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Beber S, Moshkelgosha S, Cheung M, Hedley D, Levy L, Samuels J, Renaud-Picard B, Hwang D, Martinu T, Juvet S. Exploration of Intragraft T Cell Phenotypes in Minimal Acute Cellular Rejection (ACR) Using Imaging Mass Cytometry (IMC). J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.1475] [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: 04/05/2023] Open
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Finkelstein N, Dayam RM, Law J, Goetgebuer R, Chao G, Abe KT, Sutton M, Stempak JM, Pereira D, Croitoru D, Acheampong L, Rizwan S, Rymaszewski K, Milgrom R, Ganatra D, Batista NV, Girard M, Lau I, Law R, Cheung M, Rathod B, Kitaygorodsky J, Samson R, Hu Q, Haroon N, Inman R, Piguet V, Silverberg M, Grigras AC, Watts TH, Chandran V. POS1217 ANTI-TNF THERAPY FOR IMMUNE MEDIATED INFLAMMATORY DISEASES MAY BE ASSOCIATED WITH LOWER ANTIBODY LEVELS AND VIRUS NEUTRALIZATION EFFICACY FOLLOWING SARS-CoV-2 mRNA VACCINATION. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.1667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BackgroundThe impact of immunosuppressants on COVID-19 vaccination response and durability in patients with immune-mediated inflammatory diseases (IMID) is yet to be fully characterized. Humoral response may be attenuated in these patients especially those on B cell depleting therapy and higher doses of corticosteroids, but data regarding other immunosuppressants are scarce.ObjectivesWe aimed to investigate antibody and T cell responses and durability to SARS-CoV-2 mRNA vaccines (BNT162b and/or mRNA 1273) in IMID patients on immunomodulatory maintenance therapy other than B-cell depleting therapy and corticosteroids.MethodsThis prospective observational cohort study examined the immunogenicity of SARS-CoV-2 mRNA vaccines in adult patients with IMIDs (psoriatic arthritis, psoriasis, inflammatory bowel disease and rheumatoid arthritis) with or without maintenance immunosuppressive therapies (anti-TNF, methotrexate/azathioprine [MTX/AZA], anti-TNF + MTX/AZA, anti IL12/23, anti-IL-17, anti-IL23) compared to healthy controls. Automated ELISA for IgGs to spike trimer, spike receptor binding domain (RBD) and the nucleocapsid (NP) and T-cell release of 9 cytokines (IFNg, IL2, IL4, IL17A, TNF) and cytotoxic molecules (sFasL, GzmA, GzmB, Perforinin) in cell culture supernatants following stimulation with spike or NP peptide arrays were conducted at 4 time points: T1=pre vaccination, T2=median 26 days after dose 1, T3=median 16 days after dose 2 and T4=median 106 days after dose 2. Neutralization assays against four SARS-CoV-2 variants (wild type, delta, beta and gamma) were conducted at T3.ResultsWe followed 150 subjects: 26 healthy controls and 124 IMID patients: 9 untreated, 44 on anti-TNF, 16 on anti-TNF with MTX/AZA, 10 on anti-IL23, 28 on anti-IL12/23, 9 on anti-IL17, 8 on MTX/AZA (Table 1). Most patients mounted antibody and T cell responses with increases from dose 1 to dose 2 (100% seroconversion at T3) and some decline by T4, with variability within groups. Antibody levels and neutralization efficacy was lower in anti-TNFgroups (anti-TNF, anti-TNF + MTX/AZA) compared to controls and waned by T4 (Figure 1). T cell responses were not consistently different between groups. Pooled data showed a higher antibody response to mRNA-1273 compared to BNT162b.Table 1.Baseline characteristics of study participantsControluntreated IMIDAnti- TNFAnti- TNF +MTX/AZAAnti-IL-23Anti -IL-12/23Anti -IL-17MTX/AZAn=26n=9n=44n=16n=10n=28n=9n=8p-valueIMID*N/A IBD9301002704 Psoriasis1318122 PA0732172 AS0830010 RA1100011Age median years [IQR]36 [26-46]33 [27-41]38 [30-51]53 [44-59]48 [45-61]34 [28-47]49 [46-61]42 [31-55]<0.001^Sex male (%)16 (62)5 (56)18 (41)8 (50)5 (50)13 (46)6 (67)4 (50)0.772~BMImedian kg/m2 [IQR]25 [23-28]26 [22-27]22 [24-26]26 [24-28]27 [24-35]22 [21-24]32 [26-34]26[25-33]0.001^Vaccine interval median days [IQR]74 [35-84]54 [31-64]60 [45-69]64 [50-72]74 [35-84]62 [49-69]65 [52-75]58 [21-97]0.372^*multiple IMIDs per patient possibleFigure 1.Antibody responses (A) Anti spike and anti RBD IgG levels at indicated time points. Blue line represents median ratio in convalescent patients. The red line is the seropositivity threshold: the median antibody level of those that pass both a 1% false positive rate and show ≥3SD from the log means of the negative controls. (B) Relative ratio of RBD, spike and NP across time. Black and gray lines indicate median and mean values, respectively. *p≤0.05, **p≤0.01, ***p≤0.001, ****p≤0.0001ConclusionFollowing 2 doses of mRNA vaccination there is 100% seroconversion in IMID patients on maintenance therapy. Antibody levels and neutralization efficacy in anti-TNF group are lower than controls, and wane substantially by 3 months after dose 2. These findings highlight the need for third dose in patients undergoing treatment with anti-TNF therapy and continued monitoring of immunity in these patient groups, taking into consideration newer variants and additional vaccine doses.AcknowledgementsThis work was funded by a donation from Juan and Stefania Speck and by grants VR-1 172711, VS1-175545, FDN-143250, GA1- 177703 and GA2- 177716, from Canadian Institutes of Health Research and COVID Immunity task force and by Sinai Health FoundationDisclosure of InterestsNaomi Finkelstein: None declared, Roya M. Dayam: None declared, Jaclyn Law: None declared, Rogier Goetgebuer: None declared, Gary Chao: None declared, Kento T. Abe: None declared, Mitchell Sutton: None declared, Joanne M. Stempak: None declared, Daniel Pereira: None declared, David Croitoru: None declared, Lily Acheampong: None declared, Saima Rizwan: None declared, Klaudia Rymaszewski: None declared, Raquel Milgrom: None declared, Darshini Ganatra: None declared, Nathalia V. Batista: None declared, Melanie Girard: None declared, Irene Lau: None declared, Ryan Law: None declared, Michelle Cheung: None declared, Bhavisha Rathod: None declared, Julia Kitaygorodsky: None declared, Reuben Samson: None declared, Queenie Hu: None declared, Nigil Haroon: None declared, Robert Inman Consultant of: AbbVie, Janssen, Lilly, Novartis., Grant/research support from: AbbVie, Novartis, Vincent Piguet Consultant of: AbbVie, Almirall, Celgene, Janssen, Kyowa Kirin Co. Ltd, LEO Pharma,Novartis, Pfizer, Sanofi, UCB, and Union Therapeutic, Grant/research support from: Unrestricted educational grants from AbbVie, Bausch Health, Celgene, Janssen, LEO Pharma, Lilly, L’Oréal, NAOS, Novartis, Pfizer, Pierre-Fabre, Sandoz, and Sanofi, Mark Silverberg Speakers bureau: AbbVie, Janssen, Takeda, Pfizer, Gilead and Amgen, Consultant of: AbbVie, Janssen, Takeda, Pfizer, Gilead and Amgen, Grant/research support from: AbbVie, Janssen, Takeda, Pfizer, Gilead and Amgen, Anne-Claude Grigras: None declared, Tania H. Watts: None declared, Vinod Chandran Consultant of: AbbVie, Amgen, BMS, Eli Lilly, Janssen, Novartis, Pfizer and UCB, Grant/research support from: AbbVie, Amgen, Eli-Lilly.
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Renaud-Picard B, Cheung M, Moshkelgosha S, Berra G, Hwang D, Hedley D, Juvet S, Martinu T. Imaging Mass Cytometry for Detailed Cellular and Spatial Characterization of Chronic Lung Allograft Dysfunction (CLAD). J Heart Lung Transplant 2022. [DOI: 10.1016/j.healun.2022.01.246] [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] Open
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Cheung M, Husain A, Ong K, Weissler-Snir A, Geske J, Laksman Z. International Expert Practice Patterns Display Heterogeneity With Respect to the Management and Screening of Atrial Fibrillation and Non-Sustained Ventricular Tachycardia in Patients with Hypertrophic Cardiomyopathy. Heart Lung Circ 2022. [DOI: 10.1016/j.hlc.2022.06.172] [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: 11/27/2022]
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Chin LHQ, Cheung M, Ng GHT, Lam WWM. Kidney and Inferior Vena Cava Abnormalities with Leg Thrombosis (KILT Syndrome) in a Young Healthy Male: a Case Report. Hong Kong Journal of Radiology 2021. [DOI: 10.12809/hkjr2117261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Affiliation(s)
- LHQ Chin
- Department of Radiology, Queen Mary Hospital, Hong Kong
| | - M Cheung
- Department of Radiology, Queen Mary Hospital, Hong Kong
| | - GHT Ng
- Department of Radiology, Queen Mary Hospital, Hong Kong
| | - WWM Lam
- Department of Radiology, Queen Mary Hospital, Hong Kong
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Barker S, Maguire N, Gearing R, Cheung M, Price D, Narendorf S, Buck D. Community-engaged healthcare model for currently under-served individuals involved in the healthcare system. SSM Popul Health 2021; 15:100905. [PMID: 34568536 PMCID: PMC8449048 DOI: 10.1016/j.ssmph.2021.100905] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Revised: 08/22/2021] [Accepted: 08/23/2021] [Indexed: 11/05/2022] Open
Abstract
In the US, many people are excluded from healthcare structures and systems, due to multiple macro and micro factors. Poverty, health ecosystems, mental health, and community amenities are some of the issues confronting those who are not able to access appropriate support. This population is often referred to as 'high needs, high cost' (HNHC), a term that has been applied to refer to people who repeatedly utilize services without significant benefit (we have replaced this term with 'currently under-served'; C-US). For many traditional health solutions may not address the fundamental issues confronting their health. Community-Engaged Healthcare (CEH) is an approach that equips members of the community to levy power to advocate for their own health or social solutions, designing their own interventions to address needs with support from health providers. A realist review was conducted to identify the existing literature around CEH. This yielded ten papers that were reviewed by at least two authors and rated in terms of quality. A model describing the processes underpinning CEH was then iteratively generated, resulting in additional terms that were used in a second review of the literature. A further 16 peer-reviewed articles were identified and were independently reviewed and quality rated. These articles were used to refine further iterations of the model and included in the review where appropriate. The resulting model schematically posits a set of relational factors identified to be important in the establishment of CEH. Notably, the transfer of autonomy and power over health decision-making processes is emphasized, which will require revolutionary thinking about how healthcare is delivered for patients.
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Affiliation(s)
- S.L. Barker
- University of Southampton, School of Psychology, Building 44, University Road, Southampton, SO17 1BJ, United Kingdom
| | - N. Maguire
- University of Southampton, School of Psychology, Building 44, University Road, Southampton, SO17 1BJ, United Kingdom
| | - R.E. Gearing
- University of Houston, Graduate College of Social Work, Houston, TX, 77204, USA
| | - M. Cheung
- University of Houston, Graduate College of Social Work, Houston, TX, 77204, USA
| | - D. Price
- University of Houston, Honors College, Houston, TX, 77204, USA
| | - S.C. Narendorf
- University of Houston, Graduate College of Social Work, Houston, TX, 77204, USA
| | - D.S. Buck
- University of Houston College of Medicine, Houston, TX, 77204, USA
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Suleman A, Aktar S, Liu N, Chan K, Cheung M, Prica A. BENDAMUSTINE‐RITUXIMAB COMPARED TO RITUXIMAB‐CHOP/CVP FOR TREATMENT OF PATIENTS WITH INDOLENT LYMPHOMA IN ONTARIO: A POPULATION‐BASED STUDY. Hematol Oncol 2021. [DOI: 10.1002/hon.28_2880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- A. Suleman
- University of Toronto, Department of Medicine Toronto Canada
| | - S. Aktar
- Institute for Clinical Evaluative Sciences, (ICES) Toronto Canada
| | - N. Liu
- Institute for Clinical Evaluative Sciences, (ICES) Toronto Canada
| | - K. Chan
- Sunnybrook Health Sciences Centre Odette Cancer Centre Toronto Canada
| | - M. Cheung
- Sunnybrook Health Sciences Centre Odette Cancer Centre Toronto Canada
| | - A. Prica
- Princess Margaret Cancer Centre Cancer Clinical Research Unit Toronto Canada
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Villa D, Scott DW, Morin R, Nakamura H, Larouche JF, Cheung M, Johnson N, Elemary M, Keating MM, Tonseth P, Zukotynski K, Mayo S, Goswami R, Laister R, Kuruvilla J. A PHASE II STUDY OF ACALABRUTINIB IN COMBINATION WITH R‐CHOP CHEMOTHERAPY PRIOR TO AUTOLOGOUS STEM CELL TRANSPLANTATION IN PREVIOUSLY UNTREATED MANTLE CELL LYMPHOMA. Hematol Oncol 2021. [DOI: 10.1002/hon.171_2880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- D. Villa
- BC Cancer, Centre for Lymphoid Cancer Vancouver Canada
| | - D. W. Scott
- BC Cancer, Centre for Lymphoid Cancer Vancouver Canada
| | - R. Morin
- BC Cancer, Centre for Lymphoid Cancer Vancouver Canada
| | - H. Nakamura
- BC Cancer, Centre for Lymphoid Cancer Vancouver Canada
| | - J. F. Larouche
- Centre Hospitalier Universitaire de Québec Hôpital de l’Enfant‐Jésus Quebec City Canada
| | - M. Cheung
- Sunnybrook Health Sciences Centre Department of Hematology Toronto Canada
| | - N. Johnson
- Jewish General Hospital Department of Hematology Montreal Canada
| | - M. Elemary
- Saskatchewan Cancer Agency Saskatoon Cancer Centre Saskatoon Canada
| | - M. M. Keating
- Nova Scotia Cancer Centre QEII Health Sciences Centre Halifax Canada
| | - P. Tonseth
- BC Cancer Department of Functional Imaging Vancouver Canada
| | - K. Zukotynski
- McMaster University Departments of Radiology and Medicine Hamilton Canada
| | - S. Mayo
- University of Toronto Lawrence S. Bloomberg Faculty of Nursing Toronto Canada
| | - R. Goswami
- Sunnybrook Health Sciences Centre Department of Laboratory Medicine and Pathobiology Toronto Canada
| | - R. Laister
- University Health Network Princess Margaret Cancer Centre Toronto Canada
| | - J. Kuruvilla
- University Health Network Princess Margaret Cancer Centre Toronto Canada
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Siu A, Chan S, Cheung M, Mo C, Lai S, Shek D. Predictors of psychosocial adaptation and mental wellbeing among people with chronic illness and disabilities in a chinese context. Eur Psychiatry 2021. [PMCID: PMC9480170 DOI: 10.1192/j.eurpsy.2021.2094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Introduction The process of adjustment to disability and illness among people with chronic illness and disabilities (CID) impacts on motivation for rehabilitation illness self-management, and psychological well-being. It involves a complex interplay of biopsychosocial factors, and was seldom examined in the Chinese context. Objectives Identify the predictors of mental well-being of people with from a set of variables including illness and social support, functional abilities, coping strategies, resilience. Examine how these factors interact in determining psychosocial adaptation and mental well-being by structural equations modelling (SEM). Methods We conducted a survey of people with CID, who were recruited from community-rehabilitation settings and self-help groups (N = 244). The research questionnaire collected basic demographic information, illness-related variables (e.g. pain, fatigue, functional limitations), and RIDI), social support, measures of resilience, coping, psychosocial ad as predictors, and mental well-being. Results Of General Linear Model (GLM) revealed that males have better adaptation than females. Resilience, social coping, & active problem solving are significant predictors of adaptation (Table 1), while age, breathing, pain, resilience, avoidance coping, are predictors of maladaptation (Table 2). A SEM was tested to examine the interaction among the predictors and outcome of adaptation and mental well-being (Figure 1), and the model fit was fair (CFI = 0.89; RMSEA = 0.09) Conclusions The results indicated that there are gender differences in adaptation. While all the hypothesized groups of variables contributed to mental well-being of people with CID. Resilience, illness variables, and some forms of coping are closely linked to adaptation and maladaptation. Disclosure No significant relationships.
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Bhella S, Varela NP, Aw A, Bredeson C, Cheung M, Crump M, Fraser G, Sajkowski S, Kouroukis T. First-line therapy, autologous stem-cell transplantation, and post-transplantation maintenance in the management of newly diagnosed mantle cell lymphoma. Curr Oncol 2020; 27:e632-e644. [PMID: 33380879 PMCID: PMC7755434 DOI: 10.3747/co.27.7053] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Background In Ontario, no clearly defined standard of care for the management of mantle cell lymphoma (mcl) has been developed, and substantial variability from centre to centre is evident. This guidance document was prompted by the need to harmonize practice in Ontario with respect to first-line, conditioning, and post-transplantation maintenance therapy for patients newly diagnosed with transplantation-eligible mcl. Methods The medline and embase databases were systematically searched from January 2013 to January 2020 for evidence, and the best available evidence was used to draft recommendations relevant to first-line therapy, autologous stem-cell transplantation, and post-transplantation maintenance in the management of transplantation-eligible newly diagnosed mcl. Final approval of this guidance document was obtained from the Stem Cell Transplant Advisory Committee. Recommendations These recommendations apply to all cases of transplantation-eligible newly diagnosed mcl:■ Alternating cycles of r-chop (rituximab plus cyclophosphamide-doxorubicin-vincristine-prednisolone) and r-dhap [rituximab plus dexamethasone-high-dose cytarabine-cisplatin] is the recommended first-line treatment for symptomatic patients newly diagnosed with mcl before autologous stem-cell transplantation (asct).■ Rituximab plus hyperfractionated cyclophosphamide-vincristine-doxorubicin-dexamethasone (r-hypercvad), alternating with methotrexate and cytarabine, is not recommended for the treatment of patients with newly diagnosed mcl.■ beam (carmustine-etoposide-cytarabine-melphalan), beac (carmustine-etoposide-cytarabine-cyclophosphamide), and total-body irradiation-based regimens are reasonable conditioning options for patients with mcl who have responded to first-line therapy and who are undergoing asct.■ Maintenance therapy with rituximab is recommended for patients with newly diagnosed mcl who have undergone asct.
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Affiliation(s)
- S Bhella
- Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, Toronto, ON
| | - N P Varela
- Program in Evidence-Based Care, Ontario Health (Cancer Care Ontario), and Department of Oncology, McMaster University, Hamilton, ON
| | - A Aw
- Division of Hematology, The Ottawa Hospital, Ottawa, ON
| | - C Bredeson
- Malignant Hematology and Stem Cell Transplantation, The Ottawa Hospital, Ottawa, ON
| | - M Cheung
- Division of Medical Oncology and Hematology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, ON
| | - M Crump
- Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, Toronto, ON
| | - G Fraser
- Division of Malignant Hematology, Juravinski Cancer Centre, and Department of Oncology, McMaster University, Hamilton, ON
| | | | - T Kouroukis
- Division of Malignant Hematology, Juravinski Cancer Centre, and Department of Oncology, McMaster University, Hamilton, ON
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Yeo W, Yip C, Lau T, Lai K, Chan V, Li L, Pang E, Cheung M, Kwok C, Chan V, Mo F. 332MO Comparison of NEPA-based versus olanzapine/aprepitant-based antiemetic regimen for Chinese breast cancer patients undergoing highly emetogenic chemotherapy. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.10.326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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Yeo W, Li L, Lau T, Lai K, Chan V, Wong K, Yip C, Pang E, Cheung M, Chan V, Kwok C, Suen J, Mo F. Evaluation of optimal prophylactic antiemetic regimens for doxorubicin-cyclophosphamide chemotherapy. Eur J Cancer 2020. [DOI: 10.1016/s0959-8049(20)30869-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Chan CC, Cheung M, Tsui M. Games supporting organ donation: an interview with Dr Ka-foon Chau. Hong Kong Med J 2020; 26:273-274. [PMID: 32554821 DOI: 10.12809/hkmj-hc202006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Affiliation(s)
- C C Chan
- Year 6, The Chinese University of Hong Kong
| | - M Cheung
- Year 5, The University of Hong Kong
| | - M Tsui
- Year 4, The Chinese University of Hong Kong
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Cheung M, Campbell J, Braybrook J, Thomas R, Petzing J. Benchmarking automated flow cytometry data analysis software using synthetic datasets. Cytotherapy 2020. [DOI: 10.1016/j.jcyt.2020.03.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Cheung M, Ng G, Lam W. Magnetic Resonance Imaging with Spectroscopy Findings in Neonatal Nonketotic Hyperglycinaemia: A Case Report. Hong Kong Journal of Radiology 2020. [DOI: 10.12809/hkjr2017104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Affiliation(s)
- M Cheung
- Department of Radiology, Queen Mary Hospital, Pokfulam, Hong Kong
| | - G Ng
- Department of Radiology, Queen Mary Hospital, Pokfulam, Hong Kong
| | - W Lam
- Department of Radiology, Queen Mary Hospital, Pokfulam, Hong Kong
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Lee M, Yao J, Binny S, Cheung M, Larobina M, Skillington P, Grigg L, Zentner D. 669 Long-Term Outcome of Adult Survivors of Tetralogy of Fallot. Heart Lung Circ 2020. [DOI: 10.1016/j.hlc.2020.09.676] [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: 10/23/2022]
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O’Brien C, Healy GM, Anglim BC, O’Brien A, Duignan J, Patel A, Cheung M, Cantwell CP. The Role of Interventional Radiology in the Management of Obstetric and Gynaecological Haemorrhage. Ir Med J 2019; 112:968. [PMID: 31642642] [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] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Aim We will review our experience of emergent arterial embolization used to treat haemodynamically unstable patients with obstetric and gynaecological haemorrhage. Methods This is a retrospective study of patients with haemodynamically unstable obstetric and gynaecological haemorrhage treated with emergent arterial embolization from 2010 to 2015. Results 22 patients (average age 41 (SD +/-9) years) had emergent arterial embolization. 63% had post-partum haemorrhage (PPH). 82% of cases were performed with conscious sedation and local anaesthesia. Embolization was technically successful in all cases. Embolization was clinically successful in 95% (21/22). In one case of PPH the patient represented six days later with recurrent bleeding and was treated with surgical suturing of the cervix. There were no complications or deaths. Conclusion Arterial embolization is a highly successful treatment of obstetric and gynaecological haemorrhage in unstable patients.
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Affiliation(s)
- C O’Brien
- Department of Radiology, St Vincent’s University Hospital, Elm Park, Dublin 4
| | - G M Healy
- Department of Radiology, St Vincent’s University Hospital, Elm Park, Dublin 4
| | - B C Anglim
- National Maternity Hospital, Dublin 2, Ireland
| | - A O’Brien
- Department of Radiology, St Vincent’s University Hospital, Elm Park, Dublin 4
| | - J Duignan
- Department of Radiology, St Vincent’s University Hospital, Elm Park, Dublin 4
| | - A Patel
- Department of Radiology, St Vincent’s University Hospital, Elm Park, Dublin 4
| | - M Cheung
- National Maternity Hospital, Dublin 2, Ireland
| | - C P Cantwell
- Department of Radiology, St Vincent’s University Hospital, Elm Park, Dublin 4
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Tsang CC, Tang JYM, Chan KF, Lee CY, Chan JFW, Ngan AHY, Cheung M, Lau ECL, Li X, Ng RHY, Lai CKC, Fung KSC, Lau SKP, Woo PCY. Diversity of phenotypically non-dermatophyte, non-Aspergillus filamentous fungi causing nail infections: importance of accurate identification and antifungal susceptibility testing. Emerg Microbes Infect 2019; 8:531-541. [PMID: 30938262 PMCID: PMC6455232 DOI: 10.1080/22221751.2019.1598781] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
Onychomycosis is most commonly caused by dermatophytes. In this study, we examined the spectrum of phenotypically non-dermatophyte and non-Aspergillus fungal isolates recovered over a 10-year period from nails of patients with onychomycosis in Hong Kong. A total of 24 non-duplicated isolates recovered from 24 patients were included. The median age of the patients was 51 years, and two-thirds of them were males. One-third and two-thirds had finger and toe nail infections respectively. Among these 24 nail isolates, 17 were confidently identified as 13 different known fungal species, using a polyphasic approach. These 13 species belonged to 11 genera and ≥9 families. For the remaining seven isolates, multilocus sequencing did not reveal their definite species identities. These seven potentially novel species belonged to four different known and three potentially novel genera of seven families. 33.3%, 41.7% and 95.8% of the 24 fungal isolates possessed minimum inhibitory concentrations of >1 µg/mL to terbinafine, itraconazole and fluconazole, respectively, the first line treatment of onychomycosis. A high diversity of moulds was associated with onychomycosis. A significant proportion of the isolates were potentially novel fungal species. To guide proper treatment, molecular identification and antifungal susceptibility testing should be performed for these uncommonly isolated fungal species.
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Affiliation(s)
- Chi-Ching Tsang
- a Department of Microbiology, Li Ka Shing Faculty of Medicine , The University of Hong Kong , Pokfulam, Hong Kong
| | - James Y M Tang
- a Department of Microbiology, Li Ka Shing Faculty of Medicine , The University of Hong Kong , Pokfulam, Hong Kong
| | - Ka-Fai Chan
- a Department of Microbiology, Li Ka Shing Faculty of Medicine , The University of Hong Kong , Pokfulam, Hong Kong
| | - Chun-Yi Lee
- a Department of Microbiology, Li Ka Shing Faculty of Medicine , The University of Hong Kong , Pokfulam, Hong Kong
| | - Jasper F W Chan
- a Department of Microbiology, Li Ka Shing Faculty of Medicine , The University of Hong Kong , Pokfulam, Hong Kong.,b State Key Laboratory of Emerging Infectious Diseases , The University of Hong Kong , Pokfulam, Hong Kong.,c Carol Yu Centre for Infection , The University of Hong Kong , Pokfulam, Hong Kong.,d Collaborative Innovation Centre for Diagnosis and Treatment of Infectious Diseases , The University of Hong Kong , Hong Kong
| | - Antonio H Y Ngan
- a Department of Microbiology, Li Ka Shing Faculty of Medicine , The University of Hong Kong , Pokfulam, Hong Kong
| | - Mei Cheung
- a Department of Microbiology, Li Ka Shing Faculty of Medicine , The University of Hong Kong , Pokfulam, Hong Kong.,e Department of Pathology , Queen Elizabeth Hospital , Pokfulam, King's Park, Hong Kong
| | - Eunice C L Lau
- a Department of Microbiology, Li Ka Shing Faculty of Medicine , The University of Hong Kong , Pokfulam, Hong Kong.,f Department of Pathology , United Christian Hospital , Kwun Tong, Hong Kong
| | - Xin Li
- a Department of Microbiology, Li Ka Shing Faculty of Medicine , The University of Hong Kong , Pokfulam, Hong Kong
| | - Ricky H Y Ng
- f Department of Pathology , United Christian Hospital , Kwun Tong, Hong Kong
| | - Christopher K C Lai
- e Department of Pathology , Queen Elizabeth Hospital , Pokfulam, King's Park, Hong Kong
| | - Kitty S C Fung
- f Department of Pathology , United Christian Hospital , Kwun Tong, Hong Kong
| | - Susanna K P Lau
- a Department of Microbiology, Li Ka Shing Faculty of Medicine , The University of Hong Kong , Pokfulam, Hong Kong.,b State Key Laboratory of Emerging Infectious Diseases , The University of Hong Kong , Pokfulam, Hong Kong.,c Carol Yu Centre for Infection , The University of Hong Kong , Pokfulam, Hong Kong.,d Collaborative Innovation Centre for Diagnosis and Treatment of Infectious Diseases , The University of Hong Kong , Hong Kong
| | - Patrick C Y Woo
- a Department of Microbiology, Li Ka Shing Faculty of Medicine , The University of Hong Kong , Pokfulam, Hong Kong.,b State Key Laboratory of Emerging Infectious Diseases , The University of Hong Kong , Pokfulam, Hong Kong.,c Carol Yu Centre for Infection , The University of Hong Kong , Pokfulam, Hong Kong.,d Collaborative Innovation Centre for Diagnosis and Treatment of Infectious Diseases , The University of Hong Kong , Hong Kong
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Prica A, Vijenthira A, Chan K, Cheung M. COST-EFFECTIVENESS AND COST-UTILITY ANALYSIS OF MULTIPLE TREATMENT STRATEGIES USING ABVD AND/OR BEACOPP IN THE TREATMENT OF ADVANCED-STAGE HODGKIN LYMPHOMA. Hematol Oncol 2019. [DOI: 10.1002/hon.106_2629] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- A. Prica
- Department of Hematology/Medical Oncology; Princess Margaret Cancer Centre; Toronto Canada
| | - A. Vijenthira
- Postgraduate Medicine; University of Toronto; Toronto Canada
| | - K. Chan
- Department of Hematology/Medical Oncology; Sunnybrook Health Sciences Centre; Toronto Canada
| | - M. Cheung
- Department of Hematology/Medical Oncology; Sunnybrook Health Sciences Centre; Toronto Canada
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20
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Rushton C, Alcaide M, Cheung M, Thomas N, Arthur S, Michaud N, Daigle S, Davidson J, Bushell K, Yu S, Jain M, Shepherd L, Crump M, Mann K, Kuruvilla J, Assouline S, Johnson N, Scott D, Morin R. IDENTIFYING MUTATIONS ENRICHED IN RELAPSED-REFRACTORY DLBCL TO DERIVE GENETIC FACTORS UNDERLYING TREATMENT RESISTANCE. Hematol Oncol 2019. [DOI: 10.1002/hon.4_2629] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- C. Rushton
- Molecular Biology and Biochemistry; Simon Fraser University; Burnaby Canada
| | - M. Alcaide
- Molecular Biology and Biochemistry; Simon Fraser University; Burnaby Canada
| | - M. Cheung
- Molecular Biology and Biochemistry; Simon Fraser University; Burnaby Canada
| | - N. Thomas
- Molecular Biology and Biochemistry; Simon Fraser University; Burnaby Canada
| | - S. Arthur
- Molecular Biology and Biochemistry; Simon Fraser University; Burnaby Canada
| | | | | | - J. Davidson
- Molecular Biology and Biochemistry; Simon Fraser University; Burnaby Canada
| | - K. Bushell
- Molecular Biology and Biochemistry; Simon Fraser University; Burnaby Canada
| | - S. Yu
- Molecular Biology and Biochemistry; Simon Fraser University; Burnaby Canada
| | - M. Jain
- Department of Medical Oncology and Hematology; Princess Margaret Cancer Centre; Toronto Canada
| | - L. Shepherd
- Canada Cancer Trials Group; Queen's University; Kingston Canada
| | - M. Crump
- Department of Medical Oncology and Hematology; Princess Margaret Cancer Centre; Toronto Canada
| | - K. Mann
- Department of Medicine; McGill University; Montreal Canada
| | - J. Kuruvilla
- Department of Medical Oncology and Hematology; Princess Margaret Cancer Centre; Toronto Canada
| | - S. Assouline
- Department of Oncology; McGill University; Montreal Canada
| | - N. Johnson
- Department of Medicine; McGill University; Montreal Canada
| | - D.W. Scott
- Genome Sciences Centre; BC Cancer; Vancouver Canada
| | - R.D. Morin
- Molecular Biology and Biochemistry; Simon Fraser University; Burnaby Canada
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21
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Cheung WY, Kornelsen EA, Mittmann N, Leighl NB, Cheung M, Chan KK, Bradbury PA, Ng RCH, Chen BE, Ding K, Pater JL, Tu D, Hay AE. The economic impact of the transition from branded to generic oncology drugs. ACTA ACUST UNITED AC 2019; 26:89-93. [PMID: 31043808 DOI: 10.3747/co.26.4395] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background Economic evaluations are an integral component of many clinical trials. Costs used in those analyses are based on the prices of branded drugs when they first enter the market. The effect of genericization on the cost-effectiveness (ce) or cost-utility (cu) of an intervention is unknown because economic analyses are rarely updated using the costs of generic drugs. Methods We re-examined the ce or cu of regimens previously evaluated in Canadian Cancer Trials Group (cctg) studies that included prospective economic evaluations and where genericization has occurred or is anticipated in Canada. We incorporated the new costs of generic drugs to characterize changes in ce or cu. We also determined acceptable cost levels of generic drugs that would make regimens reimbursable in a publicly funded health care system. Results The four randomized controlled trials included (representing 1979 patients) were cctg br.10 (early lung cancer, adjuvant vinorelbine-cisplatin vs. observation, n = 172), cctg br.21 (metastatic lung cancer, erlotinib vs. placebo, n = 731), cctg co.17 (metastatic colon cancer, cetuximab vs. best supportive care, n = 557), and cctg ly.12 (relapsed or refractory lymphoma, gemcitabine-dexamethasone-cisplatin vs. cytarabine-dexamethasone-cisplatin, n = 619). Since the initial publication of those trials, the genericization of vinorelbine, erlotinib, cetuximab, and cisplatin has taken place or is expected in Canada. Costs of generics improved the ces and cus of treatment significantly. For example, genericization of erlotinib ($1460.25 per 30 days) resulted in an incremental cost-effectiveness ratio (icer) of $45,746 per life-year gained compared with $94,638 for branded erlotinib. Likewise, genericization of cetuximab ($275.80 per 100 mg) produced an icer of $261,126 per quality-adjusted life-year (qaly) gained compared with $299,613 for branded cetuximab. Decreases in the cost of generic cetuximab to $129.39 and $63.51 would further improve the icer to $150,000 and $100,000 per QALY respectively. Conclusions Genericization of a costly oncology drug can modify the ce and cu of a regimen significantly. Failure to revisit economic analyses with the costs of generics could be a missed opportunity for funding bodies to optimize value-based allocation of health care resources. At current levels, the costs of generics might not be sufficiently low to sustain publicly funded health care systems.
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Affiliation(s)
| | | | | | | | - M Cheung
- University of Toronto, Toronto, ON
| | - K K Chan
- University of Toronto, Toronto, ON
| | | | - R C H Ng
- University of Toronto, Toronto, ON
| | - B E Chen
- Queen's University, Kingston, ON
| | - K Ding
- Queen's University, Kingston, ON
| | | | - D Tu
- Queen's University, Kingston, ON
| | - A E Hay
- Queen's University, Kingston, ON
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22
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Sutherland ND, Jones B, Du Plessis K, Cheung M, Konstantinov I, D'Udekem Y. P706Hospital and home based cardiac rehabilitation following Fontan surgery. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy564.p706] [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: 11/12/2022] Open
Affiliation(s)
- N D Sutherland
- Murdoch Children's Research Institute, Melbourne, Australia
| | - B Jones
- University of Melbourne, Melbourne, Australia
| | - K Du Plessis
- Murdoch Children's Research Institute, Melbourne, Australia
| | - M Cheung
- Royal Children's Hospital, Melbourne, Australia
| | | | - Y D'Udekem
- Royal Children's Hospital, Melbourne, Australia
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23
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McCloskey K, Ponsonby AL, Collier F, Allen K, Tang MLK, Carlin JB, Saffery R, Skilton MR, Cheung M, Ranganathan S, Dwyer T, Burgner D, Vuillermin P. The association between higher maternal pre-pregnancy body mass index and increased birth weight, adiposity and inflammation in the newborn. Pediatr Obes 2018; 13:46-53. [PMID: 27723247 DOI: 10.1111/ijpo.12187] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2016] [Accepted: 08/29/2016] [Indexed: 12/11/2022]
Abstract
BACKGROUND Excess adiposity and adiposity-related inflammation are known risk factors for cardiovascular disease in adults; however, little is known regarding the determinants of adiposity-related inflammation at birth. OBJECTIVES The aim of this study was to investigate the association between maternal pre-pregnancy BMI and newborn adiposity and inflammation. METHODS Paired maternal (28-week gestation) and infant (umbilical cord) blood samples were collected from a population-derived birth cohort (Barwon Infant Study, n = 1074). Data on maternal comorbidities and infant birth anthropomorphic measures were compiled, and infant aortic intima-media thickness was measured by trans-abdominal ultrasound. In a selected subgroup of term infants (n = 161), matched maternal and cord lipids, high-sensitivity C-reactive protein (hsCRP) and maternal soluble CD14 were measured. Analysis was completed by using pairwise correlation and linear regression. Because of their non-normal distribution, pathology blood measures were log transformed prior to analysis. RESULTS Maternal pre-pregnancy BMI was positively associated with increased birth weight (mean difference 17.8 g per kg m-2 , 95% CI 6.6 to 28.9; p = 0.002), newborn mean skin-fold thickness (mean difference 0.1 mm per kg m-2 , 95% CI 0.0 to 0.1; p < 0.001) and cord blood hsCRP (mean difference of 4.2% increase in hsCRP per kg m-2 increase in pre-pregnancy BMI, 95% CI 0.6 to 7.7%, p = 0.02), but not cord blood soluble CD14. Inclusion of maternal hsCRP as a covariate attenuated the associations between pre-pregnancy BMI and both newborn skin-fold thickness and cord blood hsCRP. CONCLUSION Higher maternal pre-pregnancy BMI is associated with increased newborn adiposity and inflammation. These associations may be partially mediated by maternal inflammation during pregnancy.
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Affiliation(s)
- K McCloskey
- Murdoch Childrens Research Institute, Royal Children's Hospital, Parkville, Australia.,Child Health Research Unit, Barwon Health, Geelong, Australia.,Department of Paediatrics, University of Melbourne, Parkville, Australia
| | - A-L Ponsonby
- Murdoch Childrens Research Institute, Royal Children's Hospital, Parkville, Australia.,Department of Paediatrics, University of Melbourne, Parkville, Australia
| | - F Collier
- Child Health Research Unit, Barwon Health, Geelong, Australia.,Deakin University, Geelong, Australia
| | - K Allen
- Murdoch Childrens Research Institute, Royal Children's Hospital, Parkville, Australia.,Department of Paediatrics, University of Melbourne, Parkville, Australia
| | - M L K Tang
- Murdoch Childrens Research Institute, Royal Children's Hospital, Parkville, Australia.,Department of Paediatrics, University of Melbourne, Parkville, Australia
| | - J B Carlin
- Murdoch Childrens Research Institute, Royal Children's Hospital, Parkville, Australia.,Department of Paediatrics, University of Melbourne, Parkville, Australia
| | - R Saffery
- Murdoch Childrens Research Institute, Royal Children's Hospital, Parkville, Australia.,Department of Paediatrics, University of Melbourne, Parkville, Australia
| | - M R Skilton
- Boden Institute of Obesity, Nutrition, Exercise and Eating Disorders, University of Sydney, Sydney, Australia
| | - M Cheung
- Murdoch Childrens Research Institute, Royal Children's Hospital, Parkville, Australia.,Department of Paediatrics, University of Melbourne, Parkville, Australia
| | - S Ranganathan
- Murdoch Childrens Research Institute, Royal Children's Hospital, Parkville, Australia.,Department of Paediatrics, University of Melbourne, Parkville, Australia
| | - T Dwyer
- Murdoch Childrens Research Institute, Royal Children's Hospital, Parkville, Australia.,Department of Paediatrics, University of Melbourne, Parkville, Australia
| | - D Burgner
- Murdoch Childrens Research Institute, Royal Children's Hospital, Parkville, Australia.,Department of Paediatrics, University of Melbourne, Parkville, Australia.,Department of Paediatrics, Monash University, Clayton, Australia
| | - P Vuillermin
- Murdoch Childrens Research Institute, Royal Children's Hospital, Parkville, Australia.,Child Health Research Unit, Barwon Health, Geelong, Australia.,Deakin University, Geelong, Australia
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24
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Chaudary N, Cheung M, Foltz W, Abdalaty AH, Stewart J, Lindsay P, Siddiqui I, Larsen M, Hill R, Milosevic M, Kim J, Hedley D. Preclinical Development of Targeted Stereotactic Body Radiation Therapy for Pancreatic Cancer. Int J Radiat Oncol Biol Phys 2017. [DOI: 10.1016/j.ijrobp.2017.06.2464] [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: 10/18/2022]
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25
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Hallet J, Law CHL, Cheung M, Mittmann N, Liu N, Fischer HD, Singh S. Patterns and Drivers of Costs for Neuroendocrine Tumor Care: A Comparative Population-Based Analysis. Ann Surg Oncol 2017; 24:3312-3323. [DOI: 10.1245/s10434-017-5986-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2017] [Indexed: 12/19/2022]
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Berinstein N, Smyth L, Pennell N, Weerasinghe R, Cheung M, Imrie K, Spaner D, Chodirker L, Piliotis E, Milliken V, Boudreau A, Zhang L, Reis M, Chesney A, Good D, Ghorab Z, Buckstein R. PROLONGED MOLECULAR AND CLINICAL REMISSIONS IN FOLLICULAR LYMPHOMA PATIENTS TREATED WITH HDT/ASCT AND COMBINATION IMMUNOTHERAPY WITH RITUXIMAB AND INTERFERON α. Hematol Oncol 2017. [DOI: 10.1002/hon.2439_120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- N. Berinstein
- Hematology Oncology; Odette Cancer Centre, Sunnybrook Health Sciences Centre; Toronto Canada
| | - L. Smyth
- Hematology Oncology; Odette Cancer Centre, Sunnybrook Health Sciences Centre; Toronto Canada
| | - N. Pennell
- Hematology Oncology; Odette Cancer Centre, Sunnybrook Health Sciences Centre; Toronto Canada
| | - R. Weerasinghe
- Hematology Oncology; Odette Cancer Centre, Sunnybrook Health Sciences Centre; Toronto Canada
| | - M. Cheung
- Hematology Oncology; Odette Cancer Centre, Sunnybrook Health Sciences Centre; Toronto Canada
| | - K. Imrie
- Hematology Oncology; Odette Cancer Centre, Sunnybrook Health Sciences Centre; Toronto Canada
| | - D. Spaner
- Hematology Oncology; Odette Cancer Centre, Sunnybrook Health Sciences Centre; Toronto Canada
| | - L. Chodirker
- Hematology Oncology; Odette Cancer Centre, Sunnybrook Health Sciences Centre; Toronto Canada
| | - E. Piliotis
- Hematology Oncology; Odette Cancer Centre, Sunnybrook Health Sciences Centre; Toronto Canada
| | - V. Milliken
- Hematology Oncology; Odette Cancer Centre, Sunnybrook Health Sciences Centre; Toronto Canada
| | - A. Boudreau
- Hematology Oncology; Odette Cancer Centre, Sunnybrook Health Sciences Centre; Toronto Canada
| | - L. Zhang
- Hematology Oncology; Odette Cancer Centre, Sunnybrook Health Sciences Centre; Toronto Canada
| | - M. Reis
- Laboratory Medicine; Sunnybrook Health Sciences Centre; Toronto Canada
| | - A. Chesney
- Laboratory Medicine; Sunnybrook Health Sciences Centre; Toronto Canada
| | - D. Good
- Pathology; Kingston General Hospital; Kingston Canada
| | - Z. Ghorab
- Laboratory Medicine; Sunnybrook Health Sciences Centre; Toronto Canada
| | - R. Buckstein
- Hematology Oncology; Odette Cancer Centre, Sunnybrook Health Sciences Centre; Toronto Canada
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27
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Goodman L, Linden A, Jensen G, Kaseje N, Wright N, St-Louis E, Yousef Y, Wissanji H, Cheung M, Ozgediz D, Poenaru D, Lakhoo K, Greenberg S, Ameh E, Oldham K, Bickler S, Farmer D. Funding Flows for the Global Initiative for Children’s Surgery (GICS):
Lessons Learned. Ann Glob Health 2017. [DOI: 10.1016/j.aogh.2017.03.186] [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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28
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Mozessohn L, Cheung M, Fallahpour S, Gill T, Maloul A, Zhang L, Lau O, Buckstein R. Real-World Azacitidine use does not Replicate AZA-001 Results in Higher-Risk MDS/Low-Blast Count AML: Audit of 1101 Patients in Ontario, Canada. Leuk Res 2017. [DOI: 10.1016/s0145-2126(17)30175-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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29
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Sheridan B, Brink J, Konstantinov I, Eastaugh L, Callea G, Mathew J, Cheung M, Brizard C, d'Udekem Y. Durable Ventricular Assist Devices for Infants Improve Organ Utilization and Survival. J Heart Lung Transplant 2017. [DOI: 10.1016/j.healun.2017.01.748] [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: 10/19/2022] Open
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Vohra RS, Pasquali S, Kirkham AJ, Marriott P, Johnstone M, Spreadborough P, Alderson D, Griffiths EA, Fenwick S, Elmasry M, Nunes Q, Kennedy D, Basit Khan R, Khan MAS, Magee CJ, Jones SM, Mason D, Parappally CP, Mathur P, Saunders M, Jamel S, Ul Haque S, Zafar S, Shiwani MH, Samuel N, Dar F, Jackson A, Lovett B, Dindyal S, Winter H, Fletcher T, Rahman S, Wheatley K, Nieto T, Ayaani S, Youssef H, Nijjar RS, Watkin H, Naumann D, Emeshi S, Sarmah PB, Lee K, Joji N, Heath J, Teasdale RL, Weerasinghe C, Needham PJ, Welbourn H, Forster L, Finch D, Blazeby JM, Robb W, McNair AGK, Hrycaiczuk A, Charalabopoulos A, Kadirkamanathan S, Tang CB, Jayanthi NVG, Noor N, Dobbins B, Cockbain AJ, Nilsen-Nunn A, Siqueira J, Pellen M, Cowley JB, Ho WM, Miu V, White TJ, Hodgkins KA, Kinghorn A, Tutton MG, Al-Abed YA, Menzies D, Ahmad A, Reed J, Khan S, Monk D, Vitone LJ, Murtaza G, Joel A, Brennan S, Shier D, Zhang C, Yoganathan T, Robinson SJ, McCallum IJD, Jones MJ, Elsayed M, Tuck L, Wayman J, Carney K, Aroori S, Hosie KB, Kimble A, Bunting DM, Fawole AS, Basheer M, Dave RV, Sarveswaran J, Jones E, Kendal C, Tilston MP, Gough M, Wallace T, Singh S, Downing J, Mockford KA, Issa E, Shah N, Chauhan N, Wilson TR, Forouzanfar A, Wild JRL, Nofal E, Bunnell C, Madbak K, Rao STV, Devoto L, Siddiqi N, Khawaja Z, Hewes JC, Gould L, Chambers A, Urriza Rodriguez D, Sen G, Robinson S, Carney K, Bartlett F, Rae DM, Stevenson TEJ, Sarvananthan K, Dwerryhouse SJ, Higgs SM, Old OJ, Hardy TJ, Shah R, Hornby ST, Keogh K, Frank L, Al-Akash M, Upchurch EA, Frame RJ, Hughes M, Jelley C, Weaver S, Roy S, Sillo TO, Galanopoulos G, Cuming T, Cunha P, Tayeh S, Kaptanis S, Heshaishi M, Eisawi A, Abayomi M, Ngu WS, Fleming K, Singh Bajwa D, Chitre V, Aryal K, Ferris P, Silva M, Lammy S, Mohamed S, Khawaja A, Hussain A, Ghazanfar MA, Bellini MI, Ebdewi H, Elshaer M, Gravante G, Drake B, Ogedegbe A, Mukherjee D, Arhi C, Giwa Nusrat Iqbal L, Watson NF, Kumar Aggarwal S, Orchard P, Villatoro E, Willson PD, Wa K, Mok J, Woodman T, Deguara J, Garcea G, Babu BI, Dennison AR, Malde D, Lloyd D, Satheesan S, Al-Taan O, Boddy A, Slavin JP, Jones RP, Ballance L, Gerakopoulos S, Jambulingam P, Mansour S, Sakai N, Acharya V, Sadat MM, Karim L, Larkin D, Amin K, Khan A, Law J, Jamdar S, Smith SR, Sampat K, M O'shea K, Manu M, Asprou FM, Malik NS, Chang J, Johnstone M, Lewis M, Roberts GP, Karavadra B, Photi E, Hewes J, Gould L, Chambers A, Rodriguez D, O'Reilly DA, Rate AJ, Sekhar H, Henderson LT, Starmer BZ, Coe PO, Tolofari S, Barrie J, Bashir G, Sloane J, Madanipour S, Halkias C, Trevatt AEJ, Borowski DW, Hornsby J, Courtney MJ, Virupaksha S, Seymour K, Robinson S, Hawkins H, Bawa S, Gallagher PV, Reid A, Wood P, Finch JG, Parmar J, Stirland E, Gardner-Thorpe J, Al-Muhktar A, Peterson M, Majeed A, Bajwa FM, Martin J, Choy A, Tsang A, Pore N, Andrew DR, Al-Khyatt W, Taylor C, Bhandari S, Chambers A, Subramanium D, Toh SKC, Carter NC, Mercer SJ, Knight B, Tate S, Pearce B, Wainwright D, Vijay V, Alagaratnam S, Sinha S, Khan S, El-Hasani SS, Hussain AA, Bhattacharya V, Kansal N, Fasih T, Jackson C, Siddiqui MN, Chishti IA, Fordham IJ, Siddiqui Z, Bausbacher H, Geogloma I, Gurung K, Tsavellas G, Basynat P, Kiran Shrestha A, Basu S, Chhabra Mohan Harilingam A, Rabie M, Akhtar M, Kumar P, Jafferbhoy SF, Hussain N, Raza S, Haque M, Alam I, Aseem R, Patel S, Asad M, Booth MI, Ball WR, Wood CPJ, Pinho-Gomes AC, Kausar A, Rami Obeidallah M, Varghase J, Lodhia J, Bradley D, Rengifo C, Lindsay D, Gopalswamy S, Finlay I, Wardle S, Bullen N, Iftikhar SY, Awan A, Ahmed J, Leeder P, Fusai G, Bond-Smith G, Psica A, Puri Y, Hou D, Noble F, Szentpali K, Broadhurst J, Date R, Hossack MR, Li Goh Y, Turner P, Shetty V, Riera M, Macano CAW, Sukha A, Preston SR, Hoban JR, Puntis DJ, Williams SV, Krysztopik R, Kynaston J, Batt J, Doe M, Goscimski A, Jones GH, Smith SR, Hall C, Carty N, Ahmed J, Panteleimonitis S, Gunasekera RT, Sheel ARG, Lennon H, Hindley C, Reddy M, Kenny R, Elkheir N, McGlone ER, 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Shahin Y, Ali A, Luther A, Nicholson JA, Rajendran I, Boal M, Ritchie J. Population-based cohort study of variation in the use of emergency cholecystectomy for benign gallbladder diseases. Br J Surg 2016; 103:1716-1726. [PMID: 27748962 DOI: 10.1002/bjs.10288] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2016] [Revised: 06/21/2016] [Accepted: 07/06/2016] [Indexed: 01/05/2023]
Abstract
Abstract
Background
The aims of this prospective population-based cohort study were to identify the patient and hospital characteristics associated with emergency cholecystectomy, and the influences of these in determining variations between hospitals.
Methods
Data were collected for consecutive patients undergoing cholecystectomy in acute UK and Irish hospitals between 1 March and 1 May 2014. Potential explanatory variables influencing the performance of emergency cholecystectomy were analysed by means of multilevel, multivariable logistic regression modelling using a two-level hierarchical structure with patients (level 1) nested within hospitals (level 2).
Results
Data were collected on 4744 cholecystectomies from 165 hospitals. Increasing age, lower ASA fitness grade, biliary colic, the need for further imaging (magnetic retrograde cholangiopancreatography), endoscopic interventions (endoscopic retrograde cholangiopancreatography) and admission to a non-biliary centre significantly reduced the likelihood of an emergency cholecystectomy being performed. The multilevel model was used to calculate the probability of receiving an emergency cholecystectomy for a woman aged 40 years or over with an ASA grade of I or II and a BMI of at least 25·0 kg/m2, who presented with acute cholecystitis with an ultrasound scan showing a thick-walled gallbladder and a normal common bile duct. The mean predicted probability of receiving an emergency cholecystectomy was 0·52 (95 per cent c.i. 0·45 to 0·57). The predicted probabilities ranged from 0·02 to 0·95 across the 165 hospitals, demonstrating significant variation between hospitals.
Conclusion
Patients with similar characteristics presenting to different hospitals with acute gallbladder pathology do not receive comparable care.
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Affiliation(s)
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- Trent Oesophago-Gastric Unit, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - S Pasquali
- Surgical Oncology Unit, Veneto Institute of Oncology IOV-IRCCS, Padova, Italy
| | - A J Kirkham
- Cancer Research UK Clinical Trials Unit, University of Birmingham, Birmingham, UK
| | - P Marriott
- West Midlands Research Collaborative, Academic Department of Surgery, University of Birmingham, Birmingham, UK
| | - M Johnstone
- West Midlands Research Collaborative, Academic Department of Surgery, University of Birmingham, Birmingham, UK
| | - P Spreadborough
- West Midlands Research Collaborative, Academic Department of Surgery, University of Birmingham, Birmingham, UK
| | - D Alderson
- Academic Department of Surgery, University of Birmingham, Birmingham, UK
| | - E A Griffiths
- Department of Upper Gastrointestinal Surgery, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - S Fenwick
- Aintree University Hospital NHS Foundation Trust
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- Aintree University Hospital NHS Foundation Trust
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- Aintree University Hospital NHS Foundation Trust
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- Aintree University Hospital NHS Foundation Trust
| | | | | | | | | | - D Mason
- Wirral University Teaching Hospital
| | | | | | | | - S Jamel
- Barnet and Chase Farm Hospital
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- Barnet and Chase Farm Hospital
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- Barnsley District General Hospital
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- Barnsley District General Hospital
| | | | | | | | | | | | | | - K Wheatley
- Sandwell and West Birmingham Hospitals NHS Trust
| | - T Nieto
- Sandwell and West Birmingham Hospitals NHS Trust
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- Sandwell and West Birmingham Hospitals NHS Trust
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- Heart of England Foundation NHS Trust
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- Heart of England Foundation NHS Trust
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- Heart of England Foundation NHS Trust
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- Heart of England Foundation NHS Trust
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- Heart of England Foundation NHS Trust
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- Heart of England Foundation NHS Trust
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- Blackpool Teaching Hospitals NHS Foundation Trust
| | - R L Teasdale
- Blackpool Teaching Hospitals NHS Foundation Trust
| | | | - P J Needham
- Bradford Teaching Hospitals NHS Foundation Trust
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- Bradford Teaching Hospitals NHS Foundation Trust
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- Bradford Teaching Hospitals NHS Foundation Trust
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- Bradford Teaching Hospitals NHS Foundation Trust
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- University Hospitals Bristol NHS Trust
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- Calderdale and Huddersfield NHS Trust
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- Hull and East Yorkshire NHS Trust
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- Hull and East Yorkshire NHS Trust
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- Hull and East Yorkshire NHS Trust
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- Chesterfield Royal Hospital NHS Foundation Trust
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- Chesterfield Royal Hospital NHS Foundation Trust
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- Chesterfield Royal Hospital NHS Foundation Trust
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- Colchester Hospital University NHS Foundation Trust
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- Colchester Hospital University NHS Foundation Trust
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- Colchester Hospital University NHS Foundation Trust
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- Colchester Hospital University NHS Foundation Trust
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- Colchester Hospital University NHS Foundation Trust
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- Colchester Hospital University NHS Foundation Trust
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- Countess of Chester NHS Foundation Trust
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- Countess of Chester NHS Foundation Trust
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- Countess of Chester NHS Foundation Trust
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- Croydon Health Services NHS Trust
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- North Cumbria University Hospitals Trust
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- North Cumbria University Hospitals Trust
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- Northern Lincolnshire and Goole NHS Foundation Trust
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- Northern Lincolnshire and Goole NHS Foundation Trust
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- Northern Lincolnshire and Goole NHS Foundation Trust
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- Northern Lincolnshire and Goole NHS Foundation Trust
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- Northern Lincolnshire and Goole NHS Foundation Trust
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- Northern Lincolnshire and Goole NHS Foundation Trust
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- Northern Lincolnshire and Goole NHS Foundation Trust
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- Northern Lincolnshire and Goole NHS Foundation Trust
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- Frimley Park Hospital NHS Trust
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- Gloucestershire Hospitals NHS Trust
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- Gloucestershire Hospitals NHS Trust
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- Gloucestershire Hospitals NHS Trust
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- Gloucestershire Hospitals NHS Trust
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- Great Western Hospitals NHS Foundation Trust
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- Homerton University Hospital NHS Trust
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- Tees Hospitals NHS Foundation Trust
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- Paget University Hospitals NHS Foundation Trust
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- Paget University Hospitals NHS Foundation Trust
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- Paget University Hospitals NHS Foundation Trust
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- Kettering General Hospital NHS Foundation Trust
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- Kettering General Hospital NHS Foundation Trust
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- Kettering General Hospital NHS Foundation Trust
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- Kettering General Hospital NHS Foundation Trust
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- Barking, Havering and Redbridge University Hospitals NHS Trust
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- Barking, Havering and Redbridge University Hospitals NHS Trust
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- Barking, Havering and Redbridge University Hospitals NHS Trust
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- Kingston Hospital NHS Foundation Trust
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- Kingston Hospital NHS Foundation Trust
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- Kingston Hospital NHS Foundation Trust
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- Kingston Hospital NHS Foundation Trust
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- University Hospitals of Leicester NHS Trust
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- University Hospitals of Leicester NHS Trust
| | | | - D Malde
- University Hospitals of Leicester NHS Trust
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- University Hospitals of Leicester NHS Trust
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- University Hospitals of Leicester NHS Trust
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- University Hospitals of Leicester NHS Trust
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- Leighton Hospital, Mid Cheshire Hospitals NHS Foundation Trust
| | - R P Jones
- Leighton Hospital, Mid Cheshire Hospitals NHS Foundation Trust
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- Leighton Hospital, Mid Cheshire Hospitals NHS Foundation Trust
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- Leighton Hospital, Mid Cheshire Hospitals NHS Foundation Trust
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- Luton and Dunstable University Hospital NHS Foundation Trust
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- Luton and Dunstable University Hospital NHS Foundation Trust
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- Luton and Dunstable University Hospital NHS Foundation Trust
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- Luton and Dunstable University Hospital NHS Foundation Trust
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- Macclesfield District General Hospital
| | - L Karim
- Macclesfield District General Hospital
| | - D Larkin
- Macclesfield District General Hospital
| | - K Amin
- Macclesfield District General Hospital
| | - A Khan
- Central Manchester NHS Foundation Trust
| | - J Law
- Central Manchester NHS Foundation Trust
| | - S Jamdar
- Central Manchester NHS Foundation Trust
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- Central Manchester NHS Foundation Trust
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- Central Manchester NHS Foundation Trust
| | | | - M Manu
- Royal Wolverhampton Hospitals NHS Trust
| | | | - N S Malik
- Royal Wolverhampton Hospitals NHS Trust
| | - J Chang
- Royal Wolverhampton Hospitals NHS Trust
| | | | - M Lewis
- Norfolk and Norwich University Hospitals NHS Foundation Trust
| | - G P Roberts
- Norfolk and Norwich University Hospitals NHS Foundation Trust
| | - B Karavadra
- Norfolk and Norwich University Hospitals NHS Foundation Trust
| | - E Photi
- Norfolk and Norwich University Hospitals NHS Foundation Trust
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - J Hornsby
- North Tees and Hartlepool NHS Foundation Trust
| | | | | | - K Seymour
- Northumbria Healthcare NHS Foundation Trust
| | - S Robinson
- Northumbria Healthcare NHS Foundation Trust
| | - H Hawkins
- Northumbria Healthcare NHS Foundation Trust
| | - S Bawa
- Northumbria Healthcare NHS Foundation Trust
| | | | - A Reid
- Northumbria Healthcare NHS Foundation Trust
| | - P Wood
- Northumbria Healthcare NHS Foundation Trust
| | - J G Finch
- Northampton General Hospital NHS Trust
| | - J Parmar
- Northampton General Hospital NHS Trust
| | | | | | - A Al-Muhktar
- Sheffield Teaching Hospitals NHS Foundation Trust
| | - M Peterson
- Sheffield Teaching Hospitals NHS Foundation Trust
| | - A Majeed
- Sheffield Teaching Hospitals NHS Foundation Trust
| | | | | | - A Choy
- Peterborough City Hospital
| | | | - N Pore
- United Lincolnshire Hospitals NHS Trust
| | | | | | - C Taylor
- United Lincolnshire Hospitals NHS Trust
| | | | | | | | | | | | | | | | - S Tate
- Portsmouth Hospitals NHS Trust
| | | | | | - V Vijay
- The Princess Alexandra Hospital NHS Trust
| | | | - S Sinha
- The Princess Alexandra Hospital NHS Trust
| | - S Khan
- The Princess Alexandra Hospital NHS Trust
| | | | - A A Hussain
- King's College Hospital NHS Foundation Trust
| | | | - N Kansal
- Gateshead Health NHS Foundation Trust
| | - T Fasih
- Gateshead Health NHS Foundation Trust
| | - C Jackson
- Gateshead Health NHS Foundation Trust
| | | | | | | | | | | | | | - K Gurung
- Queen Elizabeth Hospital NHS Trust
| | - G Tsavellas
- East Kent Hospitals University NHS Foundation Trust
| | - P Basynat
- East Kent Hospitals University NHS Foundation Trust
| | | | - S Basu
- East Kent Hospitals University NHS Foundation Trust
| | | | - M Rabie
- East Kent Hospitals University NHS Foundation Trust
| | - M Akhtar
- East Kent Hospitals University NHS Foundation Trust
| | - P Kumar
- Burton Hospitals NHS Foundation Trust
| | | | - N Hussain
- Burton Hospitals NHS Foundation Trust
| | - S Raza
- Burton Hospitals NHS Foundation Trust
| | - M Haque
- Royal Albert Edward Infirmary, Wigan Wrightington and Leigh NHS Trust
| | - I Alam
- Royal Albert Edward Infirmary, Wigan Wrightington and Leigh NHS Trust
| | - R Aseem
- Royal Albert Edward Infirmary, Wigan Wrightington and Leigh NHS Trust
| | - S Patel
- Royal Albert Edward Infirmary, Wigan Wrightington and Leigh NHS Trust
| | - M Asad
- Royal Albert Edward Infirmary, Wigan Wrightington and Leigh NHS Trust
| | - M I Booth
- Royal Berkshire NHS Foundation Trust
| | - W R Ball
- Royal Berkshire NHS Foundation Trust
| | | | | | | | | | - J Varghase
- Royal Bolton Hospital NHS Foundation Trust
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- Royal Bolton Hospital NHS Foundation Trust
| | - D Bradley
- Royal Bolton Hospital NHS Foundation Trust
| | - C Rengifo
- Royal Bolton Hospital NHS Foundation Trust
| | - D Lindsay
- Royal Bolton Hospital NHS Foundation Trust
| | | | | | | | | | | | - A Awan
- Royal Derby NHS Foundation Trust
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- Royal Derby NHS Foundation Trust
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- Royal Derby NHS Foundation Trust
| | | | | | | | | | - D Hou
- Hampshire Hospital NHS Foundation Trust
| | - F Noble
- Hampshire Hospital NHS Foundation Trust
| | | | | | - R Date
- Lancashire Teaching Hospitals NHS Foundation Trust
| | - M R Hossack
- Lancashire Teaching Hospitals NHS Foundation Trust
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- Lancashire Teaching Hospitals NHS Foundation Trust
| | - P Turner
- Lancashire Teaching Hospitals NHS Foundation Trust
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- Lancashire Teaching Hospitals NHS Foundation Trust
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- Royal Surrey County Hospital NHS Foundation Trust
| | - J R Hoban
- Royal Surrey County Hospital NHS Foundation Trust
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- Royal Surrey County Hospital NHS Foundation Trust
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- Royal United Hospital Bath NHS Trust
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- Royal United Hospital Bath NHS Trust
| | | | | | | | - C Hall
- Salford Royal NHS Foundation Trust
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- Salisbury Hospital Foundation Trust
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- Salisbury Hospital Foundation Trust
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- Southport and Ormskirk Hospital NHS Trust
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- Southport and Ormskirk Hospital NHS Trust
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- St George's Healthcare NHS Trust
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- St Helens and Knowsley Teaching Hospitals NHS Trust
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- Imperial College Healthcare NHS Trust
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- Imperial College Healthcare NHS Trust
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- Belfast City Hospital, Mater Infirmorum Hospital Belfast and Royal Victoria Hospital
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- Belfast City Hospital, Mater Infirmorum Hospital Belfast and Royal Victoria Hospital
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- Belfast City Hospital, Mater Infirmorum Hospital Belfast and Royal Victoria Hospital
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| | - D Johnston
- Belfast City Hospital, Mater Infirmorum Hospital Belfast and Royal Victoria Hospital
| | - B McAree
- Belfast City Hospital, Mater Infirmorum Hospital Belfast and Royal Victoria Hospital
| | | | | | | | | | | | | | | | | | | | | | | | | | - P Burke
- University Hospital Limerick
| | | | - A D K Hill
- Louth County Hospital and Our Lady of Lourdes Hospital
| | - E Khogali
- Louth County Hospital and Our Lady of Lourdes Hospital
| | - W Shabo
- Louth County Hospital and Our Lady of Lourdes Hospital
| | - E Iskandar
- Louth County Hospital and Our Lady of Lourdes Hospital
| | | | | | | | | | | | | | | | | | - P Balfe
- St Luke's General Hospital Kilkenny
| | - M Lee
- St Luke's General Hospital Kilkenny
| | - D C Winter
- St Vincent's University and Private Hospitals, Dublin
| | - M E Kelly
- St Vincent's University and Private Hospitals, Dublin
| | - E Hoti
- St Vincent's University and Private Hospitals, Dublin
| | - D Maguire
- St Vincent's University and Private Hospitals, Dublin
| | - P Karunakaran
- St Vincent's University and Private Hospitals, Dublin
| | - J G Geoghegan
- St Vincent's University and Private Hospitals, Dublin
| | - S T Martin
- St Vincent's University and Private Hospitals, Dublin
| | - F McDermott
- St Vincent's University and Private Hospitals, Dublin
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - S Gibson
- Crosshouse Hospital, Ayrshire and Arran
| | | | - D G Vass
- Crosshouse Hospital, Ayrshire and Arran
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - H C C Lim
- Glangwili General and Prince Philip Hospital
| | - D Duke
- Glangwili General and Prince Philip Hospital
| | - T Ahmed
- Glangwili General and Prince Philip Hospital
| | - W D Beasley
- Glangwili General and Prince Philip Hospital
| | | | - G Maharaj
- Glangwili General and Prince Philip Hospital
| | - C Malcolm
- Glangwili General and Prince Philip Hospital
| | | | | | | | - R Radwan
- Morriston and Singleton Hospitals
| | | | - S Wood
- Princess of Wales Hospital
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Prica A, Baldassarre F, Hicks LK, Imrie K, Kouroukis T, Cheung M. Rituximab in Lymphoma and Chronic Lymphocytic Leukaemia: A Practice Guideline. Clin Oncol (R Coll Radiol) 2016; 29:e13-e28. [PMID: 27746042 DOI: 10.1016/j.clon.2016.09.004] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [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: 04/12/2016] [Revised: 06/20/2016] [Accepted: 07/05/2016] [Indexed: 11/25/2022]
Abstract
Rituximab is the first monoclonal antibody to be approved for use by the US Food and Drug Administration in cancer. Its role in the treatment of non-Hodgkin lymphoma, including chronic lymphocytic leukaemia (CLL), has evolved significantly. We aimed to systematically review and update the literature on rituximab in lymphoma and CLL, and provide evidence-based consensus guidelines for its rational use. Validated methodology from the Cancer Care Ontario Program in Evidence-based Care was used. A comprehensive literature search was completed by a methodologist from the Hematology Disease Site Group of Cancer Care Ontario. Data were extracted from randomised controlled trials of rituximab-containing chemotherapy regimens for patients with lymphoma or CLL. Fifty-six primary randomised controlled trials were retrievable and met all inclusion criteria. Clinically important benefits in progression-free survival or overall survival were seen in the following settings: (i) addition of rituximab to combination chemotherapy for initial treatment of aggressive B-cell lymphomas, including diffuse large B-cell lymphoma, Burkitt lymphoma and HIV-related lymphoma with CD4 count ≥50/mm3; (ii) addition of rituximab to combination chemotherapy for initial and subsequent treatment of follicular lymphoma and other indolent B-cell lymphomas; (iii) use of rituximab maintenance in patients with indolent B-cell lymphomas who have responded to chemoimmunotherapy; (iv) addition of rituximab to fludarabine-based chemotherapy or chlorambucil for initial treatment of CLL. The consensus opinion of the Hematology Disease Site Group is that rituximab is recommended for these indications.
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Affiliation(s)
- A Prica
- Princess Margaret Hospital, Toronto, Ontario, Canada
| | - F Baldassarre
- Program in Evidence-based Care, Cancer Care Ontario, McMaster University, Hamilton, Ontario, Canada.
| | - L K Hicks
- St. Michael Hospital, Toronto, Ontario, Canada
| | - K Imrie
- Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - T Kouroukis
- Juravinski Cancer Centre, Hamilton, Ontario, Canada
| | - M Cheung
- Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
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Sussman J, Varela N, Cheung M, Hicks L, Kraftcheck D, Mandel J, Fraser G, Jimenez-Juan L, Boudreau A, Sajkowski S, McQuillan R. Follow-up care for survivors of lymphoma who have received curative-intent treatment. Curr Oncol 2016; 23:e499-e513. [PMID: 27803611 PMCID: PMC5081023 DOI: 10.3747/co.23.3265] [Citation(s) in RCA: 8] [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] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVE This evidence summary set out to assess the available evidence about the follow-up of asymptomatic survivors of lymphoma who have received curative-intent treatment. METHODS The medline and embase databases and the Cochrane Database of Systematic Reviews were searched for evidence published between 2000 and August 2015 relating to lymphoma survivorship follow-up. The evidence summary was developed by a Working Group at the request of the Cancer Care Ontario Survivorship and Cancer Imaging programs because of the absence of evidence-based practice documents in Ontario for the follow-up and surveillance of asymptomatic patients with lymphoma in complete remission. RESULTS Eleven retrospective studies met the inclusion criteria. The proportion of relapses initially detected by clinical manifestations ranged from 13% to 78%; for relapses initially detected by imaging, the proportion ranged from 8% to 46%. Median time for relapse detection ranged from 8.6 to 19 months for patients initially suspected because of imaging and from 8.6 to 33 months for those initially suspected because of clinical manifestations. Only one study reported significantly earlier relapse detection for patients initially suspected because of clinical manifestations (mean: 4.5 months vs. 6.0 months, p = 0.042). No benefit in terms of overall survival was observed for patients depending on whether their relapse was initially detected because of clinical manifestations or surveillance imaging. SUMMARY Findings in the present study support the importance of improving awareness on the part of survivors and clinicians about the symptoms that might be associated with recurrence. The evidence does not support routine imaging for improving outcomes in this patient population.
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Affiliation(s)
- J. Sussman
- Division of Radiation Oncology, Juravinski Cancer Centre, Hamilton
| | - N.P. Varela
- Cancer Care Ontario, Program in Evidence-Based Care, McMaster University, Hamilton
| | - M. Cheung
- Odette Cancer Centre, Sunny-brook Health Sciences Centre, Toronto
| | - L. Hicks
- Division of Hematology/Oncology, St. Michael’s Hospital, Toronto
| | - D. Kraftcheck
- Provincial Primary Care and Cancer Network, Hamilton Niagara Haldimand Brant, Grimsby
| | - J. Mandel
- Department of Diagnostic Imaging and Nuclear Medicine, Oakville Trafalgar Memorial Hospital, Oakville
| | - G. Fraser
- Division of Malignant Hematology, Juravinski Cancer Centre, Hamilton
| | | | - A. Boudreau
- Sunnybrook Health Sciences Centre, Toronto and
| | - S. Sajkowski
- Cancer Care Ontario Patient and Family Advisor, Toronto, ON
| | - R. McQuillan
- Cancer Care Ontario Patient and Family Advisor, Toronto, ON
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Luitingh T, Lee M, Jones B, Koleff J, Aguero SW, Kowalski R, Cheung M, d’Udekem Y. Effectiveness of Exercise-Testing to Detect Late Hypertension in Children Following Coarctation Repair. Heart Lung Circ 2016. [DOI: 10.1016/j.hlc.2016.06.030] [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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Tsang CC, Chan JFW, Pong WM, Chen JHK, Ngan AHY, Cheung M, Lai CKC, Tsang DNC, Lau SKP, Woo PCY. Cutaneous hyalohyphomycosis due to Parengyodontium album gen. et comb. nov. Med Mycol 2016; 54:699-713. [PMID: 27161787 DOI: 10.1093/mmy/myw025] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [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: 11/24/2015] [Accepted: 03/10/2016] [Indexed: 11/14/2022] Open
Abstract
"Engyodontium album" is an environmental saprobic mould and an emerging opportunistic pathogen able to cause both superficial and systemic infections. In this study, we isolated a mould from the skin lesion biopsy specimen of the right shin in a patient who received renal transplantation for end-stage renal failure with prednisolone, tacrolimus, and azathioprine immunosuppressant therapy. Histology of the skin biopsy showed mild squamous hyperplasia and neutrophilic infiltrate in the epidermis, active chronic inflammation in the dermis, and fat necrosis in the subcutis, with numerous fungal elements within the serum crusts. On Sabouraud glucose agar, the fungus grew as white, cobweb-like, floccose colonies. Microscopically, conidiogenous cells were arranged in whorls of one to seven at wide angles, with zigzag-shaped terminal fertile regions and smooth, hyaline, oval, apiculate conidia. DNA sequencing showed the mould isolate belonged to "E. album" but matrix-assisted laser desorption ionisation-time of flight mass spectrometry (MALDI-TOF MS) failed to identify the isolate. Phylogenetic analyses based on the internal transcribed spacer region, 28S nuclear ribosomal DNA, and β-tubulin gene and MALDI-TOF MS coupled with hierarchical cluster analysis showed that "E. album" is distantly related to other Engyodontium species and should be transferred to a novel genus within the family Cordycipitaceae, for which the name Parengyodontium album gen. et comb. nov. is proposed. Three potential cryptic species within this species complex were also revealed. Antifungal susceptibility testing showed posaconazole and voriconazole had high activities against all clinical P. album isolates and may be better drug options for treating P. album infections.
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Affiliation(s)
| | - Jasper F W Chan
- Department of Microbiology.,State Key Laboratory of Emerging Infectious Diseases.,Research Centre of Infection and Immunology.,Carol Yu Centre for Infection, the University of Hong Kong, Hong Kong
| | - Wai-Mei Pong
- Department of Pathology, Queen Elizabeth Hospital, Hong Kong
| | | | | | - Mei Cheung
- Department of Microbiology.,Department of Pathology, Queen Elizabeth Hospital, Hong Kong
| | | | | | - Susanna K P Lau
- Department of Microbiology.,State Key Laboratory of Emerging Infectious Diseases.,Research Centre of Infection and Immunology.,Carol Yu Centre for Infection, the University of Hong Kong, Hong Kong.,Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Zhejiang University, Hangzhou, China
| | - Patrick C Y Woo
- Department of Microbiology.,State Key Laboratory of Emerging Infectious Diseases.,Research Centre of Infection and Immunology.,Carol Yu Centre for Infection, the University of Hong Kong, Hong Kong.,Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Zhejiang University, Hangzhou, China
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Pondorfer P, Yun TJ, Cheung M, Ashburn D, McCrindle B, Mertens L, Grosse-Wortmann L, Manlhiot C, Al'Radi O, Vanderlaan R, Chetan D, Redington A, Van Arsdell G. Tetralogy of Fallot Repair — Long Term Follow-up: Preservation Strategy Improves Late Outcomes. Thorac Cardiovasc Surg 2016. [DOI: 10.1055/s-0036-1571561] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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36
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Chan J, Lam S, Cheung M, Lee K, Lee J. Promoting sleep among undergraduate nursing students in Hong Kong. Sleep Med 2015. [DOI: 10.1016/j.sleep.2015.02.1499] [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: 10/22/2022]
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37
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Tsang CC, Hui TWS, Lee KC, Chen JHK, Ngan AHY, Tam EWT, Chan JFW, Wu AL, Cheung M, Tse BPH, Wu AKL, Lai CKC, Tsang DNC, Que TL, Lam CW, Yuen KY, Lau SKP, Woo PCY. Genetic diversity of Aspergillus species isolated from onychomycosis and Aspergillus hongkongensis sp. nov., with implications to antifungal susceptibility testing. Diagn Microbiol Infect Dis 2015; 84:125-34. [PMID: 26658315 DOI: 10.1016/j.diagmicrobio.2015.10.027] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [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: 05/23/2015] [Revised: 10/27/2015] [Accepted: 10/30/2015] [Indexed: 11/30/2022]
Abstract
Thirteen Aspergillus isolates recovered from nails of 13 patients (fingernails, n=2; toenails, n=11) with onychomycosis were characterized. Twelve strains were identified by multilocus sequencing as Aspergillus spp. (Aspergillus sydowii [n=4], Aspergillus welwitschiae [n=3], Aspergillus terreus [n=2], Aspergillus flavus [n=1], Aspergillus tubingensis [n=1], and Aspergillus unguis [n=1]). Isolates of A. terreus, A. flavus, and A. unguis were also identifiable by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry. The 13th isolate (HKU49(T)) possessed unique morphological characteristics different from other Aspergillus spp. Molecular characterization also unambiguously showed that HKU49(T) was distinct from other Aspergillus spp. We propose the novel species Aspergillus hongkongensis to describe this previously unknown fungus. Antifungal susceptibility testing showed most Aspergillus isolates had low MICs against itraconazole and voriconazole, but all Aspergillus isolates had high MICs against fluconazole. A diverse spectrum of Aspergillus species is associated with onychomycosis. Itraconazole and voriconazole are probably better drug options for Aspergillus onychomycosis.
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Affiliation(s)
- Chi-Ching Tsang
- Department of Microbiology, The University of Hong Kong, Hong Kong
| | - Teresa W S Hui
- Department of Microbiology, The University of Hong Kong, Hong Kong; Department of Clinical Pathology, Tuen Mun Hospital, Hong Kong
| | - Kim-Chung Lee
- Department of Microbiology, The University of Hong Kong, Hong Kong
| | | | - Antonio H Y Ngan
- Department of Microbiology, The University of Hong Kong, Hong Kong
| | - Emily W T Tam
- Department of Microbiology, The University of Hong Kong, Hong Kong
| | - Jasper F W Chan
- Department of Microbiology, The University of Hong Kong, Hong Kong; State Key Laboratory of Emerging Infectious Diseases, The University of Hong Kong, Hong Kong; Research Centre of Infection and Immunology, The University of Hong Kong, Hong Kong; Carol Yu Centre for Infection, The University of Hong Kong, Hong Kong
| | - Andrea L Wu
- Department of Microbiology, The University of Hong Kong, Hong Kong
| | - Mei Cheung
- Department of Microbiology, The University of Hong Kong, Hong Kong; Department of Pathology, Queen Elizabeth Hospital, Hong Kong
| | - Brian P H Tse
- Department of Microbiology, The University of Hong Kong, Hong Kong; Department of Clinical Pathology, Pamela Youde Nethersole Eastern Hospital, Hong Kong
| | - Alan K L Wu
- Department of Clinical Pathology, Pamela Youde Nethersole Eastern Hospital, Hong Kong
| | | | | | - Tak-Lun Que
- Department of Clinical Pathology, Tuen Mun Hospital, Hong Kong
| | - Ching-Wan Lam
- Department of Pathology, The University of Hong Kong, Hong Kong
| | - Kwok-Yung Yuen
- Department of Microbiology, The University of Hong Kong, Hong Kong; State Key Laboratory of Emerging Infectious Diseases, The University of Hong Kong, Hong Kong; Research Centre of Infection and Immunology, The University of Hong Kong, Hong Kong; Carol Yu Centre for Infection, The University of Hong Kong, Hong Kong
| | - Susanna K P Lau
- Department of Microbiology, The University of Hong Kong, Hong Kong; State Key Laboratory of Emerging Infectious Diseases, The University of Hong Kong, Hong Kong; Research Centre of Infection and Immunology, The University of Hong Kong, Hong Kong; Carol Yu Centre for Infection, The University of Hong Kong, Hong Kong.
| | - Patrick C Y Woo
- Department of Microbiology, The University of Hong Kong, Hong Kong; State Key Laboratory of Emerging Infectious Diseases, The University of Hong Kong, Hong Kong; Research Centre of Infection and Immunology, The University of Hong Kong, Hong Kong; Carol Yu Centre for Infection, The University of Hong Kong, Hong Kong.
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Dimopoulos M, Cheung M, Roussel M, Liu T, Gamberi B, Kolb B, Derigs H, Eom H, Belhadj K, Lenain P, van der Jagt R, Rigaudeau S, Hall R, Jaccard A, Tosikyan A, Karlin L, Bensinger W, Schots R, Chen G, Marek J, Ervin-Haynes A, Facon T. Continuous Lenalidomide and Low-Dose Dexamethasone for the Treatment of Patients with Newly Diagnosed Multiple Myeloma and Renal Impairment in the First Trial. Clinical Lymphoma Myeloma and Leukemia 2015. [DOI: 10.1016/j.clml.2015.07.339] [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] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Abstract
ABSTRACT
Objective:
National survival rates for out-of-hospital cardiac arrests are less than 5%, and substantial resources are associated with transporting cardiac arrest victims to hospital for emergency department (ED) resuscitation. The low overall survival rate and the identification of predictors of unsuccessful resuscitation have opened debate on the “futility” of transporting such patients to the ED. This study compares the costs of prehospital pronouncement of death to the costs of transporting patients to a hospital ED for physician pronouncement.
Methods:
The study was a retrospective chart review on a matched cohort of out-of-hospital cardiac arrest patients. Patients were included if documentation was adequate and ambulance response time was less than 8 minutes. A cohort of 20 patients pronounced dead in the field were matched to 20 patients pronounced dead in an ED. Cases were matched on 6 evidence-based predictors of unsuccessful resuscitation. Direct medical costs and mean physician and prehospital provider times were compared.
Results:
The total cost of pronouncement of death in the ED was $45.35 higher than the cost of field pronouncement (p < 0.001). Paramedics spent more time delivering care when death was pronounced in the field (83.3 vs. 55.9 min; p < 0.001). Base hospital physicians spent more time when patients were transported to hospital for ED pronouncement (16.3 vs. 4.3 min; p < 0.001). Total provider time for field pronouncement was 15.5 min longer (p = 0.004), but field pronouncement consumed 12.0 min less physician time.
Conclusions:
Paramedic pronouncement of death in the field is less costly than transporting patients to hospital for physician pronouncement. Pronouncement in the field requires more paramedic time but less physician time.
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Affiliation(s)
- M Cheung
- University of Toronto, Toronto, Ontario, Canada
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40
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Mynard J, Cahoon G, Lee M, Wo N, Kowalski R, Smolich J, D’Udekem Y, Cheung M. Aortic impedance mismatching correlates with systolic and pulse pressures late after aortic coarctation repair. Heart Lung Circ 2015. [DOI: 10.1016/j.hlc.2015.06.727] [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: 10/23/2022]
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Krauss R, Gupta N, Cheung M, Smolich J, Pepe S. Antenatal betamethasone regulates microRNA-335* expression in ovine fetal heart, lungs and placenta. Heart Lung Circ 2015. [DOI: 10.1016/j.hlc.2015.06.726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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42
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Biswas S, O’Donnell K, Lui E, Wilson W, Langenberg F, Heinze S, Better N, Cheung M, Grigg L, Joshi S. Cardiac CT in patients with single ventricle physiology. Heart Lung Circ 2015. [DOI: 10.1016/j.hlc.2015.06.730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Dhaliwal A, Zeino Z, Tomkins C, Cheung M, Nwokolo C, Smith S, Harmston C, Arasaradnam RP. Utility of faecal calprotectin in inflammatory bowel disease (IBD): what cut-offs should we apply? Frontline Gastroenterol 2015; 6:14-19. [PMID: 25580205 PMCID: PMC4283700 DOI: 10.1136/flgastro-2013-100420] [Citation(s) in RCA: 67] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2013] [Revised: 02/08/2014] [Accepted: 02/26/2014] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Faecal calprotectin (FC), a cytosolic protein released by neutrophils (S100 family) in response to inflammation, is a simple, non-invasive test that can be used to differentiate irritable bowel syndrome (IBS) with inflammatory bowel disease (IBD), where there can be considerable symptom overlap. AIMS AND METHODS The aims of the study were (1) to be able to predict the ability of FC to exclude IBD and determine cut-offs when in remission, (2) to investigate the effects of time and temperature on stability of FC and (3) compare three ELISA kits to measure FC: Buhlmann, PhiCal v1 and PhiCal v2. A total of 311 patients with altered bowel habit were tested for FC; 144 with IBS, 148 with IBD and 19 with other organic causes. RESULTS Sensitivity and specificity of FC (with PhiCal v2 kit) to distinguish between functional disorder (IBS) and IBD using cut-off 50 μg/g were 88% and 78%, respectively, with a negative predictive value of 87%. Area under the receiver operating curve was 0.84 (CI 0.78 to 0.90). For those with IBD, FC values below 250 μg/g corresponded with remission of disease with a sensitivity and specificity of 90% and 76%, respectively. Area under the receiver operating curve was 0.93 (CI 0.89 to 0.97). FC was stable once extracted and frozen for up to 2.5 months. Pearson correlation was good between Buhlmann assay and PhiCal v2 (r2 = 0.95). CONCLUSIONS FC has up to 87% negative predictive value to exclude IBD, and cut-offs less than 250 μg/g had 90% sensitivity to determine remission in IBD. Once frozen, FC is stable and the ELISA monoclonal plates were broadly comparable.
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Affiliation(s)
- A Dhaliwal
- Department of Gastroenterology,University Hospitals Coventry and Warwickshire,Coventry, UK
| | - Z Zeino
- Department of Gastroenterology,University Hospitals Coventry and Warwickshire,Coventry, UK
| | - C Tomkins
- Department of Biochemistry, University Hospitals Coventry and Warwickshire, Coventry, UK
| | - M Cheung
- Department of Gastroenterology,University Hospitals Coventry and Warwickshire,Coventry, UK
| | - C Nwokolo
- Department of Gastroenterology,University Hospitals Coventry and Warwickshire,Coventry, UK
| | - S Smith
- Department of Biochemistry, University Hospitals Coventry and Warwickshire, Coventry, UK
| | - C Harmston
- Department of Colorectal Surgery, University Hospitals Coventry and Warwickshire,Coventry, UK
| | - R P Arasaradnam
- Department of Gastroenterology,University Hospitals Coventry and Warwickshire,Coventry, UK,Clinical Sciences Research Institute, Coventry, UK
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Dannhorn E, Cheung M, Rodrigues S, Cooper H, Thorburn D, Patch D, Burroughs A, O'Beirne J. De novouse of generic tacrolimus in liver transplantation - a single center experience with one-yr follow-up. Clin Transplant 2014; 28:1349-57. [DOI: 10.1111/ctr.12455] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/18/2014] [Indexed: 12/17/2022]
Affiliation(s)
- E. Dannhorn
- The Royal Free Sheila Sherlock Liver Centre and University Department of Surgery; Royal Free Hospital; London UK
| | - M. Cheung
- The Royal Free Sheila Sherlock Liver Centre and University Department of Surgery; Royal Free Hospital; London UK
| | - S. Rodrigues
- The Royal Free Sheila Sherlock Liver Centre and University Department of Surgery; Royal Free Hospital; London UK
| | - H. Cooper
- Department of Pharmacy; Royal Free Hospital; London UK
| | - D. Thorburn
- The Royal Free Sheila Sherlock Liver Centre and University Department of Surgery; Royal Free Hospital; London UK
| | - D. Patch
- The Royal Free Sheila Sherlock Liver Centre and University Department of Surgery; Royal Free Hospital; London UK
| | - A.K. Burroughs
- The Royal Free Sheila Sherlock Liver Centre and University Department of Surgery; Royal Free Hospital; London UK
| | - J. O'Beirne
- The Royal Free Sheila Sherlock Liver Centre and University Department of Surgery; Royal Free Hospital; London UK
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Prica A, Chan K, Cheung M. Combined modality therapy versus chemotherapy alone as an induction regimen for primary central nervous system lymphoma: a cost-effectiveness analysis. Neuro Oncol 2014; 16:1384-91. [PMID: 24799455 DOI: 10.1093/neuonc/nou057] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND In immunocompetent patients with primary central nervous system lymphoma (PCNSL), combined modality therapy (CMT) using high-dose methotrexate and radiotherapy (WBRT) has improved response rates compared with chemotherapy alone. The trade-off is delayed and potentially devastating treatment-related neurotoxicity (NT). METHODS A cost-effectiveness analysis using a Markov model compared CMT with chemotherapy alone in age-stratified patients with PCNSL. Baseline probabilities were derived from a systematic literature review. Direct and lost productivity costs were collected from a Canadian perspective and presented in Can$ in 2011. Outcomes were life expectancy, quality-adjusted life years (QALYs), and incremental cost-effectiveness ratio. RESULTS The quality-adjusted life expectancy was 1.55 QALYs for CMT and 1.53 QALYs for chemotherapy alone. In younger patients (aged <60 years), CMT yielded 2.44 QALYs, compared with 1.89 QALYs for chemotherapy alone, yielding an expected benefit with CMT of 0.55 QALYs or 6.6 quality-adjusted months. The CMT strategy dominated in younger patients, as it was Can$11 951 less expensive than chemotherapy alone. The chemotherapy-alone strategy dominated in older patients, as it was Can$11 244 less expensive than CMT, and there was no difference in QALYs between the strategies. The model was robust in sensitivity analyses of key variables tested through the plausible ranges obtained from costing sources and published literature. CONCLUSION The preferred induction strategy for younger patients with PCNSL appears to be CMT, which minimized cost while maximizing life expectancy and QALYs. This analysis confirms that the preferred strategy for older patients is chemotherapy alone.
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Affiliation(s)
- A Prica
- Division of Hematology, Department of Medicine, Sunnybrook Health Science Centre, University of Toronto, Toronto, Canada (A.P., M.C.); Division of Medical Oncology, Department of Medicine, Sunnybrook Health Science Centre and Princess Margaret Hospital, University of Toronto, Toronto, Canada (K.C.)
| | - K Chan
- Division of Hematology, Department of Medicine, Sunnybrook Health Science Centre, University of Toronto, Toronto, Canada (A.P., M.C.); Division of Medical Oncology, Department of Medicine, Sunnybrook Health Science Centre and Princess Margaret Hospital, University of Toronto, Toronto, Canada (K.C.)
| | - M Cheung
- Division of Hematology, Department of Medicine, Sunnybrook Health Science Centre, University of Toronto, Toronto, Canada (A.P., M.C.); Division of Medical Oncology, Department of Medicine, Sunnybrook Health Science Centre and Princess Margaret Hospital, University of Toronto, Toronto, Canada (K.C.)
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Sewell L, Cheung M, Mitchell-Issitt C, Barley K, Chebbout C, Msimanga S, Boyce S, Steiner MC, Singh SJ. S70 Implementing a COPD discharge bundle on a large scale. Thorax 2013. [DOI: 10.1136/thoraxjnl-2013-204457.77] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Cheung M. Racial and Socioeconomic Disparities in Malignant Carcinoid Cancer Cause Specific Survival: An Analysis of a National Cancer Registry. Int J Radiat Oncol Biol Phys 2013. [DOI: 10.1016/j.ijrobp.2013.06.902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Abstract
BACKGROUND Promising new drugs such as lenalidomide, an immunomodulatory agent, are available for the treatment of multiple myeloma. We describe the process of creating a provincial guideline for the use of lenalidomide, alone or in combination with other drugs, in relapsed, refractory, or newly diagnosed disease (including smoldering and symptomatic patients, and candidates and non-candidates for transplant) and in maintenance treatment (after transplant or non-transplant therapy); and for strategies to manage lenalidomide-related toxicities. METHODS Outcomes of interest included overall survival, event-free survival, progression-free survival, time to progression, time to next treatment, response rate, and incidence of serious toxicity. The medline, embase, and Cochrane Library databases, as well as meeting abstracts and the Web sites of relevant organizations, were systematically searched for relevant literature. RESULTS Recommendations were developed using the evidence from published studies and the clinical expertise of the working group and of the Cancer Care Ontario Hematology Disease Site Group. CONCLUSIONS Lenalidomide in combination with dexamethasone can be recommended for both previously untreated and treated patients with multiple myeloma. Guidelines for the management of cytopenias, venous thromboembolism, and second primary malignancies are discussed.
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Affiliation(s)
- C. Chen
- Department of Medical Oncology and Hematology, Princess Margaret Hospital, Toronto, ON
| | - F. Baldassarre
- Department of Oncology, Program in Evidence-Based Care, McMaster University, Hamilton, ON
| | - S. Kanjeekal
- Regional Cancer Centre, Windsor Regional Hospital, Windsor, ON
| | - J. Herst
- Northeast Cancer Centre, Health Sciences North, Sudbury, ON
| | - L. Hicks
- General Hematology and Oncology, Saint Michael’s Hospital, Toronto, ON
| | - M. Cheung
- Department of Medical Oncology and Hematology, Odette Cancer Centre at Sunnybrook Health Sciences Centre, Toronto, ON
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Kowalski R, Smolich J, Cheung M. Carotid Wave Intensity Analysis Reveals Increased Indices of Wave Reflection in Appropriate Weight for Age Ex-Preterm Infants. Heart Lung Circ 2013. [DOI: 10.1016/j.hlc.2013.05.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Lee M, Rakhra S, Kowalski R, Cheung M, Konstantinov I, Brizard C, d’Udekem Y. Prevalence of Prehypertension After Coarctation Repair in Infancy in Patients with a Hypoplastic Arch. Heart Lung Circ 2013. [DOI: 10.1016/j.hlc.2013.05.591] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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