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Wei WH, Cho G, Smith M, Morley S. Dissecting the complexity of pediatric blood transfusions and risk of adverse reactions in Aotearoa New Zealand. Blood Transfus 2023; 21:428-436. [PMID: 36580030 PMCID: PMC10497383 DOI: 10.2450/2022.0178-22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Accepted: 12/06/2022] [Indexed: 12/30/2022]
Abstract
BACKGROUND Children have different clinical and physiological drivers for transfusion from adult recipients. However, adverse transfusion reactions (ATRs) in pediatric patients are usually reported using the same criteria as for adults. Broad assessments of pediatric ATRs neglect substantial variation in different developmental stages. MATERIALS AND METHODS This retrospective study included 342,950 patients, ~2.43 million transfusions, and 5,540 ATR reports collated from New Zealand hospitals between 2005 and 2021. Using 16 years as the upper age limit, 138,856 pediatric transfusions and 402 pediatric ATR reports were identified and dissected at three levels: pediatric as a whole, pediatric developmental stage (i.e., neonate, infant, preschool, and school), and chronological age to identify patients at high risk of ATRs. Multivariate logistic regression analysis was followed to quantify risk factors. RESULTS Pediatric recipients had a higher ATR risk than adults (p=6.9-07) but the high risk was associated mainly with children older than 2 years. Neonates and infants accounted for 75.0% of pediatric recipients but had much lower ATR rates than adults. Pediatric transfusion recipients showed a clear male bias prior to age 11 years and then a female bias. However, gender difference in experiencing ATRs was significant only after age 13 years (p=2.3-04). Analyses focusing on the high-risk group revealed allergic reactions being the cause of the elevated risk and identified the main risk factors of number of transfusions (p=4.5-10) and multiple types of components transfused (p=2.0-13). DISCUSSION The identified ATR risk factors signal linkage with the biological drivers for transfusion. Low ATR rates in infancy could also be attributed to use of neonatal components, low transfusions per patient, and less developed immunity. The relative increase in female recipients from age 11 may be associated with increased red blood cell demand following puberty.
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Affiliation(s)
- Wen-Hua Wei
- New Zealand Blood Service, Auckland, New Zealand
- Department of Biochemistry, University of Otago, Dunedin, New Zealand
| | - Gavin Cho
- New Zealand Blood Service, Auckland, New Zealand
| | | | - Sarah Morley
- New Zealand Blood Service, Auckland, New Zealand
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2
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McGuinness S, Charlewood R, Gilder E, Parke R, Hayes K, Morley S, Al-Ibousi A, Deans R, Howe B, Johnson L, Marks DC, Reade MC. A pilot randomized clinical trial of cryopreserved versus liquid-stored platelet transfusion for bleeding in cardiac surgery: The cryopreserved versus liquid platelet-New Zealand pilot trial. Vox Sang 2021; 117:337-345. [PMID: 34581452 DOI: 10.1111/vox.13203] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 08/22/2021] [Accepted: 08/29/2021] [Indexed: 02/01/2023]
Abstract
BACKGROUND AND OBJECTIVES Platelets for transfusion have a shelf-life of 7 days, limiting availability and leading to wastage. Cryopreservation at -80°C extends shelf-life to at least 1 year, but safety and effectiveness are uncertain. MATERIALS AND METHODS This single centre blinded pilot trial enrolled adult cardiac surgery patients who were at high risk of platelet transfusion. If treating clinicians determined platelet transfusion was required, up to three units of either cryopreserved or liquid-stored platelets intraoperatively or during intensive care unit admission were administered. The primary outcome was protocol safety and feasibility. RESULTS Over 13 months, 89 patients were randomized, 23 (25.8%) of whom received a platelet transfusion. There were no differences in median blood loss up to 48 h between study groups, or in the quantities of study platelets or other blood components transfused. The median platelet concentration on the day after surgery was lower in the cryopreserved platelet group (122 × 103 /μl vs. 157 × 103 /μl, median difference 39.5 ×103 /μl, p = 0.03). There were no differences in any of the recorded safety outcomes, and no adverse events were reported on any patient. Multivariable adjustment for imbalances in baseline patient characteristics did not find study group to be a predictor of 24-h blood loss, red cell transfusion or a composite bleeding outcome. CONCLUSION This pilot randomized controlled trial demonstrated the feasibility of the protocol and adds to accumulating data supporting the safety of this intervention. Given the clear advantage of prolonged shelf-life, particularly for regional hospitals in New Zealand, a definitive non-inferiority phase III trial is warranted.
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Affiliation(s)
- Shay McGuinness
- Cardiothoracic and Vascular Intensive Care Unit, Auckland City Hospital, Auckland, New Zealand.,Medical Research Institute of New Zealand, Wellington, New Zealand.,Australian and New Zealand Intensive Care Research Centre, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | | | - Eileen Gilder
- Cardiothoracic and Vascular Intensive Care Unit, Auckland City Hospital, Auckland, New Zealand.,School of Nursing, The University of Auckland, Auckland, New Zealand
| | - Rachael Parke
- Cardiothoracic and Vascular Intensive Care Unit, Auckland City Hospital, Auckland, New Zealand.,Medical Research Institute of New Zealand, Wellington, New Zealand.,Australian and New Zealand Intensive Care Research Centre, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.,School of Nursing, The University of Auckland, Auckland, New Zealand
| | - Katia Hayes
- Greenlane Department of Cardiothoracic Anaesthesia, Auckland City Hospital, Auckland, New Zealand
| | - Sarah Morley
- New Zealand Blood Service, Auckland, New Zealand
| | | | - Renae Deans
- Faculty of Medicine, University of Queensland, Royal Brisbane and Women's Hospital, Herston, Queensland, Australia
| | - Belinda Howe
- Australian and New Zealand Intensive Care Research Centre, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Lacey Johnson
- Australian Red Cross Lifeblood, Alexandria, New South Wales, Australia
| | - Denese C Marks
- Australian Red Cross Lifeblood, Alexandria, New South Wales, Australia
| | - Michael C Reade
- Australian and New Zealand Intensive Care Research Centre, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.,Faculty of Medicine, University of Queensland, Royal Brisbane and Women's Hospital, Herston, Queensland, Australia.,Joint Health Command, Australian Defence Force, Canberra, Australian Capital Territory, Australia
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de Jong MC, Jamal K, Morley S, Beale T, Chung T, Jawad S, Hurel S, Simpson H, Srirangalingam U, Baldeweg SE, Rozalén García V, Otero S, Shawky M, Abdel-Aziz TE, Kurzawinski TR. The use of computed tomography as a first-line imaging modality in patients with primary hyperparathyroidism. Hormones (Athens) 2021; 20:499-506. [PMID: 32405929 DOI: 10.1007/s42000-020-00205-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Accepted: 04/26/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND The success of minimally invasive parathyroidectomy (MIP) relies on accurate localization of the abnormal parathyroid glands. Concordant findings on ultrasound (US) and 99mTc-scintigraphy (sestamibi) are currently considered the 'gold standard'. Computed tomography (CT) has also recently been used in preoperative planning. We sought to assess the accuracy of CT for localization of abnormal parathyroid glands in such patients. METHODS An audit of 75 patients with primary hyperparathyroidism (PHPT) who underwent neck US and CT between 2017 and 2019 at our center as their first-line imaging. RESULTS All 75 patients underwent US and CT and 54 (72.0%) also had sestamibi. CT alone identified a potential target in all patients, of which the location was correct in 63 (84.0%). The overall combined sensitivity of US and CT was 88% (95% CI 78-94) and was higher than the combined sensitivity of US and sestamibi (65% [95% CI 53-76]; p < 0.001). Twenty-one patients (28.0%) had an ectopic gland, and the sensitivity of US and CT was 86% (95% CI 64-96) versus US and sestamibi (57% [95% CI 34-77]; p = 0.016). For adenomas < 1.0 g (n = 36; 48%), the accuracy of CT was 81% (95% CI 64-91) compared with 62% (95% CI 44-77) for US and sestamibi (p = 0.04). The correct preoperative diagnosis of multiglandular disease (n = 9; 12%) seemed to be the most difficult, with similar accuracy for US and sestamibi (40% [95% CI 14-73]) and US and CT (50% [95% CI 20-80]) (p > 0.99). CONCLUSION The combination of US and CT was able to correctly identify the location of the abnormal parathyroid in 88% of patients and, in comparison with US and sestamibi, had better diagnostic accuracy, especially for smaller and ectopic adenomas. This finding suggests that US and CT could be considered as a first-line imaging modality in patients with PHPT considered for MIP.
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Affiliation(s)
- Mechteld C de Jong
- Centre for Endocrine Surgery, University College London Hospital, 235 Euston Road, London, NW1 2BU, UK.
| | - K Jamal
- Centre for Endocrine Surgery, University College London Hospital, 235 Euston Road, London, NW1 2BU, UK
| | - S Morley
- Department of Radiology, University College London Hospital, 235 Euston Road, London, NW1 2BU, UK
| | - T Beale
- Department of Radiology, University College London Hospital, 235 Euston Road, London, NW1 2BU, UK
| | - T Chung
- Department of Endocrinology, University College London Hospital, 235 Euston Road, London, NW1 2BU, UK
| | - S Jawad
- Department of Radiology, University College London Hospital, 235 Euston Road, London, NW1 2BU, UK
| | - S Hurel
- Department of Endocrinology, University College London Hospital, 235 Euston Road, London, NW1 2BU, UK
| | - H Simpson
- Department of Endocrinology, University College London Hospital, 235 Euston Road, London, NW1 2BU, UK
| | - U Srirangalingam
- Department of Endocrinology, University College London Hospital, 235 Euston Road, London, NW1 2BU, UK
| | - S E Baldeweg
- Department of Endocrinology, University College London Hospital, 235 Euston Road, London, NW1 2BU, UK
| | - V Rozalén García
- Centre for Endocrine Surgery, University College London Hospital, 235 Euston Road, London, NW1 2BU, UK
| | - S Otero
- Department of Radiology, University College London Hospital, 235 Euston Road, London, NW1 2BU, UK
| | - M Shawky
- Centre for Endocrine Surgery, University College London Hospital, 235 Euston Road, London, NW1 2BU, UK
| | - T E Abdel-Aziz
- Centre for Endocrine Surgery, University College London Hospital, 235 Euston Road, London, NW1 2BU, UK
| | - T R Kurzawinski
- Centre for Endocrine Surgery, University College London Hospital, 235 Euston Road, London, NW1 2BU, UK
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Cardigan R, New HV, Estcourt L, Zhiburt E, Dubey R, Bengtsson J, Jöud M, Castillo C, Cid J, Lozano M, Gounder D, Flanagan P, Morley S, Clarke G, Devine D, Hindawi S, AlOtaibi A, Bub CB, Kutner JM, Ikeda T, Goto N, Okazaki H, Fontaine MJ, Pasion J, Song L, Latham T, Kerkhoffs JL, de Haas M, Zwaginga JJ, Gathof BS, Ommer K, Pirenne F, Raba M, Francois A, Daly J, Powley T, Dunbar N. International Forum on Policies and Practice for Transfusion of ABO and RhD Non-Identical Platelets: Summary. Vox Sang 2021; 117:136-144. [PMID: 34258783 DOI: 10.1111/vox.13129] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Accepted: 04/27/2021] [Indexed: 01/16/2023]
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5
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Cardigan R, New HV, Estcourt L, Zhiburt E, Dubey R, Bengtsson J, Jöud M, Castillo C, Cid J, Lozano M, Gounder D, Flanagan P, Morley S, Clarke G, Devine D, Hindawi S, AlOtaibi A, Bub CB, Kutner JM, Ikeda T, Goto N, Okazaki H, Fontaine MJ, Pasion J, Song L, Latham T, Kerkhoffs JL, de Haas M, Zwaginga JJ, Gathof BS, Ommer K, Pirenne F, Raba M, Francois A, Daly J, Powley T, Dunbar N. International Forum on Policies and Practice for Transfusion of ABO and RhD Non-Identical Platelets: Responses. Vox Sang 2021; 117:e1-e20. [PMID: 34258774 DOI: 10.1111/vox.13130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Accepted: 04/27/2021] [Indexed: 11/30/2022]
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6
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Germain M, Grégoire Y, Custer BS, Goldman M, Bravo M, Kamel H, Davison K, Field S, van den Hurk K, van de Laar TJW, Irving DO, Jones A, Liumbruno G, Morley S, O'Brien SF, Pillonel J, Steinsvåg CT, Takanashi M, Tsuno NH, Vesga Carasa MA, Wendel S, Vassallo RR, Tiberghien P. An international comparison of HIV prevalence and incidence in blood donors and general population: a BEST Collaborative study. Vox Sang 2021; 116:1084-1093. [PMID: 33835513 DOI: 10.1111/vox.13107] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Revised: 03/16/2021] [Accepted: 03/17/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND AND OBJECTIVES Efficiency in mitigating HIV transmission risk by transfusion may vary internationally. We compared HIV prevalence and incidence in blood donors across different jurisdictions in relation to those rates in the general population and differences in deferral practices. MATERIALS AND METHODS Data from 2007 to 2016 were collected in Australia, Brazil (São Paulo), Canada, England, France, Italy, Ireland, Japan, the Netherlands, New Zealand, Norway, Spain (Basque Country), USA (Vitalant) and Wales. For each country/region, the number of HIV antibody-positive donations and nucleic acid testing (NAT)-only-positive donations was broken down according to first-time or repeat donor status, along with the relevant denominators. RESULTS There is a modest correlation between HIV prevalence among first-time donors and HIV prevalence in the general population. However, rates of HIV-positive donations in repeat donors, a proxy for incidence, do not correlate with incidence rates in the general population. Rates in donors from Italy and Basque Country, where deferral criteria for men having sex with men are less stringent, are higher compared with most other jurisdictions. Rates of NAT-only-positive donations are extremely low and do not differ significantly after adjustment for multiple comparisons. CONCLUSION Donor HIV rates are only weakly associated with those observed in the general population. Countries with less stringent deferral criteria have higher HIV rates in their donor population, but the rates remain very low.
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Affiliation(s)
- Marc Germain
- Medical affairs and Innovation, Héma-Québec, Québec, Canada
| | - Yves Grégoire
- Medical affairs and Innovation, Héma-Québec, Québec, Canada
| | - Brian S Custer
- Vitalant Research Institute, Vitalant, San Francisco, CA, USA
| | - Mindy Goldman
- Donor and Clinical Services, Canadian Blood Services, Ottawa, Canada
| | | | - Hany Kamel
- Medical Affairs, Vitalant, Scottsdale, AZ, USA
| | | | | | | | | | - David O Irving
- Research and Development, Australian Red Cross Blood Service, Melbourne, Australia
| | | | | | - Sarah Morley
- New Zealand Blood Service, Auckland, New Zealand
| | - Sheila F O'Brien
- Epidemiology and Surveillance, Canadian Blood Services, Ottawa, Canada
| | - Josiane Pillonel
- Direction des Maladies Infectieuses, Santé Publique France, Saint-Maurice, France
| | | | | | | | | | | | | | - Pierre Tiberghien
- Établissement Français du Sang, La Plaine Saint-Denis, France.,Inserm UMR 1098 RIGHT, Université de Franche-Comté, Établissement Français du Sang, Besançon, France
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7
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Twigg V, Francies O, Otero S, Jawad S, Beale T, Morley S. Trans-oral ultrasound-guided biopsy for head and neck lesions: an alternative for lesions not amenable to standard percutaneous image-guided biopsy. Description of the technique and case series. Clin Radiol 2021; 76:367-373. [PMID: 33558028 DOI: 10.1016/j.crad.2020.12.019] [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] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Accepted: 12/24/2020] [Indexed: 11/19/2022]
Affiliation(s)
- V Twigg
- Department of ENT, Royal National ENT Hospital, 47-49 Huntley Street, London, WC1E 6DG, UK.
| | - O Francies
- Department of Radiology, University College Hospitals NHS Trust, 235 Euston Road, Bloomsbury, London, NW1 2BU, UK
| | - S Otero
- Department of Radiology, University College Hospitals NHS Trust, 235 Euston Road, Bloomsbury, London, NW1 2BU, UK
| | - S Jawad
- Department of Radiology, University College Hospitals NHS Trust, 235 Euston Road, Bloomsbury, London, NW1 2BU, UK
| | - T Beale
- Department of Radiology, University College Hospitals NHS Trust, 235 Euston Road, Bloomsbury, London, NW1 2BU, UK
| | - S Morley
- Department of Radiology, University College Hospitals NHS Trust, 235 Euston Road, Bloomsbury, London, NW1 2BU, UK
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8
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Hartmaier RJ, Trabucco SE, Priedigkeit N, Chung JH, Parachoniak CA, Vanden Borre P, Morley S, Rosenzweig M, Gay LM, Goldberg ME, Suh J, Ali SM, Ross J, Leyland-Jones B, Young B, Williams C, Park B, Tsai M, Haley B, Peguero J, Callahan RD, Sachelarie I, Cho J, Atkinson JM, Bahreini A, Nagle AM, Puhalla SL, Watters RJ, Erdogan-Yildirim Z, Cao L, Oesterreich S, Mathew A, Lucas PC, Davidson NE, Brufsky AM, Frampton GM, Stephens PJ, Chmielecki J, Lee AV. Recurrent hyperactive ESR1 fusion proteins in endocrine therapy-resistant breast cancer. Ann Oncol 2019; 29:872-880. [PMID: 29360925 PMCID: PMC5913625 DOI: 10.1093/annonc/mdy025] [Citation(s) in RCA: 62] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Background Estrogen receptor-positive (ER-positive) metastatic breast cancer is often intractable due to endocrine therapy resistance. Although ESR1 promoter switching events have been associated with endocrine-therapy resistance, recurrent ESR1 fusion proteins have yet to be identified in advanced breast cancer. Patients and methods To identify genomic structural rearrangements (REs) including gene fusions in acquired resistance, we undertook a multimodal sequencing effort in three breast cancer patient cohorts: (i) mate-pair and/or RNAseq in 6 patient-matched primary-metastatic tumors and 51 metastases, (ii) high coverage (>500×) comprehensive genomic profiling of 287-395 cancer-related genes across 9542 solid tumors (5216 from metastatic disease), and (iii) ultra-high coverage (>5000×) genomic profiling of 62 cancer-related genes in 254 ctDNA samples. In addition to traditional gene fusion detection methods (i.e. discordant reads, split reads), ESR1 REs were detected from targeted sequencing data by applying a novel algorithm (copyshift) that identifies major copy number shifts at rearrangement hotspots. Results We identify 88 ESR1 REs across 83 unique patients with direct confirmation of 9 ESR1 fusion proteins (including 2 via immunoblot). ESR1 REs are highly enriched in ER-positive, metastatic disease and co-occur with known ESR1 missense alterations, suggestive of polyclonal resistance. Importantly, all fusions result from a breakpoint in or near ESR1 intron 6 and therefore lack an intact ligand binding domain (LBD). In vitro characterization of three fusions reveals ligand-independence and hyperactivity dependent upon the 3' partner gene. Our lower-bound estimate of ESR1 fusions is at least 1% of metastatic solid breast cancers, the prevalence in ctDNA is at least 10× enriched. We postulate this enrichment may represent secondary resistance to more aggressive endocrine therapies applied to patients with ESR1 LBD missense alterations. Conclusions Collectively, these data indicate that N-terminal ESR1 fusions involving exons 6-7 are a recurrent driver of endocrine therapy resistance and are impervious to ER-targeted therapies.
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Affiliation(s)
- R J Hartmaier
- Foundation Medicine Inc., Cambridge; Department of Pharmacology and Chemical Biolog, UPMC Hillman Cancer Center, University of Pittsburgh, Pittsburgh, USA; Women's Cancer Research Center, Magee-Women's Research Institute, Pittsburgh, USA.
| | | | - N Priedigkeit
- Department of Pharmacology and Chemical Biolog, UPMC Hillman Cancer Center, University of Pittsburgh, Pittsburgh, USA; Women's Cancer Research Center, Magee-Women's Research Institute, Pittsburgh, USA
| | | | | | | | - S Morley
- Foundation Medicine Inc., Cambridge
| | | | - L M Gay
- Foundation Medicine Inc., Cambridge
| | | | - J Suh
- Foundation Medicine Inc., Cambridge
| | - S M Ali
- Foundation Medicine Inc., Cambridge
| | - J Ross
- Foundation Medicine Inc., Cambridge
| | - B Leyland-Jones
- Department of Molecular and Experimental Medicine, Avera Cancer Institute, Sioux Falls, USA
| | - B Young
- Department of Molecular and Experimental Medicine, Avera Cancer Institute, Sioux Falls, USA
| | - C Williams
- Department of Molecular and Experimental Medicine, Avera Cancer Institute, Sioux Falls, USA
| | - B Park
- Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins, Baltimore, USA
| | - M Tsai
- Minnesota Oncology, Minneapolis, USA
| | - B Haley
- UT Southwestern Medical Center, Dallas, USA
| | - J Peguero
- Oncology Consultants Research Department, Houston, USA
| | | | | | - J Cho
- New Bern Cancer Care, New Bern, USA
| | - J M Atkinson
- Women's Cancer Research Center, Magee-Women's Research Institute, Pittsburgh, USA
| | - A Bahreini
- Women's Cancer Research Center, Magee-Women's Research Institute, Pittsburgh, USA; Department of Human Genetics, University of Pittsburgh, Pittsburgh, USA; Department of Genetics and Molecular Biology, Isfahan University of Medical Sciences, Isfahan, Iran
| | - A M Nagle
- Department of Pharmacology and Chemical Biolog, UPMC Hillman Cancer Center, University of Pittsburgh, Pittsburgh, USA; Women's Cancer Research Center, Magee-Women's Research Institute, Pittsburgh, USA
| | - S L Puhalla
- Women's Cancer Research Center, Magee-Women's Research Institute, Pittsburgh, USA; Foundation Medicine Inc., Cambridge; Department of Molecular and Experimental Medicine, Avera Cancer Institute, Sioux Falls, USA
| | - R J Watters
- Department of Pharmacology and Chemical Biolog, UPMC Hillman Cancer Center, University of Pittsburgh, Pittsburgh, USA; Women's Cancer Research Center, Magee-Women's Research Institute, Pittsburgh, USA; Department of Orthopaedic Surgery, University of Pittsburgh, Pittsburgh, USA
| | - Z Erdogan-Yildirim
- Women's Cancer Research Center, Magee-Women's Research Institute, Pittsburgh, USA; Department of Human Genetics, University of Pittsburgh, Pittsburgh, USA
| | - L Cao
- Women's Cancer Research Center, Magee-Women's Research Institute, Pittsburgh, USA; Central South University Xiangya School of Medicine, China
| | - S Oesterreich
- Department of Pharmacology and Chemical Biolog, UPMC Hillman Cancer Center, University of Pittsburgh, Pittsburgh, USA; Women's Cancer Research Center, Magee-Women's Research Institute, Pittsburgh, USA
| | - A Mathew
- Department of Medicine, University of Pittsburgh, Pittsburgh, USA
| | - P C Lucas
- Department of Pathology, University of Pittsburgh, Pittsburgh, USA
| | - N E Davidson
- Foundation Medicine Inc., Cambridge; Department of Molecular and Experimental Medicine, Avera Cancer Institute, Sioux Falls, USA
| | - A M Brufsky
- Foundation Medicine Inc., Cambridge; Department of Molecular and Experimental Medicine, Avera Cancer Institute, Sioux Falls, USA
| | | | | | | | - A V Lee
- Department of Pharmacology and Chemical Biolog, UPMC Hillman Cancer Center, University of Pittsburgh, Pittsburgh, USA; Women's Cancer Research Center, Magee-Women's Research Institute, Pittsburgh, USA
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Garrison L, Morley S, Chambers CD, Bakhireva LN. Forty Years of Assessing Neurodevelopmental and Behavioral Effects of Prenatal Alcohol Exposure in Infants: What Have We Learned? Alcohol Clin Exp Res 2019; 43:1632-1642. [PMID: 31206743 DOI: 10.1111/acer.14127] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [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: 03/23/2019] [Accepted: 06/06/2019] [Indexed: 01/01/2023]
Abstract
It has been known for over 4 decades that prenatal alcohol exposure (PAE) can adversely affect neurodevelopment and behavior (NDB). Yet, early detection of altered NDB due to PAE continues to present a major clinical challenge. Identification of altered NDB in the first 2 years of life, before higher-order cognitive processes develop, invites early interventions for affected children to improve long-term outcomes. Studies published in English from January of 1980 to July of 2018 were identified in PubMed/MEDLINE. The review focused on prospective birth cohort studies which used standardized NDB assessments in children up to 2 years of age, wherein PAE was the main exposure and NDB was the main outcome. NDB was categorized into the domains of neurocognitive, adaptive, and self-regulation based on the 2016 Updated Clinical Guidelines for Diagnosing fetal alcohol spectrum disorder. An initial search resulted in 1,867 articles for which we reviewed abstracts; 114 were selected for full-text review; and 3 additional abstracts were identified through review of references in eligible publications. Thirty-one publications met criteria and were included: of these, 24 reported neurocognitive outcomes, 24 reported adaptive behavior outcomes, and 12 reported outcomes in the domain of self-regulation. Although self-regulation was assessed in the fewest number of studies, 8/12 (75%) reported PAE-associated deficits. In contrast, results were mixed for the other 2 domains: 13/24 (54%) of the selected studies that included neurocognitive outcomes showed poorer performance following PAE, and 8/24 (33%) studies that assessed adaptive functioning found significant differences between PAE and comparison infants. There is considerable evidence to support the value of early-life assessments of infant NDB when PAE is known or suspected. More studies focusing on infant self-regulation, in particular, are needed to determine the utility of early evaluation of this critical developmental domain in infants with PAE.
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Affiliation(s)
- Laura Garrison
- Department of Pharmacy Practice and Administrative Sciences, Substance Use Research and Education Center, University of New Mexico College of Pharmacy, Albuquerque, New Mexico
| | - Sarah Morley
- Health Sciences Library and Informatics Center, University of New Mexico, Albuquerque, New Mexico
| | - Christina D Chambers
- Department of Pediatrics, University of California San Diego, La Jolla, California
| | - Ludmila N Bakhireva
- Department of Pharmacy Practice and Administrative Sciences, Substance Use Research and Education Center, University of New Mexico College of Pharmacy, Albuquerque, New Mexico.,Department of Family and Community Medicine, University of New Mexico School of Medicine, Albuquerque, New Mexico.,Division of Epidemiology, Biostatistics and Preventive Medicine, Department of Internal Medicine, University of New Mexico School of Medicine, Albuquerque, New Mexico
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Alagha M, Ju X, Morley S, Ayoub A. Reproducibility of the dynamics of facial expressions in unilateral facial palsy. Int J Oral Maxillofac Surg 2018; 47:268-275. [DOI: 10.1016/j.ijom.2017.08.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2017] [Revised: 07/10/2017] [Accepted: 08/11/2017] [Indexed: 10/18/2022]
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Tzanidakis K, Kalavrezos N, Sadiq Z, Jay A, Morley S, Wheelan J. The first case of intraosseous liposarcoma of the mandible involving the condyle. Int J Oral Maxillofac Surg 2017. [DOI: 10.1016/j.ijom.2017.02.995] [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: 11/24/2022]
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Farook S, Pomplun S, Morley S, Kalavrezos N, Sadiq Z. Diagnostic accuracy of fine-needle aspiration and core biopsy in parotid lesions. Int J Oral Maxillofac Surg 2017. [DOI: 10.1016/j.ijom.2017.02.959] [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: 11/17/2022]
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Farook S, Jay A, Morley S, Kalavrezos N, Sadiq Z. Synchronous unilateral histologically different three parotid tumours. Int J Oral Maxillofac Surg 2017. [DOI: 10.1016/j.ijom.2017.02.957] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Cavallo AV, Smith PJ, Morley S, Morsi AW. Non-Vascularized Free Toe Phalanx Transfers in Congenital Hand Deformities – the Great Ormond Street Experience. ACTA ACUST UNITED AC 2017; 28:520-7. [PMID: 14599822 DOI: 10.1016/s0266-7681(03)00084-6] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Many options of varying complexity are available for the management of congenital short digits resulting from aphalangia in symbrachydactyly and constriction ring syndrome. We have used non-vascularized free toe phalanx transfers for these children when a vascularized toe transfer has been contraindicated. We describe our technique and experience with 22 children who underwent a total of 64 transfers of the proximal (35) or middle (29) toe phalanges (average 3 per child). The mean age at initial surgery was 15 months, and the mean follow-up was 5 years. Duration of time until epiphyseal closure could not be determined accurately, but total digital elongation averaged 6 mm. Complications of this technique include joint instability, premature epiphyseal closure and, in one patient, infection and graft loss. Donor site deformity was determined according to measured growth deficit and toe function. This technique is a simple option for digital elongation and, if performed in the appropriate age group in short fingered and monodactylous subtypes of symbrachydactyly, has the potential to allow growth and function with minimal donor site deficit.
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Affiliation(s)
- A V Cavallo
- Great Ormond Street Hospital for Children, Great Ormond Street, London, UK
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Morley S. Book Review: Basic Molecular and Cell Biology. Scott Med J 2016. [DOI: 10.1177/003693309804300523] [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: 11/15/2022]
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Morley S. Book Review: The ABC of Dermatology. Scott Med J 2016. [DOI: 10.1177/003693309804300524] [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: 11/17/2022]
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Mairembam P, Jay A, Beale T, Morley S, Vaz F, Kalavrezos N, Kocjan G. Salivary gland FNA cytology: role as a triage tool and an approach to pitfalls in cytomorphology. Cytopathology 2015; 27:91-6. [PMID: 25656853 DOI: 10.1111/cyt.12232] [Citation(s) in RCA: 56] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/08/2014] [Indexed: 12/12/2022]
Abstract
OBJECTIVE To highlight the importance of salivary gland fine needle aspiration (FNA) cytology as a triage tool for surgery and to determine its sensitivity and specificity. To discuss the diagnostic pitfalls and potential role of ancillary techniques in diagnosis and prognosis. METHODS The study included a total of 920 cases of salivary gland FNAs received in the cytopathology department of University College London Hospital during December 2004 to December 2012. The cases with known histological outcomes were analysed to determine the sensitivity and specificity. RESULTS Surgery was carried out on 180 (19.6%) of 920 patients. Excluding nine with inadequate/non-diagnostic cytology, the sensitivity of FNA cytology for a malignant outcome was 89% (33/37) and the specificity was 97% (130/134). Diagnostic pitfalls are discussed with respect to eight FNAs with discrepant histology. Histological outcome was not available for 740 cases (80.4%): excluding 88 non-diagnostic FNAs, 324 (49.7%) had non-neoplastic diagnoses (not indicating surgery) and 328 (50.3%) had neoplastic diagnoses, which included recurrences/metastases of known tumours. Patients with other neoplasms on FNA were lost to follow-up and may have had surgery elsewhere. Cases with clinical concerns were discussed at weekly multidisciplinary meetings. CONCLUSION Salivary gland FNA is crucial in the distinction of non-neoplastic from neoplastic lesions, emphasizing the fact that FNA is an excellent triage tool for surgery. Salivary gland FNA has a high sensitivity and specificity. However, it is important to interpret the cytological diagnoses in the light of clinical findings and imaging. Diagnostic pitfalls are seen in a minority of cases and could potentially be overcome with the help of recently described diagnostic and prognostic markers.
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Affiliation(s)
- P Mairembam
- Department of Histopathology, University College London Hospital, London, UK
| | - A Jay
- Department of Histopathology, University College London Hospital, London, UK
| | - T Beale
- Department of Imaging, University College London Hospital, London, UK
| | - S Morley
- Department of Imaging, University College London Hospital, London, UK
| | - F Vaz
- Department of Surgery, University College London Hospital, London, UK
| | - N Kalavrezos
- Department of Surgery, University College London Hospital, London, UK
| | - G Kocjan
- Department of Histopathology, University College London Hospital, London, UK
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Robertson BF, Robertson GA, Shoaib T, Soutar DS, Morley S, Robertson AG. Pleomorphic adenomas: post-operative radiotherapy is unnecessary following primary incomplete excision: a retrospective review. J Plast Reconstr Aesthet Surg 2014; 67:e297-302. [PMID: 25287582 DOI: 10.1016/j.bjps.2014.09.030] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [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: 04/30/2014] [Revised: 09/09/2014] [Accepted: 09/14/2014] [Indexed: 10/24/2022]
Abstract
BACKGROUND Current standard treatment of Pleomorphic Salivary Adenoma (PSA) of the Parotid Gland is by surgical excision. The management of incomplete excision remains undecided with post-operative radiotherapy advocated by some and observation by others. METHODS 190 patients who underwent resection of PSA of the parotid gland within the West of Scotland region from 1981 to 2008 were identified and data collected. RESULTS 78/190 patients had a primary incomplete excision. 25/78 received post-operative radiotherapy and 53 were observed. Recurrences occurred in 11/53 in those observed and in 1/25 of those who received radiotherapy. 21/25 complained of significant side effects from the radiotherapy. 38 surgeons performed 190 procedures, with a range of experience from 1 to28 procedures. CONCLUSIONS Radiotherapy does appear to reduce recurrence with incomplete excision, however it is associated with significant side effects. We therefore feel radiotherapy should not be routinely recommended. Subspecialisation should be adopted to increase the operating surgeon's experience.
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Affiliation(s)
- B F Robertson
- Canniesburn Plastic Surgery Unit, Glasgow G4 0SF, United Kingdom.
| | - G A Robertson
- Canniesburn Plastic Surgery Unit, Glasgow G4 0SF, United Kingdom
| | - T Shoaib
- Canniesburn Plastic Surgery Unit, Glasgow G4 0SF, United Kingdom
| | - D S Soutar
- Canniesburn Plastic Surgery Unit, Glasgow G4 0SF, United Kingdom
| | - S Morley
- Canniesburn Plastic Surgery Unit, Glasgow G4 0SF, United Kingdom
| | - A G Robertson
- Beatson Oncology Centre, Glasgow, G12 0YN, United Kingdom
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Abstract
BACKGROUND Depression with comorbid pain is associated with a poor response to various treatments. The objective in this secondary analysis was to determine whether patients reporting pain have different depression and pain outcomes over time in response to acupuncture, counselling or usual care. METHODS Self-reported ratings of depression and pain from 755 patients in a pragmatic randomised controlled trial of acupuncture (302) or counselling (302) compared to usual care alone (151) are described and analysed using a series of regression models and analysis of covariance. Patient-reported outcomes of Patient Health Questionnaire (PHQ)-9 for depression, SF36 bodily pain and EQ-5D, all at baseline, 3, 6, 9 and 12 months. RESULTS At baseline, 755 patients reported EQ-5D pain categories; 384 (50.9%) reported moderate-to-extreme pain. Controlling for baseline depression, a linear regression model showed that the presence of pain at baseline was associated with poorer depression outcomes at 3 months mean difference=-1.16, (95% CI 0.12 to 2.2). Participants with moderate-to-extreme pain at baseline did better at 3 months if they received acupuncture (mean reduction in Patient Health Questionnaire 9 (PHQ-9) from baseline=6.0, 95% CI 5.0 to 7.1 and a mean reduction in SF-36 bodily pain=11.2, (95% CI 7.1 to 15.2) compared to improvements for those who received counselling (4.3, 95% CI 3.3 to 5.4; 7.6, 95% CI 3.6 to 11.6) or usual care (2.7, 95% CI 1.50 to 4.0: 7.2, 95% CI 2.3 to 12.1). In comparison, no notable differences were seen between treatment arms within the no pain comparator group. CONCLUSIONS Patients with depression and pain at baseline recovered less well from treatment over 3 months than those with depression and no pain. Reductions in both depression and pain were most marked in the acupuncture group, followed by the counselling group and then the usual care group.
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Affiliation(s)
- A Hopton
- Department of Health Sciences, University of York, York, UK
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Thompson JP, Watson ID, Thanacoody HKR, Morley S, Thomas SHL, Eddleston M, Vale JA, Bateman DN, Krishna CV. Guidelines for laboratory analyses for poisoned patients in the United Kingdom. Ann Clin Biochem 2014; 51:312-25. [PMID: 24477115 DOI: 10.1177/0004563213519754] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
To enable consistency of investigation and the establishment of best practice standards, consensus guidelines were formulated previously by the UK National Poisons Information Service and the Association for Clinical Biochemistry. These joint guidelines have now been updated to reflect current best practice. The types of laboratory investigation required for poisoned patients are categorized as either (a) essential common laboratory investigations or (b) specific toxicological assays, and also as either (i) common or (ii) specialist or infrequent. Tests in categories (a) and (bi) should be available 24 hours per day, with a maximum turnaround time of 2 h. For the specialist assays, i.e. category (bii), availability and turnaround times have been specified individually. The basis for selection of these times has been clinical utility. The adoption of these guidelines, along with the use of the National Poisons Information Service (0844 8920111) and its online poisons information resource TOXBASE(®) (www.toxbase.org) enable the poisoned patient to receive appropriate, 'best practice' investigations according to their clinical needs and will avoid unnecessary investigations.
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Affiliation(s)
- J P Thompson
- National Poisons Information Service (Cardiff), Cardiff, UK
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Morley S, Griffiths J, Philips G, Moseley H, O’Grady C, Mellish K, Lankester C, Faris B, Young R, Brown S, Rhodes L. Phase IIa randomized, placebo-controlled study of antimicrobial photodynamic therapy in bacterially colonized, chronic leg ulcers and diabetic foot ulcers: a new approach to antimicrobial therapy. Br J Dermatol 2013; 168:617-24. [DOI: 10.1111/bjd.12098] [Citation(s) in RCA: 90] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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Romeo M, O'Reilly B, Robertson BF, Morley S. Validation of the Glasgow Facial Palsy Scale for the assessment of smile reanimation surgery in facial paralysis. Clin Otolaryngol 2012; 37:181-7. [PMID: 22540420 DOI: 10.1111/j.1749-4486.2012.02484.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To evaluate the Glasgow Facial Palsy Scale as a tool to assess facial reanimation surgery in facial palsy. Software analysis of digital video data is used to measure facial movements, comparing the affected to the normal side. We present the first use of the Glasgow Facial Palsy Scale following facial re-animation surgery. DESIGN A comparison of the Glasgow Facial Palsy Scale against the Nottingham scoring system. Subjects undergoing unilateral surgical smile reanimation procedures were selected. Comparison was made with the Nottingham facial palsy scale and the House-Brackmann Scale pre- and postoperatively. SETTING Patients were recruited in the facial palsy clinic of Canniesburn Plastic Surgery Unit, Glasgow. PARTICIPANTS Seven consecutive patients were selected who were due to undergo unilateral facial reanimation. MAIN OUTCOME MEASURES The difference in pre- and post-surgical facial movement as measured using the Glasgow Facial Palsy Scale with this value being compared to that obtained using the Nottingham scoring system. Note was also taken of the correlation with House-Brackmann system and clinical correlation. RESULTS AND CONCLUSIONS Statistical analysis indicated a linear relationship between the Glasgow Facial Palsy Scale and the Nottingham System. The Pearson correlation test was used to confirm the relationship between the two methods giving a result of -0.587, which indicates significant correlation between the two methods. We conclude that the Glasgow Facial Palsy Scale is a standardised objective method of assessing the change in facial movement following smile reanimation surgery. We commend it as a useful tool to objectively assess surgical results in this challenging field.
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Affiliation(s)
- M Romeo
- Canniesburn Plastic Surgery Unit, Glasgow Royal Infirmary, NHS Scotland.
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Forster M, Sultan A, Jerjes W, Simeon C, Morley S, Carnell D, Hopper C. First-In-Man Phase I Study of Tpcs2a-Based Photochemical Internalisation (PCI) of Bleomycin in Locally Recurrent or Advanced/Metastatic, Cutaneous or Subcutaneous Malignancies. Ann Oncol 2012. [DOI: 10.1016/s0923-7534(20)33619-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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Liew C, Vassiliou L, Lalabekyan B, Jay A, Beale T, Morley S, Kalavrezos N. Managing margins in hard tissue sarcomas of the mandible. Br J Oral Maxillofac Surg 2012. [DOI: 10.1016/j.bjoms.2012.04.205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Stippler M, Smith C, McLean AR, Carlson A, Morley S, Murray-Krezan C, Kraynik J, Kennedy G. Utility of routine follow-up head CT scanning after mild traumatic brain injury: a systematic review of the literature. Emerg Med J 2012; 29:528-32. [PMID: 22307924 DOI: 10.1136/emermed-2011-200162] [Citation(s) in RCA: 62] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
OBJECTIVE To evaluate the efficacy of routine follow-up CT scans of the head after complicated mild traumatic brain injury (TBI). METHODS 74 English language studies published from 1999 to February 2011 were reviewed. The papers were found by searching the PubMed database using a combination of keywords according to Cochrane guidelines. Excluding studies with missing or inappropriate data, 1630 patients in 19 studies met the inclusion criteria: complicated mild TBI, defined as a GCS score 13-15 with abnormal initial CT findings and the presence of follow-up CT scans. For these studies, the progression and type of intracranial haemorrhage, time from trauma to first scan, time between first and second scans, whether second scans were obtained routinely or for neurological decline and the number of patients who had a neurosurgical intervention were recorded. RESULTS Routine follow-up CT scans showed hemorrhagic progression in 324 patients (19.9%). Routine follow-up head CT scans did not predict the need for neurosurgical intervention (p=0.10) but a CT scan of the head performed for decline in status did (p=0.00046). For the 56 patients (3.4%) who declined neurologically, findings on the second CT scan were worse in 38 subjects (67%) and unchanged in the rest. Overall, 39 patients (2.4%) underwent neurosurgical intervention. CONCLUSION Routine follow-up CT scans rarely alter treatment for patients with complicated mild TBI. Follow-up CT scans based on neurological decline alter treatment five times more often than routine follow-up CT scans.
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Affiliation(s)
- Martina Stippler
- Department of Neurosurgery, University of New Mexico, Albuquerque, New Mexico 87131-0001, USA.
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Ferguson L, Paterson T, Ramsay F, Arrol K, Dabernig J, Shaw-Dunn J, Morley S. Applied anatomy of the latissimus dorsi free flap for refinement in one-stage facial reanimation. J Plast Reconstr Aesthet Surg 2011; 64:1417-23. [DOI: 10.1016/j.bjps.2011.06.013] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2010] [Revised: 05/29/2011] [Accepted: 06/07/2011] [Indexed: 11/28/2022]
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Jerjes W, Hamdoon Z, Mosse C, Morley S, Hopper C. Photodynamic therapy in the management of vascular anomalies. Br J Oral Maxillofac Surg 2011. [DOI: 10.1016/j.bjoms.2011.03.126] [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: 10/18/2022]
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Jerjes W, Upile T, Hamdoon Z, Mosse C, Morley S, Hopper C. Minimal interventions for vascular anomalies. Photodiagnosis Photodyn Ther 2011. [DOI: 10.1016/j.pdpdt.2011.03.301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Maclean J, punwani S, Morley S, Marsh D, Sullivan K, Moinuddin S, Stacey C, Bainbridge A, Carnell D, Mendes R. 1272 poster HIGH QUALITY MRI-CT CO-REGISTRATION WITH T2-WEIGHTED BLADE SEQUENCES FOR HEAD AND NECK RADIOTHERAPY. Radiother Oncol 2011. [DOI: 10.1016/s0167-8140(11)71394-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Carlson A, Stippler M, Morley S, Myers O. Predictive Factors for Vision Recovery after Optic Nerve Decompression for Chronic Compressive Neuropathy: Systematic Review and Meta-Analysis. Skull Base 2011. [DOI: 10.1055/s-2011-1274186] [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: 10/18/2022]
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Sidhu R, Wilson P, Foye L, McAlindon ME, Lobo AJ, Morley S, Sanders DS. Can faecal lactoferrin be used as a discriminator for referral for colonoscopy? Intern Med J 2010; 40:867-8. [DOI: 10.1111/j.1445-5994.2010.02345.x] [Citation(s) in RCA: 2] [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: 11/27/2022]
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Sidhu R, Wilson P, Wright A, Yau CWH, D'Cruz FA, Foye L, Morley S, Lobo AJ, McAlindon ME, Sanders DS. Faecal lactoferrin--a novel test to differentiate between the irritable and inflamed bowel? Aliment Pharmacol Ther 2010. [PMID: 20331581 DOI: 10.1111/j.1365-2036.2010.04306] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
BACKGROUND Distinguishing between inflammatory bowel disease (IBD) and irritable bowel syndrome (IBS) can be challenging. AIMS To investigate the utility of faecal lactoferrin as a marker of inflammation in patients with IBD, IBS and controls. METHODS Disease activity in IBD patients was assessed using the modified Harvey-Bradshaw Activity Index. Stool samples were analysed using an ELISA assay. RESULTS We recruited 137 patients with IBS, 126 with ulcerative colitis (UC) and 104 with Crohn's disease (CD), and 98 healthy volunteers. The median +/- IQ lactoferrin concentration (microg/g faecal weight) was 0 +/- 1.4 for IBS patients, 6.6 +/- 42 for UC patients, 4 +/- 12.7 for CD patients and 0.5 +/- 2 for healthy controls. Lactoferrin levels were significantly higher in IBD patients compared with IBS/healthy controls (P < 0.001). The median lactoferrin concentrations were significantly higher in active UC & CD patients compared with inactive patients (P < 0.001 and P = 0.002 respectively). The sensitivity, specificity, positive and negative predictive values of lactoferrin in distinguishing active IBD from IBS/healthy controls were 67% and 96%, 87% and 86.8% respectively. CONCLUSIONS Lactoferrin is useful to differentiate between IBD and IBS, and can be used as an adjunct to blood parameters to determine IBD patients who have ongoing inflammation.
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Affiliation(s)
- R Sidhu
- Gastroenterology & Liver Unit, Royal Hallamshire Hospital, Glossop Road, Sheffield S102JF, United Kingdom.
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Sidhu R, Wilson P, Wright A, Yau CWH, D'Cruz FA, Foye L, Morley S, Lobo AJ, McAlindon ME, Sanders DS. Faecal lactoferrin--a novel test to differentiate between the irritable and inflamed bowel? Aliment Pharmacol Ther 2010; 31:1365-70. [PMID: 20331581 DOI: 10.1111/j.1365-2036.2010.04306.x] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.4] [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: 12/21/2022]
Abstract
BACKGROUND Distinguishing between inflammatory bowel disease (IBD) and irritable bowel syndrome (IBS) can be challenging. AIMS To investigate the utility of faecal lactoferrin as a marker of inflammation in patients with IBD, IBS and controls. METHODS Disease activity in IBD patients was assessed using the modified Harvey-Bradshaw Activity Index. Stool samples were analysed using an ELISA assay. RESULTS We recruited 137 patients with IBS, 126 with ulcerative colitis (UC) and 104 with Crohn's disease (CD), and 98 healthy volunteers. The median +/- IQ lactoferrin concentration (microg/g faecal weight) was 0 +/- 1.4 for IBS patients, 6.6 +/- 42 for UC patients, 4 +/- 12.7 for CD patients and 0.5 +/- 2 for healthy controls. Lactoferrin levels were significantly higher in IBD patients compared with IBS/healthy controls (P < 0.001). The median lactoferrin concentrations were significantly higher in active UC & CD patients compared with inactive patients (P < 0.001 and P = 0.002 respectively). The sensitivity, specificity, positive and negative predictive values of lactoferrin in distinguishing active IBD from IBS/healthy controls were 67% and 96%, 87% and 86.8% respectively. CONCLUSIONS Lactoferrin is useful to differentiate between IBD and IBS, and can be used as an adjunct to blood parameters to determine IBD patients who have ongoing inflammation.
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Affiliation(s)
- R Sidhu
- Gastroenterology & Liver Unit, Royal Hallamshire Hospital, Glossop Road, Sheffield S102JF, United Kingdom.
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Osher J, Jerjes W, Upile T, Hamdoon Z, Bhandari R, Hoonjan P, Akram S, Mosse C, Morley S, Hopper C. P22 Photodynamic therapy as the “last hope” palliative modality for patients with tongue base carcinoma. Br J Oral Maxillofac Surg 2010. [DOI: 10.1016/s0266-4356(10)60113-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Leeds JS, Forman EM, Morley S, Scott AR, Tesfaye S, Sanders DS. Abnormal liver function tests in patients with Type 1 diabetes mellitus: prevalence, clinical correlations and underlying pathologies. Diabet Med 2009; 26:1235-41. [PMID: 20002475 DOI: 10.1111/j.1464-5491.2009.02839.x] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
AIMS To determine the prevalence of elevated alanine transaminase (ALT) in a large cohort of patients with Type 1 diabetes and to examine the clinical correlations and causes. Methods Patients with Type 1 diabetes mellitus were prospectively recruited and ALT, glycated haemoglobin and lipid profile were measured. Patients with Type 2 diabetes mellitus were recruited as a comparison group. PATIENTS with abnormal ALT were investigated for underlying causes. Prevalence of abnormal ALT was analysed at three separate cut-offs and multivariable analysis used to identify independent risk factors. RESULTS Nine hundred and eleven with Type 1 diabetes and 963 with Type 2 diabetes were included. The prevalence of elevated ALT was dependent on the cut-off value: > 30 IU/l in males and > 19 IU/l in females, > 50 and > 63 IU/l was 34.5, 4.3 and 1.9%, respectively, in Type 1 diabetes and 51.4, 8.2 and 3.7%, respectively, in Type 2 diabetes. In Type 1 diabetes an elevated ALT was associated with worse glycaemic control, age > 55 years and elevated triglycerides. Investigation of these patients revealed a cause in 43.6% of patients, predominantly non-alcoholic fatty liver disease (NAFLD). CONCLUSIONS Elevated ALT is not uncommon in Type 1 diabetes and is associated with NAFLD-related risk factors. Patients with Type 1 diabetes and elevated ALT should be investigated as significant abnormalities may be found which are amenable to interventions.
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Affiliation(s)
- J S Leeds
- Departments of Gastroenterology, Royal Hallamshire Hospital, Sheffield, UK
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Dulguerov N, Young H, Norris P, Beale T, Morley S, Kalavrezos N. Ultrasound scan +/− fine-needle aspiration cytology assessment of neck lymphadenopathy in head and neck squamous cell carcinoma. Br J Oral Maxillofac Surg 2009. [DOI: 10.1016/j.bjoms.2009.06.138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Williams A, Eccleston C, Morley S, Palermo T, Lewandowski A. 1013 SYSTEMATIC REVIEW AND META‐ANALYSIS OF PSYCHOLOGICAL TREATMENTS FOR PERSISTENT OR RECURRENT PAIN IN CHILDREN AND ADOLESCENTS. Eur J Pain 2009. [DOI: 10.1016/s1090-3801(09)61016-8] [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: 10/20/2022]
Affiliation(s)
- A.C.C. Williams
- University College London, Research Department of Clinical, Educational & Health Psychology, London, United Kingdom
| | | | - S. Morley
- University of Leeds, Leeds, United Kingdom
| | - T. Palermo
- Division of Psychology, Children's Hospital Boston, Boston, United States
| | - A. Lewandowski
- Division of Psychology, Children's Hospital Boston, Boston, United States
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Damme S, Goossens M, Morley S. 19 Topical Seminar Summary: EXPLORING THE ROLE OF GOALS IN PAIN PERCEPTION, DISABILITY, AND TREATMENT. Eur J Pain 2009. [DOI: 10.1016/s1090-3801(09)60022-7] [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: 10/20/2022]
Affiliation(s)
- S. Damme
- Ghent University, Ghent, Belgium
| | | | - S. Morley
- University of Leeds, Institute of Health Sciences, Leeds, United Kingdom
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Williams A, Eccleston C, Morley S. 1012 SYSTEMATIC REVIEW AND META‐ANALYSIS OF PSYCHOLOGICAL TREATMENTS FOR PERSISTENT PAIN IN ADULTS, EXCLUDING HEADACHE. Eur J Pain 2009. [DOI: 10.1016/s1090-3801(09)61015-6] [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: 11/30/2022]
Affiliation(s)
- A. Williams
- University College London, London, United Kingdom
| | | | - S. Morley
- University of Leeds, Leeds, United Kingdom
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Chew R, Jessop F, Morley S. A case of fulminant septic shock with a rare gram-negative organism (Case Presentation). Acta Paediatr 2009; 98:1079-80; discussion 1220-1. [PMID: 19638009 DOI: 10.1111/j.1651-2227.2008.01098.x] [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] [Indexed: 11/29/2022]
Affiliation(s)
- Rusheng Chew
- Southend University Hospital NHS Foundation Trust, Westcliff-on-Sea, Cambridge, UK
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Young H, Norris P, Morley S, Kalavrezos N. Ultrasound in head and neck cancer. Int J Oral Maxillofac Surg 2009. [DOI: 10.1016/j.ijom.2009.03.126] [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: 11/24/2022]
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Vourvachis M, Jerjes W, Upile T, Vincent A, Abbas S, Morley S, Hopper C. P.324 Interstitial photodynamic therapy in deeply seated lesions. J Craniomaxillofac Surg 2008. [DOI: 10.1016/s1010-5182(08)72112-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Norris P, Young H, Morley S, Schache A, Kalavrezos N. O.598 The role of ultrasound in nodal SCC of the head and neck. J Craniomaxillofac Surg 2008. [DOI: 10.1016/s1010-5182(08)71722-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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Morley S, Clark M, Poertner H, Peck L. Symmorphosis and temperature adaptation: Testing the theory of oxygen limitation. Comp Biochem Physiol A Mol Integr Physiol 2008. [DOI: 10.1016/j.cbpa.2008.04.458] [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: 10/21/2022]
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Morley S, Rosenberg M, Federspiel W, Hattler BG, Batchinsky A. Respiratory dialysis: a new therapy for chronic obstructive pulmonary disease. Crit Care 2008. [PMCID: PMC4088674 DOI: 10.1186/cc6524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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Muller FM, Lewis-Jones S, Morley S, Kernohan N, Meiklejohn D, Goodlad JR, Evans A. Lymphomatoid granulomatosis complicating other haematological malignancies. Br J Dermatol 2007; 157:426-9. [PMID: 17596166 DOI: 10.1111/j.1365-2133.2007.08038.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Hewison J, Nixon J, Fountain J, Hawkins K, Jones CR, Mason G, Morley S, Thornton JG. A randomised trial of two methods of issuing prenatal test results: the ARIA (Amniocentesis Results: Investigation of Anxiety) trial. BJOG 2007; 114:462-8. [PMID: 17378819 DOI: 10.1111/j.1471-0528.2007.01276.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Many pregnant women experience anxiety while waiting for the results of diagnostic tests. Policies and practices intended to reduce this anxiety require evaluation. OBJECTIVES To test the following two hypotheses: * That giving amniocentesis results out on a fixed date alters maternal anxiety during the waiting period, compared with a policy of telling parents that the result will be issued "when available" (i.e. variable date). * That issuing early results from a rapid molecular test alters maternal anxiety during the waiting period, compared with not receiving any results prior to the karyotype. The effects of the two interventions on anxiety 1 month after receiving karyotype results were also examined. DESIGN A multicentre, randomised, controlled, open fixed sample, 2 x 2 factorial design trial, with equal randomisation. SETTING The prenatal diagnosis clinics in 12 hospitals in England offering amniocentesis as a diagnostic test for Down's syndrome. SAMPLE Two hundred and twenty-six women who had had an amniocentesis were randomised between June 2002 and July 2004. Eight women with abnormal results or test failure were excluded post-randomisation. INTERVENTIONS Issuing karyotype results on a prespecified fixed date, rather than issuing them as soon as they became available. Issuing karyotype results alone, or subsequent to issuing results from a rapid molecular test for the most common chromosomal abnormalities. MAIN OUTCOME MEASURES Average anxiety during the waiting period, calculated using daily scores from the short version of the Spielberger State-Trait Anxiety Inventory (STAI). Anxiety 1 month after receiving karyotype results, measured using the short form STAI. RESULTS Issuing early results from a partial but rapid test reduced maternal anxiety by a clinically significant amount during the waiting period (mean daily score 12.5 versus 14.8; scale score difference -2.36, 95% CI -1.2, -3.6), compared with receiving only the full karyotype results. There was no evidence that giving out karyotype results on a fixed or on a variable date altered maternal anxiety during the waiting period (mean daily score 13.2 versus 14.2; scale score difference -1.02, 95% CI -2.2, 0.2). One month after receiving normal karyotype results, anxiety was low in all groups, but women who had been given rapid test results tended to be more anxious than those who had not (mean single day score 9.2 versus 8.3; mean scale score difference 0.95, 95% CI -0.03, 1.9). This small to moderate effect did not reach conventional levels of statistical significance. CONCLUSIONS Rapid testing was a beneficial addition to karyotyping, at least in the short term. This does not necessarily imply that early results would be preferred to comprehensive ones if women had to choose between them. Because there are no clear advantages in anxiety terms of issuing karyotype results as soon as they become available, or on a fixed date, women could be given a choice between them.
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Affiliation(s)
- J Hewison
- Department of Obstetrics and Gynaecology, University of Leeds, Leeds, UK
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