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National increase in the community supply of take-home naloxone associated with a mass media campaign in Scotland: a segmented time series analysis. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2023:104106. [PMID: 37563038 DOI: 10.1016/j.drugpo.2023.104106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Revised: 06/15/2023] [Accepted: 06/18/2023] [Indexed: 08/12/2023]
Abstract
BACKGROUND Take-home naloxone (THN) programmes have been associated with reductions in opioid-related mortality. In response to high rates of drug-related deaths in Scotland, the Scottish Government commissioned the 'How to save a life' (HTSAL) mass media campaign to: (1) increase awareness of drug-related deaths and how to respond to an overdose, and (2) increase the supply of THN. The aim of this study was to assess the effect of the campaign on the supply of THN. METHODS We used an interrupted time series design to assess the effect of the HTSAL mass media campaign on the national community supply of THN. The study time period was August 2020-December 2021. We modelled two key dates: the start of the campaign (week beginning (w/b) 30th of August 2021) and after the end of the main campaign (w/b 25th of October 2021). RESULTS The total number of THN kits distributed in the community in Scotland during the study period was 27,064. The mean number of THN kits distributed per week (relative to the pre-campaign period), increased by 126% during the campaign and 57% post-campaign. In segmented regression analyses, the pre-campaign trend in the number of THN kits supplied was increasing by an average of 1% each week (RR=1.01, 95% CI 1.01 to 1.01, p<0.001). Once the campaign started, a significant change in level was observed, and the number of kits increased by 75% (RR=1.75, 95% CI 1.29 to 2.40, p<0.001). The trend during the campaign was stable (i.e. not increasing or decreasing) but a significant change in level was observed when the campaign ended, and the number of THN kits supplied decreased by 32% (RR=0.68, 95% CI 0.46 to 0.98, p = 0.042). The trend during the post-campaign period was stable. CONCLUSIONS The HTSAL campaign had a short term, but large and significant impact, on the community supply of THN in Scotland. Mass media campaigns could be combined with other interventions and strategies to maintain the increased uptake of THN outside of campaign periods.
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P-402 The association between embryo morphology and first trimester miscarriage after single blastocyst transfer. Hum Reprod 2022. [DOI: 10.1093/humrep/deac107.379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Study question
Can standard morphological assessment of blastocyst quality accurately predict first trimester miscarriage?
Summary answer
Decreasing trophectoderm and inner cell mass grade equally predicted first trimester miscarriage independently. After adjusting for confounders, poor embryo quality was not associated with miscarriage.
What is known already
Embryo quality determined by morphological assessment is a well-established predictor of successful implantation and live birth with in vitro fertilization treatment. Chromosomal abnormalities account for over half of first trimester miscarriages, and links between ploidy status and embryo morphology have been demonstrated. However, the association between blastocyst morphology and first trimester miscarriage is still poorly understood with consensus opinion yet to be established.
Study design, size, duration
This single centre retrospective cohort study included 2020 fresh and frozen single embryo transfers between October 2010 and October 2020. Blastocyst degree of expansion, inner cell mass (ICM) grade, and trophectoderm (TE) grade were compared for 354 pregnancies ending in first trimester miscarriage and 1666 pregnancies that surpassed 12 weeks of gestation. The association between blastocyst morphology and miscarriage was examined by logistic regression analysis.
Participants/materials, setting, methods
All single blastocyst transfers over a 10-year period resulting in first trimester miscarriage or pregnancy beyond 12 weeks of gestation were included in our analysis. Cycles involving donor oocytes, preimplantation genetic testing, resulting in biochemical pregnancy, or ectopic pregnancy were excluded. Differences between groups were analysed with chi-square and logistic regression analysis. Odds ratios (aOR) for miscarriage versus ongoing pregnancy were adjusted for maternal age, cycle type, blastocyst expansion, ICM grade, and TE grade.
Main results and the role of chance
Out of 2020 single embryo transfer cycles, a total of 354 resulted in first trimester miscarriage (17.5%). Independently, miscarriage rates increased with decreasing ICM grade (A to C; 14.6%, 18.9%, and 26.5%, p = 0.003) and TE grade (A to C; 14.6%, 17.7%, and 26.6%, p = 0.004). Univariate logistic regression showed higher risks of miscarriage with ICM grade C compared to ICM grade A (OR 2.241, 95%CI 1.292-3.886, p = 0.004), TE grade C compared to TE grade A (OR 2.116, 95%CI 1.360 – 3.292, p = 0.001), and expansion grades of 1 and 2 compared to expansion of 5 and 6 (OR 2.514, 95%CI 1.477 – 4.278, p = 0.001). After multivariable logistic regression adjusting for maternal age at embryo transfer, cycle type, and all morphological parameters (degree of expansion, ICM, and TE), only expansion grade of 1 and 2 showed a statistically significant association with first trimester miscarriage.
Limitations, reasons for caution
The main limitation of this study is the retrospective design of the analysis, and subjective nature of embryo morphological assessment. There may also be residual confounding by unknown or unmeasured confounders such as paternal age or maternal BMI.
Wider implications of the findings
Embryo selection for transfer should continue to be guided by standard morphological assessment. Decreasing grade of ICM and TE are both positively associated with an increased miscarriage risk, while poorly expanded blastocysts are most predictive of first trimester miscarriage. Patients undergoing embryo transfer should be adequately counselled about these risks.
Trial registration number
Not applicable
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P-282 Blastocyst transfer in advanced maternal age: Single versus double embryo transfer. Hum Reprod 2022. [DOI: 10.1093/humrep/deac107.271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Study question
Is there a role for elective single blastocyst transfer (eSBT) in advanced maternal age?
Summary answer
Double blastocyst transfer (DBT) versus eSBT resulted in higher live birth rates except for those undergoing their first cycle.
What is known already
Women with advanced maternal age are generally considered poorer prognosis patients with lower live birth rates compared to their younger counterparts. This often results in a higher likelihood of double embryo transfer in this group. This is not without risk as multiple pregnancy is associated with significant maternal and neonatal morbidity especially with advancing maternal age. In older women with blastocysts available for transfer, it is unclear who should be recommended double versus elective single transfer. The concept of the “good-prognosis” older woman remains elusive.
Study design, size, duration
This was a retrospective observational study looking at 511 IVF/ICSI cycles between January 2010 and January 2020. Treatment cycle details and clinical outcomes were entered prospectively into a dedicated clinic database. Data was retrieved and analysed using SPSS V25.
Participants/materials, setting, methods
The study was conducted in a large London IVF centre. Data was collected on women aged 40 or above undergoing an IVF/ICSI cycle with eSBT (Group 1, n = 79) or DBT (Group 2, n = 430). Women with more than three previous IVF attempts were excluded. eSBT was defined as a single blastocyst transfer with at least one further blastocyst available for cryopreservation. Subgroup analysis was performed for those undergoing their first cycle.
Main results and the role of chance
Data from 511 cycles was analysed. The mean age was 40.6±1.2years. The live birth rate was 27%. Group 1 was marginally younger (40.2±0.6 v 40.8±1.2, p < 0.005) and was more likely to be undergoing their first IVF cycle (84% v 68%, p = 0.003). Those in Group 1 had more eggs collected (13.6±7.3 v 11.3±5.5, p = 0.009), more zygotes (8.9±4.7 v 7.3±3.6) formed and more blastocysts frozen (3.4±2.6 v 1.1±1.7, p < 0005). More women in Group 1 had a top quality blastocyst (expansion of > 2 and inner cell mass and trophectoderm of AA, AB, BA or BB) transfer (91% v 71%, p < 0.005).
After logistic regression controlling for maternal age, number of previous IVF cycles and blastocyst quality, Group 1 had a lower likelihood of livebirth (aOR 0.550, 95%CI 0.306-0.988) but with a significantly lower multiple pregnancy rate (0% v 24%, p = 0.024).
Importantly, for those undergoing their first IVF cycle (n = 359), there was no difference in live birth rate in the two groups (aOR 0.617, 95%CI 0.329-1.156) after controlling for age and blastocyst quality but Group 2 had a higher multiple pregnancy rate (24% v 0%, p = 0.020).
Limitations, reasons for caution
This study is limited by its retrospective nature putting it at risk of information bias as it relied on accurate documentation of studied variables into the patient database. The study did not examine cumulative birth rates of fresh and subsequent frozen cycles in Group 1.
Wider implications of the findings
Women should have individualised counseling about number of blastocysts to transfer taking into account their circumstances. Those undergoing their first IVF attempt and with a blastocyst available for transfer, should be counselled that DBT is associated with a higher multiple pregnancy rate with no increase in overall live birth rate.
Trial registration number
Not Applicable
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10 Years of ST Elevation Myocardial Infarctions (STEMIs) in the Illawarra Shoalhaven Local Health District (ISLHD) – Patient Demographics. Heart Lung Circ 2022. [DOI: 10.1016/j.hlc.2022.06.554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Single Centre Experience of Primary PCI: 10-Year Procedural Outcomes. Heart Lung Circ 2022. [DOI: 10.1016/j.hlc.2022.06.624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
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Human papillomavirus (HPV) vaccination across a cascade of knowledge, willingness, and uptake among gay, bisexual, and other men who have sex with men in Canada's three largest cities. Hum Vaccin Immunother 2021; 17:5413-5425. [PMID: 34856869 DOI: 10.1080/21645515.2021.1979379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
BACKGROUND Some Canadian jurisdictions offer publicly funded HPV vaccine to gay, bisexual, and other men who have sex with men (GBM) aged ≤26 years. We characterized factors associated with being in different stages of HPV vaccination. METHODS Engage is a sexual health study of GBM in the three largest Canadian cities recruited via respondent driven sampling (RDS). We categorized participants as: (1) unaware of HPV vaccine, (2) undecided/unwilling to get vaccinated, (3) willing to get vaccinated, (4) vaccinated with one or more doses. Our RDS-II weighted analyses used multinomial logistic regression to identify factors associated with being in earlier stages of the cascade compared to Stage 4. RESULTS Across the cities, 26-40%, 7-14%, 33-39%, and 13-28% were in Stages 1 to 4, respectively. Compared to Stage 4, being in earlier stages of the cascade was associated with bisexual-identification (Stage 1: adjusted odds ratio[aOR] = 2.84, 95% confidence interval[CI] = 1.06-7.62; Stage 2: aOR = 3.09, 95%CI = 1.19-8.05), having immigrated to Canada (Stage 1: aOR = 1.79, 95%CI 1.07-2.99), preference to keep same-sex romantic relationships private (Stage 1: aOR = 1.25, 95% CI = 1.05-1.48; Stage 2: aOR = 1.24, 95%CI = 1.05-1.46), not receiving sexual health information (Stage 1: aOR = 0.31, 95% CI = 0.13-0.71; Stage 2: aOR = 0.27, 95%CI = 0.12-0.64), not accessing a health-care provider (Stage 2: aOR = 0.36, 95%CI = 0.15-0.83), and no past hepatitis A/B vaccination (Stage 1: aOR = 0.16, 95% CI = 0.09-0.30; Stage 2: aOR = 0.18, 95%CI = 0.09-0.35; Stage 3: aOR = 0.38, 95%CI = 0.21-0.61). DISCUSSION Interventions are needed to reduce social and financial barriers, increase sexual health knowledge, and improve GBM-competent health-care access to increase vaccine uptake among GBM.
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Abstract
PURPOSE OF REVIEW To evaluate the clinical potential of chemokine receptor antagonists for the treatment of patients with cancer. RECENT FINDINGS Chemokine receptors and their ligands can have a significant impact on the infiltration of cells into the tumor microenvironment. The receptors are increasingly being investigated as targets for the treatment of cancers. Recent studies are demonstrating the promise of chemokine receptor antagonists in this setting. There are many chemokine receptors, and each can have different functions depending on the cellular context. Targeting chemokine receptors is a promising strategy in both pre-clinical research and clinical trials. Inhibiting chemokine receptors that either recruit suppressive cells or improve cancer mobility and viability while sparing those necessary for proper immune trafficking may prove to dramatically improve treatment responses. Further research in this area is warranted and has the potential to dramatically improve patient outcomes.
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Human papillomavirus (HPV) vaccine uptake among a community-recruited sample of gay, bisexual, and other men who have sex with men in the three largest cities in Canada from 2017 to 2019. Vaccine 2021; 39:3756-3766. [PMID: 34074547 DOI: 10.1016/j.vaccine.2021.05.031] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Revised: 03/26/2021] [Accepted: 05/11/2021] [Indexed: 01/21/2023]
Abstract
INTRODUCTION In 2015/2016, Canada's largest provinces implemented publicly-funded human papillomavirus (HPV) vaccination programs for gay, bisexual, and other men who have sex with men (GBM) ≤ 26 years old. We sought to describe HPV vaccine uptake among GBM and determine barriers and facilitators to vaccine initiation with a focus on healthcare access and utilization. METHODS Engage is a cohort study among GBM aged 16 + years in three Canadian cities recruited from 2017 to 2019 via respondent driven sampling (RDS). Men completed a comprehensive questionnaire at baseline. By publicly-funded vaccine eligibility (≤26 years old = eligible for vaccination, ≥27 years old = ineligible), we described HPV vaccine uptake (initiation = 1 + dose, completion = 3 doses) and explored factors associated with vaccine initiation using Poisson regression. All analyses were weighted with the RDS-II Volz-Heckathorn estimator. RESULTS Across the three cities, 26-35% and 14-21% of men ≤ 26 years and 7-26% and 2-9% of men ≥ 27 years initiated and completed HPV vaccination, respectively. Vaccine initiation was significantly associated with STI/HIV testing or visiting a HIV care specialist in the past six months (≤26: prevalence ratio[PR] = 2.15, 95% confidence interval[CI] 1.06-4.36; ≥27: PR = 2.73, 95%CI 1.14-6.51) and past hepatitis A or B vaccination (≤26: PR = 2.88, 95%CI 1.64-5.05; ≥27: PR = 2.03, 95%CI 1.07-3.86). Among men ≥ 27 years old, vaccine initiation was also positively associated with accessing PrEP, living in Vancouver or Toronto, but negatively associated with identifying as Latin American and increasing age. Vaccine initiation was twice as likely among men ≥ 27 years with private insurance versus no insurance. CONCLUSIONS Sixty-five to 74% of men eligible for publicly-funded vaccine across the three cities remained unvaccinated against HPV by 2019. High vaccine cost may partly explain even lower uptake among men ≥ 27 years old. Men seeking sexual health care were more likely to initiate vaccination; bundling vaccination with these services may help improve HPV vaccine uptake.
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Safety and Efficacy of the Ultrathin Orsiro Sirolimus-Eluting Stent Use in ST Elevation Myocardial Infarct. An Analysis from a Large Australian Regional Centre. Heart Lung Circ 2021. [DOI: 10.1016/j.hlc.2021.06.503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Abstract
Congenital infections refer to a group of perinatal infections that may have similar clinical presentations, including rash and ocular findings. TORCH is the acronym that covers these infections (toxoplasmosis, other [syphilis], rubella, cytomegalovirus, herpes simplex virus). There are, however, other important causes of intrauterine/perinatal infections, including enteroviruses, varicella zoster virus, Zika virus, and parvovirus B19. Intrauterine and perinatal infections are significant causes of fetal and neonatal mortality and important contributors to childhood morbidity. A high index of suspicion for congenital infections and awareness of the prominent features of the most common congenital infections can help to facilitate early diagnosis, tailor appropriate diagnostic evaluation, and if appropriate, initiate early treatments. In the absence of maternal laboratory results diagnostic of intrauterine infections, congenital infections should be suspected in newborns with certain clinical features or combinations of clinical features, including hydrops fetalis, microcephaly, seizures, cataract, hearing loss, congenital heart disease, hepatosplenomegaly, jaundice, or rash. Primary prevention of maternal infections during pregnancy is the cornerstone of prevention of congenital infection. Available resources should focus on the promotion of public health.
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Canada's Prosthetic Coverage: a Review of Provincial Prosthetic Policy. CANADIAN PROSTHETICS & ORTHOTICS JOURNAL 2020; 2:33489. [PMID: 37614768 PMCID: PMC10443461 DOI: 10.33137/cpoj.v2i2.33489] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Accepted: 02/12/2020] [Indexed: 11/23/2022] Open
Abstract
The Canadian healthcare system serves as an example of equity and federal service to citizens across the world. However, it is not without its challenges. Prosthetic coverage across Canada is highly variable and largely unable to provide equal coverage for Canadian persons living with amputation. Many persons with limb loss are forced to rely upon personal resources, fundraising, or the charity of non-governmental organizations in order to meet this basic healthcare need. This disparity in the Canadian healthcare system is unusual and largely undescribed in the literature. We thus explore the nature of Canadian healthcare prosthetic coverage across Canada, investigating the variability in coverage, presence of prosthetic coverage policies, clarity of policy, eligibility criteria, and interval of prosthetic replacement. Our findings highlight potential areas for improvement within current Canadian healthcare policy.
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878 Safety and Efficacy of the Ultrathin Orsio Sirolimus-Eluting Stent use in ST-Elevation Myocardial Infarct. An Analysis From a Large Australian Regional Centre. Heart Lung Circ 2020. [DOI: 10.1016/j.hlc.2020.09.885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Febrile neutropenia and its associated hospitalization in breast cancer patients on docetaxel-containing regimen: A retrospective cohort study on duration of prophylactic GCSF administration. Support Care Cancer 2019; 28:3801-3812. [PMID: 31832822 DOI: 10.1007/s00520-019-05111-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2019] [Accepted: 09/30/2019] [Indexed: 01/03/2023]
Abstract
PURPOSE To compare febrile neutropenia (FN) incidence and hospitalization among breast cancer patients on docetaxel with no granulocyte colony-stimulating factors (GCSF) primary prophylaxis (PP), 4/5-day PP, or 7-day PP. METHODS We identified 3916 breast cancer patients using docetaxel-cyclophosphamide (TC), doxorubicin-cyclophosphamide then docetaxel (AC-T), fluorouracil-epirubicin-cyclophosphamide then docetaxel (FEC-T), docetaxel-carboplatin-trastuzumab (TJH), or docetaxel-doxorubicin-cyclophosphamide (TAC) from a hospital pharmacy dispensing database in Hong Kong between 2014 and 2016. Patients were offered GCSF within 5 days since administering docetaxel. Outcomes included FN incidence, time to first hospitalization, hospitalization rate, and duration. RESULTS In TC regimen, FN incidence (with odds ratio, OR) of patients with no PP, 4/5-day PP, and 7-day PP was 21.69%, 7.95% (OR 0.31, p < 0.001), and 5.33% (OR 0.20, p < 0.001), respectively. In TJH regimen, FN incidence of patients with no PP, 4/5-day PP, and 7-day PP was 38.26%, 8.33% (OR 0.15, p < 0.001), and 8.57% (OR 0.15, p < 0.001), respectively. FN incidence of patients on AC-T regimen with no PP and 4/5-day PP was 20.93% and 6.84%, respectively (OR 0.28, p = 0.005); with FEC-T regimen, the incidence was 9.91% and 4.77%, respectively (OR 0.46, p = 0.035). Only 3.27% FN cases were not hospitalized. Mean (±standard deviation, SD) time to first hospitalization was 8.21 ± 2.44 days. Mean (±SD) duration of hospitalization for patients with no PP, 4/5-day PP, and 7-day PP was 4.66 ± 2.60, 4.37 ± 2.85, and 5.12 ± 2.97 days, respectively. CONCLUSION GCSF prophylaxis in breast cancer patients on docetaxel could reduce FN incidence and hospitalization. 4/5-day PP demonstrated similar efficacy to 7-day PP with superior saving benefits on healthcare expenditure.
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Correlation Between Radial Artery Anomalies and Procedural Outcomes of Trans-radial Coronary Catheterisation. Heart Lung Circ 2019. [DOI: 10.1016/j.hlc.2019.06.604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Atrial Fibrillation: A Descriptive Study of Management in a Large Cardiology Practice. Heart Lung Circ 2018. [DOI: 10.1016/j.hlc.2018.06.241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Abstract
OBJECTIVE In this paper, we describe the development of a novel tool-the Sports Organization Concussion Risk Assessment Tool (SOCRAT)-to assist sport organizations in assessing the overall risk of concussion at a team level by identifying key risk factors. METHODS We first conducted a literature review to identify risk factors of concussion using ice hockey as a model. We then developed an algorithm by combining the severity and the probability of occurrence of concussions of the identified risk factors by adapting a risk assessment tool commonly used in engineering applications. RESULTS The following risk factors for ice hockey were identified: age, history of previous concussions, previous body checking experience, allowance of body checking, type of helmet worn and the game or practice environment. These risk factors were incorporated into the algorithm, resulting in an individual risk priority number (RPN) for each risk factor and an overall RPN that provides an estimate of the risk in the given circumstances. CONCLUSION The SOCRAT can be used to analyse how different risk factors contribute to the overall risk of concussion. The tool may be tailored to organizations to provide: (1) an RPN for each risk factor and (2) an overall RPN that takes into account all the risk factors. Further work is needed to validate the tool based on real data.
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PS-01-006 Sexual difficulties: Prevalence, impact, and help-seeking in a population-representative sample. J Sex Med 2017. [DOI: 10.1016/j.jsxm.2017.03.076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Ebola virus disease: An update on current prevention and management strategies. J Clin Virol 2016; 86:5-13. [PMID: 27893999 DOI: 10.1016/j.jcv.2016.11.005] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2016] [Revised: 10/06/2016] [Accepted: 11/08/2016] [Indexed: 11/28/2022]
Abstract
Ebola virus disease (EVD) is characterised by systemic viral replication, immuno-suppression, abnormal inflammatory responses, large volume fluid and electrolyte losses, and high mortality in under-resourced settings. There are various therapeutic strategies targeting EVD including vaccines utilizing different antigen delivery methods, antibody-based therapies and antiviral drugs. These therapies remain experimental, but received attention following their use particularly in cases treated outside West Africa during the 2014-15 outbreak, in which 20 (80%) out of 25 patients survived. Emerging data from current trials look promising and are undergoing further study, however optimised supportive care remains the key to reducing mortality from EVD.
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Long-term outcomes of accelerated BEP (bleomycin, etoposide, cisplatin) for advanced germ cell tumours: updated analysis of an Australian multicentre phase II trial by the Australian and New Zealand Urogenital and Prostate Cancer Trials Group (ANZUP). Ann Oncol 2016; 27:2302-2303. [PMID: 27502724 DOI: 10.1093/annonc/mdw313] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Recurrent, Symptomatic, Carotid Body Tumour Mediated Sinoatrial Arrest Presenting in Late Pregnancy. Heart Lung Circ 2016. [DOI: 10.1016/j.hlc.2016.06.312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Posterior corneal anatomy in a newborn baby. Acta Ophthalmol 2015. [DOI: 10.1111/j.1755-3768.2015.0640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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P14.01 Is knowledge power? associations between chlamydia knowledge and sexual practices in young australian adults: findings from the australian chlamydia control effectiveness pilot (accept). Br J Vener Dis 2015. [DOI: 10.1136/sextrans-2015-052270.513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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P04.16 “It opened my eyes” – examining the impact of the australian chlamydia control effectiveness pilot (accept) on chlamydia testing practices of general practitioners. Br J Vener Dis 2015. [DOI: 10.1136/sextrans-2015-052270.270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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P04.15 Sexual behaviour, sti testing and diagnosis down under: findings from the second australian study of health and relationships (ashr2). Br J Vener Dis 2015. [DOI: 10.1136/sextrans-2015-052270.269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Myocardial ischemia: pathogenic role of disturbed vasomotion and endothelial dysfunction in coronary atherosclerosis. Adv Cardiol 2015; 37:42-52. [PMID: 2220464 DOI: 10.1159/000418816] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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The role of computerised tomography in predicting visual outcome in ocular trauma patients. Eye (Lond) 2015; 29:867-71. [PMID: 25853401 DOI: 10.1038/eye.2015.39] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2014] [Accepted: 02/09/2015] [Indexed: 11/09/2022] Open
Abstract
PURPOSE Ocular blast injuries in the military setting are particularly associated with significant maxillofacial trauma and/or brain injury. The opportunity to perform a comprehensive ophthalmic evaluation is frequently limited in the acute multiple trauma scenario. We aim to describe the relationship between the clinical effects of acute ocular and orbital blast trauma with the findings on computerised tomography (CT). METHODS This was a retrospective consecutive case series of all soldiers with facial and/or suspected ocular injuries. A total of 80 eyes that had suffered blast injuries of varying severity were studied. Assessment of orbital and ocular CT images were performed by military consultant radiologists. A comparison was made with actual clinical findings. Statistical analysis was performed using Fisher's exact test. RESULTS No pathological findings were described in 37 of the 80 eyes imaged by orbital and ocular CT scans. Clinically, these eyes and orbits were all found to be intact, or had minor trauma. All foreign bodies and penetrating eye injuries were successfully diagnosed by CT. Absence of an orbital fracture did not rule out a globe injury. However, a corneal or scleral defect was less likely when an orbital fracture was absent. CONCLUSION The eye is a delicate structure prone to injury that requires urgent repair if breached. It is difficult to assess thoroughly in the unconscious or distressed patient. In this context, CT imaging is invaluable to be able to make a relatively confident prediction of clinical findings and decide upon the necessity for acute ophthalmic surgical intervention.
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Comparing ambulance thrombolysis and in-hospital thrombolysis for patients diagnosed with ST elevation myocardial infarction. Heart Lung Circ 2015. [DOI: 10.1016/j.hlc.2015.06.071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Pre-hospital assessment for primary angioplasty (PAPA) versus traditional assessment in the emergency department. Heart Lung Circ 2015. [DOI: 10.1016/j.hlc.2015.06.113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Hyperacute stent thrombosis after pre-hospital assessment for primary angioplasty (PAPA) ST elevation myocardial infarction. Heart Lung Circ 2015. [DOI: 10.1016/j.hlc.2015.06.390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Re: The FRCR 2B oral examination: Is it reliable? A reply. Clin Radiol 2014; 69:331-2. [DOI: 10.1016/j.crad.2013.08.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2013] [Indexed: 11/29/2022]
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EP-1892: A comparison of doses received by HRCTV, GTV & IRCTV using prescription to HRCTV-D90 or to point A using IGBRT. Radiother Oncol 2014. [DOI: 10.1016/s0167-8140(15)32010-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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S108 Statin use and cigarette smoking are associated with lower incidence of radiation pneumonitis. Thorax 2013. [DOI: 10.1136/thoraxjnl-2013-204457.115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Atrial Septal Defects in the Elderly: A Study of Clinical and Echocardiographic Predictors of Atrial Septal Defect Closure. Can J Cardiol 2013. [DOI: 10.1016/j.cjca.2013.07.108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Tumour Volume as a Predictor of Treatment Success in Patients with Laryngeal Cancer Treated with Primary Chemoradiotherapy. HONG KONG JOURNAL OF RADIOLOGY 2013. [DOI: 10.12809/hkjr1313159] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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P5.011 Are Australian General Practitioners (GPs) and Practise Nurses (PNs) Equipped For Increased Chlamydia Testing? Findings from the Australian Chlamydia Control Effectiveness Pilot (ACCEPt). Br J Vener Dis 2013. [DOI: 10.1136/sextrans-2013-051184.1058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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P3.019* Is Concurrency, Number of Partners or Duration of Partnership the Most Important Factor Associated with Chlamydia in Young Australian Adults? Br J Vener Dis 2013. [DOI: 10.1136/sextrans-2013-051184.0479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Meeting the challenge of interpreting high-resolution single nucleotide polymorphism array data in prenatal diagnosis: does increased diagnostic power outweigh the dilemma of rare variants? BJOG 2013; 120:594-606. [PMID: 23332022 DOI: 10.1111/1471-0528.12150] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/10/2012] [Indexed: 01/14/2023]
Abstract
OBJECTIVE Several studies have already shown the superiority of chromosomal microarray analysis (CMA) compared with conventional karyotyping for prenatal investigation of fetal ultrasound abnormality. This study used very high-resolution single nucleotide polymorphism (SNP) arrays to determine the impact on detection rates of all clinical categories of copy number variations (CNVs), and address the issue of interpreting and communicating findings of uncertain or unknown clinical significance, which are to be expected at higher frequency when using very high-resolution CMA. DESIGN Prospective validation study. SETTING Tertiary clinical genetics centre. POPULATION Women referred for further investigation of fetal ultrasound anomaly. METHODS We prospectively tested 104 prenatal samples using both conventional karyotyping and high-resolution arrays. MAIN OUTCOME MEASURES The detection rates for each clinical category of CNV. RESULTS Unequivocal pathogenic CNVs were found in six cases, including one with uniparental disomy (paternal UPD 14). A further four cases had a 'likely pathogenic' finding. Overall, CMA improved the detection of 'pathogenic' and 'likely pathogenic' abnormalities from 2.9% (3/104) to 9.6% (10/104). CNVs of 'unknown' clinical significance that presented interpretational difficulties beyond results from parental investigations were detected in 6.7% (7/104) of samples. CONCLUSIONS Increased detection sensitivity appears to be the main benefit of high-resolution CMA. Despite this, in this cohort there was no significant benefit in terms of improving detection of small pathogenic CNVs. A potential disadvantage is the high detection rate of CNVs of 'unknown' clinical significance. These findings emphasise the importance of establishing an evidence-based policy for the interpretation and reporting of CNVs, and the need to provide appropriate pre- and post-test counselling.
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The basis of antagonistic pleiotropy in hfq mutations that have opposite effects on fitness at slow and fast growth rates. Heredity (Edinb) 2012; 110:10-8. [PMID: 23169561 DOI: 10.1038/hdy.2012.46] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Mutations beneficial in one environment may cause costs in different environments, resulting in antagonistic pleiotropy. Here, we describe a novel form of antagonistic pleiotropy that operates even within the same environment, where benefits and deleterious effects exhibit themselves at different growth rates. The fitness of hfq mutations in Escherichia coli affecting the RNA chaperone involved in small-RNA regulation is remarkably sensitive to growth rate. E. coli populations evolving in chemostats under nutrient limitation acquired beneficial mutations in hfq during slow growth (0.1 h(-1)) but not in populations growing sixfold faster. Four identified hfq alleles from parallel populations were beneficial at 0.1 h(-1) and deleterious at 0.6 h(-1). The hfq mutations were beneficial, deleterious or neutral at an intermediate growth rate (0.5 h(-1)) and one changed from beneficial to deleterious within a 36 min difference in doubling time. The benefit of hfq mutations was due to the greater transport of limiting nutrient, which diminished at higher growth rates. The deleterious effects of hfq mutations at 0.6 h(-1) were less clear, with decreased viability a contributing factor. The results demonstrate distinct pleiotropy characteristics in the alleles of the same gene, probably because the altered residues in Hfq affected the regulation of expression of different genes in distinct ways. In addition, these results point to a source of variation in experimental measurement of the selective advantage of a mutation; estimates of fitness need to consider variation in growth rate impacting on the magnitude of the benefit of mutations and on their fitness distributions.
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SU-E-T-515: Comparison of Two Dose-Specification Methods for the Treatment of Uterine Cervix Cancer with HDR Brachytherapy Using a Tandem and Ring Applicator. Med Phys 2012; 39:3824. [PMID: 28518529 DOI: 10.1118/1.4735604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
PURPOSE To compare the dose to the high-risk clinical target volume (HRCTV)-D90 and dose-limiting structures with the dose prescription to point A (Manchester system) using conventional methods to image-guided treatment planning with dose optimization and a dose prescription to D90 of the HRCTV. METHODS CT-MR-fused image sets for 16 patients (stage IA2-IIIB) with uterine cervix cancer were obtained for each of 5 fractions of HDR brachytherapy using tandem and ring applicators to generate 2 sets of plans. In the first set, the dose was prescribed to point A with a standard dwell weight pattern reflecting the Manchester system loading pattern. In the second set, the dose was prescribed to D90 of the HRCTV with graphical plan optimization. Parameters of clinical significance (HRCTV-D90 and dose received by 1.0, 2.0, and 5.0cc of the bladder, rectum, and sigmoid) were compared, as recommended by GEC-ESTRO. RESULTS HRCTV-V for 6 patients was =30cc (largest radius, <2.0cm) and >30cc (largest radius, =2cm) for the others. For the first set of plans, when HRCTV-V was <30cc, the ratio of doses HRCTV-D90/dose to point A varied from 1.10 to 1.40. When HRCTV-V was >30cc, it varied from 0.75 to 0.95. In the second set of plans, HRCTV-D90 always received the prescription dose. Doses to 2cc of one or more organs at risk exceeded >10% of the limiting doses for 9 patients in the first set of plans but remained <10% in all patients in the second set of plans. A 10-25% dose reduction to 2cc of the bladder and 15-35% to 2cc of the rectum and sigmoid occurred in the second set of plans. CONCLUSIONS Image-guided brachytherapy with dose optimization yields a prescribed dose to the HRCTV-D90 while maintaining doses to organs at risk close to their limiting value, offering a dosimetric benefit over the traditional method.
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Response to Comment on Yeung et al “The FRCR 2B examination: A survey of candidate perceptions and experiences.”. Clin Radiol 2012. [DOI: 10.1016/j.crad.2011.06.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
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A Methodology For Evaluating Setup and Immobilization For Head and Neck Cancer Patients. Int J Radiat Oncol Biol Phys 2011. [DOI: 10.1016/j.ijrobp.2011.06.1375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
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Use of computerized medical records to determine the feasibility of testing for chlamydia without patients seeing a practitioner. Int J STD AIDS 2011; 21:755-7. [PMID: 21187357 DOI: 10.1258/ijsa.2010.010220] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
The proportion of clinically important diagnoses in a low-risk, asymptomatic population who use a computer-assisted self-interview (CASI) to assess risk was needed to determine optimal health service delivery. Medical records were retrospectively analysed between July 2008 and June 2009 for risk characteristics and diagnoses. A total of 7733 new patients completed a CASI, of whom 1060 were asymptomatic heterosexuals. From this low-risk group, 26 diagnoses were made on the day of presentation, including 22 cases of genital warts (2.08% [95% confidence interval (CI) 1.22-2.93]), three cases of genital herpes (0.28% [95% CI 0.055-0.82]) and one case of unintended pregnancy (0.094% [95% CI 0.0061-0.52]). Additionally, there were 54 cases of chlamydia detected (5.09% [95% CI 3.77-6.42]). As chlamydia is effectively diagnosed and managed from self-collected samples, patient review is not always required. This study provides evidence for an express testing service for chlamydia to streamline the screening of low-risk, asymptomatic heterosexual patients as identified by CASI without the need to for a traditional face-to-face consultation.
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Management and prevention of spontaneous pneumothorax using pleurodesis in Hong Kong. Int J Tuberc Lung Dis 2011; 15:385-390. [PMID: 21333108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023] Open
Abstract
BACKGROUND The practice of pleurodesis for the management and prevention of spontaneous pneumothorax (SP) is uncertain. DESIGN A retrospective multicentre analysis of patients admitted to 12 hospitals in Hong Kong with SP in 2004 and who subsequently underwent pleurodesis for the same episode. RESULTS Pleurodesis was performed in 394 episodes. Initial medical chemical pleurodesis was performed for 258 (65.5%) patients ('initial medical group'), while 136 (34.5%) underwent initial surgical pleurodesis ('initial surgical group'). Secondary spontaneous pneumothorax (SSP; 237 episodes, 60.2%) was the most common indication for pleurodesis; it was also performed after a first episode of primary spontaneous pneumothorax (PSP) in 22 episodes (5.6%). Tetracycline derivatives (172 episodes, 66.7%) were the most popular sclerosing agents in the initial medical group. Those in the initial medical group were older and were more likely to be males, have SSP, chronic obstructive pulmonary disease and a history of past pleurodesis (P < 0.05) compared to the initial surgical group. Compared to the tetracycline group, more patients who initially received talc slurry had the procedure performed by surgeons, had larger (≥2 cm) pneumothorax or required suction during initial drainage (P < 0.05). CONCLUSIONS Despite the availability of international guidelines, there is considerable variation in pleurodesis for SP.
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The FRCR 2B examination: a survey of candidate perceptions and experiences. Clin Radiol 2011; 66:412-9. [PMID: 21316040 DOI: 10.1016/j.crad.2010.12.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2010] [Revised: 12/20/2010] [Accepted: 12/21/2010] [Indexed: 10/18/2022]
Abstract
AIM To survey the views of recent candidates of the Fellowship of the Royal College of Radiologists (FRCR) 2B examination with reference to assessment validity, reliability, and acceptability. MATERIALS AND METHODS One thousand, two hundred and four UK radiology trainees and consultants were invited to complete an automated internet questionnaire regarding their experiences and perceptions of the FRCR 2B examination. The questionnaire was informed by a review of the literature. Eligible participants were candidates who had taken the examination within the previous 3 years. RESULTS Four hundred and ninety-seven out of 1204 (41%) responses were received; of which 258/497 (52% of respondents) were eligible for inclusion into the study. The rapid reporting component is perceived to be significantly fairer than the oral section (82 versus 70% agree; p<0.001). The oral component fared poorly in perceived performance-reducing anxiety levels but well in questions relating to validity and reliability. Female candidates are more likely to find the FRCR 2B unfair (p=0.01) and experience performance-reducing anxiety (p<0.001) than males. No gender differences were observed in first-time pass rates (p=0.6). Candidate first language did not affect anxiety levels (p=0.9) or first-time pass rates (p=0.06). Only 12% of candidates agreed that the oral examination should move to an objective structured clinical format. CONCLUSION Candidates score the FRCR 2B examination well in test validity with little desire for change to the oral examination format. Efforts to help reduce anxiety levels in the oral component would improve perceived fairness.
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Minocycline and talc slurry pleurodesis for patients with secondary spontaneous pneumothorax. Int J Tuberc Lung Dis 2010; 14:1342-1346. [PMID: 20843428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023] Open
Abstract
SETTING Few studies have evaluated the sclerosing efficacy of minocycline, and none have specifically compared its sclerosing efficacy and safety profiles with talc slurry in secondary spontaneous pneumothorax (SSP). DESIGN A retrospective analysis was conducted in patients with SSP who underwent chemical pleurodesis from January to December 2004 with minocycline or talc slurry in 12 public hospitals of Hong Kong. RESULT There were 121 episodes of minocycline pleurodesis and 64 episodes of talc slurry pleurodesis. Immediate procedural failure were similar in the minocycline and talc slurry groups (21.5% vs. 28.1%, P = 0.31). Presence of interstitial lung disease, ≥ 2 previous episodes of pneumothorax, requiring mechanical ventilation during pleurodesis and persistent air leak before pleurodesis were independently associated with procedural failure. Pain was experienced in respectively 44.6% and 37.5% of the minocycline and the talc slurry groups. Pain was more common in patients receiving high doses of talc (≥ 5 g; P = 0.03). Respiratory distress was found in respectively 1.7% and 1.6% of the minocycline and talc slurry groups. CONCLUSION Minocycline and talc slurry had comparable sclerosing efficacy in SSP, with immediate success rates of >70%. Pain was the most common adverse effect and respiratory distress was uncommon. Both appeared to be effective and safe for chemical pleurodesis in SSP.
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SBAs for the FRCR 2A CurrieS RowbothamE KarthikS WilkinsonC Cambridge, UKCambridge University Press pp. 165 2010£35/$65ISBN: 97805211556448. Br J Radiol 2010. [DOI: 10.1259/bjr-83-993-808b] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Further molecular and clinical delineation of co-locating 17p13.3 microdeletions and microduplications that show distinctive phenotypes. J Med Genet 2010; 47:299-311. [DOI: 10.1136/jmg.2009.069906] [Citation(s) in RCA: 114] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Long-term Outcome of Patients Who Underwent Percutaneous Coronary Interventions (PCI) for Stable and Unstable Acute Coronary Syndromes, Including STEMI, in a Regional Hospital Without On-site Surgical Back-up. Heart Lung Circ 2010. [DOI: 10.1016/j.hlc.2010.06.1000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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