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Antonik M, Sankar S, Shepherd J, Hassan S. The economic and resource burden of e-scooter-related orthopaedic injuries: A district general hospital's experience. Injury 2024:111493. [PMID: 38508983 DOI: 10.1016/j.injury.2024.111493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Revised: 03/03/2024] [Accepted: 03/04/2024] [Indexed: 03/22/2024]
Abstract
PURPOSE Electric scooters (e-scooters) are an increasingly popular method of transportation worldwide. However, there are concerns regarding their safety, specifically with regards to orthopaedic injuries. We aimed to investigate the overall burden and financial impact on orthopaedic services as a result of e-scooter-related orthopaedic injuries. METHODS We retrospectively identified all e-scooter-related injuries requiring orthopaedic admission or surgical intervention in a large District General Hospital in England over a 16-month period between September 2020 and December 2021. Injuries sustained, surgical management, inpatient stay and resources used were calculated. RESULTS Seventy-nine patients presented with orthopaedic injuries as a result of e-scooter transportation with a mean age of 30.1 years (SD 11.6), of which 62 were males and 17 were females. A total of 86 individual orthopaedic injuries were sustained, with fractures being the most common type of injury. Of these, 23 patients required 28 individual surgical procedures. The combined theatre and recovery time of these procedures was 5500 min, while isolated operating time was 2088 min. The total cost of theatre running time for these patients was estimated at £77,000. A total of 17 patients required hospital admission under Trauma and Orthopaedics, which accounted for total combined stay of 99 days with a mean length of stay of 5.8 days. CONCLUSION While there are potential environmental benefits to e-scooters, we demonstrate the risks of injury associated with their use and the associated increased burden to the healthcare system through additional emergency attendances, frequent outpatient clinic appointments, surgical procedures, and hospital inpatient admissions.
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Affiliation(s)
- M Antonik
- Trauma & Orthopaedic Surgery Department, Northampton General Hospital, UK
| | - S Sankar
- Trauma & Orthopaedic Surgery Department, Northampton General Hospital, UK
| | - J Shepherd
- Trauma & Orthopaedic Surgery Department, Leicester Royal Infirmary, UK; University of Leicester, Leicester, UK; National Institute for Health and Care Research, Academic Clinical Fellowship Integrated Clinical Academic Training Pathway, UK.
| | - S Hassan
- Trauma & Orthopaedic Surgery Department, Northampton General Hospital, UK
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Dearnaley D, Griffin CL, Silva P, Wilkins A, Stuttle C, Syndikus I, Hassan S, Pugh J, Cruickshank C, Hall E, Corbishley CM. International Society of Urological Pathology (ISUP) Gleason Grade Groups stratify outcomes in the CHHiP Phase 3 prostate radiotherapy trial. BJU Int 2024; 133:179-187. [PMID: 37463104 DOI: 10.1111/bju.16133] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/20/2023]
Abstract
OBJECTIVES To compare the results of Gleason Grade Group (GGG) classification following central pathology review with previous local pathology assessment, and to examine the difference between using overall and worst GGG in a large patient cohort treated with radiotherapy and short-course hormone therapy. PATIENTS AND METHODS Patients with low- to high-risk localized prostate cancer were randomized into the multicentre CHHiP fractionation trial between 2002 and 2011. Patients received short-course hormone therapy (≤6 month) and radical intensity-modulated radiotherapy (IMRT). Of 2749 consented patients, 1875 had adequate diagnostic biopsy tissue for blinded central pathology review. The median follow-up was 9.3 years. Agreement between local pathology and central pathology-derived GGG and between central pathology-derived overall and worst GGG was assessed using kappa (κ) statistics. Multivariate Cox regression and Kaplan-Meier methods were used to compare the biochemical/clinical failure (BCF) and distant metastases (DM) outcomes of patients with GGG 1-5. RESULTS There was poor agreement between local pathology- and central pathology-derived GGG (κ = 0.19) but good agreement between overall and worst GGG on central pathology review (κ = 0.89). Central pathology-derived GGG stratified BCF and DM outcomes better than local pathology, while overall and worst GGG on central pathology review performed similarly. GGG 3 segregated with GGG 4 for BCF, with BCF-free rates of 90%, 82%, 74%, 71% and 58% for GGGs 1-5, respectively, at 8 years when assessed using overall GGG. There was a progressive decrease in DM-free rates from 98%, 96%, 92%, 88% and 83% for GGGs 1-5, respectively, at 8 years with overall GGG. Patients (n = 57) who were upgraded from GGG 2-3 using worst GS had BCF-free and DM-free rates of 74% and 92% at 8 years. CHHiP eligibility criteria limit the interpretation of these results. CONCLUSION Contemporary review of International Society of Urological Pathology GGG successfully stratified patients treated with short-course hormone therapy and IMRT with regard to both BCF-free and DM-free outcomes. Patients upgraded from GGG 2 to GGG 3 using worst biopsy GS segregate with GGG 3 on long-term follow-up. We recommend that both overall and worst GS be used to derive GGG.
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Affiliation(s)
- David Dearnaley
- The Institute of Cancer Research, London, UK
- Royal Marsden Hospital NHS Foundation Trust, Sutton, UK
| | - Clare L Griffin
- Clinical Trials and Statistics Unit at the Institute of Cancer Research, London, UK
| | - Pedro Silva
- The Institute of Cancer Research, London, UK
- Royal Marsden Hospital NHS Foundation Trust, Sutton, UK
| | - Anna Wilkins
- The Institute of Cancer Research, London, UK
- Royal Marsden Hospital NHS Foundation Trust, Sutton, UK
| | | | | | - Shama Hassan
- Clinical Trials and Statistics Unit at the Institute of Cancer Research, London, UK
| | - Julia Pugh
- Clinical Trials and Statistics Unit at the Institute of Cancer Research, London, UK
| | - Clare Cruickshank
- Clinical Trials and Statistics Unit at the Institute of Cancer Research, London, UK
| | - Emma Hall
- Clinical Trials and Statistics Unit at the Institute of Cancer Research, London, UK
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Barnsley H, Uzoukwu S, Hassan S, Borri M. The use of low dose CT scouts for MR safety screening: A multi-reader evaluation. Radiography (Lond) 2024; 30:168-175. [PMID: 38035429 DOI: 10.1016/j.radi.2023.11.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2023] [Revised: 10/30/2023] [Accepted: 11/03/2023] [Indexed: 12/02/2023]
Abstract
INTRODUCTION Plain film radiographs are recommended to assist in MRI safety screening of patients with unknown medical histories, especially in an emergency setting where patients might be unable to answer a safety questionnaire. This study assesses the performance of CT scout images, which have low radiation dose and are faster and easier to acquire compared to plain film radiographs, in finding and naming a range of head and body implants. METHODS A retrospective analysis of 40 CT Head and Neck (HN) scout images and 40 CT Chest, Abdomen and Pelvis (CAP) scout images was undertaken. A subset of these were chosen to include a range of common internal implants not identifiable externally to the patient. The images were assessed by three readers with varying levels of clinical experience in MRI who were asked to find and name any implants seen. RESULTS Collectively, all readers reached a sensitivity of 85 % in finding internal implants, regardless of their clinical experience or experience in reviewing CT images, and a minimum specificity of 95 %. Implants were correctly named in 74 % of the images presented. CONCLUSION CT scout images were able to reveal most of the implants included. However, clinical experience in reviewing the images enhances a reader's ability to identify the type of implant. IMPLICATIONS FOR PRACTICE In an emergency setting, imaging can be critical in the management of patients presenting with acute illnesses. In the unconscious or unresponsive patient, the use of CT scouts, where this is the only option available, could provide valuable MRI safety information prior to a scan, improving access to the MRI scan in a timely manner.
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Affiliation(s)
- H Barnsley
- Neuroradiology, King's College Hospital NHS Foundation Trust, Denmark Hill, London, SE5 9RS, UK.
| | - S Uzoukwu
- Neuroradiology, King's College Hospital NHS Foundation Trust, Denmark Hill, London, SE5 9RS, UK
| | - S Hassan
- Neuroradiology, King's College Hospital NHS Foundation Trust, Denmark Hill, London, SE5 9RS, UK
| | - M Borri
- Neuroradiology, King's College Hospital NHS Foundation Trust, Denmark Hill, London, SE5 9RS, UK.
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Hassan S, Dritsas S, O'Dwyer ST, Aziz O, Sutton P, Wang X, Fish R. Open versus Closed technique for administration of heated intraperitoneal chemotherapy (HIPEC): Morbidity and Mortality outcomes from a high-volume centre. Eur J Surg Oncol 2023; 49:106924. [PMID: 37179147 DOI: 10.1016/j.ejso.2023.04.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 04/18/2023] [Accepted: 04/28/2023] [Indexed: 05/15/2023]
Abstract
BACKGROUND AND AIMS Cytoreductive Surgery (CRS) and Hyperthermic Intraperitoneal Chemotherapy (HIPEC) is an established treatment in selected patients with peritoneal metastases, delivered in the UK in specialist centres. HIPEC can be administered via the open coliseum technique as first described by Sugarbaker (O-HIPEC) or using a closed technique (C-HIPEC). Data comparing the safety and outcomes of these different approaches is limited. This study aims to compare morbidity and mortality rates of O-HIPEC and C-HIPEC following CRS for peritoneal metastases from colorectal cancer and appendiceal tumours. METHODS Consecutive patients undergoing CRS with open (05/2019-04/2020) and closed (05/2020-04/2021) HIPEC were identified from a prospectively maintained database. Baseline data including primary pathology, HIPEC agent and major operative procedures were analysed using Chi-squared and Fishers exact tests to ensure comparability of groups. Primary outcomes were 30- and 60-day postoperative mortality and morbidity (Common Terminology Criteria for Adverse Events, CTCAE). Secondary outcomes were length of critical care and overall hospital stay. In addition, morbidity and mortality were compared between HIPEC agents (mitomycin and oxaliplatin/5-fluorouracil). RESULTS 99 patients (39.3%) and 153 patients (60.7%) underwent O-HIPEC, C-HIPEC respectively. Groups were well matched for baseline demographics, pathology, and HIPEC agent. In the O-HIPEC and C-HIPEC groups respectively, the incidence of 60-day complications (CTCAE 1-4) was 40.4% vs 39.3% (chi squared 0.94) and severe complications (CTCAE 3-4) 14% vs 13% (Fisher's exact p = 1) There was no perioperative mortality but one death in each group within the follow up period. There was no difference in morbidity or mortality between those receiving mitomycin or oxaliplatin. CONCLUSION Closed administration of HIPEC is safe with no difference in post-operative morbidity or mortality compared to open HIPEC administration. Differences in longer term oncological outcomes including overall survival and disease-free survival between open and closed HIPEC techniques are yet to be determined.
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Affiliation(s)
- S Hassan
- Colorectal and Peritoneal Oncology Centre, The Christie NHS FT, Manchester, UK
| | - S Dritsas
- Colorectal and Peritoneal Oncology Centre, The Christie NHS FT, Manchester, UK
| | - S T O'Dwyer
- Colorectal and Peritoneal Oncology Centre, The Christie NHS FT, Manchester, UK; Division of Cancer Sciences, University of Manchester, UK
| | - O Aziz
- Colorectal and Peritoneal Oncology Centre, The Christie NHS FT, Manchester, UK; Division of Cancer Sciences, University of Manchester, UK
| | - P Sutton
- Colorectal and Peritoneal Oncology Centre, The Christie NHS FT, Manchester, UK; Division of Cancer Sciences, University of Manchester, UK
| | - X Wang
- Colorectal and Peritoneal Oncology Centre, The Christie NHS FT, Manchester, UK
| | - R Fish
- Colorectal and Peritoneal Oncology Centre, The Christie NHS FT, Manchester, UK; Division of Cancer Sciences, University of Manchester, UK.
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Syndikus I, Griffin C, Philipps L, Tree A, Khoo V, Birtle AJ, Choudhury A, Ferguson C, O'Sullivan JM, Panades M, Rimmer YL, Scrase CD, Staffurth J, Cruickshank C, Hassan S, Pugh J, Dearnaley DP, Hall E. 10-Year efficacy and co-morbidity outcomes of a phase III randomised trial of conventional vs. hypofractionated high dose intensity modulated radiotherapy for prostate cancer (CHHiP; CRUK/06/016). J Clin Oncol 2023. [DOI: 10.1200/jco.2023.41.6_suppl.304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/18/2023] Open
Abstract
304 Background: Five-year results from the CHHiP trial indicated that moderate hypofractionation of 60 Gray (Gy)/20 fractions (f) was non-inferior to 74Gy/37f (Lancet Oncology, 2016). Reporting of long-term efficacy and side effects is essential in a patient population that remain at risk of recurrence years after treatment. Here we report specific co-morbidity data collected at 10 years and an update of efficacy. Methods: Between October 2002 and June 2011, 3216 men with node negative T1b-T3a localised prostate cancer with risk of seminal vesical involvement ≤30% were randomised (1:1:1 ratio) to 74Gy/37f (control), 60Gy/20f or 57Gy/19f. Patients received 3-6 months of androgen deprivation prior to radiotherapy. The primary endpoint was time to biochemical failure (Phoenix consensus guidelines) or clinical failure (BCF). The non-inferiority design specified a critical hazard ratio (HR) of 1.208 for each hypofractionated schedule compared to control. Data on specific radiotherapy related co-morbidities were collected at 10-year follow-up and are presented as frequency and percentages. Analysis was by intention-to-treat; HRs quoted are unadjusted. Results: With a median follow up of 12.1 years, 10-year BCF-free rates (95% CI) were 74Gy: 76.0% (73.1%, 78.6%); 60Gy: 79.8% (77.1%, 82.3%) and 57Gy: 73.4% (70.5%, 76.1%). For 60Gy/20f, non-inferiority was confirmed: HR60=0.84 (90% CI 0.72, 0.97) with borderline significance for superiority (HR=0.84 (95% CI 0.70, 1.00). As in the primary analysis, for 57Gy/19f, non-inferiority could not be declared: HR57=1.13 (90% CI 0.98, 1.30). 10-year overall survival (95% CI) was 78.5% (75.9%, 81.0%), 82.9% (80.4%, 85.0%) and 79.9% (77.3%, 82.2%) in the 74Gy, 60Gy and 57Gy groups. Bone fractures were reported in 2% (15/700), 2% (19/771) and 3% (22/719) of patients in the 74Gy, 60Gy and 57Gy groups respectively at 10 years. The most common intervention reported was a sigmoidoscopy with 12% (79/681), 8% (60/739) and 9% (65/702) in the 74Gy, 60Gy and 57Gy groups respectively. Of those patients who underwent a sigmoidoscopy it was due to symptoms for 81% (63/78) 81% (48/59) and 85% (55/65) of patients in the 74Gy, 60Gy and 57Gy group respectively. Frequencies of all other pre-specified co-morbidities or related interventions (ureteric obstruction, bowel strictures, trans-urethral resection of prostate, urethrotomy, urethral dilatation or long term catheterisation or treatment of proctopathy with steroid, sucralfate, formalin, laser coagulation or rectal diversion) were <1% in all groups. Conclusions: With a median follow-up of 12 years, oncological outcomes following 60Gy/20f continue to be non-inferior to those with 74Gy/37f. Late co-morbidities were very low across all treatment groups. These data support the long-term safety of moderate hypofractionation. Clinical trial information: 97182923 .
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Affiliation(s)
- Isabel Syndikus
- Clatterbridge Cancer Centre, Department of Radiotherapy, Liverpool, United Kingdom
| | - Clare Griffin
- The Institute of Cancer Research, London, United Kingdom
| | - Lara Philipps
- The Institute of Cancer Research, London, United Kingdom
| | - Alison Tree
- The Royal Marsden NHS Foundation Trust and the Institute of Cancer Research, London, United Kingdom
| | - Vincent Khoo
- The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Alison Jane Birtle
- Rosemere Cancer Centre, Lancs Teaching Hospitals, & University of Manchester, University of Central Lancashire, Preston, United Kingdom
| | | | | | | | | | | | | | - John Staffurth
- Velindre Hospital, Cardiff University, Cardiff, United Kingdom
| | | | - Shama Hassan
- The Institute of Cancer Research, London, United Kingdom
| | - Julia Pugh
- The Institute of Cancer Research, London, United Kingdom
| | - David P. Dearnaley
- Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Emma Hall
- The Institute of Cancer Research, Clinical Trials and Statistics Unit, London, United Kingdom
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Hassan S, Paudyal N, Emaan A, Ibrahim S. Monkeypox Virus: A comprehensive narrative review. Kathmandu Univ Med J (KUMJ) 2023; 21:86-93. [PMID: 37800433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/07/2023]
Abstract
Monkeypox virus, now known as Mpox virus is a large, enveloped, double stranded deoxyribonucleic acid (DNA) virus belonging to the Orthopox viridae genus of the Poxviridae family. Though, Mpox, have earlier been endemic to only African countries, the 2022 outbreak has shown its rapid spread throughout the world. The May 2022 outbreak have shown primarily human to human transmission in contrast to animal to human transmission that had been seen previously. Recent data also suggest a possibility of a pre symptomatic spread. After an incubation period of 9 days, patients with Mpox can present with a prodrome of symptoms followed by a rash. If untreated, severe complications develop in the high-risk groups especially children and pregnant woman. Such groups of people will benefit from antiviral treatments. The current approach to prevent against it is pre-exposure and post exposure prophylaxis with vaccines. The vaccines that have been approved by Food and Drug Administration to date is ACAM2000 and JYNNEOS. Several diagnostic methods exist, among which polymerase chain reaction has proven to be the most specific and sensitive. In this review, we will discuss its epidemiology, the clinical manifestations, diagnostic modalities, complications, treatment approaches and preventive measures.
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Affiliation(s)
- S Hassan
- Nobel Medical College Teaching Hospital, Kanchanbari, Morang, Biratnagar
| | - N Paudyal
- Nobel Medical College Teaching Hospital, Kanchanbari, Morang, Biratnagar
| | - A Emaan
- Nobel Medical College Teaching Hospital, Kanchanbari, Morang, Biratnagar
| | - S Ibrahim
- Nobel Medical College Teaching Hospital, Kanchanbari, Morang, Biratnagar
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Hassan S, Naeem M, Nasir MF, Riaz P, Khan MN, Atiq I. Molecular based identification and phylogenetic relationship by using cytochrome b gene of Pangasius pangasius. BRAZ J BIOL 2022; 84:e268001. [PMID: 36541960 DOI: 10.1590/1519-6984.268001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Accepted: 10/10/2022] [Indexed: 12/24/2022] Open
Abstract
Molecular appraoch for identification of unknown species by using Cytochrome b gene is an effective and reliable as compared with morphological based identification. For DNA barcoding universal molecular genes were used to identify the species. Cytochrome b is a specific gene used for identification purpose. DNA barcoding is a reliable and effective method compared to the different traditional morphological methods of specie identification. So,in the present study which was conducted to identify the species, a total of 50 fish samples were collected from five different sites. DNA was extracted by using the Phenol Chloroform method from muscle tissue. Five sequences were sequenced (one from each site), analyzed, and identified specific species as Pangasius pangasius. Identified sequences were variable in length from 369 bp (Site 1), 364 bp (Site 2), 364 bp (Site 3), 352 bp (Site 4), and 334 bp (Site 5). Identity matches on the NCBI database confirmed the specific specie as P. pangasius. A distancing tree was drawn to show maximum likelihood among the same and different species. Yet, in many cases fishes on diverse development stages are difficult to identify by morphological characters. DNA-based identification methods offer an analytically powerful addition or even an alternative tool for species identification and phylogenetic study. This work intends to provide an updated and extensive overview on the DNA based methods for fish species identification by using Cytochrome b gene as targeted markers for identification purpose.
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Affiliation(s)
- S Hassan
- Bahauddin Zakariya University, Institute of Zoology, Multan, Punjab, Pakistan
| | - M Naeem
- Bahauddin Zakariya University, Institute of Zoology, Multan, Punjab, Pakistan
| | - M Farhan Nasir
- University of Education, Department of Zoology, Division of Science & Technology, Lahore, Punjab, Pakistan
| | - P Riaz
- Bahauddin Zakariya University, Institute of Zoology, Multan, Punjab, Pakistan
| | - M N Khan
- University of Jhang, Department of Zoology, Jhang, Punjab, Pakistan
| | - I Atiq
- Ghazi University Dera Ghazi Khan, Department of Zoology, Punjab, Pakistan
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Murray J, Cruickshank C, Bird T, Bell P, Braun J, Chuter D, Ferreira MR, Griffin C, Hassan S, Hujairi N, Melcher A, Miles E, Naismith O, Panades M, Philipps L, Reid A, Rekowski J, Sankey P, Staffurth J, Syndikus I, Tree A, Wilkins A, Hall E. PEARLS - A multicentre phase II/III trial of extended field radiotherapy for androgen sensitive prostate cancer patients with PSMA-avid pelvic and/or para-aortic lymph nodes at presentation. Clin Transl Radiat Oncol 2022; 37:130-136. [PMID: 36238579 PMCID: PMC9550847 DOI: 10.1016/j.ctro.2022.09.003] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Accepted: 09/18/2022] [Indexed: 11/24/2022] Open
Abstract
PEARLS is a multi-stage randomised controlled trial for prostate cancer patients with pelvic and/or para-aortic PSMA-avid lymph node disease at presentation. The aim of the trial is to determine whether extending the radiotherapy field to cover the para-aortic lymph nodes (up to L1/L2 vertebral interspace) can improve outcomes for this patient group.
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Affiliation(s)
- Julia Murray
- The Royal Marsden NHS Foundation Trust, London, UK
- The Institute of Cancer Research, London, UK
| | | | - Thomas Bird
- University Hospitals Bristol & Weston NHS Foundation Trust, Bristol, UK
| | | | - John Braun
- RMH Radiotherapy Focus Group & RMH Biomedical Research Centre Consumer Group, Sutton, UK
| | - Dave Chuter
- NCRI Consumer Forum, London, UK
- NCRI Living With & Beyond Cancer (Acute and Toxicities Workstream), London, UK
| | | | | | | | | | - Alan Melcher
- The Royal Marsden NHS Foundation Trust, London, UK
- The Institute of Cancer Research, London, UK
| | - Elizabeth Miles
- Radiotherapy Trials QA Group (RTTQA), Mount Vernon Hospital, Northwood, UK
| | - Olivia Naismith
- Radiotherapy Trials QA Group (RTTQA), Royal Marsden NHS Foundation Trust, London, UK
| | | | - Lara Philipps
- The Royal Marsden NHS Foundation Trust, London, UK
- The Institute of Cancer Research, London, UK
| | - Alison Reid
- The Royal Marsden NHS Foundation Trust, London, UK
| | | | - Pete Sankey
- University Hospitals Plymouth NHS Trust, Plymouth, UK
| | - John Staffurth
- Velindre University NHS Trust and Cardiff University, Cardiff, UK
| | | | - Alison Tree
- The Royal Marsden NHS Foundation Trust, London, UK
- The Institute of Cancer Research, London, UK
| | - Anna Wilkins
- The Royal Marsden NHS Foundation Trust, London, UK
- The Institute of Cancer Research, London, UK
| | - Emma Hall
- The Institute of Cancer Research, London, UK
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Boshari T, Hassan S, Hussain K, Billett J, Garry S, Weil L. Development of a refugee health assessment toolkit for specific populations to support primary care. Eur J Public Health 2022. [DOI: 10.1093/eurpub/ckac131.243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Issue/problem
The United Kingdom (UK) hosts c.136,000 refugees and last year received the most asylum applications in two decades. Despite this, expertise in migrant health is not widespread in general practice, with few comprehensive toolkits available to support crucial initial health assessments of new arrivals.
Description of the problem
A large influx of Afghan refugees entered the UK in autumn 2021. In London, primary care practitioners quickly identified a lack of readily accessible, comprehensive guidance to support them in conducting health assessments for arrivals with a complex range of needs. This was compounded by many in primary care having little or no experience of migrant health.
Results
To address this gap in advice on conducting initial health assessments, a bespoke toolkit was created. The toolkit consolidated advice from a range of partners and resources: the UK Afghan migrant health guide, clinicians with humanitarian experience, front-line practitioners, Doctors of the World, and those leading on the health and public health response. The toolkit ensured greater consistency in the nature and content of assessments, considered not only primary needs but also broader wellbeing, and was responsive to both anticipated and known health priorities.
Lessons
The initial health assessment toolkit for Afghan migrants was well received by frontline staff and has implications for international practice in other areas providing similar health support. The toolkit and associated supporting information has formed a template that can be rapidly adapted to suit emerging needs, as has been done for new arrivals from Ukraine. This work has fed into best practice by the UK National Asylum Steering Group and is to be a case study for a WHO project on country-specific health assessments.
Key messages
• The toolkit is a proof of concept for partnership working towards holistic initial health assessments of new migrants in primary care, bringing together best evidence and pragmatic practice.
• This work has implications for other countries experiencing similar trends in migration and providing health support to an increasing number of new refugees.
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Affiliation(s)
- T Boshari
- Public Health, London Borough of Newham , London, UK
| | - S Hassan
- London Operations Team, Office for Health Improvement and Disparities , London, UK
| | - K Hussain
- London Operations Team, Office for Health Improvement and Disparities , London, UK
| | - J Billett
- London Operations Team, Office for Health Improvement and Disparities , London, UK
| | - S Garry
- Public Health, London Borough of Southwark , London, UK
- Association of Directors of Public Health Asylum Seekers and Refugees, , London, UK
| | - L Weil
- London Operations Team, Office for Health Improvement and Disparities , London, UK
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Abdul Haris P, Brazil L, Blythe K, Chia K, Hassan S, Loganathan T, Smith D, Swampillai A, Al-Salihi O. P11.30.A Stereotactic Radiosurgery (SRS) for brain metastases in breast cancer: An evaluation of outcomes at a UK tertiary centre. Neuro Oncol 2022. [DOI: 10.1093/neuonc/noac174.219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Brain metastases (BM) occur in approximately 10-30% of patients with breast cancer (BC). Patients with advanced breast cancer are living longer, and the incidence of BM are increasing. Stereotactic Radiosurgery (SRS) has emerged as a strategy to treat BM. We evaluated the outcomes and potential prognostic factors of patients with BM treated with SRS.
Material and Methods
Retrospective review of patients treated with linac-based SRS for BM from BC in a single tertiary centre between August 2017-September 2021. Overall survival (OS), intracranial progression-free survival (IPFS), and prognostic factors were evaluated using Kaplan-Meier analysis, log-rank test, and Cox proportional-hazards model.
Results
76 patients were included in the analysis. Out of these, 56 had first-line local treatment with SRS, either as primary (n=34) or adjuvant to surgery (n=22). Median age was 58 years old (range 37-86), and 88% had PS 0/1. One-year survival rate was 56%.
Median OS and IPFS from SRS was 16 months (95% CI 8-24) and 7 months (95% CI 2-12), respectively. However, there were significant differences in OS (p<0.001) and IPFS (p=0.001) based on molecular subtypes. Patients with triple-negative breast cancer (TNBC) (n=14) had median OS of 7 months (95% CI 2-12), ER+/HER2- (n=22) median OS of 22 months, ER-/HER2+ (n=8) median OS of 4 months (95% CI 0-9), and ER+/HER2+ (n=11) median OS of 36 months. Similar trend was seen with IPFS.
Patients with progressive extracranial disease compared to stable disease had shorter median OS (4 months vs 23 months, HR 2.4, p=0.01) and median IPFS (4 months vs 13 months, HR 2, p=0.03). Age ≥65 years was associated with shorter median OS (4 vs 23 months, HR 2.3, p=0.02). Patients with ≥4 brain metastases had shorter IPFS (4 months vs 11 months, HR 2.4, p=0.012), but no significant difference in OS. Volume of metastases did not affect outcome in this series.
30% of patients progressed intracranially after first-line SRS. 94 % had out-of-field recurrences, and 6% in-field recurrences. 59% had further SRS, 12 % WBRT, 6% surgery, and 23% had no further local treatment.
26 patients had second-line local treatment with SRS after first-line SRS (n=9), WBRT (n=9), or surgery +/- WBRT (n=8). There were no significant differences in outcome based on the modality of first-line local treatment.
Conclusion
SRS is an effective treatment for BM from BC. There were significant differences in survival based on age, molecular subtypes, and extracranial disease status.
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Affiliation(s)
- P Abdul Haris
- Guy's and St Thomas' NHS Trust , London , United Kingdom
| | - L Brazil
- Guy's and St Thomas' NHS Trust , London , United Kingdom
| | - K Blythe
- Guy's and St Thomas' NHS Trust , London , United Kingdom
- Department of Medical Physics, Guy's and St Thomas' NHS Trust , London , United Kingdom
| | - K Chia
- Guy's and St Thomas' NHS Trust , London , United Kingdom
| | - S Hassan
- Guy's and St Thomas' NHS Trust , London , United Kingdom
| | - T Loganathan
- Guy's and St Thomas' NHS Trust , London , United Kingdom
| | - D Smith
- Guy's and St Thomas' NHS Trust , London , United Kingdom
| | - A Swampillai
- Guy's and St Thomas' NHS Trust , London , United Kingdom
| | - O Al-Salihi
- Guy's and St Thomas' NHS Trust , London , United Kingdom
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Mohd Yasin N, Abdul Hamid FS, Hassan S, Mat Yusoff Y, Mohd Sahid EN, Esa E. An insight of -50 (G>A) mutation in the direct repeat element of the β-globin gene: From Malaysian perspective. Malays J Pathol 2022; 44:301-302. [PMID: 36043595] [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: 06/15/2023]
Abstract
No abstract available.
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Affiliation(s)
- N Mohd Yasin
- Institute for Medical Research, Cancer Research Centre, Haematology Unit, 50588 Kuala Lumpur, Malaysia.
| | - F S Abdul Hamid
- Institute for Medical Research, Cancer Research Centre, Haematology Unit, 50588 Kuala Lumpur, Malaysia
| | - S Hassan
- Institute for Medical Research, Cancer Research Centre, Haematology Unit, 50588 Kuala Lumpur, Malaysia
| | - Y Mat Yusoff
- Institute for Medical Research, Cancer Research Centre, Haematology Unit, 50588 Kuala Lumpur, Malaysia
| | - E N Mohd Sahid
- Institute for Medical Research, Cancer Research Centre, Haematology Unit, 50588 Kuala Lumpur, Malaysia
| | - E Esa
- Institute for Medical Research, Cancer Research Centre, Haematology Unit, 50588 Kuala Lumpur, Malaysia
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Batcho AA, Jabbar B, Sarwar MB, Rashid B, Hassan S, Husnain T. Transient Expression Analysis of Agave sisalana Heat Shock Protein Gene (AsHSP70) in Model Species (Nicotiana benthamiana) under Heat Stress. BIOL BULL+ 2022. [DOI: 10.1134/s1062359022030037] [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: 11/23/2022]
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13
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Nweke UC, Hassan S, Meenakshi J. POS1458 HOW EASY IS IT FOR PATIENTS TO READ AND UNDERSTAND AVAILABLE PATIENT EDUCATIONAL MATERIALS FOR LUPUS? Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.3848] [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: 11/04/2022]
Abstract
BackgroundHealth Literacy (HL) informs health behaviors such as follow-up with health care providers & management plans. Poor HL is linked to poor health outcomes & healthcare disparity. In addition to personal HL, health care providers/systems & Organizations can also empower patients by developing & providing educational resources that foster HL & support a patient’s understanding of their health condition (organizational HL). Patient educational handouts are frequently provided after a physician visit to supplement instructions/education & are often obtained from online resources accessible to both physicians & patients.Lupus, a multisystem disease, preferentially effects people of color, a group at higher risk of health disparities, & poor HL. It is paramount for lupus patients to understand their disease & management to optimize health outcomes & reduce health disparities. The provision of easy to read & comprehend patient educational resources are one way to address this need.ObjectivesThe Center for Disease Control (CDC) recommends the readability of patient educational material to be at eight-grade level, while the National Institute of Health (NIH) & the American Medical Association (AMA) recommend a level no higher than sixth-grade. The Readability & Comprehension (RC) of commonly available lupus-related patient educational materials are not known & may offer an opportunity to improve patient care & outcomes.MethodsWe searched for the RC of Lupus-related patient educational materials, available at the American College of Rheumatology (ACR) & Lupus Foundation of America (LFA) websites. These reputable national organizations are at the forefront of Lupus education & research. RC were evaluated using the following measures: Flesch Kincaid Readability Ease (FKRE), Flesch Kincaid Grade Level (FKGL), Gunning Fog Score (GFS), Simple Measure of Gobbledygook (SMOG) Index, Coleman Liau Index (CLI) & Automated Readability Index (ARI).FKRE score is a widely used measure of readability with scores ranging from 0-100 & higher scores denoting greater reading ease (Goal is >60). FKGL represents the U.S. school grade needed to comprehend the text (Target is 7th grade). GFS estimates the years of formal education required to understand the text on the first reading (Goal is 7-8). SMOG index estimates the years of education needed to comprehend written materials. CLI is used to assess the U.S. grade level necessary to comprehend text material. The ARI assesses how easy a text material is to learn & estimates the U.S. grade level necessary to comprehend a passage.Descriptives for RC were obtained & compared using t test between the two sources.ResultsThere were 12 patient educational pamphlets on Lupus available (4 from ACR & 8 from LFA). Mean (SD) FKRE & FKGL were 52.73 (11.44) & 10.46 (2.14) respectively (Table 1). Mean GFS & CLI exceeded 12, while mean ARI was 18.Table 1.Reading & Comprehension of Patient Educational Materials on LupusRC Test (Values are Mean (SD))AllACRLFAPFlesch Kincaid Reading Ease52.7347.1855.500.25(11.44)(4.93)(13.00)Flesch Kincaid Grade Level10.4610.7310.330.78(2.14)(0.64)(2.64)Gunning Fog Score12.1912.6511.960.41(1.78)(0.31)(2.19)SMOG Index8.949.68.610.27(1.41)(0.67)(1.60)Coleman Liau Index13.5114.6512.940.18(2.04)(1.34)(2.15)Automated Readability Index18.0211.121.470.49(23.13)(1.45)(28.27)There were no significant differences in the RC scores among patient educational materials from the ACR or LFA.ConclusionPatient educational materials on Lupus, available at the ACR & LFA websites, are not easy to read or comprehend, using standardized RC metrics. Additionally, they are not aligned with recommended reading levels suggested by leading organizations (CDC, NIH or AMA). Patient’s understanding is critical in a complex disease like lupus to optimize health outcomes.Revision of patient lupus educational resources at these websites, to target 6-7th grade RC metrics, is recommended & could be overseen by the development of a new taskforce.Disclosure of InterestsNone declared
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Hassan S, Jameson M, Batumalai V, Crawford D, Moutrie Z, Hogan L, Loo C, Picton M, Pagulayan C, Jelen U, Alvares S, Heinke M, Sampaio S, Simon K, Twentyman T, Dwivedi N, de Leon J. PO-1374 Feasibility of magnetic resonance-guided adaptive post-prostatectomy radiotherapy. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)03338-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Dearnaley D, Hinder V, Hijab A, Horan G, Srihari N, Rich P, Houston G, Henry A, Gibbs S, Venkitaraman R, Cruickshank C, Hassan S, Mason M, Pedley I, Payne H, Brock S, Wade R, Robinson A, Din O, Lees K, Murray J, Parker C, Griffin C, Sohaib A, Hall E. OC-0105 PROMPTS RCT of screening MRI for spinal cord compression in prostate cancer (ISRCTN74112318). Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)02481-1] [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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16
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Dearnaley D, Hinder V, Hijab A, Horan G, Srihari N, Rich P, Houston JG, Henry AM, Gibbs S, Venkitaraman R, Cruickshank C, Hassan S, Miners A, Mason M, Pedley I, Payne H, Brock S, Wade R, Robinson A, Din O, Lees K, Graham J, Worlding J, Murray J, Parker C, Griffin C, Sohaib A, Hall E. Observation versus screening spinal MRI and pre-emptive treatment for spinal cord compression in patients with castration-resistant prostate cancer and spinal metastases in the UK (PROMPTS): an open-label, randomised, controlled, phase 3 trial. Lancet Oncol 2022; 23:501-513. [PMID: 35279270 PMCID: PMC8960282 DOI: 10.1016/s1470-2045(22)00092-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 02/10/2022] [Accepted: 02/10/2022] [Indexed: 02/04/2023]
Abstract
BACKGROUND Early diagnosis of malignant spinal cord compression (SCC) is crucial because pretreatment neurological status is the major determinant of outcome. In metastatic castration-resistant prostate cancer, SCC is a clinically significant cause of disease-related morbidity and mortality. We investigated whether screening for SCC with spinal MRI, and pre-emptive treatment if radiological SCC (rSCC) was detected, reduced the incidence of clinical SCC (cSCC) in asymptomatic patients with metastatic castration-resistant prostate cancer and spinal metastasis. METHODS We did a parallel-group, open-label, randomised, controlled, phase 3, superiority trial. Patients with metastatic castration-resistant prostate cancer were recruited from 45 National Health Service hospitals in the UK. Eligible patients were aged at least 18 years, with an Eastern Co-operative Oncology Group performance status of 0-2, asymptomatic spinal metastasis, no previous SCC, and no spinal MRI in the past 12 months. Participants were randomly assigned (1:1), using a minimisation algorithm with a random element (balancing factors were treatment centre, alkaline phosphatase [normal vs raised, with the upper limit of normal being defined at each participating laboratory], number of previous systemic treatments [first-line vs second-line or later], previous spinal treatment, and imaging of thorax and abdomen), to no MRI (control group) or screening spinal MRI (intervention group). Serious adverse events were monitored in the 24 h after screening MRI in the intervention group. Participants with screen-detected rSCC were offered pre-emptive treatment (radiotherapy or surgical decompression was recommended per treating physician's recommendation) and 6-monthly spinal MRI. All patients were followed up every 3 months, and then at month 30 and 36. The primary endpoint was time to and incidence of confirmed cSCC in the intention-to-treat population (defined as all patients randomly assigned), with the primary timepoint of interest being 1 year after randomisation. The study is registered with ISRCTN, ISRCTN74112318, and is now complete. FINDINGS Between Feb 26, 2013, and April 25, 2017, 420 patients were randomly assigned to the control (n=210) or screening MRI (n=210) groups. Median age was 74 years (IQR 68 to 79), 222 (53%) of 420 patients had normal alkaline phosphatase, and median prostate-specific antigen concentration was 48 ng/mL (IQR 17 to 162). Screening MRI detected rSCC in 61 (31%) of 200 patients with assessable scans in the intervention group. As of data cutoff (April 23, 2020), at a median follow-up of 22 months (IQR 13 to 31), time to cSCC was not significantly improved with screening (hazard ratio 0·64 [95% CI 0·37 to 1·11]; Gray's test p=0·12). 1-year cSCC rates were 6·7% (95% CI 3·8-10·6; 14 of 210 patients) for the control group and 4·3% (2·1-7·7; nine of 210 patients) for the intervention group (difference -2·4% [95% CI -4·2 to 0·1]). Median time to cSCC was not reached in either group. No serious adverse events were reported within 24 h of screening. INTERPRETATION Despite the substantial incidence of rSCC detected in the intervention group, the rate of cSCC in both groups was low at a median of 22 months of follow-up. Routine use of screening MRI and pre-emptive treatment to prevent cSCC is not warranted in patients with asymptomatic castration-resistant prostate cancer with spinal metastasis. FUNDING Cancer Research UK.
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Affiliation(s)
- David Dearnaley
- Division of Radiotherapy and Imaging, The Institute of Cancer Research, London, UK; Urology Unit, Royal Marsden NHS Foundation Trust, London, UK
| | - Victoria Hinder
- Clinical Trials and Statistics Unit, The Institute of Cancer Research, London, UK
| | - Adham Hijab
- Urology Unit, Royal Marsden NHS Foundation Trust, London, UK
| | - Gail Horan
- Clinical Oncology, The Queen Elizabeth Hospital King's Lynn NHS Foundation Trust, King's Lynn, UK
| | - Narayanan Srihari
- Clinical Oncology, The Shrewsbury and Telford Hospital NHS Trust, Shrewsbury, UK
| | - Philip Rich
- Radiology, St George's University Hospitals NHS Foundation Trust, London, UK
| | - J Graeme Houston
- Imaging Science and Technology, University of Dundee, Dundee, UK
| | - Ann M Henry
- Clinical Oncology, University of Leeds, Leeds, UK
| | - Stephanie Gibbs
- Clinical Oncology, Barking, Havering and Redbridge University Hospitals NHS Trust, London, UK
| | - Ram Venkitaraman
- Clinical Oncology, East Suffolk and North Essex NHS Foundation Trust, Ipswich, UK
| | - Clare Cruickshank
- Clinical Trials and Statistics Unit, The Institute of Cancer Research, London, UK
| | - Shama Hassan
- Clinical Trials and Statistics Unit, The Institute of Cancer Research, London, UK
| | - Alec Miners
- Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, UK
| | | | - Ian Pedley
- Clinical Oncology, The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle, UK
| | - Heather Payne
- Clinical Oncology, University College London Hospitals NHS Foundation Trust, London, UK
| | - Susannah Brock
- Clinical Oncology, University Hospitals Dorset NHS Foundation Trust, Poole, UK
| | - Robert Wade
- Clinical Oncology, Norfolk and Norwich University Hospitals NHS Foundation Trust, Norwich, UK
| | - Angus Robinson
- Clinical Oncology, Brighton and Sussex University Hospitals NHS Trust, Brighton, UK
| | - Omar Din
- Clinical Oncology, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
| | - Kathryn Lees
- Clinical Oncology, Maidstone and Tunbridge Wells NHS Trust, Maidstone, UK
| | - John Graham
- Clinical Oncology, Somerset NHS Foundation Trust, Taunton, UK
| | - Jane Worlding
- Oncology, University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK
| | - Julia Murray
- Division of Radiotherapy and Imaging, The Institute of Cancer Research, London, UK; Urology Unit, Royal Marsden NHS Foundation Trust, London, UK
| | - Chris Parker
- Division of Radiotherapy and Imaging, The Institute of Cancer Research, London, UK; Urology Unit, Royal Marsden NHS Foundation Trust, London, UK
| | - Clare Griffin
- Clinical Trials and Statistics Unit, The Institute of Cancer Research, London, UK
| | - Aslam Sohaib
- Urology Unit, Royal Marsden NHS Foundation Trust, London, UK
| | - Emma Hall
- Clinical Trials and Statistics Unit, The Institute of Cancer Research, London, UK.
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Ahmad N, Hussain SM, Azam SM, Shahzad MM, Noureen A, Yaqoob R, Lateef M, Yawer A, Riaz D, Usman A, Faizan M, Hassan S, Ishtiaq A, Riaz P, Ali A, Amin F, Imran M, Kausar R, Ahmed M, Bashir W, Adnan M, Siddique A, Farooq M, Ahmad S. Effects of Se nanoparticles supplementation on growth performance, hematological parameters and nutrient digestibility of Labeo rohita fingerling fed sunflower meal based diet. BRAZ J BIOL 2022; 84:e253555. [PMID: 35019098 DOI: 10.1590/1519-6984.253555] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Accepted: 08/30/2021] [Indexed: 11/22/2022] Open
Abstract
The aim of the present study is to assess the effects of selenium nanoparticles on the growth, hematology and nutrients digestibility of Labeorohita fingerlings. Fingerlings were fed with seven isocaloric sunflower meal-based diet supplemented with different concentrations of nanoparticles naming T1 to T7 (0, 0.5, 1, 1.5, 2, 2.5, and 3 mg/kg), with 5% wet body weight while chromic oxide was used as an indigestible marker. After experimentation for 90 days T3 treated group (1mg/kg -1Se-nano level) showed the best result in hematological parameters (WBC's 7.97 ×103mm-3, RBC's 2.98 ×106 mm-3 and Platelet count 67), nutrient digestibility (crude protein: 74%, ether extract: 76%, gross energy: 70%) and growth performance (weight gain 13.24 g, weight gain% 198, feed conversion ratio 1.5, survival rate 100%) as compared to the other treatment groups. Specific growth rates were found significantly higher in T5 than in other groups. The present study indicated positive effect of 1 mg/kg Se-nanoparticles on growth advancement, hematological parameters, and nutrients digestibility of L. rohita fingerlings.
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Affiliation(s)
- N Ahmad
- University of Jhang, Department of Zoology, Punjab, Pakistan
| | - S M Hussain
- Government College University, Department of Zoology, Fish Nutrition Lab, Faisalabad, Pakistan
| | - S M Azam
- University of Education Lahore, Division of Science and Technology, Department of Zoology, Punjab, Pakistan
| | - M M Shahzad
- University of Education Lahore, Division of Science and Technology, Department of Zoology, Punjab, Pakistan
| | - A Noureen
- The University of Lahore, Institute of Molecular Biology & Biotechnology - IMBB, Department of Zoology, Lahore,Pakistan
| | - R Yaqoob
- University of Education Lahore, Division of Science and Technology, Department of Zoology, Punjab, Pakistan
| | - M Lateef
- University of Education Lahore, Division of Science and Technology, Department of Zoology, Punjab, Pakistan
| | - A Yawer
- Racetox, Masaryk University, Faculty of Science, Kamenice, Brno Czech Republic
| | - D Riaz
- University of Education Lahore, Division of Science and Technology, Department of Zoology, Punjab, Pakistan
| | - A Usman
- Government College University, Department of Chemistry, Faisalabad, Pakistan Lahore, Punjab, Pakistan
| | - M Faizan
- University of Agriculture, Department of Zoology, Faisalabad, Punjab, Pakistan
| | - S Hassan
- Institute of Pure & Applied Biology Bahauddin Zakariya University, Multan, Pakistan
| | - A Ishtiaq
- Institute of Pure & Applied Biology Bahauddin Zakariya University, Multan, Pakistan
| | - P Riaz
- Institute of Pure & Applied Biology Bahauddin Zakariya University, Multan, Pakistan
| | - A Ali
- Institute of Pure & Applied Biology Bahauddin Zakariya University, Multan, Pakistan
| | - F Amin
- University of Veterinary & Animal Sciences Punjab, Department of Zoology, Lahore,Pakistan
| | - M Imran
- BahuddinZakariya University Multan, Department of Statistics, Punjab, Pakistan
| | - R Kausar
- University of Baluchistan, Department of Zoology, Quetta, Pakistan
| | - M Ahmed
- COMSATS University Islamabad, Department of Management Sciences, Vehari Campus, Vehari, Pakistan
| | - W Bashir
- Department of Zoology, Government College University, Faisalabad, Pakistan
| | - M Adnan
- Department of Zoology, Government Graduate Taleem-ul-Islam College Chenab Nagar, Chiniot, Pakistan
| | - A Siddique
- Department of Chemistry, Lahore College for Women University Lahore, Pakistan
| | - M Farooq
- Department of Zoology, Ghazi University Dera Ghazi Khan, Pakistan
| | - S Ahmad
- Institute of Pure & Applied Biology Bahauddin Zakariya University, Multan, Pakistan
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Elsayed SA, Hassan S, Hakam M, Mekhemer S, Mobarak F. Effect of two fascial incision options for access to the temporomandibular joint on facial nerve function: objective investigation. Int J Oral Maxillofac Surg 2021; 51:933-941. [PMID: 34972618 DOI: 10.1016/j.ijom.2021.12.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Revised: 12/16/2021] [Accepted: 12/17/2021] [Indexed: 10/19/2022]
Abstract
This study was performed to compare the effects on facial nerve (FN) function of the deep supra-temporalis muscle subfascial approach (DSFA) and traditional fascial approach (TFA) for access to the temporomandibular joint (TMJ), via qualitative and quantitative evaluations. Thirty patients requiring open TMJ surgery were randomly allocated to one of two groups: group A patients underwent the DSFA approach, while group B patients underwent the TFA approach. The TMJ was accessed via modified endaural incision with temporal extension. Clinical examinations, FN conduction tests, and electromyography (EMG) of the frontalis and orbicularis oculi muscles were used to assess FN function. A FN function deficit was noted in 50% of the whole sample population immediately after surgery, with no statistically significant difference between the groups (P = 0.082). Overall, 37.5% of the total study population experienced temporary loss of frontalis muscle activity, while zygomatic nerve injury was seen only in 25% of group A. Within 2-6 months, normal function returned in both groups. Nerve conduction studies showed no statistically significant difference between the groups in terms of nerve amplitude or latency after surgery. However, EMG of orbicularis oculi activity showed a significant difference between the groups after 6 months (P = 0.010). The results suggest that the traditional dissection approach is more protective of the FN, especially the zygomatic branch, than the deeper dissection technique.
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Affiliation(s)
- S A Elsayed
- Department of Oral and Maxillofacial Surgery, Faculty of Dental Medicine, Al-Azhar University for Girls, Cairo, Egypt; Department of Oral and Maxillofacial Surgery, Taibah University Dental College and Hospital, Almadinah Almunawwarah, Saudi Arabia.
| | - S Hassan
- Department of Oral and Maxillofacial Surgery, Faculty of Dental Medicine, Al-Azhar University for Girls, Cairo, Egypt
| | - M Hakam
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Cairo University, Cairo, Egypt
| | - S Mekhemer
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Cairo University, Cairo, Egypt
| | - F Mobarak
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Cairo University, Cairo, Egypt
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Paletta A, Hassan S, Nicali A. Rimozione di un calcolo del dotto di Wharton con sialodocoplastica. Dental Cadmos 2021. [DOI: 10.19256/d.cadmos.2021.36] [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: 11/20/2022]
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20
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Javaid A, Monlezun D, Iliescu G, Palaskas N, Kim P, Hassan S, Lopez-Mattei J, Cilingiroglu M, Marmagiolis K, Iliescu C. Trends in hospitalized patients with cancer and stress cardiomyopathy. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.2875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Introduction
Although cardiovascular disease (CVD) and cancer remain the top two causes of death worldwide, novel therapeutics have resulted in a decreased mortality rate in both groups. Accordingly, there has been a heightened awareness of patients with cancer experiencing stress cardiomyopathy (SC). In patients with cancer, the emotional stress of the diagnosis of cancer is compounded by the physical stress of treatments such as surgery, chemotherapy, immunotherapy, and radiotherapy. Previous studies have shown that SC in patients with cancer is associated with higher odds of in-hospital mortality when compared to patients with SC alone. No studies have examined the differences between patients with active cancer and SC compared to patients with active cancer without SC.
Purpose
To explore the unique impact that a diagnosis of SC has on patients with specific types of cancer, so that clinicians may recognize these phenomena and reduce morbidity associated with this disease.
Methods
We queried the 2016 United States National Inpatient Sample, which is the largest publicly available all-payer inpatient healthcare database, to identify demographic characteristics and outcomes in patients with active cancer and SC.
Results
Of 30,195,722 adult hospitalized patients, 4,719,591 (15.63%) had active cancer of whom 568,239 (12.04%) had SC. Among patients with active cancer, patients with SC versus those without SC were significantly more likely to have the following characteristics: female sex, white race, commercial insurance, hypertension, anemia, thrombocytopenia, and coagulation disorder (p<0.003 for all variables). The five most common primary malignancies in patients with SC were breast (13.4%), lung (10.2%), skin (9.5%), colon (8.1%), and leukemia (4.8%) (Figure 1).
In machine learning-augmented propensity score-adjusted multivariable regression fully adjusting for age, race, income, and presence of metastases, the only primary malignancies that significantly increased the likelihood of SC were lung cancer (OR 1.25; p=0.003) and breast cancer (OR 1.81; p<0.001) (Table 1). In separate regression, neither SC alone nor having both SC and cancer was significantly associated with mortality. The presence of concomitant SC and breast cancer was significantly associated with reduced mortality (OR 0.48; p=0.032).
Conclusion
In patients with active cancer, SC was not associated with in-hospital mortality. In addition, patients with both SC and breast cancer had significantly reduced mortality when compared to all patients with cancer. Further investigation will be necessary to confirm these findings and determine the possible protective factors in patients with SC and breast cancer. Furthermore, clinicians should be aware, early during hospitalization, of the increased likelihood of SC in patients with lung cancer and breast cancer, in order to reduce morbidity associated with these diagnoses.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- A Javaid
- University of Nevada, Las Vegas School of Medicine, Internal Medicine, Las Vegas, United States of America
| | - D Monlezun
- University of Texas MD Anderson Cancer Centre, Cardiology, Houston, United States of America
| | - G Iliescu
- University of Texas MD Anderson Cancer Centre, Cardiology, Houston, United States of America
| | - N Palaskas
- University of Texas MD Anderson Cancer Centre, Cardiology, Houston, United States of America
| | - P Kim
- University of Texas MD Anderson Cancer Centre, Cardiology, Houston, United States of America
| | - S Hassan
- University of Texas MD Anderson Cancer Centre, Cardiology, Houston, United States of America
| | - J Lopez-Mattei
- University of Texas MD Anderson Cancer Centre, Cardiology, Houston, United States of America
| | - M Cilingiroglu
- University of Texas MD Anderson Cancer Centre, Cardiology, Houston, United States of America
| | - K Marmagiolis
- University of Texas MD Anderson Cancer Centre, Cardiology, Houston, United States of America
| | - C Iliescu
- University of Texas MD Anderson Cancer Centre, Cardiology, Houston, United States of America
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Hassan S, Stambulic T, King M, Norman P, Payne D, Derry K, El Diasty M. POST-OPERATIVE PAIN AND ANALGESIC USE FOR CARDIAC SURGERY WITH MEDIAN STERNOTOMY. Can J Cardiol 2021. [DOI: 10.1016/j.cjca.2021.07.206] [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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Hassan S, Paleczny S, Redfearn D, Glover B, Enriquez A, Bisleri G. SIMULTANEOUS HYBRID ABLATION WITH EPI-ENDOCARDIAL MAPPING FOR THE TREATMENT OF LONG STANDING PERSISTENT ATRIAL FIBRILLATION. Can J Cardiol 2021. [DOI: 10.1016/j.cjca.2021.07.112] [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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Abdul Razzack A, Abdul Razzack S, Shenasan P, Shenasan N, Mishra S, Zarrar R, Pablo Sosa J, Mercedes Ferreira Caceres M, Garimella R, Andrews K, Mukhtar S, Agolli A, Agolli O, Hassan S, Rocha Castellanos DM, Pothuru S, Theja Reddy K. POS0701 ANIFROLUMAB, AN ANTI-INTERFERON-Α RECEPTOR MONOCLONAL ANTIBODY IN SYSTEMIC LUPUS ERYTHEMATOSUS- A META ANALYSIS. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.2782] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:Type I interferons such as Anifrolumab have been implicated in Systemic lupus erythematosus (SLE) pathogenesis on the basis of increased interferon-stimulated gene expression and genetic susceptibility. Little is known regarding its efficacy and safety profile.Objectives:To assess the efficacy and safety of Anifrolumab in patients with SLE.Methods:Electronic databases (PubMed, Embase, Scopus, Cochrane) were searched from inception until December 15th, 2020. Unadjusted odds ratios (OR) were calculated from dichotomous data using Mantel Haenszel (M-H) random-effects with statistical significance to be considered if the confidence interval excludes 1 and p<0.05. The primary outcome of interest was British Isles Lupus Assessment Group (BILAG)-based Composite Lupus Assessment (BICLA). Secondary outcomes included the proportion of patients who achieved an SLE responder index of 4 (SRI-4) reduction of 50% or more in the Cutaneous Lupus Erythematosus Disease Area and Severity Index (CLASI), reductions in the glucocorticoid dose and adverse effects.Results:A total of three studies1,2,3 with 839 participants (Anifrolumab=372, Placebo=467) were included in our analysis. Follow-up duration was at week 52. A statistically significant different was observed in the Anifrolumab arm in terms of BICLA response (OR 0.44 95%CI 0.34-0.59;p < 0.00001, I2=4), ≥50% reduction in CLASI activity score (OR 0.36 95%CI 0.21-0.60;p=0.0001, I2=0), glucocorticoid reduction (OR 0.41 95%CI 0.28-0.59;p<0.00001; I2=0) and SRI-4 response (OR 0.52 95% CI 0.30-0.90; p=0.02, I2=75). However, Adverse events were less likely in the placebo arm as compared to Anifrolumab (OR 1.54 95%CI 1.05-2.25; p=0.03; I2=0).Conclusion:Anifrolumab was found to be more effective than placebo for the management of SLE, but may also cause more severe adverse effects.References:[1]Morand EF, Furie R, Tanaka Y, Bruce IN, Askanase AD, Richez C, Bae SC, Brohawn PZ, Pineda L, Berglind A, Tummala R; TULIP-2 Trial Investigators. Trial of Anifrolumab in Active Systemic Lupus Erythematosus. N Engl J Med. 2020 Jan 16;382(3):211-221. doi: 10.1056/NEJMoa1912196. Epub 2019 Dec 18. PMID: 31851795.[2]Furie R, Khamashta M, Merrill JT, Werth VP, Kalunian K, Brohawn P, Illei GG, Drappa J, Wang L, Yoo S; CD1013 Study Investigators. Anifrolumab, an Anti-Interferon-α Receptor Monoclonal Antibody, in Moderate-to-Severe Systemic Lupus Erythematosus. Arthritis Rheumatol. 2017 Feb;69(2):376-386. doi: 10.1002/art.39962. PMID: 28130918; PMCID: PMC5299497.[3]Furie RA, Morand EF, Bruce IN, et al. Type I interferon inhibitor anifrolumab in active systemic lupus erythematosus (TULIP-1): a randomised, controlled, phase 3 trial. Lancet Rheumatol 2019; 1(4):e208-e219.Disclosure of Interests:None declared
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Hassan F, Arshad MA, Hassan S, Bilal RM, Saeed M, Rehman MS. Physiological role of Arginine in growth performance, gut health and immune response in broilers: a review. WORLD POULTRY SCI J 2021. [DOI: 10.1080/00439339.2021.1925198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- F. Hassan
- Institute of Animal and Dairy Sciences, Faculty of Animal Husbandry, University of Agriculture, Faisalabad, Pakistan
| | - M. A. Arshad
- Institute of Animal and Dairy Sciences, Faculty of Animal Husbandry, University of Agriculture, Faisalabad, Pakistan
| | - S. Hassan
- Institute of Animal and Dairy Sciences, Faculty of Animal Husbandry, University of Agriculture, Faisalabad, Pakistan
| | - R. M. Bilal
- College of Veterinary and Animal Sciences, The Islamia University of Bahawalpur, Bahawalpur, Pakistan
| | - M. Saeed
- Faculty of Animal Production and Technology, Cholistan University of Veterinary and Animal Sciences, Bahawalpur, Pakistan
| | - M. S. Rehman
- Institute of Animal and Dairy Sciences, Faculty of Animal Husbandry, University of Agriculture, Faisalabad, Pakistan
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Lacey L, Henderson I, Hassan S, Hunter H, Sajjad Y, Akhtar MA. Can preoperative parameters predict successful sperm retrieval and live birth in couples undergoing testicular sperm extraction and intracytoplasmic sperm injection for azoospermia? Middle East Fertil Soc J 2021. [DOI: 10.1186/s43043-021-00052-9] [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: 11/10/2022] Open
Abstract
Abstract
Background
We aimed to determine if the success of TESE and live-birth following TESE-ICSI can be predicted from readily available preoperative parameters for couples with azoospermia. Our methodology was as follows, this was a cohort study of couples who attended the fertility service (from 2009-2019) at an NHS hospital in whom the male partner was diagnosed with azoospermia and required conventional TESE with multiple biopsies to obtain sperm. Of 414 men included, 223 had successful TESE and of those 178 have used sperm in ICSI cycle(s). Predictive models were developed using logistic regression. We assessed model performance by internally validated concordance statistics and calibration plots. Successful sperm retrieval was defined as the presence of motile sperm which survived the freeze-thaw process and live-birth defined as delivery after 34 weeks of gestation.
Results
Successful TESE was associated with higher male age and lower FSH. The TESE model discriminated well with a c statistic of 0.81 (0.77-0.85). Live-birth was associated with lower maternal age, earlier ICSI cycle, and lower testicular volume. The live-birth model also discriminated well with a c statistic of 0.70 (0.64-0.76).
Conclusions
These results support the pragmatic counselling of couples diagnosed with azoospermia about the chances of success of the TESE procedure and of biological parenthood prior to surgical intervention. The models help to discriminate between men who have a high or low chance of successful TESE and couples who have a higher chance of achieving a live-birth after successful TESE. This will allow couples to make a better assessment of the balance of risk versus benefit prior to commitment to surgical interventions.
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Idress H, Zaidi SZJ, Sabir A, Shafiq M, Khan RU, Harito C, Hassan S, Walsh FC. Cellulose acetate based Complexation-NF membranes for the removal of Pb(II) from waste water. Sci Rep 2021; 11:1806. [PMID: 33469047 PMCID: PMC7815919 DOI: 10.1038/s41598-020-80384-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Accepted: 12/02/2020] [Indexed: 01/21/2023] Open
Abstract
This study investigates the removal of Pb(II) using polymer matrix membranes, cellulose acetate/vinyl triethoxysilane modified graphene oxide and gum Arabic (GuA) membranes. These complexation-NF membranes were successfully synthesized via dissolution casting method for better transport phenomenon. The varied concentrations of GuA were induced in the polymer matrix membrane. The prepared membranes M-GuA2–M-GuA10 were characterized by Fourier transform infrared spectroscopy, scanning electron microscopy, transmission electron microscopy, atomic force microscope and bio-fouling studies. Thermal stability of the membranes was determined by thermogravimetric analysis under nitrogen atmosphere. Dead end nanofiltration was carried out to study the perm- selectivity of all the membranes under varied pressure and concentration of Pb(NO3)2. The complexation-NF membrane performances were significantly improved after the addition of GuA in the polymer matrix membrane system. M-GuA8 membrane showed optimum result of permeation flux 8.6 l m−2 h−1. Rejection of Pb(II) ions was observed to be around 97.6% at pH 9 for all the membranes due to electrostatic interaction between CA and Gum Arabic. Moreover, with the passage of time, the rate of adsorption was also increased up to 15.7 mg g−1 until steady state was attained. Gum Arabic modified CA membranes can open up new possibilities in enhancing the permeability, hydrophilicity and anti-fouling properties.
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Affiliation(s)
- H Idress
- Department of Polymer Engineering and Technology, University of the Punjab, Lahore, 54590, Pakistan.
| | - S Z J Zaidi
- Institute of Chemical Engineering and Technology, University of the Punjab, Lahore, Pakistan.
| | - A Sabir
- Department of Polymer Engineering and Technology, University of the Punjab, Lahore, 54590, Pakistan
| | - M Shafiq
- Department of Polymer Engineering and Technology, University of the Punjab, Lahore, 54590, Pakistan
| | - R U Khan
- Department of Polymer Engineering and Technology, University of the Punjab, Lahore, 54590, Pakistan
| | - C Harito
- Industrial Engineering Department, Faculty of Engineering, Bina Nusantara University, Jakarta, 11480, Indonesia
| | - S Hassan
- Mechanical Engineering, Faculty of Engineering and Physical Sciences, University of Southampton, Highfield, Southampton, SO17 1BJ, UK
| | - F C Walsh
- Electrochemical Engineering Laboratory, Faculty of Engineering and Environment, Engineering Sciences, University of Southampton, Highfield, Southampton, SO17 1BJ, UK
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Asif E, Yakoob J, Hassan S, Khan U, Saifullah S, Ali N. The signal peptide region of vacuolating cytotoxin-A gene of Helicobacter pylori in patients with gastrointestinal disorders. Int J Infect Dis 2020. [DOI: 10.1016/j.ijid.2020.09.490] [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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Von Renteln F, Hassan S, Szummer K, Edfors R, Venetsanos D, Kober L, Braunschweig F, Lewinter C. Immediate versus staged revascularisation in multivessel coronary disease: an updated meta-analysis. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.1487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Percutaneous coronary interventions (PCIs) are often aimed at the culprit vessel in acute coronary syndromes (ACSs) followed by revascularisation of other stenoses later in the index hospitalisation or shortly after discharge. PCI delay of non-culprit coronary vessels stenoses is supported by lower contrast fluid use and thrombocyte aggregation. Distinct coronary interventions increase the risk of both non- and coronary artery complications, e.g. acute abdominal and periphery artery bleeding, suggesting undertaking all PCIs at the same time.
Purpose
To assess the effect on mortality and re-myocardial infarction (MI) of immediate versus staged revascularisation in multivessel coronary disease, with the latter constrained to initial PCI of the culprit coronary vessel.
Methods
The syntax of “randomised controlled trial (RCT) & acute coronary syndrome & complete revascularisation” was undertaken in PubMed.
Clinical characteristics were gathered at the index hospitalisation. The intervention scenario was acute coronary syndrome or not.
Meta-analyses calculated relative risk (RR) reductions on outcomes of 1) mortality and 2) re-MI. Meta-regression assessed linear difference between interventional treatment benefits and baseline characteristics.
Results
A total of 148 studies was found. Of those, 8 was found eligible for further analyses and their baseline characteristics are shown in Table 1.
Comparison of immediate versus staged revascularisation on mortality was nonsignificant (RR, 1.19; 95% CI: 0.78–1.81, p=0.43) (Figure 1). The impact of Immediate vs staged revascularisation on re-MI was also nonsignificant (RR, 0.83; 95% CI: 0.44–1.55, p=0.56). Meta-regression found no associations between the outcomes and study characteristics (not shown).
Conclusion
The intervention of immediate compared to staged revascularisation assessed on outcomes of all-cause mortality and re-MI were nonsignificant.
Figure 1
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
| | - S Hassan
- Karolinska University Hospital, Stockholm, Sweden
| | - K Szummer
- Karolinska University Hospital, Stockholm, Sweden
| | - R Edfors
- Karolinska University Hospital, Stockholm, Sweden
| | - D Venetsanos
- Karolinska University Hospital, Stockholm, Sweden
| | - L Kober
- Rigshospitalet - Copenhagen University Hospital, Heart Centre, Copenhagen, Denmark
| | | | - C Lewinter
- Karolinska University Hospital, Stockholm, Sweden
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Syndikus I, Cruickshank C, Staffurth J, Tree A, Henry A, Naismith O, Mayles H, Snelson N, Hassan S, Brown S, Porta N, Griffin C, Hall E. PIVOTALboost: A phase III randomised controlled trial of prostate and pelvis versus prostate alone radiotherapy with or without prostate boost (CRUK/16/018). Clin Transl Radiat Oncol 2020; 25:22-28. [PMID: 32995575 PMCID: PMC7508714 DOI: 10.1016/j.ctro.2020.08.003] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Accepted: 08/24/2020] [Indexed: 01/16/2023] Open
Abstract
•PIVOTALboost evaluates benefits/toxicity of pelvic node RT and focal boost dose escalation.•Unfavourable intermediate/high risk and bulky local disease are most likely to benefit.•Functional MRI imaging is used to select patients for different types of dose escalation.•HDR brachytherapy or focal dose escalation with IMRT are used as options.•Training and support is provided to reduce variations of contouring and radiotherapy planning.•The trial is recruiting patients in 38 radiotherapy centres through the UK.
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Affiliation(s)
| | - Clare Cruickshank
- Clinical Trials and Statistics Unit, The Institute of Cancer Research (ICR-CTSU), London, UK
| | | | - Alison Tree
- The Royal Marsden NHS Foundation Trust/The Institute of Cancer Research, London, UK
| | - Ann Henry
- The Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - Olivia Naismith
- National Radiotherapy Trials Quality Assurance Group, The Royal Marsden NHS Foundation Trust, London, UK
| | - Helen Mayles
- National Radiotherapy Trials Quality Assurance Group, The Clatterbridge Cancer Centre, Wirral. UK
| | - Nicola Snelson
- National Radiotherapy Trials Quality Assurance Group, The Clatterbridge Cancer Centre, Wirral. UK
| | - Shama Hassan
- Clinical Trials and Statistics Unit, The Institute of Cancer Research (ICR-CTSU), London, UK
| | - Stephanie Brown
- Clinical Trials and Statistics Unit, The Institute of Cancer Research (ICR-CTSU), London, UK
| | - Nuria Porta
- Clinical Trials and Statistics Unit, The Institute of Cancer Research (ICR-CTSU), London, UK
| | - Clare Griffin
- Clinical Trials and Statistics Unit, The Institute of Cancer Research (ICR-CTSU), London, UK
| | - Emma Hall
- Clinical Trials and Statistics Unit, The Institute of Cancer Research (ICR-CTSU), London, UK
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Hughes BA, Hassan S, Stallard J, Louette S, Smith J, Knight SL, Fenn C, Peach H, Thornton DJ, Hernon C, Goodenough J, Bhat W, West CC, Bains RD, Bourke G, Smith IM, Liddington MI. Plastic physicians: The surgical salamanders of the COVID-19 pandemic. J Plast Reconstr Aesthet Surg 2020; 74:401-406. [PMID: 33097434 PMCID: PMC7502252 DOI: 10.1016/j.bjps.2020.08.122] [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: 06/14/2020] [Accepted: 08/18/2020] [Indexed: 02/06/2023]
Abstract
At the time of writing, coronavirus disease-2019 (COVID-19) has affected 6.42 million people globally and over 380,000 deaths, with the United Kingdom now having the highest death rate in Europe. The plastic surgery department at Leeds Teaching Hospitals put necessary steps in place to maintain an excellent urgent elective and acute service whilst also managing COVID-positive medical patients in the ward. We describe the structures and pathways implemented together with complex decision-making, which has allowed us to respond early and effectively. We hope these lessons will prove a useful tool as we look to open conversations around the recovery of normal activity.
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Affiliation(s)
- B A Hughes
- Department of Plastic and Reconstructive Surgery, Leeds General Infirmary, Great George Street, Leeds, West Yorkshire LS1 3EX, UK.
| | - S Hassan
- Department of Plastic and Reconstructive Surgery, Leeds General Infirmary, Great George Street, Leeds, West Yorkshire LS1 3EX, UK
| | - J Stallard
- Department of Plastic and Reconstructive Surgery, Leeds General Infirmary, Great George Street, Leeds, West Yorkshire LS1 3EX, UK
| | - S Louette
- Department of Plastic and Reconstructive Surgery, Leeds General Infirmary, Great George Street, Leeds, West Yorkshire LS1 3EX, UK
| | - J Smith
- Department of Plastic and Reconstructive Surgery, Leeds General Infirmary, Great George Street, Leeds, West Yorkshire LS1 3EX, UK
| | - S L Knight
- Department of Plastic and Reconstructive Surgery, Leeds General Infirmary, Great George Street, Leeds, West Yorkshire LS1 3EX, UK
| | - C Fenn
- Department of Plastic and Reconstructive Surgery, Leeds General Infirmary, Great George Street, Leeds, West Yorkshire LS1 3EX, UK
| | - H Peach
- Department of Plastic and Reconstructive Surgery, Leeds General Infirmary, Great George Street, Leeds, West Yorkshire LS1 3EX, UK
| | - D J Thornton
- Department of Plastic and Reconstructive Surgery, Leeds General Infirmary, Great George Street, Leeds, West Yorkshire LS1 3EX, UK
| | - C Hernon
- Department of Plastic and Reconstructive Surgery, Leeds General Infirmary, Great George Street, Leeds, West Yorkshire LS1 3EX, UK
| | - J Goodenough
- Department of Plastic and Reconstructive Surgery, Leeds General Infirmary, Great George Street, Leeds, West Yorkshire LS1 3EX, UK
| | - W Bhat
- Department of Plastic and Reconstructive Surgery, Leeds General Infirmary, Great George Street, Leeds, West Yorkshire LS1 3EX, UK
| | - C C West
- Department of Plastic and Reconstructive Surgery, Leeds General Infirmary, Great George Street, Leeds, West Yorkshire LS1 3EX, UK
| | - R D Bains
- Department of Plastic and Reconstructive Surgery, Leeds General Infirmary, Great George Street, Leeds, West Yorkshire LS1 3EX, UK
| | - G Bourke
- Department of Plastic and Reconstructive Surgery, Leeds General Infirmary, Great George Street, Leeds, West Yorkshire LS1 3EX, UK
| | - I M Smith
- Department of Plastic and Reconstructive Surgery, Leeds General Infirmary, Great George Street, Leeds, West Yorkshire LS1 3EX, UK
| | - M I Liddington
- Department of Plastic and Reconstructive Surgery, Leeds General Infirmary, Great George Street, Leeds, West Yorkshire LS1 3EX, UK
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Hassan S, D L, Jacob L, Babu S, Kn L, Ah R, Lk R, Saldanha S, Thottian A. Corrigendum to ‘Socioeconomic and Administrative Factors Associated with Healthcare Delay and Treatment of Esophageal and Gastric Carcinoma: Experience at a Tertiary Care Centre in a Developing Country’. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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Bawadi H, Hassan S, Shanbeh Zadeh A, Sarv H, Kerkadi A, Tur JA, Shi Z. Age and gender specific cut-off points for body fat parameters among adults in Qatar. Nutr J 2020; 19:75. [PMID: 32711520 PMCID: PMC7382859 DOI: 10.1186/s12937-020-00569-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2019] [Accepted: 05/20/2020] [Indexed: 12/15/2022] Open
Abstract
Background Excessive body fat is the leading cause of many metabolic disorders. Therefore, assessing levels of body fat associated with risk of disease in specific populations is crucial. The present study aimed to identify optimal cut-off values of body fat composition including total body fat, body fat percentage, visceral fat, and trunk fat, in order to predict metabolic risk in the Qatari population. Methods This cross-sectional study was based on Qatar Biobank data of 2407 Qatari adults (1269 male and 1138 female) aged 21–70 years old. Individuals’ height, weight and body fat percentage were obtained. Blood test data including lipid profile, blood glucose and HbA1c data were also obtained. The area under the curve was calculated using ROC analysis to obtain the body fat percentage associated with risk of disease. Results The cut-off points for total fat for those aged < 40 were 34.0 kg, and for those aged ≥40 were 30.7 kg and 35.6 kg in men and women, respectively. The cut-off for body fat percent for those aged < 40 were 35.1 and 45.1%, and for those aged ≥40 were 34.8 and 46.3% in men and women, respectively. The cut-off points for trunk fat percent for those aged < 40 were 19.5 and 22.4%, and for those aged ≥40 were 21.6 and 23.4% in men and women, respectively. The cut-off points for visceral fat percent for those aged < 40 were 1.4 and 1.0%, and for those aged ≥40 were 1.9 and 1.4% in men and women, respectively. Conclusion This study established Qatari adult-specific cut-off values of body fat for different age and gender groups.
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Affiliation(s)
- H Bawadi
- Department of Human Nutrition, College of Health Sciences, QU Health, Qatar University, Doha, 2713, Qatar.
| | - S Hassan
- Department of Human Nutrition, College of Health Sciences, QU Health, Qatar University, Doha, 2713, Qatar
| | - A Shanbeh Zadeh
- Department of Human Nutrition, College of Health Sciences, QU Health, Qatar University, Doha, 2713, Qatar
| | - H Sarv
- Department of Human Nutrition, College of Health Sciences, QU Health, Qatar University, Doha, 2713, Qatar
| | - A Kerkadi
- Department of Human Nutrition, College of Health Sciences, QU Health, Qatar University, Doha, 2713, Qatar
| | - Josep A Tur
- Research Group on Community Nutrition & Oxidative Stress, University of the Balearic Islands & CIBEROBN, 07122, Palma de Mallorca, Spain
| | - Z Shi
- Department of Human Nutrition, College of Health Sciences, QU Health, Qatar University, Doha, 2713, Qatar
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Hassan S, Seung SJ, Clark RE, Gibbs JC, McArthur C, Mittmann N, Thabane L, Kendler D, Papaioannou A, Wark JD, Ashe MC, Adachi JD, Templeton JA, Giangregorio LM. Describing the resource utilisation and costs associated withvertebral fractures: the Build Better Bones with Exercise (B3E) Pilot Trial. Osteoporos Int 2020; 31:1115-1123. [PMID: 32219499 DOI: 10.1007/s00198-020-05387-z] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2019] [Accepted: 03/10/2020] [Indexed: 11/26/2022]
Abstract
UNLABELLED This analysis examined costs/resources of 141 women with vertebral fractures, randomised to a home exercise programme or control group. Total, mean costs and the incremental cost-effectiveness ratio (ICER) were calculated. Quality of life was collected. Cost drivers were caregiver time, medications and adverse events (AEs). Results show adding an exercise programme may reduce the risk of AEs. INTRODUCTION This exploratory economic analysis examined the health resource utilisation and costs experienced by women with vertebral fractures, and explored the effects of home exercise on those costs. METHODS Women ≥ 65 years with one or more X-ray-confirmed vertebral fractures were randomised 1:1 to a 12-month home exercise programme or equal attention control group. Clinical and health system resources were collected during monthly phone calls and daily diaries completed by participants. Intervention costs were included. Unit costs were applied to health system resources. Quality of life (QoL) information was collected via EQ-5D-5L at baseline, 6 and 12 months. RESULTS One hundred and forty-one women were randomised. Overall total costs (CAD 2018) were $664,923 (intervention) and $614,033 (control), respectively. The top three cost drivers were caregiver time ($250,269 and $240,811), medications ($151,000 and $122,145) and AEs ($58,807 and $71,981). The mean cost per intervention participant of $9365 ± $9988 was higher compared with the mean cost per control participant of $8772 ± $9718. The mean EQ-5D index score was higher for the intervention participants (0.81 ± 0.11) compared with that of controls (0.79 ± 0.13). The differences in quality-adjusted life year (QALY) (0.02) and mean cost ($593) were used to calculate the ICER of $29,650. CONCLUSIONS Women with osteoporosis with a previous fracture experience a number of resources and associated costs that impact their care and quality of life. Caregiver time, medications and AEs are the biggest cost drivers for this population. The next steps would be to expand this feasibility study with more participants, longer-term follow-up and more regional variability.
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Affiliation(s)
- S Hassan
- HOPE Research Centre, Sunnybrook Research Institute, Toronto, Ontario, M4N 3M5, Canada.
| | - S J Seung
- HOPE Research Centre, Sunnybrook Research Institute, Toronto, Ontario, M4N 3M5, Canada
| | - R E Clark
- University of Waterloo, Waterloo, Canada
| | - J C Gibbs
- McGill University, Montreal, Quebec, Canada
| | | | | | - L Thabane
- McMaster University, Hamilton, Canada
| | - D Kendler
- University of British Columbia, Vancouver, Canada
| | | | - J D Wark
- University of Melbourne, Melbourne, Australia
| | - M C Ashe
- University of British Columbia, Vancouver, Canada
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Abdi A, Bordbar MR, Hassan S, Rosendaal FR, van der Bom JG, Voorberg J, Fijnvandraat K, Gouw SC. Prevalence and Incidence of Non-neutralizing Antibodies in Congenital Hemophilia A- A Systematic Review and Meta-Analysis. Front Immunol 2020; 11:563. [PMID: 32457734 PMCID: PMC7221178 DOI: 10.3389/fimmu.2020.00563] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Accepted: 03/12/2020] [Indexed: 12/21/2022] Open
Abstract
Objectives: In hemophilia A the presence of non-neutralizing antibodies (NNAs) against Factor VIII (FVIII) may predict the development of neutralizing antibodies (inhibitors) and accelerate the clearance of administrated FVIII concentrates. This systematic review aimed to assess: (1) the prevalence and incidence of NNAs in patients with congenital hemophilia without inhibitors and (2) the association between NNAs and patient and treatment characteristics. Methods: We conducted a search in MEDLINE, Embase, Web of Science and the Cochrane database. We included cross-sectional and longitudinal studies reporting on NNAs in patients with hemophilia A and B, who were inhibitor-negative at the start of the observation period. Data were extracted on: hemophilia type and severity, patient and treatment characteristics, NNA prevalence and incidence, NNA assays and inhibitor development. Two independent reviewers performed study selection, data extraction and risk of bias assessment, using adapted criteria of the Joanna Briggs Institute. Studies were classified as high-quality when ≥5/9 criteria were met. NNA assays were classified as high-quality when both quality criteria were met: (1) use of positive controls and (2) competition with FVIII to establish FVIII-specificity. We reported NNA prevalence and incidence for each study. The pooled NNA prevalence was assessed for well-designed studies in previously treated patients, employing high-quality NNA assays. Results: We included data from 2,723 inhibitor-negative patients with hemophilia A, derived from 28 studies. Most studies were cross-sectional (19/28) and none reported on NNAs in hemophilia B. Study design was of high quality in 16/28 studies and the NNA assay quality was high in 9/28 studies. Various NNA assays were used, predominantly ELISA (18/28) with different cut-off values. We found a large variety in NNA prevalence (Range, 0–100%). The pooled NNA prevalence in high-quality studies was 25% (95% CI, 16–38%). The incidence of new NNA development was reported in one study (0.01 NNA per person-exposure day). Conclusion: This systematic review identified studies that were heterogeneous in study design, patient population and NNA assay type, with NNA prevalence ranging from 0 to 100% in inhibitor-negative patients with hemophilia A. The pooled NNA prevalence was 25% in high-quality studies including only previously treated patients and performing high-quality NNA assays.
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Affiliation(s)
- A Abdi
- Department of Pediatric Hematology, Amsterdam UMC, Emma Children's Hospital, University of Amsterdam, Amsterdam, Netherlands
| | - M R Bordbar
- Hematology Research Center, Nemazee Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
| | - S Hassan
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, Netherlands
| | - F R Rosendaal
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, Netherlands
| | - J G van der Bom
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, Netherlands.,Center for Clinical Transfusion Research, Sanquin Research, Leiden, Netherlands
| | - J Voorberg
- Department of Molecular Cellular Hemostasis, Sanquin Research and Landsteiner Laboratory, Amsterdam, Netherlands.,Department of Experimental Vascular Medicine, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, Netherlands
| | - K Fijnvandraat
- Department of Pediatric Hematology, Amsterdam UMC, Emma Children's Hospital, University of Amsterdam, Amsterdam, Netherlands.,Department of Molecular Cellular Hemostasis, Sanquin Research and Landsteiner Laboratory, Amsterdam, Netherlands
| | - S C Gouw
- Department of Pediatric Hematology, Amsterdam UMC, Emma Children's Hospital, University of Amsterdam, Amsterdam, Netherlands.,Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, Netherlands
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Hassan S, Trenado C, Rageh T, Schnitzler A, Groiss S. P4 Effect of conditioning and test stimulus intensity on cortical excitability by using triad-conditioning Transcranial Magnetic Stimulation. Clin Neurophysiol 2020. [DOI: 10.1016/j.clinph.2019.12.115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Dearnaley DP, Griffin C, Syndikus I, Khoo V, Birtle AJ, Choudhury A, Ferguson C, Graham J, O'Sullivan J, Panades M, Rimmer YL, Scrase CD, Staffurth J, Cruickshank C, Hassan S, Pugh J, Hall E. Eight-year outcomes of a phase III randomized trial of conventional versus hypofractionated high-dose intensity modulated radiotherapy for prostate cancer (CRUK/06/016): Update from the CHHiP Trial. J Clin Oncol 2020. [DOI: 10.1200/jco.2020.38.6_suppl.325] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
325 Background: CHHiP is a non-inferiority trial to determine efficacy and safety of hypofractionated radiotherapy for localised prostate cancer (PCa). Five year results indicated that moderate hypofractionation of 60 Gray (Gy)/20 fractions (f) was non-inferior to 74Gy/37f (Lancet Oncology, 2016). Moderate hypofractionation is now an international standard of care but with patients remaining at risk of recurrence for many years, information on long-term outcomes is important. Here we report pre-planned analysis of 8 year outcomes. Methods: Between October 2002 and June 2011, 3216 men with node negative T1b-T3a localised PCa with risk of seminal vesical involvement ≤30% were randomised (1:1:1 ratio) to 74Gy/37f (control), 60Gy/20f or 57Gy/19f. Androgen deprivation began at least 3 months prior to radiotherapy (RT) and continued until end of RT. The primary endpoint was time to biochemical failure (Phoenix consensus guidelines) or clinical failure (BCF). The non-inferiority design specified a critical hazard ratio (HR) of 1.208 for each hypofractionated schedule compared to 74Gy/37f. Late toxicity was assessed at 5 years by RTOG and LENT-SOM scales. Analysis was by intention-to-treat. Results: With a median follow up of 9.2 years, 8 year BCF-free rates (95% CI) were 74Gy: 80.6% (77.9%, 83.0%); 60Gy: 83.7% (81.2%, 85.9%) and 57Gy: 78.5% (75.8%, 81.0%). For 60Gy/20f, non-inferiority was confirmed: HR60=0.84 (90% CI 0.71, 0.99). For 57Gy/19f, non-inferiority could not be declared: HR57=1.17 (90% CI 1.00, 1.37). Clinician assessments of late toxicity were similar across groups. At 5 years, RTOG grade≥2 (G2+) bowel toxicity was observed in 14/879 (1.6%), 18/908 (2.0%) and 17/904 (1.9%) of the 74Gy, 60Gy and 57Gy groups respectively. RTOG G2+ bladder toxicity was observed in 17/879 (1.9%), 14/908 (1.5%) and 17/904 (1.9%) of the 74Gy, 60Gy and 57Gy groups respectively. Conclusions: With BCF rates over 80%, long-term follow-up confirms that 60Gy/20f is non-inferior to 74Gy/37f. Late side effects were very low across all groups. These results support the continued use of 60Gy/20f as standard of care for men with localised PCa. Clinical trial information: 97182923.
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Affiliation(s)
- David P. Dearnaley
- Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Clare Griffin
- The Institute of Cancer Research, London, United Kingdom
| | | | - Vincent Khoo
- Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | | | - Ananya Choudhury
- The Christie NHS Foundation Trust and University of Manchester, Manchester, United Kingdom
| | - Catherine Ferguson
- Sheffield Teaching Hospitals Foundation Trust, Sheffield, United Kingdom
| | - John Graham
- Musgrove Park Hospital, Taunton, United Kingdom
| | | | | | - Yvonne L. Rimmer
- Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
| | | | - John Staffurth
- Velindre Hospital, Cardiff University, Cardiff, United Kingdom
| | | | - Shama Hassan
- The Institute of Cancer Research, London, United Kingdom
| | - Julia Pugh
- The Institute of Cancer Research, London, United Kingdom
| | - Emma Hall
- The Institute of Cancer Research, London, United Kingdom
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Moorby J, Hassan S, McMillan A, Anwar MU, Muthayya P. A survey of current burns knowledge in UK undergraduate medical students. J Plast Reconstr Aesthet Surg 2020; 73:1174-1205. [PMID: 32008939 DOI: 10.1016/j.bjps.2020.01.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2020] [Accepted: 01/15/2020] [Indexed: 11/25/2022]
Affiliation(s)
- J Moorby
- Hull-York Medical School, John Hughlings Jackson Building, University Rd, Heslington, York YO10 5DD, United Kingdom.
| | - S Hassan
- Department of Plastic and Burns Surgery, Pinderfields General Hospital, Wakefield, United Kingdom
| | - A McMillan
- Hull-York Medical School, John Hughlings Jackson Building, University Rd, Heslington, York YO10 5DD, United Kingdom
| | - M U Anwar
- Department of Plastic and Burns Surgery, Pinderfields General Hospital, Wakefield, United Kingdom
| | - P Muthayya
- Department of Plastic and Burns Surgery, Pinderfields General Hospital, Wakefield, United Kingdom
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Ebisike PI, Habib SG, Hassan S, Suwaid MA, Hikima MS, Saleh MK, Jibo U, Yusuf L. Transorbital sonographic measurement of optic nerve sheath diameter among HIV-Positive patients in Northwestern Nigeria. Niger J Clin Pract 2020; 22:1570-1575. [PMID: 31719279 DOI: 10.4103/njcp.njcp_622_18] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background Human immunodeficiency virus (HIV) is a pandemic disease affecting all regions across the globe and Nigeria having the second highest prevalence worldwide. Highly active antiretroviral therapy (HAART) has profound negative effect on the optic nerve even though (HAART) has improved the health status of the affected individuals and overall reduction in mortality. Imaging modality especially ultrasound has a great role in the assessment of the optic nerve because of its availability, affordability, and easy operability with reliable sensitivity. Subjects and Methods This cross-sectional study was conducted at the Department of Radiology and Ophthalmology, AKTH, Kano, from October 2017 to June 2018. A total of 143 consenting HIV-positive adults age 18-60 years on HAART were recruited. Optic nerve sheath diameter (ONSD) of each eye was measured using 11-14 MHz linear transducer. Ethical approval was obtained from the ethic and research committee of the hospital. Results The mean ONSD value of the right eye was 3.49 mm ± 1.04 standard deviation (SD) and 3.55 mm ± 1.11 SD for the left eye. The optic nerve diameter was found to be larger on the left eye and increased slightly with age (P < 0.05). There was nonsignificantly higher values of ONSD among female (3.59 mm ± 1.12 SD) when compared with males (3.332 mm ± 0.878) with P value >0.005. Conclusion ONSD values among HIV-positive patients are significantly higher in the left eye and among female subjects. Also, patients with HIV on HAART have thicker optic nerves when compared with general population in Kano, Nigeria.
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Affiliation(s)
- P I Ebisike
- Department of Ophthalmology, Bayero University/Aminu Kano Teaching Hospital, Kano, Nigeria
| | - S G Habib
- Department of Ophthalmology, Bayero University/Aminu Kano Teaching Hospital, Kano, Nigeria
| | - S Hassan
- Department of Ophthalmology, Bayero University/Aminu Kano Teaching Hospital, Kano, Nigeria
| | - M A Suwaid
- Department of Radiology, Bayero University/Aminu Kano Teaching Hospital, Kano, Nigeria
| | - M S Hikima
- Department of Radiology, Bayero University/Aminu Kano Teaching Hospital, Kano, Nigeria
| | - M K Saleh
- Department of Radiology, Bayero University/Aminu Kano Teaching Hospital, Kano, Nigeria
| | - U Jibo
- Department of Radiology, Bayero University/Aminu Kano Teaching Hospital, Kano, Nigeria
| | - L Yusuf
- Department of Radiology, Bayero University/Aminu Kano Teaching Hospital, Kano, Nigeria
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McMillan A, Hassan S, Moorby J, Anwar MU, Muthayya P. The public's perception of firework safety and proposed use of graphic warning images on packaging. J Plast Reconstr Aesthet Surg 2019; 73:608-620. [PMID: 31883692 DOI: 10.1016/j.bjps.2019.11.061] [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] [Received: 11/12/2019] [Accepted: 11/22/2019] [Indexed: 11/26/2022]
Affiliation(s)
- A McMillan
- Hull York Medical School, John Hughlings Jackson Building, University Rd, Heslington, York YO10 5DD, United Kingdom; Department of Plastic and Burns Surgery, Pinderfields General Hospital, Wakefield, United Kingdom.
| | - S Hassan
- Department of Plastic and Burns Surgery, Pinderfields General Hospital, Wakefield, United Kingdom
| | - J Moorby
- Hull York Medical School, John Hughlings Jackson Building, University Rd, Heslington, York YO10 5DD, United Kingdom
| | - M U Anwar
- Department of Plastic and Burns Surgery, Pinderfields General Hospital, Wakefield, United Kingdom
| | - P Muthayya
- Department of Plastic and Burns Surgery, Pinderfields General Hospital, Wakefield, United Kingdom
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Kentab A, Hassan S, Hassan H. Clinical characteristics and etiology of corpus callosum abnormalities: A single centre experience in Saudi Arabia. J Neurol Sci 2019. [DOI: 10.1016/j.jns.2019.10.1676] [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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Somorin T, Fidalgo B, Hassan S, Sowale A, Kolios A, Parker A, Williams L, Collins M, McAdam EJ, Tyrrel S. Non-isothermal drying kinetics of human feces. Dry Technol 2019; 38:1819-1827. [PMID: 33767602 PMCID: PMC7932498 DOI: 10.1080/07373937.2019.1670205] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Revised: 09/16/2019] [Accepted: 09/16/2019] [Indexed: 05/24/2023]
Abstract
The non-isothermal drying behavior and kinetics of human feces (HF) were investigated by means of thermogravimetric analysis to provide data for designing a drying unit operation. The effect of heating rate and blending with woody biomass were also evaluated on drying pattern and kinetics. At low heating rate (1 K/min), there is effective transport of moisture, but a higher heating rate would be necessary at low moisture levels to reduce drying time. Blending with wood biomass improves drying characteristics of HF. The results presented in this study are relevant for designing non-sewered sanitary systems with in-situ thermal treatment.
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Affiliation(s)
- T. Somorin
- Department of Chemical & Process Engineering, University of Strathclyde, Glasgow, UK
| | - B. Fidalgo
- School of Water, Energy and Environment, Cranfield University, Cranfield, UK
| | - S. Hassan
- School of Water, Energy and Environment, Cranfield University, Cranfield, UK
| | - A. Sowale
- School of Water, Energy and Environment, Cranfield University, Cranfield, UK
| | - A. Kolios
- Naval Architecture, Ocean & Marine Engineering, University of Strathclyde, Glasgow, UK
| | - A. Parker
- School of Water, Energy and Environment, Cranfield University, Cranfield, UK
| | - L. Williams
- School of Water, Energy and Environment, Cranfield University, Cranfield, UK
| | - M. Collins
- School of Water, Energy and Environment, Cranfield University, Cranfield, UK
| | - E. J. McAdam
- School of Water, Energy and Environment, Cranfield University, Cranfield, UK
| | - S. Tyrrel
- School of Water, Energy and Environment, Cranfield University, Cranfield, UK
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Mah M, Slawinski M, Cripe L, Camino E, Al-Zaidy S, Hassan S, Jackson J, Lowes L, Iammarino M, Miller N, Alfano L, Lehman K, Mendell J, Hor K. DMD CLINICAL. Neuromuscul Disord 2019. [DOI: 10.1016/j.nmd.2019.06.372] [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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Jackson J, Leslie C, Cotto J, Korth C, Mah M, Hor K, Cripe L, Camino E, Al-Zaidy S, Hassan S, Vannatta K, Lowes L, Iammarino M, Miller N, Alfano L, Lehman K, Mendell J. DMD BRAIN. Neuromuscul Disord 2019. [DOI: 10.1016/j.nmd.2019.06.392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Naismith O, Mayles H, Bidmead M, Clark CH, Gulliford S, Hassan S, Khoo V, Roberts K, South C, Hall E, Dearnaley D. Radiotherapy Quality Assurance for the CHHiP Trial: Conventional Versus Hypofractionated High-Dose Intensity-Modulated Radiotherapy in Prostate Cancer. Clin Oncol (R Coll Radiol) 2019; 31:611-620. [PMID: 31201110 DOI: 10.1016/j.clon.2019.05.009] [Citation(s) in RCA: 8] [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: 01/24/2019] [Revised: 04/01/2019] [Accepted: 04/12/2019] [Indexed: 10/26/2022]
Abstract
AIMS The CHHiP trial investigated the use of moderate hypofractionation for the treatment of localised prostate cancer using intensity-modulated radiotherapy (IMRT). A radiotherapy quality assurance programme was developed to assess compliance with treatment protocol and to audit treatment planning and dosimetry of IMRT. This paper considers the outcome and effectiveness of the programme. MATERIALS AND METHODS Quality assurance exercises included a pre-trial process document and planning benchmark cases, prospective case reviews and a dosimetry site visit on-trial and a post-trial feedback questionnaire. RESULTS In total, 41 centres completed the quality assurance programme (37 UK, four international) between 2005 and 2010. Centres used either forward-planned (field-in-field single phase) or inverse-planned IMRT (25 versus 17). For pre-trial quality assurance exercises, 7/41 (17%) centres had minor deviations in their radiotherapy processes; 45/82 (55%) benchmark plans had minor variations and 17/82 (21%) had major variations. One hundred prospective case reviews were completed for 38 centres. Seventy-one per cent required changes to clinical outlining pre-treatment (primarily prostate apex and base, seminal vesicles and penile bulb). Errors in treatment planning were reduced relative to pre-trial quality assurance results (49% minor and 6% major variations). Dosimetry audits were conducted for 32 centres. Ion chamber dose point measurements were within ±2.5% in the planning target volume and ±8% in the rectum. 28/36 films for combined fields passed gamma criterion 3%/3 mm and 11/15 of IMRT fluence film sets passed gamma criterion 4%/4 mm using a 98% tolerance. Post-trial feedback showed that trial participation was beneficial in evolving clinical practice and that the quality assurance programme helped some centres to implement and audit prostate IMRT. CONCLUSION Overall, quality assurance results were satisfactory and the CHHiP quality assurance programme contributed to the success of the trial by auditing radiotherapy treatment planning and protocol compliance. Quality assurance supported the introduction of IMRT in UK centres, giving additional confidence and external review of IMRT where it was a newly adopted technique.
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Affiliation(s)
- O Naismith
- Royal Marsden NHS Foundation Trust, London, UK.
| | - H Mayles
- Clatterbridge Cancer Centre, Bebington, Wirral, UK
| | - M Bidmead
- Royal Marsden NHS Foundation Trust, London, UK
| | - C H Clark
- Royal Surrey County Hospital, Guildford, UK
| | - S Gulliford
- The Institute of Cancer Research, London, UK
| | - S Hassan
- The Institute of Cancer Research, London, UK
| | - V Khoo
- Royal Marsden NHS Foundation Trust, London, UK; The Institute of Cancer Research, London, UK
| | - K Roberts
- Royal Marsden NHS Foundation Trust, London, UK
| | - C South
- Royal Surrey County Hospital, Guildford, UK
| | - E Hall
- The Institute of Cancer Research, London, UK
| | - D Dearnaley
- Royal Marsden NHS Foundation Trust, London, UK; The Institute of Cancer Research, London, UK
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Hassan S, D L, Jacob L, Babu S, Kn L, Ah R, Lk R, Saldanha S, Thottian A. Socioeconomic and Administrative Factors Associated with Healthcare Delay and Treatment of Esophageal and Gastric Carcinoma: Experience at a Tertiary Care Centre in a Developing Country. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz155.276] [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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Phillips E, Wilson W, Benjamin R, Popat R, Braganza N, Clifton-Hadley L, Bygrave C, Cavenagh J, Chapman M, Owen R, Ramasamy K, Sive J, Streetly M, Nador G, Arnott S, Hassan S, Kishore B, Moore S, Virchis A, Willis F, Yong K. PF599 EFFICACY OF BORTEZOMIB, THALIDOMIDE AND DEXAMETHASONE FOR TREATMENT OF PATIENTS WITH CARFILZOMIB-REFRACTORY MYELOMA IN THE UK NCRI CARDAMON TRIAL. Hemasphere 2019. [DOI: 10.1097/01.hs9.0000560684.31002.b1] [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] Open
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Hassan S, Skilton RA, Pelle R, Odongo D, Bishop RP, Ahmed J, Seitzer U, Bakheit M, Hassan SM, El Hussein AM. Assessment of the prevalence of Theileria lestoquardi in sheep from the Sudan using serological and molecular methods. Prev Vet Med 2019; 169:104697. [PMID: 31311638 DOI: 10.1016/j.prevetmed.2019.104697] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Revised: 05/03/2019] [Accepted: 05/21/2019] [Indexed: 10/26/2022]
Abstract
Malignant theileriosis of sheep and goats caused by Theileria lestoquardi is considered to be among the most important tick borne diseases in the Sudan. Information on the prevalence of the disease in different parts of the Sudan is limited. The purpose of this study was to estimate the prevalence of the disease in five states of the Sudan using molecular and serological assays. A total of 393 blood and serum samples from clinically asymptomatic sheep were analysed using nested reverse line blot (nRLB) and loop mediated isothermal amplification (LAMP), as well as an enzyme-linked immunosorbent assay (ELISA). The results indicated a sero-prevalence of 33.8% while RLB and LAMP assays revealed molecular prevalences of 29.5 and 22.6% respectively. The prevalence of Theileria lestoquardi varied significantly according to the geographical origin of the infected animals, whereas age and gender did not have a significant effect. RLB data indicated that T. lestoquardi usually occurred as a co-infection with the non-pathogenic Theileria ovis. Using RLB as a gold standard, a sensitivity of 68.1% and a specificity of 96.4% were recorded for LAMP and a sensitivity of 75.9% and a specificity of 83.8% for ELISA. The Kappa coefficient between nRLB and LAMP indicated a significant level of agreement (0.692), but only moderate concordance (0.572) between nRLB and ELISA. The results of the present study confirm and extend earlier findings regarding the widespread of T. lestoquardi infections in sheep in the Sudan. The data provide evidence that should enable the veterinary authorities to deploy appropriate control measures.
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Affiliation(s)
- S Hassan
- Central Veterinary Research Laboratory, Khartoum, Sudan.
| | - R A Skilton
- Biosciences eastern and central Africa - International Livestock Research Institute Hub (BecA-ILRI Hub), Kenya
| | - R Pelle
- Biosciences eastern and central Africa - International Livestock Research Institute Hub (BecA-ILRI Hub), Kenya
| | - D Odongo
- School of Biological Sciences, University of Nairobi, Kenya
| | - R P Bishop
- Department of Veterinary Microbiology and Pathology, Washington State University, Pullman, WA, USA
| | - J Ahmed
- Institute for Parasitology and Tropical Veterinary Medicine, Freie Universität, Berlin, Germany
| | - U Seitzer
- Division of Veterinary Infection Biology and Immunology, Research Center Borstel, Germany
| | - M Bakheit
- Faculty of Veterinary Medicine, University of Khartoum, Sudan
| | - S M Hassan
- Faculty of Veterinary Medicine, University of Khartoum, Sudan
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Abstract
Background With recent advances in the treatment of non-small-cell lung cancer (nsclc) and current fiscal constraints within publicly funded health care systems, understanding the real-world economic effect of lung cancer management has become important. The objective of the present study was to determine the costs and resources used in the management of nsclc cohorts in Ontario. Methods Patients diagnosed between 1 April 2010 and 31 March 2015 were identified in the Ontario Cancer Registry and linked to provincial administrative databases, capturing resources such as hospitalizations, cancer clinic visits, physician services, and systemic therapies or radiotherapy. A cost-of-illness analysis using a bottom-up approach and the GETCOST macro available at ices determined the overall total and mean costs in 2017 Canadian dollars. Resource utilization results were analyzed according to the total number of encounters per resource, the number of patients using each resource, and the number of encounters per patient. A separate cost-and-resource analysis was conducted for radiotherapy. Results The 24,729 nsclc patients identified included 4542 with stage iii unresectable disease and 10,103 with stage iv nonsquamous disease. The overall total cost for all nsclc patients was $1.9 billion, with inpatient hospitalizations ($635.2 million), cancer clinic visits ($323.7 million), and physician services ($301.4 million) being the top cost contributors. The mean cost per patient was $76,816. The total cost of radiotherapy was $38.5 million. Conclusions Real-world costs for the management of nsclc during the 5-year period examined were substantial, despite the fact that median survival was poor and treatment information was limited.
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Affiliation(s)
- S J Seung
- hope Research Centre, Sunnybrook Research Institute, Toronto, ON
| | - M Hurry
- AstraZeneca Canada, Mississauga, ON
| | - S Hassan
- hope Research Centre, Sunnybrook Research Institute, Toronto, ON
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Beniey M, Marois F, Haque T, Hassan S. Abstract P3-10-11: Clinical implications of 63-gene signature associated with response to PARP inhibition in triple-negative and luminal B breast cancer. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p3-10-11] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Two recent randomized phase 3 trials have demonstrated that treatment with PARP inhibitors results in an improvement in progression-free survival (PFS) in metastatic, BRCA-mutant, HER2-negative breast cancer patients. We have previously identified a pathway-enriched 63-gene expression signature predictive of response to olaparib in seven patient-derived xenograft breast tumors, with a high overall accuracy of 86%. We found that the prevalence of our gene signature was 45% in a cohort of triple-negative breast cancer (TNBC) patients. We wanted to better understand if there were correlations between our 63-gene signature and other known prognostic markers and to determine the prognostic significance of our mutational gene signature in different PAM50 breast cancer subtypes.
Methods: We used a publicly available dataset from the NCI GDC Data Portal of TNBC patients (n = 82) to undertake clinico-pathological correlations with our 63-gene expression signature. We correlated the presence or absence of the signature with age, tumor size, lymph node status, and stage using chi2 analysis, in addition to overall survival (OS) and PFS with STATA SE. We also correlated our gene signature with known TNBC subtypes from TNBCtype. Using the METABRIC cohort (n = 2509), we looked at the mutational frequency of our gene set in cBioPortal in different breast cancer subtypes and determined the prognostic value in each subtype.
Results: We did not find any statistically significant correlations between the 63-gene expression signature and age, tumor size, lymph node status, or stage amongst the 82 TNBC patients. All TNBC subtypes including 2 basal-like, immunomodulatory, low androgen receptor, 2 mesenchymal-based, and unspecified were identified in both gene-signature predicted sensitive and resistant groups, but there were no statistically significant differences between groups. The median follow-up of the TNBC cohort was 24 months, and no statistically significant associations were identified with OS or PFS. In the METABRIC cohort, the mutational frequency of any of the 63 genes for the following subgroups was identified: basal (n = 209), 85.2%; HER2+ (n = 224), 68.8%; claudin-low (n = 218), 48.2%; luminal B (n=475), 25.1%; and luminal A (n=700), 12.7%. The median follow-up of the METABRIC cohort was 127 months. We found that patients with a mutation in any of the 63 genes demonstrated a poorer overall survival, 122.8 months, in comparison to patients without any mutation, 164.6 months (P = 0.0002). In particular, luminal B patients with a mutation in any of these genes demonstrated a poorer overall survival, 90.0 months, in comparison to patients without a mutation, 132.1 months (P = 0.009). No statistically significant difference in overall survival was observed for patients with or without any mutation amongst the luminal A subtype (P = 0.26).
Conclusion: We found that patients with a mutation from our 63-gene set demonstrated a worse prognosis in comparison to patients without a mutation amongst the luminal B subtype. This is suggestive that there may be a role for our 63-gene signature to select patients amongst the luminal B subtype who may benefit from PARP inhibition.
Citation Format: Beniey M, Marois F, Haque T, Hassan S. Clinical implications of 63-gene signature associated with response to PARP inhibition in triple-negative and luminal B breast cancer [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P3-10-11.
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Affiliation(s)
- M Beniey
- Division of Surgical Oncology, Montreal, QC, Canada; Centre de Recherche du Centre Hospitalier de l'Université de Montréal, Montreal, QC, Canada; Université de Montréal, Montreal, QC, Canada
| | - F Marois
- Division of Surgical Oncology, Montreal, QC, Canada; Centre de Recherche du Centre Hospitalier de l'Université de Montréal, Montreal, QC, Canada; Université de Montréal, Montreal, QC, Canada
| | - T Haque
- Division of Surgical Oncology, Montreal, QC, Canada; Centre de Recherche du Centre Hospitalier de l'Université de Montréal, Montreal, QC, Canada; Université de Montréal, Montreal, QC, Canada
| | - S Hassan
- Division of Surgical Oncology, Montreal, QC, Canada; Centre de Recherche du Centre Hospitalier de l'Université de Montréal, Montreal, QC, Canada; Université de Montréal, Montreal, QC, Canada
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Hassan S, Shafafy R, Mohan A, Magnussen P. Solitary ulnar shortening osteotomy for malunion of distal radius fractures: experience of a centre in the UK and review of the literature. Ann R Coll Surg Engl 2019; 101:203-207. [PMID: 30698462 DOI: 10.1308/rcsann.2018.0211] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION Isolated ulnar shortening osteotomies can be used to treat ulnocarpal abutment secondary to radial shortening following distal radius fractures. Given the increase of fragility distal radius fractures awareness of treating the sequelae of distal radius fractures is important. We present the largest reported case series in the UK of ulnar shortening osteotomies for this indication. MATERIALS AND METHODS Twenty patients with previous distal radial fractures were included, who presented with wrist pain and radiologically evident positive ulnar variance secondary to malunion of the distal radius with no significant intercalated instability. Patients were treated with a short oblique ulnar shortening osteotomy, using a Stanley jig and small AO compression plate system. Pre- and postoperative radiographical measurements of inclination, dorsal/volar angulation and ulnar variance were made. Patients were scored pre- and postoperatively using the Quick Disabilities of the Arm, Shoulder and Hand (QuickDASH) and Patient-Rated Wrist Evaluation scores by two orthopaedic surgeons. Mean follow-up was 24 months after surgery. RESULTS Radiographical analysis revealed a change in the ulnar variance with an average reduction of 5.74 mm. Mean preoperative scores were 61.1 (range 25-95.5) for QuickDASH and 70.4 (range 33-92) for Patient-Rated Wrist Evaluation. At the latest follow-up, mean postoperative QuickDASH scores were 10.6 (range 0-43.2) and 17.2 (range 0-44) for Patient-Rated Wrist Evaluation. Differences in scores after surgery for both QuickDASH and Patient-Rated Wrist Evaluation were statistically significant (P < 0.01). CONCLUSIONS The ulnar shortening osteotomy is a relatively simple procedure compared with corrective radial osteotomy, with a lower complication profile. In our series, patients showed significant improvement in pain and function by correcting the ulnar variance thus preventing ulna-carpal impaction.
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Affiliation(s)
- S Hassan
- Epsom and Saint Helier University Hospitals NHS Trust, Carshalton , Surry , UK
| | - R Shafafy
- Royal Surrey County Hospital NHS Foundation Trust, Guildford , Surrey , UK
| | - A Mohan
- Croydon University Hospital, Thornton Heath , Surrey , UK
| | - P Magnussen
- Royal Surrey County Hospital NHS Foundation Trust, Guildford , Surrey , UK
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