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Jones B, Cammidge J, Evan C, Scott G, Sherriffs P, Breen F, Andersen P, Popov K, O'Hara J. Degradation of polymer banknotes through handling, and effect on fingermark visualisation. Sci Justice 2022; 62:644-656. [DOI: 10.1016/j.scijus.2022.08.007] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Revised: 07/12/2022] [Accepted: 08/29/2022] [Indexed: 11/17/2022]
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Kaur H, Reyes-Barron C, Scott G. Immunohistochemistry Aids in the Diagnosis of Blastic Plasmacytoid Dendritic Cell Neoplasm in a Patient with Multiple Cutaneous Plaques and Nodules. Am J Clin Pathol 2021. [DOI: 10.1093/ajcp/aqab191.095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction/Objective
Blastic Plasmacytoid Dendritic Cell Neoplasm (BPDCN) is a rare hematologic malignancy of plasmacytoid dendritic cell precursors with an estimated incidence of 0.04 cases per 100,000 in the US. Given the cutaneous tropism of BPDCN, it should be differentiated from other CD56+ hematopoietic neoplasms with skin involvement such as CD56+ AML, extranodal NK/T-cell lymphoma, and other T-cell lymphomas.
Methods/Case Report
A 71-year-old male presented to the emergency department with asymptomatic, pink- violaceous plaques/nodules on the trunk for 3 months. One month prior, a dermatologist diagnosed epidermal inclusion cysts that were left untreated. The nodules progressed and a course of steroids prescribed by a primary care physician provided short term improvement before the lesions flared again. Review of systems and vitals were normal. Biopsies of representative lesions sent for histologic examination showed a diffuse dermal infiltrate of small to medium atypical cells with irregular nuclear contours, fine chromatin, one to several nucleoli and scant cytoplasm. Immunohistochemistry showed these cells were positive for CD2, CD4, CD56 and CD45 with strong expression of BCL2 and focal CD123. The cells were negative for CD3, CD20, CD79a, CD8, CD30, ALK-1, MUM-1, CD10, Cyclin- D1, C-MYC, EBER, BCL6, Langerin, Granzyme, TIA1, CD68, CD163, MPO, and Lysozyme. The histology and immunoprofile were consistent with BPDCN. A bone marrow biopsy showed cells with similar morphology and staining pattern, including expression of CD123.Treatment with chemotherapy and Tagraxofusp, was initiated. Within a week, the patient showed near resolution of cutaneous lesions. Repeat bone marrow aspirate and flow cytometry a month later showed no malignant cells.
Results (if a Case Study enter NA)
NA
Conclusion
We present this case as a rare hematologic malignancy with a challenging clinical and histopathologic diagnosis. The histologic findings suggested either a high grade myeloid or lymphoid malignancy. The combination of CD3-/CD56+/CD4+/CD123+ in the lesional cells helped establish the diagnosis of BPDCN, allowing for prompt treatment.
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Affiliation(s)
- H Kaur
- Pathology, URMC, Rochester, New York, UNITED STATES
| | | | - G Scott
- Pathology, URMC, Rochester, New York, UNITED STATES
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AbuRahma AF, Beasley M, AbuRahma ZT, Davis M, Adams E, Dean LS, Shapiro J, Scott G, Davis E. Clinical Outcome of Drug-Eluted Stenting (Zilver PTX) in Patients With Femoropopliteal Occlusive Disease a Single Center Experience. J Endovasc Ther 2021; 29:350-360. [PMID: 34622706 DOI: 10.1177/15266028211049339] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Few industry sponsored trials reported satisfactory outcomes in the use of drug-eluting stents (DES) for treatment of femoropopliteal arterial disease. This study analyzed the early/late clinical outcome from a real world single center. PATIENT POPULATIONS/METHODS A total of 115 limbs treated with Zilver PTX were analyzed for: major adverse limb event (MALE: above ankle limb amputation/major intervention at 1 year), major adverse events (MAEs; death, amputation, and target lesion thrombosis/reintervention), primary patency (based on duplex ultrasound ± ankle brachial indexes), limb salvage, and amputation free survival rates (AFS) at 1 and 2 years. RESULTS Indications included claudication in 32% and critical limb threatening ischemia (CLTI) in 68%. Lesions treated included: superficial femoral artery (SFA) 66%, both SFA and popliteal artery (PA) 19% and PA 15%. Mean lesion length was 21 cm and 68% had total occlusion. 45% were Trans-Atlantic Inter-Society Consensus (TASC) TASC II D lesions and 55% A-C lesions. Mean follow-up was 18.4 months (1-76 months). Perioperative major morbidity rate was 8.7% with 0% mortality. MALE rate at 1 year was 17% (13.5% for claudication vs 19.2% for CLTI, p=0.4499). MAE rate was 30% for claudication versus 52% for CLTI (p=0.0392). Overall primary patency rates at 1 and 2 years were 75% and 54% (86% and 71% for claudication vs 70% and 46% for CLTI, respectively, p=0.0213). Primary patency rates at 1 and 2 years were 94% and 88% for TASC A-C lesions versus 50% and 16% for TASC D lesions (p<0.0001). Overall freedom from MALE rate at 1 and 2 years were 85% and 79% (86% and 86% for claudication vs 84% and 74% for CLTI, p=0.2391). These rates were 96% and 93% for TASC A-C lesions versus 70% and 50% for D lesions, respectively (p<0.0001). Limb salvage rates at 1 and 2 years were 93% and 86% (100% and 100% for claudication vs 89% and 78% for CLTI, p=0.012). Overall AFS rates at 1 and 2 years were 79% and 71% (93% and 82% for TASC A-C vs 59% and 59% for D lesions, p=0.001). CONCLUSION Clinical outcomes after DES (Zilver PTX) in femoropopliteal arterial lesions were satisfactory for TASC A-C lesions but inferior/unsatisfactory for TASC D lesions.
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Affiliation(s)
- Ali F AbuRahma
- Department of Surgery, West Virginia University-Charleston Division, Charleston, WV, USA
| | - Matthew Beasley
- Department of Surgery, West Virginia University-Charleston Division, Charleston, WV, USA
| | - Zachary T AbuRahma
- Department of Surgery, West Virginia University-Charleston Division, Charleston, WV, USA
| | - Meghan Davis
- Department of Surgery, West Virginia University-Charleston Division, Charleston, WV, USA
| | - Elliot Adams
- Department of Surgery, West Virginia University-Charleston Division, Charleston, WV, USA
| | - L Scott Dean
- CAMC Institute for Academic Medicine, Charleston, WV, USA
| | | | | | - Elaine Davis
- CAMC Institute for Academic Medicine, Charleston, WV, USA
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Biggs A, Scott G, Solan MC, Williamson M. Achilles tendon rupture: what you need to know. Br J Hosp Med (Lond) 2021; 82:1-7. [PMID: 33646025 DOI: 10.12968/hmed.2020.0593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Heel pain and a history of a 'pop' or feeling 'something go' are the buzz phrases classically associated with Achilles tendon rupture. However, the diagnosis is often missed in clinical practice because of the assumption that this is a sporting injury suffered only by the young or middle-aged. In a sedentary older patient, the injury may be dismissed as an ankle sprain. If swelling is present but no injury is recalled then deep vein thrombosis is suspected, but Achilles rupture is not. The diagnosis of Achilles tendon rupture is clinical, based on history and examination. Radiological imaging (ultrasound scan) is useful to plan orthopaedic management and exclude concomitant deep vein thrombosis. In most cases, non-operative management with the ankle held plantar flexed in a boot is the current best practice.
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Affiliation(s)
- A Biggs
- Department of Trauma and Orthopaedics, Royal Surrey Hospital, Guildford, Surrey, UK
| | - G Scott
- Department of Trauma and Orthopaedics, Royal Surrey Hospital, Guildford, Surrey, UK
| | - M C Solan
- Department of Trauma and Orthopaedics, Royal Surrey Hospital, Guildford, Surrey, UK
| | - M Williamson
- Department of Trauma and Orthopaedics, Royal Surrey Hospital, Guildford, Surrey, UK
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Affiliation(s)
- P R Shah
- Department of Dermatology, University of Rochester Medical Center, Rochester, NY, U.S.A
| | - G Scott
- Department of Dermatology, University of Rochester Medical Center, Rochester, NY, U.S.A
| | - L A Beck
- Department of Dermatology, University of Rochester Medical Center, Rochester, NY, U.S.A
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AbuRahma AF, AbuRahma ZT, Scott G, Adams E, Beasley M, Davis M, Dean LS, Davis E. Clinical outcome of drug-coated balloon angioplasty in patients with femoropopliteal disease: A real-world single-center experience. J Vasc Surg 2019; 70:1950-1959. [PMID: 31401115 DOI: 10.1016/j.jvs.2019.03.072] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2019] [Accepted: 03/29/2019] [Indexed: 01/01/2023]
Abstract
BACKGROUND Several multicenter industry-sponsored clinical trials reported satisfactory results in the use of drug-coated balloons (DCBs) for treatment of femoropopliteal occlusive disease. However, few single-center studies have been published to verify the outcome from real-world experience. METHODS In this study, 228 patients treated with DCB angioplasty (Lutonix 0.35; Bard, Tempe, Arizona) were analyzed. Perioperative major adverse events (death, amputation, target lesion thrombosis or reintervention) were calculated. Kaplan-Meier analysis was used to estimate primary patency rates (based on duplex ultrasound with or without ankle-brachial index) and limb salvage rates. RESULTS Lesions treated were primarily TransAtlantic Inter-Society Consensus (TASC) type C and D lesions. Indications included claudication (Rutherford classes 2 and 3) in 40% and critical limb ischemia (CLI; Rutherford classes 4 and 5) in 60%. Lesions treated included 61% in the superficial femoral artery, 15% in the popliteal artery, and 24% in both superficial femoral artery and popliteal artery. Mean follow-up was 12.2 months (range, 1-42 months). Overall perioperative morbidity and mortality rates were 13% and 1%. The perioperative major adverse event rate was 3%. Symptom relief (improvement of one Rutherford category or more) was obtained in 64%. Primary patency rates were 56% and 39% at 1 year and 2 years, respectively. Limb salvage rates were 92% and 83% at 1 year and 2 years. Patients with claudication had a lower rate of early perioperative complications (4% vs 19%; P = .001). Symptom improvement was 76% for claudication vs 49% for CLI (P < .001). Overall, major amputation rate was 0% for claudication vs 13% for CLI (P < .001). The primary patency rates at 1 year and 2 years were 59% and 41% for claudication vs 54% and 37% for CLI (P = .307). The assisted primary patency rates at 1 year and 2 years were 72% and 52% for claudication vs 64% and 46% for CLI (P = .223). Primary patency rates at 1 year and 2 years were 82% and 71% for TASC A to C lesions vs 29% and 14% for TASC D lesions (P < .001). Limb salvage rates at 1 year and 2 years were 100% and 100% for claudication vs 85% and 74% for CLI (P < .001). CONCLUSIONS Clinical outcomes after DCB angioplasty in femoropopliteal lesions were inferior to what has been reported in previous studies, particularly for TASC D lesions. Further investigation from real-world experience with long-term follow-up is needed to confirm these results.
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Affiliation(s)
- Ali F AbuRahma
- Department of Surgery, West Virginia University, Charleston, WVa.
| | | | - Grant Scott
- Department of Surgery, West Virginia University, Charleston, WVa
| | - Elliot Adams
- Department of Surgery, West Virginia University, Charleston, WVa
| | - Matthew Beasley
- Department of Surgery, West Virginia University, Charleston, WVa
| | - Meghan Davis
- Department of Surgery, West Virginia University, Charleston, WVa
| | - L Scott Dean
- CAMC Health Education and Research Institute, Charleston, WVa
| | - Elaine Davis
- CAMC Health Education and Research Institute, Charleston, WVa
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Key S, Scott G, Stammers JG, Freeman MAR, Pinskerova V, Field RE, Skinner J, Banks SA. Does lateral lift-off occur in static and dynamic activity in a medially spherical total knee arthroplasty? A pulsed-fluoroscopic investigation. Bone Joint Res 2019; 8:207-215. [PMID: 31214333 PMCID: PMC6548977 DOI: 10.1302/2046-3758.85.bjr-2018-0237.r1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Objectives The medially spherical GMK Sphere (Medacta International AG, Castel San Pietro, Switzerland) total knee arthroplasty (TKA) was previously shown to accommodate lateral rollback while pivoting around a stable medial compartment, aiming to replicate native knee kinematics in which some coronal laxity, especially laterally, is also present. We assess coronal plane kinematics of the GMK Sphere and explore the occurrence and pattern of articular separation during static and dynamic activities. Methods Using pulsed fluoroscopy and image matching, the coronal kinematics and articular surface separation of 16 well-functioning TKAs were studied during weight-bearing and non-weight-bearing, static, and dynamic activities. The closest distances between the modelled articular surfaces were examined with respect to knee position, and proportions of joint poses exhibiting separation were computed. Results Overall, 1717 joint poses were analyzed. At a 1.0 mm detection threshold, 37 instances of surface separation were observed in the lateral compartment and four medially (p < 0.001). Separation was activity-dependent, both laterally and medially (p < 0.001), occurring more commonly during static deep flexion in the lateral compartment, and during static rotation in the medial compartment. Lateral separation occurred more frequently than medial during kneeling (7/14 lateral vs 1/14 medial; p = 0.031) and stepping (20/1022 lateral vs 0/1022 medial; p < 0.001). Separation varied significantly between individuals during dynamic activities. Conclusion No consistent association between closest distances of the articular surfaces and knee position was found during any activity. Lift-off was infrequent and depended on the activity performed and the individual knee. Lateral separation was consistent with the design rationale. Medial lift-off was rare and mostly in non-weight-bearing activities. Cite this article: S. Key, G. Scott, J.G. Stammers, M. A. R. Freeman†, V. Pinskerova, R. E. Field, J. Skinner, S. A. Banks. Does lateral lift-off occur in static and dynamic activity in a medially spherical total knee arthroplasty? A pulsed-fluoroscopic investigation. Bone Joint Res 2019;8:207–215. DOI: 10.1302/2046-3758.85.BJR-2018-0237.R1.
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Affiliation(s)
- S Key
- Royal London Hospital, London, UK
| | - G Scott
- Royal London Hospital, London, UK
| | | | - M A R Freeman
- †M.A.R Freeman has deceased since the submission of this manuscript
| | - V Pinskerova
- First Orthopaedic Clinic, Faculty of Medicine, Charles University, Prague, Czech Republic
| | - R E Field
- St George's, University of London, London, UK; Director of Research, South West London Elective Orthopaedic Centre, Epsom, UK
| | - J Skinner
- Royal National Orthopaedic Hospital, Stanmore, UK
| | - S A Banks
- University of Florida, Gainesville, Florida, USA
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Wong J, Ho C, Scott G, Machin JT, Briggs T. Getting It Right First Time: the national survey of surgical site infection rates in NHS trusts in England. Ann R Coll Surg Engl 2019; 101:463-471. [PMID: 31155919 DOI: 10.1308/rcsann.2019.0064] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION Surgical site infections are associated with increased morbidity and mortality in patients. The Getting It Right First Time surgical site infection programme set up a national survey to review surgical site infection rates in surgical units in England. The objectives were for frontline clinicians to assess the rates of infection following selected procedures, to examine the risk of significant complications and to review current practice in the prevention of surgical site infection. METHODS A national survey was launched in April 2017 to assess surgical site infections within 13 specialties: breast surgery, cardiothoracic surgery, cranial neurosurgery, ear, nose and throat surgery, general surgery, obstetrics and gynaecology, ophthalmology, oral and maxillofacial surgery, orthopaedic surgery, paediatric surgery, spinal surgery, urology and vascular surgery. All participating trusts prospectively identified and collected supporting information on surgical site infections diagnosed within the six-month study period. RESULTS Data were received from 95 NHS trusts. A total of 1807 surgical site infection cases were reported. There were variations in rates reported by trusts across specialties and procedures. Reoperations were reported in 36.2% of all identified cases, and surgical site infections are associated with a delayed discharge rate of 34.1% in our survey. CONCLUSION The Getting It Right First Time surgical site infection programme has introduced a different approach to infection surveillance in England. Results of the survey has demonstrated variation in surgical site infection rates among surgical units, raised the importance in addressing these issues for better patient outcomes and to reduce the financial burden on the NHS. Much work remains to be done to improve surgical site infection surveillance across surgical units and trusts in England.
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Affiliation(s)
- Jlc Wong
- Getting It Right First Time, Royal National Orthopaedic Hospital NHS Trust and NHS Improvement, Brockley Hill, Stanmore, UK
| | - Cwy Ho
- Getting It Right First Time, Royal National Orthopaedic Hospital NHS Trust and NHS Improvement, Brockley Hill, Stanmore, UK
| | - G Scott
- Getting It Right First Time, Royal National Orthopaedic Hospital NHS Trust and NHS Improvement, Brockley Hill, Stanmore, UK
| | - J T Machin
- Getting It Right First Time, Royal National Orthopaedic Hospital NHS Trust and NHS Improvement, Brockley Hill, Stanmore, UK
| | - Twr Briggs
- Getting It Right First Time, Royal National Orthopaedic Hospital NHS Trust and NHS Improvement, Brockley Hill, Stanmore, UK
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Abstract
AIMS Short-stemmed femoral implants have been used for total hip arthroplasty (THA) in young and active patients to conserve bone, provide physiological loading, and reduce the incidence of thigh pain. Only short- to mid-term results have been presented and there have been concerns regarding component malalignment, incorrect sizing, and subsidence. This systematic review reports clinical and radiological outcomes, complications, revision rates, and implant survival in THA using short-stemmed femoral components. MATERIALS AND METHODS A literature review was performed using the EMBASE, Medline, and Cochrane databases. Strict inclusion and exclusion criteria were used to identify studies reporting clinical and radiological follow-up for short-stemmed hip arthroplasties. RESULTS A total of 28 studies were eligible for inclusion. This included 5322 hips in 4657 patients with a mean age of 59 years (13 to 94). The mean follow-up was 6.1 years (0.5 to 20). The mean Harris Hip Score improved from 46 (0 to 100) to 92 (39 to 100). The mean Oxford Hip Score improved from 25 (2 to 42.5) to 35 (12.4 to 48). The mean Western Ontario & McMaster Universities Osteoarthritis Index improved from 54 (2 to 95) to 22 (0 to 98). Components were aligned in a neutral coronal alignment in up to 90.9% of cases. A total of 15 studies reported component survivorship, which was 98.6% (92% to 100%) at a mean follow-up of 12.1 years. CONCLUSION Short-stemmed femoral implants show similar improvement in clinical and radiological outcomes compared with conventional length implants. Only mid-term survivorship, however, is known. An abundance of short components have been developed and used commercially without staged clinical trials. Long-term survival is still unknown for many of these components. There remains tension between innovation and the moral duty to ensure that the introduction of new implants is controlled until safety and patient benefit are demonstrated. Implant innovation and subsequent use should be driven by proven clinical outcomes, rather than market and financial forces, and ethical practice must be ensured. Cite this article: Bone Joint J 2019;101-B:502-511.
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Affiliation(s)
- S Lidder
- Department of Orthopaedics, Royal Melbourne Hospital, Parkville, Australia
| | - D J Epstein
- Department of Orthopaedics, Royal Melbourne Hospital, Parkville, Australia
| | - G Scott
- Bone and Joint Research Unit, The Royal London Hospital, London, UK
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AbuRahma AF, AbuRahma ZT, Scott G, Adams E, Mata A, Beasley M, Dean LS, Davis E. The incidence of carotid in-stent stenosis is underestimated ≥50% or ≥80% and its clinical implications. J Vasc Surg 2018; 69:1807-1814. [PMID: 30552039 DOI: 10.1016/j.jvs.2018.08.185] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2018] [Accepted: 08/08/2018] [Indexed: 01/22/2023]
Abstract
BACKGROUND The incidence of carotid in-stent stenosis has been reported to vary between 1% and 30%. Most published studies have short follow-up, which may lead to underestimation of the incidence of in-stent stenosis. This study analyzed the incidence of ≥50% and ≥80% in-stent stenosis using validated duplex ultrasound criteria and its clinical implications. METHODS This is a retrospective analysis of prospectively collected data of 450 carotid artery stenting (CAS) procedures (February 6, 2001-December 19, 2016). All patients had postoperative carotid duplex ultrasound examination, which was repeated at 1 month, 6 months, and every 6 to 12 months thereafter. A Kaplan-Meier analysis was used to estimate rates of freedom from ≥50% in-stent stenosis (internal carotid artery peak systolic velocity of ≥224 cm/s) and ≥80% in-stent stenosis (internal carotid artery peak systolic velocity of ≥325 cm/s), freedom from reintervention, and survival. RESULTS The mean age was 68.3 years, with a mean follow-up of 40.3 months. A total of 201 patients (45% [201/450]) had CAS for symptomatic disease. Primary CAS was done in 291 patients (65%); in the remaining 35%, CAS was done for postcarotid endarterectomy (CEA) stenosis. A total of 101 patients (23%) had ≥50% late carotid in-stent stenosis, and of these, 33 (7.4%) had ≥80% in-stent stenosis. Nineteen patients (4.3%) developed late transient ischemic attack and three (0.7%) late stroke. Twenty-three (5.2%) patients had late reintervention. Rates of freedom from ≥50% in-stent stenosis in the whole series were 85%, 79%, 75%, 72%, and 70% at 1 year, 2 years, 3 years, 4 years, and 5 years, respectively. The rates of freedom from ≥50% in-stent stenosis for primary CAS and CAS for post-CEA stenosis were not statistically significant (P = .540). The rates of freedom from ≥80% in-stent stenosis for the whole series were 96%, 95%, 93%, 90%, and 89% at 1 year, 2 years, 3 years, 4 years, and 5 years, respectively. The rates of freedom from ≥80% in-stent stenosis for primary CAS and CAS for post-CEA stenosis were also not statistically significant (P = .516). Rates of freedom from reintervention were 98%, 96%, 93%, 93%, and 91% at 1 year, 2 years, 3 years, 4 years, and 5 years, respectively, and there were no significant differences between primary CAS and CAS for post-CEA stenosis (P = .939). The overall late survival rates were 99%, 97%, 96%, 94%, and 91% at 1 year, 2 years, 3 years, 4 years, and 5 years. CONCLUSIONS The incidence of ≥50% in-stent stenosis is relatively high; however, the rates of ≥80% stenosis and late neurologic events are low. Longer follow-up of patients with ≥50% carotid in-stent stenosis may yield higher incidence of ≥80% stenosis.
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Affiliation(s)
- Ali F AbuRahma
- Department of Surgery, West Virginia University, Charleston, WVa.
| | | | - Grant Scott
- Department of Surgery, West Virginia University, Charleston, WVa
| | - Elliot Adams
- Department of Surgery, West Virginia University, Charleston, WVa
| | - Abe Mata
- Department of Surgery, West Virginia University, Charleston, WVa
| | - Matthew Beasley
- Department of Surgery, West Virginia University, Charleston, WVa
| | - L Scott Dean
- CAMC Health Education and Research Institute, Charleston, WVa
| | - Elaine Davis
- CAMC Health Education and Research Institute, Charleston, WVa
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Scott G, Khan S, Asopa V, Ravikumar R, Gadikoppula S. Mid-term outcomes of neck of femur fractures treated with HA coated uncemented prosthesis. Int J Surg 2018. [DOI: 10.1016/j.ijsu.2018.05.394] [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: 10/28/2022]
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12
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AbuRahma AF, AbuRahma ZT, Adams E, Mata L, Scott G, Beasley M, Dean S, Davis E. RS07. The Incidence of Carotid In-Stent Stenosis Is Underestimated: Is It 50% or 80% and Its Clinical Implications. J Vasc Surg 2018. [DOI: 10.1016/j.jvs.2018.03.241] [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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Scott G. Michael Alexander Reykers Freeman BA (Cantab) 1953, MB BCh (Cantab)1956, FRCS 1959, MD (Cantab) 1964, MD Hc (Swe) 1992 - (1931 to 2017). Bone Joint J 2017; 99-B:1552. [PMID: 29092998 DOI: 10.1302/0301-620x.99b11.bjj-2017-1156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2017] [Accepted: 09/20/2017] [Indexed: 11/05/2022]
Affiliation(s)
- G Scott
- The British Editorial Society of Bone & Joint Surgery, 22 Buckingham Street, London WC2N 6ET, UK
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Scott G, McCarthy DM, Aldeen AZ, Czerniak A, Courtney DM, Dresden SM. Use of Online Health Information by Geriatric and Adult Emergency Department Patients: Access, Understanding, and Trust. Acad Emerg Med 2017; 24:796-802. [PMID: 28423457 DOI: 10.1111/acem.13207] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2017] [Revised: 04/14/2017] [Accepted: 04/14/2017] [Indexed: 10/19/2022]
Abstract
OBJECTIVE The objective was to characterize geriatric patients' use of online health information (OHI) relative to younger adults and assess their comfort ith OHI compared to health information (HI) from their physician. METHODS This was a prospective cross-sectional survey study of adult emergency department (ED) patients. The survey assessed patients' self-reported use of OHI in the past year and immediately prior to ED visit and analyzed differences across four age groups: 18-39, 40-64, 65-74, and 75+. Patients' ability to access, understand, and trust OHI was assessed using a 7-point Likert scale and compared to parallel questions regarding HI obtained from their doctor. Patient use of OHI was compared across age groups. Comfort with OHI and HI obtained from a doctor was compared across age groups using the Kruskal-Wallis test. Comparisons between sources of HI were made within age groups using the Wilcoxon signed-rank test. RESULTS Of 889 patients who were approached for study inclusion, 723 patients (81.3%) completed the survey. The majority of patients had used OHI in the past year in all age groups, but older patients were less likely to have used OHI: age 18-39, 90.3%; 40-64, 85.3%; 65-74, 76.4%; and 75+, 50.7% (p < 0.001). The youngest patients were most likely to have used OHI prior to coming to the ED, 47.1%, 28.3%, 17.1%, and 8.0% (p < 0.001). Older patients were more likely to have an established doctor-18-39, 79.4%; 40-64, 91.1%; 65-74, 97.5%; and 75+ 97.4% (p < 0.001)-and were more likely to have contacted their doctor prior to their ED visit: 36.7, 40.2, 46.7, and 53.5% (p = 0.02). The oldest patients were most likely to find HI more accessible from their doctor than the Internet, while the youngest patients found HI more accessible on the Internet than from their doctor. Regardless of age, patients noted that information from their physician was both easier to understand and more trustworthy than information found on the Internet. CONCLUSION Although many older patients used OHI, they were less likely than younger adults to use the Internet immediately prior to an ED visit. Despite often using OHI, patients of all age groups found healthcare information from their doctor easier to understand and more trustworthy than information from the Internet. As health systems work to efficiently provide information to patients, addressing these perceived deficiencies may be necessary to build effective OHI programs.
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Affiliation(s)
- Grant Scott
- Department of Emergency Medicine; Northwestern University Feinberg School of Medicine; Chicago IL
| | - Danielle M McCarthy
- Department of Emergency Medicine; Northwestern University Feinberg School of Medicine; Chicago IL
| | - Amer Z. Aldeen
- Department of Emergency Medicine; Northwestern University Feinberg School of Medicine; Chicago IL
| | - Alyssa Czerniak
- Department of Emergency Medicine; Northwestern University Feinberg School of Medicine; Chicago IL
| | - D. Mark Courtney
- Department of Emergency Medicine; Northwestern University Feinberg School of Medicine; Chicago IL
| | - Scott M. Dresden
- Department of Emergency Medicine; Northwestern University Feinberg School of Medicine; Chicago IL
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Kwon C, Land A, Smoller B, Scott G, Beck L, Mercurio M. Bullous pemphigoid associated with nivolumab, a programmed cell death 1 protein inhibitor. J Eur Acad Dermatol Venereol 2017; 31:e349-e350. [DOI: 10.1111/jdv.14143] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Affiliation(s)
- C.W. Kwon
- Department of Dermatology; University of Rochester Medical Center; Rochester NY USA
| | - A.S. Land
- Department of Dermatology; University of Rochester Medical Center; Rochester NY USA
| | - B.R. Smoller
- Department of Dermatology; University of Rochester Medical Center; Rochester NY USA
- Department of Pathology; University of Rochester Medical Center; Rochester NY USA
| | - G. Scott
- Department of Dermatology; University of Rochester Medical Center; Rochester NY USA
- Department of Pathology; University of Rochester Medical Center; Rochester NY USA
| | - L.A. Beck
- Department of Dermatology; University of Rochester Medical Center; Rochester NY USA
| | - M.G. Mercurio
- Department of Dermatology; University of Rochester Medical Center; Rochester NY USA
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Benz C, Scott G, Chu D, Malato J, Hann B, Park B. Abstract P6-11-01: CDK2 inhibition prevents ERpS294 and restores the ability of tamoxifen to induce regression in breast tumors expressing mutant ESR1. Cancer Res 2017. [DOI: 10.1158/1538-7445.sabcs16-p6-11-01] [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: 11/16/2022]
Abstract
Abstract
This abstract was withdrawn by the authors.
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Affiliation(s)
- C Benz
- Buck Institute for Research on Aging, Novato, CA; The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD; UCSF Helen Diller Family Comprehensive Cancer Center, San Francisco, CA
| | - G Scott
- Buck Institute for Research on Aging, Novato, CA; The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD; UCSF Helen Diller Family Comprehensive Cancer Center, San Francisco, CA
| | - D Chu
- Buck Institute for Research on Aging, Novato, CA; The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD; UCSF Helen Diller Family Comprehensive Cancer Center, San Francisco, CA
| | - J Malato
- Buck Institute for Research on Aging, Novato, CA; The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD; UCSF Helen Diller Family Comprehensive Cancer Center, San Francisco, CA
| | - B Hann
- Buck Institute for Research on Aging, Novato, CA; The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD; UCSF Helen Diller Family Comprehensive Cancer Center, San Francisco, CA
| | - B Park
- Buck Institute for Research on Aging, Novato, CA; The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD; UCSF Helen Diller Family Comprehensive Cancer Center, San Francisco, CA
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Goldberg D, Cameron S, Sharp G, Burns S, Scott G, Molyneaux P, Scoular A, Downie A, Taylor A. Hepatitis C virus among genitourinary clinic attenders in Scotland: unlinked anonymous testing. Int J STD AIDS 2017. [DOI: 10.1177/095646240101200104] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Our objective is to gauge the prevalence of hepatitis C virus (HCV) antibodies among a population at risk of contracting sexually transmitted infections (STIs) and, thus, the efficiency with which the virus is transmitted sexually. The investigators undertook an unlinked anonymous HCV antibody testing study of residual syphilis serology specimens taken from attenders of genitourinary clinics in Glasgow, Edinburgh and Aberdeen during 1996/97. The results were linked to non-identifying risk information. Anti-HCV prevalences among non-injecting heterosexual men and women, and non-injecting homosexual/bisexual males ranged between 0 and 1.2%; the only exception to this was a 7.7% (4/52) prevalence among homosexual/bisexual males in Aberdeen. The overall anti-HCV prevalence for homosexual/bisexual males was 0.6% (4/668), for heterosexual males 0.8% (32/4135), for heterosexual females 0.3% (10/3035) and for injecting drug users 49% (72/148). Only 3 (all female) of the 46 non-injectors who were antibody positive were non-UK nationals or had lived abroad. HCV antibody positive injectors were less likely to have an acute STI and more likely to know their HCV status than non-injectors; no differences in these parameters were found between positive and negative non-injectors on anonymous HCV antibody testing. Our findings are in keeping with the prevailing view that HCV can be acquired through sexual intercourse but, for most people, the probability of this occurring is extremely low. Interventions to prevent the spread of HCV should be targeted mainly at injecting drug user (IDU) populations.
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Affiliation(s)
- D Goldberg
- Scottish Centre for Infection and Environmental Health, Glasgow
| | - S Cameron
- Regional Virus Laboratory, Gartnavel General Hospital, Glasgow
| | - G Sharp
- Department of Genitourinary Medicine, Southern General Hospital, Glasgow
| | - S Burns
- Regional Virus Laboratory, City Hospital, Edinburgh
| | - G Scott
- Department of Genitourinary Medicine, Royal Infirmary, Edinburgh
| | - P Molyneaux
- University Department of Bacteriology, Foresterhill, Aberdeen
| | - A Scoular
- Department of Genitourinary Medicine, Royal Infirmary, Glasgow
| | - A Downie
- Department of Genitourinary Medicine, Royal Hospital, Aberdeen, UK
| | - A Taylor
- Scottish Centre for Infection and Environmental Health, Glasgow
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Feng JQ, Huang H, Lu Y, Ye L, Xie Y, Tsutsui TW, Kunieda T, Castranio T, Scott G, Bonewald LB, Mishina Y. The Dentin Matrix Protein 1 (Dmp1) is Specifically Expressed in Mineralized, but not Soft, Tissues during Development. J Dent Res 2016; 82:776-80. [PMID: 14514755 DOI: 10.1177/154405910308201003] [Citation(s) in RCA: 167] [Impact Index Per Article: 20.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Dentin Matrix Protein 1 ( Dmp1) was originally identified from dentin. However, its expression and function in vivo are not clear. To clarify these two issues, we have generated mice carrying a truncated Dmp1 gene by using gene targeting to replace exon 6 with a lacZ gene. Northern blot analysis shows the expected 5.8-kb Dmp1-lacZ fusion transcript and loss of the wild-type 2.8-kb Dmp1 transcript, confirmed by a lack of immunostaining for the protein. Using heterozygous animals, we demonstrate that Dmp1 is specific for mineralized tissues. Not previously shown, Dmp1 is also expressed in pulp cells. Dmp1-deficient embryos and newborns display no apparent gross abnormal phenotype, although there are a modest expansion of the hypertrophic chondrocyte zone and a modest increase in the long bone diameter. This suggests that DMP1 is not essential for early mouse skeletal or dental development.
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Affiliation(s)
- J Q Feng
- Department of Oral Biology, School of Dentistry, University of Missouri-Kansas City, 650 E. 25th Street, Kansas City, MO 64108, USA.
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Scott G. UKCC staff set for showdown with ralph. Nurs Stand 2016; 8:5. [PMID: 27527276 DOI: 10.7748/ns.8.42.5.s2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
The management dispute at nursing's regulatory body is expected to enter its final phase later this week, with eight senior staff set to issue an official grievance against Registrar Colin Ralph.
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Manavi K, Scott G. Comparison of time to undetectable HIV viral load in the first 16 weeks after the start of three and four antiretroviral regimens. Int J STD AIDS 2016; 17:522-4. [PMID: 16925897 DOI: 10.1258/095646206778145659] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
The aim of this paper is to compare the time to a viral load <50 copies/mL of three or four antiretroviral therapy (ART) regimens among ART naïve patients within the first 16 weeks after the start of treatment. A retrospective study was carried out on ART naïve patients who started HAART between 1 January 1999 and 1 January 2004. ART naïve patients with a viral load >5.3 log10 copies/mL at the time of treatment were routinely started on four ART regimens in one of the HIV centres in Edinburgh. These patients were compared with ART naïve patients with viral load >5.3 log10 copies/mL at the time of start of three ART regimens in the other centre within the study period. During the study period, of 93 ART naïve patients with a viral load >5.3 log10 copies/mL, 56 and 37 commenced four drug and three drug regimens, respectively. Patients in each group were matched for their age, prevalence of HCV, median age, and median viral load at the start of therapy; however, patients on three drug regimens had significantly lower CD4 counts ( P<0.01). The median time to undetectable viral load was 13.5 weeks for three and four drug regimens ( P>0.05). By the time of undetectable viral load, there was no difference in the CD4 count of patients on three or four drug regimens. Similar proportions of immunosuppressed patients on three and four ART regimens had undetectable viral load within the first 16 weeks of therapy.
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Affiliation(s)
- K Manavi
- Department of Genitourinary Medicine, Whittall Street Clinic, Whittall Street, Birmingham B4 6DH, UK.
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Manavi K, McMillan A, Ogilvie M, Scott G. Heterosexual men and women with HIV test positive at a later stage of infection than homo- or bisexual men. Int J STD AIDS 2016; 15:811-4. [PMID: 15601487 DOI: 10.1258/0956462042563585] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [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: 11/18/2022]
Abstract
The current strategy of offering HIV testing to individuals with known risk has had no impact on the reduction in the number of patients diagnosed with immune suppression of infection. A prospective observational study to compare the baseline CD4+ T-cell counts in HIV-infected homosexual/bisexual men, intravenous drug users, heterosexual men and women diagnosed in GUM/RIDU and that of patients diagnosed during routine maternal screening for HIV between December 1999 and January 2003 was carried out at the Departments of Genitourinary Medicine (GUM), Regional Infectious Disease Unit (RIDU) and Obstetrics in Edinburgh. Late presentation was defined as positive HIV test with baseline CD4+ T-cell count of less than 200 cells/mL. During the study period, 189 patients tested in GUM/RIDU setting and 13 screened women were diagnosed with HIV infection. Thirty-four percent of the former and 38% of the latter group had CD4+ T-cell count of less than 200 cells/mL by the time of diagnosis. Heterosexual individuals contributed to 78% of HIV tests in the GUM/RIDU setting. Amongst the 78 HIV-infected heterosexual individuals diagnosed in GUM/RIDU 45% were late presenters. Significantly fewer homosexual men were late presenters. There was no difference between the proportion of late presenters amongst women screened at the antenatal (5/13) compared to heterosexual patients diagnosed in GUM/RIDU (35/78). A significant number of HIV infected heterosexual patients are late presenters in the HIV testing at GUM/RIDU. HIV screening programmes for heterosexual individuals in any medical encounter may reduce the number of late presenters.
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Affiliation(s)
- K Manavi
- Department of Genitourinary Medicine, Royal Infirmary of Edinburgh, Lothian University Hospitals NHS Trust, Lauriston Building, 39 Lauriston Place, Edinburgh EH3 9HA, UK.
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Scott G, Imam MA, Eifert A, Freeman MAR, Pinskerova V, Field RE, Skinner J, Banks SA. Can a total knee arthroplasty be both rotationally unconstrained and anteroposteriorly stabilised? A pulsed fluoroscopic investigation. Bone Joint Res 2016; 5:80-6. [PMID: 26965166 PMCID: PMC4852793 DOI: 10.1302/2046-3758.53.2000621] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2015] [Accepted: 01/18/2016] [Indexed: 12/02/2022] Open
Abstract
OBJECTIVES Throughout the 20th Century, it has been postulated that the knee moves on the basis of a four-bar link mechanism composed of the cruciate ligaments, the femur and the tibia. As a consequence, the femur has been thought to roll back with flexion, and total knee arthroplasty (TKA) prostheses have been designed on this basis. Recent work, however, has proposed that at a position of between 0° and 120° the medial femoral condyle does not move anteroposteriorly whereas the lateral femoral condyle tends, but is not obliged, to roll back - a combination of movements which equates to tibial internal/ femoral external rotation with flexion. The aim of this paper was to assess if the articular geometry of the GMK Sphere TKA could recreate the natural knee movements in situ/in vivo. METHODS The pattern of knee movement was studied in 15 patients (six male: nine female; one male with bilateral TKAs) with 16 GMK Sphere implants, at a mean age of 66 years (53 to 76) with a mean BMI of 30 kg/m(2) (20 to 35). The motions of all 16 knees were observed using pulsed fluoroscopy during a number of weight-bearing and non-weight-bearing static and dynamic activities. RESULTS During maximally flexed kneeling and lunging activities, the mean tibial internal rotation was 8° (standard deviation (sd) 6). At a mean 112° flexion (sd 16) during lunging, the medial and lateral condyles were a mean of 2 mm (sd 3) and 8 mm (sd 4) posterior to a transverse line passing through the centre of the medial tibial concavity. With a mean flexion of 117° (sd 14) during kneeling, the medial and lateral condyles were a mean of 1 mm (sd 4) anterior and 6 mm (sd 4) posterior to the same line. During dynamic stair and pivoting activities, there was a mean anteroposterior translation of 0 mm to 2 mm of the medial femoral condyle. Backward lateral condylar translation occurred and was linearly related to tibial rotation. CONCLUSION The GMK Sphere TKA in our study group shows movements similar in pattern, although reduced in magnitude, to those in recent reports relating to normal knees during several activities. Specifically, little or no translation of the medial femoral condyle was observed during flexion, but there was posterior roll-back of the lateral femoral condyle, equating to tibiofemoral rotation. We conclude that the GMK Sphere is anteroposteriorly stable medially and permits rotation about the medial compartment.Cite this article: Professor G. Scott. Can a total knee arthroplasty be both rotationally unconstrained and anteroposteriorly stabilised?: A pulsed fluoroscopic investigation. Bone Joint Res 2016;5:80-86. DOI: 10.1302/2046-3758.53.2000621.
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Affiliation(s)
- G Scott
- Trauma and Orthopaedic Department, Royal London Hospital, Whitechapel, London, E1 1BB, UK
| | - M A Imam
- South West London Elective Orthopaedic Centre, Epsom, UK
| | - A Eifert
- Department of Biomedical Engineering, University of Florida, Florida, USA
| | | | | | - R E Field
- St Georges University of London, Director of Research, South West London Elective Orthopaedic Centre, Epsom, UK
| | - J Skinner
- Royal National Orthopaedic Hospital, Stanmore, UK
| | - S A Banks
- Department of Mechanical and Aerospace Engineering, University of Florida, Florida, USA
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Shepard T, Scott G, Cole S, Nordmark A, Bouzom F. Physiologically Based Models in Regulatory Submissions: Output From the ABPI/MHRA Forum on Physiologically Based Modeling and Simulation. CPT Pharmacometrics Syst Pharmacol 2015; 4:221-5. [PMID: 26225245 PMCID: PMC4429575 DOI: 10.1002/psp4.30] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2014] [Accepted: 02/21/2015] [Indexed: 11/12/2022] Open
Abstract
Under the remit of the Ministerial Industry Strategy Group (MISG), the Association of the British Pharmaceutical Industry (ABPI) and Medicines and Healthcare products Regulatory Agency (MHRA) hosted a meeting to explore physiologically based pharmacokinetic modeling and simulation, focusing on the clinical component of regulatory applications. The meeting took place on 30 June 2014 with international representatives from industry, academia, and regulatory agencies. Discussion topics were selected to be complementary to those discussed at an earlier US Food and Drug Administration (FDA) meeting. This report summarizes the meeting outcomes, focusing on the European regulatory perspective.
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Affiliation(s)
- T Shepard
- Medicines and Healthcare products Regulatory Agency (MHRA)London, UK
| | - G Scott
- Takeda Development Centre EuropeLondon, UK
| | - S Cole
- Medicines and Healthcare products Regulatory Agency (MHRA)London, UK
| | - A Nordmark
- Swedish Medical Products Agency (MPA)Uppsala, Sweden
| | - F Bouzom
- Technologie ServierOrleans, France
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Vijayan R, Scott G, Ahmed F. What is it about the number of stitches? Assoc Med J 2015. [DOI: 10.1136/bmj.h1042] [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: 11/04/2022]
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Ciampi Q, Bombardini T, Cortigiani L, Pratali L, Rigo F, Villari B, Picano E, Sicari R, Teramoto K, Suzuki K, Satoh Y, Minami K, Mizukoshi K, Kamijima R, Kou S, Takai M, Izumo M, Akashi Y, Cifra B, Dragulescu A, Friedberg M, Mertens L, O'driscoll J, Gargallo-Fernandez P, Araco M, Perez-Lopez M, Sharma R, Abram S, Arruda-Olson M, Scott G, Pellikka A, Nkomo T, Oh J, Milan A, Mccully B, Aguiar Rosa S, Portugal G, Moura Branco L, Galrinho A, Afonso Nogueira M, Abreu J, Cacela D, Abreu A, Fragata J, Cruz Ferreira R, Mielczarek A, Kasprzak J, Chrzanowski L, Plewka M, Lipiec P, Qawoq D, Rechcinski T, Wierzbowska-Drabik K, Magne J, Donal E, Dulgheru R, Pierard L, Lancellotti P. Oral Abstract session: Stress echo in clinical practice: Friday 5 December 2014, 08:30-10:00 * Location: Agora. Eur Heart J Cardiovasc Imaging 2014. [DOI: 10.1093/ehjci/jeu251] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Magne J, Pierard L, Lancellotti P, Marc Dweck M, Jenkins W, Shah A, Vesey A, Pringle M, Chin C, Pawade T, Boon N, Rudd J, Newby D, Boulogne C, Mohty D, Magne J, Varroud-Vial N, Ettaif H, Lavergne D, Damy T, Aboyans V, Bridoux F, Jaccard A, Abram S, Arruda-Olson M, Scott G, Pellikka A, Nkomo T, Oh J, Milan A, Mccully B. Roelandt's Young Investigator Award session: Thursday 4 December 2014, 15:30-16:30 * Location: Agora. Eur Heart J Cardiovasc Imaging 2014. [DOI: 10.1093/ehjci/jeu249] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Scott G, Olola C, Gardett I, Clawson J. Shorter dispatcher-assisted CPR time-to-compression using the latest dispatch protocol. Resuscitation 2014; 85:e161. [DOI: 10.1016/j.resuscitation.2014.02.034] [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] [Received: 02/06/2014] [Accepted: 02/07/2014] [Indexed: 11/28/2022]
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Abstract
Peri-prosthetic infection is amongst the most common causes of failure following total knee replacement (TKR). In the presence of established infection, thorough joint debridement and removal of all components is necessary following which new components may be implanted. This can be performed in one or two stages; two-stage revision with placement of an interim antibiotic-loaded spacer is regarded by many to be the standard procedure for eradication of peri-prosthetic joint infection. We present our experience of a consecutive series of 50 single-stage revision TKRs for established deep infection performed between 1979 and 2010. There were 33 women and 17 men with a mean age at revision of 66.8 years (42 to 84) and a mean follow-up of 10.5 years (2 to 24). The mean time between the primary TKR and the revision procedure was 2.05 years (1 to 8). Only one patient required a further revision for recurrent infection, representing a success rate of 98%. Nine patients required further revision for aseptic loosening, according to microbiological testing of biopsies taken at the subsequent surgery. Three other patients developed a further septic episode but none required another revision. These results suggest that a single-stage revision can produce comparable results to a two-stage revision. Single-stage revision offers a reduction in costs as well as less morbidity and inconvenience for patients.
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Affiliation(s)
- S Tibrewal
- The Royal London Hospital, Department of Orthopaedics, Whitechapel, London E1 1BB, UK
| | - F Malagelada
- The Royal London Hospital, Department of Orthopaedics, Whitechapel, London E1 1BB, UK
| | - L Jeyaseelan
- The Royal London Hospital, Department of Orthopaedics, Whitechapel, London E1 1BB, UK
| | - F Posch
- Vienna General Hospital Medical University of Vienna, Clinical Division of Haematology & Haemostaseology, Department of Medicine I, Waehringer Guertel 18-20, A-1090 Vienna, Austria
| | - G Scott
- The Royal London Hospital, Department of Orthopaedics, Whitechapel, London E1 1BB, UK
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Vijayan R, Scott G, Brownlie W. Out of sight, but not out of mind? Greater reported pain in patients who spontaneously look away during venepuncture. Eur J Pain 2014; 19:97-102. [PMID: 24890456 DOI: 10.1002/ejp.526] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/06/2014] [Indexed: 11/08/2022]
Abstract
BACKGROUND Various external factors can influence patients' experiences of noxious stimuli, but little is known of how patients' natural behaviour may be relevant. We ascertained how often patients spontaneously look or look away during venepuncture and associated reports of pain during a previously reported experimental randomized study. The study was conducted in the outpatient department of a U.K. district general hospital. METHODS Patients were randomized to hearing 'sharp scratch' or the verbal cue 'ready?' immediately before venepuncture. Whether patients looked or looked away during needle insertion was recorded. Patients were asked to rate their pain using a verbal numerical rating score (VNRS) and verbal response scale (VRS). RESULTS One hundred ninety-two patients were included; mean age 51.7 years, 55% male. During needle insertion, 73% spontaneously looked away, whereas 27% looked. There was no significant difference in the proportion of these patients assigned to the 'sharp scratch' or 'ready?' groups, nor was there any difference in mean age or gender. For the group that looked, mean VNRS was 0.48 and VRS was 1.27, significantly less than the group that looked away (mean VNRS 0.94, p = 0.014; VRS 1.61, p = 0.002). As previously reported, pain ratings between 'sharp scratch' and 'ready?' groups were not significantly different. CONCLUSIONS Almost three quarters of patients spontaneously look away during venepuncture, but their pain ratings are almost twice that of the quarter of patients who look. It is unclear why this may be, but previous experimental studies indicate that observing the body when a noxious stimulus is applied can have an analgesic effect.
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Affiliation(s)
- R Vijayan
- Milton Keynes Hospital NHS Foundation Trust, UK
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Turner M, Peacock M, Froggatt K, Payne S, Fletcher A, Gibson R, Scott G. BOTH SIDES OF THE FENCE: METHODOLOGICAL CHALLENGES IN UNDERTAKING RESEARCH INTO END OF LIFE CARE FOR PRISONERS. BMJ Support Palliat Care 2014. [DOI: 10.1136/bmjspcare-2014-000653.1] [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: 11/04/2022]
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Bal AM, Shankland GS, Scott G, Imtiaz T, Macaulay R, McGill M. Antifungal step-down therapy based on hospital intravenous to oral switch policy and susceptibility testing in adult patients with candidaemia: a single centre experience. Int J Clin Pract 2014; 68:20-7. [PMID: 24341299 DOI: 10.1111/ijcp.12231] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [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: 03/28/2013] [Accepted: 06/07/2013] [Indexed: 11/29/2022] Open
Abstract
AIMS Echinocandins are recommended for the treatment of candidaemia in moderately severe to severely ill patients. Step-down or de-escalation from echinocandin to fluconazole is advised in patients who are clinically stable but data in relation to step-down therapy are sparse. Using our hospital intravenous to oral switch therapy (IVOST) policy to guide antifungal de-escalation in patients with candidaemia, we aimed to determine what proportion of patients are de-escalated to fluconazole, the timescale to step-down, associated reduction in consumption of echinocandins and antifungal cost savings. METHODOLOGY Patients with candidaemia were followed from April 2011 to March 2013. RESULTS A total of 37 episodes of candidaemia were documented during the study period. Twenty-seven patients were commenced on an echinocandin or voriconazole and 19 (70.3%) were de-escalated to fluconazole based on the IVOST policy. The mean and median number of days to de-escalation of therapy was 4.6 and 5 days, respectively. One patient whose therapy was de-escalated relapsed. The overall 30 day crude mortality was 37.1%. The step-down approach led to significant saving in antifungal drug cost of £1133.88 per candidaemic episode and £2208.08 per de-escalation. CONCLUSION Implementation of IVOST policy led to streamlining of antifungal therapy.
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Affiliation(s)
- A M Bal
- Department of Microbiology, University Hospital Crosshouse, Kilmarnock, UK
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Fernando I, Scott G. A case of multicentric Castleman's disease in HIV infection with the rare complication of acquired angioedema. Int J STD AIDS 2013; 25:523-5. [PMID: 24352125 DOI: 10.1177/0956462413516941] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [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: 09/23/2013] [Accepted: 11/23/2013] [Indexed: 11/15/2022]
Abstract
Multicentric Castleman's disease (MCD), a polyclonal lymphoproliferative disorder of unknown aetiology, is a well-recognised complication of HIV disease. We present a case of MCD in an HIV-positive patient that is unusual on two counts: our patient's MCD first presented in the context of an immune restoration inflammatory syndrome (IRIS), following the initiation of highly active antiretroviral therapy (HAART). In addition, her MCD was associated with the unusual complication of acquired angioedema (AAE), which resolved following treatment of the MCD. While AAE is frequently found to have an underlying diagnosis of a lymphoproliferative disease, this is the first reported case linking AAE to MCD.
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Affiliation(s)
- I Fernando
- Chalmers Sexual Health Centre, NHS Lothian, Edinburgh, UK
| | - G Scott
- Chalmers Sexual Health Centre, NHS Lothian, Edinburgh, UK
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Howden R, Cooley I, Van Dodewaard C, Arthur S, Cividanes S, Leamy L, McCann Hartzell K, Gladwell W, Martin J, Scott G, Ray M, Mishina Y. Cardiac responses to 24 hrs hyperoxia in Bmp2 and Bmp4 heterozygous mice. Inhal Toxicol 2013; 25:509-16. [PMID: 23876042 DOI: 10.3109/08958378.2013.808287] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Hyperoxia or clinical oxygen (O2) therapy is known to result in increased oxidative burden. Therefore, understanding susceptibility to hyperoxia exposure is clinically important. Bone morphogenetic proteins (BMPs) 2 and 4 are involved in cardiac development and may influence responses to hyperoxia. METHODS Bmp2(+/)(-). Bmp4(+/)(-) and wild-type mice were exposed to hyperoxia (100% O2) for 24 hrs. Electrocardiograms (ECG) were recorded before and during exposure by radio-telemetry. RESULTS At baseline, a significantly higher low frequency (LF) and total power (TP) heart rate variability (HRV) were found in Bmp2(+/)(-) mice only (p < 0.05). Twenty-four hours hyperoxia-induced strain-independent reductions in heart rate, QTcB and ST-interval and increases in QRS, LF HRV and standard deviation of RR-intervals were observed. In Bmp4(+/)(-) mice only, increased PR-interval (PR-I) (24 hrs), P-wave duration (P-d; 18 and 21-24 hrs), PR-I minus P-d (PR - Pd; 24 hrs) and root of the mean squared differences of successive RR-intervals (24 hrs) were found during hyperoxia (p < 0.05). DISCUSSION Elevated baseline LF and TP HRV in Bmp2(+/)(-) mice suggests an altered autonomic nervous system regulation of cardiac function in these mice. However, this was not related to strain specific differences in responses to 24 hrs hyperoxia. During hyperoxia, Bmp4(+/-) mice were the most susceptible in terms of atrioventricular conduction changes and risk of atrial fibrillation, which may have important implications for patients treated with O2 who also harbor Bmp4 mutations. This study demonstrates significant ECG and HRV responses to 24 hrs hyperoxia in mice, which highlights the need to further work on the genetic mechanisms associated with cardiac susceptibility to hyperoxia.
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Affiliation(s)
- R Howden
- Laboratory of Systems Physiology, Department of Kinesiology, University of North Carolina at Charlotte, Charlotte NC 28223, USA.
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Chen Y, Soong J, Mohanty S, Xu L, Scott G. The neural guidance receptor Plexin C1 delays melanoma progression. Oncogene 2012; 32:4941-9. [PMID: 23160370 DOI: 10.1038/onc.2012.511] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2012] [Revised: 09/18/2012] [Accepted: 09/21/2012] [Indexed: 01/13/2023]
Abstract
Plexin C1 is a type I transmembrane receptor with intrinsic R-Ras GTPase activity, which regulates cytoskeletal remodeling and adhesion in normal human melanocytes. Melanocytes are pigment-producing cells of the epidermis, precursors for melanoma, and express high levels of Plexin C1, which is lost in melanoma in vitro and in vivo. To determine if Plexin C1 is a tumor suppressor for melanoma, we introduced Plexin C1 into a primary human melanoma cell line, and phenotypes including migration, apoptosis, proliferation and tumor growth in mice were analyzed. Complimentary studies in which Plexin C1 was silenced in human melanocytes were performed. Plexin C1 significantly inhibited migration and proliferation in melanoma, whereas in melanocytes, loss of Plexin C1 increased migration and proliferation. In mouse xenografts, Plexin C1 delayed tumor growth of melanoma at early time points, but tumors eventually escaped the suppressive effects of Plexin C1, due to Plexin C1-dependent activation of the pro-survival protein Akt. R-Ras activation stimulates melanoma migration. Plexin C1 lowered R-Ras activity in melanoma and melanocytes, consistent with inhibitory effects of Plexin C1 on migration of melanocytes and melanoma. To determine if R-Ras is expressed in melanocytic lesions in vivo, staining of tissue microarrays of nevi and melanoma were performed. R-Ras expression was highly limited in melanocytic lesions, being essentially confined to primary melanoma, and almost completely absent in nevi and metastatic melanoma. These data suggest that loss of Plexin C1 in melanoma may promote early steps in melanoma progression through suppression of migration and proliferation, but pro-survival effects of Plexin C1 ultimately abrogate the tumor suppressive effects of Plexin C1. In primary melanoma, loss of Plexin C1 may function in early steps of melanoma progression by releasing inhibition of R-Ras activation, and stimulating migration.
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Affiliation(s)
- Y Chen
- Department of Dermatology, University of Rochester School of Medicine, Rochester, NY, USA
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Rakusa M, Murphy O, McIntyre L, Porter B, Panicker J, Fowler C, Scott G, Chataway J. Testing for urinary tract colonization before high‐dose corticosteroid treatment in acute multiple sclerosis relapses: prospective algorithm validation. Eur J Neurol 2012; 20:448-452. [DOI: 10.1111/j.1468-1331.2012.03806.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2012] [Accepted: 05/23/2012] [Indexed: 11/29/2022]
Affiliation(s)
- M. Rakusa
- National Hospital for Neurology and Neurosurgery University College London Hospitals NHS Foundation Trust London UK
- Department of Neurology University Medical Centre Maribor Maribor Slovenia
| | - O. Murphy
- National Hospital for Neurology and Neurosurgery University College London Hospitals NHS Foundation Trust London UK
| | - L. McIntyre
- National Hospital for Neurology and Neurosurgery University College London Hospitals NHS Foundation Trust London UK
| | - B. Porter
- National Hospital for Neurology and Neurosurgery University College London Hospitals NHS Foundation Trust London UK
| | - J. Panicker
- National Hospital for Neurology and Neurosurgery University College London Hospitals NHS Foundation Trust London UK
| | - C. Fowler
- National Hospital for Neurology and Neurosurgery University College London Hospitals NHS Foundation Trust London UK
| | - G. Scott
- National Hospital for Neurology and Neurosurgery University College London Hospitals NHS Foundation Trust London UK
| | - J. Chataway
- National Hospital for Neurology and Neurosurgery University College London Hospitals NHS Foundation Trust London UK
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Abstract
We report the long-term results of revision total hip replacement using femoral impaction allografting with both uncemented and cemented Freeman femoral components. A standard design of component was used in both groups, with additional proximal hydroxyapatite coating in the uncemented group. A total of 33 hips in 30 patients received an uncemented component and 31 hips in 30 patients a cemented component. The mean follow-up was 9.8 years (2 to 17) in the uncemented group and 6.2 years (1 to 11) in the cemented group. Revision procedures (for all causes) were required in four patients (four hips) in the uncemented group and in five patients (five hips) in the cemented group. Harris hip scores improved significantly in both groups and were maintained independently of the extent of any migration of the femoral component within the graft or graft–cement mantle.
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Affiliation(s)
- S. Masterson
- The Royal London Hospital, Bone
and Joint Research Unit, Whitechapel Road, London E1
1BB, UK
| | - S. Lidder
- The Royal London Hospital, Bone
and Joint Research Unit, Whitechapel Road, London E1
1BB, UK
| | - G. Scott
- The Royal London Hospital, Bone
and Joint Research Unit, Whitechapel Road, London E1
1BB, UK
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Britton D, Scott G, Russell C, Held J, Ward M, Benz C, Pike I. P1-07-23: Absolute Quantification of Estrogen Receptor alpha in Breast Cancer. Cancer Res 2011. [DOI: 10.1158/0008-5472.sabcs11-p1-07-23] [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: 11/16/2022]
Abstract
Abstract
Estrogen receptor alpha (ER) is the first biomarker to have been clinically validated as a predictor of cancer therapy response. Measurements of tumor ER expression were based on radiolabeled ligand binding to receptor present in tumor lysates. Despite substantial tissue requirement, lack of specificity for ER isoforms (alpha versus beta) or receptor integrity, quantitative determination of tumor ER content (fmol/mg total protein) was possible. Introduction of anti-ER antibodies later permitted immunohistochemical (***lHC) evaluation of ER expression. IHC determination of ER status in newly diagnosed breast cancer is now a standard of care. While these IHC assays have been shown to be as predictive of endocrine responsiveness as ligand binding assays, they remain semi-quantitative at best reporting tumor ER status either categorically (e.g. + or -) or as a numeric score which is subjective and lacks a linear relationship with endocrine responsiveness. Thus the lack of precision for quantifying ER as a predictive biomarker is one of the most important unresolved issues in breast cancer. We are working to develop a proteomic liquid chromatography-mass spectrometry (LC-MS) assay to help resolve this issue. Samples included recombinant ER (rER), immunoprecipitated (IP) rER, and IP ER from MCF7 cells. ER was digested with trypsin, lyophilised and solubilised in 5 femto-mol/microliter (100 μl) heavy peptide internal standard mix. ER peptides were resolved by LC (100 μl/minute) and detected by selected reaction monitoring MS. The area under the total ion chromatogram for each peptide were used to quantify the amount of analyte present in each sample as a single point reference to the signal of the heavy peptide spike. An 11 point calibration curve (0.1-1000 fmol on column (o/c)) of light peptides with each point in the curve spiked with 100 fmol heavy peptide was also produced to determine assay characteristics such as limits of detection (LOD), limits of quantification (LOQ), linearity, accuracy and precision. Three ER peptides were selected for quantification as they gave the greatest LOD, LOQ, linearity as well as reasonable intra- and inter-assay precision following multiple digestions of rER (intra = 3 digestions in 1 day; inter = 9 digestions over 3 weeks).
Following IP of ER from four replicate MCF7 cell lysates (1mg/ml total protein) and measurement of ion intensities of the three ER peptides the mean concentration of ER was calculated to be 52 fmol (S.D of 7.5 fmol; n=4) per mg of total cell lysate after normalising for IP efficiency. We continue to develop the method to improve sensitivity and normalise for variability in IP and digestion. With the inclusion of reference peptides to known ER phosphorylation sites we are also in the process of quantifying ER phosphorylation. We aim to accurately determine ER concentration and phosphorylation status in tumor lysates and assess how these correlate with responsiveness to antiestrogen therapies.
Citation Information: Cancer Res 2011;71(24 Suppl):Abstract nr P1-07-23.
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Affiliation(s)
- D Britton
- 1Proteome Sciences Plc, London, United Kingdom; Buck Institute, Novato, CA
| | - G Scott
- 1Proteome Sciences Plc, London, United Kingdom; Buck Institute, Novato, CA
| | - C Russell
- 1Proteome Sciences Plc, London, United Kingdom; Buck Institute, Novato, CA
| | - J Held
- 1Proteome Sciences Plc, London, United Kingdom; Buck Institute, Novato, CA
| | - M Ward
- 1Proteome Sciences Plc, London, United Kingdom; Buck Institute, Novato, CA
| | - C Benz
- 1Proteome Sciences Plc, London, United Kingdom; Buck Institute, Novato, CA
| | - I Pike
- 1Proteome Sciences Plc, London, United Kingdom; Buck Institute, Novato, CA
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Rajaganeshan R, Wang H, Abouleid A, Scott G, Selvasekar CR. Conservative surgery in the management of a benign ovarian cystic teratoma presenting as a rectal mass: a case report. Ann R Coll Surg Engl 2011; 93:e46-8. [PMID: 21943447 DOI: 10.1308/147870811x582792] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Ovarian cystic teratomas constitute 10-15% of all ovarian tumours and are the most common ovarian neoplasms found in adolescence and during pregnancy. Nevertheless, ovarian cystic teratomas have also been described in patients aged 1-91 years. We report an unusual case of a benign ovarian cystic teratoma presenting as a rectal mass that was managed surgically using radical resection by a multidisciplinary team. This case report highlights the importance of preoperative investigations including colonoscopy and radiological investigations. A dedicated pelvic radiologist/pathologist and the involvement of a multidisciplinary team at the time of initial diagnosis and a gynaecologist and colorectal surgeon at the time of surgery will lead to an accurate diagnosis and the most appropriate treatment. Although rare, erosion of an ovarian dermoid into the rectum should be considered in young women who have an atypical presentation and are found to have a lesion in the rectum with biopsies indicating benign pathology.
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Ashtekar S, Scott G, Lyding J, Gruebele M. Direct imaging of two-state dynamics on the amorphous silicon surface. Phys Rev Lett 2011; 106:235501. [PMID: 21770518 DOI: 10.1103/physrevlett.106.235501] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/06/2011] [Indexed: 05/31/2023]
Abstract
Amorphous silicon is an important material, amidst a debate whether or not it is a glass. We produce amorphous Si surfaces by ion bombardment and vapor growth, and image discrete Si clusters which hop by two-state dynamics at 295 K. Independent of surface preparation, these clusters have an average diameter of ∼5 atoms. Given prior results for metallic glasses, we suggest that this cluster size is a universal feature. The hopping activation free energy of 0.93±0.15 eV is rather small, in agreement with a previously untested surface glass model. Hydrogenation quenches the two-state dynamics, apparently by increasing surface crystallinity.
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Affiliation(s)
- S Ashtekar
- Beckman Institute for Advanced Science and Technology, University of Illinois, Urbana, Illinois 61801, USA
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Hristov D, Ahn K, Scott G. TU-E-214-02: Overhauser Oxygenation Imaging: Physics, Instrumentation and Pre-Clinical Applications. Med Phys 2011. [DOI: 10.1118/1.3613200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Ahn K, Scott G, Stang P, Conolly S, Hristov D. TH-D-201C-01: Advancing an Integrated Overhauser-Enhanced MRI (OMRI) - Prepolarized MM (PMRI) System Toward Quantitative Longitudinal Studies of Tumor Hypoxia and Redox Status. Med Phys 2010. [DOI: 10.1118/1.3469549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Cameron ST, Glasier A, Muir A, Scott G, Johnstone A, Quarrell H, Oroz C, McIntyre M, Miranda D, Todd G. Expedited partner therapy for Chlamydia trachomatis at the community pharmacy. BJOG 2010; 117:1074-9. [PMID: 20497415 DOI: 10.1111/j.1471-0528.2010.02573.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Expedited partner treatment (EPT) for uncomplicated Chlamydia trachomatis at the pharmacy is an alternative approach to partner notification that has not yet been evaluated within the UK. The aim of this study was to evaluate EPT for partners using pharmacies in Lothian. DESIGN A pilot study over 18 months. SETTING Selected healthcare settings and community pharmacies in Lothian, Scotland, UK. POPULATION Sexual partners of index cases with uncomplicated C. trachomatis. METHODS Index cases with uncomplicated C. trachomatis were given a pharmacy voucher to pass onto sexual partners. Partners could redeem vouchers for free treatment (azithromycin) at one of 90 pharmacies in the area. MAIN OUTCOME MEASURES The main outcome measure was the proportion of vouchers redeemed. Secondary outcomes included patient satisfaction, as determined at a telephone follow-up of a subgroup of female index cases from one study site, 1 month later. RESULTS In total 577 vouchers were issued to chlamydia-positive index patients of mean age 22.9 years (range 15-47 years). A total of 231 vouchers were redeemed (40%), at a median of 2 days after issue. Only 4% of partners attended a clinic for treatment. Most index patients surveyed reported that partners were satisfied with this method of treatment (48 out of 55; 87%). CONCLUSIONS Expedited partner treatment for uncomplicated chlamydia at a pharmacy is a popular choice, and increases options on where, when and how partners are treated.
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Affiliation(s)
- S T Cameron
- Dean Terrace Centre, NHS Lothian, Edinburgh, UK
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Mannan K, Freeman MAR, Scott G. The Freeman femoral component with hydroxyapatite coating and retention of the neck: an update with a minimum follow-up of 17 years. ACTA ACUST UNITED AC 2010; 92:480-5. [PMID: 20357321 DOI: 10.1302/0301-620x.92b4.23149] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
The outcome at ten years of 100 Freeman hip stems (Finsbury Orthopaedics, Leatherhead, United Kingdom) retaining the neck with a proximal hydroxyapatite coating in a series of 52 men (six bilateral) and 40 women (two bilateral), has been described previously. None required revision for aseptic loosening. We have extended the follow-up to 20 years with a minimum of 17 years. The mean age of the patients at total hip replacement was 58.9 years (19 to 84). Six patients were lost to follow-up, but were included up to their last clinical review. A total of 22 patients (22 hips) had died, all from causes unrelated to their surgery. There have been 43 re-operations for failure of the acetabular component. However, in 38 of these the stem was not revised since it remained stable and there was no associated osteolysis. Two of the revisions were for damage to the trunnion after fracture of a modular ceramic head, and in another two, removal of the femoral component was because of the preference of the surgeon. In all cases the femoral component was well fixed, but could be extracted at the time of acetabular revision. In one case both components were revised for deep infection. There has been one case of aseptic loosening of the stem which occurred at 14 years. This stem had migrated distally by 7.6 mm in ten years and 8.4 mm at the time of revision at which stage it was found to be rotationally loose. With hindsight this component had been undersized at implantation. The survivorship for the stem at 17 years with aseptic loosening as the endpoint was 98.6% (95% confidence interval 95.9 to 100) when 62 hips were at risk. All remaining stems had a satisfactory clinical and radiological outcome. The Freeman proximally hydroxyapatite-coated femoral component is therefore a dependable implant and its continued use can be recommended.
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Affiliation(s)
- K Mannan
- Department of Orthopaedics Royal London Hospital, London E1 1BB, UK.
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Hay CH, Hodgson V, Scott G, Miller J. COLORIMETRIC DETERMINATION OF THE ALGIN CONTENT OF THREE SOUTH AFRICAN KELP SEAWEEDS (ECKLONIA MAXIMA, LAMINARIA PALLIDAANDMACROCYSTIS ANGUSTIFOLIA). ACTA ACUST UNITED AC 2010. [DOI: 10.1080/00359198309520096] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Travers B, Henderson S, Vasireddy S, SeQueira EJ, Cornell PJ, Richards S, Khan A, Hasan S, Withrington R, Leak A, Sandhu J, Joseph A, Packham JC, Lyle S, Martin JC, Goodfellow RM, Rhys-Dillon C, Morgan JT, Mogford S, Rowan-Phillips J, Moss D, Wilson H, McEntegart A, Morgan JT, Martin JC, Rhys Dillon C, Goodfellow R, Gould L, Bukhari M, Hassan S, Butt S, Deighton C, Gadsby K, Love V, Kara N, Gohery M, Keat A, Lewis A, Robinson R, Bastawrous S, Roychowdhury B, Roskell S, Douglas B, Keating H, Giles S, McPeake J, Molloy C, Chalam V, Mulherin D, Price T, Sheeran T, Benjamin SR, Thompson PW, Cornell P, Siddle HJ, Backhouse MR, Monkhouse RA, Harris NJ, Helliwell PS, Azzopardi L, Hudson S, Mallia C, Cassar K, Coleiro B, Cassar PJ, Aquilina D, Camilleri F, Serracino Inglott A, Azzopardi LM, Robinson S, Peta H, Margot L, David W, Mann C, Gooberman-Hill R, Jagannath D, Healey E, Goddard C, Pugh MT, Gilham L, Bawa S, Barlow JH, MacFarland L, Tindall L, Leddington Wright S, Tooby J, Ravindran J, Perkins P, McGregor L, Mabon E, Bawa S, Bond U, Swan J, O'Connor MB, Rathi J, Regan MJ, Phelan MJ, Doherty T, Martin K, Ruth C, Panthakalam S, Bondin D, Castelino M, Evin S, Gooden A, Peacock C, Teh LS, Ryan SJ, Bryant E, Carter A, Cox S, Moore AP, Jackson A, Kuisma R, Pattman J, Juarez M, Quilter A, Williamson L, Collins D, Price E, Chao Y, Mooney J, Watts R, Graham K, Birrell F, Reed M, Croyle S, Stell J, Vasireddy S, Storrs P, McLoughlin YM, Scott G, McKenna F, Papou A, Rahmeh FH, Richards SC, Westlake SL, Birrell F, Morgan L, Baqir W, Walsh NE, Ward L, Caine R, Williams M, Breslin A, Owen C, Ahmad Y, Morgan L, Blair A, Birrell F, Ramachandran Nair J, Zia A, Mewar D, Peffers GM, Larder R, Dockrell D, Wilson S, Cummings J, Bansal J, Barlow J. BHPR: Audit/Service Delivery [239-277]: 239. Arma-Based Audit of Rheumatology Service Delivered Predominantly Outside the Traditional Hospital Setting. Rheumatology (Oxford) 2010. [DOI: 10.1093/rheumatology/keq730] [Citation(s) in RCA: 3] [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: 11/14/2022] Open
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Lyall HS, Sanghrajka A, Scott G. Severe tibial bone loss in revision total knee replacement managed with structural femoral head allograft: a prospective case series from the Royal London Hospital. Knee 2009; 16:326-31. [PMID: 19356936 DOI: 10.1016/j.knee.2009.02.007] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.6] [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: 11/23/2008] [Revised: 02/15/2009] [Accepted: 02/17/2009] [Indexed: 02/02/2023]
Abstract
Large tibial bone defects may cause problems at the time of revision total knee replacement. We report on 15 patients (15 knees) followed at a mean of 5.4 years (33-115 months) who underwent revision total knee replacement for severe tibial bone loss using shaped femoral head allograft and Freeman-Samuelson revision components (Zimmer, Winterthur, Switzerland). The mean American Knee Society Score pre-operatively was 22.7 points (0-45) increasing to a mean of 77.2 points (15-95) after operation. The survivorship for the series at 6 years was seven out of nine knees. One patient required an above knee amputation at 3.5 years, whilst another underwent a second revision TKR procedure at 3.4 years. Thirteen knees did not require further surgery and showed a mean time for allograft incorporation of 1.9 years (12-36 months) with no component migration. Severe tibial bone loss at the time of revision TKR surgery is a difficult problem to treat. Our case series demonstrates that when shaped femoral heads are used as structural allograft along with long stemmed components a successful result can be achieved.
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Affiliation(s)
- H S Lyall
- Knee Research Fellow, Holly House Hospital, UK.
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Abstract
We describe the survivorship of the Medial Rotation total knee replacement (TKR) at ten years in 228 cemented primary replacements implanted between October 1994 and October 2006, with their clinical and radiological outcome. This implant has a highly congruent medial compartment, with the femoral component represented by a portion of a sphere which articulates with a matched concave surface on the medial side of the tibial insert. There were 78 men (17 bilateral TKRs) and 111 women (22 bilateral TKRs) with a mean age of 67.9 years (28 to 90). All the patients were assessed clinically and radiologically using the American Knee Society scoring systems. The mean follow-up was for six years (1 to 13) with only two patients lost to follow-up and 34 dying during the period of study, one of whom had required revision for infection. There were 11 revisions performed in total, three for aseptic loosening, six for infection, one for a periprosthetic fracture and one for a painful but well-fixed replacement performed at another centre. With revision for any cause as the endpoint, the survival at ten years was 94.5% (95% CI 85.1 to 100), and with aseptic loosening as the endpoint 98.4% (95% CI 93 to 100). The mean American Knee Society score improved from 47.6 (0 to 88) to 72.2 (26 to 100) and for function from 45.1 (0 to 100) to 93.1 (45 to 100). Radiological review failed to detect migration in any of the surviving knees. The clinical and radiological results of the Medial Rotation TKR are satisfactory at ten years. The increased congruence of the medial compartment has not led to an increased rate of loosening and continued use can be supported.
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Affiliation(s)
- K Mannan
- Bone and Joint Research Unit, Royal London Hospital, London, UK.
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Ahn K, Scott G, Stang P, Conolly S, Hristov D. TH-D-304A-01: Development of Multi-Parametric Molecular Imager by Integrating Overhauser-Enhanced MRI (OMRI) with Prepolarized MRI (PMRI). Med Phys 2009. [DOI: 10.1118/1.3182693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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