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Abbas MA, Al-Kabariti AY, Sutton C. Comprehensive understanding of the role of GPER in estrogen receptor-alpha negative breast cancer. J Steroid Biochem Mol Biol 2024; 241:106523. [PMID: 38636681 DOI: 10.1016/j.jsbmb.2024.106523] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2023] [Revised: 11/01/2023] [Accepted: 04/14/2024] [Indexed: 04/20/2024]
Abstract
G protein-coupled estrogen receptor (GPER) plays a prominent role in facilitating the rapid, non-genomic signaling of estrogens in breast cancer cells. Herein, a comprehensive overview of the role of GPER in ER-ɑ-negative breast cancer is provided. Activation of GPER affected proliferation, metastasis and epithelial mesenchymal transition in ER-ɑ negative breast cancer cells. Clinical studies have demonstrated that GPER positivity was strongly correlated with larger tumor size and advanced clinical stage, suggesting that GPER/ERK signaling may play a role in promoting tumor progression. Strong evidence existed that environmental contaminants like bisphenol A have a carcinogenic potential mediated by GPER activation. The complexity of the cross talk between GPER and other receptors including ER-β, ER-α36, Estrogen-related receptor α (ERRα) and androgen receptor has been discussed. The potential utility of small molecules and phytoestrogens targeting GPER, adds valuable insights into its therapeutic potential. This review holds promises in advancing our understanding of GPER role in ER-ɑ-negative breast cancer. Overall, the consequences of GPER activation are still an area of active research and the implication are not entirely clear.
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Affiliation(s)
- Manal A Abbas
- Department of Medical Laboratory Sciences, Faculty of Allied Medical Sciences, Al-Ahliyya Amman University, Amman 19328, Jordan; Pharmacological and Diagnostic Research Centre, Al-Ahliyya Amman University, Amman 19328, Jordan
| | - Aya Y Al-Kabariti
- Department of Biopharmaceutics and Clinical Pharmacy, Faculty of Pharmacy, Al-Ahliyya Amman University, Amman 19328, Jordan; Pharmacological and Diagnostic Research Centre, Al-Ahliyya Amman University, Amman 19328, Jordan.
| | - Chris Sutton
- School of Chemistry and Biosciences, University of Bradford, Bradford BD7 1DP, UK
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2
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Arundel CE, Clark LK, Parker A, Beard D, Coleman E, Cooper C, Devane D, Eldridge S, Galvin S, Gillies K, Hewitt CE, Sutton C, Torgerson DJ, Treweek S. Trial Forge Guidance 4: a guideline for reporting the results of randomised Studies Within A Trial (SWATs). Trials 2024; 25:183. [PMID: 38475795 PMCID: PMC10935912 DOI: 10.1186/s13063-024-08004-0] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Accepted: 02/22/2024] [Indexed: 03/14/2024] Open
Abstract
BACKGROUND Evidence to support decisions on trial processes is minimal. One way to generate this evidence is to use a Study Within A Trial (SWAT) to test trial processes or explore methodological uncertainties. SWAT evidence relies on replication to ensure sufficient power and broad applicability of findings. Prompt reporting is therefore essential; however, SWAT publications are often the first to be abandoned in the face of other time pressures. Reporting guidance for embedded methodology trials does exist but is not widely used. We sought therefore to build on these guidelines to develop a straightforward, concise reporting standard, which remains adherent to the CONSORT guideline. METHODS An iterative process was used to develop the guideline. This included initial meetings with key stakeholders, development of an initial guideline, pilot testing of draft guidelines, further iteration and pilot testing, and finalisation of the guideline. RESULTS We developed a reporting guideline applicable to randomised SWATs, including replications of previous evaluations. The guideline follows the Consolidated Standards for Reporting Trials (CONSORT) statement and provides example text to ensure ease and clarity of reporting across all domains. CONCLUSIONS The SWAT reporting guideline will aid authors, reviewers, and journal editors to produce and review clear, structured reports of randomised SWATs, whilst also adhering to the CONSORT guideline. TRIAL REGISTRATION EQUATOR Network - Guidelines Under Development ( https://www.equator-network.org/library/reporting-guidelines-under-development/reporting-guidelines-under-development-for-clinical-trials/#SWAT ). Registered on 25 March 2021.
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Affiliation(s)
- C E Arundel
- York Trials Unit, Department of Health Sciences, Faculty of Science, Lower Ground Floor ARRC Building, University of York, York, YO10 5DD, UK.
| | - L K Clark
- York Trials Unit, Department of Health Sciences, Faculty of Science, Lower Ground Floor ARRC Building, University of York, York, YO10 5DD, UK
| | - A Parker
- York Trials Unit, Department of Health Sciences, Faculty of Science, Lower Ground Floor ARRC Building, University of York, York, YO10 5DD, UK
| | - D Beard
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, Botnar Research Centre, University of Oxford, Headington, Oxford, UK
| | - E Coleman
- York Trials Unit, Department of Health Sciences, Faculty of Science, Lower Ground Floor ARRC Building, University of York, York, YO10 5DD, UK
| | - C Cooper
- Clinical Trials Research Unit, University of Sheffield, Sheffield, UK
| | - D Devane
- HRB-Trials Methodology Research Network, University of Galway, Galway, Ireland
- School of Nursing and Midwifery, University of Galway, Galway, Ireland
- Evidence Synthesis Ireland and Cochrane Ireland, University of Galway, Galway, Ireland
| | - S Eldridge
- Wolfson Institute of Population Health, Queen Mary University of London, London, UK
| | - S Galvin
- HRB-Trials Methodology Research Network, University of Galway, Galway, Ireland
| | - K Gillies
- Health Services Research Unit, University of Aberdeen, Aberdeen, UK
| | - C E Hewitt
- York Trials Unit, Department of Health Sciences, Faculty of Science, Lower Ground Floor ARRC Building, University of York, York, YO10 5DD, UK
| | - C Sutton
- School of Health Sciences, The University of Manchester, Manchester, UK
| | - D J Torgerson
- York Trials Unit, Department of Health Sciences, Faculty of Science, Lower Ground Floor ARRC Building, University of York, York, YO10 5DD, UK
| | - S Treweek
- Health Services Research Unit, University of Aberdeen, Aberdeen, UK
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3
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Eastham C, Mansell W, Sutton C, Prior Y, Keady J, Shields G, Riley C, Bowker G, Sylvestre Y, Morris L. Protocol of a feasibility randomised controlled trial of Empowered Conversations: training family carers to enhance their relationships and communication with people living with dementia. NIHR Open Res 2023; 3:36. [PMID: 37881464 PMCID: PMC10593329 DOI: 10.3310/nihropenres.13441.1] [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] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 06/30/2023] [Indexed: 10/27/2023]
Abstract
Background Communication difficulties can cause frustration, low mood, and stress for people living with dementia and their carer. Carers should be offered training on adapting their communication skills. However, it is not common for skills-based education to examine emotional aspects of care and the effect of dementia on relationships. The Empowered Conversations (EC) training course was developed in response to a gap in service provision and has been adapted to a virtual format (Zoom). It addresses the specific psychological, relationship, and communication needs of informal and family dementia carers. The primary aim of the study is to investigate the feasibility of conducting a multi-centre randomised controlled evaluation trial of EC. Secondary aims include exploring the acceptability of delivering the intervention online and examining the optimum way of establishing cost-effectiveness. Methods The feasibility trial uses a pragmatic data-collector blind parallel two-group RCT design with two arms (EC intervention plus treatment as usual, and treatment as usual waitlist control). There will be a 2:1 allocation in favour of the EC-training intervention arm. 75 participants will complete baseline outcome measures exploring their role as a carer, including their physical and mental health, attitudes to caring, quality of life, and use of health and social care services. These will be repeated after six-months. Participants allocated to the treatment group who complete the course will be invited to participate in a qualitative interview discussing their experience of EC. Conclusions The study will investigate recruitment pathways (including facilitators and barriers to recruitment), estimate retention levels and response rates to questionnaires, obtain additional evidence regarding proof of concept, and consider the most appropriate primary outcome measures and methods for evaluating cost-effectiveness. The results of the feasibility study will be used to inform the development of a multicentre randomised controlled trial in the United Kingdom. Registration ISRCTN15261686 (02/03/2022).
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Affiliation(s)
- Cassie Eastham
- Greater Manchester Mental Health NHS Foundation Trust, Prestwich, England, M25 3BL, UK
| | - Warren Mansell
- Curtin University, Perth, Western Australia, 6102, Australia
- The University of Manchester, Manchester, England, M13 9PL, UK
| | - Chris Sutton
- The University of Manchester, Manchester, England, M13 9PL, UK
| | - Yeliz Prior
- University of Salford, Salford, England, M5 4WT, UK
| | - John Keady
- The University of Manchester, Manchester, England, M13 9PL, UK
| | - Gemma Shields
- The University of Manchester, Manchester, England, M13 9PL, UK
| | - Cathy Riley
- Greater Manchester Mental Health NHS Foundation Trust, Prestwich, England, M25 3BL, UK
| | - Gail Bowker
- Independent Researcher, Manchester, England, UK
| | | | - Lydia Morris
- The University of Manchester, Manchester, England, M13 9PL, UK
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4
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Taylor PJ, Duxbury P, Moorhouse J, Russell C, Pratt D, Parker S, Sutton C, Lobban F, Drake R, Eccles S, Ryder D, Patel R, Kimber E, Kerry E, Randles N, Kelly J, Palmier-Claus J. The Mental Imagery for Suicidality in Students Trial (MISST): study protocol for a feasibility randomised controlled trial of broad-minded affective coping (BMAC) plus risk assessment and signposting versus risk assessment and signposting alone. Pilot Feasibility Stud 2023; 9:43. [PMID: 36932430 PMCID: PMC10021063 DOI: 10.1186/s40814-023-01273-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Accepted: 03/04/2023] [Indexed: 03/19/2023] Open
Abstract
BACKGROUND Going to university is an important milestone in many people's lives. It can also be a time of significant challenge and stress. There are growing concerns about mental health amongst student populations including suicide risk. Student mental health and counselling services have the potential to prevent suicide, but evidence-based therapies are required that fit these service contexts. The Broad-Minded Affective Coping intervention (BMAC) is a brief (6 sessions), positive imagery-based intervention that aims to enhance students access to past positive experiences and associated emotions and cognitions. Pilot data provides preliminary support for the BMAC for students struggling with suicidal thoughts and behaviours, but this intervention has not yet been evaluated in the context of a randomised controlled trial (RCT). The Mental Imagery for Suicidality in Students Trial (MISST) is a feasibility RCT that aims to determine the acceptability and feasibility of evaluating the BMAC as an intervention for university students at risk of suicide within a larger efficacy trial. Key feasibility uncertainties have been identified relating to recruitment, retention, and missing data. Intervention acceptability and safety will also be evaluated. METHOD MISST is a feasibility randomised controlled trial design, with 1:1 allocation to risk assessment and signposting plus BMAC or risk assessment and signposting alone. Participants will be university students who self-report experiences of suicidal ideation or behaviour in the past 3 months. Assessments take place at baseline, 8, 16, and 24 weeks. The target sample size is 66 participants. A subset of up to 20 participants will be invited to take part in semi-structured qualitative interviews to obtain further data concerning the acceptability of the intervention. DISCUSSION The BMAC intervention may provide an effective, brief talking therapy to help university students struggling with suicidal thoughts that could be readily implemented into university student counselling services. Depending on the results of MISST, the next step would be to undertake a larger-scale efficacy trial. TRIAL REGISTRATION The trial was preregistered (17 December 2021) on ISRCTN (ISRCTN13621293) and ClinicalTrials.gov (NCT05296538).
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Affiliation(s)
- Peter James Taylor
- Division of Psychology & Mental Health, University of Manchester, Manchester, UK
| | - Paula Duxbury
- Manchester Mental Health NHS Foundation Trust, Manchester, UK
| | - Jane Moorhouse
- Manchester Mental Health NHS Foundation Trust, Manchester, UK
| | - Chloe Russell
- Manchester Mental Health NHS Foundation Trust, Manchester, UK
| | - Dan Pratt
- Division of Psychology & Mental Health, University of Manchester, Manchester, UK.,Manchester Mental Health NHS Foundation Trust, Manchester, UK
| | - Sophie Parker
- Division of Psychology & Mental Health, University of Manchester, Manchester, UK.,Manchester Mental Health NHS Foundation Trust, Manchester, UK
| | - Chris Sutton
- Division of Population Health, Health Services Research, and Primary Care, University of Manchester, Manchester, UK
| | - Fiona Lobban
- LA14YW, Spectrum Centre for Mental Health Research, Lancaster University, Lancaster, UK
| | - Richard Drake
- Division of Psychology & Mental Health, University of Manchester, Manchester, UK
| | - Steve Eccles
- Manchester Mental Health NHS Foundation Trust, Manchester, UK
| | - David Ryder
- Division of Population Health, Health Services Research, and Primary Care, University of Manchester, Manchester, UK
| | - Rafeea Patel
- Manchester Mental Health NHS Foundation Trust, Manchester, UK
| | | | - Eirian Kerry
- Manchester Mental Health NHS Foundation Trust, Manchester, UK
| | - Nathan Randles
- School of Medicine, Keele University, Newcastle-Under-Lyme, UK
| | - James Kelly
- Manchester Mental Health NHS Foundation Trust, Manchester, UK.,Doctorate in Clinical Psychology, Lancaster University, Lancaster, UK
| | - Jasper Palmier-Claus
- LA14YW, Spectrum Centre for Mental Health Research, Lancaster University, Lancaster, UK. .,Lancashire & South Cumbria NHS Foundation Trust, Lancashire, UK.
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5
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Carrato K, Jain N, Eckert A, Lamberti M, Sutton C, Sens J, Horton K, Khan A, Tabori N, Sivananthan G, Smirniotopoulos J. Abstract No. 120 Genicular Nerve Radiofrequency Ablation: Is There a Predictor of Outcomes? J Vasc Interv Radiol 2023. [DOI: 10.1016/j.jvir.2022.12.170] [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: 02/27/2023] Open
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6
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Watkins C, Tishkovskaya S, Brown C, Sutton C, Garcia YS, Forshaw D, Prescott G, Thomas L, Roffe C, Booth J, Bennett K, Roe B, Hollingsworth B, Mateus C, Britt D, Panton C. Systematic voiding programme in adults with urinary incontinence following acute stroke: the ICONS-II RCT. Health Technol Assess 2022; 26:1-88. [PMID: 35881012 DOI: 10.3310/eftv1270] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Urinary incontinence affects around half of stroke survivors in the acute phase, and it often presents as a new problem after stroke or, if pre-existing, worsens significantly, adding to the disability and helplessness caused by neurological deficits. New management programmes after stroke are needed to address urinary incontinence early and effectively. OBJECTIVE The Identifying Continence OptioNs after Stroke (ICONS)-II trial aimed to evaluate the clinical effectiveness and cost-effectiveness of a systematic voiding programme for urinary incontinence after stroke in hospital. DESIGN This was a pragmatic, multicentre, individual-patient-randomised (1 : 1), parallel-group trial with an internal pilot. SETTING Eighteen NHS stroke services with stroke units took part. PARTICIPANTS Participants were adult men and women with acute stroke and urinary incontinence, including those with cognitive impairment. INTERVENTION Participants were randomised to the intervention, a systematic voiding programme, or to usual care. The systematic voiding programme comprised assessment, behavioural interventions (bladder training or prompted voiding) and review. The assessment included evaluation of the need for and possible removal of an indwelling urinary catheter. The intervention began within 24 hours of recruitment and continued until discharge from the stroke unit. MAIN OUTCOME MEASURES The primary outcome measure was severity of urinary incontinence (measured using the International Consultation on Incontinence Questionnaire) at 3 months post randomisation. Secondary outcome measures were taken at 3 and 6 months after randomisation and on discharge from the stroke unit. They included severity of urinary incontinence (at discharge and at 6 months), urinary symptoms, number of urinary tract infections, number of days indwelling urinary catheter was in situ, functional independence, quality of life, falls, mortality rate and costs. The trial statistician remained blinded until clinical effectiveness analysis was complete. RESULTS The planned sample size was 1024 participants, with 512 allocated to each of the intervention and the usual-care groups. The internal pilot did not meet the target for recruitment and was extended to March 2020, with changes made to address low recruitment. The trial was paused in March 2020 because of COVID-19, and was later stopped, at which point 157 participants had been randomised (intervention, n = 79; usual care, n = 78). There were major issues with attrition, with 45% of the primary outcome data missing: 56% of the intervention group data and 35% of the usual-care group data. In terms of the primary outcome, patients allocated to the intervention group had a lower score for severity of urinary incontinence (higher scores indicate greater severity in urinary incontinence) than those allocated to the usual-care group, with means (standard deviations) of 8.1 (7.4) and 9.1 (7.8), respectively. LIMITATIONS The trial was unable to recruit sufficient participants and had very high attrition, which resulted in seriously underpowered results. CONCLUSIONS The internal pilot did not meet its target for recruitment and, despite recruitment subsequently being more promising, it was concluded that the trial was not feasible owing to the combined problems of poor recruitment, poor retention and COVID-19. The intervention group had a slightly lower score for severity of urinary incontinence at 3 months post randomisation, but this result should be interpreted with caution. FUTURE WORK Further studies to assess the effectiveness of an intervention starting in or continuing into the community are required. TRIAL REGISTRATION This trial is registered as ISRCTN14005026. FUNDING This project was funded by the National Institute for Health and Care Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 26, No. 31. See the NIHR Journals Library website for further project information.
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Affiliation(s)
- Caroline Watkins
- Lancashire Clinical Trials Unit, Applied Health Research Hub, University of Central Lancashire, Preston, UK.,Faculty of Health and Care, University of Central Lancashire, Preston, UK
| | - Svetlana Tishkovskaya
- Lancashire Clinical Trials Unit, Applied Health Research Hub, University of Central Lancashire, Preston, UK
| | - Chris Brown
- Lancashire Clinical Trials Unit, Applied Health Research Hub, University of Central Lancashire, Preston, UK
| | - Chris Sutton
- Centre for Biostatistics, Division of Population Health, Health Services Research & Primary Care, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - Yvonne Sylvestre Garcia
- Centre for Biostatistics, Division of Population Health, Health Services Research & Primary Care, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - Denise Forshaw
- Lancashire Clinical Trials Unit, Applied Health Research Hub, University of Central Lancashire, Preston, UK
| | - Gordon Prescott
- Lancashire Clinical Trials Unit, Applied Health Research Hub, University of Central Lancashire, Preston, UK
| | - Lois Thomas
- Faculty of Health and Care, University of Central Lancashire, Preston, UK
| | - Christine Roffe
- Research Institute for Science and Technology in Medicine, Keele University, Stoke-on-Trent, UK
| | - Joanne Booth
- Research Centre for Health, School of Health and Life Sciences, Department of Nursing and Community Health, Glasgow Caledonian University, Glasgow, UK
| | - Kina Bennett
- Centre for Health Research and Innovation, NIHR Lancashire Clinical Research Facility, Lancashire Teaching Hospitals NHS Foundation Trust, Preston, UK
| | - Brenda Roe
- Faculty of Health, Social Care and Medicine, Edge Hill University, Ormskirk, UK
| | | | - Ceu Mateus
- Division of Health Research, Lancaster University, Lancaster, UK
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Mahlangu J, Bassa F, Bassingthwaighte M, Cruickshank AL, Du Plessis J, Goga Y, Joubert J, Louw V, Mahlachana N, Mathew R, Neethling B, Potgieter J, Rapiti N, Rayner B, Reynders D, Sutton C, Van Zyl A. Prophylaxis is the new standard of care in patients with haemophilia. S Afr Med J 2022; 112:405-408. [PMID: 36217868] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 05/31/2022] [Indexed: 06/16/2023] Open
Abstract
Randomised controlled clinical trial evidence on prophylaxis as optimal care for patients with haemophilia was generated more than a decade ago. However, this knowledge has not translated into clinical practice in South Africa (SA) owing to many barriers to prophylaxis. These include the high treatment burden imposed by prophylaxis (frequent injections two to four times a week), the need for intravenous access to administer replacement clotting factor therapies, and the higher volume of clotting factor required compared with episodic treatment. The recently introduced non-factor therapies in haemophilia care have addressed many of these barriers. For example, emicizumab, which is currently the only globally approved non-factor therapy, can be administered subcutaneously less frequently (weekly, fortnightly or every 4 weeks) and has led to global adoption of prophylaxis as the standard of care in haemophilia by the bleeding disorders community. Haemophilia A is the most prevalent clotting factor deficiency in SA, with >2 000 people diagnosed to date. However, only a few of these patients are currently on prophylaxis. In this 'In Practice' article, we review the rationale for prophylaxis, outline its goals and benefits, and provide evidence-based guidance on which haemophilia patients should be prioritised for emicizumab prophylaxis. This consensus guidance facilitates the adoption of prophylaxis as a national policy and the new standard of care in haemophilia in SA.
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Affiliation(s)
- J Mahlangu
- Department of Molecular Medicine and Haematology, National Health Laboratory Service, Charlotte Maxeke Johannesburg Academic Hospital and School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
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Jiwa N, Takats Z, Leff D, Sutton C. Breast health screening questionnaire, a UK perspective: The acceptability of use of nipple aspirate fluid as a screening tool for breast cancer. Eur J Surg Oncol 2022. [DOI: 10.1016/j.ejso.2022.03.079] [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: 12/01/2022] Open
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Bedwell C, Blaikie K, Actis Danna V, Sutton C, Laisser R, Tembo Kasengele C, Wakasiaka S, Victor S, Lavender T. Authors' reply re: Understanding the complexities of unexplained stillbirth in sub-Saharan Africa: a mixed-methods study. BJOG 2021; 128:2057. [PMID: 34312975 DOI: 10.1111/1471-0528.16832] [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] [Accepted: 06/03/2021] [Indexed: 11/29/2022]
Affiliation(s)
- Carol Bedwell
- International Public Health, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Kieran Blaikie
- School of Health Sciences, University of Manchester, Manchester, UK
| | | | - Chris Sutton
- School of Health Sciences, University of Manchester, Manchester, UK
| | - Rose Laisser
- Archbishop Antony Mayala School of Nursing, Catholic University of Health and Allied Health Sciences, Mwanza, Tanzania
| | - Chowa Tembo Kasengele
- Department of Public Health and Research, Ministry of Health Headquarters, Lusaka, Zambia
| | | | - Suresh Victor
- Perinatal Imaging and Health, King's College London, London, UK
| | - Tina Lavender
- International Public Health, Liverpool School of Tropical Medicine, Liverpool, UK
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10
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Lee R, Rothwell DG, Chow S, Shaw HM, Turajlic S, Smith N, Clipson A, Clarke H, Kelso N, Mitchell J, Sutton C, Sylvestre G, Nathan PD, Larkin J, Corrie PG, Plummer ER, Marais R, Dive C, Lorigan P. CAcTUS: A parallel arm, biomarker driven, phase II feasibility trial to determine the role of circulating tumor DNA in guiding a switch between targeted therapy and immune therapy in patients with advanced cutaneous melanoma. J Clin Oncol 2021. [DOI: 10.1200/jco.2021.39.15_suppl.tps9587] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
TPS9587 Background: Circulating tumor DNA (ctDNA; the tumour derived fraction of circulating free DNA in the blood) has been shown to be a biomarker of tumor burden/progression in many cancers. We recently accurately monitored treatment response and resistance in stage IV melanoma by ctDNA analysis in serial peripheral blood samples. Pre-clinical data has previously revealed that BRAF inhibition provokes a micro-environment with increased T cell infiltration, improved T cell recognition of melanoma associated antigens and reduced production of immunosuppressive cytokines that could enhance immune responses. We aimed to test the hypothesis that ctDNA could be implemented as a personalised, real-time liquid biopsy to identify when tumours are responding to targeted therapy in order optimise a switch to immunotherapy. Methods: We validated the ctDNA assays for BRAF mutation calling as a primary trial endpoint. We designed a phase II multicenter, parallel arm study across 6 UK sites, to assess primary objectives of i). Whether a ctDNA result can be turned around within 7 days and actioned in a clinically relevant timeframe ii). to assess whether a decrease in ctDNA levels of mutant BRAF by ≥80% from baseline on targeted therapy is an appropriate ‘cut off’ to instruct switching to immunotherapy. Secondary endpoints include Overall Response Rate (ORR) to immunotherapy, radiological/clinical and ctDNA determined progression free survival (PFS) on each treatment. Forty patients are planned based on inclusion criteria of stage IV or stage III unresectable cutaneous BRAF mutant melanoma, baseline ctDNA BRAF variant allele frequency (VAF) ≥1.5%, ECOG 0/1/2, no symptomatic brain metastases, no prior adjuvant nivolumab plus ipilimumab (N+I). Prior adjuvant dabrafinib + trametinib (D+T) is allowed as long as recurrence is >6 months from completion. Patients are randomised 1:1 to either standard Arm A; investigator choice of either D+T (150mg BD +2mg OD respectively) or N+I (1 mg/kg N +3 mg/kg I q3 wkly, then N 480mg q4 wkly) first line, then switch on progression to the other treatment. In the experimental Arm B; all patients start on D+T and have BRAF ctDNA monitored q2 wkly for 4 wks then q4 wkly. When ≥80% decrease vs. baseline in ctDNA BRAF VAF occurs, patients switch to N+I. If patients subsequently progress on N+I, they will resume D+T. The study is open with 9 patients enrolled at time of submission. Clinical trial information: NCT03808441.
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Affiliation(s)
- Rebecca Lee
- The Christie NHS Foundation Trust, Manchester, United Kingdom
| | - Dominic G. Rothwell
- Cancer Research UK Manchester Institute Cancer Biomarker Centre, Manchester, United Kingdom
| | - Shien Chow
- The Clatterbridge Cancer Centre, Wirral, United Kingdom
| | | | - Samra Turajlic
- The Institute of Cancer Research, London, United Kingdom
| | - Nigel Smith
- Cancer Research UK Manchester Institute Cancer Biomarker Centre, Manchester, United Kingdom
| | - Alexandra Clipson
- Cancer Research UK Manchester Institute Cancer Biomarker Centre, Manchester, United Kingdom
| | - Harry Clarke
- Cancer Research UK Manchester Institute Cancer Biomarker Centre, Manchester, United Kingdom
| | - Noel Kelso
- Cancer Research UK Manchester Institute Cancer Biomarker Centre, Manchester, United Kingdom
| | - Jackie Mitchell
- Molecular Oncology group, Cancer Research UK Manchester Institute, Manchester, United Kingdom
| | - Chris Sutton
- The University of Manchester, Manchester, United Kingdom
| | - Gema Sylvestre
- The University of Manchester, Manchester, United Kingdom
| | | | - James Larkin
- Royal Marsden Hospital NHS Foundation Trust, London, United Kingdom
| | - Philippa Gail Corrie
- Department of Oncology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
| | - Elizabeth Ruth Plummer
- Newcastle University and Northern Centre for Cancer Care, Newcastle Hospitals NHS Trust, Newcastle upon Tyne, United Kingdom
| | - Richard Marais
- Molecular Oncology Group, Cancer Research UK Manchester Institute, Manchester, United Kingdom
| | - Caroline Dive
- Cancer Research UK Manchester Institute Cancer Biomarker Centre, Manchester, United Kingdom
| | - Paul Lorigan
- University of Manchester, The Christie NHS Foundation Trust, Manchester, United Kingdom
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11
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Saleem S, Aleem I, Atiq A, Tariq S, Babar A, Abu Bakar M, Syed M, Maruf M, Tariq Mahmood M, Zeshan M, Tahseen M, Hussain R, Loya A, Sutton C. Expression of cornulin in tongue squamous cell carcinoma. Ecancermedicalscience 2021; 15. [DOI: https:/doi.org/10.3332/ecancer.2021.1197] [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: 08/30/2023] Open
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Saleem S, Aleem I, Atiq A, Tariq S, Babar A, Bakar MA, Syed M, Maruf M, Mahmood MT, Zeshan M, Tahseen M, Hussain R, Loya A, Sutton C. Expression of cornulin in tongue squamous cell carcinoma. Ecancermedicalscience 2021; 15:1197. [PMID: 33889206 PMCID: PMC8043688 DOI: 10.3332/ecancer.2021.1197] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Indexed: 12/24/2022] Open
Abstract
The aim of the study is to identify cornulin (CRNN) protein expression associated with advancement of tongue squamous cell carcinoma (TSCC). A comparison of addictive (containing potential carcinogens) versus non-addiction causative agents was expected to allow detection of differences in CRNN expression associated with TSCC. Bespoke tissue microarrays (TMAs) were prepared and immunohistochemistry (IHC) performed to determine the changes in CRNN expression in epithelial cells of node-negative (pN-), node-positive (pN+) TSCC and non-cancer patients’ oral tissues. TMAs were validated by performing IHC on whole diagnostic tissues. Chi-square test or Fisher’s-exact tests were used to establish significant expression differences. Analogous analyses were performed for biomarkers previously associated with TSCC, namely collagen I alpha 2 (COL1A2) and decorin (DCN) to compare the significance of CRNN. Keratinisation and its level (low, extensive) were studied in relation to CRNN so that the extent of squamous differentiation could better be assessed. IHC immunoreactive score (IRS) clustered the patients based on weak/moderate (Low (IRS ≤ +3)) or strong (High (IRS ≥ +4)) expression groups. A low expression was observed in a larger number of patients in control proteins COL1A2 (77.3%), DCN (87.5%) and target protein CRNN (52.3%), respectively. Low CRNN expression was observed in TSCC where nodes were involved (pN+: mean 1.4 ± 2.1) (p = 0.248). Keratinisation (%) was low (0% ≤ 50%) in 42.2% and extensive (1% ≥ 50.0%) in 57.8% patients. In conclusion, our study suggested that Low CRNN expression was associated with grade and lymph node metastasis in TSCC. CRNN expression is independent of addiction, however potentially carcinogenic addictive substances might be aiding in the disease progression.
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Affiliation(s)
- Saira Saleem
- Basic Sciences Research, Shaukat Khanum Memorial Cancer Hospital and Research Centre, 7-A Block R-3, Johar Town, Lahore, 54000, Pakistan
| | - Iffat Aleem
- Basic Sciences Research, Shaukat Khanum Memorial Cancer Hospital and Research Centre, 7-A Block R-3, Johar Town, Lahore, 54000, Pakistan
| | - Aribah Atiq
- Department of Pathology, Shaukat Khanum Memorial Cancer Hospital and Research Centre, 7-A Block R-3, Johar Town, Lahore, 54000, Pakistan
| | - Sahrish Tariq
- Basic Sciences Research, Shaukat Khanum Memorial Cancer Hospital and Research Centre, 7-A Block R-3, Johar Town, Lahore, 54000, Pakistan
| | - Amna Babar
- Department of Pathology, Shaukat Khanum Memorial Cancer Hospital and Research Centre, 7-A Block R-3, Johar Town, Lahore, 54000, Pakistan
| | - Muhammad Abu Bakar
- Cancer Registry and Clinical Data Management, Shaukat Khanum Memorial Cancer Hospital and Research Centre, 7-A Block R-3, Johar Town, Lahore, 54000, Pakistan
| | - Madiha Syed
- Department of Pathology, Shaukat Khanum Memorial Cancer Hospital and Research Centre, 7-A Block R-3, Johar Town, Lahore, 54000, Pakistan
| | - Maheen Maruf
- Department of Pathology, Shaukat Khanum Memorial Cancer Hospital and Research Centre, 7-A Block R-3, Johar Town, Lahore, 54000, Pakistan
| | - Mohammad Tariq Mahmood
- Department of Pathology, Shaukat Khanum Memorial Cancer Hospital and Research Centre, 7-A Block R-3, Johar Town, Lahore, 54000, Pakistan
| | - Muhammad Zeshan
- Basic Sciences Research, Shaukat Khanum Memorial Cancer Hospital and Research Centre, 7-A Block R-3, Johar Town, Lahore, 54000, Pakistan
| | - Muhammad Tahseen
- Department of Pathology, Shaukat Khanum Memorial Cancer Hospital and Research Centre, 7-A Block R-3, Johar Town, Lahore, 54000, Pakistan
| | - Raza Hussain
- Department of Surgical Oncology, Shaukat Khanum Memorial Cancer Hospital and Research Centre, 7-A Block R-3, Johar Town, Lahore, 54000, Pakistan
| | - Asif Loya
- Department of Pathology, Shaukat Khanum Memorial Cancer Hospital and Research Centre, 7-A Block R-3, Johar Town, Lahore, 54000, Pakistan
| | - Chris Sutton
- Institute of Cancer Therapeutics, University of Bradford, Tumbling Hill Street Bradford, BD7 1BD, United Kingdom
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Bedwell C, Blaikie K, Actis Danna V, Sutton C, Laisser R, Tembo Kasengele C, Wakasiaka S, Victor S, Lavender T. Understanding the complexities of unexplained stillbirth in sub-Saharan Africa: a mixed-methods study. BJOG 2021; 128:1206-1214. [PMID: 33319470 PMCID: PMC8248405 DOI: 10.1111/1471-0528.16629] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/07/2020] [Indexed: 01/10/2023]
Abstract
Objective To understand the complexities surrounding unexplained stillbirth for the development and implementation of culturally acceptable interventions to underpin care in Tanzania and Zambia. Design Mixed‐methods study. Setting Tertiary, secondary and primary care facilities in Mansa, Zambia, and Mwanza, Tanzania. Sample Quantitative: 1997 women giving birth at two tertiary care facilities (one in each country). Qualitative: 48 women and 19 partners from tertiary, secondary and primary care facilities. Methods Case review using data from a target of 2000 consecutive case records. Qualitative interviews with a purposive sample of women and partners, using a grounded theory approach. Results A total of 261 stillbirths were recorded, with a rate of 16% in Tanzania and 10% in Zambia, which is higher than the previous estimates of 2.24 and 2.09%, respectively, for those countries. Women in both countries who reported a previous stillbirth were more likely to have stillbirth (RR 1.86, 95% CI 1.23–2.81). The cause of death was unexplained in 28% of cases. Qualitative findings indicated that not knowing what caused the baby to be stillborn prevented women from grieving. This was compounded by the poor communication skills of health professionals, who displayed little empathy and skill when counselling bereaved families. Conclusions The stillbirth risk in both facilities was far higher than the risk recorded from national data, with women reporting a previous stillbirth being at higher risk. Women want to know the cause of stillbirth and an exploration of appropriate investigations in this setting is required. Providing health professionals with support and continuing training is key to improving the experiences of women and future care. Tweetable abstract Stillbirths receive little investigation and are often unexplained. Communication with women about the death of their baby is limited. Stillbirths receive little investigation and are often unexplained. Communication with women about the death of their baby is limited.
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Affiliation(s)
- C Bedwell
- International Public Health, Liverpool School of Tropical Medicine, Liverpool, UK
| | - K Blaikie
- School of Health Sciences, University of Manchester, Manchester, UK
| | - V Actis Danna
- International Public Health, Liverpool School of Tropical Medicine, Liverpool, UK
| | - C Sutton
- School of Health Sciences, University of Manchester, Manchester, UK
| | - R Laisser
- Archbishop Antony Mayala School of Nursing, Catholic University of Health and Allied Health Sciences, Mwanza, Tanzania
| | - C Tembo Kasengele
- Department of Public Health and Research, Ministry of Health Headquarters, Lusaka, Zambia
| | | | - S Victor
- Perinatal Imaging and Health, King's College London, London, UK
| | - T Lavender
- International Public Health, Liverpool School of Tropical Medicine, Liverpool, UK
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Hammond A, Prior Y, Cotterill S, Sutton C, Camacho E, Heal C, Adams J, Hough Y, O'Neill TW, Firth J. Clinical and cost effectiveness of arthritis gloves in rheumatoid arthritis (A-GLOVES): randomised controlled trial with economic analysis. BMC Musculoskelet Disord 2021; 22:47. [PMID: 33419426 PMCID: PMC7792116 DOI: 10.1186/s12891-020-03917-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Accepted: 12/23/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Arthritis (or compression) gloves are widely prescribed to people with rheumatoid arthritis and other forms of hand arthritis. They are prescribed for daytime wear to reduce hand pain and improve hand function, and/or night-time wear to reduce pain, improve sleep and reduce morning stiffness. However, evidence for their effectiveness is limited. The aims of this study were to investigate the clinical and cost effectiveness of arthritis gloves compared to placebo gloves on hand pain, stiffness and function in people with rheumatoid arthritis and persistent hand pain. METHODS A parallel randomised controlled trial, in adults (≥ 18 years) with rheumatoid or undifferentiated inflammatory arthritis at 16 National Health Service sites in the UK. Patients with persistent hand pain affecting function and/or sleep were eligible. Randomisation (1:1) was stratified by recent change (or not) in medication, using permuted blocks of random sizes. Three-quarter-finger length arthritis gloves (Isotoner®: applying 23-32 mmHg pressure) (intervention) were compared to loose-fitting placebo gloves (Jobskin® classic: providing no/minimal pressure) (control). Both gloves (considered to have similar thermal qualities) were provided by occupational therapists. Patients and outcome assessors were blinded; clinicians were not. The primary outcome was dominant hand pain on activity (0-10) at 12 weeks, analysed using linear regression and intention to treat principles. RESULTS Two hundred six participants were randomly assigned (103 per arm) and 163 (84 intervention: 79 control) completed 12-week follow-up. Hand pain improved by 1.0 (intervention) and 1.2 (control), an adjusted mean difference of 0.10 (95% CI: - 0.47 to 0.67; p = 0.72). Adverse events were reported by 51% of intervention and 36% of control group participants; with 6 and 7% respectively, discontinuing glove wear. Provision of arthritis gloves cost £129, with no additional benefit. CONCLUSION The trial provides evidence of no clinically important effect of arthritis gloves on any of the trial outcomes (hand pain, function and stiffness) and arthritis gloves are not cost-effective. The clinical and cost-effectiveness results support ceasing provision of arthritis gloves in routine clinical practice. FUNDING National Institute for Health Research. TRIAL REGISTRATION ISRCTN, ISRCTN25892131 ; Registered 05/09/2016: retrospectively registered.
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Affiliation(s)
- Alison Hammond
- Centre for Health Sciences Research, School of Health and Society, University of Salford, Allerton Building, Frederick Road, Salford, M6 6PU, UK.
| | - Yeliz Prior
- Centre for Health Sciences Research, School of Health and Society, University of Salford, Allerton Building, Frederick Road, Salford, M6 6PU, UK
| | - Sarah Cotterill
- Centre for Biostatistics, Division of Population Health, Health Services Research and Primary Care, University of Manchester, Manchester, UK
| | - Chris Sutton
- Centre for Biostatistics, Division of Population Health, Health Services Research and Primary Care, University of Manchester, Manchester, UK
| | - Elizabeth Camacho
- Manchester Centre for Health Economics, Division of Population Health, Health Services Research and Primary Care, University of Manchester, Manchester, UK
| | - Calvin Heal
- Centre for Biostatistics, Division of Population Health, Health Services Research and Primary Care, University of Manchester, Manchester, UK
| | - Jo Adams
- Health Sciences, University of Southampton, Southampton, UK
| | - Yvonne Hough
- Rheumatology Occupational Therapy, St Helens and Knowsley Teaching Hospitals NHS Trust, St Helens, UK
| | - Terence W O'Neill
- Centre for Epidemiology Versus Arthritis, Division of Musculoskeletal and Dermatological Sciences, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK.,NIHR Manchester Biomedical Research Centre, Manchester University NHS Foundation Trust, Manchester, UK
| | - Jill Firth
- Pennine MSK Partnership, Oldham, Manchester, UK
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Hammond A, Sutton C, Cotterill S, Woodbridge S, O'Brien R, Radford K, Forshaw D, Verstappen S, Jones C, Marsden A, Eden M, Prior Y, Culley J, Holland P, Walker-Bone K, Hough Y, O'Neill TW, Ching A, Parker J. The effect on work presenteeism of job retention vocational rehabilitation compared to a written self-help work advice pack for employed people with inflammatory arthritis: protocol for a multi-centre randomised controlled trial (the WORKWELL trial). BMC Musculoskelet Disord 2020; 21:607. [PMID: 32912199 PMCID: PMC7488441 DOI: 10.1186/s12891-020-03619-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Accepted: 08/31/2020] [Indexed: 01/01/2023] Open
Abstract
Background Work problems are common in people with inflammatory arthritis. Up to 50% stop work within 10 years due to their condition and up to 67% report presenteeism (i.e. reduced work productivity), even amongst those with low disease activity. Job retention vocational rehabilitation (JRVR) may help prevent or postpone job loss and reduce presenteeism through work assessment, work-related rehabilitation and enabling job accommodations. This aims to create a better match between the person’s abilities and their job demands. The objectives of the Workwell trial are to test the overall effectiveness and cost-effectiveness of JRVR (WORKWELL) provided by additionally trained National Health Service (NHS) occupational therapists compared to a control group who receive self-help information both in addition to usual care. Methods Based on the learning from a feasibility trial (the WORK-IA trial: ISRCTN76777720), the WORKWELL trial is a multi-centre, pragmatic, individually-randomised parallel group superiority trial, including economic evaluation, contextual factors analysis and process evaluation. Two hundred forty employed adults with rheumatoid arthritis, undifferentiated inflammatory arthritis or psoriatic arthritis (in secondary care), aged 18 years or older with work instability will be randomised to one of two groups: a self-help written work advice pack plus usual care (control intervention); or WORKWELL JRVR plus a self-help written work advice pack and usual care. WORKWELL will be delivered by occupational therapists provided with additional JRVR training from the research team. The primary outcome is presenteeism as measured using the Work Limitations Questionnaire-25. A comprehensive range of secondary outcomes of work, health, contextual factors and health resource use are included. Outcomes are measured at 6- and 12- months (with 12-months as the primary end-point). A multi-perspective within-trial cost-effectiveness analyses will also be conducted. Discussion This trial will contribute to the evidence base for provision of JRVR to people with inflammatory arthritis. If JRVR is found to be effective in enabling people to keep working, the findings will support decision-making about provision of JRVR by rheumatology teams, therapy services and healthcare commissioners, and providing evidence of the effectiveness of JRVR and the economic impact of its implementation. Trial registration Clinical Trials.Gov: NCT03942783. Registered 08/05/2019 (https://clinicaltrials.gov/ct2/show/NCT03942783); ISRCTN Registry: ISRCTN61762297. Registered:13/05/2019 (http://www.isrctn.com/ISRCTN61762297). Retrospectively registered.
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Affiliation(s)
- Alison Hammond
- Centre for Health Sciences Research, University of Salford, Allerton L701, Frederick Road, Salford, Greater Manchester, M6 6PU, UK.
| | - Chris Sutton
- Centre for Biostatistics, Division of Population Health, Health Services Research and Primary Care, University of Manchester, Manchester, UK
| | - Sarah Cotterill
- Centre for Biostatistics, Division of Population Health, Health Services Research and Primary Care, University of Manchester, Manchester, UK
| | - Sarah Woodbridge
- Centre for Health Sciences Research, University of Salford, Allerton L701, Frederick Road, Salford, Greater Manchester, M6 6PU, UK
| | - Rachel O'Brien
- School of Health and Wellbeing, Sheffield Hallam University, Sheffield, UK
| | - Kate Radford
- Division of Rehabilitation and Ageing, University of Nottingham, Nottingham, UK
| | - Denise Forshaw
- Lancashire Clinical Trials Unit, University of Central Lancashire, Brook Building, Preston, Lancashire, UK
| | - Suzanne Verstappen
- Centre for Epidemiology Versus Arthritis, Centre for Musculoskeletal Research, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK.,NIHR Manchester Biomedical Research Centre, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
| | - Cheryl Jones
- Manchester Centre for Health Economics, Division of Population Health, Health Services Research and Primary Care, University of Manchester, Manchester, UK
| | - Antonia Marsden
- Centre for Biostatistics, Division of Population Health, Health Services Research and Primary Care, University of Manchester, Manchester, UK
| | - Martin Eden
- Manchester Centre for Health Economics, Division of Population Health, Health Services Research and Primary Care, University of Manchester, Manchester, UK
| | - Yeliz Prior
- Centre for Health Sciences Research, University of Salford, Allerton L701, Frederick Road, Salford, Greater Manchester, M6 6PU, UK
| | | | - Paula Holland
- Division of Health Research, Lancaster University, Lancaster, UK
| | - Karen Walker-Bone
- MRC Versus Arthritis Centre for Musculoskeletal Health and Work, University of Southampton, Southampton, UK
| | - Yvonne Hough
- Rheumatology/ Occupational Therapy, St Helens and Knowsley Teaching Hospitals NHS Foundation Trust, St Helens Hospital, St Helens, Merseyside, UK
| | - Terence W O'Neill
- Centre for Epidemiology Versus Arthritis, Division of Musculoskeletal and Dermatological Sciences, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK.,NIHR Manchester Biomedical Research Centre, Manchester University NHS Foundation Trust, Manchester, UK
| | - Angela Ching
- Centre for Health Sciences Research, University of Salford, Allerton L701, Frederick Road, Salford, Greater Manchester, M6 6PU, UK
| | - Jennifer Parker
- Centre for Health Sciences Research, University of Salford, Allerton L701, Frederick Road, Salford, Greater Manchester, M6 6PU, UK
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Lavender T, Bedwell C, Blaikie K, Danna VA, Sutton C, Kasengele CT, Wakasiaka S, Vwalika B, Laisser R. Journey of vulnerability: a mixed-methods study to understand intrapartum transfers in Tanzania and Zambia. BMC Pregnancy Childbirth 2020; 20:292. [PMID: 32408871 PMCID: PMC7222428 DOI: 10.1186/s12884-020-02996-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Accepted: 05/06/2020] [Indexed: 02/06/2023] Open
Abstract
Background Timely intrapartum referral between facilities is pivotal in reducing maternal/neonatal mortality and morbidity but is distressing to women, resource-intensive and likely to cause delays in care provision. We explored the complexities around referrals to gain understanding of the characteristics, experiences and outcomes of those being transferred. Methods We used a mixed-method parallel convergent design, in Tanzania and Zambia. Quantitative data were collected from a consecutive, retrospective case-note review (target, n = 2000); intrapartum transfers and stillbirths were the outcomes of interest. A grounded theory approach was adopted for the qualitative element; data were collected from semi-structured interviews (n = 85) with women, partners and health providers. Observations (n = 33) of transfer were also conducted. Quantitative data were analysed descriptively, followed by binary logistic regression models, with multiple imputation for missing data. Qualitative data were analysed using Strauss’s constant comparative approach. Results Intrapartum transfer rates were 11% (111/998; 2 unknown) in Tanzania and 37% (373/996; 1 unknown) in Zambia. Main reasons for transfer were prolonged/obstructed labour and pre-eclampsia/eclampsia. Women most likely to be transferred were from Zambia (as opposed to Tanzania), HIV positive, attended antenatal clinic < 4 times and living > 30 min away from the referral hospital. Differences were observed between countries. Of those transferred, delays in care were common and an increase in poor outcomes was observed. Qualitative findings identified three categories: social threats to successful transfer, barriers to timely intrapartum care and reparative interventions which were linked to a core category: journey of vulnerability. Conclusion Although intrapartum transfers are inevitable, modifiable factors exist with the potential to improve the experience and outcomes for women. Effective transfers rely on adequate resources, effective transport infrastructures, social support and appropriate decision-making. However, women’s (and families) vulnerability can be reduced by empathic communication, timely assessment and a positive birth outcome; this can improve women’s resilience and influence positive decision-making, for the index and future pregnancy.
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Affiliation(s)
- Tina Lavender
- Jean McFarlane Building, University of Manchester, Manchester, M139PL, UK.
| | - Carol Bedwell
- Jean McFarlane Building, University of Manchester, Manchester, M139PL, UK
| | - Kieran Blaikie
- Jean McFarlane Building, University of Manchester, Manchester, M139PL, UK
| | | | - Chris Sutton
- Jean McFarlane Building, University of Manchester, Manchester, M139PL, UK
| | - Chowa Tembo Kasengele
- Ministry of Health Headquarters, Department of Public Health and Research, Lusaka, Zambia
| | | | | | - Rose Laisser
- Archbishop Antony Mayala School of Nursing, Catholic University of Health and Allied Health Sciences, Mwanza, Tanzania
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Saleem S, Tariq S, Aleem I, Sadr-Ul Shaheed, Tahseen M, Atiq A, Hassan S, Abu Bakar M, Khattak S, Syed AA, Ahmad AH, Hussain M, Yusuf MA, Sutton C. Proteomics analysis of colon cancer progression. Clin Proteomics 2019; 16:44. [PMID: 31889941 PMCID: PMC6935225 DOI: 10.1186/s12014-019-9264-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2019] [Accepted: 12/12/2019] [Indexed: 02/07/2023] Open
Abstract
Background The aim of this pilot study was to identify proteins associated with advancement of colon cancer (CC). Methods A quantitative proteomics approach was used to determine the global changes in the proteome of primary colon cancer from patients with non-cancer normal colon (NC), non-adenomatous colon polyp (NAP), non-metastatic tumor (CC NM) and metastatic tumor (CC M) tissues, to identify up- and down-regulated proteins. Total protein was extracted from each biopsy, trypsin-digested, iTRAQ-labeled and the resulting peptides separated using strong cation exchange (SCX) and reverse-phase (RP) chromatography on-line to electrospray ionization mass spectrometry (ESI-MS). Results Database searching of the MS/MS data resulted in the identification of 2777 proteins which were clustered into groups associated with disease progression. Proteins which were changed in all disease stages including benign, and hence indicative of the earliest molecular perturbations, were strongly associated with spliceosomal activity, cell cycle division, and stromal and cytoskeleton disruption reflecting increased proliferation and expansion into the surrounding healthy tissue. Those proteins changed in cancer stages but not in benign, were linked to inflammation/immune response, loss of cell adhesion, mitochondrial function and autophagy, demonstrating early evidence of cells within the nutrient-poor solid mass either undergoing cell death or adjusting for survival. Caveolin-1, which decreased and Matrix metalloproteinase-9, which increased through the three disease stages compared to normal tissue, was selected to validate the proteomics results, but significant patient-to-patient variation obfuscated interpretation so corroborated the contradictory observations made by others. Conclusion Nevertheless, the study has provided significant insights into CC stage progression for further investigation.
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Affiliation(s)
- Saira Saleem
- 1Basic Science Research, Shaukat Khanum Memorial Cancer Hospital and Research Centre, 7-A Block R-3, Johar Town, Lahore, 54000 Pakistan
| | - Sahrish Tariq
- 1Basic Science Research, Shaukat Khanum Memorial Cancer Hospital and Research Centre, 7-A Block R-3, Johar Town, Lahore, 54000 Pakistan
| | - Iffat Aleem
- 1Basic Science Research, Shaukat Khanum Memorial Cancer Hospital and Research Centre, 7-A Block R-3, Johar Town, Lahore, 54000 Pakistan
| | - Sadr-Ul Shaheed
- 2Institute of Cancer Therapeutics, University of Bradford, Tumbling Hill Street, Bradford, BD7 1BD UK
| | - Muhammad Tahseen
- 3Department of Pathology, Shaukat Khanum Memorial Cancer Hospital and Research Centre, 7-A Block R-3, Johar Town, Lahore, 54000 Pakistan
| | - Aribah Atiq
- 3Department of Pathology, Shaukat Khanum Memorial Cancer Hospital and Research Centre, 7-A Block R-3, Johar Town, Lahore, 54000 Pakistan
| | - Sadia Hassan
- 4Clinical Research Office, Shaukat Khanum Memorial Cancer Hospital and Research Centre, 7-A Block R-3, Johar Town, Lahore, 54000 Pakistan
| | - Muhammad Abu Bakar
- 5Cancer Registry and Clinical Data Management, Shaukat Khanum Memorial Cancer Hospital and Research Centre, 7-A Block R-3, Johar Town, Lahore, 54000 Pakistan
| | - Shahid Khattak
- 6Department of Surgical Oncology, Shaukat Khanum Memorial Cancer Hospital and Research Centre, 7-A Block R-3, Johar Town, Lahore, 54000 Pakistan
| | - Aamir Ali Syed
- 6Department of Surgical Oncology, Shaukat Khanum Memorial Cancer Hospital and Research Centre, 7-A Block R-3, Johar Town, Lahore, 54000 Pakistan
| | - Asad Hayat Ahmad
- 3Department of Pathology, Shaukat Khanum Memorial Cancer Hospital and Research Centre, 7-A Block R-3, Johar Town, Lahore, 54000 Pakistan
| | - Mudassar Hussain
- 3Department of Pathology, Shaukat Khanum Memorial Cancer Hospital and Research Centre, 7-A Block R-3, Johar Town, Lahore, 54000 Pakistan
| | - Muhammed Aasim Yusuf
- Department of Internal Medicine, Shaukat Khanum Mmemorial Cancer Hospital and Research Centre, 7-A Block R-3, Johar Town, Lahore, 54000 Pakistan
| | - Chris Sutton
- 2Institute of Cancer Therapeutics, University of Bradford, Tumbling Hill Street, Bradford, BD7 1BD UK
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Berekméri A, Alase A, Macleod T, Shaheed S, Sutton C, Stacey M, Wittmann M. 428 Comparative mass spectrometry proteomics of epidermal samples obtained by non-invasive tape stripping from inflammatory skin diseases. J Invest Dermatol 2019. [DOI: 10.1016/j.jid.2019.07.430] [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]
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Alex P, Williams S, Sutton L, Yesudas T, Sutton C, Thomas S, Centola M. Efficacy and safety of HAT1 compared with calcipotriol in the treatment of patients with mild to moderate chronic plaque psoriasis: results from an open-label randomized comparative pilot clinical study. Clin Exp Dermatol 2019; 45:318-322. [PMID: 31419323 PMCID: PMC7154690 DOI: 10.1111/ced.14074] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2018] [Revised: 07/25/2019] [Accepted: 08/13/2019] [Indexed: 11/26/2022]
Abstract
Psoriasis is commonly treated with topical corticosteroids, oral cytotoxic drugs and biologic agents, which can be associated with significant adverse effects (AEs), high cost and response attenuation. Additionally, patients often use alternative therapies ad hoc, which can be challenging to integrate into a treatment regimen, owing to a lack of adequately powered controlled trials assessing efficacy and safety. We developed a novel topical botanical complex, herbal anti‐inflammatory treatment (HAT1), through extensive preclinical in vitro and in vivo modelling to define key mechanisms of action and clinical potential. To assess the efficacy and safety of HAT1 in psoriasis, we performed a 10‐week, open‐label, pilot clinical trial comparing topical treatment of HAT1 with calcipotriol 0.005% in adult patients with mild to moderate psoriasis. Primary and secondary endpoints included the percentage of patients obtaining improvement of ≥ 75% in Psoriasis Area and Severity Index (PASI 75), Physician’s Global Assessment (PGA) response, and evaluation of tolerability and safety of HAT1. In the HAT1 arm, 85.7% of study patients reached PASI 75 compared with 21.4% in the calcipotriol comparator group. Additionally, 78.6% of patients in the HAT1 arm achieved a ‘clear’ or ‘minimal’ PGA response. HAT1 was well tolerated, with no AEs observed throughout the trial. These results suggest that HAT1 reduces psoriasis disease activity in a clinically relevant manner. Ongoing studies, including well‐powered, double‐blind, randomized controlled trials will be required to assess the potential of HAT1 in psoriasis.
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Affiliation(s)
- P Alex
- Haus Clinical Research Program, Haus Bioceuticals, Oklahoma City, OK, USA
| | - S Williams
- Haus Clinical Research Program, Haus Bioceuticals, Oklahoma City, OK, USA
| | - L Sutton
- Haus Clinical Research Program, Haus Bioceuticals, Oklahoma City, OK, USA
| | - T Yesudas
- Haus Clinical Research Program, Haus Bioceuticals, Oklahoma City, OK, USA
| | - C Sutton
- Haus Clinical Research Program, Haus Bioceuticals, Oklahoma City, OK, USA
| | - S Thomas
- Haus Clinical Research Program, Haus Bioceuticals, Oklahoma City, OK, USA
| | - M Centola
- Haus Clinical Research Program, Haus Bioceuticals, Oklahoma City, OK, USA
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Heath RJ, Bakshi A, Sutton C, Stewart LC, Cohen SN. An 'airy hairy' problem. Clin Exp Dermatol 2019; 45:229-231. [PMID: 31140639 DOI: 10.1111/ced.13981] [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] [Accepted: 03/20/2019] [Indexed: 11/27/2022]
Affiliation(s)
- R J Heath
- Royal Liverpool and Broadgreen University Hospitals NHS Trust, Thomas Drive, Liverpool, Merseyside, UK
| | - A Bakshi
- Royal Liverpool and Broadgreen University Hospitals NHS Trust, Thomas Drive, Liverpool, Merseyside, UK
| | - C Sutton
- Royal Liverpool and Broadgreen University Hospitals NHS Trust, Thomas Drive, Liverpool, Merseyside, UK
| | - L C Stewart
- Royal Liverpool and Broadgreen University Hospitals NHS Trust, Thomas Drive, Liverpool, Merseyside, UK
| | - S N Cohen
- Royal Liverpool and Broadgreen University Hospitals NHS Trust, Thomas Drive, Liverpool, Merseyside, UK
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Radford K, Sutton C, Sach T, Holmes J, Watkins C, Forshaw D, Jones T, Hoffman K, O'Connor R, Tyerman R, Merchán-Baeza JA, Morris R, McManus E, Drummond A, Walker M, Duley L, Shakespeare D, Hammond A, Phillips J. Early, specialist vocational rehabilitation to facilitate return to work after traumatic brain injury: the FRESH feasibility RCT. Health Technol Assess 2019; 22:1-124. [PMID: 29863459 DOI: 10.3310/hta22330] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Up to 160,000 people incur traumatic brain injury (TBI) each year in the UK. TBI can have profound effects on many areas of human functioning, including participation in work. There is limited evidence of the clinical effectiveness and cost-effectiveness of vocational rehabilitation (VR) after injury to promote early return to work (RTW) following TBI. OBJECTIVE To assess the feasibility of a definitive, multicentre, randomised controlled trial (RCT) of the clinical effectiveness and cost-effectiveness of early, specialist VR plus usual care (UC) compared with UC alone on work retention 12 months post TBI. DESIGN A multicentre, feasibility, parallel-group RCT with a feasibility economic evaluation and an embedded mixed-methods process evaluation. Randomisation was by remote computer-generated allocation. SETTING Three NHS major trauma centres (MTCs) in England. PARTICIPANTS Adults with TBI admitted for > 48 hours and working or studying prior to injury. INTERVENTIONS Early specialist TBI VR delivered by occupational therapists (OTs) in the community using a case co-ordination model. MAIN OUTCOME MEASURES Self-reported RTW 12 months post randomisation, mood, functional ability, participation, work self-efficacy, quality of life and work ability. Feasibility outcomes included recruitment and retention rates. Follow-up was by postal questionnaires in two centres and face to face in one centre. Those collecting data were blind to treatment allocation. RESULTS Out of 102 target participants, 78 were recruited (39 randomised to each arm), representing 39% of those eligible and 5% of those screened. Approximately 2.2 patients were recruited per site per month. Of those, 56% had mild injuries, 18% had moderate injuries and 26% had severe injuries. A total of 32 out of 45 nominated carers were recruited. A total of 52 out of 78 (67%) TBI participants responded at 12 months (UC, n = 23; intervention, n = 29), completing 90% of the work questions; 21 out of 23 (91%) UC respondents and 20 out of 29 (69%) intervention participants returned to work at 12 months. Two participants disengaged from the intervention. Face-to-face follow-up was no more effective than postal follow-up. RTW was most strongly related to social participation and work self-efficacy. It is feasible to assess the cost-effectiveness of VR. Intervention was delivered as intended and valued by participants. Factors likely to affect a definitive trial include deploying experienced OTs, no clear TBI definition or TBI registers, and repatriation of more severe TBI from MTCs, affecting recruitment of those most likely to benefit/least likely to drop out. LIMITATIONS Target recruitment was not reached, but mechanisms to achieve this in future studies were identified. Retention was lower than expected, particularly in UC, potentially biasing estimates of the 12-month RTW rate. CONCLUSIONS This study met most feasibility objectives. The intervention was delivered with high fidelity. When objectives were not met, strategies to ensure feasibility of a full trial were identified. Future work should test two-stage recruitment and include resources to recruit from 'spokes'. A broader measure covering work ability, self-efficacy and participation may be a more sensitive outcome. TRIAL REGISTRATION Current Controlled Trials ISRCTN38581822. FUNDING This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 22, No. 33. See the NIHR Journals Library website for further project information.
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Affiliation(s)
- Kate Radford
- Division of Rehabilitation and Ageing, School of Medicine, University of Nottingham, Nottingham, UK
| | - Chris Sutton
- Faculty of Health and Wellbeing, University of Central Lancashire, Preston, UK
| | - Tracey Sach
- Health Economics Group, Norwich Medical School, University of East Anglia, Norwich, UK
| | - Jain Holmes
- Division of Rehabilitation and Ageing, School of Medicine, University of Nottingham, Nottingham, UK
| | - Caroline Watkins
- Faculty of Health and Wellbeing, University of Central Lancashire, Preston, UK
| | - Denise Forshaw
- Faculty of Health and Wellbeing, University of Central Lancashire, Preston, UK
| | - Trevor Jones
- Division of Rehabilitation and Ageing, School of Medicine, University of Nottingham, Nottingham, UK
| | - Karen Hoffman
- Centre for Trauma Sciences, Queen Mary University of London, London, UK
| | - Rory O'Connor
- Academic Department of Rehabilitation Medicine, School of Medicine, University of Leeds, Leeds, UK
| | - Ruth Tyerman
- Community Head Injury Service, Buckinghamshire Healthcare NHS Trust, Aylesbury, UK
| | | | - Richard Morris
- Division of Rehabilitation and Ageing, School of Medicine, University of Nottingham, Nottingham, UK
| | - Emma McManus
- Health Economics Group, Norwich Medical School, University of East Anglia, Norwich, UK
| | - Avril Drummond
- Division of Rehabilitation and Ageing, School of Medicine, University of Nottingham, Nottingham, UK
| | - Marion Walker
- Division of Rehabilitation and Ageing, School of Medicine, University of Nottingham, Nottingham, UK
| | - Lelia Duley
- Division of Rehabilitation and Ageing, School of Medicine, University of Nottingham, Nottingham, UK
| | | | - Alison Hammond
- Health Sciences Research Centre, University of Salford, Salford, UK
| | - Julie Phillips
- Division of Rehabilitation and Ageing, School of Medicine, University of Nottingham, Nottingham, UK
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Sutton C, Zhang Y, Yarmohammadi H, Ziv E, Boas F, Kishore S, Camacho J, Erinjeri J. 03:45 PM Abstract No. 283 Analysis of the chemotherapy free interval following image-guided ablation in sarcoma patients. J Vasc Interv Radiol 2019. [DOI: 10.1016/j.jvir.2018.12.347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Stanmore E, Mavroeidi A, Meekes W, Skelton D, Sutton C, Benedetto V, Todd C, de jong L. EXERGAMES TO REDUCE FALLS RISK IN OLDER PEOPLE IN UK ASSISTED LIVING FACILITIES: A MULTI-CENTRE, CLUSTER RCT. Innov Aging 2018. [DOI: 10.1093/geroni/igy023.1340] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [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)
| | | | | | | | - C Sutton
- University of Central Lancashire
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Dixon P, Beaver K, Williamson S, Sutton C, Martin-Hirsch P, Hollingworth W. Cost-Consequence Analysis Alongside a Randomised Controlled Trial of Hospital Versus Telephone Follow-Up after Treatment for Endometrial Cancer. Appl Health Econ Health Policy 2018; 16:415-427. [PMID: 29651778 PMCID: PMC5940716 DOI: 10.1007/s40258-018-0378-6] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
BACKGROUND Regular outpatient follow-up programmes are usually offered to patients following treatment for gynaecological and other cancers. Despite the substantial resources involved in providing these programmes, there is evidence that routine follow-up programmes do not affect survival or the likelihood of detecting recurrence and may not meet patient needs. Alternative follow-up modalities may offer the same outcomes at lower cost. We examined the costs of using telephone-based routine follow-up of women treated for endometrial cancer undertaken by specialist gynaecology oncology nurses in comparison to routine hospital-based follow-up. METHODS The ENDCAT trial randomised 259 women at five centres in the north west of England with a known diagnosis of Stage I endometrial cancer who had completed primary treatment on a 1:1 basis to receive either standard hospital outpatient follow-up or a telephone follow-up intervention administered by specialist nurses. A cost-consequence analysis was undertaken in which we compared costs to the health system and to individuals with the trial's co-primary outcomes of psychological morbidity and participant satisfaction with information received. RESULTS Psychological morbidity, psychosocial needs, patient satisfaction and quality of life did not differ between arms. Patients randomised to telephone follow-up underwent more and longer consultations. There was no difference in total health service mean per patient costs at 6 months (mean difference £8, 95% percentile confidence interval: - £147 to £141) or 12 months (mean difference: - £77, 95% percentile confidence interval: - £334 to £154). Estimated return journey costs per patient for hospital consultations were £11.47. Productivity costs were approximately twice as high under hospital follow-up. CONCLUSION Telephone follow-up was estimated to be cost-neutral for the NHS and may free up clinic time for other patients. There was some evidence that telephone follow-up may be more efficient for patients and wider society, and is not associated with additional psychological morbidity, lower patient satisfaction or reduced quality of life. TRIAL REGISTRATION ISRCTN: 75220876, prospectively registered 28 October 2011.
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Affiliation(s)
- Padraig Dixon
- Population Health Sciences, Bristol Medical School, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol, BS8 2PS UK
- MRC Integrative Epidemiology Unit, University of Bristol, Oakfield House, Oakfield Grove, Bristol, BS8 2BN UK
| | - Kinta Beaver
- Faculty of Health and Wellbeing, University of Central Lancashire, Preston, PR1 2HE UK
| | - Susan Williamson
- Faculty of Health and Wellbeing, University of Central Lancashire, Preston, PR1 2HE UK
| | - Chris Sutton
- Faculty of Health and Wellbeing, University of Central Lancashire, Preston, PR1 2HE UK
| | - Pierre Martin-Hirsch
- Faculty of Health and Wellbeing, University of Central Lancashire, Preston, PR1 2HE UK
- Department of Obstetrics and Gynaecology, Lancashire Teaching Hospitals, Preston, PR2 9HT UK
| | - William Hollingworth
- Population Health Sciences, Bristol Medical School, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol, BS8 2PS UK
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Deyhle MR, Evans K, Sutton C, Hampton S, Parmley J, Sorensen JR, Parcell A, Hyldahl R. T Cells Accumulate In Skeletal Muscle Following Contraction-induced Damage To A Greater Degree In Women. Med Sci Sports Exerc 2018. [DOI: 10.1249/01.mss.0000535110.64507.6c] [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: 11/21/2022]
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Shaheed SU, Tait C, Kyriacou K, Linforth R, Salhab M, Sutton C. Evaluation of nipple aspirate fluid as a diagnostic tool for early detection of breast cancer. Clin Proteomics 2018; 15:3. [PMID: 29344009 PMCID: PMC5763528 DOI: 10.1186/s12014-017-9179-4] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2017] [Accepted: 12/22/2017] [Indexed: 12/17/2022] Open
Abstract
There has been tremendous progress in detection of breast cancer in postmenopausal women, resulting in two-thirds of women surviving more than 20 years after treatment. However, breast cancer remains the leading cause of cancer-related deaths in premenopausal women. Breast cancer is increasing in younger women due to changes in life-style as well as those at high risk as carriers of mutations in high-penetrance genes. Premenopausal women with breast cancer are more likely to be diagnosed with aggressive tumours and therefore have a lower survival rate. Mammography plays an important role in detecting breast cancer in postmenopausal women, but is considerably less sensitive in younger women. Imaging techniques, such as contrast-enhanced MRI improve sensitivity, but as with all imaging approaches, cannot differentiate between benign and malignant growths. Hence, current well-established detection methods are falling short of providing adequate safety, convenience, sensitivity and specificity for premenopausal women on a global level, necessitating the exploration of new methods. In order to detect and prevent the disease in high risk women as early as possible, methods that require more frequent monitoring need to be developed. The emergence of "omics" strategies over the last 20 years, enabling the characterisation and understanding of breast cancer at the molecular level, are providing the potential for long term, longitudinal monitoring of the disease. Tissue and serum biomarkers for breast cancer stratification, diagnosis and predictive outcome have emerged, but have not successfully translated into clinical screening for early detection of the disease. The use of breast-specific liquid biopsies, such as nipple aspirate fluid (NAF), a natural secretion produced by breast epithelial cells, can be collected non-invasively for biomarker profiling. As we move towards an age of active surveillance, home-based liquid biopsy collection kits are increasingly being applied and these could provide a paradigm shift where NAF biomarker profiling is used for routine breast health monitoring. The current status of established and newly emerging imaging techniques for early detection of breast cancer and the potential for alternative biomarker screening of liquid biopsies, particularly those applied to high-risk, premenopausal women, will be reviewed.
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Affiliation(s)
- Sadr-Ul Shaheed
- 1Institute of Cancer Therapeutics, University of Bradford, Bradford, UK
| | | | - Kyriacos Kyriacou
- 3The Cyprus School of Molecular Medicine, The Cyprus Institute of Neurology and Genetics, Nicosia, Cyprus
| | | | | | - Chris Sutton
- 1Institute of Cancer Therapeutics, University of Bradford, Bradford, UK
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Hives L, Bradley A, Richards J, Sutton C, Selfe J, Basu B, Maguire K, Sumner G, Gaber T, Mukherjee A, Perrin RN. Can physical assessment techniques aid diagnosis in people with chronic fatigue syndrome/myalgic encephalomyelitis? A diagnostic accuracy study. BMJ Open 2017; 7:e017521. [PMID: 29133321 PMCID: PMC5695376 DOI: 10.1136/bmjopen-2017-017521] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [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: 11/04/2022] Open
Abstract
OBJECTIVE To assess five physical signs to see whether they can assist in the screening of patients with chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME) and potentially lead to quicker treatment. METHODS This was a diagnostic accuracy study with inter-rater agreement assessment. Participants recruited from two National Health Service hospitals, local CFS/ME support groups and the community were examined by three practitioners on the same day in a randomised order. Two allied health professionals (AHPs) performed independent examinations of physical signs including: postural/mechanical disturbances of the thoracic spine, breast varicosities, tender Perrin's point, tender coeliac plexus and dampened cranial flow. A physician conducted a standard clinical neurological and rheumatological assessment while looking for patterns of illness behaviour. Each examination lasted approximately 20 min. RESULTS Ninety-four participants were assessed, 52 patients with CFS/ME and 42 non-CFS/ME controls, aged 18-60. Cohen's kappa revealed that agreement between the AHPs was substantial for presence of the tender coeliac plexus (κ=0.65, p<0.001) and moderate for postural/mechanical disturbance of the thoracic spine (κ=0.57, p<0.001) and Perrin's point (κ=0.56, p<0.001). A McNemar's test found no statistically significant bias in the diagnosis by the experienced AHP relative to actual diagnosis (p=1.0) and a marginally non-significant bias by the newly trained AHP (p=0.052). There was, however, a significant bias in the diagnosis made by the physician relative to actual diagnosis (p<0.001), indicating poor diagnostic utility of the clinical neurological and rheumatological assessment. CONCLUSIONS Using the physical signs appears to improve the accuracy of identifying people with CFS/ME and shows agreement with current diagnostic techniques. However, the present study concludes that only two of these may be needed. Examining for physical signs is both quick and simple for the AHP and may be used as an efficient screening tool for CFS/ME. This is a small single-centre study, and therefore, further validation in other centres and larger populations is needed.
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Affiliation(s)
- Lucy Hives
- School of Dentistry, University of Central Lancashire, Preston, UK
| | - Alice Bradley
- Department of Neurophysiology, Lancashire Teaching Hospitals NHS Foundation Trust, Preston, UK
| | - Jim Richards
- Allied Health Research Unit, University of Central, Lancashire, UK
| | - Chris Sutton
- Lancashire Clinical Trials Unit, University of Central Lancashire, Preston, UK
| | - James Selfe
- Department of Health Professions, Manchester Metropolitan University, Manchester, Greater Manchester, UK
| | - Bhaskar Basu
- University Hospital of South Manchester NHS Foundation Trust/ Central, Manchester University Hospitals NHS Foundation Trust, Rehabilitation Medicine, Manchester, UK
| | - Kerry Maguire
- Department of Osteopathy, The Good Health Centre, County Clare, Ireland
| | | | - Tarek Gaber
- Taylor Rehabilitation Unit leigh, Leigh Infirmary, Leigh, Greater Manchester, UK
| | - Annice Mukherjee
- Department of Endocrinology, Salford Royal NHS Foundation Trust, Salford, UK
| | - Raymond N Perrin
- Allied Health Research Unit, University of Central, Lancashire, UK
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Ortega Duran M, Shnyder S, Sutton C, Shaheed SU. Investigation of MSI status in acquired resistance to 5-fluorouracil treatment in colorectal cancer using a SILAC-based quantitative proteomic analysis method. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx393.061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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29
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Sutton C, Carvalho B. Correspondence. Int J Obstet Anesth 2017; 32:93-94. [PMID: 28801161 DOI: 10.1016/j.ijoa.2017.07.006] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2017] [Accepted: 07/10/2017] [Indexed: 11/17/2022]
Affiliation(s)
- C Sutton
- Texas Children's Hospital, Baylor College of Medicine, Houston, TX, USA
| | - B Carvalho
- Stanford University School of Medicine, Stanford, CA, USA.
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Prior Y, Sutton C, Cotterill S, Adams J, Camacho E, Arafin N, Firth J, O'Neill T, Hough Y, Jones W, Hammond A. The effects of arthritis gloves on people with Rheumatoid Arthritis or Inflammatory Arthritis with hand pain: a study protocol for a multi-centre randomised controlled trial (the A-GLOVES trial). BMC Musculoskelet Disord 2017; 18:224. [PMID: 28558734 PMCID: PMC5450242 DOI: 10.1186/s12891-017-1583-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2017] [Accepted: 05/15/2017] [Indexed: 12/03/2022] Open
Abstract
Background Arthritis gloves are regularly provided as part of the management of people with rheumatoid arthritis (RA) and undifferentiated (early) inflammatory arthritis (IA). Usually made of nylon and elastane (i.e. Lycra®), these arthritis gloves apply pressure with the aims of relieving hand pain, stiffness and improving hand function. However, a systematic review identified little evidence supporting their use. We therefore designed a trial to compare the effectiveness of the commonest type of arthritis glove provided in the United Kingdom (Isotoner gloves) (intervention) with placebo (control) gloves (i.e. larger arthritis gloves providing similar warmth to the intervention gloves but minimal pressure only) in people with these conditions. Methods Participants aged 18 years and over with RA or IA and persistent hand pain will be recruited from National Health Service Trusts in the United Kingdom. Following consent, participants will complete a questionnaire booklet, then be randomly allocated to receive intervention or placebo arthritis gloves. Within three weeks, they will be fitted with the allocated gloves by clinical specialist rheumatology occupational therapists. Twelve weeks (i.e. the primary endpoint) after completing the baseline questionnaire, participants will complete a second questionnaire, including the same measures plus additional questions to explore adherence, benefits and problems with glove-wear. A sub-sample of participants from each group will be interviewed at the end of their participation to explore their views of the gloves received. The clinical effectiveness and cost-effectiveness of the intervention, compared to placebo gloves, will be evaluated over 12 weeks. The primary outcome measure is hand pain during activity. Qualitative interviews will be thematically analysed. Discussion This study will evaluate the commonest type of arthritis glove (Isotoner) provided in the NHS (i.e. the intervention) compared to a placebo glove. The results will help occupational therapists, occupational therapy services and people with arthritis make informed choices as to the value of arthritis gloves. If effective, arthritis gloves should become more widely available in the NHS to help people with RA and IA manage hand symptoms and improve performance of daily activities, work and leisure. If not, services can determine whether to cease supplying these to reduce service costs. Trial registration ISRCTN Registry: ISRCTN25892131 Registered 05/09/2016 Electronic supplementary material The online version of this article (doi:10.1186/s12891-017-1583-4) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Yeliz Prior
- Centre for Health Sciences Research (OT), University of Salford, Frederick Road, L701 Allerton Building, Salford, Greater Manchester, M6 6PU, UK.,Mid Cheshire NHS Trust, Leighton Hospital, Leighton, Crewe, UK
| | - Chris Sutton
- Lancashire Clinical Trials Unit, UCLAN, Preston, UK
| | - Sarah Cotterill
- Centre for Biostatistics, School of Health Sciences, University of Manchester, Manchester, UK
| | - Jo Adams
- Health Sciences, University of Southampton, Southampton, UK
| | - Elizabeth Camacho
- Centre for Health Economics, Division of Population Health, Health Services Research, and Primary Care, School of Health Sciences, University of Manchester, Manchester, UK
| | - Nazina Arafin
- Centre for Health Sciences Research (OT), University of Salford, Frederick Road, L701 Allerton Building, Salford, Greater Manchester, M6 6PU, UK
| | - Jill Firth
- Pennine Musculoskeletal Partnership Ltd, Oldham, UK
| | - Terence O'Neill
- Arthritis Research UK Centre for Epidemiology, University of Manchester & NIHR Manchester Musculoskeletal Biomedical Research Unit, Central Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Sciences Centre, Manchester, UK
| | - Yvonne Hough
- St Helens and Knowsley Teaching Hospitals NHS Trust, St Helens Hospital, St Helens, UK
| | | | - Alison Hammond
- Centre for Health Sciences Research (OT), University of Salford, Frederick Road, L701 Allerton Building, Salford, Greater Manchester, M6 6PU, UK.
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Tucker M, Matthews M, Sutton C. 0253 SIMULATED SURGICAL SKILL AND DECLARATIVE MEMORY RETENTION FOLLOWING THE OB/GYN CLERKSHIP IN 3RD YEAR MEDICAL STUDENTS. Sleep 2017. [DOI: 10.1093/sleepj/zsx050.252] [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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Banerjee A, Burnell J, Sutton C. Real world persistence, adherence and switch-over across anticoagulants in atrial fibrillation-a national population-based study. Int J Popul Data Sci 2017. [PMCID: PMC9351045 DOI: 10.23889/ijpds.v1i1.334] [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: 11/24/2022] Open
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33
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Broecker J, Sutton C, Demma L, Lynde G. Comprehension of Surgical Informed Consent in Haiti. Ann Glob Health 2017. [DOI: 10.1016/j.aogh.2017.03.056] [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: 11/25/2022] Open
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Herring LY, Stevinson C, Carter P, Biddle SJH, Bowrey D, Sutton C, Davies MJ. The effects of supervised exercise training 12-24 months after bariatric surgery on physical function and body composition: a randomised controlled trial. Int J Obes (Lond) 2017; 41:909-916. [PMID: 28262676 DOI: 10.1038/ijo.2017.60] [Citation(s) in RCA: 74] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2016] [Revised: 01/30/2017] [Accepted: 02/10/2017] [Indexed: 01/09/2023]
Abstract
BACKGROUND Bariatric surgery is effective for the treatment of stage II and III obesity and its related diseases, although increasing evidence is showing weight regain ~12-24 months postsurgery. Weight regain increases the risk of physical function decline, which negatively affects an individual's ability to undertake activities of daily living. The study assessed the effects of a 12-week supervised exercise intervention on physical function and body composition in patients between 12 and 24 months post bariatric surgery. METHODS Twenty-four inactive adult bariatric surgery patients whose body mass index remained ⩾30 kg m2 12 to 24 months post surgery were randomised to an exercise intervention (n=12) or control group (n=12). Supervised exercise consisted of three 60-min gym sessions per week of moderate intensity aerobic and resistance training for 12 weeks. Control participants received usual care. The incremental shuttle walk test (ISWT) was used to assess functional walking performance after the 12-week exercise intervention, and at 24 weeks follow-up. Measures of anthropometric, physical activity, cardiovascular and psychological outcomes were also examined. Using an intention-to-treat protocol, independent t-tests were used to compare outcome measures between groups. RESULTS Significant improvements in the exercise group were observed for the ISWT, body composition, physical function, cardiovascular and self-efficacy measures from baseline to 12 weeks. A large baseline to 12-week change was observed for the ISWT (exercise: 325.00±117.28 m; control: 355.00±80.62 m, P<0.001). The exercise group at 24 weeks recorded an overall mean improvement of 143.3±86.6 m and the control group recorded a reduction of -32.50±75.93 m. Findings show a 5.6 kg difference between groups in body mass change from baseline to 24 weeks favouring the exercise group. CONCLUSIONS A 12-week supervised exercise intervention led to significant improvements in body mass and functional walking ability post intervention, with further improvements at the 24-week follow-up.
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Affiliation(s)
- L Y Herring
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK.,University Hospitals of Leicester NHS Trust, Leicester General Hospital, Leicester, UK
| | - C Stevinson
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - P Carter
- Behaviour and Health Research Unit, University of Cambridge, Cambridge, UK.,The University of Leicester, Diabetes Research Centre, Leicester, UK
| | - S J H Biddle
- Institute of Sport, Exercise and Active Living, Victoria University, Melbourne, VIC, Australia
| | - D Bowrey
- University Hospitals of Leicester NHS Trust, Leicester General Hospital, Leicester, UK
| | - C Sutton
- University Hospitals of Leicester NHS Trust, Leicester General Hospital, Leicester, UK
| | - M J Davies
- The University of Leicester, Diabetes Research Centre, Leicester, UK
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Tariq S, Tahseen M, Hassan M, Masood MA, Khattak S, Syed AA, Ahmad AH, Hussain M, Aasim Yusuf M, Sutton C, Saleem S. Stem Cell Organoids in Primary Cultures of Human Non-Malignant and Malignant Colon. J Mol Biomark Diagn 2017; 08. [DOI: 10.4172/2155-9929.1000346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/30/2023]
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Furniss G, Opel A, Hussein A, Pearman C, Grace A, Connelly D, Orlowski A, Banerjee A, McNicholas T, Providencia R, Montañes M, Providencia R, Panagopoulos D, Tomlinson D, Dalrymple-Hay M, Haywood G, Butler A, Ang R, Ullah W, Schwartz R, Fannon M, Finlay M, Hunter R, Schilling R, Das M, Asfour I, Morgan M, Ronayne C, Shaw M, Snowdon R, Gupta D, Todd D, King R, Hall M, Modi S, Mediratta N, Gupta D, Reddy V, Neuzil P, Willems S, Verma A, Heck P, Schilling R, Lambiase P, Hall M, Nicholl B, McQueenie R, Jani BD, McKeag N, Gallacher K, Mair F, Heaton D, Macdonald J, Burnell J, Ryan R, Marshall T, Sutton C, O'Callaghan S, Kenny R, Karim N, Srinivasan N, Ferreira M, Goncalves L, Lambiase P, Toledano M, Field E, Walsh H, Maguire K, Cervi E, Kaski J, Perez Tome M, Pantazis A, Elliott P, Lambiase P, Segal O. ORAL ABSTRACTS (3)EP & Ablation31LEFT ATRIAL POSTERIOR WALL ISOLATION (THE “BOX LESION PATTERN”) IN THE TREATMENT OF ATRIAL FIBRILLATION: A SINGLE CENTRE EXPERIENCE32DAY CASE CRYOBLATION (CRYO) FOR PAROXYSMAL ATRIAL FIBRILLATION (pAF) IN THE DISTRICT GENERAL HOSPITAL IS SAFE AND EFFECTIVE IF DONE IN HIGH VOLUME WITH EXPERIENCED OPERATORS33ABLATION INDEX-GUIDED PULMONARY VEIN ISOLATION FOR ATRIAL FIBRILLATION MAY IMPROVE CLINICAL OUTCOMES IN COMPARISON TO CONTACT FORCE-GUIDED ABLATION34THE PROCEDURAL COMPLICATION RATES AND SHORT-TERM SUCCESS RATES OF THORACOSCOPIC AF ABLATION DURING THE INSTITUTIONAL LEARNING CURVE35INITIAL PROCEDURAL RESULTS FROM DDRAMATIC-SVT STUDY: DD MECHANISM IDENTIFICATION AND LOCALISATION USING DIPOLE DENSITY MAPPING TO GUIDE ABLATION STRATEGY36MORBIDITY AND MORTALITY IN MIDDLE-AGED INDIVIDUALS WITH ATRIAL FIBRILLATION: UK BIOBANK DATAClinical EP37THE GM AHSN AF LANDSCAPE TOOL: A SHARED PUBLIC DATA PLATFORM TO PROMOTE QUALITY IMPROVEMENTS AND IDENTIFY OPPORTUNITIES TO PREVENT AF-RELATED STROKE IN THE DEVOLVED GREATER MANCHESTER HEALTH SYSTEM38REAL WORLD PERSISTENCE, ADHERENCE AND SWITCH-OVER ACROSS ANTICOAGULANTS IN ATRIAL FIBRILLATION-A NATIONAL POPULATION-BASED STUDY39ORTHOSTATIC HYPOTENSION AND ATRIAL FIBRILLATION40PREVALENCE OF SHORT QT AND CRITERIA OF SEVERITY IN A YOUNG ASYMPTOMATIC COHORT41SURFACE ELECTROCARDIOGRAPHIC FEATURES AND PREVALENCE OF ARRHYTHMIAS IN PAEDIATRIC FRIEDREICH'S ATAXIA42RISK STRATIFICATION OF TYPE 1 MYOTONIC DYSTROPHY: IS THE ECG ACCURATE ENOUGH TO SELECT PATIENTS AT RISK OF BRADYARRHYTHMIC EVENTS? Europace 2016. [DOI: 10.1093/europace/euw272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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McElhone K, Abbott J, Sutton C, Mullen M, Lanyon P, Rahman A, Yee CS, Akil M, Bruce IN, Ahmad Y, Gordon C, Teh LS. Sensitivity to Change and Minimal Important Differences of the LupusQoL in Patients With Systemic Lupus Erythematosus. Arthritis Care Res (Hoboken) 2016; 68:1505-13. [PMID: 26816223 PMCID: PMC5053261 DOI: 10.1002/acr.22850] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2015] [Revised: 01/07/2016] [Accepted: 01/19/2016] [Indexed: 12/13/2022]
Abstract
Objective As a health‐related quality of life (HRQOL) measure, the LupusQoL is a reliable and valid measure for adults with systemic lupus erythematosus (SLE). This study evaluates the responsiveness and minimal important differences (MIDs) for the 8 LupusQoL domains. Methods Patients experiencing a flare were recruited from 9 UK centers. At each of the 10 monthly visits, HRQOL (LupusQoL, Short Form 36 health survey [SF‐36]), global rating of change (GRC), and disease activity using the British Isles Lupus Assessment Group 2004 index were assessed. The responsiveness of the LupusQoL and the SF‐36 was evaluated primarily when patients reported an improvement or deterioration on the GRC scale and additionally with changes in physician‐reported disease activity. MIDs were estimated as mean changes when minimal change was reported on the GRC scale. Results A total of 101 patients were recruited. For all LupusQoL domains, mean HRQOL worsened when patients reported deterioration and improved when patients reported an improvement in GRC; SF‐36 domains showed comparable responsiveness. Improvement in some domains of the LupusQoL/SF‐36 was observed with a decrease in disease activity, but when disease activity worsened, there was no significant change. LupusQoL MID estimates for deterioration ranged from −2.4 to −8.7, and for improvement from 3.5 to 7.3; for the SF‐36, the same MID estimates were −2.0 to −11.1 and 2.8 to 10.9, respectively. Conclusion All LupusQoL domains are sensitive to change with patient‐reported deterioration or improvement in health status. For disease activity, some LupusQoL domains showed responsiveness when there was improvement but none for deterioration. LupusQoL items were derived from SLE patients and provide the advantage of disease‐specific domains, important to the patients, not captured by the SF‐36.
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Affiliation(s)
| | | | | | | | - Peter Lanyon
- Queen's Medical Centre Campus, Nottingham University Hospitals, Nottingham, UK
| | | | | | | | - Ian N Bruce
- The Kellgren Centre for Rheumatology, National Institute for Health Research Manchester Musculoskeletal Biomedical Research Unit, Central Manchester University Hospitals National Health Service Foundation Trust and Arthritis Research UK Centre for Epidemiology, Centre for Musculoskeletal Research, Institute of Inflammation and Repair, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
| | - Yasmeen Ahmad
- Peter Maddison Rheumatology Centre, Betsi Cadwaladr University Health Board, Llandudno Hospital, Llandudno, UK
| | - Caroline Gordon
- University of Birmingham, National Institute for Health Research Wellcome Trust Clinical Research Facility, University Hospital Birmingham National Health Service Foundation Trust, and West Birmingham Hospitals National Health Service Trust, Birmingham, UK
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Dey P, Callaghan M, Cook N, Sephton R, Sutton C, Hough E, James J, Saqib R, Selfe J. A questionnaire to identify patellofemoral pain in the community: an exploration of measurement properties. BMC Musculoskelet Disord 2016; 17:237. [PMID: 27245443 PMCID: PMC4886395 DOI: 10.1186/s12891-016-1097-5] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2015] [Accepted: 05/24/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Community-based studies of patellofemoral pain (PFP) need a questionnaire tool that discriminates between those with and those without the condition. To overcome these issues, we have designed a self-report questionnaire which aims to identify people with PFP in the community. METHODS STUDY DESIGNS comparative study and cross-sectional study. STUDY POPULATION comparative study: PFP patients, soft-tissue injury patients and adults without knee problems. Cross-sectional study: adults attending a science festival. INTERVENTION comparative study participants completed the questionnaire at baseline and two weeks later. Cross-sectional study participants completed the questionnaire once. The optimal scoring system and threshold was explored using receiver operating characteristic curves, test-retest reliability using Cohen's kappa and measurement error using Bland-Altman plots and standard error of measurement. Known-group validity was explored by comparing PFP prevalence between genders and age groups. RESULTS Eighty-four participants were recruited to the comparative study. The receiver operating characteristic curves suggested limiting the questionnaire to the clinical features and knee pain map sections (AUC 0.97 95 % CI 0.94 to 1.00). This combination had high sensitivity and specificity (over 90 %). Measurement error was less than the mean difference between the groups. Test-retest reliability estimates suggest good agreement (N = 51, k = 0.74, 95 % CI 0.52-0.91). The cross-sectional study (N = 110) showed expected differences between genders and age groups but these were not statistically significant. CONCLUSION A shortened version of the questionnaire, based on clinical features and a knee pain map, has good measurement properties. Further work is needed to validate the questionnaire in community samples.
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Affiliation(s)
- Paola Dey
- College of Clinical and Biomedical Sciences, University of Central Lancashire, Preston, PR1 2HE, UK.
| | - Michael Callaghan
- Department of Health Professions, Manchester Metropolitan University, Manchester, M15 6GX, UK
| | - Neil Cook
- College of Clinical and Biomedical Sciences, University of Central Lancashire, Preston, PR1 2HE, UK
| | - Ruth Sephton
- 5 Boroughs Partnership NHS Foundation Trust, St Helens Hospital, Marshalls Cross Road, St Helens, WA9 3DA, UK
| | - Chris Sutton
- College of Health and Wellbeing, University of Central Lancashire, Preston, PR1 2HE, UK
| | - Elaine Hough
- 5 Boroughs Partnership NHS Foundation Trust, St Helens Hospital, Marshalls Cross Road, St Helens, WA9 3DA, UK
| | - Jonathan James
- 5 Boroughs Partnership NHS Foundation Trust, St Helens Hospital, Marshalls Cross Road, St Helens, WA9 3DA, UK
| | - Rukhtam Saqib
- Stepping Hill Hospital, Stockport Foundation NHS Trust, Poplar Grove, Hazel Grove, Stockport, Cheshire, SK2 7JE, UK
| | - James Selfe
- Department of Health Professions, Manchester Metropolitan University, Manchester, M15 6GX, UK
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39
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Beaver K, Williamson S, Sutton C, Hollingworth W, Gardner A, Allton B, Abdel-Aty M, Blackwood K, Burns S, Curwen D, Ghani R, Keating P, Murray S, Tomlinson A, Walker B, Willett M, Wood N, Martin-Hirsch P. Comparing hospital and telephone follow-up for patients treated for stage-I endometrial cancer (ENDCAT trial): a randomised, multicentre, non-inferiority trial. BJOG 2016; 124:150-160. [PMID: 27062690 DOI: 10.1111/1471-0528.14000] [Citation(s) in RCA: 64] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/17/2016] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To evaluate the effectiveness of nurse-led telephone follow-up (TFU) for patients with stage-I endometrial cancer. DESIGN Multicentre, randomised, non-inferiority trial. SETTING Five centres in the North West of England. SAMPLE A cohort of 259 women treated for stage-I endometrial cancer attending hospital outpatient clinics for routine follow-up. METHODS Participants were randomly allocated to receive traditional hospital based follow-up (HFU) or nurse-led TFU. MAIN OUTCOME MEASURES Primary outcomes were psychological morbidity (State Trait Anxiety Inventory, STAI-S) and patient satisfaction with the information provided. Secondary outcomes included patient satisfaction with service, quality of life, and time to detection of recurrence. RESULTS The STAI-S scores post-randomisation were similar between groups [mean (SD): TFU 33.0 (11.0); HFU 35.5 (13.0)]. The estimated between-group difference in STAI-S was 0.7 (95% confidence interval, 95% CI -1.9 to 3.3); the confidence interval lies above the non-inferiority limit (-3.5), indicating the non-inferiority of TFU. There was no significant difference between groups in reported satisfaction with information (odds ratio, OR 0.9; 95% CI 0.4-2.1; P = 0.83). Women in the HFU group were more likely to report being kept waiting for their appointment (P = 0.001), that they did not need any information (P = 0.003), and were less likely to report that the nurse knew about their particular case and situation (P = 0.005). CONCLUSIONS The TFU provides an effective alternative to HFU for patients with stage-I endometrial cancer, with no reported physical or psychological detriment. Patient satisfaction with information was high, with similar levels between groups. TWEETABLE ABSTRACT ENDCAT trial shows effectiveness of nurse-led telephone follow-up for patients with stage-I endometrial cancer.
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Affiliation(s)
- K Beaver
- School of Health Sciences, University of Central Lancashire, Preston, UK
| | - S Williamson
- School of Health Sciences, University of Central Lancashire, Preston, UK
| | - C Sutton
- Lancashire Clinical Trials Unit, University of Central Lancashire, Preston, UK
| | - W Hollingworth
- School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - A Gardner
- Women's Health Research Department, Lancashire Teaching Hospitals NHS Foundation Trust, Royal Preston Hospital, Preston, UK
| | - B Allton
- Department of Obstetrics & Gynaecology, University Hospitals of Morecambe Bay NHS Foundation Trust, Royal Lancaster Infirmary, Lancaster, UK
| | - M Abdel-Aty
- Gynaecology Department, East Lancashire Hospitals NHS Trust, Burnley General Hospital, Burnley, UK
| | - K Blackwood
- Women's Healthcare Unit, Wrightington, Wigan & Leigh NHS Foundation Trust, Hanover Diagnostic and Treatment Centre, Wigan, UK
| | - S Burns
- Women's Healthcare Unit, Wrightington, Wigan & Leigh NHS Foundation Trust, Hanover Diagnostic and Treatment Centre, Wigan, UK
| | - D Curwen
- Gynaecological Unit, Blackpool Teaching Hospitals NHS Foundation Trust, Blackpool, UK
| | - R Ghani
- Department of Obstetrics & Gynaecology, University Hospitals of Morecambe Bay NHS Foundation Trust, Royal Lancaster Infirmary, Lancaster, UK
| | - P Keating
- Women's Health Directorate, Lancashire Teaching Hospitals NHS Foundation Trust, Royal Preston Hospital, Preston, UK
| | - S Murray
- Women's Health Directorate, Lancashire Teaching Hospitals NHS Foundation Trust, Royal Preston Hospital, Preston, UK
| | - A Tomlinson
- Corporate Cancer Team, Lancashire Teaching Hospitals NHS Foundation Trust, Royal Preston Hospital, Preston, UK
| | - B Walker
- Gynaecology Department, East Lancashire Hospitals NHS Trust, Burnley General Hospital, Burnley, UK
| | - M Willett
- Gynaecology Department, East Lancashire Hospitals NHS Trust, Burnley General Hospital, Burnley, UK
| | - N Wood
- Women's Health Directorate, Lancashire Teaching Hospitals NHS Foundation Trust, Royal Preston Hospital, Preston, UK
| | - P Martin-Hirsch
- Women's Health Directorate, Lancashire Teaching Hospitals NHS Foundation Trust, Royal Preston Hospital, Preston, UK
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Tyler E, Lobban F, Sutton C, Depp C, Johnson S, Laidlaw K, Jones SH. Feasibility randomised controlled trial of Recovery-focused Cognitive Behavioural Therapy for Older Adults with bipolar disorder (RfCBT-OA): study protocol. BMJ Open 2016; 6:e010590. [PMID: 26940112 PMCID: PMC4785318 DOI: 10.1136/bmjopen-2015-010590] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [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: 11/18/2015] [Revised: 01/05/2016] [Accepted: 01/19/2016] [Indexed: 11/29/2022] Open
Abstract
INTRODUCTION Bipolar disorder is a severe and chronic mental health problem that persists into older adulthood. The number of people living with this condition is set to rise as the UK experiences a rapid ageing of its population. To date, there has been very little research or service development with respect to psychological therapies for this group of people. METHODS AND ANALYSIS A parallel two-arm randomised controlled trial comparing a 14-session, 6-month Recovery-focused Cognitive-Behavioural Therapy for Older Adults with bipolar disorder (RfCBT-OA) plus treatment as usual (TAU) versus TAU alone. Participants will be recruited in the North-West of England via primary and secondary mental health services and through self-referral. The primary objective of the study is to evaluate the feasibility and acceptability of RfCBT-OA; therefore, a formal power calculation is not appropriate. It has been estimated that randomising 25 participants per group will be sufficient to be able to reliably determine the primary feasibility outcomes (eg, recruitment and retention rates), in line with recommendations for sample sizes for feasibility/pilot trials. Participants in both arms will complete assessments at baseline and then every 3 months, over the 12-month follow-up period. We will gain an estimate of the likely effect size of RfCBT-OA on a range of clinical outcomes and estimate parameters needed to determine the appropriate sample size for a definitive, larger trial to evaluate the effectiveness and cost-effectiveness of RfCBT-OA. Data analysis is discussed further in the Analysis section in the main paper. ETHICS AND DISSEMINATION This protocol was approved by the UK National Health Service (NHS) Ethics Committee process (REC ref: 15/NW/0330). The findings of the trial will be disseminated through peer-reviewed journals, national and international conference presentations and local, participating NHS trusts. TRIAL REGISTRATION NUMBER ISRCTN13875321; Pre-results.
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Affiliation(s)
- Elizabeth Tyler
- Division of Health Research, The Spectrum Centre for Mental Health Research, Lancaster University, Lancaster, UK
| | - Fiona Lobban
- Division of Health Research, The Spectrum Centre for Mental Health Research, Lancaster University, Lancaster, UK
| | - Chris Sutton
- Lancashire Clinical Trials Unit, College of Health and Wellbeing, University of Central Lancashire, Preston, UK
| | - Colin Depp
- Department of Psychiatry, School of Medicine of the University of California, San Diego, San Diego, California, USA
| | - Sheri Johnson
- Department of Psychology, University of California, Berkeley, Berkeley, California, USA
| | - Ken Laidlaw
- Faculty of Medicine and Health Sciences, Norwich Medical School, University of East Anglia, Norwich, UK
| | - Steven H Jones
- Division of Health Research, The Spectrum Centre for Mental Health Research, Lancaster University, Lancaster, UK
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Herring LY, Stevinson C, Davies MJ, Biddle SJ, Sutton C, Bowrey D, Carter P. Changes in physical activity behaviour and physical function after bariatric surgery: a systematic review and meta-analysis. Obes Rev 2016; 17:250-61. [PMID: 26783103 DOI: 10.1111/obr.12361] [Citation(s) in RCA: 95] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2015] [Revised: 10/30/2015] [Accepted: 11/02/2015] [Indexed: 12/14/2022]
Abstract
Although physical activity performed after bariatric surgery is associated with enhanced weight loss outcomes, there is limited information on patients' physical activity behaviour in this context. This systematic review and meta-analysis assessed pre-operative to post-operative changes in physical activity and physical function outcomes among obese adults undergoing bariatric surgery. A total of 50 studies met inclusion criteria with 26 papers reporting data for meta-analysis. Increases in both objectively recorded and self-reported physical activity at 12 months were demonstrated. Studies indicated that there was a shift towards a greater amount of active time, but of a lower intensity within the first 6 months of bariatric surgery, suggested by a reduction in moderate to vigorous physical activity but an increase in step count. A standardized mean difference (SMD) of 1.53 (95% CI: 1.02-2.04) based on nine studies indicated improved walking performance at 12 months. Similarly, analysis of five studies demonstrated increased musculoskeletal function at 3-6 months (SMD: 1.51; 95% CI: 0.60-2.42). No relationship was identified between changes in weight and walking performance post-surgery. More studies assessing physical activity, physical function and weight loss would help understand the role of physical activity in optimizing post-operative weight and functional outcomes.
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Affiliation(s)
- L Y Herring
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK.,NIHR Leicester-Loughborough Diet, Lifestyle and Physical Activity Biomedical Research Unit, Leicester, UK
| | - C Stevinson
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK.,NIHR Leicester-Loughborough Diet, Lifestyle and Physical Activity Biomedical Research Unit, Leicester, UK
| | - M J Davies
- NIHR Leicester-Loughborough Diet, Lifestyle and Physical Activity Biomedical Research Unit, Leicester, UK.,Diabetes Research Centre, University of Leicester, Leicester, UK.,University Hospitals of Leicester NHS Trust, Leicester, UK
| | - S Jh Biddle
- NIHR Leicester-Loughborough Diet, Lifestyle and Physical Activity Biomedical Research Unit, Leicester, UK.,Institute of Sport, Exercise and Active Living, Victoria University, Melbourne, Australia
| | - C Sutton
- NIHR Leicester-Loughborough Diet, Lifestyle and Physical Activity Biomedical Research Unit, Leicester, UK.,University Hospitals of Leicester NHS Trust, Leicester, UK
| | - D Bowrey
- NIHR Leicester-Loughborough Diet, Lifestyle and Physical Activity Biomedical Research Unit, Leicester, UK.,University Hospitals of Leicester NHS Trust, Leicester, UK
| | - P Carter
- NIHR Leicester-Loughborough Diet, Lifestyle and Physical Activity Biomedical Research Unit, Leicester, UK.,Diabetes Research Centre, University of Leicester, Leicester, UK
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Sutton C, Butwick AJ. Can extra carbs improve perinatal outcomes? BJOG 2016; 123:518. [PMID: 26914894 DOI: 10.1111/1471-0528.13814] [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: 11/29/2022]
Affiliation(s)
- C Sutton
- Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford, CA, USA
| | - A J Butwick
- Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford, CA, USA
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Selfe J, Janssen J, Callaghan M, Witvrouw E, Sutton C, Richards J, Stokes M, Martin D, Dixon J, Hogarth R, Baltzopoulos V, Ritchie E, Arden N, Dey P. Are there three main subgroups within the patellofemoral pain population? A detailed characterisation study of 127 patients to help develop targeted intervention (TIPPs). Br J Sports Med 2016; 50:873-80. [PMID: 26834185 PMCID: PMC4975826 DOI: 10.1136/bjsports-2015-094792] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/16/2015] [Indexed: 11/04/2022]
Abstract
Background Current multimodal approaches for the management of non-specific patellofemoral pain are not optimal, however, targeted intervention for subgroups could improve patient outcomes. This study explores whether subgrouping of non-specific patellofemoral pain patients, using a series of low cost simple clinical tests, is possible. Method The exclusivity and clinical importance of potential subgroups was assessed by applying à priori test thresholds (1 SD) from seven clinical tests in a sample of adult patients with non-specific patellofemoral pain. Hierarchical clustering and latent profile analysis, were used to gain additional insights into subgroups using data from the same clinical tests. Results 130 participants were recruited, 127 had complete data: 84 (66%) female, mean age 26 years (SD 5.7) and mean body mass index 25.4 (SD 5.83), median (IQR) time between onset of pain and assessment was 24 (7–60) months. Potential subgroups defined by the à priori test thresholds were not mutually exclusive and patients frequently fell into multiple subgroups. Using hierarchical clustering and latent profile analysis three subgroups were identified using 6 of the 7 clinical tests. These subgroups were given the following nomenclature: (1) ‘strong’, (2) ‘weak and tighter’ and (3) ‘weak and pronated foot’. Conclusions We conclude that three subgroups of patellofemoral patients may exist based on the results of six clinical tests which are feasible to perform in routine clinical practice. Further research is needed to validate these findings in other data sets and, if supported by external validation, to see if targeted interventions for these subgroups improve patient outcomes.
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Affiliation(s)
- James Selfe
- University of Central Lancashire, Preston, Lancashire, UK
| | - Jessie Janssen
- University of Central Lancashire, Preston, Lancashire, UK
| | - Michael Callaghan
- Institute for Inflammation and Repair, Centre for Musculoskeletal Research, University of Manchester, Manchester, UK
| | - Erik Witvrouw
- Aspetar, Orthopaedic and Sports Medicine Hospital, Doha, Qatar
| | - Chris Sutton
- University of Central Lancashire, Preston, Lancashire, UK
| | - Jim Richards
- University of Central Lancashire, Preston, Lancashire, UK
| | - Maria Stokes
- Faculty of Health Sciences, University of Southampton, Southampton, UK
| | | | | | | | | | - Elizabeth Ritchie
- Department of Physiotherapy, Harrogate & District NHS Foundation Trust, Harrogate District Hospital, Harrogate, North Yorkshire, UK
| | - Nigel Arden
- University of Oxford, Nuffield Orthopaedic Centre, Oxford, UK
| | - Paola Dey
- University of Central Lancashire, Preston, Lancashire, UK
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Watkins D, Zuhlke L, Engel M, Daniels R, Francis V, Shaboodien G, Kango M, Abul-Fadl A, Adeoye A, Ali S, Al-Kebsi M, Bode-Thomas F, Bukhman G, Damasceno A, Goshu DY, Elghamrawy A, Gitura B, Haileamlak A, Hailu A, Hugo-Hamman C, Justus S, Karthikeyan G, Kennedy N, Lwabi P, Mamo Y, Mntla P, Sutton C, Mocumbi AO, Mondo C, Mtaja A, Musuku J, Mucumbitsi J, Murango L, Nel G, Ogendo S, Ogola E, Ojji D, Olunuga TO, Redi MM, Rusingiza KE, Sani M, Sheta S, Shongwe S, van Dam J, Gamra H, Carapetis J, Lennon D, Mayosi BM. Seven key actions to eradicate rheumatic heart disease in Africa: the Addis Ababa communiqué. Cardiovasc J Afr 2016; 27:184-187. [PMID: 26815006 PMCID: PMC5125265 DOI: 10.5830/cvja-2015-090] [Citation(s) in RCA: 86] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2015] [Accepted: 11/14/2015] [Indexed: 11/24/2022] Open
Abstract
Acute rheumatic fever (ARF) and rheumatic heart disease (RHD) remain major causes of heart failure, stroke and death among African women and children, despite being preventable and imminently treatable. From 21 to 22 February 2015, the Social Cluster of the Africa Union Commission (AUC) hosted a consultation with RHD experts convened by the Pan-African Society of Cardiology (PASCAR) in Addis Ababa, Ethiopia, to develop a ‘roadmap’ of key actions that need to be taken by governments to eliminate ARF and eradicate RHD in Africa. Seven priority areas for action were adopted: (1) create prospective disease registers at sentinel sites in affected countries to measure disease burden and track progress towards the reduction of mortality by 25% by the year 2025, (2) ensure an adequate supply of high-quality benzathine penicillin for the primary and secondary prevention of ARF/RHD, (3) improve access to reproductive health services for women with RHD and other non-communicable diseases (NCD), (4) decentralise technical expertise and technology for diagnosing and managing ARF and RHD (including ultrasound of the heart), (5) establish national and regional centres of excellence for essential cardiac surgery for the treatment of affected patients and training of cardiovascular practitioners of the future, (6) initiate national multi-sectoral RHD programmes within NCD control programmes of affected countries, and (7) foster international partnerships with multinational organsations for resource mobilisation, monitoring and evaluation of the programme to end RHD in Africa. This Addis Ababa communiqué has since been endorsed by African Union heads of state, and plans are underway to implement the roadmap in order to end ARF and RHD in Africa in our lifetime.
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Affiliation(s)
- David Watkins
- Department of Medicine, Groote Schuur Hospital and University of Cape Town, South Africa; University of Washington, USA
| | - Liesl Zuhlke
- Department of Medicine, Groote Schuur Hospital and University of Cape Town, South Africa
| | - Mark Engel
- Department of Medicine, Groote Schuur Hospital and University of Cape Town, South Africa
| | - Rezeen Daniels
- Department of Medicine, Groote Schuur Hospital and University of Cape Town, South Africa
| | - Veronica Francis
- Department of Medicine, Groote Schuur Hospital and University of Cape Town, South Africa
| | - Gasnat Shaboodien
- Department of Medicine, Groote Schuur Hospital and University of Cape Town, South Africa
| | | | | | | | - Sulafa Ali
- University of Khartoum and Sudan Heart Centre, Sudan
| | | | | | | | | | | | - Alaa Elghamrawy
- Ministry of Health, Rheumatic Heart Disease Programme, NCDs, Egypt
| | | | | | | | | | | | | | - Neil Kennedy
- College of Medicine, University of Malawi, Malawi
| | | | - Yoseph Mamo
- Technical Adviser, NCD directorate, Federal Ministry of Health of Ethiopia, Ethiopia
| | - Pindile Mntla
- Sefako Makgatho Health Sciences University, South Africa
| | - Chris Sutton
- Sefako Makgatho Health Sciences University, South Africa
| | - Ana Olga Mocumbi
- Instituto Nacional de Saúde, Mozambique and PASCAR Vice President South
| | | | | | | | | | | | | | | | | | - Dike Ojji
- University of Abuja Teaching Hospital, Nigeria
| | | | | | | | - Mahmoud Sani
- Bayero University Kano and Aminu Kano Teaching Hospital, Nigeria
| | - Sahar Sheta
- Cairo University Children Hospital, Faculty of Medicine, Egypt
| | | | | | | | - Jonathan Carapetis
- Telethon Kids Institute, University of Western Australia, Princess Margaret Hospital for Children, Australia
| | | | - Bongani M Mayosi
- Department of Medicine, Groote Schuur Hospital and University of Cape Town, South Africa; PASCAR Secretariat, South Africa.
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Tishkovskaya S, Sutton C, Thomas L, Leathley M, Watkins C. Determining the sample size for a cluster-randomised trial: Bayesian hierarchical modelling of the ICC estimate. Trials 2015. [PMCID: PMC4660147 DOI: 10.1186/1745-6215-16-s2-p229] [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: 11/24/2022] Open
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46
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Barrett G, Berndt-Weiss L, Patel M, Sutton C, Pelletier P, Field J. Health Canada's estimation of a provisional tolerable daily intake for diethyl phthalate. Toxicol Lett 2015. [DOI: 10.1016/j.toxlet.2015.08.212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Sharman H, Rathore R, Sutton C. 13MANAGEMENT OF ELDERLY PATIENTS WITH UNINTENTIONAL WEIGHT LOSS IN SECONDARY CARE. Age Ageing 2015. [DOI: 10.1093/ageing/afv106.13] [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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Williamson S, Beaver K, Martin-Hirsch P, Patrick K, Anne T, Sutton C. 1709 Comparing hospital and telephone follow-up for women treated for endometrial cancer (ENDCAT trial). Eur J Cancer 2015. [DOI: 10.1016/s0959-8049(16)30725-0] [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: 11/16/2022]
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Shaheed SU, Hadjisavvas A, Sokratous K, Loadman P, Sutton C, Kyriacou K. Abstract 1576: Analysis of HSP10 as a putative biomarker of breast cancer. Cancer Res 2015. [DOI: 10.1158/1538-7445.am2015-1576] [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
Introduction. Detection of the very earliest stages of breast cancer remain challenging and the differentiation of those carcinomas that develop into aggressive invasive forms from those that remain benign has not been achieved. Consequently, removal of the tumor by total mastectomy, local excision (LE) plus adjuvant radiotherapy (RT), or LE alone remain the main treatments, even if they prove unnecessary. Previously, using proteomics analysis, we identified proteins that were significantly changed in expression between matched normal and tumor tissues from Cypriot patients with different stages of the disease. Heat shock protein 10 (HSP10), which is responsible for the mitochondrial protein folding, was one of the proteins identified. A range of methods were used to verify HSP10 as a possible biomarker for breast cancer.
Materials and Methods. Protein extracts from breast cancer cell lines and breast tissue biopsies from Cypriot patients with different stages of the disease were analysed by (i) Western Blotting (WB) and (ii) multiple reaction monitoring mass spectrometry (MRM MS) using two proteotypic peptides unique to HSP10, in proteins extracted form fresh frozen as well as from FFPE breast tissues. Tissue microarray analysis (TMA) was carried out on core biopsies from the Leeds Breast Tissue Bank.
Results. WB indicated that HSP10 was ubiquitously and evenly expressed across breast cancer cell lines representative of different phenotypes. WB and MRM MS revealed that expression was significantly increased in invasive carcinoma compared to normal tissue, but was patient specific for fibroadenoma and DCIS cases. TMA of 360 samples indicated a strong correlation between staining and type of breast cancer (invasive ductal and lobular), grade and ER positive phenotype.
Discussion. Proteomics analysis using iTRAQ quantitation indicated an average of 1.6 fold increase in HSP10 in invasive carcinomas compared to matched normal tissue. By comparison, WB and MRM MS analysis indicated a significantly amplified discrimination in the expression of HSP10 as has been observed with other biomarker candidates. HSP10 protein levels were in agreement with mRNA results observed in breast cancer cell lines reported in the Cancer Cell Line Encyclopaedia. In conclusion, HSP10 represents an excellent biomarker candidate for further validation.
Citation Format: Sadr-ul Shaheed, Andreas Hadjisavvas, Kleitos Sokratous, Paul Loadman, Chris Sutton, Kyriacos Kyriacou. Analysis of HSP10 as a putative biomarker of breast cancer. [abstract]. In: Proceedings of the 106th Annual Meeting of the American Association for Cancer Research; 2015 Apr 18-22; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Res 2015;75(15 Suppl):Abstract nr 1576. doi:10.1158/1538-7445.AM2015-1576
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Affiliation(s)
| | | | | | - Paul Loadman
- 1Institute of Cancer Therapeutics, Bradford, United Kingdom
| | - Chris Sutton
- 1Institute of Cancer Therapeutics, Bradford, United Kingdom
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50
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Batubara A, Carolan VA, Loadman PM, Sutton C, Shnyder SD, Clench MR. Thin-layer chromatography/matrix-assisted laser desorption/ionisation mass spectrometry and matrix-assisted laser desorption/ionisation mass spectrometry imaging for the analysis of phospholipids in LS174T colorectal adenocarcinoma xenografts treated with the vascular disrupting agent DMXAA. Rapid Commun Mass Spectrom 2015; 29:1288-1296. [PMID: 26405790 DOI: 10.1002/rcm.7223] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/17/2014] [Revised: 05/01/2015] [Accepted: 05/02/2015] [Indexed: 06/05/2023]
Abstract
RATIONALE 5,6-Dimethylxanthenone-4-acetic acid (DMXAA) is a low molecular weight drug of the flavonoid group, which has an anti-vascular effect in tumours causing endothelial cell apoptosis and activation of cytokines. Flavonoid-based compounds have been reported to lead to an upregulation in the expression of lysophosphatidylcholines (LPC)-type lipids in solid tumours. A study employing TLC/MALDI-MS and MALDI-MS imaging to examine LS174T colorectal adenocarcinoma xenografts following administration of DMXAA has been conducted into this effect. METHODS LS174T colorectal adenocarcinoma xenografts grown in male immune-deficient mice were treated with 27.5 mg/kg DMXAA. The control (before treatment) and 4 h and 24 h post-treatment tumours were excised and divided into two. MALDI-MS imaging experiments were carried out on 12 µm cryosections sections taken from one half of the tumours and from the other half the lipids were extracted and analysed by TLC/MALDI-MS. These experiments were carried out in triplicate. RESULTS Statistical analysis of the MALDI-MS imaging data set indicated an increased amount of LPC in the 24 h post-treated sample and a decreased amount of PC in the 24 h post-treated sample, compared with the 4 h post-treated sample and the control. These effects were confirmed by the TLC/MALDI-MS data. The lipid extracts were separated into six spots on the TLC plate. These were identified as arising from different lipids classes, i.e. LPC, sphingomyelins (SM), phosphatidylcholines (PC) and phosphatidylethanolamines (PE). The TLC/MALDI-MS data indicated that LPC were highly expressed in the 4 h and 24 h post-treated tumour samples compared with the control. Examination of the mass spectrometric images confirms this increase and demonstrates additionally that the increase in the signals arising from LPC appears to be localised primarily within the central areas of the xenograft. CONCLUSIONS An increase in expression of LPC lipids in solid tumours treated with DMXAA has been demonstrated and shown to be localised in the central area of the tumour.
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Affiliation(s)
- Afnan Batubara
- Biomedical Research Centre, Sheffield Hallam University, Howard Street, Sheffield, S1 1WB, UK
| | - Vikki A Carolan
- Biomedical Research Centre, Sheffield Hallam University, Howard Street, Sheffield, S1 1WB, UK
| | - Paul M Loadman
- Institute of Cancer Therapeutics, University of Bradford, Bradford, BD7 1DP, UK
| | - Chris Sutton
- Institute of Cancer Therapeutics, University of Bradford, Bradford, BD7 1DP, UK
| | - Steve D Shnyder
- Institute of Cancer Therapeutics, University of Bradford, Bradford, BD7 1DP, UK
| | - Malcolm R Clench
- Biomedical Research Centre, Sheffield Hallam University, Howard Street, Sheffield, S1 1WB, UK
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