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Simmonds WM, Awuku Y, Barrett C, Brand M, Davidson K, Epstein D, Fredericks E, Gabriel S, Grobler S, Gounden C, Katsidzira L, Louw VJ, Naidoo V, Noel C, Ogutu E, Ramonate N, Seabi N, Setshedi M, Van Zyl J, Watermeyer G, Kassianides C. Guidance for the gastrointestinal evaluation and management of iron deficiency in Sub-Saharan Africa. S Afr Med J 2024; 114:e711. [PMID: 38525666 DOI: 10.7196/samj.2024.v114i1b.711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Indexed: 03/26/2024] Open
Abstract
BACKGROUND Over 30% of the world's population is anaemic, with a significant proportion of these being iron deficient. As iron deficiency (ID) anaemia in men and post-menopausal women is mostly caused by gastrointestinal blood loss or malabsorption, the initial evaluation of a patient with ID anaemia involves referral to a gastroenterologist. The current drive towards patient blood management in sub-Saharan Africa (SSA)prescribes that we regulate not only the use of blood transfusion but also the management of patients in whom the cause of iron loss or inadequate iron absorption is sought. Recommendations have been developed to: (i) aid clinicians in the evaluation of suspected gastrointestinal iron loss and iron malabsorption, and often a combination of these; (ii) improve clinical outcomes for patients with gastrointestinal causes of ID; (iii) provide current, evidence-based, context-specific recommendations for use in the management of ID; and (iv) conserve resources by ensuring rational utilisation of blood and blood products. METHOD Development of the guidance document was facilitated by the Gastroenterology Foundation of Sub-Saharan Africa and the South African Gastroenterology Society. The consensus recommendations are based on a rigorous process involving 21 experts in gastroenterology and haematology in SSA. Following discussion of the scope and purpose of the guidance document among the experts, an initial review of the literature and existing guidelines was undertaken. Thereafter, draft recommendation statements were produced to fulfil the outlined purpose of the guidance document. These were reviewed in a round-table discussion and were subjected to two rounds of anonymised consensus voting by the full committee in an electronic Delphi exercise during 2022 using the online platform, Research Electronic Data Capture. Recommendations were modified by considering feedback from the previous round, and those reaching a consensus of over 80% were incorporated into the final document. Finally, 44 statements in the document were read and approved by all members of the working group. CONCLUSION The recommendations incorporate six areas, namely: general recommendations and practice, Helicobacter pylori, coeliac disease, suspected small bowel bleeding, inflammatory bowel disease, and preoperative care. Implementation of the recommendations is aimed at various levels from individual practitioners to healthcare institutions, departments and regional, district, provincial and national platforms. It is intended that the recommendations spur the development of centre-specific guidelines and that they are integrated with the relevant patient blood management protocols. Integration of the recommendations is intended to promote optimal evaluation and management of patients with ID, regardless of the presence of anaemia.
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Affiliation(s)
- W M Simmonds
- Gastroenterology Division, Department of Internal Medicine, Faculty of Health Sciences, University of the Free State, Bloemfontein, South Africa.
| | - Y Awuku
- Department of Medicine, University of Health and Allied Sciences, Ho, Ghana.
| | - C Barrett
- School of Clinical Medicine, Faculty of Health Sciences, University of the Free State, Bloemfontein, South Africa.
| | - M Brand
- Department of General Surgery, School of Medicine, University of Pretoria, South Africa.
| | - K Davidson
- Private practice, IBD nurse specialist, Cape Town, South Africa.
| | - D Epstein
- Division of Gastroenterology, Department of Medicine, University of Cape Town and Groote Schuur Hospital, Cape Town, South Africa.
| | - E Fredericks
- Department of Medicine, Stellenbosch University, South Africa.
| | - S Gabriel
- Gastroenterology Unit, Tygerberg Hospital and Stellenbosch University, South Africa.
| | - S Grobler
- niversitas Netcare Private Hospital, Bloemfontein, South Africa.
| | - C Gounden
- Department of Gastroenterology, School of Clinical Medicine, University of KwaZulu-Natal and Inkosi Albert Luthuli Central Hospital, Durban, South Africa.
| | - L Katsidzira
- Internal Medicine Unit, Faculty of Medicine and Health Sciences, University of Zimbabwe, Harare, Zimbabwe.
| | - V J Louw
- Division of Clinical Haematology, Department of Medicine, University of Cape Town and Groote Schuur Hospital, Cape Town, South Africa.
| | - V Naidoo
- Department of Gastroenterology, School of Clinical Medicine, University of KwaZulu-Natal and Inkosi Albert Luthuli Central Hospital, Durban, South Africa.
| | - C Noel
- Division of Gastrointestinal Surgery, Department of Surgery, Faculty of Health Sciences, University of the Free State, Bloemfontein, South Africa.
| | - E Ogutu
- Department of Internal Medicine, University of Nairobi and Kenyatta National Hospital, Kenya.
| | - N Ramonate
- Gastroenterology Division, Department of Internal Medicine, Faculty of Health Sciences, University of the Free State, Bloemfontein, South Africa.
| | - N Seabi
- Gastroenterology Division, Charlotte Maxeke Johannesburg Academic Hospital, University of the Witwatersrand, Johannesburg, South Africa.
| | - M Setshedi
- Division of Gastroenterology, Department of Medicine, University of Cape Town and Groote Schuur Hospital, Cape Town, South Africa.
| | - J Van Zyl
- Department of Internal Medicine, Faculty of Health Sciences, University of the Free State and Netcare Universitas Private Hospital, Bloemfontein, South Africa.
| | - G Watermeyer
- Division of Gastroenterology, Department of Medicine, University of Cape Town and Groote Schuur Hospital, Cape Town, South Africa.
| | - C Kassianides
- Department of Medicine, Faculty of Health Sciences, University of Cape Town and Morningside Mediclinic, Johannesburg, South Africa.
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Antons S, Liebherr M, Brand M, Brandtner A. From game engagement to craving responses - The role of gratification and compensation experiences during video-gaming in casual and at-risk gamers. Addict Behav Rep 2023; 18:100520. [PMID: 38149224 PMCID: PMC10749870 DOI: 10.1016/j.abrep.2023.100520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 09/25/2023] [Accepted: 11/28/2023] [Indexed: 12/28/2023] Open
Abstract
Introduction Although playing videogames is a common leisure activity some individuals develop problematic gaming behaviors or even symptoms of a gaming disorder. Game engagement may be involved in reinforcement learning that may result in experiences of craving, an important feature of gaming disorder. In the following study we aimed to approach the question which aspects contribute to increased craving for gaming. Methods Overall, 439 individuals participated in an online survey, answering questionnaires on game engagement, experience of gratification and compensation, craving, and symptoms of gaming disorder. A mediation model testing if the association between game engagement and facets of craving are mediated by the experience of gratification and compensation during gaming. Results Three facets of craving (reward/relief, physiological, obsessive craving) were statistically explained by game engagement and the experience of gratification and compensation. Models differed between casual gamers and at-risk gamers. The effects on reward/relief and physiological craving were fully mediated in the casual group and partially mediated in the at-risk group by gratification and compensation experiences. Conclusion Game engagement may contribute to the development of craving by increasing the experience of gratification and compensation and thus might be important in reinforcement learning. Games evoking a high engagement may therefore have a higher addictive potential. Further processes potentially related to game engagement, such as intrusive thoughts and desire thinking, which are related to craving experiences, should be considered in future studies.
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Affiliation(s)
- S. Antons
- General Psychology: Cognition and Center for Behavioral Addiction Research (CeBAR), University of Duisburg, Duisburg, Germany
- Erwin L. Hahn Institute for Magnetic Resonance Imaging, Essen, Germany
| | - M. Liebherr
- General Psychology: Cognition and Center for Behavioral Addiction Research (CeBAR), University of Duisburg, Duisburg, Germany
| | - M. Brand
- General Psychology: Cognition and Center for Behavioral Addiction Research (CeBAR), University of Duisburg, Duisburg, Germany
- Erwin L. Hahn Institute for Magnetic Resonance Imaging, Essen, Germany
| | - A. Brandtner
- General Psychology: Cognition and Center for Behavioral Addiction Research (CeBAR), University of Duisburg, Duisburg, Germany
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Smith S, Sapkaroski D, Brand M, Tran A, Zalcberg J, Stirling RG. Mapping the clinical care pathways for advanced stage non-small cell lung cancer patients in Victoria: A retrospective cohort study of supportive and palliative care. Nurs Health Sci 2023; 25:411-423. [PMID: 37562814 DOI: 10.1111/nhs.13044] [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] [Received: 11/06/2022] [Revised: 05/21/2023] [Accepted: 07/28/2023] [Indexed: 08/12/2023]
Abstract
The lung cancer Optimal Care Pathway recommends supportive care and palliative care integration throughout its various steps, with early referral to appropriate services improving the quality of life in advanced stage non-small cell lung cancer patients. Using Victorian Lung Cancer Registry data and linked administrative datasets, this retrospective cohort study mapped clinical care pathways of 525 Stage III-IV non-small cell lung cancer patients in Victoria to 11 recommendations in the Optimal Care Pathway, identifying unwarranted variations in clinical care. Supportive care and palliative care delivery were further examined to understand the involvement and timing of specialist care teams. Our findings showed that palliative care utilization is highest at the time of treatment, despite recommendations that it should be provided early after diagnosis to improve patient outcomes and satisfaction. Early supportive care screening was observed in half the cohort and almost three-quarters of the patients had been presented at a multidisciplinary meeting. Multidisciplinary meeting presentations and supportive care provide an opportunity to improve communication about palliative care needs and integration into routine clinical practice, such as at the time of treatment planning.
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Affiliation(s)
- Shantelle Smith
- Cancer Research Program, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
- School of Population Health, Curtin University, Perth, Western Australia, Australia
- Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Victoria, Australia
| | - Daniel Sapkaroski
- Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Victoria, Australia
- Department of Radiation Therapy, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Margaret Brand
- Cancer Research Program, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Anh Tran
- Cancer Research Program, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - John Zalcberg
- Cancer Research Program, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Robert G Stirling
- Cancer Research Program, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
- Department of Respiratory Medicine, Alfred Hospital, Melbourne, Victoria, Australia
- Department of Medicine, Monash University, Melbourne, Victoria, Australia
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Huang J, Faisal W, Brand M, Smith S, Alexander M, Briggs L, Conron M, Duffy M, John T, Langton D, Lesage J, MacManus M, Mitchell P, Olesen I, Parente P, Philip J, Samuel E, Torres J, Underhill CR, Zalcberg JR, Harden S, Stirling R. Patterns of care for people with small cell lung cancer in Victoria, 2011-19: a retrospective, population-based registry data study. Med J Aust 2023; 219:120-126. [PMID: 37365486 DOI: 10.5694/mja2.52017] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2022] [Revised: 04/28/2023] [Accepted: 05/02/2023] [Indexed: 06/28/2023]
Abstract
OBJECTIVES To report stage-specific patterns of treatment and the influence of management and treatment type on survival rates for people newly diagnosed with small cell lung cancer (SCLC). DESIGN Cross-sectional patterns of care study; analysis of data prospectively collected for the Victorian Lung Cancer Registry (VLCR). SETTING, PARTICIPANTS All people diagnosed with SCLC in Victoria during 1 April 2011 - 18 December 2019. MAIN OUTCOME MEASURES Stage-specific management and treatment of people with SCLC; median survival time. RESULTS During 2011-19, 1006 people were diagnosed with SCLC (10.5% of all lung cancer diagnoses in Victoria); their median age was 69 years (interquartile range [IQR], 62-77 years), 429 were women (43%), and 921 were current or former smokers (92%). Clinical stage was defined for 896 people (89%; TNM stages I-III, 268 [30%]; TNM stage IV, 628 [70%]) and ECOG performance status at diagnosis for 663 (66%; 0 or 1, 489 [49%]; 2-4, 174 [17%]). The cases of 552 patients had been discussed at multidisciplinary meetings (55%), 377 people had received supportive care screening (37%), and 388 had been referred for palliative care (39%). Active treatment was received by 891 people (89%): chemotherapy, 843 (84%); radiotherapy, 460 (46%); chemotherapy and radiotherapy, 419 (42%); surgery, 23 (2%). Treatment had commenced within fourteen days of diagnosis for 632 of 875 patients (72%). Overall median survival time from diagnosis was 8.9 months (IQR, 4.2-16 months; stage I-III: 16.3 [IQR, 9.3-30] months; stage IV: 7.2 [IQR, 3.3-12] months). Multidisciplinary meeting presentation (hazard ratio [HR], 0.66; 95% CI, 0.58-0.77), multimodality treatment (HR, 0.42; 95% CI, 0.36-0.49), and chemotherapy within fourteen days of diagnosis (HR, 0.68; 95% CI, 0.48-0.94) were each associated with lower mortality during follow-up. CONCLUSION Rates of supportive care screening, multidisciplinary meeting evaluation, and palliative care referral for people with SCLC could be improved. A national registry of SCLC-specific management and outcomes data could improve the quality and safety of care.
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Affiliation(s)
| | | | | | | | - Marliese Alexander
- Peter MacCallum Cancer Institute, Melbourne, VIC
- The University of Melbourne, Melbourne, VIC
| | | | - Matthew Conron
- The University of Melbourne, Melbourne, VIC
- St Vincent's Hospital Melbourne, Melbourne, VIC
| | - Mary Duffy
- Peter MacCallum Cancer Institute, Melbourne, VIC
| | - Thomas John
- Peter MacCallum Cancer Institute, Melbourne, VIC
| | - David Langton
- Monash University, Melbourne, VIC
- Peninsula Health, Melbourne, VIC
| | | | | | - Paul Mitchell
- Olivia Newton-John Cancer Centre at Austin Health, Melbourne, VIC
| | - Inger Olesen
- Andrew Love Cancer Centre, Barwon Health, Geelong, VIC
| | - Phillip Parente
- Eastern Health Clinical School, Monash University, Melbourne, VIC
- Eastern Health, Melbourne, VIC
| | | | - Evangeline Samuel
- Alfred Health, Melbourne, VIC
- Latrobe Regional Hospital, Traralgon, VIC
| | | | - Craig R Underhill
- Albury Wodonga Health, Wodonga, NSW
- The University of New South Wales, Sydney, NSW
| | - John R Zalcberg
- Alfred Health, Melbourne, VIC
- Monash University, Melbourne, VIC
| | - Susan Harden
- Monash University, Melbourne, VIC
- Peter MacCallum Cancer Institute, Melbourne, VIC
| | - Rob Stirling
- Alfred Health, Melbourne, VIC
- Monash University, Melbourne, VIC
- Monash University Central Clinical School, Melbourne, VIC
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5
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Sommer F, Brand M, Scheithauer MO, Hoffmann TK, Theodoraki MN, Weber R. [Diagnosis and Treatment in frontobasal fractures]. HNO 2023; 71:35-47. [PMID: 36525033 DOI: 10.1007/s00106-022-01256-9] [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] [Accepted: 10/18/2022] [Indexed: 12/23/2022]
Abstract
Traumatic brain injury can result in frontobasal fractures (FBF). The goals of treatment for FBF are to eliminate primary morbidity and/or prevent secondary morbidity. Of particular importance in this regard is the proximity of important sensory organs for hearing, vision, smell, and taste, as well as their supplying nervous structures. Medical history, clinical findings, or CT scan are necessary and should lead to an individual evaluation. Depending on the severity of the fractures, the following disciplines may be involved in the treatment of FBF: neurosurgery, plastic surgery, oral and maxillofacial surgery, and/or otorhinolaryngology. Particularly less invasive endoscopic endonasal therapy is a specialty of otorhinolaryngologic surgeons and has not been widely established in other disciplines. The present work provides an overview of the current state of the art in terms of the following aspects, taking into account the current literature: anatomic principles, classification of fractures, diagnostics (in particular clinical examination, imaging, and laboratory chemistry tests), clinical symptoms, and treatment.
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Affiliation(s)
- F Sommer
- Universitätsklinik für Hals‑, Nasen‑, Ohrenheilkunde, Kopf- und Hals-Chirurgie, Universität Ulm, Frauensteige 12, 89075, Ulm, Deutschland.
| | - M Brand
- Universitätsklinik für Hals‑, Nasen‑, Ohrenheilkunde, Kopf- und Hals-Chirurgie, Universität Ulm, Frauensteige 12, 89075, Ulm, Deutschland
| | - M O Scheithauer
- Universitätsklinik für Hals‑, Nasen‑, Ohrenheilkunde, Kopf- und Hals-Chirurgie, Universität Ulm, Frauensteige 12, 89075, Ulm, Deutschland
| | - T K Hoffmann
- Universitätsklinik für Hals‑, Nasen‑, Ohrenheilkunde, Kopf- und Hals-Chirurgie, Universität Ulm, Frauensteige 12, 89075, Ulm, Deutschland
| | - M-N Theodoraki
- Universitätsklinik für Hals‑, Nasen‑, Ohrenheilkunde, Kopf- und Hals-Chirurgie, Universität Ulm, Frauensteige 12, 89075, Ulm, Deutschland
| | - R Weber
- Hals-Nasen-Ohrenklinik des Städtischen Klinikums Karlsruhe, Karlsruhe, Deutschland
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Woodford K, Koo K, Reynolds J, Stirling RG, Harden SV, Brand M, Senthi S. Persisting Gaps in Optimal Care of Stage III Non-small Cell Lung Cancer: An Australian Patterns of Care Analysis. Oncologist 2022; 28:e92-e102. [PMID: 36541690 PMCID: PMC9907057 DOI: 10.1093/oncolo/oyac246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Accepted: 10/20/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Wide variation exists globally in the treatment and outcomes of stage III patients with non-small cell lung cancer (NSCLC). We conducted an up-to-date patterns of care analysis in the state of Victoria, Australia, with a particular focus on the proportion of patients receiving treatment with radical intent, treatment trends over time, and survival. MATERIALS AND METHODS Stage III patients with NSCLC were identified in the Victorian Lung Cancer Registry and categorized by treatment received and treatment intent. Logistic regression was used to explore factors predictive of receipt of radical treatment and the treatment trends over time. Cox regression was used to explore variables associated with overall survival (OS). Covariates evaluated included age, sex, ECOG performance status, smoking status, year of diagnosis, Australian born, Aboriginal or Torres Strait Islander status, socioeconomic status, rurality, public/private status of notifying institution, and multidisciplinary meeting discussion. RESULTS A total of 1396 patients were diagnosed between 2012 and 2019 and received treatment with radical intent 67%, palliative intent 23%, unknown intent 5% and no treatment 5%. Radical intent treatment was less likely if patients were >75 years, ECOG ≥1, had T3-4 or N3 disease or resided rurally. Surgery use decreased over time, while concurrent chemoradiotherapy and immunotherapy use increased. Median OS was 38.0, 11.1, and 4.4 months following radical treatment, palliative treatment or no treatment, respectively. CONCLUSION Almost a third of stage III patients with NSCLC still do not receive radical treatment. Strategies to facilitate radical treatment and better support decision making between increasing multimodality options are required.
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Affiliation(s)
- Katrina Woodford
- Corresponding author: Katrina Woodford, PhD, Department of Radiation Oncology, Peter MacCallum Cancer Centre, 305 Grattan Street, Melbourne, VIC 3000, Australia. Tel: +61 3 8559 6067; Fax: +61 3 85596009; E-mail:
| | - Kendrick Koo
- Alfred Health Radiation Oncology, The Alfred Hospital, Melbourne, VIC, Australia,Department of Radiation Oncology, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia,Department of Epidemiology & Preventative Medicine, School of Public Health and Preventative Medicine, Monash University, Melbourne, VIC, Australia
| | - John Reynolds
- Department of Epidemiology & Preventative Medicine, School of Public Health and Preventative Medicine, Monash University, Melbourne, VIC, Australia
| | - Robert G Stirling
- Department of Medicine, Monash University, Clayton, VIC, Australia,Department of Respiratory Medicine, The Alfred Hospital, Melbourne, VIC, Australia
| | - Susan V Harden
- Department of Radiation Oncology, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia,Department of Epidemiology & Preventative Medicine, School of Public Health and Preventative Medicine, Monash University, Melbourne, VIC, Australia
| | - Margaret Brand
- Department of Epidemiology & Preventative Medicine, School of Public Health and Preventative Medicine, Monash University, Melbourne, VIC, Australia
| | - Sashendra Senthi
- Alfred Health Radiation Oncology, The Alfred Hospital, Melbourne, VIC, Australia,Department of Surgery, Central Clinical School, Monash University, Melbourne, VIC, Australia
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McLaughlin VV, Channick R, Kim NH, Frantz RP, McConnell J, Melendres‐Groves L, Miller C, Ravichandran A, Rodriguez‐Lopez J, Brand M, Leroy S, Wetherill G, Chin KM. Safety of macitentan for the treatment of pulmonary hypertension: Real‐world experience from the OPsumit® USers Registry (OPUS) and OPsumit® Historical USers cohort (OrPHeUS). Pulm Circ 2022; 12:e12150. [PMID: 36381290 PMCID: PMC9661363 DOI: 10.1002/pul2.12150] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 08/11/2022] [Accepted: 09/09/2022] [Indexed: 12/05/2022] Open
Abstract
Macitentan is an oral endothelin receptor antagonist for the management of pulmonary arterial hypertension (PAH). The OPsumit® USers Registry (OPUS) and the OPsumit® Historical USers cohort (OrPHeUS) medical chart review provide real‐world data for patients newly initiating macitentan. This study aims to describe the characteristics, safety profile, and clinical outcomes of PAH patients newly treated with macitentan in the combined OPUS/OrPHeUS data set. OPUS was a prospective, multicenter, long‐term, observational drug registry from April 2014 to June 2020. OrPHeUS was a retrospective, US, multicenter chart review: observation period October 2013 to March 2017. All analyses were descriptive. At registry closure in June 2020, the combined population consisted of 5654 patients, of whom 81.9% were diagnosed with PAH. For these 4626 patients, median duration of macitentan exposure observed was 14.5 (Q1 = 5.2, Q3 = 29.0) months; idiopathic PAH (54.8%) was the most common form of PAH; macitentan was initiated as monotherapy (37.9%), or as part of double (48.0%) or triple therapy (14.1%); discontinuation due to nonhepatic/hepatic adverse events occurred in 17.1%/0.3% of patients; 9.9% of patients experienced ≥1 hepatic adverse events; Kaplan–Meier estimates showed that at 1 year 59.9% (95% confidence interval: 58.3, 61.5) of patients were free from hospitalization and survival was 90.4% (89.3, 91.3). This analysis of real‐world data from the combined OPUS and OrPHeUS populations demonstrated that macitentan is well tolerated in a large, diverse population of PAH patients, with overall and hepatic safety profiles consistent with previous macitentan clinical trials.
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Affiliation(s)
- VV McLaughlin
- Department of Internal Medicine, Division of Cardiovascular Medicine University of Michigan Ann Arbor MI USA
| | - R Channick
- David Geffen School of Medicine University of California Los Angeles Los Angeles CA USA
| | - NH Kim
- Division of Pulmonary, Critical Care and Sleep Medicine University of California San Diego La Jolla CA USA
| | - RP Frantz
- Department of Cardiovascular Medicine Mayo Clinic Rochester MN USA
| | - J McConnell
- Kentuckiana Pulmonary Associates Louisville KY USA
| | | | - C Miller
- Pulmonary Hypertension and Pulmonary Critical Care Medicine, Piedmont Physicians, Piedmont Healthcare Austell GA USA
| | | | | | - M Brand
- Actelion Pharmaceuticals Ltd, a Janssen Pharmaceutical Company of Johnson and Johnson, Global Epidemiology Allschwil Switzerland
| | - S Leroy
- Actelion Pharmaceuticals Ltd, a Janssen Pharmaceutical Company of Johnson and Johnson, Data Science Global Regulatory Affairs Allschwil Switzerland
| | - G Wetherill
- Actelion Pharmaceuticals Ltd, a Janssen Pharmaceutical Company of Johnson and Johnson, Medical Affairs and Established Products Allschwil Switzerland
- Current affiliation: Biometric Solutions Limited, St Ives Cambridgeshire UK
| | - KM Chin
- Department of Internal Medicine, UT Southwestern Medical Center Dallas TX USA
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Stirling R, Smith S, Brand M, Harden S, Briggs L, Leigh L, Brims F, Brooke M, Brunelli V, Chia C, Dawkins P, Lawrenson R, Duffy M, Evans S, Leong T, Marshall H, Patel D, Pavlakis N, Philip J, Rankin N, Singhal N, Stone E, Tay R, Vinod S, Windsor M, Wright G, Leong D, Zalcberg J. EP04.01-023 Development of an Australia and New Zealand Lung Cancer Clinical Quality Registry (ANZLCR). J Thorac Oncol 2022. [DOI: 10.1016/j.jtho.2022.07.435] [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: 10/14/2022]
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Smith S, Brand M, Harden S, Briggs L, Leigh L, Brims F, Brooke M, Brunelli VN, Chia C, Dawkins P, Lawrenson R, Duffy M, Evans S, Leong T, Marshall H, Patel D, Pavlakis N, Philip J, Rankin N, Singhal N, Stone E, Tay R, Vinod S, Windsor M, Wright GM, Leong D, Zalcberg J, Stirling RG. Development of an Australia and New Zealand Lung Cancer Clinical Quality Registry: a protocol paper. BMJ Open 2022; 12:e060907. [PMID: 36038161 PMCID: PMC9438055 DOI: 10.1136/bmjopen-2022-060907] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
INTRODUCTION Lung cancer is the leading cause of cancer mortality, comprising the largest national cancer disease burden in Australia and New Zealand. Regional reports identify substantial evidence-practice gaps, unwarranted variation from best practice, and variation in processes and outcomes of care between treating centres. The Australia and New Zealand Lung Cancer Registry (ANZLCR) will be developed as a Clinical Quality Registry to monitor the safety, quality and effectiveness of lung cancer care in Australia and New Zealand. METHODS AND ANALYSIS Patient participants will include all adults >18 years of age with a new diagnosis of non-small-cell lung cancer (NSCLC), SCLC, thymoma or mesothelioma. The ANZLCR will register confirmed diagnoses using opt-out consent. Data will address key patient, disease, management processes and outcomes reported as clinical quality indicators. Electronic data collection facilitated by local data collectors and local, state and federal data linkage will enhance completeness and accuracy. Data will be stored and maintained in a secure web-based data platform overseen by registry management. Central governance with binational representation from consumers, patients and carers, governance, administration, health department, health policy bodies, university research and healthcare workers will provide project oversight. ETHICS AND DISSEMINATION The ANZLCR has received national ethics approval under the National Mutual Acceptance scheme. Data will be routinely reported to participating sites describing performance against measures of agreed best practice and nationally to stakeholders including federal, state and territory departments of health. Local, regional and (bi)national benchmarks, augmented with online dashboard indicator reporting will enable local targeting of quality improvement efforts.
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Affiliation(s)
- Shantelle Smith
- Department of Epidemiology and Preventive Medicine, Monash University, Clayton, Victoria, Australia
| | - Margaret Brand
- Department of Epidemiology and Preventive Medicine, Monash University, Clayton, Victoria, Australia
| | - Susan Harden
- Department of Epidemiology and Preventive Medicine, Monash University, Clayton, Victoria, Australia
- Department of Radiation Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Lisa Briggs
- Victorian Lung Cancer Registry, Monash University, Clayton, Victoria, Australia
| | - Lillian Leigh
- Victorian Lung Cancer Registry, Monash University, Clayton, Victoria, Australia
| | - Fraser Brims
- Department of Respiratory Medicine, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia
| | - Mark Brooke
- Lung Foundation Australia, Milton, Queensland, Australia
| | - Vanessa N Brunelli
- Faculty of Health, School of Nursing, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Collin Chia
- Department of Respiratory Medicine, Launceston General Hospital, Launceston, Tasmania, Australia
| | - Paul Dawkins
- Department of Respiratory Medicine, Middlemore Hospital, Auckland, New Zealand
| | - Ross Lawrenson
- Waikato Medical Research Centre, University of Waikato, Hamilton, Waikato, New Zealand
- Strategy and Funding, Waikato District Health Board, Hamilton, New Zealand
| | - Mary Duffy
- Lung Cancer Service, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Sue Evans
- Victorian Cancer Registry, Cancer Council Victoria, Melbourne, Victoria, Australia
| | - Tracy Leong
- Department of Respiratory and Sleep Medicine, Austin Health, Heidelberg, Victoria, Australia
| | - Henry Marshall
- Department of Thoracic Medicine, The Prince Charles Hospital, Chermside, Queensland, Australia
| | - Dainik Patel
- Department of Medical Oncology, Lyell McEwin Hospital, Elizabeth Vale, South Australia, Australia
| | - Nick Pavlakis
- Medical Oncology, Genesis Care and University of Sydney, Sydney, New South Wales, Australia
| | - Jennifer Philip
- Department of Medicine, Univ Melbourne, Fitzroy, Victoria, Australia
| | - Nicole Rankin
- Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
| | - Nimit Singhal
- Department of Medicine, University of Adelaide, Adelaide, South Australia, Australia
| | - Emily Stone
- School of Clinical Medicine, University NSW, Sydney, Victoria, Australia
| | - Rebecca Tay
- Department of Medical Oncology, The Royal Hobart Hospital, Hobart, Tasmania, Australia
| | - Shalini Vinod
- Cancer Therapy Centre, Liverpool Hospital, Liverpool, New South Wales, Australia
| | - Morgan Windsor
- Department of Thoracic Surgery, Prince Charles and Royal Brisbane Hospital, Brisbane, Queensland, Australia
| | - Gavin M Wright
- Department of Surgery, Cardiothoracic Surgery Unit, St Vincent, Victoria, Australia
| | - David Leong
- Department of Medical Oncology, John James Medical Centre Deakin, Canberra, Australian Capital Territory, Australia
| | - John Zalcberg
- Cancer Research Program, Monash University, Melbourne, Victoria, Australia
| | - Rob G Stirling
- Department of Medicine, Monash University, Clayton, Victoria, Australia
- Respiratory Medicine, Alfred Hospital, Melbourne, Victoria, Australia
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Brand M. Psychologische und neurobiologischen Mechanismen der
Pornographie-Nutzungsstörung. Suchttherapie 2022. [DOI: 10.1055/s-0042-1755991] [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] [Subscribe] [Scholar Register] [Indexed: 03/22/2023]
Affiliation(s)
- M Brand
- Universität Duisburg-Essen, Duisburg-Essen
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11
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Keßling A, Schmidt L, Brand M, Wegmann E. Implizite kognitive Mechanismen bei der problematischen Nutzung
sozialer Netzwerke– ein systematischer Überblick. Suchttherapie 2022. [DOI: 10.1055/s-0042-1756077] [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] [Subscribe] [Scholar Register] [Indexed: 03/22/2023]
Affiliation(s)
- A Keßling
- Universität Duisburg-Essen, Duisburg-Essen
| | | | - M Brand
- Universität Duisburg-Essen, Duisburg-Essen
| | - E Wegmann
- Universität Duisburg-Essen, Duisburg-Essen
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12
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Brand M. Verhaltenssüchte: Herausforderungen für Theorien,
Modelle und Mechanismen. Suchttherapie 2022. [DOI: 10.1055/s-0042-1755964] [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] [Subscribe] [Scholar Register] [Indexed: 03/22/2023]
Affiliation(s)
- M Brand
- Universität Duisburg-Essen, Duisburg-Essen
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13
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Acharya S, Bhattarai S, Brand M. The advantages of mobile cardiac telemetry: ventricular standstill as a cause for syncope. QJM 2022; 115:410-411. [PMID: 35191496 DOI: 10.1093/qjmed/hcac056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 02/12/2022] [Indexed: 11/13/2022] Open
Affiliation(s)
- S Acharya
- Department of Internal Medicine, Cayuga Medical Center, 101 Dates Drive, Ithaca, NY 14850, USA
| | - S Bhattarai
- Department of Internal Medicine, B & B Hospital Pvt Ltd, Gwarko, Lalitpur, 44600, Nepal
| | - M Brand
- Department of Cardiology, Cayuga Medical Center, 101 Dates Drive, Ithaca, NY 14850, USA
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Beyreuther E, Pawelke J, Brand M, Hans S, Hideghéty K, Jansen J, Karsch L, Lessmann E, Löck S, Schürer M, Seco J, Szabo E, Schramm U. OC-0094 Beam pulse structure affects the magnitude of Flash effect in zebrafish embryo. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)02470-7] [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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15
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Pawelke J, Brand M, Hans S, Hideghety K, Karsch L, Lessmann E, Löck S, Schürer M, Szabó R, Beyreuther E. FLASH Modalities Track (Oral Presentations) INFLUENCE OF ELECTRON BEAM DOSE RATE AND PULSE STRUCTURE ON THE PROTECTING FLASH EFFECT OBSERVED IN ZEBRAFISH EMBRYO. Phys Med 2022. [DOI: 10.1016/s1120-1797(22)01453-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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16
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Lin T, Pham J, Paul E, Conron M, Wright G, Ball D, Mitchell P, Atkin N, Brand M, Zalcberg J, Stirling RG. Impacts of lung cancer multidisciplinary meeting presentation: Drivers and outcomes from a population registry retrospective cohort study. Lung Cancer 2021; 163:69-76. [PMID: 34923204 DOI: 10.1016/j.lungcan.2021.12.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2021] [Revised: 11/29/2021] [Accepted: 12/07/2021] [Indexed: 12/24/2022]
Abstract
INTRODUCTION Multidisciplinary Meetings (MDM) are recommended in routine lung cancer care, however its broader impacts demand further evaluation. We assessed the drivers and impacts of MDM presentation in the Victorian Lung Cancer Registry (VLCR). METHODS We examined the effect of MDM presentation on receipt of treatment and survival in VLCR patients diagnosed between 2011 and 2020. We compared patient characteristics, drivers of MDM discussion and survival between the two groups. RESULTS Of 9,628 patients, 5,900 (61.3%) were discussed at MDM, 3,728 (38.7%) were not. In the non-MDM group, a lower proportion received surgery (22.1% vs. 31.2%), radiotherapy (34.2% vs. 44.4%) and chemotherapy (44.7% vs. 49.0%). Patients were less likely to be discussed if ≥80 years (OR 0.73, p < 0.001), of ECOG performance status (PS) 4 (OR 0.23, p < 0.001), clinical stage IV (OR 0.34, p < 0.001) or referred from regional (OR 0.52, p < 0.001) or private hospital (OR 0.18, p < 0.001). MDM-presented patients had better median survival (1.70 vs 0.75 years, p < 0.001) and lower adjusted mortality risk (HR 0.75; 0.71-0.80, p < 0.001), a protective effect consistent across all hospital types. Undocumented PS, histopathology and clinical stage were associated with lower likelihood of MDM discussion and worse mortality. CONCLUSIONS In the VLCR, being male, ≥80 years, of poorer PS, advanced clinical stage and poor clinical characterisation significantly disadvantaged patients in relation to MDM discussion. MDM-discussed patients were more likely to undergo treatment and had a 25% lower risk of mortality. This study supports the use of MDMs in lung cancer and identifies areas of inequity to be addressed.
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Affiliation(s)
- Tiffany Lin
- Department of Respiratory Medicine, Alfred Hospital, Melbourne, Australia
| | - Jonathan Pham
- Department of Respiratory Medicine, Alfred Hospital, Melbourne, Australia
| | - Eldho Paul
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia
| | - Matthew Conron
- Department of Respiratory Medicine, St Vincent's Hospital, Melbourne, Australia
| | - Gavin Wright
- Victorian Comprehensive Cancer Centre, Melbourne, Australia
| | - David Ball
- Division of Radiation Oncology, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - Paul Mitchell
- Olivia Newton-John Cancer and Wellness Centre, Melbourne, Australia
| | - Nicola Atkin
- Parkville Integrated Palliative Care Service, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - Margaret Brand
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia
| | - John Zalcberg
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia
| | - Robert G Stirling
- Department of Respiratory Medicine, Alfred Hospital, Melbourne, Australia; Department of Medicine, Monash University, Melbourne, Australia.
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17
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Freak-Poli R, Brand M, Boelsen-Robinson T, Huse O, de Courten M, Peeters A. Development and piloting of a Checklist for healthy eating And Physical Activity in the Workplace (CEPAW). Health Promot Int 2021; 36:8-19. [PMID: 32268355 DOI: 10.1093/heapro/daaa026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
To develop and pilot a tool that assesses the infrastructure and policy workplace environment characteristics that may influence employee healthy eating and physical activity behaviours. A checklist was developed with reference to prior tools and piloted at eight worksites. Piloting of the tool demonstrated that it was generally feasible to use, took 1-2 hours to complete and appeared sensitive to differences between workplace environment characteristics. Refinement of the tool occurred after piloting. The final 21-item checklist contains sub-scores capturing policy, infrastructure, healthy eating and physical activity characteristics. This new checklist overcomes some limitations of pre-existing tools as it explicitly considers policy and is short, inexpensive and can be used by workplaces for self-assessment and by health promotion professionals in evaluation studies or as an intervention tool.
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Affiliation(s)
- Rosanne Freak-Poli
- Department of Epidemiology & Preventive Medicine, Faculty of Medicine, Nursing & Health Sciences, School of Public Health and Preventive Medicine, Monash University, The Alfred Centre, Alfred Hospital, Commercial Road, Melbourne VIC 3004.,Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Margaret Brand
- Department of Epidemiology & Preventive Medicine, Faculty of Medicine, Nursing & Health Sciences, School of Public Health and Preventive Medicine, Monash University, The Alfred Centre, Alfred Hospital, Commercial Road, Melbourne VIC 3004
| | - Tara Boelsen-Robinson
- Department of Epidemiology & Preventive Medicine, Faculty of Medicine, Nursing & Health Sciences, School of Public Health and Preventive Medicine, Monash University, The Alfred Centre, Alfred Hospital, Commercial Road, Melbourne VIC 3004.,Baker IDI Heart and Diabetes Institute, 99 Commercial Road, Melbourne. VIC 3004.,Deakin University, Geelong, Australia. Institute for Health Transformation, Faculty of Health, Locked Bag 20000, Vicoria 3220
| | - Oliver Huse
- Deakin University, Geelong, Australia. Institute for Health Transformation, Faculty of Health, Locked Bag 20000, Vicoria 3220
| | - Maximilian de Courten
- Department of Epidemiology & Preventive Medicine, Faculty of Medicine, Nursing & Health Sciences, School of Public Health and Preventive Medicine, Monash University, The Alfred Centre, Alfred Hospital, Commercial Road, Melbourne VIC 3004.,Centre for Chronic Disease Prevention and Management, Victoria University, St Albans, VIC 3021
| | - Anna Peeters
- Department of Epidemiology & Preventive Medicine, Faculty of Medicine, Nursing & Health Sciences, School of Public Health and Preventive Medicine, Monash University, The Alfred Centre, Alfred Hospital, Commercial Road, Melbourne VIC 3004.,Baker IDI Heart and Diabetes Institute, 99 Commercial Road, Melbourne. VIC 3004.,Deakin University, Geelong, Australia. Institute for Health Transformation, Faculty of Health, Locked Bag 20000, Vicoria 3220
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18
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Soh SE, Morello R, Ayton D, Ahern S, Scarborough R, Zammit C, Brand M, Stirling RG, Zalcberg J. Measurement properties of the 12-item Short Form Health Survey version 2 in Australians with lung cancer: a Rasch analysis. Health Qual Life Outcomes 2021; 19:157. [PMID: 34059079 PMCID: PMC8165769 DOI: 10.1186/s12955-021-01794-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Accepted: 05/21/2021] [Indexed: 12/24/2022] Open
Abstract
Background The 12-item Short-Form Health Survey version 2 (SF-12v2), a widely used, generic patient-reported measure of health status that provides summary scores of physical and mental health. No study to date has examined the measurement properties of the SF-12v2 in patients with lung cancer using Rasch analysis. The aim of this study was to extend the psychometric evaluations of the SF-12 within the lung cancer population to ensure its validity and reliability to assess the health status in this population. Methods Participants in the Victorian Lung Cancer Registry (VLCR) who completed the SF-12v2 between 2012 and 2016 were included in this study. The structural validity of the SF-12v2 was assessed using Rasch analysis. Overall fit to the Rasch measurement model was examined as well as five key measurement properties: uni-dimensionality, response thresholds, internal consistency, measurement invariance and targeting. Results A total of 342 participants completed the SF-12v2 three months following their lung cancer diagnosis. The SF-12 Physical Component Score (PCS-12) did not fit the overall Rasch measurement model (χ2 107.0; p < 0.001). Three items deviated significantly from the Rasch model (item fit residual beyond ± 2.5) with signs of dependency between item responses and disordered thresholds. Nevertheless, the PCS-12 was uni-dimensional with good internal consistency (person separation index [PSI] 0.83) and reasonable targeting. In contrast, the SF-12 Mental Component Score (MCS-12) had good overall model fit (χ2 35.1; p = 0.07), reasonable targeting and good internal consistency (PSI 0.81). Conclusions Rasch analysis suggests that there is general support for the reliability of the SF-12v2 as a measure of physical and mental health in people with lung cancer. However, the appropriateness of some items (e.g. pain) in the PCS-12 is questionable and further refinement of the scale including changing the response options may be required to improve the ability of the SF-12v2 to more appropriately assess the health status of this population. Supplementary Information The online version contains supplementary material available at 10.1186/s12955-021-01794-w.
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Affiliation(s)
- Sze-Ee Soh
- Department of Physiotherapy, Monash University, Melbourne, VIC, Australia. .,Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC, Australia.
| | - Renata Morello
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Darshini Ayton
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Susannah Ahern
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Ri Scarborough
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Claire Zammit
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Margaret Brand
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Robert G Stirling
- Department of Respiratory Medicine, The Alfred Hospital, Melbourne, VIC, Australia.,Department of Medicine, Monash University, Melbourne, VIC, Australia
| | - John Zalcberg
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC, Australia
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19
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Pham J, Conron M, Wright G, Mitchell P, Ball D, Philip J, Brand M, Zalcberg J, Stirling RG. Excess mortality and undertreatment in elderly lung cancer patients: treatment nihilism in the modern era? ERJ Open Res 2021; 7:00393-2020. [PMID: 34046489 PMCID: PMC8141829 DOI: 10.1183/23120541.00393-2020] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Accepted: 02/15/2021] [Indexed: 12/24/2022] Open
Abstract
Treatment of elderly patients with lung cancer is significantly hindered by concerns about treatment tolerability, toxicity and limited clinical trial data in the elderly; potentially giving rise to treatment nihilism amongst clinicians. This study aims to describe survival in elderly patients with lung cancer and explore potential causes for excess mortality. Patients diagnosed with lung cancer in the Victorian Lung Cancer Registry between 2011–2018 were analysed (n=3481). Patients were age-categorised and compared using Cox-regression modelling to determine mortality risk, after adjusting for confounding. Probability of being offered cancer treatments was also determined, further stratified by disease stage. The eldest patients (≥80 years old) had significantly shorter median survival compared with younger age groups (<60 years: 2.0 years; 60–69 years: 1.5 years; 70–79 years: 1.6 years; ≥80 years: 1.0 years; p<0.001). Amongst those diagnosed with stage 1 or 2 lung cancer, there was no significant difference in adjusted-mortality between age groups. However, in those diagnosed with stage 3 or 4 disease, the eldest patients had an increased adjusted-mortality risk of 28% compared with patients younger than 60 years old (p=0.005), associated with markedly reduced probability of cancer treatment, after controlling for sex, performance status, comorbidities and histology type (OR 0.24, compared with <60 years old strata; p<0.001). Compared to younger patients, older patients with advanced-stage lung cancer have a disproportionately higher risk of mortality and lower likelihood of receiving cancer treatments, even when performance status and comorbidity are equivalent. These healthcare inequities could be indicative of widespread treatment nihilism towards elderly patients. Treatment strongly determines lung cancer survival, yet nihilism may threaten treatment provision and survival outcomes. Older patients in this cohort had reduced multidisciplinary presentation, less treatment (OR 0.24) and 28% increased mortality risk.https://bit.ly/2ZGotj0
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Affiliation(s)
- Jonathan Pham
- Dept of Respiratory Medicine, The Alfred Hospital, Melbourne, Australia
| | - Matthew Conron
- Dept of Respiratory Medicine, St Vincent's Hospital, Melbourne, Australia
| | - Gavin Wright
- Victorian Comprehensive Cancer Centre, Melbourne, Australia.,Dept of Surgery, University of Melbourne, Melbourne, Australia
| | - Paul Mitchell
- Olivia Newton-John Cancer Wellness and Research Centre, Melbourne, Australia
| | - David Ball
- Division of Radiation Oncology, Peter MacCallum Cancer Centre, Melbourne, Australia.,The Sir Peter MacCallum Dept of Oncology, The University of Melbourne, Parkville, Australia
| | - Jennifer Philip
- Dept of Palliative Care, St Vincent's Hospital, Melbourne, Australia.,Dept of Medicine, University of Melbourne, Melbourne, Australia
| | - Margaret Brand
- Dept of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia
| | - John Zalcberg
- Dept of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia
| | - Rob G Stirling
- Dept of Respiratory Medicine, The Alfred Hospital, Melbourne, Australia.,Dept of Medicine, Monash University, Melbourne, Australia
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20
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Vahl JM, von Witzleben A, Welke C, Doescher J, Theodoraki MN, Brand M, Schuler PJ, Greve J, Hoffmann TK, Laban S. Influence of travel burden on tumor classification and survival of head and neck cancer patients. Eur Arch Otorhinolaryngol 2021; 278:4535-4543. [PMID: 33877433 DOI: 10.1007/s00405-021-06816-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Accepted: 04/09/2021] [Indexed: 10/21/2022]
Abstract
PURPOSE Cancer patients have to overcome various barriers to obtain diagnostics and treatment at head and neck cancer centers. Travel distance to a specialized hospital may result in psychosocial and financial distress, thus interfering with diagnostics, treatment, and follow-up care. In this study, we have aimed to analyze the association of travel distance with cTNM status, UICC stage at primary diagnosis, and survival outcomes of head and neck cancer (HNC) patients. METHODS We have analyzed data of 1921 consecutive HNC patients diagnosed between 2014 and 2019 at the head and neck cancer center of the Comprehensive Cancer Center Ulm (CCCU), Germany. Postal code-based travel distance calculation in kilometers, TNM status, and UICC stage were recorded at initial diagnosis. The assembly of travel distance-related groups (short, intermediate, long-distance) has been investigated. Moreover, group-related survival and recurrence analysis have been performed. RESULTS In contrast to observations from overseas, no association of travel distance and higher cTNM status or UICC stage at primary diagnosis has been observed. Furthermore, no significant differences for recurrence-free survival and overall survival by travel distance were detected. CONCLUSION In southern Germany, travel distance to head and neck cancer centers seems to be tolerable. Travel burden is not synonymous with travel distance alone but also involves sociodemographic, monetary, and disease-specific aspects as well as accessibility to proper infrastructure of transport and health care system.
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Affiliation(s)
- J M Vahl
- Department of Otorhinolaryngology, Head and Neck Surgery, Ulm University Medical Center, Frauensteige 12, 89075, Ulm, Germany.
| | - A von Witzleben
- Department of Otorhinolaryngology, Head and Neck Surgery, Ulm University Medical Center, Frauensteige 12, 89075, Ulm, Germany
| | - C Welke
- Clinical Cancer Registry Comprehensive Cancer Center Ulm, Ulm University Medical Center, 89081, Ulm, Germany
| | - J Doescher
- Department of Otorhinolaryngology, Head and Neck Surgery, Ulm University Medical Center, Frauensteige 12, 89075, Ulm, Germany
| | - M N Theodoraki
- Department of Otorhinolaryngology, Head and Neck Surgery, Ulm University Medical Center, Frauensteige 12, 89075, Ulm, Germany
| | - M Brand
- Department of Otorhinolaryngology, Head and Neck Surgery, Ulm University Medical Center, Frauensteige 12, 89075, Ulm, Germany
| | - P J Schuler
- Department of Otorhinolaryngology, Head and Neck Surgery, Ulm University Medical Center, Frauensteige 12, 89075, Ulm, Germany
| | - J Greve
- Department of Otorhinolaryngology, Head and Neck Surgery, Ulm University Medical Center, Frauensteige 12, 89075, Ulm, Germany
| | - T K Hoffmann
- Department of Otorhinolaryngology, Head and Neck Surgery, Ulm University Medical Center, Frauensteige 12, 89075, Ulm, Germany
| | - S Laban
- Department of Otorhinolaryngology, Head and Neck Surgery, Ulm University Medical Center, Frauensteige 12, 89075, Ulm, Germany
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21
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Stirling R, Perera S, Martin C, Brand M, Zalcberg J. P09.05 Surveillance, Patterns of Recurrence and Survivorship in Early Stage Lung Cancer Patients Following Curative Intent Treatment. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.01.433] [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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22
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Harden S, Stirling R, Brand M, Zalcberg J. FP02.05 Value-Based Healthcare Study (VBHC) for Treating Lung Cancer in Victoria, Australia. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.01.077] [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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Stirling R, Brand M, Earnest A, Antippa P, Ball D, Bartlett J, Blum R, Briggs L, Caldecott M, Conron M, Jennings B, Langton D, Millar J, Mitchell P, Olesen I, Parente P, Richardson G, See K, Torres J, Underhill C, Wright G, Stenger M, Mcneil J, Zalcberg J. OA05.06 Lessons Learned from the Victorian Lung Cancer Registry: Opportunities for Quality Improvement in Lung Cancer Management and Outcomes. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.01.290] [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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24
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Brand M, Gaylard P, Ramos J. Colorectal cancer liver metastases: management and five-year survival in a South African patient cohort. S AFR J SURG 2021; 59:2-6. [PMID: 33779097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
BACKGROUND Approximately 25% of patients with colorectal cancer (CRC) will be diagnosed with CRC liver metastases (CRCLM) during the course of their disease. No data regarding CRCLM presentation, management and survival outcomes has been published from either the private or public health care sectors in South Africa. This study aimed to address this deficit, reporting on a private sector cohort. METHODS A retrospective review of a private health care funder's database from 1 January 2008 to 31 December 2015 was performed. ICD-10 diagnosis codes were used to identify CRC and CRCLM. Procedure codes assigned to hospital admissions were used to identify the type of surgical treatment. Chemotherapy was identified by the WHO Anatomical Therapeutic Chemical classification system of medicines. Treatment patterns were assessed and five-year overall survival (OS) was calculated. Survival was estimated using the Kaplan-Meier method, and Cox proportional-hazards regression was used for between group survival comparisons. RESULTS Six hundred and one (601) of 3 412 patients presenting with CRC (17.6%) were diagnosed with CRCLM at presentation or during the follow-up period. Sixty patients with CRCLM (10.0%) underwent resection of the primary CRC and liver resection for metastases, 281 (46.8%) underwent CRC resection only, 180 (30%) received chemotherapy only, and 47 (7.8%) received no treatment. Five-year OS for these groups were 57.3%, 15.6%, 9.8% and 0% respectively. CONCLUSION Five-year OS of the various CRCLM treatment pathways in a South African private sector population compares to results published in international series. However, a smaller proportion of patients with CRCLM underwent liver resection, compared to international studies.
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Affiliation(s)
- M Brand
- Department of Surgery, University of Pretoria, South Africa and School of Physiology, University of the Witwatersrand, South Africa
| | - P Gaylard
- Data Management and Statistical Analysis, South Africa
| | - J Ramos
- WITS Donald Gordon Medical Centre; University of the Witwatersrand, South Africa
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van Waart J, Matley PJ, Brand M. Federation of Surgeons of South Africa consensus document for the resumption of elective surgery after level 5 COVID-19 "lockdown" period in South Africa. S AFR J SURG 2021. [DOI: 10.17159/2078-5151/2020/v58n2a3335] [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: 11/05/2022]
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26
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Brand M, Gaylard P, Ramos J. Colorectal cancer liver metastases: management and five-year survival in a South African patient cohort. S AFR J SURG 2021. [DOI: 10.17159/2078-5151/2021/v59n1a2707] [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: 11/05/2022]
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Largey G, Briggs P, Davies H, Underhill C, Ross C, Harvey K, Blum R, Parker C, Guthrie C, Parente P, Trevorah B, Torres J, Mott C, Lancaster C, Brand M, Earnest A, Pellegrini B, Reed M, Zalcberg J, Stirling R. Victorian Lung Cancer Service Redesign Project: impacts of a quality improvement collaborative on timeliness and management in lung cancer. Intern Med J 2020; 51:2061-2068. [PMID: 32896957 DOI: 10.1111/imj.15043] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Revised: 08/26/2020] [Accepted: 08/31/2020] [Indexed: 12/11/2022]
Abstract
BACKGROUND Lung cancer management is characterised by a high disease burden, poor survival and substantial variation in management and outcomes. Service redesign provides opportunities for quality improvement (QI) and this improvement may be leveraged across multiple sites using QI collaboration. AIM This initiative targeted Quality Improvement (QI) in lung cancer management, engaging a QI collaborative using service redesign methodologies in five Victorian hospitals. QI targets included timeliness from referral and diagnosis to treatment, multi-disciplinary meeting (MDM) presentation and supportive care screening. Redesign strategies targeted process sustainability through enhanced team capability. METHODS This study engaged a prospective quality improvement cohort design targeting newly diagnosed tissue confirmed lung cancer with 6-month pre-intervention period and 6-month redesign implementation period, between September 2016 and August 2017, evaluated using Interrupted Time Series Analysis. Hospital sites included three regional and two metropolitan hospitals in Victoria. QI redesign targeted time intervals from referral to first specialist appointment (FSA), referral to diagnosis, diagnosis to first treatment (any intent), MDM documented in medical records and Supportive Care Screening Tool documented in medical records. RESULTS There was a marked reduction in referral to FSA interval across all sites, with median (interquartile range) falling from 6 (0-15) to 4 (1-10) days, and proportion seen by a specialist within 14 days increased from 74.3% to 84.2%. The interval between diagnosis and treatment was not substantively changed in the 6-month implementation period. The proportion of subjects with documented presentation to the MDM increased from 61% to 67%. The proportion for which Supportive Care Screening documentation remained low at 26.3% post-intervention. CONCLUSIONS Data-driven redesign initiatives enable identification and analysis of clinical practice variation and may be utilised to enhance timeliness of cancer care and improve local data service capabilities.
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Affiliation(s)
- Geraldine Largey
- Southern Melbourne Integrated Cancer Services, Melbourne, Victoria, Australia
| | - Peter Briggs
- Southern Melbourne Integrated Cancer Services, Melbourne, Victoria, Australia
| | - Heather Davies
- Southern Melbourne Integrated Cancer Services, Melbourne, Victoria, Australia
| | - Craig Underhill
- Department of Border Medical Oncology, Albury Wodonga Health, Wodonga, Victoria, Australia
| | - Cara Ross
- Department of Border Medical Oncology, Albury Wodonga Health, Wodonga, Victoria, Australia
| | - Kellie Harvey
- Department of Respiratory Medicine, Alfred Hospital, Melbourne, Victoria, Australia
| | - Robert Blum
- Department of Medical Oncology, Bendigo Health Care Group, Bendigo, Victoria, Australia
| | - Carol Parker
- Department of Medical Oncology, Bendigo Health Care Group, Bendigo, Victoria, Australia
| | - Christal Guthrie
- Department of Medical Oncology, Bendigo Health Care Group, Bendigo, Victoria, Australia
| | - Phillip Parente
- Department of Medical Oncology, Eastern Health, Melbourne, Victoria, Australia
| | - Brooke Trevorah
- Department of Medical Oncology, Eastern Health, Melbourne, Victoria, Australia
| | - Javier Torres
- Department of Medical Oncology, Goulbourn Valley Health, Shepparton, Victoria, Australia
| | - Carole Mott
- Department of Medical Oncology, Goulbourn Valley Health, Shepparton, Victoria, Australia
| | - Cheryl Lancaster
- Department of Medical Oncology, Goulbourn Valley Health, Shepparton, Victoria, Australia
| | - Margaret Brand
- Department of Medicine, Monash University, Melbourne, Victoria, Australia
| | - Arul Earnest
- Department of Medicine, Monash University, Melbourne, Victoria, Australia
| | - Breanna Pellegrini
- Department of Medicine, Monash University, Melbourne, Victoria, Australia
| | - Marita Reed
- Department of Health and Human Services, Quality and Cancer Outcomes, Melbourne, Victoria, Australia
| | - John Zalcberg
- Department of Medicine, Monash University, Melbourne, Victoria, Australia
| | - Rob Stirling
- Department of Respiratory Medicine, Alfred Hospital, Melbourne, Victoria, Australia.,Department of Medicine, Monash University, Melbourne, Victoria, Australia
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Träber N, Uhlmann K, Girardo S, Kesavan G, Wagner K, Friedrichs J, Goswami R, Bai K, Brand M, Werner C, Balzani D, Guck J. Polyacrylamide Bead Sensors for in vivo Quantification of Cell-Scale Stress in Zebrafish Development. Sci Rep 2019; 9:17031. [PMID: 31745109 PMCID: PMC6864055 DOI: 10.1038/s41598-019-53425-6] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Accepted: 10/23/2019] [Indexed: 11/09/2022] Open
Abstract
Mechanical stress exerted and experienced by cells during tissue morphogenesis and organ formation plays an important role in embryonic development. While techniques to quantify mechanical stresses in vitro are available, few methods exist for studying stresses in living organisms. Here, we describe and characterize cell-like polyacrylamide (PAAm) bead sensors with well-defined elastic properties and size for in vivo quantification of cell-scale stresses. The beads were injected into developing zebrafish embryos and their deformations were computationally analyzed to delineate spatio-temporal local acting stresses. With this computational analysis-based cell-scale stress sensing (COMPAX) we are able to detect pulsatile pressure propagation in the developing neural rod potentially originating from polarized midline cell divisions and continuous tissue flow. COMPAX is expected to provide novel spatio-temporal insight into developmental processes at the local tissue level and to facilitate quantitative investigation and a better understanding of morphogenetic processes.
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Affiliation(s)
- N Träber
- Leibniz-Institut für Polymerforschung Dresden e. V., Hohe Str. 6, 01069, Dresden, Germany
- Biotechnology Center, Center for Molecular and Cellular Bioengineering, Technische Universität Dresden, Tatzberg 47/49, 01307, Dresden, Germany
| | - K Uhlmann
- Chair of Continuum Mechanics, Ruhr-Universität Bochum, Universitätsstraße 150, 44801, Bochum, Germany
| | - S Girardo
- Biotechnology Center, Center for Molecular and Cellular Bioengineering, Technische Universität Dresden, Tatzberg 47/49, 01307, Dresden, Germany
- Center for Regenerative Therapies Dresden, Center for Molecular and Cellular Bioengineering, Technische Universität Dresden, Fetscherstr. 105, 01307, Dresden, Germany
- Max Planck Institute for the Science of Light, Staudtstraße 2, 91058, Erlangen, Germany
| | - G Kesavan
- Center for Regenerative Therapies Dresden, Center for Molecular and Cellular Bioengineering, Technische Universität Dresden, Fetscherstr. 105, 01307, Dresden, Germany
| | - K Wagner
- Biotechnology Center, Center for Molecular and Cellular Bioengineering, Technische Universität Dresden, Tatzberg 47/49, 01307, Dresden, Germany
| | - J Friedrichs
- Leibniz-Institut für Polymerforschung Dresden e. V., Hohe Str. 6, 01069, Dresden, Germany
| | - R Goswami
- Center for Regenerative Therapies Dresden, Center for Molecular and Cellular Bioengineering, Technische Universität Dresden, Fetscherstr. 105, 01307, Dresden, Germany
- Max Planck Institute for the Science of Light, Staudtstraße 2, 91058, Erlangen, Germany
| | - K Bai
- Center for Regenerative Therapies Dresden, Center for Molecular and Cellular Bioengineering, Technische Universität Dresden, Fetscherstr. 105, 01307, Dresden, Germany
| | - M Brand
- Center for Regenerative Therapies Dresden, Center for Molecular and Cellular Bioengineering, Technische Universität Dresden, Fetscherstr. 105, 01307, Dresden, Germany
| | - C Werner
- Leibniz-Institut für Polymerforschung Dresden e. V., Hohe Str. 6, 01069, Dresden, Germany
| | - D Balzani
- Chair of Continuum Mechanics, Ruhr-Universität Bochum, Universitätsstraße 150, 44801, Bochum, Germany.
| | - J Guck
- Biotechnology Center, Center for Molecular and Cellular Bioengineering, Technische Universität Dresden, Tatzberg 47/49, 01307, Dresden, Germany.
- Max Planck Institute for the Science of Light, Staudtstraße 2, 91058, Erlangen, Germany.
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Boucard A, Marin F, Monternier PA, Brand M, Le Grand B. P4607A specific complex I-induced ROS modulator, OP2113, is a new cardioproctective agent against acute myocardial infarction injuries during reperfusion. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0990] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [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] [Indexed: 11/14/2022] Open
Abstract
Abstract
Introduction
Hospital death rates due to myocardial infarction are still a concern and heart failure occurs in nearly a quarter of older patients who present with ST elevation myocardial infarction. Novel therapies are thus desperately needed to reduce infarct size to preserve left ventricular function and to prevent the onset of heart failure.
Purpose
OP2113, trithio-p-methoxyphenylpropene (anethole trithione, 5-(4-methoxyphenyl)-3H-1,2-dithiole-3-thione, anethole dithionethiol), a potential suppressor of complex I superoxide/hydrogen peroxide (ROS) production was evaluated in a sheep model of regional ischemia in order to demonstrate cardioprotective properties against infarct size and left ventricular function remodeling.
Methods
A series of experiments was performed in vitro on isolated mitochondria and on C2C12 cells to clarify the mechanism of action and to test whether OP2113 impacts biological variables of mitochondria. In vivo, anesthetized sheep underwent 60 min ischemia and 120 min reperfusion and either received OP2113 (1–5 μg/kg, i.v at start of and for the duration of the reperfusion) or the vehicle. The animals underwent then a 3-day follow-up period until euthanasia. Ischemic biomarkers, troponin I, CPK, and ventricular function through echocardiography were quantified during reperfusion and infarct size through histological analysis.
Results
OP2113 reduced ROS production from site IQ in mitochondria isolated from rat skeletal muscle, with IC50 of 26±1.4 μM (n=3). It is specific; IC50 values for other sites are at least 15-fold higher (site IIIQo – 414 μM; site IIF – 582 μM; sites IF/DH, PF, GQ >5 mM). Furthermore, OP2113 did not affect oxidative phosphorylation, respiration or growth of C2C12 cells. In the sheep model, OP2113 (1–10 μg/kg) dose-dependently prevented reperfusion-induced ST segment increase during the first minutes. When OP2113 plasmatic concentration was superior to 1 ng/mL (generally associated with a threshold dose of 5 μg/kg), troponin Ic levels measured over the experiment was strongly decreased and the cardiac function significantly improved (+86%), when compared to the vehicle group (left panel). Finally, the infarct size was diminished by 57% comparing to the vehicle group (10.3% vs 23.8%, respectively, right panel).
Conclusion
In a large animal model of ischemia-reperfusion, OP2113 with very low infused dose, reduced ST segment elevation, reduced troponin release, improved left ejection fraction and reduced infarct size. Collectively, these results demonstrate that OP2113, through a new mechanism of action, is a potent cardioprotective compound.
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Affiliation(s)
| | - F Marin
- OP2 Drugs, Bordeaux-Pessac, France
| | - P A Monternier
- Buck Institute for Research on Aging, Novato, United States of America
| | - M Brand
- Buck Institute for Research on Aging, Novato, United States of America
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McLaughlin V, Channick R, Chin K, Leary P, Miller C, Brand M, Flynn M, Leroy S, Morganti A, Kim N. P3674Patient characteristics and treatment patterns in the multicentre, retrospective chart review of first-time Opsumit (macitentan) users in the United States (OrPHeUS). Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0529] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
The OPsumit® Historical USers cohort (OrPHeUS) is a multicentre, US, retrospective medical chart review conducted to supplement the OPsumit® USers (OPUS) Registry to fulfil the FDA request to characterise the safety of macitentan in clinical practice.
Purpose
To describe patient characteristics, treatment patterns, hepatic safety and survival in patients with pulmonary hypertension (PH) newly treated with macitentan.
Methods
OrPHeUS (NCT03197688) aimed to include 2200 new users of macitentan, between October 2013 and March 2017, who were not enrolled in OPUS. Here we present patients with follow-up data, including characteristics and treatment patterns at macitentan initiation, hepatic adverse events (HAEs) identified using preferred terms in chart entries and pharmacovigilance reporting, hospitalisations and survival.
Results
OrPHeUS included 2982 patients newly treated with macitentan and with follow-up data; the reason for macitentan prescription was pulmonary arterial hypertension (PAH) in 2362 (79.3%) patients, other PH aetiologies in 612 (20.6%) patients and 8 patients with other/unknown reasons. At macitentan initiation, the median (Q1, Q3) age of the patients was 62 (51, 72) years and 73.9% were female. WHO functional class (FC) was documented in 654 (21.9%) patients, 35.6% of patients were in FC I/II and 64.4% in FC III/IV; median (Q1, Q3) 6-minute walk distance, documented in 411 (13.8%) patients, was 293 (200, 383) metres. At macitentan initiation, 41.5% (n=1239) of patients were not receiving PAH therapy, 46.3% (n=1382) were already receiving one PAH therapy and 11.9% (n=356) were already receiving two PAH therapies. The median (Q1, Q3) exposure to macitentan was 14.9 (5.6, 27.1) months; 57% and 43% of patients had exposures of >12 and >18 months. During the exposure period, 933 (31.3%) patients discontinued treatment, including 474 (15.9%) patients who discontinued due to an adverse event (AE), 6 (0.2%) due to a HAE, 449 (15.1%) for reasons other than an AE/HAE, and 4 (0.1%) for unknown reasons. There were 275 (9.2%) patients who experienced ≥1 HAE (incidence rate [IR]: 0.07 [95% CI, 0.06, 0.08] per 1 person-year); alanine aminotransferase (ALT) or aspartate aminotransferase (AST) ≥3x upper limit of normal (ULN) were experienced by 113 (3.8%) patients (IR: 0.028 [95% CI, 0.023, 0.033] per 1 person-year); ALT/AST ≥x3 ULN and bilirubin ≥2x ULN was experienced by 33 (1.1%) patients (IR: 0.008 [95% CI, 0.006, 0.011] per 1 person-year). There were 1148 (38.5%) patients who experienced at least one hospitalisation (IR: 0.36 [95% CI, 0.34, 0.39] per 1 person-year). The 12-month Kaplan-Meier survival estimate was 92% (95% CI, 91, 93).
Conclusion
OrPHeUS provides additional real-world evidence in patients newly treated with macitentan, confirming the hepatic safety profile of macitentan.
Acknowledgement/Funding
Actelion Pharmaceuticals Ltd
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Affiliation(s)
- V McLaughlin
- University of Michigan, Ann Arbor, United States of America
| | - R Channick
- University of California Los Angeles, Los Angeles, United States of America
| | - K Chin
- University of Texas Southwestern Medical School, Dallas, United States of America
| | - P Leary
- University of Washington, Seattle, United States of America
| | - C Miller
- Piedmont Healthcare, Atlanta, United States of America
| | - M Brand
- Actelion Pharmaceuticals Ltd, Allschwil, Switzerland
| | - M Flynn
- Actelion Pharmaceuticals US, Inc, South San Francisco, United States of America
| | - S Leroy
- Actelion Pharmaceuticals Ltd, Allschwil, Switzerland
| | - A Morganti
- Actelion Pharmaceuticals Ltd, Allschwil, Switzerland
| | - N Kim
- University of California San Diego, La Jolla, United States of America
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Clark SJ, Halter M, Porter A, Smith HC, Brand M, Fothergill R, Lindridge SJ, McTigue M, Snooks H. Using deterministic record linkage to link ambulance and emergency department data: is it possible without patient identifiers? A case study from the UK. Int J Popul Data Sci 2019; 4:1104. [PMID: 34095533 PMCID: PMC8142959 DOI: 10.23889/ijpds.v4i1.1104] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
INTRODUCTION Routine linkage of emergency ambulance records with those from the emergency department is uncommon in the UK. Our study, known as the Pre-Hospital Emergency Department Data Linking Project (PHED Data), aimed to link records of all patients conveyed by a single emergency ambulance service to thirteen emergency departments in the UK from 2012-2016. OBJECTIVES We aimed to examine the feasibility and resource requirements of collecting de-identified emergency department patient record data and, using a deterministic matching algorithm, linking it to ambulance service data. METHODS We used a learning log to record contacts and activities undertaken by the research team to achieve data linkage. We also conducted semi-structured interviews with information management/governance staff involved in the process. RESULTS We found that five steps were required for successful data linkage for each hospital trust. The total time taken to achieve linkage was a mean of 65 weeks. A total of 958,057 emergency department records were obtained and, of these, 81% were linked to a corresponding ambulance record. The match rate varied between hospital trusts (50%-94%). Staff expressed strong enthusiasm for data linkage. Barriers to successful linkage were mainly due to inconsistencies between and within acute trusts in the recording of two ambulance event identifiers (CAD and call sign). Further data cleaning was required on emergency department fields before full analysis could be conducted. Ensuring the data was not re-identifiable limited validation of the matching method. CONCLUSION We conclude that deterministic record linkage based on the combination of two event identifiers (CAD and call sign) is possible. There is an appetite for data linkage in healthcare organisations but it is a slow process. Developments in standardising the recording of emergency department data are likely to improve the quality of the resultant linked dataset. This would further increase its value for providing evidence to support improvements in health care delivery. HIGHLIGHTS Ambulance records are rarely linked to other datasets; this study looks at the feasibility and resource requirement to use deterministic matching to link ambulance and emergency department data for patients conveyed by ambulance to the emergency department.It is possible to link these data, with an average match rate of 81% across 13 emergency departments and one large ambulance trust.All trusts approached provided match-able data and there was an appetite for data linkage; however, it was a long process taking an average of 65 weeks.We conclude that deterministic matching using no patient identifiers can be used in this setting.
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Affiliation(s)
- SJ Clark
- Medical Directorate, London Ambulance Service, London. SE1 8SD
| | - M Halter
- Kingston University and St George’s, University of London, Centre for Health and Social Care Research, London SW17 0RE
| | - A Porter
- Swansea University Medical School, Singleton Park, Swansea SA2 8PP
| | - HC Smith
- Department of Primary Care and Population Health, University College London, London, UK; Formally Nuffield Trust, 59 New Cavendish Street, London, UK
| | - M Brand
- Strategy Directorate, London Ambulance Service, London. SE1 8SD
| | - R Fothergill
- Clinical Audit and Research Unit, London Ambulance Service, London. SE1 0BW
- Clinical Trials Unit, Medical School, Warwick University Faculty of Health, Social Care and Education, Kingston University and St George’s, University of London, London SW17 0RE
| | - SJ Lindridge
- 27 Devonshire Way, Croydon, CR0 8BU. Emergency Care Intensive Support Team, NHS Improvement, London, SE1 8UG; Formerly Medical Directorate, London Ambulance Service NHS Trust, London, SE1 8SD
| | - M McTigue
- Operations West, London Ambulance Service, London. SE1 8SD
| | - H Snooks
- Swansea University Medical School, Singleton Park, Swansea SA2 8PP
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Eller A, Wiesmüller M, Wüst W, Heiss R, Kopp M, Saake M, Brand M, Uder M, May MM. Carotid CTA at the Lowest Tube Voltage (70 kV) in Comparison with Automated Tube Voltage Adaption. AJNR Am J Neuroradiol 2019; 40:1374-1382. [PMID: 31296525 DOI: 10.3174/ajnr.a6108] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2018] [Accepted: 05/26/2019] [Indexed: 12/28/2022]
Abstract
BACKGROUND AND PURPOSE CTA is the imaging modality of choice in many institutions for the evaluation of the supraaortic vessels, but radiation exposure remains a matter of concern. Our aim was to evaluate a 70-kV protocol for CT angiography of the carotid arteries with respect to image quality and radiation exposure compared with automated tube voltage adaption. MATERIALS AND METHODS A total of 90 consecutive patients were included in this prospective study and randomized to the study group (n = 45, 70 kV) or control group (n = 45, automated tube voltage adaptation). Volume CT dose indices and dose-length products were recorded in the examination protocol. Image quality was assessed as arterial vessel contrast, signal-to-noise ratio, contrast-to-noise ratio, and contrast-to-noise ratio in reference to the radiation dose. Subjective overall image-quality analysis, image-artifact analysis, and diagnostic evaluation were performed by 2 observers by using a 4-point Likert scale. RESULTS Radiation exposure was significantly lower in the study group (volume CT dose index reduced by 22%, dose-length product reduction by 20%; each P < .001). Contrast (P = .15), SNR (P = .4), and contrast-to-noise ratio (P = .5) did not show significant differences between the groups. The contrast-to-noise ratio in reference to the radiation dose was not significantly increased using the study protocol (P = .2). Subjective image quality and visualization of pathologic findings did not differ significantly between the groups. CONCLUSIONS Carotid CTA using the lowest available voltage (70 kV) is feasible at very-low-dose levels, while overall image quality is comparable with protocols using automated tube voltage selection.
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Affiliation(s)
- A Eller
- From the Department of Radiology (A.E., M.W., W.W., R.H., M.K., M.S., M.B., M.U., M.M.M.), University Hospital Erlangen, Erlangen, Germany
| | - M Wiesmüller
- From the Department of Radiology (A.E., M.W., W.W., R.H., M.K., M.S., M.B., M.U., M.M.M.), University Hospital Erlangen, Erlangen, Germany
| | - W Wüst
- From the Department of Radiology (A.E., M.W., W.W., R.H., M.K., M.S., M.B., M.U., M.M.M.), University Hospital Erlangen, Erlangen, Germany
| | - R Heiss
- From the Department of Radiology (A.E., M.W., W.W., R.H., M.K., M.S., M.B., M.U., M.M.M.), University Hospital Erlangen, Erlangen, Germany
| | - M Kopp
- From the Department of Radiology (A.E., M.W., W.W., R.H., M.K., M.S., M.B., M.U., M.M.M.), University Hospital Erlangen, Erlangen, Germany
| | - M Saake
- From the Department of Radiology (A.E., M.W., W.W., R.H., M.K., M.S., M.B., M.U., M.M.M.), University Hospital Erlangen, Erlangen, Germany
| | - M Brand
- From the Department of Radiology (A.E., M.W., W.W., R.H., M.K., M.S., M.B., M.U., M.M.M.), University Hospital Erlangen, Erlangen, Germany
| | - M Uder
- From the Department of Radiology (A.E., M.W., W.W., R.H., M.K., M.S., M.B., M.U., M.M.M.), University Hospital Erlangen, Erlangen, Germany
- Imaging Science Institute (M.U., M.M.M.), Erlangen, Germany
| | - M M May
- From the Department of Radiology (A.E., M.W., W.W., R.H., M.K., M.S., M.B., M.U., M.M.M.), University Hospital Erlangen, Erlangen, Germany
- Imaging Science Institute (M.U., M.M.M.), Erlangen, Germany
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Channick R, Chin K, Kim N, Brand M, Morganti A, Selej M, McLaughlin V. Patient Characteristics and Treatment Patterns with Macitentan in Pulmonary Arterial Hypertension: Insights from the OPUS Registry. J Heart Lung Transplant 2019. [DOI: 10.1016/j.healun.2019.01.1245] [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: 10/27/2022] Open
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Channick R, McLaughlin V, Chin K, McConnell J, Poch D, Brand M, Selej M, Morganti A, Kim N. Treatment of Chronic Thromboembolic Pulmonary Hypertension (CTEPH): Real-World Experience with Macitentan. J Heart Lung Transplant 2019. [DOI: 10.1016/j.healun.2019.01.1229] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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Fineberg NA, Demetrovics Z, Stein DJ, Ioannidis K, Potenza MN, Grünblatt E, Brand M, Billieux J, Carmi L, King DL, Grant JE, Yücel M, Dell'Osso B, Rumpf HJ, Hall N, Hollander E, Goudriaan A, Menchon J, Zohar J, Burkauskas J, Martinotti G, Van Ameringen M, Corazza O, Pallanti S, Chamberlain SR. Manifesto for a European research network into Problematic Usage of the Internet. Eur Neuropsychopharmacol 2018; 28:1232-1246. [PMID: 30509450 PMCID: PMC6276981 DOI: 10.1016/j.euroneuro.2018.08.004] [Citation(s) in RCA: 160] [Impact Index Per Article: 26.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2018] [Revised: 07/18/2018] [Accepted: 08/07/2018] [Indexed: 12/24/2022]
Abstract
The Internet is now all-pervasive across much of the globe. While it has positive uses (e.g. prompt access to information, rapid news dissemination), many individuals develop Problematic Use of the Internet (PUI), an umbrella term incorporating a range of repetitive impairing behaviours. The Internet can act as a conduit for, and may contribute to, functionally impairing behaviours including excessive and compulsive video gaming, compulsive sexual behaviour, buying, gambling, streaming or social networks use. There is growing public and National health authority concern about the health and societal costs of PUI across the lifespan. Gaming Disorder is being considered for inclusion as a mental disorder in diagnostic classification systems, and was listed in the ICD-11 version released for consideration by Member States (http://www.who.int/classifications/icd/revision/timeline/en/). More research is needed into disorder definitions, validation of clinical tools, prevalence, clinical parameters, brain-based biology, socio-health-economic impact, and empirically validated intervention and policy approaches. Potential cultural differences in the magnitudes and natures of types and patterns of PUI need to be better understood, to inform optimal health policy and service development. To this end, the EU under Horizon 2020 has launched a new four-year European Cooperation in Science and Technology (COST) Action Programme (CA 16207), bringing together scientists and clinicians from across the fields of impulsive, compulsive, and addictive disorders, to advance networked interdisciplinary research into PUI across Europe and beyond, ultimately seeking to inform regulatory policies and clinical practice. This paper describes nine critical and achievable research priorities identified by the Network, needed in order to advance understanding of PUI, with a view towards identifying vulnerable individuals for early intervention. The network shall enable collaborative research networks, shared multinational databases, multicentre studies and joint publications.
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Affiliation(s)
- N A Fineberg
- Hertfordshire Partnership University NHS Foundation Trust, Rosanne House, Welwyn Garden City, Hertfordshire AL8 6HG, UK; Center for Clinical & Health Research Services, School of Life and Medical Sciences, University of Hertfordshire, Hatfield, UK; School of Clinical Medicine, University of Cambridge, Cambridge, UK.
| | - Z Demetrovics
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
| | - D J Stein
- Department of Psychiatry and Mental Health at the University of Cape Town and South African MRC Unit on Risk & Resilience in Mental Disorders, Cape Town, South Africa
| | - K Ioannidis
- Department of Psychiatry, University of Cambridge, Cambridge, UK; Cambridge & Peterborough NHS Foundation Trust, Cambridge, UK
| | - M N Potenza
- Connecticut Mental Health Center and Departments of Psychiatry, Neuroscience and Child Study Center, Yale School of Medicine, New Haven, USA; Connecticut Council on Problem Gambling, Wethersfield, CT, USA
| | - E Grünblatt
- Department of Child and Adolescent Psychiatry and Psychotherapy, Psychiatric University Hospital Zurich, University of Zurich, Zurich, Switzerland; Neuroscience Center Zurich, University of Zurich and ETH Zurich, Zurich, Switzerland; Zurich Center for Integrative Human Physiology, University of Zurich, Zurich, Switzerland
| | - M Brand
- General Psychology: Cognition and Center for Behavioral Addiction Research (CeBAR), Department of Computer Science and Applied Cognitive Science Faculty of Engineering, University of Duisburg-Essen, Duisburg, Germany; Erwin L. Hahn Institute for Magnetic Resonance Imaging, Essen, Germany
| | - J Billieux
- Addictive and Compulsive Behaviours Lab, Institute for Health and Behaviour, University of Luxembourg, Esch-sur-Alzette, Luxembourg; Addiction Division, Department of Mental Health and Psychiatry, University Hospitals of Geneva, Switzerland; Centre for Excessive Gambling, Lausanne University Hospitals (CHUV), Lausanne, Switzerland
| | - L Carmi
- School of Psychological Sciences, Tel Aviv University, Tel Aviv, Israel
| | - D L King
- School of Psychology, University of Adelaide, Adelaide, Australia
| | - J E Grant
- Department of Psychiatry, University of Chicago, Chicago, USA
| | - M Yücel
- Monash Institute of Cognitive and Clinical Neurosciences, School of Psychological Sciences, Monash University, Melbourne, Australia
| | - B Dell'Osso
- Department of Pathophysiology and Transplantation, University of Milan, Fondazione IRCCS Ca' Granda and CRC "Aldo Ravelli" for neurotechnology and experimental brain therapeutics, Milan, Italy; Department of Psychiatry, University of Milan, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy; Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA; CRC "Aldo Ravelli" for Neurotechnology and Experimental Brain Therapeutics, University of Milan, Milan, Italy
| | - H J Rumpf
- University of Lübeck, Department of Psychiatry and Psychotherapy, Centre for Integrative Psychiatry, Lübeck, Germany
| | - N Hall
- Center for Clinical & Health Research Services, School of Life and Medical Sciences, University of Hertfordshire, Hatfield, UK
| | - E Hollander
- Department of Psychiatry and Compulsive, Impulsive and Autism Spectrum Program, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY, USA
| | - A Goudriaan
- Department of Psychiatry, Academisch Medisch Centrum (AMC), University of Amsterdam, Amsterdam, Netherlands; Amsterdam UMC, University of Amsterdam, Department of Psychiatry, Amsterdam Institute for Addiction Research, Meibergdreef 9, Amsterdam, Netherlands; Arkin, Amsterdam, The Netherlands
| | - J Menchon
- Department of Psychiatry, Bellvitge University, Hospital-IDIBELL, University of Barcelona, Cibersam, Barcelona, Spain
| | - J Zohar
- Sackler Medical School, Tel Aviv University, and Chaim Sheba Medical Center Tel Hashomer, Tel Aviv, Israel
| | - J Burkauskas
- Laboratory of Behavioral Medicine, Neuroscience Institute, Lithuanian University of Health Sciences, Palanga, Lithuania
| | - G Martinotti
- Department of Neuroscience, Imaging, Clinical Science, University G.d'Annunzio of Chieti-Pescara, Chieti, Italy
| | - M Van Ameringen
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Ontario, Canada
| | - O Corazza
- Center for Clinical & Health Research Services, School of Life and Medical Sciences, University of Hertfordshire, Hatfield, UK
| | - S Pallanti
- Albert Einstein College of Medicine, New York, USA; University of Florence, Italy
| | - S R Chamberlain
- Department of Psychiatry, University of Cambridge, Cambridge, UK; Cambridge & Peterborough NHS Foundation Trust, Cambridge, UK
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Kluyts HL, le Manach Y, Munlemvo DM, Madzimbamuto F, Basenero A, Coulibaly Y, Rakotoarison S, Gobin V, Samateh AL, Chaibou MS, Omigbodun AO, Amanor-Boadu SD, Tumukunde J, Madiba TE, Pearse RM, Biccard BM, Abbas N, Abdelatif AI, Abdoulaye T, Abd-rouf A, Abduljalil A, Abdulrahman A, Abdurazig S, Abokris A, Abozaid W, Abugassa S, Abuhdema F, Abujanah S, Abusamra R, Abushnaf A, Abusnina S, Abuzalout T, Ackermann H, Adamu Y, Addanfour A, Adeleke D, Adigun T, Adisa A, Adjignon SV, Adu-Aryee N, Afolabi B, Agaba A, Agaba P, Aghadi K, Agilla H, Ahmed B, Ahmed EZ, Ahmed AJ, Ahmed M, Ahossi R, Aji S, Akanyun S, Akhideno I, Akhter M, Akinyemi O, Akkari M, Akodjenou J, AL Samateh A, al Shams E, Alagbe-Briggs O, Alakkari E, Alalem R, Alashhab M, Alatise O, Alatresh A, Alayeb Alayeb M, Albakosh B, Albert F, Alberts A, Aldarrat A, Alfari A, Alfetore A, Algbali M, Algddar A, Algedar H, Alghafoud I, Alghazali A, Alhajj M, Alhendery Alhendery A, Alhoty F, Ali A, Ali Y, Ali A, Alioune BS, Alkassem M, 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Roos J, Rorke NF, Roura H, Rousseau F, Rousseau N, Royas L, Roytowski D, Rungan D, Rwehumbiza S, Ryabchiy B, Ryndine V, Saaiman C, Sabwa H, Sadat S, Saed S, Salaheddin E, Salaou H, Saleh M, Salisu-Kabara H, Doles Sama H, Samateh AL, Sam-Awortwi W, Samuel N, Sanduku D, Sani CM, Sanyang L, Sarah H, Sarkin-Pawa A, Sathiram R, Saurombe T, Schutte H, Sebei M, Sedekounou M, Segooa M, Semenya E, Semo B, Sendagire C, Senoga S, Senusi F, Serdyn T, Seshibe M, Shah G, Shamamba R, Shambare C, Shangase T, Shanin S, Shefren I, Sheshe A, Shittu O, Shkirban A, Sholadoye T, Shubba A, Sigcu N, Sihope S, Sikazwe D, Sikombe B, Simaga Abdoul K, Simo W, Singata K, Singh A, Singh S, Singh U, Sinoamadi V, Sipuka N, Sithole N, Sitima S, Skinner DL, Skinner G, Smith O, Smits C, Sofia M, Sogoba G, Sohoub A, Sookun S, Sosinska O, Souhe R, Souley G, Souleymane T, Spicer J, Spijkerman S, Steinhaus H, Steyn A, Steyn G, Steyn H, Stoltenkamp HL, Stroyer S. The ASOS Surgical Risk Calculator: development and validation of a tool for identifying African surgical patients at risk of severe postoperative complications. Br J Anaesth 2018; 121:1357-1363. [PMID: 30442264 DOI: 10.1016/j.bja.2018.08.005] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2018] [Revised: 07/19/2018] [Accepted: 08/06/2018] [Indexed: 10/28/2022] Open
Abstract
BACKGROUND The African Surgical Outcomes Study (ASOS) showed that surgical patients in Africa have a mortality twice the global average. Existing risk assessment tools are not valid for use in this population because the pattern of risk for poor outcomes differs from high-income countries. The objective of this study was to derive and validate a simple, preoperative risk stratification tool to identify African surgical patients at risk for in-hospital postoperative mortality and severe complications. METHODS ASOS was a 7-day prospective cohort study of adult patients undergoing surgery in Africa. The ASOS Surgical Risk Calculator was constructed with a multivariable logistic regression model for the outcome of in-hospital mortality and severe postoperative complications. The following preoperative risk factors were entered into the model; age, sex, smoking status, ASA physical status, preoperative chronic comorbid conditions, indication for surgery, urgency, severity, and type of surgery. RESULTS The model was derived from 8799 patients from 168 African hospitals. The composite outcome of severe postoperative complications and death occurred in 423/8799 (4.8%) patients. The ASOS Surgical Risk Calculator includes the following risk factors: age, ASA physical status, indication for surgery, urgency, severity, and type of surgery. The model showed good discrimination with an area under the receiver operating characteristic curve of 0.805 and good calibration with c-statistic corrected for optimism of 0.784. CONCLUSIONS This simple preoperative risk calculator could be used to identify high-risk surgical patients in African hospitals and facilitate increased postoperative surveillance. CLINICAL TRIAL REGISTRATION NCT03044899.
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Affiliation(s)
- H-L Kluyts
- Department of Anaesthesiology, Sefako Makgatho Health Sciences University, Pretoria, Gauteng, South Africa
| | - Y le Manach
- Department of Anesthesia, Michael DeGroote School of Medicine, Faculty of Health Sciences, McMaster University and Population Health Research Institute, David Braley Cardiac, Vascular and Stroke Research Institute, Perioperative Medicine and Surgical Research Unit, Hamilton, ON, Canada; Department of Clinical Epidemiology and Biostatistics, Michael DeGroote School of Medicine, Faculty of Health Sciences, McMaster University and Population Health Research Institute, David Braley Cardiac, Vascular and Stroke Research Institute, Perioperative Medicine and Surgical Research Unit, Hamilton, ON, Canada
| | - D M Munlemvo
- University Hospital of Kinshasa, Kinshasa, Democratic Republic of Congo
| | - F Madzimbamuto
- Department of Anaesthesia and Critical Care Medicine, University of Zimbabwe College of Health Sciences, Harare, Zimbabwe
| | - A Basenero
- Ministry of Health and Social Services Namibia, Windhoek, Namibia
| | - Y Coulibaly
- Department, Faculté de médicine de Bamako, Bamako, Mali
| | | | - V Gobin
- Ministry of Health and Quality of Life, Jawaharlal Nehru Hospital, Rose Belle, Grand Port, Mauritius
| | - A L Samateh
- Department of Surgery, Edward Francis Small Teaching Hospital, Banjul, Gambia
| | - M S Chaibou
- Department of Anesthesiology, Intensive Care and Emergency, National Hospital of Niamey, Niamey, Niger
| | - A O Omigbodun
- Department of Obstetrics and Gynaecology, College of Medicine, University of Ibadan, Ibadan, Oyo State, Nigeria
| | - S D Amanor-Boadu
- Department of Anaesthesia, University College Hospital, Ibadan, Oyo State, Nigeria
| | - J Tumukunde
- Makerere University, Makerere, Kampala, Uganda
| | - T E Madiba
- Department of Surgery, University of KwaZulu-Natal, Durban, KwaZulu-Natal, South Africa
| | - R M Pearse
- Intensive Care Medicine, Queen Mary University of London, London, UK
| | - B M Biccard
- Department of Anaesthesia and Perioperative Medicine, Groote Schuur Hospital, Faculty of Health Sciences, University of Cape Town, Observatory, Western Cape, South Africa.
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McLaughlin V, Chin K, Kim N, Sulica R, Frantz R, Brand M, Muros-Le Rouzic E, Selej M, Channick R. P3560Real-world experience with concomitant macitentan and riociguat treatment in patients with pulmonary hypertension (PH) in the OPsumit USers (OPUS) registry. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy563.p3560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- V McLaughlin
- University of Michigan, Division of Cardiovascular Medicine, Ann Arbor, United States of America
| | - K Chin
- University of Texas Southwestern Medical Center, Department of Internal Medicine, Dallas, United States of America
| | - N Kim
- University of California San Diego, Division of Pulmonary & Critical Care Medicine, La Jolla, United States of America
| | - R Sulica
- Division Pulmonary, Critical Care and Sleep Medicine, New York University Langone Health, New York, United States of America
| | - R Frantz
- Mayo Clinic, Department of Cardiovascular Medicine, Rochester, United States of America
| | - M Brand
- Actelion Pharmaceuticals Ltd, Global Clinical Science & Epidemiology, Allschwil, Switzerland
| | - E Muros-Le Rouzic
- Actelion Pharmaceuticals Ltd, Global Clinical Science & Epidemiology, Allschwil, Switzerland
| | - M Selej
- Actelion Pharmaceuticals US, Inc, Medical Affairs, South San Francisco, United States of America
| | - R Channick
- Massachusetts General Hospital, Pulmonary and Critical Care, Boston, United States of America
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Puttergill B, Kruger D, Brand M, Veller MG. Suture material use and procurement: an audit of a public hospital surgical system in Gauteng, South Africa. S AFR J SURG 2018; 56:45-49. [PMID: 30010264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
BACKGROUND Surgical systems are integral to successful, safe and cost effective clinical practice and must balance surgical demands on consumable items and their costs. Suture material is a key consumable resource, and was evaluated in an audit of consumable use and cost as well as the procurement systems within the South African Gauteng public health care sector. AIMS To determine suture use and cost in the four commonest general surgical procedures - abdominal wall closure, mastectomy, appendicectomy and inguinal hernia repair - in three academic Gauteng hospitals. Performance and availability were evaluated as a secondary aim in suture material use. METHOD A prospective observational study. Suture use was documented by the surgeon at the time of the procedure and qualitative investigation at relevant hospital departments determined suture material procurement and expenditure. RESULTS The surgeons in three facilities documented consistent material type and average number of units used; however, in some cases there was a lack of availability of appropriate material and breakage of generic material intraoperatively. There is no consistent and consolidated electronic record-keeping of suture stock and cost in all three hospitals, therefore cost of suture material used was not obtainable. CONCLUSION Clinical deficiencies in availability and quality of material may have adverse implications for patient health, healthcare costs and budgets through procedure-related complications and should be investigated. There is a lack of communication between the financial management, procurement officers, hospital and theatre stores and theatre staff. It is suggested that clinical protocols and system-based strategies be put in place to manage surgical consumables.
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Affiliation(s)
- B Puttergill
- Department of Surgery, University of the Witwatersrand, Johannesburg, South Africa
| | - D Kruger
- Department of Surgery, University of the Witwatersrand, Johannesburg, South Africa
| | - M Brand
- Department of Surgery, University of the Witwatersrand, Johannesburg, South Africa
| | - M G Veller
- Department of Surgery, University of the Witwatersrand, Johannesburg, South Africa
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Ravichandran A, Channick R, Chin K, Kim N, Brand M, Selej M, McLaughlin V. OPUS Registry: Switching to Macitentan From Other Endothelin Receptor Antagonists (ERAs). J Heart Lung Transplant 2018. [DOI: 10.1016/j.healun.2018.01.370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
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Aziz Z, Riddell MA, Absetz P, Brand M, Oldenburg B. Peer support to improve diabetes care: an implementation evaluation of the Australasian Peers for Progress Diabetes Program. BMC Public Health 2018; 18:262. [PMID: 29454327 PMCID: PMC5816559 DOI: 10.1186/s12889-018-5148-8] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2017] [Accepted: 02/02/2018] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Several studies have now demonstrated the benefits of peer support in promoting diabetes control. The aim of this study is to evaluate the implementation of a cluster randomised controlled trial of a group-based, peer support program to improve diabetes self-management and thereby, diabetes control in people with Type 2 Diabetes in Victoria, Australia. METHODS The intervention program was designed to address four key peer support functions i.e. 1) assistance in daily management, 2) social and emotional support, 3) regular linkage to clinical care, and 4) ongoing and sustained support to assist with the lifelong needs of diabetes self-care management. The intervention participants attended monthly group meetings facilitated by a trained peer leader for 12 months. Data was collected on the intervention's reach, participation, implementation fidelity, groups' effectiveness and participants' perceived support and satisfaction with the intervention. The RE-AIM and PIPE frameworks were used to guide this evaluation. RESULTS The trial reached a high proportion (79%) of its target population through mailed invitations. Out of a total of 441 eligible individuals, 273 (61.9%) were willing to participate. The intervention fidelity was high (92.7%). The proportion of successful participants who demonstrated a reduction in 5 years cardiovascular disease risk score was 65.1 and 44.8% in the intervention and control arm respectively. Ninety-four percent (94%) of the intervention participants stated that the program helped them manage their diabetes on a day to day basis. Overall, attending monthly group meetings provided 'a lot of support' to 57% and 'moderate' support to 34% of the participants. CONCLUSION Peer support programs are feasible, acceptable and can be used to supplement treatment for patients motivated to improve behaviours related to diabetes. However, program planners need to focus on the participation component in designing future programs. The use of two evaluation frameworks allowed a comprehensive evaluation of the trial from the provider-, participant- and public health perspective. The learnings gained from this evaluation will guide and improve future implementation by improving program feasibility for adoption and acceptability among participants, and will ultimately increase the likelihood of program effectiveness for the participants. TRIAL REGISTRATION Australian New Zealand Clinical Trials Registry (ANZCTR) ACTRN12609000469213 . Registered 16 June 2009.
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Affiliation(s)
- Zahra Aziz
- Melbourne School of Population & Global Health, the University of Melbourne, Melbourne, Australia. .,Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia.
| | - Michaela A Riddell
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia.,Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Melbourne, Australia
| | - Pilvikki Absetz
- School of Health Sciences, University of Tampere, FI-33014, Tampere, Finland.,Collaborative Care Systems Finland, Helsinki, Finland
| | - Margaret Brand
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia
| | - Brian Oldenburg
- Melbourne School of Population & Global Health, the University of Melbourne, Melbourne, Australia.,Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia
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von Auenmüller I, Christ M, Brand M, Dierschke W, Trappe HJ. [Quality of life and posttraumatic stress disorder after out-of-hospital cardiac arrest]. Med Klin Intensivmed Notfmed 2018; 114:252-257. [PMID: 29374288 DOI: 10.1007/s00063-018-0403-4] [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] [Received: 09/06/2017] [Revised: 11/15/2017] [Accepted: 01/02/2018] [Indexed: 11/26/2022]
Abstract
BACKGROUND Survival rate after out-of-hospital cardiac arrest (OHCA) is increasing. However, there is a lack of data concerning long-term quality of life of affected patients. OBJECTIVES This study aims to investigate the psychological effects of out-of-hospital cardiopulmonary resuscitation. METHODS All patients who were admitted to our hospital after OHCA between 01 January 2008 and 30 June 2015 and could be discharged in good neurological condition were asked to fill out the Impact of Event Scale-Revised (IES-R) and 36-Item Short Form Health Survey (SF-36). For statistical analysis, the mean, standard deviation and student's t‑test were used (level of significance p < 0.05). RESULTS Of 280 OHCA survivors, 56 patients (20.0%) were discharged from the hospital in good neurological condition. Of those, 20 patients (35.7%) were willing to participate in this study, among them 11 women and 9 men. Compared to the cohort of the German normative data, the results of the SF-36 questionnaire of OHCA survivors showed significantly lower values in all SF-36 subscales and also for the summary scores. There was no significant difference compared to patients with myocardial infarction. Average values of the IES-R subscales for intrusion and avoidance were 9.9 ± 9.3 and 9.7 ± 7.7, respectively, and 11.3 ± 7.4 for hyperarousal. Calculations indicated the suspected diagnosis of posttraumatic stress disorder in 2 of the 20 patients (10%). DISCUSSION Even in patients who could be discharged from the hospital after OHCA in good neurological condition, the quality of life is significantly lower compared to the standard population but not compared to patients with myocardial infarction. The data also suggest that a relevant number of patients after OHCA is affected by posttraumatic stress disorder. Further research efforts on optimization of post-resuscitation care should not only focus on survival rates but also on improving quality of life.
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Affiliation(s)
- I von Auenmüller
- Medizinische Klinik II (Schwerpunkt Kardiologie und Angiologie), Marien Hospital Herne, Ruhr-Universität Bochum, Hölkeskampring 40, 44625, Herne, Deutschland.
| | - M Christ
- Medizinische Klinik II (Schwerpunkt Kardiologie und Angiologie), Marien Hospital Herne, Ruhr-Universität Bochum, Hölkeskampring 40, 44625, Herne, Deutschland
| | - M Brand
- Medizinische Klinik II (Schwerpunkt Kardiologie und Angiologie), Marien Hospital Herne, Ruhr-Universität Bochum, Hölkeskampring 40, 44625, Herne, Deutschland
| | - W Dierschke
- Medizinische Klinik II (Schwerpunkt Kardiologie und Angiologie), Marien Hospital Herne, Ruhr-Universität Bochum, Hölkeskampring 40, 44625, Herne, Deutschland
| | - H-J Trappe
- Medizinische Klinik II (Schwerpunkt Kardiologie und Angiologie), Marien Hospital Herne, Ruhr-Universität Bochum, Hölkeskampring 40, 44625, Herne, Deutschland
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Puttergill B, Kruger D, Brand M, Veller MG. Suture material use and procurement: an audit of a public hospital surgical system in Gauteng, South Africa. S AFR J SURG 2018. [DOI: 10.17159/2078-5151/2018/v56n2a2384] [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: 11/05/2022]
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Kelm M, Seyfried F, Reimer S, Krajinovic K, Miras AD, Jurowich C, Germer CT, Brand M. Proximal jejunal stoma as ultima ratio in case of traumatic distal duodenal perforation facilitating successful EndoVAC ® treatment: A case report. Int J Surg Case Rep 2017; 41:401-403. [PMID: 29546001 PMCID: PMC5699878 DOI: 10.1016/j.ijscr.2017.11.022] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2017] [Revised: 11/12/2017] [Accepted: 11/13/2017] [Indexed: 02/06/2023] Open
Abstract
INTRODUCTION During damage control surgery for blunt abdominal traumata simultaneous duodenal perforations can be missed making secondary sufficient surgical treatment challenging. Endoluminal vacuum (EndoVAC™) therapy has been shown to be a revolutionary option but has anatomical and technical limits. PRESENTATION OF THE CASE A 59-year old man with hemorrhagic shock due to rupture of the mesenteric root after blunt abdominal trauma received damage control treatment. Within a scheduled second-look, perforation of the posterior duodenal wall was identified. Due to local and systemic conditions, further surgical treatment was limited. Decision for endoscopic treatment was made but proved to be difficult due to the distal location. Finally, double-barreled jejunal stoma was created for transstomal EndoVAC™ treatment. Complete leakage healing was achieved and jejunostomy reversal followed subsequently. DISCUSSION During damage control surgery simultaneous bowel injuries can be missed leading to life-threatening complications with limited surgical options. EndoVAC™ treatment is an option for gastrointestinal perforations but has anatomical limitations that can be sufficiently shifted by a transstomal approach for intestinal leakage. CONCLUSION In trauma related laparotomy complete mobilization of the duodenum is crucial. As ultima ratio, transstomal EndoVAC™ is a safe and feasible option and can be considered for similar cases.
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Affiliation(s)
- M Kelm
- Department of General, Visceral, Vascular and Pediatric Surgery, University of Würzburg, Germany
| | - F Seyfried
- Department of General, Visceral, Vascular and Pediatric Surgery, University of Würzburg, Germany.
| | - S Reimer
- Department of Internal Medicine, Division of Gastroenterology, University of Würzburg, Germany
| | - K Krajinovic
- Department of General, Visceral, Vascular and Pediatric Surgery, University of Würzburg, Germany
| | - A D Miras
- Department of Investigative Medicine, Imperial College London, UK
| | - C Jurowich
- Department of General, Visceral and Thoracic Surgery, Kreiskliniken Altoetting-Burghausen, Germany
| | - C T Germer
- Department of General, Visceral, Vascular and Pediatric Surgery, University of Würzburg, Germany
| | - M Brand
- Department of Internal Medicine, Division of Gastroenterology, University of Würzburg, Germany
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Tsai MC, Candy G, Costello MA, Grieve AD, Brand M. Do iatrogenic serosal injuries result in small bowel perforation in a rabbit model? S AFR J SURG 2017; 55:18-22. [PMID: 28876619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
BACKGROUND Surgical dogma dictates that serosal injuries should be repaired during laparotomy as these injuries may result in localised areas of bowel ischaemia and may perforate. No study has investigated whether there is a correlation between the extent of serosal injuries and the risk for perforation under normal physiological conditions. We hypothesized that small bowel serosal injuries do not result in early or late perforation at physiological intraluminal pressures regardless of their size. METHOD An in-vivo rabbit small bowel serosal injury model was developed and two experiments were conducted. The first - to determine whether and at which pressures various lengths and circumferences of serosal injuries in small bowel result in immediate bowel perforation - was performed infusing saline into isolated bowel segments with or without a variety of serosal injuries. In the second study - to determine whether or not serosal injuries result in delayed perforation - a range of injuries was created in rabbits and the effect assessed at re-laparotomy 5 days after the creation of the injury. RESULTS No perforations were observed at the site of serosal injuries at physiological intraluminal pressures. Perforations occurred at 43.7+ 18.6 cmH₂O, 23.3+ 14.4 cmH₂O, and 24.4+ 23.9 cmH₂O for controls, 4 cm long and 100% circumference serosal injuries respectively (p-value = 0.18 for various lengths and 0.71 for various circumferences). No serosal injuries perforated within 72 or 120 hours after creation. CONCLUSION Small bowel serosal injuries do not perforate or leak at physiological intraluminal pressures, either at the time of creation or up to 120 hours thereafter.
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Affiliation(s)
- M C Tsai
- Department of Surgery, University of the Witwatersrand. 9th Floor, Faculty of Health Sciences
| | - G Candy
- Department of Surgery, University of the Witwatersrand. 9th Floor, Faculty of Health Sciences
| | - M A Costello
- Central Animal Services Unit, University of the Witwatersrand. 1st Floor, Faculty of Health Sciences
| | - A D Grieve
- Department of Surgery, University of the Witwatersrand. 9th Floor, Faculty of Health Sciences
| | - M Brand
- Department of Surgery, University of the Witwatersrand. 9th Floor, Faculty of Health Sciences
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Kim N, Brand M, Chin K, Channick R, Selej M, McLaughlin V. OPUS Registry: Safety and Tolerability of Macitentan in a Real-World Setting. J Heart Lung Transplant 2017. [DOI: 10.1016/j.healun.2017.01.041] [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: 10/19/2022] Open
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Ellmann S, Kammerer F, Allmendinger T, Hammon M, Brand M, May M, Lell M, Uder M, Kramer M. Bestimmung des Dosisreduktionspotentials iterativer Rekonstruktionen intrakranieller CTA mit einer neuartigen auf paarweisen Bildvergleichen basierenden Methode. ROFO-FORTSCHR RONTG 2017. [DOI: 10.1055/s-0037-1600432] [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: 10/19/2022]
Affiliation(s)
- S Ellmann
- Universitätsklinikum Erlangen, Radiologisches Institut, Erlangen
| | - F Kammerer
- Universitätsklinikum Erlangen, Radiologisches Institut, Erlangen
| | | | - M Hammon
- Universitätsklinikum Erlangen, Radiologisches Institut, Erlangen
| | - M Brand
- Universitätsklinikum Erlangen, Radiologisches Institut, Erlangen
| | - M May
- Universitätsklinikum Erlangen, Radiologisches Institut, Erlangen
| | - M Lell
- Klinikum Nürnberg, Institut für Radiologie und Nuklearmedizin, Nürnberg
| | - M Uder
- Universitätsklinikum Erlangen, Radiologisches Institut, Erlangen
| | - M Kramer
- Universitätsklinikum Erlangen, Radiologisches Institut, Erlangen
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Brand M, Stefanidis A, Morbach C, Fan YT, Elremisy DRA, Kuznetsov VA, Carrero C, Almodares Q, Abdulrahim H, Galli E, Galli E, Moreno J, Lerena Saenz P, Ikonomidis I, Galuszka OM, Bonapace S, Clerc OF, Kuznetsov VA, Tadic S, Kataoka A, Abdul Rahman E, Calin A, Antonini-Canterin F, Schwartzenberg SS, Christ M, Roeing J, Amirie S, Grett M, Beko M, Breker I, Wennemann R, Trappe HJ, Lagoudakou S, Vintzilaios K, Mokadem N, Vlachou J, Komatanou E, Korlou P, Kakkavas A, Komninos K, Kranidis A, Gelbrich G, Simon J, Cramer M, Knobeloch F, Tiffe T, Wagner M, Heuschmann PU, Stoerk S, Yang D, Wang X, Chan AK, Cheung SH, Lee AP, Salim FF, Bakhoum SW, Ashour ZA, Soldatova AM, Krinochkin DV, Enina TN, Altamirano C, Pipkin M, Constantin I, Fava A, Diaz Babio G, Masson Juarez G, San Miguel J, Vera Janavel G, Stutzbach P, Wallentin Guron C, Thurin A, Fu M, Kontogeorgos S, Thunstrom E, Johansson MC, Da Silva C, Venkateshvaran A, Nagy AI, Lund LH, Manouras A, Leclercq C, Fournet M, Bernard A, Mabo P, Samset E, Hernandez A, Donal E, Leclercq C, Fournet M, Bernard A, Mabo P, Samset E, Hernandez A, Donal E, Martinez Lugo CML, Zuniga Sedano JZD, Alexanderson EAR, Camilletti JC, Ahmed Abdelrahman M, Raslan H, Ruisanchez Villar C, Cuesta Cosgalla JM, Zarauza Navarro J, Veiga Fernandez G, Rifaie O, Omar AMS, Vlastos D, Frogoudaki A, Vrettou AR, Vlachos S, Varoudi M, Triantafyllidi H, Parissis J, Tsivgoulis G, Lekakis J, Steffens D, Friebel J, Rauch-Krohnert U, Landmesser U, Kasner M, Adamo E, Valbusa F, Ciccio' C, Rossi A, Lanzoni L, Chiampan A, Cecchetto A, Canali G, Barbieri E, Fuchs TA, Stehli J, Benz DC, Graeni C, Buechel RR, Kaufmann PA, Gaemperli O, Yaroslavskaya EI, Krinochkin DV, Kolunin GV, Gorbatenko EA, Dyachkov SM, Jung R, Ilic A, Stojsic-Milosavljevic A, Dejanovic J, Stefanovic M, Stojsic S, Sladojevic M, Watanabe Y, Kozuma K, Yamamoto M, Takagi K, Araki M, Tada N, Shirai S, Tamanaka F, Hayashida K, Ewe SH, Fadzil MA, Najme Khir R, Ismail JR, Lim CW, Chua N, Ibrahim ZO, Kasim SS, Ding ZP, Mateescu AD, Beladan CC, Rosca M, Enache R, Calin C, Cosei I, Botezatu S, Simion M, Ginghina C, Popescu BA, Di Nora C, Poli S, Vriz O, Zito C, Carerj S, Pavan D, Vaturi M, Kazum S, Monakier D, Sagie A, Kornowski R, Shapira Y. Poster Session 2The imaging examination and quality assessmentP520Benefit of early basic transthoracic echocardiography (TTE) in emergency patients performed by physicians with low to intermediate TTE experienceP521Appropriateness criteria in echocardiography. A contemporary necessity in clinical practiceP522Interobserver variability in 2d transthoracic echocardiography impact of scanning and reading on total variability results from the STAAB cohort study quality controlP5233D printing for personalised planning of catheter-based left atrial appendage occlusionP524Central obesity: an independent role or synergistic effect to metabolic syndrome on right atrial structure?P525Dynamics of left ventricular volumes and mortality in patients with early and late effect of cardiac resynchronization therapyP526Variability of thoracic aortic diameters according to gender, age and body surface area. Time to forget absolute cut-off values?P527The association of left ventricular outflow tract velocity time integral to all-cause mortality in elderly patients with heart failureP528Left ventricular myocardial performance and atrioventricular coupling in patients with primary arterial hypertensionP529Interest of a combinatory approach based on traditional left ventricular dyssynchrony parameters and cardiac work estimated by pressure-strain loop curves for the prediction of cardiac resynchronizatP530The evaluation of cardiac performance by pressure-strain loops: a useful tool for the identification of cardiac resynchronization therapy respondersP531Left ventricle cardiac function by 2D-speckle tracking echocardiography in diabetes mellitus population: sub-clinical systolic disfunction studyP532Biphasic tissue doppler mitral annular isovolumic contraction velocities are associated with left ventricular function, isovolumic relaxation, and pulmonary wedge pressure in heart failure patientsP533Abnormal left atrial volumes and strains are associated with increased arterial stiffnes in patients with cryptogenic stroke: a novel pathophysiological pathP534Detection of coronary microvascular disease using two-dimensional speckle-tracking echocardiographyP535Predictive value of a bi-dimensional transthoracic echocardiographic sign of " binary image" to identify the anomalous origin of the left circumflex coronary artery from the right coronary sinusP536Systematic review and meta-analysis of screening for coronary artery disease in asymptomatic diabetic patientsP537Noninvasive screening test for diagnosis of nonobstructive coronary artery disease using echocardiographic criteriaP538Early echocardiography after primary angioplasty, important role in predicting left ventricular remodelingP539Prognostic impact of low-flow severe aortic stenosis in Japanese patients undergoing transcatheter aortic valve implantation: the ocean-tavi registryP540Left ventricular outflow tract geometry and its impact on aortic valve area calculations in aortic stenosis using 3D transoesophageal echocardiography and 2D transthoracic echocardiographyP541Impaired left atrial myocardial deformation predicts postoperative atrial fibrillation after aortic valve replacement in patients with aortic stenosisP542Ejection fraction-velocity ratio in predicting symptoms in severe aortic stenosisP543Incremental value of transesophageal echocardiography in conjunction with transthoracic echocardiography in the assessment of aortic stenosis severity. Eur Heart J Cardiovasc Imaging 2016. [DOI: 10.1093/ehjci/jew248] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Wegmann E, Snagowski J, Brand M. Excessive use of social networking sites: Does it reflect a generalized or specific form of Internet addiction? Personality and Individual Differences 2016. [DOI: 10.1016/j.paid.2016.05.345] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Riddell MA, Dunbar JA, Absetz P, Wolfe R, Li H, Brand M, Aziz Z, Oldenburg B. Cardiovascular risk outcome and program evaluation of a cluster randomised controlled trial of a community-based, lay peer led program for people with diabetes. BMC Public Health 2016; 16:864. [PMID: 27558630 PMCID: PMC4995663 DOI: 10.1186/s12889-016-3538-3] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2015] [Accepted: 08/17/2016] [Indexed: 02/06/2023] Open
Abstract
Background The 2013 Global Burden of Disease Study demonstrated the increasing burden of diabetes and the challenge it poses to the health systems of all countries. The chronic and complex nature of diabetes requires active self-management by patients in addition to clinical management in order to achieve optimal glycaemic control and appropriate use of available clinical services. This study is an evaluation of a “real world” peer support program aimed at improving the control and management of type 2 diabetes (T2DM) in Australia. Methods The trial used a randomised cluster design with a peer support intervention and routine care control arms and 12-month follow up. Participants in both arms received a standardised session of self-management education at baseline. The intervention program comprised monthly community-based group meetings over 12 months led by trained peer supporters and active encouragement to use primary health care and other community resources and supports related to diabetes. Clinical, behavioural and other measures were collected at baseline, 6 and 12 months. The primary outcome was the predicted 5 year cardiovascular disease risk using the United Kingdom Prospective Diabetes Study (UKPDS) Risk Equation at 12 months. Secondary outcomes included clinical measures, quality of life, measures of support, psychosocial functioning and lifestyle measures. Results Eleven of 12 planned groups were successfully implemented in the intervention arm. Both the usual care and the intervention arms demonstrated a small reduction in 5 year UKPDS risk and the mean values for biochemical and anthropometric outcomes were close to target at 12 months. There were some small positive changes in self-management behaviours. Conclusions The positive changes in self-management behaviours among intervention participants were not sufficient to reduce cardiovascular risk, possibly because approximately half of the study participants already had quite well controlled T2DM at baseline. Future research needs to address how to enhance community based programs so that they reach and benefit those most in need of resources and supports to improve metabolic control and associated clinical outcomes. Trial registration Australian New Zealand Clinical Trials Registry (ANZCTR) ACTRN12609000469213. Registered 16 June 2009. Electronic supplementary material The online version of this article (doi:10.1186/s12889-016-3538-3) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- M A Riddell
- Department of Epidemiology and Preventive Medicine, Faculty of Medicine Nursing and Health Science, Monash University, The Alfred Centre, 99 Commercial Road, Melbourne, Victoria, 3004, Australia.
| | - J A Dunbar
- Deakin Population Health Strategic Research Centre, Deakin University, Melbourne, Australia
| | - P Absetz
- School of Health Sciences, University of Tampere, Tampere, Finland
| | - R Wolfe
- Department of Epidemiology and Preventive Medicine, Faculty of Medicine Nursing and Health Science, Monash University, The Alfred Centre, 99 Commercial Road, Melbourne, Victoria, 3004, Australia
| | - H Li
- Department of Epidemiology and Preventive Medicine, Faculty of Medicine Nursing and Health Science, Monash University, The Alfred Centre, 99 Commercial Road, Melbourne, Victoria, 3004, Australia.,Institute of Chronic Disease Control, Beijing Centers for Disease Control and Prevention, Beijing, People's Republic of China
| | - M Brand
- Department of Epidemiology and Preventive Medicine, Faculty of Medicine Nursing and Health Science, Monash University, The Alfred Centre, 99 Commercial Road, Melbourne, Victoria, 3004, Australia
| | - Z Aziz
- Department of Epidemiology and Preventive Medicine, Faculty of Medicine Nursing and Health Science, Monash University, The Alfred Centre, 99 Commercial Road, Melbourne, Victoria, 3004, Australia.,Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia
| | - B Oldenburg
- Department of Epidemiology and Preventive Medicine, Faculty of Medicine Nursing and Health Science, Monash University, The Alfred Centre, 99 Commercial Road, Melbourne, Victoria, 3004, Australia.,Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia
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Christ M, von Auenmüller KI, Amirie S, Sasko BM, Brand M, Trappe HJ. [Are emergency physicians influenced by nonmedical aspects in their choice of the hospital : Observations in 280 victims of out-of-hospital cardiac arrest in times of hospital alliances]. Med Klin Intensivmed Notfmed 2016; 112:129-135. [PMID: 27435066 DOI: 10.1007/s00063-016-0195-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2015] [Revised: 05/19/2016] [Accepted: 06/05/2016] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Emergency physicians are responsible for the out-of-hospital treatment of victims from out-of-hospital cardiac arrest (OHCA), not only with regard on the medical treatment, but also in terms of the choice of the most suitable hospital. We therefore wanted to determine whether nonmedical processes such as hospital alliances lead to changing rates of hospital admissions of patients following OHCA. MATERIALS AND METHODS All patients who were admitted in our hospital following OHCA between 1 January 2008 and 30 June 2015 were identified and their data were anonymously stored in a central database. Afterward, we divided the study period into three periods: (1) the period prior to the publication of the ERC guidelines 2010, (2) the period after the publication of the ERC guidelines 2010, and (3) the period after a contract for hospital alliances with another hospital in town was signed. RESULTS Of the 280 OHCA victims, we could analyze the emergency physician's reports of 238 victims from nontraumatic OHCA; there were 143 men (60.1 %) and 95 women (39.9 %) with an age of 69.1 ± 13.7 years. Following the changes in the guidelines in 2010, we observed a 42.8 % increase of hospital admissions from 2.15 admissions per month to 3.07 in period 2 following OHCA compared to period 1. After signing of the hospital alliance, there was an additional increase of 42.3 % to an average of 4.37 hospital admissions per month. DISCUSSION AND CONCLUSION According to our data, it might be possible that not only medical influences (e.g., changes in the guidelines) but also nonmedical aspects (e.g., hospital alliances) might influence the choice of hospital for the further treatment of victims from OHCA.
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Affiliation(s)
- M Christ
- Medizinische Klinik II (Schwerpunkt Kardiologie und Angiologie), Marien Hospital Herne, Ruhr-Universität Bochum, Hölkeskampring 40, 44625, Herne, Deutschland.
| | - K I von Auenmüller
- Medizinische Klinik II (Schwerpunkt Kardiologie und Angiologie), Marien Hospital Herne, Ruhr-Universität Bochum, Hölkeskampring 40, 44625, Herne, Deutschland
| | - S Amirie
- Medizinische Klinik II (Schwerpunkt Kardiologie und Angiologie), Marien Hospital Herne, Ruhr-Universität Bochum, Hölkeskampring 40, 44625, Herne, Deutschland
| | - B M Sasko
- Medizinische Klinik II (Schwerpunkt Kardiologie und Angiologie), Marien Hospital Herne, Ruhr-Universität Bochum, Hölkeskampring 40, 44625, Herne, Deutschland
| | - M Brand
- Medizinische Klinik II (Schwerpunkt Kardiologie und Angiologie), Marien Hospital Herne, Ruhr-Universität Bochum, Hölkeskampring 40, 44625, Herne, Deutschland
| | - H-J Trappe
- Medizinische Klinik II (Schwerpunkt Kardiologie und Angiologie), Marien Hospital Herne, Ruhr-Universität Bochum, Hölkeskampring 40, 44625, Herne, Deutschland
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