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O'Neill A, Brady A, Donnelly T, McGlynn J, Moore A, Hopper C. 53 A REVIEW OF THE RAPID ACCESS FRAILTY TEAM (RAFT) IN THE EMERGENCY DEPARTMENT OF A MODEL THREE HOSPITAL. Age Ageing 2022. [DOI: 10.1093/ageing/afac218.042] [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: 11/12/2022] Open
Abstract
Abstract
Background
The Rapid Access Frailty Team (RAFT) in the Emergency Department (ED) has evolved since 2016. The team comprises of 1 senior occupational therapist and 1 senior physiotherapist. The focus of the team is recognition and management of frailty in ED. Patients discharged by RAFT in ED are often followed up in our Rapid Access Frailty Hub. This audit examined the incidence and outcomes of frail older persons presenting to our ED and the impact of intervention from the Rapid Access Frailty team.
Methods
A Variable Indicative of Placement Risk (VIP) positive patient triggers an assessment by RAFTT in ED post triage. Analysis of intervention and discharge destination were used to assess the effectiveness and role of the team.
Results
We compared data over two distinct 6 month periods, between September – February 2019-2020 and 2021-2022. 2723 patients >75 presented to ED in 2019 - 2020. Of these, 1620 were VIP positive patients. 628/1620 patients were seen by RAFFT. 443/628 (70.5%) assessed by RAFT were discharged. In comparison to 2021-2022, we saw an increase with 2818 patients >75, 1657 of which were triaged as frail. 559 patients were assessed by RAFTT and 286/559 (51%) were discharged. We observed 20% reduction in our discharge rate. Most patients received on average five interventions each. 60% of patients received a mobility assessment, 45% received falls prevention intervention and 37% were provided with equipment to facilitate discharge.
Conclusion
Over a two year period we observed an increase in frail patients presenting to our ED. Comprehensive assessment by RAFT in ED is promoting discharge. The follow up through the frailty hub has enhanced our ability to follow up in a timely manner. We hypothesize that the reduction in discharge rates in 2021- 2022 may be due to deconditioning experienced by older adults post pandemic and the increased demand for medical intervention and admission.
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Affiliation(s)
- A O'Neill
- Midlands Regional Hospital Tullamore , Tullamore, Ireland
| | - A Brady
- Midlands Regional Hospital Tullamore , Tullamore, Ireland
| | - T Donnelly
- Midlands Regional Hospital Tullamore , Tullamore, Ireland
| | - J McGlynn
- Midlands Regional Hospital Tullamore , Tullamore, Ireland
| | - A Moore
- Midlands Regional Hospital Tullamore , Tullamore, Ireland
| | - C Hopper
- Midlands Regional Hospital Tullamore , Tullamore, Ireland
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Mole G, Edminson R, Higham A, Hopper C, Hildebrand D. The Management of Childhood Intracranial Tumours and the Role of the Ophthalmologist. Neuroophthalmology 2020; 43:375-381. [PMID: 32165896 DOI: 10.1080/01658107.2019.1597130] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2018] [Revised: 03/05/2019] [Accepted: 03/16/2019] [Indexed: 10/26/2022] Open
Abstract
OBJECTIVE This study looked at a single paediatric neuro-oncology centre's experience of childhood intracranial tumours seen in the ophthalmology clinic over an approximately five-year period. This was used to analyse the role of the ophthalmologist in their long term follow up. METHODS A database was compiled of all children discussed at the neuro-oncology multi-disciplinary team (MDT) meeting between January 2012 and April 2017. All children who had an intracranial tumour determined by histology or suspected on neuro-imaging, who had also been seen in the ophthalmology clinic, were included. A retrospective case review was performed to create a record for each child. RESULTS The database contained 129 children of which 82 (64%) were boys and 47 (36%) were girls. Of these 89 (69%) had a histological diagnosis and 40 (31%) had a tumour suspected on neuroimaging. The most common tumour locations were the posterior fossa (n = 54, 42%), diencephalon (n = 20, 16%) and the visual pathways (n = 17, 13%). Papilloedema at first presentation was only found in 39 (30%) children. The most common other neuro-ophthalmic manifestations were non-paralytic strabismus (n=33), sixth nerve palsy (n=19) and seventh nerve palsy (n=12). Non-paralytic strabismus was a presenting symptom in only one case. There were 13 ophthalmic surgical procedures required for these children, the most common being strabismus surgery. CONCLUSION We report the types and locations of paediatric intracranial tumours seen in the ophthalmology clinic as well as their neuro-ophthalmic manifestations. Only 30% presented with papilloedema and approximately 10% required an ophthalmic surgical procedure.
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Affiliation(s)
- G Mole
- Department of Paediatric Ophthalmology, Oxford Eye Hospital, John Radcliffe Hospital, Oxford University Hospitals, Oxford, UK
| | - R Edminson
- Department of Paediatric Ophthalmology, Oxford Eye Hospital, John Radcliffe Hospital, Oxford University Hospitals, Oxford, UK
| | - A Higham
- Department of Paediatric Ophthalmology, Oxford Eye Hospital, John Radcliffe Hospital, Oxford University Hospitals, Oxford, UK
| | - C Hopper
- Department of Postgraduate Medical Education, Brighton & Sussex Medical School, Brighton, UK
| | - D Hildebrand
- Department of Paediatric Ophthalmology, Oxford Eye Hospital, John Radcliffe Hospital, Oxford University Hospitals, Oxford, UK
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Rashed D, Shah D, Freeman A, Cook RJ, Hopper C, Perrett CM. Rapid ex vivo examination of Mohs specimens using optical coherence tomography. Photodiagnosis Photodyn Ther 2017; 19:243-248. [PMID: 28619614 DOI: 10.1016/j.pdpdt.2017.06.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2017] [Revised: 05/07/2017] [Accepted: 06/11/2017] [Indexed: 11/15/2022]
Abstract
BACKGROUND Mohs micrographic surgery (MMS) is an effective treatment for certain non-melanoma skin cancers. Optical coherence tomography (OCT) is a biomedical imaging modality that permits high-resolution imaging of the epidermis and dermis with the potential to detect both healthy tissue and tumour. OCT may also provide a means of detecting and differentiating between the various histological subtypes of basal cell carcinomas (BCC) in vivo. OBJECTIVE The aim of this prospective ex vivo study was to evaluate the efficacy of OCT in recognising healthy and pathological margins of excised BCC lesions and detecting different BCC subtypes. METHODS Seventy-three subjects with biopsy-proven BCCs on the facial region undergoing MMS were recruited. Narrow clinically healthy margins of the skin surrounding the tumour were included in the excisional biopsy. Biopsies were scanned with the OCT instrument immediately ex vivo and processed to obtain horizontal Mohs frozen sections and compared with their corresponding OCT images. RESULTS Histopathological analysis of 280 margins showed 232 tumour free margins and 48 tumour-involved margins. OCT showed very good sensitivity (81.2%) and specificity (94.3%) in detecting healthy from tumour-involved margins. OCT accuracy was 93.4%, and the intra- and inter-observer reliability was substantial (Kappa value ranged between 0.63-0.76). CONCLUSION This study shows the accuracy of ex vivo OCT in identifying the margin status of BCCs of the head and neck region. Moreover, this modality has demonstrated good capability in distinguishing different BCC subtypes and the potential for in vivo in situ diagnostics.
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Affiliation(s)
- D Rashed
- Head and Neck Unit, University College Hospitals, London, UK; UCL Eastman Dental Institute, Department of Maxillofacial Medicine & Surgery, UCL, London, UK; Department of Dermatology, University College Hospitals, London, UK.
| | - D Shah
- Department of Dermatology, University College Hospitals, London, UK
| | - A Freeman
- Histopathology Department, University College Hospitals, London, UK
| | - R J Cook
- KCL Dental Institute, Depts. Oral Medicine & Tissue Engineering & Biophotonics, London, UK
| | - C Hopper
- Head and Neck Unit, University College Hospitals, London, UK; UCL Eastman Dental Institute, Department of Maxillofacial Medicine & Surgery, UCL, London, UK; National Medical Laser Centre, Division of Surgery and Interventional Sciences, UCL, London, UK
| | - C M Perrett
- Department of Dermatology, University College Hospitals, London, UK
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Hopper C. PDT in head and neck cancer. Photodiagnosis Photodyn Ther 2017. [DOI: 10.1016/j.pdpdt.2017.01.085] [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: 10/19/2022]
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Jerjes W, Hamdoon Z, Hamoudi R, Al-Khawalde M, Hopper C. Gigantic vascular anomaly in a PHACE syndrome patient managed with photodynamic therapy. Photodiagnosis Photodyn Ther 2016; 15:79-82. [PMID: 27229363 DOI: 10.1016/j.pdpdt.2016.05.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2015] [Revised: 05/16/2016] [Accepted: 05/20/2016] [Indexed: 11/19/2022]
Affiliation(s)
- W Jerjes
- Division of Surgery and Interventional Science, UCL, London, UK.
| | - Z Hamdoon
- Head and Neck Centre, University College London Hospitals, London, UK; Unit of Oral and Maxillofacial Surgery, UCL Eastman Dental Institute, London, UK.
| | - R Hamoudi
- Division of Surgery and Interventional Science, UCL, London, UK.
| | | | - C Hopper
- Division of Surgery and Interventional Science, UCL, London, UK; Head and Neck Centre, University College London Hospitals, London, UK; Unit of Oral and Maxillofacial Surgery, UCL Eastman Dental Institute, London, UK.
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Williams L, Rice S, Green D, Kalavrezos N, Hopper C, Brookes J. Threatened carotid blowout syndrome: are endovascular covered stents neurologically safe and do they prevent catastrophic haemorrhage? Br J Oral Maxillofac Surg 2015. [DOI: 10.1016/j.bjoms.2015.08.226] [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]
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Sobti A, Hamaudi R, Hopper C. Spectra of oral cancer microbiology: a review. Int J Oral Maxillofac Surg 2015. [DOI: 10.1016/j.ijom.2015.08.812] [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]
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Scott MA, Hopper C, Sahota A, Springett R, McIlroy BW, Bown SG, Macrobert AJ. Fluorescence Photodiagnostics and Photobleaching Studies of Cancerous Lesions using Ratio Imaging and Spectroscopic Techniques. Lasers Med Sci 2014; 15:63-72. [PMID: 24590201 DOI: 10.1007/s101030050049] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Topical or systemic administration of 5-aminolaevulinic acid results in biosynthesis of the photosensitiser protoporphyrin IX (PpIX) with some selectivity for malignant lesions. Excitation near 400 nm excites both intrinsic green tissue autofluorescence and red fluorescence from PpIX which may be exploited for the optical diagnosis of malignant and premalignant disease. In this work the utility of a cooled 12-bit single chip charge-coupled device (CCD) colour camera was investigated for photodiagnostic fluorescence ratio imaging. The red to green fluorescence intensity ratios were calculated for each pixel in real-time and fluorescence ratio images were displayed typically at a rate of 2 frames/s. Laboratory tests of fluorescence ratio imaging showed good contrast enhancement between control tissues and tissue phantoms and those containing porphyrin photosensitisers. In preliminary clinical tests, a clear demarcation between neoplastic/cancerous lesions and adjacent normal tissue was demonstrated. The extent of PpIX photobleaching during photodynamic therapy was also investigated using fluorescence ratio imaging.
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Affiliation(s)
- M A Scott
- National Medical Laser Centre, Royal Free and University College Medical School, Institute of Surgical Studies, University College London, London, UK, GB
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Salisbury C, Foster NE, Hopper C, Bishop A, Hollinghurst S, Coast J, Kaur S, Pearson J, Franchini A, Hall J, Grove S, Calnan M, Busby J, Montgomery AA. A pragmatic randomised controlled trial of the effectiveness and cost-effectiveness of 'PhysioDirect' telephone assessment and advice services for physiotherapy. Health Technol Assess 2013; 17:1-157, v-vi. [PMID: 23356839 DOI: 10.3310/hta17020] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND As a result of long delays for physiotherapy for musculoskeletal problems, several areas in the UK have introduced PhysioDirect services in which patients telephone a physiotherapist for initial assessment and treatment advice. However, there is no robust evidence about the effectiveness, cost-effectiveness or acceptability to patients of PhysioDirect. OBJECTIVE To investigate whether or not PhysioDirect is equally as clinically effective as and more cost-effective than usual care for patients with musculoskeletal (MSK) problems in primary care. DESIGN Pragmatic randomised controlled trial to assess equivalence, incorporating economic evaluation and nested qualitative research. Patients were randomised in 2 : 1 ratio to PhysioDirect or usual care using a remote automated allocation system at the level of the individual, stratifying by physiotherapy site and minimising by sex, age group and site of MSK problem. For the economic analysis, cost consequences included NHS and patient costs, and the cost of lost production. Cost-effectiveness analysis was carried out from the perspective of the NHS. Interviews were conducted with patients, physiotherapists and their managers. SETTING Four community physiotherapy services in England. PARTICIPANTS Adults referred by general practitioners or self-referred for physiotherapy for a MSK problem. INTERVENTIONS Patients allocated to PhysioDirect were invited to telephone a senior physiotherapist for initial assessment and advice using a computerised template, followed by face-to-face care when necessary. Patients allocated to usual care were put on to a waiting list for face-to-face care. MAIN OUTCOME MEASURES Primary outcome was the Short Form questionnaire-36 items, version 2 (SF-36v2) Physical Component Score (PCS) at 6 months after randomisation. Secondary outcomes included other measures of health outcome [Measure Yourself Medical Outcomes Profile, European Quality of Life-5 Dimensions (EuroQol health utility measure, EQ-5D), global improvement, response to treatment], wait for treatment, time lost from work and usual activities, patient satisfaction. Data were collected by postal questionnaires at baseline, 6 weeks and 6 months, and from routine records by researchers blind to allocation. RESULTS A total of 1506 patients were allocated to PhysioDirect and 743 to usual care. Patients allocated to PhysioDirect had a shorter wait for treatment than those allocated to usual care [median 7 days vs 34 days; arm-time ratio 0.32, 95% confidence interval (CI) 0.29 to 0.35] and had fewer non-attended face-to-face appointments [incidence rate ratio 0.55 (95% CI 0.41 to 0.73)]. The primary outcome at 6 months' follow-up was equivalent between PhysioDirect and usual care [mean PCS 43.50 vs 44.18, adjusted difference in means -0.01 (95% CI -0.80 to 0.79)]. The secondary measures of health outcome all demonstrated equivalence at 6 months, with slightly greater improvement in the PhysioDirect arm at 6 weeks' follow-up. Patients were equally satisfied with access to care but slightly less satisfied overall with PhysioDirect compared with usual care. NHS costs (physiotherapy plus other relevant NHS costs) per patient were similar in the two arms [PhysioDirect £ 198.98 vs usual care £ 179.68, difference in means £ 19.30 (95% CI -£ 37.60 to £ 76.19)], while QALYs gained were also similar [difference in means 0.007 (95% CI -0.003 to 0.016)]. Incremental cost per QALY gained was £ 2889. The probability that PhysioDirect was cost-effective at a £ 20,000 willingness-to-pay threshold was 88%. These conclusions about cost-effectiveness were robust to sensitivity analyses. There was no evidence of difference between trial arms in cost to patients or value of lost production. No adverse events were detected. CONCLUSIONS Providing physiotherapy via PhysioDirect is equally clinically effective compared with usual waiting list-based care, provides faster access to treatment, appears to be safe, and is broadly acceptable to patients. PhysioDirect is probably cost-effective compared with usual care.
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Affiliation(s)
- C Salisbury
- Centre for Academic Primary Care, School of Social and Community Medicine, University of Bristol, Bristol, UK.
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Forster M, Sultan A, Jerjes W, Simeon C, Morley S, Carnell D, Hopper C. First-In-Man Phase I Study of Tpcs2a-Based Photochemical Internalisation (PCI) of Bleomycin in Locally Recurrent or Advanced/Metastatic, Cutaneous or Subcutaneous Malignancies. Ann Oncol 2012. [DOI: 10.1016/s0923-7534(20)33619-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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McErlane F, Beresford MW, Baildam EM, Thomson W, Hyrich K, Chieng A, Davidson J, Foster HE, Gardner-Medwin J, Lunt M, Wedderburn L, Nikiphorou E, Carpenter L, Kiely P, Walsh D, Dixey J, Young A, Kapoor SR, Filer A, Fitzpatrick M, Fisher BA, Taylor PC, Buckley C, McInnes I, Raza K, Young SP, Dougados M, Kissel K, Amital H, Conaghan P, Martin-Mola E, Nasonov E, Schett G, Troum O, Veldi T, Bernasconi C, Huizinga T, Durez P, Genovese MC, Richards HB, Supronik J, Dokoupilova E, Aelion JA, Lee SH, Codding CE, Kellner H, Ikawa T, Hugot S, Ligozio G, Mpofu S, Kavanaugh A, Emery P, Fleischmann R, Van Vollenhoven R, Pavelka K, Durez P, Guerette B, Santra S, Redden L, Kupper H, Smolen JS, Wilkie R, Tajar A, McBeth J, Hooper LS, Bowen CJ, Gates L, Culliford D, Edwards CJ, Arden NK, Adams J, Ryan S, Haywood H, Pain H, Siddle HJ, Redmond AC, Waxman R, Dagg AR, Alcacer-Pitarch B, Wilkins RA, Helliwell PS, Norton S, Kiely P, Walsh D, Williams R, Young A, Halls S, Law RJ, Jones J, Markland D, Maddison P, Thom J, Parker B, Urowitz MB, Gladman DD, Bruce I, Croca SC, Pericleous C, Yong H, Isenberg D, Giles I, Rahman A, Ioannou Y, Warrell CE, Dobarro D, Handler C, Denton CP, Schreiber BE, Coghlan JG, Betteridge ZE, Woodhead F, Bunn C, Denton CP, Abraham D, Desai S, du Bois R, Wells A, McHugh N, Abignano G, Aydin S, Castillo-Gallego C, Woods D, Meekings A, McGonagle D, Emery P, Del Galdo F, Vila J, Mitchell S, Bowman S, Price E, Pease CT, Emery P, Andrews J, Bombardieri M, Sutcliffe N, Pitzalis C, Lanyon P, Hunter J, Gupta M, McLaren J, Regan M, Cooper A, Giles I, Isenberg D, Vadivelu S, Coady D, Griffiths B, Lendrem D, Foggo H, Tarn J, Ng WF, Goodhead C, Shekar P, Kelly C, Francis G, Bailey AM, Thompson L, Hamilton J, Salisbury C, Foster NE, Bishop A, Coast J, Franchini A, Hall J, Hollinghurst S, Hopper C, Grove S, Kaur S, Montgomery A, Paskins Z, Sanders T, Croft PR, Hassell AB, Coxon DE, Frisher M, Jordan KP, Jinks C, Peat G, Monk HL, Muller S, Mallen C, Hider SL, Roddy E, Muller S, Hayward R, Mallen C. Oral abstracts 3: RA Treatment and outcomes * O13. Validation of jadas in all subtypes of juvenile idiopathic arthritis in a clinical setting. Rheumatology (Oxford) 2012. [DOI: 10.1093/rheumatology/kes119] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Hamdoon Z, Jerjes W, Hopper C. Optical coherence tomography in the evaluation of tongue papillae in healthy individuals. Br J Oral Maxillofac Surg 2011. [DOI: 10.1016/j.bjoms.2011.03.111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Jerjes W, Hamdoon Z, Upile T, Hopper C. Assessment of quality of life in patients undergoing photodynamic therapy. Photodiagnosis Photodyn Ther 2011. [DOI: 10.1016/j.pdpdt.2011.03.298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Jerjes W, Hamdoon Z, Mosse C, Morley S, Hopper C. Photodynamic therapy in the management of vascular anomalies. Br J Oral Maxillofac Surg 2011. [DOI: 10.1016/j.bjoms.2011.03.126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Hamdoon Z, Jerjes W, Upile T, Hopper C. Optical coherence tomography in the evaluation of tongue papillae in healthy individuals. Photodiagnosis Photodyn Ther 2011. [DOI: 10.1016/j.pdpdt.2011.03.302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Jerjes W, Hamdoon Z, Hopper C. Photodynamic therapy outcome for skin pathologies: a single institute experience. Br J Oral Maxillofac Surg 2011. [DOI: 10.1016/j.bjoms.2011.03.135] [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]
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Jerjes W, Hamdoon Z, Hopper C. Assessment of quality of life in patients undergoing photodynamic therapy. Br J Oral Maxillofac Surg 2011. [DOI: 10.1016/j.bjoms.2011.03.134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Jerjes W, Hamdoon Z, Upile T, Hopper C. Photodynamic therapy outcome for skin pathologies: A single institute experience. Photodiagnosis Photodyn Ther 2011. [DOI: 10.1016/j.pdpdt.2011.03.074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Sheikh O, Lee Y, Sultan A, Vaz F, Hopper C. Endoscope guided interstitial photodynamic therapy for treatment of recurrent nasopharyngeal carcinoma. Photodiagnosis Photodyn Ther 2011. [DOI: 10.1016/j.pdpdt.2011.03.145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Hamdoon Z, Jerjes W, Hopper C. Optical coherence tomography of the tongue papillae for patients suffering from taste disorders following chemoradiotherapy. Br J Oral Maxillofac Surg 2011. [DOI: 10.1016/j.bjoms.2011.03.112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Sultan A, Simeon C, Mosse C, Berg K, Hogset A, Carnell D, Bown S, Hopper C. Tumour selectivity in a phase I clinical trial of photochemical internalization with PC-A11 (Amphinex®+bleomycin). Photodiagnosis Photodyn Ther 2011. [DOI: 10.1016/j.pdpdt.2011.03.245] [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: 11/24/2022]
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Hamdoon Z, Jerjes W, Upile T, Hopper C. Risk assessment of oral epithelium thickness using in vivo OCT. Photodiagnosis Photodyn Ther 2011. [DOI: 10.1016/j.pdpdt.2011.03.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Sultan A, Wang JW, Woodhams J, Jay A, Berg K, Hogset A, MacRobert A, Bown S, Hopper C. TPCS2a based bleomycin photochemical internalization in normal hamster cheek pouch. Photodiagnosis Photodyn Ther 2011. [DOI: 10.1016/j.pdpdt.2011.03.218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Jerjes W, Upile T, Hamdoon Z, Mosse C, Morley S, Hopper C. Minimal interventions for vascular anomalies. Photodiagnosis Photodyn Ther 2011. [DOI: 10.1016/j.pdpdt.2011.03.301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Jerjes W, Hamdoon Z, Abbas S, Hopper C. The management of unilateral condyle fractures: a single institute experience. Br J Oral Maxillofac Surg 2011. [DOI: 10.1016/j.bjoms.2011.03.127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Jerjes W, Hamdoon Z, Upile T, Hopper C. The management of periorbital skin tumours using surface illumination photodynamic therapy: Case series. Photodiagnosis Photodyn Ther 2011. [DOI: 10.1016/j.pdpdt.2011.03.012] [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: 11/28/2022]
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Hamdoon Z, Jerjes W, Upile T, Hopper C. Optical coherence tomography-guided photodynamic therapy for skin cancer: Case series. Photodiagnosis Photodyn Ther 2011. [DOI: 10.1016/j.pdpdt.2011.03.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Hamdoon Z, Jerjes W, Hopper C. Optical coherence tomography-guided photodynamic therapy for skin cancer: case series. Br J Oral Maxillofac Surg 2011. [DOI: 10.1016/j.bjoms.2011.03.113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Jerjes W, Hamdoon Z, Upile T, Hopper C. The role of photodynamic therapy in multidisciplinary oncological care. Photodiagnosis Photodyn Ther 2011. [DOI: 10.1016/j.pdpdt.2011.03.300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Jerjes W, Upile T, Hopper C. Politically driven. Br Dent J 2010; 209:423-4. [PMID: 21072071 DOI: 10.1038/sj.bdj.2010.984] [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: 11/09/2022]
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Jerjes W, Upile T, Hamdoon Z, Morcos M, Akram S, Hoonjan P, Hopper C. P101 Complications of temporomandibular joint arthroscopy: a prospective study of 183 cases. Br J Oral Maxillofac Surg 2010. [DOI: 10.1016/s0266-4356(10)60190-8] [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: 10/19/2022]
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Jerjes W, Upile T, Hamdoon Z, Hopper C. P25 CO2 laser of oral dysplasia: clinicopathological features of recurrence and malignant transformation. Br J Oral Maxillofac Surg 2010. [DOI: 10.1016/s0266-4356(10)60116-7] [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: 10/19/2022]
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Hamdoon Z, Jerjes W, Upile T, McKenzie G, Jay A, Hopper C. P24 Tumour resection margins subjected to optical coherence tomography. Br J Oral Maxillofac Surg 2010. [DOI: 10.1016/s0266-4356(10)60115-5] [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: 11/26/2022]
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Osher J, Jerjes W, Upile T, Hamdoon Z, Bhandari R, Hoonjan P, Akram S, Mosse C, Morley S, Hopper C. P22 Photodynamic therapy as the “last hope” palliative modality for patients with tongue base carcinoma. Br J Oral Maxillofac Surg 2010. [DOI: 10.1016/s0266-4356(10)60113-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Jerjes W, Upile T, Hamdoon Z, Hoonjan P, Hopper C. P100 Management of temporomandibular joint ankylosis: prospective study of 23 cases. Br J Oral Maxillofac Surg 2010. [DOI: 10.1016/s0266-4356(10)60189-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Jerjes W, Upile T, Shah P, Abbas S, Vincent A, Hopper C. P102 TMJ arthroscopy in patients with Ehlers Danlos Syndrome: case series. Br J Oral Maxillofac Surg 2010. [DOI: 10.1016/s0266-4356(10)60191-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Akram S, Jerjes W, Upile T, Hamdoon Z, Morcos M, Hopper C. P28 Photodynamic therapy outcome for oral dysplasia and early invasive cancer. Br J Oral Maxillofac Surg 2010. [DOI: 10.1016/s0266-4356(10)60119-2] [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: 10/19/2022]
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Hamdoon Z, Jerjes W, Upile T, McKenzie G, Jay A, Hopper C. P23 Assessment of premalignant/malignant oral lesions using optical coherence tomography. Br J Oral Maxillofac Surg 2010. [DOI: 10.1016/s0266-4356(10)60114-3] [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: 10/19/2022]
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Betz CS, Zhorzel S, Schachenmayr H, Stepp H, Havel M, Siedek V, Leunig A, Matthias C, Hopper C, Harreus U. Endoscopic measurements of free-flap perfusion in the head and neck region using red-excited Indocyanine Green: preliminary results. J Plast Reconstr Aesthet Surg 2008; 62:1602-8. [PMID: 19036663 DOI: 10.1016/j.bjps.2008.07.042] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2008] [Revised: 06/28/2008] [Accepted: 07/24/2008] [Indexed: 11/29/2022]
Abstract
BACKGROUND Free-tissue transfer has become a standard procedure for reconstructive surgery in the head and neck area. Flap failures are relatively rare (<or=5%), and a high percentage can be salvaged if detected early. Indocyanine Green (ICG) angiography might be able to improve the detection of flap malperfusion at an early stage. METHODS So far, 11 patients with free-flap reconstructions of the upper aerodigestive tract (UADT) have participated in this study. Each participant underwent three endoscopic ICG angiographies (24h intra-operatively and 72h postoperatively). The data obtained were evaluated online as well as offline on a personal computer (PC), and the results compared to the clinical outcome. RESULTS There were no partial or complete flap losses. One flap was successfully salvaged following initial arterial kinking with impeded perfusion. The ICG fluorescence angiography was tolerated well in all patients. The free flaps showed a delayed yet equal ICG fluorescence as compared to the surrounding tissue. The timing and slope of fluorescence build-up were dependent on circulatory factors. The relative fluorescence maxima of flap versus surrounding were 33% in the initially failing flap and >or=64% for all other examinations. CONCLUSIONS It was possible to prove the feasibility of endoscopic ICG fluorescence angiography in patients undergoing free-flap transfer to the UADT. The method provides instant information about the perfusion state of the tissue and is easily performed without greater patient discomfort or risk of side effects. Due to the endoscopic approach, the method seems highly promising for this indication and merits further evaluation.
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Affiliation(s)
- C S Betz
- Department of Otorhinolaryngology, Head & Neck Surgery, Ludwig Maximilian University, Grosshadern Medical Campus, Marchioninistr 15, D-81377 Munich, Germany.
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Upile T, Jerjes W, El Maaytah M, Abbas S, Singh S, Vourvachis M, Carbiner R, Vincent A, Radhi H, Hopper C, Wright A. Salivary VEGF: a non-invasive angiogenic and lymphangiogenic proxy in head and neck cancer prognostication. Br J Oral Maxillofac Surg 2008. [DOI: 10.1016/j.bjoms.2008.07.105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Upile T, Jerjes W, El Maaytah M, Abbas S, Vincent A, Radhi H, Vourvachis M, Jamil W, Carbiner R, Hopper C, Wright A. Microendoscopy in intra-operative margin analysis for laser surgery of the head & neck. Br J Oral Maxillofac Surg 2008. [DOI: 10.1016/j.bjoms.2008.07.106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Vourvachis M, Frampton S, Addis B, Jerjes W, El Maaytah M, Sandison A, Hopper C, Upile T. Branchial cysts within the parotid salivary gland. Br J Oral Maxillofac Surg 2008. [DOI: 10.1016/j.bjoms.2008.07.170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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El Maaytah M, Smith S, Jerjes W, Upile T, Abbas S, Goddard R, Petrie A, Hopper C, Newman L. Audit of maxillofacial out of hours operating in the United Kingdom. Br J Oral Maxillofac Surg 2008. [DOI: 10.1016/j.bjoms.2008.07.142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Jerjes W, Upile T, Conn B, Betz C, Abbas S, Jay A, Jamil W, Vourvachis M, Radhi R, El Maaytah M, Hopper C. Oral leukoplakia and erythroplakia subjected to optical coherence tomography: preliminary results. Br J Oral Maxillofac Surg 2008. [DOI: 10.1016/j.bjoms.2008.07.108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Jerjes W, Upile T, Radhi H, El Maaytah M, Abbas S, Vourvachis M, Jamil W, Carbiner R, Mc Carthy E, Wright A, Hopper C. Detection of Basal Cell carcinoma using elastic scattering spectroscopy. Br J Oral Maxillofac Surg 2008. [DOI: 10.1016/j.bjoms.2008.07.107] [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]
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Vourvachis M, Jerjes W, Upile T, Vincent A, Abbas S, Morley S, Hopper C. P.324 Interstitial photodynamic therapy in deeply seated lesions. J Craniomaxillofac Surg 2008. [DOI: 10.1016/s1010-5182(08)72112-7] [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: 11/30/2022] Open
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Vourvachis M, Upile T, Jerjes W, Singh S, Hopper C. P.087 Salivary vascular growth factor in oral cancer prognosis. J Craniomaxillofac Surg 2008. [DOI: 10.1016/s1010-5182(08)71875-4] [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: 10/21/2022] Open
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Vourvachis M, Upile T, Jerjes W, Singh S, Hopper C. P.150 The use of optical coherence tomography in oral dysplasias. J Craniomaxillofac Surg 2008. [DOI: 10.1016/s1010-5182(08)71938-3] [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
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Vourvachis M, Upile T, Jerjes W, Abbas S, Carbiner R, Sipaul F, Singh S, Hopper C. P.286 Management of epistaxis in UK: a new protocol. J Craniomaxillofac Surg 2008. [DOI: 10.1016/s1010-5182(08)72074-2] [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: 11/30/2022] Open
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