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Wilde C, Kaushik M, Neumann I, Verma P, Azzopardi EA, Ezra DG. Safety and efficacy of subcutaneous diode laser as a novel treatment in the management of festoons. Lasers Med Sci 2023; 38:170. [PMID: 37522966 DOI: 10.1007/s10103-023-03830-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Accepted: 07/14/2023] [Indexed: 08/01/2023]
Affiliation(s)
- Caroline Wilde
- Adnexal Department, Moorfields Eye Hospital, 162 City Road, London, EC1V2PD, UK.
| | - Megha Kaushik
- Adnexal Department, Moorfields Eye Hospital, 162 City Road, London, EC1V2PD, UK
| | - Inga Neumann
- Adnexal Department, Moorfields Eye Hospital, 162 City Road, London, EC1V2PD, UK
| | - Priya Verma
- School of Population Health and Environmental Sciences, Kings College, London, UK
| | - Ernest A Azzopardi
- UCL Division of Surgery and Interventional Sciences Royal Free Hospital, 9Th Floor (East), 2QG, 10 Pond St, London, NW3 2PS, UK
- Faculty of Medicine and Surgery, University of Malta, Imsida, Malta
- Neo Clinic, 152 Harley Street, London, W1G 7LH, UK
| | - Daniel G Ezra
- Adnexal Department, Moorfields Eye Hospital, 162 City Road, London, EC1V2PD, UK
- Neo Clinic, 152 Harley Street, London, W1G 7LH, UK
- UCL Institute of Ophthalmology, Bath Street, London, UK
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Azzopardi EA, Abdelrahman W, Azzopardi E, O’Leary B, Yarrow J, Miles N, Barbara C, Camilleri L, Clementoni MT, Murison M. Treatment of cutaneous basal cell carcinoma with combined laser extirpation and methyl aminolevulinic acid: five-year success rates. Ann R Coll Surg Engl 2021; 103:263-271. [PMID: 33557701 PMCID: PMC10752010 DOI: 10.1308/rcsann.2020.7020] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/27/2020] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION Basal cell carcinoma is the most common cancer. Excisional surgery is associated with a high clearance rate, at the expense of significant functional and aesthetic morbidity, especially within the T-zone or for extensive lesions. We report five-year follow-up outcomes for carbon dioxide laser extirpation of cutaneous basal cell carcinoma, assisted by immediate methyl aminolevulinate photodynamic therapy and cost-benefit considerations. MATERIALS AND METHODS Retrospective cohort database analysis of adult patients with biopsy-proven primary cutaneous basal cell carcinoma, completing five years of follow-up. Direct per-lesion cost was compared with conventional wide local excision. Patients with morphoeic basal cell carcinoma were excluded. RESULTS Treated lesions were up to 1% total body surface area and up to 3.8mm (1.38 ± 0.695cm, mean ± standard deviation) in biopsy-proven depth. At the five-year follow-up mark, 93.6% of treated areas remained free of recurrence. Nodular basal cell carcinoma was the most common subtype (41.5%). A mean tumour depth greater than 2 ± 0.872mm was significantly associated with recurrence (Mann-Whitney, p = 0.0487). For a service delivered through the NHS at 2015 prices, we report a 43% saving, equating to a saving of £235 per basal cell carcinoma or a national annualised saving of £70 million by 2025 for the NHS. CONCLUSION Our results suggest that CO2-assisted photodynamic therapy is non-inferior to excision but may offer better functional and cosmetic preservation at a fraction of the direct like for like cost of operative surgery. Investigation of this method by randomised controlled methodology is warranted.
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Affiliation(s)
| | - W Abdelrahman
- Morriston Hospital, Swansea Bay
University Health Board, Swansea,
UK
| | - E Azzopardi
- Morriston Hospital, Swansea Bay
University Health Board, Swansea,
UK
| | - B O’Leary
- Morriston Hospital, Swansea Bay
University Health Board, Swansea,
UK
| | - J Yarrow
- Morriston Hospital, Swansea Bay
University Health Board, Swansea,
UK
| | - N Miles
- Morriston Hospital, Swansea Bay
University Health Board, Swansea,
UK
| | | | | | | | - M Murison
- Morriston Hospital, Swansea Bay
University Health Board, Swansea,
UK
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Khan K, Azzopardi E, Camilleri L, Azzopardi EA, Bragg TH. Value of clinical, ultrasonographic and MRI signs as diagnostic differentiators of non-benign lipomatous tumours. Sci Rep 2020; 10:20756. [PMID: 33247209 PMCID: PMC7695823 DOI: 10.1038/s41598-020-77244-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2018] [Accepted: 03/07/2019] [Indexed: 11/20/2022] Open
Abstract
Suspicion of malignant change within a lipoma is a common and increasing workload within the UK Sarcoma multidisciplinary team (MDT) network, and a source of considerable patient anxiety. Currently, there is no lipoma-specific data, with regard to which clinical or radiographic features predict non-benign histology, or calculate an odds-ratio specific to a lipomatous lesion being non-benign. We performed a 9-year, double-blind, unmatched cohort study, comparing post-operative histology outcomes (benign versus non-benign) versus 15 signs across three domains: Clinical (size of tumour, depth, growth noticed by patient, previous lipoma, patient felt pain), Ultrasonographic (size, depth, vascularity, heterogenous features, septae) and MRI (size, depth, vascularity, heterogenous features, septae, complete fat signal suppression). Receiver operating characteristic (ROC) analysis, odds ratios and binary logistic regression analysis was performed double-blind. When each sign is considered independently, (ROC analysis, followed by binary logistic regression) only Ultrasound depth is a significant predictor (p = 0.044) of a histologically non-benign lipoma. Ultrasonographically determined vascularity and septation were not statistically significant predictors. None of the clinical signs were statistically significant (p > 0.05). Of the MRI signs none was statistically significant (p > 0.05). However, heterogeneous MRI features fared better than MRI depth. Ultrasound signs (Pseudo R-Square = 0.105) are more predictive of the post-operation histology outcome than Clinical signs (Pseudo R-Square = 0.082) or MRI tests (Pseudo R-Square = 0.052) Ultrasound and Clinical tests combined (Pseudo R-Square = 0.147) are more predictive of the post-operation histology outcome than MRI tests (Pseudo R-Square = 0.052). This work challenges the traditional perception of “red-flag” signs when applied to lipomatous tumours. We provide accurate data upon which an informed choice can be made, and provides a robust bases for expedited risk/benefit. The importance of an experienced and cohesive MDT network is emphasised.
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Affiliation(s)
- Karishma Khan
- The Welsh Centre for Burns and Plastic Surgery, Heol Maes Eglwys, Swansea, SA66NL, UK.,Cardiff University Medical School, Heath Park, Cardiff, CF14 4XY, UK
| | - Elayne Azzopardi
- The Welsh Centre for Burns and Plastic Surgery, Heol Maes Eglwys, Swansea, SA66NL, UK.
| | | | - Ernest A Azzopardi
- The Welsh Centre for Burns and Plastic Surgery, Heol Maes Eglwys, Swansea, SA66NL, UK.,University College London, London, UK.,University of Malta Tal-Qroqq Campus, Malta GC. EU, UK
| | - Thomas H Bragg
- The Welsh Centre for Burns and Plastic Surgery, Heol Maes Eglwys, Swansea, SA66NL, UK
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Marsden NJ, Van M, Dean S, Azzopardi EA, Hemington-Gorse S, Evans PA, Whitaker IS. Measuring coagulation in burns: an evidence-based systematic review. Scars Burn Heal 2017; 3:2059513117728201. [PMID: 29799542 PMCID: PMC5965330 DOI: 10.1177/2059513117728201] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [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] [Indexed: 01/08/2023] Open
Abstract
Introduction Dynamic monitoring of coagulation is important to predict both haemorrhagic and thrombotic complications and to guide blood product administration. Reducing blood loss and tailoring blood product administration may improve patient outcome and reduce mortality associated with transfusion. The current literature lacks a systematic, critical appraisal of current best evidence on which clinical decisions may be based. Objectives Establishing the role of different coagulation markers in burn patients, diagnosing coagulopathy, tailoring blood product administration and indicating prognosis. Methods Literature during 2004-2017 from the Cochrane Library, PubMed, Scopus, Medline and Embase was reviewed. Eligibility criteria included randomised controlled trials, systematic reviews, multi-/single-centre study and meta-analyses. Keywords searched were 'burns', 'blood coagulation disorders', 'rotem', 'blood coagulation' and 'thromboelastography'. The PRISMA flow system was used for stratification and the CASP framework for appraisal of the studies retrieved. Results In total, 13 articles were included after inclusion/exclusion criteria had been applied to the initial 79 studies retrieved. Hypercoagulation increases in proportion to the severity of thermal injury. Whole blood testing, using thrombelastography (TEG) and rotation thromboelastometry (ROTEM), was superior to standard plasma based tests, including prothrombin time (PT) and activated partial thromboplastin time (APTT) at detecting burn-related coagulopathies. Conclusions Routine laboratory markers such as PT/APTT are poor indicators of coagulation status in burns patients. Viscoelastic tests, such as TEG and ROTEM, are efficient, fast and have a potential use in the management of burn patients; however, strong evidence is lacking. This review highlights the need for more randomised controlled trials, to guide future practice.
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Affiliation(s)
- Nicholas J Marsden
- NISCHR Haemostasis Biomedical Research Unit, Morriston Hospital, Swansea, UK.,Welsh Centre for Burns and Plastic Surgery, Swansea, UK
| | - Martin Van
- Welsh Centre for Burns and Plastic Surgery, Swansea, UK
| | - Samera Dean
- Welsh Centre for Burns and Plastic Surgery, Swansea, UK
| | - Ernest A Azzopardi
- Welsh Centre for Burns and Plastic Surgery, Swansea, UK.,Reconstructive Surgery and Regenerative Medicine Group, Institute of Life Science, College of Medicine, Swansea University, Wales, UK
| | | | - Phillip A Evans
- NISCHR Haemostasis Biomedical Research Unit, Morriston Hospital, Swansea, UK.,Reconstructive Surgery and Regenerative Medicine Group, Institute of Life Science, College of Medicine, Swansea University, Wales, UK
| | - Iain S Whitaker
- Welsh Centre for Burns and Plastic Surgery, Swansea, UK.,Reconstructive Surgery and Regenerative Medicine Group, Institute of Life Science, College of Medicine, Swansea University, Wales, UK
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Azzopardi EA, Conlan RS, Whitaker IS. Polymer therapeutics in surgery: the next frontier. ACTA ACUST UNITED AC 2016; 1:19-29. [PMID: 27588210 PMCID: PMC4985703 DOI: 10.1002/jin2.6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2015] [Revised: 11/18/2015] [Accepted: 11/20/2015] [Indexed: 01/13/2023]
Abstract
Polymer therapeutics is a successful branch of nanomedicine, which is now established in several facets of everyday practice. However, to our knowledge, no literature regarding the application of the underpinning principles, general safety, and potential of this versatile class to the perioperative patient has been published. This study provides an overview of polymer therapeutics applied to clinical surgery, including the evolution of this demand‐oriented scientific field, cutting‐edge concepts, its implications, and limitations, illustrated by products already in clinical use and promising ones in development. In particular, the effect of design of polymer therapeutics on biophysical and biochemical properties, the potential for targeted delivery, smart release, and safety are addressed. Emphasis is made on principles, giving examples in salient areas of demand in current surgical practice. Exposure of the practising surgeon to this versatile class is crucial to evaluate and maximise the benefits that this established field presents and to attract a new generation of clinician–scientists with the necessary knowledge mix to drive highly successful innovation.
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Affiliation(s)
- Ernest A Azzopardi
- Reconstructive Surgery and Regenerative Medicine Research Unit, Institute for Life Science Swansea University Medical School, Swansea University Singleton Park Campus SwanseaSA2 8PP UK; The Welsh Centre for Burns and Plastic Surgery Moriston Hospital Swansea Swansea SA6 6NL UK; Institute for Life Science and Centre for NanoHealth Swansea University Medical School, Swansea University Singleton Park Campus Swansea SA2 8PP UK
| | - R Steven Conlan
- Institute for Life Science and Centre for NanoHealth Swansea University Medical School, Swansea University Singleton Park Campus Swansea SA2 8PP UK
| | - Iain S Whitaker
- Reconstructive Surgery and Regenerative Medicine Research Unit, Institute for Life Science Swansea University Medical School, Swansea University Singleton Park Campus SwanseaSA2 8PP UK; The Welsh Centre for Burns and Plastic Surgery Moriston Hospital Swansea Swansea SA6 6NL UK; Institute for Life Science and Centre for NanoHealth Swansea University Medical School, Swansea University Singleton Park Campus Swansea SA2 8PP UK
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Azzopardi EA, Azzopardi E, Camilleri L, Villapalos J, Boyce DE, Dziewulski P, Dickson WA, Whitaker IS. Gram negative wound infection in hospitalised adult burn patients--systematic review and metanalysis-. PLoS One 2014; 9:e95042. [PMID: 24751699 PMCID: PMC3994014 DOI: 10.1371/journal.pone.0095042] [Citation(s) in RCA: 114] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2013] [Accepted: 03/22/2014] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Gram negative infection is a major determinant of morbidity and survival. Traditional teaching suggests that burn wound infections in different centres are caused by differing sets of causative organisms. This study established whether Gram-negative burn wound isolates associated to clinical wound infection differ between burn centres. METHODS Studies investigating adult hospitalised patients (2000-2010) were critically appraised and qualified to a levels of evidence hierarchy. The contribution of bacterial pathogen type, and burn centre to the variance in standardised incidence of Gram-negative burn wound infection was analysed using two-way analysis of variance. PRIMARY FINDINGS Pseudomonas aeruginosa, Klebsiella pneumoniae, Acinetobacter baumanni, Enterobacter spp., Proteus spp. and Escherichia coli emerged as the commonest Gram-negative burn wound pathogens. Individual pathogens' incidence did not differ significantly between burn centres (F (4, 20) = 1.1, p = 0.3797; r2 = 9.84). INTERPRETATION Gram-negative infections predominate in burn surgery. This study is the first to establish that burn wound infections do not differ significantly between burn centres. It is the first study to report the pathogens responsible for the majority of Gram-negative infections in these patients. Whilst burn wound infection is not exclusive to these bacteria, it is hoped that reporting the presence of this group of common Gram-negative "target organisms" facilitate clinical practice and target research towards a defined clinical demand.
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Affiliation(s)
- Ernest A. Azzopardi
- Institute of Life Science, Swansea University College of Medicine, Singleton Park, Swansea, United Kingodm
- The Welsh Centre for Burns and Plastic Surgery, Moriston Hospital, Swansea, United Kingdom
| | - Elayne Azzopardi
- Research Institute for Health and Social Change, Faculty of Health, Psychology and Social Care, Manchester Metropolitan University, Elizabeth Gaskell Campus, Manchester, United Kingdom
| | - Liberato Camilleri
- Department of Statistics and Operations, Tal-Qroqq Campus, University of Malta, Msida, Malta
| | - Jorge Villapalos
- Department of Burns and Plastic Surgery, Chelsea and Westminster Hospital NHS Trust, London, United Kingdom
| | - Dean E. Boyce
- The Welsh Centre for Burns and Plastic Surgery, Moriston Hospital, Swansea, United Kingdom
| | - Peter Dziewulski
- St. Andrews Centre for Burns and Plastic Surgery, Chelmsford, United Kingdom
| | - William A. Dickson
- The Welsh Centre for Burns and Plastic Surgery, Moriston Hospital, Swansea, United Kingdom
| | - Iain S. Whitaker
- Institute of Life Science, Swansea University College of Medicine, Singleton Park, Swansea, United Kingodm
- The Welsh Centre for Burns and Plastic Surgery, Moriston Hospital, Swansea, United Kingdom
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Azzopardi EA, Camilleri L, Moseley R, Thomas DW, Ferguson EL. Statistical Characterization of Succinoylated Dextrin Degradation Behavior in Human α-Amylase. J Carbohydr Chem 2013. [DOI: 10.1080/07328303.2013.831434] [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: 01/13/2023]
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Azzopardi EA, Ferguson EL, Thomas DW. The enhanced permeability retention effect: a new paradigm for drug targeting in infection. J Antimicrob Chemother 2012; 68:257-74. [PMID: 23054997 DOI: 10.1093/jac/dks379] [Citation(s) in RCA: 191] [Impact Index Per Article: 15.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Multidrug-resistant, Gram-negative infection is a major global determinant of morbidity, mortality and cost of care. The advent of nanomedicine has enabled tailored engineering of macromolecular constructs, permitting increasingly selective targeting, alteration of volume of distribution and activity/toxicity. Macromolecules tend to passively and preferentially accumulate at sites of enhanced vascular permeability and are then retained. This enhanced permeability and retention (EPR) effect, whilst recognized as a major breakthrough in anti-tumoral targeting, has not yet been fully exploited in infection. Shared pathophysiological pathways in both cancer and infection are evident and a number of novel nanomedicines have shown promise in selective, passive, size-mediated targeting to infection. This review describes the similarities and parallels in pathophysiological pathways at molecular, cellular and circulatory levels between inflammation/infection and cancer therapy, where use of this principle has been established.
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Affiliation(s)
- Ernest A Azzopardi
- School of Dentistry, Cardiff University, Heath Park, Cardiff CF14 4XY, Wales, UK.
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Azzopardi EA, Boyce DE, Thomas DW, Dickson WA. Colistin in burn intensive care: back to the future? Burns 2012; 39:7-15. [PMID: 22871554 DOI: 10.1016/j.burns.2012.07.015] [Citation(s) in RCA: 12] [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] [Received: 05/01/2012] [Revised: 06/19/2012] [Accepted: 07/12/2012] [Indexed: 10/28/2022]
Abstract
Colistin is a venerable antibiotic whose fortunes have been revived by its excellent activity, the diminishing output of novel clinically effective antibiotics and the increasing importance of MDR infection in burn surgery, both in the civilian and military arenas. This review synthesizes current evidence on the usage of colistin in burn surgery including the structure-activity relationship; dosing, pharmacokinetics/pharmacodynamic (PK/PD), analytic methods, resistance and current research efforts into the redevelopment of this antibiotic, to distil recommendations for future research and clinical efficacy.
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Affiliation(s)
- Ernest A Azzopardi
- Wound Biology Group, Tissue Engineering and Reparative Dentistry, School of Dentistry, Cardiff University, Heath Park, Cardiff, CF144XY, UK.
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Whitaker IS, Oboumarzouk O, Rozen WM, Naderi N, Balasubramanian SP, Azzopardi EA, Kon M. The efficacy of medicinal leeches in plastic and reconstructive surgery: a systematic review of 277 reported clinical cases. Microsurgery 2012; 32:240-50. [PMID: 22407551 DOI: 10.1002/micr.20971] [Citation(s) in RCA: 81] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2011] [Accepted: 09/21/2011] [Indexed: 11/11/2022]
Abstract
BACKGROUND Although there are numerous case reports and small case series describing the experiences of leech therapy in various circumstances, there are relatively few large studies evaluating the effectiveness of leeching to relieve venous congestion. The therapeutic value of leeching is illustrated by these reports but the current literature lacks a cohesive summary of previous experiences. METHODS An electronic search of PubMed, the Cochrane library and the Centre for Reviews and Dissemination between 1966 and 2009 was used to retrieve human studies published in the English language evaluating outcomes following leech therapy. The "success" and "failure" of leech therapy were the primary outcome measures and secondary outcomes included complications, number of leeches used, pharmacological adjuncts and blood transfusion requirements. RESULTS In total, out of 461 articles, 394 articles met the exclusion criteria. The 67 included papers reported on 277 cases of leech use with an age range of 2-81 years and a male to female ratio of almost 2:1. The overall reported "success" rate following leech therapy was 77.98% (216/277). In terms of secondary outcome measures, 49.75% of cases (N = 101) required blood transfusions, 79.05% received antibiotics (N = 166) and 54.29% received concomitant anticoagulant therapy. The overall complication rate was 21.8%. CONCLUSION In the absence of robust randomized controlled trials on which the evidence may be based, this synthesis of current best evidence guides clinicians during the process of consenting patients and using leeches in their practice.
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Affiliation(s)
- Iain S Whitaker
- Department of Burns and Plastic Surgery, Morriston Hospital, Swansea, Wales, UK.
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Whitaker IS, Kamya C, Azzopardi EA, Graf J, Kon M, Lineaweaver WC. Preventing infective complications following leech therapy: Is practice keeping pace with current research? Microsurgery 2009; 29:619-25. [DOI: 10.1002/micr.20666] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Azzopardi EA, Iyer S. Re: Tripathi AK, Mee SN, Martin DL, Katsarma E. The 'transverse intraosseous loop technique' (TILT) to re-insert flexor tendons in zone 1. J Hand Surg Eur. 2009, 34: 85-9. J Hand Surg Eur Vol 2009; 34:701. [PMID: 19959461 DOI: 10.1177/1753193409342055] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Affiliation(s)
- Ernest A. Azzopardi
- Wexham Park Hospital, Department of Plastic Surgery, Slough, UK, and University of Cardiff, UK
| | - Srinivasan Iyer
- Wexham Park Hospital, Department of Plastic Surgery, Slough, UK, and University of Cardiff, UK
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Azzopardi EA, Gujral S, Mandal A, Kulkarni M. Rapidly expanding thenar eminence ganglion: a case report. Cases J 2009; 2:129. [PMID: 19200372 PMCID: PMC2649054 DOI: 10.1186/1757-1626-2-129] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/26/2008] [Accepted: 02/06/2009] [Indexed: 11/25/2022]
Abstract
Introduction This study documents the first reported case of a rapidly growing (volar) thenar eminence ganglion arising form the first carpometacarpal joint, masquerading as a sarcoma. The discussion informs the hand surgeon on the evidence regarding the unusual presenting features. Case presentation An 85 year old left hand dominant female presented with a six week history of rapidly growing lump on the thenar eminence. Clinical examination revealed a non-tender large lobulated mobile swelling measuring 5 × 4 cm and involving the whole thenar eminence. Conclusion Ganglia may present from the thenar eminence and are a source of diagnostic confusion.
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Affiliation(s)
- E A Azzopardi
- Department of Plastic Reconstructive and Aesthetic Surgery, Wexham Park Hospital, Slough, UK.
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Azzopardi EA, Whitaker IS, Laing H. Perceptions of correct preoperative storage and transfer of amputated digits: a national survey of referring emergency departments. J Plast Reconstr Aesthet Surg 2008; 61:1418-9. [PMID: 18617452 DOI: 10.1016/j.bjps.2008.02.017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2008] [Revised: 02/18/2008] [Accepted: 02/21/2008] [Indexed: 11/25/2022]
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