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Youseffi M, Jamil MMBA, Ghazali N, Parisi L, Javid F, Wahab MHA, Idrus SZS, Rahman NAA. Causes and alternative treatments of neurological conditions due to environmental toxins: An overview. INTERNATIONAL CONFERENCE ON FOOD SCIENCE AND BIOTECHNOLOGY (FSAB 2021) 2021. [DOI: 10.1063/5.0074023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
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Markose G, Cousin GCS, Ghazali N. Head and neck trans oral robotic surgery – a trainees perspective. Br J Oral Maxillofac Surg 2020. [DOI: 10.1016/j.bjoms.2020.10.193] [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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Ghazali N, Attardo G, Markose G. Modification of the microscope drape to provide a closed surgical field in transoral robotic surgery. Br J Oral Maxillofac Surg 2020; 58:867-868. [PMID: 32636093 PMCID: PMC7334942 DOI: 10.1016/j.bjoms.2020.06.022] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2020] [Accepted: 06/15/2020] [Indexed: 11/25/2022]
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Kanatas A, Velikova G, Roe B, Horgan K, Ghazali N, Shaw RJ, Rogers SN. Patient-Reported Outcomes in Breast Oncology: A Review of Validated Outcome Instruments. Tumori 2018; 98:678-88. [DOI: 10.1177/030089161209800602] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Aims and background Patient-reported outcomes (PROs) include areas of health-related quality of life but also broader concepts such as patient satisfaction with care. The aim of this review is to give an account of all instruments with potential use in patients with a history of treatment for breast cancer (including surgery, chemotherapy and/or radiotherapy) with evidence of validation in the breast cancer population. Methods All instruments included in this review were identified as PRO measures measuring breast-related quality of life and/or satisfaction that had undergone development and validation with breast oncology patients. We specifically looked for PRO measures examining patient satisfaction and/or quality of life after breast cancer treatment. Following an evaluation of 323 papers, we identified 15 instruments that were able to satisfy our inclusion criteria. Results These instruments are the EORTC QOL-C30 and QLQ-BR23 (European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Breast Cancer Module), the FACT-B (Functional Assessment of Cancer Therapy-Breast Cancer), the SLDS-BC (Satisfaction with Life Domains Scale for Breast Cancer), the BIBCQ (Body Image after Breast Cancer Questionnaire), the HIBS (Hopwood Body Image Scale), the PBIS (Polivy Body Image Scale), the MBROS (Michigan Breast Reconstruction Outcomes Study) Satisfaction and Body Image Questionnaires, the BREAST-Q, the BCTOS (Breast Cancer Treatment Outcome Scale), the BCQ, the FACT-ES (Functional Assessment of Cancer Therapy-Endocrine System), the MAS (Mastectomy Attitude Scale), and the Breast Cancer Prevention Trial Symptom Checklist (BCPT). Conclusions Suggestions for future directions include (1) to use and utilize validated instruments tailored to clinical practice; (2) to develop a comprehensive measurement of surgical outcome requiring the combination of objective and subjective measures; (3) to aim for a compromise between these two competing considerations in the form of a scale incorporating both generalizability in cancer-related QOL and specificity in breast cancer issues.
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Affiliation(s)
| | | | - Brenda Roe
- Edge Hill University, Ormskirk and University of Manchester, Manchester
| | - Kieran Horgan
- Breast Surgery Department, Leeds Teaching Hospitals, Leeds General Infirmary, Leeds
| | | | - Richard J Shaw
- Department of Molecular & Clinical Cancer Medicine, Liverpool CR-UK Centre, Liverpool
| | - Simon N Rogers
- Evidence-Based Practice Research Centre (EPRC), Faculty of Health, Edge Hill University, Ormskirk, and Regional Maxillofacial Unit, University Hospital Aintree, Liverpool, UK
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Ghazali N, Caldroney S, Dyalram D, Lubek JE. Cardiovascular complications in head & neck microvascular flap reconstruction: A retrospective risk stratification and outcomes assessment. J Craniomaxillofac Surg 2017; 45:2120-2127. [PMID: 29126769 DOI: 10.1016/j.jcms.2017.10.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2017] [Revised: 10/02/2017] [Accepted: 10/05/2017] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND To determine the incidence and predictors of cardiac complications (CC) in head & neck microvascular flap reconstruction. METHODS A series of 216 microvascular flaps performed between 2012 and 2015 were analyzed using the Revised Cardiac Risk Index (CRCI) and the Charlson Comorbidity Index (CCI). Multivariate regression analysis was undertaken for predictive factors of outcomes. RESULTS Twenty patients developed CC (9.7%) with transient cardiac arrhythmia (6.5%) and myocardial infarction (2.8%) occurring most frequently. Univariate analyses demonstrated significant differences between the two groups in terms of their age, smoking status, occurrence of peripheral vascular disease, CCI, RCRI, length of hospitalization and duration of anesthesia. Multivariate analyses showed that RCRI (p < 0.001) and amount of blood transfused (p = 0.02) were independent predictors of CC. CONCLUSIONS Cardiac complications are uncommon in head and neck microvascular flap surgery. The RCRI is a useful screening tool for estimating cardiac complication risk and improving patient and flap outcomes.
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Affiliation(s)
- Naseem Ghazali
- Department of Oral & Maxillofacial Surgery, University of Maryland, 650 West Baltimore Street, Baltimore, MD 21201, USA
| | - Steven Caldroney
- Department of Oral & Maxillofacial Surgery, University of Maryland, 650 West Baltimore Street, Baltimore, MD 21201, USA
| | - Donita Dyalram
- Department of Oral & Maxillofacial Surgery, University of Maryland, 650 West Baltimore Street, Baltimore, MD 21201, USA
| | - Joshua E Lubek
- Department of Oral & Maxillofacial Surgery, University of Maryland, 650 West Baltimore Street, Baltimore, MD 21201, USA.
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Ghazali N, Roe B, Lowe D, Tandon S, Jones T, Shaw R, Risk J, Rogers SN. Using the patients concerns inventory for distress screening in post-treatment head and neck cancer survivors. J Craniomaxillofac Surg 2017; 45:1743-1748. [PMID: 28844398 DOI: 10.1016/j.jcms.2017.07.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [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: 01/22/2017] [Revised: 07/16/2017] [Accepted: 07/18/2017] [Indexed: 10/19/2022] Open
Abstract
PURPOSE Cancer patients can experience significant distress during their cancer trajectory, which impacts upon clinical outcomes and quality of life. Screening for distress using holistic assessments can help identify and address unmet concerns/needs. The purpose of this study was to evaluate the relationship between concerns and distress, and the impact of distress on clinic outcomes in post-treatment head and neck cancer patients. METHODS 170 patients attending routine follow-up clinics were prospectively recruited. All patients completed the Patient Concerns Inventory (PCI) and the Distress thermometer (DT) at preconsultation. RESULTS The rate of significant distress (i.e. DT cut-off score ≥4) was 36% (62/170). Significantly distressed patients selected more items overall than patients without distress (mean, median (QR) of 5.40, 5 (2-8) vs 2.61, 2 (0-4), p < 0.001). Significant distress was most strongly associated with Physical and Functional well-being (p < 0.001) and Psychological and Emotional well-being domains (p = 0.001). On balance, very little difference was noted between cut-off points of either ≥4 or ≥5 PCI items of concern selected. Both cut-off points demonstrated an acceptable level of sensitivity, specificity and predictive values for significant distress. Consultations were longer with increasing numbers of concerns. CONCLUSIONS Just over one-third of patients are significantly distressed. They were more likely to express a higher number of concerns. A cutoff score ≥4 or ≥5 PCI items selected can identify those at risk of significant distress. Concerns causing significant distress were related to emotional/psychological issues and physical function.
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Affiliation(s)
- Naseem Ghazali
- Department of Molecular & Clinical Cancer Medicine, Institute of Translational Medicine, University of Liverpool, Liverpool, UK; Regional Maxillofacial Unit, Aintree University Hospitals NHS Trust, Liverpool, UK.
| | - Brenda Roe
- Evidence-Based Practice Research Centre, Faculty of Health & Social Care, Edge Hill University, Ormskirk, UK
| | - Derek Lowe
- Regional Maxillofacial Unit, Aintree University Hospitals NHS Trust, Liverpool, UK; Evidence-Based Practice Research Centre, Faculty of Health & Social Care, Edge Hill University, Ormskirk, UK
| | - Sank Tandon
- ENT Unit, Aintree University Hospitals NHS Trust, Liverpool, UK
| | - Terry Jones
- Department of Molecular & Clinical Cancer Medicine, Institute of Translational Medicine, University of Liverpool, Liverpool, UK; ENT Unit, Aintree University Hospitals NHS Trust, Liverpool, UK
| | - Richard Shaw
- Department of Molecular & Clinical Cancer Medicine, Institute of Translational Medicine, University of Liverpool, Liverpool, UK; Regional Maxillofacial Unit, Aintree University Hospitals NHS Trust, Liverpool, UK
| | - Janet Risk
- Department of Molecular & Clinical Cancer Medicine, Institute of Translational Medicine, University of Liverpool, Liverpool, UK
| | - Simon N Rogers
- Regional Maxillofacial Unit, Aintree University Hospitals NHS Trust, Liverpool, UK; Evidence-Based Practice Research Centre, Faculty of Health & Social Care, Edge Hill University, Ormskirk, UK
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Caldroney S, Aslam-Pervez N, Ghazali N, Lubek J. Ulnar fasciocutaneous free flap for reconstruction of oral cavity defects: a retrospective review. Int J Oral Maxillofac Surg 2017. [DOI: 10.1016/j.ijom.2017.02.604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Caldroney S, Ghazali N, Dyalram D, Lubek JE. Surgical resection and vascularized bone reconstruction in advanced stage medication-related osteonecrosis of the jaw. Int J Oral Maxillofac Surg 2017; 46:871-876. [PMID: 28233647 DOI: 10.1016/j.ijom.2017.01.023] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2016] [Revised: 11/23/2016] [Accepted: 01/31/2017] [Indexed: 02/05/2023]
Abstract
A retrospective review of all patients with stage 3 medication-related osteonecrosis of the jaw (MRONJ), treated by surgical resection and immediate vascularized bone reconstruction at a tertiary care medical center, was performed. Eleven patients were included, seven female and four male; their mean age was 65.8 years (range 56-73 years). Mean follow-up was 25 months. Ten patients had received intravenous bisphosphonates. The most common pathology was breast cancer (4/11). Pain (n=8) and pathological fracture (n=7) were the most common presenting symptoms. Microvascular free flaps consisted of seven fibula osteocutaneous flaps and four scapula osteocutaneous free flaps. All patients reported resolution of symptoms, with complete bone union identified radiographically (100%). Complications occurred in three patients (27%). One patient required removal of hardware at 8 months postoperative. Dental implant rehabilitation was completed in two patients. Ten patients are tolerating an oral diet. Ten patients are alive without evidence of MRONJ at any of the surgical sites. One patient died 28 months after surgery from progression of metastatic disease. Advanced MRONJ can be successfully treated in patients using vascularized tissue transfer, including those patients with significant peripheral vascular disease. Dental rehabilitation is a viable option for advanced MRONJ patients treated by vascularized flap reconstruction.
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Affiliation(s)
- S Caldroney
- Oral-Head and Neck Surgery/Microvascular Surgery, University of Maryland Greenebaum Cancer Center, Baltimore, Maryland, USA
| | - N Ghazali
- Oral-Head and Neck Surgery/Microvascular Surgery, University of Maryland Greenebaum Cancer Center, Baltimore, Maryland, USA
| | - D Dyalram
- Oral-Head and Neck Surgery/Microvascular Surgery, University of Maryland Greenebaum Cancer Center, Baltimore, Maryland, USA
| | - J E Lubek
- Oral-Head and Neck Surgery/Microvascular Surgery, University of Maryland Greenebaum Cancer Center, Baltimore, Maryland, USA.
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Ghazali N, Roe B, Lowe D, Tandon S, Jones T, Brown J, Shaw R, Risk J, Rogers SN. Screening for distress using the distress thermometer and the University of Washington Quality of Life in post-treatment head and neck cancer survivors. Eur Arch Otorhinolaryngol 2017; 274:2253-2260. [PMID: 28168421 DOI: 10.1007/s00405-017-4474-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2016] [Accepted: 01/18/2017] [Indexed: 03/04/2023]
Abstract
The primary aim was to determine the efficacy of the Distress Thermometer (DT) in screening for anxiety and mood problems against the University of Washington Quality of Life, version 4 (UWQOL). Secondary aims were to evaluate the association between demographic, clinical and health-related QOL variables with significant distress. Two hundred and sixty one disease-free HNC ambulatory patients attending routine follow-up clinics were prospectively recruited. Both DT and UWQOL were completed pre-consultation. Receiver operating characteristic (ROC) curve analyses of DT score for anxiety dysfunction yielded an area under the curve (AUC) of 0.877, with a sensitivity of 84% (43/51) and specificity of 76% (159/210) for a DT cut-off of ≥4; with a corresponding AUC of 0.825 for mood with sensitivity 78% (28/36) and specificity 71% (159/225). Treatment with radiotherapy and a longer consultation time were associated with significant distress (DT ≥4). Significant distress was also reported in two third of those reporting less than "Good" overall QOL. Distress levels were particularly associated with poor Social-Emotional function, more so than the association seen with poor physical function. DT is a reasonable screening tool for distress in the HNC population. The DT cut-off score ≥4 was effective in identifying those with significant distress. Significant distress is associated in survivors with poor health-related quality of life, those who received radiotherapy and patients who have longer consultation times in clinic.
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Affiliation(s)
- Naseem Ghazali
- Department of Molecular and Clinical Cancer Medicine, Institute of Translational Medicine, University of Liverpool, Liverpool, UK. .,Regional Maxillofacial Unit, Aintree University Hospitals NHS Trust, Lower Lane, Liverpool, L9 7AL, UK.
| | - Brenda Roe
- Faculty of Health and Social Care, Evidence-Based Practice Research Centre, Edge Hill University, Ormskirk, UK
| | - Derek Lowe
- Regional Maxillofacial Unit, Aintree University Hospitals NHS Trust, Lower Lane, Liverpool, L9 7AL, UK.,Faculty of Health and Social Care, Evidence-Based Practice Research Centre, Edge Hill University, Ormskirk, UK
| | - Sank Tandon
- ENT Unit, Aintree University Hospitals NHS Trust, Liverpool, UK
| | - Terry Jones
- Department of Molecular and Clinical Cancer Medicine, Institute of Translational Medicine, University of Liverpool, Liverpool, UK.,ENT Unit, Aintree University Hospitals NHS Trust, Liverpool, UK
| | - James Brown
- Regional Maxillofacial Unit, Aintree University Hospitals NHS Trust, Lower Lane, Liverpool, L9 7AL, UK
| | - Richard Shaw
- Department of Molecular and Clinical Cancer Medicine, Institute of Translational Medicine, University of Liverpool, Liverpool, UK.,Regional Maxillofacial Unit, Aintree University Hospitals NHS Trust, Lower Lane, Liverpool, L9 7AL, UK
| | - Janet Risk
- Department of Molecular and Clinical Cancer Medicine, Institute of Translational Medicine, University of Liverpool, Liverpool, UK
| | - Simon N Rogers
- Regional Maxillofacial Unit, Aintree University Hospitals NHS Trust, Lower Lane, Liverpool, L9 7AL, UK.,Faculty of Health and Social Care, Evidence-Based Practice Research Centre, Edge Hill University, Ormskirk, UK
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Ord R, Ghazali N, Sehgal S. Long-Term Treatment Outcomes of Central Giant Cell Lesions of the Jaws. J Oral Maxillofac Surg 2016. [DOI: 10.1016/j.joms.2016.06.126] [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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Ghazali N, Dammling C, Ord R, Brahim J. Evaluating Outcomes of Combination Pentoxifylline and Tocopherol in Preventing Osteradionecrosis of the Jaws. J Oral Maxillofac Surg 2016. [DOI: 10.1016/j.joms.2016.06.072] [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: 11/17/2022]
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Ghazali N, Parker L, Settle K, Lubek JE. Sustained response of HER2-positive metastatic salivary adenocarcinoma, not otherwise specified, treated with trastuzumab. Oral Surg Oral Med Oral Pathol Oral Radiol 2016; 122:292-9. [PMID: 27289263 DOI: 10.1016/j.oooo.2016.03.020] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2015] [Revised: 02/06/2016] [Accepted: 03/04/2016] [Indexed: 11/28/2022]
Abstract
OBJECTIVE Adenocarcinoma-not otherwise specified (AD-NOS) is an aggressive salivary gland carcinoma subtype with poor prognosis. Her2/neu-targeted therapy may be beneficial in cases of overexpression (20% of AD-NOS). Here, a case of metastatic AD-NOS of the submandibular gland showing sustained complete response to trastuzumab is reported, and the existing literature is reviewed. STUDY DESIGN AND RESULTS A 68-year-old male with poorly differentiated AD-NOS of the submandibular gland with multiple metastases (T3 N2 bM1) underwent radical surgery and adjuvant radiation. The primary lesion demonstrated Her2/neu overexpression, and treatment with trastuzumab was initiated. The patient remains alive without evidence of disease at 36-months after treatment (three cycles of trastuzumab). Literature review of all published trastuzumab-based therapy studies (1990-2015) for salivary gland carcinoma is included. CONCLUSIONS Definitive clinical trials of trastuzumab-based interventions are challenging to undertake in rare tumors. This report adds to increasing evidence for trastuzumab-based therapy in salivary carcinomas, where sustained partial response at 36-months is achievable.
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Affiliation(s)
- Naseem Ghazali
- Division of Oncology & Reconstructive Surgery, Department of Oral & Maxillofacial Surgery, Greenebaum Cancer Center, University of Maryland, Baltimore, MD, USA
| | - Lynette Parker
- Department of Pathology, University of Maryland Medical Center, Baltimore, MD, USA
| | | | - Joshua E Lubek
- Division of Oncology & Reconstructive Surgery, Department of Oral & Maxillofacial Surgery, Greenebaum Cancer Center, University of Maryland, Baltimore, MD, USA.
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13
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Ghazali N, Hanna TC, Dyalram D, Lubek JE. The Value of the “Papillon” Anterolateral Thigh Flap for Total Pharyngolaryngectomy Reconstruction: A Retrospective Case Series. J Oral Maxillofac Surg 2016; 74:406-14. [DOI: 10.1016/j.joms.2015.09.010] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2015] [Revised: 09/16/2015] [Accepted: 09/16/2015] [Indexed: 11/17/2022]
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Kayhanian S, Ghazali N, Malins T, Gahir D. Long-term survival and management of childhood oral carcinoma cuniculatum. Br J Oral Maxillofac Surg 2015. [DOI: 10.1016/j.bjoms.2015.08.149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Ghazali N, Aslam T, Henson DB. New superior-inferior visual field asymmetry indices for detecting POAG and their agreement with the glaucoma hemifield test. Eye (Lond) 2015; 29:1375-82. [PMID: 26315707 DOI: 10.1038/eye.2015.165] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2015] [Accepted: 07/28/2015] [Indexed: 11/09/2022] Open
Abstract
PURPOSE To describe and measure the discriminatory performance of three new superior-inferior asymmetry indices for detecting primary open angle glaucoma (POAG) and to compare these with the glaucoma hemifield test (GHT). METHODS In all, 412 control and 247 POAG eyes were selected from a visual field database of patients attending the Manchester Royal Eye Hospital. Age-adjusted defect asymmetries were calculated for each of the 22 vertically mirrored test point pairs used in the GHT. The three new indices, hemifield mean difference (HMD) and hemifield standard deviation (HSD) of the asymmetry values along with the number of test pairs (NP) falling outside the 85% probability limits of the control population, were calculated. ROC curves of the indices and GHT were constructed. Agreement between the indices was explored with a proportional Venn diagram and 3 × 3 contingency tables. Cases of disagreement between the indices were reviewed. RESULTS The area under the ROC curves were HMD=0.745 (95% confidence interval (CI) 0.705-0.786), HSD=0.864 (95% CI 0.833-0.894), NP=0.863 (95% CI 0.832-0.893) and GHT=0.792 (95% CI 0.754-0.829). The Venn diagram and contingency tables highlighted the good agreement between HSD, NP and GHT. Agreement was 78% (HSD vs. GHT) and 82% (NP vs. GHT) in the control sample and 70% (HSD vs. GHT) and 71% (NP vs. GHT) in the POAG sample. Five cases are presented where disagreement existed between the indices. CONCLUSIONS The new HSD and NP asymmetry indices perform better than GHT in differentiating between normal and POAG eyes in this data set. GHT can fail to detect significant asymmetry, detected by HSD and NP, when an early defect crosses sector boundaries.
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Affiliation(s)
- N Ghazali
- Institute of Human Development, Faculty of Medical and Human Development, University of Manchester, Manchester, UK
| | - T Aslam
- Institute of Human Development, Faculty of Medical and Human Development, University of Manchester, Manchester, UK.,Manchester Royal Eye Hospital, Central Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
| | - D B Henson
- Institute of Human Development, Faculty of Medical and Human Development, University of Manchester, Manchester, UK.,Manchester Royal Eye Hospital, Central Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
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Ghazali N, Roe B, Lowe D, Rogers S. Patients concerns inventory highlights perceived needs and concerns in head and neck cancer survivors and its impact on health-related quality of life. Br J Oral Maxillofac Surg 2015; 53:371-9. [DOI: 10.1016/j.bjoms.2015.01.022] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2014] [Accepted: 01/28/2015] [Indexed: 11/28/2022]
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Ghazali N, Worrell E. Post-treatment Care Pathway in Long-term Survivors of Head & Neck Cancer with Oral and/or Facial Prosthesis. Br J Oral Maxillofac Surg 2014. [DOI: 10.1016/j.bjoms.2014.07.051] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Ghazali N, Roe B, Lowe D, Rogers SN. Emergent trends of perceived needs and concerns in long-term survivors of head and neck cancer using the patients concerns inventory. Br J Oral Maxillofac Surg 2014. [DOI: 10.1016/j.bjoms.2014.07.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Zhou Y, Humphris G, Ghazali N, Friderichs S, Grosset D, Rogers SN. How head and neck consultants manage patients' emotional distress during cancer follow-up consultations: a multilevel study. Eur Arch Otorhinolaryngol 2014; 272:2473-81. [PMID: 25078155 DOI: 10.1007/s00405-014-3209-x] [Citation(s) in RCA: 14] [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] [Received: 06/13/2014] [Accepted: 07/24/2014] [Indexed: 10/25/2022]
Abstract
Head and neck cancer (HNC) patients suffer substantial emotional problems. This study aimed to explore how utterance-level variables (source, type and timing of emotional cues) and patient-level variables (e.g. age, gender and emotional well-being) relate to consultants' responses (i.e. reducing or providing space) to patient expressions of emotional distress. Forty-three HNC outpatient follow-up consultations were audio recorded and coded, for patients' expressions of emotional distress and consultants' responses, using the Verona Coding Definitions of Emotional Sequence. Multilevel logistic regression modelled the probability of the occurrence of consultant-reduced space response as a function of patient distress cue expression, controlling for consultation and patient-related variables. An average of 3.5 cues/concerns (range 1-20) was identified per consultation where 84 out of 152 total cues/concerns were responded by reducing space. Cue type did not impact on response; likewise for the quality of patient emotional well-being. However, consultants were more likely to reduce space to cues elicited by patients, as opposed to those initiated by themselves. This reduced space response was more pronounced as the consultation continued. However, about 6 min into the consultation, this effect (i.e. tendency to block patients) started to weaken. Head and neck consultants' responses to negative emotions depended on source and timing of patient emotional expressions. The findings are useful for training programme development to encourage consultants to be more flexible and open in the early stages of the consultation.
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Affiliation(s)
- Yuefang Zhou
- School of Medicine, University of St Andrews, St Andrews, Fife, KY16 9TF, St Andrews, Scotland, UK,
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Scott B, Ghazali N, Lowe D, Bekiroglu F, Rogers SN. The Patients Concerns Inventory in head and neck cancer: Comparison between self-completed paper and touch screen versions in the clinic setting. Eur J Oncol Nurs 2013; 17:863-9. [DOI: 10.1016/j.ejon.2013.05.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2013] [Revised: 04/19/2013] [Accepted: 05/05/2013] [Indexed: 10/26/2022]
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Ghazali N, Roe B, Lowe D, Rogers S. Uncovering patients’ concerns in routine head and neck oncology follow up clinics: an exploratory study. Br J Oral Maxillofac Surg 2013; 51:294-300. [DOI: 10.1016/j.bjoms.2012.08.002] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2012] [Accepted: 08/08/2012] [Indexed: 10/28/2022]
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Kanatas A, Velikova G, Roe B, Horgan K, Ghazali N, Shaw RJ, Rogers SN. Patient-reported outcomes in breast oncology: a review of validated outcome instruments. Tumori 2013. [PMID: 23389352 DOI: 10.1700/1217.13489] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
AIMS AND BACKGROUND Patient-reported outcomes (PROs) include areas of health-related quality of life but also broader concepts such as patient satisfaction with care. The aim of this review is to give an account of all instruments with potential use in patients with a history of treatment for breast cancer (including surgery, chemotherapy and/or radiotherapy) with evidence of validation in the breast cancer population. METHODS All instruments included in this review were identified as PRO measures measuring breast-related quality of life and/or satisfaction that had undergone development and validation with breast oncology patients. We specifically looked for PRO measures examining patient satisfaction and/or quality of life after breast cancer treatment. Following an evaluation of 323 papers, we identified 15 instruments that were able to satisfy our inclusion criteria. RESULTS These instruments are the EORTC QOL-C30 and QLQ-BR23 (European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Breast Cancer Module), the FACT-B (Functional Assessment of Cancer Therapy-Breast Cancer), the SLDS-BC (Satisfaction with Life Domains Scale for Breast Cancer), the BIBCQ (Body Image after Breast Cancer Questionnaire), the HIBS (Hopwood Body Image Scale), the PBIS (Polivy Body Image Scale), the MBROS (Michigan Breast Reconstruction Outcomes Study) Satisfaction and Body Image Questionnaires, the BREAST-Q, the BCTOS (Breast Cancer Treatment Outcome Scale), the BCQ, the FACT-ES (Functional Assessment of Cancer Therapy-Endocrine System), the MAS (Mastectomy Attitude Scale), and the Breast Cancer Prevention Trial Symptom Checklist (BCPT). CONCLUSIONS Suggestions for future directions include (1) to use and utilize validated instruments tailored to clinical practice; (2) to develop a comprehensive measurement of surgical outcome requiring the combination of objective and subjective measures; (3) to aim for a compromise between these two competing considerations in the form of a scale incorporating both generalizability in cancer-related QOL and specificity in breast cancer issues.
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Affiliation(s)
- Anastasios Kanatas
- Leeds Teaching Hospitals and St James Institute of Oncology, Leeds General Infirmary, Leeds, United Kingdom.
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Ghazali N, Kanatas A, Bekiroglu F, Scott B, Lowe D, Rogers SN. The Patient Concerns Inventory: A Tool to Uncover Unmet Needs in a Cancer Outpatient Clinic. ACTA ACUST UNITED AC 2013. [DOI: 10.1308/147363513x13500508919899] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The Patient Concerns Inventory (PCI) is a holistic, patient reported tool that aids in identifying concerns and issues. it is a 55-item checklist of issues that may be grouped into categories of general function, specific head and neck function, emotional-psychological and others, which include finances, treatment related matters and social care. The PCI also gives patients an opportunity to identify from a list of 15 multidisciplinary team (MDT) members whom they would like to see or be referred on to.
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Affiliation(s)
- N Ghazali
- Clinical Research Fellow, Aintree University Hospitals NHS Foundation Trust
| | - A Kanatas
- Specialist Registrar, Leeds Teaching Hospitals NHS Trust
| | - F Bekiroglu
- Consultant, Aintree University Hospitals NHS Foundation Trust
| | - B Scott
- Senior Physiotherapist, Aintree University Hospitals NHS Foundation Trust
| | - D Lowe
- Medical Statistician, Aintree University Hospitals NHS Foundation Trust
| | - SN Rogers
- Consultant, Aintree University Hospitals NHS Foundation Trust
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Ghazali N, Shaw RJ, Rogers SN, Risk JM. Genomic determinants of normal tissue toxicity after radiotherapy for head and neck malignancy: a systematic review. Oral Oncol 2012; 48:1090-100. [PMID: 22939215 DOI: 10.1016/j.oraloncology.2012.08.002] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.9] [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: 06/27/2012] [Revised: 07/31/2012] [Accepted: 08/01/2012] [Indexed: 01/06/2023]
Abstract
Interindividual variations in radiotoxicity responses exist despite uniform treatment protocols. It is speculated that normal genetic variants, particularly single nucleotide polymorphisms (SNPs) may influence normal head and neck (HN) tissue radiotoxicity. This first-ever systematic review was undertaken to evaluate the association of SNPs with normal HN tissues radiotoxicity. Multiple databases (1950-February 2012) were reviewed using a combination of related keywords and MeSH terms. All published HN radiotoxicity studies with sufficient relevant data for extraction were included. The outcomes evaluated were acute and late radiotoxicity endpoints. Methodological quality assessment based on the STrengthening the REporting of Genetic Association (STREGA) statement was performed. Seven articles from 692 articles searched fulfilled the eligibility criteria. Recruited sample sizes were small (range, 32-140). There were 5/7 case-control studies. All studies used multimodality treatment with heterogeneous radiation parameters. Candidate gene approach was used in all studies. Fourteen SNPs from 9 genes were evaluated from the following pathways: DNA damage response, radiation fibrogenesis and oxidative/xenobiotic metabolism. Acute radiotoxicity events were associated with SNPs of DNA repair genes (OR, 3.01-4.08). SNPs of TGFβ1 were associated with osteoradionecrosis (OR, 4.2) and subcutaneous fibrosis. Genetic association studies in HN radiotoxicity currently provide hypothesis-generating findings that require validation in larger studies. Future studies must incorporate critical methodological issues and technological improvements, including using a genome-wide approach. Headway is possible through case-pooling of existing clinical trial data which could create a larger sample size of well-characterized treatment and endpoints. Also, on-going HN cancer clinical trials should consider extending their toxicity evaluation to include genetic association studies.
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Affiliation(s)
- Naseem Ghazali
- Regional Maxillofacial Unit, University Hospital Aintree, Lower Lane, Liverpool L9 7AL, UK.
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Rogers SN, Cleator AJ, Lowe D, Ghazali N. Identifying pain-related concerns in routine follow-up clinics following oral and oropharyngeal cancer. World J Clin Oncol 2012; 3:116-25. [PMID: 22905338 PMCID: PMC3421024 DOI: 10.5306/wjco.v3.i8.116] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2012] [Revised: 06/14/2012] [Accepted: 08/02/2012] [Indexed: 02/06/2023] Open
Abstract
AIM: To describe clinical characteristics of head and neck cancer (HNC) patients with pain and those wishing to discuss pain concerns during consultation.
METHODS: Cross-sectional, questionnaire study using University of Washington Quality of Life, version 4 (UW-QOL) and the Patients Concerns Inventory (PCI) in disease-free, post-treatment HNC cohort. Significant pain on UW-QOL and indicating “Pain in head and neck” and “Pain elsewhere” on PCI.
RESULTS: One hundred and seventy-seven patients completed UW-QOL and PCI. The prevalence of self-reported pain issues was 38% (67/177) comprising 25% (44/177) with significant problems despite medications and 13% (23/177) with lesser or no problems but wishing to discuss pain. Patients aged under 65 years and patients having treatment involving radiotherapy were more likely to have pain issues. Just over half, 55% (24/44) of patients with significant pain did not express a need to discuss this. Those with significant pain or others wanting to discuss pain in clinic had greater problems in physical and social-emotional functioning, reported suboptimal QOL, and also had more additional PCI items to discuss in clinic compared to those without significant pain and not wishing to discuss pain.
CONCLUSION: Significant HNC-related pain is prevalent in the disease-free, posttreatment cohort. Onward referral to a specialist pain team may be beneficial. The UW-QOL and PCI package is a valuable tool that may routinely screen for significant pain in outpatient clinics.
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Affiliation(s)
- Simon N Rogers
- Simon N Rogers, Derek Lowe, Naseem Ghazali, Regional Maxillofacial Unit, University Hospital Aintree, Liverpool, L9 7LN, United Kingdom
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Kanatas A, Ghazali N, Lowe D, Udberg M, Heseltine J, O'Mahony E, Rogers SN. Issues patients would like to discuss at their review consultation: variation by early and late stage oral, oropharyngeal and laryngeal subsites. Eur Arch Otorhinolaryngol 2012; 270:1067-74. [PMID: 22743645 DOI: 10.1007/s00405-012-2092-6] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2012] [Accepted: 06/13/2012] [Indexed: 10/28/2022]
Abstract
PURPOSE The patient concerns inventory (PCI) was developed to help patients raise issues/concerns during routine follow-up and to indicate team members they want to see. This paper reports the use of the PCI across various H&N Cancer sub-sites (oral, oropharyngeal and laryngeal) and stages of disease (early and late) and describes the main concerns that patients want to discuss using a cross-sectional survey comprising the PCI with the University of Washington Quality of Life questionnaire. Patients treated for primary H&N squamous cell carcinoma, 1998-2009, were identified from the University Hospital Aintree H&N Cancer database. 447/775 (58 %) patients responded. Fear of recurrence concerns was common to all clinical groups (range 32-67 %). Speech issues were more common with laryngeal tumours, and saliva issues with oropharyngeal tumours (32 % early, 48 % late). Apart from early-stage laryngeal tumours, patients consistently reported issues concerning dental health/teeth and chewing. The median (IQR) number of concerns overall was 4 (2-7), with significant variation (p < 0.001) between clinical groups ranging from 2 (1-6) for early-stage oral to 6 (2-10) for late-stage oropharyngeal and 7 (5-9) late-stage laryngeal. The results indicated that PCI can be readily incorporated into managing HNC patients and supports a holistic multidisciplinary approach to clinic consultations. It accommodates difficult issues such as fear of recurrence and intimacy. Completion of the PCI by patients before consultation can highlight problems and concerns that doctors can target for discussion, thereby streamlining consultations, and ensuring that patient needs are better met, thus creating a more effective service.
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Affiliation(s)
- A Kanatas
- Oral and Maxillofacial Surgery Department, Leeds Teaching Hospitals and St James Institute of Oncology, Leeds, UK.
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Zuydam AC, Ghazali N, Lowe D, Skelly R, Rogers SN. Evaluation of the limitations of using the University of Washington Quality of Life swallowing domain alone to screen patients in the routine clinical setting. Br J Oral Maxillofac Surg 2012; 51:e148-54. [PMID: 22721809 DOI: 10.1016/j.bjoms.2012.05.009] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2012] [Accepted: 05/23/2012] [Indexed: 11/18/2022]
Abstract
A broad patient-completed screening tool in routine clinical practice in head and neck oncology has merit, but clinicians should be aware that its simplicity could lead to some patients and the detail of their problems being missed. The purpose of this study was to compare the University of Washington Quality of Life (UWQoL) swallowing domain with the MD Anderson Dysphagia Inventory (MDADI) in relation to the need for interventions for swallowing around one year after treatment. The group comprised 112 consecutively referred patients to speech and language therapy between January 2007 and August 2009 after primary operation for previously untreated oral and oropharyngeal squamous cell carcinoma (SCC). A total of 78 patients completed questionnaires (median time of assessment 11.7 months, IQR 6.1-12.2). There were significant (p<0.001) and moderately strong correlations (rs=0.51-0.62) between the UWQoL swallowing domain score and MDADI subscales and total scores, and also with individual MDADI questions: taking a great deal of effort (rs=0.71); being upset (rs=0.61); and not going out (rs=0.62) were the strongest in regard to swallowing. Use of a gastrostomy tube was associated with worse UWQoL and MDADI scores. In conclusion, patients who score 100 on the UWQoL do not require swallowing to be evaluated further. Those who score 70 could benefit from the detailed MDADI to help to clarify the specific problem and the impact it has before being referred to speech and language therapy. Those who score less than 70 should be brought to the attention of speech and language therapists to confirm that appropriate support and intervention are in place.
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Affiliation(s)
- A C Zuydam
- University Hospital Aintree, Lower Lane, Liverpool L9 7AL, United Kingdom.
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Ghazali N, Vadukul J, Roman AM, McNeish H, Dockerill D. Evaluating the impact of the National Patient Safety Agency Guidelines on Midazolam injection on the Ambulatory, Hospital-based Conscious Sedation Services for minor oral and maxillofacial surgery. Br J Oral Maxillofac Surg 2012. [DOI: 10.1016/j.bjoms.2012.04.081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Ghazali N, Noor Ullah O, Shaw R, Risk J, Lowe D, Jones T, Rogers S, Kapoor N. Post-treatment proximal oesophageal strictures in head and neck carcinoma. Br J Oral Maxillofac Surg 2012. [DOI: 10.1016/j.bjoms.2012.04.237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Ghazali N, Collyer JC, Tighe JV. Hemimandibulectomy and vascularized fibula flap in bisphosphonate-induced mandibular osteonecrosis with polycythaemia rubra vera. Int J Oral Maxillofac Surg 2012; 42:120-3. [PMID: 22520725 DOI: 10.1016/j.ijom.2012.03.019] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2011] [Revised: 01/11/2012] [Accepted: 03/16/2012] [Indexed: 11/16/2022]
Abstract
This report presents the successful management of an advanced and refractory bisphosphonate-related osteonecrosis of the jaws (BRONJ) by hemimandibulectomy and an osteocutaneous fibula flap reconstruction in a patient with polycythaemia rubra vera, a rare haematological condition in which there is increased risk of thrombosis and haemorrhage. Union of the vascularized bone with the mandible depends on obtaining a BRONJ-free margin and rigid fixation of the bony ends. Magnetic resonance imaging can provide accurate delineation of necrotic bone and area of osteomyelitis. Placement of a 1cm margin beyond this can envisage a BRONJ-free margin. Aggressive medical management of polycythaemia rubra vera by venesection, asprin and cytoreduction therapy along with anticoagulant prophylaxis against thromboembolic events in the first 2 weeks following major surgery can provide the basis of a good surgical and flap outcome. Nevertheless, the possibility of unpredictable haemorrhage must be considered throughout.
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Affiliation(s)
- N Ghazali
- Maxillofacial Unit, Queen Victoria Hospital, East Grinstead, United Kingdom.
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Ghazali N, Cadwallader E, Lowe D, Humphris G, Ozakinci G, Rogers SN. Fear of recurrence among head and neck cancer survivors: longitudinal trends. Psychooncology 2012; 22:807-13. [PMID: 22451036 DOI: 10.1002/pon.3069] [Citation(s) in RCA: 97] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2011] [Revised: 02/01/2012] [Accepted: 02/24/2012] [Indexed: 12/16/2022]
Abstract
BACKGROUND Fear of recurrence (FoR) following head and neck cancer (HNC) treatment is a major patient concern but is infrequently discussed in outpatient settings and may cause significant detrimental effect on patient psychological well-being. AIM The aim of this paper is to determine longitudinal trends and predictors of significant FoR. METHOD Prospective data collection was obtained in 189 post-treatment HNC patients with 456 clinic attendances from October 2008 to January 2011. All patients completed Patient Concerns Inventory (PCI), University of Washington Quality of Life Questionnaire version 4 and the FoR questionnaires using a combination of paper and touch-screen technology. RESULTS The prevalence of significant FoR was 35%, which was stable longitudinally. Logistic regression-delineated predictors of significant FoR were young age (<65 years), anxiety/mood and patient-reported FoR. Conventional prognostic factors including standard clinicopathological factors, treatment modality and length of follow-up did not predict significant FoR. Over time, 20% of patients reported significant FoR intermittently, whereas 30% experienced it consistently. The remaining 50% did not experience significant FoR. DISCUSSION Patient-related characteristics were more important than clinicopathological prognostic factors in predicting significant FoR, potentially creating a mismatch between the doctors' perception of patient's experience of FoR with what patients may experience. In the long term, FoR is expressed across a spectrum extending from 'normal' FoR to persistent significant FoR with an intermediate category of intermittent significant FoR. Those patients experiencing intermittent and consistent levels of significant FoR may benefit from psychological support. This study confirmed that self-reported screening FoR using the PCI is a valuable tool in identifying significant FoR.
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Affiliation(s)
- Naseem Ghazali
- Regional Maxillofacial Unit, University Hospital Aintree, Lower Lane, Liverpool, UK.
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Kanatas A, Ghazali N, Lowe D, Rogers SN. The identification of mood and anxiety concerns using the patients concerns inventory following head and neck cancer. Int J Oral Maxillofac Surg 2012; 41:429-36. [PMID: 22264641 DOI: 10.1016/j.ijom.2011.12.021] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [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: 02/26/2011] [Revised: 11/30/2011] [Accepted: 12/07/2011] [Indexed: 12/16/2022]
Abstract
The aim of this study was to investigate the concurrent use of the Patient Concerns Inventory (PCI) and the University of Washington Quality of life instruments (UW-QOL), as a means of identifying mood and anxiety concerns in patients following head and neck cancer treatment. From August 2007 to July 2009, 204 patients (454 clinic appointments) attending one consultant's oncology review clinic completed the UW-QOLv4 and PCI prior to their consultation. Before entering consultations, 17% (79/454) of patients reported problems with mood and 20% (89/454) reported problems with anxiety on the UW-QOL. Regarding the items raised by patients using the PCI prior to consultation, 'mood' was raised in 10% (46/454), 'anxiety' in 13% (58/454) and 'depression' in 10% (44/454) of cases. In 32% (145/454) of consultations, 44% (89/204) patients had reported significant anxiety or mood problems on the UW-QOL, or highlighted issues of anxiety, mood and/or depression on the PCI for discussion. Patients completing the PCI were more often referred to the clinical psychologist and to the emotional support worker. The results showed that the combination of the UW-QOL questionnaire and the PCI provide a practical means of screening for psychological distress in clinics.
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Affiliation(s)
- A Kanatas
- Oral and Maxillofacial Surgery, Leeds Teaching Hospitals and St James Institute of Oncology, Leeds, UK
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Bekiroglu F, Ghazali N, Laycock R, Katre C, Lowe D, Rogers S. Adjuvant radiotherapy and health-related quality of life of patients at intermediate risk of recurrence following primary surgery for oral squamous cell carcinoma. Oral Oncol 2011; 47:967-73. [DOI: 10.1016/j.oraloncology.2011.07.003] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2011] [Revised: 06/30/2011] [Accepted: 07/05/2011] [Indexed: 10/17/2022]
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Flexen J, Ghazali N, Lowe D, Rogers SN. Identifying appearance-related concerns in routine follow-up clinics following treatment for oral and oropharyngeal cancer. Br J Oral Maxillofac Surg 2011; 50:314-20. [PMID: 21680066 DOI: 10.1016/j.bjoms.2011.05.005] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2011] [Accepted: 05/10/2011] [Indexed: 02/08/2023]
Abstract
Facial disfigurement can be a consequence of treatment for oral or oropharyngeal cancer. Patients' concerns about appearance and the impact this has on quality of life are very important, but are often not recognised in a busy outpatient clinic. We aimed to assess concerns about appearance using the University of Washington Quality of Life questionnaire version 4 (UW-QoL) and the Patient Concerns Inventory (PCI), a self-administered questionnaire that allows patients to choose what they would like to discuss in their consultation. Prospective data were collected from 204 patients who attended routine follow-up clinics from August 2007 to mid-July 2009. Fifty-seven percent were male, 68% had cancer of the oral cavity, 78% had clinical T1-T2 tumours, 19% had node positive tumours, 44% had had radiotherapy since diagnosis, and 48% had had free-flap reconstructive surgery. They all completed the questionnaires using touch-screen computer technology at 454 clinic appointments. Appearance was raised on the inventory at 9% (42/454) of clinics, and at 10% (47/454) it was indicated as a serious problem on the UW-QoL questionnaire. Concerns about appearance were raised on the inventory or were shown to be a serious problem on the UW-QoL in 14% (64/454) of patients. The main factors associated with those who reported concerns about appearance were age (younger patients), sex (female), T stage (III and IV), and site (oropharynx). Patients who choose concerns about appearance for discussion on the UW-QoL questionnaire and not on the PCI risk being missed if only the PCI is completed. Both tools compliment the screening of patients who have problems with facial disfigurement; failure to identify them can have serious clinical and psychosocial implications.
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Affiliation(s)
- J Flexen
- Foundation Dentist Year 1, 303-305 Mill Lane, St. Helens, WA9 4EU Merseyside, UK.
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Ghazali N, Swann H, Rogers S, Lowe D. Longitudinal trends in fear of recurrence amongst head and neck cancer survivors. Br J Oral Maxillofac Surg 2011. [DOI: 10.1016/j.bjoms.2011.04.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Ghazali N, Cascarini L, Norris P, Barrett A, Lavery KM. Perivascular epithelioid cell tumor (PEComa) of the cheek. ACTA ACUST UNITED AC 2010; 110:e26-31. [DOI: 10.1016/j.tripleo.2009.10.053] [Citation(s) in RCA: 15] [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] [Received: 09/09/2008] [Revised: 08/10/2009] [Accepted: 10/23/2009] [Indexed: 01/25/2023]
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Kichenaradjou A, Beale V, Ghazali N, Haers P. Aesthetic and occlusal outcomes in cleft orthognathic surgery. Br J Oral Maxillofac Surg 2009. [DOI: 10.1016/j.bjoms.2009.06.059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Karavidas K, Papadogeorgakis N, Ghazali N, Parara E, Zouloumis L, Alexandridis K, Lazaridis N, McGurk M. The use of the three-dimensional surface imaging camera in the evaluation of Frey's syndrome and facial asymmetry in minimal invasive surgery for benign parotid tumours. Int J Oral Maxillofac Surg 2009. [DOI: 10.1016/j.ijom.2009.03.313] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Cusack R, Ghazali N, Johnson P. Outcomes of malar augmentation using medpore implants. Br J Oral Maxillofac Surg 2008. [DOI: 10.1016/j.bjoms.2008.07.059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Ghazali N, Bentley R, Tan S, Hameed S, Ebert J, Coward T, Huppa C. Outcomes of cranioplasty using computer-aided designed titanium plates. Br J Oral Maxillofac Surg 2007. [DOI: 10.1016/j.bjoms.2007.07.079] [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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Ghazali N, Ghazali N, Haers P, Abizadeh N, Edler R. The trans-sinusoidal maxillary distractor system for interceptive correction of unilateraol cleft lip and palate maxillary hypoplasia. Br J Oral Maxillofac Surg 2007. [DOI: 10.1016/j.bjoms.2007.07.069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Ghazali N, Abizadeh N, Nacher C, Connolly N, Bentley R, Huppa C. Co-managing patients with obstructive sleep apnoea-hypopnoea using oral mandibular advancement device: The King's College Hospital Maxillofacial Unit experience. Br J Oral Maxillofac Surg 2007. [DOI: 10.1016/j.bjoms.2007.07.159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Abstract
BACKGROUND Some oral verrucal lesions may constitute parts of the clinicopathological spectrum of proliferative verrucous leukoplakia (PVL). Because of its idiopathic yet sinister nature, it is possible that PVL may exist in other populations. The aim of this study was to review the clinicopathological features of persistent, multifocal, oral verrucal lesions in Malaysian population. METHODS Patients with multifocal oral verrucal lesions were selected from surgical and histopathological records. RESULTS Nine patients of diverse ethnicity with 43 biopsies were reviewed. The mean age at the presentation was 62 years. The most frequent sites affected were gum, sulci, cheek and tongue. Indulgence in risk habits was reported in about 70% of patients. Four cases developed multifocal carcinoma from multifocal leukoplakia. CONCLUSIONS In retrospect, none of the cases fulfilled the original PVL criteria, although three cases were suggestive of PVL. Nevertheless, these findings do not necessarily preclude the existence of PVL as a clinicopathological entity in Malaysian population.
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Affiliation(s)
- Naseem Ghazali
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, University of Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, 50300 Kuala Lumpur, Malaysia
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