1
|
Kirchheiner K, Zaharie AT, Smet S, Spampinato S, Chargari C, Mahantshetty UM, Segedin B, Bruheim K, Rai B, Cooper R, Van der Steen-Banasik E, Wiebe EM, Potter R, Kirisits C, Schmid M, Haie-Meder C, Tanderup K, De Leeuw A, Jurgenliemk-Schulz I, Nout RA. Association between Regular Vaginal Dilation and/or Sexual Activity and Long-Term Vaginal Morbidity in Cervical Cancer Survivors. Int J Radiat Oncol Biol Phys 2023; 117:S2-S3. [PMID: 37784450 DOI: 10.1016/j.ijrobp.2023.06.207] [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: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) To evaluate the association between regular vaginal dilation and/or sexual activity and vaginal morbidity in locally advanced cervical cancer patients after definitive radiochemotherapy and image-guided adaptive brachytherapy from the EMBRACE I study. MATERIALS/METHODS Physician-assessed vaginal morbidity (CTCAE v.3), vaginal dilation and patient-reported sexual activity (EORTC QLQ CX24) were assessed at baseline, every 3 months in the 1st year, every 6 months in the 2nd and 3rd year and yearly thereafter. For this longitudinal analysis, a subgroup of patients was selected with at least 3 follow-ups with information on vaginal dilation and/or sexual activity. Vaginal penetration summarized either the use of vaginal dilators or sexual activity or both. Regular vaginal penetration was defined if reported in ≥50%, infrequent if reported in <50% and absent if reported in 0% of follow-ups. Actuarial estimates of vaginal morbidity were calculated with Kaplan-Meier method and included the individual symptoms: vaginal dryness, stenosis, mucositis and bleeding. Group comparisons were evaluated with the log-rank test. RESULTS The EMBRACE I study included 1416 patients overall (2008-2015); the subgroup of patients for this longitudinal evaluation consists of 882 patients, with a median follow-up of 60 months (IQR 47-77). Of those, 565 (64%) reported regular, 205 (23%) infrequent and 112 (13%) no penetration. Reporting regular penetration was associated with a significantly lower risk of vaginal stenosis G≥2 of 23% at 5 years, compared to reporting of infrequent (37%) and no penetration (36%, p≤0.001). However, reporting regular penetration was associated with a significantly higher risk for vaginal dryness G≥1 (72% vs. 69% vs. 62%, respectively, p = 0.038) and bleeding G≥1 (61% vs. 40% vs. 25%, respectively, p≤0.001). No associations were seen for G≥1 vaginal stenosis, G≥2 dryness, G≥2 bleeding and G≥1/G≥2 mucositis. CONCLUSION Regular penetration (defined as vaginal dilation and/or sexual activity) was associated with lower risk for vaginal stenosis G≥2, but higher risk for vaginal dryness G≥1 and bleeding G≥1. Mild vaginal dryness seems to become apparent in particular for patients experiencing vaginal penetration. Minor vaginal blood loss during dilation and/or sexual activity is commonly reported by patients, resulting from atrophy of the vaginal mucosa and/or telangiectasia. While both of these G≥1 symptoms can be managed with lubricants, moisturizer and/or hormonal replacement therapy, G≥2 vaginal stenosis represents an irreversible fibrotic adverse event that can cause dyspareunia in many cancer patients. These long-term data support clinical recommendations for dilation and/or sexual activity after radiotherapy.
Collapse
Affiliation(s)
- K Kirchheiner
- Department Radiation Oncology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Vienna, Austria
| | - A T Zaharie
- Department Radiation Oncology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Vienna, Austria
| | - S Smet
- Department of Radiation Oncology, AZ Turnhout, Iridium Cancer Network, Antwerp, Turnhout, Belgium
| | - S Spampinato
- Department of Oncology, Aarhus University Hospital, Aarhus, Denmark
| | - C Chargari
- Department of Radiotherapy, Gustave-Roussy, Villejuif, Villejuif, France
| | - U M Mahantshetty
- Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai & Homi Bhabha Cancer Hospital & Research Centre, Visakhapatnam, India
| | - B Segedin
- Department of Radiotherapy and Faculty of Medicine, Institute of Oncology Ljubljana and University of Ljubljana, Ljubljana, Slovenia
| | - K Bruheim
- Department of Oncology, The Norwegian Radium Hospital, Oslo University Hospital, Oslo, Norway
| | - B Rai
- Department of Radiotherapy and Oncology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - R Cooper
- Leeds Cancer Centre, St James's University Hospital, Leeds, United Kingdom
| | | | - E M Wiebe
- Department of Oncology, Cross Cancer Institute and University of Alberta, Edmonton, AB, Canada
| | - R Potter
- Department for Radiation Oncology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria
| | - C Kirisits
- Department for Radiation Oncology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria
| | - M Schmid
- Department Radiation Oncology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria
| | - C Haie-Meder
- Department of Radiotherapy, Gustave-Roussy, Villejuif, Villejuif, France
| | - K Tanderup
- Department of Oncology, Aarhus University Hospital, Aarhus, Denmark
| | - A De Leeuw
- Department of Radiation Oncology, University Medical Center Utrecht, Utrecht, Netherlands
| | - I Jurgenliemk-Schulz
- Department of Radiation Oncology, University Medical Center Utrecht, Utrecht, Netherlands
| | - R A Nout
- Department of Radiotherapy, Erasmus MC Cancer Institute, University Medical Center Rotterdam, Rotterdam, Netherlands
| |
Collapse
|
2
|
Jones C, Gray S, Brown M, Brown J, Mc Closkey E, Rai B, Clarke N, Sachdeva A. Fracture and fall risk in men with advanced or metastatic prostate cancer treated with novel androgen receptor signalling inhibitors: A systematic review and meta-analysis of randomised controlled trials. Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)01036-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
|
3
|
Dey T, Rai B, Radhika S, Saha P, Rana S, Gowda S, Ghoshal S. Circulating Cell Free DNA as Predictive Biomarker in Cervical Cancer Patients Treated with Radical Chemo-Radiation. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.499] [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: 11/15/2022]
|
4
|
Dhiman S, Rai B, Vamsi K, Gowda S, Anand D, Miriyala R, Arora M, Jain V, Ghoshal S. Hypofractionated Two Week Short-Course Radiotherapy vs. Monthly Single Fraction Palliative Pelvic Radiation in Advanced Gynecologic Cancers. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.360] [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: 10/31/2022]
|
5
|
Spampinato S, Tanderup K, Nout R, Smet S, Lindegaard J, Fokdal L, Pötter R, Sturdza A, Segedin B, Jürgenliemk-Schulz I, Bruheim K, Mahantshetty U, Chargari C, Rai B, Cooper R, van der Steen-Banasik E, Sundset M, Wiebe E, Villafranca E, Van Limbergen E, Chopra S, Kirchheiner K. OC-0588 Impact of persistent symptoms on long-term quality of life of cervical cancer survivors in EMBRACE I. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)02610-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
6
|
Connor MJ, Genie MG, Gonzalez M, Sarwar N, Thippu Jayaprakash K, Horan G, Hosking-Jervis F, Klimowska-Nassar N, Sukumar J, Pokrovska T, Basak D, Robinson A, Beresford M, Rai B, Mangar S, Khoo V, Dudderidge T, Falconer A, Winkler M, Watson V, Ahmed HU. Metastatic prostate cancer men's attitudes towards treatment of the local tumour and metastasis evaluative research (IP5-MATTER): protocol for a prospective, multicentre discrete choice experiment study. BMJ Open 2021; 11:e048996. [PMID: 34794989 PMCID: PMC8603288 DOI: 10.1136/bmjopen-2021-048996] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
INTRODUCTION Systemic therapy with androgen deprivation therapy (ADT) and intensification with agents such as docetaxel, abiraterone acetate and enzalutamide has resulted in improved overall survival in men with de novo synchronous metastatic hormone-sensitive prostate cancer (mHSPC). Novel local cytoreductive treatments and metastasis-directed therapy are now being evaluated. Such interventions may provide added survival benefit or delay the requirement for further systemic agents and associated toxicity but can confer additional harm. Understanding men's preferences for treatment options in this disease state is crucial for patients, clinicians, carers and future healthcare service providers. METHODS Using a prospective, multicentre discrete choice experiment (DCE), we aim to determine the attributes associated with treatment that are most important to men with mHSPC. Furthermore, we plan to determine men's preferences for, and trade-offs between, the attributes (survival and side effects) of different treatment options including systemic therapy, local cytoreductive approaches (external beam radiotherapy, cytoreductive radical prostatectomy or minimally invasive ablative therapy) and metastases-directed therapies (metastasectomy or stereotactic ablative body radiotherapy). All men with newly diagnosed mHSPC within 4 months of commencing ADT and WHO performance status 0-2 are eligible. Men who have previously consented to a cytoreductive treatment or have developed castrate-resistant disease will be excluded. This study includes a qualitative analysis component, with patients (n=15) and healthcare professionals (n=5), to identify and define the key attributes associated with treatment options that would warrant trade-off evaluation in a DCE. The main phase component planned recruitment is 300 patients over 1 year, commencing in January 2021, with planned study completion in March 2022. ETHICS AND DISSEMINATION Ethical approval was obtained from the Health Research Authority East of England, Cambridgeshire and Hertfordshire Research Ethics Committee (Reference: 20/EE/0194). Project information will be reported on the publicly available Imperial College London website and the Heath Economics Research Unit (HERU website including the HERU Blog). We will use the social media accounts of IP5-MATTER, Imperial Prostate London, HERU and the individual researchers to disseminate key findings following publication. Findings from the study will be presented at national/international conferences and peer-reviewed journals. Authorship policy will follow the recommendations of the International Committee of Medical Journal Editors. TRIAL REGISTRATION NUMBER NCT04590976.
Collapse
Affiliation(s)
- Martin John Connor
- Imperial Prostate, Divison of Surgery, Department of Surgery and Cancer, Imperial College London, London, UK
- Imperial Urology, Charing Cross Hospital, Imperial College Healthcare NHS Trust, London, UK
| | - Mesfin G Genie
- Health Economics Research Unit (HERU), Faculty of Medicine, University of Aberdeen, Aberdeen, UK
- Economics, Ca' Foscari University of Venice, Venezia, Italy
| | - Michael Gonzalez
- Department of Oncology, Charing Cross Hospital, Imperial College Healthcare NHS Trust, London, UK
| | - Naveed Sarwar
- Department of Oncology, Charing Cross Hospital, Imperial College Healthcare NHS Trust, London, UK
| | - Kamalram Thippu Jayaprakash
- Department of Oncology, Addenbrooke's Hospital, Cambridge, UK
- Department of Oncology, Queen Elizabeth Hospital King's Lynn NHS Foundation Trust, King's Lynn, UK
| | - Gail Horan
- Department of Oncology, Addenbrooke's Hospital, Cambridge, UK
| | - Feargus Hosking-Jervis
- Imperial Prostate, Divison of Surgery, Department of Surgery and Cancer, Imperial College London, London, UK
| | - Natalia Klimowska-Nassar
- Imperial Prostate, Divison of Surgery, Department of Surgery and Cancer, Imperial College London, London, UK
- Imperial College Clinical Trials Unit (ICTU), Imperial College London, London, UK
| | - Johanna Sukumar
- Imperial Prostate, Divison of Surgery, Department of Surgery and Cancer, Imperial College London, London, UK
- Imperial College Clinical Trials Unit (ICTU), Imperial College London, London, UK
| | - Tzveta Pokrovska
- Department of Oncology, Charing Cross Hospital, Imperial College Healthcare NHS Trust, London, UK
| | - Dolan Basak
- Department of Oncology, Charing Cross Hospital, Imperial College Healthcare NHS Trust, London, UK
| | - Angus Robinson
- Department of Oncology, Brighton and Sussex University Hospitals NHS Trust, Brighton, UK
| | - Mark Beresford
- Department of Oncology, Royal United Hospitals Bath NHS Foundation Trust, Bath, UK
| | - Bhavan Rai
- Department of Urology, Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, UK
| | - Stephen Mangar
- Department of Oncology, Charing Cross Hospital, Imperial College Healthcare NHS Trust, London, UK
| | - Vincent Khoo
- Department of Oncology, The Royal Marsden NHS Foundation Trust and Institute of Cancer Research, London, UK
| | - Tim Dudderidge
- Department of Urology, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Alison Falconer
- Department of Oncology, Charing Cross Hospital, Imperial College Healthcare NHS Trust, London, UK
| | - Mathias Winkler
- Imperial Prostate, Divison of Surgery, Department of Surgery and Cancer, Imperial College London, London, UK
- Imperial Urology, Charing Cross Hospital, Imperial College Healthcare NHS Trust, London, UK
| | - Verity Watson
- Health Economics Research Unit (HERU), Faculty of Medicine, University of Aberdeen, Aberdeen, UK
| | - Hashim Uddin Ahmed
- Imperial Prostate, Divison of Surgery, Department of Surgery and Cancer, Imperial College London, London, UK
- Imperial Urology, Charing Cross Hospital, Imperial College Healthcare NHS Trust, London, UK
| |
Collapse
|
7
|
Baral R, Shrestha LB, Ortuño-Gutiérrez N, Pyakure P, Rai B, Rimal SP, Singh S, Sharma SK, Khanal B, Selvaraj K, Kumar AMV. Low yield but high levels of multidrug resistance in urinary tract infections in a tertiary hospital, Nepal. Public Health Action 2021; 11:70-76. [PMID: 34778019 DOI: 10.5588/pha.21.0044] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Accepted: 07/21/2021] [Indexed: 11/10/2022] Open
Abstract
SETTING There are concerns about the occurrence of multidrug resistance (MDR) in patients with urine tract infections (UTI) in Nepal. OBJECTIVE To determine culture positivity, trends in MDR among Escherichia coli and Klebsiella pneumoniae infections and seasonal changes in culture-positive UTI specimens isolated from 2014 to 2018 at the B P Koirala Institute of Health Sciences, Dharan, Eastern Nepal. DESIGN This was a cross-sectional study using secondary laboratory data. RESULTS Among 116,417 urine samples tested, 19,671 (16.9%) were culture-positive, with an increasing trend in the number of samples tested and culture positivity. E. coli was the most common bacteria (54.3%), followed by K. pneumoniae (8.8%). Among E. coli and K. pneumoniae isolates, MDR was found in respectively 42.5% and 36.0%. MDR was higher in males and people aged >55 years, but showed a decreasing trend over the years. The numbers of isolates increased over the years, with a peak always observed from July to August. CONCLUSION Low culture positivity is worrying and requires further work into improving diagnostic protocols. Decreasing trends in MDR are a welcome sign. Information on seasonal changes that peak in July-August can help laboratories better prepare for this time with adequate buffer stocks to ensure culture and antibiotic susceptibility testing.
Collapse
Affiliation(s)
- R Baral
- BP Koirala Institute of Health Sciences (BPKIHS), Dharan, Nepal
| | - L B Shrestha
- BP Koirala Institute of Health Sciences (BPKIHS), Dharan, Nepal
| | | | - P Pyakure
- BP Koirala Institute of Health Sciences (BPKIHS), Dharan, Nepal.,School of Public Health and Community Medicine, BPKIHS, Dharan, Nepal
| | - B Rai
- BP Koirala Institute of Health Sciences (BPKIHS), Dharan, Nepal
| | - S P Rimal
- BP Koirala Institute of Health Sciences (BPKIHS), Dharan, Nepal
| | - S Singh
- BP Koirala Institute of Health Sciences (BPKIHS), Dharan, Nepal
| | - S K Sharma
- BP Koirala Institute of Health Sciences (BPKIHS), Dharan, Nepal
| | - B Khanal
- BP Koirala Institute of Health Sciences (BPKIHS), Dharan, Nepal
| | - K Selvaraj
- All India Institute of Medical Sciences, Nagpur, India
| | - A M V Kumar
- International Union Against Tuberculosis and Lung Disease (The Union), Paris, France.,The Union South-East Asia Office, New Delhi, India.,Yenepoya Medical College, Yenepoya (deemed University), Mangaluru, India
| |
Collapse
|
8
|
Ng Cheong Chung J, Isgro G, Page T, Thomas D, Haslam P, McNeil A, Soomro N, Rix D, Rai B, Veeratterapillay R. 562 Biopsy of Localised Renal Masses Offers High Diagnostic Yield and Low Complication Rate in Patients with Suspicious Renal Masses. Br J Surg 2021. [DOI: 10.1093/bjs/znab259.1085] [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]
Abstract
Abstract
Aim
Biopsy of localised renal masses is generally accurate at detecting benign or malignant histology but can cause complications. The aim of this study was to determine the detection rate and complication rate of renal mass biopsies.
Method
Patients undergoing a renal mass biopsy at a single tertiary centre between January 2015 and December 2019 were identified electronically using a prospective database. Details about their biopsies were recorded including tumour size, radiological guidance, number of cores, longest margin of biopsy, accuracy of biopsy, histology type, and complications.
Results
This study included 334 biopsies (Median age 68 years (IQR 60-72); 61.4% (n = 204) male). Median size of tumour was 30mm (IQR 25-50) and 79.9% (n = 267) were solid masses. The biopsies were done under ultrasound (78.4%) or computed tomography (21.6%) guidance. 91.9% had core biopsies (n = 307) with median biopsy margin of 14mm (IQR 9-21). Benign histology was observed in 18.9% (n = 63), malignant in 72.1% (n = 241) while biopsy was non-diagnostic in 9.0% (n = 30). 62.6% (n = 209) of the cases were renal cell carcinoma with clear cell subtype more commonly seen (72.2%, n = 151). Complications following biopsy included haematoma (n = 7, 2.1%), haemorrhage (n = 3, 0.9%), pneumothorax (n = 1, 0.3%) and vasovagal episode (n = 1, 0.3%), resulting in an overall complication rate of 3.6%.
Conclusions
Biopsy of localised renal masses in this study showed a detection rate of 91% and complication rate of 3.6%. This study suggests renal mass biopsies have high diagnostic yield and low complication rate.
Collapse
Affiliation(s)
| | - G Isgro
- Freeman Hospital, Newcastle upon Tyne, United Kingdom
| | - T Page
- Freeman Hospital, Newcastle upon Tyne, United Kingdom
| | - D Thomas
- Freeman Hospital, Newcastle upon Tyne, United Kingdom
| | - P Haslam
- Freeman Hospital, Newcastle upon Tyne, United Kingdom
| | - A McNeil
- Freeman Hospital, Newcastle upon Tyne, United Kingdom
| | - N Soomro
- Freeman Hospital, Newcastle upon Tyne, United Kingdom
| | - D Rix
- Freeman Hospital, Newcastle upon Tyne, United Kingdom
| | - B Rai
- Freeman Hospital, Newcastle upon Tyne, United Kingdom
| | | |
Collapse
|
9
|
Ng Chieng Hin J, Hettiarachchilage D, Gravestock P, Rai B, Somani BK, Veeratterapillay R. Role of Ureteroscopy in Treatment of Upper Tract Urothelial Carcinoma. Curr Urol Rep 2021; 22:49. [PMID: 34622345 PMCID: PMC8497313 DOI: 10.1007/s11934-021-01065-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/15/2021] [Indexed: 12/25/2022]
Abstract
Purpose of Review Upper tract urothelial carcinoma (UTUC) is uncommon accounting for less than 10% of all urothelial tumours. Ureteroscopic management (URS) is the first line treatment for low-risk disease and has been increasingly utilised due to technological advances and increasing surgical experience. This review looks at patient outcomes relating to URS, emerging technologies and the role of adjuvant intracavitary therapy in the management of UTUC. Recent Findings URS has firmly established itself in the management algorithm for UTUC, and a good body of evidence supports its use for low-risk disease, wherein oncological outcomes are comparable to traditional nephroureterectomy (RNU). Larger tumours can now be managed using URS with a lower morbidity than radical surgery, though with higher associated local recurrence rate and risk of progression to RNU, and as a result, patient selection and close surveillance remains key. There is limited evidence for adjuvant intracavitary therapy (Mitomycin C or BCG) in UTUC although the development of novel polymers and biodegradable stents may improve drug delivery to the upper urinary tract. Summary URS has a clearly defined role in low-risk UTUC, and its use in larger tumours appears to be appropriate in a selected cohort of patients. The efficacy of adjuvant intracavitary therapy is as of yet undetermined, though developments in delivery techniques are promising. Likewise further developments of laser technology are anticipated to further expand the role of URS. Supplementary Information The online version contains supplementary material available at 10.1007/s11934-021-01065-7.
Collapse
Affiliation(s)
| | | | | | - Bhavan Rai
- Department of Urology, Freeman Hospital, Newcastle, UK
| | - Bhaskar K Somani
- Department of Urology, University Hospital Southamptom, Southamptom, UK.
| | | |
Collapse
|
10
|
Veeratterapillay R, Gravestock P, Nambiar A, Gupta A, Aboumarzouk O, Rai B, Vale L, Heer R. Time to Turn on the Blue Lights: A Systematic Review and Meta-analysis of Photodynamic Diagnosis for Bladder Cancer. EUR UROL SUPPL 2021; 31:17-27. [PMID: 34467237 PMCID: PMC8385287 DOI: 10.1016/j.euros.2021.06.011] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [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] [Accepted: 06/28/2021] [Indexed: 11/17/2022] Open
Abstract
Context White light (WL) cystoscopy and transurethral resection of bladder tumour (TURBT) comprise the current gold standard technique for detecting and grading bladder cancer. However, with WL cystoscopy, recurrence following initial TURBT is high, and identification of smaller tumours and carcinoma in situ is poor. Photodynamic diagnosis (PDD) has been developed to improve the detection of bladder. Objective To assess the effect of PDD-guided TURBT compared with WL on recurrence rates (RRs) in non-muscle-invasive bladder cancer (NMIBC). Evidence acquisition A systematic review of the literature from inception to April 2020 using Medline, EMBASE, and CENTRAL was undertaken. Randomised control trials comparing TURBT undertaken with PDD to WL that reported RRs of at least 12 mo were included in the analysis. The primary outcomes were RRs at 12 and 24 mo. The secondary outcomes were reported adverse effects. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology was used to assess the certainty of the evidence. Evidence synthesis Twelve randomised controlled trials (2288 patients) were included for the meta-analysis. PDD was found to reduce RRs at 12 mo (RR 0.73, confidence interval [CI] 0.60-0.88) and 24 mo (RR 0.75, CI 0.62-0.91). There was an increased risk of recurrence for patients undergoing WL at 12 mo (hazard ratio [HR] 1.14, CI 1.05-1.23) and 24 mo (HR 1.25, CI 1.15-1.35). Two studies reported recurrence data at 60 mo showing statistically significant outcomes in favour of PDD: one showed lower RRs for PDD (49% PDD vs 68% WL), whilst the other showed increased recurrence-free survival (68.2% PDD vs 57.3% WL). Adverse effects appeared to be minimal, though poorly reported. A GRADE analysis showed the evidence to be of moderate certainty overall. Conclusions This systematic review found that PDD reduced RRs and improved recurrence-free survival compared with WL in NMIBC over at least 2-yr follow-up. These effects may persist up to 5 yr. Further research in a pragmatic study looking at longer-term outcomes beyond 24 mo will help guide recommendations on clinical adoption. Patient summary This review suggests that photodynamic diagnosis, compared with white light cystoscopy, improves recurrence-free survival in non-muscle-invasive bladder cancer over at least 2 yr of follow-up. However, confirmatory pragmatic studies with longer-term outcomes are required for its clinical adoption.
Collapse
Affiliation(s)
| | | | - Arjun Nambiar
- Department of Urology, Freeman Hospital, Newcastle, UK
| | - Ameet Gupta
- Department of Urology, Freeman Hospital, Newcastle, UK
| | | | - Bhavan Rai
- Department of Urology, Freeman Hospital, Newcastle, UK
| | - Luke Vale
- Health Economics Group, Population Health Sciences Institute, Newcastle University, Newcastle, UK
| | - Rakesh Heer
- Department of Urology, Freeman Hospital, Newcastle, UK
- Corresponding author. Department of Urology, Newcastle University, Newcastle, UK. Tel. 0191 233 6161.
| |
Collapse
|
11
|
Connor M, Genie M, Gonzalez M, Hosking-Jervis F, Thippu Jayaprakash K, Sarwar N, Horan G, Klimowska-Nassar N, Sukumar J, Pokrovska T, Basak D, Rai B, Robinson A, Beresford M, Mangar S, Falconer A, Dudderidge T, Khoo V, Winkler M, Watson V, Ahmed H. Metastatic prostate cancer patients’ Attitudes towards Treatment of the local Tumour and metastasis Evaluative Research (IP5-MATTER): A multicentre, discrete choice experiment trial-in-progress. Eur Urol 2021. [DOI: 10.1016/s0302-2838(21)01243-4] [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]
|
12
|
Gravestock P, Veeratterapillay R, Nambiar A, Gupta A, Aboumarzouk O, Rai B, Heer R. Time to turn on the blue lights: A systematic review and meta-analysis of photodynamic diagnosis for bladder cancer. Eur Urol 2021. [DOI: 10.1016/s0302-2838(21)01093-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|
13
|
Lindegaard J, Petric P, Schmid M, Haie-Meder C, Fokdal L, Sturdza A, Hoskin P, Mahantshetty U, Segedin B, Bruheim K, Huang F, Rai B, Cooper R, van der Steen-Banasik E, Van Limbergen E, Pieters B, Tan L, Nout R, de Leeuw A, Nesvacil N, Kirchheiner K, Jürgenliemk-Schultz I, Tanderup K, Kirisits C, Pötter R, Collaborative Group E. OC-0025 Tumor regression of cervical cancer during chemoradiation evaluated by the T-score in EMBRACE I. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)06277-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
|
14
|
Patel K, Rai B, Scott M, O'Brien T. Veno-Venous Extracorporeal Membrane Oxygenation - Rapid Recovery for Post-Surgical Negative Pressure Pulmonary Edema. J Heart Lung Transplant 2021. [DOI: 10.1016/j.healun.2021.01.2107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
|
15
|
Rai B, Rosse C, Gorder K, Rudick S, Chung E, Raymond T, O'Brien T, Egnaczyk G, Answini G, Griffin J, Smith J, Hasan S, Choo J, Smith T. Left Atrial Veno-Arterial Extracorporeal Membrane Oxygenation (LAVA-ECMO) is a Feasible Option for Patients in Cardiogenic Shock for Whom Impella Offloading is Contraindicated. J Heart Lung Transplant 2021. [DOI: 10.1016/j.healun.2021.01.2095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
|
16
|
Johnson H, Garg M, Shantikumar S, Thachil J, Rai B, Aboumarzouk OM, Hashim H, Philip J. COVID-19 (SARS-CoV-2) in Non-Airborne body fluids: A systematic review & Meta-analysis. Turk J Urol 2021; 47:87-97. [PMID: 33819440 PMCID: PMC8018805 DOI: 10.5152/tud.2021.20586] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Accepted: 01/13/2021] [Indexed: 12/15/2022]
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has been predominantly respiratory. This study aimed to evaluate the presence of virus in non-airborne body fluids as transmission vehicles. Medline, EMBASE, and Cochrane Library databases were searched from December 01, 2019, to July 01, 2020, using terms relating to SARS-CoV-2 and non-airborne clinical sample sources (feces, urine, blood, serum, serum, and peritoneum). Studies in humans, of any design, were included. Risk of bias assessment was performed using the Quality Assessment of Diagnostic Accuracy 2 tool. Preferred Reporting Items for Systematic Reviews & Meta-Analyses) guidelines were used for abstracting data. If ≥5 studies reported proportions for the same non-respiratory site, a meta-analysis was conducted using either a fixed or random-effects model, depending on the presence of heterogeneity. A total of 22 studies with 648 patients were included. Most were cross-sectional and cohort studies. The SARS-CoV-2 RNA was most frequently detected in feces. Detectable RNA was reported in 17% of the blood samples, 8% of the serum, 16% in the semen, but rarely in urine. Prevalence of SARS-CoV-2 in non-airborne sites varies widely with a third of non-airborne fluids. Patients with bowel and non-specific symptoms have persistence of virus in feces for upto 2 weeks after symptom resolution. Although there was a very low detection rate in urine, given the more frequent prevalence in blood samples, the presence of SARS-CoV-2 in patients with disrupted urothelium or undergoing urinary tract procedures, is likely to be higher. Healthcare providers need to consider non-airborne transmission and persistence of SARS-CoV-2 in body fluids to enable appropriate precautions to protect healthcare workers and carers.
Collapse
Affiliation(s)
- Hans Johnson
- Bristol Medical School, University of Bristol, Bristol, UK
| | - Megha Garg
- Faculty of Health Sciences, University of Bristol, Bristol, UK
| | | | - Jecko Thachil
- Department of Haematology, Manchester University Hospitals, Manchester, UK
| | - Bhavan Rai
- Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle, UK
| | | | - Hashim Hashim
- Bristol Medical School, University of Bristol, Bristol, UK
- Bristol Urological Institute, North Bristol NHS Trust, Bristol, UK
| | - Joe Philip
- Bristol Medical School, University of Bristol, Bristol, UK
- Bristol Urological Institute, North Bristol NHS Trust, Bristol, UK
| |
Collapse
|
17
|
Ballari N, Rai B, Bahl A, Mittal BR, Ghoshal S. Prospective observational study evaluating acute and delayed treatment related toxicities of prophylactic extended field volumetric modulated arc therapy with concurrent cisplatin in cervical cancer patients with pelvic lymph node metastasis. Tech Innov Patient Support Radiat Oncol 2021; 17:48-56. [PMID: 33748442 PMCID: PMC7970137 DOI: 10.1016/j.tipsro.2021.02.009] [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: 10/30/2020] [Revised: 02/10/2021] [Accepted: 02/15/2021] [Indexed: 11/30/2022] Open
Abstract
PURPOSE To evaluate the treatment related acute and delayed toxicities of extended field Volumetric modulated arc therapy (VMAT) with concurrent chemotherapy in patients of locally advanced cervical cancer with pelvic lymph nodes. MATERIAL AND METHODS From 2014 to 2016, 15 patients of locally advanced cervical cancer with Fluoro-deoxyglucose positron emission tomography (FDG-PET) positive pelvic lymph nodes were treated with extended field Simultaneous integrated boost (SIB)-VMAT 45 Gy/55 Gy/25#/5weeks and concurrent cisplatin. Acute toxicities were documented according to common terminology criteria for adverse events version 4 (CTCAE v.4). Dose volume parameters and patient characteristics were analyzed for association with toxicities. RESULTS Median age of patients at diagnosis was 48 years. 40% (6 patients) were stage IIB & 60% (9 patients) were stage IIIB. Median number of involved pelvic lymph nodes was 2 (range, 1-4), commonest location was external iliac lymph node region (86%). Median number of concurrent chemotherapy cycles received was five. Treatment was well tolerated and there were no grade ≥ 3 acute toxicities. Commonest acute toxicities observed were vomiting (≥grade2 -13.3%) followed by & nausea (grade ≥ 2 in 6%) and were associated with volume of bowel bag receiving 45 Gy. Constitutional symptoms (≥grade 2) were observed in 6% patients and had no dosimetric associations. At a median follow up of 43 months, delayed ≥ grade1, 2, 3 toxicity were observed in 80%, 0%, and 0% respectively with diarrhea being the commonest. CONCLUSION Prophylactic para aortic extended field VMAT with concurrent chemotherapy for locally advanced cervical cancer is well tolerated with acceptable acute toxicity profile. Significant grade 3 acute/delayed toxicities were not observed in this cohort of patients.
Collapse
Affiliation(s)
- N Ballari
- Departments of Radiotherapy, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - B Rai
- Departments of Radiotherapy, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - A Bahl
- Departments of Radiotherapy, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - B R Mittal
- Nuclear Medicine, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - S Ghoshal
- Departments of Radiotherapy, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| |
Collapse
|
18
|
Connor MJ, Shah TT, Smigielska K, Day E, Sukumar J, Fiorentino F, Sarwar N, Gonzalez M, Falconer A, Klimowska-Nassar N, Evans M, Naismith OF, Thippu Jayaprakash K, Price D, Gayadeen S, Basak D, Horan G, McGrath J, Sheehan D, Kumar M, Ibrahim A, Brock C, Pearson RA, Anyamene N, Heath C, Shergill I, Rai B, Hellawell G, McCracken S, Khoubehi B, Mangar S, Khoo V, Dudderidge T, Staffurth JN, Winkler M, Ahmed HU. Additional Treatments to the Local tumour for metastatic prostate cancer-Assessment of Novel Treatment Algorithms (IP2-ATLANTA): protocol for a multicentre, phase II randomised controlled trial. BMJ Open 2021; 11:e042953. [PMID: 33632752 PMCID: PMC7908915 DOI: 10.1136/bmjopen-2020-042953] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Revised: 01/08/2021] [Accepted: 01/28/2021] [Indexed: 02/06/2023] Open
Abstract
INTRODUCTION Survival in men diagnosed with de novo synchronous metastatic prostate cancer has increased following the use of upfront systemic treatment, using chemotherapy and other novel androgen receptor targeted agents, in addition to standard androgen deprivation therapy (ADT). Local cytoreductive and metastasis-directed interventions are hypothesised to confer additional survival benefit. In this setting, IP2-ATLANTA will explore progression-free survival (PFS) outcomes with the addition of sequential multimodal local and metastasis-directed treatments compared with standard care alone. METHODS A phase II, prospective, multicentre, three-arm randomised controlled trial incorporating an embedded feasibility pilot. All men with new histologically diagnosed, hormone-sensitive, metastatic prostate cancer, within 4 months of commencing ADT and of performance status 0 to 2 are eligible. Patients will be randomised to Control (standard of care (SOC)) OR Intervention 1 (minimally invasive ablative therapy to prostate±pelvic lymph node dissection (PLND)) OR Intervention 2 (cytoreductive radical prostatectomy±PLND OR prostate radiotherapy±pelvic lymph node radiotherapy (PLNRT)). Metastatic burden will be prespecified using the Chemohormonal Therapy Versus Androgen Ablation Randomized Trial for Extensive Disease (CHAARTED) definition. Men with low burden disease in intervention arms are eligible for metastasis-directed therapy, in the form of stereotactic ablative body radiotherapy (SABR) or surgery. Standard systemic therapy will be administered in all arms with ADT±upfront systemic chemotherapy or androgen receptor agents. Patients will be followed-up for a minimum of 2 years. PRIMARY OUTCOME PFS. Secondary outcomes include predictive factors for PFS and overall survival; urinary, sexual and rectal side effects. Embedded feasibility sample size is 80, with 918 patients required in the main phase II component. Study recruitment commenced in April 2019, with planned follow-up completed by April 2024. ETHICS AND DISSEMINATION Approved by the Health Research Authority (HRA) Research Ethics Committee Wales-5 (19/WA0005). Study results will be submitted for publication in peer-reviewed journals. TRIAL REGISTRATION NUMBER NCT03763253; ISCRTN58401737.
Collapse
Affiliation(s)
- Martin John Connor
- Imperial Prostate, Division of Surgery, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, London, UK
- Imperial Urology, Imperial College Healthcare NHS Trust, London, UK
| | - Taimur Tariq Shah
- Imperial Prostate, Division of Surgery, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, London, UK
| | - Katarzyna Smigielska
- Imperial Prostate, Division of Surgery, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, London, UK
- Imperial College Clinical Trials Unit, Imperial College London, London, UK
| | - Emily Day
- Imperial College Clinical Trials Unit, Imperial College London, London, UK
| | - Johanna Sukumar
- Imperial Prostate, Division of Surgery, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, London, UK
- Imperial College Clinical Trials Unit, Imperial College London, London, UK
| | | | - Naveed Sarwar
- Department of Oncology, Imperial College Healthcare NHS Trust, London, UK
| | - Michael Gonzalez
- Department of Oncology, Imperial College Healthcare NHS Trust, London, UK
| | - Alison Falconer
- Department of Oncology, Imperial College Healthcare NHS Trust, London, UK
| | - Natalia Klimowska-Nassar
- Imperial Prostate, Division of Surgery, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, London, UK
- Imperial College Clinical Trials Unit, Imperial College London, London, UK
| | - Martin Evans
- Imperial Prostate, Division of Surgery, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, London, UK
| | - Olivia Frances Naismith
- Radiotherapy Trials Quality Assurance (RTTQA), Royal Marsden NHS Foundation Trust, London, UK
| | | | - Derek Price
- Imperial Prostate, Division of Surgery, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, London, UK
| | - Shiva Gayadeen
- Department of Oncology, Imperial College Healthcare NHS Trust, London, UK
| | - Dolan Basak
- Department of Oncology, Imperial College Healthcare NHS Trust, London, UK
| | - Gail Horan
- Department of Oncology, Addenbrooke's Hospital, Cambridge, Cambridgeshire, UK
| | - John McGrath
- Department of Urology, Royal Devon and Exeter NHS Foundation Trust, Exeter, Devon, UK
| | - Denise Sheehan
- Department of Oncology, Royal Devon and Exeter NHS Foundation Trust, Exeter, Devon, UK
| | - Manal Kumar
- Department of Urology, Arrowe Park Hospital, Wirral University Teaching Hospital NHS Foundation Trust, Wirral, UK
| | - Azman Ibrahim
- Department of Clinical Oncology, Clatterbridge Cancer Centre NHS Foundation Trust, Bebington, Wirral, UK
| | - Cathryn Brock
- Department of Oncology, Chelsea and Westminster Hospital NHS Foundation Trust, London, UK
| | - Rachel A Pearson
- Department of Oncology, Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, UK
| | - Nicola Anyamene
- Department of Oncology, London North West University Healthcare NHS Trust, Harrow, London, UK
| | - Catherine Heath
- Department of Radiotherapy, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Iqbal Shergill
- Department of Urology, Wrexham Maelor Hospital, Wrexham, UK
| | - Bhavan Rai
- Department of Urology, Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, UK
| | - Giles Hellawell
- Department of Urology, Northwick Park Hospital, London North West University Healthcare NHS Trust, Harrow, London, UK
| | - Stuart McCracken
- Department of Urology, Sunderland Royal Hospital, Sunderland, UK
| | - Bijan Khoubehi
- Department of Urology, Chelsea and Westminster Hospital NHS Foundation Trust, London, UK
| | - Stephen Mangar
- Department of Oncology, Imperial College Healthcare NHS Trust, London, UK
| | - Vincent Khoo
- Department of Oncology, The Royal Marsden NHS Foundation and Institute of Cancer Research, London, UK
| | - Tim Dudderidge
- Department of Urology, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - John Nicholas Staffurth
- Research, Velindre Cancer Centre, Cardiff, UK
- Division of Cancer and Genetics, Cardiff University School of Medicine, Cardiff, UK
| | - Mathias Winkler
- Imperial Prostate, Division of Surgery, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, London, UK
- Imperial Urology, Imperial College Healthcare NHS Trust, London, UK
| | - Hashim Uddin Ahmed
- Imperial Prostate, Division of Surgery, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, London, UK
- Imperial Urology, Imperial College Healthcare NHS Trust, London, UK
| |
Collapse
|
19
|
Murthy P, Dosani A, Sikdar KC, Koleade A, Rai B, Scotland J, Lodha A. Parental perception of neonatal retro-transfers from level 3 to level 2 neonatal intensive care units. J Matern Fetal Neonatal Med 2021; 35:5546-5554. [PMID: 33586586 DOI: 10.1080/14767058.2021.1887125] [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: 10/22/2022]
Abstract
OBJECTIVE The primary objective of this study was to determine the overall parental satisfaction with retro-transfers from a level 3 to a level 2 Neonatal Intensive Care Unit (NICU). The secondary objectives were to explore factors that caused parental satisfaction associated with retro-transfer and investigate the factors that could be modified to improve the retro-transfer process. METHODS This is a retrospective cross-sectional study. Questionnaires were mailed to all parents of infants transferred from level 3 to level 2 NICUs from 2016 to 2017. Independent samples t-tests, Spearman's rank correlations, and multiple logistic regression analyses were conducted to identify factors associated with parental retro-transfer satisfaction. RESULTS Our response rate was 39.1% (n = 140). Of all parents, 64.29% parents were extremely satisfied with the overall retro-transfer process. In our bivariate analyses, multiple factors were found to be strongly associated with parental retro-transfer satisfaction, including parental level of education, the amount of notice and rationale given for the retro-transfer and the level of parental communication and engagement with their infant's healthcare team before and after transfer. Multiple logistic regression analyses revealed that when questions regarding the retro-transfer were answered and the level 2 NICU team demonstrated a concrete understanding of the infant's medical issues and history, parental satisfaction increased. CONCLUSION Majority of parents were satisfied with the retro-transfer process. However, close collaboration and ongoing and open lines of communication between parents and the level 3 NICU healthcare teams will increase parental retro-transfer satisfaction rates.
Collapse
Affiliation(s)
- P Murthy
- Department of Pediatrics, University of Calgary, Calgary, Canada.,Alberta Health Services, Calgary, Canada.,Rockyview General Hospital, Calgary, Canada
| | - A Dosani
- School of Nursing and Midwifery, Mount Royal University, Calgary, Canada.,Department of Community Health Sciences, University of Calgary, Calgary, Canada.,O'Brien Institute for Public Health, University of Calgary, Calgary, Canada
| | - K C Sikdar
- Alberta Health Services, Calgary, Canada.,Department of Community Health Sciences, University of Calgary, Calgary, Canada
| | - A Koleade
- Alberta Health Services, Calgary, Canada
| | - B Rai
- Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - J Scotland
- Alberta Health Services, Calgary, Canada.,Rockyview General Hospital, Calgary, Canada
| | - A Lodha
- Department of Pediatrics, University of Calgary, Calgary, Canada.,Alberta Health Services, Calgary, Canada.,Department of Community Health Sciences, University of Calgary, Calgary, Canada.,Alberta Children's Hospital Research Institute, University of Calgary Calgary, Canada
| |
Collapse
|
20
|
Hameed BZ, Tanidir Y, Naik N, Teoh JYC, Shah M, Wroclawski ML, Kunjibettu AB, Castellani D, Ibrahim S, da Silva RD, Rai B, de la Rosette JJMCH, Tp R, Gauhar V, Somani B. Will "Hybrid" Meetings Replace Face-To-Face Meetings Post COVID-19 Era? Perceptions and Views From The Urological Community. Urology 2021; 156:52-57. [PMID: 33561472 PMCID: PMC8556060 DOI: 10.1016/j.urology.2021.02.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [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: 11/01/2020] [Revised: 01/08/2021] [Accepted: 02/01/2021] [Indexed: 01/28/2023]
Abstract
OBJECTIVE To understand the preference and role of 'hybrid' urological meetings compared to face-to-face and online meetings during and after COVID-19 pandemic. The secondary outcome was finding out the most preferable webinar setting. METHODS An online global survey was done between June 06 and July 05, 2020, using SurveyMonkey. The target participants were urology healthcare providers. The survey was disseminated via mailing lists and the Twitter platform. RESULTS A total of 526 urology providers from 56 countries responded to the survey and it was completed by 73.3%. Participants' overall experience was better in a face-to-face meeting, followed by a hybrid and webinar only meeting. While opportunities for networking was identified as high in face-to-face meeting, online webinars were more cost effective, and learning opportunity and reach of audience was higher for hybrid meetings. For online webinar format, Zoom platform was used by 73% and majority (69%) saw it on their laptop or desktop. The preference was for a 1-hour webinar in the evenings with 3-5 speakers. Urology residents rated face-to-face meetings to have better cost-effectiveness when compared to consultants. Post COVID-19, more than half of all respondents would prefer hybrid meetings compared to the other formats. CONCLUSION While there will be a place for face-to-face meetings, COVID-19 situation has led to a preference towards hybrid meetings which is ideal for a global reach in the future. It is plausible that most urological associations will move towards a hybrid model for their meetings.
Collapse
Affiliation(s)
- Bm Zeeshan Hameed
- Department of Urology, Kasturba Medical College Manipal, Manipal Academy of Higher Education, Manipal, KA, India
| | - Yiloren Tanidir
- Department of Urology, Marmara University Faculty of Medicine, IST, Turkey
| | - Nithesh Naik
- Faculty of Engineering, Manipal Institute of Technology, Manipal Academy of Higher Education, Manipal, India
| | - Jeremy Yuen-Chun Teoh
- S.H.Ho Urology Centre, Department of Surgery, The Chinese University of Hong Kong, Hong Kong, China
| | - Milap Shah
- Department of Urology, Kasturba Medical College Manipal, Manipal Academy of Higher Education, Manipal, KA, India
| | - Marcelo Langer Wroclawski
- Hospital Israelita Albert Einstein, São Paulo, Brazil; BP - a Beneficência Portuguesa de São Paulo, São Paulo, Brazil
| | | | - Daniele Castellani
- Urology Division, Azienda Ospedaliero-Universitaria Ospedali Riuniti di Ancona, Università Politecnica delle Marche, Ancona, Italy.
| | - Sufyan Ibrahim
- Department of Urology, Kasturba Medical College Manipal, Manipal Academy of Higher Education, Manipal, KA, India
| | | | - Bhavan Rai
- Department of Urology, Freeman Hospital, Newcastle, UK
| | | | - Rajeev Tp
- Department of Urology, Government Medical College Hospital, Guwahati, India
| | | | - Bhaskar Somani
- Department of Urology, University Hospital Southampton NHS Trust, Southampton, UK
| |
Collapse
|
21
|
Kumar R, Rai B, Gahlyan S, Kumar G. A comprehensive review on production, surface modification and characterization of nanocellulose derived from biomass and its commercial applications. EXPRESS POLYM LETT 2021. [DOI: 10.3144/expresspolymlett.2021.11] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
|
22
|
Kailavasan M, Berridge C, Kandaswamy G, Rai B, Wilkinson B, Jain S, Biyani CS, Gowda B. A Low-Cost Synthetic Abdominal Wall Model ("Raj Model") for the Training of Laparoscopic Port Insertion. World J Surg 2020; 44:1431-1435. [PMID: 31897696 DOI: 10.1007/s00268-019-05354-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To assess the content validity of a low-cost bench-top model ("Raj Model") for the training of laparoscopic port insertion at the Urology Simulation Bootcamp course (USBC). MATERIALS AND METHODS A low-cost abdominal wall model of 40 × 40 cm was created to simulate laparoscopic port placement. The model was made using different synthetic materials to represent layers (skin-vinyl sheet, subcutaneous fat-10 mm soft foam, anterior rectus sheath and muscle-floor mat, posterior rectus sheath-masking wall tape, peritoneum-sellotape). Each model was used by up to 3 trainees to practise laparoscopic port placement. The model was assessed for content validity by trainees and experts using a 5-point Likert scale. RESULT In total, 88 trainees and 6 experts participated in the study. For all aspects of the synthetic abdominal wall, good (4) or very good (5) scores ranged from 52.7-69.2%, whereas very poor (1) rating ranged from 0 to 4.3%. There was no significant difference in responses for the content validity of the model between trainees and experts. There was a high intraclass correlation amongst responses from trainees (0.89) and experts (0.79). Approximately 76.3% of trainees and experts felt that the model is suitable for training. CONCLUSION This is the first validation study of a low-cost abdominal wall model for teaching laparoscopic port placement for trainees. Our study demonstrates that this synthetic model has high content validity and is useful for surgical training.
Collapse
Affiliation(s)
| | | | | | | | | | - Sunjay Jain
- Department of Urology, St James's University Hospital, Leeds Teaching Hospitals NHS Trust, Beckett Street, Leeds, LS9 7TF, UK
| | - Chandra Shekhar Biyani
- Department of Urology, St James's University Hospital, Leeds Teaching Hospitals NHS Trust, Beckett Street, Leeds, LS9 7TF, UK.
| | | |
Collapse
|
23
|
Schmid M, Kirisits C, Tanderup K, Haie-Meder C, Fokdal L, Sturdza A, Hoskin P, Mahantshetty U, Segedin B, Bruheim K, Huang F, Rai B, Cooper R, Van der Steen-Banasik E, Van Limbergen E, Pieters B, Tan L, Nout R, De Leeuw A, Nesvacil N, Jürgenliemk-Schulz I, Lindegaard J, Pötter R. OC-1051: Local failure in cervical cancer patients after MR image-guided adaptive brachytherapy. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)01988-5] [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]
|
24
|
Pötter R, Tanderup K, Schmid M, Haie-Meder C, Fokdal L, Sturdza A, Hoskin P, Mahantshetty U, Segedin B, Bruheim K, Huang F, Rai B, Cooper R, Van der Steen-Banasik E, Van Limbergen E, Pieters B, Tan L, Nout R, De Leeuw A, Nesvacil N, Kirchheiner K, Jürgenliemk-Schulz I, Kirisits C, Lindegaard J, Embrace C. OC-0437: MRI guided adaptive brachytherapy in locally advanced cervical cancer: overall results of EMBRACE I. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)00459-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
25
|
Smet S, Tanderup K, Nout R, Jürgenliemk-Schulz I, Spampinato S, Chargari C, Lindegaard J, Mahantshetty U, Strudza A, Schmid M, Hoskin P, Segedin B, Bruheim K, Rai B, Huang F, Van Der Steen-Basanik E, Cooper R, Van Limbergen E, Sundset M, Pötter R, Kirchheiner K. OC-0317: Risk factors for persistent late fatigue after radiochemotherapy in cervical cancer (EMBRACE study). Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)00341-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
26
|
Jensen N, Pötter R, Fokdal L, Chargari C, Lindegaard J, Schmid M, Sturdza A, Mahantshetty U, Jürgenliemk-Schulz I, Hoskin P, Segedin B, Rai B, Bruheim K, Wiebe E, Van der Steen-Banasik E, Cooper R, Van Limbergen E, Sundset M, Pieters B, Nout R, Kirisits C, Kirchheiner K, Tanderup K. PH-0404: Risk factors for late diarrhoea after radio(chemo)therapy in cervical cancer: EMBRACE I results. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)00426-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
|
27
|
Peters M, De Leeuw A, Pötter R, Nomden C, Tanderup K, Kirchheiner K, Schmid M, Fortin I, Haie-Meder C, Lindegaard J, Sturdza A, Mahantshetty U, Hoskin P, Segedin B, Bruheim K, Rai B, Huang F, Cooper R, Van der Steen-Banasik E, Van Limbergen E, Nout R, Jürgenliemk-Schulz I. OC-0566: Risk factors for nodal failure in the EMBRACE study cohort. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)00588-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
|
28
|
Vittrup A, Kirchheiner K, Tanderup K, Jensen N, Spampinato S, Fokdal L, Kirisits C, Haie-Meder C, Lindegaard J, Schmid M, Sturdza A, Mahantshetty U, Jürgenliemk-Schulz I, Hoskin P, Segedin B, Bruheim K, Rai B, Wiebe E, Van der Steen-Banasik E, Cooper R, Van Limbergen E, Sundset M, Pieters B, Nout R, Pötter R. OC-0569: Incidence of severe gastrointestinal and urinary fistulas, bleeding and strictures: EMBRACE results. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)00591-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
|
29
|
Knoth J, Pötter R, Jürgenliemk-Schulz IM, Haie-Meder C, Fokdal L, Sturdza A, Hoskin P, Mahantshetty U, Segedin B, Bruheim K, Wiebe E, Rai B, Cooper R, van der Steen-Banasik E, van Limbergen E, Pieters BR, Sundset M, Tan LT, Nout RA, Tanderup K, Kirisits C, Nesvacil N, Lindegaard JC, Schmid MP. Clinical and imaging findings in cervical cancer and their impact on FIGO and TNM staging - An analysis from the EMBRACE study. Gynecol Oncol 2020; 159:136-141. [PMID: 32798000 DOI: 10.1016/j.ygyno.2020.07.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [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] [Received: 05/25/2020] [Accepted: 07/05/2020] [Indexed: 01/09/2023]
Abstract
OBJECTIVE To investigate differences in local tumour staging between clinical examination and MRI and differences between FIGO 2009, FIGO 2018 and TNM in patients with primary cervical cancer undergoing definitive radio-chemotherapy. METHODS Patients from the prospective observational multi-centre study "EMBRACE" were considered for analysis. All patients had gynaecological examination and pelvic MRI before treatment. Nodal status was assessed by MRI, CT, PET-CT or lymphadenectomy. For this analysis, patients were restaged according to the FIGO 2009, FIGO 2018 and TNM staging system. The local tumour stage was evaluated for MRI and clinical examination separately. Descriptive statistics were used to compare local tumour stages and different staging systems. RESULTS Data was available from 1338 patients. For local tumour staging, differences between MRI and clinical examination were found in 364 patients (27.2%). Affected lymph nodes were detected in 52%. The two most frequent stages with FIGO 2009 are IIB (54%) and IIIB (16%), with FIGO 2018 IIIC1 (43%) and IIB (27%) and with TNM T2b N0 M0 (27%) and T2b N1 M0 (23%) in this cohort. CONCLUSIONS MRI and clinical examination resulted in a different local tumour staging in approximately one quarter of patients. Comprehensive knowledge of the differential value of clinical examination and MRI is necessary to define one final local stage, especially when a decision about treatment options is to be taken. The use of FIGO 2009, FIGO 2018 and TNM staging system leads to differences in stage distributions complicating comparability of treatment results. TNM provides the most differentiated stage allocation.
Collapse
Affiliation(s)
- J Knoth
- Department of Radiation Oncology, Comprehensive Cancer Center, Medical University of Vienna, General Hospital of Vienna, Austria
| | - R Pötter
- Department of Radiation Oncology, Comprehensive Cancer Center, Medical University of Vienna, General Hospital of Vienna, Austria
| | | | - C Haie-Meder
- Department of Radiotherapy, Gustave-Roussy, France
| | - L Fokdal
- Department of Oncology, Aarhus University Hospital, Denmark
| | - A Sturdza
- Department of Radiation Oncology, Comprehensive Cancer Center, Medical University of Vienna, General Hospital of Vienna, Austria
| | - P Hoskin
- Mount Vernon Cancer Centre, Northwood, United Kingdom
| | - U Mahantshetty
- Department of Radiation Oncology, Tata Memorial Hospital, India
| | - B Segedin
- Department of Oncology, Institute of Oncology Ljubljana, Slovenia
| | - K Bruheim
- Department of Oncology, The Norwegian Radium Hospital, Oslo University Hospital, Norway
| | - E Wiebe
- Department of Oncology, Cross Cancer Institute and University of Alberta, Edmonton, Canada
| | - B Rai
- Department of Radiotherapy and Oncology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - R Cooper
- Leeds Cancer Centre, St James's University Hospital, United Kingdom
| | | | - E van Limbergen
- Department of Radiation Oncology, University Hospitals Leuven, Belgium
| | - B R Pieters
- Department of Radiation Oncology, Amsterdam University Medical Centers, University of Amsterdam, The Netherlands
| | - M Sundset
- Clinic of Oncology and Women's Clinic, St. Olavs Hospital, Trondheim, Norway
| | - L T Tan
- Oncology Centre, Cambridge University Hospitals NHS Foundation Trust, Addenbrooke's Hospital, Cambridge, UK
| | - R A Nout
- Department of Radiation Oncology, Erasmus MC, Erasmus University Rotterdam, The Netherlands
| | - K Tanderup
- Department of Oncology, Aarhus University Hospital, Denmark
| | - C Kirisits
- Department of Radiation Oncology, Comprehensive Cancer Center, Medical University of Vienna, General Hospital of Vienna, Austria
| | - N Nesvacil
- Department of Radiation Oncology, Comprehensive Cancer Center, Medical University of Vienna, General Hospital of Vienna, Austria
| | - J C Lindegaard
- Department of Oncology, Aarhus University Hospital, Denmark
| | - M P Schmid
- Department of Radiation Oncology, Comprehensive Cancer Center, Medical University of Vienna, General Hospital of Vienna, Austria.
| |
Collapse
|
30
|
Kailavasan M, Berridge C, Athanasiadis G, Gkentzis A, Rai B, Jain S, Biyani CS, Nabi G. Design, implementation, and evaluation of a novel curriculum to teach transurethral resection of the prostate (TURP): a 3-year experience of urology simulation bootcamp course. World J Urol 2020; 38:2899-2906. [PMID: 32040716 DOI: 10.1007/s00345-020-03104-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2019] [Accepted: 01/22/2020] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES To present the three-year experience of the multi-component TURP module at Urology Simulation Bootcamp Course (USBC) and demonstrate trainee's competence progression and satisfaction. METHODS During the USBC, a 4-h TURP module was developed and consisted of (a) familiarisation and assembly of resectoscope instrument, (b) didactic lecture on TURP operative techniques and postoperative complications, (c) learning hands-on resection on validated simulators [Samed, GmBH, Dresden, Germany; TURP Mentor™, Simbionix, Israel], and (d) practicing clot evacuation using the Ellik bladder Evacuator. Trainee's level of instrument knowledge, operative competence, and confidence were assessed pre- and post-course. Trainee's feedback was also collected. RESULTS One hundred thirty trainees participated in the USBC between 2016 and 2018. Eighty-seven percent of trainees scored themselves as 1-3 (low confidence in resection) on a 5-point Likert scale. Trainees significantly improved in their ability to perform resectoscope assembly for resection, coagulation and incision by 33.6% (p < 0.001), 28.1% (p < 0.001) and 34.0% (p < 0.001), respectively. There was a significant improvement in scores in itemised technical skill on the TURP simulator following completion of the TURP module (Mean difference = 3.4 points, 95% CI 2-4, p < 0.001). Ninety-one percent of trainees agreed that the TURP module was useful for their development in urological training. CONCLUSION Our results demonstrated that it is feasible to develop and implement a focussed module for teaching TURP with significant improvement in learning. Trainee feedback suggests that they were highly satisfied with the teaching provided and models used. This style of training can be implemented for other common surgical procedures.
Collapse
Affiliation(s)
| | | | | | | | | | - Sunjay Jain
- St James's University Hospital, Leeds Teaching Hospital Trust, Leeds, UK
| | - Chandra S Biyani
- St James's University Hospital, Leeds Teaching Hospital Trust, Leeds, UK.
| | | |
Collapse
|
31
|
|
32
|
Young M, Kailavasan M, Taylor J, Cornford P, Colquhoun A, Rochester M, Hanchanale V, Somani B, Nabi G, Garthwaite M, Gowda R, Reeves F, Rai B, Doherty R, Gkentzis A, Athanasiadis G, Patterson J, Wilkinson B, Myatt A, Biyani CS, Jain S. The Success and Evolution of a Urological "Boot Camp" for Newly Appointed UK Urology Registrars: Incorporating Simulation, Nontechnical Skills and Assessment. J Surg Educ 2019; 76:1425-1432. [PMID: 31036524 DOI: 10.1016/j.jsurg.2019.04.005] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/08/2018] [Revised: 03/02/2019] [Accepted: 04/08/2019] [Indexed: 06/09/2023]
Abstract
BACKGROUND Urological training has dramatically changed in recent years. Training durations are shorter and a drive toward consultant led care has reduced trainees experience. Within the UK, approximately 50 registrars annually embark on a 5-year Urology training programme, with variable levels of basic urological experience. OBJECTIVE To describe a simulation programme aimed at delivering the knowledge and skills necessary to safely and effectively start working as a registrar in Urology by intensive training with a 1:1 faculty to delegate ratio. DESIGN, SETTING, AND PARTICIPANTS Our course content mirrors the UK training syllabus for junior Urology registrars. We delivered 8 modules over a 4-day programme with a fifth day of assessments. Delegates level of urological knowledge, operative competency and confidence pre-, immediately post-training and at 3-months postcourse were assessed. Objective delegate and faculty feedback was also collected. Technical skills modules include; inguinoscrotal surgery, ureteroscopy, transurethral resection, urodynamics, and Botox administration as well as basic reconstructive and laparoscopic operative skills. "Nontechnical" skills included simulated ward round, out-patient, and emergency scenarios. RESULTS Feedback from delegates and faculty members has been overwhelmingly positive. We have used this feedback to tailor the content of the course for following years. An increased knowledge level (based on mean examination scores [precourse 55.5%, postcourse 70.1%]) and operative competency was observed in all skills assessed (transurethral resection of the prostate, transurethral resection of bladder tumor, Ureteroscopy, laparoscopic skills, and instrument assembly). Operative confidence was increased immediately and at 3-months postcourse. CONCLUSIONS Our "boot camp" course provides a realistic introduction and foundation to begin Urological practice. Being delivered at the beginning of the training scheme, prior to intensive patient exposure, registrars are in an optimum position to develop their newly acquired knowledge and skills to enhance training and intends to improve patient safety and satisfaction.
Collapse
Affiliation(s)
- M Young
- St James's University Hospital, Leeds Teaching Hospital Trust, Leeds, United Kingdom
| | - M Kailavasan
- Royal Birmingham Heartlands Hospital, Birmingham, United Kingdom
| | - J Taylor
- Forth Valley Royal Hospital, Scotland, United Kingdom
| | - P Cornford
- Royal Liverpool and Broadgreen University Hospitals NHS Trust, Liverpool, United Kingdom
| | - A Colquhoun
- Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
| | - M Rochester
- Norfolk & Norwich University Hospitals NHS Foundation Trust, United Kingdom
| | - V Hanchanale
- Royal Liverpool and Broadgreen University Hospitals NHS Trust, Liverpool, United Kingdom
| | - B Somani
- University Hospital Southampton NHS Trust, Southampton, United Kingdom
| | - G Nabi
- Ninewells Hospital, Dundee, United Kingdom
| | - M Garthwaite
- South Tees Hospitals NHS Foundation Trust, Middlesbrough, United Kingdom
| | - R Gowda
- South Tees Hospitals NHS Foundation Trust, Middlesbrough, United Kingdom
| | - F Reeves
- University of East Anglia, Norwich, United Kingdom
| | - B Rai
- South Tees Hospitals NHS Foundation Trust, Middlesbrough, United Kingdom
| | - R Doherty
- Norfolk & Norwich University Hospitals NHS Foundation Trust, United Kingdom
| | - A Gkentzis
- Royal Bolton Hospital, Bolton, United Kingdom
| | | | - J Patterson
- Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, United Kingdom
| | - B Wilkinson
- Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, United Kingdom
| | - A Myatt
- Hull and East Yorkshire NHS Trust, Hull, United Kingdom
| | - C S Biyani
- St James's University Hospital, Leeds Teaching Hospital Trust, Leeds, United Kingdom.
| | - S Jain
- St James's University Hospital, Leeds Teaching Hospital Trust, Leeds, United Kingdom
| |
Collapse
|
33
|
Yadav S, Rai B, Bhatta M, Thakur J. MON-313 PROFILE OF NEPHROTIC SYNDROME ATTENDING PEDIATRIC RENAL CLINIC: A SINGLE CENTER EXPERIENCE. Kidney Int Rep 2019. [DOI: 10.1016/j.ekir.2019.05.1124] [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] Open
|
34
|
Chopra S, Mittal P, Viswanathan A, Tharavichitkul E, Zubizarreta E, Nout RA, Yap ML, Grover S, Rodin D, Rai B, Gondhowiardjo S, Shrivastava SK. Global Collaborations for Cervical Cancer: Can the East-West Alliance Facilitate Treatment for all? Clin Oncol (R Coll Radiol) 2019; 31:529-538. [PMID: 31229379 DOI: 10.1016/j.clon.2019.05.022] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2019] [Revised: 05/11/2019] [Accepted: 05/28/2019] [Indexed: 12/20/2022]
Abstract
Despite the advances in the primary prevention of cervical cancer, there is an absolute increase in the incidence of cervical cancer as a result of an increase in world population. A vast majority of patients in low and low-middle income countries continue to present at a locally advanced stage, necessitating treatment with chemoradiation and brachytherapy. There is a dearth of equipment and trained professionals for the treatment of cervical cancer, especially in low and low-middle income countries. There is an urgent need to improve treatment availability and develop better treatments. Worldwide trends, however, reveal a low number of therapeutic and innovative research trials in cervical cancer. The present article elucidates the existing challenges and provides solutions to improve outcomes. The proposed strategies hinge on strengthening collaborations for global advocacy.
Collapse
Affiliation(s)
- S Chopra
- Department of Radiation Oncology, Advanced Centre for Treatment, Research and Education in Cancer (ACTREC), Tata Memorial Centre, Navi Mumbai, India; Homi Bhabha National Institute, Mumbai, India.
| | - P Mittal
- Homi Bhabha National Institute, Mumbai, India; Department of Radiation Oncology, Tata Memorial Hospital, Tata Memorial Centre, Mumbai, India
| | - A Viswanathan
- Department of Radiation Oncology, Johns Hopkins University Medical Center, Baltimore, Maryland, USA
| | - E Tharavichitkul
- Division of Radiation Oncology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - E Zubizarreta
- Division of Human Health, International Atomic of Energy Agency - Vienna International Centre, Vienna, Austria
| | - R A Nout
- Department of Radiation Oncology, Leiden University Medical Center LUM, Leiden, the Netherlands
| | - M L Yap
- Collaboration for Cancer Outcomes, Research and Evaluation (CCORE), Ingham Institute, UNSW Sydney, Liverpool, New South Wales, Australia; Liverpool and Macarthur Cancer Therapy Centres, Western Sydney University, Campbelltown, New South Wales, Australia; School of Public Health, The University of Sydney, Camperdown, Australia
| | - S Grover
- Department of Radiation Oncology, University of Pennsylvania, Philadelphia, USA; Botswana-UPENN Partnership, University of Botswana, Gaborone, Botswana
| | - D Rodin
- Department of Radiation Oncology, University of Toronto, Toronto, Ontario, Canada
| | - B Rai
- Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - S Gondhowiardjo
- Department of Radiotherapy, Dr. Cipto Mangunkusumo National General Hospital, Jakarta, Indonesia
| | - S K Shrivastava
- Department of Radiation Oncology, Apollo Hospital, Belapur, Navi Mumbai, India
| |
Collapse
|
35
|
Jayabal H, Dingari NN, Rai B. A linear viscoelastic model to understand skin mechanical behaviour and for cosmetic formulation design. Int J Cosmet Sci 2019; 41:292-299. [PMID: 31032974 DOI: 10.1111/ics.12535] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [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: 02/12/2019] [Accepted: 04/24/2019] [Indexed: 01/30/2023]
Abstract
OBJECTIVES Skin is arguably one of the most important organs that plays an active role in our everyday biological functions after brain. Owing to the wide range of applications in medicine, cosmetics industry and more recently robotics, skin research has gained tremendous attention with respect to its mechanical behaviour. Various macro modelling approaches are available for modelling skin's mechanical behaviour. The objective of this paper is to study skin's mechanical property change with age and demonstrate anti-ageing effects of cosmetic formulations from skin mechanical property change perspective. METHODS In this study, skin's mechanical behaviour was modelled using a 1D linear viscoelastic phenomenological model and the model was validated using two sets of experimentally observed skin data (strain, stress relaxation and cyclical loading). The model was further modified to study the effect of the presence of a thin layer of cosmetic polymer and to demonstrate anti-ageing effects of the cosmetic polymer from the perspective of change in the mechanical behaviour of skin with cosmetic layer. RESULTS The estimated values of skin mechanical properties from the model agree with those in literature. The extracted model features show good correlation with skin age (viscosity and time constant). The results from our model indicate that the cosmetic polymers enhance the mechanical properties of skin significantly. CONCLUSIONS This work will find its applications in designing and testing anti-ageing formulations. This model can be used to filter various combinations of cosmetic formulations by knowing the mechanical response of polymer on skin, thereby accelerating the product development.
Collapse
Affiliation(s)
- H Jayabal
- Physical Science Research Area, Tata Research Development and Design Centre, TCS Research, Tata Consultancy Services 54B, Hadapsar Industrial Estate, Pune, 411013, India
| | - N N Dingari
- Physical Science Research Area, Tata Research Development and Design Centre, TCS Research, Tata Consultancy Services 54B, Hadapsar Industrial Estate, Pune, 411013, India
| | - B Rai
- Physical Science Research Area, Tata Research Development and Design Centre, TCS Research, Tata Consultancy Services 54B, Hadapsar Industrial Estate, Pune, 411013, India
| |
Collapse
|
36
|
Nettleton J, Jones P, Pietropaolo A, Geraghty R, Rai B, Drake M, Dragos L, Veneziano D, Somani BK. The industrial revolution for the management of benign prostate obstruction: worldwide publication trends for surgical and medical therapies over the past two decades. Cent European J Urol 2019; 72:149-155. [PMID: 31482021 PMCID: PMC6715083 DOI: 10.5173/ceju.2019.1876] [Citation(s) in RCA: 4] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Revised: 03/20/2019] [Accepted: 04/24/2019] [Indexed: 01/21/2023] Open
Abstract
INTRODUCTION Research for management of benign prostate obstruction (BPO) for adult males remains a cornerstone of urology research. This landscape has witnessed the rise and fall of multiple therapies, both surgical and medical. Our aim was to formally evaluate the publication trends for these interventions over the past 20 years. MATERIAL AND METHODS A systematic search was performed in a Cochrane style. Data was analysed using the independent t-test and Pearson's correlation coefficient (SPSS version 24). To observe changes in trends more effectively, data was sub-divided into two time periods: 1997 to 2006 and 2007 to 2016. RESULTS Over the past 20 years, 4236 papers have been published concerning for BPO (surgical, n = 2177 and medical, n = 2059). For surgical treatments, these included articles on monopolar transurethral resection of prostate (TURP) (n = 340), bipolar TURP (n = 260), HoLEP (n = 293) and Greenlight laser (n = 395). For medical therapies, these included alpha blockers (848), 5-alpha reductase inhibitors (n = 618) and PDE5I (n = 91). Between the two time periods the change was +18.8% (p = 0.108) for monopolar TURP, +497.1% (<0.001) for bipolar TURP, -54.5% (p <0.001 for prostatic stents and -81.9% (p <0.001) for transurethral microwave therapy (TUMT). There was over 290% rise in number of publications related to BPO laser surgery (p <0.001). For medical interventions, the change was +11.5% (p = 0.397) for alpha blockers, -1.9% (p = 0.867), +49.0%( 0.122) for phytotherapy, +2075% (p <0.001) for PDEI and +2375.0% (p <0.001) for combined alpha blocker and anti-muscarinics. CONCLUSIONS Interventions for BPO have undergone a high volume of research. In particular, minimally invasive laser surgeries and combined medical therapies have seen significant expansion.
Collapse
Affiliation(s)
| | - Patrick Jones
- Bristol Urological Institute, Bristol, United Kingdom
| | | | - Robert Geraghty
- Department of Urology, University Hospital Southampton NHS Trust, Southampton, United Kingdom
| | - Bhavan Rai
- Department of Urology, Freeman Hospital, Newcastle, United Kingdom
| | - Marcus Drake
- Bristol Urological Institute, Bristol, United Kingdom
| | - Laurian Dragos
- Urology Department, Emergency County Hospital, Pius Branzeu, Timisoara, Romania
| | - Domenico Veneziano
- Department of Urology and Kidney Transplant G.O.M. Reggio Calabria, Italy
| | - Bhaskar K. Somani
- Consultant Urological Surgeon (Endourology Lead), University Hospital Southampton, NHS Trust Southampton, United Kingdom
| |
Collapse
|
37
|
Abstract
Objectives Long bone defects often require surgical intervention for functional restoration. The ‘gold standard’ treatment is autologous bone graft (ABG), usually from the patient’s iliac crest. However, autograft is plagued by complications including limited supply, donor site morbidity, and the need for an additional surgery. Thus, alternative therapies are being actively investigated. Autologous bone marrow (BM) is considered as a candidate due to the presence of both endogenous reparative cells and growth factors. We aimed to compare the therapeutic potentials of autologous bone marrow aspirate (BMA) and ABG, which has not previously been done. Methods We compared the efficacy of coagulated autologous BMA and ABG for the repair of ulnar defects in New Zealand White rabbits. Segmental defects (14 mm) were filled with autologous clotted BM or morcellized autograft, and healing was assessed four and 12 weeks postoperatively. Harvested ulnas were subjected to radiological, micro-CT, histological, and mechanical analyses. Results Comparable results were obtained with autologous BMA clot and ABG, except for the quantification of new bone by micro-CT. Significantly more bone was found in the ABG-treated ulnar defects than in those treated with autologous BMA clot. This is possibly due to the remnants of necrotic autograft fragments that persisted within the healing defects at week 12 post-surgery. Conclusion As similar treatment outcomes were achieved by the two strategies, the preferred treatment would be one that is associated with a lower risk of complications. Hence, these results demonstrate that coagulated BMA can be considered as an alternative autogenous therapy for long bone healing. Cite this article: Z. X. H. Lim, B. Rai, T. C. Tan, A. K. Ramruttun, J. H. Hui, V. Nurcombe, S. H. Teoh, S. M. Cool. Autologous bone marrow clot as an alternative to autograft for bone defect healing. Bone Joint Res 2019;8:107–117. DOI: 10.1302/2046-3758.83.BJR-2018-0096.R1.
Collapse
Affiliation(s)
- Z X H Lim
- Glycotherapeutics Group, Institute of Medical Biology, Agency for Science, Technology and Research, Singapore
| | - B Rai
- Glycotherapeutics Group, Institute of Medical Biology, Agency for Science, Technology and Research, Singapore; Science and Maths Cluster, Singapore University of Technology & Design (SUTD), Singapore
| | - T C Tan
- Glycotherapeutics Group, Institute of Medical Biology, Agency for Science, Technology and Research, Singapore
| | - A K Ramruttun
- Department of Orthopaedic Surgery, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - J H Hui
- Department of Orthopaedic Surgery, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - V Nurcombe
- Glycotherapeutics Group, Institute of Medical Biology, Agency for Science, Technology and Research, Singapore; Lee Kong Chian School of Medicine, Nanyang Technological University-Imperial College, Singapore
| | - S H Teoh
- Lee Kong Chian School of Medicine, Nanyang Technological University-Imperial College, Singapore; School of Chemical and Biomedical Engineering, Nanyang Technological University, Singapore
| | - S M Cool
- Glycotherapeutics Group, Institute of Medical Biology, Agency for Science, Technology and Research, Singapore; Department of Orthopaedic Surgery, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| |
Collapse
|
38
|
Knoth J, Pötter R, Jürgenliemk-Schulz I, Haie-Meder C, Fokdal L, Sturdza A, Hoskin P, Mahantshetty U, Segedin B, Bruheim K, Wiebe E, Rai B, Cooper R, Van der Steen-Banasik E, Van Limbergen E, Pieters B, Sundset M, Tan L, Nout R, Tanderup K, Kirisits C, Nesvacil N, Lindegaard J, Schmid M. PO-0827 Comparison of clinical examination and MRI for local cervical cancer staging (FIGO and T(NM)). Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)31247-2] [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: 10/26/2022]
|
39
|
Erchick DJ, Rai B, Agrawal NK, Khatry SK, Katz J, LeClerq SC, Reynolds MA, Mullany LC. Oral hygiene, prevalence of gingivitis, and associated risk factors among pregnant women in Sarlahi District, Nepal. BMC Oral Health 2019; 19:2. [PMID: 30611255 PMCID: PMC6321675 DOI: 10.1186/s12903-018-0681-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2018] [Accepted: 11/27/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The oral health status of pregnant women in low-resource communities such as Nepal has not been well characterized. This sub-population is also of specific interest given associations between poor oral health and adverse pregnancy outcomes previously documented in other settings. We explored relationships between gingivitis and risk factors among pregnant women in rural Nepal. METHODS The design was a community-based, cross-sectional study in a sub-area of Sarlahi District, Nepal. Pregnant women < 26 weeks gestation underwent clinical periodontal exams conducted by community-based oral health workers. Exams included a full mouth assessment measuring bleeding on probing (BOP), probing depth (PD) (six sites per tooth), and gingival recession, the distance from the cemento-enamel junction to the free gingival margin (two direct sites per tooth). Data on participant risk factors were collected through household surveys, including demographic characteristics, oral health behaviors, care seeking, and health attitudes. Multivariable logistic regression modeling was used to assess relationships between gingivitis and risk factors. RESULTS We enrolled 1452 participants, of which 40% (n = 582) had signs of clinical gingivitis and 60% (n = 870) clinical health. Average participant age was 23. Most participants (88%) had never received oral health care. Participants averaged 10% of sites with BOP with most (79%) having ≥1 site with BOP. Nine percent of participants had ≥1 site with PD ≥4 mm, although very few participants (0.7%) had sites with PD ≥5 mm. Few participants (13%) had any recession (≥1 mm). In the final adjusted model, odds of gingivitis increased by 3% for each year of age (aOR 1.03, 95% CI 1.00, 1.06) and were higher for women of short maternal stature (< 150 cm) (aOR 1.43, 95% CI: 1.14, 1.79) and among women reporting cost to be a barrier to seeking dental care (aOR 2.13, 95% CI: 1.09, 4.15). CONCLUSIONS Gingivitis was common and associated with age, maternal stature, self-reported high cost of dental care, and other risk factors among pregnant women in rural Nepal. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT01177111 (Nepal Oil Massage Study) and NCT02788786 (Pilot Trial).
Collapse
Affiliation(s)
- D. J. Erchick
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD USA
| | - B. Rai
- Nepal Nutrition Intervention Project, Sarlahi (NNIPS), Krishna Galli, Lalitpur, Kathmandu Nepal
| | - N. K. Agrawal
- Department of Dentistry, Institute of Medicine, Tribhuhvan University, Kathmandu, Nepal
| | - S. K. Khatry
- Nepal Nutrition Intervention Project, Sarlahi (NNIPS), Krishna Galli, Lalitpur, Kathmandu Nepal
| | - J. Katz
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD USA
| | - S. C. LeClerq
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD USA
- Nepal Nutrition Intervention Project, Sarlahi (NNIPS), Krishna Galli, Lalitpur, Kathmandu Nepal
| | - M. A. Reynolds
- Department of Advanced Oral Sciences and Therapeutics, University of Maryland School of Dentistry, Baltimore, MD USA
| | - L. C. Mullany
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD USA
| |
Collapse
|
40
|
Elangovan A, Bahl A, Patel F, Dracham C, Rai B, Trivedi G. Is bone marrow sparing intensity modulated radiotherapy better than 3-dimensional conformal radiotherapy in reducing haematological toxicities during pelvic irradiation in locally advanced carcinoma cervix?: A prospective study. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy436.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
|
41
|
Fokdal L, Tanderup K, Pötter R, Kirchheiner K, Sturdza A, Chargari C, Jürgenliemk-Schulz I, Segedin B, Tan L, Hoskin P, Mahantshetty U, Bruheim K, Rai B, Kirisits C, Lindegaard J. OC-0072: Risk factors for ureteral stricture after IGABT in cervical cancer: results from the EMBRACE studies. Radiother Oncol 2018. [DOI: 10.1016/s0167-8140(18)30382-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
|
42
|
Chowdhury MM, Ullah AA, Karim R, Ahmed A, Mohammed S, Sobhan SA, Farmidi AA, Zuwaida F, Pradan R, Mahmud R, Rai B, Pervin S, Habib R. Complete Annular Pancreas with Concurrent Entero-Pancreatico-Biliary Symptoms in Adult: A Case Report. Mymensingh Med J 2018; 27:196-200. [PMID: 29459613] [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: 06/08/2023]
Abstract
Complete Annular pancreas (AP) is a rare congenital anomaly, often presented and operated at the early age of life. Adult presentation group usually presents with either biliary or duodenal or pancreatic symptoms. We report a case of 43 years old female presenting with concurrent enteric, biliary and pancreatic symptoms admitted on April 2016 in Hepatobiliary and Pancreatic Surgery Department of BSMMU, Dhaka, Bangladesh. A complete type of annular pancreas with partial duodenal stenosis and dilated common bile duct was observed during laparotomy. We performed gastrojejunostomy as well as hepaticojejunostomy (Roux-en-Y anastomosis). Patient was discharged in a good symptom free condition. Complete Annular Pancreas can present at any age, with any one or all of the biliary, pancreatic or duodenal symptoms. Surgery is the treatment of choice and has a good outcome.
Collapse
Affiliation(s)
- M M Chowdhury
- Professor Md Mohsen Chowdhury, Professor & Head, Department of the Yellow Unit II, Hepatobiliary & Pancreatic Surgery, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh
| | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
43
|
Hosny M, Rai B, Aljaafari F, Agarwal S, McNicholas T, Boustead G, Lane T, Adshead J, Vasdev N. Can Anterior Prostatic Fat Harbor Prostate Cancer Metastasis? A Prospective Cohort Study. Curr Urol 2017; 10:182-185. [PMID: 29234260 PMCID: PMC5704707 DOI: 10.1159/000447178] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [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: 10/06/2016] [Accepted: 01/24/2017] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVES Traditionally anterior prostatic fat (APF) hasn't been included in pelvic lymph node (LN) dissection templates following radical prostatectomy. In this study we evaluate the incidence of lymphoid tissue in the APF and the incidence of LN metastasis in APF in patients who have undergone robotic-assisted laparoscopic radical prostatectomy (RALP). METHODS A prospective database of RALP has been maintained between January 2010 and September 2015. APF is routinely excised and sent separately for histopathological evaluation to identify lymphoid tissue and metastatic prostate cancer. RESULTS A total of 629 underwent RALP. Forty-six (7.3%) of the patients had lymphoid tissue on histopathological evaluation. Two patients had meta-static disease. Both patients with positive LNs were intermediate risk on pre-operative evolution (A-PSA 16.6 ng/ml, Gleason 3 + 4; B PSA 7.3 ng/ml, Gleason 4 + 3) and upgraded on final prostate pathological evaluation to high risk disease (A-Gleason 4 + 5, pT3b, B-Gleason 4 + 3, pT4). CONCLUSION There appears to be lymphatic drainage to the APF from the prostate. Hence APF should be included in pelvic LN dissection templates when lymphadenectomy is contemplated in patients undergoing radical prostatectomy.
Collapse
Affiliation(s)
- Mohannad Hosny
- Hertfordshire and South Bedfordshire Urological Cancer Centre, Department of Urology, Lister Hospital, Stevenage, UK
| | - Bhavan Rai
- Hertfordshire and South Bedfordshire Urological Cancer Centre, Department of Urology, Lister Hospital, Stevenage, UK
| | - Feras Aljaafari
- Hertfordshire and South Bedfordshire Urological Cancer Centre, Department of Urology, Lister Hospital, Stevenage, UK
| | - Samita Agarwal
- Department of Histopathology, Lister Hospital, Stevenage, UK
| | - Thomas McNicholas
- Hertfordshire and South Bedfordshire Urological Cancer Centre, Department of Urology, Lister Hospital, Stevenage, UK
| | - Gregory Boustead
- Hertfordshire and South Bedfordshire Urological Cancer Centre, Department of Urology, Lister Hospital, Stevenage, UK
| | - Thimothy Lane
- Hertfordshire and South Bedfordshire Urological Cancer Centre, Department of Urology, Lister Hospital, Stevenage, UK
| | - James Adshead
- Hertfordshire and South Bedfordshire Urological Cancer Centre, Department of Urology, Lister Hospital, Stevenage, UK
| | - Nikhil Vasdev
- Hertfordshire and South Bedfordshire Urological Cancer Centre, Department of Urology, Lister Hospital, Stevenage, UK
| |
Collapse
|
44
|
Kumar M, Pal A, Jain A, Ghoshal S, Rai B, Mohindra S, Das A. 35P Clinical significance of expression of cripto-1 in patients of squamous cell carcinoma of oropharynx. Ann Oncol 2016. [DOI: 10.1016/s0923-7534(21)00195-2] [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: 11/25/2022] Open
|
45
|
Kumar M, Pal A, Jain A, Ghoshal S, Rai B, Mohindra S, Das A. 35P Clinical significance of expression of cripto-1 in patients of squamous cell carcinoma of oropharynx. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw574.008] [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
|
46
|
Rai B, Miriyala R, Ghoshal S, Ballari N, Singla V. Margins Around the Involved Pelvic Lymph Nodes for Planning Simultaneous Integrated Boost in Patients With Cervical Cancer Undergoing Pelvic Intensity Modulated Radiation Therapy. Int J Radiat Oncol Biol Phys 2016. [DOI: 10.1016/j.ijrobp.2016.06.1421] [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]
|
47
|
Kumar N, Rai B, Bhat SA, Kharche SD, Gangwar C, Jindal SK, Chandra S. Effect of management system and season on semen freezability in Jakhrana bucks. Vet World 2016; 9:199-202. [PMID: 27051208 PMCID: PMC4819372 DOI: 10.14202/vetworld.2015.199-202] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2015] [Revised: 12/30/2015] [Accepted: 01/12/2016] [Indexed: 11/16/2022] Open
Abstract
AIM The objective of the study was to determine the effect of the management system (intensive and semi-intensive) and season (autumn and winter) on semen freezability in Jakhrana bucks. MATERIALS AND METHODS A total of 24 Jakhrana bucks of same body weight and age (BW=30 kg, age=1 year) were randomly allotted into two groups, viz., Group I (intensive system, 12 bucks) and Group II (semi-intensive system, 12 bucks). These two groups were statistically tested for their homogeneity with respect to age and BW. Semen was collected twice weekly using an artificial vagina during two seasons: autumn (September-November) and winter (December-February). A total of 240 semen samples (120 from each group and season) were evaluated for post-thaw motility (PTM), viability, abnormality, functional membrane integrity (hypo-osmotic swelling [HOS]) response and acrosomal integrity. RESULTS The mean values of PTM and acrosomal integrity of spermatozoa were significantly (p<0.01) higher in Group II as compared to Group I. The mean values of viability and abnormality were also differed significant (p<0.05) between groups. However, the mean values of HOS response were found non-significant (p>0.05) between groups. The season showed a significant effect on all parameters except viability and HOS response. The PTM and acrosomal integrity of spermatozoa were significantly (p<0.01) higher in winter as compared to autumn season. Abnormality of spermatozoa was significantly (p<0.05) lower in winter season. CONCLUSIONS This study indicates that both management system and season influence semen freezability. The semen collected from bucks reared under the semi-intensive system and winter season showed better semen freezability characteristics.
Collapse
Affiliation(s)
- Narendra Kumar
- Department of Livestock Production and Management, ICAR - National Dairy Research Institute, Karnal - 132 001, Haryana, India
| | - B Rai
- Department of Physiology Reproduction and Shelter Management, ICAR- Central Institute for Research on Goats, Mathura - 281 001, Uttar Pradesh, India
| | - Showkat A Bhat
- Department of Livestock Production and Management, ICAR - National Dairy Research Institute, Karnal - 132 001, Haryana, India
| | - S D Kharche
- Department of Physiology Reproduction and Shelter Management, ICAR- Central Institute for Research on Goats, Mathura - 281 001, Uttar Pradesh, India
| | - Chetna Gangwar
- Department of Physiology Reproduction and Shelter Management, ICAR- Central Institute for Research on Goats, Mathura - 281 001, Uttar Pradesh, India
| | - S K Jindal
- Department of Physiology Reproduction and Shelter Management, ICAR- Central Institute for Research on Goats, Mathura - 281 001, Uttar Pradesh, India
| | - Subhash Chandra
- Department of Livestock Production and Management, ICAR - National Dairy Research Institute, Karnal - 132 001, Haryana, India
| |
Collapse
|
48
|
Khosla D, Patel FD, Shukla AK, Rai B, Oinam AS, Sharma SC. Dosimetric evaluation and clinical outcome in post-operative patients of carcinoma vulva treated with intensity-modulated radiotherapy. Indian J Cancer 2016; 52:670-5. [PMID: 26960514 DOI: 10.4103/0019-509x.178448] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND To compare dosimetric parameters of intensity-modulated radiation therapy (IMRT) with 3D conformal radiotherapy (3DCRT) in post-operative patients of vulvar cancer and to assess clinical outcome and toxicity with IMRT. MATERIALS AND METHODS A total of 8 post-operative patients of vulvar cancer were treated with IMRT. All patients were also planned by 3DCRT for comparison with IMRT. The two plans were compared in terms of conformity index, homogeneity index, tumor control probability (TCP) and normal tissue complication probability (NTCP) for the planning target volume and organs at risk (OAR). RESULTS IMRT resulted in significantly lesser doses to rectum, bladder, bowel and femoral head as compared with 3DCRT plans. Mean conformity and homogeneity indices were better and within range with IMRT. The TCP was comparable between the two treatment plans and NTCP for rectum, bladder, bowel and femoral head was significantly less with IMRT as compared with 3DCRT. Treatment was well-tolerated and none of the patients developed Grade 3 or higher toxicity. CONCLUSION IMRT yielded superior plans with respect to target coverage, homogeneity and conformality while lowering dose to adjacent OAR as compared with 3DCRT. Thus, IMRT offers a reduction in NTCP while maintaining TCP.
Collapse
Affiliation(s)
- D Khosla
- Department of Radiotherapy and Oncology, Regional Cancer Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | | | | | | | | | | |
Collapse
|
49
|
Kumar N, Rai B, Bhat SA, Kharche SD, Gangwar C, Jindal SK, Chandra S. Effect of management system and season on semen freezability in Jakhrana bucks. Vet World 2016. [DOI: 10.14202/vetworld.2016.199-202] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
|
50
|
Abstract
Introduction and Objectives: The management of urolithiasis in patients with horseshoe kidney (HSK) is difficult. Stone formation occurred in 1:5 patients with HSK due to impaired urinary drainage and infections. Percutaneous nephrolithotomy and shock wave lithotripsy can be technically challenging due to altered anatomy. Materials and Methods: We conducted a systematic review of the literature to look at the role of ureteroscopy for stone management in these patients. We searched MEDLINE, PubMed and the Cochrane Library from January 1990 to April 2013 for results of ureteroscopy and stone treatment in HSK patients. Inclusion criteria were all English language articles reporting on ureteroscopy in patients with HSK. Data were extracted on the outcomes and complications. Results: A total of 3 studies was identified during this period. Forty-one patients with HSK underwent flexible ureteroscopy and stone treatment. The mean age was 42 with a male:female ratio nearly 3:1. The mean stone size was 16 mm (range: 3-35 mm). The mean operating time was 86 min with multiple stones seen in 15 patients. All 41 patients had a ureteral access sheath used and flexible ureteroscopy and holmium laser fragmentation done. Thirty-two (78%) patients were stone-free with a mean hospital stay of 1-day. Minor complications (Clavien I or II) were seen in 13 (32%) of which 6 had stent discomfort, 3 needed intravenous antibiotics for <24 h, 3 had hematuria of which 2 needed blood transfusion and one had pyelonephritis needing re-admission and antibiotics. There were no major complications found in the review. Conclusions: Retrograde stone treatment using ureteroscopy and lasertripsy in HSK patients can be performed with good stone clearance rate, but with a slightly higher complication rate. This procedure should, therefore, be done in high volume stone center with an experienced stone surgeon/team.
Collapse
Affiliation(s)
- Hiro Ishii
- Department of Urology, University Hospital Southampton NHS Trust, Southampton, United Kingdom
| | - Bhavan Rai
- Department of Urology, Ninewells Hospital, Dundee, Scotland
| | - Olivier Traxer
- Department of Urology, University Pierre et Marie Curie Paris 6, Paris, France
| | | | - Bhaskar K Somani
- Department of Urology, University Hospital Southampton NHS Trust, Southampton, United Kingdom
| |
Collapse
|