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Ibrahim A, Shabo W, O'Brien S, Hanson J, Anwar M. Low-grade appendiceal mucinous neoplasm. Ir Med J 2024; 117:903. [PMID: 38260978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/24/2024]
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2
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O'Brien S, Buckley C, Butler T, Cunningham Z, Keane S, McArdle E, Mitchell P, Donnelly SC. Persistent diaphragmatic weakness and peripheral muscle weakness are associated with anosmia in the long-COVID syndrome. QJM 2023; 116:603-604. [PMID: 36794902 DOI: 10.1093/qjmed/hcad025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 02/08/2023] [Indexed: 02/17/2023] Open
Affiliation(s)
- S O'Brien
- From the Department of Medicine, Tallaght University Hospital, Dublin, Ireland
- School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - C Buckley
- From the Department of Medicine, Tallaght University Hospital, Dublin, Ireland
- School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - T Butler
- From the Department of Medicine, Tallaght University Hospital, Dublin, Ireland
- School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - Z Cunningham
- From the Department of Medicine, Tallaght University Hospital, Dublin, Ireland
- School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - S Keane
- From the Department of Medicine, Tallaght University Hospital, Dublin, Ireland
- School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - E McArdle
- From the Department of Medicine, Tallaght University Hospital, Dublin, Ireland
- School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - P Mitchell
- From the Department of Medicine, Tallaght University Hospital, Dublin, Ireland
- School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - S C Donnelly
- From the Department of Medicine, Tallaght University Hospital, Dublin, Ireland
- School of Medicine, Trinity College Dublin, Dublin, Ireland
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3
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O'Brien S, Schaler L, Giblin A, Glover L, Wingfield M. Assisted human reproduction legislation: Listening to the voice of patients. Eur J Obstet Gynecol Reprod Biol 2023; 284:169-174. [PMID: 37003241 DOI: 10.1016/j.ejogrb.2023.03.020] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Revised: 01/09/2023] [Accepted: 03/18/2023] [Indexed: 04/01/2023]
Abstract
OBJECTIVE Legislation and policies regarding assisted human reproduction (AHR) vary widely across nations and societies. As one of only 5 European countries which currently lacks legislation, Ireland now has a unique opportunity to learn from other jurisdictions and introduce AHR law that is reflective of the ongoing myriad developments in this complex field. Draft legislation, initially published in 2017, was revised in 2022 with strong political commitment to enacting in the same year. This study sought to ascertain the views of fertility patients (service users) to the proposed AHR legislation in its current format, prior to its implementation. STUDY DESIGN A survey questionnaire, previously designed to investigate the attitudes and perceptions of healthcare professionals (HCPs) towards a broad range of issues contained within the draft AHR Bill, was adapted for a patient/service user population. The survey link was distributed via secure email to all patients that had a doctor consult at our fertility clinic in 2020-2021. RESULTS The survey link was sent to 4420 patients/service users, of whom 1044 (23.6%) responded. A majority had experienced AHR treatment. Service users indicated strong support for AHR regulation and for access to all AHR techniques for all patients, irrespective of relationship or gender status. A majority of respondents disagreed with aspects of the draft bill regarding mandatory counselling, the timing of assignment of parentage in surrogacy, the exclusion of international surrogacy and the exclusion of men from posthumous AHR. Interestingly, the fertility patient cohort were more liberal in their views and opinions regarding AHR than the Irish HCPs previously surveyed. CONCLUSION This study demonstrates the views of a large group of AHR patients/service users towards proposed AHR legislation. Many of their views concur with but others differ from those of the drafters of the legislation and from those of healthcare professionals. Consideration of the views of all these groups and a collaborative approach would help ensure that Ireland has AHR legislation that is inclusive and fit for purpose in the 21st century.
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4
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Bhutiani N, Bruenderman E, Davidyuk V, Mortensen GF, O'Brien S, Martin RCG, Vitale GC. Is More Anesthesia Care Better in Endoscopy? Comparing the Safety and Cost of Conscious Sedation and Anesthesia Provider-Based Care. J Gastrointest Surg 2022; 26:483-485. [PMID: 34506018 DOI: 10.1007/s11605-021-05120-z] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Accepted: 06/04/2021] [Indexed: 01/31/2023]
Affiliation(s)
- N Bhutiani
- Department of Surgery, Division of Surgical Oncology, University of Louisville, 550 S. Jackson St, 2nd floor, Louisville, KY, 40202, USA
| | - E Bruenderman
- Department of Surgery, Division of Surgical Oncology, University of Louisville, 550 S. Jackson St, 2nd floor, Louisville, KY, 40202, USA
| | - V Davidyuk
- Department of Surgery, Albany Medical Center, Albany, NY, USA
| | - G F Mortensen
- Department of Surgery, Division of Surgical Oncology, University of Louisville, 550 S. Jackson St, 2nd floor, Louisville, KY, 40202, USA
| | - S O'Brien
- Department of Surgery, Division of Surgical Oncology, University of Louisville, 550 S. Jackson St, 2nd floor, Louisville, KY, 40202, USA
| | - R C G Martin
- Department of Surgery, Division of Surgical Oncology, University of Louisville, 550 S. Jackson St, 2nd floor, Louisville, KY, 40202, USA
| | - Gary C Vitale
- Department of Surgery, Division of Surgical Oncology, University of Louisville, 550 S. Jackson St, 2nd floor, Louisville, KY, 40202, USA.
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O'Brien S, O'Reilly O. The national framework for the integrated prevention and management of chronic disease. Eur J Public Health 2021. [DOI: 10.1093/eurpub/ckab165.188] [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
Due to an ageing population and improvements in healthcare, the prevalence of chronic disease (CD) is rising in Ireland and internationally. In Ireland, CD care is often characterised by siloed, reactive care, culminating in repeated hospital admissions. This is neither patient-centred nor sustainable. Health services need to evolve to meet changing population need. How can Irish health services meet population need in a sustainable way? The National Clinical Programmes (NCPs) in Ireland draw together healthcare professionals from primary and secondary care to improve specific areas within the health service. Public Health Practitioners (PHPs) have been central to the population health approach taken by the NCPs. Over the past decade, an integrated approach to CD care with an emphasis on prevention and population health has been advocated by PHPs, underpinned by a compelling epidemiological case. The use of a generic model of care for the prevention and management of CD, within an integrated approach to service delivery, is associated with positive health outcomes. The “National framework for the integrated prevention and management of chronic disease in Ireland” is a national clinical model that focuses on shifting the vast majority of CD care into the community. The Framework takes a generic approach to the prevention and management of four major CDs: type 2 diabetes; asthma; COPD; cardiovascular disease. It is now being implemented under PHP leadership. The sustained action of many PHPs over the past decade has resulted in the funding of this seminal programme. This project highlights the importance of working alongside Primary and Secondary Care Clinicians in achieving service reform.
Key messages
This Framework provides an integrated approach to CD care and will transform service delivery. PHPs have a central role in the development and delivery of sustainable, evidence-based health services.
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Affiliation(s)
- S O'Brien
- Office of the NCAGL for Chronic Disease, Health Service Executive, Dublin, Ireland
| | - O O'Reilly
- Office of the NCAGL for Chronic Disease, Health Service Executive, Dublin, Ireland
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6
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Armstrong L, O'Brien S, Weir C. 756 Adapting Undergraduate Teaching in the COVID 19 Era. Br J Surg 2021. [PMCID: PMC8524509 DOI: 10.1093/bjs/znab259.869] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Abstract
Aim
The COVID-19 pandemic has drastically impacted medical education, particularly in terms of content delivery and clinical placement efficacy. The initial suspension of placements was devised to limit exposure and redirect medical staff to critical areas. Nevertheless, clinical placements are an important pillar of the undergraduate curriculum and new techniques must be developed to better facilitate its delivery. Our aim was to create a programme that effectively met the required curriculum learning outcomes for medical students.
Method
In September 2020, students from Queen’s University, Belfast, returned to placement following months of online and distance learning. Having previously focused on bedside and case-based teaching, our priority remained with patient and student safety. Complimentary non-clinical and simulation methods were introduced including laparoscopic skills, suture and knot tying sessions and foundation competencies. Rating scale questionnaires were distributed over a four-week period following each session.
Results
32 sessions were carried out and 53 questionnaires returned. Three key areas were reviewed; teaching delivery, usefulness of session and content/relevance, with each area scored out of 10. Collectively across all sessions, 94.3%, 92.4% and 88.7% respectively were scored 9 or greater for each key area.
Conclusions
The COVID-19 crisis has led to the development of alternative methods of undergraduate teaching. The insurance of patient safety whilst preparing students for their future career is a priority. We have successfully developed an effective and useful placement that blends clinical knowledge and skill-based learning. Given the ongoing pandemic and redirection of resources, further novel ways of teaching should be considered.
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Affiliation(s)
- L Armstrong
- Craigavon Area Hospital, Portadown, United Kingdom
| | - S O'Brien
- Craigavon Area Hospital, Portadown, United Kingdom
| | - C Weir
- Craigavon Area Hospital, Portadown, United Kingdom
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7
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Carton E, Fitzgerald E, Elebert R, Malone C, O'Brien S, Dunne A, Ní Muircheartaigh R, Phelan D. Changes in Multidisciplinary Tracheostomy Team Practice Over Time. Ir Med J 2021; 114:433. [PMID: 35863078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Aim Increasing numbers of tracheostomy patients are discharged from the Intensive Care Unit (ICU) to general hospital wards. There is evidence that a Multidisciplinary Tracheostomy Team (MTT) can have a positive impact on the care of tracheostomy patients discharged from the ICU. We compared tracheostomy management and patient outcome in two time periods, at the start of our MTT practice in 2009-2011 and again in 2017. Methods In a retrospective audit, we compared tracheostomy management and patient outcome in 117 patients who had a tracheostomy in 2009-2011 with 81 patients who had a tracheostomy in 2017. Results The duration of tracheostomy cannulation was significantly shorter (21 vs 31 days, p=0.0005) in 2017 compared to 2009-2011. A Mini-Trach was used after tracheostomy decannulation in 56 of the 81 (69%) tracheostomy patients in 2017. Conclusions The continued development of our MTT service over 8 years was associated with a significantly shorter duration of tracheostomy cannulation and the introduction of Mini-Trach use after tracheostomy decannulation. These results support the importance of maintaining an active MTT service to manage tracheostomy patients after discharge from the ICU.
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Affiliation(s)
- E Carton
- Department of Critical Care Medicine, Mater Hospital, Dublin, Ireland
| | - E Fitzgerald
- Department of Critical Care Medicine, Mater Hospital, Dublin, Ireland
| | - R Elebert
- Department of Critical Care Medicine, Mater Hospital, Dublin, Ireland
| | - C Malone
- Department of Critical Care Medicine, Mater Hospital, Dublin, Ireland
| | - S O'Brien
- Department of Critical Care Medicine, Mater Hospital, Dublin, Ireland
| | - A Dunne
- Department of Speech and Language Therapy, Mater Hospital, Dublin, Ireland
| | | | - D Phelan
- Department of Critical Care Medicine, Mater Hospital, Dublin, Ireland
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Abstract
Acalabrutinib was approved by the U.S. Food and Drug Administration (FDA) for treatment-naive (TN) and relapsed/refractory (R/R) use for patients with chronic lymphocytic leukemia (CLL) in November 2019 following the phase III ASCEND and ELEVATE-TN registration trials. Acalabrutinib is a second-generation Bruton tyrosine kinase inhibitor (BTKi) that was developed after ibrutinib, the first-in-class BTKi. Ibrutinib is usually well tolerated and provides durable remissions; however, some patients experience toxicities from the off-target effects that lead to treatment discontinuation. A recent press release of the phase III ELEVATE-RR trial comparing acalabrutinib to ibrutinib in relapsed high-risk CLL reported noninferior progression-free survival and statistically significantly lower rates of atrial fibrillation; however, publication of this data is pending. There is currently 53 months of follow-up for patients receiving acalabrutinib compared with 8 years for those on ibrutinib. Acalabrutinib is approved as monotherapy in the R/R or TN setting, and in the TN setting can be combined with the anti-CD20 monoclonal antibody obinutuzumab. The data for acalabrutinib development and clinical use are discussed in this review.
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Affiliation(s)
- A Blackmon
- Division of Hematology/Oncology, Department of Medicine, University of California, Irvine, California, USA
| | - S O'Brien
- Division of Hematology/Oncology, Department of Medicine, University of California, Irvine, California, USA. .,Chao Family Comprehensive Cancer Center, University of California, Irvine, California, USA
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9
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Hillmen P, Byrd JC, Ghia P, Kater AP, Chanan‐Khan A, Furman RR, O'Brien S, Yenerel MN, Illes A, Kay N, Garcia‐Marco JA, Mato A, Pinilla‐Ibarz J, Seymour JF, Lepretre S, Stilgenbauer S, Robak T, Patel P, Higgins K, Sohoni S, Jurczak W. FIRST RESULTS OF A HEAD‐TO‐HEAD TRIAL OF ACALABRUTINIB VERSUS IBRUTINIB IN PREVIOUSLY TREATED CHRONIC LYMPHOCYTIC LEUKEMIA. Hematol Oncol 2021. [DOI: 10.1002/hon.33_2879] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- P. Hillmen
- St. James’s University Hospital Experimental Haematology, Leeds UK
| | - J. C. Byrd
- The Ohio State University Comprehensive Cancer Center, Hematology Columbus USA
| | - P. Ghia
- Università Vita‐Salute San Raffaele and IRCCS Ospedale San Raffaele Experimental Oncology Milano Italy
| | - A. P. Kater
- Amsterdam University Medical Center Amsterdam, on behalf of Hovon, Hematology, Lymphoma and Myeloma Research Amsterdam Netherlands
| | - A. Chanan‐Khan
- Mayo Clinic Jacksonville Hematology, Oncology, Jacksonville USA
| | - R. R. Furman
- Weill Cornell Medicine New York Presbyterian Hospital, Hematology, Oncology New York USA
| | - S. O'Brien
- Chao Family Comprehensive Cancer Center University of California‐Irvine, Hematology, Oncology Irvine USA
| | - M. N. Yenerel
- Istanbul University, Istanbul Faculty of Medicine, Hematology Istanbul Turkey
| | - A. Illes
- University of Debrecen Historical Auxiliary Sciences Debrecen Hungary
| | - N. Kay
- Mayo Clinic Rochester, Hematology Rochester USA
| | - J. A. Garcia‐Marco
- Hospital Universitario Puerta de Hierro‐Majadahonda "Unidad de Citogenetica Molecular Servicio de Hematologia " Madrid Spain
| | - A. Mato
- University of Pennsylvania, Chronic Lymphocytic Leukemia Philadelphia USA
| | | | - J. F. Seymour
- Peter MacCallum Cancer Centre, Royal Melbourne Hospital and University of Melbourne, Haematology Victoria Australia
| | - S. Lepretre
- Centre Henri Becquerel and Normandie University UNIROUEN, Hématologie Rouen France
| | - S. Stilgenbauer
- University of Ulm Internal Medicine III, Haematology, Oncology Rheumatology and Infectious Diseases Ulm Germany
| | - T. Robak
- Medican University of Lodz Hematology Lodz Poland
| | - P. Patel
- AstraZeneca, Clinical Development Hematology R&D Oncology South San Francisco USA
| | - K. Higgins
- AstraZencea, Biostatistics South San Francisco USA
| | - S. Sohoni
- AstraZeneca, Clinical Development Hematology R&D Oncology South San Francisco USA
| | - W. Jurczak
- Maria Sklodowska‐Curie National Research Institute of Oncology Clinical Oncology Krakow Poland
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10
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O'Brien S, Armstrong L. 904 Can Patients with Acute Appendicitis be Ambulated Safely? Br J Surg 2021. [PMCID: PMC8135778 DOI: 10.1093/bjs/znab134.507] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
Introduction
During the COVID-19 pandemic, surgical service and practice has been adjusted in order to reduce acute surgical admissions. Acute appendicitis accounts for a significant proportion surgical admissions in the UK. Intercollegiate general surgery guidance during the COVID-19 pandemic advised appendicitis should be managed conservatively, or with an open appendicectomy if indicated. Our aim was to determine the efficacy and safety of our ambulation service in the conservative management of acute uncomplicated appendicitis.
Method
Data was collected prospectively from 30th March 2020 – 16th August 2020 on all patients presenting with suspected appendicitis. Stable patients with clinically suspected or CT-proven appendicitis were discharged with oral antibiotics as per trust guidance. Readmissions for ambulated patients were recorded.
Results
190 patients presented with suspected appendicitis (range 5-71years). 49.4% patients were deemed suitable for ambulation on initial assessment, 22% of which had a CT confirmed diagnosis on discharge. 65% of the ambulated patients underwent a telephone review within a 72-hour window. 13.8% of patients represented within a 30-day period, 7.4% of which proceeded to appendicectomy.
Conclusions
Patients with uncomplicated appendicitis can be safely managed with antibiotics out of hospital, with low representation rates.
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Affiliation(s)
- S O'Brien
- Craigavon Area Hospital, Portadown, United Kingdom
| | - L Armstrong
- Craigavon Area Hospital, Portadown, United Kingdom
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11
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Choudhary S, O'Brien S, Qiu Y, Thomas S, Gupta R, Birbilis N. On the dynamic passivity and corrosion resistance of a low cost and low density multi-principal-element alloy produced via commodity metals. Electrochem commun 2021. [DOI: 10.1016/j.elecom.2021.106989] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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12
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van der Nelson H, O'Brien S, Burnard S, Mayer M, Alvarez M, Knowlden J, Winter C, Dailami N, Marques E, Burden C, Siassakos D, Draycott T. Intramuscular oxytocin versus Syntometrine ® versus carbetocin for prevention of primary postpartum haemorrhage after vaginal birth: a randomised double-blinded clinical trial of effectiveness, side effects and quality of life. BJOG 2021; 128:1236-1246. [PMID: 33300296 DOI: 10.1111/1471-0528.16622] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [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: 12/03/2020] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To compare intramuscular oxytocin, Syntometrine® and carbetocin for prevention of postpartum haemorrhage after vaginal birth. DESIGN Randomised double-blinded clinical trial. SETTING Six hospitals in England. POPULATION A total of 5929 normotensive women having a singleton vaginal birth. METHODS Randomisation when birth was imminent. MAIN OUTCOME MEASURES Primary: use of additional uterotonic agents. Secondary: weighed blood loss, transfusion, manual removal of placenta, adverse effects, quality of life. RESULTS Participants receiving additional uterotonics: 368 (19.5%) oxytocin, 298 (15.6%) Syntometrine and 364 (19.1%) carbetocin. When pairwise comparisons were made: women receiving carbetocin were significantly more likely to receive additional uterotonics than those receiving Syntometrine (odds ratio [OR] 1.28, 95% CI 1.08-1.51, P = 0.004); the difference between carbetocin and oxytocin was non-significant (P = 0.78); Participants receiving Syntometrine were significantly less likely to receive additional uterotonics than those receiving oxytocin (OR 0.75, 95% CI 0.65-0.91, P = 0.002). Non-inferiority between carbetocin and Syntometrine was not shown. Use of Syntometrine reduced non-drug PPH treatments compared with oxytocin (OR 0.64, 95% CI 0.42-0.97) but not carbetocin (P = 0.64). Rates of PPH and blood transfusion were not different. Syntometrine was associated with an increase in maternal adverse effects and reduced ability of the mother to bond with her baby. CONCLUSIONS Non-inferiority of carbetocin to Syntometrine was not shown. Carbetocin is not significantly different to oxytocin for use of additional uterotonics. Use of Syntometrine reduced use of additional uterotonics and need for non-drug PPH treatments compared with oxytocin. Increased maternal adverse effects are a disadvantage of Syntometrine. TWEETABLE ABSTRACT IM carbetocin does not reduce additional uterotonic use compared with IM Syntometrine or oxytocin.
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Affiliation(s)
- H van der Nelson
- North Bristol NHS Trust, Bristol, UK.,University of Bristol, Bristol, UK
| | - S O'Brien
- North Bristol NHS Trust, Bristol, UK.,University of Bristol, Bristol, UK
| | - S Burnard
- Royal United Hospitals NHS Trust, Bath, UK
| | - M Mayer
- North Bristol NHS Trust, Bristol, UK
| | - M Alvarez
- North Bristol NHS Trust, Bristol, UK
| | | | - C Winter
- North Bristol NHS Trust, Bristol, UK
| | - N Dailami
- University of the West of England, Bristol, UK
| | - E Marques
- North Bristol NHS Trust, Bristol, UK
| | - C Burden
- North Bristol NHS Trust, Bristol, UK.,University of Bristol, Bristol, UK
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Misra G, Sim J, El‐Gizawy Z, Watts K, Jerreat S, Coia T, Ritchie J, O'Brien S. Laparoscopic ablation or excision with helium thermal coagulator versus electrodiathermy for the treatment of mild‐to‐moderate endometriosis: randomised controlled trial. BJOG 2020; 127:1528-1535. [DOI: 10.1111/1471-0528.16279] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/15/2020] [Indexed: 11/30/2022]
Affiliation(s)
- G Misra
- Maternity Unit University Hospitals of North Midlands Royal Stoke University Hospital Stoke‐on‐Trent Staffordshire UK
| | - J Sim
- School of Primary, Community and Social Care Keele University Keele Staffordshire UK
| | - Z El‐Gizawy
- Maternity Unit University Hospitals of North Midlands Royal Stoke University Hospital Stoke‐on‐Trent Staffordshire UK
| | - K Watts
- Research and Innovation University Hospitals of North Midlands Royal Stoke University Hospital Stoke‐on‐Trent Staffordshire UK
| | - S Jerreat
- Maternity Unit University Hospitals of North Midlands Royal Stoke University Hospital Stoke‐on‐Trent Staffordshire UK
| | - T Coia
- Maternity Unit University Hospitals of North Midlands Royal Stoke University Hospital Stoke‐on‐Trent Staffordshire UK
| | - J Ritchie
- Maternity Unit University Hospitals of North Midlands Royal Stoke University Hospital Stoke‐on‐Trent Staffordshire UK
| | - S O'Brien
- Maternity Unit University Hospitals of North Midlands Royal Stoke University Hospital Stoke‐on‐Trent Staffordshire UK
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14
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Stanojevic M, O'Brien S, Geiger A, Ulrey R, Cruz C, Hanley P, Keller M, Bollard C. Identification of Novel HLA-Restricted PRAME Peptides to Facilitate “Off-the-shelf” Tumor-Associated Antigen-specific T-cells. Cytotherapy 2020. [DOI: 10.1016/j.jcyt.2020.03.269] [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: 10/24/2022]
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15
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O'Brien S, Garvey P, Baker K, Brennan M, Cormican M, Cuddihy J, De Lappe N, Ellard R, Fallon Ú, Irvine N, Murphy S, O'Brien D, O'Connor M, O'Hare C, O'Sullivan MB, Part AM, Rooney P, Ryan A, Waldron G, Ward M, McKeown PJ. Investigation of a foodborne outbreak of Shigella sonnei in Ireland and Northern Ireland, December 2016: the benefits of cross-border collaboration and commercial sales data. Public Health 2020; 182:19-25. [PMID: 32120067 DOI: 10.1016/j.puhe.2020.01.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Revised: 12/11/2019] [Accepted: 01/09/2020] [Indexed: 11/16/2022]
Abstract
OBJECTIVES To describe a cross-border foodborne outbreak of Shigella sonnei that occurred in Ireland and Northern Ireland (NI) in December 2016 whilst also highlighting the valuable roles of sales data and international collaboration in the investigation and control of this outbreak. STUDY DESIGN A cross-border outbreak control team was established to investigate the outbreak. METHODS Epidemiological, microbiological, and environmental investigations were undertaken. Traditional analytical epidemiological studies were not feasible in this investigation. The restaurant chain provided sales data, which allowed assessment of a possible increased risk of illness associated with exposure to a particular type of heated food product (product A). RESULTS Confirmed cases demonstrated sole trimethoprim resistance: an atypical antibiogram for Shigella isolates in Ireland. Early communication and the sharing of information within the outbreak control team facilitated the early detection of the international dimension of this outbreak. A joint international alert using the European Centre for Disease Control's confidential Epidemic Intelligence Information System for Food- and Waterborne Diseases and Zoonoses (EPIS-FWD) did not reveal further cases outside of the island of Ireland. The outbreak investigation identified that nine of thirteen primary case individuals had consumed product A from one of multiple branches of a restaurant chain located throughout the island of Ireland. Product A was made specifically for this chain in a food production facility in NI. S. sonnei was not detected in food samples from the food production facility. Strong statistical associations were observed between visiting a branch of this restaurant chain between 5 and 9 December 2016 and eating product A and developing shigellosis. CONCLUSIONS This outbreak investigation highlights the importance of international collaboration in the efficient identification of cross-border foodborne outbreaks and the value of using sales data as the analytical component of such studies.
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Affiliation(s)
- S O'Brien
- HSE-Health Protection Surveillance Centre, Dublin, Ireland; Department of Public Health HSE-NW, Sligo, Ireland.
| | - P Garvey
- HSE-Health Protection Surveillance Centre, Dublin, Ireland
| | - K Baker
- Food Standards Agency Northern Ireland, Belfast, Northern Ireland, Ireland
| | - M Brennan
- Food Safety Authority of Ireland, Dublin, Ireland
| | - M Cormican
- National Salmonella, Shigella and Listeria Reference Laboratory, Galway, Ireland
| | - J Cuddihy
- Department of Public Health HSE-SE, Kilkenny, Ireland
| | - N De Lappe
- National Salmonella, Shigella and Listeria Reference Laboratory, Galway, Ireland
| | - R Ellard
- Food Safety Authority of Ireland, Dublin, Ireland
| | - Ú Fallon
- Department of Public Health HSE-Midlands, Co Offaly, Ireland
| | - N Irvine
- Public Health Agency Northern Ireland, Belfast, Northern Ireland, UK
| | - S Murphy
- Environmental Health Department, Newry, Mourne & Down District Council, Northern Ireland, UK
| | - D O'Brien
- HSE Environmental Health Service Dublin Specialist Section, Dublin, Ireland
| | - M O'Connor
- Department of Public Health HSE-E, Dublin, Ireland
| | - C O'Hare
- Department of Public Health HSE-SE, Kilkenny, Ireland
| | | | - A M Part
- HSE Environmental Health Service Dublin Mid Leinster, Dublin, Ireland
| | - P Rooney
- Belfast Health and Social Care Trust, Belfast, Northern Ireland, UK
| | - A Ryan
- Department of Public Health HSE-NW, Sligo, Ireland
| | - G Waldron
- Public Health Agency Northern Ireland, Belfast, Northern Ireland, UK
| | - M Ward
- Department of Public Health HSE-E, Dublin, Ireland
| | - P J McKeown
- HSE-Health Protection Surveillance Centre, Dublin, Ireland
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Topp M, Arnason J, Advani R, Brown J, Allan J, Ansell S, O'Brien S, Chavez J, Duell J, Rosenwald A, Charnas R, Ambati S, Adriaens L, Ufkin M, Zhu M, Li J, Gasparini P, Jankovic V, Fiaschi N, Zhang W, Hamon S, Thurston G, Murphy A, Yancopoulos G, Lowy I, Sternberg D, Bannerji R. CLINICAL ACTIVITY OF REGN1979, AN ANTI-CD20 X ANTI-CD3 BISPECIFIC ANTIBODY (AB) IN PATIENTS (PTS) WITH (W/) RELAPSED/REFRACTORY (R/R) B-CELL NON-HODGKIN LYMPHOMA (B-NHL). Hematol Oncol 2019. [DOI: 10.1002/hon.58_2629] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- M.S. Topp
- Department of Internal Medicine; Universitätsklinikum Würzburg; Würzburg Germany
| | - J. Arnason
- Hematology/Oncology Division; Beth Israel Deaconess Medical Center; Boston United States
| | - R. Advani
- Department of Medicine; Stanford University; Stanford United States
| | - J.R. Brown
- Center for Hematologic Oncology; Dana-Farber Cancer Institute; Boston United States
| | - J. Allan
- Division of Hematology and Medical Oncology; Weill Cornell Medicine; New York United States
| | - S. Ansell
- Department of Internal Medicine; Mayo Clinic; Rochester United States
| | - S. O'Brien
- Division of Hematology/Oncology; University of California; Irvine United States
| | - J. Chavez
- Department of Oncologic Sciences; Moffitt Cancer Center; Tampa United States
| | - J. Duell
- Department of Internal Medicine; Universitätsklinikum Würzburg; Würzburg Germany
| | - A. Rosenwald
- Institute of Pathology; University of Würzburg; Würzburg Germany
| | - R. Charnas
- Hematology/Oncology; Regeneron Pharmaceuticals, Inc.; Tarrytown United States
| | - S.R. Ambati
- Hematology/Oncology; Regeneron Pharmaceuticals, Inc.; Tarrytown United States
| | - L. Adriaens
- Hematology/Oncology; Regeneron Pharmaceuticals, Inc.; Basking Ridge United States
| | - M. Ufkin
- Hematology/Oncology; Regeneron Pharmaceuticals, Inc.; Tarrytown United States
| | - M. Zhu
- Hematology/Oncology; Regeneron Pharmaceuticals, Inc.; Tarrytown United States
| | - J. Li
- Hematology/Oncology; Regeneron Pharmaceuticals, Inc.; Basking Ridge United States
| | - P. Gasparini
- Hematology/Oncology; Regeneron Pharmaceuticals, Inc.; Tarrytown United States
| | - V. Jankovic
- Hematology/Oncology; Regeneron Pharmaceuticals, Inc.; Tarrytown United States
| | - N. Fiaschi
- Hematology/Oncology; Regeneron Pharmaceuticals, Inc.; Tarrytown United States
| | - W. Zhang
- Hematology/Oncology; Regeneron Pharmaceuticals, Inc.; Tarrytown United States
| | - S. Hamon
- Hematology/Oncology; Regeneron Pharmaceuticals, Inc.; Tarrytown United States
| | - G. Thurston
- Hematology/Oncology; Regeneron Pharmaceuticals, Inc.; Tarrytown United States
| | - A.J. Murphy
- Hematology/Oncology; Regeneron Pharmaceuticals, Inc.; Tarrytown United States
| | - G.D. Yancopoulos
- Hematology/Oncology; Regeneron Pharmaceuticals, Inc.; Tarrytown United States
| | - I. Lowy
- Hematology/Oncology; Regeneron Pharmaceuticals, Inc.; Tarrytown United States
| | - D. Sternberg
- Hematology/Oncology; Regeneron Pharmaceuticals, Inc.; Tarrytown United States
| | - R. Bannerji
- Section of Hematologic Malignancies; Rutgers Cancer Institute of New Jersey; New Brunswick United States
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17
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Pagoti R, O'Brien S, Doran E, Beverland D. Correction to: Unconstrained total knee arthroplasty in significant valgus deformity: a modified surgical technique to balance the knee and avoid instability. Knee Surg Sports Traumatol Arthrosc 2019; 27:339. [PMID: 29637235 DOI: 10.1007/s00167-018-4944-0] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The author would like to correct the following errors in the publication of the original article.
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Affiliation(s)
- R Pagoti
- Primary Joint Unit, Musgrave Park Hospital, Stockman's Lane, Belfast, BT9 7JB, UK.
| | - S O'Brien
- Primary Joint Unit, Musgrave Park Hospital, Stockman's Lane, Belfast, BT9 7JB, UK
| | - E Doran
- Primary Joint Unit, Musgrave Park Hospital, Stockman's Lane, Belfast, BT9 7JB, UK
| | - D Beverland
- Primary Joint Unit, Musgrave Park Hospital, Stockman's Lane, Belfast, BT9 7JB, UK
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18
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Lowther JA, Gustar NE, Powell AL, O'Brien S, Lees DN. A One-Year Survey of Norovirus in UK Oysters Collected at the Point of Sale. Food Environ Virol 2018; 10:278-287. [PMID: 29722006 PMCID: PMC6096945 DOI: 10.1007/s12560-018-9338-4] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/14/2017] [Accepted: 01/27/2018] [Indexed: 05/31/2023]
Abstract
Contamination of bivalve shellfish, particularly oysters, with norovirus is recognised as a food safety risk and a potential contributor to the overall burden of gastroenteritis in the community. The United Kingdom (UK) has comprehensive national baseline data on the prevalence, levels, and seasonality of norovirus in oysters in production areas resulting from a previous two-year study (2009-2011). However, previously, data on final product as sold to the consumer have been lacking. As part of a wider project to establish the overall burden of foodborne norovirus in the UK, this study aimed to address this data gap. A one-year survey of oysters collected from the point-of-sale to the consumer was carried out from March 2015 to March 2016. A total of 630 samples, originating in five different European Union Member States, were collected from 21 regions across the UK using a randomised sampling plan, and tested for norovirus using a method compliant with ISO 15216-1, in addition to Escherichia coli as the statutory indicator of hygiene status. As in the previous production area study, norovirus RNA was detected in a high proportion of samples (68.7%), with a strong winter seasonality noted. Some statistically significant differences in prevalences and levels in oysters from different countries were noted, with samples originating in the Netherlands showing lower prevalences and levels than those from either the UK or Ireland. Overall, levels detected in positive samples were considerably lower than seen previously. Investigation of potential contributing factors to this pattern of results was carried out. Application of normalisation factors to the data from the two studies based on both the numbers of norovirus illness reports received by national surveillance systems, and the national average environmental temperatures during the two study periods resulted in a much closer agreement between the two data sets, with the notably different numbers of illness reports making the major contribution to the differences observed in norovirus levels in oysters. The large majority of samples (76.5%) contained no detectable E. coli; however, in a small number of samples (2.4%) levels above the statutory end product standard (230 MPN/100 g) were detected. This study both revealed the high prevalence of norovirus RNA in oysters directly available to the UK consumer, despite the high level of compliance with the existing E. coli-based health standards, while also highlighting the difficulty in comparing the results of surveys carried out in different time periods, due to variability in risk factors.
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Affiliation(s)
- J A Lowther
- Centre for Environment, Fisheries and Aquaculture Science, Weymouth, DT4 8UB, UK.
| | - N E Gustar
- Centre for Environment, Fisheries and Aquaculture Science, Weymouth, DT4 8UB, UK
| | - A L Powell
- Centre for Environment, Fisheries and Aquaculture Science, Weymouth, DT4 8UB, UK
| | - S O'Brien
- Institute of Psychology, Health & Society, University of Liverpool, Liverpool, England, UK
| | - D N Lees
- Centre for Environment, Fisheries and Aquaculture Science, Weymouth, DT4 8UB, UK
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19
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Kennedy CA, Walsh C, Karczmarczyk M, O'Brien S, Akasheh N, Quirke M, Farrell-Ward S, Buckley T, Fogherty U, Kavanagh K, Parker CT, Sweeney T, Fanning S. Multi-drug resistant Escherichia coli in diarrhoeagenic foals: Pulsotyping, phylotyping, serotyping, antibiotic resistance and virulence profiling. Vet Microbiol 2018; 223:144-152. [PMID: 30173740 DOI: 10.1016/j.vetmic.2018.08.009] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2018] [Revised: 08/04/2018] [Accepted: 08/04/2018] [Indexed: 01/20/2023]
Abstract
Extraintestinal pathogenic E. coli (ExPEC) possess the ability to cause extraintestinal infections such as urinary tract infections, neonatal meningitis and sepsis. While information is readily available describing pathogenic E. coli populations in food-producing animals, studies in companion/sports animals such as horses are limited. In addition, many antimicrobial agents used in the treatment of equine infections are also utilised in human medicine, potentially contributing to the spread of antibiotic resistance determinants among pathogenic strains. The aim of this study was to phenotypically and genotypically characterise the multidrug resistance and virulence associated with 83 equine E. coli isolates recovered from foals with diarrhoeal disease. Serotyping was performed by both PCR and sequencing. Antibiotic resistance was assessed by disc diffusion. Phylogenetic groups, virulence genes, antibiotic resistance genes and integrons were determined by PCR. Thirty-nine (46%) of the isolates were classified as ExPEC and hence considered to be potentially pathogenic to humans and animals. Identified serogroups O1, O19a, O40, O101 and O153 are among previously reported human clinical ExPEC isolates. Over a quarter of the E. coli were assigned to pathogenic phylogroups B2 (6%) and D (23%). Class 1 and class 2 integrons were detected in 85% of E. coli, revealing their potential to transfer MDR to other pathogenic and non-pathogenic bacteria. With 65% of potentially pathogenic isolates harbouring one or more TEM, SHV and CTX-M-2 group β-lactamases, in addition to the high levels of resistance to fluoroquinolones observed, our findings signal the need for increased attention to companion/sport animal reservoirs as public health threats.
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Affiliation(s)
- C A Kennedy
- UCD Veterinary Sciences Centre, University College Dublin, Belfield, Dublin 4, Ireland
| | - C Walsh
- School of Food Science and Environmental Health, DIT, Cathal Brugha Street, Dublin, D01 HV58, Ireland; UCD-Center for Food Safety, School of Public Health, Physiotherapy & Sports Science, University College Dublin, Belfield, Dublin D04 N2E5, Ireland
| | - M Karczmarczyk
- UCD-Center for Food Safety, School of Public Health, Physiotherapy & Sports Science, University College Dublin, Belfield, Dublin D04 N2E5, Ireland
| | - S O'Brien
- UCD-Center for Food Safety, School of Public Health, Physiotherapy & Sports Science, University College Dublin, Belfield, Dublin D04 N2E5, Ireland
| | - N Akasheh
- Medical Directorate, St. James's Hospital, Dublin 8, Ireland
| | - M Quirke
- School of Food Science and Environmental Health, DIT, Cathal Brugha Street, Dublin, D01 HV58, Ireland
| | - S Farrell-Ward
- UCD-Center for Food Safety, School of Public Health, Physiotherapy & Sports Science, University College Dublin, Belfield, Dublin D04 N2E5, Ireland
| | - T Buckley
- Irish Equine Centre, Johnstown, Naas, Co. Kildare, W91 RH93, Ireland
| | - U Fogherty
- Irish Equine Centre, Johnstown, Naas, Co. Kildare, W91 RH93, Ireland
| | - K Kavanagh
- Irish Equine Centre, Johnstown, Naas, Co. Kildare, W91 RH93, Ireland
| | - C T Parker
- Produce Safety and Microbiology Research Unit, Agricultural Research Service, U.S. Department of Agriculture, 800 Buchanan Street, Albany, CA, 94710, USA
| | - T Sweeney
- UCD Veterinary Sciences Centre, University College Dublin, Belfield, Dublin 4, Ireland
| | - S Fanning
- UCD-Center for Food Safety, School of Public Health, Physiotherapy & Sports Science, University College Dublin, Belfield, Dublin D04 N2E5, Ireland.
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20
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Legault K, Schunemann H, Hillis C, Yeung C, Akl EA, Carrier M, Cervera R, Crowther M, Dentali F, Erkan D, Espinosa G, Khamashta M, Meerpohl JJ, Moffat K, O'Brien S, Pengo V, Rand JH, Rodriguez Pinto I, Thom L, Iorio A. McMaster RARE-Bestpractices clinical practice guideline on diagnosis and management of the catastrophic antiphospholipid syndrome. J Thromb Haemost 2018; 16:1656-1664. [PMID: 29978552 DOI: 10.1111/jth.14192] [Citation(s) in RCA: 82] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2018] [Indexed: 01/24/2023]
Abstract
Background The McMaster RARE-Bestpractices project group selected the catastrophic antiphospholipid syndrome (CAPS) for a pilot exercise in guideline development for a rare disease. Objectives The objectives of this exercise were to provide a proof of principle that guidelines can be developed for rare diseases and assist in clinical decision making for CAPS. Patients/Methods The GIN-McMaster Guideline Development checklist and GRADE methodology were followed throughout the guideline process. The CAPS guideline was coordinated by a steering committee, and the guideline panel was formed with representation from all relevant stakeholder groups. Systematic reviews were performed for the key questions. To supplement the published evidence, we piloted novel methods, including use of an expert-based evidence elicitation process and ad hoc analysis of registry data. Results This paper describes the CAPS guideline recommendations, including evidence appraisal and discussion of special circumstances and implementation barriers identified by the panel. Many of these recommendations are conditional, because of subgroup considerations in this heterogeneous disease, as well as variability in patient values and preferences. Conclusions The CAPS clinical practice guideline initiative met the objective of the successful development of a clinical practice guideline in a rare disease using GRADE methodology. We expect that clinicians caring for patients with suspected CAPS will find the guideline useful in assisting with diagnosis and management of this rare disease.
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Affiliation(s)
- K Legault
- McMaster University, Hamilton, Canada
| | | | - C Hillis
- McMaster University, Hamilton, Canada
| | - C Yeung
- McMaster University, Hamilton, Canada
| | - E A Akl
- McMaster University, Hamilton, Canada
- American University of Beirut, Beirut, Lebanon
| | - M Carrier
- University of Ottawa, Ottawa, Canada
| | - R Cervera
- University of Barcelona, Barcelona, Spain
| | | | - F Dentali
- Insubria University, Insubria, Italy
| | - D Erkan
- Weill Cornell Medicine College, New York, USA
| | - G Espinosa
- University of Barcelona, Barcelona, Spain
| | | | - J J Meerpohl
- Cochrane Germany, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - K Moffat
- McMaster University, Hamilton, Canada
- Hamilton Regional Laboratory Medicine Program, Hamilton, Canada
| | - S O'Brien
- Nationwide Children's Hospital, Columbus, USA
| | - V Pengo
- University of Padova, Padua, Italy
| | - J H Rand
- Weill Cornell Medicine College, New York, USA
| | | | | | - A Iorio
- McMaster University, Hamilton, Canada
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21
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Jain P, Aoki E, Keating M, Wierda WG, O'Brien S, Gonzalez GN, Ferrajoli A, Jain N, Thompson PA, Jabbour E, Kanagal-Shamanna R, Pierce S, Alousi A, Hosing C, Khouri I, Estrov Z, Cortes J, Kantarjian H, Ravandi F, Kadia TM. Characteristics, outcomes, prognostic factors and treatment of patients with T-cell prolymphocytic leukemia (T-PLL). Ann Oncol 2018; 28:1554-1559. [PMID: 28379307 DOI: 10.1093/annonc/mdx163] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2017] [Indexed: 11/13/2022] Open
Abstract
Background T-cell prolymphocytic leukemia (T-PLL) is a rare and aggressive disease. In this study, we report our experience from 119 patients with T-PLL. Patients and methods We reviewed the clinico-pathologic records of 119 consecutive patients with T-PLL, who presented to our institution between 1990 and 2016. Results One hundred and nineteen patients with T-PLL were analysed. Complex karyotype and aberrations in chromosome 14 were seen in 65% and 52% patients, respectively. Seventy-five patients (63%) were previously untreated and 43 (37%) were initially treated outside our institution. Sixty-three previously untreated patients (84%) received frontline therapies. Overall, 95 patients (80%) have died. Median overall survival (OS) from diagnosis was 19 months [95% confidence interval (CI) 16-26 months]. Using recursive partitioning (RP), we found that patients with hemoglobin < 9.3 g/dl, lactate dehydrogenase (LDH) ≥ 1668 IU/l, white blood cell ≥ 208 K/l and β2M ≥ 8 mg/l had significantly inferior OS and patients with hemoglobin < 9.3 g/dl had inferior progression-free survival (PFS). In multivariate analysis, we identified that presence of pleural effusion [hazard ratio (HR) 2.08 (95% CI 1.11-3.9); P = 0.02], high LDH (≥ 1668 IU/l) [HR 2.5 (95% CI 1.20-4.24); P < 0.001)], and low hemoglobin (< 9.3 g/dl) [HR 0.33 (95% CI 0.14-0.75); P = 0.008] were associated with shorter OS. Fifty-five previously untreated patients received treatment with an alemtuzumab-based regimen (42 monotherapy and 13 combination with pentostatin). Overall response rate, complete remission rate (CR) for single-agent alemtuzumab and alemtuzumab combined with pentostatin were 83%, 66% and 82%, 73% respectively. In patients who achieved initial CR, stem cell transplantation was not associated with longer PFS and OS. Conclusion Outcomes in T-PLL remain poor. Multicenter collaborative effort is required to conduct prospective studies.
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Affiliation(s)
- P Jain
- Department of Leukemia, The MD Anderson Cancer Center, Houston
| | - E Aoki
- Department of Leukemia, The MD Anderson Cancer Center, Houston
| | - M Keating
- Department of Leukemia, The MD Anderson Cancer Center, Houston
| | - W G Wierda
- Department of Leukemia, The MD Anderson Cancer Center, Houston
| | - S O'Brien
- Division of Hematology/Oncology, Chao Family Comprehensive Cancer Center, UC Irvine, Irvine
| | | | - A Ferrajoli
- Department of Leukemia, The MD Anderson Cancer Center, Houston
| | - N Jain
- Department of Leukemia, The MD Anderson Cancer Center, Houston
| | - P A Thompson
- Department of Leukemia, The MD Anderson Cancer Center, Houston
| | - E Jabbour
- Department of Leukemia, The MD Anderson Cancer Center, Houston
| | | | - S Pierce
- Department of Leukemia, The MD Anderson Cancer Center, Houston
| | - A Alousi
- Stem Cell Transplantation, The MD Anderson Cancer Center, Houston, USA
| | - C Hosing
- Stem Cell Transplantation, The MD Anderson Cancer Center, Houston, USA
| | - I Khouri
- Stem Cell Transplantation, The MD Anderson Cancer Center, Houston, USA
| | - Z Estrov
- Department of Leukemia, The MD Anderson Cancer Center, Houston
| | - J Cortes
- Department of Leukemia, The MD Anderson Cancer Center, Houston
| | - H Kantarjian
- Department of Leukemia, The MD Anderson Cancer Center, Houston
| | - F Ravandi
- Department of Leukemia, The MD Anderson Cancer Center, Houston
| | - T M Kadia
- Department of Leukemia, The MD Anderson Cancer Center, Houston
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22
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Dalzell MA, Smirnow N, Sateren W, Sintharaphone A, Ibrahim M, Mastroianni L, Vales Zambrano LD, O'Brien S. Rehabilitation and exercise oncology program: translating research into a model of care. ACTA ACUST UNITED AC 2017; 24:e191-e198. [PMID: 28680286 DOI: 10.3747/co.24.3498] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
INTRODUCTION The Rehabilitation and Exercise Oncology model of care (ActivOnco) was established to optimize cancer survivorship through exercise prescription and active lifestyle promotion, providing a transition of care from hospital to community. Patients having any cancer diagnosis, stage of disease, and treatment were eligible for evaluation and exercise prescription upon deterioration of performance status. The team of professionals included hospital-based physiotherapists proactively screening for rehabilitation needs, loss of functional independence, and exercise eligibility, plus exercise specialists in a community-based Wellness Centre to provide follow-up or direct access for post-treatment or non-complex patients. METHODS From January 2011 to December 2015, the hospital team assessed 1635 patients representing all major cancer sites, and the Wellness Centre team evaluated and prescribed exercise for 1066 participants. Primary interventions provided were education about fatigue management, physical activity promotion, exercise prescription, fracture risk reduction, referral to specialized follow-up services (for example, occupational therapy, lymphedema clinic), and coordination for mobility aids and paratransit services. RESULTS AND CONCLUSIONS Implementation of the ActivOnco model of care showed that exercise alone is not a panacea for all functional deterioration associated with the cancer trajectory and its treatment. However, screening to identify rehabilitation needs combined with exercise prescription can effectively improve the quality of survivorship in cancer patients. Program developments are limited by the cost of human resources, lack of hospital-based physical resources, and lack of public funding, all of which significantly limit the scope and development of appropriate services.
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Affiliation(s)
- M A Dalzell
- Hope and Cope, Jewish General Hospital, Montreal, QC
| | - N Smirnow
- Hope and Cope, Jewish General Hospital, Montreal, QC
| | - W Sateren
- Hope and Cope, Jewish General Hospital, Montreal, QC.,Rossy Cancer Network, Montreal, QC.,Segal Cancer Centre, Jewish General Hospital, Montreal, QC
| | | | - M Ibrahim
- Hope and Cope, Jewish General Hospital, Montreal, QC
| | - L Mastroianni
- Hope and Cope, Jewish General Hospital, Montreal, QC
| | | | - S O'Brien
- Hope and Cope, Jewish General Hospital, Montreal, QC
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23
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Montillo M, Byrd J, Hillmen P, O'Brien S, Barrientos J, Reddy N, Coutre S, Tam C, Mulligan S, Jaeger U, Barr P, Furman R, Kipps T, Thornton P, Moreno C, Pagel J, Burger J, Jones J, Dai S, Vezan R, James D, Brown J. LONG-TERM EFFICACY AND SAFETY IN THE RESONATE STUDY: IBRUTINIB IN PATIENTS WITH PREVIOUSLY TREATED CHRONIC LYMPHOCYTIC LEUKEMIA (CLL) WITH UP TO FOUR YEARS FOLLOW-UP. Hematol Oncol 2017. [DOI: 10.1002/hon.2438_98] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- M. Montillo
- Department of Haematology & Oncology; Niguarda Cancer Center, Niguarda Hospital; Milan Italy
| | - J.C. Byrd
- Division of Hematology, Department of Internal Medicine; The Ohio State University Comprehensive Cancer Center; Columbus USA
| | - P. Hillmen
- Department of Haematology; The Leeds Teaching Hospitals, St. James Institute of Oncology; Leeds UK
| | - S. O'Brien
- Chao Family Comprehensive Cancer Center; University of California Irvine; Orange USA
| | - J.C. Barrientos
- Division of Hematology and Medical Oncology; Department of Medicine, Hofstra Northwell School of Medicine; Hempstead USA
| | - N.M. Reddy
- Hematology/Oncology; Vanderbilt-Ingram Cancer Center; Nashville USA
| | - S. Coutre
- Division of Hematology, Stanford Cancer Center; Stanford University School of Medicine; Stanford USA
| | - C.S. Tam
- Department of Haematology, Peter MacCallum Cancer Centre and St. Vincent's Hospital; Melbourne Australia
| | - S.P. Mulligan
- Hematology; Royal North Shore Hospital, St. Leonards; Australia
| | - U. Jaeger
- Division of Hematology and Hemostaseology; Medical University of Vienna; Wien Austria
| | - P.M. Barr
- James P. Wilmot Cancer Center
- Department of Medicine, Hematology/Oncology; University of Rochester Medical Center; Rochester USA
| | - R.R. Furman
- Division of Hematology and Medical Oncology, Weill Cornell Medical College; New York USA
| | - T.J. Kipps
- Moores Cancer Center; University of California San Diego; La Jolla USA
| | - P. Thornton
- Department of Haematology; Beaumont Hospital; Dublin Republic of Ireland
| | - C. Moreno
- Hematology Department; Hospital de la Santa Creu Sant Pau; Barcelona Spain
| | - J.M. Pagel
- Hematologic Malignancies Program; Swedish Cancer Institute; Seattle USA
| | - J.A. Burger
- Department of Leukemia; University of Texas MD Anderson Cancer Center; Houston USA
| | - J. Jones
- Division of Hematology, Department of Internal Medicine; The Ohio State University Comprehensive Cancer Center; Columbus USA
| | - S. Dai
- Biostatistics; Pharmacyclics LLC, an AbbVie Company; Sunnyvale USA
| | - R. Vezan
- Clinical Research; Pharmacyclics LLC, an Abbvie Company; Sunnyvale USA
| | - D.F. James
- Clinical Research; Pharmacyclics LLC, an Abbvie Company; Sunnyvale USA
| | - J.R. Brown
- Division of Hematologic Malignancies; CLL Center, Dana-Farber Cancer Institute; Boston USA
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24
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Tam C, Byrd J, O'Brien S, Coutre S, Barr P, Furman R, Kipps T, Burger J, Stevens D, Sharman J, Ghia P, Flinn I, Zhou C, Ninomoto J, James D, Wierda W. EFFECT OF SINGLE-AGENT IBRUTINIB ON TUMOR DEBULKING AND REDUCTIONS IN TUMOR LYSIS SYNDROME (TLS) RISK IN PATIENTS (PTS) WITH CHRONIC LYMPHOCYTIC LEUKEMIA (CLL). Hematol Oncol 2017. [DOI: 10.1002/hon.2438_96] [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: 11/09/2022]
Affiliation(s)
- C.S. Tam
- Department of Haematology; Peter MacCallum Cancer Centre and St. Vincent's Hospital; Melbourne Australia
| | - J.C. Byrd
- Division of Hematology, Department of Internal Medicine; The Ohio State University Medical Center; Columbus USA
| | - S. O'Brien
- Chao Family Comprehensive Cancer Center; University of California Irvine; Orange USA
| | - S. Coutre
- Division of Hematology, Stanford Cancer Center; Stanford University School of Medicine; Stanford USA
| | - P.M. Barr
- James P. Wilmot Cancer Center
- Department of Medicine, Hematology/Oncology, Wilmot Cancer Institute; University of Rochester Medical Center; Rochester USA
| | - R.R. Furman
- Division of Hematology and Medical Oncology; Weill Cornell Medical College; New York USA
| | - T.J. Kipps
- Department of Medicine; University of California San Diego, Moores Cancer Center; La Jolla USA
| | - J.A. Burger
- Department of Leukemia; University of Texas, MD Anderson Cancer Center, Houston; Houston USA
| | - D. Stevens
- Medical Oncology/Hematology; Norton Cancer Institute; Louisville USA
| | - J. Sharman
- US Oncology Research; Willamette Valley Cancer Institute & Research Center; Eugene USA
| | - P. Ghia
- Division of Molecular Oncology and Department of Onco-Hematology, Università Vita-Salute San Raffaele and IRCCS Istituto Scientifico San Raffaele; Milan Italy
| | - I. Flinn
- Blood Cancer Research Program; Sarah Cannon Research Institute; Nashville USA
| | - C. Zhou
- Biometrics, Pharmacyclics LLC, an AbbVie Company; Sunnyvale USA
| | - J. Ninomoto
- Clinical Science, Pharmacyclics LLC, an AbbVie Company; Sunnyvale USA
| | - D.F. James
- Clinical Research, Pharmacyclics LLC, an AbbVie Company; Sunnyvale USA
| | - W.G. Wierda
- Department of Leukemia; University of Texas, MD Anderson Cancer Center, Houston; Houston USA
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Nastoupil L, Lunning M, Vose J, Schreeder M, Siddiqi T, Flowers C, Cohen J, Burger J, Wierda W, O'Brien S, Sportelli P, Miskin H, Purdom M, Weiss M, Fowler N. CHEMO-FREE TRIPLET COMBINATION OF TGR-1202, UBLITUXIMAB, AND IBRUTINIB IS WELL TOLERATED AND HIGHLY ACTIVE IN PATIENTS WITH ADVANCED CLL AND NHL. Hematol Oncol 2017. [DOI: 10.1002/hon.2437_101] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- L. Nastoupil
- Dept of Lymphoma; MD Anderson Cancer Center; Houston USA
| | - M.A. Lunning
- Lymphoma; University of Nebraska Medical Center; Omaha USA
| | - J.M. Vose
- Lymphoma; University of Nebraska Medical Center; Omaha USA
| | | | - T. Siddiqi
- Dept. of Hematology/HCT; City of Hope National Medical Center; Duarte USA
| | - C.R. Flowers
- Lymphoma; Winship Cancer Institute / Emory University; Atlanta USA
| | - J.B. Cohen
- Lymphoma; Winship Cancer Institute / Emory University; Atlanta USA
| | - J.A. Burger
- Leukemia; MD Anderson Cancer Institute; Houston USA
| | - W.G. Wierda
- Leukemia; MD Anderson Cancer Institute; Houston USA
| | - S. O'Brien
- Dept. of Hematology; University of California, Irvine Cancer Center; Irvine USA
| | | | - H.P. Miskin
- Hematology; TG Therapeutics, Inc.; New York USA
| | - M.A. Purdom
- Hematology; TG Therapeutics, Inc.; New York USA
| | - M.S. Weiss
- Hematology; TG Therapeutics, Inc.; New York USA
| | - N.H. Fowler
- Dept of Lymphoma; MD Anderson Cancer Center; Houston USA
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Hao YN, Bi K, O'Brien S, Wang XX, Lombardi J, Pearsall F, Li WL, Lei M, Wu Y, Li LT. Interface structure, precursor rheology and dielectric properties of BaTiO3/PVDF–hfp nanocomposite films prepared from colloidal perovskite nanoparticles. RSC Adv 2017. [DOI: 10.1039/c7ra03250a] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
A novel and greatly simplified strategy was developed to fabricate high-permittivity dielectric nanocomposites. Interface structure, precursor rheology and dielectric properties of the 0–3 BaTiO3/PVDF–hfp nanocomposite film were investigated.
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Adams N, Rose T, Taylor-Robinson D, Barr B, O'Brien S, Violato M, Hawker J, Whitehead M. Does socioeconomic status influence risk of gastrointestinal infections in the community in the UK? Eur J Public Health 2016. [DOI: 10.1093/eurpub/ckw174.167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Afilalo J, Kim S, O'Brien S, Brennan J, Edwards F, Mack M, McClurken J, Cleveland J, Smith P, Shahian D, Alexander K. GAIT SPEED AND OPERATIVE MORTALITY IN OLDER ADULTS FOLLOWING CARDIAC SURGERY. Can J Cardiol 2016. [DOI: 10.1016/j.cjca.2016.07.394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Dutia R, Embrey M, O'Brien S, Haeusler RA, Agénor KK, Homel P, McGinty J, Vincent RP, Alaghband-Zadeh J, Staels B, le Roux CW, Yu J, Laferrère B. Temporal changes in bile acid levels and 12α-hydroxylation after Roux-en-Y gastric bypass surgery in type 2 diabetes. Int J Obes (Lond) 2016; 40:554. [PMID: 26952775 DOI: 10.1038/ijo.2015.250] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Since the publication of the above article it has been noted that the author S O'Brien should have been listed as CS O'Brien. The authors should therefore appear as follows: R Dutia, M Embrey, CS O'Brien, RA Haeusler, KK Agénor, P Homel, J McGinty, RP Vincent, J Alaghband-Zadeh, B Staels, CW le Roux, J Yu and B Laferrère The corrected article html and online pdf versions have been amended. The authors wish to apologise for any inconvenience caused.
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O'Brien S, Moloney F, Twomey M, O'Connor O, O'Suilleabhain C. P-212 An investigation of the association between sarcopenia and post-operative morbidity and mortality in patients with gastric cancer. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw199.204] [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: 11/12/2022] Open
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O'Brien S, Bennett D, Spence D, Mawhinney I, Beverland D. Contralateral ulnar neuropathy following total hip replacement and intraoperative positioning. Int J Orthop Trauma Nurs 2016; 21:31-8. [DOI: 10.1016/j.ijotn.2015.09.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2015] [Revised: 09/04/2015] [Accepted: 09/23/2015] [Indexed: 10/23/2022]
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Kostyanev T, Bonten MJM, O'Brien S, Steel H, Ross S, François B, Tacconelli E, Winterhalter M, Stavenger RA, Karlén A, Harbarth S, Hackett J, Jafri HS, Vuong C, MacGowan A, Witschi A, Angyalosi G, Elborn JS, deWinter R, Goossens H. The Innovative Medicines Initiative's New Drugs for Bad Bugs programme: European public-private partnerships for the development of new strategies to tackle antibiotic resistance. J Antimicrob Chemother 2015; 71:290-5. [PMID: 26568581 DOI: 10.1093/jac/dkv339] [Citation(s) in RCA: 84] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
Antibiotic resistance (ABR) is a global public health threat. Despite the emergence of highly resistant organisms and the huge medical need for new drugs, the development of antibacterials has slowed to an unacceptable level worldwide. Numerous government and non-government agencies have called for public-private partnerships and innovative funding mechanisms to address this problem. To respond to this public health crisis, the Innovative Medicines Initiative Joint Undertaking programme has invested more than €660 million, with a goal of matched contributions from the European Commission and the European Federation of Pharmaceutical Industries and Associations, in the development of new antibacterial strategies. The New Drugs for Bad Bugs (ND4BB) programme, an Innovative Medicines Initiative, has the ultimate goal to boost the fight against ABR at every level from basic science and drug discovery, through clinical development to new business models and responsible use of antibiotics. Seven projects have been launched within the ND4BB programme to achieve this goal. Four of them will include clinical trials of new anti-infective compounds, as well as epidemiological studies on an unprecedented scale, which will increase our knowledge of ABR and specific pathogens, and improve the designs of the clinical trials with new investigational drugs. The need for rapid concerted action has driven the funding of seven topics, each of which should add significantly to progress in the fight against ABR. ND4BB unites expertise and provides a platform where the commitment and resources required by all parties are streamlined into a joint public-private partnership initiative of unprecedented scale.
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Affiliation(s)
- T Kostyanev
- Department of Medical Microbiology, Vaccine & Infectious Disease Institute, University of Antwerp, Antwerp, Belgium
| | - M J M Bonten
- Julius Center for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - S O'Brien
- Infection Global Medicines Development, AstraZeneca, Macclesfield, Cheshire, UK
| | - H Steel
- Infectious Diseases Therapy Area Unit, GlaxoSmithKline, London, UK
| | - S Ross
- Infectious Diseases Therapy Area Unit, GlaxoSmithKline, London, UK
| | - B François
- Centre Hospitalier Universitaire Dupuytren, Limoges, France
| | - E Tacconelli
- Internal Medicine 1, Infectious Diseases, DZIF-TTU-HAARBI, University Hospital Tübingen, Tübingen, Germany
| | - M Winterhalter
- School of Engineering & Science, Jacobs University Bremen, Bremen, Germany
| | - R A Stavenger
- Antibacterial Discovery Performance Unit, GlaxoSmithKline, Collegeville, PA, USA
| | - A Karlén
- Department of Medicinal Chemistry, Uppsala University, Uppsala, Sweden
| | - S Harbarth
- University of Geneva and Faculty of Medicine, Geneva, Switzerland
| | - J Hackett
- Infection Global Medicines Development, AstraZeneca, Gaithersburg, MD, USA
| | | | - C Vuong
- AiCuris GmbH & Co. KG, Wuppertal, Germany
| | - A MacGowan
- Bristol Centre for Antimicrobial Research & Evaluation, Department of Infection Sciences, North Bristol NHS Trust and Public Health England, Bristol, UK
| | - A Witschi
- Basilea Pharmaceutica International Ltd, Basel, Switzerland
| | | | - J S Elborn
- School of Medicine, Dentistry & Biomedical Sciences, Queen's University Belfast, Belfast, UK
| | - R deWinter
- Julius Center for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - H Goossens
- Department of Medical Microbiology, Vaccine & Infectious Disease Institute, University of Antwerp, Antwerp, Belgium Laboratory of Medical Microbiology, University Hospital Antwerp, Antwerp, Belgium
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Kwok R, O'Brien S, Lunz L, Morgan M, Frassica D, Cheston S, Feigenberg S, Nichols E. Prospective Randomized Pilot Study of Standard Skin Care Versus Medihoney in the Prophylactic and Acute Management of Radiation Dermatitis in Patients Receiving Adjuvant Radiation Therapy for Breast Cancer. Int J Radiat Oncol Biol Phys 2015. [DOI: 10.1016/j.ijrobp.2015.07.1743] [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: 11/26/2022]
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Daver N, Kantarjian H, Ravandi F, Estey E, Wang X, Garcia-Manero G, Jabbour E, Konopleva M, O'Brien S, Verstovsek S, Kadia T, Dinardo C, Pierce S, Huang X, Pemmaraju N, Diaz-Pines-Mateo M, Cortes J, Borthakur G. A phase II study of decitabine and gemtuzumab ozogamicin in newly diagnosed and relapsed acute myeloid leukemia and high-risk myelodysplastic syndrome. Leukemia 2015; 30:268-73. [PMID: 26365212 DOI: 10.1038/leu.2015.244] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2015] [Revised: 06/30/2015] [Accepted: 07/03/2015] [Indexed: 12/17/2022]
Abstract
Decitabine may open the chromatin structure of leukemia cells making them accessible to the calicheamicin epitope of gemtuzumab ozogamicin (GO). A total of 110 patients (median age 70 years; range 27-89 years) were treated with decitabine and GO in a trial designed on model-based futility to accommodate subject heterogeneity: group 1: relapsed/refractory acute myeloid leukemia (AML) with complete remission duration (CRD) <1 year (N=28, 25%); group 2: relapsed/refractory AML with CRD ⩾1 year (N=5, 5%); group 3: untreated AML unfit for intensive chemotherapy or untreated myelodysplastic syndrome (MDS) or untreated myelofibrosis (MF; N=57, 52%); and group 4: AML evolving from MDS or relapsed/refractory MDS or MF (N=20, 18%). Treatment consisted of decitabine 20 mg/m(2) daily for 5 days and GO 3 mg/m(2) on day 5. Post-induction therapy included five cycles of decitabine+GO followed by decitabine alone. Complete remission (CR)/CR with incomplete count recovery was achieved in 39 (35%) patients; group 1= 5/28 (17%), group 2=3/5 (60%), group 3=24/57 (42%) and group 4=7/20 (35%). The 8-week mortality in groups 3 and 4 was 16% and 10%, respectively. Common drug-related adverse events included nausea, mucositis and hemorrhage. Decitabine and GO improved the response rate but not overall survival compared with historical outcomes in untreated AML ⩾60 years.
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Affiliation(s)
- N Daver
- Department of Leukemia, University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - H Kantarjian
- Department of Leukemia, University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - F Ravandi
- Department of Leukemia, University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - E Estey
- Division of Hematology, University of Washington School of Medicine, Seattle, WA, USA
| | - X Wang
- Department of Biostatistics, University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - G Garcia-Manero
- Department of Leukemia, University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - E Jabbour
- Department of Leukemia, University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - M Konopleva
- Department of Leukemia, University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - S O'Brien
- Department of Leukemia, University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - S Verstovsek
- Department of Leukemia, University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - T Kadia
- Department of Leukemia, University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - C Dinardo
- Department of Leukemia, University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - S Pierce
- Department of Leukemia, University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - X Huang
- Department of Leukemia, University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - N Pemmaraju
- Department of Leukemia, University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - M Diaz-Pines-Mateo
- Department of Leukemia, University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - J Cortes
- Department of Leukemia, University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - G Borthakur
- Department of Leukemia, University of Texas MD Anderson Cancer Center, Houston, TX, USA
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Balakrishnan K, Peluso M, Fu M, Rosin NY, Burger JA, Wierda WG, Keating MJ, Faia K, O'Brien S, Kutok JL, Gandhi V. The phosphoinositide-3-kinase (PI3K)-delta and gamma inhibitor, IPI-145 (Duvelisib), overcomes signals from the PI3K/AKT/S6 pathway and promotes apoptosis in CLL. Leukemia 2015; 29:1811-22. [PMID: 25917267 DOI: 10.1038/leu.2015.105] [Citation(s) in RCA: 134] [Impact Index Per Article: 14.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2014] [Revised: 03/26/2015] [Accepted: 04/07/2015] [Indexed: 11/10/2022]
Abstract
The functional relevance of the B-cell receptor (BCR) and the evolution of protein kinases as therapeutic targets have recently shifted the paradigm for treatment of B-cell malignancies. Inhibition of p110δ with idelalisib has shown clinical activity in chronic lymphocytic leukemia (CLL). The dynamic interplay of isoforms p110δ and p110γ in leukocytes support the hypothesis that dual blockade may provide a therapeutic benefit. IPI-145, an oral inhibitor of p110δ and p110γ isoforms, sensitizes BCR-stimulated and/or stromal co-cultured primary CLL cells to apoptosis (median 20%, n=57; P<0.0001) including samples with poor prognostic markers, unmutated IgVH (n=28) and prior treatment (n=15; P<0.0001). IPI-145 potently inhibits the CD40L/IL-2/IL-10 induced proliferation of CLL cells with an IC50 in sub-nanomolar range. A corresponding dose-responsive inhibition of pAKT(Ser473) is observed with an IC50 of 0.36 nM. IPI-145 diminishes the BCR-induced chemokines CCL3 and CCL4 secretion to 17% and 37%, respectively. Pre-treatment with 1 μM IPI-145 inhibits the chemotaxis toward CXCL12; reduces pseudoemperipolesis to median 50%, inferring its ability to interfere with homing capabilities of CLL cells. BCR-activated signaling proteins AKT(Ser473), BAD(Ser112), ERK(Thr202/Tyr204) and S6(Ser235/236) are mitigated by IPI-145. Importantly, for clinical development in hematological malignancies, IPI-145 is selective to CLL B cells, sparing normal B- and T-lymphocytes.
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Affiliation(s)
- K Balakrishnan
- Department of Experimental Therapeutics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.,Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - M Peluso
- Infinity Pharmaceuticals Inc., Cambridge, MA, USA
| | - M Fu
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - N Y Rosin
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - J A Burger
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - W G Wierda
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - M J Keating
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - K Faia
- Infinity Pharmaceuticals Inc., Cambridge, MA, USA
| | - S O'Brien
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - J L Kutok
- Infinity Pharmaceuticals Inc., Cambridge, MA, USA
| | - V Gandhi
- Department of Experimental Therapeutics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.,Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
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Male C, O'Brien S, Rodriguez V, Mitchell LG. Central venous catheter-related thrombosis and thromboprophylaxis in children: a systematic review and meta-analysis: discussion. J Thromb Haemost 2015; 13:688-90. [PMID: 25510522 DOI: 10.1111/jth.12818] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2014] [Accepted: 12/11/2014] [Indexed: 10/24/2022]
Affiliation(s)
- C Male
- Department of Pediatrics, Medical University of Vienna, Vienna, Austria
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Dutia R, Embrey M, O'Brien CS, O'Brien S, Haeusler RA, Agénor KK, Homel P, McGinty J, Vincent RP, Alaghband-Zadeh J, Staels B, le Roux CW, Yu J, Laferrère B. Temporal changes in bile acid levels and 12α-hydroxylation after Roux-en-Y gastric bypass surgery in type 2 diabetes. Int J Obes (Lond) 2015; 39:806-13. [PMID: 25599611 DOI: 10.1038/ijo.2015.1] [Citation(s) in RCA: 72] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2014] [Revised: 11/26/2014] [Accepted: 12/25/2014] [Indexed: 12/18/2022]
Abstract
INTRODUCTION Gastric bypass surgery (GBP) leads to sustained weight loss and significant improvement in type 2 diabetes (T2DM). Bile acids (BAs), signaling molecules which influence glucose metabolism, are a potential mediator for the improvement in T2DM after GBP. This study sought to investigate the effect of GBP on BA levels and composition in individuals with T2DM. METHODS Plasma BA levels and composition and fibroblast growth factor (FGF)-19 levels were measured during fasting and in response to an oral glucose load before and at 1 month and 2 years post GBP in 13 severely obese women with T2DM. RESULTS A striking temporal change in BA levels and composition was observed after GBP. During the fasted state, BA concentrations were generally reduced at 1 month, but increased 2 years post GBP. Postprandial BA levels were unchanged 1 month post GBP, but an exaggerated postprandial peak was observed 2 years after the surgery. A significant increase in the 12α-hydroxylated/non12α-hydroxylated BA ratio during fasting and postprandially at 2 years, but not 1 month, post GBP was observed. Significant correlations between BAs vs FGF-19, body weight, the incretin effect and peptide YY (PYY) were also found. CONCLUSIONS This study provides evidence that GBP temporally modifies the concentration and composition of circulating BAs in individuals with T2DM, and suggests that BAs may be linked to the improvement in T2DM after GBP.
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Affiliation(s)
- R Dutia
- New York Obesity Nutrition Research Center, Department of Medicine, Columbia University College of Physicians and Surgeons, New York, NY, USA
| | - M Embrey
- New York Obesity Nutrition Research Center, Department of Medicine, Columbia University College of Physicians and Surgeons, New York, NY, USA
| | | | - S O'Brien
- New York Obesity Nutrition Research Center, Department of Medicine, Columbia University College of Physicians and Surgeons, New York, NY, USA
| | - R A Haeusler
- Department of Pathology and Cell Biology, Columbia University College of Physicians and Surgeons, New York, NY, USA
| | - K K Agénor
- New York Obesity Nutrition Research Center, Department of Medicine, Columbia University College of Physicians and Surgeons, New York, NY, USA
| | - P Homel
- Department of Medicine, Albert Einstein School of Medicine, New York, NY, USA
| | - J McGinty
- Division of Bariatric and Minimally Invasive Surgery, Department of Surgery, Mount Sinai, St. Luke's Roosevelt Hospitals, New York, NY, USA
| | - R P Vincent
- Department of Clinical Biochemistry, King's College Hospital NHS Foundation Trust Denmark Hill, London, UK
| | - J Alaghband-Zadeh
- Department of Clinical Biochemistry, Guy's & St Thomas' NHS Foundation Trust, London, UK
| | - B Staels
- European Genomic Institute for Diabetes (EGID), Université Lille 2, Inserm UMR 1011, Institut Pasteur de Lille, Lille, France
| | - C W le Roux
- Diabetes Complications Research Center, Conway Institute, University College, Dublin, Ireland
| | - J Yu
- New York Obesity Nutrition Research Center, Department of Medicine, Columbia University College of Physicians and Surgeons, New York, NY, USA
| | - B Laferrère
- New York Obesity Nutrition Research Center, Department of Medicine, Columbia University College of Physicians and Surgeons, New York, NY, USA
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Bennett DB, Hill JC, Dennison J, O'Brien S, Mantel JL, Isaac GH, Beverland DE. Metal-carbon fiber composite femoral stems in hip replacements: a randomized controlled parallel-group study with mean ten-year follow-up. J Bone Joint Surg Am 2014; 96:2062-9. [PMID: 25520340 DOI: 10.2106/jbjs.m.01542] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND Attempts to improve proximal load transfer and minimize stress shielding have included reducing the stiffness of femoral stems and using alternative stem materials, including carbon fiber composites. An uncemented implant (SR71) composed of a carbon-fiber-composite distal section and a porous-coated titanium-alloy proximal section, designed to improve proximal load transfer and provide good fixation, was clinically evaluated in a prospective randomized study. METHODS Sixty patients were enrolled and randomized to receive either the SR71 stem or an all-metal stem (Stability). All patients received a cemented all-polyethylene acetabular component and a 28-mm metal femoral head. All uncemented stems were implanted by the same surgeon. Patients were followed for up to ten years with repeated assessments of bone mineral density, radiographs, Harris hip scores (HHS), and visual analog scale (VAS) pain scores. RESULTS Ten years postoperatively, nineteen patients who had been treated with the SR71 stem and not lost to follow-up showed a significantly greater increase in proximal bone mineral density (Gruen zones 1 [p = 0.003] and 7 [p = 0.0007]) from baseline than did the twenty-two who had been treated with the Stability stem and not lost to follow-up. In contrast, the Stability group showed a significantly greater increase in distal bone mineral density (Gruen zones 2 [p = 0.0004], 3 [p = 0.0001], and 5 [p = 0.0035]) compared with the SR71 group. Radiographs demonstrated one case of progressive migration of an acetabular component used with an SR71 stem and one case of bone resorption in Gruen zones 7 and 14 in a patient treated with a Stability stem. There was no significant difference between the SR71 and Stability stems in terms of changes in the total HHS, HHS for pain, HHS for range of motion, or VAS pain scores ten years postoperatively relative to preoperative levels. There was one reported revision of an SR71 femoral stem at the ten-year review. CONCLUSIONS The investigational SR71 implant provided increased proximal bone density and reduced distal bone density. The implant showed promising results at the time of early follow-up, and the clinical outcomes were similar to those of an all-metal stem at the time of a ten-year follow-up.
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Affiliation(s)
- D B Bennett
- Orthopaedic Outcome Assessment Unit, Musgrave Park Hospital, Stockman's Lane, Belfast BT9 7JB, Northern Ireland. E-mail address for J.C. Hill:
| | - J C Hill
- Orthopaedic Outcome Assessment Unit, Musgrave Park Hospital, Stockman's Lane, Belfast BT9 7JB, Northern Ireland. E-mail address for J.C. Hill:
| | - J Dennison
- Orthopaedic Outcome Assessment Unit, Musgrave Park Hospital, Stockman's Lane, Belfast BT9 7JB, Northern Ireland. E-mail address for J.C. Hill:
| | - S O'Brien
- Orthopaedic Outcome Assessment Unit, Musgrave Park Hospital, Stockman's Lane, Belfast BT9 7JB, Northern Ireland. E-mail address for J.C. Hill:
| | - J L Mantel
- DePuy Synthes Joint Reconstruction, White Rose Office Park, Millshaw Park Lane, Leeds LS11 0BG, United Kingdom
| | - G H Isaac
- DePuy Synthes Joint Reconstruction, White Rose Office Park, Millshaw Park Lane, Leeds LS11 0BG, United Kingdom
| | - D E Beverland
- Orthopaedic Outcome Assessment Unit, Musgrave Park Hospital, Stockman's Lane, Belfast BT9 7JB, Northern Ireland. E-mail address for J.C. Hill:
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Imran M, O'Brien S, Hamblin M, Maz M. AB0349 Significance of Positive Anti-Ccp Antibody and Development of Interstitial Lung Disease in Patients with and without Clinically Apparent Rheumatoid Arthritis. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.2620] [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: 11/04/2022]
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Hill A, Horigan V, Clarke K, Dewé T, Stärk K, O'Brien S, Buncic S. A qualitative risk assessment for visual-only post-mortem meat inspection of cattle, sheep, goats and farmed/wild deer. Food Control 2014. [DOI: 10.1016/j.foodcont.2013.10.002] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [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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Napier RJ, Bennett D, McConway J, Wilson R, Sykes AM, Doran E, O'Brien S, Beverland DE. The influence of immediate knee flexion on blood loss and other parameters following total knee replacement. Bone Joint J 2014; 96-B:201-9. [PMID: 24493185 DOI: 10.1302/0301-620x.96b2.32787] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [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] [Indexed: 11/05/2022]
Abstract
In an initial randomised controlled trial (RCT) we segregated 180 patients to one of two knee positions following total knee replacement (TKR): six hours of knee flexion using either a jig or knee extension. Outcome measures included post-operative blood loss, fall in haemoglobin, blood transfusion requirements, knee range of movement, limb swelling and functional scores. A second RCT consisted of 420 TKR patients randomised to one of three post-operative knee positions: flexion for three or six hours post-operatively, or knee extension. Positioning of the knee in flexion for six hours immediately after surgery significantly reduced blood loss (p = 0.002). There were no significant differences in post-operative range of movement, swelling, pain or outcome scores between the various knee positions in either study. Post-operative knee flexion may offer a simple and cost-effective way to reduce blood loss and transfusion requirements following TKR. We also report a cautionary note regarding the potential risks of prolonged knee flexion for more than six hours observed during clinical practice in the intervening period between the two trials, with 14 of 289 patients (4.7%) reporting lower limb sensory neuropathy at their three-month review.
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Affiliation(s)
- R J Napier
- Musgrave Park Hospital, Orthopaedic Outcomes Unit, Belfast Health & Social Care Trust, Stockmans Lane, Belfast BT9 7JB, UK
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Ravandi F, Arana Yi C, Cortes JE, Levis M, Faderl S, Garcia-Manero G, Jabbour E, Konopleva M, O'Brien S, Estrov Z, Borthakur G, Thomas D, Pierce S, Brandt M, Pratz K, Luthra R, Andreeff M, Kantarjian H. Final report of phase II study of sorafenib, cytarabine and idarubicin for initial therapy in younger patients with acute myeloid leukemia. Leukemia 2014; 28:1543-5. [PMID: 24487412 DOI: 10.1038/leu.2014.54] [Citation(s) in RCA: 68] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- F Ravandi
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - C Arana Yi
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - J E Cortes
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - M Levis
- Division of Hematological Malignancies, Johns Hopkins Sidney Kimmel Cancer Center, Baltimore, MD, USA
| | - S Faderl
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - G Garcia-Manero
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - E Jabbour
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - M Konopleva
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - S O'Brien
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Z Estrov
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - G Borthakur
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - D Thomas
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - S Pierce
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - M Brandt
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - K Pratz
- Division of Hematological Malignancies, Johns Hopkins Sidney Kimmel Cancer Center, Baltimore, MD, USA
| | - R Luthra
- Division of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - M Andreeff
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - H Kantarjian
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
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Williams DP, O'Brien S, Doran E, Price AJ, Beard DJ, Murray DW, Beverland DE. Early postoperative predictors of satisfaction following total knee arthroplasty. Knee 2013; 20:442-6. [PMID: 23777807 DOI: 10.1016/j.knee.2013.05.011] [Citation(s) in RCA: 81] [Impact Index Per Article: 7.4] [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: 09/13/2012] [Revised: 04/26/2013] [Accepted: 05/22/2013] [Indexed: 02/02/2023]
Abstract
BACKGROUND Despite the excellent total knee arthroplasty (TKA) results reported using traditional outcome measures, dissatisfaction rates of up to 30% are reported following surgery. Although several preoperative factors have been identified as possible predictors of satisfaction, there is conflicting evidence. Identification of dissatisfaction in the early postoperative assessment may therefore be an alternative consideration. METHODS We examined the relationship between 12-month satisfaction, and early post-operative outcomes in a cohort of 486 TKA patients. Preoperative, and postoperative outcome measures at 3- and 12-months (Oxford knee score, pain score, SF12, and knee motion), were analysed and compared between patients who were satisfied and dissatisfied at 12-months following TKA. Mean scores, and postoperative change in scores were calculated. Postoperative outcomes were examined for correlation with satisfaction, and multivariate logistic regression models used to identify potential predictors of dissatisfaction. RESULTS Overall satisfaction was 77.0%. No preoperative differences were observed between groups. Dissatisfaction was associated with worse postoperative status across all outcome measures (p<0.001), except the 3-month SF12-physical component (p=0.052). Dissatisfied patients demonstrated minimal further improvement or even worsening of outcome scores between 3- and 12-months postoperatively (p<0.02). Both the 3-month OKS (OR=1.15, p<0.001), and knee flexion (OR=1.03, p=0.009) were significant predictors of subsequent 12-month satisfaction. CONCLUSIONS Dissatisfaction following TKA is associated with worse outcomes as early as 3months following surgery, with minimal further improvement subsequently achieved at 12-months. Early postoperative assessment following TKA should therefore be considered, including clinical assessment, to identify those patients at risk of dissatisfaction.
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Affiliation(s)
- D P Williams
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, United Kingdom.
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44
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Jain P, Kantarjian H, Ravandi F, Thomas D, O'Brien S, Kadia T, Burger J, Borthakur G, Daver N, Jabbour E, Konopleva M, Cortes J, Pemmaraju N, Kelly MA, Cardenas-Turanzas M, Garris R, Faderl S. The combination of hyper-CVAD plus nelarabine as frontline therapy in adult T-cell acute lymphoblastic leukemia and T-lymphoblastic lymphoma: MD Anderson Cancer Center experience. Leukemia 2013; 28:973-5. [DOI: 10.1038/leu.2013.312] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Milligan DJ, O'Brien S, Bennett D, Hill JC, Beverland DE. The effects of age and gender on the diameter of the femoral canal in patients who undergo total hip replacement. Bone Joint J 2013; 95-B:339-42. [PMID: 23450017 DOI: 10.1302/0301-620x.95b3.30882] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
With greater numbers of younger patients undergoing total hip replacement (THR), the effect of patient age on the diameter of the femoral canal may become more relevant. This study aimed to investigate the relationship between the diameter of the diaphysis of the femoral canal with increasing age in a large number of patients who underwent THR. A total of 1685 patients scheduled for THR had their femoral dimensions recorded from calibrated radiographs. There were 736 males and 949 females with mean ages of 67.1 years (34 to 92) and 70.2 years (29 to 92), respectively. The mean diameter of the femoral canal was 13.3 mm (8.0 to 23.0) for males and 12.7 mm (6.0 to 26.0) for females. There was a poor correlation between age and the diameter of the canal in males (r = 0.071, p = 0.05) but a stronger correlation in females (r = 0.31, p < 0.001). The diameter of the femoral canal diameter of a female patient undergoing THR could be predicted to increase by 3.2 mm between the ages of 40 and 80 years, in contrast a male would be expected to experience only a 0.6 mm increase during the same period. This increase in the diameter of the canal with age might affect the long-term survival of the femoral component in female patients.
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Affiliation(s)
- D J Milligan
- Musgrave Park Hospital, Orthopaedic Outcomes Assessment Unit, Belfast, Northern Ireland BT9 7JB, UK.
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Liddle AD, Pandit H, O'Brien S, Doran E, Penny ID, Hooper GJ, Burn PJ, Dodd CAF, Beverland DE, Maxwell AR, Murray DW. Cementless fixation in Oxford unicompartmental knee replacement: a multicentre study of 1000 knees. Bone Joint J 2013; 95-B:181-7. [PMID: 23365026 DOI: 10.1302/0301-620x.95b2.30411] [Citation(s) in RCA: 72] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
The Cementless Oxford Unicompartmental Knee Replacement (OUKR) was developed to address problems related to cementation, and has been demonstrated in a randomised study to have similar clinical outcomes with fewer radiolucencies than observed with the cemented device. However, before its widespread use it is necessary to clarify contraindications and assess the complications. This requires a larger study than any previously published. We present a prospective multicentre series of 1000 cementless OUKRs in 881 patients at a minimum follow-up of one year. All patients had radiological assessment aligned to the bone-implant interfaces and clinical scores. Analysis was performed at a mean of 38.2 months (19 to 88) following surgery. A total of 17 patients died (comprising 19 knees (1.9%)), none as a result of surgery; there were no tibial or femoral loosenings. A total of 19 knees (1.9%) had significant implant-related complications or required revision. Implant survival at six years was 97.2%, and there was a partial radiolucency at the bone-implant interface in 72 knees (8.9%), with no complete radiolucencies. There was no significant increase in complication rate compared with cemented fixation (p = 0.87), and no specific contraindications to cementless fixation were identified. Cementless OUKR appears to be safe and reproducible in patients with end-stage anteromedial osteoarthritis of the knee, with radiological evidence of improved fixation compared with previous reports using cemented fixation.
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Affiliation(s)
- A D Liddle
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, Botnar Research Centre, University of Oxford, Windmill Road, Oxford OX3 7LD, UK
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Jordan S, Steer C, DeFazio A, Quinn M, Obermair A, Friedlander M, Francis J, O'Brien S, Goss G, Wyld D, Australian Ovarian Cancer Study Group, Webb P. Patterns of chemotherapy treatment for women with invasive epithelial ovarian cancer--a population-based study. Gynecol Oncol 2013; 129:310-7. [PMID: 23403164 DOI: 10.1016/j.ygyno.2013.02.007] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2012] [Revised: 01/31/2013] [Accepted: 02/05/2013] [Indexed: 11/24/2022]
Abstract
OBJECTIVE Ovarian cancer five-year survival is poor at <40%. In the absence of effective screening or new treatments, ensuring all women receive optimal treatment is one avenue to improve survival. There is little population-based information regarding the primary chemotherapy treatment that women with epithelial ovarian cancer receive. This information is essential to identify potential gaps in care. METHODS Cancer registries identified all women diagnosed with invasive epithelial ovarian cancer in Australia in 2005 (n=1192). Histopathology, chemotherapy and comorbidity information was abstracted from medical records. Multivariable logistic regression was used to identify factors associated with chemotherapy commencement, regimen, and completion. RESULTS Women >70 years (p<0.0001), those with high-grade, stage IA/IB cancers (vs. stages IC-IV, p=0.003) and those with mucinous cancers (p=0.0002) were less likely to start chemotherapy. Most treated women received platinum-based drugs (97%), but only 68% received combination carboplatin-paclitaxel and only half completed six cycles without treatment modification/delay. Approximately 19% received single-agent carboplatin: mostly those aged >70 (p<0.0001) and/or with co-morbidities (p<0.0001). Age was the strongest predictor of completing six cycles of combination therapy. CONCLUSIONS For specific patient groups, particularly older women, there is notable variation from standard treatment. Understanding how treatment variations affect survival and determining optimal regimens for these groups are research priorities.
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Affiliation(s)
- S Jordan
- Gynaecological Cancers Group, The Population Health Department, The Queensland Institute of Medical Research, Brisbane, Queensland, Australia.
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Chen Y, Kantarjian H, Pierce S, Faderl S, O'Brien S, Qiao W, Abruzzo L, de Lima M, Kebriaei P, Jabbour E, Daver N, Kadia T, Estrov Z, Garcia-Manero G, Cortes J, Ravandi F. Prognostic significance of 11q23 aberrations in adult acute myeloid leukemia and the role of allogeneic stem cell transplantation. Leukemia 2012; 27:836-42. [PMID: 23135353 DOI: 10.1038/leu.2012.319] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
The clinical features and outcomes of 148 patients with acute myeloid leukemia (AML) and 11q23 chromosomal abnormalities were compared with those of 2640 patients with non-11q23 AML. Patients with t(9;11) ), t(6;11) or other 11q23 balanced translocations (t(11;v)(q23;v)) presented at a younger age and with higher percentage of bone marrow blasts. Unbalanced 11q23 abnormalities were commonly associated with deletions of chromosomes 5q, 7q and/or complex karyotypes. In multivariate analysis, when compared with patients with non-11q23 AML and unfavorable-risk karyotype, there was a significant difference in overall survival (OS) for patients with t(9;11) (P=0.004), whereas there were no differences in OS for patients with t(6;11) (P=0.62), t(11;19) (P=0.20) and unbalanced 11q23 aberrations (P=0.85) or t(11;v)(q23;v) (P=0.59), indicating that t(9;11) has an independent intermediate prognostic significance, with all others being poor prognostic factors for OS; this was further confirmed by comparing them with patients with non-11q23 AML and intermediate-risk karyotype. Using intention-to treat analysis based on donor availability, we also noted that allogeneic stem cell transplant in first remission had a significant benefit toward improving OS (P<0.001) and relapse-free survival (P<0.001) in patients with AML and 11q23 abnormalities.
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Affiliation(s)
- Y Chen
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
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Napier RJ, Spence D, Diamond O, O'Brien S, Walsh T, Beverland DE. Modifiable factors delaying early discharge following primary joint arthroplasty. Eur J Orthop Surg Traumatol 2012; 23:665-9. [PMID: 23412186 DOI: 10.1007/s00590-012-1053-5] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/20/2012] [Accepted: 07/02/2012] [Indexed: 01/01/2023]
Abstract
AIMS Recent NHS reforms have incentivised reduction in length of stay, with the UK department of health expecting health trusts to reduce bed days and ultimately reduce overall costs. The aim of this study was to identify avoidable causes for protracted hospital admission following total hip arthroplasty (THA) or total knee arthroplasty (TKA) within a fast-track unit. METHODS During a 6-month period, 535 consecutive patients underwent primary THA or TKA under the care of a single surgeon. All patients with a post-operative stay of greater than 72 h were identified, and reasons for delayed discharge were determined. RESULTS The majority of arthroplasty patients were discharged within 3 days post-operatively. Twenty-one per cent of THA patients and 25 % of TKA patients remained as inpatients for greater than 72 h. For the THA population, this equates to 43 % of bed days used by 21 % of patients, and for the TKA population, 44 % of bed days were used by 25 % of patients. The major factor within both groups for delayed discharge was attributed to inadequate social support. CONCLUSIONS Delayed discharge can never be totally prevented. This unit aims to develop improvement in social work provision, with a greater focus on pre-admission discharge planning to reduce the number of delayed discharges and ultimately reduce the cost burden of joint replacement surgery. It is not conducive with the ethos of fast-track arthroplasty to only identify social circumstances upon admission.
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Affiliation(s)
- R J Napier
- Outcomes Assessment Unit, Musgrave Park Hospital, Stockman's Lane, Belfast BT9 7JB, Northern Ireland, UK.
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50
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Giles FJ, Vey N, Rizzieri D, Ravandi F, Prebet T, Borthakur G, Jacobsen TF, Hagen S, Nilsson B, O'Brien S. Phase I and pharmacokinetic study of elacytarabine, a novel 5'-elaidic acid derivative of cytarabine, in adults with refractory hematological malignancies. Leukemia 2012; 26:1686-9. [PMID: 22222600 DOI: 10.1038/leu.2012.1] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
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