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Quatresooz F, Griffiths R, Bardou L, Wilson R, Osborn J, Vanhoenacker-Janvier D, Oestges C. Continuous daytime and nighttime forecast of atmospheric optical turbulence from numerical weather prediction models. Opt Express 2023; 31:33850-33872. [PMID: 37859156 DOI: 10.1364/oe.500090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Accepted: 09/14/2023] [Indexed: 10/21/2023]
Abstract
Future satellite-to-ground optical communication systems will benefit from accurate forecasts of atmospheric optical turbulence; namely for site selection, for the routing and the operation of optical links, and for the design of optical communication terminals. This work presents a numerical approach based on the Weather Research and Forecasting software that enables continuous forecast of the refractive index structure parameter, C n2, vertical profiles. Two different C n2 models are presented and compared. One is based on monitoring the turbulent kinetic energy, while the other is a hybrid model using the Tatarskii equation to depict the free atmosphere region, and the Monin-Obukhov similarity theory for describing the boundary layer. The validity of both models is assessed by using thermosonde measurements from the Terrain-induced Rotor Experiment campaign, and from day and night measurements of the coherence length collected during a six-day campaign at Paranal observatory by a Shack-Hartmann Image Motion Monitor. The novelty of this work is the ability of the presented approach to continuously predict optical turbulence both during daytime and nighttime, and its validation with measurements in day and night conditions.
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Griffiths R, Osborn J, Farley O, Butterley T, Townson MJ, Wilson R. Demonstrating 24-hour continuous vertical monitoring of atmospheric optical turbulence. Opt Express 2023; 31:6730-6740. [PMID: 36823923 DOI: 10.1364/oe.479544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Accepted: 01/15/2023] [Indexed: 06/18/2023]
Abstract
We report what is believed to be the first example of fully continuous, 24-hour vertical monitoring of atmospheric optical turbulence. This is achieved using a novel instrument, the 24-hour Shack-Hartmann Image Motion Monitor (24hSHIMM). Optical turbulence is a fundamental limitation for applications such as free-space optical communications, where it limits the achievable bandwidth, and ground-based optical astronomy, restricting the observational precision. Knowledge of the turbulence enables us to select the best sites, design optical instrumentation and optimise the operation of ground-based optical systems. The 24hSHIMM estimates the vertical optical turbulence coherence length, time, angle and Rytov variance from the measurement of a four-layer vertical turbulence profile and a wind speed profile retrieved from meteorological forecasts. To illustrate our advance we show the values of these parameters recorded during a 36-hour, continuous demonstration of the instrument. Due to its portability and ability to work in stronger turbulence, the 24hSHIMM can also operate in urban locations, providing the field with a truly continuous, versatile turbulence monitor for all but the most demanding of applications.
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Waddell T, Fife K, Griffiths R, Sharma A, Dhokia P, Groves L, Hurst M, Tsang C, Sugrue D, McKenna S, Houghton J, Carroll R. Real-world treatment sequencing and survival in previously treated advanced renal cell carcinoma patients receiving nivolumab monotherapy: a UK retrospective cohort study. BMC Cancer 2022; 22:617. [PMID: 35668384 PMCID: PMC9169585 DOI: 10.1186/s12885-022-09694-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Accepted: 05/24/2022] [Indexed: 11/10/2022] Open
Abstract
Background The CheckMate 025 trial established nivolumab monotherapy as one of the standards of care in previously treated advanced or metastatic renal cell carcinoma (aRCC). However, supporting real-world data is lacking. This study investigated characteristics, treatment sequences and clinical outcomes of patients who received nivolumab monotherapy for previously treated aRCC in the UK. Methods This was a retrospective cohort study of aRCC patients treated with nivolumab at second line or later (2L +) at 4 UK oncology centres. Eligible patients commenced nivolumab (index date) between 01 March 2016 and 30 June 2018 (index period). Study data were extracted from medical records using an electronic case report form. Data cut-off (end of follow-up) was 31 May 2019. Results In total, 151 patients were included with median follow-up of 15.2 months. Mean age was 66.9 years, male preponderance (72.2%), and mostly Eastern Cooperative Oncology Group performance status grade 0–1 (71.5%). Amongst 112 patients with a known International Metastatic RCC Database Consortium score, distribution between favourable, intermediate, and poor risk categories was 20.5%, 53.6%, and 25.9% respectively. The majority of patients (n = 109; 72.2%) received nivolumab at 2L, and these patients had a median overall survival (OS) of 23.0 months [95% confidence interval: 17.2, not reached]. All patients who received nivolumab at 2L had received TKIs at 1L. Amongst the 42 patients (27.8%) who received nivolumab in third line or later (3L +) the median OS was 12.4 months [95% CI: 8.8, 23.2]. The most common reasons for nivolumab discontinuation were disease progression (2L: 61.2%; 3L: 68.8%) and adverse events (2L: 34.7%; 3L: 28.1%). Conclusion This study provides real-world evidence on the characteristics, treatment sequences, and outcomes of aRCC patients who received 2L + nivolumab monotherapy in the UK. Nivolumab-specific survival outcomes were similar to those achieved in the CheckMate 025 trial.
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Affiliation(s)
- T Waddell
- Gastro-Oesophageal and Renal Unit, The Christie NHS Foundation Trust, Manchester, UK.
| | - K Fife
- Cambridge University NHS Foundation Trust, Cambridge, UK
| | - R Griffiths
- The Clatterbridge Cancer Centre, Birkenhead, UK
| | - A Sharma
- Mount Vernon Cancer Centre, Northwood, UK
| | - P Dhokia
- Bristol Myers Squibb, Uxbridge, UK
| | - L Groves
- Health Economics & Outcomes Research Ltd, Cardiff, UK
| | - M Hurst
- Bristol Myers Squibb, Uxbridge, UK.,Health Economics & Outcomes Research Ltd, Cardiff, UK
| | - C Tsang
- Health Economics & Outcomes Research Ltd, Cardiff, UK
| | - D Sugrue
- Health Economics & Outcomes Research Ltd, Cardiff, UK
| | - S McKenna
- Health Economics & Outcomes Research Ltd, Cardiff, UK
| | - J Houghton
- Health Economics & Outcomes Research Ltd, Cardiff, UK
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D'Sa A, Griffiths R. Medicolegal claims: a way to learn from our mistakes? Anaesthesia 2022; 77:507-509. [PMID: 35355245 DOI: 10.1111/anae.15729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 03/16/2022] [Accepted: 03/18/2022] [Indexed: 11/28/2022]
Affiliation(s)
- A D'Sa
- Department of Anaesthesia and Intensive Care, Addenbrooke's Hospital, Cambridge, UK
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Griffiths R, Cook N, James C, Manchester V. Pelvic health physiotherapy delivered via telehealth for patients presenting with pelvic organ prolapse and urinary incontinence. Physiotherapy 2022. [DOI: 10.1016/j.physio.2021.12.325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Wu H, Crost EH, Owen CD, van Bakel W, Martínez Gascueña A, Latousakis D, Hicks T, Walpole S, Urbanowicz PA, Ndeh D, Monaco S, Sánchez Salom L, Griffiths R, Reynolds RS, Colvile A, Spencer DIR, Walsh M, Angulo J, Juge N. The human gut symbiont Ruminococcus gnavus shows specificity to blood group A antigen during mucin glycan foraging: Implication for niche colonisation in the gastrointestinal tract. PLoS Biol 2021; 19:e3001498. [PMID: 34936658 PMCID: PMC8730463 DOI: 10.1371/journal.pbio.3001498] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2021] [Revised: 01/05/2022] [Accepted: 11/26/2021] [Indexed: 12/24/2022] Open
Abstract
The human gut symbiont Ruminococcus gnavus displays strain-specific repertoires of glycoside hydrolases (GHs) contributing to its spatial location in the gut. Sequence similarity network analysis identified strain-specific differences in blood-group endo-β-1,4-galactosidase belonging to the GH98 family. We determined the substrate and linkage specificities of GH98 from R. gnavus ATCC 29149, RgGH98, against a range of defined oligosaccharides and glycoconjugates including mucin. We showed by HPAEC-PAD and LC-FD-MS/MS that RgGH98 is specific for blood group A tetrasaccharide type II (BgA II). Isothermal titration calorimetry (ITC) and saturation transfer difference (STD) NMR confirmed RgGH98 affinity for blood group A over blood group B and H antigens. The molecular basis of RgGH98 strict specificity was further investigated using a combination of glycan microarrays, site-directed mutagenesis, and X-ray crystallography. The crystal structures of RgGH98 in complex with BgA trisaccharide (BgAtri) and of RgGH98 E411A with BgA II revealed a dedicated hydrogen network of residues, which were shown by site-directed mutagenesis to be critical to the recognition of the BgA epitope. We demonstrated experimentally that RgGH98 is part of an operon of 10 genes that is overexpresssed in vitro when R. gnavus ATCC 29149 is grown on mucin as sole carbon source as shown by RNAseq analysis and RT-qPCR confirmed RgGH98 expression on BgA II growth. Using MALDI-ToF MS, we showed that RgGH98 releases BgAtri from mucin and that pretreatment of mucin with RgGH98 confered R. gnavus E1 the ability to grow, by enabling the E1 strain to metabolise BgAtri and access the underlying mucin glycan chain. These data further support that the GH repertoire of R. gnavus strains enable them to colonise different nutritional niches in the human gut and has potential applications in diagnostic and therapeutics against infection.
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Affiliation(s)
- Haiyang Wu
- Quadram Institute Bioscience, Norwich, United Kingdom
| | | | - C David Owen
- Diamond Light Source Ltd, Didcot, United Kingdom
- Research Complex at Harwell, Didcot, United Kingdom
| | | | | | | | - Thomas Hicks
- University of East Anglia, Norwich, United Kingdom
| | | | | | - Didier Ndeh
- Quadram Institute Bioscience, Norwich, United Kingdom
| | | | | | | | | | - Anna Colvile
- Diamond Light Source Ltd, Didcot, United Kingdom
- Research Complex at Harwell, Didcot, United Kingdom
| | | | - Martin Walsh
- Diamond Light Source Ltd, Didcot, United Kingdom
- Research Complex at Harwell, Didcot, United Kingdom
| | - Jesus Angulo
- University of East Anglia, Norwich, United Kingdom
- Universidad de Sevilla and Instituto de Investigaciones Químicas, Sevilla, Spain
| | - Nathalie Juge
- Quadram Institute Bioscience, Norwich, United Kingdom
- * E-mail:
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Brown J, Royle KL, Ralph C, Meads D, Martin A, Howard H, Linsley C, Swain J, Powles T, Jones R, Eisen T, Maraveyas A, Griffiths R, Din O, Goh V, Wah T, Selby P, Hewison J, Brown J, Collinson F. LBA28 STAR: A randomised multi-stage phase II/III trial of standard first-line therapy (sunitinib or pazopanib) comparing temporary cessation with allowing continuation, in the treatment of locally advanced and/or metastatic renal Cancer (RCC). Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.2104] [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] Open
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Vasudev N, Ainsworth G, Brown S, Pickering L, Waddell T, Fife K, Griffiths R, Sharma A, Katona E, Howard H, Velikova G, Maraveyas A, Brown J, Venugopal B, Patel P, Jain A, Symeonides S, Nathan P, Collinson F, Powles T. LBA29 Nivolumab in combination with alternatively scheduled ipilimumab in first-line treatment of patients with advanced renal cell carcinoma: A randomized phase II trial (PRISM). Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.2105] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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10
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Pugh RJ, Bailey R, Szakmany T, Al Sallakh M, Hollinghurst J, Akbari A, Griffiths R, Battle C, Thorpe C, Subbe CP, Lyons RA. Long-term trends in critical care admissions in Wales. Anaesthesia 2021; 76:1316-1325. [PMID: 33934335 PMCID: PMC10138728 DOI: 10.1111/anae.15466] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/03/2021] [Indexed: 11/27/2022]
Abstract
As national populations age, demands on critical care services are expected to increase. In many healthcare settings, longitudinal trends indicate rising numbers and proportions of patients admitted to ICU who are older; elsewhere, including some parts of the UK, a decrease has raised concerns with regard to rationing according to age. Our aim was to investigate admission trends in Wales, where critical care capacity has not risen in the last decade. We used the Secure Anonymised Information Linkage Databank to identify and characterise critical care admissions in patients aged ≥ 18 years from 1 January 2008 to 31 December 2017. We categorised 85,629 ICU admissions as youngest (18-64 years), older (65-79 years) and oldest (≥ 80 years). The oldest group accounted for 15% of admissions, the older age group 39% and the youngest group 46%. Relative to the national population, the incidence of admission rates per 10,000 population in the oldest group decreased significantly over the study period from 91.5/10,000 in 2008 to 77.5/10,000 (a relative decrease of 15%), and among the older group from 89.2/10,000 in 2008 to 75.3/10,000 in 2017 (a relative decrease of 16%). We observed significant decreases in admissions with high comorbidity (modified Charlson comorbidity index); increases in the proportion of older patients admitted who were considered 'fit' rather than frail (electronic frailty index); and decreases in admissions with a medical diagnosis. In contrast to other healthcare settings, capacity constraints and surgical imperatives appear to have contributed to a relative exclusion of older patients presenting with acute medical illness.
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Affiliation(s)
- R J Pugh
- Department of Anaesthetics, Glan Clwyd Hospital, Bodelwyddan, UK
| | - R Bailey
- Public Health Medicine, Swansea University, Swansea, UK
| | - T Szakmany
- Department of Anaesthesia, Intensive Care and Pain Medicine, Division of Population Medicine, Cardiff University, Cardiff, UK
| | - M Al Sallakh
- Public Health Medicine, Swansea University, Swansea, UK
| | | | - A Akbari
- Public Health Medicine, Swansea University, Swansea, UK
| | - R Griffiths
- Public Health Medicine, Swansea University, Swansea, UK
| | - C Battle
- Ed Major Critical Care Unit, Morriston Hospital, Swansea, UK
| | - C Thorpe
- Department of Anaesthetics, Ysbyty Gwynedd, Bangor, UK
| | - C P Subbe
- Acute and Critical Care Medicine, School of Medical Sciences, Bangor University, Bangor, UK
| | - R A Lyons
- Public Health Medicine, Swansea University, Swansea, UK
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Griffiths R, Hamza K. Matching the Distributions of the Marginals and the Sums for the Meixner Class. Theory Probab Appl 2021. [DOI: 10.1137/s0040585x97t990496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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12
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Griffiths R, Babu S, Dixon P, Freeman N, Hurford D, Kelleher E, Moppett I, Ray D, Sahota O, Shields M, White S. Guideline for the management of hip fractures 2020: Guideline by the Association of Anaesthetists. Anaesthesia 2020; 76:225-237. [PMID: 33289066 DOI: 10.1111/anae.15291] [Citation(s) in RCA: 86] [Impact Index Per Article: 21.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/27/2020] [Indexed: 12/26/2022]
Abstract
We convened a multidisciplinary Working Party on behalf of the Association of Anaesthetists to update the 2011 guidance on the peri-operative management of people with hip fracture. Importantly, these guidelines describe the core aims and principles of peri-operative management, recommending greater standardisation of anaesthetic practice as a component of multidisciplinary care. Although much of the 2011 guidance remains applicable to contemporary practice, new evidence and consensus inform the additional recommendations made in this document. Specific changes to the 2011 guidance relate to analgesia, medicolegal practice, risk assessment, bone cement implantation syndrome and regional review networks. Areas of controversy remain, and we discuss these in further detail, relating to the mode of anaesthesia, surgical delay, blood management and transfusion thresholds, echocardiography, anticoagulant and antiplatelet management and postoperative discharge destination. Finally, these guidelines provide links to supplemental online material that can be used at readers' institutions, key references and UK national guidance about the peri-operative care of people with hip and periprosthetic fractures during the COVID-19 pandemic.
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Affiliation(s)
- R Griffiths
- Department of Anaesthesia, Peterborough and Stamford Hospitals NHS Trust Peterborough, UK and Chair, Working Party, Association of Anaesthetists, UK
| | - S Babu
- Department of Anaesthesia, Warrington and Halton Hospitals NHS Trust, Warrington, UK
| | - P Dixon
- Department of Trauma and Orthopaedics, South Tyneside and Sunderland NHS Trust, Sunderland, UK and British Orthopaedic Association, Orthopaedic Trauma Society, UK
| | - N Freeman
- Department of Anaesthesia, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - D Hurford
- Department of Anaesthesia, Cwm Taf Morgannwg University Health Board and Chair, Welsh Frailty Fracture Network, UK, UK
| | - E Kelleher
- Department of Anaesthesia, University of Galway, Galway, Ireland
| | - I Moppett
- Division of Clinical Neuroscience, School of Medicine, University of Nottingham, UK.,Department of Anaesthesia, Nottingham University Hospitals, Nottingham, UK
| | - D Ray
- Department of Anaesthesia, Royal Infirmary Edinburgh and Honorary Clinical Senior Lecturer, University of Edinburgh, Edinburgh, UK
| | - O Sahota
- Department of Healthcare of Older People, Nottingham University Hospitals, Nottingham, UK and British Geriatrics Society, UK
| | - M Shields
- Department of Anaesthesia, Royal Hospitals, Belfast, UK
| | - S White
- Department of Anaesthesia, Brighton and Sussex University Hospitals NHS Trust, Brighton, UK
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Poudel P, Griffiths R, Wong VW, Arora A, Flack JR, George A. Oral health care among patients with diabetes in Australia: A snapshot. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa166.1105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Diabetes increases the risk of periodontal disease, which in turn negatively impact on diabetes control and complications. Therefore, awareness about the diabetes-oral health link and dental problems is important for people with diabetes. This study aimed to assess self-reported oral health status and knowledge of people living with diabetes.
Methods
A survey was conducted among patients who attended four public diabetes clinics in Sydney, Australia. The questionnaire included 10 knowledge items and a validated Oral Health Impact Profile (OHIP-14) scale. A convenience sample of 200 patients were recruited. The data were analysed using SPSS software with descriptive and Pearson's Chi-Squared tests reported.
Results
The mean age of participants was 62.4(±13.5) years. More than half were males (54.5%), born overseas (64%), not working (73%) and had type 2 diabetes (88%). More than half (55.1%) of the patients reported having one or more dental problems and this was negatively associated with their oral health-related quality of life (p < 0.001). The most common dental problems were: gaps between teeth, pain in teeth and dry mouth. Only 46.2% of the participants had adequate oral health knowledge (> the mean correct score 5.2 (±2.6). The main areas with poor knowledge were around the impact of gum disease on blood glucose levels (29.6%), effects of dry mouth on tooth decay (33.8%) and the link between diabetes and teeth and gums (44.5%). Only 13% of the patients reported receiving oral health information from diabetes care providers (diabetes educator, general practitioner/diabetes specialist and dietitian/nutritionist). Receiving oral health information was found to be significantly associated with higher oral health knowledge scores (p < 0.05).
Conclusions
Considering that a majority of patients with diabetes have dental problems and inadequate oral health knowledge, diabetes care providers should take the opportunity to educate patients about oral health risks.
Key messages
People living with diabetes found to have dental problems and inadequate oral health knowledge. Considering that diabetes and dental problems adversely affect each other, it is crucial to educate patients about good oral hygiene and regular dental visit.
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Affiliation(s)
- P Poudel
- School of Nursing & Midwifery, Western Sydney University, Campbelltown, Australia
- Centre for Oral Health Outcomes and Research Translation, WSU, Ingham Institute for Applied Medical Research South Western Sydney Local Health District, Liverpool, Australia
- Ingham Institute for Applied Medical Research, South Western Sydney Local Health District, Liverpool, Australia
| | - R Griffiths
- School of Nursing & Midwifery, Western Sydney University, Campbelltown, Australia
| | - V W Wong
- Ingham Institute for Applied Medical Research, South Western Sydney Local Health District, Liverpool, Australia
- Diabetes and Endocrine Service, Liverpool and Fairfield Hospital SWSLHD, Liverpool, Australia
- Faculty of Medicine, University of New South Wales, Kensington, Australia
| | - A Arora
- School of Health Sciences, Western Sydney University, Campbelltown, Australia
- Translational Health Research Institute, Western Sydney University, Penrith, Australia
- Discipline of Child and Adolescent Health, Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Westmead, Australia
| | - J R Flack
- Faculty of Medicine, University of New South Wales, Kensington, Australia
- Diabetes Centre Bankstown-Lidcombe Hospital, South Western Sydney Local Health District, Bankstown, Australia
- School of Medicine, Western Sydney University, Campbelltown, Australia
| | - A George
- School of Nursing & Midwifery, Western Sydney University, Campbelltown, Australia
- Centre for Oral Health Outcomes and Research Translation, WSU, Ingham Institute for Applied Medical Research South Western Sydney Local Health District, Liverpool, Australia
- Ingham Institute for Applied Medical Research, South Western Sydney Local Health District, Liverpool, Australia
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Griffiths R, Schlüter DK, Akbari A, Cosgriff R, Tucker D, Taylor-Robinson D. Identifying children with Cystic Fibrosis in population-scale routinely collected data in Wales: A Retrospective Review. Int J Popul Data Sci 2020; 5:1346. [PMID: 33644411 PMCID: PMC7898022 DOI: 10.23889/ijpds.v5i1.1346] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
INTRODUCTION The challenges in identifying a cohort of people with a rare condition can be addressed by routinely collected, population-scale electronic health record (EHR) data, which provide large volumes of data at a national level. This paper describes the challenges of accurately identifying a cohort of children with Cystic Fibrosis (CF) using EHR and their validation against the UK CF Registry. OBJECTIVES To establish a proof of principle and provide insight into the merits of linked data in CF research; to identify the benefits of access to multiple data sources, in particular the UK CF Registry data, and to demonstrate the opportunity it represents as a resource for future CF research. METHODS Three EHR data sources were used to identify children with CF born in Wales between 1st January 1998 and 31st August 2015 within the Secure Anonymised Information Linkage (SAIL) Databank. The UK CF Registry was later acquired by SAIL and linked to the EHR cohort to validate the cases and explore the reasons for misclassifications. RESULTS We identified 352 children with CF in the three EHR data sources. This was greater than expected based on historical incidence rates in Wales. Subsequent validation using the UK CF Registry found that 257 (73%) of these were true cases. Approximately 98.7% (156/158) of individuals identified as CF cases in all three EHR data sources were confirmed as true cases; but this was only the case for 19.8% (20/101) of all those identified in just a single data source. CONCLUSION Identifying health conditions in EHR data can be challenging, so data quality assurance and validation is important or the merit of the research is undermined. This retrospective review identifies some of the challenges in identifying CF cases and demonstrates the benefits of linking cases across multiple data sources to improve quality.
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Affiliation(s)
- R Griffiths
- Swansea University Medical School, Swansea University
- Health Data Research UK
| | - DK Schlüter
- Department of Public Health and Policy, University of Liverpool, Liverpool L69 7ZX
| | - A Akbari
- Swansea University Medical School, Swansea University
- Health Data Research UK
- Administrative Data Research Wales
| | - R Cosgriff
- Cystic Fibrosis Trust, One Aldgate, London EC3N 1R
| | - D Tucker
- Public Health Wales, Capital Quarter 2, Tyndall Street, Cardiff. CF10 4BZ\break † Joint First Authors
| | - D Taylor-Robinson
- Department of Public Health and Policy, University of Liverpool, Liverpool L69 7ZX
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Gibson J, Dobbs T, Griffiths R, Song J, Akbari A, Whitaker S, Watkins A, Langan S, Hutchings H, Lyons R, Whitaker I. The association of smoking and socioeconomic status on melanoma skin cancer. Br J Dermatol 2020. [DOI: 10.1111/bjd.18997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Gibson J, Dobbs T, Griffiths R, Song J, Akbari A, Whitaker S, Watkins A, Langan S, Hutchings H, Lyons R, Whitaker I. 吸烟和社会经济地位与黑色素瘤皮肤癌的关联. Br J Dermatol 2020. [DOI: 10.1111/bjd.19008] [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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Gibson JAG, Dobbs TD, Griffiths R, Song J, Akbari A, Whitaker S, Watkins A, Langan SM, Hutchings HA, Lyons RA, Whitaker IS. The association of smoking and socioeconomic status on cutaneous melanoma: a population-based, data-linkage, case-control study. Br J Dermatol 2020; 182:1136-1147. [PMID: 31529485 PMCID: PMC7383980 DOI: 10.1111/bjd.18526] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/08/2019] [Indexed: 01/12/2023]
Abstract
BACKGROUND Previous studies have identified an inverse association between melanoma and smoking; however, data from population-based studies are scarce. OBJECTIVES To determine the association between smoking and socioeconomic (SES) on the risk of development of melanoma. Furthermore, we sought to determine the implications of smoking and SES on survival. METHODS We conducted a population-based case-control study. Cases were identified from the Welsh Cancer Intelligence and Surveillance Unit (WCISU) during 2000-2015 and controls from the general population. Smoking and SES were obtained from data linkage with other national databases. The association of smoking status and SES on the incidence of melanoma were assessed using binary logistic regression. Multivariate survival analysis was performed on a melanoma cohort using a Cox proportional hazard model using survival as the outcome. RESULTS During 2000-2015, 9636 patients developed melanoma. Smoking data were obtained for 7124 (73·9%) of these patients. There were 26 408 controls identified from the general population. Smoking was inversely associated with melanoma incidence [odds ratio (OR) 0·70, 95% confidence interval (CI) 0·65-0·76]. Smoking was associated with an increased overall mortality [hazard ratio (HR) 1·30, 95% CI 1·09-1·55], but not associated with melanoma-specific mortality. Patients with higher SES had an increased association with melanoma incidence (OR 1·58, 95% CI 1·44-1·73). Higher SES was associated with an increased chance of both overall (HR 0·67, 95% CI 0·56-0·81) and disease-specific survival (HR 0·69, 95% CI 0·53-0·90). CONCLUSIONS Our study has demonstrated that smoking appeared to be associated with reduced incidence of melanoma. Although smoking increases overall mortality, no association was observed with melanoma-specific mortality. Further work is required to determine if there is a biological mechanism underlying this relationship or an alternative explanation, such as survival bias. What's already known about this topic? Previous studies have been contradictory with both negative and positive associations between smoking and the incidence of melanoma reported. Previous studies have either been limited by publication bias because of selective reporting or underpowered. What does this study add? Our large study identified an inverse association between smoking status and melanoma incidence. Although smoking status was negatively associated with overall disease survival, no significant association was noted in melanoma-specific survival. Socioeconomic status remains closely associated with melanoma. Although higher socioeconomic populations are more likely to develop the disease, patients with lower socioeconomic status continue to have a worse prognosis.
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Affiliation(s)
- J A G Gibson
- Reconstructive Surgery& Regenerative Medicine Research Group, Institute of Life Science, Swansea University Medical School, Swansea, U.K.,The Welsh Centre for Burns and Plastic Surgery, Morriston Hospital, Swansea, U.K
| | - T D Dobbs
- Reconstructive Surgery& Regenerative Medicine Research Group, Institute of Life Science, Swansea University Medical School, Swansea, U.K.,The Welsh Centre for Burns and Plastic Surgery, Morriston Hospital, Swansea, U.K
| | - R Griffiths
- Health Data Research UK, Swansea University, Swansea, U.K
| | - J Song
- Health Data Research UK, Swansea University, Swansea, U.K
| | - A Akbari
- Patient and Population Health and Informatics Research and, Swansea University Medical School, Swansea, U.K.,Administrative Data Research Centre Wales, Swansea University Medical School, Swansea, U.K.,Health Data Research UK, Swansea University, Swansea, U.K
| | - S Whitaker
- Department of Dermatology, Singleton Hospital, Swansea, U.K
| | - A Watkins
- Patient and Population Health and Informatics Research and, Swansea University Medical School, Swansea, U.K.,Health Data Research UK, Swansea University, Swansea, U.K
| | - S M Langan
- Health Data Research UK, London, U.K.,London School of Hygiene & Tropical Medicine, London, U.K
| | - H A Hutchings
- Patient and Population Health and Informatics Research and, Swansea University Medical School, Swansea, U.K
| | - R A Lyons
- Patient and Population Health and Informatics Research and, Swansea University Medical School, Swansea, U.K.,Administrative Data Research Centre Wales, Swansea University Medical School, Swansea, U.K.,Health Data Research UK, Swansea University, Swansea, U.K
| | - I S Whitaker
- Reconstructive Surgery& Regenerative Medicine Research Group, Institute of Life Science, Swansea University Medical School, Swansea, U.K.,The Welsh Centre for Burns and Plastic Surgery, Morriston Hospital, Swansea, U.K
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Griffiths R, Schlüter D, Akbari A, Cosgriff R, Tucker D, Taylor-Robinson D. P071 Linkage of the UK cystic fibrosis Registry with electronic health records in Wales: a new resource for research. J Cyst Fibros 2019. [DOI: 10.1016/s1569-1993(19)30365-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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19
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Affiliation(s)
- S M White
- Royal Sussex County Hospital, Brighton, UK
| | - R Griffiths
- Peterborough and Stamford Hospitals NHS Trust, Peterborough, UK
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20
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White S, Griffiths R, Baxter M, Beanland T, Cross J, Dhesi J, Docherty AB, Foo I, Jolly G, Jones J, Moppett IK, Plunkett E, Sachdev K. Guidelines for the peri-operative care of people with dementia. Anaesthesia 2019; 74:357-372. [DOI: 10.1111/anae.14530] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/07/2018] [Indexed: 12/24/2022]
Affiliation(s)
- S. White
- Royal Sussex County Hospital; Co-Chair, Association of Anaesthetists Working Party; Brighton UK
| | - R. Griffiths
- Peterborough and Stamford Hospitals Foundation NHS Trust; Co-Chair, Association of Anaesthetists Working Party; Peterborough UK
| | - M. Baxter
- University Hospital Southampton; British Geriatrics Society; UK
| | | | - J. Cross
- Guy's and St. Thomas’ Hospitals NHS Trust; Royal College of Nursing; London UK
| | - J. Dhesi
- Guy's and St. Thomas’ Hospitals NHS Trust; British Geriatrics Society; London UK
| | - A. B. Docherty
- Department of Anaesthesia and Critical Care; University of Edinburgh; UK
| | - I. Foo
- Western General Hospital; Age Anaesthesia Association; Edinburgh UK
| | | | | | - I. K. Moppett
- Anaesthesia and Peri-operative Medicine; University of Nottingham; Royal College of Anaesthetists; UK
| | - E. Plunkett
- University Hospitals Birmingham; Association of Anaesthetists Trainees; UK
| | - K. Sachdev
- Homerton University Hospital NHS Foundation Trust; London UK
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21
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Affiliation(s)
- I K Moppett
- University of Nottingham and Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - S M White
- Brighton and Sussex University Hospitals NHS Trust, Brighton, UK
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Abstract
As longevity increases globally, the number of older, frailer, comorbid patients requiring fragility fracture surgery will increase. Fundamentally, anaesthesia should aim to maintain these patients' pre-fracture cognitive and physiological trajectories and facilitate early (ie day 1) postoperative recovery. This review describes the 10 general principles of anaesthesia for fragility fracture surgery that best achieve these aims: multidisciplinary care, 'getting it right first time', timely surgery, standardisation, sympathetic anaesthesia, avoiding ischaemia, sympathetic analgesia, re-enablement, data collection and training.
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Affiliation(s)
- S M White
- FRCA, Brighton and Sussex University Hospitals NHS Trust, Eastern Road, Brighton, East Sussex, BN2 5BE, United Kingdom.
| | - N B Foss
- Department of Anaesthesiology and Intensive Care Medicine, Hvidovre University Hospital, Kettegård Allé 30, Hvidovre, Denmark
| | - R Griffiths
- North West Anglia Hospitals NHS FT, Bretton Gate, Peterborough, PE3 9GZ, United Kingdom
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23
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Farrell K, Fernandez R, Salamonson Y, Griffiths R, Holmes-Walker DJ. Health outcomes for youth with type 1 diabetes at 18 months and 30 months post transition from pediatric to adult care. Diabetes Res Clin Pract 2018. [PMID: 29534994 DOI: 10.1016/j.diabres.2018.03.013] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
AIMS To identify (a) determinants of glycated haemoglobin (HbA1c) at 18 and 30 months following transition in young people with Type 1 diabetes mellitus (T1DM) to a youth-specific diabetes service; and to (b) evaluate the impact of the service on acute admissions with diabetic ketoacidosis (DKA) over a 14-year period. METHODS An audit of records of youth with T1DM referred from paediatric services to the multidisciplinary transition service at Westmead Hospital, from 2001 to 2012, and followed-up to 2014. RESULTS Data from 439 adolescents and young adults (Median age: 18) were analysed. The recommended standard of glycaemic control, HbA1c < 7.5% (58 mmol/mol), was achieved by 23% at baseline, 22% at 18-months, and 20% at 30-month. After adjusting for lag time (>3 months) and diabetes duration (>7 years), glycaemic control at first visit predicted subsequent glycaemic control at 18-month and 30-month follow-up. From 2001 to 2014, only 8.6% were lost to follow-up; admissions and readmissions for DKA reduced from 72% (32/47) to 4% (14/340) (p < 0.001). Furthermore, mean length of stay (LOS) significantly decreased from 6.56 to 2.36 days (p < 0.001). CONCLUSIONS Continuing engagement with the multidisciplinary transition service prevented deterioration in HbA1c following transition. Age-appropriate education and regular follow-up prevents DKA admissions and significantly reduced admission LOS.
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Affiliation(s)
- K Farrell
- School of Nursing and Midwifery, University of Western Sydney, New South Wales, Australia; New South Wales Centre for Evidence Based Health Care Australia: a Collaborating Centre of the Joanna Briggs Institute, Australia; Westmead Hospital, Westmead, New South Wales, Australia.
| | - R Fernandez
- School of Nursing and Midwifery, University of Wollongong, New South Wales, Australia; Centre for Evidence Based Initiatives in Health Care: an Affiliate Centre of the Joanna Briggs Institute, Australia; School of Medicine, University of Sydney, Australia
| | - Y Salamonson
- School of Nursing and Midwifery, University of Western Sydney, New South Wales, Australia; Centre for Applied Nursing Research (CANR), Australia; Ingham Institute for Applied Medical Research, Australia
| | - R Griffiths
- School of Nursing and Midwifery, University of Western Sydney, New South Wales, Australia; New South Wales Centre for Evidence Based Health Care Australia: a Collaborating Centre of the Joanna Briggs Institute, Australia
| | - D J Holmes-Walker
- Westmead Hospital, Westmead, New South Wales, Australia; School of Medicine, University of Sydney, Australia
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24
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White SM, Altermatt F, Barry J, Ben-David B, Coburn M, Coluzzi F, Degoli M, Dillane D, Foss NB, Gelmanas A, Griffiths R, Karpetas G, Kim JH, Kluger M, Lau PW, Matot I, McBrien M, McManus S, Montoya-Pelaez LF, Moppett IK, Parker M, Porrill O, Sanders RD, Shelton C, Sieber F, Trikha A, Xuebing X. International Fragility Fracture Network Delphi consensus statement on the principles of anaesthesia for patients with hip fracture. Anaesthesia 2018; 73:863-874. [DOI: 10.1111/anae.14225] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/01/2018] [Indexed: 01/16/2023]
Affiliation(s)
- S. M. White
- Brighton and Sussex University Hospitals NHS Trust; Brighton East Sussex UK
| | - F. Altermatt
- División de Anestesiología; Escuela de Medicina; Pontificia Universidad Católica de Chile; Santiago Chile
| | - J. Barry
- Cairns Hospital; Queensland Australia
| | - B. Ben-David
- University of Pittsburgh Medical Centre; Pittsburgh PA USA
| | - M. Coburn
- Medical Faculty; RWTH Aachen University; Aachen Germany
| | - F. Coluzzi
- Department Medical and Surgical Sciences and Biotechnologies; Sapienza University of Rome; Latina Italy
| | - M. Degoli
- Ospedale Civile di Baggiovara; Azienda Ospedaliero Universitaria di Modena; Modena Italy
| | - D. Dillane
- Anesthesiology and Pain Medicine; University of Alberta; Canada
| | - N. B. Foss
- Department of Anaesthesiology and Intensive Care Medicine; Hvidovre University Hospital; Hvidovre Denmark
| | - A. Gelmanas
- Hospital of Lithuanian University of Health Sciences Kauno klinikos; Lithuania
| | - R. Griffiths
- Peterborough and Stamford Hospitals NHS Trust; Peterborough UK
| | - G. Karpetas
- General University Hospital of Patras; Rio Greece
| | - J.-H. Kim
- Korea University College of Medicine; Seoul South Korea
| | | | - P.-W. Lau
- University of Hong Kong; Hong Kong China
| | - I. Matot
- Critical Care and Pain; Tel Aviv Medical Center; Sackeler School of Medicine; Tel Aviv Israel
| | | | | | - L. F. Montoya-Pelaez
- Department of Anaesthesia and Perioperative Medicine; Groote Schuur Hospital; University of Cape Town; Cape Town South Africa
| | - I. K. Moppett
- Anaesthesia and Critical Care Section; Division of Clinical Neuroscience; Queen's Medical Centre Campus; Nottingham University Hospitals NHS Trust; University of Nottingham; Nottingham UK
| | - M. Parker
- Peterborough and Stamford Hospitals NHS Trust; Peterborough UK
| | - O. Porrill
- New Somerset Hospital; University of Cape Town; South Africa
| | | | - C. Shelton
- Lancaster Medical School and Wythenshawe Hospital; Manchester UK
| | - F. Sieber
- Johns Hopkins Bayview Medical Center; Baltimore MD USA
| | - A. Trikha
- All India Institute of Medical Sciences; New Delhi India
| | - X. Xuebing
- University of Hong Kong-Shenzhen Hospital; Shenzhen China
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25
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Almghairbi DS, Sharp L, Griffiths R, Evley R, Gupta S, Moppett IK. An observational feasibility study of a new anaesthesia drug storage tray. Anaesthesia 2018; 73:356-364. [PMID: 29437211 DOI: 10.1111/anae.14187] [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] [Accepted: 11/21/2017] [Indexed: 11/29/2022]
Abstract
Drug errors in the anaesthetic domain remain a serious cause of iatrogenic harm. To help reduce this issue, we explored the potential safety impact of using a simple colour-coded tray for anaesthetic drug preparation and storage. Over a six-month period, three different trained researchers observed 30 cases at three NHS Trusts. Ten observations involved standard drug trays in 'normal' practice, and 20 observations, involved 'Rainbow trays' before and after their introduction. We conducted 20 semi-structured interviews immediately after completing the Rainbow tray observation with the anaesthetists involved. All discussions and detailed notes taken were transcribed, qualitatively analysed using line-by-line coding and then synthesised into narrative themes. We found that using standard, single compartment trays enabled quick, cheap, and portable drug preparation and storage, but was linked to potential or actual harmful errors, such as syringe swaps. Rainbow trays were perceived to be easy to use and effective at all three sites, aiding drug identification and separation, and hence likely to reduce drug error and increase patient safety. We have demonstrated that it is feasible to introduce a new colour-coded compartmentalised Rainbow drugs tray into clinical practice at three NHS hospitals in England. Further research is needed into their effect on the prevalence of drug error.
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Affiliation(s)
- D S Almghairbi
- Division of Clinical Neuroscience, Anaesthesia and Critical Care, University of Nottingham, Nottingham, UK
| | - L Sharp
- Pilgrim Hospital, Boston, UK
| | - R Griffiths
- Peterborough City Hospital, Peterborough, UK
| | - R Evley
- Division of Clinical Neuroscience, Anaesthesia and Critical Care, University of Nottingham, Nottingham, UK
| | - S Gupta
- Nottingham University Hospitals, Nottingham, UK
| | - I K Moppett
- Division of Clinical Neuroscience, Anaesthesia and Critical Care, University of Nottingham, Nottingham, UK
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26
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Hardy-Werbin M, Arpí O, Taus A, Rocha P, Joseph-Pietras D, Nolan L, Danson S, Griffiths R, Lopez-Botet M, Rovira A, Albanell J, Ottensmeier CH, Arriola E. Assessment of neuronal autoantibodies in patients with small cell lung cancer treated with chemotherapy with or without ipilimumab. Oncoimmunology 2017; 7:e1395125. [PMID: 29308329 PMCID: PMC5749672 DOI: 10.1080/2162402x.2017.1395125] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2017] [Accepted: 10/17/2017] [Indexed: 12/17/2022] Open
Abstract
Small-cell lung cancer (SCLC) is often associated with paraneoplastic syndromes. To assess the role of anti-neuronal autoantibodies (NAAs) as biomarkers of treatment outcome, we assessed NAAs in serial samples from SCLC patients treated with chemoimmunotherapy compared to chemotherapy alone. We evaluated 2 cohorts: in cohort 1 (C1), 47 patients received standard platinum/etoposide, and in cohort 2 (C2), 38 patients received ipilimumab, carboplatin and etoposide. Serum samples at baseline and subsequent time points were analyzed for the presence of NAAs. NAAs were detected at baseline in 25 patients (53.2%) in C1 and in 20 patients (52.6%) in C2 (most frequently anti-Sox1). NAA at baseline was associated with limited disease (75% vs 50%; p: 0.096) and better overall survival (15.1 m vs 11.7 m; p: 0.032) in C1. Thirteen patients (28.9%) showed 2 or more reactivities before treatment; this was associated with worse PFS (5.5 m vs 7.3 m; p: 0.005) in patients treated with chemoimmunotherapy. NAA titers decreased after therapy in 68.9% patients, with no differential patterns of change between cohorts. Patients whose NAA titer decreased after treatment, showed longer OS [18.5 m (95% CI: 15.8 - 21.2)] compared with those whose NAA increased [12.3 m (95% CI: 8.1 - 16.5; p 0.049)], suggesting that antibody levels correlate to tumor load. Our findings reinforce the role of NAAs as prognostic markers and tumor activity/burden in SCLC, warrant further investigation in their predictive role for immunotherapy and raise concern over the use of immunotherapy in patients with more than one anti-NAA reactivity.
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Affiliation(s)
- M. Hardy-Werbin
- Cancer Research Program, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
- Universitat de Barcelona, Barcelona, Spain
| | - O. Arpí
- Cancer Research Program, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - A. Taus
- Medical Oncology Department, Hospital del Mar-CIBERONC, Barcelona, Spain
| | - P. Rocha
- Medical Oncology Department, Hospital del Mar-CIBERONC, Barcelona, Spain
| | - D. Joseph-Pietras
- NIHR Experimental Cancer Medicine Centre, Southampton, United Kingdom
| | - L. Nolan
- Medical Oncology Department, University Hospital Southampton, Southampton, United Kingdom
| | - S. Danson
- Sheffield Experimental Cancer Medicine Centre, Weston Park Hospital, Sheffield, United Kingdom
| | - R. Griffiths
- Medical Oncology Department, The Clatterbridge Cancer Centre NHS Foundation Trust, Wirral, United Kingdom
| | - M. Lopez-Botet
- Immunology unit, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - A. Rovira
- Cancer Research Program, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - J. Albanell
- Cancer Research Program, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
- Medical Oncology Department, Hospital del Mar-CIBERONC, Barcelona, Spain
| | - C. H. Ottensmeier
- Cancer Science Unit, Faculty of Medicine, University of Southampton, Southampton, United Kingdom
- NIHR Experimental Cancer Medicine Centre, Southampton, United Kingdom
| | - E. Arriola
- Cancer Research Program, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
- Medical Oncology Department, Hospital del Mar-CIBERONC, Barcelona, Spain
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Popat S, Ardizzoni A, Ciuleanu T, Cobo Dols M, Laktionov K, Szilasi M, Califano R, Carcereny Costa E, Griffiths R, Paz-Ares L, Szczylik C, Corral J, Isla D, Jassem J, Appel W, Van Meerbeeck J, Wolf J, Jiang J, Molife L, Felip Font E. Nivolumab in previously treated patients with metastatic squamous NSCLC: Results of a European single-arm, phase 2 trial (CheckMate 171) including patients aged ≥70 years and with poor performance status. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx380.006] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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28
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Affiliation(s)
- R Griffiths
- Department of Anaesthesia, North-West Anglia Hospitals NHS Trust, Peterborough, UK
| | - D Surendra Kumar
- Department of Anaesthesia and Intensive Care Medicine, University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK
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Corpron MR, Griffiths R, Parish S, Maquivar MG. 118 Is the time of insemination linked with the reproductive response of the animal? Assessment of follicular size at fixed-time artificial insemination and behavioral patterns in beef cattle following seven-day CO-Synch + controlled internal drug release estrus synchronization protocol. J Anim Sci 2017. [DOI: 10.2527/asasann.2017.118] [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: 11/13/2022] Open
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30
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Schlüter D, Griffiths R, Akbari A, Heaven M, Diggle P, Taylor-Robinson D. EPS5.5 How does having cystic fibrosis impact on birth weight? A population level data linkage study in Wales. J Cyst Fibros 2017. [DOI: 10.1016/s1569-1993(17)30316-8] [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: 10/19/2022]
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31
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Smith TO, Cooper A, Peryer G, Griffiths R, Fox C, Cross J. Factors predicting incidence of post-operative delirium in older people following hip fracture surgery: a systematic review and meta-analysis. Int J Geriatr Psychiatry 2017; 32:386-396. [PMID: 28093812 DOI: 10.1002/gps.4655] [Citation(s) in RCA: 85] [Impact Index Per Article: 12.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2016] [Revised: 12/01/2016] [Accepted: 12/06/2016] [Indexed: 12/16/2022]
Abstract
OBJECTIVE Delirium is one of the most common complications following hip fracture surgery in older people. This study identified pre- and peri-operative factors associated with the development of post-operative delirium following hip fracture surgery. METHODS Published and unpublished literature were searched to identify all evidence reporting variables on patient characteristics, on-admission, intra-operative and post-operative management assessing incident delirium in older people following hip fracture surgery. Pooled odds ratio (OR) and mean difference of those who experienced delirium compared to those who did not were calculated for each variable. Evidence was assessed using the Downs and Black appraisal tool and interpreted using the GRADE approach. RESULTS A total of 6704 people (2090 people with post-operative delirium) from 32 studies were analysed. There was moderate evidence of nearly a two-times greater probability of post-operative delirium for those aged 80 years and over (OR: 1.77; 95% CI: 1.09, 2.87), whether patients lived in a care institution pre-admission (OR: 2.65; 95% CI: 1.79, 3.92), and a six-times greater probability of developing post-operative delirium with a pre-admission diagnosis of dementia (OR: 6.07, 95% CI: 4.84, 7.62). There was no association with intra-operative variables and probability of delirium. CONCLUSION Clinicians treating people with a hip fracture should be vigilant towards post-operative delirium if their patients are older, have pre-existing cognitive impairment and poorer overall general health. This is also the case for those who experience post-operative complications such as pneumonia or a urinary tract infection. Copyright © 2017 John Wiley & Sons, Ltd.
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Affiliation(s)
- T O Smith
- School of Health Sciences, University of East Anglia, Norwich, UK
| | - A Cooper
- School of Health Sciences, University of East Anglia, Norwich, UK
| | - G Peryer
- School of Health Sciences, University of East Anglia, Norwich, UK
| | - R Griffiths
- Department of Anaesthesia, Peterborough and Stamford Hospitals NHS Foundation Trust, Peterborough, UK
| | - C Fox
- Norwich Medical School, University of East Anglia, Norwich, UK
| | - J Cross
- School of Health Sciences, University of East Anglia, Norwich, UK
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32
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Hall SF, Griffiths R. Corrigendum: Did the addition of concomitant chemotherapy to radiotherapy improve outcomes in hypopharyngeal cancer? A population-based study. Curr Oncol 2016; 23:e526. [PMID: 27803615 DOI: 10.3747/co.23.3435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
[This corrects the article on p. 266 in vol. 23, PMID: 27536177.].
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Affiliation(s)
- S F Hall
- Department of Otolaryngology/Head and Neck Surgery, Queen's University, Kingston, ON
| | - R Griffiths
- ices Queen's, Queen's University, Kingston, ON
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33
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Clayton SC, Barber KC, Griffiths R. Frailty assessment - who, when and how? Anaesthesia 2016; 71:1116-7. [DOI: 10.1111/anae.13616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Hall SF, Griffiths R. Did the addition of concomitant chemotherapy to radiotherapy improve outcomes in hypopharyngeal cancer? A population-based study. ACTA ACUST UNITED AC 2016; 23:266-72. [PMID: 27536177 DOI: 10.3747/co.23.3085] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND For oncologists and for patients, no site-specific clinical trial evidence has emerged for the use of concurrent chemotherapy with radiotherapy (ccrt) over radiotherapy (rt) alone for cancer of the hypopharynx (hpc) or for other human papilloma virus-negative head-and-neck cancers. METHODS This retrospective population-based cohort study using administrative data compared treatments over time (1990-2000 vs. 2000-2010), treatment outcomes, and outcomes over time in 1333 cases of hpc diagnosed in Ontario between January 1990 and December 2010. RESULTS The incidence of hpc is declining; the use of ccrt that began in 2001 is increasing; and the 3-year overall survival for all patients remains poor at 34.6%. No difference in overall survival was observed in a comparison of patients treated in the decade before ccrt and of patients treated in the decade during the uptake of ccrt. CONCLUSIONS The addition of ccrt to the armamentarium of treatment options for oncologists treating head-and-neck patients did not improve outcomes for hpc at the population level.
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Affiliation(s)
- S F Hall
- Department of Otolaryngology/Head and Neck Surgery, Kingston, ON
| | - R Griffiths
- ices Queen's, Queen's University, Kingston, ON
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Affiliation(s)
- S. M. White
- Brighton and Sussex University Hospitals NHS Trust; Brighton East Sussex UK
| | - R. Griffiths
- Peterborough and Stamford Hospitals NHS Trust; Peterborough UK
| | - I. K. Moppett
- Anaesthesia and Critical Care Section; Division of Clinical Neuroscience; University of Nottingham; Nottingham UK
- Department of Anaesthesia; Queen's Medical Centre; Nottingham University Hospitals NHS Trust; Nottingham UK
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Holmes ND, Campbell KJ, Keitt B, Griffiths R, Beek J, Donlan CJ, Broome K. Correction: Reporting costs for invasive vertebrate eradications. Biol Invasions 2016. [DOI: 10.1007/s10530-016-1187-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Marufu TC, White SM, Griffiths R, Moonesinghe SR, Moppett IK. Prediction of 30-day mortality after hip fracture surgery by the Nottingham Hip Fracture Score and the Surgical Outcome Risk Tool. Anaesthesia 2016; 71:515-21. [DOI: 10.1111/anae.13418] [Citation(s) in RCA: 62] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/26/2016] [Indexed: 12/01/2022]
Affiliation(s)
- T. C. Marufu
- Anaesthesia and Critical Care Section; Division of Clinical Neuroscience; Queen's Medical Centre; University of Nottingham; Nottingham UK
- Department of Anaesthesia; Nottingham University Hospitals NHS Trust; Nottingham UK
| | - S. M. White
- Brighton and Sussex University Hospitals NHS Trust; Brighton UK
| | - R. Griffiths
- Peterborough and Stamford Hospitals NHS Trust; Peterborough UK
| | - S. R. Moonesinghe
- UCLH Surgical Outcomes Research Centre; University College London Hospitals; NIAA Health Services Research Centre; Royal College of Anaesthetists; London UK
| | - I. K. Moppett
- Anaesthesia and Critical Care Section; Division of Clinical Neuroscience; Queen's Medical Centre; University of Nottingham; Nottingham UK
- Department of Anaesthesia; Nottingham University Hospitals NHS Trust; Nottingham UK
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White SM, Moppett IK, Griffiths R, Johansen A, Wakeman R, Boulton C, Plant F, Williams A, Pappenheim K, Majeed A, Currie CT, Grocott MPW. Secondary analysis of outcomes after 11,085 hip fracture operations from the prospective UK Anaesthesia Sprint Audit of Practice (ASAP-2). Anaesthesia 2016; 71:506-14. [DOI: 10.1111/anae.13415] [Citation(s) in RCA: 109] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/25/2016] [Indexed: 12/13/2022]
Affiliation(s)
- S. M. White
- Brighton and Sussex University Hospitals NHS Trust; Brighton East Sussex UK
| | - I. K. Moppett
- Anaesthesia and Critical Care Section; Division of Clinical Neuroscience; University of Nottingham; Queen's Medical Centre Campus; Nottingham University Hospitals NHS Trust; Nottingham UK
| | - R. Griffiths
- Peterborough and Stamford Hospitals NHS Trust; Peterborough UK
| | - A. Johansen
- National Hip Fracture Database, Falls and Fragility Fracture Audit Programme; Clinical Effectiveness and Evaluation Unit; Royal College of Physicians; London UK
| | - R. Wakeman
- National Hip Fracture Database, Falls and Fragility Fracture Audit Programme; Clinical Effectiveness and Evaluation Unit; Royal College of Physicians; London UK
| | - C. Boulton
- National Hip Fracture Database, Falls and Fragility Fracture Audit Programme; Clinical Effectiveness and Evaluation Unit; Royal College of Physicians; London UK
| | - F. Plant
- The Royal National Orthopaedic Hospital; Stanmore Middlesex UK
| | - A. Williams
- Gloucestershire Royal Hospital; Gloucester Gloucestershire UK
| | - K. Pappenheim
- Association of Anaesthetists of Great Britain and Ireland; London UK
| | - A. Majeed
- King Fahad Medical City; Riyadh Saudi Arabia
| | | | - M. P. W. Grocott
- Anaesthesia and Critical Care Medicine; University of Southampton and Southampton NIHR Respiratory Biomedical Research Unit; Southampton UK
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Griffiths R. Reply to letter from Drs Kakazu and Karnwal. Br J Anaesth 2016; 116:304. [PMID: 26787810 DOI: 10.1093/bja/aev471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Affiliation(s)
| | | | - P. Clyburn
- AAGBI
- University Hospital of Wales; Cardiff
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Nightingale CE, Margarson MP, Shearer E, Redman JW, Lucas DN, Cousins JM, Fox WTA, Kennedy NJ, Venn PJ, Skues M, Gabbott D, Misra U, Pandit JJ, Popat MT, Griffiths R. Peri-operative management of the obese surgical patient 2015: Association of Anaesthetists of Great Britain and Ireland Society for Obesity and Bariatric Anaesthesia. Anaesthesia 2015; 70:859-76. [PMID: 25950621 PMCID: PMC5029585 DOI: 10.1111/anae.13101] [Citation(s) in RCA: 156] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/10/2015] [Indexed: 12/13/2022]
Abstract
Guidelines are presented for the organisational and clinical peri-operative management of anaesthesia and surgery for patients who are obese, along with a summary of the problems that obesity may cause peri-operatively. The advice presented is based on previously published advice, clinical studies and expert opinion.
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Affiliation(s)
| | | | - E Shearer
- Society for Obesity and Bariatric Anaesthesia
| | - J W Redman
- Society for Obesity and Bariatric Anaesthesia
| | - D N Lucas
- Obstetric Anaesthetists' Association
| | - J M Cousins
- Society for Obesity and Bariatric Anaesthesia
| | - W T A Fox
- Society for Obesity and Bariatric Anaesthesia
| | - N J Kennedy
- Society for Obesity and Bariatric Anaesthesia
| | | | - M Skues
- British Association of Day Surgery
| | | | - U Misra
- Obstetric Anaesthetists' Association
| | - J J Pandit
- Association of Anaesthetists of Great Britain & Ireland
| | | | - R Griffiths
- Association of Anaesthetists of Great Britain & Ireland
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Holmes ND, Campbell KJ, Keitt BS, Griffiths R, Beek J, Donlan CJ, Broome KG. Reporting costs for invasive vertebrate eradications. Biol Invasions 2015. [DOI: 10.1007/s10530-015-0920-5] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Griffiths R, White SM, Moppett IK, Parker MJ, Chesser TJS, Costa ML, Johansen A, Wilson H, Timperley AJ. Safety guideline: reducing the risk from cemented hemiarthroplasty for hip fracture 2015: Association of Anaesthetists of Great Britain and Ireland British Orthopaedic Association British Geriatric Society. Anaesthesia 2015; 70:623-6. [PMID: 25866041 PMCID: PMC6681143 DOI: 10.1111/anae.13036] [Citation(s) in RCA: 58] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/13/2015] [Indexed: 11/28/2022]
Abstract
Concise guidelines are presented for the preparation and conduct of anaesthesia and surgery in patients undergoing cemented hemiarthroplasty for hip fracture. The Working Party specifically considered recent publications highlighting complications occurring during the peri‐operative period 1, 2. The advice presented is based on previously published advice and clinical studies.
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Griffiths R. Cystathionine beta-synthase deficiency: observations on the biochemical lesion in a vitamin B6 non-responsive patient. Monogr Hum Genet 2015; 9:135-9. [PMID: 732830 DOI: 10.1159/000401625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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Ottensmeier C, Galea I, Cross N, Maishman T, Hamid D, Cave J, Wheater M, Geldart T, Mulatero C, Potter V, Danson S, Woll P, Griffiths R, Nolan L. A Novel Phase Ii Trial of Ipilimumab, Carboplatin and Etoposide (Ice) for the First Line Treatment of Extensive Stage Small Cell Lung Cancer (Sclc). Ann Oncol 2014. [DOI: 10.1093/annonc/mdu355.15] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Affiliation(s)
- R Griffiths
- Peterborough City Hospital-Anaesthesia, Bretton Gate, Peterborough, PE3 9GZ, UK
| | - M Parker
- Peterborough City Hospital-Anaesthesia, Bretton Gate, Peterborough, PE3 9GZ, UK
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White SM, Moppett IK, Griffiths R. A reply. Anaesthesia 2014; 69:1057-8. [PMID: 25117019 DOI: 10.1111/anae.12815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- S M White
- Royal Sussex County Hospital, Brighton, UK.
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White SM, Moppett IK, Griffiths R. A reply. Anaesthesia 2014; 69:644-6. [PMID: 24813138 DOI: 10.1111/anae.12741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- S M White
- Royal Sussex County Hospital, Brighton, UK.
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