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Waseem S, Kyriakides J, Amiri AR, Shetty R, Shetty N, Chammaa R. Management strategies for the painless foot drop: a systematic review of the literature. Eur Spine J 2023; 32:1099-1105. [PMID: 36843147 DOI: 10.1007/s00586-023-07534-6] [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] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Revised: 09/06/2022] [Accepted: 01/09/2023] [Indexed: 02/27/2023]
Abstract
PURPOSE Foot drop can uncommonly be a painless presenting symptom of degenerative spinal disorders. This systematic review aimed to summarise the literature on the management and outcomes of patients with a painless foot drop. METHODS We performed a systematic review of PubMed, EMBASE and Medline according to PRISMA guidelines. All studies published after 1980 in English referring to adult patients with a painless foot drop were included. Exclusion criteria included opinion based reports, review articles and articles in which foot drop was not caused by degenerative pathology of the thoracolumbar spine. RESULTS Of 62 included patients, 30 (48.4%) were male with an average age of 48.7 years (range 27-84). The mean duration of symptoms was 69.0 days (1-700). 98.8% were managed operatively. 46 (74.2%) patients had symptomatic improvement, with 41 (66.1%) having a post-intervention MRC power grading of 3 or above. Patients with a pre-procedure MRC 0 had a higher median increase in MRC post-procedure than those with MRC > 0. Of two studies comparing painful and painless symptoms, painless foot drop patients were less likely to recover to MRC equal to or over 3 than those with painful symptoms OR 0.31 (95% CI 0.04-2.65). CONCLUSION This systematic review and meta-analysis demonstrates a role for surgery in facilitating the neurological recovery of patients with a painless foot drop. Large randomised controlled studies are required to characterise the role of operative intervention in these patients and compare outcomes between patients with painless and painful foot drop.
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Affiliation(s)
- S Waseem
- Department of Trauma and Orthopaedics, The Whittington Hospital, Magdala Avenue, London, UK.
| | - J Kyriakides
- Department of Trauma and Orthopaedics, The Whittington Hospital, Magdala Avenue, London, UK
| | - A R Amiri
- Department of Trauma and Orthopaedics, The Whittington Hospital, Magdala Avenue, London, UK
| | - R Shetty
- Department of Trauma and Orthopaedics, The Whittington Hospital, Magdala Avenue, London, UK
| | - N Shetty
- Department of Trauma and Orthopaedics, The Whittington Hospital, Magdala Avenue, London, UK
| | - R Chammaa
- Department of Trauma and Orthopaedics, The Whittington Hospital, Magdala Avenue, London, UK
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Waseem S, Romann R, Davies BM, Rawal J, Hull P, Carrothers A, Chou D. Major trauma care at a regional trauma centre during the COVID-19 lockdown in England. Ann R Coll Surg Engl 2022; 104:594-599. [PMID: 34941462 PMCID: PMC9433184 DOI: 10.1308/rcsann.2021.0262] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/15/2021] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION The COVID-19 pandemic has changed the presentation of many medical and surgical conditions, including major trauma. We aimed to assess how lockdown changed the presentation, severity and management of major trauma patients at our level 1 trauma centre in England. METHODS Data were collected retrospectively from the Trauma Audit and Research Network's database between 23 March and 28 April 2020 and compared with the same period in 2019. Collected data included patient demographics, and the mechanism, severity and management of injuries. RESULTS We experienced a 56.4% reduction in major trauma admissions during the lockdown period when compared with 2019. In 2020, more patients arrived in haemodynamic shock (25.3% vs 12.2%, p=0.02); however, Glasgow Coma Scale and Injury Severity Score were unchanged. A higher proportion of incidents occurred at home (37.2% vs 53.5%, p=0.018), with no difference in trauma secondary to substance abuse or assault. During lockdown, patients had a significantly shorter hospital (17 vs 10 days, p=0.029) and critical care stay (2 vs 1 day, p=0.033). A higher proportion of major trauma patients were assessed by specialty trainees in the emergency department in 2020 (12.8% vs 53.1%, p=0.0001) with a lower proportion assessed by a consultant (69.8% vs 46.7%, p=0.001). CONCLUSIONS The COVID-19 pandemic and lockdown drastically changed human behaviour, as reflected in the change in presentation of major trauma. Changes in the management of these patients reflect adaptive measures to manage the pressures generated by the worldwide pandemic.
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Affiliation(s)
- S Waseem
- Cambridge University Hospitals NHS Foundation Trust, UK
| | - R Romann
- Cambridge University Hospitals NHS Foundation Trust, UK
| | | | - J Rawal
- Cambridge University Hospitals NHS Foundation Trust, UK
| | - P Hull
- Cambridge University Hospitals NHS Foundation Trust, UK
| | - A Carrothers
- Cambridge University Hospitals NHS Foundation Trust, UK
| | - D Chou
- Cambridge University Hospitals NHS Foundation Trust, UK
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3
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Lenihan J, Waseem S, Rawal J, Hull P, Carrothers A, Chou D. 1022 Equivalent Management for All Fragility Fractures Occurring in The Older Patient. Br J Surg 2021. [DOI: 10.1093/bjs/znab259.1019] [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: 11/14/2022]
Abstract
Abstract
Aim
Neck of femur fractures (NOFs) are painful and occur in a vulnerable group of our population. Complications occur if their pain is under treated. Optimal management in the United Kingdom is governed by Best Practice Tariff (BPT). This was extended in 2020 without supporting published evidence to include all femur fractures (ROFs).
We sought to compare PRPS for NOFs and ROFs throughout hospital admission.
Method
We performed a retrospective matched analysis of all isolated osteoporotic ROFs to NOFs at our centre between 2018-2019. We analysed electronic patient records for relevant data. Matching criteria included Age +/- 2 years; cognition; walking aids; ASA; and social residence. Primary outcome measure was patient-reported pain scores (PRPS) at set time points. Secondary outcome measures were peripheral nerve blocks (PNB); patient controlled analgesia (PCA); time to surgery; anaesthetic type; length of stay (LOS); weightbearing status and 30-day mortality. Data was statistically analysed.
Results
11 ROFs were matched to 104 NOFs. There was no statistical difference between the two groups for age, sex, nor cognition and no difference in time to surgery; anaesthetic type; LOS; nor 30-day mortality. ROFs were more painful at all time points although not statistically significant. ROFs were more likely to have traction; PCA both pre- and post-operatively and not to weight bear. NOFs were more likely to have a PNB.
Conclusions
ROFs are as painful if not more so than NOFs. Few ROFs receive PNB and require PCA. Better control of symptoms may improve outcomes. We support the extension of BPT.
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Affiliation(s)
- J Lenihan
- Addenbrooke's Hospital, Cambridge, United Kingdom
| | - S Waseem
- Addenbrooke's Hospital, Cambridge, United Kingdom
| | - J Rawal
- Addenbrooke's Hospital, Cambridge, United Kingdom
| | - P Hull
- Addenbrooke's Hospital, Cambridge, United Kingdom
| | - A Carrothers
- Addenbrooke's Hospital, Cambridge, United Kingdom
| | - D Chou
- Addenbrooke's Hospital, Cambridge, United Kingdom
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Waseem S, Lenihan J, Davies B, Rawal J, Hull P, Carrothers A, Chou D. 1514 Higher Mortality in Pelvic Acetabular Fractures Is Associated with Lower Body Mass Index. Br J Surg 2021. [DOI: 10.1093/bjs/znab259.1059] [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: 11/12/2022]
Abstract
Abstract
Aim
Fractures of the pelvis and acetabulum can be life-threatening or life changing injuries. Multiple factors can contribute to outcome including age, frailty, and baseline nutritional status. The aim of this study was to identify if low BMI (<18.5) was a predictor of outcome for patients with such injuries in terms of morbidity and mortality.
Method
We retrospectively analysed 1033 patients with pelvic or acetabular fractures referred to a single level 1 major trauma centre over a 4.5-year period (August 2015 - January 2020). Of these patients, 569 were admitted to the centre and included in our analysis. Data was collected on demographics, injury pattern, operative intervention, and complications. Comparison was made between patients that were underweight (BMI<18.5) and patients that were not, for in-hospital and post discharge complications including pulmonary embolus (PE), deep venous thrombosis (DVT), ileus, infection, loss of reduction and mortality at 6 months.
Results
Underweight patients had a statistically significant increase in mortality both in-hospital (p = 0.019) and at 6 months post injury (p = 0.039) when compared to other BMI groups. No statistical significance was found between these BMI groups comparing morbidity: DVT (p = 0.712), PE (p = 0.736) nor ileus (p = 0.149). Covariate analysis showed that a low BMI was associated with 3 times increased in-hospital mortality after correction for age and energy of injury (adjusted OR 3.028, 95% CI 1.059-8.659).
Conclusions
This study suggests increased mortality in patients with pelvic or acetabular fractures who are underweight. Surgeons should consider these findings in initiating appropriate peri-operative optimisation for these patients.
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Affiliation(s)
- S Waseem
- Cambridge Orthopaedic Pelvic Unit (COPU), Addenbrookes Major Trauma Centre, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
| | - J Lenihan
- Cambridge Orthopaedic Pelvic Unit (COPU), Addenbrookes Major Trauma Centre, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
| | - B Davies
- Division of Trauma and Orthopaedics, University of Cambridge, Cambridge, United Kingdom
| | - J Rawal
- Cambridge Orthopaedic Pelvic Unit (COPU), Addenbrookes Major Trauma Centre, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
| | - P Hull
- Cambridge Orthopaedic Pelvic Unit (COPU), Addenbrookes Major Trauma Centre, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
| | - A Carrothers
- Cambridge Orthopaedic Pelvic Unit (COPU), Addenbrookes Major Trauma Centre, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
| | - D Chou
- Cambridge Orthopaedic Pelvic Unit (COPU), Addenbrookes Major Trauma Centre, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
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Waseem S, Romann R, Lenihan J, Rawal J, Carrothers A, Hull P, Chou D. 1550 Experience from A Level-1 Major Trauma Centre in England of Trauma Epidemiology After Easing of Lockdown Restrictions. Br J Surg 2021. [DOI: 10.1093/bjs/znab259.1062] [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]
Abstract
Abstract
Aim
The COVID-19 pandemic transformed trauma care. We examined the effect of lockdown easing on trauma presentation and management.
Method
Data was retrospectively analysed from Trauma Audit and Research Network (TARN) on patients presenting to one Major Trauma Centre in the East of England with trauma. The first 47 days of lockdown (23rd March-9th May 2020, period 1) were compared with the next (10th May- 26th June 2020, period 2) and last 47 (27th June- 13th August 2020, period 3). Data collected included demographics, mechanism and severity of injury, management, and length of stay.
Results
1,249 patients were included; 62.2% were male with a mean age of 57.73. Footfall declined in April 2020 compared with 2019 (56 vs 143) but rebounded by May (123 v 120 patients). Road traffic collisions increased over periods 1-3 (18.8% v 23% v 30.1%, p = 0.038); deliberate self-harm (DSH) increased in period 2 compared with 1 and 3 (6.3% v 3.4% v 1.4%, p = 0.03) respectively. The 2020 patient age was younger than 2019, with less trauma relating to alcohol (7.3% v 13.2%, p = 0.009). Compared with 2019 reductions in total length of stay (14.1 v 17.4 days, p = <0.001), critical care length of stay (2.3 v 2.9 days, p = 0.04) and consultant driven care (54.9% v 64.9%, p < 0.001) were noted in lockdown.
Conclusions
Our study suggests that after lockdown easing, trauma footfall rapidly rebounded to 2019 levels. This should be acknowledged in resource allocation decisions if future lockdowns are necessitated.
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Affiliation(s)
- S Waseem
- Cambridge Orthopaedic Trauma Unit (COTU) Addenbrookes Major Trauma Centre Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
| | - R Romann
- Cambridge Orthopaedic Trauma Unit (COTU) Addenbrookes Major Trauma Centre Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
| | - J Lenihan
- Cambridge Orthopaedic Trauma Unit (COTU) Addenbrookes Major Trauma Centre Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
| | - J Rawal
- Cambridge Orthopaedic Trauma Unit (COTU) Addenbrookes Major Trauma Centre Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
| | - A Carrothers
- Cambridge Orthopaedic Trauma Unit (COTU) Addenbrookes Major Trauma Centre Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
| | - P Hull
- Cambridge Orthopaedic Trauma Unit (COTU) Addenbrookes Major Trauma Centre Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
| | - D Chou
- Cambridge Orthopaedic Trauma Unit (COTU) Addenbrookes Major Trauma Centre Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
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Lenihan J, Waseem S, Rawal J, Hull P, Carrothers A, Chou D. 1036 Operative Versus Non-Operative Management of Osteoporotic Femoral Fractures. Br J Surg 2021. [DOI: 10.1093/bjs/znab259.1020] [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]
Abstract
Abstract
Background
he incidence of diaphyseal and distal osteoporotic femoral fractures (OFFs) is increasing. This cohort of patients is often frail with multiple medical co-morbidities. No published data exists neither reporting severity of pain associated with these fractures nor pain in managing their fractures. There are no comparative studies investigating outcomes between conservative (CM) and surgical management (SM). We investigated pain and outcomes between CM and SM OFFs.
Method
We retrospectively analysed all OFFs admitted to our unit between 2018-2019. We analysed electronic patient records including patient-reported pain scores (PRPS). PRPS were calculated for set time periods: admission; 0-24hours CM versus day 1 post-operative; day 2-3; day 4-5. Primary outcome measure was PRPS. Secondary outcome measures included use of traction; PCA use; weightbearing status; length of stay (LOS); 30 day and 1 year mortality. Data was statistically analysed using SPSS software.
Results
22 patients were recruited (11CM, 11SM). There was no statistical difference between groups in terms of age; sex; cognition; Charlson Index; nor pre-morbid mobility status. There was no statistical difference for pain at admission nor PCA use. SM were less painful in the first 24-hour period postoperatively and in the first 3-day postoperative period compared to the same time period in CM. There was no difference in PRPS for the 72–120-hour period. There was no statistical difference between LOS; NWB status; 30 day nor 1 year mortality.
Conclusions
Operating on OFFs reduces pain in the perioperative period without increasing mortality or LOS in this frail population.
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Affiliation(s)
- J Lenihan
- Addenbrooke's Hospital, Cambridge, United Kingdom
| | - S Waseem
- Addenbrooke's Hospital, Cambridge, United Kingdom
| | - J Rawal
- Addenbrooke's Hospital, Cambridge, United Kingdom
| | - P Hull
- Addenbrooke's Hospital, Cambridge, United Kingdom
| | - A Carrothers
- Addenbrooke's Hospital, Cambridge, United Kingdom
| | - D Chou
- Addenbrooke's Hospital, Cambridge, United Kingdom
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7
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Abbassi O, Waseem S, Murphy S, Roszpopa J, Nizamoglu M, Patel AJK, Durrani AJ. Non-melanoma skin cancer activity during the COVID-19 pandemic- A single UK tertiary centre experience. JPRAS Open 2021; 32:211-213. [PMID: 33907705 PMCID: PMC8062407 DOI: 10.1016/j.jpra.2021.04.001] [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] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Accepted: 04/01/2021] [Indexed: 11/26/2022] Open
Abstract
The pandemic caused by SARS-CoV-2 virus, also known as COVID-19, has generated shockwaves in medical and surgical practice. It has necessitated re-deployment of staff and resources to cater for the unpredictable increase in footfall and demand on healthcare systems. This study aimed to investigate how the restructuring of our service altered the triage and management of non-melanoma skin cancer (NMSC) during the pandemic's first wave rise and peak. We retrospectively analysed all patients who underwent a skin excision under local anaesthetic which revealed the presence of a basal cell carcinoma (BCC) or squamous cell carcinoma (SCC) on histopathological analysis between 1st February 2020 - 31st May 2020 compared with the same period in 2019. There was a 158% increase in patients with excision of lesions confirmed on histopathological analysis as a NMSC during the COVID-19 period (168 vs. 65). In 2020, more excisions were performed by consultants (42.9% v 21.5%, p = 0.002) with a lower proportion of excisions with a close margin (27.7% v 17.8%, p = 0.096) and an involved margin (3.1% v 1.8%, p = 0.62). Five of these patients had their further management altered due to service constraints at this time The resource constraints secondary to the pandemic have yielded beneficial service adaptations with the incorporation of a more efficient model for the NMSC service. The sustainability of this model and its impact on training will require further examination when non-urgent and benign elective workload is slowly reinstated and plastic surgery trainees return to their original posts.
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Affiliation(s)
- O Abbassi
- Addenbrooke's Hospital,Hills Road, Cambridge CB20QQ, United Kingdom
| | - S Waseem
- Addenbrooke's Hospital,Hills Road, Cambridge CB20QQ, United Kingdom
| | - S Murphy
- Addenbrooke's Hospital,Hills Road, Cambridge CB20QQ, United Kingdom
| | - J Roszpopa
- Addenbrooke's Hospital,Hills Road, Cambridge CB20QQ, United Kingdom
| | - M Nizamoglu
- Addenbrooke's Hospital,Hills Road, Cambridge CB20QQ, United Kingdom
| | - A J K Patel
- Addenbrooke's Hospital,Hills Road, Cambridge CB20QQ, United Kingdom
| | - A J Durrani
- Addenbrooke's Hospital,Hills Road, Cambridge CB20QQ, United Kingdom
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8
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Waseem S, Nayar S, Hull P, Carrothers A, Rawal J, Chou D, Khanduja V. The global burden of trauma during the COVID-19 pandemic: A scoping review. J Clin Orthop Trauma 2021; 12:200-207. [PMID: 33223749 PMCID: PMC7666557 DOI: 10.1016/j.jcot.2020.11.005] [Citation(s) in RCA: 62] [Impact Index Per Article: 20.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Revised: 11/08/2020] [Accepted: 11/09/2020] [Indexed: 01/08/2023] Open
Abstract
Purpose; The COVID-19 pandemic has necessitated profound adaptations in the delivery of healthcare to manage a rise in critically unwell patients. In an attempt to slow the spread of the virus nationwide lockdown restrictions were introduced. This review aims to scope the literature on the impact of the pandemic and subsequent lockdown on the presentation and management of trauma globally. Methods; A scoping review was conducted in accordance with PRISMA-ScR guidelines. A systematic search was carried out on the Medline, EMBASE and Cochrane databases to identify papers investigating presentation and management of trauma during the COVID-19 pandemic. All studies based on patients admitted with orthopaedic trauma during the COVID-19 pandemic were included. Exclusion criteria were opinion-based reports, reviews, studies that did not provide quantitative data and papers not in English. Results; 665 studies were screened, with 57 meeting the eligibility criteria. Studies reported on the footfall of trauma in the UK, Europe, Asia, USA, Australia and New Zealand. A total of 29,591 patients during the pandemic were considered. Mean age was 43.7 years (range <1-103); 54.8% were male. Reported reductions in trauma footfall ranged from 20.3% to 84.6%, with a higher proportion of trauma occurring secondary to interpersonal violence, deliberate self-harm and falls from a height. A decrease was seen in road traffic collisions, sports injuries and trauma occurring outdoors. There was no significant change in the proportion of patients managed operatively, and the number of trauma patients reported to be COVID-19 positive was low. Conclusion; Whilst the worldwide COVID-19 pandemic has caused a reduction in the number of trauma patients; the services managing trauma have continued to function despite infrastructural, personnel and pathway changes in health systems. The substantial effect of the COVID-19 pandemic on elective orthopaedics is well described, however the contents of this review evidence minimal change in the delivery of effective trauma care despite resource constraints during this global COVID-19 pandemic.
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Affiliation(s)
- S. Waseem
- Major Trauma Centre, Cambridge University Hospitals NHS Foundation Trust, Hills Road, Cambridge, CB20QQ, United Kingdom
| | - S.K. Nayar
- Department of Trauma and Orthopaedics, Whittington Hospital, Madgala Avenue, London, N195NF, United Kingdom
| | - P. Hull
- Major Trauma Centre, Cambridge University Hospitals NHS Foundation Trust, Hills Road, Cambridge, CB20QQ, United Kingdom
| | - A. Carrothers
- Major Trauma Centre, Cambridge University Hospitals NHS Foundation Trust, Hills Road, Cambridge, CB20QQ, United Kingdom
| | - J. Rawal
- Major Trauma Centre, Cambridge University Hospitals NHS Foundation Trust, Hills Road, Cambridge, CB20QQ, United Kingdom
| | - D. Chou
- Major Trauma Centre, Cambridge University Hospitals NHS Foundation Trust, Hills Road, Cambridge, CB20QQ, United Kingdom
| | - V. Khanduja
- Major Trauma Centre, Cambridge University Hospitals NHS Foundation Trust, Hills Road, Cambridge, CB20QQ, United Kingdom,Corresponding author. Institutional address: Cambridge University Hospitals NHS Foundation Trust, Hills Road, Cambridge, CB20QQ, United Kingdom
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Waseem S, Audet J, Viswanathan S. Statistical modeling to optimize the manufacturing process of mesenchymal stromal cells. Osteoarthritis Cartilage 2019. [DOI: 10.1016/j.joca.2019.02.464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
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Lawrence CHD, Waseem S, Newsholme W, Klein JL. Trueperella bernardiae: an unusual cause of septic thrombophlebitis in an injection drug user. New Microbes New Infect 2018; 26:89-91. [PMID: 30310680 PMCID: PMC6178208 DOI: 10.1016/j.nmni.2018.09.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [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: 06/15/2018] [Revised: 08/30/2018] [Accepted: 09/04/2018] [Indexed: 11/25/2022] Open
Abstract
The clinical spectrum of human disease caused by Trueperella bernardiae is poorly described, partly as a result of historical difficulties with microbial identification. With the introduction of powerful new technologies, such as matrix-assisted desorption ionization–time of flight mass spectrometry, into routine microbiology laboratories, new insights into diseases caused by such organisms are being made. Here we report a case of septic thrombophlebitis with bacteraemia caused by this organism, together with a retrospective description of laboratory isolation of this organism over a period of 6 years in a hospital in London, UK.
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Affiliation(s)
- C H D Lawrence
- Department of Infection, St Thomas' Hospital, London, UK
| | - S Waseem
- Department of Surgery, St Thomas' Hospital, London, UK
| | - W Newsholme
- Department of Infection, St Thomas' Hospital, London, UK
| | - J L Klein
- Department of Infection, St Thomas' Hospital, London, UK
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11
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Waseem S, Bhatt S, Viswanathan S, Audet J. Statistical modeling to optimize the culture of mesenchymal stromal cells. Cytotherapy 2018. [DOI: 10.1016/j.jcyt.2018.02.158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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12
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Farooqi AA, Mukhtar S, Riaz AM, Waseem S, Minhaj S, Dilawar BA, Malik BA, Nawaz A, Bhatti S. Wnt and SHH in prostate cancer: trouble mongers occupy the TRAIL towards apoptosis. Cell Prolif 2011; 44:508-15. [PMID: 21973075 DOI: 10.1111/j.1365-2184.2011.00784.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Prostate cancer is a serious molecular disorder that arises because of reduction in tumour suppressors and overexpression of oncogenes. The malignant cells survive within the context of a three-dimensional microenvironment in which they are exposed to mechanical and physical cues. These signals are, nonetheless, deregulated through perturbations to mechanotransduction, from the nanoscale level to the tissue level. Increasingly sophisticated interpretations have uncovered significant contributions of signal transduction cascades in governing prostate cancer progression. To dismantle the major determinants that lie beneath disruption of spatiotemporal patterns of activity, crosstalk between various signalling cascades and their opposing and promoting effects on TRAIL-mediated activities cannot be ruled out. It is important to focus on that molecular multiplicity of cancer cells, various phenotypes reflecting expression of a variety of target oncogenes, reversible to irreversible, exclusive, overlapping or linked, coexist and compete with each other. Comprehensive investigations into TRAIL-mediated mitochondrial dynamics will remain a worthwhile area for underlining causes of tumourigenesis and for unravelling interference options.
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Affiliation(s)
- A A Farooqi
- Institute of Molecular Biology and Biotechnology (IMBB), The University of Lahore, Pakistan.
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Abstract
As many as half of all patients with Parkinson's disease experience pain related to their condition. Once this relationship is recognized, the pain can be managed by achieving better control of the disease. In this article, Drs Waseem and Gwinn-Hardy discuss the many causes of this type of pain, which include disease complications and primary sensory pain syndromes. They also present and evaluate the treatment options available.
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Affiliation(s)
- S Waseem
- Department of Movement Disorders and Neurogenetics, Mayo Medical School, 4500 San Pablo Rd, Jacksonville, FL 32224, USA.
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