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Guo M, Karimuddin AA, Liu G, Crump T, Brown CJ, Raval MJ, Phang PT, Ghuman A, Mok J, Sutherland JM. A cost-utility study of elective haemorrhoidectomies in Canada. Colorectal Dis 2024; 26:527-533. [PMID: 38247259 DOI: 10.1111/codi.16867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2023] [Revised: 10/23/2023] [Accepted: 12/13/2023] [Indexed: 01/23/2024]
Abstract
AIM The aim was to estimate the 10-year cost-utility of haemorrhoidectomy surgery with preference-based measures of health using Canadian health utility measures and costs. METHODS Patients undergoing elective haemorrhoidectomies by general and colorectal surgeons in British Columbia, Vancouver, between September 2015 and November 2022, completed preoperatively and postoperatively the EuroQol five-dimension five-level health-related quality of life questionnaire (EQ-5D-5L). Quality-adjusted life years (QALYs) attributable to surgery were calculated by discounting preoperative and postoperative health utility values derived from the EQ-5D-5L. Costs were measured from a health system perspective which incorporated costs of hospital stay and specialists' fees. Results are presented in 2021 Canadian dollars. RESULTS Of 94 (47%) patients who completed both the preoperative and postoperative questionnaires, the mean gain in QALYs 10 years after surgery was 1.0609, assuming a 3.5% annual discounting rate. The average cost of the surgery was $3166. The average cost per QALY was $2985 when benefits of the surgery were assumed to accrue for 10 years. The cost per QALY was higher for women ($3821) compared with men ($2485). Participants over the age of 70 had the highest cost per QALY ($8079/QALY). CONCLUSIONS Haemorrhoidectomies have been associated with significant gains in health status and are inexpensive relative to the associated gains in quality of life based on patients' perspectives of their improvement in health and well-being.
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Affiliation(s)
- M Guo
- Department of Surgery, University of British Columbia, Vancouver, British Columbia, Canada
| | - A A Karimuddin
- Department of Surgery, University of British Columbia, Vancouver, British Columbia, Canada
- Department of Colorectal Surgery, St Paul's Hospital, Vancouver, British Columbia, Canada
| | - G Liu
- Centre for Health Services and Policy Research, University of British Columbia, Vancouver, British Columbia, Canada
| | - T Crump
- Department of Surgery, McGill University, Montreal, Quebec, Canada
| | - C J Brown
- Department of Surgery, University of British Columbia, Vancouver, British Columbia, Canada
- Department of Colorectal Surgery, St Paul's Hospital, Vancouver, British Columbia, Canada
| | - M J Raval
- Department of Surgery, University of British Columbia, Vancouver, British Columbia, Canada
- Department of Colorectal Surgery, St Paul's Hospital, Vancouver, British Columbia, Canada
| | - P T Phang
- Department of Surgery, University of British Columbia, Vancouver, British Columbia, Canada
- Department of Colorectal Surgery, St Paul's Hospital, Vancouver, British Columbia, Canada
| | - A Ghuman
- Department of Surgery, University of British Columbia, Vancouver, British Columbia, Canada
- Department of Colorectal Surgery, St Paul's Hospital, Vancouver, British Columbia, Canada
| | - J Mok
- Department of Family Medicine, Queen's University, Kingston, Ontario, Canada
| | - J M Sutherland
- Centre for Health Services and Policy Research, University of British Columbia, Vancouver, British Columbia, Canada
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Wood K, Lyne A, O'Donnell K, Brown CJ, Parekh S, Monteiro J. Patient-reported outcome measures for children and adolescents having dental bleaching in the UK. Eur Arch Paediatr Dent 2022; 23:579-586. [PMID: 35713847 PMCID: PMC9204681 DOI: 10.1007/s40368-022-00721-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Accepted: 05/17/2022] [Indexed: 10/25/2022]
Abstract
PURPOSE Dental bleaching in paediatric patients can be used to address discolouration of teeth due to trauma, endodontic treatment, or enamel and dentine defects. Despite being a minimally invasive and successful treatment, the use of bleaching products in children and young people remains controversial. This evaluation was designed to provide insight into the child's perspective on dental bleaching and the influence that this treatment has upon their life. METHOD A dental bleaching patient reported outcome measure (PROM) was developed and piloted in 2019. Data were collected from 3 UK units (January-March 2020). Children attending these units for bleaching reviews were invited to complete the PROM. RESULTS Twenty seven PROM questionnaires were completed including 19 courses of external bleaching and 8 courses of internal/external bleaching. The average age was 14 years old (9-17 years). The common indications for bleaching were Amelogenesis Imperfecta, dental trauma and Molar Incisor Hypomineralisation. Patients reported improvements in their appearance (89%) and self-confidence (81%). Sensitivity was the most common side effect, reported in 63% of cases. CONCLUSION This PROM supports the use of dental bleaching in children and young people when treating dental disease that causes discolouration. Bleaching not only improved the appearance of teeth, but also patients' self-confidence. Sensitivity is a common side effect and clinicians should discuss this common risk and its management with patients and their families.
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Affiliation(s)
- K Wood
- King's College Hospital NHS Foundation Trust, London, UK.
| | - A Lyne
- Royal National ENT and Eastman Dental Hospitals, London, UK
| | - K O'Donnell
- Newcastle Dental Hospital, Newcastle upon Tyne, UK
| | - C J Brown
- Birmingham Dental Hospital and School of Dentistry, Birmingham, UK
| | - S Parekh
- Department of Paediatric Dentistry, UCL Eastman Dental Institute, London, UK
| | - J Monteiro
- Charles Clifford Dental Hospital, Sheffield, UK
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Chea N, Brown CJ, Eure T, Ramirez RA, Blazek G, Penna AR, Li R, Czaja CA, Johnston H, Barter D, Miller BF, Angell K, Marshall KE, Fell A, Lovett S, Lim S, Lynfield R, Davis SS, Phipps EC, Sievers M, Dumyati G, Concannon C, McCullough K, Woods A, Seshadri S, Myers C, Pierce R, Ocampo VLS, Guzman-Cottrill JA, Escutia G, Samper M, Thompson ND, Magill SS, Grigg CT. Risk Factors for SARS-CoV-2 Infection Among US Healthcare Personnel, May-December 2020. Emerg Infect Dis 2022; 28:95-103. [PMID: 34856114 PMCID: PMC8714235 DOI: 10.3201/eid2801.211803] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
To determine risk factors for coronavirus disease (COVID-19) among US healthcare personnel (HCP), we conducted a case-control analysis. We collected data about activities outside the workplace and COVID-19 patient care activities from HCP with positive severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) test results (cases) and from HCP with negative test results (controls) in healthcare facilities in 5 US states. We used conditional logistic regression to calculate adjusted matched odds ratios and 95% CIs for exposures. Among 345 cases and 622 controls, factors associated with risk were having close contact with persons with COVID-19 outside the workplace, having close contact with COVID-19 patients in the workplace, and assisting COVID-19 patients with activities of daily living. Protecting HCP from COVID-19 may require interventions that reduce their exposures outside the workplace and improve their ability to more safely assist COVID-19 patients with activities of daily living.
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Meier J, Stevens A, Berger M, Hogan TP, Reisch J, Cullum CM, Lee SC, Skinner CS, Zeh H, Brown CJ, Balentine CJ. Use of local anesthesia for inguinal hernia repair has decreased over time in the VA system. Hernia 2021; 26:1069-1075. [PMID: 34743254 PMCID: PMC9076752 DOI: 10.1007/s10029-021-02532-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Accepted: 10/22/2021] [Indexed: 11/26/2022]
Abstract
PURPOSE In 2003, randomized trials demonstrated potentially improved outcomes when local instead of general anesthesia is used for inguinal hernia repair. Our study aimed to evaluate how the use of local anesthesia for this procedure changed over time following the publication of the trials' level 1 evidence. METHODS We used the 1998-2018 Veterans Affairs Surgical Quality Improvement Program database to identify adults who underwent open, unilateral inguinal hernia repair under local or general anesthesia. Our primary outcome was the percentage of cases performed under local anesthesia. We used a time-series design to examine the trend and rate of change of the use of local anesthesia. RESULTS We included 97,437 veterans, of which 22,333 (22.9%) had hernia surgery under local anesthesia. The median age of veterans receiving local anesthesia remained stable at 64-67 years over time. The use of local anesthesia decreased steadily, from 38.2% at the beginning year to 15.1% in the final year (P < 0.0001). The publication of results from randomized trials (in 2003) did not appear to increase the overall use or change the rate of decline in the use of local anesthesia. Overall, we found that the use of local anesthesia decreased by about 1.5% per year. CONCLUSION The utilization of local anesthesia for inguinal hernia repair in the VA has steadily declined over the last 20 + years, despite data showing equivalence or superiority to general anesthesia. Future studies should explore barriers to the use of local anesthesia for hernia repair.
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Affiliation(s)
- J Meier
- Department of Surgery, University of Texas Southwestern Medical Center, Dallas, TX, USA.
- North Texas VA Health Care System, 4500 S. Lancaster Road, Dallas, TX, 75216, USA.
- Implementation, and Novel Interventions (S-COIN), University of Texas Southwestern Surgical Center for Outcomes, Dallas, TX, USA.
| | - A Stevens
- Department of Surgery, University of Texas Southwestern Medical Center, Dallas, TX, USA
- North Texas VA Health Care System, 4500 S. Lancaster Road, Dallas, TX, 75216, USA
- Implementation, and Novel Interventions (S-COIN), University of Texas Southwestern Surgical Center for Outcomes, Dallas, TX, USA
| | - M Berger
- Department of Anesthesiology, Duke University, Durham, NC, USA
| | - T P Hogan
- Department of Surgery, University of Texas Southwestern Medical Center, Dallas, TX, USA
- Department of Population and Data Sciences, University of Texas Southwestern Medical Center, Dallas, TX, USA
- Center for Healthcare Organization and Implementation Research, VA Bedford Health Care System, US Department of Veterans Affairs, Bedford, MA, USA
| | - J Reisch
- Department of Population and Data Sciences, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - C M Cullum
- Departments of Psychiatry, Neurology, and Neurological Surgery, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - S C Lee
- Department of Population and Data Sciences, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - C S Skinner
- Department of Population and Data Sciences, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - H Zeh
- Department of Surgery, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - C J Brown
- Department of Medicine, LA State University-New Orleans, New Orleans, Louisiana, USA
| | - C J Balentine
- Department of Surgery, University of Texas Southwestern Medical Center, Dallas, TX, USA
- North Texas VA Health Care System, 4500 S. Lancaster Road, Dallas, TX, 75216, USA
- Implementation, and Novel Interventions (S-COIN), University of Texas Southwestern Surgical Center for Outcomes, Dallas, TX, USA
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Whitehouse LLE, Smith CEL, Poulter JA, Brown CJ, Patel A, Lamb T, Brown LR, O'Sullivan EA, Mitchell RE, Berry IR, Charlton R, Inglehearn CF, Mighell AJ. NOVEL DLX3 VARIANTS IN AMELOGENESIS IMPERFECTA WITH ATTENUATED TRICHO-DENTO-OSSEOUS SYNDROME. Oral Surg Oral Med Oral Pathol Oral Radiol 2021. [DOI: 10.1016/j.oooo.2021.03.184] [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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Thompson ND, Stone ND, Brown CJ, Penna AR, Eure TR, Bamberg WM, Barney GR, Barter D, Clogher P, DeSilva MB, Dumyati G, Frank L, Felsen CB, Godine D, Irizarry L, Kainer MA, Li L, Lynfield R, Mahoehney JP, Maloney M, Nadle J, Ocampo VLS, Pierce R, Ray SM, Davis SS, Sievers M, Srinivasan K, Wilson LE, Zhang AY, Magill SS. Antimicrobial Use in a Cohort of US Nursing Homes, 2017. JAMA 2021; 325:1286-1295. [PMID: 33821897 PMCID: PMC8025112 DOI: 10.1001/jama.2021.2900] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
IMPORTANCE Controlling antimicrobial resistance in health care is a public health priority, although data describing antimicrobial use in US nursing homes are limited. OBJECTIVE To measure the prevalence of antimicrobial use and describe antimicrobial classes and common indications among nursing home residents. DESIGN, SETTING, AND PARTICIPANTS Cross-sectional, 1-day point-prevalence surveys of antimicrobial use performed between April 2017 and October 2017, last survey date October 31, 2017, and including 15 276 residents present on the survey date in 161 randomly selected nursing homes from selected counties of 10 Emerging Infections Program (EIP) states. EIP staff reviewed nursing home records to collect data on characteristics of residents and antimicrobials administered at the time of the survey. Nursing home characteristics were obtained from nursing home staff and the Nursing Home Compare website. EXPOSURES Residence in one of the participating nursing homes at the time of the survey. MAIN OUTCOMES AND MEASURES Prevalence of antimicrobial use per 100 residents, defined as the number of residents receiving antimicrobial drugs at the time of the survey divided by the total number of surveyed residents. Multivariable logistic regression modeling of antimicrobial use and percentages of drugs within various classifications. RESULTS Among 15 276 nursing home residents included in the study (mean [SD] age, 77.6 [13.7] years; 9475 [62%] women), complete prevalence data were available for 96.8%. The overall antimicrobial use prevalence was 8.2 per 100 residents (95% CI, 7.8-8.8). Antimicrobial use was more prevalent in residents admitted to the nursing home within 30 days before the survey date (18.8 per 100 residents; 95% CI, 17.4-20.3), with central venous catheters (62.8 per 100 residents; 95% CI, 56.9-68.3) or with indwelling urinary catheters (19.1 per 100 residents; 95% CI, 16.4-22.0). Antimicrobials were most often used to treat active infections (77% [95% CI, 74.8%-79.2%]) and primarily for urinary tract infections (28.1% [95% CI, 15.5%-30.7%]). While 18.2% (95% CI, 16.1%-20.1%) were for medical prophylaxis, most often use was for the urinary tract (40.8% [95% CI, 34.8%-47.1%]). Fluoroquinolones were the most common antimicrobial class (12.9% [95% CI, 11.3%-14.8%]), and 33.1% (95% CI, 30.7%-35.6%) of antimicrobials used were broad-spectrum antibiotics. CONCLUSIONS AND RELEVANCE In this cross-sectional survey of a cohort of US nursing homes in 2017, prevalence of antimicrobial use was 8.2 per 100 residents. This study provides information on the patterns of antimicrobial use among these nursing home residents.
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Affiliation(s)
- Nicola D. Thompson
- Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Nimalie D. Stone
- Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Cedric J. Brown
- Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Austin R. Penna
- Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Taniece R. Eure
- Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Wendy M. Bamberg
- Colorado Department of Public Health and Environment, Denver
- Now with Medical Epidemiology Consulting, Denver, Colorado
| | - Grant R. Barney
- New York Emerging Infections Program, Rochester
- Now with New York State Department of Health, Albany
| | - Devra Barter
- Colorado Department of Public Health and Environment, Denver
| | - Paula Clogher
- Connecticut Emerging Infections Program, New Haven
- Yale School of Public Health, New Haven, Connecticut
| | - Malini B. DeSilva
- Minnesota Department of Health, St Paul
- Now with HealthPartners Institute, Minneapolis, Minnesota
| | - Ghinwa Dumyati
- New York Emerging Infections Program, Rochester
- University of Rochester, Rochester, New York
| | - Linda Frank
- California Emerging Infections Program, Oakland
| | - Christina B. Felsen
- New York Emerging Infections Program, Rochester
- University of Rochester, Rochester, New York
| | | | | | - Marion A. Kainer
- Tennessee Department of Health, Nashville
- Now with Western Health, Melbourne, Australia
| | - Linda Li
- Maryland Emerging Infections Program, Maryland Department of Health, Baltimore
| | | | | | | | | | | | | | - Susan M. Ray
- Georgia Emerging Infections Program, Atlanta
- Emory University, Atlanta, Georgia
| | | | | | | | - Lucy E. Wilson
- Maryland Emerging Infections Program, Maryland Department of Health, Baltimore
- Now with Maryland Emerging Infections Program, University of Maryland Baltimore County, Baltimore
| | | | - Shelley S. Magill
- Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
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Sutherland JM, Karimuddin A, Liu G, Crump T, Akbar H, Phang T, Redfern K, Manoharan S, Brown CJ, Raval MJ. Health and quality of life among a cohort of patients having lateral internal sphincterotomy for anal fissures. Colorectal Dis 2020; 22:1658-1666. [PMID: 32533887 DOI: 10.1111/codi.15191] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Revised: 05/22/2020] [Accepted: 05/27/2020] [Indexed: 12/23/2022]
Abstract
AIM The aim of this study is to report changes in health-related quality of life attributable to lateral internal sphincterotomy for treatment of anal fissure. There is very little evidence on whether the overall health-related quality of life of patients is detrimentally affected by the condition, or which aspects of self-perceived health status improve after lateral internal sphincterotomy. This study will articulate which aspects of health tend to improve and guide postoperative expectations appropriately. Knowledge gained from this study may also identify gaps in an individual patient's episode of care. METHOD Patients were prospectively identified when they consented to surgical treatment of their anal fissure and were contacted by phone to participate. Participants completed a number of patient-reported outcomes preoperatively and 6 months postoperatively. Faecal incontinence-related quality of life, pain and depression were measured at both time points. The severity of faecal incontinence was measured at both times. RESULTS Participants reported high levels of pain preoperatively. Postoperatively, improvement in pain exceeded the threshold of clinical relevance (P < 0.01). Thirty-five per cent of participants reported significant effects of faecal incontinence preoperatively, while 26% did so postoperatively. Participants with multiple comorbidities were more likely to report faecal incontinence postoperatively than preoperatively. CONCLUSION This study reports that lateral internal sphincterotomy improved pain symptoms without adverse effects on continence. Not all domains of health-related quality of life were similarly positively affected by anal fissure repair.
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Affiliation(s)
- J M Sutherland
- Centre for Health Services and Policy Research, School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
| | - A Karimuddin
- Section of Colorectal Surgery, Department of Surgery, University of British Columbia, Vancouver, British Columbia, Canada
| | - G Liu
- Centre for Health Services and Policy Research, School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
| | - T Crump
- Department of Surgery, University of Calgary, Calgary, Alberta, Canada
| | - H Akbar
- Centre for Health Services and Policy Research, School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
| | - T Phang
- Section of Colorectal Surgery, Department of Surgery, University of British Columbia, Vancouver, British Columbia, Canada
| | - K Redfern
- Vancouver Coastal Health Authority, Vancouver, British Columbia, Canada
| | - S Manoharan
- Section of Colorectal Surgery, Department of Surgery, University of British Columbia, Vancouver, British Columbia, Canada
| | - C J Brown
- Section of Colorectal Surgery, Department of Surgery, University of British Columbia, Vancouver, British Columbia, Canada
| | - M J Raval
- Section of Colorectal Surgery, Department of Surgery, University of British Columbia, Vancouver, British Columbia, Canada
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Ghuman A, Kasteel N, Brown CJ, Karimuddin AA, Raval MJ, Wexner SD, Phang PT. Surgical site infection in elective colonic and rectal resections: effect of oral antibiotics and mechanical bowel preparation compared with mechanical bowel preparation only. Colorectal Dis 2020; 22:1686-1693. [PMID: 32441804 DOI: 10.1111/codi.15153] [Citation(s) in RCA: 7] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Accepted: 04/30/2020] [Indexed: 12/08/2022]
Abstract
AIM Surgical site infections are disproportionately common after colorectal surgery and may be largely preventable. The objective of this retrospective cohort study was to determine the effect of oral antibiotics and mechanical bowel preparation on surgical site infections. METHOD A retrospective study of a consecutive series of elective colonic and rectal resections following an Enhanced Recovery After Surgery pathway, which also included mechanical bowel preparation, from 1 September 2014 to 30 September 2017. The addition of oral antibiotics (neomycin and metronidazole) to the mechanical bowel preparation procedure was assessed. Development of surgical site infections within 30 days was the main outcome measured. The secondary outcome was assessment of possible surgical site infection predictors. RESULTS Seven-hundred thirty-two patients were included: 313 (43%) preintervention (mechanical bowel preparation only); and 419 (57%) postintervention (mechanical bowel preparation plus oral antibiotics). Surgical site infection rates preintervention and. postintervention were: overall, 20.8% vs 10.5%, P < 0.001; superficial, 10.9% vs 4.3%, P < 0.001; and organ space, 9.9% vs 6.2%, P = 0.03. Subgroup analysis of colonic resections revealed a significant reduction in overall (17.1% vs 6.8%), superficial (10.7% vs 4.3%) and organ space (6.4% vs. 2.6%) infections. Rectal resections had significant reduction in overall (26.2% vs 15.3%) and superficial (11.1% vs 4.4%) infection rates but not in organ space infections (15.1% vs 10.9%). Multivariate regression analysis revealed open vs minimally invasive surgery (P < 0.001) and omission of oral antibiotics (P = 0.004) as independent predictors of surgical site infections. CONCLUSION Administration of oral antibiotics resulted in significant reduction of superficial and organ space infections after colonic resection; after rectal resection, significant reduction only of superficial infections was found.
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Affiliation(s)
- A Ghuman
- Division of General Surgery, Department of Surgery, University of British Columbia, Vancouver, British Columbia, Canada.,Department of Colorectal Surgery, Cleveland Clinic Florida, Weston, Florida, USA
| | - N Kasteel
- Division of General Surgery, Department of Surgery, University of British Columbia, Vancouver, British Columbia, Canada
| | - C J Brown
- Division of General Surgery, Department of Surgery, St. Paul's Hospital, Vancouver, British Columbia, Canada
| | - A A Karimuddin
- Division of General Surgery, Department of Surgery, St. Paul's Hospital, Vancouver, British Columbia, Canada
| | - M J Raval
- Division of General Surgery, Department of Surgery, St. Paul's Hospital, Vancouver, British Columbia, Canada
| | - S D Wexner
- Department of Colorectal Surgery, Cleveland Clinic Florida, Weston, Florida, USA
| | - P T Phang
- Division of General Surgery, Department of Surgery, St. Paul's Hospital, Vancouver, British Columbia, Canada
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Punnen S, Karimuddin AA, Raval MJ, Phang PT, Brown CJ. Transanal Endoscopic Microsurgery (TEM) for rectal GI stromal tumor. Am J Surg 2020; 221:183-186. [PMID: 32782081 DOI: 10.1016/j.amjsurg.2020.07.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2019] [Revised: 07/06/2020] [Accepted: 07/15/2020] [Indexed: 11/24/2022]
Abstract
BACKGROUND Transanal endoscopic microsurgery (TEM) is effective in treating adenomas and select early rectal cancers. Our objective is to evaluate TEM in treating early rectal GISTs. METHODS Patients were identified in a prospective database with pathology confirmed rectal GIST prior to TEM over 10 years. Demographic, pathologic, operative and follow-up data was analysed and presented with descriptive statistics. RESULTS 7 cases of rectal GIST were treated with TEM with a follow-up time of 31 months (0-71). Median tumor distance from the anal verge was 4 cm (2.5-6) and median tumor size was 3 cm (2-5.7). Negative margins were achieved in 4/7 patients. Those with positive margins were treated with repeat TEM or imatinib. 1 patient had local recurrence successfully treated by TEM. CONCLUSIONS Overall, TEM is safe for locally excising GISTs. As rectal GISTs are rare, a multicenter registry may better elucidate outcomes with this treatment.
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Affiliation(s)
- S Punnen
- University of British Columbia, 2329 West Mall, Vancouver, BC, v6t1z4, Canada
| | - A A Karimuddin
- University of British Columbia, 2329 West Mall, Vancouver, BC, v6t1z4, Canada; St. Paul's Hospital, 1081 Burrard Street, Vancouver, BC, v6z1y6, Canada
| | - M J Raval
- University of British Columbia, 2329 West Mall, Vancouver, BC, v6t1z4, Canada; St. Paul's Hospital, 1081 Burrard Street, Vancouver, BC, v6z1y6, Canada
| | - P T Phang
- University of British Columbia, 2329 West Mall, Vancouver, BC, v6t1z4, Canada; St. Paul's Hospital, 1081 Burrard Street, Vancouver, BC, v6z1y6, Canada
| | - C J Brown
- University of British Columbia, 2329 West Mall, Vancouver, BC, v6t1z4, Canada; St. Paul's Hospital, 1081 Burrard Street, Vancouver, BC, v6z1y6, Canada.
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Clement EA, Rouleau-Fournier F, Brown CJ. Techniques for safe laparoscopic anterior resection for complicated diverticular disease. Tech Coloproctol 2020; 24:979. [PMID: 32367291 DOI: 10.1007/s10151-020-02215-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Accepted: 04/07/2020] [Indexed: 11/28/2022]
Affiliation(s)
- E A Clement
- Department of Surgery, Division of General Surgery, University of Alberta, Edmonton, AB, Canada.
| | - F Rouleau-Fournier
- Department of Surgery, Division of General Surgery, Section of Colorectal Surgery, University of British Columbia, Vancouver, BC, Canada
| | - C J Brown
- Department of Surgery, Division of General Surgery, Section of Colorectal Surgery, University of British Columbia, Vancouver, BC, Canada
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Frosi Y, Inoue K, Ramlan SR, Lane DP, Watanabe T, Brown CJ. Simultaneous measurement of p53:Mdm2 and p53:Mdm4 protein-protein interactions in whole cells using fluorescence labelled foci. Sci Rep 2019; 9:17933. [PMID: 31784573 PMCID: PMC6884555 DOI: 10.1038/s41598-019-54123-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [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: 08/22/2019] [Accepted: 11/08/2019] [Indexed: 12/26/2022] Open
Abstract
In this report we describe the development of a Fluorescent Protein-Protein Interaction-visualization (FLUOPPI) to enable the simultaneous measurement of both Mdm2:p53 and Mdm4:p53 interactions in order to assess the relative efficiencies of mimetic molecules of the p53 peptide helix against both PPIs. Mdm2 and Mdm4 overexpression frequently leads to the inactivation of non-mutated p53 in human cancers, via inhibition of its transcriptional activity, enhancing its degradation by the proteasome or by preventing its nuclear import. Development of inhibitors to disrupt the binding of one or both of these protein interactions have been the subject of intensive pharmaceutical development for anti-cancer therapies. Using the bimodal FLUOPPI system we have characterised compounds that were either monospecific for Mdm2 or bispecific for both Mdm2 and Mdm4. We have also demonstrated that the FLUOPPI assay can reliably differentiate between specific and non-specific disruption of these protein complexes via accurate assessment and normalization to the cell population under measurement. We envision that this methodology will increase the efficiency of identifying compounds that are either specific against a single PPI from a closely related family of interactions or compounds that interact across multiple related PPI pairs, depending on which is more desirable.
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Affiliation(s)
- Y Frosi
- p53 Laboratory, A*STAR (Agency for Science, Technology and Research), 8A Biomedical Grove, #06-04/05, Neuros/Immunos, Singapore, 138648, Singapore
| | - K Inoue
- R&D Division, Medical & Biological Laboratories, Co., Ltd., 1063-103 Terasawaoka, Ina, Nagano, 396-0002, Japan
| | - Siti Radhiah Ramlan
- p53 Laboratory, A*STAR (Agency for Science, Technology and Research), 8A Biomedical Grove, #06-04/05, Neuros/Immunos, Singapore, 138648, Singapore
| | - D P Lane
- p53 Laboratory, A*STAR (Agency for Science, Technology and Research), 8A Biomedical Grove, #06-04/05, Neuros/Immunos, Singapore, 138648, Singapore
| | - T Watanabe
- R&D Division, Medical & Biological Laboratories, Co., Ltd., 1063-103 Terasawaoka, Ina, Nagano, 396-0002, Japan.
| | - C J Brown
- p53 Laboratory, A*STAR (Agency for Science, Technology and Research), 8A Biomedical Grove, #06-04/05, Neuros/Immunos, Singapore, 138648, Singapore.
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12
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Abstract
Background Total mesorectal excision (tme) is the current standard of care for the treatment of rectal cancer. However, that surgery is associated with significant morbidity and mortality. Clinicians and patients are seeking alternatives to radical resection. Currently, prevalent organ-sparing strategies under investigation include local excision and nonoperative management (nom). Methods We reviewed the current evidence in the literature to create an overview of the use of transanal endoscopic surgery and watch-and-wait strategies in the modern management of rectal cancer. Results Compared with radical resection, transanal endoscopic surgery in patients with early rectal cancer (cT1) having favourable histopathologic features is associated with an increased risk of local recurrence, but no difference in 5-year survival. In patients with T2 or early T3 cancer, strategies that use neoadjuvant or adjuvant therapy as adjuncts to local excision are under evaluation. Nonoperative management is a new option for patients who experience a complete clinical response after neoadjuvant chemoradiotherapy (ncrt). The selection criteria that will appropriately identify patients for whom nom will succeed are not established. Conclusions Local excision is appropriate for early rectal cancer with favourable histopathologic features. Although organ-preserving strategies are promising, the quality of the evidence to date is insufficient to replace the current standard care in most patients. Patients should be offered nom in the safe setting of a clinical trial or registry. Rigorous follow-up, including endoscopy and imaging at frequent intervals is recommended when radical resection is forgone.
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Affiliation(s)
- F Rouleau-Fournier
- Department of Surgery, St. Paul's Hospital, Providence Health Care, Vancouver, BC
| | - C J Brown
- Department of Surgery, St. Paul's Hospital, Providence Health Care, Vancouver, BC
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13
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Brown CJ, Hochman D, Raval MJ, Moloo H, Phang PT, Bouchard A, Williams L, Drolet S, Boushey R. A multi-centre randomized controlled trial of open vs closed management of the rectal defect after transanal endoscopic microsurgery. Colorectal Dis 2019; 21:1025-1031. [PMID: 31081281 DOI: 10.1111/codi.14689] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2019] [Accepted: 04/12/2019] [Indexed: 01/17/2023]
Abstract
AIM Transanal endoscopic microsurgery (TEM) is a technically challenging strategy that allows expanded indications for local excision of rectal lesions. Transluminal suturing is difficult, so open management of the resultant defect is appealing. Expert opinion suggests there is more pain when the defect is left open. The aim of this study was to determine if closure of the defect created during full thickness excision of rectal lesions with TEM leads to less postoperative pain compared to leaving the defect open. METHOD At the time of surgery, patients undergoing a full thickness TEM were randomized to sutured (TEM-S) or open (TEM-O) management of the rectal defect. At five Canadian academic colorectal surgery centres, experienced TEM surgeons enrolled patients ≥ 18 years treated by full thickness TEM. The primary outcome was postoperative pain measured by the visual analogue scale. Secondary outcomes included postoperative pain medication use and 30-day postoperative complications, including bleeding, infection and hospital readmission. RESULTS Between March 2012 and October 2013, 50 patients were enrolled and randomized to sutured (TEM-S, n = 28) or open (TEM-O, n = 22) management of the rectal defect. There was no difference between the two study groups in postoperative pain on postoperative day 1 (2.8 vs 2.6, P = 0.76), day 3 (2.8 vs 2.1, P = 0.23) and day 7 (2.8 vs 1.7, P = 0.10). CONCLUSION In this multicentre randomized controlled trial, there was no difference in postoperative pain between sutured or open defect management in patients having a full thickness excision with TEM.
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Affiliation(s)
- C J Brown
- Department of Surgery, University of British Columbia and St Paul's Hospital, Vancouver, British Columbia, Canada
| | - D Hochman
- Department of Surgery, University of Manitoba, Winnipeg, Manitoba, Canada
| | - M J Raval
- Department of Surgery, University of British Columbia and St Paul's Hospital, Vancouver, British Columbia, Canada
| | - H Moloo
- Department of Surgery, University of Ottawa, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - P T Phang
- Department of Surgery, University of British Columbia and St Paul's Hospital, Vancouver, British Columbia, Canada
| | - A Bouchard
- Department of Surgery, CHU de Québec - Université Laval, Quebec City, Quebec, Canada
| | - L Williams
- Department of Surgery, Dalhousie University, Halifax, Nova Scotia, Canada
| | - S Drolet
- Department of Surgery, CHU de Québec - Université Laval, Quebec City, Quebec, Canada
| | - R Boushey
- Department of Surgery, University of Ottawa, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
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14
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Garfinkle R, Filion KB, Bhatnagar S, Sigler G, Banks A, Letarte F, Liberman S, Brown CJ, Boutros M. Prediction model and web-based risk calculator for postoperative ileus after loop ileostomy closure. Br J Surg 2019; 106:1676-1684. [DOI: 10.1002/bjs.11235] [Citation(s) in RCA: 5] [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] [Received: 01/04/2019] [Revised: 03/13/2019] [Accepted: 04/16/2019] [Indexed: 12/13/2022]
Abstract
Abstract
Background
Postoperative ileus (POI) is a significant complication after loop ileostomy closure given both its frequency and impact on the patient. The purpose of this study was to develop and externally validate a prediction model for POI after loop ileostomy closure.
Methods
The model was developed and validated according to the TRIPOD checklist for prediction model development and validation. The development cohort included consecutive patients who underwent loop ileostomy closure in two teaching hospitals in Montreal, Canada. Candidate variables considered for inclusion in the model were chosen a priori based on subject knowledge. The final prediction model, which modelled the 30-day cumulative incidence of POI using logistic regression, was selected using the highest area under the receiver operating characteristic curve (AUC) criterion. Model calibration was assessed using the Hosmer–Lemeshow goodness-of-fit test. The model was then validated externally in an independent cohort of similar patients from the University of British Columbia.
Results
The development cohort included 531 patients, in whom the incidence of POI was 16·8 per cent. The final model included five variables: age, ASA fitness grade, underlying pathology/treatment, interval between ileostomy creation and closure, and duration of surgery for ileostomy closure (AUC 0·68, 95 per cent c.i. 0·61 to 0·74). The model demonstrated good calibration (P = 0·142). The validation cohort consisted of 216 patients, and the incidence of POI was 15·7 per cent. On external validation, the model maintained good discrimination (AUC 0·72, 0·63 to 0·81) and calibration (P = 0·538).
Conclusion
A prediction model was developed for POI after loop ileostomy closure and included five variables. The model maintained good performance on external validation.
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Affiliation(s)
- R Garfinkle
- Division of Colon and Rectal Surgery, Jewish General Hospital, Montreal, Quebec, Canada
| | - K B Filion
- Center for Clinical Epidemiology, Lady Davis Institute, Jewish General Hospital, Montreal, Quebec, Canada
- Department of Epidemiology, Biostatistics and Occupational Health, Montreal, Quebec, Canada
- Department of Medicine, McGill University, Montreal, Quebec, Canada
| | - S Bhatnagar
- Department of Epidemiology, Biostatistics and Occupational Health, Montreal, Quebec, Canada
| | - G Sigler
- Division of Colon and Rectal Surgery, Jewish General Hospital, Montreal, Quebec, Canada
- Division of General Surgery, Department of Surgery, University of Ottawa, Ottawa, Ontario, Canada
| | - A Banks
- Division of Colon and Rectal Surgery, Jewish General Hospital, Montreal, Quebec, Canada
- Faculty of Medicine, McGill University, Montreal, Quebec, Canada
| | - F Letarte
- Division of General Surgery, Department of Surgery, University Hospital of Quebec, Quebec City, Quebec, Canada
- Division of General Surgery, Department of Surgery, St Paul's Hospital, Vancouver, British Columbia, Canada
| | - S Liberman
- Division of General Surgery, Department of Surgery, McGill University Health Center, Montreal, Quebec, Canada
| | - C J Brown
- Division of General Surgery, Department of Surgery, St Paul's Hospital, Vancouver, British Columbia, Canada
| | - M Boutros
- Division of Colon and Rectal Surgery, Jewish General Hospital, Montreal, Quebec, Canada
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15
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Adame MF, Najera E, Lovelock CE, Brown CJ. Avoided emissions and conservation of scrub mangroves: potential for a Blue Carbon project in the Gulf of California, Mexico. Biol Lett 2018; 14:20180400. [PMID: 30958255 DOI: 10.1098/rsbl.2018.0400] [Citation(s) in RCA: 17] [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] [Indexed: 11/12/2022] Open
Abstract
Mangroves are considered ideal ecosystems for Blue Carbon projects. However, because of their short stature, some mangroves ('scrub' mangroves, less than 2 m) do not fulfil the current definition of 'forests', which makes them ineligible for emission reduction programmes such as REDD+. Short stature mangroves can be the dominant form of mangroves in arid and nutrient-poor landscapes, and emissions from their deforestation and degradation could be substantial. Here, we describe a Blue Carbon project in the Gulf of California, Mexico, to illustrate that projects that avoid emissions from deforestation and degradation could provide financial resources to protect mangroves that cannot be included in other emission reduction programmes. The goal of the project is to protect 16 058 ha of mangroves through conservation concessions from the Mexican Federal Government. The cumulative avoided emissions of the project are 2.84 million Mg CO2 over 100 years, valued at $US 426 000 per year (US$15 per Mg CO2 in the California market). The funds could be used for community-based projects that will improve mangrove management, such as surveillance, eradication of invasive species, rehabilitation after tropical storms and environmental education. The strong institutional support, secure financial status, community engagement and clear project boundaries provide favourable conditions to implement this Blue Carbon project. Financial resources from Blue Carbon projects, even in mangroves of short stature, can provide substantial resources to enhance community resilience and mangrove protection.
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Affiliation(s)
- M F Adame
- 1 Australian Rivers Institute, Griffith University , Nathan, QLD , Australia
| | - E Najera
- 2 Wildcoast-Costasalvaje , Ensenada , Mexico
| | - C E Lovelock
- 3 School of Biological Sciences, The University of Queensland , QLD , Australia
| | - C J Brown
- 1 Australian Rivers Institute, Griffith University , Nathan, QLD , Australia
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16
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Thompson ND, Brown CJ, Eure T, Penna A, Bamberg W, Barney G, Barter D, Clogher P, Desilva M, Dumyati G, Epson E, Frank L, Godine D, Irizarry L, Kainer MA, Lynfield R, Mahoehney JP, Maloney M, Morabit S, Nadle J, Ocampo VLS, Pierce R, Ray SM, Shrum S, Sievers M, Wilson LE, Stone ND, Magill SS. 1831. Point Prevalence and Epidemiology of Antimicrobial Use in US Nursing Homes, 2017. Open Forum Infect Dis 2018. [PMCID: PMC6252607 DOI: 10.1093/ofid/ofy210.1487] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background The role of nursing homes (NH) in transmission of antimicrobial-resistant (AR) organisms is of growing concern. AR control requires evidence-based NH stewardship interventions; however, data on antimicrobial use (AU) from US NHs are scant. In the absence of other AU surveillance approaches, NH prevalence surveys can generate essential data, including rationale and indication. In 2017, an AU prevalence survey was conducted through the CDC’s Emerging Infections Program (EIP) to determine the prevalence and epidemiology of AU in NH residents. Methods NHs from California, Colorado, Connecticut, Georgia, Maryland, Minnesota, New Mexico, New York, Oregon, and Tennessee were randomly selected to participate in a 1-day AU point prevalence survey; participation was voluntary. For NH residents receiving antimicrobial drugs (AD) at the time of the survey, EIP staff reviewed available medical records to collect the AD route, rationale, and infection site(s). AD were categorized using the World Health Organization Anatomical Therapeutic Chemical classification system. Data were analyzed in SAS 9.4. Results Of 15,295 residents in 161 NHs, 1,261 (prevalence 8.2%, 95% confidence interval 7.8%-8.7%) received ≥1 AD at the time of the survey (AD range 1–4/resident). Of 1,452 total ADs, 77% were administered for treatment of an active infection, 19% for prophylaxis, 3% for noninfectious reasons, and no rationale documented in 1%. Most AD (80%) were administered by the oral/enteral route and most (87%) were antibacterials. The three most common infection sites were urinary tract (29%, of which 1/4 was for prophylaxis); wound, cellulitis or soft tissue (20%); and respiratory tract (14%). Among the 1,268 antibacterials (figure), fluoroquinolones (15%), combination penicillins (8%), third-generation cephalosporins (8%), and glycopepetides (5%) ranked among the top 10 classes in use. Conclusion This large-scale prevalence survey provides insight into AU in US NHs. On a given day, approximately 1 in 12 NH residents was receiving ≥1 AD. Notably, 30% of AD were administered for UTI, and AD in classes recommended for stewardship intervention were common. These findings highlight areas for evaluation to identify unnecessary use in NH. Prevalence survey data are important to inform and track the impact of stewardship interventions. ![]()
Disclosures All authors: No reported disclosures.
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Affiliation(s)
- Nicola D Thompson
- Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Cedric J Brown
- Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Taniece Eure
- Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Austin Penna
- Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Wendy Bamberg
- Colorado Department of Public Health and Environment, Denver, Colorado
| | - Grant Barney
- NY Emerging Infections Program, Center for Community Health, University of Rochester Medical Center, Rochester, New York
| | - Devra Barter
- Colorado Department of Public Health and Environment, Denver, Colorado
| | | | - Malini Desilva
- Infectious Disease Epidemiology, Prevention and Control Division, Minnesota Department of Health, Saint Paul, Minnesota
| | - Ghinwa Dumyati
- NY Emerging Infections Program, Center for Community Health and Prevention, University of Rochester Medical Center, Rochester, New York
| | - Erin Epson
- Healthcare-Associated Infections Program, California Department of Public Health, Richmond, California
| | - Linda Frank
- California Emerging Infections Program, Oakland, California
| | - Deborah Godine
- California Emerging Infections Program, Oakland, California
| | | | - Marion A Kainer
- Communicable and Environmental Diseases and Emergency Preparedness, Tennessee Department of Public Health, Nashville, Tennessee
| | - Ruth Lynfield
- State Epidemiologist and Medical Director for Infectious Diseases, Epidemiology and Community Health, Minnesota Department of Health, St. Paul, Minnesota
| | - J P Mahoehney
- Minnesota EIP/Department of Health, Minneapolis, Minnesota
| | - Meghan Maloney
- Connecticut Department of Public Health, Hartford, Connecticut
| | - Susan Morabit
- Georgia Emerging Infections Program, Decatur, Georgia
| | - Joelle Nadle
- California Emerging Infections Program, Oakland, California
| | - Valerie L S Ocampo
- Acute and Communicable Disease Prevention, Oregon Health Authority, Portland, Oregon
| | - Rebecca Pierce
- Public Health Division, Oregon Health Authority, Portland, Oregon
| | - Susan M Ray
- Division of Infectious Diseases, Emory University School of Medicine, Atlanta, Georgia
| | - Sarah Shrum
- New Mexico Department of Health, Santa Fe, New Mexico
| | - Marla Sievers
- New Mexico EIP/Department of Health, Santa Fe, New Mexico
| | | | - Nimalie D Stone
- Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Shelley S Magill
- Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
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17
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Brown CJ, Loyd C, Tyler Richardson J, Boogaerts G. VALIDATION OF THE ACUTE CARE MOBILITY ASSESSMENT: A MEASURE OF HOSPITAL MOBILITY. Innov Aging 2018. [DOI: 10.1093/geroni/igy023.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- C J Brown
- The University of Alabama at Birmingham, Birmingham, Alabama, United States
| | - C Loyd
- Postdoctoral Scholar, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - J Tyler Richardson
- Assistant Professor, Physical Medicine & Rehabilitation, University of Alabama at Birmingham, Birmingham, Alabama USA
| | - G Boogaerts
- University of Alabama at Birmingham School of Medicine, Birmingham, Alabama USA
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18
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Brown CJ, Gentles JQ, Phang TP, Karimuddin AA, Raval MJ. Transanal endoscopic microsurgery as day surgery - a single-centre experience with 500 patients. Colorectal Dis 2018; 20:O310-O315. [PMID: 29992737 DOI: 10.1111/codi.14337] [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] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2017] [Accepted: 07/02/2018] [Indexed: 02/08/2023]
Abstract
AIM Transanal endoscopic microsurgery (TEM) is the current treatment of choice for rectal adenomas and early rectal cancer. Postoperative admission to hospital is common but possibly unnecessary. Our objective was to analyse predictors and outcomes of TEM patients having same day discharge (TEM-D) compared with those who were admitted to hospital (TEM-A). METHOD At St Paul's Hospital (SPH), demographic, surgical, pathological and follow-up data have been collected prospectively since TEM was started in 2007. Trends in admission and readmission rates were analysed using the Cochran-Armitage trend test, and predictors of admission were analysed using univariate and multivariate logistic regressions. RESULTS Between 2007 and 2016, 500 patients were treated by TEM at SPH. The overall admission rate was 29% (145/500), but this decreased to 19% in the last 3 years of the study (P < 0.001). The readmission rate was 5.2% (n = 26/500) and did not change significantly over the study period (P = 0.30). Reasons for admission included the following: surgeon discretion/monitoring (35%), urinary retention (26%), haemorrhage (10%), breach of peritoneal cavity (7%), infection (7%) and other (15%). The most common reasons for readmission were haemorrhage (54%, n = 14), pain (19%, n = 5) and infection (12%, n = 3). Factors associated with admission were as follows: tumour height (OR 1.09, 1.02-1.17), prolonged operative time (OR 1.25, 1.14-1.37), unsutured surgical defect (OR 1.99, 1.22-3.25) and surgeon experience (OR 4.62, 2.75-7.77). CONCLUSION Outpatient TEM is safe and carries a low risk of readmission. In centres with an outpatient TEM strategy, predictors of hospital admission include proximal tumours, prolonged surgical time and open management of the surgical defect.
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Affiliation(s)
- C J Brown
- Department of Surgery, University of British Columbia and St Paul's Hospital, Vancouver, BC, Canada.,Department of Surgery, University of British Columbia, Vancouver, BC, Canada
| | - J Q Gentles
- Department of Surgery, University of British Columbia, Vancouver, BC, Canada
| | - T P Phang
- Department of Surgery, University of British Columbia and St Paul's Hospital, Vancouver, BC, Canada.,Department of Surgery, University of British Columbia, Vancouver, BC, Canada
| | - A A Karimuddin
- Department of Surgery, University of British Columbia and St Paul's Hospital, Vancouver, BC, Canada.,Department of Surgery, University of British Columbia, Vancouver, BC, Canada
| | - M J Raval
- Department of Surgery, University of British Columbia and St Paul's Hospital, Vancouver, BC, Canada.,Department of Surgery, University of British Columbia, Vancouver, BC, Canada
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19
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Letarte F, Raval M, Karimuddin A, Phang PT, Brown CJ. Salvage TME following TEM: a possible indication for TaTME. Tech Coloproctol 2018; 22:355-361. [PMID: 29725785 DOI: 10.1007/s10151-018-1784-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2017] [Accepted: 12/07/2017] [Indexed: 01/16/2023]
Abstract
BACKGROUND Salvage surgery after transanal endoscopic microsurgery (TEM) has shown mixed results. Transanal total mesorectal excision (TaTME) might be advantageous in this population. The aim of this study was to assess the short-term oncologic and operative outcomes of salvage surgery after TEM, comparing TaTME to conventional salavge TME (sTME). METHODS Consecutive patients treated with salvage surgery after TEM were identified. Patients who underwent TaTME were compared to those who had conventional sTME. The primary outcome was the ability to perform an appropriate oncologic procedure defined by a composite outcome (negative distal margins, negative radial margins and complete or near complete mesorectum specimen). RESULTS During the study period, 41 patients had salvage surgery after TEM. Of those, 11 patients had TaTME while 30 patients had sTME. All patients in the TaTME group met the composite outcome of appropriate oncologic procedure compared to 76.7% for the conventional sTME group (p = 0.19). TaTME was associated with significantly higher rates of sphincter preservation (100 vs. 50%, p = 0.01), higher rates of laparoscopic surgery (100 vs. 23.3%, p < 0.001) and lower rates of conversion to open surgery (9.1 vs. 57%, p < 0.001). No difference was found in postoperative morbidity (36.3 vs. 36.7%, p = 0.77). CONCLUSIONS The present study demonstrates that for patients requiring salvage surgery after TEM, TaTME is associated with significantly higher rates of sphincter-sparing surgery when compared to conventional transabdominal TME while producing adequate short-term oncologic outcomes. Salvage surgery after TEM might be a clear indication for TaTME rather than conventional surgery.
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Affiliation(s)
- F Letarte
- Department of Colorectal Surgery, St. Paul's Hospital Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - M Raval
- Department of Colorectal Surgery, St. Paul's Hospital Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - A Karimuddin
- Department of Colorectal Surgery, St. Paul's Hospital Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - P T Phang
- Department of Colorectal Surgery, St. Paul's Hospital Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - C J Brown
- Department of Colorectal Surgery, St. Paul's Hospital Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada. .,Division of General Surgery, Providence Health Care, Vancouver, Canada. .,Section of Colorectal Surgery, St. Paul Hospital, University of British Columbia (UBC), C310-1081 Burrard Street, Vancouver, V6Z 1Y6, Canada.
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20
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McKevitt EC, Dingee CK, Warburton R, Pao JS, Brown CJ, Wilson C, Kuusk U. Coordination of radiologic and clinical care reduces the wait time to breast cancer diagnosis. ACTA ACUST UNITED AC 2017; 24:e388-e393. [PMID: 29089809 DOI: 10.3747/co.24.3767] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
BACKGROUND In 2009, a Rapid Access Breast Clinic (rabc) was opened at our urban hospital. Compared with the traditional system (ts), the navigated care through the clinic was associated with a significantly shorter time to surgical consultation. Since 2009, many radiology facilities have introduced facilitated-care pathways for patients with breast pathology. Our objective was to determine if that change in diagnostic imaging pathways had eliminated the advantage in time to care previously shown for the rabc. METHODS All patients seen in the rabc and the office-based ts in November-December 2012 were included in the analysis. A retrospective chart review tabulated demographic, surgeon, pathology, and radiologic data, including time intervals to care for all patients. The results were compared with data from 2009. RESULTS In 2012, time from presentation to surgical consultation was less for the rabc group than for the ts group (36 days vs. 73 days, p < 0.001) for both malignant (31 days vs. 55 days, p = 0.008) and benign diagnoses (43 days vs. 79 days, p < 0.001). Comparing the 2012 results with results from 2009, a decline in mean wait time was observed for the ts group (86 days vs. 73 days, p = 0.02). Compared with patients having investigations in the ts, rabc patients with cancer were more likely to undergo surgery within 60 days of presentation (33% vs. 15%, p = 0.04). CONCLUSIONS The coordination of radiology and clinical care reduces wait times for diagnosis and surgery in breast cancer. To achieve recommended targets, we recommend implementation of more systematic coordination of care for a breast cancer diagnosis and of navigation to surgeons for patients needing surgical care.
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Affiliation(s)
- E C McKevitt
- Department of Surgery, Providence Health Care.,Department of Surgery, University of British Columbia
| | - C K Dingee
- Department of Surgery, Providence Health Care.,Department of Surgery, University of British Columbia
| | - R Warburton
- Department of Surgery, Providence Health Care.,Department of Surgery, University of British Columbia
| | - J S Pao
- Department of Surgery, Providence Health Care.,Department of Surgery, University of British Columbia
| | - C J Brown
- Department of Surgery, Providence Health Care.,Department of Surgery, University of British Columbia
| | - C Wilson
- Department of Radiology, BC Cancer Agency; and.,Department of Radiology, University of British Columbia, Vancouver, BC
| | - U Kuusk
- Department of Surgery, Providence Health Care.,Department of Surgery, University of British Columbia
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21
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Duffy N, Brown CJ, Bulens SN, Bamberg W, Janelle SJ, Jacob JT, Bower C, Wilson L, Vaeth E, Lynfield R, Vagnone PS, Phipps EC, Hancock EB, Dumyati G, Concannon C, Beldavs ZG, Cassidy PM, Kainer M, Muleta D, See I. Wide Range of Carbapenem-resistant Enterobacteriaceae Incidence and Trends in Emerging Infections Program Surveillance, 2012–2015. Open Forum Infect Dis 2017. [PMCID: PMC5631630 DOI: 10.1093/ofid/ofx162.118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Background Carbapenem-resistant Enterobacteriaceae (CRE) are an urgent threat in the United States because of high morbidity and mortality, few treatment options, and potential for rapid spread among patients. To assess for changes in CRE epidemiology and risk among populations, we analyzed CDC Emerging Infections Program (EIP) 2012–2015 surveillance data for CRE. Methods Active, population-based CRE surveillance was initiated in January 2012 at 3 EIP sites (GA, MN, OR) and expanded to 5 additional sites (CO, MD, NM, New York, TN) by 2014. An incident case was the first Escherichia coli, Enterobacter, or Klebsiella isolate (non-susceptible to at least one carbapenem and resistant to all third-generation cephalosporins tested) collected from urine or a normally sterile body site from a patient during a 30-day period. Data were collected from patients’ medical records. Cases were hospital-onset (HO) or long-term care facility (LTCF) onset if patients were in the respective facility ≥3 days prior to culture or at the time of culture; and community-onset (CO) otherwise. We calculated incidence rates based on census data for EIP sites and described by type of infection onset. Results A total of 1,582 incident CRE cases were reported in 2012–2015. Most cases (88%) were identified through urine cultures; 946 (60%) were female, and median age was 66 years (interquartile range: 55–77). The median incidence by site was 2.95 per 100,000 population (range: 0.35–8.98). Among the three sites with four full years of data, a different trend was seen in each (Figure). Trends in GA and MN were statistically significant, and no significant trend was seen in OR. Overall, 480 cases (30%) were HO, 524 (33%) were LTCF onset, and 578 (37%) were CO. Of CO cases, 308 (53%) had been hospitalized, admitted to a long- term acute care hospital or were a LTCF resident in the prior year. Conclusion CRE incidence varied more than 20-fold across surveillance sites, with evidence of continued increases in MN. Measuring impact of programs aimed at reducing CRE transmission in other regions will require obtaining local data to identify cases occurring during and after healthcare facility discharge. Further study of changes in incidence in some settings and areas might offer opportunities to refine and expand effective control strategies. Disclosures All authors: No reported disclosures.
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Affiliation(s)
- Nadezhda Duffy
- Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Cedric J Brown
- Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Sandra N Bulens
- Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Wendy Bamberg
- Colorado Department of Public Health and Environment, Denver, Colorado
| | - Sarah J Janelle
- Colorado Department of Public Health and Environment, Denver, Colorado
| | - Jesse T Jacob
- Georgia Emerging Infections Program, Decatur, Georgia
- Emory University School of Medicine, Atlanta, Georgia
| | - Chris Bower
- Georgia Emerging Infections Program, Decatur, Georgia
- Atlanta Veterans Affairs Medical Center, Decatur, Georgia
| | - Lucy Wilson
- Maryland Department of Health and Mental Hygiene, Baltimore, Maryland
| | - Elisabeth Vaeth
- Maryland Department of Health and Mental Hygiene, Baltimore, Maryland
| | | | | | - Erin C Phipps
- University of New Mexico, New Mexico Emerging Infections Program, Albuquerque, New Mexico
| | - Emily B Hancock
- New Mexico Emerging Infections Program, University of New Mexico, Albuquerque, New Mexico
| | - Ghinwa Dumyati
- Center for Community Health, University of Rochester Medical Center, Rochester, New York
| | - Cathleen Concannon
- NY Emerging Infections Program, Center for Community Health, University of Rochester Medical Center, Rochester, New York
| | | | | | - Marion Kainer
- Tennessee Department of Health, Nashville, Tennessee
| | - Daniel Muleta
- Tennessee Department of Health, Nashville, Tennessee
| | - Isaac See
- Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
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Aird LNF, Bristol SG, Phang PT, Raval MJ, Brown CJ. Randomized double-blind trial comparing the cosmetic outcome of cutting diathermy versus scalpel for skin incisions. Br J Surg 2015; 102:489-94. [DOI: 10.1002/bjs.9751] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2014] [Revised: 06/20/2014] [Accepted: 11/17/2014] [Indexed: 11/12/2022]
Abstract
Abstract
Background
Controversy exists about whether cutting diathermy for skin incisions leads to a cosmetically inferior scar. Cosmetic outcomes were compared between skin incisions created with cutting diathermy versus scalpel. Wound infection rates and postoperative incisional pain were also compared.
Methods
This was a randomized double-blind trial comparing cutting diathermy and scalpel in patients undergoing bowel resection. Scar cosmesis was assessed at 6 months after surgery by a plastic surgeon and a research associate using the Vancouver Scar Scale (VSS) and the Patient and Observer Scar Assessment Scale (POSAS). Patients also used POSAS to self-evaluate their scars. Wound infections within 30 days were recorded, and incision pain scores were measured on the first 5 days after operation.
Results
A total of 66 patients were randomized to cutting diathermy (31) or scalpel (35). At 6 months, there was no significant difference between the diathermy and scalpel groups in mean(s.d.) VSS scores (4·9(2·6) versus 5·0(1·9); P = 0·837), mean POSAS total scores (19·2(8·0) versus 20·0(7·4); P = 0·684) or subjective POSAS total scores (20·2(12·1) versus 21·3(10·4); P = 0·725). Neither were there significant differences in wound infection rates between the groups (5 of 30 versus 5 of 32; P = 1·000). Pain scores on day 1 after operation were significantly lower in the diathermy group (mean 1·68 versus 3·13; P = 0·018), but were not significantly different on days 2–5.
Conclusion
Cutting diathermy is a cosmetically acceptable technique for abdominal skin incisions. There is no increased risk of wound infection, and diathermy may convey benefit in terms of early postoperative wound pain. Registration number: NCT01496404 (http://www.clinicaltrials.gov).
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Affiliation(s)
- L N F Aird
- Divisions of General Surgery, University of British Columbia, British Columbia, Canada
| | - S G Bristol
- Divisions of Plastic Surgery, University of British Columbia, British Columbia, Canada
- Department of Surgery, St Paul's Hospital, Vancouver, British Columbia, Canada
| | - P T Phang
- Divisions of General Surgery, University of British Columbia, British Columbia, Canada
- Department of Surgery, St Paul's Hospital, Vancouver, British Columbia, Canada
| | - M J Raval
- Divisions of General Surgery, University of British Columbia, British Columbia, Canada
- Department of Surgery, St Paul's Hospital, Vancouver, British Columbia, Canada
| | - C J Brown
- Divisions of General Surgery, University of British Columbia, British Columbia, Canada
- Department of Surgery, St Paul's Hospital, Vancouver, British Columbia, Canada
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Zakariaee R, Brown CJ, Hamarneh G, Parsons CA, Spadinger I. Sci-Thur AM: YIS - 11: Estimation of Bladder-Wall Cumulative Dose in Multi-Fraction Image-Based Gynaecological Brachytherapy Using Deformable Point Set Registration. Med Phys 2014. [DOI: 10.1118/1.4894973] [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: 11/07/2022] Open
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24
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Wilson IM, Vucic EA, Enfield KSS, Thu KL, Zhang YA, Chari R, Lockwood WW, Radulovich N, Starczynowski DT, Banáth JP, Zhang M, Pusic A, Fuller M, Lonergan KM, Rowbotham D, Yee J, English JC, Buys TPH, Selamat SA, Laird-Offringa IA, Liu P, Anderson M, You M, Tsao MS, Brown CJ, Bennewith KL, MacAulay CE, Karsan A, Gazdar AF, Lam S, Lam WL. EYA4 is inactivated biallelically at a high frequency in sporadic lung cancer and is associated with familial lung cancer risk. Oncogene 2013; 33:4464-73. [PMID: 24096489 PMCID: PMC4527534 DOI: 10.1038/onc.2013.396] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2013] [Revised: 07/30/2013] [Accepted: 08/06/2013] [Indexed: 02/07/2023]
Abstract
In an effort to identify novel biallelically inactivated tumor suppressor genes (TSG) in sporadic invasive and pre-invasive non-small cell lung cancer (NSCLC) genomes, we applied a comprehensive integrated multi-‘omics approach to investigate patient matched, paired NSCLC tumor and non-malignant parenchymal tissues. By surveying lung tumor genomes for genes concomitantly inactivated within individual tumors by multiple mechanisms, and by the frequency of disruption in tumors across multiple cohorts, we have identified a putative lung cancer TSG, Eyes Absent 4 (EYA4). EYA4 is frequently and concomitantly deleted, hypermethylated and underexpressed in multiple independent lung tumor data sets, in both major NSCLC subtypes, and in the earliest stages of lung cancer. We find not only that decreased EYA4 expression is associated with poor survival in sporadic lung cancers, but EYA4 SNPs are associated with increased familial cancer risk, consistent with EYA4’s proximity to the previously reported lung cancer susceptibility locus on 6q. Functionally, we find that EYA4 displays TSG-like properties with a role in modulating apoptosis and DNA repair. Cross examination of EYA4 expression across multiple tumor types suggests a cell type-specific tumorigenic role for EYA4, consistent with a tumor suppressor function in cancers of epithelial origin. This work shows a clear role for EYA4 as a putative TSG in NSCLC.
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Affiliation(s)
- I M Wilson
- Integrative Oncology Genetics Unit, British Columbia Cancer Research Centre, Vancouver, BC, Canada
| | - E A Vucic
- Integrative Oncology Genetics Unit, British Columbia Cancer Research Centre, Vancouver, BC, Canada
| | - K S S Enfield
- Integrative Oncology Genetics Unit, British Columbia Cancer Research Centre, Vancouver, BC, Canada
| | - K L Thu
- Integrative Oncology Genetics Unit, British Columbia Cancer Research Centre, Vancouver, BC, Canada
| | - Y A Zhang
- Hamon Center for Therapeutic Oncology Research, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - R Chari
- 1] Integrative Oncology Genetics Unit, British Columbia Cancer Research Centre, Vancouver, BC, Canada [2] Department of Genetics, Harvard Medical School, Boston, MA, USA
| | - W W Lockwood
- 1] Integrative Oncology Genetics Unit, British Columbia Cancer Research Centre, Vancouver, BC, Canada [2] National Human Genome Research Institute, Cancer Genetics Branch, Bethesda, MD, USA
| | - N Radulovich
- Ontario Cancer Institute/Princess Margaret Hospital, Toronto, ON, Canada
| | - D T Starczynowski
- Division of Experimental Hematology and Cancer Biology, Cincinnati Children's Hospital Research Foundation, Cincinnati, OH, USA
| | - J P Banáth
- Integrative Oncology Genetics Unit, British Columbia Cancer Research Centre, Vancouver, BC, Canada
| | - M Zhang
- Integrative Oncology Genetics Unit, British Columbia Cancer Research Centre, Vancouver, BC, Canada
| | - A Pusic
- Integrative Oncology Genetics Unit, British Columbia Cancer Research Centre, Vancouver, BC, Canada
| | - M Fuller
- Integrative Oncology Genetics Unit, British Columbia Cancer Research Centre, Vancouver, BC, Canada
| | - K M Lonergan
- Integrative Oncology Genetics Unit, British Columbia Cancer Research Centre, Vancouver, BC, Canada
| | - D Rowbotham
- Integrative Oncology Genetics Unit, British Columbia Cancer Research Centre, Vancouver, BC, Canada
| | - J Yee
- Department of Surgery, Vancouver General Hospital, Vancouver, BC, Canada
| | - J C English
- Department of Pathology, Vancouver General Hospital, Vancouver, BC, Canada
| | - T P H Buys
- Integrative Oncology Genetics Unit, British Columbia Cancer Research Centre, Vancouver, BC, Canada
| | - S A Selamat
- Department of Biochemistry and Molecular Biology, University of Southern California, Los Angeles, CA, USA
| | - I A Laird-Offringa
- Department of Biochemistry and Molecular Biology, University of Southern California, Los Angeles, CA, USA
| | - P Liu
- Medical College of Wisconsin Cancer Center, Milwaukee, WI, USA
| | - M Anderson
- Medical College of Wisconsin Cancer Center, Milwaukee, WI, USA
| | - M You
- Medical College of Wisconsin Cancer Center, Milwaukee, WI, USA
| | - M S Tsao
- Ontario Cancer Institute/Princess Margaret Hospital, Toronto, ON, Canada
| | - C J Brown
- Department of Medical Genetics, University of British Columbia, Life Sciences Centre, Vancouver, BC, Canada
| | - K L Bennewith
- Integrative Oncology Genetics Unit, British Columbia Cancer Research Centre, Vancouver, BC, Canada
| | - C E MacAulay
- Integrative Oncology Genetics Unit, British Columbia Cancer Research Centre, Vancouver, BC, Canada
| | - A Karsan
- Integrative Oncology Genetics Unit, British Columbia Cancer Research Centre, Vancouver, BC, Canada
| | - A F Gazdar
- Hamon Center for Therapeutic Oncology Research, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - S Lam
- Integrative Oncology Genetics Unit, British Columbia Cancer Research Centre, Vancouver, BC, Canada
| | - W L Lam
- Integrative Oncology Genetics Unit, British Columbia Cancer Research Centre, Vancouver, BC, Canada
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Iwane MK, Chaves SS, Szilagyi PG, Edwards KM, Hall CB, Staat MA, Brown CJ, Griffin MR, Weinberg GA, Poehling KA, Prill MM, Williams JV, Bridges CB. Disparities between black and white children in hospitalizations associated with acute respiratory illness and laboratory-confirmed influenza and respiratory syncytial virus in 3 US counties--2002-2009. Am J Epidemiol 2013; 177:656-65. [PMID: 23436899 DOI: 10.1093/aje/kws299] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Few US studies have assessed racial disparities in viral respiratory hospitalizations among children. This study enrolled black and white children under 5 years of age who were hospitalized for acute respiratory illness (ARI) in 3 US counties during October-May 2002-2009. Population-based rates of hospitalization were calculated by race for ARI and laboratory-confirmed influenza and respiratory syncytial virus (RSV), using US Census denominators. Relative rates of hospitalization between racial groups were estimated. Of 1,415 hospitalized black children and 1,824 hospitalized white children with ARI enrolled in the study, 108 (8%) black children and 111 (6%) white children had influenza and 230 (19%) black children and 441 (29%) white children had RSV. Hospitalization rates were higher among black children than among white children for ARI (relative rate (RR) = 1.7, 95% confidence interval (CI): 1.6, 1.8) and influenza (RR = 2.1, 95% CI: 1.6, 2.9). For RSV, rates were similar among black and white children under age 12 months but higher for black children aged 12 months or more (for ages 12-23 months, RR = 1.7, 95% CI: 1.1, 2.5; for ages 24-59 months, RR = 2.2, 95% CI: 1.3, 3.6). Black children versus white children were significantly more likely to have public insurance or no insurance (85% vs. 43%) and a history of asthma/wheezing (28% vs. 18%) but not more severe illness. The observed racial disparities require further study.
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Affiliation(s)
- Marika K Iwane
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA.
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Brown CJ, Nash EF, Carrolan V, Rashid R, Whitehouse JL. P93 Clinical Outcomes and Patient Satisfaction Following Initiation of the TOBI Podhaler in CF Adults. Thorax 2012. [DOI: 10.1136/thoraxjnl-2012-202678.335] [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: 11/03/2022]
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Peñaherrera MS, Jiang R, Avila L, Yuen RKC, Brown CJ, Robinson WP. Patterns of placental development evaluated by X chromosome inactivation profiling provide a basis to evaluate the origin of epigenetic variation. Hum Reprod 2012; 27:1745-53. [PMID: 22431562 PMCID: PMC3357192 DOI: 10.1093/humrep/des072] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Inactivation of the maternally or paternally derived X chromosome (XCI) initially occurs in a random manner in early development; however as tissues form, a ‘patchiness’ will occur in terms of which X is inactivated if cells positioned near each other are clonally descended from a common precursor. Determining the relationship between skewed XCI in different tissues and in different samples from the same tissue provides a molecular assessment of the developmental history of a particular tissue that can then be used to understand how genetic and epigenetic variation arises in development. METHODS XCI skewing was evaluated in and compared between amnion, chorion, trophoblast and mesenchyme using multiple sampling sites from 14 term placentae. XCI was also evaluated in chorionic villus samples obtained at multiple sites and depths from four additional term placentae. The pattern of variation was then compared with methylation variation associated with the H19/IGF2 imprinting control region (ICR); promoter regions of KISS1, PTPN6, CASP8 and APC; and LINE-1 elements. RESULTS Mean placental level of skewing for amnion and chorion are correlated, consistent with a common developmental origin of at least a component of these membranes from inner cell mass derivatives subsequent to XCI, while trophoblast appears to be derived independently, consistent with its origin from the trophectoderm. Villus samples taken from different depths spanning the fetal to maternal side of the placenta were highly clonally related. Comparing patterns of clonal growth identified through XCI to the distribution of epigenetic variation in other genomic regions suggests that some variation arises early in development (e.g. LINE-1 methylation), whereas other variation arises predominantly after villus tree formation (e.g. methylation at H19/IGF2 ICR). CONCLUSIONS The patterns of XCI skewing are consistent with a model whereby each biopsied site of chorionic villi represents one or a few individual villus trees, each of which is clonally derived from only one or a few precursor cells. Sampling of placentae to evaluate changes associated with clinical pathology should be done with consideration of the tree-to-tree differences. A limitation of this study is the small number of placentas used and therefore placental-specific differences in variation could not be assessed.
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Affiliation(s)
- M S Peñaherrera
- Department of Medical Genetics, University of British Columbia, Vancouver, BC, Canada
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28
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Griffith M, Mwenifumbo JC, Cheung PY, Paul JE, Pugh TJ, Tang MJ, Chittaranjan S, Morin RD, Asano JK, Ally AA, Miao L, Lee A, Chan SY, Taylor G, Severson T, Hou YC, Griffith OL, Cheng GSW, Novik K, Moore R, Luk M, Owen D, Brown CJ, Morin GB, Gill S, Tai IT, Marra MA. Novel mRNA isoforms and mutations of uridine monophosphate synthetase and 5-fluorouracil resistance in colorectal cancer. Pharmacogenomics J 2012; 13:148-58. [PMID: 22249354 DOI: 10.1038/tpj.2011.65] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
The drug fluorouracil (5-FU) is a widely used antimetabolite chemotherapy in the treatment of colorectal cancer. The gene uridine monophosphate synthetase (UMPS) is thought to be primarily responsible for conversion of 5-FU to active anticancer metabolites in tumor cells. Mutation or aberrant expression of UMPS may contribute to 5-FU resistance during treatment. We undertook a characterization of UMPS mRNA isoform expression and sequence variation in 5-FU-resistant cell lines and drug-naive or -exposed primary and metastatic tumors. We observed reciprocal differential expression of two UMPS isoforms in a colorectal cancer cell line with acquired 5-FU resistance relative to the 5-FU-sensitive cell line from which it was derived. A novel isoform arising as a consequence of exon skipping was increased in abundance in resistant cells. The underlying mechanism responsible for this shift in isoform expression was determined to be a heterozygous splice site mutation acquired in the resistant cell line. We developed sequencing and expression assays to specifically detect alternative UMPS isoforms and used these to determine that UMPS was recurrently disrupted by mutations and aberrant splicing in additional 5-FU-resistant colorectal cancer cell lines and colorectal tumors. The observed mutations, aberrant splicing and downregulation of UMPS represent novel mechanisms for acquired 5-FU resistance in colorectal cancer.
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Affiliation(s)
- M Griffith
- Canada's Michael Smith Genome Sciences Centre, Vancouver, British Columbia, Canada
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Abstract
This paper presents a finite element (FE) model to identify parameters that affect the performance of an improved cancellous bone screw fixation technique, and hence potentially improve fracture treatment. In cancellous bone of low apparent density, it can be difficult to achieve adequate screw fixation and hence provide stable fracture fixation that enables bone healing. Data from predictive FE models indicate that cements can have a significant potential to improve screw holding power in cancellous bone. These FE models are used to demonstrate the key parameters that determine pull-out strength in a variety of screw, bone and cement set-ups, and to compare the effectiveness of different configurations. The paper concludes that significant advantages, up to an order of magnitude, in screw pull-out strength in cancellous bone might be gained by the appropriate use of a currently approved calcium phosphate cement.
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Affiliation(s)
- C J Brown
- School of Engineering and Design, Brunel University, Uxbridge, UB8 3PH, UK.
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Abstract
OBJECTIVE Newborns are not routinely screened for cytomegalovirus (CMV), the leading infectious cause of developmental disability. Congenital CMV satisfies a number of criteria for inclusion in newborn screening, and screening potentially offers benefits. Screening could also introduce harms such as anxiety and unnecessary costs for the families of the substantial proportion of CMV-infected children who never develop CMV-related disabilities. Our objective was to assess attitudes toward newborn screening for CMV. METHODS We analyzed responses to 5 statements about CMV and newborn screening from 3922 participants in the 2009 HealthStyles survey, a national mail survey designed to include a group similar to the US population with respect to gender, age, race/ethnicity, income, and household size. Two-step cluster analysis was performed to identify clusters of parental attitudes. RESULTS The majority of respondents strongly or somewhat agreed that they would want to have their newborn tested for CMV even if it was not performed routinely (84%), they had to pay $20 (87%), or CMV-related problems never developed (84%). Nearly half (47%) of them "would worry that the CMV test would lead to unneeded doctor visits and expenses," and 32% "think CMV problems are too rare to worry about." Three clusters of parent respondents were identified on the basis of their attitudes toward CMV screening: "strongly in favor" (31%), "moderately in favor" (49%), and "weakly opposed" (20%). CONCLUSIONS Among most parents, costs, worry, and anxiety associated with newborn screening for CMV would be acceptable. Although attitudes were generally favorable, a minority of the parents were weakly opposed to newborn screening for CMV.
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Affiliation(s)
- Erica S Din
- Centers for Disease Control and Prevention, Atlanta, GA, USA
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Sellers WFS, Ahmad I, Bathke PSJ, Brown CJ, Fernandez T, Barker A. Intravenous magnesium sulphate prevents intravenous salbutamol tachycardia in asthma. Br J Anaesth 2010; 105:869-70. [PMID: 21081685 DOI: 10.1093/bja/aeq329] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Aslani N, Brown CJ. Does mesh offer an advantage over tissue in the open repair of umbilical hernias? A systematic review and meta-analysis. Hernia 2010; 14:455-62. [PMID: 20635190 DOI: 10.1007/s10029-010-0705-9] [Citation(s) in RCA: 76] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2010] [Accepted: 07/01/2010] [Indexed: 10/19/2022]
Abstract
PURPOSE To determine the best surgical approach for the open repair of primary umbilical hernias. METHODS Studies were identified through searching MEDLINE, EMBASE, and the Cochrane database, as well as hand-searching references. Randomized controlled trials (RCTs) and observational studies comparing mesh to suture repair for primary umbilical hernias published between January 1965 and October 2009 were included. Data regarding the recurrence rate, complications, number of subjects, length of follow-up, size of hernia, and type of mesh were extracted. Log odds ratios were calculated and weighed by the Mantel-Haenszel method to obtain a pooled estimate with 95% confidence interval (CI). A fixed effects model was used. RESULTS Three RCTs and ten observational studies were identified. The pooled odds ratio (OR) for RCTs was 0.09 in favor of mesh (95% CI 0.02-0.39). The pooled OR for observational studies was 0.40 in favor of mesh (95% CI 0.21-0.75). There was no difference in complication rates between mesh and tissue repair in RCTs or observational studies. CONCLUSIONS The use of mesh in umbilical hernia repair results in decreased recurrence and similar wound complications rates compared to tissue repair for primary umbilical hernias.
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Affiliation(s)
- N Aslani
- University of British Columbia, Vancouver, BC, Canada.
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Brown CJ, Rahman S, Morton AC, Beauchamp CL, Bramwell H, Buttle DJ. Inhibitors of collagenase but not of gelatinase reduce cartilage explant proteoglycan breakdown despite only low levels of matrix metalloproteinase activity. Mol Pathol 2010; 49:M331-9. [PMID: 16696099 PMCID: PMC408083 DOI: 10.1136/mp.49.6.m331] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [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
Aims-To investigate the level of matrix metalloproteinase activity during the time-course of cartilage explant proteoglycan breakdown; to determine the effects of selective small-molecule inhibitors of matrix metalloproteinases on proteoglycan degradation.Methods-The levels of matrix metalloproteinase activity in cartilage explant cultures and conditioned media were monitored by use of a quenched fluorescent substrate. The constants for inhibition of certain matrix metalloproteinases by a series of synthetic inhibitors were determined. Bovine and human cartilage explant cultures were treated with interleukin-1, tumor necrosis factor or retinoic acid and the amount of proteoglycan released into the culture medium in the absence and presence of the inhibitors was quantified. Control experiments, examining the inhibition of other proteinases, and investigating possible toxic or non-specific effects of the inhibitors, were carried out.Results-The profile of inhibition of proteoglycan release suggested the involvement of interstitial collagenase-like, rather than gelatinase- or possibly stromelysin-like, proteinases. No evidence was found for toxic or non-specific mechanisms of inhibition. Very low levels of activity of the known matrix metalloproteinases were present during the time-course of aggrecan breakdown.Conclusions-A novel collagenase-like proteinase(s) may be involved in cartilage proteoglycan breakdown. Gelatinase-type matrix metalloproteinases do not seem to be involved in this process. Specific collagenase inhibitors may be therapeutically efficacious in the treatment of arthritis.
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Affiliation(s)
- C J Brown
- Institute for Bone and Joint Medicine, Department of Human Metabolism and Clinical Biochemistry, University of Sheffield Medical School, Beech Hill Road, Sheffield S10 2RX
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Abstract
OBJECTIVE The aim of this study was to examine the association of nocturia with incident falls in a population-based sample of community-dwelling elderly persons. METHODS The University of Alabama at Birmingham Study of Aging is a prospective cohort study of 1000 community-dwelling older adults in the USA designed to examine factors associated with impaired mobility. Subjects were recruited from a stratified, random sample of Medicare beneficiaries to include equal numbers of black women, black men, white women and white men. Nocturia was assessed at baseline and falls were assessed at baseline and every 6 months for a total of 36 months of follow-up. RESULTS A total of 692 individuals (mean age 74.5 +/- 6.2, 48% female, 52% black) did not fall in the 12 months prior to baseline. Of these 692, 214 (30.9%) reported falling at least once during the subsequent 3 years. In unadjusted analysis, three or more nightly episodes of nocturia were associated with an incident fall [RR = 1.27, 95% CI (1.01-1.60)]. After multivariable logistic regression, three or more episodes of nocturia were associated with an increased risk of falling [RR = 1.28, (1.02-1.59)]. DISCUSSION In a racially diverse, community-based sample of older men and women who had not fallen in the previous year, nocturia three or more times a night was associated in multivariable analysis with a 28% increased risk of an incident fall within 3 years. While this study has several advantages over previous reports (longitudinal follow-up, performance-based measures of function, population-based sampling), causality cannot be ascertained. Further research is needed to ascertain the impact of treatments to reduce nocturia as part of a multi-component programme to reduce fall risk.
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Affiliation(s)
- C P Vaughan
- Department of Veterans Affairs Birmingham/Atlanta Geriatric Research, Education, and Clinical Center, Atlanta, GA, USA.
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Scully M, Brown J, Patel R, McDonald V, Brown CJ, Machin S. Human leukocyte antigen association in idiopathic thrombotic thrombocytopenic purpura: evidence for an immunogenetic link. J Thromb Haemost 2010; 8:257-62. [PMID: 19922436 DOI: 10.1111/j.1538-7836.2009.03692.x] [Citation(s) in RCA: 70] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Thrombotic thrombocytopenic purpura (TTP) is a rare, acute, life-threatening disorder, associated with a deficiency in ADAMTS 13. The majority of acute, idiopathic, adult TTP cases are associated with anti-ADAMTS 13 IgG antibodies. However, the factor(s) precipitating an acute TTP episode are not always obvious; indeed, a multifactorial etiology is likely. OBJECTIVES AND METHODS DNA was used for human leukocyte antigen (HLA) class II typing, using polymerase chain reaction (PCR)-sequence-specific primer and PCR-sequence-specific oligonucleotide probe to methodology to investigate 50 European acquired idiopathic TTP cases. RESULTS There was an increase in the frequency of HLA-DQB1*0301 (HLA-DQ7) in patients with TTP as compared with controls [58.0% vs. 34.5% (P=0.048)]. The frequencies of HLA-DRB1*11 and HLA-DRB3* were also significantly increased in TTP patients as compared with controls [44.0% vs. 12.0% (P=0.0024) and 84.0% vs. 58.0% (P=0.024)], although it remains uncertain whether susceptibility is influenced by HLA-DQ or HLA-DR molecules or other genes in this haplotype. The frequencies of HLA-DRB1*04 and HLA-DRB4 (HLA-DR53) were significantly decreased in the patient group as compared with controls [10.0% vs. 35.0% and 26.0% vs. 61.5% (P=0.0096 and P=0.0024, respectively)], and may have a protective effect against the development of TTP. CONCLUSION Analysis identified HLA class II types associated with susceptibility to and a protective effect against the development of acute acquired TTP in European patients. This provides the first description of a genetic factor predicting the risk of developing acquired antibody-mediated TTP.
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Affiliation(s)
- M Scully
- Department of Haematology, University College of London Hospitals, and Haemostasis Research Unit, University College London, London, UK.
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Latosinsky S, Thirlby R, Urbach D, Baxter NN, Brasel KJ, Brown CJ, Chaudhury P, Cutter CS, Divino C, Dixon E, Dubois L, Fitzgerald GWN, Henteleff HJA, Kirkpatrick AW, Latosinsky S, MacLean A, Mastracci TM, McLeod RS, Morris A, Neumayer LA, Temple LR, McKenzie ME. CAGS and ACS evidence based reviews in surgery. 32: Use of a surgical safety checklist to reduce morbidity and mortality. Can J Surg 2010; 53:64-66. [PMID: 20100416 PMCID: PMC2810011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023] Open
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Nenshi R, Kennedy E, Baxter NN, Saskin R, Sutradhar R, Urbach DR, Sroka G, Feldman LS, Vassiliou MC, Kaneva PA, Fayez R, Fried GM, Krajewski SA, Brown CJ, Hur C, McCrea PH, Mitchell A, Porter G, Grushka J, Razek T, Khwaja K, Fata P, Martel G, Moloo H, Picciano G, Boushey RP, Poulin EC, Mamazza J, Haas B, Xiong W, Brennan-Barnes M, Gomez D, Nathens AB, Yang I, Forbes SS, Stephen WJ, Loeb M, Smith R, Christoffersen EP, McLean RF, Westerholm J, Garcia-Osogobio S, Farrokhyar F, Cadeddu M, Anvari M, Ponton-Carss A, Hutchison C, Violato C, Segedi M, Mittleman M, Fisman D, Kinlin L, Rousseau M, Saleh W, Ferri LE, Feldman LS, Stanbridge DD, Mayrand S, Fried GM, Pandya A, Gagliardi A, Nathens A, Ahmed N, Tran T, Demyttenaere SV, Polyhronopoulos G, Seguin C, Artho GP, Kaneva P, Fried GM, Feldman LS, Demyttenaere SV, Bergman S, Anderson J, Mikami DJ, Melvin WS, Racz JM, Dubois L, Katchky A, Wall WJ, Faryniuk A, Hochman D, Clarkson CA, Rubiano AM, Clarkson CA, Boone D, Ball CG, Dixon E, Kirkpatrick AW, Sutherland FR, Feliciano DV, Wyrzykowski AD, Nicholas JM, Dente CJ, Ball CG, Feliciano DV, Ullah SM, McAlister VC, Malik S, Ramsey D, Pooler S, Teague B, Misra M, Cadeddu M, Anvari M, Kaminsky M, Vergis A, Gillman LM, Gillman LM, Vergis A, Altaf A, Ellsmere J, Bonjer HJ, Klassen D, Orzech N, Palter V, Aggarwal R, Okrainec A, Grantcharov TP, Ghaderi I, Feldman LS, Sroka G, Kaneva PA, Fried GM, Shlomovitz E, Reznick RK, Kucharczyk W, Lee L, Iqbal S, Barayan H, Lu Y, Fata P, Razek T, Khwaja K, Boora PS, White JS, Vogt KN, Charyk-Stewart T, Minuk L, Eckert K, Chin-Yee I, Gray D, Parry N, Humphrey RJ, Bütter A, Schmidt J, Grieci T, Gagnon R, Han V, Duhaime S, Pitt DF, Palter V, Orzech N, Aggarwal R, Okrainec A, Grantcharov TP, Dubois L, Vogt KN, Davies W, Schlachta CM, Shi X, Birch DW, Gu Y, Moser MA, Swanson TW, Schaeffer DF, Tang BQ, Rusnak CH, Amson BJ, Vogt KN, Dubois L, Hobbs A, Etemad-Rezai R, Schlachta CM, Claydon E, McAlister V, Grushka J, Sur W, Laberge JM, Tchervenkov J, Bell L, Flageole H, Labidi S, Gagné JP, Gowing R, Kahnamoui K, McAlister CC, Marble A, Coughlin S, Karanicolas P, Emmerton-Coughlin H, Kanbur B, Kanbur S, Colquhoun P, Trottier DC, Doucette S, Huynh H, Soto CM, Poulin EC, Mamazza J, Boushey RP, Jamal MH, Rousseau M, Meterissian S, Snell L, Racz JM, Davies E, Aminazadeh N, Farrokhyar F, Reid S, Naeeni A, Naeeni M, Kashfi A, Kahnamoui K, Martin K, Weir M, Taylor B, Martin KM, Girotti MJ, Parry NG, Hanna WC, Fraser S, Weissglas I, Ghitulescu G, Bilek A, Marek J, Galatas C, Bergman S, Chiu CG, Nguyen NH, Bloom SW, Wiebe S, Klassen D, Bonjer J, Lawlor D, Plowman J, Ransom T, Vallis M, Ellsmere J, Menezes AC, Karmali S, Birch DW, Forbes SS, Eskicioglu C, Brenneman FD, McLeod RS, Fraser SA, Bergman S, Garzon J, Gomez D, Lawless B, Haas B, Nathens AB, Lumb KJ, Harkness L, Williamson J, Charyk-Stewart T, Gray D, Malthaner RA, Van Koughnett JA, Vogt KN, Gray DK, Parry NG, Teague B, Cadeddu M, Anvari M, Misra M, Pooler S, Malik S, Swain P, Chackungal S, Vogt KN, Yoshy C, Etemad-Rezai R, Cunningham I, Dubois L, Schlachta CM, Scott L, Vinden C, Okrainec A, Henao O, Azzie G, Deen S, Hameed M, Ramirez V, Veillette C, Bray P, Jewett M, Okrainec A, Pagliarello G, Brenneman F, Buczkowski A, Nathens A, Razek T, Widder S, Anderson I, Klassen D, Saadia R, Johner A, Hameed SM, Qureshi AP, Vergis A, Jimenez CM, Green J, Pryor AD, Schlachta CM, Okrainec A, Perri MT, Trejos AL, Naish MD, Patel RV, Malthaner RA, Stanger J, Stewart K, Yasui Y, Cass C, Damaraju S, Graham K, Bharadwaj S, Srinathan S, Tan L, Unruh H, Finley C, Miller L, Ferri LE, Urbach DR, Darling G, Spicer J, Ergun S, McDonald B, Rousseau M, Kaneva P, Ferri LE, Spicer J, Andalib A, Benay C, Rousseau M, Kushner Y, Marcus V, Ferri LE, Hunt I, Gazala S, Razzak R, Chuck A, Valji A, Stewart K, Tsuyuki R, Bédard ELR, Bottoni DA, Campbell G, Malthaner RA, Rousseau M, Guevremont P, Chasen M, Spicer J, Eckert E, Alcindor T, Ades S, Ferri LE, McGory R, Nagpal D, Fortin D, Inculet RI, Malthaner RA, Ko M, Shargall Y, Compeau C, Razzak R, Gazala S, Hunt I, Veenstra J, Valji A, Stewart K, Bédard ELR, Davis PJ, Mancuso M, Mujoomdar AA, Gazala S, Bédard ELR, Lee L, Spicer J, Robineau C, Sirois C, Mulder D, Ferri LE, Cools-Lartigue J, Chang SY, Mayrand S, Marcus V, Fried GM, Ferri LE, Perry T, Hunt I, Allegretto M, Maguire C, Abele J, Williams D, Stewart K, Bédard ELR, Grover HS, Basi S, Chiasson P, Basi S, Gregory W, Irshad K, Schieman C, MacGregor JH, Kelly E, Gelfand G, Graham AJ, McFadden SP, Grondin SC, Croome KP, Chudzinski R, Hanto DW, Jamal MH, Doi SA, Barkun JS, Wong SL, Kwan AHL, Yang S, Law C, Luo Y, Spiers J, Forse A, Taylor W, Apriasz I, Mysliwiec B, Sarin N, Gregor J, Moulton CE, McLeod RS, Barnett H, Nhan C, Gallinger S, Demyttenaere SV, Nau P, Muscarella P, Melvin WS, Ellison EC, Wiseman SM, Melck AL, Davidge KM, Eskicioglu C, Lipa J, Ferguson P, Swallow CJ, Wright FC, Edwards JP, Kelly EJ, Lin Y, Lenders T, Ghali WA, Graham A, Francescutti V, Farrokhyar F, Tozer R, Heller B, Lovrics P, Jansz G, Kahnamoui K, Spiegle G, Schmocker S, Huang H, Victor C, Law C, Kennedy ED, McCart JA, Aslani N, Swanson T, Kennecke H, Woods R, Davis N, Klevan AE, Ramsay JA, Stephen WJ, Smith M, Plourde M, Johnson PM, Yaffe P, Walsh M, Hoskin D, Huynh HP, Trottier DC, Soto C, Auer R, Poulin EC, Mamazza J, Boushey RP, Moloo H, Huynh HP, Trottier DC, Soto C, Moloo H, Poulin EC, Mamazza J, Boushey RP, Nhan C, Driman DK, Smith AJ, Hunter A, McLeod RS, Eskicioglu C, Fenech DS, Victor C, McLeod RS, Trottier DC, Huynh H, Sabri E, Soto C, Scheer A, Zolfaghari S, Moloo H, Mamazza J, Poulin EC, Boushey RP, Hallet J, Guénette-Lemieux M, Bouchard A, Grégoire RC, Thibault C, Dionne G, Côté F, Langis P, Gagné JP, Raval MJ, Phang PT, Brown CJ, Kuzmanovic A, Planting A, Raval MJ, Phang PT, Brown CJ, Huynh HP, Trottier DC, Moloo H, Poulin EC, Mamazza J, Friedlich M, Stern HS, Boushey RP, Tang BQ, Moloo H, Bleier J, Goldberg SM, Alsharif J, Martel G, Bouchard A, Sabri E, Ramsay CR, Mamazza J, Poulin EC, Boushey RP, Richardson D, Porter G, Johnson P, Al-Sukhni E, Ridgway PF, O'Connor B, McLeod RS, Swallow CJ, Forbes SS, Urbach DR, Sutradhar R, Paszat L, Rabeneck L, Baxter NN, Chung W, Ko D, Sun C, Brown CJ, Raval M, Phang PT, Pao JS, Woods R, Raval MJ, Phang PT, Brown CJ, Power A, Francescutti V, Ramsey D, Kelly S, Stephen W, Simunovic M, Coates A, Goldsmith CH, Thabane L, Reeson D, Smith AJ, McLeod RS, DeNardi F, Whelan TJ, Levine MN, Al-Khayal KA, Buie WD, Wallace L, Sigalet D, Eskicioglu C, Gagliardi A, Fenech DS, Victor C, McLeod RS. Abstracts of presentations to the Annual Meetings of the Canadian Association of General Surgeons Canadian Association of Thoracic Surgeons Canadian Hepato-Pancreato-Biliary Society Canadian Society of Surgical Oncology Canadian Society of Colon and Rectal Surgeons: Victoria, BC Sept. 10-13, 2009. Can J Surg 2009; 52:S1-S48. [PMID: 35488397 PMCID: PMC2726442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2023] Open
Affiliation(s)
- R Nenshi
- From the Institute for Clinical and Evaluative Sciences, Toronto, Ont
| | - E Kennedy
- From the Institute for Clinical and Evaluative Sciences, Toronto, Ont
| | - N N Baxter
- From the Institute for Clinical and Evaluative Sciences, Toronto, Ont
| | - R Saskin
- From the Institute for Clinical and Evaluative Sciences, Toronto, Ont
| | - R Sutradhar
- From the Institute for Clinical and Evaluative Sciences, Toronto, Ont
| | - D R Urbach
- From the Institute for Clinical and Evaluative Sciences, Toronto, Ont
| | - G Sroka
- From the Steinberg-Bernstein Centre for Minimally Invasive Surgery and Innovation, McGill University, Montréal, Que
| | - L S Feldman
- From the Steinberg-Bernstein Centre for Minimally Invasive Surgery and Innovation, McGill University, Montréal, Que
| | - M C Vassiliou
- From the Steinberg-Bernstein Centre for Minimally Invasive Surgery and Innovation, McGill University, Montréal, Que
| | - P A Kaneva
- From the Steinberg-Bernstein Centre for Minimally Invasive Surgery and Innovation, McGill University, Montréal, Que
| | - R Fayez
- From the Steinberg-Bernstein Centre for Minimally Invasive Surgery and Innovation, McGill University, Montréal, Que
| | - G M Fried
- From the Steinberg-Bernstein Centre for Minimally Invasive Surgery and Innovation, McGill University, Montréal, Que
| | - S A Krajewski
- From the Department of Surgery, University of British Columbia, Vancouver, BC, and the Institute for Technology Assessment, Massachusetts General Hospital, Boston, Mass
| | - C J Brown
- From the Department of Surgery, University of British Columbia, Vancouver, BC, and the Institute for Technology Assessment, Massachusetts General Hospital, Boston, Mass
| | - C Hur
- From the Department of Surgery, University of British Columbia, Vancouver, BC, and the Institute for Technology Assessment, Massachusetts General Hospital, Boston, Mass
| | - P H McCrea
- From the Department of Surgery, Dalhousie University, Queen Elizabeth II Health Sciences Centre, Halifax, NS
| | - A Mitchell
- From the Department of Surgery, Dalhousie University, Queen Elizabeth II Health Sciences Centre, Halifax, NS
| | - G Porter
- From the Department of Surgery, Dalhousie University, Queen Elizabeth II Health Sciences Centre, Halifax, NS
| | - J Grushka
- From the Division of General Surgery, Montréal General Hospital, McGill University, Montréal, Que
| | - T Razek
- From the Division of General Surgery, Montréal General Hospital, McGill University, Montréal, Que
| | - K Khwaja
- From the Division of General Surgery, Montréal General Hospital, McGill University, Montréal, Que
| | - P Fata
- From the Division of General Surgery, Montréal General Hospital, McGill University, Montréal, Que
| | - G Martel
- From The Ottawa Hospital, University of Ottawa, Ottawa, Ont
| | - H Moloo
- From The Ottawa Hospital, University of Ottawa, Ottawa, Ont
| | - G Picciano
- From The Ottawa Hospital, University of Ottawa, Ottawa, Ont
| | - R P Boushey
- From The Ottawa Hospital, University of Ottawa, Ottawa, Ont
| | - E C Poulin
- From The Ottawa Hospital, University of Ottawa, Ottawa, Ont
| | - J Mamazza
- From The Ottawa Hospital, University of Ottawa, Ottawa, Ont
| | - B Haas
- From the Division of General Surgery, St. Michael's Hospital, University of Toronto, Toronto, and the Children's Hospital of Eastern Ontario, Ottawa, Ont
| | - W Xiong
- From the Division of General Surgery, St. Michael's Hospital, University of Toronto, Toronto, and the Children's Hospital of Eastern Ontario, Ottawa, Ont
| | - M Brennan-Barnes
- From the Division of General Surgery, St. Michael's Hospital, University of Toronto, Toronto, and the Children's Hospital of Eastern Ontario, Ottawa, Ont
| | - D Gomez
- From the Division of General Surgery, St. Michael's Hospital, University of Toronto, Toronto, and the Children's Hospital of Eastern Ontario, Ottawa, Ont
| | - A B Nathens
- From the Division of General Surgery, St. Michael's Hospital, University of Toronto, Toronto, and the Children's Hospital of Eastern Ontario, Ottawa, Ont
| | - I Yang
- From the Departments of Surgery and Anesthesiology, McMaster University, Hamilton Health Sciences, Hamilton, Ont
| | - S S Forbes
- From the Departments of Surgery and Anesthesiology, McMaster University, Hamilton Health Sciences, Hamilton, Ont
| | - W J Stephen
- From the Departments of Surgery and Anesthesiology, McMaster University, Hamilton Health Sciences, Hamilton, Ont
| | - M Loeb
- From the Departments of Surgery and Anesthesiology, McMaster University, Hamilton Health Sciences, Hamilton, Ont
| | - R Smith
- From the Departments of Surgery and Anesthesiology, McMaster University, Hamilton Health Sciences, Hamilton, Ont
| | - E P Christoffersen
- From the Departments of Surgery and Anesthesiology, McMaster University, Hamilton Health Sciences, Hamilton, Ont
| | - R F McLean
- From the Departments of Surgery and Anesthesiology, McMaster University, Hamilton Health Sciences, Hamilton, Ont
| | - J Westerholm
- From the Centre for Minimal Access Surgery, McMaster University, Hamilton, Ont
| | - S Garcia-Osogobio
- From the Centre for Minimal Access Surgery, McMaster University, Hamilton, Ont
| | - F Farrokhyar
- From the Centre for Minimal Access Surgery, McMaster University, Hamilton, Ont
| | - M Cadeddu
- From the Centre for Minimal Access Surgery, McMaster University, Hamilton, Ont
| | - M Anvari
- From the Centre for Minimal Access Surgery, McMaster University, Hamilton, Ont
| | - A Ponton-Carss
- From the Department of Surgery, University of Calgary, Calgary, Alta
| | - C Hutchison
- From the Department of Surgery, University of Calgary, Calgary, Alta
| | - C Violato
- From the Department of Surgery, University of Calgary, Calgary, Alta
| | - M Segedi
- From the Harvard School of Public Health, Beth Israel Deaconess Medical Center, Boston, Mass., the University of British Columbia, Vancouver, BC, and The Hospital for Sick Children, University of Toronto, Toronto, Ont
| | - M Mittleman
- From the Harvard School of Public Health, Beth Israel Deaconess Medical Center, Boston, Mass., the University of British Columbia, Vancouver, BC, and The Hospital for Sick Children, University of Toronto, Toronto, Ont
| | - D Fisman
- From the Harvard School of Public Health, Beth Israel Deaconess Medical Center, Boston, Mass., the University of British Columbia, Vancouver, BC, and The Hospital for Sick Children, University of Toronto, Toronto, Ont
| | - L Kinlin
- From the Harvard School of Public Health, Beth Israel Deaconess Medical Center, Boston, Mass., the University of British Columbia, Vancouver, BC, and The Hospital for Sick Children, University of Toronto, Toronto, Ont
| | - M Rousseau
- From the Steinberg-Bernstein Centre for Minimally Invasive Surgery, McGill University Health Centre, Montréal, Que
| | - W Saleh
- From the Steinberg-Bernstein Centre for Minimally Invasive Surgery, McGill University Health Centre, Montréal, Que
| | - L E Ferri
- From the Steinberg-Bernstein Centre for Minimally Invasive Surgery, McGill University Health Centre, Montréal, Que
| | - L S Feldman
- From the Steinberg-Bernstein Centre for Minimally Invasive Surgery, McGill University Health Centre, Montréal, Que
| | - D D Stanbridge
- From the Steinberg-Bernstein Centre for Minimally Invasive Surgery, McGill University Health Centre, Montréal, Que
| | - S Mayrand
- From the Steinberg-Bernstein Centre for Minimally Invasive Surgery, McGill University Health Centre, Montréal, Que
| | - G M Fried
- From the Steinberg-Bernstein Centre for Minimally Invasive Surgery, McGill University Health Centre, Montréal, Que
| | - A Pandya
- From the Division of General Surgery, University of Toronto, Toronto, Ont
| | - A Gagliardi
- From the Division of General Surgery, University of Toronto, Toronto, Ont
| | - A Nathens
- From the Division of General Surgery, University of Toronto, Toronto, Ont
| | - N Ahmed
- From the Division of General Surgery, University of Toronto, Toronto, Ont
| | - T Tran
- From the Department of Surgery, McGill University, Montréal, Que
| | - S V Demyttenaere
- From the Department of Surgery, McGill University, Montréal, Que
| | | | - C Seguin
- From the Department of Surgery, McGill University, Montréal, Que
| | - G P Artho
- From the Department of Surgery, McGill University, Montréal, Que
| | - P Kaneva
- From the Department of Surgery, McGill University, Montréal, Que
| | - G M Fried
- From the Department of Surgery, McGill University, Montréal, Que
| | - L S Feldman
- From the Department of Surgery, McGill University, Montréal, Que
| | - S V Demyttenaere
- From the Department of Surgery, Ohio State University, Columbus, Ohio, and the Department of Surgery, Jewish General Hospital, McGill University, Montréal, Que
| | - S Bergman
- From the Department of Surgery, Ohio State University, Columbus, Ohio, and the Department of Surgery, Jewish General Hospital, McGill University, Montréal, Que
| | - J Anderson
- From the Department of Surgery, Ohio State University, Columbus, Ohio, and the Department of Surgery, Jewish General Hospital, McGill University, Montréal, Que
| | - D J Mikami
- From the Department of Surgery, Ohio State University, Columbus, Ohio, and the Department of Surgery, Jewish General Hospital, McGill University, Montréal, Que
| | - W S Melvin
- From the Department of Surgery, Ohio State University, Columbus, Ohio, and the Department of Surgery, Jewish General Hospital, McGill University, Montréal, Que
| | - J M Racz
- From the Department of Surgery, University of Western Ontario, London, Ont
| | - L Dubois
- From the Department of Surgery, University of Western Ontario, London, Ont
| | - A Katchky
- From the Department of Surgery, University of Western Ontario, London, Ont
| | - W J Wall
- From the Department of Surgery, University of Western Ontario, London, Ont
| | - A Faryniuk
- From the Department of Surgery, University of Manitoba, Winnipeg, Man
| | - D Hochman
- From the Department of Surgery, University of Manitoba, Winnipeg, Man
| | - C A Clarkson
- From the Neiva City University Hospital, Neiva, Huila, Colombia
| | - A M Rubiano
- From the Neiva City University Hospital, Neiva, Huila, Colombia
| | - C A Clarkson
- From the Department of Surgery, Memorial University of Newfoundland, St. John's, NL
| | - D Boone
- From the Department of Surgery, Memorial University of Newfoundland, St. John's, NL
| | - C G Ball
- From the Departments of Surgery, Emory University, Atlanta, Ga., and the University of Calgary, Calgary, Alta
| | - E Dixon
- From the Departments of Surgery, Emory University, Atlanta, Ga., and the University of Calgary, Calgary, Alta
| | - A W Kirkpatrick
- From the Departments of Surgery, Emory University, Atlanta, Ga., and the University of Calgary, Calgary, Alta
| | - F R Sutherland
- From the Departments of Surgery, Emory University, Atlanta, Ga., and the University of Calgary, Calgary, Alta
| | - D V Feliciano
- From the Departments of Surgery, Emory University, Atlanta, Ga., and the University of Calgary, Calgary, Alta
| | - A D Wyrzykowski
- From the Department of Surgery, Emory University, Atlanta, Ga
| | - J M Nicholas
- From the Department of Surgery, Emory University, Atlanta, Ga
| | - C J Dente
- From the Department of Surgery, Emory University, Atlanta, Ga
| | - C G Ball
- From the Department of Surgery, Emory University, Atlanta, Ga
| | - D V Feliciano
- From the Department of Surgery, Emory University, Atlanta, Ga
| | - S M Ullah
- From the Division of Clinical Anatomy, Department of Anatomy and Cell Biology, Department of Surgery, University Hospital, University of Western Ontario, London, Ont
| | - V C McAlister
- From the Division of Clinical Anatomy, Department of Anatomy and Cell Biology, Department of Surgery, University Hospital, University of Western Ontario, London, Ont
| | - S Malik
- From the Centre for Minimal Access Surgery, St. Joseph's Hospital, McMaster University, Hamilton, Ont
| | - D Ramsey
- From the Centre for Minimal Access Surgery, St. Joseph's Hospital, McMaster University, Hamilton, Ont
| | - S Pooler
- From the Centre for Minimal Access Surgery, St. Joseph's Hospital, McMaster University, Hamilton, Ont
| | - B Teague
- From the Centre for Minimal Access Surgery, St. Joseph's Hospital, McMaster University, Hamilton, Ont
| | - M Misra
- From the Centre for Minimal Access Surgery, St. Joseph's Hospital, McMaster University, Hamilton, Ont
| | - M Cadeddu
- From the Centre for Minimal Access Surgery, St. Joseph's Hospital, McMaster University, Hamilton, Ont
| | - M Anvari
- From the Centre for Minimal Access Surgery, St. Joseph's Hospital, McMaster University, Hamilton, Ont
| | - M Kaminsky
- From the Department of Surgery, University of Manitoba, Winnipeg, Man., the Department of Critical Care Medicine and Regional Trauma Services, University of Calgary, Calgary, Alta., and the Division of General Surgery, University of Toronto, Toronto, Ont
| | - A Vergis
- From the Department of Surgery, University of Manitoba, Winnipeg, Man., the Department of Critical Care Medicine and Regional Trauma Services, University of Calgary, Calgary, Alta., and the Division of General Surgery, University of Toronto, Toronto, Ont
| | - L M Gillman
- From the Department of Surgery, University of Manitoba, Winnipeg, Man., the Department of Critical Care Medicine and Regional Trauma Services, University of Calgary, Calgary, Alta., and the Division of General Surgery, University of Toronto, Toronto, Ont
| | - L M Gillman
- From the Department of Surgery, University of Manitoba, Winnipeg, Man., the Department of Critical Care Medicine, Regional Trauma Services, University of Calgary, Calgary, Alta., and the Division of General Surgery, University of Toronto, Toronto, Ont
| | - A Vergis
- From the Department of Surgery, University of Manitoba, Winnipeg, Man., the Department of Critical Care Medicine, Regional Trauma Services, University of Calgary, Calgary, Alta., and the Division of General Surgery, University of Toronto, Toronto, Ont
| | - A Altaf
- From the Queen Elizabeth II Health Sciences Centre, Dalhousie University, Halifax, NS
| | - J Ellsmere
- From the Queen Elizabeth II Health Sciences Centre, Dalhousie University, Halifax, NS
| | - H J Bonjer
- From the Queen Elizabeth II Health Sciences Centre, Dalhousie University, Halifax, NS
| | - D Klassen
- From the Queen Elizabeth II Health Sciences Centre, Dalhousie University, Halifax, NS
| | - N Orzech
- From the Departments of Surgery, St. Michael's Hospital, Toronto Western Hospital, University of Toronto, Toronto, and the Department of Biosurgery and Surgical Technology, Imperial College, London, Ont
| | - V Palter
- From the Departments of Surgery, St. Michael's Hospital, Toronto Western Hospital, University of Toronto, Toronto, and the Department of Biosurgery and Surgical Technology, Imperial College, London, Ont
| | - R Aggarwal
- From the Departments of Surgery, St. Michael's Hospital, Toronto Western Hospital, University of Toronto, Toronto, and the Department of Biosurgery and Surgical Technology, Imperial College, London, Ont
| | - A Okrainec
- From the Departments of Surgery, St. Michael's Hospital, Toronto Western Hospital, University of Toronto, Toronto, and the Department of Biosurgery and Surgical Technology, Imperial College, London, Ont
| | - T P Grantcharov
- From the Departments of Surgery, St. Michael's Hospital, Toronto Western Hospital, University of Toronto, Toronto, and the Department of Biosurgery and Surgical Technology, Imperial College, London, Ont
| | - I Ghaderi
- From the Steinberg-Bernstein Centre for Minimally Invasive Surgery, McGill University, Montréal, Que., and the University of Western Ontario, London, Ont
| | - L S Feldman
- From the Steinberg-Bernstein Centre for Minimally Invasive Surgery, McGill University, Montréal, Que., and the University of Western Ontario, London, Ont
| | - G Sroka
- From the Steinberg-Bernstein Centre for Minimally Invasive Surgery, McGill University, Montréal, Que., and the University of Western Ontario, London, Ont
| | - P A Kaneva
- From the Steinberg-Bernstein Centre for Minimally Invasive Surgery, McGill University, Montréal, Que., and the University of Western Ontario, London, Ont
| | - G M Fried
- From the Steinberg-Bernstein Centre for Minimally Invasive Surgery, McGill University, Montréal, Que., and the University of Western Ontario, London, Ont
| | - E Shlomovitz
- From the Departments of Surgery and Diagnostic Imaging, University Health Network, University of Toronto, Toronto, Ont
| | - R K Reznick
- From the Departments of Surgery and Diagnostic Imaging, University Health Network, University of Toronto, Toronto, Ont
| | - W Kucharczyk
- From the Departments of Surgery and Diagnostic Imaging, University Health Network, University of Toronto, Toronto, Ont
| | - L Lee
- From the Departments of Surgery and Medicine, McGill University Health Centre, Montréal, Que
| | - S Iqbal
- From the Departments of Surgery and Medicine, McGill University Health Centre, Montréal, Que
| | - H Barayan
- From the Departments of Surgery and Medicine, McGill University Health Centre, Montréal, Que
| | - Y Lu
- From the Departments of Surgery and Medicine, McGill University Health Centre, Montréal, Que
| | - P Fata
- From the Departments of Surgery and Medicine, McGill University Health Centre, Montréal, Que
| | - T Razek
- From the Departments of Surgery and Medicine, McGill University Health Centre, Montréal, Que
| | - K Khwaja
- From the Departments of Surgery and Medicine, McGill University Health Centre, Montréal, Que
| | - P S Boora
- From the Department of Surgery, University of Alberta, Edmonton, Alta
| | - J S White
- From the Department of Surgery, University of Alberta, Edmonton, Alta
| | - K N Vogt
- From the Divisions of General Surgery and Hematology, Trauma Program, London Health Sciences Centre, London, Ont
| | - T Charyk-Stewart
- From the Divisions of General Surgery and Hematology, Trauma Program, London Health Sciences Centre, London, Ont
| | - L Minuk
- From the Divisions of General Surgery and Hematology, Trauma Program, London Health Sciences Centre, London, Ont
| | - K Eckert
- From the Divisions of General Surgery and Hematology, Trauma Program, London Health Sciences Centre, London, Ont
| | - I Chin-Yee
- From the Divisions of General Surgery and Hematology, Trauma Program, London Health Sciences Centre, London, Ont
| | - D Gray
- From the Divisions of General Surgery and Hematology, Trauma Program, London Health Sciences Centre, London, Ont
| | - N Parry
- From the Divisions of General Surgery and Hematology, Trauma Program, London Health Sciences Centre, London, Ont
| | - R J Humphrey
- From the Departments of Surgery and Pediatrics, London Health Sciences Centre, University of Western Ontario, London, Ont
| | - A Bütter
- From the Departments of Surgery and Pediatrics, London Health Sciences Centre, University of Western Ontario, London, Ont
| | - J Schmidt
- From the Departments of Surgery and Pediatrics, London Health Sciences Centre, University of Western Ontario, London, Ont
| | - T Grieci
- From the Departments of Surgery and Pediatrics, London Health Sciences Centre, University of Western Ontario, London, Ont
| | - R Gagnon
- From the Departments of Surgery and Pediatrics, London Health Sciences Centre, University of Western Ontario, London, Ont
| | - V Han
- From the Departments of Surgery and Pediatrics, London Health Sciences Centre, University of Western Ontario, London, Ont
| | - S Duhaime
- From the University of Ottawa, Ottawa, Ont
| | - D F Pitt
- From the University of Ottawa, Ottawa, Ont
| | - V Palter
- From the Departments of Surgery, St. Michael's Hospital, Toronto Western Hospital, Toronto, and Imperial College, London, Ont
| | - N Orzech
- From the Departments of Surgery, St. Michael's Hospital, Toronto Western Hospital, Toronto, and Imperial College, London, Ont
| | - R Aggarwal
- From the Departments of Surgery, St. Michael's Hospital, Toronto Western Hospital, Toronto, and Imperial College, London, Ont
| | - A Okrainec
- From the Departments of Surgery, St. Michael's Hospital, Toronto Western Hospital, Toronto, and Imperial College, London, Ont
| | - T P Grantcharov
- From the Departments of Surgery, St. Michael's Hospital, Toronto Western Hospital, Toronto, and Imperial College, London, Ont
| | - L Dubois
- From the Department of Surgery, University of Western Ontario, London, Ont
| | - K N Vogt
- From the Department of Surgery, University of Western Ontario, London, Ont
| | - W Davies
- From the Department of Surgery, University of Western Ontario, London, Ont
| | - C M Schlachta
- From the Department of Surgery, University of Western Ontario, London, Ont
| | - X Shi
- From the Centre for the Advancement of Minimally Invasive Surgery, Edmonton, Alta
| | - D W Birch
- From the Centre for the Advancement of Minimally Invasive Surgery, Edmonton, Alta
| | - Y Gu
- From the Department of Surgery, University of Saskatchewan, Saskatoon, Sask
| | - M A Moser
- From the Department of Surgery, University of Saskatchewan, Saskatoon, Sask
| | - T W Swanson
- From the Department of Surgery, Royal Jubilee Hospital, Victoria, BC, University of British Columbia, Vancouver, BC
| | - D F Schaeffer
- From the Department of Surgery, Royal Jubilee Hospital, Victoria, BC, University of British Columbia, Vancouver, BC
| | - B Q Tang
- From the Department of Surgery, Royal Jubilee Hospital, Victoria, BC, University of British Columbia, Vancouver, BC
| | - C H Rusnak
- From the Department of Surgery, Royal Jubilee Hospital, Victoria, BC, University of British Columbia, Vancouver, BC
| | - B J Amson
- From the Department of Surgery, Royal Jubilee Hospital, Victoria, BC, University of British Columbia, Vancouver, BC
| | - K N Vogt
- From the Divisions of General Surgery and Radiology, London Health Sciences Centre, London, Ont
| | - L Dubois
- From the Divisions of General Surgery and Radiology, London Health Sciences Centre, London, Ont
| | - A Hobbs
- From the Divisions of General Surgery and Radiology, London Health Sciences Centre, London, Ont
| | - R Etemad-Rezai
- From the Divisions of General Surgery and Radiology, London Health Sciences Centre, London, Ont
| | - C M Schlachta
- From the Divisions of General Surgery and Radiology, London Health Sciences Centre, London, Ont
| | - E Claydon
- From the Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ont
| | - V McAlister
- From the Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ont
| | - J Grushka
- From the Divisions of Pediatric Surgery and Nephrology, Department of Pediatrics, Montréal Children's Hospital, and the Department of Surgery, McGill University, Montréal, Que
| | - W Sur
- From the Divisions of Pediatric Surgery and Nephrology, Department of Pediatrics, Montréal Children's Hospital, and the Department of Surgery, McGill University, Montréal, Que
| | - J-M Laberge
- From the Divisions of Pediatric Surgery and Nephrology, Department of Pediatrics, Montréal Children's Hospital, and the Department of Surgery, McGill University, Montréal, Que
| | - J Tchervenkov
- From the Divisions of Pediatric Surgery and Nephrology, Department of Pediatrics, Montréal Children's Hospital, and the Department of Surgery, McGill University, Montréal, Que
| | - L Bell
- From the Divisions of Pediatric Surgery and Nephrology, Department of Pediatrics, Montréal Children's Hospital, and the Department of Surgery, McGill University, Montréal, Que
| | - H Flageole
- From the Divisions of Pediatric Surgery and Nephrology, Department of Pediatrics, Montréal Children's Hospital, and the Department of Surgery, McGill University, Montréal, Que
| | - S Labidi
- From the Québec Centre for Minimally Invasive Surgery, Centre hospitalier universitaire de Québec, Québec, Que
| | - J P Gagné
- From the Québec Centre for Minimally Invasive Surgery, Centre hospitalier universitaire de Québec, Québec, Que
| | - R Gowing
- From the Department of Surgery, McMaster University, Hamilton, Ont
| | - K Kahnamoui
- From the Department of Surgery, McMaster University, Hamilton, Ont
| | - C C McAlister
- From the University of Toronto, Toronto, Ont., Dalhousie University, Halifax, NS
| | - A Marble
- From the University of Toronto, Toronto, Ont., Dalhousie University, Halifax, NS
| | - S Coughlin
- From the University of Western Ontario, London, Ont
| | | | | | - B Kanbur
- From the University of Western Ontario, London, Ont
| | - S Kanbur
- From the University of Western Ontario, London, Ont
| | - P Colquhoun
- From the University of Western Ontario, London, Ont
| | - D C Trottier
- From the Department of Surgery, University of Ottawa, The Ottawa Hospital, Ottawa, Ont
| | - S Doucette
- From the Department of Surgery, University of Ottawa, The Ottawa Hospital, Ottawa, Ont
| | - H Huynh
- From the Department of Surgery, University of Ottawa, The Ottawa Hospital, Ottawa, Ont
| | - C M Soto
- From the Department of Surgery, University of Ottawa, The Ottawa Hospital, Ottawa, Ont
| | - E C Poulin
- From the Department of Surgery, University of Ottawa, The Ottawa Hospital, Ottawa, Ont
| | - J Mamazza
- From the Department of Surgery, University of Ottawa, The Ottawa Hospital, Ottawa, Ont
| | - R P Boushey
- From the Department of Surgery, University of Ottawa, The Ottawa Hospital, Ottawa, Ont
| | - M H Jamal
- From the Centre for Medical Education, Division of General Surgery, McGill University, Montréal, Que
| | - M Rousseau
- From the Centre for Medical Education, Division of General Surgery, McGill University, Montréal, Que
| | - S Meterissian
- From the Centre for Medical Education, Division of General Surgery, McGill University, Montréal, Que
| | - L Snell
- From the Centre for Medical Education, Division of General Surgery, McGill University, Montréal, Que
| | - J M Racz
- From the Department of Surgery, University of Western Ontario, London, Ont
| | - E Davies
- From the Department of Surgery, University of Western Ontario, London, Ont
| | - N Aminazadeh
- From the Department of Surgery, McMaster University, Hamilton, Ont
| | - F Farrokhyar
- From the Department of Surgery, McMaster University, Hamilton, Ont
| | - S Reid
- From the Department of Surgery, McMaster University, Hamilton, Ont
| | - A Naeeni
- From the Department of Surgery, McMaster University, Hamilton, Ont
| | - M Naeeni
- From the Department of Surgery, McMaster University, Hamilton, Ont
| | - A Kashfi
- From the Department of Surgery, McMaster University, Hamilton, Ont
| | - K Kahnamoui
- From the Department of Surgery, McMaster University, Hamilton, Ont
| | - K Martin
- From the London Health Sciences Centre, London, Ont
| | - M Weir
- From the London Health Sciences Centre, London, Ont
| | - B Taylor
- From the London Health Sciences Centre, London, Ont
| | - K M Martin
- From the London Health Sciences Centre, Children's Hospital of Western Ontario, London, Ont
| | - M J Girotti
- From the London Health Sciences Centre, Children's Hospital of Western Ontario, London, Ont
| | - N G Parry
- From the London Health Sciences Centre, Children's Hospital of Western Ontario, London, Ont
| | - W C Hanna
- From the Department of Surgery, Jewish General Hospital, McGill University, Montréal, Que
| | - S Fraser
- From the Department of Surgery, Jewish General Hospital, McGill University, Montréal, Que
| | - I Weissglas
- From the Department of Surgery, Jewish General Hospital, McGill University, Montréal, Que
| | - G Ghitulescu
- From the Department of Surgery, Jewish General Hospital, McGill University, Montréal, Que
| | - A Bilek
- From the Department of Surgery, Jewish General Hospital, McGill University, Montréal, Que
| | - J Marek
- From the Department of Surgery, Jewish General Hospital, McGill University, Montréal, Que
| | - C Galatas
- From the Department of Surgery, Jewish General Hospital, McGill University, Montréal, Que
| | - S Bergman
- From the Department of Surgery, Jewish General Hospital, McGill University, Montréal, Que
| | - C G Chiu
- From the Richmond Hospital, Richmond, BC
| | - N H Nguyen
- From the Richmond Hospital, Richmond, BC
| | - S W Bloom
- From the Richmond Hospital, Richmond, BC
| | - S Wiebe
- From the Queen Elizabeth II Health Sciences Centre (QEIIHSC), Halifax, NS
| | - D Klassen
- From the Queen Elizabeth II Health Sciences Centre (QEIIHSC), Halifax, NS
| | - J Bonjer
- From the Queen Elizabeth II Health Sciences Centre (QEIIHSC), Halifax, NS
| | - D Lawlor
- From the Queen Elizabeth II Health Sciences Centre (QEIIHSC), Halifax, NS
| | - J Plowman
- From the Queen Elizabeth II Health Sciences Centre (QEIIHSC), Halifax, NS
| | - T Ransom
- From the Queen Elizabeth II Health Sciences Centre (QEIIHSC), Halifax, NS
| | - M Vallis
- From the Queen Elizabeth II Health Sciences Centre (QEIIHSC), Halifax, NS
| | - J Ellsmere
- From the Queen Elizabeth II Health Sciences Centre (QEIIHSC), Halifax, NS
| | - A C Menezes
- From the Centre for the Advancement of Minimally Invasive Surgery (CAMIS), Alberta Health Services, Department of Surgery, University of Alberta, Edmonton, Alta
| | - S Karmali
- From the Centre for the Advancement of Minimally Invasive Surgery (CAMIS), Alberta Health Services, Department of Surgery, University of Alberta, Edmonton, Alta
| | - D W Birch
- From the Centre for the Advancement of Minimally Invasive Surgery (CAMIS), Alberta Health Services, Department of Surgery, University of Alberta, Edmonton, Alta
| | - S S Forbes
- From the Department of Surgery, University of Toronto, Toronto, Ont
| | - C Eskicioglu
- From the Department of Surgery, University of Toronto, Toronto, Ont
| | - F D Brenneman
- From the Department of Surgery, University of Toronto, Toronto, Ont
| | - R S McLeod
- From the Department of Surgery, University of Toronto, Toronto, Ont
| | - S A Fraser
- From the Department of General Surgery, Sir Mortimer B. Davis Jewish General Hospital, McGill University, Montréal, Que
| | - S Bergman
- From the Department of General Surgery, Sir Mortimer B. Davis Jewish General Hospital, McGill University, Montréal, Que
| | - J Garzon
- From the Department of General Surgery, Sir Mortimer B. Davis Jewish General Hospital, McGill University, Montréal, Que
| | - D Gomez
- From the Department of Surgery, St. Michael's Hospital, University of Toronto, Toronto, Ont
| | - B Lawless
- From the Department of Surgery, St. Michael's Hospital, University of Toronto, Toronto, Ont
| | - B Haas
- From the Department of Surgery, St. Michael's Hospital, University of Toronto, Toronto, Ont
| | - A B Nathens
- From the Department of Surgery, St. Michael's Hospital, University of Toronto, Toronto, Ont
| | - K J Lumb
- From the Department of Surgery, Trauma Program, London Health Sciences Centre, London, Ont
| | - L Harkness
- From the Department of Surgery, Trauma Program, London Health Sciences Centre, London, Ont
| | - J Williamson
- From the Department of Surgery, Trauma Program, London Health Sciences Centre, London, Ont
| | - T Charyk-Stewart
- From the Department of Surgery, Trauma Program, London Health Sciences Centre, London, Ont
| | - D Gray
- From the Department of Surgery, Trauma Program, London Health Sciences Centre, London, Ont
| | - R A Malthaner
- From the Department of Surgery, Trauma Program, London Health Sciences Centre, London, Ont
| | - J A Van Koughnett
- From the Division of General Surgery, University of Western Ontario, London, Ont
| | - K N Vogt
- From the Division of General Surgery, University of Western Ontario, London, Ont
| | - D K Gray
- From the Division of General Surgery, University of Western Ontario, London, Ont
| | - N G Parry
- From the Division of General Surgery, University of Western Ontario, London, Ont
| | - B Teague
- From the Centre for Minimal Access Surgery, St. Joseph's Healthcare, McMaster University, Hamilton, Ont
| | - M Cadeddu
- From the Centre for Minimal Access Surgery, St. Joseph's Healthcare, McMaster University, Hamilton, Ont
| | - M Anvari
- From the Centre for Minimal Access Surgery, St. Joseph's Healthcare, McMaster University, Hamilton, Ont
| | - M Misra
- From the Centre for Minimal Access Surgery, St. Joseph's Healthcare, McMaster University, Hamilton, Ont
| | - S Pooler
- From the Centre for Minimal Access Surgery, St. Joseph's Healthcare, McMaster University, Hamilton, Ont
| | - S Malik
- From the Centre for Minimal Access Surgery, St. Joseph's Healthcare, McMaster University, Hamilton, Ont
| | - P Swain
- From the Centre for Minimal Access Surgery, St. Joseph's Healthcare, McMaster University, Hamilton, Ont
| | - S Chackungal
- From the Division of General Surgery, Department of Radiology, Lawson Health Research Institute, London Health Sciences Centre, University of Western Ontario, London, Ont
| | - K N Vogt
- From the Division of General Surgery, Department of Radiology, Lawson Health Research Institute, London Health Sciences Centre, University of Western Ontario, London, Ont
| | - C Yoshy
- From the Division of General Surgery, Department of Radiology, Lawson Health Research Institute, London Health Sciences Centre, University of Western Ontario, London, Ont
| | - R Etemad-Rezai
- From the Division of General Surgery, Department of Radiology, Lawson Health Research Institute, London Health Sciences Centre, University of Western Ontario, London, Ont
| | - I Cunningham
- From the Division of General Surgery, Department of Radiology, Lawson Health Research Institute, London Health Sciences Centre, University of Western Ontario, London, Ont
| | - L Dubois
- From the Division of General Surgery, Department of Radiology, Lawson Health Research Institute, London Health Sciences Centre, University of Western Ontario, London, Ont
| | - C M Schlachta
- From the Division of General Surgery, Department of Radiology, Lawson Health Research Institute, London Health Sciences Centre, University of Western Ontario, London, Ont
| | - L Scott
- From the Division of General Surgery, Department of Radiology, Lawson Health Research Institute, London Health Sciences Centre, University of Western Ontario, London, Ont
| | - C Vinden
- From the Division of General Surgery, Department of Radiology, Lawson Health Research Institute, London Health Sciences Centre, University of Western Ontario, London, Ont
| | - A Okrainec
- From the Toronto Western Hospital, University Health Network, Hospital for Sick Children, University of Toronto, Toronto, Ont
| | - O Henao
- From the Toronto Western Hospital, University Health Network, Hospital for Sick Children, University of Toronto, Toronto, Ont
| | - G Azzie
- From the Toronto Western Hospital, University Health Network, Hospital for Sick Children, University of Toronto, Toronto, Ont
| | - S Deen
- From the Department of Surgery, Vancouver General Hospital, University of British Columbia, Vancouver, BC
| | - M Hameed
- From the Department of Surgery, Vancouver General Hospital, University of British Columbia, Vancouver, BC
| | - V Ramirez
- From the University Health Network, University of Toronto, Toronto, Ont
| | - C Veillette
- From the University Health Network, University of Toronto, Toronto, Ont
| | - P Bray
- From the University Health Network, University of Toronto, Toronto, Ont
| | - M Jewett
- From the University Health Network, University of Toronto, Toronto, Ont
| | - A Okrainec
- From the University Health Network, University of Toronto, Toronto, Ont
| | - G Pagliarello
- From the Departments of Surgery, University of British Columbia, Vancouver, BC, University of Alberta, Edmonton, University of Calgary, Calgary, Alta, University of Toronto, Toronto, Ont., McGill University, Montréal, Que, Dalhousie University, CAGS Committee on Acute Surgery and Critical Care, Halifax, NS
| | - F Brenneman
- From the Departments of Surgery, University of British Columbia, Vancouver, BC, University of Alberta, Edmonton, University of Calgary, Calgary, Alta, University of Toronto, Toronto, Ont., McGill University, Montréal, Que, Dalhousie University, CAGS Committee on Acute Surgery and Critical Care, Halifax, NS
| | - A Buczkowski
- From the Departments of Surgery, University of British Columbia, Vancouver, BC, University of Alberta, Edmonton, University of Calgary, Calgary, Alta, University of Toronto, Toronto, Ont., McGill University, Montréal, Que, Dalhousie University, CAGS Committee on Acute Surgery and Critical Care, Halifax, NS
| | - A Nathens
- From the Departments of Surgery, University of British Columbia, Vancouver, BC, University of Alberta, Edmonton, University of Calgary, Calgary, Alta, University of Toronto, Toronto, Ont., McGill University, Montréal, Que, Dalhousie University, CAGS Committee on Acute Surgery and Critical Care, Halifax, NS
| | - T Razek
- From the Departments of Surgery, University of British Columbia, Vancouver, BC, University of Alberta, Edmonton, University of Calgary, Calgary, Alta, University of Toronto, Toronto, Ont., McGill University, Montréal, Que, Dalhousie University, CAGS Committee on Acute Surgery and Critical Care, Halifax, NS
| | - S Widder
- From the Departments of Surgery, University of British Columbia, Vancouver, BC, University of Alberta, Edmonton, University of Calgary, Calgary, Alta, University of Toronto, Toronto, Ont., McGill University, Montréal, Que, Dalhousie University, CAGS Committee on Acute Surgery and Critical Care, Halifax, NS
| | - I Anderson
- From the Departments of Surgery, University of British Columbia, Vancouver, BC, University of Alberta, Edmonton, University of Calgary, Calgary, Alta, University of Toronto, Toronto, Ont., McGill University, Montréal, Que, Dalhousie University, CAGS Committee on Acute Surgery and Critical Care, Halifax, NS
| | - D Klassen
- From the Departments of Surgery, University of British Columbia, Vancouver, BC, University of Alberta, Edmonton, University of Calgary, Calgary, Alta, University of Toronto, Toronto, Ont., McGill University, Montréal, Que, Dalhousie University, CAGS Committee on Acute Surgery and Critical Care, Halifax, NS
| | - R Saadia
- From the Departments of Surgery, University of British Columbia, Vancouver, BC, University of Alberta, Edmonton, University of Calgary, Calgary, Alta, University of Toronto, Toronto, Ont., McGill University, Montréal, Que, Dalhousie University, CAGS Committee on Acute Surgery and Critical Care, Halifax, NS
| | - A Johner
- From the Departments of Surgery, University of British Columbia, Vancouver, BC, University of Alberta, Edmonton, University of Calgary, Calgary, Alta, University of Toronto, Toronto, Ont., McGill University, Montréal, Que, Dalhousie University, CAGS Committee on Acute Surgery and Critical Care, Halifax, NS
| | - S M Hameed
- From the Departments of Surgery, University of British Columbia, Vancouver, BC, University of Alberta, Edmonton, University of Calgary, Calgary, Alta, University of Toronto, Toronto, Ont., McGill University, Montréal, Que, Dalhousie University, CAGS Committee on Acute Surgery and Critical Care, Halifax, NS
| | - A P Qureshi
- From the Division of General Surgery, University of Toronto, University Health Network, Toronto Western Hospital, Toronto, the Departments of Surgery and Oncology, University of Western Ontario, London, Ont., and Duke University Medical Center, Durham, NC
| | - A Vergis
- From the Division of General Surgery, University of Toronto, University Health Network, Toronto Western Hospital, Toronto, the Departments of Surgery and Oncology, University of Western Ontario, London, Ont., and Duke University Medical Center, Durham, NC
| | - C M Jimenez
- From the Division of General Surgery, University of Toronto, University Health Network, Toronto Western Hospital, Toronto, the Departments of Surgery and Oncology, University of Western Ontario, London, Ont., and Duke University Medical Center, Durham, NC
| | - J Green
- From the Division of General Surgery, University of Toronto, University Health Network, Toronto Western Hospital, Toronto, the Departments of Surgery and Oncology, University of Western Ontario, London, Ont., and Duke University Medical Center, Durham, NC
| | - A D Pryor
- From the Division of General Surgery, University of Toronto, University Health Network, Toronto Western Hospital, Toronto, the Departments of Surgery and Oncology, University of Western Ontario, London, Ont., and Duke University Medical Center, Durham, NC
| | - C M Schlachta
- From the Division of General Surgery, University of Toronto, University Health Network, Toronto Western Hospital, Toronto, the Departments of Surgery and Oncology, University of Western Ontario, London, Ont., and Duke University Medical Center, Durham, NC
| | - A Okrainec
- From the Division of General Surgery, University of Toronto, University Health Network, Toronto Western Hospital, Toronto, the Departments of Surgery and Oncology, University of Western Ontario, London, Ont., and Duke University Medical Center, Durham, NC
| | - M T Perri
- From CSTAR, Division of Thoracic Surgery, University of Western Ontario, London, Ont
| | - A L Trejos
- From CSTAR, Division of Thoracic Surgery, University of Western Ontario, London, Ont
| | - M D Naish
- From CSTAR, Division of Thoracic Surgery, University of Western Ontario, London, Ont
| | - R V Patel
- From CSTAR, Division of Thoracic Surgery, University of Western Ontario, London, Ont
| | - R A Malthaner
- From CSTAR, Division of Thoracic Surgery, University of Western Ontario, London, Ont
| | - J Stanger
- From the Department of Surgery, Cross Cancer Institute, University of Alberta, Edmonton, Alta
| | - K Stewart
- From the Department of Surgery, Cross Cancer Institute, University of Alberta, Edmonton, Alta
| | - Y Yasui
- From the Department of Surgery, Cross Cancer Institute, University of Alberta, Edmonton, Alta
| | - C Cass
- From the Department of Surgery, Cross Cancer Institute, University of Alberta, Edmonton, Alta
| | - S Damaraju
- From the Department of Surgery, Cross Cancer Institute, University of Alberta, Edmonton, Alta
| | - K Graham
- From the Department of Surgery, Cross Cancer Institute, University of Alberta, Edmonton, Alta
| | - S Bharadwaj
- From the Department of Surgery, University of Manitoba, Winnipeg, Man
| | - S Srinathan
- From the Department of Surgery, University of Manitoba, Winnipeg, Man
| | - L Tan
- From the Department of Surgery, University of Manitoba, Winnipeg, Man
| | - H Unruh
- From the Department of Surgery, University of Manitoba, Winnipeg, Man
| | - C Finley
- From the Division of Thoracic Surgery, Department of Surgery, University of Toronto, Toronto, Ont
| | - L Miller
- From the Division of Thoracic Surgery, Department of Surgery, University of Toronto, Toronto, Ont
| | - L E Ferri
- From the Division of Thoracic Surgery, Department of Surgery, University of Toronto, Toronto, Ont
| | - D R Urbach
- From the Division of Thoracic Surgery, Department of Surgery, University of Toronto, Toronto, Ont
| | - G Darling
- From the Division of Thoracic Surgery, Department of Surgery, University of Toronto, Toronto, Ont
| | - J Spicer
- From the Division of Thoracic Surgery, McGill University Health Centre, Montréal, Que
| | - S Ergun
- From the Division of Thoracic Surgery, McGill University Health Centre, Montréal, Que
| | - B McDonald
- From the Division of Thoracic Surgery, McGill University Health Centre, Montréal, Que
| | - M Rousseau
- From the Division of Thoracic Surgery, McGill University Health Centre, Montréal, Que
| | - P Kaneva
- From the Division of Thoracic Surgery, McGill University Health Centre, Montréal, Que
| | - L E Ferri
- From the Division of Thoracic Surgery, McGill University Health Centre, Montréal, Que
| | - J Spicer
- From the Division of Thoracic Surgery, Department of Pathology, McGill University Health Centre, Montréal, Que
| | - A Andalib
- From the Division of Thoracic Surgery, Department of Pathology, McGill University Health Centre, Montréal, Que
| | - C Benay
- From the Division of Thoracic Surgery, Department of Pathology, McGill University Health Centre, Montréal, Que
| | - M Rousseau
- From the Division of Thoracic Surgery, Department of Pathology, McGill University Health Centre, Montréal, Que
| | - Y Kushner
- From the Division of Thoracic Surgery, Department of Pathology, McGill University Health Centre, Montréal, Que
| | - V Marcus
- From the Division of Thoracic Surgery, Department of Pathology, McGill University Health Centre, Montréal, Que
| | - L E Ferri
- From the Division of Thoracic Surgery, Department of Pathology, McGill University Health Centre, Montréal, Que
| | - I Hunt
- From the Division of Thoracic Surgery, Departments of Surgery and Cardiology, University of Alberta, Institute of Health Economics, Edmonton, Alta
| | - S Gazala
- From the Division of Thoracic Surgery, Departments of Surgery and Cardiology, University of Alberta, Institute of Health Economics, Edmonton, Alta
| | - R Razzak
- From the Division of Thoracic Surgery, Departments of Surgery and Cardiology, University of Alberta, Institute of Health Economics, Edmonton, Alta
| | - A Chuck
- From the Division of Thoracic Surgery, Departments of Surgery and Cardiology, University of Alberta, Institute of Health Economics, Edmonton, Alta
| | - A Valji
- From the Division of Thoracic Surgery, Departments of Surgery and Cardiology, University of Alberta, Institute of Health Economics, Edmonton, Alta
| | - K Stewart
- From the Division of Thoracic Surgery, Departments of Surgery and Cardiology, University of Alberta, Institute of Health Economics, Edmonton, Alta
| | - R Tsuyuki
- From the Division of Thoracic Surgery, Departments of Surgery and Cardiology, University of Alberta, Institute of Health Economics, Edmonton, Alta
| | - E L R Bédard
- From the Division of Thoracic Surgery, Departments of Surgery and Cardiology, University of Alberta, Institute of Health Economics, Edmonton, Alta
| | - D A Bottoni
- From the Division of Thoracic Surgery, London Health Sciences Centre, University of Western Ontario, London, Ont
| | - G Campbell
- From the Division of Thoracic Surgery, London Health Sciences Centre, University of Western Ontario, London, Ont
| | - R A Malthaner
- From the Division of Thoracic Surgery, London Health Sciences Centre, University of Western Ontario, London, Ont
| | - M Rousseau
- From the McGill University Health Centre, Montréal, Que
| | - P Guevremont
- From the McGill University Health Centre, Montréal, Que
| | - M Chasen
- From the McGill University Health Centre, Montréal, Que
| | - J Spicer
- From the McGill University Health Centre, Montréal, Que
| | - E Eckert
- From the McGill University Health Centre, Montréal, Que
| | - T Alcindor
- From the McGill University Health Centre, Montréal, Que
| | - S Ades
- From the McGill University Health Centre, Montréal, Que
| | - L E Ferri
- From the McGill University Health Centre, Montréal, Que
| | - R McGory
- From the Division of Thoracic Surgery, London Health Sciences Centre, London, Ont
| | - D Nagpal
- From the Division of Thoracic Surgery, London Health Sciences Centre, London, Ont
| | - D Fortin
- From the Division of Thoracic Surgery, London Health Sciences Centre, London, Ont
| | - R I Inculet
- From the Division of Thoracic Surgery, London Health Sciences Centre, London, Ont
| | - R A Malthaner
- From the Division of Thoracic Surgery, London Health Sciences Centre, London, Ont
| | - M Ko
- From the Division of Thoracic Surgery, St. Joseph's Health Centre, University of Toronto, Toronto, Ont
| | - Y Shargall
- From the Division of Thoracic Surgery, St. Joseph's Health Centre, University of Toronto, Toronto, Ont
| | - C Compeau
- From the Division of Thoracic Surgery, St. Joseph's Health Centre, University of Toronto, Toronto, Ont
| | - R Razzak
- From the Division of Thoracic Surgery, University of Alberta, Edmonton, Alta
| | - S Gazala
- From the Division of Thoracic Surgery, University of Alberta, Edmonton, Alta
| | - I Hunt
- From the Division of Thoracic Surgery, University of Alberta, Edmonton, Alta
| | - J Veenstra
- From the Division of Thoracic Surgery, University of Alberta, Edmonton, Alta
| | - A Valji
- From the Division of Thoracic Surgery, University of Alberta, Edmonton, Alta
| | - K Stewart
- From the Division of Thoracic Surgery, University of Alberta, Edmonton, Alta
| | - E L R Bédard
- From the Division of Thoracic Surgery, University of Alberta, Edmonton, Alta
| | - P J Davis
- From the Division of General Surgery, Department of Surgery, The Moncton Hospital, Moncton, NB, and Dalhousie University, Halifax, NS
| | - M Mancuso
- From the Division of General Surgery, Department of Surgery, The Moncton Hospital, Moncton, NB, and Dalhousie University, Halifax, NS
| | - A A Mujoomdar
- From the Division of General Surgery, Department of Surgery, The Moncton Hospital, Moncton, NB, and Dalhousie University, Halifax, NS
| | - S Gazala
- From the University of Alberta, Edmonton, Alta
| | | | - L Lee
- From the Division of Thoracic Surgery, McGill University Health Centre, Montréal, Que
| | - J Spicer
- From the Division of Thoracic Surgery, McGill University Health Centre, Montréal, Que
| | - C Robineau
- From the Division of Thoracic Surgery, McGill University Health Centre, Montréal, Que
| | - C Sirois
- From the Division of Thoracic Surgery, McGill University Health Centre, Montréal, Que
| | - D Mulder
- From the Division of Thoracic Surgery, McGill University Health Centre, Montréal, Que
| | - L E Ferri
- From the Division of Thoracic Surgery, McGill University Health Centre, Montréal, Que
| | - J Cools-Lartigue
- From the Departments of Surgery, Pathology and Medicine, McGill University, Montréal, Que
| | - S-Y Chang
- From the Departments of Surgery, Pathology and Medicine, McGill University, Montréal, Que
| | - S Mayrand
- From the Departments of Surgery, Pathology and Medicine, McGill University, Montréal, Que
| | - V Marcus
- From the Departments of Surgery, Pathology and Medicine, McGill University, Montréal, Que
| | - G M Fried
- From the Departments of Surgery, Pathology and Medicine, McGill University, Montréal, Que
| | - L E Ferri
- From the Departments of Surgery, Pathology and Medicine, McGill University, Montréal, Que
| | - T Perry
- From the Departments of Surgery and Diagnostic Imaging, University of Alberta, Edmonton, Alta
| | - I Hunt
- From the Departments of Surgery and Diagnostic Imaging, University of Alberta, Edmonton, Alta
| | - M Allegretto
- From the Departments of Surgery and Diagnostic Imaging, University of Alberta, Edmonton, Alta
| | - C Maguire
- From the Departments of Surgery and Diagnostic Imaging, University of Alberta, Edmonton, Alta
| | - J Abele
- From the Departments of Surgery and Diagnostic Imaging, University of Alberta, Edmonton, Alta
| | - D Williams
- From the Departments of Surgery and Diagnostic Imaging, University of Alberta, Edmonton, Alta
| | - K Stewart
- From the Departments of Surgery and Diagnostic Imaging, University of Alberta, Edmonton, Alta
| | - E L R Bédard
- From the Departments of Surgery and Diagnostic Imaging, University of Alberta, Edmonton, Alta
| | - H S Grover
- From the Division of Thoracic Surgery, Department of Surgery, William Osler Health Centre, Brampton, McMaster University, Hamilton, Ont
| | - S Basi
- From the Division of Thoracic Surgery, Department of Surgery, William Osler Health Centre, Brampton, McMaster University, Hamilton, Ont
| | - P Chiasson
- From the Division of Thoracic Surgery, Department of Surgery, William Osler Health Centre, Brampton, McMaster University, Hamilton, Ont
| | - S Basi
- From the Division of Thoracic Surgery, Department of Surgery, William Osler Health Centre, Brampton, McMaster University, Hamilton, Ont
| | - W Gregory
- From the Division of Thoracic Surgery, Department of Surgery, William Osler Health Centre, Brampton, McMaster University, Hamilton, Ont
| | - K Irshad
- From the Division of Thoracic Surgery, Department of Surgery, William Osler Health Centre, Brampton, McMaster University, Hamilton, Ont
| | - C Schieman
- From the Division of Thoracic Surgery, Departments of Surgery and Diagnostic Imaging, University of Calgary, Calgary, Alta
| | - J H MacGregor
- From the Division of Thoracic Surgery, Departments of Surgery and Diagnostic Imaging, University of Calgary, Calgary, Alta
| | - E Kelly
- From the Division of Thoracic Surgery, Departments of Surgery and Diagnostic Imaging, University of Calgary, Calgary, Alta
| | - G Gelfand
- From the Division of Thoracic Surgery, Departments of Surgery and Diagnostic Imaging, University of Calgary, Calgary, Alta
| | - A J Graham
- From the Division of Thoracic Surgery, Departments of Surgery and Diagnostic Imaging, University of Calgary, Calgary, Alta
| | - S P McFadden
- From the Division of Thoracic Surgery, Departments of Surgery and Diagnostic Imaging, University of Calgary, Calgary, Alta
| | - S C Grondin
- From the Division of Thoracic Surgery, Departments of Surgery and Diagnostic Imaging, University of Calgary, Calgary, Alta
| | - K P Croome
- From the Department of General Surgery, University of Western Ontario, London, Ont., Center for Transplant Outcomes and Quality Improvement, The Transplant Institute, Beth Israel Deaconess Medical Center, and the Department of Epidemiology, Harvard University, Boston, Mass
| | - R Chudzinski
- From the Department of General Surgery, University of Western Ontario, London, Ont., Center for Transplant Outcomes and Quality Improvement, The Transplant Institute, Beth Israel Deaconess Medical Center, and the Department of Epidemiology, Harvard University, Boston, Mass
| | - D W Hanto
- From the Department of General Surgery, University of Western Ontario, London, Ont., Center for Transplant Outcomes and Quality Improvement, The Transplant Institute, Beth Israel Deaconess Medical Center, and the Department of Epidemiology, Harvard University, Boston, Mass
| | - M H Jamal
- From the Department of Surgery, McGill University Health Centre, Montréal, Que., School of Population Health, University of Queensland, Brisbane, Australia
| | - S A Doi
- From the Department of Surgery, McGill University Health Centre, Montréal, Que., School of Population Health, University of Queensland, Brisbane, Australia
| | - J S Barkun
- From the Department of Surgery, McGill University Health Centre, Montréal, Que., School of Population Health, University of Queensland, Brisbane, Australia
| | - S L Wong
- From the Department of Surgery, Health Science Centre, St. John's, NL
| | - A H L Kwan
- From the Department of Surgery, Health Science Centre, St. John's, NL
| | - S Yang
- From the Sunnybrook Health Sciences Centre, Toronto, Ont
| | - C Law
- From the Sunnybrook Health Sciences Centre, Toronto, Ont
| | - Y Luo
- From the Hôtel-Dieu Grace Hospital, Windsor, Ont
| | - J Spiers
- From the Hôtel-Dieu Grace Hospital, Windsor, Ont
| | - A Forse
- From the Hôtel-Dieu Grace Hospital, Windsor, Ont
| | - W Taylor
- From the Hôtel-Dieu Grace Hospital, Windsor, Ont
| | - I Apriasz
- From the Departments of General Surgery and Gastroenterology, London Health Sciences Centre, University of Western Ontario, London, Ont
| | - B Mysliwiec
- From the Departments of General Surgery and Gastroenterology, London Health Sciences Centre, University of Western Ontario, London, Ont
| | - N Sarin
- From the Departments of General Surgery and Gastroenterology, London Health Sciences Centre, University of Western Ontario, London, Ont
| | - J Gregor
- From the Departments of General Surgery and Gastroenterology, London Health Sciences Centre, University of Western Ontario, London, Ont
| | - C E Moulton
- From Cancer Care Ontario HPB Surgical Oncology Community of Practice, Department of Surgery, University of Toronto, Surgical Oncology Program, Cancer Care Ontario, Toronto, Ont
| | - R S McLeod
- From Cancer Care Ontario HPB Surgical Oncology Community of Practice, Department of Surgery, University of Toronto, Surgical Oncology Program, Cancer Care Ontario, Toronto, Ont
| | - H Barnett
- From Cancer Care Ontario HPB Surgical Oncology Community of Practice, Department of Surgery, University of Toronto, Surgical Oncology Program, Cancer Care Ontario, Toronto, Ont
| | - C Nhan
- From Cancer Care Ontario HPB Surgical Oncology Community of Practice, Department of Surgery, University of Toronto, Surgical Oncology Program, Cancer Care Ontario, Toronto, Ont
| | - S Gallinger
- From Cancer Care Ontario HPB Surgical Oncology Community of Practice, Department of Surgery, University of Toronto, Surgical Oncology Program, Cancer Care Ontario, Toronto, Ont
| | - S V Demyttenaere
- From the Department of Surgery, Ohio State University Medical Centre, Columbus, Ohio
| | - P Nau
- From the Department of Surgery, Ohio State University Medical Centre, Columbus, Ohio
| | - P Muscarella
- From the Department of Surgery, Ohio State University Medical Centre, Columbus, Ohio
| | - W S Melvin
- From the Department of Surgery, Ohio State University Medical Centre, Columbus, Ohio
| | - E C Ellison
- From the Department of Surgery, Ohio State University Medical Centre, Columbus, Ohio
| | - S M Wiseman
- From St. Paul's Hospital, Department of Surgery, University of British Columbia, Vancouver, BC
| | - A L Melck
- From St. Paul's Hospital, Department of Surgery, University of British Columbia, Vancouver, BC
| | - K M Davidge
- From the Divisions of Plastic, Orthopedic, and General Surgery, University of Toronto, Toronto, Ont
| | - C Eskicioglu
- From the Divisions of Plastic, Orthopedic, and General Surgery, University of Toronto, Toronto, Ont
| | - J Lipa
- From the Divisions of Plastic, Orthopedic, and General Surgery, University of Toronto, Toronto, Ont
| | - P Ferguson
- From the Divisions of Plastic, Orthopedic, and General Surgery, University of Toronto, Toronto, Ont
| | - C J Swallow
- From the Divisions of Plastic, Orthopedic, and General Surgery, University of Toronto, Toronto, Ont
| | - F C Wright
- From the Divisions of Plastic, Orthopedic, and General Surgery, University of Toronto, Toronto, Ont
| | - J P Edwards
- From the Department of Surgery, Medicine, Community Health Sciences, Health Information Network Calgary, Centre for Health Policy Studies, University of Calgary, Calgary, Alta
| | - E J Kelly
- From the Department of Surgery, Medicine, Community Health Sciences, Health Information Network Calgary, Centre for Health Policy Studies, University of Calgary, Calgary, Alta
| | - Y Lin
- From the Department of Surgery, Medicine, Community Health Sciences, Health Information Network Calgary, Centre for Health Policy Studies, University of Calgary, Calgary, Alta
| | - T Lenders
- From the Department of Surgery, Medicine, Community Health Sciences, Health Information Network Calgary, Centre for Health Policy Studies, University of Calgary, Calgary, Alta
| | - W A Ghali
- From the Department of Surgery, Medicine, Community Health Sciences, Health Information Network Calgary, Centre for Health Policy Studies, University of Calgary, Calgary, Alta
| | - A Graham
- From the Department of Surgery, Medicine, Community Health Sciences, Health Information Network Calgary, Centre for Health Policy Studies, University of Calgary, Calgary, Alta
| | - V Francescutti
- From the Division of General Surgery, Department of Medical Oncology, McMaster University, Hamilton, Ont
| | - F Farrokhyar
- From the Division of General Surgery, Department of Medical Oncology, McMaster University, Hamilton, Ont
| | - R Tozer
- From the Division of General Surgery, Department of Medical Oncology, McMaster University, Hamilton, Ont
| | - B Heller
- From the Division of General Surgery, Department of Medical Oncology, McMaster University, Hamilton, Ont
| | - P Lovrics
- From the Division of General Surgery, Department of Medical Oncology, McMaster University, Hamilton, Ont
| | - G Jansz
- From the Division of General Surgery, Department of Medical Oncology, McMaster University, Hamilton, Ont
| | - K Kahnamoui
- From the Division of General Surgery, Department of Medical Oncology, McMaster University, Hamilton, Ont
| | - G Spiegle
- From the Department of Surgery, Toronto General Hospital, Sunnybrook Health Science Centre, Mount Sinai Hospital, University of Toronto, Toronto, Ont
| | - S Schmocker
- From the Department of Surgery, Toronto General Hospital, Sunnybrook Health Science Centre, Mount Sinai Hospital, University of Toronto, Toronto, Ont
| | - H Huang
- From the Department of Surgery, Toronto General Hospital, Sunnybrook Health Science Centre, Mount Sinai Hospital, University of Toronto, Toronto, Ont
| | - C Victor
- From the Department of Surgery, Toronto General Hospital, Sunnybrook Health Science Centre, Mount Sinai Hospital, University of Toronto, Toronto, Ont
| | - C Law
- From the Department of Surgery, Toronto General Hospital, Sunnybrook Health Science Centre, Mount Sinai Hospital, University of Toronto, Toronto, Ont
| | - E D Kennedy
- From the Department of Surgery, Toronto General Hospital, Sunnybrook Health Science Centre, Mount Sinai Hospital, University of Toronto, Toronto, Ont
| | - J A McCart
- From the Department of Surgery, Toronto General Hospital, Sunnybrook Health Science Centre, Mount Sinai Hospital, University of Toronto, Toronto, Ont
| | - N Aslani
- From the British Columbia Cancer Agency, Vancouver, BC
| | - T Swanson
- From the British Columbia Cancer Agency, Vancouver, BC
| | - H Kennecke
- From the British Columbia Cancer Agency, Vancouver, BC
| | - R Woods
- From the British Columbia Cancer Agency, Vancouver, BC
| | - N Davis
- From the British Columbia Cancer Agency, Vancouver, BC
| | - A E Klevan
- From the Departments of Surgery, Pathology and Molecular Medicine, Hamilton Health Sciences, McMaster University, Hamilton, Ont
| | - J A Ramsay
- From the Departments of Surgery, Pathology and Molecular Medicine, Hamilton Health Sciences, McMaster University, Hamilton, Ont
| | - W J Stephen
- From the Departments of Surgery, Pathology and Molecular Medicine, Hamilton Health Sciences, McMaster University, Hamilton, Ont
| | - M Smith
- From the Division of General Surgery, Dalhousie University, Halifax, NS
| | - M Plourde
- From the Division of General Surgery, Dalhousie University, Halifax, NS
| | - P M Johnson
- From the Division of General Surgery, Dalhousie University, Halifax, NS
| | - P Yaffe
- From the Departments of Medical Sciences, Surgery, Pathology, and Microbiology and Immunology, Dalhousie University, Halifax, NS
| | - M Walsh
- From the Departments of Medical Sciences, Surgery, Pathology, and Microbiology and Immunology, Dalhousie University, Halifax, NS
| | - D Hoskin
- From the Departments of Medical Sciences, Surgery, Pathology, and Microbiology and Immunology, Dalhousie University, Halifax, NS
| | - H P Huynh
- From the Minimally Invasive Surgery Research Group, The Ottawa Hospital, University of Ottawa, Ottawa, Ont
| | - D C Trottier
- From the Minimally Invasive Surgery Research Group, The Ottawa Hospital, University of Ottawa, Ottawa, Ont
| | - C Soto
- From the Minimally Invasive Surgery Research Group, The Ottawa Hospital, University of Ottawa, Ottawa, Ont
| | - R Auer
- From the Minimally Invasive Surgery Research Group, The Ottawa Hospital, University of Ottawa, Ottawa, Ont
| | - E C Poulin
- From the Minimally Invasive Surgery Research Group, The Ottawa Hospital, University of Ottawa, Ottawa, Ont
| | - J Mamazza
- From the Minimally Invasive Surgery Research Group, The Ottawa Hospital, University of Ottawa, Ottawa, Ont
| | - R P Boushey
- From the Minimally Invasive Surgery Research Group, The Ottawa Hospital, University of Ottawa, Ottawa, Ont
| | - H Moloo
- From the Minimally Invasive Surgery Research Group, The Ottawa Hospital, University of Ottawa, Ottawa, Ont
| | - H P Huynh
- From the Minimally Invasive Surgery Research Group, The Ottawa Hospital, University of Ottawa, Ottawa, Ont
| | - D C Trottier
- From the Minimally Invasive Surgery Research Group, The Ottawa Hospital, University of Ottawa, Ottawa, Ont
| | - C Soto
- From the Minimally Invasive Surgery Research Group, The Ottawa Hospital, University of Ottawa, Ottawa, Ont
| | - H Moloo
- From the Minimally Invasive Surgery Research Group, The Ottawa Hospital, University of Ottawa, Ottawa, Ont
| | - E C Poulin
- From the Minimally Invasive Surgery Research Group, The Ottawa Hospital, University of Ottawa, Ottawa, Ont
| | - J Mamazza
- From the Minimally Invasive Surgery Research Group, The Ottawa Hospital, University of Ottawa, Ottawa, Ont
| | - R P Boushey
- From the Minimally Invasive Surgery Research Group, The Ottawa Hospital, University of Ottawa, Ottawa, Ont
| | - C Nhan
- From the Surgical Oncology Program, Cancer Care Ontario, the Department of Surgery, University of Toronto, Toronto, and the Department of Pathology, University of Western Ontario, London, Ont
| | - D K Driman
- From the Surgical Oncology Program, Cancer Care Ontario, the Department of Surgery, University of Toronto, Toronto, and the Department of Pathology, University of Western Ontario, London, Ont
| | - A J Smith
- From the Surgical Oncology Program, Cancer Care Ontario, the Department of Surgery, University of Toronto, Toronto, and the Department of Pathology, University of Western Ontario, London, Ont
| | - A Hunter
- From the Surgical Oncology Program, Cancer Care Ontario, the Department of Surgery, University of Toronto, Toronto, and the Department of Pathology, University of Western Ontario, London, Ont
| | - R S McLeod
- From the Surgical Oncology Program, Cancer Care Ontario, the Department of Surgery, University of Toronto, Toronto, and the Department of Pathology, University of Western Ontario, London, Ont
| | - C Eskicioglu
- From the Division of General Surgery, University of Toronto, Toronto, Ont
| | - D S Fenech
- From the Division of General Surgery, University of Toronto, Toronto, Ont
| | - C Victor
- From the Division of General Surgery, University of Toronto, Toronto, Ont
| | - R S McLeod
- From the Division of General Surgery, University of Toronto, Toronto, Ont
| | - D C Trottier
- From the Department of Surgery, University of Ottawa, The Ottawa Hospital, Ottawa, Ont
| | - H Huynh
- From the Department of Surgery, University of Ottawa, The Ottawa Hospital, Ottawa, Ont
| | - E Sabri
- From the Department of Surgery, University of Ottawa, The Ottawa Hospital, Ottawa, Ont
| | - C Soto
- From the Department of Surgery, University of Ottawa, The Ottawa Hospital, Ottawa, Ont
| | - A Scheer
- From the Department of Surgery, University of Ottawa, The Ottawa Hospital, Ottawa, Ont
| | - S Zolfaghari
- From the Department of Surgery, University of Ottawa, The Ottawa Hospital, Ottawa, Ont
| | - H Moloo
- From the Department of Surgery, University of Ottawa, The Ottawa Hospital, Ottawa, Ont
| | - J Mamazza
- From the Department of Surgery, University of Ottawa, The Ottawa Hospital, Ottawa, Ont
| | - E C Poulin
- From the Department of Surgery, University of Ottawa, The Ottawa Hospital, Ottawa, Ont
| | - R P Boushey
- From the Department of Surgery, University of Ottawa, The Ottawa Hospital, Ottawa, Ont
| | - J Hallet
- From the Centre de chirurgie minimalement invasive de Québec, Centre hospitalier universitaire de Québec, Université Laval, Québec, Que
| | - M Guénette-Lemieux
- From the Centre de chirurgie minimalement invasive de Québec, Centre hospitalier universitaire de Québec, Université Laval, Québec, Que
| | - A Bouchard
- From the Centre de chirurgie minimalement invasive de Québec, Centre hospitalier universitaire de Québec, Université Laval, Québec, Que
| | - R C Grégoire
- From the Centre de chirurgie minimalement invasive de Québec, Centre hospitalier universitaire de Québec, Université Laval, Québec, Que
| | - C Thibault
- From the Centre de chirurgie minimalement invasive de Québec, Centre hospitalier universitaire de Québec, Université Laval, Québec, Que
| | - G Dionne
- From the Centre de chirurgie minimalement invasive de Québec, Centre hospitalier universitaire de Québec, Université Laval, Québec, Que
| | - F Côté
- From the Centre de chirurgie minimalement invasive de Québec, Centre hospitalier universitaire de Québec, Université Laval, Québec, Que
| | - P Langis
- From the Centre de chirurgie minimalement invasive de Québec, Centre hospitalier universitaire de Québec, Université Laval, Québec, Que
| | - J-P Gagné
- From the Centre de chirurgie minimalement invasive de Québec, Centre hospitalier universitaire de Québec, Université Laval, Québec, Que
| | - M J Raval
- From the Department of Surgery, St. Paul's Hospital and University of British Columbia, Vancouver, BC
| | - P T Phang
- From the Department of Surgery, St. Paul's Hospital and University of British Columbia, Vancouver, BC
| | - C J Brown
- From the Department of Surgery, St. Paul's Hospital and University of British Columbia, Vancouver, BC
| | - A Kuzmanovic
- From the Department of Surgery, St. Paul's Hospital and University of British Columbia, Vancouver, BC
| | - A Planting
- From the Department of Colorectal Surgery, St. Paul's Hospital, University of British Columbia, Vancouver, BC
| | - M J Raval
- From the Department of Colorectal Surgery, St. Paul's Hospital, University of British Columbia, Vancouver, BC
| | - P T Phang
- From the Department of Colorectal Surgery, St. Paul's Hospital, University of British Columbia, Vancouver, BC
| | - C J Brown
- From the Department of Colorectal Surgery, St. Paul's Hospital, University of British Columbia, Vancouver, BC
| | - H P Huynh
- From the Minimally Invasive Surgery Research Group, The Ottawa Hospital, University of Ottawa, Ottawa, Ont
| | - D C Trottier
- From the Minimally Invasive Surgery Research Group, The Ottawa Hospital, University of Ottawa, Ottawa, Ont
| | - H Moloo
- From the Minimally Invasive Surgery Research Group, The Ottawa Hospital, University of Ottawa, Ottawa, Ont
| | - E C Poulin
- From the Minimally Invasive Surgery Research Group, The Ottawa Hospital, University of Ottawa, Ottawa, Ont
| | - J Mamazza
- From the Minimally Invasive Surgery Research Group, The Ottawa Hospital, University of Ottawa, Ottawa, Ont
| | - M Friedlich
- From the Minimally Invasive Surgery Research Group, The Ottawa Hospital, University of Ottawa, Ottawa, Ont
| | - H S Stern
- From the Minimally Invasive Surgery Research Group, The Ottawa Hospital, University of Ottawa, Ottawa, Ont
| | - R P Boushey
- From the Minimally Invasive Surgery Research Group, The Ottawa Hospital, University of Ottawa, Ottawa, Ont
| | - B Q Tang
- From the Department of Surgery, Division of General Surgery, Royal Jubilee Hospital, Vancouver Island Health Authority, Victoria, BC
| | - H Moloo
- From the Department of Colorectal Surgery, University of Minnesota, Minneapolis, Minn., the Department of Surgery, University of Ottawa, Ottawa, Ont., and the Department of Colorectal Surgery, University of Pennsylvania, Philadelphia, Pa
| | - J Bleier
- From the Department of Colorectal Surgery, University of Minnesota, Minneapolis, Minn., the Department of Surgery, University of Ottawa, Ottawa, Ont., and the Department of Colorectal Surgery, University of Pennsylvania, Philadelphia, Pa
| | - S M Goldberg
- From the Department of Colorectal Surgery, University of Minnesota, Minneapolis, Minn., the Department of Surgery, University of Ottawa, Ottawa, Ont., and the Department of Colorectal Surgery, University of Pennsylvania, Philadelphia, Pa
| | - J Alsharif
- From the Minimally Invasive Surgery Research Group, The Ottawa Hospital, University of Ottawa, Ottawa, Ont
| | - G Martel
- From the Minimally Invasive Surgery Research Group, The Ottawa Hospital, University of Ottawa, Ottawa, Ont
| | - A Bouchard
- From the Minimally Invasive Surgery Research Group, The Ottawa Hospital, University of Ottawa, Ottawa, Ont
| | - E Sabri
- From the Minimally Invasive Surgery Research Group, The Ottawa Hospital, University of Ottawa, Ottawa, Ont
| | - C R Ramsay
- From the Minimally Invasive Surgery Research Group, The Ottawa Hospital, University of Ottawa, Ottawa, Ont
| | - J Mamazza
- From the Minimally Invasive Surgery Research Group, The Ottawa Hospital, University of Ottawa, Ottawa, Ont
| | - E C Poulin
- From the Minimally Invasive Surgery Research Group, The Ottawa Hospital, University of Ottawa, Ottawa, Ont
| | - R P Boushey
- From the Minimally Invasive Surgery Research Group, The Ottawa Hospital, University of Ottawa, Ottawa, Ont
| | - D Richardson
- From the Division of General Surgery, Dalhousie University, Halifax, NS
| | - G Porter
- From the Division of General Surgery, Dalhousie University, Halifax, NS
| | - P Johnson
- From the Division of General Surgery, Dalhousie University, Halifax, NS
| | - E Al-Sukhni
- From the Mount Sinai Hospital, University of Toronto, Toronto, Ont
| | - P F Ridgway
- From the Mount Sinai Hospital, University of Toronto, Toronto, Ont
| | - B O'Connor
- From the Mount Sinai Hospital, University of Toronto, Toronto, Ont
| | - R S McLeod
- From the Mount Sinai Hospital, University of Toronto, Toronto, Ont
| | - C J Swallow
- From the Mount Sinai Hospital, University of Toronto, Toronto, Ont
| | - S S Forbes
- From the Department of Surgery, University of Toronto, Toronto, Ont
| | - D R Urbach
- From the Department of Surgery, University of Toronto, Toronto, Ont
| | - R Sutradhar
- From the Department of Surgery, University of Toronto, Toronto, Ont
| | - L Paszat
- From the Department of Surgery, University of Toronto, Toronto, Ont
| | - L Rabeneck
- From the Department of Surgery, University of Toronto, Toronto, Ont
| | - N N Baxter
- From the Department of Surgery, University of Toronto, Toronto, Ont
| | - W Chung
- From the Division of General Surgery, St. Paul's Hospital, University of British Columbia, Vancouver, BC
| | - D Ko
- From the Division of General Surgery, St. Paul's Hospital, University of British Columbia, Vancouver, BC
| | - C Sun
- From the Division of General Surgery, St. Paul's Hospital, University of British Columbia, Vancouver, BC
| | - C J Brown
- From the Division of General Surgery, St. Paul's Hospital, University of British Columbia, Vancouver, BC
| | - M Raval
- From the Division of General Surgery, St. Paul's Hospital, University of British Columbia, Vancouver, BC
| | - P T Phang
- From the Division of General Surgery, St. Paul's Hospital, University of British Columbia, Vancouver, BC
| | - J S Pao
- From the Department of Surgery, St. Paul's Hospital, BC Cancer Agency, Vancouver, BC
| | - R Woods
- From the Department of Surgery, St. Paul's Hospital, BC Cancer Agency, Vancouver, BC
| | - M J Raval
- From the Department of Surgery, St. Paul's Hospital, BC Cancer Agency, Vancouver, BC
| | - P T Phang
- From the Department of Surgery, St. Paul's Hospital, BC Cancer Agency, Vancouver, BC
| | - C J Brown
- From the Department of Surgery, St. Paul's Hospital, BC Cancer Agency, Vancouver, BC
| | - A Power
- From the Department of Surgery, McMaster University, Hamilton, Ont
| | - V Francescutti
- From the Department of Surgery, McMaster University, Hamilton, Ont
| | - D Ramsey
- From the Department of Surgery, McMaster University, Hamilton, Ont
| | - S Kelly
- From the Department of Surgery, McMaster University, Hamilton, Ont
| | - W Stephen
- From the Department of Surgery, McMaster University, Hamilton, Ont
| | - M Simunovic
- From the Department of Surgery, Clinical Epidemiology and Biostatistics, Hamilton Health Sciences, McMaster University, Hamilton, Ont
| | - A Coates
- From the Department of Surgery, Clinical Epidemiology and Biostatistics, Hamilton Health Sciences, McMaster University, Hamilton, Ont
| | - C H Goldsmith
- From the Department of Surgery, Clinical Epidemiology and Biostatistics, Hamilton Health Sciences, McMaster University, Hamilton, Ont
| | - L Thabane
- From the Department of Surgery, Clinical Epidemiology and Biostatistics, Hamilton Health Sciences, McMaster University, Hamilton, Ont
| | - D Reeson
- From the Department of Surgery, Clinical Epidemiology and Biostatistics, Hamilton Health Sciences, McMaster University, Hamilton, Ont
| | - A J Smith
- From the Department of Surgery, Clinical Epidemiology and Biostatistics, Hamilton Health Sciences, McMaster University, Hamilton, Ont
| | - R S McLeod
- From the Department of Surgery, Clinical Epidemiology and Biostatistics, Hamilton Health Sciences, McMaster University, Hamilton, Ont
| | - F DeNardi
- From the Department of Surgery, Clinical Epidemiology and Biostatistics, Hamilton Health Sciences, McMaster University, Hamilton, Ont
| | - T J Whelan
- From the Department of Surgery, Clinical Epidemiology and Biostatistics, Hamilton Health Sciences, McMaster University, Hamilton, Ont
| | - M N Levine
- From the Department of Surgery, Clinical Epidemiology and Biostatistics, Hamilton Health Sciences, McMaster University, Hamilton, Ont
| | - K A Al-Khayal
- From the Department of Surgery, University of Calgary, Calgary, Alta
| | - W D Buie
- From the Department of Surgery, University of Calgary, Calgary, Alta
| | - L Wallace
- From the Department of Surgery, University of Calgary, Calgary, Alta
| | - D Sigalet
- From the Department of Surgery, University of Calgary, Calgary, Alta
| | - C Eskicioglu
- From the Division of General Surgery, University of Toronto, Toronto, Ont
| | - A Gagliardi
- From the Division of General Surgery, University of Toronto, Toronto, Ont
| | - D S Fenech
- From the Division of General Surgery, University of Toronto, Toronto, Ont
| | - C Victor
- From the Division of General Surgery, University of Toronto, Toronto, Ont
| | - R S McLeod
- From the Division of General Surgery, University of Toronto, Toronto, Ont
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38
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Jones NR, Brown CJ, Brown GC, Damiani M. Method for cotemporal and coplanar comparison of magnetic resonance imaging and neuropathology of formalin-fixed human brains. J Clin Neurosci 2008; 5:70-2. [PMID: 18644292 DOI: 10.1016/s0967-5868(98)90206-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/1996] [Accepted: 05/30/1996] [Indexed: 11/29/2022]
Abstract
We describe the design and production of a mitre box that allows magnetic resonance imaging and pathological sectioning of a formalin-fixed brain so that the pathological and radiological slices are coplanar and therefore readily comparable.
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Affiliation(s)
- N R Jones
- Department of Surgery (Neurosurgery), University of Adelaide, Adelaide, South Australia, Australia
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39
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Warwick RM, Rushambuza FG, Brown J, Patel R, Tabb S, Poniatowski S, Ranson AJ, Brown CJ. Confirmation of cadaveric blood sample identity by DNA profiling using Short Tandem Repeat (STR) analysis. Cell Tissue Bank 2008; 9:323-8. [PMID: 18483780 DOI: 10.1007/s10561-008-9071-6] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2008] [Accepted: 04/15/2008] [Indexed: 12/01/2022]
Abstract
Blood samples collected from deceased tissue donors for mandatory transfusion microbiology testing may be taken either at the time of tissue donation, or residual samples may be retrieved from hospital laboratories where they were originally used for ante-mortem tests. In the latter case, sample labelling may not conform to the required standard, which stipulates that three independent identifiers be provided. If no alternative adequately labelled sample is available for testing the donated tissues may have to be discarded, which can adversely affect tissue sufficiency. An alternative method to ensure that the blood sample to be tested is from the intended deceased donor is to confirm the identity of the blood sample by Deoxyribonucleic Nucleic Acid (DNA) Short Tandem Repeats (STR) analysis, then comparing the DNA profile with the DNA from the donated tissues. If the two DNA profiles are identical, probability calculations can demonstrate the chance of the two samples of DNA being from the same or different individuals. The authors have used this approach to salvage deceased tissue donations.
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Affiliation(s)
- Ruth M Warwick
- Tissue Services, NHS Blood and Transplant (NHSBT), Deansbrook Road, Edgware, Middlesex, HA8 9BD, UK.
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40
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Abstract
BACKGROUND Total mesorectal resection (TME) has led to improved survival and reduced local recurrence in patients with rectal cancer. Straight coloanal anastomosis after TME can lead to problems with frequent bowel movements, fecal urgency and incontinence. The colonic J pouch, side-to-end anastomosis and transverse coloplasty have been developed as alternative surgical strategies in order to improve bowel function. OBJECTIVES The purpose of this study is to determine which rectal reconstructive technique results in the best postoperative bowel function. SEARCH STRATEGY A systematic search of the literature (MEDLINE, Cancerlit, Embase and Cochrane Databases) was conducted from inception to Feb 14, 2006 by two independent investigators. SELECTION CRITERIA Randomized controlled trials in which patients with rectal cancer undergoing low rectal resection and coloanal anastomosis were randomized to at least two different anastomotic techniques. Furthermore, a measure of postoperative bowel function was necessary for inclusion. DATA COLLECTION AND ANALYSIS Studies identified for potential inclusion were independently assessed for eligibility by at least two reviewers. Data from included trials was collected using a standardized data collection form. Data was collated and qualitatively summarized for bowel function outcomes and meta-analysis statistical techniques were used to pool data on postoperative complications. MAIN RESULTS Of 2609 relevant studies, 16 randomized controlled trials (RCTs) met our inclusion criteria. Nine RCTs (n=473) compared straight coloanal anastomosis (SCA) to the colonic J pouch (CJP). Up to 18 months postoperatively, the CJP was superior to SCA in most studies in bowel frequency, urgency, fecal incontinence and use of antidiarrheal medication. There were too few patients with long-term bowel function outcomes to determine if this advantage continued after 18 months postop. Four RCTs (n=215) compared the side-to-end anastomosis (STE) to the CJP. These studies showed no difference in bowel function outcomes between these two techniques. Similarly, three RCTs (n=158) compared transverse coloplasty (TC) to CJP. Similarly, there were no differences in bowel function outcomes in these small studies. Overall, there were no significant differences in postoperative complications with any of the anastomotic strategies. AUTHORS' CONCLUSIONS In several randomized controlled trials, the CJP has been shown to be superior to the SCA in bowel function outcomes in patients with rectal cancer for at least 18 months after gastrointestinal continuity is re-established. The TC and STE anastomoses have been shown to have similar bowel function outcomes when compared to the CJP in small randomized controlled trials; further study is necessary to determine the role of these alternative coloanal anastomotic strategies.
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Affiliation(s)
- C J Brown
- University of Toronto, Surgery, 449-600 University Avenue, Toronto, Ontario, Canada, M5G 1X5.
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41
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Simpson DJ, Brown CJ, Yettram AL, Procter P, Andrew GJ. Finite element analysis of intramedullary devices: The effect of the gap between the implant and the bone. Proc Inst Mech Eng H 2008; 222:333-45. [DOI: 10.1243/09544119jeim337] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
This paper examines the interaction interface between the implant and the bone for an intramedullary femoral nailing system using a finite element (FE) model and specifically considers the hypothesis that the local geometry at the interface is significant to the resulting localized contact stress between the medial and lateral aspect of nail and endosteum. Contact mechanics algorithms are used in the FE modelling technique that can be developed to deal with any form of intramedullary device for which contact at the bone—implant interface is important. Global stiffness data from the FE model are compared with available data from an experiment carried out on a construct of the bone and the device that uses intramedullary femoral nails. Acceptable agreement is obtained. The results demonstrate that the mechanical interface between the implant and the bone is significantly affected by the gap geometry and magnitude. In particular, larger gaps lead to greater concentrations of stress on the medial side, while the distribution of stress is more uniform at the lateral contacts. Furthermore, the results show that the gap can have a marked effect on the stresses that occur on the fracture plane.
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Affiliation(s)
- D J Simpson
- Oxford Orthopaedic Engineering Centre, Nuffield Department of Orthopaedic Surgery, University of Oxford, Oxford, UK
| | - C J Brown
- School of Engineering and Design, Brunel University, Uxbridge, UK
| | - A L Yettram
- School of Engineering and Design, Brunel University, Uxbridge, UK
| | - P Procter
- School of Engineering and Design, Brunel University, Uxbridge, UK
| | - G J Andrew
- Department of Orthopaedics, Ysbyty Gwynedd, Bangor, UK
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42
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Devon KM, Vergara O, Victor JC, Swallow CJ, Cohen Z, Gryfe R, MacRae HM, McLeod RS, Murata A, Phang PT, Jones K, Merritt N, Belliveau P, Hurlbut D, Scheer A, Sabri E, Moloo H, Poulin EC, Mamazza J, Boushey R, Brown CJ, Zhang H, Gallinger S, Gryfe R, McLeod RS, Walters TD, Steinhart AH, Bernstein C, Tremaine W, Wolff BG, Ross S, Parkes R, McKenzie M, McLeod RS, Richardson D, deMontbrun S, McIntyre PB, Johnson PM, Shum J, Colquhoun PHD, Taylor BM, Polyhronopoulos GN, Feldman LS, McCluney AL, Buithieu J, Martinie J, Metrakos P, Fried GM, Chiasson PM, Burpee SE, Corrigan R, Manson P, Omiccioli A, Singh R, Hegge SG, McKinley CA, Lemieux P, Rhéaume P, Lévesque I, Bujold E, Brochu G, Mrad BA, Stoklossa CJ, Birch DW, Chen J, Christou NV, Turcotte S, Forget MA, Beauseigle D, Lapointe R, Garzon PM, Shah SA, Wei AC, Girgrah N, Levy GA, Wong P, Lilly LB, Grant DR, Cattral MS, McGilvary I, Greig PD, Tawadros PS, Wang Z, Birch S, Szaszi K, Kapus A, Rotstein OD, Mihailovic A, Nansamba C, Coyte P, Howar A, Urbach D, Govindarajan A, Cranford V, Wirtzfeld D, Gallinger S, Law CHL, Smith AJ, Gagliardi AR, Haggar F, Moloo H, Grimshaw J, Poulin EC, Mamazza J, Boushey RP, McConnell Y, Johnson P, Porter G, Govindarajan A, Kiss A, Rabeneck L, Smith AJ, Hodgson D, Law CHL, White C, Taylor MC, Borowiec AM, Fedorak RN, Polyhronopoulos GN, Feldman LS, Kaneva PA, Fried GM, Keshoofy M, Gutauskas A, Smith RF, Christou NV, Al-Sabah S, Ladouceur M, Christou NV, Thompson SK, Ruszkiewicz AR, Jamieson GG, Wijnhoven BPL, Game PA, Devitt PG, Watson DI, Poole B, Ehlen TG, Davis NL, Tuma F, Smith T, Hamoud M, Elfeitori A, Boushey R, Poulin E, Mamazza J, MacKenzie JR, Teel W, Reinhartz A, Schieman J, Brophy J, Hsu KE, Ferri LE, Feldman LS, Fried GM, Hsu KE, Man FY, Gizicki RA, Feldman LS, Fried GM, Taylor MC, Bruce S, Burtally A, Brochu G, Gagné JP, Martel G, Poulin EC, Mamazza J, Boushey RP, Deen S, Griffith O, Masoudi H, Wiseman SM, Cox H, Pasieka JL, Parr ZE, Thompson SK, Jamieson GG, Myers JC, Game PA, Devitt PG, Bélanger M, Brochu G, Moloo H, Haggar F, Grimshaw J, Coyle D, Graham ID, Sabri E, Poulin EC, Mamazza J, Balaa F, Stern H, Boushey RP, Moloo H, Sabri E, Wassif E, Haggar F, Poulin EC, Mamazza J, Boushey RP, Reso A, Estifanos D, Church N, Mitchell P, O'Neill C, Colquhoun P, Schlachta CM, Etemad-Rezai R, Jayaraman S, Passi R, Hodder AS, Pace DE, Chuah TK, Wirtzfeld D, Lee TYY, Pollett W, Trottier D, May G, Moloo H, Haggar F, Boushey R, Poulin E, Mamazza J, Singh R, Boutross-Tadross O, Deif B, Elias R, Stephen WJ, Omiccioli A, Singh R, Hegge SG, McKinley CA, Singh R, Omiccioli A, Hegge SG, McKinley CA, Sampath S, Segal BE, Carter JJ, Nguyen NH, Frimer M, Houston G, Bloom SW, Lemieux P, Couture C, Simard S, Lebel S, El Fitori A, Sabri E, Wassif E, Mamazza J, Poulin E, Boushey R, Warnock GL, Waddell J, Proctor G, Krajewski SA, Brown JA, Phang PT, Raval MJ, Brown CJ, Simunovic M, Major D, Qui F, To T, Baxter N, Urbach D, McGuire A, George R, Berg R, George R, Hristov H, McAlister ED, George R, Jones K, Bardell A, Isotalo P, Stotland PK, Chia S, Cyriac JS, Hagen JA, Klein LV, Hodgson N, Holowaty E, Lee G, Sussman J, Whelan T, Simunovic M, Apriasz I, Mohan S, Mccreery G, Patel R, Schlachta CM, Schlachta CM, Sorsdahl AK, Lefebvre KL, McCune ML, Hebbard PC, Wirtzfeld DA, Huynh QHP, Klein LV, Hagen JA, Xeroulis G, Dubrowski A, Leslie K, Mihailovic A, Howard A, Willan A, Coyte P, Urbach D, Sawisky G, Stoklossa CJ, Birch DW, Dickie BH, Stoklossa CJ, Davey D, Birch DW, Bohacek L, Pace DE, Karanicolas PJ, Colquhoun PH, Dahlke E, Guyatt GH, Butler MS, de Gara CJ, Boutros M, Zabalotny B, Charlin B, Meterissian S, Finley C, Clifton J, Fitzgerald M, Yee J, Quadri S, Knox J, Wong R, Xu W, Hornby J, Keshavjee S, Darling G, Schieman C, Tiruta C, Blitz M, Graham A, Gelfand G, McFadden S, Grondin S, de Perrot M, Anraku M, Feld R, Bezjak A, Burkes R, Roberts H, Cho J, Visbal A, Leighl N, Keshavjee S, Johnston M, Villeneuve PJ, Sundaresan RS, Gray DA, Rakovich G, Brigand C, Gaboury L, Martin J, Ferraro P, Duranceau A, Low D, Huang J, Cantone N, Schembre D, Mohan S, Trejos AL, Bassan H, Lin AW, Patel RV, Malthaner RA, Blitz M, Graham AJ, Gelfand G, McFadden SD, Grondin SC, Kondra J, Clifton J, Suarez G, Ross B, Evans K, Finley RJ, Yee J, Sugimura H, Spratt EH, Compeau CG, Shargall Y, Lara-Guerra H, Leighl N, Salvarrey A, Sakurada A, Paul N, Boerner S, Geddie W, Pond G, Shepherd FA, Tsao MS, Waddell TK. Abstracts of presentations to the Annual Meetings of the Canadian Society of Colon and Rectal Surgeons Canadian Association of General Surgeons Canadian Association of Thoracic Surgeons: Canadian Surgery Forum, Toronto, Ont., September 6-9, 2007. Can J Surg 2007; 50:1-32. [PMID: 37353894 PMCID: PMC10390043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/25/2023] Open
Affiliation(s)
- K M Devon
- Dr. Zane Cohen Digestive Diseases Research Unit, Samuel Lunenfeld Research Institute, Department of Surgery, Mount Sinai Hospital, University of Toronto, Toronto, Ont
| | - O Vergara
- Dr. Zane Cohen Digestive Diseases Research Unit, Samuel Lunenfeld Research Institute, Department of Surgery, Mount Sinai Hospital, University of Toronto, Toronto, Ont
| | - J C Victor
- Dr. Zane Cohen Digestive Diseases Research Unit, Samuel Lunenfeld Research Institute, Department of Surgery, Mount Sinai Hospital, University of Toronto, Toronto, Ont
| | - C J Swallow
- Dr. Zane Cohen Digestive Diseases Research Unit, Samuel Lunenfeld Research Institute, Department of Surgery, Mount Sinai Hospital, University of Toronto, Toronto, Ont
| | - Z Cohen
- Dr. Zane Cohen Digestive Diseases Research Unit, Samuel Lunenfeld Research Institute, Department of Surgery, Mount Sinai Hospital, University of Toronto, Toronto, Ont
| | - R Gryfe
- Dr. Zane Cohen Digestive Diseases Research Unit, Samuel Lunenfeld Research Institute, Department of Surgery, Mount Sinai Hospital, University of Toronto, Toronto, Ont
| | - H M MacRae
- Dr. Zane Cohen Digestive Diseases Research Unit, Samuel Lunenfeld Research Institute, Department of Surgery, Mount Sinai Hospital, University of Toronto, Toronto, Ont
| | - R S McLeod
- Dr. Zane Cohen Digestive Diseases Research Unit, Samuel Lunenfeld Research Institute, Department of Surgery, Mount Sinai Hospital, University of Toronto, Toronto, Ont
| | - A Murata
- Division of General Surgery, University of British Columbia, Vancouver, BC
| | - P T Phang
- Division of General Surgery, University of British Columbia, Vancouver, BC
| | - K Jones
- Departments of Surgery and Pathology, Kingston General Hospital, Queen's University, Kingston, Ont
| | - N Merritt
- Departments of Surgery and Pathology, Kingston General Hospital, Queen's University, Kingston, Ont
| | - P Belliveau
- Departments of Surgery and Pathology, Kingston General Hospital, Queen's University, Kingston, Ont
| | - D Hurlbut
- Departments of Surgery and Pathology, Kingston General Hospital, Queen's University, Kingston, Ont
| | - A Scheer
- Department of General Surgery, Ottawa Hospital, Ottawa, Ont
| | - E Sabri
- Department of General Surgery, Ottawa Hospital, Ottawa, Ont
| | - H Moloo
- Department of General Surgery, Ottawa Hospital, Ottawa, Ont
| | - E C Poulin
- Department of General Surgery, Ottawa Hospital, Ottawa, Ont
| | - J Mamazza
- Department of General Surgery, Ottawa Hospital, Ottawa, Ont
| | - R Boushey
- Department of General Surgery, Ottawa Hospital, Ottawa, Ont
| | - C J Brown
- University of British Columbia, Vancouver, BC, University of Toronto, Toronto, Ont
| | - H Zhang
- University of British Columbia, Vancouver, BC, University of Toronto, Toronto, Ont
| | - S Gallinger
- University of British Columbia, Vancouver, BC, University of Toronto, Toronto, Ont
| | - R Gryfe
- University of British Columbia, Vancouver, BC, University of Toronto, Toronto, Ont
| | - R S McLeod
- University of British Columbia, Vancouver, BC, University of Toronto, Toronto, Ont
| | - T D Walters
- University of Toronto, Toronto, Ont., University of Manitoba, Winnipeg, Man., Mayo Clinic, Rochester, NY, University of Calgary, Calgary, Alta., Samuel Lunenfeld Research Institute, Mount Sinai Hospital, Toronto, Ont
| | - A H Steinhart
- University of Toronto, Toronto, Ont., University of Manitoba, Winnipeg, Man., Mayo Clinic, Rochester, NY, University of Calgary, Calgary, Alta., Samuel Lunenfeld Research Institute, Mount Sinai Hospital, Toronto, Ont
| | - C Bernstein
- University of Toronto, Toronto, Ont., University of Manitoba, Winnipeg, Man., Mayo Clinic, Rochester, NY, University of Calgary, Calgary, Alta., Samuel Lunenfeld Research Institute, Mount Sinai Hospital, Toronto, Ont
| | - W Tremaine
- University of Toronto, Toronto, Ont., University of Manitoba, Winnipeg, Man., Mayo Clinic, Rochester, NY, University of Calgary, Calgary, Alta., Samuel Lunenfeld Research Institute, Mount Sinai Hospital, Toronto, Ont
| | - B G Wolff
- University of Toronto, Toronto, Ont., University of Manitoba, Winnipeg, Man., Mayo Clinic, Rochester, NY, University of Calgary, Calgary, Alta., Samuel Lunenfeld Research Institute, Mount Sinai Hospital, Toronto, Ont
| | - S Ross
- University of Toronto, Toronto, Ont., University of Manitoba, Winnipeg, Man., Mayo Clinic, Rochester, NY, University of Calgary, Calgary, Alta., Samuel Lunenfeld Research Institute, Mount Sinai Hospital, Toronto, Ont
| | - R Parkes
- University of Toronto, Toronto, Ont., University of Manitoba, Winnipeg, Man., Mayo Clinic, Rochester, NY, University of Calgary, Calgary, Alta., Samuel Lunenfeld Research Institute, Mount Sinai Hospital, Toronto, Ont
| | - M McKenzie
- University of Toronto, Toronto, Ont., University of Manitoba, Winnipeg, Man., Mayo Clinic, Rochester, NY, University of Calgary, Calgary, Alta., Samuel Lunenfeld Research Institute, Mount Sinai Hospital, Toronto, Ont
| | - R S McLeod
- University of Toronto, Toronto, Ont., University of Manitoba, Winnipeg, Man., Mayo Clinic, Rochester, NY, University of Calgary, Calgary, Alta., Samuel Lunenfeld Research Institute, Mount Sinai Hospital, Toronto, Ont
| | - D Richardson
- Department of Surgery, Dalhousie University, Halifax, NS
| | - S deMontbrun
- Department of Surgery, Dalhousie University, Halifax, NS
| | - P B McIntyre
- Department of Surgery, Dalhousie University, Halifax, NS
| | - P M Johnson
- Department of Surgery, Dalhousie University, Halifax, NS
| | - J Shum
- London Health Sciences Centre, University of Western Ontario, London, Ont
| | - P H D Colquhoun
- London Health Sciences Centre, University of Western Ontario, London, Ont
| | - B M Taylor
- London Health Sciences Centre, University of Western Ontario, London, Ont
| | - G N Polyhronopoulos
- Steinberg-Bernstein Centre for Minimally Invasive Surgery, McGill University, Montréal, Que
| | - L S Feldman
- Steinberg-Bernstein Centre for Minimally Invasive Surgery, McGill University, Montréal, Que
| | - A L McCluney
- Steinberg-Bernstein Centre for Minimally Invasive Surgery, McGill University, Montréal, Que
| | - J Buithieu
- Steinberg-Bernstein Centre for Minimally Invasive Surgery, McGill University, Montréal, Que
| | - J Martinie
- Steinberg-Bernstein Centre for Minimally Invasive Surgery, McGill University, Montréal, Que
| | - P Metrakos
- Steinberg-Bernstein Centre for Minimally Invasive Surgery, McGill University, Montréal, Que
| | - G M Fried
- Steinberg-Bernstein Centre for Minimally Invasive Surgery, McGill University, Montréal, Que
| | - P M Chiasson
- Southern Arizona Center for Minimally Invasive Surgery, Northwest Medical Center, Tucson, Ariz., USA
| | - S E Burpee
- Southern Arizona Center for Minimally Invasive Surgery, Northwest Medical Center, Tucson, Ariz., USA
| | - R Corrigan
- Southern Arizona Center for Minimally Invasive Surgery, Northwest Medical Center, Tucson, Ariz., USA
| | - P Manson
- Southern Arizona Center for Minimally Invasive Surgery, Northwest Medical Center, Tucson, Ariz., USA
| | - A Omiccioli
- Centre for Minimal Access Surgery, North Bay General Hospital, North Bay, Ont
| | - R Singh
- Centre for Minimal Access Surgery, North Bay General Hospital, North Bay, Ont
| | - S G Hegge
- Centre for Minimal Access Surgery, North Bay General Hospital, North Bay, Ont
| | - C A McKinley
- Centre for Minimal Access Surgery, North Bay General Hospital, North Bay, Ont
| | - P Lemieux
- Surgery Department, CHUQ (St-François d'Assise and CHUL pavilions), Université Laval, Québec, Que
| | - P Rhéaume
- Surgery Department, CHUQ (St-François d'Assise and CHUL pavilions), Université Laval, Québec, Que
| | - I Lévesque
- Surgery Department, CHUQ (St-François d'Assise and CHUL pavilions), Université Laval, Québec, Que
| | - E Bujold
- Surgery Department, CHUQ (St-François d'Assise and CHUL pavilions), Université Laval, Québec, Que
| | - G Brochu
- Surgery Department, CHUQ (St-François d'Assise and CHUL pavilions), Université Laval, Québec, Que
| | - B A Mrad
- Department of Surgery, University of Alberta, Centre for the Advancement of Minimally Invasive Surgery (CAMIS), Royal Alexandra Hospital, Edmonton, Alta
| | - C Johnson Stoklossa
- Department of Surgery, University of Alberta, Centre for the Advancement of Minimally Invasive Surgery (CAMIS), Royal Alexandra Hospital, Edmonton, Alta
| | - D W Birch
- Department of Surgery, University of Alberta, Centre for the Advancement of Minimally Invasive Surgery (CAMIS), Royal Alexandra Hospital, Edmonton, Alta
| | - J Chen
- Section of Bariatric Surgery, Division of General Surgery, McGill University, Montréal, Que
| | - N V Christou
- Section of Bariatric Surgery, Division of General Surgery, McGill University, Montréal, Que
| | - S Turcotte
- Immuno-oncology Laboratory, Institut du cancer de Montréal, Centre hospitalier de l'Université de Montréal, CHUM Research Center and Department of Surgery, Université de Montréal, Montréal, Que
| | - M-A Forget
- Immuno-oncology Laboratory, Institut du cancer de Montréal, Centre hospitalier de l'Université de Montréal, CHUM Research Center and Department of Surgery, Université de Montréal, Montréal, Que
| | - D Beauseigle
- Immuno-oncology Laboratory, Institut du cancer de Montréal, Centre hospitalier de l'Université de Montréal, CHUM Research Center and Department of Surgery, Université de Montréal, Montréal, Que
| | - R Lapointe
- Immuno-oncology Laboratory, Institut du cancer de Montréal, Centre hospitalier de l'Université de Montréal, CHUM Research Center and Department of Surgery, Université de Montréal, Montréal, Que
| | - P M Garzon
- Multi-Organ Transplant Unit, University Health Network, University of Toronto, Toronto, Ont
| | - S A Shah
- Multi-Organ Transplant Unit, University Health Network, University of Toronto, Toronto, Ont
| | - A C Wei
- Multi-Organ Transplant Unit, University Health Network, University of Toronto, Toronto, Ont
| | - N Girgrah
- Multi-Organ Transplant Unit, University Health Network, University of Toronto, Toronto, Ont
| | - G A Levy
- Multi-Organ Transplant Unit, University Health Network, University of Toronto, Toronto, Ont
| | - P Wong
- Multi-Organ Transplant Unit, University Health Network, University of Toronto, Toronto, Ont
| | - L B Lilly
- Multi-Organ Transplant Unit, University Health Network, University of Toronto, Toronto, Ont
| | - D R Grant
- Multi-Organ Transplant Unit, University Health Network, University of Toronto, Toronto, Ont
| | - M S Cattral
- Multi-Organ Transplant Unit, University Health Network, University of Toronto, Toronto, Ont
| | - I McGilvary
- Multi-Organ Transplant Unit, University Health Network, University of Toronto, Toronto, Ont
| | - P D Greig
- Multi-Organ Transplant Unit, University Health Network, University of Toronto, Toronto, Ont
| | - P S Tawadros
- St. Michael's Hospital, University of Toronto, Toronto, Ont
| | - Z Wang
- St. Michael's Hospital, University of Toronto, Toronto, Ont
| | - S Birch
- St. Michael's Hospital, University of Toronto, Toronto, Ont
| | - K Szaszi
- St. Michael's Hospital, University of Toronto, Toronto, Ont
| | - A Kapus
- St. Michael's Hospital, University of Toronto, Toronto, Ont
| | - O D Rotstein
- St. Michael's Hospital, University of Toronto, Toronto, Ont
| | - A Mihailovic
- Departments of Surgery and Health Policy Management and Evaluation, University of Toronto, Toronto, Ont., Injury Control Center - Uganda, Kampala, Uganda
| | - C Nansamba
- Departments of Surgery and Health Policy Management and Evaluation, University of Toronto, Toronto, Ont., Injury Control Center - Uganda, Kampala, Uganda
| | - P Coyte
- Departments of Surgery and Health Policy Management and Evaluation, University of Toronto, Toronto, Ont., Injury Control Center - Uganda, Kampala, Uganda
| | - A Howar
- Departments of Surgery and Health Policy Management and Evaluation, University of Toronto, Toronto, Ont., Injury Control Center - Uganda, Kampala, Uganda
| | - D Urbach
- Departments of Surgery and Health Policy Management and Evaluation, University of Toronto, Toronto, Ont., Injury Control Center - Uganda, Kampala, Uganda
| | - A Govindarajan
- Division of General Surgery, Toronto Sunnybrook Regional Cancer Centre, Toronto, Ont., Department of Surgery, Memorial University of Newfoundland, St. John's, Nfld
| | - V Cranford
- Division of General Surgery, Toronto Sunnybrook Regional Cancer Centre, Toronto, Ont., Department of Surgery, Memorial University of Newfoundland, St. John's, Nfld
| | - D Wirtzfeld
- Division of General Surgery, Toronto Sunnybrook Regional Cancer Centre, Toronto, Ont., Department of Surgery, Memorial University of Newfoundland, St. John's, Nfld
| | - S Gallinger
- Division of General Surgery, Toronto Sunnybrook Regional Cancer Centre, Toronto, Ont., Department of Surgery, Memorial University of Newfoundland, St. John's, Nfld
| | - C H L Law
- Division of General Surgery, Toronto Sunnybrook Regional Cancer Centre, Toronto, Ont., Department of Surgery, Memorial University of Newfoundland, St. John's, Nfld
| | - A J Smith
- Division of General Surgery, Toronto Sunnybrook Regional Cancer Centre, Toronto, Ont., Department of Surgery, Memorial University of Newfoundland, St. John's, Nfld
| | - A R Gagliardi
- Division of General Surgery, Toronto Sunnybrook Regional Cancer Centre, Toronto, Ont., Department of Surgery, Memorial University of Newfoundland, St. John's, Nfld
| | - F Haggar
- University of Ottawa, Ottawa Hospital, Ottawa, Ont
| | - H Moloo
- University of Ottawa, Ottawa Hospital, Ottawa, Ont
| | - J Grimshaw
- University of Ottawa, Ottawa Hospital, Ottawa, Ont
| | - E C Poulin
- University of Ottawa, Ottawa Hospital, Ottawa, Ont
| | - J Mamazza
- University of Ottawa, Ottawa Hospital, Ottawa, Ont
| | - R P Boushey
- University of Ottawa, Ottawa Hospital, Ottawa, Ont
| | - Y McConnell
- Division of General Surgery, Queen Elizabeth II Health Sciences Centre, Dalhousie University, Halifax, NS
| | - P Johnson
- Division of General Surgery, Queen Elizabeth II Health Sciences Centre, Dalhousie University, Halifax, NS
| | - G Porter
- Division of General Surgery, Queen Elizabeth II Health Sciences Centre, Dalhousie University, Halifax, NS
| | - A Govindarajan
- Department of General Surgery, Institute for Clinical Evaluative Sciences, Toronto Sunnybrook Regional Cancer Centre, Department of Radiation Oncology, Princess Margaret Hospital, Toronto, Ont
| | - A Kiss
- Department of General Surgery, Institute for Clinical Evaluative Sciences, Toronto Sunnybrook Regional Cancer Centre, Department of Radiation Oncology, Princess Margaret Hospital, Toronto, Ont
| | - L Rabeneck
- Department of General Surgery, Institute for Clinical Evaluative Sciences, Toronto Sunnybrook Regional Cancer Centre, Department of Radiation Oncology, Princess Margaret Hospital, Toronto, Ont
| | - A J Smith
- Department of General Surgery, Institute for Clinical Evaluative Sciences, Toronto Sunnybrook Regional Cancer Centre, Department of Radiation Oncology, Princess Margaret Hospital, Toronto, Ont
| | - D Hodgson
- Department of General Surgery, Institute for Clinical Evaluative Sciences, Toronto Sunnybrook Regional Cancer Centre, Department of Radiation Oncology, Princess Margaret Hospital, Toronto, Ont
| | - C H L Law
- Department of General Surgery, Institute for Clinical Evaluative Sciences, Toronto Sunnybrook Regional Cancer Centre, Department of Radiation Oncology, Princess Margaret Hospital, Toronto, Ont
| | - C White
- Department of Surgery, University of Manitoba, Winnipeg, Man
| | - M C Taylor
- Department of Surgery, University of Manitoba, Winnipeg, Man
| | - A M Borowiec
- Departments of General Surgery and Gastroenterology, University of Alberta, Edmonton, Alta
| | - R N Fedorak
- Departments of General Surgery and Gastroenterology, University of Alberta, Edmonton, Alta
| | - G N Polyhronopoulos
- Steinberg-Bernstein Centre for Minimally Invasive Surgery, McGill University Health Centre, Montréal, Que
| | - L S Feldman
- Steinberg-Bernstein Centre for Minimally Invasive Surgery, McGill University Health Centre, Montréal, Que
| | - P A Kaneva
- Steinberg-Bernstein Centre for Minimally Invasive Surgery, McGill University Health Centre, Montréal, Que
| | - G M Fried
- Steinberg-Bernstein Centre for Minimally Invasive Surgery, McGill University Health Centre, Montréal, Que
| | - M Keshoofy
- Department of General Surgery, Ottawa Hospital, Ottawa, Ont
| | - A Gutauskas
- Department of General Surgery, Ottawa Hospital, Ottawa, Ont
| | | | - N V Christou
- Section of Bariatric Surgery, Division of General Surgery, McGill University, Montréal, Que
| | - S Al-Sabah
- Section of Bariatric Surgery, Division of General Surgery, McGill University Health Centre, Montréal, Que
| | - M Ladouceur
- Section of Bariatric Surgery, Division of General Surgery, McGill University Health Centre, Montréal, Que
| | - N V Christou
- Section of Bariatric Surgery, Division of General Surgery, McGill University Health Centre, Montréal, Que
| | - S K Thompson
- Department of Surgery, Royal Adelaide Hospital, Adelaide, SA, Australia
| | - A R Ruszkiewicz
- Department of Surgery, Royal Adelaide Hospital, Adelaide, SA, Australia
| | - G G Jamieson
- Department of Surgery, Royal Adelaide Hospital, Adelaide, SA, Australia
| | - B P L Wijnhoven
- Department of Surgery, Royal Adelaide Hospital, Adelaide, SA, Australia
| | - P A Game
- Department of Surgery, Royal Adelaide Hospital, Adelaide, SA, Australia
| | - P G Devitt
- Department of Surgery, Royal Adelaide Hospital, Adelaide, SA, Australia
| | - D I Watson
- Department of Surgery, Royal Adelaide Hospital, Adelaide, SA, Australia
| | - B Poole
- Department of Surgical Oncology, BC Cancer Agency, Faculty of Medicine, University of British Columbia, Vancouver, BC
| | - T G Ehlen
- Department of Surgical Oncology, BC Cancer Agency, Faculty of Medicine, University of British Columbia, Vancouver, BC
| | - N L Davis
- Department of Surgical Oncology, BC Cancer Agency, Faculty of Medicine, University of British Columbia, Vancouver, BC
| | - F Tuma
- Department of Head and Neck Surgery, St. Clare's Mercy Hospital, St. John's, Nfld
| | - T Smith
- Department of Head and Neck Surgery, St. Clare's Mercy Hospital, St. John's, Nfld
| | - M Hamoud
- Department of Surgery, Ottawa Hospital, University of Ottawa, Ottawa, Ont
| | - A Elfeitori
- Department of Surgery, Ottawa Hospital, University of Ottawa, Ottawa, Ont
| | - R Boushey
- Department of Surgery, Ottawa Hospital, University of Ottawa, Ottawa, Ont
| | - E Poulin
- Department of Surgery, Ottawa Hospital, University of Ottawa, Ottawa, Ont
| | - J Mamazza
- Department of Surgery, Ottawa Hospital, University of Ottawa, Ottawa, Ont
| | - J R MacKenzie
- Occupational Health Clinic for Ontario Workers, Sarnia, Ont
| | - W Teel
- Occupational Health Clinic for Ontario Workers, Sarnia, Ont
| | - A Reinhartz
- Occupational Health Clinic for Ontario Workers, Sarnia, Ont
| | - J Schieman
- Occupational Health Clinic for Ontario Workers, Sarnia, Ont
| | - J Brophy
- Occupational Health Clinic for Ontario Workers, Sarnia, Ont
| | - K E Hsu
- Steinberg-Bernstein Centre for Minimally Invasive Surgery, McGill University, Montréal, Que
| | - L E Ferri
- Steinberg-Bernstein Centre for Minimally Invasive Surgery, McGill University, Montréal, Que
| | - L S Feldman
- Steinberg-Bernstein Centre for Minimally Invasive Surgery, McGill University, Montréal, Que
| | - G M Fried
- Steinberg-Bernstein Centre for Minimally Invasive Surgery, McGill University, Montréal, Que
| | - K E Hsu
- Steinberg-Bernstein Centre for Minimally Invasive Surgery, McGill University Health Centre, Department of Surgery, McGill University, Montréal, Que
| | - F Y Man
- Steinberg-Bernstein Centre for Minimally Invasive Surgery, McGill University Health Centre, Department of Surgery, McGill University, Montréal, Que
| | - R A Gizicki
- Steinberg-Bernstein Centre for Minimally Invasive Surgery, McGill University Health Centre, Department of Surgery, McGill University, Montréal, Que
| | - L S Feldman
- Steinberg-Bernstein Centre for Minimally Invasive Surgery, McGill University Health Centre, Department of Surgery, McGill University, Montréal, Que
| | - G M Fried
- Steinberg-Bernstein Centre for Minimally Invasive Surgery, McGill University Health Centre, Department of Surgery, McGill University, Montréal, Que
| | - M C Taylor
- Manitoba Centre for Health Policy and the Department of Surgery, University of Manitoba, Winnipeg, Man
| | - S Bruce
- Manitoba Centre for Health Policy and the Department of Surgery, University of Manitoba, Winnipeg, Man
| | - A Burtally
- Québec Centre for Minimally Invasive Surgery, Centre Hospitalier Universitaire de Québec, Québec, Que
| | - G Brochu
- Québec Centre for Minimally Invasive Surgery, Centre Hospitalier Universitaire de Québec, Québec, Que
| | - J P Gagné
- Québec Centre for Minimally Invasive Surgery, Centre Hospitalier Universitaire de Québec, Québec, Que
| | - G Martel
- Minimally Invasive Surgery Group, Division of General Surgery, Ottawa Hospital, University of Ottawa, Ottawa, Ont
| | - E C Poulin
- Minimally Invasive Surgery Group, Division of General Surgery, Ottawa Hospital, University of Ottawa, Ottawa, Ont
| | - J Mamazza
- Minimally Invasive Surgery Group, Division of General Surgery, Ottawa Hospital, University of Ottawa, Ottawa, Ont
| | - R P Boushey
- Minimally Invasive Surgery Group, Division of General Surgery, Ottawa Hospital, University of Ottawa, Ottawa, Ont
| | - S Deen
- Department of Surgery, St. Paul's Hospital, University of British Columbia, Vancouver, BC
| | - O Griffith
- Department of Surgery, St. Paul's Hospital, University of British Columbia, Vancouver, BC
| | - H Masoudi
- Department of Surgery, St. Paul's Hospital, University of British Columbia, Vancouver, BC
| | - S M Wiseman
- Department of Surgery, St. Paul's Hospital, University of British Columbia, Vancouver, BC
| | - H Cox
- Department of Surgery, University of Calgary, Calgary, Alta
| | - J L Pasieka
- Department of Surgery, University of Calgary, Calgary, Alta
| | - Z E Parr
- Departments of Surgery, Foothills Hospital, Calgary, Alta., Royal Adelaide Hospital, Adelaide, SA, Australia
| | - S K Thompson
- Departments of Surgery, Foothills Hospital, Calgary, Alta., Royal Adelaide Hospital, Adelaide, SA, Australia
| | - G G Jamieson
- Departments of Surgery, Foothills Hospital, Calgary, Alta., Royal Adelaide Hospital, Adelaide, SA, Australia
| | - J C Myers
- Departments of Surgery, Foothills Hospital, Calgary, Alta., Royal Adelaide Hospital, Adelaide, SA, Australia
| | - P A Game
- Departments of Surgery, Foothills Hospital, Calgary, Alta., Royal Adelaide Hospital, Adelaide, SA, Australia
| | - P G Devitt
- Departments of Surgery, Foothills Hospital, Calgary, Alta., Royal Adelaide Hospital, Adelaide, SA, Australia
| | - M Bélanger
- Service de chirurgie générale, CHUL-CHUQ, Québec, Que
| | - G Brochu
- Service de chirurgie générale, CHUL-CHUQ, Québec, Que
| | - H Moloo
- Department of Surgery, Ottawa Hospital, Department of Epidemiology, University of Ottawa, Ottawa, Ont
| | - F Haggar
- Department of Surgery, Ottawa Hospital, Department of Epidemiology, University of Ottawa, Ottawa, Ont
| | - J Grimshaw
- Department of Surgery, Ottawa Hospital, Department of Epidemiology, University of Ottawa, Ottawa, Ont
| | - D Coyle
- Department of Surgery, Ottawa Hospital, Department of Epidemiology, University of Ottawa, Ottawa, Ont
| | - I D Graham
- Department of Surgery, Ottawa Hospital, Department of Epidemiology, University of Ottawa, Ottawa, Ont
| | - E Sabri
- Department of Surgery, Ottawa Hospital, Department of Epidemiology, University of Ottawa, Ottawa, Ont
| | - E C Poulin
- Department of Surgery, Ottawa Hospital, Department of Epidemiology, University of Ottawa, Ottawa, Ont
| | - J Mamazza
- Department of Surgery, Ottawa Hospital, Department of Epidemiology, University of Ottawa, Ottawa, Ont
| | - F Balaa
- Department of Surgery, Ottawa Hospital, Department of Epidemiology, University of Ottawa, Ottawa, Ont
| | - H Stern
- Department of Surgery, Ottawa Hospital, Department of Epidemiology, University of Ottawa, Ottawa, Ont
| | - R P Boushey
- Department of Surgery, Ottawa Hospital, Department of Epidemiology, University of Ottawa, Ottawa, Ont
| | - H Moloo
- Ottawa Hospital, Ottawa, Ont
| | - E Sabri
- Ottawa Hospital, Ottawa, Ont
| | | | | | | | | | | | - A Reso
- Division of General Surgery, Peter Lougheed Centre, Calgary, Alta
| | - D Estifanos
- Division of General Surgery, Peter Lougheed Centre, Calgary, Alta
| | - N Church
- Division of General Surgery, Peter Lougheed Centre, Calgary, Alta
| | - P Mitchell
- Division of General Surgery, Peter Lougheed Centre, Calgary, Alta
| | - C O'Neill
- Division of General Surgery and Department of Diagnostic Radiology and Nuclear Medicine, Schulich School of Medicine and Dentistry, London, Ont
| | - P Colquhoun
- Division of General Surgery and Department of Diagnostic Radiology and Nuclear Medicine, Schulich School of Medicine and Dentistry, London, Ont
| | - C M Schlachta
- Division of General Surgery and Department of Diagnostic Radiology and Nuclear Medicine, Schulich School of Medicine and Dentistry, London, Ont
| | - R Etemad-Rezai
- Division of General Surgery and Department of Diagnostic Radiology and Nuclear Medicine, Schulich School of Medicine and Dentistry, London, Ont
| | - S Jayaraman
- Division of General Surgery and Department of Diagnostic Radiology and Nuclear Medicine, Schulich School of Medicine and Dentistry, London, Ont
| | - R Passi
- Division of General Surgery and Department of Diagnostic Radiology and Nuclear Medicine, Schulich School of Medicine and Dentistry, London, Ont
| | - A S Hodder
- Division of General Surgery, Memorial University, St. John's, Nfld
| | - D E Pace
- Division of General Surgery, Memorial University, St. John's, Nfld
| | - T K Chuah
- Discipline of Surgery, Health Sciences Centre, Memorial University, St. John's, Nfld
| | - D Wirtzfeld
- Discipline of Surgery, Health Sciences Centre, Memorial University, St. John's, Nfld
| | - T Y Y Lee
- Discipline of Surgery, Health Sciences Centre, Memorial University, St. John's, Nfld
| | - W Pollett
- Discipline of Surgery, Health Sciences Centre, Memorial University, St. John's, Nfld
| | - D Trottier
- Department of Surgery, University of Ottawa, Ottawa, Department of Gastroenterology, St. Michael's Hospital, Toronto, Ont
| | - G May
- Department of Surgery, University of Ottawa, Ottawa, Department of Gastroenterology, St. Michael's Hospital, Toronto, Ont
| | - H Moloo
- Department of Surgery, University of Ottawa, Ottawa, Department of Gastroenterology, St. Michael's Hospital, Toronto, Ont
| | - F Haggar
- Department of Surgery, University of Ottawa, Ottawa, Department of Gastroenterology, St. Michael's Hospital, Toronto, Ont
| | - R Boushey
- Department of Surgery, University of Ottawa, Ottawa, Department of Gastroenterology, St. Michael's Hospital, Toronto, Ont
| | - E Poulin
- Department of Surgery, University of Ottawa, Ottawa, Department of Gastroenterology, St. Michael's Hospital, Toronto, Ont
| | - J Mamazza
- Department of Surgery, University of Ottawa, Ottawa, Department of Gastroenterology, St. Michael's Hospital, Toronto, Ont
| | - R Singh
- Departments of Surgery and Pathology, McMaster University, Hamilton, Ont
| | - O Boutross-Tadross
- Departments of Surgery and Pathology, McMaster University, Hamilton, Ont
| | - B Deif
- Departments of Surgery and Pathology, McMaster University, Hamilton, Ont
| | - R Elias
- Departments of Surgery and Pathology, McMaster University, Hamilton, Ont
| | - W J Stephen
- Departments of Surgery and Pathology, McMaster University, Hamilton, Ont
| | - A Omiccioli
- The Center for Minimal Access Surgery, North Bay General Hospital, North Bay, Ont
| | - R Singh
- The Center for Minimal Access Surgery, North Bay General Hospital, North Bay, Ont
| | - S G Hegge
- The Center for Minimal Access Surgery, North Bay General Hospital, North Bay, Ont
| | - C A McKinley
- The Center for Minimal Access Surgery, North Bay General Hospital, North Bay, Ont
| | - R Singh
- The Centre for Minimal Access Surgery, North Bay General Hospital, North Bay, Ont
| | - A Omiccioli
- The Centre for Minimal Access Surgery, North Bay General Hospital, North Bay, Ont
| | - S G Hegge
- The Centre for Minimal Access Surgery, North Bay General Hospital, North Bay, Ont
| | - C A McKinley
- The Centre for Minimal Access Surgery, North Bay General Hospital, North Bay, Ont
| | - S Sampath
- Department of Surgery, Richmond Hospital, Richmond, BC
| | - B E Segal
- Department of Surgery, Richmond Hospital, Richmond, BC
| | - J J Carter
- Department of Surgery, Richmond Hospital, Richmond, BC
| | - N H Nguyen
- Department of Surgery, Richmond Hospital, Richmond, BC
| | - M Frimer
- Department of Surgery, Richmond Hospital, Richmond, BC
| | - G Houston
- Department of Surgery, Richmond Hospital, Richmond, BC
| | - S W Bloom
- Department of Surgery, Richmond Hospital, Richmond, BC
| | - P Lemieux
- Surgery and Pathology Departments, Hôpital Laval, Université Laval, Québec, Que
| | - C Couture
- Surgery and Pathology Departments, Hôpital Laval, Université Laval, Québec, Que
| | - S Simard
- Surgery and Pathology Departments, Hôpital Laval, Université Laval, Québec, Que
| | - S Lebel
- Surgery and Pathology Departments, Hôpital Laval, Université Laval, Québec, Que
| | - A El Fitori
- Department of Surgery, Ottawa Hospital, University of Ottawa, Ottawa, Ont
| | - E Sabri
- Department of Surgery, Ottawa Hospital, University of Ottawa, Ottawa, Ont
| | - E Wassif
- Department of Surgery, Ottawa Hospital, University of Ottawa, Ottawa, Ont
| | - J Mamazza
- Department of Surgery, Ottawa Hospital, University of Ottawa, Ottawa, Ont
| | - E Poulin
- Department of Surgery, Ottawa Hospital, University of Ottawa, Ottawa, Ont
| | - R Boushey
- Department of Surgery, Ottawa Hospital, University of Ottawa, Ottawa, Ont
| | - G L Warnock
- Department of Surgery, University of British Columbia, Vancouver, BC, Division of Orthopaedic Surgery, St. Michael's Hospital, Toronto, Ont., Canadian Medical Association, Ottawa, Ont
| | - J Waddell
- Department of Surgery, University of British Columbia, Vancouver, BC, Division of Orthopaedic Surgery, St. Michael's Hospital, Toronto, Ont., Canadian Medical Association, Ottawa, Ont
| | - G Proctor
- Department of Surgery, University of British Columbia, Vancouver, BC, Division of Orthopaedic Surgery, St. Michael's Hospital, Toronto, Ont., Canadian Medical Association, Ottawa, Ont
| | - S A Krajewski
- Departments of Surgery and Radiology, St. Paul's Hospital, University of British Columbia, Vancouver, BC
| | - J A Brown
- Departments of Surgery and Radiology, St. Paul's Hospital, University of British Columbia, Vancouver, BC
| | - P T Phang
- Departments of Surgery and Radiology, St. Paul's Hospital, University of British Columbia, Vancouver, BC
| | - M J Raval
- Departments of Surgery and Radiology, St. Paul's Hospital, University of British Columbia, Vancouver, BC
| | - C J Brown
- Departments of Surgery and Radiology, St. Paul's Hospital, University of British Columbia, Vancouver, BC
| | - M Simunovic
- McMaster University, Hamilton, Ont., Institut national de santé publique du Québec, Québec, Que., Institute for Clinical Evaluative Sciences, Hospital for Sick Children, University of Toronto, Toronto, Ont
| | - D Major
- McMaster University, Hamilton, Ont., Institut national de santé publique du Québec, Québec, Que., Institute for Clinical Evaluative Sciences, Hospital for Sick Children, University of Toronto, Toronto, Ont
| | - F Qui
- McMaster University, Hamilton, Ont., Institut national de santé publique du Québec, Québec, Que., Institute for Clinical Evaluative Sciences, Hospital for Sick Children, University of Toronto, Toronto, Ont
| | - T To
- McMaster University, Hamilton, Ont., Institut national de santé publique du Québec, Québec, Que., Institute for Clinical Evaluative Sciences, Hospital for Sick Children, University of Toronto, Toronto, Ont
| | - N Baxter
- McMaster University, Hamilton, Ont., Institut national de santé publique du Québec, Québec, Que., Institute for Clinical Evaluative Sciences, Hospital for Sick Children, University of Toronto, Toronto, Ont
| | - D Urbach
- McMaster University, Hamilton, Ont., Institut national de santé publique du Québec, Québec, Que., Institute for Clinical Evaluative Sciences, Hospital for Sick Children, University of Toronto, Toronto, Ont
| | - A McGuire
- Departments of Surgery and Oncology, Queen's University, Kingston, Ont
| | - R George
- Departments of Surgery and Oncology, Queen's University, Kingston, Ont
| | - R Berg
- Departments of Surgery and Oncology, Queen's University, Kingston, Ont
| | - R George
- Departments of Surgery and Oncology, Queen's University, Kingston, Ont
| | - H Hristov
- Departments of Surgery and Oncology, Queen's University, Kingston, Ont
| | - E D McAlister
- Department of Surgery and Oncology and Department of Pathology and Molecular Medicine, Queen's University, Kingston, Ont
| | - R George
- Department of Surgery and Oncology and Department of Pathology and Molecular Medicine, Queen's University, Kingston, Ont
| | - K Jones
- Department of Surgery and Oncology and Department of Pathology and Molecular Medicine, Queen's University, Kingston, Ont
| | - A Bardell
- Department of Surgery and Oncology and Department of Pathology and Molecular Medicine, Queen's University, Kingston, Ont
| | - P Isotalo
- Department of Surgery and Oncology and Department of Pathology and Molecular Medicine, Queen's University, Kingston, Ont
| | - P K Stotland
- Minimally Invasive Surgery Program, Department of Surgery, University of Toronto, Humber River Regional Hospital, Toronto, Ont
| | - S Chia
- Minimally Invasive Surgery Program, Department of Surgery, University of Toronto, Humber River Regional Hospital, Toronto, Ont
| | - J S Cyriac
- Minimally Invasive Surgery Program, Department of Surgery, University of Toronto, Humber River Regional Hospital, Toronto, Ont
| | - J A Hagen
- Minimally Invasive Surgery Program, Department of Surgery, University of Toronto, Humber River Regional Hospital, Toronto, Ont
| | - L V Klein
- Minimally Invasive Surgery Program, Department of Surgery, University of Toronto, Humber River Regional Hospital, Toronto, Ont
| | - N Hodgson
- Department of Surgery, Medicine and Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ont., Cancer Care Ontario, Toronto, Ont
| | - E Holowaty
- Department of Surgery, Medicine and Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ont., Cancer Care Ontario, Toronto, Ont
| | - G Lee
- Department of Surgery, Medicine and Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ont., Cancer Care Ontario, Toronto, Ont
| | - J Sussman
- Department of Surgery, Medicine and Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ont., Cancer Care Ontario, Toronto, Ont
| | - T Whelan
- Department of Surgery, Medicine and Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ont., Cancer Care Ontario, Toronto, Ont
| | - M Simunovic
- Department of Surgery, Medicine and Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ont., Cancer Care Ontario, Toronto, Ont
| | - I Apriasz
- Canadian Surgical Technologies and Advanced Robotics (CSTAR), Lawson Health Research Institute, Schulich School of Medicine and Dentistry, London, Ont
| | - S Mohan
- Canadian Surgical Technologies and Advanced Robotics (CSTAR), Lawson Health Research Institute, Schulich School of Medicine and Dentistry, London, Ont
| | - G Mccreery
- Canadian Surgical Technologies and Advanced Robotics (CSTAR), Lawson Health Research Institute, Schulich School of Medicine and Dentistry, London, Ont
| | - R Patel
- Canadian Surgical Technologies and Advanced Robotics (CSTAR), Lawson Health Research Institute, Schulich School of Medicine and Dentistry, London, Ont
| | - C M Schlachta
- Canadian Surgical Technologies and Advanced Robotics (CSTAR), Lawson Health Research Institute, Schulich School of Medicine and Dentistry, London, Ont
| | - C M Schlachta
- Canadian Surgical Technologies and Advanced Robotics (CSTAR), Lawson Health Research Institute, Schulich School of Medicine and Dentistry, London, Ont., Stratford General Hospital, Stratford, Ont
| | - A K Sorsdahl
- Canadian Surgical Technologies and Advanced Robotics (CSTAR), Lawson Health Research Institute, Schulich School of Medicine and Dentistry, London, Ont., Stratford General Hospital, Stratford, Ont
| | - K L Lefebvre
- Canadian Surgical Technologies and Advanced Robotics (CSTAR), Lawson Health Research Institute, Schulich School of Medicine and Dentistry, London, Ont., Stratford General Hospital, Stratford, Ont
| | - M L McCune
- Canadian Surgical Technologies and Advanced Robotics (CSTAR), Lawson Health Research Institute, Schulich School of Medicine and Dentistry, London, Ont., Stratford General Hospital, Stratford, Ont
| | - P C Hebbard
- Department of Surgery, Memorial University of Newfoundland, St. John's, Nfld
| | - D A Wirtzfeld
- Department of Surgery, Memorial University of Newfoundland, St. John's, Nfld
| | - Q H P Huynh
- The Minimally Invasive Surgery Program, Humber River Regional Hospital, Department of Surgery, University of Toronto, Toronto, Ont
| | - L V Klein
- The Minimally Invasive Surgery Program, Humber River Regional Hospital, Department of Surgery, University of Toronto, Toronto, Ont
| | - J A Hagen
- The Minimally Invasive Surgery Program, Humber River Regional Hospital, Department of Surgery, University of Toronto, Toronto, Ont
| | - G Xeroulis
- Department of Surgery, Division of General Surgery, University of Western Ontario, London, Ont
| | - A Dubrowski
- Department of Surgery, Division of General Surgery, University of Western Ontario, London, Ont
| | - K Leslie
- Department of Surgery, Division of General Surgery, University of Western Ontario, London, Ont
| | - A Mihailovic
- Departments of Surgery and Health Policy, Management and Evaluation, University of Toronto, Hospital for Sick Children, Toronto, Ont
| | - A Howard
- Departments of Surgery and Health Policy, Management and Evaluation, University of Toronto, Hospital for Sick Children, Toronto, Ont
| | - A Willan
- Departments of Surgery and Health Policy, Management and Evaluation, University of Toronto, Hospital for Sick Children, Toronto, Ont
| | - P Coyte
- Departments of Surgery and Health Policy, Management and Evaluation, University of Toronto, Hospital for Sick Children, Toronto, Ont
| | - D Urbach
- Departments of Surgery and Health Policy, Management and Evaluation, University of Toronto, Hospital for Sick Children, Toronto, Ont
| | - G Sawisky
- Department of Surgery, University of Alberta, Centre for the Advancement of Minimally Invasive Surgery (CAMIS), Royal Alexandra Hospital, Edmonton, Alta
| | - C Johnson Stoklossa
- Department of Surgery, University of Alberta, Centre for the Advancement of Minimally Invasive Surgery (CAMIS), Royal Alexandra Hospital, Edmonton, Alta
| | - D W Birch
- Department of Surgery, University of Alberta, Centre for the Advancement of Minimally Invasive Surgery (CAMIS), Royal Alexandra Hospital, Edmonton, Alta
| | - B H Dickie
- Department of Surgery, University of Alberta, Centre for the Advancement of Minimally Invasive Surgery (CAMIS), Royal Alexandra Hospital, Edmonton, Alta
| | - C Johnson Stoklossa
- Department of Surgery, University of Alberta, Centre for the Advancement of Minimally Invasive Surgery (CAMIS), Royal Alexandra Hospital, Edmonton, Alta
| | - D Davey
- Department of Surgery, University of Alberta, Centre for the Advancement of Minimally Invasive Surgery (CAMIS), Royal Alexandra Hospital, Edmonton, Alta
| | - D W Birch
- Department of Surgery, University of Alberta, Centre for the Advancement of Minimally Invasive Surgery (CAMIS), Royal Alexandra Hospital, Edmonton, Alta
| | - L Bohacek
- Department of Surgery, Memorial University, St. John's, Nfld
| | - D E Pace
- Department of Surgery, Memorial University, St. John's, Nfld
| | - P J Karanicolas
- Department of Surgery, University of Western Ontario, London, Ont., Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ont
| | - P H Colquhoun
- Department of Surgery, University of Western Ontario, London, Ont., Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ont
| | - E Dahlke
- Department of Surgery, University of Western Ontario, London, Ont., Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ont
| | - G H Guyatt
- Department of Surgery, University of Western Ontario, London, Ont., Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ont
| | - M S Butler
- Department of General Surgery, Royal Alexandra Hospital and University of Alberta Hospital, Edmonton, Alta
| | - C J de Gara
- Department of General Surgery, Royal Alexandra Hospital and University of Alberta Hospital, Edmonton, Alta
| | - M Boutros
- Centre for Medical Education and the Division of General Surgery, McGill University, Centre for Medical Education, Univeristé de Montréal, Montréal, Que
| | - B Zabalotny
- Centre for Medical Education and the Division of General Surgery, McGill University, Centre for Medical Education, Univeristé de Montréal, Montréal, Que
| | - B Charlin
- Centre for Medical Education and the Division of General Surgery, McGill University, Centre for Medical Education, Univeristé de Montréal, Montréal, Que
| | - S Meterissian
- Centre for Medical Education and the Division of General Surgery, McGill University, Centre for Medical Education, Univeristé de Montréal, Montréal, Que
| | - C Finley
- Vancouver General Hospital and the University of British Columbia, Vancouver, BC
| | - J Clifton
- Vancouver General Hospital and the University of British Columbia, Vancouver, BC
| | - M Fitzgerald
- Vancouver General Hospital and the University of British Columbia, Vancouver, BC
| | - J Yee
- Vancouver General Hospital and the University of British Columbia, Vancouver, BC
| | - S Quadri
- Toronto General Hospital, Princess Margaret Hospital, Toronto, Ont
| | - J Knox
- Toronto General Hospital, Princess Margaret Hospital, Toronto, Ont
| | - R Wong
- Toronto General Hospital, Princess Margaret Hospital, Toronto, Ont
| | - W Xu
- Toronto General Hospital, Princess Margaret Hospital, Toronto, Ont
| | - J Hornby
- Toronto General Hospital, Princess Margaret Hospital, Toronto, Ont
| | - S Keshavjee
- Toronto General Hospital, Princess Margaret Hospital, Toronto, Ont
| | - G Darling
- Toronto General Hospital, Princess Margaret Hospital, Toronto, Ont
| | - C Schieman
- Division of Thoracic Surgery, University of Calgary, Calgary, Alta
| | - C Tiruta
- Division of Thoracic Surgery, University of Calgary, Calgary, Alta
| | - M Blitz
- Division of Thoracic Surgery, University of Calgary, Calgary, Alta
| | - A Graham
- Division of Thoracic Surgery, University of Calgary, Calgary, Alta
| | - G Gelfand
- Division of Thoracic Surgery, University of Calgary, Calgary, Alta
| | - S McFadden
- Division of Thoracic Surgery, University of Calgary, Calgary, Alta
| | - S Grondin
- Division of Thoracic Surgery, University of Calgary, Calgary, Alta
| | - M de Perrot
- Toronto General Hospital, Princess Margaret Hospital, University of Toronto, Toronto, Ont
| | - M Anraku
- Toronto General Hospital, Princess Margaret Hospital, University of Toronto, Toronto, Ont
| | - R Feld
- Toronto General Hospital, Princess Margaret Hospital, University of Toronto, Toronto, Ont
| | - A Bezjak
- Toronto General Hospital, Princess Margaret Hospital, University of Toronto, Toronto, Ont
| | - R Burkes
- Toronto General Hospital, Princess Margaret Hospital, University of Toronto, Toronto, Ont
| | - H Roberts
- Toronto General Hospital, Princess Margaret Hospital, University of Toronto, Toronto, Ont
| | - J Cho
- Toronto General Hospital, Princess Margaret Hospital, University of Toronto, Toronto, Ont
| | - A Visbal
- Toronto General Hospital, Princess Margaret Hospital, University of Toronto, Toronto, Ont
| | - N Leighl
- Toronto General Hospital, Princess Margaret Hospital, University of Toronto, Toronto, Ont
| | - S Keshavjee
- Toronto General Hospital, Princess Margaret Hospital, University of Toronto, Toronto, Ont
| | - M Johnston
- Toronto General Hospital, Princess Margaret Hospital, University of Toronto, Toronto, Ont
| | - P J Villeneuve
- Centre for Cancer Therapeutics, Ottawa Health Research Institute, Division of Thoracic Surgery, University of Ottawa, Ottawa, Ont
| | - R S Sundaresan
- Centre for Cancer Therapeutics, Ottawa Health Research Institute, Division of Thoracic Surgery, University of Ottawa, Ottawa, Ont
| | - D A Gray
- Centre for Cancer Therapeutics, Ottawa Health Research Institute, Division of Thoracic Surgery, University of Ottawa, Ottawa, Ont
| | - G Rakovich
- Service de chirurgie thoracique, Service anatomo-pathologie, Centre hospitalier de l'Université de Montréal, Montréal, Que., Service chirurgie digestive, CHU Strasbourg, Strasbourg, France
| | - C Brigand
- Service de chirurgie thoracique, Service anatomo-pathologie, Centre hospitalier de l'Université de Montréal, Montréal, Que., Service chirurgie digestive, CHU Strasbourg, Strasbourg, France
| | - L Gaboury
- Service de chirurgie thoracique, Service anatomo-pathologie, Centre hospitalier de l'Université de Montréal, Montréal, Que., Service chirurgie digestive, CHU Strasbourg, Strasbourg, France
| | - J Martin
- Service de chirurgie thoracique, Service anatomo-pathologie, Centre hospitalier de l'Université de Montréal, Montréal, Que., Service chirurgie digestive, CHU Strasbourg, Strasbourg, France
| | - P Ferraro
- Service de chirurgie thoracique, Service anatomo-pathologie, Centre hospitalier de l'Université de Montréal, Montréal, Que., Service chirurgie digestive, CHU Strasbourg, Strasbourg, France
| | - A Duranceau
- Service de chirurgie thoracique, Service anatomo-pathologie, Centre hospitalier de l'Université de Montréal, Montréal, Que., Service chirurgie digestive, CHU Strasbourg, Strasbourg, France
| | - D Low
- Departments of Thoracic Surgery and Gastroenterology, Virginia Mason Medical Center, Seattle, Wash., USA
| | - J Huang
- Departments of Thoracic Surgery and Gastroenterology, Virginia Mason Medical Center, Seattle, Wash., USA
| | - N Cantone
- Departments of Thoracic Surgery and Gastroenterology, Virginia Mason Medical Center, Seattle, Wash., USA
| | - D Schembre
- Departments of Thoracic Surgery and Gastroenterology, Virginia Mason Medical Center, Seattle, Wash., USA
| | - S Mohan
- Canadian Surgical Technologies and Advanced Robotics (CSTAR), University of Western Ontario, London, Ont
| | - A L Trejos
- Canadian Surgical Technologies and Advanced Robotics (CSTAR), University of Western Ontario, London, Ont
| | - H Bassan
- Canadian Surgical Technologies and Advanced Robotics (CSTAR), University of Western Ontario, London, Ont
| | - A W Lin
- Canadian Surgical Technologies and Advanced Robotics (CSTAR), University of Western Ontario, London, Ont
| | - R V Patel
- Canadian Surgical Technologies and Advanced Robotics (CSTAR), University of Western Ontario, London, Ont
| | - R A Malthaner
- Canadian Surgical Technologies and Advanced Robotics (CSTAR), University of Western Ontario, London, Ont
| | - M Blitz
- Division of Thoracic Surgery, Department of Surgery, University of Calgary, Calgary, Alta
| | - A J Graham
- Division of Thoracic Surgery, Department of Surgery, University of Calgary, Calgary, Alta
| | - G Gelfand
- Division of Thoracic Surgery, Department of Surgery, University of Calgary, Calgary, Alta
| | - S D McFadden
- Division of Thoracic Surgery, Department of Surgery, University of Calgary, Calgary, Alta
| | - S C Grondin
- Division of Thoracic Surgery, Department of Surgery, University of Calgary, Calgary, Alta
| | - J Kondra
- Department of Thoracic Surgery, Vancouver General Hospital, University of British Columbia, Vancouver, BC
| | - J Clifton
- Department of Thoracic Surgery, Vancouver General Hospital, University of British Columbia, Vancouver, BC
| | - G Suarez
- Department of Thoracic Surgery, Vancouver General Hospital, University of British Columbia, Vancouver, BC
| | - B Ross
- Department of Thoracic Surgery, Vancouver General Hospital, University of British Columbia, Vancouver, BC
| | - K Evans
- Department of Thoracic Surgery, Vancouver General Hospital, University of British Columbia, Vancouver, BC
| | - R J Finley
- Department of Thoracic Surgery, Vancouver General Hospital, University of British Columbia, Vancouver, BC
| | - J Yee
- Department of Thoracic Surgery, Vancouver General Hospital, University of British Columbia, Vancouver, BC
| | - H Sugimura
- Division of Thoracic Surgery, Department of Surgery, University of Toronto, St. Joseph's Health Centre, Toronto, Ont
| | - E H Spratt
- Division of Thoracic Surgery, Department of Surgery, University of Toronto, St. Joseph's Health Centre, Toronto, Ont
| | - C G Compeau
- Division of Thoracic Surgery, Department of Surgery, University of Toronto, St. Joseph's Health Centre, Toronto, Ont
| | - Y Shargall
- Division of Thoracic Surgery, Department of Surgery, University of Toronto, St. Joseph's Health Centre, Toronto, Ont
| | - H Lara-Guerra
- Departments of Thoracic Surgery, Medical Oncology, Laboratory Medicine, Diagnostic Imaging, University Health Network, University of Toronto, Toronto, Ont
| | - N Leighl
- Departments of Thoracic Surgery, Medical Oncology, Laboratory Medicine, Diagnostic Imaging, University Health Network, University of Toronto, Toronto, Ont
| | - A Salvarrey
- Departments of Thoracic Surgery, Medical Oncology, Laboratory Medicine, Diagnostic Imaging, University Health Network, University of Toronto, Toronto, Ont
| | - A Sakurada
- Departments of Thoracic Surgery, Medical Oncology, Laboratory Medicine, Diagnostic Imaging, University Health Network, University of Toronto, Toronto, Ont
| | - N Paul
- Departments of Thoracic Surgery, Medical Oncology, Laboratory Medicine, Diagnostic Imaging, University Health Network, University of Toronto, Toronto, Ont
| | - S Boerner
- Departments of Thoracic Surgery, Medical Oncology, Laboratory Medicine, Diagnostic Imaging, University Health Network, University of Toronto, Toronto, Ont
| | - W Geddie
- Departments of Thoracic Surgery, Medical Oncology, Laboratory Medicine, Diagnostic Imaging, University Health Network, University of Toronto, Toronto, Ont
| | - G Pond
- Departments of Thoracic Surgery, Medical Oncology, Laboratory Medicine, Diagnostic Imaging, University Health Network, University of Toronto, Toronto, Ont
| | - F A Shepherd
- Departments of Thoracic Surgery, Medical Oncology, Laboratory Medicine, Diagnostic Imaging, University Health Network, University of Toronto, Toronto, Ont
| | - M S Tsao
- Departments of Thoracic Surgery, Medical Oncology, Laboratory Medicine, Diagnostic Imaging, University Health Network, University of Toronto, Toronto, Ont
| | - T K Waddell
- Departments of Thoracic Surgery, Medical Oncology, Laboratory Medicine, Diagnostic Imaging, University Health Network, University of Toronto, Toronto, Ont
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Harvey A, Zhang H, Nixon J, Brown CJ. Comparison of data extraction from standardized versus traditional narrative operative reports for database-related research and quality control. Surgery 2007; 141:708-14. [PMID: 17560246 DOI: 10.1016/j.surg.2007.01.022] [Citation(s) in RCA: 67] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2006] [Revised: 12/13/2006] [Accepted: 01/06/2007] [Indexed: 12/01/2022]
Abstract
BACKGROUND The purpose of this study was to compare the completeness and reproducibility of data extracted from a standardized operative report (SOR) with the non-standardized operative report (NSOR). METHODS Between July and December 2003, operative data were collected from all laparoscopic cholecystectomy procedures performed at the Peter Lougheed Centre Hospital. A standardized format for dictating laparoscopic cholecystectomy operative reports was introduced on October 1, 2003. Non-standardized operative reports dictated in the first 3 months of the study period were compared with SORs dictated in the final 3 months. Two physicians independently extracted data from each operative report into a surgical database. RESULTS During the study period, 221 cholecystectomy reports were analyzed (119 SOR and 102 NSOR). Completeness of data extraction for identifying variables (eg, patient name, age, and date of procedure) was similar in the 2 types of reports. However, most other operative and perioperative details were more completely reported in the SOR (95% to 100%) when compared to the NSOR (14% to 100% complete). Furthermore, interobserver agreement between 2 independent data extractors was better for the SOR than the NSOR (0.9972 vs 0.9809, P < .0001). CONCLUSIONS Standardized operative reports result in more complete and reliably interpretable operative data compared with NSORs.
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Affiliation(s)
- A Harvey
- Division of General Surgery, Peter Lougheed Center, Calgary, Canada
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Beaumont JC, Brown CJ, Sayer MDJ. Evaluation of techniques used in the assessment of subtidal epibiotic assemblage structure. Biofouling 2007; 23:343-56. [PMID: 17852069 DOI: 10.1080/08927010701492219] [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] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
A comparative study was carried out to evaluate the efficiency of a number of techniques commonly used for assessing the structure of subtidal epifaunal communities. Assessments were made of the epifaunal assemblages fouling two substrata: concrete and PVC plastic. Where possible, each technique was undertaken in three ways, namely, in situ underwater, in the laboratory and using image analysis on photographs taken in situ. Comparisons were also made of biomass estimates made on samples taken in situ and in the laboratory. All method and technique combinations assessed detected differences in the epibiotic communities associated with the two fouling substrata. Sampling in situ, in the laboratory and using image analysis gave similar estimates of percent cover. However, there were significant differences in measurements made for most taxa with respect to abundance and frequency counts depending on how the technique was carried out. Laboratory-based sampling of abundance and frequency counts and biomass determinations, rather than in situ or image-analysis based sampling, are recommended for use in future studies of epifaunal fouling.
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Affiliation(s)
- J C Beaumont
- Scottish Association for Marine Science, Dunstaffnage Marine Laboratory, Dunbeg, Oban, UK.
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Hyde TB, Dayan GH, Langidrik JR, Nandy R, Edwards R, Briand K, Konelios M, Marin M, Nguyen HQ, Khalifah AP, O'leary MJ, Williams NJ, Bellini WJ, Bi D, Brown CJ, Seward JF, Papania MJ. Measles outbreak in the Republic of the Marshall Islands, 2003. Int J Epidemiol 2005; 35:299-306. [PMID: 16299123 DOI: 10.1093/ije/dyi222] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Measles is a highly contagious viral infection. Measles transmission can be prevented through high population immunity (>or=95%) achieved by measles vaccination. In the Republic of the Marshall Islands (RMI), no measles cases were reported during 1989-2002; however, a large measles outbreak occurred in 2003. Reported 1-dose measles vaccine coverage among children aged 12-23 months varied widely (52-94%) between 1990 and 2000. METHODS RMI is a Pacific island nation (1999 population: 50,840). A measles case was defined as fever, rash, and cough, or coryza, or conjunctivitis, in an RMI resident between July 13 and November 7, 2003. A vaccination campaign was used for outbreak control. RESULTS Of the 826 reported measles cases, 766 (92%) occurred in the capital (Majuro). There were 186 (23%) cases in infants aged <1 year and 309 (37%) of cases in persons aged >or=15 years. The attack rate was highest among infants (Majuro atoll: 213 cases/1,000 infants). Among cases aged 1-14 years, 281 (59%) reported no measles vaccination before July 2003. There were 100 hospitalizations and 3 deaths. The measles H1 genotype was identified. The vaccination campaign resulted in 93% coverage among persons aged 6 months to 40 years. Interpretation Populations without endemic measles transmission can accumulate substantial susceptibility and be at risk for large outbreaks when measles virus is imported. 'Islands' of measles susceptibility may develop in infants, adults, and any groups with low vaccine coverage. To prevent outbreaks, high population immunity must be sustained by maintaining and documenting high vaccine coverage.
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Affiliation(s)
- Terri B Hyde
- Viral Vaccine Preventable Diseases Branch, National Immunization Program, NIP, Centers for Disease Control and Prevention, CDC, Atlanta, GA 30333, USA.
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46
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Abstract
OBJECTIVES Our objectives were the following: (1) to describe the sociodemographic factors, vaccine beliefs, and behaviors that are associated with parental opposition to compulsory vaccination, and (2) to determine if the availability of a philosophical exemption in a parent's state of residence is associated with parental opposition to compulsory vaccination. METHODS Data from the 2002 HealthStyles survey were analyzed. Chi-square analysis was used to identify significant associations between belief and behavior questions and opposition to compulsory vaccination for school entry. Multivariate logistic regression was conducted using significant variables from the bivariate analysis to identify independent predictors of opposition to compulsory vaccination among surveyed parents. RESULTS Of respondents with at least one child aged < or = 18 years living in the household (n=1,527), 12% were opposed to compulsory vaccination. Survey results indicate that a parent's belief regarding compulsory vaccination for school entry is significantly associated with beliefs in the safety and utility of vaccines, as well as intention to have the youngest child fully vaccinated. Residence in a state that permits philosophical exemption to vaccination also was significantly associated with a parent's opposition to compulsory vaccination for school entry. CONCLUSIONS Providing basic information to parents regarding vaccines and vaccine-preventable diseases may help reduce opposition to compulsory vaccination by reinforcing the safety and importance of routine childhood vaccinations.
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47
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Abstract
Non-random X-chromosome inactivation (XCI) has been associated with X-linked diseases, neoplastic diseases, recurrent pregnancy loss, and trisomy risk. It also occurs more commonly in older female populations. To understand the etiology of non-random XCI and utilize this assay appropriately in clinical research and practice, the age-related alteration in XCI patterns in normal females needs to be clearly defined. In the present study, we evaluated the XCI status in 350 unselected women aged 0-88 years with unknown history of genetic disorders or abnormal pregnancies. DNA samples were extracted from peripheral blood and analyzed by a methylation-based assay at the androgen receptor locus. A weak but significant positive correlation was observed between age and degree of skewing in XCI over the whole age range (r = 0.23, p < 0.0001), and skewing values become non-normally distributed at older ages. However, the increase in skewed XCI appears to be more pronounced after age 30 than at younger ages. This trend supports the model of increased skewing with age as a consequence of hematopoietic stem cell senescence. An alternative possibility is that there is allele-specific loss of methylation with time that results in the appearance of increased XCI skewing using a methylation-based assay.
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Affiliation(s)
- C Hatakeyama
- Department of Medical Genetics, University of British Columbia, Vancouver, BC, Canada
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Abstract
OBJECTIVE To investigate the structural integrity of intramedullary nails with two lag screws, and to give guidance to orthopaedic surgeons in the choice of appropriate devices. DESIGN Alternative designs of the construct are considered, and the use of a slotted upper lag screw insertion hole is analysed. BACKGROUND Intramedullary fixation devices with a single lag screw have been known to fail at the lag screw insertion hole. Using two lag screws is considered. It has also been proposed to use a slot in the nail for the upper lag screw to prevent the upper lag screw from sticking. METHODS Bending and torsion load cases are analysed using finite element method. Consideration of both load conditions is essential. RESULTS The results present the overall stiffness of the assembly, the load sharing between lag screws, and the possibility for cut-out to occur. CONCLUSIONS While the slot for the upper lag screw might be advantageous with regard to the stresses in the lag screws, it could be detrimental for cut-out occurring adjacent to the lag screws. RELEVANCE Comparative analyses demonstrate that two lag screws may be advantageous in patients whose cancellous bone quality is good and who impose large loads on the lag screw/nail interface. However, the use of two screws might pre-dispose to failure by cut-out of the lag screws. The addition of a slotted hole for the upper lag screw appears to do nothing significant to reduce the risk of such a failure.
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Affiliation(s)
- C J Brown
- Department of Mechanical Engineering, Brunel University, Uxbridge, UB8 3PH, UK.
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Chow JC, Hall LL, Lawrence JB, Brown CJ. Ectopic XIST transcripts in human somatic cells show variable expression and localization. Cytogenet Genome Res 2004; 99:92-8. [PMID: 12900550 DOI: 10.1159/000071579] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2003] [Accepted: 02/06/2003] [Indexed: 11/19/2022] Open
Abstract
XIST encodes a functional RNA that is expressed exclusively from the inactive X in female mammals and is required for the silencing of most of the genes on the chromosome. XIST transcripts remain in the nucleus, and their specific localization to the inactive X is important for silencing; however, it is not known how these transcripts localize to the inactive X chromosome. Expression of mouse and human XIST from ectopic sites has suggested that localization to the chromosome from which the gene is expressed may be dependent upon either the copy number of the integrated constructs or the level of ectopic XIST expression. To further examine the behavior of XIST transgenes when expressed from ectopic sites, we introduced an XIST-containing PAC into the human male somatic cell line HT-1080. In five different transformant clones, the degree of localization and associated DNA condensation of the surrounding chromatin varied within nuclei of the same clone, as well as among different clones. Comparing the number of integrated transgenes and the levels of XIST expression revealed that neither factor was sufficient for a tight localization of the XIST signal. Therefore, the extent of expression and localization of XIST transcripts from ectopic transgenes is likely dependent upon many interacting factors, including the number of integrated transgenes, the level of XIST expression, and the site of integration.
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Affiliation(s)
- J C Chow
- Department of Medical Genetics, University of British Columbia, Vancouver, BC, Canada
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Abstract
Compensating for the dosage difference in X-linked genes between male and female mammals involves the formation of an extremely stable heterochromatin structure on one of the two X chromosomes in females. The inactive X acquires numerous features of silent chromatin, including the expression of a noncoding RNA, a switch to late replication, histone modifications, recruitment of the histone variant macroH2A and DNA hypermethylation. Although the induction of inactivation in differentiating mouse embryonic stem cells suggests that the onset of each of these features appears to occur in a sequential manner, it is likely that there is a much more complex interplay between the different features which leads to the extremely stable silencing observed in female somatic cells. Expression of the untranslated RNA, XIST, is required in cis for the establishment of the heterochromatic state. Recent results have started to elucidate how expression of Xist is controlled, including the role of the antisense transcript Tsix.
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Affiliation(s)
- J C Chow
- Department of Medical Genetics, University of British Columbia, 6174 University Blvd., Vancouver, British Columbia, Canada
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