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Marks E, Doyle K, Magennis B, O'Connell M, McGreevy C. 131 USE OF FDG-PET BRAIN IMAGING IN THE DIAGNOSIS AND MANAGEMENT OF DEMENTIA IN A UNIVERSITY HOSPITAL. Age Ageing 2022. [DOI: 10.1093/ageing/afac218.110] [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: 11/13/2022] Open
Abstract
Abstract
Background
Neuroimaging is an increasingly important tool dementia work-up. Subtype diagnosis helps predict the course of the disease, aiding prognostication and management. Amyloid-beta peptide is intrinsic to the pathogenesis of Alzheimer’s disease (AD), forming characteristic neuritic plaques which can be imaged in vivo on positron emission tomography (PET) scans. NICE recommendations advise use of PET imaging if dementia sub-type diagnosis is unclear and AD is suspected. We sought to establish the referral patterns for FDG-PET brain scans for patients aged 60 and over in a university hospital and to establish whether this imaging modality contributed to a change in diagnosis or treatment.
Methods
Requests for FDG-PET CT brain from 2019 – 2022 were retrospectively reviewed. Information was obtained from clinical notes and patient information software. Patient demographics, indication for scan, source of referral and whether imaging results led to a change in diagnosis or treatment was recorded.
Results
A total of 32 patients were reviewed, with a mean age of 65 years (13 females; 41%). We further analysed the 25 who were aged over 60; this subgroup had a mean age of 70 (9 females; 36%). All 25 patients were appropriately referred to assess for dementia subtype. A revision in diagnosis based on PET imaging was made in 17 (68%) cases. In 9 (30%) cases, results prompted change in dementia-specific pharmacological treatment, including donepezil and memantine. A further 6 (24%) had pharmacological treatment for non-cognitive symptoms of dementia adjusted, such as anti-depressants or anti-psychotics. The majority of referrals had come from neurologists (n = 15; 60%) rather than geriatricians (n = 10; 40%). The final diagnosis was AD in 12 cases (48%) and fronto-temporal dementia in 3 cases (12%).
Conclusion
PET scans are a useful functional imaging modality which can help to differentiate dementia subtypes and influence management.
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Affiliation(s)
- E Marks
- Mater Misericordiae University Hospital , Dublin, Ireland
| | - K Doyle
- Mater Misericordiae University Hospital , Dublin, Ireland
| | - B Magennis
- Mater Misericordiae University Hospital , Dublin, Ireland
| | - M O'Connell
- Mater Misericordiae University Hospital , Dublin, Ireland
| | - C McGreevy
- Mater Misericordiae University Hospital , Dublin, Ireland
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2
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Shah A, Farah N, McNamee E, Lindow SW, O'Connell M. Demographic changes in primiparae of Irish ethnicity between 2000 and 2020. Eur J Obstet Gynecol Reprod Biol 2022; 278:137-140. [PMID: 36174435 DOI: 10.1016/j.ejogrb.2022.09.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 09/05/2022] [Accepted: 09/12/2022] [Indexed: 11/04/2022]
Abstract
BACKGROUND Trends in maternal demographic changes linked to lifestyle and socio-economic conditions reflect greatly on maternal, perinatal and infant mortality rates. Hospital data reflect a heterogenous population where specific demographic changes may not be obvious. OBJECTIVES To report yearly demographic changes in Irish primiparae from 2000 to 2020, specifically looking at age, BMI, smoking and marital status of patients attending the Coombe Women and Infant's University Hospital (CWIUH). METHODS Retrospective report of demographic details contemporaneously documented on the CWIUH data base. FINDINGS In the years 2000 to 2020 inclusive there were 47,659 primiparous women of Irish ethnicity delivered at the CWIUH (70.2% of the total primiparae), of those 99.3% were Caucasian. There was a significant rise in mean age at first delivery in Irish mothers; 26.0 years old in the 2000 to 30.9 years old in 2020 associated with a rise in mean BMI of 9.1%. Smoking rates (ever smoked) showed a significant reduction from 53.9% in 2000 to 39.3% in 2020. There was a significant decrease in rates of marriage, with 61.9% married in 2000 compared to 46.3% in 2020. Birth weight and prematurity rates remained unchanged, with fall in mean gestational age at first delivery from 279.3 days in 2000 to 275.8 days in 2020. CONCLUSION This study highlights that Irish primiparae are older, heavier, less likely to smoke and to be married than they were 20 years ago. These trends are an interesting glimpse into changing economic and cultural climate over just the past 2 decades.
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Affiliation(s)
- A Shah
- The Coombe Women and Infants' University Hospital, Cork Street, Dublin, Ireland.
| | - N Farah
- The Coombe Women and Infants' University Hospital, Cork Street, Dublin, Ireland
| | - E McNamee
- The Coombe Women and Infants' University Hospital, Cork Street, Dublin, Ireland
| | - S W Lindow
- The Coombe Women and Infants' University Hospital, Cork Street, Dublin, Ireland
| | - M O'Connell
- The Coombe Women and Infants' University Hospital, Cork Street, Dublin, Ireland
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3
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O'Connor C, Gallagher C, Hollywood A, Paul L, O'Connell M. Anakinra for recalcitrant pyoderma gangrenosum. Clin Exp Dermatol 2021; 46:1558-1560. [PMID: 34137070 DOI: 10.1111/ced.14809] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/15/2021] [Indexed: 11/30/2022]
Abstract
Pyoderma gangrenosum (PG) is an autoinflammatory neutrophilic dermatosis characterized by rapidly enlarging, painful ulcers. Anakinra is a recombinant interleukin (IL)-1 receptor antagonist that blocks the activity of IL-1α and IL-1β by competitively inhibiting IL-1 binding to the IL-1 type 1 receptor. We present a series of two patients with recalcitrant PG, who had limited therapeutic options and multiple comorbidities and multiple previous treatment failures, who obtained 100% healing with anakinra. Compared with conventional first-line therapies for PG, the safety profile of anakinra may be preferable for patients with multiple comorbidities. Further research is needed to assess the safety and efficacy of anakinra for PG.
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Affiliation(s)
- C O'Connor
- Department of Dermatology, University Hospital Waterford, Waterford, Ireland.,Department of Medicine, University College Cork, Cork, Ireland
| | - C Gallagher
- Department of Dermatology, University Hospital Waterford, Waterford, Ireland
| | - A Hollywood
- Department of Dermatology, University Hospital Waterford, Waterford, Ireland
| | - L Paul
- Department of Dermatology, University Hospital Waterford, Waterford, Ireland
| | - M O'Connell
- Department of Dermatology, University Hospital Waterford, Waterford, Ireland
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4
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O'Connor C, Gallagher C, O'Connell M, Bourke J, Murphy M, Bennett M. Bare necessities? The utility of full skin examination in the COVID-19 era. Clin Exp Dermatol 2021; 46:720-722. [PMID: 33639003 PMCID: PMC8013915 DOI: 10.1111/ced.14620] [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] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Revised: 01/18/2021] [Accepted: 02/22/2021] [Indexed: 12/24/2022]
Abstract
Full skin examination (FSE) may improve the detection of malignant melanoma (MM). The objective of this study was to assess the safety of targeted lesion examination (TLE) compared with FSE in our Pigmented Lesion Clinic (PLC). Patients attending the PLC were randomized in a 2 : 1 ratio to FSE (intervention) or TLE (standard care). Demographic details and risk factors were documented, and the time taken to perform FSE and TLE was noted. Of 763 participants, 520 were assigned to FSE and 243 were assigned to TLE. On average, FSE took 4.02 min and TLE took 30 s to perform. Of the 520 participants assigned to FSE, 37 (7.1%) had incidental findings, of whom 12 patients (2.3%) had additional lesions biopsied. No additional melanomas were detected that would have been missed by use of the standard protocol. This study suggests that in low-risk patients referred to a PLC with a lesion of concern, the possibility of missing incidental cutaneous malignancies using lesion-directed examination is low.
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Affiliation(s)
- C O'Connor
- Department of Dermatology, South Infirmary Victoria University Hospital, Cork, Ireland.,Department of Medicine, University College Cork, Cork, Ireland
| | - C Gallagher
- Department of Dermatology, South Infirmary Victoria University Hospital, Cork, Ireland
| | - M O'Connell
- Department of Dermatology, South Infirmary Victoria University Hospital, Cork, Ireland
| | - J Bourke
- Department of Dermatology, South Infirmary Victoria University Hospital, Cork, Ireland.,Department of Medicine, University College Cork, Cork, Ireland
| | - M Murphy
- Department of Dermatology, South Infirmary Victoria University Hospital, Cork, Ireland.,Department of Medicine, University College Cork, Cork, Ireland
| | - M Bennett
- Department of Dermatology, South Infirmary Victoria University Hospital, Cork, Ireland
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Jomeen J, Martin CR, Jones C, Marshall C, Ayers S, Burt K, Frodsham L, Horsch A, Midwinter D, O'Connell M, Shakespeare J, Sheen K, Thomson G. Tokophobia and fear of birth: a workshop consensus statement on current issues and recommendations for future research. J Reprod Infant Psychol 2020; 39:2-15. [PMID: 33206580 DOI: 10.1080/02646838.2020.1843908] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Objective: To discuss and develop a statement on the current state of the evidence and opinion in Fear of Childbirth (FoC) and Tokophobia (Tocophobia), and to provide recommendations. Background: A group met in 2019 to discuss the state of clinical and academic knowledge relating to FoC/Tokophobia. Five key areas were agreed as the focus of the meeting. Methods: 12 internationally acknowledged experts, in this or a closely related area (e.g. PTSD) met to discuss their understanding of the evidence for FoC/ Tokophobia and current practice. The consensus described in this paper constitutes the expression of the general opinion of the participants and does not necessarily imply unanimity. Keys points: Work focussed on tokophobia is recent and there remains a wide range of issues, which were addressed in the workshop including complexity in defining prevalence, a theoretical lack of understanding, which creates challenge for robust assessment and the identification of risk factors. An improved aetiological and developmental understanding of the tokophobia is required to underpin appropriate, effective and evidence-based interventions. Evaluation of pathways of care and relevant interventions, should be a focus of future research. Conclusion: Significant gaps remain within the FoC/tokophobia knowledge base. Further research is necessary.
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Affiliation(s)
- J Jomeen
- School of Health & Human Sciences, Southern Cross University , Bilinga, Australia.,Institute for Clinical and Applied Health Research (ICAHR), University of Hull , Hull, UK
| | - C R Martin
- School of Health & Human Sciences, Southern Cross University , Bilinga, Australia.,Institute for Clinical and Applied Health Research (ICAHR), University of Hull , Hull, UK.,School of Nursing and Allied Health, Buckinghamshire New University , High Wycombe, UK
| | - C Jones
- Institute for Clinical and Applied Health Research (ICAHR), University of Hull , Hull, UK
| | - C Marshall
- Perinatal Mental Health Team, Humber Teaching NHS Foundation Trust , Hull, UK
| | - S Ayers
- Centre for Maternal and Child Health Research, School of Health Sciences, City, University of London , London, UK
| | - K Burt
- Expert by Experience , UK
| | - L Frodsham
- Obstetric Medicine, Guy's and St Thomas' NHS Foundation Trust , London, UK
| | - A Horsch
- Institute of Higher Education and Research in Healthcare (IUFRS), University of Lausanne , Lausanne, Switzerland.,Department Woman-Mother-Child, University Hospital , Lausanne, Switzerland
| | - D Midwinter
- Maternity and Midwifery Services, North Lincolnshire and Goole NHS Foundation Trust , Scunthorpe, UK
| | - M O'Connell
- School of Nursing and Midwifery, Royal College of Surgeons Ireland in Bahrain , Adliya, Bahrain
| | | | - K Sheen
- School of Psychology, Faculty of Health, Liverpool John Moores University , Liverpool, UK
| | - G Thomson
- Maternal and Infant Nutrition & Nurture Unit, School of Community Health & Midwifery, University of Central Lancashire , Lancashire, UK.,School of Education, Health and Social Studies, Dalarna University , Falun, Sweden
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Spergel J, Blaiss M, Lio P, Kessel A, Takiya L, Werth J, O'Connell M, Zang C, Cork M. P500 EFFICACY OF CRISABOROLE IN PATIENTS WITH MILD-TO-MODERATE ATOPIC DERMATITIS WITH AND WITHOUT COMORBID ALLERGIC RHINITIS. Ann Allergy Asthma Immunol 2020. [DOI: 10.1016/j.anai.2020.08.158] [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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7
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McKiernan K, Jimenez H, McEachern M, Hubbard J, O'Connell M. Abstract P5-07-16: Role of collagen X in enhancing the metastatic potential of breast cancer cells using a MDA-MB-231 cell line model. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p5-07-16] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Breast cancer is the second highest cause of cancer related deaths for women in developed countries. Breast cancer patients with distant metastasis at the time of diagnosis have an estimated 5-year relative survival rate of 26% as compared to a 99% survival rate of patients who have localized tumors. Evidence suggests that collagens play a role in enhancing the metastatic capability of breast cancer cells. Short chain collagen, collagen X, is encoded by the collagen type x alpha 1 chain (COL10A1) gene and is normally expressed exclusively by hypertrophic chondrocytes during endochondral ossification. Recently, COL10A1 gene expression has been found to be overexpressed in various tumor types, including breast tumors. It is hypothesized that an increase in COL10A1 expression may play a role in breast cancer metastasis. The goal of our project was to evaluate the role of collagen X in breast cancer metastasis using the MDA-MB-231 breast cancer cell line. Stable cell lines were generated to express either GFP only (MDA-VEC) or GFP tagged COL10A1 (MDA-COL). GFP and COL10A1 transcript and protein levels were examined to confirm overexpression of collagen X and transwell assays were used to determine changes in the invasive capability of the cells. Cells overexpressing collagen X demonstrated a higher rate of invasion suggesting that collagen X may play a role in enhancing the metastatic potential of breast cancer cells. Understanding the role collagen X plays in breast cancer metastasis may provide a mechanism for developing diagnostic and prognostic strategies for identifying patients whose breast cancer is more prone to metastasize.
Citation Format: McKiernan K, Jimenez H, McEachern M, Hubbard J, O'Connell M. Role of collagen X in enhancing the metastatic potential of breast cancer cells using a MDA-MB-231 cell line model [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P5-07-16.
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8
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McCarthy S, Paul L, O'Connell M. Skin Cancer Awareness Amongst Irish Golfers. Ir Med J 2017; 110:620. [PMID: 29169002] [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: 06/07/2023]
Abstract
Aim The aim of this study was to assess skin cancer awareness and identify the UV protective measures used by golfers within the Munster region of Ireland. Methods Subjects were recruited from throughout the Munster region at a regional competition, and at three other local golf clubs and "pro" shops. Participants filled out a short anonymous validated questionnaire when collecting their score cards7. Results One hundred and sixty-three golfers completed the questionnaire with a mean age of 65.6 years. 137 (84%) were male and 26 (16%) were female. We noted a high incidence of both non-melanoma and melanoma skin cancer in our subjects. Sixteen (9.8%) had a previous history of skin cancer, with 8 melanomas and 8 non-melanoma skin cancers. A high percentage, 85%, of the golfers surveyed were compliant with SPF use. However many were using too low a SPF, 63 (44%) were using a SPF less than 30. Knowledge of risk of skin cancer is better amongst the golfers surveyed when compared to the general population. Most respondents (N = 96 (59%)) were aware that melanoma can lead to death if left untreated and 114 (70%) recognized that melanoma can be cured if treated early. Conclusion Golfers may benefit from targeted education emphasizing the importance of higher SPF use. Other interventions that may benefit this population would include availability of sunscreens and educational literature in 'pro' shops at golf courses.
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Affiliation(s)
- S McCarthy
- Department of Dermatology, South Infirmary Victoria University Hospital, Cork, Ireland
| | - L Paul
- Department of Dermatology, South Infirmary Victoria University Hospital, Cork, Ireland
| | - M O'Connell
- Department of Dermatology, South Infirmary Victoria University Hospital, Cork, Ireland
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9
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Lonergan PE, Nic An Riogh A, O'Kelly F, Lundon DJ, O'Sullivan D, O'Connell M, Hegarty PK. Dynamic sentinel node biopsy for penile cancer: an initial experience in an Irish Hospital. Ir J Med Sci 2017; 186:841-845. [PMID: 28102480 DOI: 10.1007/s11845-017-1558-3] [Citation(s) in RCA: 2] [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: 11/04/2016] [Accepted: 01/11/2017] [Indexed: 11/30/2022]
Abstract
BACKGROUND The presence of nodal metastases is the single most important prognostic factor in penile cancer. However, reliable assessment of nodal status in clinically node-negative (cN0) patients poses a challenge. Approximately 20% of these patients harbour occult nodal metastases. Currently available non-invasive radiological investigations are unreliable in excluding micrometastatic disease. AIM Dynamic sentinel node biopsy (DSNB) is a minimally invasive procedure for assessing lymph node involvement. We report our initial experience with DSNB in assessing the status of regional lymph nodes in cN0 penile cancer patients. METHODS DSNB was performed in penile cancer patients with at least one cN0 groin. All patients undergoing DSNB at our institution were included. Lymphoscintigraphic images were obtained from all patients, after intradermal, peritumoral injection of a Technetium-99m nanocolloid. The sentinel nodes were defined as the nodes identified on lymphoscintigraphy, which were also radioactive intraoperatively using a gamma probe. RESULTS In total, 18 groins from 11 patients underwent DSNB. Of these, 11 patients underwent bilateral DSNB and 4 had unilateral DSNB. The mean (range) age of patients at the time of presentation of their primary tumour was 63 (39-78) years. A mean of 1.2 nodes per groin was retrieved. One lymph node was positive in one patient, who subsequently underwent a bilateral inguinal lymph node dissection. Overall, the median (range) follow-up was 12.8 (2.7-31.3) months with no local or regional recurrences. CONCLUSION Further cases and longer follow-up will define the accuracy of this technique in the Irish population.
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Affiliation(s)
- P E Lonergan
- Department of Urology, Mater Misericordiae University Hospital, Eccles Street, Dublin 7, Ireland.
| | - A Nic An Riogh
- Department of Urology, Mater Misericordiae University Hospital, Eccles Street, Dublin 7, Ireland
| | - F O'Kelly
- Department of Urology, Mater Misericordiae University Hospital, Eccles Street, Dublin 7, Ireland
| | - D J Lundon
- Department of Urology, Mater Misericordiae University Hospital, Eccles Street, Dublin 7, Ireland
| | - D O'Sullivan
- Department of Radiology, Mater Misericordiae University Hospital, Dublin, Ireland
| | - M O'Connell
- Department of Radiology, Mater Misericordiae University Hospital, Dublin, Ireland
| | - P K Hegarty
- Department of Urology, Mater Misericordiae University Hospital, Eccles Street, Dublin 7, Ireland.,Mater Private Hospital, Dublin, Ireland.,Mater Private Hospital, Cork, Ireland
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Dupan S, O'Connell M, Kenny RA, Finucane C. 41BAROREFLEX SENSITIVITY AND ARTERIAL STIFFNESS INFLUENCE ORTHOSTATIC BLOOD PRESSURE RESPONSES IN OLDER ADULTS: INSIGHTS FROM THE IRISH LONGITUDINAL STUDY ON AGEING. Age Ageing 2016. [DOI: 10.1093/ageing/afw026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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11
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O'Connell M, Wonodi C. Routine immunization consultants (RICON) review in Nigeria: A country
driven management approach for health systems strengthening in routine
immunization. Ann Glob Health 2015. [DOI: 10.1016/j.aogh.2015.02.920] [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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12
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Anglim B, Maher N, Cunningham O, Mulcahy D, Harbison J, O'Connell M. A rare case of cryptogenic stroke with an incidental finding of patent foramen ovale. Ir Med J 2015; 108:92. [PMID: 25876305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
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13
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Essex MN, O'Connell M, Bhadra Brown P. Response to nonsteroidal anti-inflammatory drugs in African Americans with osteoarthritis of the knee. J Int Med Res 2013; 40:2251-66. [PMID: 23321182 DOI: 10.1177/030006051204000623] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
OBJECTIVE This 6-week, randomized, double-blind, parallel-group study compared the analgesic efficacy, tolerability and safety of celecoxib, naproxen and placebo in African Americans with osteoarthritis (OA) of the knee. METHODS A total of 322 patients aged ≥ 45 years with OA of the knee in a flare state received 200 mg celecoxib orally once daily, 500 mg naproxen orally twice daily or placebo for 6 weeks. The primary endpoint was change from baseline in the Patient's Assessment of Arthritis Pain. RESULTS Celecoxib was as effective as naproxen in reducing OA pain. Similar efficacy was observed in many of the secondary outcome measures. Celecoxib was well tolerated and demonstrated favorable upper gastro-intestinal tolerability. Improvements in outcome measures were numerically greater in the active treatment groups compared with the placebo group, but did not reach statistical significance. CONCLUSIONS Celecoxib was as effective as naproxen in relieving OA pain in African Americans and was well tolerated. Few significant differences were observed between active treatments and placebo, possibly because of a strong placebo effect.
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Affiliation(s)
- M N Essex
- US Medical Affairs, Pfizer Inc., New York, NY 10017, USA.
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14
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Greiner H, Schaller-Ammann R, Huber A, O'Connell M, Krejci J, Porro G, Korsatko S, Gurban J, Deller S, Brunner M, Berghofer A, Priedl J, Zijlstra E, Heise T, Pieber TR, Schaupp L. Continuous Blood Glucose Monitoring (Cgm) System Based on Intravenous Microdialysis and Glucose Sensing. BIOMED ENG-BIOMED TE 2013; 58 Suppl 1:/j/bmte.2013.58.issue-s1-I/bmt-2013-4224/bmt-2013-4224.xml. [PMID: 24042873 DOI: 10.1515/bmt-2013-4224] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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15
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Eastin T, O'Connell M, Gorgas D, Schwaab J. 33 A Novel Approach to the Asynchronous Learning Curriculum. Ann Emerg Med 2012. [DOI: 10.1016/j.annemergmed.2012.07.056] [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: 10/27/2022]
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16
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Cheung WY, Shi Q, O'Connell M, Cassidy J, Blanke CD, Kerr DJ, Van Cutsem E, Alberts SR, Yothers GA, Sargent DJ. Predictive and prognostic value of gender in early-stage colon cancer: A pooled analysis of 33,345 patients from the ACCENT database. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.3619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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17
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Martyn F, Phelan O, O'Connell M. Hepatitis C: is there a case for universal screening in pregnancy? Ir Med J 2011; 104:144-146. [PMID: 21736090] [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: 05/31/2023]
Abstract
Hepatitis C (HCV) is not routinely screened for antenatally in all maternity hospitals. Most hospitals adopt a policy of targeted screening. The policy in the Coombe Women and Infants University Hospital in Dublin changed from targeted screening in 2006 to universal screening in 2007. We audited the two consecutive years. The prevalence of HCV in our antenatal population was 1.4% for 2006 (67/4666) when targeted screening applied and in 2007--0.71% (66/9222) when universal screening came into affect. One woman in 2007 would not have been detected by targeted screening--1.49% (1/67). Fifty five percent (37/67) of women were HCV-RNA positive in 2006 and 57.5% (38/66) were positive in 2007. We conclude that there were similar detection rates for HCV in 2006 and 2007 and that universal screening is not required if inclusive criteria for selective screening are employed but is of use in research context.
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Affiliation(s)
- F Martyn
- Department of Obstetrics & Gynaecology, Coombe Women & Infant's University Hospital, Dolphin's Barn, Dublin 8.
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18
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Clifford A, O'Connell M, Gabriel S, Miller LE, Block JE. The KineSpring load absorber implant: rationale, design and biomechanical characterization. J Med Eng Technol 2011; 35:65-71. [PMID: 21142591 DOI: 10.3109/03091902.2010.535592] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Osteoarthritis (OA) of the knee is the leading cause of disability in the adult population. Although a number of treatments for knee OA are available, none effectively prevent OA progression. Currently, a wide therapeutic gap exists for patients who have unsuccessfully exhausted conservative OA treatments but who are hesitant or ineligible to undergo invasive surgery. The KineSpring device is a novel, joint preserving, minimally invasive implant that reduces medial compartment loading without significantly impacting the loading of the lateral compartment. This article describes the rationale for and the design of the KineSpring device and summarizes results of initial biomechanical testing in an OA cadaver model.
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Affiliation(s)
- A Clifford
- Moximed, Inc., 26460 Corporate Avenue, Hayward, CA 94545, USA
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Burton F, Alkaade S, Collins D, Muddana V, Slivka A, Brand RE, Gelrud A, Banks PA, Sherman S, Anderson MA, Romagnuolo J, Lawrence C, Baillie J, Gardner TB, Lewis MD, Amann ST, Lieb JG, O'Connell M, Kennard ED, Yadav D, Whitcomb DC, Forsmark CE. Use and perceived effectiveness of non-analgesic medical therapies for chronic pancreatitis in the United States. Aliment Pharmacol Ther 2011; 33:149-59. [PMID: 21083584 PMCID: PMC3142582 DOI: 10.1111/j.1365-2036.2010.04491.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND Effectiveness of medical therapies in chronic pancreatitis has been described in small studies of selected patients. AIM To describe frequency and perceived effectiveness of non-analgesic medical therapies in chronic pancreatitis patients evaluated at US referral centres. METHODS Using data on 516 chronic pancreatitis patients enrolled prospectively in the NAPS2 Study, we evaluated how often medical therapies [pancreatic enzyme replacement therapy (PERT), vitamins/antioxidants (AO), octreotide, coeliac plexus block (CPB)] were utilized and considered useful by physicians. RESULTS Oral PERT was commonly used (70%), more frequently in the presence of exocrine insufficiency (EI) (88% vs. 61%, P < 0.001) and pain (74% vs. 59%, P < 0.002). On multivariable analyses, predictors of PERT usage were EI (OR 5.14, 95% CI 2.87-9.18), constant (OR 3.42, 95% CI 1.93-6.04) or intermittent pain (OR 1.98, 95% CI 1.14-3.45). Efficacy of PERT was predicted only by EI (OR 2.16, 95% CI 1.36-3.42). AO were tried less often (14%) and were more effective in idiopathic and obstructive vs. alcoholic chronic pancreatitis (25% vs. 4%, P = 0.03). Other therapies were infrequently used (CPB - 5%, octreotide - 7%) with efficacy generally <50%. CONCLUSIONS Pancreatic enzyme replacement therapy is commonly utilized, but is considered useful in only subsets of chronic pancreatitis patients. Other medical therapies are used infrequently and have limited efficacy.
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Affiliation(s)
- F. Burton
- Division of Gastroenterology, Hepatology and Nutrition, St. Louis University, St. Louis, MO
| | - S. Alkaade
- Division of Gastroenterology, Hepatology and Nutrition, St. Louis University, St. Louis, MO
| | - D. Collins
- Division of Gastroenterology and Hepatology, Department of Medicine, University of Florida, Gainesville, FL
| | - V. Muddana
- Division of Gastroenterology, Hepatology and Nutrition, Department of Medicine, University of Pittsburgh, Pittsburgh, PA
| | - A. Slivka
- Division of Gastroenterology, Hepatology and Nutrition, Department of Medicine, University of Pittsburgh, Pittsburgh, PA
| | - R. E. Brand
- Division of Gastroenterology, Hepatology and Nutrition, Department of Medicine, University of Pittsburgh, Pittsburgh, PA
| | - A. Gelrud
- Division of Gastroenterology, Hepatology and Nutrition, Department of Medicine, University of Pittsburgh, Pittsburgh, PA
| | - P. A. Banks
- Division of Gastroenterology, Brigham and Women's Hospital, Boston, MA
| | - S. Sherman
- Division of Gastroenterology, Hepatology and Nutrition, Department of Medicine, Indiana University Medical Center, Indianapolis, IN
| | - M. A. Anderson
- Division of Gastroenterology, Hepatology and Nutrition, Department of Medicine University of Michigan, Ann Arbor, MI
| | - J. Romagnuolo
- Digestive Disease Center, Medical University of South Carolina, Charleston, SC
| | - C. Lawrence
- Digestive Disease Center, Medical University of South Carolina, Charleston, SC
| | - J. Baillie
- Department of Medicine, Duke University Medical Center, Durham, NC
| | | | - M. D. Lewis
- Division of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, FL
| | - S. T. Amann
- North Mississippi Medical Center, Tupelo, MS
| | - J. G. Lieb
- University of Pennsylvania School of Medicine, Philadelphia, PA
| | - M. O'Connell
- Division of Gastroenterology, Hepatology and Nutrition, Department of Medicine, University of Pittsburgh, Pittsburgh, PA
| | - E. D. Kennard
- Epidemiology Data Center, University of Pittsburgh, Pittsburgh, PA
| | - D. Yadav
- Division of Gastroenterology, Hepatology and Nutrition, Department of Medicine, University of Pittsburgh, Pittsburgh, PA
| | - D. C. Whitcomb
- Division of Gastroenterology, Hepatology and Nutrition, Department of Medicine, University of Pittsburgh, Pittsburgh, PA
| | - C. E. Forsmark
- Division of Gastroenterology and Hepatology, Department of Medicine, University of Florida, Gainesville, FL
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Khan R, Burgoyne L, O'Connell M, Dempsey EM. Antenatal management of the expectant mother and extreme preterm infant at the limits of viability. Ir Med J 2010; 103:266-269. [PMID: 21186749] [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: 05/30/2023]
Abstract
We explored the opinions of healthcare providers on the antenatal management and outcome of preterm delivery at less than 28 weeks gestation. An anonymous postal questionnaire was sent to health care providers. The response rate was 55% (74% Obstetrician, 70% neonatologist). Twenty four weeks is the limit at which most would advocate intervention. At 23 weeks 67% of neonatologists advocate antenatal steroids. 50% of all health care providers advocate cardiotocographic monitoring at 24 weeks gestation. Written information on survival and long-term outcome is provided by 8% of the respondents. Neonatologists (50%) were more likely than obstetrician (40%) to advocate caesarean section at 25 weeks. We conclude that 24 weeks is the limit at which most would advocate intervention. Significant variation exists both between and within each health care group at less than 25 weeks. Establishment and provision of national outcome data may aid decision making at the limits of viability.
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Affiliation(s)
- R Khan
- Neonatal Intensive Care Unit, Cork University Maternity Hospital, Wilton, Cork
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Browne F, O'Connell M, Merchant W, Potts E, Fenn C, Stables G. Spontaneous resolution of a giant keratoacanthoma penetrating through the nose. Clin Exp Dermatol 2010; 36:369-71. [PMID: 21564174 DOI: 10.1111/j.1365-2230.2010.03933.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Although keratoacanthomas are common and spontaneous resolution well recognized, case reports with photographic documentation of resolution are few. The subtype of giant keratoacanthoma (GKA) can give rise to severe cosmetic destruction because of their size and their predilection for cosmetically sensitive areas (nose and eyelids). Spontaneous resolution of GKAs has not been widely reported. We present an impressive series of clinical photographs documenting the spontaneous resolution of a GKS on the nose of a 56-year-old patient.
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Affiliation(s)
- F Browne
- Department of Dermatology, Leeds General Infirmary, Leeds, UK.
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22
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Andre T, Shi Q, Yothers GA, Bot BM, Haller DG, Van Cutsem E, Cassidy J, Benedetti J, O'Connell M, Sargent DJ. Outcomes following adjuvant treatment (AT) for colon cancer (CC) 1978-1995 versus 1996-2007: Impact on recurrence rate, time from recurrence to death (TRD), and overall survival (OS)—Findings from the ACCENT dataset. J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.3616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Joshi A, Calman F, O'Connell M, Jeannon JP, Pracy P, Simo R. Current Trends in the Follow-up of Head and Neck Cancer Patients in the UK. Clin Oncol (R Coll Radiol) 2010; 22:114-8. [DOI: 10.1016/j.clon.2009.11.004] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2008] [Revised: 10/12/2009] [Accepted: 11/05/2009] [Indexed: 10/20/2022]
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Ellenbogen A, Hauser R, Omidvar O, Hsu A, O'Connell M, Kell S, Gupta S. P2.136 Comparative efflcacy and safety of a novel carbidopa–levodopa product (IPX066) and Sinemet in advanced Parkinson's disease. Parkinsonism Relat Disord 2009. [DOI: 10.1016/s1353-8020(09)70487-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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O'Connell M, Kolb G, Schelhaas KP, Schürer J, Tiemann D, Ziogas A, Hessel V. An Investigation into the Transient Behavior of a Microreactor System for Reforming of Diesel Fuel in the kW Range. Chem Eng Technol 2009. [DOI: 10.1002/ceat.200900391] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Katz DL, O'Connell M, Njike VY, Yeh MC, Nawaz H. Strategies for the prevention and control of obesity in the school setting: systematic review and meta-analysis. Int J Obes (Lond) 2009; 32:1780-9. [PMID: 19079319 DOI: 10.1038/ijo.2008.158] [Citation(s) in RCA: 229] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
OBJECTIVE To determine the effectiveness of school-based strategies for obesity prevention and control using methods of systematic review and meta-analysis. METHODS Peer-reviewed studies published between 1966 and October 2004 were considered for review. Studies meeting eligibility criteria were published in English, targeted children aged 3-18 in a school setting, reported weight-related outcomes, included a control measurement and had at least a 6-month follow-up period. Studies employed interventions related to nutrition, physical activity, reduction in television viewing or combinations thereof. Weight related data were analyzed using RevMan software. RESULTS Sixty-four studies were considered for inclusion. Fourteen did not meet inclusion criteria; 29 were excluded due to poor methodological quality. Twenty-one papers describing 19 studies were included in the systematic review and 8 of these were included in the meta-analysis. Nutrition and physical activity interventions resulted in significant reductions in body weight compared with control ((standardized mean difference, SMD=-0.29, 95% confidence interval (CI)=-0.45 to -0.14), random effects model). Parental or family involvement of nutrition and physical activity interventions also induced weight reduction ((SMD=-0.20, 95%CI=-0.41 to 0.00), random effects model). CONCLUSION Combination nutrition and physical activity interventions are effective at achieving weight reduction in school settings. Several promising strategies for addressing obesity in the school setting are suggested, and warrant replication and further testing.
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Affiliation(s)
- D L Katz
- Yale Prevention Research Center, Derby, CT 06418, USA.
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Jeannon JP, Calman F, Gleeson M, McGurk M, Morgan P, O'Connell M, Odell E, Simo R. Management of advanced parotid cancer. A systematic review. Eur J Surg Oncol 2009; 35:908-15. [DOI: 10.1016/j.ejso.2008.10.009] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2008] [Revised: 10/10/2008] [Accepted: 10/17/2008] [Indexed: 10/21/2022] Open
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Gleeson TG, Moriarty J, Shortt CP, Gleeson JP, Fitzpatrick P, Byrne B, McHugh J, O'Connell M, O'Gorman P, Eustace SJ. Accuracy of whole-body low-dose multidetector CT (WBLDCT) versus skeletal survey in the detection of myelomatous lesions, and correlation of disease distribution with whole-body MRI (WBMRI). Skeletal Radiol 2009; 38:225-36. [PMID: 19009290 DOI: 10.1007/s00256-008-0607-4] [Citation(s) in RCA: 132] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2008] [Revised: 10/05/2008] [Accepted: 10/07/2008] [Indexed: 02/02/2023]
Abstract
AIM The aim of the study is to assess the feasibility of whole-body low-dose computed tomography (WBLDCT) in the diagnosis and staging of multiple myeloma and compare to skeletal survey (SS), using bone marrow biopsy and whole-body magnetic resonance imaging (WBMRI; where available) as gold standard. MATERIALS AND METHODS Patients referred over an 18-month period for investigation of suspected multiple myeloma or restaging of myeloma were randomized to undergo one of two WBLDCT protocols using high kVp, low mAs technique (140 kVp, 14 mAs; or 140 kVp, 25 mAs). Recent WBMRI scans were reviewed in 23 cases. Each imaging modality was assessed by two radiologists in consensus and scored from 0-3 (0 = normal, 1 = 1-4 lesions, 2 = 5-20 lesions, 3 >or= 20 lesions/diffuse disease) in ten anatomical areas. Overall stage of disease, image quality score, and the degree of confidence of diagnosis were recorded. Diagnostic accuracy of skeletal survey and WBLDCT were determined using a gold standard of bone marrow biopsy and distribution of disease was compared to WBMRI. RESULTS Thirty-nine patients were evaluated. WBLDCT identified more osteolytic lesions than skeletal survey with a greater degree of diagnostic confidence and led to restaging in 18 instances (16 upstaged, two downstaged). In those with recent WBMRI, distribution of disease on WBLDCT showed superior correlation with WBMRI when compared with SS. Overall reader impression of stage on WBLDCT showed significant correlation with WBMRI (kappa = 0.454, p < 0.05). WBLDCT provided complementary information to WBMRI in nine patients with normal marrow signal following treatment response, but which were shown to have diffuse residual cortical abnormalities on CT. CONCLUSION WBLDCT at effective doses lower than previously reported, is superior to SS at detecting osteolytic lesions and at determining overall stage of multiple myeloma, and provides complementary information to WBMRI.
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Affiliation(s)
- T G Gleeson
- Department of Radiology and Diagnostic Imaging, Mater Misericordiae University Hospital, Eccles St., Dublin 7, Ireland.
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Hassan J, Moran J, Awan A, O'Connell M, Connell J, Dooley S, Hall W. P.020 Presence of high T cell counts and EBV-lytic antigen specific cells in paediatric renal transplant patients with high EBV viral loads: Predictive markers for risk PTLD. J Clin Virol 2009. [DOI: 10.1016/s1386-6532(08)70083-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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31
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Jeannon JP, Abbs I, Calman F, Gleeson M, Lyons A, Hussain K, McGurk M, O'Connell M, Probert D, Ng R, Simo R. Implementing the National Institute of Clinical Excellence improving outcome guidelines for head and neck cancer: developing a business plan with reorganisation of head and neck cancer services. Clin Otolaryngol 2008; 33:149-51. [PMID: 18429872 DOI: 10.1111/j.1749-4486.2008.01637.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
The implementation of the National Institute of Clinical Excellence improving outcome guidelines (NICE-IOG) manual for head and neck cancer may have a huge potential cost implication. Head and neck cancer is a rare disease which utilises large quantities of resources which can only be provided in a tertiary centre. Head and neck cancer services should be centralised into a single site for each cancer network. A new higher tariff rate for complex head and neck cancer cases is needed which recognises the true cost of this work. Each network should set its own tariff to make head and neck cancer care financially viable.
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Duffner F, Fitzsimons A, Brophy G, O'Kiely P, O'Connell M. Dominance ofLactobacillus plantarumstrains in grass silage as demonstrated by a novel competition assay. ACTA ACUST UNITED AC 2008. [DOI: 10.1111/j.1365-2672.1994.tb01656.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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33
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Duffner F, O'Connell M. Comparative evaluation of plasmid profiling and ribotyping in the analysis ofLactobacillus plantarumstrain heterogeneity in silage. ACTA ACUST UNITED AC 2008. [DOI: 10.1111/j.1365-2672.1995.tb01668.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [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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34
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Moniz-Cook E, Vernooij-Dassen M, Woods R, Verhey F, Chattat R, De Vugt M, Mountain G, O'Connell M, Harrison J, Vasse E, Dröes RM, Orrell M. A European consensus on outcome measures for psychosocial intervention research in dementia care. Aging Ment Health 2008; 12:14-29. [PMID: 18297476 DOI: 10.1080/13607860801919850] [Citation(s) in RCA: 264] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Psychosocial intervention makes a vital contribution to dementia care. However, the lack of consensus about which outcome measures to use to evaluate effectiveness prevents meaningful comparisons between different studies and interventions. This study used an iterative collaborative, evidence-based approach to identify the best of currently available outcome measures for European psychosocial intervention research. This included consensus workshops, a web-based pan-European consultation and a systematic literature review and a rigorous evaluation against agreed criteria looking at utility across Europe, feasibility and psychometric properties. For people with dementia the measures covered the domains of quality of life, mood, global function, behaviour and daily living skills. Family carer domains included mood and burden, which incorporated coping with behaviour and quality of life. The only specific staff domain identified was morale, but this included satisfaction and coping with behaviour. In conclusion twenty-two measures across nine domains were recommended in order to improve the comparability of intervention studies in Europe. Areas were identified where improved outcome measures for psychosocial intervention research studies are required.
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Affiliation(s)
- E Moniz-Cook
- Institute of Rehabilitation, University of Hull & Humber Mental Health Teaching NHS Trust, Hull, UK.
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35
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Katz DL, O'Connell M, Njike VY, Yeh MC, Nawaz H. WITHDRAWN: Strategies for the prevention and control of obesity in the school setting: systematic review and meta-analysis. Int J Obes (Lond) 2007:0803684. [PMID: 17667913 DOI: 10.1038/sj.ijo.0803684] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2007] [Revised: 06/01/2007] [Accepted: 06/12/2007] [Indexed: 01/09/2023]
Abstract
The authors hereby retract the e-publication dated July 31, 2007, entitled, 'Strategies for the prevention and control of obesity in the school setting: systematic review and meta-analysis,' and are submitting a revised version with the same title. A secondary review of the manuscript took place following its initial acceptance, resulting in additional statistical analyses along with some pertinent revisions to the accompanying narrative.
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Affiliation(s)
- D L Katz
- [1] 1Yale Prevention Research Center, Derby, CT, USA [2] 2Department of Epidemiology and Public Health, Yale University School of Medicine, New Haven, CT, USA
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Abstract
INTRODUCTION Metastasis of squamous cell carcinoma to the neck with an occult primary is a recognised clinical and pathological entity. Despite well established diagnostic protocols, this condition still represents a management challenge. CASE REPORT We report the case of a 46-year-old man who presented with metastatic cervical lymphadenopathy of unknown origin. He had undergone tonsillectomy as a child. The only abnormal finding was the presence of a tonsillar remnant, which harboured the primary carcinoma. CONCLUSION According to our literature search, this is the only recorded case in which the index tumour was found in a tonsillar remnant. This case illustrates the importance of thorough clinical examination in patients with potential unknown primaries, and of the need, in previously tonsillectomised patients, to perform excisional biopsy of the tonsillar remnant.
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Affiliation(s)
- R Simo
- Department of Otorhinolaryngology, Head and Neck Surgery, Guy's and St Thomas' Hospital NHS Foundation Trust, London, UK.
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38
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Kirby A, O'Connell M. Staged neck dissection (ND) pre- or post-chemoradiotherapy (CRT) is associated with improved disease-free survival (DFS) but not overall survival (OS) in locally advanced oropharyngeal squamous cell carcinoma (OPHSCC)-20-year experience from a single cent. Radiother Oncol 2007. [DOI: 10.1016/s0167-8140(07)80209-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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39
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Sayers G, McCarthy T, O'Connell M, O'Leary M, O'Brien D, Cafferkey M, McNamara E. Haemolytic uraemic syndrome associated with interfamilial spread of E. coli O26:H11. Epidemiol Infect 2006; 134:724-8. [PMID: 16371176 PMCID: PMC2870445 DOI: 10.1017/s0950268805005455] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/09/2005] [Indexed: 11/06/2022] Open
Abstract
In September 2000, haemolytic uraemic syndrome (HUS) was diagnosed in a 10-month-old child with a prodromal history of vomiting and diarrhoea (non-bloody). Investigation revealed that a self-limiting gastrointestinal illness (mean duration 48 h) had occurred among immediate and extended family in the 2 weeks prior to the child's admission. The epidemiology of the illness suggested person-to-person spread. Five children (close family contacts) had E. coli O26 verocytotoxin (VT1 and VT2) isolated from stools. Stool culture and serology from the index case were negative for shiga toxin-producing E. coli (STEC) organisms. Control measures in accordance with the Public Health Laboratory Service (PHLS), verocytotoxogenic organisms (VTEC) guidelines were applied to prevent further spread among the extended family and contacts. Despite detailed food and environmental exposure histories, the source of the illness was not identified. This incident highlights the importance of investigation of cases of post-diarrhoeal HUS, for potential shiga toxin E. coli aetiology.
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Affiliation(s)
- G Sayers
- Department of Public Health, Health Service Executive Eastern Region, Dublin.
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Abstract
INTRODUCTION BCG vaccination is currently recommended for all newborns in Ireland except where specifically contraindicated. This paper describes a marked increase in the number of referrals of patients with localised complications after vaccination to two Dublin paediatric hospitals. This increase coincided with the introduction of a new strain of BCG vaccine METHODS A population surveillance study was undertaken to determine the frequency and spectrum of complications associated with the new strain of BCG vaccine introduced in Ireland. Patients were identified though review of the infectious disease service case records and microbiology laboratory culture reports for the two year period from August 2002 to July 2004. Prospectively gathered data were supplemented by retrospective chart review. All infants who had inoculation site abscesses, suppurative adenopathy, or non-suppurative adenopathy with nodes > or =2 cm were included. RESULTS Fifty eight patients presented a median of 13 weeks post-inoculation: 32 with suppurative adenitis, 17 with inoculation site abscess, three with both inoculation site abscess and suppurative adenitis, and six with non-suppurative adenopathy. The overall complication rate was estimated at 1/931 vaccinees with 1/1543 developing suppurative adenitis. Twenty six infants required surgery. DISCUSSION This series illustrates the role of hospitals in sentinel surveillance and highlights the importance of having a well functioning and responsive system of adverse event reporting. These events raise a serious question as to the suitability of this vaccine strain for use in a national immunisation programme in a country where the prevalence of tuberculous disease is 10.4/100,000.
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Affiliation(s)
- T Bolger
- Our Lady's Hospital for Sick Children, Dublin, Eire.
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41
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Jefferies S, Kote-Jarai Z, Goldgar D, Houlston R, Frazer-Williams MJ, A'Hern R, Eeles R, Henk J, Gore M, Rhys-Evans P, Archer D, Bishop K, Solomon E, Hodgson S, McGurk M, Hibbert J, O'Connell M, Partridge M, Chevretton E, Calman F, Saunders M, Shotton K, Brown A, Whittaker S, Foulkes W. Association between polymorphisms of the GPX1 gene and second primary tumours after index squamous cell cancer of the head and neck. Oral Oncol 2005; 41:455-61. [PMID: 15878749 DOI: 10.1016/j.oraloncology.2004.09.012] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2004] [Accepted: 09/20/2004] [Indexed: 12/14/2022]
Abstract
We investigated the association between genetic polymorphisms in GPX1 gene amongst patients who had index squamous cell carcinoma (SCCHN) and a second primary tumour (SPT) after a primary SCCHN in a case-control study. GPX1 genotypes were determined for 61 patients with SPT and for 259 control subjects by a PCR technique using a fluorescent-labelled primer. Analysis was by an ABI automated fluorescent sequencer. The associations between specific genotypes and the development of SPT were examined by logistic regression. A significant difference was found between the control group and the SPT cases in allele frequencies of GPX1 ALA( *)6 and ALA( *)7 (p(trend)=0.04). These results suggest that polymorphisms in the GPX1 gene may be a marker for SPT development and further studies are indicated.
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Affiliation(s)
- S Jefferies
- Addenbrooke's Hospital, Cambridge CB2 2QQ, UK
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Cantwell C, Ryan M, O'Connell M, Cunningham P, Brennan D, Costigan D, Lynch T, Eustace S. A comparison of inflammatory myopathies at whole-body turbo STIR MRI. Clin Radiol 2005; 60:261-7. [PMID: 15664582 DOI: 10.1016/j.crad.2004.06.027] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- C Cantwell
- Cappagh National Orthopaedic Hospital, Finglas, Dublin, Eire
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Affiliation(s)
- H Brodaty
- Alzheimer's Disease International, Sydney, Australia.
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Thirion P, Michiels S, Pignon JP, Buyse M, Braud AC, Carlson RW, O'Connell M, Sargent P, Piedbois P. Modulation of fluorouracil by leucovorin in patients with advanced colorectal cancer: an updated meta-analysis. J Clin Oncol 2004; 22:3766-75. [PMID: 15365073 DOI: 10.1200/jco.2004.03.104] [Citation(s) in RCA: 241] [Impact Index Per Article: 12.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
PURPOSE The modulation of fluorouracil (FU) by folinic acid (leucovorin [LV]) has been shown to be effective in terms of tumor response rate in patients with advanced colorectal cancer, but a meta-analysis of nine trials previously published by our group failed to demonstrate a statistically significant survival difference between FU and FU-LV. We present an update of the meta-analysis, with a longer follow-up and the inclusion of 10 newer trials. PATIENTS AND METHODS Analyses are based on individual data from 3,300 patients randomized in 19 trials on an intent-to-treat basis. Two trials had multiple comparisons, leading to a total of 21 pair-wise comparisons. FU doses were similar in both arms in 10 pair-wise comparisons, 15% to 33% higher in the FU-alone arm in six comparisons, and more than 66% higher in five comparisons. RESULTS Overall analysis showed a two-fold increase in tumor response rates (11% for FU-LV v 21% for FU-LV v 11% for FU [corrected] alone; odds ratio, 0.53; 95% CI, 0.44 to 0.63; P <.0001) and a small but statistically significant overall survival benefit for FU-LV over FU alone (median survival, 11.7 v 10.5 months, respectively; hazards ratio, 0.90; 95% CI, 0.87 to 0.94; P =.004), which were primarily seen in the first year. We observed a significant interaction between treatment benefit and dose of FU, with tumor response and overall survival advantages of FU-LV over FU-alone being restricted to trials in which a similar dose of FU was prescribed in both arms. CONCLUSION This updated analysis demonstrates, on a large data set, that FU-LV improves both response rate and overall survival compared with FU alone and that this benefit is consistent across various prognostic factors.
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Roh MS, Colangelo L, Wieand S, O'Connell M, Petrelli N, Smith R, Mamounas E, Hyams D, Wolmark N. Response to preoperative multimodality therapy predicts survival in patients with carcinoma of the rectum. J Clin Oncol 2004. [DOI: 10.1200/jco.2004.22.90140.3505] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [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
Affiliation(s)
- M. S. Roh
- NSABP Operations Center, Pittsburgh, PA
| | | | - S. Wieand
- NSABP Operations Center, Pittsburgh, PA
| | | | | | - R. Smith
- NSABP Operations Center, Pittsburgh, PA
| | | | - D. Hyams
- NSABP Operations Center, Pittsburgh, PA
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Abstract
BACKGROUND Male fertility potential cannot be measured by conventional parameters for the assisted reproduction technique; ICSI. This study determines the relationship between testicular and ejaculated sperm mitochondrial (mt) DNA deletions, nuclear (n) DNA fragmentation, and fertilization and pregnancy rates in ICSI. METHODS Ejaculated sperm were obtained from 77 men and testicular sperm from 28 men with obstructive azoospermia undergoing ICSI. Testicular sperm were retrieved using a Trucut needle. mtDNA was analysed using a long PCR. The alkaline Comet assay determined nDNA fragmentation. RESULTS Of subjects who achieved a pregnancy (50%) using testicular sperm, only 26% had partners' sperm with wild-type (WT) mtDNA. Of pregnant subjects (38%) using ejaculated sperm, only 8% had partner sperm with WT mtDNA. In each, the successful group had less mtDNA deletions and less nDNA fragmentation. There were inverse relationships between pregnancy and mtDNA deletion numbers, size and nDNA fragmentation for both testicular and ejaculated sperm. No relationships were observed with fertilization rates. An algorithm for the prediction of pregnancy is presented based on the quality of sperm nDNA and mtDNA. CONCLUSION In both testicular and ejaculated sperm, mtDNA deletions and nDNA fragmentation are closely associated with pregnancy in ICSI.
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Affiliation(s)
- S E M Lewis
- School of Medicine, Obstetrics & Gynaecology, Queen's University, Belfast BT12 6BJ, UK.
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Boland M, Sayers G, Coleman T, Bergin C, Sheehan N, Creamer E, O'Connell M, Jones L, Zochowski W. A cluster of leptospirosis cases in canoeists following a competition on the River Liffey. Epidemiol Infect 2004; 132:195-200. [PMID: 15061493 PMCID: PMC2870094 DOI: 10.1017/s0950268803001596] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
On 6 November 2001, a possible case of leptospirosis was notified in a canoeist following a white-water event on the River Liffey. It emerged that a second race participant was also a possible case. An outbreak control team coordinated the epidemiological investigation, laboratory investigation, environmental assessment, communication and control measures. A cluster of six laboratory-confirmed cases of leptospirosis, serologically Leptospira interrogans serogroup Icterohaemorrhagiae was found. The attack rate was 9.2% (6/65). Fever, chills, red eyes and shortness of breath were significantly associated with being a confirmed case. Five cases were hospitalized. Swallowing more than one mouthful of water was associated with an increased risk of developing leptospirosis. Increased rainfall and release of hydroelectric water may have contributed to this outbreak. A multidisciplinary approach and use of the Internet and e-mail facilitated rapid and effective communication.
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Affiliation(s)
- M Boland
- Department of Public Health, Eastern Regional Health Authority, Dublin
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Hurson C, Synnott K, Ryan M, O'Connell M, Eustace S, McCormack D, O'Byrne J. The natural history of the periacetabular fragment following Ganz osteotomy. J Surg Orthop Adv 2004; 13:91-3. [PMID: 15281405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/30/2023]
Abstract
The vascularity of the acetabular free fragment in Ganz osteotomies has remained a concern. This study aims to assess the role of MR imaging in the postoperative evaluation of Ganz osteotomies. Twenty patients (19 females, 1 male), average age 24 years (range, 12-36 years), had sequential magnetic resonance imaging studies of the pelvis at 6 weeks and 6 months following Ganz osteotomies. Normal healing with no evidence of periosteotomy edema was seen in 17 patients at 6 weeks. Three patients showed evidence of reduced vascularity. In two of these, there were focal changes suggestive of subclinical ischemia. The other had gross signal changes in the osteotomy fragment suggestive of diffuse ischemia. The patients with focal changes were asymptomatic and had normal 6-month scans. The patient with diffuse changes complained of persistent groin pain, which resolved after 4 months. The 6-month scan showed some persistent vascular changes. The scan at 1 year showed complete resolution. The study suggests that Ganz osteotomy has minimal effect on the vascularity of the acetabular free fragment.
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Affiliation(s)
- C Hurson
- Department of Orthopaedic Surgery, Cappagh National Orthopaedic Hospital, Finglas, Dublin, Ireland.
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Tepper JE, O'Connell M, Hollis D, Niedzwiecki D, Cooke E, Mayer RJ. Analysis of surgical salvage after failure of primary therapy in rectal cancer: results from Intergroup Study 0114. J Clin Oncol 2003; 21:3623-8. [PMID: 14512393 DOI: 10.1200/jco.2003.03.018] [Citation(s) in RCA: 80] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
PURPOSE Intergroup Study 0114 was designed to study the effect of various chemotherapy regimens delivered after potentially curative surgical resection of T3, T4, and/or node-positive rectal cancer. A subset analysis was undertaken to investigate the prevalence and influence of salvage therapy among patients with recurrent disease. PATIENTS AND METHODS Adjuvant therapy consisted of two cycles of fluorouracil (FU)-based chemotherapy followed by pelvic irradiation with chemotherapy and two more cycles of chemotherapy after radiation therapy. A total of 1,792 patients were entered onto the study and 1,696 were assessable. After a median of 8.9 years of follow-up, 715 patients (42%) had disease recurrence, and an additional 10% died without evidence of disease. Five hundred patients with follow-up information available had a single organ or single site of first recurrence (73.5% of all recurrences). RESULTS A total of 171 patients (34% of those with a single organ or single site of recurrence) had a potentially curative resection of the metastatic or locally recurrent disease. Single-site first recurrences in the liver, lung, or pelvis occurred in 448 patients (90% of the single-site recurrences), with 159 (35%) of these undergoing surgical resection for attempted cure. Overall survival differed significantly between the resected and nonresected groups (P <.0001), with overall 5-year probabilities of.27 and.06, respectively. Controlling for worst performance status at the time of recurrence does not alter this relationship. Patients who underwent salvage surgery had significantly increased survival (P <.001) for each site. CONCLUSION Attempted surgical salvage of rectal cancer recurrence is performed commonly in the United States. The chance of a long-term cure with such intervention is approximately 27%.
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Affiliation(s)
- J E Tepper
- Department of Radiation Oncology, Campus Box No. 7512, University of North Carolina, Chapel Hill, NC 27599-7512, USA.
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Walsh T, O'Connell M, O'Leary M, Mcquillan C, O'Herlhy C, Keane D. A retrospective review of the management of an abnormal fetal blood sample in primigravidae patients treated with oxytocin in labour. J OBSTET GYNAECOL 2003. [DOI: 10.1080/718591695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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