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Lee R, Okuda K, Gallant S, Grubb B, Rogers T, Nakano S, Pickles R, Boucher R, Randell S. 668: Novel method of ex vivo airway tissue culture to model cystic fibrosis. J Cyst Fibros 2021. [DOI: 10.1016/s1569-1993(21)02091-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Pickles R, Atherton P, Turnbull H, Burns A, Iqbal M. Stereotactic ablative radiotherapy (SABR) for non-small cell lung cancer (NSCLC): analysis of T3N0M0 patients. Lung Cancer 2020. [DOI: 10.1016/s0169-5002(20)30100-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Pickles R, Atherton P, Turnbull H, Iqbal M. Effectiveness of 6-week follow-up assessments and chest x-rays for non-small cell lung cancer (NSCLC) patients treated with stereotactic ablative radiotherapy (SABR): a pilot study. Lung Cancer 2020. [DOI: 10.1016/s0169-5002(20)30102-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Iqbal M, Pickles R, Mackenzie L, Burns A, Turnbull H, Atherton P. Experience of stereotactic ablative radiotherapy (SABR) in early stage non-small cell lung cancer (NSCLC): an analysis of treatment response and survival outcome. Lung Cancer 2019. [DOI: 10.1016/s0169-5002(19)30221-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Sanganalmath P, Lester JE, Bradshaw AG, Das T, Esler C, Roy AEF, Toy E, Lester JF, Button M, Wilson P, Comins C, Atherton P, Pickles R, Foweraker K, Walker GA, Keni M, Hatton MQ. Continuous Hyperfractionated Accelerated Radiotherapy (CHART) for Non-small Cell Lung Cancer (NSCLC): 7 Years' Experience From Nine UK Centres. Clin Oncol (R Coll Radiol) 2018; 30:144-150. [PMID: 29336865 DOI: 10.1016/j.clon.2017.12.019] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2017] [Revised: 08/27/2017] [Accepted: 11/06/2017] [Indexed: 01/15/2023]
Abstract
AIM Continuous hyperfractionated accelerated radiotherapy (CHART) remains an option to treat non-small cell lung cancer (NSCLC; NICE, 2011). We have previously published treatment outcomes from 1998-2003 across five UK centres. Here we update the UK CHART experience, reporting outcomes and toxicities for patients treated between 2003 and 2009. MATERIALS AND METHODS UK CHART centres were invited to participate in a retrospective data analysis of NSCLC patients treated with CHART from 2003 to 2009. Nine (of 14) centres were able to submit their data into a standard database. The Kaplan-Meier method estimated survival and the Log-rank test analysed the significance. RESULTS In total, 849 patients had CHART treatment, with a median age of 71 years (range 31-91), 534 (63%) were men, 55% had undergone positron emission tomography-computed tomography (PET-CT) and 26% had prior chemotherapy; 839 (99%) patients received all the prescribed treatment. The median overall survival was 22 months with 2 and 3 year survival of 47% and 32%, respectively. Statistically significant differences in survival were noted for stage IA versus IB (33.2 months versus 25 months; P = 0.032) and IIIA versus IIIB (20 months versus 16 months; P = 0.018). Response at 3 months and outcomes were significantly linked; complete response showing survival of 34 months against 19 months, 15 months and 8 months for partial response, stable and progressive disease, respectively (P < 0.001). Age, gender, performance status, prior chemotherapy and PET-CT did not affect the survival outcomes. Treatment was well tolerated with <5% reporting ≥grade 3 toxicity. CONCLUSION In routine practice, CHART results for NSCLC remain encouraging and we have been able to show an improvement in survival compared with the original trial cohort. We have confirmed that CHART remains deliverable with low toxicity rates and we are taking a dose-escalated CHART regimen forward in a randomised phase II study of sequential chemoradiotherapy against other accelerated dose-escalated schedules.
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Affiliation(s)
| | | | - A G Bradshaw
- Weston Park Hospital, Sheffield, UK; Newcastle on Tyne Hospitals NHS Trust, Freeman Hospital, Newcastle, UK
| | - T Das
- Weston Park Hospital, Sheffield, UK
| | - C Esler
- University Hospitals of Leicester NHS Trust, Leicester, UK
| | - A E F Roy
- Plymouth Hospitals NHS Trust, Plymouth, UK
| | - E Toy
- Royal Devon and Exeter NHS Foundation Trust, Exeter, UK
| | | | - M Button
- Velindre Cancer Centre, Cardiff, UK
| | - P Wilson
- University Hospitals Bristol NHS Trust, Bristol, UK
| | - C Comins
- University Hospitals Bristol NHS Trust, Bristol, UK
| | - P Atherton
- Newcastle on Tyne Hospitals NHS Trust, Freeman Hospital, Newcastle, UK
| | - R Pickles
- Newcastle on Tyne Hospitals NHS Trust, Freeman Hospital, Newcastle, UK
| | - K Foweraker
- Nottingham University Hospitals NHS Trust, City Hospital, Nottingham, UK
| | - G A Walker
- Derby Hospitals NHS Trust, Royal Derby Hospital, UK
| | - M Keni
- Derby Hospitals NHS Trust, Royal Derby Hospital, UK
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McGee M, Brienesse S, Shiel E, Murch S, Pickles R, Leitch J. Staphylococcus aureus Myocarditis: Case Report and Literature Review. Heart Lung Circ 2018. [DOI: 10.1016/j.hlc.2018.06.516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Iqbal MS, Pickles R, Pedley I, Frew J, Azzabi A, Heer R, Thorpe A, Johnson M, Robson L, McMenemin R. Delays in the diagnosis and treatment of muscle invasive bladder cancer: A pilot project mapping the pathway. Journal of Clinical Urology 2015. [DOI: 10.1177/2051415814557067] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background: The patient pathway for muscle invasive bladder cancer (MIBC) is multidisciplinary. Trans-urethral resection of bladder tumour (TURBT) counts as the first definitive treatment and subsequent definitive therapy thereafter is often delayed, which may adversely affect outcome. We elected to scrutinise the management pathway in detail to understand these delays and improve the patient experience. Method: A retrospective mapping analysis was conducted on 17 patients with MIBC. The causes of any delays and measures to avoid these were identified. A prospective study of 17 patients with MIBC was then undertaken to see if the strategies used to re-engineer the patient care pathway had been effective. Result: The median time from GP referral to first appointment was 9 days (range: 1–37) and from TURBT to subsequent radical treatment was 75 days (range: 27–105) in keeping with published literature. The median time for a referral letter from urology to oncology following MDT was 15 days. We therefore modified the MDT proforma to use as a formal referral, and a project manager proactively managed the patient pathway. Capacity issues were addressed by protecting clinical slots for bladder patients and establishing monthly evening clinics. After implementing the strategies, the median days from first appointment to TURBT improved from 31 to 23 days and time from TURBT to subsequent treatment improved from 75 to 66 days. The time from MDT referral to being seen by an oncologist or urologist significantly reduced from 32 to 15 days. Conclusion: Retrospective analysis identified delays between initial TURBT to definitive therapy and strategies adopted to reduce these were effective. TURBT is a diagnostic process and if acknowledged as first treatment results in delays of what is the definitive treatment. We found the initial diagnostic pathway to work well but non-muscle invasive bladder cancer (NMIBC) and MIBC are then managed very differently and warrant two separate pathways.
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Affiliation(s)
- M Shahid Iqbal
- Department of Clinical Oncology, Northern Centre for Cancer Care, Freeman Hospital, UK
| | - R Pickles
- Department of Therapeutic Radiography, Northern Centre for Cancer Care, Freeman Hospital, UK
| | - I Pedley
- Department of Clinical Oncology, Northern Centre for Cancer Care, Freeman Hospital, UK
| | - J Frew
- Department of Clinical Oncology, Northern Centre for Cancer Care, Freeman Hospital, UK
| | - A Azzabi
- Department of Clinical Oncology, Northern Centre for Cancer Care, Freeman Hospital, UK
| | - R Heer
- Department of Urology, Newcastle University and Freeman Hospital, Newcastle upon Tyne, UK
| | - A Thorpe
- Department of Urology, Freeman Hospital, UK
| | - M Johnson
- Department of Urology, Freeman Hospital, UK
| | - L Robson
- Department of Urology, Freeman Hospital, UK
| | - R McMenemin
- Department of Clinical Oncology, Northern Centre for Cancer Care, Freeman Hospital, UK
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Jackel D, Attia J, Pickles R. General medicine advanced training: lessons from the John Hunter training programme. Intern Med J 2014; 44:302-6. [DOI: 10.1111/imj.12357] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2013] [Accepted: 12/17/2013] [Indexed: 11/27/2022]
Affiliation(s)
- D. Jackel
- Division of Medicine; John Hunter Hospital; Newcastle New South Wales Australia
| | - J. Attia
- Division of Medicine; John Hunter Hospital; Newcastle New South Wales Australia
- School of Medicine and Public Health; University of Newcastle; Newcastle New South Wales Australia
- Hunter Medical Research Institute; Newcastle New South Wales Australia
| | - R. Pickles
- Division of Medicine; John Hunter Hospital; Newcastle New South Wales Australia
- School of Medicine and Public Health; University of Newcastle; Newcastle New South Wales Australia
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Kagzi M, Pickles R, McFetrich C, Macdonald A, Mulvenna P, McMenemin R, McCallum H, McDonald F, Atherton P. EP-1230 ASSESSING ACUTE RADIATION OESOPHAGITIS AFTER CHART FOR NON-SMALL CELL LUNG CANCER: A SINGLE CENTRE EXPERIENCE. Radiother Oncol 2012. [DOI: 10.1016/s0167-8140(12)71563-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Pickles R, Mulvenna P, McMenemin R, Atherton P, Mcdonald F, Kagzi M, McFetrich C. 144 Prospective data of continuous hyperfractionated accelerated radiotherapy (CHART): does performance status have an impact on radiation acute toxicities and resources? Lung Cancer 2012. [DOI: 10.1016/s0169-5002(12)70145-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Hellard M, Fuller A, Spelman D, Spicer WJ, Pickles R, Jenney A. Totally implantable venous access device infections in patients with AIDS. AIDS 1997; 11:697-8. [PMID: 9108962] [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: 02/04/2023]
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Detering K, Jenney A, Hall A, Fuller A, Pickles R, Snell G. Metastatic choroidal abscess due to Pseudomonas aeruginosa in patients with cystic fibrosis. Clin Infect Dis 1997; 24:525-6. [PMID: 9114220 DOI: 10.1093/clinids/24.3.525] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Affiliation(s)
- K Detering
- Department of Respiratory Medicine, Alfred Hospital, Prahran, Victoria, Australia
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Boucher RC, Knowles MR, Johnson LG, Olsen JC, Pickles R, Wilson JM, Engelhardt J, Yang Y, Grossman M. Gene therapy for cystic fibrosis using E1-deleted adenovirus: a phase I trial in the nasal cavity. The University of North Carolina at Chapel Hill. Hum Gene Ther 1994; 5:615-39. [PMID: 7519885 DOI: 10.1089/hum.1994.5.5-615] [Citation(s) in RCA: 95] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
Cystic fibrosis (CF) is an autosomal recessive disease that reflects mutations in the CFTR gene. Multiple mutations in this gene have been detected that lead to a protein (CFTR) that is abnormally metabolized, dysfunction, or both. The full spectrum of the activities of the gene product have not been defined, but it is clear that CFTR can act as a cAMP-regulated Cl- channel. This type of defect is consistent with the physiologic characterization of CF epithelia, which has revealed abnormalities in salt and water transport. In the lung, abnormalities in epithelial salt and water metabolism lead to abnormal mucociliary clearance. This defect in clerance represents a major failure of lung defense and leads ultimately to infection of the lung with Staphylococcus aureus, Pseudomonas aeruginosa, and other bacterial organisms. The chronic inflammatory response to this persistent intraluminal bacterial infection leads to protease-induced destruction of airway walls and finally, lung failure. More than 95% of CF patients die of lung disease. The clinical therapy of CF lung disease is limited to agents designed to promote clearance of secretions from the lung and antibiotics to treat the chronic bacterial infection. Recent laboratory demonstrations that introduction of the normal CFTR cDNA into CF cells corrects the ion transport defects of these cells has led to the hypothesis that gene therapy in the lung can be an effective, novel mode of therapy for this lung disease. The classic gene transfer vectors, e.g., retroviruses, appear to be not well suited for therapy of lung disease because of the low proliferation rate of airway epithelia in vivo. Recently, adenoviruses, which have a natural tropism for airway epithelia, have been genetically modified (E1-deleted) in an attempt to reduce potential toxicity of this virus and provide space for the CFTR cDNA. A series of in vitro studies have shown that this vector is highly efficient for transferring CFTR into airway epithelial cells in culture and correcting the CF defect. Further, studies in whole animals appear to indicate that this mode of gene transfer is associated with a low degree of toxicity. The present study is a dose-effect study designed to test for the safety and efficacy of E1-deleted recombinant adenovirus containing the CFTR cDNA under a CMV-beta-actin promoter in CF nasal epithelia.(ABSTRACT TRUNCATED AT 400 WORDS)
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Pickles R, Long G, Murugasu R. Isolated renal mucormycosis. Med J Aust 1994; 160:514-6. [PMID: 8170430] [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: 01/29/2023]
Abstract
OBJECTIVE To report a case of isolated renal mucormycosis in a previously healthy man, and to briefly review the literature relating to this rare condition. CLINICAL FEATURES An 18-year-old man presented with a two-month history of fevers followed by two weeks of severe left loin pain. Initial treatment with antibiotics failed and abdominal computed tomography and renal perfusion scans were requested, demonstrating a non-functioning left kidney. INTERVENTION AND OUTCOME Nephrectomy was performed, the histology of which was consistent with mucormycosis. Amphotericin B was administered for one month. The patient made a complete recovery and no underlying disorder was found. CONCLUSIONS This man is believed to be the first reported Australian with isolated renal mucormycosis, and only the second person worldwide in whom an identifiable underlying disorder was absent.
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Affiliation(s)
- R Pickles
- John Hunter Hospital, New Lambton Heights, NSW
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Abstract
An attempt has been made to redetermine the enthalpy and entropy of formation of the charge-transfer complex between tetracyanoethylene and biphenylene in dichloromethane solution from measurements of the equilibrium constant at different temperatures. The results obtained under conditions where biphenylene is in excess differ from those previously published in which tetracyanoethylene was in excess. It is argued that the optimum condition for determining equilibrium constants of a 1:1 complex is when the reactants are mixed in solution in this ratio. Determinations under this condition yield ΔH = −2.6 kcal mole−1 and ΔS = −4.1 e.u.The energies of the intermolecular charge-transfer transitions of biphenylene with several different acceptors suggest that the ionization potential of biphenylene is ~7.4 eV.
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