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Kerhoulas Z, Ojaghi R, Hayes E, Khoury J, Pollock J. What are the common factors that lead to the failure to achieve minimal clinically important difference after shoulder surgery? A scoping review. Eur J Orthop Surg Traumatol 2024; 34:1749-1755. [PMID: 38480530 DOI: 10.1007/s00590-024-03867-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Accepted: 02/16/2024] [Indexed: 05/19/2024]
Abstract
INTRODUCTION The goal of this research is to identify the factors that negatively impact the achievement of the minimum clinically significant change (MCID) for the American Shoulder and Elbow Surgeons (ASES) score within the realm of various orthopedic shoulder procedures. METHODS We conducted a comprehensive review of studies published from 2002 to 2023, utilizing OvidMedline and PubMed databases. Our search criteria included terms such as "minimal clinically important difference" or "MCID" along with associated MeSH terms, in addition to "American shoulder and elbow surgeon" or "ASES." We selectively included primary investigations that assessed factors linked to the failure to achieve MCID for the ASES score subsequent to orthopedic shoulder procedures, while excluding papers addressing anatomical, surgical, or injury-related aspects. RESULTS Our analysis identified 149 full-text articles, leading to the inclusion of 12 studies for detailed analysis. The selected studies investigated outcomes following various orthopedic shoulder procedures, encompassing biceps tenodesis, total shoulder arthroplasty, and rotator cuff repair. Notably, factors, such as gender, body mass index, diabetes, smoking habits, opioid usage, depression, anxiety, workers' compensation, occupational satisfaction, and the preoperative ASES score, were all associated with the inability to attain MCID. CONCLUSION In summary, numerous factors exert a negative influence on the attainment of MCID following shoulder procedures, and these factors appear to be irrespective of the specific surgical technique employed. Patients presenting with these factors may perceive their surgical outcomes as less successful when compared to those without these factors. Identifying these factors can enable healthcare providers to provide more effective counseling to patients regarding their expected outcomes and rehabilitation course. Furthermore, these findings can aid in the development of a screening tool to better identify these risk factors and optimize them before surgery.
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Affiliation(s)
- Zoe Kerhoulas
- Division of Orthopedics, Department of Surgery, University of Ottawa, 415-203 Catherin St, Ottawa, ON, K2P 1J5, Canada
| | - Reza Ojaghi
- Division of Orthopedics, Department of Surgery, University of Ottawa, 415-203 Catherin St, Ottawa, ON, K2P 1J5, Canada.
| | - Emmitt Hayes
- Division of Orthopedics, Department of Surgery, University of Ottawa, 415-203 Catherin St, Ottawa, ON, K2P 1J5, Canada
| | - Jason Khoury
- Division of Orthopedics, Department of Surgery, University of Ottawa, 415-203 Catherin St, Ottawa, ON, K2P 1J5, Canada
| | - J Pollock
- Division of Orthopedics, Department of Surgery, University of Ottawa, 415-203 Catherin St, Ottawa, ON, K2P 1J5, Canada
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Krane NA, Loyo M, Pollock J, Hill M, Johnson CZ, Stevens AA. Exploratory Study of the Brain Response in Facial Synkinesis after Bell Palsy with Systematic Review and Meta-analysis of the Literature. AJNR Am J Neuroradiol 2022; 43:1470-1475. [PMID: 36574328 PMCID: PMC9575525 DOI: 10.3174/ajnr.a7619] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Accepted: 06/28/2022] [Indexed: 01/26/2023]
Abstract
BACKGROUND Facial synkinesis, characterized by unintentional facial movements paired with intentional movements, is a debilitating sequela of Bell palsy. PURPOSE Our aim was to determine whether persistent peripheral nerve changes arising from Bell palsy result in persistent altered brain function in motor pathways in synkinesis. DATA SOURCES A literature search using terms related to facial paralysis, Bell palsy, synkinesis, and fMRI through May 2021 was conducted in MEDLINE and EMBASE. Additionally, an fMRI study examined lip and eyeblink movements in 2 groups: individuals who fully recovered following Bell palsy and individuals who developed synkinesis. STUDY SELECTION Task-based data of the whole brain that required lip movements in healthy controls were extracted from 7 publications. Three studies contributed similar whole-brain analyses in acute Bell palsy. DATA ANALYSIS The meta-analysis of fMRI in healthy control and Bell palsy groups determined common clusters of activation within each group using activation likelihood estimates. A separate fMRI study used multivariate general linear modeling to identify changes associated with synkinesis in smiling and blinking tasks. DATA SYNTHESIS A region of the precentral gyrus contralateral to the paretic side of the face was hypoactive in synkinesis during lip movements compared with controls. This region was centered in a cluster of activation identified in the meta-analysis of the healthy controls but absent from individuals with Bell palsy. LIMITATIONS The meta-analysis relied on a small set of studies. The small sample of subjects with synkinesis limited the power of the fMRI analysis. CONCLUSIONS Premotor pathways show persistent functional changes in synkinesis first identifiable in acute Bell palsy.
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Affiliation(s)
- N A Krane
- From the Division of Facial Plastic and Reconstructive Surgery (N.A.K., M.L., C.Z.J.), Department of Otolaryngology-Head and Neck Surgery
| | - M Loyo
- From the Division of Facial Plastic and Reconstructive Surgery (N.A.K., M.L., C.Z.J.), Department of Otolaryngology-Head and Neck Surgery
| | - J Pollock
- Division of Neuroradiology (J.P.), Department of Diagnostic Radiology
| | - M Hill
- Department of Otolaryngology-Head and Neck Surgery (M.H.), University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - C Z Johnson
- From the Division of Facial Plastic and Reconstructive Surgery (N.A.K., M.L., C.Z.J.), Department of Otolaryngology-Head and Neck Surgery
| | - A A Stevens
- Advanced Imaging Research Center (A.A.S.), Oregon Health & Science University, Portland, Oregon
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Anderson S, Pollock J, Hogan J, Hammond J, Jain V, Madura J. Is there strength in numbers? Current trends in U.S. general surgery practice consolidation. Am J Surg 2022; 223:481. [DOI: 10.1016/j.amjsurg.2022.02.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Thomas RJ, Whittaker J, Pollock J. Discerning a smile - The intricacies of analysis of post-neck dissection asymmetry. Am J Otolaryngol 2022; 43:103271. [PMID: 34800862 DOI: 10.1016/j.amjoto.2021.103271] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Accepted: 10/14/2021] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Iatrogenic facial nerve palsy is distressing to the patient and clinician. The deformity is aesthetically displeasing, and can be functionality problematic for oral competence, dental lip trauma and speech. Furthermore such injuries have litigation implications. Marginal mandibular nerve (MMN) palsy causes an obvious asymmetrical smile. MMN is at particular risk during procedures such as rhytidoplasties, mandibular fracture, tumour resection and neck dissections. Cited causes for the high incidence are large anatomical variations, unreliable landmarks, an exposed neural course and tumour grade or nodal involvement dictating requisite nerve sacrifice. An alternative cause for post-operative asymmetry is damage to the cervical branch of the facial nerve or platysmal dysfunction due to its division. The later tends to have a transient course and recovers. Distinction between MMN palsy and palsy of the cervical branch of the facial nerve or platysma division should therefore be made. In 1979 Ellenbogen differentiated between MMN palsy and "Pseudo-paralysis of the mandibular branch of the facial nerve". Despite this, there is paucity in the literature & confusion amongst clinicians in distinguishing between these palsies, and there is little regarding these post-operative sequelae and neck dissections. METHOD This article reflects on the surgical anatomy of the MMN and cervical nerve in relation to danger zones during lymphadenectomy. The authors review the anatomy of the smile. Finally, case studies are utilised to evaluate the differences between MMN palsy and its pseudo-palsy to allow clinical differentiation. CONCLUSION Here we present a simple method for clinical differentiation between these two prognostically different injuries, allowing appropriate reassurance, ongoing therapy & management.
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Affiliation(s)
- R J Thomas
- Charing Cross Hospital, Imperial College Healthcare NHS Trust, United Kingdom of Great Britain and Northern Ireland.
| | | | - J Pollock
- Nottingham City Hospital, Hucknall Road, Nottingham NG5 1PB, United Kingdom of Great Britain and Northern Ireland.
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Sierra A, Bollig T, Pollock J, Lindor R, Joseph A. 370 Trends in Emergency Department Patients’ Payment Method by Ethnicity from 2014-2018. Ann Emerg Med 2021. [DOI: 10.1016/j.annemergmed.2021.09.385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Buzzell N, Blash S, Miner K, Pollock J, Hawkins N, Gavin W. 128 Comparison of multiple maturation times on juvenile invitro embryo transfer (JIVET)-derived oocytes and embryo development in the goat. Reprod Fertil Dev 2021. [DOI: 10.1071/rdv33n2ab128] [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] [Indexed: 11/23/2022] Open
Abstract
Juvenile invitro embryo transfer (JIVET) is an assisted reproductive technology (ART) with the potential to produce numerous offspring from a single young female goat at 4 to 8 weeks of age. It has been reported in small ruminants that there can be a marked variable response to the administration of exogenous hormones for superovulation, the subsequent number of oocytes generated, and subsequent embryo developmental potential. The industry standard (as well as the recommendation of commercial media suppliers) invitro maturation time is 21 to 24h for conventionally derived oocytes. This study investigated multiple maturation times for JIVET-derived oocytes: 16, 22, and 28h. Oocytes were collected from four JIVET animals at 6 to 8 weeks of age. The hormonal superovulation regimen used on the juvenile animals consisted of 4×40-mg FSH injections at ∼12h apart and a 400IU of PMSG injection given with the first FSH injection. Surgical recovery of the oocytes via a midline laparotomy was performed the day following the last FSH injection. All of the oocytes were collected via aspirating follicles that were 4mm and larger. Oocytes with compact cumulus cells subsequently underwent IVM, IVF, and invitro culture (IVC) utilising IVF Bioscience media and methods. A single straw of identical cryopreserved/thawed semen from the same buck was utilised for each of the IVF procedures. The results were (37/88) 42%, (37/85) 44%, and (39/91) 43% cleaved and (23/88) 26%, (24/85) 28%, and (28/91) 31% blastocyst rate based on respective maturation times for JIVET-derived ova. Development rate during the cleavage stage and blastocyst stage was analysed using a repeated-measures logistic regression model utilising generalized estimating equations (GEE), with maturation time as fixed effect and a compound symmetry within subject (juvenile goat) covariance structure. The main effect of maturation time on the odds of development during the cleavage stage (P=0.8727) and blastocyst stage (P=0.3857) was not significant. These results indicate that the time in maturation media does not have as profound an effect on development to blastocysts as a factor in the variability reported by other laboratories. The development rate of embryos from one juvenile goat produced very high blastocyst rates of (5/12) 42%, (11/12) 92%, and (11/15) 73%, respectively. Additional logistic regression analysis showed that the odds of development in this juvenile donor was significantly different compared with the other donors (pooled) during the cleavage stage at 16h (P=0.0083) and 28h (P=0.0021) maturation times. Likewise, the odds of development in this donor was significantly different than that of the other donors (pooled) during the blastocyst stage at 22h (P=0.0002) and 28h (P=0.0003) maturation times. This further indicates the wide variation of oocyte quality from JIVET-derived oocytes and indicates potential for higher development rates at 22 and 28h in this specific goat.
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Pollock J, Low AS, McHugh RE, Muwonge A, Stevens MP, Corbishley A, Gally DL. Alternatives to antibiotics in a One Health context and the role genomics can play in reducing antimicrobial use. Clin Microbiol Infect 2020; 26:1617-1621. [PMID: 32220638 DOI: 10.1016/j.cmi.2020.02.028] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Revised: 02/19/2020] [Accepted: 02/22/2020] [Indexed: 01/16/2023]
Abstract
BACKGROUND This review follows on from the International Conference on One Health Antimicrobial Resistance (ICOHAR 2019), where strategies to improve the fundamental understanding and management of antimicrobial resistance at the interface between humans, animals and the environment were discussed. OBJECTIVE This review identifies alternatives to antimicrobials in a One Health context, noting how advances in genomic technologies are assisting their development and enabling more targeted use of antimicrobials. SOURCES Key articles on the use of microbiota modulation, livestock breeding and gene editing, vaccination, antivirulence strategies and bacteriophage therapy are discussed. CONTENT Antimicrobials are central for disease control, but reducing their use is paramount as a result of the rise of transmissible antimicrobial resistance. This review discusses antimicrobial alternatives in the context of improved understanding of fundamental host-pathogen and microbiota interactions using genomic tools. IMPLICATIONS Host and microbial genomics and other novel technologies play an important role in devising disease control strategies for healthier animals and humans that in turn reduce our reliance on antimicrobials.
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Affiliation(s)
- J Pollock
- The Roslin Institute and Royal (Dick) School of Veterinary Studies, Edinburgh, UK
| | - A S Low
- The Roslin Institute and Royal (Dick) School of Veterinary Studies, Edinburgh, UK
| | - R E McHugh
- Institute of Infection, Immunity & Inflammation, University of Glasgow, Glasgow, Scotland, UK; Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, Glasgow, Scotland, UK
| | - A Muwonge
- The Roslin Institute and Royal (Dick) School of Veterinary Studies, Edinburgh, UK
| | - M P Stevens
- The Roslin Institute and Royal (Dick) School of Veterinary Studies, Edinburgh, UK
| | - A Corbishley
- The Roslin Institute and Royal (Dick) School of Veterinary Studies, Edinburgh, UK
| | - D L Gally
- The Roslin Institute and Royal (Dick) School of Veterinary Studies, Edinburgh, UK.
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Buzzell N, Blash S, Miner K, Schofield M, Pollock J, Hawkins N, Hevy M, Gavin W. 154 A method of oviductal semen deposition for use in the goat. Reprod Fertil Dev 2020. [DOI: 10.1071/rdv32n2ab154] [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] [Indexed: 11/23/2022] Open
Abstract
The objective of this study was to investigate a method of oviducal semen deposition as a strategy for producing offspring from poor-quality cryopreserved goat sperm. Invitro fertilisation (IVF) and AI are common assisted reproductive technologies used in small ruminants, but they have varied results in the goat. The use of poor-quality cryopreserved-thawed sperm (<50% live/dead ratio at post-thaw) can decrease the rate of success. These procedures were performed in the month of November in Central Massachusetts in the United States (42° N). Seven 10-year-old dairy goats (Saanen, Toggenburg, and Alpine breeds) were synchronised and superovulated using a progesterone implant on Day 0, a prostaglandin injection at Day 7, two daily injections of 36mg of FSH ~12h apart on Days 12-15, and progesterone implant removal on Day 14 followed by an injection of 50µg of gonadotrophin-releasing hormone. Sperm deposition was performed on Day 17 (72 h after implant removal). The animals were anaesthetised using a standardised protocol, intubated, and maintained using isoflurane, and sterile prep was performed before a midline laparotomy procedure. Straws from a single ejaculate from a transgenic founder that was cryopreserved using a commercial two-step glycerol-egg yolk-based extender were used. A straw from this collection was post-thawed 30 days after collection and, using a commercial live/dead stain, 67% live sperm was determined. The optimal type of sperm prep and sperm concentration is unknown and may be dependent on sperm quality. Therefore, different gradient preps using Vitrolife SpermGrad at three volumes (1.5 (used on two animals), 1.0, and 0.5mL) as well as two volumes of IVF Bioscience Bovine BO-SemenPrep (4.0mL (used on two animals) and 2.0mL) were used. All five pellets were diluted in 1.0mL of IVF Bioscience Bovine BO-IVF media. Sperm concentrations ranging from 75×106 to 27×106 spermmL−1 were deposited into one oviduct; then, a 10:1 dilution was performed and 7.5×106 to 2.7×10 spermmL−1 were deposited into the contralateral oviduct. The depositions were performed just proximal to the uterotubal junction in a volume of 0.1mL of diluent via a tuberculin syringe attached to a 20-gauge needle. Two days following the procedure, oviducts were flushed postmortem from three of the seven randomly selected goats. All three had fertilised embryos, and nineteen 8-cell embryos were retrieved. Three of these embryos were surgically transferred to the distal uterine horn of a suitable recipient. The recipient became pregnant and produced a single offspring. The remaining four of seven goats were killed 41 days post-surgery. Two of the four goats were pregnant, with one carrying one fetus and the other carrying five fetuses. Further studies are needed to optimise this method, but these initial results indicate that oviducal semen deposition directly into the oviduct proximal to the uterotubal junction may be a suitable alternative for producing offspring from suboptimal cryopreserved-thawed goat sperm.
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Buzzell N, Blash S, Miner K, Schofield M, Pollock J, Hawkins N, Hevy M, Gavin W. 194 Superovulation response does not affect embryo development of pronuclear microinjected embryos in the goat. Reprod Fertil Dev 2019. [DOI: 10.1071/rdv31n1ab194] [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] [Indexed: 11/23/2022] Open
Abstract
Superovulation of donor animals is essential in the production of transgenic founder goats generated through microinjection. There can be a marked variable response to the exogenous hormones used for superovulation. The objective of this study was to examine how the superovulatory response of individual goats affected the ability of the fertilized, microinjected embryos to develop into offspring. The donors were superovulated using a progesterone implant on Day 0, a prostaglandin injection at Day 7, 2 injections ~12h apart of 32 to 36mg of FSH on Day 12 to 15, progesterone implant removal on Day 14, bred by intact bucks several times starting on Day 15 to 16, an injection of 50μg of gonadotropin-releasing hormone, and surgical collection of 1- to 2-cell embryos from retrograde flushing of the oviduct on Day 17 (~24-48 h, 1-2 days after breeding). Surgical collection allows for an accurate ovulation point (OP) count before the oviduct being retrograde flushed and ova collected and counted. Data from donor animals were grouped by superovulatory response based on OP counts of 1-10, 11-20, 21-30, or >30. The number of donors that contributed per group were 130, 280, 175, and 52, respectively. The recovery rate was 76, 72, 68, and 62%, respectively. After collection, ova were viewed under a dissecting microscope and assessed for fertilization by identifying pronuclei, and 1 pronucleus was microinjected. The fertilization rate was 47, 52, 51, and 56%, respectively. The survivability rate after microinjection was 80, 76, 75, and 76%, respectively. Surviving embryos were transferred (3-5) into recipient goats following a 2- to 6-h in vitro culture (as 1- to 2-cell embryos), allowing for a suitable period to assess viability post-injection. Further in vitro development rates were not assessed because of the short timeframe the embryos stayed in culture. The conception rates were 71, 56, 65, and 53%, respectively, and abortion rates were 23, 10, 14, and 9%, respectively. As some recipients received embryos from multiple donors, this data could not be included in the analysis as identifying which offspring were from the corresponding embryo group could not be confirmed. Data were analysed using SAS software (version 9.4, SAS Institute Inc., Cary, NC, USA). The Wald chi square test under linear regression was used to analyse the number of offspring produced per embryo transferred. No significant differences were found between groups (all P-values were>0.05). This analysis indicated that the range of superovulation response does not affect the developmental competence of the pronuclear microinjected embryo or the ability to produce viable offspring.
Table 1.Comparison of the donor ovulation counts, number of embryos transferred, offspring produced and overall efficiency
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Buzzell N, Blash S, Miner K, Schofield M, Pollock J, Hawkins N, Hevy M, Gavin W. 94 Impact of number of embryos transferred on the number of offspring produced in a commercial transgenic founder production operation. Reprod Fertil Dev 2019. [DOI: 10.1071/rdv31n1ab94] [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] [Indexed: 11/23/2022] Open
Abstract
The production of transgenic founder dairy goats (cross-bred Saanens, Alpines, Toggenburgs, and Nubians) involves the collection, microinjection, and transfer of numerous embryos into suitable recipient goats to ultimately produce a transgenic founder(s). The objective of this study was to determine the most efficient number of microinjection embryos to transfer to suitable recipients for transgenic founder generation. This is critically important in a commercial production program, as it impacts the goal for the number of embryos collected from donors, number of recipients utilised, and, hence, the overall number of surgical procedures being performed. The entire embryo collection, transfer, and founder-generation process is continuously being evaluated for ways to become more efficient in producing transgenic animals. During LFB USA’s commercial founder-production campaigns over the years (1997-2017), pronuclear microinjection was performed and 3, 4, or 5 embryos were transferred to female goat recipients. The recipients were synchronized using a progesterone implant on Day 0, a prostaglandin injection at Day 7, an injection of 300-500IU of pregnant mare serum gonadotropin on Day 13, progesterone implant removal on Day 14, and surgical transfer of pronuclear microinjected 1- or 2-cell embryos into the oviduct on Day 17. The individual totals and calculation for offspring per embryos transferred was compared for 3, 4, and 5 embryos transferred per recipient and was determined to be (1659/8637) 0.19, (912/4548) 0.20, and (112/675) 0.17, respectively. These embryo efficacy ratios were not significantly different (P>0.05) using the Wald Chi-squared test under logistic regression, and suggests that the number of offspring born is not impacted by number of embryos transferred. Seasonality was also evaluated in this production environment located in North America, with in-season being considered September to December and out-of-season being January to July. Nulliparous recipients during in-season (September to December) embryo transfer operations produced a significant difference, with totals and calculation for (offspring per embryo transferred) of (470/2346) 0.20, (260/1088) 0.24, and (23/190) 0.12 for 3, 4, and 5 embryo transfers, respectively (Table 1). This data indicates that when using nulliparous recipients during the in-season, transferring 4 embryos is optimal for offspring produced.
Table 1.Comparison of the individual totals and the calculation of (offspring/embryo) by parity and season
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Howard L, Berdusco R, Momoli F, Pollock J, Liew A, Papp S, Lalonde KA, Gofton W, Ruggiero S, Lapner P. Open reduction internal fixation vs non-operative management in proximal humerus fractures: a prospective, randomized controlled trial protocol. BMC Musculoskelet Disord 2018; 19:299. [PMID: 30121091 PMCID: PMC6098830 DOI: 10.1186/s12891-018-2223-3] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2018] [Accepted: 08/03/2018] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Proximal humerus fractures are the third most common fracture in the elderly population and are expected to increase due to the aging population. Surgical fixation with locking plate technology has increased over the last decade despite a lack of proven superiority in the literature. Three previous randomized controlled trials have not shown a difference in patient-centered outcomes when comparing non-operative treatment with open reduction and internal fixation. Low patient enrollment and other methodological concerns however limit the generalizability of these conclusions and as a result, management of these fractures remains a controversy. By comparing the functional outcomes of locked plate surgical fixation versus non-operative treatment of displaced three and four-part proximal humerus fractures in the elderly population with a large scale, prospective, multi-centered randomized controlled trial, the optimal management strategy for this common injury may be determined. METHODS We will conduct a prospective, single blind randomized controlled parallel arm trial to compare non-operative management of proximal humerus fractures with open reduction and internal fixation using locked plating technology. One-hundred and sixty patients > age 60 with acute 3- or 4- part proximal humerus fractures will be randomized to either open reduction and internal fixation with locked plating technology or non-operative management treatment arms. The primary outcome measure is the Constant Score at 24 months post-operative. Secondary outcome measures include the American Shoulder and Elbow Surgeon's Score (ASES), EuroQol EQ-5D-5 L Health Questionnaire Score, short form PROMIS upper extremity score and IPAQ for the elderly score. Further outcome measures include assessment of the initial classification, displacement and angulation and the quality of surgical reduction via a standard computed tomography (CT) scan; rates of non-union, malunion, arthrosis, osteopenia or other complications including infection, nerve injury, intra-articular screw penetration, reoperation rates and hospital re-admission rates. DISCUSSION The results of this trial will provide Level 1 evidence to guide decision-making in the treatment of proximal humerus fractures in the elderly population. TRIAL REGISTRATION ClinicalTrials.gov NCT02362100 . Registered 5 Feb 2015.
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Affiliation(s)
- Lisa Howard
- Division of Orthopaedic Surgery, Ottawa Hospital Research Institute, University of Ottawa, Ottawa, ON Canada
| | - Randa Berdusco
- Orthopaedic Sports Medicine & Upper Extremity Reconstruction, Fellowship, University of Manitoba, Winnipeg, MB Canada
| | - Franco Momoli
- Ottawa Hospital Research Institute, Ottawa, Canada
- School of Epidemiology, Public Health, and Preventive Medicine, University of Ottawa, Ottawa, Canada
- Children’s Hospital of Eastern Ontario Research Institute, Ottawa, Canada
| | - J. Pollock
- Division of Orthopaedic Surgery, Ottawa Hospital Research Institute, University of Ottawa, Ottawa, ON Canada
| | - Allan Liew
- Division of Orthopaedic Surgery, Ottawa Hospital Research Institute, University of Ottawa, Ottawa, ON Canada
| | - Steve Papp
- Division of Orthopaedic Surgery, Ottawa Hospital Research Institute, University of Ottawa, Ottawa, ON Canada
| | - Karl-Andre Lalonde
- Division of Orthopaedic Surgery, Ottawa Hospital Research Institute, University of Ottawa, Ottawa, ON Canada
| | - Wade Gofton
- Division of Orthopaedic Surgery, Ottawa Hospital Research Institute, University of Ottawa, Ottawa, ON Canada
| | - Sara Ruggiero
- Division of Orthopaedic Surgery, Ottawa Hospital Research Institute, University of Ottawa, Ottawa, ON Canada
| | - Peter Lapner
- Division of Orthopaedic Surgery, Ottawa Hospital Research Institute, University of Ottawa, Ottawa, ON Canada
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Kachnic L, Moughan J, Suntharalingam M, Ilson D, Konski A, Burrows W, Anker C, Ad VB, Thakrar H, Hayes J, Gore E, Kavadi V, Komaki R, Raben A, Giguere J, Pollock J, Greenberger J, Videtic G, Roof K, Watkins Bruner D. Patient-Reported Outcomes (PROs) in NRG Oncology/RTOG 0436: A Phase 3 Trial Evaluating the Addition of Cetuximab to Paclitaxel, Cisplatin, and Radiation for Esophageal Cancer Treated Without Surgery. Int J Radiat Oncol Biol Phys 2016. [DOI: 10.1016/j.ijrobp.2016.06.088] [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: 11/25/2022]
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Bonfield M, Cramp F, Pollock J. Deep vein thrombosis resolution, recurrence and post-thrombotic syndrome: a prospective observational study protocol. BMC Hematol 2016; 16:24. [PMID: 27651905 PMCID: PMC5025593 DOI: 10.1186/s12878-016-0063-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/08/2016] [Accepted: 09/05/2016] [Indexed: 11/12/2022]
Abstract
Background Reasons for the variation in response of deep vein thrombosis (DVT) to anticoagulation treatment are not known. Some patients develop complications such as post-thrombotic syndrome or recurrent DVT but others make a full recovery. The aim of the study is to identify the level of variation in response to anticoagulation treatment and provide more precise and quantitative disease characterisation in response to treatment. Methods A prospective observational study using duplex ultrasound to examine changes in thrombus characterisation, evolution and resolution over a 2 year period in patients with a confirmed DVT. Logistic regression analysis will be used to seek associations between characteristics present at baseline and the outcomes of DVT resolution, recurrence and the development of post-thrombotic syndrome (PTS). Discussion This research into the response to treatment of lower limb DVT and predictive factors for DVT resolution, recurrence and PTS could inform a more tailored approach to anticoagulation therapy for the future management of DVT. UKCRN ID: 16016. Registered on 20 January 2014.
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Affiliation(s)
- M Bonfield
- Vascular Studies Unit, University Hospitals Bristol NHS Foundation Trust, Bristol, UK ; University of the West of England, Bristol, UK
| | - F Cramp
- University of the West of England, Bristol, UK
| | - J Pollock
- University of the West of England, Bristol, UK
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Pollock J, Bedenice D, Jennings SH, Papich MG. Pharmacokinetics of an extended-release formulation of eprinomectin in healthy adult alpacas and its use in alpacas confirmed with mange. J Vet Pharmacol Ther 2016; 40:192-199. [DOI: 10.1111/jvp.12341] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2016] [Accepted: 05/27/2016] [Indexed: 11/26/2022]
Affiliation(s)
- J. Pollock
- Cummings School of Veterinary Medicine at Tufts Universtity; North Grafton MA USA
| | - D. Bedenice
- Cummings School of Veterinary Medicine at Tufts Universtity; North Grafton MA USA
| | - S. H. Jennings
- Cummings School of Veterinary Medicine at Tufts Universtity; North Grafton MA USA
| | - M. G. Papich
- Department of Molecular Biomedical Sciences; College of Veterinary Medicine; North Carolina State University; St Raleigh NC USA
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Halls S, Dures E, Kirwan J, Pollock J, Baker G, Edmunds A, Hewlett S. AB1128-HPR Developing A New Rheumatoid Arthritis (RA) Stiffness Patient Reported Outcome Measure (PROM). Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.3962] [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: 11/03/2022]
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Halls S, Dures E, Kirwan J, Pollock J, Baker G, Edmunds A, Hewlett S. AB1127-HPR Construct Validity Testing of Rast, A New RA Stiffness Patient Reported Outcome Measure (PROM). Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.3956] [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: 11/03/2022]
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Plummer Z, Almeida C, Ambler N, Blair P, Choy E, Dures E, Hammond A, Hollingworth W, Kirwan J, Pollock J, Rooke C, Thorn J, Tomkinson K, Hewlett S. AB1130-HPR Cognitive Therapy for Reducing The Impact of Rheumatoid Arthritis Fatigue: Sucessful Strategies for Meeting Targets in A Complex Health Care Intervention. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.1968] [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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Krommyda M, Pollock J, Misbahuddin A. Secondary normal pressure hydrocephalus post gamma knife radiosurgery for treatment of vestibular schwannoma. J Neurol Sci 2015. [DOI: 10.1016/j.jns.2015.08.978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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20
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Hewlett S, Ambler N, Almeida C, Blair PS, Choy E, Dures E, Hammond A, Hollingworth W, Kirwan J, Plummer Z, Rooke C, Thorn J, Tomkinson K, Pollock J. Protocol for a randomised controlled trial for Reducing Arthritis Fatigue by clinical Teams (RAFT) using cognitive-behavioural approaches. BMJ Open 2015; 5:e009061. [PMID: 26251413 PMCID: PMC4538284 DOI: 10.1136/bmjopen-2015-009061] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
INTRODUCTION Rheumatoid arthritis (RA) fatigue is distressing, leading to unmanageable physical and cognitive exhaustion impacting on health, leisure and work. Group cognitive-behavioural (CB) therapy delivered by a clinical psychologist demonstrated large improvements in fatigue impact. However, few rheumatology teams include a clinical psychologist, therefore, this study aims to examine whether conventional rheumatology teams can reproduce similar results, potentially widening intervention availability. METHODS AND ANALYSIS This is a multicentre, randomised, controlled trial of a group CB intervention for RA fatigue self-management, delivered by local rheumatology clinical teams. 7 centres will each recruit 4 consecutive cohorts of 10-16 patients with RA (fatigue severity ≥ 6/10). After consenting, patients will have baseline assessments, then usual care (fatigue self-management booklet, discussed for 5-6 min), then be randomised into control (no action) or intervention arms. The intervention, Reducing Arthritis Fatigue by clinical Teams (RAFT) will be cofacilitated by two local rheumatology clinicians (eg, nurse/occupational therapist), who will have had brief training in CB approaches, a RAFT manual and materials, and delivered an observed practice course. Groups of 5-8 patients will attend 6 × 2 h sessions (weeks 1-6) and a 1 hr consolidation session (week 14) addressing different self-management topics and behaviours. The primary outcome is fatigue impact (26 weeks); secondary outcomes are fatigue severity, coping and multidimensional impact, quality of life, clinical and mood status (to week 104). Statistical and health economic analyses will follow a predetermined plan to establish whether the intervention is clinically and cost-effective. Effects of teaching CB skills to clinicians will be evaluated qualitatively. ETHICS AND DISSEMINATION Approval was given by an NHS Research Ethics Committee, and participants will provide written informed consent. The copyrighted RAFT package will be freely available. Findings will be submitted to the National Institute for Health and Care Excellence, Clinical Commissioning Groups and all UK rheumatology departments. ISRCTN 52709998; Protocol v3 09.02.2015.
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Affiliation(s)
- S Hewlett
- Department of Nursing and Midwifery, University of the West of England Bristol, Bristol, UK
| | - N Ambler
- Pain Management Centre, Southmead Hospital, Bristol, UK
| | - C Almeida
- Department of Nursing and Midwifery, University of the West of England Bristol, Bristol, UK
| | - P S Blair
- School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - E Choy
- Section of Rheumatology, Institute of Infection and Immunity, Cardiff University, Cardiff, UK
| | - E Dures
- Department of Nursing and Midwifery, University of the West of England Bristol, Bristol, UK
| | - A Hammond
- Centre for Health Sciences Research, School of Health Sciences, University of Salford, Salford, UK
| | - W Hollingworth
- School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - J Kirwan
- Academic Rheumatology, School of Clinical Sciences, University of Bristol, Bristol, UK
| | - Z Plummer
- Department of Nursing and Midwifery, University of the West of England Bristol, Bristol, UK
| | - C Rooke
- Patient research partner, Academic Rheumatology, Bristol Royal Infirmary, Bristol, UK
| | - J Thorn
- School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - K Tomkinson
- School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - J Pollock
- Department of Health and Social Sciences, University of the West of England Bristol, Bristol, UK
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Wilson O, Briggs W, Hewlett S, Pollock J, Woodburn J, Quest E, Swales C, Kirwan J. OP0100-HPR Does Self-Report of Foot Problems Agree with Clinical Examination in People with Rheumatoid Arthritis? Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.1709] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [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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22
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Zipursky A, Pollock J, Yeow R, Israels LG, Chown B. The pathogenesis and prevention of Rh immunization in pregnancy. Bibl Haematol 2015; 29:280-3. [PMID: 4178385 DOI: 10.1159/000384619] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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23
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Xu X, Su S, Wang X, Barnes V, De Miguel C, Ownby D, Pollock J, Snieder H, Chen W, Wang X. Obesity is associated with more activated neutrophils in African American male youth. Int J Obes (Lond) 2014; 39:26-32. [PMID: 25388404 PMCID: PMC4286492 DOI: 10.1038/ijo.2014.194] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2014] [Revised: 09/30/2014] [Accepted: 10/13/2014] [Indexed: 12/14/2022]
Abstract
BACKGROUND There is emerging evidence suggesting the role of peripheral blood leukocytes in the pathogenesis of obesity and related diseases. However, few studies have taken a genome-wide approach to investigating gene expression profiles in peripheral leukocytes between obese and lean individuals with the consideration of obesity-related shifts in leukocyte types. METHOD We conducted this study in 95 African Americans (AAs) of both genders (age 14-20 years, 46 lean and 49 obese). Complete blood count with differential test (CBC) was performed in whole blood. Genome-wide gene expression analysis was obtained using the Illumina HumanHT-12 V4 Beadchip with RNA extracted from peripheral leukocytes. Out of the 95 participants, 64 had neutrophils stored. The validation study was based on real-time PCR with RNA extracted from purified neutrophils. RESULTS CBC test suggested that, in males, obesity was associated with increased neutrophil percentage (P=0.03). Genome-wide gene expression analysis showed that, in males, the majority of the most differentially expressed genes were related to neutrophil activation. Validation of the gene expression levels of ELANE (neutrophil elastase) and MPO (myeloperoxidase) in purified neutrophils demonstrated that the expression of these two genes--important biomarkers of neutrophils activation--were significantly elevated in obese males (P=0.01 and P=0.02, respectively). CONCLUSION The identification of increased neutrophil percentage and activation in obese AA males suggests that neutrophils have an essential role in the pathogenesis of obesity-related disease. Further functional and mechanistic studies on neutrophils may contribute to the development of novel intervention strategies reducing the burden associated with obesity-related health problems.
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Affiliation(s)
- X Xu
- Department of Pediatrics, Georgia Prevention Center, Institute of Public and Preventive Health, Georgia Regents University, Augusta, GA, USA
| | - S Su
- Department of Pediatrics, Georgia Prevention Center, Institute of Public and Preventive Health, Georgia Regents University, Augusta, GA, USA
| | - X Wang
- Department of Pediatrics, Georgia Prevention Center, Institute of Public and Preventive Health, Georgia Regents University, Augusta, GA, USA
| | - V Barnes
- Department of Pediatrics, Georgia Prevention Center, Institute of Public and Preventive Health, Georgia Regents University, Augusta, GA, USA
| | - C De Miguel
- Cardio-Rental Physiology and Medicine, Division of Nephrology, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - D Ownby
- Department of Experimental Medicine, Georgia Regents University, Augusta, GA, USA
| | - J Pollock
- Cardio-Rental Physiology and Medicine, Division of Nephrology, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - H Snieder
- Department of Epidemiology, University Medical Center Groningen, Groningen, The Netherlands
| | - W Chen
- Department of Physiology and Endocrinology, Georgia Regents University, Augusta, GA, USA
| | - X Wang
- Department of Pediatrics, Georgia Prevention Center, Institute of Public and Preventive Health, Georgia Regents University, Augusta, GA, USA
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Pollock J, Hassan A, Smith M. Periocular necrotising soft tissue infections-three cases of mistaken identity. Eye (Lond) 2014; 29:151. [PMID: 25341433 DOI: 10.1038/eye.2014.241] [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] Open
Affiliation(s)
- J Pollock
- Department of Plastic and Reconstructive Surgery, Leicester Royal Infirmary, Leicester, UK
| | - A Hassan
- Department of Plastic and Reconstructive Surgery, Leicester Royal Infirmary, Leicester, UK
| | - M Smith
- Department of Plastic and Reconstructive Surgery, Leicester Royal Infirmary, Leicester, UK
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Strasser J, Koprowski C, Kuske R, Lyden M, Attai D, Mahalingam S, Komarnicky L, Nigh S, Pollock J, Han B, Mantz C, Finkelstein S, Hong R, Yashar C. Outcomes for APBI With Strut-Based Brachytherapy: 596 Patients With 39-Month Median Follow-Up. Int J Radiat Oncol Biol Phys 2014. [DOI: 10.1016/j.ijrobp.2014.05.931] [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: 10/24/2022]
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26
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Yashar C, Scanderbeg D, Quiet C, Snyder M, Lyden M, Attai D, Komarnicky L, Reiff J, Nigh S, Pollock J, Butler E, Han B, Mantz C, Finkelstein S, Hong R, Kuske R. Outcomes for APBI With Strut-Based Brachytherapy: First 200 Accrued Patients (52-Month Median Follow-Up). Int J Radiat Oncol Biol Phys 2014. [DOI: 10.1016/j.ijrobp.2014.05.926] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [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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27
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Ilson D, Winter K, Suntharalingham M, Dicker A, Kachnic L, Konski A, Chakravarthy A, Anker C, Thakrar H, Horiba N, Kavadi V, Giguere J, Deutsch M, Raben A, Roof K, Videtic G, Pollock J, Safran H, Crane C. Rtog 0436: A Phase III Trial of Cisplatin, Paclitaxel and Radiation with or Without Cetuximab in the Nonoperative Treatment of Esophageal Cancer. Ann Oncol 2014. [DOI: 10.1093/annonc/mdu193.5] [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: 11/13/2022] Open
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Yashar C, Butler E, Einck JP, Finkelstein SE, Graves YJ, Han B, Hong RL, Komarnicky LT, Lyden M, Mahalingam SB, Mantz CA, Nasr N, Nigh SS, Pollock J, Reiff JE, Scanderbeg D, Snyder MR, Strasser JF, Kuske RR. Abstract P5-14-06: Outcomes in 500 patients from a large, retrospective study of APBI with a strut-based breast brachytherapy applicator. Cancer Res 2013. [DOI: 10.1158/0008-5472.sabcs13-p5-14-06] [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: 11/16/2022]
Abstract
Abstract
Purpose/Objectives:
The SAVI Collaborative Research Group (SCRG) is a coalition of 14 institutions who have retrospectively compiled a large database of APBI patients treated with a strut-based brachytherapy device (SAVI). This report details the findings of statistical correlations between numerous dosimetric variables and cosmetic outcome.
Materials/Methods:
The SCRG study enrolled 1005 patients. A subset of patients with complete dosimetry and more than 1 year of follow-up by a radiation oncologist were analyzed for toxicity, cosmesis and recurrence/survival. Dosimetric parameters were tabulated for patients, including: V90, V95, V100, V150, V200, skin spacing (skin-bridge), maximum skin dose, tumor size, PTV-Eval volume and applicator size (model). Toxicity (e.g., telangiectasia, fibrosis, fat necrosis, seroma) were graded by physicians for patients with at least 1 year of follow-up (up to 6 years) using the CTCAE v3 Scale and fat necrosis using a simplified CTCAE scale (Grade 1 asymptomatic but seen on imaging, grade 2 symptomatic without intervention, & grade 3 required intervention).
Results:
Median follow up in this cohort was 29.2 months (range 2.4 to 72.2 months). Follow up was >2 yr and >3 yr for 323 and 191 subjects, respectively. Overall, in 500 subjects the late toxicity (grade ≥2) rates were less than 5% during follow up: telangiectasia 1.0%, fibrosis 4.1%, seroma 2.9% and fat necrosis 0.6%. Cosmesis was reported at various post-APBI follow-up visits following treatment completion (6, 12, 24, 36, 48 & 60+ months). For the 6 and 12 month intervals, 98% (n = 122) and 97% (n = 262) were reported excellent or good (E/G), respectively. At 24, 36, 48 and 60 month intervals, the E/G rates were 93% (n = 184), 90% (n = 98), 100% (n = 41) and 94% (n = 15), respectively. The raw rates of ipsilateral breast tumor recurrence (IBTR) and TR/MM were 1.6% (n = 8) and 1.2% (n = 6), respectively, in 500 patients with >1 year of follow up. The 1- and 2-year actuarial rates of overall survival and disease-free survival were: 1-year, 99.6% & 99.4%, resp. and 2-year, 99.2% & 96.7%.
Conclusions:
APBI treatment with the strut-based applicators was well-tolerated, demonstrated low toxicity rates, favorable cosmetic outcomes and excellent local control over the follow-up to date. Patients with challenging breast anatomy were successfully treated with strut-based devices.
Citation Information: Cancer Res 2013;73(24 Suppl): Abstract nr P5-14-06.
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Affiliation(s)
- C Yashar
- University of California San Diego, La Jolla, CA; Schiffler Cancer Center, Wheeling, WV; 21st Century Oncology Translational Research Center (TRC), Scottsdale, AZ; South Florida Radiation Oncology, Boynton Beach, FL; Virginia Hospital Center, Arlington, VA; Drexel University College of Medicine, Philadelphia, PA; BioStat International, Inc., Tampa, FL; The Christ Hospital Cancer Center, Cincinnati, OH; 21st Century Oncology, Fort Myers, FL; Northwest Community Hospital, Arlington Heights, IL; Christiana Care Health System, Newark, DE; Arizona Breast Cancer Specialists, Phoenix, AZ
| | - E Butler
- University of California San Diego, La Jolla, CA; Schiffler Cancer Center, Wheeling, WV; 21st Century Oncology Translational Research Center (TRC), Scottsdale, AZ; South Florida Radiation Oncology, Boynton Beach, FL; Virginia Hospital Center, Arlington, VA; Drexel University College of Medicine, Philadelphia, PA; BioStat International, Inc., Tampa, FL; The Christ Hospital Cancer Center, Cincinnati, OH; 21st Century Oncology, Fort Myers, FL; Northwest Community Hospital, Arlington Heights, IL; Christiana Care Health System, Newark, DE; Arizona Breast Cancer Specialists, Phoenix, AZ
| | - JP Einck
- University of California San Diego, La Jolla, CA; Schiffler Cancer Center, Wheeling, WV; 21st Century Oncology Translational Research Center (TRC), Scottsdale, AZ; South Florida Radiation Oncology, Boynton Beach, FL; Virginia Hospital Center, Arlington, VA; Drexel University College of Medicine, Philadelphia, PA; BioStat International, Inc., Tampa, FL; The Christ Hospital Cancer Center, Cincinnati, OH; 21st Century Oncology, Fort Myers, FL; Northwest Community Hospital, Arlington Heights, IL; Christiana Care Health System, Newark, DE; Arizona Breast Cancer Specialists, Phoenix, AZ
| | - SE Finkelstein
- University of California San Diego, La Jolla, CA; Schiffler Cancer Center, Wheeling, WV; 21st Century Oncology Translational Research Center (TRC), Scottsdale, AZ; South Florida Radiation Oncology, Boynton Beach, FL; Virginia Hospital Center, Arlington, VA; Drexel University College of Medicine, Philadelphia, PA; BioStat International, Inc., Tampa, FL; The Christ Hospital Cancer Center, Cincinnati, OH; 21st Century Oncology, Fort Myers, FL; Northwest Community Hospital, Arlington Heights, IL; Christiana Care Health System, Newark, DE; Arizona Breast Cancer Specialists, Phoenix, AZ
| | - YJ Graves
- University of California San Diego, La Jolla, CA; Schiffler Cancer Center, Wheeling, WV; 21st Century Oncology Translational Research Center (TRC), Scottsdale, AZ; South Florida Radiation Oncology, Boynton Beach, FL; Virginia Hospital Center, Arlington, VA; Drexel University College of Medicine, Philadelphia, PA; BioStat International, Inc., Tampa, FL; The Christ Hospital Cancer Center, Cincinnati, OH; 21st Century Oncology, Fort Myers, FL; Northwest Community Hospital, Arlington Heights, IL; Christiana Care Health System, Newark, DE; Arizona Breast Cancer Specialists, Phoenix, AZ
| | - B Han
- University of California San Diego, La Jolla, CA; Schiffler Cancer Center, Wheeling, WV; 21st Century Oncology Translational Research Center (TRC), Scottsdale, AZ; South Florida Radiation Oncology, Boynton Beach, FL; Virginia Hospital Center, Arlington, VA; Drexel University College of Medicine, Philadelphia, PA; BioStat International, Inc., Tampa, FL; The Christ Hospital Cancer Center, Cincinnati, OH; 21st Century Oncology, Fort Myers, FL; Northwest Community Hospital, Arlington Heights, IL; Christiana Care Health System, Newark, DE; Arizona Breast Cancer Specialists, Phoenix, AZ
| | - RL Hong
- University of California San Diego, La Jolla, CA; Schiffler Cancer Center, Wheeling, WV; 21st Century Oncology Translational Research Center (TRC), Scottsdale, AZ; South Florida Radiation Oncology, Boynton Beach, FL; Virginia Hospital Center, Arlington, VA; Drexel University College of Medicine, Philadelphia, PA; BioStat International, Inc., Tampa, FL; The Christ Hospital Cancer Center, Cincinnati, OH; 21st Century Oncology, Fort Myers, FL; Northwest Community Hospital, Arlington Heights, IL; Christiana Care Health System, Newark, DE; Arizona Breast Cancer Specialists, Phoenix, AZ
| | - LT Komarnicky
- University of California San Diego, La Jolla, CA; Schiffler Cancer Center, Wheeling, WV; 21st Century Oncology Translational Research Center (TRC), Scottsdale, AZ; South Florida Radiation Oncology, Boynton Beach, FL; Virginia Hospital Center, Arlington, VA; Drexel University College of Medicine, Philadelphia, PA; BioStat International, Inc., Tampa, FL; The Christ Hospital Cancer Center, Cincinnati, OH; 21st Century Oncology, Fort Myers, FL; Northwest Community Hospital, Arlington Heights, IL; Christiana Care Health System, Newark, DE; Arizona Breast Cancer Specialists, Phoenix, AZ
| | - M Lyden
- University of California San Diego, La Jolla, CA; Schiffler Cancer Center, Wheeling, WV; 21st Century Oncology Translational Research Center (TRC), Scottsdale, AZ; South Florida Radiation Oncology, Boynton Beach, FL; Virginia Hospital Center, Arlington, VA; Drexel University College of Medicine, Philadelphia, PA; BioStat International, Inc., Tampa, FL; The Christ Hospital Cancer Center, Cincinnati, OH; 21st Century Oncology, Fort Myers, FL; Northwest Community Hospital, Arlington Heights, IL; Christiana Care Health System, Newark, DE; Arizona Breast Cancer Specialists, Phoenix, AZ
| | - SB Mahalingam
- University of California San Diego, La Jolla, CA; Schiffler Cancer Center, Wheeling, WV; 21st Century Oncology Translational Research Center (TRC), Scottsdale, AZ; South Florida Radiation Oncology, Boynton Beach, FL; Virginia Hospital Center, Arlington, VA; Drexel University College of Medicine, Philadelphia, PA; BioStat International, Inc., Tampa, FL; The Christ Hospital Cancer Center, Cincinnati, OH; 21st Century Oncology, Fort Myers, FL; Northwest Community Hospital, Arlington Heights, IL; Christiana Care Health System, Newark, DE; Arizona Breast Cancer Specialists, Phoenix, AZ
| | - CA Mantz
- University of California San Diego, La Jolla, CA; Schiffler Cancer Center, Wheeling, WV; 21st Century Oncology Translational Research Center (TRC), Scottsdale, AZ; South Florida Radiation Oncology, Boynton Beach, FL; Virginia Hospital Center, Arlington, VA; Drexel University College of Medicine, Philadelphia, PA; BioStat International, Inc., Tampa, FL; The Christ Hospital Cancer Center, Cincinnati, OH; 21st Century Oncology, Fort Myers, FL; Northwest Community Hospital, Arlington Heights, IL; Christiana Care Health System, Newark, DE; Arizona Breast Cancer Specialists, Phoenix, AZ
| | - N Nasr
- University of California San Diego, La Jolla, CA; Schiffler Cancer Center, Wheeling, WV; 21st Century Oncology Translational Research Center (TRC), Scottsdale, AZ; South Florida Radiation Oncology, Boynton Beach, FL; Virginia Hospital Center, Arlington, VA; Drexel University College of Medicine, Philadelphia, PA; BioStat International, Inc., Tampa, FL; The Christ Hospital Cancer Center, Cincinnati, OH; 21st Century Oncology, Fort Myers, FL; Northwest Community Hospital, Arlington Heights, IL; Christiana Care Health System, Newark, DE; Arizona Breast Cancer Specialists, Phoenix, AZ
| | - SS Nigh
- University of California San Diego, La Jolla, CA; Schiffler Cancer Center, Wheeling, WV; 21st Century Oncology Translational Research Center (TRC), Scottsdale, AZ; South Florida Radiation Oncology, Boynton Beach, FL; Virginia Hospital Center, Arlington, VA; Drexel University College of Medicine, Philadelphia, PA; BioStat International, Inc., Tampa, FL; The Christ Hospital Cancer Center, Cincinnati, OH; 21st Century Oncology, Fort Myers, FL; Northwest Community Hospital, Arlington Heights, IL; Christiana Care Health System, Newark, DE; Arizona Breast Cancer Specialists, Phoenix, AZ
| | - J Pollock
- University of California San Diego, La Jolla, CA; Schiffler Cancer Center, Wheeling, WV; 21st Century Oncology Translational Research Center (TRC), Scottsdale, AZ; South Florida Radiation Oncology, Boynton Beach, FL; Virginia Hospital Center, Arlington, VA; Drexel University College of Medicine, Philadelphia, PA; BioStat International, Inc., Tampa, FL; The Christ Hospital Cancer Center, Cincinnati, OH; 21st Century Oncology, Fort Myers, FL; Northwest Community Hospital, Arlington Heights, IL; Christiana Care Health System, Newark, DE; Arizona Breast Cancer Specialists, Phoenix, AZ
| | - JE Reiff
- University of California San Diego, La Jolla, CA; Schiffler Cancer Center, Wheeling, WV; 21st Century Oncology Translational Research Center (TRC), Scottsdale, AZ; South Florida Radiation Oncology, Boynton Beach, FL; Virginia Hospital Center, Arlington, VA; Drexel University College of Medicine, Philadelphia, PA; BioStat International, Inc., Tampa, FL; The Christ Hospital Cancer Center, Cincinnati, OH; 21st Century Oncology, Fort Myers, FL; Northwest Community Hospital, Arlington Heights, IL; Christiana Care Health System, Newark, DE; Arizona Breast Cancer Specialists, Phoenix, AZ
| | - D Scanderbeg
- University of California San Diego, La Jolla, CA; Schiffler Cancer Center, Wheeling, WV; 21st Century Oncology Translational Research Center (TRC), Scottsdale, AZ; South Florida Radiation Oncology, Boynton Beach, FL; Virginia Hospital Center, Arlington, VA; Drexel University College of Medicine, Philadelphia, PA; BioStat International, Inc., Tampa, FL; The Christ Hospital Cancer Center, Cincinnati, OH; 21st Century Oncology, Fort Myers, FL; Northwest Community Hospital, Arlington Heights, IL; Christiana Care Health System, Newark, DE; Arizona Breast Cancer Specialists, Phoenix, AZ
| | - MR Snyder
- University of California San Diego, La Jolla, CA; Schiffler Cancer Center, Wheeling, WV; 21st Century Oncology Translational Research Center (TRC), Scottsdale, AZ; South Florida Radiation Oncology, Boynton Beach, FL; Virginia Hospital Center, Arlington, VA; Drexel University College of Medicine, Philadelphia, PA; BioStat International, Inc., Tampa, FL; The Christ Hospital Cancer Center, Cincinnati, OH; 21st Century Oncology, Fort Myers, FL; Northwest Community Hospital, Arlington Heights, IL; Christiana Care Health System, Newark, DE; Arizona Breast Cancer Specialists, Phoenix, AZ
| | - JF Strasser
- University of California San Diego, La Jolla, CA; Schiffler Cancer Center, Wheeling, WV; 21st Century Oncology Translational Research Center (TRC), Scottsdale, AZ; South Florida Radiation Oncology, Boynton Beach, FL; Virginia Hospital Center, Arlington, VA; Drexel University College of Medicine, Philadelphia, PA; BioStat International, Inc., Tampa, FL; The Christ Hospital Cancer Center, Cincinnati, OH; 21st Century Oncology, Fort Myers, FL; Northwest Community Hospital, Arlington Heights, IL; Christiana Care Health System, Newark, DE; Arizona Breast Cancer Specialists, Phoenix, AZ
| | - RR Kuske
- University of California San Diego, La Jolla, CA; Schiffler Cancer Center, Wheeling, WV; 21st Century Oncology Translational Research Center (TRC), Scottsdale, AZ; South Florida Radiation Oncology, Boynton Beach, FL; Virginia Hospital Center, Arlington, VA; Drexel University College of Medicine, Philadelphia, PA; BioStat International, Inc., Tampa, FL; The Christ Hospital Cancer Center, Cincinnati, OH; 21st Century Oncology, Fort Myers, FL; Northwest Community Hospital, Arlington Heights, IL; Christiana Care Health System, Newark, DE; Arizona Breast Cancer Specialists, Phoenix, AZ
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Flurey CA, Morris M, Pollock J, Hughes R, Richards P, Hewlett S. AB0825-HPR “It’s like a juggling act“: ra patients experience a life of ‘fluctuating balances’. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2013-eular.3147] [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: 11/03/2022]
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Flurey C, Morris M, Pollock J, Hughes R, Richards P, Hewlett S. THU0470-HPR Will i waste your time? Delays in help-seeking for RA flares. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2012-eular.2435] [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: 11/03/2022]
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Flurey CA, Morris M, Pollock J, Hughes R, Richards P, Hewlett S. THU0579 Rheumatoid Arthritis Flares: Inflammatory or Avalanche? Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2013-eular.1107] [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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Flurey C, Morris M, Pollock J, Hughes R, Richards P, Hewlett S. AB1427-HPR “it gets me down every single day”: are men with RA getting the support they need? Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2012-eular.1419] [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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Cornell P, Trehane A, Thompson P, Rahmeh F, Greenwood M, Baqai TJ, Cambridge S, Shaikh M, Rooney M, Donnelly S, Tahir H, Ryan S, Kamath S, Hassell A, McCuish WJ, Bearne L, Mackenzie-Green B, Price E, Williamson L, Collins D, Tang E, Hayes J, McLoughlin YM, Chamberlain V, Campbell S, Shah P, McKenna F, Cornell P, Westlake S, Thompson P, Richards S, Homer D, Gould E, Empson B, Kemp P, Richards AG, Walker J, Taylor S, Bari SF, Alachkar M, Rajak R, Lawson T, O'Sullivan M, Samant S, Butt S, Gadsby K, Flurey CA, Morris M, Hughes R, Pollock J, Richards P, Hewlett S, Edwards KR, Rowe I, Sanders T, Dunn K, Konstantinou K, Hay E, Jones LE, Adams J, White P, Donovan-Hall M, Hislop K, Barbosa Boucas S, Nichols VP, Williamson EM, Toye F, Lamb SE, Rodham K, Gavin J, Watts L, Coulson N, Diver C, Avis M, Gupta A, Ryan SJ, Stangroom S, Pearce JM, Byrne J, Manning VL, Hurley M, Scott DL, Choy E, Bearne L, Taylor J, Morris M, Dures E, Hewlett S, Wilson A, Adams J, Larkin L, Kennedy N, Gallagher S, Fraser AD, Shrestha P, Batley M, Koduri G, Scott DL, Flurey CA, Morris M, Hughes R, Pollock J, Richards P, Hewlett S, Kumar K, Raza K, Nightingale P, Horne R, Chapman S, Greenfield S, Gill P, Ferguson AM, Ibrahim F, Scott DL, Lempp H, Tierney M, Fraser A, Kennedy N, Barbosa Boucas S, Hislop K, Dziedzic K, Arden N, Burridge J, Hammond A, Stokes M, Lewis M, Gooberman-Hill R, Coales K, Adams J, Nutland H, Dean A, Laxminarayan R, Gates L, Bowen C, Arden N, Hermsen L, Terwee CB, Leone SS, vd Zwaard B, Smalbrugge M, Dekker J, vd Horst H, Wilkie R, Ferguson AM, Nicky Thomas V, Lempp H, Cope A, Scott DL, Simpson C, Weinman J, Agarwal S, Kirkham B, Patel A, Ibrahim F, Barn R, Brandon M, Rafferty D, Sturrock R, Turner D, Woodburn J, Rafferty D, Paul L, Marshall R, Gill J, McInnes I, Roderick Porter D, Woodburn J, Hennessy K, Woodburn J, Steultjens M, Siddle HJ, Hodgson RJ, Hensor EM, Grainger AJ, Redmond A, Wakefield RJ, Helliwell PS, Hammond A, Rayner J, Law RJ, Breslin A, Kraus A, Maddison P, Thom JM, Newcombe LW, Woodburn J, Porter D, Saunders S, McCarey D, Gupta M, Turner D, McGavin L, Freeburn R, Crilly A, Lockhart JC, Ferrell WR, Goodyear C, Ledingham J, Waterman T, Berkin L, Nicolaou M, Watson P, Lillicrap M, Birrell F, Mooney J, Merkel PA, Poland F, Spalding N, Grayson P, Leduc R, Shereff D, Richesson R, Watts RA, Roussou E, Thapper M, Bateman J, Allen M, Kidd J, Parsons N, Davies D, Watt KA, Scally MD, Bosworth A, Wilkinson K, Collins S, Jacklin CB, Ball SK, Grosart R, Marks J, Litwic AE, Sriranganathan MK, Mukherjee S, Khurshid MA, Matthews SM, Hall A, Sheeran T, Baskar S, Muether M, Mackenzie-Green B, Hetherington A, Wickrematilake G, Williamson L, Daniels LE, Gwynne CE, Khan A, Lawson T, Clunie G, Stephenson S, Gaffney K, Belsey J, Harvey NC, Clarke-Harris R, Murray R, Costello P, Garrett E, Holbrook J, Teh AL, Wong J, Dogra S, Barton S, Davies L, Inskip H, Hanson M, Gluckman P, Cooper C, Godfrey K, Lillycrop K, Anderton T, Clarke S, Rao Chaganti S, Viner N, Seymour R, Edwards MH, Parsons C, Ward K, Thompson J, Prentice A, Dennison E, Cooper C, Clark E, Cumming M, Morrison L, Gould VC, Tobias J, Holroyd CR, Winder N, Osmond C, Fall C, Barker D, Ring S, Lawlor D, Tobias J, Davey Smith G, Cooper C, Harvey NC, Toms TE, Afreedi S, Salt K, Roskell S, Passey K, Price T, Venkatachalam S, Sheeran T, Davies R, Southwood TR, Kearsley-Fleet L, Hyrich KL, Kingsbury D, Quartier P, Patel G, Arora V, Kupper H, Mozaffarian N, Kearsley-Fleet L, Baildam E, Beresford MW, Davies R, Foster HE, Mowbray K, Southwood TR, Thomson W, Hyrich KL, Saunders E, Baildam E, Chieng A, Davidson J, Foster H, Gardner-Medwin J, Wedderburn L, Thomson W, Hyrich K, McErlane F, Beresford M, Baildam E, Chieng SE, Davidson J, Foster HE, Gardner-Medwin J, Lunt M, Wedderburn L, Thomson W, Hyrich K, Rooney M, Finnegan S, Gibson DS, Borg FA, Bale PJ, Armon K, Cavelle A, Foster HE, McDonagh J, Bale PJ, Armon K, Wu Q, Pesenacker AM, Stansfield A, King D, Barge D, Abinun M, Foster HE, Wedderburn L, Stanley K, Morrissey D, Parsons S, Kuttikat A, Shenker N, Garrood T, Medley S, Ferguson AM, Keeling D, Duffort P, Irving K, Goulston L, Culliford D, Coakley P, Taylor P, Hart D, Spector T, Hakim A, Arden N, Mian A, Garrood T, Magan T, Chaudhary M, Lazic S, Sofat N, Thomas MJ, Moore A, Roddy E, Peat G, Rees F, Lanyon P, Jordan N, Chaib A, Sangle S, Tungekar F, Sabharwal T, Abbs I, Khamashta M, D'Cruz D, Dzifa Dey I, Isenberg DA, Chin CW, Cheung C, Ng M, Gao F, Qiong Huang F, Thao Le T, Yong Fong K, San Tan R, Yin Wong T, Julian T, Parker B, Al-Husain A, Yvonne Alexander M, Bruce I, Jordan N, Abbs I, D'cruz D, McDonald G, Miguel L, Hall C, Isenberg DA, Magee A, Butters T, Jury E, Yee CS, Toescu V, Hickman R, Leung MH, Situnayake D, Bowman S, Gordon C, Yee CS, Toescu V, Hickman R, Leung MH, Situnayake D, Bowman S, Gordon C, Lazarus MN, Isenberg DA, Ehrenstein M, Carter LM, Isenberg DA, Ehrenstein MR, Chanchlani N, Gayed M, Yee CS, Gordon C, Ball E, Rooney M, Bell A, Reynolds JA, Ray DW, O'Neill T, Alexander Y, Bruce I, Sutton EJ, Watson KD, Isenberg D, Rahman A, Gordon C, Yee CS, Lanyon P, Jayne D, Akil M, D'Cruz D, Khamashta M, Lutalo P, Erb N, Prabu A, Edwards CJ, Youssef H, McHugh N, Vital E, Amft N, Griffiths B, Teh LS, Zoma A, Bruce I, Durrani M, Jordan N, Sangle S, D'Cruz D, Pericleous C, Ruiz-Limon P, Romay-Penabad Z, Carrera-Marin A, Garza-Garcia A, Murfitt L, Driscoll PC, Giles IP, Ioannou Y, Rahman A, Pierangeli SS, Ripoll VM, Lambrianides A, Heywood WE, Ioannou J, Giles IP, Rahman A, Stevens C, Dures E, Morris M, Knowles S, Hewlett S, Marshall R, Reddy V, Croca S, Gerona D, De La Torre Ortega I, Isenberg DA, Leandro M, Cambridge G, Reddy V, Cambridge G, Isenberg DA, Glennie M, Cragg M, Leandro M, Croca SC, Isenberg DA, Giles I, Ioannou Y, Rahman A, Croca SC, Isenberg DA, Giles I, Ioannou Y, Rahman A, Artim Esen B, Pericleous C, MacKie I, Ioannou Y, Rahman A, Isenberg DA, Giles I, Skeoch S, Haque S, Pemberton P, Bruce I. BHPR: Audit and Clinical Evaluation * 103. Dental Health in Children and Young Adults with Inflammatory Arthritis: Access to Dental Care. Rheumatology (Oxford) 2013. [DOI: 10.1093/rheumatology/ket196] [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: 11/12/2022] Open
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Sharma KS, Pollock J, Hasham S, Brotherston TM. CASE REPORT Treatment of Otophyma: Case Report and Review of the Literature. Eplasty 2013; 13:e18. [PMID: 23641297 PMCID: PMC3624775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
OBJECTIVES Otophyma is a rare condition that can present as the end stage of any chronic inflammatory disease affecting the ear such as rosacea, eczema, or otitis externa. It can result in conductive hearing loss, low self-esteem, and social embarrassment. This report highlights a case of otophyma treated successfully using a full-thickness skin graft. METHODS We present a case of a 41-year-old lady referred to our department with a 23-year history of bilateral otophyma. During this time, her hearing progressively diminished as the swelling occluded her external auditory meatus. She had been unsuccessfully managed for years with topical emollients, steroids, and regular ear toileting. RESULT She was treated by excision of the phymatous tissue and full-thickness grafting, which resulted in a patent external auditory meatus and an improvement in her hearing. CONCLUSIONS The use of a full-thickness skin graft is one of the many treatment options available for the treatment of otophyma. We present a literature review on this uncommon condition and a discussion on the various treatment options available to the patient.
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Affiliation(s)
- K. S. Sharma
- Department of Plastic and Reconstructive Surgery, Sheffield Teaching Hospitals, Sheffield, United Kingdom,Correspondence:
| | - J. Pollock
- Department of Plastic and Reconstructive Surgery, Sheffield Teaching Hospitals, Sheffield, United Kingdom
| | - S. Hasham
- Department of Plastic and Reconstructive Surgery, Sheffield Teaching Hospitals, Sheffield, United Kingdom
| | - T. M. Brotherston
- Department of Plastic and Reconstructive Surgery, Sheffield Teaching Hospitals, Sheffield, United Kingdom
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Gavin C, Pollock J. The Suboccipital Transtentorial Approach: Indications, Technique, and Outcomes in Five Illustrative Cases. Skull Base Surg 2012. [DOI: 10.1055/s-0032-1314101] [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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Gavin C, Owa A, Pollock J. Multidisciplinary Management of Petroclival Meningiomas. Skull Base Surg 2012. [DOI: 10.1055/s-0032-1314212] [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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Harris C, Remedios D, Aptowitzer T, Keat A, Hamilton L, Guile G, Belkhiri A, Newman D, Toms A, Macgregor A, Gaffney K, Morton L, Jones GT, MacDonald AG, Downham C, Macfarlane GJ, Tillett W, Jadon D, Wallis D, Costa L, Waldron N, Griffith N, Cavill C, Korendowych E, de Vries C, McHugh N, Iaremenko O, Fedkov D, Emery P, Baeten D, Sieper J, Braun J, van der Heijde D, McInnes I, Van Laar J, Landewe R, Wordsworth BP, Wollenhaupt J, Kellner H, Paramarta I, Bertolino A, Wright AM, Hueber W, Sofat N, Smee C, Hermansson M, Wajed J, Sanyal K, Kiely P, Howard M, Howe FA, Barrick TR, Abraham AM, Pearce MS, Mann KD, Francis RM, Birrell F, Carr A, Macleod I, Ng WF, Kavanaugh A, van der Heijde D, Chattopadhyay C, Gladman D, Mease P, McInnes I, Krueger G, Xu W, Goldstein N, Beutler A, Van Laar J, Baraliakos X, Braun J, Laurent DD, Baeten D, van der Heijde D, Sieper J, Emery P, McInnes I, Landewe R, Wordsworth BP, Wollenhaupt J, Kellner H, Wright AM, Gsteiger S, Hueber W, Conaghan PG, Peterfy CG, DiCarlo J, Olech E, Alberts AR, Alper JA, Devenport J, Anisfeld AM, Troum OM, Cooper P, Gimpel M, Deakin G, Jameson K, Godtschailk M, Gadola S, Stokes M, Cooper C, Gordon C, Kalunian K, Petri M, Strand V, Kilgallen B, Barry A, Wallace D, Flurey CA, Morris M, Pollock J, Hughes R, Richards P, Hewlett S. Oral abstracts 1: Spondyloarthropathies * O1. Detecting axial spondyloarthritis amongst primary care back pain referrals. Rheumatology (Oxford) 2012. [DOI: 10.1093/rheumatology/kes118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Backhouse MR, Vinall KA, Redmond A, Helliwell P, Keenan AM, Dale RM, Thomas A, Aronson D, Turner-Cobb J, Sengupta R, France B, Hill I, Flurey CA, Morris M, Pollock J, Hughes R, Richards P, Hewlett S, Ryan S, Lille K, Adams J, Haq I, McArthur M, Goodacre L, Birt L, Wilson O, Kirwan J, Dures E, Quest E, Hewlett S, Rajak R, Thomas T, Lawson T, Petford S, Hale E, Kitas GD, Ryan S, Gooberman-Hill R, Jinks C, Dziedzic K, Boucas SB, Hislop K, Rhodes C, Adams J, Ali F, Jinks C, Ong BN, Backhouse MR, White D, Hensor E, Keenan AM, Helliwell P, Redmond A, Ferguson AM, Douiri A, Scott DL, Lempp H, Halls S, Law RJ, Jones J, Markland D, Maddison P, Thom J, Law RJ, Thom JM, Maddison P, Breslin A, Kraus A, Gordhan C, Dennis S, Connor J, Chowdhary B, Lottay N, Juneja P, Bacon PA, Isaacs D, Jack J, Keller M, Tibble J, Haq I, Hammond A, Gill R, Tyson S, Tennant A, Nordenskiold U, Pease EE, Pease CT, Trehane A, Rahmeh F, Cornell P, Westlake SL, Rose K, Alber CF, Watson L, Stratton R, Lazarus M, McNeilly NE, Waterfield J, Hurley M, Greenwood J, Clayton AM, Lynch M, Clewes A, Dawson J, Abernethy V, Griffiths AE, Chamberlain VA, McLoughlin Y, Campbell S, Hayes J, Moffat C, McKenna F, Shah P, Rajak R, Williams A, Rhys-Dillon C, Goodfellow R, Martin JC, Rajak R, Bari F, Hughes G, Thomas E, Baker S, Collins D, Price E, Williamson L, Dunkley L, Youll MJ, Rodziewicz M, Reynolds JA, Berry J, Pavey C, Hyrich K, Gorodkin R, Wilkinson K, Bruce I, Barton A, Silman A, Ho P, Cornell T, Westlake SL, Richards S, Holmes A, Parker S, Smith H, Briggs N, Arthanari S, Nisar M, Thwaites C, Ryan S, Kamath S, Price S, Robinson SM, Walker D, Coop H, Al-Allaf W, Baker S, Williamson L, Price E, Collins D, Charleton RC, Griffiths B, Edwards EA, Partlett R, Martin K, Tarzi M, Panthakalam S, Freeman T, Ainley L, Turner M, Hughes L, Russell B, Jenkins S, Done J, Young A, Jones T, Gaywood IC, Pande I, Pradere MJ, Bhaduri M, Smith A, Cook H, Abraham S, Ngcozana T, Denton CP, Parker L, Black CM, Ong V, Thompson N, White C, Duddy M, Jobanputra P, Bacon P, Smith J, Richardson A, Giancola G, Soh V, Spencer S, Greenhalgh A, Hanson M, De Lord D, Lloyd M, Wong H, Wren D, Grover B, Hall J, Neville C, Alton P, Kelly S, Bombardieri M, Humby F, Ng N, Di Cicco M, Hands R, Epis O, Filer A, Buckley C, McInnes I, Taylor P, Pitzalis C, Freeston J, Conaghan P, Grainger A, O'Connor PJ, Evans R, Emery P, Hodgson R, Emery P, Fleischmann R, Han C, van der Heijde D, Conaghan P, Xu W, Hsia E, Kavanaugh A, Gladman D, Chattopadhyay C, Beutler A, Han C, Zayat AS, Conaghan P, Freeston J, Hensor E, Ellegard K, Terslev L, Emery P, Wakefield RJ, Ciurtin C, Leandro M, Dey D, Nandagudi A, Giles I, Shipley M, Morris V, Ioannou J, Ehrenstein M, Sen D, Chan M, Quinlan TM, Brophy R, Mewar D, Patel D, Wilby MJ, Pellegrini V, Eyes B, Crooks D, Anderson M, Ball E, McKeeman H, Burns J, Yau WH, Moore O, Foo J, Benson C, Patterson C, Wright G, Taggart A, Drew S, Tanner L, Sanyal K, Bourke BE, Lloyd M, Alston C, Baqai C, Chard M, Sandhu V, Neville C, Jordan K, Munns C, Zouita L, Shattles W, Davies U, Makadsi R, Griffith S, Kiely PD, Ciurtin C, Dimofte I, Dabu M, Dabu B, Dobarro D, Schreiber BE, Warrell C, Handler C, Coghlan G, Denton C, Ishorari J, Bunn C, Beynon H, Denton CP, Stratton R, George Malal JJ, Boton-Maggs B, Leung A, Farewell D, Choy E, Gullick NJ, Young A, Choy EH, Scott DL, Wincup C, Fisher B, Charles P, Taylor P, Gullick NJ, Pollard LC, Kirkham BW, Scott DL, Ma MH, Ramanujan S, Cavet G, Haney D, Kingsley GH, Scott D, Cope A, Singh A, Wilson J, Isaacs A, Wing C, McLaughlin M, Penn H, Genovese MC, Sebba A, Rubbert-Roth A, Scali J, Zilberstein M, Thompson L, Van Vollenhoven R, De Benedetti F, Brunner H, Allen R, Brown D, Chaitow J, Pardeo M, Espada G, Flato B, Horneff G, Devlin C, Kenwright A, Schneider R, Woo P, Martini A, Lovell D, Ruperto N, John H, Hale ED, Treharne GJ, Kitas GD, Carroll D, Mercer L, Low A, Galloway J, Watson K, Lunt M, Symmons D, Hyrich K, Low A, Mercer L, Galloway J, Davies R, Watson K, Lunt M, Dixon W, Hyrich K, Symmons D, Balarajah S, Sandhu A, Ariyo M, Rankin E, Sandoo A, van Zanten JJV, Toms TE, Carroll D, Kitas GD, Sandoo A, Smith JP, Kitas GD, Malik S, Toberty E, Thalayasingam N, Hamilton J, Kelly C, Puntis D, Malik S, Hamilton J, Saravanan V, Rynne M, Heycock C, Kelly C, Rajak R, Goodfellow R, Rhys-Dillon C, Winter R, Wardle P, Martin JC, Toms T, Sandoo A, Smith J, Cadman S, Nightingale P, Kitas G, Alhusain AZ, Verstappen SM, Mirjafari H, Lunt M, Charlton-Menys V, Bunn D, Symmons D, Durrington P, Bruce I, Cooney JK, Thom JM, Moore JP, Lemmey A, Jones JG, Maddison PJ, Ahmad YA, Ahmed TJ, Leone F, Kiely PD, Browne HK, Rhys-Dillon C, Wig S, Chevance A, Moore T, Manning J, Vail A, Herrick AL, Derrett-Smith E, Hoyles R, Moinzadeh P, Chighizola C, Khan K, Ong V, Abraham D, Denton CP, Schreiber BE, Dobarro D, Warrell CE, Handler C, Denton CP, Coghlan G, Sykes R, Muir L, Ennis H, Herrick AL, Shiwen X, Thompson K, Khan K, Liu S, Denton CP, Leask A, Abraham DJ, Strickland G, Pauling J, Betteridge Z, Dunphy J, Owen P, McHugh N, Abignano G, Cuomo G, Buch MH, Rosenberg WM, Valentini G, Emery P, Del Galdo F, Jenkins J, Pauling JD, McHugh N, Khan K, Shiwen X, Abraham D, Denton CP, Ong V, Moinzadeh P, Howell K, Ong V, Nihtyanova S, Denton CP, Moinzadeh P, Fonseca C, Khan K, Abraham D, Ong V, Denton CP, Malaviya AP, Hadjinicolaou AV, Nisar MK, Ruddlesden M, Furlong A, Baker S, Hall FC, Hadjinicolaou AV, Malaviya AP, Nisar MK, Ruddlesden M, Raut-Roy D, Furlong A, Baker S, Hall FC, Peluso R, Dario Di Minno MN, Iervolino S, Costa L, Atteno M, Lofrano M, Soscia E, Castiglione F, Foglia F, Scarpa R, Wallis D, Thomas A, Hill I, France B, Sengupta R, Dougados M, Keystone E, Heckaman M, Mease P, Landewe R, Nguyen D, Heckaman M, Mease P, Winfield RA, Dyke C, Clemence M, Mackay K, Haywood KL, Packham J, Jordan KP, Davies H, Brophy S, Irvine E, Cooksey R, Dennis MS, Siebert S, Kingsley GH, Ibrahim F, Scott DL, Kavanaugh A, McInnes I, Chattopadhyay C, Krueger G, Gladman D, Beutler A, Gathany T, Mudivarthy S, Mack M, Tandon N, Han C, Mease P, McInnes I, Sieper J, Braun J, Emery P, van der Heijde D, Isaacs J, Dahmen G, Wollenhaupt J, Schulze-Koops H, Gsteiger S, Bertolino A, Hueber W, Tak PP, Cohen CJ, Karaderi T, Pointon JJ, Wordsworth BP, Cooksey R, Davies H, Dennis MS, Siebert S, Brophy S, Keidel S, Pointon JJ, Farrar C, Karaderi T, Appleton LH, Wordsworth BP, Adshead R, Tahir H, Greenwood M, Donnelly SP, Wajed J, Kirkham B. BHPR research: qualitative * 1. Complex reasoning determines patients' perception of outcome following foot surgery in rheumatoid arhtritis. Rheumatology (Oxford) 2012. [DOI: 10.1093/rheumatology/kes110] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Kachnic L, Winter K, Meropol N, Anne P, Wong S, Watson J, Mitchell E, Pollock J, Lee R, Willett C. Longitudinal Quality of Life (QOL) and Patient-Reported Bowel Function in RTOG 0247. Int J Radiat Oncol Biol Phys 2011. [DOI: 10.1016/j.ijrobp.2011.06.200] [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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Wong SJ, Moughan J, Meropol NJ, Anne PR, Kachnic LA, Rashid A, Watson JC, Mitchell EP, Pollock J, Haddock MG, Erickson B, Willett CG. Efficacy endpoints of RTOG 0247: A randomized phase II study of neoadjuvant capecitabine (C) and irinotecan (I) or C and oxaliplatin (O) with concurrent radiation therapy (RT) for locally advanced rectal cancer. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.3517] [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: 11/20/2022] Open
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Vassalos A, Peng E, Young D, Walker S, Pollock J, MacArthur K, Lyall F, Danton MHD. Pre-operative sildenafil and pulmonary endothelial-related complications following cardiopulmonary bypass: a randomised trial in children undergoing cardiac surgery*. Anaesthesia 2011; 66:472-80. [DOI: 10.1111/j.1365-2044.2011.06702.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [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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Ickinger C, Musenge E, Tikly M, Barnes J, Donnison C, Scott M, Bartholomew P, Rynne M, Hamilton J, Saravanan V, Heycock C, Kelly C, de la Torre I, Moura RA, Leandro M, Edwards J, Cambridge G, de la Torre I, Leandro M, Edwards J, Cambridge G, Daniels LE, Gullick NJ, Rees JD, Kirkham BW, Daniels LE, Gullick NJ, Kirkham BW, Rees J, Scott IC, Johnson D, Scott DL, Kingsley G, Ma MH, Cope AP, Scott DL, Kirkham BW, Brode S, Nisar MK, Ostor AJ, Gullick NJ, Oakley SP, Rees JD, Jones T, Mistlin A, Panayi GS, Kirkham BW, El Miedany Y, Palmer D, Porkodi R, Rajendran P, Waller R, Williamson L, Collins D, Price E, Juarez MJ, El Miedany Y, El Gaafary M, Youssef S, Palmer D, El Miedany Y, El Gaafary M, Palmer D, El Miedany Y, El Gaafary M, Palmer D, El Miedany Y, Palmer D, Cramp F, Hewlett S, Almeida C, Kirwan J, Choy E, Chalder T, Pollock J, Christensen R, Mirjafari H, Verstappen S, Bunn D, Edlin H, Charlton-Menys V, Pemberton P, Marshall T, Wilson P, Lunt M, Symmons D, Bruce IN, Bell C, Rowe IF, Jayakumar K, Norton SJ, Dixey J, Williams P, Young A, Kurunadalingam H, Parwaiz I, Kumar K, Howlett K, Hands B, Raza K, Pitzalis C, Buckley C, Kelly S, Filer A, Wheater G, Hogan VE, Onno Teng Y, Tekstra J, Tuck SP, Lafeber FP, Huizinga TW, Bijlsma JW, Francis RM, Datta HK, van Laar J, Pratt AG, Charles PJ, Choudhury M, Wilson G, Venables PJ, Isaacs J, Raza K, Kumar K, Stack R, Kwiatkowska B, Rantapaa-Dahlqvist S, Saxne T, Sidiropoulos P, Kteniadaki E, Misirlaki C, Mann H, Vencovsky J, Ciurea A, Tamborrini G, Kyburz D, Bastian H, Burmester GR, Detert J, Buckley CD, Sheehy C, Shipman A, Stech I, Mukhtyar C, Atzeni F, Sitia S, Tomasoni L, Gianturco L, Ricci C, Sarzi-Puttini P, De Gennaro Colonna V, Turiel M, Galloway J, Low A, Mercer LK, Dixon W, Ustianowski A, Watson K, Lunt M, Fisher B, Plant D, Lundberg K, Charles PJ, Barton A, Venables P, Pratt AG, Lorenzi AR, Wilson G, Platt PN, Isaacs J. Rheumatoid arthritis - clinical aspects: 134. Predictors of Joint Damage in South Africans with Rheumatoid Arthritis. Rheumatology (Oxford) 2011. [DOI: 10.1093/rheumatology/ker029] [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: 11/12/2022] Open
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Taylor J, Morris M, Weinman J, Davis B, Andrews T, Hewlett S, Flurey C, Morris M, Pollock J, Hughes R, Richards P, Hewlett S, Collins S, Ryan S. Understanding the patient perspective: IP43. Being Diagnosed with an Inflammatory Arthritis: The Patients' Perspective. Rheumatology (Oxford) 2011. [DOI: 10.1093/rheumatology/ker053] [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: 11/13/2022] Open
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Pollock J, Giachino AA, Rakhra K, DiPrimio G, Hrushowy H, Conway AF, Andreyechen M. SLAC wrist in the absence of recognised trauma and CPPD. Hand Surg 2010; 15:193-201. [PMID: 21089194 DOI: 10.1142/s0218810410004837] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/09/2010] [Revised: 07/12/2010] [Accepted: 07/20/2010] [Indexed: 12/21/2022]
Abstract
PURPOSE This comparative cohort study was designed to determine whether non-traumatic SLAC wrist exists, and is associated with abnormal carpal bone kinematics (specifically, decreased lunate flexion). METHODS SLAC patients with no recognised history of upper extremity trauma were prospectively compared with an age-matched control group. RESULTS Thirty-five subjects (69 wrists), included 33 non-traumatic SLAC wrists and 36 control wrists. The non-traumatic SLAC group had significantly different radiographic kinematic analysis compared to the control group. Flexion of the asymptomatic non-degenerative wrist of the non-traumatic SLAC group was distributed 70% through the lunocapitate (LC) joint and only 30% through the RL joint (p < 0.05). Conversely, flexion was more evenly distributed in the control group (48% LC and 52% RL). The non-traumatic SLAC group had abnormal wrist kinematics even in the non-involved side. CONCLUSIONS This study suggests that non-traumatic SLAC does exist. We believe that non-traumatic SLAC begins with abnormal wrist kinematics and that the dorsal radiolunate ligament restricts lunate flexion but not scaphoid flexion, leading to increased SL angles and, with years, eventual attrition of the SL ligament.
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Affiliation(s)
- J Pollock
- Division of Orthopaedic Surgery, University of Ottawa, Ottawa, Ontario, Canada
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Mytton J, Towner E, Gray S, Emond A, Pollock J. Environmental risk factors for injuries in UK primary school aged children. Inj Prev 2010. [DOI: 10.1136/ip.2010.029215.469] [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: 11/03/2022]
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Ndosi M, Vinall K, Hale C, Bird H, Hill J, Cornell P, Westlake S, Richards S, Sanderson T, Calnan M, Morris M, Richards P, Hewlett S, Richards A, Taylor S, Porcheret M, Grime J, Jordan K, Dziedzic K, Hewlett S, Ambler N, Knops B, Cliss A, Almeida C, Pope D, Hammond A, Swinkels A, Kitchen K, Pollock J, Hurley M, Walsh N, Mitchell H, Nicholas J, Day SH, Butt S, Deighton C, Gadsby K. Concurrent Oral 5 - BHPR Audit/Service Delivery and Research [OP32-OP39]: OP32. Is Nurse-Led Care Effective in Rheumatology? a Systematic Review. Rheumatology (Oxford) 2010. [DOI: 10.1093/rheumatology/keq705] [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: 11/12/2022] Open
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Baxter J, Dale O, Morgan J, Morritt A, Pollock J. “Bare Below the Elbows” – Professionalism vs Infection Risk. Int J Surg 2010. [DOI: 10.1016/j.ijsu.2010.07.119] [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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Gombojav N, Manaseki-Holland S, Pollock J, Henderson AJ. The effects of social variables on symptom recognition and medical care seeking behaviour for acute respiratory infections in infants in urban Mongolia. Arch Dis Child 2009; 94:849-54. [PMID: 19574234 DOI: 10.1136/adc.2008.157115] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [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: 11/04/2022]
Abstract
OBJECTIVE To investigate potentially modifiable factors associated with carers' recognition of symptoms and timely presentation of infants with acute respiratory infections (ARI) in urban Mongolia. METHODS A prospective cohort study nested in a randomised controlled trial of infant swaddling. Data were collected on social, educational and childcare variables and all doctor contacts for ARI in primary and secondary care by regular questionnaires to carers of infants during the first 6 months of life. FINDINGS Analyses were based on 9024 ARI related doctor contacts for 4554 illness episodes in 1218 infants. Delay in medical care seeking (>3 days from acute lower respiratory infection (ALRI) symptom onset) was associated with younger maternal age (OR (95% CI) 3.8 (1.2 to 11.6)), single child families (3.8 (1.2 to 11.61)), absent father (4.1 (1.2 to 14.4)) and residence more than 1 km from a clinic (3.5 (1.2 to 10.2)). CONCLUSION There is a continuing need to educate carers of infants in the management of ARI, particularly those of younger age and those with limited family support.
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Affiliation(s)
- N Gombojav
- Department of General Practice, Health Sciences University, Ulaanbaatar, Mongolia
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Ben-Josef E, Moughan J, Ajani J, Flam M, Gunderson L, Pollock J, Myerson R, Anne R, Rosenthal S, Willett C. The Impact of Overall Treatment Time on Survival and Local Control in Anal Cancer Patients: A Pooled Data Analysis of RTOG Trials 8704 and 9811. Int J Radiat Oncol Biol Phys 2009. [DOI: 10.1016/j.ijrobp.2009.07.084] [Citation(s) in RCA: 4] [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] [Indexed: 11/25/2022]
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Pollock J. Methods in Social Epidemiology. J Public Health (Oxf) 2009. [DOI: 10.1093/pubmed/fdp023] [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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