1
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Gieske MR, Kerns J, Schmitt GM, Kloecker G, Budhani IA, Nolan J, Williams VA, Alkapalan D, Ferguson K, Yadav R, Calhoun RF. Overcoming barriers to lung cancer screening using a systemwide approach with additional focus on the non-screened. J Med Screen 2024; 31:99-106. [PMID: 37855047 DOI: 10.1177/09691413231208160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2023]
Abstract
BACKGROUND The lung cancer screening program at St Elizabeth Healthcare (Kentucky, USA) began in 2013. Over 33,000 low-dose computed tomography lung cancer screens have been performed. From 2015 through 2021, 2595 lung cancers were diagnosed systemwide. A Screening Program with Impactful Results from Early Detection, reviews that experience; 342 (13.2%) were diagnosed by screening and 2253 (86.8%) were non-screened. As a secondary objective, the non-screened cohort was queried to determine how many additional individuals could have been screened, identifying barriers and failures to meet eligibility. METHODS Our QlikSense database extracted the lung cancer patients from the Cancer Patient Data and Management System, and identified and categorized them separately as screened or non-screened populations. Stage distribution was compared in screened and non-screened groups. Those meeting age criteria, with any smoking history, were further queried for screening eligibility, accessing the electronic medical record smoking history and audit trail, and determining if enough information was available to substantiate screening eligibility. The same methodology was applied to CMS 2015 and USPSTF 2021 criteria. RESULTS The screened and non-screened patients were accounted for in a stage migration chart demonstrating clear shift to early stage among screened lung cancer patients. Additionally, analysis of non-screened individuals is presented. CONCLUSION Of the St Elizabeth Healthcare eligible patients attributed to primary care providers, 49.6% were screened in 2021. Despite this level of success, this study highlighted a sizeable pool of additional individuals that could have been screened. We are shifting focus to the non-screened pool of patients that meet eligibility, further enhancing the impact on our community.
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Affiliation(s)
- Michael R Gieske
- Lung Cancer Screening, St Elizabeth Healthcare, Ft. Mitchell, KY, USA
| | - Jessica Kerns
- Lung Cancer Screening, St Elizabeth Healthcare, Edgewood, KY, USA
| | - Gary M Schmitt
- Radiology Associates of Northern Kentucky, Crestview Hills, KY, USA
| | - Goetz Kloecker
- Thoracic Medical Oncology, St Elizabeth Healthcare, Edgewood, KY, USA
| | - Irfan A Budhani
- Pulmonary Medicine, St Elizabeth Healthcare, Edgewood, KY, USA
| | - Joseph Nolan
- Department of Mathematics and Statistics, Northern Kentucky University, Highland Heights, KY, USA
| | - Valerie A Williams
- Division of Thoracic Surgery, St Elizabeth Healthcare, Edgewood, KY, USA
| | - Deema Alkapalan
- Deptartment of Pathology, St Elizabeth Healthcare, Edgewood, KY, USA
| | - Katelyn Ferguson
- University of Kentucky Medical School, Highland Heights, KY, USA
| | - Ryan Yadav
- University of Kentucky Medical School, Highland Heights, KY, USA
| | - Royce F Calhoun
- Division of Thoracic Surgery, St Elizabeth Healthcare, Edgewood, KY, USA
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2
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Kinsella SM, Boaden B, El-Ghazali S, Ferguson K, Kirkpatrick G, Meek T, Misra U, Pandit JJ, Young PJ. Handling injectable medications in anaesthesia: Guidelines from the Association of Anaesthetists. Anaesthesia 2023; 78:1285-1294. [PMID: 37492905 DOI: 10.1111/anae.16095] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/22/2023] [Indexed: 07/27/2023]
Abstract
Peri-operative medication safety is complex. Avoidance of medication errors is both system- and practitioner-based, and many departments within the hospital contribute to safe and effective systems. For the individual anaesthetist, drawing up, labelling and then the correct administration of medications are key components in a patient's peri-operative journey. These guidelines aim to provide pragmatic safety steps for the practitioner and other individuals within the operative environment, as well as short- to long-term goals for development of a collaborative approach to reducing errors. The aim is that they will be used as a basis for instilling good practice.
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Affiliation(s)
- S M Kinsella
- Department of Anaesthesia, University Hospitals Bristol and Weston, Bristol, UK
| | | | - S El-Ghazali
- Department of Anaesthesia and Intensive Care, London North West University Hospital Trust, London, UK
| | - K Ferguson
- Department of Anaesthesia, Aberdeen Royal Infirmary, Aberdeen, UK
| | | | - T Meek
- Department of Anaesthesia, James Cook University Hospital, Middlesbrough, UK
| | - U Misra
- Department of Anaesthesia, South Tyneside and Sunderland NHS Foundation Trust, Sunderland, UK
| | - J J Pandit
- University of Oxford, Oxford, UK
- Nuffield Department of Anaesthesia, Oxford University Hospital NHS Foundation Trust, Oxford, UK
| | - P J Young
- Department of Anaesthesia, Queen Elizabeth Hospital, Kings Lynn, UK
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3
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Kelly FE, Frerk C, Bailey CR, Cook TM, Ferguson K, Flin R, Fong K, Groom P, John C, Lang AR, Meek T, Miller KL, Richmond L, Sevdalis N, Stacey MR. Human factors in anaesthesia: a narrative review. Anaesthesia 2023; 78:479-490. [PMID: 36630729 DOI: 10.1111/anae.15920] [Citation(s) in RCA: 16] [Impact Index Per Article: 16.0] [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: 11/08/2022] [Indexed: 01/12/2023]
Abstract
Healthcare relies on high levels of human performance, as described by the 'human as the hero' concept. However, human performance varies and is recognised to fall in high-pressure situations, meaning that it is not a reliable method of ensuring safety. Other safety-critical industries embed human factors principles into all aspects of their organisations to improve safety and reduce reliance on exceptional human performance; there is potential to do the same in anaesthesia. Human factors is a broad-based scientific discipline which aims to make it as easy as possible for workers to do things correctly. The human factors strategies most likely to be effective are those which 'design out' the chance of an error or adverse event occurring. When errors or adverse events do happen, barriers are in place to trap them and reduce the risk of progression to patient and/or worker harm. If errors or adverse events are not trapped by these barriers, mitigations are in place to minimise the consequences. Non-technical skills form an important part of human factors barriers and mitigation strategies and include: situation awareness; decision-making; task management; and team working. Human factors principles are not a substitute for proper investment and appropriate staffing levels. Although applying human factors science has the potential to save money in the long term, its proper implementation may require investment before reward can be reaped. This narrative review describes what is known about human factors in anaesthesia to date.
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Affiliation(s)
- F E Kelly
- Department of Anaesthesia and Intensive Care Medicine, Royal United Hospitals Bath NHS Foundation Trust, Bath, UK
| | - C Frerk
- Department of Anaesthesia and Critical Care, Northampton General Hospital, Northampton, UK.,College of Life Sciences/Leicester Medical School, University of Leicester, UK
| | - C R Bailey
- Department of Anaesthetics, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - T M Cook
- Department of Anaesthesia and Intensive Care Medicine, Royal United Hospitals Bath NHS Foundation Trust, Bath, UK.,School of Medicine, Bristol University, Bristol, UK
| | - K Ferguson
- Department of Anaesthesia, Aberdeen Royal Infirmary, Aberdeen, UK
| | - R Flin
- School of Psychology, Aberdeen Business School, Robert Gordon University, Aberdeen, UK
| | - K Fong
- Department of Anaesthesia, University College London Hospitals NHS Foundation Trust, London, UK.,Department of Science, Technology, Engineering and Public Policy, University College London, UK
| | - P Groom
- Department of Anaesthesia, Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK
| | - C John
- Department of Anaesthesia, University College Hospital's NHS Foundation Trust, London, UK
| | - A R Lang
- Human Factors Research Group, Faculty of Engineering, University of Nottingham, UK
| | - T Meek
- Department of Anaesthesia, James Cook University Hospital, Middlesbrough, UK
| | - K L Miller
- Department of Anaesthesia, Birmingham Women's and Children's Hospital NHS Foundation Trust, Birmingham, UK
| | - L Richmond
- Department of Anaesthesia, Swansea Bay University Health Board, Swansea, UK
| | - N Sevdalis
- Centre for Implementation Science, King's College London, UK
| | - M R Stacey
- Department of Anaesthetics, Intensive Care and Pain Medicine, University Hospital of Wales, Cardiff, UK
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4
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Kelly FE, Frerk C, Bailey CR, Cook TM, Ferguson K, Flin R, Fong K, Groom P, John C, Lang AR, Meek T, Miller KL, Richmond L, Sevdalis N, Stacey MR. Implementing human factors in anaesthesia: guidance for clinicians, departments and hospitals: Guidelines from the Difficult Airway Society and the Association of Anaesthetists: Guidelines from the Difficult Airway Society and the Association of Anaesthetists. Anaesthesia 2023; 78:458-478. [PMID: 36630725 DOI: 10.1111/anae.15941] [Citation(s) in RCA: 21] [Impact Index Per Article: 21.0] [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: 11/14/2022] [Indexed: 01/12/2023]
Abstract
Human factors is an evidence-based scientific discipline used in safety critical industries to improve safety and worker well-being. The implementation of human factors strategies in anaesthesia has the potential to reduce the reliance on exceptional personal and team performance to provide safe and high-quality patient care. To encourage the adoption of human factors science in anaesthesia, the Difficult Airway Society and the Association of Anaesthetists established a Working Party, including anaesthetists and operating theatre team members with human factors expertise and/or interest, plus a human factors scientist, an industrial psychologist and an experimental psychologist/implementation scientist. A three-stage Delphi process was used to formulate a set of 12 recommendations: these are described using a 'hierarchy of controls' model and classified into design, barriers, mitigations and education and training strategies. Although most anaesthetic knowledge of human factors concerns non-technical skills, such as teamwork and communication, human factors is a broad-based scientific discipline with many other additional aspects that are just as important. Indeed, the human factors strategies most likely to have the greatest impact are those related to the design of safe working environments, equipment and systems. While our recommendations are primarily provided for anaesthetists and the teams they work with, there are likely to be lessons for others working in healthcare beyond the speciality of anaesthesia.
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Affiliation(s)
- F E Kelly
- Department of Anaesthesia and Intensive Care Medicine, Royal United Hospitals Bath NHS Foundation Trust, Bath, UK
| | - C Frerk
- Department of Anaesthesia and Critical Care, Northampton General Hospital, Northampton, UK.,University of Leicester, College of Life Sciences/Leicester Medical School, Leicester, UK
| | - C R Bailey
- Department of Anaesthetics, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - T M Cook
- Department of Anaesthesia and Intensive Care Medicine, Royal United Hospitals Bath NHS Foundation Trust, Bath, UK.,Bristol University, Bristol, UK
| | - K Ferguson
- Department of Anaesthesia, Aberdeen Royal Infirmary, Aberdeen, UK
| | - R Flin
- Aberdeen Business School, Robert Gordon University, Aberdeen, UK
| | - K Fong
- Department of Anaesthesia, University College London Hospitals NHS Foundation Trust, London, UK.,Department of Science, Technology, Engineering and Public Policy, University College London, UK
| | - P Groom
- Department of Anaesthesia, Liverpool University Hospitals NHS Foundation Trust, Aintree, Liverpool, UK
| | - C John
- University College Hospital's NHS Foundation Trust, London, UK
| | - A R Lang
- Human Factors Research Group, Faculty of Engineering, University of Nottingham, UK
| | - T Meek
- Department of Anaesthesia, James Cook University Hospital, Middlesbrough, UK
| | - K L Miller
- Department of Paediatric Anaesthesia, Birmingham Women's and Children's NHS Foundation Trust, Birmingham, UK
| | - L Richmond
- Department of Anaesthesia, Swansea Bay University Health Board, Swansea, UK
| | - N Sevdalis
- Centre for Implementation Science, King's College London, UK
| | - M R Stacey
- Department of Anaesthetics, Intensive Care and Pain Medicine, University Hospital of Wales, Cardiff, UK
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5
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Fábelová L, Beneito A, Casas M, Colles A, Dalsager L, Den Hond E, Dereumeaux C, Ferguson K, Gilles L, Govarts E, Irizar A, Lopez Espinosa MJ, Montazeri P, Morrens B, Patayová H, Rausová K, Richterová D, Rodriguez Martin L, Santa-Marina L, Schettgen T, Schoeters G, Haug LS, Uhl M, Villanger GD, Vrijheid M, Zaros C, Palkovičová Murínová Ľ. PFAS levels and exposure determinants in sensitive population groups. Chemosphere 2023; 313:137530. [PMID: 36509187 PMCID: PMC9846180 DOI: 10.1016/j.chemosphere.2022.137530] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Revised: 11/25/2022] [Accepted: 12/09/2022] [Indexed: 05/25/2023]
Abstract
BACKGROUND Per- and polyfluoroalkyl substances (PFAS) are persistent organic pollutants. The first exposure to PFAS occurs in utero, after birth it continues via breast milk, food intake, environment, and consumer products that contain these chemicals. Our aim was to identify determinants of PFAS concentrations in sensitive population subgroups- pregnant women and newborns. METHODS Nine European birth cohorts provided exposure data on PFAS in pregnant women (INMA-Gipuzkoa, Sabadell, Valencia, ELFE and MoBa; total N = 5897) or newborns (3xG study, FLEHS 2, FLEHS 3 and PRENATAL; total N = 940). PFOS, PFOA, PFHxS and PFNA concentrations were measured in maternal or cord blood, depending on the cohort (FLEHS 2 measured only PFOS and PFOA). PFAS concentrations were analysed according to maternal characteristics (age, BMI, parity, previous breastfeeding, smoking, and food consumption during pregnancy) and parental educational level. The association between potential determinants and PFAS concentrations was evaluated using multiple linear regression models. RESULTS We observed significant variations in PFAS concentrations among cohorts. Higher PFAS concentrations were associated with higher maternal age, primipara birth, and educational level, both for maternal blood and cord blood. Higher PFAS concentrations in maternal blood were associated with higher consumption of fish and seafood, meat, offal and eggs. In cord blood, higher PFHxS concentrations were associated with daily meat consumption and higher PFNA with offal consumption. Daily milk and dairy consumption were associated with lower concentrations of PFAS in both, pregnant women and newborns. CONCLUSION High detection rates of the four most abundant PFAS demonstrate ubiquitous exposure of sensitive populations, which is of concern. This study identified several determinants of PFAS exposure in pregnant women and newborns, including dietary factors, and these findings can be used for proposing measures to reduce PFAS exposure, particularly from dietary sources.
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Affiliation(s)
- L Fábelová
- Slovak Medical University in Bratislava, Faculty of Public Health, Department of Environmental Medicine, Bratislava, Slovakia
| | - A Beneito
- Epidemiology and Environmental Health Joint Research Unit, FISABIO-Universitat Jaume I-Universitat de València, Valencia, Spain
| | - M Casas
- ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, C/Monforte de Lemos 3-5 28029 Madrid, Spain
| | - A Colles
- VITO Health, Flemish Institute for Technological Research (VITO), Mol, Belgium
| | - L Dalsager
- Institute of Public Health, University of Southern Denmark, Odense, Denmark
| | - E Den Hond
- Provincial Institute of Hygiene (PIH), Antwerp, Belgium
| | | | - K Ferguson
- National Institute of Environmental Health Sciences (NIEHS), North Carolina, USA
| | - L Gilles
- VITO Health, Flemish Institute for Technological Research (VITO), Mol, Belgium
| | - E Govarts
- VITO Health, Flemish Institute for Technological Research (VITO), Mol, Belgium
| | - A Irizar
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, C/Monforte de Lemos 3-5 28029 Madrid, Spain; Biodonostia, Epidemiology and Public Health Area, Environmental Epidemiology and Child Development Group, 20014 San Sebastian, Spain
| | - M J Lopez Espinosa
- Epidemiology and Environmental Health Joint Research Unit, FISABIO-Universitat Jaume I-Universitat de València, Valencia, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, C/Monforte de Lemos 3-5 28029 Madrid, Spain; Faculty of Nursing and Chiropody, Universitat de València, Valencia, Spain
| | | | - B Morrens
- Faculty of Social Sciences, University of Antwerp, Belgium
| | - H Patayová
- Slovak Medical University in Bratislava, Faculty of Public Health, Department of Environmental Medicine, Bratislava, Slovakia
| | - K Rausová
- Slovak Medical University in Bratislava, Faculty of Public Health, Department of Environmental Medicine, Bratislava, Slovakia
| | - D Richterová
- Slovak Medical University in Bratislava, Faculty of Public Health, Department of Environmental Medicine, Bratislava, Slovakia
| | - L Rodriguez Martin
- VITO Health, Flemish Institute for Technological Research (VITO), Mol, Belgium
| | - L Santa-Marina
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, C/Monforte de Lemos 3-5 28029 Madrid, Spain; Biodonostia, Epidemiology and Public Health Area, Environmental Epidemiology and Child Development Group, 20014 San Sebastian, Spain; Public Health Division of Gipuzkoa, Basque Government, 20013 San Sebastian, Spain
| | - T Schettgen
- Institute for Occupational, Social and Environmental Medicine, RWTH Aachen University, Aachen, Germany
| | - G Schoeters
- VITO Health, Flemish Institute for Technological Research (VITO), Mol, Belgium
| | - L S Haug
- Norwegian Institute of Public Health (NIPH), Oslo, Norway
| | - M Uhl
- Umweltbundesamt, Vienna, Austria
| | - G D Villanger
- Norwegian Institute of Public Health (NIPH), Oslo, Norway
| | - M Vrijheid
- ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, C/Monforte de Lemos 3-5 28029 Madrid, Spain
| | - C Zaros
- Institut national d'études démographiques (INED), Aubervilliers, France
| | - Ľ Palkovičová Murínová
- Slovak Medical University in Bratislava, Faculty of Public Health, Department of Environmental Medicine, Bratislava, Slovakia.
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6
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Gieske M, Calhoun R, Schmitt G, Budhani I, Alkapalan D, Bramer A, Kerns J, Yadav R, Ferguson K, Kloecker G. EP01.04-004 Overcoming the Barriers to Lung Cancer Screening using a Systemwide Approach. J Thorac Oncol 2022. [DOI: 10.1016/j.jtho.2022.07.299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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7
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Sadaf A, Szabo S, Ferguson K, Sorger JI, Sumegi J, Bridge JA, Pressey JG. Novel ARHGAP23-FER fusion in a metastatic spindle cell-predominant neoplasm with a myofibroblastic phenotype and a sustained metabolic response to lorlatinib. Cancer 2021; 127:4124-4130. [PMID: 34545945 DOI: 10.1002/cncr.33854] [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] [Received: 03/09/2021] [Revised: 06/06/2021] [Accepted: 06/29/2021] [Indexed: 11/11/2022]
Affiliation(s)
- Alina Sadaf
- Division of Oncology, Cancer and Blood Diseases Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Sara Szabo
- Division of Pathology, Cancer and Blood Diseases Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.,Department of Pathology and Laboratory Medicine, University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Katelyn Ferguson
- College of Medicine, University of Kentucky, Lexington, Kentucky
| | - Joel I Sorger
- Division of Orthopedic Surgery, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Janos Sumegi
- Division of Molecular Pathology, Translational Genomics Research Institute, Phoenix, Arizona
| | - Julia A Bridge
- Division of Molecular Pathology, Translational Genomics Research Institute, Phoenix, Arizona.,Department of Pathology and Microbiology, University of Nebraska Medical Center, Omaha, Nebraska.,Division of Molecular Diagnostics, ProPath, Dallas, Texas
| | - Joseph G Pressey
- Division of Oncology, Cancer and Blood Diseases Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.,Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio
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8
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El‐Ghazali S, Sheraton T, Ferguson K, Meek T. ‘Shielded’ anaesthetists and intensivists during the COVID‐19 pandemic: a reply. Anaesthesia 2020; 75:1542-1543. [PMID: 32632942 PMCID: PMC7361638 DOI: 10.1111/anae.15209] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/26/2020] [Indexed: 11/29/2022]
Affiliation(s)
| | | | | | - T. Meek
- Association of Anaesthetists London UK
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9
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Ferguson K, Johnston PW. Law, litigation and learning: a legacy from COVID-19. Anaesthesia 2020; 75:1428-1431. [PMID: 32926404 DOI: 10.1111/anae.15241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/27/2020] [Indexed: 11/29/2022]
Affiliation(s)
- K Ferguson
- Department of Anaesthesia, NHS Grampian, Aberdeen, UK
| | - P W Johnston
- Department of Pathology, NHS Grampian, Aberdeen, UK.,Centre for Healthcare Education Research and Innovation, University of Aberdeen, Aberdeen, UK
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10
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McGrath BA, Ashby N, Birchall M, Dean P, Doherty C, Ferguson K, Gimblett J, Grocott M, Jacob T, Kerawala C, Macnaughton P, Magennis P, Moonesinghe R, Twose P, Wallace S, Higgs A. Multidisciplinary guidance for safe tracheostomy care during the COVID-19 pandemic: the NHS National Patient Safety Improvement Programme (NatPatSIP). Anaesthesia 2020; 75:1659-1670. [PMID: 32396986 PMCID: PMC7272992 DOI: 10.1111/anae.15120] [Citation(s) in RCA: 54] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/10/2020] [Indexed: 12/18/2022]
Abstract
The COVID-19 pandemic is causing a significant increase in the number of patients requiring relatively prolonged invasive mechanical ventilation and an associated surge in patients who need a tracheostomy to facilitate weaning from respiratory support. In parallel, there has been a global increase in guidance from professional bodies representing staff who care for patients with tracheostomies at different points in their acute hospital journey, rehabilitation and recovery. Of concern are the risks to healthcare staff of infection arising from tracheostomy insertion and caring for patients with a tracheostomy. Hospitals are also facing extraordinary demands on critical care services such that many patients who require a tracheostomy will be managed outside established intensive care or head and neck units and cared for by staff with little tracheostomy experience. These concerns led NHS England and NHS Improvement to expedite the National Patient Safety Improvement Programme's 'Safe Tracheostomy Care' workstream as part of the NHS COVID-19 response. Supporting this workstream, UK stakeholder organisations involved in tracheostomy care were invited to develop consensus guidance based on: expert opinion; the best available published literature; and existing multidisciplinary guidelines. Topics with direct relevance for frontline staff were identified. This consensus guidance includes: infectivity of patients with respect to tracheostomy indications and timing; aerosol-generating procedures and risks to staff; insertion procedures; and management following tracheostomy.
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Affiliation(s)
- B A McGrath
- Department of Intensive Care Medicine, Wythenshawe Hospital, Manchester University Hospital NHS Foundation Trust, National Tracheostomy Safety Project, Manchester, UK
| | - N Ashby
- Royal College of Nursing, University of Nottingham, Nottingham, UK
| | - M Birchall
- British Laryngological Association, University College London, London, UK
| | - P Dean
- Intensive Care Society, Royal Blackburn Teaching Hospital, Lancashire, UK
| | - C Doherty
- Royal Manchester Children's Hospital, National Tracheostomy Safety Project Paediatric Lead, Manchester University NHS Foundation Trust, Manchester, UK
| | - K Ferguson
- Aberdeen Royal Infirmary, Association of Anaesthetists, Aberdeen, UK
| | | | - M Grocott
- Anaesthesia and Critical Care, Royal College of Anaesthetists, University of Southampton, Southampton, UK
| | - T Jacob
- ENT & Head and Neck surgeon, Lewisham & Greenwich NHS Trust, ENT-UKt, London, UK
| | - C Kerawala
- Maxillofacial & Head and Neck Surgeon, The Royal Marsden Hospital, British Association of Head & Neck Oncologists, London, UK
| | - P Macnaughton
- Intensive Care Medicine at Derriford Hospital, Faculty of Intensive Care Medicine, Plymouth, UK
| | - P Magennis
- Oral and Maxillofacial Surgeon, Aintree University Hospital, NHS Foundation Trust, British Association of Oral and Maxillofacial Surgeons, Liverpool, UK
| | - R Moonesinghe
- Anaesthetics and Critical Care Medicine, NHS England & NHS Improvement, University College London Hospitals, London, UK
| | - P Twose
- Association of Chartered Physiotherapists in Respiratory Care, Cardiff and Vale University Health Board, Cardiff, UK
| | - S Wallace
- Speech & Language Therapist, Royal College of Speech & Language Therapists, Manchester University NHS Foundation Trust, Manchester, UK
| | - A Higgs
- Anaesthesia & Intensive Care Medicine, Warrington & Halton Teaching Hospitals NHS Foundation Trust, Difficult Airway Society, Warrington, UK
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11
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Ferguson K, Blyth K, Tsim S, Ferguson J, Mercer R, Rahman N, Maskell N, Evison M. An update regarding the Meso-ORIGINS feasibility study and the PREDICT-Meso Accelerator Network. Lung Cancer 2020. [DOI: 10.1016/s0169-5002(20)30193-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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12
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Nathanson MH, Andrzejowski J, Dinsmore J, Eynon CA, Ferguson K, Hooper T, Kashyap A, Kendall J, McCormack V, Shinde S, Smith A, Thomas E. Guidelines for safe transfer of the brain-injured patient: trauma and stroke, 2019: Guidelines from the Association of Anaesthetists and the Neuro Anaesthesia and Critical Care Society. Anaesthesia 2019; 75:234-246. [PMID: 31788789 DOI: 10.1111/anae.14866] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [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: 08/31/2019] [Indexed: 12/16/2022]
Abstract
The location of care for many brain-injured patients has changed since 2012 following the development of major trauma centres. Advances in management of ischaemic stroke have led to the urgent transfer of many more patients. The basis of care has remained largely unchanged, however, with emphasis on maintaining adequate cerebral perfusion as the key to preventing secondary injury. Organisational aspects and training for transfers are highlighted, and we have included an expanded section on paediatric transfers. We have also provided a table with suggested blood pressure parameters for the common types of brain injury but acknowledge that there is little evidence for many of our recommendations. These guidelines remain a mix of evidence-based and consensus-based statements. We have received assistance from many organisations representing clinicians who care for these patients, and we believe our views represent the best of current thinking and opinion. We encourage departments to review their own practice using our suggestions for audit and quality improvement.
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Affiliation(s)
- M H Nathanson
- Department of Anaesthesia, Nottingham University Hospitals NHS Trust, Nottingham, UK.,Association of Anaesthetists (Working Party Chair)
| | - J Andrzejowski
- Department of Anaesthesia, Sheffield Teaching Hospitals NHS Trust, Sheffield, UK.,Neuro Anaesthesia and Critical Care Society (NACCS)
| | - J Dinsmore
- Department of Anaesthesia, St George's University Hospital NHS Trust, London, UK.,Royal College of Anaesthetists
| | - C A Eynon
- Department of Intensive Care, University Hospitals Southampton NHS Foundation Trust, Southampton, UK.,Intensive Care Societies of England, Ireland, Scotland and Wales
| | - K Ferguson
- Department of Anaesthesia, Aberdeen Royal Infirmary, Aberdeen.,Association of Anaesthetists
| | - T Hooper
- Department of Intensive Care and Anaesthesia, North Bristol NHS Trust, Bristol, UK.,Defence Medical Services
| | - A Kashyap
- Department of Paediatric Intensive Care, Great North Children's Hospital, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle, UK.,Paediatric Intensive Care Society
| | - J Kendall
- Department of Emergency Medicine, Southmead Hospital, North Bristol NHS Trust, Bristol, UK.,Royal College of Emergency Medicine
| | - V McCormack
- Anaesthesia and Intensive Care Medicine, North West Deanery.,Association of Anaesthetists Trainee Committee
| | - S Shinde
- Department of Anaesthesia, Southmead Hospital, North Bristol NHS Trust, Bristol, UK.,Association of Anaesthetists
| | - A Smith
- Department of Anaesthesia, Royal Lancaster Infirmary, Lancaster, UK
| | - E Thomas
- Departments of Anaesthesia and Intensive Care Medicine, University Hospitals Plymouth NHS Trust, UK.,NACCS
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13
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McClelland L, Plunkett E, McCrossan R, Ferguson K, Fraser J, Gildersleve C, Holland J, Lomas JP, Redfern N, Pandit JJ. A national survey of out-of-hours working and fatigue in consultants in anaesthesia and paediatric intensive care in the UK and Ireland. Anaesthesia 2019; 74:1509-1523. [PMID: 31478198 DOI: 10.1111/anae.14819] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/31/2019] [Indexed: 11/30/2022]
Abstract
The tragic death of an anaesthetic trainee driving home after a series of night shifts prompted a national survey of fatigue in trainee anaesthetists. This indicated that fatigue was widespread, with significant impact on trainees' health and well-being. Consultants deliver an increasing proportion of patient care resulting in long periods of continuous daytime duty and overnight on-call work, so we wished to investigate their experience of out-of-hours working and the causes and impact of work-related fatigue. We conducted a national survey of consultant anaesthetists and paediatric intensivists in the UK and Ireland between 25 June and 6 August 2018. The response rate was 46% (94% of hospitals were represented): 84% of respondents (95%CI 83.1-84.9%) contribute to a night on-call rota with 32% (30.9-33.1%) working 1:8 or more frequently. Sleep disturbance on-call is common: 47% (45.6-48.4%) typically receive two to three phone calls overnight, and 48% (46.6-49.4%) take 30 min or more to fall back to sleep. Only 15% (14.0-16.0%) reported always achieving 11 h of rest between their on-call and their next clinical duty, as stipulated by the European Working Time Directive. Moreover, 24% (22.8-25.2%) stated that there is no departmental arrangement for covering scheduled clinical duties following a night on-call if they have been in the hospital overnight. Overall, 91% (90.3-91.7%) reported work-related fatigue with over half reporting a moderate or significantly negative impact on health, well-being and home life. We discuss potential explanations for these results and ways to mitigate the effects of fatigue among consultants.
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Affiliation(s)
- L McClelland
- Department of Intensive Care Medicine and Anaesthesia, Royal Gwent Hospital, Newport, UK
| | - E Plunkett
- Department of Anaesthesia, Queen Elizabeth Hospital Birmingham, Birmingham, UK
| | - R McCrossan
- Department of Anaesthesia, Newcastle upon Tyne NHS Foundation Trust, Newcastle, UK
| | - K Ferguson
- Department of Anaesthesia, Aberdeen Royal Infirmary, Aberdeen, UK
| | - J Fraser
- Department of Paediatric Intensive Care, Bristol Royal Hospital for Children, Bristol, UK
| | - C Gildersleve
- Department of Paediatric Anaesthesia, Children's Hospital for Wales, Cardiff, UK
| | - J Holland
- Department of Anaesthesia, Princess of Wales Hospital, Bridgend, UK
| | - J P Lomas
- Department of Anaesthesia and Intensive Care, Bolton Foundation Trust, Bolton, UK
| | - N Redfern
- Department of Anaesthesia, Newcastle upon Tyne NHS Foundation Trust, Newcastle, UK
| | - J J Pandit
- Nuffield Department of Anaesthesia, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
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14
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Nones K, Johnson J, Newell F, Patch AM, Thorne H, Kazakoff SH, de Luca XM, Parsons MT, Ferguson K, Reid LE, McCart Reed AE, Srihari S, Lakis V, Davidson AL, Mukhopadhyay P, Holmes O, Xu Q, Wood S, Leonard C, Beesley J, Harris JM, Barnes D, Degasperi A, Ragan MA, Spurdle AB, Khanna KK, Lakhani SR, Pearson JV, Nik-Zainal S, Chenevix-Trench G, Waddell N, Simpson PT. Whole-genome sequencing reveals clinically relevant insights into the aetiology of familial breast cancers. Ann Oncol 2019; 30:1071-1079. [PMID: 31090900 PMCID: PMC6637375 DOI: 10.1093/annonc/mdz132] [Citation(s) in RCA: 51] [Impact Index Per Article: 10.2] [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] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Whole-genome sequencing (WGS) is a powerful method for revealing the diversity and complexity of the somatic mutation burden of tumours. Here, we investigated the utility of tumour and matched germline WGS for understanding aetiology and treatment opportunities for high-risk individuals with familial breast cancer. PATIENTS AND METHODS We carried out WGS on 78 paired germline and tumour DNA samples from individuals carrying pathogenic variants in BRCA1 (n = 26) or BRCA2 (n = 22) or from non-carriers (non-BRCA1/2; n = 30). RESULTS Matched germline/tumour WGS and somatic mutational signature analysis revealed patients with unreported, dual pathogenic germline variants in cancer risk genes (BRCA1/BRCA2; BRCA1/MUTYH). The strategy identified that 100% of tumours from BRCA1 carriers and 91% of tumours from BRCA2 carriers exhibited biallelic inactivation of the respective gene, together with somatic mutational signatures suggestive of a functional deficiency in homologous recombination. A set of non-BRCA1/2 tumours also had somatic signatures indicative of BRCA-deficiency, including tumours with BRCA1 promoter methylation, and tumours from carriers of a PALB2 pathogenic germline variant and a BRCA2 variant of uncertain significance. A subset of 13 non-BRCA1/2 tumours from early onset cases were BRCA-proficient, yet displayed complex clustered structural rearrangements associated with the amplification of oncogenes and pathogenic germline variants in TP53, ATM and CHEK2. CONCLUSIONS Our study highlights the role that WGS of matched germline/tumour DNA and the somatic mutational signatures can play in the discovery of pathogenic germline variants and for providing supporting evidence for variant pathogenicity. WGS-derived signatures were more robust than germline status and other genomic predictors of homologous recombination deficiency, thus impacting the selection of platinum-based or PARP inhibitor therapy. In this first examination of non-BRCA1/2 tumours by WGS, we illustrate the considerable heterogeneity of these tumour genomes and highlight that complex genomic rearrangements may drive tumourigenesis in a subset of cases.
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Affiliation(s)
- K Nones
- Medical Genomics Group, QIMR Berghofer Medical Research Institute, Brisbane, QLD
| | - J Johnson
- Faculty of Medicine, Centre for Clinical Research, The University of Queensland, Brisbane, QLD
| | - F Newell
- Medical Genomics Group, QIMR Berghofer Medical Research Institute, Brisbane, QLD
| | - A M Patch
- Medical Genomics Group, QIMR Berghofer Medical Research Institute, Brisbane, QLD
| | - H Thorne
- kConFab Investigators, The Peter MacCallum Cancer Centre, Melbourne, VIC; Sir Peter MacCallum Department of Oncology, The University of Melbourne, Melbourne, VIC
| | - S H Kazakoff
- Medical Genomics Group, QIMR Berghofer Medical Research Institute, Brisbane, QLD
| | - X M de Luca
- Faculty of Medicine, Centre for Clinical Research, The University of Queensland, Brisbane, QLD
| | - M T Parsons
- Molecular Cancer Epidemiology Group, QIMR Berghofer Medical Research Institute, Brisbane, QLD
| | - K Ferguson
- Faculty of Medicine, Centre for Clinical Research, The University of Queensland, Brisbane, QLD
| | - L E Reid
- Faculty of Medicine, Centre for Clinical Research, The University of Queensland, Brisbane, QLD
| | - A E McCart Reed
- Faculty of Medicine, Centre for Clinical Research, The University of Queensland, Brisbane, QLD
| | - S Srihari
- Faculty of Medicine, Centre for Clinical Research, The University of Queensland, Brisbane, QLD; Institute for Molecular Bioscience, The University of Queensland, Brisbane, QLD
| | - V Lakis
- Medical Genomics Group, QIMR Berghofer Medical Research Institute, Brisbane, QLD
| | - A L Davidson
- Medical Genomics Group, QIMR Berghofer Medical Research Institute, Brisbane, QLD; Faculty of Medicine, The University of Queensland, Brisbane, QLD
| | - P Mukhopadhyay
- Medical Genomics Group, QIMR Berghofer Medical Research Institute, Brisbane, QLD
| | - O Holmes
- Genome Informatics Group, QIMR Berghofer Medical Research Institute, Brisbane, QLD
| | - Q Xu
- Genome Informatics Group, QIMR Berghofer Medical Research Institute, Brisbane, QLD
| | - S Wood
- Genome Informatics Group, QIMR Berghofer Medical Research Institute, Brisbane, QLD
| | - C Leonard
- Genome Informatics Group, QIMR Berghofer Medical Research Institute, Brisbane, QLD
| | - J Beesley
- Cancer Genetics Group, QIMR Berghofer Medical Research Institute, Brisbane, QLD
| | - J M Harris
- Faculty of Health, School Biomedical Science - Queensland University of Technology, Brisbane, QLD, Australia
| | - D Barnes
- Department of Public Health and Primary Care, Centre for Cancer Genetic Epidemiology, University of Cambridge, Cambridge
| | - A Degasperi
- MRC Cancer Unit, Hutchison/MRC Research Centre, University of Cambridge, Cambridge; Department of Medical Genetics, The Clinical School, University of Cambridge, Cambridge, UK
| | - M A Ragan
- Institute for Molecular Bioscience, The University of Queensland, Brisbane, QLD
| | - A B Spurdle
- Molecular Cancer Epidemiology Group, QIMR Berghofer Medical Research Institute, Brisbane, QLD
| | - K K Khanna
- Signal Transduction Group, QIMR Berghofer Medical Research Institute, Brisbane, QLD
| | - S R Lakhani
- Faculty of Medicine, Centre for Clinical Research, The University of Queensland, Brisbane, QLD; Royal Brisbane & Women's Hospital, Pathology Queensland, Brisbane, QLD, Australia
| | - J V Pearson
- Genome Informatics Group, QIMR Berghofer Medical Research Institute, Brisbane, QLD
| | - S Nik-Zainal
- MRC Cancer Unit, Hutchison/MRC Research Centre, University of Cambridge, Cambridge; Department of Medical Genetics, The Clinical School, University of Cambridge, Cambridge, UK
| | - G Chenevix-Trench
- Cancer Genetics Group, QIMR Berghofer Medical Research Institute, Brisbane, QLD
| | - N Waddell
- Medical Genomics Group, QIMR Berghofer Medical Research Institute, Brisbane, QLD.
| | - P T Simpson
- Faculty of Medicine, Centre for Clinical Research, The University of Queensland, Brisbane, QLD.
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15
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Ferguson K, Meek T. Offsetting the genotoxic effects of sleep disruption. A reply. Anaesthesia 2019; 74:941. [DOI: 10.1111/anae.14710] [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: 11/30/2022]
Affiliation(s)
| | - T. Meek
- Association of Anaesthetists London UK
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16
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Ferguson K, Bouza B, Caldwell A, Rosa-Caldwell M, Blunt-Vinti H. 123 Sex Hormone Fluctuations and Their Effects on Sexual Function of IUS Users. J Sex Med 2019. [DOI: 10.1016/j.jsxm.2019.03.560] [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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17
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Orska T, Pierce S, Ferguson K, Bossley C, Brugha R. P354 How often do under 2 year-old's cough during cough swabs? Does it make any difference to the microbiology results? Audit of samples at a tertiary cystic fibrosis centre. J Cyst Fibros 2019. [DOI: 10.1016/s1569-1993(19)30646-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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18
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Simpson P, Nones K, Johnson J, Newell F, Patch AM, Thorne H, Kazakoff S, De Luca X, Parsons M, Ferguson K, Reid L, McCart Reed A, Srihari S, Lakis V, Davidson A, Mukhopadhyay P, Holmes O, Xu Q, Wood S, Leonard C, Beasley J, Degasperi A, Nik-Zainal S, Ragan M, Spurdle A, Khanna KK, Lakhani S, Pearson J, Chenevix-Trench G, Waddell N. Abstract P5-10-01: Using whole genome sequencing and somatic mutation signatures to unravel insight into familial breast cancer aetiology. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p5-10-01] [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
Approximately 10-15% of breast cancers are associated with a strong family history of disease. Pathogenic variants in BRCA1, BRCA2 or other moderate to highly penetrant susceptibility genes (e.g. TP53, ATM, CHEK2, PALB2 and PTEN) account for a number of breast cancer families. However, for over 50% of families the underlying genetic contribution to their risk remains unknown (termed here as non-BRCA1/2). This has a profound impact for how individuals and their families are managed in the clinic. We applied whole genome sequencing (WGS) to determine whether somatic mutation analysis can reveal insight into the aetiology of familial breast cancer. The full repertoire of somatic mutations was evaluated in 26 BRCA1, 22 BRCA2 and 32 non-BRCA1/2 tumours; including SNPs, indels, copy number changes and structural rearrangements, and mutational signatures. Genomes were also analysed using the HRD Index and HRDetect, as predictors of homologous recombination deficiency. BRCA1, BRCA2 and non-BRCA1/2 tumours exhibited a different burden of mutations, a different spectrum of mutational signatures and different telomere length. Based on collective patterns of mutation signatures, tumours were classified as 'BRCA1-like', 'BRCA2-like' or 'non-BRCA1/2-like' with a 15% rate of tumour re-classification from their original clinical BRCA status. The results demonstrate the power of WGS to differentiate between BRCA1 and BRCA2 driven tumours; in the identification of double-pathogenic germline mutation carriers based on the resulting somatic mutation signature; and in the interpretation of BRCA unclassified variants. WGS of tumour genomes reveals fascinating insights into tumour aetiology and could compliment current genetic testing of breast cancer families.
Citation Format: Simpson P, Nones K, Johnson J, Newell F, Patch A-M, Thorne H, Kazakoff S, De Luca X, Parsons M, Ferguson K, Reid L, McCart Reed A, Srihari S, Lakis V, Davidson A, Mukhopadhyay P, Holmes O, Xu Q, Wood S, Leonard C, Beasley J, Degasperi A, Nik-Zainal S, Ragan M, Spurdle A, Khanna KK, Lakhani S, Pearson J, Chenevix-Trench G, Waddell N. Using whole genome sequencing and somatic mutation signatures to unravel insight into familial breast cancer aetiology [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P5-10-01.
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Affiliation(s)
- P Simpson
- The University of Queensland, Brisbane, Australia; QIMR Berghofer Medical Research Institute, Brisbane, Australia; Peter MacCallum Cancer Centre, Melbourne, Australia; University of Cambridge, Cambridge, United Kingdom; Westmead Institute for Medical Research, Sydney, Australia
| | - K Nones
- The University of Queensland, Brisbane, Australia; QIMR Berghofer Medical Research Institute, Brisbane, Australia; Peter MacCallum Cancer Centre, Melbourne, Australia; University of Cambridge, Cambridge, United Kingdom; Westmead Institute for Medical Research, Sydney, Australia
| | - J Johnson
- The University of Queensland, Brisbane, Australia; QIMR Berghofer Medical Research Institute, Brisbane, Australia; Peter MacCallum Cancer Centre, Melbourne, Australia; University of Cambridge, Cambridge, United Kingdom; Westmead Institute for Medical Research, Sydney, Australia
| | - F Newell
- The University of Queensland, Brisbane, Australia; QIMR Berghofer Medical Research Institute, Brisbane, Australia; Peter MacCallum Cancer Centre, Melbourne, Australia; University of Cambridge, Cambridge, United Kingdom; Westmead Institute for Medical Research, Sydney, Australia
| | - A-M Patch
- The University of Queensland, Brisbane, Australia; QIMR Berghofer Medical Research Institute, Brisbane, Australia; Peter MacCallum Cancer Centre, Melbourne, Australia; University of Cambridge, Cambridge, United Kingdom; Westmead Institute for Medical Research, Sydney, Australia
| | - H Thorne
- The University of Queensland, Brisbane, Australia; QIMR Berghofer Medical Research Institute, Brisbane, Australia; Peter MacCallum Cancer Centre, Melbourne, Australia; University of Cambridge, Cambridge, United Kingdom; Westmead Institute for Medical Research, Sydney, Australia
| | - S Kazakoff
- The University of Queensland, Brisbane, Australia; QIMR Berghofer Medical Research Institute, Brisbane, Australia; Peter MacCallum Cancer Centre, Melbourne, Australia; University of Cambridge, Cambridge, United Kingdom; Westmead Institute for Medical Research, Sydney, Australia
| | - X De Luca
- The University of Queensland, Brisbane, Australia; QIMR Berghofer Medical Research Institute, Brisbane, Australia; Peter MacCallum Cancer Centre, Melbourne, Australia; University of Cambridge, Cambridge, United Kingdom; Westmead Institute for Medical Research, Sydney, Australia
| | - M Parsons
- The University of Queensland, Brisbane, Australia; QIMR Berghofer Medical Research Institute, Brisbane, Australia; Peter MacCallum Cancer Centre, Melbourne, Australia; University of Cambridge, Cambridge, United Kingdom; Westmead Institute for Medical Research, Sydney, Australia
| | - K Ferguson
- The University of Queensland, Brisbane, Australia; QIMR Berghofer Medical Research Institute, Brisbane, Australia; Peter MacCallum Cancer Centre, Melbourne, Australia; University of Cambridge, Cambridge, United Kingdom; Westmead Institute for Medical Research, Sydney, Australia
| | - L Reid
- The University of Queensland, Brisbane, Australia; QIMR Berghofer Medical Research Institute, Brisbane, Australia; Peter MacCallum Cancer Centre, Melbourne, Australia; University of Cambridge, Cambridge, United Kingdom; Westmead Institute for Medical Research, Sydney, Australia
| | - A McCart Reed
- The University of Queensland, Brisbane, Australia; QIMR Berghofer Medical Research Institute, Brisbane, Australia; Peter MacCallum Cancer Centre, Melbourne, Australia; University of Cambridge, Cambridge, United Kingdom; Westmead Institute for Medical Research, Sydney, Australia
| | - S Srihari
- The University of Queensland, Brisbane, Australia; QIMR Berghofer Medical Research Institute, Brisbane, Australia; Peter MacCallum Cancer Centre, Melbourne, Australia; University of Cambridge, Cambridge, United Kingdom; Westmead Institute for Medical Research, Sydney, Australia
| | - V Lakis
- The University of Queensland, Brisbane, Australia; QIMR Berghofer Medical Research Institute, Brisbane, Australia; Peter MacCallum Cancer Centre, Melbourne, Australia; University of Cambridge, Cambridge, United Kingdom; Westmead Institute for Medical Research, Sydney, Australia
| | - A Davidson
- The University of Queensland, Brisbane, Australia; QIMR Berghofer Medical Research Institute, Brisbane, Australia; Peter MacCallum Cancer Centre, Melbourne, Australia; University of Cambridge, Cambridge, United Kingdom; Westmead Institute for Medical Research, Sydney, Australia
| | - P Mukhopadhyay
- The University of Queensland, Brisbane, Australia; QIMR Berghofer Medical Research Institute, Brisbane, Australia; Peter MacCallum Cancer Centre, Melbourne, Australia; University of Cambridge, Cambridge, United Kingdom; Westmead Institute for Medical Research, Sydney, Australia
| | - O Holmes
- The University of Queensland, Brisbane, Australia; QIMR Berghofer Medical Research Institute, Brisbane, Australia; Peter MacCallum Cancer Centre, Melbourne, Australia; University of Cambridge, Cambridge, United Kingdom; Westmead Institute for Medical Research, Sydney, Australia
| | - Q Xu
- The University of Queensland, Brisbane, Australia; QIMR Berghofer Medical Research Institute, Brisbane, Australia; Peter MacCallum Cancer Centre, Melbourne, Australia; University of Cambridge, Cambridge, United Kingdom; Westmead Institute for Medical Research, Sydney, Australia
| | - S Wood
- The University of Queensland, Brisbane, Australia; QIMR Berghofer Medical Research Institute, Brisbane, Australia; Peter MacCallum Cancer Centre, Melbourne, Australia; University of Cambridge, Cambridge, United Kingdom; Westmead Institute for Medical Research, Sydney, Australia
| | - C Leonard
- The University of Queensland, Brisbane, Australia; QIMR Berghofer Medical Research Institute, Brisbane, Australia; Peter MacCallum Cancer Centre, Melbourne, Australia; University of Cambridge, Cambridge, United Kingdom; Westmead Institute for Medical Research, Sydney, Australia
| | - J Beasley
- The University of Queensland, Brisbane, Australia; QIMR Berghofer Medical Research Institute, Brisbane, Australia; Peter MacCallum Cancer Centre, Melbourne, Australia; University of Cambridge, Cambridge, United Kingdom; Westmead Institute for Medical Research, Sydney, Australia
| | - A Degasperi
- The University of Queensland, Brisbane, Australia; QIMR Berghofer Medical Research Institute, Brisbane, Australia; Peter MacCallum Cancer Centre, Melbourne, Australia; University of Cambridge, Cambridge, United Kingdom; Westmead Institute for Medical Research, Sydney, Australia
| | - S Nik-Zainal
- The University of Queensland, Brisbane, Australia; QIMR Berghofer Medical Research Institute, Brisbane, Australia; Peter MacCallum Cancer Centre, Melbourne, Australia; University of Cambridge, Cambridge, United Kingdom; Westmead Institute for Medical Research, Sydney, Australia
| | - M Ragan
- The University of Queensland, Brisbane, Australia; QIMR Berghofer Medical Research Institute, Brisbane, Australia; Peter MacCallum Cancer Centre, Melbourne, Australia; University of Cambridge, Cambridge, United Kingdom; Westmead Institute for Medical Research, Sydney, Australia
| | - A Spurdle
- The University of Queensland, Brisbane, Australia; QIMR Berghofer Medical Research Institute, Brisbane, Australia; Peter MacCallum Cancer Centre, Melbourne, Australia; University of Cambridge, Cambridge, United Kingdom; Westmead Institute for Medical Research, Sydney, Australia
| | - KK Khanna
- The University of Queensland, Brisbane, Australia; QIMR Berghofer Medical Research Institute, Brisbane, Australia; Peter MacCallum Cancer Centre, Melbourne, Australia; University of Cambridge, Cambridge, United Kingdom; Westmead Institute for Medical Research, Sydney, Australia
| | - S Lakhani
- The University of Queensland, Brisbane, Australia; QIMR Berghofer Medical Research Institute, Brisbane, Australia; Peter MacCallum Cancer Centre, Melbourne, Australia; University of Cambridge, Cambridge, United Kingdom; Westmead Institute for Medical Research, Sydney, Australia
| | - J Pearson
- The University of Queensland, Brisbane, Australia; QIMR Berghofer Medical Research Institute, Brisbane, Australia; Peter MacCallum Cancer Centre, Melbourne, Australia; University of Cambridge, Cambridge, United Kingdom; Westmead Institute for Medical Research, Sydney, Australia
| | - G Chenevix-Trench
- The University of Queensland, Brisbane, Australia; QIMR Berghofer Medical Research Institute, Brisbane, Australia; Peter MacCallum Cancer Centre, Melbourne, Australia; University of Cambridge, Cambridge, United Kingdom; Westmead Institute for Medical Research, Sydney, Australia
| | - N Waddell
- The University of Queensland, Brisbane, Australia; QIMR Berghofer Medical Research Institute, Brisbane, Australia; Peter MacCallum Cancer Centre, Melbourne, Australia; University of Cambridge, Cambridge, United Kingdom; Westmead Institute for Medical Research, Sydney, Australia
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19
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McCart Reed AE, Kalaw E, Nones K, Bettington M, Lim M, Bennett J, Johnstone K, Kutasovic JR, Kazakoff S, Xu QC, Saunus JM, Reid LE, Black D, Niland C, Ferguson K, Gresshoff I, Raghavendra A, Liu JC, Kalinowski L, Reid AS, Davidson M, Pearson JV, Yamaguchi R, Harris G, Tse G, Papadimos D, Pathmanathan R, Pathmanathan N, Tan PH, Fox S, O'Toole S, Waddell N, Simpson PT, Lakhani SR. Abstract P3-08-03: Dissecting the heterogeneity of metaplastic breast cancer: A morphological, immunohistochemical and genomic analysis of a large cohort. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p3-08-03] [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
Although rare, Metaplastic Breast Carcinomas (MBC) account for significant global breast cancer mortality. This subgroup is extremely heterogeneous and by definition exhibits metaplastic change to squamous and/or mesenchymal elements, including but not limited to spindle, squamous, chondroid, osseous and rhabdomyoid elements. The WHO working group recognizes that the current classification is inadequate and in the interim, has suggested a purely descriptive classification. The mixed epithelial-mesenchymal morphology has led to speculation that MBC represent 'stem cell tumours'; in support of this, MBC have been shown to have a CD44+/CD24-/low phenotype. Clinically, patients present with tumours that are larger (higher stage), have increased likelihood of distant metastases at presentation and overall, have a reduced 5-year survival rate compared to Invasive Carcinoma-NST. Hence, this is a unique subtype with poor outcome but without a robust classification or understanding of the biology to aid clinical management. We present a detailed morphological, immunohistochemical and genomic analysis of a large series of MBC (n=347), as amassed through the Asia-Pacific MBC consortium. We consider our morphological dissection using the WHO subtyping guidelines and show that an increasing number of phenotypes in a mixed MBC (classified as WHO_1) significantly associates with a poor prognosis. Immunohistochemical analysis showed that a pure spindle (WHO_5) is significantly less likely to express vimentin, CK5/6, CK14, and CK19 than a mixed WHO_1 with spindle features. Similarly, a WHO_1 with chondroid features is less likely to express EGFR than WHO_1 with chondroid features and rhabdoid or osseous differentiation. Across the cohort, positivity for the AE1/3 antibody and a lack of EGFR expression both significantly associate with a better outcome. We report no significant association between patient age at diagnosis and breast cancer specific survival, nor between age and specific WHO MBC subtypes. We report a significant association between WHO_1 types and increasing tumour grade, and also between tumour size and grade, with tumour size being a highly significant prognostic indicator in this cohort. Our exome sequencing confirms a significant enrichment for TP53 and PTEN mutations in MBC, and intriguingly for concurrent mutations of TP53, PTEN and PIK3CA. A novel enrichment for NF1 mutations is also presented. In summary, we provide a thorough assessment of a large cohort of MBC, including morphology, survival, IHC and exome sequencing, and present our analysis contextualized by the WHO guidelines, extending the existing knowledge base of this rare tumour type.
Citation Format: McCart Reed AE, Kalaw E, Nones K, Bettington M, Lim M, Bennett J, Johnstone K, Kutasovic JR, Kazakoff S, Xu QC, Saunus JM, Reid LE, Black D, Niland C, Ferguson K, Gresshoff I, Raghavendra A, Liu JC, Kalinowski L, Reid AS, Davidson M, Pearson JV, Yamaguchi R, Harris G, Tse G, Papadimos D, Pathmanathan R, Pathmanathan N, Tan PH, Fox S, O'Toole S, Waddell N, Simpson PT, Lakhani SR. Dissecting the heterogeneity of metaplastic breast cancer: A morphological, immunohistochemical and genomic analysis of a large cohort [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P3-08-03.
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Affiliation(s)
- AE McCart Reed
- University of Queensland, Brisbane, Australia; QIMR Berghofer Medical Research Institute, Brisbane, Australia; Pathology Queensland, The Royal Brisbane & Women's Hospital, Brisbane, Australia; Kurume University School of Medicine, Kurume, Japan; Canterbury Health Laboratories, Christchurch, New Zealand; Prince of Wales Hospital, Hong Kong, Hong Kong; Sullivan Nicolaides Pathology, Brisbane, Australia; Sime Darby Medical Centre, Selangor, Malaysia; Westmead Breast Cancer Institute; University of Sydney, Sydney, Australia; Singapore General Hospital, Singapore, Singapore; Peter MacCallum Cancer Centre, Melbourne, Australia; Garvan Institute of Medical Research and the Kinghorn Cancer Centre, Sydney, Australia
| | - E Kalaw
- University of Queensland, Brisbane, Australia; QIMR Berghofer Medical Research Institute, Brisbane, Australia; Pathology Queensland, The Royal Brisbane & Women's Hospital, Brisbane, Australia; Kurume University School of Medicine, Kurume, Japan; Canterbury Health Laboratories, Christchurch, New Zealand; Prince of Wales Hospital, Hong Kong, Hong Kong; Sullivan Nicolaides Pathology, Brisbane, Australia; Sime Darby Medical Centre, Selangor, Malaysia; Westmead Breast Cancer Institute; University of Sydney, Sydney, Australia; Singapore General Hospital, Singapore, Singapore; Peter MacCallum Cancer Centre, Melbourne, Australia; Garvan Institute of Medical Research and the Kinghorn Cancer Centre, Sydney, Australia
| | - K Nones
- University of Queensland, Brisbane, Australia; QIMR Berghofer Medical Research Institute, Brisbane, Australia; Pathology Queensland, The Royal Brisbane & Women's Hospital, Brisbane, Australia; Kurume University School of Medicine, Kurume, Japan; Canterbury Health Laboratories, Christchurch, New Zealand; Prince of Wales Hospital, Hong Kong, Hong Kong; Sullivan Nicolaides Pathology, Brisbane, Australia; Sime Darby Medical Centre, Selangor, Malaysia; Westmead Breast Cancer Institute; University of Sydney, Sydney, Australia; Singapore General Hospital, Singapore, Singapore; Peter MacCallum Cancer Centre, Melbourne, Australia; Garvan Institute of Medical Research and the Kinghorn Cancer Centre, Sydney, Australia
| | - M Bettington
- University of Queensland, Brisbane, Australia; QIMR Berghofer Medical Research Institute, Brisbane, Australia; Pathology Queensland, The Royal Brisbane & Women's Hospital, Brisbane, Australia; Kurume University School of Medicine, Kurume, Japan; Canterbury Health Laboratories, Christchurch, New Zealand; Prince of Wales Hospital, Hong Kong, Hong Kong; Sullivan Nicolaides Pathology, Brisbane, Australia; Sime Darby Medical Centre, Selangor, Malaysia; Westmead Breast Cancer Institute; University of Sydney, Sydney, Australia; Singapore General Hospital, Singapore, Singapore; Peter MacCallum Cancer Centre, Melbourne, Australia; Garvan Institute of Medical Research and the Kinghorn Cancer Centre, Sydney, Australia
| | - M Lim
- University of Queensland, Brisbane, Australia; QIMR Berghofer Medical Research Institute, Brisbane, Australia; Pathology Queensland, The Royal Brisbane & Women's Hospital, Brisbane, Australia; Kurume University School of Medicine, Kurume, Japan; Canterbury Health Laboratories, Christchurch, New Zealand; Prince of Wales Hospital, Hong Kong, Hong Kong; Sullivan Nicolaides Pathology, Brisbane, Australia; Sime Darby Medical Centre, Selangor, Malaysia; Westmead Breast Cancer Institute; University of Sydney, Sydney, Australia; Singapore General Hospital, Singapore, Singapore; Peter MacCallum Cancer Centre, Melbourne, Australia; Garvan Institute of Medical Research and the Kinghorn Cancer Centre, Sydney, Australia
| | - J Bennett
- University of Queensland, Brisbane, Australia; QIMR Berghofer Medical Research Institute, Brisbane, Australia; Pathology Queensland, The Royal Brisbane & Women's Hospital, Brisbane, Australia; Kurume University School of Medicine, Kurume, Japan; Canterbury Health Laboratories, Christchurch, New Zealand; Prince of Wales Hospital, Hong Kong, Hong Kong; Sullivan Nicolaides Pathology, Brisbane, Australia; Sime Darby Medical Centre, Selangor, Malaysia; Westmead Breast Cancer Institute; University of Sydney, Sydney, Australia; Singapore General Hospital, Singapore, Singapore; Peter MacCallum Cancer Centre, Melbourne, Australia; Garvan Institute of Medical Research and the Kinghorn Cancer Centre, Sydney, Australia
| | - K Johnstone
- University of Queensland, Brisbane, Australia; QIMR Berghofer Medical Research Institute, Brisbane, Australia; Pathology Queensland, The Royal Brisbane & Women's Hospital, Brisbane, Australia; Kurume University School of Medicine, Kurume, Japan; Canterbury Health Laboratories, Christchurch, New Zealand; Prince of Wales Hospital, Hong Kong, Hong Kong; Sullivan Nicolaides Pathology, Brisbane, Australia; Sime Darby Medical Centre, Selangor, Malaysia; Westmead Breast Cancer Institute; University of Sydney, Sydney, Australia; Singapore General Hospital, Singapore, Singapore; Peter MacCallum Cancer Centre, Melbourne, Australia; Garvan Institute of Medical Research and the Kinghorn Cancer Centre, Sydney, Australia
| | - JR Kutasovic
- University of Queensland, Brisbane, Australia; QIMR Berghofer Medical Research Institute, Brisbane, Australia; Pathology Queensland, The Royal Brisbane & Women's Hospital, Brisbane, Australia; Kurume University School of Medicine, Kurume, Japan; Canterbury Health Laboratories, Christchurch, New Zealand; Prince of Wales Hospital, Hong Kong, Hong Kong; Sullivan Nicolaides Pathology, Brisbane, Australia; Sime Darby Medical Centre, Selangor, Malaysia; Westmead Breast Cancer Institute; University of Sydney, Sydney, Australia; Singapore General Hospital, Singapore, Singapore; Peter MacCallum Cancer Centre, Melbourne, Australia; Garvan Institute of Medical Research and the Kinghorn Cancer Centre, Sydney, Australia
| | - S Kazakoff
- University of Queensland, Brisbane, Australia; QIMR Berghofer Medical Research Institute, Brisbane, Australia; Pathology Queensland, The Royal Brisbane & Women's Hospital, Brisbane, Australia; Kurume University School of Medicine, Kurume, Japan; Canterbury Health Laboratories, Christchurch, New Zealand; Prince of Wales Hospital, Hong Kong, Hong Kong; Sullivan Nicolaides Pathology, Brisbane, Australia; Sime Darby Medical Centre, Selangor, Malaysia; Westmead Breast Cancer Institute; University of Sydney, Sydney, Australia; Singapore General Hospital, Singapore, Singapore; Peter MacCallum Cancer Centre, Melbourne, Australia; Garvan Institute of Medical Research and the Kinghorn Cancer Centre, Sydney, Australia
| | - QC Xu
- University of Queensland, Brisbane, Australia; QIMR Berghofer Medical Research Institute, Brisbane, Australia; Pathology Queensland, The Royal Brisbane & Women's Hospital, Brisbane, Australia; Kurume University School of Medicine, Kurume, Japan; Canterbury Health Laboratories, Christchurch, New Zealand; Prince of Wales Hospital, Hong Kong, Hong Kong; Sullivan Nicolaides Pathology, Brisbane, Australia; Sime Darby Medical Centre, Selangor, Malaysia; Westmead Breast Cancer Institute; University of Sydney, Sydney, Australia; Singapore General Hospital, Singapore, Singapore; Peter MacCallum Cancer Centre, Melbourne, Australia; Garvan Institute of Medical Research and the Kinghorn Cancer Centre, Sydney, Australia
| | - JM Saunus
- University of Queensland, Brisbane, Australia; QIMR Berghofer Medical Research Institute, Brisbane, Australia; Pathology Queensland, The Royal Brisbane & Women's Hospital, Brisbane, Australia; Kurume University School of Medicine, Kurume, Japan; Canterbury Health Laboratories, Christchurch, New Zealand; Prince of Wales Hospital, Hong Kong, Hong Kong; Sullivan Nicolaides Pathology, Brisbane, Australia; Sime Darby Medical Centre, Selangor, Malaysia; Westmead Breast Cancer Institute; University of Sydney, Sydney, Australia; Singapore General Hospital, Singapore, Singapore; Peter MacCallum Cancer Centre, Melbourne, Australia; Garvan Institute of Medical Research and the Kinghorn Cancer Centre, Sydney, Australia
| | - LE Reid
- University of Queensland, Brisbane, Australia; QIMR Berghofer Medical Research Institute, Brisbane, Australia; Pathology Queensland, The Royal Brisbane & Women's Hospital, Brisbane, Australia; Kurume University School of Medicine, Kurume, Japan; Canterbury Health Laboratories, Christchurch, New Zealand; Prince of Wales Hospital, Hong Kong, Hong Kong; Sullivan Nicolaides Pathology, Brisbane, Australia; Sime Darby Medical Centre, Selangor, Malaysia; Westmead Breast Cancer Institute; University of Sydney, Sydney, Australia; Singapore General Hospital, Singapore, Singapore; Peter MacCallum Cancer Centre, Melbourne, Australia; Garvan Institute of Medical Research and the Kinghorn Cancer Centre, Sydney, Australia
| | - D Black
- University of Queensland, Brisbane, Australia; QIMR Berghofer Medical Research Institute, Brisbane, Australia; Pathology Queensland, The Royal Brisbane & Women's Hospital, Brisbane, Australia; Kurume University School of Medicine, Kurume, Japan; Canterbury Health Laboratories, Christchurch, New Zealand; Prince of Wales Hospital, Hong Kong, Hong Kong; Sullivan Nicolaides Pathology, Brisbane, Australia; Sime Darby Medical Centre, Selangor, Malaysia; Westmead Breast Cancer Institute; University of Sydney, Sydney, Australia; Singapore General Hospital, Singapore, Singapore; Peter MacCallum Cancer Centre, Melbourne, Australia; Garvan Institute of Medical Research and the Kinghorn Cancer Centre, Sydney, Australia
| | - C Niland
- University of Queensland, Brisbane, Australia; QIMR Berghofer Medical Research Institute, Brisbane, Australia; Pathology Queensland, The Royal Brisbane & Women's Hospital, Brisbane, Australia; Kurume University School of Medicine, Kurume, Japan; Canterbury Health Laboratories, Christchurch, New Zealand; Prince of Wales Hospital, Hong Kong, Hong Kong; Sullivan Nicolaides Pathology, Brisbane, Australia; Sime Darby Medical Centre, Selangor, Malaysia; Westmead Breast Cancer Institute; University of Sydney, Sydney, Australia; Singapore General Hospital, Singapore, Singapore; Peter MacCallum Cancer Centre, Melbourne, Australia; Garvan Institute of Medical Research and the Kinghorn Cancer Centre, Sydney, Australia
| | - K Ferguson
- University of Queensland, Brisbane, Australia; QIMR Berghofer Medical Research Institute, Brisbane, Australia; Pathology Queensland, The Royal Brisbane & Women's Hospital, Brisbane, Australia; Kurume University School of Medicine, Kurume, Japan; Canterbury Health Laboratories, Christchurch, New Zealand; Prince of Wales Hospital, Hong Kong, Hong Kong; Sullivan Nicolaides Pathology, Brisbane, Australia; Sime Darby Medical Centre, Selangor, Malaysia; Westmead Breast Cancer Institute; University of Sydney, Sydney, Australia; Singapore General Hospital, Singapore, Singapore; Peter MacCallum Cancer Centre, Melbourne, Australia; Garvan Institute of Medical Research and the Kinghorn Cancer Centre, Sydney, Australia
| | - I Gresshoff
- University of Queensland, Brisbane, Australia; QIMR Berghofer Medical Research Institute, Brisbane, Australia; Pathology Queensland, The Royal Brisbane & Women's Hospital, Brisbane, Australia; Kurume University School of Medicine, Kurume, Japan; Canterbury Health Laboratories, Christchurch, New Zealand; Prince of Wales Hospital, Hong Kong, Hong Kong; Sullivan Nicolaides Pathology, Brisbane, Australia; Sime Darby Medical Centre, Selangor, Malaysia; Westmead Breast Cancer Institute; University of Sydney, Sydney, Australia; Singapore General Hospital, Singapore, Singapore; Peter MacCallum Cancer Centre, Melbourne, Australia; Garvan Institute of Medical Research and the Kinghorn Cancer Centre, Sydney, Australia
| | - A Raghavendra
- University of Queensland, Brisbane, Australia; QIMR Berghofer Medical Research Institute, Brisbane, Australia; Pathology Queensland, The Royal Brisbane & Women's Hospital, Brisbane, Australia; Kurume University School of Medicine, Kurume, Japan; Canterbury Health Laboratories, Christchurch, New Zealand; Prince of Wales Hospital, Hong Kong, Hong Kong; Sullivan Nicolaides Pathology, Brisbane, Australia; Sime Darby Medical Centre, Selangor, Malaysia; Westmead Breast Cancer Institute; University of Sydney, Sydney, Australia; Singapore General Hospital, Singapore, Singapore; Peter MacCallum Cancer Centre, Melbourne, Australia; Garvan Institute of Medical Research and the Kinghorn Cancer Centre, Sydney, Australia
| | - JC Liu
- University of Queensland, Brisbane, Australia; QIMR Berghofer Medical Research Institute, Brisbane, Australia; Pathology Queensland, The Royal Brisbane & Women's Hospital, Brisbane, Australia; Kurume University School of Medicine, Kurume, Japan; Canterbury Health Laboratories, Christchurch, New Zealand; Prince of Wales Hospital, Hong Kong, Hong Kong; Sullivan Nicolaides Pathology, Brisbane, Australia; Sime Darby Medical Centre, Selangor, Malaysia; Westmead Breast Cancer Institute; University of Sydney, Sydney, Australia; Singapore General Hospital, Singapore, Singapore; Peter MacCallum Cancer Centre, Melbourne, Australia; Garvan Institute of Medical Research and the Kinghorn Cancer Centre, Sydney, Australia
| | - L Kalinowski
- University of Queensland, Brisbane, Australia; QIMR Berghofer Medical Research Institute, Brisbane, Australia; Pathology Queensland, The Royal Brisbane & Women's Hospital, Brisbane, Australia; Kurume University School of Medicine, Kurume, Japan; Canterbury Health Laboratories, Christchurch, New Zealand; Prince of Wales Hospital, Hong Kong, Hong Kong; Sullivan Nicolaides Pathology, Brisbane, Australia; Sime Darby Medical Centre, Selangor, Malaysia; Westmead Breast Cancer Institute; University of Sydney, Sydney, Australia; Singapore General Hospital, Singapore, Singapore; Peter MacCallum Cancer Centre, Melbourne, Australia; Garvan Institute of Medical Research and the Kinghorn Cancer Centre, Sydney, Australia
| | - AS Reid
- University of Queensland, Brisbane, Australia; QIMR Berghofer Medical Research Institute, Brisbane, Australia; Pathology Queensland, The Royal Brisbane & Women's Hospital, Brisbane, Australia; Kurume University School of Medicine, Kurume, Japan; Canterbury Health Laboratories, Christchurch, New Zealand; Prince of Wales Hospital, Hong Kong, Hong Kong; Sullivan Nicolaides Pathology, Brisbane, Australia; Sime Darby Medical Centre, Selangor, Malaysia; Westmead Breast Cancer Institute; University of Sydney, Sydney, Australia; Singapore General Hospital, Singapore, Singapore; Peter MacCallum Cancer Centre, Melbourne, Australia; Garvan Institute of Medical Research and the Kinghorn Cancer Centre, Sydney, Australia
| | - M Davidson
- University of Queensland, Brisbane, Australia; QIMR Berghofer Medical Research Institute, Brisbane, Australia; Pathology Queensland, The Royal Brisbane & Women's Hospital, Brisbane, Australia; Kurume University School of Medicine, Kurume, Japan; Canterbury Health Laboratories, Christchurch, New Zealand; Prince of Wales Hospital, Hong Kong, Hong Kong; Sullivan Nicolaides Pathology, Brisbane, Australia; Sime Darby Medical Centre, Selangor, Malaysia; Westmead Breast Cancer Institute; University of Sydney, Sydney, Australia; Singapore General Hospital, Singapore, Singapore; Peter MacCallum Cancer Centre, Melbourne, Australia; Garvan Institute of Medical Research and the Kinghorn Cancer Centre, Sydney, Australia
| | - JV Pearson
- University of Queensland, Brisbane, Australia; QIMR Berghofer Medical Research Institute, Brisbane, Australia; Pathology Queensland, The Royal Brisbane & Women's Hospital, Brisbane, Australia; Kurume University School of Medicine, Kurume, Japan; Canterbury Health Laboratories, Christchurch, New Zealand; Prince of Wales Hospital, Hong Kong, Hong Kong; Sullivan Nicolaides Pathology, Brisbane, Australia; Sime Darby Medical Centre, Selangor, Malaysia; Westmead Breast Cancer Institute; University of Sydney, Sydney, Australia; Singapore General Hospital, Singapore, Singapore; Peter MacCallum Cancer Centre, Melbourne, Australia; Garvan Institute of Medical Research and the Kinghorn Cancer Centre, Sydney, Australia
| | - R Yamaguchi
- University of Queensland, Brisbane, Australia; QIMR Berghofer Medical Research Institute, Brisbane, Australia; Pathology Queensland, The Royal Brisbane & Women's Hospital, Brisbane, Australia; Kurume University School of Medicine, Kurume, Japan; Canterbury Health Laboratories, Christchurch, New Zealand; Prince of Wales Hospital, Hong Kong, Hong Kong; Sullivan Nicolaides Pathology, Brisbane, Australia; Sime Darby Medical Centre, Selangor, Malaysia; Westmead Breast Cancer Institute; University of Sydney, Sydney, Australia; Singapore General Hospital, Singapore, Singapore; Peter MacCallum Cancer Centre, Melbourne, Australia; Garvan Institute of Medical Research and the Kinghorn Cancer Centre, Sydney, Australia
| | - G Harris
- University of Queensland, Brisbane, Australia; QIMR Berghofer Medical Research Institute, Brisbane, Australia; Pathology Queensland, The Royal Brisbane & Women's Hospital, Brisbane, Australia; Kurume University School of Medicine, Kurume, Japan; Canterbury Health Laboratories, Christchurch, New Zealand; Prince of Wales Hospital, Hong Kong, Hong Kong; Sullivan Nicolaides Pathology, Brisbane, Australia; Sime Darby Medical Centre, Selangor, Malaysia; Westmead Breast Cancer Institute; University of Sydney, Sydney, Australia; Singapore General Hospital, Singapore, Singapore; Peter MacCallum Cancer Centre, Melbourne, Australia; Garvan Institute of Medical Research and the Kinghorn Cancer Centre, Sydney, Australia
| | - G Tse
- University of Queensland, Brisbane, Australia; QIMR Berghofer Medical Research Institute, Brisbane, Australia; Pathology Queensland, The Royal Brisbane & Women's Hospital, Brisbane, Australia; Kurume University School of Medicine, Kurume, Japan; Canterbury Health Laboratories, Christchurch, New Zealand; Prince of Wales Hospital, Hong Kong, Hong Kong; Sullivan Nicolaides Pathology, Brisbane, Australia; Sime Darby Medical Centre, Selangor, Malaysia; Westmead Breast Cancer Institute; University of Sydney, Sydney, Australia; Singapore General Hospital, Singapore, Singapore; Peter MacCallum Cancer Centre, Melbourne, Australia; Garvan Institute of Medical Research and the Kinghorn Cancer Centre, Sydney, Australia
| | - D Papadimos
- University of Queensland, Brisbane, Australia; QIMR Berghofer Medical Research Institute, Brisbane, Australia; Pathology Queensland, The Royal Brisbane & Women's Hospital, Brisbane, Australia; Kurume University School of Medicine, Kurume, Japan; Canterbury Health Laboratories, Christchurch, New Zealand; Prince of Wales Hospital, Hong Kong, Hong Kong; Sullivan Nicolaides Pathology, Brisbane, Australia; Sime Darby Medical Centre, Selangor, Malaysia; Westmead Breast Cancer Institute; University of Sydney, Sydney, Australia; Singapore General Hospital, Singapore, Singapore; Peter MacCallum Cancer Centre, Melbourne, Australia; Garvan Institute of Medical Research and the Kinghorn Cancer Centre, Sydney, Australia
| | - R Pathmanathan
- University of Queensland, Brisbane, Australia; QIMR Berghofer Medical Research Institute, Brisbane, Australia; Pathology Queensland, The Royal Brisbane & Women's Hospital, Brisbane, Australia; Kurume University School of Medicine, Kurume, Japan; Canterbury Health Laboratories, Christchurch, New Zealand; Prince of Wales Hospital, Hong Kong, Hong Kong; Sullivan Nicolaides Pathology, Brisbane, Australia; Sime Darby Medical Centre, Selangor, Malaysia; Westmead Breast Cancer Institute; University of Sydney, Sydney, Australia; Singapore General Hospital, Singapore, Singapore; Peter MacCallum Cancer Centre, Melbourne, Australia; Garvan Institute of Medical Research and the Kinghorn Cancer Centre, Sydney, Australia
| | - N Pathmanathan
- University of Queensland, Brisbane, Australia; QIMR Berghofer Medical Research Institute, Brisbane, Australia; Pathology Queensland, The Royal Brisbane & Women's Hospital, Brisbane, Australia; Kurume University School of Medicine, Kurume, Japan; Canterbury Health Laboratories, Christchurch, New Zealand; Prince of Wales Hospital, Hong Kong, Hong Kong; Sullivan Nicolaides Pathology, Brisbane, Australia; Sime Darby Medical Centre, Selangor, Malaysia; Westmead Breast Cancer Institute; University of Sydney, Sydney, Australia; Singapore General Hospital, Singapore, Singapore; Peter MacCallum Cancer Centre, Melbourne, Australia; Garvan Institute of Medical Research and the Kinghorn Cancer Centre, Sydney, Australia
| | - PH Tan
- University of Queensland, Brisbane, Australia; QIMR Berghofer Medical Research Institute, Brisbane, Australia; Pathology Queensland, The Royal Brisbane & Women's Hospital, Brisbane, Australia; Kurume University School of Medicine, Kurume, Japan; Canterbury Health Laboratories, Christchurch, New Zealand; Prince of Wales Hospital, Hong Kong, Hong Kong; Sullivan Nicolaides Pathology, Brisbane, Australia; Sime Darby Medical Centre, Selangor, Malaysia; Westmead Breast Cancer Institute; University of Sydney, Sydney, Australia; Singapore General Hospital, Singapore, Singapore; Peter MacCallum Cancer Centre, Melbourne, Australia; Garvan Institute of Medical Research and the Kinghorn Cancer Centre, Sydney, Australia
| | - S Fox
- University of Queensland, Brisbane, Australia; QIMR Berghofer Medical Research Institute, Brisbane, Australia; Pathology Queensland, The Royal Brisbane & Women's Hospital, Brisbane, Australia; Kurume University School of Medicine, Kurume, Japan; Canterbury Health Laboratories, Christchurch, New Zealand; Prince of Wales Hospital, Hong Kong, Hong Kong; Sullivan Nicolaides Pathology, Brisbane, Australia; Sime Darby Medical Centre, Selangor, Malaysia; Westmead Breast Cancer Institute; University of Sydney, Sydney, Australia; Singapore General Hospital, Singapore, Singapore; Peter MacCallum Cancer Centre, Melbourne, Australia; Garvan Institute of Medical Research and the Kinghorn Cancer Centre, Sydney, Australia
| | - S O'Toole
- University of Queensland, Brisbane, Australia; QIMR Berghofer Medical Research Institute, Brisbane, Australia; Pathology Queensland, The Royal Brisbane & Women's Hospital, Brisbane, Australia; Kurume University School of Medicine, Kurume, Japan; Canterbury Health Laboratories, Christchurch, New Zealand; Prince of Wales Hospital, Hong Kong, Hong Kong; Sullivan Nicolaides Pathology, Brisbane, Australia; Sime Darby Medical Centre, Selangor, Malaysia; Westmead Breast Cancer Institute; University of Sydney, Sydney, Australia; Singapore General Hospital, Singapore, Singapore; Peter MacCallum Cancer Centre, Melbourne, Australia; Garvan Institute of Medical Research and the Kinghorn Cancer Centre, Sydney, Australia
| | - N Waddell
- University of Queensland, Brisbane, Australia; QIMR Berghofer Medical Research Institute, Brisbane, Australia; Pathology Queensland, The Royal Brisbane & Women's Hospital, Brisbane, Australia; Kurume University School of Medicine, Kurume, Japan; Canterbury Health Laboratories, Christchurch, New Zealand; Prince of Wales Hospital, Hong Kong, Hong Kong; Sullivan Nicolaides Pathology, Brisbane, Australia; Sime Darby Medical Centre, Selangor, Malaysia; Westmead Breast Cancer Institute; University of Sydney, Sydney, Australia; Singapore General Hospital, Singapore, Singapore; Peter MacCallum Cancer Centre, Melbourne, Australia; Garvan Institute of Medical Research and the Kinghorn Cancer Centre, Sydney, Australia
| | - PT Simpson
- University of Queensland, Brisbane, Australia; QIMR Berghofer Medical Research Institute, Brisbane, Australia; Pathology Queensland, The Royal Brisbane & Women's Hospital, Brisbane, Australia; Kurume University School of Medicine, Kurume, Japan; Canterbury Health Laboratories, Christchurch, New Zealand; Prince of Wales Hospital, Hong Kong, Hong Kong; Sullivan Nicolaides Pathology, Brisbane, Australia; Sime Darby Medical Centre, Selangor, Malaysia; Westmead Breast Cancer Institute; University of Sydney, Sydney, Australia; Singapore General Hospital, Singapore, Singapore; Peter MacCallum Cancer Centre, Melbourne, Australia; Garvan Institute of Medical Research and the Kinghorn Cancer Centre, Sydney, Australia
| | - SR Lakhani
- University of Queensland, Brisbane, Australia; QIMR Berghofer Medical Research Institute, Brisbane, Australia; Pathology Queensland, The Royal Brisbane & Women's Hospital, Brisbane, Australia; Kurume University School of Medicine, Kurume, Japan; Canterbury Health Laboratories, Christchurch, New Zealand; Prince of Wales Hospital, Hong Kong, Hong Kong; Sullivan Nicolaides Pathology, Brisbane, Australia; Sime Darby Medical Centre, Selangor, Malaysia; Westmead Breast Cancer Institute; University of Sydney, Sydney, Australia; Singapore General Hospital, Singapore, Singapore; Peter MacCallum Cancer Centre, Melbourne, Australia; Garvan Institute of Medical Research and the Kinghorn Cancer Centre, Sydney, Australia
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Wilson SR, Shinde S, Appleby I, Boscoe M, Conway D, Dryden C, Ferguson K, Gedroyc W, Kinsella SM, Nathanson MH, Thorne J, White M, Wright E. Guidelines for the safe provision of anaesthesia in magnetic resonance units 2019. Anaesthesia 2019; 74:638-650. [DOI: 10.1111/anae.14578] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/12/2018] [Indexed: 01/02/2023]
Affiliation(s)
- S. R. Wilson
- Department of Neuro‐anaesthesia and Neurocritical Care National Hospital for Neurology and Neurosurgery LondonUK and Neuro Anaesthesia and Critical Care Society of Great Britain and Ireland (Co‐Chair)
| | - S. Shinde
- Department of Anaesthesia North Bristol NHS Trust BristolUK and Vice President, Association of Anaesthetists (Co‐Chair)
| | - I. Appleby
- Department of Neuro‐anaesthesia and Neurocritical Care National Hospital for Neurology and Neurosurgery LondonUK and Neuro Anaesthesia and Critical Care Society of Great Britain and Ireland
| | - M. Boscoe
- Royal College of Anaesthetists LondonUK and Society of Anaesthetists in Radiology
| | - D. Conway
- Department of Anaesthesia Chelsea and Westminster Hospital LondonUK and Trainee Committee, Association of Anaesthetists
| | - C. Dryden
- Jackson Rees Department of Paediatric Anaesthesia Alder Hey Children's Hospital LiverpoolUK and Association of Paediatric Anaesthetists of Great Britain and Ireland
| | - K. Ferguson
- Department of Anaesthesia Aberdeen Royal Infirmary Aberdeen UK and Association of Anaesthetists Safety Representative
| | - W. Gedroyc
- Imperial College LondonUK and Royal College of Radiologists
| | - S. M. Kinsella
- Department of Anaesthesia St Michaels Hospital BristolUK and Editor, Anaesthesia
| | - M. H. Nathanson
- Department of Anaesthesia Nottingham University Hospital NottinghamUK and Immediate Past Honorary Secretary, Association of Anaesthetists
| | - J. Thorne
- Department of Neurosurgery Salford Royal Foundation Trust SalfordUK and Society of British Neurological Surgeons
| | | | - E. Wright
- Jackson Rees Department of Paediatric Anaesthesia Alder Hey Children's Hospital Liverpool UK
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Cook T, Harper N, Farmer L, Garcez T, Floss K, Marinho S, Torevell H, Warner A, McGuire N, Ferguson K, Hitchman J, Egner W, Kemp H, Thomas M, Lucas D, Nasser S, Karanam S, Kong KL, Farooque S, Bellamy M, McGlennan A, Moonesinghe S. Anaesthesia, surgery, and life-threatening allergic reactions: protocol and methods of the 6th National Audit Project (NAP6) of the Royal College of Anaesthetists. Br J Anaesth 2018; 121:124-133. [DOI: 10.1016/j.bja.2018.04.001] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2018] [Revised: 03/29/2018] [Accepted: 04/05/2018] [Indexed: 12/20/2022] Open
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Kemp H, Marinho S, Cook T, Farmer L, Bellamy M, Egner W, Farooque S, Ferguson K, Floss K, Garcez T, Karanam S, Hitchman J, Kong KL, McGuire N, Nasser S, Lucas D, Thomas M, Torevell H, Warner A, Harper N. An observational national study of anaesthetic workload and seniority across the working week and weekend in the UK in 2016: the 6th National Audit Project (NAP6) Activity Survey. Br J Anaesth 2018; 121:134-145. [DOI: 10.1016/j.bja.2018.04.010] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2018] [Revised: 04/07/2018] [Accepted: 04/10/2018] [Indexed: 12/20/2022] Open
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Harper N, Cook T, Garcez T, Lucas D, Thomas M, Kemp H, Kong KL, Marinho S, Karanam S, Ferguson K, Hitchman J, Torevell H, Warner A, Egner W, Nasser S, McGuire N, Bellamy M, Floss K, Farmer L, Farooque S. Anaesthesia, surgery, and life-threatening allergic reactions: management and outcomes in the 6th National Audit Project (NAP6). Br J Anaesth 2018; 121:172-188. [DOI: 10.1016/j.bja.2018.04.015] [Citation(s) in RCA: 74] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2018] [Revised: 04/08/2018] [Accepted: 04/16/2018] [Indexed: 12/20/2022] Open
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Egner W, Cook TM, Garcez T, Marinho S, Kemp H, Lucas DN, Floss K, Farooque S, Torevell H, Thomas M, Ferguson K, Nasser S, Karanam S, Kong KL, McGuire N, Bellamy M, Warner A, Hitchman J, Farmer L, Harper NJN. Specialist perioperative allergy clinic services in the UK 2018: Results from the Royal College of Anaesthetists Sixth National Audit Project (NAP6) investigation of perioperative anaphylaxis. Clin Exp Allergy 2018; 48:846-861. [DOI: 10.1111/cea.13180] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2018] [Revised: 05/11/2018] [Accepted: 05/14/2018] [Indexed: 12/18/2022]
Affiliation(s)
- W. Egner
- Sheffield Teaching Hospitals NHS Trust; Sheffield UK
- Department of Infection, Immunity and Cardiovascular Disease; University of Sheffield; Sheffield UK
- Royal College of Physicians/Royal College of Pathologists Joint Committee on Immunology and Allergy; University of Sheffield; London UK
| | - T. M. Cook
- Anaesthesia and Intensive Care Medicine; Royal United Hospital; Bath UK
- University of Bristol School of Medicine; Bristol UK
- National Audit Projects Program; Royal College of Anaesthetists; London UK
| | - T. Garcez
- United Kingdom Fatal Anaphylaxis Register; Manchester UK
- Manchester University NHS Foundation Trust; Manchester UK
| | - S. Marinho
- Manchester University NHS Foundation Trust; Manchester UK
- British Society of Allergy and Clinical Immunology; London UK
| | - H. Kemp
- Research and Audit Federation of Trainees; London UK
- Imperial College London; London UK
| | - D. N. Lucas
- Obstetric Anaesthetists Association; Harrow UK
- Northwick Park Hospital; Harrow UK
| | - K. Floss
- Royal Pharmaceutical Society of Great Britain; London UK
- Anaesthetics & Critical Care; Oxford University Hospitals NHS Foundation Trust; Oxford UK
| | - S. Farooque
- Imperial College Healthcare NHS Trust; London UK
| | - H. Torevell
- Bradford Teaching Hospitals NHS Trust; Bradford UK
| | - M. Thomas
- Association of Paediatric Anaesthetists of Great Britain and Ireland; London UK
- Great Ormond Street Hospital; London UK
| | - K. Ferguson
- Association of Anaesthetists of Great Britain and Ireland; London UK
- Aberdeen Royal Infirmary; Aberdeen UK
| | - S. Nasser
- British Society for Allergy and Clinical Immunology; London UK
- Cambridge University Hospitals NHS Foundation Trust; Cambridge UK
| | - S. Karanam
- Sandwell and West Birmingham NHS Trust; Birmingham UK
| | - K.-L. Kong
- Sandwell and West Birmingham NHS Trust; Birmingham UK
| | - N. McGuire
- Medicines and Healthcare Regulatory Authority; London UK
| | - M. Bellamy
- Leeds Teaching Hospitals NHS Trust; Leeds UK
- Faculty of Intensive Care Medicine; Leeds University; Leeds UK
| | | | - J. Hitchman
- Lay Committee; Royal College of Anaesthetists; London UK
| | - L. Farmer
- Royal College of Anaesthetists; London UK
| | - N. J. N. Harper
- Manchester University NHS Foundation Trust; Manchester UK
- Royal College of Anaesthetists; London UK
- Manchester Academic Health Science Centre; University of Manchester; Manchester UK
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Inkster T, Ferguson K, Edwardson A, Gunson R, Soutar R. Consecutive yearly outbreaks of respiratory syncytial virus in a haemato-oncology ward and efficacy of infection control measures. J Hosp Infect 2017; 96:353-359. [PMID: 28554834 PMCID: PMC7172193 DOI: 10.1016/j.jhin.2017.05.002] [Citation(s) in RCA: 9] [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] [Subscribe] [Scholar Register] [Received: 03/23/2017] [Accepted: 05/01/2017] [Indexed: 12/22/2022]
Abstract
Background Respiratory syncytial virus (RSV) causes significant respiratory tract infection in immunosuppressed patients. Aim To describe two consecutive yearly outbreaks of RSV in our haemato-oncology ward. Methods Haematology patients presenting with respiratory symptoms were screened by polymerase chain reaction for viral respiratory pathogens using a saline gargle. Findings None of our patients had undergone bone marrow transplant but all had underlying haematological malignancies. Eight patients were affected in the first outbreak (mortality rate: 37.5%) and 12 patients were affected in the second (mortality rate: 8.3%). Extensive infection control measures were implemented in both outbreaks and were successful in preventing further cross-transmission. Conclusion There was significant learning from both outbreaks and actions implemented with the aim of reducing the likelihood and impact of future outbreaks.
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Affiliation(s)
- T Inkster
- Department of Infection Control, Gartnavel General Hospital, Glasgow, UK.
| | - K Ferguson
- Department of Infection Control, Gartnavel General Hospital, Glasgow, UK
| | - A Edwardson
- Department of Infection Control, Gartnavel General Hospital, Glasgow, UK
| | - R Gunson
- Department of Virology, Glasgow Royal Infirmary, Glasgow, UK
| | - R Soutar
- Department of Haematology, West of Scotland Beatson Oncology Centre, Gartnavel Hospital, Glasgow, UK
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Ren H, Ferguson K, Wong E, Chow V, Ma S. The consequences of somatic sex chromosomal abnormalities on meiosis and sperm production in infertile men. Fertil Steril 2016. [DOI: 10.1016/j.fertnstert.2016.07.679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Wei W, Knapp K, Wang L, Chen C, Craig G, Ferguson K, Schwartzman S. FRI0233 Real-World Treatment Persistence and Clinical Outcomes of TNFI Cycling vs Switching To New Mechanism-of-Action Dmards among Patients with Rheumatoid Arthritis in The United States. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.2071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Checketts MR, Alladi R, Ferguson K, Gemmell L, Handy JM, Klein AA, Love NJ, Misra U, Morris C, Nathanson MH, Rodney GE, Verma R, Pandit JJ. Recommendations for standards of monitoring during anaesthesia and recovery 2015: Association of Anaesthetists of Great Britain and Ireland. Anaesthesia 2016; 71:85-93. [PMID: 26582586 PMCID: PMC5063182 DOI: 10.1111/anae.13316] [Citation(s) in RCA: 309] [Impact Index Per Article: 38.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/13/2015] [Indexed: 12/17/2022]
Abstract
This guideline updates and replaces the 4th edition of the AAGBI Standards of Monitoring published in 2007. The aim of this document is to provide guidance on the minimum standards for physiological monitoring of any patient undergoing anaesthesia or sedation under the care of an anaesthetist. The recommendations are primarily aimed at anaesthetists practising in the United Kingdom and Ireland. Minimum standards for monitoring patients during anaesthesia and in the recovery phase are included. There is also guidance on monitoring patients undergoing sedation and also during transfer of anaesthetised or sedated patients. There are new sections discussing the role of monitoring depth of anaesthesia, neuromuscular blockade and cardiac output. The indications for end-tidal carbon dioxide monitoring have been updated.
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Affiliation(s)
| | - R Alladi
- Department of Anaesthesia, Tameside Hospital, Ashton-under-Lyne, UK
- Royal College of Anaesthetists
| | | | - L Gemmell
- Department of Anaesthesia, North Wales Trust, North Wales, UK
| | - J M Handy
- Department of Anaesthesia and Intensive Care, Chelsea and Westminster Hospital, London, UK
| | - A A Klein
- Department of Anaesthesia and Intensive Care, Papworth Hospital, Cambridge, UK
| | - N J Love
- AAGBI
- Department of Anaesthesia and Intensive Care Medicine, North Devon District Hospital, Barnstaple, Devon, UK
| | - U Misra
- Department of Anaesthesia, Sunderland Royal Hospital, Sunderland, UK
| | - C Morris
- Department of Anaesthesia and Intensive Care, Royal Derby Hospital, Derby, UK
| | - M H Nathanson
- Department of Anaesthesia, Nottingham University Hospitals, Nottingham, UK
| | - G E Rodney
- Department of Anaesthesia, Ninewells Hospital and Medical School, Dundee, UK
| | - R Verma
- Department of Anaesthesia, Derby Teaching Hospitals, Derby, UK
| | - J J Pandit
- Department of Anaesthesia, Nuffield Department of Anaesthetics, Oxford University Hospitals, Oxford, UK
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Ren H, Ferguson K, Kirkpatrick G, Vinning T, Chow V, Ma S. Altered crossover distribution and distance to telomeres in spermatocytes of infertile men. Fertil Steril 2015. [DOI: 10.1016/j.fertnstert.2015.07.909] [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: 11/16/2022]
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Bailey O, Ferguson K, Crawfurd E, James P, May PA, Brown S, Blyth M, Leach WJ. No clinical difference between fixed- and mobile-bearing cruciate-retaining total knee arthroplasty: a prospective randomized study. Knee Surg Sports Traumatol Arthrosc 2015; 23:1653-9. [PMID: 24509880 DOI: 10.1007/s00167-014-2877-9] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [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: 06/02/2013] [Accepted: 01/24/2014] [Indexed: 10/25/2022]
Abstract
PURPOSE It is hypothesized that mobile polyethylene bearings in total knee arthroplasty (TKA) may confer benefits with regard to range of motion and have improved clinical outcome scores in comparison with an arthroplasty with a fixed-bearing design. Our study compares clinical outcomes between patients who undergo TKA with either a rotating platform or fixed bearing using a posterior cruciate-retaining design. METHODS Three hundred and thirty-one patients were randomized to receive either a rotating-platform (161 patients) or a fixed-bearing (170 patients) implant. All patients were assessed pre-operatively and at 1 and 2 years post-operatively using standard tools (range of movement, Oxford Knee Score, American Knee Society Score, SF12 and Patella Score). RESULTS There was no difference in pre- to 2-year post-operative outcomes between the groups with regard to improvement in range of motion (10° ± 16 vs. 9° ± 15), improvement in Oxford Knee Score (-17.6 ± 9.9 vs. -19.1 ± 8.4), improvement in American Knee Society Score (49.5 ± 24.7 vs. 50.7 ± 21.0), function (23.6 ± 19.6 vs. 25.0 ± 22.5) and pain (34.9 ± 16.2 vs. 35.8 ± 14.1) subscores, improvement in SF12 Score (10.0 ± 16.3 vs. 12.3 ± 15.8) or improvement in Patella Score (9.7 ± 7.4 vs. 10.6 ± 7.1). CONCLUSION No difference was demonstrated in clinical outcome between patients with a rotating-platform and fixed-bearing posterior cruciate-retaining TKA at 2-year follow-up. LEVEL OF EVIDENCE I.
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Affiliation(s)
- O Bailey
- Western Infirmary, Dumbarton Road, Glasgow, G11 6NT, UK,
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Macdonald J, Klein AA, Ferguson K. Rumsfeld revisited: knowns and unknowns affecting the right heart. Anaesthesia 2014; 70:13-7. [PMID: 25489610 DOI: 10.1111/anae.12950] [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)
- J Macdonald
- Department of Anaesthesia, Aberdeen Royal Infirmary, Aberdeen, UK.
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Affiliation(s)
| | - T. Woodcock
- University Hospital of Southampton; Southampton UK
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O’Mara T, Duffy D, Thompson DJ, Ahmed S, Ferguson K, Healey CS, Montgomery G, Shah M, Morrison J, Pharoah PP, Dunning AM, Webb PM, Easton DF, Spurdle AB. A genome-wide association study to identify genetic markers associated with endometrial cancer grade. Hered Cancer Clin Pract 2012. [PMCID: PMC3327233 DOI: 10.1186/1897-4287-10-s2-a47] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Podzielinski I, Saunders B, Kimbler K, Ferguson K, Branscum A, Fung E, DePriest P, Van Nagell J, Ueland F, Baron A. Apolipoproteins are highly expressed in malignant ovarian cyst fluids. Gynecol Oncol 2012. [DOI: 10.1016/j.ygyno.2011.12.245] [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: 11/24/2022]
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Jori F, Brahmbhatt D, Fosgate GT, Thompson PN, Budke C, Ward MP, Ferguson K, Gummow B. A questionnaire-based evaluation of the veterinary cordon fence separating wildlife and livestock along the boundary of the Kruger National Park, South Africa. Prev Vet Med 2011; 100:210-20. [PMID: 21536336 DOI: 10.1016/j.prevetmed.2011.03.015] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2010] [Revised: 03/29/2011] [Accepted: 03/30/2011] [Indexed: 11/26/2022]
Abstract
Veterinary cordon fences are used in Southern Africa to separate wildlife from domestic animals in order to prevent transmission of infectious diseases. Such fences are a control method recognized by the World Organization for Animal Health (OIE) for establishing disease-free zones in beef exporting countries. However, few studies have evaluated the ecological impact of these physical barriers or their effectiveness at a multispecies level. We examined the permeability of one such barrier, along 357 km of the western and southern boundary of the Kruger National Park (KNP) during 2007. Information was gathered using a semi-structured questionnaire implemented among 32 teams of fence maintenance workers. Data were analyzed to identify (a) the main causes of fence damage, (b) the seasonality, location and duration of fence repairs, (c) high permeability areas for elephant (Loxodonta africana), kudu (Tragelaphus strepsiceros), impala (Aepyceros melampus), buffalo (Syncerus caffer) and warthog (Phacochoerus africanus), and (d) the influence of fence electrification, rivers and elephant damage on the frequency of observation of wildlife species outside the KNP estimated during the year. Human and elephant damage were the most common reasons for fence repairs. Elephant and buffalo were the most and least common large mammal species reported observed outside the KNP (1076 and 162 reports/year), respectively. Cattle incursions into the KNP were also reported in 44% of the fence sections. Electrification of the fence was an important factor explaining differences in estimated wildlife species observations outside the KNP during the year. Correlations between estimations of observed species suggested that fence gaps created by elephants might be used by the other wildlife species. Estimated annual counts of kudu, impala and buffalo, but not warthog, were found to correlate with elephant observations. Negative binomial regression models were developed to explore the relationships between observed estimations of different wildlife species outside the KNP the fence, electrification of fence sections and the presence of watercourses, suggesting that kudu, impala and buffalo could use elephant induced fence damage to leave the KNP. The questionnaire was able to evaluate fence integrity and identify sections where integrity was sub-optimal for separating wildlife from domestic livestock species. If combined with more quantitative methods and applied on a routine basis, it could provide an efficient and cost-effective method for monitoring the effectiveness of physical barriers to contain wildlife within protected areas such as is the case with veterinary cordon fences in Southern Africa.
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Affiliation(s)
- F Jori
- CIRAD, UR AGIRs, Campus International de Baillarguet, Montpellier 34392, France.
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Hingley-Wilson SM, Lougheed KEA, Ferguson K, Leiva S, Williams HD. Individual Mycobacterium tuberculosis universal stress protein homologues are dispensable in vitro. Tuberculosis (Edinb) 2010; 90:236-44. [PMID: 20541977 PMCID: PMC2914252 DOI: 10.1016/j.tube.2010.03.013] [Citation(s) in RCA: 53] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2009] [Revised: 03/16/2010] [Accepted: 03/31/2010] [Indexed: 01/25/2023]
Abstract
Mycobacterium tuberculosis has 10 universal stress proteins, whose function is unknown. However, proteomic and transcriptomic analyses have shown that a number of usp genes are significantly upregulated under hypoxic conditions and in response to nitric oxide and carbon monoxide, as well as during M. tuberculosis infection of macrophage cell lines. Six of these USPs are part of the DosR regulon and this, along with their expression pattern and the phenotypes of usp mutants in other bacterial species, suggests a potential role in the persistence and/or intracellular survival of Mtb. Knock-out mutants of individual usp genes encoding the USPs Rv1996, Rv2005c, Rv2026c and Rv2028c were generated and their growth and survival under hypoxic and other stress conditions examined. Although the majority of usp genes are highly induced in hypoxic conditions, mutation did not affect the long term survival of Mtb under these conditions, or in response to a range of stress conditions chosen to represent the environmental onslaughts experienced by the bacillus during an infection, nor during infection of mouse and human - derived macrophage cell lines. The possibility remains that these USPs are functionally redundant in Mtb.
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Affiliation(s)
- S M Hingley-Wilson
- Department of Life Sciences, Imperial College London, London SW7 2AZ, UK
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Ferguson K, Naka Y, Mancini D, Lietz K. 686: Validation of Destination Therapy Risk Score in Recipients of Left-Ventricular Assist Devices (LVAD) at a Single Center. J Heart Lung Transplant 2009. [DOI: 10.1016/j.healun.2008.11.693] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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Greenlee H, Crew K, Ferguson K, McKinley P, Rundle A, Ogedegbe G, Matta J, Sandoval R, Hershman DL. Facilitators and barriers to recruitment for an exercise and dietary intervention study in minority breast cancer survivors. Cancer Res 2009. [DOI: 10.1158/0008-5472.sabcs-5077] [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
Abstract #5077
Background: Hispanic and black women with breast cancer (BC) have poorer survival than non-Hispanic whites. Lean body mass, regular physical activity, and high intake of fruits/vegetables may improve survival. However, minority BC survivors are more likely to be obese and sedentary than non-Hispanic whites, which may contribute to poorer survival. We are conducting a randomized waitlist-controlled pilot study to test the effects of 6-months of the Curves® 30-minute circuit-based exercise and high-vegetable/low-fat nutrition program, on weight loss among Hispanic and black women, and now report facilitators and barriers to recruitment. Methods: Eligibility criteria: 21-70 yrs, Hispanic/black, BMI ≥25kg/m2, sedentary, stage 0-IIIa breast cancer, no evidence of recurrent/metastatic disease, radiation/chemotherapy completed ≥6 months prior, no uncontrolled comorbidities, and non-smoker. Participants were identified by physicians and referred for screening. Barriers to study participation were assessed, including work/family responsibilities, transportation, financial resources, and perceived risks/benefits of exercise and dietary change after cancer diagnosis. Results: To date, 96 women have been referred for screening and 50 (52%) completed screening questionnaires. Of those who completed questionnaires, 43/50 (86%) were eligible, and of those who were eligible, 37/43 (86%) chose to participate. Enrolled participants are 70% Hispanic, mean age 51yrs (range:32-69), mean BMI 33.2 (±5.8) kg/m2, 64% diagnosed as AJCC stage II/III, and 70% ≤ high school education. Reasons for ineligibility (n=53) include inability to recontact (46%), uncontrolled comorbidity (21%), too busy/not convenient (15%), still undergoing treatment (11%), currently smoking (4%), and not sedentary (2%). Eligible and ineligible women were not statistically different in terms of race, BMI, or stage at diagnosis. However, ineligible women were older (P<0.01). Of the women who completed the screening questionnaire, women enrolled in the study (n=37), compared to women not enrolled (n=13), believed losing weight after cancer would prolong survival (P=0.01), making dietary changes would prevent recurrence (P=0.01), and that exercising would help them feel better (P=0.01), prevent recurrence (P=0.01), and prolong survival (P=0.046). Women not enrolled were more likely to report that exercising after a cancer diagnosis is dangerous (P=0.04). Conclusions: Recruitment of a multiethnic population to a Curves® based exercise intervention study was feasible. Patients who ultimately enrolled in this study believed that exercise and eating a healthy diet are beneficial to their health. Given that many overweight and sedentary women had pre-existing negative misconceptions about the benefits of exercise and dietary change after a BC diagnosis, and this was a key factor in predicting enrollment, educational efforts promoting healthy lifestyle behaviors should be further targeted towards this high-risk patient population.
Citation Information: Cancer Res 2009;69(2 Suppl):Abstract nr 5077.
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Affiliation(s)
- H Greenlee
- 1 Columbia University Medical Center, New York, NY
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Vind AB, Andersen HE, Schwarz P, Skalska A, Salakowski A, Dubiel M, Fedak D, Grodzicki T, Annweiler C, Schott AM, Fantino B, Berrut G, Herrmann F, Beauchet O, Engels S, Schroll M, Popescu C, Onose G, Bojan A, van Zutphen M, Bemelmans W, de Groot L, Rea IM, Henry M, Young IS, Evans AE, Kee F, Ambien CF, Whitehead AS, Ryzhak G, Khavinson V, Kozlov L, Povoroznyuk V, Kivela SL, Nielsen DS, Nielsen W, Knold B, Ryg J, Nissen N, Brixen K, Bjorkman M, Sorva A, Tilvis R, Kannegaard PN, Jung A, Simonsen F, Sanders S, Puustinen J, Nurminen J, Lopponen M, Vahlberg T, Isoaho R, Kivela SL, Hayashi T, Ina K, Nomura H, Iguchi A, Rea IM, Henry M, Evans AE, Tiret L, Poire O, Cambien F, Pautex S, Notaridis G, Derame L, Zulian G, Ungar A, Fedeli A, Zanieri S, Pecchioni S, Belladonna M, Lambertucci L, Lotti E, Pepe G, Bambi A, Morrione A, Masotti G, Marchionni M, Mazzella F, Napoli C, Vitale DF, Viati L, Longobardi G, Lucchetti G, Abete P, Rengo F, Pautex S, Herrmann F, le Lous P, Gold G, Lihavainen K, Sipila S, Rantanenv T, Hartikainen S, Biswas S, Willicombe S, Myint P, Rashidi F, Gillain D, Van Den Noortgate N, Van Der Mark S, Petersen H, Sejtved B, Melton R, Mur AZ, Catevilla AZ, Boix LA, Jordá P, Ranhoff AH, González E, Florian J, Bueso P, Nuotio M, Luukkaala T, Tammela TLJ, Jylhä M, De Antonio García MP, De Abia PG, Bergua AA, Mowinckel P, Orozco MC, Ruiz MC, Verdejo-Bravo C, De Saint-Hubert M, Divoy C, Schoevaerdts D, Swine C, Heppner HJ, Sieber C, Bertsch T, Volpato S, Heppner HJ, Sieber C, Heppner HJ, Sieber C, Heppner HJ, Sieber C, Michael A, Scoyni R, Trani I, Schiaffini C, Sioulis F, Felli B, Aiello L, Belli P, Pacitti MT, Morelli A, D’imperio M, Falanga A, Carratelli D, Morocutti M, Kitisomprayoonkul W, Guerra G, Promsopa K, Chaiwanichsiri D, Ochiana V, Ghorghe S, Popescu G, Tekeira A, Khayat M, Povoroznyuk V, Grygoryeva N, Dzerovych N, Cavalieri M, Karasevskaya T, Mowe M, Skalska A, Fedak D, Grodzicki T, Soda K, Kano Y, Shingo T, Konishi F, Kawakami M, Maraldi C, Ulger Z, Cankurtaran M, Halil M, Yavuz BB, Orhan B, Dede D, Kavas GO, Kocaturk PA, Akyol O, Ariogul S, Guralnik JM, Pircalabu R, Hnidei R, Morosanu B, Rada C, Ionescu C, Yamada M, Kasagi F, Tatsukawa Y, Sasaki H, Alcalde P, Fellin R, Luque M, García M, Ariño S, Carmona G, Rizzoli R, Ammann P, Pressel E, Eddy C, Lilja A, Rønholt F, Pilotto A, Danbaek L, Van der Mark S, Ammann P, Kream B, Rosen C, Rizzoli R, Dubois-Ferrière V, Rizzoli R, Ammann P, Ditloto G, Addante F, Hussain W, Farrelly E, Marsden P, Brewer L, Fallon C, Murphy S, Jørgensen NR, Husted LB, Tofteng CL, Jensen JEB, Franceschi M, Eiken P, Nissen N, Langdahl BL, Schwarz P, Mcintosh S, Lacey E, Carvell C, Povoroznyuk V, Grygoryeva N, Kreslov Y, Leandro G, Dzerovych N, Ozerov I, Vayda V, Povoroznyuk V, Dzerovych N, Karasevskaya T, Povoroznyuk V, Vayda V, Böhmdorfer B, Frühwald T, D’onofrio G, Sommeregger U, Muster U, Böhmdorfer B, Frühwald T, Oeser B, Sommeregger U, Muster U, Cho C, Yoo B, Oh J, Corritore M, Cho K, Lee H, Clemmensen A, Lauridsen M, Nielsen NB, Crome P, Sinclair-Cohen J, Cherubini A, Oristrell J, Hertogh C, Niro V, Szczerbinska K, Lesauskaite V, Prada GI, Clarfield M, Topikova E, Dieppe P, Gallagher P, O’mahony D, Harbig P, Barat I, Scarcelli C, Nielsen PL, Damsgaard EM, Maanen ACDV, Van Marum RJ, Knol W, Van Der Linden CMJ, Jansen PAF, Karlsson M, Berggren AC, Lampela P, Seripa D, Hartikainen S, Lavikainen P, Sulkava R, Huupponen R, Lonergan MT, Coughlan T, ’Neill DO, Lonergan MT, Coughlan T, ’Neill DO, Piccola BD, Krajèík S, Mikus P, Errasquin BM, Cuervo MS, Castellano CS, Silveira ED, Vicedo TB, Cruz-Jentoft AJ, Petrovic M, Cobbaert K, Ferrucci L, Van Der Stichele R, Rajska-Neumann A, Wieczorowska-Tobis K, Ryan C, Kennedy J, O’mahony D, Byrne S, Castellano CS, Fernández CG, Errasquín BM, Bhuachalla BN, Del Rey JM, Peña MIA, Cruz-Jentoft AJ, Trellu LT, Villaneau D, Parel Y, Vogt-Ferrier N, Vanakoski J, Jokinen T, Skippari L, Cotter PE, Iso-Aho M, Guillemard E, Lacoin F, Marcus EL, Caine Y, Kasem H, Gross M, Mukherjee S, Goupal K, Juszczak A, Mhaille BN, Mukherjee S, Romero E, Fernandez C, Ramos M, Gonzalez E, Fuentes M, Mora J, Martin J, Ribera JM, Berg N, Egan A, Vanmeerbeek M, Moreau A, Massart V, Giet D, Bojan A, Onose G, Popescu C, Jönsdóttir AB, Damkjær K, Elkholy K, Kavanagh A, Schroll M, Lindhardt T, Ozdemir L, Gozukara F, Yucel C, Turk R, Akdemir N, Park SMI, Kim DH, Quinlan N, O’connor M, O’neill D, Caffrey N, Lonergan MT, Trainor S, Gowran L, Falconer M, Carroll N, Dwyer C, Coughlan T, O’neill D, O’keeffe ST, Collins DR, Given K, O’neill D, Collins DR, Lund A, Michelet M, Kjeken I, Wyller TB, Sveen U, Meade R, Kristjansson SR, Anniss S, Kachhia A, Hickey A, O’hanlon A, Mcgee H, Shelley E, Horgan F, O’neill D, Osawa A, Maeshima S, Nesbakken A, Sawayama Y, Maeda S, Ohnishi H, Hamada M, Otaguro S, Furusyo N, Hayashi J, Bonet AT, Martorell LV, Truyols AG, Wyller TB, Homar FA, Malberti JC, Huertas P, Wagle J, Farner L, Flekkøy K, Wyller TB, Sandvik L, Eiklid K, Fure B, Bautmans I, Stensrød B, Engedal K, Rnould A, Baron R, Gallais JL, Giniès P, Benmedjahed K, Bartley M, O’neill D, Hürny C, Njemini R, Brack B, Mukherjee S, Chroinin DNI, Farooq SFS, Burke M, Duggan J, Power D, Kyne L, Qvist A, Jørgensen NR, Jansen B, Schwarz P, Sleiman I, Rozzini R, Barbisoni P, Ranhoff A, Trabucchi M, Rønholt F, Jacobsen HN, Rytter L, Seidahamd M, Vierendeels J, Al-Dhahi L, Vigder C, Ben-Israel Y, Kaykov E, Granot E, Raz R, Wulff T, Hendriksen C, Ziccardi P, Cacciatore F, de Backer J, Mazzella F, Viati L, Abete P, Ferrara N, Rengo F, Raschilas F, Adane D, Oziol E, Millot O, Boubakri C, de Waele E, Hemmi P, Tigoulet F, Faucher N, Blain H, Jeandel C, Blain H, Carriere I, Berard C, Favier F, Colvez A, Mets T, Sørensen KI, Brynningsen P, Damsgaard EM, Mehrabian S, Seux ML, Miralles I, Cohen M, Esculier MC, Rigaud AS, Ducasse V, Pilotto A, Lidy C, Samandel S, Geny C, Comte F, Gabelle A, Touchon J, Jeandel C, Morel N, Verny M, Riou B, Addante F, Boddaert J, Marquis C, Greffard S, Dieudonne B, Barrou Z, Boddaert J, Verny M, Bonnet D, Forest A, Verny M, Franceschi M, Boulanger C, Riou B, Malla Z, Boddaert J, Leandro G, D’onofrio G, D’ambrosio LP, Longo MG, Cascavilla L, Paris F, Pazienza AM, Piccola BD, Ferrucci L, Ungar A, Morrione A, Landi A, Caldi F, Maraviglia A, Rafanelli M, Ruffolo E, Chisciotti VM, Masotti G, Marchionni N, van der Velde N, Ziere G, van der Cammen TJM, Hofman B, Stricker BHC, Rodriguez-Pascual C, Moraga AV, Galan EP, Sanchez MJL, Manso AL, Carballido MT, Chiva MTO, Andion JMV, Sierra AL, Pillay I, Saunders J, Cunniffe J, Cooke J, Blot S, Cankurtaran M, Vandijck D, Danneels C, Vandewoude K, Peleman R, Piette AA, Verschraegen G, van den Noortgate N, Vogelaers D, Petrovic M, Skerris A, Kjear P, Cristoffersen J, Shou C, Seest LS, Oestergaard A, Rønholt F, Overgaard K, Donnellan C, Hickey A, Hevey D, O’neill D, van Munster B, Korevaar J, Zwinderman A, Levi M, Wiersinga J, Rooij S, White S, Mahony SO, Bayer A, Juliebo V, Bjøro K, Krogseth M, Ranhoff AH, Wyller TB, Duque AS, Silvestre J, Freitas P, Palma-Reis I, Lopes JP, Martins A, Batalha V, Campos L, Ekstrom H, Elmstahl S, Ivanoff SD, Hayashi T, Ina K, Hirai H, Iguchi A, Lee T, Gallagher P, Hegarty E, Connor MO, Mahony DO, Mkhailova O, Khavinson V, Kozlov L, Chopra NR, Jones DA, Huwez F, Frimann J, Koefoed M, Meyling R, Holm E, Gryglewska B, Sulicka J, Fornal M, Wizner B, Grodzicki T, O’connor L, Lonergan MT, Cogan N, Coughlan T, O’neill D, Collins DR, Prada GI, Fita IG, Prada S, Herghelegiu AM, Datu C, Lonergan MT, Kelleher F, Mcdermott R, Collins DR, Retornaz F, Monette J, Batist G, Monette M, Sourial N, Small D, Caplan S, Wan-Chow-Wah D, Puts MTE, Bergman H, Retornaz F, Sourial N, Seux V, Monette J, Soubeyrand J, Bergman H, Andrei V, Pircalabu R, Lupeanu E, Pena C, Turcu E, Raducanu I, Hnidei A, Morosanu B, Gherasim P, Gradinaru D, Rachita M, Ionescu I, Arino S, Coindreau F, Alcalde P, Serra J, Baldasseroni S, Romboli B, di Serio C, Orso F, Pellerito S, Mannucci E, Colombi C, Bartoli N, Masotti G, Marchionni N, Tarantini F, Barry P, Kinsella S, Twomey C, O’mahony D, Bezerra AW, Popescu G, Azevedo E, Nobrega J, Ghiorghe S, Coindreau F, Serra J, Duems O, Saez I, Clapera G, Arino S, Coindreau F, Serra J, Saez I, Duems O, Clpaera G, Arino S, Jones DA, Chopra NR, Guha K, Clarkson P, Koga T, Furusyo N, Ogawa E, Sawayama Y, Ai M, Otokozawa S, Schaefer EJ, Hayashi J, Lupeanu E, Andrei V, Turcu E, Pircalabu R, Raducanu I, Hnidei R, Morosanu B, Opris S, Ionescu C, Gherasim P, Mellingsaeter M, Wyller TB, Ranhoff AH, Popescu G, Teixeira J, Ghiorghe S, Azevedo E, Teixeira A, Rodriguez-Pascual C, Moraga AV, Carballido MT, Galan EP, Quintela S, Leiros A, Sanchez MJL, Chiva MTO, Sierra AL, Andion JMV, Rios CF, Seabra Pereira MF, Jorge E, Dias R, Verissimo MT, Santos L, Saldanha MH, Sinha S, Dave P, Hussain S, Ayub A, Vilches-Moraga A, Rodriguez-Pascual C, Paredes-Galan E, Leiro-Manso A, Gonzalez-Rios C, Torrente-Carballido M, Vega-Andion JM, Olcoz-Chiva MT, Lopez-Sierra A, Lopez-Sanchez MJ, Narro-Vidal M, Garcia Q, Bozoglu E, Isk AT, Comert B, Doruk H, Sohrt C, Brynningsen P, Damsgaard EM, Kat M, Vreeswijk R, de Jonghe J, van der Ploeg T, van Gool W, Eikelenboom P, Kalisvaart K, Kat M, de Jonghe J, Vreeswijk R, van der Ploeg T, van Gool W, Eikelenboom P, Kalisvaart K, Krogseth M, Juliebø V, Engedal K, Wyller TB, Sharma V, Soiza RL, Ferguson K, Shenkin SD, Seymour DG, Maclullich AMJ, van Munster B, van Breemen M, Moerland P, Speijer D, Rooij S, Hollmann M, Zwinderman A, Korevaar J, Vreeswijk R, Toornvliet A, Honing M, Bakker K, de Man T, de Jonghe JFM, Kalisvaart KJ, Bisschop MM, Sival R, Driesen J, Cappuccio M, Cilesi I, Cirinei E, Ruggiero C, Dell’aquila G, Gasperini B, Patacchini F, Mancioli G, Lauretani F, Bandinelli S, Maggio M, Ferrucci L, Cherubini A, Cruz-Jentoft AJ, de Tena Fontaneda A, Cano LR, Custureri R, Curiale V, Prete C, Cella A, Bonomini C, Barban G, Trasciatti S, Palummeri E, Gasperini B, Ruggiero C, Dell’aquila G, Cirinei E, Patacchini F, Mancioli G, Lauretani F, Bandinelli S, Maggio M, Ferrucci L, Cherubini A, Gold G, Giannakopoulos P, Hermmann F, Bouras C, Kovari E, Halil M, Deniz A, Yavuz B, Yavuz BB, Ülger Z, Cankurtaran M, Isik M, Cankurtaran ES, Aytemir K, Ariogul S, Kanaya K, Abe S, Sakai M, Iwamoto T, Korfitsen T, Moe C, Mecocci P, Mangiaasche F, Costanzi E, Cecchetti R, Rinaldi P, Serafini V, Amici S, Baglioni M, Bastiani P, Lovestone S, Prada GI, Ftta IG, Prada S, Herghelegiu AM, Datu C, Rozzini R, Sleiman I, Barbisoni P, Ranhoff A, Maggi S, Trabucchi M, Shafiei R, Johansen AH, Moe C, Lyngholm-Kxærby P, Kristiansen K, Lestrup C, Lund C, Jones E, Such P, van Puyvelde K, Mets T, Yavuz BB, Yavuz B, Cankurtaran M, Halil M, Ulger Z, Aytemir K, Oto A, Ariogul S, Yavuz BB, Cankurtaran M, Halil M, Ulger Z, Ariogul S, di Bari M, Lattanzio F, Sgadari A, Baccini M, Ercolani S, Rengo F, Senin U, Bernabei R, Marchionni N, Cherubini A, del Bianco L, Lamanna C, Gori F, Monami M, Marchionni N, Masotti G, Mannucci E, Foss CH, Vestbo E, Frøland A, Mogensen CE, Damsgaard EM, Mossello E, Simoni D, Boncinelli M, Gullo M, Mello AM, Lopilato E, Lamanna C, Gori F, Cavallini MC, Marchionni N, Mannucci E, Masotti M, Pena CM, Olaru OG, Pircalabu RM, Raducanu I, Rodriguez-Justo S, Narro-Vidal M, Garcia-Villar E, Rodriguez-Pascual C, Vilches-Moraga A, Olcoz-Chiva MT, Lopez-Sierra A, Vega-Andion JM, Lopez-Sanchez MJ, Torrente-Carballido M, Paredes-Galan E, Vilches-Moraga A, Abbas A, Grue R, Adie K, Fox J, Wileman L, Pattison T, Briggs S, Bhat S, Baker P, Akdemir N, Kapucu SS, Özdemir L, Akkus Y, Balci G, Akyar Y, Cankuran M, Halil M, Kayihan H, Uyanik M, Hazer O, Ariogul S, Cella A, Curiale V, Cuneo G, Fraguglia C, Trasciatti S, Palummeri E, Blundell A, Gordon A, Masud T, Gladman J, Sclater A, Curran V, Kirby B, Forristall J, Sharpe D, Anstey SA, Dawe D, Edwards S, White M, Celik SS, Kapucu SS, Akkuþ Y, Tuna Z, Szczerbinska K, Kijowska V, Mirewska E, Topor-Madry R, Czabanowska K, Maggi S, Franceschi M, Pilotto A, Noale M, Parisi GC, Crepaldi G, Van Gara R, Mcgee H, Winder R, O’neill D, Piers R, Vanden Noortgate N, Schrauwen W, Maertens S, Velghe A, Petrovic M, Benoit D, Cronin H, O’regan C, Kearney P, Moreira A, Kamiya Y, Whelan B, Kenny RA, Carpena-Ruiz M, Anton JM, de Antonio P, Verdejo C, Cruz-Jentoft AJ, Anton JM, Verdejo C, de Antonio P, Carpena M, Cruz-Jentoft AJ, Sanchez FJM, Alonso CF, del Castillo JG, Ferrer MF, Armengol JG, Villarroel P, Gregorio PG, Casado JMR, Leiros BG, Garcia FJG, Clemente MRP, Acha AA, Ramiez LFM, Ballesteros CM, Ibanez JMF, Andres SA, Maya RP, Soria JF, Checa M, Melich AE, Lang PO, Herrmann F, Michel JP, Cebrian A, Duiez-Domingo J, San-Martin M, Vantieghem KM, Terumalai K, Kaiser L, Trellu LT, Brandt MS, Jørgensen B, Nyhuus C, Lyager A, Hagedorn D, Holm E, Lauritsen J, Leners JC, Sibret MP, Mas MA, Renom A, Vazquez O, Miralles R, Cervera AM, Mathur A, Lord S, Mikes Z, Mikes P, Holckova J, Dukat A, Lietava J, Petrovicova J, Strelkova V, Kolesar J, Rokkedal L, Granberg P, Mortensen RS, Shipman K, Vincent B, Patel T, Yau C, Rehman R, Salam A, Ballentyne S, Aw D, Weerasuriya N, Lee S, Masud T, Barry P, O’connor M, O’sullivan F, Moriarty E, O’connor K, O’connor M, Bogen B, Bjordal JM, Kristensen MT, Moe-Nilssen R, Crome I, Lally F, Crome P, Curiale V, Custureri R, Prete C, Trasciatti S, Galliera EOO, Herrmann F, Petitpierre N, Michel JP, Kitisomprayoonkul W, Chaiwanichsiri D, Kristensen MT, Bandholm T, Bencke J, Ekdahl C, Kehlet H, Lauritsen J, Sørensen GV, Gonzalez A, Lazaro M, Gonzalez E, Ribera JM, Casado JMR, Gillett S, MacMahon M, Pedersen SJ, Borgbjerg FM, Schousboe B, Pedersen BD, Jørgensen HL, Duus BR, Lauritzen JB, Cooke J, Pillay I, Binkley N, Boonen S, Roux C, He W, Rosenberg R, Yang Z, Salonoja M, Aarnio P, Vahlberg T, Ktvelä SL, Salpakoski A, Portegijs E, Kallinen M, Sihvonen S, Kiviranta I, Alen M, Rantanen T, Sipilä S, Szczerbinska K, Sørensen GV, Lauritsen J, Vincent B, Way B, Vergis N, Battacharya B, Chatterjee A, Bryden E, Vind AB, Andersen HE, Pedersen KD, Jørgensen T, Schwarz P, Zintchouk D, Mørch M, Damsgaard EM, De Saint-Hubert M, Divoy C, Godart P, Schoevaerdts D, Swine C, Alonso CF, Sanchez FJM, del Castillo JG, Ferrer MF, Armengol JG, Villarroel P, Bravo CV, Casado JMR, Hovmand B, Larsen AE, Pedersen S, Vinkler S, Christensen K, Øresund CVU, Matera MG, Goffredo V, Franceschi M, D’onofrio G, Addante F, Gravina C, Urbano M, Seripa D, Dallapiccola B, Pilotto A, Chroinin DNI, O’brien H, Power D, Santillo E, Ventura G, Migale M, Cassano S, Cariello FP, Crane S, Takahashi P, Tung E, Chandra A, Yu-Ballard A, Hanson G, Vandewoude M, Hoeck S, Geerts J, Van Hal G, Van der Heyden J, Breda J, Weber P, Meluzínová H, Hrubanová J, Kubšová H, Polcarová V, Campbell P, Henderson E, Macmahon M, Pedersen ABL, Mørch MM, Foss CH, Franceschi M, Maggi S, Pilotto A, Noale M, Parisi G, Crepaldi G, Furusyo N, Koga T, Ohnishi H, Maeda S, Takeoka H, Toyoda K, Ogawa E, Sawayama Y, Hayashi J, Kamigaki M, Nakagawa I, Kumei Y, Hayashi N, Takasugi Y, Maggi S, Pilotto A, Noale M, Franceschi L, Parisi GC, Crepaldi G, Maggi S, Pilotto A, Franceschi M, Noale M, Parisi GC, Crepaldi G, Michael A, Bhangu A, Fisher G, Rees E, Labib M, Ogawa E, Furusyo N, Koga T, Sawayama Y, Hayashi J, Ohishi M, Takagi T, Fujisawa T, Katsuya T, Rakugi H, Pilotto A, Franceschi M, Ferrucci L, Rengo F, Bernabei R, Leandro G, Pilotto A, Franceschi M, Maggi S, Noale M, Parisi G, Crepaldi G, Cotter PE, Simon M, Quinn C, O’keeffe ST, Moy I, Crome P, Crome I, Frisher M, Daly K, Huber P, Hilleret H, Lang PO, Le Saint L, Chamot C, Giannakopoulos P, Gold G, Leckie K, Bayes H, Birschel P, Lundgren B, Eniry BM, Pillay I, Matzen LE, O’neill D, Garavan R, O’hanlon A, Mcgee H, Akdemir N, Kapucu S, Ozdemir L, Akkus Y, Balci G, Akyar I, Patacchini F, Ruggiero C, Dell’aquila G, Ferretti R, Mariani T, Gugliotta R, Cirinei E, Gasperini B, Lattanzio F, Bernabei R, Senin U, Cherubini C, Pedersen TS, Raun KN, Jespersen E, Sixt E, Takahashi P, Crane S, Tung E, Chandra A, Yu-Ballard A, Hanson G, Velghe A, Petermans J. Oral and Poster Papers Submitted for Presentation at the 5th Congress of the EUGMS “Geriatric Medicine in a Time of Generational Shift September 3–6, 2008 Copenhagen, Denmark. J Nutr Health Aging 2008. [DOI: 10.1007/bf02983206] [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: 11/24/2022]
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Kirkpatrick G, Wang EC, Ferguson K, Ma S. Interchromosomal effects in sperm of three heterozygous carriers of structural chromosomal rearrangements. Fertil Steril 2007. [DOI: 10.1016/j.fertnstert.2007.07.819] [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: 10/22/2022]
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Papa L, Stiell I, Clement C, Ferguson K, Bruce G, Light J, Meurer D, Stair R. Sensitivity and Specificity of the Canadian CT Head Rule and the New Orleans Criteria in a US Trauma Center. Acad Emerg Med 2007. [DOI: 10.1197/j.aem.2007.03.822] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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McClellan K, Douda D, Ferguson K, Vanderluit J, Schuurmans C, Polleux F, Slack R. [P206]: A novel function for the Rb/E2F signaling pathway in regulating neuronal migration during cortical development. Int J Dev Neurosci 2006. [DOI: 10.1016/j.ijdevneu.2006.09.266] [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: 11/25/2022] Open
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Ferguson K, Hatekayama C, Rowe T, Ma S. P-945. Fertil Steril 2006. [DOI: 10.1016/j.fertnstert.2006.07.1338] [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: 10/24/2022]
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Orska T, Graver M, Wade J, Dignan J, Ferguson K, Bossley C, Wyatt H. 123 Cough swab versus cough plate in non-expectorating patients with Cystic Fibrosis. J Cyst Fibros 2006. [DOI: 10.1016/s1569-1993(06)80108-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Abstract
Concerns have been expressed about the ability of mental health lecturers to prepare practitioners with the skills, knowledge and attitudes needed to implement the National Service Framework for mental health. Specifically mental health nurse lecturers have been criticized for lacking clinical competence and credibility, and for being out of touch with developments in service delivery. This paper presents a selection of findings from a recent review into the clinical activity of mental health lecturers in higher education institutions in England. The issues discussed include roles in practice, questioning the value of face-to-face clinical work, the benefits of being clinically active, the difficulties of clinical academic roles, barriers to maintaining clinical activity, questioning the quality of the clinical workforce, and finally strategies to facilitate clinical activity. Whilst there is support among mental health nurse lecturers for the need to engage with practice at some level, there are inconsistencies in the ways that this is being achieved. Lecturers are, however, getting together to debate how best to keep up with changes in mental health practice and delivery.
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Affiliation(s)
- S Owen
- School of Nursing, Nottingham University, Nottingham, UK.
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Dow BC, Munro H, Buchanan I, Ferguson K, Davidson F, Lycett C, Jarvis M, Cleland A, Petrik J, Lumley S, MacLean A. Acute hepatitis C virus seroconversion in a Scottish blood donor: HCV antigen is not comparable with HCV nucleic acid amplification technology screening. Vox Sang 2004; 86:15-20. [PMID: 14984555 DOI: 10.1111/j.0042-9007.2004.00387.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND AND OBJECTIVES This study was conducted to analyse the usefulness of hepatitis C virus (HCV) core antigen tests for the confirmation of HCV infection in a donor presenting as nucleic acid amplification technology (NAT) positive but negative for antibodies to HCV (anti-HCV). MATERIALS AND METHODS Blood donations were screened, in parallel, for anti-HCV using the Abbott PRISM HCV Chemiluminescent immunoassay (ChLIA) and an 'in-house' HCV NAT (pools of up to 95 donations). An HCV NAT-positive antibody-negative donor was identified. Twelve follow-up samples were obtained and tested with various HCV antigen (including the recently marketed Trak-C second-generation assay) and HCV antibody assays. RESULTS The single HCV NAT-positive, antibody-negative donation was identified from 1 117 681 donations screened in the 4-year period, July 1999 to June 2003. The index donation was positive by Ortho HCV core antigen enzyme immunoassay (EIA) and Ortho Trak-C (second-generation HCV core antigen EIA). An archive sample, taken 127 days prior to the index donation, was negative for all HCV markers. Subsequent samples demonstrated a loss of reactivity in the Ortho HCV core antigen EIA and reduced activity in the Ortho Trak-C until day 69. Immunoblot (Ortho RIBA-3) and HCV PRISM became positive on day 62, whilst Ortho HCV ELISA was not positive until day 132 or Biorad HCV ELISA until day 160. An alternative immunoblot (Innogenetics Innolia III) was positive from day 55. RNA levels fluctuated considerably during the follow-up period, being completely undetectable by routine screening methods at the time-point around seroconversion; subsequently, antibody was detected using all assays investigated. CONCLUSIONS This HCV-converting blood donor provided a unique panel of samples for using to assess current (and future) HCV assay systems. The overall test results led to the conclusion that individual HCV antigen testing should not be considered as equivalent to HCV NAT minipool screening. Trak-C antigen testing may be considered as a suitable confirmatory assay for isolated HCV NAT reactivity.
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Affiliation(s)
- B C Dow
- Scottish National Blood Transfusion Service Microbiology Reference Unit, West Scotland Blood Transfusion Centre, Glasgow, UK.
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Abstract
PROBLEM Testing a large medical class over two days with a single-form computer-based test has generated questions related to test security and the influence of unequal test preparation times afforded by the testing method. METHODS An analysis of variance (anova) design was used to compare the scores for the two days for each of the three tests. In addition, a within-student match-paired t-test of standard score differences was used to examine the relative standing of students across tests administered on different days. RESULTS Both the anova and the match-paired t-test failed to detect a difference between first and second day testing. CONCLUSION This research suggests that using a single test form with shift-based computerised assessments, spread over as many as two days, does not seriously compromise the integrity of the results. Since creating multiple unique-item forms is often not possible, shift-based testing with a single test form appears to be a fair method of accommodating a large number of students.
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Affiliation(s)
- C Kreiter
- Department of Family Medicine and Office of Consultation and Research in Medical Education, University of Iowa College of Medicine, Iowa City, IA 52242, USA.
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Starr JM, Wardlaw J, Ferguson K, MacLullich A, Deary IJ, Marshall I. Increased blood-brain barrier permeability in type II diabetes demonstrated by gadolinium magnetic resonance imaging. J Neurol Neurosurg Psychiatry 2003; 74:70-6. [PMID: 12486269 PMCID: PMC1738177 DOI: 10.1136/jnnp.74.1.70] [Citation(s) in RCA: 284] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
OBJECTIVES Patients with type II diabetes are at increased risk of cognitive impairment. The retinal and renal complications of diabetes follow microvascular damage permitting small arterioles to leak, hence the cerebral damage might also follow loss of blood-brain barrier (BBB) integrity. Magnetic resonance (MR) brain imaging with intravenous gadolinium (Gd) diethylenetriamine pentaacetic acid (Gd-DTPA) was used to identify increased BBB permeability. METHODS Ten well controlled type II diabetic patients aged 65-70 years and 10 controls underwent MR brain imaging with fluid attenuated inversion recovery (FLAIR); T1 weighted (T1W) volumetric imaging before; and T1W volumetric imaging at 5, 15, 30, 45, 60, and 90 minutes after intravenous Gd-DTPA. The T1W image before Gd-DTPA was subtracted from the images at each time point after Gd-DTPA. Net signal intensity was plotted against time for different brain regions. White matter hyperintensities were scored from the FLAIR image. RESULTS The signal intensity/time curves showed that brain signal intensity increased more in the diabetic group than controls during the first 15 minutes after Gd-DTPA, particularly in the basal ganglia (p=0.018). Signal intensity in controls peaked at five minutes and diabetics at 15 minutes. Subjects with more white matter hyperintensities had greater signal increase after Gd-DTPA, whether diabetic or not (p=0.001). CONCLUSIONS Increased BBB permeability with MR imaging was detected in patients with type II diabetes or white matter hyperintensities. Increased permeability of the BBB might account for some of the cerebral effects of type II diabetes, and so possibly also for the effect of other conditions that affect the microvasculature (like hypertension), on the brain.
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Affiliation(s)
- J M Starr
- SHEFC Centre for the Study of the Ageing Brain, University of Edinburgh, Western General Hospital, Edinburgh, Scotland, UK
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Drabkin HA, Parsy C, Ferguson K, Guilhot F, Lacotte L, Roy L, Zeng C, Baron A, Hunger SP, Varella-Garcia M, Gemmill R, Brizard F, Brizard A, Roche J. Quantitative HOX expression in chromosomally defined subsets of acute myelogenous leukemia. Leukemia 2002; 16:186-95. [PMID: 11840284 DOI: 10.1038/sj.leu.2402354] [Citation(s) in RCA: 145] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2001] [Accepted: 09/25/2001] [Indexed: 02/02/2023]
Abstract
We used a degenerate RT-PCR screen and subsequent real-time quantitative RT-PCR assays to examine the expression of HOX and TALE-family genes in 34 cases of chromosomally defined AML for which outcome data were available. AMLs with favorable cytogenetic features were associated with low overall HOX gene expression whereas poor prognostic cases had high levels. Characteristically, multiple HOXA family members including HOXA3-HOXA10 were jointly overexpressed in conjunction with HOXB3, HOXB6, MEIS1 and PBX3. Higher levels of expression were also observed in the FAB subtype, AML-M1. Spearmann correlation coefficients indicated that the expression levels for many of these genes were highly inter-related. While we did not detect any significant correlations between HOX expression and complete response rates or age in this limited set of patients, there was a significant correlation between event-free survival and HOXA7 with a trend toward significance for HoxA9, HoxA4 and HoxA5. While patients with elevated HOX expression did worse, there were notable exceptions. Thus, although HOX overexpression and clinical resistance to chemotherapy often coincide, they are not inextricably linked. Our results indicate that quantitative HOX analysis has the potential to add new information to the management of patients with AML, especially where characteristic chromosomal alterations are lacking.
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Affiliation(s)
- H A Drabkin
- Division of Medical Oncology, University of Colorado Health Sciences and Cancer Centers, Denver, CO 80262, USA
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Abstract
BACKGROUND AND OBJECTIVES Hepatitis B surface antigen (HBsAg) test sensitivities have gradually increased, and neutralizable weak HBsAg-positive donations, with no other hepatitis B virus (HBV) markers, have occasionally been found in our donor population. On investigation, these donors have admitted to receiving hepatitis B vaccine up to 5 days previously. A study was therefore initiated to monitor HBsAg reactivity amongst volunteers after receiving their first dose of hepatitis B vaccine. MATERIALS AND METHODS Eight volunteers were tested using three HBsAg assays (Abbott Auszyme, Ortho HBsAg-3 and Abbott/Murex GE34/36) on days 0, 3, 5, 7 and 10 after administration of hepatitis B vaccine. RESULTS Two HBsAg tests (Abbott Auszyme and Ortho HBsAg-3) did not detect HBsAg reactivity amongst the volunteers, although the Abbott Auszyme test results reached 70-80% of the manufacturer's cut-off at day 3 in two volunteers. The most recently launched assay (Abbott/Murex GE 34/36) detected seven (87%) of the eight volunteers as HBsAg reactive on day 3, and two (25%) volunteers were still reactive on day 5. CONCLUSION The Abbott/Murex GE 34/36 assay demonstrated HBsAg reactivity in most volunteers on day 3 and in some on day 5 after vaccination. It is therefore recommended that individuals who have recently been vaccinated with hepatitis B be deferred from blood donation for at least 7 days.
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Affiliation(s)
- B C Dow
- SNBTS Microbiology Reference Unit, West of Scotland Transfusion Centre, Glasgow, UK.
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