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Adams ST, Scott M, West C, Walsh CJ. Separating the components of an abdominal wall fellowship. Ann R Coll Surg Engl 2024; 106:2-8. [PMID: 36374299 PMCID: PMC10757876 DOI: 10.1308/rcsann.2022.0058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/19/2022] [Indexed: 01/02/2024] Open
Abstract
Complex abdominal wall reconstruction is an emerging subspecialty yet, despite the abundance of abdominal wall hernias requiring treatment and the increasing complexity of this type of surgery, there are few opportunities for surgeons to gain subspecialist training in this field. In this paper we discuss the need for focused training in complex abdominal wall reconstruction, outline some of the problems that may be hindering the availability of such opportunities and propose potential solutions to these issues.
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Affiliation(s)
- ST Adams
- St Helens and Knowsley Teaching Hospitals NHS Trust, UK
- Wirral University Teaching Hospitals (WUTH) NHS Foundation Trust, UK
| | - M Scott
- St Helens and Knowsley Teaching Hospitals NHS Trust, UK
| | - C West
- St Helens and Knowsley Teaching Hospitals NHS Trust, UK
| | - CJ Walsh
- Wirral University Teaching Hospitals (WUTH) NHS Foundation Trust, UK
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Adams ST, Bedwani NH, Massey LH, Bhargava A, Byrne C, Jensen KK, Smart NJ, Walsh CJ. Physical activity recommendations pre and post abdominal wall reconstruction: a scoping review of the evidence. Hernia 2022; 26:701-714. [PMID: 35024980 DOI: 10.1007/s10029-022-02562-5] [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: 10/24/2021] [Accepted: 12/31/2021] [Indexed: 11/27/2022]
Abstract
PURPOSE There are no universally agreed guidelines regarding which types of physical activity are safe and/or recommended in the perioperative period for patients undergoing ventral hernia repair or abdominal wall reconstruction (AWR). This study is intended to identify and summarise the literature on this topic. METHODS Database searches of PubMed, CINAHL, Allied & Complementary medicine database, PEDro and Web of Science were performed followed by a snowballing search using two papers identified by the database search and four hand-selected papers of the authors' choosing. Inclusion-cohort studies, randomized controlled trials, prospective or retrospective. Studies concerning complex incisional hernia repairs and AWRs including a "prehabilitation" and/or "rehabilitation" program targeting the abdominal wall muscles in which the interventions were of a physical exercise nature. RoB2 and Robins-I were used to assess risk of bias. Prospero CRD42021236745. No external funding. Data from the included studies were extracted using a table based on the Cochrane Consumers and Communication Review Group's data extraction template. RESULTS The database search yielded 5423 records. After screening two titles were selected for inclusion in our study. The snowballing search identified 49 records. After screening one title was selected for inclusion in our study. Three total papers were included-two randomised studies and one cohort study (combined 423 patients). All three studies subjected their patients to varying types of physical activity preoperatively, one study also prescribed these activities postoperatively. The outcomes differed between the studies therefore meta-analysis was impossible-two studies measured hernia recurrence, one measured peak torque. All three studies showed improved outcomes in their study groups compared to controls however significant methodological flaws and confounding factors existed in all three studies. No adverse events were reported. CONCLUSIONS The literature supporting the advice given to patients regarding recommended physical activity levels in the perioperative period for AWR patients is sparse. Further research is urgently required on this subject.
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Affiliation(s)
- S T Adams
- Department of General Surgery, Wirral University Teaching Hospitals NHS Foundation Trust, Arrowe Park Hospital, Arrowe Park Rd, Upton, CH49 5PE, Wirral, UK.
- Department of General Surgery, St Helen's and Knowsley Teaching Hospitals NHS Trust, Rainhill, Prescot, UK.
- Department of Plastic Surgery, St Helen's and Knowsley Teaching Hospitals NHS Trust, Rainhill, Prescot, UK.
| | - N H Bedwani
- Department of General Surgery, North Middlesex University Hospital NHS Trust, London, UK
| | - L H Massey
- Royal Devon and Exeter NHS Foundation Trust, Exeter, UK
| | - A Bhargava
- Barking, Havering and Redbridge University Hospitals NHS Trust, Romford, UK
| | - C Byrne
- College of Life and Environmental Sciences, Sport and Health Sciences, University of Exeter, Exeter, UK
| | - K K Jensen
- Digestive Disease Center, Bispebjerg University Hospital, Copenhagen, Denmark
| | - N J Smart
- Royal Devon and Exeter NHS Foundation Trust, Exeter, UK
| | - C J Walsh
- Department of General Surgery, Wirral University Teaching Hospitals NHS Foundation Trust, Arrowe Park Hospital, Arrowe Park Rd, Upton, CH49 5PE, Wirral, UK
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Adams ST, Harington M. Subspecialist abdominal wall reconstruction services in Canada. Can J Surg 2022; 65:E264-E265. [PMID: 35396268 PMCID: PMC9259462 DOI: 10.1503/cjs.009621] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/25/2021] [Indexed: 12/02/2022] Open
Abstract
Recent years have seen considerable increases in both the demand for, and complexity of, ventral hernia repairs. This has led to calls for abdominal wall surgery to become a recognized subspecialty in the United States and Europe, with some centres responding by forming specialized, multidisciplinary teams for abdominal wall reconstruction. At present, however, no Canadian city has followed suit. In this article, we outline the major arguments underlying the drive toward the centralization of complex abdominal wall services.
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Affiliation(s)
- Simon T Adams
- From the Department of Plastic Surgery, St. Helen's & Knowsley Teaching Hospitals NHS Trust, Prescot, Merseyside, England (Adams); the Department of General Surgery, Wirral University Teaching Hospitals NHS Foundation Trust, Upton, Merseyside, England (Adams); the Department of General Surgery, St. Helen's & Knowsley Teaching Hospitals NHS Trust, Prescot, Merseyside, England (Adams); the Department of General Surgery, University of Saskatchewan, Saskatoon, Sask. (Harington)
| | - Michael Harington
- From the Department of Plastic Surgery, St. Helen's & Knowsley Teaching Hospitals NHS Trust, Prescot, Merseyside, England (Adams); the Department of General Surgery, Wirral University Teaching Hospitals NHS Foundation Trust, Upton, Merseyside, England (Adams); the Department of General Surgery, St. Helen's & Knowsley Teaching Hospitals NHS Trust, Prescot, Merseyside, England (Adams); the Department of General Surgery, University of Saskatchewan, Saskatoon, Sask. (Harington)
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Adams ST, Slade D, Shuttleworth P, West C, Scott M, Benson A, Tokala A, Walsh CJ. Reading a preoperative CT scan to guide complex abdominal wall reconstructive surgery. Hernia 2022; 27:265-272. [PMID: 34988686 DOI: 10.1007/s10029-021-02548-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Accepted: 12/19/2021] [Indexed: 11/30/2022]
Abstract
Computed tomography (CT) scanning is the imaging modality of choice when planning the overall management and operative approach to complex abdominal wall hernias. Despite its availability and well-recognised benefits there are no guidelines or recommendations regarding how best to read or report such scans for this application. In this paper we aim to outline an approach to interpreting preoperative CT scans in abdominal wall reconstruction (AWR). This approach breaks up the interpretive process into 4 steps-concentrating on the hernia or hernias, any complicating features of the hernia(s), the surrounding soft tissues and the abdominopelvic cavity as a whole-and was developed as a distillation of the authors' collective experience. We describe the key features that should be looked for at each of the four steps and the rationale for their inclusion.
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Affiliation(s)
- S T Adams
- Department of Plastic Surgery, St Helen's and Knowsley Teaching Hospitals NHS Trust, Prescot, Merseyside, UK. .,Department of General Surgery, Wirral University Teaching Hospitals NHS Foundation Trust, Arrowe Park Hospital, Arrowe Park Rd, Upton, Wirral, CH49 5PE, UK. .,Department of General Surgery, St Helen's and Knowsley Teaching Hospitals NHS Trust, Prescot, Merseyside, UK.
| | - D Slade
- Department of Surgery, Salford Royal NHS Foundation Trust, Salford, Lancashire, UK
| | - P Shuttleworth
- Department of General Surgery, Wirral University Teaching Hospitals NHS Foundation Trust, Arrowe Park Hospital, Arrowe Park Rd, Upton, Wirral, CH49 5PE, UK
| | - C West
- Department of Plastic Surgery, St Helen's and Knowsley Teaching Hospitals NHS Trust, Prescot, Merseyside, UK
| | - M Scott
- Department of General Surgery, St Helen's and Knowsley Teaching Hospitals NHS Trust, Prescot, Merseyside, UK
| | - A Benson
- Department of Plastic Surgery, St Helen's and Knowsley Teaching Hospitals NHS Trust, Prescot, Merseyside, UK
| | - A Tokala
- Department of Radiology, Salford Royal NHS Foundation Trust, Salford, Lancashire, UK
| | - C J Walsh
- Department of General Surgery, Wirral University Teaching Hospitals NHS Foundation Trust, Arrowe Park Hospital, Arrowe Park Rd, Upton, Wirral, CH49 5PE, UK
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Adams ST, West C, Walsh CJ. The Role of Indocyanine Green Fluorescence Angiography in Complex Abdominal Wall Reconstruction: A Scoping Review of the Literature. J Plast Reconstr Aesthet Surg 2021; 75:674-682. [PMID: 34753685 DOI: 10.1016/j.bjps.2021.08.048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Revised: 06/24/2021] [Accepted: 08/26/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND Indocyanine green fluorescence angiography (ICGFA) is a technique for assessing vascularity and perfusion which has multiple proven applications across a variety of surgical procedures. Studies have been performed assessing its potential role in evaluating skin flap viability in complex abdominal wall reconstruction (CAWR) in order to avoid postoperative surgical site occurrences (SSO). OBJECTIVES This scoping review was intended to summarise the literature concerning ICGFA in CAWR in order to facilitate future evidence-based guidelines for its use. ELIGIBILITY CRITERIA Inclusion - cohort studies, randomised controlled trials, case series, case reports and ventral midline hernias only. Exclusion - patients aged under 18 years and non-human test subjects. SOURCES OF EVIDENCE PubMed, MEDLINE®, Cochrane, Embase and OpenGrey RESULTS: A total of 3416 unique titles were yielded from our search of which 9 met our inclusion criteria: 3 case reports, 1 retrospective case series, 1 prospective case series, 3 non-blinded, non-randomised retrospective case-controlled studies and 1 prospective, double-blinded randomised controlled study. The included studies varied considerably in size and method however the consensus appeared to support ICGFA as being a safe and feasible means of assessing tissue flap vascularity in CAWR. The studies returned contrasting results regarding the impact of ICGFA in predicting and avoiding SSOs however there were insufficient numbers of studies for a meta-analysis. CONCLUSIONS We identify three case reports and four lower quality studies suggesting a possible application for ICGFA in CAWR and two higher quality studies showing no overall benefit. Evidence-based guidelines on the role of ICGFA in CAWR will require the assessment of further studies.
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Affiliation(s)
- Simon T Adams
- Department of Plastic Surgery, St Helen's & Knowsley Teaching Hospitals NHS Trust; Department of General Surgery, Wirral University Teaching Hospitals (WUTH) NHS Foundation Trust.
| | - Christian West
- Department of Plastic Surgery, St Helen's & Knowsley Teaching Hospitals NHS Trust
| | - Ciaran J Walsh
- Department of General Surgery, Wirral University Teaching Hospitals (WUTH) NHS Foundation Trust
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Adams ST, Ginther DN, Neuls ED, Hayes P. Author response. Can J Surg 2017; 60:E6-E7. [PMID: 29173264 DOI: 10.1503/cjs.1760063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Affiliation(s)
- Simon T Adams
- From the University of Saskatchewan, Saskatoon, Sask
| | | | - Evan D Neuls
- From the University of Saskatchewan, Saskatoon, Sask
| | - Paul Hayes
- From the University of Saskatchewan, Saskatoon, Sask
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Banks J, Adams ST, Laughlan K, Allgar V, Miller GV, Jayagopal V, Gale R, Sedman P, Leveson SH. Roux-en-Y gastric bypass could slow progression of retinopathy in type 2 diabetes: a pilot study. Obes Surg 2015; 25:777-81. [PMID: 25416083 DOI: 10.1007/s11695-014-1476-7] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
BACKGROUND Type 2 diabetes mellitus (T2DM) is a well-recognised complication of obesity. One of the microvascular complications of T2DM is diabetic retinopathy (DR). Bariatric surgery has been shown to effectively treat obesity and can induce remission of T2DM. It is not known what effect this improvement may have on pre-existing DR. We aimed to investigate this. METHOD A dual-centre, observer-blinded, case-control study investigated the progression of DR in patients who received Roux-en-Y gastric bypass (treatment group (TG)), compared with controls who received medical therapy (control group (CG)) for their T2DM. Retinal images were taken pre-operatively and approximately 2 years post-operatively for the TG and over a 2-year interval for the CG. Data were collected for confounding variables, including glycaemic control (HbA(1c)) and BMI. RESULTS Forty-five patients were recruited (TG = 21, CG = 24). Groups were significantly heterogeneous. DR showed significant progression for those in the CG (p = 0.03) but not in TG (p = 0.135), no significant difference was found when adjusting for confounding variables (p = 0.480). There was a significant trend in favour of surgery in improvement of glycaemic control (p = 0.017). CONCLUSION The trends within these pilot data may represent a real difference in the progression of DR in patients who have received surgery, compared with medical treatment alone. Due to heterogeneity of group characteristics, further work needs to be done to validate these results. Should there be a true difference, there will be potential cost savings for the National Health Service (NHS) along with a reduced burden of disease for patients.
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Affiliation(s)
- Jenny Banks
- Department of Surgery, Torbay Hospital, Newton Road, Torquay, Devon, TQ2 7AA, UK,
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Adams ST, Salhab M, Hussain ZI, Miller GV, Leveson SH. Preoperatively determinable factors predictive of diabetes mellitus remission following Roux-en-Y gastric bypass: a review of the literature. Acta Diabetol 2013; 50:475-8. [PMID: 23467919 DOI: 10.1007/s00592-013-0453-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2012] [Accepted: 01/11/2013] [Indexed: 01/13/2023]
Abstract
It is well established that weight loss in general and bariatric surgery in particular can improve glycaemic control in diabetics. Current NICE guidelines recommend that those patients with type 2 diabetes mellitus and a BMI of 35 kg/m(2) or more should be considered for bariatric surgery in order to optimise their glycaemic control and minimise their risk of long-term complications. The commonest bariatric procedure in the UK is the Roux-en-Y gastric bypass that has been shown to result in long-standing type 2 diabetes resolution in 83 % of patients. Since such surgery carries a small but significant risk of mortality, as well as posing considerable lifestyle implications for the patient, numerous studies have been performed with a view to identifying which patients and which procedures are most likely to result in these desired benefits. This paper summarises the existing literature on this topic.
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Affiliation(s)
- S T Adams
- Department of General Surgery, York Hospital, Wigginton Road, York, YO318HE, UK,
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Adams ST, Salhab M, Hussain ZI, Miller GV, Leveson SH. Roux-en-Y gastric bypass for morbid obesity: what are the preoperative predictors of weight loss? Postgrad Med J 2013; 89:411-6; quiz 415, 416. [PMID: 23472004 DOI: 10.1136/postgradmedj-2012-131310] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Obesity has become an increasingly important health problem over the past 30 years. Presently around a quarter of the UK adult population are obese and this figure is set to increase further in the coming decades. The health consequences of obesity on multiple body systems have been well established as has the financial cost of the condition to both the individuals affected as well as to society as a whole. Bariatric surgery has been shown to be the only long term effective solution in terms of sustained weight loss and comorbidity resolution. The commonest bariatric procedure in the UK is the Roux-en-y gastric bypass which consistently results in the loss of 70%-80% of excess bodyweight. Results however are variable and in order to optimise resource allocation and avoid exposing patients unlikely to benefit from surgery to its inherent risks, much research has been done to try to identify those patients most likely to obtain a good result. The only factor which has been subjected to meta-analysis is that of preoperative weight loss which shows a positive association with postoperative weight loss following bypass surgery. Although the remaining data are not based on level 1 evidence those other preoperatively identifiable factors which are associated with an improved outcome include Caucasian or Hispanic ethnicity, higher educational status, non-shift-work working patterns, female gender and divorced or single marital status. Similarly increased levels of preoperative physical activity and an absence of binge eating behaviour are consistent with a favourable result whereas increased age, smoking and other socioeconomic factors have not been shown to have a significant impact. Conversely diabetes mellitus seems to have a slight negative correlation with postoperative weight loss; however, a history of sexual abuse or psychiatric illness has not been shown to have a lasting influence.
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Affiliation(s)
- Simon T Adams
- Department of General Surgery, York Hospital, York, UK.
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Adams ST, da Silva Neto EH, Datta S, Ware JF, Lampropoulos C, Christou G, Myaesoedov Y, Zeldov E, Friedman JR. Geometric-phase interference in a Mn12 single-molecule magnet with fourfold rotational symmetry. Phys Rev Lett 2013; 110:087205. [PMID: 23473196 DOI: 10.1103/physrevlett.110.087205] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/22/2012] [Revised: 01/11/2013] [Indexed: 06/01/2023]
Abstract
We study the magnetic relaxation rate Γ of the single-molecule magnet Mn(12)-tBuAc as a function of the magnetic field component H(T) transverse to the molecule's easy axis. When the spin is near a magnetic quantum tunneling resonance, we find that Γ increases abruptly at certain values of H(T). These increases are observed just beyond values of H(T) at which a geometric-phase interference effect suppresses tunneling between two excited energy levels. The effect is washed out by rotating H(T) away from the spin's hard axis, thereby suppressing the interference effect. Detailed numerical calculations of Γ using the known spin Hamiltonian accurately reproduce the observed behavior. These results are the first experimental evidence for geometric-phase interference in a single-molecule magnet with true fourfold symmetry.
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Affiliation(s)
- S T Adams
- Department of Physics, Amherst College, Amherst, Massachusetts 01002-5000, USA
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Abstract
Point-of-care testing (POCT) is a sensitive, specific and rapid form of testing for the presence of HIV antibodies. Post-exposure prophylaxis for HIV infection can reduce seroconversion rates by up to 80%. Needlestick injuries are the second commonest cause of occupational injury in the NHS and 20% of these occur during operations. In the NHS, in order to protect staff and patients from the risk of bloodborne viruses such as HIV, it is mandatory to report such injuries; however, numerous studies have shown that many groups, particularly doctors, are reluctant to do so. This article outlines the arguments for and against the introduction of preoperatively seeking consent from patients to have their blood tested for HIV via POCT in order to improve the reporting rates of needlestick injuries incurred during surgery and to protect staff from infection.
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Affiliation(s)
- Simon T Adams
- Department of General Surgery, York Hospital, Wigginton Road, York, YO31 8HE, UK.
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Adams ST, Cox J, Rao GS. Axillary silicone lymphadenopathy presenting with a lump and altered sensation in the breast: a case report. J Med Case Rep 2009; 3:6442. [PMID: 19830102 PMCID: PMC2726483 DOI: 10.1186/1752-1947-3-6442] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.6] [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: 01/31/2008] [Accepted: 01/22/2009] [Indexed: 11/29/2022] Open
Abstract
Introduction Silicone lymphadenopathy is a rare but recognised complication of procedures involving the use of silicone. It has a poorly understood mechanism but is thought to occur following the transportation of silicone particles from silicone-containing prostheses to lymph nodes by macrophages. Case presentation We report of a case involving a 35-year-old woman who presented to the breast clinic with a breast lump and altered sensation below her left nipple 5 years after bilateral cosmetic breast augmentations. A small lump was detected inferior to the nipple but clinical examination and initial ultrasound investigation showed both implants to be intact. However, mammography and magnetic resonance imaging of both breasts revealed both intracapsular and extracapsular rupture of the left breast prosthesis. The patient went on to develop a flu-like illness and tender lumps in the left axilla and right mastoid regions. An excision biopsy of the left axillary lesion and replacement of the ruptured implant was performed. Subsequent histological analysis showed that the axillary lump was a lymph node containing large amounts of silicone. Conclusion The exclusion of malignancy remains the priority when dealing with lumps in the breast or axilla. Silicone lymphadenopathy should however be considered as a differential diagnosis in patients in whom silicone prostheses are present.
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Affiliation(s)
- Simon T Adams
- University Hospital of North Durham North Road, Durham, County Durham DH1 5TW UK
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Adams ST, Woods C, Lyall H, Higson M. Standards of practice in UK emergency departments before, during and after conscious sedation. Emerg Med J 2008; 25:728-31. [DOI: 10.1136/emj.2008.059840] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Baker EA, Bouldin N, Durham M, Lowell ME, Gonzalez M, Jodaitis N, Cruz LN, Torres I, Torres M, Adams ST. The Latino Health Advocacy Program: a collaborative lay health advisor approach. Health Educ Behav 1997; 24:495-509. [PMID: 9247827 DOI: 10.1177/109019819702400408] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
There have been numerous calls in the literature for health educators to develop programs to improve access to and utilization of health and human services by traditionally underserved communities, including Latinos. While the literature suggests several principles that can guide the development of these programs, it is important to address the needs, and build on the strengths, of the specific community of interest. It is, therefore, important to use collaborative approaches in which community members take an active role in the initiation, design, implementation, and evaluation of program activities. Lay health advisor programs are particularly well suited to this approach as they are designed to build on the strength of already existing community relationships to improve community health. This article describes a collaborative, culturally appropriate, holistic, and ecological lay health advisor program--the Latino Health Advocacy Program. Lessons learned and implications for future program development are discussed.
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Affiliation(s)
- E A Baker
- St. Louis University School of Public Health, USA
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Polk HC, Calhoun JH, Lowrey LD, Blanchard SP, Brewer RJ, Adams ST, Chedid L. Nonspecific enhancement of host defenses against infection: experimental evidence of a new order of efficacy and safety. Surgery 1981; 90:376-80. [PMID: 7020139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
Enhancement of nonspecific host defenses against bacterial challenge has been a long-standing goal often thwarted by variable efficacy, inconsistent bioassay, and paradoxic immunosuppression. Muramyl dipeptide provides enhanced survival after intravenous challenge with less than 8 x 10(3) Klebsiella, as well as improved local control of infection at sites of intramuscular bacterial injection, with and without a surgical foreign body. No depression of host response was seen over wide ranges of doses and intervals. Muramyl dipeptide provides a new order of efficacy and safety and warrants continued careful assessment.
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Adams ST. [Uveal effusion and its differential diagnosis]. Bull Soc Ophtalmol Fr 1976; 76:493-4. [PMID: 1052144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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Adams ST. Editorial: Retinal detachment. The role of the general ophthalmologist. Arch Ophthalmol 1976; 94:569-70. [PMID: 1267634 DOI: 10.1001/archopht.1976.03910030263001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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Cruse JM, Lewis GK, Whitten HD, Watson ES, Fields JF, Adams ST, Harvey GF, Paslay JW, Baldwin J, Porter M. Fate of murine fibrosarcoma allografts and radiolabeled tumor-enhancing IgG2, normal (nonenhancing) IgG2 and bacterial endotoxin in endotoxin-tolerant and nontolerant mice. J Reticuloendothel Soc 1974; 15:75-84. [PMID: 4810604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
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Adams ST. Arctic ophthalmological survey, 1970-71--the Government of Canada and Canadian universities. Can J Ophthalmol 1973; 8:218-25. [PMID: 4707203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
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Adams ST. Arctic Ophthalmology Symposium. Editor's miscellany. Can J Ophthalmol 1973; 8:306-8. [PMID: 4707217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
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Adams ST. Spontaneous collapse of senile retinoschisis. Can J Ophthalmol 1972; 7:240-2. [PMID: 4670105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
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Simpson ER, Adams ST. Spontaneous uveal effusion. Can J Ophthalmol 1970; 5:41-5. [PMID: 5447397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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Green CE, Eastman ME, Adams ST. Birth order, family size and extra-sensory perception. Br J Soc Clin Psychol 1966; 5:150-2. [PMID: 5939459 DOI: 10.1111/j.2044-8260.1966.tb00968.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
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Adams ST. Retinal detachment failures. Can J Ophthalmol 1966; 1:151-3. [PMID: 5911692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
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