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Salman R, More SR, Ferreira Botelho MP, Ketwaroo PM, Masand PM, Jadhav SP. Evaluation of paediatric pulmonary vein stenosis by cardiac CT angiography: a comparative study with transthoracic echocardiography and catheter angiogram. Clin Radiol 2023; 78:e718-e723. [PMID: 37394393 DOI: 10.1016/j.crad.2023.06.002] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 05/18/2023] [Accepted: 06/01/2023] [Indexed: 07/04/2023]
Abstract
AIM To compare prospective electrocardiogram (ECG)-gated cardiac computed tomographic angiography (CCTA) with transthoracic echocardiography (TTE) and cardiac catheter angiography (CCA) for paediatric pulmonary vein (PV) stenosis. MATERIALS AND METHODS Retrospective chart review was undertaken of all patients who underwent CCTA for PV evaluation over a 4-year period. Patient demographics, findings of CCTA, TTE, and CCA, as well as interventions performed, were recorded for each PV. RESULTS Thirty-five patients were included (23 male patients). All patients had a prior TTE with time interval between TTE and CCTA ranging from 0 to 90 days. CCTA detected 92 abnormalities in 32 patients. TTE missed 16 PV abnormalities (16/92, 17%), detected 37 abnormalities with certainty (37/92, 40%), and was suggestive in 39 abnormalities (39/92, 42%). CCTA was negative for PV abnormalities when TTE was positive or suspicious in three patients. Nineteen patients underwent CCA (18 patients with 52 abnormalities and one patient with normal PV), confirming CCTA findings. Thirty-nine were treated with angioplasty/stenting (39/52,75%). Failed recanalisation occurred in three PVs (3/52, 6%) and no intervention was attempted for the rest as the gradient was not significant (10/52,19%). Nine patients underwent surgical repair (26/92, 28%). Five patients (14/92, 15%) were managed with no intervention based on CCTA findings and poor clinical prognosis. CONCLUSIONS CCTA plays an important role in detecting paediatric PV stenosis and identifies additional findings compared to TTE that have direct surgical/interventional implications. CCTA complements TTE in imaging these patients and helps guide management.
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Affiliation(s)
- R Salman
- Edward B. Singleton Department of Radiology, Division of Body Imaging, Texas Children's Hospital and Baylor College of Medicine, 6701 Fannin St., Suite 470, Houston, TX 77030, USA
| | - S R More
- Virtual Radiologic Corporation, 11995 Singletree Lane, Eden Praire, MN 55344, USA
| | - M P Ferreira Botelho
- Edward B. Singleton Department of Radiology, Division of Body Imaging, Texas Children's Hospital and Baylor College of Medicine, 6701 Fannin St., Suite 470, Houston, TX 77030, USA
| | - P M Ketwaroo
- Edward B. Singleton Department of Radiology, Division of Body Imaging, Texas Children's Hospital and Baylor College of Medicine, 6701 Fannin St., Suite 470, Houston, TX 77030, USA
| | - P M Masand
- Edward B. Singleton Department of Radiology, Division of Body Imaging, Texas Children's Hospital and Baylor College of Medicine, 6701 Fannin St., Suite 470, Houston, TX 77030, USA
| | - S P Jadhav
- Edward B. Singleton Department of Radiology, Division of Body Imaging, Texas Children's Hospital and Baylor College of Medicine, 6701 Fannin St., Suite 470, Houston, TX 77030, USA.
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Kralik SF, Vallejo JG, Kukreja MK, Salman R, Orman G, Huisman TAGM, Desai NK. Diagnostic Accuracy of MRI for Detection of Meningitis in Infants. AJNR Am J Neuroradiol 2022; 43:1350-1355. [PMID: 36574323 PMCID: PMC9451630 DOI: 10.3174/ajnr.a7610] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Accepted: 06/28/2022] [Indexed: 02/01/2023]
Abstract
PURPOSE To determine the accuracy of MR imaging for diagnosis of meningitis in infants. MATERIALS AND METHODS Retrospective review of infants less than 1 year of age who underwent a brain MR imaging for meningitis from 2010-2018. Gold standard for diagnosis of bacterial meningitis was a positive bacterial CSF culture or a positive blood culture with an elevated CSF WBC count, and diagnosis of viral meningitis was a positive CSF PCR result and elevated CSF WBC count. Sensitivity, specificity, PPV, NPV, and accuracy for MR imaging diagnosis of meningitis were calculated. RESULTS Two hundred nine infants with mean age 80 days (range 0-347 days) were included. There were 178 true positives with the most common pathogens being: Group B Streptococcus (58), E. coli (50), Streptococcus pneumoniae (21), H. influenzae (4); Herpes simplex virus 1 or 2 (18); Enterovirus (4); and other (23). There were 31 true negatives. Range of sensitivity, specificity, PPV, NPV, and accuracy of MR imaging for detection of meningitis was 67.4-83.5%, 92.3-95.7%, 95.0-98.6%, 33.3-76.5%, and 71.3-86.5% respectively. MR imaging sensitivity decreased after 10 days from time of presentation while specificity remained stable. Among individual MR imaging findings, leptomeningeal enhancement was the most sensitive finding, while cerebritis, infarction, ventriculitis, abscess, and intraventricular purulent material were the most specific findings. CONCLUSIONS MR imaging of the brain demonstrates high specificity and moderate sensitivity for diagnosis among infants presenting with signs and symptoms of meningitis. The results reflect current standard of care for imaging of infants with meningitis however a selection bias for imaging of more severe meningitis may affect these results.
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Affiliation(s)
- S F Kralik
- From the Department of Radiology (S.F.K., M.K.K., R.S., G.O., T.A.G.M.H., N.K.D.), Texas Children's Hospital, Houston, Texas
| | - J G Vallejo
- Department of Pediatrics (J.G.V.), Baylor College of Medicine, Houston Texas
| | - M K Kukreja
- From the Department of Radiology (S.F.K., M.K.K., R.S., G.O., T.A.G.M.H., N.K.D.), Texas Children's Hospital, Houston, Texas
| | - R Salman
- From the Department of Radiology (S.F.K., M.K.K., R.S., G.O., T.A.G.M.H., N.K.D.), Texas Children's Hospital, Houston, Texas
| | - G Orman
- From the Department of Radiology (S.F.K., M.K.K., R.S., G.O., T.A.G.M.H., N.K.D.), Texas Children's Hospital, Houston, Texas
| | - T A G M Huisman
- From the Department of Radiology (S.F.K., M.K.K., R.S., G.O., T.A.G.M.H., N.K.D.), Texas Children's Hospital, Houston, Texas
| | - N K Desai
- From the Department of Radiology (S.F.K., M.K.K., R.S., G.O., T.A.G.M.H., N.K.D.), Texas Children's Hospital, Houston, Texas
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Black CR, Salman R, Mcsweeney J, Philip RK, Linnane B, Neylon OM. Activity Levels and Outcomes of a Standalone Regional Paediatric High Dependency Unit. Ir Med J 2022; 115:586. [PMID: 35695817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Aim The Paediatric High Dependency Unit (PHDU) at University Hospital Limerick (UHL) operates as the only standalone unit outside of Dublin centres. The aim of this study was to describe a regional PHDU population, compare outcomes with international standards (PICANet) and ensure adequate clinical governance. Methods This is a retrospective analysis of 126 admission records from January - December 2019. Results There were 126 admissions to PHDU in 2019, of which respiratory (n=81, 64.3%) and neurological (n=23, 18.3%) subgroups represented the largest populations. Median length of stay was two days with mean age of admission 3.97 ± 4.5 years and slightly more male admissions (56%). Of the total, 65% required oxygen, 32.1% needed CPAP directly and 38% commenced high-flow, of whom 29% transitioned to CPAP. Transfer for tertiary care was required in 10.3%, of whom 7.9% needed PICU. Conclusion The data show UHL PHDU to have a patient population reflecting international trends as well as producing satisfactory patient outcomes. With a low rate of transfer for tertiary care and given that 15 other paediatric units exist in the Republic of Ireland outside Dublin, development of regional PHDU capacity would provide great opportunity to decrease strain on PICU bed capacity, particularly during busy Winter months.
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Affiliation(s)
- C R Black
- Department of Paediatrics, University Hospital Limerick
| | - R Salman
- Department of Paediatrics, University Hospital Limerick
| | - J Mcsweeney
- Department of Paediatrics, University Hospital Limerick
| | - R K Philip
- Department of Paediatrics, University Hospital Limerick
- University of Limerick School of Medicine, Limerick
| | - B Linnane
- Department of Paediatrics, University Hospital Limerick
- University of Limerick School of Medicine, Limerick
| | - O M Neylon
- Department of Paediatrics, University Hospital Limerick
- University of Limerick School of Medicine, Limerick
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Sher A, Salman R, Seghers V, Desai N, Sammer M. Performance of Pediatric Neuroradiologists Working from Home during a Pandemic at a Quaternary Pediatric Academic Hospital. AJNR Am J Neuroradiol 2022; 43:474-477. [PMID: 35086800 PMCID: PMC8910801 DOI: 10.3174/ajnr.a7411] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Accepted: 11/20/2021] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE As a result of the coronavirus disease 2019 (COVID-19) pandemic, many radiology departments shifted to working a portion of clinical assignments from home. To determine the effect of working from home on performance, productivity, quality, and safety, we evaluated turnaround time, volume of studies, and error rates on rotations worked from home compared with in the hospital. MATERIALS AND METHODS The number of studies interpreted per day for each neuroradiologist, turnaround times, and error rates reported to peer learning was identified from April 1, 2020, through September 30, 2020. For each neuroradiologist, mean turnaround times and volumes per day at home versus in the hospital were compared. Similar comparison was performed for STAT studies. RESULTS During the time period, 2597 CTs (1897 at home, 700 in the hospital) and 3685 MRIs (2601 at home, 1084 in the hospital) were read. By individual neuroradiologists, 57% (4/7) had shorter turnaround time at home and 57% (4/7) demonstrated an increase in the mean number of studies per day read at home. No statistically significant difference was noted in the neuroradiologists' performance while reading STAT studies. Reported error rates were not found to be higher at home, with statistically significantly lower rates when working at home (P = .018). CONCLUSIONS Variable productivity and performance of neuroradiologists when working from home versus in the hospital were found, being 57% faster and/or more productive while working at home without an increase in error rates. The decision to work at home versus in the hospital may best be based on local factors, balancing the variability among individual neuroradiologist's and the institution's needs, recognizing that working from home is not a one-size-fits-all phenomenon but requires adaptability for successful implementation.
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Affiliation(s)
- A.C. Sher
- From the Edward B. Singleton Department of Radiology, Baylor College of Medicine and Texas Children’s Hospital, Houston, Texas
| | - R. Salman
- From the Edward B. Singleton Department of Radiology, Baylor College of Medicine and Texas Children’s Hospital, Houston, Texas
| | - V.J. Seghers
- From the Edward B. Singleton Department of Radiology, Baylor College of Medicine and Texas Children’s Hospital, Houston, Texas
| | - N.K. Desai
- From the Edward B. Singleton Department of Radiology, Baylor College of Medicine and Texas Children’s Hospital, Houston, Texas
| | - M.B.K. Sammer
- From the Edward B. Singleton Department of Radiology, Baylor College of Medicine and Texas Children’s Hospital, Houston, Texas
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Crompton R, Salman R. 912 Unusual Presentation Of JAK-2; A Degenerating Breast Neurofibroma. Br J Surg 2021. [DOI: 10.1093/bjs/znab259.214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Abstract
Introduction
29-year-old lady presented to ED with acutely enlarging painless right breast swelling. No history of trauma; diagnosis likely breast abscess. Significant growth during short inpatient admission with incidental clinical finding of multiple cutaneous skin nodules from childhood, mother had similar lesions. CT chest performed illustrating large anterior chest wall mass 15.2x15.7x24.7cm. Transferred to regional plastic surgery unit for resection. Haematological abnormality identified on routine bloods which was life changing.
Description
Attended ED following a three-day history of a rapidly progressive right breast mass causing necrosis and blistering of overlying skin with drop in haemoglobin from 138 to 94 overnight. Transferred to regional plastic surgery unit where she underwent an evacuation of breast haematoma and excision of neurofibroma and was transfused 2 units of blood. Pathology revealed a degenerating neurofibroma. Abnormal coagulation and blood film during inpatient stay prompted subsequent bone marrow biopsy which revealed diagnosis of myeloproliferative neoplasm later found to be JAK-2 V617F mutation positive.
Discussion
Patient moved to UK 6 years ago from Lithuania, previously lived within area affected by Chernobyl nuclear disaster. JAK-2 myeloproliferative disease typically presents in middle aged but also reported as radiation acquired. Risk benefit of anti-platelet therapy for myeloproliferative malignancy evaluated due to high probability of re-bleeding. Complex case of Neurofibromatosis-1 and Myeloproliferative disease; diagnosis presented as a breast lump. Multidisciplinary input from surgery, haematology, genetics and neurology for best outcome.
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Affiliation(s)
- R Crompton
- Southern health and social care trust, Belfast, United Kingdom
| | - R Salman
- Southern health and social care trust, Belfast, United Kingdom
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Saade C, Siblini L, Karout L, Khalife S, Hilal H, Abbas S, Salman R, Naffaa L. To repeat or not to repeat: Radiologists demonstrated more decisiveness than their fellow radiographers in reducing the repeat rate during mobile chest radiography. Radiography (Lond) 2020; 27:304-309. [PMID: 33023812 DOI: 10.1016/j.radi.2020.09.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Revised: 07/27/2020] [Accepted: 09/01/2020] [Indexed: 11/16/2022]
Abstract
INTRODUCTION Radiologists and radiographers play a complementary role in providing an optimal image quality with decrease radiation dose and proper diagnosis during chest radiographs. We aim Investigate years of experience among radiologists and radiographers on perception of image quality and its impact on repeat rate when evaluating portable pediatric chest radiographs. METHODS IRB approved retrospective study consisted of randomly selected images (n = 131) of pediatric portable chest radiographs. Images were blindly assessed by four radiologists and four radiographers. Readers were asked to assess qualitative and quantitative image quality by rating: image quality, decision to repeat and image technique. All data was compared employing Pearson's Correlation, Visual grading characteristic (VGC) and Cohens' kappa analyses. RESULTS Image quality: Radiologists (88.4%) rated images as excellent significantly more than radiographers (11.6%), and radiographers (90.1%) as poor significantly more than radiologists (9.9%) (p < 0.05). Repeat: Radiologists (57%) decided not to repeat images significantly more than radiographers (43%) (p < 0.05). Image technique: Radiologists rated images as acceptable (65%) and excellent (97.7%) significantly more than radiographers (35% and 2.3% respectively) (p < 0.05), whereas radiographers (84%) assessed image technique as poor significantly more than radiologists (16%) (p < 0.05). VGC: radiographers had slightly better qualitative evaluation of image quality than radiologists. An association between image quality (p < 0.002) and repeat decision (p < 0.044) with years of experience was established when comparing years of experience with image assessment rubric, while no association was noted with image technique (p < 0.9). CONCLUSION Radiologists demonstrated more decisiveness than their fellow radiographers in reducing the repeat rate of portable pediatric chest radiographs. Interestingly, years of experience only seem to affect image technique and image quality assessment among radiologists. IMPLICATIONS FOR PRACTICE Continuous education of radiographers and close collaboration with radiologists is crucial to achieve optimal image quality and low radiation doses.
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Affiliation(s)
- C Saade
- Faculty of Health Sciences, Medical Imaging Sciences, American University of Beirut Medical Center, P.O.Box: 11-0236 Riad El-Solh, Beirut, 1107 2020, Lebanon.
| | - L Siblini
- Faculty of Health Sciences, Medical Imaging Sciences, American University of Beirut Medical Center, P.O.Box: 11-0236 Riad El-Solh, Beirut, 1107 2020, Lebanon.
| | - L Karout
- Diagnostic Radiology Department, American University of Beirut Medical Center, P.O.Box: 11-0236 Riad El-Solh, Beirut, 1107 2020, Lebanon.
| | - S Khalife
- Faculty of Health Sciences, Medical Imaging Sciences, American University of Beirut Medical Center, P.O.Box: 11-0236 Riad El-Solh, Beirut, 1107 2020, Lebanon.
| | - H Hilal
- Faculty of Health Sciences, Medical Imaging Sciences, American University of Beirut Medical Center, P.O.Box: 11-0236 Riad El-Solh, Beirut, 1107 2020, Lebanon.
| | - S Abbas
- Faculty of Health Sciences, Medical Imaging Sciences, American University of Beirut Medical Center, P.O.Box: 11-0236 Riad El-Solh, Beirut, 1107 2020, Lebanon.
| | - R Salman
- Edward B. Singleton Department of Radiology, Texas Children's Hospital, Baylor College of Medicine, Houston, Texas, USA.
| | - L Naffaa
- Diagnostic Radiology Department, American University of Beirut Medical Center, P.O.Box: 11-0236 Riad El-Solh, Beirut, 1107 2020, Lebanon.
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Wilson D, Ambler G, Shakeshaft C, Banerjee G, Charidimou A, Seiffge D, White M, Cohen H, Yousry T, Salman R, Lip GYH, Muir K, Brown MM, Jäger HR, Werring DJ. Potential missed opportunities to prevent ischaemic stroke: prospective multicentre cohort study of atrial fibrillation-associated ischaemic stroke and TIA. BMJ Open 2019; 9:e028387. [PMID: 31345970 PMCID: PMC6661679 DOI: 10.1136/bmjopen-2018-028387] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Revised: 06/06/2019] [Accepted: 06/18/2019] [Indexed: 12/25/2022] Open
Abstract
OBJECTIVE We report on: (1) the proportion of patients with known atrial fibrillation (AF); and (2) demographic, clinical or radiological differences between patients with known AF (and not treated) and patients with newly diagnosed AF, in a cohort of patients who presented with ischaemic stroke or transient ischaemic attack (TIA) not previously treated with anticoagulation. DESIGN We reviewed cross-sectional baseline demographic and clinical data from a prospective observational cohort study, (CROMIS-2). SETTING Patients were recruited from 79 hospital stroke centres throughout the UK and one centre in the Netherlands. PARTICIPANTS Patients were eligible if they were adults who presented with ischaemic stroke or TIA and AF and had not been previously treated with oral anticoagulation. MAIN OUTCOME MEASURES Proportion of patients with known AF before index ischaemic stroke or TIA from a cohort of patients who have not been previously treated with oral anticoagulation. Secondary analysis includes the comparison of CHA2DS2-VASc and HAS-BLED scores and other demographics and risk factors between those with newly diagnosed AF and those with previously known AF. RESULTS Of 1470 patients included in the analysis (mean age 76 years (SD 10)), 622 (42%) were female; 999 (68%) patients had newly diagnosed AF and 471 (32%) patients had known AF. Of the 471 patients with known AF, 68% had a strong indication for anticoagulation and 89% should have been considered for anticoagulation based upon CHA2DS2-VASc score. Patients with known AF were more likely to have a prior history of dementia (4% vs 2%, p=0.02) and had higher HAS-BLED scores (median 3 vs 2). CHA2DS2-VASc, other risk factors and demographics were similar. CONCLUSIONS About 1/3 of patients who present with stroke and have AF who have not been treated with oral anticoagulation have previously known AF. Of these patients, at least 68% were not adequately treated with oral anticoagulation. TRIAL REGISTRATION NUMBER NCT02513316.
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Affiliation(s)
- Duncan Wilson
- New Zealand Brain Research Institute, Christchuch, New Zealand
- Brain Repair and Rehabilitation, Institute of Neurology, UCL, London, UK
| | - Gareth Ambler
- Department of Statistical science, University College London, London, UK
| | - Clare Shakeshaft
- Brain Repair and Rehabilitation, Institute of Neurology, UCL, London, UK
| | - Gargi Banerjee
- Brain Repair and Rehabilitation, Institute of Neurology, UCL, London, UK
| | - Andreas Charidimou
- Stroke Research Group, Department of Brain Repair and Rehabilitation, UCL Institute of Neurology and The National Hospital for Neurology and Neurosurgery, London, UK
- Department of Neurology, Hemorrhagic Stroke Research Program, Massachusetts General Hospital Stroke Research Center, Harvard Medical School, Boston, Massachusetts, USA
| | - David Seiffge
- Brain Repair and Rehabilitation, Institute of Neurology, UCL, London, UK
| | - Mark White
- Brain Repair and Rehabilitation, Institute of Neurology, UCL, London, UK
| | - Hannah Cohen
- Haemostasis Research Unit, Department of Haematology, University College London, London, UK
| | - Tarek Yousry
- Lysholm Department of Neuroradiology, University College London Hospitals NHS Foundation Trust National Hospital for Neurology and Neurosurgery, London, UK
| | - Rustam Salman
- Centre for clinical brain sciences, University of Edinburgh, Edinburgh, UK
| | - Gregory Y H Lip
- Institute of Cardiovascular Sciences, University of Birmingham, Birmingham, UK
| | | | | | - H R Jäger
- Stroke Research Group, Department of Brain Repair and Rehabilitation, UCL Institute of Neurology and The National Hospital for Neurology and Neurosurgery, London, UK
| | - David J Werring
- Department of Brain Repair and Rehabilitation, UCL Institute of Neurology, London, UK
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Scally N, McGarry K, Salman R, Mathers H. A Non-resolving axillary rash - Nothing to worry about? Int J Surg 2018. [DOI: 10.1016/j.ijsu.2018.05.048] [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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Kizilhan J, Salman R. 5.1-O8MiMi – violence prevention with migrants for migrants. Capacity building for refugee women and girls in Germany. Eur J Public Health 2018. [DOI: 10.1093/eurpub/cky047.162] [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: 11/14/2022] Open
Affiliation(s)
- J Kizilhan
- Baden-Wuerttemberg Cooperative State University, Germany
| | - R Salman
- Ethno-Medizinisches Zentrum e.V, Germany
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Salman R, Rowan C, Naseer R. Fast track screening pathway for patients with haemoptysis and low probability of lung cancer. Lung Cancer 2018. [DOI: 10.1016/s0169-5002(18)30088-6] [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: 11/28/2022]
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Salem R, Massoud R, Kanj SS, Hamdan M, Salman R, Bazarbachi A, El-Cheikh J. Progressive multifocal leukoencephalopathy in patients receiving rituximab and cyclophosphamide after haplo-identical T-cell replete transplantation and review of the literature. Curr Res Transl Med 2017; 65:127-132. [PMID: 29132903 DOI: 10.1016/j.retram.2017.10.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2017] [Revised: 10/06/2017] [Accepted: 10/13/2017] [Indexed: 11/28/2022]
Abstract
John Cunningham virus (JCV) reactivation, occurring mainly in immunocompromised patients, leads to progressive multifocal leukoencephalopathy, an uncommon but lethal disease. JCV reactivation after T-cell replete haploidentical stem cell transplantation, in the pre-cyclophosphamide era, is poorly represented in the literature. We therefore describe two cases of acute myeloid leukemia who developed JCV reactivation after receiving cyclophosphamide and rituximab post haploidentical stem cell transplantation, and review the literature, aiming to a better understanding of the disease course and its risk factors.
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Affiliation(s)
- R Salem
- Bone Marrow Transplantation Program, Department of Internal Medicine, American University of Beirut, Beirut, Lebanon
| | - R Massoud
- Bone Marrow Transplantation Program, Department of Internal Medicine, American University of Beirut, Beirut, Lebanon
| | - S S Kanj
- Infectious Disease, Department of Internal Medicine, American University of Beirut, Beirut, Lebanon
| | - M Hamdan
- Infectious Disease, Department of Internal Medicine, American University of Beirut, Beirut, Lebanon
| | - R Salman
- Diagnostic Radiology Department, American University of Beirut, Beirut, Lebanon
| | - A Bazarbachi
- Bone Marrow Transplantation Program, Department of Internal Medicine, American University of Beirut, Beirut, Lebanon
| | - J El-Cheikh
- Bone Marrow Transplantation Program, Department of Internal Medicine, American University of Beirut, Beirut, Lebanon.
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Schwarz B, Markin K, Salman R, Gutenbrunner C. [Barriers for Migrants Regarding the Access to Medical Rehabilitation on Behalf of the German Pension Insurance]. REHABILITATION 2015; 54:362-8. [PMID: 26676733 DOI: 10.1055/s-0041-108279] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVE To identify barriers for migrants regarding the access to medical rehabilitation on behalf of the German Pension Insurance. METHODS Focus groups with migrants (n=5, 42 participants) and experts (n=1, 14 participants) were conducted and examined by qualitative content analysis. RESULTS We identified 4 categories of access barriers: 1. system-related, migrant-specific, 2. person-related, migrant-specific, 3. system-related, primarily not migrant-specific, and 4. person-related, primarily not migrant-specific barriers. Barriers in categories 3 and 4 are mostly class- or gender-specific. Due to associations between migration background, social status and gender roles, these barriers are often of specific importance to migrants as well. Taking such intersections of single categories of inequality (migration background, social status, gender) into account, access barriers can interact and form complexes of barriers. CONCLUSION In order to explain and overcome the low utilization of medical rehabilitation by migrants, the interaction of migrant-, class- and gender-specific barriers in the system and in persons have to be considered.
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Affiliation(s)
- B Schwarz
- Institut für Sozialmedizin und Epidemiologie, Universität zu Lübeck
| | - K Markin
- Ethno-Medizinisches Zentrum, Hannover
| | - R Salman
- Ethno-Medizinisches Zentrum, Hannover
| | - C Gutenbrunner
- Klinik für Rehabilitationsmedizin, Medizinische Hochschule Hannover
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Schwarz B, Starikow K, Salman R, Gutenbrunner C. Barrieren für MigrantInnen beim Zugang in die medizinische Rehabilitation der Gesetzlichen Rentenversicherung (GRV). Palliativmedizin 2014. [DOI: 10.1055/s-0034-1374496] [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] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Dennis M, Salman R, Mead G, McGill C, Perry D. Incorporation of text recognition into trial it systems to safeguard against enrolment of ineligible patients or inappropriate reporting of adverse events. Trials 2013. [PMCID: PMC3980621 DOI: 10.1186/1745-6215-14-s1-o15] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Horns K, Seeger K, Heinmüller M, Limm H, Waldhoff HP, Salman R, Gündel H, Angerer P. [Health promotion for long-term unemployed. Effects on motivation for a healthy lifestyle]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2012; 55:728-38. [PMID: 22526862 DOI: 10.1007/s00103-012-1477-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Among the long-term unemployed ill health is often a hindrance to successful reintegration in the job market. In a quasi-experimental controlled study we examined the effects of a health promotion intervention program tailored to the specific needs of the long-term unemployed combining individual sessions based on motivational interviewing and participatory group sessions including physical activity. Over a period of 3 months the participants of the intervention group (n = 179) showed more improvement compared to the control group (n = 108) in terms of motivation for lifestyle changes towards more physical activity and healthier nutrition. Participants of the intervention group developed an intention to act significantly more often (active lifestyle: odds ratio 4.44; 95% CI: 2.00-9.83; healthy nutrition: odds ratio 3.94; 95% CI: 1.55-10.00) and actually implemented a behavior change significantly more often (active lifestyle: odds ratio 2.77; 95% CI: 1.35-5.71; healthy nutrition: odds ratio 4.34; 95% CI: 1.92-9.78). In terms of smoking and alcohol consumption no significant intervention effects were detected. The results of the study show the effectiveness of the described health promotion program regarding a lifestyle change towards more healthy nutrition and more physical activity.
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Affiliation(s)
- K Horns
- Institut und Poliklinik für Arbeits-, Sozial- und Umweltmedizin, Ludwig-Maximilians-Universität München, Ziemssenstr. 1, 80336, München, Deutschland.
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Bisson S, Gerken U, Krauth C, Salman R, Machleidt W, Walter U. Komm- und Zugehstruktur: Welche MigrantInnen lassen sich durch diese Zugänge zum Besuch von Informationsveranstaltungen zu Suchtprävention bewegen? Gesundheitswesen 2011. [DOI: 10.1055/s-0031-1283408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Limm H, Heinmüller M, Horns K, Kimil A, Salman R, Hofmann H, Gündel H, Angerer P. Schulung zum Gesundheits-Coach für Mitarbeiter in arbeitsmarktintegrativen Maßnahmen – erste Evaluationsergebnisse. Gesundheitswesen 2010. [DOI: 10.1055/s-0030-1266528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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A'Walelu O, Gerken U, Machleidt W, Salman R, Walter U, Krauth C. Kosten und Kosteneffektivität der Zugangswege zur Förderung des Gesundheits- und präventiven Verhaltens von Migranten. Gesundheitswesen 2008. [DOI: 10.1055/s-0028-1086262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Gerken U, Bisson S, Krauth C, Machleidt W, Salman R, Walter U. Gesundheitsbezogene Lebensqualität russisch- und türkischsprachiger Migranten in Hannover. Gesundheitswesen 2008. [DOI: 10.1055/s-0028-1086274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Gerken U, A'Walelu O, Bisson S, Krauth C, Salman R, Machleidt W, Walter U. Erreichbarkeit von russisch- und türkischsprachigen Migranten über Informationsveranstaltungen mit Zugeh- und Kommstruktur zum Thema Suchtprävention. Gesundheitswesen 2008. [DOI: 10.1055/s-0028-1086273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Walter U, Krauth C, Kurtz V, Salman R, Machleidt W. Gesundheit und gesundheitliche Versorgung von Migranten unter besonderer Berücksichtigung von Sucht. Nervenarzt 2007; 78:1058-61. [PMID: 17530211 DOI: 10.1007/s00115-007-2295-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Adequate knowledge about the target group is essential for user-focused health care. Little differentiated information on the health and health care of migrants is available in Germany, and focused research on migrant groups hardly exists. The burden of the migration itself, the change in the socioeconomic status (compared to the home country) and - compared with the locals - a more restricted access to the health care system affect the health of migrants. A major health problem with this group is addiction. Characteristics of health and health behaviour of Turkish- and Russian-speaking migrants in Germany are examined by a study supported by the German Federal Ministry of Education and Research.
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Affiliation(s)
- U Walter
- Stiftungslehrstuhl Prävention und Rehabilitation in der System- und Versorgungsforschung an der Abt. Epidemiologie, Sozialmedizin und Gesundheitssystemforschung, Medizinische Hochschule, 30625, Hannover.
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Manning BJ, Salman R, Gillen P. Laparoscopic Nissen fundoplication: predicting outcome from peri-operative evaluation. Ir J Med Sci 2006; 175:55-8. [PMID: 16872031 DOI: 10.1007/bf03167951] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND Although laparoscopic Nissen fundoplicaton is a safe, effective treatment for gastrooesophageal reflux (GOR), questions remain about the durability of the procedure and patient selection criteria. AIMS To review a single surgeon's experience of laparoscopic Nissen fundoplicaton and to determine which factors, if any are likely to influence long term outcome. METHODS Data were collected on all 124 patients who underwent laparoscopic Nissen fundoplication over a five-year period, and a detailed questionnaire was used to evaluate outcome. RESULTS Eighty-nine per cent of patients were satisfied with the results of surgery whilst 8.8% of patients had significant recurrence of symptoms. Time since surgery was longer in those patients with symptom recurrence who were also more likely to be female. Pre-operative age, body mass index (BMI),Visick Score, endoscopic findings or pH analysis scores were not predictive of outcome, nor were intra-operative findings or post-operative complications. CONCLUSION Although laparoscopic Nissen fundoplication is a safe and effective treatment for GOR, it is difficult to predict the small but significant group of patients with poor longterm outcome based on pre-operative assessment and peri-operative parameters alone.
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Affiliation(s)
- B J Manning
- Dept of Surgery, Our Lady of Lourdes Hospital, Drogheda, Co Louth
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Neverov VA, Salman R. [Specific features of hemodialysis patients and recipients of allogenic kidney determining requirements for the operation of endoprosthesis of the hip joint]. Vestn Khir Im I I Grek 2005; 164:58-62. [PMID: 16755739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
The authors consider specific general status of 23 patients aged from 26 through 63 years who underwent operations of total endoprosthesis of the hip joint for aseptic necrosis of the femoral bone head (18 cases) and pathological fracture of the femur neck (5 cases). Out of 23 patients 11 were given dialysis treatment and 12 underwent allotransplantation of the kidney. A technique of complex preoperative management is described that allowed avoidance of general peri- and postoperative complications.
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Pallasch G, Salman R, Hartwig C. Verbesserung des Impfschutzes für sozial benachteiligte Gruppen unter Mitarbeit von Vertrauenspersonen - Ergebnisse einer kultur- und sprachsensiblen Intervention des Gesundheitsamtes Stade und des Ethno-Medizinischen Zentrums für Migrantenkinder im Altländer Viertel. Gesundheitswesen 2005; 67:33-8. [PMID: 15672304 DOI: 10.1055/s-2004-813912] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
In January 2002, a vaccination campaign against measles, mumps and rubella was carried out in the Altlander Viertel, a district in Stade, Germany. The campaign was directed towards children of immigrants, a group often at a disadvantage in terms of health. This campaign was organised and carried out by the public health department in Stade for the first time in September 2002. During regular health screenings when children were enrolled for school it was found that they children were poorly protected by vaccination against measles, mumps and rubella. Since several attempts to improve the situation, for example by organising information events, had not been successful, it was decided to develop special measures for this particular group in order to improve their health. Together with the Ethno-Medical Centre in Hanover the concept of a vaccination campaign considering the special situation of immigrants was developed. The core measures were to find, train and use key persons within the groups of immigrants are living in the Altlander Viertel in Stade. These key persons helped to inform and motivate the immigrants to go to the vacciantion stations set up in the district. In this way it was possible to carry out a successful intervention (vaccination campaign).
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McMillan HM, Salman R, Khan MF, McAnena O, O'Connor RD. An ominous inguinal hernia. Ir J Med Sci 2004; 173:57. [PMID: 15732240 DOI: 10.1007/bf02914528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Salman R, Henessey E, Curren C, Uhlmann V, Given F. 967 The detection of metastatic cancer cells in peripheral blood using reverse transcriptase polymerase chain reaction for CK 19. EJC Suppl 2003. [DOI: 10.1016/s1359-6349(03)90994-3] [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: 10/26/2022] Open
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Salman R, Hennessy E, Uhlmann V, Curren C, Courtney D. 377 A double marker RT-PCR approach for the detection of disseminating breast cancer cells in peripheral blood. EJC Suppl 2003. [DOI: 10.1016/s1359-6349(03)90409-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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McMonagle C, Salman R, Uhlmann V, Curren C. 415 Effect of herceptin on gene expression in her2 positive breast cancer cell line. EJC Suppl 2003. [DOI: 10.1016/s1359-6349(03)90447-2] [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: 10/26/2022] Open
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Affiliation(s)
- R G Casey
- Department of General Surgery, Our Lady of Lourdes Hospital, Drogheda, Co Louth, Ireland.
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Salman R, Curren C, Uhlmann V, Courtney D. 378 Serum levels of matrix metalloprotinase 2 and 9 in patients with breast cancer. EJC Suppl 2003. [DOI: 10.1016/s1359-6349(03)90410-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
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Gardemann J, Salman R. [Migration-specific expertising in the spheres of tension between medicine, law, psychology and politics -- report on an interdisciplinary meeting of experts]. Gesundheitswesen 2002; 64:645-50. [PMID: 12516015 DOI: 10.1055/s-2002-36459] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
The 4th conference of transcultural medical appraisal was organized once again by the ethno-medical center in Hannover on 2nd and 3rd of November, 2001. For the first time, medical estimators and decision-makers from the spheres of medicine, psychology, law and administration got together thematically and interdisciplinary. As to the public health authorities, the intensive discussion and working session on the topic of deportation, transportability and asylum was of high relevance. The specific working group included judges, clinical and public health physicians, psychologists, migration authority officials and representatives of migrant organisations. In full agreement finally it was pointed out that medical or psychological estimation concerning asylum and deportation should remain in the hands of the public health authorities because of their expert knowledge, experience and full independence in the sphere of medical and psychological appraisal.
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Affiliation(s)
- J Gardemann
- Facharzt für Kinderheilkunde und öffentliches Gesundheitswesen, Fachhochschule Münster, Kompetenzzentrum Humanitäre Hilfe.
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Leahy DT, Salman R, Mulcahy H, Sheahan K, O'Donoghue DP, Parfrey NA. Prognostic significance of p53 abnormalities in colorectal carcinoma detected by PCR-SSCP and immunohistochemical analysis. J Pathol 1996; 180:364-70. [PMID: 9014855 DOI: 10.1002/(sici)1096-9896(199612)180:4<364::aid-path683>3.0.co;2-0] [Citation(s) in RCA: 40] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Abnormalities in the p53 tumour suppressor gene and in the expression of its protein are common in colorectal carcinoma. The prognostic significance of these p53 abnormalities was studied in 66 patients with colorectal cancer, followed for more than 10 years. Single-strand conformation polymorphism (SSCP) analysis was used to detect alterations in exons 5-8 of the p53 gene. Paraffin sections were examined immunohistochemically for p53 overexpression with the monoclonal antibody DO-7 (Dako) both with and without microwave antigen retrieval. Abnormalities of the p53 gene were found in 41 per cent of cases by SSCP analysis. Outcome was unrelated to SSCP abnormalities (P = 0.19), except for the Dukes' A and B subgroup, where decreased survival was found in cases with abnormal SSCP (P = 0.01). Overexpression of p53 protein was seen by immunohistochemistry in 47 per cent of cases without, and in 52 per cent of cases with microwave antigen retrieval. Immunohistochemical overexpression of p53 protein either with or without microwave antigen retrieval was an independent prognostic indicator of poor survival. These results suggest that for routine purposes, immunohistochemical detection of the p53 protein product may be more useful than SSCP analysis of the encoding p53 gene in identifying those at high risk of colorectal cancer recurrence and death.
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Affiliation(s)
- D T Leahy
- Department of Pathology and Gastroenterology, St. Vincent's Hospital, University College, Dublin, Ireland
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Affiliation(s)
- M Afzal
- Camel Research Centre, Abu Dhabi, United Arab Emirates
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