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Touré M, Sfairy SM, Bédard SK, McFadden N, Hanel R, Lemay F, He J, Pavic M, Poder TG. Cancer population norms using a new value set for the SF-6Dv2 based on the preferences of patients with breast or colorectal cancer in Quebec. Qual Life Res 2024:10.1007/s11136-024-03653-9. [PMID: 38642218 DOI: 10.1007/s11136-024-03653-9] [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] [Accepted: 03/15/2024] [Indexed: 04/22/2024]
Abstract
BACKGROUND Because health resources are limited, health programs should be compared to allow the most efficient ones to emerge. To that aim, health utility instruments have been developed to allow the calculation of quality-adjusted life-year (QALY). However, generic instruments, which can be used by any individual regardless of their health profile, typically consider the preferences of the general population when developing their value set. Consequently, they are often criticized for lacking sensitivity in certain domains, such as cancer. In response, the latest version of the Short Form 6-Dimension (SF-6Dv2) has been adapted to suit the preferences of patients with breast or colorectal cancer in the Canadian province of Quebec. By extension, our study's aim was to determine cancer population norms of utility among patients with breast or colorectal cancer in Quebec using the SF-6Dv2. METHOD To determine the cancer population norms, we exploited the data that were used in the development of a new value set for the SF-6Dv2. This value set was developed considering the preferences of patients with breast or colorectal cancer. Stratification by time of data collection (i.e., T1 and T2), sociodemographic variables (i.e., age, sex, body mass index, and self-reported health problems affecting quality of life), and clinical aspects (i.e., cancer site, histopathological classification, cancer stage at diagnosis, modality, and treatment characteristics) was performed. RESULTS In 353 observations, patients were more likely to have negative utility scores at T1 than at T2. Males had higher mean utility scores than females considering type of cancer and comorbidities. Considering the SF-6Dv2's dimensions, more females than males reported having health issues, most which concerned physical functioning. Significant differences by sex surfaced for all dimensions except "Role Limitation" and "Mental health." Patients with multifocal cancer had the highest mean and median utility values in all cancer sites considered. CONCLUSION Cancer population norms can serve as a baseline for interpreting the scores obtained by a given population in comparison to the situation of another group. In this way, our results can assist in comparing utility scores among cancer patients with different sociodemographic groups to other patients/populations groups. To our knowledge, our identified utility norms are the first for patients with breast or colorectal cancer from Quebec.
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Affiliation(s)
- Moustapha Touré
- Département d'économie, École de Gestion, Université de Sherbrooke, Sherbrooke, QC, Canada
- Centre de Recherche de l'IUSMM, CIUSSS de l'Est de L'île de Montréal, Montréal, QC, Canada
| | - Sarah-Maria Sfairy
- Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Suzanne K Bédard
- Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Nathalie McFadden
- Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Robert Hanel
- Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Frédéric Lemay
- Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, QC, Canada
- Institut de Recherche sur le Cancer de l'Université de Sherbrooke, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Jie He
- Département d'économie, École de Gestion, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Michel Pavic
- Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, QC, Canada
- Institut de Recherche sur le Cancer de l'Université de Sherbrooke, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Thomas G Poder
- Centre de Recherche de l'IUSMM, CIUSSS de l'Est de L'île de Montréal, Montréal, QC, Canada.
- Département de gestion, d'évaluation et de politiques de santé, École de santé publique, Université de Montréal, Montréal, QC, Canada.
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Difficult cholecystectomy with cholecystogastric fistula12. Surviving nonsurvivable injuries: patients who elude the “lethal” Abbreviated Injury Scale (AIS) score of six13. Gunshot wounds sustained during legal intervention v. those inflicted by civilians: a comparative analysis14. The impact of delayed time to first head CT on functional outcomes after blunt head trauma with moderately depressed GCS15. Contemporary utility of diagnostic peritoneal aspiration in trauma16. Impact of delayed time to first head CT in traumatic brain injury17. Radiologic predictors of in-hospital mortality after traumatic craniocervical dissociation18. Measurement properties of a patient-reported instrument to evaluate functional status after major surgery19. The safety of venous thromboembolism chemoprophylaxis use in endoscopic retrograde cholangiopancreatography20. Characterizing Canadian rural surgeons: trends over time and 10-year replacement needs21. Contextual interference for skills development and transfer in laparoscopic surgery: a randomized controlled trial22. Evaluating the accuracy and design of visual backgrounds in academic surgical journals23. Defining rural surgery in Canada24. Validity of video-based general and procedure-specific self-assessment tools for surgical trainees in laparoscopic cholecystectomy25. Examining the equity and diversity characteristics of academic general surgeons in Canada26. Video-based coaching for surgical residents: a systematic review and meta-analysis27. Very-low-energy diets prior to nonbariatric surgery: a systematic review and meta-analysis28. Factors associated with resident research success: a descriptive analysis of Canadian general surgery trainees29. Global surgery pilot curriculum in Canadian undergraduate medical education: a novel approach30. How useful is ultrasound in predicting surgical findings of “mild cholecystitis”?31. Implementing a colorectal surgery “virtual hospital”: description of a novel outpatient care pathway to advance surgical care32. Trends in training and workforce planning for Canadian pediatric surgeons: a 10-year model33. Patient perspectives on intraoperative blood transfusion: results of semistructured interviews with perioperative patients34. Understanding intraoperative transfusion decision-making variability: a qualitative study using the Theoretical Domains Framework35. Effectiveness of preoperative oscillating positive expiratory pressure (OPEP) therapy in reduction of postoperative respiratory morbidity in patients undergoing surgery: a systematic review37. Accuracy of point-of-care testing devices for hemoglobin in the operating room: a systematic review and meta-analysis38. Opioid-free analgesia after outpatient general surgery: a qualitative study focused on the perspectives of patients and clinicians involved in a pilot trial39. The impact of the COVID-19 pandemic on general surgery residency: an analysis of operative volumes by residents at a Canadian general surgery residency program40. Postoperative care protocols for elderly emergency surgical patients: a quality improvement initiative42. Adverse events following robotic compared to laparoscopic and open surgery: a population-based analysis43. Is accrual higher for patients randomized to pragmatic v. exploratory randomized clinical trials? A systematic review and meta-analysis44. Effect of preoperative proton-pump inhibitor use on postoperative infectious and renal complications after elective general surgery45. The early burden of COVID-19 in emergency general surgery care across Canada46. Laparoscopic subtotal cholecystectomy for the difficult gallbladder: evolution of technique at a single teaching hospital and retrospective review47. The demand for emergency general surgery in Canada: a public health crisis48. Attitudes of Canadian general surgery staff and residents toward point-of-care ultrasound49. Psychological impact of COVID-19 on Canadian surgical residents50. Validation of an artificial intelligence platform for the guidance of safe laparoscopic cholecystectomy51. Predictors of recurrent appendicitis after nonoperative management: a prospective cohort study52. The effect of the first wave of the COVID-19 pandemic on colorectal and hepatobiliary oncologic outcomes at a tertiary care centre53. Trends in training and workforce representation for Canadian general surgeons working in critical care: a descriptive study54. White presentation: teaching safe opioid prescription and opioid use disorder management in Canadian universities56. How bad is really bad, eh? Impact of the first wave of the COVID-19 pandemic on residents’ operative volume: the experience of a Canadian general surgery program57. Surgeon-specific encounters within a multidisciplinary care pathway: Is there a role for shared care models in surgery?59. A pan-Canadian analysis of approach to treatment for acute appendicitis60. Appendix neoplasm stratified by age: understanding the best treatment for appendicitis61. Predicting acute cholecystitis on final pathology to prioritize surgical urgency: an evaluation of the Tokyo criteria and development of a novel predictive score62. Obesity is an independent predictor of acute renal failure after surgery64. Validation of a clinical decision-making assessment tool in general surgery65. Moral distress in the provision of palliative care delivery for surgical patients in British Columbia: lessons learned from the perspectives of general surgeons66. Delays in presentation and severity of illness predict adverse surgical outcomes among patients transferred from rural Indigenous communities for acute care surgery67. Remote video-based suturing education with smartphones (REVISE): a randomized controlled trial68. Modified Delphi consensus on appropriate use of laboratory investigations in acute care surgery patients72. Impacts of inpatient food at a tertiary care centre on patient satisfaction, nutrition and planetary health73. Racial disparities in health outcomes for oncological surgery in Canada75. Risk of recurrent laryngeal nerve injury from thyroidectomy is lower when intraoperative nerve monitoring (IONM) is used: an analysis of 17 688 patients from the NSQIP database01. The impact of the COVID-19 pandemic on non-smallcell lung cancer pathologic stage and presentation02. Screening criteria evaluation for expansion in pulmonary neoplasias (screen)03. Robotic-assisted lobectomy for early-stage lung cancer provides better patient-reported quality of life than video-assisted lobectomy: early results of the RAVAL trial04. Breathe Anew: designing and testing the feasibility of a novel intervention for lung cancer survivorship05. Learning objectives for thoracic surgery: developing a national standard for undergraduate medical education06. Plasma cell-free DNA as a point-of-care well-being biomarker for early-stage non-small-cell lung cancer patients07. Sarcopenia determined by skeletal muscle index predicts overall survival, disease-free survival and postoperative complications in resectable esophageal cancer: a systematic review and meta-analysis08. The short- and long-term effects of open v. minimally invasive thymectomy in myasthenia gravis patients: a systematic review and meta-analysis09. Optimizing opioid prescribing practices following minimally invasive lung resections through a structured quality improvement process10. Effects of virtual postoperative postdischarge care in patients undergoing lung resection during the COVID-19 pandemic11. Initiating Ethiopia’s first minimally invasive surgery program: a novel approach for collaborations in global surgical education12. Patient outcomes following salvage lung cancer surgery after definitive chemotherapy or radiation13. Replacing chest X-rays after chest tube removal with clinical assessment in postoperative thoracic surgery patients14. Updating the practice of thoracic surgery in Canada: a survey of the Canadian Association of Thoracic Surgeons15. The impact of COVID-19 on the diagnosis and treatment of lung cancer16. Development of a prediction model for survival time in esophageal cancer patients treated with resection17. The development and validation of a mixed reality thoracic surgical anatomy atlas18. Routine placement of feeding tubes should be avoided in esophageal cancer patients undergoing surgery19. Nodal count is no different during robotic segmentectomy compared with robotic lobectomy20. Point-of-care ultrasound-guided percutaneous biopsy of solid masses in the thoracic outpatient clinic: a safe, high-yield procedure to accelerate tissue diagnosis for patients with advanced thoracic malignancy21. Sarcopenia and modified frailty index are not associated with adverse outcomes after esophagectomy for esophageal cancer: a retrospective cohort study22. Near-infrared-guided segmental resection for lung cancer: an analysis of the learning curve23. Routine use of feeding jejunostomy tubes in patients undergoing esophagectomy for esophageal malignancy is safe and associated with low complication rates01. Ghost ileostomy versus loop ileostomy following total mesorectal excision for rectal cancer: a systematic review and meta-analysis02. Analysis of 100 consecutive colorectal cancers presenting at a Canadian tertiary care centre: delayed diagnosis and advanced disease03. Clinical delays and comparative outcomes in younger and older adults with colorectal cancer: a systematic review04. Recurrence rates of rectal cancer after transanal total mesorectal excision (taTME): a systematic review and meta-analysis05. Transanal total mesorectal excision for abdominoperineal resection (taTME-APR) is associated with poor oncological outcomes in rectal cancer patients: a word of caution from a multicentric Canadian cohort study06. Association between survival and receipt of recommended and timely treatment in locally advanced rectal cancer: a population-based study07. Trends and the impact of incomplete preoperative staging in rectal cancer08. Postoperative outcomes after elective colorectal surgery in patients with cirrhosis09. Bowel stimulation before loop ileostomy closure to reduce postoperative ileus: a multicentre, single-blinded, randomized controlled trial10. Recurrence following perineal rectosigmoidectomy ( Altemeier) with levatorplasty: a systematic review and meta-analysis11. Nonmodifiable risk factors and receipt of surveillance investigations following treatment of rectal cancer12. Safety and effectiveness of endoscopic full-thickness resection for the management of colorectal lesions: a systematic review and meta-analysis13. Impact of preoperative carbohydrate loading before colectomy: a systematic review and meta-analysis of randomized controlled trials14. Statin therapy in patients undergoing short-course neoadjuvant radiotherapy for rectal cancer15. Feasibility of targeted lymphadenectomy during complete mesocolic excision for colon cancer using indocyanine green immunofluorescence lymphatic mapping16. Feasibility of expanding an ambulatory colectomy protocol: a retrospective analysis of early discharge following minimally invasive colectomy in an enhanced recovery pathway17. Impact of rectal cancer on bowel dysfunction before treatment and its relationship with post-treatment function18. Canadian cost–utility analysis of artificial-intelligence-assisted colonoscopy for adenoma detection in fecal immunochemical-based colorectal cancer screening19. A comparison of outcomes following intracorporeal and extracorporeal anastomotic techniques in laparoscopic right colectomies20. Assessment of metabolic signatures using desorption electrospray ionization mass spectrometry (DESI) and rapid evaporative ionization mass spectrometry (REIMS) of rectal cancer samples to assist in determining treatment response21. The association between hospital characteristics and minimally invasive rectal cancer surgery: a population-based study22. Cancer centre level designation and the impact on treatment and outcomes in those with rectal cancer: a population-based study23. Oncological outcomes after colorectal cancer in patients with liver cirrhosis: a systematic review and meta-analysis24. Optimal preoperative nutrition for penetrating Crohn disease: a systematic review and meta-analysis25. Lymph node ratio as a predictor of survival for colon cancer: a systematic review and meta-analysis26. Barriers and facilitators for use of new recommendations for optimal endoscopic localization of colorectal neoplasms according to gastroenterologists and surgeons27. Emergency colorectal surgery in patients with cirrhosis: a population-based descriptive study28. Local recurrence rates and associated risk factors after transanal endoscopic microsurgery for benign polyps and adenocarcinomas29. Bowel dysfunction impacts mental health after restorative proctectomy for rectal cancer30. Evolution of psychological morbidity following restorative proctectomy for rectal cancer: a systematic review and meta-analysis31. Frailty predicts LARS and quality of life in rectal cancer survivors after restorative proctectomy32. Low anterior resection syndrome in a reference North American population: prevalence and predictive factors33. The evolution of enhanced recovery: same day discharge after laparoscopic colectomy34. Effect of ERAS protocols on length of stay after colorectal surgery: an interrupted time series analysis35. Practice patterns and outcomes in individuals with cirrhosis and colorectal cancer: a population-based study36. Understanding the impact of bowel function on quality of life after rectal cancer surgery37. Right-sided colectomies for diverticulitis have worse outcomes compared with left-sided colectomies38. Symptom burden and time from symptom onset to cancer diagnosis in patients with early-onset colorectal cancer39. The impact of access to robotic rectal surgery at a tertiary care centre: a Canadian perspective40. Management of rectal neuroendocrine tumours by transanal endoscopic microsurgery41. The gut microbiota modulates colorectal anastomotic healing in patients undergoing surgery for colorectal cancer42. Is there added risk of complications for concomitant procedures during an ileocolic resection for Crohn disease?43. Cost of stoma-related hospital readmissions for rectal cancer patients following restorative proctectomy with a diverting loop ileostomy: a nationwide readmissions database analysis44. Older age associated with quality of rectal cancer care: an ACS-NSQIP database study45. Outcomes of patients undergoing elective bowel resection before and after implementation of an anemia screening and treatment program47. Loop ileostomy closure as a 23-hour stay procedure: a randomized controlled trial48. Extended duration perioperative thromboprophylaxis with low-molecular-weight heparin to improve disease-free survival following surgical resection of colorectal cancer: a multicentre randomized controlled trial (PERIOP-01 Trial)49. Three-stage versus modified 2-stage ileal pouch anal anastomosis: perioperative outcomes, function and quality of life50. Compliance with extended venous thromboembolism prophylaxis in rectal cancer51. Extended-duration venous thromboembolism prophylaxis after diversion in rectal cancer52. Financial and occupational impact of low anterior resection syndrome: a qualitative study53. Nonoperative management for rectal cancer: patient perspectives54. Trends in ileostomy-related emergency department visits for rectal cancer patients55. Long-term implications of treatment of fecal incontinence: a single Canadian centre’s retrospective cohort study: a 17-year follow-up56. Externally benchmarking colorectal resection outcomes in our province against the ACS NSQIP risk calculator: identifying opportunities for improvement57. Externally benchmarking our provincial colectomy outcomes against the ACS NSQIP using the Codman Score: to identify possible opportunities for improvement of outcomes58. Rural v. urban documentation of recommended practices for optimal endoscopic colorectal lesion localization01. Incidence of in-hospital opioid use and pain after inguinal hernia repair02. Ventral hernia repair following liver transplantation: outcome of repair techniques and risk factors for recurrence01. Impact of the COVID-19 pandemic on bariatric surgery in North America: a retrospective analysis of 834 647 patients02. Patient selection and 30-day outcomes of SADI-S compared to RYGB: a retrospective cohort study of 47 375 patients03. New persistent opioid use following bariatric surgery: a systematic review and pooled proportion meta-analysis04. Bariatric surgery should be offered to active-duty military personnel: a retrospective study of the Canadian Armed Forces experience05. Opioid prescribing practices and use following bariatric surgery: a systematic review and pooled summary of data06. Sacred sharing circles: urban Indigenous Manitobans’ experiences with bariatric surgery07. Gastrogastric hernia after laparoscopic gastric great curve plication: a video presentation08. Characterization of comorbidities predictive of bariatric surgery09. Efficacy of preoperative high-dose liraglutide in patients with superobesity10. The effect of linear stapled gastrojejunostomy size in Roux-en-Y gastric bypass11. Fragility of statistically significant outcomes in randomized trials comparing bariatric surgeries12. Weight loss outcomes for patients undergoing conversion to Roux-en-Y gastric bypass after sleeve gastrectomy13. Are long waiting lists for bariatric surgery detrimental to patients? A single-centre experience14. Does upper gastrointestinal swallow study after bariatric surgery lead to earlier detection of leak?15. Pharmaceutical utilization before and after bariatric surgery16. Same-day discharge Roux-en-Y gastric bypass at a Canadian bariatric centre: pathway implementation and early experiences17. Safety and efficiency of performing primary bariatric surgery at an ambulatory site of a tertiary care hospital: a 5-year experience18. Impact of psychiatric diagnosis on weight loss outcomes 3 years after bariatric surgery19. Ursodeoxycholic acid (UDCA) for prevention of gallstone disease after laparoscopic sleeve gastrectomy (LSG): an Atlantic Canada perspective20. Fecal microbial transplantation and fibre supplementation in patients with severe obesity and metabolic syndrome: a randomized double-blind, placebo-controlled phase 2 trial01. Incidence, timing and outcomes of venous thromboembolism in patients undergoing surgery for esophagogastric cancer: a population-based cohort study04. Omission of axillary staging and survival in elderly women with early-stage breast cancer: a population-based cohort study05. Patients’ experiences receiving cancer surgery during the COVID-19 pandemic: a qualitative study06. Cancer surgery outcomes are better at high-volume centres07. Attitudes of Canadian colorectal cancer care providers toward liver transplantation for colorectal liver metastases: a national survey08. Quality of narrative central and lateral neck dissection reports for thyroid cancer treatment suggests need for a national standardized synoptic operative template09. Transoral endoscopic thyroidectomy vestibular approach (TOETVA): indications and technique10. Temporal trends in lymph node assessment as a quality indicator in colorectal cancer patients treated at a high-volume Canadian centre11. Molecular landscape of early-stage breast cancer with nodal metastasis12. Beta testing of a risk-stratified patient decision aid to facilitate shared decision making for postoperative extended thromboprophylaxis in patients undergoing major abdominal surgery for cancer13. Breast reconstruction use and impact on oncologic outcomes among inflammatory breast cancer patients: a systematic review14. Association between patient-reported symptoms and health care resource utilization: a first step to develop patient-centred value measures in cancer care15. Complications after colorectal liver metastases resection in Newfoundland and Labrador16. Why do patients with nonmetastatic primary retroperitoneal sarcoma not undergo resection?17. Loss of FAM46Cexpression predicts inferior postresection survival and induces ion channelopathy in gastric adenocarcinoma18. Liver-directed therapy of neuroendocrine liver metastases19. Neoadjuvant pembrolizumab use in microsatellite instability high (MSI-H) rectal cancer: benefits of its use in lynch syndrome20. MOLLI for excision of nonpalpable breast lesions: a case series22. Patients awaiting mastectomy report increased depression, anxiety, and decreased quality of life compared with patients awaiting lumpectomy for treatment of breast cancer23. Is microscopic margin status important in retroperitoneal sarcoma (RPS) resection? A systematic review and meta-analysis24. Absence of benefit of routine surveillance in very-low-risk and low-risk gastric gastrointestinal stromal tumors25. Effect of intraoperative in-room specimen radiography on margin status in breast-conserving surgery26. Active surveillance for DCIS of the breast: qualitative interviews with patients and physicians01 Outcomes following extrahepatic and intraportal pancreatic islet transplantation: a comparative cohort study02. Cholang-funga-gitis03. Evaluating the effect of a low-calorie prehepatectomy diet on perioperative outcomes: a systematic review and meta-analysis04. Toxicity profiles of systemic therapy for advanced hepatocellular carcinoma: a systematic review to guide neoadjuvant trials05. Should cell salvage be used in liver resection and transplantation? A systematic review and meta-analysis06. The association between surgeon and hospital variation in use of laparoscopic liver resection and short-term outcomes07. Systematic review and meta-analysis of prognostic factors for early recurrence in intrahepatic cholangiocarcinoma after curative-intent resection08. Impact of neoadjuvant chemotherapy on postoperative outcomes of patients undergoing hepatectomy for intrahepatic cholangiocarcinoma: ACS-NSQIP propensity-matched analysis09. The impact of prophylactic negative pressure wound therapy on surgical site infections in pancreatic resection: a systematic review and meta-analysis10. Does hepatic pedicle clamping increase the risk of colonic anastomotic leak after combined hepatectomy and colectomy? Analysis of the ACS NSQIP database11. Development of a culture process to grow a full-liver tissue substitute12. Liver transplantation for fibrolamellar hepatocellular carcinoma: an analysis of the European Liver Transplant Registry13. Arming beneficial viruses to treat pancreatic cancer14. Hepaticoduodenostomy versus hepaticojenunostomy for biliary reconstruction: a retrospective review of a single-centre experience15. Feasibility and safety of a “shared care” model in complex hepatopancreatobiliary surgery: a 5-year analysis of pancreaticoduodenectomy16. Laparoscopic v. open pancreaticoduodenectomy: initial institutional experience and NSQIP-matched analysis17. Laparoscopic spleen-preserving distal pancreatectomy: Why not do a Warshaw?18. The impact of COVID-19 on pancreaticoduodenectomy outcomes in a high-volume hepatopancreatobiliary centre19. Transitioning from open to minimally invasive pancreaticoduodenectomy: the learning curve factor in an academic centre20. Closed-incision negative-pressure wound therapy following pancreaticoduodenectomy for prevention of surgical site infections in high-risk patients21. Robotic Appleby procedure for recurrent pancreatic cancer22. The influence of viral hepatitis status on posthepatectomy complications in patients with hepatocellular carcinoma: a NSQIP analysis. Can J Surg 2022. [DOI: 10.1503/cjs.014322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
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Reid M, Lee A, Leslie K, Feldman LS, Hameed SM, Kirkpatrick R, Lovrics PJ, MacDonald PH, Pace D, Shaw JM, Swallow CJ, Pagliarello G, Bigam DL, Porter G, Mathieson A, McFadden N, Lapointe R, MacLean T, Kuziemsky C, Balaa F. A framework for role allocation in education, research and leadership services in Canadian academic divisions of general surgery: a modified Delphi consensus. Can J Surg 2022; 65:E73-E81. [PMID: 35115320 PMCID: PMC8820837 DOI: 10.1503/cjs.021120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/09/2021] [Indexed: 11/02/2022] Open
Affiliation(s)
- Morgann Reid
- From the Telfer School of Management, University of Ottawa, Ottawa, Ont. (Reid); the Division of General Surgery, Department of Surgery, Faculty of Medicine, University of Ottawa, Ottawa, Ont. (Lee, Pagliarello, Balaa); the Division of General Surgery, Department of Surgery, Schulich School of Medicine and Dentistry, Western University, London, Ont. (Leslie); the Department of Surgery, McGill University, Montréal, Que. (Feldman); the Department of Surgery, University of British Columbia, Vancouver, BC (Hameed); the Division of Clinical Sciences, Northern Ontario School of Medicine, Laurentian University, Sudbury, and Lakehead University, Thunder Bay, Ont. (Kirkpatrick); the Division of Surgery, McMaster University, Hamilton, Ont. (Lovrics); the Department of Surgery, Queen's University, Kingston, Ont. (MacDonald); the Department of Surgery, Memorial University of Newfoundland, St. John's, Nfld. (Pace, Mathieson); the College of Medicine, University of Saskatchewan, Saskatoon, Sask. (Shaw); the Department of Surgery, Mount Sinai Hospital, University of Toronto, Toronto, Ont. (Swallow); the Department of Surgery, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alta. (Bigam, Porter); the Division of General Surgery, Department of Surgery, Université de Sherbrooke, Sherbrooke, Que. (McFadden); the Division of General Surgery, Department of Surgery, Université de Montréal, Montréal, Que. (Lapointe); the Department of Surgery, Foothills Medical Centre, University of Calgary, Calgary, Alta. (MacLean); and the Office of Research Services and School of Business, MacEwan University, Edmonton, Alta. (Kuziemsky)
| | - Alex Lee
- From the Telfer School of Management, University of Ottawa, Ottawa, Ont. (Reid); the Division of General Surgery, Department of Surgery, Faculty of Medicine, University of Ottawa, Ottawa, Ont. (Lee, Pagliarello, Balaa); the Division of General Surgery, Department of Surgery, Schulich School of Medicine and Dentistry, Western University, London, Ont. (Leslie); the Department of Surgery, McGill University, Montréal, Que. (Feldman); the Department of Surgery, University of British Columbia, Vancouver, BC (Hameed); the Division of Clinical Sciences, Northern Ontario School of Medicine, Laurentian University, Sudbury, and Lakehead University, Thunder Bay, Ont. (Kirkpatrick); the Division of Surgery, McMaster University, Hamilton, Ont. (Lovrics); the Department of Surgery, Queen's University, Kingston, Ont. (MacDonald); the Department of Surgery, Memorial University of Newfoundland, St. John's, Nfld. (Pace, Mathieson); the College of Medicine, University of Saskatchewan, Saskatoon, Sask. (Shaw); the Department of Surgery, Mount Sinai Hospital, University of Toronto, Toronto, Ont. (Swallow); the Department of Surgery, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alta. (Bigam, Porter); the Division of General Surgery, Department of Surgery, Université de Sherbrooke, Sherbrooke, Que. (McFadden); the Division of General Surgery, Department of Surgery, Université de Montréal, Montréal, Que. (Lapointe); the Department of Surgery, Foothills Medical Centre, University of Calgary, Calgary, Alta. (MacLean); and the Office of Research Services and School of Business, MacEwan University, Edmonton, Alta. (Kuziemsky)
| | - Ken Leslie
- From the Telfer School of Management, University of Ottawa, Ottawa, Ont. (Reid); the Division of General Surgery, Department of Surgery, Faculty of Medicine, University of Ottawa, Ottawa, Ont. (Lee, Pagliarello, Balaa); the Division of General Surgery, Department of Surgery, Schulich School of Medicine and Dentistry, Western University, London, Ont. (Leslie); the Department of Surgery, McGill University, Montréal, Que. (Feldman); the Department of Surgery, University of British Columbia, Vancouver, BC (Hameed); the Division of Clinical Sciences, Northern Ontario School of Medicine, Laurentian University, Sudbury, and Lakehead University, Thunder Bay, Ont. (Kirkpatrick); the Division of Surgery, McMaster University, Hamilton, Ont. (Lovrics); the Department of Surgery, Queen's University, Kingston, Ont. (MacDonald); the Department of Surgery, Memorial University of Newfoundland, St. John's, Nfld. (Pace, Mathieson); the College of Medicine, University of Saskatchewan, Saskatoon, Sask. (Shaw); the Department of Surgery, Mount Sinai Hospital, University of Toronto, Toronto, Ont. (Swallow); the Department of Surgery, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alta. (Bigam, Porter); the Division of General Surgery, Department of Surgery, Université de Sherbrooke, Sherbrooke, Que. (McFadden); the Division of General Surgery, Department of Surgery, Université de Montréal, Montréal, Que. (Lapointe); the Department of Surgery, Foothills Medical Centre, University of Calgary, Calgary, Alta. (MacLean); and the Office of Research Services and School of Business, MacEwan University, Edmonton, Alta. (Kuziemsky)
| | - Liane S Feldman
- From the Telfer School of Management, University of Ottawa, Ottawa, Ont. (Reid); the Division of General Surgery, Department of Surgery, Faculty of Medicine, University of Ottawa, Ottawa, Ont. (Lee, Pagliarello, Balaa); the Division of General Surgery, Department of Surgery, Schulich School of Medicine and Dentistry, Western University, London, Ont. (Leslie); the Department of Surgery, McGill University, Montréal, Que. (Feldman); the Department of Surgery, University of British Columbia, Vancouver, BC (Hameed); the Division of Clinical Sciences, Northern Ontario School of Medicine, Laurentian University, Sudbury, and Lakehead University, Thunder Bay, Ont. (Kirkpatrick); the Division of Surgery, McMaster University, Hamilton, Ont. (Lovrics); the Department of Surgery, Queen's University, Kingston, Ont. (MacDonald); the Department of Surgery, Memorial University of Newfoundland, St. John's, Nfld. (Pace, Mathieson); the College of Medicine, University of Saskatchewan, Saskatoon, Sask. (Shaw); the Department of Surgery, Mount Sinai Hospital, University of Toronto, Toronto, Ont. (Swallow); the Department of Surgery, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alta. (Bigam, Porter); the Division of General Surgery, Department of Surgery, Université de Sherbrooke, Sherbrooke, Que. (McFadden); the Division of General Surgery, Department of Surgery, Université de Montréal, Montréal, Que. (Lapointe); the Department of Surgery, Foothills Medical Centre, University of Calgary, Calgary, Alta. (MacLean); and the Office of Research Services and School of Business, MacEwan University, Edmonton, Alta. (Kuziemsky)
| | - S Morad Hameed
- From the Telfer School of Management, University of Ottawa, Ottawa, Ont. (Reid); the Division of General Surgery, Department of Surgery, Faculty of Medicine, University of Ottawa, Ottawa, Ont. (Lee, Pagliarello, Balaa); the Division of General Surgery, Department of Surgery, Schulich School of Medicine and Dentistry, Western University, London, Ont. (Leslie); the Department of Surgery, McGill University, Montréal, Que. (Feldman); the Department of Surgery, University of British Columbia, Vancouver, BC (Hameed); the Division of Clinical Sciences, Northern Ontario School of Medicine, Laurentian University, Sudbury, and Lakehead University, Thunder Bay, Ont. (Kirkpatrick); the Division of Surgery, McMaster University, Hamilton, Ont. (Lovrics); the Department of Surgery, Queen's University, Kingston, Ont. (MacDonald); the Department of Surgery, Memorial University of Newfoundland, St. John's, Nfld. (Pace, Mathieson); the College of Medicine, University of Saskatchewan, Saskatoon, Sask. (Shaw); the Department of Surgery, Mount Sinai Hospital, University of Toronto, Toronto, Ont. (Swallow); the Department of Surgery, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alta. (Bigam, Porter); the Division of General Surgery, Department of Surgery, Université de Sherbrooke, Sherbrooke, Que. (McFadden); the Division of General Surgery, Department of Surgery, Université de Montréal, Montréal, Que. (Lapointe); the Department of Surgery, Foothills Medical Centre, University of Calgary, Calgary, Alta. (MacLean); and the Office of Research Services and School of Business, MacEwan University, Edmonton, Alta. (Kuziemsky)
| | - Roy Kirkpatrick
- From the Telfer School of Management, University of Ottawa, Ottawa, Ont. (Reid); the Division of General Surgery, Department of Surgery, Faculty of Medicine, University of Ottawa, Ottawa, Ont. (Lee, Pagliarello, Balaa); the Division of General Surgery, Department of Surgery, Schulich School of Medicine and Dentistry, Western University, London, Ont. (Leslie); the Department of Surgery, McGill University, Montréal, Que. (Feldman); the Department of Surgery, University of British Columbia, Vancouver, BC (Hameed); the Division of Clinical Sciences, Northern Ontario School of Medicine, Laurentian University, Sudbury, and Lakehead University, Thunder Bay, Ont. (Kirkpatrick); the Division of Surgery, McMaster University, Hamilton, Ont. (Lovrics); the Department of Surgery, Queen's University, Kingston, Ont. (MacDonald); the Department of Surgery, Memorial University of Newfoundland, St. John's, Nfld. (Pace, Mathieson); the College of Medicine, University of Saskatchewan, Saskatoon, Sask. (Shaw); the Department of Surgery, Mount Sinai Hospital, University of Toronto, Toronto, Ont. (Swallow); the Department of Surgery, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alta. (Bigam, Porter); the Division of General Surgery, Department of Surgery, Université de Sherbrooke, Sherbrooke, Que. (McFadden); the Division of General Surgery, Department of Surgery, Université de Montréal, Montréal, Que. (Lapointe); the Department of Surgery, Foothills Medical Centre, University of Calgary, Calgary, Alta. (MacLean); and the Office of Research Services and School of Business, MacEwan University, Edmonton, Alta. (Kuziemsky)
| | - Peter J Lovrics
- From the Telfer School of Management, University of Ottawa, Ottawa, Ont. (Reid); the Division of General Surgery, Department of Surgery, Faculty of Medicine, University of Ottawa, Ottawa, Ont. (Lee, Pagliarello, Balaa); the Division of General Surgery, Department of Surgery, Schulich School of Medicine and Dentistry, Western University, London, Ont. (Leslie); the Department of Surgery, McGill University, Montréal, Que. (Feldman); the Department of Surgery, University of British Columbia, Vancouver, BC (Hameed); the Division of Clinical Sciences, Northern Ontario School of Medicine, Laurentian University, Sudbury, and Lakehead University, Thunder Bay, Ont. (Kirkpatrick); the Division of Surgery, McMaster University, Hamilton, Ont. (Lovrics); the Department of Surgery, Queen's University, Kingston, Ont. (MacDonald); the Department of Surgery, Memorial University of Newfoundland, St. John's, Nfld. (Pace, Mathieson); the College of Medicine, University of Saskatchewan, Saskatoon, Sask. (Shaw); the Department of Surgery, Mount Sinai Hospital, University of Toronto, Toronto, Ont. (Swallow); the Department of Surgery, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alta. (Bigam, Porter); the Division of General Surgery, Department of Surgery, Université de Sherbrooke, Sherbrooke, Que. (McFadden); the Division of General Surgery, Department of Surgery, Université de Montréal, Montréal, Que. (Lapointe); the Department of Surgery, Foothills Medical Centre, University of Calgary, Calgary, Alta. (MacLean); and the Office of Research Services and School of Business, MacEwan University, Edmonton, Alta. (Kuziemsky)
| | - P Hugh MacDonald
- From the Telfer School of Management, University of Ottawa, Ottawa, Ont. (Reid); the Division of General Surgery, Department of Surgery, Faculty of Medicine, University of Ottawa, Ottawa, Ont. (Lee, Pagliarello, Balaa); the Division of General Surgery, Department of Surgery, Schulich School of Medicine and Dentistry, Western University, London, Ont. (Leslie); the Department of Surgery, McGill University, Montréal, Que. (Feldman); the Department of Surgery, University of British Columbia, Vancouver, BC (Hameed); the Division of Clinical Sciences, Northern Ontario School of Medicine, Laurentian University, Sudbury, and Lakehead University, Thunder Bay, Ont. (Kirkpatrick); the Division of Surgery, McMaster University, Hamilton, Ont. (Lovrics); the Department of Surgery, Queen's University, Kingston, Ont. (MacDonald); the Department of Surgery, Memorial University of Newfoundland, St. John's, Nfld. (Pace, Mathieson); the College of Medicine, University of Saskatchewan, Saskatoon, Sask. (Shaw); the Department of Surgery, Mount Sinai Hospital, University of Toronto, Toronto, Ont. (Swallow); the Department of Surgery, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alta. (Bigam, Porter); the Division of General Surgery, Department of Surgery, Université de Sherbrooke, Sherbrooke, Que. (McFadden); the Division of General Surgery, Department of Surgery, Université de Montréal, Montréal, Que. (Lapointe); the Department of Surgery, Foothills Medical Centre, University of Calgary, Calgary, Alta. (MacLean); and the Office of Research Services and School of Business, MacEwan University, Edmonton, Alta. (Kuziemsky)
| | - David Pace
- From the Telfer School of Management, University of Ottawa, Ottawa, Ont. (Reid); the Division of General Surgery, Department of Surgery, Faculty of Medicine, University of Ottawa, Ottawa, Ont. (Lee, Pagliarello, Balaa); the Division of General Surgery, Department of Surgery, Schulich School of Medicine and Dentistry, Western University, London, Ont. (Leslie); the Department of Surgery, McGill University, Montréal, Que. (Feldman); the Department of Surgery, University of British Columbia, Vancouver, BC (Hameed); the Division of Clinical Sciences, Northern Ontario School of Medicine, Laurentian University, Sudbury, and Lakehead University, Thunder Bay, Ont. (Kirkpatrick); the Division of Surgery, McMaster University, Hamilton, Ont. (Lovrics); the Department of Surgery, Queen's University, Kingston, Ont. (MacDonald); the Department of Surgery, Memorial University of Newfoundland, St. John's, Nfld. (Pace, Mathieson); the College of Medicine, University of Saskatchewan, Saskatoon, Sask. (Shaw); the Department of Surgery, Mount Sinai Hospital, University of Toronto, Toronto, Ont. (Swallow); the Department of Surgery, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alta. (Bigam, Porter); the Division of General Surgery, Department of Surgery, Université de Sherbrooke, Sherbrooke, Que. (McFadden); the Division of General Surgery, Department of Surgery, Université de Montréal, Montréal, Que. (Lapointe); the Department of Surgery, Foothills Medical Centre, University of Calgary, Calgary, Alta. (MacLean); and the Office of Research Services and School of Business, MacEwan University, Edmonton, Alta. (Kuziemsky)
| | - John M Shaw
- From the Telfer School of Management, University of Ottawa, Ottawa, Ont. (Reid); the Division of General Surgery, Department of Surgery, Faculty of Medicine, University of Ottawa, Ottawa, Ont. (Lee, Pagliarello, Balaa); the Division of General Surgery, Department of Surgery, Schulich School of Medicine and Dentistry, Western University, London, Ont. (Leslie); the Department of Surgery, McGill University, Montréal, Que. (Feldman); the Department of Surgery, University of British Columbia, Vancouver, BC (Hameed); the Division of Clinical Sciences, Northern Ontario School of Medicine, Laurentian University, Sudbury, and Lakehead University, Thunder Bay, Ont. (Kirkpatrick); the Division of Surgery, McMaster University, Hamilton, Ont. (Lovrics); the Department of Surgery, Queen's University, Kingston, Ont. (MacDonald); the Department of Surgery, Memorial University of Newfoundland, St. John's, Nfld. (Pace, Mathieson); the College of Medicine, University of Saskatchewan, Saskatoon, Sask. (Shaw); the Department of Surgery, Mount Sinai Hospital, University of Toronto, Toronto, Ont. (Swallow); the Department of Surgery, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alta. (Bigam, Porter); the Division of General Surgery, Department of Surgery, Université de Sherbrooke, Sherbrooke, Que. (McFadden); the Division of General Surgery, Department of Surgery, Université de Montréal, Montréal, Que. (Lapointe); the Department of Surgery, Foothills Medical Centre, University of Calgary, Calgary, Alta. (MacLean); and the Office of Research Services and School of Business, MacEwan University, Edmonton, Alta. (Kuziemsky)
| | - Carol J Swallow
- From the Telfer School of Management, University of Ottawa, Ottawa, Ont. (Reid); the Division of General Surgery, Department of Surgery, Faculty of Medicine, University of Ottawa, Ottawa, Ont. (Lee, Pagliarello, Balaa); the Division of General Surgery, Department of Surgery, Schulich School of Medicine and Dentistry, Western University, London, Ont. (Leslie); the Department of Surgery, McGill University, Montréal, Que. (Feldman); the Department of Surgery, University of British Columbia, Vancouver, BC (Hameed); the Division of Clinical Sciences, Northern Ontario School of Medicine, Laurentian University, Sudbury, and Lakehead University, Thunder Bay, Ont. (Kirkpatrick); the Division of Surgery, McMaster University, Hamilton, Ont. (Lovrics); the Department of Surgery, Queen's University, Kingston, Ont. (MacDonald); the Department of Surgery, Memorial University of Newfoundland, St. John's, Nfld. (Pace, Mathieson); the College of Medicine, University of Saskatchewan, Saskatoon, Sask. (Shaw); the Department of Surgery, Mount Sinai Hospital, University of Toronto, Toronto, Ont. (Swallow); the Department of Surgery, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alta. (Bigam, Porter); the Division of General Surgery, Department of Surgery, Université de Sherbrooke, Sherbrooke, Que. (McFadden); the Division of General Surgery, Department of Surgery, Université de Montréal, Montréal, Que. (Lapointe); the Department of Surgery, Foothills Medical Centre, University of Calgary, Calgary, Alta. (MacLean); and the Office of Research Services and School of Business, MacEwan University, Edmonton, Alta. (Kuziemsky)
| | - Giuseppe Pagliarello
- From the Telfer School of Management, University of Ottawa, Ottawa, Ont. (Reid); the Division of General Surgery, Department of Surgery, Faculty of Medicine, University of Ottawa, Ottawa, Ont. (Lee, Pagliarello, Balaa); the Division of General Surgery, Department of Surgery, Schulich School of Medicine and Dentistry, Western University, London, Ont. (Leslie); the Department of Surgery, McGill University, Montréal, Que. (Feldman); the Department of Surgery, University of British Columbia, Vancouver, BC (Hameed); the Division of Clinical Sciences, Northern Ontario School of Medicine, Laurentian University, Sudbury, and Lakehead University, Thunder Bay, Ont. (Kirkpatrick); the Division of Surgery, McMaster University, Hamilton, Ont. (Lovrics); the Department of Surgery, Queen's University, Kingston, Ont. (MacDonald); the Department of Surgery, Memorial University of Newfoundland, St. John's, Nfld. (Pace, Mathieson); the College of Medicine, University of Saskatchewan, Saskatoon, Sask. (Shaw); the Department of Surgery, Mount Sinai Hospital, University of Toronto, Toronto, Ont. (Swallow); the Department of Surgery, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alta. (Bigam, Porter); the Division of General Surgery, Department of Surgery, Université de Sherbrooke, Sherbrooke, Que. (McFadden); the Division of General Surgery, Department of Surgery, Université de Montréal, Montréal, Que. (Lapointe); the Department of Surgery, Foothills Medical Centre, University of Calgary, Calgary, Alta. (MacLean); and the Office of Research Services and School of Business, MacEwan University, Edmonton, Alta. (Kuziemsky)
| | - David L Bigam
- From the Telfer School of Management, University of Ottawa, Ottawa, Ont. (Reid); the Division of General Surgery, Department of Surgery, Faculty of Medicine, University of Ottawa, Ottawa, Ont. (Lee, Pagliarello, Balaa); the Division of General Surgery, Department of Surgery, Schulich School of Medicine and Dentistry, Western University, London, Ont. (Leslie); the Department of Surgery, McGill University, Montréal, Que. (Feldman); the Department of Surgery, University of British Columbia, Vancouver, BC (Hameed); the Division of Clinical Sciences, Northern Ontario School of Medicine, Laurentian University, Sudbury, and Lakehead University, Thunder Bay, Ont. (Kirkpatrick); the Division of Surgery, McMaster University, Hamilton, Ont. (Lovrics); the Department of Surgery, Queen's University, Kingston, Ont. (MacDonald); the Department of Surgery, Memorial University of Newfoundland, St. John's, Nfld. (Pace, Mathieson); the College of Medicine, University of Saskatchewan, Saskatoon, Sask. (Shaw); the Department of Surgery, Mount Sinai Hospital, University of Toronto, Toronto, Ont. (Swallow); the Department of Surgery, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alta. (Bigam, Porter); the Division of General Surgery, Department of Surgery, Université de Sherbrooke, Sherbrooke, Que. (McFadden); the Division of General Surgery, Department of Surgery, Université de Montréal, Montréal, Que. (Lapointe); the Department of Surgery, Foothills Medical Centre, University of Calgary, Calgary, Alta. (MacLean); and the Office of Research Services and School of Business, MacEwan University, Edmonton, Alta. (Kuziemsky)
| | - Geoff Porter
- From the Telfer School of Management, University of Ottawa, Ottawa, Ont. (Reid); the Division of General Surgery, Department of Surgery, Faculty of Medicine, University of Ottawa, Ottawa, Ont. (Lee, Pagliarello, Balaa); the Division of General Surgery, Department of Surgery, Schulich School of Medicine and Dentistry, Western University, London, Ont. (Leslie); the Department of Surgery, McGill University, Montréal, Que. (Feldman); the Department of Surgery, University of British Columbia, Vancouver, BC (Hameed); the Division of Clinical Sciences, Northern Ontario School of Medicine, Laurentian University, Sudbury, and Lakehead University, Thunder Bay, Ont. (Kirkpatrick); the Division of Surgery, McMaster University, Hamilton, Ont. (Lovrics); the Department of Surgery, Queen's University, Kingston, Ont. (MacDonald); the Department of Surgery, Memorial University of Newfoundland, St. John's, Nfld. (Pace, Mathieson); the College of Medicine, University of Saskatchewan, Saskatoon, Sask. (Shaw); the Department of Surgery, Mount Sinai Hospital, University of Toronto, Toronto, Ont. (Swallow); the Department of Surgery, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alta. (Bigam, Porter); the Division of General Surgery, Department of Surgery, Université de Sherbrooke, Sherbrooke, Que. (McFadden); the Division of General Surgery, Department of Surgery, Université de Montréal, Montréal, Que. (Lapointe); the Department of Surgery, Foothills Medical Centre, University of Calgary, Calgary, Alta. (MacLean); and the Office of Research Services and School of Business, MacEwan University, Edmonton, Alta. (Kuziemsky)
| | - Alex Mathieson
- From the Telfer School of Management, University of Ottawa, Ottawa, Ont. (Reid); the Division of General Surgery, Department of Surgery, Faculty of Medicine, University of Ottawa, Ottawa, Ont. (Lee, Pagliarello, Balaa); the Division of General Surgery, Department of Surgery, Schulich School of Medicine and Dentistry, Western University, London, Ont. (Leslie); the Department of Surgery, McGill University, Montréal, Que. (Feldman); the Department of Surgery, University of British Columbia, Vancouver, BC (Hameed); the Division of Clinical Sciences, Northern Ontario School of Medicine, Laurentian University, Sudbury, and Lakehead University, Thunder Bay, Ont. (Kirkpatrick); the Division of Surgery, McMaster University, Hamilton, Ont. (Lovrics); the Department of Surgery, Queen's University, Kingston, Ont. (MacDonald); the Department of Surgery, Memorial University of Newfoundland, St. John's, Nfld. (Pace, Mathieson); the College of Medicine, University of Saskatchewan, Saskatoon, Sask. (Shaw); the Department of Surgery, Mount Sinai Hospital, University of Toronto, Toronto, Ont. (Swallow); the Department of Surgery, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alta. (Bigam, Porter); the Division of General Surgery, Department of Surgery, Université de Sherbrooke, Sherbrooke, Que. (McFadden); the Division of General Surgery, Department of Surgery, Université de Montréal, Montréal, Que. (Lapointe); the Department of Surgery, Foothills Medical Centre, University of Calgary, Calgary, Alta. (MacLean); and the Office of Research Services and School of Business, MacEwan University, Edmonton, Alta. (Kuziemsky)
| | - Nathalie McFadden
- From the Telfer School of Management, University of Ottawa, Ottawa, Ont. (Reid); the Division of General Surgery, Department of Surgery, Faculty of Medicine, University of Ottawa, Ottawa, Ont. (Lee, Pagliarello, Balaa); the Division of General Surgery, Department of Surgery, Schulich School of Medicine and Dentistry, Western University, London, Ont. (Leslie); the Department of Surgery, McGill University, Montréal, Que. (Feldman); the Department of Surgery, University of British Columbia, Vancouver, BC (Hameed); the Division of Clinical Sciences, Northern Ontario School of Medicine, Laurentian University, Sudbury, and Lakehead University, Thunder Bay, Ont. (Kirkpatrick); the Division of Surgery, McMaster University, Hamilton, Ont. (Lovrics); the Department of Surgery, Queen's University, Kingston, Ont. (MacDonald); the Department of Surgery, Memorial University of Newfoundland, St. John's, Nfld. (Pace, Mathieson); the College of Medicine, University of Saskatchewan, Saskatoon, Sask. (Shaw); the Department of Surgery, Mount Sinai Hospital, University of Toronto, Toronto, Ont. (Swallow); the Department of Surgery, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alta. (Bigam, Porter); the Division of General Surgery, Department of Surgery, Université de Sherbrooke, Sherbrooke, Que. (McFadden); the Division of General Surgery, Department of Surgery, Université de Montréal, Montréal, Que. (Lapointe); the Department of Surgery, Foothills Medical Centre, University of Calgary, Calgary, Alta. (MacLean); and the Office of Research Services and School of Business, MacEwan University, Edmonton, Alta. (Kuziemsky)
| | - Réal Lapointe
- From the Telfer School of Management, University of Ottawa, Ottawa, Ont. (Reid); the Division of General Surgery, Department of Surgery, Faculty of Medicine, University of Ottawa, Ottawa, Ont. (Lee, Pagliarello, Balaa); the Division of General Surgery, Department of Surgery, Schulich School of Medicine and Dentistry, Western University, London, Ont. (Leslie); the Department of Surgery, McGill University, Montréal, Que. (Feldman); the Department of Surgery, University of British Columbia, Vancouver, BC (Hameed); the Division of Clinical Sciences, Northern Ontario School of Medicine, Laurentian University, Sudbury, and Lakehead University, Thunder Bay, Ont. (Kirkpatrick); the Division of Surgery, McMaster University, Hamilton, Ont. (Lovrics); the Department of Surgery, Queen's University, Kingston, Ont. (MacDonald); the Department of Surgery, Memorial University of Newfoundland, St. John's, Nfld. (Pace, Mathieson); the College of Medicine, University of Saskatchewan, Saskatoon, Sask. (Shaw); the Department of Surgery, Mount Sinai Hospital, University of Toronto, Toronto, Ont. (Swallow); the Department of Surgery, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alta. (Bigam, Porter); the Division of General Surgery, Department of Surgery, Université de Sherbrooke, Sherbrooke, Que. (McFadden); the Division of General Surgery, Department of Surgery, Université de Montréal, Montréal, Que. (Lapointe); the Department of Surgery, Foothills Medical Centre, University of Calgary, Calgary, Alta. (MacLean); and the Office of Research Services and School of Business, MacEwan University, Edmonton, Alta. (Kuziemsky)
| | - Tony MacLean
- From the Telfer School of Management, University of Ottawa, Ottawa, Ont. (Reid); the Division of General Surgery, Department of Surgery, Faculty of Medicine, University of Ottawa, Ottawa, Ont. (Lee, Pagliarello, Balaa); the Division of General Surgery, Department of Surgery, Schulich School of Medicine and Dentistry, Western University, London, Ont. (Leslie); the Department of Surgery, McGill University, Montréal, Que. (Feldman); the Department of Surgery, University of British Columbia, Vancouver, BC (Hameed); the Division of Clinical Sciences, Northern Ontario School of Medicine, Laurentian University, Sudbury, and Lakehead University, Thunder Bay, Ont. (Kirkpatrick); the Division of Surgery, McMaster University, Hamilton, Ont. (Lovrics); the Department of Surgery, Queen's University, Kingston, Ont. (MacDonald); the Department of Surgery, Memorial University of Newfoundland, St. John's, Nfld. (Pace, Mathieson); the College of Medicine, University of Saskatchewan, Saskatoon, Sask. (Shaw); the Department of Surgery, Mount Sinai Hospital, University of Toronto, Toronto, Ont. (Swallow); the Department of Surgery, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alta. (Bigam, Porter); the Division of General Surgery, Department of Surgery, Université de Sherbrooke, Sherbrooke, Que. (McFadden); the Division of General Surgery, Department of Surgery, Université de Montréal, Montréal, Que. (Lapointe); the Department of Surgery, Foothills Medical Centre, University of Calgary, Calgary, Alta. (MacLean); and the Office of Research Services and School of Business, MacEwan University, Edmonton, Alta. (Kuziemsky)
| | - Craig Kuziemsky
- From the Telfer School of Management, University of Ottawa, Ottawa, Ont. (Reid); the Division of General Surgery, Department of Surgery, Faculty of Medicine, University of Ottawa, Ottawa, Ont. (Lee, Pagliarello, Balaa); the Division of General Surgery, Department of Surgery, Schulich School of Medicine and Dentistry, Western University, London, Ont. (Leslie); the Department of Surgery, McGill University, Montréal, Que. (Feldman); the Department of Surgery, University of British Columbia, Vancouver, BC (Hameed); the Division of Clinical Sciences, Northern Ontario School of Medicine, Laurentian University, Sudbury, and Lakehead University, Thunder Bay, Ont. (Kirkpatrick); the Division of Surgery, McMaster University, Hamilton, Ont. (Lovrics); the Department of Surgery, Queen's University, Kingston, Ont. (MacDonald); the Department of Surgery, Memorial University of Newfoundland, St. John's, Nfld. (Pace, Mathieson); the College of Medicine, University of Saskatchewan, Saskatoon, Sask. (Shaw); the Department of Surgery, Mount Sinai Hospital, University of Toronto, Toronto, Ont. (Swallow); the Department of Surgery, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alta. (Bigam, Porter); the Division of General Surgery, Department of Surgery, Université de Sherbrooke, Sherbrooke, Que. (McFadden); the Division of General Surgery, Department of Surgery, Université de Montréal, Montréal, Que. (Lapointe); the Department of Surgery, Foothills Medical Centre, University of Calgary, Calgary, Alta. (MacLean); and the Office of Research Services and School of Business, MacEwan University, Edmonton, Alta. (Kuziemsky)
| | - Fady Balaa
- From the Telfer School of Management, University of Ottawa, Ottawa, Ont. (Reid); the Division of General Surgery, Department of Surgery, Faculty of Medicine, University of Ottawa, Ottawa, Ont. (Lee, Pagliarello, Balaa); the Division of General Surgery, Department of Surgery, Schulich School of Medicine and Dentistry, Western University, London, Ont. (Leslie); the Department of Surgery, McGill University, Montréal, Que. (Feldman); the Department of Surgery, University of British Columbia, Vancouver, BC (Hameed); the Division of Clinical Sciences, Northern Ontario School of Medicine, Laurentian University, Sudbury, and Lakehead University, Thunder Bay, Ont. (Kirkpatrick); the Division of Surgery, McMaster University, Hamilton, Ont. (Lovrics); the Department of Surgery, Queen's University, Kingston, Ont. (MacDonald); the Department of Surgery, Memorial University of Newfoundland, St. John's, Nfld. (Pace, Mathieson); the College of Medicine, University of Saskatchewan, Saskatoon, Sask. (Shaw); the Department of Surgery, Mount Sinai Hospital, University of Toronto, Toronto, Ont. (Swallow); the Department of Surgery, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alta. (Bigam, Porter); the Division of General Surgery, Department of Surgery, Université de Sherbrooke, Sherbrooke, Que. (McFadden); the Division of General Surgery, Department of Surgery, Université de Montréal, Montréal, Que. (Lapointe); the Department of Surgery, Foothills Medical Centre, University of Calgary, Calgary, Alta. (MacLean); and the Office of Research Services and School of Business, MacEwan University, Edmonton, Alta. (Kuziemsky)
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Herring E, Tremblay É, McFadden N, Kanaoka S, Beaulieu JF. Multitarget Stool mRNA Test for Detecting Colorectal Cancer Lesions Including Advanced Adenomas. Cancers (Basel) 2021; 13:cancers13061228. [PMID: 33799738 PMCID: PMC7998137 DOI: 10.3390/cancers13061228] [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] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 03/09/2021] [Accepted: 03/10/2021] [Indexed: 02/06/2023] Open
Abstract
Current approved non-invasive screening methods for colorectal cancer (CRC) include FIT and DNA-FIT testing, but their efficacy for detecting precancerous lesions that are susceptible to progressing to CRC such as advanced adenomas (AA) remains limited, thus requiring further options to improve the detection of CRC lesions at earlier stages. One of these is host mRNA stool testing. The aims of the present study were to identify specific stool mRNA targets that can predict AA and to investigate their stability under a clinical-like setting. A panel of mRNA targets was tested on stool samples obtained from 102 patients including 78 CRC stage I-III and 24 AA as well as 32 healthy controls. Area under the receiver operating characteristic (ROC) curves were calculated to establish sensitivities and specificities for individual and combined targets. Stability experiments were performed on freshly obtained specimens. Six of the tested targets were found to be specifically increased in the stools of patients with CRC and three in the stools of both AA and CRC patients. After optimization for the choice of the 5 best markers for AA and CRC, ROC curve analysis revealed overall sensitivities of 75% and 89% for AA and CRC, respectively, for a ≥95% specificity, and up to 75% and 95% for AA and CRC, respectively, when combined with the FIT score. Targets were found to be stable in the stools up to 3 days at room temperature. In conclusion, these studies show that the detection of host mRNA in the stools is a valid approach for the screening of colorectal cancerous lesions at all stages and is applicable to a clinical-like setup.
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Affiliation(s)
- Elizabeth Herring
- Laboratory of Intestinal Physiopathology, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, QC J1H 5N4, Canada; (E.H.); (É.T.)
- Centre de Recherche du Centre Hospitalier, Universitaire de Sherbrooke, Sherbrooke, QC J1H 5N4, Canada;
| | - Éric Tremblay
- Laboratory of Intestinal Physiopathology, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, QC J1H 5N4, Canada; (E.H.); (É.T.)
- Centre de Recherche du Centre Hospitalier, Universitaire de Sherbrooke, Sherbrooke, QC J1H 5N4, Canada;
| | - Nathalie McFadden
- Centre de Recherche du Centre Hospitalier, Universitaire de Sherbrooke, Sherbrooke, QC J1H 5N4, Canada;
- Department of Surgery, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, QC J1H 5N4, Canada
| | - Shigeru Kanaoka
- Department of Gastroenterology, Hamamatsu Medical Center, Naka-ku, Hamamatsu 432-8580, Japan;
| | - Jean-François Beaulieu
- Laboratory of Intestinal Physiopathology, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, QC J1H 5N4, Canada; (E.H.); (É.T.)
- Centre de Recherche du Centre Hospitalier, Universitaire de Sherbrooke, Sherbrooke, QC J1H 5N4, Canada;
- Correspondence: ; Tel.: +1-819-821-8000
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Abstract
BACKGROUND Cost-utility analysis (CUA) is becoming more commonly used in healthcare decision-making. CUA uses the quality-adjusted life-years (QALY) metric, which combines the length of life with the health-related quality of life (HRQoL). Most QALY-measuring instruments were validated for general populations. For patients with cancer, the perception of their health state is different and may vary by the type of cancer considered. In Quebec, no preference weights for QALY have been developed, neither for the general population nor particular subpopulations. METHODS/DESIGN This survey is a prospective, longitudinal cohort study. The study objectives are: to assess the extent of difference in health utilities between the general population and patients with breast or colorectal cancer; to develop a QALY preference weights dataset for patients with cancer; and to perform "mapping" with different HRQoL questionnaires by correlating the SF-6Dv2 with the EQ-5D-5L, European Organization for Research and Treatment of Cancer Quality of Life Questionnaire C30, and functional assessment of cancer therapy - general questionnaires. Data will be collected via a self-administered online survey. Patients' health utilities will be measured within 2 days before the beginning of a chemotherapy treatment cycle and about 8 days after the start of the chemotherapy. Health utilities will be measured by a hybrid method using the time-trade-off and discrete choice experiment methods. ETHICS AND DISSEMINATION The proposed research was reviewed and approved by the Institutional Research Ethics Review Boards of the CHUS. We will disseminate our study findings through peer-reviewed publications and conference presentations.
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Affiliation(s)
- Thomas G. Poder
- UETMISSS and CRCHUS, CIUSSS de l’Estrie—CHUS, 1036 Belvedere Sud, Hôpital Youville
| | | | | | - Michel Pavic
- Département de médecine, Université de Sherbrooke, Sherbrooke, QC, Canada
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Halkett GKB, Wigley CA, Aoun SM, Portaluri M, Tramacere F, Livi L, Detti B, Arcangeli S, Lund JA, Kristensen A, McFadden N, Grun A, Bydder S, Sackerer I, Greimel E, Spry N. International validation of the EORTC QLQ-PRT20 module for assessment of quality of life symptoms relating to radiation proctitis: a phase IV study. Radiat Oncol 2018; 13:162. [PMID: 30157890 PMCID: PMC6116442 DOI: 10.1186/s13014-018-1107-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [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: 01/07/2018] [Accepted: 08/20/2018] [Indexed: 01/02/2023] Open
Abstract
Background Although patients experience radiation proctitis post radiotherapy no internationally tested instruments exist to measure these symptoms. This Phase IV study tested the scale structure, reliability and validity and cross-cultural applicability of the EORTC proctitis module (QLQ-PRT23) in patients who were receiving pelvic radiotherapy. Methods Patients (n = 358) from six countries completed the EORTC QLQ-C30, QLQ-PRT23 and EORTC Quality of Life Group debriefing questions. Clinicians completed the EORTC Radiation Therapy Oncology Group scale. Questionnaires were completed at four time-points. The module’s scale structure was examined and validated using standard psychometric analysis techniques. Results Three items were dropped from the module (QLQ-PRT23 → QLQ-PRT20). Factor analysis identified five factors in the module: bowel control; bloating and gas; emotional function/lifestyle; pain; and leakage. Inter-item correlations were within r = 0.3–0.7. Test-Retest reliability was high. All multi-item scales discriminated between patients showing symptoms and those without symptomology. The module discriminated symptoms from the clinician completed scoring and for age, gender and comorbidities. Conclusion The EORTC QLQ-PRT20 is designed to be used in addition to the EORTC QLQ-C30 to measure quality of life in patients who receive pelvic radiotherapy. The EORTC QLQ-PRT20 is quick to complete, acceptable to patients, has good content validity and high reliability. Trial registration Australian and New Zealand Clinical Trials Registry (ANZCTR) ACTRN12609000972224. Electronic supplementary material The online version of this article (10.1186/s13014-018-1107-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Georgia K B Halkett
- School of Nursing, Midwifery and Paramedicine, Curtin University, GPO Box U1987, Perth, WA, 6845, Australia. .,Institute for Health Research, University of Notre Dame, Perth, Western Australia.
| | - Charles Adam Wigley
- Institute for Health Research, University of Notre Dame, Perth, Western Australia
| | - Samar M Aoun
- Institute for Health Research, University of Notre Dame, Perth, Western Australia.,Palliative Care Unit, School of Psychology and Public Health, La Trobe University, Bundoora, VIC, Australia
| | - Maurizio Portaluri
- Radiation Oncology Dept. "A. Perrino" General Hospital, ASL Brindisi, Italy
| | | | | | | | | | - Jo-Asmund Lund
- Cancer Clinic, St. Olavs University Hospital, Trondheim, Norway
| | - Are Kristensen
- Cancer Clinic, St. Olavs University Hospital, Trondheim, Norway
| | - Nathalie McFadden
- Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, Quebec, Canada
| | - Arne Grun
- Charité - University Medicine, Berlin, Germany
| | - Sean Bydder
- Department of Radiation Oncology, Sir Charles Gairdner Hospital, Perth, Western Australia
| | - Irina Sackerer
- Department of Radiation Oncology, Technical University of Munich, Munich, Germany.,Radiation Oncology, Freising and Dachau, Germany
| | | | - Nigel Spry
- Department of Radiation Oncology, Sir Charles Gairdner Hospital, Perth, Western Australia.,Genesis Cancer Care, Joondalup, WA, Australia
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Bouffard-Cloutier A, Paré A, McFadden N. Periumbilical vs transumbilical laparoscopic incision: A patients' satisfaction-centered randomised trial. Int J Surg 2017; 43:86-91. [PMID: 28552811 DOI: 10.1016/j.ijsu.2017.05.040] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2017] [Accepted: 05/18/2017] [Indexed: 11/24/2022]
Abstract
BACKGROUND While studies suggested that transumbilical incisions (TUI) incur better postoperative cosmetic satisfaction scores (CSS) and shorter operative time (OT) than periumbilical incisions (PUI) during general surgery laparoscopic interventions, others did not. Concerns have been raised toward the potential negative impact of TUI on the incidence of surgical site infection (SSI) but this issue is under documented. METHODS A controlled trial was conducted between August 2014 and August 2015 in our hospital. Individuals aged 18-70 undergoing a laparoscopic rectopexy, cholecystectomy, appendectomy or proctocolectomy were considered. Patients were randomized in two groups (PUI or TUI) following a 1:1 allocation ratio. Participants with a body mass index >40, with a history of abdominal surgery, undergoing co-operations, requesting a specific incision or converted to open surgery were excluded. RESULTS Among the 56 randomized patients, 50 (27 PUI vs 23 PUI) produced analyzable data. There were no significant difference between the characteristics of both groups. CSS evolution (pre-op vs 1 month post-op), SSI incidence and OT were also comparable. Only 28% of participants valued the appearance of their umbilicus prior to intervention. Those who did had a significantly worst CSS evolution (OR -1.7; IC95-2.6/-0.72, p = 0.001). Higher preoperative CSS was also a predictor of postoperative CSS decline (OR -0.4; IC95-0.6/-0.2, p = 0.001). CONCLUSIONS SUI and TUI were similar for all tested outcomes. Among the participants, the minority of patients who valued the appearance of their umbilicus and those with a high preoperative CSS were particularly prone to postoperative CSS decline.
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Affiliation(s)
- Audrey Bouffard-Cloutier
- Department of Surgery, Division of General Surgery, Université de Sherbrooke, Sherbrooke, Quebec, Canada
| | - Alex Paré
- Department of Surgery, Division of General Surgery, Université de Sherbrooke, Sherbrooke, Quebec, Canada
| | - Nathalie McFadden
- Department of Surgery, Division of General Surgery, Université de Sherbrooke, Sherbrooke, Quebec, Canada.
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8
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Bougie A, McFadden N, Mayer S, Lebel M, Devroede G. Neurostimulation for fecal incontinence after correction of repair of imperforate anus. World J Clin Cases 2017; 5:124-127. [PMID: 28352637 PMCID: PMC5352961 DOI: 10.12998/wjcc.v5.i3.124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2016] [Revised: 10/25/2016] [Accepted: 11/22/2016] [Indexed: 02/05/2023] Open
Abstract
We are reporting the case of a 32-year-old female who had suffered from fecal incontinence (FI). She was born with an imperforate anus and a recto-vaginal fistula; she underwent repair at 6 mo of age. At 29 years of age, she was still fecally incontinent despite extensive pelvic floor reeducation. A magnetic resonance imaging and an anal electromyography were performed. Because her symptoms were considered to be probably due to extra-sphincteric implantation of the neo-anus, a redo was performed of the recto-neo-anal intra-sphincteric anastomosis. A neurostimulator device was subsequently implanted for persistent incontinence. Solid and liquid FI resolved, and her quality of life improved markedly. Combining surgery to correct the position of the neo-anus within the anal sphincter complex and neurostimulation could thus become a new approach in cases of refractory FI for patients with imperforate anus as a newborn. Follow-up into adulthood after pediatric imperforate anus surgery should be recommended for adult patients with persistent FI.
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9
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Leblanc D, McFadden N, Lebel M, Devroede G. Fecal continence can be restored by sacral neurostimulation after traumatic unilateral pudendal neuropathy: a case report. Int J Colorectal Dis 2015; 30:569-70. [PMID: 25296707 DOI: 10.1007/s00384-014-2019-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/29/2014] [Indexed: 02/04/2023]
Affiliation(s)
- Dominique Leblanc
- Département de Chirurgie, service de chirurgie, Centre Hospitalier Universitaire de Sherbrooke, Faculté de Médecine, Sherbrooke, Québec, Canada
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10
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Pepin J, Vo TT, Boutros M, Marcotte E, Dial S, Dubé S, Vasilevsky CA, McFadden N, Patino C, Labbé AC. Risk factors for mortality following emergency colectomy for fulminant Clostridium difficile infection. Dis Colon Rectum 2009; 52:400-5. [PMID: 19333038 DOI: 10.1007/dcr.0b013e31819a69aa] [Citation(s) in RCA: 63] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
PURPOSE This study evaluated risk factors for mortality after emergency colectomy for fulminant Clostridium difficile infection. METHODS Retrospective study of 130 cases of Clostridium difficile infection that required a colectomy between 1994 and 2007 in four hospitals of Quebec, Canada. Primary outcome was 30-day mortality. RESULTS Twenty-five cases underwent colectomy in 1994 to 2002, 41 in 2003, 40 in 2004, and 24 in 2005 to 2007. Common indications were septic shock (41 percent) and nonresponse to medical treatment (39 percent). Overall, 30-day mortality was 37 percent. Mortality increased with age but was not influenced by comorbidities burden. Mortality correlated with preoperative lactate (< or =2.1 mmol/L: 26 percent; 2.2-4.9 mmol/L: 52 percent; > or =5.0 mmol/L: 75 percent, P < 0.001), leukocytosis (<20.0 x 10(9)/L: 32 percent; 20.0-49.9 x 10(9)/L: 33 percent; > or =50.0 x 10(9)/L: 73 percent, P = 0.008), albumin (> or =25 g/L: 19 percent; 15-24 g/L: 38 percent; <15 g/L: 52 percent, P = 0.04) and renal failure. In multivariate analysis, risk factors for mortality were age (per year, adjusted odds ratio: 1.03, 95 percent confidence interval: 1.00-1.06), preoperative lactate greater than or equal to 5.0 mmol/L (adjusted odds ratio: 10.32, 95 percent confidence interval: 2.59-41.1), leukocytosis greater than or equal to 50.0 x10(9)/L (adjusted odds ratio: 3.68, 95 percent confidence interval: 0.92-14.8) and albumin less than 15 g/L (adjusted odds ratio, 6.57, 95 percent confidence interval: 1.31-33.1). CONCLUSIONS Incidence of Clostridium difficile infection-related emergency colectomies increased 20-fold during the epidemic. Postoperative mortality can be predicted by simple laboratory parameters. Three-fourths of patients with leukocytosis greater or equal to 50.0 x10(9)/L or lactate greater or equal to 5.0 mmol/L died. When possible, emergency colectomy should be performed earlier.
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Affiliation(s)
- Jacques Pepin
- University of Sherbrooke, Sherbrooke, Quebec, Canada.
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11
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Abstract
The combined positron emission tomography/computed tomography scan is ideal in the initial staging of lymphomas and for evaluating the response to treatment. In posttreatment studies, the presence of a residual, metabolically active mass at the site of initially documented lymphoma is not expected to be anything other than residual active disease. We describe a case of intestinal non-Hodgkin's lymphoma that responded to chemotherapy but with a residual metabolically active mass at the site of initial disease. This mass was revealed to be a clinically silent closed intestinal perforation with abscess formation. Similar conditions should be kept in mind during the interpretation of posttreatment combined positron emission tomography/computed tomography scan and before exposing the patient to additional chemotherapy.
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Affiliation(s)
- Rami Kotb
- Department of Hematology and Oncology, Centre Hospitalier Universitaire de Sherbrooke, Quebec, Canada.
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12
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Santschi M, Echavé V, Laflamme S, McFadden N, Cyr C. Seat-belt injuries in children involved in motor vehicle crashes. Can J Surg 2005; 48:373-6. [PMID: 16248135 PMCID: PMC3211905] [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: 05/05/2023] Open
Abstract
BACKGROUND The efficacy of seat belts in reducing deaths from motor vehicle crashes is well documented. A unique association of injuries has emerged in adults and children with the use of seat belts. The "seat-belt syndrome" refers to the spectrum of injuries associated with lap-belt restraints, particularly flexion-distraction injuries to the spine (Chance fractures). METHODS We describe the injuries sustained by 8 children, including 2 sets of twins, in 3 different motor vehicle crashes. RESULTS All children were rear seat passengers wearing lap or 3-point restraints. All had abdominal lap-belt ecchymosis and multiple abdominal injuries due to the common mechanism of seat-belt compression with hyperflexion and distraction during deceleration. Five of the children had lumbar spine fractures and 4 remained permanently paraplegic. CONCLUSIONS These incidents illustrate the need for acute awareness of the complete spectrum of intra-abdominal and spinal injuries in restrained pediatric passengers in motor vehicle crashes and for rear seat restraints that include shoulder belts with the ability to adjust them to fit smaller passengers, including older children.
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Affiliation(s)
- Miriam Santschi
- Department of Pediatrics, Faculty of Medicine, Université de Sherbrooke, Sherbrooke, Que.
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13
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Dehni N, McFadden N, McNamara DA, Guiguet M, Tiret E, Parc R. Oncologic results following abdominoperineal resection for adenocarcinoma of the low rectum. Dis Colon Rectum 2003; 46:867-74; discussion 874. [PMID: 12847358 DOI: 10.1007/s10350-004-6675-1] [Citation(s) in RCA: 57] [Impact Index Per Article: 2.7] [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] [Indexed: 01/19/2023]
Abstract
PURPOSE The role of abdominoperineal resection for rectal cancer has changed because of advances in sphincter-preserving surgery. Our aim was to evaluate the results of this operation in the five-year period following introduction of the concept of total mesorectal excision METHODS Data on all patients undergoing abdominoperineal resection for very low rectal cancer between 1992 and 1997 were collected prospectively. All patients had had total mesorectal excision. Curative resection was defined as absence of macroscopic disease after resection and local recurrence as any infiltration or tumor identified in the pelvis, alone or combined with distant disease. Survival and local recurrence rates were calculated using the Kaplan-Meier method and log-rank analysis. RESULTS Of 165 abdominoperineal resections performed, 106 were for primary adenocarcinoma of the rectum. The male:female ratio was 50:56, with a median age of 65 (range, 33-85) years. There was one postoperative death. Twenty-seven patients received short-course preoperative radiotherapy (25 Gy over 1 week), whereas 22 had a longer course, with concomitant chemotherapy in 2. Postoperative chemotherapy was administered in 29, postoperative radiotherapy in 4, and combined therapy in 8. After curative resection (n = 91), survival at five years was 76 percent and differed significantly by stage. Recurrence at any site was 7 percent (3/34) for Stage I, 27 percent (6/26) for Stage II, and 53 percent (16/31) for Stage III. Nine patients presented with local recurrence, with an overall rate at five years of 10 percent. Isolated locale recurrence was observed in only 5 percent of patients CONCLUSIONS After abdominoperineal resection and total mesorectal excision, good rates of local control may be achieved provided surgical technique is meticulous.
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Affiliation(s)
- N Dehni
- Department of Digestive Surgery, INSERM U444, Hospital Saint-Antoine, University of Paris VI, Paris, France
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14
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Santschi M, Laflamme S, McFadden N, Echavé V, Cyr C. The Spectrum of Lap Belt Injuries Sustained by Multiple Victims in Motor Vehicle Crash. Paediatr Child Health 2002. [DOI: 10.1093/pch/7.suppl_a.31ab] [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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15
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Wearden P, Hill RC, Hollingsed M, Santoscoy R, McFadden N. Successful case of extracorporeal life support in a patient with postcardiotomy cardiogenic shock. W V Med J 1995; 91:57-8. [PMID: 7610644] [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: 01/26/2023]
Abstract
Over the past five years, the use of extracorporeal life support in the adult population has gained acceptance. Indications have ranged from respiratory failure secondary to trauma, and adult respiratory distress syndrome, to cardiac failure secondary to a number of causes. The results of extracorporeal life support, when applied to postcardiotomy patients, have been variable. In this article, we present the successful utilization of extracorporeal life support for 28 hours in a patient with postcardiotomy cardiogenic shock following mitral valve replacement.
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Affiliation(s)
- P Wearden
- Robert C. Byrd Health Sciences Center, West Virginia University, Department of Surgery, Morgantown, USA
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16
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Orstavik KH, McFadden N, Hagelsteen J, Ormerod E, van der Hagen CB. Instability of lymphocyte chromosomes in a girl with Rothmund-Thomson syndrome. J Med Genet 1994; 31:570-2. [PMID: 7966195 PMCID: PMC1049982 DOI: 10.1136/jmg.31.7.570] [Citation(s) in RCA: 39] [Impact Index Per Article: 1.3] [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: 01/28/2023]
Abstract
Rothmund-Thomson syndrome is a rare autosomal recessive syndrome characterised by poikiloderma of the face and extremities, alopecia, short stature, and skeletal defects. We report a patient with the characteristic features of Rothmund-Thomson syndrome who also had lymphocyte chromosome abnormalities. She has a small flat face with short palpebral fissures and micrognathia together with severe skeletal abnormalities of the upper extremities with absence of both radii, short dysmorphic ulnae, a rudimentary right thumb, and aplasia of the left thumb. She also has anal atresia with a rectovaginal fistula. From the age of 3 months she developed poikiloderma skin changes on the face and extensor surfaces of the extremities. Mental development seems to be normal. Lymphocyte chromosomes in the neonatal period showed an unidentified marker chromosome in eight of a total of 32 cells. A repeat analysis at the age of 10 months showed three abnormal cells out of 100 analysed: 47,XX,-7,+i(7q),+7p, 46,XX,t(3;18)(p14.2;q22), and 49,XX,+del(3)(p11.2),+mar,+mar. A skin biopsy from an affected area showed poor growth and five of 48 cells analysed had structural abnormalities. The father had one of 48 cells with an additional marker chromosome and two cells with different 7;14 translocations. The abnormal chromosome complements in lymphocytes indicate that there may be in vivo chromosome instability in Rothmund-Thomson syndrome.
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Affiliation(s)
- K H Orstavik
- Department of Medical Genetics, Ullevål University Hospital, Oslo, Norway
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17
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Abstract
A patient who developed localized, granulomatous reactions in a tattoo is described. With the use of scanning electron microscopy and energy dispersive x-ray microanalysis, both aluminum and titanium particles were found in the involved skin sections. Intradermal provocation testing with separate suspensions of aluminum and titanium induced a positive response only in the case of aluminum. Examination by scanning electron microscopy and energy dispersive x-ray microanalysis of the provoked response established aluminum as the only nonorganic element present in the test site tissue. This is the first report of confirmed aluminum-induced, delayed-hypersensitivity granulomas in a tattoo.
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Affiliation(s)
- N McFadden
- Department of Dermatology, University of Oslo Medical School, Norway
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18
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McFadden N, Hande KO. [A study of new patients at a dermatologic outpatient clinic]. Tidsskr Nor Laegeforen 1989; 109:436-7. [PMID: 2919372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
Data on all new dermatology outpatients seen during the period 1 January to 30 June 1987 were analyzed in order to obtain information on the types of patients attending the clinic and on the skin diseases presented. We also recorded the source of referral, the frequency of the need for surgery, and patient compliance. There was a general predominance of female patients (60%), particularly in the 21-30 years age group. The leading diagnoses were atopic dermatitis (18%) and psoriasis (11%), and 2/3 of the atopic dermatitis patients were female. A skin biopsy was performed in 12% of the new patients and the clinical pre-biopsy diagnosis was correct in 72% of the cases. Surgery was necessary in 16% of all new patients. 54% of the patients required a follow-up appointment. 11% of these (108 patients) failed to appear. Patients with atopic dermatitis were the chief offenders in this latter group. The results of the study suggest that out-patient costs and waiting lists could be reduced by revising the indications for biopsy and follow-up appointments.
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Thune P, Jansén C, Wennersten G, Rystedt I, Brodthagen H, McFadden N. The Scandinavian multicenter photopatch study 1980-1985: final report. Photodermatol 1988; 5:261-9. [PMID: 2977817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
At 16 different dermatology clinics in Scandinavia from 1980-1985, photopatch testing was performed on 1993 patients with suspected photodermatosis. The collective results are presented in this article. The most common cause of sun-related dermatosis was polymorphic light eruption (PLE) (38%), while secondary aggravation of pre-existing skin diseases was established in 16% of the patient group. Photocontact dermatitis (11%) and contact dermatitis (10%) were responsible for 274 and 369 positive test reactions (respectively) on photopatch testing using the SPDRG standard series. Musk ambrette and para-aminobenzoic acid were the leading photosensitizers, while perfume mixture, balsam of Peru and lichen mixture were the most frequent causes of contact sensitivity. The principal photoallergens and contact allergens in the PLE, persistent light reaction and actinic reticuloid groups are discussed, together with the problems, risks and possible mechanisms of induction of photosensitization in these patients. The incidence, causes and diagnostic and therapeutic implications of secondary sunscreen sensitivity in these groups are also addressed.
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Affiliation(s)
- P Thune
- Ullevaal Hospital, Oslo, Norway
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McFadden N, Larsen TE. Reticular erythematous mucinosis and photosensitivity: a case study. Photodermatol 1988; 5:270-2. [PMID: 3249684] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Affiliation(s)
- N McFadden
- Department of Dermatology, Ullevål Hospital, Oslo, Norway
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22
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McFadden N, Ree K, Søyland E, Larsen TE. Scleredema adultorum associated with a monoclonal gammopathy and generalized hyperpigmentation. Arch Dermatol 1987; 123:629-32. [PMID: 3579342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Scleredema associated with a monoclonal gammopathy and generalized skin pigmentation is described in a 56-year-old man with hyperlipoproteinemia and cardiovascular disease. The patient had IgG-lambda paraproteinemia, without any evidence of multiple myeloma or immunoglobulin deposition in affected skin. Ultrastructural studies of pigmented lesional skin showed increased transfer of melanosomes to basal keratinocytes and dermal melanophages containing complex melanosomes. In addition, cytoplasmic, electron-opaque lipid droplets were seen in approximately every third keratinocyte or melanocyte, while only an occasional dermal cell contained lipid droplets. The hyperpigmentation appeared to be directly related to the scleredema, while the lipid deposition in skin was a likely consequence of the hyperlipoproteinemia. The findings further support the contention that paraproteinemia and hyperpigmentation may, in some patients, be associated features of scleredema adultorum.
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McFadden N. [Polymorphous light exanthema. Diagnosis, treatment and pathogenesis]. Tidsskr Nor Laegeforen 1987; 107:830-2. [PMID: 3296304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
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McFadden N, Larsen TE. Polymorphous light eruption: the properties of a UVA-induced PLME patient group. Photodermatol 1986; 3:36-40. [PMID: 3703701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Experimental induction of PLME lesions in 22 patients, using a pure, high-intensity UVA light source is reported. Fourteen patients had a reduced MED value for either UVB (11 patients) and/or UVA (7 patients). The UVA-SUN 2000 dose required to provoke a positive PLME reaction varied from 26 to 104 J/cm2. The small papular PMLE-type patients were shown to be more photosensitive and the UVA provocation doses required exceeded 50 J/cm2 in 20/22 patients. Lesional immunoglobulin deposition along the BMZ was seen in 3 patients while lesional BMZ complement deposits occurred in 9/15 patients, 2 of whom had similar findings in the dermal capillaries. Complement deposition occurred in non-irradiated control sites in 4 patients. The immunohistologic findings, for reasons given, fail to support the hypothesis of an immune cell-mediated response as the primary event in the pathogenesis of PMLE.
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McFadden N, Falk ES. Infantile acropustulosis. Cutis 1985; 36:49-51. [PMID: 3893914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
We report two patients with infantile acropustulosis; one patient with a history of atopic dermatitis and the second with an abnormally high IgE serum value. Atopy has not been reported previously in patients with infantile acropustulosis. Immunofluorescent studies of involved skin gave negative results.
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McFadden N. PUVA-induced lupus erythematosus in a patient with polymorphous light eruption. Photodermatol 1984; 1:148-50. [PMID: 6527959] [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: 01/20/2023]
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28
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McFadden N. UVA sensitivity and topical photoprotection in polymorphous light eruption. Photodermatol 1984; 1:76-8. [PMID: 6531284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
The efficacy of a non-PABA, non-benzophenone broad-spectrum sunscreen was investigated experimentally in 8 patients with polymorphous light eruption (PMLE). A UVA-SUN 2000 lamp, emitting high intensity UVA radiation was used to irradiate unprotected and sunscreen protected skin sites of the upper back of each patient. Morphological and histological skin changes were noted in non-protected test-sites, while no clinical or microscopic changes were observed in the sunscreen-treated test-sites. Low minimal erythema dose (MED) values for both UVA and UVB light were noted in several PMLE patients.
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McFadden N. [Cutaneous Larva migrans. Creeping eruption]. Tidsskr Nor Laegeforen 1983; 103:21-2. [PMID: 6845292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
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Abstract
During a period of 2 1/2 years, 7 of 2000 patients routinely tested at our laboratory revealed contact allergy to oak moss in perfumes. All reacted to a mixture of different lichens and to some specific lichen compounds. The sensitivity was probably induced by cosmetics containing lichen substances. The following 3 compounds caused reactions in all patients tested: atranorin, evernic and usnic acids. 3 patients were photosensitive, but stronger reactions were elicited by prolonged contact during occlusion of the patches and complete protection against light, rather than by irradiation alone. The data suggest that the sensitizing capacity of the lichen compounds is primarily of a contact rather than of a photocontact nature.
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