristolUK
- Department of Anaesthesia, North Bristol NHS TrustBristolUK
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Wang B, Barnes J, Ferrara SJ, Sproules S, Zhang X, Mague JT, Donahue JP. Fully Reduced and Mixed-Valent Multi-Copper Aggregates Supported by Tetradentate Diamino Bis(thiolate) Ligands. Inorg Chem 2023. [PMID: 37310001 DOI: 10.1021/acs.inorgchem.3c00784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Tetradentate diamino bis(thiolate) ligands (l-N2S2(2-)) with saturated linkages between heteroatoms support fully reduced [(Cu(l-N2S2))2Cu2] complexes that bear relevance as an entry point toward molecules featuring the Cu2ICu2II(μ4-S) core composition of nitrous oxide reductase (N2OR). Tetracopper [(Cu(l-N2(SMe2)2))2Cu2] (l-N2(SMe2H)2 = N1,N2-bis(2-methyl-2-mercaptopropane)-N1,N2-dimethylethane-1,2-diamine) does not support clean S atom oxidative addition but undergoes Cl atom transfer from PhICl2 or Ph3CCl to afford [(Cu(l-N2(SMe2)2))3(CuCl)5], 14. When introduced to Cu(I) sources, the l-N2(SArH)2 ligand (l-N2(SArH)2 = N1,N2-bis(2-mercaptophenyl)-N1,N2-dimethylethane-1,2-diamine), made by a newly devised route from N1,N2-bis(2-fluorophenyl)-N1,N2-dimethylethane-1,2-diamine, ultimately yields the mixed-valent pentacopper [(Cu(l-N2SAr2))3Cu2] (19), which has 3-fold rotational symmetry (D3) around a Cu2 axis. The single CuII ion of 19 is ensconced within an equatorial l-N2(SAr)2(2-) ligand, as shown by 14N coupling in its EPR spectrum. Formation of 19 proceeds from an initial, fully reduced product, [(Cu(l-N2SAr2))3Cu2(Cu(MeCN))] (17), which is C2 symmetric and exceedingly air-sensitive. While unreactive toward chalcogen donors, 19 supports reversible reduction to the all-cuprous state; generation of [19]1- and treatment with S atom donors only return 19 because structural adjustments necessary for oxidative addition are noncompetitive with outer-sphere electron transfer. Oxidation of 19 is marked by intense darkening, consistent with greater mixed valency, and by dimerization in the crystalline state to a decacopper species ([20]2+) of S4 symmetry.
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Affiliation(s)
- Bo Wang
- Department of Chemistry, Tulane University, 6400 Freret Street, New Orleans, Louisiana 70118-5638, United States
| | - Justin Barnes
- Department of Chemistry, Tulane University, 6400 Freret Street, New Orleans, Louisiana 70118-5638, United States
| | - Skylar J Ferrara
- Department of Chemistry, Tulane University, 6400 Freret Street, New Orleans, Louisiana 70118-5638, United States
| | - Stephen Sproules
- WestCHEM, School of Chemistry, University of Glasgow, Glasgow G12 8QQ, U.K
| | - Xiaodong Zhang
- Department of Chemistry, Tulane University, 6400 Freret Street, New Orleans, Louisiana 70118-5638, United States
| | - Joel T Mague
- Department of Chemistry, Tulane University, 6400 Freret Street, New Orleans, Louisiana 70118-5638, United States
| | - James P Donahue
- Department of Chemistry, Tulane University, 6400 Freret Street, New Orleans, Louisiana 70118-5638, United States
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Verma S, Ramsay A, Drezek K, Pico A, Chubrikova O, Barnes J, Guiry J, Winship T, D'Alessandro D, Ton V, Coglianese E. Post-Implant Outcomes in Diabetic vs. Non-Diabetic Durable LVAD Patients. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.785] [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: 04/05/2023] Open
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Chubrikova O, Ramsay A, Drezek K, Verma S, Winship T, Barnes J, Guiry J, Pico A, D'Alessandro D, Ton V, Coglianese E. Effects of ICU Infection on Durable LVAD Patient Outcomes. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.1569] [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: 04/05/2023] Open
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Abstract
IMPORTANCE In the US, suicide is the 10th leading cause of death and a serious mental health emergency. National programs that address suicide list access to mental health care as key in prevention, and more large-scale policies are needed to improve access to mental health care and address this crisis. The Patient Protection and Affordable Care Act (ACA) Medicaid Expansion Program was implemented in several states with the goal of increasing access to the health care system. OBJECTIVE To compare changes in suicide rates in states that expanded Medicaid under the ACA vs states that did not. DESIGN, SETTING, AND PARTICIPANTS In this cross-sectional study, state-level mortality rates were obtained from the National Center for Health Statistics for US individuals aged 20 to 64 years from January 1, 2000, to December 31, 2018. Data analysis was performed from April 18, 2021, to April 15, 2022. EXPOSURES Changes in suicide mortality rates among nonelderly adults before and after Medicaid expansion in expansion and nonexpansion states were compared using adjusted difference-in-differences analyses via hierarchical bayesian linear regression. MAIN OUTCOMES AND MEASURES Suicide rates using death by suicide as the primary measure. RESULTS Of the total population at risk for suicide, 50.4% were female, 13.3% were Black, 79.5% were White, and 7.2% were of other races. The analytic data set contained suicide mortality data for 2907 state-age-year units covering the general US population. A total of 553 912 deaths by suicide occurred during the study period, with most occurring in White (496 219 [89.6%]) and male (429 580 [77.6%]) individuals. There were smaller increases in the suicide rate after 2014 in Medicaid expansion (2.56 per 100 000 increase) compared with nonexpansion states (3.10 per 100 000 increase). In adjusted difference-in-differences analysis, a significant decrease of -0.40 (95% credible interval, -0.66 to -0.14) suicides per 100 000 individuals was found, translating to 1818 suicides that were averted in 2015 to 2018. CONCLUSIONS AND RELEVANCE In this cross-sectional study, although suicide rates increased in both groups, blunting of these rates occurred among nonelderly adults in the Medicaid expansion states compared with nonexpansion states. Because this difference may be linked to increased access to mental health care, policy makers should consider suicide prevention as a benefit of expanding access to health care.
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Affiliation(s)
- Hetal Patel
- Department of Psychiatry, Washington University School of Medicine in St Louis, St Louis, Missouri
| | - Justin Barnes
- Department of Radiation Oncology, Washington University School of Medicine in St Louis, St Louis, Missouri
| | - Nosayaba Osazuwa-Peters
- Deputy Editor, Diversity, Equity, and Inclusion, JAMA Otolaryngology–Head and Neck Surgery
- Department of Population Health Sciences, Duke University School of Medicine, Durham, North Carolina
- Department of Head and Neck Surgery & Communication Sciences, Duke University School of Medicine, Durham, North Carolina
| | - Laura Jean Bierut
- Department of Psychiatry, Washington University School of Medicine in St Louis, St Louis, Missouri
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Jakeman M, Barnes J, Taghizadeh R. Prevention and Management of Post-Deep Inferior Epigastric Perforator Flap Abdominal Bulge: a Five-year Single Surgeon Series. J Plast Reconstr Aesthet Surg 2022; 75:3683-3689. [DOI: 10.1016/j.bjps.2022.06.017] [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] [Received: 05/26/2021] [Revised: 03/12/2022] [Accepted: 06/08/2022] [Indexed: 11/16/2022]
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Martinez L, Cacciottolo P, Barnes J, Sylvester K, Oates K, Kydd A, Lewis C, Parameshwar J, Pettit S, Bhagra S. Circulatory Power is Superior to Peak Oxygen Consumption in Predicting Adverse Outcomes in Ambulatory Patients Assessed for Heart Transplantation. J Heart Lung Transplant 2022. [DOI: 10.1016/j.healun.2022.01.1674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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9
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Logan T, Barnes J, Ton V, Thomas S, Camuso J, Milley K, Dempsey A, D'Alessandro D, Coglianese E. Outcomes in Patients with a Centrifugal Flow with Full Magnetic Levitation Left Ventricular Assist Device (CF-FML LVAD) Who Did Not Receive Bridging with a Continuous Heparin Infusion (CHI) After Implantation. J Heart Lung Transplant 2022. [DOI: 10.1016/j.healun.2022.01.1233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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10
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Zahirsha Z, Barnes J, Simpson MC, Osazuwa-Peters N. 25553 Suicide risk among melanoma and nonepithelial skin cancer patients: A Surveillance, Epidemiology, and End Results analysis. J Am Acad Dermatol 2021. [DOI: 10.1016/j.jaad.2021.06.056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Roy A, Brenneman RJ, Hogan J, Barnes J, Huang Y, Morris R, Goddu SM, Michael A, Garcia-Ramirez J, Li H, Zoberi JE, Bullock A, Kim E, Smith Z, Figenshau R, Andriole G, Baumann B, Michalski J, Gay H. PRSOR07 Presentation Time: 12:30 PM. Brachytherapy 2021. [DOI: 10.1016/j.brachy.2021.06.071] [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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12
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Mackey S, Barnes J, Pike K, De Carvalho D. The relation between the flexion relaxation phenomenon onset angle and lumbar spine muscle reflex onset time in response to 30 min of slumped sitting. J Electromyogr Kinesiol 2021; 58:102545. [PMID: 33756279 DOI: 10.1016/j.jelekin.2021.102545] [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] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Revised: 03/04/2021] [Accepted: 03/08/2021] [Indexed: 11/26/2022] Open
Abstract
Viscoelastic creep of spine tissue, induced by submaximal spine flexion in sitting, can delay the onset of the flexion-relaxation phenomenon (FRP) and low back reflexes (LBR). Theoretically, these two outcome measures should be correlated; however, no studies have investigated this. This study aims to determine whether 30 min of near-maximal spine flexion will affect the onset of FRP and LBR in the lumbar erector spinae (LS) and lumbar multifidus (LM), and to examine the relation between these parameters. 15 participants were recruited (9F, 6M). Spine angle (between L1 and S2) was monitored synchronously with bilateral muscle activity in the LS (L1) and the LM (L4). FRP onset and LBR were measured in a randomized order before and after 30 min of slouched sitting. No significant difference was found for any muscle LBR onset time between pre and post-sitting (p > 0.05). A significant increase in FRP onset was found in the RLM (p = 0.016) following sitting. No significant correlation was found between the FRP and the LBR for any muscle. These results suggest that the LBR onset might not be as sensitive as an outcome measure to investigate shorter exposures of sitting as FRP.
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Affiliation(s)
- S Mackey
- School of Human Kinetics and Recreation, Memorial University of Newfoundland, St. John's NL, Canada
| | - J Barnes
- School of Human Kinetics and Recreation, Memorial University of Newfoundland, St. John's NL, Canada
| | - K Pike
- School of Human Kinetics and Recreation, Memorial University of Newfoundland, St. John's NL, Canada
| | - D De Carvalho
- Faculty of Medicine, Memorial University of Newfoundland, St. John's NL, Canada.
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Panth N, Barnes J, Sethi RKV, Varvares MA, Osazuwa-Peters N. Socioeconomic and Demographic Variation in Insurance Coverage Among Patients With Head and Neck Cancer After the Affordable Care Act. JAMA Otolaryngol Head Neck Surg 2021; 145:1144-1149. [PMID: 31670798 DOI: 10.1001/jamaoto.2019.2724] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Importance Health insurance status has a significant association with early diagnosis and stage at presentation, which are the most important predictors of survival among patients with head and neck cancer (HNC). Literature on the association of the Patient Protection and Affordable Care Act (ACA) with changes in insurance status among patients with HNC remains limited. To our knowledge, no studies have evaluated changes in insurance rates across sociodemographic subgroups of patients with HNC. Objective To assess the association of the implementation of the ACA with insurance status across socioeconomic and demographic subpopulations of patients with HNC. Design, Setting, and Participants A retrospective cohort study using data from the National Cancer Database (NCDB), a hospital-based cancer registry (2011-2015) for adults diagnosed with a malignant primary HNC was carried out. The analyses were conducted from November 2018 through December 2018. Main Outcomes and Measures Changes in the percentage of patients with insurance. Results A total of 131 779 patients with HNC were identified in the pre-ACA (77 071) and post-ACA (54 708) periods. Overall, 98 207 (74.5%) participants were men and 33 572 (25.5) were women, with 73 124 (55.5%) being aged between 50 to 64 years. There was a 2.68 percentage point decrease (PPD) (95% CI, 2.93-2.42) in the percentage of patients with HNC without insurance from the pre-ACA to the post-ACA period. Changes in the percentage of uninsured patients varied significantly by age, with the largest reduction in uninsured status among patients with HNC aged 18 to 34 years (5.12 PPD; 95% CI, 3.18-7.06) and the smallest reduction in uninsured among those aged 65 to 74 years (0.24 PPD; 95% CI, 0.03-0.45). There was a significantly greater reduction in uninsured status in low-income zip codes (3.45 PPD; 95% CI, 2.76-4.14) than in high-income zip codes (1.99 PPD; 95% CI, 1.63-2.36). Conclusions and Relevance There was a significant association between ACA implementation and percentage decrease in uninsured patients. Young adults and those residing in low-income zip codes experienced a significantly higher rate of insurance uptake compared with older adults and residents of high-income areas. This suggests that coverage expansions enacted through the ACA are not only associated with increased access to care among the broader HNC population, but that they may also yield a greater benefit among subpopulations with historically limited insurance coverage.
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Affiliation(s)
- Neelima Panth
- Duke University School of Medicine, Durham, North Carolina
| | - Justin Barnes
- St Louis University School of Medicine, St Louis, Missouri
| | - Rosh K V Sethi
- Department of Otolaryngology, Massachusetts Eye and Ear, Boston, Massachusetts.,Department of Otolaryngology, Harvard Medical School, Boston, Massachusetts
| | - Mark A Varvares
- Department of Otolaryngology, Massachusetts Eye and Ear, Boston, Massachusetts.,Department of Otolaryngology, Harvard Medical School, Boston, Massachusetts
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Okoli C, Schwenk A, Radford M, Myland M, Taylor S, Darley A, Barnes J, Fox A, Grimson F, Reeves I, Munshi S, Croucher A, Boxall N, Benn P, Paice A, van Wyk J, Khoo S. Polypharmacy and potential drug-drug interactions for people with HIV in the UK from the Climate-HIV database. HIV Med 2020; 21:471-480. [PMID: 32671950 PMCID: PMC7497154 DOI: 10.1111/hiv.12879] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/28/2020] [Indexed: 11/30/2022]
Abstract
Objectives People with HIV (PWHIV) are likely to need therapies for comorbidities as they age. We assessed risk of drug–drug interactions (DDIs) in PWHIV. Methods The Climate‐HIV electronic recording system was used to cross‐sectionally analyse records from PWHIV aged ≥ 18 years attending four UK HIV units with a current antiretroviral (ARV) prescription in February 2018. Antiretroviral and non‐ARV medications were categorized by clinical significance of DDIs (University of Liverpool DDI tool). Potential DDIs were predicted using treatment guidelines for commonly recorded comorbidities. Results Among 4630 PWHIV (44% female), 41% were ≥ 50 years old. The average number of non‐ARV comedications increased from < 1 for patients aged ≤ 24 years to > 5 for patients aged ≥ 75 years; 65% were taking one or more non‐ARV comedications. The median (interquartile range) number of non‐ARVs was 1 (0–2) and 2 (1–5) for those aged < 50 and ≥ 50 years, respectively. Common comorbidities/concurrent health conditions occurred more frequently in patients aged ≥ 50 years vs. < 50 (53% vs. 34%). Boosted protease inhibitors were associated with the highest proportion of contraindicated comedications; dolutegravir and raltegravir had the fewest. For non‐ARVs, sildenafil and quetiapine were most likely to result in DDIs. Guideline‐recommended treatments for hepatitis C, hepatitis B, and tuberculosis had the highest proportions of contraindications when combined with ARV regimens, while treatments for hepatitis C, malignancy, and mental health conditions had the highest proportion of combinations potentially causing DDIs requiring dose monitoring or adjustment. Conclusions Non‐ARV use by PWHIV is high and increases with age. Treatment decisions for ageing PWHIV should consider guideline recommendations for comorbidities.
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Affiliation(s)
- C Okoli
- ViiV Healthcare, Brentford, UK
| | - A Schwenk
- North Middlesex University Hospital NHS Trust, London, UK
| | | | - M Myland
- IQVIA Real World Insights, UK & Ireland, London, UK
| | - S Taylor
- Birmingham Heartlands HIV Service, Department of Infection and Immunology, Birmingham Heartlands Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - A Darley
- Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - J Barnes
- Birmingham Heartlands HIV Service, Department of Infection and Immunology, Birmingham Heartlands Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - A Fox
- Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - F Grimson
- IQVIA Real World Insights, UK & Ireland, London, UK
| | - I Reeves
- Homerton University Hospital NHS Foundation Trust, London, UK
| | - S Munshi
- Homerton University Hospital NHS Foundation Trust, London, UK
| | - A Croucher
- Homerton University Hospital NHS Foundation Trust, London, UK
| | - N Boxall
- IQVIA Real World Insights, UK & Ireland, London, UK
| | - P Benn
- ViiV Healthcare, Brentford, UK
| | - A Paice
- ViiV Healthcare, Brentford, UK
| | | | - S Khoo
- University of Liverpool, Liverpool, UK
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Kellezi B, Earthy S, Sleney J, Beckett K, Barnes J, Christie N, Horsley D, Jones T, Kendrick D. What can trauma patients' experiences and perspectives tell us about the perceived quality of trauma care? a qualitative study set within the UK National Health Service. Injury 2020; 51:1231-1237. [PMID: 32127201 DOI: 10.1016/j.injury.2020.02.063] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Revised: 01/17/2020] [Accepted: 02/12/2020] [Indexed: 02/02/2023]
Abstract
The global drive for improvements in the efficiency and quality of healthcare has led to the development of frameworks to assist in defining and measuring 'good quality care'. However, such frameworks lack a systematic or meaningful definition of what 'good quality care' means from the patients' perspective. The present research provides an in-depth analysis of patients' experiences in a hospital setting from a quality of care perspective. Forty-five adults (aged 16-70) hospitalised in one of four UK NHS trusts following an unintentional injury were interviewed about their experiences of care. The findings show variability in perceived quality of care within the same hospital episode which cannot be meaningfully captured by existing frameworks. The context of trauma care (e.g. distressing nature of injury, patient vulnerability, expectations of hospitalisation and participants' interaction with different service providers) defined the care experience and the value of being 'cared for'. Participants identified some aspects of good and care which related to holistic, person-centred and personalised care beyond the medical needs. Participants discussed the value of being understood, staff thinking of their needs beyond hospitalisation, staff trying 'their best' despite constrains of current care, having their emotional needs recognised and addressed and staff competence. Patients reported also poor quality of care and 'not being cared for' by specific staff groups which they expected to fulfil this role, rushed and unsympathetic care, lack of recognition for emotional impact of injury mapped onto existing quality frameworks e.g. safety, equity, accessibility and patient-centeredness as well as quality of interaction with providers, empathetic care which extended beyond medical needs, coordination of care, and the positivity of care delivery as important dimensions of quality care with implications for their recovery. The findings have implications for quality frameworks and theoretical definitions of quality of care; they demonstrate the importance of patient experience in addition to clinical effectiveness and safety as an essential dimension of quality care. In terms of practice, the findings support the need to incorporate knowledge and training of injured adults' psychological needs, and the value of interaction with professionals as a patient defined dimension of the quality of care.
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Affiliation(s)
- B Kellezi
- Department of Psychology, School of Social Sciences, Nottingham Trent University, Burton Street, Nottingham, NG1 4BU. United Kingdom; Division of Primary Care, floor 13, Tower Building, University Park, Nottingham, NG7 2RD, United Kingdom.
| | - S Earthy
- Department of Interprofessional Studies, Faculty of Education, Health and Social Care, University of Winchester, Sparkford Road, Winchester, NH, SO22 4NR, United Kingdom
| | - J Sleney
- Department of Sociology, Faculty of Arts and Human Sciences, University of Surrey, Guildford, Surrey, GU2 7XH, United Kingdom
| | - K Beckett
- University of the West of England, Based at: Oakfield House, School for Social and Community Medicine, University of Bristol, Oakfield Grove, Bristol BS8 2BN, United Kingdom
| | - J Barnes
- Design School, Loughborough University, Ashby Road, Loughborough LE11 3TU, United Kingdom
| | - N Christie
- Centre for Transport Studies, UCL, Gower Street, London, WC1E 6BT, United Kingdom
| | - D Horsley
- Department of Psychology, School of Social Sciences, Nottingham Trent University, Burton Street, Nottingham, NG1 4BU. United Kingdom
| | - T Jones
- Collaboration for Leadership in Applied Health Research and Care (CLAHRC) East Midlands, Nottingham, United Kingdom
| | - D Kendrick
- Division of Primary Care, University of Nottingham, floor 13, Tower Building, University Park, Nottingham, NG7 2RD, United Kingdom
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Halkyard E, Alsayed T, Angus F, Barnes J, Bayman N, Blackhall F, Cooksley T, Kasipandian V, Monaghan P, Trainer P, Higham C. Salt ‘n’ Safe: introduction of guidelines for the management of hyponatraemia at a specialist oncology treatment centre. Lung Cancer 2020. [DOI: 10.1016/s0169-5002(20)30225-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Barnes J, Saldanha J, Lucera E. Preclinical pilot study results of 24-h apomorphine subcutaneous infusion delivered via the h-Patch wearable device. J Neurol Sci 2019. [DOI: 10.1016/j.jns.2019.10.1447] [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: 10/25/2022]
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Barnes J, Kennedy WR, Fischer-Valuck BW, Baumann BC, Michalski JM, Gay HA. Treatment patterns of high-dose-rate and low-dose-rate brachytherapy as monotherapy for prostate cancer. J Contemp Brachytherapy 2019; 11:320-328. [PMID: 31523232 PMCID: PMC6737564 DOI: 10.5114/jcb.2019.86974] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2019] [Accepted: 05/27/2019] [Indexed: 11/17/2022] Open
Abstract
PURPOSE Monotherapy with high-dose-rate (HDR) or low-dose-rate (LDR) brachytherapy are both recommended modalities for prostate cancer. The choice between HDR and LDR is dependent on patient, physician, and hospital preferences. We sought to identify treatment patterns and factors associated with receipt of HDR or LDR monotherapy. MATERIAL AND METHODS We queried the National Cancer Database (NCDB) for patients with localized low- or intermediate-risk prostate cancer treated with HDR or LDR monotherapy. Descriptive statistics were used to analyze patterns of HDR vs. LDR. Patient characteristics were correlated with HDR vs. LDR using multivariable logistic regression. RESULTS We identified 50,326 patients from 2004-2014: LDR 37,863 (75.2%) vs. HDR 12,463 (24.8%). Median follow-up was 70.3 months. The overall use of monotherapy declined over time. HDR application declined relative to LDR. In 2004, 27.0% of cases were HDR compared to 19.2% in 2014. Factors associated with increased likelihood of HDR on multivariable analysis included: increasing age (OR: 1.01, 95% CI: 1.01-1.01), cT2c disease (OR: 1.25, 95% CI: 1.11-1.41), treatment at an academic center (OR: 2.45, 95% CI: 2.24-2.65), non-white race (OR: 1.34, 95% CI: 1.27-1.42), and income > $63,000 (OR: 1.73, 95% CI: 1.59-1.88). LDR was more common in 2010-2014 (OR: 0.59, 95% CI: 0.54-0.65), Charlson-Deyo comorbidity index > 0 (OR: 0.89, 95% CI: 0.84-0.95), and for patients receiving hormone therapy (OR: 0.88, 95% CI: 0.83-0.93). No difference in prostate-specific antigen (PSA) or Gleason score and receipt of HDR vs. LDR was observed. Mean overall survival was 127.0 months for HDR and 125.4 for LDR, and was not statistically different. CONCLUSIONS We observed an overall decrease in brachytherapy (BT) monotherapy use since 2004 for localized prostate cancer. Despite similar survival outcomes, the use of HDR monotherapy declined relative to LDR.
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Affiliation(s)
- Justin Barnes
- Saint Louis University School of Medicine, Saint Louis, MO 63104, United States
| | - William R Kennedy
- Department of Radiation Oncology, Washington University School of Medicine, Saint Louis, MO 63110, United States
| | - Benjamin W Fischer-Valuck
- Department of Radiation Oncology, Emory University School of Medicine, Atlanta, GA 30307, United States
| | - Brian C Baumann
- Department of Radiation Oncology, Washington University School of Medicine, Saint Louis, MO 63110, United States
| | - Jeff M Michalski
- Department of Radiation Oncology, Washington University School of Medicine, Saint Louis, MO 63110, United States
| | - Hiram A Gay
- Department of Radiation Oncology, Washington University School of Medicine, Saint Louis, MO 63110, United States
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Barnes J, Johnson KJ, Boakye EA, Varvares MA, Osazuwa-Peters N. The Affordable Care Act and cost-related medication non-compliance in cancer survivors. J Clin Oncol 2019. [DOI: 10.1200/jco.2019.37.15_suppl.106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
106 Background: Cost-related medication non-compliance (CRN), which is associated with access-to-care barriers and poorer health outcomes, is more prevalent among cancer survivors than other adults. While CRN in survivors has been decreasing recently, evidence for a change driven by the Affordable Care Act (ACA) is limited. We aimed to quantify the impact of the ACA on CRN in non-elderly cancer survivors using population-based data and a quasi-experimental design. Methods: We utilized 2011-2017 National Health Interview Survey data. CRN was defined as not being able to afford medication or taking less than prescribed, skipping doses, or delaying prescription filling due to cost. Linear probability models applied to difference-in-difference analyses were used to compare CRN changes after the ACA in non-elderly ( < 65 years) cancer survivors relative to control groups expected to be impacted less by ACA provisions--non-elderly adults without a cancer history, elderly survivors, and non-elderly survivors with high income. Results: We identified 6,176 non-elderly and 8,508 elderly cancer survivors and 142,732 other non-elderly adults. Non-elderly cancer survivors had a 6.31 (95% CI = 3.47, 9.15; p < .001) percentage point (PP) decrease in CRN relative to non-elderly adults without a cancer history, particularly for those earning 125-249% of the federal poverty limit (FPL) (8.46 PP; 95% CI = 0.45, 16.46; p = .038) and < 125% FPL (11.8 PP; 95% CI = 4.51 to 19.1; p = .002). Relative to elderly survivors, CRN decreased 6.01 PP (95% CI = 3.12, 8.90; p < .001) in non-elderly survivors after the ACA, especially for individuals earning < 125% FPL (15.7 PP; 95% CI = 7.7, 23.7; p < .001). Relative to non-elderly survivors earning > 400% FPL, those earning < 125% FPL had an 8.36 PP (95% CI = 1.44, 15.3; p = .018) reduction in CRN. Conclusions: CRN decreased in non-elderly cancer survivors after the ACA relative to both elderly survivors and adults without a history of cancer. Furthermore, reductions in CRN were observed in low relative to high income survivors. Thus, the ACA is associated with decreasing CRN in cancer survivors, especially those with low income, and hence may improve health care access and affordability for this vulnerable population.
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Affiliation(s)
- Justin Barnes
- Saint Louis University School of Medicine, St. Louis, MO
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Wu MR, Barnes J, Martínez-Pinedo G, Metzger BD. Fingerprints of Heavy-Element Nucleosynthesis in the Late-Time Lightcurves of Kilonovae. Phys Rev Lett 2019; 122:062701. [PMID: 30822042 DOI: 10.1103/physrevlett.122.062701] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/30/2018] [Revised: 11/15/2018] [Indexed: 06/09/2023]
Abstract
The kilonova emission observed following the binary neutron star merger event GW170817 provided the first direct evidence for the synthesis of heavy nuclei through the rapid neutron capture process (r process). The late-time transition in the spectral energy distribution to near-infrared wavelengths was interpreted as indicating the production of lanthanide nuclei, with atomic mass number A≳140. However, compelling evidence for the presence of even heavier third-peak (A≈195) r-process elements (e.g., gold, platinum) or translead nuclei remains elusive. At early times (∼days) most of the r-process heating arises from a large statistical ensemble of β decays, which thermalize efficiently while the ejecta is still dense, generating a heating rate that is reasonably approximated by a single power law. However, at later times of weeks to months, the decay energy input can also possibly be dominated by a discrete number of α decays, ^{223}Ra (half-life t_{1/2}=11.43 d), ^{225}Ac (t_{1/2}=10.0 d, following the β decay of ^{225}Ra with t_{1/2}=14.9 d), and the fissioning isotope ^{254}Cf (t_{1/2}=60.5 d), which liberate more energy per decay and thermalize with greater efficiency than β-decay products. Late-time nebular observations of kilonovae which constrain the radioactive power provide the potential to identify signatures of these individual isotopes, thus confirming the production of heavy nuclei. In order to constrain the bolometric light to the required accuracy, multiepoch and wideband observations are required with sensitive instruments like the James Webb Space Telescope. In addition, by comparing the nuclear heating rate obtained with an abundance distribution that follows the solar r abundance pattern, to the bolometric lightcurve of AT2017gfo, we find that the yet-uncertain r abundance of ^{72}Ge plays a decisive role in powering the lightcurve, if one assumes that GW170817 has produced a full range of the solar r abundances down to mass number A∼70.
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Affiliation(s)
- Meng-Ru Wu
- Institute of Physics, Academia Sinica, Taipei 11529, Taiwan
- Institute of Astronomy and Astrophysics, Academia Sinica, Taipei 10617, Taiwan
| | - J Barnes
- Department of Physics and Columbia Astrophysics Laboratory, Columbia University, Pupin Hall, New York, New York 10027, USA
| | - G Martínez-Pinedo
- GSI Helmholtzzentrum für Schwerionenforschung, Planckstraße 1, 64291 Darmstadt, Germany
- Institut für Kernphysik (Theoriezentrum), Technische Universität Darmstadt, Schlossgartenstraße 2, 64289 Darmstadt, Germany
| | - B D Metzger
- Department of Physics and Columbia Astrophysics Laboratory, Columbia University, Pupin Hall, New York, New York 10027, USA
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Gabani P, Lin AJ, Barnes J, Oppelt P, Adkins DR, Rich JT, Zevallos JP, Daly MD, Gay HA, Thorstad WL. Radiation therapy dose de-escalation compared to standard dose radiation therapy in definitive treatment of HPV-positive oropharyngeal squamous cell carcinoma. Radiother Oncol 2019; 134:81-88. [PMID: 31005228 DOI: 10.1016/j.radonc.2019.01.016] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2018] [Revised: 01/09/2019] [Accepted: 01/11/2019] [Indexed: 10/27/2022]
Abstract
BACKGROUND Despite existing evidence that human papillomavirus (HPV)-positive oropharyngeal squamous cell carcinoma (OPSCC) has a favorable prognosis compared to HPV-negative OPSCC, randomized studies have yet to report the effect of de-escalating radiation therapy (RT) dose for definitive treatment. The aim of this study was to assess the effectiveness of dose de-escalated RT (DDRT) vs. standard dose RT (SDRT) in patients with HPV-positive OPSCC. METHODS This was an observational study using the National Cancer Database (Year 2010-2014) to identify patients who had HPV-positive OPSCC and were treated with definitive RT or chemo-RT. Patients undergoing surgery were excluded. Patients receiving ≥50 Gy, but <66 Gy were categorized as receiving DDRT. Patients receiving ≥66 Gy were categorized as receiving SDRT. Inverse probability of treatment weighting (IPTW) using propensity scores was used to balance the two groups. Kaplan-Meier analysis was used to estimate overall survival (OS). Subset analyses in patients receiving RT alone and concurrent chemo-RT were also performed. Multivariable Cox proportional hazards modeling was used to evaluate factors associated with OS. RESULTS 759 patients with HPV-positive OPSCC were identified: 104 received DDRT and 655 received SDRT. The median follow-up was 30.5 (2.4-81.4) months. After IPTW-adjusted analysis, there was no difference in the 3-yr OS between the two groups (82.2% vs. 79.3%; P = 0.85). In the subset of patients receiving concurrent chemoradiotherapy, IPTW-adjusted analysis also did not show a difference in the 3-yr OS between the two groups (83.1% vs. 79.6%; P = 0.83). On multivariable analysis, DDRT was not associated with an inferior OS (HR 0.88; 95% CI, 0.53-1.47; P = 0.63). CONCLUSIONS In this study, DDRT was not associated with an inferior OS compared to SDRT in patients with HPV-positive OPSCC. Randomized clinical trials to address DDRT in this patient population are currently ongoing.
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Affiliation(s)
- Prashant Gabani
- Department of Radiation Oncology, Washington University School of Medicine, Saint Louis, United States
| | - Alexander J Lin
- Department of Radiation Oncology, Washington University School of Medicine, Saint Louis, United States
| | - Justin Barnes
- Saint Louis University School of Medicine, Saint Louis, United States
| | - Peter Oppelt
- Division of Medical Oncology, Washington University School of Medicine, Saint Louis, United States
| | - Douglas R Adkins
- Division of Medical Oncology, Washington University School of Medicine, Saint Louis, United States
| | - Jason T Rich
- Department of Otolaryngology, Washington University School of Medicine, Saint Louis, United States
| | - Jose P Zevallos
- Department of Otolaryngology, Washington University School of Medicine, Saint Louis, United States
| | - Mackenzie D Daly
- Department of Radiation Oncology, Washington University School of Medicine, Saint Louis, United States
| | - Hiram A Gay
- Department of Radiation Oncology, Washington University School of Medicine, Saint Louis, United States
| | - Wade L Thorstad
- Department of Radiation Oncology, Washington University School of Medicine, Saint Louis, United States.
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McLean K, Glasbey J, Borakati A, Brooks T, Chang H, Choi S, Goodson R, Nielsen M, Pronin S, Salloum N, Sewart E, Vanniasegaram D, Drake T, Gillies M, Harrison E, Chapman S, Khatri C, Kong C, Claireaux H, Bath M, Mohan M, McNamee L, Kelly M, Mitchell H, Fitzgerald J, Bhangu A, Nepogodiev D, Antoniou I, Dean R, Davies N, Trecarten S, Henderson I, Holmes C, Wylie J, Shuttleworth R, Jindal A, Hughes F, Gouda P, Fleck R, Hanrahan M, Karunakaran P, Chen J, Sykes M, Sethi R, Suresh S, Patel P, Patel M, Varma R, Mushtaq J, Gundogan B, Bolton W, Khan T, Burke J, Morley R, Favero N, Adams R, Thirumal V, Kennedy E, Ong K, Tan Y, Gabriel J, Bakhsh A, Low J, Yener A, Paraoan V, Preece R, Tilston T, Cumber E, Dean S, Ross T, McCance E, Amin H, Satterthwaite L, Clement K, Gratton R, Mills E, Chiu S, Hung G, Rafiq N, Hayes J, Robertson K, Dynes K, Huang H, Assadullah S, Duncumb J, Moon R, Poo S, Mehta J, Joshi K, Callan R, Norris J, Chilvers N, Keevil H, Jull P, Mallick S, Elf D, Carr L, Player C, Barton E, Martin A, Ratu S, Roberts E, Phan P, Dyal A, Rogers J, Henson A, Reid N, Burke D, Culleton G, Lynne S, Mansoor S, Brennan C, Blessed R, Holloway C, Hill A, Goldsmith T, Mackin S, Kim S, Woin E, Brent G, Coffin J, Ziff O, Momoh Z, Debenham R, Ahmed M, Yong C, Wan J, Copley H, Raut P, Chaudhry F, Nixon G, Dorman C, Tan R, Kanabar S, Canning N, Dolaghan M, Bell N, McMenamin M, Chhabra A, Duke K, Turner L, Patel T, Chew L, Mirza M, Lunawat S, Oremule B, Ward N, Khan M, Tan E, Maclennan D, McGregor R, Chisholm E, Griffin E, Bell L, Hughes B, Davies J, Haq H, Ahmed H, Ungcharoen N, Whacha C, Thethi R, Markham R, Lee A, Batt E, Bullock N, Francescon C, Davies J, Shafiq N, Zhao J, Vivekanantham S, Barai I, Allen J, Marshall D, McIntyre C, Wilson H, Ashton A, Lek C, Behar N, Davis-Hall M, Seneviratne N, Esteve L, Sirakaya M, Ali S, Pope S, Ahn J, Craig-McQuaide A, Gatfield W, Leong S, Demetri A, Kerr A, Rees C, Loveday J, Liu S, Wijesekera M, Maru D, Attalla M, Smith N, Brown D, Sritharan P, Shah A, Charavanamuttu V, Heppenstall-Harris G, Ng K, Raghvani T, Rajan N, Hulley K, Moody N, Williams M, Cotton A, Sharifpour M, Lwin K, Bright M, Chitnis A, Abdelhadi M, Semana A, Morgan F, Reid R, Dickson J, Anderson L, McMullan R, Ahern N, Asmadi A, Anderson L, Boon Xuan JL, Crozier L, McAleer S, Lees D, Adebayo A, Das M, Amphlett A, Al-Robeye A, Valli A, Khangura J, Winarski A, Ali A, Woodward H, Gouldthrope C, Turner M, Sasapu K, Tonkins M, Wild J, Robinson M, Hardie J, Heminway R, Narramore R, Ramjeeawon N, Hibberd A, Winslow F, Ho W, Chong B, Lim K, Ho S, Crewdson J, Singagireson S, Kalra N, Koumpa F, Jhala H, Soon W, Karia M, Rasiah M, Xylas D, Gilbert H, Sundar-Singh M, Wills J, Akhtar S, Patel S, Hu L, Brathwaite-Shirley C, Nayee H, Amin O, Rangan T, Turner E, McCrann C, Shepherd R, Patel N, Prest-Smith J, Auyoung E, Murtaza A, Coates A, Prys-Jones O, King M, Gaffney S, Dewdney C, Nehikhare I, Lavery J, Bassett J, Davies K, Ahmad K, Collins A, Acres M, Egerton C, Cheng K, Chen X, Chan N, Sheldon A, Khan S, Empey J, Ingram E, Malik A, Johnstone M, Goodier R, Shah J, Giles J, Sanders J, McLure S, Pal S, Rangedara A, Baker A, Asbjoernsen C, Girling C, Gray L, Gauntlett L, Joyner C, Qureshi S, Mogan Y, Ng J, Kumar A, Park J, Tan D, Choo K, Raman K, Buakuma P, Xiao C, Govinden S, Thompson O, Charalambos M, Brown E, Karsan R, Dogra T, Bullman L, Dawson P, Frank A, Abid H, Tung L, Qureshi U, Tahmina A, Matthews B, Harris R, O'Connor A, Mazan K, Iqbal S, Stanger S, Thompson J, Sullivan J, Uppal E, MacAskill A, Bamgbose F, Neophytou C, Carroll A, Rookes C, Datta U, Dhutia A, Rashid S, Ahmed N, Lo T, Bhanderi S, Blore C, Ahmed S, Shaheen H, Abburu S, Majid S, Abbas Z, Talukdar S, Burney L, Patel J, Al-Obaedi O, Roberts A, Mahboob S, Singh B, Sheth S, Karia P, Prabhudesai A, Kow K, Koysombat K, Wang S, Morrison P, Maheswaran Y, Keane P, Copley P, Brewster O, Xu G, Harries P, Wall C, Al-Mousawi A, Bonsu S, Cunha P, Ward T, Paul J, Nadanakumaran K, Tayeh S, Holyoak H, Remedios J, Theodoropoulou K, Luhishi A, Jacob L, Long F, Atayi A, Sarwar S, Parker O, Harvey J, Ross H, Rampal R, Thomas G, Vanmali P, McGowan C, Stein J, Robertson V, Carthew L, Teng V, Fong J, Street A, Thakker C, O'Reilly D, Bravo M, Pizzolato A, Khokhar H, Ryan M, Cheskes L, Carr R, Salih A, Bassiony S, Yuen R, Chrastek D, Rosen O'Sullivan H, Amajuoyi A, Wang A, Sitta O, Wye J, Qamar M, Major C, Kaushal A, Morgan C, Petrarca M, Allot R, Verma K, Dutt S, Chilima C, Peroos S, Kosasih S, Chin H, Ashken L, Pearse R, O'Loughlin R, Menon A, Singh K, Norton J, Sagar R, Jathanna N, Rothwell L, Watson N, Harding F, Dube P, Khalid H, Punjabi N, Sagmeister M, Gill P, Shahid S, Hudson-Phillips S, George D, Ashwood J, Lewis T, Dhar M, Sangal P, Rhema I, Kotecha D, Afzal Z, Syeed J, Prakash E, Jalota P, Herron J, Kimani L, Delport A, Shukla A, Agarwal V, Parthiban S, Thakur H, Cymes W, Rinkoff S, Turnbull J, Hayat M, Darr S, Khan U, Lim J, Higgins A, Lakshmipathy G, Forte B, Canning E, Jaitley A, Lamont J, Toner E, Ghaffar A, McDowell M, Salmon D, O'Carroll O, Khan A, Kelly M, Clesham K, Palmer C, Lyons R, Bell A, Chin R, Waldron R, Trimble A, Cox S, Ashfaq U, Campbell J, Holliday R, McCabe G, Morris F, Priestland R, Vernon O, Ledsam A, Vaughan R, Lim D, Bakewell Z, Hughes R, Koshy R, Jackson H, Narayan P, Cardwell A, Jubainville C, Arif T, Elliott L, Gupta V, Bhaskaran G, Odeleye A, Ahmed F, Shah R, Pickard J, Suleman Y, North A, McClymont L, Hussain N, Ibrahim I, Ng G, Wong V, Lim A, Harris L, Tharmachandirar T, Mittapalli D, Patel V, Lakhani M, Bazeer H, Narwani V, Sandhu K, Wingfield L, Gentry S, Adjei H, Bhatti M, Braganza L, Barnes J, Mistry S, Chillarge G, Stokes S, Cleere J, Wadanamby S, Bucko A, Meek J, Boxall N, Heywood E, Wiltshire J, Toh C, Ward A, Shurovi B, Horth D, Patel B, Ali B, Spencer T, Axelson T, Kretzmer L, Chhina C, Anandarajah C, Fautz T, Horst C, Thevathasan A, Ng J, Hirst F, Brewer C, Logan A, Lockey J, Forrest P, Keelty N, Wood A, Springford L, Avery P, Schulz T, Bemand T, Howells L, Collier H, Khajuria A, Tharakan R, Parsons S, Buchan A, McGalliard R, Mason J, Cundy O, Li N, Redgrave N, Watson R, Pezas T, Dennis Y, Segall E, Hameed M, Lynch A, Chamberlain M, Peck F, Neo Y, Russell G, Elseedawy M, Lee S, Foster N, Soo Y, Puan L, Dennis R, Goradia H, Qureshi A, Osman S, Reeves T, Dinsmore L, Marsden M, Lu Q, Pitts-Tucker T, Dunn C, Walford R, Heathcote E, Martin R, Pericleous A, Brzyska K, Reid K, Williams M, Wetherall N, McAleer E, Thomas D, Kiff R, Milne S, Holmes M, Bartlett J, Lucas de Carvalho J, Bloomfield T, Tongo F, Bremner R, Yong N, Atraszkiewicz B, Mehdi A, Tahir M, Sherliker G, Tear A, Pandey A, Broyd A, Omer H, Raphael M, Chaudhry W, Shahidi S, Jawad A, Gill C, Fisher IH, Adeleja I, Clark I, Aidoo-Micah G, Stather P, Salam G, Glover T, Deas G, Sim N, Obute R, Wynell-Mayow W, Sait M, Mitha N, de Bernier G, Siddiqui M, Shaunak R, Wali A, Cuthbert G, Bhudia R, Webb E, Shah S, Ansari N, Perera M, Kelly N, McAllister R, Stanley G, Keane C, Shatkar V, Maxwell-Armstrong C, Henderson L, Maple N, Manson R, Adams R, Semple E, Mills M, Daoub A, Marsh A, Ramnarine A, Hartley J, Malaj M, Jewell P, Whatling E, Hitchen N, Chen M, Goh B, Fern J, Rogers S, Derbyshire L, Robertson D, Abuhussein N, Deekonda P, Abid A, Harrison P, Aildasani L, Turley H, Sherif M, Pandey G, Filby J, Johnston A, Burke E, Mohamud M, Gohil K, Tsui A, Singh R, Lim S, O'Sullivan K, McKelvey L, O'Neill S, Roberts H, Brown F, Cao Y, Buckle R, Liew Y, Sii S, Ventre C, Graham C, Filipescu T, Yousif A, Dawar R, Wright A, Peters M, Varley R, Owczarek S, Hartley S, Khattak M, Iqbal A, Ali M, Durrani B, Narang Y, Bethell G, Horne L, Pinto R, Nicholls K, Kisyov I, Torrance H, English W, Lakhani S, Ashraf S, Venn M, Elangovan V, Kazmi Z, Brecher J, Sukumar S, Mastan A, Mortimer A, Parker J, Boyle J, Elkawafi M, Beckett J, Mohite A, Narain A, Mazumdar E, Sreh A, Hague A, Weinberg D, Fletcher L, Steel M, Shufflebotham H, Masood M, Sinha Y, Jenvey C, Kitt H, Slade R, Craig A, Deall C, Reakes T, Chervenkoff J, Strange E, O'Bryan M, Murkin C, Joshi D, Bergara T, Naqib S, Wylam D, Scotcher S, Hewitt C, Stoddart M, Kerai A, Trist A, Cole S, Knight C, Stevens S, Cooper G, Ingham R, Dobson J, O'Kane A, Moradzadeh J, Duffy A, Henderson C, Ashraf S, McLaughin C, Hoskins T, Reehal R, Bookless L, McLean R, Stone E, Wright E, Abdikadir H, Roberts C, Spence O, Srikantharajah M, Ruiz E, Matthews J, Gardner E, Hester E, Naran P, Simpson R, Minhas M, Cornish E, Semnani S, Rojoa D, Radotra A, Eraifej J, Eparh K, Smith D, Mistry B, Hickling S, Din W, Liu C, Mithrakumar P, Mirdavoudi V, Rashid M, Mcgenity C, Hussain O, Kadicheeni M, Gardner H, Anim-Addo N, Pearce J, Aslanyan A, Ntala C, Sorah T, Parkin J, Alizadeh M, White A, Edozie F, Johnston J, Kahar A, Navayogaarajah V, Patel B, Carter D, Khonsari P, Burgess A, Kong C, Ponweera A, Cody A, Tan Y, Ng A, Croall A, Allan C, Ng S, Raghuvir V, Telfer R, Greenhalgh A, McKerr C, Edison M, Patel B, Dear K, Hardy M, Williams P, Hassan S, Sajjad U, O'Neill E, Lopes S, Healy L, Jamal N, Tan S, Lazenby D, Husnoo S, Beecroft S, Sarvanandan T, Weston C, Bassam N, Rabinthiran S, Hayat U, Ng L, Varma D, Sukkari M, Mian A, Omar A, Kim J, Sellathurai J, Mahmood J, O'Connell C, Bose R, Heneghan H, Lalor P, Matheson J, Doherty C, Cullen C, Cooper D, Angelov S, Drislane C, Smith A, Kreibich A, Palkhi E, Durr A, Lotfallah A, Gold D, Mckean E, Dhanji A, Anilkumar A, Thacoor A, Siddiqui Z, Lim S, Piquet A, Anderson S, McCormack D, Gulati J, Ibrahim A, Murray S, Walsh S, McGrath A, Ziprin P, Chua E, Lou C, Bloomer J, Paine H, Osei-Kuffour D, White C, Szczap A, Gokani S, Patel K, Malys M, Reed A, Torlot G, Cumber E, Charania A, Ahmad S, Varma N, Cheema H, Austreng L, Petra H, Chaudhary M, Zegeye M, Cheung F, Coffey D, Heer R, Singh S, Seager E, Cumming S, Suresh R, Verma S, Ptacek I, Gwozdz A, Yang T, Khetarpal A, Shumon S, Fung T, Leung W, Kwang P, Chew L, Loke W, Curran A, Chan C, McGarrigle C, Mohan K, Cullen S, Wong E, Toale C, Collins D, Keane N, Traynor B, Shanahan D, Yan A, Jafree D, Topham C, Mitrasinovic S, Omara S, Bingham G, Lykoudis P, Miranda B, Whitehurst K, Kumaran G, Devabalan Y, Aziz H, Shoa M, Dindyal S, Yates J, Bernstein I, Rattan G, Coulson R, Stezaker S, Isaac A, Salem M, McBride A, McFarlane H, Yow L, MacDonald J, Bartlett R, Turaga S, White U, Liew W, Yim N, Ang A, Simpson A, McAuley D, Craig E, Murphy L, Shepherd P, Kee J, Abdulmajid A, Chung A, Warwick H, Livesey A, Holton P, Theodoreson M, Jenkin S, Turner J, Entwisle J, Marchal S, O'Connor S, Blege H, Aithie J, Sabine L, Stewart G, Jackson S, Kishore A, Lankage C, Acquaah F, Joyce H, McKevitt K, Coffey C, Fawaz A, Dolbec K, O'Sullivan D, Geraghty J, Lim E, Bolton L, FitzPatrick D, Robinson C, Ramtoola T, Collinson S, Grundy L, McEnhill P, Harbhajan Singh G, Loughran D, Golding D, Keeling R, Williams R, Whitham R, Yoganathan S, Nachiappan R, Egan R, Owasil R, Kwan M, He A, Goh R, Bhome R, Wilson H, Teoh P, Raji K, Jayakody N, Matthams J, Chong J, Luk C, Greig R, Trail M, Charalambous G, Rocke A, Gardiner N, Bulley F, Warren N, Brennan E, Fergurson P, Wilson R, Whittingham H, Brown E, Khanijau R, Gandhi K, Morris S, Boulton A, Chandan N, Barthorpe A, Maamari R, Sandhu S, McCann M, Higgs L, Balian V, Reeder C, Diaper C, Sale T, Ali H, Archer C, Clarke A, Heskin J, Hurst P, Farmer J, O'Flynn L, Doan L, Shuker B, Stott G, Vithanage N, Hoban K, Nesargikar P, Kennedy H, Grossart C, Tan E, Roy C, Sim P, Leslie K, Sim D, Abul M, Cody N, Tay A, Woon E, Sng S, Mah J, Robson J, Shakweh E, Wing V, Mills H, Li M, Barrow T, Balaji S, Jordan H, Phillips C, Naveed H, Hirani S, Tai A, Ratnakumaran R, Sahathevan A, Shafi A, Seedat M, Weaver R, Batho A, Punj R, Selvachandran H, Bhatt N, Botchey S, Khonat Z, Brennan K, Morrison C, Devlin E, Linton A, Galloway E, McGarvie S, Ramsay N, McRobbie H, Whewell H, Dean W, Nelaj S, Eragat M, Mishra A, Kane T, Zuhair M, Wells M, Wilkinson D, Woodcock N, Sun E, Aziz N, Ghaffar MKA. Critical care usage after major gastrointestinal and liver surgery: a prospective, multicentre observational study. Br J Anaesth 2019; 122:42-50. [PMID: 30579405 DOI: 10.1016/j.bja.2018.07.029] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2018] [Revised: 07/19/2018] [Accepted: 07/23/2018] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Patient selection for critical care admission must balance patient safety with optimal resource allocation. This study aimed to determine the relationship between critical care admission, and postoperative mortality after abdominal surgery. METHODS This prespecified secondary analysis of a multicentre, prospective, observational study included consecutive patients enrolled in the DISCOVER study from UK and Republic of Ireland undergoing major gastrointestinal and liver surgery between October and December 2014. The primary outcome was 30-day mortality. Multivariate logistic regression was used to explore associations between critical care admission (planned and unplanned) and mortality, and inter-centre variation in critical care admission after emergency laparotomy. RESULTS Of 4529 patients included, 37.8% (n=1713) underwent planned critical care admissions from theatre. Some 3.1% (n=86/2816) admitted to ward-level care subsequently underwent unplanned critical care admission. Overall 30-day mortality was 2.9% (n=133/4519), and the risk-adjusted association between 30-day mortality and critical care admission was higher in unplanned [odds ratio (OR): 8.65, 95% confidence interval (CI): 3.51-19.97) than planned admissions (OR: 2.32, 95% CI: 1.43-3.85). Some 26.7% of patients (n=1210/4529) underwent emergency laparotomies. After adjustment, 49.3% (95% CI: 46.8-51.9%, P<0.001) were predicted to have planned critical care admissions, with 7% (n=10/145) of centres outside the 95% CI. CONCLUSIONS After risk adjustment, no 30-day survival benefit was identified for either planned or unplanned postoperative admissions to critical care within this cohort. This likely represents appropriate admission of the highest-risk patients. Planned admissions in selected, intermediate-risk patients may present a strategy to mitigate the risk of unplanned admission. Substantial inter-centre variation exists in planned critical care admissions after emergency laparotomies.
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Affiliation(s)
- AR White
- Dept of Complementary Medicine, Postgraduate Medical School, University of Exeter, 25 Victoria Park Road, Exeter EX2 4NT (UK)
| | - NC Abbot
- Dept of Complementary Medicine, Postgraduate Medical School, University of Exeter, 25 Victoria Park Road, Exeter EX2 4NT (UK)
| | - J Barnes
- Dept of Complementary Medicine, Postgraduate Medical School, University of Exeter, 25 Victoria Park Road, Exeter EX2 4NT (UK)
| | - E Ernst
- Dept of Complementary Medicine, Postgraduate Medical School, University of Exeter, 25 Victoria Park Road, Exeter EX2 4NT (UK)
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Kellezi B, Baines DL, Coupland C, Beckett K, Barnes J, Sleney J, Christie N, Kendrick D. The impact of injuries on health service resource use and costs in primary and secondary care in the English NHS. J Public Health (Oxf) 2018; 38:e464-e471. [PMID: 28158513 DOI: 10.1093/pubmed/fdv173] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
| | - D L Baines
- Centre for Technology Enabled Health Research, Coventry University, Coventry CV1 5FB, UK
| | - C Coupland
- Division of Primary Care, University Park, Nottingham NG7 2RD, UK
| | - K Beckett
- Centre for Research in Clinical Practice, University of the West of England/University Hospitals Bristol NHS Foundation Trust Education Centre, Bristol BS2 8AE, UK
| | - J Barnes
- Design School, Loughborough University, Loughborough LE11 3TU, UK
| | - J Sleney
- Faculty of Arts and Human Sciences, University of Surrey, Surrey, UK
| | - N Christie
- Centre for Transport Studies, University College London, London WC1E 6BT, UK
| | - D Kendrick
- Division of Primary Care, University Park, Nottingham NG7 2RD, UK
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Kendrick D, Baker R, Hill T, Beckett K, Coupland C, Kellezi B, Joseph S, Barnes J, Sleney J, Christie N, Morriss R. Early risk factors for depression, anxiety and post-traumatic distress after hospital admission for unintentional injury: Multicentre cohort study. J Psychosom Res 2018; 112:15-24. [PMID: 30097131 DOI: 10.1016/j.jpsychores.2018.06.008] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2018] [Revised: 06/11/2018] [Accepted: 06/11/2018] [Indexed: 10/14/2022]
Abstract
OBJECTIVE To quantify psychological morbidity and identify baseline factors associated with depression, anxiety and post-traumatic distress symptoms up to 12 months post-injury. METHODS Multicentre cohort study of 668 adults, aged 16 to 70, admitted to 4 UK NHS hospital trusts. Data on injury, socio-demographic characteristics and health status was collected at recruitment. Depression, anxiety and post-traumatic distress were measured at 1, 2, 4 and 12 months post-injury. Multilevel linear regression assessed associations between patient and injury characteristics and psychological outcomes over 12 months follow-up. RESULTS Depression, anxiety and post-traumatic distress scores were highest 1 month post-injury, and remained above baseline at 2, 4 and 12 months post-injury. Moderate or severe injuries, previous psychiatric diagnoses, higher pre-injury depression and anxiety scores, middle age (45-64 years), greater deprivation and lower pre-injury quality of life (QoL) were associated with higher depression scores post-injury. Previous psychiatric diagnoses, higher pre-injury depression and anxiety scores, middle age, greater deprivation and lower pre-injury QoL were associated with higher anxiety scores post-injury. Traffic injuries or injuries from being struck by objects, multiple injures (≥3), being female, previous psychiatric diagnoses, higher pre-injury anxiety scores and greater deprivation were associated with higher post-traumatic distress scores post-injury. CONCLUSION A range of risk factors, identifiable shortly after injury, are associated with psychological morbidity occurring up to 12 months post-injury in a general trauma population. Further research is required to explore the utility of these, and other risk factors in predicting psychological morbidity on an individual patient basis.
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Affiliation(s)
- D Kendrick
- Division of Primary Care, School of Medicine, University of Nottingham, NG7 2RD, UK.
| | - R Baker
- Division of Primary Care, School of Medicine, University of Nottingham, NG7 2RD, UK
| | - T Hill
- Division of Primary Care, School of Medicine, University of Nottingham, NG7 2RD, UK
| | - K Beckett
- Centre for Health & Clinical Research, University of the West of England, BS16 1DD, UK
| | - C Coupland
- Division of Primary Care, School of Medicine, University of Nottingham, NG7 2RD, UK
| | - B Kellezi
- Department of Psychology, Nottingham Trent University, NG1 4BU, UK
| | - S Joseph
- School of Education, University of Nottingham, NG8 1BB, UK
| | - J Barnes
- Loughborough Design School, Loughborough University, LE11 3TU, UK
| | - J Sleney
- Department of Sociology, University of Surrey, GU2 7XH, UK
| | - N Christie
- Centre for Transport Studies, University College London, WC1E 6BT, UK
| | - R Morriss
- Division of Psychiatry and Applied Psychology, University of Nottingham, NG7 2TU, UK
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Gabani P, Barnes J, Lin AJ, Rudra S, Oppelt P, Adkins D, Rich JT, Zevallos JP, Daly MD, Gay HA, Thorstad WL. Induction chemotherapy in the treatment of nasopharyngeal carcinoma: Clinical outcomes and patterns of care. Cancer Med 2018; 7:3592-3603. [PMID: 30008178 PMCID: PMC6089177 DOI: 10.1002/cam4.1626] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2018] [Revised: 05/17/2018] [Accepted: 05/25/2018] [Indexed: 11/09/2022] Open
Abstract
The role of induction chemotherapy in nasopharyngeal carcinoma (NPC) remains controversial. The primary aim of this study was to use the National Cancer Database to evaluate the patterns of care of induction chemotherapy in NPC and its impact on overall survival (OS). Patients with NPC from 2004 to 2014 were obtained from the NCDB. Patients were considered to have received induction chemotherapy if it was started ≥43 days before the start of RT and concurrent CRT if chemotherapy started within 21 days after the start of RT. Propensity score matching was used to control for selection bias. Cox proportional hazards model was used to determine significant predictors of OS. Logistic regression model was used to determine predictors of the use of induction chemotherapy. Significance was defined as a P value <.05. A total of 4857 patients were identified: 4041 patients (87.2%) received concurrent CRT and 816 patients (16.8%) received induction chemotherapy. The use of induction therapy remained stable between 2004 and 2014. Younger patients and those with higher T- and N-stage had a higher likelihood of being treated with induction chemotherapy. The 5-year OS in patients treated with induction chemotherapy and CRT was 66.3% vs 69.1%, respectively (P = .25). There was no difference in OS when these two groups were analyzed after propensity score matching. No differences in OS existed between these treatment groups in patients with T3-T4N1 or TanyN2-3 disease (P = .76). Propensity score matching also did not reveal any difference in OS in patients with T3-T4N1 or TanyN2-3 disease. The use of induction chemotherapy has remained stable in the last decade. In this study of patients with NPC, induction chemotherapy was not associated with improved OS compared to CRT alone.
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Affiliation(s)
- Prashant Gabani
- Department of Radiation Oncology, Washington University School of Medicine, Saint Louis, MO, USA
| | - Justin Barnes
- Saint Louis University School of Medicine, Saint Louis, MO, USA
| | - Alexander J Lin
- Department of Radiation Oncology, Washington University School of Medicine, Saint Louis, MO, USA
| | - Soumon Rudra
- Department of Radiation Oncology, Washington University School of Medicine, Saint Louis, MO, USA
| | - Peter Oppelt
- Division of Medical Oncology, Washington University School of Medicine, Saint Louis, MO, USA
| | - Douglas Adkins
- Division of Medical Oncology, Washington University School of Medicine, Saint Louis, MO, USA
| | - Jason T Rich
- Department of Otolaryngology, Washington University School of Medicine, Saint Louis, MO, USA
| | - Jose P Zevallos
- Department of Otolaryngology, Washington University School of Medicine, Saint Louis, MO, USA
| | - Mackenzie D Daly
- Department of Radiation Oncology, Washington University School of Medicine, Saint Louis, MO, USA
| | - Hiram A Gay
- Department of Radiation Oncology, Washington University School of Medicine, Saint Louis, MO, USA
| | - Wade L Thorstad
- Department of Radiation Oncology, Washington University School of Medicine, Saint Louis, MO, USA
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Córdova-Noboa H, Oviedo-Rondón E, Sarsour A, Barnes J, Ferzola P, Rademacher-Heilshorn M, Braun U. Performance, meat quality, and pectoral myopathies of broilers fed either corn or sorghum based diets supplemented with guanidinoacetic acid. Poult Sci 2018; 97:2479-2493. [DOI: 10.3382/ps/pey096] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2017] [Accepted: 03/09/2018] [Indexed: 11/20/2022] Open
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Córdova-Noboa H, Oviedo-Rondón E, Sarsour A, Barnes J, Sapcota D, López D, Gross L, Rademacher-Heilshorn M, Braun U. Effect of guanidinoacetic acid supplementation on live performance, meat quality, pectoral myopathies and blood parameters of male broilers fed corn-based diets with or without poultry by-products. Poult Sci 2018; 97:2494-2505. [DOI: 10.3382/ps/pey097] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2017] [Accepted: 03/09/2018] [Indexed: 11/20/2022] Open
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Raza SJ, Xu P, Barnes J, Fisher R, May A, Darwish O, Dang B, Adsul P, Freeman CA, Siddiqui SA. Outcomes of renal salvage for penetrating renal trauma: a single institution experience. Can J Urol 2018; 25:9323-9327. [PMID: 29900820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
INTRODUCTION Conservative management of penetrating renal trauma is emerging, with data originating from centers with variable level of trauma care. This study reviews the outcomes of renal salvage after penetrating trauma at a level I trauma center. MATERIALS AND METHODS An institutional review board approved trauma registry at Saint Louis University Hospital was retrospectively analyzed, for patients with penetrating renal trauma from 2009 to 2014. Patients were divided into nephrectomy group (NG) or non-nephrectomy group (non-NG), and compared. A multi-variable analysis was performed to determine predictors of nephrectomy, with cross validation to evaluate the performance of the multi-variable model. Data was analyzed using R version 3.3.2. A p value of < 0.05 was considered as significant. RESULTS A total of 121 patients were identified with penetrating renal trauma. Gunshot injury was the leading cause of injury (87%). Eighteen (15%) patients required nephrectomy. The overall mean injury severity score (ISS). was 20. High grade (grade 4-5) renal injuries were noted in 41 patients (34%). Among these, 14 patients (34%) underwent a nephrectomy, while 27 patients (66%) were managed conservatively to salvage renal units. CT grade of renal injury was the only predictor of nephrectomy, on multi-variable analysis (OR 17.09 CI 2.75-105.99, p = 0.002). CT grade of injury and injury severity score were predictors of endoscopic intervention on a sub group analysis of non-NG. CONCLUSIONS CT grade of injury predicts nephrectomy after penetrating renal trauma. Conservative management is a feasible option in penetrating renal trauma even with a higher grade of injury.
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Affiliation(s)
- S Johar Raza
- Division of Urology, Department of Surgery, Saint Louis University Hospital, St. Louis, Missouri, USA
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Brunt H, Barnes J, Jones SJ, Longhurst JWS, Scally G, Hayes E. Air pollution, deprivation and health: understanding relationships to add value to local air quality management policy and practice in Wales, UK. J Public Health (Oxf) 2018; 39:485-497. [PMID: 27613763 DOI: 10.1093/pubmed/fdw084] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2016] [Accepted: 07/16/2016] [Indexed: 11/13/2022] Open
Abstract
Background Air pollution exposure reduces life expectancy. Air pollution, deprivation and poor-health status combinations can create increased and disproportionate disease burdens. Problems and solutions are rarely considered in a broad public health context, but doing so can add value to air quality management efforts by reducing air pollution risks, impacts and inequalities. Methods An ecological study assessed small-area associations between air pollution (nitrogen dioxide and particulate matter), deprivation status and health outcomes in Wales, UK. Results Air pollution concentrations were highest in 'most' deprived areas. When considered separately, deprivation-health associations were stronger than air pollution-health associations. Considered simultaneously, air pollution added to deprivation-health associations; interactions between air pollution and deprivation modified and strengthened associations with all-cause and respiratory disease mortality, especially in 'most' deprived areas where most-vulnerable people lived and where health needs were greatest. Conclusion There is a need to reduce air pollution-related risks for all. However, it is also the case that greater health gains can result from considering local air pollution problems and solutions in the context of wider health-determinants and acting on a better understanding of relationships. Informed and co-ordinated air pollution mitigation and public health action in high deprivation and pollution areas can reduce risks and inequalities. To achieve this, greater public health integration and collaboration in local air quality management policy and practice is needed.
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Affiliation(s)
- H Brunt
- Air Quality Management Resource Centre, University of the West of England, Bristol, UK.,Health Protection Team, Public Health Wales, Cardiff, UK
| | - J Barnes
- Air Quality Management Resource Centre, University of the West of England, Bristol, UK
| | - S J Jones
- Health Protection Team, Public Health Wales,Cardiff, UK
| | - J W S Longhurst
- Air Quality Management Resource Centre, University of the West of England, Bristol, UK
| | - G Scally
- WHO Collaborating Centre for Healthy Urban Environments, University of the West of England, Bristol, UK
| | - E Hayes
- Air Quality Management Resource Centre, University of the West of England, Bristol, UK
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Barnes J, Johnson KJ. Assessing the impact of early Medicaid expansion on insurance, stage at diagnosis, and survival among young adults ineligible for dependent coverage. J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.15_suppl.6563] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Barnes J, Johnson KJ. Assessing the impact of early Medicaid expansion on insurance rates among children with cancer. J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.15_suppl.e18606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Barnes J, Coleman B, Hwang S, Stolic A, Bousvaros A, Nurko S, Salinas GD. Educational needs in the diagnosis and management of pediatric functional constipation: a US survey of specialist and primary care clinicians. Postgrad Med 2018; 130:428-435. [PMID: 29667860 DOI: 10.1080/00325481.2018.1464364] [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] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
OBJECTIVES The goal of this study was to identify opportunities among gastroenterologists and gastroenterology nurse practitioners (NPs)/physician assistants (PAs) for continuing medical education (CME) related to functional constipation. METHODS An online, case-vignette survey was designed to identify and quantify practice patterns of pediatric gastroenterology clinicians. Case vignettes are a validated method for assessing clinician practice patterns. The survey consisted of three patient cases: a 3-year-old female with a 6-month history of constipation; a 6-year-old male with a 1-year history of constipation refractory to treatment and a sacral dimple with nearby tuft of hair; and a 16-year-old male with a 10-year history of constipation, and a sullen, depressed mood. Survey responses were compared to NASPGHAN guideline recommendations for diagnosis and management to identify areas where additional education may be beneficial. RESULTS Responses were collected from 197 gastroenterologists, 116 gastroenterology NPs/PAs, and 206 pediatrician/primary care clinicians. Several of the practice patterns observed suggest opportunities for future CME: low use of applicable Rome III diagnostic criteria; approximately 85% recommended testing beyond what is recommended for the 3-year-old patient; over 1/3 did not perform several recommended tests for the 6-year-old patient; and over 25% did not refer the 16-year-old patient for psychological evaluation. Further, there was little consensus in treatment approach among the three clinician groups. Primary care familiarity with NASPGHAN guidelines was low. CONCLUSIONS CME programs focusing on applying diagnostic criteria, matching diagnostic workup to patient presentation, treatment selection, and identifying patients who may benefit from psychological evaluation may fill knowledge and practice gaps of clinicians who manage pediatric patients with functional constipation.
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Affiliation(s)
| | | | | | - Aleksandra Stolic
- b Independent Medical Education, Medical External Affairs , Takeda Pharmaceuticals U.S.A., Inc , Deerfield , IL , USA
| | | | - Samuel Nurko
- c Boston Children's Hospital , Boston , MA , USA
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Xu P, Barnes J, Choe E, Syed J, Siddiqui S. MP86-01 VARIABILITY OF RETAIL PRICING OF GENERIC UROLOGIC MEDICATIONS IN A MAJOR US METROPOLITAN AREA. J Urol 2018. [DOI: 10.1016/j.juro.2018.02.2881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Kasliwal MM, Nakar E, Singer LP, Kaplan DL, Cook DO, Van Sistine A, Lau RM, Fremling C, Gottlieb O, Jencson JE, Adams SM, Feindt U, Hotokezaka K, Ghosh S, Perley DA, Yu PC, Piran T, Allison JR, Anupama GC, Balasubramanian A, Bannister KW, Bally J, Barnes J, Barway S, Bellm E, Bhalerao V, Bhattacharya D, Blagorodnova N, Bloom JS, Brady PR, Cannella C, Chatterjee D, Cenko SB, Cobb BE, Copperwheat C, Corsi A, De K, Dobie D, Emery SWK, Evans PA, Fox OD, Frail DA, Frohmaier C, Goobar A, Hallinan G, Harrison F, Helou G, Hinderer T, Ho AYQ, Horesh A, Ip WH, Itoh R, Kasen D, Kim H, Kuin NPM, Kupfer T, Lynch C, Madsen K, Mazzali PA, Miller AA, Mooley K, Murphy T, Ngeow CC, Nichols D, Nissanke S, Nugent P, Ofek EO, Qi H, Quimby RM, Rosswog S, Rusu F, Sadler EM, Schmidt P, Sollerman J, Steele I, Williamson AR, Xu Y, Yan L, Yatsu Y, Zhang C, Zhao W. Illuminating gravitational waves: A concordant picture of photons from a neutron star merger. Science 2017; 358:1559-1565. [PMID: 29038373 DOI: 10.1126/science.aap9455] [Citation(s) in RCA: 441] [Impact Index Per Article: 63.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2017] [Accepted: 10/05/2017] [Indexed: 11/02/2022]
Abstract
Merging neutron stars offer an excellent laboratory for simultaneously studying strong-field gravity and matter in extreme environments. We establish the physical association of an electromagnetic counterpart (EM170817) with gravitational waves (GW170817) detected from merging neutron stars. By synthesizing a panchromatic data set, we demonstrate that merging neutron stars are a long-sought production site forging heavy elements by r-process nucleosynthesis. The weak gamma rays seen in EM170817 are dissimilar to classical short gamma-ray bursts with ultrarelativistic jets. Instead, we suggest that breakout of a wide-angle, mildly relativistic cocoon engulfing the jet explains the low-luminosity gamma rays, the high-luminosity ultraviolet-optical-infrared, and the delayed radio and x-ray emission. We posit that all neutron star mergers may lead to a wide-angle cocoon breakout, sometimes accompanied by a successful jet and sometimes by a choked jet.
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Affiliation(s)
- M M Kasliwal
- Division of Physics, Math and Astronomy, California Institute of Technology, 1200 East California Boulevard, Pasadena, CA 91125, USA.
| | - E Nakar
- The Raymond and Beverly Sackler School of Physics and Astronomy, Tel Aviv University, Tel Aviv 69978, Israel
| | - L P Singer
- Astroparticle Physics Laboratory, NASA Goddard Space Flight Center, Mail Code 661, Greenbelt, MD 20771, USA.,Joint Space-Science Institute, University of Maryland, College Park, MD 20742, USA
| | - D L Kaplan
- Department of Physics, University of Wisconsin, Milwaukee, WI 53201, USA
| | - D O Cook
- Division of Physics, Math and Astronomy, California Institute of Technology, 1200 East California Boulevard, Pasadena, CA 91125, USA
| | - A Van Sistine
- Department of Physics, University of Wisconsin, Milwaukee, WI 53201, USA
| | - R M Lau
- Division of Physics, Math and Astronomy, California Institute of Technology, 1200 East California Boulevard, Pasadena, CA 91125, USA
| | - C Fremling
- Division of Physics, Math and Astronomy, California Institute of Technology, 1200 East California Boulevard, Pasadena, CA 91125, USA
| | - O Gottlieb
- The Raymond and Beverly Sackler School of Physics and Astronomy, Tel Aviv University, Tel Aviv 69978, Israel
| | - J E Jencson
- Division of Physics, Math and Astronomy, California Institute of Technology, 1200 East California Boulevard, Pasadena, CA 91125, USA
| | - S M Adams
- Division of Physics, Math and Astronomy, California Institute of Technology, 1200 East California Boulevard, Pasadena, CA 91125, USA
| | - U Feindt
- The Oskar Klein Centre, Department of Physics, Stockholm University, AlbaNova, SE-106 91 Stockholm, Sweden
| | - K Hotokezaka
- Center for Computational Astrophysics, Simons Foundation, Flatiron Institute, 162 5th Avenue, New York, NY 10010, USA.,Department of Astrophysical Sciences, Princeton University, Peyton Hall, Princeton, NJ 08544, USA
| | - S Ghosh
- Department of Physics, University of Wisconsin, Milwaukee, WI 53201, USA
| | - D A Perley
- Astrophysics Research Institute, Liverpool John Moores University, IC2, Liverpool Science Park, 146 Browlow Hill, Liverpool L3 5RF, UK
| | - P-C Yu
- Graduate Institute of Astronomy, National Central University, No. 300, Zhongda Road, Zhongli District, Taoyuan City 32001, Taiwan
| | - T Piran
- Racah Institute of Physics, The Hebrew University of Jerusalem, Jerusalem 91904, Israel
| | - J R Allison
- Sydney Institute for Astronomy, School of Physics A28, The University of Sydney, New South Wales 2006, Australia.,Australian Research Council Centre of Excellence for All-sky Astrophysics in 3 Dimensions, Australia
| | - G C Anupama
- Indian Institute of Astrophysics, II Block Koramangala, Bangalore 560034, India
| | - A Balasubramanian
- Indian Institute of Science Education and Research, Dr. Homi Bhabha Road, Pashan, Pune 411008, India
| | - K W Bannister
- Australia Telescope National Facility, Astronomy and Space Science, Commonwealth Scientific and Industrial Research Organisation, Post Office Box 76, Epping, New South Wales 1710, Australia
| | - J Bally
- Department of Astrophysical and Planetary Sciences, University of Colorado, Boulder, CO 80305, USA
| | - J Barnes
- Columbia Astrophysics Laboratory, Columbia University, New York, NY 10027, USA
| | - S Barway
- South African Astronomical Observatory, Post Office Box 9, Observatory, Cape Town 7935, South Africa
| | - E Bellm
- Department of Astronomy, University of Washington, Seattle, WA 98195, USA
| | - V Bhalerao
- Department of Physics, Indian Institute of Technology Bombay, Mumbai 400076, India
| | - D Bhattacharya
- Inter-University Centre for Astronomy and Astrophysics, Post Office Bag 4, Ganeshkhind, Pune 411007, India
| | - N Blagorodnova
- Division of Physics, Math and Astronomy, California Institute of Technology, 1200 East California Boulevard, Pasadena, CA 91125, USA
| | - J S Bloom
- Department of Astronomy, University of California, Berkeley, CA 94720-3411, USA.,Lawrence Berkeley National Laboratory, 1 Cyclotron Road, MS 50B-4206, Berkeley, CA 94720, USA
| | - P R Brady
- Department of Physics, University of Wisconsin, Milwaukee, WI 53201, USA
| | - C Cannella
- Division of Physics, Math and Astronomy, California Institute of Technology, 1200 East California Boulevard, Pasadena, CA 91125, USA
| | - D Chatterjee
- Department of Physics, University of Wisconsin, Milwaukee, WI 53201, USA
| | - S B Cenko
- Astroparticle Physics Laboratory, NASA Goddard Space Flight Center, Mail Code 661, Greenbelt, MD 20771, USA.,Joint Space-Science Institute, University of Maryland, College Park, MD 20742, USA
| | - B E Cobb
- Department of Physics, George Washington University, Washington, DC 20052, USA
| | - C Copperwheat
- Astrophysics Research Institute, Liverpool John Moores University, IC2, Liverpool Science Park, 146 Browlow Hill, Liverpool L3 5RF, UK
| | - A Corsi
- Department of Physics and Astronomy, Texas Tech University, Box 41051, Lubbock, TX 79409-1051, USA
| | - K De
- Division of Physics, Math and Astronomy, California Institute of Technology, 1200 East California Boulevard, Pasadena, CA 91125, USA
| | - D Dobie
- Sydney Institute for Astronomy, School of Physics A28, The University of Sydney, New South Wales 2006, Australia.,Australian Research Council Centre of Excellence for All-sky Astrophysics, Australia.,Australia Telescope National Facility, Astronomy and Space Science, Commonwealth Scientific and Industrial Research Organisation, Post Office Box 76, Epping, New South Wales 1710, Australia
| | - S W K Emery
- University College London, Mullard Space Science Laboratory, Holmbury St. Mary, Dorking RH5 6NT, UK
| | - P A Evans
- X-ray and Observational Astronomy Research Group, Leicester Institute for Space and Earth Observation, Department of Physics and Astronomy, University of Leicester, University Road, Leicester, LE1 7RH, UK
| | - O D Fox
- Space Telescope Science Institute, 3700 San Martin Drive, Baltimore, MD 21218, USA
| | - D A Frail
- National Radio Astronomy Observatory, Socorro, NM 87825, USA
| | - C Frohmaier
- Department of Physics and Astronomy, University of Southampton, Southampton, Hampshire SO17 1BJ, UK.,Institute of Cosmology and Gravitation, Dennis Sciama Building, University of Portsmouth, Burnaby Road, Portsmouth PO1 3FX, UK
| | - A Goobar
- The Oskar Klein Centre, Department of Physics, Stockholm University, AlbaNova, SE-106 91 Stockholm, Sweden
| | - G Hallinan
- Division of Physics, Math and Astronomy, California Institute of Technology, 1200 East California Boulevard, Pasadena, CA 91125, USA
| | - F Harrison
- Division of Physics, Math and Astronomy, California Institute of Technology, 1200 East California Boulevard, Pasadena, CA 91125, USA
| | - G Helou
- Infrared Processing and Analysis Center, California Institute of Technology, Pasadena, CA 91125, USA
| | - T Hinderer
- Institute of Mathematics, Astrophysics and Particle Physics, Radboud University, Heyendaalseweg 135, 6525 AJ Nijmegen, Netherlands
| | - A Y Q Ho
- Division of Physics, Math and Astronomy, California Institute of Technology, 1200 East California Boulevard, Pasadena, CA 91125, USA
| | - A Horesh
- Racah Institute of Physics, The Hebrew University of Jerusalem, Jerusalem 91904, Israel
| | - W-H Ip
- Department of Astrophysical Sciences, Princeton University, Peyton Hall, Princeton, NJ 08544, USA
| | - R Itoh
- Department of Physics, Tokyo Institute of Technology, 2-12-1 Ookayama, Meguro-ku, Tokyo 152-8551, Japan
| | - D Kasen
- Department of Astronomy, University of California, Berkeley, CA 94720-3411, USA.,Department of Physics, University of California, Berkeley, CA 94720, USA
| | - H Kim
- Gemini Observatory, Casilla 603, La Serena, Chile
| | - N P M Kuin
- University College London, Mullard Space Science Laboratory, Holmbury St. Mary, Dorking RH5 6NT, UK
| | - T Kupfer
- Division of Physics, Math and Astronomy, California Institute of Technology, 1200 East California Boulevard, Pasadena, CA 91125, USA
| | - C Lynch
- Sydney Institute for Astronomy, School of Physics A28, The University of Sydney, New South Wales 2006, Australia.,Australian Research Council Centre of Excellence for All-sky Astrophysics, Australia
| | - K Madsen
- Division of Physics, Math and Astronomy, California Institute of Technology, 1200 East California Boulevard, Pasadena, CA 91125, USA
| | - P A Mazzali
- Astrophysics Research Institute, Liverpool John Moores University, IC2, Liverpool Science Park, 146 Browlow Hill, Liverpool L3 5RF, UK.,Max-Planck Institute for Astrophysics, Garching, Germany
| | - A A Miller
- Center for Interdisciplinary Exploration and Research in Astrophysics and Department of Physics and Astronomy, Northwestern University, Evanston, IL 60208, USA.,The Adler Planetarium, Chicago, IL 60605, USA
| | - K Mooley
- Astrophysics, Department of Physics, University of Oxford, Keble Road, Oxford OX1 3RH, UK
| | - T Murphy
- Sydney Institute for Astronomy, School of Physics A28, The University of Sydney, New South Wales 2006, Australia.,Australian Research Council Centre of Excellence for All-sky Astrophysics, Australia
| | - C-C Ngeow
- Graduate Institute of Astronomy, National Central University, No. 300, Zhongda Road, Zhongli District, Taoyuan City 32001, Taiwan
| | - D Nichols
- Institute of Mathematics, Astrophysics and Particle Physics, Radboud University, Heyendaalseweg 135, 6525 AJ Nijmegen, Netherlands
| | - S Nissanke
- Institute of Mathematics, Astrophysics and Particle Physics, Radboud University, Heyendaalseweg 135, 6525 AJ Nijmegen, Netherlands
| | - P Nugent
- Department of Astronomy, University of California, Berkeley, CA 94720-3411, USA.,Lawrence Berkeley National Laboratory, 1 Cyclotron Road, MS 50B-4206, Berkeley, CA 94720, USA
| | - E O Ofek
- Department of Particle Physics and Astrophysics, Weizmann Institute of Science, Rehovot 7610001, Israel
| | - H Qi
- Department of Physics, University of Wisconsin, Milwaukee, WI 53201, USA
| | - R M Quimby
- Department of Astronomy, San Diego State University, San Diego, CA 92182, USA.,Kavli Institute for the Physics and Mathematics of the Universe (WPI), The University of Tokyo Institutes for Advanced Study, The University of Tokyo, Kashiwa, Chiba 277-8583, Japan
| | - S Rosswog
- The Oskar Klein Centre, Department of Astronomy, Stockholm University, AlbaNova, SE-106 91 Stockholm, Sweden
| | - F Rusu
- School of Engineering (EECS), University of California, Merced, CA 95343, USA
| | - E M Sadler
- Sydney Institute for Astronomy, School of Physics A28, The University of Sydney, New South Wales 2006, Australia.,Australian Research Council Centre of Excellence for All-sky Astrophysics, Australia
| | - P Schmidt
- Institute of Mathematics, Astrophysics and Particle Physics, Radboud University, Heyendaalseweg 135, 6525 AJ Nijmegen, Netherlands
| | - J Sollerman
- The Oskar Klein Centre, Department of Astronomy, Stockholm University, AlbaNova, SE-106 91 Stockholm, Sweden
| | - I Steele
- Astrophysics Research Institute, Liverpool John Moores University, IC2, Liverpool Science Park, 146 Browlow Hill, Liverpool L3 5RF, UK
| | - A R Williamson
- Institute of Mathematics, Astrophysics and Particle Physics, Radboud University, Heyendaalseweg 135, 6525 AJ Nijmegen, Netherlands
| | - Y Xu
- Division of Physics, Math and Astronomy, California Institute of Technology, 1200 East California Boulevard, Pasadena, CA 91125, USA
| | - L Yan
- Division of Physics, Math and Astronomy, California Institute of Technology, 1200 East California Boulevard, Pasadena, CA 91125, USA.,Infrared Processing and Analysis Center, California Institute of Technology, Pasadena, CA 91125, USA
| | - Y Yatsu
- Department of Physics, Tokyo Institute of Technology, 2-12-1 Ookayama, Meguro-ku, Tokyo 152-8551, Japan
| | - C Zhang
- Department of Physics, University of Wisconsin, Milwaukee, WI 53201, USA
| | - W Zhao
- School of Engineering (EECS), University of California, Merced, CA 95343, USA
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Bruce D, Kocialkowski C, Bintcliffe F, Monsell F, Barnes J, Brown R. Analysis of a paediatric orthopaedic network: a six-year experience in the South West of the United Kingdom. J Child Orthop 2017; 11:404-413. [PMID: 29081857 PMCID: PMC5643936 DOI: 10.1302/1863-2548.11.170076] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
PURPOSE We report our experience of a paediatric orthopaedic network, based on a 'hub and spoke' model, covering the South West of the United Kingdom. We identify the areas of most clinical concern, the effect of the network on stream-lining patient management and the benefits of the network to the clinician. METHODS Prospective data were collected from the minutes of the bi-annual meetings of the South West Paediatric Network (UK) between November 2006 and May 2012. Data collected included details of the condition, previous treatment, problems, complications and advice given. Cases continue to be followed up in subsequent meetings. RESULTS In total 131 cases were included and hip conditions were discussed most frequently (35.1%). The most common indication for discussion was to support and confirm the local management plan. In total, a mean average of 8.75 cases in total were presented per consultant during the study period, with those within ten to 12 years of starting independent practice presenting the majority. The clinical outcome for patients discussed in this forum was local provision of care in 74%, with transfer to the regional centre in 15.7%. Following advice, 14% of direct referrals were given appropriate advice and avoided a journey to the tertiary centre. CONCLUSION The network has enabled local provision of care, reduced the burden of travel on patients and prevented unnecessary referrals to the tertiary centre. Additionally, it provides a mechanism to reassure and educate clinicians.
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Affiliation(s)
- D. Bruce
- Royal United Hospital, Bath BA1 3NG, UK,Correspondence should be sent to: D. Bruce, Orthopaedic Trauma Department, Southmead hospital, Southmead Road, Bristol, BS10 5NB, United Kingdom. E-mail:
| | | | - F. Bintcliffe
- Eastbourne District General Hospital, Eastbourne BN21 2UD, UK
| | - F. Monsell
- Bristol Royal Hospital for Children, Upper Maudlin Street, Bristol BS2 8BJ, UK
| | - J. Barnes
- Bristol Royal Hospital for Children, Upper Maudlin Street, Bristol BS2 8BJ, UK
| | - R. Brown
- Cheltenham General Hospital, Cheltenham GL53 7AN, UK
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Cindy Parks, Yates M, PACU Team, Barnes J. PACU Documentation: A Collaborative Approach to Meaningful Documentation. J Perianesth Nurs 2017. [DOI: 10.1016/j.jopan.2017.06.102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Raposo S, Sims T, Barnes J, Carstensen L. HOW AND WHEN DO OLDER ADULTS EXPERIENCE BETTER EMOTIONAL WELL-BEING? Innov Aging 2017. [DOI: 10.1093/geroni/igx004.1775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- S. Raposo
- Stanford University, Stanford, California
| | - T. Sims
- Stanford University, Stanford, California
| | - J. Barnes
- Stanford University, Stanford, California
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Kendrick D, Kelllezi B, Coupland C, Maula A, Beckett K, Morriss R, Joseph S, Barnes J, Sleney J, Christie N. Psychological morbidity and health-related quality of life after injury: multicentre cohort study. Qual Life Res 2017; 26:1233-1250. [PMID: 27785608 PMCID: PMC5376395 DOI: 10.1007/s11136-016-1439-7] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/13/2016] [Indexed: 12/16/2022]
Abstract
PURPOSE To demonstrate the impact of psychological morbidity 1 month post-injury on subsequent post-injury quality of life (HRQoL) in a general injury population in the UK to inform development of trauma care and rehabilitation services. METHODS Multicentre cohort study of 16-70-year-olds admitted to 4 UK hospitals following injury. Psychological morbidity and HRQoL (EQ-5D-3L) were measured at recruitment and 1, 2, 4 and 12 months post-injury. A reduction in EQ-5D compared to retrospectively assessed pre-injury levels of at least 0.074 was taken as the minimal important difference (MID). Multilevel logistic regression explored relationships between psychological morbidity 1 month post-injury and MID in HRQoL over the 12 months after injury. RESULTS A total of 668 adults participated. Follow-up rates were 77% (1 month) and 63% (12 months). Substantial reductions in HRQoL were seen; 93% reported a MID at 1 month and 58% at 12 months. Problems with pain, mobility and usual activities were commonly reported at each time point. Depression and anxiety scores 1 month post-injury were independently associated with subsequent MID in HRQoL. The relationship between depression and HRQoL was partly explained by anxiety and to a lesser extent by pain and social functioning. The relationship between anxiety and HRQoL was not explained by factors measured in our study. CONCLUSIONS Hospitalised injuries result in substantial reductions in HRQoL up to 12 months later. Depression and anxiety early in the recovery period are independently associated with lower HRQoL. Identifying and managing these problems, ensuring adequate pain control and facilitating social functioning are key elements in improving HRQoL post-injury.
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Affiliation(s)
- D Kendrick
- Division of Primary Care, University of Nottingham, University Park, Nottingham, NG7 2RD, UK.
| | - B Kelllezi
- Division of Psychology, Nottingham Trent University, Nottingham, NG1 4BU, UK
| | - C Coupland
- Division of Primary Care, University of Nottingham, University Park, Nottingham, NG7 2RD, UK
| | - A Maula
- Division of Primary Care, University of Nottingham, University Park, Nottingham, NG7 2RD, UK
| | - K Beckett
- Research and Innovation, University of the West of England, Bristol, BS2 8AE, UK
| | - R Morriss
- Division of Psychiatry and Applied Psychology, University of Nottingham, Nottingham, NG7 2TU, UK
| | - S Joseph
- School of Education, University of Nottingham, Nottingham, NG8 1BB, UK
| | - J Barnes
- Loughborough Design School, Loughborough University, Loughborough, LE11 3TU, UK
| | - J Sleney
- Department of Sociology, University of Surrey, Guildford, GU2 7XH, UK
| | - N Christie
- Centre for Transport Studies, University College London, London, WC1E 6BT, UK
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Gharibi S, Kimble B, Vogelnest L, Barnes J, Stadler CK, Govendir M. Pharmacokinetics of posaconazole in koalas (Phascolarctos cinereus) after intravenous and oral administration. J Vet Pharmacol Ther 2017; 40:675-681. [DOI: 10.1111/jvp.12407] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2016] [Accepted: 03/05/2017] [Indexed: 11/27/2022]
Affiliation(s)
- S. Gharibi
- Sydney School of Veterinary Science; The University of Sydney; Camperdown NSW Australia
| | - B. Kimble
- Sydney School of Veterinary Science; The University of Sydney; Camperdown NSW Australia
| | | | - J. Barnes
- Santa Barbara Zoo; Santa Barbara CA USA
| | | | - M. Govendir
- Sydney School of Veterinary Science; The University of Sydney; Camperdown NSW Australia
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Barnes J, Johnson SJ, French JJ. Correlation of Ki-67 indices from biopsy and resection specimens of neuroendocrine tumours. Ann R Coll Surg Engl 2017; 99:193-197. [PMID: 27490982 PMCID: PMC5450268 DOI: 10.1308/rcsann.2016.0225] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/17/2016] [Indexed: 01/04/2023] Open
Abstract
INTRODUCTION Neuroendocrine tumours (NETs) are a heterogeneous group of tumours with a highly variable presentation and prognosis. Management decisions are complex. Ki-67 levels in tissue samples are a key indicator used to grade tumours and guide treatment. This study assessed whether the Ki-67 index and tumour grade generated from tissue samples correlated with that assessed in resection specimens. METHODS This was a retrospective cohort analysis of all patients who had both a tissue sample and a resection specimen analysed in our trust, a tertiary referral centre, during 2012 and 2013. RESULTS Data from 36 patients were reviewed. Ki-67 indices from tissue samples and resection specimens showed strong correlation (r=0.95, p<0.001). Tumour grading was the same in the tissue sample and resection specimens for 22 patients (61.1%). In four patients (11.1%), the tissue sample overestimated the grade while in ten (27.8%), the sample underestimated the grade. CONCLUSIONS In most cases, the Ki-67 index and tumour grade from the tissue sample matched that of the resection specimen. However, in nearly 40% of cases, the tissue sample grading did not match the resection tumour grading. In the majority of these, the tissue sample underestimated disease activity. A low Ki-67 index in a tissue sample should therefore be taken as provisional and should not, in isolation, persuade clinicians to choose a more conservative treatment approach if there is clinical, biochemical or radiological evidence suggestive of a more aggressive disease pathology.
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Affiliation(s)
- J Barnes
- Newcastle upon Tyne Hospitals NHS Foundation Trust , UK
| | - S J Johnson
- Newcastle upon Tyne Hospitals NHS Foundation Trust , UK
| | - J J French
- Newcastle upon Tyne Hospitals NHS Foundation Trust , UK
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Barnes J, Ellis ML, Gilliam T, Lum J, Fiedler L, Jani J, Lansdowne S, Cerenzia W. Corrigendum to Abstract 389 “Identification of Educational Gaps Amongst Physicians Who Manage Patients with Chronic Heart Failure”. J Card Fail 2017; 23:93. [DOI: 10.1016/j.cardfail.2016.09.020] [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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Vohra RS, Pasquali S, Kirkham AJ, Marriott P, Johnstone M, Spreadborough P, Alderson D, Griffiths EA, Fenwick S, Elmasry M, Nunes Q, Kennedy D, Basit Khan R, Khan MAS, Magee CJ, Jones SM, Mason D, Parappally CP, Mathur P, Saunders M, Jamel S, Ul Haque S, Zafar S, Shiwani MH, Samuel N, Dar F, Jackson A, Lovett B, Dindyal S, Winter H, Fletcher T, Rahman S, Wheatley K, Nieto T, Ayaani S, Youssef H, Nijjar RS, Watkin H, Naumann D, Emeshi S, Sarmah PB, Lee K, Joji N, Heath J, Teasdale RL, Weerasinghe C, Needham PJ, Welbourn H, Forster L, Finch D, Blazeby JM, Robb W, McNair AGK, Hrycaiczuk A, Charalabopoulos A, Kadirkamanathan S, Tang CB, Jayanthi NVG, Noor N, Dobbins B, Cockbain AJ, Nilsen-Nunn A, Siqueira J, Pellen M, Cowley JB, Ho WM, Miu V, White TJ, Hodgkins KA, Kinghorn A, Tutton MG, Al-Abed YA, Menzies D, Ahmad A, Reed J, Khan S, Monk D, Vitone LJ, Murtaza G, Joel A, Brennan S, Shier D, Zhang C, Yoganathan T, Robinson SJ, McCallum IJD, Jones MJ, Elsayed M, Tuck L, Wayman J, Carney K, Aroori S, Hosie KB, Kimble A, Bunting DM, Fawole AS, Basheer M, Dave RV, Sarveswaran J, Jones E, Kendal C, Tilston MP, Gough M, Wallace T, Singh S, Downing J, Mockford KA, Issa E, Shah N, Chauhan N, Wilson TR, Forouzanfar A, Wild JRL, Nofal E, Bunnell C, Madbak K, Rao STV, Devoto L, Siddiqi N, Khawaja Z, Hewes JC, Gould L, Chambers A, Urriza Rodriguez D, Sen G, Robinson S, Carney K, Bartlett F, Rae DM, Stevenson TEJ, Sarvananthan K, Dwerryhouse SJ, Higgs SM, Old OJ, Hardy TJ, Shah R, Hornby ST, Keogh K, Frank L, Al-Akash M, Upchurch EA, Frame RJ, Hughes M, Jelley C, Weaver S, Roy S, Sillo TO, Galanopoulos G, Cuming T, Cunha P, Tayeh S, Kaptanis S, Heshaishi M, Eisawi A, Abayomi M, Ngu WS, Fleming K, Singh Bajwa D, Chitre V, Aryal K, Ferris P, Silva M, Lammy S, Mohamed S, Khawaja A, Hussain A, Ghazanfar MA, Bellini MI, Ebdewi H, Elshaer M, Gravante G, Drake B, Ogedegbe A, Mukherjee D, Arhi C, Giwa Nusrat Iqbal L, Watson NF, Kumar Aggarwal S, Orchard P, Villatoro E, Willson PD, Wa K, Mok J, Woodman T, Deguara J, Garcea G, Babu BI, Dennison AR, Malde D, Lloyd D, Satheesan S, Al-Taan O, Boddy A, Slavin JP, Jones RP, Ballance L, Gerakopoulos S, Jambulingam P, Mansour S, Sakai N, Acharya V, Sadat MM, Karim L, Larkin D, Amin K, Khan A, Law J, Jamdar S, Smith SR, Sampat K, M O'shea K, Manu M, Asprou FM, Malik NS, Chang J, Johnstone M, Lewis M, Roberts GP, Karavadra B, Photi E, Hewes J, Gould L, Chambers A, Rodriguez D, O'Reilly DA, Rate AJ, Sekhar H, Henderson LT, Starmer BZ, Coe PO, Tolofari S, Barrie J, Bashir G, Sloane J, Madanipour S, Halkias C, Trevatt AEJ, Borowski DW, Hornsby J, Courtney MJ, Virupaksha S, Seymour K, Robinson S, Hawkins H, Bawa S, Gallagher PV, Reid A, Wood P, Finch JG, Parmar J, Stirland E, Gardner-Thorpe J, Al-Muhktar A, Peterson M, Majeed A, Bajwa FM, Martin J, Choy A, Tsang A, Pore N, Andrew DR, Al-Khyatt W, Taylor C, Bhandari S, Chambers A, Subramanium D, Toh SKC, Carter NC, Mercer SJ, Knight B, Tate S, Pearce B, Wainwright D, Vijay V, Alagaratnam S, Sinha S, Khan S, El-Hasani SS, Hussain AA, Bhattacharya V, Kansal N, Fasih T, Jackson C, Siddiqui MN, Chishti IA, Fordham IJ, Siddiqui Z, Bausbacher H, Geogloma I, Gurung K, Tsavellas G, Basynat P, Kiran Shrestha A, Basu S, Chhabra Mohan Harilingam A, Rabie M, Akhtar M, Kumar P, Jafferbhoy SF, Hussain N, Raza S, Haque M, Alam I, Aseem R, Patel S, Asad M, Booth MI, Ball WR, Wood CPJ, Pinho-Gomes AC, Kausar A, Rami Obeidallah M, Varghase J, Lodhia J, Bradley D, Rengifo C, Lindsay D, Gopalswamy S, Finlay I, Wardle S, Bullen N, Iftikhar SY, Awan A, Ahmed J, Leeder P, Fusai G, Bond-Smith G, Psica A, Puri Y, Hou D, Noble F, Szentpali K, Broadhurst J, Date R, Hossack MR, Li Goh Y, Turner P, Shetty V, Riera M, Macano CAW, Sukha A, Preston SR, Hoban JR, Puntis DJ, Williams SV, Krysztopik R, Kynaston J, Batt J, Doe M, Goscimski A, Jones GH, Smith SR, Hall C, Carty N, Ahmed J, Panteleimonitis S, Gunasekera RT, Sheel ARG, Lennon H, Hindley C, Reddy M, Kenny R, Elkheir N, McGlone ER, 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Shahin Y, Ali A, Luther A, Nicholson JA, Rajendran I, Boal M, Ritchie J. Population-based cohort study of variation in the use of emergency cholecystectomy for benign gallbladder diseases. Br J Surg 2016; 103:1716-1726. [PMID: 27748962 DOI: 10.1002/bjs.10288] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2016] [Revised: 06/21/2016] [Accepted: 07/06/2016] [Indexed: 01/05/2023]
Abstract
Abstract
Background
The aims of this prospective population-based cohort study were to identify the patient and hospital characteristics associated with emergency cholecystectomy, and the influences of these in determining variations between hospitals.
Methods
Data were collected for consecutive patients undergoing cholecystectomy in acute UK and Irish hospitals between 1 March and 1 May 2014. Potential explanatory variables influencing the performance of emergency cholecystectomy were analysed by means of multilevel, multivariable logistic regression modelling using a two-level hierarchical structure with patients (level 1) nested within hospitals (level 2).
Results
Data were collected on 4744 cholecystectomies from 165 hospitals. Increasing age, lower ASA fitness grade, biliary colic, the need for further imaging (magnetic retrograde cholangiopancreatography), endoscopic interventions (endoscopic retrograde cholangiopancreatography) and admission to a non-biliary centre significantly reduced the likelihood of an emergency cholecystectomy being performed. The multilevel model was used to calculate the probability of receiving an emergency cholecystectomy for a woman aged 40 years or over with an ASA grade of I or II and a BMI of at least 25·0 kg/m2, who presented with acute cholecystitis with an ultrasound scan showing a thick-walled gallbladder and a normal common bile duct. The mean predicted probability of receiving an emergency cholecystectomy was 0·52 (95 per cent c.i. 0·45 to 0·57). The predicted probabilities ranged from 0·02 to 0·95 across the 165 hospitals, demonstrating significant variation between hospitals.
Conclusion
Patients with similar characteristics presenting to different hospitals with acute gallbladder pathology do not receive comparable care.
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Affiliation(s)
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- Trent Oesophago-Gastric Unit, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - S Pasquali
- Surgical Oncology Unit, Veneto Institute of Oncology IOV-IRCCS, Padova, Italy
| | - A J Kirkham
- Cancer Research UK Clinical Trials Unit, University of Birmingham, Birmingham, UK
| | - P Marriott
- West Midlands Research Collaborative, Academic Department of Surgery, University of Birmingham, Birmingham, UK
| | - M Johnstone
- West Midlands Research Collaborative, Academic Department of Surgery, University of Birmingham, Birmingham, UK
| | - P Spreadborough
- West Midlands Research Collaborative, Academic Department of Surgery, University of Birmingham, Birmingham, UK
| | - D Alderson
- Academic Department of Surgery, University of Birmingham, Birmingham, UK
| | - E A Griffiths
- Department of Upper Gastrointestinal Surgery, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - S Fenwick
- Aintree University Hospital NHS Foundation Trust
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- Aintree University Hospital NHS Foundation Trust
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- Aintree University Hospital NHS Foundation Trust
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- Aintree University Hospital NHS Foundation Trust
| | | | | | | | | | - D Mason
- Wirral University Teaching Hospital
| | | | | | | | - S Jamel
- Barnet and Chase Farm Hospital
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- Barnet and Chase Farm Hospital
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- Barnsley District General Hospital
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- Barnsley District General Hospital
| | | | | | | | | | | | | | - K Wheatley
- Sandwell and West Birmingham Hospitals NHS Trust
| | - T Nieto
- Sandwell and West Birmingham Hospitals NHS Trust
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- Sandwell and West Birmingham Hospitals NHS Trust
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- Heart of England Foundation NHS Trust
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- Heart of England Foundation NHS Trust
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- Heart of England Foundation NHS Trust
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- Heart of England Foundation NHS Trust
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- Heart of England Foundation NHS Trust
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- Heart of England Foundation NHS Trust
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- Blackpool Teaching Hospitals NHS Foundation Trust
| | - R L Teasdale
- Blackpool Teaching Hospitals NHS Foundation Trust
| | | | - P J Needham
- Bradford Teaching Hospitals NHS Foundation Trust
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- Bradford Teaching Hospitals NHS Foundation Trust
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- Bradford Teaching Hospitals NHS Foundation Trust
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- Bradford Teaching Hospitals NHS Foundation Trust
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- University Hospitals Bristol NHS Trust
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- Calderdale and Huddersfield NHS Trust
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- Hull and East Yorkshire NHS Trust
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- Hull and East Yorkshire NHS Trust
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- Hull and East Yorkshire NHS Trust
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- Chesterfield Royal Hospital NHS Foundation Trust
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- Chesterfield Royal Hospital NHS Foundation Trust
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- Chesterfield Royal Hospital NHS Foundation Trust
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- Colchester Hospital University NHS Foundation Trust
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- Colchester Hospital University NHS Foundation Trust
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- Colchester Hospital University NHS Foundation Trust
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- Colchester Hospital University NHS Foundation Trust
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- Colchester Hospital University NHS Foundation Trust
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- Colchester Hospital University NHS Foundation Trust
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- Countess of Chester NHS Foundation Trust
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- Countess of Chester NHS Foundation Trust
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- Countess of Chester NHS Foundation Trust
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- Croydon Health Services NHS Trust
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- North Cumbria University Hospitals Trust
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- North Cumbria University Hospitals Trust
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- Northern Lincolnshire and Goole NHS Foundation Trust
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- Northern Lincolnshire and Goole NHS Foundation Trust
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- Northern Lincolnshire and Goole NHS Foundation Trust
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- Northern Lincolnshire and Goole NHS Foundation Trust
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- Northern Lincolnshire and Goole NHS Foundation Trust
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- Northern Lincolnshire and Goole NHS Foundation Trust
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- Northern Lincolnshire and Goole NHS Foundation Trust
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- Northern Lincolnshire and Goole NHS Foundation Trust
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- Frimley Park Hospital NHS Trust
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- Gloucestershire Hospitals NHS Trust
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- Gloucestershire Hospitals NHS Trust
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- Gloucestershire Hospitals NHS Trust
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- Gloucestershire Hospitals NHS Trust
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- Great Western Hospitals NHS Foundation Trust
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- Homerton University Hospital NHS Trust
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- Tees Hospitals NHS Foundation Trust
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- Paget University Hospitals NHS Foundation Trust
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- Paget University Hospitals NHS Foundation Trust
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- Paget University Hospitals NHS Foundation Trust
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- Kettering General Hospital NHS Foundation Trust
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- Kettering General Hospital NHS Foundation Trust
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- Kettering General Hospital NHS Foundation Trust
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- Kettering General Hospital NHS Foundation Trust
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- Barking, Havering and Redbridge University Hospitals NHS Trust
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- Barking, Havering and Redbridge University Hospitals NHS Trust
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- Barking, Havering and Redbridge University Hospitals NHS Trust
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- Kingston Hospital NHS Foundation Trust
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- Kingston Hospital NHS Foundation Trust
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- Kingston Hospital NHS Foundation Trust
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- Kingston Hospital NHS Foundation Trust
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- University Hospitals of Leicester NHS Trust
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- University Hospitals of Leicester NHS Trust
| | | | - D Malde
- University Hospitals of Leicester NHS Trust
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- University Hospitals of Leicester NHS Trust
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- University Hospitals of Leicester NHS Trust
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- University Hospitals of Leicester NHS Trust
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- Leighton Hospital, Mid Cheshire Hospitals NHS Foundation Trust
| | - R P Jones
- Leighton Hospital, Mid Cheshire Hospitals NHS Foundation Trust
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- Leighton Hospital, Mid Cheshire Hospitals NHS Foundation Trust
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- Leighton Hospital, Mid Cheshire Hospitals NHS Foundation Trust
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- Luton and Dunstable University Hospital NHS Foundation Trust
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- Luton and Dunstable University Hospital NHS Foundation Trust
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- Luton and Dunstable University Hospital NHS Foundation Trust
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- Luton and Dunstable University Hospital NHS Foundation Trust
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- Macclesfield District General Hospital
| | - L Karim
- Macclesfield District General Hospital
| | - D Larkin
- Macclesfield District General Hospital
| | - K Amin
- Macclesfield District General Hospital
| | - A Khan
- Central Manchester NHS Foundation Trust
| | - J Law
- Central Manchester NHS Foundation Trust
| | - S Jamdar
- Central Manchester NHS Foundation Trust
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- Central Manchester NHS Foundation Trust
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- Central Manchester NHS Foundation Trust
| | | | - M Manu
- Royal Wolverhampton Hospitals NHS Trust
| | | | - N S Malik
- Royal Wolverhampton Hospitals NHS Trust
| | - J Chang
- Royal Wolverhampton Hospitals NHS Trust
| | | | - M Lewis
- Norfolk and Norwich University Hospitals NHS Foundation Trust
| | - G P Roberts
- Norfolk and Norwich University Hospitals NHS Foundation Trust
| | - B Karavadra
- Norfolk and Norwich University Hospitals NHS Foundation Trust
| | - E Photi
- Norfolk and Norwich University Hospitals NHS Foundation Trust
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - J Hornsby
- North Tees and Hartlepool NHS Foundation Trust
| | | | | | - K Seymour
- Northumbria Healthcare NHS Foundation Trust
| | - S Robinson
- Northumbria Healthcare NHS Foundation Trust
| | - H Hawkins
- Northumbria Healthcare NHS Foundation Trust
| | - S Bawa
- Northumbria Healthcare NHS Foundation Trust
| | | | - A Reid
- Northumbria Healthcare NHS Foundation Trust
| | - P Wood
- Northumbria Healthcare NHS Foundation Trust
| | - J G Finch
- Northampton General Hospital NHS Trust
| | - J Parmar
- Northampton General Hospital NHS Trust
| | | | | | - A Al-Muhktar
- Sheffield Teaching Hospitals NHS Foundation Trust
| | - M Peterson
- Sheffield Teaching Hospitals NHS Foundation Trust
| | - A Majeed
- Sheffield Teaching Hospitals NHS Foundation Trust
| | | | | | - A Choy
- Peterborough City Hospital
| | | | - N Pore
- United Lincolnshire Hospitals NHS Trust
| | | | | | - C Taylor
- United Lincolnshire Hospitals NHS Trust
| | | | | | | | | | | | | | | | - S Tate
- Portsmouth Hospitals NHS Trust
| | | | | | - V Vijay
- The Princess Alexandra Hospital NHS Trust
| | | | - S Sinha
- The Princess Alexandra Hospital NHS Trust
| | - S Khan
- The Princess Alexandra Hospital NHS Trust
| | | | - A A Hussain
- King's College Hospital NHS Foundation Trust
| | | | - N Kansal
- Gateshead Health NHS Foundation Trust
| | - T Fasih
- Gateshead Health NHS Foundation Trust
| | - C Jackson
- Gateshead Health NHS Foundation Trust
| | | | | | | | | | | | | | - K Gurung
- Queen Elizabeth Hospital NHS Trust
| | - G Tsavellas
- East Kent Hospitals University NHS Foundation Trust
| | - P Basynat
- East Kent Hospitals University NHS Foundation Trust
| | | | - S Basu
- East Kent Hospitals University NHS Foundation Trust
| | | | - M Rabie
- East Kent Hospitals University NHS Foundation Trust
| | - M Akhtar
- East Kent Hospitals University NHS Foundation Trust
| | - P Kumar
- Burton Hospitals NHS Foundation Trust
| | | | - N Hussain
- Burton Hospitals NHS Foundation Trust
| | - S Raza
- Burton Hospitals NHS Foundation Trust
| | - M Haque
- Royal Albert Edward Infirmary, Wigan Wrightington and Leigh NHS Trust
| | - I Alam
- Royal Albert Edward Infirmary, Wigan Wrightington and Leigh NHS Trust
| | - R Aseem
- Royal Albert Edward Infirmary, Wigan Wrightington and Leigh NHS Trust
| | - S Patel
- Royal Albert Edward Infirmary, Wigan Wrightington and Leigh NHS Trust
| | - M Asad
- Royal Albert Edward Infirmary, Wigan Wrightington and Leigh NHS Trust
| | - M I Booth
- Royal Berkshire NHS Foundation Trust
| | - W R Ball
- Royal Berkshire NHS Foundation Trust
| | | | | | | | | | - J Varghase
- Royal Bolton Hospital NHS Foundation Trust
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- Royal Bolton Hospital NHS Foundation Trust
| | - D Bradley
- Royal Bolton Hospital NHS Foundation Trust
| | - C Rengifo
- Royal Bolton Hospital NHS Foundation Trust
| | - D Lindsay
- Royal Bolton Hospital NHS Foundation Trust
| | | | | | | | | | | | - A Awan
- Royal Derby NHS Foundation Trust
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- Royal Derby NHS Foundation Trust
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- Royal Derby NHS Foundation Trust
| | | | | | | | | | - D Hou
- Hampshire Hospital NHS Foundation Trust
| | - F Noble
- Hampshire Hospital NHS Foundation Trust
| | | | | | - R Date
- Lancashire Teaching Hospitals NHS Foundation Trust
| | - M R Hossack
- Lancashire Teaching Hospitals NHS Foundation Trust
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- Lancashire Teaching Hospitals NHS Foundation Trust
| | - P Turner
- Lancashire Teaching Hospitals NHS Foundation Trust
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- Lancashire Teaching Hospitals NHS Foundation Trust
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- Royal Surrey County Hospital NHS Foundation Trust
| | - J R Hoban
- Royal Surrey County Hospital NHS Foundation Trust
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- Royal Surrey County Hospital NHS Foundation Trust
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- Royal United Hospital Bath NHS Trust
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- Royal United Hospital Bath NHS Trust
| | | | | | | | - C Hall
- Salford Royal NHS Foundation Trust
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- Salisbury Hospital Foundation Trust
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- Salisbury Hospital Foundation Trust
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- Southport and Ormskirk Hospital NHS Trust
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- Southport and Ormskirk Hospital NHS Trust
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- St George's Healthcare NHS Trust
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- St Helens and Knowsley Teaching Hospitals NHS Trust
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- Imperial College Healthcare NHS Trust
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- Imperial College Healthcare NHS Trust
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- Belfast City Hospital, Mater Infirmorum Hospital Belfast and Royal Victoria Hospital
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- Belfast City Hospital, Mater Infirmorum Hospital Belfast and Royal Victoria Hospital
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- Belfast City Hospital, Mater Infirmorum Hospital Belfast and Royal Victoria Hospital
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| | - D Johnston
- Belfast City Hospital, Mater Infirmorum Hospital Belfast and Royal Victoria Hospital
| | - B McAree
- Belfast City Hospital, Mater Infirmorum Hospital Belfast and Royal Victoria Hospital
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- University Hospital Limerick
| | | | - A D K Hill
- Louth County Hospital and Our Lady of Lourdes Hospital
| | - E Khogali
- Louth County Hospital and Our Lady of Lourdes Hospital
| | - W Shabo
- Louth County Hospital and Our Lady of Lourdes Hospital
| | - E Iskandar
- Louth County Hospital and Our Lady of Lourdes Hospital
| | | | | | | | | | | | | | | | | | - P Balfe
- St Luke's General Hospital Kilkenny
| | - M Lee
- St Luke's General Hospital Kilkenny
| | - D C Winter
- St Vincent's University and Private Hospitals, Dublin
| | - M E Kelly
- St Vincent's University and Private Hospitals, Dublin
| | - E Hoti
- St Vincent's University and Private Hospitals, Dublin
| | - D Maguire
- St Vincent's University and Private Hospitals, Dublin
| | - P Karunakaran
- St Vincent's University and Private Hospitals, Dublin
| | - J G Geoghegan
- St Vincent's University and Private Hospitals, Dublin
| | - S T Martin
- St Vincent's University and Private Hospitals, Dublin
| | - F McDermott
- St Vincent's University and Private Hospitals, Dublin
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - S Gibson
- Crosshouse Hospital, Ayrshire and Arran
| | | | - D G Vass
- Crosshouse Hospital, Ayrshire and Arran
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - H C C Lim
- Glangwili General and Prince Philip Hospital
| | - D Duke
- Glangwili General and Prince Philip Hospital
| | - T Ahmed
- Glangwili General and Prince Philip Hospital
| | - W D Beasley
- Glangwili General and Prince Philip Hospital
| | | | - G Maharaj
- Glangwili General and Prince Philip Hospital
| | - C Malcolm
- Glangwili General and Prince Philip Hospital
| | | | | | | | - R Radwan
- Morriston and Singleton Hospitals
| | | | - S Wood
- Princess of Wales Hospital
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Tatler AL, Barnes J, Habgood A, Goodwin A, McAnulty R, Jenkins RG. S66 Caffeine Inhibits TGFβ Activation by Epithelial Cells, Interrupts Fibroblast Responses to TGFβ, and Reduces Pulmonary Fibrosis in Ex VivoPrecision-cut Lung Slices. Thorax 2015. [DOI: 10.1136/thoraxjnl-2015-207770.72] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Abstract
AstraZeneca ran a bespoke study to generate age-matched clinical pathology and histopathology data from a cohort of Beagle dogs aged between 25 and 37 months to support the use of these older animals in routine preclinical toxicology studies. As the upper age range of Beagle dogs routinely used in toxicology studies does not normally exceed 24 months, there is an absence of appropriate age-matched historical control data. The generation of such data was crucial to understand whether age-related differences in spontaneous findings might confound the interpretation of toxicology study data. While the majority of the histopathology findings in all the older dogs occurred at a similar prevalence as those expected in young adult dogs (<24 months), a number of differences were observed in the thymus (involution), bone marrow (increased adiposity), testes (degenerative changes), and lung (fibrosis, pigment and alveolar hyperplasia) that could be misinterpreted as a test article effect. Minor differences in some clinical pathology values (hemoglobin, alkaline phosphatase, absolute reticulocytes) were of a small magnitude and considered unlikely to affect the interpretation of study data.
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Affiliation(s)
- J. Barnes
- Drug Safety and Metabolism, AstraZeneca, Macclesfield, UK
| | - P. Cotton
- Drug Safety and Metabolism, AstraZeneca, Macclesfield, UK
| | - S. Robinson
- Drug Safety and Metabolism, AstraZeneca, Macclesfield, UK
| | - M. Jacobsen
- Drug Safety and Metabolism, AstraZeneca, Macclesfield, UK
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Moir JAG, Burns J, Barnes J, Colgan F, White SA, Littler P, Manas DM, French JJ. Selective internal radiation therapy for liver malignancies. Br J Surg 2015; 102:1533-40. [PMID: 26364826 DOI: 10.1002/bjs.9924] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2014] [Revised: 07/06/2015] [Accepted: 07/24/2015] [Indexed: 01/11/2023]
Abstract
BACKGROUND Selective internal radiation therapy (SIRT) is a non-ablative technique for the treatment of liver primaries and metastases, with the intention of reducing tumour bulk. This study aimed to determine optimal patient selection, and elucidate its role as a downsizing modality. METHODS Data were collected retrospectively on patients who underwent SIRT between 2011 and 2014. The procedure was performed percutaneously by an expert radiologist. Response was analysed in two categories, based on radiological (CT/MRI according to Response Evaluation Criteria In Solid Tumours (RECIST)) and biological (α-fetoprotein, carcinoembryonic antigen, carbohydrate antigen 19-9, chromogranin A) parameters. RESULTS Forty-four patients were included. Liver metastases from colorectal cancer (22 patients) and hepatocellular carcinoma (HCC) (9) were the most common pathologies. Radiological response data were collected from 31 patients. A reduction in sum of diameters (SOD) was observed in patients with HCC (median -24.1 (95 per cent c.i. -43.4 to -3.8) per cent) and neuroendocrine tumours (-30.0 (-45.6 to -7.7) per cent), whereas a slight increase in SOD was seen in patients with colorectal cancer (4.9 (-10.6 to 55.3) per cent). Biological response was assessed in 17 patients, with a reduction in 12, a mixed response in two and no improvement in three. Six- and 12-month overall survival rates were 71 and 41 per cent respectively. There was no difference in overall survival between the RECIST response groups (median survival 375, 290 and 214 days for patients with a partial response, stable disease and progressive disease respectively; P = 0.130), or according to primary pathology (P = 0.063). Seven patients underwent liver resection with variable responses after SIRT. CONCLUSION SIRT may be used to downsize tumours and may be used as a bridge to surgery in patients with tumours deemed borderline for resection.
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Affiliation(s)
- J A G Moir
- Departments of Hepatopancreatobiliary and Transplant Surgery, Freeman Hospital, Newcastle upon Tyne, UK
| | - J Burns
- Departments of Hepatopancreatobiliary and Transplant Surgery, Freeman Hospital, Newcastle upon Tyne, UK
| | - J Barnes
- Departments of Hepatopancreatobiliary and Transplant Surgery, Freeman Hospital, Newcastle upon Tyne, UK
| | - F Colgan
- Departments of Interventional Radiology, Freeman Hospital, Newcastle upon Tyne, UK
| | - S A White
- Departments of Hepatopancreatobiliary and Transplant Surgery, Freeman Hospital, Newcastle upon Tyne, UK
| | - P Littler
- Departments of Interventional Radiology, Freeman Hospital, Newcastle upon Tyne, UK
| | - D M Manas
- Departments of Hepatopancreatobiliary and Transplant Surgery, Freeman Hospital, Newcastle upon Tyne, UK
| | - J J French
- Departments of Hepatopancreatobiliary and Transplant Surgery, Freeman Hospital, Newcastle upon Tyne, UK
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Affiliation(s)
- I Eshun-Wilson
- Division of Infectious Diseases, Department of Medicine, Tygerberg Academic Hospital, University of Stellenbosch, South Africa
| | - M.D. Zeier
- Division of Infectious Diseases, Department of Medicine, Tygerberg Academic Hospital, University of Stellenbosch, South Africa
| | - J Barnes
- Department of Community Health, Faculty of Health Sciences, University of Stellenbosch, South Africa
| | - J.J. Taljaard
- Division of Infectious Diseases, Department of Medicine, Tygerberg Academic Hospital, University of Stellenbosch, South Africa
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Abstract
We present a case of necrotising pancreatitis following ampullary biopsy in a patient with Barrett's oesophagus. The patient needed multiple necrosectomies and several admissions to the intensive care unit. This report is only the third and most severe case of pancreatitis following ampullary biopsy, highlighting its importance as a complication.
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Affiliation(s)
- D Skelton
- Newcastle upon Tyne Hospitals NHS Foundation Trust, UK
| | - J Barnes
- Newcastle upon Tyne Hospitals NHS Foundation Trust, UK
| | - J French
- Newcastle upon Tyne Hospitals NHS Foundation Trust, UK
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Hurst S, Barnes J, Rhodes E. PD27-01 ADVANCING CARE FOR OVERACTIVE BLADDER: A TAILORED LEARNING APPROACH TO IMPROVE CLINICAL DECISION-MAKING. J Urol 2015. [DOI: 10.1016/j.juro.2015.02.445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Glauser TA, Barnes J, Nevins H, Cerenzia W. The Educational Needs of Clinicians Regarding Anticoagulation Therapy for Prevention of Thromboembolism and Stroke in Patients With Atrial Fibrillation. Am J Med Qual 2014; 31:38-46. [DOI: 10.1177/1062860614547363] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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