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Beavers KN, Mitchell C. Uncommon castration complication: Penile amputation and sheath ablation following an iatrogenic phallectomy. EQUINE VET EDUC 2017. [DOI: 10.1111/eve.12712] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Laubscher M, Mitchell C, Timms A, Goodier D, Calder P. Intramedullary femoral lengthening with an 'unstable' hip without prior stabilisation: preliminary results of a case series. SA ORTHOPAEDIC JOURNAL 2017. [DOI: 10.17159/2309-8309/2017/v16n4a7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Mitchell C, Srinivasan S, Zhan X, Wu M, Reed S, Guthrie K, LaCroix A, Fiedler T, Munch M, Liu C, Hoffman N, Blair I, Newton K, Freeman E, Joffe H, Cohen L, Fredricks D. 1: Associations between serum estrogen, vaginal microbiota and vaginal glycogen in postmenopausal women. Am J Obstet Gynecol 2016. [DOI: 10.1016/j.ajog.2016.09.028] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Khoja L, Horsley L, Heesters A, Machin JD, Mitchell C, Clamp AR, Jayson GC, Hasan J. Does clinical trial participation improve outcomes in patients with ovarian cancer? ESMO Open 2016; 1:e000057. [PMID: 27843621 PMCID: PMC5070238 DOI: 10.1136/esmoopen-2016-000057] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2016] [Accepted: 04/08/2016] [Indexed: 12/15/2022] Open
Abstract
INTRODUCTION Treatment on a clinical trial is considered to be beneficial to oncology patients. However, supportive evidence for this is scarce. Trial effect describes the phenomenon of improved health outcomes in patients treated with standard of care (SOC) on trial compared to those receiving SOC outside of a clinical trial. We evaluated trial effect in patients with ovarian cancer treated at our tertiary cancer centre. METHODS We performed a retrospective cohort study of patients with ovarian cancer treated at The Christie National Health Service Foundation Trust. Patients treated on one of three first-line clinical trials: (SCOTROC-4, ICON-5, ICON-7) were matched (for age, International Federation of Gynaecology and Obstetrics stage, surgical status and performance status) with individuals receiving the same SOC off trial. Survival was calculated using Kaplan-Meier methodology. RESULTS 60 patients were evaluated; 30 on trial and 30 on SOC off trial. The median progression-free survival (PFS) was 21.8 months (control group) and 25.9 months (trial group), median overall survival (OS) was 64.3 months (control group) and 68.9 months (trial group). There was no difference in PFS (log-rank test: HR 0.87 (95% CI 0.48 to 1.54), p=0.6) or OS (log-rank test: HR 0.87 (95% CI 0.46 to 1.64), p=0.7) between groups. CONCLUSIONS Patient survival was similar regardless if treated on trial or as SOC. Our findings do not support trial effect, at least in a tertiary cancer centre. Clinical trial participation in specialised cancer centres promotes best practice to the benefit of all patients. These findings may impact discussions round consent of patients to trials and organisation of oncology services.
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Laubscher M, Mitchell C, Timms A, Goodier D, Calder P. Outcomes following femoral lengthening. Bone Joint J 2016; 98-B:1382-1388. [DOI: 10.1302/0301-620x.98b10.36643] [Citation(s) in RCA: 71] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2015] [Accepted: 06/03/2016] [Indexed: 01/20/2023]
Abstract
Aims Patients undergoing femoral lengthening by external fixation tolerate treatment less well when compared to tibial lengthening. Lengthening of the femur with an intramedullary device may have advantages. Patients and Methods We reviewed all cases of simple femoral lengthening performed at our unit from 2009 to 2014. Cases of nonunions, concurrent deformities, congenital limb deficiencies and lengthening with an unstable hip were excluded, leaving 33 cases (in 22 patients; 11 patients had bilateral procedures) for review. Healing index, implant tolerance and complications were compared. Results In 20 cases (15 patients) the Precice lengthening nail was used and in 13 cases (seven patients) the LRS external fixator system. The desired length was achieved in all cases in the Precice group and in 12 of 13 cases in the LRS group. The mean healing index was 31.3 days/cm in the Precice and 47.1 days/cm in the LRS group (p < 0.001). This was associated with an earlier ability to bear full weight without aids in the Precice group. There were more complications with LRS lengthening, including pin site infections and regenerate deformity. Implant tolerance and the patients’ perception of the cosmetic result were better with the Precice treatment. Conclusion Femoral lengthening with the Precice femoral nail achieved excellent functional results with fewer complications and greater patient satisfaction when compared with the LRS system in our patients. Cite this article: Bone Joint J 2016;98-B:1382–8.
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Hansen W, Mitchell C, Ayutyanont N, Bremer Z, Bhattarai B, Stowell J. 360 Perception of Point-of-Care Ultrasound Performed by Emergency Physicians. Ann Emerg Med 2016. [DOI: 10.1016/j.annemergmed.2016.08.377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Chalmers D, Nicol D, Kaye J, Bell J, Campbell AV, Ho CWL, Kato K, Minari J, Ho CH, Mitchell C, Molnár-Gábor F, Otlowski M, Thiel D, Fullerton SM, Whitton T. Has the biobank bubble burst? Withstanding the challenges for sustainable biobanking in the digital era. BMC Med Ethics 2016; 17:39. [PMID: 27405974 PMCID: PMC4941036 DOI: 10.1186/s12910-016-0124-2] [Citation(s) in RCA: 73] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2015] [Accepted: 06/14/2016] [Indexed: 11/27/2022] Open
Abstract
Biobanks have been heralded as essential tools for translating biomedical research into practice, driving precision medicine to improve pathways for global healthcare treatment and services. Many nations have established specific governance systems to facilitate research and to address the complex ethical, legal and social challenges that they present, but this has not lead to uniformity across the world. Despite significant progress in responding to the ethical, legal and social implications of biobanking, operational, sustainability and funding challenges continue to emerge. No coherent strategy has yet been identified for addressing them. This has brought into question the overall viability and usefulness of biobanks in light of the significant resources required to keep them running. This review sets out the challenges that the biobanking community has had to overcome since their inception in the early 2000s. The first section provides a brief outline of the diversity in biobank and regulatory architecture in seven countries: Australia, Germany, Japan, Singapore, Taiwan, the UK, and the USA. The article then discusses four waves of responses to biobanking challenges. This article had its genesis in a discussion on biobanks during the Centre for Health, Law and Emerging Technologies (HeLEX) conference in Oxford UK, co-sponsored by the Centre for Law and Genetics (University of Tasmania). This article aims to provide a review of the issues associated with biobank practices and governance, with a view to informing the future course of both large-scale and smaller scale biobanks.
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Mitchell C, Ploem MC, Hennekam RCM, Kaye J. A Duty To Warn Relatives in Clinical Genetics: Arguably 'Fair just and reasonable' in English Law? TOTTEL'S JOURNAL OF PROFESSIONAL NEGLIGENCE 2016; 32:120-136. [PMID: 27478488 PMCID: PMC4962911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
The use of 'next-generation' genetic sequencing technology that allows the sequencing of large parts, or even the entirety, of a patient's genome is advancing rapidly in the UK and around the world. This is set to greatly increase the level of health information that will be of relevance to relatives and the latest medical guidance advises that there is a professional duty to consider warning a patient's relatives of a serious genetic risk in limited circumstances. However, the High Court in ABC v St George's Healthcare NHS Trust [2015] EWHC 1394 (QB), recently found that a legal duty on the part of doctors to warn a patient's daughter of a genetic risk of Huntington's Disease without the patient's consent, was not even 'reasonably arguable' and would not be 'fair, just and reasonable'. This article considers the courts' approach to a duty of care towards 'third parties' in this context and concludes that some form of a duty of care to genetic relatives in clinical genetics is at very least arguably 'fair, just and reasonable'.
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Kaye J, Briceño Moraia L, Curren L, Bell J, Mitchell C, Soini S, Hoppe N, Øien M, Rial-Sebbag E. Consent for Biobanking: The Legal Frameworks of Countries in the BioSHaRE-EU Project. Biopreserv Biobank 2016; 14:195-200. [PMID: 27145287 PMCID: PMC5967579 DOI: 10.1089/bio.2015.0123] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Currently, there is no single, Europe-wide regulation of biomedical research using human samples and data. Instead, the law that applies spans a number of areas of law, such as data protection, clinical trials, and tissue regulation. In the absence of harmonized regulation, there is considerable scope for national legal variation. This article analyzes the legislative frameworks that apply to biobanking activities to identify differences in legal requirements between the BioSHaRE-EU project countries: Finland, France, Germany, the Netherlands, Norway, and the United Kingdom. This article highlights the primary role of consent and accompanying governance mechanisms, such as research ethics committee oversight, which enable consent exemptions in the context of research. Our analysis identifies a complicated legal landscape, whereby broadly similar provisions are contained in varied sources of law in each jurisdiction. The challenge for researchers is locating the applicable legal provisions within each national legal framework.
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Kaye J, Briceño Moraia L, Mitchell C, Bell J, Bovenberg JA, Tassé AM, Knoppers BM. Access Governance for Biobanks: The Case of the BioSHaRE-EU Cohorts. Biopreserv Biobank 2016; 14:201-6. [PMID: 27183185 PMCID: PMC5939924 DOI: 10.1089/bio.2015.0124] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
Currently, researchers have to apply separately to individual biobanks if they want to carry out studies that use samples and data from multiple biobanks. This article analyzes the access governance arrangements of the original five biobank members of the Biobank Standardisation and Harmonisation for Research Excellence in the European Union (BioSHaRE-EU) project in Finland, Germany, the Netherlands, Norway, and the United Kingdom to identify similarities and differences in policies and procedures, and consider the potential for internal policy “harmonization.” Our analysis found differences in the range of researchers and organizations eligible to access biobanks; application processes; requirements for Research Ethics Committee approval; and terms of Material Transfer Agreements relating to ownership and commercialization. However, the main elements of access are the same across biobanks; access will be granted to bona fide researchers conducting research in the public interest, and all biobanks will consider the scientific merit of the proposed use and it's compatibility with the biobank's objectives. These findings suggest potential areas for harmonization across biobanks. This could be achieved through a single centralized application to a number of biobanks or a system of mutual recognition that places a presumption in favor of access to one biobank if already approved by another member of the same consortium. Biobanking and Biomolecular Resources Research Infrastructure-European Research Infrastructure Consortia (BBMRI-ERIC), a European consortium of biobanks and bioresources with its own ethical, legal, and social implications (ELSI) common service, could provide a platform by developing guidelines for harmonized internal processes.
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Haworth A, Reynolds H, DiFranco M, Sun Y, Wraith D, Williams S, Parameswaran B, Mitchell C, Ebert M. OC-0061: Focal brachytherapy: what dose to what volume? Radiother Oncol 2016. [DOI: 10.1016/s0167-8140(16)31310-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Arif AA, Mitchell C. Use of Exhaled Nitric Oxide as a Biomarker in Diagnosis and Management of Chronic Obstructive Pulmonary Disease. J Prim Care Community Health 2016; 7:102-6. [PMID: 26718918 PMCID: PMC5932718 DOI: 10.1177/2150131915624922] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Chronic obstructive pulmonary disease (COPD), a progressive and nonreversible disease, is a leading cause of mortality and morbidity throughout the world. Because airway inflammation is a hallmark of COPD, it has been proposed that measuring exhaled nitric oxide, a marker of inflammation, in exhaled breath condensate could prove to be an inexpensive and efficient method to detect COPD in outpatient settings. METHODS This study used secondary data on a sample of 10,214 individuals 30 years and older from the National Health and Nutrition Examination Survey 2007 to 2010. Binary and ordinal logistic regression analyses were used to test the association of exhaled nitric oxide (eNO) with COPD and COPD severity. RESULTS The prevalence of COPD was 7.2%, based on self-reported physician diagnoses and 11.4% based on prebronchodilator spirometry analysis. This study found no statistically significant association between eNO, COPD, and COPD severity (P > .05). CONCLUSIONS The findings of this study do not support use of eNO as a biomarker of inflammation in diagnosis and management of COPD.
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Kaye J, Bell J, Briceno L, Mitchell C. Biobank Report: United Kingdom. THE JOURNAL OF LAW, MEDICINE & ETHICS : A JOURNAL OF THE AMERICAN SOCIETY OF LAW, MEDICINE & ETHICS 2016; 44:96-105. [PMID: 27256127 DOI: 10.1177/1073110516644202] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
The United Kingdom is a leader in genomics research, and the presence of numerous types of biobanks and the linking of health data and research within the UK evidences the importance of biobank-based research in the UK. There is no biobank-specific law in the UK and research on biobank materials is governed by a confusing set of statutory law, common law, regulations, and guidance documents. Several layers of applicable law, from European to local, further complicate an understanding of privacy protections. Finally, biobanks frequently contain data in addition to the samples; the legal framework in the UK generally differentiates between data and samples and the form of the data affects the applicability of legal provisions. Biobanks must be licensed by the Human Tissue Authority; certain projects must be reviewed by Research Ethics Committees, and all projects are encouraged to be reviewed by them. Data Access Committees in biobanks are also common in the UK. While this confusing array of legal provisions leaves privacy protections in biobanking somewhat unclear, changes at the EU level may contribute to harmonization of approaches to privacy.
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Donald KJ, Clarke HV, Mitchell C, Cornwell RM, Hubbard SF, Karley AJ. Protection of Pea Aphids Associated with Coinfecting Bacterial Symbionts Persists During Superparasitism by a Braconid Wasp. MICROBIAL ECOLOGY 2016; 71:1-4. [PMID: 26520831 DOI: 10.1007/s00248-015-0690-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/03/2015] [Accepted: 10/12/2015] [Indexed: 06/05/2023]
Abstract
Bacterial endosymbionts that associate facultatively with insect herbivores can influence insect fitness and trophic interactions. The pea aphid, Acyrthosiphon pisum, can be protected from parasitism by the braconid wasp Aphidius ervi when harbouring particular symbiotic bacteria, with specific endosymbiont coinfections providing almost complete protection. However, studies often quantify aphid mummification with no control over parasitoid oviposition per aphid; thus, if mummy production fails or is low, the causes are often unclear. Here, we show that the high level of protection associated with the coinfecting endosymbionts Hamiltonella defensa and X-type is maintained even when pea aphids are superparasitised. This contrasts strongly with the protection provided by H. defensa alone, which has been shown by others to be overcome by superparasitism. By dissecting aphids exposed to two parasitoid attacks, we reveal that A. ervi deposits eggs equally freely in endosymbiont-infected and uninfected nymphs, and lack of mummification in endosymbiont-protected nymphs arises from failure of the wasp eggs to hatch or emerging larvae to develop.
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Au-Yeung G, Lang F, Mitchell C, Jarman K, Lackovic K, Cullinane C, Mileshkin L, Rischin D, Etemadmoghadam D, Bowtell D. 1PD A high throughput compound screen identifies potential combinations to overcome resistance to Cdk2 inhibitors in Cyclin E1 amplified high grade serous ovarian cancer. Ann Oncol 2015. [DOI: 10.1093/annonc/mdv517.01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Pitt A, Mitchell C, Colwell B, Appelqvist I, Ashby F, Lloyd C, Gilbody S, Lawson R. M9 Lung Health of OPiate Users (LHOp): A pilot study to assess the respiratory health of opiate misusers attending a community substance misuse clinic. Thorax 2015. [DOI: 10.1136/thoraxjnl-2015-207770.436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Reynolds HM, Williams S, Zhang A, Chakravorty R, Rawlinson D, Ong CS, Esteva M, Mitchell C, Parameswaran B, Finnegan M, Liney G, Haworth A. Development of a registration framework to validate MRI with histology for prostate focal therapy. Med Phys 2015; 42:7078-89. [DOI: 10.1118/1.4935343] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
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Mitchell C, Bailey N, Bulbeck H, Hopkins K, Price S, Stewart W, Hilton D, Nicoll J, Kurian K. PO81A LACK OF CONSENT TO DONATE BRAIN TUMOUR TISSUE FOR RESEARCH HAMPERS PROGRESS. Neuro Oncol 2015. [DOI: 10.1093/neuonc/nov284.70] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Rooney J, Zou Y, Cowling B, Mitchell C, Bönnemann C. Late-onset mild myopathy with protein aggregates in two transgenic mouse models of FHL1. Neuromuscul Disord 2015. [DOI: 10.1016/j.nmd.2015.06.334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Smith K, Mitchell C, Trotter Z. 358 Point-of-Care Ultrasound for Ankle Injuries in the Pediatric Emergency Department. Ann Emerg Med 2015. [DOI: 10.1016/j.annemergmed.2015.07.394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Mitchell C, Arif AA. The Association Between Exhaled Nitric Oxide in Exhaled Breath Condensate and Chronic Obstructive Pulmonary Disease. Ann Epidemiol 2015. [DOI: 10.1016/j.annepidem.2015.06.065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Mitchell C, Platt S. PP70 Evaluation of user-perceived impact of edinburgh access practice keep well interventions on the health and wellbeing of gypsy/traveller and homeless service users: a mixed methods approach. Br J Soc Med 2015. [DOI: 10.1136/jech-2015-206256.166] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Lucas C, Wilkinson J, Mitchell C, Kenna D, Turton J, Mustafa N, Williams C. 55 Is whole genome sequencing necessary to exclude cross infection with Mycobacterium abscessus ST26 in paediatric cystic fibrosis patients? J Cyst Fibros 2015. [DOI: 10.1016/s1569-1993(15)30232-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Osorio D, Filatov A, Hagiwara M, Mitchell C, Wisoff J, Golfinos J, Roland JT, Allen J, Karajannis M. TR-13 * EFFECTS OF EVEROLIMUS ON MENINGIOMA GROWTH IN PATIENTS WITH NEUROFIBROMATOSIS TYPE 2. Neuro Oncol 2015. [DOI: 10.1093/neuonc/nov061.158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Poudel A, Gray LC, Mitchell C, Nissen LM, Hubbard RE. 52 * GERIATRICIAN CONSULTATIONS ON APPROPRIATE PRESCRIBING FOR FRAIL OLDER PEOPLE IN RESIDENTIAL AGED CARE FACILITIES. Age Ageing 2015. [DOI: 10.1093/ageing/afv035.01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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