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Mirnezami AH, Drami I, Glyn T, Sutton PA, Tiernan J, Behrenbruch C, Guerra G, Waters PS, Woodward N, Applin S, Charles SJ, Rose SA, Denys A, Pape E, van Ramshorst GH, Baker D, Bignall E, Blair I, Davis P, Edwards T, Jackson K, Leendertse PG, Love-Mott E, MacKenzie L, Martens F, Meredith D, Nettleton SE, Trotman MP, van Hecke JJM, Weemaes AMJ, Abecasis N, Angenete E, Aziz O, Bacalbasa N, Barton D, Baseckas G, Beggs A, Brown K, Buchwald P, Burling D, Burns E, Caycedo-Marulanda A, Chang GJ, Coyne PE, Croner RS, Daniels IR, Denost QD, Drozdov E, Eglinton T, Espín-Basany E, Evans MD, Flatmark K, Folkesson J, Frizelle FA, Gallego MA, Gil-Moreno A, Goffredo P, Griffiths B, Gwenaël F, Harris DA, Iversen LH, Kandaswamy GV, Kazi M, Kelly ME, Kokelaar R, Kusters M, Langheinrich MC, Larach T, Lydrup ML, Lyons A, Mann C, McDermott FD, Monson JRT, Neeff H, Negoi I, Ng JL, Nicolaou M, Palmer G, Parnaby C, Pellino G, Peterson AC, Quyn A, Rogers A, Rothbarth J, Abu Saadeh F, Saklani A, Sammour T, Sayyed R, Smart NJ, Smith T, Sorrentino L, Steele SR, Stitzenberg K, Taylor C, Teras J, Thanapal MR, Thorgersen E, Vasquez-Jimenez W, Waller J, Weber K, Wolthuis A, Winter DC, Brangan G, Vimalachandran D, Aalbers AGJ, Abdul Aziz N, Abraham-Nordling M, Akiyoshi T, Alahmadi R, Alberda W, Albert M, Andric M, Angeles M, Antoniou A, Armitage J, Auer R, Austin KK, Aytac E, Baker RP, Bali M, Baransi S, Bebington B, Bedford M, Bednarski BK, Beets GL, Berg PL, Bergzoll C, Biondo S, Boyle K, Bordeianou L, Brecelj E, Bremers AB, Brunner M, Bui A, Burgess A, Burger JWA, Campain N, Carvalhal S, Castro L, Ceelen W, Chan KKL, Chew MH, Chok AK, Chong P, Christensen HK, Clouston H, Collins D, Colquhoun AJ, Constantinides J, Corr A, Coscia M, Cosimelli M, Cotsoglou C, Damjanovic L, Davies M, Davies RJ, Delaney CP, de Wilt JHW, Deutsch C, Dietz D, Domingo S, Dozois EJ, Duff M, Egger E, Enrique-Navascues JM, Espín-Basany E, Eyjólfsdóttir B, Fahy M, Fearnhead NS, Fichtner-Feigl S, Fleming F, Flor B, Foskett K, Funder J, García-Granero E, García-Sabrido JL, Gargiulo M, Gava VG, Gentilini L, George ML, George V, Georgiou P, Ghosh A, Ghouti L, Giner F, Ginther N, Glover T, Golda T, Gomez CM, Harris C, Hagemans JAW, Hanchanale V, Harji DP, Helbren C, Helewa RM, Hellawell G, Heriot AG, Hochman D, Hohenberger W, Holm T, Holmström A, Hompes R, Hornung B, Hurton S, Hyun E, Ito M, Jenkins JT, Jourand K, Kaffenberger S, Kapur S, Kanemitsu Y, Kaufman M, Kelley SR, Keller DS, Kersting S, Ketelaers SHJ, Khan MS, Khaw J, Kim H, Kim HJ, Kiran R, Koh CE, Kok NFM, Kontovounisios C, Kose F, Koutra M, Kraft M, Kristensen HØ, Kumar S, Lago V, Lakkis Z, Lampe B, Larsen SG, Larson DW, Law WL, Laurberg S, Lee PJ, Limbert M, Loria A, Lynch AC, Mackintosh M, Mantyh C, Mathis KL, Margues CFS, Martinez A, Martling A, Meijerink WJHJ, Merchea A, Merkel S, Mehta AM, McArthur DR, McCormick JJ, McGrath JS, McPhee A, Maciel J, Malde S, Manfredelli S, Mikalauskas S, Modest D, Morton JR, Mullaney TG, Navarro AS, Neto JWM, Nguyen B, Nielsen MB, Nieuwenhuijzen GAP, Nilsson PJ, Nordkamp S, O’Dwyer ST, Paarnio K, Pappou E, Park J, Patsouras D, Peacock O, Pfeffer F, Piqeur F, Pinson J, Poggioli G, Proud D, Quinn M, Oliver A, Radwan RW, Rajendran N, Rao C, Rasheed S, Rasmussen PC, Rausa E, Regenbogen SE, Reims HM, Renehan A, Rintala J, Rocha R, Rochester M, Rohila J, Rottoli M, Roxburgh C, Rutten HJT, Safar B, Sagar PM, Sahai A, Schizas AMP, Schwarzkopf E, Scripcariu D, Scripcariu V, Seifert G, Selvasekar C, Shaban M, Shaikh I, Shida D, Simpson A, Skeie-Jensen T, Smart P, Smith JJ, Solbakken AM, Solomon MJ, Sørensen MM, Spasojevic M, Steffens D, Stocchi L, Stylianides NA, Swartling T, Sumrien H, Swartking T, Takala H, Tan EJ, Taylor D, Tejedor P, Tekin A, Tekkis PP, Thaysen HV, Thurairaja R, Toh EL, Tsarkov P, Tolenaar J, Tsukada Y, Tsukamoto S, Tuech JJ, Turner G, Turner WH, Tuynman JB, Valente M, van Rees J, van Zoggel D, Vásquez-Jiménez W, Verhoef C, Vierimaa M, Vizzielli G, Voogt ELK, Uehara K, Wakeman C, Warrier S, Wasmuth HH, Weiser MR, Westney OL, Wheeler JMD, Wild J, Wilson M, Yano H, Yip B, Yip J, Yoo RN, Zappa MA. The empty pelvis syndrome: a core data set from the PelvEx collaborative. Br J Surg 2024; 111:znae042. [PMID: 38456677 PMCID: PMC10921833 DOI: 10.1093/bjs/znae042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Accepted: 01/15/2024] [Indexed: 03/09/2024]
Abstract
BACKGROUND Empty pelvis syndrome (EPS) is a significant source of morbidity following pelvic exenteration (PE), but is undefined. EPS outcome reporting and descriptors of radicality of PE are inconsistent; therefore, the best approaches for prevention are unknown. To facilitate future research into EPS, the aim of this study is to define a measurable core outcome set, core descriptor set and written definition for EPS. Consensus on strategies to mitigate EPS was also explored. METHOD Three-stage consensus methodology was used: longlisting with systematic review, healthcare professional event, patient engagement, and Delphi-piloting; shortlisting with two rounds of modified Delphi; and a confirmatory stage using a modified nominal group technique. This included a selection of measurement instruments, and iterative generation of a written EPS definition. RESULTS One hundred and three and 119 participants took part in the modified Delphi and consensus meetings, respectively. This encompassed international patient and healthcare professional representation with multidisciplinary input. Seventy statements were longlisted, seven core outcomes (bowel obstruction, enteroperineal fistula, chronic perineal sinus, infected pelvic collection, bowel obstruction, morbidity from reconstruction, re-intervention, and quality of life), and four core descriptors (magnitude of surgery, radiotherapy-induced damage, methods of reconstruction, and changes in volume of pelvic dead space) reached consensus-where applicable, measurement of these outcomes and descriptors was defined. A written definition for EPS was agreed. CONCLUSIONS EPS is an area of unmet research and clinical need. This study provides an agreed definition and core data set for EPS to facilitate further research.
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Collins A, Collins D, Dhungyel O. The virulence of Dichelobacter nodosus, measured by the elastase test, is an important predictor for virulent footrot diagnosis in New South Wales sheep flocks. Aust Vet J 2023; 101:522-530. [PMID: 37794558 DOI: 10.1111/avj.13295] [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: 07/24/2022] [Revised: 09/11/2023] [Accepted: 09/25/2023] [Indexed: 10/06/2023]
Abstract
Ovine footrot is a contagious bacterial disease that causes foot lesions, and depending on the virulence of the causative strains, may lead to severe underrunning of the hoof and lameness. Virulent footrot can be identified, treated and controlled more effectively than less virulent benign forms. The in vitro elastase test for virulence of the causative bacteria, Dichelobacter nodosus, has been used to support clinical diagnosis. However, not all laboratory-designated virulent D. nodosus strains cause clinical signs of virulent footrot. This study evaluated retrospectively how well the elastase test supported clinical footrot diagnosis in 150 sheep flocks examined for suspect footrot in New South Wales between August 2020 and December 2021. Flocks were included if measures of clinical disease, environmental conditions and the virulence of D. nodosus isolates were available. Variation in the elastase activity result between D. nodosus isolated from the same flock made bacterial virulence hard to interpret, but calculating the mean elastase rate for all isolates from the same flock made correlations between bacterial virulence and flock footrot diagnosis possible. Simplifying bacterial virulence into whether there were any elastase-positive D. nodosus isolates before 12 days increased the predictive value of elastase results for virulent diagnosis, compared with using the first day that any isolate was elastase positive or the percentage of elastase-positive isolates by 12 days, but not all clinically virulent flocks had isolates with elastase activity before 12 days. Logistic regression models were fitted to identify the minimum number of predictors for virulent footrot diagnosis, with models suggesting that virulent footrot diagnosis was best predicted by adding the elastase test result and environmental conditions to the prevalence of severe foot lesions (score 4 and 5). However, performing the same analysis with different breeds, ages of sheep and seasons might highlight other factors important in the diagnosis of virulent footrot.
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Affiliation(s)
- A Collins
- New South Wales Department of Primary Industries, Elizabeth Macarthur Agricultural Institute, Menangle, New South Wales, 2568, Australia
| | - D Collins
- New South Wales Department of Primary Industries, Elizabeth Macarthur Agricultural Institute, Menangle, New South Wales, 2568, Australia
| | - O Dhungyel
- Sydney School of Veterinary Science, Faculty of Science, The University of Sydney, Camden, New South Wales, 2570, Australia
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West CT, West MA, Mirnezami AH, Drami I, Denys A, Glyn T, Sutton PA, Tiernan J, Behrenbruch C, Guerra G, Waters PS, Woodward N, Applin S, Charles SJ, Rose SA, Pape E, van Ramshorst GH, Aalbers AGJ, Abdul AN, Abecasis N, Abraham-Nordling M, Akiyoshi T, Alahmadi R, Alberda W, Albert M, Andric M, Angeles M, Angenete E, Antoniou A, Armitage J, Auer R, Austin KK, Aytac E, Aziz O, Bacalbasa N, Baker RP, Bali M, Baransi S, Baseckas G, Bebington B, Bedford M, Bednarski BK, Beets GL, Berg PL, Bergzoll C, Biondo S, Boyle K, Bordeianou L, Brecelj E, Bremers AB, Brown K, Brunner M, Buchwald P, Bui A, Burgess A, Burger JWA, Burling D, Burns E, Campain N, Carvalhal S, Castro L, Caycedo-Marulanda A, Ceelen W, Chan KKL, Chang GJ, Chew MH, Chok AK, Chong P, Christensen HK, Clouston H, Collins D, Colquhoun AJ, Constantinides J, Corr A, Coscia M, Cosimelli M, Cotsoglou C, Coyne PE, Croner RS, Damjanovic L, Daniels IR, Davies M, Davies RJ, Delaney CP, de Wilt JHW, Denost QD, Deutsch C, Dietz D, Domingo S, Dozois EJ, Drozdov E, Duff M, Egger E, Eglinton T, Enrique-Navascues JM, Espín-Basany E, Evans MD, Eyjólfsdóttir B, Fahy M, Fearnhead NS, Fichtner-Feigl S, Flatmark K, Fleming F, Flor B, Folkesson J, Foskett K, Frizelle FA, Funder J, Gallego MA, García-Granero E, García-Sabrido JL, Gargiulo M, Gava VG, Gentilini L, George ML, George V, Georgiou P, Ghosh A, Ghouti L, Gil-Moreno A, Giner F, Ginther N, Glover T, Goffredo P, Golda T, Gomez CM, Griffiths B, Gwenaël F, Harris C, Harris DA, Hagemans JAW, Hanchanale V, Harji DP, Helbren C, Helewa RM, Hellawell G, Heriot AG, Hochman D, Hohenberger W, Holm T, Holmström A, Hompes R, Hornung B, Hurton S, Hyun E, Ito M, Iversen LH, Jenkins JT, Jourand K, Kaffenberger S, Kandaswamy GV, Kapur S, Kanemitsu Y, Kaufman M, Kazi M, Kelley SR, Keller DS, Kelly ME, Kersting S, Ketelaers SHJ, Khan MS, Khaw J, Kim H, Kim HJ, Kiran R, Koh CE, Kok NFM, Kokelaar R, Kontovounisios C, Kose F, Koutra M, Kraft M, Kristensen HØ, Kumar S, Kusters M, Lago V, Lakkis Z, Lampe B, Langheinrich MC, Larach T, Larsen SG, Larson DW, Law WL, Laurberg S, Lee PJ, Limbert M, Loria A, Lydrup ML, Lyons A, Lynch AC, Mackintosh M, Mann C, Mantyh C, Mathis KL, Margues CFS, Martinez A, Martling A, Meijerink WJHJ, Merchea A, Merkel S, Mehta AM, McArthur DR, McCormick JJ, McDermott FD, McGrath JS, McPhee A, Maciel J, Malde S, Manfredelli S, Mikalauskas S, Modest D, Monson JRT, Morton JR, Mullaney TG, Navarro AS, Neeff H, Negoi I, Neto JWM, Nguyen B, Nielsen MB, Nieuwenhuijzen GAP, Nilsson PJ, Nordkamp S, O’Dwyer ST, Paarnio K, Palmer G, Pappou E, Park J, Patsouras D, Peacock A, Pellino G, Peterson AC, Pfeffer F, Piqeur F, Pinson J, Poggioli G, Proud D, Quinn M, Oliver A, Quyn A, Radwan RW, Rajendran N, Rao C, Rasheed S, Rasmussen PC, Rausa E, Regenbogen SE, Reims HM, Renehan A, Rintala J, Rocha R, Rochester M, Rohila J, Rothbarth J, Rottoli M, Roxburgh C, Rutten HJT, Safar B, Sagar PM, Sahai A, Saklani A, Sammour T, Sayyed R, Schizas AMP, Schwarzkopf E, Scripcariu D, Scripcariu V, Seifert G, Selvasekar C, Shaban M, Shaikh I, Shida D, Simpson A, Skeie-Jensen T, Smart NJ, Smart P, Smith JJ, Smith T, Solbakken AM, Solomon MJ, Sørensen MM, Spasojevic M, Steele SR, Steffens D, Stitzenberg K, Stocchi L, Stylianides NA, Swartling T, Sumrien H, Swartking T, Takala H, Tan EJ, Taylor C, Taylor D, Tejedor P, Tekin A, Tekkis PP, Teras J, Thanapal MR, Thaysen HV, Thorgersen E, Thurairaja R, Toh EL, Tsarkov P, Tolenaar J, Tsukada Y, Tsukamoto S, Tuech JJ, Turner G, Turner WH, Tuynman JB, Valente M, van Rees J, van Zoggel D, Vásquez-Jiménez W, Verhoef C, Vierimaa M, Vizzielli G, Voogt ELK, Uehara K, Wakeman C, Warrier S, Wasmuth HH, Weber K, Weiser MR, Westney OL, Wheeler JMD, Wild J, Wilson M, Wolthuis A, Yano H, Yip B, Yip J, Yoo RN, Zappa MA, Winter DC. Empty pelvis syndrome: PelvEx Collaborative guideline proposal. Br J Surg 2023; 110:1730-1731. [PMID: 37757457 PMCID: PMC10805575 DOI: 10.1093/bjs/znad301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 08/22/2023] [Accepted: 08/28/2023] [Indexed: 09/29/2023]
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Schwartz M, Xue D, Collins D, Kauffman M, Dunbar M, Crowder K, Project DA, Ruple A. Big data from small animals: integrating multi-level environmental data into the Dog Aging Project. REV SCI TECH OIE 2023; 42:65-74. [PMID: 37232318 DOI: 10.20506/rst.42.3349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Environmental exposures can have large impacts on health outcomes. While many resources have been dedicated to understanding how humans are influenced by the environment, few efforts have been made to study the role of built and natural environmental features on animal health. The Dog Aging Project (DAP) is a longitudinal community science study of aging in companion dogs. Using a combination of owner-reported surveys and secondary sources linked through geocoded coordinates, DAP has captured home, yard and neighbourhood variables for over 40,000 dogs. The DAP environmental data set spans four domains: the physical and built environment; chemical environment and exposures; diet and exercise; and social environment and interactions. By combining biometric data, measures of cognitive function and behaviour, and medical records, DAP is attempting to use a big-data approach to transform the understanding of how the surrounding world affects the health of companion dogs. In this paper, the authors describe the data infrastructure developed to integrate and analyse multi-level environmental data that can be used to improve the understanding of canine co-morbidity and aging.
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Collins D, Crickmer M, Brolly K, Abrams D, Ritchie A, Milsom W. Epidemiology of Emergency Medical Search and Rescue in the North Shore Mountains of Vancouver, Canada, from 1995 to 2020. Wilderness Environ Med 2023; 34:55-62. [PMID: 36710126 DOI: 10.1016/j.wem.2022.11.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Revised: 09/28/2022] [Accepted: 11/03/2022] [Indexed: 01/30/2023]
Abstract
INTRODUCTION Little is known about the epidemiology of emergency medical search and rescue incidents globally. The purpose of this study was to describe the epidemiology of emergency medical search and rescue incidents in the North Shore Mountains of Vancouver, British Columbia, Canada. METHODS This was a retrospective review and descriptive analysis of search and rescue incident reports created by North Shore Rescue over a 25 y period from 1995 to 2019, inclusive. Incident reports were screened for inclusion against a priori criteria defining a medical callout. The National Advisory Committee of Aeronautics (NACA) severity score was used as a method to grade medical acuity of included subjects. RESULTS We included 906 subjects. Their median age was 35 y (interquartile range, 24-53), and 65% of subjects were men. Forty-one percent (n=371) of subjects were classified as non-trauma and 54% (n=489) as trauma. The top 3 activities were hiking (53%), biking (10%), and snow sports (10%). Forty-nine percent of incidents were classified as having a NACA score of ≥3. For subjects with trauma, the top 3 body regions were lower limb (52%), head (18%), and torso (12%). For subjects with non-traumatic conditions, the top 3 causes were mental health crises (25%), exposure (25%), and cardiovascular incidents (11%). CONCLUSIONS Half of the incidents were serious enough to require medical assessment at a hospital (NACA score ≥3). Given this medical acuity, there is a need for evidence-based guidelines and core training competencies for mountain medical search and rescue. Standardized core data sets and outcomes are needed to monitor quality of care over time.
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Affiliation(s)
- Dylan Collins
- Department of Emergency Medicine, University of British Columbia, Vancouver, British Columbia, Canada.
| | - Michael Crickmer
- Department of Emergency Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Kayla Brolly
- North Shore Rescue, North Vancouver, British Columbia, Canada
| | - Daniel Abrams
- Department of Emergency Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Alec Ritchie
- Department of Emergency Medicine, University of British Columbia, Vancouver, British Columbia, Canada; North Shore Rescue, North Vancouver, British Columbia, Canada
| | - William Milsom
- North Shore Rescue, North Vancouver, British Columbia, Canada; Department of Zoology, University of British Columbia, Vancouver, British Columbia, Canada
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Fahy MR, Kelly ME, Aalbers AGJ, Abdul Aziz N, Abecasis N, Abraham-Nordling M, Akiyoshi T, Alberda W, Albert M, Andric M, Angeles MA, Angenete E, Antoniou A, Auer R, Austin KK, Aytac E, Aziz O, Bacalbasa N, Baker RP, Bali M, Baransi S, Baseckas G, Bebington B, Bedford M, Bednarski BK, Beets GL, Berg PL, Bergzoll C, Beynon J, Biondo S, Boyle K, Bordeianou L, Brecelj E, Bremers AB, Brunner M, Buchwald P, Bui A, Burgess A, Burger JWA, Burling D, Burns E, Campain N, Carvalhal S, Castro L, Caycedo-Marulanda A, Ceelan W, Chan KKL, Chang GJ, Chang M, Chew MH, Chok AY, Chong P, Clouston H, Codd M, Collins D, Colquhoun AJ, Constantinides J, Corr A, Coscia M, Cosimelli M, Cotsoglou C, Coyne PE, Croner RS, Damjanovich L, Daniels IR, Davies M, Delaney CP, de Wilt JHW, Denost Q, Deutsch C, Dietz D, Domingo S, Dozois EJ, Drozdov E, Duff M, Eglinton T, Enriquez-Navascues JM, Espín-Basany E, Evans MD, Eyjólfsdóttir B, Fearnhead NS, Ferron G, Flatmark K, Fleming FJ, Flor B, Folkesson J, Frizelle FA, Funder J, Gallego MA, Gargiulo M, García-Granero E, García-Sabrido JL, Gargiulo M, Gava VG, Gentilini L, George ML, George V, Georgiou P, Ghosh A, Ghouti L, Gil-Moreno A, Giner F, Ginther DN, Glyn T, Glynn R, Golda T, Griffiths B, Harris DA, Hagemans JAW, Hanchanale V, Harji DP, Helewa RM, Hellawell G, Heriot AG, Hochman D, Hohenberger W, Holm T, Hompes R, Hornung B, Hurton S, Hyun E, Ito M, Iversen LH, Jenkins JT, Jourand K, Kaffenberger S, Kandaswamy GV, Kapur S, Kanemitsu Y, Kazi M, Kelley SR, Keller DS, Ketelaers SHJ, Khan MS, Kiran RP, Kim H, Kim HJ, Koh CE, Kok NFM, Kokelaar R, Kontovounisios C, Kose F, Koutra M, Kristensen HØ, Kroon HM, Kumar S, Kusters M, Lago V, Lampe B, Lakkis Z, Larach JT, Larkin JO, Larsen SG, Larson DW, Law WL, Lee PJ, Limbert M, Loria A, Lydrup ML, Lyons A, Lynch AC, Maciel J, Manfredelli S, Mann C, Mantyh C, Mathis KL, Marques CFS, Martinez A, Martling A, Mehigan BJ, Meijerink WJHJ, Merchea A, Merkel S, Mehta AM, Mikalauskas S, McArthur DR, McCormick JJ, McCormick P, McDermott FD, McGrath JS, Malde S, Mirnezami A, Monson JRT, Navarro AS, Negoi I, Neto JWM, Ng JL, Nguyen B, Nielsen MB, Nieuwenhuijzen GAP, Nilsson PJ, Nordkamp S, Nugent T, Oliver A, O’Dwyer ST, O’Sullivan NJ, Paarnio K, Palmer G, Pappou E, Park J, Patsouras D, Peacock O, Pellino G, Peterson AC, Pinson J, Poggioli G, Proud D, Quinn M, Quyn A, Rajendran N, Radwan RW, Rajendran N, Rao C, Rasheed S, Rausa E, Regenbogen SE, Reims HM, Renehan A, Rintala J, Rocha R, Rochester M, Rohila J, Rothbarth J, Rottoli M, Roxburgh C, Rutten HJT, Safar B, Sagar PM, Sahai A, Saklani A, Sammour T, Sayyed R, Schizas AMP, Schwarzkopf E, Scripcariu D, Scripcariu V, Selvasekar C, Shaikh I, Simpson A, Skeie-Jensen T, Smart NJ, Smart P, Smith JJ, Solbakken AM, Solomon MJ, Sørensen MM, Sorrentino L, Steele SR, Steffens D, Stitzenberg K, Stocchi L, Stylianides NA, Swartling T, Spasojevic M, Sumrien H, Sutton PA, Swartking T, Takala H, Tan EJ, Taylor C, Tekin A, Tekkis PP, Teras J, Thaysen HV, Thurairaja R, Thorgersen EB, Toh EL, Tsarkov P, Tsukada Y, Tsukamoto S, Tuech JJ, Turner WH, Tuynman JB, Valente M, van Ramshorst GH, van Zoggel D, Vasquez-Jimenez W, Vather R, Verhoef C, Vierimaa M, Vizzielli G, Voogt ELK, Uehara K, Urrejola G, Wakeman C, Warrier SK, Wasmuth HH, Waters PS, Weber K, Weiser MR, Wheeler JMD, Wild J, Williams A, Wilson M, Wolthuis A, Yano H, Yip B, Yip J, Yoo RN, Zappa MA, Winter DC. Minimum standards of pelvic exenterative practice: PelvEx Collaborative guideline. Br J Surg 2022; 109:1251-1263. [PMID: 36170347 DOI: 10.1093/bjs/znac317] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 07/18/2022] [Accepted: 08/18/2022] [Indexed: 12/31/2022]
Abstract
This document outlines the important aspects of caring for patients who have been diagnosed with advanced pelvic cancer. It is primarily aimed at those who are establishing a service that adequately caters to this patient group. The relevant literature has been summarized and an attempt made to simplify the approach to management of these complex cases.
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Conlon N, Roche S, O’Neill F, Meiller J, Browne A, Breen L, O’Driscoll L, Cremona M, Hennessy B, Crown J, Collins D. Neratinib plus dasatinib has pre-clinical efficacy against HER2-positive breast cancer. Eur J Cancer 2022. [DOI: 10.1016/s0959-8049(22)00974-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Carroll H, Broderick A, McCarthy O, Kennedy M, Bambury R, Power D, Collins D, Connolly R, Noonan S, Collins D, Cunningham E, O'Driscoll K, Nuzum D, Twomey K, O'Riordan A, O'Sullivan F, Roe C, O'Leary M, Lowney A, O'Reilly S. 1292P A review of in-hospital end-of-life care (EOLC) for oncology patients during the COVID-19 pandemic. Ann Oncol 2022. [PMCID: PMC9472553 DOI: 10.1016/j.annonc.2022.07.1424] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Collins D, McCarthy J, Mammone T, Pernodet N, Karaman-Jurukovska N. 439 Macrocystis pyrifera kelp ferment affects several factors for skin barrier function. J Invest Dermatol 2022. [DOI: 10.1016/j.jid.2022.05.448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Collins D. Preventing hospital readmission through better medication continuity after hospital discharge. BMJ Evid Based Med 2021; 26:e11. [PMID: 32796015 DOI: 10.1136/bmjebm-2020-111405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/03/2020] [Indexed: 11/04/2022]
Affiliation(s)
- Dylan Collins
- Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
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Killeen E, Doyle K, O'Toole R, Doran T, Collins D, Brewer L. 99 ASSESSMENT AND MANAGEMENT OF PAIN IN OLDER ADULTS WITH ACUTE FRACTURE ADMITTED UNDER AN ORTHOPAEDIC SERVICE. Age Ageing 2021. [DOI: 10.1093/ageing/afab219.99] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2023] Open
Abstract
Abstract
Background
Older adults with acute fractures often have suboptimal pain control, in particular those with cognitive impairment. Effective pain management improves rehabilitation engagement and earlier discharge from acute care. Our study aimed to evaluate pain management of older adults with acute fracture admitted under an orthopaedic service in a tertiary hospital.
Methods
Prospective review of patients over 65 years with an acute fracture admitted under an orthopaedic service. Review of chart, medication prescription and pain status. Data included type of fracture, comorbidities, cognitive status and analgesia prescribed. Data analysed using Excel.
Results
40 inpatients included. Median age 82 years (range 65-93 years), 70% female. 53% had cognitive impairment, ranging from mild to severe dementia. 75% had >5 regular medications pre-admission. 80% had >5 comorbidities.
Two-thirds (73%) had an acute hip fracture. Most (80%) inpatients had a surgical intervention, the remaining were managed conservatively.
Analgesia prescriptions included paracetamol for almost all patients (95%), non-steroidal anti-inflammatory drugs for 3 (8%) and regular opioids in only 3 (8%).
43% of patients reported pain at time of data collection. 13% had analgesia changed in the 24 hours beforehand. Pain adversely affected function in 205 and mobility in 28%.
2 patients were unable to verbalise pain however no pain scales or visual assessments were used.
Documentation of pain assessment was best by nurses (100%) followed by doctors (60%) and allied health professionals (40%).
Conclusion
Older adults with acute fracture are often multimorbid with cognitive impairment. This patient population are often untreated for pain with suboptimal pain assessment and analgesia review or prescriptions. Consequently we developed a pain policy for use on our orthopaedic service as a guide for effective pain assessment and management for older adults with acute fracture.
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Affiliation(s)
| | - K Doyle
- Beaumont Hospital , Dublin, Ireland
| | | | - T Doran
- Beaumont Hospital , Dublin, Ireland
| | | | - L Brewer
- Beaumont Hospital , Dublin, Ireland
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12
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Murphy B, Downey C, Flannery S, Daly T, Conway S, Gaffar M, Dawson P, Collins D, Kenny P, McCarthy T, Cashman J, Hurson C, O'Daly B, Quinlan J. 1235 A Multi-Site Review of Second Hip Fractures Across 6 Dublin Teaching Hospitals. Br J Surg 2021. [DOI: 10.1093/bjs/znab259.1034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Abstract
Introduction
Hip fractures are a common presentation to Irish hospitals with 3,701 hip fractures recorded by 16 hospitals in the Irish Hip Fracture Database (IHFD) in 2019. Second hip fractures (HF2) make up a significant proportion of hip fractures and represent an opportunity to prevent subsequent fragility fracture.
Method
Hip fracture datasheets from 2019 in six Dublin hospitals were analysed.
Results
1,284 hip fractures in total were recorded in 2019 in these six hospitals. 112 of these were second hip fractures (8.72%). 24.1% of patients had a HF2 in year 1 post their first hip fracture (HF1). 14.3% of patients had a HF2 in Year 2, 8% in Year 3, 8.9% in Year 4 and 6.3% in Year 5. 17.9% of patients had an HF2 at an unknown time in relation to their HF1. 57.6% of all patients with any hip fracture were started on bone protection medications (BPMs) during their admission. 18.9% continued a pre-admission prescription. 7% of all patients were previously assessed and determined not to require BPM. 6.9% of patients were awaiting outpatient department (OPD) assessment for bone protection. 8.6% had no assessment for bone protection conducted. Of all patients with an HF2, 48.2% were started on BPMs on admission with their HF2. 33% continued BPMs started pre-admission.
Discussion
In 2019, approximately 1 in 10 hip fractures were second hip fractures. Evidence suggests that fracture liaison services represent a viable, economic means of preventing second hip fractures to improve patient outcomes and reduce healthcare expenditure.
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Affiliation(s)
- B Murphy
- Department of Trauma & Orthopaedic Surgery, St. Vincent's University Hospital, Dublin, Ireland
| | - C Downey
- Department of Trauma & Orthopaedic Surgery, Tallaght University Hospital, Dublin, Ireland
| | - S Flannery
- Department of Trauma & Orthopaedic Surgery, Tallaght University Hospital, Dublin, Ireland
| | - T Daly
- Department of Trauma & Orthopaedic Surgery, Connolly Hospital, Dublin, Ireland
| | - S Conway
- Department of Trauma & Orthopaedic Surgery, Beaumont Hospital, Dublin, Ireland
| | - M Gaffar
- Department of Trauma & Orthopaedic Surgery, St James' Hospital, Dublin, Ireland
| | - P Dawson
- Department of Trauma & Orthopaedic Surgery, Mater Misericordiae Hospital, Dublin, Ireland
| | - D Collins
- Department of Trauma & Orthopaedic Surgery, Beaumont Hospital, Dublin, Ireland
| | - P Kenny
- Department of Trauma & Orthopaedic Surgery, Connolly Hospital, Dublin, Ireland
| | - T McCarthy
- Department of Trauma & Orthopaedic Surgery, St James' Hospital, Dublin, Ireland
| | - J Cashman
- Department of Trauma & Orthopaedic Surgery, Mater Misericordiae Hospital, Dublin, Ireland
| | - C Hurson
- Department of Trauma & Orthopaedic Surgery, St. Vincent's University Hospital, Dublin, Ireland
| | - B O'Daly
- Department of Trauma & Orthopaedic Surgery, Tallaght University Hospital, Dublin, Ireland
| | - J Quinlan
- Department of Trauma & Orthopaedic Surgery, Tallaght University Hospital, Dublin, Ireland
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13
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Geoghegan L, Harrison C, Collins D, Gardiner M, Rodrigues J. 1237 Optimising Outpatient Care After Paediatric Burns: The Development of a Chatbot To Identify Complications And Provide Clinical Advice. Br J Surg 2021. [DOI: 10.1093/bjs/znab258.046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Abstract
Aim
More than 6000 children require specialist care from one of fourteen regional burns services in England and Wales each year. Families often have to travel long distances and may not have access to specialist care with restricted services due to Covid-19. This quality improvement project aimed to:
Method
We conducted a national service evaluation of children’s burns services in England and Wales. We then conducted a PRISMA compliant systematic review up to September 2020 to identify studies reporting chatbot use to deliver outpatient care. A chatbot was then developed using Dialogflow to identify complications and provide advice to families.
Results
Across England and Wales, 11 children’s burns services reported outpatient practice: six services follow up all children at three months, three have variable follow-up and two discharge all patients. Our systematic review identified 10 studies reporting chatbot use although none were used following burns. A frame-based system-focused chatbot was developed in conjunction with expert burns surgeons and patient representatives.
Conclusions
Chatbots are effective and acceptable alternatives for in-person follow up. We demonstrate national variation in the provision of outpatient paediatric burn care and have developed a chatbot that can address clinical concerns and provide reassurance to patients and family members. Future studies will determine the acceptability and safety of this chatbot.
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Affiliation(s)
- L Geoghegan
- Section of Vascular Surgery, Department of Surgery and Cancer, Imperial College London, London, United Kingdom
| | - C Harrison
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, United Kingdom
| | - D Collins
- Department of Plastic, Reconstructive and Burns Surgery, Chelsea and Westminster Hospital., London, United Kingdom
| | - M Gardiner
- Department of Plastic and Reconstructive Surgery, Frimley Park Hospital., Guildford, United Kingdom
| | - J Rodrigues
- Department of Plastic and Reconstructive Surgery, Stoke Mandeville Hospital, Aylesbury, United Kingdom
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14
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Fadel M, Iskandarani M, Cuddihy J, Jones I, Collins D, Kontovounisios C. 593 Colonic Perforation Following Major Burns: A Systematic Review. Br J Surg 2021. [DOI: 10.1093/bjs/znab259.929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Abstract
Introduction
Major burns complicated by stress ulceration and perforation of the stomach or duodenum is a recognised clinical phenomenon. Colonic perforation in burns patients is seemingly uncommon, and the overall incidence, clinical signs/diagnosis of perforation, intervention required, and mortality is incompletely described in the literature.
Method
We performed a systematic review of the literature on severe burns resulting in colonic perforation during admission. Relevant studies from January 1975 to June 2020 were retrieved from MEDLINE and EMBASE databases. Patient demographics, total body surface area (TBSA), site of colonic perforation, management and overall outcome were extracted. We present a case series of five major burns patients who had colonic perforations in our Specialist Burns Centre.
Results
We identified 54 studies, of which nine (two case series and seven case reports) met the inclusion criteria. In most cases, the TBSA associated with a colonic perforation was ≥ 30% (10/16 patients, 63%) and the abdomen was involved in 9/16 patients (56%). Perforations mainly affected the right colon (12/16 patients, 75%), usually occurring after the second week of admission (13/16 patients, 81%). Right-sided colonic perforations were associated with an increased mortality rate compared to left-sided perforations (42% vs 25%).
Conclusions
The current literature, mainly limited to case series and case reports, confirms that colonic perforations in burns patients are rare. The resulting perforation is related to the systemic effect of burn injuries including sepsis and gastrointestinal stasis. We have identified patients who are at higher risk of developing colonic perforations in order to prompt early diagnosis and intervention.
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Affiliation(s)
- M Fadel
- Chelsea and Westminster Hospital, London, United Kingdom
| | - M Iskandarani
- Chelsea and Westminster Hospital, London, United Kingdom
| | - J Cuddihy
- Chelsea and Westminster Hospital, London, United Kingdom
| | - I Jones
- Chelsea and Westminster Hospital, London, United Kingdom
| | - D Collins
- Chelsea and Westminster Hospital, London, United Kingdom
| | - C Kontovounisios
- Chelsea and Westminster Hospital, London, United Kingdom
- Royal Marsden Hospital, London, United Kingdom
- Imperial College London, London, United Kingdom
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15
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Corallo K, Cassereau L, Collins D, Pernodet N. 244 Comprehensive Approach to Addressing Skin Inflammaging. J Invest Dermatol 2021. [DOI: 10.1016/j.jid.2021.08.249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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16
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Cassereau L, Corallo K, Collins D, Pernodet N. 376 Designing Formulation Systems to Ensure Efficient Delivery of Anti-Aging Actives to Skin for Boosted Efficacy. J Invest Dermatol 2021. [DOI: 10.1016/j.jid.2021.08.385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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17
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Graziose R, Collins D, Dog TL, Weil A, Schnittger S, Lee W, Green S, Pernodet N. LB738 Anti-inflammatory activity of traditionally used, bioactive mushrooms in skin. J Invest Dermatol 2021. [DOI: 10.1016/j.jid.2021.07.091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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18
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Geoghegan L, Scarborough A, Wormald JCR, Harrison CJ, Collins D, Gardiner M, Bruce J, Rodrigues JN. Automated conversational agents for post-intervention follow-up: a systematic review. BJS Open 2021; 5:zrab070. [PMID: 34323916 PMCID: PMC8320342 DOI: 10.1093/bjsopen/zrab070] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Accepted: 06/17/2021] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Advances in natural language processing and other machine learning techniques have led to the development of automated agents (chatbots) that mimic human conversation. These systems have mainly been used in commercial settings, and within medicine, for symptom checking and psychotherapy. The aim of this systematic review was to determine the acceptability and implementation success of chatbots in the follow-up of patients who have undergone a physical healthcare intervention. METHODS A systematic review of MEDLINE, MEDLINE In-process, EMBASE, PsychINFO, CINAHL, CENTRAL and the grey literature using a PRISMA-compliant methodology up to September 2020 was conducted. Abstract screening and data extraction were performed in duplicate. Risk of bias and quality assessments were performed for each study. RESULTS The search identified 904 studies of which 10 met full inclusion criteria: three randomised control trials, one non-randomised clinical trial and six cohort studies. Chatbots were used for monitoring after the management of cancer, hypertension and asthma, orthopaedic intervention, ureteroscopy and intervention for varicose veins. All chatbots were deployed on mobile devices. A number of metrics were identified and ranged from a 31 per cent chatbot engagement rate to a 97 per cent response rate for system-generated questions. No study examined patient safety. CONCLUSION A range of chatbot builds and uses was identified. Further investigation of acceptability, efficacy and mechanistic evaluation in outpatient care pathways may lend support to implementation in routine clinical care.
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Affiliation(s)
- L Geoghegan
- Section of Vascular Surgery, Department of Surgery and Cancer, Imperial College London, London, UK
| | - A Scarborough
- Department of Cardiothoracic Surgery, King’s College Hospital, London, UK
| | - J C R Wormald
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - C J Harrison
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - D Collins
- Department of Plastic, Reconstructive and Burns Surgery, Chelsea and Westminster Hospital, London, UK
| | - M Gardiner
- Department of Plastic and Reconstructive Surgery, Frimley Park Hospital, Guildford, UK
| | - J Bruce
- Warwick Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, UK
| | - J N Rodrigues
- Warwick Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, UK
- Department of Plastic and Reconstructive Surgery, Stoke Mandeville Hospital, Aylesbury, UK
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19
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Laatikainen T, Inglin L, Collins D, Ciobanu A, Curocichin G, Salaru V, Zatic T, Anisei A, Chiosa D, Munteanu M, Alexa Z, Farrington J. Implementing Package of Essential Non-communicable Disease Interventions in the Republic of Moldova-a feasibility study. Eur J Public Health 2021; 30:1146-1151. [PMID: 32298428 DOI: 10.1093/eurpub/ckaa037] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The aim of this study is to determine the feasibility of implementing and evaluating the World Health Organization Package of Essential Non-communicable Disease Interventions (WHO PEN) approach in primary healthcare in the Republic of Moldova. METHODS According to our published a priori methods, 20 primary care clinics were randomized to 10 intervention and 10 control clinics. The intervention consisted of implementation of adapted WHO PEN guidelines and structured training for health workers; the control clinics continued with usual care. Data were gathered from paper-based patient records in July 2017 and August 2018 resulting in a total of 1174 and 995 patients in intervention and control clinics at baseline and 1329 and 1256 at follow-up. Pre-defined indicators describing assessment of risk factors and total cardiovascular risk, prescribing medications and treatment outcomes were calculated. Differences between baseline and follow-up as well as between intervention and control clinics were calculated using logistic and linear regression models and by assessing interaction effects. RESULTS Improvements were seen in recording smoking status, activity to measure HbA1c among diabetes patients and achieving control in hypertension treatment. Improvement was also seen in identification of patients with hypertension or diabetes. Less improvement or even deterioration was seen in assessing total risk or prescribing statins for high-risk patients. CONCLUSIONS It is feasible to evaluate the quality and management of patients with non-communicable diseases in low-resource settings from routine data. Modest improvements in risk factor identification and management can be achieved in a relatively short period of time.
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Affiliation(s)
- Tiina Laatikainen
- Institute of Public Health and Clinical Nutrition, Faculty of Medicine, University of Eastern Finland, Kuopio, Finland.,Chronic Disease Prevention Unit, National Institute for Health and Welfare, Helsinki, Finland.,Join Municipal Authority for North Karelia Health and Social Services (Siun Sote), Joensuu, Finland
| | - Laura Inglin
- Institute of Public Health and Clinical Nutrition, Faculty of Medicine, University of Eastern Finland, Kuopio, Finland
| | - Dylan Collins
- Faculty of Medicine, University of British Columbia, Vancouver, Canada
| | - Angela Ciobanu
- Division of Ncds and Promoting Health through the Life Course, World Health Organization Regional Office for Europe, Copenhagen, Denmark
| | - Ghenadie Curocichin
- Department of Family Medicine, Nicolae Testemitanu State Medical and Pharmaceutical University, Chisinau, Republic of Moldova
| | - Virginia Salaru
- Department of Family Medicine, Nicolae Testemitanu State Medical and Pharmaceutical University, Chisinau, Republic of Moldova
| | - Tatiana Zatic
- Department of Primary, Emergency and Community Health Policies, Ministry of Health, Labour and Social Protection, Chisinau, Republic of Moldova
| | - Angela Anisei
- Department on Quality Management of Health Services, National Public Health Agency, Chisinau, Republic of Moldova
| | - Diana Chiosa
- Department of Family Medicine, Nicolae Testemitanu State Medical and Pharmaceutical University, Chisinau, Republic of Moldova
| | - Maria Munteanu
- Department of Family Medicine, Nicolae Testemitanu State Medical and Pharmaceutical University, Chisinau, Republic of Moldova
| | - Zinaida Alexa
- Department Endocrinology, Nicolae Testemitanu State Medical and Pharmaceutical University, Chisinau, Republic of Moldova
| | - Jill Farrington
- Division of Ncds and Promoting Health through the Life Course, World Health Organization Regional Office for Europe, Copenhagen, Denmark
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20
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Papamihali K, Collins D, Karamouzian M, Purssell R, Graham B, Buxton J. Crystal methamphetamine use in British Columbia, Canada: A cross-sectional study of people who access harm reduction services. PLoS One 2021; 16:e0252090. [PMID: 34038452 PMCID: PMC8153500 DOI: 10.1371/journal.pone.0252090] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2021] [Accepted: 05/09/2021] [Indexed: 01/18/2023] Open
Abstract
INTRODUCTION Increased use of crystal methamphetamine ("crystal meth") has been observed across North America and international jurisdictions, including a notable increase in the presence of methamphetamines in illicit drug toxicity deaths in British Columbia (BC), Canada. We used data from a cross-sectional survey and urine toxicology screening to report the prevalence, correlates, and validity of self-reported crystal meth use among clients of harm reduction sites in BC. MATERIALS AND METHODS Survey data were collected from 1,107 participants across 25 communities in BC, through the 2018 and 2019 Harm Reduction Client Survey. We described reported substance use and used a multivariate logistic regression model to characterize crystal meth use. Urine samples provided by a subset of participants were used to derive validity of self-reported three-day crystal meth use compared to urine toxicology screening. RESULTS Excluding tobacco, crystal meth was the most frequently reported substance used in the past three days in 2018 and 2019 (59.7% and 71.7%, respectively). Smoking was the dominant route of administration for crystal meth, crack, heroin, and fentanyl. Multivariate analysis determined significantly higher odds of crystal meth use among those who used opioids (Adjusted Odds Ratio [AOR] = 3.13), cannabis (AOR = 2.10), and alcohol (1.41), and among those who were not regularly housed (AOR = 2.08) and unemployed (AOR = 1.75). Age ≥50 was inversely associated with crystal meth use (AOR = 0.63). Sensitivity of self-reported crystal meth use was 86%, specificity was 86%, positive predictive value was 96%, and negative predictive value was 65%. CONCLUSIONS Crystal meth was the most commonly used substance among clients of harm reduction sites in BC in 2018 and 2019, and was frequently used concurrently with opioids. Comparison to urine samples demonstrated high validity of self-reported crystal meth use. Understanding evolving patterns of substance use will be imperative in tailoring harm reduction and substance use services for individuals that use crystal meth.
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Affiliation(s)
- Kristi Papamihali
- British Columbia Centre for Disease Control, Vancouver, British Columbia, Canada
| | - Dylan Collins
- Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Mohammad Karamouzian
- School of Population and Public Health, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
- HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Roy Purssell
- British Columbia Centre for Disease Control, Vancouver, British Columbia, Canada
- Department of Emergency Medicine, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
- British Columbia Drug and Poison Information Centre, Vancouver, British Columbia, Canada
| | - Brittany Graham
- British Columbia Centre for Disease Control, Vancouver, British Columbia, Canada
| | - Jane Buxton
- British Columbia Centre for Disease Control, Vancouver, British Columbia, Canada
- School of Population and Public Health, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
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21
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Collins D, Inglin L, Laatikainen T, Shoismatuloeva M, Sultonova D, Jonova B, Faromuzova K, Abdullaeva M, Otambekova M, Farrington JL. Evaluation and pilot implementation of essential interventions for the management of hypertension and prevention of cardiovascular diseases in primary health care in the Republic of Tajikistan. BMC Health Serv Res 2021; 21:472. [PMID: 34006266 PMCID: PMC8132349 DOI: 10.1186/s12913-021-06490-5] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2020] [Accepted: 05/06/2021] [Indexed: 12/02/2022] Open
Abstract
Background The aim of this study was to determine the feasibility of implementing and evaluating essential interventions for the management of hypertension and prevention of cardiovascular disease in primary healthcare in Tajikistan. Methods The study protocol was published a priori. A pragmatic, sequential, mixed methods explanatory design was piloted. The quantitative strand is reported here. All primary health care facilities that met inclusion criteria in Shahrinav district were included and computer randomized to either usual care or intervention. The intervention consisted of: adaptation of WHO PEN/HEARTS clinical algorithms for hypertension and diabetes, a two-day training of doctors and nurses, supportive supervision visits, clinical decision support tools, and quality improvement support. Data were collected from paper-based clinical records at baseline and 12 months follow-up. The primary outcome was blood pressure control among patients with hypertension, in addition to several secondary process indicators along the care pathway. Age and sex adjusted logistic regression models were used for intervention and control clinics to determine changes between baseline and follow-up and to assess interactions between allocation group and time. For continuous variables, multivariate linear regression models were used. Results 19 primary health care centres were included of which ten were randomized to intervention and nine to control. 120 clinicians received training. The records of all registered hypertensive patients were reviewed at baseline and follow-up for a total of 1,085 patient records. Blood pressure control significantly improved in the intervention clinics (OR 3.556, 95 % CI 2.219, 5.696) but not the control clinics (OR 0.644, 95 % CI 0.370, 1.121) (p < 0.001 for interaction). Smoking assessment, statin prescribing, triple therapy prescribing, and blood pressure measurement significantly improved in intervention clinics relative to control, whereas cholesterol and glucose testing, and aspirin prescribing did not. Conclusions It is feasible to use routine, paper-based, clinical records to evaluate essential CVD interventions in primary health care in Tajikistan. Adapted WHO PEN/HEARTS guidelines in the context of a complex intervention significantly improved blood pressure control after 12 months.
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Affiliation(s)
| | - Laura Inglin
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | - Tiina Laatikainen
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland.,Finnish Institute for Health and Welfare, Helsinki, Finland.,Joint municipal authority for North Karelia Health and Social Services, Joensuu, Finland
| | | | - Dilorom Sultonova
- Service of State Supervision for Medical Activities and Social Protection of the Population of the Republic of Tajikistan, Dushanbe, Tajikistan
| | - Bunafsha Jonova
- Republican Clinical and Training Centre of Family Medicine, Dushanbe, Tajikistan
| | - Katoyon Faromuzova
- Department of Epidemiology and Health Economics of the Faculty of Medicine, Tajik State University, Dushanbe, Tajikistan.,Public Health, Faculty of Medicine, Social Hygiene and Health Organization, Tajik State University, Dushanbe, Tajikistan
| | | | | | - Jill L Farrington
- World Health Organization Regional Office for Europe, Copenhagen, Denmark
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22
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Keren B, Voll J, Herewini A, Paranawidana R, Prasad J, Collins D. 482 New Zealand Rural Hospital Junior Doctor General Surgery Guidelines for Emergency Department (ED): every little helps. Br J Surg 2021. [DOI: 10.1093/bjs/znab134.432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Abstract
Introduction
Clinical guidelines are associated with improved patient outcomes. This is especially true for junior staff members with little clinical experience. We created Pocket Guidelines for the management of surgical patients in ED, aimed at house officers.
Method
Seventeen common surgical conditions were selected for guidelines. Information was collated on presentation, exam findings, differential diagnosis, laboratory tests, imaging, indications for referral, and timing. Evidence based guidelines were approved by General Surgical consultants in the department. The utility of our guidelines was assessed by surveying 20 junior doctors.
Results
16 out of 20 house officers responded to the survey, ranging from post graduate year (PGY) 1 to 4, majority of them (37.5%) being PGY1. 69% were female and 31% were male.
A 5- point Likert scale was utilised for answers. No house officers ‘strongly agreed’ with being confident in managing surgical conditions in ED. Over 80% strongly agreed with the need to have ED clinical guidelines for surgical patients. Over 90% of house officers, having studied the pocket guidelines, found these useful.
Conclusions
We implemented pocket guidelines for general surgery in a rural hospital ED to streamline surgical admissions. Guidelines were found to be beneficial by the majority of junior doctors.
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Affiliation(s)
- B Keren
- Bay of Plenty District Health Board, Whakatane, New Zealand
| | - J Voll
- Bay of Plenty District Health Board, Whakatane, New Zealand
| | - A Herewini
- Bay of Plenty District Health Board, Whakatane, New Zealand
| | - R Paranawidana
- Bay of Plenty District Health Board, Whakatane, New Zealand
- Royal Australasian College of Surgeons, Melbourne, Australia
| | - J Prasad
- Bay of Plenty District Health Board, Whakatane, New Zealand
- Royal Australasian College of Surgeons, Melbourne, Australia
| | - D Collins
- Bay of Plenty District Health Board, Whakatane, New Zealand
- Royal Australasian College of Surgeons, Melbourne, Australia
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23
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Mclaughlin R, O'Reilly D, Ronayne C, Barrett E, Kalachand R, De Frein A, Macanovic B, Connolly R, Power D, Bambury R, Reilly S, Collins D. 152P Analysis of patient access to breast cancer drugs in the USA and Europe with a focus on the UK and Ireland. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.03.166] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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24
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Alfano H, Collins D. Good practice in sport science and medicine support: practitioners’ perspectives on quality, pressure and support. Managing Sport and Leisure 2021. [DOI: 10.1080/23750472.2021.1918019] [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: 10/21/2022]
Affiliation(s)
- H. Alfano
- Moray House School of Education, University of Edinburgh, Edinburgh, UK
| | - D. Collins
- Moray House School of Education, University of Edinburgh, Edinburgh, UK
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Laatikainen T, Dumcheva A, Kiriazova T, Zeziulin O, Inglin L, Collins D, Farrington J. Capacity building of health care professionals to perform interprofessional management of non-communicable diseases in primary care - experiences from Ukraine. BMC Health Serv Res 2021; 21:91. [PMID: 33499868 PMCID: PMC7839221 DOI: 10.1186/s12913-021-06068-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Accepted: 01/09/2021] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Non-communicable diseases are leading causes of death and disability across the world. Countries with the highest non-communicable disease (NCD) burden in the WHO European Region are often those that have some of the greatest health system challenges for achieving good outcomes in prevention and care. The aim of this study was to evaluate the effect of an interprofessional capacity building intervention carried out in Ukraine to improve the management non-communicable diseases in primary health care. METHODS A mixed-methods evaluation study was performed in 2018 to analyse the effect of a capacity building intervention carried out for over 10,000 primary care professionals in Ukraine in 2018. Quantitative data were collected from primary health care records of intervention and control areas preceding the intervention and 1.5 to 2 years after the intervention. Altogether 2798 patient records before and 2795 after the intervention were reviewed. In control areas, 1202 patient records were reviewed. Qualitative data were collected carrying out focus group interviews for health professionals, clinic managers and patients. Also, observations of clinical practice and patient pathways were performed. RESULTS The capacity building intervention improved the capacity of professionals in detection and management of non-communicable disease risk factors. Significant improvement was seen in detection rates of both behavioural and biological risk factors and in medication prescription rates in the intervention areas. However, almost similar improvement in prescription rates was also observed in control clinics. Improvements in control of blood pressure, blood glucose and cholesterol were not seen during the evaluated implementation period. Qualitative analyses highlighted the improved knowledge and skills but challenges in changing the current practice. CONCLUSIONS A large scale capacity building intervention improved primary health care professionals' knowledge, skills and clinical practice on NCD risk detection and reduction. We were not able to detect improvements in treatment outcomes - at least within 1.5 to 2 years follow-up. Improvement of treatment outcomes would most likely need more comprehensive systems change.
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Affiliation(s)
- Tiina Laatikainen
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland.
- Finnish Institute for Health and Welfare, Mannerheimintie 166, 00300, Helsinki, Finland.
- Joint municipal authority for North Karelia health and social services (Siun sote), Joensuu, Finland.
| | | | | | | | - Laura Inglin
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | | | - Jill Farrington
- World Health Organization Regional Office for Europe, Copenhagen, Denmark
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Lim S, Collins D, Riley T. Environmental sources of Clostridioides (Clostridium) difficile in the hospital. Int J Infect Dis 2020. [DOI: 10.1016/j.ijid.2020.09.720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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Collins D, Riley T. Investigation of community-associated Clostridium (Clostridioides) difficile infections in the Asia-Pacific region. Int J Infect Dis 2020. [DOI: 10.1016/j.ijid.2020.09.717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Lim S, Collins D, Riley T. Evaluation of peracetic acid sporicidal wipes in removing Clostridioides (Clostridium) difficile spores from rubber surfaces. Int J Infect Dis 2020. [DOI: 10.1016/j.ijid.2020.09.814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Borisov A, Khan M, Mudaliar S, Chakrabarti S, Collins D, Shaipanich T, Wilson D, Ignaszewski A, Toma M. CLINICAL CHARACTERISTICS OF PATIENTS WITH SUSPECTED AND CONFIRMED CARDIAC SARCOIDOSIS REFERRED TO A SPECIALIZED CLINIC. Can J Cardiol 2020. [DOI: 10.1016/j.cjca.2020.07.127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Davies A, Teare L, Falder S, Dumville J, Shah M, Jenkins A, Collins D, Dheansa B, Coy K, Booth S, Moore L, Marlow K, Agha R, Young A. Consensus demonstrates four indicators needed to standardize burn wound infection reporting across trials in a single-country study (ICon-B study). J Hosp Infect 2020; 106:217-225. [DOI: 10.1016/j.jhin.2020.07.022] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2020] [Accepted: 07/22/2020] [Indexed: 01/10/2023]
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Saha M, D'Cruz A, Paul N, Healy R, Collins D, Charles DA, Sahu S, Fonia A. Toxic epidermal necrolysis and co-existent SARS-CoV-2 (COVID-19) treated with intravenous immunoglobulin: 'Killing 2 birds with one stone'. J Eur Acad Dermatol Venereol 2020; 35:e97-e98. [PMID: 32805059 PMCID: PMC7461446 DOI: 10.1111/jdv.16887] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Revised: 07/29/2020] [Accepted: 08/11/2020] [Indexed: 01/10/2023]
Affiliation(s)
- M Saha
- Queen Elizabeth Hospital, Lewisham and Greenwich NHS Trust, London, UK
| | - A D'Cruz
- Queen Elizabeth Hospital, Lewisham and Greenwich NHS Trust, London, UK
| | - N Paul
- Queen Elizabeth Hospital, Lewisham and Greenwich NHS Trust, London, UK
| | - R Healy
- Queen Elizabeth Hospital, Lewisham and Greenwich NHS Trust, London, UK
| | - D Collins
- Queen Elizabeth Hospital, Lewisham and Greenwich NHS Trust, London, UK
| | - D-A Charles
- Queen Elizabeth Hospital, Lewisham and Greenwich NHS Trust, London, UK
| | - S Sahu
- Queen Elizabeth Hospital, Lewisham and Greenwich NHS Trust, London, UK
| | - A Fonia
- Queen Elizabeth Hospital, Lewisham and Greenwich NHS Trust, London, UK
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Kelly ME, Aalbers AGJ, Abdul Aziz N, Abecasis N, Abraham‐Nordling M, Akiyoshi T, Alberda W, Albert M, Andric M, Angenete E, Antoniou A, Auer R, Austin KK, Aziz O, Baker RP, Bali M, Baseckas G, Bebington B, Bednarski BK, Beets GL, Berg PL, Beynon J, Biondo S, Boyle K, Bordeianou L, Bremers AB, Brunner M, Buchwald P, Bui A, Burgess A, Burger JWA, Burling D, Burns E, Campain N, Carvalhal S, Castro L, Caycedo‐Marulanda A, Chan KKL, Chang GJ, Chew MH, Chong PC, Christensen HK, Clouston H, Codd M, Collins D, Colquhoun A, Corr A, Coscia M, Coyne PE, Creavin B, Croner RS, Damjanovic L, Daniels IR, Davies M, Davies RJ, Delaney CP, Denost Q, Deutsch C, Dietz D, Domingo S, Dozois EJ, Duff M, Eglinton T, Enrique‐Navascues JM, Espin‐Basany E, Evans MD, Fearnhead NS, Flatmark K, Fleming F, Frizelle FA, Gallego MA, Garcia‐Granero E, Garcia‐Sabrido JL, Gentilini L, George ML, Ghouti L, Giner F, Ginther N, Glynn R, Golda T, Griffiths B, Harris DA, Hagemans JAW, Hanchanale V, Harji DP, Helewa RM, Heriot AG, Hochman D, Hohenberger W, Holm T, Hompes R, Jenkins JT, Kaffenberger S, Kandaswamy GV, Kapur S, Kanemitsu Y, Kelley SR, Keller DS, Khan MS, Kiran RP, Kim H, Kim HJ, Koh CE, Kok NFM, Kokelaar R, Kontovounisios C, Kristensen HØ, Kroon HM, Kusters M, Lago V, Larsen SG, Larson DW, Law WL, Laurberg S, Lee PJ, Limbert M, Lydrup ML, Lyons A, Lynch AC, Mantyh C, Mathis KL, Margues CFS, Martling A, Meijerink WJHJ, Merkel S, Mehta AM, McArthur DR, McDermott FD, McGrath JS, Malde S, Mirnezami A, Monson JRT, Morton JR, Mullaney TG, Negoi I, Neto JWM, Nguyen B, Nielsen MB, Nieuwenhuijzen GAP, Nilsson PJ, O’Connell PR, O’Dwyer ST, Palmer G, Pappou E, Park J, Patsouras D, Pellino G, Peterson AC, Poggioli G, Proud D, Quinn M, Quyn A, Radwan RW, van Ramshorst GH, Rasheed S, Rasmussen PC, Regenbogen SE, Renehan A, Rocha R, Rochester M, Rohila J, Rothbarth J, Rottoli M, Roxburgh C, Rutten HJT, Ryan ÉJ, Safar B, Sagar PM, Sahai A, Saklani A, Sammour T, Sayyed R, Schizas AMP, Schwarzkopf E, Scripcariu V, Selvasekar C, Shaikh I, Hellawell G, Shida D, Simpson A, Smart NJ, Smart P, Smith JJ, Solbakken AM, Solomon MJ, Sørensen MM, Steele SR, Steffens D, Stitzenberg K, Stocchi L, Stylianides NA, Sumrien H, Sutton PA, Swartking T, Taylor C, Tekkis PP, Teras J, Thurairaja R, Toh EL, Tsarkov P, Tsukada Y, Tsukamoto S, Tuech JJ, Turner WH, Tuynman JB, Vasquez‐Jimenez W, Verhoef C, Vizzielli G, Voogt ELK, Uehara K, Wakeman C, Warrier S, Wasmuth HH, Weber K, Weiser MR, Wheeler JMD, Wild J, Wilson M, de Wilt JHW, Wolthuis A, Yano H, Yip B, Yip J, Yoo RN, van Zoggel D, Winter DC. Simultaneous pelvic exenteration and liver resection for primary rectal cancer with synchronous liver metastases: results from the PelvEx Collaborative. Colorectal Dis 2020; 22:1258-1262. [PMID: 32294308 DOI: 10.1111/codi.15064] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Accepted: 03/24/2020] [Indexed: 02/08/2023]
Abstract
AIM At presentation, 15-20% of patients with rectal cancer already have synchronous liver metastases. The aim of this study was to determine the surgical and survival outcomes in patients with advanced rectal cancer who underwent combined pelvic exenteration and liver (oligometastatic) resection. METHOD Data from 20 international institutions that performed simultaneous pelvic exenteration and liver resection between 2007 and 2017 were accumulated. Primarily, we examined perioperative outcomes, morbidity and mortality. We also assessed the impact that margin status had on survival. RESULTS Of 128 patients, 72 (56.2%) were men with a median age of 60 years [interquartile range (IQR) 15 years]. The median size of the liver oligometastatic deposits was 2 cm (IQR 1.8 cm). The median duration of surgery was 406 min (IQR 240 min), with a median blood loss of 1090 ml (IQR 2010 ml). A negative resection margin (R0 resection) was achieved in 73.5% of pelvic exenterations and 66.4% of liver resections. The 30-day mortality rate was 1.6%, and 32% of patients had a major postoperative complication. The 5-year overall survival for patients in whom an R0 resection of both primary and metastatic disease was achieved was 54.6% compared with 20% for those with an R1/R2 resection (P = 0.006). CONCLUSION Simultaneous pelvic exenteration and liver resection is feasible, with acceptable morbidity and mortality. Simultaneous resection should only be performed where an R0 resection of both pelvic and hepatic disease is anticipated.
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Iqbal S, Collins D. 1615P Crowdfunding for anticancer therapies: An analysis of non-US GoFundMe pages. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.1923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Iqbal S, Farooq A, Aziz NA, Dea P, Aherne D, O'Reilly S, Power D, Bambury R, Collins D. 1218P Real world outcome and toxicity of adjuvant chemotherapy in non-small cell lung cancer. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.1420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Ni Choinin A, Allen M, Milewski L, Power D, Connolly R, Collins D, O'Reilly S, Bambury R. 1751P Lessons from a pandemic: An audit of acute medical oncology admissions during SARS-CoV-2 outbreak. Ann Oncol 2020. [PMCID: PMC7506404 DOI: 10.1016/j.annonc.2020.08.1815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Collins D, Lam H, Firdaus H, Antipolo J, Mangao P. Modeling the likely economic cost of non-adherence to TB medicines in the Philippines. Int J Tuberc Lung Dis 2020; 24:902-909. [PMID: 33156756 DOI: 10.5588/ijtld.19.0652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
SETTING: The Philippines has a population of over 90 million people and is one of the 22 highest TB burden countries in the world.OBJECTIVE: To understand the economic cost of non-adherence to TB medicines due to loss to follow up and stock-outs in the Philippines.DESIGN: Data were collected on the economic costs of non-adherence to TB medicines and a model was developed to show those costs under different scenarios.RESULTS: The model showed that as many as 1958 and 233 persons are likely to have died as a result of DS-TB and MDR-TB loss to follow up, respectively, and 588 persons are likely to have died as a result of TB medicine stock outs. The related economic impact in each case is likely have been to be as much as US$72.2 million, US$13.4 million and US$21.0 million, respectively.CONCLUSION: The economic costs of non-adherence to TB medicines due to loss to follow-up and stock-outs represent a significant economic burden for the country and it is likely that the cost of addressing these problems would be much less than this burden and, therefore, a wise investment.
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Affiliation(s)
- D Collins
- Management Sciences for Health, Medford, MA, Boston University School of Public Health, Boston, MA, USA
| | - H Lam
- University of the Philippines, Ermita, Manila, Philippines
| | - H Firdaus
- Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - J Antipolo
- Management Sciences for Health, Medford, MA
| | - P Mangao
- Management Sciences for Health, Medford, MA
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Conroy M, O'Sullivan H, Collins D, Bambury R, Power D, Grossman S, O'Reilly S. 123P The prognostic role of lymphocyte count for treatment response in immune checkpoint inhibitor therapy. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Macanovic B, Crowley F, Collins D, Bambury R. 1213P Next generation sequencing of metastatic prostate cancer: Targetable alternations in DNA damage repair genes and beyond. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Stakelum A, Zaborowski A, Collins D, Winter DC. The influence of the gastrointestinal microbiome on colorectal metastasis: a narrative review. Colorectal Dis 2020; 22:1101-1107. [PMID: 31869511 DOI: 10.1111/codi.14930] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [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: 04/30/2019] [Accepted: 11/12/2019] [Indexed: 02/08/2023]
Abstract
INTRODUCTION The gastrointestinal microbiome has been suggested to contribute to the development of both primary and secondary colorectal cancer. Despite advances in understanding the prognostic and predictive value of clinico-pathological parameters, the underlying mechanisms that result in progression to metastatic disease have yet to be defined. The metastatic cascade involves a number of sequential steps, including detachment of tumour cells from the primary site, intravasation and dissemination within the circulatory and lymphatic systems, with extravasation and proliferation at a secondary site. OBJECTIVE An analysis of the literature relating to the gastrointestinal microbiome and its role in colorectal metastasis was conducted. This review aims to examine the current evidence supporting a role for the microbiome in colorectal metastasis and to describe the mechanisms by which it may contribute to metastatic progression. CONCLUSION The invasive pathways utilized by bacteria and how they may be manipulated by tumour cells for migration and metastasis are presented and the potential of the intestinal microbiome as a therapeutic target in colorectal carcinogenesis and metastasis is detailed here.
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Affiliation(s)
- A Stakelum
- Centre for Colorectal Disease, St Vincent's University Hospital, Dublin 4, Ireland
| | - A Zaborowski
- Centre for Colorectal Disease, St Vincent's University Hospital, Dublin 4, Ireland
| | - D Collins
- Centre for Colorectal Disease, St Vincent's University Hospital, Dublin 4, Ireland
| | - D C Winter
- Centre for Colorectal Disease, St Vincent's University Hospital, Dublin 4, Ireland
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Trivero J, Dong K, Goyarts E, Pelle E, Collins D, Corallo K, Pernodet N. 235 The importance of sirtuins in skin and new findings about sirt2 and its link to mechanobiology. J Invest Dermatol 2020. [DOI: 10.1016/j.jid.2020.03.240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Sundararaj KCS, Chapman AB, Sprenger CJ, Collins D, Saha M. Levamisole-induced cutaneous vasculitis. Clin Exp Dermatol 2020; 45:935-937. [PMID: 32597532 DOI: 10.1111/ced.14313] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Revised: 05/11/2020] [Accepted: 05/13/2020] [Indexed: 11/29/2022]
Affiliation(s)
- K C S Sundararaj
- Departments of, Department of, Dermatology, Queen Elizabeth Hospital, Lewisham and Greenwich NHS Trust, London, UK
| | - A B Chapman
- Departments of, Department of, Dermatology, Queen Elizabeth Hospital, Lewisham and Greenwich NHS Trust, London, UK
| | - C J Sprenger
- Departments of, Department of, Dermatology, Queen Elizabeth Hospital, Lewisham and Greenwich NHS Trust, London, UK
| | - D Collins
- Department of, Histopathology, Queen Elizabeth Hospital, Lewisham and Greenwich NHS Trust, London, UK
| | - M Saha
- Departments of, Department of, Dermatology, Queen Elizabeth Hospital, Lewisham and Greenwich NHS Trust, London, UK
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Blake A, Collins D, O'Connor E, Bergin C, McLaughlin AM, Martin-Loeches I. Clinical and biochemical characteristics of patients admitted to ICU with SARS-CoV-2. Med Intensiva 2020; 44:589-590. [PMID: 32425288 PMCID: PMC7229922 DOI: 10.1016/j.medin.2020.05.003] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Affiliation(s)
- A Blake
- Department of Intensive Care Medicine, St James's Hospital, Dublin, Ireland
| | - D Collins
- Department of Intensive Care Medicine, St James's Hospital, Dublin, Ireland
| | - E O'Connor
- Department of Intensive Care Medicine, St James's Hospital, Dublin, Ireland
| | - C Bergin
- Department of Infectious Diseases, St James's Hospital, Dublin, Ireland
| | - A M McLaughlin
- Department of Respiratory Medicine, St James's Hospital, Dublin, Ireland
| | - I Martin-Loeches
- Department of Intensive Care Medicine, St James's Hospital, Dublin, Ireland.
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Collins D. Ibuprofen for acute pain relief in the emergency department. BMJ Evid Based Med 2020; 26:bmjebm-2019-111312. [PMID: 32127374 DOI: 10.1136/bmjebm-2019-111312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/04/2020] [Indexed: 11/04/2022]
Affiliation(s)
- Dylan Collins
- Faculty of Medicine, The University of British Columbia, Vancouver, British Columbia, Canada
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Alfano H, Collins D. Good practice delivery in sport science and medicine support: perceptions of experienced sport leaders and practitioners. Managing Sport and Leisure 2020. [DOI: 10.1080/23750472.2020.1727768] [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: 10/24/2022]
Affiliation(s)
- H. Alfano
- Moray House School of Education, University of Edinburgh, Edinburgh, UK
| | - D. Collins
- Moray House School of Education, University of Edinburgh, Edinburgh, UK
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Collins D, Laatikainen T, Farrington J. Implementing essential interventions for cardiovascular disease risk management in primary healthcare: lessons from Eastern Europe and Central Asia. BMJ Glob Health 2020; 5:e002111. [PMID: 32133194 PMCID: PMC7042567 DOI: 10.1136/bmjgh-2019-002111] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Revised: 01/12/2020] [Accepted: 01/13/2020] [Indexed: 11/16/2022] Open
Abstract
Globally, non-communicable diseases (NCDs) are the leading cause of morbidity and mortality, including in the WHO European region. Within this region, the Member States with the greatest cardiovascular disease (CVD) burden are also some of the lowest resourced. As the need for technical support for the implementation of essential CVD/NCD interventions in primary healthcare (PHC) in these regions grew urgent, the WHO Regional Office for Europe has been directly supporting national governments in the development, assessment, scale-up and quality improvement of large scale PHC interventions for CVD. Herein, we synthesise the key learnings from providing technical support to national governments under the auspices of the WHO across the European region and share these learnings as a resource for public health professionals to consider when increasing coverage of quality essential health services. Based on our experience providing technical support to a diversity of Member States in the European Region (eg, Tajikistan, Republic of Moldova, Ukraine and Uzbekistan), we have identified six key lessons: prioritising NCDs for public health intervention, identifying and mapping existing resources, engaging key stakeholders, tailoring interventions to the local health system, generating local evidence and ensuring quality improvement while mainstreaming. Common challenges across all phases of implementation include multiple and inconsistent international toolkits and guidance, lack of national capacity for evidence-based healthcare, limited access to essential medicines and technologies, inconsistent national guidelines and limited experience in evaluation methodology, clinical epidemiology and guideline implementation. We map the lessons to the Consolidated Framework for Implementation Research and highlight key learnings and challenges specific to the region. Member States in the region are at various stages of implementation; however, several are currently conducting pragmatic clinical trials to generate local evidence for health policy. As this work expands, greater engagement with peer-to-peer sharing of contextual wisdom, sharing of resources, publishing methodology and results and development of region-specific resources is planned.
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Affiliation(s)
- Dylan Collins
- The University of British Columbia, Vancouver, British Columbia, Canada
| | - Tiina Laatikainen
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Joensuu, Finland
- National Institute for Health and Welfare, Helsinki, Uusimaa, Finland
| | - Jill Farrington
- World Health Organization Regional Office for Europe, Copenhagen, Denmark
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Collins D, Ciobanu A, Laatikainen T, Curocichin G, Salaru V, Zatic T, Anisei A, Farrington J. Protocol for the evaluation of a pilot implementation of essential interventions for the prevention of cardiovascular diseases in primary healthcare in the Republic of Moldova. BMJ Open 2019; 9:e025705. [PMID: 31278091 PMCID: PMC6615880 DOI: 10.1136/bmjopen-2018-025705] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Revised: 06/02/2019] [Accepted: 06/06/2019] [Indexed: 01/03/2023] Open
Abstract
INTRODUCTION Nearly 90% of all deaths in the Republic of Moldova are caused by non-communicable diseases, the majority of which (55%) are caused by cardiovascular diseases (CVD). In addition to reducing premature mortality from CVD, it is estimated that strengthening primary healthcare could cut the number of hypertension-related hospital admissions and diabetes-related hospitalisations in half. The aim of this evaluation is to determine the feasibility of implementing and evaluating essential interventions for the prevention of CVD in primary healthcare in the Republic of Moldova, with a view towards national scale-up. METHODS AND ANALYSIS A national steering group including international experts will be convened to adapt WHO Package of Essential NCD Intervention from Primary Healthcare in Low Resource Settings protocols 1 and 2 to the health system of the Republic of Moldova, develop and conduct training of primary healthcare workers and test a core set of indicators to monitor the quality of care and change in clinical practice. To evaluate the impact of this pilot implementation, a pragmatic, sequential mixed methods explanatory design, composed of quantitative and qualitative strands of equal weight, will be used. Twenty primary healthcare centres will be selected and randomised to the training and implementation arm (n=10) and the usual care arm (n=10). At baseline and 12 months follow-up, a standardised data collection form will be piloted to extract data directly from patient paper records in order to estimate the change in clinical practice. Semi-structured interviews and interclinic peer workshops will be conducted at 12 months follow-up, and qualitative data collected from these formats will be analysed thematically for explanatory themes that relate to the quantitative findings. ETHICS AND DISSEMINATION Ethical review and approval has been obtained. Findings of the evaluation will be shared in a project report to key stakeholders, presented back to participants and written into a manuscript for an open access peer-reviewed scientific journal.
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Affiliation(s)
- Dylan Collins
- University of British Columbia, Vancouver, British Columbia, Canada
| | - Angela Ciobanu
- World Health Organization, Chisinau, The Republic of Moldova
| | - Tiina Laatikainen
- Epidemiology and Health Promotion, National Institute for Health and Welfare, Helsinki, Finland
| | | | - Virginia Salaru
- World Health Organization, Chisinau, The Republic of Moldova
| | - Tatiana Zatic
- World Health Organization, Chisinau, The Republic of Moldova
| | - Angela Anisei
- World Health Organization, Chisinau, The Republic of Moldova
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McLean K, Glasbey J, Borakati A, Brooks T, Chang H, Choi S, Goodson R, Nielsen M, Pronin S, Salloum N, Sewart E, Vanniasegaram D, Drake T, Gillies M, Harrison E, Chapman S, Khatri C, Kong C, Claireaux H, Bath M, Mohan M, McNamee L, Kelly M, Mitchell H, Fitzgerald J, Bhangu A, Nepogodiev D, Antoniou I, Dean R, Davies N, Trecarten S, Henderson I, Holmes C, Wylie J, Shuttleworth R, Jindal A, Hughes F, Gouda P, Fleck R, Hanrahan M, Karunakaran P, Chen J, Sykes M, Sethi R, Suresh S, Patel P, Patel M, Varma R, Mushtaq J, Gundogan B, Bolton W, Khan T, Burke J, Morley R, Favero N, Adams R, Thirumal V, Kennedy E, Ong K, Tan Y, Gabriel J, Bakhsh A, Low J, Yener A, Paraoan V, Preece R, Tilston T, Cumber E, Dean S, Ross T, McCance E, Amin H, Satterthwaite L, Clement K, Gratton R, Mills E, Chiu S, Hung G, Rafiq N, Hayes J, Robertson K, Dynes K, Huang H, Assadullah S, Duncumb J, Moon R, Poo S, Mehta J, Joshi K, Callan R, Norris J, Chilvers N, Keevil H, Jull P, Mallick S, Elf D, Carr L, Player C, Barton E, Martin A, Ratu S, Roberts E, Phan P, Dyal A, Rogers J, Henson A, Reid N, Burke D, Culleton G, Lynne S, Mansoor S, Brennan C, Blessed R, Holloway C, Hill A, Goldsmith T, Mackin S, Kim S, Woin E, Brent G, Coffin J, Ziff O, Momoh Z, Debenham R, Ahmed M, Yong C, Wan J, Copley H, Raut P, Chaudhry F, Nixon G, Dorman C, Tan R, Kanabar S, Canning N, Dolaghan M, Bell N, McMenamin M, Chhabra A, Duke K, Turner L, Patel T, Chew L, Mirza M, Lunawat S, Oremule B, Ward N, Khan M, Tan E, Maclennan D, McGregor R, Chisholm E, Griffin E, Bell L, Hughes B, Davies J, Haq H, Ahmed H, Ungcharoen N, Whacha C, Thethi R, Markham R, Lee A, Batt E, Bullock N, Francescon C, Davies J, Shafiq N, Zhao J, Vivekanantham S, Barai I, Allen J, Marshall D, McIntyre C, Wilson H, Ashton A, Lek C, Behar N, Davis-Hall M, Seneviratne N, Esteve L, Sirakaya M, Ali S, Pope S, Ahn J, Craig-McQuaide A, Gatfield W, Leong S, Demetri A, Kerr A, Rees C, Loveday J, Liu S, Wijesekera M, Maru D, Attalla M, Smith N, Brown D, Sritharan P, Shah A, Charavanamuttu V, Heppenstall-Harris G, Ng K, Raghvani T, Rajan N, Hulley K, Moody N, Williams M, Cotton A, Sharifpour M, Lwin K, Bright M, Chitnis A, Abdelhadi M, Semana A, Morgan F, Reid R, Dickson J, Anderson L, McMullan R, Ahern N, Asmadi A, Anderson L, Boon Xuan JL, Crozier L, McAleer S, Lees D, Adebayo A, Das M, Amphlett A, Al-Robeye A, Valli A, Khangura J, Winarski A, Ali A, Woodward H, Gouldthrope C, Turner M, Sasapu K, Tonkins M, Wild J, Robinson M, Hardie J, Heminway R, Narramore R, Ramjeeawon N, Hibberd A, Winslow F, Ho W, Chong B, Lim K, Ho S, Crewdson J, Singagireson S, Kalra N, Koumpa F, Jhala H, Soon W, Karia M, Rasiah M, Xylas D, Gilbert H, Sundar-Singh M, Wills J, Akhtar S, Patel S, Hu L, Brathwaite-Shirley C, Nayee H, Amin O, Rangan T, Turner E, McCrann C, Shepherd R, Patel N, Prest-Smith J, Auyoung E, Murtaza A, Coates A, Prys-Jones O, King M, Gaffney S, Dewdney C, Nehikhare I, Lavery J, Bassett J, Davies K, Ahmad K, Collins A, Acres M, Egerton C, Cheng K, Chen X, Chan N, Sheldon A, Khan S, Empey J, Ingram E, Malik A, Johnstone M, Goodier R, Shah J, Giles J, Sanders J, McLure S, Pal S, Rangedara A, Baker A, Asbjoernsen C, Girling C, Gray L, Gauntlett L, Joyner C, Qureshi S, Mogan Y, Ng J, Kumar A, Park J, Tan D, Choo K, Raman K, Buakuma P, Xiao C, Govinden S, Thompson O, Charalambos M, Brown E, Karsan R, Dogra T, Bullman L, Dawson P, Frank A, Abid H, Tung L, Qureshi U, Tahmina A, Matthews B, Harris R, O'Connor A, Mazan K, Iqbal S, Stanger S, Thompson J, Sullivan J, Uppal E, MacAskill A, Bamgbose F, Neophytou C, Carroll A, Rookes C, Datta U, Dhutia A, Rashid S, Ahmed N, Lo T, Bhanderi S, Blore C, Ahmed S, Shaheen H, Abburu S, Majid S, Abbas Z, Talukdar S, Burney L, Patel J, Al-Obaedi O, Roberts A, Mahboob S, Singh B, Sheth S, Karia P, Prabhudesai A, Kow K, Koysombat K, Wang S, Morrison P, Maheswaran Y, Keane P, Copley P, Brewster O, Xu G, Harries P, Wall C, Al-Mousawi A, Bonsu S, Cunha P, Ward T, Paul J, Nadanakumaran K, Tayeh S, Holyoak H, Remedios J, Theodoropoulou K, Luhishi A, Jacob L, Long F, Atayi A, Sarwar S, Parker O, Harvey J, Ross H, Rampal R, Thomas G, Vanmali P, McGowan C, Stein J, Robertson V, Carthew L, Teng V, Fong J, Street A, Thakker C, O'Reilly D, Bravo M, Pizzolato A, Khokhar H, Ryan M, Cheskes L, Carr R, Salih A, Bassiony S, Yuen R, Chrastek D, Rosen O'Sullivan H, Amajuoyi A, Wang A, Sitta O, Wye J, Qamar M, Major C, Kaushal A, Morgan C, Petrarca M, Allot R, Verma K, Dutt S, Chilima C, Peroos S, Kosasih S, Chin H, Ashken L, Pearse R, O'Loughlin R, Menon A, Singh K, Norton J, Sagar R, Jathanna N, Rothwell L, Watson N, Harding F, Dube P, Khalid H, Punjabi N, Sagmeister M, Gill P, Shahid S, Hudson-Phillips S, George D, Ashwood J, Lewis T, Dhar M, Sangal P, Rhema I, Kotecha D, Afzal Z, Syeed J, Prakash E, Jalota P, Herron J, Kimani L, Delport A, Shukla A, Agarwal V, Parthiban S, Thakur H, Cymes W, Rinkoff S, Turnbull J, Hayat M, Darr S, Khan U, Lim J, Higgins A, Lakshmipathy G, Forte B, Canning E, Jaitley A, Lamont J, Toner E, Ghaffar A, McDowell M, Salmon D, O'Carroll O, Khan A, Kelly M, Clesham K, Palmer C, Lyons R, Bell A, Chin R, Waldron R, Trimble A, Cox S, Ashfaq U, Campbell J, Holliday R, McCabe G, Morris F, Priestland R, Vernon O, Ledsam A, Vaughan R, Lim D, Bakewell Z, Hughes R, Koshy R, Jackson H, Narayan P, Cardwell A, Jubainville C, Arif T, Elliott L, Gupta V, Bhaskaran G, Odeleye A, Ahmed F, Shah R, Pickard J, Suleman Y, North A, McClymont L, Hussain N, Ibrahim I, Ng G, Wong V, Lim A, Harris L, Tharmachandirar T, Mittapalli D, Patel V, Lakhani M, Bazeer H, Narwani V, Sandhu K, Wingfield L, Gentry S, Adjei H, Bhatti M, Braganza L, Barnes J, Mistry S, Chillarge G, Stokes S, Cleere J, Wadanamby S, Bucko A, Meek J, Boxall N, Heywood E, Wiltshire J, Toh C, Ward A, Shurovi B, Horth D, Patel B, Ali B, Spencer T, Axelson T, Kretzmer L, Chhina C, Anandarajah C, Fautz T, Horst C, Thevathasan A, Ng J, Hirst F, Brewer C, Logan A, Lockey J, Forrest P, Keelty N, Wood A, Springford L, Avery P, Schulz T, Bemand T, Howells L, Collier H, Khajuria A, Tharakan R, Parsons S, Buchan A, McGalliard R, Mason J, Cundy O, Li N, Redgrave N, Watson R, Pezas T, Dennis Y, Segall E, Hameed M, Lynch A, Chamberlain M, Peck F, Neo Y, Russell G, Elseedawy M, Lee S, Foster N, Soo Y, Puan L, Dennis R, Goradia H, Qureshi A, Osman S, Reeves T, Dinsmore L, Marsden M, Lu Q, Pitts-Tucker T, Dunn C, Walford R, Heathcote E, Martin R, Pericleous A, Brzyska K, Reid K, Williams M, Wetherall N, McAleer E, Thomas D, Kiff R, Milne S, Holmes M, Bartlett J, Lucas de Carvalho J, Bloomfield T, Tongo F, Bremner R, Yong N, Atraszkiewicz B, Mehdi A, Tahir M, Sherliker G, Tear A, Pandey A, Broyd A, Omer H, Raphael M, Chaudhry W, Shahidi S, Jawad A, Gill C, Fisher IH, Adeleja I, Clark I, Aidoo-Micah G, Stather P, Salam G, Glover T, Deas G, Sim N, Obute R, Wynell-Mayow W, Sait M, Mitha N, de Bernier G, Siddiqui M, Shaunak R, Wali A, Cuthbert G, Bhudia R, Webb E, Shah S, Ansari N, Perera M, Kelly N, McAllister R, Stanley G, Keane C, Shatkar V, Maxwell-Armstrong C, Henderson L, Maple N, Manson R, Adams R, Semple E, Mills M, Daoub A, Marsh A, Ramnarine A, Hartley J, Malaj M, Jewell P, Whatling E, Hitchen N, Chen M, Goh B, Fern J, Rogers S, Derbyshire L, Robertson D, Abuhussein N, Deekonda P, Abid A, Harrison P, Aildasani L, Turley H, Sherif M, Pandey G, Filby J, Johnston A, Burke E, Mohamud M, Gohil K, Tsui A, Singh R, Lim S, O'Sullivan K, McKelvey L, O'Neill S, Roberts H, Brown F, Cao Y, Buckle R, Liew Y, Sii S, Ventre C, Graham C, Filipescu T, Yousif A, Dawar R, Wright A, Peters M, Varley R, Owczarek S, Hartley S, Khattak M, Iqbal A, Ali M, Durrani B, Narang Y, Bethell G, Horne L, Pinto R, Nicholls K, Kisyov I, Torrance H, English W, Lakhani S, Ashraf S, Venn M, Elangovan V, Kazmi Z, Brecher J, Sukumar S, Mastan A, Mortimer A, Parker J, Boyle J, Elkawafi M, Beckett J, Mohite A, Narain A, Mazumdar E, Sreh A, Hague A, Weinberg D, Fletcher L, Steel M, Shufflebotham H, Masood M, Sinha Y, Jenvey C, Kitt H, Slade R, Craig A, Deall C, Reakes T, Chervenkoff J, Strange E, O'Bryan M, Murkin C, Joshi D, Bergara T, Naqib S, Wylam D, Scotcher S, Hewitt C, Stoddart M, Kerai A, Trist A, Cole S, Knight C, Stevens S, Cooper G, Ingham R, Dobson J, O'Kane A, Moradzadeh J, Duffy A, Henderson C, Ashraf S, McLaughin C, Hoskins T, Reehal R, Bookless L, McLean R, Stone E, Wright E, Abdikadir H, Roberts C, Spence O, Srikantharajah M, Ruiz E, Matthews J, Gardner E, Hester E, Naran P, Simpson R, Minhas M, Cornish E, Semnani S, Rojoa D, Radotra A, Eraifej J, Eparh K, Smith D, Mistry B, Hickling S, Din W, Liu C, Mithrakumar P, Mirdavoudi V, Rashid M, Mcgenity C, Hussain O, Kadicheeni M, Gardner H, Anim-Addo N, Pearce J, Aslanyan A, Ntala C, Sorah T, Parkin J, Alizadeh M, White A, Edozie F, Johnston J, Kahar A, Navayogaarajah V, Patel B, Carter D, Khonsari P, Burgess A, Kong C, Ponweera A, Cody A, Tan Y, Ng A, Croall A, Allan C, Ng S, Raghuvir V, Telfer R, Greenhalgh A, McKerr C, Edison M, Patel B, Dear K, Hardy M, Williams P, Hassan S, Sajjad U, O'Neill E, Lopes S, Healy L, Jamal N, Tan S, Lazenby D, Husnoo S, Beecroft S, Sarvanandan T, Weston C, Bassam N, Rabinthiran S, Hayat U, Ng L, Varma D, Sukkari M, Mian A, Omar A, Kim J, Sellathurai J, Mahmood J, O'Connell C, Bose R, Heneghan H, Lalor P, Matheson J, Doherty C, Cullen C, Cooper D, Angelov S, Drislane C, Smith A, Kreibich A, Palkhi E, Durr A, Lotfallah A, Gold D, Mckean E, Dhanji A, Anilkumar A, Thacoor A, Siddiqui Z, Lim S, Piquet A, Anderson S, McCormack D, Gulati J, Ibrahim A, Murray S, Walsh S, McGrath A, Ziprin P, Chua E, Lou C, Bloomer J, Paine H, Osei-Kuffour D, White C, Szczap A, Gokani S, Patel K, Malys M, Reed A, Torlot G, Cumber E, Charania A, Ahmad S, Varma N, Cheema H, Austreng L, Petra H, Chaudhary M, Zegeye M, Cheung F, Coffey D, Heer R, Singh S, Seager E, Cumming S, Suresh R, Verma S, Ptacek I, Gwozdz A, Yang T, Khetarpal A, Shumon S, Fung T, Leung W, Kwang P, Chew L, Loke W, Curran A, Chan C, McGarrigle C, Mohan K, Cullen S, Wong E, Toale C, Collins D, Keane N, Traynor B, Shanahan D, Yan A, Jafree D, Topham C, Mitrasinovic S, Omara S, Bingham G, Lykoudis P, Miranda B, Whitehurst K, Kumaran G, Devabalan Y, Aziz H, Shoa M, Dindyal S, Yates J, Bernstein I, Rattan G, Coulson R, Stezaker S, Isaac A, Salem M, McBride A, McFarlane H, Yow L, MacDonald J, Bartlett R, Turaga S, White U, Liew W, Yim N, Ang A, Simpson A, McAuley D, Craig E, Murphy L, Shepherd P, Kee J, Abdulmajid A, Chung A, Warwick H, Livesey A, Holton P, Theodoreson M, Jenkin S, Turner J, Entwisle J, Marchal S, O'Connor S, Blege H, Aithie J, Sabine L, Stewart G, Jackson S, Kishore A, Lankage C, Acquaah F, Joyce H, McKevitt K, Coffey C, Fawaz A, Dolbec K, O'Sullivan D, Geraghty J, Lim E, Bolton L, FitzPatrick D, Robinson C, Ramtoola T, Collinson S, Grundy L, McEnhill P, Harbhajan Singh G, Loughran D, Golding D, Keeling R, Williams R, Whitham R, Yoganathan S, Nachiappan R, Egan R, Owasil R, Kwan M, He A, Goh R, Bhome R, Wilson H, Teoh P, Raji K, Jayakody N, Matthams J, Chong J, Luk C, Greig R, Trail M, Charalambous G, Rocke A, Gardiner N, Bulley F, Warren N, Brennan E, Fergurson P, Wilson R, Whittingham H, Brown E, Khanijau R, Gandhi K, Morris S, Boulton A, Chandan N, Barthorpe A, Maamari R, Sandhu S, McCann M, Higgs L, Balian V, Reeder C, Diaper C, Sale T, Ali H, Archer C, Clarke A, Heskin J, Hurst P, Farmer J, O'Flynn L, Doan L, Shuker B, Stott G, Vithanage N, Hoban K, Nesargikar P, Kennedy H, Grossart C, Tan E, Roy C, Sim P, Leslie K, Sim D, Abul M, Cody N, Tay A, Woon E, Sng S, Mah J, Robson J, Shakweh E, Wing V, Mills H, Li M, Barrow T, Balaji S, Jordan H, Phillips C, Naveed H, Hirani S, Tai A, Ratnakumaran R, Sahathevan A, Shafi A, Seedat M, Weaver R, Batho A, Punj R, Selvachandran H, Bhatt N, Botchey S, Khonat Z, Brennan K, Morrison C, Devlin E, Linton A, Galloway E, McGarvie S, Ramsay N, McRobbie H, Whewell H, Dean W, Nelaj S, Eragat M, Mishra A, Kane T, Zuhair M, Wells M, Wilkinson D, Woodcock N, Sun E, Aziz N, Ghaffar MKA. Critical care usage after major gastrointestinal and liver surgery: a prospective, multicentre observational study. Br J Anaesth 2019; 122:42-50. [PMID: 30579405 DOI: 10.1016/j.bja.2018.07.029] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2018] [Revised: 07/19/2018] [Accepted: 07/23/2018] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Patient selection for critical care admission must balance patient safety with optimal resource allocation. This study aimed to determine the relationship between critical care admission, and postoperative mortality after abdominal surgery. METHODS This prespecified secondary analysis of a multicentre, prospective, observational study included consecutive patients enrolled in the DISCOVER study from UK and Republic of Ireland undergoing major gastrointestinal and liver surgery between October and December 2014. The primary outcome was 30-day mortality. Multivariate logistic regression was used to explore associations between critical care admission (planned and unplanned) and mortality, and inter-centre variation in critical care admission after emergency laparotomy. RESULTS Of 4529 patients included, 37.8% (n=1713) underwent planned critical care admissions from theatre. Some 3.1% (n=86/2816) admitted to ward-level care subsequently underwent unplanned critical care admission. Overall 30-day mortality was 2.9% (n=133/4519), and the risk-adjusted association between 30-day mortality and critical care admission was higher in unplanned [odds ratio (OR): 8.65, 95% confidence interval (CI): 3.51-19.97) than planned admissions (OR: 2.32, 95% CI: 1.43-3.85). Some 26.7% of patients (n=1210/4529) underwent emergency laparotomies. After adjustment, 49.3% (95% CI: 46.8-51.9%, P<0.001) were predicted to have planned critical care admissions, with 7% (n=10/145) of centres outside the 95% CI. CONCLUSIONS After risk adjustment, no 30-day survival benefit was identified for either planned or unplanned postoperative admissions to critical care within this cohort. This likely represents appropriate admission of the highest-risk patients. Planned admissions in selected, intermediate-risk patients may present a strategy to mitigate the risk of unplanned admission. Substantial inter-centre variation exists in planned critical care admissions after emergency laparotomies.
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Pickering C, Kiely J, Suraci B, Collins D. The magnitude of Yo-Yo test improvements following an aerobic training intervention are associated with total genotype score. PLoS One 2018; 13:e0207597. [PMID: 30485313 PMCID: PMC6261586 DOI: 10.1371/journal.pone.0207597] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2018] [Accepted: 11/01/2018] [Indexed: 11/18/2022] Open
Abstract
Recent research has demonstrated that there is considerable inter-individual variation in the response to aerobic training, and that this variation is partially mediated by genetic factors. As such, we aimed to investigate if a genetic based algorithm successfully predicted the magnitude of improvements following eight-weeks of aerobic training in youth soccer players. A genetic test was utilised to examine five single nucleotide polymorphisms (VEGF rs2010963, ADRB2 rs1042713 and rs1042714, CRP rs1205 & PPARGC1A rs8192678), whose occurrence is believed to impact aerobic training adaptations. 42 male soccer players (17.0 ± 1y, 176 ± 6 cm, 69 ± 9 kg) were tested and stratified into three different Total Genotype Score groups; "low", "medium"and "high", based on the possession of favourable polymorphisms. Subjects underwent two Yo-Yo tests separated by eight-weeks of sports-specific aerobic training. Overall, there were no significant differences between the genotype groups in pre-training Yo-Yo performance, but evident between-group response differentials emerged in post-training Yo-Yo test performance. Subjects in the "high" group saw much larger improvements (58%) than those in the 'medium" (35%) and "low" (7%) groups. There were significant (p<0.05) differences between the groups in the magnitude of improvement, with athletes in the "high" and medium group having larger improvements than the "low" group (d = 2.59 "high" vs "low"; d = 1.32 "medium" vs "low"). In conclusion, the magnitude of improvements in aerobic fitness following a training intervention were associated with a genetic algorithm comprised of five single nucleotide polymorphisms. This information could lead to the development of more individualised aerobic training designs, targeting optimal fitness adaptations.
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Affiliation(s)
- C. Pickering
- Institute of Coaching and Performance, School of Sport & Wellbeing, University of Central Lancashire, Preston, United Kingdom
- Exercise and Nutritional Genomics Research Centre, DNAFit Ltd, London, United Kingdom
| | - J. Kiely
- Institute of Coaching and Performance, School of Sport & Wellbeing, University of Central Lancashire, Preston, United Kingdom
| | - B. Suraci
- Exercise and Nutritional Genomics Research Centre, DNAFit Ltd, London, United Kingdom
- Suraci Consultancy, Portsmouth, United Kingdom
| | - D. Collins
- Institute of Coaching and Performance, School of Sport & Wellbeing, University of Central Lancashire, Preston, United Kingdom
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Khandhar S, Collins D, Schatz C, Liu C, Chandy J. P2.15-12 Exparel vs. Bupivicaine for Postoperative Analgesia After VATS Lung Resection: Results of a Randomized Control Trial. J Thorac Oncol 2018. [DOI: 10.1016/j.jtho.2018.08.1453] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Collins D, Alexander C, Darimont CT. Staqeya: the lone wolf at the edge of its ecological niche. Ecology 2018; 100:e02513. [PMID: 30198558 DOI: 10.1002/ecy.2513] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [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: 07/26/2018] [Revised: 08/27/2018] [Accepted: 09/05/2018] [Indexed: 11/08/2022]
Affiliation(s)
- Dylan Collins
- Department of Geography, University of Victoria, Box 1700, Stn CSC, Victoria, British Columbia, V8W 2Y2, Canada
| | - Cheryl Alexander
- Wild Awake Photography, 5010 Lockehaven Drive, Victoria, British Columbia, V8N 4J5, Canada
| | - Chris T Darimont
- Department of Geography, University of Victoria, Box 1700, Stn CSC, Victoria, British Columbia, V8W 2Y2, Canada.,Raincoast Conservation Foundation, Sidney, British Columbia, V8L 3Y3, Canada
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