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Hafezi Nejad N, Bailey C, Lyons G, Liddell R. Abstract No. 464 Peripheral endovascular interventions: national burden, regional variations, disparities, direct and indirect costs in the United States. J Vasc Interv Radiol 2021. [DOI: 10.1016/j.jvir.2021.03.273] [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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Esfandiary T, Bailey C, Liddell R, Singh H, Lyons G. Abstract No. 193 Vascular sequelae of COVID-19: interventional radiology in the management of coronavirus-associated angiopathy. J Vasc Interv Radiol 2021. [PMCID: PMC8079608 DOI: 10.1016/j.jvir.2021.03.199] [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: 11/23/2022] Open
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Golden S, Kolarich A, Lyons G. Abstract No. 553 The growth of clinical interventional radiology: increasing interventional radiology evaluation and management charges over time. J Vasc Interv Radiol 2021. [DOI: 10.1016/j.jvir.2021.03.363] [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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Ng R, Lyons G. Abstract No. 513 Endovascular interventions safely and effectively maintain long-term patency in patients with arterial complications of liver transplantation. J Vasc Interv Radiol 2021. [DOI: 10.1016/j.jvir.2021.03.322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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Suchowerska N, Toohey J, Carroll S, Rogers L, Lyons G, Beith J, Dos Santos Esteves A, McKenzie D. PO-0918: Radiotherapy and Her2 targeting agents: synergism and antagonism in clonogenic and confluence assays. Radiother Oncol 2017. [DOI: 10.1016/s0167-8140(17)31355-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Nicholas A, Jaleel S, Lyons G, Schoenmakers E, Dattani M, Crowne E, Bernhard B, Kirk J, Roche E, Chatterjee V, Schoenmakers N. Molecular spectrum of TSHβ subunit gene defects in central hypothyroidism in the UK and Ireland. Clin Endocrinol (Oxf) 2017; 86:410-418. [PMID: 27362444 PMCID: PMC5324561 DOI: 10.1111/cen.13149] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2016] [Revised: 06/24/2016] [Accepted: 06/28/2016] [Indexed: 02/02/2023]
Abstract
OBJECTIVE Homozygous mutations in the TSH beta subunit gene (TSHB) result in severe, isolated, central congenital hypothyroidism (CCH). This entity evades diagnosis in TSH-based congenital hypothyroidism (CH) screening programmes in the UK and Ireland. Accordingly, genetic diagnosis, enabling ascertainment of affected relatives in families, is critical for prompt diagnosis and treatment of the disorder. DESIGN, PATIENTS AND MEASUREMENTS Four cases of isolated TSH deficiency from three unrelated families in the UK and Ireland were investigated for mutations or deletions in TSHB. Haplotype analysis, to investigate a founder effect, was undertaken in cases with identical mutations (c.373delT). RESULTS Two siblings in kindred 1 were homozygous for a previously described TSHB mutation (c.373delT). In kindreds 2 and 3, the affected individuals were compound heterozygous for TSHB c.373delT and either a 5·4-kB TSHB deletion (kindred 2, c.1-4389_417*195delinsCTCA) or a novel TSHB missense mutation (kindred 3, c.2T>C, p.Met1?). Neurodevelopmental retardation, following delayed diagnosis and treatment, was present in 3 cases. In contrast, the younger sibling in kindred 1 developed normally following genetic diagnosis and treatment from birth. CONCLUSIONS This study, including the identification of a second, novel, TSHB deletion, expands the molecular spectrum of TSHB defects and suggests that allele loss may be a commoner basis for TSH deficiency than previously suspected. Delayed diagnosis and treatment of profound central hypothyroidism in such cases result in neurodevelopmental retardation. Inclusion of thyroxine (T4) plus thyroxine-binding globulin (TBG), or free thyroxine (FT4) in CH screening, together with genetic case ascertainment enabling earlier therapeutic intervention, could prevent such adverse sequelae.
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Affiliation(s)
- A.K. Nicholas
- University of Cambridge Metabolic Research LaboratoriesWellcome Trust‐Medical Research Council Institute of Metabolic ScienceAddenbrooke's HospitalCambridgeUK
| | - S. Jaleel
- Department of Paediatric Endocrinology & DiabetesNational Children's HospitalAMNCHDublinIreland
| | - G. Lyons
- University of Cambridge Metabolic Research LaboratoriesWellcome Trust‐Medical Research Council Institute of Metabolic ScienceAddenbrooke's HospitalCambridgeUK
| | - E. Schoenmakers
- University of Cambridge Metabolic Research LaboratoriesWellcome Trust‐Medical Research Council Institute of Metabolic ScienceAddenbrooke's HospitalCambridgeUK
| | - M.T. Dattani
- University College London Institute of Child HealthDevelopmental Endocrinology Research GroupSection of Genetics and Epigenetics in Health and DiseaseGenetics and Genomic Medicine ProgrammeLondonUK
| | - E. Crowne
- Department of Paediatric Endocrinology & DiabetesBristol Royal Hospital for ChildrenUniversity Hospitals Bristol NHS Foundation TrustBristolUK
| | - B. Bernhard
- Department of Clinical GeneticsNorth West Thames Regional Genetics ServiceNorth West London Hospitals NHS TrustHarrowUK
| | - J. Kirk
- Department of EndocrinologyBirmingham Children's HospitalBirminghamUK
| | - E.F. Roche
- Department of Paediatric Endocrinology & DiabetesNational Children's HospitalAMNCHDublinIreland
- University of DublinTrinity College DublinDublinIreland
| | - V.K. Chatterjee
- University of Cambridge Metabolic Research LaboratoriesWellcome Trust‐Medical Research Council Institute of Metabolic ScienceAddenbrooke's HospitalCambridgeUK
| | - N. Schoenmakers
- University of Cambridge Metabolic Research LaboratoriesWellcome Trust‐Medical Research Council Institute of Metabolic ScienceAddenbrooke's HospitalCambridgeUK
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Detterbeck FC, Nicholson AG, Franklin WA, Marom EM, Travis WD, Girard N, Arenberg DA, Bolejack V, Donington JS, Mazzone PJ, Tanoue LT, Rusch VW, Crowley J, Asamura H, Rami-Porta R, Goldstraw P, Rami-Porta R, Asamura H, Ball D, Beer DG, Beyruti R, Bolejack V, Chansky K, Crowley J, Detterbeck F, Erich Eberhardt WE, Edwards J, Galateau-Sallé F, Giroux D, Gleeson F, Groome P, Huang J, Kennedy C, Kim J, Kim YT, Kingsbury L, Kondo H, Krasnik M, Kubota K, Lerut A, Lyons G, Marino M, Marom EM, van Meerbeeck J, Mitchell A, Nakano T, Nicholson AG, Nowak A, Peake M, Rice T, Rosenzweig K, Ruffini E, Rusch V, Saijo N, Van Schil P, Sculier JP, Shemanski L, Stratton K, Suzuki K, Tachimori Y, Thomas CF, Travis W, Tsao MS, Turrisi A, Vansteenkiste J, Watanabe H, Wu YL, Baas P, Erasmus J, Hasegawa S, Inai K, Kernstine K, Kindler H, Krug L, Nackaerts K, Pass H, Rice D, Falkson C, Filosso PL, Giaccone G, Kondo K, Lucchi M, Okumura M, Blackstone E, Erasmus J, Flieder D, Godoy M, Goo JM, Goodman LR, Jett J, de Leyn P, Marchevsky A, MacMahon H, Naidich D, Okada M, Perlman M, Powell C, van Schil P, Tsao MS, Warth A, Cavaco FA, Barrera EA, Arca JA, Lamelas IP, Obrer AA, Jorge RG, Ball D, Bascom G, Blanco Orozco A, González Castro M, Blum M, Chimondeguy D, Cvijanovic V, Defranchi S, de Olaiz Navarro B, Escobar Campuzano I, Macía Vidueira I, Fernández Araujo E, Andreo García F, Fong K, Francisco Corral G, Cerezo González S, Freixinet Gilart J, García Arangüena L, García Barajas S, Girard P, Goksel T, González Budiño M, González Casaurrán G, Gullón Blanco J, Hernández J, Hernández Rodríguez H, Herrero Collantes J, Iglesias Heras M, Izquierdo Elena J, Jakobsen E, Kostas S, León Atance P, Núñez Ares A, Liao M, Losanovscky M, Lyons G, Magaroles R, De Esteban Júlvez L, Mariñán Gorospe M, McCaughan B, Kennedy C, Melchor Íñiguez R, Miravet Sorribes L, Naranjo Gozalo S, Álvarez de Arriba C, Núñez Delgado M, Padilla Alarcón J, Peñalver Cuesta J, Park J, Pass H, Pavón Fernández M, Rosenberg M, Ruffini E, Rusch V, Sánchez de Cos Escuín J, Saura Vinuesa A, Serra Mitjans M, Strand T, Subotic D, Swisher S, Terra R, Thomas C, Tournoy K, Van Schil P, Velasquez M, Wu Y, Yokoi K. The IASLC Lung Cancer Staging Project: Summary of Proposals for Revisions of the Classification of Lung Cancers with Multiple Pulmonary Sites of Involvement in the Forthcoming Eighth Edition of the TNM Classification. J Thorac Oncol 2016; 11:639-650. [DOI: 10.1016/j.jtho.2016.01.024] [Citation(s) in RCA: 111] [Impact Index Per Article: 13.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2015] [Revised: 01/20/2016] [Accepted: 01/21/2016] [Indexed: 12/25/2022]
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Detterbeck FC, Bolejack V, Arenberg DA, Crowley J, Donington JS, Franklin WA, Girard N, Marom EM, Mazzone PJ, Nicholson AG, Rusch VW, Tanoue LT, Travis WD, Asamura H, Rami-Porta R, Goldstraw P, Rami-Porta R, Asamura H, Ball D, Beer DG, Beyruti R, Bolejack V, Chansky K, Crowley J, Detterbeck F, Erich Eberhardt WE, Edwards J, Galateau-Sallé F, Giroux D, Gleeson F, Groome P, Huang J, Kennedy C, Kim J, Kim YT, Kingsbury L, Kondo H, Krasnik M, Kubota K, Lerut A, Lyons G, Marino M, Marom EM, van Meerbeeck J, Mitchell A, Nakano T, Nicholson AG, Nowak A, Peake M, Rice T, Rosenzweig K, Ruffini E, Rusch V, Saijo N, Van Schil P, Sculier JP, Shemanski L, Stratton K, Suzuki K, Tachimori Y, Thomas CF, Travis W, Tsao MS, Turrisi A, Vansteenkiste J, Watanabe H, Wu YL, Baas P, Erasmus J, Hasegawa S, Inai K, Kernstine K, Kindler H, Krug L, Nackaerts K, Pass H, Rice D, Falkson C, Filosso PL, Giaccone G, Kondo K, Lucchi M, Okumura M, Blackstone E, Erasmus J, Flieder D, Godoy M, Goo JM, Goodman LR, Jett J, de Leyn P, Marchevsky A, MacMahon H, Naidich D, Okada M, Perlman M, Powell C, van Schil P, Tsao MS, Warth A, Cavaco FA, Barrera EA, Arca JA, Lamelas IP, Obrer AA, Jorge RG, Ball D, Bascom G, Blanco Orozco A, González Castro M, Blum M, Chimondeguy D, Cvijanovic V, Defranchi S, de Olaiz Navarro B, Escobar Campuzano I, Macía Vidueira I, Fernández Araujo E, Andreo García F, Fong K, Francisco Corral G, Cerezo González S, Freixinet Gilart J, García Arangüena L, García Barajas S, Girard P, Goksel T, González Budiño M, González Casaurrán G, Gullón Blanco J, Hernández Hernández J, Hernández Rodríguez H, Herrero Collantes J, Iglesias Heras M, Izquierdo Elena J, Jakobsen E, Kostas S, León Atance P, Núñez Ares A, Liao M, Losanovscky M, Lyons G, Magaroles R, De Esteban Júlvez L, Mariñán Gorospe M, McCaughan B, Kennedy C, Melchor Íñiguez R, Miravet Sorribes L, Naranjo Gozalo S, Álvarez de Arriba C, Núñez Delgado M, Padilla Alarcón J, Peñalver Cuesta J, Park J, Pass H, Pavón Fernández M, Rosenberg M, Ruffini E, Rusch V, Sánchez de Cos Escuín J, Saura Vinuesa A, Serra Mitjans M, Strand T, Subotic D, Swisher S, Terra R, Thomas C, Tournoy K, Van Schil P, Velasquez M, Wu Y, Yokoi K. The IASLC Lung Cancer Staging Project: Background Data and Proposals for the Classification of Lung Cancer with Separate Tumor Nodules in the Forthcoming Eighth Edition of the TNM Classification for Lung Cancer. J Thorac Oncol 2016; 11:681-692. [DOI: 10.1016/j.jtho.2015.12.114] [Citation(s) in RCA: 81] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2015] [Revised: 12/01/2015] [Accepted: 12/29/2015] [Indexed: 12/01/2022]
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Robertson NL, Hricak H, Sonoda Y, Sosa RE, Benz M, Lyons G, Abu-Rustum NR, Sala E, Vargas HA. The impact of FDG-PET/CT in the management of patients with vulvar and vaginal cancer. Gynecol Oncol 2016; 140:420-4. [PMID: 26790773 DOI: 10.1016/j.ygyno.2016.01.011] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2015] [Revised: 01/07/2016] [Accepted: 01/08/2016] [Indexed: 11/24/2022]
Abstract
OBJECTIVES To evaluate the changes in prognostic impression and patient management following PET/CT in patients with vulvar and vaginal carcinoma; and to compare PET/CT findings with those of conventional imaging modalities. METHODS We summarized prospectively and retrospectively collected data for 50 consecutive patients from our institution that enrolled in the National Oncologic PET Registry and underwent FDG-PET/CT for a suspected or known primary or recurrent vulvar/vaginal cancer. RESULTS 54/83 (65%) studies included had a diagnosis of vulvar cancer, and the remaining 29/83 (35%), a diagnosis of vaginal cancer. Following FDG-PET/CT, the physician's prognostic impression changed in 51% of cases. A change in patient management, defined as a change to/from a non-interventional strategy (observation or additional imaging), to/from an interventional strategy (biopsy or treatment), was documented in 36% of studies. The electronic records demonstrated that 95% of the management strategies recorded in the physician questionnaires were implemented as planned. MRI and/or CT were performed within one month of the FDG-PET/CT in 20/83 (24%) and 28/83 (34%) cases, respectively. FDG-PET/CT detected nodes suspicious for metastases on 29/83 (35%) studies performed. MRI and CT detected positive nodes on 6 and 11 studies respectively. Distant metastases were identified in 10 cases imaged with FDG-PET and 5 cases that had additional conventional CT imaging. All suspicious lesions seen on CT were positively identified on PET/CT. In 4 cases, an abnormality identified on PET/CT, was not seen on diagnostic CT. CONCLUSIONS FDG-PET/CT may play an important role in the management of vulvar and vaginal carcinoma.
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Affiliation(s)
- N L Robertson
- Department of Radiology, Memorial Sloan Kettering Cancer Center, 1275 York Av, room C278, New York, NY 10065, USA.
| | - H Hricak
- Department of Radiology, Memorial Sloan Kettering Cancer Center, 1275 York Av, room C278, New York, NY 10065, USA
| | - Y Sonoda
- Gynecologic Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - R E Sosa
- Department of Radiology, Memorial Sloan Kettering Cancer Center, 1275 York Av, room C278, New York, NY 10065, USA
| | - M Benz
- Department of Radiology, Memorial Sloan Kettering Cancer Center, 1275 York Av, room C278, New York, NY 10065, USA
| | - G Lyons
- Department of Radiology, Memorial Sloan Kettering Cancer Center, 1275 York Av, room C278, New York, NY 10065, USA
| | - N R Abu-Rustum
- Gynecologic Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - E Sala
- Department of Radiology, Memorial Sloan Kettering Cancer Center, 1275 York Av, room C278, New York, NY 10065, USA
| | - H A Vargas
- Department of Radiology, Memorial Sloan Kettering Cancer Center, 1275 York Av, room C278, New York, NY 10065, USA
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Nicholson AG, Chansky K, Crowley J, Beyruti R, Kubota K, Turrisi A, Eberhardt WEE, van Meerbeeck J, Rami-Porta R, Asamura H, Ball D, Beer DG, Beyruti R, Bolejack V, Chansky K, Crowley J, Detterbeck F, Erich Eberhardt WE, Edwards J, Galateau-Sallé F, Giroux D, Gleeson F, Groome P, Huang J, Kennedy C, Kim J, Kim YT, Kingsbury L, Kondo H, Krasnik M, Kubota K, Lerut T, Lyons G, Marino M, Marom EM, van Meerbeeck J, Mitchell A, Nakano T, Nicholson AG, Nowak A, Peake M, Rice T, Rosenzweig K, Ruffini E, Rusch V, Saijo N, Van Schil P, Sculier JP, Shemanski L, Stratton K, Suzuki K, Tachimori Y, Thomas CF, Travis W, Tsao MS, Turrisi A, Vansteenkiste J, Watanabe H, Wu YL, Baas P, Erasmus J, Hasegawa S, Inai K, Kernstine K, Kindler H, Krug L, Nackaerts K, Pass H, Rice D, Falkson C, Filosso PL, Giaccone G, Kondo K, Lucchi M, Okumura M, Blackstone E, Cavaco FA, Barrera EA, Arca JA, Lamelas IP, Obrer AA, Jorge RG, Ball D, Bascom G, Blanco Orozco A, González Castro M, Blum M, Chimondeguy D, Cvijanovic V, Defranchi S, de Olaiz Navarro B, Escobar Campuzano I, Vidueira IM, Araujo EF, García FA, Fong K, Corral GF, González SC, Gilart JF, Arangüena LG, Barajas SG, Girard P, Goksel T, González Budiño M, González Casaurrán G, Gullón Blanco J, Hernández Hernández J, Rodríguez HH, Collantes JH, Heras MI, Izquierdo Elena J, Jakobsen E, Kostas S, Atance PL, Ares AN, Liao M, Losanovscky M, Lyons G, Magaroles R, De Esteban Júlvez L, Gorospe MM, McCaughan B, Kennedy C, Melchor Íñiguez R, Miravet Sorribes L, Naranjo Gozalo S, de Arriba CÁ, Núñez Delgado M, Alarcón JP, Peñalver Cuesta J, Park J, Pass H, Pavón Fernández M, Rosenberg M, Rusch V, de Cos Escuín JS, Vinuesa AS, Serra Mitjans M, Strand T, Subotic D, Swisher S, Terra R, Thomas C, Tournoy K, Van Schil P, Velasquez M, Wu Y, Yokoi K. The International Association for the Study of Lung Cancer Lung Cancer Staging Project: Proposals for the Revision of the Clinical and Pathologic Staging of Small Cell Lung Cancer in the Forthcoming Eighth Edition of the TNM Classification for Lung Cancer. J Thorac Oncol 2015; 11:300-11. [PMID: 26723244 DOI: 10.1016/j.jtho.2015.10.008] [Citation(s) in RCA: 244] [Impact Index Per Article: 27.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2015] [Revised: 10/01/2015] [Accepted: 10/03/2015] [Indexed: 12/12/2022]
Abstract
INTRODUCTION Small cell lung cancer (SCLC) is commonly classified as either limited or extensive, but the Union for International Cancer Control TNM Classification of Malignant Tumours seventh edition (2009) recommended tumor, node, and metastasis (TNM) staging based on analysis of the International Association for the Study of Lung Cancer (IASLC) database. METHODS Survival analyses were performed for clinically and pathologically staged patients presenting with SCLC from 1999 through 2010. Prognosis was compared in relation to the TNM seventh edition staging to serve as validation and analyzed in relation to proposed changes to the T descriptors found in the eighth edition. RESULTS There were 5002 patients: 4848 patients with clinical and 582 with pathological stages. Among these, 428 had both. Survival differences were confirmed for T and N categories and maintained in relation to proposed revisions to T descriptors for seventh edition TNM categories and proposed changes in the eighth edition. There were also survival differences, notably at 12 months, in patients with brain-only single-site metastasis (SSM) compared to SSM at other sites, and SSM without a pleural effusion showed a better prognosis than other patients in the M1b category. CONCLUSION We confirm the prognostic value of clinical and pathological TNM staging in patients with SCLC, and recommend continued usage for SCLC in relation to proposed changes to T, N, and M descriptors for NSCLC in the eighth edition. However, for M descriptors, it remains uncertain whether survival differences in patients with SSM in the brain simply reflect better treatment options rather than better survival based on anatomic extent of disease.
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Affiliation(s)
- Andrew G Nicholson
- Department of Histopathology, Royal Brompton and Harefield NHS Foundation Trust and Imperial College, London, UK.
| | - Kari Chansky
- Cancer Research and Biostatistics, Seattle, WA, USA
| | - John Crowley
- Cancer Research and Biostatistics, Seattle, WA, USA
| | - Ricardo Beyruti
- Department of Thoracic Surgery, University of São Paulo, São Paulo, Brazil
| | - Kaoru Kubota
- Department of Pulmonary Medicine and Oncology, Graduate School of Medicine, Nippon Medical School, Tokyo, Japan
| | - Andrew Turrisi
- Department of Radiotherapy, Sinai Grace Hospital, Detroit, MI, USA
| | - Wilfried E E Eberhardt
- Department of Medical Oncology, West German Cancer Centre, Ruhrlandklinik, University Hospital Essen, University Duisburg-Essen, Germany
| | - Jan van Meerbeeck
- Department of Oncology, Antwerp University Hospital, Edegem (Antwerp), Belgium
| | - Ramón Rami-Porta
- Department of Thoracic Surgery, Hospital Universitari Mútua Terrassa and CIBERES Lung Cancer Group, Terrassa, Barcelona, Spain
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Quinn C, Deegan B, Cooke J, Carew S, Hannigan A, Breen P, Dunne C, Lyons G, Lyons D. 48COMPARISON OF NEUROMUSCULAR ELECTRICAL STIMULATION AND COMPRESSION STOCKINGS IN HEALTHY OLDER PEOPLE WITH ORTHOSTATIC HYPOTENSION DURING ACTIVE AND PASSIVE ORTHOSTATIC CHALLENGES - A RANDOMISED CROSSOVER STUDY. Age Ageing 2015. [DOI: 10.1093/ageing/afv109.01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Stuart T, McCall R, Sharma H, Lyons G. Modelling of wicking and moisture interactions of flax and viscose fibres. Carbohydr Polym 2015; 123:359-68. [DOI: 10.1016/j.carbpol.2015.01.053] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2014] [Revised: 01/02/2015] [Accepted: 01/15/2015] [Indexed: 10/24/2022]
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Sharma HSS, Carmichael E, Muhamad M, McCall D, Andrews F, Lyons G, McRoberts WC, Hornsby PR. Biorefining of perennial ryegrass for the production of nanofibrillated cellulose. RSC Adv 2012. [DOI: 10.1039/c2ra20716h] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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Sadashivaiah J, Wilson R, Thein A, McLure H, Hammond CJ, Lyons G. Role of prophylactic uterine artery balloon catheters in the management of women with suspected placenta accreta. Int J Obstet Anesth 2011; 20:282-7. [PMID: 21852107 DOI: 10.1016/j.ijoa.2011.06.006] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2010] [Revised: 06/06/2011] [Accepted: 06/18/2011] [Indexed: 10/17/2022]
Abstract
BACKGROUND Placenta praevia and accreta are leading causes of major obstetric haemorrhage and peripartum hysterectomy. Detection is largely based on a high index of clinical suspicion, though the diagnostic accuracy of radiological imaging is improving. Interventional radiological techniques can reduce blood loss and the incidence of hysterectomy. METHODS We have reviewed our experience with bilateral prophylactic uterine artery balloon occlusion in the management of women with suspected placenta accreta. Thirteen women at high risk of major haemorrhage due to placenta praevia or suspected placenta accreta were retrospectively studied. Uterine artery balloons were placed prophylactically under neuraxial anaesthesia in the angiography suite followed by caesarean delivery in the obstetric operating theatre. RESULTS Intraoperative blood loss and transfusion requirements were low in our case series. There were no hysterectomies or admissions to the intensive care unit. Fetal bradycardia necessitating immediate caesarean delivery occurred in two women (15.4%). CONCLUSION In our case series in women with suspected placenta accreta, prophylactic use of uterine artery balloons was associated with a low requirement for blood transfusion but with possible increased risk of fetal compromise. Performing the interventional procedure at a different site from the operative room complicated management.
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Affiliation(s)
- J Sadashivaiah
- Department of Obstetric Anaesthesia, St. James' University Hospital, Leeds, UK.
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Collyer T, Holbrook S, Lyons G. Anaesthetic management of the pregnant patient with liver disease. Trends in Anaesthesia and Critical Care 2011. [DOI: 10.1016/j.tacc.2011.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Affiliation(s)
- G Lyons
- Department of Obstetric Anaesthesia, St James' University Hospital, Leeds, UK.
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Basaranoglu G, Lyons G. Experienced hands would reduce failures of spinal anesthesia. Minerva Anestesiol 2010; 76:688-689. [PMID: 20820144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
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Kocarev M, Watkins E, McLure H, Columb M, Lyons G. Sensory testing of spinal anaesthesia for caesarean section: differential block and variability. Int J Obstet Anesth 2010; 19:261-5. [DOI: 10.1016/j.ijoa.2010.02.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2008] [Revised: 09/11/2009] [Accepted: 02/10/2010] [Indexed: 10/19/2022]
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Qua EH, Hornsby PR, Sharma HSS, Lyons G, McCall RD. Preparation and characterization of poly(vinyl alcohol) nanocomposites made from cellulose nanofibers. J Appl Polym Sci 2009. [DOI: 10.1002/app.30116] [Citation(s) in RCA: 132] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Hennebry M, Stocks G, Belavadi P, Barnes J, Wray S, Columb M, Lyons G. Effect of i.v. phenylephrine or ephedrine on the ED50 of intrathecal bupivacaine with fentanyl for Caesarean section. Br J Anaesth 2009; 102:806-11. [DOI: 10.1093/bja/aep095] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
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Collyer T, Gray D, Sandhu R, Berridge J, Lyons G. Assessment of platelet inhibition secondary to clopidogrel and aspirin therapy in preoperative acute surgical patients measured by Thrombelastography® Platelet Mapping™. Br J Anaesth 2009; 102:492-8. [DOI: 10.1093/bja/aep039] [Citation(s) in RCA: 84] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
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Chatterton TJ, Coulter A, Musselwhite C, Lyons G, Clegg S. Understanding how transport choices are affected by the environment and health: views expressed in a study on the use of carbon calculators. Public Health 2008; 123:e45-9. [PMID: 19101000 DOI: 10.1016/j.puhe.2008.10.022] [Citation(s) in RCA: 27] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVES To examine the influence that the provision of environmental information might be able to make on personal travel behaviour through analysis of the views of members of the public expressed in a study for the UK Department for Transport on attitudes towards carbon calculator tools. STUDY DESIGN A three-stage qualitative survey taking an ideographic approach to analysing public attitudes to the use of carbon calculator tools in relation to making transport decisions. METHODS Interviews and discussion groups with stakeholders, non-users and users providing extensive data that were analysed using the British Market Research Bureau's matrix mapping methodology. RESULTS Despite considerable awareness of climate change as an issue, personal carbon emissions were not found to have much influence on personal transport choice, which could be seen as being dominated by issues of cost (both in time and money), comfort and convenience. CONCLUSIONS The spatial and temporal dislocation of the cause and effects of climate change make it difficult to link the impacts of personal travel behaviour with specific activities. If environmental- and health-based information is to be provided as a lever to change travel behaviour, it may be necessary to provide information on issues such as local air pollution and personal health impacts in order to link wider benefits with a travel user's self-interest.
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Affiliation(s)
- T J Chatterton
- Air Quality Management Resource Centre, Institute for Sustainability, Health and Environment, University of the West of England, Bristol BS16 1QY, UK.
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Lyons G. Epidurals for Childbirth. Br J Anaesth 2008. [DOI: 10.1093/bja/aen031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Schulenburg HE, Sri-Chandana C, Lyons G, Columb MO, McLure HA. Hyaluronidase reduces local anaesthetic volumes for sub-Tenon’s anaesthesia. Br J Anaesth 2007; 99:717-20. [PMID: 17895235 DOI: 10.1093/bja/aem272] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Volumes of local anaesthetics for sub-Tenon's anaesthesia vary. Lower volumes produce less akinesia, whereas higher volumes increase chemosis and intra-ocular pressures. Hyaluronidase is often added to local anaesthetics to improve akinesia without increasing the volume of the injection, but this is controversial. This randomized, sequential allocation study examines the addition of hyaluronidase on the minimum local anaesthetic volume (MLAV) required for a sub-Tenon's block. METHODS Sixty-two patients having sub-Tenon's blocks for cataract surgery were randomized into two groups. The control group (n=31) received 2% w/v lidocaine and the study group (n=31) received 2% w/v lidocaine with hyaluronidase 15 IU ml(-1). Using parallel up-down sequential allocation from a 4 ml starting volume, the volumes in both groups were changed using a testing interval of 1 ml according to the quality of globe akinesia. The median effective local anaesthetic volume (MLAV) was calculated for both groups using probit regression. RESULTS The groups were similar for age, sex, and ocular axial length. The MLAV in the hyaluronidase group was 2.6 ml [95% confidence interval (CI), 2.1-3.l] and 6.4 ml (95% CI, 5.1-8.1) in the control group (P<0.002). CONCLUSIONS Hyaluronidase permits a significant 2.4-fold (95% CI, 1.8-3.4) reduction in MLAV for sub-Tenon's anaesthesia.
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Affiliation(s)
- H E Schulenburg
- Department of Anaesthesia, D Floor, Jubilee Building, The General Infirmary at Leeds, Great George Street, Leeds LS1 3EX, UK.
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Abstract
An Asian multiparous woman weighing 47 kg, who suffered from a rare myopathy, congenital fibre type disproportion, was given morphine 10 mg intramuscularly for labour analgesia. After delivery, she had diastolic hypertension and proteinuria and was prescribed magnesium sulphate. Some hours later she became unresponsive with little respiratory effort. Blood gas analysis revealed a respiratory acidosis. Naloxone administration reversed the symptoms. Further doses were required as the respiratory depression recurred. Opioid-related narcosis is the most likely diagnosis in this case. Other possible differential diagnoses were magnesium overdose or a post-ictal state. The presence of a myopathy could render this patient susceptible to the respiratory effects of opioids. Other explanations for an exaggerated and delayed response to opioids include co-administration of other respiratory depressant drugs such as magnesium sulphate, co-morbidity such as renal impairment and genetic variability in the metabolism of morphine. Robust guidelines and highlighting patients with risk factors are required to prevent this complication from recurring.
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Affiliation(s)
- K Robins
- Department of Anaesthesia, St James' University Hospital, Leeds, UK.
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Lyons G. Analgesia, Anaesthesia and Pregnancy—A Practical Guide. Br J Anaesth 2007. [DOI: 10.1093/bja/aem255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Dunstan JA, Breckler L, Hale J, Lehmann H, Franklin P, Lyons G, Ching SYL, Mori TA, Barden A, Prescott SL. Supplementation with vitamins C, E, beta-carotene and selenium has no effect on anti-oxidant status and immune responses in allergic adults: a randomized controlled trial. Clin Exp Allergy 2007; 37:180-7. [PMID: 17250690 DOI: 10.1111/j.1365-2222.2007.02657.x] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
BACKGROUND Anti-oxidants are of growing interest in early treatment and prevention of allergic diseases in early life, but the effects on allergen-specific immune responses need to be documented further before intervention studies in infants are undertaken. The aim of this study in adults was to determine the effects of dietary anti-oxidants on allergen-specific immune responses in sensitized individuals. METHODS In a randomized controlled trial, 54 allergic adults received an anti-oxidant supplement (n=36) comprising beta-carotene (9 mg/day), vitamin C (1500 mg/day), vitamin E (130 mg/day), zinc (45 mg/day), selenium (76 microg/day) and garlic (150 mg/day) or a placebo (n=18) for 4 weeks. Anti-oxidant capacity (AC), serum levels of vitamin C, vitamin E, beta-carotene and selenium, peripheral blood responses, exhaled nitric oxide (eNO), as a marker of airway inflammation, and plasma F(2) isoprostanes, as a measure of oxidative stress, were measured before and after supplementation. RESULTS Anti-oxidant supplementation resulted in significant increases in serum levels of vitamin C, vitamin E, beta-carotene and selenium levels, compared with the placebo group (P<0.001). There was no change in serum AC, plasma F(2)-isoprostanes, eNO or immune responses following supplementation with anti-oxidants compared with placebo. CONCLUSION Supplementation with anti-oxidants resulted in significantly increased levels of vitamin C, vitamin E, beta-carotene and selenium but no change in immune responses, serum AC or plasma F(2)-isoprostanes.
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Affiliation(s)
- J A Dunstan
- School of Paediatrics and Child Health, University of Western Australia, Perth, WA, Australia.
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Abstract
As anaesthetic-related maternal mortality reduces in the developed world, alternative indicators of obstetric anaesthetic quality are required. Serious morbidity is difficult to define and quantify, but can be reduced by the provision of effective critical care. Regional anaesthesia, although safer than general anaesthesia, is not without risks. Evidence-based strategies exist to reduce the risks.
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Affiliation(s)
- A P Robinson
- Department of Obstetric Anaesthesia, St James's University Hospital, Leeds, UK
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Dunstan JA, Breckler L, Hale J, Lehmann H, Franklin P, Lyons G, Lyonso G, Ching SYL, Mori TA, Barden A, Prescott SL. Associations between antioxidant status, markers of oxidative stress and immune responses in allergic adults. Clin Exp Allergy 2007; 36:993-1000. [PMID: 16911355 DOI: 10.1111/j.1365-2222.2006.02539.x] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND There has been growing interest in the role of antioxidant function in controlling inflammatory disease states, such as allergy. This study investigated the relationship between antioxidant status, markers of airways inflammation [exhaled nitric oxide (eNO)], oxidative stress (F(2) isoprostanes) and immune responses in allergic adults. METHODS Antioxidants (vitamins C, E, beta-carotene and selenium) and total antioxidant capacity (tAC) in serum were examined in relation to eNO, plasma F(2) isoprostanes and peripheral blood mononuclear cell (PBMC) cytokine and lymphoproliferative response to house dust mite (HDM) allergen, Staphylococcus enterotoxin B (SEB), phytohaemaglutinin (PHA) and lipopolysaccharide (LPS) in 54 allergic adults. RESULTS Firstly, levels of specific vitamins did not correlate with tAC. Secondly, we did not see any evidence that specific vitamin levels (or tAC) were associated with either polarization or attenuation of in vitro immune responses. If anything, there were positive correlations between antioxidant (vitamin C and selenium) levels and HDM allergen responses [lymphoproliferation (selenium; r=0.35, P=0.013) and both Th2 IL13 (vitamin C; tau=0.254, P=0.028) and Th1 IFN-gamma (vitamin C; tau=0.302, P=0.009) responses]. There were also significant positive relationships between antioxidant levels and IL-10 responses to polyclonal stimulation by SEB (r=0.292, P=0.036) and LPS (r=0.34, P=0.015) (beta-carotene) and PHA (r=0.34, P=0.021) (tAC). Thirdly, although airways inflammation (eNO) was associated with both in vitro and in vivo (skin test reactivity) to HDM, we did not see any correlation between eNO and oxidative stress (F(2)-isoprostanes). Finally, there were no consistent relationships between oxidative stress and immune responses. CONCLUSION There was no evidence that higher antioxidant levels were associated with reduced allergen responsiveness in allergic adults. If anything, antioxidant status was associated with increased immune responsiveness. The significance of this needs to be addressed in future intervention studies.
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Affiliation(s)
- J A Dunstan
- School of Paediatrics and Child Health, University of Western Australia, Perth, WA, Australia
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Schulenburg H, Sri-Chandana C, Dutton M, Lyons G, Columb M, McLure H. �Does hyaluronidase permit volume reduction in sub-Tenon's anaesthesia for cataract extractions? Anaesthesia 2007. [DOI: 10.1111/j.1365-2044.2006.04944_16.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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McDonnell E, Lyons G, Chau S. Effects of storing blood in citrated silicone-coated glass tubes vs. citrated plastic tubes on thromboelastograph variables. Eur J Anaesthesiol 2007; 24:291-2. [PMID: 17087845 DOI: 10.1017/s0265021506001487] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/15/2006] [Indexed: 11/06/2022]
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Dunstan JA, Breckler L, Hale J, Lehmann H, Franklin P, Lyons G, Ching SYL, Mori TA, Barden A, Prescott SL. Associations between antioxidant status, markers of oxidative stress and immune responses in allergic adults. Clin Exp Allergy 2006. [DOI: 10.1111/j.1365-2222.2006.02610.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Backe SK, Kocarev M, Wilson RC, Lyons G. Effect of maternal facial oxygen on neonatal behavioural scores during elective Caesarean section with spinal anaesthesia. Eur J Anaesthesiol 2006; 24:66-70. [PMID: 16895615 DOI: 10.1017/s0265021506001153] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/16/2006] [Indexed: 11/06/2022]
Abstract
BACKGROUND AND OBJECTIVE For many, the administration of additional oxygen to the women receiving regional anaesthesia for Caesarean section is traditional, but for others it is controversial because of doubts about its efficacy. The aim of our study was to determine if beneficial effects of maternal oxygen therapy on the fetus could be revealed using a neonatal behavioural scoring system. METHODS Sixty women with a normal singleton pregnancy beyond 36 weeks gestation, undergoing elective Caesarean section under spinal anaesthesia were randomized into two groups: Group 1 received air and oxygen mixture through a Hudson style face mask (FiO2 of 0.21-0.25). Group 2 received FiO2 of 0.40-0.60 through an identical Hudson style face mask. Neurologic Adaptive Capacity Score on all the infants within 5 min of birth and between 10 and 24 h after the Caesarean delivery was performed. Apgar score, umbilical venous blood oxygen tension and umbilical artery standardized base excess were recorded. RESULTS Initial Neurologic Adaptive Capacity Scores at birth in Groups 1 and 2 were 32.6 (SD 4.6) and 31.3 (SD 4.3), respectively. Latter scores were 36.0 (SD 3.0) and 36.5 (SD 1.9), respectively. Neither were statistically significant. There were no significant differences between the groups for any of the recorded variables. CONCLUSIONS Administering maternal oxygen using a standard commercial Hudson style face mask does not appear to significantly improve oxygen delivery to, nor does it influence acidosis or behavioural effects in, the normal neonate at elective Caesarean delivery with spinal anaesthesia.
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Affiliation(s)
- S K Backe
- Wansbeck General Hospital, Department of Anaesthesia, Ashington, UK
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McCall T, Fassett DR, Lyons G, Couldwell WT. Inflammatory pseudotumor of the cavernous sinus and skull base. Neurosurg Rev 2006; 29:194-200. [PMID: 16565875 DOI: 10.1007/s10143-006-0017-9] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2005] [Revised: 11/02/2005] [Accepted: 11/04/2005] [Indexed: 11/29/2022]
Abstract
Inflammatory pseudotumor is a non-neoplastic process of unknown etiology characterized by a proliferation of connective tissue with an inflammatory infiltrate. Intracranial inflammatory pseudotumors classically involve the cavernous sinus but can also occur in the supratentorial or infratentorial compartments and spinal canal. Symptoms are dependent on location, and, when present in the cavernous sinus, typically include cranial nerve palsies of those nerves in the cavernous sinus. These lesions are rapidly responsive to steroid therapy. Surgery is typically indicated for biopsy only, but complete resection may be justified for lesions outside the cavernous sinus.
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Affiliation(s)
- Todd McCall
- Department of Neurosurgery, University of Utah, 30 North 1900 East, Suite 3B409, Salt Lake City, UT, 84132, USA
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Arshak A, Arshak K, Morris D, Jafer E, Korostynska O, Lyons G, Waldron D. A review of digestible microsystems for gastrointestinal tract diagnostic applications. Crit Rev Biomed Eng 2006; 34:163-86. [PMID: 16749891 DOI: 10.1615/critrevbiomedeng.v34.i2.20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
Present methods for investigation of the GI tract are invasive, distressing for the patient, and give a low diagnostic yield. Wireless, radio telemetry capsules, capable of monitoring physiological changes or visualizing the GI tract are noninvasive and could realize a faster time to diagnoses along with improved treatment of both organic diseases and functional disorders. Consequently, the patient's quality of life would improve. In this paper, early radiotelemetry capsules and the motivating factors for their development are discussed. Following this, prototype and commercially available digestible microsystems making use of microelectronics and microelectromechanical systems are presented. It is shown that these capsules have the potential to combine the functions of their predecessors and furthermore can be used for visualizing the gastrointestinal tract. These systems have the potential to improve diagnostic yield and, in the future, treatment of disease using these capsules should become a reality.
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Affiliation(s)
- A Arshak
- Physics Department, University of Limerick, Ireland.
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Saravanan S, Kocarev M, Wilson RC, Watkins E, Columb MO, Lyons G. Equivalent dose of ephedrine and phenylephrine in the prevention of post-spinal hypotension in Caesarean section. Br J Anaesth 2006; 96:95-9. [PMID: 16311286 DOI: 10.1093/bja/aei265] [Citation(s) in RCA: 122] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Comparative studies of ephedrine and phenylephrine in prevention of hypotension after spinal anaesthesia for Caesarean section have lacked a consensus on dose equivalence. The aim of this study was to determine the minimum vasopressor dose for each of these drugs to calculate the dose ratio for clinical equivalence in the prevention of hypotension. METHODS Patients with a normal singleton pregnancy beyond 36 weeks gestation undergoing elective Caesarean section under spinal anaesthesia were randomized into two groups. The first patient in Group A received 50 mg of ephedrine in saline 0.9% w/v, 500 ml, at 999 ml h(-1), the maximum rate possible on the pump and the first patient in Group B received 500 microg of phenylephrine in saline 0.9% w/v, 500 ml, at the same rate. The initial dose for dilution was an arbitrary choice. The dose of vasopressor in the saline bag for every subsequent patient was established by the efficacy of the dose in preventing hypotension in the previous patient according to the technique of up-down sequential allocation. Minimum vasopressor dose for each drug was determined according to the Dixon-Massey formula. RESULTS The minimum vasopressor dose in saline 500 ml was 532.9 microg (95% CI 506.0-559.8) for phenylephrine and 43.3 mg (95% CI 39.2-47.3) for ephedrine. The concentration needed for equivalence at an infusion rate of 999 ml h(-1) was 1.07 microg ml(-1) for phenylephrine and 86.66 microg ml(-1) for ephedrine. Mean (sd) dose used for phenylephrine was 496.45 (78.3) microg and for ephedrine 39.64 (6.33) mg. CONCLUSION This study demonstrates a potency ratio of 81.2 (95% CI 73.0-89.7) for equivalence between phenylephrine and ephedrine in prevention of hypotension after spinal anaesthesia for Caesarean section.
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Affiliation(s)
- S Saravanan
- Department of Anaesthesia, Hull Royal Infirmary, Anlaby Road, Hull, UK
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Sharma HSS, Kilpatrick M, Lyons G, Sturgeon S, Archer J, Moore S, Cheung L, Finegan K. Visible and near-infrared calibrations for quality assessment of fresh phase I and II mushroom (Agaricus bisporus) compost. Appl Spectrosc 2005; 59:1399-405. [PMID: 16316519 DOI: 10.1366/000370205774783241] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
Previous studies have shown that visible and near-infrared spectra (Vis-NIR) of dry and milled compost can be used for generating partial least squares (PLS) calibrations of phase II compost parameters including ammonia, nitrogen dry matter (NDM), dry matter (DM), pH, conductivity, carbon, microbial population, and potential productivity. The objective of this study was to develop robust calibrations for some of the key parameters from the spectra of fresh phase I and II composts. Samples of substrates from six commercial production yards were obtained during winter and summer months of 2000-2004 to monitor changes in quality and were analyzed for the test factors. Vis-NIR reflectance measurements of fresh samples (740) were made over the range of 400-2500 nm. After mathematical pretreatments, PLS calibrations of the key parameters were developed using the NIR (1100-2500 nm) and visible and NIR (400-2500 nm) regions and subsequently validated using an independent sample set of 123 phase I and II samples obtained during 2004-2005. The phase I and II standard errors of laboratory measurements of ammonia, pH, conductivity, DM, NDM, and ash were lower than the standard error of predictions of the same parameters, respectively, by the best NIR or Vis-NIR models. The degree of precision for some of the calibrations, especially ammonia, NDM, and DM, is suitable for composters to monitor changes in quality parameters during production. The laboratory measurement errors for phase I samples were greater than those of the phase II samples, except for ash, due to a higher degree of heterogeneity in the substrate. The calibrations, especially for pH, conductivity, and ash, need to be improved with new sample sets. A major advantage of NIR spectroscopy is the ability to assess substrate quality for a range of target parameters simultaneously, within a few hours of receiving the samples. The main drawbacks are the expensive instrumentation, expertise, and training necessary for operating the spectrometer and a dedicated chemometrician required for maintaining the equations compared to the reference methods.
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Affiliation(s)
- H S S Sharma
- Department of Applied Plant Science, School of Agriculture and Food Science, The Queen's University of Belfast, Applied Plant Science Division, Newforge Lane, Belfast BT9 5PX, UK.
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Beale N, Evans B, Plaat F, Columb MO, Lyons G, Stocks GM. Effect of epidural volume extension on dose requirement of intrathecal hyperbaric bupivacaine at Caesarean section. Br J Anaesth 2005; 95:500-3. [PMID: 16040637 DOI: 10.1093/bja/aei200] [Citation(s) in RCA: 32] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND The technique of epidural volume extension (EVE) involves the injection of saline into the extradural space immediately following the intrathecal injection, as part of a combined spinal-epidural (CSE) anaesthetic. One of the suggested benefits of EVE is a reduction in local anaesthetic required. The aim of this study was to test this hypothesis by comparing the median effective doses (ED50) of hyperbaric bupivacaine with fentanyl 25 microg with and without EVE for Caesarean section. METHODS Sixty women were randomized to receive either CSE anaesthesia with EVE (EVE group) or no EVE (NEVE group). Using a double-blinded, up-down sequential technique, varying doses of bupivacaine with fentanyl 25 microg were administered. ED50 was estimated from up-down reversals and probit regression. RESULTS The ED50 for bupivacaine was similar and not significantly different in the two groups (5.1 mg in the EVE and 6.1 mg in the NEVE group; difference 1.0 mg, 95% CI -0.12 to 2.2, P=0.08). CONCLUSIONS This study illustrates that whilst low doses of intrathecal bupivacaine can be effectively used for Caesarean section, at such doses EVE does not appear to offer reliable or clinically relevant reductions in dosing with intrathecal bupivacaine.
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Affiliation(s)
- N Beale
- Queen Charlotte's and Chelsea Hospital, London, UK
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Lyons G. The Life Satisfaction Matrix: an instrument and procedure for assessing the subjective quality of life of individuals with profound multiple disabilities. J Intellect Disabil Res 2005; 49:766-9. [PMID: 16162124 DOI: 10.1111/j.1365-2788.2005.00748.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
BACKGROUND Assessing and measuring subjective quality of life (QOL) for individuals with profound multiple disabilities (PMD) remain amongst the most difficult challenges for theorists and practitioners in the field. The usual approaches using proxy reporting by familiar others have been demonstrated to be of questionable reliability and validity for persons with PMD. METHOD The author's continuing research into understanding the nature of subjective QOL of these individuals has led to the development and evaluating the Life Satisfaction Matrix (LSM), an instrument and procedure for assessing the subjective QOL of these individuals. RESULTS Qualitative research that provides empirical evidence to support the assumptions underpinning, and face validity of, the LSM is described in this article. CONCLUSION Results of the study described herein demonstrate some potential to meet and overcome the above-mentioned challenges to assess and measure the subjective QOL of individuals with PMD.
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Affiliation(s)
- G Lyons
- School of Education, Macquarie University, Sydney, Australia.
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Affiliation(s)
- B J Hunt
- Department of Clinical & Laboratory Haematology & Lupus Unit, Guy's & St Thomas' Foundation Trust, London, UK.
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Sharma HSS, Kilpatrick M, Lyons G. Prediction of potential mushroom yield by visible and near-infrared spectroscopy using fresh phase II compost. Appl Spectrosc 2005; 59:1054-9. [PMID: 16105216 DOI: 10.1366/0003702054615269] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
Potential mushroom (Agaricus bisporus) yield of phase II compost is determined by interactions of key quality parameters including dry matter, nitrogen dry matter, ammonia, pH, conductivity, thermophilic microorganisms, C : N ratio, fiber fractions, ash, and certain minerals. This study was aimed at generating robust visible and near-infrared (Vis-NIR) calibrations for predicting potential yield, using spectra from fresh phase II compost. Four compost comparative trials were carried out during the winter and summer months of 2001-2003, under controlled experimental conditions employing six commercially prepared composts, with eight replicate (8 bag) plots per treatment (48 x 8 = 384). The substrates were prepared by windrow or bunker phase I, followed by phase II production. The fresh samples were scanned for Vis-NIR (400-2498 nm) spectra, averaged, transformed, and regressed against the recorded yield by employing a modified partial least squares algorithm. The best calibration model generated from the database explained 84% of yield variation within the data set with a standard error of calibration of 13.75 kg/tonne of fresh compost. The model was successfully tested for robustness with yield results obtained from a validation trial, carried out under similar experimental conditions in early 2004, and the standard error of prediction was 18.21 kg/tonne, which was slightly higher than the mean experimental error (17.94 kg/tonne) of the trial. The accuracy of the model is acceptable for estimating potential yield by classifying phase II substrate as poor (180-220 kg), medium (220-260 kg), and high (260-300 kg) yielding compost. The yield prediction model is being transferred to a new instrument based at Loughgall for routine evaluation of commercial phase II samples.
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Affiliation(s)
- H S S Sharma
- Department of Applied Plant Science, School of Agriculture and Food Science, Queen's University Belfast, UK
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Robins K, Wilson R, Watkins EJ, Columb MO, Lyons G. Chlorhexidine spray versus single use sachets for skin preparation before regional nerve blockade for elective caesarean section: an effectiveness, time and cost study. Int J Obstet Anesth 2005; 14:189-92. [PMID: 15935648 DOI: 10.1016/j.ijoa.2005.02.006] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2004] [Revised: 02/01/2005] [Accepted: 02/01/2005] [Indexed: 11/26/2022]
Abstract
INTRODUCTION The importance of skin preparation before regional nerve blockade to prevent infection remains unchallenged. A multi-use spray chlorhexidine may have benefits over single use sachets in terms of convenience and cost, but its efficacy is unknown. We conducted a prospective randomised trial to compare spray and sachet chlorhexidine. METHODS Elective caesarean section patients were randomised to receive chlorhexidine as a spray (chlorhexidine 0.5% in an alcoholic solution Hydrex DS Derma spray, Adams Healthcare, Leeds, UK) or sachet chlorhexidine (chlorhexidine 0.05% aqueous solution, Unisept, Seton. Leeds, UK) before a standardised combined spinal epidural technique. Skin colonisation was examined before skin preparation and again after epidural catheter removal. RESULTS Both techniques were effective in reducing skin colonisation (P=0.0001). There was no difference in effectiveness between the groups, with the spray reducing skin colonisation from 88.5% before to 3% after catheter removal, compared with 90% to 12% in the sachet group. Time to achieve skin preparation was significantly reduced in the spray group (2.6 min compared to 4.5 min; P=0.02). The spray cost per patient was 0.01 compared to sachet 0.33. CONCLUSIONS We suggest a chlorhexidine spray is as effective as single use sachets and is also quicker to apply and less costly.
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Affiliation(s)
- K Robins
- Department of Obstetric Anaesthesia, St. James's University Hospital, Leeds, UK.
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Abstract
OBJECTIVE To establish the risk of serious complications from severe pre-eclampsia and eclampsia in a region using a common guideline for the management of these conditions. DESIGN A five-year prospective study. SETTING Sixteen maternity units in Yorkshire. POPULATION All women managed with severe pre-eclampsia and eclampsia. METHODS A common guideline was developed for the management of women with these conditions. A network of midwives prospectively collected outcome data. MAIN OUTCOME MEASURE Incidence of the conditions and serious complication rates. RESULTS A total of 210,631 women delivered in the 16 units between 1 January 1999 and 31 December 2003. One thousand eighty-seven women were diagnosed with severe pre-eclampsia or eclampsia (5.2/1000). One hundred and fifty-one women had serious complications including 82 women (39/10,000) having eclamptic seizures and 49 women (23/10,000) requiring ICU admission. There were no maternal deaths but 54 out of 1145 babies died before discharge, giving a mortality rate of 47.2/1000. Of the 82 cases of eclampsia, 45 occurred antenatally (55%), 18 before admission to the maternity unit. Eleven cases occurred in labour (13%), including 1 during a caesarean section, and 26 cases occurred following delivery (32%). Twenty-five women developed pulmonary oedema (2.3% of cases) and six women required renal dialysis (0.55% of cases). One hundred and sixty-five (15%) required no antihypertensive therapy and 489 (53%) of the remainder required only oral therapy. Two hundred and one (18.5%) required more than one drug. CONCLUSION A regional guideline for severe pre-eclampsia and eclampsia can be developed and implemented. Its use may contribute to a low rate of serious complications.
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Affiliation(s)
- D J Tuffnell
- Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK
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Akerman N, Saxena S, Wilson R, Columb M, Lyons G. Effect of intrathecal diamorphine on block height during spinal anaesthesia for Caesarean section with bupivacaine. Br J Anaesth 2005; 94:843-7. [PMID: 15849209 DOI: 10.1093/bja/aei138] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Opioid analgesics are commonly added to intrathecal bupivacaine to improve patient comfort during Caesarean section under spinal anaesthesia, and provide post-operative pain relief. We sought to discover if the addition of diamorphine influenced block height when given with 0.5% w/v hyperbaric bupivacaine. METHOD Eighty ASA I and II women of at least 37 weeks gestation and planned for elective Caesarean section under combined spinal-epidural anaesthesia were recruited. They were randomized into two groups to receive intrathecal hyperbaric bupivacaine 0.5% at an initial dose of 13 mg, with the next dose determined by the response of the previous patient (dose interval 1 mg). One group also received diamorphine 400 microg intrathecally. If a block height of T5 to blunt light touch had been achieved after 20 min, the block was deemed effective. A difference in the ED50 for hyperbaric bupivacaine between the groups would indicate that diamorphine influenced block height. Intraoperative patient discomfort and need for analgesic supplementation was noted. RESULTS The median effective dose (ED50) to achieve a T5 block to light touch for Caesarean section using hyperbaric bupivacaine 0.5% was 9.95 mg [95% confidence interval (CI) 9.0-10.90] and with the addition of diamorphine it was 9.3 mg (95% CI 8.15-10.40), while the ED95 was 13.55 mg (95% CI 10.10-17.0) and 13.6 mg (95% CI 9.15-18.05), respectively. Five women who had received intrathecal diamorphine and 13 who had not received diamorphine needed intraoperative supplementation (not significant). CONCLUSION The addition of intrathecal diamorphine does not appear to influence block height.
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Affiliation(s)
- N Akerman
- Department of Obstetric Anaesthesia, St James' University Hospital, Leeds, UK
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Affiliation(s)
- N Akerman
- Obstetric Anaesthesia, St. James' University Hospital, Leeds, UK,
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Lyons G. Radiograph mix-up. N Y State Dent J 2005; 71:8; author reply 8. [PMID: 15887460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
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