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Portal EAR, Sands K, Farley C, Boostrom I, Jones E, Barrell M, Carvalho MJ, Milton R, Iregbu K, Modibbo F, Uwaezuoke S, Akpulu C, Audu L, Edwin C, Yusuf AH, Adeleye A, Mukkadas AS, Maduekwe D, Gambo S, Sani J, Walsh TR, Spiller OB. Characterisation of colistin resistance in Gram-negative microbiota of pregnant women and neonates in Nigeria. Nat Commun 2024; 15:2302. [PMID: 38485761 PMCID: PMC10940312 DOI: 10.1038/s41467-024-45673-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Accepted: 01/30/2024] [Indexed: 03/18/2024] Open
Abstract
A mobile colistin resistance gene mcr was first reported in 2016 in China and has since been found with increasing prevalence across South-East Asia. Here we survey the presence of mcr genes in 4907 rectal swabs from mothers and neonates from three hospital sites across Nigeria; a country with limited availability or history of colistin use clinically. Forty mother and seven neonatal swabs carried mcr genes in a range of bacterial species: 46 Enterobacter spp. and single isolates of; Shigella, E. coli and Klebsiella quasipneumoniae. Ninety percent of the genes were mcr-10 (n = 45) we also found mcr-1 (n = 3) and mcr-9 (n = 1). While the prevalence during this collection (2015-2016) was low, the widespread diversity of mcr-gene type and range of bacterial species in this sentinel population sampling is concerning. It suggests that agricultural colistin use was likely encouraging sustainment of mcr-positive isolates in the community and implementation of medical colistin use will rapidly select and expand resistant isolates.
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Affiliation(s)
- E A R Portal
- Department of Medical Microbiology, Division of Infection and Immunity, Cardiff University, Cardiff, UK.
- Ineos Oxford Institute for Antimicrobial Research, Department of Biology, University of Oxford, Oxford, UK.
| | - K Sands
- Department of Medical Microbiology, Division of Infection and Immunity, Cardiff University, Cardiff, UK.
- Ineos Oxford Institute for Antimicrobial Research, Department of Biology, University of Oxford, Oxford, UK.
| | - C Farley
- Department of Medical Microbiology, Division of Infection and Immunity, Cardiff University, Cardiff, UK
| | - I Boostrom
- Department of Medical Microbiology, Division of Infection and Immunity, Cardiff University, Cardiff, UK
| | - E Jones
- Department of Medical Microbiology, Division of Infection and Immunity, Cardiff University, Cardiff, UK
| | - M Barrell
- Department of Medical Microbiology, Division of Infection and Immunity, Cardiff University, Cardiff, UK
| | - M J Carvalho
- Department of Medical Microbiology, Division of Infection and Immunity, Cardiff University, Cardiff, UK
- Institute of Biomedicine, Department of Medical Sciences, University of Aveiro, Aveiro, Portugal
| | - R Milton
- Department of Medical Microbiology, Division of Infection and Immunity, Cardiff University, Cardiff, UK
- Centre for Trials Research, Cardiff University, Cardiff, UK
| | - K Iregbu
- National Hospital Abuja, Abuja, Nigeria
| | - F Modibbo
- Murtala Muhammad Specialist Hospital, Kano, Nigeria
| | - S Uwaezuoke
- Federal Medical Centre -Jabi, Abuja, Nigeria
| | - C Akpulu
- Ineos Oxford Institute for Antimicrobial Research, Department of Biology, University of Oxford, Oxford, UK
- National Hospital Abuja, Abuja, Nigeria
- Interdisciplinary Biosciences DTP, University of Oxford, Oxford, UK
| | - L Audu
- National Hospital Abuja, Abuja, Nigeria
| | - C Edwin
- Department of Medical Microbiology Aminu Kano Teaching Hospital, Kano, Nigeria
| | - A H Yusuf
- Department of Medical Microbiology Aminu Kano Teaching Hospital, Kano, Nigeria
| | - A Adeleye
- Department of Medical Microbiology Aminu Kano Teaching Hospital, Kano, Nigeria
| | - A S Mukkadas
- Department of Medical Microbiology Aminu Kano Teaching Hospital, Kano, Nigeria
| | - D Maduekwe
- Wuse General Hospital Abuja, Abuja, Nigeria
| | - S Gambo
- Department of Paediatrics, Murtala Muhammed Specialist Hospital, Kano, Nigeria
| | - J Sani
- Department of Paediatrics Abdullahi Wase Teaching Hospital, Kano, Nigeria
| | - T R Walsh
- Department of Medical Microbiology, Division of Infection and Immunity, Cardiff University, Cardiff, UK
- Ineos Oxford Institute for Antimicrobial Research, Department of Biology, University of Oxford, Oxford, UK
| | - O B Spiller
- Department of Medical Microbiology, Division of Infection and Immunity, Cardiff University, Cardiff, UK
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Ariyaratnam P, Lee A, Milton R, Troxler M, Barlow IF, Ferrier G, Scott D. Predictors of long-term survival in 5,680 patients admitted to a UK major trauma centre with thoracic injuries. Ann R Coll Surg Engl 2023. [PMID: 36779446 DOI: 10.1308/rcsann.2023.0001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/14/2023] Open
Abstract
INTRODUCTION The long-term outcomes of chest trauma are largely unknown. We sought to determine the predictors of in-hospital and long-term survival in patients admitted to a major trauma centre (MTC) with chest injuries and to evaluate spatial patterns of injury in our network area. METHODS Retrospective analysis of data collected on the National Trauma Audit Research Network (TARN) database using multivariate analysis and Cox regression analysis. Spatial analysis was performed using ArcGis 10.7.1. RESULTS Some 5,680 patients were admitted with chest trauma between December 1999 and December 2019. Median patient age was 45 years and the median Injury Severity Score (ISS) was 20. The proportion of patients who had an operation was 39.8%. Age, blood transfusion, head injury, shock, emergency thoracotomy and heart disease were predictors of hospital mortality (p < 0.05). However, having an operation on concomitant injuries was protective. ISS and Glasgow Coma Score were discriminators of in-hospital mortality (C-indices 0.76 and 0.80, respectively). The 10-year survival values for patients who survived to discharge from hospital and who were aged <40, 50, 60, 70, 80 and >80 years were 99%, 93%, 95%, 87%, 75% and 43%, respectively. Preadmission lung disease and alcohol/drug misuse were poor predictors of long-term survival (p < 0.05). Hotspot analysis revealed the areas with the highest incidents were all close to the MTC. CONCLUSIONS The MTC is geographically central to areas with high numbers of trauma incidents. Although emergency thoracotomy was a predictor of poor in-hospital outcomes, having surgery for concomitant injuries improved outcomes. Patients surviving to discharge have good long-term survivals.
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Affiliation(s)
| | | | - R Milton
- The Leeds Teaching Hospitals NHS Trust, UK
| | - M Troxler
- The Leeds Teaching Hospitals NHS Trust, UK
| | - I F Barlow
- The Leeds Teaching Hospitals NHS Trust, UK
| | | | - Dja Scott
- The Leeds Teaching Hospitals NHS Trust, UK
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Mullins E, Perry A, Banerjee J, Townson J, Grozeva D, Milton R, Kirby N, Playle R, Bourne T, Lees C. Pregnancy and neonatal outcomes of COVID-19: The PAN-COVID study. Eur J Obstet Gynecol Reprod Biol 2022; 276:161-167. [PMID: 35914420 PMCID: PMC9295331 DOI: 10.1016/j.ejogrb.2022.07.010] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Revised: 06/15/2022] [Accepted: 07/14/2022] [Indexed: 12/16/2022]
Abstract
OBJECTIVE To assess perinatal outcomes for pregnancies affected by suspected or confirmed SARS-CoV-2 infection. METHODS Prospective, web-based registry. Pregnant women were invited to participate if they had suspected or confirmed SARS-CoV-2 infection between 1st January 2020 and 31st March 2021 to assess the impact of infection on maternal and perinatal outcomes including miscarriage, stillbirth, fetal growth restriction, pre-term birth and transmission to the infant. RESULTS Between April 2020 and March 2021, the study recruited 8239 participants who had suspected or confirmed SARs-CoV-2 infection episodes in pregnancy between January 2020 and March 2021. Maternal death affected 14/8197 (0.2%) participants, 176/8187 (2.2%) of participants required ventilatory support. Pre-eclampsia affected 389/8189 (4.8%) participants, eclampsia was reported in 40/ 8024 (0.5%) of all participants. Stillbirth affected 35/8187 (0.4 %) participants. In participants delivering within 2 weeks of delivery 21/2686 (0.8 %) were affected by stillbirth compared with 8/4596 (0.2 %) delivering ≥ 2 weeks after infection (95 % CI 0.3-1.0). SGA affected 744/7696 (9.3 %) of livebirths, FGR affected 360/8175 (4.4 %) of all pregnancies. Pre-term birth occurred in 922/8066 (11.5%), the majority of these were indicated pre-term births, 220/7987 (2.8%) participants experienced spontaneous pre-term births. Early neonatal deaths affected 11/8050 livebirths. Of all neonates, 80/7993 (1.0%) tested positive for SARS-CoV-2. CONCLUSIONS Infection was associated with indicated pre-term birth, most commonly for fetal compromise. The overall proportions of women affected by SGA and FGR were not higher than expected, however there was the proportion affected by stillbirth in participants delivering within 2 weeks of infection was significantly higher than those delivering ≥ 2 weeks after infection. We suggest that clinicians' threshold for delivery should be low if there are concerns with fetal movements or fetal heart rate monitoring in the time around infection. The proportion affected by pre-eclampsia amongst participants was not higher than would be expected, although we report a higher than expected proportion affected by eclampsia. There appears to be no effect on birthweight or congenital malformations in women affected by SARS-CoV-2 infection in pregnancy and neonatal infection is uncommon. This study reflects a population with a range of infection severity for SARS-COV-2 in pregnancy, generalisable to whole obstetric populations.
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Affiliation(s)
- E Mullins
- Imperial College London and The George Institute for Global Health, Imperial College Healthcare NHS Trust, London W12 0HS, UK.
| | - A Perry
- Lead Research Midwife and Manager, Women's Health Research Centre, Imperial College London, W12 0HS, UK
| | - J Banerjee
- Imperial College Healthcare NHS Trust, Institute of Reproductive and Developmental Biology, Imperial College London, W12 0HS, UK
| | - J Townson
- Centre for Trials Research, Cardiff University, Neuadd Meirionnydd, Heath Park, Cardiff CF14 4YS, UK
| | - D Grozeva
- Centre for Trials Research, Cardiff University, Neuadd Meirionnydd, Heath Park, Cardiff CF14 4YS, UK
| | - R Milton
- Centre for Trials Research, Cardiff University, Neuadd Meirionnydd, Heath Park, Cardiff CF14 4YS, UK
| | - N Kirby
- Centre for Trials Research, Cardiff University, Neuadd Meirionnydd, Heath Park, Cardiff CF14 4YS, UK
| | - R Playle
- Centre for Trials Research, Cardiff University, Neuadd Meirionnydd, Heath Park, Cardiff CF14 4YS, UK
| | - T Bourne
- Imperial College London, Consultant Gyanecologist, Queen Charlotte's and Chelsea Hospital, London W12 0HS, UK
| | - C Lees
- Centre for Fetal Care, Imperial College Healthcare NHS Trust, Institute of Reproductive and Developmental Biology, Imperial College London, London W12 0HS, UK
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Milton R, Alkali FI, Modibbo F, Sanders J, Mukaddas AS, Kassim A, Sa'ad FH, Tukur FM, Pell B, Hood K, Ghazal P, Iregbu KC. A qualitative focus group study concerning perceptions and experiences of Nigerian mothers on stillbirths. BMC Pregnancy Childbirth 2021; 21:830. [PMID: 34906118 PMCID: PMC8670111 DOI: 10.1186/s12884-021-04207-4] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Accepted: 10/18/2021] [Indexed: 11/17/2022] Open
Abstract
Objective To explore the experiences and perceptions of stillbirth among mothers from a tertiary medical centre in Kano, Northern Nigeria. Design Qualitative, interpretative. Setting Tertiary healthcare facility, Murtala Muhammad Specialist Hospital (MMSH), Kano, Northern Nigeria. Sample Mothers who had given birth to a liveborn baby at the MMSH in the prior 6 months (n = 31). In order to capture the experiences and perception of stillbirth within this cohort we approached mothers who had in a previous pregnancy experienced a stillbirth. Of the 31 who attended 16 had a previous stillbirth. Methods Semi-structured Focus Group Discussions, consisting of open-ended questions about stillbirth, beliefs, experiences and influences were held in MMSH, conducted over 1 day. Results Our findings highlight that this is a resource-poor tertiary facility serving an ever-growing population, increasing strain on the hospital and healthcare workers. Many of the participants highlighted needing permission from certain family members before accessing healthcare or medical treatment. We identified that mothers generally have knowledge on self-care during pregnancy, yet certain societal factors prevented that from being their priority. Judgement and blame was a common theme, yet a complex area entwined with traditions, superstitions and the pressure to procreate with many mothers described being made to feel useless and worthless if they did not birth a live baby. Conclusions As access to healthcare becomes easier, there are certain traditions, family and social dynamics and beliefs which conflict with scientific knowledge and act as a major barrier to uptake of healthcare services. The findings highlight the need for investment in maternity care, appropriate health education and public enlightenment; they will help inform appropriate interventions aimed at reducing stigma around stillbirth and aide in educating mothers about the importance of appropriate health seeking behaviour. Stillbirths are occurring in this area of the world unnecessarily, globally there has been extensive research conducted on stillbirth prevention. This research has highlighted some of the areas which can be tackled by modifying existing successful interventions to work towards reducing preventable stillbirths. Supplementary Information The online version contains supplementary material available at 10.1186/s12884-021-04207-4.
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Affiliation(s)
- R Milton
- Centre for Trials Research, Cardiff University, Cardiff, UK.
| | - F I Alkali
- Department of Biochemistry, Bayero University, Kano, Nigeria
| | - F Modibbo
- Murtala Muhammad Specialist Hospital, Kano, Nigeria
| | - J Sanders
- School of Healthcare Sciences, Cardiff University, Cardiff, UK
| | - A S Mukaddas
- Department of Biological Sciences, Bayero University, Kano, Nigeria
| | - A Kassim
- Department of Biological Sciences, Bayero University, Kano, Nigeria
| | - F H Sa'ad
- Department of Medical Microbiology and Parasitology, Bayero University, Kano, Nigeria
| | - F M Tukur
- Department of Biological Sciences, Bayero University, Kano, Nigeria
| | - B Pell
- Centre for the Development and Evaluation of Complex Intervention for Public Health Improvement, Cardiff University, Cardiff, UK
| | - K Hood
- Centre for Trials Research, Cardiff University, Cardiff, UK
| | - P Ghazal
- Systems Immunity Research Institute, School of Medicine, Cardiff University, Cardiff, UK
| | - K C Iregbu
- Department of Medical Microbiology, National Hospital, Abuja, Nigeria
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Marshall C, Cheyne L, Rodger K, Robson J, Paramasivam E, Darby M, Milton R, Kennedy M, Callister M. Sustained lung cancer mortality reduction following a symptom awareness campaign. Lung Cancer 2020. [DOI: 10.1016/s0169-5002(20)30048-9] [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: 10/25/2022]
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Kouritas V, Kefaloyannis E, Milton R, Chaudhuri N, Papagiannopoulos K, Brunelli A. O-138DOES PRESENCE OF PLEURAL ADHESIONS ALTER THE OUTCOME OF PATIENTS UNDERGOING MAJOR LUNG RESECTION? Interact Cardiovasc Thorac Surg 2016. [DOI: 10.1093/icvts/ivw260.136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Patella M, Kostoulas N, Papagiannopoulos K, Milton R, Chaudhuri N, Kefaloyannis E, Brunelli A. B-006THE INFLUENCE OF OPERATING ROOM SCHEDULING ON EARLY OUTCOME FOLLOWING ELECTIVE ANATOMIC LUNG RESECTIONS. Interact Cardiovasc Thorac Surg 2016. [DOI: 10.1093/icvts/ivw260.06] [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: 11/14/2022] Open
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Drosos P, Pompili C, Ismail H, Tentzeris V, Papagiannopoulos K, Milton R, Chaudhuri N, Kefaloyannis E, Brunelli A. O-015FACTORS ASSOCIATED WITH POSTOPERATIVE COSTS FOLLOWING ANATOMIC LUNG RESECTIONS WITHOUT MAJOR COMPLICATIONS. Interact Cardiovasc Thorac Surg 2016. [DOI: 10.1093/icvts/ivw260.15] [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: 11/14/2022] Open
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Vallance A, Tcherveniakov P, Bogdan C, Chaudhuri N, Milton R, Kefaloyannis E. The evolution of intraoperative conversion in video assisted thoracoscopic lobectomy. Ann R Coll Surg Engl 2016; 99:129-133. [PMID: 27502339 DOI: 10.1308/rcsann.2016.0253] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION Unplanned conversion to thoracotomy remains a major concern in video assisted thoracoscopic surgery (VATS) lobectomy. This study aimed to investigate the development of a VATS lobectomy programme over a five-year period, with a focus on the causes and consequences of unplanned conversions. METHODS A single centre retrospective review was performed of patients who underwent complete anatomical lung resection initiated by VATS between January 2010 and April 2015. RESULTS In total, 1,270 patients underwent a lobectomy in the study period and 684 (53.9%) of these were commenced thoracoscopically. There were 75 cases (10.9%) with unplanned conversion. The proportion of lobectomies started as VATS was significantly higher in the second half of the study period (2010-2012: 277/713 [38.8%], 2013-2015: 407/557 [73.1%], p<0.001). The conversion rate dropped initially from 20.4% (11/54) in 2010 to 9.9% (15/151) in 2013 and then remained consistently under 10% until 2015. Conversions were most commonly secondary to vascular injury (26/75, 34.7%). Patients undergoing unplanned conversion had a longer length of stay than VATS completed patients (9 vs 6 days, p<0.001). There was a higher incidence of respiratory failure (10/75 [14.1%] vs 23/607 [3.8%], p<0.001) and 30-day mortality (7/75 [9.3%] vs 6/607 [1.0%], p=0.003) in patients with unplanned conversion than in those with completed VATS. CONCLUSIONS As our VATS lobectomy programme developed, the unplanned conversion rate dropped initially and then remained constant at approximately 10%. With increasing unit experience, it is both safe and technically possible to complete the majority of lobectomy procedures thoracoscopically.
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Affiliation(s)
| | | | - C Bogdan
- Leeds Teaching Hospitals NHS Trust , UK
| | | | - R Milton
- Leeds Teaching Hospitals NHS Trust , UK
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Hopkinson JB, Milton R, King A, Edwards D. People with dementia: what is known about their experience of cancer treatment and cancer treatment outcomes? A systematic review. Psychooncology 2016; 25:1137-1146. [PMID: 27246507 DOI: 10.1002/pon.4185] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [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: 12/31/2015] [Revised: 05/27/2016] [Accepted: 05/27/2016] [Indexed: 11/09/2022]
Abstract
OBJECTIVE The objective of the study is to report a systematic review of what is currently known about the experience of cancer treatment and cancer treatment in adults with dementia. METHODS The analytic plan and inclusion/exclusion criteria were specified in advance of the search process in a protocol. Searches were conducted in MEDLINE, CINAHL, PsycINFO and the Cochrane Library for publications about people with cancer and a pre-existing dementia. Limits were English language; 2000 to 12/2015; adults; >18 years old. The search identified 5214 titles and abstracts that were assessed against eligibility criteria and 101 were selected for full-text examination by two researchers who agreed inclusion of nine papers, extracted data independently then conducted a content analysis and narrative synthesis. RESULTS Nine studies conducted in four resource rich countries were included in the review. These studies evidence that when compared with other cancer patients, those with dementia are diagnosed at a later stage, receive less treatment, are more likely to experience complications from treatment and have poorer survival. The experience of supportive care and preferences of people with dementia receiving cancer services and cancer treatment have not been investigated. Research into how the cancer team manage the particular needs of people with dementia and their family members has been limited to one study that reported how a cancer team managed the particular needs of seven people with dementia. CONCLUSION Further work is needed to establish practice guidelines for the management of cancer in people with dementia. Copyright © 2016 John Wiley & Sons, Ltd.
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Affiliation(s)
- J B Hopkinson
- School of Healthcare Sciences, Cardiff University, Cardiff, UK.
| | - R Milton
- School of Medicine, Cardiff University, Cardiff, UK
| | - A King
- School of Healthcare Sciences, Cardiff University, Cardiff, UK
| | - D Edwards
- School of Healthcare Sciences, Cardiff University, Cardiff, UK
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Sandri A, Papagiannopoulos K, Milton R, Chaudhuri N, Kefaloyannis M, Pompili C, Tentzeris V, Brunelli A. F-146HIGH RISK PATIENTS AND POSTOPERATIVE COMPLICATIONS FOLLOWING VIDEO-ASSISTED THORACOSCOPIC LOBECTOMY: A CASE MATCHED COMPARISON WITH LOWER RISK COUNTERPARTS. Interact Cardiovasc Thorac Surg 2015. [DOI: 10.1093/icvts/ivv204.146] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Tcherveniakov P, Bogdan C, Kefaloyannis M, Brunelli A, Milton R, Papagiannopoulos K, Chaudhuri N. P-186POSITIVE IMPACT OF AN ENDOBRONCHIAL VALVE PROGRAMME AND DEDICATED MULTIDISCIPLINARY TEAM ON RATES OF LUNG VOLUME REDUCTION SURGERY. Interact Cardiovasc Thorac Surg 2015. [DOI: 10.1093/icvts/ivv204.186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Tentzeris V, Sandri A, Drosos P, Pompili C, Papagiannopoulos K, Milton R, Chaudhuri N, Kefaloyannis M, Brunelli A. F-148RISK ADJUSTED FINANCIAL MODEL TO ESTIMATE THE COST OF A VIDEO-ASSISTED THORACOSCOPIC LOBECTOMY PROGRAMME. Interact Cardiovasc Thorac Surg 2015. [DOI: 10.1093/icvts/ivv204.148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Hristova R, Pompili C, Papagiannopoulos K, Milton R, Chaudhuri N, Kefaloyannis M, Brunelli A. P-268A PREDICTION MODEL OF PLEURAL DRAINAGE BASED ON ELECTRONIC CONTINUOUS FLUID MEASUREMENT. Interact Cardiovasc Thorac Surg 2015. [DOI: 10.1093/icvts/ivv204.268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Patella M, Sandri A, Papagiannopoulos K, Milton R, Chaudhuri N, Kefaloyannis M, Brunelli A. F-039REAL TIME MONITORING OF A VIDEO-ASSISTED THORACOSCOPIC SURGERY LOBECTOMY PROGRAMME USING A SPECIFIC CARDIOPULMONARY COMPLICATIONS RISK-ADJUSTED CONTROL CHART. Interact Cardiovasc Thorac Surg 2015. [DOI: 10.1093/icvts/ivv204.39] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Pompili C, Hristova R, Xiumè F, Patella M, Milton R, Salati M, Sandri A, Papagiannopoulos K, Brunelli A. O-137REGULATED DRAINAGE REDUCES THE INCIDENCE OF RECURRENCE AFTER UNIPORTAL VIDEO-ASSISTED THORACOSCOPIC BULLECTOMY FOR PRIMARY SPONTANEOUS PNEUMOTHORAX: A PROPENSITY CASE MATCHED COMPARISON VERSUS UNREGULATED DRAINAGE. Interact Cardiovasc Thorac Surg 2015. [DOI: 10.1093/icvts/ivv204.137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Dave RV, Pathak S, White AD, Hidalgo E, Prasad KR, Lodge JPA, Milton R, Toogood GJ. Outcome after liver resection in patients presenting with simultaneous hepatopulmonary colorectal metastases. Br J Surg 2014; 102:261-8. [PMID: 25529247 DOI: 10.1002/bjs.9737] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2014] [Revised: 09/24/2014] [Accepted: 11/10/2014] [Indexed: 12/22/2022]
Abstract
BACKGROUND The most common sites of metastasis from colorectal cancer (CRC) are hepatic and pulmonary; they can present simultaneously (hepatic and pulmonary metastases) or sequentially (hepatic then pulmonary metastases, or vice versa). Simultaneous disease may be aggressive, and thus may be approached with caution by the clinician. The aim of this study was to determine the outcomes following hepatic and pulmonary resection for simultaneously presenting metastatic CRC. METHODS A retrospective review was undertaken of a prospectively maintained database to identify patients presenting with simultaneous hepatopulmonary disease who underwent hepatic resection. Patients' electronic records were used to identify clinicopathological variables. The log rank test was used to determine survival, and χ(2) analysis to determine predictors of failure of intended treatment. RESULTS Fifty-nine patients were identified and underwent hepatic resection; median survival was 45·4 months and the 5-year survival rate 38 per cent. Twenty-two patients (37 per cent) did not have the intended pulmonary intervention owing to progression or recurrence of disease. Thirty-seven patients who progressed to hepatopulmonary resection had a median survival of 54·2 months (5-year survival rate 43 per cent). Those who had hepatic resection alone had a median survival of 24·0 months (5-year survival rate 30 per cent). Failure to progress to pulmonary resection was predicted by heavy nodal burden of primary colorectal disease and bilobar hepatic metastases. Redo pulmonary surgery following pulmonary recurrence did not confer a survival benefit. CONCLUSION Selected patients with simultaneous hepatopulmonary CRC metastases should be considered for attempted curative resection, but some patients may not receive the intended treatment owing to progression of pulmonary disease after hepatic resection.
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Affiliation(s)
- R V Dave
- Departments of Hepatobiliary and Transplant Surgery, St James's University Hospital, Leeds, UK
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Hristova R, Bogdan C, Kostopanagiotou K, Vachlas K, Kefaloyannis E, Milton R, Papagiannopoulos K, Chaudhuri N. P-206 * NEGATIVE PRESSURE WOUND THERAPY. A NOVEL ADJUNCT IN THE TREATMENT OF POSTOPERATIVE SEVERE SURGICAL EMPHYSEMA. Interact Cardiovasc Thorac Surg 2014. [DOI: 10.1093/icvts/ivu167.206] [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: 11/13/2022] Open
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Tentzeris V, Kefaloyannis E, Begum S, Hristova R, Milton R, Chaudhuri N, Thorpe A, Papagiannopoulos K. F-055 * BUILDING UP A VIDEO-ASSISTED THORACOSCOPIC LUNG RESECTION PROGRAMME: ELEMENTS TO IMPROVE FAST ADOPTION. Interact Cardiovasc Thorac Surg 2014. [DOI: 10.1093/icvts/ivu167.55] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Kouritas V, Begum SSS, Tentzeris V, Milton R, Chaudhuri N, Papagiannopoulos K. P-145 * VIDEO-ASSISTED THORACOSCOPIC LUNG RESECTIONS: CHALLENGING CURRENT FITNESS GUIDELINES. Interact Cardiovasc Thorac Surg 2014. [DOI: 10.1093/icvts/ivu167.145] [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: 11/14/2022] Open
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Cheyne L, Gill A, Milton R, Clarke K, Snee M, Franks K, Callister M. 170 The introduction of stereotactic ablative radiotherapy increases overall radical treatment rates for stage I lung cancer but does not reduce surgical resection rates – a single centre study. Lung Cancer 2014. [DOI: 10.1016/s0169-5002(14)70171-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Cheyne L, Esterbrook G, Viadyanathan S, Milton R, Smith G, Blaxill P, Clarke K, Snee M, Franks K, Callister MEJ. S109 The introduction of stereotactic ablative radiotherapy increases overall radical treatment rates for stage I lung cancer but does not reduce surgical resection rates–a two centre study. Thorax 2013. [DOI: 10.1136/thoraxjnl-2013-204457.116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Khawaja SA, Hristova R, Thorpe A, Kefaloyannis E, Milton R, Papagiannopoulos K, Chaudhuri N. P-160IS UK STILL IN THE EUROZONE? VALIDATING AN OFF-THE-SHELF RISK SCORING SYSTEM: A PROSPECTIVE AUDIT. Interact Cardiovasc Thorac Surg 2013. [DOI: 10.1093/icvts/ivt288.160] [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: 11/14/2022] Open
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Cheyne L, Taylor A, Milton R, Fear J, Callister MEJ. Social deprivation does not affect lung cancer stage at presentation or disease outcome. Lung Cancer 2013; 81:247-51. [PMID: 23570796 DOI: 10.1016/j.lungcan.2013.03.012] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2012] [Revised: 03/04/2013] [Accepted: 03/11/2013] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Lung cancer mortality rates are higher in more deprived populations. This may simply reflect higher incidence of the disease, or additionally delayed presentation and worse outcomes amongst more deprived patients. Low socio-economic status (SES) has also been linked to cancer fatalism which might account for such differences. We determined the interaction between SES, patient's characteristics at presentation with lung cancer, and disease outcome at a large UK teaching hospital. METHODS Stage, PS at presentation, treatment and survival data, index of multiple deprivation score and ACORN group (geo-demographic segmentation tool) were analysed for 1432 patients. RESULTS There were no significant differences in stage or PS distribution by IMD quintile or ACORN group. When patients with stage I/II disease were considered, there were no differences in IMD or ACORN group for those undergoing or not undergoing surgical resection. Similarly when the whole cohort was considered, there were no differences in these parameters between those receiving and not receiving any anti-cancer therapy. There was a non-significant trend to lower IMD score (i.e. less deprivation) in the stage IIIb/IV patients receiving palliative chemotherapy compared to those not receiving chemotherapy. There was no significant difference in median survival or one-year survival according to IMD quintile or ACORN group. CONCLUSION In our patient cohort, deprivation does not appear to affect stage or performance status at presentation, nor survival from lung cancer. If cancer fatalism is more prevalent in deprived populations, this does not appear to lead to later diagnosis nor worse disease outcome.
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Affiliation(s)
- L Cheyne
- Leeds Teaching Hospitals NHS Trust, United Kingdom.
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Bogdan C, Minhas T, Tuggey J, Crawford M, Milton R. 206 Impact of surgical attendance on referral for thoracic surgery. Lung Cancer 2013. [DOI: 10.1016/s0169-5002(13)70206-x] [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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Cheyne L, Milton R, Fear J, Callister MEJ. P63 Variability in GP Referral Rates For Chest X-Ray Does Not Appear to Affect Stage or Performance Status of Patients Diagnosed with Lung Cancer. Thorax 2012. [DOI: 10.1136/thoraxjnl-2012-202678.204] [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: 11/03/2022]
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Cheyne L, Foster C, Lovatt V, Hewitt F, Cresswell L, Fullard B, Fear J, Darby M, Robertson R, Plant PK, Milton R, Callister MEJ. S91 Improved Lung Cancer Survival and Reduced Emergency Diagnoses Resulting from an Early Diagnosis Campaign in Leeds 2011. Thorax 2012. [DOI: 10.1136/thoraxjnl-2012-202678.097] [Citation(s) in RCA: 4] [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: 11/04/2022]
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Belvedere O, Chaudhuri N, Thorpe A, Milton R, Davidson L, McKinley C, Egan P, Daly C, Papagiannopoulos K, Rabbitts P. 1117 Identifying the challenges in establishing a lung cancer tissue repository for translational research: a single institution experience. EJC Suppl 2009. [DOI: 10.1016/s1359-6349(09)70410-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Kayhan N, Milton R, Peivandi AA, Denk K, Mehlhorn U, Dahm M, Vahl CF. Should minimally invasive aortic valve replacement be the standard approach? Thorac Cardiovasc Surg 2008. [DOI: 10.1055/s-2008-1037938] [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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Obermer E, Milton R. A micro-photometric method for the determination of free cholesterol and cholesterol esters in blood-plasma. Biochem J 2006; 27:345-50. [PMID: 16745103 PMCID: PMC1252885 DOI: 10.1042/bj0270345] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Karthik S, Milton R, Thorpe JAC. Recurrent chest wall haemangioma -- 'A vascular lake'. Eur J Cardiothorac Surg 2004; 26:209-10. [PMID: 15201003 DOI: 10.1016/j.ejcts.2004.04.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2004] [Revised: 03/30/2004] [Accepted: 04/05/2004] [Indexed: 10/26/2022] Open
Affiliation(s)
- S Karthik
- Thoracic Unit, Leeds General Infirmary, Great George Street, Leeds LS1 3EX, UK.
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Sandoe JAT, Kumar B, Stoddart B, Milton R, Dave J, Nair UR, Wilcox MH. Effect of extended perioperative antibiotic prophylaxis on intravascular catheter colonization and infection in cardiothoracic surgery patients. J Antimicrob Chemother 2003; 52:877-9. [PMID: 14563889 DOI: 10.1093/jac/dkg442] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Intravascular catheter-related infections (CRI) account for one third of nosocomial bloodstream infections in England. UK Department of Health guidelines state that antibiotic prophylaxis is not required during placement, or use of, central venous catheters, to prevent CRI. However, some clinicians continue to use antibiotics in an attempt to prevent CRI. We investigated the effect of extended routine perioperative antibiotic prophylaxis in cardiothoracic patients on rates of intravascular catheter (IVC) colonization and infection. Investigations were undertaken in patients undergoing uncomplicated cardiothoracic surgery during July 2001-February 2002. Patients who received three doses of cefuroxime as perioperative prophylaxis were compared with those who received extended cefuroxime prophylaxis until the IVC was removed. Patients were not randomized into groups, but received the different prophylaxis regimens according to the usual practice of the consultant cardiothoracic surgeon. A roll tip method was used to determine IVC colonization. Of 191 patients who fulfilled the inclusion criteria, 12 were excluded because data were incomplete. One hundred and forty-six patients received routine prophylaxis, and 33 prophylaxis until the IVC was removed. Twenty-three out of 146 (16%) IVCs in the 'routine' group and four out of 33 (12%) in the 'extended' group became colonized; no IVC-related bloodstream infections occurred during the survey. The duration of IVC placement and the types of operation performed in the two groups were not significantly different (P > 0.05). In routine cardiothoracic surgery patients, extending routine perioperative antibiotic prophylaxis until all IVCs have been removed does not influence rates of IVC colonization.
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Affiliation(s)
- J A T Sandoe
- Departments of Microbiology and Cardiothoracic Surgery, Leeds Teaching Hospitals and University of Leeds, Leeds, UK.
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Armstrong J, Narracott AJ, Milton R, Galea J, Cooper GJ, Lawford PV, Hose DR, Cumberland DC, Holt CM. Development of an ex vivo model to investigate the effects of altered haemodynamics on human bypass grafts. J Med Eng Technol 2000; 24:183-91. [PMID: 11204241 DOI: 10.1080/03091900050204223] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
The insertion of vein grafts into the arterial circulation may contribute to vessel wall thickening and accelerated atherosclerosis, a common feature of late vein graft failure. We aimed to develop a model suitable for investigation of the effects of altered haemodynamics on human saphenous vein following its implantation into the arterial circulation. Segments of human saphenous vein obtained from patients undergoing coronary artery bypass surgery were sutured at each end to PTFE and placed into a flow system. Pressure and flow rates to stimulate the arterial and venous systems were achieved. A theoretical model of the flow chamber was created and computational fluid dynamics software (FLOTRAN, Swanson Analysis Systems) was used to determine the flow profile within the model. In summary, a flow model has been developed to investigate the effect of altered haemodynamics on the molecular and pathological changes that occur in vein grafts incorporated into the arterial circulation.
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Affiliation(s)
- J Armstrong
- Cardiovascular Research Group, University of Sheffield Division of Clinical Sciences, Northern General Hospital, Sheffield, UK
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Kent SB, Baca M, Elder J, Miller M, Milton R, Milton S, Rao JK, Schnölzer M. Breaking the shackles of the genetic code: engineering retroviral proteases through total chemical synthesis. Adv Exp Med Biol 1995; 362:425-38. [PMID: 8540353 DOI: 10.1007/978-1-4615-1871-6_55] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Affiliation(s)
- S B Kent
- Scripps Research Institute, La Jolla, California 92037, USA
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Milton R. Analysis of data on cataract progression. Exp Eye Res 1992. [DOI: 10.1016/0014-4835(92)90466-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Milton R. Are you seeing a mass killer? Aust Fam Physician 1992; 21:739, 742-3. [PMID: 1622355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Whatever the underlying reasons, we have to be prepared for more episodes of this nature, and as medical practitioners do what we can to prevent them. With the wisdom of hindsight it is possible to suggest that the Knight and Vitkovic killings could have been avoided. Knight had a history of violence causing him to leave Duntroon Military College. Despite this, he was not prevented from holding a shooter's licence in his own State, and in particular nothing was done to stop him having a collection of weapons. Vitkovic sought help from a university psychology clinic and from the Church of Scientology. Coroner Hal Hallenstein criticised the Church of Scientology for failing to help Vitkovic after he failed their personality test on 8 October 1987, and also suggested that a general obligation be placed on psychologists to refer to a psychiatrist if they think that is required. Practitioners' concern for their own safety must be considered. It would have been an extraordinarily difficult and possibly risky task to try to deter Julian Knight from persisting in his adoration of aggression and love of weapons, or to talk Frank Vitkovic out of watching violent films and videos and later purchasing a semi-automatic weapon. Nevertheless, the practitioner's responsibility remains, and as a last resort notification to police of the risk posed by the person might have to be considered. Unfortunately the anonymity of a practitioner making such a notification might not be able to be guaranteed, given current freedom of information legislation.(ABSTRACT TRUNCATED AT 250 WORDS)
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Gaasterland D, Kupfer C, Milton R, Ross K, McCain L, MacLellan H. Studies of aqueous humour dynamics in man. VI. Effect of age upon parameters of intraocular pressure in normal human eyes. Exp Eye Res 1978; 26:651-6. [PMID: 680022 DOI: 10.1016/0014-4835(78)90099-4] [Citation(s) in RCA: 63] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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Milton R, Yadava RP, Ainsworth RW. Miliary tuberculosis in a nonagenarian. Br Med J 1969; 1:315. [PMID: 5762656 PMCID: PMC1982181 DOI: 10.1136/bmj.1.5639.315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
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Milton R, Agrin A. Resolution of a crisis in a therapeutic community for alcoholics. Q J Stud Alcohol 1966; 27:517-524. [PMID: 5970701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
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Milton R. Instrumental methods for the analysis of food additives William H. Butz and Henry J. Noebels. Interscience Publishers, New York, 1961. pp. viii + 288. $11. Talanta 1962. [DOI: 10.1016/0039-9140(62)80195-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Milton R. Preparation of Samples of Foodstuffs and Biological Materials for Determination of Lead. Anal Chem 1953. [DOI: 10.1021/ac60078a603] [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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Milton R. National Health Service. West J Med 1948. [DOI: 10.1136/bmj.1.4541.116] [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: 11/03/2022]
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Hunter D, Milton R, Perry KMA, Barrie HJ, Loutit JF, Marshall TS. Investigation for Signs of Benzene Intoxication in Workers using Aeroplane Dope and Rubber Solvents. Occup Environ Med 1944. [DOI: 10.1136/oem.1.4.238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Hunter D, Milton R, Perry KMA, Thompson DR. Effect of Aluminium and Alumina on the Lung in Grinders of Duralumin Aeroplane Propellers. Occup Environ Med 1944. [DOI: 10.1136/oem.1.3.159] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Elsdon GD, Obermer E, Milton R, Lindsey AJ, Doyle AL, Hadley WH. Notes. Analyst 1938. [DOI: 10.1039/an9386300422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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